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La trombosis venosa portal (TVP) es la oclusión de la vena por material trombótico con o sin extensión a otros segmentos del sistema venoso esplácnico (vena esplénica y mesentérica). La oclusión portal por un trombo ocurre con mayor frecuencia en pacientes con cirrosis, diagnosticándose en la mayoría de las ocasiones como un hallazgo casual en una prueba de imagen de rutina. No obstante, la TVP no cirrótica, pese a ser una patología poco frecuente con una prevalencia entre el 0,7–3,7 por cada 100000 habitantes, constituye la segunda causa más frecuente de hipertensión portal. Las manifestaciones clínicas dependen de la temporalidad (agudo o crónico) del evento. El diagnóstico de TVP se realiza mediante ecografía Doppler y se confirma la extensión y la presencia de factores asociados mediante (TC/RM) con contraste. Es fundamental de cara al abordaje terapéutico diferenciar si existe una cirrosis subyacente o aparece en un paciente no cirrótico. En ambos casos, la anticoagulación es el tratamiento indicado, no obstante, la duración de la misma depende de otros factores, entre los que se encuentran la extensión, la temporalidad y la existencia o no de patología protrombótica no tratable asociada. Además, en caso de fracaso de la anticoagulación se dispone de otros tratamientos alternativos, entre los que se encuentra la derivación postosistémica intrahepática transyugular.

La hipertensión portal de origen no cirrótico está constituida por un grupo heterogéneo de patologías de etiología intra- y extrahepáticas. En la mayoría de los casos existe una lesión de tipo vascular y se clasifican en: prehepática, hepática y posthepática según el sitio donde se produce la obstrucción al flujo sanguíneo. A pesar de su baja prevalencia, pueden condicionar una importante morbimortalidad en los pacientes afectados, generalmente jóvenes, por lo que es clave para el clínico tener un alto índice de sospecha e instaurar el tratamiento tan pronto como sea posible. Desde el punto de vista diagnóstico, la ecografía Doppler y la angiotomografía computarizada serán las pruebas más rentables. La medición de presiones portales y la biopsia hepática pueden ser indispensables según el contexto. La terapia dependerá de la etiología de la enfermedad. Tratar la causa de base cuando se conozca, retirar los fármacos hepatotóxicos y el inicio precoz de la anticoagulación serán la base de la mayoría de ellas. Las terapias endovasculares cada vez tienen más relevancia y el trasplante hepático puede ser una opción en los casos en los que se establezca insuficiencia hepática o cuando las complicaciones de la hipertensión portal hayan sido refractarias a los demás tratamientos.

Reducción de eventos cardiovasculares mayores (MACE) a 5 años en pacientes que sufrieron un síndrome coronario agudo (SCA) revascularizado percutáneamente y completaron un programa de rehabilitación cardiaca.

Non-melanoma skin cancer (NMSC) has risen dramatically as a result of chronic exposure to sunlight ultraviolet (UV) radiation, climatic changes and clinical conditions associated with immunosuppression. In spite of considerable progress, our understanding of the mechanisms that control NMSC development and their associated molecular and immunological landscapes is still limited. Here we demonstrated a critical role for galectin-7 (Gal-7), a β-galactoside-binding protein preferentially expressed in skin tissue, during NMSC development. Transgenic mice (Tg46)overexpressing Gal-7 in keratinocytes showed higher number of papillomas compared to WT mice or mice lacking Gal-7 (Lgals7−/−) when subjected to a skin carcinogenesis protocol, in which tumor initiator 7,12-dimethylbenz[a]anthracene (DMBA) and tumor promoter 12-O-tetradecanoyl-phorbol-13-acetate (TPA) were sequentially administered. RNAseq analysis of Tg46tumor lesions revealed a unique profile compatible with cells of the myelomonocytic lineage infiltrating these tumors, an effect that was substantiated by a higher number of CD11b+Gr1+cells in tumor-draining lymph nodes. Heightened c-Met activation and Cxcl-1 expression in Tg46lesions suggested a contribution of this pathway to the recruitment of these cells. Remarkably, Gal-7 bound to the surface of CD11b+Ly6ChiLy6Glomonocytic myeloid cells and enhanced their immunosuppressive activity, as evidenced by increased IL-10 and TGF-β1secretion, and higher T-cell inhibitory activity. In vivo, carcinogen-treated Lgals7−/−animals adoptively transferred with Gal-7-conditioned monocytic myeloid cells developed higher number of papillomas, whereas depletion of these cells in Tg46-treated mice led to reduction in the number of tumors. Finally, human NMSC biopsies showed increased LGALS7mRNA and Gal-7 protein expression and displayed transcriptional profiles associated with myeloid programs, accompanied by elevated CXCL1 expression and c-Met activation. Thus, Gal-7 emerges as a critical mediator of skin carcinogenesis and a potential therapeutic target in human NMSC.

