Reduction of NrF2 as coadjuvant during the development of persistent periapical lesions.

BACKGROUND: Persistent periapical lesions (PPL) are the result of pulpar necrosis induced by bacterial infection resulting in bone degradation and culminating with the loss of dental piece. Pathological changes in the peripapice are associated with the presence of free radicals. The transcription factor Nrf2 is the main regulator of the endogenous antioxidant response against oxidative stress and has been implicated in the regulation of osteoclastogenesis.The aim is to determine the oxidative condition in samples from patients with Persistent Periapical Injuries as a detonating factor of tissue damage. MATERIAL AND METHODS: An observational, descriptive, cross-sectional study was carried out in samples with PPL (cases) and samples by removal of third molars (controls) obtained in the clinic of the specialty in endodontics, University of Guadalajara. Samples were submitted to histological staining with Hematoxylin-Eosin, lipoperoxide analysis, Superoxide Dismutase (SOD), Glutathione-Peroxidase (GPx) and Catalase (CAT) activities were determined by immunoenzymatic assays and NrF2 by Western Blot analysis. RESULTS: Samples from PPL patients histologically showed an increased presence of lymphocytes, plasma cells, and eosinophils, as well as a decrease in extracellular matrix proteins and fibroblast cells. There was a rise in lipid peroxidation, GPx and SOD activities, but an important decline (36%) in Catalase activity was observed (p<0.005); finally, NrF2-protein was diminished at 10.41%. All comparisons were between cases vs controls. CONCLUSIONS: The alterations in antioxidants endogenous NrF2-controlled are related to osseous destruction in patients with PPL.

Evolución de la vacunación frente al meningococo del serogrupo B: ¿qué ha cambiado a lo largo de 5 años? / Evolution of vaccination against serogroup B meningococcus: what has changed over 5 years?

Introducción: la infección por meningococo del serogrupo B puede provocar enfermedad meningocócica invasiva, con un 20-30% de secuelas y hasta un 10% de mortalidad. Material y métodos: estudio observacional, descriptivo y retrospectivo de vacunación frente al meningococo del serogrupo B en la población pediátrica del Sector I de Zaragoza desde octubre de 2015 hasta diciembre de 2019. Se estudió: edad de inicio de la vacunación, edad a la fecha de la primera dosis (≤3 meses, 4-11 meses, 12-23 meses, 2-9 años, 10-16 años), sexo, centro de salud (CS) y número de dosis recibidas. Resultados: se vacunó a 11 776 pacientes, de los cuales un 51,6% fueron varones. Presentaron una edad media de inicio de vacunación a los 5,0 ± 4,4 años y 2,2 ± 0,6 dosis recibidas. La distribución del total de vacunados fue muy variada, con una diferencia del 17,8% entre el CS con más vacunados y el CS con menos vacunados. El 0,7% recibieron primera dosis en 2015, el 23,8% en 2016, el 38% en 2017, el 26,7% en 2018 y el 10,8% en 2019. El 12% tenía ≤3 meses al inicio de la vacunación, el 11,5% tenía 4-11 meses, el 6,7% tenía 12-23 meses, el 50,4% 2-9 años y el 19,5% 10-16 años, existiendo diferencias en relación con la fecha de primera dosis (p = 0,000). El 2017 cuenta con mayor incidencia de vacunación global (12,2%), aunque en lactantes fue superior en 2018 (42,1%) y en los grupos de 2-9 años y adolescentes en 2017: el 15,8 y el 5,4% respectivamente. La incidencia global acumulada fue 32,5%, siendo en lactantes de 133,5%. Conclusiones: a pesar de las prometedoras cifras de incidencia acumulada, encontramos numerosas diferencias de vacunación entre grupos de edad y CS, por lo que resulta interesante la vacunación sistemática y financiada de meningococo B (AU)

