Eficacia de la recomendación de un patrón de dieta mediterránea en preescolares con sobrepeso y obesidad / Efficacy of the recommendation of a Mediterranean diet pattern in preschoolers with overweight and obesity

INTRODUCCIÓN: Tras realizar algunas puntualizaciones -no suficientemente aclaradas en las guías de alimentación- hemos recurrido a la dieta mediterránea tradicional y hemos medido los valores antropométricos al comienzo y al finalizar el año del estudio en pacientes que hacían un cumplimiento razonablemente correcto de las guías, y aun así tenían sobrepeso y obesidad. PACIENTES Y MÉTODOS: Se incluyeron niños de 2 a 8 años con sobrepeso y obesidad en un programa de educación nutricional denominado «Aprendiendo a comer del Mediterráneo». Para evaluar la calidad de la dieta, hemos utilizado el test Kidmed y para poder medir las nuevas propuestas hemos diseñado el test de la Dieta Mediterránea Tradicional. RESULTADOS: Se obtuvo una muestra de 92 pacientes (42 niñas y 50 niños). La edad media fue de 5,3 años. Tras un año de intervención dejaron de ser obesos el 75,7% y dejaron de tener sobrepeso el 74,3%. En conjunto, el percentil del IMC descendió 12,1 puntos. Se consiguió una mejoría en la calidad de la alimentación reflejada en una mejor puntuación de ambos índices. El test Kidmed no resultó apropiado para el control del sobrepeso. CONCLUSIONES: La aplicación de un patrón de dieta mediterránea tradicional en el ámbito familiar ha resultado muy efectiva en el control de niños con sobrepeso u obesidad. Consideramos que el cumplimiento del test de la Dieta Mediterránea Tradicional junto al programa nutricional «Aprendiendo a comer del Mediterráneo» han sido claves en los resultados

INTRODUCTION: After making some points -not sufficiently clarified in the feeding guides- we have resorted to the traditional Mediterranean diet and we have measured the anthropometric values at the beginning and at the end of the study, in patients who made a reasonably correct compliance with the guidelines, and even so they were overweight and obese. PATIENTS AND METHODS: Children aged 2 to 8 years with overweight and obesity were included in a nutritional education program called «Learning to eat from the Mediterranean». To evaluate the quality of the diet, we used the Kidmed test and to measure the new proposals we designed the test Traditional Mediterranean Diet. RESULTS: A sample of 92 patients was obtained (42 girls and 50 boys). The average age was 5.3 years. After one year of intervention, 75.7% were no longer obese and 74.3% stopped being overweight. Overall, the BMI percentile fell 12.1 points. An improvement in the quality of the food reflected in a better score of both indices was achieved. The Kidmed test was not appropriate for the control of overweight. CONCLUSIONS: The application of a traditional Mediterranean diet pattern in the family environment has been very effective in the control of overweight or obese children. We believe that compliance with the Traditional Mediterranean Diet test along with the nutritional program «Learning to eat from the Mediterranean» have been key in the results

Dermatomiositis asociada con carcinoma hepatocelular relacionado con el virus de la hepatitis B: un reporte de caso en Perú / Dermatomyositis associated with hepatitis B virus-related hepatocellular carcinoma: a case report in Peru

La dermatomiositis (DM) es una miopatía inflamatoria de causa desconocida caracterizada por inflamación muscular, debilidad músculo-esquelética proximal y manifestaciones cutáneas típicas. Se ha asociado a malignidades como un síndrome paraneoplásico. Reportamos el caso de un paciente varón de 33 años, diagnosticado de hepatitis B, VHB crónico inactivo, que presentó lesiones papulares, pruriginosas y descamativas en cara, manos, zona inguinal y pies. Al examen físico se evidenció pápulas de Gottron, signo del heliotropo, debilidad muscular simétrica proximal. Se realizó una biopsia de piel donde se encontraron hallazgos compatibles con DM. Tras una ecografía abdominal se encontró una tumoración hepática, cuyo resultado en biopsia fue de carcinoma hepatocelular moderadamente diferenciado. Posteriormente se le realiza segmentectomía con lo cual síntomas de DM disminuyen. Es un caso infrecuente, y de sumo interés por lo que se decide reportar.

