La visita infantil a la unidad de cuidados intensivos pediátricos desde la experiencia de las enfermeras / Children's visits to the paediatric intensive care unit from the nurses’ experience

Objetivo Explorar la experiencia de las enfermeras en relación con la facilitación de la visita infantil a la UCIP. Método Estudio fenomenológico interpretativo mediante entrevistas en profundidad. El estudio se desarrolló en las UCIP de dos centros públicos madrileños de nivel IIIC. Participaron 12 enfermeras con experiencia mayor de dos años en UCIP que, en el momento de la entrevista, prestaban servicios en dichas unidades. Además, se entrevistó a una psicóloga con experiencia de cuatro años en UCIP cuya información se consideró en el contexto de los datos en la sombra. La información se analizó mediante un análisis temático del discurso. ResultadosLa experiencia de las enfermeras en relación a la facilitación de la visita infantil a la UCIP se puede condensar en cuatro temas: el emerger de la demanda, la preparación progresiva, la toma de decisiones desde el consenso y la creación de espacios de intimidad. Conclusiones Las experiencias de facilitación de la visita responden, principalmente, a la demanda de las familias que viven hospitalizaciones prologadas o al final de la vida. El rol de la enfermera es de acompañamiento reconociendo la labor prioritaria de los padres en la preparación de los niños y el desarrollo de la visita. Las enfermeras se sienten inseguras y faltas de recursos para el apoyo emocional y reclaman protocolos de actuación que orienten la intervención y toma de decisiones. (AU)

Aim To explore nurses’ experience related to promoting the visits of siblings to PICU. Methods An interpretative phenomenological study was carried out through in-depth interviews in two PICUs belonging to third level public hospitals in Madrid. Twelve nurses with more than two years of experience in PICU were interviewed. They all were working in PICU during the study. Furthermore, a PICU psychologist with an experience of four years was interviewed and this was considered shadowed data. Data analysis followed a thematic discourse analysis. Results Nurses’ experience of facilitating children's visits to PICU can be condensed into four themes: emerging demand for visits, progressive preparation, decision-making through common consensus and creating intimate spaces. Conclusions The experience of nurses in facilitating visits is mainly in response to the demand of families going through prolonged hospitalisation or end-of-life situations. The role of the nurse is one of accompaniment, recognising the major role of parents in the preparation of children and in developing the visit. Nurses feel insecure and lack resources for emotional support and demand action protocols to guide intervention and decision making. (AU)

Children's visits to the paediatric intensive care unit from the nurses' experience.

BACKGROUND: Family process disruption is one of the main consequences of the hospitalization of a critically ill child in a Paediatric Intensive Care Unit (PICU). Children's visits to PICU may help improve family coping. However, this is not standard practice and nurses' experiences in facilitating children's visits to units where it is encouraged is unknown. AIM: To explore nurses' experience related to promoting the visits of siblings to PICU. METHODS: An interpretative phenomenological study was carried out through in-depth interviews in two PICUs belonging to third level public hospitals in Madrid. Twelve nurses with more than two years of experience in PICU were interviewed. They were all were working in PICU during the study. Furthermore, a PICU psychologist with an experience of four years was interviewed and this was considered shadowed data. Data analysis followed a thematic discourse analysis. RESULTS: Nurses' experience of facilitating children's visits to PICU can be condensed into four themes: emerging demand for visits, progressive preparation, decision-making through common consensus and creating intimate spaces. CONCLUSIONS: The experience of nurses in facilitating visits is mainly in response to the demand of families going through prolonged hospitalisation or end-of-life situations. The role of the nurse is one of accompaniment, recognising the major role of parents in the preparation of children and in developing the visit. Nurses feel insecure and lack resources for emotional support and demand action protocols to guide intervention and decision making.

Prospective cohort study on the management and complications of peripheral venous catheter in patients hospitalised in internal medicine.

