Italian translation, cultural adaptation, and validation of the Intermittent Catheterization Acceptance Test (I-CAT).

Aims: The purpose of the present study was to translate and culturally adapt the Intermittent Catheterization Acceptance Test (I-CAT) for Italian individuals with spinal cord injury and spina bifida and to measure its psychometric properties. Methods: Consent from the authors of I-CAT was received, and then, following international guidelines, it was culturally adapted to Italian. The included participants adults who practice self-catheteri-zation. In order to evaluate criterion validity, the Qualiveen-30, Spinal Cord Independence Measure (SCIM-self reported), and the Moorong self-efficacy scale (MSES) were administered together. Test-retest reliability was assessed administering the I-CAT a second time within a week. Following the COSMIN checklist, psychometric properties were evaluated. Results: All translated items resulted identical or similar to the original versions. Internal consistency, evaluated on 34 individuals, showed values of Cronbach's alpha of 0.889, test-retest reliability was evaluated through the intraclass correlation coefficient with values of 0.96. Statistically significant correlation between the I-ICAT and Qualiveen were found through Pearson's correlation coefficient and Spearman's Correlation Coefficient for criterion validity. Conclusions: The Italian validation of I-CAT allows Italian professionals to investigate psychological barriers linked with self-catheterization in people with urinary tract dysfunction before learning about aseptic Intermittent Self Catheterization (IC) and improving patients' acceptance of it. This tool can also be used as follow-up after the training of intermittent self-catheterization techniques. Finally, it is an important tool for medical research.

Nanostructured lipid carriers loaded with curcuminoids: Physicochemical characterization, in vitro release, ex vivo skin penetration, stability and antioxidant activity.

Four formulations of nanostructured lipid carriers (NLC) loaded with curcuminoids where prepared, testing two types of solid lipids (Compritol® 888 ATO and Precirol® ATO 5) and two kinds of stabilizers (poloxamer 407 and polysorbate 80). Particle size values between 111 and 214 nm and polydispersity indices < 0.3 were registered, with low Z potential values due to the nonionic character of the stabilizers. The results showed that the type of surfactant had an impact on the in vitro release rate and on the ex vivo skin permeation capability of curcuminoids. Polysorbate 80 delayed the release, but favors the transport of a higher amount of curcuminoids to the receptor solution during the ex vivo permeation studies than the systems with poloxamer 407. Confocal microscopy confirmed that all systems favored the penetration of curcuminoids to deeper layers of the skin and in a greater amount than curcuminoids in solution. Exposure of the systems to intense radiation caused the degradation of curcuminoids, without loss of antioxidant activity, confirming that the degradation products also function as antioxidants. The NLC prepared can be valuable carriers to enhance the penetration of curcuminoids into the skin, to treat different disorders and skin diseases.

Portal venous versus systemic venous drainage of pancreas grafts: impact on long-term results.

Portal venous (PV) and systemic venous (SV) drainage methods are used in pancreas transplantation. The impact of the reconstruction technique on long-term outcome remains unclear. We compared the efficacy and side effects of both methods in 192 recipients who received synchronous pancreas kidney transplants between November 1995 and November 2007. SV and PV drainage were used in 147 and 45 cases, respectively. Pancreas function was determined by hemoglobin A1c levels and annual oral glucose tolerance test. Serum creatinine assessed kidney function. Serum lipid (low-density lipoprotein, high-density lipoprotein and cholesterol) levels and body mass index were measured annually. Patient and graft survival were calculated by log-rank analysis. Pancreas survival for SV versus PV patients was similar after 5 years (81.8% vs. 75.5%) and 10 years (65.1% vs. 60%; p = NS). Similarly, no difference was detected between the groups regarding kidney survival after 5 years (92.9% vs. 84.4%) and 10 years (81.6% vs. 75.5%; p = NS). Patient survival did not differ at 5 years (94.3% vs. 88.8%) and 10 years (85.1% vs. 84.4%; p = NS). Pancreas and kidney function and the lipid profiles were similar in both groups. SV and PV drainage of pancreas grafts offer similar long-term graft survival and function and choice of method should remain the preference of the surgeon.

