[Efficacy of Physiotherapy Interventions on the Respiratory Musculature Through Respiratory Training Techniques in Post-operative Lung Transplant Recipients: Systematic Review]. / Eficacia de las intervenciones fisioterápicas sobre la musculatura respiratoria mediante técnicas de entrenamiento respiratorio en el postoperatorio de trasplantados pulmonares: una revisión sistemática.

Introduction: Respiratory muscles are a limiter of exercise capacity in lung transplant patients. It is necessary to know the effectiveness of specific respiratory muscle training techniques carried out in the management of adult lung transplant patients in the postoperative period. Methodology: A systematic review of clinical trials was carried out, which included adult lung transplant patients undergoing post-transplant respiratory training. A search was carried out in the databases PubMed/Medline, EMBASE, Scopus, Web of Science, Cochrane Library between January 2012 and September 2023, using the terms: "breathing exercise", "respiratory muscle training", "inspiratory muscle training", "respiratory exercise", "pulmonary rehabilitation", "lung rehabilitation"; in combination with "lung transplantation", "lung transplant", "posttransplant lung". No language limit. Results: Eleven trials were included with a total of 639 patients analyzed. Most training programs begin upon hospital discharge (more than one month post-transplant), few do so early (Intensive Care Unit). The duration varies from 1-12 months post-transplant. The interventions were based on aerobic training and peripheral muscle strength. Some of them included breathing exercises and chest expansions. The most used outcome variable was submaximal exercise capacity measured with the 6-minute walk test. Conclusions: Training the respiratory muscles of the adult transplant patient favors the improvement of exercise capacity and quality of life. Aerobic training, as well as strength training of the rest of the peripheral muscles, contribute to the improvement of respiratory muscles.

Usefulness of 18F-FDG PET-CT in the Management of Febrile Neutropenia: A Retrospective Cohort from a Tertiary University Hospital and a Systematic Review.

Febrile neutropenia (FN) is a complication of hematologic malignancy therapy. An early diagnosis would allow optimization of antimicrobials. The 18F-FDG-PET-CT may be useful; however, its role is not well established. We analyzed retrospectively patients with hematological malignancies who underwent 18F-FDG-PET-CT as part of FN management in our university hospital and compared with conventional imaging. In addition, we performed a systematic review of the literature assessing the usefulness of 18F-FDG-PET-CT in FN. A total of 24 cases of FN underwent 18F-FDG-PET-CT. In addition, 92% had conventional CT. In 5/24 episodes (21%), the fever was of infectious etiology: two were bacterial, two were fungal, and one was parasitic. When compared with conventional imaging, 18F-FDG-PET-CT had an added value in 20 cases (83%): it diagnosed a new site of infection in 4 patients (17%), excluded infection in 16 (67%), and helped modify antimicrobials in 16 (67%). Antimicrobials could be discontinued in 10 (41.6%). We identified seven publications of low quality and one randomized trial. Our results support those of the literature. The available data suggest that 18F-FDG-PET-CT is useful in the management of FN, especially to diagnose fungal infections and rationalize antimicrobials. This review points out the low level of evidence and indicates the gaps in knowledge.

Individual interventions to improve adherence to pharmaceutical treatment, diet and physical activity among adults with primary hypertension. A systematic review protocol.

INTRODUCTION: Hypertension is a chronic disease with 31% worldwide prevalence in adults. It has been associated with non-adherence to therapeutic regime with a negative impact on the prognosis of the disease and healthcare-associated costs. So, it is necessary to identify effective interventions to improve adherence among the afflicted population. The objective of this protocol is to describe the methods for a systematic review that will evaluate the effect of individual interventions so as to improve adherence to the prescribed pharmacological treatment, as well as to prescribed diet and physical activity in adults with primary hypertension. METHODS AND ANALYSIS: A systematic search of studies will be conducted in PubMed/MEDLINE, BVS, CINAHL, Embase, Cochrane and Scopus databases. Randomised and non-randomised clinical studies conducted in human beings, published from 1 January 2009 to 13 December 2019, are to be included, in any language. Adherence to pharmacological treatment, diet and physical activity, measured by direct and indirect methods, will be the primary outcome. Two independent reviewers will select relevant studies and will extract the data following the Cochrane's Handbook for Systematic Reviews of Approach and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. Methodological quality will be evaluated using the risk-of-bias (RoB) 2 and Risk of Bias in Non-randomised Studies - of Interventions (ROBINS-I) tools. Risk of bias will also be evaluated, and if the criteria are met, a meta-analysis will be finally performed. ETHICS AND DISSEMINATION: Information to be analysed is of a grouped nature, and given that its sources are published studies, no ethics committee approval is required. Results will be published in scientific journals, and in conferences, seminars and symposiums. Copyrights will be addressed by giving due credit through bibliographic references. PROSPERO REGISTRATION NUMBER: CRD42020147655.

