[Sociodemographic characteristics and risk factors associated to significative bacteriuria in a Spanish health area]. / Características sociodemográficas y factores de riesgo asociados a las bacteriurias significativas en un área de salud del sudeste español.

OBJECTIVE: To determine the epidemiological characteristics of significative bacteriuria (SB) and their relationship with sociodemographic factors and to analyze risk factors in inpatients. METHODS: Cross-sectional descriptive study carried out on urine culture samples received between 2016-2020 in the Microbiology laboratory, differentiating between minors and adults. The dependent variable was the presence of SB and the independent variables were age, sex, year, type of sample and source of the sample. In urine cultures of inpatients, risk factors were evaluated from the Minimum Basic Data Set. RESULTS: A total of 68,587 valid records (96.3% of the total) were analyzed. 40.8% (95% CI: 40.4%-41.2%) of urine cultures in adults and 33.8% (95% CI: 32.9%-34.7%) in children were positive, with an incidence that ranged in adults between 18.2 cases/1,000 inhabitants in 2016 and 14.6 cases/1,000 inhabitants in 2020 and 21.1 and 8.4 cases/1,000 inhabitants respectively in minors. Positive urine cultures were more frequent in children from urban areas compared to rural areas (OR=1.37; p<0.01). In hospitalized adults, for each year of age the risk of SB increased by 2%, it was 36% higher in women, 18% higher in obese patients and 17% more frequent in patients with kidney disease, (p<0.01). No relationship was observed between SB and diagnosis of COVID-19. CONCLUSIONS: The sociodemographic characteristics of the population with SB in our health area are similar to those found in other geographical areas worldwide, observing a decreasing trend in incidence in the years studied. The frequency of SB in children is higher in urban areas.

Psychological Interventions for Parents of Children with Cancer: A Systematic Review and Meta-analysis

This study provides a systematic review and meta-analysis of randomized controlled trials that analyzed the efficacy of psychological interventions for parents of children with cancer. The search was conducted in the databases PsycInfo, Medline, PsycArticles, and PsycTests. Fourteen studies met the inclusion criteria. Two independent researchers extracted relevant data, and the studies were assessed for methodological quality. The standardized mean difference (d) was used as the effect size index. The meta-analyses, which applied random and mixed-effects models, showed that weighted effect sizes were statistically significant for depression at posttreatment (d= 1.19). However, the methodological quality moderated the depression estimate. The weighted effect sizes for the remaining variables were not statistically significant: stress/burnout (d= 0.90), quality of life (d= 1.26), anxiety (d= 0.21), posttraumatic stress (d= 0.05), and general indicator of emotional symptoms (d= 0.33). This review also highlights several methodological limitations of the studies. Future directions for research that examines interventions targeting primary caregivers of children with cancer are discussed. In conclusion, more high-quality research is needed to establish the efficacy of psychological interventions for parents of children with cancer (AU)

Adaptation of antibiotic treatment to clinical practice guidelines in patients aged ⩾65 years hospitalised due to community-acquired pneumonia.

Early, conforming antibiotic treatment in elderly patients hospitalised for community-acquired pneumonia (CAP) is a key factor in the prognosis and mortality. The objective was to examine whether empirical antibiotic treatment was conforming according to the Spanish Society of Pulmonology and Thoracic Surgery guidelines in these patients. Multicentre study in patients aged ⩾65 years hospitalised due to CAP in the 2013-14 and 2014-15 influenza seasons. We collected socio-demographic information, comorbidities, influenza/pneumococcal vaccination history and antibiotics administered using a questionnaire and medical records. Bivariate analyses and multilevel logistic regression were made. In total, 1857 hospitalised patients were included, 82 of whom required intensive care unit (ICU) admission. Treatment was conforming in 51.4% (95% confidence interval (CI) 49.1-53.8%) of patients without ICU admission and was associated with absence of renal failure without haemodialysis (odds ratio (OR) 1.49, 95% CI 1.15-1.95) and no cognitive dysfunction (OR 1.71, 95% CI 1.25-2.35), when the effect of the autonomous community was controlled for. In patients with ICU admission, treatment was conforming in 45.1% (95% CI 34.1-56.1%) of patients and was associated with the hospital visits in the last year (<3 vs. ⩾3, OR 2.70, 95% CI 1.03-7.12) and there was some evidence that this was associated with season. Although the reference guidelines are national, wide variability between autonomous communities was found. In patients hospitalised due to CAP, health services should guarantee the administration of antibiotics in a consensual manner that is conforming according to clinical practice guidelines.

Muscle Pathology in Free-Ranging Stranded Cetaceans.

Despite the profound impact that skeletal muscle disorders may pose for the daily activities of wild terrestrial and marine mammals, such conditions have been rarely described in cetaceans. In this study, the authors aimed to determine the nature and prevalence of skeletal muscle lesions in small and large odontocetes and mysticetes ( n = 153) from 19 different species. A macroscopic evaluation of the epaxial muscle mass and a histologic examination of the longissimus dorsi muscle were performed in all cases. The only macroscopically evident change was variable degrees of atrophy of the epaxial muscles ( longissimus dorsi, multifidus, spinalis) in emaciated specimens. The histopathological study revealed single or combined morphological changes in 91.5% of the cases. These changes included the following: degenerative lesions (75.2%), muscle atrophy (37.9%), chronic myopathic changes (25.5%), parasitic infestation (9.2%), and myositis (1.9%). The skeletal muscle is easily sampled during a necropsy and provides essential microscopic information that reflects both local and systemic conditions. Thus, skeletal muscle should be systematically sampled, processed, and examined in all stranded cetaceans.

[Demands and expectations of parents who refuse vaccinations and perspective of health professional on the refusal to vaccinate]. / Demandas y expectativas de padres y madres que rechazan la vacunación y perspectiva de los profesionales sanitarios sobre la negativa a vacunar.

