Rol de enfermería en el área COVID en un hospital pediátrico de alta complejidad / The role of nurses in the COVID area in a pediatric tertiary-care hospital

Introducción: la pandemia por SARS-CoV-2 planteó un desafío para todo el equipo de salud. Fue necesario analizar y pensar en este contexto el rol de enfermería en la atención y cuidados del paciente y su familia. Los procesos asistenciales debieron adaptarse a nuevas y diversas situaciones que generaron la atención de pacientes en su mayoría con comorbilidades asociadas. El objetivo del trabajo fue describir el rol de enfermería y la implementación de diversos protocolos y procesos de atención de pacientes en salas de internación pediátrica del área COVID de un hospital de alta complejidad. Material y métodos: se realizó un estudio retrospectivo y descriptivo sobre el personal de enfermería que participó en la atención de casos sospechosos o confirmados de COVID-19 durante la pandemia y los protocolos implementados para los cuidados de enfermería. Resultados: solo el 52.5% (n 79) del personal tenía experiencia mayor a tres años, el 75% (n: 113) pertenecían al género femenino, el 47% (n: 71) eran licenciados en enfermería. Conclusiones: Los profesionales enfermeros han logrado mediante sus fortalezas disciplinares dar respuesta a las necesidades del paciente pediátrico y su familia frente a la crisis sanitaria. Las competencias desarrolladas en la administración de los recursos disponibles, la adaptación, flexibilidad a los procesos y líneas estratégicas en tiempo real, posicionan al enfermero como un valor fundamental en el cuidado asistencial (AU)

Introduction: The SARS CoV-2 pandemic posed a challenge for the entire healthcare team. It was necessary to analyze and reflect on the role of nursing in the care of patients and their families in this context. Care processes had to be adapted to new and diverse situations that were generated by the care for patients who usually had associated comorbidities. The aim of the study was to describe the nursing role and the implementation of different protocols and processes for patient care in pediatric inpatient wards in the COVID area of a tertiary-care hospital. Material and methods: a retrospective descriptive study was conducted in the nursing personnel involved in the care of suspected or confirmed cases of COVID-19 during the pandemic and the protocols implemented for nursing care. Results: only 52.5% (n: 79) of the personnel had more than three years of experience, 75% (n: 113) were female, and 47% (n: 71) had a nursing degree. Conclusions: Through their disciplinary strengths, nursing professionals have been able to respond to the needs of pediatric patients and their families in the face of the health crisis. The skills developed in the management of available resources, adaptation, and flexibility to processes and real-time strategies, have positioned nurses as a fundamental factor in healthcare (AU)

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)

Percepción del dolor según el modo de punción de la fístula arteriovenosa en pacientes sometidos a hemodiálisis. Revisión sistemática / Pain perception according to manner of arteriovenous fistula cannulation in patients undergoing hemodialysis. Systematic review

Objetivo: Valorar la posible asociación entre la forma de punción de la fístula arteriovenosa y el dolor que siente el paciente por la inserción de la aguja. Metodología: Se ha seguido la declaración PRISMA para revisiones sistemáticas. Se han consultado 6 bases de datos; Medline, Scopus, Cuiden, CINAHL, SciELO, y Cochrane PLUS. Además, se realizó una búsqueda secundaría manual para detectar literatura gris no encontrada en las bases de datos o mediantes las estrategias definidas. Criterios de inclusión; estudios de nivel de evidencia 1 en la escala Scottish Intercollegiate Guidelines Network, publicados en los últimos 10 años, idiomas español/inglés, y temática relacionada con las técnicas utilizadas en hemodiálisis para el abordaje de la fistula. Los artículos se evaluaron de forma crítica para detectar cualquier riesgo de sesgo mediante el instrumento CASPe y el manual Cochrane para Revisiones Sistemáticas de Intervenciones. Resultados: Se identificaron un total de 150 resultados, seleccionándose finalmente 9 estudios. Los resultados han sido muy heterogéneas, encontrándose resultados para el dolor, tasas de infección, número de intentos de canalización, flujo sanguíneo, presión venosa, tiempo de hemostasia, seguridad, dilataciones aneurismáticas, estética del brazo portador de la fístula y calidad de vida del paciente. Conclusiones: La evidencia no respalda el uso preferencial de la técnica del ojal sobre la canalización tradicional. Por tanto, se necesita mejorar el rigor metodológico y un mayor tamaño muestral para dilucidar que técnica da mejores prestaciones respecto al dolor, permitiendo por tanto mejorar la calidad de vida de los pacientes de hemodiálisis

