Formulative Study and Characterization of Novel Biomaterials Based on Chitosan/Hydrolyzed Collagen Films.

To date, the need for biomaterials capable of improving the treatment of chronic skin wounds remains a clinical challenge. The aim of the present work is to formulate and characterize chitosan (Cs)/hydrolyzed collagen (HC) films as potential biomaterials with improved mechanical and hydration performances compared to single component formulations. Films were made by the solvent casting method, with or without glycerin and/or PEG1500 as plasticizers, resulting in a total of eight formulations. All films were characterized by their physico-chemical characteristics and their mechanical and hydration features. A full factorial design was also used to statistically assess the effect of HC concentration, type and concentration of plasticizers and their possible interactions on mechanical and swelling behaviors. Solid state characterization confirmed the hybrid nature of the films, with suggested electrostatic interactions between Cs and HC. Mechanical and swelling properties, along with the analysis of the experimental design, allowed the identification of formulations containing high HC concentration (2% w/v) and glycerin or glycerin/PEG1500 as more suitable candidates for skin wound treatment. Finally, viability assay of immortalized human keratinocytes (HaCaT) showed no statistical differences in cell survival compared to the complete culture medium, suggesting their potential as a promising tool for biomedical applications.

Alarming incidence of reinfections after treatment for Chlamydia trachomatis and gonorrhoea: Can we predict and prevent them? / Alarmante incidencia de reinfecciones tras el tratamiento de Chlamydia trachomatis y gonorrea: ¿podemos predecirlas y prevenirlas?

Background: Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections are a public health problem, worsened by frequent reinfections, whose incidence rate is not known in Spain. The objective of this study is to estimate in patients diagnosed with NG, CT or mixed infection (NG and CT): (1) the incidence of reinfections by the same microorganism, (2) the total incidence of Sexually Transmitted Infections (STI), both by the same microorganism and by infections other than the initial one, and (3) to identify predictors of reinfection. Methods: Observational prospective case series involving 986 patients with CT and/or NG at specialized STI clinics in Biscay (Spain) between 2016 and 2019. Results: The six month cumulative incidence of reinfection by the same microorganism was 17.24% (CI95%: 14.9–19.7) and 24.65% (CI95%: 21.9–27.4) for any STI (reinfection or other). Being an immigrant (OR=1.8; CI95%: 1.3–2.6), men who have sex with men (OR=1.8; CI95%: 1.3–2.6), number of sexual partners (OR=4.3; CI95%: 2.7–6.8 for more than 5 partners), having a new partner (OR=1.7; CI95%: 1.08–2.6), not always using a condom (OR=1.4; CI95%: 1.02–1.9) and consumption of alcohol prior to sex (OR=3.8; CI95%: 1.5–9.5) were associated with reinfection by any STI. Conclusion: These characteristics allow doctors to identify patients in whom to prioritize short-term rescreening for repeated infections with any STIs after initial treatment for NG or CT.(AU)

Introducción: Las infecciones por Chlamydia trachomatis (CT) y Neisseria gonorrhoeae (NG) son un problema de salud pública, agravado por frecuentes reinfecciones, cuya incidencia desconocemos en España. Objetivos: Estimar en pacientes diagnosticados de NG, CT o infección mixta (NG y CT): 1) la incidencia de reinfecciones por el mismo germen, 2) la incidencia total de infecciones de transmisión sexual (ITS), tanto por el mismo germen, como por infecciones diferentes a la inicial y 3) identificar características que predicen la reinfección. Métodos: Estudio observacional prospectivo de una serie de casos: 986 pacientes diagnosticados de CT y/o NG en las consultas de ITS de Bizkaia (España) entre septiembre de 2016 a enero de 2019. Resultados: En 6 meses de seguimiento promedio la incidencia de reinfección por el mismo germen fue del 17,24% (IC95%: 14,9-19,7) y la de cualquier ITS (reinfección u otra) del 24,65% (IC95%: 21,9-27,4). Los factores asociados con la reinfección por cualquier ITS fueron: ser inmigrante (OR=1,8; IC95%: 1,3-2,6), hombre que tiene sexo con hombres (OR=1,8; IC95%: 1,3-2,6), número de parejas sexuales (OR=4,3; IC95%: 2,7-6,8 para más de 5 parejas), tener una pareja nueva (OR=1,7; IC95%: 1,08-2,6), no utilizar siempre preservativo (OR=1,4; IC95%: 1,02-1,9) y consumo de alcohol en relación al sexo (OR=3,8; IC95%: 1,5-9,5). Conclusión. Estas características sirven para identificar pacientes de alto riesgo en los que priorizar el rescreening de ITS tras una infección, que debe ser completo, incluyendo otras infecciones diferentes a la inicial.(AU)

Characterization and Molecular Modelling of Non-Antibiotic Nanohybrids for Wound Healing Purposes.