OBJECTIVE: To analyse compliance with the recommendations on the insertion-maintenance of peripheral venous catheter (PVC) and the incidence of complications according to the healthcare department that inserted the PVCs. PATIENTS AND METHODS: We conducted a prospective cohort follow-up study of PVCs, from their insertion in the emergency or internal medicine (IM) department until their withdrawal. RESULTS: We monitored 590 PVCs, 274 from the emergency department and 316 from IM. In terms of compliance with the process indicators, there was a cannulation rate in the antecubital fossa of 3.5 and 1.6 per 100 catheters-day (p < .001) in the emergency and IM departments, respectively. The sterile placement rates were 1.6 and 12.4 (p < .001), and the rate for transparent dressing was 2.1 and 11.5 (p < .001) per 100 catheters-day in the emergency and IM departments, respectively. The complications rates showed no differences between the departments. The most common complication was phlebitis (95 cases, 16.1%). CONCLUSIONS: Compliance with the insertion-maintenance recommendations for PVC showed differences between the departments; however, the incidence of complications was similar.

Prospective cohort study on the management and complications of peripheral venous catheters in patients hospitalised in Internal Medicine. / Estudio de cohortes prospectivo sobre el manejo y las complicaciones del catéter venoso periférico en pacientes ingresados en Medicina Interna.

OBJECTIVE: To analyse compliance with the recommendations on the insertion-maintenance of peripheral venous catheters (PVC) and the incidence of complications according to the healthcare department that inserted the PVCs. PATIENTS AND METHODS: We conducted a prospective cohort follow-up study of PVCs, from their insertion in the emergency or internal medicine (IM) department until their withdrawal. RESULTS: We monitored 590 PVCs, 274 from the emergency department and 316 from IM. In terms of compliance with the process indicators, there was a cannulation rate in the antecubital fossa of 3.5 and 1.6 per 100 catheters-day (P<.001) in the emergency and IM departments, respectively. The sterile placement rates were 1.6 and 12.4 (P<.001), and the rate for transparent dressing was 2.1 and 11.5 (P<.001) per 100 catheters-day in the emergency and IM departments, respectively. The complications rates showed no differences between the departments. The most common complication was phlebitis (95 cases, 16.1%). CONCLUSIONS: Compliance with the insertion-maintenance recommendations for PVC showed differences between the departments; however, the incidence of complications was similar.

Evaluation of endovenous sedation using BIS monitoring in dentistry. A systematic review.

BACKGROUND: The aim of the present review was evaluate the utility and validity of the Bispectral Index (BIS) in dental treatment carried out under endovenous sedation, and compare its efficacy with clinical sedation scales. MATERIAL AND METHODS: Electronic and manual literature searches were conducted by two independent reviewers for articles published up to April 2017 in several databases, including Medline and Cochrane Library. RESULTS: Sixteen articles met the inclusion criteria. A correlation was identified between BIS and clinical sedation scales. A BIS range between 75 and 84 showed a high probability of corresponding to an Observer's Assessment of Alertness and Sedation Scale (OAA/S) value of 3; a scored 3 on the Ramsay scale corresponds around 85 on the BIS; while BIS values between 57 and 64 corresponded to a University of Michigan Sedation Scale value of 3. BIS monitoring provides continuous measurement of the patient's hypnotic state or state of consciousness, awareness, and recall. It proved impossible to perform an analysis of statistical data drawn from the studies reviewed due to the disparity of inclusion criteria among the works. CONCLUSIONS: BIS for sedation monitoring might make possible to evaluate sedation levels objectively in real time, reducing the dose of the sedative required, increasing safety, and minimizing secondary effects.

Resistive switching control for conductive Si-nanocrystals embedded in Si/SiO2 multilayers.

In this paper, we report on the enhanced control of resistive switching in multilayer Si/SiO2 structures, which permit the formation of Si nanocrystals with a typical size of 5.88 nm and overall good shape homogeneity. The deposition of a different number of Si and SiO2 bilayers (6, 8 and 10) allowed control of SET/RESET voltages in negative bias ranges 4.5-10 V and 6.3-13 V for six- and ten-bilayer devices, respectively. The corresponding resistance ratio between ON/OFF states varied in the ranges 107-105 for the aforementioned number of bilayers. Based on the result of XPS measurements, we suggest that the resistive switching in the studied system occurs due to the formation and annihilation of Si-Si and Si-O bonds, which serve as conductive pathways and isolating material, respectively.

Fluorescence properties of Yb3+-Er3+ co-doped phosphate glasses containing silver nanoparticles.

