Longitudinal profiling of human androgenotes through single-cell analysis unveils paternal gene expression dynamics in early embryo development.

STUDY QUESTION: How do transcriptomics vary in haploid human androgenote embryos at single cell level in the first four cell cycles of embryo development? SUMMARY ANSWER: Gene expression peaks at the fourth cell cycle, however some androcytes exhibit unique transcriptional behaviors. WHAT IS KNOWN ALREADY: The developmental potential of an embryo is determined by the competence of the oocyte and the sperm. However, studies of the contribution of the paternal genome using pure haploid androgenotes are very scarce. STUDY DESIGN, SIZE, DURATION: This study was performed analyzing the single-cell transcriptomic sequencing of 38 androcytes obtained from 10 androgenote bioconstructs previously produced in vitro (de Castro et al., 2023). These results were analyzed through different bioinformatics software such as g: Profiler, GSEA, Cytoscape, and Reactome. PARTICIPANTS/MATERIALS, SETTING, METHODS: Single cell sequencing was used to obtain the transcriptomic profiles of the different androcytes. The results obtained were compared between the different cycles studied using the DESeq2 program and functional enrichment pathways using g: Profiler, Cytoscape, and Reactome. MAIN RESULTS AND THE ROLE OF CHANCE: A wave of paternally driven transcriptomic activation was found during the third-cell cycle, with 1128 upregulated and 225 downregulated genes and the fourth-cell cycle, with 1373 upregulated and 286 downregulated genes, compared to first-cell cycle androcytes. Differentially expressed routes related to cell differentiation, DNA-binding transcription, RNA biosynthesis and RNA polymerase II transcription regulatory complex, and cell death were found in the third and fourth with respect to the first-cell cycle. Conversely, in the fourth cell cycle, 153 downregulated and 332 upregulated genes were found compared with third cell cycle, associated with differentially expressed processes related to E-box binding and zinc finger protein 652 (ZNF652) transcription factor. Further, significant overexpression of LEUTX, PRAMEF1, DUXA, RFPL4A, TRIM43, and ZNF675 found in androgenotes, compared to biparental embryos, highlights the paternal contributions to zygote genome activation. LARGE SCALE DATA: All raw sequencing data are available through the Gene Expression Omnibus (GEO) under accessions number: GSE216501. LIMITATIONS, REASONS FOR CAUTION: Extrapolation of biological events from uniparental constructs to biparental embryos should be done with caution. Maternal and paternal genomes do not act independently of each other in a natural condition. The absence of one genome may affect gene transcription of the other. In this sense, the haploid condition of the bioconstructs could mask the transcriptomic patterns of the single cells. WIDER IMPLICATIONS OF THE FINDINGS: The results obtained demonstrated the level of involvement of the human paternal haploid genome in the early stages of embryo development as well as its evolution at the transcriptomic level, laying the groundwork for the use of these bioconstructs as reliable models to dispel doubts about the genetic role played by the paternal genome in the early cycles of embryo development. STUDY FUNDING/COMPETING INTEREST(S): This study was funded by Instituto de Salud Carlos III (ISCIII) through the project 'PI22/00924', co-funded by European Regional Development Fund (ERDF); 'A way to make Europe'. F.D. was supported by the Spanish Ministry of Economy and Competitiveness through the Miguel Servet program (CPII018/00002). M.J.E. was supported by Instituto de Salud Carlos III (PI19/00577 [M.J.E.]) and FI20/00086. P.dC. was supported by a predoctoral grant for training in research into health (PFIS PI19/00577) from the Instituto de Salud Carlos III. All authors declare having no conflict of interest with regard to this trial.

Do immature and mature sibling oocytes recovered from stimulated cycles have the same reproductive potential?

