Cannabinoids induce cell death in leukaemic cells through Parthanatos and PARP-related metabolic disruptions.

BACKGROUND: Several studies have described a potential anti-tumour effect of cannabinoids (CNB). CNB receptor 2 (CB2) is mostly present in hematopoietic stem cells (HSC). The present study evaluates the anti-leukaemic effect of CNB. METHODS: Cell lines and primary cells from acute myeloid leukaemia (AML) patients were used and the effect of the CNB derivative WIN-55 was evaluated in vitro, ex vivo and in vivo. RESULTS: We demonstrate a potent antileukemic effect of WIN-55 which is abolished with CB antagonists. WIN-treated mice, xenografted with AML cells, had better survival as compared to vehicle or cytarabine. DNA damage-related genes were affected upon exposure to WIN. Co-incubation with the PARP inhibitor Olaparib prevented WIN-induced cell death, suggesting PARP-mediated apoptosis which was further confirmed with the translocation of AIF to the nucleus observed in WIN-treated cells. Nicotinamide prevented WIN-related apoptosis, indicating NAD+ depletion. Finally, WIN altered glycolytic enzymes levels as well as the activity of G6PDH. These effects are reversed through PARP1 inhibition. CONCLUSIONS: WIN-55 exerts an antileukemic effect through Parthanatos, leading to translocation of AIF to the nucleus and depletion of NAD+, which are reversed through PARP1 inhibition. It also induces metabolic disruptions. These effects are not observed in normal HSC.

Systemic Challenges in Internship Training for Health-Service Psychology: A Call to Action From Trainee Stakeholders.

The challenges observed in health service psychology (HSP) training during COVID-19 revealed systemic and philosophical issues that preexisted the pandemic, but became more visible during the global health crisis. In a position paper written by 23 trainees across different sites and training specializations, the authors use lessons learned from COVID-19 as a touchstone for a call to action in HSP training. Historically, trainee voices have been conspicuously absent from literature about clinical training. We describe longstanding dilemmas in HSP training that were exacerbated by the pandemic and will continue to require resolution after the pandemic has subsided. The authors make recommendations for systems-level changes that would advance equity and sustainability in HSP training. This article advances the conversation about HSP training by including the perspective of trainees as essential stakeholders.

Telomeres and oocyte maturation rate are not reduced by COVID-19 except in severe cases.

In brief: COVID-19 does not affect the telomeres or fertility outcomes in mild cases. However, in women with severe symptoms, telomeres of granulosa cells are shorter, and the oocyte maturation rate is decreased. Abstract: The coronavirus SARS-CoV-2 causes COVID-19 disease and affects primarily the lungs and also other organs, causing accelerated cell aging. One of the main pathways involved in aging is telomere attrition, which ultimately leads to defective tissue regeneration and organ dysfunction. Indeed, short telomeres in aged people aggravate the COVID-19 symptoms, and COVID-19 survivors showed shorter telomeres in blood cells. The SARS-CoV-2 has been detected in testis, but the ovaries, which express the viral entry factors, have not been fully explored. Our objective was to analyze telomeres and reproductive outcomes in women who had COVID-19 and controls. In this prospective cohort study, granulosa cells (GCs) and blood were collected from 65 women. Telomere length (TL) was measured by high-throughput in situ hybridization. Mean TL of GCs and peripheral blood mononuclear cells (PBMCs) was alike in control and mild cases. However, mean TL of GCs was lower in severe cases compared to controls (P = 0.017). Control and COVID groups had similar ovarian reserve and number of total oocytes after puncture. However, the oocyte maturation rate was lower in severe cases (P = 0.018). Interestingly, a positive correlation between the oocyte maturation rate and TL of GCs was found in the control group (P = 0.024). Our findings point to a potential impact of the coronavirus infection on telomeres and reproductive outcomes in severe cases. This might be considered upon possible new SARS-CoV threats, to favor treatments that enhance oocyte maturation in women severely affected by coronavirus undergoing ART.

RADIOPROTECTION SURVEILLANCE OF THE TJ-II OPERATION BY TLD.

The TJ-II stellarator presently in operation at the National Laboratory of Fusion is subject to radiological surveillance in compliance with the Spanish Nuclear Regulation. During its pulsed operation hard X-rays are emitted by the runaway electrons, and soft X-rays are generated by bremsstrahlung of thermalized electrons. Inside the experimental hall, the plasma heating systems and some active diagnostics are additional sources of radiation. Outside the experimental hall, some auxiliary systems, such as high-voltage power supplies, must be checked for radiological influence. In order to verify the adequate radiological classification of the different working areas, 15 dosemeters are distributed in radiologically controlled areas close to the machine, as well as in areas of public use in the TJ-II building. The integrated dose equivalent is analyzed to help establish the range of radiological influence of the stellarator. The results of the period 2015-20 are presented and analyzed.

