Multiple juvenile xanthogranuloma.

Juvenile xanthogranuloma is the most frequent form of non-Langerhans cell histiocytosis in children. Clinically, it presents as well defined, yellowish papules that are typically located on the head, neck, upper trunk, and proximal region of the extremities. Although solitary lesions are the most common presentation, few cases of multiple juvenile xanthogranuloma have been described, more frequently associated with extracutaneous involvement. We report a 2-month-old girl with 22 cutaneous papules, clinically and histologically compatible with juvenile xanthogranulomas. Screening of visceral involvement was performed with no evidence of systemic disease. Identifying high-risk factors of systemic disease in patients with multiple juvenile xanthogranuloma is essential to perform an appropriate management of this entity.

Development of dye-sensitized solar cells using pigment extracts produced by Talaromyces atroroseus GH2.

The identification of more efficient, clean, secure, and competitive energy supply is necessary to align with the needs of sustainable devices. For this reason, a study for developing innovative dye-sensitized solar cells (DSSCs) based on microbial pigments is reported starting from Talaromyces atroroseus GH2. The fungus was cultivated by fermentation and the extracellular pigment extract was characterized by HPLC-DAD-ESI-MS analyses. The most abundant compound among the 22 azaphilone-type pigments identified was represented by PP-O. The device's behavior was investigated in relation to electrolyte and pH for verifying the stability on time and the photovoltaic performance. Devices obtained were characterized by UV-vis measurements to verify the absorbance intensity and transmittance percentage. Moreover, photovoltaic parameters through photo-electrochemical measurements (I-V curves) and impedance characteristics by Electrochemical Impedance Spectroscopy (EIS) were determined. The best microbial device showed a short-circuit current density (Jsc) of 0.69 mA/cm2, an open-circuit photo-voltage (Voc) of 0.27 V and a Fill Factor (FF) of 0.60. Furthermore, the power conversion efficiency (PCE) of the device was 0.11%. Thus, the present study demonstrated the potential of microbial origin pigments for developing DSSCs.

Neoadjuvant photodynamic therapy as a therapeutic alternative in multiple basal cell carcinoma induced by radiotherapy.

INTRODUCTION: Non-melanoma skin cancer within previously irradiated areas presents a common challenge, requiring innovative therapies. Complex scenarios, like XRT-induced basal cell carcinoma (BCC) or Gorlin's syndrome, often involve multiple synchronous tumor lesions where photodynamic therapy (PDT) offers a viable therapeutic alternative. CLINICAL CASE: We present the case of a 49-year-old male with a history of XRT for brain tumors. The patient was undergoing treatment for recurrent basal cell carcinomas (BCCs) in the right temporal irradiated area, unresponsive to conventional treatments. In the latest evaluation, the patient presented a nodular tumor and several peripheral superficial foci. Photodynamic therapy (PDT) was administered using methyl aminolevulinate 160 mg/g in cream (Metvix®) in two sessions spaced 7 days apart before surgery. The photosensitizer was applied 3 h before initiating PDT, and red light exposure was performed with the Aktilite© lamp (wavelength 630 nm, 100 mm distance, voltage 100 to 240 V, frequency 50 Hz, power 180 W) for 7 min. CONCLUSIóN: PDT with methyl aminolevulinate demonstrated efficacy as a neoadjuvant treatment in a case of multiple XRT-induced BCCs before surgery. PDT emerges as a valuable therapeutic alternative for multiple BCCs, particularly in non-responsive cases.

Biotechnological approaches for the production of natural colorants by Talaromyces/Penicillium: A review.

There has been an increased interest in replacing synthetic colorants by colorants obtained from natural sources, especially microbial pigments. Monascus pigments have been used as natural colorings and food additives in Asia for centuries but have raised toxicity issues. Recently, Talaromyces/Penicillium species have been recognized as potential strains to produce natural pigments similar to those produced by Monascus species. To date, it has not been published a literature compilation about the research and development activity of Talaromyces/Penicillium pigments. Developing a new bioprocess requires several steps, from an initial concept to a practical and feasible application. Industrial applications of fungal pigments will depend on: (i) characterization of the molecules to assure a safe consumption, (ii) stability of the pigments to the processing conditions required by the products where they will be incorporated, (iii) optimizing process conditions to achieve high yields, iv) implementing an efficient product recovery and (v) scale-up of the bioprocess. The above aspects have been reviewed in detail to evaluate the feasibility of reaching a commercial scale of the pigments produced by Talaromyces/Penicillium. Finally, the biological activities of the pigments and their potential applications are discussed.