RESEARCH QUESTION: How can laboratory and clinical outcomes of spontaneously, early maturing germinal-vesicle oocytes and sibling in-vivo-matured (metaphase II [MII]) oocytes be quantified and compared? DESIGN: A prospective, non-randomized intra-cohort study of oocytes from women aged 38 years or younger, with six or fewer MII oocytes and four or more germinal vesicles retrieved. No indication was identified for genetic tests or oocyte or embryo cryopreservation. The study was carried out at IVIRMA-Valencia. Early maturing germinal vesicles were selected for reproductive purposes. In vitro- and in-vivo MII oocytes were fertilized. After time-lapse culture, hatching blastocysts from germinal vesicles were biopsied for aneuploidy screening and vitrified. Laboratory and clinical outcomes were compared according to oocyte origin. RESULTS: Almost 70% of germinal vesicles had matured early and spontaneously, and had comparable in vitro-outcomes and morphokinetics to sibling in vivo-matured oocytes. Fifty per cent of biopsied blastocysts were euploid. Germinal-vesicle rescue increased the number of MII oocytes per cycle to 3.9, finally adding one extra-blastocyst per cycle. A live birth confirmed the feasibility of this approach. Further data, however, are needed to quantify its real contribution to standard intracytoplasmic sperm injection cycles. Nevertheless, 40% of patients obtained either an immediate advantage (reduction of cancellation rate) or long-term benefit (availability of extra blastocysts of attempts). CONCLUSIONS: Germinal-vesicle rescue can be considered as a complementary approach when folliculometry (expected) and number of MII (observed) are unequal.

Predictive validity of the Braden scale for assessing risk of developing pressure ulcers and dependence-related lesions.

OBJECTIVE: In 2014, a new theoretical model explained the mechanism of the development of pressure ulcers (PUs) and that of seven types of lesions known as dependence-related lesions (DRL). The aim of this study was to calculate the incidence of DRL that have been classified as PUs and to check the predictive validity of the Braden scale for assessing DRL in accordance with the new theoretical model in an intensive care unit (ICU). Method This longitudinal, prospective study was conducted in a Spanish ICU. The patients were monitored for 14 days in the ICU until they developed DRL, died, or were discharged. The patients' risk of developing DRL was assessed each day using the Braden scale. The following parameters were taken as reference for validating the scale: sensitivity (Se), specificity (Sp), positive and negative predictive values (PPV and NPV, respectively), relative risk (RR) and the area under the receiver operating characteristic (ROC) curve. RESULTS: Of the 295 patients included in the study, 27.5% developed DRL, which 50.6% were categorised as PUs, 17.3% caused by moisture, and 13.6% caused by friction. The rest were categorised as caused by a combination of factors. Risk according to the Braden scale was greater in the group of patients with DRL than in the group of patients without. The highest risk score provided the best predictive validity parameters for the DRL (Se 0.90, Sp 0.26, PPV 0.31, NPV 0.78 and RR 3.15 [confidence interval (CI) 95%: 1.42-6.96]). These vaules show the individuals at risk are well detected, although it is at the expense of generating a number of false positive cases. CONCLUSIONS: The Braden scale has demonstrated a moderate capacity for predicting PUs and DRL caused by moisture, but no capacity for predicting DRL caused by friction.

[Validation of EMINA and EVARUCI scales for assessing the risk of developing pressure ulcers in critical patients]. / Validación de las escalas de valoración de riesgo de úlceras por presión EMINA y EVARUCI en pacientes críticos.

OBJECTIVE: To contribute to the validation of the EMINA and EVAUCI scales for assessing the risk of pressure ulcers in the critical patient and compare their predictive capacity in this same context. METHOD: Prospective study from December 2012 until June 2013. SETTING: Polyvalent intensive care unit of 14 beds in a reference hospital for two sanitary areas. PATIENTS: patients of 18 years of age or older and without pressure ulcers were included. They were followed until development of a pressure ulcer of grade I or greater, medical discharge, death or 30 days. MAIN VARIABLES: presence of ulcers, daily score of the risk of developing pressure ulcers through EMINA and EVARUCI evaluation. The validity of both scales was calculated using sensitivity, specificity, and positive and negative predictive value. The level of significance was P≤0.05. RESULTS: A total of 189 patients were evaluated. 67.2% were male with a mean age of 59.4 (DE: 16,8) years old, 53 (28%) developed pressure ulcers, being the incidence rate of 41 ulcers per 1000 admission days. The mean day of diagnosis was 7.7 days (DE: 4,4) and the most frequent area was the sacrum. The sensitivity and specificity for the mean of observations was 94.34 (IC95% 87.17-100) and 33.33 (IC95% 25.01-41.66) for the EMINA scale for a risk>10 and 92.45 (IC95% 84.40-100) and 42.96 (IC95% 34.24-51.68) for the EVARUCI scale for a risk of>11. CONCLUSIONS: No differences were found in predictive capacity of both scales. For sensitivities>90%the scales show to be insufficiently specific in the pressure ulcer risk detection in critical patients.