Er3+-Yb3+ co-doped phosphate glasses containing silver nitrate (SN), were fabricated. Transmission electron microscopy (TEM) and x-ray photoelectron spectroscopy (XPS) analyses were used to evidence the nucleation and presence of silver nanoparticles (SNP). The basic parameters of the glasses were inspected by means of absorption and fluorescence spectra, and fluorescence lifetimes under excitation at 916 nm (in-band of Yb3+), and at 406 nm (in-band of surface plasmon resonance given by the presence of SNP). The spectra as well as estimates for the basic parameters defining the lasing/amplifying potential of the glasses were studied as a function of SN concentration. The experimental results indicate that by increasing the SN content an enhancement of Er3+/Yb3+ fluorescence takes place.

Effects of TiO2 nanoparticles and sunscreens on coastal marine microalgae: Ultraviolet radiation is key variable for toxicity assessment.

Given the large numbers of sunbathers on beaches, sunscreen compounds are being released into the coastal aquatic environment in significant amounts. Until now the effect of these potential pollutants on microbiota has been not well-known. Phytoplankton is a key component of the microbiota community. It forms the basis of the aquatic trophic networks, and any change in the natural population of phytoplankton can affect the structure of aquatic biota. This paper describes an experiment performed outdoors (in natural sunlight conditions including ultraviolet radiation (UVR) and with UVR blocked) on mixed microalgae populations (four species from different key marine taxonomic groups, Nannochloropsis gaditana, Chaetoceros gracilis, Pleurochrysis roscoffensis and Amphidinium carterae), for three days, exposed to a range of concentrations of three commercial sunscreens (with variable TiO2 concentrations: highest concentration for sunscreen C, followed by sunscreen A; and sunscreen B did not contain TiO2 in its composition). With regard to UVR effect, in the absence of sunscreens, the most sensitive species is the centric diatom, Chaetoceros gracilis, and the least is Nannochloropsis gaditana; this last species presented the same behavior in the absence of UVR and with high sunscreen concentrations. The toxicity gradient obtained for sunscreens and nanoparticles under UVR is: TiO2 NPs>Sunscreen C>Sunscreen A>Sunscreen B. The differential sensitivity of microalgae to sunscreens and TiO2 NPs can produce a change in the dynamics of phytoplankton populations and provoke undesirable ecological effects (such as giving dinoflagellates more prominence). The effects of UVR, commonly neglected in bioassays, could alter the results in important ways and should be considered when performing environmentally-relevant bioassays. The toxicity mediated by hydrogen peroxide production associated with the concentration of TiO2 NPs cannot be considered the only factor responsible for the toxicity: the organic compounds in the sunscreens must also be taken into account.

Impact of regulatory measures on antipsychotics drug consumption in Castilla y León, Spain.

OBJECTIVES: Antipsychotics are currently used to treat different diseases; even some off-labelled conditions are treated with this medication. Consumption and cost of antipsychotic drugs sharply increased in Spain after second-generation drugs were marketed; several regulatory measures were adopted to curb this trend. The aim of this study was to examine the impact of these measures upon the use and cost of antipsychotics. STUDY DESIGN: Study of drug use (SDU) from 1995 to 2012. Consumption and cost data were obtained from the CONCYLIA database; this database contains the retail community pharmacies sales of medicinal products reimbursed by the National Health System in Castilla y León (Spain). METHODS: Data are presented as defined daily doses per 1000 inhabitants per day (DID) and day treatment cost (DTC). RESULTS: First-generation antipsychotics prescriptions gradually decreased from 3.0 to 1.8 DID; meanwhile, prescriptions for second-generation antipsychotics considerably increased from 0.3 to 9.9 DID. The use of risperidone dropped after the marketing of its structural derivative paliperidone with a similar efficacy but with a substantially higher cost per day. In 2011 and thereafter, patients in Spain began to pay a part of the medications cost, but this did not decrease antipsychotics consumption. Global cost of antipsychotics only began to fall after measures were adopted to lower the price of medicines because of the economic collapse in Spain after May 2010. CONCLUSION: Several health policy measures have tried to reduce antipsychotics consumption in Spain, special ways of dispensing, marketing of generic drugs and special economic measures for patients. These measures eventually failed to avoid the increase in antipsychotics use. The cost only dropped when lowering prescription drug prices took place.

