Kefir micro-organisms: their role in grain assembly and health properties of fermented milk.

Kefir is a homemade viscous and slightly effervescent beverage obtained by milk fermentation with kefir grains, which are built up by a complex community of lactic acid and acetic acid bacteria and yeasts confined in a matrix of proteins and polysaccharides. The present review summarizes the role of kefir micro-organisms in grain assembly and in the beneficial properties attributed to kefir. The use of both culture-dependent and independent methods has made possible to determine the micro-organisms that constitute this ecosystem. Kefir consumption has been associated with a wide range of functional and probiotic properties that could be attributed to the micro-organisms present in kefir and/or to the metabolites synthetized by them during milk fermentation. In this context, the role of micro-organisms in kefir health promoting properties is discussed with particular attention to the contribution of yeast as well as bioactive metabolites such as lactic and acetic acid, exopolysaccharides and bioactive peptides. Even though many advances on the knowledge of this ancient fermented milk have been made, further studies are necessary to elucidate the complex nature of the kefir ecosystem.

Availability and use of healthcare resources in prisons according to the transference model: a comparative study in Spain.

OBJECTIVE: In most European countries, correctional healthcare provision is under strain or in the process of change regarding its management model and the implications that such modifications may entail for the improvement of inmates' health. This paper compares the functioning and the results of health management in a facility whose healthcare service is integrated within an autonomic health system and others which depend on the department of corrections. MATERIALS AND METHODS: Cross-sectional study where the study unit is the facility itself. From the data collected from the record of Monthly Health Statistics of Penitentiary Institutions we have constructed a series of indicators according to the recommendations of the National Health System. RESULTS: The physician to nurse ratio per inmate is higher in the transferred facility. Only the transferred establishment has telemedicine resources. Attendance to primary health services is higher that in all non-transferred establishments, while the mean attendance to specialized consultation in the transferred facility doubles that of the remaining centers. DISCUSSION: We have observed greater access to specialized care in the correctional facility managed by the community health system when compared to that of the facilities managed by Penitentiary Institutions. This statement is based on a series of effectivity indicators and results that have provided significantly improved outcome in the transferred facility.

Disponibilidad y uso de recursos de asistencia sanitaria en prisión según el modelo de transferencia: estudio comparativo en España / Availability and use of healthcare resources in prisons according to the transference model: a comparative study in Spain

Objetivo: En la mayoría de los países europeos, los servicios sanitarios penitenciarios se encuentran sometidos a tensión o en proceso de cambio en lo que respecta a su modelo de gestión y a las repercusiones que estos cambios puedan tener en la mejora de la salud de los reclusos. Este trabajo compara el funcionamiento y los resultados de la gestión sanitaria en una prisión cuyo servicio sanitario está integrado en un servicio de salud autonómico con otros dependientes de instituciones penitenciarias. Materiales y métodos: Estudio transversal en el que la unidad de estudio es el centro. A partir de datos obtenidos del registro de Estadística Sanitaria Mensual de Instituciones Penitenciarias se han construido una serie de indicadores propuestos por el Sistema Nacional de Salud. Resultados: La ratio de médicos y de enfermeros por interno es mayor en el centro transferido. Solo el centro transferido dispone de recursos de telemedicina. La frecuentación de los servicios de atención primaria es superior en todos los centros no transferidos, mientras que la frecuentación de consultas especializadas del centro transferido duplica la media de las consultas especializadas de los demás centros. Discusión: Se ha evidenciado una mayor accesibilidad de la asistencia especializada en el centro penitenciario gestionado por el servicio comunitario de salud, si lo comparamos con el gestionado por Instituciones Penitenciarias. Esta afirmación se sustenta en unos indicadores de efectividad y resultados que han proporcionado datos significativamene mejores en el centro transferido (AU)

Objective: In most European countries, correctional healthcare provision is under strain or in the process of change regarding its management model and the implications that such modifications may entail for the improvement of inmates’ health. This paper compares the functioning and the results of health management in a facility whose healthcare service is integrated within an autonomic health system and others which depend on the department of corrections. Materials and methods: Cross-sectional study where the study unit is the facility itself. From the data collected from the record of Monthly Health Statistics of Penitentiary Institutions we have constructed a series of indicators according to the recommendations of the National Health System. Results: The physician to nurse ratio per inmate is higher in the transferred facility. Only the transferred establishment has telemedicine resources. Attendance to primary health services is higher that in all non-transferred establishments, while the mean attendance to specialized consultation in the transferred facility doubles that of the remaining centers. Discussion: We have observed greater access to specialized care in the correctional facility managed by the community health system when compared to that of the facilities managed by Penitentiary Institutions. This statement is based on a series of effectivity indicators and results that have provided significantly improved outcome in the transferred facility (AU)

Integración de la Sanidad Penitenciaria del País Vasco en Osakidetza. Tres años de experiencia / No disponible

Se han cumplido tres años de la transferencia de la asistencia sanitaria de los tres centros penitenciarios del País Vasco al Servicio Vasco de Salud - Osakidetza. A lo largo de este tiempo se han producido cambios considerables como la integración de los centros de salud penitenciarios en la red de Atención Primaria y en la Red de Salud mental comunitaria, una mayor coordinación con la asistencia especializada y hospitalaria, la implantación de la historia clínica informatizada, la creación y legalización de los Depósitos Farmacéuticos, programas de Telemedicina y otros (AU)

No disponible

External ophthalmomyiasis: a case series.

