Evaluation of infection prevention and control programmes according to the European Centre for Disease Prevention and Control and the World Health Organization in Spain 2012-2022: indicators of core component 1.

BACKGROUND: Key and core components of effective infection prevention and control programmes (IPCPs) issued by the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO) have been described. WHO core component 1 relates to the structure, organization and management of IPCPs. AIM: The objective of this study was to assess the status and the time trends of some indicators of core component 1 of IPCPs in acute hospitals in Spain throughout the period 2012-2022. METHODS: Hospital-level data from the Spanish point prevalence survey for years 2012-2022 were analysed. Core component 1 indicators were calculated and tested for association to healthcare-associated infections (HAIs). In addition, trends were also examined. RESULTS: Overall, 67.0% and 57.2% of Spanish hospitals reported having an annual infection prevention and control (IPC) plan and an annual IPC report that was approved by the hospital managing director, respectively. The global median number of full-time equivalent (FTE) IPC nurses per 250 beds for the period was 0.87 and the global median number of FTE IPC doctors was 0.70. The rates of blood cultures and stool tests for Clostridioides difficile were 39.9 and 6.1 per 1000 patient-days, respectively. No significant correlation was found between core component 1 indicators and HAI prevalence. CONCLUSION: Spain is currently at a basic level on the structure, organization and management of IPCPs. Profound differences were found between hospitals depending on size and type.

Trends of antimicrobial use through selected antimicrobial indicators in Spanish hospitals, 2012 to 2021.

BACKGROUND: Surveillance of antimicrobial consumption is an important component of control strategies to tackle antimicrobial resistance. AIM: To evaluate the consumption of antimicrobials using six indicators proposed by the European Center for Disease Prevention and Control. METHODS: Point prevalence survey data on antimicrobial use in Spanish hospitals throughout the period 2012-2021 were analysed. A descriptive analysis of each indicator by year was performed globally and by hospital size. A logistic regression model was used to identify significant time trends. FINDINGS: In all, 515,414 patients and 318,125 antimicrobials were included. The prevalence of antimicrobial use remained stable throughout the study period (45.7%; 95% confidence interval (CI): 45.6-45.8). Percentages of antimicrobials for systemic use and those administered parenterally showed a small and significant increasing trend (odds ratio (OR): 1.02; 95% CI: 1.01-1.02; and OR: 1.03; 95% CI: 1.02-1.03, respectively). Small improvements were found in the percentages of antimicrobials prescribed for medical prophylaxis and with the reason for use documented in patients' medical records (-0.6% and 4.2%, respectively). The percentage of surgical prophylaxis prescribed for more than 24 h shows a significant improvement, decreasing from 49.9% (95% CI: 48.6-51.3) in 2012 to 37.1% (95% CI: 35.7-38.5) in 2021. CONCLUSION: During the last decade, Spanish hospitals have had a stable but high prevalence of antimicrobial use. Little to no improvement has been made in most of the indicators analysed, except for a reduction in the prescription of surgical prophylaxis for more than 24 h.

Toxicity and larvicidal activity on Aedes aegypti of citronella essential oil submitted to enzymatic esterification / Toxicidade e atividade larvicida sobre Aedes aegypti de óleo essencial de citronella submetido à esterificação enzimática

Abstract The essential oil of citronella (Cymbopogon winterianus) has several biological activities, among them the insect repellent action. Some studies showed that cinnamic acid esters can be applied as natural pesticides, insecticides and fungicides. In this context, the objective of the present work was to evaluate the production of esters from citronella essential oil with cinnamic acid via enzymatic esterification. Besides, the essential oil toxicity before and after esterification against Artemia salina and larvicidal action on Aedes aegypti was investigated. Esters were produced using cinnamic acid as the acylating agent and citronella essential oil (3:1) in heptane and 15 wt% NS 88011 enzyme as biocatalysts, at 70 °C and 150 rpm. Conversion rates of citronellyl and geranyl cinnamates were 58.7 and 69.0% for NS 88011, respectively. For the toxicity to Artemia salina LC50 results of 5.29 μg mL-1 were obtained for the essential oil and 4.36 μg mL-1 for the esterified oils obtained with NS 88011. In the insecticidal activity against Aedes aegypti larvae, was obtained LC50 of 111.84 μg mL-1 for the essential oil of citronella and 86.30 μg mL-1 for the esterified oils obtained with the enzyme NS 88011, indicating high toxicity of the esters. The results demonstrated that the evaluated samples present potential of application as bioinsecticide.

