[Association between therapeutic adherence and phases of grief in patients with type 2 diabetes mellitus]. / Asociación entre la adherencia terapéutica y las fases de duelo en pacientes con diabetes mellitus tipo 2.

OBJECTIVE: To evaluate the association between therapeutic adherence and the phases of grief in patients with type 2 diabetes mellitus. DESIGN: Cross-sectional observational study. SITE: Family Medicine Unit No. 53 of the Mexican Institute of Social Security in the State of Guanajuato. PARTICIPANTS: A total of 354 patients with type 2 diabetes mellitus were recruited, of whom 236 corresponded to the group without therapeutic adherence and 118 to the group with therapeutic adherence. INTERVENTIONS: Two structured surveys were administered to both groups. MAIN MEASUREMENTS: The Morisky 8 scale was used to measure therapeutic adherence and the phases of grief scale (EFD-66) to measure grief due to loss of health. RESULTS: The median denial phase and depression phase scores were higher in the nonadherence group than in the adherence group (p=.000). The median negotiation phase and acceptance phase score was higher in the adherence group than in the nonadherence group (p=.000). Multivariate analysis identifies that denial is the main factor associated with non-adherence (OR=1.25; 95% CI: 1.14-1.37); while negotiation (OR=0.88; 95% CI: 0.82-0.94) and acceptance are associated with adherence (OR=0.79; 95% CI: 0.75-0.83). CONCLUSIONS: There is an association between therapeutic adherence and phases of grief.

Biopsia guiada por ecografía para el diagnóstico de masas ováricas. Revisión sistemática / Ecography guided biopsy for the diagnosis of ovarian masses. Systematic review

El diagnóstico definitivo del cáncer de ovario precisa de confirmación histológica. En determinadas situaciones, para evitar la morbilidad de la resección quirúrgica, es posible hacer una biopsia guiada por ecografía para obtener el diagnóstico anatomopatológico. El objetivo de esta revisión sistemática fue evaluar la adecuación, fiabilidad, precisión y perfil de seguridad de la biopsia guiada por ecografía de masas ováricas. Siguiendo el modelo PRISMA 2020, se hizo una búsqueda bibliográfica en PubMed, Embase y Scopus y se recopilaron un total de 10.245 artículos, de los cuales 24 fueron finalmente incluidos. Los trabajos incluían de forma mayoritaria pacientes con tumores inoperables avanzados, pobre performance status y otros factores de mal pronóstico, con masas de contenido sólido y márgenes irregulares, generalmente accesibles por vía transvaginal. En la mayoría de los artículos las pacientes presentaban historia previa de malignidad o tumores inoperables en estadios avanzados. Las masas ováricas biopsiables se definían en la ecografía como malignas o potencialmente malignas, con la presencia destacada de un componente sólido o mixto con márgenes irregulares o heterogéneos. La técnica más utilizada en los estudios incluidos fue la biopsia con aguja gruesa o tru-cut, con altos valores de adecuación, fiabilidad, precisión y rendimiento, así como un buen perfil de seguridad y bajas tasas de complicaciones. En conclusión, la biopsia con aguja gruesa de las masas anexiales guiada por ecografía, en pacientes subsidiarios de tratamiento neoadyuvante, es una técnica con altas tasas de adecuación, fiabilidad, precisión y buen perfil de seguridad.(AU)

The definitive diagnosis of ovarian cancer requires histological confirmation. In certain situations, to avoid the morbidity of surgical resection, it is possible to perform an ultrasound-guided biopsy to obtain the pathological diagnosis. The aim of this systematic review was to assess the adequacy, reliability, accuracy, and safety profile of ultrasound-guided biopsy of ovarian masses. Following the PRISMA 2020 model, a bibliographic search was carried out in PubMed, Embase and Scopus, collecting a total of 10,245 articles, of which 24 were finally included. The studies mainly included patients with advanced inoperable tumors, poor performance status and other poor prognostic factors, with masses of solid content and irregular margins, generally accessible through the transvaginal route. In most of the articles, the patients had a previous history of malignancy or had inoperable tumors in advanced stages. Biopsiable ovarian masses were defined ultrasonographically as malignant or potentially malignant, mainly highlighting the presence of a solid or mixed component and irregular or heterogeneous margins. The most widely used technique in the included studies was core needle or tru-cut biopsy, presenting high values of adequacy, reliability, precision and performance, as well as a good safety profile with low complication rates. In conclusion, ultrasound-guided core needle biopsy of adnexal masses in patients eligible for neoadjuvant treatment is a technique with high adequacy, reliability, and precision rates, as well as a good safety profile.(AU)

Mathematical modeling for operative improvement of the decoloration of Acid Red 27 by a novel microbial consortium of Trametes versicolor and Pseudomonas putida: A multivariate sensitivity analysis.

