Influence of vitamin D supplementation on the quality of life of asthma patients: Findings from ACVID randomised clinical trial.

Published data on vitamin D and the quality of life of asthma patients are scarce and disparate. The ACVID clinical trial, published in 2020, showed the efficacy of calcifediol in improving asthma control in asthma patients with vitamin D deficiency. Data on vitamin D and quality of life measured by the Mini-AQLQ questionnaire were analysed: supplemented patients showed improved quality of life compared with a placebo group, and the initial mini-AQLQ scores were improved for both groups.

Eco-friendly extraction of Mastocarpus stellatus carrageenan for the synthesis of gold nanoparticles with improved biological activity.

Carrageenan was extracted from Mastocarpus stellatus using hot water extraction under atmospheric and pressurized conditions. The influence of heating temperature during a non-isothermal heating profile up to temperatures in the range 70-190 °C was studied to evaluate the extraction yields and properties of the carrageenan fraction. Under the selected conditions (130 °C), extracted carrageenan (CMs) was used for the green synthesis of gold nanoparticles (AuNPs). After the optimization of the reaction conditions, the synthesized gold nanoparticles (Au@CMs) were characterized by UV-Vis spectroscopy, Z potential measurements, electron microscopy, and X-ray diffraction analysis, which confirmed the formation of spherical, polycrystalline, and negatively charged nanoparticles with a mean diameter of 14.3 ± 2.1 nm. The study conducted by scanning transmission electron microscopy, energy dispersive X-ray analysis and mapping confirmed the presence of carrageenan stabilizing AuNPs. Finally, Fourier transformed infrared spectroscopy was performed to analyze the functional groups of CMs involved in the reduction and stabilization of AuNPs. The selective cytotoxicity and the antioxidant activity of the Au@CMs were evaluated in different cell lines and compared to the CMs. Au@CMs showed an improved antioxidant capacity in cells under oxidative stress and the induction of apoptosis in a monocytic cell line, while no antitumor effect was observed in a lung endothelial cell line.

Saccorhiza polyschides used to synthesize gold and silver nanoparticles with enhanced antiproliferative and immunostimulant activity.

Over the last years, there has been an increasing trend towards the use of environmentally friendly processes to synthesize nanomaterials. In the case of nanomedicine, the use of bionanofactories with associated biological properties, such as seaweed, has emerged as a promising field of work due to the possibility they open for both the preservation of those properties in the nanomaterials synthesized and/or the reduction of their toxicity. In the present study, gold (Au@SP) and silver (Ag@SP) nanoparticles were synthesized using an aqueous extract of Saccorhiza polyschides (SP). Several techniques showed that the nanoparticles formed were spherical and stable, with mean diameters of 14 ± 2 nm for Au@SP and 15 ± 3 nm for Ag@SP. The composition of the biomolecules in the extract and the nanoparticles were also analyzed. The analyses performed indicate that the extract acts as a protective medium, with the particles embedded in it preventing aggregation and coalescence. Au@SP and Ag@SP showed superior immunostimulant and antiproliferative activity on immune and tumor cells, respectively, to that of the SP extract. Moreover, the nanoparticles were able to modulate the release of reactive oxygen species depending on the concentration. Hence, both nanoparticles have a significant therapeutic potential for the treatment of cancer or in immunostimulant therapy.

The relationship of obesity with lifestyle and dietary exposure to endocrine-disrupting chemicals.

Phytoestrogens are natural components of plants, including numerous foods that form part of the habitual diet of humans and animals. They have similar estrogenic effects to those of synthetic endocrine disrupters such as monomers of plastic materials, e.g., polycarbonates and epoxy resins. The most frequently used monomer is bisphenol A (BPA), which has been found to migrate from drink and food packaging, plastic baby bottles, and the coating of cans. Numerous studies have associated exposure to endocrine disrupters with obesity, classifying them as obesogens. The objectives of this study were to estimate the dietary exposure to phytoestrogens and BPA in a group of Spanish schoolchildren and to estimate their potential obesogenic effects. The diet of this population of healthy Spanish children was estimated to have a mean total estrogenic capacity of 5.10-12 M eq.E2 (5 pmol/day). The effects of this additional estrogenic burden are highly controversial, and no definitive conclusion has been reached. Thus, some authors consider exposure to these substances with estrogenic activity to be positive at certain stages of life, whereas others regard it as posing a risk at any age. In the present population of children, the likelihood of normal weight versus obesity was significantly related to the total proliferative effect (OR = 0.51, p = 0.026) as well as to the energy expenditure on physical activity, with lesser activity implying a greater risk of obesity (OR = 13.54, p = 0.001). Further research is warranted on the obesogenic effects of exposure to endocrine disruptors present in foods.

