Empiema subdural y su relación con hematomas subdurales: experiencia local y revisión de la literatura / Subdural empyema and its relationship to subdural hematomas: local experience and literature review

RESUMEN: Los empiemas subdurales, tanto los de aparición espontánea o como complicación en la evolución de un hematoma subdural (HSD), son infrecuentes y de los cuales existen pocas publicaciones en la literatura(1). En este trabajo se revisa una serie de 15 casos operados en el Hospital de Urgencia Asistencia Pública (HUAP) en un período de 15 años. Se observó que en general tienen buena evolución con el tratamiento instaurado en forma oportuna y que son larvados en su presentación, pudiendo llegar a ser diagnosticados incluso en el intraoperatorio. No se observó diferencia en su evolución cuando se operaron a través de una craniectomía o de una craneotomía (plaqueta)(2). No se encontró tampoco diferencia cuando se trataron con o sin drenaje. Como consenso general, deben ser tratados con antibioticoterapia prolongada de al menos 3-4 semanas para controlar el foco infeccioso(2). Ninguno de los casos revisados requirió de reintervención.

ABSTRACT Subdural empyemas, both spontaneous or as a complication in the evolution of subdural hematomas, are an uncommon fact of which there are few publications in literature. In this review we analyze a retrospective serie of 15 cases operated in HUAP in a period of 15 years. In general we don't observed differences in the outcome using different surgical techniques, both in those treated by craniectomy as those treated by craniotomy. Also we don't observed differences in those treated with or without drainage. In the same way is clear that the optimal period of antibiotic treatment must be 3-4 weeks to fully cover them. None of the cases treated, needed reintervention.

The seeds of invasion: enhanced germination in invasive European populations of black locust (Robinia pseudoacacia L.) compared to native American populations.

Local adaptation and the evolution of phenotypic plasticity may facilitate biological invasions. Both processes can enhance germination and seedling recruitment, which are crucial life-history traits for plants. The rate, timing and speed of germination have recently been documented as playing a major role during the invasion process. Black locust (Robinia pseudoacacia L.) is a North American tree, which has spread widely throughout Europe. A recent study demonstrated that a few populations are the source of European black locust. Thus, invasive populations can be compared to native ones in order to identify genetic-based phenotypic differentiation and the role of phenotypic plasticity can thereby be assessed. A quantitative genetics experiment was performed to evaluate 13 juvenile traits of both native and invasive black locust populations (3000 seeds, 20 populations) subjected to three different thermal treatments (18 °C, 22 °C and 31 °C). The results revealed European populations to have a higher germination rate than the native American populations (88% versus 60%), and even when genetic distance between populations was considered. Moreover, this trait showed lower plasticity to temperature in the invasive range than in the native one. Conversely, other studied traits showed high plasticity to temperature, but they responded in a similar way to temperature increase: the warmer the temperature, the higher the growth rate or germination traits values. The demonstrated genetic differentiation between native and invasive populations testifies to a shift between ranges for the maximum germination percentage. This pattern could be due to human-mediated introduction of black locust.

Elevación de los marcadores de estrés oxidativo en pacientes con endometriosis / Elevation of oxidative stress biomarkers in patients with endometriosis

RESUMEN Introducción y objetivos: La endometriosis es una de las principales patologías ginecológicas que afecta a mujeres en edad reproductiva. Existen muchas teorías en cuanto a su fisiopatología destacando las alteraciones genéticas y epigenéticas, los desbalances hormonales y otros factores como la inflamación crónica y el estrés oxidativo; pero en realidad, su origen continúa siendo desconocido. Estudios recientes han implicado al estrés oxidativo y la consecuente generación de radicales libres de oxígeno en la fisiopatología de la entidad mediante la generación de inflamación crónica pélvica. El objetivo de este estudio es corroborar que existen vías de estrés oxidativo que se encuentran alteradas en estas pacientes. Métodos: Se realizará un análisis de marcadores de estrés oxidativo en plasma sanguíneo, entre ellos los niveles de proteínas carboniladas y el cociente glutatión oxidado/glutatión reducido (GSSG/GSH), comparando los resultados en pacientes con endometriosis (n=19) versus un grupo control (n=11). Resultados: existe un incremento de las proteínas carboniladas en las pacientes con endometriosis (p < 0,041). No se obtuvieron diferencias estadísticamente significativas en relación al cociente GSSG/GSH o a los niveles de GSH. Conclusión: existe evidencia para relacionar al estrés oxidativo con la fisiopatología de la endometriosis, sin poder determinar a día de hoy que vías de oxidación están implicadas.

