Synthesis, characterization, and antibacterial activities of a heteroscorpionate derivative platinum complex against methicillin-resistant Staphylococcus aureus.

Staphylococcus aureus is one of the species with the greatest clinical importance and greatest impact on public health. In fact, methicillin-resistant S. aureus (MRSA) is considered a pandemic pathogen, being essential to develop effective medicines and combat its rapid spread. This study aimed to foster the translation of clinical research outcomes based on metallodrugs into clinical practice for the treatment of MRSA. Bearing in mind the promising anti-Gram-positive effect of the heteroscorpionate ligand 1,1'-(2-(4-isopropylphenyl)ethane-1,1-diyl)bis(3,5-dimethyl-1H-pyrazole) (2P), we propose the coordination of this compound to platinum as a clinical strategy with the ultimate aim of overcoming resistance in the treatment of MRSA. Therefore, the novel metallodrug 2P-Pt were synthetized, fully characterized and its antibacterial effect against the planktonic and biofilm state of S. aureus evaluated. In this sense, three different strains of S. aureus were studied, one collection strain of S. aureus sensitive to methicillin and two clinical MRSA strains. To appraise the antibacterial activity, minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), minimum biofilm inhibitory concentration (MBIC), and minimum biofilm eradication concentration (MBEC) were determined. Moreover, successful outcomes on the development of biofilm in a wound-like medium were obtained. The mechanism of action for 2P-Pt was proposed by measuring the MIC and MBC with EDTA (cation mediated mechanism) and DMSO (exogenous oxidative stress mechanism). Moreover, to shed light on the plausible antistaphylococcal mechanism of this novel platinum agent, additional experiments using transmission electron microscopy were carried out. 2P-Pt inhibited the growth and eradicated the three strains evaluated in the planktonic state. Another point worth stressing is the inhibition in the growth of MRSA biofilm even in a wounded medium. The results of this work support this novel agent as a promising therapeutic alternative for preventing infections caused by MRSA.

Immunogenicity of Multi-Target Chimeric RHDV Virus-Like Particles Delivering Foreign B-Cell Epitopes.

The rabbit hemorrhagic disease virus (RHDV) vaccine platform is a nanoparticle composed of 180 copies of the viral capsid protein, VP60, self-assembled into virus-like particles (VLPs). RHDV VLPs are able to accept the simultaneous incorporation of target epitopes at different insertion sites. The resulting chimeric RHDV VLPs displaying immunogenic foreign antigens have been shown to induce specific protective immune responses against inserted heterologous T-cytotoxic and B-cell epitopes in the mouse and pig models. In this study, we explored whether RHDV-based engineered VLPs can be developed as efficient multivalent vaccines co-delivering different foreign B-cell antigens. We generated bivalent chimeric RHDV VLPs displaying two model B-cell epitopes at different surface-exposed insertion sites, as well as the corresponding monovalent chimeric VLPs. The immunogenic potential of the bivalent chimeric VLPs versus the monovalent constructs was assessed in the mouse model. We found that the bivalent chimeric VLPs elicited a strong and balanced antibody response towards the two target epitopes tested, although slight reductions were observed in the levels of specific serum antibody titers induced by bivalent chimeric VLPs as compared with the corresponding monovalent constructs. These results suggest that RHDV VLPs could represent a promising platform for the development of efficient multivalent vaccines.

Chimeric RHDV Virus-Like Particles Displaying Foot-and-Mouth Disease Virus Epitopes Elicit Neutralizing Antibodies and Confer Partial Protection in Pigs.