Resumo O óleo essencial de citronela (Cymbopogon winterianus) possui diversas atividades biológicas, entre elas a ação repelente a insetos. Alguns estudos mostraram que os ésteres do ácido cinâmico podem ser aplicados como pesticidas naturais, inseticidas e fungicidas. Nesse contexto, o objetivo do presente trabalho foi avaliar a produção de ésteres a partir do óleo essencial de citronela com ácido cinâmico via esterificação enzimática. Além disso, foi investigada a toxicidade do óleo essencial antes e após a esterificação contra Artemia salina e a ação larvicida sobre Aedes aegypti. Os ésteres foram produzidos utilizando ácido cinâmico como agente acilante e óleo essencial de citronela (3: 1) em heptano e 15% em peso da enzima NS 88011 como biocatalisadores, a 70 ° C e 150 rpm. As taxas de conversão de cinamatos de citronelil e geranil foram 58,7 e 69,0% para NS 88011, respectivamente. Para a toxicidade sobre Artemia salina foram obtidos CL50 de 5,29 μg mL-1 para o óleo essencial e 4,36 μg mL-1 para os óleos esterificados com NS 88011. Na atividade inseticida contra larvas de Aedes aegypti, obteve-se CL50 de 111,84 μg mL-1 para o óleo essencial de citronela e 86,30 μg mL-1 para os óleos esterificados com a enzima NS 88011, indicando alta toxicidade dos ésteres. Os resultados demonstraram que as amostras avaliadas apresentam potencial de aplicação como bioinseticida.

Toxicity and larvicidal activity on Aedes aegypti of citronella essential oil submitted to enzymatic esterification / Toxicidade e atividade larvicida sobre Aedes aegypti de óleo essencial de citronella submetido à esterificação enzimática

The essential oil of citronella (Cymbopogon winterianus) has several biological activities, among them the insect repellent action. Some studies showed that cinnamic acid esters can be applied as natural pesticides, insecticides and fungicides. In this context, the objective of the present work was to evaluate the production of esters from citronella essential oil with cinnamic acid via enzymatic esterification. Besides, the essential oil toxicity before and after esterification against Artemia salina and larvicidal action on Aedes aegypti was investigated. Esters were produced using cinnamic acid as the acylating agent and citronella essential oil (3:1) in heptane and 15 wt% NS 88011 enzyme as biocatalysts, at 70 °C and 150 rpm. Conversion rates of citronellyl and geranyl cinnamates were 58.7 and 69.0% for NS 88011, respectively. For the toxicity to Artemia salina LC50 results of 5.29 μg mL-¹ were obtained for the essential oil and 4.36 μg mL-¹ for the esterified oils obtained with NS 88011. In the insecticidal activity against Aedes aegypti larvae, was obtained LC50 of 111.84 μg mL-¹ for the essential oil of citronella and 86.30 μg mL-¹ for the esterified oils obtained with the enzyme NS 88011, indicating high toxicity of the esters. The results demonstrated that the evaluated samples present potential of application as bioinsecticide.

O óleo essencial de citronela (Cymbopogon winterianus) possui diversas atividades biológicas, entre elas a ação repelente a insetos. Alguns estudos mostraram que os ésteres do ácido cinâmico podem ser aplicados como pesticidas naturais, inseticidas e fungicidas. Nesse contexto, o objetivo do presente trabalho foi avaliar a produção de ésteres a partir do óleo essencial de citronela com ácido cinâmico via esterificação enzimática. Além disso, foi investigada a toxicidade do óleo essencial antes e após a esterificação contra Artemia salina e a ação larvicida sobre Aedes aegypti. Os ésteres foram produzidos utilizando ácido cinâmico como agente acilante e óleo essencial de citronela (3: 1) em heptano e 15% em peso da enzima NS 88011 como biocatalisadores, a 70 ° C e 150 rpm. As taxas de conversão de cinamatos de citronelil e geranil foram 58,7 e 69,0% para NS 88011, respectivamente. Para a toxicidade sobre Artemia salina foram obtidos CL50 de 5,29 μg mL-¹ para o óleo essencial e 4,36 μg mL-¹ para os óleos esterificados com NS 88011. Na atividade inseticida contra larvas de Aedes aegypti, obteve-se CL50 de 111,84 μg mL-¹ para o óleo essencial de citronela e 86,30 μg mL-¹ para os óleos esterificados com a enzima NS 88011, indicando alta toxicidade dos ésteres. Os resultados demonstraram que as amostras avaliadas apresentam potencial de aplicação como bioinseticida.

