Tabaquismo y relación con estilos de vida en una consulta de Atención Primaria / Smoking and relationship with lifestyles in a Primary Care consultation

Objetivo.Estimar la prevalencia de fumadores y relacio-nar tabaquismo con determinados estilos de vida, dietamediterránea, consumo de alcohol y actividad física.Pacientes y métodos.Estudio observacional, descrip-tivo y transversal realizado en pacientes de 18 a 69 años,que acuden a consulta de Atención Primaria durantedos meses y configurada por dos grupos: fumadores yno fumadores. Se realizaron tres cuestionarios estructu-rados y validados: ISCA (Interrogatorio Sistematizadode Consumos Alcohólicos), IPAQ(International PhysicalActivity Questionnaire) y PREDIMED (PREvención conDIeta MEDiterránea). Las encuestas fueron anónimas,supervisadas y asistidas. Los datos se analizaron con elprograma Jamovi, interfaz gráfica (GUI) del lenguajeestadístico R. test Chi-cuadrado para comparar varia-bles categóricas. En todos los contrastes de hipótesisla significación estadística fue p<0,05.Resultados.Muestra de 313 pacientes, 246 no fu-madores y 67 fumadores. Prevalencia de fumadores21,4%. La relación entre dieta y ser fumador y no fu-mador, presenta diferencias no significativas (χ2=10,6;p=0,014) y (OR: 0,615 y IC 95%: 0,352-1,08). Serfumador está relacionado con una menor actividadfísica (χ2=14,5; p=0,002) y (OR: 0,369 y IC 95%:0,197-0,690). Fumar está relacionado con un mayorconsumo de alcohol (χ2=77,6; p<0,001) y (OR: 58,3y IC 95%: 3,56-954).Conclusión.El tabaco es un hábito que condicionaotras conductas poco saludables (más consumo de al-cohol, menor actividad física y menor seguimientode la dieta mediterránea) y, por tanto, es fundamentalque en la deshabituación tabáquica se contemple unabordaje integral del paciente. (AU)

Objective.To estimate the prevalence of smoking andto relate smoking to certain lifestyles, Mediterraneandiet, alcohol consumption and physical activity.Patients and method.Observational, descriptiveand cross-sectional study in patients aged 18 to 69years attending the Primary Care consultation for twomonths and configured by two groups: smokers andnon-smokers. Three structured and validated ques-tionnaires were performed: ISCA (Systematic Alcohol Consumption Questionnaire), IPAQ (InternationalPhysical Activity Questionnaire) and PREDIMED(Mediterranean Diet Prevention). Anonymous, su-pervised and assisted surveys. Data were analizedby Jamovi program, graphic interface (GUI) of thestatistical language R. Test Chi-cuadradoto comparecategorical variables. In all hypothesis contrasts, sta-tistical significance p<0.05.Results.Sample of 313 patients, 246 non-smokersand 67 smokers. Prevalence of smoking 21.4%. Re-lationship between diet and being a smoker and non-smoker presents non-significant differences (χ2=10.6,p=0.014) and (OR: 0.615 and 95% CI: 0.352-1.08).Being a smoker is related to less physical activity(χ2=14.5; p=0.002) and (OR: 0.369 and 95% CI:0.197-0.690). Smoking is related to higher alcoholconsumption (χ2=77.6; p<0.001) and (OR: 58.3 and95% CI: 3.56-954).Conclusion.Tobacco is a habit that conditions otherunhealthy behaviors (more alcohol consumption, lessphysical activity and less adherence to the Medite-rranean diet) and therefore it is fundamental that insmoking cessation a comprehensive approach of thepatient is considered. (AU)

Optimized meropenem dosage regimens using a pharmacokinetic/pharmacodynamic population approach in patients undergoing continuous venovenous haemodiafiltration with high-adsorbent membrane.