A mild case of hemolytic disease of the fetus and newborn due to anti-Sc2.

We report the case of a newborn girl with jaundice due to increased indirect bilirubin with a positive direct antiglobulin test (DAT) and compensated hemolysis. The result of the newborn's DAT was discrepant with the negative result of the mother's indirect antiglobulin test. The multiparous mother had a previous history of fetal hydrops miscarriage, with no known cause, and no record of the cause was found at the hospital where she was treated. After referring samples from the mother and newborn to a reference laboratory, the rare alloanti-Sc2 was identified in the mother's plasma and in the newborn's eluate. HEA BeadChip genotyping of the newborn's DNA sample predicted the SC:1,2 phenotype.We report the case of a newborn girl with jaundice due to increased indirect bilirubin with a positive direct antiglobulin test (DAT) and compensated hemolysis. The result of the newborn's DAT was discrepant with the negative result of the mother's indirect antiglobulin test. The multiparous mother had a previous history of fetal hydrops miscarriage, with no known cause, and no record of the cause was found at the hospital where she was treated. After referring samples from the mother and newborn to a reference laboratory, the rare alloanti-Sc2 was identified in the mother's plasma and in the newborn's eluate. HEA BeadChip genotyping of the newborn's DNA sample predicted the SC:1,2 phenotype.

Fisheries interactions and the challenges for target and nontargeted take on shark conservation in the Mexican Pacific.

Sharks have been of great cultural and socioeconomic importance in Mexico since the late 19th century, when the first fisheries were prosecuted in the Gulf of California to export fins to China. Mexican shark and ray fisheries are classified mainly by the size of the fishing vessel and include small- (7.5-10m), medium- (10-27m), and large-sized (>27m) fisheries. All are multispecies fisheries that use longline or gillnet gear, with their relative productivity varying over time. Off the Pacific coast, early shark small size vessel fisheries in the Gulf of California were driven by the need for vitamin A from livers, especially during World War II. As this fishery declined, new shark fishing opportunities arose because of government support and the development of the medium-sized fishery, which was capable of farther offshore excursions. Shark meat became an important part of the diets of poor and impoverished citizens during the 1950s and 1960s. The establishment of a Mexican Exclusive Economic Zone in 1976 pushed foreign vessels from Asia out of Mexican waters and led to the development of the large-sized vessel fishery to exploit pelagic sharks in offshore waters. By the early 1980s, Mexico shark fisheries were among the most productive in the world; however, a national economic crisis reduced effort and landings until the late 1980s, when several new fisheries emerged. Landings from Pacific states fluctuated between ~13,000 and 24,000t (dressed weight) during 1987-2012 but expanded steadily thereafter because of government support and offshore fleet expansion. Shark fisheries landings from the Mexican Pacific are currently at their highest recorded levels, exceeding 31,000t; however, a lack of species-specific landings and life history information has precluded population assessments of targeted stocks. In addition, though several recent management measures have been enacted to protect Mexican shark and ray fishery resources, the enforcement of these regulations is severely lacking. Therefore, the long-term sustainability of current fishing levels is unknown but should engender concern based on anecdotal evidence of serial depletion among historical elasmobranch targets in the Mexican Pacific.

Incidencia de criterios de alarma y actitud frente a los pacientes con cefalea atendidos en urgencias / Incidence of alarm criteria and attitude towards patients with headache attended in emergency departments

Introducción. Los criterios de alarma permiten identificar a las personas que consultan por cefaleas secundarias graves en los servicios de urgencias. Objetivo. Determinar las características sociodemográficas de los pacientes que acuden a urgencias por cefalea, la incidencia de criterios de alarma, el tratamiento y el diagnóstico tras un año de seguimiento. Pacientes y métodos. Estudio transversal retrospectivo y observacional de personas atendidas en el servicio de urgencias del Hospital Arnau de Vilanova entre junio de 2014 y mayo de 2015 por cefalea. Resultados. Se identificó a un total de 303 personas, de las cuales 165 se incluyeron finalmente en el estudio. Hubo un predomino de mujeres (66,7%). La edad media fue de 41,2 ± 15,9 años. Sólo un 16,4% fue derivado desde atención primaria y 52 (31,5%) presentaban criterios de alarma. En la mitad de estos casos se realizó una tomografía computarizada craneal, y en 4 (7,7%), una punción lumbar. Se identificó una causa grave de la cefalea en 4 casos (2,4%). Tras un año de seguimiento, tres pacientes que inicialmente no consultaron por criterios de alarma fueron diagnosticados de enfermedades graves del sistema nervioso central, y 23 (13,9%) volvieron a urgencias por el mismo motivo. Conclusiones. Sólo uno de cada dos pacientes cumple criterios de alarma. La proporción de cefalea secundaria grave es realmente baja. Es necesario mejorar el abordaje multidisciplinar de la cefalea en nuestro ámbito para evitar la consulta a urgencias por cefaleas primarias sin criterios de alarma