Currently there is a clear trend towards the establishment of virus-like particles (VLPs) as a powerful tool for vaccine development. VLPs are tunable nanoparticles that can be engineered to be used as platforms for multimeric display of foreign antigens. We have previously reported that VLPs derived from rabbit hemorrhagic disease virus (RHDV) constitute an excellent vaccine vector, capable of inducing specific protective immune responses against inserted heterologous T-cytotoxic and B-cell epitopes. Here, we evaluate the ability of chimeric RHDV VLPs to elicit immune response and protection against Foot-and-Mouth disease virus (FMDV), one of the most devastating livestock diseases. For this purpose, we generated a set of chimeric VLPs containing two FMDV-derived epitopes: a neutralizing B-cell epitope (VP1 (140-158)) and a T-cell epitope [3A (21-35)]. The epitopes were inserted joined or individually at two different locations within the RHDV capsid protein. The immunogenicity and protection potential of the chimeric VLPs were analyzed in the mouse and pig models. Herein we show that the RHDV engineered VLPs displaying FMDV-derived epitopes elicit a robust neutralizing immune response in mice and pigs, affording partial clinical protection against an FMDV challenge in pigs.

Melatonin modulates red-ox state and decreases viability of rat pancreatic stellate cells.

In this work we have studied the effects of pharmacological concentrations of melatonin (1 µM-1 mM) on pancreatic stellate cells (PSC). Cell viability was analyzed by AlamarBlue test. Production of reactive oxygen species (ROS) was monitored following CM-H2DCFDA and MitoSOX Red-derived fluorescence. Total protein carbonyls and lipid peroxidation were analyzed by HPLC and spectrophotometric methods respectively. Mitochondrial membrane potential (ψm) was monitored by TMRM-derived fluorescence. Reduced (GSH) and oxidized (GSSG) levels of glutathione were determined by fluorescence techniques. Quantitative reverse transcription-polymerase chain reaction was employed to detect the expression of Nrf2-regulated antioxidant enzymes. Determination of SOD activity and total antioxidant capacity (TAC) were carried out by colorimetric methods, whereas expression of SOD was analyzed by Western blotting and RT-qPCR. The results show that melatonin decreased PSC viability in a concentration-dependent manner. Melatonin evoked a concentration-dependent increase in ROS production in the mitochondria and in the cytosol. Oxidation of proteins was detected in the presence of melatonin, whereas lipids oxidation was not observed. Depolarization of ψm was noted with 1 mM melatonin. A decrease in the GSH/GSSG ratio was observed, that depended on the concentration of melatonin used. A concentration-dependent increase in the expression of the antioxidant enzymes catalytic subunit of glutamate-cysteine ligase, catalase, NAD(P)H-quinone oxidoreductase 1 and heme oxygenase-1 was detected in cells incubated with melatonin. Finally, decreases in the expression and in the activity of superoxide dismutase were observed. We conclude that pharmacological concentrations melatonin modify the redox state of PSC, which might decrease cellular viability.

Melatonin induces reactive oxygen species generation and changes in glutathione levels and reduces viability in human pancreatic stellate cells.

In this study, the effects of pharmacological concentrations of melatonin (1 µM-1 mM) on human pancreatic stellate cells (HPSCs) have been examined. Cell type-specific markers and expression of melatonin receptors were analyzed by western blot analysis. Changes in intracellular free Ca2+ concentration were followed by fluorimetric analysis of fura-2-loaded cells. Reduced glutathione (GSH) and oxidized glutathione (GSSG) levels were determined by fluorescence techniques. Production of reactive oxygen species (ROS) was monitored following 5-(and-6)-chloromethyl-2',7'-dichlorodihydrofluorescein diacetate acetyl ester and MitoSOX™ Red-derived fluorescence. Cell viability was studied using the AlamarBlue® test. Cultured cells expressed markers typical of stellate cells. However, cell membrane receptors for melatonin could not be detected. Thapsigargin, bradykinin, or melatonin induced changes in intracellular free Ca2+ concentration. In the presence of the indole, a decrease in the GSH/GSSG ratio was observed that depended on the concentration of melatonin used. Furthermore, the indole evoked a concentration-dependent increase in ROS production in the mitochondria and in the cytosol. Finally, melatonin decreased HPSC viability in a time and concentration-dependent manner. We conclude that melatonin, at pharmacological concentrations, induces changes in the oxidative state of HPSC. This might regulate cellular viability and could not involve specific plasma membrane receptors.

