Beneficios de una intervención conjunta con la familia de mujeres con cáncer de mama antes de la cirugía / Benefits of including the family of women with breast cancer before surgery

Objetivo: analizar los beneficios de una intervención conjunta con la familia de mujeres con cáncer de mama, previa a una cirugía, en términos de impacto en la imagen corporal, autoestima y calidad de vida. Método: ensayo clínico aleatorizado, sin medicamentos, controlado, no cegado de dos grupos de comparación. Ambos grupos recibieron la misma sesión de educación sanitaria: en el grupo control las pacientes asistían solas y en el experimental, acompañadas de un familiar. Se incluyeron mujeres diagnosticadas en 2018 de cáncer de mama, en espera para intervención quirúrgica, mayores de 18 años y que convivieran con un familiar directo. Se calculó un tamaño muestral de 53 participantes. Se estratificaron según el tipo de intervención (mastectomía/cirugía conservadora). Se recogieron variables sociodemográficas, clínicas, y tras la cirugía: la escala BIS de imagen corporal, la escala Rosenberg de autoestima y el cuestionario QLQ BR-23 de calidad de vida. Resultados: participaron 52 pacientes hallándose diferencias no significativas entre los grupos control/experimental. Tanto de forma general como en cada estrato se encontraron diferencias significativas (p< 0,001) en la imagen corporal, teniendo el 100% de las del grupo experimental la imagen corporal completa. No se hallaron diferencias respecto a la autoestima ni la calidad de vida, exceptuando una menor sintomatología braquial de las mujeres del grupo experimental sometidas a cirugía conservadora (p= 0,009). Conclusiones: es imprescindible integrar a la familia en el proceso de cuidados de las pacientes con cáncer de mama que se van a someter a cirugía, ya que no solo disminuye el riesgo de trastorno de la imagen corporal, sino que mejoran su sintomatología.(AU)

Objective: to analyse the benefits of a joint intervention with the family of women with breast cancer before surgery, in terms of impact on body image, self-esteem and quality of life. Method: a randomised clinical trial, medication-free, controlled and unblinded with two comparison arms. Both groups received the same healthcare education session: patients in the control group attended alone, and patients in the experimental group were accompanied by a relative. The study included women over 18 years of age who were diagnosed with breast cancer in 2018, waiting for a surgical intervention and living with a close relative. The sample size was estimated at 53 participants, who were stratified according to type of intervention (mastectomy / breast conserving surgery). Sociodemographic and clinical variables were collected; and the BIS Body Image Scale, the Rosenberg Self-esteem Scale, and the QLQ BR-23 questionnaire on quality of life were applied after the surgical procedure. Results: the study included 52 patients, and non-significant differences were found between the control and the experimental arms. Both in general and in each group, there were significant differences (p< 0.001) in body image, with 100% of the experimental group having their complete body image. No differences were found regarding self-esteem or quality of life, except for a lower brachial symptomatology in the women from the experimental arm undergoing breast conserving surgery (p= 0.009). Conclusions: it is essential to integrate the family into the care process for patients with breast cancer undergoing surgery, because this not only reduces the risk of body image disorders but also improves their symptomatology.(AU)

Prevalencia de hipertrigliceridemia en adultos y factores cardiometabólicos asociados. Estudio SIMETAP-HTG / Prevalence of hypertriglyceridemia in adults and related cardiometabolic factors. SIMETAP-HTG study

OBJETIVO: Determinar en la población adulta las tasas de prevalencia brutas y ajustadas por edad y sexo de hipertrigliceridemia (HTG) y valorar su asociación con factores de riesgo cardiovascular, enfermedad renal crónica y enfermedades cardiovasculares y cardiometabólicas. MÉTODOS: Estudio observacional transversal realizado en Atención Primaria, con 6.588 sujetos de estudio adultos, seleccionados aleatoriamente con base poblacional. Los pacientes tenían HTG si la concentración de triglicéridos era≥150mg/dL (≥1,7mmol/L) o estaban en tratamiento hipolipidemiante para reducir los triglicéridos. Se valoraron las asociaciones mediante análisis univariado y multivariante, y se determinaron las prevalencias brutas y ajustadas por edad y sexo. RESULTADOS: Las medias aritméticas y geométricas de las concentraciones de triglicéridos fueron respectivamente 120,5 y 104,2mg/dL en la población global, 135,7 y 116,0mg/dL en hombres, y 108,6 y 95,7mg/dL en mujeres. Las prevalencias brutas de HTG fueron 29,6% en población global, 36,9% en hombres y 23,8% en mujeres. Las prevalencias ajustadas por edad y sexo de HTG fueron 27,0% en población global, 34,6% en hombres y 21,4% en mujeres. Las variables independientes que más se asociaban con la HTG fueron hipercolesterolemia (OR: 4,6), c-HDL bajo (OR: 4,1), esteatosis hepática (OR: 2,8), diabetes (OR: 2,0) y obesidad (OR: 1,9). CONCLUSIONES: Las medias de triglicéridos y las prevalencias de HTG se encuentran intermedias entre las de otros estudios nacionales e internacionales. La quinta parte de la población adulta femenina y más de un tercio de la masculina presentaba HTG. Los factores independientes asociados con HTG fueron hipercolesterolemia y c-HDL bajo, y las variables cardiometabólicas diabetes, esteatosis hepática y obesidad

