Molecular recognition of carboxylates in the protein leucine zipper by a multivalent supramolecular ligand: residue-specific, sensitive and label-free probing by UV resonance Raman spectroscopy.

Ultraviolet resonance Raman (UVRR) spectroscopy is a selective, sensitive and label-free vibrational spectroscopic technique. Here, we demonstrate as proof of concept that UVRR can be used for probing the recognition between a multivalent supramolecular ligand and acidic residues in leucine zipper, an α-helical structural motif of many proteins.

Molecular tweezers target a protein-protein interface and thereby modulate complex formation.

Molecular tweezers for lysine and arginine select a few residues on a protein surface and by their unique complexation mode disrupt a critical protein-protein interaction. Detailed structural information was gained by NMR experiments, strongly supported by QM/MM calculations and further substantiated by ITC, fluorescence anisotropy, ELISA and bio-layer-interference studies.

Toxicity and adherence to treatment for latent tuberculosis infection in patients with hematologic malignancies.

PURPOSE: Oncohematological patients undergoing chemotherapy who have latent tuberculosis infection (LTBI) are at a high risk of developing active tuberculosis (TB). The identification and treatment of these patients can prevent LTBI progressing to active TB. This study analyzed the degree of adherence with and safety of the treatment of latent tuberculosis infection (TLTBI) in oncohematological patients undergoing antineoplastic chemotherapy. METHODS: This is a retrospective study of a cohort of oncohematological patients receiving TLTBI and antineoplastic chemotherapy simultaneously, between January 2007 and June 2010. The proportions of toxicity and adherence to TLTBI in these patients were compared with a non-oncohematological control group, matched for age, sex, and year in which the TLTBI was started. In addition, a minimum 2-year follow-up was carried out for all patients. RESULTS: A total of 105 patients who received TLTBI were included, 21 of whom had received antineoplastic chemotherapy simultaneously. The mean age of the patients was 63 years. There were no significant baseline differences in transaminase values. The percentages of patients completing treatment were 76.2% in the control group and 71.4% in the oncohematological group [risk ratio (RR): 1.07, 95% confidence interval (CI): 0.79-1.43]. The voluntary dropout proportion was similar in both groups (12.3 vs. 11.8%, RR: 1.05, 95% CI: 0.25-4.42). Treatment was discontinued because of toxicity in three oncohematological patients and in 11 patients from the control group (RR: 1.14; 95% CI: 035-3.66). No patient developed TB during the follow-up period. CONCLUSION: The safety of TLTBI is not influenced by simultaneous antineoplastic chemotherapy in oncohematological patients.

Importance of nutritional support in older people.

Proper nutrition is an essential part of successful aging and may delay the onset of diseases. Nutrition-related problems in older subjects have been long-time ignored; good nutritional status is an essential component of health and a relevant part of therapeutic plans of most chronic diseases. Moreover, food and nutrition are a relevant aspect of most cultures and are strongly linked with individual lifestyles. Research has proved that nutritional intervention can improve outcomes in many clinical scenarios. This is especially true for older individuals with different acute and chronic conditions and diseases, or with malnutrition. Nutritional intervention can provide sufficient energy, protein and micronutrients, maintain or improve nutritional status, reduce morbidity and increase survival. Evidence is still lacking on the impact of nutritional intervention on physical and mental function, and on quality of life, very relevant outcomes for older individuals. Nutritional screening and assessment should become part of health care of both healthy and sick older people. Nutritional counseling and intervention should be embedded in a general care plan that takes into account all aspects of an aging person. Nutritional programs that aim for high compliance should be individualized, and would have to consider every aspect of old age: beliefs, attitudes, preferences, expectations, and aspirations.