Aims: To assess the possible association between the manner of arteriovenous fistula cannulation and the patient pain related to the insertion of the needle for the hemodialysis session. Methodology: The PRISMA statement for systematic reviews has been followed. Six databases have been consulted: Medline, Scopus, Cuiden, CINAHL, SciELO, and Cochrane PLUS. In addition, a secondary manual search was performed to detect grey literature not found in databases or through defined strategies. Inclusion criteria: studies of level of evidence 1 on the Scottish Intercollegiate Guidelines Network scale, published in the last 10 years, Spanish/English languages, and topics related to the techniques used to canalize the hemodialysis fistula. The articles were critically evaluated to detect any risk of bias using the CASPe instrument and the Cochrane Handbook for Systematic Reviews of Interventions. Results: A total of 150 results were identified, 9 of which were finally selected. The results have been very heterogeneous, finding results for pain, infection rates number of attempts of channalization, blood flow, venous pressure, time of hemostasis, safety, aneurysmal dilations, esthetics of the fistula-carrying arm and quality of life of the patient. Conclusions: The evidence does not support the preferential use of the buttonhole technique over traditional channeling. Therefore, it is necessary to improve the methodological quality and a larger sample size to elucidate which technique gives better benefits with respect to pain, thus allowing to improve the quality of life of hemodialysis patients

Aspectos anatómicos y técnicos de la cirugia de citorredución de cáncer de ovario en abdomen superior / Anatomical and technical aspects of debulking surgery for ovarian cancer in the upper abdomen

RESUMEN El Cáncer de Ovario Epitelial es la novena causa de cáncer en la mujer y la neoplasia ginecológica más letal en países desarrollados. La mayoría de las pacientes son diagnosticadas en etapa avanzada de la enfermedad debido a la ausencia de síntomas específicos. La cirugía y la quimioterapia cumplen un rol fundamental en el tratamiento de esta enfermedad. En pacientes con enfermedad avanzada (estadios III - IV) al momento del diagnóstico, la extirpación de todo tumor macroscópico (citorreducción óptima) ha demostrado ser el factor pronóstico más importante, demostrando un beneficio tanto en tiempo libre de enfermedad como en sobrevida global. Nuestro objetivo es describir, desde una perspectiva multidisciplinaria, los aspectos técnicos más relevantes de la citorreducción del abdomen superior para aquellas pacientes con neoplasias de origen ginecológico.

ABSTRACT Epithelial Ovarian cancer is the ninth most frequent cancer in women and the most lethal gynecologic malignancy in developed countries. The majority of patients are diagnosed in advanced stage of the disease due to the lack of specific symptoms. Surgery and systemic treatment play a key role in the treatment of this disease. For those patients with advanced stage at the time of diagnosis (III - IV), removal of all macroscopic disease (optimal cytoreduction) has been shown as the most important prognostic factor, demonstrating improvement not only in progression free survival but also in overall survival. Our aim is to describe, in a multidisciplinary fashion, the most relevant aspect about oncological debulking procedures in the upper abdominal cavity for women with gynecological malignancies.

Life cycle assessment of carbon capture and utilization from ammonia process in Mexico.

Post-combustion CO2 capture (PCC) of flue gas from an ammonia plant (AP) and the environmental performance of the carbon capture utilization (CCU) technology for greenhouse gas (GHG) emissions to an enhanced oil recovery (EOR) system in Mexico was performed as case study. The process simulations (PS) and life cycle assessment (LCA) were used as supporting tools to quantify the CO2 capture and their environmental impacts, respectively. Two scenarios were considered: 1) the AP with its shift and CO2 removal unit and 2) Scenario 1 plus PCC of the flue gas from the AP primary reformer (AP-2CO2) and the global warming (GW) impact. Also, the GW of the whole of a CO2-EOR project, from these two streams of captured CO2, was evaluated. Results show that 372,426 tCO2/year can be PCC from the flue gas of the primary reformer and 480,000 tons/y of capacity from the AP. The energy requirement for solvent regeneration is estimated to be 2.8 MJ/kgCO2 or a GW impact of 0.22 kgCO2e/kgCO2 captured. GW performances are 297.6 kgCO2e emitted/barrel (bbl) for scenario one, and 106.5 kgCO2e emitted/bbl for the second. The net emissions, in scenario one, were 0.52 tCO2e/bbl and 0.33 tCO2e/bbl in scenario two. Based on PS, this study could be used to evaluate the potential of CO2 capture of 4080 t/d of 4 ammonia plants. The integration of PS-LCA to a PCC study allows the applicability as methodological framework for the development of a cluster of projects in which of CO2 could be recycled back to fuel, chemical, petrochemical products or for enhanced oil recovery (EOR). With AP-2CO2, "CO2 emission free" ammonia production could be achieved.