Introduction. Alarm criteria make it possible to identify persons who visit emergency services because of severe secondary headaches. Aims. To determine the socio-demographic characteristics of the patients who visit emergency departments due to headache, the incidence of alarm criteria, treatment and the diagnosis after one year’s follow-up. Patients and methods. We conducted a retrospective observational cross-sectional study of the persons attended in the emergency department of the Arnau de Vilanova Hospital between June 2014 and May 2015 due to headache. Results. A total of 303 persons were identified, of whom 165 were finally included in the study. There was a predominance of women (66.7%). The mean age was 41.2 ± 15.9 years. Only 16.4% were referred from primary care and 52 (31.5%) presented alarm criteria. A computerised tomography head scan was performed in half of these cases, and lumbar puncture was carried out in four of them (7.7%). A serious cause of headache was found in four cases (2.4%). After one year of follow-up, three patients who did not initially visit because of alarm criteria were diagnosed with severe diseases of the central nervous system, and 23 (13.9%) returned to the emergency department for the same reason. Conclusions. Only one out of every two patients meets the alarm criteria. The proportion of severe secondary headache is really low. The multidisciplinary management of headache needs to be improved in our setting to prevent people visiting the emergency department due to primary headaches without any alarm criteria

[Incidence of alarm criteria and attitude towards patients with headache attended in emergency departments]. / Incidencia de criterios de alarma y actitud frente a los pacientes con cefalea atendidos en urgencias.

INTRODUCTION: Alarm criteria make it possible to identify persons who visit emergency services because of severe secondary headaches. AIMS: To determine the socio-demographic characteristics of the patients who visit emergency departments due to headache, the incidence of alarm criteria, treatment and the diagnosis after one year's follow-up. PATIENTS AND METHODS: We conducted a retrospective observational cross-sectional study of the persons attended in the emergency department of the Arnau de Vilanova Hospital between June 2014 and May 2015 due to headache. RESULTS: A total of 303 persons were identified, of whom 165 were finally included in the study. There was a predominance of women (66.7%). The mean age was 41.2 ± 15.9 years. Only 16.4% were referred from primary care and 52 (31.5%) presented alarm criteria. A computerised tomography head scan was performed in half of these cases, and lumbar puncture was carried out in four of them (7.7%). A serious cause of headache was found in four cases (2.4%). After one year of follow-up, three patients who did not initially visit because of alarm criteria were diagnosed with severe diseases of the central nervous system, and 23 (13.9%) returned to the emergency department for the same reason. CONCLUSIONS: Only one out of every two patients meets the alarm criteria. The proportion of severe secondary headache is really low. The multidisciplinary management of headache needs to be improved in our setting to prevent people visiting the emergency department due to primary headaches without any alarm criteria.

TITLE: Incidencia de criterios de alarma y actitud frente a los pacientes con cefalea atendidos en urgencias.Introduccion. Los criterios de alarma permiten identificar a las personas que consultan por cefaleas secundarias graves en los servicios de urgencias. Objetivo. Determinar las caracteristicas sociodemograficas de los pacientes que acuden a urgencias por cefalea, la incidencia de criterios de alarma, el tratamiento y el diagnostico tras un año de seguimiento. Pacientes y metodos. Estudio transversal retrospectivo y observacional de personas atendidas en el servicio de urgencias del Hospital Arnau de Vilanova entre junio de 2014 y mayo de 2015 por cefalea. Resultados. Se identifico a un total de 303 personas, de las cuales 165 se incluyeron finalmente en el estudio. Hubo un predomino de mujeres (66,7%). La edad media fue de 41,2 ± 15,9 años. Solo un 16,4% fue derivado desde atencion primaria y 52 (31,5%) presentaban criterios de alarma. En la mitad de estos casos se realizo una tomografia computarizada craneal, y en 4 (7,7%), una puncion lumbar. Se identifico una causa grave de la cefalea en 4 casos (2,4%). Tras un año de seguimiento, tres pacientes que inicialmente no consultaron por criterios de alarma fueron diagnosticados de enfermedades graves del sistema nervioso central, y 23 (13,9%) volvieron a urgencias por el mismo motivo. Conclusiones. Solo uno de cada dos pacientes cumple criterios de alarma. La proporcion de cefalea secundaria grave es realmente baja. Es necesario mejorar el abordaje multidisciplinar de la cefalea en nuestro ambito para evitar la consulta a urgencias por cefaleas primarias sin criterios de alarma.

