Correlation of dorsiflexion angle and plantar pressure following arthrodesis of the first metatarsophalangeal joint.

BACKGROUND: The correlation between angle of fusion of the first metatarsophalangeal (1MTTP) joint and pressures under metatarsal heads and hallux has not been well characterized. The main purpose was to investigate the correlation between fusion dorsiflexion angle of the 1MTTP joint and plantar pressures under the first metatarsal head and hallux during gait. METHODS: Patients who underwent arthrodesis of the 1MTTP joint from 2005 to 2010 were seen for a follow-up examination. Of 27 patients, 15 (22 feet) with a mean follow-up of 26.2 months were evaluated in the study. Main outcomes included the fusion clinical and radiological dorsiflexion angles and the mean and maximum dynamic plantar pressures under all 5 metatarsal heads and under the hallux. Plantar pressures were measured through an in-shoe system while patients walked normally along a corridor. RESULTS: The dorsiflexion angle was positively correlated with mean dynamic plantar pressures under the first metatarsal head: P = .02 (r = 0.5) for clinical angle, and P = .01 (r = 0.58) for radiological angle. Patients with 15 degrees or more of clinical dorsiflexion angle demonstrated higher mean dynamic plantar pressure under the first metatarsal head (P = .05) and higher maximum dynamic plantar pressure under the second metatarsal head (P = .04) compared with patients with less than 15 degrees. In contrast, the latter patients demonstrated higher mean dynamic plantar pressure beneath the hallux (P = .04). Patients with 30 degrees or more of radiological dorsiflexion angle demonstrated significantly higher mean dynamic plantar pressure under the first metatarsal head (P = .04) compared with patients with less than 30 degrees. CONCLUSION: Higher dorsiflexion angles correlate with higher plantar pressures under the first metatarsal head. Lower dorsiflexion angles increase plantar pressures beneath the hallux during gait. CLINICAL RELEVANCE: Significant increase in plantar pressure under the first metatarsal head may be avoided by performing the arthrodesis of the 1MTTP joint below 30° and 15° for the radiological and clinical dorsiflexion angles, respectively.

Selective 1D HCH experiment: a fast NMR tool that connect protons belonging to different spin systems.

A selective 1D version of the HCH experiment (selHCH) is proposed for the efficient and fast correlation between protons belonging to different spin systems. The experiment consists of two consecutive, doubly selective heteronuclear J(CH) transfer steps that can individually be optimized. As any conventional proton-selective 1D experiment, the successful application of a frequency-selective 180° pulse on a well-isolated proton is the only practical requirement. The resulting clean selHCH spectrum probes to be an excellent complement to the conventional selTOCSY experiment to trace out proton-proton J connectivities through transparent non-protonated carbons or heteroatom centers. Several selHCH examples on small molecules are provided showing the improvements with respect to the selTOCSY experiment.

Measurement of long-range proton-carbon coupling constants from pure in-phase 1D multiplets.

The SELective INverse detection of carbon-proton CORrelation pulse sequence that yields a 1D spectrum of a proton directly bonded to a selected carbon resonance has been converted into a proton and carbon double-selective variant that provides a (1)H spectrum of a selected proton that is long-range coupled to a specific carbon resonance. The resulting 1D proton multiplet exhibits a pure absorptive in-phase lineshape for precise measurement of specific long-range proton-carbon coupling constants in small organic molecules at natural abundance.

Structure-guided minimalist redesign of the L-fuculose-1-phosphate aldolase active site: expedient synthesis of novel polyhydroxylated pyrrolizidines and their inhibitory properties against glycosidases and intestinal disaccharidases.

A minimalist active site redesign of the L-fuculose-1-phosphate aldolase from E. coli FucA was envisaged, to extend its tolerance towards bulky and conformationally restricted N-Cbz-amino aldehyde acceptor substrates (Cbz=benzyloxycarbonyl). Various mutants at the active site of the FucA wild type were obtained and screened with seven sterically demanding N-Cbz-amino aldehydes including N-Cbz-prolinal derivatives. FucA F131A showed an aldol activity of 62 µmol h(-1) mg(-1) with (R)-N-Cbz-prolinal, whereas no detectable activity was observed with the FucA wild type. For the other substrates, the F131A mutant gave aldol activities from 4 to about 25 times higher than those observed with the FucA wild type. With regard to the stereochemistry of the reactions, the (R)-amino aldehydes gave exclusively the anti configured aldol adducts whereas their S counterparts gave variable ratios of anti/syn diastereoisomers. Interestingly, the F131A mutant was highly stereoselective both with (R)- and with (S)-N-Cbz-prolinal, exclusively producing the anti and syn aldol adducts, respectively. Molecular models suggest that this improved activity towards bulky and more rigid substrates, such as N-Cbz-prolinal, could arise from a better fit of the substrate into the hydrophobic pocket created by the F131A mutation, due to an additional π-cation interaction with the residue K205' and to efficient contact between the substrate and the mechanistically important Y113' and Y209' residues. An expedient synthesis of novel polyhydroxylated pyrrolizidines related to the hyacinthacine and alexine types was accomplished through aldol additions of dihydroxyacetone phosphate (DHAP) to hydroxyprolinal derivatives with the hyperactive FucA F131A as catalyst. The iminocyclitols obtained were fully characterised and found to be moderate to weak inhibitors (relative to 1,4-dideoxy-1,4-imino-L-arabinitol (LAB) and 1,4-dideoxy-1,4-imino-D-arabinitol (DAB)) against glycosidases and rat intestinal saccharidases.