Oestrus ovis or 'sheep botfly' causes common ophthalmomyiasis in warm climates. It is a self-limited infestation with symptoms such as foreign body sensation and/or tearing. The larvae can be observed in the conjunctiva and should be extracted with forceps. The development of larvae beyond the first stage does not occur in healthy humans, although they may penetrate the ocular globe, causing so-called internal myiasis. External ophthalmomyiasis is typical of rural areas, but it may be observed occasionally in urban environments.

[A new prison health care model: the experience of the Basque Country]. / Un nuevo modelo asistencial penitenciario: la experiencia del País Vasco.

A year after the transfer of prison health care functions and services from the State Administration to the Autonomous Community of the Basque Country, the process up to completion of the transfer, the current status of the transferred services and remaining challenges are described.

Necesidades y objetivos de los pediatras del País Vasco/Euskadi (España) / Needs and objectives of the paediatricians in the Basque Country

Objetivos: conocer la situación laboral, la carga de trabajo y las propuestas de mejora para los pediatras de la Comunidad Autónoma del País Vasco/Euskadi. Material y métodos: encuesta enviada por correo electrónico a todos los pediatras de Atención Primaria (PAP) del País Vasco/Euskadi (N=255). La encuesta contenía preguntas sobre el perfil socioprofesional y las expectativas de futuro. Resultados: han respondido a la encuesta 192 pediatras, el 75% de los encuestados. El 68% son mujeres; el 70%, mayores de 45 años, y un 30%, mayores de 55 años. El 20% tiene menos de 800 tarjetas individuales sanitarias (TIS), y el 25%, más de 1000. La mayoría (55%) tiene que compartir personal de Enfermería con otro pediatra. El 30% se siente quemado y, a pesar de ello, el 70% no cambiaría su puesto de trabajo de PAP. Hay una demanda de formación continuada y de menor burocratización de las consultas. Conclusiones: feminización del colectivo de PAP. El número de TIS excede el pactado con el Servicio de Salud Osakidetza (800 TIS/pediatra). El apoyo de Enfermería es insuficiente. La edad es elevada y los problemas detectados se acrecentarán en los próximos años. Hay un elevado porcentaje de pediatras quemados. La Administración debería facilitar la formación continuada de los profesionales(AU)

Objectives: to assess the social and working conditions and the needs of primary care paediatricians in the Autonomous Community of the Basque Country. Material and methods: a survey was carried out to the primary care paediatricians in February 2010. The questionnaire was sent to 255 paediatricians. It included questions about their social and working profile and future expectations. Results: the total number of answers was 192 (75%). There was a majority of women (68%) and aged more of 45 years (70%). The number of patients assigned to each paediatrician is more than 1000 (25%) and only 20% have less than 800 patients. Most paediatricians (55%) must share the nurse with another paediatrician. Thirty percent of paediatricians suffer burnout but 70% would not change his work in Primary Care. There is a great demand of continuous training and less bureaucratization. Conclusions: feminization is growing in Paediatric Primary Care. The number of patients assigned to each paediatrician is higher than agreed (800 patients) with the Sanitary Administration. The help of nursery is insufficient. The age of paediatricians is high and the detected problems will grow on in the next years. There is a high percentage of burnout paediatricians. The Sanitary Administration should provide continuous training for the paediatricians who work in Primary Care(AU)

Un nuevo modelo asistencial penitenciario: la experiencia del País Vasco / A new prison health care model: the experience of the Basque Country

Un año después del traspaso de las funciones y servicios de la Administración del Estado a la Comunidad Autónoma del País Vasco en materia de sanidad penitenciaria, se describe el proceso que se ha seguido hasta la culminación de la transferencia, la situación actual de los servicios transferidos y los retos pendientes(AU)

A year after the transfer of prison health care functions and services from the State Administration to the Autonomous Community of the Basque Country, the process up to completion of the transfer, the current status of the transferred services and remaining challenges are described(AU)

Criterios de diagnóstico genético en casos de retraso mental y del desarrollo de origen idiopático / Genetic diagnostic criteria in cases of mental retardation and development of idiopathic origin

Diversos estudios estiman que el retraso mental afecta a un 1-3 % de la población, y en cerca de un 50 % de los casos se desconoce la etiología. La incertidumbre sobre la etiología, y la recurrencia, hacen que la prevención del retraso mental presente graves repercusiones de tipo terapéutico, social e incluso económicas. La clave principal es lograr un diagnóstico preciso, probando una hipótesis clínica mediante la realización de las pruebas genéticas adecuadas. Debido al creciente desarrollo de la tecnología en el campo de la genética, y a la disponibilidad de nuevas pruebas, en este artículo se revisan e integran los criterios establecidos en las guías consensuadas de diferentes sociedades científicas (pediátricas, neurológicas y genéticas) respecto a su utilización en el diagnóstico del retraso mental y del retraso del desarrollo (AU)

