Comparison between Accelerated Partial Breast Irradiation with multicatheter interstitial brachytherapy and Whole Breast Irradiation, in clinical practice.

PURPOSE: The aim of this study was to compare accelerated partial breast irradiation (APBI) with multicatheter interstitial brachytherapy (BT) and whole breast irradiation (WBI), in terms of toxicity, aesthetic result, quality of life and survival, in clinical practice. MATERIALS AND METHODS: A comparative study of two prospectively recorded cohorts of 76 breast cancer patients who complied with the recommendations of GEC-ESTRO for APBI was conducted. The main objective was toxicity, quality of life measured through validated questionnaires and the aesthetic results. Secondary objectives were overall survival and disease-free survival. RESULTS: Seventy-six stage I/II breast cancer patients, with a mean age of 66 years entered the study. APBI group showed less acute G1-2 dermatitis (51.4 vs 94.9%, p < 0.001) and late hyperpigmentation (0 vs 17.9%, p = 0.04). There were no differences in aesthetic results, both assessed by the patient herself and by the doctor. Statistically significant differences in measures of quality of life were observed in favour of the APBI, both in EORTC QLQ-BR23 and body image scale questionnaires. With a median follow-up of 72 months (6 years), the estimated overall survival at 5 and 10 years was 96.8 and 77.7%, respectively, and disease-free survival at 5 and 10 years was 91.1 and 69.4%, respectively, without statistically significant differences between groups. DISCUSSION: APBI is an attractive alternative in candidate patients with initial breast cancer, with benefits in acute toxicity and quality of life and fewer visits to the hospital, without compromising tumor control or survival.

Exploitation of artichoke byproducts to obtain bioactive extracts enriched in inositols and caffeoylquinic acids by Microwave Assisted Extraction.

Byproducts from artichoke represent the majority of the mass collected from the plant and constitute an interesting source of bioactive compounds such as inositols and caffeoylquinic acids. In this work, a microwave assisted extraction (MAE) methodology was developed for the simultaneous extraction of these compounds from artichoke stalks, leaves, receptacles and external bracts. Optimal MAE conditions to maximize the extraction of these bioactives and the antioxidant activity were 97 °C, 3 min, ethanol:water (50:50, v/v). Moreover, a GC-MS methodology was also developed for the simultaneous determination of these compounds in a single run; optimal derivatization conditions were achieved using hexamethyldisilazane and N,O-bis(trimethylsilyl)trifluoroacetamide with 1% trimethylchlorosilane. Artichoke receptacle extracts were the richest in caffeoylquinic acids (28-35 mg g-1 dry sample), followed by the bracts (9-18 mg g-1 dry sample), while those from leaves showed the highest concentrations of inositols (up to 15 mg g-1 dry sample). Receptacle extracts also had the highest antioxidant activity (123 mg TE g-1 dry sample) and the greatest concentration of total phenolic compounds (47 mg GAE g-1 dry sample). Therefore, the developed methodology could be considered as a valuable procedure to obtain and characterize bioactive ingredients with industrial interest from artichoke byproducts, opening new routes of revalorization of artichoke agro-industrial residues.

Laparoscopic cytoreductive surgery and HIPEC is effective regarding peritoneum tissue paclitaxel distribution.

