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The purpose of this pilot study was to examine the effectiveness of a 6-week workplace mindfulness- and self-compassion-based intervention (MSCBI) on perceived stress, burnout, immune functioning (assessed with the biomarker Immunoglobulin A), self-compassion, and experiential avoidance compared to a Workplace Stress Management Intervention. Both interventions were contextual, i.e., they were carried out in the workplace setting and during working hours. We followed a randomised controlled trial study design. The total sample was composed of 24 employees of an automotive company. One-way analyses of covariance between groups revealed significant differences in post-intervention levels of perceived stress, salivary Immunoglobulin A (sIgA), emotional exhaustion, self-compassion, and experiential avoidance, after adjusting for pre-test scores. The results of this study have several implications. Firstly, it confirms that MSCBIs might be more effective than regular psychoeducational interventions for work-related stress and burnout treatment. Secondly, sIgA can be used to assess immune function state changes when MSCBIs are carried out. Furthermore, these results indicate that it is feasible to carry out MSCBIs within companies and during working hours, and that these interventions can help effectively manage stress and burnout associated with the work environment. more...

Patients with obstructive sleep apnea (OSA) that do not tolerate/accept continuous positive airway pressure (CPAP) are candidates for surgical alternatives. Hypoglossal nerve stimulation (HNS) through the implantation of the Inspire (R) device constitutes a minimally invasive operative option. The main objective of this study is to estimate, under real-world clinical practice conditions, the 3-month impact on the quality of life (IQoL) of the HNS in patients with moderate/severe OSA who do not tolerate or accept CPAP, compared to patients who did not receive HNS. As a baseline, the unadjusted EuroQol utility index was 0.764 (SD:0.190) in the intervention group (IGr) and 0.733 (SD:0.205) in the control group (CGr); three months later, the indexes were 0.935 (SD: 0.101) and 0.727 (SD:0.200), respectively. The positive impact on quality of life was estimated to be +0.177 (95% CI: 0.044-0.310; p = 0.010). All dimensions in the IGr improved compared to CGr, especially for usual activities (p < 0.001) and anxiety/depression (p > 0.001). At the end of the follow-up, there was no significant difference in the quality of life between the general Spanish population and the IGr (difference: 0.012; CI95%: -0.03 to -0.057; p = 0.0578) for the same age range; however, there was a difference concerning the CGr (difference: -0.196; CI95%: -0.257 to -0.135; p < 0.001). In conclusion, patients with moderate/severe OSA implanted with the Inspire (R) device showed a positive IQoL. more...

Background The development of liver cirrhosis is usually an asymptomatic process until late stages when complications occur. The potential reversibility of the disease is dependent on early diagnosis of liver fibrosis and timely targeted treatment. Recently, the use of non-invasive tools has been suggested for screening of liver fibrosis, especially in subjects with risk factors for chronic liver disease. Nevertheless, large population-based studies with cost-effectiveness analyses are still lacking to support the widespread use of such tools. The aim of this study is to investigate whether non-invasive liver stiffness measurement in the general population is useful to identify subjects with asymptomatic, advanced chronic liver disease. Methods This study aims to include 30,000 subjects from eight European countries. Subjects from the general population aged ≥ 40 years without known liver disease will be invited to participate in the study either through phone calls/letters or through their primary care center. In the first study visit, subjects will undergo bloodwork as well as hepatic fat quantification and liver stiffness measurement (LSM) by vibration-controlled transient elastography. If LSM is ≥ 8 kPa and/or if ALT levels are ≥1.5 x upper limit of normal, subjects will be referred to hospital for further evaluation and consideration of liver biopsy. The primary outcome is the percentage of subjects with LSM ≥ 8kPa. In addition, a health economic evaluation will be performed to assess the cost-effectiveness and budget impact of such an intervention. The project is funded by the European Commission H2020 program. Discussion This study comes at an especially important time, as the burden of chronic liver diseases is expected to increase in the coming years. There is consequently an urgent need to change our current approach, from diagnosing the disease late when the impact of interventions may be limited to diagnosing the disease earlier, when the patient is asymptomatic and free of complications, and the disease potentially reversible. Ultimately, the LiverScreen study will serve as a basis from which diagnostic pathways can be developed and adapted to the specific socio-economic and healthcare conditions in each country. Trial registration This study is registered on Clinicaltrials.gov (NCT03789825). more...

OBJECTIVE: The objective of this study is to review three cases using urokinase in patients with urinary catheter obstructed by clots, as well to carry out a review of the published literature. METHODS: It was done a review of three cases from 2019 to 2020 who required urokinase due to urinary catheters obstructed by clots in our department. In addition, a reference search was performed in Pubmed. RESULTS: The first case was a woman with metastatic breast carcinoma who required nephrostomy placement. The second case was a renal trauma that required bladder catheterization. The third case was a male with a benign ureteric obstruction who required nephrostomy placement due to sepsis. After instillations with urokinase, the first two cases responded adequately, while the third was unsuccessful. CONCLUSIONS: Urokinase may be an effective and well-tolerated therapy in the treatment of coagulated urinary catheters that does not respond to other measures. more...