BACKGROUND: The pharmacokinetics (PK) of antibiotics change during sepsis and continuous renal replacement therapies in critically ill patients. Limited evidence exists on the use of the oXiris® high-adsorbent membrane. OBJECTIVES: To develop a PK/pharmacodynamic (PD) model for meropenem in critically ill sepsis patients undergoing continuous venovenous haemodiafiltration (CVVHDF) with the oXiris® membrane, and to design an optimal dosing regimen assessed according to the PTA. METHODS: A prospective, open-label, observational PK trial was performed (EUDRACT 2011-005902-30). We conducted PK studies (plasma and ultrafiltrate) for at least 24 h after concomitant administration of CVVHDF and meropenem 1 g q8h. We constructed a PK model using the non-linear mixed-effects approach (NONMEM 7.3). We evaluated the suitability of different dosage regimens using Monte Carlo simulations and calculated the PTA as the percentage of subjects achieving a given percentage of time above the MIC (fT>MIC). RESULTS: The PK of meropenem was best captured by a two-open-compartment model with zero-order input kinetics and first-order elimination. Extracorporeal CL was 7.78 L/h [relative standard error (RSE) 16.45 L/h] and central compartment V (Vc) was 24.9 L (RSE 13.73 L). Simulations showed that, for susceptible Pseudomonas aeruginosa isolates (EUCAST MIC ≤2 mg/L) and attainment of 100%fT>MIC, 500 mg q8h given as extended (EI) or continuous infusion (CI) would be sufficient. For a target of 100%fT>4×MIC, CI of 3000 mg q24h or 2000 mg q8h administered as EI or CI would be required. CONCLUSIONS: We have constructed a PK model of meropenem in sepsis patients undergoing CVVHDF using the oXiris® membrane. This tool will support physicians when calculating the optimal initial dose.

Evolución del perfil de los pacientes sometidos a cirugía abierta de aneurisma de aorta abdominal en la era endovascular / Changes in the profile of patients subjected to open repair of abdominal aortic aneurysm in the endovascular era

INTRODUCCIÓN: El incremento del uso de la cirugía endovascular en el tratamiento del aneurisma de aorta abdominal (AAA) puede haber modificado el perfil de los pacientes que son tratados mediante cirugía abierta (CA) y sus resultados. OBJETIVO: Evaluar la evolución, las características clínicas y anatómicas de los pacientes tratados mediante CA electiva de AAA en los últimos años en nuestro servicio y su relación con los resultados postoperatorios. MATERIAL Y MÉTODOS: Realizamos un estudio retrospectivo de pacientes tratados mediante CA electiva de AAA entre 2008 y 2014 con TAC preoperatoria disponible. Registramos: datos demográficos (edad, sexo), comorbilidad (cardíaca, respiratoria, renal), medicación preoperatoria, características anatómicas (diámetro, longitud, calcificación, trombo y angulación del cuello aórtico proximal) y parámetros analíticos. Definimos cuello aórtico proximal hostil como: <10 mm de longitud o >50% de la circunferencia de trombo o >50% calcificación o angulación infrarrenal >60°. Registramos: mortalidad, complicaciones, reintervenciones y reingresos. Dividimos la muestra en 2 periodos: 1 (2008-2011) y 2 (2012-2014). RESULTADOS: Incluimos a 107 pacientes con edad media de 69,26 años (DE = 6,239). El tiempo medio de seguimiento fue 28,39 meses (DE = 23,13) con una supervivencia del 78,6% (n = 92) a los 64 meses. En el periodo 2 aumentó la incidencia de cuello hostil (45,2 vs. 64,6%; p < 0,05) y la calcificación >50% en el cuello aórtico (8,1 vs. 24,1%; p < 0,05). También en el periodo 2 se requirió un mayor número de transfusiones sanguíneas (26,2 vs. 56,9%; p < 0,05) pero se produjeron menos complicaciones cardiológicas en los 30 primeros días (16,7 vs. 4,6%; p < 0,05). Las tasas de mortalidad, reintervención y reingreso fueron similares en ambos periodos (p > 0,05). CONCLUSIÓN: En nuestra serie los pacientes tratados mediante CA de AAA presentan características anatómicas progresivamente menos favorables, sin que ello se acompañe de una mayor morbimortalidad postoperatoria