Análisis de la cultura de seguridad del paciente en unidades extra-hospitalarias de hemodiálisis. Evolución tras la implantación de medidas / Analysis of the safety culture of the patient in out-of-hospital hemodialysis units. Evolution after the implementation of measures

INTRODUCCIÓN: El fomento de la cultura de seguridad del paciente es recomendado para una atención más segura. OBJETIVOS:· Conocer la frecuencia de percepciones y actitudes de los profesionales de los centros de hemodiálisis en relación con la seguridad del paciente.·Identificar puntos fuertes y oportunidades de mejora en el ámbito de la seguridad del paciente.·Comparar los resultados obtenidos, tras la implantación de medidas, con los del estudio de 2014. Material y MÉTODO: Estudio cuantitativo, descriptivo, transversal y comparativo, para medir la cultura de seguridad del paciente en seis centros periféricos de hemodiálisis mediante un cuestionario anónimo autoapli-ado (Cuestionario sobre la seguridad de los pacientes, versión española del Hospital Survey on Patient Safe-ty) en agosto-2014 y marzo-2017. En ese trascurso de tiempo se puso en marcha un sistema de notificación de eventos dversos y se realizó formación en seguridad del paciente. RESULTADOS: La media de la valoración del grado de seguridad percibido por todos los profesionales, fue de 8.02 (±1.42). Se ha incrementado notablemente el grado de notificación manifestada por los profesionales (62.5%). Se identificaron como fortalezas: el trabajo en equipo (86.2%), el feed back sobre errores (75.5%) y las expectativas en la dirección/supervisión (75.1%). Siete de las doce dimensiones presentaron mejoría significativa con respecto a los resultados del 2014. CONCLUSIONES: Podría atribuirse el incremento significativo de los porcentajes de respuesta positiva a la formación realizada en los centros y a la implantación del sistema de notificación y los informes publicados

INTRODUCTION: Developing patient safety culture is recommended for safer care. OBJECTIVES: • Knowing the frequency of staff perceptions and attitudes of health-care workers in hemodialysis centers concerning patient safety.• Identifying strengths and improvement areas in relation to patient safety.• Contrasting the results obtained, after the implementation of measures, with those of the 2014 study. Material and METHOD: A quantitative, descriptive, cross sectional and comparative study to evaluate patient safety culture in six hemodialysis centers through an anonymous self-administered questionnaire (Patient Safety Questionnaire, Spanish version of the Hospital Survey on Patient Safety) in August 2014 and March 2017. An adverse event notification system was implemented during this period, as well as a patient safety training. RESULTS: The average rating of staff security perception was 8.02 (± 1.42). The notification expressed by professionals has increased significantly (62.5%). Teamwork (86.2%), error feedback (75.5%) and management/supervision expectations (75.1%) were identified as strengths. Seven out of the twelve dimensions studied showed a significant improvement in relation to the 2014 results. CONCLUSIONS: A significant increase in positive response ratio could be attributed to the training programs carried out in the centers and to the implementation of the notification system, as well as to the reports already published

Valoración enfermera del estado emocional del paciente en hemodiálisis mediante la herramienta para la detección del estado emocional de pacientes en diálisis (EE-D) / Nurse evaluation of the patient’s emotional state on hemodialysis using the tool for the detection of the emotional state of patients on dialysis (EE-D)

