Infection control in long term care institutions for the elderly: A reflection document on the situation in Spain.

A progressively increasing percentage of the elderly live during the last years of their lives in nursing homes. Although these institutions are intended to mimic life at home as much as possible, they have characteristics that make them quite similar to a "nosocomiun", i.e. an establishment for the treatment of the sick. The very coexistence among the elderly, the fact of sharing caregivers and the very significant exposure to third parties, together with the frequent predisposing diseases to infection in this population, make infection frequent among residents and also easily transmissible. This leads us to ask what can be done to prevent infection in this environment and more specifically what is the state of the art of the matter in a Western European nation such as ours. The Board of Trustees of the Health Sciences Foundation has asked itself a series of questions on the subject of infection prevention in Nursing Homes, the structure of procedures, the legislation available, compliance with the measures indicated, the best indicators of the processes and therefore, the need to promote in Spain a document of recommendations to avoid infections in this poplation whose morbidity and mortality need not be highlighted. To this end, a multidisciplinary group of experts in different aspects of this problem has been convened and asked the proposed questions. The questions were discussed by the group as a whole and led to a series of conclusions agreed upon by the participants. The results of the meeting are reported below.

Management of the oral hemangiomas in infants and children: Scoping review.

BACKGROUND: Pediatric oral hemangiomas are benign vascular tumors that can be seen from birth, particularly in females. Hemangiomas are most frequent located in the lips and usually regress spontaneously, thus they do not require any type of treatment in most cases. The present scoping review pretended to synthesize the most relevant and currently available information from the international dental literature published in the last 25 years, regarding the management of pediatric oral hemangiomas. MATERIAL AND METHODS: An exhaustive literature search was performed in four electronic databases (PubMed, Embase, Google Scholar, and Cochrane). Initially, 241 related titles and abstracts were found. After the duplication removal, screening, and assessment processes, 37 records were included for full-text reading. Finally, 20 articles in the English language were included in the scoping review for data extraction and assessment. RESULTS: We identified and subsequently discussed three fundamental issues associated to the management of pediatric oral hemangiomas: (i) clinical characteristics, differential diagnosis, and histopathological findings; (ii) evolution and complications; and (iii) current available treatment modalities. CONCLUSIONS: Although these like-tumor lesions are uncommon, pediatric dentistry practitioners must be familiar with the inherent clinical characteristics, diagnosis approaches, and currently available treatment options. Nowadays, surgical removal and non-invasive medical/pharmacologic therapies are the best management modalities for pediatric oral hemangiomas.

Alcohol-based mouthwash as a risk factor of oral cancer: A systematic review.

BACKGROUND: Oral and pharynx cancer represent a serious global problem, reaching an incidence of half a million cases annually. The role of tobacco and alcohol have been studied and proven to be one of its risk factors. We also know that mouthwashes contain a variable percentage of alcohol, so there is a reasonable concern about their role in carcinogenesis. MATERIALS AND METHODS: To answer the PICOS (Population; Intervention; Comparison; Outcomes; Study) question: Do patients (Population) who use alcohol-based mouthwashes (Intervention) compared to those who do not use them (Comparison) have higher acetaldehyde levels in saliva or higher risk of oral cancer development? (Outcomes) Meta-analyses, systematic reviews, randomized and non-randomized clinical trials, case-control studies, and prospective and retrospective cohort studies were included (Study). Two independent authors conducted literature screening through MEDLINE, Scopus and the Cochrane Library, and they also conducted article and data extraction to undertake quality analyses. The main outcome measures were salivary acetaldehyde levels or the risk of oral cancer development. The most relevant data was extracted and the risk of bias from the studies included was also evaluated. RESULTS: Out of 497 potentially eligible papers, 8 studies were included in the qualitative analysis which include a total of 43,499 subjects: two meta-analyses, a clinical trial, three case-control studies and two cohort studies. One study (n = 3,926) found a relationship between alcohol mouthwash and oral cancer, two studies (n = 25,033) found this relationship when a high frequency of mouthwash was present, three studies (n = 14,482) failed to find this relationship and 2 studies (n = 58) found a temporary increase of acetaldehyde levels in saliva after alcohol mouthwash. CONCLUSIONS: It cannot be guaranteed that the use of mouthwash represents an independent risk factor for the development of head and neck cancer. However, the risk does increase when it occurs in association with other carcinogenic risk factors.

