Simultaneous Formation of Polyhydroxyurethanes and Multicomponent Semi-IPN Hydrogels.

This study introduces an efficient strategy for synthesizing polyhydroxyurethane-based multicomponent hydrogels with enhanced rheological properties. In a single-step process, 3D materials composed of Polymer 1 (PHU) and Polymer 2 (PVA or gelatin) were produced. Polymer 1, a crosslinked polyhydroxyurethane (PHU), grew within a colloidal solution of Polymer 2, forming an interconnected network. The synthesis of Polymer 1 utilized a Non-Isocyanate Polyurethane (NIPU) methodology based on the aminolysis of bis(cyclic carbonate) (bisCC) monomers derived from 1-thioglycerol and 1,2-dithioglycerol (monomers A and E, respectively). This method, applied for the first time in Semi-Interpenetrating Network (SIPN) formation, demonstrated exceptional orthogonality since the functional groups in Polymer 2 do not interfere with Polymer 1 formation. Optimizing PHU formation involved a 20-trial methodology, identifying influential variables such as polymer concentration, temperature, solvent (an aprotic and a protic solvent), and the organo-catalyst used [a thiourea derivative (TU) and 1,8-diazabicyclo [5.4.0]undec-7-ene (DBU)]. The highest molecular weights were achieved under near-bulk polymerization conditions using TU-protic and DBU-aprotic as catalyst-solvent combinations. Monomer E-based PHU exhibited higher Mw¯ than monomer A-based PHU (34.1 kDa and 16.4 kDa, respectively). Applying the enhanced methodology to prepare 10 multicomponent hydrogels using PVA or gelatin as the polymer scaffold revealed superior rheological properties in PVA-based hydrogels, exhibiting solid-like gel behavior. Incorporating monomer E enhanced mechanical properties and elasticity (with loss tangent values of 0.09 and 0.14). SEM images unveiled distinct microstructures, including a sponge-like pattern in certain PVA-based hydrogels when monomer A was chosen, indicating the formation of highly superporous interpenetrated materials. In summary, this innovative approach presents a versatile methodology for obtaining advanced hydrogel-based systems with potential applications in various biomedical fields.

Pharmacist care in hospital emergency departments: a consensus paper from the Spanish hospital pharmacy and emergency medicine associations. / Atención farmacéutica en los servicios de urgencias: documento de posicionamiento de la Sociedad Española de Farmacia Hospitalaria (SEFH) y la Sociedad Española de Medicina de Urgencias y Emergencias (SEMES).

OBJECTIVES: To draft a list of actions and quality indicators for pharmacist care in hospital emergency departments, based on consensus among a panel of experts regarding which actions to prioritize in this setting. MATERIAL AND METHODS: A panel of experts from the Spanish Society of Hospital Pharmacy (SEFH) and the Spanish Society of Emergency Medicine (SEMES) evaluated a preliminary list of potential actions and quality of care indicators. The experts used a questionnaire to assess the proposals on the basis of available evidence. In the first round, each expert individually assessed the importance of each proposed action based on 4 dimensions: evidence base, impact on clinical response and patient safety, ease of implementation, and priority. In the second round the experts attended a virtual meeting to reach consensus on a revised list of proposals; suggestions and comments that had been made anonymously in the first round were included. The group then prioritized each action as basic, intermediate, or advanced. RESULTS: The experts evaluated a total of 26 potential actions and associated quality indicators. No items were eliminated in the analysis of scores and comments from the first round. After the second round, 25 actions survived. Nine were considered basic, 10 intermediate, and 6 advanced. CONCLUSION: The expert panel's list of pharmacist actions and care quality indicators provides a basis for developing a pharmacist care program in Spanish emergency departments on 3 levels of priority. The list can serve as a guide to pharmacists, managers, physicians, and nurses involved in the effort to improve drug therapy in this hospital setting.

