Molecular characterization and expression analysis of anti-Müllerian hormone in common carp (Cyprinus carpio) adult testes.

Anti-Müllerian hormone (Amh) is a member of the transforming growth factor-ß (Tgf-ß) superfamily required in the regression of Müllerian ducts during gonadal sex differentiation of higher vertebrates. Teleost fish lack Müllerian ducts, but identified Amh orthologs have been shown to exert crucial functions during sex determination and differentiation of several species of teleosts. However, the function of Amh during gametogenesis in adult fish remains poorly investigated. Therefore, to expand present knowledge on the role of Amh in teleosts, the present study aimed to isolate and clone full-length amh cDNA in the common carp, Cyprinus carpio, and examine its expression levels throughout the male reproductive cycle and in response to different hormone treatments of testicular explants. Molecular cloning and characterization showed that the common carp Amh precursor amino acid sequence shared common features to other fish Amh precursors, including a conserved C-terminus (Tgf-ß domain) and a double proteolytic cleavage site (R-X-X-R-X-X-R) upstream to the Tgf-ß domain. Expression analysis showed amh dimorphic expression in the adult gonads with higher expression in the testes than ovaries. In testes, amh mRNA was detected in Sertoli cells contacting different types of germ cells, although the expression was greatest in Sertoli cells associated with type A undifferentiated spermatogonia. Expression analysis during the reproductive cycle showed that amh transcripts were down-regulated during the developing phase, which is characterized by an increased proliferation of type A undifferentiated spermatogonia and Sertoli cells and appearance of spermatocytes (meiosis) in the testes. Furthermore, ex vivo experiments showed that a 7 day exposure to Fsh or estrogens was required to decrease amh mRNA levels in common carp testicular explants. In summary, this study provided information on the molecular characterization and transcript abundance of amh in common carp adult testes. Altogether, these data will be useful for further investigations on sex determination and differentiation in this species, and also to improved strategies for improved carp aquaculture, such as inhibiting precocious maturation of males.

Estrategia de orientación psicopedagógica para la prevención del síndrome de Burnout Laboral / Psychopedagogical Strategy for preventing Burnout Syndrome at workplace

RESUMEN Introducción: el síndrome de Burnout consiste en una respuesta prolongada del organismo ante los factores estresantes, emocionales e interpersonales que se presentan en el trabajo e incluye fatiga crónica, ineficacia y negación de lo ocurrido. Se suele presentar en aquellas situaciones laborales en las que los excesivos niveles de exigencia ya se han vuelto un hábito inconsciente e incluso socialmente valorado. Objetivo: elaborar una estrategia de orientación educativa a los profesores desde la función orientadora del psicopedagogo, para la prevención del Síndrome de Burnout Laboral. Métodos: se realizó un estudio descriptivo, prospectivo y cualitativo mediante los métodos teóricos y empíricos, como: histórico-lógico, análisis-síntesis, encuestas, entrevistas, observación, técnica grupal e inventario para la evaluación del Burnout. Resultados: los resultados permitieron precisar las manifestaciones de este síndrome y sus insuficiencias. En la muestra estudiada se comprobó que de 19 profesionales se manifiestan en 15 (79%), en alguna medida indicadores de esta afectación, como síntomas de cansancio emocional y la baja realización personal. Conclusiones: la estrategia de orientación aplicada contribuye con la preparación del psicopedagogo en la prevención del Síndrome de Burnout Laboral y perfecciona el proceso docente educativo, proporciona mayor estabilidad psicológica y favorece la unidad de influencias educativas.

ABSTRACT Introduction: Burnout syndrome is provoqued by a prolonged response of the organism to stress, emotional and interpersonal factors such as chronic fatigue, inefficiency and refutation. It is usually present in those workers with ridiculous levels of tasks have already become an unconscious and social habit. Objective: to elaborate an educational guidance strategy for teachers, according to their function of Psychopedagogue for Burnout syndrome prevention. Methods: a descriptive, prospective and qualitative study was carried out using theoretical and empirical methods such as: historical-logical, analysis-synthesis, surveys, interviews, observation, group technique and Burnout syndrome records. Results: there were insufficiencies. From the total sample of 19 professionals, some indicators revealed 15 (79%) of participants with emotional fatigue and low self-realization highlighted symptoms. Conclusions: the strategy contributes to prepare the psychopedagogue on Burnout syndrome prevention and improves the educational process. It also provides greater psychological stability and favors educational influences unity.

Hipertricosis cubital en una paciente con pubarquia precoz: Caso clmico / Hypertrichosis cubiti in a girl with precocious puberty: Case report

La hipertricosis cubital es un aumento localizado de la densidad, longitud y espesor del vello. Es una entidad benigna con muy escasos pacientes descritos en la literatura médica (alrededor de medio centenar). La mitad de los casos descritos asocian otros defectos o malformaciones, y la otra mitad son problemas puramente estéticos. La pubarquia precoz en niñas se define como el inicio del vello púbico antes de los 8 años de edad. Se presenta a una paciente de 6 años con la asociación no descrita previamente de hipertricosis cubital y pubarquia precoz.

