Educating Engineers for the Public Good Through International Internships: Evidence from a Case Study at Universitat Politècnica de València.

At Universitat Politècnica de València, Meridies, an internship programme that places engineering students in countries of Latin America, is one of the few opportunities the students have to explore the implications of being a professional in society in a different cultural and social context. This programme was analyzed using the capabilities approach as a frame of reference for examining the effects of the programme on eight student participants. The eight pro-public-good capabilities proposed by Melanie Walker were investigated through semi-structured interviews. The internship is an environment in which students can put into practice the knowledge they have acquired in undergraduate studies and to find practical relevance in what they studied. Occasionally, this also entails a critical questioning of what they have learned, a greater awareness of the limits of the contents of their studies and of the way things were taught, and interest in less explored issues that are closely linked to social justice. However, tensions can arise between the pro-public-good oriented perspectives of this programme, and a more instrumental vision. One way to overcome these tensions is to foster consideration of reflexivity, that is, the dynamic relationship between technology and society. To do so, the programme must create space before and during the internship, and upon the return of the students, to discuss and collectively reflect upon their lived experience. Additionally, it ought to engage supervisors in this educational journey, both at the university and in the host institutions, and also involve socially committed organisations in this task.

Diagnóstico de trombosis carotídea asintomática en el postoperatorio de la disección cervical radical modificada / Diagnosis of asymptomatic carotid thrombosis in the posoperative period in modified radical cervical dissection

RESUMEN Introducción: El tratamiento del carcinoma papilar de tiroides (CPT) implica la tiroidectomía total (TT) con disección cervical radical modificada en caso de evidenciarse adenopatías. Existen diversas complicaciones vasculares y neurológicas asociadas a este proceso, en este caso vamos a describir la trombosis carotídea como una rara lesión secundaria en el postoperatorio (0,1%). Material y métodos: Caso clínico diagnosticado y tratado en nuestro centro. Caso clínico: Mujer de 55 años diagnosticada de CPT e intervenida realizando TT y disección yugular modificada. Durante el postoperatorio inició con clínica de tos irritativa y disfagia, por lo que se le realizó una tomografía computarizada (TC) cervical en el que se apreciaba trombosis de la arteria carótida común izquierda con repermeabilización distal. En la resonancia magnética nuclear (RMN) cerebral no se encontraron alteraciones. Se inició tratamiento anticoagulante y posteriormente antiagregante. La lesión no progresó consiguiendo una evolución favorable. Conclusiones: La trombosis carotídea se trata de una complicación extremadamente rara de la disección cervical. Debe sospecharse para llevar a cabo un diagnóstico temprano e iniciar el tratamiento lo antes posible, para evitar así la progresión de la enfermedad con secuelas que podrían ser irreversibles.

ABSTRACT Introduction: The treatment of papillary thyroid carcinoma (PTC) involves total thyroidectomy (TT) with modified radical cervical dissection in case of evidence of lymphadenopathy. There are several vascular and neurological complications associated with this process, in this case we will describe carotid thrombosis as a rare secondary lesion in the postoperative period (0.1%). Material and methods: Clinical case diagnosed and treated in our center. Case report: A 55-year-old woman diagnosed with PTC and operated on with TT and modified jugular dissection. During the postoperative period, he started with a clinic of irritative cough and dysphagia. A cervical computed tomography (CT) scan showed thrombosis of the left common carotid artery with distal repermeabilization. In cerebral nuclear magnetic resonance (NMR) no alterations were found. Anticoagulant treatment and antiplatelet therapy were started. The lesion did not progress, achieving a favorable evolution. Conclusions: The carotid thrombosis is an extremely rare complication of cervical dissection. It should be suspected to carry out an early diagnosis and start the treatment as soon as possible, thus preventing the progression of the disease with sequelae that could be irreversible.

Rendimiento diagnóstico de la punción aspiración con aguja fina de tejido tiroideo / Diagnostic efficacy of fine needle aspiration of thyroid tissue

Introducción. La punción aspiración con aguja fina (PAAF) de la glándula tiroides constituye un proceso diagnóstico que permite determinar de forma segura y fiable, si un nódulo tiroideo es benigno o maligno. Objetivo. El objetivo del estudio fue evaluar la eficacia diagnóstica de la PAAF en nuestro centro. Material y métodos. Se llevó a cabo de 2009 a 2013 un estudio retrospectivo de pacientes con nódulo tiroideo sospechoso de ser maligno. Las variables del estudio fueron: edad, sexo, tamaño del nódulo tiroideo, realización de PAAF, estudio anatomo-patológico de la biopsia y diagnóstico definitivo. Se comparó el rendimiento diagnóstico de la PAAF frente a los resultados de la biopsia posoperatoria. Resultados. Durante los cinco años del estudio, se practicó PAAF de tejido tiroideo a 112 pacientes (30,2 %, hombres, y 69,8 %, mujeres), con un tamaño medio nodular de 2 cm (rango: 1 a 4). La PAAF fue positiva para neoplasia maligna en 26 casos (23,2 %) y negativa en 86 casos (76,8 %). Los resultados del rendimiento de la prueba fueron: sensibilidad de 45,5 % (intervalo de confianza 95 % [IC95%] 28,1-63,6), especificidad de 86,1 % (IC95% 76,5-92,8), valor predictivo positivo de 57,7 % (IC95% 36,9-76,6) y valor predictivo negativo de 79,1 % (IC95% 69-87,1). Conclusión. Tras este análisis, se obtiene un resultado malo con posibilidad de ser mediocre, por lo que habría que replantearse la utilidad de esta prueba invasiva en nuestro centro y la búsqueda de posibles errores.

Background: Thyroid fine needle aspiration (FNA) is a safe and reliable diagnostic procedure for determining if a thyroid nodule is benign or malignant. Objective: The objective of this study was to evaluate the efficacy of FNA diagnosed in our center. Material and methods: Retrospective study of patients with thyroid nodule suspicious for malignancy, in the period 2009 to 2013. The variables used in this study were: age, sex, size of thyroid nodule, FNA performance, pathology and definitive diagnosis. The diagnostic accuracy of FNA was compared with the results of postoperative biopsy. Results: During the 5-year study, FNA of thyroid tissue was performed at 112 patients (30.2% men and 69.8% women), with nodules of average size of 2 cm (range 1-4). FNA was positive for malignancy in 26 cases (23.2%) and negative in 86 cases (76.8%). The performance results of the test were: sensitivity 45.5% (confidence interval [CI] 95%: 28.1% -63.6%), specificity of 86.1% (95% CI: 76.5 % - 92.8%), positive predictive value of 57.7% (95% CI: 36.9% - 76.6%) and negative predictive value of 79.1% (95% CI: 69% - 87 1%) Conclusion: A bad result with the possibility of being mediocre is obtained with this analysis, which should rethink the usefulness of this invasive test in our center and search for possible errors.