The importance of cell uptake in photothermal treatments mediated by biomimetic magnetic nanoparticles.

Biomimetic magnetic nanoparticles (BMNPs) mediated by MamC have proven to be photothermal agents able to allow an optimized cytotoxicity against tumoral cells when used simultaneously as drug nanotransporters and as hyperthermia agents. However, it remains unclear whether BMNPs need to be internalized by the cells and/or if there is a threshold for internal Fe concentration for the photothermal therapy to be effective. In this study, three different situations for photothermal treatments have been simulated to disentangle the effect of BMNPs cell uptake on cell viability after photothermal treatments. Human hepatoblastoma (HepG2) cell line was treated with suspensions of BMNPs, and protocols were developed to have only intracellular BMNPs, only extracellular BMNPs or both, followed by photothermal exposure of the treated cell cultures. Our data demonstrate that: (1) Although the heating efficiency of the photothermal agent is not altered by its location (intra/extracellular), the intracellular location of BMNPs is crucial to ensure the cytotoxic effect of photothermal treatments, especially at low Fe concentration. In fact, the concentration of BMNPs needed to reach the same cytotoxic effect following upon laser irradiation of 0.2 W/cm2 is three times larger if BMNPs are located extracellularly compared to that needed if BMNPs are located intracellularly; (2) For a given location of the BMNPs, cell death increases with BMNPs (or Fe) concentration. When BMNPs are located intracellularly, there is a threshold for Fe concentration (∼ 0.5 mM at laser power intensities of 0.1 W/cm2) needed to affect cell viability following upon cell exposure to photothermia. (3) Bulk temperature rise is not the only factor accounting for cell death. Actually, temperature increases inside the cells cause more damage to cell structures and trigger cell death more efficiently than an increase in the temperature outside the cell.

Annual variations of total and fractionated chlorophyll and phytoplankton groups in the Gulf of Cadiz.

Chlorophyll and phytoplankton distribution and concentration in the Gulf of Cadiz were studied during 2014 and 2015. In both years the highest chlorophyll concentrations are found at coastal stations during spring. Pico- and nanophytoplankton are the main contributors to total chlorophyll, with highest concentrations at the outer limit of the continental shelf. Microphytoplankton is responsible for most of the inshore chlorophyll. Picophytoplankton was analyzed to determine density, biomass and distribution. Prochlorococcus and Synechococcus show differences in distribution depending on distance from the coast and depth. Our results suggest temperature and consequent water stratification seem to be the main factors determining deep fluorescence maxima (DFM), mainly formed by picophytoplankton, especially Prochlorococcus. Pigment identification assisted by CHEMTAX analysis was carried out to analyze relative concentrations of larger phytoplankton.

[Implementation of a best practice guideline for the prevention of falls: Perception among hospitalized patients and its caregivers]. / Implantación de una guía de buenas prácticas para la prevención de caídas: percepción de los pacientes hospitalizados y sus cuidadores.

OBJECTIVE: To analyze the influence that the implementation of a fall prevention Best Practice Guideline (BPG) could have on the perception of patients and their caregivers about the utility of the activities implemented, about the care provided during admission and the adherence (the level of follow-up) to the recommendations received at discharge. MATERIAL AND METHOD: Design. Quasi-experimental study. Patients >65 years admitted≥48h to the Medical Area of the General Hospital of Albacete. SAMPLE: 104 subjects (consecutive sampling January-March 2013). Experimental group (EG). Patients admitted to BPG implementation units. Control group (CG). Usual care units. VARIABLES: Sociodemographic characteristics; previous and during admission falls, cognitive status (Pfeiffer); independence in daily life activities (ADLs); satisfaction with care and information provided, utility perceived, adherence to recommendations at discharge. DATA SOURCES: Interview and clinical history. Statistical analysis (SPSS 15.0). Descriptive and bivariant. Relative Risk. CI95%. RESULTS: 104 patients, EG 46.2% (48) and CG 53.8% (56). Women 51.9%, average age 79.9 years (s.d.=7.8). Pfeiffer 4,3 (s.d.=3.7). Previous falls 31.1%. In process, 1 fall in each group. There were statistically significant differences between EG/CG: age, cognitive status and independence in ADLs. In the EG was higher the percentage of perception about the usefulness of the recommendations to prevent falls (P<.001), greater adherence to them (P=0.0002), and to be very or quite satisfied with the information (P<.00004) and care received (P=.002). CONCLUSION: To implement recommendations according to an Evidence-based BPG to prevent falls in older people has shown, in users and caregivers, greater satisfaction, better perception of its usefulness and greater adherence to the recommendations.

