Association of vitamin D levels and oral lichen planus. Systematic review and meta-analysis.

BACKGROUND: Oral lichen planus (OLP) is an inmuno-mediated mucocutaneous chronical inflammatory disease. Multiple predisposing factors are considered, such as autoimmune response, microorganisms, medications, dental materials, psychological stress, genetic predisposition or nutritional deficiencies. The deficiency of vitamin D has been related to various autoimmune diseases like OLP. MATERIAL AND METHODS: The electronic search was conducted in the MEDLINE (Pubmed), Scopus, Cochrane Library and Web of Science databases. To assess any potential risk of bias, the authors critically appraised each study by the Newcastle-Ottawa Scale for cohort and case-control studies. Pooled analyses were performed using a random-effects model. Heterogeneity of the studies was assessed by the I2 statistics. Forest Plots were performed to graphically represent the difference between vitamin D concentrations in the OLP compared to healthy group, with a 95% confidence interval. RESULTS: After applying our inclusion and exclusion criteria, 7 articles were included in our review. The median concentration vitamin D in ng/ml found in serum for patients with OLP was of 26,6311,75ng/ml and for healthy patients was of 31,438,7ng/ml. Regarding the quantitative analysis, 7 studies were included. The difference in the concentration of vitamin D in healthy patients and patients with OLP statistically significant (Weighted Mean Difference (WMD): -6.20, 95% CI: -11.24 to -1.15, p=0.02 and I2 heterogeneity: 94%, p<0.00001). CONCLUSIONS: The patients with OLP have statistically lower vitamin D levels than healthy patients.

Pre-surgical socket analysis for immediate implant placement.

BACKGROUND: Traditional protocols for implant surgery suggest a healing period of 2-3 months from dental extraction to implant placement. Based on all the volumetric modifications produced by that approach, there are authors who advocate for immediate implantology. The aim of the present study was to determine the prevalence of different sockets, and the dimensions of the bone around the upper anterior incisors and canines, to determine the predictability of immediate implants in our population. MATERIAL AND METHODS: This is an observational, cross-sectional study based on cone-beam computed tomography images of the anterior maxila of patients attending the Odontological Hospital of the University of Barcelona (OHUB) and requesting for implant treatment. Different measurements were performed on every analyzed tooth, and also they were categorized by using the main dental sockets classifications. RESULTS: Bone attachment levels and cortical thickness are lower in women compared to men in all three types of teeth (the difference in the bone attachment levels ranges from 4.68%-8.63% and in the bone thickness goes from 0.02-0.58mm). Bone attachment level gradually reduces with age. The reductions observed in all the measurements are higher in the case of canines, compared with the other teeth. The differences from patients <45 years old and patients between 55-64 years old are 13.58±14.55mm in the case of central incisors, 10.04±5.52 in the case of lateral incisors and 22.39±13.65mm in the case of canines. CONCLUSIONS: According to our results, the canines are the teeth with the greatest complexity when it comes to immediate implantology treatments. Furthermore, that kind of treatment is more complex as age increases, since we observed a gradual percentage of unfavourable sockets in older patients.

Treatment of recurrent aphtous stomatitis: A systematic review.

BACKGROUND: Recurrent Aphtous Stomatitis (RAS) is the most common process affecting the oral mucosa. It is painful, multifactorial and generally recurrent. The aim of this systematic review is to know the last treatment approaches and their effectivity. MATERIAL AND METHODS: we compared the outcome of different kind of treatments in terms of the improvement of the lesions, reduction of the size of those lesions and the time needed for their healing. Inclusion criteria were: clinical trials, articles written in English or Spanish and published less than 5 years ago. RESULTS: we used the following keywords: "treatment", "aphtous stomatitis", "canker sores"; combined with Boolean operators AND y OR. We selected 28 articles for reading the whole text, and after applying the eligibility criteria, we selected 17 articles for our revision. Among all the treatments, we emphasize the barrier method based in compound of cellulose rubber and a calcium/sodium copolymer PVM/MA, with which the difference in the 3rd and 7th day was of -6,29 ± 0,14 points in the pain score. The treatment with insulin and chitosan gel, brought a pain suppression on the third day, with no reactivation of the pain during the whole study. The application of a film composed of polyurethane and sesame oil with chitosan, brought a reduction in the size of the lesions of 4,54 ± 2,84mm on the 6th day compared with the situation before the beginning of the treatment. The different kinds of laser, which produced a reduction in the pain score just at the beginning of the treatment up to 8,1 ± 1,6 points, and a reduction of the size of the lesions of 4,42 ± 1,02mm on the 7th day. CONCLUSIONS: Besides the classic treatments for RAS, we have to take into account other treatment modalities, above all the different kinds of laser.