[Emotional impact of the Covid-19 pandemic on healthcare workers in one of the most important infection outbreaks in Europe]. / Impacto emocional de la pandemia de Covid-19 en los trabajadores sanitarios de uno de los focos de contagio más importantes de Europa.

BACKGROUND AND OBJECTIVES: The Covid-19 pandemic has put healthcare professionals around the world in an unprecedented challenge. This may cause some emotional difficulties and mental health problems. The aim of the present study was to analyze the emotional status among the health care workers form the Hospital of Igualada (Barcelona), while they were facing with Covid-19 in one of the most affected regions in all of Europe. PATIENTS AND METHODS: A total of 395 participants were included in the study. A cross-sectional assessment was carried out between the months of March and April. Information about anxiety, depression, and stress was gathered. We also collected demographic data and concerning potentially stressful factors. RESULTS: A significant proportion of professionals reported symptoms of anxiety (31.4%) and depression (12.2%) from moderate to severe intensity. Symptoms of acute stress were reported by 14.5% of participants. We performed a regression analysis, which explained the 30% of the variance associated with the degree of emotional distress (Ry=0.30). The final model reveals that females (or young males), who are working in the frontline as nursing assistants, caretakers or radiology technicians, with the uncertainty of a possible infection, the perception of inadequate protection measures and having experienced the death of a close person by Covid-19, showed a heightened risk of experiencing psychological distress. CONCLUSIONS: Coping with the Covid-19 pandemic caused a significant impact on emotional status of healthcare workers involved in this study.

Emotional impact of the Covid-19 pandemic on healthcare workers in one of the most important infection outbreaks in Europe.

BACKGROUND AND OBJECTIVES: The Covid-19 pandemic has put healthcare professionals around the world in an unprecedented challenge. This may cause some emotional difficulties and mental health problems. The aim of the present study was to analyze the emotional status among the health care workers form the Hospital of Igualada (Barcelona), while they were facing with Covid-19 in one of the most affected regions in all of Europe. PATIENTS AND METHODS: A total of 395 participants were included in the study. A cross-sectional assessment was carried out between the months of March and April. Information about anxiety, depression, and stress was gathered. We also collected demographic data and concerning potentially stressful factors. RESULTS: A significant proportion of professionals reported symptoms of anxiety (31.4%) and depression (12.2%) from moderate to severe intensity. Symptoms of acute stress were reported by 14.5% of participants. We performed a regression analysis, which explained the 30% of the variance associated with the degree of emotional distress (R²â€¯= 0.30). The final model reveals that females (or young males), who are working in the frontline as nursing assistants, caretakers or radiology technicians, with the uncertainty of a possible infection, the perception of inadequate protection measures and having experienced the death of a close person by Covid-19, showed a heightened risk of experiencing psychological distress. CONCLUSIONS: Coping with the Covid-19 pandemic caused a significant impact on emotional status of healthcare workers involved in this study.