Similar morphokinetic patterns in embryos derived from obese and normoweight infertile women: a time-lapse study.

STUDY QUESTION: Does female obesity affect the dynamic parameters of embryo quality assessed by time-lapse analysis? SUMMARY ANSWER: Female obesity does not affect the dynamic embryo quality as determined by image acquisition and time-lapse analysis. WHAT IS KNOWN ALREADY: Female obesity impairs natural and assisted reproduction but there is no agreement on the specific contribution of gametes, embryos or endometrial receptivity. In this preliminary study the dynamic parameters of embryo quality are assessed for the first time by time-lapse analysis. STUDY DESIGN, SIZE, DURATION: Two-year cohort retrospective study comparing embryos from three groups of patients according to the presence of infertility and/or obesity. PARTICIPANTS AND SETTING: Participants attended a University-affiliated private clinic where ICSI was performed. Using an IVF incubator with a built-in camera designed to automatically acquire images at defined time points, we monitored individual embryos from 89 patients: 71 embryos from 13 obese infertile women, 242 embryos from 45 normoweight infertile women and 111 embryos from 31 normoweight fertile oocyte donors. The chronological pattern of cell divisions (timings of cell cleavages) and other morphologic features (time-dependent cell size and nucleation) was recorded. MAIN RESULTS AND THE ROLE OF CHANCE: Embryos from obese and normoweight infertile women showed similar cleavage patterns, but occurring more slowly, to those from fertile donors. These differences were statistically significant for t2 (time of cleavage to two-blastomere embryo) (P = 0.016), t3 (P = 0.014), t4 (P = 0.003) and t5 (P = 0.040). LIMITATIONS, REASONS FOR CAUTION: These are preliminary data from a retrospective analysis with a limited sample size. GENERALIZABILITY TO OTHER POPULATIONS: Not recommended until further studies using time-lapse analysis of a larger sample have been performed. STUDY FUNDING/COMPETING INTEREST(S): None.

[Pressure ulcers in the critical patient: detection of risk factors]. / Úlceras por presión en el enfermo crítico: detección de factores de riesgo.

INTRODUCTION: Patients admitted to intensive care units (ICU) are more vulnerable to the appearance of pressure ulcers. This is the reason why the highest rates of pressure ulcers (PU) incidence and prevalence are found in the ICU. This study has aimed to identify risk factors related to the appearance of PU in critically ill patients. PATIENTS AND METHOD: This was a prospective and observational study that included all patients admitted for more than 24 h from October 2009 to June 2010. Dependent variable: Appearance of PU. INDEPENDENT VARIABLES: APACHE II score, risk assessment score (EMINA), body mass index (BMI), support surface, nutrition, norepineprhine, sedation and care support devices. Data analyses: Kaplan-Meyer survival and Cox regression analysis. Significance p < 0.05. RESULTS: A total of 236 patients were included. A significant association was found to BMI≥30 (RR: 2.51), EMINA >10 (RR: 2.96), hyperproteic nutrition (RR: 0.946), turning (RR: 0.88), sedation (RR: 0.95), polyurethane nasogastric feeding tube (RR: 0.94), dynamic support surface (RR:0.88). Significant association of p < 0.1 for Norepinephrine (RR: 2.34). CONCLUSIONS: BMI≥ 30, EMINA and norepinephrine are predictive factors of risk for PU development. Sedation days, dynamic support surfaces, hyperproteic nutrition, turning, and polyurethane nasogastric feeding tube were established as protective factors against PU.