Postural control strategies are revealed by the complexity of fractional components of COP.

The complexity of the center of pressure (COP) provides important information regarding the underlying mechanisms of postural control. The relationships between COP complexity and balance performance are not fully established and might depend on the task constraints and the filtering decomposition of the COP signal. This study assessed COP complexity under different task constraints and it was assessed if emergent dynamics of COP fluctuations differ according to fractional components of COP related to peripheral or central adjustments. One hundred and sixty-two participants performed two sitting balance tasks. Accuracy was required by following a target that moved in the mediolateral (ML) or in the anteroposterior (AP) axis. Complexity dynamics of COP were addressed through detrended fluctuation analysis (DFA) in the axis constrained by accuracy requirements and in the one nonconstrained. Decomposition of COP components was applied by low-pass, band-pass, and high-pass filters. DFA of low-pass and band-pass components of COP in the constrained axis were small-to-moderately related (r = 0.190-0.237) to balance performance. DFA of the high-pass component of the COP exhibited the opposite relationship (r = -0.283 to -0.453) in both axes (constrained and nonconstrained). This study evidences that COP complexity is linked to better performance. This positive relationship complexity/performance is observed in the low- and mid-frequency components of the COP. These components might be related to central mechanisms of postural control. The lack of relationships between the different frequencies analyzed in the study suggests that they are capturing different components of postural control.NEW & NOTEWORTHY The relationship between the complexity of the center of pressure (COP) and balance performance is not fully established. The task constraints and the filtering decomposition of the COP could influence this relationship. COP complexity is related to a better balance performance only in low frequencies and midfrequencies of the COP. The different frequencies measure different postural control components. Filtering decomposition should be explored in future studies to address the underlying mechanisms of postural control.

In vitro assessment of the combination of cylindrospermopsin and the organophosphate chlorpyrifos on the human neuroblastoma SH-SY5Y cell line.

Cylindrospermopsin (CYN) is a cyanotoxicant which occurrence is increasing due to climate change. Cylindrospermopsin is able to exert damage in the organism at several levels, among them, in the nervous system. Moreover, it is important to take into account that it is not usually present isolated in nature, but in combination with some other pollutants, being the case of the pesticide chlorpyrifos (CPF). Thus, the aim of the present work was to assess the effects of the interaction of CYN in combination with CPF in the human neuroblastoma cell line SH-SY5Y by evaluating cytotoxicity and mechanistic endpoints. The mixtures 0.25 + 21, 0.5 + 42, 1 + 84 µg/mL of CYN + CPF based on cytotoxicity results, were evaluated, and the isobologram method detected an antagonistic effect after 24 and 48 h of exposure. Moreover, although no alterations of reactive oxygen species were detected, a significant decrease of glutathione levels was observed after exposure to both, CPF alone and the combination, at all the concentrations and times of exposure assayed. In addition, CYN + CPF caused a marked decrease in the acetylcholinesterase activity, providing similar values to CPF alone. However, these effects were less severe than expected. All these findings, together with the morphological study results, point out that it is important to take into account the interaction of CYN with other pollutants. Further research is required to contribute to the risk assessment of CYN and other contaminants considering more realistic exposure scenarios.

Research gaps and future needs for allergen prediction in food safety.

The allergenicity and protein risk assessments in food safety are facing new challenges. Demands for healthier and more sustainable food systems have led to significant advances in biotechnology, the development of more complex foods, and the search for alternative protein sources. All this has increased the pressure on the safety assessment prediction approaches anchored into requirements defined in the late 90's. In 2022, the EFSA's Panel on Genetically Modified Organisms published a scientific opinion focusing on the developments needed for allergenicity and protein safety assessments of new products derived from biotechnology. Here, we further elaborate on the main elements described in this scientific opinion and prioritize those development needs requiring critical attention. The starting point of any new recommendation would require a focus on clinical relevance and the development of a fit-for-purpose database targeted for specific risk assessment goals. Furthermore, it is imperative to review and clarify the main purpose of the allergenicity risk assessment. An internationally agreed consensus on the overall purpose of allergenicity risk assessment will accelerate the development of fit-for-purpose methodologies, where the role of exposure should be better clarified. Considering the experience gained over the last 25 years and recent scientific developments in the fields of biotechnology, allergy, and risk assessment, it is time to revise and improve the allergenicity safety assessment to ensure the reliability of allergenicity assessments for food of the future.