Tratamiento transdisciplinario del linfedema mediante terapia físico-combinada compleja. Análisis de nuestra experiencia / Complex physical-combined decongestion therapy in lymphedema: Analysis of our experience

INTRODUCCIÓN: El tratamiento actual del linfedema se realiza por un equipo transdisciplinario y con terapia físico-combinada descongestiva compleja. OBJETIVO: Evaluar la respuesta a las primeras 10 sesiones continuas de terapia físico-combinada compleja, en pacientes con linfedema de las extremidades inferiores. MÉTODO: Se analizan 20 pacientes ingresados por linfedema con compromiso del miembro inferior. Se comparó el porcentaje de reducción del edema, en función de la perimetría realizando 9 mediciones en el miembro inferior tomadas al ingreso y al finalizar las 10 sesiones, más cálculos de volumetría. Los pacientes fueron tratados con terapia físico-combinada descongestiva compleja: drenaje linfático manual, vendaje multicapa y ejercicios miolinfokinéticos. RESULTADOS: Los pacientes varones que cumplieron terapia descongestiva compleja completa redujeron su perimetría en un 5,2% y las mujeres en un 6,2%, la volumetría disminuyó en un 8,7% para los hombres y en un 13,6% para las mujeres. CONCLUSIÓN: Para obtener un óptimo resultado en corto tiempo (10 sesiones), especialmente para pacientes que residen alejados de nuestro centro, se requiere hacer terapia descongestiva compleja completa

INTRODUCTION: Lymphedema treatment is being currently being performed by a multi-disciplinary health team using a complex physical-combined decongestion therapy. OBJECTIVE: To evaluate patient response to the first 10 sessions of a complex physical-combined decongestion therapy to treat lower-limb lymphedema. METHOD: Twenty patients with lower-limb lymphedema were evaluated and treated with 10 sessions of a complex physical-combined decongestion therapy, which includes: manual lymphatic drainage, multi-layer bandage and mio- lymphatic kinetic exercises. The edema reduction percentage was compared, based on the lower limb perimeter by evaluating 9 measurements s taken at the beginning and at the end of the sessions cycle, along with volumetric calculations. RESULTS: Male patients that completed the therapy showed a 5.2% decrease in their lower limb perimeter, while female patients showed a 6.2% decrease. Volumetric measurements decreased by 8.7% in males and 13.6% in females. CONCLUSION: To achieve an optimal result in a short period of time (10 sessions), a complex physical-combined decongestion therapy is required

In vivo adhesion of malignant B cells to bone marrow microvasculature is regulated by α4ß1 cytoplasmic-binding proteins.

Multiple myeloma (MM) and chronic lymphocytic leukemia (CLL) cells must attach to the bone marrow (BM) microvasculature before lodging in the BM microenvironment. Using intravital microscopy (IVM) of the BM calvariae we demonstrate that the α4ß1 integrin is required for MM and CLL cell firm arrest onto the BM microvasculature, while endothelial P-selectin and E-selectin mediate cell rolling. Talin, kindlin-3 and ICAP-1 are ß1-integrin-binding partners that regulate ß1-mediated cell adhesion. We show that talin and kindlin-3 cooperatively stimulate high affinity and strength of α4ß1-dependent MM and CLL cell attachment, whereas ICAP-1 negatively regulates this adhesion. A functional connection between talin/kindlin-3 and Rac1 was found to be required for MM cell attachment mediated by α4ß1. Importantly, IVM analyses with talin- and kindlin-3-silenced MM cells indicate that these proteins are needed for cell arrest on the BM microvasculature. Instead, MM cell arrest is repressed by ICAP-1. Moreover, MM cells silenced for talin and kindlin-3, and cultured on α4ß1 ligands showed higher susceptibility to bortezomib-mediated cell apoptosis. Our results highlight the requirement of α4ß1 and selectins for the in vivo attachment of MM and CLL cells to the BM microvasculature, and indicate that talin, kindlin-3 and ICAP-1 differentially control physiological adhesion by regulating α4ß1 activity.

Impacto que genera el diagnóstico de VIH en mujeres trabajadoras de la Región de Antofagasta y Metropolitana / Impact of hiv diagnosis in working women in the Region of Antofagasta and the Metropolitan Region

