Feasibility and acceptability of asynchronous VOT among patients with MDR-TB.

BACKGROUND: We conducted a feasibility and acceptability study of video-observed therapy (VOT) among patients with multidrug-resistant TB (MDR-TB) and other types of drug-resistant TB (DR-TB) in the Philippines.METHODS: Patients aged ≥13 years were approached to use VOT. A smartphone with VOT mobile application to video-record medication intake was provided. Healthcare workers (HCWs) monitored adherence by watching videos via a web-based dashboard. Good adherence was defined as intake of >90% of expected doses. Feasibility and acceptability were assessed using a semi-structured questionnaire on a Likert scale.RESULTS: Of 308 patients, 110 (36%) patients chose VOT; 67 completed treatment using VOT and 43 stopped VOT prior to treatment outcome; 74/110 (67%) had good adherence. The treatment success rate was 88% and the loss to follow-up rate was 8.1%. Among HCWs, 90% (9/10) had a positive perception of VOT. All HCWs agreed that VOT data accurately reflect medication intake of the patients; 88/89 (99%) mentioned benefits of VOT, notably convenience, sense of comfort, privacy and security.CONCLUSIONS: VOT is feasible and acceptable for both patients and HCWs. This study could provide guidance to the country programme to launch VOT for treatment of patients with MDR-TB and other DR-TB.

Análisis del temperamento infantil relacionado con el uso de pantallas / Analysis of infant temperament related to screen use

Introducción: el objetivo del estudio fue describir el tiempo de uso de pantallas y relacionarlo con los rasgos temperamentales y del comportamiento del niño. Material y métodos: estudio observacional descriptivo mediante cuestionario estructurado entregado a los progenitores para saber el tiempo de exposición de su hijo/a a las pantallas y valoración del temperamento infantil con el cuestionario Emotionality Sociability and Activity Temperament (EAS) de niños con edades comprendidas entre 0 y 10 años del centro de salud Revolería y Torrero-La Paz de Zaragoza (España) durante los meses de junio de 2019 hasta febrero de 2020. El estudio fue aprobado por el Comité de Ética e Investigación de la Comunidad Autónoma de Aragón (PI 19/00260). Resultados: participación de 212 niños. El 54,1% fueron niñas. Edad media: 5,3±2,7 años; peso medio: 21,2±9,6 kg; talla media: 1,11±0,20 m; el 62,9% se clasificó en peso normal. Un 76,1% realiza ejercicio físico. Edad de inicio a la exposición a las pantallas: el 39,0% fue con una edad superior a 24 meses; el 42,4% se expone un tiempo medio de 60-120 minutos al uso de pantallas. Evaluación del temperamento infantil con la escala EAS (sociabilidad: 18,1±3,1; actividad 19,0±4,2; emocionalidad 13,9±4,0 y timidez: 12,3±4,1). Conclusiones: en la muestra estudiada, los niños con edades superiores presentaron un tiempo mayor de uso a la exposición y uso de pantallas. No se hallaron diferencias significativas entre el tiempo de uso de las pantallas y los cambios del temperamento infantil (AU)

Introduction: the aim of this study was to describe the screen time in children and analyse its association with personality traits and behaviour.Methods: observational and descriptive study through a structured, self-administered questionnaire completed by parents to assess screen time in their children and the Emotionality, Activity and Sociability (EAS) questionnaire to assess traits and behaviours in children aged 0 to 10 years in the caseloads of the Revolería and Torrero-La Paz primary care centres in Zaragoza (Spain) between June 2019 and February 2020. Research Ethics Committee of the Autonomous Community of Aragón (PI 19/00260).Results: the sample included 212 children, 54.1% female. The mean age was 5.3 ± 2.7 years; the mean weight 21.2 ± 9.6 kg, the mean height 1.1 ± 0.2 m, and 62.9% had a normal weight. Of the total, 76.1% reported physical activity. The age at which exposure to screens started was greater than 24 months in 39%; and 42.4% used screens between 60 and 120 minutes on average. The assessment of traits with the EAS survey yielded the following mean scores: sociability, 18.1 ± 3.1; activity, 19.0 ± 4.2; emotionality, 13.9 ± 4.04; shyness, 12.3 ± 4.1.Conclusion: in the sample under study, screen time and use were greater in older children. There were no statistically significant differences in screen time associated with differences in temperament. (AU)

The impact of hip fracture on health-related quality of life and activities of daily living: the SPARE-HIP prospective cohort study.