Introducción: Las alteraciones psicológicas y emocionales influyen en el estado bio-psico-social del paciente en hemodiálisis. Un mejor conocimiento de estos aspectos nos ayuda a la comprensión y al manejo de las situaciones difíciles en su día a día. Objetivos: Con este estudio se describe el estado emocional de los pacientes en hemodiálisis por medio del cuestionario EE-D, aplicado por profesionales de enfermería y analizaremos si existe relación entre éste y otras variables individuales. Metodología: Se realizó un estudio descriptivo de corte trasversal, a 84 pacientes en hemodiálisis. Se utilizó el cuestionario EE-D, donde se valora la tristeza y el nerviosismo percibido por el paciente en la última semana, sus preocupaciones en diferentes ámbitos y que motivaciones encuentra para sentirse mejor o ilusionarse. Se recopilaron en un cuestionario ad hoc, datos demográficos, laborales, de adhesión al tratamiento farmacológico, etc. Resultados: En el parámetro tristeza obtuvimos una media de 3.8 (0 nada y 10 máxima), la moda fue 0 y un 73.8% obtuvo un nivel igual o inferior a 5. En cuanto al nerviosismo, la media fue 3, la moda 0 y el 79.8% manifestaron un nivel igual o inferior a 5. En cuanto a las preocupaciones casi la mitad de los pacientes refirió tener preocupaciones relacionadas con el ámbito familiar y con su enfermedad o tratamiento, seguido por el ámbito emocional, laboral y religioso respectivamente. Conclusiones: Nuestros pacientes presentan niveles bajos de tristeza, medios en cuanto a sus preocupaciones relacionadas con su enfermedad, mostrando en su mayoría facilidad para ilusionarse al encontrar motivaciones para ello (AU)

Introduction: Psychological and emotional alterations influence the bio-psycho-social state of the patient on hemodialysis. A better understanding of these aspects helps to understand and manage difficult daily situations. Objectives: This study describes the emotional state of patients on hemodialysis using the EE-D questionnaire, applied by nursing professionals and we will analyze if there is a relationship between this and other individual variables. Methodology: A cross-sectional descriptive study was carried out in 84 patients on hemodialysis. The EE-D questionnaire was used, which evaluates the sadness and nervousness perceived by the patient in the last week, their concerns in different areas and what motivations they find to feel better or to be excited. Demographic, labor, adherence to pharmacological data, etc. were collected in an ad hoc questionnaire. Results: In the sadness parameter, we obtained a mean of 3.8 (0 nothing and 10 maximum), the mode was 0 and 73.8% obtained a level equal to or less than 5. Regarding the concerns, almost half of the patients reported having concerns related to the family environment and their illness or treatment, followed by the emotional, occupational and religious environment, respectively. Conclusions: Our patients present low levels of sadness and middle ones in the concerns related to their illness, showing in the majority, facilities to be excited, when finding motivations for it (AU)

Genetic Assessment of African Swine Fever Isolates Involved in Outbreaks in the Democratic Republic of Congo between 2005 and 2012 Reveals Co-Circulation of p72 Genotypes I, IX and XIV, Including 19 Variants.

African swine fever (ASF) is a devastating disease of domestic pigs. It is a socioeconomically important disease, initially described from Kenya, but subsequently reported in most Sub-Saharan countries. ASF spread to Europe, South America and the Caribbean through multiple introductions which were initially eradicated-except for Sardinia-followed by re­introduction into Europe in 2007. In this study of ASF within the Democratic Republic of the Congo, 62 domestic pig samples, collected between 2005-2012, were examined for viral DNA and sequencing at multiple loci: C-terminus of the B646L gene (p72 protein), central hypervariable region (CVR) of the B602L gene, and the E183L gene (p54 protein). Phylogenetic analyses identified three circulating genotypes: I (64.5% of samples), IX (32.3%), and XIV (3.2%). This is the first evidence of genotypes IX and XIV within this country. Examination of the CVR revealed high levels of intra-genotypic variation, with 19 identified variants.

Rabbit hemorrhagic disease virus capsid, a versatile platform for foreign B-cell epitope display inducing protective humoral immune responses.

Virus-like particles (VLPs), comprised of viral structural proteins devoid of genetic material, are tunable nanoparticles that can be chemically or genetically engineered, to be used as platforms for multimeric display of foreign antigens. Here, we report the engineering of chimeric VLPs, derived from rabbit hemorrhagic disease virus (RHDV) for presentation of foreign B-cell antigens to the immune system. The RHDV capsid comprises 180 copies of a single capsid subunit (VP60). To evaluate the ability of chimeric RHDV VLPs to elicit protective humoral responses against foreign antigens, we tested two B-cell epitopes: a novel neutralizing B-cell epitope, derived from feline calicivirus capsid protein, and a well characterized B-cell epitope from the extracellular domain of influenza A virus M2 protein (M2e). We generated sets of chimeric RHDV VLPs by insertion of the foreign B-cell epitopes at three different locations within VP60 protein (which involved different levels of surface accessibility) and in different copy numbers per site. The immunogenic potential of the chimeric VLPs was analyzed in the mouse model. The results presented here indicated that chimeric RHDV VLPs elicit potent protective humoral responses against displayed foreign B-cell epitopes, demonstrated by both, in vitro neutralization and in vivo protection against a lethal challenge.