La deshabituación tabáquica supone un reto en prevención secundaria. Los programas de rehabilitación cardiaca (PRC) incrementan los resultados de abstinencia. El objetivo fue valorar si una intervención antitabaco precoz (IAP) mejora la tasa de abstinencia obtenida tras un PRC.

Microalgal-bacterial membrane photobioreactors (MPBRs) have emerged as a transformative wastewater treatment technology for reducing carbon emissions whilst achieving high quality effluent. However, membrane fouling negatively affects process performance by increasing energy consumption and reducing membrane lifespan. In this study, light/dark photoperiods were varied to optimize treatment performance and biomass properties and reduce membrane fouling. Increasing the length of the light period favored higher production of biomass but decreased bioflocculation. An intermediate photoperiod of 16/8 h achieved high values of biomass concentration (3.21 ± 0.45 g L−1) and nutrient removal rates (4.71 mg N L−1d−1and 0.67 mg P L−1d−1, respectively), while preventing accumulation of biopolymer clusters (≤5.5 mg DOC L−1) in the suspension. In addition, short-term fouling—associated with floc deposition forming a cake layer—was minimized at intermediate photoperiods, thus increasing the sustainable (i.e., threshold) permeate flux. Under these sustainable flux conditions, membrane fouling was mainly determined by the biopolymer cluster content, with best performance being attained at 16/8 h. The above results reveal that the photoperiod is a crucial parameter for controlling membrane fouling in microalgal-bacterial membrane photobioreactors.

El acné es una enfermedad inflamatoria crónica de la unidad pilosebácea que afecta predominantemente la región facial, pudiendo alterar en gran medida la calidad de vida del paciente. Es una de las patologías dermatológicas más frecuentes y representa un número importante de consultas médicas. El acné se clasifica como comedoniano, papulopustuloso leve o moderado, papulopustuloso grave o nodular moderado, y acné grave noduloquístico o con tendencia a desarrollar cicatrices. Actualmente, existen tratamientos que pueden controlar sus síntomas y efectos a largo plazo. En el presente trabajo se desarrollan protocolos diagnósticos y terapéuticos de utilidad para el correcto manejo de la patología por parte del facultativo.

Las infecciones de transmisión sexual (ITS) son un problema de salud pública en aumento progresivo en las últimas décadas. Son especialmente preocupantes en el adolescente dada su vulnerabilidad. En este protocolo trataremos el abordaje diagnóstico y terapéutico de las ITS más frecuentes en el adolescente: gonococo, clamidia, sífilis, herpes y lesiones por el virus del papiloma humano (VPH).

Los inhibidores de la bomba de protones (IBP) son fármacos utilizados frecuentemente para el manejo de diferentes enfermedades gastrointestinales. Aunque sus indicaciones y dosis están bien establecidas, se han comunicado elevadas tasas de maluso.

Mepraia spinolai,(Porter) 1934, is a diurnal triatomine endemic to Chile and a wild vector of the protozoan Trypanosoma cruzi,(Chagas) 1909, which causes Chagas disease. Behavioral changes in M. spinolaiinduced by this parasite have been reported previously, which include detection of a potential host, defecation latency, and some life history traits. In this study we assessed changes in locomotor and daily activity due to infection with T. cruzi. No difference was detected in distance traveled between infected and uninfected individuals. However, the groups differed in their daily activity patterns; infected individuals showed significant reduction of movements during the light phase and concentrated their activity in the dark phase. Uninfected individuals showed no differences in locomotor activity between the phases. The results suggest that T. cruziinduces a displacement in the activity of M. spinolaitoward the dark phase of the circadian cycle, which may improve its vector competence.

Realizar una revisión sistemática sobre la aplicación de la Terapia de la Conciencia Corporal Basal (TCCB o BBAT) así como la calidad metodológica de la investigación realizada en pacientes con trastornos mentales.

