Evolución de los casos de tosferina tras la vacunación de la embarazada y la pandemia COVID-19 / Effect of pertussis vaccine in pregnancy and COVID-19 pandemic in the cases of wooping cough

Introducción: La tosferina ha aumentado su incidencia y severidad especialmente en lactantes, por lo que la vacunación de la embarazada se ha introducido como estrategia preventiva. La pandemia de la COVID-19 parece haber disminuido la incidencia de distintas enfermedades respiratorias. Métodos: Estudio retrospectivo entre 2012-2021, analizando la influencia de la vacunación de la embarazada y del primer año de la pandemia de la COVID-19 en los casos de tosferina. Resultados: Se incluyeron 960 pacientes de atención primaria y hospitalaria con sospecha de tosferina, con 130 casos diagnosticados (104 niños y 26 adultos). En el periodo posvacunal, se observó una disminución de casos y de severidad de la tosferina en niños menores de 6 meses y de los diagnósticos en mujeres adultas. No se detectó ningún paciente con tosferina durante el periodo de la COVID-19. Conclusión: Tanto la vacunación de la embarazada como el primer año de la pandemia de la COVID-19 han disminuido significativamente los casos de tosferina.(AU)

Background: Whooping cough has had an increased incidence and severity specially in infants and maternal immunization has been implemented as a prevention strategy. COVID-19 pandemic seems to decrease the incidence of other respiratory diseases. Methods: Retrospective study from 2012 to 2021 to assess the influence of pertussis maternal immunizations and the first year of COVID-19 pandemic in the cases of whooping cough. Results: 960 suspected cases from primary care and hospital, with 130 cases (104 children and 26 adults) being diagnosed of whooping cough. In the post-vaccination period, a reduction in the cases and severity in infants up to 6 months old was observed as well as in the pertussis diagnosis in adult women. There were no whooping cough cases during the COVID-19 period. Conclusions: Both the pertussis vaccination in pregnancy and the first year of the COVID-19 pandemic have decreased the number of pertussis cases.(AU)

Effect of pertussis vaccine in pregnancy and COVID-19 pandemic in the cases of wooping cough.

BACKGROUND: Whooping cough has had an increased incidence and severity specially in infants and maternal immunization has been implemented as a prevention strategy. COVID-19 pandemic seems to decrease the incidence of other respiratory diseases. METHODS: Retrospective study from 2012 to 2021 to assess the influence of pertussis maternal immunizations and the first year of COVID-19 pandemic in the cases of whooping cough. RESULTS: 960 suspected cases from primary care and hospital, with 130 cases (104 children and 26 adults) being diagnosed of whooping cough. In the post-vaccination period, a reduction in the cases and severity in infants up to 6 months old was observed as well as in the pertussis diagnosis in adult women. There were no whooping cough cases during the COVID-19 period. CONCLUSIONS: Both the pertussis vaccination in pregnancy and the first year of the COVID-19 pandemic have decreased the number of pertussis cases.

Effect of Brief Produce Exposure and Unconstrained Grocery Gift Cards on Caregiver Influence on Diet of Elementary Age Children: A Randomized Clinical Trial.

