Prenatal and child vitamin D levels and allergy and asthma in childhood.

BACKGROUND: Early-life vitamin D deficiency may impair immune system development contributing to allergy and asthma onset. Findings from prospective studies are inconsistent. OBJECTIVE: To examine whether maternal and child vitamin D levels are associated with allergic and asthma-related symptoms throughout childhood in a Spanish birth cohort. METHODS: 25-Hydroxyvitamin D3 (25(OH)D3) levels were measured in the serum of pregnant women (N = 2525) and children (N = 803). Information on allergic and asthma-related symptoms was obtained from repeated questionnaires from 1 to 9 years. RESULTS: A total of 19% of mothers and 24% of children had deficient 25(OH)D3 levels (<20 ng/ml). Higher child 25(OH)D3 levels at 4 years were associated with lower odds of atopic eczema from 4 to 9 years (adjusted odds ratio = 0.90; 95% CI = 0.84-0.97 per 5 ng/ml). Higher maternal and child 25(OH)D3 levels were associated with a lower prevalence of late-onset wheezing at the limit of statistical significance (adjusted relative risk ratio (RRRadj) = 0.86; 95% CI = 0.74-1.00 and RRRadj = 0.76; 95% CI = 0.58-1.02 per 5 ng/ml, respectively). All the remaining associations were null. CONCLUSION: Child 25(OH)D3 levels at pre-school age are associated with a reduced odds of atopic eczema in later childhood and both maternal and child levels may reduce the prevalence of late-onset wheezing. IMPACT: In this Spanish birth cohort, with a total of 19% of mothers and 24% of children with deficient levels of vitamin D, higher child vitamin D at 4 years of age was associated with reduced odds of atopic eczema up to 9 years. There was also some evidence that higher maternal and child vitamin D levels reduced the prevalence of late-onset wheezing. Although these findings need replication, they may imply optimal vitamin D levels at pre-school age to prevent atopic eczema.

Upside-down kidney placement: An alternative in pediatric renal transplantation.

PURPOSE: "Upside-down" kidney placement has been reported as an acceptable alternative in cases of technical difficulty in kidney transplantation but there are few reports in the pediatric population. The aim of our study is to analyze whether the placement of the upside-down kidney could affect graft outcome or produce more complications. MATERIALS AND METHODS: A retrospective study was conducted of pediatric kidney transplants performed in our center between 2005 and 2017 with at least 6 months' follow-up. Epidemiological and anthropometric data, type of donor (deceased/living), graft position (normal/upside-down), reason for the upside-down placement, early, medium and long-term complications and renal function were analyzed and compared with patients transplanted in the same period with a normal graft placement. RESULTS: From 181 transplants, 167 grafts were placed in a normal position (mean age: 10 y and mean weight: 30 kg) and 14 were placed upside-down (10 y, 37 kg) mainly because of vessel shortness after laparoscopic nephrectomy. Male predominance was observed in both groups. 57% of grafts from the control group and 64% of those from study group came from a living donor. Four vascular and two ureteral re-anastomoses were recorded in the control group and two vascular and one ureteral re-anastomosis in the study group (p > 0.05). In the latter group, no grafts have been lost due to vascular or urological causes and no patients have required dialysis. CONCLUSIONS: When necessary, an upside-down placement for the renal graft is a safe alternative in the pediatric population. LEVEL OF EVIDENCE: Level III.

The Early Asexual Development Regulator fluG Codes for a Putative Bifunctional Enzyme.

FluG is a long recognized early regulator of asexual development in Aspergillus nidulans. fluG null mutants show profuse aerial growth and no conidial production. Initial studies reported sequence homology of FluG with a prokaryotic type I glutamine synthetase, but catalytic activity has not been demonstrated. In this study, we conducted an in-depth analysis of the FluG sequence, which revealed a single polypeptide containing a putative N-terminal amidohydrolase region linked to a putative C-terminal γ-glutamyl ligase region. Each region corresponded, separately and completely, to respective single function bacterial enzymes. Separate expression of these regions confirmed that the C-terminal region was essential for asexual development. The N-terminal region alone did not support conidial development, but contributed to increased conidial production under high nutrient availability. Point mutations directed at respective key catalytic residues in each region demonstrated that they were essential for biological function. Moreover, the substitution of the N- and C-terminal regions with homologs from Lactobacillus paracasei and Pseudomonas aeruginosa, respectively, maintained functionality, albeit with altered characteristics. Taken together, the results lead us to conclude that FluG is a bifunctional enzyme that participates in an as yet unidentified metabolic or signaling pathway involving a γ-glutamylated intermediate that contributes to developmental fate.