[Identification of simple safe practices in a primary care area]. / Identificación de las prácticas seguras simples en un área de atención primaria.

OBJECTIVES: To assess the safe practices (SP) prepared by the Health Risk Management Functional Unit (UFGRS), according to their complexity of introduction and the impact on patient safety, and to identify simple SP. MATERIAL AND METHODS: A number of important SP have been prepared by the UFGRS of Madrid Health Area 4 Primary Care (PC). They were subsequently assessed according to their complexity of introduction and their potential impact on patient safety, simple SP (SSP) for the prevention of adverse events, low complexity of introduction and impact on patient safety. Lastly, the barriers to their effective introduction were identified, and actions were designed to overcome these barriers. RESULTS: Of the 50 PS prepared, 42 have been applied in the whole Area. Seven Level 1 SP (which fulfil the ideal conditions) were identified as simple SP. The main barriers were due to lack of training, culture, leadership of the management teams and professionals of the centre and lack of knowledge of the SPs. CONCLUSIONS: A large number of SP has been prepared by the UFGRS, with simple SP being identified for PC. The majority of these have to do with the safe use of drugs and vaccines.

Adaptación de una cepa compatible con Acidithiobacillus ferrooxidans sobre concentrados de calcopirita (CuFeS2), esfalerita (ZnS) y galena (PbS) / Adaptation of a strain Acidithiobacillus ferrooxidans compatible on concentrates of chalcopyrite (CuFeS2), sphalerite (ZnS) and galena (PbS)

En este estudio se evaluó la adaptación de una cepa compatible con Acidithiobacillus ferrooxidans a altas densidades de pulpa de calcopirita, esfalerita y galena, con dos distribuciones de tamaño de partícula, -200 y -325 serie Tyler de tamices. Los microorganismos fueron adaptados por la disminución gradual de la fuente principal de energía, sulfato ferroso, y el aumento en el contenido de mineral, para finalmente realizar un subcultivo sin la adición de fuente de energía externa. La realización de subcultivos en serie resultó ser una estrategia eficaz para la adaptación a altas densidades de pulpa de esfalerita, calcopirita y galena indicando que el protocolo empleado es adecuado. Los resultados muestran que la cepa compatible con Acidithiobacillus ferrooxidans es más resistente a altas concentraciones de esfalerita, seguido por calcopirita y finalmente por galena. El tamaño de partícula juega un papel fundamental en la adaptación de los microorganismos al mineral.

In this study the adaptation of Acidithiobacillus ferrooxidans-like to high concentrations of chalcopyrite, sphalerite and galena were evaluated with two mineral-particle sizes: 200 and 325 Tyler mesh. The strain was adapted using two simultaneous processes. The first one consisted in a gradual decreasing of the main energy source, ferrous sulphate. The second one consisted in a gradual increasing of the mineral content. Finally, a test was made without ferrous sulphate. The serial subculturing was found to be an efficient strategy to adapt Acidithiobacillus ferrooxidans-like to higher concentrations of chalcopyrite, sphalerite and galena. This indicates that a suitable protocol was employed. The results showed that Acidithiobacillus ferrooxidans-like is more resistant to high concentration of sphalerite, chalcopyrite and galena in descendant order. The particle size played an important role in the adaption of microorganism to the mineral.

Trabecular bone deficits among Vietnamese immigrants.