Estudio de la calidad de vida y la función visual en niños con glaucoma en España / Quality of life and visual function in children with glaucoma in Spain

Objetivo: Evaluar el efecto del glaucoma en la función visual, la calidad de vida en los niños y la calidad de vida percibida por los cuidadores en niños de hasta 16 años. Material y métodos: Se diseñó un estudio observacional y prospectivo. Se aplicó el cuestionario GQL-15 (Glaucoma Quality of Life) a los niños y a los cuidadores, y el cuestionario VFQ-25 (Visual Functioning Questionnarie) a los niños. Se registraron diferentes variables de la historia clínica que podrían influir en la calidad de vida y la función visual. Resultados: Se incluyó a un total de 24 pacientes con una edad media de 9,13 ± 3,08 años, de los cuales 3 tenían afectación unilateral y 20 presentaban glaucoma congénito primario. Los padres reportaron una peor calidad de vida que los niños: el resultado de la encuesta GQL-15 fue de 32,30 ± 11,56 puntos en los niños y de 37,5 2 ± 14,59 puntos en los cuidadores (p = 0,001). El parámetro que más se relacionó con la calidad de vida y la función visual fue el defecto medio del campo visual en el mejor ojo. Se encontró una correlación estadísticamente significativa entre el resultado de GQL-15 y el defecto medio del campo visual (niños: R = 0,63; p < 0,01 y cuidadores: R = 0,81; p < 0,001). Conclusiones: El daño funcional visual producido por el glaucoma tiene un impacto importante en la calidad de vida y en la función visual de los niños con glaucoma, si bien la calidad de vida percibida por los cuidadores es peor que la percibida por el niño

Objective: To evaluate the effect of glaucoma on visual function, as well as quality of life in children and quality of life perceived by caregivers in children up to 16 years of age. Material and methods: An observational and prospective study was designed using the questionnaire GQL-15 (Glaucoma Quality of Life) and conducted on children and caregivers. The questionnaire VFQ-25 (Visual Functioning Questionnaire) was conducted on children. Different variables of the clinical history that could influence the quality of life and visual function were recorded. Results: The study included 24 patients with a mean age of 9.13 ± 3.08 years, and included 3 with unilateral involvement, and 20 diagnosed with primary congenital glaucoma. Parents reported a worse quality of life than children. The result of the GQL-15 survey was 32.3 ± 11.56 points in children and 37.52 ± 14.59 points in caregivers (P = .001). The parameter most related to quality of life and visual function was the mean deviation (MD) of the visual field in the best eye. A statistically significant correlation was found between the result of GQL-15 and the mean deviation of the visual field (children: R = 0.63, P < .01, caregivers: R= 0.81, P < .001). Conclusions: Functional loss has an impact on the quality of life and visual function in children with glaucoma, although the quality of life perceived by the caregivers is worse than that perceived by the child

Quality of life and visual function in children with glaucoma in Spain. / Estudio de la calidad de vida y la función visual en niños con glaucoma en España.

OBJECTIVE: To evaluate the effect of glaucoma on visual function, as well as quality of life in children and quality of life perceived by caregivers in children up to 16 years of age. MATERIAL AND METHODS: An observational and prospective study was designed using the questionnaire GQL-15 (Glaucoma Quality of Life) and conducted on children and caregivers. The questionnaire VFQ-25 (Visual Functioning Questionnaire) was conducted on children. Different variables of the clinical history that could influence the quality of life and visual function were recorded. RESULTS: The study included 24 patients with a mean age of 9.13±3.08 years, and included 3 with unilateral involvement, and 20 diagnosed with primary congenital glaucoma. Parents reported a worse quality of life than children. The result of the GQL-15 survey was 32.3±11.56 points in children and 37.52±14.59 points in caregivers (P=.001). The parameter most related to quality of life and visual function was the mean deviation (MD) of the visual field in the best eye. A statistically significant correlation was found between the result of GQL-15 and the mean deviation of the visual field (children: R=0.63, P<.01, caregivers: R=0.81, P<.001). CONCLUSIONS: Functional loss has an impact on the quality of life and visual function in children with glaucoma, although the quality of life perceived by the caregivers is worse than that perceived by the child.

Lactobacillus plantarum CIDCA 8327: An α-glucan producing-strain isolated from kefir grains.

Lactobacillus plantarum CIDCA 8327 is an exopolysaccharide (EPS)-producer strain isolated from kefir with promising properties for the development of functional foods. The aim of the present study was to characterize the structure of the EPS synthesized by this strain grown in skim milk or semidefined medium (SDM). Additionally, genes involved in EPS synthesis were detected by PCR. L. plantarum produces an EPS with a molecular weight of 104Da in both media. When grown in SDM produce an heteropolysaccharide composed mainly of glucose, glucosamine and rhamnose meanwhile the EPS produced in milk was composed exclusively of glucose indicating the influence of the sugar source. FTIR spectra of this EPS showed signals attributable to an α-glucan. Both by 1H NMR and methylation analysis it was possible to determine that this polysaccharide is a branched α-(1→4)-d-glucan composed of 80% linear α-(1→4)-d-glucopyranosyl units and 19% (1→4)-d-glucopyranosyl units substituted at O-3 by single α-d-glucopyranosil residues.