Alternatives to subcutaneous injection of amino-amide or amino-ester anesthetics before arterial puncture for blood gas analysis: a systematic review. / Alternativas anestésicas a la inyección de amidas por vía subcutánea en punciones arteriales para gasometría: una revisión sistemática.

OBJECTIVES: Arterial puncture for blood gas analysis is a painful procedure in the emergency department (ED). Local subcutaneous injection of anesthetics containing amino amides or esters is the usual painrelief technique applied before arterial puncture, but it is little used in some care settings, such as the ED. We aimed to analyze the literature on anesthetic approaches other than the traditional one of local injection of amino-amide or amino-ester compounds for pain relief during arterial puncture and to assess the efficacy of the alternatives. MATERIAL AND METHODS: . A systematic review of the literature was conducted in 6 bibliographic databases. We selected randomized clinical trials (RCTs) published in English or Spanish between 2000 and 2018. The trials compared self-reported pain immediately after arterial puncture for blood gas analysis. Some form of anesthesia other than local injection of an amino-amide or -ester compound was compared to another anesthetic technique, placebo, or no anesthetic. RESULTS: We found 16 RCTs. Four compared the effect of topical anesthetic creams containing amino amides and/or amino esters, two assessed ultrasound-guided puncture, four used small-caliber needles or special syringes, one used a needle-free high-pressure anesthetic injection system, and five studied cryoanesthesia by application of ice or aerosols. CONCLUSION: The only effective alternative approaches to pain relief during arterial puncture for blood gas analysis were the use of very fine-caliber needles, the use of needle-free pressure injectors for subcutaneous delivery of amino amides, and the application of ice for at least 3 minutes.

OBJETIVO: La punción arterial para gasometría es una técnica dolorosa. La estrategia anestésica de elección consiste en la inyección local de amidas o esteres por vía subcutánea, pero resulta poco frecuente en algunos ámbitos asistenciales, como los servicios de urgencias. El objetivo de este trabajo es en describir las estrategias anestésicas distintas a la técnica clásica de inyección local de amidas o esteres y evaluar su eficacia en la punción arterial para gasometría. METODO: Se realizó una revisión sistemática de la literatura a través de 6 bases de datos bibliográficas. Fueron seleccionados ensayos clínicos publicados entre 2000 y 2018, en inglés o español, que comparasen el dolor autopercibido por el paciente inmediatamente después de una punción arterial para gasometría en función de si se les aplicó alguna medida anestésica diferente a la inyección subcutánea de amidas o esteres frente a otro procedimiento anestésico local, un placebo o ninguna intervención anestésica. RESULTADOS: Se localizaron 16 ensayos clínicos aleatorizados: 4 evaluaron la aplicación de anestésicos tópicos compuestos a base de esteres o amidas, 2 la punción ecoguiada, 4 el empleo de agujas de pequeño calibre o jeringuillas especiales, 1 el uso de inyectores a presión sin aguja y 5 la crioanestesia mediante hielo o aerosoles. CONCLUSIONES: Tan sólo el uso de agujas de calibre muy fino, la sustitución de jeringuillas clásicas por inyectores a presión sin aguja para la administración de amidas o esteres subcutáneas o la aplicación previa de hielo durante al menos 3 minutos se mostraron eficaces en la reducción del dolor derivado de la punción arterial para gasometría.

