Social and clinical predictors of perianal colonisation by multidrug-resistant bacteria for geriatric patients in the internal medicine service.

BACKGROUND: Colonisation by multidrug-resistant (MDR) bacteria is a global health issue. The identification of patients with a higher risk of colonisation is essential. Patients admitted to internal medicine services might represent a vulnerable population with a high risk of colonisation. This study was the first to assess social and clinical variables associated with a higher risk of perianal colonisation by MDR bacteria in a Spanish cohort of patients admitted to internal medicine service. METHODS: Patients admitted to an internal medicine service during 12 months of recruitment (1 March 2022 to 1 March 2023) were included in the study. Perianal swabs were performed at admission to identify the presence of MDR bacteria. Social and clinical variables were collected following a directed acyclic graph. A cluster analysis was performed to identify clinical profiles of higher risk. Bivariate analyses and multivariable logistic regression models were fitted to identify potential predictors of MDR bacteria colonisation. RESULTS: A total of 245 patients, according to the required sample size, were included. Of them, 46 (18.8%) were colonised by MDR bacteria in perianal swabs. Female sex, age > 80 years, dependency on activities of daily living, cognitive deterioration and living in long-term care facilities constituted the highest risk clinical profile. After adjustments, living in long-term care facilities and malnutrition remained the main risk factors identified. CONCLUSION: Patients admitted to internal medicine services presented a high frequency of perianal colonisation by MDR bacteria. Social and clinical variables associated with bio-psycho-social susceptibility were associated with colonisation. Special surveillance is needed in internal medicine services to control the transmission.

Retrospective analysis of epidemiologic features and clinical course of COVID-19 patients and comparison between vaccinated and unvaccinated patients.

At our Pneumology Department, we dealt with three waves of COVID-19 pandemics. The purpose of this study is to compare patients' epidemiological and clinical characteristics across waves and to assess the effect of vaccination on clinical presentation, course, and prognosis. From March 2020 to March 2022, a retrospective cohort study was conducted to compare patient characteristics. Based on the time of hospital admission, data from 456 patients were collected and divided into three groups (IW, IIW, and IIIW). In addition, we looked at the link between vaccination and clinical presentation and hospitalization outcome. The average age and comorbidities of patients increased, as did the worsening of respiratory conditions at admission (PaO2/FiO2 median 207 in IW, 95.5 in IIW, and 99 in IIIW). Continuous positive airway pressure (CPAP) was the primary respiratory support during the first wave, but an increase in the use of high flow nasal cannula and noninvasive ventilation was later observed, resulting in a higher hospital discharge rate and a lower intubation rate. Vaccinated patients had less severe COVID-19-related respiratory failure, a better clinical course, and a higher hospital discharge rate (71.4% in V-group vs 44.7% in NV-group, p<0.001). Patients' characteristics changed over the three waves, possibly due to virus mutations. The advancement of clinical and therapeutic management knowledge has contributed to a reduction in the severity of respiratory failure. The vaccination campaign improved the clinical course and reduced mortality.

Mecanismos de resistencia a la colistina, la nitrofurantoína y la fosfomicina en Enterobacterales / Mechanisms of resistance to colistin, nitrofurantoin and fosfomycin in Enterobacteriaceae

Resumen Las enterobacterias son un grupo amplio y heterogéneo de bacilos Gram negativos que se aíslan de forma rutinaria en el laboratorio clínico y se asocian a una gran cantidad de cuadros clínicos. Aquellas resistentes a antibióticos de última línea, como a los carbapenémicos, representan un gran reto en los centros de salud. Ante la dificultad para tratar infecciones causadas por este tipo de bacterias, se ha retomado el uso de antimicrobianos clásicos como la colistina, la nitrofurantoína y la fosfomicina. El objetivo de este trabajo es detallar los principales mecanismos de resistencia para estos tres fármacos descritos en enterobacterias. Para ello, se efectuó una revisión bibliográfica de artículos científicos publicados entre los años 1999 y 2022, utilizando las bases de datos PubMed (NCBI), PLOS, Redalyc, Google Scholar y Science Direct. En este proceso, se usaron las palabras clave "Carbapenem-Resistant Enterobacteriaceae", "colistin", nitrofurantoin", "fosfomycin", "resistance" y "plasmids". Se encontró que los mecanismos de resistencia son variados y abarcan fenómenos como modificación del sitio blanco, inactivación enzimática, impermeabilidad y eflujo. Además, los determinantes genéticos de resistencia se encuentran en cromosomas o en plásmidos. Conocer este tipo de información permite mejorar la vigilancia basada en el laboratorio, combatir el problema de resistencia a los antimicrobianos y optimizar el uso de estos antibióticos que forman parte del escaso arsenal para el tratamiento de ciertas infecciones causadas por microorganismos multidrogorresistentes.