Anaerobic digestion (AD) has been extensively investigated to obtain energy from chicken manure (CM). However, CM has high total and volatile solids (TS and VS) contents, making wet AD unsuitable for treatment due to high levels of water consumption and large digester volumes. Previous studies have shown that anaerobic codigestion (AcoD) of sewage sludge and wine distillery wastewater (SS:WDW) resulted in lower methane production (MP) values than those obtained in AD of SS alone due to the lower VS content of the WDW. The present study was carried out to address these challenges. AcoD of SS:WDW:CM is proposed here for the first time as an effective new alternative for managing three wastes in one and the same digester. To achieve this goal, different proportions of SS:WDW:CM (50:50:0; 49:49:2; 47:47:6; 44:44:12 w/w/w) were considered. Increasing the proportion of CM resulted in an increase both in MP (from 3.3 to 11.5 L CH4/L reactor) and SMP (from 197 to 229 L CH4/kg VS), along with high organic matter removal rates (% TCODr= 60 ± 3% and % VSr= 64 ± 3%). However, it also resulted in a reduced methane rate (from 0.116 to 0.045 d–1) and a longer lag phase (from 0.394 to 3.199 d) due to the high amount of nonsoluble organic matter in the CM. Optimal conditions were 44:44:12 (w/w/w) SS:WDW:CM, which resulted in removal rates of %VSr= 60%, SMP = 229 L CH4/kg VS, MP = 11.5 L CH4/L reactor, and methane productivity (at 30 days) = 0.38 L CH4/L reactor/d.

Although most of the patients affected by COVID-19 recover their health and return to their previous situation, some of them present symptoms that can last a long time after the acute illness. The main objective of this study is to assess the correlation between symptoms of long COVID and symptoms of central sensitization. Secondarily, it will try to describe the symptoms of long COVID and its correlation with alexithymia and depression.

To determine the patterns of antibiotic susceptibility of Escherichia colistrains isolated from adult patients with urinary tract infection (UTI), and to stratify the results by age and type of UTI to verify if there are statistically significant differences that can help physicians to prescribe better empirical antibiotherapy.

La compresión medular metastásica (CMM) es una complicación severa en pacientes con cáncer cuya incidencia es difícil de estimar con exactitud. El objetivo del presente estudio es describir la incidencia, las características epidemiológicas y el pronóstico de la compresión medular metastásica en pacientes con cáncer.

La profilaxis preexposición (PrEP) consiste en administrar fármacos antirretrovirales a personas seronegativas para el VIH con prácticas de alto riesgo, con el fin de reducir la probabilidad de adquirir la infección. A pesar de su eficacia y seguridad, en España, la PrEP aún no está disponible dentro del sistema sanitario público.

Comparar la PET/TC con 18F-FDG y la angioTC en el diagnóstico de la afectación extracraneal en pacientes con sospecha de vasculitis de grandes vasos (VGV).

Los trastornos relacionados con mutaciones del gen IRF6, comprenden desde una afectación casi asintomática con la única presencia de hoyuelos labiales que son la manifestación más sutil del síndrome de van der Woude, hasta manifestaciones congénitas graves que incluyen anomalías faciales, musculoesqueléticas y genitourinarias que corresponden al síndrome de pterigiumpoplíteo.

The crystal orientation fabric of ice reflects its flow history, information which is required to better constrain projections of future ice sheet behavior. Here we present a novel combination of polarimetric phase‐sensitive radar and seismic anisotropy measurements to provide independent and consistent constraints on ice fabric at Korff Ice Rise, within the Weddell Sea sector of West Antarctica. The nature and depth distribution of fabric in the ice column is constrained using the azimuthal variation in (1) the received power anomaly and phase difference of polarimetric vertical radar soundings and (2) seismic velocities and shear wave splitting measurements. Radar and seismic observations are modeled separately to determine the nature and strength of fabric within the ice column. Both methods indicate ice fabric above 200‐m depth which is consistent with present‐day ice‐divide flow. However, both measurements also indicate an oblique girdle fabric below 230‐m depth within the ice column, inconsistent with steady state divide flow. Our interpretation is that this deeper fabric is a remnant fabric from a previous episode of flow, which is currently being overwritten by ongoing fabric development associated with the present‐day flow regime. The preexisting fabric is consistent with ice flow from the south prior to ice‐divide formation, in agreement with models of Holocene ice sheet evolution. These findings apply new constraints to the flow history at Korff Ice Rise prior to divide formation and demonstrate the capacity of radar and seismic measurements to map fabric and thus constrain past ice flow. When ice flows its crystals become oriented in specific ways dependent on the way the ice is flowing, forming what we call a fabric. When this occurs in an ice stream the form of this fabric is determined by the flow direction and geometry of the ice stream bed. These fabrics remain imprinted within the ice but can become overwritten by new fabrics which result from a subsequent flow pattern. The study site here is Korff Ice Rise, which is an isolated area of grounded ice within the floating Ronne Ice Shelf in the Weddell Sea, West Antarctica. Here the ice flows in a very specific way, forming a characteristic fabric. We can measure this fabric using radar and seismic measurements. We also see an older fabric which must have formed when the ice was flowing differently. This older fabric is consistent with a time when the ice sheet was much thinner and ice was flowing from the continent of Antarctica further upstream, and over the current site. This study shows how measurements of fabric within Antarctic ice help us look at how the ice sheet behaved in the past. This past behavior would have affected global sea levels. Backscatter power anomaly and phase difference in polarimetric radar data have been used to constrain ice fabric variation with depthFabric derived from seismic observations is consistent with the fabric derived from radar measurementsFabric at Korff Ice Rise indicates a previous episode of grounded north‐south ice flow prior to ice divide formation

