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Resumen: Antecedentes y objetivo: La calidad de vida profesional se define como el bienestar derivado del equilibrio entre las exigencias del ámbito laboral y los recursos para afrontarlas, el deterioro de la calidad de vida profesional puede contribuir en el síndrome de burnout o del profesional quemado. El objetivo de este estudio consiste en evaluar mediante cuestionario validado la calidad de vida profesional de los dermatólogos españoles. Material y métodos: Se diseñó un estudio transversal que incluyó dermatólogos españoles que respondieran a un formulario autoadministrado enviado a través de aplicaciones de mensajería online. El formulario incluyó datos sociodemográficos, 3 preguntas de respuestas abiertas y el Cuestionario de Calidad de Vida Profesional (CVP-35). Resultados: Se incluyó a 106 participantes en este estudio, siendo un 58% (62/106) mujeres. La edad media fue de 41 años (intervalo de confianza [IC] del 95%: 43,3-38,8). Las puntuaciones para el dominio «carga de trabajo» de CVP-35 fueron superiores en las mujeres (p = 0,02) y en los jefes de servicio (p = 0,005). La presión asistencial fue el tema tratado con más frecuencia como factor limitante de la calidad de vida laboral, y el principal cambio identificado tras la pandemia de COVID-19. Conclusiones: En nuestro estudio las mujeres refirieron una mayor carga de trabajo. El incremento de carga asistencial y de trabajo a distancia fueron los principales cambios por la pandemia de COVID-19. La presión asistencial es una gran limitante de la calidad de vida profesional de nuestros compañeros, reducirla mejoraría la satisfacción diaria y la calidad asistencial. Abstract: Background and objective: Quality of professional life (QPL) is defined as a sense of well-being derived from a balance between the challenges of work and the resources available to deal with them. Impaired QPL can contribute to burnout. The aim of this study was to evaluate QPL in Spanish dermatologists using a validated questionnaire. Material and methods: We designed a cross-sectional study in which Spanish dermatologists were invited to complete an online questionnaire sent out by messaging applications. The dermatologists were asked to provide sociodemographic information, answer 3 open questions, and complete the 35-item Spanish QPL questionnaire (Spanish abbreviation, CVP-35). Results: We analyzed the information submitted by 106 dermatologists (62 women, 58%) with a mean age of 41 years (95% CI, 43.3-38.8 years). Women and department heads scored significantly higher in the workload domain of the questionnaire (P = .02 and P = .005, respectively). A heavy caseload was mentioned as the main factor contributing to impaired QPL and the main change in the wake of the COVID-19 pandemic. Conclusions: Female dermatologists reported heavier workloads. Heavy caseloads and more remote work were the main changes identified after the COVID-19 pandemic. Heavy caseloads have a significant impact on the QPL of dermatologists in Spain. Reducing caseloads would improve general job satisfaction and quality of care provision.

Background: The COVID-19 pandemic may have adversely affected the early diagnosis of skin cancer. Objective: To compare epidemiological, clinical and histopathological characteristics in patients undergoing cutaneous squamous cell carcinoma (SCC) surgery before and after the beginning of the pandemic. Material & methods: We conducted a cross-sectional study including two case series: (1) patients operated on for SCC in the year after the first state of alarm in Spain (15 March 2020), and (2) patients with SCC operated on in the previous year. Epidemiological, clinical and histopathological variables, tumour stage and risk grade were collected. Results: 248 patients were included (127 undergoing surgery before the pandemic and 121 after the pandemic). After the beginning of the pandemic, the percentage of high-risk SCC significantly increased from 35.3% to 46.2% (p = 0.011). However, no significant differences were found in thickness, perineural invasion or metastases. Conclusions: Although there has not been a significant reduction in the number of SCC operated on after the pandemic, there has been a significant increase in high-risk SCC. All this could lead to an increase in skin cancer mortality in the future. Resumen: Antecedentes: La pandemia de COVID-19 ha podido afectar negativamente el diagnóstico precoz del cáncer de piel. Objetivo: Comparar las características epidemiológicas, clínicas e histopatológicas en los pacientes intervenidos de carcinoma de células escamosas (CCE) cutáneo antes de la pandemia y después del inicio de la pandemia. Material y métodos: Se diseñó un estudio transversal que incluía 2 series de pacientes: 1) pacientes intervenidos de CCE el año posterior a la declaración del confinamiento general en España (15 de marzo de 2020), y 2) pacientes intervenidos de CCE el año previo. Se recogieron variables epidemiológicas, clínicas e histopatológicas, así como el estadio tumoral y el grado de riesgo. Resultados: Se incluyeron 248 pacientes (127 intervenidos antes de la pandemia y 121 intervenidos después de la pandemia). Tras el inicio de la pandemia, el porcentaje de CCE de alto riesgo aumentó significativamente de 32,3 a 45,5% (p = 0,011). No obstante, no se encontraron diferencias significativas en el grosor tumoral, la invasión perineural o la presencia de metástasis. Conclusiones: Aunque no se produjo una reducción significativa en el número de CCE intervenidos después de la pandemia, ha habido un incremento significativo en los CCE de alto riesgo. Todo ello puede conllevar un incremento en la mortalidad por cáncer de piel en el futuro.