Hypertrichosis cubiti is a localized increase in hair density, length and thickness. It is an uncommon and benign entity with very few patients described in the medical literature (more or less than half a hundred). Half of the described patients associate other defects or malformations and the other half are purely aesthetic cases. Early pubarche in girls is defined as the onset of pubic hair before 8 years of age. We present a six-year-old patient with the association not previously described of hypertrichosis cubiti and precocious pubarche.

[Hypertrichosis cubiti in a girl with precocious puberty: Case report]. / Hipertricosis cubital en una paciente con pubarquia precoz: Caso clmico.

Hypertrichosis cubiti is a localized increase in hair density, length and thickness. It is an uncommon and benign entity with very few patients described in the medical literature (more or less than half a hundred). Half of the described patients associate other defects or malformations and the other half are purely aesthetic cases. Early pubarche in girls is defined as the onset of pubic hair before 8 years of age. We present a six-year-old patient with the association not previously described of hypertrichosis cubiti and precocious pubarche.

La hipertricosis cubital es un aumento localizado de la densidad, longitud y espesor del vello. Es una entidad benigna con muy escasos pacientes descritos en la literatura médica (alrededor de medio centenar). La mitad de los casos descritos asocian otros defectos o malformaciones, y la otra mitad son problemas puramente estéticos. La pubarquia precoz en niñas se define como el inicio del vello púbico antes de los 8 años de edad. Se presenta a una paciente de 6 años con la asociación no descrita previamente de hipertricosis cubital y pubarquia precoz.

Enfermedad de Osgood-Schlatter en un adolescente deportista: Caso clínico / Osgood-Schlatter disease in adolescent athlete: Case report

El dolor de rodilla es uno de los síntomas musculoesqueléticos más frecuentes en jóvenes físicamente activos y aparece, sobre todo, en adolescentes varones. Dentro del diagnóstico diferencial, hay que considerar entidades habituales de diagnóstico clínico, como la osteocondrosis apofisaria, y también otras en las que se precisan estudios complementarios. Se presenta el caso de un varón deportista de 12 años con dolor continuo en la rodilla derecha que se intensificaba con la actividad física y la presión directa. Se hizo el diagnóstico de enfermedad de Osgood-Schlatter mediante los datos exploratorios, reproducción del dolor ante la palpación a punta de dedo sobre la tuberosidad tibial anterior, y se confirmó mediante radiología. Se describe esta entidad y otras derivadas de la sobreutilización en la actividad física con las que hacer diagnóstico diferencial; se insiste en las medidas preventivas en cuanto a una correcta orientación en la actividad deportiva.

Knee pain is one of the most frequent musculoskeletal symptoms in young physically active males. Common entities of clinical diagnosis as osteochondritis/apophysitis and others that need complementary studies should be considered in the differential diagnosis. We present the case of a 12-year-old male athlete with continuous pain in his right knee that intensifies with physical activity and with direct pressure. Diagnosis of Osgood-Schlatter disease is made by exploratory data, pain-to-finger palpation on the anterior tibial tuberosity, and is confirmed by radiology. This entity is described as well as the main pathologies derived from overuse to make differential diagnosis and to stress preventive measures regarding a correct orientation in the sport activity.

[Osgood-Schlatter disease in adolescent athlete. Case report]. / Enfermedad de Osgood-Schlatter en un adolescente deportista. Caso clínico.

Knee pain is one of the most frequent musculoskeletal symptoms in young physically active males. Common entities of clinical diagnosis as osteochondritis/apophysitis and others that need complementary studies should be considered in the differential diagnosis. We present the case of a 12-year-old male athlete with continuous pain in his right knee that intensifies with physical activity and with direct pressure. Diagnosis of Osgood-Schlatter disease is made by exploratory data, pain-to-finger palpation on the anterior tibial tuberosity, and is confirmed by radiology. This entity is described as well as the main pathologies derived from overuse to make differential diagnosis and to stress preventive measures regarding a correct orientation in the sport activity.

El dolor de rodilla es uno de los síntomas musculoesqueléticos más frecuentes en jóvenes físicamente activos y aparece, sobre todo, en adolescentes varones. Dentro del diagnóstico diferencial, hay que considerar entidades habituales de diagnóstico clínico, como la osteocondrosis apofisaria, y también otras en las que se precisan estudios complementarios. Se presenta el caso de un varón deportista de 12 años con dolor continuo en la rodilla derecha que se intensificaba con la actividad física y la presión directa. Se hizo el diagnóstico de enfermedad de Osgood-Schlatter mediante los datos exploratorios, reproducción del dolor ante la palpación a punta de dedo sobre la tuberosidad tibial anterior, y se confirmó mediante radiología. Se describe esta entidad y otras derivadas de la sobreutilización en la actividad física con las que hacer diagnóstico diferencial; se insiste en las medidas preventivas en cuanto a una correcta orientación en la actividad deportiva.

