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Presentation of the Prehospital Emergency Research Network and an analysis of bibliometric indicators for scientific productivity in out-of-hospital care
No full textLa investigación permite mejorar el conocimiento científico y su aplicación a la práctica profesional. En la asistencia extrahospitalaria, muchos de los avances provienen de entornos hospitalarios, quizás debido a dificultades inherentes al entorno extrahospitalario, como la heterogeneidad, la dificultad en la recogida de datos y la presencia de sesgos no controlados. Las redes de investigación permiten, entre otras cosas, la interconexión de distintos investigadores y la homogenización en la recogida de datos. En este artículo se presenta la Red de Investigación en Emergencias Prehospitalarias (RINVEMER) y los resultados de un análisis bibliométrico de la producción científica en emergencias prehospitalarias en España. Desde 1975 se han publicado 512 trabajos en revistas indexadas en la Web of Science, siendo el primero en 1999, realizados por 381 investigadores españoles del ámbito de las emergencias prehospitalarias, con el mayor número de autores pertenecientes a la Empresa Pública de Emergencias Sanitarias (EPES) de Andalucía, con un total de 61. Además, se han realizado 63 tesis doctorales, con el mayor número registrado en la Universidad de Oviedo, con ocho. La producción científica en emergencias extrahospitalarias en España ha crecido sustancialmente en los últimos años, y la creación de RINVEMER permitirá mejorar las interconexiones entre los investigadores.Ye
Melatonin and multiple sclerosis: antioxidant, anti-inflammatory and immunomodulator mechanism of action.
No full textMelatonin is an indole hormone secreted primarily by the pineal gland that showing anti-oxidant, anti-inflammatory and anti-apoptotic capacity. It can play an important role in the pathophysiological mechanisms of various diseases. In this regard, different studies have shown that there is a relationship between Melatonin and Multiple Sclerosis (MS). MS is a chronic immune-mediated disease of the Central Nervous System. The objective of this review was to evaluate the mechanisms of action of melatonin on oxidative stress, inflammation and intestinal dysbiosis caused by MS, as well as its interaction with different hormones and factors that can influence the pathophysiology of the disease. Melatonin causes a significant increase in the levels of catalase, superoxide dismutase, glutathione peroxidase, glutathione and can counteract and inhibit the effects of the NLRP3 inflammasome, which would also be beneficial during SARS-CoV-2 infection. In addition, melatonin increases antimicrobial peptides, especially Reg3β, which could be useful in controlling the microbiota. Melatonin could exert a beneficial effect in people suffering from MS, running as a promising candidate for the treatment of this disease. However, more research in human is needed to help understand the possible interaction between melatonin and certain sex hormones, such as estrogens, to know the potential therapeutic efficacy in both men and women.S
Cortistatin regulates fibrosis and myofibroblast activation in experimental hepatotoxic- and cholestatic-induced liver injury.
No full textLiver fibrosis induced by chronic hepatic injury remains a major cause of morbidity and mortality worldwide. Identification of susceptibility/prognosis factors and new therapeutic tools for treating hepatic fibrotic disorders are urgent medical needs. Cortistatin is a neuropeptide with potent anti-inflammatory and anti-fibrotic activities in lung that binds to receptors that are expressed in liver fibroblasts and hepatic stellate cells. We evaluated the capacity of cortistatin to regulate liver fibrosis. We experimentally induced liver fibrosis in mice by chronic CCl4 exposure and bile duct ligation and evaluated the histopathological signs and fibrotic markers. Hepatic expression of cortistatin inversely correlated with liver fibrosis grade in mice and humans with hepatic disorders. Cortistatin-deficient mice showed exacerbated signs of liver damage and fibrosis and increased mortality rates when challenged by hepatotoxic and cholestatic injury. Compared with wild-type mice, non-parenchymal liver cells isolated from cortistatin-deficient mice showed increased presence of cells with activated myofibroblast phenotypes and a differential genetic signature that is indicative of activated hepatic stellate cells and periportal fibroblasts and of myofibroblasts with active contractile apparatus. Cortistatin treatment reversed in vivo and in vitro these exaggerated fibrogenic phenotypes and protected from progression to severe liver fibrosis in response to hepatic injury. We identify cortistatin as an endogenous molecular brake on liver fibrosis and its deficiency as a potential poor-prognosis marker for chronic hepatic disorders that link with fibrosis. Cortistatin-based therapies emerge as attractive strategies for ameliorating severe hepatic fibrosis of various aetiologies
Different profiles of advanced heart failure among patients with and without diabetes mellitus. Findings from the EPICTER study.