Abstract Enterobacteriaceae is a large and heterogeneous group of Gram-negative bacilli that are routinely isolated in the clinical laboratory and are associated with a large number of clinical conditions. Those resistant to last-line antibiotics, such as carbapenems, represent a great challenge in health-care centers. Given the difficulty in treating this type of infections, the use of old drugs such as colistin, nitrofurantoin and fosfomycin has been studied. The objective of this work is to detail the main resistance mechanisms described in Enterobacteriaceae for these three antibiotics. To do this, a survey of scientific articles from the years 1999 to 2022 was carried out using databases such as PubMed (NCBI), Google Scholar, PLOS, Redalyc and Science Direct. In this process, keywords "Carbapenem- Resistant Enterobacteriaceae", "colistin", nitrofurantoin", "fosfomycin", "resistance" and "plasmids" were used. Resistance mechanisms were found to be varied and involve phenomena such as target site modification, enzyme inactivation, impermeability, and efflux. In addition, the genetic determinants of resistance are found at the chromosomal level or in plasmids. Knowing this type of information makes it possible to improve laboratory-based surveillance, fight the problem of resistance to antibiotics and take care of these antibiotics, which are part of the scarce arsenal for the treatment of certain infections caused by multidrug-resistant microorganisms.

The preparation of stable spherical alkali lignin nanoparticles with great thermal stability and no cytotoxicity.

In order to further develop the potential applications of lignin biomass, the research on lignin nanoparticles (LNPs) and their nanocomposites has attracted increasing attention. In this study, a facile and no chemical modification approach to prepare stable alkali lignin nanospheres is presented. The nanospheres around 85-125 nm were prepared through the π-π interactions between molecules in the self-assembly process. Lignin alkali was dissolved in ethylene glycol at different initial concentrations and subsequently ultrasound and dialysis treatment were conducted to prepare LNPs. The prepared LNPs had zeta potentials between -20 mV and -40 mV, and they were electrostatically stable over the pH range of 3 to 12 in aqueous solution. The chemical structure of LNPs was not significantly modified compared to lignin. Meanwhile the increased content of carboxyl and aliphatic hydroxyl groups in the LNPs structure was observed. Furthermore, the thermal stability and solubility in organic solvents (ethanol, acetone and THF) of LNPs were enhanced compared to those of lignin. In vitro cell viability evaluation indicated that the prepared LNPs had no cytotoxicity and excellent biocompatibility with mouse fibroblast. Therefore, we proposed here the production of high-quality and renewable LNPs, which will provide a novel perspective for multifunctional applications of bio-based nanomaterials.

Specialization of the photoreceptor transcriptome by Srrm3-dependent microexons is required for outer segment maintenance and vision.

Retinal photoreceptors have a distinct transcriptomic profile compared to other neuronal subtypes, likely reflecting their unique cellular morphology and function in the detection of light stimuli by way of the ciliary outer segment. We discovered a layer of this molecular specialization by revealing that the vertebrate retina expresses the largest number of tissue-enriched microexons of all tissue types. A subset of these microexons is included exclusively in photoreceptor transcripts, particularly in genes involved in cilia biogenesis and vesicle-mediated transport. This microexon program is regulated by Srrm3, a paralog of the neural microexon regulator Srrm4. Despite the fact that both proteins positively regulate retina microexons in vitro, only Srrm3 is highly expressed in mature photoreceptors. Its deletion in zebrafish results in widespread down-regulation of microexon inclusion from early developmental stages, followed by other transcriptomic alterations, severe photoreceptor defects, and blindness. These results shed light on the transcriptomic specialization and functionality of photoreceptors, uncovering unique cell type-specific roles for Srrm3 and microexons with implications for retinal diseases.

European aerosol phenomenology - 8: Harmonised source apportionment of organic aerosol using 22 Year-long ACSM/AMS datasets.