Resistencia al cambio: prescripción enfermera / Resistance to change: nurse prescription

No disponible

Eficiencia en la prescripción enfermera en Andalucía. Un paso atrás en el sistema sanitario tras anulación por Real Decreto / No disponible

Objetivos: Analizar la eficiencia en la prescripción enfermera en Andalucía, España, entre 2009-2015, de productos sanitarios inherentes a su labor asistencial. Asimismo, analizar las alegaciones de la Organización Médica Colegial al Ministerio de Sanidad, Servicios Sociales e Igualdad al anteproyecto de ley de prescripción enfermera. Diseño. Revisión. Fuentes de datos: Se revisaron bases de datos bibliográficas de habla latina, española y extranjera: Fundación Index, Hemeroteca Doyma y Medline. Google Scholar con los mismos términos de búsqueda, añadiendo el término "Andalucía": "prescripción enfermera" AND "eficiencia" OR "Andalucía". Se buscó también en la literatura gris utilizando los mismos criterios en la web del Servicio Andaluz de Salud (SAS). Se complementó con una entrevista con la directora de cuidados del SAS. Extracción de datos: Se localizaron 617 artículos, de los que se seleccionaron 20. En la literatura gris se encontraron 52, de los cuales quedaron 4. Resultados: Los estudios sobre eficiencia en prescripción enfermera en Andalucía son escasos pero contundentes, como los datos aportados por la Dirección de Cuidados del Servicio Andaluz de Salud sobre los productos sanitarios inherentes a su profesión. La modificación del anteproyecto del Real Decreto 954/2015, por presiones de la Organización Médica Colegial, deja la competencia de prescripción enfermera exclusivamente a la indicación médica, quien diagnostica y prescribe y la elimina sin argumentación avalada por evidencia científica. Conclusiones: Podemos corroborar que la incorporación de la prescripción enfermera al sistema sanitario publico ha supuesto una mejora en la eficiencia del mismo. Por otro lado, las alegaciones de la Organización Medica colegial critican este acto sanitario sin que sus argumentos tengan una base científica

Objectives: To analyse the efficiency of nurse prescription of the health products inherent to their care work, in Andalusia, Spain, between the years 2009-2015. To also analyse the discussions by the Medical Colleges Organisation and the Ministry of Health, Social Services and Equality, before the draft bill on nurse prescription and their outcome. Design. Scoping review. Data source: Main bibliographic databases of Latin-American, Spanish, and foreign languages were reviewed, including, Fundación Index, Doyma, and Medline Library. Google Scholar was also used with the same search terms, adding to limit the search the term "Andalusia": "prescription nurse" AND "efficiency" OR "Andalusia". Another search was conducted in the grey literature using the same criteria in the Andalusian Health Service (SAS) web site. It was complemented with an interview with the care director of the SAS. Data extraction A total of 617 articles were found, of which 20 were selected. In the grey literature, 52 documents were found, of which 4 were used. Results: Few studies were found on the efficiency in nurse prescription in Andalusia, although they are as strong as the data provided by the Andalusian Health Care Directorate on the health products inherent in their profession. After modification of Royal Decree 954/2015, and under pressure from the Medical Colleges Organisation, it leaves the competence of prescription nurse exclusively to the medical indication, who diagnoses and prescribes and eliminates it without argument scientifically endorsed. Conclusions : We corroborate the incorporation of efficiency in the Health System through the nurse prescription, and the rupture with the Royal Decree 954/2015. The allegations of the Medical Colleges Organisation are without argument

Eficiencia en la prescripción enfermera en Andalucía. Un paso atrás en el sistema sanitario tras anulación por Real Decreto.