Importance: Children's diets affect health trajectories but are difficult to influence, especially for resource-constrained families. Objective: To assess the effectiveness of providing 4 weeks of grocery gift cards and small produce boxes to caregivers on their ability to support healthy shifts in children's diets. Design, Setting, and Participants: This 2-group randomized clinical trial was conducted from May to July 2021, with 4 weeks of intervention and follow-up at 8 weeks. Resources were provided curbside at 3 schools, 3 housing sites, and 1 after-school site for use at home. Participants consisted of 1 index child ages 5 to 11 years with 1 index caregiver from 68 low-income families. Data were analyzed from July 2021 through March 2022. Interventions: During each week for 4 weeks, caregivers were offered 10-lb (4.5 kg) boxes of fruits and vegetables, $10.00 grocery gift cards, an additional $10.00 gift card over the last 3 weeks triggered by a task completion, and a 1-time choice of a $25.00 food preparation tool. Main Outcomes and Measures: Index child and caregiver diets were measured together over the phone at baseline, 4 weeks, and 8 weeks using the 2019 to 2020 Texas School Physical Activity and Nutrition (SPAN) tool, which measures the number of times food items were eaten over the prior day to report a SPAN Healthy Eating Index (SHEI) score and subscores for specific categories of foods (range, 0-57, with higher scores indicating a more healthful diet). Results: Among 68 children (mean [SD] age, 8.2 [1.7] years; 35 [51.5%] girls) and caregivers (mean [SD] age, 37.9 [7.9] years; 63 mothers [92.6%]) from primarily low-income families, 26 caregivers were Hispanic or Latino (38.2%), while 18 caregivers were Black (26.4%), 25 caregivers were White (36.7%), and 24 caregivers had more than 1 race (35.3%). Most families were below the federal poverty level (41 of 60 families that reported income [68.3%]). Per participating caregiver, a mean (SD) 2.7 [1.4] fruit and vegetable boxes and $42.35 ($25.46) worth of gift cards were picked up over 4 weeks. Mean (SE) child SPAN SHEI increased from 32.03 (0.62) times/d to 33.75 (0.69) times/d at 4 weeks (ie, postintervention) and 34.03 (0.69) times/d 4 weeks later (ie, at 8 weeks of follow-up). Mean (SE) child fruit and vegetable intake increased from 5.31 (0.47) times/d to 5.78 (0.51) times/d postintervention and 6.03 (0.51) times/d at follow-up. Children in the control group did not have improved diet (overall mean [SE] SHEI: 31.48 [0.58] times/d at baseline, 31.68 [0.54] times/d postintervention, and 31.81 [0.52] times/d at follow-up; mean [SE] fruit and vegetable intake: 5.21 [0.45] times/d at baseline, 4.77 [0.45] times/d postintervention, and 4.68 [0.41] times/d at follow-up). Compared with children in the control group, mean SHEI was increased for children in the intervention group by 2.07 times/d postintervention and 2.23 times/d at follow-up. Improvements as a function of program dose were statistically significant for child SHEI (P = .01) and fruit and vegetable intake (P = .03). No significant changes in caregiver diets were found. Conclusions and Relevance: This study found that easily accessed fruits and vegetables and unconstrained grocery store cards provided directly to caregivers over 4 weeks resulted in improvements in child diet, which were sustained over 4 additional weeks. Future work may investigate whether diet improvement from a brief intervention optimized for caregiver flexibility reflects a natural maximum or potential for greater improvements on extension. Trial Registration: ClinicalTrials.gov Identifier: NCT04827654.

[Effect of pertussis vaccine in pregnancy and COVID-19 pandemic in the cases of wooping cough]. / Evolución de los casos de tosferina tras la vacunación de la embarazada y la pandemia COVID-19.

Background: Whooping cough has had an increased incidence and severity specially in infants and maternal immunization has been implemented as a prevention strategy. COVID-19 pandemic seems to decrease the incidence of other respiratory diseases. Methods: Retrospective study from 2012 to 2021 to assess the influence of pertussis maternal immunizations and the first year of COVID-19 pandemic in the cases of whooping cough. Results: 960 suspected cases from primary care and hospital, with 130 cases (104 children and 26 adults) being diagnosed of whooping cough. In the post-vaccination period, a reduction in the cases and severity in infants up to 6 months old was observed as well as in the pertussis diagnosis in adult women. There were no whooping cough cases during the COVID-19 period. Conclusions: Both the pertussis vaccination in pregnancy and the first year of the COVID-19 pandemic have decreased the number of pertussis cases.

Effect of Layperson-Delivered, Empathy-Focused Program of Telephone Calls on Loneliness, Depression, and Anxiety Among Adults During the COVID-19 Pandemic: A Randomized Clinical Trial.