ABSTRACT Introduction and objectives: Endometriosis is one of the main gynecological pathologies that affects women of reproductive age. There are many theories regarding its physiopathology highlighting genetic and epigenetic alterations, hormonal imbalances and other factors such as chronic inflammation and oxidative stress; but actually, its origin continues to be unknown. Recent studies have implicated oxidative stress and the consequent generation of oxygen free radicals in the physiopathology of the entity through the generation of chronic pelvic inflammation. The objective of this study is to corroborate that there are oxidative stress pathways that are altered in these patients. Methods: An analysis of oxidative stress biomarkers in blood plasma will be carried out, including carbonylated protein levels and the oxidized/reduced glutathione ratio (GSSG / GSH), comparing the results in patients with endometriosis (n = 19) versus a control group (n = 11). Results: there is an increase of carbonylated proteins in patients with endometriosis (p <0.041). There were no statistically significant differences in relation to the GSSG/GSH ratio or GSH levels. Conclusion: there is evidence to relate oxidative stress to the pathophysiology of endometriosis, without being able to determine to date which oxidation pathways are involved.

Incidence of asthma in young adults from Castellon, Spain: A prospective cohort study

Background: The objective was to estimate the incidence of asthma in young adults from 13-15 years old to 23-25 years old, and associated factors. Methods: In 2012, a population-based prospective cohort study was carried out in Castellon from the cohort who had participated in the International Study of Asthma and Allergy in Childhood in 1994 and 2002. A telephone survey was undertaken using the same questionnaires. A new case of asthma was defined as a participant free of the disease in 2002 who suffered asthma, was diagnosed with asthma, or took medications against asthma based on self-report from 2002 to 2012. Results: The mean age of participants was 24.9 ± 0.6 with a follow-up of 79.1%. Asthma cumulative incidence was 3.4%: 44 new cases occurred among 1280 participants. The incidence was higher in females than males with relative risk (RR) =2.02 (95% confidence interval [CI] 1.1-3.8). A significant decrease of asthma incidence density was observed (8.2 cases to 3.5 cases per 1000 person/year). Factors associated with the incidence of asthma were allergic rhinitis (RR = 4.05; 95% CI 1.7-9.6), bronchitis (RR = 2.13; 95% CI 1.0-4.5), mother's age at time of birth (RR=0.87; 95% CI 0.8-0.9) and a pet other than a dog or cat (RR = 0.42; 95% CI 0.2-0.9). For gender, some variations in the risk factors were observed. Conclusions: A significant decrease in the incidence of asthma was observed. Several risk and protective factors were found (AU)

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Incidence of asthma in young adults from Castellon, Spain: A prospective cohort study.

BACKGROUND: The objective was to estimate the incidence of asthma in young adults from 13-15 years old to 23-25 years old, and associated factors. METHODS: In 2012, a population-based prospective cohort study was carried out in Castellon from the cohort who had participated in the International Study of Asthma and Allergy in Childhood in 1994 and 2002. A telephone survey was undertaken using the same questionnaires. A new case of asthma was defined as a participant free of the disease in 2002 who suffered asthma, was diagnosed with asthma, or took medications against asthma based on self-report from 2002 to 2012. RESULTS: The mean age of participants was 24.9±0.6 with a follow-up of 79.1%. Asthma cumulative incidence was 3.4%: 44 new cases occurred among 1280 participants. The incidence was higher in females than males with relative risk (RR)=2.02 (95% confidence interval [CI] 1.1-3.8). A significant decrease of asthma incidence density was observed (8.2 cases to 3.5 cases per 1000 person/year). Factors associated with the incidence of asthma were allergic rhinitis (RR=4.05; 95% CI 1.7-9.6), bronchitis (RR=2.13; 95% CI 1.0-4.5), mother's age at time of birth (RR=0.87; 95% CI 0.8-0.9) and a pet other than a dog or cat (RR=0.42; 95% CI 0.2-0.9). For gender, some variations in the risk factors were observed. CONCLUSIONS: A significant decrease in the incidence of asthma was observed. Several risk and protective factors were found.