In this work, it is presented a first approach of a mathematical and kinetic analysis for improving the decoloration and further degradation process of an azo dye named acid red 27 (AR27), by means of a novel microbial consortium formed by the fungus Trametes versicolor and the bacterium Pseudomonas putida. A multivariate analysis was carried out by simulating scenarios with different operating conditions and developing a specific mathematical model based on kinetic equations describing all stages of the biological process, from microbial growth and substrate consuming to decoloration and degradation of intermediate compounds. Additionally, a sensitivity analysis was performed by using a factorial design and the Response Surface Method (RSM), for determining individual and interactive effects of variables like, initial glucose concentration, initial dye concentration and the moment in time for bacterial inoculation, on response variables assessed in terms of the minimum time for: full decoloration of AR27 (R1 = 2.375 days); maximum production of aromatic metabolites (R2 = 1.575 days); and full depletion of aromatic metabolites (R3 = 12.9 days). Using RSM the following conditions improved the biological process, being: an initial glucose concentration of 20 g l-1, an initial AR27 concentration of 0.2 g l-1 and an inoculation moment in time of P. putida at day 1. The mathematical model is a feasible tool for describing AR27 decoloration and its further degradation by the microbial consortium of T. versicolor and P. putida, this model will also work as a mathematical basis for designing novel bio-reaction systems than can operate with the same principle of the described consortium.

Sustainable approach to the control of airborne phytopathogenic fungi by application of compost extracts.

The search for new sustainable alternatives for plant disease control has gained interest in the last decades. Compost extracts are nowadays considered a remarkable alternative to agrochemicals due to their biopesticidal properties. However, these properties could be affected by the different variables of extraction protocols and by starting compost. This work focused on the physicochemical and biological characterization of compost extracts obtained from a wide range of composted materials and different extraction protocols (CEP). CEP-1 and CEP-4 involved incubation at 20 °C for 48 h and 14 days, respectively; CEP-2 incubation for 24 h at 40 °C; while CEP-3 were incubated for 12 h at 70 °C. Electrical conductivity, pH, total organic carbon (TOC) and phenolic content were determined as well as the actinobacterial count and enzyme profiles related to plant pathogen suppression. Additionally, the influence of the different materials and protocols on the in vitro growth inhibition of Alternaria alternata and Botrytis cinerea was determined. The starting materials and extraction protocols significantly influenced the physicochemical and biological characteristics of extracts. Treatments based on long incubation times at 20 °C, as well as those based on short incubation times at 40 °C, resulted in extracts with increased suppressive properties. However, extracts derived from CEP-3 protocol were characterized by high phenolic and TOC content, low functional biodiversity, and a more discreet antagonistic capacity. Therefore, the development and optimization of suitable extraction protocols could lead to compost extracts with increased phytoprotective capacities, thus becoming an effective and sustainable alternative to chemical inputs.

Machine learning-based models for accessing thermal conductivity of liquids at different temperature conditions.

Combating global warming-related climate change demands prompt actions to reduce greenhouse gas emissions, particularly carbon dioxide. Biomass-based biofuels represent a promising alternative fossil energy source. To convert biomass into energy, numerous conversion processes are performed at high pressure and temperature conditions, and the design and dimensioning of such processes requires thermophysical property data, particularly thermal conductivity, which are not always available in the literature. In this paper, we proposed the application of Chemoinformatics methodologies to investigate the prediction of thermal conductivity for hydrocarbons and oxygenated compounds. A compilation of experimental data followed by a careful data curation were performed to establish a database. The support vector machine algorithm has been applied to the database leading to models with good predictive abilities. The support vector regression (SVR) model has then been applied to an external set of compounds, i.e. not considered during the training of models. It showed that our SVR model can be used for the prediction of thermal conductivity values for temperatures and/or compounds that are not covered experimentally in the literature.

Anti-interleukin-17 therapies for moderate/severe psoriasis in clinical practice: effectiveness, safety and association with clinical patient factors.

OBJECTIVES: Interleukin-17 (IL-17) contributes to the pathogenesis of psoriasis. Secukinumab, ixekizumab, and brodalumab are monoclonal antibodies anti-IL-17 antibodies, approved for the treatment of moderate/severe plaque psoriasis.The aim of the study was to describe the effectiveness and safety of anti-IL-17 agents in moderate/severe plaque psoriasis in clinical practice. We also analysed anti-IL-17 therapies' survival, dose adjustment, and clinical patients' factors associated with their effectiveness and safety. METHODS: A retrospective, longitudinal study was conducted at a tertiary hospital. We included patients with moderate/severe psoriasis treated with anti-IL-17 agents. The effectiveness was evaluated with Psoriasis Area and Severity Index (PASI) score and safety through the adverse drug reactions (ADRs) collected. RESULTS: 38 patients were studied (median age=47.4 years, 71.0% male). The mean number of biological therapies that patients received was 2.6, and anti-IL-17 therapy was the first biological therapy for 36.8% of patients. The median years in treatment were 2.5 (95% CI 1.95 to 2.98) for secukinumab, 1.2 (95% CI 0.36 to 1.47) for ixekizumab, and 0.7 (IQR 0.71) for brodalumab. The median PASI score after 6 months of treatment was 0 (IQR 0) and 85.3% of patients achieved a PASI of 90 (84.0% with secukinumab, 87.5% with ixekizumab, and 100% with brodalumab). Dose adjustment was associated with the line of treatment (p=0.034 for naïve patients), age (p=0.044 for younger patients), and concomitant pathologies (p=0.015 without more diseases).24 patients suffered from ADRs, mainly infections of the upper respiratory tract, and there were no statistically significant differences between the three therapies. CONCLUSIONS: Anti-IL-17 agents constitute an effective treatment for patients with moderate/severe plaque psoriasis and for longer. Dose reductions were associated with fewer lines of treatment, younger patients and absence of concomitant pathologies. ADR were minor and similar among the anti-IL-17.

