A case of lipogranulomatous conjunctivitis in a horse.

OBJECTIVE: To describe a case of lipogranulomatous conjunctivitis in a horse. ANIMAL STUDIED: A client-owned 12-year-old Standardbred gelding presenting with chronic conjunctivitis and palpebral masses. METHODS: Complete ophthalmic examination, surgical excision, histopathology, and bacterial culture of biopsy samples were performed. RESULTS: Upper and lower eyelids of both eyes were affected, with multiple yellow-to-white nodules on the palpebral conjunctiva, adjacent to the eyelid margin. Nodule removal was achieved via partial tarsal plate excision. Histopathological examination revealed granulomatous inflammation and large droplets of presumed free lipid in the conjunctival lamina propria. The animal was diagnosed with lipogranulomatous conjunctivitis. No postoperative ocular discomfort was observed for months; however, 3 years later, new conjunctival nodules were noticed, requiring a second surgical procedure on three of the eyelids. Transient entropion in the left lower eyelid was observed 2 months after the second surgery, and no recurrence of conjunctival nodules was observed after 18 months of follow-up. CONCLUSION: To our knowledge, this is the first report of lipogranulomatous conjunctivitis in horses.

Effect of starvation and pesticide exposure on neutral lipid composition of the digestive gland of males of the apple snails Pomacea canaliculata.

Pollutants as well as starvation usually modify homeostasis of neutral lipids in aquatic organisms. However, studies on the simultaneous effects of both stressors are scarce. The aim of this study was to evaluate the effect of toxicant exposure under starvation conditions on neutral lipids of the freshwater snail Pomacea canaliculata, selected as the model organism. Starved adult male snails were exposed to sublethal concentration of the pesticide cypermethrin (100 µg/L) during 4 and 10 days. Fed snails were sacrificed at the onset of the experiment (T0), along with starved snails exposed to the pesticide vehicle (ethanol) and another group without solvent served as controls. Total lipid content, neutral lipid classes, fatty acid composition, and pesticide accumulation were determined in the digestive gland of snails. The ethanol concentration used was not an additional stressful agent. As expected, starvation caused a decrease in neutral lipid content in the digestive gland of snails with respect to T0 snails. Pesticide exposure caused, on the other hand, an increase in triacylglycerol content compared to ethanol exposure at day 10 of the bioassay. This increment correlated with the bioconcentration of cypermethrin, which was 47% higher by day 10 than by day 4. The fatty acid profile of triacylglycerols in the digestive gland was significantly altered under starvation and pesticide exposure. Stressed male snails showed the ability to preserve polyunsaturated fatty acids, as evidenced by their significant increase with respect to T0 snails. These results suggest that the alteration of lipid homeostasis could be involved in an adaptive mechanism of aquatic organisms to lipophilic and obesogenic pollutants.

Skeletal anomalies in reared Senegalese sole Solea senegalensis juveniles: a radiographic approach.

Reared Senegalese sole Solea senegalensis Kaup show a high incidence of vertebral anomalies; however, little is known about its skeletal anomaly profile in the later farming phases. The purpose of this study was to provide a detailed description and quantification of the most common skeletal anomalies in reared Senegalese sole in the juvenile stage by means of computed radiography. A total of 374 Senegalese sole were classified according to the external morphology of the fish as normal or altered and then radiographed in latero-lateral and in dorso-ventral projections. Radiographic evaluation of anomalies focused especially on vertebral body anomalies (VBA) and vertebral column deviations (VCD). The 2 orthogonal projections provided a more complete visualization of the skeleton. Approximately 75% of the individuals showed at least 1 anomaly, while VBA and/or VCD were detected in 48.9% of the specimens. Regarding external morphology, 88% of the fish were categorized as normal, although about 72% of these normal fish displayed abnormalities in radiographies. The most frequent anomalies consisted of deformations of the caudal complex plates (hypurals, parhypural and epural), preurals and caudal vertebrae. Scoliosis was the most prevalent among VCD, affecting the caudal area in almost 15% of the individuals. The anomaly profile at the juvenile stages showed some differences compared to what has been reported previously in earlier stages of development. In light of these results, further investigation into the progression of skeletal anomalies over time and the causative factors at later stages is required.

