Timed adoptive T cell transfer during chemotherapy in patients with recurrent platinum-sensitive epithelial ovarian cancer.

BACKGROUND: The presence of T cells and suppressive myeloid cells in epithelial ovarian cancer (EOC) correlate with good and bad clinical outcome, respectively. This suggests that EOC may be sensitive to adoptive cell therapy with autologous tumor-infiltrating lymphocytes (TIL), provided that immunosuppression by myeloid-derived suppressor cells and M2 macrophages is reduced. Platinum-based chemotherapy can alleviate such immunosuppression, potentially creating a window of opportunity for T cell-based immunotherapy. METHODS: We initiated a phase I/II trial (NCT04072263) in patients with recurrent platinum-sensitive EOC receiving TIL during platinum-based chemotherapy. TILs were administered 2 weeks after the second, third and fourth chemotherapy course. Patients were treated in two cohorts with or without interferon-α (IFNa), as conditioning and TIL support regimen. The primary endpoint was to evaluate the feasibility and safety according to CTCAE V.4.03 criteria and the clinical response and immune modulatory effects of this treatment were evaluated as secondary endpoints. RESULTS: Sixteen patients were enrolled. TIL could be successfully expanded for all patients. TIL treatment during chemotherapy without IFNa (n=13) was safe but the combination with IFNa added to the chemotherapy-induced toxicity with 2 out of 3 patients developing thrombocytopenia as dose-limiting toxicity. Fourteen patients completed treatment with a full TIL cycle and were further evaluated for clinical and immunological response. Platinum-based chemotherapy resulted in reduction of circulating myeloid cell numbers and IL-6 plasma levels, confirming its immunosuppression-alleviating effect. Three complete (CR), nine partial responses and two stable diseases were recorded, resulting in an objective response rate of 86% (Response Evaluation Criteria In Solid Tumors V.1.1). Interestingly, progression free survival that exceeded the previous platinum-free interval was detected in two patients, including an exceptionally long and ongoing CR in one patient that coincided with sustained alleviation of immune suppression. CONCLUSION: TIL therapy can be safely combined with platinum-based chemotherapy but not in combination with IFNa. The chemotherapy-mediated reduction in immunosuppression and the increase in platinum-free interval for two patients warrants further exploration of properly-timed TIL infusions during platinum-based chemotherapy, possibly further benefiting from IL-2 support, as a novel treatment option for EOC patients.

Vaccination adjuvated against hepatitis B in Spanish National Healthcare System (SNS) workers typed as non-responders to conventional vaccines.

TRIAL DESIGN: An interventional, phase 4, single group assignment, without masking (open label), preventive clinical trial was carried out in health workers with biological risk in their tasks, who have been filed as non-responders to conventional vaccination against Hepatitis B. METHODS: 67 health workers with biological risk in their tasks, who have been filed as non-responders to conventional vaccination against Hepatitis B, were enrolled in the Clinical Trial. All participants were from 18 years up to 64 years old. INCLUSION CRITERIA: NHS workers -including university students doing their internships in health centres dependent on the National Health System (inclusion of students is regulated and limited by specific instructions on labour prevention in each autonomous community)- classified as non-responders. The criteria defining them as non-responders to the conventional hepatitis B vaccine is anti HBsAb titers < 10 mUI/ml following the application of six doses of conventional vaccine at 20 µg doses (two complete guidelines). The objective of this study was to provide Health workers-staff with an additional protection tool against hepatitis B infection, and to evaluate the efficacy of the adjuvanted vaccine in healthy non-responders to conventional hepatitis B vaccine. The primary outcome was the measurement of antibody antiHBs before the first Fendrix® dose and a month after the administration of each dose. Other outcome was collection of adverse effects during administration and all those that could be related to the vaccine and that occur within 30 days after each dose. In this study, only one group was assigned. There was no randomization or masking. RESULTS: The participants were recruited between April 13, 2018 and October 31, 2019. 67 participants were enrolled in the Clinical Trial and included the analyses. The primary immunisation consists of 4 separate 0.5 ml doses of Fendrix®, administered at the following schedule: 1 month, 2 months and 6 months from the date of the first dose. Once the positivity was reached in any of the doses, the participant finished the study and was not given the following doses. 68.66% (46 out 67) had a positive response to first dose of Fendrix®. 57.14% (12 out 21) had a positive response to second dose of Fendrix®. 22.22% (2 out 9) had a positive response to third dose of Fendrix and 42.96% (3 out 7) had a positive response to last dose of Fendrix®. Overall, 94.02% (64 out 67) of participants had a positive response to Fendrix®. No serious adverse event occurred. CONCLUSIONS: The use of Fendrix®, is a viable vaccine alternative for NHS workers classified as "non-responders". Revaccination of healthy non-responders with Fendrix®, resulted in very high proportions of responders without adverse events. TRIAL REGISTRATION: The trial was registered in the Spanish National Trial Register (REEC), ClinicalTrials.gov and inclusion has been stopped (identifier NCT03410953; EudraCT-number 2016-004991-23). FUNDING: GRS 1360/A/16: Call for aid for the financing of research projects in biomedicine, health management and socio-health care to be developed in the centres of the Regional Health Management of Autonomous Community of Castile-Leon. In addition, this work has been supported by the Spanish Platform for Clinical Research and Clinical Trials, SCReN (Spanish Clinical Research Network), funded by the Subdirectorate General for Research Evaluation and Promotion of the Carlos III Health Institute (ISCIII), through the project PT13/0002/0039 and project PT17/0017/0023 integrated in the State Plan for R&D&I 2013-2016 and co-financed by and the European Regional Development Fund (ERDF).

