Osteomielitis aséptica craneal asociada a pioderma gangrenoso / Cranial aseptic osteomyelitis associated with pyoderma gangrenosum

Las dermatosis neutrofílicas (DN) constituyen un grupo heterogéneo de enfermedades. Excepcionalmente, las DN pueden acompañarse de acúmulos de neutrófilos estériles en otros tejidos distintos a la piel. Una paciente de 34 años consultó por una cefalea que no respondía al tratamiento analgésico. Una TAC demostró una lesión osteolítica a nivel parietal derecho, cuyo estudio histopatológico sugería una osteomielitis. Un año después del inicio de la cefalea desarrolló un pioderma gangrenoso en cara anterior de ambas piernas. Tras tratamiento con corticoterapia sistémica se resolvieron las lesiones cutáneas y la cefalea. La afectación ósea en las dermatosis neutrofílicas es excepcional. Habitualmente afecta a la población infantil en el contexto de una osteomielitis crónica recurrente multifocal (OCRM). Solo se han descrito dos casos en adultos, una paciente de 26 años, con una OCRM desde la infancia, y un varón de 67 años que desarrolló una osteomielitis aséptica en continuidad de un pioderma gangrenoso (AU)

Neutrophilic dermatoses include a heterogeneous group of entities. Uncommonly, they can accumulate aseptic neutrophilic abscesses in other tissues in addition to the skin. A 34-year-old female complained of a headache which was unresponsive to usual drugs. A TAC revealed an osteolytic lesion in the right parietal bone. The biopsy showed osteomyelitis. One year later, pyoderma gangrenosum appeared in the anterior aspect of both legs. The headache and the cutaneous lesions disappeared after treatment with oral prednisone. The bone involvement in the background of neutrophilic dermatoses is exceptional. Usually, it involves children in the context of chronic recurrent multiple osteomyelitis (CRMO). Only two cases have been described in adults. One of them was a 26-year-old woman who had had CRMO since childhood, and the other one in contiguity with the cutaneous lesions of pyoderma gangrenosum (AU)

Prevalence and sociobehavioural determinants of early childhood caries among 5-year-old Portuguese children: a longitudinal study.

PURPOSE: To assess the prevalence of early childhood caries (ECC) and associated factors among a 5-year-old cohort. METHODS: An observational longitudinal study was conducted with a sample of 142 preschoolers. A calibrated dentist performed intraoral examinations following International Caries Detection and Assessment System (ICDAS-II) criteria at baseline and after 6 months. A questionnaire on sociodemographic variables and oral health-related behaviours was answered by caregivers. Statistical analysis included descriptive statistics and computation of confidence intervals (95% confidence level). RESULTS: Baseline prevalence of ECC and severe ECC (S-ECC) were 40.1% and 11.3%, respectively. After 6 months ECC and S-ECC prevalence rates were 46.5%, and 13.2%, respectively. At both evaluations most caries lesions were untreated. Parental education and occupation were significantly associated with ECC. Behaviour variables found to be significantly associated with the disease comprised: establishing toothbrushing habits before the first year, toothbrushing twice daily and with parental assistance, frequency of dental visits, age at first dental visits, daily ingestion of sweets and number of daily meals. CONCLUSION: The prevalence of ECC was very high, with most of the lesions left untreated. ECC experience was associated with participants' socioeconomic background and several of the surveyed oral health-related behaviour variables.

Development of appropriateness criteria for hip arthroscopy in patients with femoroacetabular impingement. / Desarrollo de criterios de uso adecuado para la artroscopia de cadera en pacientes con choque femoroacetabular.