Prevalence of traffic rule infractions in Cali, Colombia, at sites where injury crashes occurred.

This study aim to determine the proportion of traffic rule infractions in Cali, Colombia, in places where a road traffic injury (RTI) occurred. Description of videotaping of sites where a person was injured in an RTI in 2009. Counts of road users and infractions were established for each road user group and were compared using a Z-test. They were found 13,491 users, distributed as follow: 8.9% were pedestrians, 4.6% cyclists, 24.6% motorcyclists, and 61.8% were automobile drivers. The most frequent traffic violation among motorcyclists was transiting on lines designated for other vehicles (55.2%). Among cyclists, the most frequent violations were transiting without a helmet (99.2%) and not wearing the designated vest (100%). Among pedestrians, crossing streets at prohibited places (77.3%), even at sites where a pedestrian bridge was present (72.7%), represented two common violations. Vulnerable road users committed more traffic infractions than automobile drivers (p < 0.001). High rates of traffic rule infractions among vulnerable road users were observed. Studies to better understand the occurrence of these behaviours and the promotion of effective interventions are warranted.

Psychometric properties of the Valued Living Questionnaire Adapted to Dementia Caregiving.

OBJECTIVES: Caring for a relative with dementia is associated with physical and emotional health problems in caregivers. There are no studies analysing the role of personal values in the caregiver stress process. This study aims to analyse the psychometric properties of the Valued Living Questionnaire Adapted to Caregiving (VLQAC), and to explore the relationship between personal values and stressors, coping strategies and caregiver distress. METHOD: A total of 253 individual interviews with caregivers of relatives with dementia were conducted, and the following variables were assessed: personal values, stressors, cognitive fusion, emotional acceptance, depression, anxiety, and satisfaction with life. An exploratory factor analysis and hierarchical regression analyses were carried out. RESULTS: Two factors were obtained, Commitment to Own Values and Commitment to Family Values which explain 43.42% of variance, with reliability coefficients (Cronbach's alpha) of .76 and .61, respectively. Personal values had a significant effect on emotional distress (depression and anxiety) and satisfaction with life, even when controlling for socio-demographic variables, stressors and coping strategies. CONCLUSION: Results suggest that the personal values construct of dementia caregivers is two-dimensional. The personal values of the caregivers play an important role in accounting for distress and satisfaction with life in this population.

New insight on vertebral anomalies in cultured Senegalese sole (Solea senegalensis, Kaup) at early stages of development.

Senegalese sole (Solea senegalensis, Kaup) is a promising flatfish species in aquaculture. However, skeletal anomalies are still a great concern in sole farming. Investigation of this issue is crucial to improving larval quality and optimizing production. The aim of this study was to thoroughly assess anomalies in the rachis of reared sole at early developmental stages. Sole (n = 507) were sampled at 31 or 32 days after hatching (dah). The specimens were stained with alcian blue and alizarin red and evaluated for the detection of vertebral deformities. Most fish presented 9:34:3 vertebrae in abdominal, caudal and caudal complex regions, respectively. Remarkably, all specimens showed at least one spinal anomaly. Alterations of neural/haemal elements, as well as deformities of hypurals, parhypural and epural, were recurrent. Vertebral body anomalies and/or vertebral column deviations were identified in 52% of the individuals. Vertebral deformations and fusions were common, especially in caudal complex. 'Minor' anomalies were predominant, and some of the detected disorders might be a result of non-/low-pathological processes. These results contribute a new insight into the main skeletal anomalies affecting cultured sole larvae. Further research is required to determine their impact on fish welfare and external appearances at commercial stages.

Stressors and anxiety in dementia caregiving: multiple mediation analysis of rumination, experiential avoidance, and leisure.