El propósito del presente artículo expone como el diagnóstico de VIH ha afectado a mujeres chilenas en su rol de trabajadoras, conociéndolo desde su propia perspectiva. Es una investigación cualitativa, donde se entrevistan a 3 mujeres sero positivo de edad entre los 20 y 65 años, que cuentan con experiencia laboral previo al diagnóstico de VIH. Los resultados identifican un antes y después del diagnóstico de VIH, donde para mantener su rol de trabajadoras ocultan su diagnóstico al empleador y a sus compañeros de trabajo por miedo a ser discriminada; dan a conocer abiertamente su diagnóstico al contexto social que se desenvuelven para evitar prejuicios; o cambian su rubro laboral. De esta manera, se reconoce que la ley del SIDA de Chile no logra cubrir una protección real que permita el respeto, fiscalización y responsabilidad de estas normas, siendo vulnerados los derechos de las mujeres que viven con VIH. Las mujeres diagnosticadas sufren apartheid ocupacional e injusticia ocupacional, ya que no logran realizar su rol como trabajadoras debido a la desinformación que existe en la sociedad frente al VIH y a los estigmas que se encuentran en torno a ella, desencadenando prejuicios sociales históricos que han favorecido que mujeres vivan ocultando su realidad...

The purpose of this article is to present how an HIV diagnosis has affected Chilean women in their role as workers, from the perspective of the women themselves. It is qualitative research involving three interviews which HIV positive women between the ages of 20 and 65 who have work experience prior to receiving their HIV diagnosis. The results identify that there is a difference in the women’s experience pre- and post-diagnosis, whereby to maintain their role as workers they hide their diagnosis from their employer and colleagues for fear of discrimination; that the women openly disclose their diagnosis in the social context in which they operate to avoid bias; or that they change their job. Thus, it is clear that the AIDS Chile legislation fails to offer real protection to ensure respect, execution of, and accountability regarding these rules being violated for women living with HIV. The diagnosed women suffer an occupational apartheid and occupational injustice, as they are unable to perform their role as workers due to the misunderstandings that exist in society regarding HIV and to the stigmas that surround it and, moreover, are victims of historical social biases that have favored women live hiding their HIV reality...

In vitro and in vivo evaluation of Δ9-tetrahidrocannabinol/PLGA nanoparticles for cancer chemotherapy.

Nanoplatforms can optimize the efficacy and safety of chemotherapy, and thus cancer therapy. However, new approaches are encouraged in developing new nanomedicines against malignant cells. In this work, a reproducible methodology is described to prepare Δ(9)-tetrahidrocannabinol (Δ(9)-THC)-loaded poly(d,l-lactide-co-glycolide) (PLGA) nanoparticles against lung cancer. The nanoformulation is further improved by surface functionalization with the biodegradable polymers chitosan and poly(ethylene glycol) (PEG) in order to optimize the biological fate and antitumor effect. Mean nanoparticle size (≈ 290 nm) increased upon coating with PEG, CS, and PEG-CS up to ≈ 590 nm, ≈ 745 nm, and ≈ 790 nm, respectively. Surface electrical charge was controlled by the type of polymeric coating onto the PLGA particles. Drug entrapment efficiencies (≈ 95%) were not affected by any of the polymeric coatings. On the opposite, the characteristic sustained (biphasic) Δ(9)-THC release from the particles can be accelerated or slowed down when using PEG or chitosan, respectively. Blood compatibility studies demonstrated the adequate in vivo safety margin of all of the PLGA-based nanoformulations, while protein adsorption investigations postulated the protective role of PEGylation against opsonization and plasma clearance. Cell viability studies comparing the activity of the nanoformulations against human A-549 and murine LL2 lung adenocarcinoma cells, and human embryo lung fibroblastic MRC-5 cells revealed a statistically significant selective cytotoxic effect toward the lung cancer cell lines. In addition, cytotoxicity assays in A-549 cells demonstrated the more intense anticancer activity of Δ(9)-THC-loaded PEGylated PLGA nanoparticles. These promising results were confirmed by in vivo studies in LL2 lung tumor-bearing immunocompetent C57BL/6 mice.

Anaerobic co-digestion of wine/fruit-juice production waste with landfill leachate diluted municipal sludge cake under semi-continuous flow operation.

Anaerobic co-digestion of four organic waste streams; a thickened waste activated sludge (TWAS) and screen cake (SC) from a fruit-juice/winery wastewater treatment plant along with municipal sludge cake (MC) and landfill leachate (LL) was evaluated. A total of eight semi-continuously-fed single and co-digesters were operated side-by-side at sludge retention times (SRT) of 20 and 10 days. Co-digestion of industrial waste streams (TWAS and SC) with MC and LL resulted in increased operational stability compared to the single digestion of industrial TWAS at the higher organic loading (10 d SRT). Although digester operational temperature had no statistically significant effect on organics removal and biogas production, mesophilic digesters had consistently higher total coliform densities (8838-37,959 most probable number or MPN/g-dry weight) compared to the thermophilic digesters (41-6723 MPN/g-dry weight) at both SRTs. Coliform analysis results also proved that most of the thermophilic digestates could be classified as Class A biosolids according to regulations. Furthermore, addition of industrial TWAS to co-digesters enhanced the dewaterability of the digested streams. A cost-benefit analysis confirmed the benefits and indicated that a full-scale co-digester utilizing all four waste streams can decrease the total capital and operational cost by 22% ($10.52 million).