Respuesta metabólica inmunológica e inflamatoria a la agresión anestésico quirúrgica / No disponible

En su conjunto, la respuesta inmune pretende: destruir los elementos extraños o no reparables del organismo; delimitar y aislar el foco inflamatorio, reparar las lesiones promoviendo la cicatrización y la neovascularización, activar los mecanismos generales que aporten células y nutrientes (activación neuroendocrina y metabólica); y evitar la generalización del proceso, induciendo una cierta inmunodepresión sistémica contrarreguladora. En el presente trabajo se hace una revisión sobre los aspectos fisiopatológicos derivados de la respuesta metabólica, inmunológica e inflamatoria a la agresión quirúrgica(AU)

On the Whole, the immune response seeks: to destroy the foreing or not repairable elements of the organism; to limit and to isolate the focus of the inflamation; to repair the lesion by advancyng the cicatrization and the neovascularización; to activate the general mechanisms that bring cells and nutrients (neuroendocrina and metabolic activation); and to avoid the generalization of the process inducing a certain systemic contraregulatory inmunodepression In the present work a review is maid of the physiopatologyc aspects derived from the metabolic, immunological and inflammatory response to the surgical aggression(AU)

Aspectos clínicos del estrés quirúrgico / No disponible

La agresión quirúrgica provoca una respuesta endocrinometabólica, siendo el dolor postoperatorio uno de los factores implicados en la producción de dicha respuesta, consecuencia de la activación del sistema simpático y estimulación del eje endocrino hipotálamo-hipofisario-adrenal (HHA). El anestesiólogo puede modificar estas respuestas endocrinas y metabólicas al utilizar los distintos fármacos o técnicas anestésicas durante el acto quirúrgico. En un intento de frenar los efectos de la secreción de catecolaminas, debida al estrés quirúrgico, se han utilizado fármacos como los bloqueantes beta adrenérgicos, con el fin de evitar complicaciones como la isquemia miocárdica perioperatoria. Los resultados han demostrado que los betabloqueantes no disminuyen la respuesta neuroendocrina al estrés, pero sí disminuyen los requerimientos analgésicos, se produce una recuperación de la anestesia más rápida y una mejoría en la estabilidad hemodinámica. En el presente trabajo se hace una revisión sobre los aspectos clínicos derivados de la respuesta neuroendocrina, metabólica, inmunológica e inflamatoria a la agresión quirúrgica(AU)

The surgical aggression provokes an endocrinometabolic response, with the postoperatory pain beeing one of the factors involved in the production of the above mentioned response, consequence of the activation of the simpathetic nervous system and stimulation of the endocrine hypothalamus - hipofisario-adrenal axis (HHA). The anaesthtetist can modify these endocrine and metabolic responses on by using the different drugs or anesthesic techniques during the surgical operation. In an attempt to the limit the effects of the catecolamines secretion due to the surgical stress, the medicaments such as adrenergic betablockers have been iused, in order to avoid complications such perioperatory myocardic ischemia. The results have demonstrated that betablockers do not reduce the neuroendocrine response to the stress, but do reduce the analgesic requirements, tand a faster recovery from the anesthesia is produced, and an improvement in the hemodinámic stability In the present work a review is made on the clinical aspects derived from the neuroendocrine, metabolic, immunological and inflammatory response to the surgical aggression(AU)

Respuesta neuroendocrina a la agresión anestésico quirúrgica / No disponible

Durante una intervención quirúrgica, el SNA es influenciado por la estimulación quirúrgica y por los efectos de los fármacos anestésicos empleados. En la anestesia general se ha demostrado un aumento del tono simpático durante la intubación orotraqueal a pesar de una inducción anestésica correcta. La anestesia espinal produce un bloqueo del SNS, proporcional al nivel del bloqueo alcanzado. Cuando la ansiolisis y el control del dolor son adecuados, los niveles de catecolaminas en orina (CATO) en el periodo postoperatorio, no difieren significativamente de los valores encontrados preoperatoriamente. Por otro lado, los niveles plasmáticos sufren importantes variaciones en función de los estímulos, y así los niveles de Adrenalina (AD) en sangre aumentan bruscamente después de la incisión quirúrgica. La secreción de AD se puede minimizar con una adecuada técnica anestésica (anestesia intravenosa con opiáceos) que disminuya la agresión durante la incisión y la secreción de ACTH como respuesta al estrés. En el presente trabajo se hace una revisión sobre los aspectos fisiopatológicos derivados de la respuesta neuroendocrina a la agresión quirúrgica. Dicho estudio se basa en la detección de las hormonas más significativas de la respuesta ante la agresión(AU)