The Potential of Proton Therapy for Locally Advanced Breast Cancer: Clinical and Technical Considerations.

Proton therapy is a promising therapeutic modality with unique physical properties that allow for abrupt dose fall-off distal to the target of interest, thereby sparing nearby organs at risk. A number of studies have identified the utility of proton radiation in mitigating treatment related sequelae for patients with locally advanced breast cancers. Thus, in the following review, we highlight clinical and technical considerations for proton radiotherapy delivery in patients with locally advanced breast cancer.

Mitigation of phytotoxic effect of compost by application of optimized aqueous extraction protocols.

The abuse of chemical fertilizers in recent decades has led the promotion of less harmful alternatives, such as compost or aqueous extracts obtained from it. Therefore, it is essential to develop liquid biofertilizers, which in addition of being stable and useful for fertigation and foliar application in intensive agriculture had a remarkable phytostimulant extracts. For this purpose, a collection of aqueous extracts was obtained by applying four different Compost Extraction Protocols (CEP1, CEP2, CEP3, CEP4) in terms of incubation time, temperature and agitation of compost samples from agri-food waste, olive mill waste, sewage sludge and vegetable waste. Subsequently, a physicochemical characterization of the obtained set was performed in which pH, electrical conductivity and Total Organic Carbon (TOC) were measured. In addition, a biological characterization was also carried out by calculating the Germination Index (GI) and determining the Biological Oxygen Demand (BOD5). Furthermore, functional diversity was studied using the Biolog EcoPlates technique. The results obtained confirmed the great heterogeneity of the selected raw materials. However, it was observed that the less aggressive treatments in terms of temperature and incubation time, such as CEP1 (48 h, room temperature (RT)) or CEP4 (14 days, RT), provided aqueous compost extracts with better phytostimulant characteristics than the starting composts. It was even possible to find a compost extraction protocol that maximize the beneficial effects of compost. This was the case of CEP1, which improved the GI and reduced the phytotoxicity in most of the raw materials analyzed. Therefore, the use of this type of liquid organic amendment could mitigate the phytotoxic effect of several composts being a good alternative to the use of chemical fertilizers.

Farmers' perceptions and acceptance of crossbred guinea pigs in Mantaro Valley, Peru.

This study aimed at assessing farmers' perceptions and acceptance of the proposed breeding strategy of Instituto Veterinario de Investigaciones Tropicales y de Altura (IVITA), located in the Central Andes of Peru. A total of 34 farmers, who had received guinea pigs from IVITA, were interviewed. The questionnaire was performed in Spanish language and covered topics about the guinea pig production, feeding, mating system, training, the main products, perception and acceptance of crossbred lines ("cuy RG"), and the farmers' comment about the terminal crossbred animal ("cuy G"). The preferred feeding strategy was a combination of forage and supplement. All farmers implemented a controlled mating system. Most farmers had received training on feeding, reproduction, management, equipment, and facilities. The main product is animals for slaughter. The 82.40% of farmers reported that they do not purchase guinea pigs from IVITA anymore, because they are highly susceptibility to lymphadenitis, which is a highly contagious disease and causes swollen lymph nodes and affects the meat quality. Most of the respondents classified the "cuy RG" and "cuy G" as suitable for meat production and were satisfied with the performance of the animals. Therefore, 58.80% of respondents already recommended "cuy RG" to other farmers. However, 17.70% of the respondents would not recommend these animals because they are susceptible to disease, especially lymphadenitis. Therefore, IVITA should engage in more structured dialogue with farmers and regularly include their opinion in future improvement of its breeding strategies. This could help to reach higher acceptance rates by farmers.

Epidural analgesia in a patient with factor XI deficit.

FXI deficiency is a rare bleeding disorder characterised by a decreased level or activity of factor. Pregnant women are at increased risk of uterine bleeding during childbirth. Neuroaxial analgesia may increase the risk of epidural hematoma in these patients. However, there is no consensus on the anaesthetic management. We present the clinical case of a 36-year-old woman with a personal history of factor XI deficiency, pregnant with 38 weeks gestation who is scheduled to perform birth induction. Pre-induction factor levels were measured. They were less than 40%, so it was decided to transfuse 20 ml/kg of fresh frozen plasma. After the transfusion it had levels greater than 40%, so epidural analgesia was performed without incident. The patient had no complications secondary to epidural analgesia or transfusion of a high volume of plasma.

