Olive Polyphenol Oxidase Gene Family.

The phenolic compounds containing hydroxytyrosol are the minor components of virgin olive oil (VOO) with the greatest impact on its functional properties and health benefits. Olive breeding for improving the phenolic composition of VOO is strongly dependent on the identification of the key genes determining the biosynthesis of these compounds in the olive fruit and also their transformation during the oil extraction process. In this work, olive polyphenol oxidase (PPO) genes have been identified and fully characterized in order to evaluate their specific role in the metabolism of hydroxytyrosol-derived compounds by combining gene expression analysis and metabolomics data. Four PPO genes have been identified, synthesized, cloned and expressed in Escherichia coli, and the functional identity of the recombinant proteins has been verified using olive phenolic substrates. Among the characterized genes, two stand out: (i) OePPO2 with its diphenolase activity, which is very active in the oxidative degradation of phenols during oil extraction and also seems to be highly involved in the natural defense mechanism in response to biotic stress, and (ii) OePPO3, which codes for a tyrosinase protein, having diphenolase but also monophenolase activity, which catalyzes the hydroxylation of tyrosol to form hydroxytyrosol.

The Spanish Fabry women study: a retrospective observational study describing the phenotype of females with GLA variants.

BACKGROUND: Fabry disease (FD) is an X-linked condition caused by variants in the GLA gene. Since females have two X chromosomes, they were historically thought to be carriers. Although increased knowledge has shown that females often develop the disease, data from Spain and other countries reported that females were undertreated. The aim of this study was to provide a wider and more recent description of the disease characteristics and associated management of females with a GLA variant in a Spanish cohort. RESULTS: Ninety-seven females from 12 hospitals were included in this retrospective study. Mean age was 50.1 ± 17.2 years. Median follow-up time from GLA variant identification was 36.1 months, and most (70.1%) were identified through family screening. Variants associated with classic/non-classic phenotypes were similarly distributed (40.2%/53.6%). Missense variants were the most prevalent (n = 84, 86.6%). In the overall group, 70.4% had major organ involvement (i.e., cardiac, renal, cerebrovascular, peripheral nervous system or gastrointestinal), and 47.3% also had typical Fabry signs (angiokeratoma, cornea verticillata or increased plasma lyso-Gb3). Cardiac involvement was the most prevalent (49.5%) and the main reason for treatment initiation. A total of 33 (34%) patients received disease-specific therapy, 55% of whom were diagnosed by family screening. Females carrying variants associated with a classic phenotype had higher frequencies of clinical manifestations (92.3%) and were predominant in the treated subgroup (69.7%). Despite this, there were 34 untreated females (56.7% of total untreated), with both phenotypes represented, who had major organ involvement, with 27 of cardiac, renal or cerebrovascular nature. Age or comorbidities in this subgroup were comparable to the treated subgroup (P = 0.8 and P = 0.8, respectively). CONCLUSIONS: Efforts have been made in recent years to diagnose and treat timely Fabry females in Spain. A high percentage of females with pathogenic variants, regardless of their associated phenotype, will likely develop disease. A proportion of females with severe disease in this cohort received specific treatment. Still a significant number of females, even with same profile as the treated ones, who may be eligible for treatment according to European recommendations, remained untreated. Reasons for this merit further investigation.

Physical, Mechanical and Radiological Characteristics of a Fly Ash Geopolymer Incorporating Titanium Dioxide Waste as Passive Fire Insulating Material in Steel Structures.

This research analyzes whether a titanium dioxide waste (TiO2 waste) can be used as a source material for geopolymers with good fire resistance properties. Samples with different proportions were prepared, replacing fly ashes with titanium dioxide waste on geopolymers (0, 20, 30, 40 and 100% w/w). The activating solution has a Na2O/SiO2 molar ratio of 0.98. Physical (bulk density, moisture content and water absorption) and mechanical (superficial hardness and compressive strength) characteristics have been evaluated. In addition, their thermal behavior at high temperatures (fire resistance, compressive strength at elevated temperature and absorbed energy) has also been evaluated to see if they can be used as fire insulating materials. This work also studies the radiological activity of geopolymer materials. The replacement of FA with WTiO2 increases the bulk density due to its higher specific bulk density. The highest compressive strength values were obtained with a TiO2 waste content between 30 and 40% w/w. The compressive strength decreases at high temperatures, especially when more TiO2 waste is added. When the amount of TiO2 waste is increased, so is the plateau of evaporation, and this, in turn, increases the resistance to fire. Geopolymers containing FA and TiO2 waste do not present radiological problems, although, when the TiO2 waste is increased, the activity index of the geopolymer also rises.