Organic aerosol (OA) is a key component of total submicron particulate matter (PM1), and comprehensive knowledge of OA sources across Europe is crucial to mitigate PM1 levels. Europe has a well-established air quality research infrastructure from which yearlong datasets using 21 aerosol chemical speciation monitors (ACSMs) and 1 aerosol mass spectrometer (AMS) were gathered during 2013-2019. It includes 9 non-urban and 13 urban sites. This study developed a state-of-the-art source apportionment protocol to analyse long-term OA mass spectrum data by applying the most advanced source apportionment strategies (i.e., rolling PMF, ME-2, and bootstrap). This harmonised protocol was followed strictly for all 22 datasets, making the source apportionment results more comparable. In addition, it enables quantification of the most common OA components such as hydrocarbon-like OA (HOA), biomass burning OA (BBOA), cooking-like OA (COA), more oxidised-oxygenated OA (MO-OOA), and less oxidised-oxygenated OA (LO-OOA). Other components such as coal combustion OA (CCOA), solid fuel OA (SFOA: mainly mixture of coal and peat combustion), cigarette smoke OA (CSOA), sea salt (mostly inorganic but part of the OA mass spectrum), coffee OA, and ship industry OA could also be separated at a few specific sites. Oxygenated OA (OOA) components make up most of the submicron OA mass (average = 71.1%, range from 43.7 to 100%). Solid fuel combustion-related OA components (i.e., BBOA, CCOA, and SFOA) are still considerable with in total 16.0% yearly contribution to the OA, yet mainly during winter months (21.4%). Overall, this comprehensive protocol works effectively across all sites governed by different sources and generates robust and consistent source apportionment results. Our work presents a comprehensive overview of OA sources in Europe with a unique combination of high time resolution (30-240 min) and long-term data coverage (9-36 months), providing essential information to improve/validate air quality, health impact, and climate models.

Authentication of recycled plastic content in water bottles using volatile fingerprint and chemometrics.

The environment is threatened by the continuously increasing volume of plastic residue. Plastic recycling is an interesting alternative to mitigate this problem. However, recycled plastic products may have pollutants from their recycling process, collecting system and/or previous life which may hurt consumers health, thus making it key to authenticate and characterize recycled materials. An innovative non-targeted methodology by means of static headspace gas chromatography-mass spectrometry (SHS-GC-MS) has been developed to measure the volatile organic profile of virgin polyethylene terephthalate (PET) and with diverse content of recycled PET samples. A home-made MS database, with 161 organic compounds characteristics from plastic materials based on the literature, was made. Seventeen of those compounds were found in the studied samples and identified by matching their MS spectra with MS database libraries. These compounds are mainly aldehydes (pentanal, hexanal, heptanal, octanal, nonanal and decanal), and benzene derivatives (styrene, p-xylene, benzaldehyde, methylbenzene, and 1,2-dichlorobenzene) which we found to be the common in the samples of recycled PET. The combination of the dataset consisting in the peak area of the detected species by SHS-GC-MS and the use of chemometrics shown to be a valuable methodology for the discrimination between virgin PET samples and those with different recycled PET content based on their volatile profile. In addition, a novel strategy applying a statistical model based on partial least squares (PLS) regression was proposed, for the first time, to quantify the recycled plastic content in the PET samples.

Gold, Silver, and Iron Oxide Nanoparticle Incorporation into Silk Hydrogels for Biomedical Applications: Elaboration, Structure, and Properties.

Silk fibroin (SF) is a versatile material with biodegradable and biocompatible properties, which make it fit for broad biomedical applications. In this context, the incorporation of nanosized objects into SF allows the development of a variety of bionanocomposites with tailored properties and functions. Herein, we report a thorough investigation on the design, characterization, and biological evaluation of SF hydrogels incorporating gold, silver, or iron oxide nanoparticles. The latter are synthesized in aqueous media using a biocompatible ligand allowing their utilization in various biomedical applications. This ligand seems to play a pivotal role in nanoparticle dispersion within the hydrogel. Results show that the incorporation of nanoparticles does not greatly influence the mechanism of SF gelation and has a minor impact on the mechanical properties of the so-obtained bionanocomposites. By contrast, significant changes are observed in the swelling behavior of these materials, depending on the nanoparticle used. Interestingly, the main characteristics of these bionanocomposites, related to their potential use for biomedical purposes, show the successful input of nanoparticles, including antibacterial properties for gold and silver nanoparticles and magnetic properties for iron oxide ones.