The Male Warrior Hypothesis: Testosterone-related Cooperation and Aggression in the Context of Intergroup Conflict.

The Male Warrior Hypothesis (MWH) establishes that men's psychology has been shaped by inter-group competition to acquire and protect reproductive resources. In this context, sex-specific selective pressures would have favored cooperation with the members of one's group in combination with hostility towards outsiders. We investigate the role of developmental testosterone, as measured indirectly through static markers of prenatal testosterone (2D:4D digit ratio) and pubertal testosterone (body musculature and facial masculinity), on both cooperation and aggressive behavior in the context of intergroup conflict among men. Supporting the MWH, our results show that the intergroup conflict scenario promotes cooperation within group members and aggression toward outgroup members. Regarding the hormonal underpinnings of this phenomenon, we find that body musculature is positively associated with aggression and cooperation, but only for cooperation when context (inter-group competition) is taken into account. Finally, we did not find evidence that the formidability of the group affected individual rates of aggression or cooperation, controlling for individual characteristics.

Prevalencia del tabaquismo en estudiantes de 6º curso de Medicina (MIR-O) / Prevalence of smoking habit in 6th year medical students (pre-residency) (MIR-O)

Objetivo: Estudiar la prevalencia del tabaquismo en los estudiantes de 6º curso de Medicina de la Univer-sidad de Santiago de Compostela (USC). Material y método: Se utiliza una encuesta anual de la Consellería de Sanidade, conocida como SICRI para conocer tanto la prevalencia de tabaquismo como la exposición pasiva al humo de tabaco en MIR-0. Resultados: Se obtiene una prevalencia de tabaquismo del 19,31%, correspondiendo al 20% en las mujeres y un 17,85% en los hombres. Entre las mujeres lo más frecuente es el consumo ocasional o esporádico (58,34% de las fumadoras) y entre el sexo masculino predomina el consumo diario (60% de los hombres fumadores). Conclusiones: La prevalencia de consumo de tabaco continúa siendo elevada a pesar de los conocimientos adquiridos en la facultad sobre las consecuencias nega-tivas del tabaco sobre la salud, que parecen no influir negativamente sobre los futuros médicos

Objective: To study the prevalence of smoking among students of the sixth year of Medicine at the University of Santiago de Compostela (USC). Matherial and method: An annual survey of the Con-sellería de Sanidade, known as SICRI, is used to know both the prevalence of smoking and passive exposure to tobacco smoke in MIR-0. Results: A smoking prevalence of 19.31% is ob-tained, 20% corresponding to women and 17.85% to men. Amongst the female smokers, sporadic con-sumptions the most frequent trend (58.34%) and male consumers are more prone for daily consumption (60%). Conclusions: Smoking prevalence continues to be high despite the knowledge acquired at university about the negative health consequences of tobacco, which appear to not have a negative influence among the future doctors