Importance: Loneliness is a risk factor for many clinical conditions, but there are few effective interventions deployable at scale. Objective: To determine whether a layperson-delivered, empathy-focused program of telephone calls could rapidly improve loneliness, depression, and anxiety in at-risk adults. Design, Setting, and Participants: From July 6 to September 24, 2020, we recruited and followed up 240 adults who were assigned to receive calls (intervention group) or no calls (control group) via block randomization. Loneliness, depression, and anxiety were measured using validated scales at enrollment and after 4 weeks. Intention-to-treat analyses were conducted. Meals on Wheels Central Texas (MOWCTX) clients received calls in their homes or wherever they might have been when the call was received. The study included MOWCTX clients who fit their service criteria, including being homebound and expressing a need for food. A total of 296 participants were screened, of whom 240 were randomized to intervention or control. Interventions: Sixteen callers, aged 17 to 23 years, were briefly trained in empathetic conversational techniques. Each called 6 to 9 participants over 4 weeks daily for the first 5 days, after which clients could choose to drop down to fewer calls but no less than 2 calls a week. Main Outcomes and Measures: Primary outcome was loneliness (3-item UCLA Loneliness Scale, range 3-9; and 6-item De Jong Giervald Loneliness [De Jong] Scale, range 0-6). Secondary outcomes were depression (Personal Health Questionnaire for Depression), anxiety (Generalized Anxiety Disorder scale), and self-rated health (Short Form Health Survey Questionnaire). Results: The 240 participants were aged 27 to 101 years, with 63% aged at least 65 years (n = 149 of 232), 56% living alone (n = 135 of 240), 79% women (n = 190 of 240), 39% Black or African American (n = 94 of 240), and 22% Hispanic or Latino (n = 52 of 240), and all reported at least 1 chronic condition. Of 240 participants enrolled, 13 were lost to follow-up in the intervention arm and 1 in the control arm. Postassessment differences between intervention and control after 4 weeks showed an improvement of 1.1 on the UCLA Loneliness Scale (95% CI, 0.5-1.7; P < .001; Cohen d of 0.48), and improvement of 0.32 on De Jong (95% CI, -0.20 to 0.81; P = .06; Cohen d, 0.17) for loneliness; an improvement of 1.5 on the Personal Health Questionnaire for Depression (95% CI, 0.22-2.7; P < .001; Cohen d, 0.31) for depression; and an improvement of 1.8 on the Generalized Anxiety Disorder scale (95% CI, 0.44 to 3.2; P < .001; Cohen d, 0.35) for anxiety. General physical health on the Short Form Health Questionnaire Survey showed no change, but mental health improved by 2.6 (95% CI, 0.81 to 4.4; P = .003; Cohen d of 0.46). Conclusions and Relevance: A layperson-delivered, empathy-oriented telephone call program reduced loneliness, depression, and anxiety compared with the control group and improved the general mental health of participants within 4 weeks. Future research can determine whether effects on depression and anxiety can be extended to maximize clinical relevance. Trial Registration: ClinicalTrials.gov Identifier: NCT04595708.

Comparison of two different ways to apply a circular plaster cast for distal radius fractures: biomechanical study.

INTRODUCTION: Although conservative treatment with circular plaster cast is the most commonly used method in distal radius fractures, the best method to apply it remains unclear. MATERIAL AND METHODS: Two frequently used configurations of circular plaster cast (with and without a splint) were selected to compare. Group C was applied only with circular bandages (three units) and group S with a splint (one unit) and over it, a circular bandage (two units). Both configurations had the same weight. Five prototypes of each group were built and mechanically tested. Three-point flexural tensile strength and maximum deflection were measured and compared. RESULTS: The previously splinted prototypes (group S) obtained higher tensile strength with the same weight (p < 0.05). DISCUSSION: No other study regarding strength and configuration of circular casts for distal radius fractures immobilization has been previously published, leading to a high variability in construction among orthopedic surgeons. Data confirms that applying a splint before circular bandage offers more mechanical resistance to the cast in flexion, with the same weight. CONCLUSION: Applying a splint before circular bandage for plaster casts used for distal radius fractures make them more resistant to usual forces.

Fibrosis Quística: tratamiento actual y avances con la nanotecnología / Cystic Fibrosis: actual treatment and future perspectives with nanotechnology