Analgesia epidural en paciente con déficit de factor XI / Epidural analgesia in a patient with factor XI deficit

El déficit de factorXI es una enfermedad hemorrágica rara que se caracteriza por presentar disminución del nivel o de la actividad del factor. Las mujeres embarazadas con esta patología presentan mayor riesgo de sangrado uterino durante el parto. El uso de analgesia neuroaxial en estas pacientes puede aumentar el riesgo de producir hematoma epidural. Es necesario realizar un seguimiento multidisciplinar en el que participen activamente anestesiólogos, hematólogos y ginecólogos. Actualmente disponemos de escasa bibliografía sobre el manejo anestésico de este tipo de patología. Presentamos el caso clínico de una mujer de 36años con antecedentes personales de déficit de factorXI, embarazada de 38 semanas de gestación que es programada para realización de inducción del parto. Previamente a la inducción se midieron los niveles del factor, y al ser inferiores al 40% se decidió transfundir 20ml/kg de plasma fresco congelado. Tras la transfusión presentó niveles superiores al 40%, por lo que se realizó analgesia epidural sin incidencias. La paciente no presentó complicaciones secundarias a la analgesia epidural ni a la transfusión de un volumen elevado de plasma.(AU)

Factor XI deficiency is a rare bleeding disorder characterized by a decreased level or activity of factor. Pregnant women are at increased risk of uterine bleeding during childbirth. Neuroaxial analgesia may increase the risk of epidural hematoma in these patients. However, there is no consensus on the anesthetic management. We present the clinical case of a 36-year-old woman with a personal history of factorXI deficiency, pregnant with 38weeks gestation who is scheduled to perform birth induction. Pre-induction factor levels were measured. They were less than 40%, so it was decided to transfuse 20mL/kg of fresh frozen plasma. After the transfusion it had levels greater than 40%, so epidural analgesia was performed without incident. The patient had no complications secondary to epidural analgesia or transfusion of a high volume of plasma.(AU)

Vitamin d deficiency with high parathyroid hormone levels is related to late onset SEPSIS among preterm infants.

Preterm infants (PTs) are at greater risk for vitamin D deficiency, which relates to the possibility of a higher incidence of comorbidities. Our goal was twofold, 1) to monitor vitamin D, calcium, phosphorus, parathyroid hormone (PTH), matrix metalloproteinase-8 (MMP-8) serum levels at three-time points during hospitalization, and 2) to assess the association between 25-hydroxyvitamin D (25OHD) levels and outcomes in PTs. METHODS: We carried out a follow-up on 50 Caucasian PTs ≤ 32 weeks of gestational age (GA) and/or ≤ 1500 g birth weight at 28 days and at 4 months. PTs were divided into two subgroups for tests of association with clinical outcomes based on vitamin D deficient infants 25(OH) D cord blood levels: ≤ 20 ng/ml). At an initial stage, 25(OH) D levels were determined in maternal/preterm blood samples and were compared to full term delivery infants. RESULTS: There were no differences in 25(OH) D serum levels at birth when comparing PTs to term infants, or regarding maternal levels. A strong positive correlation was detected between maternal and neonatal 25(OH) D serum levels among PTs and term infants (r: 0.466; p < 0.001). Neonates with vitamin D deficiency did not present a higher incidence of comorbidities. PTs were classified in two subgroups based on vitamin D and PTH (group 1: vitamin D < 20 ng/mL and PTH > 60 pg/mL; group 2: vitamin D > 20 and PTH < 60 pg/mL). The PTs in group 1 showed a higher incidence of LOS (RR: 2; 95% CI: 1.31-3.55). No relationship was observed between MMP-8 serum levels and the incidence of sepsis. CONCLUSIONS: This study did not find any evidence of an increase in preterm birth risk related to vitamin D level at birth. Vitamin D deficiency by itself is not associated with a higher incidence of comorbidities. However, the binomial vitamin D-PTH must be taken into consideration.