Dermatomyositis is an idiopathic inflammatory myopathie characterized by proximal skeletal muscle weakness, typical skin manifestations and muscle inflammation. This disease has been associated with malignancies as a paraneoplastic syndrome. We present a patient of thirty-three years diagnosed with hepatitis B, chronic inactive HBV who presents papular, pruritic and desquamative lesions on the face, hands, inguinal area and feet. At the physical examination is evidentiated Gottron's papules, heliotrope sign and proximal symmetric muscular weakness. Findings compatible with DM were found in a skin biopsy. An abdominal ultrasound revealed a liver tumor whereby a biopsy was performed and the result was a moderately differentiated hepatocellular carcinoma. Subsequently, a segmentectomy has been made and consequently the DM symptoms decreased. This case is of great interest and rare reason why we decided to reported it.

Assessment of the Sulfamethoxazole mobility in natural soils and of the risk of contamination of water resources at the catchment scale.

Sulfamethoxazole (SMX) is one of the antibiotics most commonly detected in aquatic and terrestrial environments and is still widely used, especially in low income countries. SMX is assumed to be highly mobile in soils due to its intrinsic molecular properties. Ten soils with contrasting properties and representative of the catchment soil types and land uses were collected throughout the watershed, which undergoes very rapid urban development. SMX displacement experiments were carried out in repacked columns of the 10 soils to explore SMX reactive transfer (mobility and reactivity) in order to assess the contamination risk of water resources in the context of the Bolivian Altiplano. Relevant sorption processes were identified by modelling (HYDRUS-1D) considering different sorption concepts. SMX mobility was best simulated when considering irreversible sorption as well as instantaneous and rate-limited reversible sorption, depending on the soil type. SMX mobility appeared lower in soils located upstream of the watershed (organic and acidic soils - Regosol) in relation with a higher adsorption capacity compared to the soils located downstream (lower organic carbon content - Cambisol). By combining soil column experiments and soil profiles description, this study suggests that SMX can be classified as a moderately to highly mobile compound in the studied watershed, depending principally on soil properties such as pH and OC. Potential risks of surface and groundwater pollution by SMX were thus identified in the lower part of the studied catchment, threatening Lake Titicaca water quality.

[Dermatomyositis associated with hepatitis B virus-related hepatocellular carcinoma: a case report in Peru]. / Dermatomiositis asociada con carcinoma hepatocelular relacionado con el virus de la hepatitis B: un reporte de caso en Perú.

Dermatomyositis is an idiopathic inflammatory myopathie characterized by proximal skeletal muscle weakness, typical skin manifestations and muscle inflammation. This disease has been associated with malignancies as a paraneoplastic syndrome. We present a patient of thirty-three years diagnosed with hepatitis B, chronic inactive HBV who presents papular, pruritic and desquamative lesions on the face, hands, inguinal area and feet. At the physical examination is evidentiated Gottron's papules, heliotrope sign and proximal symmetric muscular weakness. Findings compatible with DM were found in a skin biopsy. An abdominal ultrasound revealed a liver tumor whereby a biopsy was performed and the result was a moderately differentiated hepatocellular carcinoma. Subsequently, a segmentectomy has been made and consequently the DM symptoms decreased. This case is of great interest and rare reason why we decided to reported it.

Water flow paths are hotspots for the dissemination of antibiotic resistance in soil.

Antibiotic resistance genes in soil pose a potential risk for human health. They can enter the soil by irrigation with untreated or insufficiently treated waste water. We hypothesized that water flow paths trigger the formation of antibiotic resistance, since they transport antibiotics, multi-resistant bacteria and free resistance genes through the soil. To test this, we irrigated soil cores once or twice with waste water only, or with waste water added with sulfamethoxazole (SMX) and ciprofloxacin (CIP). The treatments also contained a dye to stain the water flow paths and allowed to sample these separately from unstained bulk soil. The fate of SMX and CIP was assessed by sorption experiments, leachate analyses and the quantification of total and extractable SMX and CIP in soil. The abundance of resistance genes to SMX (sul1 and sul2) and to CIP (qnrB and qnrS) was quantified by qPCR. The sorption of CIP was larger than the dye and SMX. Ciprofloxacin accumulated exclusively in the water flow paths but the resistance genes qnrB and qnrS were not detectable. The SMX concentration in the water flow paths doubled the concentration of the bulk soil, as did the abundance of sul genes, particularly sul1 gene. These results suggest that flow paths do function as hotspots for the accumulation of antibiotics and trigger the formation of resistance genes in soil. Their dissemination also depends on the mobility of the antibiotic, which was much larger for SMX than for CIP.

