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Depósito Legal y Repositorio Institucional de Asturias : qué son, para que sirven y cómo se gestionan
Get PDFPresentación de sesión formativa (destinada a personal de la Consejería de Salud y del SESPA) que puede tener difusión pública sobre la definición, función, funcionamiento y gestión del Deposito Legal en Asturias, en relación a publicaciones, y RIA, Repositorio Institucional de Asturias, como fuente de información, y repositorio documental de la Administración del Principado de Asturia
Serum phosphate is associated with increased risk of bone fragility fractures in haemodialysis patients
Get PDFBackground. Bone fragility fractures are associated with high morbidity and mortality. This study analysed the association between the current biochemical parameters of chronic kidney disease–mineral and bone disorders (CKD-MBD) and bone fragility fractures in the COSMOS (Current management Of Secondary hyperparathyroidism: a Multicentre Observational Study) project. Methods. COSMOS is a 3-year, multicentre, open cohort, prospective, observational study carried out in 6797 haemodialysis patients (227 centres from 20 European countries). The association of bone fragility fractures (outcome) with serum calcium, phosphate and parathyroid hormone (PTH) (exposure), was assessed using standard Cox proportional hazards regression and Cox proportional haz- ards regression for recurrent events. Additional analyses were performed considering all-cause mortality as a competitive event for bone fragility fracture occurrence. Multivariable models were used in all strategies, with the fully adjusted model including a total of 24 variables. Results. During a median follow-up of 24 months, 252 (4%) patients experienced at least one bone fragility fracture (incident bone fragility fracture rate 28.5 per 1000 patient-years). In the fractured and non-fractured patients, the percentage of men was 43.7% and 61.4%, mean age 68.1 and 63.8 years and a haemodialysis vintage of 55.9 and 38.3 months, respectively. Baseline serum phosphate > 6.1 mg/dL (reference value 4.3–6.1 mg/dL) was significantly associated with a higher bone fragility fracture risk in both regression models {hazard ratio (HR) 1.53 [95% confidence interval (CI) 1.10–2.13] and HR 1.44 (95% CI 1.02–2.05)}. The significant association persisted after competitive risk analysis [subHR 1.42 (95% CI 1.02–1.98)] but the finding was not confirmed when serum phosphate was considered as a continuous variable. Baseline serum calcium showed no association with bone fragility fracture risk in any regression model. Baseline serum PTH > 800 pg/mL was significantly associated with a higher bone fragility fracture risk in both regression models, but the association disappeared after a competitive risk analysis. Conclusions. Hyperphosphatemia was independently and consistently associated with an increased bone fracture risk, suggesting serum phosphate could be a novel risk factor for bone fractures in haemodialysis patients.Instituto de Investigación Sanitaria del Principado de Asturias (ISPA
Urban search and rescue operations (USAR) in collapsed buildings after the 2023 earthquake in Türkiye
Get PDFThe earthquakes that occurred in February 2023 in Türkiye had some of the worst consequences of recent years. The
Turkish authorities first deployed local resources and then appealed for international help. The International Search
and Rescue Group of the United Nations aims to establish minimum international standards for search and rescue
teams and a methodology for coordinating responses to earthquakes, tsunamis, and other natural disasters. A main
concern of the group is to coordinate operations on the ground. This article offers perspectives on the epidemiology
of earthquakes, the management of emergency response teams and Türkiye’s disaster management agency (AFAD); it
also explains how rescues are carried out in collapsed buildings. The experience of Firefighters Without Borders after
the recent earthquakes and a rescue that took 14 hours are also described.Instituto de Investigación Sanitaria del Principado de Asturias (ISPA
Impact of the COVID-19 Pandemic on the Profile of Patients in SAMU-Asturias EMS (Spain): A Two-Year Retrospective Analysis of Advanced Life Support Unit Data
Get PDFAbstract
Introduction: The coronavirus disease 2019 (COVID-19) pandemic had important
consequences on the health system. Emergency Medical Services (EMS) were a key element
in the response and were forced to modify their daily procedures. The main objective of this
study was to find out if there were differences in response times and in the profile of patients
treated by the Advanced Life Support (ALS) units of Servicio de Asistencia Médica Urgente
(SAMU)-Asturias, the EMS of the Principality of Asturias, between the pre-pandemic
period and the pandemic period.
Methodology: This was a descriptive, cross-sectional, observational, and retrospective study
that included all patients treated by SAMU-Asturias ALS from January 1, 2019 through
December 31, 2020.
Results: The pandemic has had an impact on daily activity of SAMU-Asturias, with a 9.2%
decrease in daily ALS services during the pandemic, longer prehospital times during the
pandemic period (mean = 54’35”; SD= 0’48”; P = 0.00) mainly due to an increase in scene
time (mean = 28’01”; SD= 12’57”; P = 0.00), and a slight increase in the average age of
patients during the pandemic in relation to the pre-pandemic period. No differences were
found between the types of incidents for ALS or between the resolution of the patients.
Conclusions: The COVID-19 pandemic mainly affects prehospital times in an emergency
service, with no differences being observed in types of incidents; in EMS future pandemic
planning, this should be taken into consideration.Instituto de Investigación Sanitaria del Principado de Asturias (ISPA
Guía para escribir con claridad en la Administración
Get PDFGuía elaborada por la Cátedra Rafael del Riego de Buen Gobierno dependiente de la Universidad de Oviedo, en colaboración con la Dirección General de de Gobernanza Pública, Transparencia, Participación Ciudadana y Agenda 2030.