Alternativas anestésicas a la inyección de amidas por vía subcutánea en punciones arteriales para gasometría: una revisión sistemática / Alternatives to subcutaneous injection of amino-amide or amino-ester anesthetics before arterial puncture for blood gas analysis: a systematic review

Introducción y objetivo: La punción arterial para gasometría es una técnica dolorosa. La estrategia anestésica de elección consiste en la inyección local de amidas o esteres por vía subcutánea, pero resulta poco frecuente en algunos ámbitos asistenciales, como los servicios de urgencias. El objetivo de este trabajo es en describir las estrategias anestésicas distintas a la técnica clásica de inyección local de amidas o esteres y evaluar su eficacia en la punción arterial para gasometría. Método: Se realizó una revisión sistemática de la literatura a través de 6 bases de datos bibliográficas. Fueron seleccionados ensayos clínicos publicados entre 2000 y 2018, en inglés o español, que comparasen el dolor autopercibido por el paciente inmediatamente después de una punción arterial para gasometría en función de si se les aplicó alguna medida anestésica diferente a la inyección subcutánea de amidas o esteres frente a otro procedimiento anestésico local, un placebo o ninguna intervención anestésica. Resultados: Se localizaron 16 ensayos clínicos aleatorizados: 4 evaluaron la aplicación de anestésicos tópicos compuestos a base de esteres o amidas, 2 la punción ecoguiada, 4 el empleo de agujas de pequeño calibre o jeringuillas especiales, 1 el uso de inyectores a presión sin aguja y 5 la crioanestesia mediante hielo o aerosoles. Conclusión: Tan sólo el uso de agujas de calibre muy fino, la sustitución de jeringuillas clásicas por inyectores a presión sin aguja para la administración de amidas o esteres subcutáneas o la aplicación previa de hielo durante al menos 3 minutos se mostraron eficaces en la reducción del dolor derivado de la punción arterial para gasometría

Background and objective: Arterial puncture for blood gas analysis is a painful procedure in the emergency department (ED). Local subcutaneous injection of anesthetics containing amino amides or esters is the usual painrelief technique applied before arterial puncture, but it is little used in some care settings, such as the ED. We aimed to analyze the literature on anesthetic approaches other than the traditional one of local injection of amino-amide or amino-ester compounds for pain relief during arterial puncture and to assess the efficacy of the alternatives. Methods: A systematic review of the literature was conducted in 6 bibliographic databases. We selected randomized clinical trials (RCTs) published in English or Spanish between 2000 and 2018. The trials compared self-reported pain immediately after arterial puncture for blood gas analysis. Some form of anesthesia other than local injection of an amino-amide or -ester compound was compared to another anesthetic technique, placebo, or no anesthetic. Results: We found 16 RCTs. Four compared the effect of topical anesthetic creams containing amino amides and/or amino esters, two assessed ultrasound-guided puncture, four used small-caliber needles or special syringes, one used a needle-free high-pressure anesthetic injection system, and five studied cryoanesthesia by application of ice or aerosols. Conclusion: The only effective alternative approaches to pain relief during arterial puncture for blood gas analysis were the use of very fine-caliber needles, the use of needle-free pressure injectors for subcutaneous delivery of amino amides, and the application of ice for at least 3 minutes

Hipercolesterolemia familiar: experiencia en la Unidad de Lípidos de Álava / Familial hypercholesterolemia: Experience in the Lipid Clinic of Alava

Introducción: La hipercolesterolemia familiar (HF) es el trastorno genético autosómico dominante más frecuentemente asociado a enfermedad cardiovascular (ECV) prematura. Material y métodos: Estudio observacional, retrospectivo, para determinar las características clínicas, los parámetros analíticos y los factores de riesgo cardiovascular de 133 pacientes con diagnóstico genético confirmado de HF en seguimiento en la Unidad de Lípidos de Álava. Resultados: El 8,30% de los pacientes ha presentado ECV (en el 100% de los casos cardiopatía isquémica [CI]). El 40,60% alcanza el objetivo de cLDL: el 45,50% en prevención primaria y el 27,30% en prevención secundaria. El 81,80% de los pacientes con CI son varones. El odds ratio (OR) de presentar CI en los varones frente a las mujeres es 4,97 (1,03-23,93; p = 0,03). El OR de presentar CI en los pacientes con historia familiar de ECV prematura es 6,86 (1,32-35,67; p = 0,02). Encontramos una asociación estadísticamente significativa entre fumar y el riesgo de ECV (p=0,005) y también entre tener diabetes y el riesgo de ECV (p = 0,0001). Si el tratamiento con estatinas se inicia antes de los 40 años, el OR de presentar CI es 6,40 (1,53-26,50; p = 0,009). El tiempo medio desde el diagnóstico hasta el evento en el grupo de exfumadores es 10,80 ± 5,80 años y en el grupo de no fumadores es 17,50 ± 2,50 años (p = 0,01). Conclusiones: En nuestra población de referencia con HF, encontramos un mayor riesgo de presentar un evento cardiovascular en los pacientes varones, con antecedentes familiares de ECV prematura, diabéticos y en los que se ha iniciado el tratamiento hipolipidemiante después de los 40 años de edad