OBJECTIVE: The treatment of the ectopic ureter in the pediatric patient must be individualized in each case METHOD: Description of clinical cases, therapeutic management and evolution of patients. RESULTS: We present four pediatric patients with ectopic ureters who underwent surgery. We describe a case of laparoscopic nephroureterectomy, one of laparoscopic uretero-ureterostomy, one of bilateral ureteral reimplantation and another of unilateral reimplantation. The discussion about the diagnosis and different surgical treatments of each case is deepened. CONCLUSIONS: We present four cases of pediatric patients with ectopic ureters, treated by different surgeries. We present how was the preoperative diagnosis and the importance of individualizing the surgical treatment in each case. Aspects recently described in the context of ureteral ectopy, such as diagnostic evaluation by MRI or the role of minimally invasive techniques in treatment, should be taken into account in its management. more...

The mental health of university students is a public health concern, as psychopathology has significantly risen among this population. Mindfulness-based programs may support their mental health, though more research is needed. We used a two-armed pilot randomized controlled trial to study the feasibility, preliminary effectiveness, and potential mechanisms of a brief 6-week instructor-led mindfulness- and compassion-based program (MCBP for University Life) on perceived stress and psychological distress. Thirty undergraduate psychology students participated (15 in the intervention group, and 15 as wait-list controls). Those in the intervention arm engaged well with the course and formal at-home practice, attending at least five sessions and meditating between 4-6 days per week. Significant improvements in perceived stress, psychological distress, mindfulness skills, decentering, self-compassion, and experiential avoidance were found at the end of the intervention, while the wait-list group remained unchanged. There were significant differences between the two groups in those variables at post-test, favoring the intervention arm with major effects. Reductions in stress were mediated by improvements in mindfulness skills, decentering, and self-compassion; meanwhile reductions in psychological distress were mediated by improvements in decentering. These results suggest that this intervention might be feasible and effective for university students, but more high-quality research is needed. more...

El presente trabajo surge de un grupo de investigación sobre la enseñanza de la ciencia integrado por docentes de niveles educativos no universitarios (Infantil, Primaria y Secundaria y Adultos) y de nivel universitario (Escuela Universitaria de Magisterio). En este estudio abordamos el desarrollo de las competencias básicas a través de experiencias en el área de ciencias desde una concepción constructivista basadas en la utilización del método científico. Nuestro interés en este trabajo se centra en las etapas educativas de Infantil y de Adultos por la interrelación entre ambas etapas como consecuencia de la incidencia que los mayores como cuidadores tiene en la adquisición de competencias (lingüísticas, del mundo físico y natural…), en el desarrollo de hábitos y en la conquista de actitudes y valores en los más pequeños. more...

Objectives Inflammatory bowel disease (IBD) is a chronic and idiopathic gastrointestinal pathology whose bi-directional relation with psychological variables (e.g., quality of life, fatigue, and stress) has been studied in depth. Dispositional mindfulness has been related to a better quality of life and health in chronic diseases. The present study aims to examine the potential mediator influence of dispositional mindfulness in the association between disease severity and health-related quality of life, stress, and fatigue in IBD patients. Methods In a cross-sectional study, 152 patients diagnosed with IBD were recruited from the digestive unit of Sagunt Hospital (Spain) where they were receiving treatment. Dispositional mindfulness, fatigue, perceived stress, health-related quality of life, and illness severity were measured. Subsequently, descriptive statistical analyses, Pearson product-moment correlations, multivariate analysis of variance, and mediation analyses were performed. Results Dispositional mindfulness facets were positively associated with quality of life, lower fatigue, and lower perceived stress levels (except for the observe subscale). Mediation analyses showed that IBD severity (moderate vs. mild patients) indirectly influenced quality of life (ab = -6.16, 95% CI [-13.46, -0.76]), perceived stress (ab = 2.23, 95% CI [0.41, 4.24]), and fatigue (ab = 3.24, 95% CI [0.48, 6.66]) through its effect on the dispositional mindfulness facet "acting with awareness." Conclusions Dispositional mindful awareness seems to be a protective factor in addition to a promising intervention target in IBD patients, whose severity only influences quality of life, perceived stress, and fatigue through it. more...

OBJECTIVE: To describe the case of a patient with subcutaneous inguinal recurrence of penile cancer without lymph node involvement. METHODS: Description of a clinical case and review of the literature on the subject. RESULTS: We present the case of a 72-year-old man with penile cancer and extranodal inguinal extension that affected subcutaneous cell tissue, with a history of negative sentinel lymph node and subsequently without invasion of the regional lymph nodes in lymphadenectomy after chemotherapy. The patient presented disease progression despite multimodal treatment. CONCLUSION: Extranodal inguinal involvement in penile cancer may occur despite a history of negative sentinel lymph node. The evolution of the patient we presented was disastrous despite the multimodal treatment carried out. OBJETIVO: Describir el caso de un paciente con recurrencia inguinal subcutanea de cancer de pene sin afectacion ganglionar.METODOS: Descripcion de un caso clinico y revision de la literatura sobre el tema.RESULTADOS: Presentamos el caso de un hombre de 72 anos con cancer de pene y extension inguinal extranodal que afecto al tejido celular subcutaneo, con antecedente de ganglio centinelal negativo y posteriormente sin invasion de los ganglios linfaticos regionales en linfadenectomia tras quimioterapia. El paciente presento progresion de enfermedad a pesar de un tratamiento multimodal.CONCLUSION: La afectacion extraganglionar inguinal en cancer de pene puede producirse a pesar de un antecedente de ganglio centinela negativo para neoplasia. La evolucion del paciente que presentamos fue nefasta a pesar del tratamiento multimodal llevado a cabo. more...