Atopic dermatitis is a prevalent skin condition that affects up to 17% of adult population. It can lead to itching, pain, and other symptoms such as sleep disturbance, anxiety, and depression. Due to its high prevalence and limiting symptoms, atopic dermatitis often has a great impact on patients’ quality of life but there is scarce information regarding how atopic dermatitis affects women’s sexual health and reproductive desires. The purpose of this article was to assess the impact of atopic dermatitis on sexual function and reproductive wishes in women. A cross-sectional study was conducted from February to March 2022. A total of 102 women with atopic dermatitis were recruited through online questionnaires sent through the Spanish Atopic Dermatitis Association; 68.6% of the patients acknowledged impairment in sexual function, especially those with more severe disease and those with genital and gluteal involvement. In addition, 51% of the women considered that atopic dermatitis may have an influence on their gestational desire, particularly those with gluteal involvement. In conclusion, atopic dermatitis has a great impact on sexual function and reproductive desires in women.

Most of the therapeutic systems developed for managing chronic skin wounds lack adequate mechanical and hydration properties, primarily because they rely on a single component. This study addresses this issue by combining organic and inorganic materials to obtain hybrid films with enhanced mechanical behavior, adhesion, and fluid absorption properties. To that aim, chitosan/hydrolyzed collagen blends were mixed with halloysite/antimicrobial nanohybrids at 10% and 20% (w/w) using glycerin or glycerin/polyethylene glycol-1500 as plasticizers. The films were characterized through the use of Fourier-transform infrared (FTIR) spectroscopy, thermogravimetric analysis (TGA), and electron microscopy. The mechanical properties were evaluated macroscopically using tensile tests, and at a nanoscale through atomic force microscopy (AFM) and nanoindentation. Thermodynamic studies were conducted to assess their hydrophilic or hydrophobic character. Additionally, in vitro cytocompatibility tests were performed on human keratinocytes. Results from FTIR, TGA, AFM and electron microscopy confirmed the hybrid nature of the films. Both tensile tests and nanomechanical measurements postulated that the nanohybrids improved the films’ toughness and adhesion and optimized the nanoindentation properties. All nanohybrid-loaded films were hydrophilic and non-cytotoxic, showcasing their potential for skin wound applications given their enhanced performance at the macro- and nanoscale.

To date, the need for biomaterials capable of improving the treatment of chronic skin wounds remains a clinical challenge. The aim of the present work is to formulate and characterize chitosan (Cs)/hydrolyzed collagen (HC) films as potential biomaterials with improved mechanical and hydration performances compared to single component formulations. Films were made by the solvent casting method, with or without glycerin and/or PEG1500 as plasticizers, resulting in a total of eight formulations. All films were characterized by their physico-chemical characteristics and their mechanical and hydration features. A full factorial design was also used to statistically assess the effect of HC concentration, type and concentration of plasticizers and their possible interactions on mechanical and swelling behaviors. Solid state characterization confirmed the hybrid nature of the films, with suggested electrostatic interactions between Cs and HC. Mechanical and swelling properties, along with the analysis of the experimental design, allowed the identification of formulations containing high HC concentration (2% w/v) and glycerin or glycerin/PEG1500 as more suitable candidates for skin wound treatment. Finally, viability assay of immortalized human keratinocytes (HaCaT) showed no statistical differences in cell survival compared to the complete culture medium, suggesting their potential as a promising tool for biomedical applications.