INTRODUCTION: The use of hip arthroscopy as a treatment for femoroacetabular impingement (FAI) has increased exponentially in recent years without robust evidence or consensus about the patients who benefit from it. OBJECTIVE: To develop explicit criteria for the appropriate indication of hip arthroscopy in FAI. METHOD: A panel of experts was formed with 11 traumatologists following the RAND/UCLA method to identify the appropriateness criteria for hip arthroscopy in patients with FAI. The panel made independent evaluations of each indication using a nine-point adequacy scale, then met face-to-face to vote using an iterative discussion process. The influence of the variables on the final score was studied using multinomial logistic regression models. The Classification and Regression Tree (CART) analysis was used to summarize the results in the form of decision trees. RESULTS: Twenty-three point four percent of the 192 scenarios evaluated in the face-to-face meeting was considered appropriate (40% agreement), 26.6% uncertain and 50% inappropriate (75% agreement). The most influential variables in considering the use of arthroscopy appropriate were: joint symptoms compatible with shock test, duration of symptoms, functionality, age and Hip Outcome Score (HOS) scale. CONCLUSIONS: We developed an explicit set of criteria for the appropriate use of hip arthroscopy in FAI using the RAND/UCLA method, providing a tool that would identify patients who are potential candidates for surgical treatment using arthroscopic hip surgery.

Grape and wine amino acid composition from Carignan noir grapevines growing under rainfed conditions in the Maule Valley, Chile: Effects of location and rootstock.

Nitrogen compounds play a key role on grape and wine quality. Their composition in grapes depends mainly on variety, viticultural management, and terroir, and affects fermentation kinetics and the volatile compound formation. The aim of this work was to study grape and wine amino acid composition of ungrafted or grafted onto cv. País Carignan grapevines growing under rainfed conditions in ten sites of the Maule Valley (Chile). The results showed that proline was the most abundant amino acid in grapes and wines. In general, Carignan noir grapevines grafted over País showed lower grape amino acid content respect to ungrafted vines. Cool night index (CI) was inversely correlated to several amino acids, showing that their plant synthesis or accumulation increased with lower minimum temperatures during the last month before harvest. Truquilemu (Tru) and Ciénaga de Name (Cdn) sites showed the highest concentration for several amino acids and total amino acid content in grapes, which led to a faster alcoholic fermentation.

Influence of the use of fungicides on the volatile composition of Monastrell red wines obtained from inoculated fermentation.

The influence of six fungicides (famoxadone, fenhexamid, fluquinconazole, kresoxim-methyl, quinoxyfen and trifloxystrobin) on the volatile composition of red wines obtained from inoculated fermentation was studied. Although treatments were carried out under critical agricultural practices (CAP), the residues in the wines were below their maximum residue limit (MRL). Ethyl decanoate was the compound most influenced by these fungicides, while diethyl succinate, decanoic acid, ß-ionone, and citronellol concentration were not changed with any of the treatments. The treatment of grapes with trifloxystrobin induced changes in only one volatile compound, and the variation in volatile composition of wines from grapes treated with fenhexamid, fluquinconazole and quinoxyfen compared to control wines was almost negligible invaluable. The treatment with famoxadone influenced more volatile compounds than the other ones, except for wine from grapes treated with kresoxim-methyl, which was the only wine that showed a big change in its aromatic composition.

Intervención grupal del síndrome subacromial en atención primaria / A group intervention for shoulder impingement syndrome in primary care

Introducción. El aumento de consultas por dolor de hombro en los servicios de rehabilitación impone buscar alternativas eficientes para mejorar su manejo. Objetivos. Evaluar la efectividad de un programa de rehabilitación grupal para mejorar la funcionalidad y el dolor en pacientes afectos de síndrome subacromial y ver qué variables se asocian a un mejor resultado funcional final. Métodos. Estudio longitudinal prospectivo de intervención antes/después. Muestra: 211 pacientes. La intervención consistió en 10 sesiones de electroterapia analgésica individual, 5 sesiones de cinesiterapia grupal y una sesión informativa: «escuela de hombro». El seguimiento fue de un año. Medimos la funcionalidad con el test de Constant y el dolor con la escala visual analógica. Pruebas estadísticas: chi cuadrado, T-test, ANOVA y regresión lineal múltiple (p < 0,05). Resultados. La funcionalidad mejoró significativamente en los 4 períodos estudiados respecto al valor inicial y se estabilizó a los 6 meses. El perfil de paciente que obtuvo mayor funcionalidad fue: mujer, mayor de 60 años, sin dolor en reposo inicial y laboralmente no activa. La mejora del dolor observada a largo plazo no fue significativa. El consumo de analgésicos se redujo significativamente a los 3 meses. La adherencia al tratamiento domiciliario de ejercicios fue del 81% a los 3 y 6 meses y del 70,6% al año. Conclusiones. La aplicación de un programa de rehabilitación grupal en pacientes afectos de síndrome subacromial se ha mostrado efectivo para mejorar la funcionalidad a largo plazo. Sin embargo, el dolor no ha mostrado mejoría significativa a lo largo del estudio (AU)