No full textThis work aims to compare the characteristics of advanced heart failure (HF) in patients with and without type 2 diabetes mellitus (DM) and to determine the relevance of variables used to define advanced HF. This cross-sectional, multicenter study included patients hospitalized for HF. They were classified into four groups according to presence/absence of advanced HF, determined based on general and cardiac criteria, and presence/absence of DM. To analyze the importance of variables, we grew a random forest algorithm (RF) based on mortality at six months. A total of 3153 patients were included. The prevalence of advanced HF among patients with DM was 24% compared to 23% among those without DM (p=0.53). Patients with advanced HF and DM had more comorbidity related to cardiovascular and renal diseases; their prognosis was the poorest (log-rank <0.0001) though the adjusted hazard ratio by group in the Cox regression analysis was not significant. The variables that were significantly related to mortality were the number of comorbidities (p=0.005) and systolic blood pressure (p=0.024). The RF showed that general criteria were more important for defining advanced HF than cardiac criteria. Patients with advanced HF and DM were characterized by DM in progression with macro and microvascular complications. The outcomes among advanced HF patients were poor; patients with advanced HF and DM had the poorest outcomes. General criteria were the most important to establish accurately a definition of advanced HF, being decisive the evidence of disease progression in patients with DM
Comparing an e-Health program vs home rehabilitation program in patients with non-specific low back pain: A study protocol randomized feasibility trial.
No full textThere is little evidence on the reliability of the web application-based rehabilitation systems to treat chronic low back pain (CLBP). This protocol describes a double-blind, randomized controlled feasibility trial of an e-Health intervention developed to support the self-management of people with CLBP in primary care physiotherapy. Three Hospitals with primary care for outpatients will be the units of randomisation, in each Hospital the participants will be randomized to one of two groups, a pragmatic control group receiving either the usual home program based on electrostimulation and McKenzie Therapy and e-Health intervention. Patients are followed up at 2 and 6 months. The primary outcomes are (1) acceptability and demand of the intervention by GPs, physiotherapists and patients and (2) feasibility and optimal study design/methods for a definitive trial. Secondary outcomes will include analysis in the clinical outcomes of pain, disability, fear of movement, quality of life, isometric resistance of the trunk flexors, lumbar anteflexion and lumbar segmental range of motion. The specific e-Health programs to home could increase adherence to treatment, prevent stages of greater pain and disability, and improve the painful symptomatology. The e-Health programs could be an effective healthcare tool that can reach a large number of people living in rural or remote areas
Caring behaviours demonstrated to nursing students in the interpersonal relation with the faculty: A cross sectional study.
No full textNursing students need to experience caring in their educational environment in order to learn how to care for the patients. The present study describes the caring model demonstrated by the faculty to the nursing students through their behaviours, from the perspective of both students and faculty members. A cross-sectional, descriptive, observational study was conducted. The sample included 286 students and faculty members. The Nursing Students' Perceptions of Instructor Caring assessing tool was used to gather the data. After analysing 676 questionnaires, it was revealed a moderately high level of caring perceived by the students. The most appreciated dimension was control versus flexibility, reporting a mean value of 82.29 and a confidence interval from 81.14 to 83.44, and the least valued was appreciation of life's meanings, reporting a mean value of 63.90 and a confidence interval from 62.20 to 65.60. The students' perception of the care demonstrated by the faculty was significantly lower than the care that the latter believed to transmit in all dimensions (p The caring perceived by the student was expressed through behaviours that inspired confidence in them, promoted a climate of learning and support, helped them to recognise the meaning of life, showed them flexibility and fostered their professional autonomy. The findings of this study can help to improve nursing education by providing a view of the interpersonal relations that the students established during their training with the faculty
diaPASEF Proteomics and Feature Selection for the Description of Sputum Proteome Profiles in a Cohort of Different Subtypes of Lung Cancer Patients and Controls.