BACKGROUND: Despite the robust associations between stressors and anxiety in dementia caregiving, there is a lack of research examining which factors contribute to explain this relationship. This study was designed to test a multiple mediation model of behavioral and psychological symptoms of dementia (BPSD) and anxiety that proposes higher levels of rumination and experiential avoidance and lower levels of leisure satisfaction as potential mediating variables. METHODS: The sample consisted of 256 family caregivers. In order to test a simultaneously parallel multiple mediation model of the BPSD to anxiety pathway, a PROCESS method was used and bias-corrected and accelerated bootstrapping method was used to test confidence intervals. RESULTS: Higher levels of stressors significantly predicted anxiety. Greater stressors significantly predicted higher levels of rumination and experiential avoidance, and lower levels of leisure satisfaction. These three coping variables significantly predicted anxiety. Finally, rumination, experiential avoidance, and leisure satisfaction significantly mediated the link between stressors and anxiety. The explained variance for the final model was 47.09%. Significant contrasts were found between rumination and leisure satisfaction, with rumination being a significantly higher mediator. CONCLUSIONS: The results suggest that caregivers' experiential avoidance, rumination, and leisure satisfaction may function as mechanisms through which BPSD influence on caregivers' anxiety. Training caregivers in reducing their levels of experiential avoidance and rumination by techniques that foster their ability of acceptance of their negative internal experiences, and increase their level of leisure satisfaction, may be helpful to reduce their anxiety symptoms developed by stressors.

Moderating effect of self-efficacy on the relation between behavior problems in persons with dementia and the distress they cause in caregivers.

INTRODUCTION: Behavioral and psychological symptoms in dementia (BPSD) are the principal sources of stress in caregivers. The aim of the present work is to analyze the moderating effect of self-efficacy for managing BPSD on the distress these problems generate in family caregivers. METHOD: The participants were 231 family caregivers of people with dementia. We assessed the frequency and caregiver distress associated with three dimensions of BPSD (depressive, disruptive and memory problems). In addition, we assessed the moderating effect of self-efficacy for dealing with BPSD in the relationship between the dementia patient's frequency of BPSD and caregiver distress through hierarchical regression analyses, one for each of the dimensions of BPSD. RESULTS: We found a moderating effect of self-efficacy on the relation between the frequency of BPSD and the distress in caregivers for the dimensions of depressive and disruptive behaviors. Caregivers having to deal with a high frequency of behavior problems but with high levels of self-efficacy presented significantly lower levels of distress associated with depressive and disruptive behavior problems compared to those caregivers with low levels of self-efficacy. No differences in the effects of self-efficacy were found for distress levels of caregivers who dealt with low frequency of BPSD. Also, we did not find a moderating effect of self-efficacy on the relation between the frequency of memory problems and caregivers' distress. CONCLUSIONS: The results suggest that self-efficacy for managing BPSD attenuates the relation between the frequency of behavior problems ­ both disruptive and depressive ­ and the distress they cause in caregivers.

Anger and health in dementia caregivers: exploring the mediation effect of optimism.

Although previous studies indicate a negative association between caregivers' anger and health, the potential mechanisms linking this relationship are not yet fully understood. The aim of this study was to explore the potential mediating role of optimism in the relationship between anger and caregivers' physical health. Dementia caregivers (n = 108) were interviewed and filled out instruments assessing their anger (reaction), optimism and health (vitality). A mediational model was tested to determine whether optimism partially mediated the relationship between anger and vitality. Angry reaction was negatively associated with optimism and vitality; optimism was positively associated with vitality. Finally, the relationship between angry reaction and vitality decreased when optimism was entered simultaneously. A non-parametric bootstrap approach confirmed that optimism significantly mediated some of the relationship between angry reaction and vitality. These findings suggest that low optimism may help explain the association between caregivers' anger and reduced sense of vitality. The results provide a specific target for intervention with caregivers.

Effects of Enteromyxum scophthalmi experimental infection on the neuroendocrine system of turbot, Scophthalmus maximus (L.).