Toxicity and larvicidal activity on Aedes aegypti of citronella essential oil submitted to enzymatic esterification

Abstract The essential oil of citronella (Cymbopogon winterianus) has several biological activities, among them the insect repellent action. Some studies showed that cinnamic acid esters can be applied as natural pesticides, insecticides and fungicides. In this context, the objective of the present work was to evaluate the production of esters from citronella essential oil with cinnamic acid via enzymatic esterification. Besides, the essential oil toxicity before and after esterification against Artemia salina and larvicidal action on Aedes aegypti was investigated. Esters were produced using cinnamic acid as the acylating agent and citronella essential oil (3:1) in heptane and 15 wt% NS 88011 enzyme as biocatalysts, at 70 °C and 150 rpm. Conversion rates of citronellyl and geranyl cinnamates were 58.7 and 69.0% for NS 88011, respectively. For the toxicity to Artemia salina LC50 results of 5.29 g mL-1 were obtained for the essential oil and 4.36 g mL-1 for the esterified oils obtained with NS 88011. In the insecticidal activity against Aedes aegypti larvae, was obtained LC50 of 111.84 g mL-1 for the essential oil of citronella and 86.30 g mL-1 for the esterified oils obtained with the enzyme NS 88011, indicating high toxicity of the esters. The results demonstrated that the evaluated samples present potential of application as bioinsecticide.

Resumo O óleo essencial de citronela (Cymbopogon winterianus) possui diversas atividades biológicas, entre elas a ação repelente a insetos. Alguns estudos mostraram que os ésteres do ácido cinâmico podem ser aplicados como pesticidas naturais, inseticidas e fungicidas. Nesse contexto, o objetivo do presente trabalho foi avaliar a produção de ésteres a partir do óleo essencial de citronela com ácido cinâmico via esterificação enzimática. Além disso, foi investigada a toxicidade do óleo essencial antes e após a esterificação contra Artemia salina e a ação larvicida sobre Aedes aegypti. Os ésteres foram produzidos utilizando ácido cinâmico como agente acilante e óleo essencial de citronela (3: 1) em heptano e 15% em peso da enzima NS 88011 como biocatalisadores, a 70 ° C e 150 rpm. As taxas de conversão de cinamatos de citronelil e geranil foram 58,7 e 69,0% para NS 88011, respectivamente. Para a toxicidade sobre Artemia salina foram obtidos CL50 de 5,29 g mL-1 para o óleo essencial e 4,36 g mL-1 para os óleos esterificados com NS 88011. Na atividade inseticida contra larvas de Aedes aegypti, obteve-se CL50 de 111,84 g mL-1 para o óleo essencial de citronela e 86,30 g mL-1 para os óleos esterificados com a enzima NS 88011, indicando alta toxicidade dos ésteres. Os resultados demonstraram que as amostras avaliadas apresentam potencial de aplicação como bioinseticida.

Psychometric properties of the Spanish version of the Frontal Assessment Battery (FAB-E) and normative values in a representative adult population sample.

BACKGROUND: The Frontal Assessment Battery is a short bedside test used to assess executive functions (EF). The aims of the present study were, first, to evaluate the psychometric proprieties of the Spanish version of the FAB (FAB-E) in a representative sample, and second, to establish cut-off points for impairment in executive function according to age and education level. METHODS: A sample of 798 healthy Spanish adult subjects aged 19 to 91 participated in this study. Neuropsychological assessment of participants was conducted using the FAB-E, Mini-Mental State Examination (MMSE) and Trail Making Test (TMT). We examined internal consistency, intraclass correlation, test-retest reliability, and concurrent and divergent validity. In addition, we established a cut-off point for detecting executive function impairment based on the 5th percentile by age group and education level. RESULTS: The analysis of the psychometric properties of the FAB-E showed good internal consistency (Cronbach's α = 0.60), intraclass correlation (0.72), test-retest reliability (0.70) and concurrent and divergent validity between the TMT (r = -0.523), MMSE (r = 0.426) and the FAB-E. The cut-off points for each age group were 16 points for the ≤ 29 group, 15 points for the 30-39 group, 14 points for the 40-49 and 50-59 groups, 12 points for the 60-69 group, and 10 points for the ≥ 70 age group. CONCLUSIONS: The psychometric analysis showed that the FAB-E has good validity and reliability. Thus, FAB-E may be a helpful tool to evaluate EF in a healthy Spanish population. In addition, this study provides information on reference data that will be very valuable for clinicians and researchers.