INTRODUCCIÓN: Actualmente, los tratamientos existentes para tratar la fibrosis quística (FQ) están diseñados para controlar sus síntomas, consistentes principalmente en retención de moco e infección crónica. Se propone la vía pulmonar como alternativa para la administración de los fármacos, principalmente antimicrobianos. Sin embargo, su rápido aclaramiento, que conduce a niveles bajos de fármaco e incremento de los regímenes posológicos, así como la aparición de efectos adversos, hacen de la nanotecnología una estrategia interesante para esta enfermedad. OBJETIVO: estudiar y analizar los diferentes sistemas nanoparticulares existentes para su uso por vía pulmonar, concretando en el uso de sistemas lipídicos para el tratamiento de la FQ. MÉTODO: se realizó una búsqueda no sistemática de artículos en diferentes bases de datos, en los últimos 10 años principalmente, siguiendo pautas establecidas de palabras clave. RESULTADOS: Los progresos que se han conseguido en los últimos años hacen que la FQ pase a ser una enfermedad de adultos. Los tratamientos que se están usando en la actualidad están siendo cada vez más desplazados por otras alternativas, como los sistemas nanoparticulares, siendo idóneos para la administración pulmonar debido a su pequeño tamaño, su liberación sostenida y su elevada biocompatibilidad. Entre éstos, destacan los liposomas por su similitud estructural con el surfactante pulmonar, así como por su capacidad de destruir las biopelículas bacterianas. La mayoría de las formulaciones encontradas contenían un solo fármaco. CONCLUSIÓN: Existen evidencias científicas que indican que la investigación debe dirigirse hacia el desarrollo de formulaciones que sean capaces de destruir la biopelícula

INTRODUCTION: Currently, the management of treatments in cystic fibrosis (CF) is mainly focused to control symptoms, which consist of mucus retention and chronic infection. The pulmonary route is proposed as an interesting alternative for administering drugs, especially antimicrobials. However, the rapid clearance of these, which leads to low drug levels and increased dosage regimens, as well as the appearance of adverse effects, make nanotechnology an interesting strategy for this disease. OBJECTIVE: to study and analyze the different nanoparticulate systems available for use via the lung, specifying the use of lipid systems for the treatment of CF. Method: a non-systematic search of articles in different databases was carried out, mainly in the last 10 years, following established guidelines for selecting keywords. RESULTS: the progress in recent years makes CF become an adult disease. Current treatments are increasingly being displaced by other alternatives, such as nanoparticular systems, being suitable for pulmonary administration due to their small size, sustained release and high biocompatibility. Among these, liposomes stand out for their structural similarity to lung surfactant, as well as for their ability to destroy bacterial biofilms. Most of the formulations contained a single drug. CONCLUSIONS: Scientific literature evidenced that research studies should be directed towards the development of formulations that are intended to destroy the biofilm

[The technological tools of the diagnosis and treatment of attention deficit disorder and hyperactivity]. / Herramientas tecnológicas del diagnóstico y tratamiento del trastorno por déficit de atención e hiperactividad.

Attention deficit disorder and hyperactivity (ADHD) is the main reason for consultation in most Pediatric Neurology units in Spain. The new technologies also associate benefits for both patients and professionals and the health system itself, which makes its rational implementation essential. Genetics, neuroimaging or virtual reality, for example, are clear exponents of the results that can be achieved by optimizing traditional processes. The different technologies that we collect in this article are fully operational and have thousands of experience in patients. The incorporation of them to the usual clinical practice is in our hands.

El trastorno por déficit de atención e hiperactividad (TDAH) es el principal motivo de consulta en la mayoría de las unidades de Neurología Pediátrica en España. Las nuevas tecnologías asocian además beneficios tanto para los pacientes como para los profesionales y el propio sistema sanitario. Se hace imprescindible su implementación racional. La genética, la neuroimagen o la realidad virtual por ejemplo, son claros exponentes de los resultados que se pueden conseguir al optimizar los procesos tradicionales. Las diferentes tecnologías que recogemos en este artículo están completamente operativas y cuentan con miles de pacientes de experiencia. La incorporación de las mismas a la práctica clínica habitual está en nuestras manos.

Herramientas tecnológicas del diagnóstico y tratamiento del trastorno por déficit de atención e hiperactividad / The technological tools of the diagnosis and treatment of attention deficit disorder and hyperactivity

El trastorno por déficit de atención e hiperactividad (TDAH) es el principal motivo de consulta en la mayoría de las unidades de Neurología Pediátrica en España. Las nuevas tecnologías asocian además beneficios tanto para los pacientes como para los profesionales y el propio sistema sanitario. Se hace imprescindible su implementación racional. La genética, la neuroimagen o la realidad virtual por ejemplo, son claros exponentes de los resultados que se pueden conseguir al optimizar los procesos tradicionales. Las diferentes tecnologías que recogemos en este artículo están completamente operativas y cuentan con miles de pacientes de experiencia. La incorporación de las mismas a la práctica clínica habitual está en nuestras manos.