Introduction: Familial hypercholesterolaemia (FH) is the autosomal dominant genetic disorder most frequently associated with premature cardiovascular disease (CVD). Material and methods: A retrospective, observational study was conducted to determine the clinical characteristics, analytical parameters and cardiovascular risk factors of 133 patients with a genetically confirmed diagnosis of FH on follow-up in the Lipid Clinic of Alava. Results: CVD was observed in 8.30% of the patients (ischaemic heart disease in 100% of the cases). The LDL concentration goal was achieved in 40.6% (45.50% in primary prevention and 27.30% in secondary prevention). The large majority (81.80%) of patients with coronary heart disease (CHD) were male. The odds ratio (OR) of males having CHD compared to females is 4.97 (1.03-23.93, P = .03). The OR of developing CHD in patients with a family history of premature CVD is 6.86 (1.32-35.67, P = .02). A statistically significant association was found between smoking and the risk of CVD (P = .005), and also between having diabetes and the risk of CVD (P = 0.0001). If the treatment with statins begins at older than 40 years, the OR of suffering CHD is 6.40 (1.53-26.5) (P = .009). The mean time from diagnosis to the cardiovascular event in the group of ex-smokers is 10.80 ± 5.80 years, and in the non-smoking group it is 17.50 ± 2.50 years (P = .011). Conclusions: In our reference population with FH, it was found that there was an increased risk of suffering a cardiovascular event in male patients, with a family history of premature CVD, diabetics, and in those in whom lipid lowering treatment was started after 40 years of age

Familial hypercholesterolemia: Experience in the Lipid Clinic of Alava. / Hipercolesterolemia familiar: experiencia en la Unidad de Lípidos de Álava.

INTRODUCTION: Familial hypercholesterolaemia (FH) is the autosomal dominant genetic disorder most frequently associated with premature cardiovascular disease (CVD). MATERIAL AND METHODS: A retrospective, observational study was conducted to determine the clinical characteristics, analytical parameters and cardiovascular risk factors of 133 patients with a genetically confirmed diagnosis of FH on follow-up in the Lipid Clinic of Alava. RESULTS: CVD was observed in 8.30% of the patients (ischaemic heart disease in 100% of the cases). The LDL concentration goal was achieved in 40.6% (45.50% in primary prevention and 27.30% in secondary prevention). The large majority (81.80%) of patients with coronary heart disease (CHD) were male. The odds ratio (OR) of males having CHD compared to females is 4.97 (1.03-23.93, P=.03). The OR of developing CHD in patients with a family history of premature CVD is 6.86 (1.32-35.67, P=.02). A statistically significant association was found between smoking and the risk of CVD (P=.005), and also between having diabetes and the risk of CVD (P=0.0001). If the treatment with statins begins at older than 40 years, the OR of suffering CHD is 6.40 (1.53-26.5) (P=.009). The mean time from diagnosis to the cardiovascular event in the group of ex-smokers is 10.80±5.80 years, and in the non-smoking group it is 17.50±2.50 years (P=.011). CONCLUSIONS: In our reference population with FH, it was found that there was an increased risk of suffering a cardiovascular event in male patients, with a family history of premature CVD, diabetics, and in those in whom lipid lowering treatment was started after 40 years of age.

The role of subtotal petrosectomy in cochlear implant recipients.

Describe the indications and outcome of subtotal petrosectomy for cochlear implant recipients. Tertiary care referral center. This is a retrospective study of all subtotal petrosectomies and cochlear implants performed between January 2012 and December 2014. We review the charts of these patients collecting the following data: age, gender, otologic history, audiologic tests, indication of subtotal petrosectomy, data of surgery, surgical and immediate complications, late complications and follow-up of for at least 2.5 years. 12 cases of subtotal petrosectomies with cochlear implantation in 11 patients were performed during this period; 2 children and 10 adults. The indication for a cochlear implant was in 10 cases bilateral severe to profound sensorineural hearing loss and in the remaining 2 cases was asymmetric hearing loss or unilateral hearing loss. The reason for performing a subtotal petrosectomy was chronic otitis media with or without cholesteatoma, radical cavities from previous surgeries or electrode extrusion of previously implanted devices. All cases were performed in one stage. One patient had an infectious complication that required revision surgery and finally an explantation. No other complications are described. Subtotal petrosectomy combined with cochlear implantation is a procedure required in certain situations. It is an effective and safe procedure for managing middle ear problems and creating a safe cavity to receive a cochlear implant either in adults and children.