Incidence of allergic rhinitis in a cohort of young adults from 13-15 years old to 23-25 years old in Castellon (Spain)

BACKGROUND: The objective of this study was to estimate the incidence of Allergic Rhinitis (AR) in young adults and its risk or protective factors. METHODS: A population-based prospective cohort study was carried out in 2012. The cohort participated in the International Study of Asthma and Allergy in Childhood in Castellon in 1994 and 2002. A telephone survey was conducted using the same questionnaires. A new case of AR was defined as the participants free of the disease in 2002, who self-reported suffering from AR or taking medications for AR in the period 2002-2012. RESULTS: Of the 1805 schoolchildren in the cohort in 2002, 1435 young adults (23-25 years old) participated (follow-up 79.1%) in 2012; 743 were female and 692 male; their mean age was 24.9±0.6 years. Two hundred new cases of AR occurred in 1259 participants free of the disease with an incidence of 17.3 per 1000 person-years, and the incidence increased from 2002 (RR=1.42; 95% CI 1.15-1.75). The risk factors of AR adjusted by age and gender were sinusitis (RR=1.77; 95% CI 1.16-2.68), atopic dermatitis (RR=1.51; 95% CI 1.11-2.06) and constant exposure to truck traffic (RR=1.88; 95% CI 1.12-3.17). For male participants, the risk factors were asthma, sinusitis and atopic dermatitis, and for females bronchitis was a risk factor and presence of older siblings a protective factor. CONCLUSIONS: An increase in AR incidence was observed. Sinusitis, atopic dermatitis and constant exposure to truck traffic were the risk factors of the AR with some differences by gender

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Incidence of allergic rhinitis in a cohort of young adults from 13-15 years old to 23-25 years old in Castellon (Spain).

BACKGROUND: The objective of this study was to estimate the incidence of Allergic Rhinitis (AR) in young adults and its risk or protective factors. METHODS: A population-based prospective cohort study was carried out in 2012. The cohort participated in the International Study of Asthma and Allergy in Childhood in Castellon in 1994 and 2002. A telephone survey was conducted using the same questionnaires. A new case of AR was defined as the participants free of the disease in 2002, who self-reported suffering from AR or taking medications for AR in the period 2002-2012. RESULTS: Of the 1805 schoolchildren in the cohort in 2002, 1435 young adults (23-25 years old) participated (follow-up 79.1%) in 2012; 743 were female and 692 male; their mean age was 24.9±0.6 years. Two hundred new cases of AR occurred in 1259 participants free of the disease with an incidence of 17.3 per 1000 person-years, and the incidence increased from 2002 (RR=1.42; 95% CI 1.15-1.75). The risk factors of AR adjusted by age and gender were sinusitis (RR=1.77; 95% CI 1.16-2.68), atopic dermatitis (RR=1.51; 95% CI 1.11-2.06) and constant exposure to truck traffic (RR=1.88; 95% CI 1.12-3.17). For male participants, the risk factors were asthma, sinusitis and atopic dermatitis, and for females bronchitis was a risk factor and presence of older siblings a protective factor. CONCLUSIONS: An increase in AR incidence was observed. Sinusitis, atopic dermatitis and constant exposure to truck traffic were the risk factors of the AR with some differences by gender.

Sindrome de Riley Day, manifestaciones bucales: revisión de la literatura / Riley Day syndrome, oral manifestations: revision of literature

Riley Day es una rara enfermedad o transtorno hereditario que afecta el desarrollo y funcionamiento de los nervios. Ocasiona Insensibilidad al dolor, no tiene cura ni tratamiento paliativo. Se transmite de padres a hijos, la persona debe heredar una copia del gen defectuoso de cada uno de los padres para desarrollar la afecci6n. El odontopediatra debe de estar capacitado para reconocer esta enfermedad, siendo un transtorno hereditario las primeras manifestaciones clínicas y orales se van a dar des de la infancia y van a ir aumentando con la edad; por eso el pro- pósito del presente reporte es describir el caso de un niño de 2 años 4 meses con Riley day, sus manifestaciones clínicas, datos epidemio16gicos y sugerencias de manejo odontologico de los pacientes con esta enfermedad...

Riley Day is a rare hereditary disease or disorder that affects the development and functioning of nerves. It causes insensitivity to pain, has no cure or treatment paliativo. It is transmitted from parent to child, the person must inherit a defective copy of the gene from each parent to develop afeccion. The dentist should be able to recognize this disease, an inherited disorder being the first clinical and oral manifestations are to be given since childhood and will gradually increase with age; therefore the purpose of this report is to describe the case of a 2 years 4 months Riley Day, its clinical manifestations, oral manifestations, epidemiological data and suggestions for dental management of patients with this disease....