OBJETIVO: Desarrollar un conjunto de actividades e indicadores de atención farmacéutica en los servicios de urgencias hospitalarios mediante un consenso colectivo de un panel de expertos que permita priorizar las actividades a realizar por los farmacéuticos en estas unidades. METODO: Un comité formado por miembros de la Sociedad Española de Farmacia Hospitalaria (SEFH) y de la Sociedad Española de Medicina de Urgencias y Emergencias (SEMES) evaluó una propuesta inicial de actividades e indicadores potenciales, basados en la evidencia científica disponible, en formato de cuestionario. En una primera ronda, cada uno de los expertos del panel clasificó de forma individual la relevancia de cada una de las actividades propuestas en cuatro dimensiones: evidencia científica, impacto en la respuesta clínica y seguridad para el paciente, facilidad de implementación y grado de prioridad. La segunda ronda se realizó mediante una reunión grupal de forma virtual, a partir del cuestionario modificado de acuerdo con las sugerencias planteadas, así como los comentarios vertidos por los participantes del panel de forma anónima. En esta ronda, cada actividad fue clasificada por consenso como básica, intermedia o avanzada en función del grado de prioridad de implantación considerado por el grupo de expertos. RESULTADOS: Se propusieron un total de 26 potenciales actividades a los expertos, con indicadores asociados. Tras el análisis de las puntuaciones y los comentarios realizados en la primera ronda, no se eliminó ninguna de las actividades propuestas. Tras la segunda ronda, se mantuvieron 25 actividades, de las cuales se puntuaron 9 como actividades básicas, 10 actividades como intermedias y 6 actividades como avanzadas. CONCLUSIONES: El desarrollo del conjunto de actividades e indicadores de atención farmacéutica en urgencias, priorizados por grado de relevancia para la unidad, es la base para el desarrollo de esta cartera de servicios en los hospitales españoles, y sirve como guía tanto para farmacéuticos como para gestores, médicos y enfermeros de la unidad a fin de mejorar la farmacoterapia los pacientes atendidos en los servicios de urgencias.

Biodegradable Guar-Gum-Based Super-Porous Matrices for Gastroretentive Controlled Drug Release in the Treatment of Helicobacter pylori: A Proof of Concept.

An increase in resistance to key antibiotics has made the need for novel treatments for the gastric colonization of Helicobacter pylori (H. pylori) a matter of the utmost urgency. Recent studies tackling this topic have focused either on the discovery of new compounds to ameliorate therapeutic regimes (such as vonoprazan) or the synthesis of gastroretentive drug delivery systems (GRDDSs) to improve the pharmacokinetics of oral formulations. The use of semi-interpenetrating polymer networks (semi-IPNs) that can act as super-porous hydrogels for this purpose is proposed in the present work, specifically those displaying low ecological footprint, easy synthesis, self-floating properties, high encapsulation efficiency for drugs such as amoxicillin (AMOX), great mucoadhesiveness, and optimal mechanical strength when exposed to stomach-like fluids. To achieve such systems, biodegradable synthetic copolymers containing acid-labile monomers were prepared and interpenetrated with guar gum (GG) in a one-pot polymerization process based on thiol-ene click reactions. The resulting matrices were characterized by SEM, GPC, TGA, NMR, and rheology studies, and the acidic hydrolysis of the acid-sensitive polymers was also studied. Results confirm that some of the obtained matrices are expected to perform optimally as GRDDSs for the sustained release of active pharmaceutical ingredients at the gastrointestinal level, being a priori facilitated by its disaggregation. Therefore, the optimal performance of these systems is assessed by varying the molar ratio of the labile monomer in the matrices.

The synthetic molecule stauprimide impairs cell growth and migration in triple-negative breast cancer.

Stauprimide, a semi-synthetic derivative of staurosporine, is known mainly for its potent differentiation-enhancing properties in embryonic stem cells. Here, we studied the effects of stauprimide in cell growth and migration of triple-negative breast cancer cells in vitro, evaluating its potential antitumoral activity in an orthotopic mouse model of breast cancer in vivo. Our results from survival curves, EdU incorporation, cell cycle analysis and annexin-V detection in MDA-MB-231 cells indicated that stauprimide inhibited cell proliferation, arresting cell cycle in G2/M without induction of apoptosis. A decrease in the migratory capability of MDA-MB-231 was also assessed in response to stauprimide. In this work we pointed to a mechanism of action of stauprimide involving the modulation of ERK1/2, Akt and p38 MAPK signalling pathways, and the downregulation of MYC in MDA-MB-231 cells. In addition, orthotopic MDA-MB-231 xenograft and 4T1 syngeneic models suggested an effect of stauprimide in vivo, increasing the necrotic core of tumors and reducing metastasis in lung and liver of mice. Together, our results point to the promising role of stauprimide as a putative therapeutic agent in triple-negative breast cancer.

