Estudio de la actividad antimicrobiana de Xenophyllum poposum sobre microorganismos de la cavidad bucal por el método de difusión radial / Study of the antimicrobial activity of Xenophyllum poposum on microorganisms of the oral cavity by the radial diffusion method

Resumen En este estudio se evaluó la actividad antimicrobiana in vitro de extractos de Xenophyllum poposum sobre microorganismos bucales como Streptococcus mutans, Streptococcus sobrinus, Lactobacillus casei, Actinomyces naeslundii, Actinomyces odontolyticus, Candida albicans y Veillonella sp. Se empleó el método de difusión radial en agar y como controles negativo y positivo de inhibición se emplearon etanol y clorhexidina al 0,12% (Plac out NF®) respectivamente. Los extractos con mayor actividad antimicrobiana fueron el etanólico y el clorofórmico. La diferencia entre ambos no fue estadísticamente significativa (p≥0,05). Tampoco se observó diferencia significativa con respecto a la clorhexidina, excepto sobre Veillonella sp., ya que el extracto etanólico presentó halos de inhibición significativamente menores sobre este microorganismo. Esto es importante ya que Veillonella se considera indicador de salud en relación a la caries dental. En base a esto, el extracto etanólico de Xenophyllum poposum podría ser usado como control químico de la biopelícula dental.

Abstract In this study, the in vitro antimicrobial activity of Xenophyllum poposum extracts on oral microorganisms such as Streptococcus mutans, Streptococcus sobrinus, Lactobacillus casei, Actinomyces naeslundii, Actinomyces odontolyticus, Candida albicans, Veillonella sp. was evaluated. The radial diffusion method in agar was used and 0.12% ethanol and chlorhexidine (Plac out NF®) were used as negative and positive inhibition controls, respectively. The extracts with the highest antimicrobial activity were the ethanolic and chloroform extracts. The difference between the two was not statistically significant (p≥0.05). No significant difference was observed with respect to chlorhexidine, except on Veillonella sp., since the ethanolic extract presented significantly lower inhibition halos on this microorganism. This is important as Veillonella is considered an indicator of health in relation to dental caries. Based on this, the ethanolic extract of Xenophyllum poposum could be used as chemical control of dental biofilm.

Resumo Neste estudo, a atividade antimicrobiana de extratos de Xenophyllum poposum sobre microrganismos orais como Streptococcus mutans, Streptococcus sobrinus, Lactobacillus casei, Actinomyces naeslundii, Actinomyces odontolyticus, Candida albicans e Veillonella sp. Foi utilizado o método de difusão radial em ágar e etanol 0,12% e clorexidina (Plac out NF®) como controles de inibição negativa e positiva, respectivamente. Os extratos com maior atividade antimicrobiana foram os extratos etanólico e clorofórmio. A diferença entre os dois não foi estatisticamente significativa (p≥0,05). Não foi observada diferença significativa em relação à clorexidina 0,12%, exceto em Veillonella sp., uma vez que o extrato etanólico apresentou halos de inibição significativamente menores neste microrganismo. Isso é importante, pois a Veillonella é considerada um indicador de saúde em relação à cárie dentária. Com base nisso, o extrato etanólico de Xenophyllum poposum pode ser utilizado como controle químico do biofilme dental.

Efectividad de las unidades de hospitalización a domicilio para el tratamiento de las infecciones del tracto urinario atendidas en urgencias / Effectiveness of a home hospitalization program for patients with urinary tract infection after discharge from an emergency department