Impact of the first superspreading outbreak of COVID-19 related to a nightlife establishment in Andalusia, Spain.

INTRODUCTION AND AIM OF THE STUDY: A notable proportion of COVID outbreaks are generated by "super-spreading events", where a few subjects transmit the pathogen to many secondary cases, increasing contact networks and the spread of the pathogen. We conducted a description of a COVID-19 superspreading event in Córdoba during July 2020, linked to a nightlife establishment. MATERIAL AND METHODS: Retrospective observational study describing characteristics of person, time, PCR result and contact network of confirmed cases. PCR results in Córdoba during July and August and information collected in surveillance systems were analyzed. RESULTS: 935 individuals associated with the outbreak were included; 120 (12.83%) became confirmed cases. July 17 was the day with the highest incidence, with 27 new cases (22.5% of the total). People under 25 years old represented 69.2% of the cases. The average number of close contacts per person was 10.7, with a decrease as age raised. During the outbreak, incidence increased at the provincial level compared to previous weeks; at the end, incidence did not return to initial values but remained high with a relevant percentage of cases having unknown epidemiological association. CONCLUSIONS: A greater transmission capacity of SARS-CoV-2 was observed in a closed, crowded space, and among young people that tended to report a greater number of social contacts and may present little or no symptoms. Developing preventive measures in scenarios that combine these factors and early detection of cases are essential to avoid an increase in the spread of the virus.

Ocular manifestations of multiple sclerosis in patients from three countries: A Web-based survey.

OBJECTIVE: This study evaluates the epidemiological characteristics, ophthalmological manifestations, and different therapeutic options available for patients with multiple sclerosis (MS) in China, Spain, and Cuba. METHODS: A self-designed questionnaire was used to conduct a comparable descriptive cross-sectional study on patients with MS. The survey included patients' demographic data, ocular manifestations related to MS, and treatment methodology followed in the three countries. The online survey was designed using the Wenjuanxing survey platform, and a survey link was circulated through WhatsApp, WeChat, and emails. Quantitative data were expressed as mean and standard deviation, the Kruskal-Wallis test was used for non-parametric variables. Qualitative data were expressed as numerical and percentage. The chi-square test (χ2) was used to compare the group's response categories. The statistical difference was considered significant when p < 0.05. RESULTS: The female-to-male ratio in all the three countries was 2-3:1, and relapsing-remitting MS (RRMS) was the most frequent in all three countries. Vision loss was slow and progressive in half of the patients from the three countries, with no significant differences (p = 0.524). A higher percentage of steroid treatment was observed in Chinese patients in comparison with the patients from other two countries (p < 0.001), and a similar trend was seen in the use of traditional medicines. Almost one-third of patients who did not receive any treatment recovered spontaneously in all the three countries (p = 0.097). CONCLUSIONS: MS occurs more frequently in the relapsing-remitting clinical form and there is a clear female predominance. The first ocular crisis or clinical debut of MS is characterized by slow and progressive visual impairment, increasing and adding to other ocular manifestations during its evolutionary course. Spontaneous recovery of vision after an attack of optic neuritis in the course of MS is possible.

The social and occupational consequences of the COVID-19 pandemic among patients with multiple sclerosis in three distinct populations: A web-based cross-sectional survey.

