The role of nursing students as future health promoters of healthy behaviors is influenced by their attitude towards smoking. A cross-sectional study using a self-administered survey was performed to ...analyze smoking prevalence among undergraduate the nursing students who attend nursing faculties in 2 European countries (Spain and Portugal) during academic period 2015 to 2016. A total of 1469 subjects were surveyed (response rate of 79.8%). An 80% of the students were female with a mean age of 21.9 (4.8) years. The overall prevalence of tobacco use was 18.9%, with an average percentage of 16.2% in Portugal and 18.3% in Spain. Statistical significance was observed in relation to smoke and previous studies (16.4% vs 27.1%; P < .001). Only 1.1% of the students reported using electronic cigarette. 15.8% of smokers started smoking while at university with statistical gender and previous studies differences (P < .001). Fagerström and Richmond test showed low nicotine dependence (2.8 ± 2) and moderate motivation to stop smoking (4.9 ± 3), respectively. Smoking prevalence among nursing students was slightly higher than the general European population. For that reason, measures to reduce tobacco use have to be focused on students and university policies on tobacco control should be a challenge in the future.
•Fully dense nanocrystalline W-10Cr-0.5Y alloy produced by MA and HIP.•Y-rich nanoparticles at GB inhibit grain growth and improve strength and toughness.•W-10Cr-0.5Y exhibits excellent oxidation ...resistance under accident-like conditions.•W-10Cr-0.5Y withstood 1000 pulses of 1ms and 0.19GW/m2 at 400°C without damage.•1000 pulses of 0.38GW/m2 result in better performance than W reference material.
The use of self-passivating tungsten alloys for the first wall armor of future fusion reactors is advantageous concerning safety issues in comparison with pure tungsten. Bulk W-10Cr-0.5Y alloy manufactured by mechanical alloying followed by HIP resulted in a fully dense material with grain size around 100nm and a dispersion of Y-rich oxide nanoparticles located at the grain boundaries. An improvement in flexural strength and fracture toughness was observed with respect to previous works. Oxidation tests under isothermal and accident-like conditions revealed a very promising oxidation behavior for the W-10Cr-0.5Y alloy. Thermo-shock tests at JUDITH-1 to simulate ELM-like loads resulted in a crack network at the surface with roughness values lower than those of a pure W reference material. An additional thermal treatment at 1550°C improves slightly the oxidation and significantly thermo-shock resistance of the alloy.
OBJECTIVESTo describe the therapeutic management of Rheumatoid Arthritis (RA), Psoriatic Arthritis (PsA) and Ankylosing Spondylitis (AS) in patients initiating treatment with biological agents. ...MATERIALS AND METHODSObservational, retrospective, longitudinal study in 33 Spanish hospitals. Patients with RA, PsA and AS starting treatment with biological agents between September 2009 and August 2010 and a follow-up longer than 3 years were included. Clinical-demographic characteristics, drugs, biological therapy survival, and reasons for discontinuation or switching were analyzed. RESULTSFour hundred and sixty-three patients were included (183 RA, 119 PsA and 161 AS), with a mean follow-up of 3.8 years. At the end of follow-up, a high proportion continued with the first biological prescribed (41.0% of RA, 59.7% of PsA and 51.6% of AS), 31.1%, 47.9% and 42.9% of RA, PsA and AS patients requiring dosage adjustments, respectively. There was temporary discontinuation in 8.2%, 8.4% and 15.5% of patients, and a switch of biologic agent was required in 37.7%, 26.1% and 24.2%. Definitive discontinuation occurred in 13.1%, 5.9% and 8.7% of RA, PsA and AS patients, respectively. Mean time to discontinuation or switching was 30.1 months for RA and 35.7 months for PsA and AS. CONCLUSIONSOur results suggest that, in practice, half of patients with RA and two thirds with PsA or AS maintained the first biological, but with frequent dose adjustments.
The brittle fracture strength of a self-passivating W-Cr10-Ti2 alloy (in wt.%) was measured through un-notched cantilever bending at the microscopic scale. The material behaved purely elastic and ...fractured catastrophically in an unstable fashion. An average nominal strength of 5.9 GPa was measured. The scatter in strength was shown to be significantly higher than the sum of all random errors indicating an inherent variability of the material's strength. The measurements from 28 tests followed a Weibull distribution with a modulus of m = 12. Results from a size effect study at the microscopic scale were successfully predicted through Weibull scaling. Extrapolation into the macroscopic range overestimated the measured three-point bend strength, which is likely due to the presence of large-scale heterogeneities. The test technique sampled a material thickness of only several micrometres and is hence suitable for future ion irradiation studies.
To describe the therapeutic management of rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS) in patients initiating treatment with biological agents.
Observational, ...retrospective, longitudinal study in 33 Spanish hospitals. Patients with RA, PsA and AS starting treatment with biological agents between September 2009 and August 2010 and a follow-up longer than 3 years were included. Clinical-demographic characteristics, drugs, biological therapy survival, and reasons for discontinuation or switching were analysed.
Four hundred and sixty-three patients were included (183 RA, 119 PsA and 161 AS), with a mean follow-up of 3.8 years. At the end of follow-up, a high proportion continued with the first biological prescribed (41.0% of RA, 59.7% of PsA and 51.6% of AS), 31.1%, 47.9% and 42.9% of RA, PsA and AS patients requiring dosage adjustments, respectively. There was temporary discontinuation in 8.2%, 8.4% and 15.5% of patients, and a switch of biologic agent was required in 37.7%, 26.1% and 24.2%. Definitive discontinuation occurred in 13.1%, 5.9% and 8.7% of RA, PsA and AS patients, respectively. Mean time to discontinuation or switching was 30.1 months for RA and 35.7 months for PsA and AS.
