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PubMed | University of Vigo, Servicio de Medicina Interna and Escuela Universitaria de Enfermeria
Type: Journal Article | Journal: Medicina clinica | Year: 2016

To assess whether an educational intervention in perimenopausal women with hypertension, diabetes mellitus and/or dyslipidaemia would improve adherence to a Mediterranean diet pattern and achieve changes in anthropometric parameters.Randomized clinical trial of parallel groups: 320 women (45-60 years) in 2 urban primary care services.hip and waist circumference, body mass index (BMI), total, visceral and trunk fat (bioimpedance measures) and adherence to Mediterranean diet (MEDAS-14 questionnaire). Intervention group: 3 interactive workshops on prevention of cardiovascular disease, and control group: information by post.Two hundred and thirty women completed the study (113 control group and 117 intervention group). The differences between groups were significant in all parameters one year later. In the intragroup comparison, the intervention group maintained their BMI and improved adherence to the Mediterranean diet. The control group increased their BMI, abdominal and hip circumference and fat parameters (total, visceral and trunk fat).A simple educational intervention in perimenopausal women with cardiovascular risk can improve their healthy habits.


Veredas F.J.,University of Malaga | Mesa H.,Advance Health | Morente L.,Escuela Universitaria de Enfermeria
Medical and Biological Engineering and Computing | Year: 2015

A pressure ulcer is a clinical pathology of localised damage to the skin and underlying tissue caused by pressure, shear or friction. Reliable diagnosis supported by precise wound evaluation is crucial in order to success on treatment decisions. This paper presents a computer-vision approach to wound-area detection based on statistical colour models. Starting with a training set consisting of 113 real wound images, colour histogram models are created for four different tissue types. Back-projections of colour pixels on those histogram models are used, from a Bayesian perspective, to get an estimate of the posterior probability of a pixel to belong to any of those tissue classes. Performance measures obtained from contingency tables based on a gold standard of segmented images supplied by experts have been used for model selection. The resulting fitted model has been validated on a training set consisting of 322 wound images manually segmented and labelled by expert clinicians. The final fitted segmentation model shows robustness and gives high mean performance rates [(AUC:.9426 (SD.0563); accuracy:.8777 (SD.0799); F-score: 0.7389 (SD.1550); Cohen’s kappa:.6585 (SD.1787)] when segmenting significant wound areas that include healing tissues. © 2015, International Federation for Medical and Biological Engineering.


Veredas F.J.,University of Malaga | Luque-Baena R.M.,University of Extremadura | Martin-Santos F.J.,Servicio Andaluz de Salud | Morilla-Herrera J.C.,Servicio Andaluz de Salud | Morente L.,Escuela Universitaria de Enfermeria
Neurocomputing | Year: 2015

A pressure ulcer is a clinical pathology of localized damage to the skin and underlying tissue caused by pressure, shear or friction. Diagnosis, care and treatment of pressure ulcers can result in extremely expensive costs for health systems. A reliable diagnosis supported by precise wound evaluation is crucial in order to succeed on the treatment decision and, in some cases, to save the patient's life. However, current clinical evaluation procedures, focused mainly on visual inspection, do not seem to be accurate enough to accomplish this important task. This paper presents a computer-vision approach based on image processing algorithms and supervised learning techniques to help detect and classify wound tissue types that play an important role in wound diagnosis. The system proposed involves the use of the k-means clustering algorithm for image segmentation and compares three different machine learning approaches-neural networks, support vector machines and random forest decision trees-to classify effectively each segmented region as the appropriate tissue type. Feature selection based on a wrapper approach with recursive feature elimination is shown to be effective in keeping the efficacy of the classifiers up and significantly reducing the number of necessary predictors. Results obtained show high performance rates from classifiers based on fitted neural networks, random forest models and support vector machines (overall accuracy on a testing set [95% CI], respectively: 81.87% [80.03%, 83.61%]; 87.37% [85.76%, 88.86%]; 88.08% [86.51%, 89.53%]), with significant differences found between the three machine learning approaches. This study seeks to provide, using standard classification algorithms, a consistent and robust methodological framework as a basis for the development of reliable computational systems to support ulcer diagnosis. © 2015 Elsevier B.V.