INTRODUCTION: The increasing use of endovascular repair in the treatment of abdominal aortic aneurysm (AAA) may have modified the profile of patients undergoing open repair (OR), as well as the results. OBJECTIVE: The aim is to evaluate the clinical and anatomical characteristics of patients with AAA undergoing elective OR in our department over the last few years, and their relationship with the post-operative results. METHODS: A retrospective study was conducted on patients undergoing elective AAA OR between 2008 and 2014 and who had a pre-operative computed tomography (CT) scan available. The following variables were recorded: Demographics (age, gender), comorbidities (cardiac, respiratory, renal), pre-operative medication, anatomical characteristics (proximal neck diameter, length, calcification, thrombus, and angulation), and blood test parameters. A hostile proximal infrarenal aortic neck was defined as: <10 mm length and/or >50% circumference thrombus and/or >50% calcification and/or >60° angulation. The mortality, complications, re-interventions and re-admissions were recorded. The sample was divided into 2 periods: 1 (2008-2011) and 2 (2012-2014). RESULTS: A total of 107 patients were included, with mean age of 69.26 years (SD = 6.239). Mean follow-up was 28.39 months (SD = 23.13), with a survival rate of 78.6% (n = 12) at 64 months. It was found that there was a greater incidence of hostile neck (45.2 vs. 64.6%; P<.05) and proximal neck calcification >50% (8.1 vs. 24.1%; P<.05) in the second period of time. During period 2 a greater number of blood transfusions were required (26.2 vs. 56.9%; P<.05), but fewer cardiac complications were recorded during the first 30 days post-surgery (16.7 vs. 4.6%; P<.05). The mortality, re-intervention, and re-admission rates were similar in both periods (P>.05). CONCLUSION: In our series, the patients with AAA who underwent elective OR showed increasingly less favourable anatomical characteristics, but this does not lead to increased postoperative morbidity and mortality

Embolización de malformación arteriovenosa congénita con etilenvinilalcohol / Embolization of a congenital arteriovenous malformation with ethylene-vinyl alcohol

No disponible

[Bone graft reconstruction for posterior mandibular segment using the formwork technique]. / Greffes osseuses des secteurs mandibulaires postérieurs par technique de « coffrage ¼.

INTRODUCTION: Pre-implant bone graft in posterior mandibular segments is difficult because of masticatory and lingual mechanical constraints, because of the limited bone vascularization, and because of the difficulty to cover it with the mucosa. The formwork technique is especially well adapted to this topography. TECHNICAL NOTE: The recipient site is abraded with a drill. Grooves are created to receive and stabilize the grafts. The bone grafts were harvested from the ramus. The thinned cortices are assembled in a formwork and synthesized by mini-plates. The gaps are filled by bone powder collected during bone harvesting. DISCUSSION: The bone volume reconstructed with the formwork technique allows anchoring implants more than 8mm long. The proximity of the inferior alveolar nerve does not contra indicate this technique. The formwork size and its positioning on the alveolar crest can be adapted to prosthetic requirements by using osteosynthesis plates. The lateral implant walls are supported by the formwork cortices; the implant apex is anchored on the native alveolar crest. The primary stability of implants is high, and the torque is important. The ramus harvesting decreases operative risks.

Genomic full-length analysis of the B*08:79 allele suggests exon shuffling involving the B*08:01:01 and B*07:06 alleles.

B*08:79 is composed by partial B*08:01:01 and B*07:06 sequences because of a possible recombination event within intron 2.

Sequencing of a single HLA-B genotype including two rare alleles allows the detection of a new allele, B*44:130.

The novel HLA-B*44:130 allele was found in a Spanish donor. B*44:130 differs from B*44:40 by four nucleotide changes at codons 11, 12 and 24, producing three amino acid replacements, 11A>S, 12M>V and 24T>S.

Ochratoxin A levels in the plasma of healthy blood donors from Valencia and estimation of exposure degree: comparison with previous national Spanish data.