Rationalizing the relative abundances of trimetallic nitride template-based endohedral metallofullerenes from aromaticity measures.

The synthesis of endohedral metallofullerenes (EMFs) from a carbon soot sample of an arc discharge leads to a variety of EMFs that are obtained in different relative abundances. In the present work, we show that these abundances can be predicted from aromaticity calculations. In particular, we use the normalized Additive Local Aromaticity (ALAN) index. Our results show that the most abundant Sc3N-based and Y3N-based EMFs in fullerene soot are the most aromatic. This study reinforces the idea that aromaticity plays a key role in determining the stability of EMFs.

Investigation of cyano-bridged coordination nanoparticles Gd(3+)/[Fe(CN)6](3-)/D-mannitol as T1-weighted MRI contrast agents.

Cyano-bridged Gd(3+)/[Fe(CN)6](3-) coordination polymer nanoparticles of 3-4 nm stabilized with D-mannitol presenting a high r1 relaxivity value of 11.4 mM(-1) s(-1) were investigated in vivo as contrast agents (CA) for Magnetic Resonance Imaging (MRI). They allow an increase of the MR image contrast and can act as an efficient intravascular T1 CA with a relatively long blood-circulation lifetime (60 min) without specific toxicity.

Effect of pretreatments and air-frying, a novel technology, on acrylamide generation in fried potatoes.

This paper investigated the effect of air-frying technology, in combination with a pretreatment based of soaking the samples in different chemical agent solutions (citric acid, glycine, calcium lactate, sodium chloride, or nicotinic acid [vitamin B3]), on the generation of acrylamide in fried potatoes. The influence of reducing sugars on the development of surface's color was also analyzed. The experiments were conducted at 180 °C by means of air-frying and deep-oil-frying, as a reference technology. Based on the evolution of color crust with frying time, it could be concluded that the rate of Maillard reaction decreased as the initial reducing sugars content increased in the raw material, and was also lower for deep-oil-frying than for air-frying regardless of pretreatments applied. Air-frying reduced acrylamide content by about 90% compared with conventional deep-oil-frying without being necessary the application of a pretreatment. However, deep-oil fried potatoes pretreated with solutions of nicotinic acid, citric acid, glycine at 1%, and NaCl at 2% presented much lower acrylamide levels (up to 80% to 90% reduction) than nonpretreated samples.

²°¹Tl⁺-labelled Prussian blue nanoparticles as contrast agents for SPECT scintigraphy.

Prussian blue (PB) and its analogues on the nanometric scale are exciting nano-objects that combine the advantages of molecular-based materials and nanochemistry. Herein, we demonstrate that ultra-small PB nanoparticles of 2-3 nm can be easily labelled with radioactive (201)Tl(+) to obtain new nanoprobes as radiotracers for 201-thallium-based imaging.

Flake size-dependent cyto and genotoxic evaluation of graphene oxide on in vitro A549, CaCo2 and vero cell lines.

This study was carried out by varying both graphene oxide (GO) concentration (10 μg/mL, 50 μg/mL, 100 μg/mL) and flakes sizes of 1320 nm and 130 nm. Characterization by scanning electron microscopy and Raman spectroscopy demonstrate that the area of GO flakes varies of one order of magnitude but their chemical structure remains unmodified. A 24-h cytotoxicity test showed, for A549, a loss in the viability, while the test exhibits overall a positive increase in the viability for CaCo2 and Vero. A 24-h comet assay shows a marked GO genotoxicity: for micrometer-sized GO flakes the genotoxicity is in positive correlation with the concentration, while for nanometer-sized GO flakes there was a high degree of genotoxicity at the lowest concentration tested.

Validation of receptor-binding assays to detect antibiotics in goat's milk.