Respuesta al artículo: «Brote de bacteriemia por Serratia marcescensen hemodiálisis». Comentarios al artículo: «Brote de bacteriemia por Serratia marcescens en pacientes portadores de catéteres tunelizados en hemodiálisis secundario a colonización de la solución antiséptica. Experiencia en 4 centros» / Answer to the article: «Serratia marcescens bacteraemia outbreak in hemodialysis». Comment on «Serratia marcescens bacteraemia outbreak in haemodialysis patients with tunnelled catheters due to colonisation of antiseptic solution. Experience at 4 hospitals»

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Brote de bacteriemia por Serratia marcescens en pacientes portadores de catéteres tunelizados en hemodiálisis secundario a colonización de la solución antiséptica. Experiencia en 4 centros / Serratia marcescens bacteraemia outbreak in haemodialysis patients with tunnelled catheters due to colonisation of antiseptic solution. Experience at 4 hospitals

Introducción: La aplicación de una solución antiséptica previa al uso de los catéteres tunelizados es una práctica recomendada. Estas medidas habituales en la manipulación de los catéteres para hemodiálisis son cruciales para evitar complicaciones. Presentamos un brote de infección por Serratia marcescens (S. marcescens) en varias unidades de hemodiálisis de la Comunidad Autónoma de Madrid. Material y métodos: Los primeros casos de bacteriemia por S. marcescensfueron aislados en diciembre de 2014. La detección de un germen infrecuente en varios pacientes se puso en conocimiento de los Servicios de Medicina Preventiva por sospecha de probable brote nosocomial. Se recogieron datos de 4 centros donde se detectaron episodios de bacteriemias similares por S. marcescens. Resultados: Fueron detectados un total de 21 casos de bacteriemia por S. marcescens. La edad media de los pacientes era de 72±10 años. El tiempo medio en hemodiálisis de los pacientes afectados era de 33±13 meses (rango: 3-83), el tiempo medio del catéter tunelizado era de 22±13 meses. En 11 casos el cuadro clínico fue semejante, caracterizado por hipotensión y malestar general durante la sesión de hemodiálisis. En otros 7 pacientes se asoció fiebre. En 3 casos la forma de presentación fue asintomática y se detectó por hemocultivos. Todos eran portadores de catéteres tunelizados (12 pacientes con catéter en la vena yugular derecha, 5 en la yugular izquierda, 2 en la femoral derecha y 2 en la subclavia izquierda). El tratamiento que se aplicó en 6 casos fue gentamicina posdiálisis intravenosa (1mg/kg) más sellado del catéter con solución de ciprofloxacino durante 3 semanas. En 12 pacientes el tratamiento fue ceftazidima 2g IV más sellado de catéter con el mismo antibiótico durante 2 semanas. Cuatro pacientes recibieron dosis de ciprofloxacino oral, en un caso se asoció a vancomicina IV, durante 2 semanas. A las 48h de iniciar el tratamiento, los pacientes quedaron asintomáticos y no presentaron nuevos episodios. No se observó ninguna complicación mayor. Esta situación fue comunicada por los equipos a las autoridades sanitarias. Posteriormente, se notificó la presencia de lotes de antiséptico de clorhexidina acuosa al 0,05 y 2% colonizados por S. marcescens. Dada la aplicación de forma rutinaria del antiséptico en el manejo de los catéteres en estas unidades, este fue considerado el foco de contagio. Tras la retirada de los lotes no acontecieron nuevos casos. Conclusiones: Las bacteriemias por gérmenes no convencionales deben ponernos sobre aviso para investigar posibles brotes. La aplicación de una solución contaminada por S. marcescens en los catéteres en hemodiálisis fue la vía de bacteriemia. El tratamiento antibiótico intravenoso y el sellado de los catéteres permitió una excelente supervivencia tanto de los pacientes como de los catéteres (AU)

