Diagnostic approach to subcutaneous nodules in patients with neuroendocrine tumours treated with depot somatostatin analogs: a cross-sectional study.

BACKGROUND: The presence of cutaneous nodules in patients with gastroenteropancreatic neuroendocrine tumours (GEP-NETs) receiving depot somatostatin analogs (SSAs) is a diagnostic challenge as differential diagnosis between injection site reactions and metastases is essential. OBJECTIVE: To characterize the clinical, radiological, cytological and histopathological features of subcutaneous nodules in patients with GEP-NETs treated with SSAs. MATERIALS AND METHODS: Retrospective, cross-sectional study of patients with GEP-NETs treated with SSAs in whom subcutaneous nodules were detected on routine abdominal computed tomography (CT) scans. High resolution and colour Doppler ultrasonography was performed. Those patients with inconclusive radiological studies went through fine-needle aspiration cytology (FNAC) and/or biopsy. RESULTS: Twelve patients (five males, seven females) were included (six midgut carcinoid NETs, six pancreatic NETs). Three patients received intramuscular depot octreotide, seven subcutaneous lanreotide, and two both treatments. CT scan findings were nonspecific. Sonography revealed a hyperechoic pattern in recent injections, and a hypoechoic pattern with a characteristic hyperechoic peripheral rim in long-term injections (more than 3 months after injection). On colour Doppler sonography, nodules showed no signs of intralesional vascularity. Fine-needle aspiration cytology (FNAC) was performed in five patients, revealing a characteristic acellular proteinaceous material. Biopsy in four patients showed different reactional infiltrates around the acellular material. CONCLUSIONS: High resolution and colour Doppler ultrasonography may be very useful for the differential diagnosis of subcutaneous nodules in patients with GEP-NETs treated with SSAs. FNAC and a biopsy are useful tests for confirmation of the diagnosis in patients with inconclusive findings. We propose a management algorithm.

High-vacuum annealing reduction of Co/CoO nanoparticles.

Porous films of Co/CoO magnetic nanoparticles have been obtained by inert gas condensation and partially oxidized in situ in the deposition chamber. These nanoparticle films were subjected to thermal treatments in high vacuum and the chemical and structural changes monitored by x-ray diffraction, transmission electron microscopy, transport and magnetic measurements (with a focus on the exchange-bias phenomenon), which evidence that for vacuum annealing temperatures above 360 °C, most of the CoO phase is reduced to metallic Co without requiring the presence of an external reducing agent (e.g., H2) or a plasma. Additionally, there is a certain degree of particle coalescence resulting in the formation of greater nanoparticles as the annealing temperature increases. This yields a smaller proportion of CoO compared to metallic Co and a reduction of the Co/CoO interface density, pinpointed by a drastic decrease of the exchange-bias field. The crucial roles of the vacuum level and the surface-to-volume ratio are evidenced by magnetic measurements, highlighting the potential of magnetometry as a probe for the reduction/oxidation of composite nanostructures.

A novel single nucleotide polymorphism assay for the detection of N501Y SARS-CoV-2 variants.

The N501Y mutation in SARS-CoV-2 variants found in several strains from the UK, South Africa and Brazil has been linked to increased transmission. In order to discriminate N501Y variants quickly, a single nucleotide polymorphism (SNP) discrimination assay was designed and validated. It was then deployed prospectively in 757 nasopharyngeal swabs. Validation of the novel variant discrimination assay corroborated the results in all validation panel samples (n = 63) through sequencing. This novel variant discrimination assay was then deployed prospectively in 757 clinical nasopharyngeal swabs during the last week of January 2021. N501Y was found in 206 (27.4 %) of the samples: 94 (28.2 %) men and 112 (26.85 %) women (p = 0.73). The patients in whom it was identified had a mean age of 47.8 ± 25.8 (0-96) years, similar to that of patients without this variant: 51.7 ± 25.9 (0-104) years (p = 0.06). 501Y variant was confirmed in 34 samples by sequence method and 501 N wild type was confirmed in 67. This method is sensitive, specific, and simple to apply in any microbiology lab.

The oxidation of metal-capped Co cluster films under ambient conditions.