SUMMARY: Compared to white women, lower areal bone mineral density (aBMD) in middle-aged Vietnamese immigrants is due to reduced trabecular volumetric bone mineral density (vBMD), which in turn is associated with greater trabecular separation along with lower estrogen levels. INTRODUCTION: The epidemiology of osteoporosis in Asian populations is still poorly known, but we previously found a deficit in lumbar spine aBMD among postmenopausal Southeast Asian women, compared to white women, that persisted after correction for bone size. This issue was revisited using more sophisticated imaging techniques. METHODS: Twenty Vietnamese immigrants (age, 44-79 years) were compared to 162 same-aged white women with respect to aBMD at the hip, spine and wrist, vBMD at the hip and spine by quantitative computed tomography and vBMD and bone microstructure at the ultradistal radius by high-resolution pQCT. Bone turnover and sex steroid levels were assessed in a subset (20 Vietnamese and 40 white women). RESULTS: The aBMD was lower at all sites among the Vietnamese women, but femoral neck vBMD did not differ from middle-aged white women. Significant differences in lumbar spine and ultradistal radius vBMD in the Vietnamese immigrants were due to lower trabecular vBMD, which was associated with increased trabecular separation. Bone resorption was elevated and bone formation depressed among the Vietnamese immigrants, although trends were not statistically significant. Serum estradiol was positively associated with trabecular vBMD in the Vietnamese women, but their estrogen levels were dramatically lower compared to white women. CONCLUSIONS: Although reported discrepancies in aBMD among Asian women are mainly an artifact of smaller bone size, we identified a specific deficit in the trabecular bone among a sample of Vietnamese immigrants that may be related to low estrogen levels and which needs further study.

Direct observation and theory of trajectory-dependent electronic energy losses in medium-energy ion scattering.

The energy spectrum associated with scattering of 100 keV H+ ions from the outermost few atomic layers of Cu(111) in different scattering geometries provides direct evidence of trajectory-dependent electronic energy loss. Theoretical simulations, combining standard Monte Carlo calculations of the elastic scattering trajectories with coupled-channel calculations to describe inner-shell ionization and excitation as a function of impact parameter, reproduce the effects well and provide a means for far more complete analysis of medium-energy ion scattering data.

Evaluación de la efectividad de la nimodipina en el tratamiento del vértigo de origen periférico: reporte preliminar / Evaluation of the effectiveness of nimodipine in the treatment of vertigo of peripheral origin: preliminary report

El vértigo es un síntoma que se caracteriza por la ilusión de movimiento. Esto afecta tanto el bienestar individual como la capacidad para realizar las actividades propias de la vida cotidiana, ejerciendo un impacto negativo sobre la calidad de vida, por lo tanto es importante encontrar una terapia efectiva y cómoda que permita al paciente incorporarse a las labores de la vida diaria lo mas rápido posible y con la mejor calidad de vida. Métodos: Se evaluó la efectividad en el tratamiento del vértigo de origen periférico de dos formulaciones de nimodipina, la nimodipina convencional de administración tres veces al día (Nimotop® 30 mg) versus la nimodipina 90 mg. AP de administración una vez al día (Tropocer®). Se realizó un estudio clínico prospectivo, aleatorizado, doble ciego, doble simulado (doble dummy), multicéntrico nacional, de grupos paralelos, donde se incluyeron pacientes con vértigo de origen periférico, definido como una puntuación mayor o igual a 7 en el Vertigo-Dizziness Differential Diagnosis Score (VDDDS)¹. Los pacientes fueron evaluados mediante la escala Índice de Severidad del Vértigo2 y el Índice de Discapacidad Vestibular. Resultados: En el grupo de nimodipina AP el Índice de Severidad del Vértigo² disminuyó en un cincuenta por ciento en el 38% de los pacientes a los 14 días, en 53% y 92% a las 4 y 8 semanas respectivamente. El Índice de Discapacidad Vestibular disminuyó en un 50% a los 14 días en el 31% de los pacientes y en 77% y 92% a las 4 y 8 semanas respectivamente. En el grupo de nimodipina convencional el Índice de Severidad del Vértigo disminuyó en un 50% en: 25% de los pacientes a los 14 días, en 67% y 93% a las 4 y 8 semanas respectivamente. El índice de Discapacidad Vestibular disminuyó en 50% a los 14 días en el 30% de los pacientes y en 78% y 100% a las 4 y 8 semanas respectivamente, sin diferencias significativas entre los grupos

