Colloidal Physics Modeling Reveals How Per-Ribosome Productivity Increases with Growth Rate in Escherichia coli.

Faster-growing cells must synthesize proteins more quickly. Increased ribosome abundance only partly accounts for increases in total protein synthesis rates. The productivity of individual ribosomes must increase too, almost doubling by an unknown mechanism. Prior models point to diffusive transport as a limiting factor but raise a paradox: faster-growing cells are more crowded, yet crowding slows diffusion. We suspected that physical crowding, transport, and stoichiometry, considered together, might reveal a more nuanced explanation. To investigate, we built a first-principles physics-based model of Escherichia coli cytoplasm in which Brownian motion and diffusion arise directly from physical interactions between individual molecules of finite size, density, and physiological abundance. Using our microscopically detailed model, we predicted that physical transport of individual ternary complexes accounts for ~80% of translation elongation latency. We also found that volumetric crowding increases during faster growth even as cytoplasmic mass density remains relatively constant. Despite slowed diffusion, we predicted that improved proximity between ternary complexes and ribosomes wins out, illustrating a simple physics-based mechanism for how individual elongating ribosomes become more productive. We speculate that crowding imposes a physical limit on growth rate and undergirds cellular behavior more broadly. Unfitted colloidal-scale modeling offers systems biology a complementary "physics engine" for exploring how cellular-scale behaviors arise from physical transport and reactions among individual molecules. IMPORTANCE Ribosomes are the factories in cells that synthesize proteins. When cells grow faster, there are not enough ribosomes to keep up with the demand for faster protein synthesis without individual ribosomes becoming more productive. Yet, faster-growing cells are more crowded, seemingly making it harder for each ribosome to do its work. Our computational model of the physics of translation elongation reveals the underlying mechanism for how individual ribosomes become more productive: proximity and stoichiometry of translation molecules overcome crowding. Our model also suggests a universal physical limitation of cell growth rates.

Fungal Diseases in Elasmobranchs and Their Possible Treatment with a Special Mention to Azole Antifungal Agents.

INTRODUCTION: Elasmobranchs currently constitute an important part of the animal collection of many aquariums worldwide. Their maintenance under human care has allowed us to describe and identify new pathogens and diseases affecting them, as well as to determine different treatments for these diseases. Great advances in elasmobranch husbandry have been developed. METHODS: A search was performed on scientific databases as PubMed and other specialized sources (IAAAM archive). RESULTS: Little information on pharmacotherapeutics is available in this taxonomic group, and treatments lack a scientific base and instead are frequently dependent on empirical knowledge. Pharmacokinetic studies are the first step to determining therapeutic protocols that are safe and effective. The available bibliography shows that a majority of the mycoses recorded in cartilaginous fish are severe, aggravated by the fact that the antifungal treatments administered, following the guidelines used for teleost species, are ineffective in elasmobranchs. Azoles appear to be a promising group of antifungals for use in treating systemic mycoses in sharks and rays. CONCLUSIONS: Based on the findings of this review, it is essential to investigate the pharmacokinetics of the different antifungals in these species in order to provide therapeutic options for fungal infections in cartilaginous fish.

Leptospirosis: Epidemiological and Clinical Characteristics at the National Reference Hospital in Panama.

Leptospirosis represents a public health problem in Panama, with an incidence rate of 1 in 100,000 inhabitants in 2014. Despite active surveillance and reports of outbreaks in the news, publications about human leptospirosis in Panama are scarce. The objective of this study was to describe the epidemiological and clinical features of leptospirosis in a cohort of patients admitted to the national reference hospital from January 2013 to December 2018. A total of 188 patients with suspected leptospirosis were identified, but only 56.9% (107 of 188) of the medical records could be retrieved. Microagglutination assays were completed in 45% (48 of 107) of the patients, confirming leptospirosis in 29.2% (14 of 48) of the patients. The most prevalent serogroup identified was Leptospira interrogans icterohemorrhagiae (4 of 14, 28.6%). The majority of patients with confirmed disease were middle-aged (36.4 ± 15.7 years), male (11 of 14, 78.6%), and symptomatic for 6.8 ± 0.7 days before admission. The predominant clinical presentation was fever (13 of 14, 92.9%), abdominal pain (7 of 14, 50%), and jaundice (8 of 14, 57.1%). Respiratory failure (8 of 14, 57.1%), elevated creatinine levels on admission (8 of 14, 57.1%), transfusion of blood-derived products (6 of 14, 42.9%), and required use of vasopressors (4 of 14, 28.6%) were common complications. Mortality was 28.6% (4 of 14). Empiric antibiotic therapy was initiated in almost all patients (10 of 12, 83.3%), and was appropriate in 90% (9 of 10) of them. Our study highlights the high prevalence of severe disease and reveals the diagnostic challenges concealing the true burden of leptospirosis in Panama. However, the small number of confirmed patients limits the generalization of these findings.