A long-life lithium ion sulfur battery exploiting high performance electrodes.

A novel lithium ion sulfur battery is formed by coupling an activated ordered mesoporous carbon-sulfur (AOMC-S) cathode and a nanostructured tin-carbon anode. The lithium ion cell has improved reversibility, high energy content and excellent cycle life.

Structural basis for the development of avian virus capsids that display influenza virus proteins and induce protective immunity.

UNLABELLED: Bioengineering of viruses and virus-like particles (VLPs) is a well-established approach in the development of new and improved vaccines against viral and bacterial pathogens. We report here that the capsid of a major avian pathogen, infectious bursal disease virus (IBDV), can accommodate heterologous proteins to induce protective immunity. The structural units of the ~70-nm-diameter T=13 IBDV capsid are trimers of VP2, which is made as a precursor (pVP2). The pVP2 C-terminal domain has an amphipathic α helix that controls VP2 polymorphism. In the absence of the VP3 scaffolding protein, 466-residue pVP2 intermediates bearing this α helix assemble into genuine VLPs only when expressed with an N-terminal His6 tag (the HT-VP2-466 protein). HT-VP2-466 capsids are optimal for protein insertion, as they are large enough (cargo space, ~78,000 nm(3)) and are assembled from a single protein. We explored HT-VP2-466-based chimeric capsids initially using enhanced green fluorescent protein (EGFP). The VLP assembly yield was efficient when we coexpressed EGFP-HT-VP2-466 and HT-VP2-466 from two recombinant baculoviruses. The native EGFP structure (~240 copies/virion) was successfully inserted in a functional form, as VLPs were fluorescent, and three-dimensional cryo-electron microscopy showed that the EGFP molecules incorporated at the inner capsid surface. Immunization of mice with purified EGFP-VLPs elicited anti-EGFP antibodies. We also inserted hemagglutinin (HA) and matrix (M2) protein epitopes derived from the mouse-adapted A/PR/8/34 influenza virus and engineered several HA- and M2-derived chimeric capsids. Mice immunized with VLPs containing the HA stalk, an M2 fragment, or both antigens developed full protection against viral challenge. IMPORTANCE: Virus-like particles (VLPs) are multimeric protein cages that mimic the infectious virus capsid and are potential candidates as nonliving vaccines that induce long-lasting protection. Chimeric VLPs can display or include foreign antigens, which could be a conserved epitope to elicit broadly neutralizing antibodies or several variable epitopes effective against a large number of viral strains. We report the biochemical, structural, and immunological characterization of chimeric VLPs derived from infectious bursal disease virus (IBDV), an important poultry pathogen. To test the potential of IBDV VLPs as a vaccine vehicle, we used the enhanced green fluorescent protein and two fragments derived from the hemagglutinin and the M2 matrix protein of the human murine-adapted influenza virus. The IBDV capsid protein fused to influenza virus peptides formed assemblies able to protect mice against viral challenge. Our studies establish the basis for a new generation of multivalent IBDV-based vaccines.

Ordered mesoporous carbons obtained by a simple soft template method as sulfur immobilizers for lithium-sulfur cells.

Carbon materials with ordered mesoporous structures were synthesized using soft template methods and then activated by CO2 treatment. Sulfur was incorporated in these carbons via a simple chemical deposition method in aqueous solutions and the resulting composites were tested as electrodes in Li-S cells. The electrochemical results showed that well-ordered mesoporous carbons perform better than those with a random mesopore arrangement (wormhole-like mesoporous structure). The mesopore ordering yields a framework of well-connected empty sites that results in an enhancement of both the charge carrier mobility and the reversibility of the electrochemical reaction. Although the activation with CO2 partially destroys the mesopore arrangement, which adversely affects the electrode performance, it notably increases the surface area and the micropore content which improves the connectivity between the mesopores. The final observation was an irrelevant effect of the activation process at low current densities. However, at higher rates the activated carbon composite delivered higher capacities. The hierarchical pore structure formed by micro- and mesopores should guarantee the required fast mobility of the Li(+).