Evaluation of corneal anaesthesia after the application of topical 2 per cent lidocaine, 0.5 per cent bupivacaine and 1 per cent ropivacaine in dogs.

The objective of this study was to describe and compare the efficacy and duration of topical anaesthesia induced by 2 per cent lidocaine (L), 0.5 per cent bupivacaine (B) and 1 per cent ropivacaine (R) in the dog using 24 clinically healthy beagles with normal ocular examination. Dogs were randomly divided into three groups: 2 per cent lidocaine (n=8), 0.5 per cent bupivacaine (n=8) and 1 per cent ropivacaine (n=8). The baseline corneal touch threshold (CTT) was measured using a Cochet-Bonnet aesthesiometer. Following baseline CTT measurement, a single drop of the assigned anaesthetic was applied to each eye and the CTT was measured bilaterally within one minute after administration and every five minutes until the basal CTT value was restored. Data were analysed with non-parametric analysis of variance models and Dunnet's test for post hoc analysis. One per cent ropivacaine was the most effective drug (LCTTmax=3 cm, BCTTmax=2 cm, RCTTmax=0 cm; P<0.001), and had the shortest latency (LLatency=5 minutes, BLatency=5 minutes, RLatency=1 minute; P<0.001) and the smallest AUC (LAUC=80 cm×minute, BAUC=68.25 cm×minute, RAUC=36.88 cm×minute; P<0.001). There was no statistical difference in the duration of corneal anaesthesia between the groups (P=0.09) and all topical anaesthetics tested reduced corneal sensitivity, although 1 per cent ropivacaine had the maximal and quickest anaesthetic effect. This drug could be used for specific diagnostic procedures where quick and short, but effective, corneal anaesthesia is needed.

Mesophilic batch anaerobic co-digestion of fruit-juice industrial waste and municipal waste sludge: process and cost-benefit analysis.

The feasibility of anaerobic co-digestion of two juice-based beverage industrial wastes, screen cake (SC) and thickened waste activated sludge (TWAS), along with municipal sludge cake (MC) was investigated. Experiments were conducted in twenty mesophilic batch 160 ml serum bottles with no inhibition occurred. The statistical analysis proved that the substrate type had statistically significant effect on both ultimate biogas and methane yields (P=0.0003<0.05). The maximum and minimum ultimate cumulative methane yields were 890.90 and 308.34 mL/g-VSremoved from the digesters containing only TWAS and SC as substrate. First-order reaction model well described VS utilization in all digesters. The first 2-day and 10-day specific biodegradation rate constants were statistically higher in the digesters containing SC (P=0.004<0.05) and MC (P=0.0005<0.05), respectively. The cost-benefit analysis showed that the capital, operating and total costs can be decreased by 21.5%, 29.8% and 27.6%, respectively using a co-digester rather than two separate digesters.

Pilotaje de un dispositivo de monitorización cardiaca remota / Pilot study with a remote cardiac monitoring device

Objetivos: evaluar la eficacia de un sistema de monitorización (la calidad y amplitud del registro, señal transmitida en la tarjeta, parámetros de medición), el grado de satisfacción de los usuarios y la futura implementación del dispositivo en pacientes de bajo riesgo para poder llegar a un mayor número de enfermos en un programa de rehabilitación cardíaca (RC) domiciliario. Material y método: estudio descriptivo transversal sobre pacientes en el programa de RC. La recogida de datos se realizó a través de un registro. Se aplicó un análisis descriptivo de todas las variables del estudio, y para evaluar la eficacia del dispositivo se efectuó la prueba ANOVA de un factor, utilizando el programa SPSS 18.0.Resultados: participaron 60 pacientes (86,3% eran varones, con una edad media de 54,9 años). La calidad del registro fue buena en un40% de los casos y la amplitud en un 52%. Los registros presentaron escasos artefactos (28%) y solo el 24% había tenido alguna desconexión en el dispositivo. Se ha comprobado la fiabilidad del dispositivo con el empleo del pulsímetro como muy buena (76%). El uso de la camiseta le ha resultado muy cómoda a un 56%, y ha ayudado a realizar mejor la actividad física al 64%. El 92% recomendaría el uso de la camiseta a otras personas. Conclusiones: la plataforma de monitorización cardiaca de Nuuboha desarrollado una solución que permite biomonitorizar de forma remota y no invasiva con un registro de calidad en el tratamiento domiciliario de los pacientes, además se han definido las mejoras a implantaren el futuro sistema remoto (AU)