The Infestation of Olive Fruits by Bactrocera oleae (Rossi) Modifies the Expression of Key Genes in the Biosynthesis of Volatile and Phenolic Compounds and Alters the Composition of Virgin Olive Oil.

Bactrocera oleae, the olive fruit fly, is one of the most important pests affecting the olive fruit, causing serious quantitative and qualitative damage to olive oil production. In this study, the changes induced by B. oleae infestation in the biosynthesis of volatile and phenolic compounds in olive (cvs. Picual, Manzanilla, and Hojiblanca) have been analyzed. Despite cultivar differences, the oils obtained from infested fruits showed a significant increase in the content of certain volatile compounds such as (E)-hex-2-enal, ethanol, ethyl acetate, and ß-ocimene and a drastic decrease of the phenolic contents. The impact of those changes on the inferred quality of the oils has been studied. In parallel, the changes induced by the attack of the olive fly on the expression of some key genes in the biosynthesis of volatile and phenolic compounds, such as lipoxygenase, ß-glucosidase, and polyphenol oxidase, have been analyzed. The strong induction of a new olive polyphenol oxidase gene (OePPO2) explains the reduction of phenolic content in the oils obtained from infested fruits and suggest the existence of a PPO-mediated oxidative defense system in olives.

N,N-Dimethyldithiocarbamate Elicits Pneumococcal Hypersensitivity to Copper and Macrophage-Mediated Clearance.

Streptococcus pneumoniae is a Gram-positive, encapsulated bacterium that is a significant cause of disease burden in pediatric and elderly populations. The rise in unencapsulated disease-causing strains and antimicrobial resistance in S. pneumoniae has increased the need for developing new antimicrobial strategies. Recent work by our laboratory has identified N,N-dimethyldithiocarbamate (DMDC) as a copper-dependent antimicrobial against bacterial, fungal, and parasitic pathogens. As a bactericidal antibiotic against S. pneumoniae, DMDC's ability to work as a copper-dependent antibiotic and its ability to work in vivo warranted further investigation. Here, our group studied the mechanisms of action of DMDC under various medium and excess-metal conditions and investigated DMDC's interactions with the innate immune system in vitro and in vivo. Of note, we found that DMDC plus copper significantly increased the internal copper concentration, hydrogen peroxide stress, nitric oxide stress, and the in vitro macrophage killing efficiency and decreased capsule. Furthermore, we found that in vivo DMDC treatment increased the quantity of innate immune cells in the lung during infection. Taken together, this study provides mechanistic insights regarding DMDC's activity as an antibiotic at the host-pathogen interface.

Importance of the origin of mesenchymal (stem) stromal cells in cancer biology: "alliance" or "war" in intercellular signals.

Mesenchymal stem cells (MSCs) play a central role in the intercellular signaling within the tumor microenvironment (TME), exchanging signals with cancer cells and tumor stromal cells, such as cancer-associated fibroblasts and inflammatory mononuclear cells. Research attributes both pro-tumor and anti-tumor actions to MSCs; however, evidence indicates that MSCs specific effect on the tumor depends on the source of the MSCs and the type of tumor. There are consistent data proving that MSCs from reproductive tissues, such as the uterus, umbilical cord or placenta, have potent anti-tumor effects and tropism towards tumor tissues. More interestingly, products derived from MSCs, such as secretome or extracellular vesicles, seem to reproduce the effects of their parental cells, showing a potential advantage for clinical treatments by avoiding the drawbacks associated with cell therapy. Given these perspectives, it appears necessary new research to optimize the production, safety and antitumor potency of the products derived from the MSCs suitable for oncological therapies.

Joint Tumor Bud-MMP/TIMP Count at the Invasive Front Improves the Prognostic Evaluation of Invasive Breast Carcinoma.