Enteromyxum scophthalmi is an intestinal myxosporean parasite responsible for serious outbreaks in turbot Scophthalmus maximus (L.) culture, in North-western Spain. The disease affects the digestive tract, provokes severe catarrhal enteritis, emaciation and high rates of mortality. The digestive parasitization triggers a response with the coordinate participation of immune and neuroendocrine systems through the action of peptides released by enteroendocrine cells and present in nervous elements, acting as neuro-immune modulators. The present study was designed to assess the response of the turbot neuroendocrine system against E. scophthalmi infection. Immunohistochemical tests were applied to sections of the gastrointestinal tract of uninfected and E. scophthalmi-infected turbot to characterize the presence of bombesin (BOM), glucagon (GLUC), somatostatin (SOM), leu-enkephalin (LEU) and met-enkephalin (MET). The occurrence of E. scophthalmi in the turbot gastrointestinal tract increased the number of enteroendocrine cells immunoreactive to SOM, LEU and MET. On the other hand, BOM and GLUC immunoreactive cells were less numerous in the gastrointestinal tract of the parasitized turbot. Scarce immunoreactivity to BOM, GLUC and SOM was observed in nerve fibres and neurons of the myenteric plexus of control and infected fish. The results indicate that E. scophthalmi infection in turbot induced changes in the neuroendocrine system, with the diminution of the anorexigenic peptides BOM and GLUC; the increase of enkephalins, related to pro-inflammatory processes; and the increase of SOM, which may cause inhibitory effects on the immune response, constituting a compensatory mechanism to the exacerbated response observed in E. scophthalmi-infected turbot.

Study of the distribution of active caspase-3-positive cells in turbot, Scophthalmus maximus (L.), enteromyxosis.

Enteromyxosis caused by Enteromyxum scophthalmi is one of the parasitizations with a higher economic impact on turbot, Scophthalmus maximus (L.), aquaculture. This myxosporean produces severe catarrhal enteritis with abundant inflammatory infiltrates in the lamina propria-submucosa (LP), epithelial detachment and leucocyte depletion of the lymphohaematopoietic organs. Some advances made on the pathogenesis pointed to a role of apoptosis in the enteromyxosis. Therefore, the main aim of this work was to employ the TUNEL assay and the anti-(active caspase-3) immunohistochemical assay to detect apoptotic cells in both healthy and E. scophthalmi-infected turbot in order to establish the presence and distribution of apoptotic cells during development of the disease. More apoptotic cells located within the gastrointestinal epithelium were observed in the initial stages of the infection in E. scophthalmi-infected turbot compared with non-infected turbot. As the infection progressed, a higher degree of apoptosis occurred in the epithelium of folds heavily parasitized. In the severely infected turbot, apoptosis was also found among the leucocytes of the intestinal inflammatory infiltrates. Moreover, the number of active caspase-3-positive cells in the lymphohaematopoietic organs tended to increase with disease severity. In view of the results, increased apoptosis in the epithelium may favour the scaling that occurs during enteromyxosis and cell death of leucocytes in the intestinal LP, contributing to leucocyte depletion in severe cases.

Could a patient with SMC1A duplication be classified as a human cohesinopathy?

The disorders caused by mutations in genes encoding subunits and accessory proteins of cohesin complex are collectively termed as cohesinopathies. The best known cohesinopathy is Cornelia de Lange Syndrome (CdLS), which is a multisystem developmental disorder characterized by facial dysmorphism, limb malformations, growth and cognitive impairment. Mutations in five genes, encoding subunits of the cohesin complex (SMC1A, SMC3, RAD21) and its regulators (NIPBL, HDAC8), are responsible for ∼ 70% of CdLS cases. We describe a 16-year-old boy with facial dysmorphism, growth retardation, intellectual disability, hirsutism and small hands, who has a small Supernumerary Marker Chromosome (sSMC) present in mosaic form. sSMC is composed of two duplicated segments encompassing 17 genes including SMC1A gene, at the regions Xp11.22 and Xp11.21q11.1. Clinical comparison between our patient with a previously reported individual with a SMC1A duplication and four male carriers of similar sSMC reported in databases, suggest that they all share clinical features related to cohesinopathies. Although our patient does not have the classical CdLS craniofacial phenotype, he has pre and postnatal growth retardation, intellectual disability and mild musculoskeletal anomalies, features commonly seen in patients with cohesinopathies.