The healing process of chronic wounds continues to be a current clinical challenge, worsened by the risk of microbial infections and bacterial resistance to the most frequent antibiotics. In this work, non-antibiotic nanohybrids based on chlorhexidine dihydrochloride and clay minerals have been developed in order to design advanced therapeutic systems aimed to enhance wound healing in chronic lesions. To prepare the nanohybrids, two methodologies have been compared: the intercalation solution procedure and the spray-drying technique, the latter as a one-step process able to reduce preparation times. Nanohybrids were then fully studied by solid state characterization techniques. Computational calculations were also performed to assess the interactions between the drug and the clays at the molecular level. In vitro human fibroblast biocompatibility and antimicrobial activity against Staphylococcus aureus and Pseudomonas aeruginosa were assessed to check biocompatibility and potential microbicidal effects of the obtained nanomaterials. The results demonstrated the effective organic/inorganic character of the nanohybrids with homogeneous drug distribution into the clayey structures, which had been confirmed by classical mechanics calculations. Good biocompatibility and microbicidal effects were also observed, especially for the spray-dried nanohybrids. It was suggested that it could be due to a greater contact area with target cells and bacterial suspensions.

Biological Activity of Hybrid Molecules Based on Major Constituents of Cinnammomun verum and Thymus vulgaris Essential Oils.

Plants have been used by humans since ancient times due their antimicrobial and medicinal properties. Essential oils (EOs) are complex mixtures of secondary plant metabolites, including terpenoids, phenylpropanoids, and other aromatic compounds. Cinnamomun verum and Thyme vulgaris EOs and their organic extracts exert numerous biological activities because of their major compounds, particularly thymol, carvacrol, eugenol, and benzoic and cinnamic acid. The structural motifs presented by these phytochemicals are responsible for their biological activities. Modification or hybridization of these structures could lead to new bio-based compounds with improved efficacy or multiple modes of action. In this work, we aimed to develop reliable methods of obtaining six hybrid molecules from the major constituents of C. verum and T. vulgaris EOs. For the first time, we tested their efficacy in the inhibition of the mycelium growth and spore germination of two of the most important phytopathogenic fungi, Fusarium oxysporum and Colletotrichum gloeosporioides, and one opportunistic human pathogen, Aspergillus niger. The cytotoxic activity of the obtained hybrids was assessed using the brine shrimp lethality assay. In addition, we report for the first time a biocatalytic process for the obtention of these bioactive hybrid molecules. The results of this work enable the possibility of using hybrid molecules based on the major constituents of EOs as active ingredients in strategic industries such as agriculture, aquaculture, and pharmaceuticals.

Alarming incidence of reinfections after treatment for Chlamydia trachomatis and gonorrhoea: Can we predict and prevent them?

BACKGROUND: Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections are a public health problem, worsened by frequent reinfections, whose incidence rate is not known in Spain. The objective of this study is to estimate in patients diagnosed with NG, CT or mixed infection (NG and CT): (1) the incidence of reinfections by the same microorganism, (2) the total incidence of Sexually Transmitted Infections (STI), both by the same microorganism and by infections other than the initial one, and (3) to identify predictors of reinfection. METHODS: Observational prospective case series involving 986 patients with CT and/or NG at specialized STI clinics in Biscay (Spain) between 2016 and 2019. RESULTS: The six month cumulative incidence of reinfection by the same microorganism was 17.24% (CI95%: 14.9-19.7) and 24.65% (CI95%: 21.9-27.4) for any STI (reinfection or other). Being an immigrant (OR=1.8; CI95%: 1.3-2.6), men who have sex with men (OR=1.8; CI95%: 1.3-2.6), number of sexual partners (OR=4.3; CI95%: 2.7-6.8 for more than 5 partners), having a new partner (OR=1.7; CI95%: 1.08-2.6), not always using a condom (OR=1.4; CI95%: 1.02-1.9) and consumption of alcohol prior to sex (OR=3.8; CI95%: 1.5-9.5) were associated with reinfection by any STI. CONCLUSION: These characteristics allow doctors to identify patients in whom to prioritize short-term rescreening for repeated infections with any STIs after initial treatment for NG or CT.