Blood plasma levels of ochratoxin A, a toxic secondary metabolite of several fungal species belonging to the genera Aspergillus and Penicillium, were determined in 168 blood donors from the population of Valencia (Spain) using LC-FLD. In conjunction with blood collection, detailed information on diet was obtained by using a questionnaire that encompassed a wide range of products potentially contaminated with the toxin. The investigation revealed a detection frequency of 100%. Mean level was 1.09 microg OTA/l of plasma and concentrations ranged between 0.15 and 5.71 microg OTA/l of plasma. Men's levels were slightly higher than levels observed in women. Results were analysed by Spearman rank correlation test and Gamma correlation statistic. There was no strong correlation between individual consumption of 26 food groups, described as possibly contaminated with OTA and plasma level of OTA. Multiple regression and factorial regression models were obtained explaining 14.9 and 64.4%, respectively, but they could not explain overall variability. Daily dietary intake of ochratoxin A was calculated on the basis of plasma toxin levels using the Breitholtz and Klassen formulae; for the overall population, mean values were 1.47 +/- 1.25 and 2.16 +/- 1.88 ng/kg bw/day, respectively. All results have been compared with other Spanish data.

Actividades de aprendizaje y evaluación a través del campus virtual. Experiencia en Fisiología y Fisiopatología I del Grado de Farmacia / A web-based learning platform for activities and assessment. An experiment in teaching physiology and pathophysiology in a degree course in Pharmacy

Nuestro objetivo consiste en fomentar, entre alumnos internos del Departamento de Fisiología, el autoaprendizaje, el trabajo autónomo y en equipo, espíritu crítico y habilidad para buscar y analizar información. A la vez se pretende iniciar a estos alumnos en los sistemas de transferencia de resultados de la investigación básica a la investigación aplicada.Para ello a los alumnos se les proporciona materiales que contienen información sobre las materias objeto de aprendizaje y enlaces a diferentes sitios webs de interés relacionados con el tema. En ellos se promueve la exposición de trabajos y la participación en jornadas especializadas.El uso de estos materiales bajo supervisión del profesorado, ha permitido la mejora del conocimiento en Fisiología y la creación de equipos especializados en diferentes aspectos de la Fisiología. Además, la transferencia de información entre alumnos, ha propiciado que puedan adquirir una visión clara y amplia sobre qué es un trabajo de investigación básica o un trabajo de investigación aplicada, así como la importancia del trabajo en equipo, lo que ha posibilitado que pudieran diseñar pequeños experimentos y estudiar su aplicabilidad.Al final del periodo de formación, los alumnos demostraron haber adquirido las competencias genéricas CG1, CG3, CG5, CG6, CG11, CG13 y CG15 incluidas en la ficha Verifica para el Grado en Farmacia, así como las competencias específicas para el módulo 5 (Medicina y Farmacología) CEM5.8, CEM5.9 y CEM5.11, concluyendo así que la aplicación de métodos de enseñanza basados en el autoaprendizaje (bajo supervisión de equipos docentes) constituye una excelente herramienta para la promoción de la adquisición de competencias generales y específicas en el Grado en Farmacia(AU)

Our goal is to motivate students of physiology in the area of independent study, working alone and in groups, enabling them to develop a critical spirit and skills, and to be capable of seeking and analyzing information. At the same time, we seek to introduce these students to the systems of transferring results from basic to applied research. For this purpose, the students were provided with materials containing information on subjects appropriate for independent study, and links to various websites of interest related to the subject. The teaching staff promoted the presentation of students’ projects, and encouraged them to participate in specialized workshops. The use of these materials, under the teachers’ supervision, has led to the students acquiring greater knowledge of physiology, and to the creation of teams specialized in diverse aspects of the subject. Moreover, the transfer of information among students has made it possible for them to acquire a keen, broad-ranging view of what isinvolved in a basic or applied research project, and to understand the importance of working as part of a team. Thus, the students designed small-scale experiments and studied their applicability.By the end of this training period, the students showed they had acquired the generic skills 1, 3, 5, 6, 11, 13 and 15 required to be awarded a Degree in Pharmacy, as well as the specific skills necessary for Module 5 (Medicine and Pharmacology), numbers 5.8, 5.9 and 5.11. Accordingly, it can be concluded that the application of teaching methods based on independent study (under the supervision of teaching staff) constitutes an excellent tool for promoting students’ acquisition of general and specific skills as part of their studies for the Pharmacy Degree(AU)

Long-term storage in liquid nitrogen does not affect cell viability in cardiac valve allografts.