Introduction: infection by serogroup B meningococcus can cause invasive meningococcal disease, with development of sequelae in 20-30% of cases and a mortality of up to 10%.Material and methods: observational, descriptive and retrospective study of vaccination against serogroup B meningococcus in the paediatric population of health sector I of Zaragoza between October 2015 and December 2019. We analysed the age at primary vaccination, age group at time of first dose (≤3 months, 4-11 months, 12-23 months, 2-9 years, 10-16 years), sex, primary care centre (PCC) and number of received doses.Results: 11 776 patients were vaccinated, of who 51.6% were male. The mean age at initiation of vaccination was 5.0 ± 4.4 years, and they received a mean of 2.2 ± 0.6 doses. The distribution of vaccinated patients by PCC was heterogeneous, with a difference of 17.8% between the centre with the most vaccinated patients and the centre with the least. Of all patients, 0.7% received the first dose in 2015, 23.8% in 2016, 38% in 2017, 26.7% in 2018 and 10.8% in 2019. Twelve percent were aged 3 months or less when they received the first dose, 11.5% 4-11 months, 6.7% 12-23 months, 50.4% 2-9 years and 19.5% 10-16 years, with differences based on the date of the first dose (p = 0.000). The highest frequency of overall vaccination corresponded to 2017 (12.2%), although in children under 2 years it was higher in 2018 (42.1%) and in children aged 2-9 years and adolescents it was highest in 2017: 15.8% and 5.4%, respectively. The cumulative frequency of vaccination was 32.5% in the overall sample and 133.5% in the group aged less than 2 years.Conclusions: although we found promising cumulative vaccination rates, there were numerous differences in vaccination between age groups and PCCs, which is why publicly funded routine vaccination against meningococcus B is worth contemplating. (AU)

Eccema coxsackium en pacientes con dermatitis atópica / Coxsackium eczema in patients with atopic dermatitis

El eccema coxsackium es una dermatosis infecciosa caracterizada por lesiones papulovesiculosas, eccematosas e incluso costrosas de predominio en extremidades, nalgas y región perioral. Suele aparecer en pacientes con afectación cutánea previa, como es el caso de la dermatitis atópica de los niños. El germen causante más frecuentemente aislado es el Coxsackie A6. Está considerado como una forma atípica de la enfermedad mano-pie-boca y es importante un correcto diagnóstico diferencial para evitar tratamientos innecesarios (AU)

Eczema coxsackium is an infectious dermatosis characterized by papulovesicular, ezzematous and even crusty lesions predominantly on the extremities, buttocks and perioral region. It usually appears in patients with previous skin involvement, as in the case of atopic dermatitis in children. The most frequently isolated causative germ is Coxsackie A6. It is considered an atypical form of Hand, Foot and Mouth Disease and a correct differential diagnosis is important to avoid unnecessary treatments. (AU)

Randomized clinical trial of nutritional counseling for malnourished hospital patients. / Ensayo clínico aleatorizado del asesoramiento nutricional en pacientes desnutridos hospitalizados.

INTRODUCTION: Malnutrition is associated with an increased risk of mortality and morbidity, longer hospital stays and general loss of quality of life. The aim of this study is to assess the impact of dietary counseling for malnourished hospital patients. PATIENTS AND METHODS: Prospective, randomized, open-label study of 106 hospital patients with malnutrition (54 in the control group and 52 in the intervention group). The intervention group received dietary counseling, and the control group underwent standard treatment. We determined the patients' nutritional state (body mass index, laboratory parameters, malnutrition universal screening tool), degree of dependence (Barthel index), quality of life (SF-12), degree of satisfaction (CSQ-8), the number and length of readmissions and mortality. RESULTS: The patients who underwent the "intervention" increased their weight at 6 months, while the controls lost weight (difference in body mass index, 2.14kg/m(2); p<.001). The intervention group had better results when compared with the control group in the Malnutrition Universal Screening Tool scores (difference, -1.29; p<.001), Barthel index (difference, 7.49; p=.025), SF-12 (difference, 13.72; p<.001) and CSQ-8 (difference, 4.34, p<.001) and required fewer readmissions (difference, -0.37; p=.04) and shorter stays for readmissions (difference, -6.75; p=.035). Mortality and laboratory parameters were similar for the 2 groups. CONCLUSIONS: Nutritional counseling improved the patients' nutritional state, quality of life and degree of dependence and decreased the number of hospital readmissions.

