[Update on the treatment and care of scars]. / Actualización en el tratamiento y cuidado de las cicatrices.

Scars due to burns cause important aesthetic and functional squeal, causing psicologic disorders that can limit personal and social relationships of these patients. In this article we review the type of scars, the factors influencing its function, its characteristics, and we update the different options to prevent and treat pathologic scars in these patients. The text concludes with an exhibition of camouflage techniques of scars through make-up.

[Physical rehabilitation in extensively burned patients]. / Rehabilitación física en el paciente gran quemado.

The rehabilitation of the extensively burned patient aims to prevent and minimize consequences of the own lesion this is supported by three pillars: 1) postural treatment to prevent contractures; 2) kinesiotherapy to maintain/restore joint range of movement and muscle strength; 3) functional recovery. Physical therapy is essential in the multidisciplinary team. A coordinated team assures better results and positively influences the quality of life of the patients.

[Psychosocial nursing care patient with major burns]. / Cuidados psicosociales de enfermeía en el paciente gran quemado.

We must consider the patient as a human being from a holistic point of view; that is, not only from a physical point of view, but also from a mental emotional and spiritual perspective (not to be confused with religion). A patient with major burns is seen as a critical patient by the physician, and for him the most important issue is the survival of the patient. It is when the patient is admitted in the Burns Unit when the long and not easy road to recovery begins, in the understanding this is a new way to integrate, feel and ultimately learn to live again. The role of nursing during this journey will be vital. The prompt and better recovery of the patient will largely depend on the link established between nurse and patient, as well as his/her integration in the new life that awaits him. The following topics are developed in this article: Emotional evolution during his stage in the Burns Unit. Psychoemotional nursing care (fear, pain, image change, long hospital stay, resources). Management of the self-protection measures of the nursing staff to maintain its own emotional stability.

Novel isoquinoline derivatives as antimicrobial agents.

The wide variety of potent biological activities of natural and synthetic isoquinoline alkaloids encouraged us to develop novel antimicrobial isoquinoline compounds. We synthesized a variety of differently functionalized 1-pentyl-6,7-dimethoxy-1,2,3,4-tetrahydroisoquinolines (THIQs), including dihydroisoquinolinium salts (2 and 5), methyl pentanoate-THIQ (6), 1-pentanol-THIQ (7), ester derivatives (8-15) and carbamate derivatives (16-23). We employed classic intramolecular Bischler-Napieralski cyclodehydration to generate the isoquinoline core. All the structures were characterized by nuclear magnetic resonance and mass spectrometry. The bactericide and fungicide activities were evaluated for all the synthesized compounds and structure-activity relationships were established. Many compounds exhibited high and broad-range bactericidal activity. Fluorophenylpropanoate ester 13 and the halogenated phenyl- (17, 18) and phenethyl carbamates (21, 22) exerted the most remarkable bactericidal activity. However, few compounds displayed antifungal activity against most of the fungi tested. Among them, chlorinated derivatives like chlorobenzoate and chlorophenylpropanoate esters (10 and 14, respectively) and chlorophenethyl carbamate 22, exhibited the greatest antifungal activity.

Influence of high-pressure processing on nutritional composition and bioactive compounds of Phaseolus coccineus L.

The influence of high-pressure processing (HPP) prior to cooking on nutritional composition and bioactive compounds content of four varieties of Phaseolus coccineus L. was studied. Cooking and HPP+C increased the protein content. However, minerals, total carbohydrates, ciceritol and α-galactosides were reduced. Fat was not affected by cooking but decreased after HPP+C. For dietary fiber, the behavior observed was different depending on the sample and the treatment applied. HPP+C could be considered a good processing technology to retain the advantageous lower myo-inositol phosphates isoforms and supply prebiotic oligosaccharides. The trypsin inhibitors activity was lower in the cooked and HPP+C samples; however, there were no significant differences between both thermal treatments. Thus, HPP+C reduced cooking time and preserving or improving the nutritional composition of the beans and their bioactive compounds content.

Predictors of attitudes about people with intellectual disabilities: empathy for a change towards inclusion.