Antibiotic pollution in the Katari subcatchment of the Titicaca Lake: Major transformation products and occurrence of resistance genes.

An increasing number of studies pointed out the ubiquitous presence of medical residues in surface and ground water as well as in soil compartments. Not only antibiotics can be found in the environment but also their transformation products about which little information is generally available. The development of bacterial resistance to antibiotics is particularly worrying as it can lead to sanitary and health problems. Studies about the dissemination of antibiotics and associated resistances in the Bolivian Altiplano are scarce. We provide baseline information on the occurrence of Sulfamethoxazole (SMX) and Trimethoprim (TMP) antibiotics as well as on the most common human SMX transformation products (TP) and on the occurrence of sulfonamide resistance genes. The studied water and soil compartments presented high levels of antibiotic pollution. This situation was shown to be mainly linked with uncontrolled discharges of treated and untreated wastewaters, resulting on the presence of antibiotics in the Titicaca Lake. SMX TPs were detected in surface waters and on soil sampled next to the wastewater treatment plant (WWTP). SMX resistance genes sulI and sulII were widely detected in the basin hydrological network, even in areas unpolluted with antibiotics. Mechanisms of co-selection of antibiotic- and metal- resistance may be involved in the prevalence of ARG's in pristine areas with no anthropogenic activity and free of antibiotic pollution.

Oral health and quality of life in the municipal senior citizen's social clubs for people over 65 of Valencia, Spain.

BACKGROUND: The world population is aging considerably. The state of elderly's dentition is poor. Many authors agree that the oral health status influence the elderly's quality of life.The objective of our study was to analyze the relation between the oral health status and the general health status through the quality of life of elderly people aged 65 years or more in Valencia, Spain. MATERIAL AND METHODS: A cross-sectional oral health survey and an oral examination have been designed to study an elderly population. There were 202 adults (103 men and 99 women). Age: 65 years of age and over. Randomly selected senior citizen's social clubs. The Oral Health Impact Profile (OHIP-14) has been used to obtain the health survey. Moreover, the EuroQol-5d and a Visual Analogue Scale (VAS) have been the tools to obtain the general health status. Finally, sociodemographic and oral health questions have been needed. RESULTS: Descriptive and inferential results have been done and the main results are the following, the mean additive score of the OHIP-14 was 8.88, the mean value of the EuroQol-5d was 0.58 and of the VAS, 72.90. The OHIP-14 was consistently and significantly correlated with the index EuroQol-5d and with variables such as number of teeth, missing teeth, DMFT, dental status (being or not edentulous) and occupation. The EuroQol-5d was related to dental habits, sex, income, systemic pathologies and filled teeth. CONCLUSIONS: The oral health has a high impact on quality of life. The oral health and the general health are closely related. The oral hygiene and getting toothless influence negatively on the quality of life of elderly people.

Haematological recovery in poor and good haematopoietic stem cell mobilisers.

OBJECTIVES: Evaluate whether poor mobilisers had delayed haematopoietic (neutrophil and platelet) recovery despite receiving similar cell dose as good mobilisers. BACKGROUND: Autologous haematopoietic progenitor cell (HPC) transplantation is indicated to treat some haematological malignancies. This procedure requires HPC mobilisation from bone marrow to peripheral blood. Cell dose is important for a fast haematological recovery. Despite being poor mobilisers, some patients can collect enough cell numbers for transplantation. RESULTS: Fifteen poor mobiliser patients (peak of CD34+ cells ≤10 µL(-1) in peripheral blood) were transplanted at our institution. Haematological recovery (neutrophil ≥ 500 µL(-1) ) in this group was compared to that observed in the group of 16 patients of good mobilisers (peak of CD34+ cells ≥20 µL(-1) in peripheral blood) who received similar cell dose (2·637 ± 0·1744 × 10(6) kg(-1) vs 2·727 ± 0·1746 × 10(6) kg(-1) ; P = 0·7177). The poor mobiliser group had neutrophil and platelet recovery later than the good mobiliser group (on day 12, range 9-14 vs day 10, range 9-22, P = 0·0381 for neutrophil, and on day 22·89 ± 11·16 and 14·08 ± 4·821, P = 0·0193 for platelet). Mortality rates and transfusion requirements were not different between the groups. CONCLUSION: Poor mobilisers have delayed neutrophil and platelet recovery after autologous HPC transplantation despite having received the same cell dose as good mobilisers.