[The impact of research in clinical practice]. / El impacto de la investigación en la práctica clínica.

This work analyzes the way in which scientific knowledge can modify clinical practice and generate changes in the behavior of professionals, incorporating the new discoveries to their common practice. The main phases of the research process are three: knowledge production, transmission and application. Analyzing each of them will allow us to evaluate the overall impact of research in clinical practice. There is a great amount of information related to the way in which new knowledge should reach health care providers. The challenge is to reduce the gap between clinical practice and the generation of new knowledge based on improved evidence.

Estrategias de formación durante la pandemia por covid-19 en un hospital universitario / Training strategies during the covid-19 pandemic in a university hospital

La pandemia causada por el SARS-CoV-2, declarada Emergencia de Salud Pública de Importancia Internacional por el director general de la Organización Mundial de la Salud (OMS) en marzo de 2020, originó una emergencia sanitaria impactando en todos los aspectos de la gestión, formación y asistencia en los hospitales. La pandemia supuso un reto en la formación de los profesionales sanitarios que se vieron obligados a adquirir conocimientos rápida y eficazmente para planificar, ejecutar y tomar decisiones sobre el diagnóstico y tratamiento de pacientes infectados por SARS-CoV-2. La formación tradicional se adaptó al contexto de la pandemia, teniendo en cuenta la distancia de seguridad obligatoria y la demanda de una formación de corta duración y eficaz, cuyo contenido variaba en poco tiempo. En este contexto, el Hospital Universitario Puerta de Hierro-Majadahonda (Madrid, España) implementó una estrategia de formación digital basada en la producción y publicación de píldoras formativas a través de una aplicación móvil desarrollada por la Unidad de Formación Continuada (app Formación SanidadMadrid). Durante la pandemia se crearon, produjeron y publicaron a través de la app, un total de 24 píldoras formativas en tres modalidades: vídeo de corta duración, acceso a websites con información actualizada y documentos breves sobre procedimientos. El diseño de las píldoras formativas se fundamentó en las metodologías de enseñanza-aprendizaje mobile learning y microlearning, como herramientas útiles y eficaces para dar respuesta a las necesidades formativas de un hospital universitario ante una emergencia sanitaria, dada la gran aceptación por parte de los profesionales sanitarios.(AU)

The pandemic caused by SARS-CoV-2 was declared a Public Health Emergency of International Concern by the Director General of the World Health Organization (WHO) in March, 2020. This created a health emergency with impact upon all aspects of management, training, and care in hospitals. The pandemic represented a challenge for the training of healthcare professionals, who were forced to acquire knowledge fast and effectively in order to plan, act, and make decisions about the diagnosis and treatment of patients infected by SARS-CoV-2. Traditional training was adapted to the pandemic setting, taking into account the compulsory safety distance and the demand for short-duration effective training, with contents changing within a short time. In this context, the Hospital Universitario Puerta de Hierro-Majadahonda (Madrid, Spain) implemented a strategy for digital training based on the creation and publication of educational pills through a mobile application developed by the Continuation Training Unit (Formación SanidadMadrid App). During the pandemic, 24 educational pills were created, produced and published through the app, in three forms: short-duration video, access to websites with updated information, and brief documents on procedures. The design of the educational pills was based on these teaching-learning methods: mobile learning and microlearning, considered useful and effective tools to give an answer to training needs in a university hospital when faced with a health emergency, given their wide acceptance by healthcare professionals.(AU)

[Analysis of Spanish scientific production in rare diseases: 1990-2000]. / Análisis de la producción científica española sobre enfermedades raras: 1990-2000.