Carcinoma medular de tiroides en un paciente con síndrome de Birt-Hogg-Dubé / Medullary thyroid carcinoma in a patient with Birt-Hogg-Dube syndrome

No disponible

Abordaje por fosa media para el cierre de fístulas de líquido cefalorraquídeo espontáneas a oído medio / Middle cranial fossa approach for the repair of spontaneous cerebrospinal fluid leaks to the middle ear

Introducción. Las fístulas espontáneas de líquido cefalorraquídeo (LCR) al oído medio por dehiscencias espontáneas óseas del tegmen pueden ser origen de hipoacusia de transmisión y complicarse con meningitis u otras complicaciones intracraneales. El tratamiento quirúrgico para el cierre de estas comunicaciones anómalas puede realizarse por vía transmastoidea o por abordaje por fosa craneal media (FCM). Material y métodos. Se realiza un estudio retrospectivo de los pacientes intervenidos en nuestro servicio de fístulas de LCR espontáneas a oído medio por medio de abordaje por FCM en un período de 6años (2009-2014). Resultados. Se intervienen 13 pacientes con fístulas espontáneas por este abordaje, siendo el síntoma de presentación de todos ellos la hipoacusia de transmisión. En todos los casos se realiza un cierre multicapa (músculo, fascia temporal y cortical ósea) para cerrar el defecto o defectos existentes. El seguimiento mínimo en todos ellos es de 14meses, con cierre de la fístula en todos los casos salvo en uno, que precisó reintervención. No hubo complicaciones intraoperatorias ni postoperatorias debido a la técnica empleada, y la audiometría se normaliza en todos los casos, salvo en el caso de fracaso mencionado. Conclusiones. El abordaje por FCM y cierre en multicapa es una técnica adecuada y eficaz para el cierre de fístulas de LCR espontáneas a oído medio y consigue, además del cierre de la comunicación, el re-establecimiento de la audición (AU)

Introduction. Spontaneous cerebrospinal fluid (CSF) leaks to the middle ear due to tegmen tympani defects can result in hearing loss or hypoacusis and predispose to meningitis as well as other neurological complications. Surgical repair of the defect can be performed through a middle cranial fossa (MCF) approach or a transmastoid approach. Material and methods. We conducted a retrospective study of the patients in our Department due to a spontaneous CSF leak to the middle ear treated using a MCF approach during a 6-year period (2009-2014). Results. Thirteen patients with spontaneous CSF leak to the middle ear were treated with this approach. The primary and first symptom in all of them was conductive hearing loss. In all cases, the defect or defects were closed in a multilayer manner using muscle, temporalis fascia and cortical bone. Minimum follow-up in this series was 14 months, with successful closure in all but one patient (who required reintervention). We found no intra- or postoperative complications due to the craniotomy, and the audiometry improved and normalised in all cases except for the failed case. Conclusions. The MCF approach with a multilayer closure of the defect is an effective technique for repairing spontaneous CSF leaks to the middle ear and for restoring hearing in these patients (AU)

Middle cranial fossa approach for the repair of spontaneous cerebrospinal fluid leaks to the middle ear. / Abordaje por fosa media para el cierre de fístulas de líquido cefalorraquídeo espontáneas a oído medio.