Immunohistochemical diagnosis of tenacibaculosis in paraffin-embedded tissues of Senegalese sole Solea senegalensis Kaup, 1858.

A sensitive and specific immunohistochemical technique was developed to improve the diagnosis of tenacibaculosis and to better understand its pathogenesis. Senegalese sole Solea senegalensis Kaup, 1858 were inoculated subcutaneously with a bacterial suspension of Tenacibaculum maritimum, and samples were taken at different hours post-inoculation. Sections from different organs were used as positive controls. In addition, a total of 128 field samples from different organs collected from tenacibaculosis outbreaks were used. Tenacibaculum maritimum antigens were detected in several organs of experimentally infected Senegalese sole and in at least one of the tissues from fish suffering from natural tenacibaculosis previously confirmed by culture and PCR-based methods. In fish collected during outbreaks, a strong positive reaction was detected in ulcerative skin areas. Moreover, bacterial antigen was identified inside scale pockets and in sites of the skin with mild lesion. In kidney and spleen, evident immunostaining of bacterial antigen was detected in both naturally and experimentally infected fish. Besides, the presence of T. maritimum in the intestinal tract without associated histological changes suggests that this organ may act as a reservoir for T. maritimum. The results of this study confirm the usefulness of IHC for the diagnosis of tenacibaculosis in paraffin-embedded tissues.

Esperanto for histones: CENP-A, not CenH3, is the centromeric histone H3 variant.

The first centromeric protein identified in any species was CENP-A, a divergent member of the histone H3 family that was recognised by autoantibodies from patients with scleroderma-spectrum disease. It has recently been suggested to rename this protein CenH3. Here, we argue that the original name should be maintained both because it is the basis of a long established nomenclature for centromere proteins and because it avoids confusion due to the presence of canonical histone H3 at centromeres.

Corrección intrauterina de mielomeningocele: experiencia del programa de medicina y terapia fetal del Hospital Universitario Virgen del Rocío / Intrauterine myelomeningocele repair: Experience of the fetal medicine and therapy program of the Virgen de Rocío University Hospital

La forma más frecuente de espina bífida es el mielomeningocele, para el que no existe un tratamiento postnatal óptimo. Además del trastorno motor o sensitivo dependiente del nivel de la lesión, los niños suelen tener asociada la malformación de Arnold Chiari ii. El mielomeningocele presenta una alta mortalidad y puede acompañarse, hasta en el 80-90%, de hidrocefalia que es responsable de la gran afectación neurocognitiva, precisando de derivación para su supervivencia. La reparación intrauterina de malformaciones fetales mediante acceso abierto a través de histerotomía se ha convertido en una opción terapéutica gracias a la mejora de las técnicas quirúrgicas y anestésicas, y de la correspondiente instrumentación, que han convertido este tipo de intervenciones en una práctica relativamente frecuente. El tratamiento anestésico debe orientarse tanto a la madre como al feto, siendo importante mantener controlados los factores hemodinámicos que regulan el flujo placentario, la dinámica uterina, las pérdidas sanguíneas y el bienestar fetal. Dentro de nuestro Programa de Medicina y Terapia Fetal se han realizado 21 procedimientos de cirugía fetal abierta, 17 procedimientos EXIT y 4 procedimientos para la corrección intrauterina de mielomeningocele fetal. Describimos nuestra experiencia en la corrección intrauterina de mielomeningocele fetal mediante cirugía fetal abierta (AU)

The most frequent form of spina bifida is myelomeningocele. There is no optimal postnatal treatment for this defect. In addition to the motor or sensory deficits, which depend on the location of the lesion, the defect is usually associated with Chiari ii malformation in affected children. Myelomeningocele has high mortality and, in up to 80% to 90% of patients, can be accompanied by hydrocephalus, which causes severe neurocognitive impairment and requires the patient to be shunted for survival. Intrauterine repair of fetal malformations employing open access through hysterotomy has become a therapeutic option due to improved anesthetic and surgical techniques and instrumentation, which have allowed this type of intervention to become relatively frequent. Anesthetic treatment should focus on both the mother and fetus and the hemodynamic factors regulating placental flow, uterine dynamics, blood loss and fetal well-being must remain well-controlled. Within our Program for Fetal Medicine and Therapy, 21 open fetal interventions have been performed: 17 EXIT procedures and 4 procedures for the intrauterine correction of fetal myelomeningocele. We describe our experience of the intrauterine repair of fetal myelomeningocele through open fetal surgery (AU)

Nuclear lipid droplets: a novel nuclear domain.