[Multicenter program for the integrated care of newborns with perinatal hypoxic-ischemic insult (ARAHIP)]. / Programa multicéntrico para la atención integral del recién nacido con agresión hipóxico-isquémica perinatal (ARAHIP).

INTRODUCTION: Newborns with perinatal indicators of a potential hypoxic-ischemic event require an integrated care in order to control the aggravating factors of brain damage, and the early identification of candidates for hypothermia treatment. PATIENTS AND METHODS: The application of a prospective, populational program that organizes and systematizes medical care during the first 6 hours of life to all newborns over 35 weeks gestational age born with indicators of a perinatal hypoxic-ischemic insult. The program includes 12 hospitals (91,217 m(2)); two level i centers, five level ii centers, and five level iii hospitals. The program establishes four protocols: a) detection of the newborn with a potential hypoxic-ischemic insult, b) surveillance of the neurological repercussions and other organ involvement, c) control and treatment of complications, d) procedures and monitoring during transport. RESULTS: From June 2011 to June 2013, 213 of 32325 newborns above 35 weeks gestational age met the criteria of a potential hypoxic-ischemic insult (7.4/1000), with 92% of them being cared for following the program specifications. Moderate-severe hypoxic-ischemic encephalopathy was diagnosed in 33 cases (1/1,000), and 31 out of the 33 received treatment with hypothermia (94%). CONCLUSIONS: The program for the Integrated Care of Newborns with Perinatal Hypoxic-Ischemic Insult has led to providing a comprehensive care to the newborns with a suspected perinatal hypoxic-ischemic insult. Aggravators of brain damage have been controlled, and cases of moderate-severe hypoxic-ischemic encephalopathy have been detected, allowing the start of hypothermia treatment within the first six hours of life. Populational programs are fundamental to reducing the mortality and morbidity of hypoxic-ischemic encephalopathy.

Preemptive kidney transplantation: experience in two centers.

INTRODUCTION: End-stage renal disease (ESRD) is a prevalent, important cause of death. Transplantation increases survival and improves the quality of life of patients with ESRD while long-term dialysis is related to poor outcomes even among patients who undergo subsequent transplantations. OBJECTIVES: To compare the advantages of preemptive procedures with kidney transplants among patients on renal replacement therapy. METHODS: This retrospective study was performed in two Córdoba city transplantation centers. Patients were divided into three groups: preemptive kidney transplant (PKT), patients on hemodialysis who received living donor kidney transplants (LDT), and subjects who received grafts from deceased donors (DDT). Serum creatinine, delayed graft function (DGF), subclinical rejection, and interstitial fibrosis/tubular atrophy (IF/TA) were evaluated at 6 months. RESULTS: Eighty patients were included: PKT (n = 28), LDT (n = 27), DDT (n = 25) mean age 29, 30, and 35 years, respectively. Women predominated among PKT and men in the other groups. In all groups, cyclosporine was the calcineurin inhibitor mostly used. Creatinine at 6 months was lower in the living donor groups (1.26 mg/dL PKT and 1.32 mg/dL LDT; P = NS) in relation to the deceased donor group (1.96 mg/dL; P < .05). DDT had the highest rate of DGF: 44% DDT versus 11.5% LDT vs 0% PKT (P < .05). Subclinical rejection was significantly lower among preemptive transplantations: PKT 7.6% versus LDT 18.5% versus DDT 24% (P < .05). IF/TA was higher in transplants from deceased donors: PKT 11.1%; LDT 11.5%; DDT 32%. CONCLUSIONS: Preemptive kidney transplantation offered the advantages of a lower creatinine, no DGF, as well as a reduced incidence of subclinical rejection and chronic allograft nephropathy at 6 months posttransplantation.