INTRODUCTION: Spontaneous cerebrospinal fluid (CSF) leaks to the middle ear due to tegmen tympani defects can result in hearing loss or hypoacusis and predispose to meningitis as well as other neurological complications. Surgical repair of the defect can be performed through a middle cranial fossa (MCF) approach or a transmastoid approach. MATERIAL AND METHODS: We conducted a retrospective study of the patients in our Department due to a spontaneous CSF leak to the middle ear treated using a MCF approach during a 6-year period (2009-2014). RESULTS: Thirteen patients with spontaneous CSF leak to the middle ear were treated with this approach. The primary and first symptom in all of them was conductive hearing loss. In all cases, the defect or defects were closed in a multilayer manner using muscle, temporalis fascia and cortical bone. Minimum follow-up in this series was 14 months, with successful closure in all but one patient (who required reintervention). We found no intra- or postoperative complications due to the craniotomy, and the audiometry improved and normalised in all cases except for the failed case. CONCLUSIONS: The MCF approach with a multilayer closure of the defect is an effective technique for repairing spontaneous CSF leaks to the middle ear and for restoring hearing in these patients.

Desigualdad de género y riesgos laborales en Enfermería / Gender inequality and occupational risks in nursing

La Enfermería, profesión compuesta mayoritariamente por mujeres, constituye todavía hoy un colectivo laboral expuesto a desigualdades de género. En los últimos tiempos, el ritmo, la exigencia, la demanda y la carga de trabajo de los profesionales enfermeros es cada vez más elevado; al igual que en otras profesiones de predominio femenino. Sobre las enfermeras recae de forma mayoritaria la responsabilidad de conciliarla vida laboral y la doméstica, situación que supone una sobrecarga de trabajo y produce una disminución de la calidad de vida y, en ocasiones, obliga a reducir la jornada laboral a tiempo parcial. Por otra parte, las profesionales de la Enfermería conforman un grupo de riesgo laboral conocido, expuesto fundamentalmente a riesgos físicos, biológicos, químicos y psicosociales. Todas estas variables han de tenerse en consideración para prevenir la aparición de complicaciones y mejorarlos niveles de salud de las enfermeras (AU)

Nursing, a professional setting formed by women in its majority, still represents today a working group exposed to gender inequality. Recently, there has been a gradual increase in the rhythm, requirements, demands, and workload of professional nurses, and the same occurs in other professions with female prevalence. The responsibility of balancing work and domestic life lies heavily upon nurses, a situation which represents a work overload, and leads t a reduction in quality of life and, occasionally, forces to reduce the working day to part-time. Moreover, nursing professionals form a group with known occupational risks, primarily exposed to physical,biologic, chemical and psychosocial risks. All these variables must be taken into account in order to prevent complications, and to improve the health levels of nurses (AU)

Efficient serum-resistant lipopolyplexes targeted to the folate receptor.

In this work, we have developed and evaluated a new targeted lipopolyplex (LPP), by combining polyethylenimine (PEI), 1,2-dioleoyl-3-(trimethylammonium) propane (DOTAP)/Chol liposomes, the plasmids pCMVLuc/pCMVIL-12, and the ligand folic acid (FA), able to transfect HeLa and B16-F10 cells in the presence of very high concentration of serum (60% FBS). These complexes (Fol-LPP) have a net positive surface charge. The combination of folic acid with lipopolyplexes also enhanced significantly the transfection activity of the therapeutic gene interleukin-12 (IL-12), without any significant cytotoxicity. The specificity of the folate receptor (FR)-mediated gene transfer was corroborated by employing a folate receptor deficient cell line (HepG2). This formulation improved gene delivery showed by conventional lipoplexes or polyplexes resulting an efficient, simple, and nontoxic method for gene delivery of therapeutic genes in vitro and very probably in vivo.

[Descriptive study of intrapartum antibiotic prophylaxis of neonatal infection by group B Streptococcus in Txagorritxu]. / Infección neonatal: estudio descriptivo de profilaxis antibiótica.

INTRODUCTION: GBS is one of the most important causes of neonatal sepsis of vertical transmission (1-2% of the carriers). The infection may involve newborn's death or severe complications. The culture of vaginal and rectal GBS is a screening test and it is performed to all pregnant women between 35-37 weeks of gestation. If it is positive, intrapartum penicillin is prescribed. If it is negative or unknown, the antibiotic per protocol is given according to risk factors: rupture of membranes more than 18 hours, intrapartum temperature, or prematurity. The aim of this study is to quantify women who receive intrapartum antibiotic in relation to the positive culture and achievement with the SEGO's recommendation. MATERIAL AND METHODS: It describes a sample of 261 women of the Txagorritxu Hospital who have given birth during the work shift of researchers, excluding cesarean sections. VARIABLES: results of culture, antibiotic administration. Data were collected by reviewing and analyzed medical records using SPSS 17.0. RESULTS: From 261 women, 69 (26.4%) received antibiotic administration. From 69, 46 (66.67%) had a positive culture. 26 (37.68%) received antibiotics according to risk factors, although their cultures were negative or unknown. DISCUSSION: The results suggest there is a correct application of the SEGO's recommendation. Carrier women with no risk factors would not have received antibiotic therapy without screening.