Liquid nitrogen is the most common medium used by tissue banks for the storage of cryopreserved heart valves. This study evaluates the effect of the length of storage on human cryopreserved heart valves. Human tissues (14 aortic and 13 pulmonary) were frozen in a controlled-rate freezer (1 degrees C/min) and stored in the liquid phase of a nitrogen tank for 9.1+/-1.6 years. The preservative solution was medium M199 containing 5% human serum albumin and 10% Me(2)SO. After thawing in a water bath at 42 degrees C, the cryoprotectant was removed. Then, fragments from vascular wall and leaflet were dissected. Explant cultures and histological studies were performed in order to assess cell viability and structural integrity. CD90 and CD31 expression was analysed in cultured cells using flow cytometry. Light microscopy, immunofluorescence staining and laser scanning confocal microscopy were used to evaluate cell viability and extracellular matrix components. Electron microscopy was used for ultrastructural study. Cell cultures could be obtained from all the specimens assayed. Cells grew from explants showing a fibroblastic phenotype. CD90 expression was common in cultured cells but a low percentage of cells expressed CD31. Histological results showed a good preservation estructure in both leaflets and vascular walls. Morphological features of cellular irreversible damage were very rare. No differences which could be due to length of allograft storage period were observed. We concluded that allografts stored in liquid nitrogen up to 13 years did not significantly undergo loss of cell viability other than that due to disinfection, freezing and thawing protocols.

Donor screening for hepatitis B virus infection in a cell and tissue bank.

BACKGROUND AND OBJECTIVES: Hepatitis B virus (HBV) has been transmitted by tissue transplantation. In order to reduce the risk of HBV transmission, testing for antibody to HBV core antigen (anti-HBc) is used in addition to testing for hepatitis B surface antigen (HBsAg) in many blood centers and tissue banks. DESIGN AND METHODS: We retrospectively analyzed the results of HBV assays in tissue donors. All tissue donors were tested for HBsAg and anti-HBc. All anti-HBc positive sera were tested for the antibody to HBsAg (anti-HBs). From July 2006, an HBV nucleic acid testing (NAT) assay was also performed. RESULTS: A total of 6855 tissue donors from January 1999 till July 2007 were tested for HBV assays: 4756 women and 2099 men. Positive HBsAg was found in 23 (0.36%) living donors, while no multiorgan or cord blood (CB) donor was found to be positive for HBsAg. Positive anti-HBc was found in 80 multiorgan donors (12.94%), 599 living donors (17.84%), and 103 CB donors (3.57%) (P<0.005), while isolated anti-HBc was found in 12 multiorgan (1.94%), in 126 living tissue donors (3.75%), and in 8 CB donors (0.28%). A total of 1310 donors were analyzed for single-sample DNA HBV NAT assay. DISCUSSION: We consider that anti-HBc and NAT assays must both still be performed in addition to HBsAg assay for HBV screening in tissue donors. All these tests will be useful in order to define an algorithm for safe and efficient management of the tissue bank.

[Optimising the quality of the unit dose dispensing process through the implementation of the semi-automated Kardex system]. / Optimización de la calidad del proceso de dispensación de medicamentos en dosis unitaria mediante la implantación del sistema semiautomático Kardex.