BACKGROUND: Tumor budding is a histological phenomenon consisting of the formation of small clusters of one to five undifferentiated malignant cells detached from the main tumor mass which are observed in the tumor stroma. In the present study, we investigated the prognostic significance of tumor budding in breast cancer and its relationship with the expressions of matrix metalloproteases (MMPs) and their tissue inhibitors (TIMPs). METHODS: The number of buds was counted in whole-tissue sections from 153 patients with invasive ductal carcinomas who underwent a long follow-up period. In addition, an immunohistochemical study of MMP-9, -11, and -14 TIMP-1 and -2 expression by cell types at the invasive tumor front was carried out. RESULTS: There was a wide variability in the number of buds among tumors, ranging from 0 to 28 (median = 5). Tumor budding count ≥ 4 was the optimal cut-off to predict both relapse-free and overall survival. High-grade tumor budding was associated with MMP/TIMP expression by cancer-associated fibroblasts. In addition, we found that the combination of tumor budding grade with MMP/TIMP expression by stromal cells, and especially with MMP-11 expression by mononuclear inflammatory cells, significantly improved the prognostic evaluation. CONCLUSION: High-grade tumor budding is associated with a more aggressive tumor phenotype, which, combined with MMP/TIMP expression by stromal cells at the invasive front of the tumor, identifies patients with poor prognosis.

Study of the olive ß-glucosidase gene family putatively involved in the synthesis of phenolic compounds of virgin olive oil.

BACKGROUND: Hydrolysis of the fruit phenolic glucosides occurring during the oil extraction process is the main biochemical reaction affecting the biosynthesis and accumulation of secoiridoid compounds in virgin olive oil. An integrated approach at the molecular, biochemical, and metabolic level was used to study the olive ß-glucosidase gene family in seven olive cultivars selected by their different phenolic profiles. RESULTS: Eight ß-glucosidase genes have been identified by in silico analysis of an olive transcriptome. Their expression levels were analyzed by reverse transcription quantitative polymerase chain reaction in olive fruits at different ripening stages: I, green fruits, 16-19 weeks after flowering (WAF); II, yellow-green fruits, 22-25 WAF; III, turning fruits, 28-31 WAF; and IV, fully ripe fruits, 35-40 WAF. Gene expression was compared with the level of ß-glucosidase activity in the fruit and with the phenolic composition of fruits and oils from different olive cultivars. Phylogenetic analysis of the encoded proteins and differences found among the ß-glucosidase genes based on Gene Ontology enrichment analysis data suggests maximum involvement of two genes, OeBGLU1A and OeBGLU1B, in the phenolic composition of virgin olive oil. Positive correlation coefficients were found within each olive cultivar between OeBGLU1A and OeBGLU1B gene expression data and the phenolic content of the oil. CONCLUSION: The results obtained suggest that the expression pattern of specific ß-glucosidase genes may be an accurate predictor for the phenolic content of virgin olive oil that could be used in olive breeding programs. © 2021 Society of Chemical Industry.

Hereditary Leiomyomatosis and Renal Cell Cancer Syndrome in Spain: Clinical and Genetic Characterization.

Hereditary leiomyomatosis and renal cell cancer syndrome (HLRCC) is a very rare hereditary disorder characterized by cutaneous leiomyomas (CLMs), uterine leiomyomas (ULMs), renal cysts (RCys) and renal cell cancers (RCCs). We aimed to describe the genetics, clinical features and potential genotype-phenotype associations in the largest cohort of fumarate hydratase enzyme mutation carriers known from Spain using a multicentre, retrospective study of individuals with a genetic or clinical diagnosis of HLRCC. We collected clinical information from medical records, analysed genetic variants and looked for genotype-phenotype associations. Analyses were performed using R 3.6.0. software. We included 197 individuals: 74 index cases and 123 relatives. CLMs were diagnosed in 65% of patients, ULMs in 90% of women, RCys in 37% and RCC in 10.9%. Twenty-seven different pathogenic variants were detected, 12 (44%) of them not reported previously. Patients with missense pathogenic variants showed higher frequencies of CLMs, ULMs and RCys, than those with loss-of-function variants (p = 0.0380, p = 0.0015 and p = 0.024, respectively). This is the first report of patients with HLRCC from Spain. The frequency of RCCs was lower than those reported in the previously published series. Individuals with missense pathogenic variants had higher frequencies of CLMs, ULMs and RCys.

