An optimized electro-fenton pretreatment for the degradation and mineralization of a mixture of ofloxacin, norfloxacin, and ciprofloxacin.

The electro-Fenton process (EFP) is a powerful advanced oxidation process beneficial to treating recalcitrant contaminants, and there has been a continuing interest in combining this technology to enhance the efficiency of conventional wastewater treatment processes. In this work, an optimized EFP process is performed as pretreatment for the degradation and mineralization of three blank fluoroquinolones (FQs) drugs: ofloxacin (OFL), norfloxacin (NOR), and ciprofloxacin (CIP). The optimization of the experiment was carried out using a Box-Behnken experimental design. Faster and complete degradation of the drugs mixture was achieved in 90 min with 61.12 ± 2.0% of mineralization in 180 min, under the optimized conditions: j = 244.0 mA cm-2, [Fe2+] = 0.31 mM, and [FQs] = 87.0 mg L-1. Furthermore, a low toxicity effluent was obtained in 90 min of the experiment, according to bioassay toxicity with Vibrio fischeri. Five short-chain carboxylic acids, including oxalic, maleic, oxamic, formic, and fumaric acids, were detected and quantified, in addition to F- and NO3- inorganic ions. The inhibition of the reactive oxygen species with scavenger proof was also evaluated in this paper.

EGFR-mediated macrophage activation promotes colitis-associated tumorigenesis.

Epidermal growth factor receptor (EGFR) signaling is a known mediator of colorectal carcinogenesis. Studies have focused on the role of EGFR signaling in epithelial cells, although the exact nature of the role of EGFR in colorectal carcinogenesis remains a topic of debate. Here, we present evidence that EGFR signaling in myeloid cells, specifically macrophages, is critical for colon tumorigenesis in the azoxymethane-dextran sodium sulfate (AOM-DSS) model of colitis-associated carcinogenesis (CAC). In a human tissue microarray, colonic macrophages demonstrated robust EGFR activation in the pre-cancerous stages of colitis and dysplasia. Utilizing the AOM-DSS model, mice with a myeloid-specific deletion of Egfr had significantly decreased tumor multiplicity and burden, protection from high-grade dysplasia and significantly reduced colitis. Intriguingly, mice with gastrointestinal epithelial cell-specific Egfr deletion demonstrated no differences in tumorigenesis in the AOM-DSS model. The alterations in tumorigenesis in myeloid-specific Egfr knockout mice were accompanied by decreased macrophage, neutrophil and T-cell infiltration. Pro-tumorigenic M2 macrophage activation was diminished in myeloid-specific Egfr-deficient mice, as marked by decreased Arg1 and Il10 mRNA expression and decreased interleukin (IL)-4, IL10 and IL-13 protein levels. Surprisingly, diminished M1 macrophage activation was also detectable, as marked by significantly reduced Nos2 and Il1b mRNA levels and decreased interferon (IFN)-γ, tumor necrosis factor (TNF)-α and IL-1ß protein levels. The alterations in M1 and M2 macrophage activation were confirmed in bone marrow-derived macrophages from mice with the myeloid-specific Egfr knockout. The combined effect of restrained M1 and M2 macrophage activation resulted in decreased production of pro-angiogenic factors, CXCL1 and vascular endothelial growth factor (VEGF), and reduced CD31+ blood vessels, which likely contributed to protection from tumorigenesis. These data reveal that EGFR signaling in macrophages, but not in colonic epithelial cells, has a significant role in CAC. EGFR signaling in macrophages may prove to be an effective biomarker of CAC or target for chemoprevention in patients with inflammatory bowel disease.

Pathogenic Helicobacter pylori strains translocate DNA and activate TLR9 via the cancer-associated cag type IV secretion system.

Helicobacter pylori (H. pylori) is the strongest identified risk factor for gastric cancer, the third most common cause of cancer-related death worldwide. An H. pylori constituent that augments cancer risk is the strain-specific cag pathogenicity island, which encodes a type IV secretion system (T4SS) that translocates a pro-inflammatory and oncogenic protein, CagA, into epithelial cells. However, the majority of persons colonized with CagA+ H. pylori strains do not develop cancer, suggesting that other microbial effectors also have a role in carcinogenesis. Toll-like receptor 9 (TLR9) is an endosome bound, innate immune receptor that detects and responds to hypo-methylated CpG DNA motifs that are most commonly found in microbial genomes. High-expression tlr9 polymorphisms have been linked to the development of premalignant lesions in the stomach. We now demonstrate that levels of H. pylori-mediated TLR9 activation and expression are directly related to gastric cancer risk in human populations. Mechanistically, we show for the first time that the H. pylori cancer-associated cag T4SS is required for TLR9 activation and that H. pylori DNA is actively translocated by the cag T4SS to engage this host receptor. Activation of TLR9 occurs through a contact-dependent mechanism between pathogen and host, and involves transfer of microbial DNA that is both protected as well as exposed during transport. These results indicate that TLR9 activation via the cag island may modify the risk for malignancy within the context of H. pylori infection and provide an important framework for future studies investigating the microbial-epithelial interface in gastric carcinogenesis.

Epigenetic silencing of miR-124 prevents spermine oxidase regulation: implications for Helicobacter pylori-induced gastric cancer.