Background: The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes the disease COVID-19, has caused a pandemic that has rapidly affected the whole world and caused a significant threat to public health. The aim of this study was to investigate and analyze the social and occupational effects of the COVID-19 pandemic on patients with multiple sclerosis (MS) in three different countries: China, Spain, and Cuba. Methods: A cross-sectional survey was designed to assess the social and occupational effects of the COVID-19 pandemic in MS patients in these three countries, using a 25-item anonymous online questionnaire, structured into three sections. Quantitative data are expressed as mean (standard deviation), and quantitative data as absolute frequency and percentage. Results: A total of 361 participants responded to the questionnaire: 194 from China, 104 from Spain, and 63 from Cuba. We found no cases of COVID-19 among Chinese patients with MS, and few cases in Spain and Cuba. Respondents reported different levels of impact on relationships with friends, family, and colleagues, and patients in all three countries described increased use of digital or social media platforms. Spanish patients reported a significantly less negative impact than those in Cuba and China. Mental and cognitive effects were similar in all three countries, although China seemed to have a better situation. We also found that the time spent exercising decreased at specific points during the pandemic, but with few changes in dietary habits. Patients reported little or no change in their means of transport in all three countries. Most patients in all three countries reported little or no physical deterioration, especially in Chinese patients (82.47%), compared to the Spanish (70.20%) and Cuban respondents (73.02%). In general, patients from all three countries demonstrated confidence in overcoming the COVID-19 pandemic, although to a lesser extent among Spanish respondents. Conclusions: During the pandemic, family support was more effective in China than in Cuba and Spain. Neither COVID-19 infections nor the number of MS relapses increased significantly during lockdown in any of the three countries. Regarding their economic situation, Spanish MS patients reported a significantly less severe negative impact than those in Cuba and China. Patients from all three countries used digital or social media platforms more frequently, probably to maintain personal relationships. Chinese and Cuban respondents were more confident of the control of the pandemic than the Spanish, who were more pessimistic.

Introducción: El nuevo coronavirus de tipo 2, causante del síndrome respiratorio agudo severo o COVID-19, se ha expandido rápidamente a nivel mundial, convirtiéndose en una grave amenaza para la salud pública en forma de pandemia. El objetivo de este estudio es analizar los efectos sociolaborales de la pandemia de COVID-19 en pacientes con esclerosis múltiple (EM) en 3 países diferentes (China, España y Cuba). Métodos: Diseñamos un estudio transversal para valorar los efectos sociolaborales de la pandemia de COVID-19 en pacientes con EM procedentes de China, España y Cuba mediante un cuestionario digital de 25 preguntas divididas en 3 apartados. Los datos cuantitativos se expresan como medias y desviaciones estándar, mientras que los datos cualitativos se expresan mediante valores y porcentajes. Resultados: Un total de 361 pacientes respondieron al cuestionario (194 de China, 104 de España y 63 de Cuba). No encontramos ningún paciente chino con EM que hubiera padecido COVID-19, y los casos diagnosticados en España y Cuba fueron muy infrecuentes. A raíz de la pandemia, se observaron cambios en las relaciones con amigos, familiares y compañeros; además, los pacientes con EM usaron plataformas digitales y redes sociales con más frecuencia en los 3 países. El impacto negativo fue significativamente menor en España que en Cuba o China. Los efectos mentales y cognitivos de la pandemia fueron similares en los 3 países, aunque parece que la situación previa era mejor en China. Igualmente, observamos que el tiempo dedicado al ejercicio se redujo en momentos específicos durante la pandemia. Por el contrario, no se detectaron grandes cambios en los hábitos alimentarios. Los pacientes de los 3 países consideraron que no se produjeron cambios en su medio de transporte, o que estos fueron escasos. La mayoría de los pacientes ha experimentado poco o ningún deterioro físico, particularmente los pacientes chinos (82,47%) en comparación con los españoles (70,20%) y cubanos (73,02%). En líneas generales, todos los pacientes se mostraron esperanzados en superar la pandemia, aunque los pacientes españoles en menor grado. Conclusiones: Durante la pandemia, el apoyo familiar fue más importante en China que en Cuba o España. En ninguno de los 3 países se observó un aumento significativo en el número de casos de COVID-19 ni de brotes o recaídas durante el periodo de confinamiento. En términos económicos, los pacientes con EM españoles sufrieron un impacto negativo significativamente menor que los cubanos y chinos. Todos los pacientes usaron plataformas digitales o redes sociales con más frecuencia, probablemente con el fin de mantener relaciones personales. Los pacientes chinos y cubanos mostraron mayor confianza en el control de la pandemia que los españoles, que resultaron ser más pesimistas.

[Patient safety: Patients perception at primary care level at an urban healthcare district]. / Seguridad del paciente: percepción de los pacientes en atención primaria de un distrito sanitario urbano.