Short- and long-term effects of nicotine and the histone deacetylase inhibitor phenylbutyrate on novel object recognition in zebrafish.

RATIONALE: Zebrafish have a sophisticated color- and shape-sensitive visual system, so we examined color cue-based novel object recognition in zebrafish. We evaluated preference in the absence or presence of drugs that affect attention and memory retention in rodents: nicotine and the histone deacetylase inhibitor (HDACi) phenylbutyrate (PhB). OBJECTIVES: The objective of this study was to evaluate whether nicotine and PhB affect innate preferences of zebrafish for familiar and novel objects after short- and long-retention intervals. METHODS: We developed modified object recognition (OR) tasks using neutral novel and familiar objects in different colors. We also tested objects which differed with respect to the exploratory behavior they elicited from naïve zebrafish. RESULTS: Zebrafish showed an innate preference for exploring red or green objects rather than yellow or blue objects. Zebrafish were better at discriminating color changes than changes in object shape or size. Nicotine significantly enhanced or changed short-term innate novel object preference whereas PhB had similar effects when preference was assessed 24 h after training. Analysis of other zebrafish behaviors corroborated these results. CONCLUSIONS: Zebrafish were innately reluctant or prone to explore colored novel objects, so drug effects on innate preference for objects can be evaluated changing the color of objects with a simple geometry. Zebrafish exhibited recognition memory for novel objects with similar innate significance. Interestingly, nicotine and PhB significantly modified innate object preference.

Reproductive cycle and maternal-embryonic nutritional relationship of shovelnose guitarfish Pseudobatos productus in the Gulf of California.

Samples of the shovelnose guitarfish Pseudobatos productus were collected on board a vessel and at landings of artisanal commercial fisheries in the Gulf of California from May 2004 to June 2007. Samples of 650 females, 2047 embryos and 484 uterine eggs were examined. The reproductive cycle is annual, ovulation and parturition occur in July, the uterine eggs are in diapause for 9 months (July-March) before an accelerated growth of embryos of 3 months. Histological analyses of the uterine wall of pregnant females suggested that no secretions were used for embryo nourishment. The standard percentage of water content was 48·6% in fertilized eggs and 80·75% in full-term embryos. Dry mass loss during embryonic development was 16·3% and the chemical balance of development was 0·84. This indicates that P. productus is a strictly lecithotrophic, viviparous species, that makes no maternal contribution of nutrients during embryonic development.

Selected Lactobacillus strains isolated from sugary and milk kefir reduce Salmonella infection of epithelial cells in vitro.

The isolation of potentially probiotic strains and the subsequent study of their properties are very important steps to gain insight in the health benefits ascribed to sugary and milk kefir. The aim of the present study was to characterise fifteen Lactobacillus strains isolated from these beverages by determining some surface properties and their ability to antagonise enterocyte cell damage after Salmonella infection in vitro. Lactobacillus surface properties were determined by hydrophobicity, autoaggregation, and coaggregation assays with Salmonella. In addition, lactobacilli adhesion to Caco-2/TC-7 cells and the effect on Salmonella invasion were evaluated. Finally, the disassembly of F-actin cytoskeleton on intestinal epithelial cells was assayed in vitro when Salmonella infection was performed in the presence of selected Lactobacillus strains. Ten out of the 15 strains showed a high adhesion capacity to Caco-2/TC-7 cells. Most of the strains were hydrophilic and non-autoaggregating. Strains isolated from sugary kefir were non-coaggregating with Salmonella, while strains Lactobacillus paracasei CIDCA 83120, 83121, 83123, 83124, 8339, 83102 isolated from milk kefir were able to coaggregate after 1 h. L. paracasei CIDCA 8339 and Lactobacillus kefiri CIDCA 83102 were able to diminish Salmonella invasion to the enterocytes. An antagonistic effect on cytoskeleton disruption elicited by the pathogen was also demonstrated. Our results suggest that both strains isolated from milk kefir could be considered as appropriate probiotic candidates.