Introduction. Due to the increase in consultations for shoulder pain in rehabilitation services, there is a need for efficient alternatives to improve the management of this disorder. Objectives. To evaluate the effectiveness of a supervised group exercise program to improve functionality and pain in patients with shoulder impingement syndrome and to identify the variables that are associated with a better functional outcome. Methods. A prospective longitudinal, pre and post intervention study was carried out in a sample of 211 patients. The treatment consisted of 10 individual sessions of analgesic electrotherapy, 5 sessions of group exercise therapy and an educational session: «shoulder school». One year follow-up was performed. Shoulder function and pain were assessed using Constant's test and the visual analogue scale. The statistical analysis was carried out with the chi-square test, T-test, ANOVA and multiple linear regression (P < .05). Results. Functionality improved significantly in all periods studied compared with baseline and stabilized at 6 months. The profile of patients who achieved greater functionality was female, older than 60 years, with no initial rest pain and occupationally inactive. Long-term pain improvement was not significant. Analgesic use was significantly reduced at 3 months. Adherence to home exercise treatment was 81% at 3 and 6 months and 70.6% at one year. Conclusions. The application of a group rehabilitation program in patients with shoulder impingement syndrome was effective in improving long-term functionality. However, there was no significant pain improvement during the study (AU)

Potential markers of cisplatin treatment response unveiled by NMR metabolomics of human lung cells.

In this work, (1)H high resolution magic angle spinning (HRMAS) nuclear magnetic resonance (NMR) spectroscopy was used to characterize the variations in the metabolome (small metabolites and mobile lipids) of A549 human lung cells in response to exposure to the alkylating drug cisplatin. Multivariate analysis and signal integration of spectral data were carried out to unveil exposure-induced effects and follow their time course. Parallel and strongly correlated increases in lipids (particularly unsaturated triglycerides) and nucleotide sugars (particularly uridine diphosphate N-acetylglucosamine) were found in cisplatin-treated cells, highlighting these compounds as potential biomarkers of treatment response. Other significant changes upon drug exposure comprised an increase in sorbitol and decreases in niacinamide and several amino acids (glutamine, alanine, lysine, methionine, citrulline, phenylalanine and tyrosine). These results show that in vitro NMR metabolomics is a powerful tool for detecting variations in a range of intracellular compounds upon drug exposure, thus offering the possibility of identifying candidate metabolite markers for in vivo monitoring of tumor responsiveness to treatment.

Complicaciones y preservación nerviosa de la prostatectomía en relación con el intervalo de tiempo desde la biopsia diagnóstica / Complications and Nerve Preservation in Prostatectomy According to the Time Interval from Diagnostic Biopsy

Objetivos: Sintetizar la evidencia disponible sobre las complicaciones y la capacidad de preservación nerviosa bilateral de la prostatectomía radical en pacientes con cáncer próstatico en función del tiempo transcurrido de la biopsia diagnóstica (superior o inferior a las seis semanas). Material y métodos: Se identificaron los estudios relevantes utilizando estrategias de búsqueda estructuradas y específicas para cada una de las bases de datos consultadas sin ninguna limitación. Se evaluó la calidad metodológica de cada uno de los estudios incluidos y se extrajeron los datos de forma independiente. Resultados: Para la prostatectomía radical abierta, dos de los estudios concluyeron que el intervalo de tiempo transcurrido entre la realización de la biopsia prostática y la cirugía inferior a las 4 o 6 semanas no influye en la tasa de complicaciones posquirúrgicas y la capacidad de preservación nerviosa durante la cirugía. En cuanto a la prostatectomía radical laparoscópica asistida por robot el estudio incluido concluye que la realización de este tipo de intervenciones dentro de un periodo de tiempo inferior a las cuatro o seis semanas posteriores a la biopsia diagnóstica, se asocia a un mayor riesgo de sufrir complicaciones postquirúrgicas. No obstante, estos estudios contaban con importantes limitaciones metodológicas. Conclusiones: El intervalo de tiempo entre la realización de la biopsia diagnóstica y la cirugía abierta no influye en la tasa de complicaciones o preservación nerviosa. En cambio, un periodo de tiempo inferior a las cuatro semanas entre la biopsia diagnóstica y la cirugía laparoscópica se asocia con mayor riesgo de complicaciones quirúrgicas (AU)