BACKGROUND: In some patients with peritoneal carcinomatosis, we could perform the cytoreductive surgery and the HIPEC procedure by a complete laparoscopic approach to avoid morbidity. We consider that using laparoscopic approach for performing peritoneal carcinomatosis cytoreductive surgery and HIPEC with closed CO2 recirculation technique is possible and safe, with equal efficacy to conventional methods and hemodynamic complications. OBJECTIVE: Monitoring the effectiveness of the drug distribution in a laparoscopic ctoreductive and HIPEC surgery group with CO2 recirculation respect to a closed and open HIPEC group METHODS: Porcine model that included fifteen mini-pigs. Five pigs were operated with laparoscopic approach performing a pelvic and retroperitoneal lymphadenectomy. They later received a total laparoscopic closed HIPEC with CO2 recirculation (G1). Group 2 (G2): five pigs operated by an open cytoreductive surgery and closed HIPEC technique. Group 3 (G3): five animals in which an open cytoreductive surgery and an open HIPEC technique was performed. Blood and peritoneal determinations were realized after recirculation of the drug, at 60 min using chromatographic analysis. RESULTS: G1-G2: phrenic right peritoneum, p: 0.46. Phrenic left peritoneum, p: 0.46. Pelvic peritoneum, p: 0.17. Serum paclitaxel: p: 0.01. G1-G3: phrenic right peritoneum, p: 0.34. Phrenic left peritoneum, p: 0.34. Pelvic peritoneum, p: 0.17. Serum paclitaxel G1-G3, p: 0.02. CONCLUSIONS: A total laparoscopic approach for ctoreductive surgery and closed HIPEC with CO2 recirculation may be safe and feasible. In our experimental model there was no significant difference in tissue drug distribution respect the conventional techniques and there was a less toxicity because the serum drug concentration was significantly lower with laparoscopic approach respect the other groups.

Gas chromatographic-based techniques for the characterization of low molecular weight carbohydrates and phenylalkanoid glycosides of Sedum roseum root supplements.

An extensive characterization of low molecular weight carbohydrates (LMWC) and phenylalkanoid glycosides (PAG) of Sedum roseum root supplements has been carried out for the first time by gas chromatography coupled to mass spectrometry (GC-MS) and by comprehensive two-dimensional gas chromatography coupled to time-of-flight mass spectrometry (GC × GC-ToF MS). Optimization of the required derivatization procedure for improved determination of PAG showed the combined use of trimethylsilylimidazole and trimethylchlorosilane as the most appropriate reagents. Up to 37 compounds were qualitative- and quantitatively characterized in different dietary supplements of S. roseum by GC-MS. In addition to the well-known rosin, rosarin, rosavin and salidroside, other carbohydrates, polyalcohols, acids, etc. were determined. Among them, several seven-carbon monosaccharides such as coriose and 2,7-anhydro-ß-d-altro-heptulose were detected for the first time in S. roseum root supplements. Sedoheptulose was found to be the most abundant compound (9-151 mg g-1), followed by rosiridin (20-81 mg g-1) and rosavin (11-56 mg g-1). The use of GC × GC-ToF MS allowed the detection and tentative assignation of 48 additional compounds mainly belonging to the phenylalkanoid glycoside, pentosyl-hexose and hexosyl-hexose families.

Pasture flock chicken cecal microbiome responses to prebiotics and plum fiber feed amendments.

When prebiotics and other fermentation substrates are delivered to animals as feed supplements, the typical goal is to improve weight gain and feed conversion. In this work, we examined pasture flock chicken cecal contents using next generation sequencing (NGS) to identify and understand the composition of the microbiome when prebiotics and fermentation substrates were supplemented. We generated 16S rRNA sequencing data for 120 separate cecal samples from groups of chickens receiving one of 3 prebiotics or fiber feed additives. The data indicated that respective feed additives enrich for specific bacterial community members and modulate the diversity of the microbiome. We applied synthetic learning in microbial ecology (SLiME) analysis to interpret 16S rRNA microbial community data and identify specific bacterial operational taxonomic units (OTU) that are predictive of the particular feed additives used in these experiments. The results suggest that feed can influence microbiome composition in a predictable way, and thus diet may have indirect effects on weight gain and feed conversion through the microbiome.

Enhydrin Regulates Postprandial Hyperglycemia in Diabetic Rats by Inhibition of α-Glucosidase Activity.