We investigated nuclear neutral-lipid (NL) composition and organization, as NL may represent an alternative source for providing fatty acids and cholesterol (C) to membranes, signaling paths, and transcription factors in the nucleus. We show here that nuclear NL were organized into nonpolar domains in the form of nuclear-lipid droplets (nLD). By fluorescent confocal microscopy, representative nLD were observed in situ within the nuclei of rat hepatocytes in vivo and HepG2 cells, maintained under standard conditions in culture, and within nuclei isolated from rat liver. nLD were resistant to Triton X-100 and became stained with Sudan Red, OsO4, and BODIPY493/503. nLD and control cytosolic-lipid droplets (cLD) were isolated from rat-liver nuclei and from homogenates, respectively, by sucrose-gradient sedimentation. Lipids were extracted, separated by thin-layer chromatography, and quantified. nLD were composed of 37% lipids and 63% proteins. The nLD lipid composition was as follows: 19% triacylglycerols (TAG), 39% cholesteryl esters, 27% C, and 15% polar lipids; whereas the cLD composition contained different proportions of these same lipid classes, in particular 91% TAG. The TAG fatty acids from both lipid droplets were enriched in oleic, linoleic, and palmitic acids. The TAG from the nLD corresponded to a small pool, whereas the TAG from the cLD constituted the main cellular pool (at about 100% yield from the total homogenate). In conclusion, nLD are a domain within the nucleus where NL are stored and organized and may be involved in nuclear lipid homeostasis.

[Intrauterine myelomeningocele repair: experience of the fetal medicine and therapy program of the Virgen de Rocío University Hospital]. / Corrección intrauterina de mielomeningocele: experiencia del programa de medicina y terapia fetal del Hospital Universitario Virgen del Rocío.

The most frequent form of spina bifida is myelomeningocele. There is no optimal postnatal treatment for this defect. In addition to the motor or sensory deficits, which depend on the location of the lesion, the defect is usually associated with Chiari ii malformation in affected children. Myelomeningocele has high mortality and, in up to 80% to 90% of patients, can be accompanied by hydrocephalus, which causes severe neurocognitive impairment and requires the patient to be shunted for survival. Intrauterine repair of fetal malformations employing open access through hysterotomy has become a therapeutic option due to improved anesthetic and surgical techniques and instrumentation, which have allowed this type of intervention to become relatively frequent. Anesthetic treatment should focus on both the mother and fetus and the hemodynamic factors regulating placental flow, uterine dynamics, blood loss and fetal well-being must remain well-controlled. Within our Program for Fetal Medicine and Therapy, 21 open fetal interventions have been performed: 17 EXIT procedures and 4 procedures for the intrauterine correction of fetal myelomeningocele. We describe our experience of the intrauterine repair of fetal myelomeningocele through open fetal surgery.

Spirituality and self-efficacy in dementia family caregiving: trust in God and in yourself.

BACKGROUND: Research indicates that spirituality and self-efficacy have been associated with higher levels of caregivers' well-being. However, these two concepts have rarely been examined simultaneously. The aim of this study was to analyze the combined effect of spirituality and self-efficacy on the caregiving stress process. METHODS: The study design was cross-sectional. Dementia family caregivers (n = 122) were assessed in relation to the following variables: stressors (time since caregiving began, daily hours caring, frequency of behavioral problems, patient's functional status); appraisal (caregiver's appraisal of behavioral problems), caregiver's personal resources (self-efficacy, spiritual meaning, social support), and outcomes (depression and anxiety). RESULTS: Participants were divided into four groups corresponding to four profiles defined by their scores on spiritual meaning and self-efficacy: LELS = Low self-efficacy and low spirituality; HELS = High self-efficacy and low spirituality; LEHS = Low self-efficacy and high spirituality; and HEHS = High self-efficacy and high spirituality. No differences were found between groups in stressors, appraisal, or personal resources. Caregivers in the HEHS group had significantly less depression compared to the LEHS group. Regression analysis showed that being a HEHS caregiver, low appraisal of behavioral problems and high social support were associated with low caregiver depression. Only high appraisal of behavioral problems was associated with high levels of anxiety. CONCLUSION: The results of this study suggest that spirituality and self-efficacy had an additive effect on caregivers' well-being. A high sense of spiritual meaning and a high self-efficacy, in combination, was associated with lower levels of depression in caregivers.