Caracterización fenotípica psicomotora y psicolingüística en el síndrome de Wolf-Hirschhorn: un estudio de 18 casos / PSYCHOMOTOR AND PSYCHOLINGUISTIC PHENOTYPIC CHARACTERIZATION IN WOLF-HIRSCHHORN SYNDROME: A STUDY OF 18 CASES

Introducción. El síndrome de Wolf-Hirschhorn (SWH) es una enfermedad rara de origen genético causado por una deleción parcial en la región terminal del brazo corto del cromosoma 4. La finalidad de este estudio es explorar variables del fenotipo cognitivo y su relación con el desarrollo evolutivo motor, visuoespacial, visuomotriz y del lenguaje en niños/as con esta patología. Pacientes y método. La investigación se dirige a una muestra incidental de 18 pacientes con diagnóstico clínico en el SWH, entre 1 y 23 años de edad, procedentes de diferentes países de habla hispana. Variables e instrumentos. Se recogieron diferentes variables diagnósticas, clínicas y neuropsicológicas como el desarrollo somático (desarrollo físico, motor y sensorial) y desarrollo cognitivo (desarrollo visuoespacial, visuomotriz, lenguaje comprensivo y expresivo). Se utilizaron dos instrumentos de medida: Cuestionario ad hoc de evaluación del desarrollo motor, visuoespacial, visuomotriz y del lenguaje, y la versión española de la Escala Barthel. La recogida de datos fue realizada mediante la información proporcionada por los progenitores. Resultados. El principal hallazgo de este estudio es que los/as niños/as con baja talla actual, bajo peso actual, menor perímetro craneal actual y con estatus epiléptico presentan mayor incidencia de problemas en el desarrollo evolutivo, en comparación con aquellos/as que actualmente presentan mayor talla, más peso, mayor perímetro craneal y sin estatus epiléptico. Conclusiones. Se constata un doble fenotipo cognitivo específico acorde a la muestra estudiada que puede ayudar a crear un primer perfil neuroevolutivo del SWH en la praxis sanitaria, educativa y/o social. (AU)

Introduction. Wolf-Hirschhorn Syndrome (WHS) is a rare genetic disorder caused by a partial deletion in the terminal region of the short arm of chromosome 4. The purpose of this study is to explore cognitive phenotype variables and their relationship with motor, visuospatial, visuomotor and language development in children with WHS. Patients and method. The research targets an incidental sample of 18 patients clinically diagnosed with WHS, aged between 1 and 23 years, from various Spanish-speaking countries. Variables and instruments. Different diagnostic, clinical and neuropsychological variables were collected, including somatic development (physical, motor and sensory) and cognitive development (visuospatial, visuomotor, receptive and expressive language). Two measurement instruments were utilized: an ad hoc questionnaire assessing motor, visuospatial, visuomotor and language development, and the Spanish version of the Barthel Scale. Data collection relied on information provided by the parents. Results. The main finding of this study indicates that children with lower current height, weight, and head circumference, as well as those experiencing status epilepticus, demonstrate a higher incidence of developmental problems compared to those with higher current measurements of those variables, and with no status epilepticus. Conclusions. A distinct double cognitive phenotype was observed within the studied sample, which may help to create an initial neurodevelopmental profile of WHS for clinical, educational, and social purposes. (AU)

Prevalence of adverse drug events in emergency departments. FARM-URG multi-center project.