[Prevention of mechanical ventilator-associated pneumonia: a comparison of two different oral hygiene methods]. / Prevención de la neumonía asociada a la ventilación mecánica: estudio comparativo de dos métodos de higiene oral.

INTRODUCTION: Oral hygiene (OH) forms a part of the patient's safety in the prevention of mechanical ventilator-associated pneumonia (VAP). The dental plaque index (DP) is considered as a quality marker for OH. HYPOTHESIS: The association of electric toothbrush and conventional OH in intubated patients decreases the DP and incidence of VAP. OBJECTIVE: To verify the reduction of DP in patients receiving OH and electric toothbrush and its association with to the decrease of VAP incidence. MATERIALS AND METHODS: A 3-year long randomized, single blind and prospective study conducted in a 14-bed polyvalent intensive care unit. Patients were included when there was more than 48hours of mechanical ventilation and no expected respiratory infection. Patients were randomized into two groups: Standard (OH with chlorhexidine) (GS) and Raspall (Standard OH with electric dental brush) (GR). The VAP was identified following clinical, medical and microbiological criteria. The DP and halitosis were observed daily. Oral and pharyngeal swabs were collected during the first 5 days. RESULTS: 147 patients were included. Mean age was 53.9±17.5. No significant differences were found in the VAP incidence between the two groups (OR=0.78; 95% IC, 0.36-1.68; p=0.56). The relation between halitosis and DP was p=0.7. The dental plaque index on the 5th day was 1.98 (n=60) in GR and 2.04 (n=57) in GS (p=0.3). The dental plaque index on the 10th day was 1.68 (n=29) in GR and 1.91 (n=32) in GS (p=0.7). CONCLUSIONS: There is a tendency towards a decrease in the DP which is clearing in the GR group and no relation between VAP and greater DP or halitosis.

Frequency of outpatient care adverse events in an occupational mutual insurance company in Spain.

BACKGROUND: Occupational mutual insurance companies (OMICs), in collaboration with the Spanish Social Security System, provide healthcare and manage the economic benefits for the workers in Spain. They have ambulatory care centers that attend outpatient trauma pathology, although most of the studies published have focused on surgical and hospital activity. The aim of this study was to detect adverse events (AEs) in outpatient trauma care in the context of an OMIC. METHODS: A cohort study designed to identify harmful safety incidents (adverse events, AEs) in 2017 was conducted. A random sample of 313 medical records among patients who were visited more than 3 medical and nursing attendances during their outpatient process. The AEs detected were classified according to category, severity and preventability. RESULTS: We identified 48 AEs (15.3% of medical records, 95% CI 11.3-19.3), most of them procedure-related, while 27 (56.2%) were preventable and 46 mild (95.8%). CONCLUSIONS: The AEs identified are double than those found in primary care general consultations in Spain and are close to the lower range of studies on surgical AEs in traumatology and orthopedics. Preventable AEs were within expected limits. Over half of AEs are preventable, within that group, the mild AEs have an increased rate of preventability. These results highlight the relevance of research of patient safety in the outpatient care of trauma and orthopaedic procedures in an OMIC for patient safety and contribute to introduce improvements in outpatient care.

A glycerophospholipid-specific pocket in the RVFV class II fusion protein drives target membrane insertion.

The Rift Valley fever virus (RVFV) is transmitted by infected mosquitoes, causing severe disease in humans and livestock across Africa. We determined the x-ray structure of the RVFV class II fusion protein Gc in its postfusion form and in complex with a glycerophospholipid (GPL) bound in a conserved cavity next to the fusion loop. Site-directed mutagenesis and molecular dynamics simulations further revealed a built-in motif allowing en bloc insertion of the fusion loop into membranes, making few nonpolar side-chain interactions with the aliphatic moiety and multiple polar interactions with lipid head groups upon membrane restructuring. The GPL head-group recognition pocket is conserved in the fusion proteins of other arthropod-borne viruses, such as Zika and chikungunya viruses, which have recently caused major epidemics worldwide.