Objectives: to assess the efficacy of a monitoring system (quality and range of recording, signal transmitted in the card, measurement parameters),the extent of satisfaction by users, and the future implementation of the device in low-risk patients in order to reach a higher number of patients in a Home-based Cardiac Rehabilitation (CR)Program. Materials and method: transversal descriptive study on patients in the CR Program. Data collection was conducted through a registry. A descriptive analysis for all the study variables was implemented, and in order to assess the device efficacy, the ANOVA test for a single factor was conducted, using the SPSS 18.0 program. Results: sixty (60) patients were included in the study (86.3% were male, with a median age of 54.9 years). The registry quality was good in 40% of cases, and the range was good in 52% of cases. Registries presented few artifacts (28%), and only 24% showed some disconnection in the device. The device reliability has been confirmed as very good (76%) by using the pulsimeter. Wearing the t-shirt has been very comfortable for 56% of patients, and it has helped to a better practice of physical activities to 64% of patients. 92% of the subjects would recommend the use of the t-shirt to other people. Conclusions: the Cardiac Monitoring Platform by Nuubo has developed a solution which allows remote and non-invasive bio-monitoring, with a good quality registry for patient treatment at home; besides, the improvements to be implemented in the future remote system have been defined (AU)

Condición de salud de pacientes diabéticos y su satisfacción con el tratamiento para la enfermedad / Health condition of type 2 diabetic patients and their satisfaction regarding disease treatment

La diabetes mellitus (DM) va en aumento en nuestro país, con alta prevalencia de complicaciones especialmente por mal control metabólico. Objetivo: evaluar asociación de condición de salud, variables sociodemográficas y años de diagnóstico con satisfacción del paciente con características del tratamiento de diabetes. Material y método: estudio de prevalencia en 340 pacientes de 1.100 usuarios DM2 controlados en Programa Cardiovascular de un Centro de Salud Familiar (CESFAM) de Macul, Región Metropolitana, Chile, previo consentimiento informado. Muestreo aleatorio simple (confianza 95 por ciento, merma 10 por ciento). Recolección de información en CESFAM y/o visita domiciliaria por investigadoras e internas de enfermería entrenadas. Satisfacción del paciente, medida con subescala satisfacción del cuestionario Diabetes Quality of Life (EsDQOL). Análisis con estadística descriptiva, Chi2, Odd Ratios, IC (95 por ciento). Resultados: Población mayoritariamente adulta mayor, femenina, promedio años estudio 8,7. El 42,6 por ciento tiene diagnóstico de DM hace más de 10 años. Refieren mayor satisfacción con: tratamiento medicamentoso, controles recibidos, vida en general. Existe mayor insatisfacción con: tiempo ocupado en ejercicios, cómo duerme, vida sexual. Satisfacción con tratamiento medicamentoso se asocia a compensación de diabetes (p= 0,026). Pacientes insatisfechos con tratamiento tienen 2 veces más riesgo de descompensación que los satisfechos, IC [1,08-3,7]. Insatisfacción con tiempo dedicado a enfermedad, controles, tiempo ocupado en controles y ejercicio indicado se asocian a complicaciones (p < 0,05). Conclusión: Insatisfacción con características del tratamiento de DM2 se asocia mayormente a complicaciones que a compensación de DM, pacientes insatisfechos tienen más riesgo de complicaciones que los satisfechos.

Diabetes Mellitus is increasing in our country, with a high prevalence of complications mainly because of poor metabolic control. Objectives: to evaluate association of health condition, demographic variables, and years since diagnosis with patient satisfaction regarding disease treatment. Methodology: prevalence study, 340 patient taken out of a population of 1.100 patients attended in the Cardiovascular Program of an outpatient clinic in Macul district. Informed consent was requested. Simple randomized sample (CI 95 percent, loss 10 percent). Data collected in the outpatient clinic or through home visits done by researchers or trained senior nursing students. Patient satisfaction was measured by the satisfaction subscale of the Diabetes Quality of Life Questionnaire (EsDQOL). Analysis: descriptive statistics, Chi2, Odds Ratios, CI (95 percent). Results: Population of mainly older adults, female, average years of school attendance 8.7. 42.6 percent has been diagnosed since more than 10 years. They refer greater satisfaction with: pharmacologic treatment, care received in outpatient visits, life in general. There exists more dissatisfaction with: time spent in exercise, sleep, sexual life. Satisfaction with pharmacologic treatment has association with diabetes compensation (p= 0.026). Patients dissatisfed with treatment have 2 times more risk of poor metabolic control than satisfed patients, IC[1.08-3.7]. Dissatisfaction with time spent in the disease, outpatient visits, and time spent in exercises, are associated with complications (p < 0.05). Conclusion: Dissatisfaction is more associated to complications than to poor metabolic control. Patient dissatisfed have more risk of complications than those satisfed.