Physical properties of inulin and inulin-orange juice: physical characterization and technological application.

In this work two systems based on a carbohydrate polymer were studied: inulin as model system and inulin-orange juice as complex system. Both system were stored at different water activity conditions and subsequently characterized. Water adsorption isotherms type II were fitted by the GAB model and the water monolayer content was determined for each system. From thermal analyzes it was found that at low water activities (aw) systems were fully amorphous. As aw increased, crystallinity was developed. This behavior was corroborated by X-ray diffraction. In the inulin-orange juice system, crystallization appears at lower water activity caused by the intensification of the chemical interaction of the low molecular weight species contained in orange juice. Glass transition temperature (Tg), determined by modulated differential scanning calorimeter, decreased with aw. As water is adsorbed, the physical appearance of samples changed which could be observed by optical microscopy and effectively related with the microstructure found by scanning electron microscopy.

Bentonite and anthracite in alginate-based controlled release formulations to reduce leaching of chloridazon and metribuzin in a calcareous soil.

The leaching of herbicides through soil can be minimized using controlled release formulations (CRFs). In this research, bentonite and anthracite have been used as modifying agents in alginate-based CRFs prepared with chloridazon and metribuzin. These CRFs have been evaluated in a calcareous soil. The Kf and Koc values obtained from sorption experiments in soil have demonstrated a high leaching potential for both herbicides, mainly for metribuzin. Release kinetics in soil have showed that the control of release rate of chloridazon and metribuzin was possible by using bentonite and anthracite in CRFs, being this effect greater when we use anthracite as modifying sorbent. Using an empirical equation, the time taken for 50% of the active ingredient to be released (T50(soil)) was calculated. T50 values ranged between 2.88 d for metribuzin-bentonite alginate-based granules and 14.37 d for chloridazon-anthracite alginate-based granules, being the release rate higher in metribuzin CRFs than in those prepared with chloridazon, which has lower water solubility. Besides, a linear correlation between T50 values in water and soil was obtained. Mobility experiments carried out in a calcareous soil have shown that the use of CRFs reduces the presence of herbicides in the leachate compared to technical products, mainly for chloridazon. We found that one could design a right profile in the release rate of active ingredients from CRFs in each agro-environmental situation, and thus prevent the environmental pollution derived from the use of chloridazon and metribuzin.

Glass transition study in model food systems prepared with mixtures of fructose, glucose, and sucrose.

The glass transition temperature of model food systems prepared with several glucose/fructose/sucrose mass fractions was studied using differential scanning calorimetry (DSC). A distance-based experimental design for mixtures of 3 components was used to establish the proportion of sugars of the model systems. Thus, 32 compositions including individual sugars and sugar mixtures, both binary and ternary were prepared and analyzed. Thermograms showing the complete process of heating-cooling-reheating were used to determine the precise glass transition temperature during cooling (T(g)(c)) or reheating (T(g)(H) in amorphous sugars. The Scheffe cubic model was applied to experimental results to determine the influence of sugar composition on the glass transition temperature (P < 0.05). The final model proved to be appropriate (R(2) > 0.97, CV < 9%, model significance <0.0001) to predict the T(g) values of any dry mixture of amorphous fructose, glucose, and sucrose.

Modifying sorbents in controlled release formulations to prevent herbicides pollution.

The herbicides chloridazon and metribuzin, identified as groundwater pollutants, were incorporated in alginate-based granules to obtain controlled release properties. In this research the effect of incorporation of sorbents such as bentonite, anthracite and activated carbon in alginate basic formulation were not only studied on encapsulation efficiency but also on the release rate of herbicides which was studied using water release kinetic tests. In addition, sorption studies of herbicides with bentonite, anthracite and activated carbon were made. The kinetic experiments of chloridazon and metribuzin release in water have shown that the release rate is higher in metribuzin systems than in those prepared with chloridazon, which has lower water solubility. Besides, it can be deduced that the use of sorbents reduces the release rate of the chloridazon and metribuzin in comparison to the technical product and to the alginate formulation without sorbents. The highest decrease in release rate corresponds to the formulations prepared with activated carbon as a sorbent. The water uptake, permeability, and time taken for 50% of the active ingredient to be released into water, T(50), were calculated to compare the formulations. On the basis of a parameter of an empirical equation used to fit the herbicide release data, the release of chloridazon and metribuzin from the various formulations into water is controlled by a diffusion mechanism. Sorption capacity of the sorbents for chloridazon and metribuzin, ranging from 0.53mgkg(-1) for the metribuzin sorption on bentonite to 2.03x10(5)mgkg(-1) for the sorption of chloridazon on the activated carbon, was the most important factor modulating the herbicide release.