Validación de las escalas de valoración de riesgo de úlceras por presión EMINA y EVARUCI en pacientes críticos / Validation of EMINA and EVARUCI scales for assessing the risk of developing pressure ulcers in critical patients

Objetivo: Contribuir a la validación de las escalas EMINA y EVARUCI en el paciente crítico para posteriormente comparar su capacidad predictiva en este mismo contexto. Método: Estudio prospectivo desde diciembre del 2012 hasta junio del 2013. Ámbito: Unidad de Cuidados Intensivos polivalente de 14 camas de hospital de referencia de 2 áreas sanitarias. Pacientes: Incluidos mayores de edad y sin úlceras al ingreso. En estudio hasta que desarrollaron úlcera grado i o superior, fueron defunción, alta o su estancia superó los 30 días. Variables de interés principales: presencia de úlcera, puntuación diaria de riesgo de desarrollar úlceras mediante valoración EMINA y EVARUCI. La validez de ambas escalas se calculó mediante sensibilidad, especificidad, valor predictivo positivo y negativo. El nivel de significación se estableció para p ≤ 0,05. Resultados: Se estudió a 189 pacientes. El 67,2% eran hombres con una edad media ± desviación estándar de 59,4 ± 16,8) años, 53 (28%) desarrollaron úlceras, siendo la tasa de incidencia de 41 úlceras por cada 1.000 días de ingreso. El día medio de aparición fue de 7,7 ± 4,4 días y la localización más frecuente, sacro. La sensibilidad y la especificidad para la media de las observaciones fue de 94,34 (87,17-100) y 33,33 (25,01-41,66) para la escala EMINA para riesgo > 10 y 92,45 (84,40-100) y 42,96 (34,24-51,68) para EVARUCI riesgo > 11. Conclusiones: No se hallaron diferencias en la capacidad predictiva de ambas escalas. Para sensibilidades > 90%, las escalas se muestran poco específicas en la detección del riesgo de úlceras en el paciente crítico

Objective: To contribute to the validation of the EMINA and EVAUCI scales for assessing the risk of pressure ulcers in the critical patient and compare their predictive capacity in this same context. Method: Prospective study from December 2012 until June 2013. Setting: Polyvalent intensive care unit of 14 beds in a reference hospital for two sanitary areas. Patients: patients of 18 years of age or older and without pressure ulcers were included. They were followed until development of a pressure ulcer of grade I or greater, medical discharge, death or 30 days. Main variables: presence of ulcers, daily score of the risk of developing pressure ulcers through EMINA and EVARUCI evaluation. The validity of both scales was calculated using sensitivity, specificity, and positive and negative predictive value. The level of significance was P ≤ 0.05. Results: A total of 189 patients were evaluated. 67.2% were male with a mean age of 59.4 (DE: 16,8) years old, 53 (28%) developed pressure ulcers, being the incidence rate of 41 ulcers per 1000 admission days. The mean day of diagnosis was 7.7 days (DE: 4,4) and the most frequent area was the sacrum. The sensitivity and specificity for the mean of observations was 94.34 (IC95% 87.17-100) and 33.33 (IC95% 25.01-41.66) for the EMINA scale for a risk > 10 and 92.45 (IC95% 84.40-100) and 42.96 (IC95% 34.24-51.68) for the EVARUCI scale for a risk of > 11. Conclusions: No differences were found in predictive capacity of both scales. For sensitivities > 90%the scales show to be insufficiently specific in the pressure ulcer risk detection in critical patients

[Education as a key piece in the prevention and good course of pressure ulcers]. / La educación como pieza clave en la prevención y buena evolución de las úlceras por presión.