BACKGROUND AND OBJECTIVE: To analyze the Spanish scientific production in a group of rare diseases selected during the period 1990-2000. MATERIAL AND METHOD: Analysis of the following disease groups: congenital anomalies, metabolism inborn errors and primary immunodeficiencies. Bibliometric tools were used to assess and analyze the evolution of research in this area. The MEDLINE database was utilized for references search. RESULTS: Total references recovered for the study were 2978: 82.5% original articles and 17.3% reviews. The number of authors was 14,752 and the mean author/article was 4.9%. Seven types of institutions were coded with hospitals being the most productive with 78% of articles published. The Bradford nucleus was formed by 1,288 articles and 43.2% of the total had been published in 12 journals (2.1%). CONCLUSIONS: Despite rare diseases research is still scarce, important efforts have been made at a national level focused on the development and strengthening of research in this field. Nevertheless, it is necessary to join efforts in this field to facilitate an appropriate research policy making that may help improve the current status.

Evaluación de las estrategias formativas digitales para profesionales sanitarios implementadas durante la pandemia por COVID-19 / Evaluation of the digital educational strategies for healthcare professionals implemented during the COVID-19 pandemic

Objetivo: evaluar la implementación de la estrategia educativa de microaprendizaje mediante el uso de una aplicación móvil para los profesionales sanitarios de un hospital universitario durante la pandemia por COVID-19. Método: se realizó una encuesta a trabajadores del hospital. Se monitorizaron las visualizaciones de las píldoras formativas. El cuestionario permitió recoger información del perfil sociodemográfico de los participantes, el uso de aplicaciones móviles formativas y el de las píldoras creadas ad hoc durante la pandemia por COVID-19. El número de usuarios registrados en la aplicación era de 4.572. Los datos obtenidos se analizaron mediante un análisis descriptivo, utilizándose la prueba T de Student y el test ANOVA para análisis bivariantes. Resultados: participaron 633 profesionales, edad media (DE) 44,8 (11,1) años. El 81,7% (n= 517) era mujer. El 93,5% (n= 592) era trabajador sanitario. Las enfermeras representaron el 41,2% (n= 261) y los médicos el 22,3% (n= 141). Durante la pandemia, el 55,8% (n= 353) de los sujetos del estudio había trabajado dando asistencia directa a pacientes COVID (+). El 94% (n= 595) utilizó la visualización de vídeos para formarse/informarse para su ámbito profesional. El 94,9% refirió conocer las píldoras formativas de la app Formación SanidadMadrid. Las 22 píldoras formativas recibieron 25.539 visualizaciones en total. Se registró alta satisfacción de los participantes en el uso de este método para su formación durante la pandemia. Conclusiones: la estrategia formativa de microlearning basada en píldoras formativas disponibles en una aplicación móvil demostró ser un elemento clave para el desarrollo de nuevas metodologías formativas digitales en el entorno hospitalario durante una situación pandémica.(AU)

Objective: to evaluate the implementation of the microlearning educational strategy through the use of a mobile application for the healthcare professionals of a university hospital during the COVID-19 pandemic. Methods: a survey was conducted on hospital staff. The visualizations of knowledge pills were monitored. The questionnaire allowed to collect information about the sociodemographic profile of participants, the use of educational mobile applications, and of the pills created ad hoc during the COVID-19 pandemic. The number of users registered in the application was of 4,572. The data obtained were analysed through descriptive analysis, using the Student’s T test and the ANOVA test for bivariate analyses. Results: the study included 633 professionals, with a mean age (SD) of 44.8 (11.1) years; 81.7% (n= 517) were female and 93.5% (n= 592) were healthcare professionals. Nurses represented 41.2% (n= 261) of the sample, and doctors 22.3% (n= 141). During the pandemic, 55.8% (n= 353) of the study subjects had worked providing direct assistance to COVID (+) patients; 94% (n= 595) visualized videos for training / getting information for their professional setting; and 94.9% reported awareness of the knowledge pills by the Formación SanidadMadrid App. The 22 knowledge pills received 25,539 visualizations in total. There was high satisfaction by participants regarding the use of this method for their training during the pandemic. Conclusions: the microlearning educational strategy, based on knowledge pills available at a mobile application, demonstrated being a key element for the development of new digital training methodologies in the hospital setting during a pandemics scenario.(AU)