[Delta-9-tetrahydrocannabinol-cannabidiol in the treatment of spasticity in chronic spinal cord injury: a clinical experience]. / Delta-9-tetrahidrocannabinol-cannabidiol en el tratamiento de la espasticidad en la lesion medular cronica: una experiencia clinica.

INTRODUCTION: Spasticity in chronic spinal cord injury is a condition that can have negative repercussions on the patient's quality of life. Its treatment is complex and sometimes the outcome is insufficient. Cannabinoids have recently been used in multiple sclerosis to successfully treat spasticity that is refractory to other therapies. AIM: To quantify the clinical response of a group of patients with spastic chronic spinal cord injury to the orally administered drug delta-9-tetrahydrocannabinol-cannabidiol (Sativex ®) as medication for use in special situations. PATIENTS AND METHODS: The research consists of a six-month observational study in patients with chronic spinal cord injuries with refractory spasticity. The variables collected were: modified Ashworth scale, Penn spasm frequency scale, Numeric Rating Scale, and Visual Analogue Scale for pain. Additionally, clinical variables and side effects of the treatment were also collected. RESULTS: Fifteen patients took part in this study. A significant improvement was observed on three of the scales recorded: modified Ashworth scale (z = -2.97; p = 0.003), Penn spasm frequency scale (z = -2.76; p = 0.006) and Numeric Rating Scale (z = -3.21; p = 0.001). The use of the drug was withdrawn in two patients due to side effects. CONCLUSIONS: Sativex can be considered an alternative in patients with spasticity associated with chronic spinal cord injury for whom other therapeutic measures have been insufficient. Further studies need to be conducted before the use of this drug can be recommended and so as to define a complete profile of its long-term side effects.

TITLE: Delta-9-tetrahidrocannabinol-cannabidiol en el tratamiento de la espasticidad en la lesion medular cronica: una experiencia clinica.Introduccion. La espasticidad en la lesion medular cronica es una condicion que puede repercutir negativamente en la calidad de vida del paciente. Su tratamiento es complejo y, en ocasiones, el resultado es insuficiente. Recientemente, en la esclerosis multiple los cannabinoides se han empleado con exito en el tratamiento de la espasticidad refractaria a otras terapias. Objetivo. Cuantificar la respuesta clinica de un grupo de pacientes con lesion medular cronica espastica al farmaco delta-9-tetrahidrocannabinol-cannabidiol (Sativex ®), de administracion oral, como medicamento de uso en situaciones especiales. Pacientes y metodos. Estudio observacional durante seis meses en lesionados medulares cronicos con espasticidad refractaria. Las variables recogidas fueron: escala modificada de Ashworth, escala de frecuencia de espasmos de Penn, Numeric Rating Scale y escala visual analogica del dolor. De forma adicional se recogieron variables clinicas y efectos secundarios del tratamiento. Resultados. Quince pacientes tomaron parte en el estudio. Se observo mejoria significativa en tres de las escalas registradas: escala de Ashworth modificada (z = -2,97; p = 0,003), escala de frecuencia de espasmos de Penn (z = -2,76; p = 0,006) y Numeric Rating Scale (z = -3,21; p = 0,001). Se suspendio el uso del farmaco en dos pacientes por efectos secundarios. Conclusiones. Sativex se muestra como una alternativa en pacientes con espasticidad asociada a lesion medular cronica, en las que otras medidas terapeuticas resultan insuficientes. Son necesarios mas estudios para recomendar el uso de este farmaco y definir un perfil completo de sus efectos adversos a largo plazo.