Ventilación mecánica domiciliaria en niños: estudio multicéntrico español / Domiciliary mechanical ventilation in children: a spanish multicentre study

Introducción: La ventilación mecánica domiciliaria (VMD) es una técnica cada vez más frecuente en el niño. Existen pocos estudios que hayan analizado las características y necesidades de los niños sometidos a esta técnica. Material y métodos: Estudio descriptivo observacional transversal multicéntrico de pacientes entre un mes y 16 años dependientes de ventilación mecánica domiciliaria. Resultados: Se estudiaron 163 pacientes de 17 hospitales españoles con una edad media de 7,6 años. La causa más frecuente de VMD fueron los trastornos neuromusculares. El inicio de la VMD fue a una edad media de 4,6 años. Un 71,3% recibieron ventilación no invasiva. Los pacientes con ventilación invasiva tenían menor edad, menor edad de inicio de la VMD y mayor tiempo de uso diario. El 80,9% precisaban VM solo durante el sueño, y un 11,7% durante todo el día. Únicamente un 3,4% de los pacientes tiene asistencia sanitaria externa como ayuda a la familia. Un 48,2% es controlado en consultas específicas de VMD o consultas multidisciplinares. Un 72,1% de los pacientes está escolarizado (recibiendo enseñanza adaptada un 42,3%). Solo un 47,8% de los pacientes escolarizados cuentan con cuidadores específicos en su centro escolar. Conclusiones: La VMD en niños se utiliza en un grupo muy heterogéneo de pacientes iniciándose en un importante porcentaje en los primeros 3 años de vida. A pesar de que un significativo porcentaje de pacientes tiene una gran dependencia de la VMD pocas familias cuentan con ayudas específicas tanto a nivel escolar como en el domicilio, y el seguimiento sanitario es heterogéneo y poco coordinado(AU)

Introduction: Domiciliary mechanical ventilation (DMV) use is increasing in children. Few studies have analysed the characteristics of patients using this technique. Materials and methods: An observational, descriptive, transversal, multicentre study was conducted on patients between 1 month and 16 years of age dependent on domiciliary mechanical ventilation. Results: A total of 163 patients with a median age of 7.6 years from 17 Spanish hospitals were studied. The main reasons for DMV were neuromuscular disorders. The median age at beginning of DMV was 4.6 years. Almost three-quarters (71.3%) received non-invasive ventilation. Patients depending on invasive ventilation were younger, started DMV at an earlier age, and had more hours of mechanical ventilation per day. The large majority (80.9%) used DMV during sleep time only, and 11.7% during the whole day. Only 3.4% of patients had external health assistance. Just under half (48.2%) were being followed up in specific DMV or multidisciplinary clinics. Almost three-quarters (72.1%) of patients attended school (42.3% with adapted schooling). Only 47.8% of school patients had specific caregivers in their schools. Conclusions: DMV in children is used in a very heterogeneous group of patients, and in an important number of patients it is started before the third year of life. Despite there being a significant proportion of patients with a high dependency on DMV, few families receive specific support at home or at school, and health care surveillance is variable and poorly coordinated(AU)

Atriplex atacamensis and Atriplex halimus resist As contamination in Pre-Andean soils (northern Chile).

The Pre-Andean area of Chile exhibits saline soils of volcanic origin naturally contaminated with arsenic (As), and we hypothesise that revegetation with resistant species may be a valid alternative for soil management in this area. Thus, the xerophytic and halophytic shrubs Atriplex halimus and Atriplex atacamensis were cultivated in containers for 90 days in Pre-Andean soil, As-soil, (111±19 mg As kg(-1), pH8.4±0.1) or control soil (12.7±1.1 mg As kg(-1), pH7.8±0.1) to evaluate As accumulation and resistance using stress bioindicators (chlorophylls, malondialdehyde (MDA) and total thiols). Sequential extraction of As-soil indicated that 52.3% of As was found in the most available fraction. The As distribution was significantly different between the species: A. halimus translocated the As to leaves, whilst A. atacamensis retained the As in roots. At 30 and 90 days, A. halimus showed similar As concentrations in the leaves (approximately 5.5 mg As kg(-1)), and As increased in stems and roots (up to 4.73 and 16.3 mg As kg(-1), respectively). In A. atacamensis, As concentration was lower (2.6 in leaves; 3.2 in stems and 6.9 in roots in mg As kg(-1)). Both species exhibited a high concentration of B in leaves (362-389 mg kg(-1)). If the plants are used for animal feed, it should be considered that A. halimus accumulates higher concentration of As and B in the leaves than A. atacamensis. Neither plant growth nor stress bioindicators were negatively affected by the high levels of available As, with the exception of MDA in the leaves of A. halimus. The results indicate that these plants resist contamination by arsenic, accumulating mainly the metalloid in the roots and can be recommended to generate plant cover in As-contaminated soils in the Pre-Andean region, under saline conditions controlled, preventing the dispersion of this metalloid via wind and leaching.