Intervención educativa para prevenir incontinenciaen ancianos con fractura de cadera ECA: resultados preliminares / No disponible

Evaluar la efectividad de una intervención educativa para reducir la incidencia de incontinencia en pacientes >65 años confractura de cadera. Diseño: Ensayo clínico aleatorio. Muestreo consecutivo con asignación aleatoria a los grupos experimental y control(enmascaramiento de la secuencia de aleatorización). En el grupo experimental se realiza la intervención educativa «Entrenamiento delhábito urinario» (taxonomía NIC) en el posoperatorio, reforzando la enseñanza al paciente y cuidador con un folleto de diseño propio.Se evalúa el desarrollo de incontinencia urinaria a los tres y seis meses tras el alta. En los 45 sujetos incluidos hasta junio, la incidencia deincontinencia urinaria a los 6 meses en el grupo control ha sido del 46,7%, y en el grupo experimental del 28,6%; RR=0,61 [IC 95% 0,23-1,65]. Prevenir la incontinencia evita sufrimiento al paciente, disminuye la carga del cuidador y el gasto (AU)

To evaluate the effectiveness of an educational intervention to reduce the incidence of incontinence in pacientes >65 years withhip fracture. Design: Random clinical test. Consecutive sampling with experimental random assignment for the groups and control (maskingof the sequence of randomization). In the experimental group the educational intervention «Urinary habit Training» (taxonomy NIC) inthe postoperative is carried out, reinforcing the teaching to the patient and carer with a leaflet of own design. The development of urinaryincontinence in the three and six months after the discharge is evaluated. In the 45 individuals included until June, the incidence of urinaryincontinence at the 6 months in the control group has been of 46.7%, and in the experimental group of 28.6%; RR=0,61 [IC 95% 0.23-1.65]. To prevent the incontinence saves suffering to the patient, decreases the burden of the carer and the expense (AU)

Corrección de ductus arterioso pesistente no diagnosticado durante el tratamiento endovascular de coartación de aorta / No disponible

No disponible

Beneficios del ejercicio sobre la circulación arterial periférica en pacientes diabéticos tipo 2 con claudicación intermitente: serie de casos / Benefits of exercise on the peripheral arterial circulation in diabetic type 2 patients with intermittent claudication: A series of cases

Objetivo Analizar el efecto de un programa de deambulación sobre el estado de la circulación arterial de miembros inferiores en pacientes diabéticos con enfermedad arterial periférica (estadio I de Leriche-Fontaine).Pacientes y métodosSe realiza un estudio de cohortes retrospectivo sobre 15 individuos diabéticos tipo II con enfermedad arterial periférica pertenecientes al Centro de Salud de la Zubia (Distrito Metropolitano-Granada). El cálculo del índice tobillo/brazo y la determinación de la máxima velocidad y distancia de deambulación se realizaron previa y posteriormente al desarrollo de un programa de deambulación de 90 días de duración.ResultadosLa media obtenida en el índice tobillo/brazo del miembro inferior derecho es de basal: 0.96 ± 0.122/postbasal: 1.01 ± 0.089; p<0,046. Asimismo, la media del índice de tobillo/brazo en el miembro inferior izquierdo es de basal: 0.612±0,201/postbasal: 0.837±0,281; p<0.052. También se encuentran diferencias estadísticamente significativas en la máxima distancia recorrida (basal: 22.13 [5.21]/postbasal: 25.15 [4.25]; p<0,046), así como en la máxima velocidad de deambulación (basal: 5.43 [1.03]/postbasal: 7.089 [4.35]; p<0,048).ConclusiónUn programa de deambulación de 2,5km diarios produce un aumento de la distancia de claudicación intermitente y del índice tobillo/brazo en pacientes diabéticos tipo II con enfermedad arterial periférica (estadio i de Leriche-Fontaine)(AU)