OBJECTIVES: To analyse the efficiency of nurse prescription of the health products inherent to their care work, in Andalusia, Spain, between the years 2009-2015. To also analyse the discussions by the Medical Colleges Organisation and the Ministry of Health, Social Services and Equality, before the draft bill on nurse prescription and their outcome. DESIGN: Scoping review. DATA SOURCE: Main bibliographic databases of Latin-American, Spanish, and foreign languages were reviewed, including, Fundación Index, Doyma, and Medline Library. Google Scholar was also used with the same search terms, adding to limit the search the term "Andalusia": "prescription nurse" AND "efficiency" OR "Andalusia". Another search was conducted in the grey literature using the same criteria in the Andalusian Health Service (SAS) web site. It was complemented with an interview with the care director of the SAS. DATA EXTRACTION: A total of 617 articles were found, of which 20 were selected. In the grey literature, 52 documents were found, of which 4 were used. RESULTS: Few studies were found on the efficiency in nurse prescription in Andalusia, although they are as strong as the data provided by the Andalusian Health Care Directorate on the health products inherent in their profession. After modification of Royal Decree 954/2015, and under pressure from the Medical Colleges Organisation, it leaves the competence of prescription nurse exclusively to the medical indication, who diagnoses and prescribes and eliminates it without argument scientifically endorsed. CONCLUSIONS: We corroborate the incorporation of efficiency in the Health System through the nurse prescription, and the rupture with the Royal Decree 954/2015. The allegations of the Medical Colleges Organisation are without argument.

Effect of inoculum on the anaerobic digestion of food waste accounting for the concentration of trace elements.

The production of renewable energy in the form of methane from the anaerobic digestion (AD) of food waste (FW) varies depending on factors such as the quantity and quality of the inoculum. This research evaluated the influence of trace elements (Ca, K, Fe, Zn, Al, Mg, Co, Ni, and Mo) present in inoculum from different sources (wastewater treatment plants (WWTPs): 2 agro-industrial WWTPs and 1 municipal WWTP) on the AD of FW. This study found that the source of the inoculum determines the content of macronutrients and trace elements, which can alter the requirements of the AD process and therefore affect methane production. The inoculum obtained from municipal WWTPs contain potentially inhibitory concentrations of Zn and Al that negatively affect methane production (<70 mL CH4·gVS-1), the hydrolysis constant (<0.19 d-1), and the lag-phase (>7 days). It was also found that high concentrations of trace elements such as Ni (35.2 mg kg-1) and Mo (15.4 mg kg-1) in the inoculum increase methane production (140.7 mL CH4·gVS-1) and hydrolysis constant (>0.18d-1) in addition to presenting short lag-phase (<1 day) in the AD of food waste.

Cura de úlcera en la pierna con miel. Caso clínico / Treating a leg ulcer with honey. Clinical case

Las lesiones vasculares de las extremidades inferiores constituyen un problema de salud con importantes consecuencias socioeconómicas y sanitarias, no existe un tratamiento único y efectivo para su curación. El propósito de este trabajo es contribuir al conocimiento existente sobre el uso tópico de la miel para la curación de este tipo de lesiones y su aplicación en la práctica clínica. Se presenta el caso clínico de A.M.L., de 80 años de edad, con úlcera venosa en miembro inferior derecho de dos meses de evolución. Diagnóstico enfermero: deterioro de la integridad cutánea manifestado por úlcera en cara externa tibial de tobillo derecho relacionado con insuficiencia venosa de miembros inferiores. Resultado esperado: cicatrización completa de la úlcera en seis meses (NOC: Curación de la herida: por segunda intención). Intervención enfermera: se establece el tratamiento de cura de la herida con la aplicación de miel sobre ella tres veces por semana (NIC: Cuidados de la herida).Tras una rápida cicatrización inicial de la cavidad de la herida y eliminación de los pequeños esfacelos del lecho, la lesión se complica y agrava y se establece cura con apósito hidrocoloide de silicona y compresión tres veces por semana. Se consiguió la completa cicatrización de la herida en tres meses y medio aproximadamente desde el inicio de la segunda intervención. Son necesarios más estudios para determinar el uso seguro y eficaz de la miel como tratamiento de las úlceras venosas en extremidades inferiores