MEDES y Dialnet, dos iniciativas de gran alcance para la literatura científica en habla hispana / MEDES and Dialnet, two far-reaching initiatives for scientific literature in Spanish

En este décimo artículo de la serie «Puesta al día en la búsqueda de información científica» se presentan dos bases de datos de literatura científica hispana ambas desarrolladas por fundaciones preocupadas por proporcionar acceso a información científica de calidad en español. La primera es la base de datos MEDES (MEDicina en ESpañol), una iniciativa de la Fundación Lilly cuyo primer objetivo es fomentar la visibilidad y el uso de las publicaciones biomédicas en español. La segunda es Dialnet, considerado uno de los mayores portales bibliográficos de literatura científica hispana y que, junto con el acceso a referencias bibliográficas de temáticas diversas, integra diferentes servicios documentales como alertas bibliográficas, un repositorio que da acceso en la medida de lo posible a los textos completos de artículos de revistas, capítulos de libros, tesis doctorales, actas de congresos, etc., así como la generación de perfiles de autores (AU)

In this tenth article in the series «An Update in the Search for Scientific Information», we present two databases of scientific literature in Spanish, both of them developed by foundations concerned with providing access to good-quality scientific information in Spanish. The first one is the MEDES database (MEDicina en ESpañol), an initiative by the Lilly Foundation with the primary objective to promote the visibility and use of biomedical publications in Spanish. The second one is Dialnet, considered one of the largest bibliographic websites of scientific literature in Spanish and which, with the access to bibliographic references for diverse topics, integrates different documentary services such as bibliographic alerts, a repository that allows access to the extent possible to full-text journal articles, book chapters, doctoral theses, proceedings of congresses, etc., as well as the generation of author profiles (AU)

Recursos 2.0 indispensables para profesionales en Ciencias de la Salud / Essential web 2.0 resources for health science professionals

La web 2.0 o web social ha supuesto una revolución en el mundo de internet. Los contenidos estáticos basados en una comunicación unidireccional que antes caracterizaban la web, se han transformado en contenidos dinámicos, basados en la interacción de los usuarios a través de las redes. De esta forma los usuarios han pasado de ser consumidores a ser los protagonistas creando, compartiendo y enriqueciendo los contenidos a los que acceden. Muchas son las herramientas que configuran el mapa de la web 2.0. En este noveno artículo de la serie «Puesta al día en la búsqueda de información científica» se presentan algunas de las que más pueden interesar a los profesionales de las Ciencias de la Salud con dos finalidades principales. Por una parte, se presentan algunas herramientas indispensables para la difusión de contenidos o el desarrollo de un perfil profesional en la red como son herramientas para creación de blogs; algunas de las principales redes sociales profesionales y académicas (LinkedIn, ResearchGate y Academia.edu); y otros recursos como SlideShare. Por otra, se presentan algunas herramientas de trabajo colaborativo para, por ejemplo, el desarrollo de revisiones sistemáticas, gestores de referencias, discos duros virtuales, herramientas de gestión de proyectos, o marcadores sociales. En definitiva, un pequeño botón de muestra de herramientas que las nuevas tecnologías ponen a disposición de los usuarios para mejorar y facilitar el desarrollo profesional