Experience with tocilizumab in severe COVID-19 pneumonia after 80 days of follow-up: A retrospective cohort study.

OBJECTIVES: To describe the clinical characteristics and predictors of major outcomes in patients treated with tocilizumab (TCZ) for severe COVID-19 pneumonia. PATIENTS AND METHODS: Case series of all sequential patients with severe COVID-19 pneumonia treated with TCZ at an Academic Spanish hospital (March 12 - May 2, 2020). Clinical outcomes: death, length of hospital stay. An early clinical response to TCZ (48-72 h after the administration) was assessed by variations in respiratory function markers, Brescia COVID Respiratory Severity Scale (BCRSS), inflammatory parameters, and patients' and physicians' opinion. Associations were tested by multiple logistic regression. RESULTS: From a cohort of 236 patients, 77 patients treated with TCZ were included (median age 62 years (IQR 53.0-72.0), 64.9% were males), 42.9% had Charlson index ≥3; hypertension (41.6%), obesity (34.7%), and diabetes (20.8%). Median follow-up was 83.0 days (78.0-86.5), no patient was readmitted. ICU admission was required for 42 (54.5%), invasive mechanical ventilation in 38 (49.4%) and 10 patients died (12.9% global, 23.8% at ICU admitted). After multivariate adjustment, TCZ response by BCRSS (OR 0.03 (0.01-0.68), p = 0.028), and Charlson index (OR 3.54 (1.20-10.44), p = 0.022) has been identified as independent factors associated with mortality. Median of hospital stay was 16.0 days (11.0-23.0); BCRSS, physician subjective and D-dimer response were associated with shorter hospitalization stay. CONCLUSIONS: In a Mediterranean cohort, use of tocilizumab for severe COVID-19 show 12.9% of mortality. Early TCZ-response by BCRSS and low comorbidity were associated with increased survival. Early TCZ-response was related to shorter median hospital stay.

An Aromatic Aldehyde Synthase Controls the Synthesis of Hydroxytyrosol Derivatives Present in Virgin Olive Oil.

The phenolic composition of virgin olive oil (VOO) is strongly determined by the content and distribution of secoiridoid phenolic glucosides present in the olive fruit. Among them, oleuropein is the most abundant in olive mesocarp and is characterized by containing an hydroxytyrosol residue in its chemical structure. Hydroxytyrosol-containing molecules are those that exhibit the most important biological activities in virgin olive oil. In this regard, we identified an aromatic aldehyde synthase gene (OeAAS) from an olive transcriptome, which was synthesized, expressed in Eschrichia coli, and purified its encoded protein. The recombinant OeAAS is a bifunctional enzyme catalyzing decarboxylation and amine-oxidation reactions in a single step. OeAAS displays strict substrate specificity for l-DOPA to form 2,4-dihydroxyphenylacetaldehyde, the immediate precursor of hydroxytyrosol. In addition to the biochemical characterization of the enzyme, the expression analysis carried out in different olive cultivars and ripening stages indicate that OeAAS gene is temporally regulated in a cultivar-dependent manner. High correlation coefficients were found between OeAAS expression levels and the phenolic content of olive fruits and oils, which supports a key role for OeAAS in the accumulation of hydroxytyrosol-derived secoiridoid compounds in olive fruit and virgin olive oil.

MMP11 expression in intratumoral inflammatory cells in breast cancer.

AIMS: It is known that matrix metalloproteinase (MMP)-11 has a role in tumour development and progression, and also that immune cells can influence cancer cells to increase their proliferative and invasive properties. The aim of the present study was to propose the evaluation of MMP11 expression by intratumoral mononuclear inflammatory cells (MICs) as a useful biological marker for breast cancer prognosis. METHODS AND RESULTS: This study comprised 246 women with invasive breast carcinoma, and a long follow-up period. Patients were stratified with regard to nodal status and to the development of metastatic disease. The median follow-up period in patients without metastasis was 146 months and in patients with metastatic disease 31 months. MMP11 was determined by immunohistochemistry. For relapse-free survival (RFS) and overall survival (OS) analysis we used the Cox's univariate method. Cox's regression model was used to examine the interactions between different prognostic factors in a multivariate analysis. CONCLUSIONS: Our results showed that MMP11 expression by stromal cells was significantly associated with prognosis. MMP11 expression by cancer-associated fibroblasts (CAFs) was associated with both shortened RFS and OS, but MMP11 expression by MICs showed a stronger association with both shortened RFS and OS, therefore being the most potent and independent factor to predict RFS and OS.