OBJECTIVE: Adverse drug events are a well-known cause of emergency department admissions. FARM-URG is a project promoted by  the REDFASTER working group of the Spanish Society of Hospital  Pharmacy. Its aim is to evaluate these adverse events through regular  prevalence measurements. The present study shows the results of the first observations. The goal was to determine the prevalence of adverse drug  events with respect to the total number of patients treated in emergency  departments and carry out a description of the different events identified. METHOD: This is a multicenter cross-sectional study carried out in the emergency room of 13 Spanish hospitals. The identification and  registration of patients were obtained from the emergency department  patient census at the time of the first prevalence measurement (16 June  2020). The REDCap® platform was used for patient registration. RESULTS: The 2020 FARM-URG registry, which included 13 hospitals, evaluated 772 patients, of whom 57 (7.4%) consulted for  adverse drug events. Antithrombotic drugs were responsible for most of  these episodes, acenocoumarol being the main drug involved (22.8%).  Nine (15.8%) adverse drug events were caused by inappropriate drug  prescriptions according to the STOPP-START criteria. Nineteen (33.0%)  patients returned to the emergency service within 30 days from discharge. CONCLUSIONS: Adverse drug events are a frequent cause of emergency department visits and are commonly associated with a  significant percentage of re-visits. The FARM-URG project has been created with the purpose of obtaining dynamic and updated information on such  events.

Objetivo: Los acontecimientos adversos por medicamentos son una causa conocida de asistencia a los servicios de urgencias. El objetivo del  proyecto FARM-URG, impulsado por el Grupo de Trabajo REDFASTER de la  Sociedad Española de Farmacia Hospitalaria, es evaluar estos  acontecimientos adversos mediante cortes periódicos. En este estudio se  muestran los resultados del primer registro. Sus objetivos fueron  determinar la prevalencia de acontecimientos adversos respecto al total de pacientes atendidos y caracterizarlos.Método: Estudio multicéntrico transversal realizado en los servicios de urgencias de hospitales españoles. La identificación y registro de  pacientes se obtuvo a partir del censo de pacientes atendidos en urgencias en el momento del corte (16 de junio de 2020). Se revisaron las historias  clínicas retrospectivamente y se registraron los datos en la plataforma  REDCap®.Resultados: En este corte FARM-URG de 2020 participaron 13 hospitales, que evaluaron 772 pacientes, de los cuales 57 (7,4%) habían consultado por un acontecimiento adverso por medicamentos. El grupo de  fármacos antitrombóticos fue responsable de la mayor parte de estos  episodios, siendo acenocumarol (22,8%) el principal fármaco implicado.  Nueve (15,8%) de los acontecimientos adversos fueron causados por  fármacos con prescripción inapropiada según los criterios STOPP-START.  Diecinueve (33,0%) pacientes volvieron a visitar el servicio de urgencias  antes de los 30 días del alta.Conclusiones: Los acontecimientos adversos por medicamentos son un motivo frecuente de visita a los servicios de urgencias y están  asociados a un importante porcentaje de visitas posteriores tras el alta. El  proyecto FARM-URG nace con el propósito de obtener información  periódicamente para la posible implementación de medidas preventivas.

In-Depth Study into Polymeric Materials in Low-Density Gastroretentive Formulations.

The extensive use of oral dosage forms for the treatment of diseases may be linked to deficient pharmacokinetic properties. In some cases the drug is barely soluble; in others, the rapid transit of the formulation through the gastrointestinal tract (GIT) makes it difficult to achieve therapeutic levels in the organism; moreover, some drugs must act locally due to a gastric pathology, but the time they remain in the stomach is short. The use of formulations capable of improving all these parameters, as well as increasing the resident time in the stomach, has been the target of numerous research works, with low-density systems being the most promising and widely explored, however, there is further scope to improve these systems. There are a vast variety of polymeric materials used in low-density gastroretentive systems and a number of methods to improve the bioavailability of the drugs. This works aims to expedite the development of breakthrough approaches by providing an in-depth understanding of the polymeric materials currently used, both natural and synthetic, their properties, advantages, and drawbacks.

