12096 research outputs found
Sort by
Comparación del riesgo hemorrágico perioperatorio en pacientes anticoagulados vs. no anticoagulados en cirugía de retina
No full textIntroducción: la cirugía vitreorretiniana en pacientes anticoagulados sigue siendo un tema
controvertido debido a las posibles complicaciones hemorrágicas que puedan causar, esto lleva
a que muchos cirujanos decidan suspender la anticoagulación antes del procedimiento. Sin
embargo, esta actuación puede aumentar de manera notoria el riesgo de sufrir eventos
tromboembólicos graves.
Objetivos: comparar los riesgos hemorrágicos en pacientes sometidos a cirugía vitreorretiniana
que mantienen la terapia anticoagulante frente a aquellos en los que se suspende, así como
evaluar la aparición de complicaciones y la evolución de la agudeza visual.
Metodología: revisión de tipo sistemático de la literatura desde 2010, siguiendo el protocolo
PRISMA y el sistema PICO: pacientes anticoagulados sometidos a cirugía de retina, comparando
aquellos que continuaron con la terapia anticoagulante frente a los que la suspendieron,
valorando las posibles complicaciones hemorrágicas perioperatorias.
Resultados: 16 estudios son los que se incluyen en el análisis de este trabajo. Los resultados
muestran que continuar con la anticoagulación no incrementa el riesgo de complicaciones
perioperatorias especialmente si se utiliza material quirúrgico menos invasivo, al igual que el
uso de anestesia retrobulbar es seguro. También se ha visto que la agudeza visual mejora tras
la cirugía sin diferencias significativas entre pacientes anticoagulados y no anticoagulados,
aunque esta diferencia sí podría verse afectada por otros factores.
Conclusiones: mantener la anticoagulación durante la cirugía vitrerretiniana es una práctica
segura y efectiva, de manera que se evitan los riesgos trombóticos asociados a su suspensión
sin aumentar el riesgo de sangrado ni los resultados visuales.Introduction: vitreoretinal surgery in anticoagulated patients remains a controversial topic due
to the potential risk of hemorrhagic complications, leading many surgeons to discontinue
anticoagulation prior to the procedure. However, this approach can significantly increase the
risk of serious thromboembolic events.
Objectives: to compare hemorrhagic risks in patients undergoing vitreoretinal surgery who
continue anticoagulant therapy versus those in whom it is suspended, and to evaluate the
occurrence of complications and visual acuity outcomes.
Methodology: a systematic literature review was conducted from 2010 onwards, following the
PRISMA protocol and using the PICO framework: anticoagulated patients undergoing retinal
surgery were compared based on whether anticoagulant therapy was maintained or suspended,
evaluating potential perioperative hemorrhagic complications.
Results: sixteen studies were included in the analysis. The findings show that continuing
anticoagulation does not increase the risk of perioperative complications, especially when less
invasive surgical tools are used. Additionally, retrobulbar anesthesia is considered safe. Visual
acuity was also found to improve after surgery, with no significant differences between
anticoagulated and non-anticoagulated patients, although this outcome could be influenced by
other factors.
Conclusions: maintaining anticoagulation during vitreoretinal surgery is a safe and effective
practice, preventing thrombotic risks associated with discontinuation without increasing the risk
of bleeding or negatively affecting visual outcomes.Graduado o Graduada en Medicina por la Universidad Pública de NavarraMedikuntzan graduatua Nafarroako Unibertsitate Publikoa
Ni-Mo2C/y-Al2O3 catalysts for syngas production in pyrolysis-dry reforming of plastics - the effect of amine nature on catalyst performance
No full textPyrolysis combined with dry reforming (PCDR) is eco-friendly technology for plastic waste management, allowing for sustainable production of syngas. Design of suitable catalysts with high performance and stability is crucial for its industrialization. In this work, Ni-Mo2C/γ-Al2O3 catalysts were synthesized using organic–inorganic precursors. Three types of amines (hexylamine – aliphatic linear, cyclohexylamine – aliphatic cyclic, aniline – aromatic) were used as carbon source in the precursor preparation to investigate their effect on catalyst physicochemical properties and its catalytic performance. Catalytic performance of the obtained catalysts was examined in PCDR of model waste plastic mixture. It was revealed that catalytic activity of catalysts prepared with aliphatic amines was higher compared to aromatic aniline, amine commonly used for carbide synthesis. The differences in catalyst properties, which affected their catalytic activity were characterized using N2-adsorption at −196 °C, XRD, H2-TPR, SEM, TG/DTG and CO2-adsorption methods. A correlation was observed between amine molecule complexity and Mo2C crystallite size, significantly affecting hydrogen generation. The less complex the amine, the smaller the crystallite and the increased hydrogen production. Moreover, the use of aliphatic amines resulted in the stronger Ni-support interactions, the increased number of more favorable, larger mesopores as well as the presence of the metallic Mo phase and the lack of unbound carbon in contrast to the catalyst obtained using aniline. The catalyst synthesized using hexylamine increased H2 yield by more than tenfold, syngas yield by more than threefold, and the H2/CO ratio by fivefold, which offers an opportunity for future industrialization of PCDR.The financial support for this study from Gdańsk University of Technology by the DEC-23/2020/IDUB/I.3.3 grant under the ARGENTUM—“Excellence Initiative—Research University” program is gratefully acknowledged