Carcinoid Heart Disease From a Primary Liver Carcinoid Tumor.

Carcinoid heart disease (CaHD) is part of the carcinoid syndrome. Cardiac involvement is present in 20% to 60% of patients with carcinoid syndrome and is normally from liver metastasis. We report the case of a patient who presented with CaHD disease with an undiagnosed primary tumor or a possible primary liver carcinoid tumor. (Level of Difficulty: Advanced.).

Papel del cirujano vascular en la fijación anterior de columna / Role of the vascular surgeon in anterior spine fixation

La fijación anterior de columna es una técnica bien implantada en la cirugía espinal. La presencia y necesidad de manipular los vasos principales, la aorta y las ilíacas y el riesgo hemorrágico que ello presenta hacen recomendable la colaboración de un cirujano vascular como cirujano de abordaje durante los procedimientos. Presentamos la experiencia de nuestro hospital en el tratamiento de fijación anterior de columna entre los servicios de traumatología y de cirugía vascular con una serie de 28 casos comprendidos entre el 2017 y el 2021.(AU)

Anterior spinal fixation is a well-established technique in spinal surgery: The presence and need for manipulation of the main vessels, aorta and iliac, and the risk of bleeding that presents, makes it advisable to have a Vascular Surgeon as an approach surgeon during the procedures. We present the experience of our Hospital in the treatment of anterior fixation of the experience of our Hospital in the treatment of anterior of the spine with the traumatology and vascular surgery service with a series of 28 cases between 2017 and 2021.(AU)

Fatal vascular complication due to metallosis.

Metallosis is a well-known complication at the site of total hip and knee arthroplasty. Vascular involvement of this complication is rare and generally results from vascular compression by a mass or pseudotumor. In the present report, we have described a case of lower limb acute arterial ischemia due to arterial injury as a complication of metallosis with a fatal outcome.

Predictive markers of nonalcoholic fatty liver disease in lean patients. A multinomial regression model and a 2k factorial analysis.

OBJECTIVE: Nonalcoholic fatty liver disease (NAFLD) is associated with obesity and insulin resistance; however, there is a group of non-obese patients with NAFLD that need to be characterized. Our aim was to evaluate the factors associated with NAFLD in non-obese subjects in a third-level hospital. METHODS: A comparative cross-sectional study was performed. Participants were divided into four groups: non-obese without NAFLD (group 1), non-obese with NAFLD (group 2), obese without NAFLD (group 3), and obese with NAFLD (group 4). We evaluated the effect of clinical and biochemical characteristics with the disease by groups using a multinomial regression model and a 2K factorial analysis. RESULTS: We included 278 participants. Low platelet-lymphocyte ratio (PLR) as a novel parameter associated with NAFLD in non-obese subjects. Age, uric acid, alanine transaminase (ALT), high-density lipoprotein (HDL)-cholesterol, and neutrophil-lymphocyte ratio (NLR) were other related parameters (akaike information criterion = 557). NLR had the larger OR in groups with NAFLD (lean with NAFLD 7.12, obese with NAFLD 13.02). The 2k factorial design found inverse effect on PLR by NAFLD (effect -21.89, P < 0.001), which was higher than BMI (effect -1.33, P < 0.045). CONCLUSION: Our study found that PLR is a novel parameter with inverse correlation with NAFLD in non-obese patients. Other related parameters are age, hyperuricemia, elevation of ALT and NLR, and low HDL-cholesterol.