ANTECEDENTES Y OBJETIVO: La actual pandemia de Covid-19 ha puesto a los profesionales sanitarios de todo el mundo ante un desafío sin precedentes. Esto les ha podido causarles dificultades emocionales y problemas de salud mental. El objetivo del presente estudio fue analizar el estado emocional de los trabajadores del Hospital de Igualada (Barcelona), mientras se enfrentaban a uno de los focos de contagio más importantes de Europa. PACIENTES Y MÉTODOS: Se incluyó a un total de 395 trabajadores. Se realizó una evaluación transversal entre los meses de marzo y abril. Se recogió información sobre síntomas de ansiedad, depresión, estrés. También se recogieron datos demográficos y sobre factores potencialmente estresantes. RESULTADOS: Un porcentaje significativo de profesionales reportó síntomas de ansiedad (71.6%) y depresión (60.3%). El 14.5% informó de síntomas de estrés agudo. Se realizó un análisis de regresión que explicó el 30% de la variancia asociada al nivel de malestar emocional (R²â€¯= 0.30). Los factores de riesgo asociados a mayor malestar psicológico fueron el hecho de ser mujer (o hombre joven), trabajar como auxiliar de enfermería, celador o técnico de radiología, estar en contacto directo con pacientes Covid-19, no haber realizado la PCR, tener la sensación de no contar con los elementos de protección personales y haber experimentado la muerte de una persona cercana por Covid-19. CONCLUSIONES: El afrontamiento inicial de la situación de crisis asociada a la pandemia del Covid-19, tuvo un importante impacto emocional en los profesionales sanitarios analizados.

Reduction of periprosthetic Staphylococcus aureus infection by preoperative screening and decolonization of nasal carriers undergoing total knee arthroplasty.

OBJECTIVE: The aim of this study was to evaluate whether the establishment of a preoperative screening and decolonization protocol for Staphylococcus aureus carriers undergoing total knee arthroplasty (TKA) could decrease the incidence of periprosthetic joint infection (PJI) caused by this microorganism. METHODS: We conducted a retrospective study comparing a control group comprising 400 patients (134 men, and 266 women; mean age: 72.2 ± 6.8 years) who went through surgery between January 2009 and December 2013, with a second intervention group of 403 patients (125 men, and 278 women; mean age: 72.4 ± 6.9 years) in which the protocol of screening and decolonization of S. aureus nasal carriers was applied between January 2014 and December 2016. During this latter period patients were preoperatively screened and, if positive, treated with mupirocin nasal ointment and chlorhexidine soap, for 5 days prior to surgery. RESULTS: In the control group, 17 of 400 patients (4.2%) had a SSI, 8 (2%) of them caused by S. aureus and 9 (2.2%) by other microorganisms. In the intervention group 20.6% of patients had a positive S. aureus nasal swab and were treated according to the protocol. 5 of 403 patients (1.2%) in this group had a SSI, 1 (0.2%) due to S. aureus and 4 (1%) to other microorganisms. When comparing surgical-site infection (SSI) rates between the two groups, we found a statistically significant reduction in both global SSI (p = 0.009) and specifically S. aureus SSI (p = 0.02), in the intervention group. No decolonized S. aureus nasal carrier presented a SSI. DISCUSSION: In patients undergoing TKA a preoperative screening and decolonization protocol for S. aureus nasal carriers, using mupirocin nasal ointment and chlorhexidine soap, is an effective measure to reduce the rate of SSI caused by this microorganism. LEVEL OF EVIDENCE: Level III; Therapeutic Study.

Accurate measurement of small heteronuclear coupling constants from pure-phase α/ß HSQMBC cross-peaks.

A simple proton-selective α/ß-HSQMBC experiment is proposed for the accurate measurement of long-range proton-carbon coupling constants (nJCH) in small molecules without need for an individualized and time-consuming post-processing fitting procedure. The method acquires two pure-phase In-phase (IP) and Anti-phase (AP) multiplets completely free of any phase distortion due to the absence of JHH evolution. Accurate nJCH values can be directly measured analyzing the relative displacement of the resulting IPAP cross-peaks. Discussion about signal intensity dependence and cross-talk is made for a range of experimental conditions. The robustness of the method is evaluated by comparing the nJCH value measured from the analysis of the three available IP, AP and IPAP multiplet patterns. Multiple-frequency and region-selective versions of the method can also be efficiently recorded provided that excited protons are not mutually coupled.

IPAP-HSQMBC: measurement of long-range heteronuclear coupling constants from spin-state selective multiplets.

A new NMR approach is proposed for the measurement of long-range heteronuclear coupling constants ((n)J(XH), n>1) in natural abundance molecules. Two complementary in-phase (IP) and anti-phase (AP) data are separately recorded from a modified HSQMBC experiment and then added/subtracted to provide spin-state-selective α/ß-HSQMBC spectra. The magnitude of (n)J(XH) can be directly determined by simple analysis of the relative displacement between α- and ß-cross-peaks. The robustness of this IPAP-HSQMBC experiment is evaluated experimentally and by simulation using a variety of different conditions. Important aspects such as signal intensity dependence and presence of unwanted cross-talk effects are discussed and examples on the measurement of small proton-carbon ((n)J(CH)) and proton-nitrogen ((n)J(NH)) coupling constants are provided.