[Vaccines and preventive activities in patients with inflammatory arthritis]. / Vacunas y actividades preventivas en pacientes con artritis inflamatorias.

Patients with inflammatory arthritis and eligible for immunosuppressive therapy account for more than 1% of general population, and represents a significant workload on family doctors. They are prone to other comorbidities, with an increased cardiovascular risk and a higher incidence of infections than the general population, especially skin infections and pneumonitis. This comorbidity can be considered vulnerable to a prevention program-prevention of cardiovascular risk, cancer screening, vaccination schedule for adults. As for prevention through vaccination, importance should be given to pneumococcal infection - significant in adults aged 50 or over, especially amongst immunosuppressed patients. The 13-valent conjugate vaccine, which has been recently approved for adults, must be considered. An attempt has been made to write a simple, applicable document on preventive measures that should be implemented both at primary and secondary care level for those adults.

First Report of Fragaria chiloensis cryptic virus, Fragaria chiloensis latent virus, Strawberry mild yellow edge virus, Strawberry necrotic shock virus, and Strawberry pallidosis associated virus in Single and Mixed Infections in Strawberry in Central Mexico.

For phytosanitary purposes, the prevalence and incidence of viruses found in strawberry production within a centralized breeding program was investigated in Abasolo and Irapuato Counties, Guanajuato State, Mexico. Single and mixed infections of Strawberry mottle virus (SMoV) and Strawberry crinkle virus (SCV) were originally reported in the area (3), and subsequently, Strawberry latent ringspot virus (SLRSV) was also found (4). Samples of strawberry plants showing viral symptoms: stunting, mild chlorosis and reddening, occasional wrinkled, curled, and deformed leaves that may exhibit mottling, and chlorotic spots, forming a putative virus complex were collected in April and December 2007 and July and December 2008. The detection and identification of viruses reported in the United States, the country of origin of most of the imported plantlets, was carried out with sets of primers for 11 viruses, through reverse transcription (RT)-PCR (developed by Robert Martin and Ioannis Tzanetakis in Corvallis, OR). The endogenous NADH 2 subunit was employed to test the quality of the RNA extracted. Amplification conditions were: 40 cycles of 1 min at each temperature, denaturation at 95°C, annealing at 50°C for Strawberry necrotic shock virus (SNSV); 52°C for Strawberry mild yellow edge virus (SMYEV); 55°C for Fragaria chiloensis latent virus (FClLV), Strawberry pallidosis associated virus (SPaV), Fragaria chiloensis cryptic virus (FClCV), and SMoV; and 58°C for SCV and NADH dehydrogenase, followed by a final extension at 72°C of 5 min after completion of the 40 cycles. The cloning and nucleotide sequencing of amplified fragments revealed the presence of seven viral species in 40 samples collected. These were FClLV, SCV, SMoV, SNSV, SPaV, and SMYEV, which were allocated GenBank accession numbers of JQ629412, JQ629413, JQ629414, JQ629415, JQ629416, and JQ629417, respectively. Strawberry UC-4 and UC-10 (1,2) were planted as indicators of viral infections on an experimental plot. All seven viruses were detected in single or mixed infections. SMoV was the most commonly found in combination with other viruses. Out of 40 samples, 35 were positive for the presence of viruses and six had single infections, of which five had SMoV and one had SPaV. The remaining 29 samples had mixed infections with two or more viruses in a total of 22 combinations. The combination of FCICV + SMoV was present in five samples, whereas the combination of SMoV + SMYEV was in two samples. All other samples had two and up to six different viruses per plant. SMoV was detected in 26 out of the 40 samples tested. SNSV and FClCV were detected in 14 samples. SMYEV was present in 13 samples. SCV was present in nine samples, whereas SPaV and FClLV were found in eight samples each. To the best of our knowledge, this is the first report of FClLV, FClCV, SNSV, SMYEV, and SPaV in Mexico. References: (1) N. W. Frazier. Plant Dis. Rep. 58:28, 1974. (2) N. W. Frazier. Plant Dis. Rep. 58:203, 1974. (3) D. Teliz-Ortiz and A. Trejo-Reyes. Rev. Mex. Fitopatol. 7:38, 1989. (4) L. Pérez-Moreno et al. Rev. Mex. Fitopatol. 22:187, 2004.