Silk Polymers and Nanoparticles: A Powerful Combination for the Design of Versatile Biomaterials.

Silk fibroin (SF) is a natural protein largely used in the textile industry but also in biomedicine, catalysis, and other materials applications. SF is biocompatible, biodegradable, and possesses high tensile strength. Moreover, it is a versatile compound that can be formed into different materials at the macro, micro- and nano-scales, such as nanofibers, nanoparticles, hydrogels, microspheres, and other formats. Silk can be further integrated into emerging and promising additive manufacturing techniques like bioprinting, stereolithography or digital light processing 3D printing. As such, the development of methodologies for the functionalization of silk materials provide added value. Inorganic nanoparticles (INPs) have interesting and unexpected properties differing from bulk materials. These properties include better catalysis efficiency (better surface/volume ratio and consequently decreased quantify of catalyst), antibacterial activity, fluorescence properties, and UV-radiation protection or superparamagnetic behavior depending on the metal used. Given the promising results and performance of INPs, their use in many different procedures has been growing. Therefore, combining the useful properties of silk fibroin materials with those from INPs is increasingly relevant in many applications. Two main methodologies have been used in the literature to form silk-based bionanocomposites: in situ synthesis of INPs in silk materials, or the addition of preformed INPs to silk materials. This work presents an overview of current silk nanocomposites developed by these two main methodologies. An evaluation of overall INP characteristics and their distribution within the material is presented for each approach. Finally, an outlook is provided about the potential applications of these resultant nanocomposite materials.

Factores de riesgo nutricionales y culturales asociados a anemia en mujeres embarazadas en Somotillo / Nutritional and cultural risk factors associated with anemia in pregnant women in Somotillo / Fatores de risco nutricionais e culturais associados à anemia em mulheres grávidas em Somotillo

Objetivo: identificar los factores de riesgo nutricional y culturales asociados a anemia en mujeres embarazadas en Somotillo. Método: estudio de casos y controles anidados, con mujeres embarazadas entre agosto y noviembre de 2016 en centros de salud cabecera. Los factores se identificaron mediante el cálculo de odds ratio a través del programa estadístico SPSS versión 22. Resultados: la mayoría de las embarazadas se encuentran entre 14 a 24 años, con estado civil de unión libre, nivel académico universitario, en la ocupación amas de casa, con religión católica y procedencia urbana, con antecedente preconcepcional del IMC mayor de 23. Conclusión: se concluyó que de las variables nutricionales que se comportaron como factor de riesgo fue el no consumir los suplementos de ácido fólico y hierro, y de la variable de los factores culturales que se comportó como factor de riesgo fue el inapropiado consumo de tacos, pozol, chicha de maíz como alimentos de costumbre.

Objective: to identify nutritional and cultural risk factors associated with anemia in pregnant women in Somotillo. Method: study of nested cases and controls, with pregnant women between August and November of 2016 in health centers. Factors were identified by the calculation of odds ratio through the statistical program SPSS version 22. Results: the majority of pregnant women are between 14 and 24 years of age, with a marital status of free union, university academic level, occupation of housewives, with catholic religion and urban origin, with a preconceptional antecedent of the BMI greater than 23. Conclusion: it was concluded that of the nutritional variables that behaved as a risk factor was not to take supplements of folic acid and iron, and the variable of cultural factors that behaved as a risk factor was the inappropriate consumption of tacos, pozol, Corn chicha as usual food.

Objetivo: identificar os fatores de risco nutricional e culturais associados à anemia em mulheres grávidas em Somotillo. Método: estudo de caso-controle aninhado, com mulheres grávidas entre agosto e novembro de 2016, no centros primários de saúde. Os fatores foram identificados calculando odds ratio através SPSS 22. Resultados: a maioria das mulheres grávidas estão entre 14 e 24 anos, com estado civil de união livre, em nível acadêmico da universidade, na casa de ocupação amor com a religião católica e origem urbana, com a história de preconceito de IMC maior que 23. Conclusão: concluiu-se que as variáveis nutricionais que se comportaram como fator de risco foi o não consumo dos suplementos de ácido fólico e ferro, e da variável dos fatores culturais que se comportaram como um fator de risco foi o inapropriado consumo de tacos, pozol, chicha de milho como alimentos de costume.