[Outcome of acute lymphoblastic leukemia in the pediatric age group over a 29-year period (1972-2000)]. / Evolución de la leucemia linfoblástica aguda en la edad pediátrica en 29 años (1972-2000).

OBJECTIVE: To evaluate the progress achieved in the treatment of acute lymphoblastic leukemia (ALL) in our hospital. MATERIAL AND METHODS: A total of 235 patients diagnosed with ALL in the central region of Cuba from 1972 to 2000 were included. Four groups were considered according to the diagnostic period and treatment protocol. Group 1 was composed of 20 patients who did not receive a uniform treatment regimen. The remaining groups were treated with different protocols of the Latin American Group for Malignant Hemopathy Therapy (Glathem). Group 2 was treated with less aggressive classical regimens from the 1970s, and groups 3 and 4 received more aggressive regimens, type Berlin-Frankfurt-Munster (BFM). Intravenous high-dose methotrexate was used in group 4 but not in group 3. Classification by prognostic groups was based on age and leukocyte count. RESULTS: Of 215 patients included in the Glathem protocols, remission occurred in 197 (91.6%). Overall survival in the distinct treatment groups progressively increased during the study period, from a 5-year survival of 15% in group 1 to 72% in group 4. Event-free survival in patients included in the Glathem protocols increased from 42% in group 2 (classical protocols) to 68.7% in the BFM protocols (groups 3 and 4). Significant differences were found among the different treatment and prognostic groups considered. CONCLUSIONS: During the period analyzed, survival in children with ALL progressively increased in parallel with improved treatment regimens. These results demonstrate the importance of well-programmed polychemotherapy to achieve prolonged survival and a high percentage of cure in this disease.

Evolución de la leucemia linfoblástica aguda en la edad pediátrica en 29 años (1972-2000) / Outcome of acute lymphoblastic leukemia in the pediatric age group over a 29-year period (1972-2000)

Objetivo Analizar los progresos obtenidos en el tratamiento de la leucemia linfoblástica aguda (LLA) en nuestro centro. Material y métodos Se incluyen en este estudio un total de 235 pacientes diagnosticados de LLA en la región central de Cuba de 1972 a 2000. Se consideraron 4 grupos según el período de diagnóstico y protocolo de tratamiento. El grupo 1 está constituido por 20 pacientes que no recibieron un esquema de tratamiento uniforme. Los restantes grupos fueron tratados con distintos protocolos del Grupo Latinoamericano de Tratamiento de Hemopatías Malignas (Glathem). El grupo 2 fue tratado con esquemas clásicos poco agresivos, de la década de 1970 y los grupos 3 y 4 recibieron esquemas más agresivos, tipo BFM. En el grupo 4 se utilizó metotrexato intravenoso en dosis elevadas, pero no en el grupo 3. La clasificación por grupos pronósticos se hizo según a la edad y la cifra de leucocitos. Resultados De 215 pacientes incluidos en los protocolos del Glathem hicieron remisión 197 (91,6 por ciento). El análisis de la supervivencia global en los distintos grupos de tratamiento muestra un incremento progresivo en el período analizado, desde el 15 por ciento de supervivencia a los 5 años en el grupo 1 hasta el 72 por ciento en el grupo 4. La supervivencia libre de eventos en los pacientes incluidos en los protocolos del Glathem se elevó de 42 por ciento en el grupo 2 (protocolos clásicos) al 68,7 por ciento en los protocolos BFM (grupos 3 y 4). Existen diferencias significativas entre los distintos grupos de tratamiento y los distintos grupos pronósticos considerados. Conclusiones Durante el período analizado se ha producido un incremento progresivo de la supervivencia de niños diagnosticados de LLA a medida que se han ido perfeccionando los esquemas terapéuticos. Esto demuestra la importancia de una poliquimioterapia bien programada para obtener supervivencias prolongadas y un elevado porcentaje de curación en esta enfermedad(AU)