Introduction: The application of antiseptic solution for handling tunnelled catheters is recommended in patients undergoing haemodialysis. These routine antiseptic procedures in handling catheters are crucial to avoid complications. We report an outbreak of Serratia marcescens (S. marcescens)bacteraemia in numerous haemodialysis units of the Community of Madrid. Material and methods: The first cases of bacteraemia due to S. marcescens were isolated in December 2014. The Preventive Medicine Services were informed of the detection of an atypical pathogen in several patients, suspecting a probable nosocomial outbreak. Information from 4 centres with similar S. marcescens bacteraemia was analysed. Results: Twenty-one cases of bacteraemia related to S. marcescenswere identified. The mean age of affected patients was 72±10 years. The mean time on haemodialysis of affected patients was 33±13 months (range: 3-83 months), the median time of tunnelled catheter was 22±13 months. In 11 cases the clinical picture was similar, with hypotension and general malaise during the haemodialysis session. Fever was present in a further 7 cases. In 3 cases the presentation was asymptomatic and was detected by blood cultures. All patients had tunnelled catheters (12 patients with catheter in the right jugular vein, 5 in the left jugular, 2 in the right femoral artery and 2 in the left subclavian artery). Gentamicin intravenous doses (1mg/kg) with catheter lock solution with ciprofloxacin post-dialysis were administered for 3 weeks in 6 patients. In 12 patients the treatment was ceftazidime (2g IV) plus catheter lock solution with the same antibiotic, for 2 weeks. Four patients received oral ciprofloxacin for 2 weeks, in one case together with IV vancomycin. The patients were asymptomatic and without new episodes 48 hours after the treatment. No major complications were observed. The teams informed the health authorities of the situation, which then reported the presence of batches of antiseptic (chlorhexidine 0.05 and 2%) colonised by S. marcescens. Given the routine application of this antiseptic in handling catheters at these units, this was considered the source of contagion and new cases were not observed after the removal of the batches. Conclusions: The presence of bacteraemia due to unconventional germs should alert us to a potential outbreak. The application of a solution contaminated by S. marcescens in haemodialysis catheters was the source of bacteraemia. The intravenous antibiotic treatment and the catheter lock solution allowed an excellent survival of patients and catheters (AU)

Scaffold electrodes based on thioctic acid-capped gold nanoparticles coordinated Alcohol Dehydrogenase and Azure A films for high performance biosensor.

Nanometric size gold nanoparticles capped with thiotic acid are used to coordinate with the Zn (II) present in the catalytic center of Alcohol Dehydrogenase (ADH). In combination with the NADH oxidation molecular catalyst Azure A, electrografted onto carbon screen-printed electrodes, they are used as scaffold electrodes for the construction of a very efficient ethanol biosensor. The final biosensing device exhibits a highly efficient ethanol oxidation with low overpotential of -0.25 V besides a very good analytical performance with a detection limit of 0.14±0.01 µM and a stable response for more than one month.

[Quality indicators in an intensive care unit: a two-year healthcare-associated infection surveillance program]. / Indicadores de calidad en una Unidad de Cuidados Intensivos: dos años de un sistema de vigilancia de la infección asociada a los cuidados sanitarios.

OBJECTIVE: To estimate quality healthcare indicators in an intensive care unit (ICU). METHODS: A prospective observational study was conducted on all patients referred to the medical ICU of Ramón y Cajal hospital (Madrid) for more than 48 hours, from January 1 2008 to December 31 2009. RESULTS: A total of 503 patients were included, of whom 7.4% developed a healthcare-associated infection (HAI) attributable to their stay in the ICU. The median length of stay was 5 days. A ventilator-associated pneumonia (VAP) was observed in 1.9% of patients, with a VAP rate of 3.8 per 1,000 ventilator-days. A catheter-associated urinary tract infection (CAUTI) was found in 3.6% of the patients, with a CAUTI rate of 4.5 per 1,000 catheter-days. The cumulative incidence of central line-associated bloodstream infection (CLABSI) was 1.8%, with a CLABSI rate of 2.2 per 1,000 central line-days. CONCLUSIONS: Our results are similar to those of other studies using the same methodology. An HAI surveillance system is a key factor for implementing a healthcare quality improvement system. The obtained indicators allow intra-comparison over time and with other similar hospitals, the monitoring of infection control measures, and thus an effective improvement in healthcare quality and patient safety.

Constitutive heterochromatin polymorphisms in human chromosomes identified by whole comparative genomic hybridization.

Whole comparative genomic hybridization (W-CGH) is a new technique that reveals cryptic differences in highly repetitive DNA sequences, when different genomes are compared using metaphase or interphase chromosomes. W-CGH provides a quick approach to identify differential expansion of these DNA sequences at the single-chromosome level in the whole genome. In this study, we have determined the frequency of constitutive chromatin polymorphisms in the centromeric regions of human chromosomes using a whole-genome in situ cross-hybridization method to compare the whole genome of five different unrelated individuals. Results showed that the pericentromeric constitutive heterochromatin of chromosome 6 exhibited a high incidence of polymorphisms in repetitive DNA families located in pericentromeric regions. The constitutive heterochromatin of chromosomes 5 and 9 was also identified as highly polymorphic. Although further studies are necessary to corroborate and assess the overall incidence of these polymorphisms in human populations, the use of W-CGH could be pertinent and of clinical relevance to assess rapidly, from a chromosomal viewpoint, genome similarities and differences in closely related genomes such as those of relatives, or in more specific situations such as bone marrow transplantation where chimerism is produced in the recipient.