During the last few years, numerous attempts were made to identify effective α-glucosidase inhibitors from natural sources in order to develop new alternatives for diabetes management. Smallanthus sonchifolius (yacon) leaves were found to be effective in controlling postprandial hyperglycemia. Enhydrin, a constituent of yacon leaves, was noted for its significant hypoglycemic properties in diabetic rats. These properties were also demonstrated for yacon leaves decoction, which is rich in phenolic compounds such as chlorogenic acid and its derivatives. The purpose of the present study was to evaluate the potential of yacon leaves decoction and the isolated compound enhydrin to inhibit α-glucosidase enzyme, a possible mechanism of the above antihyperglycemic effect. In vitro assays showed that both 10% decoction and enhydrin significantly inhibited the activity of the yeast α-glucosidase enzyme in a dose-dependent manner, IC50 values being 50.40 and 134.17 µg/ml, respectively. In vivo experiments showed a rapid decrease in the hyperglycemic peak after sucrose load (2 g/kg body weight) in normal rats treated with the 10% decoction (140 mg/kg) and enhydrin (0.8 mg/kg). Both treatments caused a significant decrease in blood glucose levels in diabetic rats after sucrose load compared to diabetic control. These results suggest that both products assayed could be effective in the management of postprandial hyperglycemia through inhibition of α-glucosidase in the small intestine.

[A study using positron emission tomography of a case of vascular dementia due to left thalamic haematoma, an example of the diaschisis phenomenon]. / Estudio con tomografia por emision de positrones de un caso de demencia vascular por hematoma talamico izquierdo, ejemplo del fenomeno de diasquisis.

INTRODUCTION: Thalamic vascular lesions as strategic strokes can cause amnesia, executive dysfunctions or dysphasia and behavioral or psychological symptoms causing vascular dementia. CASE REPORT: A 58 years-old woman with hypertension and dyslipemia, who after a left thalamic hemorrhage with good radiological evolution, presents a severe amnesic syndrome as well as other subtle changes in orientation and in language, difficulties in managing money and depressive symptoms requiring anxiolytic and antidepressive treatment. All this joined to limitations in the normal course of her work. Followed by neurology service, a positron emission tomography with 18F-2-fluoro-2-deoxy-D-glucose integrated with computed tomography was performed, which showed a hypometabolism in left thalamic area and also in ipsilateral inferior frontal region, explained by the diaschisis phenomenon. CONCLUSIONS: Diaschisis phenomenon is a neuroimaging and pathophysiological finding whereby thalamic or basal ganglia strokes cause hypoperfusion/hypometabolism in the ipsilateral or contralateral cortex and could explain cortical distal symptoms. This case report demonstrates the presence of thalamocortical connections, which helps to understand the circuitry of memory and help to explain the association of other cortical symptoms as dysphasia or executive dysfunction.

TITLE: Estudio con tomografia por emision de positrones de un caso de demencia vascular por hematoma talamico izquierdo, ejemplo del fenomeno de diasquisis.Introduccion. Las lesiones vasculares talamicas que se comportan como ictus estrategicos pueden causar amnesia, disfunciones ejecutivas o disfasia, asi como sintomas comportamentales o psicologicos, y causar una demencia vascular. Caso clinico. Mujer de 58 años, hipertensa y dislipidemica, que, tras una hemorragia talamica izquierda que evoluciono radiologicamente de manera favorable, presento un sindrome amnesico grave y otras alteraciones sutiles en la orientacion y el lenguaje, dificultades en el manejo del dinero y sintomas depresivos que precisaron tratamiento ansiolitico y antidepresivo, todo lo cual fue causa de limitaciones para el normal desempeño de su trabajo. Seguida en la consulta de neurologia, se le practico una tomografia por emision de positrones/tomografia axial computarizada con 18F-2-fluoro-2-desoxi-D-glucosa, donde se aprecio un hipometabolismo en el talamo izquierdo y, ademas, en la region frontal inferior ipsilateral, que se explicaria mediante el fenomeno de diasquisis. Conclusiones. El fenomeno de diasquisis es un hallazgo de neuroimagen y fisiopatologico por el cual los ictus talamicos o de los ganglios basales causan hipoperfusion/hipometabolismo en la corteza ipsilateral o contralateral, y que puede explicar sintomas a distancia corticales. El presente caso evidencia la presencia de conexiones talamocorticales, lo cual ayuda a comprender los circuitos de la memoria y a explicar la asociacion en el de otros sintomas corticales, como la disfasia o las alteraciones ejecutivas.