Alteraciones de la expresión génica en la infección por SARS-CoV-2 en distintos modelos de estudio / Alterations of gene expression in SARS-CoV-2 infection in different study models

Objetivo: La pandemia por SARS-CoV-2 ha supuesto un auténtico reto para el mundo científico debido a la rápida transmisión y elevada mortalidad que produce este nuevo coronavirus. La enfermedad asociada se ha denominado COVID-19 y abarca desde casos asintomáticos hasta graves que evolucionan rápidamente a síndrome de distrés respiratorio agudo, alteraciones multisistémicas y la muerte. La comunidad científica ha aunado esfuerzos para tratar de conocer mejor el proceso fisiopatológico de la infección con la intención de combatir de forma más eficaz la enfermedad. En este trabajo presentamos un estudio para conocer las alteraciones de la expresión génica provocadas por la infección. Metodología: Se han usado tres modelos de estudio distintos: cultivos de células epiteliales bronquiales, organoides de las vías respiratorias y muestras obtenidas de autopsias en pacientes, con y sin infección por SARS-CoV-2. Se han analizado los perfiles de expresión alterados por la infección en cada modelo, así como las categorías funcionales enriquecidas. Resultados: Solo 4 genes son comunes en los tres tipos de modelos de estudio, siendo el modelo de autopsias el más dispar. Dentro de los genes comunes en los modelos de cultivo celular y organoide de pulmón encontramos funciones relacionadas con procesos inflamatorios. Conclusiones: Los estudios in vitro son un buen modelo para tener una foto fija de las alteraciones en los patrones de infección, mientras que las autopsias no son un buen modelo debido al sesgo provocado por la necrosis. (AU)

Short summary: Three different study models have been used to study the gene expression profiles produced by SARS-CoV-2: bronchial epithelial cell cultures, airway organoids, and autopsy samples from patients with and without SARS-infection. CoV-2. Basis: The SARS-CoV-2 pandemic has been a real challenge for the scientific world due to the rapid transmission and high mortality caused by this new coronavirus. The associated disease has been named COVID-19 and ranges from asymptomatic to severe cases that rapidly progress to acute respiratory distress syndrome, multisystem disorders, and death. The scientific community has joined efforts to try to better understand the pathophysiological process of the infection with the intention of combating the disease more effectively. In this work we present a study to determine the alterations in gene expression caused by the infection. Methods: Three different study models have been used: bronchial epithelial cell cultures, airway organoids, and samples obtained from autopsies in patients with and without SARS-CoV-2 infection. The expression profiles altered by the infection in each model have been analyzed, as well as the functional categories enriched. Results: Only 4 genes are common in the three types of study models, the autopsy model being the most disparate. Within the common genes in cell and organoid culture models of the lung, we find functions related to inflammatory processes. Conclusions: In vitro studies are a good model to have a snapshot of alterations in infection patterns, while autopsies are not a good model due to bias caused by necrosis. (AU)

Descripción de un caso de hernia diafragmática de Morgagni con derrame pericárdico masivo resuelto mediante pericardiocentesis intrauterina / Description of a case of Morgagni's diaphragmatic hernia with massive pericardial effusion resolved by intrauterine pericardiocentesis

Introducción: Las hernias diafragmáticas de Morgagni diagnosticadas prenatalmente son una rara entidad, con menor riesgo asociado de hipoplasia pulmonar y problemas respiratorios que las hernias diafragmáticas posteriores. Nuestro caso pone de manifiesto cómo en los casos de hernia diafragmática de Morgagni los pulmones tienden a desarrollarse completamente, a pesar del significativo derrame pericárdico o cuán disminuidos pueden aparentar. Principales síntomas y/o hallazgos clínicos: Hernia diafragmática de Morgagni diagnosticada a las 14 semanas de gestación, con derrame pericárdico masivo y herniación torácica anterior del hígado. Diagnósticos principales, intervenciones terapéuticas y resultados: No se identificaron otras malformaciones asociadas, se descartaron otras causas de derrame pericárdico y el cariotipo fetal analizado fue normal. A las 25 semanas, se realizó una pericardiocentesis fetal intrauterina, consiguiendo una significativa distensión pulmonar, con una adecuada vascularización. Tras el nacimiento, la recién nacida precisó soporte ventilatorio debido a una hipoxemia severa causada por la hipertensión pulmonar, corrigiéndose el defecto quirúrgicamente a los 6 días de vida. La evolución posterior fue favorable, sin presentar problemas respiratorios significativos. Conclusión: La detección ecográfica de esta rara anomalía resulta útil para el manejo óptimo, y el drenaje pericárdico puede favorecer una resolución prenatal del derrame pericárdico, permitiéndonos evaluar de forma adecuada el riesgo de hipoplasia pulmonar.(AU)

Introduction: Morgagni diaphragmatic hernia with prenatal diagnosis is a rare entity, with lower risk of pulmonary hypoplasia and respiratory problems than posterior diaphragmatic hernia. Our case highlights how in Morgagni diaphragmatic hernia cases lungs tend to develop properly, despite significant pericardial effusion or how greatly diminished they may seem. Main symptoms and/or clinical findings: Morgagni diaphragmatic hernia diagnosed at 14 weeks, with massive pericardial effusion and anterior thoracic herniation of the liver. Main diagnosis, therapeutic interventions, and results: No other malformations were identified, other causes of pericardial effusion were ruled out and foetal karyotype was normal. At 25 weeks, in-utero pericardiocentesis was performed, observing significant pulmonary distension and adequate vascularization. After delivery, the newborn required respiratory support due to severe hypoxaemia related to pulmonary hypertension. Six days later surgical diaphragm closure was performed. The newborn had no significant respiratory problems and progressed positively after surgery. Conclusion: Ultrasonographic detection of this rare anomaly is useful for optimal management, and pericardial drainage can provide prenatal resolution of pericardial effusion, enabling us to evaluate pulmonary hypoplasia risk.(AU)