Valoración de las necesidades de los ancianos que viven solos en una zona básica de salud / Evaluation of the situation of the elderly who live alone in a health zone

Objetivo. Conocer cuáles son las necesidades de los ancianos que viven solos y que presentan algún grado de dependencia para las actividades de la vida diaria. Método. Estudio descriptivo transversal, realizado en el centro de salud urbano San Andrés-Torcal (Málaga). Se han estudiado las personas mayores de 65 años que vivían solas y en las que se había detectado la existencia de dependencia. Resultados. Muestra de 64 personas, 58 mujeres y 6 varones, con una media de edad de 83,3 años (desviación estándar: 4,13). Dieciséis personas consiguen autonomía asistida por otras personas (25%); mientras que siguen sin tener una o más necesidades cubiertas 48 (75%). Diagnósticos enfermeros más frecuentes: deterioro de la movilidad física, 58; riesgo de caídas, 54; déficit de actividades recreativas, 48; deterioro de la eliminación urinaria, 38; aislamiento social o deterioro de la interacción social, 36.Tienen familia 56 personas. La mitad no tiene contacto con sus vecinos, no reciben visitas 12 (18,8%), y no tienen a quien contar sus problemas 26 (40,6%). Hay barreras arquitectónicas en la vivienda en 48 casos y en el acceso al domicilio en 29. El total de la muestra recibe una pensión de entre 301 y 600 euros. Conclusiones. Las personas valoradas presentan numerosas áreas de dependencia y hay una alta proporción cuyas necesidades básicas no son cubiertas de forma adecuada. Por los múltiples y distintos problemas que presentan estas personas, consideramos necesario realizar una captación activa de esta población vulnerable, así como la realización de una atención diferenciada y ofrecer la ayuda necesaria para que puedan tener información y acceso a los recursos disponibles, tanto sanitarios como sociales (AU)

Objective. To determine the needs of elderly individuals living alone and with some degree of dependency for activities of daily live. Method. We performed a cross-sectional descriptive study in an urban health center (San Andrés-Torcal in Málaga, Spain). Personsaged more than 65 years old who lived alone and had some degree of dependency were studied. Results. The sample was composed of 64 elderly individuals, 58 women and 6 men. The mean age was 83.3 years (SD 4.13). Sixteen people (25%) were independent for daily living when aided by others, while 48 (75%) had one or more needs that were not covered. The most frequent nursing diagnoses were: impaired physical mobility in 58, risk of falls in 54, diversional activity deficit in 48, impaired urinary elimination in 38, and social isolation or deterioration in social interaction in 36. Fifty-six individuals had family. Half had no contact with neighbors, 12 (18.8%), did not receive visits, and 26 (40.6%) had nobody to whom they could tell their problems. Architectonic barriers to the house were identified in 48 individuals and access barriers to the home were found in 29. The total sample received a pension of between 301 and 600 euros. Conclusions. The persons evaluated showed numerous areas of dependency and there was a high proportion whose basic needs were not suitably covered. Because of the multiple and distinct problems identified, we believe that active screening should be performed in this vulnerable population. In addition, special attention should be paid to these individuals and the required help should be offered so that they have information and access to the available health and social resources (AU)

[Nursing diagnosis of risks. Analysis of cost effectiveness]. / Diagnósticos de enfermería sobre riesgos. Análisis coste-efectividad.