Pressurized liquid extraction of Aglaonema sp. iminosugars: Chemical composition, bioactivity, cell viability and thermal stability.

Pressurized liquid extraction of Aglaonema sp. iminosugars has been optimized. A single cycle under optimal conditions (80mg, 100°C, 2min) was enough to extract ⩾96% of most iminosugars. Further incubation with Saccharomyces cerevisiae for 5h removed coextracted interfering low molecular weight carbohydrates from extracts of different Aglaonema cultivars. A complete characterization of these extracts was carried out by gas chromatography-mass spectrometry: three iminosugars were tentatively identified for the first time; α-homonojirimycin and 2,5-dideoxy-2,5-imino-d-mannitol were the major iminosugars determined. α-Glucosidase inhibition activity, cell viability and thermal stability of Aglaonema extracts were also evaluated. Extracts with IC50 for α-glucosidase activity in the 0.010-0.079mgmL(-1) range showed no decrease of Caco-2 cell viability at concentrations lower than 125µgmL(-1) and were stable at 50°C for 30days. These results highlight the potential of Aglaonema extracts as a source of bioactives to be used as functional ingredients.

Analysis of iminosugars and other low molecular weight carbohydrates in Aglaonema sp. extracts by hydrophilic interaction liquid chromatography coupled to mass spectrometry.

A method by hydrophilic interaction liquid chromatography coupled to tandem mass spectrometry (HILIC-MS(2)) has been successfully developed for the simultaneous analysis of bioactive iminosugars and other low molecular weight carbohydrates in Aglaonema leaf extracts. Among other experimental chromatographic conditions, mobile phase eluents, additives and column temperature were evaluated in terms of retention time, resolution, peak width and symmetry provided for target carbohydrates. In general, narrow peaks (wh: 0.2-0.6min) with good symmetry (As: 0.9-1.3) and excellent resolution (Rs>1.8) were obtained for iminosugars using an acetonitrile:water gradient with 5mM ammonium acetate in both eluents at 55°C. Tandem mass spectra were used to confirm the presence of previously detected iminosugars in Aglaonema extracts and to tentatively identify for the first time others such as miglitol isomer, glycosyl-miglitol isomers and glycosyl-DMDP isomers. Concentration of total iminosugars varied from 1.35 to 2.84mgg(-1) in the extracts of the different Aglaonema samples analyzed. To the best of our knowledge, this is the first time that a HILIC-MS(2) method has been proposed for the simultaneous analysis of iminosugars and other low molecular weight carbohydrates of Aglaonema sp. extracts.

Los caballos y las Órdenes de Caballería: una visión a través de Las Siete Partidas de Alfonso X 'El Sabio', y de otros documentos / The horses and the Orders of Chivalry: a vision through 'The Seven-Part Code' of Alfonso XI 'The Wise' and other documents

El código de honor que regía la vida del caballero medieval fue una conquista relativamente tardía -durante el S. XII, aproximadamente-, lograda principalmente por la Iglesia para controlar los desmanes de los primitivos guerreros. Los cambios sociales y culturales acentuaron la evolución. Para este estudio, se han utilizado documentos del S. XIII donde se observa la importancia de los Caballos Hispanos de la época, especialmente por su uso bélico contra los musulmanes. Además, se ha extraído la información más interesante dentro de Las Siete Partidas de Alfonso X 'El Sabio', donde se muestra la visión que se tenía de los caballeros y sus armas (siendo el caballo el arma ideal) durante la Baja Edad Media. Todos estos documentos son esenciales para comprender este periodo histórico y la evolución posterior, con la unión de las coronas peninsulares y la formación de un ejército único para toda España, con la caballería como eje

