Problemas de salud de los cuidadores familiares de personas mayores de 65 años afectadas de insuficiencia renal crónica: una revisión sistemática / Health problems of family caregivers of people over 65 suffering from chronic renal failure: a systematic review

La insuficiencia renal crónica exige unos cuidados específicos, continuos y variados, lo que afecta a la salud de los cuidadores familiares. Por ello, nos planteamos conocer los problemas de salud de los cuidadores familiares de personas afectadas de insuficiencia renal crónica mayores de 65 años, debido al mayor riesgo y prevalencia a partir de esta edad. Para este fin, se realizó una revisión sistemática de la literatura científica en diferentes bases de datos, nacionales e internacionales, de los últimos diez años. Se seleccionaron 19 estudios. Estos hacen referencia a la influencia de la severidad de la carga y a la disminución de la calidad de vida de estos cuidadores, siendo las alteraciones psicológicas los problemas de salud mayormente expuestos. Este conocimiento puede servir para establecer estrategias de abordaje socio-sanitario, que conduzcan hacia la mejora de la calidad de vida, no solo de los cuidadores sino también, de los pacientes (AU)

Chronic renal insufficiency demands specific, continuous and varied care, which affects the health of family caregivers. Therefore, we propose to determine the health problems of family caregivers who care for patients over 65 years with chronic renal failure, due to increased risk and prevalence from this age onwards. For this purpose, we made a systematic review of the scientific literature on different national and international databases in the last ten years. Nineteen studies were selected. These refer to the influence of the severity of the burden and lower quality of life of these caregivers. Psychological disorders are the health problems that are most mentioned. This knowledge may serve for developing strategies for a socio-medical approach, which might lead to improved quality of life, not only of caregivers but also of patients (AU)

Descripción de los pacientes intervenidos mediante cirugía de Mohs en España. Datos basales del registro español de cirugía de Mohs (REGESMOHS) / Description of Patients Undergoing Mohs Surgery in Spain: Initial Report on Data From the Spanish Registry of Mohs Surgery (REGESMOHS)

INTRODUCCIÓN: En julio de 2013 se inició la recogida de datos del registro español de cirugía micrográfica de Mohs, que describe la aplicación y los resultados de esta técnica en España. En este artículo se describen las características del paciente y de los tumores tratados. MATERIAL Y MÉTODOS: Se trata de un estudio de cohortes prospectivo en el que participan centros en los que se practica al menos una intervención semanal de cirugía micrográfica de Mohs. En cada centro se incluyen todos los pacientes que son valorados para realizar cirugía de Mohs, excepto los declarados judicialmente incapaces. En este artículo describimos las características de los pacientes y los tumores incluidos en la cohorte. RESULTADOS: El número de pacientes incluidos desde julio de 2013 hasta octubre de 2014 es de 655. La mayoría de los tumores cutáneos intervenidos correspondieron a carcinoma basocelular, siendo el infiltrante el subtipo histológico más frecuente. La mayoría de las cirugías se practicaron en tumores localizados en la cara y el cuero cabelludo, siendo la localización más frecuente la nariz. Casi el 40% de los tumores operados son recurrentes o persistentes, y el tamaño tumoral prequirúrgico es similar en nuestro medio al descrito en otros estudios australianos o europeos. Hasta el 45,5% de los pacientes había recibido algún tratamiento quirúrgico previo. CONCLUSIÓN: Los datos observados son similares a los de otras series publicadas, y son relevantes para poder valorar la aplicabilidad en nuestro contexto de estudios realizados en otros medios

INTRODUCTION: The Spanish registry of Mohs micrographic surgery started collecting data in July 2013. The aim of the registry is to report on the use of this technique in Spain and the outcomes achieved. In the present article, we describe the characteristics of patients and the tumors treated. MATERIAL AND METHODS: This is a prospective cohort study of patients treated with Mohs micrographic surgery. The participating centers are hospitals where at least one intervention of this type is performed each week. All patients considered for Mohs micrographic surgery in participating centers are included in the registry except those who have been declared legally incompetent. RESULTS: Between July 2013 and October 2014, data from 655 patients were included in the registry. The most common tumor involved was basal cell carcinoma, and the most common histological subtype was infiltrative basal cell carcinoma. Most of the tumors treated were located on the face or scalp, and the most common site was the nose. Almost 40% of the tumors treated were recurrent or persistent, and preoperative tumor size was similar to that reported in other European studies and in Australia. In total, 45.5% of patients had received previous surgical treatment. CONCLUSION: The findings are similar to those reported in other studies, and the data collected are useful for assessing whether the results of studies carried out elsewhere are applicable in Spain