Ingesta de tomate reduce niveles de colesterol en ratas Wistar / Tomato intake lowers cholesterol levels in rats

Cardiovascular diseases are closely associated with lifestyle risk factors, some of them modifiable. Animal studies and clinical observations have suggested a relationship between serum total cholesterol and atherosclerosis. Studies have shown that levels of triglycerides and cholesterol were modified by the consumption of fresh tomato juice. The aim of this study was to investigate the effect of daily consumption of tomato mash on cholesterol and other biochemical parameters in Wistar rats. To carry out this research two groups of rats (n = 6 each one), were formed, one of which was supplemented with a mash diet tomato and the other was used for control. After 15 days of testing, the rats were sacrificed and plasma collected was used for biochemical determination of total cholesterol, triglycerides, glucose, glutamicoxaloacetic transaminase and glutamic pyruvic transaminase. The cholesterol level decreased in the study group (33,7+/-2,78 mg/dL) with respect to that of control group (58,6+/-10,6 mg/dL). This study showed an ipocholesterolemic effect of the tomato in rats. Future studies could examine this activity in dyslipidemic subjects.

Valproic acid induces differentiation and transient tumor regression, but spares leukemia-initiating activity in mouse models of APL.

Aberrant histone acetylation was physiopathologically associated with the development of acute myeloid leukemias (AMLs). Reversal of histone deacetylation by histone deacetylase inhibitor (HDACis) activates a cell death program that allows tumor regression in mouse models of AMLs. We have used several models of PML-RARA-driven acute promyelocytic leukemias (APLs) to analyze the in vivo effects of valproic acid, a well-characterized HDACis. Valproic acid (VPA)-induced rapid tumor regression and sharply prolonged survival. However, discontinuation of treatment was associated to an immediate relapse. In vivo, as well as ex vivo, VPA-induced terminal granulocytic differentiation. Yet, despite full differentiation, leukemia-initiating cell (LIC) activity was actually enhanced by VPA treatment. In contrast to all-trans retinoic acid (ATRA) or arsenic, VPA did not degrade PML-RARA. However, in combination with ATRA, VPA synergized for PML-RARA degradation and LIC eradication in vivo. Our studies indicate that VPA triggers differentiation, but spares LIC activity, further uncouple differentiation from APL clearance and stress the importance of PML-RARA degradation in APL cure.

Condición de salud y cumplimiento de la guía clínica chilena para el cuidado del paciente diabético tipo / Health condition and compliance of the chilean clinical guideline for type 2 diabetic patients

Objetivo: Identificar condición de salud (CS) de los pacientes diabéticos tipo 2. Medir el cumplimiento de las atenciones de salud según guía clínica. Identificar variables asociadas a CS. Material y método: estudio de pre-valencia, abril 2010. Población: 1.100 pacientes DM2 controlados en Programa Cardiovascular, considerando criterios de inclusión, exclusión, consentimiento informado. Muestra: 340 por aleatorización simple (confianza 95 por ciento merma 10 por ciento). Recolección de datos realizada en CESFAM o visita domiciliaria por investigadoras e internas de enfermería entrenadas, con encuesta validada, exámenes, plantilla para información y ficha clínica. Para el análisis se utilizó estadística descriptiva, Chi2, Odds Ratios con IC (95 por ciento). Resultados: CS: descompensados (HbA1c>7 por ciento) 56.5 por ciento, patologías agregadas 97.9 por ciento, complicaciones 25 por ciento, mayor frecuencia retinopatía diabética. hombres mayor riesgo de amputación (p=0.003). Presión arterial >130/85 mm.hg. 58.2 por ciento, sobrepeso-obesidad 71.2 por ciento, autovalencia (adultos mayores) 23.1 por ciento. Cumplimiento recomendaciones ministeriales: controles/profesionales/año a lo menos cinco 41.5 por ciento, CESFAM adapta esta recomendación. Evaluación anual de: pie diabético 78 por ciento, fondo ojo 41,6 por ciento. Indicación régimen (nutricionista) último control 80 por ciento. Cinco controles profesionales/ año o más es protector de compensación de diabetes, IC (0.62-0.95), resto de recomendaciones y adaptación de éstas no se asocian a condición de salud (p > 0.05). Conclusiones: Los componentes de condición de salud están en general por sobre lo esperado. En ningún paciente se cumple en un 100 por ciento las recomendaciones de la guía clínica. Cinco o más controles profesionales anuales se asocian a compensación de la diabetes. Importante cumplir recomendaciones para mejorar control metabólico y disminuir/retrasar complicaciones para una mejor calidad de vida de pacientes.