Different studies show that mental retardation affects 1-3 % of the population, and in about 50 % of the cases the aetiology is unknown. The uncertainty on the aetiology, and recurrence, means that prevention of mental retardation can have serious, therapeutic, social, and even economic repercussions. The key is to obtain an accurate diagnosis, proving a clinical hypothesis by the accomplishment of the most suitable genetic tests. Due to the increasing development of the technology in the field of the genetics, and the availability of new tests, this article reviews the criteria established in the practice guidelines from different scientific societies (paediatric, neurological and genetic) with respect to their use in diagnosis and integrates them from the point of view of their use in mental retardation and developmental delay (AU)

[Genetic diagnostic criteria in cases of mental retardation and development of idiopathic origin]. / Criterios de diagnóstico genético en casos de retraso mental y del desarrollo de origen idiopático.

Different studies show that mental retardation affects 1-3% of the population, and in about 50 % of the cases the aetiology is unknown. The uncertainty on the aetiology, and recurrence, means that prevention of mental retardation can have serious, therapeutic, social, and even economic repercussions. The key is to obtain an accurate diagnosis, proving a clinical hypothesis by the accomplishment of the most suitable genetic tests. Due to the increasing development of the technology in the field of the genetics, and the availability of new tests, this article reviews the criteria established in the practice guidelines from different scientific societies (paediatric, neurological and genetic) with respect to their use in diagnosis and integrates them from the point of view of their use in mental retardation and developmental delay.

Evaluación del tiempo de respuesta global de un laboratorio de urgencias con impresión remota / Evaluation of the global turnaround time in an emergency laboratory with remote printing

En el presente artículo se realiza una evaluación del tiempo de respuesta (TR) global de un laboratorio de urgencias, en el que el envío de resultados desde el laboratorio hasta el Servicio de Urgencias es mediante impresión remota, y se compara con los tiempos de respuesta obtenidos en el mismo laboratorio cuando el envío de resultados era mediante celadores. Se estudiaron 225 peticiones repartidas en los tres turnos laborales ( mañana, tarde y noche), en las que se analiza el tiempo transcurrido desde la solicitud del análisis hasta su recepción en el laboratorio y el tiempo intralaboratorio. Se considera importante realizar estudios periódicos del tiempo de respuesta y proponer medidas de mejora, así como reevaluar el resultado de la implantación de estas medidas. (AU)

Nuevo procedimiento colorimétrico para la determinación de adenosina desaminasa en líquidos biológicos / New colorimetric procedure of determining adenosine deaminase in body fluids

Se ha evaluado un nuevo reactivo para la determinación del enzima adenosina desaminasa (ADA) en los analizadores Cobas Mira S (Roche) y Synchron CX7 (Beckman), utilizando un método cinético colorimétrico basado en la cuantificación de inosina. La precisión expresada como coeficientes de variación fue menor del 3 por ciento (intradía) y menor del 2.7 por ciento (interdía) para valores de ADA entre 15.4 y 112 U/L. El método resultó lineal hasta valores de 395 U/L y presentó un límite de detección menor de 0.5 U/L. No se han observado interferencias debidas a bilirrubina (hasta 25 mg/dL), ni lípidos (Ivelip® hasta 2 por ciento), pero sí se observan aumentos significativos en la actividad de ADA debidos a hemolisis. Al comparar este método con un método comercial basado en la detección del amoniaco liberado, se obtuvieron coeficientes de correlación superiores a 0.97 en todos los casos. En conclusión, el nuevo procedimiento evaluado presenta una buena practicabilidad junto con una precisión y sensibilidad satisfactorias; por lo que resulta adecuado para las determinaciones urgentes y de rutina de adenosina desaminasa en fluídos biológicos (AU)

[Modulation of uterine contractile activity by steroid sex hormones. Review]. / Modulación de la actividad contráctil uterina por hormonas esteroides sexuales. Revisión.

Sexual steroids play an important role in the regulation of contractile uterine activity. Progesterone has shown a relaxant effect on rabbit, rat and human uterus. In addition it has been reported that 5 beta-reduced metabolites are more potent than their precursor in the rat uterus. In the regard to their mechanism of action it is known they act by means of a non-genomic mechanism and it has not been identified a some data suggest steroids inhibit calcium influx to muscular cell by blockade of voltage- and/or receptor- operated channels. Regulation of uterine contractility by steroid hormones during sexual cycle and pregnancy suggest an important physiologic role by inducing a quiescent state necessary for maintaining of pregnancy.

Beak infection by Penicillium cyclopium in a macaw (Ara ararauna).

A case of localized beak infection by Penicillium cyclopium in a macaw (Ara ararauna) is described. A necrotic lesion, with destruction of the corneous layer, was localized in the upper zone of the beak. Diagnosis was carried out on samples of the affected zone by direct microscopic observation, routine fungal culturing techniques, and scanning electron microscopy. Results were consistent: P. cyclopium was the only microorganism associated with the lesion site. No previous reports concerning this type of beak pathology have been found in the literature.