ObjectiveTo evaluate the effect of a walking program on lower limbs arterial circulation in diabetic patients with peripheral arterial disease (Leriche-Fontaine Stage I).Patients and methodsA retrospective cohort study was conducted on 15 individuals with type II diabetic peripheral arterial disease who belonged to the Zubia Health Center (Metropolitan Health Area of Granada). Ankle/brachial index and maximum walking speed and distance were measured before and after a 90-day long walking program.ResultsThe mean obtained in the right ankle/brachial index was basal: 0.96±0.122/post-baseline: 0.089±1.01; P<0.046. Mean obtained in the left ankle/brachial index was basal: 0.612±0.201/postbasal: 0.837±0.281; P<0.052. Statistically significant differences were also found in maximum walking distance (basal 22.13±5.21/postbasal: 25.15±4.25; P<0.046) as well as maximum walking speed (basal: 5.43 [1.03]/postbasal: 7,089 [4.35]; P <0.048).ConclusionA walking program of 2.5km per day produces an increase in intermittent claudication distance and ankle/brachial index in type II diabetic patients with peripheral arterial disease (Leriche-Fontaine Stage I)(AU)

Abordaje electroterápico en la enfermedad de Raynaud: a propósito de un caso / Electrotherapy approach to Raynaud & apos; s disease: a case report

Introducción: El síndrome de Raynaud primario consiste en un complejo sintomático secundario a vasospasmo vascular periférico en respuesta a un estímulo térmico frío y/o emocional, en las partes acras del cuerpo, cuya prevalencia en adultos varía entre el 3,7 y el 13%. Objetivos: Analizar la sintomatología y la topografía de la manifestación del síndrome de raynaud, así como conseguir una sudación normal mediante el protocolo de tratamiento diseñado. Resultados: Reducción significativa del sudor en un 66%, con disminución del número de crisis y aumento de los periodos intercríticos; se consiguió coloración normocrómica y desaparición de las fases de cambio cromático. Conclusiones: Los hallazgos termohigrométricos y colorimétricos nos inducen a considerar la modalidad electroterapéutica de iontoforesis con agua corriente como un procedimiento eficaz a largo plazo que permite conseguir una euhidrosis de la zona afecta, así como una mejora de los cambios vasculares relacionados con la enfermedad de Raynaud(AU)

Introduction: Primary Raynaud's syndrome consists in a symptomatic complex secondary to peripheral vasospasm in response to cold thermal stimulus and/or emotional stimulus in the distal parts of the body whose prevalence in adults varies from 3.7% to 13%. Objectives: To analyze the symptoms and topography of the manifestation of Raynaud's syndrome, as well as the achieving of normal sweating by the treatment protocol designed. Results: There is a significant reduction of perspiration, that is 66%, with a decrease in the number of episodes and increase of the periods between episodes, achieving normochromic coloring with the disappearance of the phases of chromatic change. Conclusions: The thermohygrometric and colorimetric findings lead us to consider iontophoresis electrotherapy with running water as a long-term effective procedure that makes it possible to achieve hidrosis of the affected area and improvement in the vascular changes associated to Raynaud's disease(AU)

Independencia para actividades de la vida diaria en ancianos previamente autónomos intervenidos por fractura de cadera secundaria a una caída tras 6 meses de evolución / Independence in activities of daily living 6 months after surgery in previously independent elderly patients with hip fracture caused by a fall