Circulating bilirubin levels, but not their genetic determinants, are inversely associated with steatotic liver disease in adolescents
No full textEpidemiologic studies suggest that elevated plasma unconjugated bilirubin confer protection against steatotic liver disease (SLD) in adults. However, evidence supporting this protective role in adolescents remains limited. We aimed to assess the association between serum bilirubin levels and their genetic determinants in protecting against SLD in Chilean adolescents. We conducted a cross-sectional study with 704 adolescents aged 15.4 ± 1 years (52% girls) of the Chilean Growth and Obesity Cohort Study. Ultrasonography echogenicity was used to diagnose SLD. We measured Z-scores of body mass index (z-BMI), total bilirubin (TB), and the genetic determinants of bilirubin (including rs887829 genotypes of UGT1A1 and bilirubin polygenic scores). Multiple logistic regression models evaluated the associations between standardized TB and its genetic determinants with SLD. We found that 1-SD of standardized plasma TB was significantly associated with a 30% reduction in the likelihood of SLD after adjustment by sex, age, z-BMI, and ethnicity (OR = 0.7; 95% CI = 0.50-0.96; p = 0.03). No significant associations were found among the rs887829 genotypes, bilirubin polygenic scores, and SLD in logistic regression models adjusted by covariates. Increased circulating bilirubin levels are unlikely causally associated with protection against SLD, and the cross-sectional association could be due to unmeasured confounding.This work was supported by projects FONDECYT 1150416, 1161456, 1200839, and 11190856 from Agencia Nacional de Investigación y Desarrollo de Chile ANID (former Comisión Nacional de Investigación Científica y Tecnológica de Chile CONICYT).; Genotyping was performed at the Spanish National Cancer Research Centre in the Human Genotyping lab, a member of CeGen, PRB3, and is supported by grant PT17/0019, of the PE I+D+i 2013\u20132016, funded by ISCIII and ERDF. J.P.M. thanks the Advanced Center for Chronic Diseases (ACCDiS) for its doctoral fellowship in the PhD Program in Epidemiology, Pontificia Universidad Católica de Chile. J.P.M. also thanks Catterina Ferreccio and Javiera Leniz for their critical review of the manuscript
Secondary victimisation in the Jury Court
No full textPara la víctima del delito ser parte de un procedimiento judicial puede ser casi en la totalidad de las ocasiones tan doloroso y traumático como el delito en sí mismo. Enfrentarse a un Tribunal y especialmente a los acusados, escuchar a los testigos o a los peritos es una situación harto compleja e intimidante para cualquier ciudadano. En este contexto, el riesgo de sufrir una revictimización es además de posible y probable, una realidad de la que los operadores jurídicos no podemos desentendernos. El objeto del presente trabajo es el estudio de la victimización secundaria en el proceso ante el Tribunal del Jurado. Para ello, se toma como base la victimización secundaria sufrida por una víctima de delito ante los dos juicios orales ante el Tribunal del Jurado que enjuiciaron la muerte violenta de su hermano, además de las lesiones que le causaron a él.For crime victims, being part of a judicial proceeding can usually be as painful and
traumatic as the crime itself. Facing court, and especially the accused and hearing
testimony or expert testimony is a highly complex and intimidating situation for
any citizen. In this context, the risk of revictimization or secondary victimization
is not only possible and probable, but also a reality that legal practitioners cannot
ignore. The purpose of this paper is to study secondary victimization in trial before
a jury court. To this end, we take as a basis the revictimization suffered by a crime
victim during the two oral trials before a jury court that judged the violent death
of his brother in addition to the injuries caused to him
Monitoring of blind rivets installations: contributions from the manufacturing chain and time-series imaging