Dyslipidemia as a risk factor for liver fibrosis progression in a multicentric population with non-alcoholic steatohepatitis.

Background: Nonalcoholic fatty liver disease (NAFLD) is a serious worldwide health problem, with an estimated global prevalence of 24%; it has a notable relationship with other metabolic disorders, like obesity and type 2 diabetes mellitus (T2DM). Nonalcoholic steatohepatitis (NASH) is one of the most important clinical entities of NAFLD, which is associated with an increased risk of progression to liver cirrhosis and hepatocellular carcinoma (HCC). Mexico is one of the countries with the highest prevalence of metabolic diseases; therefore, we sought to investigate the impact that these clinical entities have in the progression to advanced fibrosis in Mexican patients with NASH. Methods: We performed a multicenter retrospective cross-sectional study, from January 2012 to December 2017. A total of 215 patients with biopsy-proven NASH and fibrosis were enrolled. NASH was diagnosed according NAS score and liver fibrosis was staged by the Kleiner scoring system. For comparing the risk of liver fibrosis progression, we divided our sample into two groups. Those patients with stage F0-F2 liver fibrosis were included in the group with non-significant liver fibrosis (n=178) and those individuals with F3-F4 fibrosis were included in the significant fibrosis group (n=37). We carried out a multivariate analysis to find risk factors associated with liver fibrosis progression. Results: From the 215 patients included, 37 had significant liver fibrosis (F3-4). After logistic regression analysis T2DM (p=0.044), systemic arterial hypertension (p=0.014), cholesterol (p=0.041) and triglycerides (p=0.015) were the main predictor of advanced liver fibrosis. Conclusions: In a Mexican population, dyslipidemia was the most important risk factor associated with advanced liver fibrosis and cirrhosis.

Current trends of liver cirrhosis in Mexico: Similitudes and differences with other world regions.

AIM: To investigate the main current etiologies of cirrhosis in Mexico. METHODS: We performed a cross-sectional retrospective multicenter study that included eight hospitals in different areas of Mexico. These hospitals provide health care to people of diverse social classes. The inclusion criteria were a histological, clinical, biochemical, endoscopic, or imaging diagnosis of liver cirrhosis. Data were obtained during a 5-year period (January 2012-December 2017). RESULTS: A total of 1210 patients were included. The mean age was 62.5 years (SD = 12.1), and the percentages of men and women were similar (52.0% vs 48.0%). The most frequent causes of liver cirrhosis were hepatitis C virus (HCV) (36.2%), alcoholic liver disease (ALD) (31.2%), and nonalcoholic steatohepatitis (23.2%), and the least frequent were hepatitis B virus (1.1%), autoimmune disorders (7.3%), and other conditions (1.0%). CONCLUSION: HCV and ALD are the most frequent causes of cirrhosis in Mexico. However, we note that non-alcoholic fatty liver disease (NAFLD) as an etiology of cirrhosis increased by 100% compared with the rate noted previously. We conclude that NAFLD will soon become one of the most frequent etiologies of liver cirrhosis in Mexico.

Linfoma de la zona gris con características intermedias entre un linfoma difuso de células B grandes y un linfoma Hodgkin clásico. Reporte de un caso y revisión de la literatura / Grey zone lymphoma with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma. Case report and literature review

Resumen Entre los linfomas de la zona gris (LZG) encontramos neoplasias con características compartidas entre un linfoma difuso de células B grandes (LDCBG) y un linfoma de Hodgkin clásico (LHC). Lo poco habitual de la patología combinado con la heterogenicidad de la enfermedad, su reciente descripción como entidad específica que conlleva a dificultad y reto diagnóstico, así como la falta de suficiente experiencia terapéutica hacen de la enfermedad una entidad compleja de difícil diagnóstico y reto terapéutico que justifica su descripción continua. Se presenta una paciente con fiebre de un mes sin respuesta al manejo inicial, se estudió y realizó biopsia de ganglio inguinal izquierdo con resultado diagnóstico de LZG con características intermedias entre LDCBG y LHC. Aunque no existen guías establecidas para el manejo de esta entidad, la evidencia actual sugiere mejor respuesta en tratamientos dirigidos a LDCBG, misma terapia empleada en esta paciente con la cual se obtuvo respuesta favorable.