Objetivo. Medir la recuperación de la independencia para actividades de la vida diaria (AVD) en ancianos independientes y sin deterioro cognitivo que han tenido fractura de cadera secundaria a caída a los 6 meses tras intervención quirúrgica. Método. Estudio analítico, longitudinal, prospectivo, de seguimiento de una cohorte. Inclusión: sujetos previamente independientes para las AVD o con dependencia leve, sin deterioro del estado mental. Muestreo consecutivo. Variables: edad, sexo, lugar de residencia, tipo de fractura, estado mental (SPMSQ de Pfeiffer), independencia para AVD (según índice de Barthel [IB]) previa y a los 6 meses de la caída. Resultados. Se han incluido 207 pacientes, siendo más frecuente fue el sexo femenino (74,4%) y la fractura pertrocantérea (45,9%). La media de edad fue 80,17 años (desviación estándar [DE] = 6,95), el 7,7% estaba institucionalizado. A los 6 meses de la intervención quirúrgica, la media del IB fue de 73,37 (DE = 26,76) (antes de la caída era de 90,05); un 16,8% presentó incontinencia urinaria (previa 5,9%); un 59,2% caminó sin ayuda (previo 82,4%) y un 24,6% subía escaleras sin ayuda (previo 50,7%). Un 64,6% (previamente, un 82,1%) recuperó la capacidad de caminar por la calle. Hubo peor recuperación de la independencia en las personas institucionalizadas, en los que no eran capaces de caminar por la calle previamente a la fractura y en los que tenían leve deterioro intelectual, de forma estadísticamente significativa. Conclusiones. Sólo un 33,6% recuperó o superó su nivel de independencia previo en los 6 meses transcurridos

Objective. To measure recovery of independence in activities of daily living (ADL) 6 months after surgery in elderly patients (previously independent and without cognitive impairment) with hip fracture caused by a fall. Method. We performed a longitudinal, prospective cohort study of patients who were previously independent for ADL, or had mild dependence, and who showed no cognitive impairment. Consecutive sampling was performed. The variables studied were age, sex, habitual residence, type of hip fracture, mental status (SPMSQ Pfeiffer), and independence in ADL (according to Barthel Index [BI]) prior to the fall and 6 months after the fall. Results. The study included 207 patients. There was a predominance of female sex (74.4%) and pertrochanteric fractures (45.9%). The mean age was 80.17 years old (SD = 6.95), and 7.7% were institutionalized. Six months after surgery, the mean BI score was 73.37 (SD = 26.76) (versus 90.05 before the fall), 16.8% showed urinary incontinence (versus 5.9%), 59.2% walked without assistance (versus 82.4%) and 24.6% climbed stairs unaided (versus 50.7%). The ability to walk down the street was regained in 64.6% (versus 82.1% before the fall). Recovery of autonomy for ADL was statistically significantly lower in patients unable to walk outdoors, who were institutionalized or who had mild cognitive impairment before the fall. Conclusions. Only 33.6% of patients regained prior levels of autonomy 6 months after surgery

Patología cerebro-vascular hemorrágica en adultos asociada al consumo de cocaína / Cerebral haemorrhage in adults associated with the use of cocaine

La cocaína es la segunda droga de comercio ilegal más consumida en España después del cannabis. El número de pacientes atendidos en los servicios de urgencias tras consumir cocaína y los casos de muerte secundarios al consumo de la misma han ido aumentando hasta multiplicarse por seis en los últimos años. El consumo de este alcaloide ocasiona efectos nocivos, constatados sobre diferentes órganos y sistemas corporales, e incluso la muerte. A nivel del SNC destaca, por su gravedad e incidencia, la patología cerebro-vascular hemorrágica (PCVH). Este tipo de cuadro se halla asociado al consumo de drogas ilícitas entre el 9,5% y el 34% de los accidentes vasculares en menores de 45 años, siendo la cocaína la más frecuentemente implicada en su presentación. Por otro lado, la rotura de un aneurisma o malformación arteriovenosa se ha detectado hasta en el 50% de los pacientes con PCVH secundarios al consumo de cocaína. Presentamos tres casos de muerte súbita en adultos por patología cerebro-vascular hemorrágica asociada al consumo de cocaína

Cocaine is the second most frequent illegal drug consumed in Spain after cannabis. A significant increase has occurred in the number of individuals treated in emergency departments after cocaine use just as in the number of cocaine-related deaths. These rates have been actually multiplied by six in the latest years. Cocaine causes injury in different organ systems, even death. In the CNS the use of cocaine is frequently associated with cerebral haemorrhage. Stroke in young adults below 45 years is usually related to drug use between 9,5% and 34% of cases, and cocaine is the most frequently mentioned drug. Otherwise, even 50% of cocainerelated stroke is the result of rupture of saccular aneurysms involving the arteries at the base of the brain and vascular malformation. In this paper, we present three cases of sudden death in adults due to cerebral haemorrhage associated with cocaine use

Spectroscopic characterization of two different microwave (2.45 GHz) induced argon plasmas at atmospheric pressure.