Características clínicas y epidemiológicas de la infección por Chlamydia trachomatis en pacientes de consultas de infecciones de transmisión sexual / Clinical and epidemiological characteristics of Chlamydia trachomatis infection among sexually transmitted infection clinics patients

Introducción: Las infecciones por Chlamydia trachomatis (CT) son un problema de salud pública por su alta incidencia y consecuencias sobre la salud reproductiva. Nuestro objetivo es describir las características sociodemográficas, conductuales y clínicas de los pacientes con infección por CT para adaptar las intervenciones preventivas a los grupos con mayor riesgo. Métodos: Serie de casos prospectiva de todos los pacientes diagnosticados de CT entre septiembre del 2016 a enero del 2019 en las consultas de referencia para infecciones de transmisión sexual (ITS) de Osakidetza en Bizkaia.Resultados: Aceptaron participar 847 pacientes (88,2%): 41% mujeres, 33,8% varones heterosexuales y 25% hombres que tenían sexo con hombres (HSH); 33% eran inmigrantes y 26% menores de 25 años (33% entre las mujeres). Un 20% utilizaba siempre preservativo. Un 36% había tenido ITS anteriormente y 28% tenía otra ITS simultánea. El 55% de las infecciones fueron asintomáticas (70% entre las mujeres). El recto fue la localización más frecuente entre los HSH (69,5%), seguida de la uretra (31,4%) y la faringe (14,5%). En las mujeres, la infección afectó principalmente el cérvix (86,5% de los casos), seguido del recto (17,6%) y la faringe (13,8%). Se estudió a los contactos del 58% de los pacientes. La tasa de reinfección a las cuatro semanas fue del 17% entre aquellos con criterios para realizar un test de cura.Conclusión: Estos resultados justifican la implantación de cribados oportunistas en mujeres menores de 25 años e inmigrantes jóvenes de ambos sexos, con toma de muestras genitales y extra-genitales, y el establecimiento de guías apropiadas para la notificación de contactos.(AU)

Background: Chlamydia trachomatis (CT) infections are a public health problem because of its high incidence and consequences on reproductive health. Our aim is to describe the socio-demographic, behavioral and clinical characteristics of patients with CT infection in order to adapt preventive interventions for the highest risk groups. Methods: Prospective case series of all patients diagnosed with CT between September 2016 and January 2019 in the reference STI clinics of Osakidetza (Basque Health Service) in Bizkaia (Spain). Results: 847 patients (88.2%) agreed to participate: 41% women, 33.8% heterosexual men and 25% men who has sex with men (MSM); 33% were immigrants and 26% were under the age of 25 (33% of the women). Only 20% systematically used condoms. 36% had previously had STI and 28% had simultaneously another STI. 55% of the infections were asymptomatic (70% among women). In MSM, the rectum was affected in 69.5% of cases, the urethra in 31.4%, and the pharynx in 14.5%. The cervix was affected in 86.5% of the women, the rectum in 17.6%, and the pharynx in 13.8%. A contact study was only carried out in 58% of cases. The reinfection rate at 4 weeks was 17% among those with criteria to perform a test of cure. Conclusion: Our results justify implement opportunistic screening in women under the age of 25 and young immigrants of both sexes, by taking genital and extragenital samples, as well as developing appropriate guidelines for the notification and follow-up of contacts.(AU)

Models and Techniques to Study Aortic Valve Calcification in Vitro, ex Vivo and in Vivo. An Overview.

Aortic valve stenosis secondary to aortic valve calcification is the most common valve disease in the Western world. Calcification is a result of pathological proliferation and osteogenic differentiation of resident valve interstitial cells. To develop non-surgical treatments, the molecular and cellular mechanisms of pathological calcification must be revealed. In the current overview, we present methods for evaluation of calcification in different ex vivo, in vitro and in vivo situations including imaging in patients. The latter include echocardiography, scanning with computed tomography and magnetic resonance imaging. Particular emphasis is on translational studies of calcific aortic valve stenosis with a special focus on cell culture using human primary cell cultures. Such models are widely used and suitable for screening of drugs against calcification. Animal models are presented, but there is no animal model that faithfully mimics human calcific aortic valve disease. A model of experimentally induced calcification in whole porcine aortic valve leaflets ex vivo is also included. Finally, miscellaneous methods and aspects of aortic valve calcification, such as, for instance, biomarkers are presented.

Clinical and epidemiological characteristics of Chlamydia trachomatis infection among sexually transmitted infection clinics patients.