[Carbapenem resistance in Pseudomonas aeruginosa isolated from urine cultures: prevalence and risk factors]. / Resistencia a carbapenemas en Pseudomonas aeruginosa aisladas en urocultivos: prevalencia y factores de riesgo.

OBJECTIVE: Pseudomonas aeruginosa is a non-fermentative gram-negative bacillus with a great ability to develop resistance to multiple antibiotics, including carbapenems, which is a growing problem worldwide. The aim of this study was to analyse the prevalence of carbapenem-resistant P. aeruginosa (CRPA) in urine cultures and to determine the risk factors associated with the development of carbapanem resistance. METHODS: Positive urine cultures to P. aeruginosa between September 2012 and September 2014 were identified. We excluded repetitive cultures from the same patient. We created a database with different variables, including antimicrobial resistance. The prevalence of carbapenem resistance and the risk factors for growth of CRPA were analysed. RESULTS: Ninety-one patients with positive urine cultures to P. aeruginosa were included. The prevalence of CRPA was 22%. The risk factors to CRPA infection in the univariate analysis were: congestive heart failure (p=0.02), previous treatment with ampicillin (p=0.04), meropenem (p=0.04), piperacillin-tazobactam (p=0.01), trimethoprim-sulfamethoxazole (p= 0.01) and previous treatment with more than one antibiotic (p<0.01). Only congestive heart failure (p<0.01) and previous treatment with more than one antibiotic (p<0.01) showed statistically significant differences in the multivariate analysis. CONCLUSIONS: The prevalence of CRPA in urine cultures is high in our population. We should assess the presence of risk factors as previous treatment with more than one antibiotic or comorbidities such as heart failure, in order to select an appropriate empirical treatment in patients with severe urinary tract infections.

Effects of maternal diet and environmental exposure to organochlorine pesticides on newborn weight in Southern Spain.

An appropriate eating pattern is essential during childbearing years and pregnancy to ensure a healthy pregnancy and newborn. Our group developed a Mediterranean Diet Score for Pregnancy (MDS-P) based on the MD and the specific need of pregnant women for Fe, Ca, and folic acid. Humans are daily exposed to endocrine disruptors, which may alter body weight and hormone system regulation. This study analyzed the relationship of maternal diet and in utero exposure to organochlorine pesticides (OCPs) with newborn weight in mothers and newborns from Southern Spain. Higher MDS-P score, folic acid supplementation, and greater in utero exposure to endosulfan-diol and endosulfan-1 were related to higher newborn weight. MDS-P score was not associated with maternal weight gain during pregnancy (above or below 12 Kg). Residues from one or more OCPs were detected in 96.5% of umbilical cord serum samples from 320 newborns. The most frequent residues were endosulfans (96.5%). The presence of endosulfan-diol, endosulfan-I, p-p´DDT, folic acid supplementation, and a higher MDS-P (>8) were predictive factors for newborn overweight (>3500 g). Conversely, smoking during pregnancy, shorter gestation time (32-36 vs. 37-39 weeks), and lesser maternal weight gain during pregnancy predicted lower newborn weight (<2500 g). These results indicate prenatal exposure to OCPs in Southern Spain and its possible impact on the weight of healthy full-term newborns. Further studies are warranted to interpret the consequences of this exposure and identify preventive measures. Adherence to the MD and folic acid supplementation during pregnancy emerged as predictive factors for overweight in newborns.

Pleurodesis con sangre autóloga en neumotórax espontaneo secundario con fuga aérea persistente / Autologous blood pleurodesis in secondary spontaneous pneumothorax with persistent air leak