Estudio comparativo de eficacia y seguridad de dos protocolos antieméticos en quimioterapia ginecológica / No disponible

Objetivo: Evaluar la eficacia y seguridad de una actualización de un protocolo antiemético de quimioterapia en tumores ginecológicos. Método Estudio prospectivo, observacional, realizado durante 12 meses en un hospital general de 400 camas. Se evaluó la eficacia del protocolo antiemético antiguo, se implantó el protocolo nuevo, y se midió su eficacia. Se incluyeron pacientes con tumores ginecológicos que acudían al hospital de día. Tras cada ciclo de quimioterapia, en una encuesta, registraban el número y severidad de náuseas/vómitos y otros efectos adversos. Se midió la eficacia como respuesta completa (sin náuseas y sin vómitos) en la fase aguda (primeras 24h posquimioterapia) y en retardada (día 2-5 posquimioterapia). Se evaluó si la edad, el tipo de protocolo y el poder emetógeno de los esquemas podían influir en la respuesta. Resultados Se analizaron 102 ciclos de quimioterapia con el protocolo antiguo (52 pacientes) y 293 ciclos (98 pacientes) con el protocolo nuevo. Se encontraron diferencias significativas en la respuesta completa en la fase retardada con el protocolo nuevo (67,38 vs 36,27%), p < 0,0001. La probabilidad de obtener respuesta completa con el protocolo nuevo era dos veces mayor que con el antiguo en emesis aguda (OR=1,85; IC 95% = 1,05-3,24; p=0,03) y cuatro veces mayor en emesis retardada (OR=4,27; IC 95% = 2,59-7,02; p<0,0001). Conclusiones Con el nuevo protocolo se consiguió un mayor porcentaje de respuesta completa en la emesis retardada. La edad y el bajo poder emetógeno de los esquemas fueron factores predictivos de respuesta completa en la emesis aguda (AU)

Objectives: To evaluate the efficacy and safety of an update to an anti-emetic protocol in chemotherapy for gynecological tumours. Method: Prospective observational study performed over 12 months in a general hospital with400 beds. We evaluated the efficacy of the old anti-emetic protocol, a new protocol was implemented, and its efficacy was determined. We included patients with gynaecological tumours that sought treatment at the Day Hospital. After each chemotherapy cycle, patients filled out a survey that registered the number and severity of episodes of nausea/vomiting and other adverse effects. The efficacy of treatment was measured as complete response (no nausea orvomit) in the acute phase (first 24 h after chemotherapy) and late phase (2-5 days after chemotherapy). We also evaluated whether age, the type of protocol, and the emetogenous power of the different treatment schemes could influence patient response. Results: We analysed 102 chemotherapy cycles under the old protocol (52 patients) and293 cycles under the new protocol (98 patients). We observed significant differences in completeresponse rates in the late phase between old and new protocols (36.27% vs 67.38%, P<.0001).The probability of obtaining a complete response using the new protocol was twice as high as with the old protocol in acute emesis (OR = 1.85, 95% CI: 1.05-3.24, P=.03) and four times higherin late emesis (OR = 4.27, 95% CI: 2.59-7.02, P<.0001).Conclusions: A greater percentage of complete responses to late emesis was obtained using the new protocol. Age and the low emetogenous power of the treatment schemes were predictive factors for complete response in acute emesis (AU)