BACKGROUND: Chlamydia trachomatis (CT) infections are a public health problem because of its high incidence and consequences on reproductive health. Our aim is to describe the socio-demographic, behavioral and clinical characteristics of patients with CT infection in order to adapt preventive interventions for the highest risk groups. METHODS: Prospective case series of all patients diagnosed with CT between September 2016 and January 2019 in the reference STI clinics of Osakidetza (Basque Health Service) in Bizkaia (Spain). RESULTS: 847 patients (88.2%) agreed to participate: 41% women, 33.8% heterosexual men and 25% men who has sex with men (MSM); 33% were immigrants and 26% were under the age of 25 (33% of the women). Only 20% systematically used condoms. 36% had previously had STI and 28% had simultaneously another STI. 55% of the infections were asymptomatic (70% among women). In MSM, the rectum was affected in 69.5% of cases, the urethra in 31.4%, and the pharynx in 14.5%. The cervix was affected in 86.5% of the women, the rectum in 17.6%, and the pharynx in 13.8%. A contact study was only carried out in 58% of cases. The reinfection rate at 4 weeks was 17% among those with criteria to perform a test of cure. CONCLUSION: Our results justify implement opportunistic screening in women under the age of 25 and young immigrants of both sexes, by taking genital and extragenital samples, as well as developing appropriate guidelines for the notification and follow-up of contacts.

Applications of artificial intelligence in dentistry: A comprehensive review.

OBJECTIVE: To perform a comprehensive review of the use of artificial intelligence (AI) and machine learning (ML) in dentistry, providing the community with a broad insight on the different advances that these technologies and tools have produced, paying special attention to the area of esthetic dentistry and color research. MATERIALS AND METHODS: The comprehensive review was conducted in MEDLINE/PubMed, Web of Science, and Scopus databases, for papers published in English language in the last 20 years. RESULTS: Out of 3871 eligible papers, 120 were included for final appraisal. Study methodologies included deep learning (DL; n = 76), fuzzy logic (FL; n = 12), and other ML techniques (n = 32), which were mainly applied to disease identification, image segmentation, image correction, and biomimetic color analysis and modeling. CONCLUSIONS: The insight provided by the present work has reported outstanding results in the design of high-performance decision support systems for the aforementioned areas. The future of digital dentistry goes through the design of integrated approaches providing personalized treatments to patients. In addition, esthetic dentistry can benefit from those advances by developing models allowing a complete characterization of tooth color, enhancing the accuracy of dental restorations. CLINICAL SIGNIFICANCE: The use of AI and ML has an increasing impact on the dental profession and is complementing the development of digital technologies and tools, with a wide application in treatment planning and esthetic dentistry procedures.

Social networks: A quality tool for health dissemination?

BACKGROUND: Social networks are integrated in our lives and, amongst other functions, they are a means of dissemination. There are numerous social network accounts dedicated to health that could be used as an educational resource. The aim of this study was to evaluate the quality of accounts dedicated to health in different social networks, assessing their content and didactic and technological effectiveness and accessibility. MATERIALS AND METHODS: Observational cross-sectional descriptive study in which an analysis of social networks related to health was carried out from April to June 2021 in Spain. Twenty-eight accounts were analysed using a mixed qualitative-quantitative methodology. Content analysis of the speeches disseminated through the selected accounts was performed. In addition, the quality of the accounts was assessed with the Instrumento de Evaluación de Recursos Educativos Digitales (#IE_RED) (Digital Educational Resources Evaluation Instrument [#IE_RED]). RESULTS: Four categories were identified according to the content: student-focused profiles, specific professionals' profiles, current health issues and profiles promoting a healthy lifestyle. In addition, the quality of the accounts obtained a score that indicates they meet the requirements to be validated as a good educational digital resource but could be improved. Instagram social network accounts and those managed by nurses scored significantly higher. CONCLUSIONS: The analysed accounts were revealed as a quality tool for health dissemination, with varied content and applicable to teaching. Their use could be applied both to the training of health professionals and to the promotion of the population's health.

Reorganization of Thalamic Inputs to Lesioned Cortex Following Experimental Traumatic Brain Injury.

Traumatic brain injury (TBI) disrupts thalamic and cortical integrity. The effect of post-injury reorganization and plasticity in thalamocortical pathways on the functional outcome remains unclear. We evaluated whether TBI causes structural changes in the thalamocortical axonal projection terminals in the primary somatosensory cortex (S1) that lead to hyperexcitability. TBI was induced in adult male Sprague Dawley rats with lateral fluid-percussion injury. A virus carrying the fluorescent-tagged opsin channel rhodopsin 2 transgene was injected into the ventroposterior thalamus. We then traced the thalamocortical pathways and analyzed the reorganization of their axonal terminals in S1. Next, we optogenetically stimulated the thalamocortical relays from the ventral posterior lateral and medial nuclei to assess the post-TBI functionality of the pathway. Immunohistochemical analysis revealed that TBI did not alter the spatial distribution or lamina-specific targeting of projection terminals in S1. TBI reduced the axon terminal density in the motor cortex by 44% and in S1 by 30%. A nematic tensor-based analysis revealed that in control rats, the axon terminals in layer V were orientated perpendicular to the pial surface (60.3°). In TBI rats their orientation was more parallel to the pial surface (5.43°, difference between the groups p < 0.05). Moreover, the level of anisotropy of the axon terminals was high in controls (0.063) compared with TBI rats (0.045, p < 0.05). Optical stimulation of the sensory thalamus increased alpha activity in electroencephalography by 312% in controls (p > 0.05) and 237% (p > 0.05) in TBI rats compared with the baseline. However, only TBI rats showed increased beta activity (33%) with harmonics at 5 Hz. Our findings indicate that TBI induces reorganization of thalamocortical axonal terminals in the perilesional cortex, which alters responses to thalamic stimulation.