Eficacia de intervenciones educativas en la adherencia terapéutica de pacientes hipertensos / Effectiveness of educational interventions on the therapeutic adherence of hypertension patients / Eficácia das intervenções educativas na adesão terapêutica de pacientes hipertensos

Este estudio exploratorio con abordaje cualitativo fenomenológico busca identificar la eficacia de intervenciones educativas en \r\nla adherencia terapéutica de un grupo de pacientes hipertensos, seleccionados de un barrio con alto grado de vulnerabilidad \r\ndel municipio de Toluviejo, Sucre, a quienes se invitó a participar en la investigación. Para recolectar la información socioeco\r\n-\r\nnómica de los participantes, se construyó una ficha de caracterización; para determinar el grado de adherencia al tratamiento \r\nfarmacológico prescrito para la hipertensión, se utilizó el test de Morisky-Green antes y después de la intervención con estrategias \r\neducativas, tales como charlas grupales, grupos focales con pacientes y cuidadores, y jornadas lúdicas.\r\nComo resultado se logró establecer que los pacientes modificaron significativamente su respuesta al seguimiento del tratamiento, \r\ncon un aumento del 26,70% de los pacientes con respuestas indicativas de adherencia, comparado con los resultados iniciales. Se \r\nconcluye que la intervención educativa pudo tener alguna incidencia de manera directa y efectiva sobre el grupo en estudio, lo \r\ncual influyó en los resultados obtenidos.

An exploratory study was performed using a phenomenolo-\r\ngical qualitative approach, aimed at identifying the effective\r\n-\r\nness of educational mediation on the therapeutic adherence \r\nof hypertensive patients in the high-vulnerability municipality \r\nof Toluviejo, Sucre. Socioeconomic information was collected \r\nthrough a characterization chart; A Morisky-Green Test was \r\nused before and after the mediation in order to determine the \r\nadherence to the hypertension treatment. Educational strate\r\n-\r\ngies, such as group discussions, focus groups with patients and \r\ncaregivers, and recreational days were used.\r\nResults showed a significant improvement of treatment \r\nresponse with an increased adherence of 26.70% in comparison \r\nto previous results. We conclude that educational mediation \r\ncould have had some direct and effective impact on the study \r\ngroup, contributing to the results obtained

Este estudo exploratório, com abordagem qualitativa feno\r\n-\r\nmenológica teve como objetivo identificar a eficácia das \r\nintervenções educativas sobre a adesão terapêutica de um \r\ngrupo de pacientes hipertensos, selecionados a partir de um \r\nbairro com um alto grau de vulnerabilidade, do município de \r\nToluviejo, Sucre, os quais foram convidados a participar da \r\ninvestigação. Para a coleta de informações socioeconômicas \r\ndos participantes, uma ficha de caracterização foi construída; \r\ne para determinar o grau de adesão ao tratamento farmaco\r\n-\r\nlógico prescrito para hipertensão, o teste de Morisky-Green foi \r\nutilizado antes e após a intervenção com estratégias educa\r\n-\r\ncionais, tais como discussões em grupo, grupos focais com \r\npacientes e cuidadores, e atividades recreativas.\r\nComo resultado, ficou estabelecido que os pacientes modifi\r\n-\r\ncaram significativamente a sua resposta à monitorização do \r\ntratamento, com um aumento de 26,70% dos pacientes com \r\nrespostas indicativas de adesão, em comparação com os resul\r\n-\r\ntados iniciais. Concluímos que a intervenção educativa pode \r\nter impactado direta e efetivamente o grupo em estudo, o que \r\ninfluenciou nos resultados obtidos.

Estudio de calidad de vida en pacientes intervenidos de bypassaortobifemoral por isquemia arterial crónica de miembros inferiores / Quality of life study of patients after aortobifemoral bypass due to lower limb arterial ischaemia

OBJETIVO: Evaluar la calidad de vida relacionada con la salud de pacientes intervenidos de bypass aortobifemoral por isquemia de MMII y los factores que influyen en esta. MATERIAL Y MÉTODOS: Estudio de cohortes históricas incluyendo pacientes intervenidos por isquemia de MMII mediante bypassaortobifemoral (2002-2012). Variable principal: calidad de vida (analizada mediante Cuestionario SF-36). Se recogieron aspectos demográficos, antecedentes personales, grado de isquemia pre y postoperatoria, complicaciones postoperatorias, datos quirúrgicos y permeabilidad del injerto. La muestra se dividió en 2 grupos, según el resultado obtenido en el cuestionario, estableciendo como punto de corte 50 puntos. Se analizaron las diferencias entre los grupos con todas las variables y posteriormente con el resultado obtenido en cada dominio del cuestionario. Los resultados se analizaron mediante los test de Chi-cuadrado de Pearson, Fisher y «t» de Student (p < 0,05). RESULTADOS: Se intervinieron 119 pacientes, se obtuvieron 40 encuestas correctamente contestadas. El 80% de los pacientes obtuvieron puntuaciones mayores a 50 puntos. Puntuación media del cuestionario: 63,62 ± 20,92 puntos. La mayor puntuación fue en el dominio de rol emocional (media 85,83 ± 34,44 puntos) y la menor en salud general (47,21 ± 20,44 puntos). En el análisis univariable se observó mejor calidad de vida global en pacientes con edades superiores a 65 años en el momento de la encuesta (p = 0,044; RR 1,462, IC [1,043-2,047]), sin encontrar diferencias significativas en el resto de los parámetros analizados. Si analizamos los resultados por dominios la impotencia sexual postoperatoria presentó peores puntuaciones en los dominios de salud general (p = 0,019), dolor (p = 0,031) y vitalidad (p = 0,026). Además, las reintervenciones precoces afectaron negativamente a la salud general (p = 0,033) y la presencia de isquemia crítica afectó negativamente en el dominio del dolor (p = 0,040). CONCLUSIONES: Los pacientes intervenidos de bypass aortobifemoral presentan una buena percepción de calidad de vida tras la cirugía