OBJECTIVE: To evaluate if an education program for the nursing staff helps to reduce the incidence of pressure ulcers and prevent their poor evolution. MATERIAL AND METHODS: A prospective and observational study where the prevention and educational methods have been used to prevent and treat pressure ulcers. All patients admitted to Intensive Care Unit during one year were included (six months of basal period and six months of post-training period). The following variables were analyzed: incidence of Pressure Ulcers, risk score according to EMINA, ulcer grade and location. RESULTS: A total of 134 ulcers were identified in the 69 patients (14.37%) with pressure ulcers included in the basal period. Forty-four patients (7.88%) of the patients in the post-training period developed 77 pressure ulcers. The significance level was p < 0.01, OR: 0.40 (95% CI: 0.26-0.62). Fifteen of the 211 pressure ulcers evolved to grade III-IV p > 0.20. CONCLUSIONS: Conducting a training program in the application of standardized prevention methods for the nursing staff reduces the incidence of pressure ulcers.

Analysis of soluble human and mouse interferon-gamma receptors expressed in eukaryotic cells.

The extracellular domains of the human and mouse interferon-gamma receptors were produced in insect Spodoptera frugiperda cells infected with recombinant baculoviruses and in mammalian Chinese-hamster-ovary cells. The receptors expressed in both systems are secreted into the culture medium. Their signal peptides are cleaved off and the proteins show heterogeneity in glycosylation which, however, does not affect the capacity to bind interferon gamma or specific antibodies. The soluble mouse receptors exhibit binding capacities similar to those of cell-surface-anchored receptors, whereas the human receptors exhibit a lower binding capacity. All soluble receptors inhibit the binding of interferon gamma to cellular receptors and neutralize the antiviral activity exerted by interferon gamma. These receptors could therefore be useful for structure/function analyses and in vivo studies.

Úlceras por presión en el enfermo crítico: detección de factores de riesgo / No disponible

Introducción: Los pacientes ingresados en unidades de cuidados intensivos (UCI) son más vulnerables a la aparición de úlceras por presión (UPP), y es por ello que allí se registran los mayores índices de incidencia y prevalencia. El objetivo del estudio fue detectar los factores de riesgo para la aparición de UPP en los pacientes críticos. Material y método Se trata de un estudio observacional y prospectivo. Se incluyeron todos los pacientes ingresados > 24 h desde octubre de 2009 hasta junio de 2010. Variable dependiente: aparición de UPP. Variables independientes: escala (..)

Introduction: Patients admitted to intensive care units (ICU) are more vulnerable to the appearance of pressure ulcers. This is the reason why the highest rates of pressure ulcers (PU) incidence and prevalence are found in the ICU. This study has aimed to identify risk factors related to the appearance of PU in critically ill patients. Patients and method: This was a prospective and observational study that included all patients admitted for more than 24 h from October 2009 to June 2010. Dependent (..)(AU)

Prevención de la neumonía asociada a la ventilación mecánica: estudio comparativo de dos métodos de higiene oral / Prevention of mechanical ventilator-associated pneumonia: a comparison of two different oral hygiene methods

IntroducciónLa higiene oral (HO) forma parte de la seguridad del paciente en la prevención de neumonía asociada a ventilación mecánica (NAV). El índice de placa dental (IP) se considera un indicador de calidad de HO. Hipótesis: la asociación cepillo dental eléctrico+HO convencional en pacientes intubados disminuye el IP y reduce el porcentaje de NAV.ObjetivoVerificar la disminución del IP en pacientes sometidos a HO+cepillo dental eléctrico y su asociación a disminución de NAV.Material y métodoEstudio prospectivo, aleatorizado, simple ciego de 3 años de duración, en un servicio de medicina intensiva polivalente de 14 camas. Incluidos pacientes ingresados con ventilación mecánica más de 48 horas sin infección respiratoria. Pacientes aleatorizados en dos grupos: estándar (GS) (HO con clorhexidina) y raspall (GR) (estándar+cepillo eléctrico). La NAV se identificó por criterios clínicos, médicos y microbiológicos. Se midieron diariamente IP y halitosis. Recogidos frotis oral y faríngeo los primeros 5 días.ResultadosTotal de la muestra, 147 pacientes. Media de edad, 53,9±17,5. Sin diferencias significativas en cuanto a disminución de NAV entre GS y GR (OR=0,78; IC del 95%, 0,36-1,68; p=0,56). La relación halitosis/índice de placa fue p=0,7. El valor de IP al quinto día fue 1,98 (n=60) en GR y 2,04 (n=57) en GS (p=0,3). El valor de IP al décimo día fue 1,68 (n=29) en GR y 1,91 (n=32) en GS (p=0,7).ConclusionesHay una tendencia hacia la disminución del IP, que es más evidente en el GR que en el GS. No hay relación entre NAV y mayor IP o halitosis(AU)