Tratamento atípico da biprotrusão dentoalveolar / Atipical treatment of dentoalveolar biprotrusion ­ a case report

A biprotrusão dentoalveolar é caracterizada pelo posicionamento mais anterior dos incisivos superiores e inferiores, o que traz como consequência um selamento labial deficiente e um perfil convexo, comprometendo a estética facial do paciente e fazendo com que este busque no tratamento ortodôntico a sua correção. O plano de tratamento destes casos, na sua maioria, envolve a realização de extrações, porém, quando já previamente ao tratamento o paciente apresenta ausências dentárias, o planejamento é simplificado, já que a retração anterior necessária pode ser direcionada para estes espaços sem que haja necessidade de extrações nestas regiões. O objetivo deste trabalho foi apresentar um caso clínico que promoveu a correção da biprotrusão e, consequentemente, da estética do sorriso e facial da paciente, através da realização da exodontia de apenas dois primeiros pré-molares superiores e retração anteroinferior redirecionada para os espaços já existentes, em consequência da perda do molar inferior esquerdo e devido à agenesia do incisivo lateral inferior direito. Além disso, no controle de sete anos pós-tratamento, observou-se estabilidade oclusal e manutenção da estética facial.

Dental biprotrusion is characterized by greater buccal tipping of the upper and lower incisors, rendering poor lip closure and convex profile, compromising the patient's facial esthetics and making him/her to seek orthodontic treatment for correction. In these cases the treatment plan, mostly involves performing extractions, but when already prior to treatment the patient has missing teeth, the treatment plan becomes simplified, since the anterior retraction required might be directed to these areas with no need for removal. The goal of this study is to show a case that promoted the correction of biprotrusion and consequently the patient smile and facial esthetics by performing the extraction of only two first maxillary premolars and anterior retraction redirected for the existing spaces as a result of the mandibular left molar loss and due to agenesis of the right lateral incisor. In addition, the 7-year follow-up control demonstrated occlusal stability and maintenance of the facial esthetics.

Conductas facilitadoras del apego en las interacciones parento-filiales y función reflexiva parental en familias adoptivas / No disponible

Los procesos de desarrollo que se ponen en juego cuando los niños y niñas adoptados llegan a sus nuevas familias han sido ampliamente estudiados y analizados en la investigación hasta la actualidad. Sin embargo, son pocos los estudios que se han encargado de analizar de manera más concreta y exhaustiva las interacciones que se producen entre padres y madres adoptivos con sus hijos e hijas adoptados. En este estudio, se analizan las interacciones parento-filiales en familias adoptivas y no adoptivas, así como las relaciones entre conductas parentales facilitadoras del apego y con la función reflexiva parental, en las familias adoptivas. Para ello, se evaluó a un total de 88 díadas a través de una tarea conjunta de construcción y una entrevista a las madres y padres. Los datos mostraron que ambos grupos eran semejantes en sus interacciones, aunque en las díadas adoptivas la frecuencia de conductas promotoras del apego fue significativamente mayor. Así mismo, se encontraron correlaciones significativas entre las conductas parentales facilitadoras del apego, observadas durante las interacciones parento-filiales. Finalmente, se observó que un pensamiento reflexivo parental más positivo sobre los menores adoptados y su relación con ellos estaba asociado a un mayor número de conductas promotoras del apego durante la interacción

While research into adopted children and their new families is abundant, studies exploring interactions in their relationship are more uncommon. Few studies have specifically analyzed the interactions between adoptive parents and adopted children. This work studies parent-child interaction in a sample of adoptive and non-adoptive dyads, as well as the relationships between attachment facilitating parental behaviors and parental reflective function in adoptive families. Through a co-construction task and an interview, 88 dyads were assessed. The data showed noteworthy similarities between the two groups and a significantly greater presence of some attachment facilitating behaviors in the adoptive dyads. Also, significant correlations were found between attachment facilitating parental behaviors, observed during parent-child interactions. Finally, a more positive parental reflective thinking about the adopted children and their relationship with them appeared to be associated with a higher number of attachment facilitating behaviors in the interaction

Diagnóstico ecográfico de la ventriculomegalia fetal. Seguimiento posnatal / Ultrasound diagnosis of fetal ventriculomegaly. Postnatal follow-up