Objetivo. Comparar la evolución de las infecciones del tracto urinario superior (ITUS) atendidas en urgencias que se derivan y tratan en hospitalización a domicilio (HAD) frente a las que ingresan en hospitalización convencional (HC). Método. Estudio prospectivo, cuasiexperimental de pacientes con ITUS atendidos en tres hospitales de Osakidetza-Sistema Vasco de Salud (SVS) entre enero de 2012 y junio de 2013. Los pacientes se dividieron en 2 grupos según destino (ingresados en HAD en HC). Se recogieron datos sociodemográficos, antecedentes nefrourológicos, comorbilidades, factores de riesgo de infección complicada, forma de presentación en urgencias, pruebas diagnósticas realizadas y tratamientos prescritos. La variable de resultado principal fue la mala evolución (complicaciones locales durante el ingreso, recurrencia de la infección o reingreso relacionado con la infección). Se realizó un modelo multivariable de regresión logística para analizar la mala evolución, que incluyó el ingreso en HAD como la variable independiente principal. Resultados. Los pacientes derivados a HAD incluyen una mayor proporción de mujeres (70,6% frente a 57,1%, p = 0,04), con menos ingresos previos (2,4% frente a 9,5%, p = 0,03) y menos criterios de presentar ITUS complicadas (58,7% frente a 83,3%, p < 0,001), en relación a los ingresados en HC. No hubo diferencias en complicaciones entre los dos grupos, excepto en la frecuencia de síndrome confusional que fue inferior en el grupo HAD (8,3% frente a 0,8%, p = 0,007). No se encontraron diferencias en las variables de mala evolución entre los que ingresaron en HC y en HAD. Conclusiones. No hay diferencias en la evolución de los pacientes con ITUS ingresados en HAD comparados con los ingresados en HC (AU)

Objective. To compare outcomes of urinary tract infections (UTIs) in patients referred to a home hospitalization program or admitted to a conventional ward after initial management in the emergency department. Methods. Prospective, quasi-experimental study of patients with UTIs attended in 3 hospital emergency departments in the public health system of the Basque Country, Spain, between January 2012 and June 2013. Patients were assigned to 2 groups according to site of treatment (home or hospital ward) after discharge from the emergency department. We collected sociodemographic data, history of kidney or urologic symptoms, concomitant diseases, risk for complicated UTI, presentation on admission to the emergency department, diagnostic findings, and prescribed treatments. The main outcome was poor clinical course (local complications during hospital or home care, recurrence, or readmission related to UTI. Multivariate logistic modeling was used to analyze factors related to poor clinical course. Home hospitalization was the main independent variable of interest. Results. Patients referred to home hospitalization were more often women (70.6% vs 57.1% men, P=.04). Fewer cases of prior admission were recorded in the group treated at home (2.4% vs 9.5% of hospitalized patients, P=.03). Likewise, fewer home-hospitalization patients had risk factors for complicated UTI (58.7% vs 83.3% in the hospitalized group, P<,001). The only significant difference in complications between the 2 groups was a lower rate of acute confusional state in patients assigned to home hospitalization (0.8% vs 8.3% in hospitalized patients, P=.007). The frequency of poor clinical course was similar in home-hospitalized and ward-admitted patients. Conclusion. The clinical course of UTI is similar whether patients are hospitalized after emergency department management or discharged to a home hospitalization program (AU)

The IRYSS-COPD appropriateness study: objectives, methodology, and description of the prospective cohort.

BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) often experience exacerbations of the disease that require hospitalization. Current guidelines offer little guidance for identifying patients whose clinical situation is appropriate for admission to the hospital, and properly developed and validated severity scores for COPD exacerbations are lacking. To address these important gaps in clinical care, we created the IRYSS-COPD Appropriateness Study. METHODS/DESIGN: The RAND/UCLA Appropriateness Methodology was used to identify appropriate and inappropriate scenarios for hospital admission for patients experiencing COPD exacerbations. These scenarios were then applied to a prospective cohort of patients attending the emergency departments (ED) of 16 participating hospitals. Information was recorded during the time the patient was evaluated in the ED, at the time a decision was made to admit the patient to the hospital or discharge home, and during follow-up after admission or discharge home. While complete data were generally available at the time of ED admission, data were often missing at the time of decision making. Predefined assumptions were used to impute much of the missing data. DISCUSSION: The IRYSS-COPD Appropriateness Study will validate the appropriateness criteria developed by the RAND/UCLA Appropriateness Methodology and thus better delineate the requirements for admission or discharge of patients experiencing exacerbations of COPD. The study will also provide a better understanding of the determinants of outcomes of COPD exacerbations, and evaluate the equity and variability in access and outcomes in these patients.