Lipopolyplexes as nanomedicines for therapeutic gene delivery.

We describe an efficient, nonviral gene transfer system that employs polyethylenimine (PEI 800, 25, 22 kDa), and 1,2-dioleoyl-3-(trimethylammonium) propane (DOTAP) and cholesterol (Chol) as lipids (lipopolyplex), at three different lipid/DNA molar ratios (2/1, 5/1, and 17/1), employing five different formulation strategies. PEIs of 800, 25, and 22 kDa are highly effective in condensing plasmid DNA, leading to a complete condensation at N/P⁺/⁻ ratios above 4. Increasing the molar ratio lipid/DNA in the complex results in higher positive values of the zeta potential, while the particle size increases in some protocols, but not in others. PEI of molecular weight 800 kDa used in the formulation of lipopolyplexes results in bigger particles compared to that obtained with the smaller PEI species. Transfection activity is measured using pCMVLuc expressing luciferase is maximal by using strategies 3 and 4 and an N/P molar ratio of 17/1. These complexes have a high efficiency of gene delivery to liver cancer cells, even in the presence of a high serum concentration. Complexes formed with linear PEI are more effective than lipopolyplexes containing branched PEI. The ternary complexes are much more efficient than conventional lipoplexes (cationic lipid and DNA) and polyplexes (cationic polymer and DNA). The same behavior is observed for complexes prepared with the therapeutic gene pCMVIL-12 expressing interleukin-12.

Estudio descriptivo de profilaxis antibiótica. Infección neonatal / Descriptive study of intrapartum antibiotic prophilaxis of neonatal infection by group b streptococcus in Txagorritxu

Introducción. El SGB (Streptococcus grupo B) es una de las causas más importantes de sepsis neonatal por transmisión vertical (1-2% de las portadoras). La infección puede comportar la muerte del recién nacido o complicaciones severas. El cultivo vagino-rectal del SGB es una prueba de detección que se realiza a todas las embarazadas entre las semanas 35-37 de gestación. Si es positivo se prescribe penicilina intraparto. Si es negativo o desconocido, el antibiótico se protocoliza según factores de riesgo: rotura de membranas mayor de 18 horas, fiebre intraparto o prematuridad. El objetivo del estudio es cuantificar las mujeres que reciben antibiótico intraparto en relación con el cultivo positivo y el cumplimiento de la recomendación de la SEGO (Sociedad Española de Ginecología y Obstetricia). Material y métodos. Se describe una muestra de 261 mujeres del hospital de Txagorritxu, que han parido durante el turno de trabajo de los investigadores, excluyendo las cesáreas. Variables: resultado de cultivo, administración de antibiótico. Los datos fueron recogidos por revisión de historia clínica y analizados con el programa SPSS 17.0. Resultados. De las 261 mujeres, 69 (26,4%) recibieron la administración antibiótico. De las 69, 46 (66,67%) tenían un cultivo positivo. Recibieron antibioterapia según factores de riesgo 26 (37,68%), aunque sus cultivos fueran negativo o desconocido. Discusión. Los resultados apuntan a una aplicación correcta de la recomendación de la SEGO. Las mujeres portadoras sin factores de riesgo no habrían recibido antibioterapia sin screening(AU)

Introduction. GBS is one of the most important causes of neonatal sepsis of vertical transmission (1-2% of the carriers). The infection may involve newborn's death or severe complications. The culture of vaginal and rectal GBS is a screening test and it is performed to all pregnant women between 35-37 weeks of gestation. If it is positive, intrapartum penicillin is prescribed. If it is negative or unknown, the antibiotic per protocol is given according to risk factors: rupture of membranes more than 18 hours, intrapartum temperature, or prematurity. The aim of this study is to quantify women who receive intrapartum antibiotic in relation to the positive culture and achievement with the SEGO's recommendation. Material and methods. It describes a sample of 261 women of the Txagorritxu Hospital who have given birth during the work shift of researchers, excluding cesarean sections. Variables: results of culture, antibiotic administration. Data were collected by reviewing and analyzed medical records using SPSS 17.0. Results. From 261 women, 69 (26.4%) received antibiotic administration. From 69, 46 (66.67%) had a positive culture. 26 (37.68%) received antibiotics according to risk factors, although their cultures were negative or unknown. Discussion. The results suggest there is a correct application of the SEGO's recommendation. Carrier women with no risk factors would not have received antibiotic therapy without screening(AU)

Liposomes and lipopolymeric carriers for gene delivery.