Chronic inflammation contributes to the development of various forms of cancer. The polyamine catabolic enzyme spermine oxidase (SMOX) is induced in chronic inflammatory conditions, including Helicobacter pylori-associated gastritis, where its production of hydrogen peroxide contributes to DNA damage and subsequent tumorigenesis. MicroRNA expression levels are also altered in inflammatory conditions; specifically, the tumor suppressor miR-124 becomes silenced by DNA methylation. We sought to determine if this repression of miR-124 is associated with elevated SMOX activity and concluded that miR-124 is indeed a negative regulator of SMOX. In gastric adenocarcinoma cells harboring highly methylated and silenced mir-124 gene loci, 5-azacytidine treatment allowed miR-124 re-expression and decreased SMOX expression. Overexpression of an exogenous miR-124-3p mimic repressed SMOX mRNA and protein expression as well as H2O2 production by >50% within 24 h. Reporter assays indicated that direct interaction of miR-124 with the 3'-untranslated region of SMOX mRNA contributes to this negative regulation. Importantly, overexpression of miR-124 before infection with H. pylori prevented the induction of SMOX believed to contribute to inflammation-associated tumorigenesis. Compelling human in vivo data from H. pylori-positive gastritis tissues indicated that the mir-124 gene loci are more heavily methylated in a Colombian population characterized by elevated SMOX expression and a high risk for gastric cancer. Furthermore, the degree of mir-124 methylation significantly correlated with SMOX expression throughout the population. These results indicate a protective role for miR-124 through the inhibition of SMOX-mediated DNA damage in the etiology of H. pylori-associated gastric cancer.

Increased Helicobacter pylori-associated gastric cancer risk in the Andean region of Colombia is mediated by spermine oxidase.

Helicobacter pylori infection causes gastric cancer, the third leading cause of cancer death worldwide. More than half of the world's population is infected, making universal eradication impractical. Clinical trials suggest that antibiotic treatment only reduces gastric cancer risk in patients with non-atrophic gastritis (NAG), and is ineffective once preneoplastic lesions of multifocal atrophic gastritis (MAG) and intestinal metaplasia (IM) have occurred. Therefore, additional strategies for risk stratification and chemoprevention of gastric cancer are needed. We have implicated polyamines, generated by the rate-limiting enzyme ornithine decarboxylase (ODC), in gastric carcinogenesis. During H. pylori infection, the enzyme spermine oxidase (SMOX) is induced, which generates hydrogen peroxide from the catabolism of the polyamine spermine. Herein, we assessed the role of SMOX in the increased gastric cancer risk in Colombia associated with the Andean mountain region when compared with the low-risk region on the Pacific coast. When cocultured with gastric epithelial cells, clinical strains of H. pylori from the high-risk region induced more SMOX expression and oxidative DNA damage, and less apoptosis than low-risk strains. These findings were not attributable to differences in the cytotoxin-associated gene A oncoprotein. Gastric tissues from subjects from the high-risk region exhibited greater levels of SMOX and oxidative DNA damage by immunohistochemistry and flow cytometry, and this occurred in NAG, MAG and IM. In Mongolian gerbils, a prototype colonizing strain from the high-risk region induced more SMOX, DNA damage, dysplasia and adenocarcinoma than a colonizing strain from the low-risk region. Treatment of gerbils with either α-difluoromethylornithine, an inhibitor of ODC, or MDL 72527 (N(1),N(4)-Di(buta-2,3-dien-1-yl)butane-1,4-diamine dihydrochloride), an inhibitor of SMOX, reduced gastric dysplasia and carcinoma, as well as apoptosis-resistant cells with DNA damage. These data indicate that aberrant activation of polyamine-driven oxidative stress is a marker of gastric cancer risk and a target for chemoprevention.

Análisis del deseo sexual en una muestra de drogodependientes en periodo de abstinencia / Analysis of sexual desire in a sample of drug addicts in abstinence period

Objetivos. El propósito de esta investigación fue analizar qué variables influían en el deseo sexual en drogodependientes en periodo de abstinencia. Los objetivos planteados son: a) comparar los niveles de deseo sexual entre sujetos drogodependientes en periodo de abstinencia y sujetos sin historia de consumo de drogas; b) determinar, en sujetos drogodependientes en periodo de abstinencia la relación entre la edad y tener pareja con el deseo sexual; c) examinar, en sujetos drogodependientes en periodo de abstinencia, la relación entre estados emocionales y deseo sexual; y d) determinar, en sujetos drogodependientes en periodo de abstinencia, qué variables tienen mayor capacidad de predicción del deseo sexual. Métodos. La muestra estuvo formada por 100 hombres cuya edad osciló entre 19 y 72 años, pertenecientes a distintos programas de tratamientos en drogadicción. Además, se utilizó una muestra de 46 varones sin historia de consumo de drogas con edades entre 18 y 81 años. Resultados. Los análisis no ofrecieron diferencias entre los diferentes grupos (alcohol, cocaína, heroína más cocaína y sujetos sin historia de consumo de drogas), ni en deseo sexual diádico (F3,125 = 0,71, p = 0,543), ni en deseo sexual solitario (F3,125 = 0,73, p = 0,535). Las variables ansiedad estado y edad mostraron capacidad predictiva (F2,70 = 6,56; p < 0,01), presentando ambas una relación negativa con el deseo sexual diádico, en sujetos drogodependientes en periodo de abstinencia. Conclusiones. No parecen existir diferencias entre población sin historia de consumo de drogas y drogodependientes en periodo de abstinencia en deseo sexual. En estos últimos, existe relación entre una alta ansiedad estado y un nivel de deseo sexual diádico bajo, así como una relación negativa de la edad conjuntamente con la ansiedad estado, con respecto al deseo sexual diádico (AU)