Maternal assessment of recommendations on the newborn infant care upon hospital discharge.

INTRODUCTION: It is common for pediatricians to provide parents with information on how to look after their newborn baby at the time of discharge from the hospital. The objectives of this study are to determine the level of satisfaction regarding such information, to be aware of what additional information parents would have liked to receive, and to establish which factors may impact any additional information request. POPULATION AND METHODS: Descriptive study evaluating the opinion of women at 5-15 days post- partum regarding such information. RESULTS: A hundred and seventy-six surveys were collected. Of these, 68.8% respondents had attended childbirth classes. Sixty-one point four percent referred to have looked for advice on the newborn infant care, mostly on the Internet and in books. Seventy-four point four percent considered that the information provided sufficed. Most commonly, information was requested on breastfeeding (33.3%), bottle feeding (20.0%), and umbilical cord care (11.1%). Mothers who requested more information attended childbirth classes more frequently (significant) and searched for information during pregnancy (not significant). In addition, this group significantly assigned a lower score to the opportunity to ask questions and the level of trust on the pediatrician. CONCLUSIONS: Maternal satisfaction regarding the information provided is adequate; and most mothers do not request additional information. The topic on which they most frequently request additional information is breastfeeding. The decision to request information does not depend on maternal age, maternal education, employment condition, or having other children. Likewise, mothers have questions that are not satisfactorily answered during childbirth classes.

Valoración de las madres acerca de las recomendaciones para el cuidado del recién nacido al momento del alta hospitalaria / Maternal assessment of recommendations on the newborn infant care upon hospital discharge

Introducción. Es habitual que el pediatra ofrezca a los padres información sobre cuidados del neonato al momento del alta hospitalaria. Los objetivos del estudio son conocer la satisfacción respecto a dicha información, qué otras informaciones les hubiese gustado recibir y determinar qué factores pueden influir en esa demanda. Población y métodos. Estudio descriptivo que evalúa la opinión de las puérperas a los 5-15 días del parto, en cuanto a dicha información. Resultados. Se recogieron 176 encuestas. El 68,8% asistió a clases de preparación para el parto. El 61,4% refirió haber buscado consejos sobre cuidados del recién nacido, mayoritariamente en internet y libros. El 74,4% consideró suficiente la información recibida. Los aspectos de información más demandados fueron lactancia materna (33,3%), artificial (20,0%) y cuidados del cordón umbilical (11,1%). Las madres que demandaron más información acudieron con más frecuencia a clases de preparación para el parto (significativo) y buscaron información durante la gestación (no significativo). Asimismo, este grupo otorgó significativamente peores puntuaciones a la facilidad para plantear dudas y el grado de confianza en el pediatra. Conclusiones. La satisfacción de las madres respecto a la información ofrecida es buena; la mayoría no demanda más información. El aspecto sobre el que con más frecuencia demandan más información es la lactancia. La demanda de información es independiente de la edad materna, los estudios maternos, la situación laboral o la existencia de hijos previos. Asimismo, las dudas que les surgen a las madres no se ven satisfechas únicamente por la asistencia a clases de preparación para el parto.

Introduction.It is common for pediatricians to provide parents with information on how to look after their newborn baby at the time of discharge from the hospital. The objectives of this study are to determine the level of satisfaction regarding such information, to be aware of what additional information parents would have liked to receive, and to establish which factors may impact any additional information request. Population and Methods.Descriptive study evaluating the opinion of women at 5-15 days post- partum regarding such information. Results.A hundred and seventy-six surveys were collected. Of these, 68.8% respondents had attended childbirth classes. Sixty-one point four percent referred to have looked for advice on the newborn infant care, mostly on the Internet and in books. Seventy-four point four percent considered that the information provided sufficed. Most commonly, information was requested on breastfeeding (33.3%), bottle feeding (20.0%), and umbilical cord care (11.1%). Mothers who requested more information attended childbirth classes more frequently (significant) and searched for information during pregnancy (not significant). In addition, this group significantly assigned a lower score to the opportunity to ask questions and the level of trust on the pediatrician. Conclusions.Maternal satisfaction regarding the information provided is adequate; and most mothers do not request additional information. The topic on which they most frequently request additional information is breastfeeding. The decision to request information does not depend on maternal age, maternal education, employment condition, or having other children. Likewise, mothers have questions that are not satisfactorily answered during childbirth classes.