Vertigo is a symptom that is characterized by the illusion of movement. It affects both individual welfare and the ability to perform activities of daily living, having a negative impact on quality of life, so it is important to find a comfortable and effective therapy that allows the patient to join the work of the daily life as soon as possible and with the best quality of life. Methods: We evaluated the effectiveness in the treatment of vertigo of peripheral origin of two formulations of nimodipine: conventional nimodipine of administration three times daily (30 mg Nimotop®) versus nimodipine 90 mg. Extender Release (ER) administration once day (ER Tropocer® 90 mg). We performed a prospective, randomized, double-blind, double dummy, national multicenter parallel-group, clinical study which included patients with vertigo of peripheral origin, defined as a score greater than or equal to 7 at the Vertigo-dizziness Differential Diagnosis Score (VDDDS). Patients were evaluated with the scale Index of Severity of Vertigo and Vestibular Disability Index. Results: In the nimodipine ER group, the index of severity of vertigo decreased 50%: in 38% of patients to 14 days in 53% and 92% at 4 and 8 weeks respectively. The vestibular disability index decreased 50% to 14 days in 31% of patients and in 77% and 92% at 4 and 8 weeks respectively. In the nimodipine Conventional group, the index of severi-ty of vertigo decreased in 50% in 25% of patients to 14 days in 67% and 93% at 4 and 8 weeks respectivelyAU)

Surface plasmon resonance and magnetism of thiol-capped gold nanoparticles.

Surface plasmon resonance measurements and magnetic characterization studies have been carried out for two types of thiol-capped gold nanoparticles (NPs) with similar diameters between 2.0 and 2.5 nm and different organic molecules linked to the sulfur atom: dodecanethiol and tiopronin. In addition, Au NPs capped with tetraoctyl ammonium bromide have also been included in the investigation since such capping molecules weakly interact with the gold surface atoms and, therefore, this system can be used as a model for naked gold NPs; such particles presented a bimodal size distribution with diameters around 1.5 and 5 nm. The plasmon resonance is non-existent for tiopronin-capped NPs, whereas a trace of such a feature is observed for NPs covered with dodecanethiol molecules and a bulk-like feature is measured for NPs capped with tetralkyl ammonium salts. These differences would indicate that the modification of the surface electronic structure of the Au NPs depends on the geometry and self-assembling capabilities of the capping molecules and on the electric charge transferred between Au and S atoms. Regarding the magnetization, dodecanethiol-capped NPs have a ferromagnetic-like behaviour, while the NPs capped with tiopronin exhibit a paramagnetic behaviour and tetralkyl ammonium-protected NPs are diamagnetic across the studied temperature range; straight chains with a well-defined symmetry axis can induce orbital momentum on surface electrons close to the binding atoms. The orbital momentum not only contributes to the magnetization but also to the local anisotropy, giving rise to permanent magnetism. Due to the domain structure of the adsorbed molecules, orbital momentum is not induced for tiopronin-capped NPs and the charge transfer only induces a paramagnetic spin component.

Diabetes team consultation: impact on length of stay of diabetic patients admitted to a short-stay unit.

OBJECTIVE: To assess the impact of endocrinology team consultation on hospital stay and clinical outcomes of diabetic patients admitted with a primary non-diabetes-related diagnosis in a short stay unit (SSU). METHODS: Patients admitted to the SSU between 2001 and 2005. Between 2001 and 2003 there was no endocrinology team consultation available and the management of hyperglycemia was handled by the SSU team alone. From 2003 until 2005 an endocrinology team was in charge of diabetes care. We compared in both periods: prevalence of diabetes, length of hospital stay, mortality, early readmissions and number of patients requiring conventional hospitalization. RESULTS: In period 2001-2003, 1023 patients were admitted, among which 212 were diabetic (20.7%). Over the years 2003-2005, 892 patients were hospitalized, 223 were diabetic (25%). Clinical characteristics of diabetic patients from both periods were comparable, but glycaemia at admission was higher on the second period (217 mg/dl versus 198 mg/dl). The length of stay of diabetic patients in the second period decreased from 5.49 to 4.90 days. There were no significant differences in mortality (1.4% versus 0.4%) or in early re-admissions among the two periods. CONCLUSIONS: The intervention of a diabetes team diminished the average length of stay of diabetic patients.

Variations in bone density among persons of African heritage.