[Domiciliary mechanical ventilation in children: a Spanish multicentre study]. / Ventilación mecánica domiciliaria en niños: estudio multicéntrico español.

INTRODUCTION: Domiciliary mechanical ventilation (DMV) use is increasing in children. Few studies have analysed the characteristics of patients using this technique. MATERIALS AND METHODS: An observational, descriptive, transversal, multicentre study was conducted on patients between 1 month and 16 years of age dependent on domiciliary mechanical ventilation. RESULTS: A total of 163 patients with a median age of 7.6 years from 17 Spanish hospitals were studied. The main reasons for DMV were neuromuscular disorders. The median age at beginning of DMV was 4.6 years. Almost three-quarters (71.3%) received non-invasive ventilation. Patients depending on invasive ventilation were younger, started DMV at an earlier age, and had more hours of mechanical ventilation per day. The large majority (80.9%) used DMV during sleep time only, and 11.7% during the whole day. Only 3.4% of patients had external health assistance. Just under half (48.2%) were being followed up in specific DMV or multidisciplinary clinics. Almost three-quarters (72.1%) of patients attended school (42.3% with adapted schooling). Only 47.8% of school patients had specific caregivers in their schools. CONCLUSIONS: DMV in children is used in a very heterogeneous group of patients, and in an important number of patients it is started before the third year of life. Despite there being a significant proportion of patients with a high dependency on DMV, few families receive specific support at home or at school, and health care surveillance is variable and poorly coordinated.

Efectos hipoalgésicos y de movilidad cervical tras la manipulación vertebral cervical o la manipulación vertebral dorsal en pacientes con cervicalgia mecánica subaguda: estudio piloto / Hypoalgesic and cervical motion effects after a cervical spine or thoracic spine manipulation in subjects with subacute mechanical neck pain: a pilot study

Objetivo Comparar el efecto en el dolor, movilidad cervical y umbral de dolor a la presión después de una manipulación vertebral cervical o dorsal en pacientes con cervicalgia mecánica subaguda. Métodos Se realizó un estudio piloto aleatorizado a simple ciego. Los pacientes fueron asignados aleatoriamente dentro del grupo de manipulación cervical (n=9) o al grupo de manipulación dorsal (n=9). Las variables medidas fueron el dolor en reposo del paciente (escala visual analógica), rango de movilidad cervical y el umbral de dolor a la presión, antes y 5min después de la intervención por un evaluador ciego. Las comparaciones intragrupales e intergrupales se realizaron con el análisis de varianza (ANOVA) y la prueba de la t de Student. Resultados Dieciocho pacientes, 7 varones y 11 mujeres, con dolor mecánico subagudo de cuello participaron en el estudio. Los cambios intragrupales mostraron una mejora estadísticamente significativa en el dolor de cuello, movilidad cervical y los umbrales de dolor a la presión en ambos grupos (p<0,05). La comparación inter-grupal del efecto no mostró diferencias significativas entre los grupos en ninguna de las variables medidas (p>0,05). Por tanto, ambos grupos mostraron una mejoría similar en las variables. Conclusiones Nuestros resultados sugieren que una manipulación cervical y dorsal produce un efecto similar en la disminución del dolor e incremento del rango de movilidad activo y umbrales de dolor mecánico en pacientes con cervicalgia mecánica subaguda. Se necesitan ensayos clínicos aleatorizados con una muestra de pacientes mayor para confirmar nuestros resultados (AU)