OBJECTIVE: To evaluate the effect of the incorporation of the semi-automated Kardex medication storage and dispensing system on the quality of the filling process of medicine trolleys in unit doses. METHOD: The speed of filling medicine trolleys in unit doses using the Kardex system was analysed retrospectively (n = 33,946 dispensings) and compared with the manual filling system (n = 5,284 dispensings); different filling procedures were used and compared. For each filling system and procedure, we obtained information for the number of dispensings and the time spent carrying this out. The speed of the process was calculated as the number of dispensings per hour. In addition, the drugs contained in the Kardex system were checked and the correspondence between both the actual and the theoretical content was assessed. RESULTS: The speed of the trolley filling process, expressed as the number of dispensings per hour, increased from 394 with the manual system (filling trolleys individually, n = 5,284 dispensings) to 417, 540 and 592 with the Kardex system when trolleys were filled individually (n = 16,530 dispensings), or grouped in two (n = 10,369 dispensings) or in three (n = 7,047 dispensings) respectively, at the start of the filling process. The check of the contents in the Kardex system detected 36% of trays with differences in quantity, one tray with out of date medication and three trays which should in theory have been empty and contained medication. CONCLUSIONS: The Kardex system optimises the speed of trolley filling with regard to the manual system, provided that the trolleys are grouped at the time of starting the preparation. The check of the cabinet contents shows that possibilities of error exist, related to its handling, which can be minimised by incorporating bar codes into the system s replenishment process.

Optimización de la calidad del proceso de dispensación de medicamentos en dosis unitaria mediante la implantación del sistema semiautomático Kardex® / No disponible

Objetivo: Evaluar el impacto de la incorporación del sistema semiautomático del almacenaje y dispensación de medicamentos Kardex® sobre la calidad del proceso de llenado de carros de medicamentos en dosis unitaria. Método: Se analiza retrospectivamente la velocidad de llenado de carros de medicamentos en dosis unitaria utilizando el sistema Kardex® (n = 33.946 dispensaciones) comparativamente conel sistema de llenado manual (n = 5.284 dispensaciones); se utilizan y comparan diferentes procedimientos de llenado. Para cada sistema y procedimiento de llenado se obtiene el número de dispensaciones y el tiempo invertido en realizarlas y se calcula la velocidad de proceso expresada en número de dispensaciones por hora. También, se revisan los medicamentos contenidos en el Kardex® y se evalúa la concordancia entre el contenido real y teórico del mismo.Resultados: La velocidad del proceso de llenado de carros,expresada en número dispensaciones por hora, pasa de 394 con el sistema manual (llenado de carros individual, n = 5.284 dispensaciones)a 417, 540 y 592 con Kardex®, realizando el llenado individual (n = 16.530 dispensaciones), o agrupando los carros de2 en 2 (n = 10.369 dispensaciones) o de 3 en 3 (n = 7.047 dispensaciones), respectivamente, en el momento de iniciar el llenado.La revisión del contenido del Kardex® permite detectar un 36% de cubetas con diferencias en cantidad, una cubeta con (..) (AU)

Objective: To evaluate the effect of the incorporation of the semi-automated Kardex® medication storage and dispensing systemon the quality of the filling process of medicine trolleys in unitdoses.Method: The speed of filling medicine trolleys in unit dosesusing the Kardex® system was analysed retrospectively (n =33,946 dispensings) and compared with the manual filling system(n = 5,284 dispensings); different filling procedures were used and compared. For each filling system and procedure, we obtained information for the number of dispensings and the time spent carryingthis out. The speed of the process was calculated as the number of dispensings per hour. In addition, the drugs contained in the Kardex® system were checked and the correspondence between both the actual and the theoretical content was assessed. Results: The speed of the trolley filling process, expressed as the number of dispensings per hour, increased from 394 with the manual system (filling trolleys individually, n = 5,284 dispensings)to 417, 540 and 592 with the Kardex® system when trolleys were filled individually (n = 16,530 dispensings), or grouped in twos (n= 10,369 dispensings) or in threes (n = 7,047 dispensings)respectively, at the start of the filling process. The check of the contents in the Kardex® system detected 36% of trays with differences in quantity, one tray with out of date medication and threetrays which should in theory have been empty and contained (..) (AU)

Automated separation of cord blood units in top and bottom bags using the Compomat G4.