AIM: To determine in the adult population the crude and the sex- and age-adjusted prevalence rates of hypertriglyceridaemia (HTG) and to assess its association with cardiovascular risk factors, chronic kidney disease, cardiovascular and cardiometabolic diseases. METHODS: Cross-sectional observational study conducted in Primary Care, with 6,588 adult study subjects, randomly selected on base-population. Patients had HTG if the triglyceride level was≥150mg/dL (≥1.7mmol/L), or were on lipid-lowering therapy to lower triglyceride. Associations were assessed by univariate and multivariate analysis, and crude and sex- and age-adjusted prevalence rates were determined. RESULTS: The arithmetic and geometric means of triglyceride levels were respectively 120.5 and 104.2mg/dL in global population, 135.7 and 116.0mg/dL in men, and 108.6 and 95.7mg/dL in women. The crude HTG prevalence rates were 29.6% in global population, 36.9% in men and 23.8% in women. The sex- and age-adjusted HTG prevalence rates were 27.0% in global population, 34.6% in men and 21.4% in women. The independent variables that were most associated with HTG were hypercholesterolemia (OR: 4.6), low HDL-C (OR: 4.1), hepatic steatosis (OR: 2.8), diabetes (OR: 2.0), and obesity (OR: 1.9). CONCLUSIONS: The means of triglyceride levels and HTG prevalence rates are intermediate between those of other national and international studies. A fifth of the female adult population and more than a third of the male population had HTG. The independent factors associated with HTG were hypercholesterolemia and low HDL-C, and the cardiometabolic variables diabetes, hepatic steatosis and obesity

Uso de productos barrera para prevenir complicaciones en la piel periestomal / Use of barrier products in order to prevent complications in the peristomal skin

OBJETIVO: evaluar la eficacia del uso de un aerosol protector barrera para la prevención de la maceración e irritación de la piel periestomal, en el paciente quirúrgico, antes de la colocación de los discos, y valorar la eficacia de la aplicación de dicho aerosol previo a la retirada de los adhesivos. MÉTODO: se llevó a cabo un ensayo clínico aleatorizado con dos grupos de comparación: grupo control (cura habitual) y grupo experimental (cura habitual + aplicación de aerosol como método barrera antes de la colocación del disco y spray quita-adhesivo para su retirada). Se incluyeron a los pacientes ostomizados en el Hospital Universitario Infanta Cristina (Parla, Madrid) en 2019, atendidos en la Consulta de Cirugía General. Se aleatorizaron a dos grupos, 15 por grupo. Se recogieron variables descriptivas el día de la captación y de resultado a los 10 días del seguimiento. Se llevaron a cabo análisis univariante y bivariante. La relación entre las distintas variables se evaluó mediante pruebas estadísticas. RESULTADOS: se aleatorizaron 30 pacientes, 15 en grupo control y 15 en grupo experimental. Se observaron diferencias clínicas en los grupos de comparación al inicio del estudio. Al comparar las variables de resultado a los 10 días de la cirugía en los dos grupos del estudio, se observaron diferencias estadísticamente significativas en la presencia de complicaciones en la piel periestomal (p< 0,001) con un 80% (n= 12) en el grupo control frente al 6,7% (n= 1) en el grupo experimental, y en el tipo de complicaciones entre ambos grupos (0,002), destacando las lesiones de tipo L2 Erosivas. CONCLUSIONES: la utilización tanto de un aerosol protector barrera sobre la piel del paciente antes de la colocación del disco de ostomías como la aplicación para su retirada de un spray quita-adhesivo, parece reducir el riesgo de complicaciones en la piel periestomal en el paciente quirúrgico

OBJECTIVES: to assess the efficacy of using a protective barrier spray for preventing peristomal skin maceration and irritation in surgical patients before disc placement, and to assess the efficacy of the application of said spray before removing the adhesive discs. METHOD: a randomized clinical trial was conducted with two comparison arms: the control group (standard cure) and the experimental arm (standard cure + application of spray as barrier method before disc placement and adhesive remover spray for removing them). The study included ostomized patients from the Hospital Universitario Infanta Cristina (Parla, Madrid) in 2019, seen at the General Surgery Unit. Patients were randomly assigned to two 15-patient arms. Descriptive variables were collected on recruitment day, and for outcomes at 10 days follow-up. Univariate and bivariate analyses were conducted. The relationship between different variables was evaluated through statistical tests. RESULTS: thirty (30) patients were randomized, 15 patients to the control arm and 15 patients to the experimental arm. Clinical differences were observed in the comparison arms at study initiation. When comparing the outcome variables at 10 days after surgery in the two study arms, statistically significant differences were observed regarding the presence of complications in the peristomal skin (p< 0.001) with 80% (n= 12) in the control arm vs. 6.7% (n= 1) in the experimental arm, and in terms of type of complications between both arms (0,002), particularly L2-type erosive lesions. CONCLUSIONS: the use of a protective barrier spray on the skin of the patient before placing the ostomy disc as well as the application of an adhesive remover spray for removal seems to reduce the risk of complications in the peristomal skin of surgical patients

Prevalence of hypertriglyceridemia in adults and related cardiometabolic factors. SIMETAP-HTG study. / Prevalencia de hipertrigliceridemia en adultos y factores cardiometabólicos asociados. Estudio SIMETAP-HTG.

