Diez recomendaciones para mejorar la enseñanza de la Geriatría en el pregrado

IntroductionPopulation ageing and scientific progress have made specific training in Geriatrics essential for any medical students. There are different international recommendations on the teaching of Geriatric Medicine at undergraduate level, but they are still far from being offered systematically. The aim of this work was to develop a National list of recommendations in order to improve training in Geriatric Medicine at the undergraduate level.Material and methodsA list of 10 recommendations was produced by reflecting on the Geriatric training situation in Spain in 2016/2017 and international recommendations. Consensus was reached among the members of the Spanish Society of Geriatrics and Gerontology (SEGG) working group on «Geriatric training at undergraduate level» through 2 meetings and online discussions.ResultsA list of 10 of recommendations on Geriatric training in Spanish Medical Schools is proposed, including areas such as, the status of the discipline in the curriculum, length, contents, practical training, lecturers, teaching methods, and innovation.ConclusionsThese recommendations are intended to improve Geriatrics training. They can be used by different Medical Schools either to adapt their programs or to start training in Geriatric Medicine.     

Does the Spanish version of the SWLS measure the same in Spain and Peru?

AimSatisfaction with life is a measure of protection in older adults. There lies the importance of providing quality instruments. The aim of the study was to evaluate the invariance of the life satisfaction scale (SWLS) in two samples of older adults in Spain and Peru.MethodThe participants were 857 older adults in Spain (mean age = 68.23 years, SD = 5.93) and 336 older adults in Peru (average age = 72.42, SD = 7.07). All multi-group confirmatory factor analyzes were estimated in Mplus 8.0.ResultsThe results indicate the presence of a strict invariance of the one-dimensional structure of the SWLS in samples of older adults in Spain and Peru, which allows for meaningful comparisons of latent means and covariances. Comparison of latent means showed small differences in the construct between the cultural groups.ConclusionsThe SWLS is a valid instrument for intercultural comparisons between Spanish and Peruvian population. The measurement invariance assessment contributes to a better understanding of life satisfaction in populations from different cultural contexts.     

Expresión sexual y regulación de la sexualidad en residencias de personas mayores

Objectives

The study had three objectives: (a) To determine how staff perceives the frequency of different sexual expressions in long-term care facilities for older people; (2) to quantify policies aimed at guaranteeing residents’ sexual rights in such institutions, and (3) to determine factors influencing the presence of these kind of policies.

First proposal of quality indicators and standards and recommendations to improve the healthcare in the Spanish National Registry of Hip Fracture

BackgroundThe Spanish National Hip Fracture Registry (or Registro Nacional de Fractura de Cadera, RNFC) is a database of hip fracture patients admitted to Spanish hospitals. Its goals include assessment and continuous improvement of the care process.ObjectivesTo (1) establish a series of indicators, (2) evaluate their initial fulfillment, (3) propose quality standards, (4) suggest recommendations to facilitate standards compliance, and (5) monitor the indicators.MethodThe indicators fulfilled the criteria of (1) evaluating the process or outcome, (2) being clinically relevant for patients, (3) being modifiable through changes in healthcare practice, and (4) being considered important by the RNFC participants. The first quartile obtained by the group of hospitals in each of the respective variables was proposed as the standard. The Indicators Advisory Committee (IAC) elaborated a list of recommendations for each indicator, based on the available evidence.ResultsSeven indicators were chosen. These indicators (its baseline compliance vs. the standard to be reached, respectively) were: the proportion of patients receiving surgery within 48 h (44% vs. 63%), mobilized the first postoperative day (56% vs. 86%), with antiosteoporotic medication at discharge (32% vs. 61%), with calcium supplements at discharge (46% vs. 77%), with vitamin D supplements at discharge (67% vs. 92%), who developed pressure ulcers during hospitalization (7.2% vs. 2.1%) and with independent mobility at 30 days (58% vs. 70%). The IAC has established 25 recommendations for improving care.ConclusionThe indicators and standards chosen are presented, as well as the list of recommendations. This process completes the first step to improve quality of care. The results will be evaluated 6 months after implementing the recommendations.     

Widening the antimicrobial spectrum of esters of bicyclic amines: In vitro effect on gram-positive Streptococcus pneumoniae and gram-negative non-typeable Haemophilus influenzae biofilms

Antibiotic resistance is a global current threat of increasing importance. Moreover, biofilms represent a medical challenge since the inherent antibiotic resistance of their producers demands the use of high doses of antibiotics over prolonged periods. Frequently, these therapeutic measures fail, contributing to bacterial persistence, therefore demanding the development of novel antimicrobials. Esters of bicyclic amines (EBAs), which are strong inhibitors of Streptococcus pneumoniae growth, were initially designed as inhibitors of pneumococcal choline-binding proteins on the basis of their structural analogy to the choline residues in the cell wall. However, instead of mimicking the characteristic cell chaining phenotype caused by exogenously added choline on planktonic cultures of pneumococcal cells, EBAs showed an unexpected lytic activity. In this work we demonstrate that EBAs display a second, and even more important, function as cell membrane destabilizers. We then assayed the inhibitory and disintegrating activity of these molecules on pneumococcal biofilms. The selected compound (EBA 31) produced the highest effect on S. pneumoniae (encapsulated and non-encapsulated) biofilms at very low concentrations. EBA 31 was also effective on mixed biofilms of non-encapsulated S. pneumoniae plus non-typeable Haemophilus influenzae, two pathogens frequently forming a self-produced biofilm in the human nasopharynx. These results support the role of EBAs as a promising alternative for the development of novel, broad-range antimicrobial drugs encompassing both Gram-positive and Gram-negative pathogens.     

Campanian–early Eocene cephalopods from Kharga Oasis,Western Desert,Egypt

The Campanian–lower Eocene sedimentary succession in the Kharga Oasis yields rare cephalopods that have so far received little attention. Eight cephalopod species; six nautiloids and two ammonites, are identified in the study area. The nautiloids are referred to five genera in three families. All nautiloid species are recorded from the Paleocene and Eocene rocks, two of which are described as new, as follows: Cimomia kurkurensis nov. sp. and Deltoidonautilus hassani nov. sp. The two ammonite species are Libycoceras ismaelis (von Zittel, 1884) and Baculites ovatus Say, 1820, representing the families Sphenodiscidae and Baculitidae, respectively. Baculites anceps of Quaas (1902, non Lamarck, 1822) from the Maastrichtian of the Western Desert of Egypt is here assigned to Baculites ovatus. The palaeobiogeography of these species is studied in detail.     

Bilan initial d’imagerie de l’adénocarcinome pancréatique : données de la littérature sur la place actuelle de la tomographie par émission de positons au 18F-fluorodéoxyglucose (TEP FDG)

In pancreatic adenocarcinoma, initial imaging is essential to better select patients for surgery. Recent literature analysis of F18-Fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET) in pancreatic adenocarcinoma is summarized in the present article. Performances of FDG PET in the fields of lymph node involvement, metastatic involvement and therapeutic efficacy assessment are described for its correct use in pancreatic adenocarcinoma.