Clinical and epidemiological characteristics of Chlamydia trachomatis infection among sexually transmitted infection clinics patients. / Características clínicas y epidemiológicas de la infección por Chlamydia trachomatis en pacientes de consultas de infecciones de transmisión sexual.

BACKGROUND: Chlamydia trachomatis (CT) infections are a public health problem because of its high incidence and consequences on reproductive health. Our aim is to describe the socio-demographic, behavioral and clinical characteristics of patients with CT infection in order to adapt preventive interventions for the highest risk groups. METHODS: Prospective case series of all patients diagnosed with CT between September 2016 and January 2019 in the reference STI clinics of Osakidetza (Basque Health Service) in Bizkaia (Spain) RESULTS: 847 patients (88.2%) agreed to participate: 41% women, 33.8% heterosexual men and 25% men who has sex with men (MSM); 33% were immigrants and 26% were under the age of 25 (33% of the women). Only 20% systematically used condoms. 36% had previously had STI and 28% had simultaneously another STI. 55% of the infections were asymptomatic (70% among women). In MSM, the rectum was affected in 69.5% of cases, the urethra in 31.4%, and the pharynx in 14.5%. The cervix was affected in 86.5% of the women, the rectum in 17.6%, and the pharynx in 13.8%. A contact study was only carried out in 58% of cases. The reinfection rate at 4 weeks was 17% among those with criteria to perform a test of cure. CONCLUSION: Our results justify implement opportunistic screening in women under the age of 25 and young immigrants of both sexes, by taking genital and extragenital samples, as well as developing appropriate guidelines for the notification and follow-up of contacts.

Estudio de calidad de vida y adherencia al tratamiento en pacientes de 2 a 16 años con diabetes mellitus tipo 1 en Andalucía / Study of the quality of life and adherence to treatment in patients from 2 to 16 years-old with type 1 diabetes mellitus in Andalusia, Spain

INTRODUCCIÓN: La diabetes mellitus 1 es la segunda enfermedad crónica y el trastorno endocrino-metabólico más frecuente en la infancia. Se estima una prevalencia entre 1,1 y 1,4/1000 menores de 15 años. En Andalucía la prevalencia es mayor (1,7 por mil). El objetivo del estudio es analizar la calidad de vida y adherencia al tratamiento, centrándonos en la población pediátrica de Andalucía. MÉTODOS: Estudio analítico observacional transversal multicéntrico. La muestra fue de 178 pacientes de seis hospitales con Endocrinología Pediátrica. A cada paciente se le entregaron dos cuestionarios; la encuesta de calidad de vida (PedsQL versión 3.0) y adherencia al tratamiento SCI-R. Además, se recogieron datos demográficos, clínicos, del control metabólico, y complicaciones. RESULTADOS: Se obtuvieron niveles altos tanto en la adherencia como en la calidad de vida. La primera se relacionó de forma inversa con la edad y la HbA1c, aunque el coeficiente fue tan bajo que no permite sacar conclusiones significativas. La calidad de vida se asoció con el uso de sistema de monitorización continua de glucosa en tiempo real (MCG-TR) integrado con ISCI, así como con menos hipoglucemias graves y complicaciones renales. La HbA1c media fue 7,1%. El 12,9% de los pacientes usaban ISCI. El 83,2% empleaban exclusivamente la glucemia capilar, mientras que el 16,8% usaba algún dispositivo de monitorización de glucosa intersticial. CONCLUSIONES: Se trata del primer estudio realizado en Andalucía que analiza la calidad de vida en pacientes pediátricos. Los resultados muestran niveles altos de adherencia y de calidad de vida, además de un buen control metabólico