Diseño y desarrollo de una intervención dietética en niños con prediabetes / Design and development of a dietary intervention in children with prediabetes

Introducción La prediabetes es una condición patológica donde la concentración de glucemia se presenta en valores más elevados a las concentraciones normales, pero menores a las consideradas en el diagnóstico de una diabetes mellitus tipo 2 (DM2). La condición de prediabetes hasta hace unos años se presentaba en adultos con unos factores de riesgo asociados como eran sobrepeso u obesidad, sedentarismo, malos hábitos alimenticios, problemas cardiovasculares, etc. En los últimos años se ha empezado a detectar en niños, cobrando cada vez una mayor importancia los hábitos familiares que estos niños tienen instaurados. Material y métodos En nuestro estudio se han evaluado 29 niños prediabéticos de Pedro Abad, Córdoba. para ello hemos realizado un ensayo aleatorizado cruzado con grupo de intervención (GI) y grupo de control (GC), empleando una intervención dietética con refuerzo nutricional. El objetivo principal del presente estudio fue determinar si los hábitos alimentarios de niños prediabéticos mejoraban con una intervención dietética basada en una educación nutricional. Resultados A través de una evaluación nutricional mediante diferentes test y visitas realizadas a los niños, los resultados correspondientes a la primera fase del estudio, relacionan una mejora en los hábitos alimentarios y en la adherencia a la dieta mediterránea por parte de los niños intervenidos. Conclusiones Los hábitos alimentarios de los niños prediabéticos mejoran con una intervención dietética basada en una educación nutricional, ya que al proveerles del conocimiento de los distintos alimentos y del aporte de nutrientes que estos nos proporcionan, pueden hacer una mejor selección de los alimentos (AU)

Introduction Prediabetes is a pathological condition where the blood glucose concentration is higher than normal concentrations, but lower than those considered in the diagnosis of type 2 diabetes mellitus (DM2). Until a few years ago, the prediabetes condition occurred in adults with associated risk factors such as overweight or obesity, sedentary lifestyle, poor eating habits, cardiovascular problems, etc. In recent years it has begun to be detected in children, with the family habits that these children have established becoming increasingly important. Material and methods In our study, 29 pre-diabetic children from Pedro Abad, Córdoba, have been evaluated. For this, we have carried out a randomized crossover trial with an intervention group (IG) and a control group (CG), using a dietary intervention with nutritional reinforcement. The main objective of the present study was to determine if the eating habits of pre-diabetic children improved with a dietary intervention based on nutritional education. Results Through a nutritional evaluation through different tests and visits made to the children, the results corresponding to the first phase of the study, relate an improvement in eating habits and adherence to the Mediterranean Diet by the intervened children. Conclusions The eating habits of pre-diabetic children improve with a dietary intervention based on nutritional education, since by providing them with knowledge of the different foods and the contribution of nutrients that they provide us, they can make a better selection of foods (AU)

[Design and development of a dietary intervention in children with prediabetes]. / Diseño y desarrollo de una intervención dietética en niños con prediabetes.

INTRODUCTION: Prediabetes is a pathological condition where the blood glucose concentration is higher than normal concentrations, but lower than those considered in the diagnosis of type 2 diabetes mellitus (DM2). Until a few years ago, the prediabetes condition occurred in adults with associated risk factors such as overweight or obesity, sedentary lifestyle, poor eating habits, cardiovascular problems, etc. In recent years it has begun to be detected in children, with the family habits that these children have established becoming increasingly important. MATERIAL AND METHODS: In our study, 29 pre-diabetic children from Pedro Abad, Córdoba, have been evaluated. For this, we have carried out a randomized crossover trial with an intervention group (IG) and a control group (CG), using a dietary intervention with nutritional reinforcement. The main objective of the present study was to determine if the eating habits of pre-diabetic children improved with a dietary intervention based on nutritional education. RESULTS: Through a nutritional evaluation through different tests and visits made to the children, the results corresponding to the first phase of the study, relate an improvement in eating habits and adherence to the Mediterranean Diet by the intervened children. CONCLUSIONS: The eating habits of pre-diabetic children improve with a dietary intervention based on nutritional education, since by providing them with knowledge of the different foods and the contribution of nutrients that they provide us, they can make a better selection of foods.

Enseñanza de las maniobras de soporte vital básico en alumnos de un ciclo formativo, ¿se mantiene la calidad de las maniobras en el tiempo? / Teaching basic life support maneuvers in students of a training cycle, is the quality of the maneuvers maintained over time?