Abstract In the grey zone lymphomas (GZL), there are overlapping characteristics between diffuse large B-cell lymphoma (DLBCL) and classic Hodgkin lymphoma (CHL). The unusual nature of the pathology combined with the heterogeneity of the disease, its recent description as a specific entity, its diagnostic difficulty, and the lack of sufficient therapeutic experience justifies its continuous description. The case is presented of a patient with a fever of one month onset, with no response to initial management. A left inguinal lymph node biopsy reported a diagnosis of GZL with intermediate characteristics between DLBCL and CHL. Although there are no established guidelines for the management of this condition, the current evidence suggests a better response in treatments meant for diffuse large B-cell lymphoma. This same therapy was used in this patient, with a favourable clinical outcome.

Epidemiology of home enteral nutrition: an approximation to reality.

INTRODUCTION: home enteral nutrition (HEN) has undergone an important development; however, there is a notable lack of information with regard to its incidence and characteristics. OBJECTIVES: our aim was to assess the state of HEN in our area. METHODS: an observational, prospective study, involving all patients who had initiated HEN in the Nutrition Unit during a year. Epidemiological, functional, and nutritional evolution of the patients was described and incidence of HEN was calculated. RESULTS: HEN incidences totalled 229/100,000 inhabitants/year. The HEN population in our area was characterized by the aged and a high frequency of comorbidity and functional limitations. Neurological and oncological diseases accounted for 50% of indications. The remaining cases were malnourished patients who had received short periods of HEN after hospitalization or a hip fracture. Oral supplements (60%) with standard and hypercaloric formulas were used the most. At baseline, 75% of the patients suffered from malnutrition. During the follow-up, patients showed weight gain (1.6%), an increase in the percentage of normal weight and overweight (from 74% to 82.7%, p = 0.001) and a reduction in pressure ulcers (15.7% vs10.3%, p < 0.001). The median duration of HEN was 8.5 months. Only a quarter of the patients experienced complications (mostly mild gastrointestinal complications); 43.1% had died at the end of the follow-up. CONCLUSIONS: in our area, the HEN incidence was much higher than those described in the literature. HEN appears to be a safe therapy with few complications that improves the nutritional status of the patients, even with short periods of administration.

Long QT syndrome secondary to drug interaction between hydroxychloroquine and amiodarone / Síndrome de QT largo secundario a la interacción entre hidroxicloroquina y amiodarona

Abstract: A 67-year-old female patient with a diagnosis of heart failure with preserved ejection fraction secondary to severe mitral regurgitation in treatment with metoprolol, spironolactone, and digoxin. She was diagnosed systemic lupus erythematosus (SLE) because of the presence of arthritis, alopecia, thrombocytopenia, direct positive Coombs +++, positive ANAs 1:1,280 and positive lupus anticoagulant. The rheumatology service indicated hydroxychloroquine 200 mg every 24 hours. She presented atrial fibrillation, and amiodarone was initiated. Two weeks later the patient was admitted because of presyncope, electrocardiogram showed sinus bradycardia with long QT interval. A temporary pacemaker was placed, and hydroxychloroquine and amiodarone suspended. Twenty-four hours later, a new electrocardiogram was taken showing pacemaker rhythm with reduction of the QT interval. After 72 hours the temporary pacemaker was removed and on the fifth day the patient was discharged with an electrocardiogram in sinus rhythm with a corrected QT (Bazett) of 456 miliseconds. The hydroxychloroquine was reinitiated following discharge. She presented another episode of atrial fibrillation, and was treated with amiodarone, hydroxychloroquine was suspended previously, and she did not present prolongation of QT interval. The long QT syndrome was present when amiodarone and hydroxychloroquine interacted.(AU)