Objectives: To determine compliance with Chilean clinical guideline and to measure their impact through evaluation of patient’s health condition (HC), to determine associations. Methods: prevalence study, April 2010. Population: 1,100 diabetic patients controlled in the Cardiovascular Program, considering criteria of inclusion, exclusion, informed consent. Sample: 340 randomized patients (Confidence level: 95 percent; Loss: 10 percent). Information was collected in an outpatient clinic and through home visits performed by researchers and trained senior nursing students, with a validated survey, exams, staff for file information. For the purposes of the analysis, descriptive statistics was used, Chi2, Odds Ratios with CI (95 percent). Results: HC: decompensation (HbA1c>7 percent 56.5 percent derived illnesses 97.9 percent, complications 25 percent, greater frequency of diabetic retinopathy. Males with greater risk of amputation (p=0.003). Blood pressure >130/85 mm. hg. 58.2 percent, overweight-obesity 71.2 percent, self-care (older adults) 23.1 percent. Compliance with clinical guideline: controls/professionals/year at least five 41.5 percent, CESFAM adapts this recommendation. Annual evaluation of: diabetic foot 78 percent, fundoscopy 41.6 percent. Regime indication (dietician) last control 80 percent. Five professional controls/year or more protect compensation for diabetes, IC (0.62-0.95), other recommendations and adaptation of recommendations are not associated with health status (p > 0.05). Conclusions: components of hC are better than expected. In none of the patients are the recommendations of the clinical guideline fulfilled in a 100 percent. 5 or more annual outpatient visits are associated to good metabolic control. Compliance with clinical guideline recommendations is important to improve metabolic control, to lessen complications and to improve patient’s quality of life.

Physical fitness and obesity are associated in a dose-dependent manner in children.

AIMS: To analyze the relationships between physical fitness, lifestyle-related factors, and obesity in a large population of children. METHODS: A cross-sectional study design including children aged 7-12 years (n = 715) was used. Adiposity measures included subcutaneous fat mass (SFM) and body mass index (BMI). Physical fitness and lifestyle-related factors were also assessed. RESULTS: When SFM was used as the adiposity variable, the odds ratios (OR) for being obese in boys in the highest quartiles of fitness were 0.02 (95% CI 0.02-0.13) for aerobic fitness, 0.04 (95% CI 0.01-0.16) for dynamic force, and 5.32 (95% CI 1.82-15.58) for running speed (in which quartile 1 corresponds to the best performance) compared with boys in the lowest quartile. In girls, the OR for those in the highest quartiles of fitness were 0.04 (95% CI 0.01-0.14), 0.16 (95% CI 0.05-0.51), and 5.24 (95% CI 1.74-15.75), respectively, showing a significant dose-response relationship between fitness and fatness in both sexes (p for trend <0.001). CONCLUSIONS: An inverse relationship between physical fitness levels and the risk of being overweight/obese was found inasmuch as children with higher physical fitness seem to be more protected against fat mass accumulation than their counterparts with lower fitness levels.

Uveal inflammation in septic newborn foals.

BACKGROUND: Septicemia in humans is described as a leading cause of uveitis, which eventually can induce blindness. HYPOTHESIS/OBJECTIVES: Uveal inflammatory findings could be related to sepsis severity in newborn foals and might be used as an indirect indicator for survival. ANIMALS: Seventy-four septic foals, 54 nonseptic foals, and 42 healthy foals. METHODS: Prospective observational clinical study. A detailed blinded, ophthalmic examination was performed by boarded ophthalmologists on all admitted newborn foals. Foals were grouped as septic (when blood culture resulted positive or the sepsis score was > or =14), nonseptic, and controls. Based on blood culture results, the septic group was subdivided into bacteremic and nonbacteremic foals. RESULTS: Blood culture was performed in 62/74 septic foals, from which 35 (56%) were bacteremic and 27 (44%) were non-bacteremic. Anterior uveitis was diagnosed in a significantly (P < .005) higher number of septic/bacteremic foals (14/35, 40%) than in septic/nonbacteremic foals (5/27, 19%), nonseptic foals (4/54, 7%), and control foals (0%). Anterior chamber fibrin was only observed in 4/14 (29%) septic/bacteremic foals with anterior uveitis. Anterior uveitis was also associated with posterior uveitis in 6/35 (19%) septic/bacteremic foals. The diagnosis of uveitis was related to nonsurvival (P = .001, odds ratio = 6.2, 95% confidence interval = 2.1-18.2). CONCLUSIONS AND CLINICAL IMPORTANCE: Anterior uveitis is highly prevalent in septic newborn foals, especially in those with a positive blood culture, and it should be considered as a survival prognostic factor.