Intervención en salud en una zona desfavorecida con el farmacéutico como equipo motor de la acción social / Health intervention in a disadvantaged area with the pharmacist as the driving force behind social action

JUSTIFICACIÓN: diferentes estudios muestran que mayor pobreza y peor salud de la población son dos factores directamente relacionados. La pandemia además, se ha cebado con esta población aumentando la situación de pobreza y a su vez dificultando el acceso al sistema sanitario. Por otra parte, la misión de la estrategia social del farmacéutico en la agenda 2030 es promover e impulsar la acción y la innovación social en las actuaciones de los profesionales farmacéuticos mediante el desarrollo y la coordinación de iniciativas sociales alineadas con los Objetivos de Desarrollo Sostenible, con especial atención a pacientes y colectivos vulnerables y la cooperación al desarrollo.OBJETIVOS: mejorar la asistencia sanitaria y la alfabetización en salud de los pacientes del barrio a través del acompañamiento farmacéutico y de sesiones formativas. Potenciar la comunicación con las farmacias colaboradoras y el CS (Centro de Salud).Material y métodos: Población diana: Usuarios de Cáritas pertenecientes a dos parroquias de un barrio desfavorecido que solicitan ayuda con la aportación económica de sus medicamentos y productos sanitarios durante los meses de septiembre, octubre y noviembre de 2021.Proponemos que ese servicio lo preste un farmacéutico que aprovecha para hacer entrevistas, revisiones de botiquines, tomas de parámetros, recomendaciones nutricionales, consejos de lactancia. Se establece comunicación telefónica directa con un pediatra y una médica de Atención Primera del CS y con las dos farmacias colaboradoras. Se imparten charlas a madres y mayores. Material: salones y despachos parroquiales o domicilios de los pacientes. Registro y tratamiento de datos: programa ItCon de Cáritas: base de datos donde registramos las intervenciones, ayudas y entrevistas.(AU)

The pattern of mortality in dogs with gastric dilatation and volvulus.

INTRODUCTION: The primary study objective was to characterize the pattern of in-hospital mortality in dogs with gastric dilatation and volvulus (GDV), with a focus on preoperative nonsurvival. MATERIALS AND METHODS: A retrospective review of medical records from a 10-year period was undertaken at a university teaching hospital. Data collected included signalment, physical examination parameters at hospital presentation, blood lactate concentration, and outcome. RESULTS: A total of 498 dogs were included. Overall, 319 (64.1%) survived to discharge and 179 (35.9%) were nonsurvivors. Of the nonsurvivors, 149 (31.3% of all dogs) were euthanized and 30 (6%) died. Of those dogs euthanized, the majority (n = 116) were euthanized at the time of hospital presentation prior to surgery (ie, without intent to treat). When dogs that were euthanized prior to surgery were excluded, 83.5% of dogs survived to discharge. Median group age was higher in those euthanized than in the group of dogs that survived to discharge. CONCLUSIONS: Preoperative euthanasia and hence nonsurvival without intent to treat accounted for the majority of GDV mortality in this study. Given the high rate of nonsurvival without intent to treat it is likely that efforts focused at disease prevention will ultimately affect a much greater improvement in overall disease mortality than those focused on improving treatment.

Arctic marine fungi: biomass, functional genes, and putative ecological roles.

Recent molecular evidence suggests a global distribution of marine fungi; however, the ecological relevance and corresponding biological contributions of fungi to marine ecosystems remains largely unknown. We assessed fungal biomass from the open Arctic Ocean by applying novel biomass conversion factors from cultured isolates to environmental sterol and CARD-FISH data. We found an average of 16.54 nmol m-3 of ergosterol in sea ice and seawater, which corresponds to 1.74 mg C m-3 (444.56 mg C m-2 in seawater). Using Chytridiomycota-specific probes, we observed free-living and particulate-attached cells that averaged 34.07 µg C m-3 in sea ice and seawater (11.66 mg C m-2 in seawater). Summed CARD-FISH and ergosterol values approximate 1.77 mg C m-3 in sea ice and seawater (456.23 mg C m-2 in seawater), which is similar to biomass estimates of other marine taxa generally considered integral to marine food webs and ecosystem processes. Using the GeoChip microarray, we detected evidence for fungal viruses within the Partitiviridae in sediment, as well as fungal genes involved in the degradation of biomass and the assimilation of nitrate. To bridge our observations of fungi on particulate and the detection of degradative genes, we germinated fungal conidia in zooplankton fecal pellets and germinated fungal conidia after 8 months incubation in sterile seawater. Ultimately, these data suggest that fungi could be as important in oceanic ecosystems as they are in freshwater environments.

Mid-term outcomes of mobile-bearing lateral unicompartmental knee arthroplasty.