The Web 2.0 or social web has represented a revolution in the world of Internet. Static contents based on one-way communication, which used to be characteristic of the web, now have transformed into dynamic contents, based on the interaction of users through networks. In this way, users have become protagonists rather than consumers, by creating, sharing and improving the contents accessed. There are many tools that form the Web 2.0 map. In this ninth article of the series «Update in the search of scientific information», we present some which Health Science Professionals can be more interested in, with two main objectives. On one hand, we present some essential tools for diffusion of contents or developing a professional profile in the network, such as tools for creating blogs; some of the main professional and academic social networks (LinkedIn, ResearchGate and Academia.edu), and other resources such as SlideShare. On the other hand, some collaborative work tools are presented, for example for the development of systematic reviews, reference managers, virtual hard disks, project management tools, or social markers. In conclusion, a small example of those tools that new technologies have made available for users, in order to improve and facilitate their professional development

La recuperación de información de cuidados a través de Cuiden® / Healthcare information retrieval through CUIDEN®

Este cuarto artículo de la serie 'Puesta al día en la búsqueda de información científica' se centra en la base de datos CUIDEN®. Está gestionada por la Fundación Index y es considerada como una de las herramientas de información fundamentales para estar al día sobre la producción científica generada en el espacio iberoamericano sobre cuidados en salud y temática clínico-asistencial en todas sus especialidades. La base de datos tiene una opción de acceso gratuito bajo modalidad de usuario registrado, CUIDEN®, y otra opción de acceso bajo suscripción, CUIDEN® Plus. El objetivo de este artículo es describir las principales características y funcionalidades de esta herramienta a través de las distintas opciones de búsqueda simple, avanzada y por palabras clave. Además, se destacan las diferencias entre la versión gratuita y la de suscripción, de modo que el usuario pueda tener en cuenta las limitaciones y ventajas de una y otra a la hora de afrontar una búsqueda de información

This fourth article of the series 'Update in the search for scientific information' is focused on the CUIDEN® database, managed by the Index Foundation, and considered one of the essential information tools in order to be updated about the scientific developments within the Ibero-American area in terms of healthcare and clinical practice in all its specialties. This database has a free access option under the Registered User mode, CUIDEN®, and another option of access by subscription, CUIDEN® Plus. The objective of this article is to describe the main characteristics and features of this tool, through its different search options: simple, advanced, and by key words. Besides, the differences between the free and the subscription versions are highlighted, so that the user can take into account their specific limitations and advantages at the time of initiating a search for information

MEDLINE-PubMed: la puerta de acceso al conocimento en Ciencias de la Salud / MEDLINE-PubMed: the door of access to knowledge in Health Sciences

Este artículo es el segundo de la serie «Puesta al día en la búsqueda de información científica». En él se aborda MEDLINE y su principal puerta de acceso, PubMed; se trata del recurso más conocido y utilizado en el mundo para recuperar información en Ciencias de la Salud. Este artículo tiene como propósito hacer un recorrido sobre las cuestiones fundamentales que ayuden a los profesionales del ámbito sanitario a recuperar información relevante para el ejercicio de su profesión. Para ello se presentan las principales características y sus opciones de búsqueda: Búsqueda simple, Búsqueda avanzada, Single Citation Matcher. Búsqueda por palabras clave: el MesH y Filtroso Límites (Tipo de documento (Article types), Disponibilidad del texto(Text availability), Fecha de publicación (Publication dates), Idioma (Languages), Grupos de edad (Ages), Materias (Subjects), Sexo (Sex), etc.). También se presentan las opciones de guardado y recuperación de los documentos obtenidos: 1) Guardarlo en un archivo(File); 2) Citation manager; 3) Clipboard; 4) Collection; 5) enviarlos por correo electrónico (E-mail); 6) o guardarlos en una cuenta personalizada de PubMed (My NCBI) como bibliografía (My Bibliography) (AU)

This article is the second in the «Update in the search for scientific information» series. MEDLINE is addressed here, and its main door of access, Pubmed, which is the best known and more widely used at global level in order to retrieve information on Health Sciences. The objective of this article is to go over the essential matters which will help healthcare professionals to retrieve information relevant to their practice. For this aim, their main characteristics and search options are hereby presented: Simple Search, Advanced Search, Single Citation Matcher, Search by key words: MesH and Filters or Limits, Type of Document, Text availability, Publication Dates, Languages, Age Groups, Subjects, Gender, etc. The options for saving and retrieving the documents obtained are also presented here: 1) Saving it in a file; 2) Citation manager; 3)Clipboard; 4) Collection; 5) Send by e-mail; 6) or Save in a personalized PubMed account (My NCBI) as bibliography (My Bibliography) (AU)