El objetivo de este estudio fue determinar la incidencia de miocardiopatía séptica (MS) en pacientes con sepsis y shock séptico, describir sus características y comprobar su evolución.

La pérdida de peso es un motivo frecuente de consulta que abarca múltiples posibilidades diagnósticas. El objetivo de este trabajo es estudiar las características de los pacientes que acuden a consulta por pérdida de peso y establecer la relación de esta con las neoplasias.

AbstractThis paper analyses the structure of boards of directors and its impact on business performance, which is approximated by economic profitability and the Tobin’s Q ratio. We focus on three basic aspects of boards that have been reviewed in the recent reform of the Good Governance Code: the size of boards, their independence and their diversity. For the study of diversity, we use an index that integrates not only the gender of board members, but also their age and nationality, since these are factors that can influence the knowledge, experience and skills of the directors. The results confirm a high degree of compliance with the recommendations of the Good Governance Code, and suggest that the performance of the advisory and monitoring functions are factors that determine the composition of boards. With respect to the performance of the company, we note that there is a negative and significant relationship with the independence of boards. However, the results are sensitive to the performance measure employed.

In recent years, traditional diets enriched with fresh plant-based foods have been gradually abandoned, increasing the consumption of animal foods and highly processed food. The aim of this study was to assess the effects of a nutritional intervention with a Traditional Mediterranean Diet in patients with recurring colds (RC) and frequent inflammatory complications (IC).

La pérdida del pene de causa iatrogénica es una circunstancia muy infrecuente. Se presenta un caso desafiante de reconstrucción peneana total diferida en varón genético.

El síndrome de Stevens-Johnson y la necrólisis epidérmica tóxica son 2 graves enfermedades inmunológicas dentro del contexto de síndrome mucocutáneo ampolloso, con diferente grado de afectación cutánea y que suelen presentar afectación de al menos 2 membranas mucosas.

The crystal orientation fabric of glacier ice impacts its strength and flow. Crystal fabric is therefore an important consideration when modeling ice flow. Here, we show that shear‐wave splitting (SWS) measured with glacial microseismicity can be used to invert seismic anisotropy and ice fabric, if represented in a statistical sense. Rutford Ice Stream (RIS) is a fast‐flowing Antarctic ice stream, a setting crucial for informing large‐scale ice sheet models. We present >200,000 SWS measurements from glacial microseismicity, registered at a 38‐station seismic network located ∼40 km upstream of the grounding line. A representative subset of these data is inverted for ice fabric. Due to the character of SWS, which accumulates along the raypath, we include information on the depth structure from radar measurements. We find that the following three‐layer configuration fits the data best: a broad vertical cone fabric near the base of RIS (500 m thick), a thick vertical girdle fabric, orientated perpendicular to flow, in the middle (1,200 m thick), and a tilted cone fabric in the uppermost 400 m. Such a variation of fabric implies a depth‐dependent strength profile of the ice with the middle layer being ∼3.5 times harder to deform along flow than across flow. At the same time, the middle layer is a factor ∼16 softer to shear than to compression or extension along flow. If such a configuration is representative for fast‐flowing ice streams, it would call for a more complex integration of viscosity in ice sheet models. We introduce a method to derive information on the ice viscosity of a >2 km thick Antarctic Ice Stream using very small earthquakes, which are created as the ice stream flows over its bed. When ice flows, the individual ice crystals rearrange in a specific configuration. This configuration can vary, depending on the direction of applied force, making the bulk ice harder or easier to deform. This behavior can be expressed through a variable, the ice viscosity. Here, we use the recordings of icequakes recorded at seismic stations on top of the ice to infer the configuration of ice crystals and through further mathematical calculations, the viscosity between the ice‐bed and the surface. Our results show that the crystal configuration and viscosity vary with depth, which severely affects the ice stream's behavior upon deformation. Such a behavior is so far not included in many numerical models which simulate the large‐scale behavior of ice streams. Split shear‐waves from basal microseismicity are used to invert for ice fabricThe preferred model has three depth layers of distinct fabric including a tilted cone, thick girdle, and vertical coneIce viscosity varies with depth, direction, and component of deformation, with significant implications for ice deformation Split shear‐waves from basal microseismicity are used to invert for ice fabric The preferred model has three depth layers of distinct fabric including a tilted cone, thick girdle, and vertical cone Ice viscosity varies with depth, direction, and component of deformation, with significant implications for ice deformation