The epidemiology of bone loss in populations of African heritage is still poorly known. We compared a convenience sample of 47 African-American (AA) residents of Rochester, Minnesota (32 women, 15 men) and 66 recent immigrants from Somalia (all women) with 684 white subjects (349 women, 335 men) previously recruited from an age-stratified random sample of community residents. Areal bone mineral density (BMD, g/cm(2)) and volumetric bone mineral apparent density (BMAD, g/cm(3)) were determined for lumbar spine and proximal femur using the Hologic QDR 2000 for white subjects and the QDR 4500 for the others; the instruments were cross-calibrated from data on 20 volunteers. Lumbar spine BMD was 18% higher in AA ( p<0.001) and 4% lower in Somali ( p = 0.147) than white women. Femoral neck BMD was 27% higher in AA women but also 11% greater in Somali women (both p<0.001) compared with whites. Lumbar spine BMD was 6% higher ( p = 0.132) and femoral neck BMD 21% higher ( p<0.001) in AA than white men. No Somali men were studied. After correcting for bone size differences, both lumbar spine ( p<0.01) and femoral neck BMAD ( p<0.001) were greater for Somali than white women, but the difference between Somali and AA women persisted. Lumbar spine and femoral neck BMAD values also remained significantly greater for AA women (both p<0.001) and men ( p<0.05; p<0.001) compared with whites. Weight was associated with BMAD at both skeletal sites in all groups, but adjustment for differences in weight did not reduce the discrepancy in BMAD values between Somali and AA women or between the latter group and whites. This heterogeneity among different ethnic groups of African heritage may provide an opportunity for research to better explain race-specific differences in bone metabolism.

Bone density in an immigrant population from Southeast Asia.

The epidemiology of bone loss in populations of Asian heritage is still poorly known. This study compared the skeletal status of a convenience sample of 396 Southeast Asian immigrants (172 Vietnamese, 171 Cambodians and 53 Laotians) residing in Rochester, Minnesota in 1997 with 684 white subjects previously recruited from an age-stratified random sample of community residents. Areal bone mineral density (BMD, g/cm2) and volumetric bone mineral apparent density (BMAD, g/cm3) were determined for lumbar spine and proximal femur using the Hologic QDR 2000 instrument for the white population and the QDR 4500 for Southeast Asian subjects; the machines were cross-calibrated from data on 20 volunteers. Lumbar spine BMD was 7% higher in white than Southeast Asian women (p < 0.001), and similar results were observed for the femoral neck; lumbar spine BMD was 12% higher in white than nonwhite men (p < 0.001). Race-specific discrepancies were reduced by calculating BMAD: for premenopausal women, lumbar spine and femoral neck differences between whites and Southeast Asians were eliminated; for postmenopausal women the lumbar spine differences persisted (p < 0.0001), while femoral neck BMAD was actually higher for Southeast Asians. There were no race-specific differences in femoral neck BMAD among men of any age (p = 0.312), but lumbar spine BMAD was less for younger (p = 0.042) but not older (p = 0.693) Southeast Asian men. There were differences among the Southeast Asian subgroups, but no clear pattern emerged. Predictors of lumbar spine BMAD in Southeast Asian women were age (p < 0.001), weight (p = 0.015) and gravidity (p = 0.037). Even after adjusting for bone size using BMAD, 32% and 9% of Southeast Asian women and men, respectively, would be considered to have osteoporosis at the femoral neck and 25% and 4%, respectively, at the lumbar spine. These findings indicate a need for culturally sensitive educational interventions for Southeast Asians and for physicians to pursue diagnosis and treatment to prevent osteoporosis-related disabilities in this population.