Effect of Extrusion Conditions and the Optimization of Phenolic Compound Content and Antioxidant Activity of Wheat Bran Using Response Surface Methodology.

The extrusion process (EP) consists of heat and mechanical treatments under different conditions of moisture, shear, and pressure and rapidly causes structural alterations and changes in the functional properties of the extruded material. The aim of this study was to evaluate the effect of extrusion conditions and optimize the wheat bran extrusion conditions to achieve the greatest content of phenolic compounds and antioxidant activity using response surface methodology. The EP factors evaluated were feed moisture (FM) (25-33.54%) and final extrusion temperature (T) (140-180 °C). The properties evaluated in the extruded material were bound total phenol content (BTPC), total phenolic compounds and antioxidant activity (AOX). Analysis of variance (ANOVA) and response surface methodology were used in the evaluation. The determination coefficients, (FM)2 and (T)2, very significantly affected the BTPC and bound 2,2-diphenyl-1-picrylhydrazyl content (BDPPHC). The optimization was performed by overlaying two contour plots to predict the best combination regions. The optimized extrusion conditions were the following: FM = 30% and T = 140 °C, which provided BTPC = 3547.01 µgGAE/g (predicted: 3589.3 µgGAE/g) and BDPPHC = 9.5 µmolTE/g (predicted: 10.4 µmolTE/g); and FM = 30% and T = 180 °C, which provided BTPC = 3342.3 µgGAE/g (predicted: 3727.7 µgGAE/g) and BDPPHC = 9.5 µmolTE/g (predicted: 9.3 µmolTE/g). The EP increased the phenolic compounds and AOX, and enhancement of these properties in wheat bran products could make them functional foods.

Prognostic Influence of Tumor Stroma on Breast Cancer Subtypes.

INTRODUCTION: The objective of the present work was to evaluate the impact of the phenotype of both intratumoral mononuclear inflammatory cells (MICs) and cancer-associated fibroblast (CAFs), assessed as to their expression of matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) on prognosis in different breast cancer subtypes. MATERIALS AND METHODS: A total of 247 tumors of patients with primary ductal invasive breast cancer were categorized into 1 of 4 major subtypes, using the 3 standard immunohistochemical markers (estrogen receptor [ER], progesterone receptor [PR], and human epidermal growth factor receptor/Neu 2 [HER2] receptor status). An immunohistochemical study was performed using tissue arrays and specific antibodies against MMP-9, MMP-11, and MMP-14, and TIMP-1 and TIMP-2. RESULTS: MMP-11 expression by MICs was significantly and strongly associated with prognosis in all breast cancer subtypes. There were other significant associations with poor prognosis in luminal A tumors: expressions of MMP-9, MMP-11, and TIMP-2 by CAFs, in luminal B tumors: MMP-14 expression by MICs and TIMP-2 expression by MICs, in HER-2-positive tumors: expression of MMP-9 by MICs, and in triple negative breast cancers: expression of TIMP-1 by MICs. CONCLUSION: Characterization of both tumor stromal CAFs and MICs, with regard to the expression of MMPs and TIMPs, improve the prognostic evaluation of all breast cancer subtypes.

Postprandial triglyceride-rich lipoproteins promote lipid accumulation and apolipoprotein B-48 receptor transcriptional activity in human circulating and murine bone marrow neutrophils in a fatty acid-dependent manner.