Interdisciplinary research in the fields of ecohydrology and ecogeomorphology is becoming increasingly important as a way to understand how biological and physical processes interact with each other in river systems. The objectives of the current study were 1) to determine changes in invertebrate community due to hydrological stages, 2) to link local physical features [flow configuration, sediment composition and morphological feature) with the ecological structure between and within dissimilar morphological units (meander and confluence), and 3) to determine the existence and the origin of bed hydro-geomorphic patches, determining their ecological structure. Results were discussed in the frame of prevailing ecological models and concepts. The study site extends over a floodplain area of the large Paraná River (Argentina), including minor and major secondary channels as well as the main channel. Overall results suggested that hydrodynamics was the driving force determining distribution patterns of benthic assemblages in the floodplain. However, while the invertebrates living in minor secondary channels seem to benefit from flooding, this hydrological phase had the opposite effect on organisms from the main and major secondary channels. We also found a clear linkage between physical features and invertebrate ecology, which caused a dissimilar fauna structure between and within the meander and the confluence. Furthermore, several sandy-patches were recorded in the confluence. These patches were colonized by the particular benthic assemblage recorded in the main channel, supported the view of rivers as patchy discontinua, under uncertain ecological equilibrium. Hydrodynamics was the driving force influencing invertebrate ecology in lotic environments of a large river floodplainThere was a strong linkage between ecological structure and physical features between and within the meander and the confluenceThe presence and dynamics of sandy-patches supported the ecological view of rivers as patchy discontinua

En este artículo revisamos los puntos clave indispensables para realizar una correcta estadificación del cáncer de cérvix mediante resonancia magnética.

Primero, valorar la adherencia a las recomendaciones de la guía de práctica clínica de manejo de la infección por Clostridium difficilede las sociedades americanas de enfermedades infecciosas y epidemiología de 2010 y evaluar su influencia en la evolución de los pacientes. Segundo, identificar las recomendaciones no aplicadas en la práctica para su posterior implementación.

RESUMENEl propósito de este trabajo es analizar el impacto que la emisión de ADR no patrocinados, que no es decidida por la empresa sino por inversores estadounidenses, tiene sobre el valor de la empresa y si tiene consecuencias en la volatilidad de sus precios y en la actividad negociadora en el mercado bursátil español. Además analizamos qué características tienen las empresas españolas elegidas por los inversores para emitir sobre ellas ADR no patrocinados o involuntarios. Los resultados ponen de relieve que la emisión de ADR no patrocinados tiene un impacto positivo sobre el valor de la empresa. Además, observamos una reducción de la actividad negociadora y un aumento de la volatilidad, fundamentalmente en las horas en que permanecen abiertos ambos mercados. Finalmente, observamos que los inversores, a la hora de elegir empresas para invertir a través de ADR no patrocinados se deciden por empresas grandes, con presencia internacional y con oportunidades de crecimiento futuras.

La hepatitis C es una infección vírica que afecta a unos 180 millones de personas en el mundo. Se trata de la primera causa de trasplante hepático en nuestro país.

The incidence of bronchial hyperreactivity has increased to one-third of the population in developed countries, which requires the adoption of preventive and therapeutic measures. The objective of the present study was to assess the effects of a traditional Mediterranean diet on patients diagnosed with childhood asthma and determine if there is a beneficial effect from this dietary intervention.