La existencia de agentes biológicos como el virus de la peste porcina clásica para la producción de vacunas veterinarias, entre otros de igual importancia para nuestro país y la región en general, justifica una buena gestión de la seguridad biológica, ya que el desconocimiento del riesgo por parte del personal que labora en estas vacunas puede provocar contaminaciones de graves consecuencias medio ambientales, en el proceso de producción y a nivel personal si son causantes de accidentes fatales. El objetivo de la investigación fue realizar un análisis de la percepción de riesgo existente en el personal responsable del proceso de producción de la vacuna contra la peste porcina clásica. La aplicación del RISKPERCEP en el personal de la instalación de producción de la vacuna de la peste porcina clásica mostró como resultados el comportamiento de diferentes variables que hacen evidente la alta subestimación del riesgo existente en el personal evaluado y que existe la necesidad de profundizar en la formación en bioseguridad para todo el personal que labora en el proceso. Finalmente, se relacionan estos temas y su importancia para mejorar la calidad de la producción en estos procesos, así como incrementar el conocimiento acerca del riesgo biológico a todos los niveles.

La importancia que tienen para la avicultura cubana el virus de la enfermedad infecciosa de la bolsa (Gumboro) y el virus de la viruela aviar, así como la producción de vacunas que permitan controlar las enfermedades producidas por estos agentes biológicos, justifican la necesidad del establecimiento de una buena gestión de la bioseguridad, ya que el desconocimiento de los peligros y riesgos del personal que labora en estas vacunas puede provocar accidentes de consecuencias indeseables para el producto, escapes de estos microorganismos durante sus procesos productivos y la consecuente contaminación del medio ambiente. El objetivo de la presente investigación fue realizar un análisis de la percepción de riesgo existente en el personal responsable del proceso de producción de dos vacunas aviares. Para ello se utilizó el software RISKPERCEP en una instalación de producción de vacunas aviares; su aplicación mostró variables que demostraron subestimación del riesgo por el personal expuesto y variables con tendencia a la sobrestimación, asociadas fundamentalmente al incorrecto diseño de la instalación. Se concluye que existe la necesidad de una buena capacitación y que se impartan cursos de actualización de bioseguridad donde se tengan en cuenta todos los aspectos del diseño del laboratorio que puedan solucionarse.

Las medidas de bioseguridad son el conjunto de conductas mínimas a ser adoptadas, a fin de reducir o eliminar los riesgos para el personal, la comunidad y el medio ambiente. Los laboratorios veterinarios manipulan materiales biológicos que pueden suponer riesgos biológicos tanto para los animales como para el hombre, por lo que los profesionales de estos laboratorios están expuestos a una variedad de riesgos relacionados con su trabajo que pueden afectar su salud. El objetivo de este trabajo fue evaluar el riesgo en el control de calidad de las vacunas virales mediante el uso del método BIOGAVAL, una forma cómoda y fiable de evaluar el riesgo de exposición a agentes biológicos. El estudio se realizó en la Unidad Empresarial de Base Control de la Calidad de la Empresa Productora de Vacunas Virales y Bacterianas el cual pertenece a LABIOFAM. La muestra de estudio estuvo conformada por 18 trabajadores, distribuidos en tres áreas. En los resultados obtenidos para valores superiores a 12 del nivel de acción biológica se requiere la adopción de medidas preventivas para reducir la exposición en el caso de Avulavirus, Pestivirus y Coronavirus, mientras que para Alphavirus se requieren acciones correctoras inmediatas ya que representa una situación de riesgo intolerable.