Purpose To compare the immediate effects on neck pain, active cervical range of motion and pressure pain thresholds after a single cervical or thoracic spine manipulation in patients with subacute mechanical neck pain. Methods A randomized single-blinded pilot study was conducted. Subjects were divided randomly into either a cervical spine manipulation group (n=9) or a thoracic spine manipulation group (n=9). Outcome measures were neck pain at rest (visual analogue scale), active cervical range of motion and pressure pain thresholds over C5-C6 zygapophyseal joints and both lateral epicondyles, before treatment and 5minutes after treatment by an assessor blinded to the treatment allocation. Intragroup and intergroup comparisons were made with different analyses of variance (ANOVA) and the T-student test. Results Eighteen patients, 7 males and 11 females, with subacute mechanical neck pain participated. Within-group changes showed a significant improvement in neck pain, cervical mobility and pressure pain thresholds in both groups (p<.05). The intergroup comparison did not show significant differences between either manipulative group s in any of the measures (p>.05). Therefore, both groups exhibited similar improvements in the outcomes. Conclusions Our results suggest that a single cervical spine manipulation or a single thoracic thrust spine manipulation produce similar effects in reducing neck pain at rest and in increasing active cervical range of motion and segmental pressure pain thresholds in individuals with sub-acute mechanical neck pain. Future randomized clinical trials with greater sample sizes are now needed to further confirm our results (AU)

Sodium caseinate induces mouse granulopoiesis.

OBJECTIVE AND DESIGN: Sodium caseinate (CasNa) induces differentiation and M-CSF production in mouse band granulocytes in vitro; however, it is not yet known if this molecule can also induce the proliferation and activation of the granulocyte lineage in vivo. In this work we evaluated the induction in vivo of granulopoiesis and the activation of granulocytes in mice treated with CasNa. MATERIAL OR SUBJECTS: BALB/c male mice 8-12 weeks old were used. TREATMENT: The animals were inoculated intraperitoneally with 1 ml of CasNa (10% in PBS p/v) four times (every 48 h). METHODS: Granulocyte proliferation was evaluated by flow cytometry; activation was evaluated by phagocytic indices. The cytokine was measured using an ELISA assay. RESULTS: We show that CasNa increased bone marrow granulopoiesis percentage (38.35 ± 10.88 vs. 64.94 ± 34.14 BrdU+/Gr-1+ cells) and the granulocytes generated presented increased phagocytic indices (0.3 ± 0.1 vs. 0.6 ± 0.11, p < 0.05). We also show that G-CSF (974 ± 411 vs. 3189 ± 350 pg/ml, p < 0.05) and GM-CSF increased in serum, but only G-CSF in bone marrow plasma. CONCLUSIONS: CasNa induces granulopoiesis with functional granulocytes, suggesting that this molecule could be an innate immune system activator.

Prevalencia de las úlceras por presión en una zona rural de la provincia de Cádiz / Prevalence of pressure ulcers in a rural area of province of Cadiz

Introducción. Las úlceras por presión (UPP) son una enfermedad frecuente en muchos países del mundo, que repercute directamente en la calidad de vida del enfermo y sus cuidadores, y que genera un alto coste sociosanitario. Nos hemos propuesto como objetivo conocer la prevalencia de las úlceras por presión y otros factores asociados en nuestra zona de trabajo. Material y métodos. Hemos realizado un estudio observacional transversal en el Municipio de Paterna de Rivera (Cádiz). Participantes son los pacientes incluidos en el Programa de Asistencia Domiciliaria (PAD) (n=86). Se ha disenado un cuestionario específico con variables sociosanitarias. Para la determinación del riesgo de desarrollar UPP se utilizó la Escala de Braden. Para la estadificación de dichas úlceras se usó la escala recomendada por el Grupo Nacional para el Estudio y Asesoramiento en Úlceras por Presión y Heridas Crónicas (GNEAUPP), que ha adoptado la de la National Pressure Ulcers Advisory Panel (NPUAP). El denominador para el cálculo de la prevalencia ha sido el número de pacientes incluidos en el PAD. Resultados. Hay 86 pacientes incluidos en el PAD. El 66,6% son mujeres. La media de edad es 77,7±12 años. El principal grupo patológico para la inclusión en el PAD fue el osteoarticular, en el 37% de los casos (32 pacientes). El cuidador principal es la hija con el 51% y una media de edad de 52,2±13,7 años. El riesgo de desarrollar UPP (Escala de Braden) fue: «alto» en el 9% de los pacientes, «moderado» en el 29% y «bajo» en el 62%. La prevalencia de UPP fue del 9,3%. La localización de las lesiones fue en orden decreciente de frecuencia: sacro, trocánter, talón, escápula, maléolo y mama. Según la severidad de las lesiones, predomina el estadio III con un 37,5% de afectados. La media de antigüedad de las lesiones fue 9,6±7,1 meses. Entre las medidas preventivas sólo el 12,8% de los cuidadores reconocen hacer cambios posturales frecuentes. Conclusiones. La prevalencia de UPP en nuestro municipio es intermedia. Hemos observado la existencia de diversas metodologías de estudio de este problema de salud. Vamos a proponer en nuestra área de influencia un protocolo de prevención y tratamiento para mitigar en lo posible el problema abordado (AU)