AIM: To determine in the adult population the crude and the sex- and age-adjusted prevalence rates of hypertriglyceridaemia (HTG) and to assess its association with cardiovascular risk factors, chronic kidney disease, cardiovascular and cardiometabolic diseases. METHODS: Cross-sectional observational study conducted in Primary Care, with 6,588 adult study subjects, randomly selected on base-population. Patients had HTG if the triglyceride level was≥150mg/dL (≥1.7mmol/L), or were on lipid-lowering therapy to lower triglyceride. Associations were assessed by univariate and multivariate analysis, and crude and sex- and age-adjusted prevalence rates were determined. RESULTS: The arithmetic and geometric means of triglyceride levels were respectively 120.5 and 104.2mg/dL in global population, 135.7 and 116.0mg/dL in men, and 108.6 and 95.7mg/dL in women. The crude HTG prevalence rates were 29.6% in global population, 36.9% in men and 23.8% in women. The sex- and age-adjusted HTG prevalence rates were 27.0% in global population, 34.6% in men and 21.4% in women. The independent variables that were most associated with HTG were hypercholesterolemia (OR: 4.6), low HDL-C (OR: 4.1), hepatic steatosis (OR: 2.8), diabetes (OR: 2.0), and obesity (OR: 1.9). CONCLUSIONS: The means of triglyceride levels and HTG prevalence rates are intermediate between those of other national and international studies. A fifth of the female adult population and more than a third of the male population had HTG. The independent factors associated with HTG were hypercholesterolemia and low HDL-C, and the cardiometabolic variables diabetes, hepatic steatosis and obesity.

Pre-Surgical Nutrition Support Reduces the Incidence of Surgical Wound Complications in Oncological Patients.

Patients who suffer from cancer are at a higher risk of complications when they experience malnutrition. Evidence shows that oral nutritional supplements favor the healing process. The main objective of this study was to evaluate the efficacy of preoperative oral nutritional intervention in oncological patients undergoing surgery. This study assessed retrospectively 55 cancer patients who previously had undergone abdominal surgery and did not have receive pre-surgical nutritional support (control group), and prospectively 30 oncological patients undergoing gastrointestinal surgery and received pre-surgical high-protein nutritional support (experimental group). All patients had to have a NRS 2002 score ≥ 3. Analytical and clinical parameters were analyzed and the NRS 2002 screening test was performed. Post-operative assessments of surgical wound complications were also carried out to determine the impact of nutrition support. Pre-surgical nutritional interventions reduced the incidence and severity of wound complications as well as the length of hospital stays. Only 26.7% of patients in the experimental group had complications compared to 60% of the control group (P = 0.003). We conclude that pre-surgical nutritional interventions of patients undergoing surgery can improve post-surgical patient outcomes of malnourished patients.

Taller lúdico de prevención de violencia contra la mujer / Leisure workshop for the prevention of domestic violence against women

Según la Organización Mundial de la Salud, la violencia contra la mujer es un problema de salud pública. Este artículo describe una intervención preventiva dirigida a familias con hijos en edad escolar y cuyos objetivos eran promover la autoestima, presentar modelos de familia basados en la igualdad y desmontar roles de género tradicionales. Se expusieron en el centro de salud paneles de sensibilización sobre el tema. Paralelamente se captaron los participantes: siete niños, nueve niñas, 13 madres, 10 padres, un padrino. Contenidos: dinámica de grupo: el árbol de la autoestima; cuentacuentos: "La cenicienta que no quería comer perdices"; títeres: "No somos de trapo";conclusión: el árbol de la autoestima ha crecido. El carácter lúdico del taller garantizó la atención y participación de los asistentes. El árbol de la autoestima está expuesto en el centro de salud. Para una prevención eficaz son necesarias intervenciones que integren a toda la familia, escenario del problema (AU)

According to the World Health Organization, violence against women is a public health problem. This article describes a preventive intervention aimed at families with children of school age, the aims of which were to promote self-esteem, present family models based on equality and undo traditional gender roles. Awareness panels on the issue were presented at the health center. Participants were recruited simultaneously: seven boys, nine girls, 13mothers, 10 fathers, a tutor. Contents: group dynamics: the self-esteem tree; storytelling: "Cinderella did not want to eat partridges";puppets: "We are not rag dolls"; conclusion: the tree of self-esteem has grown. The leisure nature of the workshop ensured the attention and participation from the audience. The self-esteem tree is exhibited in the health center. For effective prevention, interventions that integrate the whole family, the scene of the problem, are required (AU)