Most of the therapeutic systems developed for managing chronic skin wounds lack adequate mechanical and hydration properties, primarily because they rely on a single component. This study addresses this issue by combining organic and inorganic materials to obtain hybrid films with enhanced mechanical behavior, adhesion, and fluid absorption properties. To that aim, chitosan/hydrolyzed collagen blends were mixed with halloysite/antimicrobial nanohybrids at 10% and 20% (w/w) using glycerin or glycerin/polyethylene glycol-1500 as plasticizers. The films were characterized through the use of Fourier-transform infrared (FTIR) spectroscopy, thermogravimetric analysis (TGA), and electron microscopy. The mechanical properties were evaluated macroscopically using tensile tests, and at a nanoscale through atomic force microscopy (AFM) and nanoindentation. Thermodynamic studies were conducted to assess their hydrophilic or hydrophobic character. Additionally, in vitro cytocompatibility tests were performed on human keratinocytes. Results from FTIR, TGA, AFM and electron microscopy confirmed the hybrid nature of the films. Both tensile tests and nanomechanical measurements postulated that the nanohybrids improved the films' toughness and adhesion and optimized the nanoindentation properties. All nanohybrid-loaded films were hydrophilic and non-cytotoxic, showcasing their potential for skin wound applications given their enhanced performance at the macro- and nanoscale. [ABSTRACT FROM AUTHOR]

BackgroundSweden is rapidly becoming an increasingly multicultural and digitalized society. Encounters between pediatric nurses and migrant mothers, who are often primary caregivers, are impeded by language problems and cultural differences. To support mothers, doulas, who are women having the same linguistic and cultural backgrounds, serve as cultural bridges in interactions with health care professionals. In addition, information and communication technology (ICT) can potentially be used to manage interactions owing to its accessibility. ObjectiveThe objective of this study was to investigate the role of ICT in managing communicative challenges related to language problems and cultural differences in encounters with migrant mothers from the perspectives of Swedish pediatric nurses and doulas. MethodsDeep semistructured interviews with five pediatric nurses and four doulas from a migrant-dense urban area in western Sweden were audio recorded, transcribed, and analyzed using thematic content analysis. ResultsThe results showed that ICT contributes to mitigating communicative challenges in interactions by providing opportunities for nurses and migrant mothers to receive distance interpreting via telephones and to themselves interpret using language translation apps. Using images and films from the internet is especially beneficial while discussing complex and culturally sensitive issues to complement or substitute verbal messages. These findings suggest that ICT helps enable migrant mothers to play a more active role in interactions with health care professionals. This has important implications for their involvement in other areas, such as child care, language learning, and integration in Sweden. ConclusionsThe findings of this study suggest that ICT can be a bridging tool between health care professionals and migrants. The advantages and disadvantages of translation tools should be discussed to ensure that quality communication occurs in health care interactions and that health information is accessible. This study also suggests the development of targeted multimodal digital support, including pictorial and video resources, for pediatric care services.

To date, the need for biomaterials capable of improving the treatment of chronic skin wounds remains a clinical challenge. The aim of the present work is to formulate and characterize chitosan (Cs)/hydrolyzed collagen (HC) films as potential biomaterials with improved mechanical and hydration performances compared to single component formulations. Films were made by the solvent casting method, with or without glycerin and/or PEG1500 as plasticizers, resulting in a total of eight formulations. All films were characterized by their physico-chemical characteristics and their mechanical and hydration features. A full factorial design was also used to statistically assess the effect of HC concentration, type and concentration of plasticizers and their possible interactions on mechanical and swelling behaviors. Solid state characterization confirmed the hybrid nature of the films, with suggested electrostatic interactions between Cs and HC. Mechanical and swelling properties, along with the analysis of the experimental design, allowed the identification of formulations containing high HC concentration (2% w/v) and glycerin or glycerin/PEG1500 as more suitable candidates for skin wound treatment. Finally, viability assay of immortalized human keratinocytes (HaCaT) showed no statistical differences in cell survival compared to the complete culture medium, suggesting their potential as a promising tool for biomedical applications. [ABSTRACT FROM AUTHOR]