Whole-comparative genomic hybridization in domestic sheep (Ovis aries) breeds.

Whole-comparative genomic hybridization (W-CGH) allows identification of chromosomal polymorphisms related to highly repetitive DNA sequences localized in constitutive heterochromatin. Such polymorphisms are detected establishing competition between genomic DNAs in an in situ hybridization environment without subtraction of highly repetitive DNA sequences, when comparing two species from closely related taxa (same species, sub-species, or breeds) or somewhat related taxa. This experimental approach was applied to investigating differences in highly repetitive sequences of three sheep breeds (Castellana, Ojalada, and Assaf). To this end, W-CGH was carried out using mouflon (sheep ancestor) chromosomes as a common target to co-hybridize equimolar quantities of two genomic DNAs obtained from either Castellana, Ojalada or Assaf sheep breeds. The results showed that the amount of constitutive heterochromatin is greater in all pericentromeric heterochromatin regions of acrocentric chromosomes than in metacentric or sex chromosomes. Additionally, when W-CGH was performed using DNAs from the Iberian breeds Castellana and Ojalada, chromosomal pericentromeric regions revealed quantitatively and qualitatively a presence of DNA families similar to that obtained from any of the above-cited breeds. On the contrary, when the DNA used in W-CGH experiments was obtained from Assaf, as compared to either Castellana or Ojalada, two different pericentromeric DNA families of highly repetitive sequences could be detected. Lastly, sex chromosomes were shown to be homogeneous among all breeds and thus revealed no detectable constitutive heterochromatin. W-CGH results were confirmed using DNA breakage detection-FISH experiments (DBD-FISH) carried out on lymphocytes. As a whole, the results showed that two different repetitive DNA families are present in the pericentromeric heterochromatin of the sheep breeds studied here. Additionally, they suggest a differential presence of these distinct repetitive DNA families in Castellana and Ojalada breeds as compared to the Assaf breed. Finally, the results of W-CGH after using mouflon as the targeted chromosomes also show that the two DNA families are present in the ancestor.

A highly conserved pericentromeric domain in human and gorilla chromosomes.

Significant similarity between human and gorilla genomes has been found in all chromosome arms, but not in centromeres, using whole-comparative genomic hybridization (W-CGH). In human chromosomes, centromeric regions, generally containing highly repetitive DNAs, are characterized by the presence of specific human DNA sequences and an absence of homology with gorilla DNA sequences. The only exception is the pericentromeric area of human chromosome 9, which, in addition to a large block of human DNA, also contains a region of homology with gorilla DNA sequences; the localization of these sequences coincides with that of human satellite III. Since highly repetitive DNAs are known for their high mutation frequency, we hypothesized that the chromosome 9 pericentromeric DNA conserved in human chromosomes and deriving from the gorilla genome may thus play some important functional role.

Hacia un hospital sin látex / No disponible

El objetivo principal de este trabajo es describir los pasos que se han dado en un hospital público para ir «Hacia un Hospital sin Látex». El aumento de la prevalencia de las enfermedades alérgicas, nos lleva a realizar una serie de actuaciones englobadas dentro de una política hospitalaria para disminuir la presencia de látex en el hospital. Con ello, queremos conseguir disminuir la alergia al látex de los trabajadores y evitar en los pacientes especialmente sensibles las posibles reacciones alérgicas al ser intervenidos quirúrgicamente

The main objective of this work is to describe the steps that hand been given in a public hospital in order to go «Towards a hospital without latex». The increasing of allergy illness is the reason because of that; we have to make a number of actions in a hospitable policy, with the purpose of decreasing the latex content in the hospital. With these actions we want to get a latex allergy decreasing in the workers avoiding in the sensitive patients the possible allergy reactions when they are performed an operation

Arcyptera fusca and Arcyptera tornosi repetitive DNA families: whole-comparative genomic hybridization (W-CGH) as a novel approach to the study of satellite DNA libraries.