SCOPE: Postprandial triglyceride-rich lipoproteins (TRLs) promote atherosclerosis. Recent research points the bone marrow (BM) as a primary site in atherosclerosis. We elucidated how the acute administration of monounsaturated fatty acids (MUFAs) MUFAs, omega-3 polyunsaturated fatty acids (PUFAs) PUFAs and saturated fatty acids (SFAs) affects human circulating and murine BM neutrophil lipid accumulation and functionality. METHODS AND RESULTS: Postprandial hypertriglyceridemia was induced in healthy subjects and Apoe-/- mice by the acute administration of dietary fats enriched in MUFAs, PUFAs, or SFAs. Postprandial hypertriglyceridemia increased apolipoprotein-B48 receptor (ApoB48R) transcriptional activity that was linearly correlated with intracellular triglycerides (TGs) TGs accumulation in human circulating and murine BM neutrophils. MUFA and omega-3 PUFAs attenuated ApoB48R gene expression and intracellular TG accumulation compared to SFAs. TRLs induced apoB48R-dependent TG accumulation in human neutrophils ex vivo. Murine BM neutrophils showed a decrease in surface L-selectin and an increase in TNF-α and IL-1ß mRNA expressions only after SFAs administration. TRLs enriched in SFAs induced BM neutrophil degranulation ex vivo suggesting cell priming/activation. CONCLUSION: Postprandial TRLs disrupts the normal biology and function of circulating and BM neutrophils. MUFA- and omega-3 PUFA-rich dietary fats such as virgin olive oil or fish oil has the potential to prevent excessive neutrophil lipid accumulation and activation by targeting the fatty acid composition of TRLs.

Nasoalveolar Molding Therapy for the Treatment of Unilateral Cleft Lip and Palate Improves Nasal Symmetry and Maxillary Alveolar Dimensions.

OBJECTIVE: The aim of this study is to assess the esthetic and morphologic outcomes before surgery using nasoalveolar molding (NAM) therapy in children with unilateral cleft lip and palate. DESIGN: A prospective analysis was performed. SETTING: The study was carried out in the Congenital Malformations Craniofacial and Cleft Lip and Palate Unit, Hospital Virgen de las Nieves, Andalusian Health Service, Granada (Spain). PATIENTS: Twenty consecutively enrolled infants ranging in age from 7 to 30 days with nonsyndromic unilateral cleft lip and palate treated from 2008 to 2012. INTERVENTIONS: All patients were treated with NAM appliances to align the alveolar segments and reduce severity of the nasal deformity. MAIN OUTCOME MEASURE: The extraoral nasal measurements were performed on casts and nasal photographs. The measurements consisted of bialar width (BAW), columellar deviation (CD), cleft nostril height (CNH), cleft nostril width (CNW), non-CNH, non-CNW, and the deviation of the columella to the horizontal line represented by bilateral pupil line (BIA). The authors have made the measurements following Barilla method. Also 2 intraoral measurements were taken. RESULTS: Following NAM the extraoral records showed a statistically significant decrease in CD (P < 0.0001), CNW (P < 0.0001), and BAW (P < 0.001). Furthermore, statistically significant increases in CNH (P < 0.05) and BIA (P < 0.0001) were observed.Following Barilla measurements, the authors have found a high percentage of symmetry in all the nasal measurements after the NAM therapy.Intraoral results showed a statistically significant decrease in the gap between the greater and lesser alveolar segments and a statistically significant increase in maxillary arch width. CONCLUSIONS: Nasoalveolar molding improves nasal symmetry and achieves an improvement of all maxillary alveolar dimensions, increasing alveolar rim width, reducing the size of alveolar cleft gap, and improving shape of the maxillary dental arch. As a consequence of reducing the alveolar and nasal deformities before surgery, it is expected that the primary repair will be easier for the surgeon and more successful.

Analyzing the concept of disruptive behavior in healthcare work: an integrative review* / Análisis del concepto comportamiento destructivo en el trabajo sanitario: revisión integrativa / Análise do conceito comportamento destrutivo no trabalho em saúde: revisão integrativa

Abstract OBJECTIVE To analyze the concept of disruptive behavior in healthcare work. METHOD An integrative review carried out in the theoretical phase of a qualitative research substantiated by the theoretical framework of the Hybrid Model of Concept Development. The search for articles was conducted in the CINAHL, LILACS, PsycINFO, PubMed and SciVerse Scopus databases in 2013. RESULTS 70 scientific articles answered the guiding question and lead to attributes of disruptive behavior, being: incivility, psychological violence and physical/sexual violence; with their main antecedents (intrapersonal, interpersonal and organizational) being: personality characteristics, stress and work overload; and consequences of: workers' moral/mental distress, compromised patient safety, labor loss, and disruption of communication, collaboration and teamwork. CONCLUSION Analysis of the disruptive behavior concept in healthcare work showed a construct in its theoretical stage that encompasses different disrespectful conduct adopted by health workers in the hospital context, which deserve the attention of leadership for better recognition and proper handling of cases and their consequences.