No full textThe high mortality, the presence of an initial asymptomatic stage and the fact that diagnosis in early stages reduces mortality justify the implementation of screening programs in the populations at risk of lung cancer. It is imperative to develop less aggressive methods that can complement existing diagnosis technologies. In this study, we aimed to identify lung cancer protein biomarkers and pathways affected in sputum samples, using the recently developed diaPASEF mass spectrometry (MS) acquisition mode. The sputum proteome of lung cancer cases and controls was analyzed through nano-HPLC-MS using the diaPASEF mode. For functional analysis, the results from differential expression analysis were further analyzed in the STRING platform, and feature selection was performed using sparse partial least squares discriminant analysis (sPLS-DA). Our results showed an activation of inflammation, with an alteration of pathways and processes related to acute-phase, complement, and immune responses. The resulting sPLS-DA model separated between case and control groups with high levels of sensitivity and specificity. In conclusion, we showed how new-generation proteomics can be used to detect potential biomarkers in sputum samples, and ultimately to discriminate patients from controls and even to help to differentiate between different cancer subtypes.S
Time Following a Gluten-Free Diet, Ultra-Processed Food Consumption and Quality of Life in Children with Celiac Disease
No full textFeatured Application The data from the present study indicate that nutritionists and other healthcare professionals should monitor the quality of life and diet quality of children with celiac disease, especially from the first year of treatment with a gluten-free diet. Maintaining a strict gluten-free diet (GFD) may affect the quality of life of children with celiac disease (CD) and promote a less healthy diet by substituting gluten-containing foods with ultra-processed foods. We aimed to assess the influences of the GFD and ultra-processed food consumption on parents' perception of the quality of life of children with CD. Fifty-eight children (mean age 8.6 +/- 4.1 years) were included. The participants were divided into groups based on the time following a GFD: = 12 months (n = 37). Their dietary consumption was assessed through a three-day food record. The 20-item Celiac Disease Quality Of Life survey (CD-QOL), which contains four subscales (limitations, dysphoria, health concerns, and inadequate treatment) was used to assess the quality of life. The children who followed a GFD for >= 12 months presented poorer scores in the limitations subscale than those who followed a GFD for = 12 months presented poorer scores in the limitations subscale than those who followed a GFD forThis research was funded by the FEDER project No. B-AGR-658. It was also partially funded by the grant “Investigation grant program by the Association of Celiacs and Sensitive to Gluten of the Community of Madrid”. M.F.-A. was additionally funded by the Spanish Ministry of Education, Culture, and Sports (grant number FPU17/03715). This study is included in the thesis of A.L., enrolled in the doctoral program of Nutrition and Food Sciences at the University of Granada.S
P-097 MINIMALLY INVASIVE REPAIR IN SEVERE RECTUS DIASTASIS WITH MIDLINE HERNIA ASSOCIATED IN MALES SHOWS HIGH RECURRENCE IN MID-TERM FOLLOW-UP. CASE-CONTROL STUDY
No full textOnce-Weekly Semaglutide Use in Patients with Type 2 Diabetes: Results from the SURE Spain Multicentre, Prospective, Observational Study.
No full textType 2 diabetes (T2D) is a complex disease for which an individualised treatment approach is recommended. Once-weekly (OW) semaglutide is a glucagon-like peptide-1 receptor agonist approved for the treatment of insufficiently controlled T2D. The aim of this study was to investigate the use of OW semaglutide in adults with T2D in a real-world context. SURE Spain, from the 10-country SURE programme, was a prospective, multicentre, open-label, observational study, approximately 30 weeks in duration. Adults with T2D and ≥1 documented HbA1c value ≤12 weeks before semaglutide initiation were enrolled. Change in HbA1c from baseline to end of study (EOS) was the primary endpoint, with change in body weight (BW), waist circumference, and patient-reported outcomes as secondary endpoints. Of the 227 patients initiating semaglutide, 196 (86.3%) completed the study on-treatment with semaglutide. The estimated mean changes in HbA1c and body weight between baseline and EOS were -1.3%-points (95% confidence interval (CI) -1.51;-1.18%-points) and -5.7 kg (95% CI -6.36;-4.98 kg). No new safety concerns were identified. Therefore, in routine clinical practice in Spain, OW semaglutide was shown to be associated with statistically significant and clinically relevant reductions in HbA1c and BW in adults with T2D.S