Valoración de las madres acerca de las recomendaciones para el cuidado del recién nacido al momento del alta hospitalaria / Maternal assessment of recommendations on the newborn infant care upon hospital discharge

Introducción. Es habitual que el pediatra ofrezca a los padres información sobre cuidados del neonato al momento del alta hospitalaria. Los objetivos del estudio son conocer la satisfacción respecto a dicha información, qué otras informaciones les hubiese gustado recibir y determinar qué factores pueden influir en esa demanda. Población y métodos. Estudio descriptivo que evalúa la opinión de las puérperas a los 5-15 días del parto, en cuanto a dicha información. Resultados. Se recogieron 176 encuestas. El 68,8% asistió a clases de preparación para el parto. El 61,4% refirió haber buscado consejos sobre cuidados del recién nacido, mayoritariamente en internet y libros. El 74,4% consideró suficiente la información recibida. Los aspectos de información más demandados fueron lactancia materna (33,3%), artificial (20,0%) y cuidados del cordón umbilical (11,1%). Las madres que demandaron más información acudieron con más frecuencia a clases de preparación para el parto (significativo) y buscaron información durante la gestación (no significativo). Asimismo, este grupo otorgó significativamente peores puntuaciones a la facilidad para plantear dudas y el grado de confianza en el pediatra. Conclusiones. La satisfacción de las madres respecto a la información ofrecida es buena; la mayoría no demanda más información. El aspecto sobre el que con más frecuencia demandan más información es la lactancia. La demanda de información es independiente de la edad materna, los estudios maternos, la situación laboral o la existencia de hijos previos. Asimismo, las dudas que les surgen a las madres no se ven satisfechas únicamente por la asistencia a clases de preparación para el parto.(AU)

Introduction.It is common for pediatricians to provide parents with information on how to look after their newborn baby at the time of discharge from the hospital. The objectives of this study are to determine the level of satisfaction regarding such information, to be aware of what additional information parents would have liked to receive, and to establish which factors may impact any additional information request. Population and Methods.Descriptive study evaluating the opinion of women at 5-15 days post- partum regarding such information. Results.A hundred and seventy-six surveys were collected. Of these, 68.8% respondents had attended childbirth classes. Sixty-one point four percent referred to have looked for advice on the newborn infant care, mostly on the Internet and in books. Seventy-four point four percent considered that the information provided sufficed. Most commonly, information was requested on breastfeeding (33.3%), bottle feeding (20.0%), and umbilical cord care (11.1%). Mothers who requested more information attended childbirth classes more frequently (significant) and searched for information during pregnancy (not significant). In addition, this group significantly assigned a lower score to the opportunity to ask questions and the level of trust on the pediatrician. Conclusions.Maternal satisfaction regarding the information provided is adequate; and most mothers do not request additional information. The topic on which they most frequently request additional information is breastfeeding. The decision to request information does not depend on maternal age, maternal education, employment condition, or having other children. Likewise, mothers have questions that are not satisfactorily answered during childbirth classes.(AU)

Valoración de las madres acerca de las recomendaciones para el cuidado del recién nacido al momento del alta hospitalaria / Maternal assessment of recommendations on the newborn infant care upon hospital discharge

Introducción. Es habitual que el pediatra ofrezca a los padres información sobre cuidados del neonato al momento del alta hospitalaria. Los objetivos del estudio son conocer la satisfacción respecto a dicha información, qué otras informaciones les hubiese gustado recibir y determinar qué factores pueden influir en esa demanda. Población y métodos. Estudio descriptivo que evalúa la opinión de las puérperas a los 5-15 días del parto, en cuanto a dicha información. Resultados. Se recogieron 176 encuestas. El 68,8% asistió a clases de preparación para el parto. El 61,4% refirió haber buscado consejos sobre cuidados del recién nacido, mayoritariamente en internet y libros. El 74,4% consideró suficiente la información recibida. Los aspectos de información más demandados fueron lactancia materna (33,3%), artificial (20,0%) y cuidados del cordón umbilical (11,1%). Las madres que demandaron más información acudieron con más frecuencia a clases de preparación para el parto (significativo) y buscaron información durante la gestación (no significativo). Asimismo, este grupo otorgó significativamente peores puntuaciones a la facilidad para plantear dudas y el grado de confianza en el pediatra. Conclusiones. La satisfacción de las madres respecto a la información ofrecida es buena; la mayoría no demanda más información. El aspecto sobre el que con más frecuencia demandan más información es la lactancia. La demanda de información es independiente de la edad materna, los estudios maternos, la situación laboral o la existencia de hijos previos. Asimismo, las dudas que les surgen a las madres no se ven satisfechas únicamente por la asistencia a clases de preparación para el parto.(AU)

Introduction.It is common for pediatricians to provide parents with information on how to look after their newborn baby at the time of discharge from the hospital. The objectives of this study are to determine the level of satisfaction regarding such information, to be aware of what additional information parents would have liked to receive, and to establish which factors may impact any additional information request. Population and Methods.Descriptive study evaluating the opinion of women at 5-15 days post- partum regarding such information. Results.A hundred and seventy-six surveys were collected. Of these, 68.8% respondents had attended childbirth classes. Sixty-one point four percent referred to have looked for advice on the newborn infant care, mostly on the Internet and in books. Seventy-four point four percent considered that the information provided sufficed. Most commonly, information was requested on breastfeeding (33.3%), bottle feeding (20.0%), and umbilical cord care (11.1%). Mothers who requested more information attended childbirth classes more frequently (significant) and searched for information during pregnancy (not significant). In addition, this group significantly assigned a lower score to the opportunity to ask questions and the level of trust on the pediatrician. Conclusions.Maternal satisfaction regarding the information provided is adequate; and most mothers do not request additional information. The topic on which they most frequently request additional information is breastfeeding. The decision to request information does not depend on maternal age, maternal education, employment condition, or having other children. Likewise, mothers have questions that are not satisfactorily answered during childbirth classes.(AU)

Maternal assessment of recommendations on the newborn infant care upon hospital discharge. / Maternal assessment of recommendations on the newborn infant care upon hospital discharge.