OBJECTIVE: To evaluate the progress achieved in the treatment of acute lymphoblastic leukemia (ALL) in our hospital. MATERIAL AND METHODS: A total of 235 patients diagnosed with ALL in the central region of Cuba from 1972 to 2000 were included. Four groups were considered according to the diagnostic period and treatment protocol. Group 1 was composed of 20 patients who did not receive a uniform treatment regimen. The remaining groups were treated with different protocols of the Latin American Group for Malignant Hemopathy Therapy (Glathem). Group 2 was treated with less aggressive classical regimens from the 1970s, and groups 3 and 4 received more aggressive regimens, type Berlin-Frankfurt-Munster (BFM). Intravenous high-dose methotrexate was used in group 4 but not in group 3. Classification by prognostic groups was based on age and leukocyte count. RESULTS: Of 215 patients included in the Glathem protocols, remission occurred in 197 (91.6 percent). Overall survival in the distinct treatment groups progressively increased during the study period, from a 5-year survival of 15percent in group 1 to 72 percent in group 4. Event-free survival in patients included in the Glathem protocols increased from 42 percent in group 2 (classical protocols) to 68.7percent in the BFM protocols (groups 3 and 4). Significant differences were found among the different treatment and prognostic groups considered. CONCLUSIONS: During the period analyzed, survival in children with ALL progressively increased in parallel with improved treatment regimens. These results demonstrate the importance of well-programmed polychemotherapy to achieve prolonged survival and a high percentage of cure in this disease(AU)

Evolución de la leucemia linfoblástica aguda en la edad pediátrica en 29 años (1972-2000) / Outcome of acute lymphoblastic leukemia in the pediatric age group over a 29-year period (1972-2000)

Objetivo Analizar los progresos obtenidos en el tratamiento de la leucemia linfoblástica aguda (LLA) en nuestro centro. Material y métodos Se incluyen en este estudio un total de 235 pacientes diagnosticados de LLA en la región central de Cuba de 1972 a 2000. Se consideraron 4 grupos según el período de diagnóstico y protocolo de tratamiento. El grupo 1 está constituido por 20 pacientes que no recibieron un esquema de tratamiento uniforme. Los restantes grupos fueron tratados con distintos protocolos del Grupo Latinoamericano de Tratamiento de Hemopatías Malignas (Glathem). El grupo 2 fue tratado con esquemas clásicos poco agresivos, de la década de 1970 y los grupos 3 y 4 recibieron esquemas más agresivos, tipo BFM. En el grupo 4 se utilizó metotrexato intravenoso en dosis elevadas, pero no en el grupo 3. La clasificación por grupos pronósticos se hizo según a la edad y la cifra de leucocitos. Resultados De 215 pacientes incluidos en los protocolos del Glathem hicieron remisión 197 (91,6 %). El análisis de la supervivencia global en los distintos grupos de tratamiento muestra un incremento progresivo en el período analizado, desde el 15 % de supervivencia a los 5 años en el grupo 1 hasta el 72 % en el grupo 4. La supervivencia libre de eventos en los pacientes incluidos en los protocolos del Glathem se elevó de 42 % en el grupo 2 (protocolos clásicos) al 68,7 % en los protocolos BFM (grupos 3 y 4). Existen diferencias significativas entre los distintos grupos de tratamiento y los distintos grupos pronósticos considerados. Conclusiones Durante el período analizado se ha producido un incremento progresivo de la supervivencia de niños diagnosticados de LLA a medida que se han ido perfeccionando los esquemas terapéuticos. Esto demuestra la importancia de una poliquimioterapia bien programada para obtener supervivencias prolongadas y un elevado porcentaje de curación en esta enfermedad