Whole-comparative genomic hybridization (W-CGH) has been used to exemplify a simple methodology which allows identifying and mapping whole genome differences for highly repetitive DNA sequences between two related species of unknown genomic background. The use of this technique to the species binomy Arcyptera fusca/Arcyptera tornosi has allowed the identification of different DNA families mainly concentrated within the para-/peri-centromeric and distal heterochromatic regions of different chromosomes, which are differentially expanded in both genomes. Additionally, W-CGH allowed chromosome mapping of particular euchromatic regions immersed in the chromosome arms which have been affected by processes of DNA amplification and losses. A molecular approach was also conducted to analyse satellite DNA families in these species. We have found three different families showing an unequal representation in both species. Two of these families showed a centromeric location (EcoRV-390CEN and Sau3A-419CEN), whereas the last one was located at distal heterochromatic regions (Sau3A-197TEL). As A. fusca is a widely distributed species represented in most European high mountains, whereas A. tornosi is an endemic species represented in the Iberian Peninsula, the differences and resemblances reported here offer a good basis to support a close evolutionary relationship between both of the actually isolated species. Finally, W-CGH allowed identification of an asynchronic pattern of heterochromatin condensation through early prophase (characteristic in both species) which is uncommon or probably has been poorly analysed within classical early condensing chromosome domains through meiosis. The congruence of the obtained cytological and molecular results is analysed in light of the ancestral genome relationship between both species.

Efeito da suplementação de linhaça, óleo de canola e vitamina E na dieta sobre as concentrações de ácidos graxos poliinsaturados em ovos de galinha / Effect of dietary supplementation of flaxseed, canola oil and vitamin E upon polyunsaturated fatty acids in chicken eggs

Estudou-se o efeito de diferentes fontes de ácidos graxos insaturados (óleo de canola e semente de linhaça), acrescidas de diferentes teores de alfa-tocoferol nas dietas de poedeiras, sobre a composição de ácidos graxos da gema do ovo foi estudado. Foram utilizadas 288 galinhas da linhagem Babcock que receberam dietas com 6 por cento de óleo de canola, 20 por cento de semente de linhaça moída ou 3 por cento de óleo de canola e 10 por cento de linhaça moída com teores de 0, 100 e 200UI/kg de alfa-tocoferol. As dietas com 20 por cento de semente de linhaça proporcionaram teores mais elevados de ácidos graxos poliinsaturados no ovo com aumento, em particular, dos teores de ácido alfa-linolênico e EPA (ácido eicosapentaenóico) e diminuição de ácido araquidônico na gema. Os teores de vitamina E contidos nas rações experimentais não determinaram alteração significativa na deposição dos diferentes ácidos graxos na gema dos ovos, exceto com relação aos ácidos graxos saturados.

The effect of dietary sources of polyunsaturated fatty acids - canola oil and flaxseed - with different vitamin E supplementation on the fatty acid deposition into the eggs of 288 Babcock laying hens was investigated. Birds were fed diets containing 6 percent of canola oil, 20 percent of flaxseed or a combination of 3 percent of canola oil and 10 percent of flaxseed, enriched with 0, 100 or 200Ul of dl-alpha-tocopheril acetate. The inclusion of flaxseed in the diets increased the yolk polyunsaturated fatty acids, mainly alpha-linolenic acid and EPA (eicosapentaenoic acid). The concentration of alpha-tocopherol in the diet did not change the egg yolk, fatty acids deposition but changed the saturated fatty acids deposition.

Programas de calidad en la rehabilitación sociosanitaria / Quality programs in socio-health care rehabilitation

En los últimos años se ha producido un incremento en el número de personas mayores que pasan los últimos años de sus vidas en situaciones de dependencia. La atención sociosanitaria es el conjunto integrado de servicios y prestaciones sociales y sanitarias que se destinan a la rehabilitación y cuidados de personas que se encuentran en diferentes situaciones de dependencia. Los diferentes programas sociosanitarios han diseñado diferentes instrumentos de evaluación para medir las necesidades de cuidados asistenciales de las personas mayores, y dentro de éstas, existe también la preocupación por la medición de la calidad. En el presente trabajo la calidad se define desde diferentes ópticas y se desarrollan brevemente distintos programas de calidad que se aplican en el ámbito sociosanitario. Es de esperar que en estos programas se establezcan unos objetivos a cumplir basados en la igualdad de oportunidades y unos mínimos de obligado cumplimiento. Creemos necesario el establecimiento de un sistema de valoración de dependencia único para todas las comunidades autónomas (AU)

Spatio-temporal dynamics of a neutralized B chromosome in the grasshopper Eyprepocnemis plorans.