Introduction. Pressure ulcers (PU) is a condition prevalent in many countries around the world that directly affects the quality of life of the patient, their caregivers, and also leads to high health and social welfare costs. The objective of this study is to determine the prevalence of PU and other associated factors. Material and methods. An observational cross-sectional study was conducted in the municipality of Paterna de Rivera (Cadiz). Participants were patient included in the Home-Care Services (n=86). A specific Questionnaire with health and social welfare variables was designed. The Braden scale was used to determine the risk of developing PU. The scale recommended by the National Group for the Study and Advice on Pressure Ulcers and Chronic Wounds (GNEAUPP), which has adopted the National Pressure Ulcers Advisory Panel (NPUAP), was used to stage the ulcers. The denominator for calculating the prevalence was the number of patients included in the Home-Care Services Program. Results. A total of 86 patients were included in the HCP, of which 66.6% were women. The mean age was 77.7±12 years. The main disease group for inclusion in the HCP was osteoarticular in 37% of the cases (32 patients). The main carer was the daughter (51%) with a mean age of 52.2±13.7 years. The risk of developing PU (Braden Scale) was: high in the 9% of the patients, moderate in the 29%, and low in 62%. The prevalence of PU was 9.3%. The location of the wound was, in descending order of frequency: sacrum, trochanter, heel, scapula, ankle and breast. The severity of the wounds was predominantly Stage III in 37.5% of those affected. The mean age of the wound was 9.6±7.1 months. Among the preventive measures, only 12.8% of the caregivers knew about making frequent posture changes. Conclusions. PU prevalence PU in this municipality was considered intermediate. We have noted that there are various methodologies to study this health problem. We are going to propose, in our area of influence, a protocol on prevention and treatment to mitigate this problem insofar as is possible (AU)

L-tryptophan supplementation can decrease fatigue perception during an aerobic exercise with supramaximal intercalated anaerobic bouts in young healthy men.

Physical exercise is often terminated not due to muscle fatigue but because of inadequate neural drive in the serotonergic system. Modifications in activity levels of the serotonergic system, induced by variations in the availability of L-tryptophan (a serotonin precursor) may alter neural drive. We examined the effect of L-tryptophan supplementation on physical performance by combining aerobic work with brief periods of supramaximal intensity that closely mimics the activity typical of team sports. Twenty healthy young sportsmen (mean age 21.2 +/- 0.7 years) performed a submaximal exercise on a cycle ergometer, with a workload corresponding to 50% of their respective VO(2) max for 10 min, followed by a maximal intensity exercise for 30 s. This sequence was repeated three times and, after the fourth series, each participant continued to exercise at the highest speed that he could sustain for 20 min. This protocol was performed twice: once with and finally without supplementation of L-tryptophan, in random order and double-blind. Peak power output, average anaerobic power output, and power output during the last 20 min of the trial were higher on the trials performed with L-tryptophan supplementation than on those performed with placebo. The distance covered during the last 20 min of the trial was 11,959 +/- 1,753 m on placebo and 12,526 +/- 1,617 m on L-tryptophan (p < .05). In conclusion, in some types of exercises, modification of the serotonergic system may improve the physical performance.

Vitreous levels of interleukine-8 and monocyte chemoattractant protein-1 in macular oedema with branch retinal vein occlusion.