Diagnosis of multiple sclerosis using optical coherence tomography supported by explainable artificial intelligence.

BACKGROUND/OBJECTIVES: Study of retinal structure based on optical coherence tomography (OCT) data can facilitate early diagnosis of relapsing-remitting multiple sclerosis (RRMS). Although artificial intelligence can provide highly reliable diagnoses, the results obtained must be explainable. SUBJECTS/METHODS: The study included 79 recently diagnosed RRMS patients and 69 age matched healthy control subjects. Thickness (Avg) and inter-eye difference (Diff) features are obtained in 4 retinal layers using the posterior pole protocol. Each layer is divided into six analysis zones. The Support Vector Machine plus Recursive Feature Elimination with Leave-One-Out Cross Validation (SVM-RFE-LOOCV) approach is used to find the subset of features that reduces dimensionality and optimises the performance of the classifier. RESULTS: SVM-RFE-LOOCV was used to identify OCT features with greatest capacity for early diagnosis, determining the area of the papillomacular bundle to be the most influential. A correlation was observed between loss of layer thickness and increase in functional disability. There was also greater functional deterioration in patients with greater asymmetry between left and right eyes. The classifier based on the top-ranked features obtained sensitivity = 0.86 and specificity = 0.90. CONCLUSIONS: There was consistency between the features identified as relevant by the SVM-RFE-LOOCV approach and the retinotopic distribution of the retinal nerve fibres and the optic nerve head. This simple method contributes to implementation of an assisted diagnosis system and its accuracy exceeds that achieved with magnetic resonance imaging of the central nervous system, the current gold standard. This paper provides novel insights into RRMS affectation of the neuroretina.

Prevalence of suspected abuse of non-institutionalized older people treated in primary care. PRESENCIA study.

OBJECTIVES: To determine the prevalence of suspected abuse of non-institutionalised elderly people and the associated variables. PATIENTS AND METHOD: Observational, descriptive, cross-sectional, multicentre study in patients aged 65 years or older, non-institutionalised, consecutively selected in primary care (PC). The EASI questionnaires (Suspected Elderly Abuse Index), the EAI questionnaire (Suspected Abuse Index in patients with cognitive impairment), the Barthel index, and the EUROQOL-5D questionnaire were used with patients, and the CASE questionnaire and the Zarit test were used with caregivers. Socio-demographic, health, and quality of life variables were analysed in all patients. RESULTS: Eight hundred four patients were included, mean age 78.9±7.9 years, 58.3% women. The prevalence of suspected abuse was 11.3% (95% CI: 9.1%-13.9%). Suspected abuse was more frequent in women than in men (14.4% vs. 7.1%; odds ratio (OR)=1.97; 95% CI=1.1-3.4; p=0.016) and in those who lived with two or more people compared to those who lived alone (18.4% vs. 7.3%; OR=2.42; 95% CI=1.1-5.0; p=0.017). Among older patients, the lower their dependency, the lower the prevalence of suspected abuse (30.0% in highly dependent vs. 8.7% in non-dependent: p-trend=0.006); and the better the perceived health status, the lower the prevalence of suspected abuse (29.6% in poor health status vs. 6.9% in optimal health status; p-trend=<0.001). Among caregivers, the prevalence of suspected abuse was 20.4% (95% CI=12.8%-28.0%). A trend of higher prevalence of suspected abuse could be observed with higher scores on the CASE questionnaire (56.3% at high risk and 9.6% with no risk of abuse; p-trend=0.007). In the case of the ZARIT questionnaire with scores below 47, the prevalence of suspected abuse was 9.1%, and for scores above 55, it was 52.6% (p-trend<0.001). CONCLUSIONS: The results of the PRESENCIA study show that approximately 1 in 10 patients aged ≥65 meet the criteria for suspected abuse. The probability of abuse increases in women, in patients with greater dependency and in patients with poorer perceived health status. Caregivers with greater overload and greater risk presented a greater suspicion of elder abuse.