Introducción: El neumotórax espontáneo secundario (NES) es la presencia de aire en la cavidad pleural con ausencia de traumatismo, asociado a alguna enfermedad pulmonar subyacente. La pleurodesis es considerada una alternativa al tratamiento de esta patología. La fuga aérea persistente o masiva es una complicación importante del NES, donde la utilización de pleurodesis con sangre autóloga constituye una opción conveniente en pacientes con alto riesgo quirúrgico. Objetivos: Se propuso describir las características de pacientes con NES tratados con pleurodesis con sangre autóloga en Hospital Regional de Concepción. Pacientes y método: Estudio descriptivo transversal, período enero 2012 - enero 2015. Se realizó una revisión de base de datos, protocolos quirúrgicos y fichas clínicas, seguimiento clínico a 36 meses, donde se describieron características clínicas, morbimortalidad, resultados inmediatos y tardíos. Resultados: Del total de pacientes (n=7), 5 (71,4 %) fueron hombres, con edad promedio de 60,7±8,2 años. La causa del NES fue mayoritariamente enfermedad pulmonar difusa en seis pacientes (85,7 %). Se realizaron siete pleurodesis con sangre autóloga sin necesidad de repetir el procedimiento. Se observó cierre de fístula en el 100 % de los pacientes. Al seguimiento no se observó necesidad de nuevos procedimientos. Discusión: La pleurodesis con sangre autóloga es un tratamiento efectivo y seguro en el manejo de la fuga aérea persistente o masiva, con adecuados resultados inmediatos y tardíos en casos seleccionados.

Introduction: Secondary spontaneous pneumothorax (NES) is pleural air occupation without trauma associated with the presence of some underlying lung disease. Pleurodesis is considered an alternative to the treatment of this disease. Persistent or massive air leak is a major complication of NES, where the use of pleurodesis with autologous blood is an accepted option in patients with high surgical risk and air leak. Objetive: Describe characteristics of patients with NES treated with pleurodesis with autologous blood in Hospital Regional of Concepción. Patients and methods: Cross-sectional descriptive study period January 2012- January 2015. It`s made a review of Database, surgical protocols and review medical records, 36 months' clinical follow-up. Description of clinical features, morbidity and mortality, immediate and remote results. Results: Of all patients (n=7), 5 (71.4 %) were males, mean age 60.7 ± 8.2 years. The cause of NES was predominantly diffuse lung disease in 6 (85.7%) patients. Seven pleurodesis with autologous blood were performed without repeating the procedure. Fistula closure was observed in 100% of patients. In follow the need for new procedures wasn't observed. Discussion: Pleurodesis with autologous blood is an effective and safe treatment in the management of persistent or massive air leak, with immediate and remote adequate results.

Nutrición Parenteral Domiciliaria en España 2011 y 2012; informe del grupo de nutrición artificial domiciliaria y ambulatoria NADYA / Home parenteral nutrition in Spain 2011 and 2012; a report of the home and ambulatory artificial nutrition group NADYA

Objetivo: Comunicar los datos del registro de Nutrición Parenteral Domiciliaria (NPD) del grupo de trabajo NADYA-SENPE de los años 2011 y 2012. Material y métodos: Recopilación de los datos del registro "on-line" introducidos por los colaboradores del grupo NADYA responsables del seguimiento de la NPD desde el 1 de enero de 2011 al 31 de diciembre de 2012 dividido por años naturales. Resultados: Año 2010: Se registraron 184 pacientes, procedentes de 29 hospitales, lo que representa una tasa de 3,98 pacientes/millón habitantes/año 2011, con 186 episodios de NPD. Durante el año 2012 se registraron 203 pacientes, procedentes de 29 hospitales, lo que representa una tasa de 4,39 pacientes/millón habitantes/año 2012, con un total de 211 episodios de NPD. Conclusiones: Se observa un aumento progresivo de los pacientes registrados respecto a años anteriores. El principal grupo patológico sigue siendo oncológico ocupando el primer lugar desde 2003. Aunque el registro NADYA es un registro consolidado y ha sido y es fuente imprescindible de información relevante para el conocimiento de los avances de la Nutrición Artificial Domiciliaria en nuestro país, queda un amplio margen para la mejora. En especial lo que hace referencia al registro de pacientes pediátricos y al registro de las complicaciones (AU)