Objectives: To summarize the available evidence on complications and bilateral nerve preservation in radical prostatectomy in patients according to the time interval from diagnostic biopsy (more or less than six weeks). Material and methods: Relevant studies were identified by using structured and specific search strategies for each of the databases consulted, without limitations. The methodological quality of each of the studies included was evaluated and the data were extracted independently. Results: For open radical prostatectomy, two of the studies concluded that a time interval of less than 4 or 6 weeks between prostate biopsy and surgery had no influence on the postsurgical complications rate or on nerve preservation during surgery. For laparoscopic robotic-assisted radical prostatectomy, the study included concluded that performing this type of intervention in an interval of less than 4 or 6 weeks after diagnostic biopsy was associated with a higher risk of postsurgical complications. However, all these studies had major methodological limitations. Conclusions: The time interval between diagnostic biopsy and open surgery has no influence on the complications rate or nerve preservations. In contrast, an interval of less than 4 weeks between diagnostic biopsy and laparoscopic surgery is associated with a higher risk of surgical complications (AU)

[Complications and nerve preservation in prostatectomy according to the time interval from diagnostic biopsy]. / Complicaciones y preservación nerviosa de la prostatectomía en relación con el intervalo de tiempo desde la biopsia diagnóstica.

OBJECTIVES: To summarize the available evidence on complications and bilateral nerve preservation in radical prostatectomy in patients according to the time interval from diagnostic biopsy (more or less than six weeks). MATERIAL AND METHODS: Relevant studies were identified by using structured and specific search strategies for each of the databases consulted, without limitations. The methodological quality of each of the studies included was evaluated and the data were extracted independently. RESULTS: For open radical prostatectomy, two of the studies concluded that a time interval of less than 4 or 6 weeks between prostate biopsy and surgery had no influence on the postsurgical complications rate or on nerve preservation during surgery. For laparoscopic robotic-assisted radical prostatectomy, the study included concluded that performing this type of intervention in an interval of less than 4 or 6 weeks after diagnostic biopsy was associated with a higher risk of postsurgical complications. However, all these studies had major methodological limitations. CONCLUSIONS: The time interval between diagnostic biopsy and open surgery has no influence on the complications rate or nerve preservations. In contrast, an interval of less than 4 weeks between diagnostic biopsy and laparoscopic surgery is associated with a higher risk of surgical complications.

Eficacia de la colonografía por tomografía computarizada frente a la colonoscopia como prueba de cribado del cáncer colorrectal / Efficacy of CT colonography versus colonoscopy in screening for colorectal cancer

Objetivo. Determinar la eficacia y efectividad de la colonografía por tomografía computarizada (CTC) frente a la colonoscopia como pruebas de cribado para el cáncer colorrectal (CCR). Material y métodos. Se realizó una revisión sistemática de la literatura científica que incluyó todos los estudios que evaluaran la eficacia de la CTC como prueba de cribado del CCR. Quedaron excluidos aquellos artículos que analizaran la eficacia de otras técnicas de cribado para el CCR o los que utilizaran la CTC como técnica diagnóstica o en poblaciones sintomáticas. De las 213 referencias obtenidas se seleccionaron 9 estudios tras lectura crítica. Resultados. La especificidad demostrada para la CTC en el cribado del CCR fue alta y disminuía con el diámetro del pólipo a detectar. La sensibilidad para la CTC para detectar pólipos de diámetro igual o menor de 6mm resultó ser muy baja y heterogénea, aunque aumentaba para la detección de pólipos de más de 9mm de diámetro. Conclusión. La CTC demostró tener alta especificidad y una sensibilidad muy heterogénea, aunque en la mayoría de los casos no alcanzó los porcentajes de sensibilidad y especificidad logrados por la colonoscopia (AU)