INTRODUCTION: It is common for pediatricians to provide parents with information on how to look after their newborn baby at the time of discharge from the hospital. The objectives of this study are to determine the level of satisfaction regarding such information, to be aware of what additional information parents would have liked to receive, and to establish which factors may impact any additional information request. POPULATION AND METHODS: Descriptive study evaluating the opinion of women at 5-15 days post- partum regarding such information. RESULTS: A hundred and seventy-six surveys were collected. Of these, 68.8

respondents had attended childbirth classes. Sixty-one point four percent referred to have looked for advice on the newborn infant care, mostly on the Internet and in books. Seventy-four point four percent considered that the information provided sufficed. Most commonly, information was requested on breastfeeding (33.3

), bottle feeding (20.0

), and umbilical cord care (11.1

). Mothers who requested more information attended childbirth classes more frequently (significant) and searched for information during pregnancy (not significant). In addition, this group significantly assigned a lower score to the opportunity to ask questions and the level of trust on the pediatrician. CONCLUSIONS: Maternal satisfaction regarding the information provided is adequate; and most mothers do not request additional information. The topic on which they most frequently request additional information is breastfeeding. The decision to request information does not depend on maternal age, maternal education, employment condition, or having other children. Likewise, mothers have questions that are not satisfactorily answered during childbirth classes.

Variabilidad e idoneidad en el tratamiento antimicrobiano de las faringoamigdalitis agudas pediátricas en Asturias, España / Variability of antibiotic treatment in paediatric acute pharyngotonsillitis in Asturias, Spain

Introducción. Las faringoamigdalitis agudas suponen un importante porcentaje de las consultas pediátricas y una de las principales causas de prescripción antibiótica. Nuestro objetivo fue analizar los hábitos de prescripción antimicrobiana en niños diagnosticados con faringoamigdalitis aguda en servicios de urgencias hospitalarios y consultas pediátricas de atención primaria en Asturias (España). Métodos. Estudio descriptivo multicéntrico que evalúa pacientes pediátricos diagnosticados con faringoamigdalitis aguda en los servicios de urgencias de 5 hospitales y en 80 consultas pediátricas de atención primaria. La idoneidad de las prescripciones se estableció por comparación con estándares de referencia. Resultados. Se incluyeron 563 niños con faringoamigdalitis agudas, 49,7% en atención primaria (IC 95% 45,6-53,8%), a los largo de 30 días no consecutivos (6,8% de las consultas pediátricas). Se prescribieron antibióticos en el 75,5% de las faringoamigdalitis (IC 95% 71,9-79,0%) [(78,3% en los menores de 3 años (IC 95% 71,8-84,8%)]. El antibiótico más indicado fue la amoxicilina [39,1% de los casos que recibieron antibioterapia (IC 95% 34,4-43,7%)]. Se encontraron diferencias significativas en el porcentaje de prescripción antibiótica entre atención primaria y urgencias hospitalarias (70,0% contra 80,9%, p= 0,003). El tratamiento prescrito se consideró de primera elección en el 43,3% de los tratados (IC 95% 38,6-48,0%) e inadecuado en el 56,0% (IC 95% 51,3-60,7%). Conclusiones. Pese a que la mayoría de las faringoamigdalitis agudas pediátricas son de probable etiología vírica, tres cuartas partes de ellas reciben tratamiento antibiótico en nuestro medio, siendo la elección inapropiada en más de la mitad de los casos.

Introduction. Acute pharyngotonsillitis accounts for a large portion of antibiotic prescriptions in pediatric offices. Our aim was to analyze the antimicrobial prescription habits for acute pharyngotonsillitis in children from hospital emergency departments and primary care pediatric clinics in Asturias (Spain). Methods. Multicenter descriptive study evaluating pediatric patients with a diagnosis of acute pharyngotonsillitis in 5 hospital emergency departments and 80 pediatric primary care clinics. Appropriateness of prescription was established by comparing with reference standards. Results. Five hundred sixty-three children with acute pharyngotonsillitis [49.7% in primary care CI 95% 45.6-53.8%)] were included along 30 nonconsecutive days. Antibiotics were prescribed in 75.5% of cases (95% CI 71.9-79.0%) [78.3% in children under 3 years of age (95% CI 71.8-84.8%)]. Amoxicillin was the antibiotic most frequently prescribed [39.1% (95% CI 34.4-43.7%)]. Significant differences in the frequency or antibiotic prescription were found between primary care and hospital emergency departments (70% vs. 80.9%, p= 0.003). The treatment prescribed was considered first choice in 43.3% (95% CI 38.6-48.0%) and inappropriate in 56.0% (95% CI 51.3-60.7%). Conclusions. Although in most cases pediatric acute pharyngotonsillitis is viral in origin, three out of four are treated with antibiotics. Treatment was inappropriate in more than half of the cases in our study.