Objective: To report the data of the Home Parenteral Nutrition (HPN) registry of the NADYA-SENPE working group for the years 2011 and 2012. Methodology: We compiled the data from the on-line registry introduced by reviewers of NADYA group responsible for monitoring of NPD introduced by since January 1, 2011 to december 31, 2012. Included fields were: age, sex, diagnosis and reason for HPN, access path, complications, beginning and end dates, complementary oral or enteral nutrition, activity level, autonomy degree, product and fungible material supply, withdrawal reason and intestinal transplant indication. Results: Year 2010: 184 patients from 29 hospitals, representing a rate of 3.98 patients/million inhabitants/ year 2011, with 186 episodes were recorded NPD. During 2012, 203 patients from 29 hospitals, representing a rate of 4.39 patients/million inhabitants/year 2012, a total of 211 episodes were recorded NPD. Conclusions: We observe an increase in registered patients with respect to previous years. Neoplasia remains as the main pathology since 2003. Although NADYA is consolidated registry and has been indispensable source of information relevant to the understanding of the progress of Home Artificial Nutrition in our country, there is ample room for improvement. Especially that refers to the registration of pediatric patients and the registration of complications (AU)

[Decrease in allogenic transfusions due to the spread of use of postoperative retransfusion systems in knee replacement surgery]. / Disminución de las transfusiones alogénicas por la generalización del uso de recuperadores de sangre postoperatorios en cirugía de prótesis de rodilla.

OBJECTIVES: Surgical teams have several tools in order to reduce the need for postoperative allogenic transfusion. Postoperative autotransfusion of unwashed shed blood has become common practice for total knee replacement surgery since 2006 in our hospital. This study was designed to evaluate if this practice has reduced allogenic blood transfusions. MATERIAL AND METHODS: A retrospective study comparing two cohorts, group 2004 with patients operated on for total knee replacement during the year 2004, before the use of the retransfusion system, and group 2008, patients operated on in the year 2008, with regular use of the retransfusion system. Gender, preoperative and postoperative haemoglobin levels, total amount of calculated erythrocytes lost, reinfusion of shed blood and allogenic blood transfusion during hospital stay were recorded. RESULTS: Both groups were similar as regards gender, preoperative and postoperative hemoglobin levels, and total amount of erythrocytes lost. The proportion of transfused patients was significantly lower in group 2008 versus group 2004 (20.18% versus 42.19%), with a relative risk of being transfused of 0.47 and a NNT of 4.54. P=.0017. CONCLUSIONS: In our hospital the use of postoperative retransfusion systems has reduced the proportion of transfused patients during hospitalization for total knee replacement surgery, although this result cannot be generalized due to the lack of a fixed transfusion trigger.

Evaluación de un programa de educación sexual sobre conocimientos y conductas sexuales en embarazadas / Evaluation of a sexual education program on knowledge and sexual behaviour in pregnant

Objetivo: Evaluar el nivel de conocimientos de la sexualidad en la gestación previos y posteriores a un programa formativo implementado por un grupo de gestantes en el segundo y tercer trimestre. Material y método: diseño cuasi-experimental pre-post test de un único grupo. Participaron 40 mujeres grávidas de bajo riesgo que se encontraban en su segundo y tercer trimestre de gestación. Todas eran de raza blanca. El 85% de las gestantes comprendían una edad entre 20 y 35 años, un 60% eran primigestas. Resultados: al 60% de las mujeres del estudio les ha afectado el embarazo a su vida sexual. El trimestre que ellas creen que pueden disfrutar más del sexo, en un primer cuestionario el 62.5% contestaron que en el segundo, después de implantar el programa, el 95% dieron esa respuesta. Entre las diferentes técnicas sexuales que existen, el 87.5% la conocían en un principio, después de realizar nuestro programa el porcentaje aumentó a un 97.4%. En cuanto a los beneficios de los ejercicios de Kegel, en un primer cuestionario tan sólo el 25% sabían la respuesta correcta, mientras que más tarde aumentó a un 85% y su práctica era realizada un 12.5% antes de la intervención, y después un 40%. Discusión-Conclusión: después de aplicar nuestro programa específico se notaron algunas mejoras en el nivel de conocimientos y actitudes sexuales aunque debido probablemente a la pequeña muestra utilizada no se han encontrado resultados estadísticamente significativos salvo en una variable (práctica de Kegel) (AU)