Background.To calculate the 1-year prevalence of schizophrenia and related disorders in a catchment area of Malaga (Spain) and determine the prevalence by gender, dwelling (rural or urban) and socioeconomic area (deprived or non-deprived area).Method.This cross-sectional study comprised the mental health area covered by Carlos Haya Hospital. We used multiple large clinical databases and key informants to identify cases.Results.The mean 1-year prevalence of schizophrenia and related disorders was 6.27 per 1000. It was nearly double in men (8.45 per 1000) than in women (4.26 per 1000) (p< 0.001), with a male-to-female ratio of 1.98. The rate was higher in urban (6.64 per 1000) than rural areas (3.95 per 1000) (p< 0.0001) and in socioeconomic deprived areas (7.56 per 1000) than non-deprived areas (6.12 per 1000) (p= 0.005). For the subgroup of schizophrenia, the rates were: men, 5.88 per 1000 and women, 2.2 per 1000 (p< 0.0001), with a male-to-female ratio of 2.67. The rate was also higher in urban (4.2 per 1000) than rural areas (2.49 per 1000) (p< 0.0001) and in socioeconomic deprived areas (4.49 per 1000) than non-deprived areas (3.9 per 1000) (p =0.149).Conclusions.The use of multiple clinical sources of information not only from mental health services, but also from emergency departments, primary care and private settings revealed high prevalence rates of schizophrenia and related disorders. This diagnosis is more common in men and in cities. Such precise estimates of the prevalence of schizophrenia have important repercussions for resource allocation and policy planning.

This contribution illustrates the advantages of measures and indicators based on the notions of Shannon entropy which is widely implemented in thermodynamics, information theory, econometrics, and biology. The presented case study applies these indicators to a fleet of industrial assets, introducing innovatively the entropy concept to the field of availability. There is no reason to deal the effect of performance variables in assets independently without taking into account disparities in terms of reliability, operation hours, applied maintenance, operating conditions, and usage profiles, etc. Therefore, the characteristic of the method and their independence from the heterogeneity of the sample that compares is intended to be promising for applications in availability analysis. In other words, this research presents a derivation from well-known concepts such as the Gini, Hoover and Theil indices illustrating their application by the support of an example where attributes for different groups of assets are compared. To illustrate the application we are using two relevant and innovative scenarios as case study examples.

El cáncer de mama en mujeres jóvenes representa un grupo singular por su edad, diagnóstico, comportamiento tumoral, deseo genésico y pronóstico. Hemos realizado un estudio descriptivo retrospectivo entre 1995 y 2012 de 1.392 mujeres diagnosticadas en nuestro centro de cáncer de mama. Se seleccionó a 56 (4,02%) mujeres cuya edad al diagnóstico era <35 años. Se estudiaron diferentes variables como datos epidemiológicos, métodos diagnósticos, abordaje quirúrgico, resultados histológicos y tasa de supervivencia. Se realizo análisis estadístico con programa informático SPSS 15.0. La edad media fue de 31,83+2,92 (24-35) años. Existían antecedentes familiares de cáncer de mama en 11 (19,62%) pacientes. Una paciente había presentado previamente un cáncer de ovario (1,78%). Eran nulíparas 24 (42,85%) y 5 (8,92%) tuvieron una gestación tras el diagnóstico-tratamiento del cáncer de mama. Los hallazgos clínicos fueron la presencia de nódulos en 49 (87,5%). La ecografía mamaria fue indicada como 1.ermétodo diagnóstico por imagen en 35 (62,5%) casos. El tratamiento neodyuvante fue de elección en 6 (10,70%). El tratamiento quirúrgico fue indicado inicialmente en 49 (87,5%). La cirugía conservadora pudo realizarse en 23 (41,07%). El tipo histólógico más frecuente fue el carcinoma ductal infiltrante en 41 (73,2%). Respecto al seguimiento, 31 (55,35%) pacientes continúan vivas y en remisión completa. El tratamiento del cáncer de mama en pacientes jóvenes debe individualizarse. Siempre que sea posible se recomendará la realización de cirugía conservadora (valorando la quimioterapia neoadyuvante para disminuir el tamaño tumoral) así como la cirugía oncoplástica, ya que pueden contribuir a mejorar la calidad de vida sin empeorar la supervivencia de dichas pacientes.

Analizar las propiedades psicométricas de 2 herramientas de medida de la satisfacción con la atención recibida de la enfermera en atención primaria y estimar los valores de esta satisfacción y las características del paciente y el servicio asociadas con su variabilidad.