Dirección y ejecución del proyecto: Eva Mª Menéndez Sebastián,
Directora de la Cátedra Rafael del Riego de Buen Gobierno de la Universidad de Oviedo.
Con la colaboración de: Grupo de investigación del Proyecto «La ciudadanía digital y su reflejo administrativo/Digital citizenship: administrative implications», ref. TED2021-129283B-I00, financiado por MCIN/AEI/10.13039/501100011033 y la Unión Europea NextGenerationEU/PRTR
Ablación miomas por radiofrecuencia. Hospital Universitario Central de Asturias
No full textProtocolo del Servicio de Obstetricia y Ginecología el HUCA. Área Sanitaria I
Hospital surge capacity preparedness in disasters and emergencies: a systematic review
Get PDFAbstract
Background: Adequate and effective emergency preparedness for hospital surge capacity is a prerequisite
to ensuring standard healthcare services for disaster victims. This study aimed to identify, review, and
synthesize the preparedness activities for and the barriers to hospital surge capacity in disasters and
emergencies.
Methods: We systematically searched seven databases (PubMed, MEDLINE, CINAHL, Scopus, Embase,
Ovid, and PsycINFO). We included all English peer-reviewed studies published in January 2016 and July
2022 on surge capacity preparedness in hospital settings. Two independent researchers screened titles
and abstracts, reviewed the full texts, and conducted data extractions using CADIMA software. We
assessed the rigor of the included studies using the NIH quality assessment tools for quantitative studies,
the Noyes et al. guidelines for qualitative studies, and the MMAT tool for mixed methods studies and
summarized findings using the narrative synthesis method. We also used PRISMA reporting guidelines.
Results: From the 2560 studies identified, we finally include 13 peer-reviewed studies: 10 quantitative,
one qualitative, and two mixed methods. Five studies were done in the USA, three in Iran (n ¼ 3), and the
remaining in Australia, Pakistan, Sweden, Taiwan, and Tanzania. The study identified various ways to
increase hospital surge capacity preparedness in all four domains (staff, stuff, space, and system); among
them, the use of the Hospital Medical Surge Preparedness Index and the Surge Simulation Tool for surge
planning was noteworthy. Moreover, nine studies (69%) recognized several barriers to hospital surge
capacity preparedness.
Conclusion: The review provides synthesized evidence of contemporary literature on strategies for and
barriers to hospital surge capacity preparedness. Despite the risk of selection bias due to the omission of
gray literature, the study findings could help hospital authorities, public health workers, and policymakers to develop effective plans and programs for improving hospital surge capacity preparedness with
actions, such as enhancing coordination, new or adapted flows of patients, disaster planning implementation, or the development of specific tools for surge capacity.Instituto de Investigación Sanitaria del Principado de Asturias (ISPA
Pathophysiology of bone disease in chronic kidney disease: from basics to renal osteodystrophy and osteoporosis
Get PDFChronic kidney disease (CKD) is a highly prevalent disease that has become a public health problem. Progression of CKD is associated with serious complications, including the systemic CKD-mineral and bone disorder (CKD-MBD). Laboratory, bone and vascular abnormalities define this condition, and all have been independently related to cardiovascular disease and high mortality rates. The "old" cross-talk between kidney and bone (classically known as "renal osteodystrophies") has been recently expanded to the cardiovascular system, emphasizing the importance of the bone component of CKD-MBD. Moreover, a recently recognized higher susceptibility of patients with CKD to falls and bone fractures led to important paradigm changes in the new CKD-MBD guidelines. Evaluation of bone mineral density and the diagnosis of "osteoporosis" emerges in nephrology as a new possibility "if results will impact clinical decisions". Obviously, it is still reasonable to perform a bone biopsy if knowledge of the type of renal osteodystrophy will be clinically useful (low versus high turnover-bone disease). However, it is now considered that the inability to perform a bone biopsy may not justify withholding antiresorptive therapies to patients with high risk of fracture. This view adds to the effects of parathyroid hormone in CKD patients and the classical treatment of secondary hyperparathyroidism. The availability of new antiosteoporotic treatments bring the opportunity to come back to the basics, and the knowledge of new pathophysiological pathways [OPG/RANKL (LGR4); Wnt-beta-catenin pathway], also affected in CKD, offers great opportunities to further unravel the complex physiopathology of CKD-MBD and to improve outcomes.Instituto de Investigación Sanitaria del Principado de Asturia
De la sidra a los biorreactores: Magayas y borras como fuente de nutrientes de bajo coste
Get PDFEl objetivo principal de este estudio fue evaluar diversas metodologías para transformar tanto la magaya como las borras en nutrientes de bajo costo para la formulación de medios de cultivo y fermentación. El objetivo subyacente es abrir nuevas oportunidades y promover la utilización eficiente de ambos subproductos en el campo de la biotecnología.The main objective of this study was to evaluate various methodologies to transform both apple pomace and lees into low-cost nutrients for the formulation of culture and fermentation media. The underlying objective is to open new opportunities and promote the efficient use of both byproducts in the field of biotechnology.El soporte económico de este trabajo procede de la Agencia Estatal de Investigación, referencia PID2020-118737RR-C21, financiado por MCIN/ AEI /10.13039/50110001103