Objective: Evaluate the level of knowledge of sexuality in pregnancy before and after a training program implemented by a group of pregnant women in the second and third trimesters. Materials and methods: A quasi-experimental pre-post test single group. A total of 40 pregnant women at low risk who were in their second and third trimester were included. Regarding the ethnical group all women were white. The 85% of pregnant women included had an age between 20 and 35 years and for the 60% it was their first pregnancy. Results: 60% of women have altered her sex life. The initially believed that the most suitable month to enjoy sex live more was on the second trimester, as shown on the first questionnaire (62.5%). After implementing the program, these results increased up to the 95%. Regarding the different sexual techniques, 87.5% knew them at first, after participating in our program this percentage increased to 97.4%. In relation to the benefits of Kegel exercises, in the first questionnaire only 25% knew the correct answer, while after the program increased to 85%. Its practice increased to 12.5% before the intervention, and then a 40% of pregnant women said they knew it and practiced it. Discussion-Conclusion: after applying our specific program noted some improvements in the level of knowledge and sexual attitudes but probably due to the small sample used was not found statistically significant results except for one variable (practice Kegel) (AU)

Fungal decay and shelf life of oranges coated with chitosan and bergamot, thyme, and tea tree essential oils.

UNLABELLED: Chitosan coatings, containing or not essential oils (bergamot, thyme and tea tree oil), were applied to oranges (cv. Navel Powell). Antifungal effect was evaluated by applying coatings before and after inoculating the fruit with Penicillium italicum CECT 2294 (10(5) spores/mL), preventive and curative treatments, respectively. The effect of coatings on the quality parameters (acidity, pH, soluble solids, juice percentage, weight loss, firmness, color parameters, and respiration rate) was controlled for the different oranges samples throughout the cold storage time. Preventive antimicrobial treatments with coatings containing tea tree oil were the most effective with a reduction of the microbial growth (expressed as the percentage of infected samples) of 50%, as compared to the uncoated samples. The coatings did not lead to any relevant changes in the development of the sample quality parameters throughout the cold storage, except for a slightly reduced loss of both weight and firmness when the coatings contained bergamot oil. PRACTICAL APPLICATIONS: Results of this study are a useful tool for the development of new environmental friendly and healthier commercial applications in the control of the main postharvest fungal decay of citrus fruits.

Effects of dietary addition of capsicum extract on intake, water consumption, and rumen fermentation of fattening heifers fed a high-concentrate diet.

Four beef Holstein heifers (BW = 438 ± 71 kg) fitted with a 1-cm i.d. plastic ruminal trocars were used in a 4 × 4 Latin square design to evaluate the effect of 3 doses of capsicum extract (CAP) on intake, water consumption, and ruminal fermentation in heifers fed a high-concentrate diet. Animals were fed (DM basis) 10% barley straw and 90% concentrate (32.2% barley grain, 27.9% ground corn, 7.5% wheat bran, 10.7% soybean meal, 10.7% soybean hulls, 7.2% corn gluten feed, 3.1% mineral-vitamin mix; 16.6% CP, 18.3% NDF). Treatments were no additive (CTR), 125 (CAP125), 250 (CAP250), and 500 (CAP500) mg/d of capsicum oleoresin standardized with 6% of capsaicin and dihydrocapsaicin (XTract 6933, Pancosma, Geneva, Switzerland). Each experimental period consisted of 25 d (15 d for adaptation, 5 d of continuous measurement of DMI, and 3 d for rumen sample collection). Animals had ad libitum access to water and feed offered once daily at 0800 h. Data were analyzed by the MIXED procedure of SAS. The model included the fixed effects of period and treatment, the random effect of heifer, and the residual error. The effects were tested for linear and quadratic effects. A linear response was observed (CTR, CAP125, CAP250, and CAP500, respectively) for DMI (8.56, 9.84, 8.68, and 9.40 kg/d; P < 0.04), ruminal pH (6.03, 5.84, 5.96, and 5.86; P < 0.08) and total VFA (134.3, 144.8, 140.1, and 142.8 mM; P < 0.08). There was a strong correlation between water consumption and DMI (R(2) = 0.98). Dry matter intake in the first 2 h after feeding was reduced (P < 0.05) in all CAP treatments compared with control. The molar proportion of acetate tended to decrease linearly (from 59.6 to 55.5 mol/100 mol; P < 0.06), and ammonia N concentration tended to increase linearly (from 14.4 to 16.0 mg N/dL; P < 0.08). In contrast, the molar proportion of propionate (23.8 mol/100 mol), butyrate (14.2 mol/100 mol), and lactate (0.28 mol/100 mol) were not affected by treatments. Results indicate that capsicum extract stimulated DMI and modified the pattern of DMI in beef cattle fed high concentrate diets.