Objective. The purpose of this work was to analyse which variables influence sexual desire in a drug abusers sample during periods of abstinence. The objectives were: a) to compare levels of sexual desire among subjects with a history of drug abuse and subjects without a history of drug abuse; b) to determine the relation between age and having sexual partner or not in subjects with a history of drug abuse; c) to examine the relation among anxiety and depression and sexual desire in subjects with a history of drug abuse; d) to determine which variables predict sexual desire in subjects with a history of drug abuse. Methods. Research was with a sample of 100 men (aged 19 to 72) who belong to drug addiction treatment programs. Furthermore, there was another sample of 46 men (aged 18 to 81) without a history of drug abuse. Results. The analysis did not show differences among the groups (alcohol, cocaine, heroin plus cocaine and subjects without a history of drug abuse) in dyadic sexual desire (F3,125 =0.71, p =0.543) and solitary sexual desire (F3,125 =0.73, p =0.535). However, the variables of anxiety state and age showed predictive capacity for dyadic sexual desire in subjects with a history of drug abuse. Conclusions. In sexual desire there is no difference between subjects without a history of drug abuse and drug addicts during periods of abstinence. In subjects with a history of drug abuse there is a negative relationship between anxiety state and down levels of dyadic sexual desire, and a negative relation between age in conjunction with anxiety state (AU)

A type VI secretion system effector protein, VgrG1, from Aeromonas hydrophila that induces host cell toxicity by ADP ribosylation of actin.

We recently delineated the importance of a type VI secretion system (T6SS) gene cluster in the virulence of diarrheal isolate SSU of Aeromonas hydrophila and showed that VasH, a sigma(54) activator and T6SS component, was involved in the production of its associated effectors, e.g., hemolysin-coregulated protein. To identify additional T6SS effectors and/or secreted proteins, we subjected culture supernatants from deletion mutants of A. hydrophila, namely, a Delta act mutant (a T2SS-associated cytotoxic enterotoxin-encoding gene) and a Delta act Delta vasH mutant, to 2-dimensional gel electrophoresis and mass spectrometric analysis. Based on these approaches, we identified a member of the VgrG protein family, VgrG1, that contained a vegetative insecticidal protein (VIP-2) domain at its carboxyl-terminal end. Consequently, the vgrG1 gene was cloned in pBI-EGFP and pET-30a vectors to be expressed in HeLa Tet-Off cells and Escherichia coli, respectively. We assessed the ADP-ribosyltransferase (ADPRT) activity of various domains of purified recombinant VgrG1 (rVgrG1) and provided evidence that only the full-length VgrG1, as well as its carboxyl-terminal domain encoding the VIP-2 domain, showed ADPRT activity. Importantly, bacterium-host cell interaction was needed for the T6SS to induce cytotoxicity in eukaryotic cells, and we demonstrated translocation of VgrG1. Furthermore, our data indicated that expression of the genes encoding the full-length VgrG1 and its carboxyl-terminal domain in HeLa Tet-Off cells disrupted the actin cytoskeleton, which was followed by a decrease in cell viability and an increase in apoptosis. Taken together, these findings demonstrated for the first time that VgrG1 of A. hydrophila possessed actin ADPRT activity associated with its VIP-2 domain and that this domain alone was able to induce a rounded phenotype in HeLa Tet-Off cells, followed by apoptosis mediated by caspase 9 activation.

[Insomnia Severity Index: some indicators about its reliability and validity on an older adults sample]. / Insomnia Severity Index: algunos indicadores acerca de su fiabilidad y validez en una muestra de personas mayores.

INTRODUCTION: The Insomnia Severity Index (ISI) is a short instrument developed to assess insomnia severity from which there is no study in Spain that guarantees its psychometric properties. AIM: To examine the reliability, factorial structure, and convergent and discriminant validity of the Spanish version of the ISI in an older adult sample. SUBJECTS AND METHODS: A sample of 230 older adults, aging from 56 to 87 years old (71,11 +/- 5,56) filled in the ISI, together with Athens Insomnia Scale-5 (AIS-5) and Mini Mental State Examination (MMSE). RESULTS: Principal component analysis shows only one factor which explains 68.99% of total variance, with an internal consistency reliability equals 0.91. Regarding its validity, ISI shows statistically significant positive correlations with AIS-5 (r = 0.93) and negative with MMSE (r = -0.15). Moreover, it differentiates between men and women, people with and without cognitive impairment, and people with and without medical treatment. CONCLUSION: First data of the Spanish version of the ISI endorse single-dimensional structure, with an appropriate internal consistency reliability, and evidences of its measures validity.

