Identifying gaps in the cascade of care for latent TB infection in a low-incidence setting.

BACKGROUND: The End TB Strategy calls for the global scale-up of treatment for latent TB infection (LTBI). We aimed to evaluate a nurse-led care programme for LTBI by identifying gaps in the care cascade in a low-incidence TB setting.METHODS: We included people at risk of TB over a 15-year period. We define three main outcomes in the LTBI care cascade: 1) attendance at the first appointment, 2) completion of the evaluation process, and 3) completion of treatment.RESULTS: We identified 6,126 individuals (2,369 TB contacts, 1,749 biological therapy candidates, and 2,008 transplant candidates). Overall, 5,938 (96.9%) attended, 5,872/5,938 (98.9%) completed the evaluation and 1,624/1,847 (87.9%) completed treatment. Pre-biological (aOR 2.32, 95% CI 1.54-3.49) and pre-transplant (aOR 1.82, 95% CI 1.20-2.76) candidates were more likely to attend the first appointment, while age was associated with completing the evaluation process (aOR 1.02, 95% CI 1.003-1.04). Female sex (aOR 1.47, 95% CI 1.08-1.99) was associated with completing the treatment.CONCLUSION: Successful assessment and treatment of LTBI is achievable when delivered as a part of a comprehensive, nurse-led, patient-centred programme in specialist TB clinics.

Examining the utility of pinhole-type screens for lightfield display.

The use of microlens arrays for lightfield display has the drawback of providing images with strong chromatic aliasing. To overcome this problem, pinhole-type lightfield monitors are proposed. This paper is devoted to evaluating the capability for such lightfield monitors to offer the user a convincing 3D experience with images with enough brightness and continuous aspect. Thus, we have designed a psychophysical test specifically adapted for lightfield monitors, which allowed us to confirm the usability of pinhole-type monitors.

Chromatic and achromatic visual fields in relation to choroidal thickness in patients with high myopia: A pilot study.

PURPOSE: To analyse the relationship between the choroidal thickness and the visual perception of patients with high myopia but without retinal damage. METHODS: All patients underwent ophthalmic evaluation including a slit lamp examination and dilated ophthalmoscopy, subjective refraction, best corrected visual acuity, axial length, optical coherence tomography, contrast sensitivity function and sensitivity of the visual pathways. RESULTS: We included eleven eyes of subjects with high myopia. There are statistical correlations between choroidal thickness and almost all the contrast sensitivity values. The sensitivity of magnocellular and koniocellular pathways is the most affected, and the homogeneity of the sensibility of the magnocellular pathway depends on the choroidal thickness; when the thickness decreases, the sensitivity impairment extends from the center to the periphery of the visual field. CONCLUSIONS: Patients with high myopia without any fundus changes have visual impairments. We have found that choroidal thickness correlates with perceptual parameters such as contrast sensitivity or mean defect and pattern standard deviation of the visual fields of some visual pathways. Our study shows that the magnocellular and koniocellular pathways are the most affected, so that these patients have impairment in motion perception and blue-yellow contrast perception.

Eplerenone, a new treatment for an old problem: Retinitis pigmentosa with recalcitrant macular edema. / Eplerenona, un nuevo tratamiento para un viejo problema: retinosis pigmentaria asociada a edema macular recalcitrante.

CASE REPORT: The case involves a 35-year-old man, with a history of retinitis pigmentosa, who presented with a bilateral cystoid macular oedema associated with bilateral epiretinal membrane, which was resistant to treatment with oral acetazolamide and intravitreal bevacizumab. The treatment with oral eplerenone was able to improve the visual acuity and macular thickness of this patient. DISCUSSION: A variety of treatments have been proposed for the management of cystoid macular oedema, associated with retinitis pigmentosa, with variable results. The treatment with oral eplerenone might be a good option for the control of this condition.