African swine fever virus serodiagnosis: a general review with a focus on the analyses of African serum samples.

African swine fever (ASF) is an infectious disease that causes heavy mortality in domestic pigs. At present there is no vaccine against ASF, and eradication in countries where the disease is endemic is based only on competent diagnosis programs and the sacrifice of infected animals. Due to the presence of natural attenuated strains, certain infection conditions may result in reduced mortality. In these situations, the disease can be diagnosed by detection of specific antibodies. The use of classical and validated diagnosis assays, such as ELISA and Indirect Immunofluorescence or Immunoblotting, allowed the eradication of ASF in the Iberian Peninsula in the 1990s. However, given that conventional tests include the use of antigens obtained from ASF virus (ASFV)-infected cells, they have several disadvantages, such as difficulties to achieve standardization and also the risks associated with the manipulation of live virus. Such drawbacks have led to the development of alternative and more robust systems for the production of ASFV antigens for use in anti-ASFV antibody detection systems. In the present review, we provide an update on current knowledge about antigen targets for ASFV serodiagnosis, the significant progress made in recombinant antigen production, and the refinement of ASF serological diagnostic assays. Moreover, we describe the accuracy of an ELISA developed for the serodiagnosis of ASFV in Africa. This assay is based on a novel p30 recombinant protein (p30r) obtained from an Eastern African viral isolate (Morara strain), which shares 100% amino acid sequence identity with the Georgia virus isolate. That study included the analyses of 587 field sera collected from domestic pigs and warthogs in Senegal (West Africa), the Democratic Republic of Congo (Central Africa), Mozambique (South-East Africa), and South Africa. The results revealed that the novel p30r-based ELISA allows the accurate detection of antibodies against ASFV, independently of the geographical origin of the sera.

B epitope multiplicity and B/T epitope orientation influence immunogenicity of foot-and-mouth disease peptide vaccines.

Synthetic peptides incorporating protective B- and T-cell epitopes are candidates for new safer foot-and-mouth disease (FMD) vaccines. We have reported that dendrimeric peptides including four copies of a B-cell epitope (VP1 136 to 154) linked to a T-cell epitope (3A 21 to 35) of FMD virus (FMDV) elicit potent B- and T-cell specific responses and confer protection to viral challenge, while juxtaposition of these epitopes in a linear peptide induces less efficient responses. To assess the relevance of B-cell epitope multivalency, dendrimers bearing two (B2T) or four (B4T) copies of the B-cell epitope from type O FMDV (a widespread circulating serotype) were tested in CD1 mice and showed that multivalency is advantageous over simple B-T-epitope juxtaposition, resulting in efficient induction of neutralizing antibodies and optimal release of IFN γ . Interestingly, the bivalent B2T construction elicited similar or even better B- and T-cell specific responses than tetravalent B4T. In addition, the presence of the T-cell epitope and its orientation were shown to be critical for the immunogenicity of the linear juxtaposed monovalent peptides analyzed in parallel. Taken together, our results provide useful insights for a more accurate design of FMD subunit vaccines.

[Ulcer caused by bites of spider. Report of a case]. / Ulcera provocada por picadura de araña. A propósito de un caso.

A case of ulcer of long evolution (more than one year), what happens is presented by different phases and treatment, its origin was caused by a spider bite.

Úlcera provocada por picadura de araña. A propósito de un caso / Ulcer caused by bites of spider. Purpous of a case

Se presenta un caso de úlcera de larga evolución (más de un año), que pasa por diferentes fases y tratamientos, Su origen fue provocado por una picadura de araña(AU)

A case of ulcer of long evolution (more than one year), what happens is presented by different phases and treatment, its origin was caused by a spider bite (AU)

Gomez-Lopez-Hernandez syndrome: two new cases and review of the literature.