The honor code followed by the medieval knight was a relatively late achievement -during the 12th century, approximately-, mainly thanks to the Church in order to control the abuses of primitive warriors. Social and cultural changes increased evolution. For this work, some documents from the 13th century have been used, which show the importance of Hispanic Horses of that time, in special for their military services against muslims. Besides, the most interesting information from The Seven-Part Code of Alfonso X 'The Wise', has been extracted and it shows how the knights and their weapons (the ideal weapon the horse) were considerated during the Middle Ages. All these documents are essential to understanding this historical epoch and the next period, with the union of peninsular crowns and the consolidation of a unique army for Spain, with the cavalry as a central axis

Estrategias efectivas para incrementar el consumo de la bebida láctea "Purita Mamá" en gestantes y nodrizas de la provincia de Ñuble, año 2012 / Effective strategies to increasing the consumption of the dairy drink "Purita Mamá" for pregnant and lacting women from the Ñuble province, year 2012

Objective: To identify effective strategies to increase the consumption of the product "Purita Mama" in pregnant and lactating women from Ñuble. Subjects and methods: Observational cross sectional study; two instruments were applied, the first one observing of consumption and acceptability of the product in pregnant and lactating women from a non-probabilistic sample; the second one applied to the health team showing major variations in the consumption from a non-probabilistic "intentional" sample. Results: The product was consumed by 38% of pregnant and 34.6% of lactating women; acceptability was regular in 54.6% and 48.2% of pregnant and lactating women, respectively. On the other hand, 34% of the professionals and technicians who work directly with pregnant and lactating women "did not know" the product. The main effective educational strategy implemented (60.2%), is product tasting. Conclusion: The largest consumption of the product is seen in those establishments who implement effective instructional strategies.

Objetivo: identificar estrategias efectivas para que los equipos de salud de la provincia de Ñuble - Chile incrementen el consumo del producto lácteo "Purita Mama" para gestantes y nodrizas. Sujetos y métodos: estudio observacional, pasivo de caso y control donde se aplicaron dos instrumentos, el primero de consumo y aceptabilidad del producto en gestantes y nodrizas a una muestra no probabilística "por cuota"; y el segundo, aplicado a los equipo de salud que presentó mayores variaciones en el consumo a una muestra no probabilística "intencional". Resultados: Consumen el producto 38% de las gestantes y 34,6% de las nodrizas; de las que lo consumen su aceptabilidad es regular en 54,6% de las gestantes y en 48,2% de las nodrizas. Por otra parte "no conocen el producto" 34% de los profesionales y técnicos que trabajan directamente con gestantes y nodrizas. La principal estrategia educativa efectiva implementada (60.2%), es la "degustación del producto". Conclusión: El mayor consumo del producto, se presenta en aquellos establecimientos donde se implementan estrategias educativas efectivas.

Optimization of pressurized liquid extraction of inositols from pine nuts (Pinus pinea L.).

Pressurized liquid extraction (PLE) has been used for the first time to extract bioactive inositols from pine nuts. The influence of extraction time, temperature and cycles of extraction in the yield and composition of the extract was studied. A quadratic lineal model using multiple linear regression in the stepwise mode was used to evaluate possible trends in the process. Under optimised PLE conditions (50°C, 18 min, 3 cycles of 1.5 mL water each one) at 10 MPa, a noticeable reduction in extraction time and solvent volume, compared with solid-liquid extraction (SLE; room temperature, 2h, 2 cycles of 5 mL water each one) was achieved; 5.7 mg/g inositols were extracted by PLE, whereas yields of only 3.7 mg/g were obtained by SLE. Subsequent incubation of PLE extracts with Saccharomyces cerevisiae (37°C, 5h) allowed the removal of other co-extracted low molecular weight carbohydrates which may interfere in the bioactivity of inositols.