Our results suggest that, in practice, half of patients with RA and two thirds with PsA or AS maintained the first biological, but with frequent dose adjustments.
Describir el manejo terapéutico de la artritis reumatoide (AR), la artritis psoriásica (Aps) y la espondilitis anquilosante (EA) en pacientes que inician tratamiento con agentes biológicos.
Estudio observacional, retrospectivo, longitudinal en 33 hospitales españoles. Se incluyeron pacientes con AR, Aps y EA que iniciaron tratamiento con agentes biológicos entre septiembre de 2009 y agosto de 2010, con un seguimiento de más de 3 años. Se analizaron las características clínico-demográficas, los fármacos, la supervivencia de la terapia biológica y las causas de cambio o interrupción.
Se incluyeron 463 pacientes (183 AR, 119 Aps y 161 EA) con un seguimiento medio de 3,8 años. Al final del seguimiento una elevada proporción continuaba con el primer biológico prescrito (41,0% de AR, 59,7% de Aps y 51,6% de EA), precisando ajustes de dosis el 31,1%, 47,9% y 42,9% de pacientes con AR, Aps y EA, respectivamente. Hubo interrupción temporal en el 8,2%, 8,4% y 15,5% de los pacientes y se precisó cambio de biológico en el 37,7%, 26,1% y 24,2%. La interrupción definitiva ocurrió en el 13,1%, 5,9% y 8,7% de pacientes con AR, Aps y EA, respectivamente. El tiempo medio de cambio o interrupción fue de 30,1 meses para la AR y de 35,7 meses para la Aps y la EA.
Nuestros resultados sugieren que, en la práctica, la mitad de los pacientes con AR y 2/3 con Aps o EA continúan con el primer biológico, pero con frecuentes ajustes de tratamiento.
To assess the efficacy and safety of golimumab in the 140 patients included in Spain as the first part of the GO-MORE trial, a multinational study involving patients with active rheumatoid arthritis ...(RA) despite treatment with different disease-modifying antirheumatic drugs (DMARDs).
The patients received subcutaneous golimumab 50mg once a month during 6 months. The primary endpoint was the percentage of individuals with a good or moderate EULAR DAS28-ESR response after 6 months of treatment.
A total of 140 patients were included. Of these, 76.4% had very active disease (DAS28-ESR>5.1). 76.4% were taking methotrexate, 40.0% other DMARDs in monotherapy or combined, and 65.0% received corticosteroids. After 6 months, 82.9% of the patients showed a good or moderate EULAR response, 41.4% had low disease activity, and 30.7% were in remission. The percentage of responders one month after the first dose was 69.3%. The efficacy was similar in patients treated with methotrexate or other DMARDs, with different methotrexate doses, with or without corticosteroids, or in subjects who had failed one or more DMARDs. The response to golimumab was observed from the first dose. Golimumab was well tolerated and its safety profile was consistent with the findings of previous studies. Serious adverse events were reported in 11 patients (7.9%).
The addition of subcutaneous golimumab 50 mg once a month to different DMARDs in patients with active RA yielded a moderate or good response after 6 months in 82.9% of the cases. The response was observed early, from the start of the second month, after a single dose of golimumab.
Introducción Desde 1986 se han realizado cinco estudios de prevalencia de Staphylococcus spp. en España. En este trabajo se presentan los datos de 2006 correspondientes al sexto estudio. Métodos ...Participaron 145 hospitales de todas las areas geográficas y se estudiaron 866 cepas de estafilococos (463 S. aureus ). Se determinó la sensibilidad a 16 antimicrobianos mediante un sistema automatizado de microdilución en caldo. La sensibilidad a tigeciclina se determinó mediante el método de E-test. Resultados La resistencia de S. aureus a oxacilina se ha estabilizado (el 31,2% en 2002 frente al 29,2% en 2006), así como la resistencia a eritromicina, clindamicina y ciprofloxacino. En 2006 los aislados fueron más sensibles a gentamicina (el 16,9% en 2002 frente al 8,6% en 2006; p < 0,001), ninguno presentó sensibilidad disminuida a vancomicina y la resistencia a cotrimoxazol (0,9%) y a rifampicina (0,6%) fue anecdótica. Un aislado fue resistente a linezolid. La resistencia de los estafilococos coagulasa negativos a oxacilina (el 61,3% en 2002 frente al 66,7% en 2006) y a eritromicina (el 63,0% en 2002 frente al 66,5% en 2006) se ha mantenido relativamente estable, aunque ha aumentado la resistencia a gentamicina (el 27,8% en 2002 frente al 44,2% en 2006; p < 0,001), ciprofloxacino (el 44,9% en 2002 frente al 54,3% en 2006; p = 0,010) y clindamicina (el 33,8% en 2002 frente al 46,2% en 2006; p = 0,001). Dos aislados presentaron sensibilidad disminuida a teicoplanina y uno fue resistente a linezolid. Todos los Staphylococcus spp. fueron uniformemente sensibles a quinupristina-dalfopristina y a tigeciclina. Conclusiones En España la resistencia de Staphylococcus spp. a oxacilina sigue siendo elevada, aunque parece haberse estabilizado. Asimismo, comienzan a aparecer aislados resistentes a linezolid.
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