Insomnia Severity Index: algunos indicadores acerca de su fiabilidad y validez en una muestra de personas mayores / Insomnia severity index: some indicators about its reliability and validity on an older adults sample

Introducción. El Insomnia Severity Index (ISI) es un instrumento breve para evaluar la gravedad del insomnio del cual no existe ningún estudio en España que avale sus propiedades psicométricas. Objetivo. Examinar la fiabilidad, estructura factorial y validez convergente y discriminante de la versión española del ISI en una muestra de personas mayores. Sujetos y métodos. Una muestra de 230 adultos mayores con edades comprendidas entre 56 y 87 años (edad media: 71,11 ± 5,56 años) contestó al ISI, junto con el Athens Insomnia Scale-5 (AIS-5) y el Minimental State Examination (MMSE). Resultados. El análisis de componentes principales extrajo un único factor que explicó el 68,99% de la varianza, con un valor de fiabilidad de consistencia interna igual a 0,91. En cuanto a su validez, el ISI mostró correlaciones estadísticamente significativas de signo positivo con el AIS-5 (r = 0,93) y de signo negativo con el MMSE (r = –0,15). Además, mostró capacidad para diferenciar entre hombres y mujeres, personas con y sin deterioro cognitivo, y personas con y sin tratamiento médico. Conclusión. Los primerosdatos psicométricos de la versión española del ISI avalan una estructura unidimensional de la escala, con una adecuadafiabilidad de consistencia interna y evidencias acerca de la validez de sus medidas

Introduction. The Insomnia Severity Index (ISI) is a short instrument developed to assess insomnia severity from which there is no study in Spain that guarantees its psychometric properties. Aim. To examine the reliability, factorial structure, and convergent and discriminant validity of the Spanish version of the ISI in an older adult sample. Subjects and methods. A sample of 230 older adults, aging from 56 to 87 years old (71,11 ± 5,56) filled in the ISI, together with AthensInsomnia Scale-5 (AIS-5) and Mini Mental State Examination (MMSE). Results. Principal component analysis shows only one factor which explains 68.99% of total variance, with an internal consistency reliability equals 0.91. Regarding its validity, ISI shows statistically significant positive correlations with AIS-5 (r = 0.93) and negative with MMSE (r = –0.15). Moreover, it differentiates between men and women, people with and without cognitive impairment, and people with and without medical treatment. Conclusion. First data of the Spanish version of the ISI endorse single-dimensional structure, with an appropriateinternal consistency reliability, and evidences of its measures validity

Further characterization of a type III secretion system (T3SS) and of a new effector protein from a clinical isolate of Aeromonas hydrophila--part I.

A type III secretion system (T3SS)-associated cytotoxin, AexT, with ADP-ribosyltransferase activity and homology to Pseudomonas aeruginosa bifuncational toxins ExoT/S, was recently identified from a fish pathogen Aeromonas salmonicida. In this study, we reported the molecular characterization of an aexT-like toxin gene (designated as aexU) from a diarrheal isolate SSU of A. hydrophila. The aexU gene was 1539bp in length and encoded a protein of 512 amino acid (aa) residues. The NH(2)-terminus of AexU (aa residues 1-231) exhibited a 67% homology with the NH(2)-terminus of AexT from A. salmonicida. Importantly, its COOH-terminus (aa residues 232-512) had no homology with any known functional proteins in the database; however, the full-length AexU retained ADP-ribosyltransferase activity. The expression and subsequent secretion of AexU was T3SS dependent, as inactivation of the ascV gene that codes for an inner-membrane component of the T3SS channel from the wild-type (WT) bacterium, blocked translocation of AexU in HT-29 human colonic epithelial cells. We provided evidence that inactivation of acrV and axsE genes (homologs of lcrV and exsE in Yersinia species and P. aeruginosa, respectively) from A. hydrophila SSU, altered expression and/or secretion of AexU. We deleted an aexU gene from the WT, as well as from the DeltaaopB mutant, of A. hydrophila, generating a single knockout (DeltaaexU) and a double knockout mutant, DeltaaopB/DeltaaexU. Increased phagocytosis was observed in RAW264.7 murine macrophages infected with the DeltaaopB/DeltaaexU mutant, as compared to macrophages when infected with the parental DeltaaopB strain. Further, mice infected with the DeltaaexU mutant had a 60% survival rate, compared to animals infected with the WT or the DeltaaexU-complemented strain that caused 90-100% of the animals to die at a 2-3 LD(50s) dose. Immunization of mice with the recombinant AexU protected them from subsequent lethal challenge dose by the WT bacterium. Finally, we detected specific anti-AexU antibodies in the sera of mice that survived challenge by the WT bacterium, which may indicate that AexU plays an important role in the pathogenesis of Aeromonas infections.

[Internal structure of Dysfunctional Beliefs and Attitudes about Sleep Scale in a Spanish shift workers sample]. / Estructura interna de la Dysfunctional Beliefs and Attitudes about Sleep Scale en una muestra espanola de trabajadores con turnos rotatorios.

INTRODUCTION: Dysfunctional beliefs are some of the psychological factors that explains the origin and maintenance of insomnia. Morin developed a five theoretical dimension scale, the Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS), to assess them. AIMS: To analyze the internal structure of the Spanish version of DBAS, and to establish the differences on DBAS scores between two groups above described. SUBJECTS AND METHODS: The sample was 237 workers of those 197 were shift workers and the rest had a stable timetable (mean age = 43.07; standard deviation = 9.39). The DBAS and the Pittsburgh Sleep Quality Index was administrated to them. RESULTS: The results of the items analysis and reliability of each five dimensions were moderate, except for the first and second dimension of Morin's proposal. Confirmatory factorial analysis isolated four factors: consequences of the insomnia on the diurnal yield/functioning (alpha = 0.75); control and prediction of the sleep (alpha = 0.70); consequences of the insomnia on the physical and mental health (alpha = 0.69), and expectations on the association sleep-age (alpha = 0.60). It was corroborated that either first, second or third factor allowed differentiating one group of another. CONCLUSIONS: All these results allowed us to consider Spanish version of DBAS as an appropriated 18 items adapted version. The structure of four factors is theoretically coherent, and it shows an adequate internal consistency and high capacity to differentiate well from bad sleepers.