Resumen: Paciente femenina de 67 años, con diagnóstico de insuficiencia cardiaca con fracción de expulsión preservada, secundaria a insuficiencia mitral severa, en tratamiento con metoprolol, espironolactona y digoxina. Le fue diagnosticado lupus eritematoso sistémico, debido a la presencia de artritis, alopecia, trombocitopenia, Coombs directo positivo +++, anticuerpos antinucleares positivos 1:1,280 y anticoagulante lúpico positivo. El Servicio de Reumatología indicó hidroxicloroquina 200 mg cada 24 horas. Presentó fibrilación auricular, por lo que se le inició amiodarona. Dos semanas posteriores la paciente es ingresada debido a un episodio de presíncope, se le realizó electrocardiograma que demostró bradicardia sinusal con un intervalo QT prolongado. Se le colocó un marcapasos temporal, además de que se suspendió hidroxicloroquina y amiodarona. Después de 72 horas se retiró el marcapasos, y al quinto día se egresó con un electrocardiograma en ritmo sinusal con el intervalo QT corregido por Bazett de 456 milisegundos. La hidroxicloroquina fue reiniciada al egreso. La paciente presentó otro episodio de fibrilación auricular y fue tratada con amiodarona, previa suspensión de hidroxicloroquina, sin presentar prolongación del intervalo QT. El síndrome de QT largo sólo se presentó con la interacción de amiodarona con hidroxicloroquina.(AU)

Capping of Mn-Doped ZnS Quantum Dots with DHLA for Their Stabilization in Aqueous Media: Determination of the Nanoparticle Number Concentration and Surface Ligand Density.

Colloidal Mn2+-doped ZnS quantum dots (QDs) were synthesized, surface modified, and thoroughly characterized using a pool of complementary techniques. Cap exchange of the native l-cysteine coating of the QDs with dihydrolipoic acid (DHLA) ligands is proposed as a strategy to produce nanocrystals with a strong phosphorescent-type emission and improved aqueous stability. Moreover, such a stable DHLA coating can facilitate further bioconjugation of these QDs to biomolecules using established reagents such as cross-linker molecules. First, a structural and morphological characterization of the l-cysteine QD core was performed by resorting to complementary techniques, including X-ray powder diffraction (XRD) and microscopy tools. XRD patterns provided information about the local structure of ions within the nanocrystal structure and the number of metal atoms constituting the core of a QD. The judicious combination of the data obtained from these complementary characterization tools with the analysis of the QDs using inductively coupled plasma-mass spectrometry (ICP-MS) allowed us to assess the number concentration of nanoparticles in an aqueous sample, a key parameter when such materials are going to be used in bioanalytical or toxicological studies. Asymmetric flow field-flow fractionation (AF4) coupled online to ICP-MS detection proved to be an invaluable tool to compute the number of DHLA molecules attached to the surface of a single QD, a key feature that is difficult to estimate in nanoparticles and that critically affects the behavior of nanoparticles when entering the biological media (e.g., cellular uptake, biodistribution, or protein corona formation). This hybrid technique also allowed us to demonstrate that the elemental composition of the nanoparticle core remains unaffected after the ligand exchange process. Finally, the photostability and robustness of the DHLA-capped QDs, critical parameters for bioanalytical applications, were assessed by molecular luminescence spectroscopy.

Prevalence of allergic sensitization to conifer pollen in a high cypress exposure area.

