Copper complex molecules as dye-sensitizers: Hybrid MetaGGA and standard + van der Waals functionals.

This study focuses on the use of Density Functional Theory calculations with two main approaches: computational chemistry and computational physics. The following three cases were considered for the derivation: (I) computational chemistry using the M06 hybrid functional, (II) computational chemistry using the standard PBE functional including vdW interactions, and (III) computational physics using the standard PBE functional including vdW interactions and periodic boundary conditions. Since the approximation using hybrid functionals M06 has been extensively validated, this method was used as a reference. The second and third methods are less expensive, it is ideal for use to extend large systems. From the sensitized molecules are found in the gas phase and include solvent effects through the integral equation formalism polarizable continuum model. In a systematic analysis of 15 Cu complex molecules, a complete characterization for DSSCs has been carried out and molecular geometry, electronic and optical measurements have been reported.

Study protocol for a multicenter prospective controlled and randomized trial of transanal total mesorectal excision versus laparoscopic low anterior resection in rectal cancer.

PURPOSE: Compared with the open approach, laparoscopic total mesorectal excision (TME) achieves faster patient recovery, reduces morbidity rates, and shortens hospital stay. However, in laparoscopic low anterior resection (L-LAR), conversion to open surgery is required in almost 20% of cases. Transanal TME (Ta-TME) combined with laparoscopy, also called hybrid natural orifice transluminal endoscopic surgery (NOTES), is a less invasive procedure that can overcome some of the limitations of laparoscopic rectal surgery. In this study, we aim to determine whether Ta-TME has a lower rate of conversion to open surgery than L-LAR, and thus achieves faster patient recovery without altering the pathological, functional, or oncological results. The main objective is to compare the results for conversion to open surgery between Ta-TME and L-LAR. METHODS: Multicenter, prospective randomized controlled study of patients diagnosed with rectal adenocarcinoma who will be randomly allocated to Ta-TME or L-LAR groups after the application of inclusion and exclusion criteria. The main endpoint is conversion to open surgery and the secondary endpoints are general morbidity and mortality and hospital stay. Demographic, surgical, and pathological variables will also be studied, along with quality of life and survival. A sample size of 53 patients per group is calculated. With an estimated loss of 10%, the final sample required will be 116 patients. CONCLUSIONS: Ta-TME achieves a lower conversion rate to open surgery than L-LAR, thus improving patient recovery and reducing overall morbidity. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02550769. Registration no. Ethical and Clinical Research Committee, Parc Taulí University Hospital: ID 2014/064.

Impact of regulatory measures on antipsychotics drug consumption in Castilla y León, Spain.

OBJECTIVES: Antipsychotics are currently used to treat different diseases; even some off-labelled conditions are treated with this medication. Consumption and cost of antipsychotic drugs sharply increased in Spain after second-generation drugs were marketed; several regulatory measures were adopted to curb this trend. The aim of this study was to examine the impact of these measures upon the use and cost of antipsychotics. STUDY DESIGN: Study of drug use (SDU) from 1995 to 2012. Consumption and cost data were obtained from the CONCYLIA database; this database contains the retail community pharmacies sales of medicinal products reimbursed by the National Health System in Castilla y León (Spain). METHODS: Data are presented as defined daily doses per 1000 inhabitants per day (DID) and day treatment cost (DTC). RESULTS: First-generation antipsychotics prescriptions gradually decreased from 3.0 to 1.8 DID; meanwhile, prescriptions for second-generation antipsychotics considerably increased from 0.3 to 9.9 DID. The use of risperidone dropped after the marketing of its structural derivative paliperidone with a similar efficacy but with a substantially higher cost per day. In 2011 and thereafter, patients in Spain began to pay a part of the medications cost, but this did not decrease antipsychotics consumption. Global cost of antipsychotics only began to fall after measures were adopted to lower the price of medicines because of the economic collapse in Spain after May 2010. CONCLUSION: Several health policy measures have tried to reduce antipsychotics consumption in Spain, special ways of dispensing, marketing of generic drugs and special economic measures for patients. These measures eventually failed to avoid the increase in antipsychotics use. The cost only dropped when lowering prescription drug prices took place.

Riesgo cardiovascular en población infantil con sobrepeso y obesidad / Cardiovascular risk in infants overweight and obese

Introducción: El sobrepeso y la obesidad conducen a la aparición de comorbilidades como la diabetes mellitus tipo 2, hipertensión arterial, dislipidemias. Objetivos: Determinar la presencia de riesgo cardiovascular en niños y adolescentes con sobrepeso y obesidad, por género y grupos de edad. Diseño: Estudio descriptivo, transversal. Participantes: Niños y adolescentes, de ambos géneros, comprendidos entre los 5 a 18 años. Intervención: El diagnóstico de sobrepeso y obesidad se hizo de acuerdo a la clasificación de Must y col. con los siguientes criterios: de 85 a 95 para el sobrepeso y más de 95 percentil obesidad. En sangre se determinó el perfil lipídico, glucosa e insulina; con estas dos últimas se determinó el índice HOMA, para identificar resistencia a la insulina (RI), mediante la ecuación de Matthew, el síndrome metabólico (SM) con la referencia de Cook y las dislipidemias (D) con las sugerencias de Friedman y de Daniels. Principales medidas de resultados: Riesgo cardiovascular. Resultados: Los obesos presentan mayores riesgos cardiovasculares que los que tienen sobrepeso: RI 77,8%, SM 22,2%; D: colesterol total (CT) 64,4%, C-HDL 33,3%, C-LDL 19,5% y triglicéridos (Tg) 40%. El género masculino, independientemente de su estado nutricional, tuvo mayor riesgo que el femenino: RI 74,1%, SM 22,2%, D: CT 63%, C-HDL 37%, C-LDL 36% y Tg 40,7%. En cuanto a la edad, en los mayores de 10 años se ha encontrado RI en 78% y C-HDL 31,7%; los demás factores de riesgo fueron mayores en los menores de 10 años. Conclusiones: Los riesgos afectaron más a los obesos que a los que tenían sobrepeso, más al género masculino y, en cuanto a la edad, los mayores de 10 años presentaron mayor prevalencia de RI y de C-HDL bajo. A mayor IMC más riesgo cardiovascular, lo que compromete muy seriamente la salud y que se hace más preocupante porque su aparición es a temprana edad.