OBJECTIVE: To evaluate the health related quality of life of patients after aortobifemoral bypass due to limb ischaemia and the factors influencing it. MATERIAL AND METHODS: Historical cohort study including patients undergoing bypass surgery due to limb ischaemia, from 2002-2012. Primary endpoint: quality of life (determined using the SF-36 questionnaire). Data was collected on demographics, medical history, degree of pre- and postoperative ischaemia, postoperative complications, surgical data and graft patency. The sample was divided into two groups according to the result obtained in the questionnaire, establishing 50 as the cut-off point. The differences between the two groups with all variables and subsequently with the results obtained in each domain of the questionnaire were analysed, using chi-squared test, Fisher and Student t tests (P < .05). RESULTS: A total of 119 patients had surgery, from whom 40 correctly completed questionnaires were obtained. The large majority (80%) of patients surveyed had scores greater than 50 points. The mean questionnaire score was 63.62 ± 20.92 points. The highest score was in the domain of Emotional role (mean 85.83 ± 34.44 points), and was lower in General health (47.21 ± 20.44 points). In the univariate analysis, a better overall quality of life was observed in patients over 65 years at the time of the survey (P = .044; RR 1.462, 95% CI; 1.043-2.047), with no significant differences in other parameters analysed. In the analysis of the results by domains, postoperative impotence had worse scores in the domains of general health (P = .019), pain (P = .031), and vitality (P = .026). In addition, early reoperations adversely affected the General health (P = .033), and the presence of critical ischaemia also adversely affected the domain of Pain (P = .040). CONCLUSIONS: Patients undergoing aortobifemoral bypass have a good perception of quality of life after surgery

Vacunas acelulares (DTPa/dTpa) contra la tos ferina: duración de la protección / Acellular vaccines (DTPa/dTpa) against whooping cough, protection duration

INTRODUCCIÓN: En el último decenio se ha documentado un incremento en la incidencia de casos de tos ferina en países desarrollados. OBJETIVO: Conocer si la administración de la dTpa en lugar de la DTPa como 5.ª dosis podría estar contribuyendo a la aparición de los casos. MÉTODOS: Se realizó un estudio descriptivo de los casos de tos ferina declarados durante una epidemia en la ciudad de Alicante, durante los 5 primeros meses de 2014. Se consideraron casos de tos ferina aquellos confirmados por la PCR. Para el análisis del tiempo de protección se incluyó a vacunados con 5 dosis. RESULTADOS: Se notificaron 104 casos de tos ferina confirmados por la PCR, 85 casos (82%) tenían 5 dosis de la vacuna. El tiempo de protección en años mostró una media (DE) 2,1 ± 1,1 años con la dTpa y de 5,1 ± 1,5 con la DTPa (p < 0,001). En cuanto a la protección, ajustada por edad, se observa que pasados 3 años solo el 47,6% de los vacunados con dTpa la mantenían y en los vacunados con la DTPa estaban protegidos el 100% (p < 0,001). CONCLUSIÓN: Nuestro estudio encontró que los vacunados correctamente contra la tos ferina y a quienes en la última dosis de revacunación se les administró dTpa tuvieron un periodo de protección más corto que los que fueron vacunados con DTPa

INTRODUCTION: An increase in whooping cough in most of the developed countries has been detected in the last decade. OBJECTIVE: To determine whether the administration of dTpa vaccine instead of DTPa fifth dose is contributing to the appearance of these cases. METHODS: A descriptive study based on cases of whooping cough reported during an epidemic period in the city of Alicante in the first 5 months of 2014. Only pertussis cases confirmed by PCR were included in the study, and only those vaccinated with 5 doses were included in the analysis of the period of protection. RESULTS: A total of 104 cases of pertussis confirmed by PCR were reported, with 85 cases (82%) having had 5 doses of vaccine. The mean time and standard deviation (SD) of protection was 2.1 ± 1.1 years with dTpa, and 5.1 ± 1.5 years with DTPa (p < .001). In the protection, adjusted for age, it was observed that, after 3 years, only 47.6% of people vaccinated with dTpa were still protected, while people vaccinated with DTPa were 100% protected (P<.001). CONCLUSIONS: This study found that people who were properly vaccinated against pertussis and received their last re-vaccination dose with dTpa had a shorter period of protection than those who were vaccinated with DTPa

[Acellular vaccines (DTPa/dTpa) against whooping cough, protection duration]. / Vacunas acelulares (DTPa/dTpa) contra la tos ferina: duración de la protección.