No full textFastening is a crucial operation in the aircraft manufacturing cycle, and the demand for automated solutions has grown in recent years. Blind rivets are particularly suitable for automation due to their ease of use. However, fastening with blind rivets requires indirect evaluation of the formed head for in-line quality monitoring. This study presents two approaches to address this problem. Firstly, an analysis of the drilling-riveting chain assesses the impact of the previous operation on riveting outcomes. Secondly, time-dependent signals from the riveting process are coded into images and analysed using deep learning techniques. Despite some limitations, both methods for monitoring blind riveting have demonstrated high precision and accuracy values above 0.9, with 1 indicating perfect precision or accuracy, suggesting that they can reliably predict the quality of rivet installations.This project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No 958303 and from the ELKARTEK program of the Basque Government (EKOHEGAZ project, Contract no. KK-2021/00092). The authors would like to acknowledge the open access funding provided by Universidad Pública de Navarra
Critical evaluation of Inditex's Sustainability Report (2024): compliance, consistency, environmental and social performance
No full textEste trabajo realizará un análisis del info1me de sostenibilidad 2024 de Inditex,
analizando su impacto ambiental y social a través de fuentes académicas y periodísticas
externas. Se contextualizará la sostenibilidad desde sus orígenes teóricos hasta su
aplicación empresarial actual, especialmente en el sector textil, destacando el papel de
Inditex como referente del modelo de "fast fashion". El análisis revela avances en
ciertas partes del modelo de producción pero también imp01tantes carencias en el
control de la cadena de suministro, emisiones indirectas y transparencia en iniciativas
referentes a la economía circular. En el ámbito social, se evalúan iniciativas como el
plan "Trabajador en el centro" y casos de conflictos laborales. Se cuestionará la
veracidad de algunos compromisos por la ausencia de autocrítica y la omisión de
escándalos recientes, ale1tando sobre prácticas de greenwashing. El trabajo defiende la
necesidad de transfo1mar estos inf01mes en henamientas más útiles y verificables.This paper will analyze Inditex's 2024 sustainability rep01t, examining its environmental
and social in1pact through extemal academic and jomnalistic sources. Sustainability will
be contextualized from its theoretical origins to its cmTent application in business,
especially in the textile sector, highlighting Inditex's role as a leader in the "fast
fashion" model. The analysis reveals progress in ce1tain paits of the production model
but also significant sho1tcomings in supply chain control, indirect emissions, and
transparency in initiatives related to the circular economy. In the Social field, initiatives
such as the "Worker at the Center" plan and cases of labor disputes ai·e evaluated. The
veracity of sorne commitrnents will be questioned due to the absence of self-criticism
and the omission of recent scandals, warning about greenwashing practices. The paper
defends the need to transfonn these rep01ts into more useful and verifiable toolsGraduado o Graduada en Administración y Dirección de Empresas por la Universidad Pública de Navarra (Programa Internacional)Enpresen Administrazio eta Zuzendaritzan Graduatua Nafarroako Unibertsitate Publikoan (Nazioarteko Programa
Eficacia de la combinación de un programa de terapia de espejo con electroestimulación y realidad virtual tras un accidente cerebrovascular
No full textIntroducción: el ictus es la principal causa de discapacidad y la segunda de mortalidad
del planeta, provocado por obstrucción o rotura de vasos cerebrales, afectando diversas
funciones sensoriomotoras.
Objetivos: comprobar la evidencia científica sobre programas de terapia de espejo
combinados con electroestimulación o realidad virtual para diseñar un plan
rehabilitador óptimo.
Metodología: se realizó una búsqueda bibliográfica en las bases de datos PubMed,
Scopus y PEDro. La calidad metodológica y el riesgo de sesgo se evaluaron mediante la
escala PEDro, el “Journal CitaMon Reports” y el “SCImago Journal and Country Rank”.
Resultados: se incluyeron 14 ensayos clínicos aleatorizados: siete combinaron terapia
de espejo con electroestimulación y siete con sistemas de realidad virtual. Todos
mostraron mejoras en la destreza manual, la recuperación sensoriomotora y la
funcionalidad en actividades diarias.
Conclusión: un programa de terapia de espejo integrado en realidad virtual y
complementado con electroestimulación puede optimizar la rehabilitación tras un ictus.Background: Stroke and cerebrovascular accidents are among the main causes of
disability and the second leading cause of death globally. They often result from
obstruction or rupture of cerebral vessels, causing hemorrhages and affecting
sensorimotor functions.
Objectives: To evaluate the scientific evidence of mirror therapy combined with
electrostimulation or virtual reality, aiming to design an optimal rehabilitation plan for
stroke patients.
Methods: We searched PubMed, Scopus, and PEDro databases to obtain the necessary
articles for this review. PEDro scale, “Journal CitaMon Reports,” and “SCImago Journal
and Country Rank” were used to assess methodological quality and risk of bias.
Results: Fourteen randomized clinical trials were included: seven combined mirror
therapy with electrostimulation, and seven with virtual reality. All studies reported
improvements in manual dexterity, sensorimotor recovery, and daily activity
performance.