Más allá de compartir los datos / Beyond "data sharing"

No disponible

Ingesta de energía y nutrientes; armonización de las Bases de Datos de Composición de Alimentos / Intake of energy and nutrients: harmonization of foof composition databases

La conversión de consumo de alimentos a ingesta de nutrientes necesita una base de datos de composición de alimentos (FCDB) que recoge los valores nutricionales medios de una porción dada de alimento. Las limitaciones de las FCDBs son, en ocasiones, poco conocidas por los usuarios. Los estudios multicéntricos han planteados varios retos metodológicos que permitan estandarizar la composición de alimentos y la ingesta de nutrientes para la evaluación nutricional en diferentes poblaciones y áreas geográficas. Las diferencias entre FCDBs incluyen las atribuibles a aspectos técnicos, como la descripción de los alimentos, cálculo de energía y definición de los nutrientes, métodos analíticos y principios para el cálculo de recetas. Estas diferencias necesitan ser identificadas y eliminadas antes de comparar los datos obtenidos de diferentes estudios, especialmente cuando dichos datos dietéticos se relacionan con resultados de salud. Desde 1984 se han realizado diversas iniciativas para estandarizar los FCDBs en el mundo (INFOOD, EPIC, EUROFIR, etc.). Los datos de composición de alimentos pueden ser obtenidos de diferentes fuentes como análisis de empresas privadas, universidades, laboratorios gubernamentales e industria alimentaria. También pueden tomarse prestados de la literatura científica o incluso del etiquetado nutricional. Existen diferentes propuestas para evaluar la calidad de los datos de composición de alimentos. Para el desarrollo de una FCDB es fundamental documentar, lo más detallado posible, cada uno de los valores de los diferentes componentes y nutrientes de un alimento. El objetivo de la AECOSAN y la asociación BEDCA fue el desarrollo y mantenimiento en España de una FCDB de acuerdo con los estándares definidos para Europa. BEDCA es actualmente la única FCDB desarrollada en España con datos compilados y documentados siguiendo los estándares de EuroFIR (AU)

Food composition databases (FCDBs) provide detailed information about the nutritional composition of foods. The conversion of food consumption into nutrient intake need a Food composition database (FCDB) which lists the mean nutritional values for a given food portion. The limitations of FCDBs are sometimes little known by the users. Multicentre studies have raised several methodology challenges which allow to standardize nutritional assessments in different populations and geographical areas for food composition and nutrient intake. Differences between FCDBs include those attributed to technical matters, such as description of foods, calculation of energy and definition of nutrients, analytical methods, and principles for recipe calculation. Such differences need to be identified and eliminated before comparing data from different studies, especially when dietary data is related to a health outcome. There are ongoing efforts since 1984 to standardize FCDBs over the world (INFOODS, EPIC, EuroFIR, etc.). Food composition data can be gathered from different sources like private company analysis, universities, government laboratories and food industry. They can also be borrowed from scientific literature or even from the food labelling. There are different proposals to evaluate the quality of food composition data. For the development of a FCDB it is fundamental document in the most detailed way, each of the data values of the different components and nutrients of a food. The objective of AECOSAN (Agencia Española de Consumo Seguridad Alimentaria y Nutrición) and BEDCA (Base de Datos Española de Composición de Alimentos) association was the development and support of a reference FCDB in Spain according to the standards to be defined in Europe. BEDCA is currently the only FCDB developed in Spain with compiled and documented data following EuroFIR standards (AU)

On the parameter optimization of Support Vector Machines for binary classification.

Classifying biological data is a common task in the biomedical context. Predicting the class of new, unknown information allows researchers to gain insight and make decisions based on the available data. Also, using classification methods often implies choosing the best parameters to obtain optimal class separation, and the number of parameters might be large in biological datasets. Support Vector Machines provide a well-established and powerful classification method to analyse data and find the minimal-risk separation between different classes. Finding that separation strongly depends on the available feature set and the tuning of hyper-parameters. Techniques for feature selection and SVM parameters optimization are known to improve classification accuracy, and its literature is extensive. In this paper we review the strategies that are used to improve the classification performance of SVMs and perform our own experimentation to study the influence of features and hyper-parameters in the optimization process, using several known kernels.