Mediterranean diet and childhood asthma

BACKGROUND: The incidence of bronchial hyperreactivity has increased to one-third of the population in developed countries, which requires the adoption of preventive and therapeutic measures. The objective of the present study was to assess the effects of a traditional Mediterranean diet on patients diagnosed with childhood asthma and determine if there is a beneficial effect from this dietary intervention. METHODS: Prospective before-after comparison study of 50 girls and 54 boys aged 1-5 years, who were enrolled in the 1-year programme "Learning to Eat from the Mediterranean", designed to promote the adoption of a traditional Mediterranean diet. We studied the clinical and therapeutic variables and anthropometric measurements. RESULTS: All studied symptomatic indicators (number and intensity of asthmatic attack, infections and hospital admissions) showed a positive and statistically significant evolution of bronchial hyperreactivity from the first weeks of the intervention onwards. Throughout the treatment, 32.2% of patients remained free of crisis, 35.3% of the patients only had one attack throughout the year and 24.9% had two episodes, compared to 4.73 episodes on average in the previous year. The use of inhaled corticosteroids markedly decreased from 3.92 ± 1.61 to 1.11 ± 1.09 times per patient per year (P < 0.001) and that of inhaled bronchodilators decreased from 4.14 ± 1.61 to 1.12 ± 1.40 (P < 0.001). As a result, the families involved in the programme reported a high level of satisfaction. CONCLUSIONS: The adoption of a traditional Mediterranean diet could contribute significantly to the improvement of patients diagnosed with childhood asthma

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Mediterranean diet and childhood asthma.

BACKGROUND: The incidence of bronchial hyperreactivity has increased to one-third of the population in developed countries, which requires the adoption of preventive and therapeutic measures. The objective of the present study was to assess the effects of a traditional Mediterranean diet on patients diagnosed with childhood asthma and determine if there is a beneficial effect from this dietary intervention. METHODS: Prospective before-after comparison study of 50 girls and 54 boys aged 1-5 years, who were enrolled in the 1-year programme "Learning to Eat from the Mediterranean", designed to promote the adoption of a traditional Mediterranean diet. We studied the clinical and therapeutic variables and anthropometric measurements. RESULTS: All studied symptomatic indicators (number and intensity of asthmatic attack, infections and hospital admissions) showed a positive and statistically significant evolution of bronchial hyperreactivity from the first weeks of the intervention onwards. Throughout the treatment, 32.2% of patients remained free of crisis, 35.3% of the patients only had one attack throughout the year and 24.9% had two episodes, compared to 4.73 episodes on average in the previous year. The use of inhaled corticosteroids markedly decreased from 3.92 ± 1.61 to 1.11 ± 1.09 times per patient per year (P<0.001) and that of inhaled bronchodilators decreased from 4.14 ± 1.61 to 1.12 ± 1.40 (P<0.001). As a result, the families involved in the programme reported a high level of satisfaction. CONCLUSIONS: The adoption of a traditional Mediterranean diet could contribute significantly to the improvement of patients diagnosed with childhood asthma.

Environmental fate of naproxen, carbamazepine and triclosan in wastewater, surface water and wastewater irrigated soil - Results of laboratory scale experiments.

Lab-scale photolysis, biodegradation and transport experiments were carried out for naproxen, carbamazepine and triclosan in soil, wastewater and surface water from a region where untreated wastewater is used for agricultural irrigation. Results showed that both photolysis and biodegradation occurred for the three emerging pollutants in the tested matrices as follows: triclosan>naproxen>carbamazepine. The highest photolysis rate for the three pollutants was obtained in experiments using surface water, while biodegradation rates were higher in wastewater and soil than in surface water. Carbamazepine showed to be recalcitrant to biodegradation both in soil and water; although photolysis occurred at a higher level than biodegradation, this compound was poorly degraded by natural processes. Transport experiments showed that naproxen was the most mobile compound through the first 30cm of the soil profile; conversely, the mobility of carbamazepine and triclosan through the soil was delayed. Biodegradation of target pollutants occurred within soil columns during transport experiments. Triclosan was not detected either in leachates or the soil in columns, suggesting its complete biodegradation. Data of these experiments can be used to develop more reliable fate-on-the-field and environmental risk assessment studies.