The Hierarchical Factor Structure of the Spanish Version of Depression Anxiety and Stress Scale -21

The Depression Anxiety and Stress Scale-21 (DASS-21) is one of the most widely used self-reports for the measurement of emotional symptoms. However, some controversy remains concerning its factor structure. Additionally, more data of the psychometric properties of the Spanish version of the DASS-21 are needed. The aim of this study was to explore the hierarchical factor structure of the DASS-21 and to further analyze its psychometric properties in Spain and Colombia. Four samples with a total of 2980 participants completed the Spanish version of the DASS-21. Two of the samples were composed of undergraduates of each country and the other two samples were recruited online. The results strongly supported a hierarchical factor structure of the DASS-21 consisting of three first-order factors (depression, anxiety, and stress) and one second-order factor (emotional symptoms). Initial evidence of measurement invariance was found for country (Spain vs. Colombia) and sample (undergraduates vs. online). The DASS-21 showed good psychometric properties in all samples. The DASS-21 seems to be a good option to measure emotional symptoms in Spain and Colombia, and its hierarchical factor structure indicates that it provides general and specific measures of emotional symptoms that are theoretically meaningful (AU)

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Usefulness of WISC-IV in Determining Intellectual Giftedness.

Several studies question the usefulness of the Wechsler Intelligence Scale for Children (WISC-IV) in determining giftedness due to the importance of speed in some of its subtests, which may penalize children of high intellectual level. This study analyzes the factor structure of the WISC-IV of gifted children based on confirmatory factor analysis. Participants were eighty-seven gifted children from Spain (6-13 years old). Score discrepancies were also examined for the main indexes: Verbal Comprehension, Processing Speed, Working Memory and Perceptual Organization. Results pointed out four models with a good fit from the five models analyzed: a two-factor model according to GAI subscales (RMSEA = .001, p = .84), a four-factor first-order model including main indexes (RMSEA = .05, p = .19), a four-factor model with g as a direct factor (RMSEA = .001, p = .84) and a four-factor model with g as an indirect higher-order factor (RMSEA = .05, p = .13). Discrepancies were found between Verbal Comprehension and Processing Speed, and between Perceptual Organization and Processing Speed. Verbal Comprehension yielded the highest score, whereas the lowest scores were obtained in Processing Speed and Working Memory. These results support the use of this scale in the assessment and diagnosis of Spanish children with a high intellectual level.

Impact of the parenting style of foster parents on the behaviour problems of foster children.

BACKGROUND: Few studies have analysed the effects of the parenting style used by foster carers on children's behaviour problems. This study examines the role played by the quality of the emotional relationship with foster carers and the kind of discipline they use as regard internalizing and externalizing problems among foster children. METHODS: Participants were 104 foster children (56 boys and 48 girls) and their respective foster families. The Child Behaviour Checklist, the Affect and Communication Scale, and the Rules and Demands Scale were completed by foster parents. A series of linear regression analyses were performed using the stepwise method. RESULTS: The main findings were as follows: an authoritarian parenting style explained the internalizing problems presented by foster children (11% of the variance); criticism/rejection, authoritarian parenting and permissive parenting explained externalizing problems (37% of the variance); and criticism/rejection and authoritarian parenting explained total problems (29% of the variance). These results indicate that criticism/rejection on the part of foster parents, as well as the use of inappropriate parenting styles (authoritarian and permissive), has an important effect in relation to the behaviour problems of foster children. CONCLUSIONS: This highlights the key role that foster carers play in terms of tackling the behaviour problems that foster children present. The findings also suggest that preparation for fostering should focus especially on ways of helping foster parents both to acquire positive parenting strategies and to avoid authoritarian and permissive parenting.

[Clinical practice variation in cataract surgery]. / Variabilidad clínica en la cirugía de la catarata.

PURPOSE: Cataract surgery rates have dramatically increased in the last two decades. However, clinical practice variation in cataract surgery has not been thoroughly studied. The aim of this review is to analyze clinical practice variation, including the causes and consequences of this phenomenon. Then, its role in health care planning and health care quality is focused, emphasizing the importance of reducing it and providing several practical strategies to accomplish it. RECENT FINDINGS: The latest researches are presented in this article. They identify the development and implementation of clinical practice guidelines as the best tool to standardize care processes. CONCLUSION: Managing unwarranted or unwanted variation would improve quality of care and may lead to a significant saving in health care spending.