BACKGROUND: Sensitization to Pinales (Cupressaceae and Pinaceae) has increased dramatically in recent years. The prevalence of sensitization in different geographic areas is related to exposure to specific pollens. OBJECTIVES: To investigate the prevalence of allergy to different conifer pollens, describe the characteristics of patients with such allergy, and identify the involved allergens. METHODS: Patients were recruited at five hospitals near Madrid. Extracts from conifer pollen were prepared and used in skin-prick testing. Wheal sizes were recorded, and serum samples obtained from patients with positive reactions to Cupressus arizonica and/or Pinus pinea. The specific immunoglobulin E value to C. arizonica and Cup a 1 was determined. Individual immunoblots for each patient and with a pool of sera were performed. Allergenic proteins were sequenced by using liquid chromatography-tandem mass spectrometry. RESULTS: Of 499 individuals included in the study, 17 (14%) had positive skin-prick test results to some conifer pollen extracts. Sixty-four patients had positive results to C. arizonica (prevalence 12.8%) and 11 had positive results to P. pinea (2.2%). All the patients had respiratory symptoms (61.4% during the C. arizonica pollination period), and 62.9% had asthma. Approximately 86% of the patients had positive specific immunoglobulin E results to C. arizonica and 92.3% had positive results to Cup a 1. Fourteen different bands were recognized by immunoblot; the most frequent bands were those detected at 43, 18, 16, and 14 kDa. All sequenced proteins corresponded to Cup a 1. CONCLUSION: Allergy to conifer pollen could be considered a relevant cause of respiratory allergy in central Spain. Asthma was more frequent than in other studies. We only identified Cup a 1 as involved in sensitization.

The talking card: Randomized controlled trial of a novel audio-recording tool for asthma control.

BACKGROUND: Asthma care plans typically include complicated written instructions. Customized, audio-recorded instructions may bridge health literacy gaps and improve treatment plan understanding. OBJECTIVE: To measure the effects of a recordable greeting card-style tool (Talking Card) on asthma control and parental care of children with asthma. METHODS: Multisite randomized trial in two primary care clinics, including children 4-11 years old with uncontrolled asthma and their parents. Parent-child dyads were randomized to usual care of asthma or usual care plus the Talking Card. Dyads completed three asthma-focused visits over 3 months. At the visit, card recipients received customized instructions recorded by the pediatrician onto an audio chip in the card. Asthma control was measured by using the Childhood Asthma Control Test. Card use and parental satisfaction were measured by parental survey (card arm only). Outcomes were analyzed by using generalized estimating equations and frequency distributions. RESULTS: Sixty-four dyads participated and attended 166 clinic visits. Card use was associated with a 1.6-point increase in Childhood Asthma Control Test score (p = 0.02) and a clinic visit regardless of card use with a three-point increase (p < 0.001). Satisfaction and self-efficacy were high among the card users. The mean satisfaction score was 8.9 of 10, with 96% agreeing or strongly agreeing that the card helped them take better care of asthma. CONCLUSIONS: The Talking Card, a novel audio communication tool, was associated with improved asthma control and deemed highly desirable by parents and children struggling to control asthma. This inexpensive portable tool may be useful in other chronic disorders and in locales with low literacy and poor access to digital technology.

ECONOMIC BURDEN OF HOME ARTIFICIAL NUTRITION IN THE HEALTH AREA OF SANTIAGO DE COMPOSTELA.

INTRODUCTION: home artificial nutrition (HAN) is a growing therapy, but the absence of obligatory registries complicates the calculation of its real economic burden. The aim of this study was to assess the state and economic impact of HAN in our health area. METHODS: an observational, prospective study was designed to calculate the cost of nutritional formulas and materials in patients who initiated HAN in the nutrition unit during a year. RESULTS: we included 573 new patients with HAN during the study period, 60% of whom were treated with oral supplements. The median daily cost of oral HAN was 3.65 (IQR 18.63) euros compared to a cost of 8.86 (IQR 20.02) euros for enteral-access HAN. The daily expenditure per 1 000 kcal of diet was higher for patients on oral HAN than for patients with tubes (5.13 vs. 4.52 euros, p < 0.001). The median cost of the complete HAN treatments during the study period was also calculated (186.60 euros and 531.99 euros for oral and tube HAN, respectively). The total estimated cost for all patients who initiated HAN in the study period was around one million euros. CONCLUSIONS: HAN represented an important economic burden in our health area, but the estimated daily cost of HAN was moderate, probably because of the high frequency of oral HAN, the adjusted treatments, and the centralized dispensation by the hospital pharmacy.

