Browsing by Author "Alfonso Sánchez, José L."

Background: Minimally invasive surgery (MIS) is the standard method for resection of colorectal cancer, but its indications have limitations that are constantly debated. In our study, the center had to meet the following four factors: surgeons should have considerable experience, there should be a high percentage of MIS, a low conversion rate, and good results in the intervention. Methods: Retrospective observational study of a cohort of 948 patients with colorectal cancer who underwent scheduled open surgery (OS) and MIS between 2011-2016. Results: There were no differences based on sex, body mass index, or location of the tumor, but OS was related to older age, higher ASA, a higher stage, previous surgery, and operative adverse events. The location of the primary tumor and the existence of synchronous tumors were related to variability in the technique. The implementation of MIS increased from 36.2% in 2011 to 89.6% in 2016. The surgeon's experience decreased the conversion rate from 6.5% in 2011 to 3.1% in 2016, with 2% in T0-2 tumors. In logistic regression, the factor that most increased the possibility of choosing MIS was the pT grade of the tumor, and the factors that most contraindicated MIS were stages 2-4, ASA 4, stage 1, previous surgery, and advanced age. Conclusions: In hospitals where surgeons have long experience, minimally invasive surgery could be implemented in up to 90% of cases, with low conversion rates (3-4%) and good results for patients.

The Covid-19 pandemic forced universities to convert their traditional faceto- face exams to online exams with doubts as to whether student cheating or technical difficulties would affect their final grades. After taking three of these exams online, we considered comparing their grades with those of previous years on traditional exams. The average mark of the traditional exams before the pandemic was 6.95 over 10, while the average mark of the three exams carried out in the Covid-19 era is 6.64. The student's t test indicated that there are no significant differences between the two types of exams in the mean (p = 0.408), the median (p = 0.378), the range (p = 0.307), the minimum (p = 0.410) and the maximum (p = 0.072). Taking online exams did not modify the exam grades compared to previous years. There is a lot of variability in similar studies in the literature due to cheating that can be performed in online exams. A proctoring system, good question design, and limited exam time can minimize these differences.

Background: Forecasting the behavior of epidemic outbreaks is vital in public health. This makes it possible to anticipate the planning and organization of the health system, as well as possible restrictive or preventive measures. During the COVID-19 pandemic, this need for prediction has been crucial. This paper attempts to characterize the alternative models that were applied in the first wave of this pandemic context, trying to shed light that could help to understand them for future practical applications. Methods: A systematic literature search was performed in standardized bibliographic repertoires, using keywords and Boolean operators to refine the findings, and selecting articles according to the main PRISMA 2020 statement recommendations. Results: After identifying models used throughout the first wave of this pandemic (between March and June 2020), we begin by examining standard data-driven epidemiological models, including studies applying models such as SIR (Susceptible-Infected-Recovered), SQUIDER, SEIR, time-dependent SIR, and other alternatives. For data-driven methods, we identify experiences using autoregressive integrated moving average (ARIMA), evolutionary genetic programming machine learning, short-term memory (LSTM), and global epidemic and mobility models. Conclusions: The COVID-19 pandemic has led to intensive and evolving use of alternative infectious disease prediction models. At this point it is not easy to decide which prediction method is the best in a generic way. Moreover, although models such as the LSTM emerge as remarkably versatile and useful, the practical applicability of the alternatives depends on the specific context of the underlying variable and on the information of the target to be prioritized. In addition, the robustness of the assessment is conditioned by heterogeneity in the quality of information sources and differences in the characteristics of disease control interventions. Further comprehensive comparison of the performance of models in comparable situations, assessing their predictive validity, is needed. This will help determine the most reliable and practical methods for application in future outbreaks and eventual pandemics.

The use of films as learning tool for Public Health topics has been rarely used in the literature despite their positive outcomes. The good results achieved in them have motivated us to implement this activity in the Public Health course of the Medicine degree. To get optimal results, it is necessary to find a list of movies that fit with the lessons on the agenda. The professors made a list of 25 films and groups of two or three students were organized. At the end of the course, each group made a presentation to the class about the movies and their Public Health issues, relating them to the agenda and the conflict raised. The activity was positive, especially valuing the learning experience and the contents treated.

Diverticulitis and hemorrhoidal proctitis in the population are significant public health problems. We studied the potential association between the intake of certain plant foods and diverticulitis or hemorrhoidal episodes through a case–control study including 410 cases and 401 controls. We used a semiquantitative food frequency questionnaire. The intake was additionally quantified according to a 24 h recall. The plant foods or derived food products were categorized by their main chemical components into ethanol, caffeine/theine/theobromine, capsaicin, alliin, acids, eugenol, and miscellaneous foods such as curcumin. The mean score for overall intake of plant foods under consideration was 6.3 points, and this was significantly higher in cases (8.5) than in controls (4.1). Overall intake was similar in cases presenting with diverticulitis or hemorrhoidal proctitis. Cases had 13 times the odds of being in the upper quartile for overall intake (>7 points), compared to controls. Explanatory logistic regression models showed that the strongest association with diverticulitis and hemorrhoidal proctitis was shown by the chemical food group of capsaicin, followed by ethanol, eugenol, caffeine/theine/theobromine, and acids. Neither alliin nor miscellaneous food groups showed any association. High, frequent consumption of capsaicin, followed by ethanol, eugenol, caffeine/theine/theobromine, and acids increase the risk of diverticulitis and hemorrhoidal proctitis.

Diverticulitis and hemorrhoidal proctitis in the population are significant public health problems. We studied the potential association between the intake of certain plant foods and diverticulitis or hemorrhoidal episodes through a case–control study including 410 cases and 401 controls. We used a semiquantitative food frequency questionnaire. The intake was additionally quantified according to a 24 h recall. The plant foods or derived food products were categorized by their main chemical components into ethanol, caffeine/theine/theobromine, capsaicin, alliin, acids, eugenol, and miscellaneous foods such as curcumin. The mean score for overall intake of plant foods under consideration was 6.3 points, and this was significantly higher in cases (8.5) than in controls (4.1). Overall intake was similar in cases presenting with diverticulitis or hemorrhoidal proctitis. Cases had 13 times the odds of being in the upper quartile for overall intake (>7 points), compared to controls. Explanatory logistic regression models showed that the strongest association with diverticulitis and hemorrhoidal proctitis was shown by the chemical food group of capsaicin, followed by ethanol, eugenol, caffeine/theine/theobromine, and acids. Neither alliin nor miscellaneous food groups showed any association. High, frequent consumption of capsaicin, followed by ethanol, eugenol, caffeine/theine/theobromine, and acids increase the risk of diverticulitis and hemorrhoidal proctitis.

YouTube is a free and easily accessible tool, with growing importance in the teaching field due to the content of the videos and their interaction options through comments, responses and insertion in social networks. However, some limitations can reduce the value of this tool in University teaching if institutional control is not carried out. Our project consists of the search for experiences based on learning Anatomy on YouTube to be able to incorporate this tool in our department. Almost all researchers found that most of students use YouTube as a source of anatomical knowledge, despite limitations and criticism based on ethical and privacy issues, the video experience itself, the YouTube search algorithm, lack of quality control, advertising purposes or excessive video offer. Researchers experienced that most of the available videos had a poor quality and many mistakes, so professors must be involved in the search and selection of the best appropriate videos. We conclude that YouTube can be used as a source of knowledge for anatomical learning. However it is necessary to inform students of the inconveniences and risks, and make a critical selection by the professors of the videos that best fit in the teaching program.