Usefulness of WISC-IV in determining intellectual Giftedness

Several studies question the usefulness of the Wechsler Intelligence Scale for Children (WISC-IV) in determining giftedness due to the importance of speed in some of its subtests, which may penalize children of high intellectual level. This study analyzes the factor structure of the WISC-IV of gifted children based on confirmatory factor analysis. Participants were eighty-seven gifted children from Spain (6-13 years old). Score discrepancies were also examined for the main indexes: Verbal Comprehension, Processing Speed, Working Memory and Perceptual Organization. Results pointed out four models with a good fit from the five models analyzed: a two-factor model according to GAI subscales (RMSEA = .001, p = .84), a four-factor first-order model including main indexes (RMSEA = .05, p = .19), a four factor model with g as a direct factor (RMSEA = .001, p = .84) and a four-factor model with g as an indirect higher-order factor (RMSEA = .05, p = .13). Discrepancies were found between Verbal Comprehension and Processing Speed, and between Perceptual Organization and Processing Speed. Verbal Comprehension yielded the highest score, whereas the lowest scores were obtained in Processing Speed and Working Memory. These results support the use of this scale in the assessment and diagnosis of Spanish children with a high intellectual level (AU)

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Estabilidad temporal del CI y potencial de aprendizaje en niños superdotados: implicaciones diagnósticas / Temporal stability of IQ and learning potential in gifted children: di-agnostic implications

Tradicionalmente la determinación de la sobredotación se ha realizado con tests tradicionales de inteligencia. El principal argumento para hacerlo ha sido la estabilidad temporal de esta medida. En los últimos años algunos autores defienden una determinación temprana de la sobredotación en niños, aunque otros señalan que la determinación del C.I. en niños pequeños arroja un número importante de falsos positivos debido a la variabilidad de la medida de la inteligencia por influencia de diferentes factores tales como la plasticidad cerebral, la estimulación, etc…, por lo que proponen el uso de índices complementarios para el diagnóstico de sobredotación. En este trabajo se realiza un estudio longitudinal de dos años a 49 niños de entre 5 y 9 años, -inicialmente identificados como superdotados-, para comprobar la estabilidad de su C.I. y de otras medidas tales como el potencial de aprendizaje y la memoria de trabajo. Los resultados muestran como las medidas de potencial de aprendizaje y memoria de trabajo permanecen estables en el tiempo mientras que el C.I. de un grupo de niños de menor edad no se mantiene en dicho periodo. Estos resultados señalan la utilidad de las medidas de P.A. como un índice complementario en la determinación de la sobredotación en niños pequeños

Traditionally the determination of the giftedness has performed with traditional intelligence tests. The main argument to do so has been the temporal stability of this measure. In recent years some authors defend a determination early giftedness in children, although others point out that toddlers evaluation produces a significant number of false positives due to the variability in the measurement of intelligence by different factors such as plasticity, stimulation, etc.., therefore proposed the use of complementary indices for giftedness diagnosis. This paper presents a longitudinal study of two years to 49 children aged between 5 and 9 years, initially identified as gifted, to check the stability of your IQ and other measures such as the learning potential and working memory. The results show how learning potential and working memory measures remain stable in time while the IQ of a group of younger children is not maintained during this period. These results indicate the usefulness of P.A. measures as a supplementary index in the determination of the giftedness on young children

Valoración de un programa de habilidades interpersonales en niños superdotados / Evaluation of an interpersonal skills program in gifted children

Algunos trabajos de investigación informan que cierto número de niños superdotados muestran problemas de adaptación social y habilidades sociales e interpersonales, mientras que otros consideran que esto no ocurre. Partiendo de lo anterior, Neihart, Reis, Robinson y Moon (2002) hablan de enfoque de resiliencia versus enfoque de riesgo. En este trabajo se considera el beneficio de aplicar programas de entrenamiento en habilidades interpersonales en niños superdotados para prevenir posibles problemas. Por ello, se pretende valorar la eficacia de un programa de entrenamiento en resolución de problemas interpersonales en esta población. En esta investigación participaron 40 niños superdotados de edades comprendidas entre 7 y 13 años, divididos en un grupo tratamiento y un grupo control de lista de espera. Los resultados mostraron diferencias significativas en las medidas de valoración directa en el grupo tratamiento tras la aplicación del programa. También se detectaron diferencias significativas entre el grupo tratamiento y el grupo control en las medidas postratamiento a favor del primero, y se confirmó la relación del potencial de aprendizaje de los niños con los beneficios obtenidos. En definitiva, el programa de entrenamiento se muestra eficaz en la mejora de las habilidades de solución de problemas interpersonales evaluadas en niños superdotados.