Fate of atrazine in a soil under different agronomic management practices.

Agricultural management affects the movement of atrazine in soil and leaching to groundwater. The objective of this study was to determine atrazine adsorption in a soil after 20 years of atrazine application under agronomic management practices differing in tillage practice (conventional and zero tillage), residue management (with and without residue retention) and crop rotation (wheat-maize rotation and maize monoculture). Atrazine sorption was determined using batch and column experiments. In the batch experiment, the highest distribution coefficient Kd (1.1 L kg(-1)) at 0-10 cm soil depth was observed under zero tillage, crop rotation and residue retention (conservation agriculture). The key factor in adsorption was soil organic matter content and type. This was confirmed in the column experiment, in which the highest Kd values were observed in treatments with residue retention, under either zero or conventional tillage (0.81 and 0.68 L kg(-1), respectively). Under zero tillage, the fact that there was no soil movement helped to increase the Kd. The increased soil organic matter content with conservation agriculture may be more important than preferential flow due to higher pore connectivity in the same system. The soil's capacity to adsorb 2-hydroxyatrazine (HA), an important atrazine metabolite, was more important than its capacity to adsorb atrazine, and was similar under all four management practices (Kd ranged from 30 to 40 L kg(-1)). The HA adsorption was attributed to the type and amount of clay in the soil, which is unaffected by agronomic management. Soils under conservation agriculture had higher atrazine retention potential than soils under conventional tillage, the system that predominates in the study area.

Interleukin-6 and insulin incrase and nitric oxide and adiponectin decrease in blind dogs with pituitary-dependent hyperadrenocorticism.

In this study, two populations of dogs with pituitary dependent hypercortisolism (PDH) were compared over a 2-year period. One group had normal vision (Group A, n=27) and one group was blind (Group B, n=20). Group B was characterised by the rapid appearance of the clinical signs of PDH that precede blindness. We found increases in pre-adrenocorticotropic hormone cortisol (P=0.002), IL-6 (P=0.0001), insulin, and insulin sensitivity (detected with the Homeostatic Model Assessment, P<0.0001) in Group B but not in Group A. The nitric oxide (NO) and the total adiponectin concentrations decreased (P=0.0001 and P=0.02, respectively) in Group B versus Group A. The IL-6 and insulin concentrations and the HOMA-A index were positively correlated with the cortisol concentration and were negatively correlated with the NO concentration. With the exception of adiponectin, the other variables were associated with blindness. We concluded that blindness in PDH is a haemodynamic event associated with metabolic changes, with the increase in the IL-6 concentration and the decrease in the NO concentration affecting the retinal vasculature and producing a high risk of vision loss.

Impact of long-term wastewater irrigation on sorption and transport of atrazine in Mexican agricultural soils.

In the Mezquital Valley, Mexico, crops have been irrigated with untreated municipal wastewater for more than a century. Atrazine has been applied to maize and alfalfa grown in the area for weed control for 15 years. Our objectives were to analyse (i) how wastewater irrigation affects the filtering of atrazine, and (ii) if the length of irrigation has a significant impact. We compared atrazine sorption to Phaeozems that have been irrigated with raw wastewater for 35 (P35) and 85 (P85) years with sorption to a non-irrigated (P0) Phaeozem soil under rainfed agriculture. The use of bromide as an inert water tracer in column experiments and the subsequent analysis of the tracers' breakthrough curves allowed the calibration of the hydrodynamic parameters of a two-site non equilibrium convection-dispersion model. The quality of the irrigation water significantly altered the soils' hydrodynamic properties (hydraulic conductivity, dispersivity and the size of pores that are hydraulically active). The impacts on soil chemical properties (total organic carbon content and pH) were not significant, while the sodium adsorption ratio was significantly increased. Sorption and desorption isotherms, determined in batch and column experiments, showed enhanced atrazine sorption and reduced and slower desorption in wastewater-irrigated soils. These effects increased with the length of irrigation. The intensified sorption-desorption hysteresis in wastewater-irrigated soils indicated that the soil organic matter developed in these soils had fewer high-energy, easily accessible sorption sites available, leading to lower and slower atrazine desorption rates. This study leads to the conclusion that wastewater irrigation decreases atrazine mobility in the Mezquital valley Phaeozems by decreasing the hydraulic conductivity and increasing the soil's sorption capacity.