Estructura interna de la Dysfunctional Beliefs and Attitudes about Sleep Scale en una muestra española de trabajadores con turnos rotatorios / Internal structure of Dysfunctional Beliefs and Attitudes about Sleep Scale in a spanish shift workers sample

Introducción. Uno de los factores psicológicos que explicanel origen y mantenimiento del insomnio son los pensamientosdisfuncionales incompatibles con la conciliación del sueño. Paraevaluarlos, Morin elaboró la escala de creencias y actitudes sobreel sueño –Dysfunctional Beliefs and Attitudes about Sleep Scale(DBAS)– integrada por cinco dimensiones teóricas. Objetivos. Analizarla estructura interna de la versión española de la DBAS en unamuestra de trabajadores con turnos rotatorios y determinar su capacidadpara diferenciar a estos sujetos de los que tienen un horariolaboral normal. Sujetos y métodos. A una muestra de 237 trabajadores,197 con horario laboral rotatorio y 40 con horario normal(media de edad = 43,07; desviación típica = 9,39) se le aplicó laDBAS y el índice de calidad de sueño de Pittsburgh. Resultados. Elanálisis de ítems y de la fiabilidad de cada una de las cinco dimensionesoriginales de la DBAS pone de manifiesto los valores moderadosde las correlaciones ítem-total, así como la falta de homogeneidad,a excepción de la primera y segunda dimensión. El análisisfactorial exploratorio permite aislar cuatro factores: consecuenciasdel insomnio sobre el rendimiento/funcionamiento diurno (alfa =0,75); control y predicción del sueño (alfa = 0,70); consecuenciasdel insomnio sobre la salud física y mental (alfa = 0,69) y expectativassobre la asociación sueño-edad (alfa = 0,60); asimismo, se demuestraque los tres primeros diferencian a trabajadores con turnosrotatorios de trabajadores con horario laboral normal. Conclusiones.Se obtiene una versión adaptada de la DBAS formada por 18ítems distribuidos en cuatro factores coherentes conceptualmente,que muestran unos índices aceptables de consistencia interna; lostres primeros manifiestan capacidad para diferenciar a buenos demalos dormidores

Introduction. Dysfunctional beliefs are some of the psychological factors that explains the origin and maintenanceof insomnia. Morin developed a five theoretical dimension scale, the Dysfunctional Beliefs and Attitudes about Sleep Scale(DBAS), to assess them. Aims. To analyze the internal structure of the Spanish version of DBAS, and to establish thedifferences on DBAS scores between two groups above described. Subjects and methods. The sample was 237 workers of those197 were shift workers and the rest had a stable timetable (mean age = 43.07; standar deviation = 9.39). The DBAS and thePittsburgh Sleep Quality Index was administrated to them. Results. The results of the items analysis and reliability of each fivedimensions were moderate, except for the first and second dimension of Morin’s proposal. Confirmatory factorial analysisisolated four factors: consequences of the insomnia on the diurnal yield/functioning (alpha = 0.75); control and prediction ofthe sleep (alpha = 0.70); consequences of the insomnia on the physical and mental health (alpha = 0.69), and expectations onthe association sleep-age (alpha = 0.60). It was corroborated that either first, second or third factor allowed differentiatingone group of another. Conclusions. All these results allowed us to consider Spanish version of DBAS as an appropriated 18items adapted version. The structure of four factors is theoretically coherent, and it shows an adequate internal consistencyand high capacity to differentiate well from bad sleepers

Antibioterapia empírica en el pie diabético y no diabético / Empirical antibiotic therapy for diabetic and non-diabetic foot

Introducción. La neuropatía, la isquemia y la infección son los tres factores directamente relacionados con la aparición y desarrollo de las úlceras en los pacientes diabéticos. La infección definida mediante parámetros clínicos y apoyada por cultivos microbiológicos es el principal factor pronóstico de la lesión. Objetivo. Estudiar la etiología infecciosa de las úlceras en pacientes diabéticos y no diabéticos, así como la sensibilidad in vitro a antimicrobianos de los microorganismos aislados, nos permitirá establecer la mejor pauta antibiótica empírica en nuestro medio asistencial. Pacientes y métodos. Estudio observacional, transversal y prospectivo de 200 pacientes consecutivos, diabéticos y no diabéticos, ingresados por la presencia de úlceras isquémicas o neuropáticas con signos locales de infección. Toma de tres muestras microbiológicas el día del ingreso previa administración del tratamiento empírico (ciprofloxacino + clindamicina) y valoración de su respuesta clínica y sus modificaciones a específico por resistencia de los microorganismos. Resultados. En la mayoría de los cultivos se aisló microbiota polimicrobiana con predominio de aerobios-anaerobios gramnegativos y aerobios grampositivos. Staphylococcus aureus (10,6%), Pseudomonas aeruginosa y Bacteroides fragilis fueron los microorganismos más frecuentemente aislados. La terapia empírica tuvo que modificarse en más del 50% de los casos por resistencia. La mayor sensibilidad in vitro para los microorganismos grampositivos fue para la vancomicina, seguida de cloxacilina y amoxicilina/clavulánico. En el caso de aerobios-anaerobios gramnegativos, fue para meropenem, tobramicina e imipenem, y para los anaerobios, imipenem, cefoxitina y amoxicilina/clavulánico. Conclusiones. La administración de amoxicilina/clavulánico solo o asociado a tobramicina constituye una pauta antibiótica con amplio espectro para los pacientes ambulatorios. En régimen de ingreso el antibiótico de elección sería imipenem, seguido de piperacilina/tazobactam