Certain research studies report that a number of gifted children show social adaptation issues, as well as problems with social and interpersonal skills, while others consider that this does not occur. In this regard, Neihart, Reis, Robinson and Moon (2002) speaks of a resilience approach versus a risk approach. From the risk viewpoint, this paper presents the benefits of applying training programs in interpersonal skills as to prevent potential problems in gifted children. For this reason, we aim to evaluate the effectiveness of a training program for solving interpersonal problems in this population. Participants include 40 gifted children aged 7 to 13, divided into a treatment group and a control - waitlisted - group. Program application results show significant differences in direct assessment measurements in the treatment group. An increase in effect sizes between the treatment group and the control group is also detected, in favor of the former, and a relationship between the children's learning potential and the benefits obtained is also confirmed. In short, the training program proves effective in interpersonal problem-solving skill improvement in children with high intellectual capacity.

¿Cuál es la incidencia de caídas real en un hospital? / What is the real incidence of falls in hospitals?

Objetivos. Conocer la incidencia de caídas en un hospital de agudos de nivel 2. Comparar la incidencia de caídas encontrada en el estudio observacional con las caídas notificadas Método. Estudio observacional prospectivo para registrar las caídas de pacientes con seguimiento diario en las unidades de hospitalización médico quirúrgicas, y revisión del registro de notificación de caídas. El seguimiento de los pacientes se realizó entre diciembre de 2008 y marzo de 2009 en el Hospital Universitario de Fuenlabrada. Se ha calculado la incidencia acumulada de caídas, la asociación entre variables cualitativas y la validez del registro de notificación de caídas con respecto al patrón de referencia, el estudio observacional. Resultados. Se ha completado un seguimiento a 1.001 pacientes encontrando una incidencia acumulada de un 1,60% de los pacientes seguidos, frente a una incidencia notificada del 0,9%. No se han encontrado diferencias estadísticamente significativas p=0,167. El registro de notificación de caídas presenta un índice Kappa de 0,24 con una sensibilidad de 18,75% y una especificidad de 99,39% con respecto al patrón de referencia, el estudio observacional. Conclusión. La incidencia de caídas prácticamente se duplica si la recogida de datos es observacional frente a los sistemas de notificación (AU)

Aims. To determine the incidence of falls at acute hospital level and to compare this incidence with that found in the observational study with the notified falls. Method. We used a prospective observational study to register patient falls, with daily follow-up in the medical-surgical hospital units, and reviewed the notification of falls records. The patient monitoring was conducted between December 2008 and March 2009 at Fuenlabrada University Hospital. The accumulated incidence of falls was calculated, the association between qualitative variables, and the validity of the notification of falls record with regards to the reference pattern, the observational study. Results. A follow-up has been completed 1,001 patients, finding an accumulated incidence of 1.6% of the followed-up patients, compared to a notified incidence of 0.9%. No statistically significant differences were found (P=.167. The notification of falls record had a Kappa index of 0.24, with a sensitivity of 18.75% and a specificity of 99.39%, compared to the reference, the observational study. Conclusion. The incidence of falls practically doubles when using data from observational studies as opposed to those from notification systems (AU)

Carbohydrate-based polyesters made from bicyclic acetalized galactaric acid.