Vascular lesions in lower limbs represent a health problem with major socioeconomic and healthcare consequences; there is not an unique and effective treatment for them. The purpose of this article is to contribute to the existing knowledge about the topical use of honey for treating this type of lesions, and its application on clinical practice. The clinical case of A.M.L. is presented: an 80-year-old patient with a venous ulcer in the right lower limb, with two months of evolution. Nursing diagnosis: deterioration of cutaneous integrity caused by an ulcer in the external face of the right ankle tibia, associated with venous insufficiency in lower limbs. Expected result: complete scarring of the ulcer within six months (NOC: Wound healing: by second intention). Nursing intervention: The treatment for wound healing is established by applying honey on it three times per week (NIC: Wound care). After a fast initial scarring of the wound cavity, and removal of the small sloughing in the wound bed, the lesion gets complicated and worsens, and healing is established with hydrocolloid dressing with silicone and compression three times per week. Complete wound scarring was achieved at approximately three months and a half since the initiation of the second intervention. More studies are required in order to establish the safe and effective use of honey as treatment for venous ulcers in lower limbs

Atención enfermera extrahospitalaria en una urgencia ocular. Gestión compartida de la demanda / Out-of-hospital nursing care in an eye emergency. Shared management of the demand

Dentro de la clasificación avanzada y gestión de la demanda urgente en puestos fijos de Atención Primaria y Hospitalizada, el triaje ha demostrado una gran eficacia en la gestión de las urgencias. Dada la elevada frecuentación de procesos banales o de menor entidad, y a fin de contribuir a mejorar la resolución de dicho problema, el Servicio Andaluz de Salud ha puesto en marcha un subproceso de consulta enfermera de urgencias, con el objeto de ser resolutiva en el tratamiento de procesos banales donde los pacientes hayan sido clasificados como prioridad 5. La aplicación del triaje, utilizando como herramientas la gestión compartida de la demanda y la administración avanzada de medicación, consigue mejorar la accesibilidad del paciente al intensificar los cuidados sobre él y abre una segunda puerta de acceso a la demanda asistencial urgente, estando actualmente limitada prácticamente al médico, además de aumentar la satisfacción por la asistencia. A pesar de los buenos resultados obtenidos y la evidencia disponible referente al triaje, es un proceso que no está establecido en todas las Unidades de Gestión Clínica de Atención Primaria del Servicio Andaluz de Salud. Es preciso investigar dichas herramientas aplicadas en la clasificación avanzada de urgencias en puestos fijos y en la actuación finalista en la consulta enfermera de urgencias. El objetivo del presente artículo es compartir, mediante la descripción de un caso clínico, la experiencia llevada a cabo en la Unidad de Gestión Clínica de Lora del Río (Sevilla), a fin de mostrar la capacidad de resolución del profesional enfermero en las urgencias extrahospitalaria utilizando la gestión compartida de la demanda

Within the advanced classification and management of emergency care demand in Primary and Hospital Care permanent positions, the triage has demonstrated great efficacy for managing emergencies. Given the high frequency of banal or minor episodes, and in order to contribute to an improved solution for said problem, the Andalusian Health System has established a sub-procedure of Emergency Nursing Care, in order to assist in the treatment of banal episodes, where patients have been classified as Priority 5. The implementation of the triage, using as tools the shared management of the demand and the advanced administration of medication, achieves an improved access for patients, by intensifying the level of care, and opens a second door of access to the urgent demand for care, which is nowadays practically limited to the physician, besides increasing the satisfaction for the care received. Even though good results have been obtained, and there is evidence available about the triage, this is a process which has not been established in all Primary Care Clinical Management Units in the Andalusian Health Service. Further research is required about said tools implemented in the advanced classification of emergencies in permanent positions and in the final action in the Emergency Nursing Office. The object of the present article is to share, through the description of a clinical case, the experience conducted in the Clinical Management Unit in Lora del Río, in order to show the problem-solving ability of nursing professionals in out-of-hospital emergencies, using the shared management of demand