Navas M.,University of Malaga | Luque-Baena R.M.,University of Malaga | Morente L.,Escuela Universitaria de Enfermeria | Coronado D.,Wimasis SL | And 2 more authors.
Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics) | Year: 2013

Pressure ulcer is a clinical pathology of localized damage to the skin and underlying tissue caused by pressure, shear or friction. Diagnosis, care and treatment of pressure ulcers can result in extremely expensive costs for health systems. A reliable diagnosis supported by precise wound evaluation is crucial in order to success on the treatment decision and, in some cases, to save the patient's life. However, current evaluation procedures, focused mainly on visual inspection, do not seem to be accurate enough to accomplish this important task. This paper presents a computer-vision approach based on image processing algorithms and supervised learning techniques to help detecting and classifying wound tissue types which play an important role in wound diagnosis. The system proposed involves the use of the k-means clustering algorithm for image segmentation and a standard multilayer perceptron neural network to classify effectively each segmented region as the appropriate tissue type. Results obtained show a high performance rate which enables to support ulcer diagnosis by a reliable computational system. © 2013 Springer-Verlag Berlin Heidelberg.


De Bengoa Vallejo R.B.,Escuela Universitaria de Enfermeria | Losa Iglesias M.E.,Complutense University of Madrid | Alou Cervera L.,Rey Juan Carlos University | FernAndez D.S.,Rey Juan Carlos University | Prieto J.P.,Rey Juan Carlos University
Dermatologic Surgery | Year: 2010

BACKGROUND A common problem associated with toenail removal surgery is the accompanying bacterial infection that often ensues. The foot has a particularly difficult anatomy to prepare antiseptically for surgery, which contributes to this wide-spread problem. OBJECTIVE To compare the antiseptic efficacy of two skin pretreatment methods before toenail avulsion surgery. METHODS Two presurgical methods were performed on 24 patients each (48 patients total). Swab samples were taken from each patient at five distinct stages (pretreatment, post-treatment, after surgery, after saline solution irrigation of the nail bed, and after phenol application) throughout the surgical procedure, and bacterial culture analysis was performed (total inocula count and identification of specific microorganisms). RESULTS We found both methods to be effective at reducing the initial bacterial load when used at pretreatment, but the reduction in bacterial load was lost after the nail avulsion surgery, achieving values similar to the initial bacterial load before the presurgical scrub, from 5.17 and 5.04 log10 colony-forming units (CFU)/cm2 to 4.86 and 5.07 log10 CFU/cm2, respectively. An interoperative irrigation step was effective in reducing the bacterial load by 95.2% and 95.3%, respectively. STUDY LIMITATIONS Our patients underwent phenol-based nail avulsion, resulting in no bacterial load after complete nail removal because of the intrinsic antiseptic nature of the phenol. CONCLUSIONS Incorporation of intraoperative irrigation of sterile saline solution after nail avulsion surgery reduces potential bacterial load. Every effort should be made to lower the risk of contamination after nail plate avulsion. © 2010 by the American Society for Dermatologic Surgery, Inc.


Morente L.,Escuela Universitaria de Enfermeria | Veredas F.J.,University of Malaga
HEALTHINF 2013 - Proceedings of the International Conference on Health Informatics | Year: 2013

Pressure ulcers (PrU) are considered as one of the most challenging problems that Nursing professionals have to deal with in their daily practice. Nowadays, the education on PrUs is manly based on traditional lecturing, seminars and face-to-face instruction, sometimes with the support of photographs of wounds being used as teaching material. This traditional educational methodology suffers from some important limitations, which could affect the efficacy of the learning process. This current study has been designed to introduce information and communication technologies (ICT) in the education on PrU for undergraduate students, with the main objective of evaluating the advantages an disadvantages of using ICT, by comparing the learning results obtained from using an e-learning tool with those from a traditional teaching methodology. In order to meet this major objective, a web-based learning system named ePULab has been designed and developed as an adaptive e-learning tool for the autonomous acquisition of knowledge on PrU evaluation. In this article, the ePULab software is described in details and the general results from an experimental educational validation study are also presented and analysed.


PubMed | University of Malaga, Servicio Andaluz de Salud and Escuela Universitaria de Enfermeria
Type: Journal Article | Journal: Computer methods and programs in biomedicine | Year: 2014