The dimethyl ester of 2,3:4,5-di-O-methylene-galactaric acid (Galx) was made to react in the melt with 1,n-alkanediols HO(CH(2))(n)OH containing even numbers of methylenes (n from 6 to 12) to produce linear polycyclic polyesters. Two sets of poly(alkylene 2,3:4,5-di-O-methylene-galactarate) polyesters (PE-nGalx) with weight-average molecular weights in the ∼ 5000-10000 and ∼ 35000-45000 ranges were obtained using TBT and DBTO catalysts, respectively. For comparative purposes a set of poly(alkylene adipate) polyesters (PE-nAd) was also synthesized with molecular weights in the higher range using a similar procedure. The thermal stability of PE-nGalx was greater than that of PE-nAd although it notably decayed as molecular weight decreased. The replacement of Ad by Galx in the polyesters caused increases in T(g) of up to 70 °C, and almost doubled the tensile mechanical parameters. All PE-nGalx were semicrystalline but only those made from 1,12-dodecanediol were able to crystallize from the melt with a crystallization rate that diminished as the molecular weight increased. In general, the galactarate containing polyesters displayed higher solubility and wettability than polyadipates, they hydrolyzed faster and exhibited comparable sensitivity to the action of lipases.

Tacrolimus modulates liver and pancreas nitric oxide synthetase and heme-oxygenase isoforms and cytokine production after endotoxemia.

Cytoprotective effects of tacrolimus are due to its unspecific anti-inflammatory and anti-oxidant properties. Neither the exact mechanisms nor if there is any organ-specificity or dose-dependent response have not been yet elucidated. Our aim was to evaluate the effect of tacrolimus on oxidative stress and mediator production in liver and pancreatic tissue secondary to endotoxemia. Wistar rats were pretreated with intraperitoneal injection of tacrolimus (0.07, 0.15, and 0.3mg/kg) 24h before Escherichia coli LPS was administrated. Animals were sacrificed 24h after LPS administration and iNOS, eNOS, and nNOS and type 1 and 2 heme-oxygenase (HO) expression were measured. TNF-α and IL-1 tissue expression and plasmatic NO, CO, TNF-α, and IL-1 were also determined. LPS exposure increased iNOS expression in both organs, eNOS did not show variations and liver nNOS expression was significantly lower. Tacrolimus diminished both pancreas and liver iNOS and nNOS expression. Both liver and pancreatic eNOS expression augmented when tacrolimus was administrated. High doses of tacrolimus were correlated with ameliorated liver HO-1 plus HO-2 and pancreas HO-1 expression after LPS stimulation. Tacrolimus treatment diminished TNF-α but not IL-1 expression increase after LPS challenge in hepatic tissue. Pancreatic TNF-α and IL-1 values diminished partially when high doses were employed. Plasmatic NO, CO, TNF-α, and IL-1 concentrations increase after LPS challenge was diminished when highest doses of tacrolimus were given. In conclusion, tacrolimus exerts a protective effect on commonly observed harmful phenomena after LPS stimulation by modulating liver and pancreas oxidative enzyme expression and cytokine production.

Quantitative (1) H MR spectroscopic imaging of the prostate gland using LCModel and a dedicated basis-set: correlation with histologic findings.

Proton magnetic resonance spectroscopic imaging ((1) H-MRSI) has been advocated as a valuable tool for prostate cancer diagnosis. However, a barrier to widespread clinical use of this technique is the lack of robust quantification methods that yield reproducible results in an institution-independent manner. The main goal of this study was to develop a standardized and fully automated approach (LCModel-based) for quantitative prostate (1) H-MRSI. To this end, a dedicated basis set was constructed by the combination of simulated (citrate, Cit; choline, Cho, and creatine, CR) and experimentally acquired (spermine, Spm) spectra. The overlapping Spm, Cho, and Cr could be resolved and quantified individually, thus allowing for the independent assessment of glandular (Cit and Spm) and proliferative (Cho) components. Several metabolite ratios were calculated and compared to the histologic findings of prostatectomy specimens from 10 prostate cancer patients with Gleason scores (3 + 3) and (3 + 4). The Cho mole fraction and the Cho/(Cit + Spm) ratio were found to best discriminate between prostate cancer and healthy tissue. The comparison between the quantitative MRSI results and the histologic findings suggests that no correlation exists between the detected metabolic alterations and the Gleason score of low-grade tumors.