BIlateral juxtapapillary retinal capillary haemangioma: Usefulness of aflibercept in the management of its complications. / Hemangioma capilar retiniano yuxtapapilar bilateral: utilidad de aflibercept en el manejo de sus complicaciones.

CASE REPORT: A 45 year-old man with a history of adrenal phaeochromocytoma presented with a subretinal juxtapapillary haemorrhage on his left eye and a small asymptomatic vascular tumour in the contralateral eye. With the mentioned findings, the patient was diagnosed with bilateral retinal capillary haemangioma in the context of a von Hippel Lindau disease. Intravitreal aflibercept was prescribed, with a good outcome of the disease. DISCUSSION: Many treatments have been proposed for the management of juxtapapillary retinal capillary haemangioma with variable results. Intravitreal aflibercept can be a useful treatment with a good safety profile.

[Healthy sleep: evidence and guidelines for action. Official document of the Spanish Sleep Society]. / Sueño saludable: evidencias y guias de actuacion. Documento oficial de la Sociedad Española de Sueño.

One of the main objectives of the Spanish Sleep Society is to promote healthy sleep in both the general population and in health professionals. This document aims to conduct a review of the current scientific literature on sleep habits that can serve as the basis on which to establish a set of general recommendations, regarding healthy sleep, for use by the general population in Spain as well as to identify the main challenges faced by research into sleep habits. The document has been developed by a multidisciplinary team made up of members of the Spanish Sleep Society who are experts in paediatric sleep medicine, clinical neurophysiology, pulmonology, neurology, chronobiology, physiology and psychology. The existing scientific literature dealing with sleep habits in the general population was reviewed, and the following aspects were addressed: the current state of sleep habits in the Spanish population; a generic review of the optimum number of hours of sleep; the impact of the environmental setting (noise, temperature, illumination, etc.), hours of sleep, diet and sport, together with several specific sections for children and teenagers, shift-workers and drivers of different vehicles. The conclusions from all the aspects addressed in this document have resulted in a set of final general recommendations that will serve as a guide for the general population and health professionals. Likewise, the principal environmental challenges and future lines of research are also discussed.

A risk prediction model for severe intraventricular hemorrhage in very low birth weight infants and the effect of prophylactic indomethacin.

OBJECTIVE: Develop a risk prediction model for severe intraventricular hemorrhage (IVH) in very low birth weight infants (VLBWI). STUDY DESIGN: Prospectively collected data of infants with birth weight 500 to 1249 g born between 2001 and 2010 in centers from the Neocosur Network were used. Forward stepwise logistic regression model was employed. The model was tested in the 2011 cohort and then applied to the population of VLBWI that received prophylactic indomethacin to analyze its effect in the risk of severe IVH. RESULT: Data from 6538 VLBWI were analyzed. The area under ROC curve for the model was 0.79 and 0.76 when tested in the 2011 cohort. The prophylactic indomethacin group had lower incidence of severe IVH, especially in the highest-risk groups. CONCLUSION: A model for early severe IVH prediction was developed and tested in our population. Prophylactic indomethacin was associated with a lower risk-adjusted incidence of severe IVH.

Síndrome de burnout en profesionales sanitarios de Cuidados Paliativos de la Comunidad de Madrid / No disponible

Objetivo: la prevalencia del síndrome de burnout en profesionales sanitarios que trabajan en unidades de Cuidados Paliativos de la Comunidad de Madrid, dentro del ámbito de la sanidad pública y concertada. Métodos: estudio transversal descriptivo realizado entre personal médico y de enfermería de unidades de atención domiciliaria (equipos de soporte -ESAD- y unidades de la AECC) y servicios de cuidados paliativos de hospitales de la red pública y concertada. De un total de 193 individuos, mediante muestreo aleatorio simple se seleccionó un grupo de 60, a los cuales se administró el cuestionario Maslach Burnout Inventory (MBI),validado en castellano. Fue enviado por correo en febrero 2005. El MBI consta de tres subescalas (cansancio emocional -CE-, despersonalización -DP- y realización personal -RP-). Se tuvieron en cuenta variables de tipo demográfico y laboral. Resultados: la tasa de respuestas fue del 75% (45 personas). Un 57,8% de los individuos presentaba cansancio emocional bajo, 68,9% despersonalización baja y 62,2% realización personal alta. Además un tercio de los participantes (15) se ajustaba al patrón de bajo nivel de burnout en las tres subescalas (es decir, CE bajo, DP baja y RP elevada). Conclusiones: los profesionales de Cuidados Paliativos de la Comunidad de Madrid han manifestado niveles bajos de desgaste profesional en relación con otros estudio realizados en nuestro país, fundamentalmente en atención primaria (AU)