In this work we have examined the ability of various lipopolyplexes to deliver genes into liver cancer cells. We evaluated different parameters such as the protocol of preparation, the lipid/DNA molar ratio, and the molecular weight and type of PEI, to optimize the formulation to achieve high transfection activity. Our hypothesis was that the association of PEI with cationic liposomes (lipopolyplexes) would increase luciferase expression compared to lipoplexes (cationic lipid and DNA) and polyplexes (cationic polymer and DNA) alone.

Hábito tabáquico y riesgo cardiovascularen trabajadores administrativos / Tobacco smoking and cardiovascular risk in administrative employees

Objetivo: analizar el consumo de tabaco entre trabajadoresadministrativos, medir las diferencias de género y surelación con los factores de riesgo cardiovasculares (FRCV).Material y métodos: muestra compuesta por 432 administrativosaparejados por edad (216 hombres y 216 mujeres).Los datos se obtuvieron de reconocimientos médicoslaborales en trabajadores administrativos de Vizcaya y se analizaronlas siguientes variables: edad, género y hábito de fumar.Los fumadores se estratificaron en tres grupos según elconsumo de tabaco. Posteriormente, se realizó una comparaciónentre ambos géneros a través del test de homogeneidadde porcentajes con un índice de confianza del 95%.Resultados: no existen diferencias significativas entre hombresy mujeres administrativos en lo referente al hábito tabáquicoexcepto en el grupo de grandes fumadores (>20 cig/día).Conclusiones: no se evidencian diferencias de género entrelos administrativos en lo que al consumo de tabaco se refiere,si bien en el grupo de grandes fumadores se observancifras superiores en los hombres y, por consiguiente, un mayorriesgo cardiovascular. Además, los porcentajes halladosen este estudio coinciden con los presentes en la poblaciónde la Comunidad Autónoma del País Vasco (CAPV) y son similaresa los observados en la población española (AU)

Objective: to analyse tobacco consumption amongst administrativeemployees, measure gender differences andtheir relationship with cardiovascular risk factors (CVRF).Material and methods: our sample is composed of 432administrative employees paired by age (216 men and 216women). Data were obtained from occupational medicalcheck-ups of administrative employees from Vizcaya and thefollowing variables were analysed: age, gender and smoking.Smokers were stratified into 3 groups based on theirtobacco consumption. Subsequently, both genders werecompared using the percentage Homogeneity Test with a95% confidence index.Results: there are no significant differences between maleand female administrative employees in regards to smokingexcept in the case of heavy smokers (> 20 cigarettes/day).Conclusions: no gender differences were evidenced betweenadministrative employees in terms of smoking, eventhough in the group of heavy smoker higher values wereobserved in men and, therefore, they presented a highercardiovascular risk. Furthermore, the percentages found inthis study mirror those of the population of the AutonomousCommunity of the Basque Country and are similar tothose observed in the Spanish population (AU)

[Chronic pathologies among cleaning and administrative personnel]. / Patologías crónicas en trabajadores de limpieza y administrativos.

Workers' health is of vital importance in order for workers to work at their utmost on their jobs. The prevalence of specific pathologies affects the normal functioning of workers, provoking incapacities and absences from work. The authors measure the prevalence of chronic type illnesses among cleaning and administrative personnel. The authors analyze differences based on gender and they evaluate its influence on the work assigned. In both labor groups, there exists a significant difference in the prevalence of varicose veins and scoliosis favorable in the feminine sex, a fact which corresponds to gender reasons and not to the type of work carried out. Arterial hypertension, on the other hand, is more prevalent among men in both groups, making them be exposed to a greater cardiovascular risk. The remaining pathologies found did not show any significant gender differences.