Gomez-Lopez-Hernandez syndrome, or cerebellotrigeminal-dermal dysplasia, is a rare neurocutaneous syndrome of trigeminal anesthesia, scalp alopecia and cerebellar anomalies. Other features include craniosynostosis, short stature, hypertelorism, down-slanting palpebral fissures, corneal opacities, mediofacial hypoplasia, and turri-brachycephaly. There have been 19 cases documented to date and we report on two additional male patients, 1 and 6 years of age, with typical features, mild mental retardation and dyspraxia. In both cases, MRI findings included rhombencephalosynapsis, a constant neuroimaging feature in this syndrome, comprising fusion of the cerebellar hemispheres with agenesis of the cerebellar vermis. Based on literature and our experience, we propose the presence of trigeminal anesthesia and/or partial alopecia of the scalp to complete the diagnosis of the syndrome.

Coronary involvement in infants with Kawasaki disease treated with intravenous gamma-globulin.

AIM: To analyze the clinical spectrum and the incidence of coronary involvement in infants with typical Kawasaki's disease (KD). PATIENTS AND METHODS: A retrospective study was performed on children one year of age or younger diagnosed from February 1992 to January 2006 with typical KD. Children with incomplete forms of the disease were not included. RESULTS: Twenty-five infants were diagnosed with KD during the study period. The median age of the patients was 10 months (range, 4-12 months). All children but one received intravenous gammaglobulin (IVIG), 84% before the 10th day of disease. Seven patients (28%) required the administration of more than one dose of IVIG, because persistence of fever. Coronary artery disease (CAD) was recorded in 6 cases (24%), five of them being boys. All patients with CAD were treated with ASA plus IVIG and 84% of them received this therapy within the first 10 days of the KD onset. CONCLUSIONS: In spite of the exclusion of our study of incomplete presentations and of an early administration of IVIG in our patients, we have observed a high rate of infants who developed CAD, which is similar to the one reported in children who do not receive IVIG.

Fatiga postural: centrada en la espalda del personal de enfermería de las unidades de medicina interna / No disponible

Objetivo: Conocer el grado de carga postural (centrada principalmente en la espalda) que se deriva de los cuidados de enfermería habituales en las unidades de Medicina Interna. Material y Método: La determinación del grado de carga postural se ha realizado mediante la aplicación del método REBA a las principales posturas de trabajo que se adoptan en las labores de enfermería. En cuatro posturas: posición de traslado de cama a silla, posición de sondaje vesical, posición de traslado de suelo a cama- personal a los pies, posición de traslado de suelo a cama-personal a los hombros, el nivel de riesgo fue Muy alto (nivel de acción 4), con un requerimiento de actuación de carácter inmediato. Dos posturas: posición de repartir/colocar bandejas del carro de comidas y posición de extracción de analítica con paciente colaborador obtuvieron una valoración de nivel de riesgo Alto (nivel de acción 3), con un requerimiento de intervención rápida. Las posturas de: posición de curar y posición de alimentar vía oral a paciente encamado (personal de pie) fueron evaluadas con un nivel de riesgo Medio (nivel de acción 2) con un requerimiento de intervención necesaria

Objective: To know the postural load degree (focus mainly in back) related with the usual health care activities of nurses in a hospital plant of Internal Medicine. Material and Method: The postural load degree has been assessed by means the REBA method, analysing the main working postures adopted by nurses staff. In four working postures: "transferring patient from the bed to chair", "vesical drilling", "transferring patient form ground to bed personnel at patient's feet" and "transferring patient from ground to bed personnel at patient's shoulders", the risk level was very high (level of action 4), with a immediate requirement of performance. Two postures: "distribute to place trays on the meals-car" and "blood extraction with collaborating patient" obtained a High risk score (level of action 3), with a requirement of fast intervention. The postures: "cure on bed" and "oral feed bedridden patient", were evaluated with a level of moderate risk (level of action 2) with a requirement of intervention neccesary