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Hospital de Órbigo, Spain

Gonzalez-Torres M.A.,Hospital Universitario Of Basurto
International Forum of Psychoanalysis | Year: 2014

An individual's identity is gradually built upon a lifelong process of maturation. Sexual life and how our desire is channeled and expressed represent a key area of that global identity. Also, the nation to which we feel we belong constitutes another cornerstone of that complex structure. The obvious attraction that nationalism awakens in many parts of the world might be related to the facilitation of a valuable identity acquired by just belonging to a idealized group instead of through a tiresome and continuous effort. In this process, "others" are chosen by us to establish comparisons with our tribe, helping us through a mirroring process to shape our own image. We project upon those "others" all kinds of undesirable traits. Those attributions tend to be very similar, regardless of which specific groups are involved. The "others" are always lazy, dishonest, untrustworthy, dirty. Interestingly, there are a specific set of "positive" attributions that are almost always present: the "others," and specifically the men in that group, are sexually more potent, attractive, or able. This contradictory image of the "other" can help us to understand the complex dynamics, at the individual and group levels, that are present in radical nationalist movements, and to open up new fields of inquiry and exploration in which psychoanalytic theory can offer guidance. © 2013 © 2013 The International Federation of Psychoanalytic Societies. Source

Quindos G.,University of the Basque Country | Eraso E.,University of the Basque Country | Lopez-Soria L.M.,Hospital Universitario Of Cruces | Ezpeleta G.,Hospital Universitario Of Basurto
Enfermedades Infecciosas y Microbiologia Clinica | Year: 2012

Diagnosis of invasive mycoses is a difficult challenge due to the limitations and low sensitivity of traditional microbiology methods which lead to diagnostic and therapeutic delays. The aim of this review is to summarise the state of the art of the molecular diagnosis of invasive fungal disease and to clarify its current role in the clinical practice. Conventional microbiological methods could be complemented with molecular methods in the rapid and definitive identification of fungal isolates. Biomarkers (β-glucan, galactomannan) are very useful in immunocompromised patients and have been included as probable invasive mycoses by the EORTC/MSG. Nucleic acid detection is currently used as a complementary tool for diagnosis. However, PCR can be very useful in mould invasive mycoses. Finally, the combined detection using biomarkers can improve the diagnosis. However, their applicability in the microbiology laboratory is not so easy and further studies are required for the appropriate evaluation of its clinical usefulness. © 2011 Elsevier España, S.L. All rights reserved. © 2011 Elsevier España, S.L. All rights reserved. Source

Murga N.,Hospital Universitario Of Basurto
Revista Espanola de Cardiologia Suplementos | Year: 2013

The management of chronic ischemic heart disease has advanced and mortality has decreased. However, despite improvements in diagnosis and therapy, angina may persist and have a serious effect on quality of life. The beneficial effects of the secondary prevention of cardiovascular disease on morbidity and mortality have been well established, but these benefits are frequently diminished by nonadherence, therapeutic inertia and social inequality. Patients with a history of ischemic heart disease are at an increased risk of a new coronary event, and systematic follow-up coupled to the use of risk markers that enable risk to be stratified could help us improve outcomes. Changing health-care needs, comorbidities and aging all increase costs in patients with chronic disease. In integrated-care models, the primary care team takes the leading role in monitoring and providing care for patients with stable disease, while the cardiologist acts as a consultant and deals with newly diagnosed conditions and with patients who need closer follow-up or special investigations. © 2013 Sociedad Española de Cardiología. Source

Llopis Roca F.,Hospital Universitari Of Bellvitge | Juan Pastor A.,Hospital Universitari Josep Trueta | Ferre Losa C.,Hospital Universitari Of Bellvitge | Martin Sanchez F.J.,Servicio de Urgencias | And 4 more authors.
Emergencias | Year: 2014

Objective: The aim of the REGICE project is to describe the real situation of short-stay units (SSU) in Spain. The project's first study provided information on their organizational structure, location, responsible hospital department, and staffing. Methods: Cross-sectional study based on a survey of all Spanish hospitals listed on the web page of the Ministry of Health in 2012. Hospital directors who reported that their facilities had SSU were asked to provide information on how they were structured and how staff were organized. Results: Of the 591 hospitals surveyed, 67 (11.3%) had a SSU; 48 of them (71.6%) were included in the database for the REGICE 1 study. Sixty-five percent of the units were administered by the emergency department (ED), 23% by internal medicine and 12% by another department. Fifty-two percent were located on a conventional hospital ward and 44% in the ED area. The mean (SD) number of beds was 15.08 (6.34) (range, 5-30 beds). The ED chief was responsible for the unit in 60% of the hospitals and the internal medicine department in 23%; 42% of the units had a chief of service other than the head of the department the unit belonged to. The number of staff physicians and their work scheduled varied greatly. The ratio of physicians to beds was 1:5.8 (range, 1:2-1:12). Nursing staff was more similar across hospitals. Seventy percent of the short-stay units participated in training resident physicians. Conclusions: Only 11.3% of the surveyed hospitals have a SSU. These units usually belong to the ED. Staff organization in these units varies greatly from hospital to hospital. Source

Villa G.,University of Oviedo | Fernandez-Ortiz L.,University of Oviedo | Cuervo J.,University of Oviedo | Rebollo P.,University of Oviedo | And 3 more authors.
Peritoneal Dialysis International | Year: 2012

Background: We undertook a cost-effectiveness analysis of the Spanish Renal Replacement Therapy (RRT) program for end-stage renal disease patients from a societal perspective. The current Spanish situation was compared with several hypothetical scenarios. Methods: A Markov chain model was used as a foundation for simulations of the Spanish RRT program in three temporal horizons (5, 10, and 15 years). The current situation (scenario 1) was compared with three different scenarios: increased proportion of overall scheduled (planned) incident patients (scenario 2); constant proportion of overall scheduled incident patients, but increased proportion of scheduled incident patients on peritoneal dialysis (PD), resulting in a lower proportion of scheduled incident patients on hemodialysis (HD) (scenario 3); and increased overall proportion of scheduled incident patients together with increased scheduled incidence of patients on PD (scenario 4). Results: The incremental cost-effectiveness ratios (ICERs) of scenarios 2, 3, and 4, when compared with scenario 1, were estimated to be, respectively, -€83 150, -€354 977, and -€235 886 per incremental quality-adjusted life year (ΔQALY), evidencing both moderate cost savings and slight effectiveness gains. The net health benefits that would accrue to society were estimated to be, respectively, 0.0045, 0.0211, and 0.0219 ΔQALYs considering a willingness-to-pay threshold of €35 000/ΔQALY. Conclusions: Scenario 1, the current Spanish situation, was dominated by all the proposed scenarios. Interestingly, scenarios 3 and 4 showed the best results in terms of cost-effectiveness. From a cost-effectiveness perspective, an increase in the overall scheduled incidence of RRT, and particularly that of PD, should be promoted. © 2012 International Society for Peritoneal Dialysis. Source

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