Introducción: la nutrición artificial domiciliaria (NAD) es una terapia en creciente desarrollo, pero la ausencia de registros obligatorios hace difícil calcular la carga económica que implica. Nuestro objetivo es evaluar el estado y el impacto económico de la NAD en nuestra área sanitaria. Métodos: estudio observacional y prospectivo diseñado para estimar el gasto en fórmulas y materiales nutricionales en los pacientes que iniciaron NAD durante 1 año. Resultados: se incluyeron 573 pacientes que iniciaron NAD en el período de estudio. El 60% recibieron suplementos orales. La mediana de gasto diario fue de 3,65 (RIC 18,63) euros en la NAD oral y de 8,86 (RIC 20,02) euros en la NAD por acceso enteral. El gasto por 1.000 kcal de dieta fue superior en los pacientes con NAD oral respecto a los pacientes con NAD enteral (5,13 vs. 4,52 euros, p < 0.001). Asimismo se calculó la mediana de gasto completo de los tratamientos durante todo el período de estudio (186,60 euros y 531,99 euros en NAD oral y enteral, respectivamente). Considerando el gasto conjunto de todos los pacientes que iniciaron NAD en el período de estudio, el gasto estimado estaría en torno a un millón de euros. Conclusiones: la NAD representa una importante carga económica en nuestra área sanitaria. Sin embargo, el gasto diario estimado fue moderado, probablemente por la elevada proporción de NAD oral en nuestra muestra, la revisión frecuente de la indicación y la centralización de la dispensación desde el servicio de Farmacia Hospitalaria.

Economic burden of home artificial nutrition in the health area of Santiago de Compostela / Impacto económico de la nutrición artificial domiciliaria en el área sanitaria de Santiago de Compostela

Introduction: home artificial nutrition (HAN) is a growing therapy, but the absence of obligatory registries complicates the calculation of its real economic burden. The aim of this study was to assess the state and economic impact of HAN in our health area. Methods: an observational, prospective study was designed to calculate the cost of nutritional formulas and materials in patients who initiated HAN in the nutrition unit during a year. Results: we included 573 new patients with HAN during the study period, 60% of whom were treated with oral supplements. The median daily cost of oral HAN was 3.65 (IQR 18.63) euros compared to a cost of 8.86 (IQR 20.02) euros for enteral-access HAN. The daily expenditure per 1 000 kcal of diet was higher for patients on oral HAN than for patients with tubes (5.13 vs. 4.52 euros, p <0.001). The median cost of the complete HAN treatments during the study period was also calculated (186.60 euros and 531.99 euros for oral and tube HAN, respectively). The total estimated cost for all patients who initiated HAN in the study period was around one million euros. Conclusions: HAN represented an important economic burden in our health area, but the estimated daily cost of HAN was moderate, probably because of the high frequency of oral HAN, the adjusted treatments, and the centralized dispensation by the hospital pharmacy (AU)

Introducción: la nutrición artificial domiciliaria (NAD) es una terapia en creciente desarrollo, pero la ausencia de registros obligatorios hace difícil calcular la carga econó- mica que implica. Nuestro objetivo es evaluar el estado y el impacto económico de la NAD en nuestra área sanitaria. Métodos: estudio observacional y prospectivo diseñado para estimar el gasto en fórmulas y materiales nutricionales en los pacientes que iniciaron NAD durante 1 año. Resultados: se incluyeron 573 pacientes que iniciaron NAD en el período de estudio. El 60% recibieron suplementos orales. La mediana de gasto diario fue de 3,65 (RIC 18,63) euros en la NAD oral y de 8,86 (RIC 20,02) euros en la NAD por acceso enteral. El gasto por 1.000 kcal de dieta fue superior en los pacientes con NAD oral respecto a los pacientes con NAD enteral (5,13 vs. 4,52 euros, p<0.001). Asimismo se calculó la mediana de gasto completo de los tratamientos durante todo el período de estudio (186,60 euros y 531,99 euros en NAD oral y enteral, respectivamente). Considerando el gasto conjunto de todos los pacientes que iniciaron NAD en el período de estudio, el gasto estimado estaría en torno a un millón de euros. Conclusiones: la NAD representa una importante carga económica en nuestra área sanitaria. Sin embargo, el gasto diario estimado fue moderado, probablemente por la elevada proporción de NAD oral en nuestra muestra, la revisión frecuente de la indicación y la centralización de la dispensación desde el servicio de Farmacia Hospitalaria (AU)

[Anthropometric measures in urban child population from 6 to 12 years from the northwest of México]. / Medidas antropométricas en la población infantil urbana de 6 a 12 años del noroeste de México.