Aim: to study the prevalence of burnout syndrome in health professionals working in palliative care units within Madrid region's public and semi-public health system. Methods: a cross-sectional descriptive study of home care medical and nursing staff -medical support team (ESAD), and also the Spanish Association Against Cancer (AECC) and palliative care services from public and semi-public hospitals. By means of simple random sampling 60 subjects were selected from a total group of 193 people. They were sent a questionnaire by mail in February 2005, the Maslach Burnout Inventory (MBI) as validated in the Spanish language. MBI has three sub-stages: emotional exhaustion (EE), depersonalitazion (DP), and personal accomplishment (PA). Not only demographic but also professional variables were taken into account. Results: response rate was 75% (45 out of 60 subjects); 57.8% showed low emotional exhaustion, 68.9% had low depersonalization, and 62.2% reported high personal accomplishment. Moreover, one third of participants(15) conform to the pattern of low burnout level in the three different substages, that is, low CE, low DP, and high RP. Conclusions: in comparison to other studies in our country, Madrid's professional palliative care staff exhibited low burnout levels (AU)

Application of the S-CIELAB color model to processed and calibrated images with a colorimetric dithering method.

This work uses the S-CIELAB color model to compare images that have been calibrated and processed using a colorimetric dithering method which simulates increments in viewing distance. Firstly, we obtain XYZ calibrated images by applying the appropriate color transformations to the original images. These transformations depend on whether the image is viewed on a display device or encoded by a capture device, for example. Secondly, we use a colorimetric dithering method consisting of a partitive additive mixing of XYZ tristimulus values. The number of dithered pixels depends on simulated viewing distance. The dithered tristimulus values are transformed to digital data to observe the dithering effects in the image. Finally, we predict color differences using the S-CIELAB model as color appearance model for images. Moreover, this paper proposes some applications of this method to artistic and industrial problems where one must compare two images that appear different at close viewing distance, but match when they are seen from afar.

Bases psicológicas del biofeedback / Psychological basis of biofeedback

En la relación estímulo-respuesta, en ocasiones, resulta necesario el reforzamiento o premio. Así, de todo el repertorio de conductas que proporciona un sujeto, aquella que reduzca los estímulos impulsores a la vez que se enlace con el patrón de inicio será la que más frecuentemente se verá recompensada. Este hecho constituye la base explicativa de la retroalimentación biológica: las respuestas autónomas pueden condicionarse instrumentalmente y los procesos fisiológicos pueden someterse a sistemas de control voluntario. En definitiva, el funcionamiento de un sistema puede cambiar al suminstrarle información desde una fuente externa y este hecho tiene importantes implicaciones en el manejo educativo de los transtornos miccionales, especialmente de la micción no coordinada (AU)

Implementations of a novel algorithm for colour constancy.

In agreement with the principles of the relativistic model proposed by Creutzfeldt et al., with the photometric rule (lightness anchoring rule) and with the influence of simultaneous contrast in the appearance of a visual scene, we propose a first-stage mechanism yielding substantial colour constancy. We have defined a set of first-stage colour descriptors, and to test their utility, we have performed a simulation using a Machine Vision System (MVS). The statistical stability of the descriptors for Munsell samples under different illuminants is good.