We report on the unexpected deterioration under ambient conditions of films of Co clusters capped with relatively thick (>100 nm) Cu (or Ti) layers deposited by either thermal evaporation or by radiofrequency sputtering. The magnetic character of the clusters, prepared by gas-phase condensation, allows monitoring the oxidation of the samples through the decay of the saturation magnetization, which takes place on a timescale of days. By contrast, diluted (<10 at.%) cluster-assembled granular Co:Cu films, prepared by co-deposition of the Co clusters with a Cu vapour, are perfectly stable under ambient conditions. We tentatively explain the oxidation of the cluster films as stemming from their very high porosity.

Multiple-goal pursuit and its relation to cognitive, self-regulatory, and motivational strategies.

BACKGROUND: The topic of academic goals has provided very important information about students' motivation. Traditional research has described several mutually exclusive goals that elicit different motivational patterns. Nevertheless, goal-orientation research has reported the possibility that more than one goal may operate simultaneously. AIM: The purpose of this study was to characterise multiple-goal groups of students, who use various types of cognitive, self-regulatory, and motivational strategies. SAMPLE: Participants were 595 Spanish-speaking university students at the University of A Coruña. METHOD: In order to examine the relationships between goal orientations and strategies, a Pearson correlational analysis was performed. Then, a cluster analysis was performed to identify potential subgroups of students with more than one simultaneously operative goal. Finally, a one-way test was conducted to determine whether the multiple-goal clusters differed in any of the nine strategies. RESULTS: Only those students who reported high task orientation tended to exhibit more frequent use of cognitive and self-regulatory strategies. Nevertheless, this does not mean that learning processes are only optimised by task orientation. When multiple-goal adoption was considered, students who developed the most positive self-regulation were characterised by their focus on learning, but also by their desire to avoid being judged negatively by others. CONCLUSIONS: Students should not adopt only task goals, which are sometimes overvalued, but also other kinds of goals that allow them to manage their learning and make it more flexible in each situation. This aspect characterises self-regulated learning, which is defined not only by cognitive and behavioural regulation but also by motivational regulation.

[Results after treatment with sildenafil citrate in 100 patients with erectile dysfunction]. / Resultados tras el tratamiento con Citrato de Sildenafilo en 100 pacientes con disfunción eréctil.

OBJECTIVE: In order to know the efficiency, tolerance and acceptance of Sildenafil Citrate in our area as a new treatment for Eréctil Dysfunction (E.D.). MATERIAL AND METHODS: We include 100 patients with E.D. who were assisted in our medical office from November 1998 to February 2000 to evaluate them according to several predeterminated variables. RESULTS: The positive response index (E.D. improvement) was 69.9%. We only found side effects in 11.8% (headache 5.4%, flushing 4.3%, diarrhea/blurred vision 2.2%). The most widely used dose was 50 mgrs (65.6%). Only 50.5% of the patients had enough information about Sildenafil. The highest positive response index corresponded to the mild E.D. (76.1%). Also the best results were achieved with the mixed and psychological etiology (74.1%). The Sildenafil treatment was rejected (fear or its price) by the 46.2% of the patients. CONCLUSIONS: The Sildenafil Citrate is an effective treatment for the E.D. It hardly has any side effects. The 50 mgrs dose got the best results. Almost half of the patients complained about an insufficient information on this pharmaceutical. Sildenafil got a good response even when there were risk associated factors of E.D.

Factores que condicionan la aceptación y consumo de los suplementos nutricionales en el paciente ingresado / Factors determining the compliance and intake of nutritional supplements in hospitalized patients