INTRODUCTION: Diabetes mellitus 1 is the second most frequent chronic disease, and the most frequent endocrine-metabolic disorder in childhood. The estimated prevalence is between 1.1 and 1.4 / 1000 children under 15 years years-old. In Andalusia the prevalence is higher (1.7 per thousand). The objective of the study is to evaluate health-related quality of life (HRQoL) and adherence to treatment, specifically in the paediatric population of Andalusia. METHODS: A multicentre cross-sectional observational analytical study was conducted on a sample of 178 patients from six hospitals with a Paediatric Endocrinology Unit. Each patient received two questionnaires; quality of life (PedsQL version 3.0) and adherence to the self-care recommendations (SCI-R) treatment. The demographic, clinical, metabolic control data, and possible complications were also collected. RESULTS: High levels were obtained in both adherence and health-related quality of life (HRQoL). Adherence was inversely related to age and HbA1c. The health-related quality of life (HRQoL) was associated with the use of a continuous real-time glucose monitoring system (MCG-TR) combined with continuous subcutaneous insulin infusion (CSII), as well as with a lower number of severe hypoglycaemia and renal complications. The mean HbA1c was 7.1%. 12,9% of patients used ISCI. 83.2% used capillary glycemia exclusively, while 16.8% used some interstitial glucose monitoring device. CONCLUSIONS: This is the first study in Andalusia that analyzes the health-related quality of life (HRQoL) of pediatric patients. The results show high levels of adherence and health-related quality of life (HRQoL), as well as good metabolic control

[Study of the quality of life and adherence to treatment in patients from 2 to 16 years-old with type 1 diabetes mellitus in Andalusia, Spain]. / Estudio de calidad de vida y adherencia al tratamiento en pacientes de 2 a 16 años con diabetes mellitus tipo 1 en Andalucía.

INTRODUCTION: Diabetes mellitus 1 is the second most frequent chronic disease, and the most frequent endocrine-metabolic disorder in childhood. The estimated prevalence is between 1.1 and 1.4 / 1000 children under 15 years years-old. In Andalusia the prevalence is higher (1.7 per thousand). The objective of the study is to evaluate health-related quality of life (HRQoL) and adherence to treatment, specifically in the paediatric population of Andalusia. METHODS: A multicentre cross-sectional observational analytical study was conducted on a sample of 178 patients from six hospitals with a Paediatric Endocrinology Unit. Each patient received two questionnaires; quality of life (PedsQL version 3.0) and adherence to the self-care recommendations (SCI-R) treatment. The demographic, clinical, metabolic control data, and possible complications were also collected. RESULTS: High levels were obtained in both adherence and health-related quality of life (HRQoL). Adherence was inversely related to age and HbA1c. The health-related quality of life (HRQoL) was associated with the use of a continuous real-time glucose monitoring system (MCG-TR) combined with continuous subcutaneous insulin infusion (CSII), as well as with a lower number of severe hypoglycaemia and renal complications. The mean HbA1c was 7.1%. 12,9% of patients used ISCI. 83.2% used capillary glycemia exclusively, while 16.8% used some interstitial glucose monitoring device. CONCLUSIONS: This is the first study in Andalusia that analyzes the health-related quality of life (HRQoL) of pediatric patients. The results show high levels of adherence and health-related quality of life (HRQoL), as well as good metabolic control.

[Bladder catheterization in the hospitalized elderly people]. / Empleo del sondaje vesical en el anciano hospitalizado.

OBJECTIVES: To determine the prevalence of patients with bladder catheterization in a geriatrics service and to analyze the factors associated with the use of urinary catheterization in hospitalized elderly people. MATERIAL AND METHOD: This descriptive and retrospective study (January to December 2019) included all the patients admitted to a geriatric service, with bladder catheterization during their hospital admission. Sociodemographic and clinical data were collected. RESULTS: In 2019, 10.20% of the patients admitted required urinary catheters. Most of these patients were males (60.6%), with an average age of 86.5 years (SD: 8.65). 43.4% of the urinary catheters that were placed temporarily were indicated in the geriatric unit, 28.9% in another medical service and 26.3% in the emergency department. The median of days with a urinary catheter was 7.5 days. The most common reason to indicate a urinary catheter was acute urinary retention (AUR) (67.7%). At hospital discharge, 22.3% of the patients needed to continue with a urinary catheter at home, without needing it prior to admission. CONCLUSIONS: In our study, a high percentage of bladder catheterization was needed during the hospitalization, the most common cause being AUR. The average use (in days) of urinary catheters is high, with the consequent risk of nosocomial urinary tract infections. It is necessary to improve the prescribing habits of urinary catheterization and its early withdrawal through specific educational efforts and avoiding their inappropriate use.