Objetivos. Conocer la prevalencia de la ventriculomegalia fetal (VM). Estudiar la evolución de los casos diagnosticados prenatalmente y realizar el seguimiento neurológico de los nacidos vivos. Método. Estudio observacional de los casos de VM diagnosticados prenatalmente en nuestro servicio entre 2004 y 2012. Resultados. Diagnosticamos 61 casos de VM, siendo la prevalencia del 2,25 por 1.000. En 54 pacientes el diagnóstico se realizó en el segundo trimestre y en 7 pacientes durante el tercer trimestre. La bilateralidad se observó en el 91% de los casos. En el 79,4% de casos, la VM fue leve (10-12 mm) y en un 5,6% moderada (12-15 mm). Un 15% de los fetos mostraban una VM severa (> 15 mm) o hidrocefalia y en un 13% de los casos la VM evolucionó desfavorablemente durante la gestación. En 23 casos se diagnosticaron otras anomalías asociadas. Conclusiones. El pronóstico más favorable lo observamos cuando la afectación es leve, aislada y no progresiva (AU)

Objetives. To determine the prevalence of fetal ventriculomegaly and identify the neurological outcomes of newborns with a prenatal diagnosis. Method. Observational study of ventriculomegaly prenatally diagnosed by ultrasound in our department between 2004 and 2012. Results. We diagnosed 61 cases of ventriculomegaly. The prevalence rate was 2.25 per 1,000. Diagnosis was made during the second trimester in 54 patients and during the third trimester in 7. Bilateral ventriculomegaly was found in 91% of the fetuses. Ventriculomegaly was mild (10-12 mm) in 79.4% and moderate (12-15 mm) in 5.6%. Severe ventriculomegaly (>15 mm) or hydrocephalus was diagnosed in 15% of the fetuses. The clinical course during pregnancy was unfavorable in 13%. Associated anomalies were diagnosed in 23 cases. Conclusions. Mild, isolated and non-progressive ventriculomegaly has the best neurological prognosis (AU)

Percepción del estrés en los estudiantes de Enfermería ante sus prácticas clínicas / Stress perception in Nursing students facing their clinical practices

Objetivo. Esta investigación pretende conocer cuáles son las principales fuentes de estrés durante el periodo de prácticas de los estudiantes de Enfermería de la Universidad de Murcia en función de su sexo, curso y edad. Metodología. Se trata de un estudio transversal de corte descriptiva. La muestra estuvo compuesta por un total de 45 alumnos, 30 mujeres y 15 hombres, de Enfermería de la Universidad de Murcia del curso académico 2010/2011. El instrumento de recogida de la información fue cuestionario KEKZAK. Resultados. El desconocimiento ante una determinada situación clínica y el riesgo de dañar al paciente son las dos principales fuentes estresoras para los estudiantes de enfermería. Los hombres suelen sufrir un mayor estrés que sus compañeras; no obstante, a medida que aumenta la edad y se avanza de curso el grado de estrés es cada vez menor. Conclusiones. El estrés de los estudiantes de enfermería marca su formación durante el período de prácticas clínicas. Por tanto, se hace necesario que el aprendizaje teórico que sustenta a las prácticas atienda a estas necesidades que los propios estudiantes de enfermería demandan(AU)

Objective: This research aims to establish what the Nursing students’ main stress sources are during their practice period, according to their gender, grade and age. Methodology. It is a descriptive transversal study. The sample was composed by 45 Nursing students, 30 women and 15 men, at the University of Murcia in 2010/2011. The information gathering tool was KEZKAK questionnaire. Results. The ignorance facing a determined clinical situation and the risk of damaging the patient are the Nursing students’ two main stress sources. Men often suffer from a bigger stress than women; nevertheless, as well as the age increases and the students pass grades, the stress level is smaller. Conclusions. Nursing students’ stress determines their formation within their clinical practices period. Thus, it is necessary that the theoretical learning that supports these practices considers theses needs that own Nursing students require(AU)

Mordida cruzada posterior invertida – tratamento em paciente adulto / Reverse posterior crossbite: treatment of an adult patient

A mordida cruzada posterior invertida, também conhecida como “Síndrome de Brodie” ou “mordida em tesoura”, caracteriza-se pela relação transversal posterior acentuada, com excesso de vestibularização dos molares superiores e/ou excesso de lingualização dos molares inferiores, uni ou bilateralmente. Este tipo de má oclusão pode ser corrigido com tratamento ortodôntico, cirúrgico ou de uma maneira combinada, dependendo de sua origem: dentoalveolar ou esquelética e da fase em que se realiza o tratamento. A terapia ortodôntica geralmente relaciona-se à utilização de elásticos interarcos cruzados, necessitando de muita colaboração por parte dos pacientes quanto ao uso. E a terapia cirúrgica nem sempre é aceita pelo paciente. Deste modo, este trabalho apresenta uma abordagem simples e eficaz de tratamento ortodôntico da mordida cruzada posterior invertida em um paciente adulto, que possibilitou não só a correção da mordida cruzada posterior invertida como também a melhora da simetria facial.