[Therapeutic adherence of patients with cardiovascular risk in primary care. REAAP project]. / Adherencia terapéutica de pacientes con riesgo cardiovascular en atención primaria. Proyecto REAAP.

OBJECTIVE: To describe the perceptions and daily experiences of primary care (PC) physicians in dealing with the lack of therapeutic adherence in patients with cardiovascular risk, as well as their expectations and possible areas for improvement. MATERIAL AND METHODS: A qualitative study (within the framework of the REAAP project: Network of Experts in Adherence in Primary Care) carried out in several autonomous communities in Spain using an open-ended questionnaire completed by PC physicians and analyzed using the framework analysis method to guide the coding of the topics. RESULTS: Eighteen physicians participated, and three main themes were identified from their responses: an approach to adherence during clinical practice, barriers that hinder the appropriate adherence, and interventions to improve it. The strategies most frequently mentioned to facilitate patients' therapeutic adherence were improving physician-patient communication and continuity of care, involving community pharmacies, and simplifying treatment by prescribing drugs in fixed combinations. CONCLUSIONS: There is no single ideal strategy to facilitate therapeutic adherence, and it is necessary to combine several interventions to optimize it. The first step is to understand the problems and the tools available. Initiatives such as the REAAP project are an important means to improve patient adherence, and for healthcare personnel to recognize the importance that this issue deserves.

Home blood pressure self-measurement: "Current situation and new perspectives".

The method typically used to diagnose and monitor hypertensive patients has been to measure blood pressure in the physician's surgery; however, it is a well-known fact that this approach poses certain drawbacks, such as observer bias, failure to detect an alert reaction in the clinic, etc., difficulties that affect its accuracy as a diagnostic method. In recent years, the varying international scientific societies have persistently recommended the use of blood pressure measurements outside the clinic (at home or in the outpatient setting), using validated automatic devices. Data from some studies suggest that if we rely solely on in-office measurements, approximately 15-20% of the time we may be wrong when making decisions, both in terms of diagnosis and patient follow-up. Home blood pressure measurements are a simple and very affordable method that has a similar reproducibility and prognostic value as ambulatory blood pressure monitoring, the availability of which is currently very limited. Moreover, ambulatory self-measurements have the significant benefit of being able to improve control of hypertensive individuals. Healthcare professionals and patients should be aware of the methodology of home blood pressure measurement, its usefulness and limitations.

Effect of prebiotic carbohydrates on the growth and tolerance of Lactobacillus.

Resistance to gastrointestinal conditions is a requirement for bacteria to be considered probiotics. In this work, we tested the resistance of six different Lactobacillus strains and the effect of carbon source to four different gastrointestinal conditions: presence of α-amylase, pancreatin, bile extract and low pH. Novel galactooligosaccharides synthesized from lactulose (GOS-Lu) as well as commercial galactooligosaccharides synthesized from lactose (GOS-La) and lactulose were used as carbon sources and compared with glucose. In general, all strains grew in all carbon sources, although after 24 h of fermentation the population of all Lactobacillus strains was higher for both types of GOS than for glucose and lactulose. No differences were found among GOS-Lu and GOS-La. α-amylase and pancreatin resistance was retained at all times for all strains. However, a dependence on carbon source and Lactobacillus strain was observed for bile extract and low pH resistance. High hydrophobicity was found for all strains with GOS-Lu when compared with other carbon sources. However, concentrations of lactic and acetic acids were higher in glucose and lactulose than GOS-Lu and GOS-La. These results show that the resistance to gastrointestinal conditions and hydrophobicity is directly related with the carbon source and Lactobacillus strains. In this sense, the use of prebiotics as GOS and lactulose could be an excellent alternative to monosaccharides to support growth of probiotic Lactobacillus strains and improve their survival through the gastrointestinal tract.

Study of the helminth fauna in eagle owl (Bubo bubo) in the south of Spain.