Objetivo Evaluar la calidad de las maniobras de soporte vital básico tras un proceso formativo normalizado y estudiar su evolución a corto plazo. Materiales y métodos Estudio experimental con alumnos de los ciclos formativos de Técnico Superior en Acondicionamiento Físico y Técnico Superior en Enseñanza y Animación Sociodeportiva del Colegio de la Trinidad de Córdoba. Se realiza una evaluación inicial, una evaluación 15 días tras la formación y otra a los 30 días, que constan de una evaluación mediante un test teórico y una evaluación práctica de 2min de RCP. Para el desarrollo de las evaluaciones prácticas, se utiliza el simulador Resusci Anne® QCPR. Se considera como variable principal el porcentaje global de RCP obtenido mediante SimPad SkillReporter®. Resultados Se estudia una muestra de 45 alumnos, 71,1% varones. Se observan diferencias estadísticamente significativas entre la puntuación teórica total de la evaluación inicial y la de los 15 días (7,81 vs. 6,82 puntos; p<0,0001) y entre la evaluación de los 15 días y la de los 30 días (6,82 vs. 7,66 puntos; p<0,0001), y en el porcentaje global de RCP entre la evaluación inicial y la de los 15 días (27 vs. 49 puntos; p=0,008) y entre la evaluación inicial y la evaluación a los 30 días (27 vs. 6,15 puntos; p<0,0001). Conclusiones La calidad de la maniobra de RCP mejora a corto plazo tras la formación, siendo cercana a los estándares de calidad establecidos por la ERC (AU)

Objective To evaluate the quality of basic life support after a standardized training process and study their short-term evolution. Materials and methods Experimental study with students from the training cycles of Higher Technician in Physical Conditioning and Higher Technician in Teaching and Socio-Sports Animation of the Colegio de la Trinidad from Córdoba. An initial evaluation is carried out, an evaluation of 15 days after training and another 30 days later; consisting of an evaluation by a theoretical test, and a practical evaluation of 2min of CPR. For the development of practical evaluations, we used the Resusci Anne® QCPR simulator. The main outcome variable is the global percentage of CPR obtained using the SimPad SkillReporter®. Results We study 45 students, 71.1% of them male. Statistically significant differences are observed in the total theoretical score of the initial evaluation and the 15 days evaluation (7.81 vs. 6.82 points; P<.0001), and between the 15-day and 30-day evaluation (6.82 vs. 7.66 points; P<.0001); and in the overall percentage of CPR between the initial evaluation and the 15-day evaluation (27 vs. 49 points; P=.008) and between the initial evaluation and the 30 days evaluation (27 vs. 6.15 points; P<.0001). Conclusions The CPR quality improves after training, being close to the quality standards established by the ERC (AU)

Análisis cuantitativo del COVID-19 y sus impactos psicológicos y educativos en estudiantes universitarios y de secundaria en Córdoba, España / Quantitative analysis of COVID-19 and its psychological and educational impacts on university and secondary students in Córdoba, Spain

Introducción La pandemia COVID-19, que empezó en Wuhan, China, a finales del 2019, y, que hoy amenaza a todos los habitantes del planeta, configura el tema de investigación prioritaria en la actualidad. En este contexto, este artículo enfoca la manera en que este problema de salud afecta directamente al estado psicológico y educativo de 344 estudiantes universitarios y de secundaria, en Córdoba, España. Material y métodos Para el análisis se ha empleado el modelo de ecuaciones estructurales (SEM), a través de la cuantificación de un conjunto de relaciones entre una o más variables independientes, intentando condensar el escenario de pandemia y sus implicaciones sanitarias, psicológicas y educativas. Resultados La primera variable latente «Salud», es causal de la variable latente «Psicología», y de las variables endógenas «efectos relaciones sociales», «efectos tristeza» y «efectos sexualidad», lo cual confirma que la COVID-19 afectó seriamente al comportamiento psicológico de los estudiantes de universidad y de secundaria de Córdoba (AU)

Introduccion The COVID-19 pandemic that began in Wuhan, China, at the end of 2019, and which today threatens all the inhabitants of the planet, is currently the priority research topic. In this context, this article focuses on how this health problem directly affects the psychological and educational status of 344 university and high school students in Córdoba, Spain. Material and methods For the analysis, the structural equation model (SEM) has been used, through the quantification of a set of relationships between one or more independent variables, trying to condense the pandemic scenario and its health, psychological and educational implications. Results The first latent variable “Health” is causal of the latent variable “Psychology”, and, of the endogenous variables, “social relations effects”, “sadness effects” and “sexuality effects”, which confirms that the COVID-19 seriously affected the psychological behavior of university and high school students in Córdoba (AU)

Identificar el pie de riesgo en pacientes con diabetes. Un espacio de mejora en atención primaria / Identify the risk foot in patients with diabetes. A space for improvement in primary care