El impacto de la investigación en la práctica clínica / The impact of research in clinical practice

En este trabajo se analiza el modo en que el conocimiento científico puede modificar la práctica clínica y producir cambios en el comportamiento de los profesionales incorporando los nuevos descubrimientos a su práctica habitual. Tres son las fases principales en el proceso investigador: producción del conocimiento, transmisión y aplicación. Analizar cada una de ellas permitirá evaluar de forma integral el impacto de la investigación en la práctica clínica. Existe gran cantidad de información en relación con la forma en que los nuevos conocimientos deben llegar a los profesionales sanitarios. El reto está en reducir la brecha entre la generación de nuevos conocimientos basados en la mejor evidencia y la práctica clínica (AU)

This work analyzes the way in which scientific knowledge can modify clinical practice and generate changes in the behavior of professionals, incorporating the new discoveries to their common practice. The main phases of the research process are three: knowledge production, transmission and application. Analyzing each of them will allow us to evaluate the overall impact of research in clinical practice. There is a great amount of information related to the way in which new knowledge should reach health care providers. The challenge is to reduce the gap between clinical practice and the generation of new knowledge based on improved evidence (AU)

Respuesta. Análisis bibliométrico sobre enfermedades raras en España: adecuar la metodología al objetivo de estudio / Reply. Bibliometric analysis of rare diseases in Spain: need for adaptation of the methodology to the objective

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Análisis de la producción científica española sobre enfermedades raras: 1990-2000 / Analysis of Spanish scientific production in rare diseases: 1990-2000

Fundamento y objetivo: Análisis de la producción científica de los investigadores españoles en un grupo de enfermedades raras seleccionadas durante el período comprendido entre 1990 y 2000. Material y método: Se analizaron los siguientes grupos de enfermedades: anomalías congénitas, errores innatos del metabolismo e inmunodeficiencias primarias. Para la evaluación y análisis de la evolución de la investigación en esta área se aplicaron herramientas bibliométricas. Para la búsqueda bibliográfica se utilizó la base de datos MEDLINE. Resultados: El total de las referencias recuperadas para el estudio fue de 2.978, de las cuales el 82,5% son artículos originales y el 17,3% revisiones. El número total de autores fue de 14.752 y la media de autores por artículo de 4,9. Se codificaron 7 tipos de instituciones, de las cuales los hospitales fueron los más productivos, con un 78% de los artículos publicados. El núcleo Bradford está formado por 1.288 artículos, de los que el 43,2% está publicado en 12 revistas (2,1%). Conclusiones: A pesar de que la investigación en enfermedades raras es todavía escasa, en toda España se han llevado a cabo esfuerzos importantes encaminados al desarrollo y potenciación de la investigación en este campo. No obstante, aunar esfuerzos en este sentido facilitará diseñar políticas de investigación adecuadas que contribuyan a mejorar el panorama actual

Background and objective: To analyze the Spanish scientific production in a group of rare diseases selected during the period 1990-2000. Material and method: Analysis of the following disease groups: congenital anomalies, metabolism inborn errors and primary immunodeficiences. Bibliometric tools were used to assess and analyze the evolution of research in this area. The MEDLINE database was utilized for references search. Results: Total references recovered for the study were 2978: 82.5% original articles and 17.3% reviews. The number of authors was 14,752 and the mean author/article was 4.9%. Seven types of institutions were coded with hospitals being the most productive with 78% of articles published. The Bradford nucleus was formed by 1,288 articles and 43.2% of the total had been published in 12 journals (2.1%). Conclusions: Despite rare diseases research is still scarce, important efforts have been made at a national level focused on the development and strengthening of research in this field. Nevertheless, it is necessary to join efforts in this field to facilitate an appropriate research policy making that may help improve the current status