Social change towards inclusion is a very common topic, but progress is slow. Because of its importance in the current educational context, knowing how to speed up this transformation is fundamental. A multiple regression analysis with a transversal quantitative designed survey (n = 245) was conducted. The aim was to identify internal and external factors predicting attitudes towards people with intellectual disability in undergraduate students at the University of Murcia (Spain). According to the expected estimate, the variables 'empathic concern' and 'chosen degree' predict good attitudes towards people with intellectual disability among university students. On the other hand, external variables such as 'previous knowledge about disability' or 'contact with people with disabilities' are not explanatory factors. These findings contribute to the existing knowledge about predictive variables for attitudes towards people with intellectual disabilities in the future Spanish education professionals.

Prospective study to evaluate the influence of joint washing and the use of hyaluronic acid on 111 arthrocentesis.

BACKGROUND: Temporomandibular dysfunction is a generic term that covers a large number of clinical problems affecting not only temporomandibular joint but also the masticatory musculature and related structures. Arthrocentesis is used in patients with joint pathology in which conservative treatment has failed. METHODS: A prospective, observational, analytical cohort study has been carried out to evaluate the results of 111 arthrocentesis. We have performed an inferential statistics study between the variables: improvement of pain and improvement in the oral opening with the variables and access joint, washing joint, hyaluronic acid infiltration, and type of joint pathology. RESULTS: Joint washing and intra-articular hyaluronic acid injection significantly improved the pain at 1-week, 1-month, and 3-month postarthrocentesis, although this improvement was limited in time, at 6 months, joint washing and hyaluronic acid infiltration are no longer significant. Only the joint access (p = 0.014) and the type of joint pathology (p = 0.028) are significant. CONCLUSIONS: The effectiveness of joint access in the arthrocentesis at 6 months is high, although less than at 1-month and 3-month postarthrocentesis. The type of joint pathology is another important factor. Patients with degenerative pathology worsen the most after 6-month postarthrocentesis. Arthrocentesis could avoid the evolution of acute pathology.

[Guidelines for the treatment on infections caused by methicillin-resistant Staphylococcus aureus]. / Guía de tratamiento de la infección producida por Staphylococcus aureus resistente a meticilina.

Infections due to methicillin-resistant Staphylococcus aureus (MRSA) have undergone important changes in the last five years that have influenced the choice of therapy: i) increase of their frequency in hospital-associated settings and, more recently, in community settings; ii) better knowledge of clinical implications of the pharmacokinetic and pharmacodynamic properties of vancomycin; iii) improvement of current standard methods for rapid detection of MRSA in clinical samples; iv) clear evidence that vancomycin is losing efficacy against MRSA with MIC > 1 microg/mL; and v) appearance of new antibiotics suitable for use in these infections (linezolid, daptomycin, tigecyclin). Under this situation guidelines for the treatment of common infections caused by MRSA appear to be necessary to improve the efficacy and reduce the mortality.

[Eating habits in physical therapy students]. / Hábitos dietéticos en estudiantes de fisioterapia.

OBJECTIVE: a) To know the eating and exercising habits of undergraduate Physical Therapy students; b) To promote awareness among these future health professionals and educators of the need to foster adequate eating habits among patients and the general population. METHODS: A dietary and physical activity questionnaire, regarding a seven-day period, distributed among students of the School of Physical Therapy (University of Valladolid) in the city of Soria, Spain (n = 131; sex (m/f): 38/93). RESULTS: Results show that a high percentage of the subjects follow the recommendations of the new Nutritional Pyramid of the Spanish Nutrition Society (SEN) regarding intake of meat, fish, milk, dairy products and exercise habits. This is not the case, however, for products such as pasta, bread and cereals, vegetables, fruits, legumes and olive oil. Furthermore, fast food is taken, on average, once a week despite the recommended sporadic monthly intakes. CONCLUSIONS: According to results, formative programmes should be carried out to enable these students to encourage healthy diets. Thus, diseases related to non-healthy eating habits could be prevented, and information on the issue could be spread among the population.

[Different manners to learning nursing]. / Diferentes formas de aprender enfermería.

After presenting how research on student learning has changed significantly over the years, depending on the quantitative or qualitative viewpoint used, the authors concentrate on three focuses: superficial, profound and high yield, studying which of these focuses dominates in the learning among nursing students at the University School of Nursing in Murcia. As a result, the authors pose the following question: Why from first year to second year courses is there a positive evolution regarding the profound focus which changes to a negative evolution from second to third year courses which favor the superficial focus?

Pediatric myringoplasty: Prognostic factors in surgical outcome and hearing threshold recovery.