Pressure ulcers (PrU) are considered as one of the most challenging problems that Nursing professionals have to deal with in their daily practice. Nowadays, the education on PrUs is mainly based on traditional lecturing, seminars and face-to-face instruction, sometimes with the support of photographs of wounds being used as teaching material. This traditional educational methodology suffers from some important limitations, which could affect the efficacy of the learning process. This current study has been designed to introduce information and communication technologies (ICT) in the education on PrU for undergraduate students, with the main objective of evaluating the advantages an disadvantages of using ICT, by comparing the learning results obtained from using an e-learning tool with those from a traditional teaching methodology. In order to meet this major objective, a web-based learning system named ePULab has been designed and developed as an adaptive e-learning tool for the autonomous acquisition of knowledge on PrU evaluation. This innovative system has been validated by means of a randomized controlled trial that compares its learning efficacy with that from a control group receiving a traditional face-to-face instruction. Students using ePULab gave significantly better (p<0.01) learning acquisition scores (from pre-test mean 8.27 (SD 1.39) to post-test mean 15.83 (SD 2.52)) than those following traditional lecture-style classes (from pre-test mean 8.23 (SD 1.23) to post-test mean 11.6 (SD 2.52)). In this article, the ePULab software is described in detail and the results from that experimental educational validation study are also presented and analyzed.


PubMed | Complutense University of Madrid, Rey Juan Carlos University and Escuela Universitaria de Enfermeria.
Type: Journal Article | Journal: European journal of dermatology : EJD | Year: 2014

For treatment of ingrown toenails, a phenolization is often chosen. Many reports describe an intra-operative irrigation, or lavage, of the wound with alcohol to neutralize any residual phenol. There are conflicting reports in the literature as to whether a true neutralization is required or merely effective removal of excess phenol. We hypothesized that intra-operative irrigation with 70% alcohol after the application of phenol does not remove enough phenol and a quantity of phenol still remains in the wound nail fold performing its action.The aim of our study was to analyze the suitability and effectiveness of the alcohol lavage step during the treatment of ingrown toenails with a phenolization procedure.We performed an in vivo study in 29 patients who underwent unilateral phenol chemical matricectomy to measure the amount of phenol remaining after five irrigations with a total of 15 ml of alcohol.There were measurable amounts of phenol collected after five alcohol irrigation steps, suggesting that phenol was not neutralized by the alcohol. After the first irrigation, only 45.74% of phenol was eliminated. An additional 12 ml of alcohol were necessary to eliminate the remaining 54.25% in the nail bed.A single alcohol lavage step after the phenolization procedure did not eliminate enough phenol. However, 15 ml of alcohol can serve as a suitable and effective means of diluting and removing any excess or residual phenol from the exposed area by its drag effect.


Iglesias M.E.L.,Rey Juan Carlos University | Vallejo R.B.d.B.,Escuela Universitaria de Enfermeria | Fuentes P.S.,Rey Juan Carlos University
Journal of Medical Ethics | Year: 2010

Objectives To describe the distress experienced by Spanish podiatrists related to ethical dilemmas, organisational matters, and lack of resources. Design A 2008 email survey of a representative sample of 485 Spanish podiatrists presenting statements about different ethical dilemmas, values and goals at the workplace. Results The response rate was 44.8%. Of all the respondents, 57% described sometimes having to act against their own conscience as distressing. Time constraints is the main cause of moral distress (67%) and 58% of respondents said that they found it distressing that patients have long waits for treatment. Distress related to inadequate treatment due to economical constraints or ineffectiveness was described by 60% of the podiatrists. Another 51% reported that time spent on administration and documentation is distressing. Female doctors experienced more distress than their male colleagues. Last, 36% of respondents reported that their workplace lacked strategies for dealing with ethical dilemmas. Conclusion These study results identify moral distress among Spanish podiatrists mainly related to time constraints, patient demands and lack of resources. Moral distress varies with sex and age. Organisational strategies such as moral deliberation and responsive evaluation offer the potential to address moral distress.


PubMed | Servicio de Atencion Primaria Novoa Santos, España University, Servicio de Medicina Interna, Escuela Universitaria de Enfermeria and Servicio de Atencion Primaria A Ponte
Type: | Journal: Gaceta sanitaria | Year: 2016

To assess whether an educational intervention in women in perimenopausal age with diabetes mellitus, hypertension and/or dyslipidemia could improve aspects of quality of life and exercise.A randomized clinical trial.physical activity, quality of life and weight in women aged 45-60 years (n = 320) at time 0 and 12 months after surgery. intervention group (IG): 3 interactive workshops on cardiovascular disease prevention and control group (CG): information by mail.The IG obtained better scores on the mental component of quality of life one year later (p < 0.05) and showed a significant increase in physical activity (p < 0.01). GI women maintained their weight while in CG women it increased (p < 0.01).A simple educational intervention in premenopausal women with a cardiovascular risk factor improves aspects of quality of life and of healthy habits such as physical activity.

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