Attention deficit disorder and hyperactivity (ADHD) is the main reason for consultation in most Pediatric Neurology units in Spain. The new technologies also associate benefits for both patients and professionals and the health system itself, which makes its rational implementation essential. Genetics, neuroimaging or virtual reality, for example, are clear exponents of the results that can be achieved by optimizing traditional processes. The different technologies that we collect in this article are fully operational and have thousands of experience in patients. The incorporation of them to the usual clinical practice is in our hands.

Home Albumin Infusion Therapy, Another Alternative Treatment in Patients With Congenital Nephrotic Syndrome of the Finnish Type.

Background: Congenital nephrotic syndrome of the Finnish type (CNF) is a rare, severe glomerular disease caused by mutations in the NPHS1 gene, which codes for nephrin. It is characterised by massive proteinuria and severe edoema. Progression to end-stage kidney failure occurs during early childhood and the only curative treatment is kidney transplantation. Nowadays, patients need aggressive medical treatment, which includes daily albumin infusions (for months) until they get clinical stability to receive transplant. Objective: In our paediatric hospital, we implemented a multidisciplinary program for the home infusion of albumin with outpatient follow-up. The aim of the study was to assess the safety and efficacy of this program for the first four years of its implementation. Material and Methods: Retrospective observational study of CNF paediatric patients treated with home albumin infusion therapy from March 2014 to July 2018 at a tertiary care paediatric hospital. Information on albumin administration was obtained from the electronic prescription assistance program and details on clinical and care-related variables from the hospital's electronic information systems. Results: Four patients with CNF received albumin infusions for 18, 21, 22 months, and 3 years. The treatment was safe, and the complication rates were to be expected considering the severity of disease. Patients required a median of two hospital admissions a year (19 in total); 47% due to catheter-related complications, but there were just three catheter infections. Conclusions: In our experience, home albumin infusion therapy is safe and effective and helps to improve children health and quality of life.

Eficacia de un plan de cuidados de enfermería específico para el paciente con delirio / Effectiveness of a Specific Nursing Care Plan for the Patient with Delirium

RESUMEN Introducción: El síndrome confusional agudo o delirio es un trastorno psiquiátrico severo frecuente en pacientes mayores ingresados, tiende a agravarse en las horas del final de la tarde y nocturnas, con un gran impacto en los cuidados nocturnos. Objetivos: Evaluar la eficacia de los cuidados de enfermería específicos ante el delirio nocturno en pacientes hospitalizados. Métodos: Ensayo clínico cuasi-experimental en dos unidades de hospitalización de Medicina Interna de un hospital de alta complejidad. Se identificaron un grupo control y un grupo experimental, mediante muestreo de conveniencia. En ambos grupos, se seleccionaron pacientes con delirio, mediante la escala validada Intensive Care Delirium Screening Checklist. Se expuso al grupo experimental a plan de cuidados específico basado en bibliografía y plan de cuidados estándar al grupo control. Sobre resultados de indicadores de delirio, pre y posaplicación de planes de cuidados en ambos grupos, se realizaron pruebas de contraste (ANOVA, t-Student y Chi2-test de Fisher). Resultados: Con incidencia de 12-15 por ciento, los grupos control y experimental mostraron resultados homogéneos en el test del delirio PRE (p > 0,05). La edad, motivo de ingreso, género, y número de interrupciones durante el sueño, no mostraron repercusión sobre los resultados de delirio. Tras la aplicación de los planes de cuidados, el grupo experimental mostró reducción significativa de los índices de delirio (p < 0,05), y no se obtuvieron cambios significativos en el grupo control (p > 0,05). Conclusiones: El plan de cuidados específico a pacientes con delirio demostró ser eficaz al mejorar los indicadores del test de delirio y evitar el empeoramiento del cuadro(AU)