PURPOSE: The medical morbidity and mortality associated with neck of femur fractures is well-documented, whereas there is limited data for patient-reported outcomes. The aim of this study was to characterize the impact of neck of femur fractures on activities of daily living and patient-reported health-related quality of life. METHODS: Design and participants: Multicentric prospective cohort study. Consecutive sample patients with fragility hip fracture over 50 years old admitted in 48 hospitals in Spain. OUTCOMES: daily living activity function (Barthel Index) and health-related quality of life (EQ-5D) pre-fracture, admission to hospital and at 1- and 4-month follow-up post-fracture. STATISTICS: Barthel and EQ-5D over time are described as mean (SD) and median (interquartile range). RESULTS: A total of 997 patients were recruited at baseline with 4-month outcomes available for, and 856 patients (89.5%). Barthel Index fell from 78.77 (23.75) at baseline to 43.62 (19.86) on admission to hospital with the fracture. Scores partially recovered to 54.89 (25.40) and 64.09 (21.35) at 1- and 4-month post-fracture, respectively. EQ-5D fell from a median of 0.75 (0.47-0.91) to - 0.01 (- 0.03 to 0.51) on admission. Partial recovery was observed again to (0.51 (- 0.06 to 0.67)) and (0.60 (0.10 to 0.80)) at 1- and 4-month post-fracture, respectively. CONCLUSIONS: Hip fracture results in a large decline in the ability to perform activities of daily living and patient-reported health-related quality of life with only partial recovery amongst survivors 4-month post-fracture.

Properties of antibacterial nano textile for use in hospital environments / Propiedades del nanotextil antibacteriano para su uso en entornosm hospitalarios / Propriedades do nano têxtil antibacteriano para seu uso em meios hospitalares

Abstract In hospital environments, there are several problems related to Healthcare-Associated Infections (HAIs), contaminated hospital textiles, can contribute to the spread and transmission of (HAIs), due to retention of viruses and bacteria. The antibacterial metallic nanoparticles immersed in hospital textiles can allow reduction of microorganisms. This paper presents a technological surveillance of the principal properties of antibacterial nanotextiles to be used in hospital environments, based on international standards. Initially, the search equation was determined for "antibacterial" AND "nanoparticle." Subsequently, the main properties were selected, by means of a multiple authors' review. Afterwards, the properties were related to international standards. Finally, we present the results found associated to the materials used to develop nonwoven textiles, and their properties for hospital environments, the sizes of samples and also the equipment required for characterization.

Resumen En los ambientes hospitalarios, existen varios problemas relacionados con las infecciones asociadas a la atención de la salud (HAI, por sus siglas en inglés), los tejidos hospitalarios contaminados, pueden contribuir a la propagación y transmisión de los HAIs, debido a la retención de virus y bacterias. Las nanopartículas metálicas antibacterianas sumergidas en tejidos hospitalarios permiten reducir los microorganismos. Este documento presenta una vigilancia tecnológica de las principales propiedades del nanotextil antibacteriano para uso en ambientes hospitalarios, basados en estándares internacionales. Inicialmente, la ecuación de búsqueda se determinó "antibacteriano" Y "nanopartícula". Posteriormente, se seleccionaron las principales propiedades, mediante la revisión de diferentes autores. Luego, las propiedades se relacionaron con los estándares internacionales. Finalmente, se presentan los resultados encontrados asociados a los materiales utilizados para el desarrollo de materiales no tejidos y sus propiedades para ambientes hospitalarios, tamaños de muestras y también el equipo necesario para la caracterización.

Resumo Nos ambientes hospitaleiros, existem vários problemas relacionados com as infecções associadas à atenção da saúde (HAI), os tecidos hospitalários contaminados, podem contribuir à propagação e transmissão dos HAIs, devido à retenção de vírus e bactérias. As nano partículas metálicas antibacterianas submergidas em tecidos hospitalários permitem reduzir os microorganismos. Este documento apresenta uma vigilância tecnológica das principais propriedades do nano têxtil antibacteriano para uso em ambientes hospitalários, baseados em padrões internacionais. Inicialmente, a equação de busca determinou-se "antibacteriano" e "nano partícula". Posteriormente, selecionaram-se as principais propriedades, mediante a revisão de diferentes autores. Posteriormente, as propriedades relacionaram-se com os padrões internacionais. Finalmente, apresentam-se os resultados encontrados associados aos materiais utilizados para o desenvolvimento de tecidos não tecidos e suas propriedades para ambientes hospitaleiros, tamanhos de amostras e também a equipe necessária para a caracterização.

Imaging and histologic prognostic factors in triple-negative breast cancer and carcinoma in situ as a prognostic factor. / Valoración de los factores pronósticos radiopatológicos del cáncer de mama triple negativo y análisis del carcinoma in situ como factor pronóstico.