Objective. To determine the efficacy and effectiveness of CT colonography in comparison with those of colonoscopy in screening for colorectal cancer. Material and methods. We systematically reviewed all the studies in the scientific literature that assessed the efficacy of CT colonography in screening for colorectal cancer. We excluded articles that assessed the efficacy of other screening techniques for colorectal cancer and those that used CT colonography in the diagnostic workup of suspected lesions or symptomatic patients. After a critical reading of the 213 references obtained, we selected nine studies. Results. The specificity of CT colonography in screening for colorectal cancer was high, although it decreased with the diameter of the polyp to be detected. The sensitivity of CT colonography in the detection of polyps less than or equal to 6mm in diameter was very low and heterogeneous, although it was higher for polyps greater than 9mm in diameter. Conclusion. CT colonography has high specificity but very heterogeneous sensitivity, although in most cases it was not as sensitive or specific as conventional colonoscopy (AU)

La vitamina K como profilaxis para la enfermedad hemorrágica del recién nacido / Prophylactic Vitamin K for Vitamin K Deficiency Bleeding of the Newborn

Objetivo La administración de vitamina K inmediatamente después del nacimiento ha demostrado un descenso significativo de la incidencia de hemorragias neonatales, pero no existe evidencia suficiente que determine la forma de administración más adecuada. El objetivo de esta revisión es determinar la eficacia de la vitamina K administrada por vía oral frente a la vía intramuscular en la prevención de la enfermedad hemorrágica del recién nacido. Métodos Se realizó una revisión sistematizada de las principales bases de datos (Medline, Embase y Cochrane), entre otras sin limitación por fecha, idioma ni tipo de estudio. Los estudios seleccionados evaluaban la eficacia de la vitamina K. Se excluyeron aquellos estudios realizados en embarazadas, niños pretérmino o en pacientes afectos de alguna enfermedad. La validez de estos estudios fue evaluada mediante herramientas CASPe para revisiones sistemáticas y ensayos clínicos. Resultados Los estudios incluidos fueron cuatro ensayos clínicos y una revisión sistemática. Únicamente dos estudios evaluaron aspectos clínicos en los cuales se observó un descenso en la incidencia de hemorragias en el recién nacido tras la profilaxis con vitamina K por vía intramuscular. Con respecto a la vía oral, diferentes estudios analizaron la eficacia de la vitamina K mediante la determinación de parámetros bioquímicos (factor X, índice y tiempo de protrombina, vitamina K1 en plasma y antígeno de protrombina, entre otros) con resultados poco concluyentes en cuanto a la vía de administración y al número de dosis. Conclusiones(..)(AU)

Background The administration of vitamin K immediately after birth has shown a significant decrease in the incidence of newborn bleeding, but there is not enough evidence to determine the most appropriate method of administration. The objective of this review is to determine the effectiveness of orally administered vitamin K compared to the intramuscular route in the prevention of haemorrhagic disease of newborn (HDN).Methods We conducted a systematic review of the main databases (Medline, Embase and Cochrane, among others) without limitation by date, language or type of study. Selected studies evaluated the efficacy and safety of vitamin K. Excluded were studies in pregnant women in preterm infants or patients with pathology. The validity of these studies was assessed by CASPe tools for systematic reviews and clinical trials. Results Only two studies evaluated clinical aspects. They showed a reduction in the incidence of bleeding in the newborn after intramuscular prophylaxis with vitamin K. With regard to the oral route, different studies examined the effectiveness of vitamin K by determining biochemical parameters (factor X, prothrombin time and index, vitamin K1 in plasma and prothrombin antigen, among others) with inconclusive results regarding the route of administration and the number of doses. Conclusions There is sufficient evidence to support the effectiveness of a single intramuscular dose of vitamin K to prevent the classic form of HDN. With regard to late HDN and oral route, the results are inconclusive because the studies used biochemical indicators of effectiveness, which cannot be correlated with the actual coagulation status of the newborn due to lack of scientific evidence(AU)

[Efficacy of CT colonography versus colonoscopy in screening for colorectal cancer]. / Eficacia de la colonografía por tomografía computarizada frente a la colonoscopia como prueba de cribado del cáncer colorrectal.