ABSTRACT Introduction: Acute confusional syndrome or delirium is a severe psychiatric disorder of frequent presentation in hospitalized elderly patients. It worsens likely in the late afternoon and evening hours, with a great impact on night care. Objectives: To evaluate the effectiveness of specific nursing care for sundown delirium in hospitalized patients. Methods: Quasi-experimental clinical trial in two hospitalization units of internal medicine of a high-complexity hospital. A control group and an experimental group were identified by convenience sampling. In both groups, patients with delirium were selected, using the validated scale Intensive Care Delirium Screening Checklist. The experimental group was exposed to a specific care plan, considering the bibliography; and the control group was exposed to a standard care plan. Regarding the results of delirium indicators, before and after the application of the care plans in both groups, contrast tests were performed (ANOVA, t-Student and Fisher's Chi-square test). Results: With an incidence of 12-15 percent, the control and experimental groups showed homogeneous results in the delirium test PRE (p >0.05). Age, reason for admission, gender, and number of interruptions during sleep did not show repercussion on delirium results. After the application of the care plans, the experimental group showed a significant reduction in delirium rates (p < 0.05), and no significant changes were obtained in the control group (p >0.05). Conclusions: The specific care plan for patients with delirium was shown to be effective in improving the indicators of the delirium test and avoiding the worsening of the health status(AU)

The Effects of Parenteral K1 Administration in Pseudoxanthoma Elasticum Patients Versus Controls. A Pilot Study.

INTRODUCTION: Pseudoxanthoma elasticum (PXE) is a rare disease caused by mutations in the ABCC6 gene. Vitamin K1 is involved in the posttranslational carboxylation of some proteins related to inhibition of the calcification process. Our aim was to investigate, in patients affected by PXE, baseline levels of vitamin K1-dependent proteins and -metabolites and whether parenteral administration of phytomenadione was effective in modulating their levels. METHODS: We included eight PXE patients with typical clinical symptoms (skin, retina, and vascular calcification) and two ABCC6 causative mutations; 13 clinically unaffected first-degree patients' relatives (9 carrying one ABCC6 mutation and 4 non-carriers). We assessed urinary vitamin K1 metabolites and serum Glu- and Gla-OC, Gas6 and undercaboxylated prothrombin (PIVKA-II), at baseline and after 1 and 6 weeks after a single intramuscular injection of 10 mg vitamin K1. RESULTS: Comparison of PXE patients, heterozygous, and non-carriers revealed differences in baseline levels of serum MK-4 and of urinary vitamin K metabolites. The response to phytomenadione administration on vitamin K-dependent proteins was similar in all groups. CONCLUSION: The physiological axis between vitamin K1 and vitamin K-dependent proteins is preserved; however, differences in the concentration of vitamin K metabolites and of MK-4 suggest that vitamin K1 metabolism/catabolism could be altered in PXE patients.

Double blind randomized clinical trial controlled by placebo with a fos enriched cookie on saciety and cardiovascular risk factors in obese patients.

INTRODUCTION: It is essential to determine which snack foods are most affective for appetite control. The objective of the current study was to assess the responses of two different cookies on satiety and cardiovascular risk factors. MATERIAL AND METHODS: 38 patients were randomized: group I (FOS enriched cookie, n=19) and group II (control cookie, n=19). Previous and after 1 month , the subjects rated their feelings of satiety/hunger with a test meal of 5 cookies. RESULTS: After the test meal, the basal area under curve of the first hunger/satiety score was higher with satiety cookie than with control cookie, the data after 1 month of treatment was higher with satiety cookie than with control cookie, too. The score was higher than the fasting level for 20 minutes with satiety cookie and for 40 minutes with the same cookie, too. In satiety group, these scores (20 min and 40 min) were higher than control group before and after 1 month of treatment. The results were in the same way with the 100 mm 5-point visual satiety scale. Cardiovascular risk factors and dietary intake remained unchanged after dietary intervention. CONCLUSION: A FOS enriched cookie produced greater ratings of satiety than a control cookie, without effects on cardiovascular risk factors or dietary intakes.