Long-Term in vivo Evaluation of Orthotypical and Heterotypical Bioengineered Human Corneas.

PURPOSE: Human cornea substitutes generated by tissue engineering currently require limbal stem cells for the generation of orthotypical epithelial cell cultures. We recently reported that bioengineered corneas can be fabricated in vitro from a heterotypical source obtained from Wharton's jelly in the human umbilical cord (HWJSC). METHODS: Here, we generated a partial thickness cornea model based on plastic compression nanostructured fibrin-agarose biomaterials with cornea epithelial cells on top, as an orthotypical model (HOC), or with HWJSC, as a heterotypical model (HHC), and determined their potential in vivo usefulness by implantation in an animal model. RESULTS: No major side effects were seen 3 and 12 months after implantation of either bioengineered partial cornea model in rabbit corneas. Clinical results determined by slit lamp and optical coherence tomography were positive after 12 months. Histological and immunohistochemical findings demonstrated that in vitro HOC and HHC had moderate levels of stromal and epithelial cell marker expression, whereas in vivo grafted corneas were more similar to control corneas. CONCLUSION: These results suggest that both models are potentially useful to treat diseases requiring anterior cornea replacement, and that HHC may be an efficient alternative to the use of HOC which circumvents the need to generate cornea epithelial cell cultures.

Tendencia en el uso de implantes mamarios de los cirujanos plásticos iberolatinoamericanos. Estudio FILACP 2010-2020 / Trend in the use of breast implants of iberolatin american plastic surgeons. FILACP study 2010-2020

INTRODUCCIÓN Y OBJETIVO: Desde su creación en 2010, el Comité de Registro de Implantes de la FILACP (Federación Ibero Latinoamericana de Cirugía Plástica), entidad internacional que agrupa a los 22 Sociedades Nacionales de Cirugía Plástica de habla hispana y portuguesa, ha trabajando para conocer las preferencias y usos habituales entre sus miembros en la cirugía de aumento mamario con implantes. Con ese objetivo, realizó entre 2010 y 2020 una serie de encuestas periódicas para investigar las variables implicadas en la cirugía mamaria con implantes llevada a cabo por los cirujanos plásticos de Ibero Latinoamérica y la forma en que pudiera haber influido en ellos la incidencia del linfoma anaplásico de células grandes asociado a implantes mamarios (LACG-AIM) y su posible relación etiopatogénica con determinados tipos de implantes. Presentamos en este artículo los datos obtenidos y analizamos las tendencias observadas. MATERIAL Y MÉTODO: Estudio comparativo de datos recogidos en 4 encuestas enviadas a 5000 miembros de la FILACP: la primera presentada en 2012, con 25 preguntas sobre cirugía mamaria primaria con implantes y 18 sobre cirugía secundaria; la segunda presentada en 2016 con 31 preguntas sobre cirugía primaria y 52 sobre cirugía secundaria; la tercera en 2018 con 40 preguntas tanto de cirugía primaria como secundaria; y la cuarta en 2020, con 13 preguntas generales. RESULTADOS: Los datos recogidos reflejan una preferencia de los cirujanos plásticos iberolatinoamericanos por el uso de implantes redondos, con tendencia al incremento del uso de los de cubierta lisa frente a los texturizados, con abordaje quirúrgico preferencial por vía periareolar, colocación en plano submuscular, y una concienciación creciente de la necesidad de realizar capsulectomía quirúrgica en las cirugías secundarias y del envío de la cápsula extirpada a estudio anatomopatológico. Refieren también un buen conocimiento del LACG-AIM y de las variables implicadas en su diagnóstico y tratamiento. Recogemos también a fecha abril de 2020 los casos de LACG-AIM notificados por las Sociedades Nacionales de la FILACP: 106 casos en 9 países, con 2 fallecimientos. CONCLUSIONES: La tendencia entre nuestros encuestados, seguramente influidos por el conocimiento de los factores relacionados con la etiología del LACG-AIM, va hacia el uso cada vez más mayoritario de implantes de cubierta lisa y de forma redonda, y representa una estimación importante y actualizada de los usos de un colectivo profesional muy representativo en un entorno internacional que suele recoger solo datos de profesionales y publicaciones anglosajonas