Recomendaciones para el soporte nutricional y metabólico especializado del paciente crítico. Actualización. Consenso SEMICYUC-SENPE: Paciente quemado crítico / Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): Critically- burned patient

La respuesta que se objetiva tras una agresión térmica grave se caracteriza por hipermetabolismo (es el modelo de agresión más hipermetabólica que existe) e hipercatabolismo, con una elevada destrucción de la musculatura esquelética. Los trastornos metabólicos son más evidentes en las 2 primeras semanas tras la quemadura, aunque pueden prolongarse en relación directa con las complicaciones aparecidas. El soporte nutrometabólico forma parte indiscutible del tratamiento de estos pacientes y debe ser precoz, utilizando preferentemente la vía enteral y la nutrición parenteral complementaria. Es dificultoso el cálculo exacto de los requerimientos caloricoproteicos, aun empleando calorimetría indirecta, debido a las elevadas pérdidas cutáneas de proteínas y CO2. Cabe destacar la indicación de farmaconutrientes específicos, de dosis elevadas de micronutrientes y, en algunas situaciones, del empleo de medicaciones o fármacos con efectos anabólicos (AU)

The response to severe burns is characterized by hypermetabolism (the most hypermetabolic existing model of aggression) and hypercatabolism, with a high degree of destruction of the skeletal musculature. Metabolic disorders are most evident in the first two weeks after the burn, although they can be prolonged in direct relation to the complications that these patients develop. Nutritional-metabolic support is an essential part of the treatment of these patients and should be started early, preferentially through the enteral route, with parenteral nutrition as complementary support. Exact calculation of calorie-protein requirements in these patients is dificult, even when indirect calorimetry is used, due to the high loss of proteins and CO2 through the skin. Specific pharmaconutrients are indicated, with a high dose of micronutrients. The use of drugs or medications with anabolic effects is also sometimes indicated (AU)

[Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): critically-burned patient]. / Recomendaciones para el soporte nutricional y metabólico especializado del paciente crítico. Actualización. Consenso SEMICYUC-SENPE: paciente quemado crítico.

The response to severe burns is characterized by hypermetabolism (the most hypermetabolic existing model of aggression) and hypercatabolism, with a high degree of destruction of the skeletal musculature. Metabolic disorders are most evident in the first two weeks after the burn, although they can be prolonged in direct relation to the complications that these patients develop. Nutritional-metabolic support is an essential part of the treatment of these patients and should be started early, preferentially through the enteral route, with parenteral nutrition as complementary support. Exact calculation of calorie-protein requirements in these patients is difficult, even when indirect calorimetry is used, due to the high loss of proteins and CO(2) through the skin. Specific pharmaconutrients are indicated, with a high dose of micronutrients. The use of drugs or medications with anabolic effects is also sometimes indicated.

Guidelines for specialized nutritional and metabolic support in the critically-ill patient: update. Consensus SEMICYUC-SENPE: critically-ill burnt patient.

The response to severe burns is characterized by hypermetabolism (the most hypermetabolic existing model of aggression) and hypercatabolism, with a high degree of destruction of the skeletal musculature. Metabolic disorders are most evident in the first two weeks after the burn, although they can be prolonged in direct relation to the complications that these patients develop. Nutritional-metabolic support is an essential part of the treatment of these patients and should be started early, preferentially through the enteral route, with parenteral nutrition as complementary support. Exact calculation of calorie-protein requirements in these patients is difficult, even when indirect calorimetry is used, due to the high loss of proteins and CO2 through the skin. Specific pharmaconutrients are indicated, with a high dose of micronutrients. The use of drugs or medications with anabolic effects is also sometimes indicated.