PURPOSE: To investigate whether interleukine-8 (IL-8) and monocyte chemoattractant protein-1 (MCP-1) are related with macular oedema in patients with branch retinal vein occlusions (BRVOs). DESIGN: Retrospective case-control study. PARTICIPANTS: Nineteen patients who had macular oedema due to BRVO and nine patients with non-ischaemic ocular diseases (control group). METHODS: Macular oedema was examined by optical coherence tomography. Both venous blood and vitreous samples were obtained at the time of vitreoretinal surgery. IL-8 and MCP-1 levels in vitreous fluid and plasma were determined with enzyme-linked immunosorbent assay kits. Variables were compared with the Mann-Whitney U-test, Wilcoxon's signed-ranked test, and the chi2-test, when appropriate. To examine correlations, Spearman's rank-order correlation coefficients were calculated. Statistical significance was set at P<0.05. RESULTS: The vitreous fluid levels of IL-8 (median: 63.5 pg/ml) and MCP-1 (median: 1522.4 pg/ml) were significantly higher in the patients with BRVO than in the control group (median: 5.1 and 746.5 pg/ml respectively; P<0.001 and <0.001 respectively). Vitreous IL-8 and MCP-1 were significantly correlated in patients with BRVO (P=0.009). CONCLUSIONS: Both IL-8 and MCP-1 were elevated in the vitreous fluid of patients with BRVO and macular oedema. Both chemokines may contribute to the pathogenesis of macular oedema in patients with BRVO.

Suspensión de la anticoagulación en pacientes con síndrome antifosfolipídico primario en los que se negativizan los anticuerpos antifosfolipídicos / No disponible

No disponible

Remobilization of leaf S compounds and senescence in response to restricted sulphate supply during the vegetative stage of oilseed rape are affected by mineral N availability.

The impact of sulphur limitation on the remobilization of endogenous S compounds during the rosette stage of oilseed rape, and the interactions with N availability on these processes, were examined using a long-term (34)SO(4)(2-) labelling method combined with a study of leaf senescence progression (using SAG12/Cab as a molecular indicator) and gene expression of the transporters, BnSultr4;1 and BnSultr4;2, involved in vacuolar sulphate efflux. After 51 d on hydroponic culture at 0.3 mM (34)SO(4)(2-) (1 atom% excess), the labelling was stopped and plants were subject for 28 d to High S-High N (HS-HN, control), Low S-High N (LS-HN) or Low S-Low N (LS-LN) conditions. Compared with the control, LS-HN plants showed delayed leaf senescence and, whilst the shoot growth and the foliar soluble protein amounts were not affected, S, (34)S, and SO(4)(2-) amounts in the old leaves declined rapidly and were associated with the up-regulation of BnSultr4;1. In LS-LN plants, shoot growth was reduced, leaf senescence was accelerated, and the rapid S mobilization in old leaves was accompanied by decreased (34)S and SO(4)(2-), higher protein mobilization, and up-regulation of BnSultr4;2, but without any change of expression of BnSultr4;1. The data suggest that to sustain the S demand for growth under S restriction (i) vacuolar SO(4)(2-) is specifically remobilized in LS-HN conditions without any acceleration of leaf senescence, (ii) SO(4)(2-) mobilization is related to an up-regulation of BnSultr4;1 and/or BnSultr4;2 expression, and (iii) the relationship between sulphate mobilization and up-regulation of expression of BnSultr4 genes is specifically dependent on the N availability.

Evaluation of the quality of four Mexican drug products containing sodium naproxen.

BACKGROUND: There is currently a lot of concern about the quality and therapeutic effectiveness of Mexican pharmaceutical products, and considerable price differences between alternative products containing the same active principle. OBJECTIVE: To establish whether four Mexican drug products, a high price and three lower-cost branded drug products containing sodium naproxen (550 mg immediate release tablets) have equivalent, and consistent pharmaceutical qualities. METHODS: The four products were acquired in Mexico city. Assay for sodium naproxen, content uniformity, disintegration time and dissolution tests were performed according to USP procedures. Drug dissolution profiles were compared using a similarity factor (f(2)). RESULTS AND DISCUSSION: All of the tested products met pharmacopeial quality standards with respect to their active pharmaceutical content and a released drug percentage >70% in 45 min. Lot-to-lot lack of similarity between drug dissolution profiles was observed for two of the products tested. CONCLUSION: There was no significant differences in the quality of the pharmaceutical products tested when judged by the USP pharmaceutical quality standards. However, some differences were observed in the dissolution profiles of the brands tested. Whether these differences are clinically meaningful requires in vivo bioequivalence studies.