Resumen OBJETIVO Analizar el concepto comportamiento destructivo en el trabajo sanitario. MÉTODO Revisión integrativa realizada en la fase teórica de investigación cualitativa fundamentada por el marco de referencia teórico-metodológico del Modelo Híbrido de Análisis de Conceptos. La búsqueda de artículos fue realizada en las bases de datos CINAHL, LILACS, PsycINFO, PubMed y SciVerse Scopus, en 2013. RESULTADOS 70 artículos científicos respondieron a la cuestión orientadora y atendieron los criterios de inclusión, permitiendo evidenciar los atributos del comportamiento destructivo: incivilidad, violencia psicológica y violencia física/sexual; sus principales antecedentes (intrapersonales, interpersonales y organizativos): características de personalidad, estrés y sobrecarga laboral; y consecuentes: sufrimiento moral/psíquico de los trabajadores, compromiso de la seguridad del paciente, perjuicios laborales, rompimiento de la comunicación, la colaboración y el trabajo en equipo. CONCLUSIÓN El análisis del concepto comportamiento destructivo en el trabajo en salud evidenció, en su fase teórica, un constructo que abarca diferentes conductas que presentan la falta de respeto adoptadas por trabajadores de salud en el marco hospitalario, mereciendo atención de liderazgos del área para mayor reconocimiento y manejo adecuado de los casos y sus consecuencias.

Resumo OBJETIVO Analisar o conceito comportamento destrutivo no trabalho em saúde. MÉTODO Revisão integrativa realizada na fase teórica de pesquisa qualitativa fundamentada pelo referencial teórico-metodológico do Modelo Híbrido de Análise de Conceitos. A busca dos artigos foi realizada nas bases de dados CINAHL, LILACS, PsycINFO, PubMed e SciVerse Scopus, em 2013. RESULTADOS 70 artigos científicos responderam à questão norteadora e atenderam aos critérios de inclusão, permitindo evidenciar os atributos do comportamento destrutivo: incivilidade, violência psicológica e violência física/sexual; seus principais antecedentes (intrapessoais, interpessoais e organizacionais): características de personalidade, estresse e sobrecarga de trabalho; e consequentes: sofrimento moral/psíquico dos trabalhadores, comprometimento da segurança do paciente, prejuízos laborais, rompimento da comunicação, da colaboração e do trabalho em equipe. CONCLUSÃO A análise do conceito comportamento destrutivo no trabalho em saúde evidenciou, em sua fase teórica, um constructo que abrange diferentes condutas desrespeitosas adotadas por trabalhadores de saúde no contexto hospitalar, merecendo atenção de lideranças da área para maior reconhecimento e manejo adequado dos casos e suas consequências.

[Application of therapy in negative pressure complex wounds in pediatrics]. / Aplicación de la terapia de presión negativa en heridas complejas en pediatría.

Negative pressure wound therapy (NPWT) has been widely used in the adult patient, contrary to what happens in children, with just a few long series papers. NPWT avoids long and expensive hospital admissions, reducing the hospital costs; it also decreases the family dynamics and allows for an early return to everyday activities. In this article, we present three clinical cases consisting of a toddler, a child and a teenager with complex wounds treated with NPWT in the pediatric surgery department of the Virgen de las Nieves University Hospital in Granada. The results were excellent, with a good adherence to treatment in all cases, achieving a complete closure in two cases; the third case needed a deferred surgical closure after surgical site preparation, and showed a decrease of the wound size after the NPWT. Moreover, successful pain management was achieved during the wound cleansing, which was done under an ambulatory regime. No general anesthesia was needed. From our experience, we propose the NPWT as an alternative therapy to the classic surgical approach for this type of complex lesions in children, which offers the same advantages and results than in adults.