En el campo de la nutrición artificial por vía parenteral (NP) se debate en torno a la aplicación de conceptos como estandarización, individualización, protocolización o normalización. Las Unidades de Nutrición Artificial (UNA) que diseñan o revisan su sistema de provisión de NP deben tener en cuenta las referencias metodológicas y normativas existentes así como los recursos de que dispone para realizar el proceso. El objetivo de este trabajo consiste en revisar y evaluar las posibilidades existentes para diseñar un proceso eficiente y seguro aplicando la metodología de la mejora continua de la calidad. Se revisan los requerimientos actuales en términos de calidad de formulación, seguridad y contención de costes así como los recursos disponibles para no mermar las posibilidades de adaptar el tratamiento a las necesidades del paciente ni comprometer su eficacia. La solución al problema de si el enfoque escogido en el sistema de provisión de NP es adecuado debe venir de la revisión de la calidad del servicio a través de la evaluación de indicadores tanto de proceso como de resultado. En esta labor el farmacéutico del hospital juega un papel relevante como agente garante del cumplimiento de las normas de buena práctica.In the field of parenteral artificial nutrition (PN) there is debate over the application of such concepts as standardisation, individualisation, protocolisation and normalisation. Artificial Nutrition Units (ANU) that are designing or reviewing their PN provision system must take into account the existing methodological and regulatory references as well as the resources available for implementing the process. The aim of this article is to review and evaluate the possibilities that exist for designing an efficient, safe process, applying the methodology of continuous quality improvement. Current requirements are reviewed in terms of quality of formulation, safety, and cost containment, as well as the resources available to avoid jeopardising the possibilities of adapting the treatment to suit patient needs or compromising its efficacy. The solution to the problem of whether the chosen approach in the system of PN provision is appropriate must come from review of the quality of service through the evaluation of indicators both of process and results. In this task, the hospital pharmacist plays a significant role as an agent in guaranteeing compliance with good practice guidelines.

Objetivo: Comunicar los datos del registro de Nutrición Parenteral Domiciliaria (NPD) del grupo de trabajo NADYA-SENPE del año 2006. Material y métodos: Recopilación de los datos del registro "on-line" introducidos desde el 1 de enero al 31 de diciembre de 2006. Resultados: Se registraron 103 pacientes con NPD (47 hombres y 56 mujeres), pertenecientes a 19 centros hospitalarios. Edad media: 53,3 ± 14,9 años (para los 91 pacientes ≥ 14 años, y 2 ± 0 años (para los 12 pacientes > 14 años). Patología más frecuente: neoplasia (29%) seguida de alteraciones de la motilidad intestinal (13%). Motivo de indicación: 40% síndrome de intestino corto, seguido de obstrucción intestinal (22%) y malabsorción (21%). Catéteres más utilizados: tunelizados (45%) y reservorios subcutáneos (32%). Complicaciones mas frecuentes: sépticas relacionadas con el catéter (0,85 infecciones por cada mil días de NPD). Duración de la NPD: > 2 años en el 50% de casos. Al acabar el año seguía en activo el 70,9% de los pacientes; la muerte fue la principal causa de la finalización de la NPD (53%). El 52% de los pacientes recibíeron alimentación oral o enteral complementaria. El 48% de los pacientes tenían un nivel de actividad normal, siendo autónomos el 55% del total. El hospital suministró la formula de NP en el 82% de los casos y el material fungible en el 78%. Se consideraron candidatos a trasplante intestinal el 27% de los pacientes. Conclusiones: Se observa un aumento de los pacientes registrados respecto a años anteriores con una prevalencia muy variable según comunidades autónomas. La principal patología sigue siendo la neoplasia, que ocupa el primer lugar desde 2003. Se aprecia una disminución de las complicaciones sépticas relacionadas con el catéter respecto a 2004 y 2005.Objective: To report the data of the Home Parenteral Nutrition (HPN) registry of the NADYA-SENPE working group for the year 2006. Methodology: We compiled the data from the on-line registry introduced by the responsible Units for the monitoring of HPN from January 1st to December 31st 2006. Results: 103 patients with HPN were registered (47 males and 56 females), belonging to 19 hospitals. Average age for the 91 patients older than 14 years old was 53.3 ± 14.9 years old, and that for the 12 patients under 14 years old was 2 ± 0 years old. Most frequent pathology was neoplasm (29%), followed by intestinal motility disorders (13%). The reason for HPN provision was short bowel syndrome (40%), intestinal obstruction (22%), and malabsorption (21%). Tunneled catheters were mostly used (45%), followed by implanted port-catheters (32%). Catheter related infections were the most frequent complications, with a rate of 0.85 episodes / 103 days. HPD was provided for more than two years in 50% of the cases. By the end of 2006, 70.9% of the patients remained active; exitus was the most frequent reason to end HPN (53%). Complementary oral or enteral nutrition was provided to 52% of the patients. 48% of the patients had a normal activity level, and a 55% were autonomous. PN formula was supplied by the hospital in 82% of the cases, while this number was 78% for fungible materials. 27% of the patients were eligible for intestinal transplant. Conclusions: We observe an increase in registered patients with respect to previous years, with a very different prevalence among regions. Neoplasia remains as the main pathology since 2003. We observe a decrease in catheter-related infections with respect to the 2004-2005 period.