OBJECTIVES: To analyze what factors in magnetic resonance imaging (MRI) and histological study of triple-negative breast cancers are related to tumor recurrence and to shorter disease-free survival. To analyze survival and recurrence in function of the presence of an in situ component. MATERIAL AND METHODS: This was a retrospective study of MRI staging examinations in 122 women with triple-negative breast cancer done from 2007 through 2014. In the MRI, we evaluated morphological variables (size, margins, morphology, internal signal in T2-weighted sequences) and dynamic variables (perfusion and diffusion). In the histological study, we evaluated Ki67, p53, CK5/6, nuclear grade, and Scarff-Bloom grade, as well as the presence of an in situ component and tumor grade (high grade or not high grade). We compared the variables between patients with tumor recurrence and those without, and we conducted a survival analysis. RESULTS: Non-nodular enhancement was more common in patients with tumor recurrence (p=0.038) and was associated with shorter disease-free survival (p=0.023). Neither diffusion restriction (p=0.079) nor ki67 (p=0.052) was associated with a worse prognosis. An in situ component was detected in 44% of triple-negative tumors, and a greater proportion of patients in the group with tumor recurrence had an in situ component; however, the presence of an in situ component was not associated with shorter survival (p = 0.185). CONCLUSION: Non-nodular enhancement was associated with a worse prognosis. Diffusion restriction, ki67, and the presence of an in situ component were not associated with shorter disease-free survival.

Discrimination of endocardial electrogram disorganization using a signal regularity analysis.

Measures from the theory of nonlinear dynamics were applied on complex fractionated atrial electrograms (CFAEs) in order to characterize their physiological dynamic behavior. The results were obtained considering 113 short term atrial electrograms (A-EGMs) which were annotated by three experts into four classes of fractionation according to A-EGMs signal regularity. The following measures were applied on A-EGM signals: General Correlation Dimension, Approximate Entropy, Detrended Fluctuation Analysis, Lempel-Ziv Complexity, and Katz-Sevcik, Variance and Box Counting Fractal Dimension. Assessment of disorganization was evaluated by a Kruskal Wallis statistical test. Except Detrended Fluctuation Analysis and Variance Fractal Dimension, the CFAE disorganization was found statistically significant even for low significant level alpha = 0.001. Moreover, the increasing complexity of A-EGM signals was reflected by higher values of General Correlation Dimension of order 1 and Approximate Entropy.

[Evaluation of the p53 Arg72Pro polymorphism as a prognostic factor in severe head injury and the inclusion of this indicator in a predictive model]. / Evaluación del polimorfismo Arg72Pro de p53 como factor pronóstico del traumatismo craneoencefálico grave y su participación en la construcción de un modelo predictivo.

BACKGROUND AND OBJECTIVE: Physiologic variables have traditionally been studied as prognostic factors in severe head injury. Until recently it was not thought that genetic factors might play a role. The main objective of this study was to construct a logistic regression model including physiologic variables and the p53 Arg72Pro polymorphism, which can promote neuron death through apoptosis. MATERIAL AND METHODS: We included 90 patients admitted to the postoperative recovery unit with severe head injury. Patients with previous neurologic deficits were excluded. Clinical variables were recorded. The p53 Arg72Pro polymorphism was analyzed using polymerase chain reaction of DNA in blood. Neurologic outcome was assessed on the Glasgow Outcome Scale. A predictive logistic regression model was then constructed based on relevant candidate variables (sex, age, poor Glasgow score, the Acute Physiology and Chronic Health Evaluation II score, pupil size, pupil reactivity, subarachnoid hemorrhage, number of days in the recovery unit, number of days on mechanical ventilation, and the early development of hypotension) in addition to the p53 Arg72Pro polymorphism. RESULTS: The Arg/Arg polymorphism was an independent predictor of poor outcome (odds ratio, 3.55; 95% confidence interval [CI], 1.11-1132; P = .032). The selected model (including the variables age, gene polymorphism, pupil reactivity, and Glasgow score) had adequate discriminatory power (sensitivity 823%, 95% CI 72.8%-91.8%; specificity 78.6%, 95% CI 63.4%-93.8%), classifying 81.1% of the patients correctly. The p53 Arg72Pro polymorphism, along with pupil reactivity, age and Glasgow score, is useful in a predictive model of good or poor outcome on discharge after head injury.

Short- and medium-term effects of experimental nitrogen fertilization on arthropods associated with Calluna vulgaris heathlands in north-west Spain.