The reversed posterior crossbite, also known as “Brodie Syndrome” or scissors-bite”, is characterized by posterior transverse relationship with excessive buccal tipping of maxillary molars and / or excessive lingual tipping of mandibular molars, unilaterally or bilaterally. These malocclusions can be corrected with orthodontic treatment, surgery or a combined manner, depending on their etiology: dentoalveolar or skeletal, and the stage at which treatment takes place. The orthodontic treatment generally relates to the use of interarch cross elastic, requiring a lot of cooperation from patients about the use of elastics, and patients often refuse a surgical therapy. Thus, this paper presents a simple and effective approach to orthodontic treatment of reversed posterior crossbite in an adult patient, which allowed not only the correction of reversed posterior crossbite as well as the improvement of facial symmetry.

Adherencia al tratamiento farmacológico de pacientes mayores polimedicados / Adherence to pharmacological treatment in polymedicated elderly patients

Objetivos: valorar las características personales, conocimiento del tratamiento e independencia en el acceso a medicamentos como factores relacionados con la adherencia al tratamiento farmacológico de pacientes mayores de 64 años polimedicados en el ámbito rural de Palencia. Material y método: estudio descriptivo transversal en pacientes mayores de 64 años de una zona básica de salud rural de Palencia que tomaban cinco o más medicamentos por patologías crónicas. Se utilizó encuesta propia, con comprobación en la historia clínica. Se estudiaron las variables: sexo, edad, medicación, recogida de medicación (médico y farmacia), olvido en última semana, modo de recordarla, cese cuando se encuentra bien o mal, conocimiento del nombre, identificación de las cajas y si sabían para qué sirven. En el análisis bivariante se utilizó la Ji cuadradoo prueba exacta de Fisher. Resultados: se estudiaron 94 pacientes. El 12,5% conocía el nombre del medicamento y el 50% sabía para qué sirven. El 55,6% de las mujeres frente al 35,5% de los hombres no van a la farmacia a recoger los medicamentos. El 83,9% de los hombres y el 74,6% de las mujeres referían no haber olvidado la medicación en la última semana. Un 44,7% recordaba cómo y cuándo tomar la medicación dejándola cerca de los utensilios de comida. Un 33,3% dejaban de tomar la medicación si se encuentran mal entre los que no acudían al médico a por recetas, frente al 12,7% entre los que sí acudían al médico. Conclusiones: la mayoría de los pacientes refiere no haber olvidado tomar los medicamentos en la última semana pero solo la mitad sabe para qué sirven, por lo que se propone educación sanitaria personalizada para conseguir una mayor responsabilidad individual en la toma de su medicación (AU)

Objectives: To assess the personal characteristics, treatment know ledge and independence in the access to drugs as factors related to thead herence to treatment in polymedicated patients over the age of 64 years in a rural setting of the province of Palencia. Material and method: Cross-sectional descriptive study in patients over the age of 64 in a rural basic health care area of the province of Palencia who were on five or more medications for chronic conditions. A self-developed questionnaire was used, along with verification of the medical records. Variables studied included: gender, age, medication, dispensing and collection of medication (physician or pharmacists), forgetting to take medication in the last week, medication reminder, cessation when the patient feels better or worse, identification of the drug name and whether the patient knows what the medication is for. The Chi square or the Fisher exact tests were used in bivariate analysis. Results: Ninety four patients were studied. 12,5% knew the name of the drug and 50% knew what it was for. 55,6% of cases vs 35,5% of malecases do not go to the pharmacy to pick up the medicines. 83,9% of menand 74,6% of women claimed not to have forgotten to take their medication in the last week. 44,7% remembered how and when to take the medication by leaving it near kitchen utensils. 33,3% stopped taking the medication if they felt bad and did not go to the doctor for prescriptions vs 12,7% of patients who did go to see their doctor. Conclusions: The majority of patients claim not to have forgotten to take their medication in the last week but only half knows what they are for. Consequently, individual patient education is recommended to achieve greater individual patient responsibility in the taking of medication (AU)

Biocompatibility of intracortical microelectrodes: current status and future prospects.