OBJECTIVE: To determine the efficacy and effectiveness of CT colonography in comparison with those of colonoscopy in screening for colorectal cancer. MATERIAL AND METHODS: We systematically reviewed all the studies in the scientific literature that assessed the efficacy of CT colonography in screening for colorectal cancer. We excluded articles that assessed the efficacy of other screening techniques for colorectal cancer and those that used CT colonography in the diagnostic workup of suspected lesions or symptomatic patients. After a critical reading of the 213 references obtained, we selected nine studies. RESULTS: The specificity of CT colonography in screening for colorectal cancer was high, although it decreased with the diameter of the polyp to be detected. The sensitivity of CT colonography in the detection of polyps less than or equal to 6mm in diameter was very low and heterogeneous, although it was higher for polyps greater than 9mm in diameter. CONCLUSION: CT colonography has high specificity but very heterogeneous sensitivity, although in most cases it was not as sensitive or specific as conventional colonoscopy.

[Prophylactic vitamin K for vitamin K deficiency bleeding of the newborn]. / La vitamina K como profilaxis para la enfermedad hemorrágica del recién nacido.

BACKGROUND: The administration of vitamin K immediately after birth has shown a significant decrease in the incidence of newborn bleeding, but there is not enough evidence to determine the most appropriate method of administration. The objective of this review is to determine the effectiveness of orally administered vitamin K compared to the intramuscular route in the prevention of hemorrhagic disease of newborn (HDN). METHODS: We conducted a systematic review of the main databases (Medline, Embase and Cochrane, among others) without limitation by date, language or type of study. Selected studies evaluated the efficacy and safety of vitamin K. Excluded were studies in pregnant women in preterm infants or patients with pathology. The validity of these studies was assessed by CASPe tools for systematic reviews and clinical trials. RESULTS: Only two studies evaluated clinical aspects. They showed a reduction in the incidence of bleeding in the newborn after intramuscular prophylaxis with vitamin K. With regard to the oral route, different studies examined the effectiveness of vitamin K by determining biochemical parameters (factor X, prothrombin time and index, vitamin K1 in plasma and prothrombin antigen, among others) with inconclusive results regarding the route of administration and the number of doses. CONCLUSIONS: There is sufficient evidence to support the effectiveness of a single intramuscular dose of vitamin K to prevent the classic form of HDN. With regard to late HDN and oral route, the results are inconclusive because the studies used biochemical indicators of effectiveness, which can not be correlated with the actual coagulation status of the newborn due to lack of scientific evidence.

NMR methods for beer characterization and quality control.

The use of high-resolution NMR spectroscopy in the brewing industry is described; most studies having aimed at assessing the composition of beer and its raw materials and correlating it to a variety of quality parameters. First, the application of NMR to the qualitative characterization of beer is reviewed, addressing both targeted and untargeted methods and focusing on both beer extracts and direct beer analysis. A subsequent chapter addresses the NMR studies, which envisage the development of new rapid methods for beer analysis and quality control, such as site-specific natural fractionation-NMR and multivariate data analysis methods for marker search or rapid compound quantification. Finally, possible future perspectives toward a deeper and more complete understanding of beer and its brewing process are discussed.

Quantification of organic acids in beer by nuclear magnetic resonance (NMR)-based methods.