The suitability of different receptor-binding assays to detect antibiotics in raw goat's milk was investigated. Detection capability of most ß-lactams and tetracyclines assessed applying the Betastar Combo, the SNAP Betalactam, the SNAP Tetracycline, and the Twinsensor tests was at or below maximum residue limits established by European legislation. Regarding test specificity, cross-reactions with antibiotics other than ß-lactams and tetracyclines were not found, and no false-positive results were obtained for the Betastar Combo and the SNAP tests when bulk samples of goat's milk were analyzed. For the Twinsensor test, the false-positive rate was 1%. The performance of the Betastar Combo and the SNAP tests was practically unaffected by the milk quality parameters using individual samples of goat's milk collected at points throughout the entire lactation period (false-positive rate, ≤5%). However, a larger number of positive results were obtained by the Twinsensor test in this type of milk sample (>10%), especially in the last weeks of lactation. Interferences related to the use of the preservative azidiol were not observed in any case. Neither were any significant differences found in relation to the interpretation method (visual versus instrumental) applied. In general, the response of the Betastar Combo, SNAP, and Twinsensor tests was optimal for the analysis of bulk caprine milk; thus, they may be used to monitor milk for the presence of ß-lactam and tetracycline residues in quality control programs.

Human infection by a "fish tapeworm", Diphyllobothrium latum, in a non-endemic country.

We document a case of locally acquired "broad- or fish-tapeworm" infection caused by Diphyllobothrium latum in a 27-year-old Spanish man, confirmed by molecular analysis (COI gene). The patient had naturally expelled a worm of 110 cm in length, but the physical examination did not yield any remarkable findings, and the patient did not suffer from any particular symptoms. Laboratory test results were normal except for a remarkable increase in the red blood cell count, and an evident decrease in the mean corpuscular volume and mean corpuscular hemoglobin. Vitamin B12 and folic acid values were in the normal range without signs of anemia. It was suggested that these anomalies in erythrocyte formation might not be related to the parasite, and analysis of the patient's anamnestic data revealed that the infection could only have been caused by the ingestion of imported fish, although no light could be shed on the specific source of infection. From a public health viewpoint, this human case of fish-borne zoonosis is exemplary, suggesting that not only is control of fish and fish product quality essential, but also increased awareness of the general population with regard to changes in culinary habits.

Ecotoxicological impact of MSW landfills: assessment of teratogenic effects by means of an adapted FETAX assay.

The introduction of chemical products into the environment can cause long-term effects on the ecosystems. Increasing efforts are being made to determine the extent of contamination in particularly affected areas using diverse methods to assess the ecotoxicological impact. We used a modified Frog Embrio Toxicity Assay-Xenopus method to determine the extent of toxicological load in different sample soils obtained near three municipal solid waste landfills in Catalonia (Spain). The results show that the Garraf landfill facility produces more embryotoxic damage to the surroundings, than the others ones: Can Mata landfill and Montferrer-Castellbó landfill. The aim of this work is to demonstrate how different management of complex sources of contamination as the controlled dumping sites can modulate the presence of toxics in the environment and their effects and through this, help determine the safer way to treat these wastes. To this effect some conceptual modifications have been made on the established American Society for Testing and Materials protocol. The validity of the new model, both as to model of calculation as to protocol, has been demonstrated in three different sites with complex sources of contamination.

A diversified approach to evaluate biostimulation and bioaugmentation strategies for heavy-oil-contaminated soil.

A diversified approach involving chemical, microbiological and ecotoxicity assessment of soil polluted by heavy mineral oil was adopted, in order to improve our understanding of the biodegradability of pollutants, microbial community dynamics and ecotoxicological effects of various bioremediation strategies. With the aim of improving hydrocarbon degradation, the following bioremediation treatments were assayed: i) addition of inorganic nutrients; ii) addition of the rhamnolipid-based biosurfactant M(AT10); iii) inoculation of an aliphatic hydrocarbon-degrading microbial consortium (TD); and iv) inoculation of a known hydrocarbon-degrading white-rot fungus strain of Trametes versicolor. After 200 days, all the bioremediation assays achieved between 30% and 50% total petroleum hydrocarbon (TPH) biodegradation, with the T. versicolor inoculation degrading it the most. Biostimulation and T. versicolor inoculation promoted the Brevundimonas genus concurrently with other α-proteobacteria, ß-proteobacteria and Cytophaga-Flexibacter-Bacteroides (CFB) as well as Actinobacteria groups. However, T. versicolor inoculation, which produced the highest hydrocarbon degradation in soil, also promoted autochthonous Gram-positive bacterial groups, such as Firmicutes and Actinobacteria. An acute toxicity test using Eisenia fetida confirmed the improvement in the quality of the soil after all biostimulation and bioaugmentation strategies.