BACKGROUND: The degree of overweight-obesity varies according to the conditions of each population and depending on geographical area, race or ethnicity, socioeconomic status, and susceptibility of each individual. The aim of this study was to determine anthropometric measures in urban child population from 6 to 12 years of Ciudad Obregón, Sonora. METHODS: We studied 684 schoolchildren from 6 to 12 years of age, of both genders in the urban area of Ciudad Obregón, Sonora. We measured weight, height, arm circumference (AC), waist, and body mass index (BMI). We used descriptive statistics (frequencies, percentages), and to compare the growth charts of this study vs. the reference standards (CDC and Ramos-Galván), we employed statistical inference (Student t test). RESULTS: On average, weight, height, AC, BMI for age by gender were higher than the reference standards at all ages. Seventy-four boys (22 %) and 51 girls (14.5 %) were above 95th percentile. With regards to size, 42 children (12.6 %) were below the 5th percentile and 37 (10.5 %) above the 95th percentile. CONCLUSION: Schoolchildren in the southern zone of Sonora showed a higher anthropometric pattern than the reference standards.

INTRODUCCIÓN: el grado de sobrepeso-obesidad tendrá variaciones de acuerdo con las condiciones de cada población, según el ámbito geográfico, la raza o etnia, el status socioeconómico y la susceptibilidad de cada individuo. El objetivo de este estudio fue determinar medidas antropométricas en la población infantil urbana de 6 a 12 años de Ciudad Obregón, Sonora. MÉTODOS: se estudiaron 684 escolares de 6 a 12 años de edad, sanos y de ambos géneros de la zona urbana de Ciudad Obregón, Sonora, en quienes se midieron peso, talla, perímetro braquial (PB), cintura e índice de masa corporal (IMC). Se realizó estadística descriptiva mediante frecuencias, porcentajes, e inferencial mediante t de Student para comparar las tablas de crecimiento de Ramos Galván y las del Centro para el Control y Prevención de Enfermedades (CDC). RESULTADOS: en promedio, peso, talla, PB, IMC por edad según el género fueron superiores a los estándares de referencia en todas las edades. Setenta y cuatro niños (22 %) y 51 niñas (14.5 %) se situaron por arriba del percentil 95. Con respecto a la talla, 42 niños (12,6 %) se encontraron por abajo del percentil 5 y 37 (10.5 %) por arriba del percentil 95. CONCLUSIÓN: los escolares de la zona sur del estado de Sonora presentaron un patrón antropométrico superior a los patrones de referencia conocidos.

Influence of Mn²âº concentration on Mn²âº-doped ZnS quantum dot synthesis: evaluation of the structural and photoluminescent properties.

The intentional introduction of transition metal impurities into semiconductor nanocrystals is an attractive approach for tuning quantum dot photoluminescence emission. Particularly, doping of ZnS quantum dots with Mn(2+) (Mn:ZnS QDs) results in a phosphorescence-type emission, attributed to the incorporation of manganese ions into the nanocrystal structure, so that delayed radiational deactivation of the energy of nanoparticles, excited through the energy levels of the metal, is enabled. However, the development of effective doping strategies can be challenging, especially if a highly efficient photoluminescent emission within a known crystalline core structure, is required (e.g. for analytical phosphorescence applications). The spectroscopic properties and the crystal structure of Mn(2+)-doped ZnS QDs are studied here to provide a better understanding on how the luminescence emission and the crystalline composition are influenced by the presence of Mn(2+) and its concentration used during the synthesis. In order to further control and optimize the synthesis of doped QDs for future bioanalytical applications, different complementary techniques including photoluminescence and X-ray powder diffraction have been employed. The information obtained has allowed standardization of the synthesis conditions of these doped QDs and the identification and quantification of the crystal phases obtained under different synthesis conditions.