Colpoperineocleisis de Labhardt: una alternativa segura y eficaz para el tratamiento del prolapso genital en pacientes sin actividad sexual / Labhardt colpocleisis in the treatment of pelvic organ prolapse

Introducción: El prolapso genital impacta negativamente la calidad de vida y autoimagen de la mujer. Rutinariamente indicamos la colpoperineocleisis de Labhardt a pacientes de edad avanzada y sin actividad sexual. Objetivo: Evaluar los resultados con esta técnica e identificar posibles factores de riesgo que predigan la falla. Métodos: Análisis retrospectivo de pacientes tratadas con la técnica entre los años 2008-2010. Se realizó análisis univariado y multivariado para identificar factores de riesgo asociados a la falla y se construyeron curvas libre de falla anatómica a fin de evaluar la durabilidad. Resultados: 68 pacientes cumplieron los criterios de inclusión. La edad promedio fue 71,9 +/- 5,7 años; 95,6 por ciento fueron clasificadas en etapa III o IV según POP-Q. El tiempo operatorio fue de 54 +/- 20 minutos. Seguimiento promedio de 21 meses; la tasa de recidiva anatómica fue de 14,7 por ciento. La tasa de incontinencia de orina de esfuerzo (IOE) de novo fue de 5,9 por ciento. El análisis univariado identificó como factor predictor de recidiva el flujo vaginal posoperatorio; en análisis multivariado de Cox, esa condición mantuvo significancia estadística (OR 6,3). Se identificó como factor de riesgo el no acatamiento de la técnica quirúrgica (OR 7,2). Conclusión: La colpoperineocleisis de Labhardt es una técnica segura, con baja tasa de complicaciones, una tasa de recurrencia aceptable y baja tasa de IOE de novo. Pilar del éxito es evitar la infección y respetar la técnica quirúrgica. Es necesario estudios comparativos con otras técnicas oclusivas, como también evaluar el rol de la infección como causa de falla de la técnica.

Introduction: Genital prolapse affects up to 50 percent of multiparous women, impacting their quality of life and self-image. At our Institution Labhardt's colpoperineocleisis is usually proposed to older patients, without sexual activity, regardless the type or grade of prolapse. Objective: To evaluate the results with this technique and identify potential risk factors predicting the failure. Methods: Analysis of a retrospective cohort of patients treated with this technique between 2008 and 2010. Univariate and multivariate analysis were carried out to identify risk factors and failure-free curves were built to estimate durability. Results: 68 patients met the inclusion criteria. Average age was 71.9 +/- 5.7 years; 95.6 percent of patients were classified as stage III or IV based on POP-Q system. Operative time was 54 +/- 20 min. At 21 months of follow-up, recurrence rate was 14.7 percent. De novo stress urine incontinence (SUI) was diagnosed in 5.9 percent of patients. In univariate analysis, post operative vaginal discharge was identified as predicting factor for defect recurrence. In Cox analysis, this condition remained significant (OR 6.3), In addition, failure to observe the surgical technique was also identified as risk factor for defect recurrence (OR 7.2). Conclusion: Labhardt 's colpoperineocleisis is a safe technique, with low complication rate, acceptable recurrence rate, and low de novo SUI rate. Mainstay for success is to avoid infection and observe the surgical technique. Comparative studies with other occlusive techniques might be carried out, as well as exploring the role of infection as predisposing condition for failure.

Feeding behavior and ruminal acidosis in beef cattle offered a total mixed ration or dietary components separately.