[Variability of antibiotic treatment in paediatric acute pharyngotonsillitis in Asturias, Spain]. / Variabilidad e idoneidad en el tratamiento antimicrobiano de las faringoamigdalitis agudas pediátricas en Asturias, España.

Introduction. Acute pharyngotonsillitis accounts for a large portion of antibiotic prescriptions in pediatric offces. Our aim was to analyze the antimicrobial prescription habits for acute pharyngotonsillitis in children from hospital emergency departments and primary care pediatric clinics in Asturias (Spain). Methods. Multicenter descriptive study evaluating pediatric patients with a diagnosis of acute pharyngotonsillitis in 5 hospital emergency departments and 80 pediatric primary care clinics. Appropriateness of prescription was established by comparing with reference standards. Results. Five hundred sixty-three children with acute pharyngotonsillitis [49.7% in primary care CI 95% 45.6-53.8%)] were included along 30 nonconsecutive days. Antibiotics were prescribed in 75.5% of cases (95% CI 71.9-79.0%) [78.3% in children under 3 years of age (95% CI 71.8-84.8%)]. Amoxicillin was the antibiotic most frequently prescribed [39.1% (95% CI 34.4-43.7%)]. Signifcant differences in the frequency or antibiotic prescription were found between primary care and hospital emergency departments (70% vs. 80.9%, p= 0.003). The treatment prescribed was considered frst choice in 43.3% (95% CI 38.6-48.0%) and inappropriate in 56.0% (95% CI 51.3-60.7%). Conclusions. Although in most cases pediatric acute pharyngotonsillitis is viral in origin, three out of four are treated with antibiotics. Treatment was inappropriate in more than half of the cases in our study.

Variabilidad e idoneidad en el tratamiento antimicrobiano de las faringoamigdalitis agudas pediátricas en Asturias, España / Variability of antibiotic treatment in paediatric acute pharyngotonsillitis in Asturias, Spain

Introducción. Las faringoamigdalitis agudas suponen un importante porcentaje de las consultas pediátricas y una de las principales causas de prescripción antibiótica. Nuestro objetivo fue analizar los hábitos de prescripción antimicrobiana en niños diagnosticados con faringoamigdalitis aguda en servicios de urgencias hospitalarios y consultas pediátricas de atención primaria en Asturias (España). Métodos. Estudio descriptivo multicéntrico que evalúa pacientes pediátricos diagnosticados con faringoamigdalitis aguda en los servicios de urgencias de 5 hospitales y en 80 consultas pediátricas de atención primaria. La idoneidad de las prescripciones se estableció por comparación con estándares de referencia. Resultados. Se incluyeron 563 niños con faringoamigdalitis agudas, 49,7% en atención primaria (IC 95% 45,6-53,8%), a los largo de 30 días no consecutivos (6,8% de las consultas pediátricas). Se prescribieron antibióticos en el 75,5% de las faringoamigdalitis (IC 95% 71,9-79,0%) [(78,3% en los menores de 3 años (IC 95% 71,8-84,8%)]. El antibiótico más indicado fue la amoxicilina [39,1% de los casos que recibieron antibioterapia (IC 95% 34,4-43,7%)]. Se encontraron diferencias signifcativas en el porcentaje de prescripción antibiótica entre atención primaria y urgencias hospitalarias (70,0% contra 80,9%, p= 0,003). El tratamiento prescrito se consideró de primera elección en el 43,3% de los tratados (IC 95% 38,6-48,0%) e inadecuado en el 56,0% (IC 95% 51,3-60,7%). Conclusiones. Pese a que la mayoría de las faringomigdalitis agudas pediátricas son de probable etiología vírica, tres cuartas partes de ellas reciben tratamiento antibiótico en nuestro medio, siendo la elección inapropiada en más de la mitad de los casos.