Introduction. Neuropathy, ischaemia and infection are the three factors directly related to the appearance and development of ulcers in diabetic patients. Infection defined by means of clinical parameters and backed up by microbiological cultures is the main prognostic factor of the lesion. Aims. To study the infectious causation of ulcers in diabetic and non-diabetic patients, in addition to the in vitro sensitivity to antimicrobials of the microorganisms that were recovered, in order to enable us to develop a better empirical antibiotic regimen in our health care area. Patients and methods. We conducted a prospective, cross-sectional, observational study involving 200 consecutive diabetic and non-diabetic patients who were admitted to hospital due to the presence of ischaemic or neuropathic ulcers with local signs of infection. Three microbiological samples were taken on the day of admission before administration of the empirical treatment (ciprofloxacin + clindamycin) and their clinical response and modifications in the specific due to resistance of the microorganisms were evaluated. Results. Polymicrobial microbiota were recovered from most of the cultures, with predominance of gram-negative aerobic-anaerobics and gram-positive aerobics. Staphylococcus aureus (10.6%), Pseudomonas aeruginosa and Bacteroides fragilis were the most frequently recovered micro-organisms. The empirical therapy had to be modified in over 50% of cases due to resistance. The highest sensitivity in vitro for the grampositive micro-organisms was to vancomycin, followed by cloxacillin and amoxicillin/clavulanic acid. In the case of gram-negative aerobic-anaerobics, it was found to be meropenem, tobramycin and imipenem, while the anaerobics were seen to be more sensitive to imipenem, cefoxitin and amoxicillin/clavulanic acid. Conclusions. Administration of amoxicillin/ clavulanic acid alone or in association with tobramycin constitutes a wide-spectrum antibiotic regimen for outpatients. If the patient is hospitalised, the preferred antibiotic would be imipenem, followed by piperacillin/ tazobactam

Imagen de la Psicología como profesión sanitaria en profesores de Psicología y Medicina / Image of Psychology as a sanitary profession in Psychology and Medicine university professors

El objetivo del presente estudio es conocer la imagen que tienen los profesores de Psicología y Medicina de la Psicología comodisciplina sanitaria. Participaron un total de 593 profesores universitarios de Psicología y Medicina. Se les aplicó un cuestionariode opinión sobre la Psicología como profesión sanitaria elaborado por los investigadores que les fue facilitado a travésde correo electrónico. Los datos se analizaron en función de la disciplina, área académica y categoría docente de los profesores.Los resultados indicaron que existe una opinión favorable de los profesores de Psicología y Medicina acerca de la PsicologíaClínica como disciplina sanitaria. Los datos obtenidos son útiles como aproximación sobre la opinión de los profesores dePsicología y Medicina acerca de la Psicología como profesión sanitaria

The aim of this study is to know the Psychology and Medicine professors´ opinion about Psychology as a sanitary profession. Atotal of 593 Psychology and Medicine University professors participated in the study. A questionnaire about Psychology as asanitary profession was designed and it was provided to the professors by an e-mail. The data were analyzed according toprofessors´ discipline, academic area and professional profile. The results indicated that there is a favourable opinion of thePsychology and Medicine professors about Clinical Psychology as a sanitary profession. The data obtained are useful as anapproximation about the Psychology and Medicine professors´ opinion about Psychology as a sanitary profession

Imagen de la Psicología como profesión sanitaria en psicólogos españoles / Image of Psychology as a sanitary profession in Spanish psychologists

Este estudio pretende conocer la opinión que tienen los psicólogos colegiados españoles acerca del carácter sanitario de susfunciones. La muestra se compuso por 1.206 profesionales colegiados a los que se les administró un Cuestionario de Opiniónsobre la Psicología como Profesión Sanitaria (COPPS) a través de los servidores de correo electrónico del Colegio Oficial dePsicólogos. Se analizaron los datos según perfil profesional e institución en la que trabajaban. Los resultados encontrados reflejanuna posición general muy favorable al carácter sanitario de la Psicología y más acentuada para el caso de la PsicologíaClínica. Estos datos son muy útiles para el conocimiento sobre la profesión del Psicólogo y sus funciones en el marco delas Ciencias de la Salud

The aim of this study is to know the professional Psychology Association Members´ Opinion about the sanitary character oftheir professional functions. The sample was composed by 1.206 professionals who filled a Questionnaire of Opinion aboutthe Psychology as a Sanitary Profession (COPPS) by the net server of the Professional Psychologist Association. Data wereanalyzed according to the professional profile and the institution where the psychologists worked. The findings conclude a generalfavourable opinion about Psychology. Even, these results were more favourable in the case of the Clinical Psychology.Data are very useful for the knowledge about Psychology profession and psychologist functions in the context of the HealthSciences

Imagen de la Psicología como profesión sanitaria entre los estudiantes de Psicología / Image of Psychology as a sanitary profession among Psychology students