Evaluación clínica de la glandula iroides y dosaje de la hormona estimulante de la tiroides (TSH) y T4 libre en mujeres embarazadas de nivel socio económico bajo / Clinical evaluation of thyroid gland and thyroid stimulating hormone (THS) and free T4 determination in pregnant women of low socio-economic level

Pregunta de Investigación.- ¿Cual será la correlación clínica de la glándula tiroides y de la hormona estimulante de la tiroides (TSH) y T4 libre en mujeres habitantes de altura de 15 a 21 semanas de edad gestacional? Objetivo general.- Valoración clínica de la glándula tiroides y cuantificación TSH y T4 libre en mujeres habitantes de altura de 15 a 21 semanas de gestación de nivel socio-económico bajo. Diseño.- Distritos de Salud de la ciudad de El Alto y un centro de Salud de la ciudad de La Paz. La Unidad de Hormonas del Laboratorio labclincs. Pacientes.- 102 mujeres embarazadas residentes en su mayoría de la ciudad de EL ALto a 4100 m de altura. Metodos.- Clínico, basado en el método palpatorio de Perez y Col. y laboratorial aplicando el método de radioinmunoanálisis para la cuantificación sérica de TSH y T4 libre. Resultados.- El hallazgo más importante fue el elevado porcentaje (32 porciento), de frecuencia de bocio. Los resultados de TSH y T4 libre séricos, muestran una distribución que en su mayor porcentaje están dentro de los valores de referencia normales, eceptuando el 4 porciento de mujeres gestantes que presentaron hipotiroidismo suclínico con valores de referencia normales sin sintomatología clínica y un caso aislado de hipertiroidismo. Colclusiones.- La elevada frecuencia de bocio encontrada en este estudio es una alerta para tomar medidas preventivas de suplemento de yodo a la mujer embarazada acorde a normas establecidad por la OMS/OPS.(au)

Delivery rates for preventive services in 44 midwestern clinics.

OBJECTIVE: To determine the rates at which private primary-care clinics are recommending blood pressure and cholesterol measurement, smoking cessation, clinical breast examination, screening mammography, Papanicolaou testing, and influenza and pneumococcus immunizations. MATERIAL AND METHODS: We conducted a mail survey of 7,997 randomly selected patients from 44 primary-care clinics in and around Minneapolis-St. Paul, Minnesota, of whom 6,830 (85.4%) completed the questionnaire on preventive services delivery rates. The responses were analyzed statistically, including stratification by reason for the clinic visit. RESULTS: On the average, about two-thirds of the patients in each clinic reported being up-to-date on preventive services before their clinic visit; an exception was pneumococcus immunization (mean rate, 33%). Except for blood pressure and smoking cessation advice, less than 30% of patients who were not up-to-date on a preventive service were offered it if the clinic visit was for a reason other than a checkup or physical examination. For patients who said that they saw their physician for a checkup or physical examination, the rate was more than 50% only for Papanicolaou smear. In contrast, nearly all responding practitioners agreed that each of the eight preventive services was very important or important. CONCLUSION: Preventive services consensus goals are not being met, even for patients who report that their clinic visit was for a checkup or physical examination. This finding suggests that it may be necessary to develop clinical systems that support and enable the delivery of preventive services.

[Favorable response to corticoid therapy in a patient with transverse myelitis in systemic lupus erythematosus]. / Respuesta favorable a la corticoterapia en una paciente afecta de mielitis transversa en el curso de lupus eritematoso sistémico.

Transverse myelitis is one of the most unusual neurologic complications of systemic lupus erythematosus. Its pathogenetic mechanisms are controversial. Several therapeutic regimens have been attempted with contradictory results. Corticotherapy appears to improve prognosis, although some authors question its beneficial effects. The case of a patient with systemic lupus erythematosus and transverse myelitis, who presented a favourable clinical course following early treatment with high-dose corticoids, is reported.

[Volvulus of the transverse colon: a rare cause of intestinal obstruction]. / Vólvulo de colon transverso: una causa poco frecuente de obstrucción intestinal.

Volvulus of the transverse colon is rare, given its short and fixed mesentery and the normal fixation of the hepatic and splenic flexures of the colon. The case reported herein brings the total of reported cases to 72. Various predisposing factors have been identified, most notably congenital abnormalities, physiologic disturbances and mechanical obstruction; in our case these three factors were present. The possible role of colonoscopy in diagnosis and/or therapy is unclear. In our patient, colonoscopy proved to be of no use for diagnosis or treatment.