Conclusions: Integrated mirror therapy with virtual reality and targeted
electrostimulation could be an optimal rehabilitation strategy for stroke recovery.Graduado o Graduada en Fisioterapia por la Universidad Pública de NavarraFisioterapian Graduatua Nafarroako Unibertsitate Publikoa
Las escalas de alerta temprana en la detección del deterioro clínico de pacientes hospitalizados
No full textAntecedentes: la identificación y manejo precoz del deterioro clínico de los
pacientes hospitalizados puede prevenir la progresión hacia situaciones críticas
como la parada cardiorrespiratoria, el ingreso en la Unidad de Cuidados Intensivos o
incluso la muerte. Con el objetivo de reconocer al paciente en riesgo de deterioro
clínico, se han desarrollado y aplicado las Escalas de Alerta Temprana, herramientas
que se aplican a pie de cama y permiten detectar cambios en el estado del paciente
antes de que ocurran eventos graves.
Objetivo: analizar la utilidad de las Escalas de Alerta Temprana en la detección del
deterioro clínico de los pacientes hospitalizados.
Metodología: se ha llevado a cabo una revisión de alcance en las bases de datos de
PubMed y CINAHL, utilizando la estrategia PIO.
Resultados: se incluyeron 25 estudios de los cuales se extrajo la información más
relevante, que se agrupó en cinco áreas clave: beneficios de las Escalas de Alerta
Temprana, limitaciones en su implementación, escalas más utilizadas, análisis
específico de la escala NEWS/NEWS2 y perspectivas futuras como la monitorización
continua.
Conclusiones: las Escalas de Alerta Temprana son herramientas eficaces para la
detección precoz del deterioro clínico en pacientes hospitalizados. Su
implementación reduce el número de eventos adversos graves, aumenta la
seguridad del paciente y facilita la toma de decisiones clínicas. No obstante, deben
aplicarse como complemento al juicio clínico y con protocolos estandarizados.Background: early identification and management of clinical deterioration in
hospitalized patients can prevent progression to critical situations such as
cardiorespiratory arrest, admission to the Intensive Care Unit (ICU) or even death.
With the aim of recognizing patients at risk of clinical deterioration, Early Warning
Scales have been developed and applied, tools that are applied at the bedside and
allow changes in the patient's condition to be detected before serious events occur.
Objective: to analyze the usefulness of Early Warning Scales in the detection of
clinical deterioration in hospitalized patients.
Methodology: a scoping review was carried out in PubMed and CINAHL databases,
using the PIO strategy.
Results: 25 studies were included from which the most relevant information was
extracted and grouped into five key areas: benefits of Early Warning Scales,
limitations in their implementation, most commonly used scales, specific analysis of
the NEWS/NEWS2 scale and future perspectives such as continuous monitoring.
Conclusions: early Warning Scales are effective tools for early detection of clinical
deterioration in hospitalized patients. Their implementation reduces the number of
serious adverse events, increases patient safety and facilitates clinical decision
making. However, they should be applied as a complement to clinical judgment and
with standardized protocols.Graduado o Graduada en Enfermería por la Universidad Pública de NavarraErizaintzan Graduatua Nafarroako Unibertsitate Publikoa
Austerity and asymmetries in the fiscal policies of the Eurozone: the case of Southern Europe
No full textIn this paper, we analyse the effects of several austerity policies implemented by the Southern European countries, i.e., Portugal, Italy, Greece, and Spain on the economies of the European Union and the rest of the world. In particular, we simulate the reduction in one point in the government deficit-to-GDP ratio in each of these countries, through several alternative policies, both from the spending side and the revenue side. The empirical methodology is based on a computable general equilibrium model, which incorporates the backward sectoral linkages and inter-country flows generated by fiscal consolidations. Our results show that these austerity policies were generally more painful, in terms of a fall in the levels of activity and a worsening in income distribution for labour, in the scenarios of tax increases rather than in those based on spending cuts. The effects on the rest of the European Union and the rest of the world were however mostly negligible.Open Access funding provided by Universidad Pública de Navarra. This paper is the result of a project financed by the Instituto de Estudios Fiscales (Spanish Ministry of Finance). The authors also acknowledge the financial support from the University of Castilla-La Mancha through the project 2022-GRIN-34135, co-financed by the European Union via the European Regional Development Fund (O. Bajo-Rubio), and from the Spanish Ministry of Science and Innovation through the project PID2020-GB-C32 and the project PID2023-148185NB-100 financed by MICIU/AEI/10.13039/501100011033 and FEDER, EU (A. G. Gómez-Plana)
Casos clínicos. Fisioterapia geriátrica
No full textPresentación de tres casos clínicos de personas mayores con dificultades principalmente motoras con sus respectivos diagnósticos y planes de intervención fisioterapéutica. Para la asignatura Fisioterapia geriátrica