Estudio comparativo de efectividad de dos ácidos grasos hiperoxigenados en el tratamiento de úlceras de grado I en pacientes geriátricos hospitalizados / Comparative study of the effectiveness two of hyperoxygenated fatty acids in the treatment of grade I ulcers in geriatric hospitalized patients

Objetivo. Evaluar si existe equivalencia entre dos tratamientos con base de ácidos grasos hiperoxigenados, AGHO y Mepentol®: AGHO y fitoterapia. Método. Ensayo clínico aleatorizado con triple enmascaramiento, en pacientes hospitalizados en la Unidad de Geriatría del Hospital Clínico San Carlos, entre noviembre de 2006 y enero de 2008, con dos grupos de tratamiento: intervención y control. Se determinó un límite de equivalencia teórico del 15% entre ambos. El muestreo accidental de pacientes ingresados que desarrollaron úlceras grado I. La muestra calculada de 151 úlceras. Método. La intervención fue la aplicación de Mepentol® al grupo control y AGHO al grupo intervención, la asignación al grupo fue aleatoria; la variable de resultado la curación: desaparición del eritema al menos 72h. Se calcula la diferencia absoluta de incidencia de curación entre ambos tratamientos y su IC del 95%. Resultados. Finalizaron el estudio 148 úlceras (72 control y 76 intervención). Curaron 40 úlceras (55,6%) en el grupo control y 53 (69,7%) en el grupo intervención p=0,074. La diferencia de incidencia de curación entre ambos grupos de tratamiento fue del 14% (IC del 95% 29% a –1%). El límite superior del intervalo de confianza de la diferencia se encuentra fuera del margen de equivalencia. Conclusiones. No podemos concluir que el tratamiento de ácidos grasos AGHO sea equivalente al tratamiento de Mepentol®. Con ambos tratamientos la curación es clínicamente relevante(AU)

Objective.To evaluate whether there is equivalence between two treatments for grade I ulcers with a base of hyperoxygenated fatty acids, AGHO® and Mepentol®: AGHO and phytotherapy. Method. A randomized, controlled, triple blind clinical trial was conducted with patients admitted at the Elderly Ward at San Carlos Hospital in Madrid between November 2006 and January 2008. There were two treatment groups: Experimental and control. A theoretical limit of 15% was determined between both groups. We took a random sample of patients admitted to the Elderly Ward, which produced a sample of 151 sores. Method. The control group received treatment with Mepentol® and the experimental group received AGHO®. The assignment to the group was at random. The output variable was healing of erythema within the first 72h. We calculated the absolute difference in the incidence of healing between both treatments with a level of confidence of 95%. Results. The sample at the end of the study was 148 (72 control and 76 experimental). There was a healing incidence of 55.6% in the control group and 69.7% in the experimental group (p=0.074). The difference in the incidence of healing between both treatments was 14% (95% CI: 29% to −1%). The upper limit of the confidence interval of the difference is outside the margin of equivalence. Conclusions. We cannot conclude that the treatment with AGHO fatty acids is equivalent to Mepentol® treatment. With both treatments the healing is clinically significant(AU)

[Comparative study of the effectiveness two of hyperoxygenated fatty acids in the treatment of grade I ulcers in geriatric hospitalized patients]. / Estudio comparativo de efectividad de dos ácidos grasos hiperoxigenados en el tratamiento de úlceras de grado I en pacientes geriátricos hospitalizados.

OBJECTIVE: To evaluate whether there is equivalence between two treatments for grade I ulcers with a base of hyperoxygenated fatty acids, AGHO and Mepentol: AGHO and phytotherapy. METHOD: A randomized, controlled, triple blind clinical trial was conducted with patients admitted at the Elderly Ward at San Carlos Hospital in Madrid between November 2006 and January 2008. There were two treatment groups: Experimental and control. A theoretical limit of 15% was determined between both groups. We took a random sample of patients admitted to the Elderly Ward, which produced a sample of 151 sores. The control group received treatment with Mepentol and the experimental group received AGHO. The assignment to the group was at random. The output variable was healing of erythema within the first 72h. We calculated the absolute difference in the incidence of healing between both treatments with a level of confidence of 95%. RESULTS: The sample at the end of the study was 148 (72 control and 76 experimental). There was a healing incidence of 55.6% in the control group and 69.7% in the experimental group (p=0.074). The difference in the incidence of healing between both treatments was 14% (95% CI: 29% to -1%). The upper limit of the confidence interval of the difference is outside the margin of equivalence. CONCLUSIONS: We cannot conclude that the treatment with AGHO fatty acids is equivalent to Mepentol treatment. With both treatments the healing is clinically significant.