Introduction: Overweight and obesity lead the occurrence of comorbidities such as type 2 diabetes mellitus, hypertension, and dyslipidemias. Objectives: To determine the presence of cardiovascular risk in children and adolescents overweight and obese, by gender and age groups. Design: Cross sectional study. Participants: Children and adolescents of both genders, 5-18 year-old. Interventions: Diagnosis of overweight and obesity was done according to Must et al. classification with the following criteria: 85 to 95 for overweight and more than 95 percentile for obesity. Serum lipid profile, glucose and insulin were analyzed, and with the latter two HOMA index was determined to identify insulin resistance (IR), using Matthew´s equation, the metabolic syndrome (MS) with reference to Cook and dyslipidemias (D) with Friedman and Daniels’ suggestions. Main outcome measures: Cardiovascular risk. Results: Obese children had higher cardiovascular risks than overweight: IR 77.8%, SM 22.2%, D: total cholesterol (TC) 64.4%, HDL-C 33.3%, LDL-C 19.5% and triglycerides (Tg) 40%. Males had higher risk than females regardless of nutritional status: IR 74.1%, SM 22.2%, D: TC 63%, HDL-C 37%, LDL-C 36%, Tg 40.7%. Children over 10 had IR 78% and HDL-C 31.7%; other risk factors were higher in those under 10 years. Conclusions: Risks affected obese more than overweight children, more to males, and those over 10 years had higher prevalence of IR and low HDL-C. With higher BMI more cardiovascular risk and serious health compromise, worrisome because of early age onset.

[Cognitive deterioration following cerebral infarction: frequency and determining factors]. / Deterioro cognitivo después de un infarto cerebral: frecuencia y factores determinantes.

INTRODUCTION: Stroke is often associated with cognitive deterioration (CD) in varying degrees, and the risk factors associated to CD after a stroke vary from one study to another. AIMS: To determine the frequency of CD following cerebral infarction and to identify the factors that account for its presence. PATIENTS AND METHODS: A descriptive study was performed involving 126 stroke survivors who were hospitalised for rehabilitation. Patients were classified as having CD if they had scores below the cut-off point in one of the cognitive tests that were applied, i.e. the Folstein Minimental Test (< 24) or the Command-Condition Clock Test (< 7). The explanatory variables were: demographic variables (age, sex and years of schooling), comorbidity (arterial hypertension, diabetes mellitus and intelligence quotient), noxious habits (smoking and drinking), variables related to the lesion (extension, hemisphere and location), and others related to the consequences of the stroke (neurological status and depression). Bivariate and logistic regression analyses were performed to determine the role of these variables in CD. RESULTS: CD was observed in 51.6% of the patients. In the bivariate analysis, the extension of the infarction, age, years of schooling, degree of neurological compromise and depression were associated with the presence of CD. The logistic regression model showed that the factors explaining CD were severe neurological compromise (OR = 22.9; CI 95% = 4.2-125.2), having major depression (OR = 2.9; CI 95% = 1.14-7.8) and older age (OR = 0.94; CI 95% = 0.89-0.98). CONCLUSIONS: A little more than half of all stroke survivors, who are undergoing rehabilitation in hospital, have CD. The factors with the greatest explanatory power to account for CI were neurological status, depression and age.

[Subclinical attention changes in transient ischemic attacks in the vertebrobasilar region]. / Alteraciones subclínicas de la atención en accidentes isquémicos transitorios de la región vertebrobasilar.

INTRODUCTION: A significant number of patients who have had cerebrovascular illness apparently recover their former abilities completely but return to normal life with subtle cognitive deficits which may affect their daily lives. Such is the situation of patients with transitory ischemic accidents who present with sustained, undiagnosed attention deficits. OBJECTIVES: To identify subclinical alterations due to attention deficits in patients with transitory ischemic accidents, and to contribute to the study of the physiopathological mechanisms involved in the integration of this function. PATIENTS AND METHODS: We examined 44 persons, divided into three groups for this study: one group had vertebro-basilar transitory ischemic accidents, a second group had supratentorial infarct and a third was healthy. All were given a specially designed computerized test of continuous work to evaluate the sustained attention component. RESULTS: Significant differences were found between the transitory ischemic accidents and healthy groups, regarding the variables including correct answers, omissions and indications of attention. This was not seen with the variables involving reaction time and number of errors. This demonstrated the existence of attention disorders involving omission in the group of patients with transitory ischemic accidents. CONCLUSION: These findings suggest the hypothesis that in the vertebro-basilar region there are important mechanisms involved in the process of sustained attention.