Exploración neuropsicológica en un caso de sufrimiento fetal agudo: diagnóstico e intervención / Neuropsychological exploration in a acute fetal distress case: diagnosis and intervention

En el presente artículo se muestran los resultados del proceso de corrección de una niña de edad escolar que presento sufrimiento fetal agudo a los 6 meses de gestación. Se describe el proceso de evaluación y la interpretación de los resultados a la luz de la teoría neuropsicológica de Luria y la psicología histórico-cultural de Vigotsky. Se presenta la propuesta de un programa de corrección neuropsicológica, el cual tiene como objetivo lograr un mejor funcionamiento de los mecanismos de regulación y control y de análisis y síntesis espacial simultanea. Finalmente, se exponen y contrastan los resultados de la evaluación aplicada después del programa de corrección con el estado inicial de la menor...

The present article shows the correction process result of a girl in school age who presents acute fetal distress at six month of gestation. Describes the evaluation process and the result of the interpretation at the neuropsychology theory light of Luria and Vigotsky Historic-Cultural psychology. Present the proposal of a Neuropsychological correction program, which has as objective achieved a better regulation and control and analysis and simultaneous spatial synthesis mechanism operation. Finally, exposed and contrasts evaluation results applied after the correction program with the initial state of the minor...

Situación bucal de pobladores con discapacidades en el distrito de SanLuis - Lima / Dental Status of people with special needs from the District of San Luis - Lima

Objetivo: Establecer el estado de la salud bucal de personas con diversas discapacidades, residentes en un distrito de clase media-baja de la ciudad de Lima. Materiales y métodos: Se examinó a residentes registrados en la Oficina Municipal de Atención de la Persona con Discapacidad - OMAPED, de San Luis, como parte de la primera fase del desarrollo del Sistema de atención Odontológico Especializado a implementar. La clasificación utilizada, incluía la discapacidad a) Motora b) Sensorial y c) Mental. La información bucal recabada, fue el CPOD, apiñamiento dentario (Van der Linden), el Índice de Higiene Oral simplificado de Greene y Vermillion (IHOs), y la presencia de bolsas periodontales, piezas extruidas y atrición dental. Resultados: El total examinado fue de 102 personas, considerando válidos finalmente 89. Las edades oscilaron entre 6 y 93 años. Del total, el 42,2% presentaban discapacidad motora; 35,3% discapacidad mental y el 9,8% discapacidad sensorial. El CPOD, reflejaba un incremento progresivo con el paso de los años, siendo mas pronunciado a partir de los 51 años, donde se observó, el valor mínino de 18 y el máximo de 32. Entre los componentes del CPOD, las piezas perdidas prevalecieron enlos 3 grupos de discapacidad, siendo mayor en los subgrupos motor y sensorial. También llama la atención que las obturaciones eran muy escasas. Conclusiones: La condición bucal de las personas con discapacidad se deteriora rápidamente con la edad.

Objective: To establish the dental status of people with special needs, who live in a district of a Low-Middle Economical class in Lima. Materials and methods: People registered at the office for people with special needs of the City Hall of District of San Luis (OMAPED) were examined. This study is a first stage of the development of an Specialized System of Dental Care. The classification of the special needs included: a) mobility handicap, b) sensorial handicap; c) mental handicap. The dental status included information of DMF-t; crowding (Van der Linden classification), Oral Hygiene Green Vermillion index, presence of periodontal pockets, extruded teeth, and dental attrition. Results: A total of 102 people with special needs were examined, only 89 were considered in the data. Age ranged from 6 to 93 years old. 42.2% of the total examined people had mobility handicap, 35.5% had mental handicap, and 9.8% had sensorial handicap. DMF-t showed a progressive rise as people grew older, it reached its highest value at the age of 51, with a minimum value of 18 and a maximum value of 32. Regarding the components of DMF-t, missing teeth component was more frequent in the three groups of handicapped; the highest values were observed in the motor and sensorial handicap. It also calls the attention the very few restored teeth. Conclusions: The dental status of people with special needs deteriorates rapidly with aging.