Introducción: Es importante evaluar el papel de los alimentos tipo «snacks¼ sobre el apetito. El objetivo de este trabajo fue evaluar la respuesta en términos de saciedad y el efecto sobre factores de riesgo cardiovascular de dos galletas diferentes. Material y Métodos: Se randomizaron 38 pacientes: grupo I (galleta enriquecida en FOS, n=19) y grupo II (galleta control, n=19). Antes de la intervención nutricional y tras un mes, a los pacientes se les valoró la saciedad con un test de prueba con 5 galletas. Resultados: Tras el test de prueba, el area bajo la curva del test de saciedad fue mayor con la galleta saciante que con la galleta control, detectándose el mismo resultado con el test trás 1 mes de ingerir las galletas. Analizando los diferentes tiempos, el score de saciedad mostró una puntuación superior en los tiempos 20 y 40 minutos frente al valor basal (tiempo 0) tras la ingesta de la galleta saciante, comparado con la galleta control. Los valores de saciedad en los tiempos (20 minutos y 40 minutos) fueron superiores que los que presentó la galleta control. Este resultado fue similar, al realizar el test tras 1 mes tomando la galleta saciante. Los resultados fueron similares al utilizar una escala visual de saciedad de 100 mm con 5 cuestiones. No se detectaron efectos sobre los factores de riesgo cardiovascular tras la intervención nutricional, ni sobre la ingesta dietética global. Conclusion: La galleta enriquecida en FOS produce mayores niveles de saciedad que la galleta control. Sin embargo no existieron efectos sobre los factores de riesgo cardiovascular ni la ingesta dietética global.

Double blind randomized clinical trial controlled by placebo with a FOSenriched cookie on saciety and cardiovascular risk factors in obese patients / Ensayo clínico randomizado controlado con placebo de una galleta enriquecida en FOS, efecto sobre la saciedad y factores de riesgo cardiovascular en pacientes obesos

Introduction: It is essential to determine which snack foods are most affective for appetite control. The objective of the current study was to assess the responses of two different cookies on satiety and cardiovascular risk factors. Material and Methods: 38 patients were randomized: group I (FOS enriched cookie, n=19) and group II (control cookie, n=19). Previous and after 1 month , the subjects rated their feelings of satiety/hunger with a test meal of 5 cookies. Results: After the test meal, the basal area under curve of the first hunger/satiety score was higher with satiety cookie than with control cookie, the data after 1 month of treatment was higher with satiety cookie than with control cookie, too. The score was higher than the fasting level for 20 minutes with satiety cookie and for 40 minutes with the same cookie, too. In satiety group, these scores (20 min and 40 min) were higher than control group before and after 1 month of treatment. The results were in the same way with the 100 mm 5-point visual satiety scale. Cardiovascular risk factors and dietary intake remained unchanged after dietary intervention. Conclusion: A FOS enriched cookie produced greater ratings of satiety than a control cookie, without effects on cardiovascular risk factors or dietary intakes (AU)

Introducción: Es importante evaluar el papel de los alimentos tipo "snacks" sobre el apetito. El objetivo de este trabajo fue evaluar la respuesta en términos de saciedad y el efecto sobre factores de riesgo cardiovascular de dos galletas diferentes. Material y Métodos: Se randomizaron 38 pacientes: grupo I (galleta enriquecida en FOS, n=19) y grupo II (galleta control, n=19). Antes de la intervención nutricional y tras un mes, a los pacientes se les valoró la saciedad con un test de prueba con 5 galletas. Resultados: Tras el test de prueba, el área bajo la curva del test de saciedad fue mayor con la galleta saciante que con la galleta control, detectándose el mismo resultado con el test trás 1 mes de ingerir las galletas. Analizando los diferentes tiempos, el score de saciedad mostró una puntuación superior en los tiempos 20 y 40 minutos frente al valor basal (tiempo 0) tras la ingesta de la galleta saciante, comparado con la galleta control. Los valores de saciedad en los tiempos (20 minutos y 40 minutos) fueron superiores que los que presentó la galleta control. Este resultado fue similar, al realizar el test tras 1 mes tomando la galleta saciante. Los resultados fueron similares al utilizar una escala visual de saciedad de 100 mm con 5 cuestiones. No se detectaron efectos sobre los factores de riesgo cardiovascular tras la intervención nutricional, ni sobre la ingesta dietética global. Conclusion: La galleta enriquecida en FOS produce mayores niveles de saciedad que la galleta control. Sin embargo no existieron efectos sobre los factores de riesgo cardiovascular ni la ingesta dietética global (AU)

Comparación biomecánica entre los sistemas convencionales y uni-lock en osteosíntesis del ángulo mandibular. Estudio fotoelástico / Biomechanical comparison of the conventional and uni-lock systems for mandibular osteosynthesis. A photoelastic study