We studied the short- and medium-term effects of experimental nitrogen fertilization (3 and 15 months after the treatment) on the arthropods of Calluna vulgaris heathlands in NW Spain. Three heathland sites were selected with two permanent plots per site: control and fertilized. Ammonium nitrate fertilizer (56 kg N ha(-1) yr(-1)) was applied monthly and insects were caught using pitfall traps. We found mainly species-level responses to nitrogen addition. Seven species (e.g. Lochmaea suturalis) showed a consistent trend (benefited or harmed) in both periods and were proposed as possible reliable indicators of the effects of nitrogen deposition in these ecosystems. We also found variable arthropod trophic-group responses: (a) herbivores (leaf beetles, true bugs) increased in abundance on a short-term scale; (b) predators (carabid beetles, true bugs) showed opposite and less clear responses in both periods. Further long-term studies are needed to determine the mechanisms underlying the observed arthropod responses.

Predicting survival in critical patients by use of body temperature regularity measurement based on approximate entropy.

Body temperature is a classical diagnostic tool for a number of diseases. However, it is usually employed as a plain binary classification function (febrile or not febrile), and therefore its diagnostic power has not been fully developed. In this paper, we describe how body temperature regularity can be used for diagnosis. Our proposed methodology is based on obtaining accurate long-term temperature recordings at high sampling frequencies and analyzing the temperature signal using a regularity metric (approximate entropy). In this study, we assessed our methodology using temperature registers acquired from patients with multiple organ failure admitted to an intensive care unit. Our results indicate there is a correlation between the patient's condition and the regularity of the body temperature. This finding enabled us to design a classifier for two outcomes (survival or death) and test it on a dataset including 36 subjects. The classifier achieved an accuracy of 72%.

[Enteral prostheses for palliative treatment of gastroduodenal obstruction: endoscopic procedure]. / Prótesis enterales en el tratamiento paliativo de la obstrucción gastroduodenal: técnica endoscópica.

Malignant gastroduodenal obstruction may cause significant morbidity. Insertion of enteral prostheses as a palliative treatment is an acceptable option to achieve an appropriate gastric voiding without the morbidity associated to palliative surgery, with a lesser procedure-related mortality and a lower cost, while providing a better quality of life. Its is important to unify and consolidate the endoscopic procedure for the placement of enteral prostheses, avoiding variations that may preclude an adequate analysis of this procedure outcome.

Prótesis enterales en el tratamiento paliativo de la obstrucción gastroduodenal: técnica endoscópica / Enteral prostheses for palliative treatment of gastroduodenal obstruction: endoscopic procedure

La obstrucción gastroduodenal neoplásica puede causar una significativa morbilidad. La inserción de prótesis enterales como tratamiento paliativo es una aceptable opción para conseguir un adecuado vaciamiento gástrico sin la morbilidad asociada a la cirugía paliativa, con menor mortalidad relacionada con el procedimiento y menor coste, proporcionando una mejor calidad de vida. Es importante unificar y consolidar la técnica endoscópica de colocación de las prótesis enterales evitando variaciones que impidan un adecuado análisis de los resultados de esta técnica (AU)

Malignant gastroduodenal obstruction may cause significant morbidity. Insertion of enteral prostheses as a palliative treatment is an acceptable option to achieve an appropriate gastric voiding without the morbidity associated to palliative surgery, with a lesser procedure-related mortality and a lower cost, while providing a better quality of life.Its is important to unify and consolidate the endoscopic procedure for the placement of enteral prostheses, avoiding variations that may preclude an adequate analysis of this procedure outcome (AU)

A novel statistical model for simulation of arterial and intracranial pressure.

We describe a novel statistical model of pressure signals that incorporates the effects of respiration on arterial (ABP) and intracranial pressure (ICP). This model can be used to synthesize pulsatile ABP and ICP signals with similar time, frequency, and variability characteristics of real pressure signals. These synthetic signals can be used during the development, simulation, or quantitative assessment of biomedical algorithms in a variety of applications.

Fiebre Q / Q fever

No disponible

Incontinentia pigmenti: a report of ten cases.

A multidisciplinary approach is necessary in the care of patients with incontentia pigmenti (Bloch-Sulzberger syndrome).

A double-blind trial comparing disodium cromoglycate (DSCG), and ketotifen in extrinsic asthmatic children.

A double-blind non crossover trial comparing disodium cromoglycate (DSCG), with ketotifen, was carried out in twenty-seven extrinsic asthmatic children over 12 weeks. Assessment was made using symptom score and drug score charts. Both drugs showed a similar protective effect in the group studied. None of the subjects had to withdraw from the trial and no side-effects were noted in weight-curve, arterial pressure and pulse rate. PEFR values remained unchanged for both drugs throughout the trial. A non-significant tendency for additional corticosteroid support in the Ketotifen group was noted.