Introduction. Acute pharyngotonsillitis accounts for a large portion of antibiotic prescriptions in pediatric offces. Our aim was to analyze the antimicrobial prescription habits for acute pharyngotonsillitis in children from hospital emergency departments and primary care pediatric clinics in Asturias (Spain). Methods. Multicenter descriptive study evaluating pediatric patients with a diagnosis of acute pharyngotonsillitis in 5 hospital emergency departments and 80 pediatric primary care clinics. Appropriateness of prescription was established by comparing with reference standards. Results. Five hundred sixty-three children with acute pharyngotonsillitis [49.7% in primary care CI 95% 45.6-53.8%)] were included along 30 nonconsecutive days. Antibiotics were prescribed in 75.5% of cases (95% CI 71.9-79.0%) [78.3% in children under 3 years of age (95% CI 71.8-84.8%)]. Amoxicillin was the antibiotic most frequently prescribed [39.1% (95% CI 34.4-43.7%)]. Signifcant differences in the frequency or antibiotic prescription were found between primary care and hospital emergency departments (70% vs. 80.9%, p= 0.003). The treatment prescribed was considered frst choice in 43.3% (95% CI 38.6-48.0%) and inappropriate in 56.0% (95% CI 51.3-60.7%). Conclusions. Although in most cases pediatric acute pharyngotonsillitis is viral in origin, three out of four are treated with antibiotics. Treatment was inappropriate in more than half of the cases in our study.

Variabilidad e idoneidad en el tratamiento antimicrobiano de las faringoamigdalitis agudas pediátricas en Asturias, España / Variability of antibiotic treatment in paediatric acute pharyngotonsillitis in Asturias, Spain

Introducción. Las faringoamigdalitis agudas suponen un importante porcentaje de las consultas pediátricas y una de las principales causas de prescripción antibiótica. Nuestro objetivo fue analizar los hábitos de prescripción antimicrobiana en niños diagnosticados con faringoamigdalitis aguda en servicios de urgencias hospitalarios y consultas pediátricas de atención primaria en Asturias (España). Métodos. Estudio descriptivo multicéntrico que evalúa pacientes pediátricos diagnosticados con faringoamigdalitis aguda en los servicios de urgencias de 5 hospitales y en 80 consultas pediátricas de atención primaria. La idoneidad de las prescripciones se estableció por comparación con estándares de referencia. Resultados. Se incluyeron 563 niños con faringoamigdalitis agudas, 49,7% en atención primaria (IC 95% 45,6-53,8%), a los largo de 30 días no consecutivos (6,8% de las consultas pediátricas). Se prescribieron antibióticos en el 75,5% de las faringoamigdalitis (IC 95% 71,9-79,0%) [(78,3% en los menores de 3 años (IC 95% 71,8-84,8%)]. El antibiótico más indicado fue la amoxicilina [39,1% de los casos que recibieron antibioterapia (IC 95% 34,4-43,7%)]. Se encontraron diferencias signifcativas en el porcentaje de prescripción antibiótica entre atención primaria y urgencias hospitalarias (70,0% contra 80,9%, p= 0,003). El tratamiento prescrito se consideró de primera elección en el 43,3% de los tratados (IC 95% 38,6-48,0%) e inadecuado en el 56,0% (IC 95% 51,3-60,7%). Conclusiones. Pese a que la mayoría de las faringomigdalitis agudas pediátricas son de probable etiología vírica, tres cuartas partes de ellas reciben tratamiento antibiótico en nuestro medio, siendo la elección inapropiada en más de la mitad de los casos.(AU)

Introduction. Acute pharyngotonsillitis accounts for a large portion of antibiotic prescriptions in pediatric offces. Our aim was to analyze the antimicrobial prescription habits for acute pharyngotonsillitis in children from hospital emergency departments and primary care pediatric clinics in Asturias (Spain). Methods. Multicenter descriptive study evaluating pediatric patients with a diagnosis of acute pharyngotonsillitis in 5 hospital emergency departments and 80 pediatric primary care clinics. Appropriateness of prescription was established by comparing with reference standards. Results. Five hundred sixty-three children with acute pharyngotonsillitis [49.7% in primary care CI 95% 45.6-53.8%)] were included along 30 nonconsecutive days. Antibiotics were prescribed in 75.5% of cases (95% CI 71.9-79.0%) [78.3% in children under 3 years of age (95% CI 71.8-84.8%)]. Amoxicillin was the antibiotic most frequently prescribed [39.1% (95% CI 34.4-43.7%)]. Signifcant differences in the frequency or antibiotic prescription were found between primary care and hospital emergency departments (70% vs. 80.9%, p= 0.003). The treatment prescribed was considered frst choice in 43.3% (95% CI 38.6-48.0%) and inappropriate in 56.0% (95% CI 51.3-60.7%). Conclusions. Although in most cases pediatric acute pharyngotonsillitis is viral in origin, three out of four are treated with antibiotics. Treatment was inappropriate in more than half of the cases in our study.(AU)

Variabilidad e idoneidad en el tratamiento antimicrobiano de las faringoamigdalitis agudas pediátricas en Asturias, España / Variability of antibiotic treatment in paediatric acute pharyngotonsillitis in Asturias, Spain