Objetivo: Análisis descriptivo y valoración de los datos registrados por el Grupo de Trabajo NADYA-SENPE de pacientes que han recibido nutrición parenteral domiciliaria (NPD) en nuestro país durante el año 2000. Material y métodos: Se han recopilado datos (epidemiológicos, diagnóstico, vía de acceso, complicaciones, reingresos hospitalarios, duración del tratamiento y evolución) a partir de un cuestionario previamente diseñado para ello. Los datos obtenidos del cuestionario se introdujeron en una base de datos para la ulterior gestión de los mismos. Resultados: Los datos correspondían a 67 pacientes (edad media de 5 ± 4 años para pacientes < 14 años y 48 ± 15 años para ≥ 14 años) controlados por 14 centros hospitalarios. Las patologías que con más frecuencia han comportado este tratamiento fueron: isquemia mesentérica (28,4%), seguida de enfermedad neoplásica (16,4%), enteritis rádica (13,4%), alteraciones de la motilidad (7,5%) y enfermedad de Crohn (2,9%), entre otras. Se observó un predominio de los catéteres tunelizados (77,6%) sobre los implantados (20,9%), y de la administración cíclica (nocturna) de la nutrición parenteral (NP) (91,0%). Las farmacias hospitalarias suministraron las fórmulas de NPD con más frecuencia que el Nutriservice (71,5% frente a 19,4%). La duración media del tratamiento fue de 7,48 ± 4,39 meses. Se presentaron 0,32 complicaciones/100 días de NPD relacionadas con el tratamiento nutritivo con predominio de las infecciosas (0,12 sepsis por catéter/100 d de NPD), seguidas de las metabólicas (0,06/100 d de NPD), y de las mecánicas (0,03/100 d de NPD) e hidroelectrolíticas (0,03/100 días de NPD). Estas complicaciones comportaron 0,3 hospitalizaciones/ 100 días de NPD. Al finalizar el año, seguían en activo 61,2% de los pacientes; 37,3% habían abandonado el tratamiento (exitus 40%, nutrición oral 48% y nutrición enteral 4%), y 1,5% pacientes habían dejado de ser controlados por el equipo inicialmente responsable. Conclusiones: Podemos concluir que existe un incremento del registro de la NPD en nuestro país (1997: 0,7 pacientes/10(6) habitantes, 2000: 1,9 pacientes/10(6) habitantes), que hay un predominio de patología vascular y que la incidencia de complicaciones, retirada del tratamiento e ingresos hospitalarios son semejantes a otras series lo que avala la calidad del tratamiento.Aim: We analyze the registered data of home parenteral nutrition (HPN) in our country during the year 2000. Method: The data were collected through a previously designed questionnaire. Apart from epidemiological information, the form includes the disease to prescribe this treatment, the specific nutritional treatment used and its duration, access path, complications and readmission rate in hospital, follow-up of the treatment, and progress. All data were processed and analysed by the co-ordinating team. Results: Fourten hospitals participated, and 67 pacientes were enrolled. Middle age was 5 ± 4 years for patients < 14 years old, and 48 ± 15 years for those ≥ 14 years old. The more prevalent diagnosis were: ischemic bowel (28.4%), neoplasm (16.4%), radiation enteritis (13.4%), motility disorders (7.5%), Crohn’s disease (2.9%), and other. The mean time on HPN was 7.5 ± 4.4 months. Tunelized catheter was the preferential route (77.6%), followed by the implantated one (20.9%). The intermittent method (nocturnal) was preferential (91.0%). Patients receive the formula from hospital pharmacy more frequently than from Nutriservice (71.5% versus 19.4%). The complications related to nutrition (0.32/100 days of HPN) included the infections (0,12 catheter sepsis/100 d of HPN), metabolic (0.06/100 d of HPN), mechanic (0.03/100 d of HPN) and electrolitic disorders (0.03/100 d of HPN). The readmission rate, for nutritional problems, was 0,3 hospitalizations /100 d of HPN. At the end of the year, 61.2% of the patients remained in the HPN program, 37.3% abandoned the treatment (due to death (40%), to progress to oral feeding (48%), and to progress to enteral nutrition (4%); and 1.5% of the patients were not follow up. Conclusions: This review illustrates that there is an increment in the registration of HPN patients in our country (1997: 0.7 pacients/10(6) habitants, 2000: 1.9 pacients/ 10(6) habitants), that vascular pathology is the more frequent diagnoses in HPN patients, and the rate of readmission and complications and the behaviour is similar to other series making this as a safe treatment in our place.