BACKGROUND: Today, there is a discussion on the importance of the utilization of the nursing diagnosis: This makes convenient to evaluate the principal two existing methodological alternatives, that they are: 1) the problems identification, 2) the diagnoses statement of the NANDA within process nursing. The study is centered on the risk diagnoses. OBJECT: 1) To know which the two work methodologies is more effective. 2) To know if exist economic differences. METHODS: It is accomplished a cohorts study, in a population of user included in Program of Handicapped. These were studied during a year. RESULTS: In the group of patients without diagnoses the incidence rate was of 0.64 conversions/person-year), in the group with diagnoses was of 0.22 (p < 0.001). The mean of visits after that the is made real, in the group with diagnoses was of 0.35, in the group without diagnoses of 1.69 (p = 0.012). DISCUSSION: The analysis cost-efficiency of the two work methodologies is clearly more favorable for the methodology than states nursing diagnosis of the taxonomy of the NANDA.

Factores que influyen en la aparición de malformaciones congénitas en un área de salud / Factors that influence in the appearance of congenital malformations in a health area

Se realizó un estudio analítico, retrospectivo y longitudinal, de caso control, de un universo integrado por 257 niños de 0 a 15 años, con una o más malformaciones congénitas, y los cuales fueron pareados con igual cantidad de niños de la misma edad y sexo, sin dichas malformaciones, que vivían en la misma cuadra y lo más cercano posible al afectado. La información fue recogida mediante una encuesta personal aplicada a la madre, padre o tutor en ambos grupos. Se procedió a determinar el riesgo relativo y la fracción etiológica del riesgo para cada factor donde fue posible calcularlo y se halló una frecuencia de malformaciones congénitas de 2,4 por ciento, con predominio en los varones de 1 a 4 años, que afectaban funadamentalmente el sistema osteomioarticular, el aparato genitourinario y el sistema cardiovascular, en ese orden. Los antecedentes maternos de hijos anteriores malformados, el bajo nivel de escolaridad de la madre, la exposición a riesgos físico-químicos y los antecedentes de malformación en la familia de los progenitores, constituyeron factores que pudieron relacionarse de manera casual con la presencia de malformaciones congénitas.Durante el embarazo, el uso de medicamentos en el primer trimestre y la exposición a rayos x en el primer y segundo trimestre se asociaron significamente con la aparaición de estas anomalías. El estudio de la fracción etiológica permitió inferir que se podría disminuir la frecuencia de malformaciones hasta en un 50 por ciento si se lograra controlar estos factores

Factores que influyen en la aparición de malformaciones congénitas en un área de salud / Factors that influence in the appearance of congenital malformations in a health area

Se realizó un estudio analítico, retrospectivo y longitudinal, de caso control, de un universo integrado por 257 niños de 0 a 15 años, con una o más malformaciones congénitas, y los cuales fueron pareados con igual cantidad de niños de la misma edad y sexo, sin dichas malformaciones, que vivían en la misma cuadra y lo más cercano posible al afectado. La información fue recogida mediante una encuesta personal aplicada a la madre, padre o tutor en ambos grupos. Se procedió a determinar el riesgo relativo y la fracción etiológica del riesgo para cada factor donde fue posible calcularlo y se halló una frecuencia de malformaciones congénitas de 2,4 por ciento, con predominio en los varones de 1 a 4 años, que afectaban funadamentalmente el sistema osteomioarticular, el aparato genitourinario y el sistema cardiovascular, en ese orden. Los antecedentes maternos de hijos anteriores malformados, el bajo nivel de escolaridad de la madre, la exposición a riesgos físico-químicos y los antecedentes de malformación en la familia de los progenitores, constituyeron factores que pudieron relacionarse de manera casual con la presencia de malformaciones congénitas.Durante el embarazo, el uso de medicamentos en el primer trimestre y la exposición a rayos x en el primer y segundo trimestre se asociaron significamente con la aparaición de estas anomalías. El estudio de la fracción etiológica permitió inferir que se podría disminuir la frecuencia de malformaciones hasta en un 50 por ciento si se lograra controlar estos factores