In this study we show the results of the eagle owls' (Bubo bubo) helminthfauna found in Andalusia. A total number of 50 specimens have been analysed in a period of 10 years (from 2011 to 2020). Prevalence ( P % ), mean intensity (IM) and mean abundance (AM) of parasitation have been obtained. The percentage of parasitation in the total sample was 80% (40 out of 50 eagle owls): 78% nematodes, 8% trematodes, 6% cestodes and 4% acantocephalans. 7 species of helminths were identified: 6 nematodes, and 1 trematode. In the case of cestodes and acantocephalans it was not possible to determine species and only the genus was identified. The intestinal nematode Capillaria tenuissima ( P %  = 58% (44-71.2); IM = 11,52 (5.83-28.9)) was the core species whereas Synhimantus laticeps (P% = 16 (7.5-28.8); IM = 4 (1.75-7.25)) and Hartertia hispanica (P% = 16 (7.5-28.8); IM = 1,5 (1-2)) were the secondary species. The remainder species were considered satellite species, with low prevalence and average abundance. Likewise, descriptive parameters of the helminth community were determined: species richness, 1.56 (1.29-1.94), total abundance, 12 (7.24-26.40), Brillouin's diversity index, 0.18 (0.10-0.29) and Berger-Parker dominance index, 0.88 (0.81-0.93). The data from this study show a non-diverse helminthic community, without species dominance with C. tenuissima as the central species, followed by S. laticeps and H. hispanica as secondary species. Worth mentioning is the presence of H. hispanica, which is considered an endemic species in Spain and specifically in Andalusia. To the authors' knowledge, this is the largest population sample taken in parasitological studies about helminths of this raptor in Europe and the first one carried out in the south of Spain (Andalusia).

Evaluation of prophylaxis in primary prevention with acetylsalicylic acid in people with diabetes: A scoping review.

BACKGROUND: The efficacy and safety of acetylsalicylic acid (ASA) prophylaxis for the primary prevention of atherosclerotic cardiovascular disease (ACVD) remain controversial in people with diabetes (DM) without ACVD, because the possible increased risk of major bleeding could outweigh the potential reduction in the risk of mortality and of major adverse cardiovascular events (MACE) considered individually or together. OBJECTIVE: To evaluate the overall risk-benefit of ASA prophylaxis in primary prevention in people with DM and to compare the recommendations of the guidelines with the results of the meta-analyses (MA) and systematic reviews (SR). MATERIAL AND METHODS: We searched Medline, Google Scholar, Embase, and the Cochrane Library for SR and MA published from 2009 to 2020 which compared the effects of ASA prophylaxis versus placebo or control followed up for at least one year in people with DM without ACVD. Heterogeneity among the randomized clinical trials (RCT) included in the SR and MA was assessed. Cardiovascular outcomes of efficacy (all-cause mortality [ACM], cardiovascular mortality [CVM], myocardial infarction [MI], stroke and MACE) and of safety (major bleeding events [MBE], major gastrointestinal bleeding events [MGIBE], and intracranial and extracranial bleeding) were shown. RESULTS: The recommendations of 12 guidelines were evaluated. The results of 25 SR and MA that included a total of 20 RCT were assessed. None of the MA or SR showed that ASA prophylaxis decreased the risk of ACM, CVM or MI. Only two of the 19 SR and MA that evaluated ischemic stroke showed a decrease in the stroke risk (mean 20.0% [SD±5.7]), bordering on statistical significance. Almost half of the MA and SR showed, bordering on statistical significance, a risk reduction for the MACE composite endpoint (mean 10.5% [SD±3.3]). The significant increases in MGIBE risk ranged from 35% to 55%. The significant increases in the risk of MBE and extracraneal bleeding were 33.4% (SD±14.9) and 54.5% (SD±0.7) respectively. CONCLUSION: The overall risk-benefit assessment of ASA prophylaxis in primary prevention suggests that it should not be applied in people with DM.

Effect of glycation on sodium caseinate-stabilized emulsions obtained by ultrasound.