Objetivo: Un año más, el Grupo de Trabajo NADYA-SENPE, presenta el análisis del registro de los pacientes con Nutrición Enteral Domiciliaria (NED) de nuestro país correspondiente al año 2000. Material y métodos: La información se ha recogido en un cuestionario cerrado incluido en nuestra página web (www.nadya-senpe.com). Este formulario incluye datos epidemiológicos, indicación del motivo de este tratamiento, pauta de tratamiento y vía de acceso, complicaciones y hospitalizaciones, seguimiento de los pacientes, calidad de vida y evolución. Los datos son procesados y analizados por el equipo coordinador. Resultados: Se han registrado datos de 22 hospitales que representan un total de 2.986 pacientes analizados, con una edad media de 65,1 ± 19,7 años. Predominio de pacientes con alteraciones neurológicas (41,2%), seguidos de los neoplásicos (33,3%). El tiempo medio de NED fue 6,3 ± 4,4 meses. Se observó una elevada prevalencia de la vía oral (50,8%), seguido de la administración a través de sonda nasogástrica (SNG) (30,5%), siendo el porcentaje de ostomías de un 17,4%. La fórmula polimérica fue la más utilizada en un 83,2%. Los pacientes fueron controlados, mayoritariamente, por la unidad de nutrición de su hospital de referencia (70,1%). Las complicaciones, relacionadas con la nutrición, más frecuentemente observadas fueron las gastrointestinales (0,25 complicaciones/paciente), seguidas de las mecánicas (0,19 complicaciones/paciente), y de las metabólicas (0,007 complicaciones/pacientes). Se realizaron 0,3 cambios de sonda/paciente/año. Se registraron 0,03 hospitalizaciones/ paciente, asociadas a la nutrición. Al finalizar el año, el 54,9% de los pacientes continuaban en activo, mientras que en un 30,3% se suspendió la NED por diversos motivos. El 21,9% no presentaba incapacidad o el grado de la misma era ligero. Conclusiones: Existe un incremento, en relación a años previos en el número de pacientes con NED registrados. Persiste el gran peso de las patologías neurológicas y oncológicas en este tratamiento a domicilio. Probablemente, por existir un elevado número de pacientes oncológicos, la administración de la NED por boca es elevada. A destacar que hay pocos pacientes con ostomías. Finalmente, la NED en nuestro país es un tratamiento seguro con bajo número de complicaciones.Goal: Once again, the NADYA-SENPE Working Group analysed the registered data of Home Enteral Nutrition (HEN) in our country, during the year 2000. Material and methods: The data were collected through a closed questionnaire included on our web site (www.nadya-senpe.com). Apart from epidemiological information, the form includes the indication to prescribe this treatment, the specific nutritional treatment used and its duration, access path, complications and readmission rate in hospital, follow-up of the treatment, patient’s quality of life and progress. All data were processed and analysed by the co-ordinating team. Results: Twenty two hospital participated and 2,986 patients, aged 65.1 ± 19.7 years, were enrolled. Of these patients, 41.2% were diagnosed with neurological diseases and 33.3% with cancer. The mean time on HEN was 6.3 ± 4.4 months. Oral nutrition was the preferential route (50.8%), followed by nasoenteral tube (30.5%), and in 17.4% ostomy tubes were placed. Polymeric was the formula composition mainly used (83.2%). Patients were followed (70.1 %) by the hospital reference Nutritional Support Unit. The complications related to nutrition included the gastrointestinal (0.25 complications/ patient), the mechanical one (0.19 complications/patient), and the metabolic (0.007 complications/ patient). Feeding tube need to be replaced 0.3 times/ patient/year. The readmission rate, for nutritional problems, was observed in 0.03 patients. At the end of the year, 54.9% of the patients were in the HEN program, and in 30.3% HEN was finish due to different reasons. In 21,9% of the patients no, o light, discapacity degree was found. Conclusions: Related to previous years, there is an increment in the number of enrolled patients. Neurological diseases and cancer were the more frequent diagnoses in HEN patients. Oral access was the higher feeding route due, probably, to the high prevalence of cancer patients. In spite of the elevated prevalence of neurological diseases, a few number of patients were feed with ostomy tube. Finally, due to the few readmission rate and complications, HEN is a safe treatment in our country.