Objetivos: Identificar los factores condicionantes del pie de riesgo (PR) comparando 2 métodos de evaluación (cualitativo y cuantitativo) para neuropatía, arteriopatía y deformidades del pie. Concordancia entre alteraciones detectadas y registradas en el historial clínico (HC). Material y métodos: Estudio observacional. Ámbito: 2 centros de atención primaria del Instituto Catalán Salud. Población: Quinientos treinta y dos pacientes con diabetes, ambos sexos >18 años con registros del PR y consentimiento informado. Mediciones: Neuropatía: valoración síntomas (NSS) y signos discapacidad (NDS). Arteriopatía: índice tobillo brazo (ITB), cuestionario Edimburgo, pulsos pedios. Deformidades pie: pedigrafía. Valores de referencia cuantitativos: Neuropatía definida: NDS>6 puntos o 3-5 y NSS>5 puntos. ITB: valor normalidad (0,90-1,30). Resultados: Mujeres: 46,42%; edad media: 67,29 años (DE: 7,69). Ciento cincuenta y tres pacientes sin complicaciones neurovasculares. Cualitativo: Sin diferenciar manifestaciones clínicas: 252 pacientes presentaron neuropatía; 99 pacientes presentaron ITB alterado; 28 pacientes presentaron complicaciones y 101 pacientes cuestionario Edimburgo alterado. Cuantitativo: Diferenciando manifestaciones clínicas: del grupo neuropatía, 110 pacientes solo presentaron síntomas; 46 pacientes presentaron neuropatía definida y 96 pacientes puntuación NDS y NSS, sin criterios neuropatía definida. ITB alterado: 52, solo ITB>1,30; 47, solo ITB<0,90; 12, asociaron neuropatía e ITB>1,30 y 16 con ITB<0,90. Cuestionario Edimburgo: 47 pacientes presentaron clínica atípica y 54, típica. Concordancia entre alteraciones neurovasculares cuantitativas y registradas r=0,32 para neuropatía y r=0,21 en arteriopatía. El punto de presión sobre el 5.° metatarso se asoció a neuropatía cuantitativa: OR: 2,32 (1,188-4,546); p=0,01.Conclusión: La evaluación, identificando manifestaciones clínicas, mejora la identificación del PR aunque necesitamos más investigación (AU)

Goals: Identify conditioning factors of the foot risk (FR) by comparing two evaluation methods (qualitative and quantitative) for neuropathy, arteriopathy, foot deformities. Concordance between detected the alterations and registered in clinical history (CH). Material and methods: It is an observational study. Ambit: in two primary care centers of the Catalan Health Institute. Population: Five hundred thirty-two patients with diabetes, both >18 years with FR records and informed consent. Measurements: Neuropathy: symptom assessment (NSS) and signs of disability (NDS). Arteriopathy: Index ABI. Edinburgh Questionnaire, fart pulses. Foot deformities: Pedigraphy. Quantitative reference: Values Defined neuropathy: NDS>6 points or 3-5 and NSS>5 points. ITB: Normal value (.90-1.30). Results: Women, 46.42%. Middle ages, 67.29 years (SD 7.69). One hundred fifty-three patients did not present neurovascular alterations. Qualitative: Without differentiating clinical manifestations: 252, patients presented neuropathy; 99, altered ITB; 28, two complications and 101, Edinburgh Quiz: altered. Quantitative: Differentiating clinical manifestations: among the neuropathy group; 110, patients only presented symptoms; 46, definite neuropathy. In 96, NDS and NSS scores without defined neuropathy criteria. Altered ABI: 52, only ABI>1.30; 47, ABI<.90; 12, associated neuropathy and ABI>1.30 and 16, with ABI<.90. Edinburgh questionnaire: 47, presented atypical symptoms and 26, typical. Agreement, between quantitative and recorded neurovascular alterations r=.32 for neuropathy and r=.21 in arteriopathy. The pressure point on the 5th metatarsal, was associated with quantitative neuropathy: OR: 2.32 (1.188–4.546), P=.01. Conclusion: The evaluation, identifying clinical manifestations, improves the identification of FR, although we need more research (AU)

Biologically synthesized silver nanoparticles as potent antibacterial effective against multidrug-resistant Pseudomonas aeruginosa.

Pseudomonas aeruginosa is one of the most worrisome infectious bacteria due to its intrinsic and acquired resistance against several antibiotics and the recalcitrance of its infections; hence, the development of novel antimicrobials effective against multidrug-resistant P. aeruginosa is mandatory. In this work, silver nanoparticles obtained by green synthesis using a leaf extract and fungi were tested against a battery of clinical strains from cystic fibrosis, pneumonia and burnt patients, some of them with multidrug resistance. Both nanoparticles showed a potent antibacterial effect, causing severe damage to the cell wall, membrane and DNA, and inducing the production of reactive oxygen species. Moreover, the nanoparticles derived from fungi showed synergistic antibacterial effects with the antibiotics meropenem and levofloxacin for some clinical strains and both kinds of nanoparticles were nontoxic for larvae of the moth Galleria mellonella, encouraging further research for their implementation in the treatment of P. aeruginosa infections.