Valoración del crecimiento y tolerancia de fórmula modificado para lactantes con trastornos digestivos menores en Atención Primaria / Evaluation of growth and tolerance to modified formula for infants with minor digestive disorders in Prtimary Care

Objetivos. Analizar patrones de crecimiento, tolerancia, adherencia así como incidencia de trastornos digestivos menores y su resolución en lactantes con fórmula adaptada modificada comercializada. Pacientes y métodos. Estudio longitudinal, prospectivo, abierto y controlado en Atención Primaria. Se incluyeron lactantes sanos con indicación de lactancia artificial, grupo A (Almirón 1, fórmula adaptada) y grupo B con trastornos digestivos menores (Almirón Digest, fórmula modificada). Se registraron variables epidemiológicas y antropométricas (peso, longitud, perímetro cefálico, relación peso/longitud, perímetro cefálico, relación peso/longitud), trastornos digestivos, tolerancia, adherencia, y encuesta de satisfacción para padres/profesionales en controles (basal, al mes, 3 y 6 meses). Resultados. De noviembre 2007 a mayo 2008, 173 pediatras incluyeron a 777 lactantes, 537 en grupo A (69%) y 240 en grup B (31%). Edad de inclusión de 3,35 semanas ± 3,4 días (42% menos de 1 mes); 54% eran varones. No diferencias estadísticamente significativas entre grupos vara variables epidemiológicas, antecedentes personales, ni parámetros antropométricos en ninguna visita. El patrón de crecimiento fue adecuado según curvas de referencia. En visita basal, se observaron diferencias estadísticamente significativas entre los grupos A y B para regurgitaciones (236 lactantes, 22% versus 49,5%), disquecia (111 lactantes, 5% versus 35%), cólicos del lactantes (201 lactantes, 20% versus 81%), estreñimiento (162 lactantes, 11% versus 43%). Disminución de trastornos digestivos significativamente mayor en grupo B (p<0,001) en mes 1 y 3. No se objetivaron diferencias estadísticamente significativas, tolerancia, adherencia ni en las encuestas de satisfacción, siendo adecuadas en ambos grupos. Conclusiones. Los patrones de crecimiento fueron adecuados en ambos grupos, alcanzando curvas de referencia al finalizar el estudio. Los trastornos digestivos menores mejoran en el grupo de fórmula modificada al mes 1º y 3º del inicio de su administración. La aceptabilidad y adherencia en el grupo con fórmula modificada fueron muy satisfactorias (AU)

Objectives. To analyze growth patterns, tolerance, adherence and incidence of minor digestive disorders and their resolution in infants with mmodified comercial adapted formula. Patients and methods. A longitudinal, prospective, openlabel and controlled study in Primary Helath Care. Healthy infants with indication of artificial feeding, group A (Almiron 1, adapted formula) and group B with minor digestive disorders (Almiron Digest, modified formula) were included. Epidemiological and anthropometric variables (weight, length, head circumference, weight/length ratio), digestive disorders, tolerance, adherence and satisfaction survey for parents/professionals in the controls (baseline, at one month, 3 and 6 months) were recorderd. Results. From November 2007 to May 2008, 172 pediatricians included 777 infants, 537 in group A (69%) and 240 in group B (31%9. Inclusion age of 3.35 weeks ± days (42% younger than 1 month); 54% were males. No statistically significant differences were found between groups for epidemiological variables, personal backgrounds or anthropometric parameters in any visit. The growth pattern was adequate according to the reference curves. In the baseline visit, statistically significant differences were observed between groups A and B for regurgitations (236 infants, 22% versus 49,%), dyschezia (111 infants, 5% versus 35%), cholics in infants (201 infants, 20% versus 81%), constipation (162 infants, 11% versus 43%). Decrease of digestive disorders was significantly greater in group B (p<0.001) in months 1 and 3. No statistically significant differences were observed for tolerance, adherence or in satisfaction surveys, these being adequate in both groups. Conclusions. The growth patterns were adequate in both groups, reaching reference curves at the end of the suty. The minor digestive disorders improved in the modified formula group at month 1 and 3 of initiation of its administration. Acceptability and adherence in the modified formula group were very satisfactory (AU)