Background: Surgery is an essential part of hidradenitis suppurativa (HS) treatment. Understanding and reducing surgical recurrence are crucial to obtaining the best results in patients' treatment. Objective: The aim of the study was to characterize surgical recurrences in a cohort of patients with HS treated with wide excision and second-intention healing. Methods: A prospective nested case-control study was conducted. A cohort of patients with HS treated with wide excision and second-intention healing was monitored for 68 weeks. The surgical procedure was classified as case (recurrence) or control (no recurrence). The type of recurrence was classified according to the elementary lesion in tunnel or abscess and inflammatory nodule (AN) recurrence. Sociodemographic and clinical data likely related to recurrence and the type of recurrence were evaluated. Results: Sixty-three patients were included, receiving a total of 82 surgical procedures. The mean age of the patients was 36.18 years, and the surgical site presented a Hurley stage II severity in 79.26% (65/82) of the interventions. Tunnel recurrence was observed in 8.5% (7/82) and AN recurrence in 15.85% (13/82) of the interventions. Obesity was associated with a higher risk of recurrence, for both tunnel and AN recurrence. Hurley III at the surgical site, a history of pilonidal sinus, and higher International Hidradenitis Suppurativa Severity Score System (IHS4) after surgery and at week 68 increased the risk of tunnel recurrence. Conclusion: We propose classifying surgical recurrence based on the elemental type of lesion. Tunnel recurrence could originate in the depth of the surgical scar and could be associated with both surgical site factors and inflammatory load. AN recurrence could originate in the borders of the surgical scar and may particularly benefit from preoperative ultrasound. [ABSTRACT FROM AUTHOR]

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the hair follicle which presents with painful nodules, abscesses, and fistulae in apocrine gland-bearing areas of the skin. Approved treatments include antibiotics and biologic drugs such as adalimumab. Despite these treatments, HS management is challenging. Acitretin is an oral retinoid used for its management as 3rd or 4th line therapy. There is little evidence regarding the effectiveness and safety of acitretin treatment for HS, and no reports have previously explored the potential clinical predictors associated with the response to the treatment. Methods: Retrospective cohort study to assess the effectiveness and safety of acitretin treatment in HS patients who failed to respond to topical therapies. Results: Sixty-two patients with moderate to severe HS were included. A significant decrease in the International HS Severity Scoring System (IHS4) score was found over time. Higher basal IHS4 score, family history of HS, follicular phenotype, and history of follicular plugging conditions were potential predictors of response. Most patients did not suffer any adverse events, and no severe side effects were observed. The main cause of discontinuation was lack of efficacy. Conclusion: Acitretin can be considered as a therapeutic option for patients with HS. The presence of follicular phenotype or a history of components of follicular occlusion syndrome is associated with better outcomes. [ABSTRACT FROM AUTHOR]