Spatial and temporal patterns of frequency variation for a neutralized B chromosome in the grasshopper Eyprepocnemis plorans were analyzed along six transects in the east of Spain to explore possible factors affecting the population dynamics of this polymorphism. Three parameters were employed to quantify B frequency: prevalence, load and mean frequency. Of them, load seemed to be the less sensitive parameter, probably due to its small range of variation. Prevalence, however, shows ample variation, but the mean frequency of B chromosomes per individual is the best parameter to characterize B frequency. Only river transects revealed significant differences among populations, and the use of two geographic explicit approaches (Mantel test and distograms) revealed significant isolation by distance (IBD), especially at the Segura River mouth, presumably due to low gene flow and drift. No temporal trend was found in the Segura River transects, which is consistent with the slow changes in B frequency expected during the random walk for neutralized B chromosomes. But these transects showed a clear spatial pattern, with B1 showing lower frequency in the upper course of this river. The present results provide the first empirical evidence of IBD in the evolution of a neutralized B chromosome, and support the notion that B dynamics at this evolutionary stage is best explained by a metapopulation approach.

[Treatment approach for vesicogenital fistula. Retrospective analysis of our data]. / Planteamiento terapéutico de las fístulas vesicogenitales. Análisis retrospectivo de nuestra serie.

The vesicogenital fistula are abnormal communications between female genitalia and urinary bladder. We recorded all the vesicogenital fistula diagnosed since 1986, analyzing aetiology, treatment applied, complications and results. Total number of fistula have been 20 (18 vesicovaginal and 2 vesicouterine). The distribution in vesicovaginal fistula was iatrogenic in 15 cases (83%) and tumoral in 3 cases (17%). Vesicouterine fistula were due to cesarean. The initial treatment of the iatrogenic fistula was conservative using foley catheter. Twenty percent of the patients were cured with this treatment (3 cases). Surgical repair was necessary for the other patients, using different surgical approach according to the type of the fistula, intensity and patient age. It was successful in 91% of the patients. The results shows that simple surgical approach generate less morbidity and the early intervention is not less efficient.

Planteamiento terapéutico de las fístulas vesicogenitales. Análisis retrospectivode nuestra serie / Treatment approach for vesicogenital fistula. Restrospective analysis of our data

Las fístulas vesicogenitales son comunicaciones anómalas de la vejiga urinaria con cualquier parte del aparato genital femenino. En el presente trabajo analizamos nuestra serie de fístulas vesicogenitales diagnosticadas y tratadas desde 1986, analizando las causas etiológicas, tratamientos aplicados, complicaciones y resultados de los mismos.El número total de fístulas han sido 20 (18 vesicovaginales y 2 vesicouterinas). De las fístulas vesicovaginales 15 (83 por ciento) eran yatrógenas y 3 (17 por ciento) neoplásicas. Las fístulas vesicouterinas aparecieron tras sendas cesáreas.El tratamiento inicial de las fístulas yatrógenas fue conservador con sondaje vesical, produciéndose su resolución en el 20 por ciento de las mismas (3 casos). En el resto de las pacientes se realizó tratamiento quirúrgico por vía abdominal con distintas técnicas según el tipo de fístula, intensidad y edad de la paciente, resultando satisfactorio en el 91 por ciento de los casos. La utilización de técnicas sencillas que generan menor morbilidad así como la actuación precoz no implica un peor resultado en las fístulas yatrógenas simples. (AU)

FISHing in the microwave: the easy way to preserve proteins. I. Colocalization of DNA probes and surface antigens in human leukocytes.

Most of the techniques for simultaneous visualization of proteic cell components and DNA probes are difficult to carry out. We have developed an alternative protocol for simultaneous visualization of DNA probes and cell surface antigens in human cells. The method exploits microwave energy to denature DNA and to anneal the probe after antigen fluorescent detection of unfixed cells previously embedded in a microgel. CD3 antigens and whole genome DNA probes or specific repetitive DNA sequences were colocalized in peripheral blood samples. The results show a strong, specific and consistent hybridization pattern in each cell that allowed correlation between cell subtype (PROTEINS) and nuclear phenotype (DNA).