Efectos de una dieta mediterránea tradicional en niños con sobrepeso y obesidad tras un año de intervención / Effects of the Mediterranean traditional diet in overweight and obese children after one year of intervention

Introducción: la estrategia preventiva y terapéutica de la obesidad ofrece un escaso desarrollo en el sistema asistencial. No hay evidencia suficiente para determinar qué dieta es la más eficiente. El objetivo del estudio fue valorar el efecto de una intervención basada en una dieta mediterránea/tradicional. Pacientes y métodos: se realizó en niños de 2 a 14 años con sobrepeso y obesidad a partir de un programa nutricional denominado "Aprendiendo a comer". Se tomaron medidas antropométricas y se utilizaron test de calidad nutricional. No hubo restricción calórica, no se promovió actividad deportiva ni hubo tratamiento cognitivo-conductual. Se promocionó en todo el ámbito familiar. Se dio prioridad a los alimentos naturales, perecederos y de temporada. Resultados: noventa y ocho niños completaron el estudio. El 61,2% presentó normopeso al finalizar la intervención. Dejaron de ser obesos y de tener sobrepeso el 73,1% y el 82,6%, respectivamente. La pérdida de masa grasa fue del 18,7%, la masa magra aumentó adecuadamente y el índice de calidad nutricional KidMed fue óptimo en el 95% al finalizar la intervención. Conclusiones: frente a las dietas hipocalóricas y de bajo índice glucémico, proponemos una dieta basada en la dieta mediterránea/tradicional y desde Atención Primaria. La disminución observada en el percentil del índice de masa corporal es clínicamente relevante, con un descenso importante de niños con sobrepeso y obesidad. El porcentaje de masa grasa corporal disminuyó de forma significativa. La dieta que proponemos es fácil de cumplimentar y, junto con el programa de educación nutricional, consideramos que es el pilar fundamental del estudio(AU)

Introduction: the preventive and therapeutic strategy for obesity offers a poor development in the health care system. There is not enough evidence to determine what diet is the most efficient. The purpose of the study was to evaluate the effect of an intervention based on a Traditional Mediterranean diet. Methods: the study was conducted in overweight and obese children aged 2 to 14 years through the nutrition education program "Learning to eat". Anthropometric measurements and Mediterranean diet tests were used. There was neither calorie restriction nor physical activity promotion nor was cognitive-behavioral therapy. Mediterranean diet was promoted throughout the family environment. Priority was given to natural, perishable and seasonal foods. Results: the study was completed by 98 children; 61.2% showed a normal weight at the end of the intervention. At the end of the study, 73.1% and 82.6% were no longer obese or overweight. The proportion of fat mass decreased 18.66%, lean mass increased properly, and KidMed diet quality index was optimal in 95% after the intervention. Conclusions: opposed to low-calorie and low glycemic index diets, we propose a diet based on the Mediterranean Traditional Diet and from Primary Care. The observed decrease in Body Mass Index is clinically relevant, with a significant decrease in the proportion of overweight and obesity. The percentage of body fat mass decreased significantly. The Traditional Mediterranean Diet is easy to complete and along with the nutritional education program proposed, we consider it as the main pillar of the study(AU)

Efectividad de un programa de control de la infección nosocomial en un hospital de media estancia / No disponible

