Nanostructured fibrin-based hydrogel membranes for use as an augmentation strategy in Achilles tendon surgical repair in rats.

Hydrogels are polymeric biomaterials characterised by their promising biological and biomechanical properties, which make them potential alternatives for use in tendon repair. The aim of the present study was to generate in vitro, and determine the therapeutic efficacy in vivo, of novel nanostructured fibrin-based hydrogels to be used as an augmentation strategy for the surgical repair of rat Achilles tendon injuries. Fibrin, fibrin-agarose and fibrin-collagen nanostructured hydrogels (NFH, NFAH and NFCH, respectively) were generated and their biomechanical properties and cell-biomaterial interactions characterised ex vivo. Achilles tendon ruptures were created in 24 adult Wistar rats, which were next treated with direct repair (control group) or direct repair augmented with the generated biomaterials (6 rats/group). After 4 and 8 weeks, the animals were euthanised for macroscopical and histological analyses. Biomechanical characterisation showed optimal properties of the biomaterials for use in tendon repair. Moreover, biological analyses confirmed that tendon-derived fibroblasts were able to adhere to the surface of the generated biomaterials, with high levels of viability and functionality. In vivo studies demonstrated successful tendon repair in all groups. Lastly, histological analyses disclosed better tissue and extracellular matrix organisation and alignment with biomaterial-based augmentation strategies than direct repair, especially when NFAH and NFCH were used. The present study demonstrated that nanostructured fibrin-collagen hydrogels can be used to enhance the healing process in the surgical repair of tendon ruptures.

Actualización de la retinopatía diabética para médicos de atención primaria: hacia una mejora de la medicina telemática / Update of diabetic retinopathy for Primary Care physicians: Towards an improvement of telematic medicine

La retinopatía diabética (RD) está considerada como la causa más frecuente de ceguera en la población activa en países industrializados. El edema macular diabético es la causa más frecuente de disminución de la agudeza visual en los diabéticos. De acuerdo con los resultados de los grandes estudios multicéntricos, la prevención de la ceguera por RD pasa por la realización de revisiones periódicas del fondo de ojo de los pacientes diabéticos de manera que puedan ser tratadas a tiempo. El uso de cámaras no midriáticas y la telemedicina han demostrado ser útiles para este fin (sensibilidad > 80% y especificidad > 90%). Si se sigue este método, la primera retinografía debería realizarse a los 5 años del diagnóstico en los diabéticos tipo 1 y en el momento del diagnóstico en los diabéticos tipo 2. Por tanto, el papel del médico de atención primaria es fundamental para la detección precoz de esta enfermedad (AU)

Diabetic retinopathy (DR) is considered the most common cause of blindness in the working-age population in industrialised countries, with diabetic macular oedema being the most common reason of decreased visual acuity in diabetics. According to the results of large multicentre studies, blindness prevention for RD involves conducting periodic check-ups, which include examinations of the back of the eye, so they can be treated in time. The use of non-mydriatic cameras and telemedicine have been shown to be useful in this regard (sensitivity > 80% and specificity > 90%). If this procedure is followed, the first retinography should be performed 5 years from diagnosis in type 1 diabetics and immediately after diagnosis in type 2 diabetics. Therefore the role of the Primary Care physician is crucial to enable early diagnosis of this disease (AU)

[Update of diabetic retinopathy for Primary Care physicians: Towards an improvement of telematic medicine]. / Actualización de la retinopatía diabética para médicos de atención primaria: hacia una mejora de la medicina telemática.

Diabetic retinopathy (DR) is considered the most common cause of blindness in the working-age population in industrialised countries, with diabetic macular oedema being the most common reason of decreased visual acuity in diabetics. According to the results of large multicentre studies, blindness prevention for RD involves conducting periodic check-ups, which include examinations of the back of the eye, so they can be treated in time. The use of non-mydriatic cameras and telemedicine have been shown to be useful in this regard (sensitivity>80% and specificity>90%). If this procedure is followed, the first retinography should be performed 5 years from diagnosis in type 1 diabetics and immediately after diagnosis in type 2 diabetics. Therefore the role of the Primary Care physician is crucial to enable early diagnosis of this disease.

¿Existen diferencias en la calidad percibida y satisfacción del usuario que asiste a un centro deportivo de titularidad privada o pública? Un estudio piloto / Existem diferenças na qualidade percebida e a satisfação do utente de um centro desportivo privado ou público? Um estudo-piloto / Are there differences in perceived quality or satisfaction of the user who attends a sports center of private or public ownership? A pilot study

Las exigencias del sector deportivo y los cambios a los que se ve sometido han provocado que la calidad sea un factor determinante para el logro de resultados y el éxito en las organizaciones, incluso en tiempos de crisis. El objeto de este estudio es realizar una primera aproximación sobre las diferencias en la calidad percibida y satisfacción del usuario entre centros deportivos con diferente titularidad y modelos de gestión. Los participantes del estudio fueron 287 usuarios de dos centros deportivos gallegos (privado y concesión pública). Se ha utilizado la escala QSport-10 y el análisis de importancia-valoración. Para establecer las posibles diferencias entre ambos modelos de gestión se utilizó la prueba de Chi-cuadrado (p ≤ 0,05). Los resultados sugieren que existen diferencias en la calidad percibida y satisfacción de los usuarios entre la instalación privada y de concesión pública, en especial en la dimensión personal. Como conclusión, ante un coste de servicio parejo la calidad percibida del centro deportivo privado es significativamente mayor, al igual que la satisfacción en todos los elementos considerados a excepción de equipamientos deportivos (AU)