During a surgical intervention, the Autonomous Neurological System (SNA) is influenced by the surgical stimulation and by the effects of the anesthesic drugs used. In general anesthesia an increase of the simpathetic tone during the orotracheal intubation has been demonstrated in spite of a correct anesthesic induction. The spinal anesthesia produces a blockade of the Central Nervous System (SNC) proportional to the level of the blockage reached. When the sedation and the control of pain are adequate, the levels of catecolaminas in urine ((CATO) in the postoperatory period, do not differ significantly from the magnitude found in the preoperatory. On the other hand, the plasmatic levels undergo important variations depending on the stimuly, and in the adrenalin levels (AD) in blood increase sharply after the surgical incision.. AD secretion can be minimized with an adequate anesthesic technique (intravenous anesthesia with opiates) that reduces the aggression during the incision and ACTH secretion as a response to the stress. In the present work a review is made on the physiopatologics aspects derived from the norendocrine response to the surgical aggression. This study is based on the detection of the most significant hormones in the response to the aggression (AU)

[Effect of a campaign to promote breast-feeding among women in the province of Malaga who had their babies by caesarean section]. / Efecto de una campaña de promoción de la lactancia materna en la provincia de Málaga en mujeres cuyos partos finalizaron con cesárea.

OBJECTIVE: To determine whether an intervention to foster breast-feeding did actually increase it and how long it lasted in nursing mothers who gave birth through caesarean section. DESIGN: Evaluation of a community intervention. SETTING: Mother-and-Child Hospital in Málaga. PARTICIPANTS: Sample of 152 pregnant women who delivered their baby by caesarean section, 76 in 1996 and 76 in 1998. INTERVENTIONS: During 1997, activities to promote breast-feeding were organised in the health district. These included workshops aimed at primary care and specialist professionals, public events to promote breast-feeding (public feeds, photography competitions, media comment, etc), accords with institutions (university, nursing college inter al) and changes in the health services (improvement of services to new mothers and neonates; co-ordination between primary and hospital care). MAIN MEASUREMENTS AND RESULTS: In 1996, only 28% of women who started feeding did so with serotherapy. In 1998 this became 85% (P<.0005). Length of breast-feeding also increased significantly (P<.215). There was greater involvement of nursing, though it was not statistically significant (P<.06), moving from 40% in 1996 to 65.2% in 1998. CONCLUSIONS: The campaign showed its efficacy as a method of promotion of breast-feeding, on achieving an earlier start in breast-feeding, longer duration of it and greater involvement of nurses. Practical applications included changes in hospital routines, professional training, working out of strategies and specific records for the ongoing assessment of breast-feeding.

Efecto de una campaña de promoción de la lactancia materna en la provincia de Málaga en mujeres cuyos partos finalizaron con cesárea / Effect of a campaign to promote breast-feeding among women in the province of Malaga who had their babies by case caesarean section

Objetivo. Determinar si una intervención para fomentar la lactancia materna la ha incrementado y su duración en las gestantes que han dado a luz mediante cesárea. Diseño. Evaluación de una intervención comunitaria. Emplazamiento. Hospital Materno-Infantil de Málaga. Participantes. Muestra de 152 embarazadas que finalizaron el parto por vía cesárea, de las cuales 76 pertenecen al año 1996 y otras 76 al año 1998.Intervenciones. Durante el año 1997 se han realizado actividades de promoción de la lactancia en el distrito sanitario que incluyen talleres dirigidos a los profesionales de atención primaria y especializada, actos públicos de promoción de la lactancia materna (lactaciones públicas, concursos de fotografía, intervenciones en medios de comunicación, etc.), acuerdos con instituciones (universidad, colegio de enfermería, entre otros) y cambios en los servicios de salud (mejora de servicios ofertados a puérperas y recién nacidos y coordinación entre la atención primaria y la hospitalaria).Mediciones principales y resultados. En el año 1996, sólo el 28 por ciento de las mujeres que iniciaron la lactancia lo hicieron con sueroterapia. En 1998, este porcentaje llega a ser del 85 por ciento (p < 0,0005). La duración de la lactancia también muestra un incremento significativo (p < 0,215). Ambos datos expresan una tendencia al incremento. Hay mayor implicación de la enfermería, aunque sin significación estadística (p < 0,06), que ha pasado de un 40 por ciento en el año 1996 a un 65,2 por ciento en el año 1998.Conclusiones. La campaña demuestra su eficacia como método de promoción de la lactancia materna al conseguir una puesta al pecho más inmediata, mayores períodos de lactancia y más implicación de la enfermería. Las aplicaciones prácticas incluyen cambios en la rutina hospitalaria, capacitación profesional, elaboración de estrategias y registros específicos para la evaluación continua de esta práctica (AU)