Introducción. Las faringoamigdalitis agudas suponen un importante porcentaje de las consultas pediátricas y una de las principales causas de prescripción antibiótica. Nuestro objetivo fue analizar los hábitos de prescripción antimicrobiana en niños diagnosticados con faringoamigdalitis aguda en servicios de urgencias hospitalarios y consultas pediátricas de atención primaria en Asturias (España). Métodos. Estudio descriptivo multicéntrico que evalúa pacientes pediátricos diagnosticados con faringoamigdalitis aguda en los servicios de urgencias de 5 hospitales y en 80 consultas pediátricas de atención primaria. La idoneidad de las prescripciones se estableció por comparación con estándares de referencia. Resultados. Se incluyeron 563 niños con faringoamigdalitis agudas, 49,7% en atención primaria (IC 95% 45,6-53,8%), a los largo de 30 días no consecutivos (6,8% de las consultas pediátricas). Se prescribieron antibióticos en el 75,5% de las faringoamigdalitis (IC 95% 71,9-79,0%) [(78,3% en los menores de 3 años (IC 95% 71,8-84,8%)]. El antibiótico más indicado fue la amoxicilina [39,1% de los casos que recibieron antibioterapia (IC 95% 34,4-43,7%)]. Se encontraron diferencias signifcativas en el porcentaje de prescripción antibiótica entre atención primaria y urgencias hospitalarias (70,0% contra 80,9%, p= 0,003). El tratamiento prescrito se consideró de primera elección en el 43,3% de los tratados (IC 95% 38,6-48,0%) e inadecuado en el 56,0% (IC 95% 51,3-60,7%). Conclusiones. Pese a que la mayoría de las faringomigdalitis agudas pediátricas son de probable etiología vírica, tres cuartas partes de ellas reciben tratamiento antibiótico en nuestro medio, siendo la elección inapropiada en más de la mitad de los casos.(AU)

Introduction. Acute pharyngotonsillitis accounts for a large portion of antibiotic prescriptions in pediatric offces. Our aim was to analyze the antimicrobial prescription habits for acute pharyngotonsillitis in children from hospital emergency departments and primary care pediatric clinics in Asturias (Spain). Methods. Multicenter descriptive study evaluating pediatric patients with a diagnosis of acute pharyngotonsillitis in 5 hospital emergency departments and 80 pediatric primary care clinics. Appropriateness of prescription was established by comparing with reference standards. Results. Five hundred sixty-three children with acute pharyngotonsillitis [49.7% in primary care CI 95% 45.6-53.8%)] were included along 30 nonconsecutive days. Antibiotics were prescribed in 75.5% of cases (95% CI 71.9-79.0%) [78.3% in children under 3 years of age (95% CI 71.8-84.8%)]. Amoxicillin was the antibiotic most frequently prescribed [39.1% (95% CI 34.4-43.7%)]. Signifcant differences in the frequency or antibiotic prescription were found between primary care and hospital emergency departments (70% vs. 80.9%, p= 0.003). The treatment prescribed was considered frst choice in 43.3% (95% CI 38.6-48.0%) and inappropriate in 56.0% (95% CI 51.3-60.7%). Conclusions. Although in most cases pediatric acute pharyngotonsillitis is viral in origin, three out of four are treated with antibiotics. Treatment was inappropriate in more than half of the cases in our study.(AU)

[Acute torsion of wandering spleen: a rare cause of acute abdomen]. / Torsión aguda de bazo errante, causa poco frecuente de abdomen agudo.

BACKGROUND: Wandering spleen is a rare clinical entity characterized by an anomalous position of the spleen in the abdomen due to impaired splenic ligamentous attachments that produce an elongation of the vascular pedicle. This makes a partial or complete volvulus of the vascular axis more likely. Wandering spleen's clinical presentation is variable--from an asymptomatic patient to one with chronic abdominal pain or an acute abdomen. The most common complication is the acute torsion of the splenic pedicle causing acute abdominal pain. CLINICAL CASE: A 30-year-old woman who turned up at the Emergency Department with acute abdominal pain. Diagnostic imaging (ultrasonography and computerized axial tomography) revealed a huge spleen in an abnormal location and without vascularization. An urgent splenectomy was performed. CONCLUSION: Acute torsion of wandering spleen is a rare cause of acute abdomen, which makes early diagnosis difficult and can result in delayed treatment. This would lead to having to perform a splenectomy. Due to splenic necrosis or infarction, which increases the risk of postsplenectomy sepsis.

Guatemalan plants extracts as virucides against HIV-1 infection.

Prevention methods to avoid transmission of pathogens, including HIV, are crucial in the control of infectious diseases, not only to block epidemic spread but to avoid long-term treatments leading to emergence of resistances and drug associated side effects. Together with vaccine development, the discovery of new virucidal agents represents a research priority in this setting. In the screening of new compounds with antiviral activity, three Guatemalan plant extracts from Justicia reptans, Neurolaena lobata and Pouteria viridis were evaluated with a classic antiviral assay and were found to inhibit HIV replication. This activity was corroborated by an original recombinant virus assay, leading us to perform a deeper study of the virucidal activity. Active fractions were non-toxic in vitro and also inhibited other enveloped viruses. Moreover, these fractions were able to inhibit the transfer of HIV from dendritic cells (DCs) to lymphocytes, that represents the main way of HIV spread in vivo.