La malnutrición calórico-proteica, que puede afectar al 30-50% de los pacientes hospitalizados, aumenta el tiempo de hospitalización y el coste por proceso patológico en nuestros pacientes. Existe suficiente evidencia científica que avala que la administración de suplementos nutricionales (SN) puede mejorar tanto parámetros nutricionales como funcionales y previene la aparición de malnutrición en pacientes que no cubren todas sus necesidades nutricionales con la dieta convencional o con la dieta adaptada. También, se ha documentado que pueden reducir la duración de la estancia hospitalaria y las tasa de mortalidad en algunas condiciones. Sin embargo, se ha observado, tanto en la práctica clínica habitual como en algunos ensayos clínicos, que el cumplimiento terapéutico y la adherencia al tratamiento son bajos, observándose en algunos ensayos que hasta menos de la mitad de los pacientes llegaban a consumir lo prescrito. Son múltiples los factores que intervienen en el cumplimiento terapéutico, aunque hasta el momento, no han sido bien estudiados. En este artículo, vamos a hacer una reflexión sobre este aspecto. Las causas que ocasionan este incumplimiento se podrían agrupar en tres tipos de motivos: factores socio sanitarios, factores relacionados con el paciente y su patología; y factores relacionados con las características de los suplementos. Entre los factores socio sanitarios, cabe destacar aquellos relacionados con la adecuada formación en Nutrición de los médicos y de todos los profesionales sanitarios implicados en el tratamiento del paciente, así como la implicación en el tratamiento por parte de los cuidadores en general, incluyendo a los familiares; siendo fundamental el tipo de institución en la que se encuentra ingresado el paciente (sobre todo cuando se trata de unidades de agudos frente a las de crónicos ) y de la existencia de servicio de nutrición en el centro en cuestión. Entre los factores dependientes del paciente son importantes: la edad, pues se describe peor adherencia en los más mayores; la patología de base: la presencia de enfermedad tumoral, la insuficiencia renal, la disgeusia y disfagia, entre otras causas, condicionan una peor adherencia al tratamiento), así como la duración del ingreso, ya que cuando se prolonga empeora también la adherencia. Finalmente, también tienen trascendencia los factores relacionados con el suplemento en sí mismo, en función de su composición, forma de presentación, tipo de envase y sus características organolépticas (olor, sabor y textura). Hecha esta reflexión se sugieren unas pautas a seguir para conseguir una tasa mayor de cumplimiento del tratamiento indicado con suplementos nutricionales al paciente ingresado (AU)

Protein-calorie malnutrition, which can affect 30-50% of hospitalized patients, increases the length of hospital stay and cost per pathological process in our patients. There is enough scientific evidence supporting that the administration of nutritional supplements (NS) can improve both nutritional and functional parameters and prevents malnutrition in patients who do not meet all their nutritional needs through conventional diet or with an adapted diet. It has also been documented that NS can reduce the length of hospital stay and mortality rate in some conditions. However, it has been observed both in clinical practice and in some clinical trials that compliance and adherence are low. In fact, in some trials, less than half of the patients came to consume the supplements prescribed. There are many factors involved in adherence, but so far they have not been properly analyzed. In this article, we want to reflect on this matter. The reasons behind this lack of compliance could be grouped into three categories: socio-sanitary factors, factors related to the patient and its pathology, and those related to the characteristics of supplements. Among the socio-sanitary factors, it should be highlighted the relevance of adequate nutrition training of physicians and all health professionals involved in patient care, the collaboration in the treatment by caregivers, including family, being essential to this matter the type of institution where the patient is admitted (especially when it comes to acute care units compared to those of chronic care) and the availability of a nutrition service at the center in question. Regarding patient-dependent factors, the most important are: age, as it has been described poorer adherence in the elderly, the underlying disease (the presence of oncologic disease, kidney failure, dysgeusia and dysphagia, among other causes, determine a worse adhesion to treatment) and length of stay, with longer stays correlating with a lesser grade of compliance. Finally, there are also of relevance the factors related to the supplement itself, such as their composition, presentation, packing and their organoleptic properties (smell, taste and texture). Once made this reflection, we suggest some advices to achieve a higher rate of compliance with the prescribed nutritional supplements in hospitalized patients (AU)

Artritis crónica juvenil: a propósito de un caso post-enteritis por Campylobacter jejuni / Juvenile chronic arthritis developed after a Campylobacter jejuni enteritis. A case report

La artritis crónica juvenil es la enfermedad reumática más frecuente en niños. El diagnóstico precoz y el tratamiento energético de los pacientes con mal pronóstico sirven para mejorar la calidad de vida y la evolución. Presentamos un caso de artritis crónica juvenil que se presentó después de una enteritis por Campylobacter jejuni. (AU)