Con el objetivo de conocer la opinión de los estudiantes de Psicología acerca del carácter sanitario de la misma, se realiza unestudio de poblaciones mediante encuestas en una amplia muestra de estudiantes de segundo ciclo de Psicología (N = 1.571)de 14 facultades españolas de Psicología. Se aplica el Cuestionario de Opinión sobre la Psicología como Profesión Sanitaria(COPPS). Los resultados muestran que los estudiantes sitúan claramente la Psicología dentro del ámbito sanitario. Otros datosde interés muestran que los estudiantes perciben una alta afinidad entre disciplinas médicas y disciplinas psicológicas, afinidadque no se limita a la Psicología Clínica, lo que respalda la propuesta de que otras disciplinas psicológicas además de laPsicología Clínica deberían ser consideradas sanitarias. Se discuten las implicaciones de estos datos en la percepción socialdel psicólogo como profesional sanitario

The aim of this study is to explore the opinion of Psychology students about Psychology as a sanitary profession. A survey descriptivestudy is conducted. The Questionnaire of Opinion about Psychology as a Sanitary Profession was applied to a sample of1.571 University students taking last Psychology courses from 14 Spanish Universities. Results show that Psychology students considerPsychology as a sanitary profession. Students perceive a high affinity between medical disciplines and psychological disciplinesbeyond Clinical Psychology. It supports that other psychological disciplines beyond Clinical Psychology should be consideredas sanitary professions. Implications for social perception of the psychologist as a sanitary professional are discussed

Imagen de la Psicología como profesión sanitaria entre la población general / Image of Psychology as a sanitary profession among general population

En este estudio se evalúa la percepción de la población general sobre el psicólogo como profesional vinculado a la salud. Setrata de un estudio de poblaciones mediante encuestas telefónicas a una muestra de 1.562 personas de las diferentes provinciasespañolas. Se empleó un cuestionario de opinión para evaluar la percepción de las competencias del psicólogo y lasasistencias y demanda de los profesionales de la salud mental. Los resultados, analizados según las variables de sexo, profesióny edad, reflejaron una posición muy favorable al carácter sanitario de la profesión del psicólogo. Se manifestó una clarapreferencia por los psicólogos para abordar situaciones emocionales, catástrofes o emergencias en todas las variables mencionadas.Los datos suponen una aportación útil y valiosa acerca de la percepción del Psicólogo como profesional sanitario

This study explores the general population perception about psychologists as professional in the sanitary system. It is a populationstudy by telephonic surveys with a sample composed by 1.562 people along the different Spanish regions. It is used aQuestionnaire of Opinion to assess the perception of Psychologist competences and the assistances and demand of the mentalhealth professional. The results were analyzed by sex, profession and age. Data conclude a favourable position about Psychologyas a sanitary profession. It was manifested a clear preference in favour of psychologists to cope emotional situations, catastropheor emergencies in all the mentioned variables. Data are useful and worthy contributions about the perception ofpsychologist as a sanitary professional

Proteína C reactiva como factor pronóstico de mortalidad en los aneurismas de aorta abdominal rotos / C-reactive protein as a prognostic factor for mortality in ruptures abdominal aortic aneurysms

Objetivo. Determinar si el valor plasmático preoperatorio de diversos marcadores biológicos de inflamación –proteína C reactiva (PCR), leucocitos y fibrinógeno– se asocia a la mortalidad de los pacientes con rotura de aneurisma de aorta abdominal (AAA). Pacientes y métodos. Estudio prospectivo de 37 pacientes intervenidos quirúrgicamente de AAA roto. Se extrajo una muestra de sangre periférica a cada uno de ellos para el estudio preoperatorio de los biomarcadores de inflamación. Además, se recogieron datos correspondientes a variables clínicas pre, intra y postoperatorias. Para el análisis de los valores plasmáticos de PCR se utilizó un test convencional (Tina-Quant). Resultados. De los marcadores biológicos de inflamación estudiados, sólo la PCR fue un factor pronóstico de mortalidad perioperatoria, y la mediana fue significativamente superior en los fallecidos en comparación con los supervivientes (p=0,021). Se categorizó la PCR en dos grupos con la utilización como punto de corte el valor obtenido en la curva ROC (3,2 mg/dL) para la máxima sensibilidad y especificidad de esta variable con relación a la mortalidad. Los pacientes cuya PCR al ingreso fue >=3,2 mg/dL tuvieron una mortalidad significativamente mayor que aquellos cuya cifra era < 3,2 mg/dL (71 frente a 10%) (p=0,002). En el análisis multivariante, las variables pronósticas de mortalidad fueron: valor preoperatorio de PCR, duración del pinzamiento aórtico e inestabilidad hemodinámica durante la intervención. Conclusiones. La elevación de la PCR preoperatoria es un factor pronóstico de mortalidad en los AAA rotos, por lo que puede ser, junto a otros factores previamente identificados, útil para la estratificación del riesgo quirúrgico de estos pacientes