OBJECTIVES: Patient safety is a quality objective and a priority in healthcare. Most of the research has focused on the hospital setting and from the professional perspective. The objective of our study is to know the opinion of the patient who attends primary care regarding its safety in this area. MATERIAL AND METHODS: Cross-sectional observational study. A survey carried out with patients chosen through four health centres representing different socioeconomic levels of the same Basic Health Zone. Fifty patients per centre were surveyed. RESULTS: Two hundred patients surveyed of whom more than 90% reported no negative experiences in terms of errors in medication, identification, diagnosis or clinical management, highlighting the good care received and the good resolution of their problem. However, only around half claimed to understand the explanations of the healthcare professionals or to have had the opportunity to give an opinion or have shared decision-making on their management. These factors were closely related to the perceived lack of time in consultation and constant change of physician. CONCLUSIONS: The vast majority of our patients report no adverse effects or safety issues during their primary care attendance. However, there is evidence of the need to strengthen aspects related to consultation time and increase the number and stability of human resources in health centres to improve patient satisfaction with the health system.

Toxicity and larvicidal activity on Aedes aegypti of citronella essential oil submitted to enzymatic esterification.

The essential oil of citronella (Cymbopogon winterianus) has several biological activities, among them the insect repellent action. Some studies showed that cinnamic acid esters can be applied as natural pesticides, insecticides and fungicides. In this context, the objective of the present work was to evaluate the production of esters from citronella essential oil with cinnamic acid via enzymatic esterification. Besides, the essential oil toxicity before and after esterification against Artemia salina and larvicidal action on Aedes aegypti was investigated. Esters were produced using cinnamic acid as the acylating agent and citronella essential oil (3:1) in heptane and 15 wt% NS 88011 enzyme as biocatalysts, at 70 °C and 150 rpm. Conversion rates of citronellyl and geranyl cinnamates were 58.7 and 69.0% for NS 88011, respectively. For the toxicity to Artemia salina LC50 results of 5.29 µg mL-1 were obtained for the essential oil and 4.36 µg mL-1 for the esterified oils obtained with NS 88011. In the insecticidal activity against Aedes aegypti larvae, was obtained LC50 of 111.84 µg mL-1 for the essential oil of citronella and 86.30 µg mL-1 for the esterified oils obtained with the enzyme NS 88011, indicating high toxicity of the esters. The results demonstrated that the evaluated samples present potential of application as bioinsecticide.

In vitro effect of toothpaste with low fluoride combined with sodium trimetaphosphate on dentine erosion.

PURPOSE: This study sought to evaluate in vitro the effect of a dentifrice containing sodium trimetaphosphate (TMP) combined or not with low fluoride (500 ppm NaF) on dentine erosion of intrinsic origin. METHODS: Human root dentine blocks were selected based on surface microhardness and randomly allocated into five groups (n = 12): negative control (0 ppm F; no TMP); F500 (500 ppm NaF); F1500 (1500 ppm NaF-positive control); TMP (1% TMP); and F + TMP (500 ppm NaF + 1% TMP). The blocks were submitted to erosion cycles (3 ×/day) for 3 days (0.01 M HCl, pH 1.5-30 s), treatment (1 min-1:3 p/p dentifrice/distilled water) and remineralization (artificial saliva/120 min). Dentine alterations were determined according to the percentage of microhardness loss (%HL), surface loss (SL) and surface analysis by scanning electron microscopy. The data were analyzed using one-way ANOVA (p < 0.05). RESULTS: The values of SL and %HL in each group were, respectively: negative control (1.36 ± 0.36; 57.29 ± 14.14), F500 (1.46 ± 0.28; 65.66 ± 5.11), F1500 (1.52 ± 0.36; 61.66 ± 5.15), TMP (1.45 ± 0.45; 62.08 ± 3.83) and F + TMP (1.38 ± 0.42; 63.38 ± 6.47). There was no statistically significant difference in all the parameters (p = 0.873 and p = 0.152). CONCLUSION: The dentifrices containing TMP combined or not with fluoride were not able to prevent dentine erosion.

Association of tyrosine hydroxylase expression in brain and tumor with increased tumor growth in sympathectomized mice.

OBJECTIVE: Lymphocytes express tyrosine hydroxylase (TH), the rate-limiting enzyme for the synthesis of dopamine, norepinephrine and epinephrine. This suggests a broader role for cathecholamines in lymphocyte function, as well as the potential secretion of catecholamines by tumors of lymphoid origin. Our aim was to evaluate the expression of Th by murine lymphoma cells in an in vivo mouse model. For this, L5178Y-R lymphoma cells were implanted in nerve-intact and sympathectomized male BALB/c mice. Relative Th gene expression in tumor and brain was determined by quantitative PCR. Body composition, tumor volume, and plasma TH1/TH2/TH17 cytokines were also evaluated as markers of tumor-host condition and anti-tumor immune response in absence of adrenergic innervation. RESULTS: We found a significant (p = 0.045) 3.3-fold decrease of Th gene expression in tumor and a non-significant (p = 0.60) 6.9-fold increase in brain after sympathectomy. Sympathectomized mice also showed a significant increase in tumor mass at days 18 (p = 0.032) and 28 (p = 0.022) and increased interscapular fat (p = 0.04). TH1/TH2 and TH17 cytokines levels in plasma from sympathectomized tumor-bearing mice were not different from control mice. CONCLUSION: The L5178Y-R lymphoma does not express Th during in vivo progression.