IntroductionOral hygiene (OH) forms a part of the patient's safety in the prevention of mechanical ventilator-associated pneumonia (VAP). The dental plaque index (DP) is considered as a quality marker for OH.HypothesisThe association of electric toothbrush and conventional OH in intubated patients decreases the DP and incidence of VAP.ObjectiveTo verify the reduction of DP in patients receiving OH and electric toothbrush and its association with to the decrease of VAP incidence.Materials and methodsA 3-year long randomized, single blind and prospective study conducted in a 14-bed polyvalent intensive care unit. Patients were included when there was more than 48hours of mechanical ventilation and no expected respiratory infection. Patients were randomized into two groups: Standard (OH with chlorhexidine) (GS) and Raspall (Standard OH with electric dental brush) (GR). The VAP was identified following clinical, medical and microbiological criteria. The DP and halitosis were observed daily. Oral and pharyngeal swabs were collected during the first 5 days.Results147 patients were included. Mean age was 53.9±17.5. No significant differences were found in the VAP incidence between the two groups (OR=0.78; 95% IC, 0.36-1.68; p=0.56). The relation between halitosis and DP was p=0.7. The dental plaque index on the 5th day was 1.98 (n=60) in GR and 2.04 (n=57) in GS (p=0.3). The dental plaque index on the 10th day was 1.68 (n=29) in GR and 1.91 (n=32) in GS (p=0.7).ConclusionsThere is a tendency towards a decrease in the DP which is clearing in the GR group and no relation between VAP and greater DP or halitosis(AU)

La educación como pieza clave en la prevención y buena evolución de las úlceras por presión / Education as a key piece in the prevention and good course of pressure ulcers

Objetivo. Evaluar si la educación dirigida a los profesionales de enfermería disminuye laincidencia de úlceras por presión (UPP) y su mala evolución.Material y métodos. Estudio prospectivo, observacional, basado en medidas educacionalessobre prevención y tratamiento. Incluyó a todos los pacientes ingresados en elServicio de Medicina Intensiva durante un año (seis meses periodo basal [PB] y seis mesesperiodo pos-educacional [PE]). Las variables fueron incidencia de UPP, riesgo según escalaEMINA, grados y localización.Resultados. Pacientes ulcerados en PB 69 (14,37%) con 134 UPP. En PE 44 pacientes(7,88%) con 77 UPP. Nivel de signifi cación p < 0,01, odds ratio: 0,40 (intervalo de confi anzadel 95%; 0,26-0,62).Del total de 211 UPP, 15 (7,10%) evolucionaron a grado III-IV (11 en PB y 4 en PE); p > 0,20.Conclusiones. La formación de los profesionales en cuanto a la aplicación de medidaspreventivas estandarizadas disminuye la incidencia de UPP(AU)

Objective. To evaluate if an education program for the nursing staff helps to reduce theincidence of pressure ulcers and prevent their poor evolution.Material and methods. A prospective and observational study where the prevention andeducational methods have been used to prevent and treat pressure ulcers. All patients hasadmittedto Intensive Care Unit during one year were included (six months of basalperiod and six months of post-training period). The following variables were analyzed:incidence of Pressure Ulcers, risk score according to EMINA, ulcer grade and location.Results. A total of 134 ulcers were identifi ed in the 69 patients (14.37%) with pressureulcers included in the basal period. Forty-four patients (7.88%) of the patients in thepost-training period developed 77 pressure ulcers. The signifi cance level was p < 0.01,OR: 0.40 (95% CI: 0.26-0.62). Fifteen of the 211 pressure ulcers evolved to grade III-IV p> 0.20.Conclusions. Conducting a training program in the application of standardized preventionmethods for the nursing staff reduces the incidence of pressure ulcers(AU)