A surface-wave-sustained discharge created by using a surfatron device in a tube open to the atmosphere can be used to maintain a microwave (2.45 GHz) plasma at atmospheric pressure at powers of less than 300 W. The TIA (Torche a Injection Axiale) is a device also producing a plasma that, moreover, permits us to work at high power (higher than 200 W and up to 1000 W). A study of the departure from the thermodynamic equilibrium existing in the argon plasmas created by both devices has been done by using optical emission spectroscopy techniques in order to characterize them and to evaluate their possible advantages when they are used for applied purposes.

Docencia de fisioterapia en las escuelas andaluzas / Teaching in physiotherapy's andalusian schools

En este trabajo se analizan los cambios producidos en la disciplina de electroterapia, hidroterapia y termoterapia, que es impartida en el primer curso de la diplomatura de Fisioterapia de Cádiz con motivo de la renovación de los planes de estudios. Asimismo se compara esta asignatura con las de igual contenido impartidas en el resto de escuelas andaluzas. También comprobamos la planificación docente específica de Fisioterapia de primer curso de las citadas escuelas con el fin de saber si existe docencia unificada, dado que ésta es la única forma de mejorar y completar la enseñanza, además de conseguir docencia de calidad (AU)

[Hyper-IgM syndrome: mucocutaneous lesions and neutropenia]. / Síndrome de hiper-IgM: lesiones mucocutáneas y neutropenia.

The hyper-IgM syndrome is a rare immunodeficiency disease in which the ability of B cells to switch immunoglobulin production from IgM to IgG, IgA and IgE is defective. The deficiency of IgG and IgA leads to recurrent infections of the respiratory tract, but some patients are susceptible to infection with opportunistic microorganisms, such as Cryptococcus neoformans, and also are prone to neutropenia and mucocutaneous ulcerations. We report a case of a two-year-old boy that was given the diagnosis of the hyper-IgM syndrome on the basis of low serum concentrations of IgG and IgA and high serum levels of IgM associated with C. neoformans infection, neutropenia and mucocutaneous ulcerations. Intravenous immune globulin improves dramatically the disorder, including neutropenia. To date, periodical infusion of immune globulin has prevented the development of serious infections.

Löffler's syndrome: pulmonary vein and transmitral doppler flow analysis by transesophageal echocardiography-report of a case.

Löffler's syndrome is defined by prolonged and profound eosinophilia and restrictive cardiomyopathy. Doppler echocardiography is useful in both the diagnosis and management of this entity. On the other hand, diastolic dysfunction is assessed better by transesophageal echocardiography than by transthoracic echocardiography, mainly in the analysis of pulmonary vein Doppler flow. We describe a patient with Löffler's syndrome, whose pulmonary vein flow, obtained by transesophageal echocardiography, was helpful for better management of the disease.

Rapid determination of polycyclic aromatic hydrocarbons in tea infusion samples by high-performance liquid chromatography and fluorimetric detection based on solid-phase extraction.

This paper describes a method for the determination of PAHs in black, green and decaffeinated tea infusion samples. The method is based on the solid phase extraction of the PAHs using Sep-Pak vac tC-18 cartridges. The PAHs are then eluted from the cartridges with dichloromethane. Quantification and detection are carried out by HPLC with a fluorimetric detector using a program of excitation and emission wavelength pairs. Recoveries at concentration levels in the range 190-1790 ng l-1 were higher than 65% for all PAHs except dibenz[a,h]anthracene, for which it was around 54%. The mean content of PAHs was in the range 28.7-112 ng l-1 in the tea infusions, with relative standard deviations between 2 and 18% (n = 4).