Introducción. Las implicaciones biomecánicas de la interacción de las placas y tornillos de titanio con la mandíbula fracturada no son del todo conocidas. Los modelos matemáticos desarrollados hasta hoy en día muestran ciertas limitaciones, y los estudios experimentales han fracasado en reproducir las fuerzas musculares y la distribución de las tensiones internas en la interfaz entre mandíbula e implante. Material y métodos. En el presente estudio, empleamos un simulador estático del sistema musculo-esquelético masticatorio para demostrar en réplicas mandibulares de resina epoxi, por medio de la fotoelasticidad tridimensional, la distribución de tensiones que se produce en fracturas del cuerpo mandibular tras la aplicación de diferentes métodos de osteosíntesis. Resultados. Los resultados muestran que el simulador y la fotoelasticidad 3D son útiles para estudiar las interacciones entre el hueso y el material de osteosíntesis. Los sistemas «lock» o bloqueados reflejaron la distribución de tensiones más favorable en la mandíbula de resina epoxi fracturada. Conclusiones. La fotoelasticidad tridimensional en modelos de resina epoxi es un método útil para evaluar la distribución de tensiones en una estructura para estudios biomecánicos. En lo que se refiere a la osteosíntesis mandibular, las placas tipo «lock» mostraron ser las menos agresivas para el hueso(AU)

Introduction. The biomechanical effects of the interaction between titanium plates and screws and the fractured mandible are not well known. The mathematical models that have been developed to date show limitations and the experimental studies fail in reproducing muscle forces and internal stress distributions in the bone-implant interface with the mandibular structure. Material and methods. In the present study we use a static simulator of the masticatory system to show, in epoxy resin mandibular models, by means of 3D (three-dimensional) photoelasticity, the stress distribution using different osteosynthesis methods in mandibular body fractures. Results. The results showed that the simulator and 3D photoelasticity were useful for studying interactions between bone and osteosynthesis materials. The "Lock" system displayed the most favourable stress distribution in the epoxy resin mandible. Conclusions. 3D photoelasticity in epoxy resin models is a useful method to evaluate stress distribution for biomechanical studies. In terms of mandibular osteosynthesis, "lock" plates show the most favourable stress distribution due to being less aggressive to the bone(AU)

Biomechanical, histological and histomorphometric analyses of calcium phosphate cement compared to PMMA for vertebral augmentation in a validated animal model.

INTRODUCTION: Calcium phosphate cements (biocements) are alternative materials for use in vertebral augmentation procedures, and are a potential solution to problems associated with polymethylmethacrylate (PMMA) cements. The aim of this study is to demonstrate the utility of percutaneously injected biocements compared with PMMA in a validated animal model of osteoporosis. MATERIALS AND METHODS: Fortyseven augmentation procedures were performed on 11 osteoporotic sheep. 9 vertebrae were augmented with PMMA and 38 with a biocement. The animals were killed in four groups: at 7 days, 3 months, 6 months, and 1 year after intervention. Radiological study and TC of the pieces were obtained to evaluate for leakage, cement diffusion, and integration. In total, 26 biomechanic studies and 27 histomorphometry analyses were performed, included control vertebrae. RESULTS: In 20.9% of the vertebrae, the hole was empty at sacrifice. The pattern of fracture was heterogeneous, and cement augmentation did not increase vertebral strength or decrease vertebral stiffness compared to control vertebrae, with neither PMMA or biocement. The rate of remodeling of the biocement was not predictable. In the single majority, there is peripheral remodeling, staying the volume of injected biocement stable. CONCLUSIONS: Even though this animal model may not be useful to analyze the biomechanical pattern of treated vertebrae, it demonstrates that the percutaneous use of biocements in vertebral augmentation techniques is not predictable. This is one reason not to recommend its use presently as a substitute for PMMA in vertebral reinforcement procedures.

Representaciones y conceptualizaciones de la enfermedad oral en pacientes de la Clínica Odontológica Santa Mónica de la Escuela Colombiana de Medicina, 1994 / Bucal disease

Observando que la relación interpersonal odontólogo-paciente, no comprende totalmente los parámetros que lo convertirían en completamente eficiente, se desarrolló un estudio descriptivo cualitativo, con el fín de proveer conocimientos sobre un ser bio-psico-social. Se seleccionaron treinta (30) pacientes según edad y sexo, y se aplicaron entrevistas semiestructuradas, las cuales se analizaron horizontal y verticalmente. Se encontró que los pacientes poseen más una representación, expresada por medio de metáforas, que una conceptualización de la cavidad oral y su enfermedad