Cord blood (CB) has become a real alternative source of haematopoietic stem cells for bone marrow reconstitution in a variety of malignant disorders. As a response to this increasing activity, CB banks have been developed to guarantee the quality of processed CB units. Volume reduction of CB units maximizes storage space and also has other advantages. The aim of this study was to develop a program for the volume reduction of CB in the Compomat G4 device. We also compared two different top and bottom systems for CB fractionation (Compomat G4 and Optipress II). We empirically designed three different programs for volume reduction of CB with Compomat G4: two for final BC volume of 41 ml (CB1 and CB2) and the other one for buffy coat (BC) volume of 25 ml (CB3). Significantly worse recoveries were achieved for CB processed with program CB3. A RBC depletion of >or=50%, >or=60% and >or=70% were achieved for 67%, 39% and 9% of all units respectively. When comparing Compomat G4 and Optipress II, total nucleated cell recovery was similar for both methods, while lymphocytes recovery was significantly better for Optipress II.

Utility of bag segment and cryovial samples for quality control and confirmatory HLA typing in umbilical cord blood banking.

Many cord blood (CB) banks have been established worldwide as a response to the increasing number of CB transplantations. In this study, we describe a quality control program in which the utility of an integral bag segment and cryovial containing aliquots of cryopreserved product as haematopoietic content control and HLA typing confirmation for CB units has been evaluated. For this purpose, every month one stored CB unit and its satellite cryovials were thawed and washed. Nucleated cell counts, viability and clonogenic assays were performed from the bag and cryovial before washing. After washing, total nucleated cell, CD34+ counts, viability, and clonogenic assays were performed from the bag. In order to assure the ability of bag segments to confirm hematopoietic potential of CB units, clonogenic assays and viability were performed from attached segments of 10 CB units and the results were compared with those from bags and cryovials. When comparing all variables between thawed bag and cryovial samples, they showed similar results. Mean colony-forming unit (CFU) content of segment samples was 118.8 +/- 93.72 x 10(4) that resulted similar to bags and cryovials haematopoietic content. In conclusion, the quality control system described in this paper demonstrates that CB units are processed preserving the quantity and quality of the progenitor cells. The contiguous segment haematopoietic content is representative of the final product.

[Perioperative management of chronic medications not related with surgical procedures]. / Manejo perioperatorio de la medicación crónica no relacionada con la cirugía.

The correct management of chronic medications not related with surgical procedures in the perioperative period has a relevant place because each year millions of patients around the world undergo surgical procedures. For this reason the assistencial team should be aware of the importance of continuate or discontinuate determinate drugs during perioperative period because some of them are considered an important risk factor in the development of complications. The key is to differentiate necessary from unnecessary medication. This is a complex aspect, little studied, which difficult clinical decisions and favours the coexistence of several trends of clinical practice. The purpose of this review is to describe the factors that determinate the continuity or suspension of chronic medications which are not related with surgery in the perioperative period and to provide practice recommendations in lights of available publications.

Manejo perioperatorio de la medicación crónica no relacionada con la cirugía / Perioperative management of chronic medications not related with surgical procedures

El correcto manejo de la medicación crónica no relacionada con la cirugía adquiere un papel relevante ya que en todo el mundo millones de pacientes se someten año tras año a intervenciones quirúrgicas. El equipo asistencial debe tener presente la importancia de continuar o suprimir determinados fármacos durante el perioperatorio ya que algunos de ellos se consideran un factor de riesgo en el desarrollo de complicaciones. La cuestión fundamental es diferenciar la medicación necesaria de la innecesaria, o bien perjudicial. Éste es un aspecto complejo y todavía poco estudiado lo cual dificulta en algunos casos la toma de decisiones y conlleva a la coexistencia de diversas tendencias de práctica clínica. En este trabajo se revisan los aspectos que condicionan la suspensión o continuidad de la medicación crónica que no está relacionada con la cirugía y se proporcionan recomendaciones prácticas para el manejo de la misma en base a la bibliografía disponible (AU)