The demands of the sports sector and the changes, which it is subjected, have caused that quality becomes a decisive factor for achieving results and success in organizations, even in times of crisis. The purpose of this research is to carry out a first approach on differences perceived quality and user´s satisfaction between sports centers with different ownership and management models. The study involved 287 users in two Galician sports centers (private and public concession). The QSport-10 scale and the importance performance analysis was used. In order to establish possible differences between management models the chi-square test (p ≤ 0.05) was used. The results suggest that there are differences in perceived quality and satisfaction of the user between private and public concession centers, especially in the staff dimension. In conclusion, even with a similar cost of service, the perceived quality of private center is significantly higher, and the satisfaction in all the considered elements with the exception of sports equipment (AU)

As demandas do setor de esportes e as mudanças que ela está passando por ter causado que a qualidade é a chave para alcançar resultados e sucesso nas organizações, mesmo em tempos de crise. O objetivo deste estudo é uma primeira abordagem sobre as diferenças de qualidade percebida e a satisfação do usuário entre instalações desportivas com diferentes modelos de propriedade e de gestão. Participaram do estudo 287 usuários em duas (provisão privada e pública) centros esportivos da Galiza. Foi usado QSport-10 escala e análise de importância-classificação. Para estabelecer possíveis diferenças entre os modelos de gestão do teste do qui-quadrado (p ≤ 0,05) foi utilizado. Os resultados sugerem que há diferenças na qualidade percebida entre os usuários privados e facilidade de concessão pública, especialmente na dimensão pessoal. Em conclusão, mesmo a um custo de serviço de qualidade percebida do centro desportivo privado é significativamente maior, e a satisfação em todos os elementos considerados com excepção do equipamento desportivo (AU)

[Granulocyte-apheresis in ocular Behçet's disease resistant to medical treatment]. / Granulocito-aferesis en Behçet ocular refractario al tratamiento médico.

OBJECTIVE: To assess the feasibility of granulocyte apheresis (GCAP) in patients with Ocular Behçet's Disease (BD) resistant to immunosuppressive therapy (prednisone, cyclosporin, azathyoprine or mycophenolate mofetil). METHODS: Prospective observational study of five cases, carried out in a university centre. Four patients were resistant to medical treatment and one refused immunosuppressive drugs. The intervention procedure consisted of an extracorporeal GCAP using a column filled with cellulose acetate beads (Adacolumn, JIMRO, Takasaki, Japan). All patients received underwent a schedule of therapy of five sessions, once a week for five consecutive weeks. Visual acuity (Snellen lines), the degree of intraocular inflammation and doses of immunosuppressive therapy were measured and observed every week. RESULTS: Visual acuity improved in the five cases. Intraocular inflammation was measured and observed in every case, relapses were avoided, and treatment with prednisone was reduced by more than half of the initial dose (average reduction 52.7%, SD 14). CONCLUSIONS: GCAP has been shown to be safe and effective as a new therapy in five cases of Ocular Behçet's Disease refractory to medical treatment. Further research is needed in order to confirm the promising results of these initial investigations.

Granulocito-aferesis en Behçet ocular refractario al tratamiento médico / Granulocyte-Apheresis in ocular Behçets disease resistant to medical treatment

Objetivo: El objetivo del estudio fue evaluar la viabilidad de la granulocitoaferesis (GCAP) en pacientes con enfermedad de Behçet (EB) ocular resistente al tratamiento con inmunosupresores (prednisona, ciclosporina, azatioprina o micofenolato mofetilo). Métodos: Estudio prospectivo de cinco pacientes, realizado en un hospital universitario de tercer nivel. Cuatro pacientes eran resistentes al tratamiento médico y uno rechazaba los fármacos inmunosupresores. El procedimiento consistió en realizar una GCAP extracorpórea mediante una columna rellena con gránulos de acetato de celulosa (Adacolumn®, JIMRO, Takasaki, Japón). Todos los pacientes fueron tratados con cinco sesiones, una semanal durante cinco semanas consecutivas. En cada sesión se controlaba la agudeza visual (AV) mediante las lineas de Snellen, el grado de inflamación intraocular y las dosis de tratamiento inmunosupresor. Resultados: La agudeza visual mejoró en los cinco casos. La inflamación intraocular se controló, no hubo recidivas y el tratamiento con prednisona se redujo en más de la mitad de la dosis inicial (reducción media de 52,7%, DE 14 ). Conclusiones: La GCAP ha demostrado ser un nuevo tratamiento seguro y eficaz en cinco casos de EB ocular resistente al tratamiento médico. Es preciso seguir investigando para confirmar los esperanzadores resultados de estos estudios iniciales(AU)

Objective: To assess the feasibility of granulocyte apheresis (GCAP) in patients with Ocular Behçets Disease (BD) resistant to immunosuppressive therapy (prednisone, cyclosporin, azathyoprine or mycophenolate mofetil). Methods: Prospective observational study of five cases, carried out in a university centre. Four patients were resistant to medical treatment and one refused immunosuppressive drugs. The intervention procedure consisted of an extracorporeal GCAP using a column filled with cellulose acetate beads (Adacolumn, JIMRO, Takasaki, Japan). All patients received underwent a schedule of therapy of five sessions, once a week for five consecutive weeks. Visual acuity (Snellen lines), the degree of intraocular inflammation and doses of immunosuppressive therapy were measured and observed every week. Results: Visual acuity improved in the five cases. Intraocular inflammation was measured and observed in every case, relapses were avoided, and treatment with prednisone was reduced by more than half of the initial dose (average reduction 52.7%, SD 14). Conclusions: GCAP has been shown to be safe and effective as a new therapy in five cases of Ocular Behçets Disease refractory to medical treatment. Further research is needed in order to confirm the promising results of these initial investigations(AU)