Menopause Representations Questionnaire: development and validation with Portuguese women.

OBJECTIVE: This study aimed to develop and validate a Portuguese version of the Menopause Representations Questionnaire (MenoSentations-Q), a self-report measure to assess cognitive appraisal of menopause, based on cognitive components of the Self-Regulation Model and the results from a previous Portuguese qualitative study. METHODS: A total of 309 Portuguese women, aged 45-65 years, completed the questionnaire. Factorial, convergent, discriminant, and criterion validity, as well as reliability and psychometric sensitivity, were studied. RESULTS: MenoSentations-Q has demonstrated acceptable factorial, convergent, and discriminant validity, as well as good values of sensitivity and reliability for the four factors (i.e. identity; positive consequences; negative consequences; and control, awareness, and cause). Criterion validity was only obtained for two factors. CONCLUSIONS: MenoSentations-Q, a brief measure of menopausal representations, in this sample of Portuguese women provides information to inform interventions that might include challenging unhelpful menopausal representations. This instrument could be used in both clinical and community settings.

[Discussion groups as an approach to assess knowledge, attitudes and practices of hand hygiene among the adult intensive care unit professionals from a referral hospital]. / Grupos de discusión como abordaje para valorar conocimiento, actitudes y prácticas de higiene de manos en profesionales de la unidad de cuidados intensivos de adultos de un hospital de referencia.

OBJECTIVES: The adherence to hand hygiene practices among the adult Intensive Care Unit (ICU) professionals in this hospital has not improved substantially in the last years, regardless of the theoretical training sessions conducted. A study was made of the knowledge, attitudes, and practices of the ICU personnel in this field. METHODS: Several small discussion groups with ICU staff organised by preventive medicine professionals were scheduled in March 2018. Semi-structured questions on hand hygiene and use of gloves were included. The points discussed were listed into strengths and weaknesses. Knowledge was then assessed using an anonymous questionnaire, after the sessions. RESULTS: Thirteen 60-minute sessions were carried out with 157 participants from all professional categories (82% from ICU, median=11 participants / session). The majority perceived hand hygiene as a priority issue of personal responsibility for patient safety. They identified factors that limit their ability to improve their adherence. Certain habits have more to do with personal preferences than with theoretical knowledge or technical indications. CONCLUSIONS: The discussion groups have helped to make a diagnosis of the situation that will be useful to strengthen those areas of improvement that have been identified. If we aim for a cultural change, and eliminate incorrect habits, it seems more useful to carry out adequate continuing education as part of the daily routine of professionals.

Self-regulation model applied to menopause: a mixed-methods study.

Objectives: Considering that bio-psycho-sociocultural variables influence menopause, this research aimed to assess the suitability of the self-regulation model in explaining the menopausal experience, and to explore differences among participants with different characteristics (e.g. health, sexual related) regarding menopause representations.Methods: Overall, 27 Portuguese women aged 40-65 years were assessed for sociodemographics, health, and sexual activity, as well as menopausal status and symptoms. Semi-structured in-depth interviews were conducted. A directed content analysis was performed, and the qualitative data presented. Afterward, the frequencies of the categories were analyzed through quantitative methods (Mann-Whitney U tests).Results: Aging was the most frequently mentioned feature regarding menopause Identity, whereas vasomotor symptoms were the most mentioned regarding Negative Consequences and menses cessation regarding Positive Consequences. Features related to Cause (hormonal changes) and Control (need for acceptance) of menopause were also identified. No differences were found in the frequency of menopause representations between women with different characteristics (e.g. with higher vs. lower vasomotor symptom severity).Conclusion: The suitability of the self-regulation model to explain these women's menopause experience was confirmed and the representations did not vary among participants with different characteristics. This research might help professionals and researchers in developing comprehensive interventions, based on this theoretical model.