Objetivo: Evaluar la efectividad de un programa de control de la infección nosocomial en el Hospital de Guadarrama de Madrid. Material y método: Estudio observacional prospectivo antes-después con intervención durante los años 2002-2006. Monitorización de la incidencia de infección nosocomial en seis cohartes de pacientes de tres Unidades de hospitalización. Monitorización de la calidad de los cuidados prestados mediante realización de audits de enfermería semestrales durante todo el período de estudio. Evaluación del cumplimiento de las recomendaciones de higiene de manos mediante el consumo de solución alcohólica. Resultados: Se estudiaron 284 pacientes antes y 401 después de la intervención. La incidencia de infección disminuyó tras la intervención. Se realizaron un total de diez audits de enfermería a lo largo de los cinco años. Se incluyeron 580 pacientes y se evaluaron 1.406 cuidados. El cumplimiento global con los estándares de cuidados al inicio del estudio fue de 73% y de 83% al final del estudio. El consumo de solución alcohólica fue de 2 ml/estancia en el 2002 y de 20 ml/estancia en el 2006 (p<0,05). Conclusiones: La puesta en marcha de un programa de control de la infección nosocomial adaptado al tipo de pacientes y las características del hospital ha mostrado ser una herramienta eficaz para la mejora del cumplimiento de las recomendaciones de cuidados y de la higiene de manos y en la disminución del riesgo de infección nosocomial (AU)

Objective: Evaluate the effectiveness of an infection control program in the Hospital de Guadarrama, Madrid. Methods: In 2002.-2006 an observational prospective study before and after intervention was carried out. Incidence of Nosocomial infection in six cohorts of hospitalized patients in three Units was analysed. The quality of care provided by nurses to hospitalized patients was assessed through biannual audits. Compliance with hand hygiene was measured with the consumption of alcohol based handrub solution. Results: 284 patients before and 401 after the intervention were compared. Nosocomial Infection rates decreased after intervention. Ten audits were done in total during the five years of the study. 580 patients and 1406 observations were evaluated. Global compliance with protocols of care was 73% before and 83% after intervention. The consumption of alcohol-based handrub solution increased from 2 to 20 mL per patient-day between 2002 and 2006 (p<0.05). Conclusions: Introduction of an infection control program and adaptation to the patient hospitalized in a non-acute hospital produced a sustained improvement in compliance with protocols and hand hygiene, and reduction of nosocomial infections (AU)

Antidepressant activity of some Hypericum reflexum L. fil. extracts in the forced swimming test in mice.

We previously reported that oral administration of the methanol extract obtained from the aerial part in blossom of Hypericum reflexum L. fil. was active in the tetrabenazine and forced swimming test. In the present study, the effect of the aqueous, butanol and chloroform fractions obtained from the methanol extract of this species on the central nervous system was investigated in mice, particularly in animal models of depression. Antidepressant activity was detected in the butanol and chloroform fractions of this species using the forced swimming test since both fractions induced a significant reduction of the immobility time, producing no effects or only a slight depression on spontaneous motor activity when assessed in a photocell activity meter. Moreover, these fractions did not alter significantly the pentobarbital-induced sleeping time. On the other hand, the chloroform fraction produced a slight but significant hypothermia and was also effective in antagonizing the ptosis induced by tetrabenazine. Furthermore, the butanol fraction produced a slight potentiation of the head twitches and syndrome induced by 5-HTP. Taken together, these data indicate that the butanol and chloroform fractions from Hypericum reflexum possess antidepressant-like effects in mice, providing further support for the traditional use of these plants in the Canary Islands folk medicine against central nervous disorders.

Mother to child transmission of HIV in Vitória, Brazil: factors associated with lack of HIV prevention.

Screening HIV infection in pregnancy provides an ideal opportunity to make an early diagnosis in women in order to provide treatment to reduce vertical transmission to the newborn. The objectives were to describe the profile of HIV-infected pregnant women attending municipal hospitals in Vitória and to identify the causes associated with the lack of HIV therapeutic prophylaxis. Descriptive analysis of antenatal and HIV surveillance data of pregnant women in Vitória, Brazil from 1997 to 2001 was performed. HIV infection was reported in 208 pregnant women. Their median age was 23 years, antenatal care was reported in 96.2% and HIV infection was diagnosed during antenatal care in 60.1%. Zidovudine (ZDV) therapy was initiated in 88% of the cases, 57.9% of which started before 20 weeks of gestation. The remaining 12% of the total of pregnant women received no therapy. Factors associated with lack of mother to child transmission (MTCT) prevention were: test not available (14 cases), delay of test result (seven cases) and patient's refusal to take medication (four cases). After delivery, 8.2% of the newborn did not receive ZDV and 14 women breastfed. Among the 196 live births, 3.1% (95%CI 1.9-4.3) of MTCT was reported. These data from an area with comprehensive HIV and antenatal surveillance provide an opportunity to identify gaps in public health efforts to reduce MTCT.