Efeito hipoglicemiante da farinha do fruto de maracujá-do-mato (Passiflora nitida Kunth) em ratos normais e diabéticos / Hypoglycemic effect of Passiflora nitida Kunth fruit flour on normal and diabetic rats

A região amazônica é detentora de uma vasta biodiversidade de frutos, porém pouco explorada quanto o seu potencial nutricional e econômico. Dentre estes frutos destaca-se o maracujá-do-mato (Passiflora nitida Kunth), espécie silvestre, de fruto comestível, com sabor exótico e de boa aceitabilidade para consumo. No presente estudo objetivou-se analisar as características nutricionais do mesocarpo do fruto da P. nitida e avaliar o potencial hipoglicemiante em ratos normais e diabéticos. A farinha do mesocarpo do fruto foi elaborada e analisada quanto a composição centesimal. A atividade hipoglicemiante foi avaliada por meio de dois modelos experimentais em ratos Wistar. O mesocarpo apresentou baixa concentração de macronutrientes e alto teor de umidade, cinzas e fibras. No experimento agudo, após 15 minutos da administração da sacarose, os níveis glicêmicos foram de 146±12 mg dL-1 no grupo controle e 112±2,5 mg dL-1, no grupo que recebeu 1g kg-1 de peso da farinha. No experimento crônico, após 21 dias, houve redução de 493 mg dL-1 para 302 mg dL-1 (38,7 %) e 195 mg dL-1 (60,4%) na glicemia nos grupos que foram tratados com 20 e 40% de ração enriquecida com a farinha, respectivamente, em relação ao grupo diabético não tratado. Em ambos os modelos experimentais, a farinha do mesocarpo mostrou-se eficaz na redução da glicemia. O fruto de P. nitida mostrou-se um produto natural em potencial para o controle da glicemia no diabetes.

The Amazon region has a vast biodiversity of fruits but is little explored as to its nutritional and economic potential. Among these fruits is "maracuja-do-mato" (Passiflora nitida Kunth), a wild species of edible fruit with exotic flavor and good acceptability for consumption. The aim of the present study was to analyze the nutritional characteristics of P. nitida fruit mesocarp and to evaluate its hypoglycemic potential in normal and diabetic rats. Flour from the fruit mesocarp was prepared and analyzed as to its centesimal composition. Hypoglycemic activity was assessed by means of two experimental models in Wistar rats. The mesocarp showed low concentration of macronutrients and high humidity, ash and fiber content. In the acute experiment, after 15 minutes of sucrose administration, glucose levels were 146 ± 12 mg dL-1 in the control group and 112 ± 2.5 mg dL-1 in the group receiving 1 g kg-1 flour weight. In the chronic experiment, after 21 days, glucose levels reduced from 493 mg dL-1 to 302 mg dL-1 (38.7%) and 195 mg dL-1 (60.4%) in the groups treated with 20 and 40% animal food enriched with the flour, respectively, in relation to the diabetic untreated group. In both experimental models, the mesocarp flour was effective in reducing blood glucose. P. nitida fruit seems to be a potential natural product in the glycemic control of diabetes.

MDMA (ecstasy) delays pubertal development and alters sperm quality after developmental exposure in the rat.

3,4-Methylenedioxymethamphetamine, MDMA or "ecstasy" is consumed mainly by young population at childbearing age. Therefore, there may be a risk of exposure of some pregnant women. The effects of the developmental exposure to MDMA on the sexual development and long-term sexual behaviour/fertility were assessed in Sprague-Dawley rats. MDMA was administered subcutaneously at 0 (control), 0.5, 5 and 10 mg/kg to female rats once a day, three consecutive days a week during 10 weeks, including gestation and lactation. The male offspring was evaluated for sexual maturation and mated with untreated sexually receptive females to evaluate the mating and pregnancy rates. Hormonal, haematological, biochemical, histological, genotoxicological and testicular and sperm parameters were also evaluated. A significant higher incidence of DNA damage in sperm and interstitial oedema in testes was found. There was also a significant and dose-related decrease in sperm count and a significant decrease in sperm motility at all doses. A significant delay in preputial separation onset in all treated groups was observed. This study reports by the first time an alteration of spermatogenesis after in utero and lactation MDMA exposure in the rat.