Rehabilitation of sensory and/or motor functions in patients with neurological diseases is more and more dealing with artificial electrical stimulation and recording from populations of neurons using biocompatible chronic implants. As more and more patients have benefited from these approaches, the interest in neural interfaces has grown significantly. However an important problem reported with all available microelectrodes to date is long-term viability and biocompatibility. Therefore it is essential to understand the signals that lead to neuroglial activation and create a targeted intervention to control the response, reduce the adverse nature of the reactions and maintain an ideal environment for the brain-electrode interface. We discuss some of the exciting opportunities and challenges that lie in this intersection of neuroscience research, bioengineering, neurology and biomaterials.

Repercusión de la implantación de laley de dependencia sobre los profesionalesde enfermería / Impact and repercussion resulting from the implantation of the Dependency Law on nursing professionals

Objetivos: detectar la sobrecarga de trabajo que sobre los profesionales deEnfermería ha podido producir la puesta en marcha de la Ley 39/2006, identificarproblemas relacionados con la implantación del Baremo de Valoraciónde Dependencia (BVD) y conocer las necesidades específicas de formaciónen los profesionales enfermeros como valoradores de la dependenciaen los pacientes inmovilizados.Material y métodos: se realiza un estudio trasversal descriptivo duranteabril de 2009 de la opinión de los profesionales de Enfermería de los Equiposde Atención Primaria (EAP) del área de Palencia. Se realiza a través deencuestas personales y anónimas, mediante un cuestionario de elaboraciónpropia, que recogía datos demográficos, laborales, aspectos relativos a la cumplimentacióndel BVD, trámites administrativos y necesidades formativas.Resultados: población diana son 151 enfermeros, de los cuales contestan un64,23% (97). El tiempo medio de realización del BVD es de 77,55 minutos;un 40,4% (38) cree que es complicado de completar, 8,5% (8) fácil yun 51,1% depende de los casos; el 69,1% (65) demanda más formación yun 58,5% (55) opina que se deberían crear equipos de valoración enfermerosindependientes. Un 63,8% (60) piensan que no han sido cubiertas las necesidadesde los pacientes, el 23,4% (22) que sus pacientes fallecen antesde recibirlas y un 12,8% (12) que las ayudas han sido eficaces.Conclusiones: la cumplimentación del baremo de valoración de dependenciaha supuesto una sobrecarga de trabajo enfermero. El BVD es difícilde rellenar, denso y en algunas ocasiones no recoge la situación real del paciente.La creación de grupos de profesionales enfermeros entrenados e independientesdel EAP hubiera salvado obstáculos como la valoración subjetivay presiones por parte de las familias (AU)

Objectives: to detect the work overload that the coming into effect of Law39/2006 might have had on nursing professionals, to identify problems relatingto the implantation of the Dependency Law Assessment Rating Scale andto determine the specific training needs of nursing professionals as evaluatorsof the dependency level of immobilised patients.Material and methods: a cross-sectional descriptive study was conducted inApril 2009 on the opinion of the nursing professionals that comprise primarycare teams in the area of Palencia. Anonymous personal polls were carriedout using a self-elaborated questionnaire which gathered information on demographicdata, work-related data, aspects relating to the completion of thedependency law assessment rating scale, administrative- red tape proceduresand training needs.Results: the target population was composed of 151 nurses, of which 64,23%(97) responded. Mean time for the completion of the assessment rating scalewas 77,55 minutes; 40,4% (38) thought it was hard to complete, 8,5%(8) easy to complete and 51,1% said complexity was case-dependent;69,1%(65) requested more information and 58,5% (55) were of the opinionthat independent assessment nursing teams should be created. 63,8% (60)thought that patient needs had not been covered, 23,4% (22) stated thattheir patients died before they could be assessed and 12,8% (12) that the aidshad been effective.Conclusions: the completion of the dependency assessment rating scale hasrepresented an increase in the work load of nurses. The dependency assessmentrating scale is hard to fill in, it is long and in some instances does notreflect the real situation of the patients. The creation of trained groups of nursingprofessionals that work independently from the primary care centreswould have solved these obstacles such as subjective assessment and the pressureon the part of the families (AU)