Ontology-guided feature engineering for clinical text classification.

In this study we present novel feature engineering techniques that leverage the biomedical domain knowledge encoded in the Unified Medical Language System (UMLS) to improve machine-learning based clinical text classification. Critical steps in clinical text classification include identification of features and passages relevant to the classification task, and representation of clinical text to enable discrimination between documents of different classes. We developed novel information-theoretic techniques that utilize the taxonomical structure of the Unified Medical Language System (UMLS) to improve feature ranking, and we developed a semantic similarity measure that projects clinical text into a feature space that improves classification. We evaluated these methods on the 2008 Integrating Informatics with Biology and the Bedside (I2B2) obesity challenge. The methods we developed improve upon the results of this challenge's top machine-learning based system, and may improve the performance of other machine-learning based clinical text classification systems. We have released all tools developed as part of this study as open source, available at http://code.google.com/p/ytex.

Use of administrative data to identify colorectal liver metastasis.

BACKGROUND: The ability to identify patients with colorectal cancer (CRC) liver metastasis (LM) using administrative data is unknown. The goals of this study were to evaluate whether administrative data can accurately identify patients with CRCLM and to develop a diagnostic algorithm capable of identifying such patients. MATERIALS AND METHODS: A retrospective cohort study was conducted to validate the diagnostic and procedural codes found in administrative databases of the Veterans Administration (VA) system. CRC patients evaluated at a major VA center were identified (1997-2008, n = 1671) and classified as having liver-specific ICD-9 and/or CPT codes. The presence of CRCLM was verified by primary chart abstraction in the study sample. Contingency tables were created and the positive predictive value (PPV) for CRCLM was calculated for each candidate administrative code. A multivariate logistic-regression model was used to identify independent predictors (codes) of CRCLM, which were used to develop a diagnostic algorithm. Validity of the algorithm was determined by discrimination (c-statistic) of the model and PPV of the algorithm. RESULTS: Multivariate logistic regression identified ICD-9 diagnosis codes 155.2 (OR 9.7 [95% CI 2.5-38.4]) and 197.7 (84.6 [52.9-135.3]), and procedure code 50.22 (5.9 [1.3-25.5]) as independent predictors of CRCLM diagnosis. The model's discrimination was 0.89. The diagnostic algorithm, defined as the presence of any of these codes, had a PPV of 87%. CONCLUSIONS: VA administrative databases reliably identify patients with CRCLM. This diagnostic algorithm is highly predictive of CRCLM diagnosis and can be used for research studies evaluating population-level features of this disease within the VA system.

Organizing research data.

Research relies on ever larger amounts of data from experiments, automated production equipment, questionnaries, times series such as weather records, and so on. A major task in science is to combine, process and analyse such data to obtain evidence of patterns and correlations.Most research data are on digital form, which in principle ensures easy processing and analysis, easy long-term preservation, and easy reuse in future research, perhaps in entirely unanticipated ways. However, in practice, obstacles such as incompatible or undocumented data formats, poor data quality and lack of familiarity with current technology prevent researchers from making full use of available data.This paper argues that relational databases are excellent tools for veterinary research and animal production; provides a small example to introduce basic database concepts; and points out some concerns that must be addressed when organizing data for research purposes.

Automatic epileptic seizure detection in EEGs based on line length feature and artificial neural networks.

About 1% of the people in the world suffer from epilepsy. The main characteristic of epilepsy is the recurrent seizures. Careful analysis of the electroencephalogram (EEG) recordings can provide valuable information for understanding the mechanisms behind epileptic disorders. Since epileptic seizures occur irregularly and unpredictably, automatic seizure detection in EEG recordings is highly required. Wavelet transform (WT) is an effective analysis tool for non-stationary signals, such as EEGs. The line length feature reflects the waveform dimensionality changes and is a measure sensitive to variation of the signal amplitude and frequency. This paper presents a novel method for automatic epileptic seizure detection, which uses line length features based on wavelet transform multiresolution decomposition and combines with an artificial neural network (ANN) to classify the EEG signals regarding the existence of seizure or not. To the knowledge of the authors, there exists no similar work in the literature. A famous public dataset was used to evaluate the proposed method. The high accuracy obtained for three different classification problems testified the great success of the method.

Evaluation of meta-concepts for information retrieval in a quality-controlled health gateway.

