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OBJECTIVES: The Clarke questionnaire, validated in Spanish language, assesses hypoglycemia awareness in patients with type 1 diabetes. This study aimed to analyze its psychometric properties in patients with type 2 diabetes (T2DM). METHODS: This was a questionnaire validation study. Patients with T2DM and treated with insulin, sulfonylureas or glinides were consecutively recruited from six endocrinology consultations and six primary care centers. The internal structure of the 8-item Clarke questionnaire was analyzed by exploratory (training sample) and confirmatory (testing sample) factor analysis; the internal consistency using Omega's McDonald coefficient; and goodness of fit with comparative fit index (CFI, cutoff >0.9), Goodness of Fit Index (GFI, cutoff >0.9), and root mean-square error of approximation (RMSEA, cutoff <0.09), as well as unidimensionality indicators. RESULTS: The 265 participants (56.8% men) had a mean age of 67.8 years. Confirmatory factor analysis for one dimension obtained poor indicators: fit test (p < 0.001); CFI = 0.748; RMSEA = 0.122 and SRMR = 0.134. Exploratory factor analysis showed 2 or 3 dimensions with poor adjustment indicators. Omega's McDonald was 0.739. CONCLUSIONS: The Spanish version of the Clarke questionnaire was not valid or reliable for assessing hypoglycemia awareness in people with T2DM in Spanish population.

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Objetivo. Evaluar los resultados obtenidos con la implantación del programa de Hospitalización Domiciliaria Quirúrgica (HDQ) en el Consorci Hospitalari de Vic durante un periodo de dos años. Método. Estudio longitudinal realizado entre enero de 2011 y diciembre de 2012, sobre los pacientes incluidos en el programa de HDQ. Se estudiaron variables sociodemográficas, clínicas, económicas, de gestión y de percepción del usuario. Los datos se obtuvieron de los registros del programa HDQ, de la Unidad de Planificación y de los sistemas de información, y mediante encuestas telefónicas. Se realizó un análisis descriptivo univariado con el paquete estadístico IBM SPSS Statistics 19. Resultados. Se valoraron 691 pacientes. El 80.75 % se incluyó en el programa HDQ, su estancia media global fue de 5.01 días y la tasa de reingreso del 3.05 %. Destacó un mayor número de pacientes tratados de sexo masculino; las especialidades que aportaron más pacientes al programa fueron cirugía general, traumatología y urología. Se asignó el plan de cuidados del «paciente quirúrgico intervenido» al 82 % de los pacientes, y las complicaciones potenciales enfermeras más registradas fueron el dolor (539) y la infección (436). La puntuación media de satisfacción global sobre la atención recibida y el funcionamiento de HDQ fue de 8.67 ± 1.37 sobre 10. Conclusiones. Los resultados objetivan el impacto de la HDQ en nuestro ámbito y ponen de manifiesto la relevancia del rol de la atención enfermera especializada en el domicilio (AU)

Objective. To evaluate the results after two years of the implementation of surgical patients’ hospital home care program in Consorci Hospitalari de Vic. Method. Longitudinal study conducted between January 2011 and December 2012 on patients enrolled in hospital home care program patients. Sociodemographic, clinical, financial, management and patients experience variables were analysed. Data were obtained from hospital home care program records and Hospital Information Systems in addition to telephone surveys. We performed a univariate descriptive analysis using the statistical package SPSS Statistics 19. Results. 691 patients were assessed, and 80.75 % were included in hospital home care program. The average hospital length of stay was 5.01 days, with a 3.05 % of readmission rate. A higher number of male patients were treated; patients under general surgery, orthopaedics and urology specialties were the more prevalence in the program. 82 % of patients were assigned to the care plan «surgical patient», and the most recorded potential complications were pain (539) and infection (436). The mean overall satisfaction score with care was 8.67 ± 1.37 out of 10. Conclusions. The results objectively reflect the impact of hospital home care program in our context. Moreover, it highlights the importance of the advanced nursing role (AU)

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Analysis of four genomic regions from 37 geographically diverse isolates of broad bean wilt virus 1 (BBWV-1) showed high genetic diversity in comparison to most plant viruses. Comparison of synonymous and nonsynonymous substitutions of the small coat protein gene (SCP) revealed negative selection for most amino acid positions. Phylogenetic analysis of SCP showed that some BBWV-1 isolates from distant geographical areas were genetically close, suggesting long-distance migration. Analysis of genetic differentiation revealed high gene flow between Spanish and Near Eastern subpopulations, which were separated from North-Central and South-Eastern European subpopulations. Finally, putative recombinant and reassortant genomes were also identified.

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The genetic variation and evolutionary mechanisms of broad bean wilt virus 2 (BBWV-2) were studied by nucleotide sequence analysis of four genomic regions of 30 isolates from different countries. Nucleotide diversity was high (0.198) for a plant virus. Phylogenetic and genetic structure analyses showed low population subdivision, suggesting a significant gene flow between distant geographic areas. Analysis of synonymous and nonsynonymous substitutions showed different negative selection pressures for different parts of the coding regions, but no positive selection was found. Several recombination detection methods showed that some BBWV-2 genomes might have originated from recombination or reassortment.

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Wegener’s granulomatosis is a multisystemic granulomatous vasculitis that predominantly affects the airways and the kidneys, but may affect any organ. Otorhinolaryngological manifestations may be oral ulcers, gingival swelling or septal perforations that can cause saddle nose deformities, rhinitis, sinusitis and hearing loss. The oral ulcers usually occur when the disease is advanced. Renal involvement is characterized by focal and segmental glomerulosclerosis, and determines the evolution. The diagnosis is made by clinical symptoms and signs, the presence of c-ANCA and a positive biopsy. The anatomic pathology is characterized by vasculitis, granulomatous inflammation with multinuclear giant cells and necrosis. The prognosis has improved as a result of treatment with immunosuppressants associated with corticosteroids. We report a case of a 53-year-old patient with Wegener’s granulomatosis with oral manifestation, which began as chronic mastitis (AU)

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Several histopathological modalities of tumours can grow in the rhinopharynx. Solitary extramedullary plasmocytoma (SEP) is a low frequent variety of low-grade lymphoma. The aim of this work is to present a new case of SEP localized in rhinopharynx and to perform a review of diagnostic and therapeutic protocols of these neoplasias. They must be taken into account in the differential diagnosis of nasopharyngeal tumours.

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La nasofaringe es el asiento de tumores de muy variada naturaleza. El plasmocitoma solitario extramedular (PSE) es una variante poco frecuente de linfoma de bajo grado, cuya localización a este nivel es muy rara. El objetivo de este trabajo es presentar un nuevo caso de PSE localizado a nivel de la amígdala tubárica y revisar los protocolos diagnósticos y terapéuticos de este tipo infrecuente de neoplasias que deben tenerse en cuenta en el diagnóstico diferencial de los tumores de nasofaringe (AU)

Several histopathological modalities of tumours can grow in the rhinopharynx. Solitary extramedullary plasmocytoma (SEP) is a low frequent variety of low-grade lymphoma. The aim of this work is to present a new case of SEP localized in rhinopharynx and to perform a review of diagnostic and therapeutic protocols of these neoplasias. They must be taken into account in the differential diagnosis of nasopharyngeal tumours (AU)

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