CONCLUSIONS: This study shows as decisive factors the history of tympanostomy tube insertion and surgical approach. The closure of the perforation observed at the 6th post-operative month is almost definitive, without finding significant differences ahead. The myringoplasty can be performed simultaneously in bilateral perforations and in a day-case basis with same success rates. Astatistically significant audiometric improvement area is described, after myringoplasty, undescribed previously in literature. OBJECTIVES: The aim of this study was to evaluate prognostic factors in surgical outcome and hearing threshold after myringoplasty, in pediatric age. METHODS: A 10-year retrospective review of 142 myringoplasties performed by a single surgeon of the Pediatric ENT Department of 12 de Octubre University Hospital. Multiple prognostic factors were investigated, such as those related to perforation and surgery, contralateral ear status, and pre- and post-operative hearing threshold. RESULTS: The overall rate of closure of the perforation was 74.64%. The re-perforation rate was directly proportional to the number of tympanostomy tube insertion (OR = 1.64). Other determining factors were the surgical approach, the graft position and side. There was a post-operative significant improvement (p < 0.001) insuring that the more affected frequencies, low (125-500 Hz) and high frequencies (4000-8000 Hz), were the more improved after the procedure.

[Pure primary prostate transitional cell carcinoma. A review of our series]. / Carcinoma transicional primario puro de próstata. Revisión de nuestra serie.

Primary prostate transitional cell carcinoma is a very uncommon tumor, that represents about 1% of all prostate tumours. In our institution, only six patients have been diagnosed with pure transitional cell prostate carcinoma until 2002. Bladder origin of the neplasic was ruled out in all cases. We report a study about the progression and survival of prostate transitional cell carcinoma. These prostatic tumours carry a poor prognostic (median survival is 4.6 months) with a strong tendency to metastatic spread. Therefore, we suggest a radical prostatectomy (without cystectomy) when it rules out bladder origin tumour.

Linfoma no Hodgkin estadio IV con metástasis mamaria y vaginal / Non Hodgkin lymphoma stage IV with breast and vaginal metastasis

Resumen ANTECEDENTES: La afectación mamaria por un linfoma es poco frecuente; casi siempre se trata de linfomas tipo B que se caracterizan por falta de especificidad clínica y radiológica, lo que dificulta el diagnóstico diferencial con tumoraciones mamarias de otro origen. CASO CLÍNICO: Paciente de 72 años de edad, con antecedentes de hipercolesterolemia, hipertensión arterial, artrosis y depresión, con dos partos y menopausia a los 55 años. Madre con antecedente de cáncer de mama posmenopáusico. En la mamografía de la mama derecha se encontró una masa retroareolar de 8 cm, de contornos mal definidos y una adenopatía axilar con engrosamiento cortical. La biopsia reportó un linfoma no Hodgkin B de alto grado. Se administraron 8 ciclos de quimioterapia con el esquema R-CHOP. Luego de este esquema el PET-TC mostró una lesión mamaria derecha residual, metabólicamente inactiva, sin enfermedad nodal ni extramamaria supra ni infradiafragmática. CONCLUSIONES: Una neoplasia maligna mamaria no siempre se trata de un carcinoma ductal o lobulillar. Es necesario valorar la posibilidad de otras estirpes histológicas o, incluso, de una afectación metastásica. La entrevista y exploración adecuadas son fundamentales para una buena orientación diagnóstica.

Abstract BACKGROUND: The mammary affectation by a lymphoma is not frequent; it almost always involves type B lymphomas. It is characterized by a lack of clinical and radiological specificity, which makes differential diagnosis difficult with mammary tumors of another origin. CLINICAL CASE: A 72-year-old patient with a history of hypercholesterolemia, hypertension, osteoarthritis and depression, with two deliveries and menopause at 55 years of age. Mother with a history of postmenopausal breast cancer. The mammography of the right breast reported the existence of a retroareolar mass of 8 cm, of ill-defined contours and an axillary adenopathy with cortical thickening. The biopsy reported a high-grade non-Hodgkin B lymphoma. 8 cycles of chemotherapy were administered with the R-CHOP scheme. After this procedure, the PET-CT showed a residual, metabolically inactive right mammary lesion, with nodal or extramammary supra or infradiaphragmatic disease. CONCLUSIONS: A malignant mammary neoplasm is not always a ductal or lobular carcinoma. It is necessary to evaluate the possibility of other histological strains or, even, of a metastatic affectation. The adequate interview and exploration are fundamental for a good diagnostic orientation.