The organic acids present in beer provide important information on the product's quality and history, determining organoleptic properties and being useful indicators of fermentation performance. NMR spectroscopy may be used for rapid quantification of organic acids in beer and different NMR-based methodologies are hereby compared for the six main acids found in beer (acetic, citric, lactic, malic, pyruvic and succinic). The use of partial least squares (PLS) regression enables faster quantification, compared to traditional integration methods, and the performance of PLS models built using different reference methods (capillary electrophoresis (CE), both with direct and indirect UV detection, and enzymatic essays) was investigated. The best multivariate models were obtained using CE/indirect detection and enzymatic essays as reference and their response was compared with NMR integration, either using an internal reference or an electrical reference signal (Electronic REference To access In vivo Concentrations, ERETIC). NMR integration results generally agree with those obtained by PLS, with some overestimation for malic and pyruvic acids, probably due to peak overlap and subsequent integral errors, and an apparent relative underestimation for citric acid. Overall, these results make the PLS-NMR method an interesting choice for organic acid quantification in beer.

Evaluación de la satisfacción de los familiares de pacientes con enfermedad terminal con la atención recibida en un Centro de Salud / No disponible

Objetivo: evaluar el grado de satisfacción de los familiares con la asistencia prestada por el Grupo de Atención al paciente Terminal del Centro de Salud (CS) Método: estudio descriptivo transversal retrospectivo. Población: cuidadores principales de los 57 pacientes atendidos desde el 1 de mayo de 2004 al 31 de diciembre de 2005. Se les realizó una encuesta de satisfacción mediante entrevista personal o telefónicamente según posibilidades. Variables: datos de filiación del cuidador, parentesco, lugar de trabajo, psicopatología concomitante, asistencia a talleres, datos socioeconómicos, datos sobre el conocimiento del paciente en relación con el diagnóstico y pronóstico, y datos sobre opinión general del cuidador acerca del funcionamiento del grupo. Resultados: obtuvimos datos de 47 de los 57 cuidadores incluidos en principio (10 pérdidas). El cuidador tipo resultó ser una mujer de 51 años de media, casada, hija del paciente, que no trabajaba fuera de casa y sí residía en el mismo domicilio. Cuarenta y dos cuidadores (89%) estaban de acuerdo con el lugar del fallecimiento. Los 47 consideraron que la información recibida era buena o muy buena y que la accesibilidad era adecuada o muy adecuada. Treinta y nueve cuidadores (68,5%), consideraron el alivio de síntomas adecuado o muy adecuado. Treinta y cuatro cuidadores (59,6%) expresaron tener una muy buena opinión de del Grupo de Atención a enfermos paliativos. Conclusiones: integrar la atención al paciente con enfermedad en estadio terminal en la AP hace que se obtengan beneficios que quedan reflejados en la evaluación positiva que realizan los cuidadores principales de estos pacientes

Objective: to assess family members´ degree of satisfaction with patient care in a Health Center. Method: a descriptive, cross-sectional retrospective method. Population: focused on the main caregivers who assisted an average of fifty-seven patients from May 2004 to December 31, 2005. Ultimately a survey was carried out (by telephone or personally, depending on circumstances) to detect patient level of satisfaction. Variables: the following should be highlighted: caregiver demographic data, kinship, working place, concomitant psychopathology, workshop attendance, socio-economic data, and patient knowledge on diagnosis and prognosis. Results: relevant data from 47 caregivers were obtained (from an average of 57 professionals). A prototypical caregiver had the following characteristics: 51 years of age, female, married, daughter of patient, unemployed, sharing the patient’s home. Moreover, 42 caregivers (89%) agreed on the place where the patient dies. Even 47 of them considered the information and accessibility given good or excellent. Furthermore, 34 caregivers (59.6%), held the care provided by the palliative staff in quite high esteem. Conclusion: by integrating end-stage patient care into Palliative Care a higher percentage of deaths are occurring at home. This means not only improved family satisfaction, but also better patient quality of life

Rheological behavior of thermoreversible kappa-carrageenan/nanosilica gels.