BACKGROUND: This research was undertaken to evaluate Oxford Domed Lateral unicompartmental knee replacement (UKR) survival and clinical and radiological outcomes. The study also considered the influence of body mass index (BMI) on results and proposed contralateral healthy knee anatomic femorotibial angle (AFTA) as a predictor of postoperative knee alignment. METHODS: A retrospective evaluation of 41 primary Oxford Domed Lateral UKR performed in 41 patients in the same institution was undertaken on a patient group comprising of 10 men and 31 women with a mean age of 63 years (range: 38-81 years). A minimum follow-up of two years was required. RESULTS: The total revision rate was one out of 41 patients (2.4%), with a mean follow-up of 49 months (range: 25-84 months). One patient presented with a traumatic medial dislocation of the bearing after 15 months (resulting in an overall dislocation rate of 2.4%). The visual analogue scale (VAS) and the Oxford knee score (OKS) demonstrated significant postoperative improvement (P < 0.001). Survival at five years, with revision for any reason as the endpoint, was 97.5%. No significant correlation was observed between BMI and postoperative flexion angle, radiologically measured parameters, or pre- and postoperative VAS and OKS. Significant correlation was found (r = 0.77, P < 0.001) between postoperative and contralateral healthy knee anatomic femorotibial angles. CONCLUSIONS: The Oxford Domed Lateral UKR presents a low dislocation rate and excellent mid-term clinical and functional results. Contralateral healthy knee AFTA appears to be a predictor of postoperative knee alignment.

Novedades en displasias óseas / Advances in bone dysplasias

La prevalencia de las displasias óseas se calcula en un caso por cada 1.000 habitantes, lo que evidencia que, en algún momento de la trayectoria profesional de un especialista en cirugía ortopédica, se encontrará ante un paciente afecto por ellas. El objetivo de este trabajo es revisar los aspectos generales de las displasias óseas y centrarnos en las que, por su frecuencia e importancia, hemos considerado más destacadas (acondroplasia, displasia epifisaria múltiple, displasia espondiloepifisaria y osteogénesis imperfecta), revisando sus características fundamentales y los últimos avances terapéuticos. No existe tratamiento curativo para estas enfermedades, por lo que el diagnóstico precoz y el manejo terapéutico adecuado se convierten en la clave para mejorar la calidad de vida de estos pacientes (AU)

The prevalence of bone dysplasias is estimated to be one case per 1,000 inhabitants, which suggests that, at some point in the career of an orthopaedic surgeon, he will face with one of these patients. The aim of this paper is to review the general aspects of bone dysplasias and focus on those, which due to their frequency and importance, we consider most relevant (achondroplasia, multiple epiphyseal dysplasia, spondyloepiphyseal dysplasia, osteogenesis imperfecta), reviewing their fundamental features and the latest therapeutic advances. There is no cure for these diseases, so early diagnosis and appropriate therapeutic management, becomes the key to improving quality of life of these patients (AU)

[Advances in bone dysplasias]. / Novedades en displasias óseas.

The prevalence of bone dysplasias is estimated to be one case per 1,000 inhabitants, which suggests that, at some point in the career of an orthopaedic surgeon, he will face with one of these patients. The aim of this paper is to review the general aspects of bone dysplasias and focus on those, which due to their frequency and importance, we consider most relevant (achondroplasia, multiple epiphyseal dysplasia, spondyloepiphyseal dysplasia, osteogenesis imperfecta), reviewing their fundamental features and the latest therapeutic advances. There is no cure for these diseases, so early diagnosis and appropriate therapeutic management, becomes the key to improving quality of life of these patients.

Radioactivity levels in aerosol particles surrounding a large TENORM waste repository after application of preliminary restoration work.

In this paper, (238)U-series radionuclides have been analysed in particulate matter samples collected at a phosphogypsum stack system located near the city of Huelva (SW Spain) during the course of 1 year. The results have been compared to those collected at a reference (background) site located a few km away, in order to establish if the stack system provokes an increase in radionuclide exposure due to inhalation with particulate matter. The (222)Rn progeny, which is considered a very important contributor to the internal dose rate received by the population, was collected for 6 months. The results indicate that for several types of radionuclides there is a significant increase in the radioactivity adsorbed by the aerosol particles collected at phosphogypsum stacks. The isotope analysis indicates that this increment could be affected by the water vapour emissions from the factory, which contain high concentrations of these radionuclides. However, the majority of these radionuclides could not be detected at the background location. The corresponding dose increment estimated at the sampling point is, however, negligible. This fact is a consequence of the very small radionuclide concentration increment, together with relatively conservative nature of the occupational factor applied. Regarding the Rn progeny, no significant differences between either the collecting sites has been registered due to of the dominant wind regime at the sampling locations.

[Gray-platelet syndrome associated with Marfan disease in a Mexican family]. / Síndrome de la plaqueta gris asociado a enfermedad de Marfán en una familia mexicana.

Grey-platelet syndrome is a rare familial platelet impairment characterised by lack of alpha granules and giant vacuolated platelets. A Mexican family with grey-platelet syndrome associated to Marfan disease is presented. The family was comprised of 22 members, of whom 3 (the propositus and two of his nephews) could be studied. Two of them, with haemorrhagic symptoms since childhood, had moderate prolongation of the Ivy bleeding time which improved after DDAVP administration, plus moderate thrombocytopenia, giant platelets and abnormal platelet aggregation induced by adrenalin, ADP and collagen. Platelet factor 4 was normal. Electron microscope examination of platelets showed lack of alpha granules and increased dense bodies. The rarity of the casual association of two low-frequency genetic diseases, namely Marfan disease and the grey-platelet syndrome, is commented, along with the response attained with DDAVP in the two affected individuals.