This work explores the potential of high-intensity ultrasound to produce fine-dispersion, long-time-stable, oil-in-water emulsions prepared with native and glycated bovine sodium caseinate (SC). Regardless the ultrasound amplitude and time assayed, the sonicated emulsions of native SC at 0.5 mg/mL had much higher emulsifying activity indexes compared with those emulsions formed by Ultra-Turrax (IKA Werke GmbH & Co., Staufen, Germany) homogenization. Nevertheless, the native SC emulsions were very unstable despite the optimization of parameters such as protein concentration, amplitude of ultrasound wave, and sonication time by using a Box-Behnken design. Early glycation of SC with either galactose, lactose, or 10 kDa dextran substantially improved both emulsifying activity and the stability, whereas at advanced stages of glycation, SC emulsions showed notably reduced emulsifying properties, likely because extensive glycation of SC promoted its polymerization mainly through covalent cross-linking, as was demonstrated by particle size measurements. The increase in particle diameter of glycoconjugates likely affected the diffusion of SC from bulk to the oil-water interface and slowed the reorientation process of the protein at the interface. These findings show that the combined effect of early-stage glycation of SC and high-intensity ultrasound as an emergent technique to form emulsions has the potential to provide improved emulsions that could be used in several food applications.

[Diaphragmatic pacemaker as an alternative to mechanical ventilation in patients with cervical spinal injury]. / Marcapasos diafragmático como alternativa a la ventilación mecánica en el paciente con lesión medular cervical.

OBJECTIVE: To verify that the diaphragmatic pacemaker is a form of respiratory support that can be used to replace a volumetric respirator in cervical spinal injury patients with cervical spinal lesion and diaphragmatic paralysis by means of its comparison with the traditional volumetric respirator. DESIGN: Retrospective study of a prospective database and age-matched case-control study. SETTING: Intensive Care Unit and Intermediate Care Respiratory Unit, Paraplegics National Hospital, Toledo (Spain). PATIENTS: We collected data on all patients discharged from the Hospital with permanent respiratory support by volumetric respirator or diaphragmatic pacemaker during a follow-up period of 25 years. Personal interviews were conducted to evaluate health-related quality of life. Comparison and survival tests were used for statistical comparisons. INTERVENTIONS: Quality of life questionnaire. MAIN VARIABLES: The main variables collected were demographic data, hospital stay, mortality, family reintegration and health-related quality of life. RESULTS: We evaluated the clinical records of 101 patients, 37 in the pacemaker-group and 64 in the volumetric respirator-group. Our results show that ICU admission duration and hospitalization as well as family reintegration, without significant differences, with a tendency to greater survival in pacemaker patients (18.18 versus 9.67 years by the Kaplan-Meier method, p<0.001). However, this difference becomes non-significant (p=0.06) after adjustment of the groups by age. Furthermore, better quality of life was found in these same patients with pacemakers in terms of security, communication, sociability, comfort and mobility in the patients. CONCLUSIONS: Diaphragmatic pacemaker ventilation is an effective alternative to mechanical ventilation with similar efficacy that improve quality of life in patients with severe respiratory failure due to cervical spinal cord injury.

Microbiological analysis of autologous bone particles obtained by low-speed drilling and treated with different decontamination agents.

The aim of this study was to compare the effectiveness of three agents - two antibiotics (amoxicillin and clindamycin) and an antiseptic (chlorhexidine) - to decontaminate bone grafts obtained by low-speed drilling. The study included 248 bone tissue samples harvested from 62 patients by low-speed drilling before dental implant placement. Each of four samples obtained from every patient was dropped, using a sterile instrument, into a sterile tube containing a 500-µl solution of 400µg/mL amoxicillin, 150µg/mL clindamycin, 0.12% chlorhexidine, or physiological saline for 1min. The number of colony-forming units (CFU) was determined at 48h of culture. The use of clindamycin, amoxicillin, or chlorhexidine as decontaminant for 1min significantly reduced the CFU count when compared to physiological saline (control agent). In both anaerobic and CO2-rich atmospheres, significant differences in CFU/mL were found between the control and chlorhexidine groups (P<0.001), control and amoxicillin groups (P<0.001), control and clindamycin groups (P<0.001), chlorhexidine and amoxicillin groups (P<0.0001), and chlorhexidine and clindamycin groups (P<0.0001). In conclusion, clindamycin had the highest decontaminating effect on bone particles obtained by low-speed drilling, followed by chlorhexidine and amoxicillin. Clindamycin may therefore be a valid alternative option for the routine decontamination of intraoral bone grafts.

Simultaneous treatment effects in learning four tennis shots in contextual interference conditions.