Eighty continental crossbred beef heifers (414.9 ± 37.9 kg of BW), 16 of which were ruminally cannulated, were used in a 52-d experiment with a generalized randomized block design, to assess if self-selection of dietary ingredients modulates ruminal pH and improves rumen function of feedlot finishing cattle. Treatments were total mixed ration [TMR; 85% barley grain (BG), 10% corn silage (CS), 5% supplement]; or free-choice (self-selection; FC) diets of barley grain and corn silage (BGCS), barley grain and wheat distillers grain (BGDG), or corn silage and wheat distillers grain (CSDG). Heifers were housed in groups of 10 in 8 pens equipped with the GrowSafe System (Airdrie, AB, Canada) enabling feed intake and feeding behavior to be continuously monitored. Two cannulated heifers were randomly assigned to each pen and equipped with indwelling pH probes for continuous measurement of ruminal pH during 4 periods (d 1 to 4, d 7 to 14, d 21 to 28, and d 42 to 49). Rumen fluid samples were collected from cannulated heifers on d 7 and 42 before feed delivery, and on d 4 and 49 at 2 h post-feed delivery for determination of VFA. Heifers fed the TMR had shorter (P = 0.01) and smaller (P = 0.03) meals than those fed the FC diets. Cattle fed BGCS and BGDG increased (P < 0.01) intake of BG over time by up to 80 and 70%, respectively. Increased consumption of BG arose from an increase (P < 0.01) in eating rate over the same (P > 0.10) feeding time, which was accompanied by an increase (P < 0.05) in eating rate but a decrease (P < 0.05) in feeding time of either CS or DG. Even with increased BG consumption, ruminal pH and VFA profiles were not different (P > 0.10) among FC diets or compared with the TMR. Cattle fed FC CSDG consumed DG at 60% of dietary DM over the trial, resulting in greater (P < 0.05) mean ruminal pH and acetate-to-propionate ratio and less (P < 0.05) area under the curve than those given the other FC diets or the TMR. Finishing feedlot cattle fed FC diets containing BG self-regulate intake of diets that have a similar composition, intake level, and ruminal fermentation profile to those fed a TMR.

[Evaluation of children with tuberculosis contact]. / Estudio del niñio en contacto con paciente tuberculoso.

Tuberculosis (TB) is a worldwide infectious disease, caused by Mycobacterium tuberculosis (Koch bacilli), that has re-emerged since the decade of the 80's in relation to the pandemic of HIV infection. Chile has one of the lowest TB prevalence rates in Latin America. In children, TB exhibits some differences from adult disease in terms of pathogenesis, clinical manifestations and probability of progression from the infected state to disease, making it more difficult to diagnose and increasing the likelihood of developing the disease once the infection is acquired. There is a National Program for the Prevention and Control of TB that allows us to develop prevention and chemoprophylaxis strategies. This article summarizes these strategies to guide the study and management of children in contact with TB patients.

Estudio del niño en contacto con paciente tuberculoso / Evaluation of children with tuberculosis contact

La tuberculosis (TBC) es una enfermedad de distribución mundial, producida por Mycobacterium tuberculosis (bacilo de Koch), que ha re-emergido desde la década de los 80 en relación a la pandemia de VIH. Chile es uno de los países latinoamericanos con menores tasas de prevalencia de TBC. En los niños, la TBC presenta algunas características distintas al adulto en cuanto a patogenia, clínica y probabilidad de progresión desde una infección latente a enfermedad, siendo más difícil realizar el diagnóstico y mayor la probabilidad de desarrollar enfermedad una vez infectados. Existe un Programa Nacional de Prevención y Control de la TBC que nos permite plantear estrategias de prevención y quimioprofilaxis. Este artículo esquematiza estas estrategias para orientar el estudio y manejo de niños que entran en contacto con pacientes con TBC.

Tuberculosis (TB) is a worldwide infectious disease, caused by Mycobacterium tuberculosis (Koch bacilli), that has re-emerged since the decade of the 80’s in relation to the pandemic of HIV infection. Chile has one of the lowest TB prevalence rates in Latin America. In children, TB exhibits some differences from adult disease in terms of pathogenesis, clinical manifestations and probability of progression from the infected state to disease, making it more difficult to diagnose and increasing the likelihood of developing the disease once the infection is acquired. There is a National Program for the Prevention and Control of TB that allows us to develop prevention and chemoprophylaxis strategies. This article summarizes these strategies to guide the study and management of children in contact with TB patients.