INTRODUCTION: An increase in whooping cough in most of the developed countries has been detected in the last decade. OBJECTIVE: To determine whether the administration of dTpa vaccine instead of DTPa fifth dose is contributing to the appearance of these cases. METHODS: A descriptive study based on cases of whooping cough reported during an epidemic period in the city of Alicante in the first 5 months of 2014. Only pertussis cases confirmed by PCR were included in the study, and only those vaccinated with 5 doses were included in the analysis of the period of protection. RESULTS: A total of 104 cases of pertussis confirmed by PCR were reported, with 85 cases (82%) having had 5 doses of vaccine. The mean time and standard deviation (SD) of protection was 2.1±1.1 years with dTpa, and 5.1±1.5 years with DTPa (p<.001). In the protection, adjusted for age, it was observed that, after 3 years, only 47.6% of people vaccinated with dTpa were still protected, while people vaccinated with DTPa were 100% protected (P<.001). CONCLUSIONS: This study found that people who were properly vaccinated against pertussis and received their last re-vaccination dose with dTpa had a shorter period of protection than those who were vaccinated with DTPa.

Oral administration of kefiran exerts a bifidogenic effect on BALB/c mice intestinal microbiota.

The activity of kefiran, the exopolysaccharide present in kefir grains, was evaluated on intestinal bacterial populations in BALB/c mice. Animals were orally administered with kefiran and Eubacteria, lactobacilli and bifidobacteria populations were monitored in faeces of mice at days 0, 2, 7, 14 and 21. Profiles obtained by Denaturing Gradient Gel Electrophoresis (DGGE) with primers for Eubacteria were compared by principal component analysis and clearly defined clusters, correlating with the time of kefiran consumption, were obtained. Furthermore, profile analysis of PCR products amplified with specific oligonucleotides for bifidobacteria showed an increment in the number of DGGE bands in the groups administered with kefiran. Fluorescent In Situ Hybridisation (FISH) with specific probes for bifidobacteria showed an increment of this population in faeces, in accordance to DGGE results. The bifidobacteria population was also studied on distal colon content after 0, 2 and 7 days of kefiran administration. Analysis of PCR products by DGGE with Eubacteria primers showed an increment in the number and intensity of bands with high GC content of mice administered with kefiran. Sequencing of DGGE bands confirmed that bifidobacteria were one of the bacterial populations modified by kefiran administration. DGGE profiles of PCR amplicons obtained by using Bifidobacterium or Lactobacillus specific primers confirmed that kefiran administration enhances bifidobacteria, however no changes were observed in Lactobacillus populations. The results of the analysis of bifidobacteria populations assessed on different sampling sites in a murine model support the use of this exopolysaccharide as a bifidogenic functional ingredient.

The effect of a multidisciplinary intervention program on hepatic adiposity in overweight-obese children: protocol of the EFIGRO study.

BACKGROUND: Non-alcoholic fatty liver disease is the most frequent liver abnormality observed in overweight or obese children and is strongly associated with metabolic syndrome and insulin resistance. OBJECTIVES: (i) To evaluate the effect of a 22-week multidisciplinary intervention program on hepatic fat fraction in overweight or obese children and (ii) to examine the effect of the intervention on cardiometabolic risk factors, self-esteem and well-being. METHODS: A total of 160 children, 9-11 years, will be recruited by pediatricians and randomly assigned to control (N = 80) or intervention (N = 80) groups. The control group will receive a family-based lifestyle and psycho-educational program (2 days/month), while the intervention group will attend the same lifestyle education and psycho-educational program plus the exercise program (3 days/week). The duration of training sessions will be 90 min of exercise, including warm-up, moderate to vigorous aerobic activities, and strength exercises. The primary outcome is the change in hepatic fat fraction (magnetic resonance imaging, MRI). Secondary outcomes include cardiometabolic risk factors such as total adiposity (dual Xray absorptiometry), visceral adiposity (MRI), functional peak aerobic capacity (cardiopulmonary exercise testing), blood pressure, muscular fitness, speed­agility, and fasting blood insulin, glucose, C-reactive protein, alanine aminotransferase, aspartate aminotransferase, gamma glutamyltransferase, lipid profile and psychological measurements (questionnaires). All the measurements will be evaluated at baseline prior to randomization and after the intervention. DISCUSSION: This study will provide insight in the efficacy of a multidisciplinary intervention program including healthy lifestyle education, psycho-education and supervised exercise to reduce hepatic fat and cardiometabolic risk in overweight children.