The rheological behavior of silica/kappa-carrageenan nanocomposites has been investigated as a function of silica particle size and load. The addition of silica nanoparticles was observed to invariably impair the gelation process, as viewed by the reduction of gel strength and decrease of gelation and melting temperatures. This weakening effect is seen, for the lowest particle size, to become slightly more marked as silica concentration (or load) is increased and at the lowest load as particle size is increased. These results suggest that, under these conditions, the particles act as physical barriers to polysaccharide chain aggregation and, hence, gelation. However, for larger particle sizes and higher loads, gel strength does not weaken with size or concentration but, rather, becomes relatively stronger for intermediate particles sizes, or remains unchanged for the largest particles, as a function of load. This indicates that larger particles in higher number do not seem to increasingly disrupt the gel, as expected, but rather promote the formation of stable gel network of intermediate strength. The possibility of this being caused by the larger negative surface charge found for the larger particles is discussed. This may impede further approximation of neighboring particles thus leaving enough inter-particle space for gel formation, taking advantage of a high local polysaccharide concentration due to the higher total space occupied by large particles at higher loads.

A catalogue of molecular, physiological and symbiotic properties of soybean-nodulating rhizobial strains from different soybean cropping areas of China.

We have analysed 198 fast-growing soybean-nodulating rhizobial strains from four different regions of China for the following characteristics: generation time; number of plasmids; lipopolysaccharide (LPS), nodulation factors (LCOs) and PCR profiles; acidification of growth medium; capacity to grow at acid, neutral, and alkaline pH; growth on LC medium; growth at 28 and 37 degrees C; melanin production capacity; Congo red absorption and symbiotic characteristics. These unbiased analyses of a total subset of strains isolated from specific soybean-cropping areas (an approach which could be called "strainomics") can be used to answer various biological questions. We illustrate this by a comparison of the molecular characteristics of five strains with interesting symbiotic properties. From this comparison we conclude, for instance, that differences in the efficiency of nitrogen fixation or competitiveness for nodulation of these strains are not apparently related to differences in Nod factor structure.

Variability of cork from Portuguese Quercus suber studied by solid-state (13)C-NMR and FTIR spectroscopies.

A new approach is presented for the study of the variability of Portuguese reproduction cork using solid-state (13)C-NMR spectroscopy and photoacoustic (PAS) FTIR (FTIR-PAS) spectroscopy combined with chemometrics. Cork samples were collected from 12 different geographical sites, and their (13)C-cross-polarization with magic angle spinning (CP/MAS) and FTIR spectra were registered. A large spectral variability among the cork samples was detected by principal component analysis and found to relate to the suberin and carbohydrate contents. This variability was independent of the sample geographical origin but significantly dependent on the cork quality, thus enabling the distinction of cork samples according to the latter property. The suberin content of the cork samples was predicted using multivariate regression models based on the (13)C-NMR and FTIR spectra of the samples as reported previously. Finally, the relationship between the variability of the (13)C-CP/MAS spectra with that of the FTIR-PAS spectra was studied by outer product analysis. This type of multivariate analysis enabled a clear correlation to be established between the peaks assigned to suberin and carbohydrate in the FTIR spectrum and those appearing in the (13)C-CP/MAS spectra.

Enzymatic isolation and structural characterisation of polymeric suberin of cork from Quercus suber L.

An enzymatic method has been used to isolate, for the first time, polymeric suberin from the bark of Quercus suber L. or cork. This was achieved by solvent extraction (dichloromethane, ethanol and water), followed by a step-by-step enzymatic treatment with cellulase, hemicellulase and pectinase, and a final extraction with dioxane/water. The progress of suberin isolation was monitored by Fourier transform infrared spectroscopy using a photoacoustic cell (FTIR-PAS). The material obtained (polymeric suberin (PS)) was characterised by solid-state and liquid-state nuclear magnetic resonance, FTIR-PAS and vapour pressure osmometry, and compared with the suberin fraction obtained by alkaline depolymerisation (depolymerised suberin (DS)). The results showed that PS is an aliphatic polyester of saturated and unsaturated fatty acids, with an average molecular weight (M(w)) of 2050 g mol(-1). Although this fraction represents only 10% of the whole suberin of cork, its polymeric nature gives valuable information about the native form of the polymer. DS was found to have an average M(w) of 750 g mol(-1) and to comprise a significant amount of acidic and alcoholic short aliphatic chains.