[Efficacy of a training technique concerning clinical interview skills associated with psychodiagnostic ability of the physician]. / Eficacia de una técnica de adiestramiento sobre las destrezas de entrevista clínica asociadas con la capacidad psicodiagnóstica del médico.

OBJECTIVE: To evaluate the efficacy of a training technique to improve clinical interview skills connected with Primary Care doctors' psycho-diagnostic ability: visual contact, posture, verbal and non-verbal ways of advancing the interview, verbal interruptions and questions with a psychological content. DESIGN: The doctors were randomly divided into two groups. A before-and-after design with blind evaluations was used. SETTING: University postgraduate Internal Medicine Course. MATERIAL: 20 doctors. INTERVENTIONS: Step-by-step training with feedback, using role-play and video-recording (experimental) was compared with a self-administered teaching programme (self-training). MEASUREMENTS AND RESULTS: Skills were measured by video-recordings of a patient interview one month before and one month after the intervention. The Observation Scale of Doctor's Skills was used. In the second evaluation, the experimental group differed from the self-training group in visual contact, posture and non-verbal ways of advancing the interview. CONCLUSIONS: The efficacy of a training technique in improving non-verbal active listening skills was shown. It was valuable as a support to the psycho-diagnostic ability of the doctor.

Clinical interview skills and identification of emotional disorders in primary care.

OBJECTIVE: The aim of this research was to study the relationship between the clinical interview skills of primary care physicians and their psychodiagnostic ability during office visits. METHOD: Ten doctors took part in the study, and 233 patients were assessed. The patients were seen and diagnosed by their physicians and interviewed afterward by a psychiatrist using the Present State Examination. All the interviews with the primary care physicians were recorded on videotape, and the Physician's Skills Observation Scale was used to analyze 10 interviews per doctor, five psychiatric cases and five nonpsychiatric cases. RESULTS: The physician's active listening (eye contact, posture, and absence of verbal interruptions) and ability to ask questions with psychological content were associated with the ability to identify the patient's emotional problems. This association was shown to be independent of the physician's characteristics (social, academic, attitudinal, and professional), the sociodemographic characteristics of the patients, the time spent in exploration during the office visit, and the severity of the emotional or somatic disorder. CONCLUSIONS: The findings of this research highlight the need to train primary care physicians in specific interview skills, in order to improve their ability to identify mental disorders in their practices.

[Clinical characteristics of gastric infection caused by Helicobacter pylori]. / Características clínicas de la afección gástrica por Helicobacter pylori.

In a series of 150 patients submitted for diagnostic gastroscopy, a prospective study of nine anamnesis variables and four exploratory ones was done. Endoscopic and histopathologic diagnoses, as well as the clinical data, were obtained by blinded observers. Helicobacter pylory (Hp) presence in antral mucosa was determined by culture. A clear relationship between Hp presence and peptic ulcer disease, bulboduodenitis and histologic gastritis was found, as expected, but no clinical variable correlated positively with it. We conclude, therefore, that Hp presence in antral mucosa cannot be predicted clinically, a fact probably related to the unspecificity of symptoms in gastroduodenal disease and not to a lack of pathogenicity of this organism.