Comparación entre la efectividad del psoraleno más luz ultravioleta A (PUVA) y la luz ultravioleta B de banda estrecha (UVB-NB) en el tratamiento de la psoriasis / Comparison of the effectiveness of psoralen plus ultraviolet A light (PUVA) and ultraviolet B narrow band (UVB-NB) in the treatment of psoriasis

La psoriasis es una enfermedad inflamatoria crónica caracterizada por la hiperproliferación de queratinocitos como respuesta a la activación del sistema inmune. El manejo de esta patología es variado, pero las opciones terapéuticas disminuyen cuando la severidad aumenta, y hay que recurrir a medicaciones o terapias que traen mayores efectos secundarios no deseados. La fototerapia hace parte de los tratamientos utilizados en formas severas; la primera que se introdujo fue el uso de psoralenos más luz ultravioleta A (PUVA), pero es una terapia no del todo inocua que puede producir cataratas o inclusive cáncer de piel, lo que imposibilita su uso en algunos pacientes. Con el advenimiento de la terapia con luz ultravioleta B de banda estrecha (UVB-NB) en 1997, se abrió un nuevo espectro de alternativas de tratamiento para este tipo de pacientes, con similares características en cuanto a efectividad. Al comparar estos dos tipos de terapias, la literatura no es concluyente y deja un sinnúmero de dudas acerca de cuál de las dos terapias es más efectiva. Con la aparición de nuevas terapias, es importante conocer la más efectiva, pues son tratamientos menos costosos en comparación con los que están llegando al mercado.

Psoriasis is a chronic inflammatory disease characterized by keratinocyte hyperproliferation in response to activation of the immune system. The management of this condition is varied, but the therapeutic options decrease as the severity increases, and we must resort to medications or therapies that bring more unwanted side effects. Phototherapy is part of the treatments used in severe forms, the first to be introduced was the use of psoralen plus ultraviolet A light (PUVA), but it is not entirely safe therapy that can cause cataracts or even skin cancer, which precludes their use in some patients. With the advent of light therapy narrow band ultraviolet B (UVB-NB) in 1997, it opened a new spectrum of treatment alternatives for these patients, with similar characteristics in terms of effectiveness. By comparing these two types of therapies, the literature is not conclusive and leaves a host of questions about which of the two therapies is more effective. With the advent of new therapies, it is important to know the most effective, they are less expensive treatments compared with those who are coming to market.

Perfil del usuario derivado desde Atención Primaria a una Unidad de Salud Mental / No disponible

Objetivo: la recogida y análisis de los datos de laactividad asistencial de una Unidad de Salud Mentaldeberían proporcionar elementos de reflexión para laplanificación de los Servicios y la formación de los profesionales.Resultados: en nuestro caso hemos analizado variablessociodemográficas y clínicas de los 1.224 casosnuevos atendidos durante el año 2008, siendo los datosmás llamativos la elevada proporción de mujeres (el70% de los casos) y la diferencia en la incidencia de losdiagnósticos según procedencia, edad o género.Conclusión: el perfil del usuario que acude a nuestroequipo de salud mental es una mujer, casada o en pareja,de 25 a 35 años, de nivel socioeconómico medio yprocedencia urbana que consulta por padecer un trastornoafectivo o de ansiedad(AU)

Objectives: the gathering and analysis of data relatingto the type of patients of a Mental Health Unit provideus with information which should be taken intoaccount as regards service planning and the formationof doctors.Results: we have analyzed socio-demographic andclinical variables of 1.224 new cases treated during2008. The most relevant data gathered refer to the higherproportion of female patients (70% of the cases) andthe difference of diagnoses depending on their provenance,age or gender.Conclusions: the most common profile of a patientseeking medical care in our Mental Health Unit is thatof a married woman, 25 to 35 years old, from a mediumsocio-economical level and with an urban provenance,affected by an affective or anxiety disorder(AU)