Objective To evaluate the progress achieved in the treatment of acute lymphoblastic leukemia (ALL) in our hospital. Material and methods A total of 235 patients diagnosed with ALL in the central region of Cuba from 1972 to 2000 were included. Four groups were considered according to the diagnostic period and treatment protocol. Group 1 was composed of 20 patients who did not receive a uniform treatment regimen. The remaining groups were treated with different protocols of the Latin American Group for Malignant Hemopathy Therapy (Glathem). Group 2 was treated with less aggressive classical regimens from the 1970s, and groups 3 and 4 received more aggressive regimens, type Berlin-Frankfurt-Munster (BFM). Intravenous high-dose methotrexate was used in group 4 but not in group 3. Classification by prognostic groups was based on age and leukocyte count. Results Of 215 patients included in the Glathem protocols, remission occurred in 197 (91.6 %). Overall survival in the distinct treatment groups progressively increased during the study period, from a 5-year survival of 15 % in group 1 to 72 % in group 4. Event-free survival in patients included in the Glathem protocols increased from 42 % in group 2 (classical protocols) to 68.7 % in the BFM protocols (groups 3 and 4). Significant differences were found among the different treatment and prognostic groups considered. Conclusions During the period analyzed, survival in children with ALL progressively increased in parallel with improved treatment regimens. These results demonstrate the importance of well-programmed polychemotherapy to achieve prolonged survival and a high percentage of cure in this disease

Cirugía Bucal Ambulatoria en pacientes pediátricos: Casuística del año 2000 en la Clínica Odontológica de la Universidad de Barcelona

Objetivos: Este trabajo pretende demostrar que se pueden realizar la mayoría de las intervenciones quirúrgicas de la cavidad bucal en la población pediátrica en un medio ambulatorio, así como valorar y mostrar la actividad realizada en el Máster de Cirugía e Implantología Bucal de la Facultad de Odontología de la Universidad de Barcelona durante el año 2000. Diseño del estudio: Para la realización de este trabajo se ha contabilizado la actividad quirúrgica de las unidades de cirugía bucal y cirugía con láser en la población pediátrica en el Máster de Cirugía e Implantología Bucal de la Universidad de Barcelona. Resultados: De las 3187 intervenciones quirúrgicas realizadas en nuestro servicio, 489 fueron en pacientes menores de 18 años. La exodoncia quirúrgica de terceros molares inferiores fue la más frecuente (556%), seguida de otras extracciones dentarias (336%), quirúrgicas o no, y del resto de intervenciones (106%) que incluyeron: fenestraciones de caninos u otros dientes incluidos, exéresis de frenillos, de mucoceles y reubicaciones dentarias. Se presentaron complicaciones tras la extracción quirúrgica de los terceros molares en un 1593% de los casos, siendo las más frecuentes el dolor (435%) y la tumefacción (435%), signos propios de la inflamación postoperatoria. Conclusiones: Nuestra experiencia muestra que la cirugía bucal ambulatoria puede practicarse de forma segura en la población pediátrica siempre y cuando se disponga de los medios y del personal sanitario adecuados.(AU)

Use of bentonite and activated carbon in controlled release formulations of carbofuran.

Controlled release systems (CRS), unlike the conventional formulations, facilitate a gradual and controlled discharge of the pesticides, reducing the losses by evaporation and leaching and minimizing pesticide pollution. In this study, carbofuran-an insecticide-nematicide identified as a groundwater pollutant-was incorporated in alginate-based granules to obtain controlled release properties. The effect on carbofuran release rate caused by the incorporation of bentonite, activated carbon, and different mixtures of both sorbents in alginate basic formulation was studied by immersion of the granules in water. The water uptake, sorption capacity of the sorbent, permeability, and time taken for 50% of the active ingredient to be released into water, T(50), were calculated by the comparison of the preparations. T(50) values were higher for those formulations containing bentonite and/or activated carbon (T(50) values range from 14.76 h for the alginate formulation containing only bentonite as the sorbent to 29.5 weeks for the alginate formulation containing only activated carbon as the sorbent) than for the preparation without these sorbents (11.72 h). On the basis of a parameter of an empirical equation used to fit the insecticide-nematicide release data, it appears that the release of carbofuran from the various formulations into water is controlled by a diffusion mechanism. The sorption capacity of the sorbents for carbofuran was the most important factor modulating carbofuran release. In addition, it was observed that there is a linear correlation of the T(50) values and the content of activated carbon in dry granules.