This study investigated simultaneous treatments in contextual interference (blocked and random practice) and their effect on the process of learning four tennis shots. 8 tennis players participated in the research, which was carried out in two phases. The first phase involved a 3-wk. period of 12 sessions with 192 practice tennis shots per session for each tennis player. The second phase comprised 4 retention tests carried out at 48 hr. and 2, 4, and 6 weeks following the learning phase. This phase consisted of evaluating the retention of the skills that had been practiced during the learning phase. The results indicated an improvement in the quality of shots for both practice conditions during the learning phase. Differences in retention appeared relative to differences in the type of practice conditions (random or blocked) in which the skill was learned and also depended on the type of shot and the time that had elapsed since the learning period.

Advances in structure elucidation of low molecular weight carbohydrates by liquid chromatography-multiple-stage mass spectrometry analysis.

Oligosaccharides are gaining importance because of their beneficial properties in human health. They normally appear in natural and synthetic products as complex mixtures of different monomeric units, glycosidic linkages and degrees of polymerization, being disaccharides and trisaccharides usually the most abundant ones. Although liquid chromatography-mass spectrometry is a useful technique for oligosaccharides analysis, the similarity of their structures makes difficult their characterization. Moreover, there is still scarce information about the relationship between carbohydrate chemical structure, mass spectra and chromatographic data. Then, in this work, chromatographic parameters for 23 disaccharides with different linkages and monomeric units (glucose, galactose, mannose and fructose) were determined using porous graphitized and hydrophilic interaction liquid chromatography columns. Moreover, diagnostic ions of these disaccharides obtained by tandem mass spectra (MS2) were established by stepwise linear discriminant analysis. The relationship between carbohydrate chemical structure and their chromatographic retention data and characteristic ions obtained by multiple-stage mass spectrometry (MSn) was successful in establishing some specific criteria that allowed the characterization of trisaccharides with different structural features.

[Skills perceived by general practitioners for providing care to immigrant patients]. / Aptitudes percibidas por el médico de familia en la atención a pacientes inmigrantes.

OBJECTIVE: To identify the skills perceived by general practitioners for providing competent care to immigrants MATERIAL AND METHODS: Observational, descriptive and cross-sectional study with data collection using a 21-item questionnaire completed electronically by the general practitioners and validated by the National Validation Commission of SEMERGEN. It was structured with closed-ended, multiple-choice test questions, including variables related to the doctor and variables related to the immigrant patient. The level of professional competence was assessed using a 1 to 10 Likert scale. RESULTS: A total 610 family physicians with a mean age of 47.5±12.3 years responded and 64.1% were women. Of these, 112 (18.4%) were residents. The response rate was 4.9%. A large majority (72.6%) had not taken part in continuing education courses on caring for immigrants in the last 5years. Participants reported difficulties in the clinic: 73% of the cases with the language, 38.7% with the allotted time, and 32.3% due to knowledge of the culture. Most (96.9%) of patients attended the clinic due to a common illness. The cause in 14.4% was related to the migratory process (infectious disease acquired in the country of origin), and in 26.4% with the health conditions in the host country (lack of stable housing, overcrowding, and conditions of work). The perceived level of competence was 6.2±1.9. CONCLUSIONS: The competence perceived by general practitioners in providing care to immigrants is moderate. The most important barriers for these professionals are ignorance of the language, lack of time allocated for consultation, and ignorance of the patient's culture.

Microscopical Techniques to Analyze the Hepatic and Peritoneal Changes Caused by Fasciola hepatica Infection.

The helminth parasite Fasciola hepatica modulates the host immune response at early stages of infection (Rodríguez et al., PLoS Negl Trop Dis 9:e0004234, 2015; Vukman et al., J Immunol 190:2873-2879, 2013). Nevertheless, little is known about the cell composition of the peritoneal fluid at these early stages of infection.In this chapter, we describe a method to perform peritoneal lavages and to recover peritoneal fluid from sheep experimentally infected and noninfected with F. hepatica at early stages of infection. In addition, with the aim to characterize the peritoneal fluid immune cell phenotype, we describe a procedure to obtain the total leukocyte count, the differential leukocyte count and the preparation and storage of peritoneal fluid smears, together with the application of an immunocytochemical technique and an automatic method to count the immunoreactive cells. Finally, the present protocol describes the evaluation of the gross and the histopathological lesions together with the immunohistochemical analysis of the hepatic tissue.