Aim. To determine whether the preoperative plasma values of several biological markers of inflammation –C-reactive protein (CRP), leukocytes and fibrinogen– are linked with the mortality of patients with a ruptured abdominal aortic aneurysm (AAA). Patients and methods. We performed a prospective study of 37 patients who had undergone surgery to treat a ruptured AAA. A peripheral blood sample was taken from each of the patients for use in the preoperative study of biomarkers of inflammation. Additionally, data concerning pre, intra and postoperative clinical variables were also collected. A conventional (Tina-Quant) test was used to analyse the CRP values in plasma. Results. Of the biological markers of inflammation studied, only CRP was a prognostic factor for perioperative mortality, and the mean was significantly higher in those who died than in survivors (p=0.021). CRP was categorised in two groups using a cut-off point taken as the value obtained from the ROC curve (3.2 mg/dL) for the maximum sensitivity and specificity of this variable in relation to mortality. Mortality among patients with a CRP on admission >=3.2 mg/dL was significantly higher than among those with a figure < 3.2 mg/dL (71 versus 10%) (p=0.002). In the multivariate analysis, the prognostic variables for mortality were: preoperative CRP value, duration of aortic clamping and haemodynamic instability during the intervention. Conclusions. Elevation of preoperative CRP levels is a prognostic factor for mortality in ruptured AAA, which means that, together with other previously identified factors, it may be useful for the stratification of surgical risk in these patients

Influencia de los pensamientos previos a acostarse en la calidad del sueño / Influence of the thoughts previous to go to bed in the quality of the sleep summary

Objetivo. Existen datos que indican que la actividad mental excesiva en el momento de dormirse (preocupaciones o pensamientos intrusivos) pueden precipitar y mantener los trastornos del sueño; no obstante, queda mucho por determinar sobre esta asociación. El objetivo del presente estudio es determinar el tipo y la frecuencia de pensamientos que se dan en el momento previo de dormirse (pensamientos laborales, relacionados con la pareja, familiares, ocio, salud, economía, etc..), y si estos pensamientos influyen en la calidad del sue´ño, así com examinar el efto que tiene la edad sobre la calidad del sueño. Material y métodos: Una muestra formada por 200 sujetos normales (100 hombre y 100 mujeres)de 20 a 55 años rellenaron durante 28 días un autorregistro de pensamientos previos al sueño y contestaron el Cuestionario de Calidad de Sueño de Pittsburgh. Resultados. Los resultados indican que la calidad del sueño empeora a media que aumenta la edad y cuando se tienen pensamientos sobre economía y salud antes de dormir. Se encontrí, además, una correlación negativa entre la frecuencia de pensamientos acerca del trabajo y sobre la pareja y la calidad de sueño, lo cual sugiere que probablemente sea la cualidad o tipo de activación mental antes de dormir, no la intensidad lo que afecta a la calidad del sueño (AU)

Evidence exists that excessive mental activity at sleep time (worries or intrusive thoughts) can accelerate and maintain sleep disorders. This aasociation however is not completely clear. The goal of this study is to determine the type and frequency of the thoughts present during the moment prior to falling as sleep (thoughts dealing with work, relationships, family, free time, health, economy, etc.), the influence of these thoughts on sleep quality, as well the effect of age on sleep quality. Methods. A sample composed of 200 normal subjects (100 men and 100 women), ranging in age from 20 to 55 years, was administeres a self recorded pre-sleep thought registry during 28 days and each subjects also filled out the Pittsburg Sleep Quality Index. Results. The results indicate that sleep quality is worsened ad a consequence of age and the presence before sleep of thoughts dealing with economy and health. A negative correlation is also found between the frequency of thoughts dealing with work and relationships and sleep quality. This correlations suggests that, in all likelihood, it is the quality-not the intensity- or type of mental activation present before falling asleep, which affects the quality of sleep (AU)

Estudio enzimático de la pared arterial en un modelo experimental de hiperplasia intimal y relación con la respuesta histológica / Enzymatic study of the arterial wall in an experimental model of intimal hyperplasia and relationship to the histological response

Objetivos: La proliferación de células musculares lisas responsables de la Hiperplasia Intima¡ origina en las placas arterioscleróticas una alteración en la actividad de enzimas musculares. Nosotros queríamos comprobar si en la hiperplasia intimal, producida en el modelo experimental ya descrito en anteriores trabajos, también habría modificaciones enzimáticas y, en tal caso, si guardan relación con el crecimiento intimal medido en la imagen histológica. Material y métodos: En ratas Wistar Albina hemos provocado una denudación en el endotelio de la aorta abdominal infrarrenal, comprobando en cada semana posterior a la lesión la respuesta histológica y los cambios bioquímicos, actividad enzimática de la laetato-deshidrogenasa (LD), creatín-kinasa (CK) y sus isoenzimas. Resultados: Obtenemos engrosamiento intimal claramente significativo desde la 2.ª semana tras la lesión endotelial, siendo mayor en ta 3.'-' y 4.-'. A nivel bioquímico destaca el predominio de las isoenzimas LD-5 y CK-BB en la pared de la aorta abdominal de las ratas, con un incremento de la LD-5, del cociente LD-5/LD-3 y de la CK-BB conforme aumenta la hiperplasia intima¡, siendo significativo para las isoenzimas de la LD (p<0.05).Conclusiones: La pared de la aorta de las ratas Wistar Albina tiene actividad de enzimas musculares específicas y el estímulo de las células musculares lisas origina variaciones evidentes de las isoenzimas de la laetato-deshidrogenasa y de la crea tín-kinasa, guardando estas variaciones una relación muy clara con la respuesta de hiperplasia intimal obtenida, de forma que son mayores en los grupos y las ratas con mayor proliferación intima¡. (AU)