BACKGRAUND AND OBJECTIVE: Since its creation in 2010, the Implant Registry Committee of FILACP (Iberolatinoamerican Federation of Plastic Surgery) an international entity that gathers the 22 National Societies of Plastic Surgery of Spanish and Portuguese language, has worked to know the common preferences and uses among its members in breast augmentation surgery with implants. With this aim, between 2010 and 2020, it carried out a series of periodic surveys to investigate the variables involved in breast surgery with implants carried out by plastic surgeons from Iberolatinamerica and how the incidence of breast implants associated anaplastic large cell lymphoma (BIA-ALCL) and its possible etiopathogenic relationship with certain types of implants might have influenced them. We present in this article the data obtained and analyze the observed trends. METHODS: Comparative study of data collected in 4 surveys sent to 5000 FILACP members: the first one presented in 2012, with 25 questions on primary breast surgery with implants and 18 on secondary surgery; the second one presented in 2016 with 31 questions on primary surgery and 52 on secondary surgery; the third one in 2018 with 40 questions on both primary and secondary surgery; and the fourth one in 2020, with 13 general questions. RESULTS: General data reflects a preference of Iberolatinamerican plastic surgeons for the use of round implants, with a tendency to increase the use of smooth cover versus textured implants, with a preferential surgical periareolar approach, submuscular placement, and awareness growing need for surgical capsulectomy in secondary surgeries, and for the pathology study of the removed capsule. They also report a good knowledge of BIA-ALCL and the variables involved in its diagnosis and treatment. As of April 2020, we also collected the cases of LACG-AIM reported by the FILACP National Societies: 106 cases in 9 countries, with 2 deaths. CONCLUSIONS: The trend among our respondents, surely influenced by the knowledge of the factors related to the etiology of BIA-ALCL, is towards the increasing use of smooth and round-shaped implants, and represents an important and updated estimate of the uses of a highly representative professional collective in an international environment that usually collects only data from anglo-saxon professionals and publications

Una monografía en tiempos de pandemia / A monograph in times of pandemic

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Linfoma anaplásico de células grandes e implantes mamarios: revisión sistemática de las casuísticas publicadas / Anaplastic large cell lymphoma and breast implants: systematic review of published cases

INTRODUCCIÓN Y OBJETIVO: Desde 1995 en que se publicó la primera notificación que relacionaba el linfoma anaplásico de células grandes al hecho de portar implantes mamarios (LACG-AIM) han transcurrido más de 25 años y han sido publicados cientos de artículos. El presente trabajo tiene como objetivo realizar una revisión sistemática y analítica de los casos publicados, así como sintetizar el conocimiento actual sobre esta entidad y acercarlo al lector de habla hispana. MATERIAL Y MÉTODO: Realizamos una búsqueda sistemática en las bases de datos PubMed, ScienceDirect y SciELO así como en el buscador de Google Académico entre 1995 y octubre de 2019, que pretende revisar las características de los casos recogidos en la literatura en dicho periodo de tiempo. RESULTADOS: El número total de casos recogidos en la bibliografía analizada fue de 122. La información resultó heterogénea y mayoritariamente basada en notificaciones de casos. Cabe destacar la escasez de casos publicados desde países íbero-latinoamericanos. Exponemos los principales datos recogidos relativos a características del linfoma, sintomatología, diagnóstico, patogenia, estudios genéticos, mutaciones, tratamiento, pronóstico y supervivencia. CONCLUSIONES: Aunque el diagnóstico y tratamiento actual del LACG-AIM se encuentran bastante estandarizados, la incidencia real y la etiología de esta entidad necesitan de estudios más rigurosos. La falta de criterios comunes a la hora de recoger o notificar los casos hace difícil una recogida veraz y uniforme. Es necesaria la comunicación de cualquier incidente relacionado con las prótesis mamarias, tanto a los registros nacionales de implantes como a la comunidad científica, a fin de recopilar información de calidad como base para latoma de decisiones basadas en evidencia

BACKGROUND AND OBJECTIVE: In 1995, the first notification relating anaplastic large cell lymphoma (BIA-ALCL) and breast implants was established. Twenty four years later, hundreds of articles have been published about this topic. The aim of this study is to review the published cases and summarize the current knowledge about this entity bringing it closer to Hispanic readers. METHODS: A systematic review was performed in PubMed, ScienceDirect, SciELO and Google Scholar databases since 1995 to October 2019. RESULTS: A total number of 122 case reports were analyzed. The information collected was heterogeneous. The shortage of Ibero-Latinoamerican published cases was evidenced. Data elements abstracted included information about patient demographics, medical history, implant characteristics, presenting symptoms, diagnosis and staging, treatment, and patient outcomes. CONCLUSIONS: Despite diagnosis and current treatment to BIA-ALCL are fairly standardized, more rigorous studies are required to establish actual incidence and etiology. The lack of common criteria when collecting or reporting clinical cases makes difficult a truthful and uniform data collection. Communication of any incident related to breast implants, both to the national implant registries and to the scientific community, is necessary in order to gather quality information as a basis for evidence-based decision making