BACKGROUND: CISMeF is a French quality-controlled health gateway that uses the MeSH thesaurus. We introduced two new concepts, metaterms (medical specialty which has semantic links with one or more MeSH terms, subheadings and resource types) and resource types. OBJECTIVE: Evaluate precision and recall of metaterms. METHODS: We created 16 pairs of queries. Each pair concerned the same topic, but one used metaterms and one MeSH terms. To assess precision, each document retrieved by the query was classified as irrelevant, partly relevant or fully relevant. RESULTS: The 16 queries yielded 943 documents for metaterm queries and 139 for MeSH term queries. The recall of MeSH term queries was 0.44 (compared to 1 for metaterm queries) and the precision were identical for MeSH term and metaterm queries. CONCLUSION: Metaconcept such as CISMeF metaterms allows a better recall with a similar precision that MeSH terms in a quality controlled health gateway.

Development of an ontology-anchored data warehouse meta-model.

Data warehouses must provide a flexible data model that is integrated with knowledge and metadata describing their components and contents. To provide for advanced query functionality at The Ohio State University Medical Center (OSUMC), we have developed an abstraction layer, or meta-model for our existing Information Warehouse (IW) in order to conceptually and semantically describe and classify its structure and contents using the UMLS.

Perspectivas actuales en el tratamiento del trastorno de estrés postraumático en la población infantil: análisis bibliométrico / Current approaches to post-traumatic stress disorder among children: a biblimetric analysis

El Trastorno de Estrés Postraumático en la población pediátrica, ha sido poco investigado. Así hasta 1987 no se reconoce, en los criterios diagnósticos, que las reacciones de los niños al trauma pueden diferir de la de los adultos. Teniendo en cuenta estas diferencias en cuanto a la semiología del Trastorno de Estrés Postraumático, es lógico pensar que la evaluación e intervención de estos pacientes no puede plantearse de igual modo que en el caso de la población adulta. Por todo ello, el objetivo del presente artículo es describir la evolución de la literatura científica, en los últimos 10 años, y establecer el estado actual de la cuestión, determinando las deficiencias y necesidades a considerar para desarrollar vías de estudio en futuras investigaciones

Very little attention has been paid by researchers to post-traumatic stress disorder (PTSD)in the paediatric population. Not until 1987 the fact that child reaction to trauma may differ from adult reaction is reflected in diagnostic criteria. Bearing these differences in mind with regard to the PTSD semiology, we may think that planning of assessment and intervention must differ in the case of chifdren. Therefore, the aim af this paper is to follow the evolution of literature during the last 10 years, and to establish the current state of the art of PTSD in children. Deficiencies and needs will be remarked in order to develop future research fines

Utilización de fuentes o canales en Internet: cómo mantenerse al día de manera más eficiente / Use of Internala sources channels: how to remain more efficiently up-to-date

El acceso a la información en Internet suele realizarse visitando directamente sitios web sin conocer de antemano si hay nuevos contenidos. En este artículo se describe otro sistema de acceso a la información basado en la distribución de contenidos en documentos fuente (feeds) y el uso de agregadores para su lectura. Se comentan los agregadores más habituales, tanto software de escritorio como servicios basados en páginas web. También se mencionan fuentes de información de interés en Pediatría, incluyendo noticias, publicaciones científicas y sistemas de búsqueda en bases de datos bibliográficas como PubMed. Se concluye que esta tecnología, aunque todavía incipiente, puede resultar ya de utilidad, y probablemente verá multiplicadas sus aplicaciones en los próximos años

In the World Wide Web, information is usually accessed directly visiting websites, without previously knowing if there are new contents available. In this article we describe another way of accessing to information based on content syndication through web feeds, and on the use of aggregators to retrieve it. Most common aggregators are explained, both desktop software and web-based services. Web feeds related to Pediatrics, including news, scientific journals, and bibliographic databases search systems like Pub- Med. This technology, although still incipient, may already be useful, and it probably will have much more applications over the next years

Impact of genomic technologies on studies of bacterial gene expression.

The ability to simultaneously monitor expression of all genes in any bacterium whose genome has been sequenced has only recently become available. This requires not only careful experimentation but also that voluminous data be organized and interpreted. Here we review the emerging technologies that are impacting the study of bacterial global regulatory mechanisms with a view toward discussing both perceived best practices and the current state of the art. To do this, we concentrate upon examples using Escherichia coli and Bacillus subtilis because prior work in these organisms provides a sound basis for comparison.