OBJECTIVES: To examine the opinions, beliefs and attitudes about vaccination, of parents who decide not to vaccinate their children. To determine the opinions and attitudes of the health professionals on the behaviour towards childhood vaccination. METHOD: Qualitative research based on semi-structured interviews and focal groups in Granada, Spain, including parents who chose to not vaccinate their children, and healthcare professionals who can provide a technical point of view. An analysis was made of the semantic content, and answers were categorized in thematic units. RESULTS: The parents argued on the benefit of suffering vaccine-preventable diseases in a natural way, without non-natural, aggressive or toxic products. Vaccination was considered unnecessary, if given adequate hygienic-sanitary conditions, effectiveness unproven and more dangerous than the diseases they prevent, especially the polyvalent vaccines. They believed that vaccination programs are moved by biased studies and interests other than prevention. Health care professionals believe that they had fears without scientific basis, which requires improving information systems. CONCLUSIONS: Non-vaccinators are unaware of the benefit/risk ratio between the vaccination and the individual risk for preventable diseases, and ask for informed consent. Health care professionals believe that non-vaccinators' arguments are not correctly contrasted and expose the existence of failures in actual vaccination coverage and information registration systems. It was suggested to centralize registers and compare them in schools, working with local leaders and reporting regularly on the status of vaccine-preventable diseases.

Outpatients' perceptions of their experiences in musculoskeletal rehabilitation care.

BACKGROUND: While patients' satisfaction with rehabilitation care is often measured, the knowledge of their experiences during delivery of care and of which characteristics may lead them to experience problems remains largely undocumented. AIM: To assess the quality of patients' experiences receiving post-acute care for musculoskeletal disorders in outpatient rehabilitation settings. To describe the extent to which variations in reported quality of patients' experiences were related to their characteristics. DESIGN: A cross sectional, self-reported survey. SETTING: 3 outpatient rehabilitation units. POPULATION: Four hundred sixty-five outpatients. Mean age 39.4 (SD=11.9). METHODS: A problem score (from 0 to 100%) of self-reported experiences was calculated on 7 specific aspects of care (belonging to organizational environment and professionals' attitudes and behaviors) and compared among participants' subgroups. RESULTS: Mean scores of the organizational environment area showed higher amount of problems (43.3%) than the professionals' attitudes and behaviours area (34.7%). Two multivariate linear regression models (with adjusted R(2) 9.3% and 4.9%) indicated that older patients and those with high global rating change were less likely to experience problems in the two areas. CONCLUSION: Problems on aspects of care were commonly experienced by patients with musculoskeletal disorders in outpatient rehabilitation settings. The age and health of patients were associated to these problems, but explained only a small variation in them. CLINICAL REHABILITATION IMPACT: Surveys measuring patients' experiences can be used to monitor the actual performance of rehabilitation settings and to pinpoint the exact issues needing to be addressed to improve quality as well as to make comparison among centres.

[Consumption of the probiotic Lactobacillus planctarum CECT 7315/7316 improves general health in the elderly subjects]. / El consumo del probiótico Lactobacillus plantarum CECT 7315/7316 mejora el estado de salud general en personas de edad avanzada.

INTRODUCTION: Ageing induces changes in gut microbiota that may affect the quality of life. In this work we analyze the effect of Lactobacillus plantarum CECT 7315/7316 on the regulation of intestinal transit and on nutritional status. METHODS: We carried out a double-blind, randomized and controlled by placebo clinical trial. We evaluated the evolution of the weekly defecation frequency and blood levels of total proteins, albumin, cholesterol and reactive C-protein. RESULTS: Lactobacillus plantarum CECT 7315/7316 helps to regulate intestinal transit and improves the nutritional status in elderly. CONCLUSIONS: Consumption of functional foods containing L. plantarum CECT 7315/7316 improves the quality of life in elderly subjects.

[Opinion of healthcare professionals on patient safety in a primary level hospital]. / Opinión de los profesionales sanitarios sobre seguridad del paciente en un hospital de primer nivel.

OBJECTIVE: To identify the patient safety (PS) culture perceived by health professionals of the Hospital Universitario Virgen de las Nieves (HUVN) in Granada. METHODOLOGY: A descriptive cross-sectional study of professionals working in HUVN using the Spanish version of the questionnaire Hospital Survey On Patient Safety Culture (AHRQ), in July-August 2008. The sample size was estimated as 476 surveys (included 60% losses). RESULTS: The response rate was 62.8% (299 questionnaires). In the previous 12 months, 90.2% of professionals had not notified any adverse event (AE). The average perception of PS was 6.57 ± 1.82 (scale 0-10). Teamwork in the unit for PS was the best rated dimension (66.9%). There was a positive correlation (c. Pearson) between the perception of PS and the years that professionals had worked in specialisation (0.21), hospital (0.197) and unit (0.138), respectively (all, p < 0.05). According to category, the physicians have reported an AE with a likelihood 32.26 times greater than the assistants and technicians (p < 0.05). The PS perception dimension was viewed favourably by 34.1%. The management support (3.7%) and staffing (9%) were the main areas for improvement. CONCLUSIONS: The perception of PS at HUVN is good, even if the communication of errors is poor. The main area for improvement is a non-punitive communication of errors. It is advisable to promote a campaign to raise public awareness of the problem, to perform training programs for professionals and to implement systems for recording adverse events.

Evolution of caries and fluorosis in schoolchildren of the Canary Islands (Spain): 1991, 1998, 2006.

The aim of this work is to assess the evolution of caries and fluorosis prevalence and indices at 7 and 12 years of age in the Canary Islands through three cross epidemiological studies conducted in 1991, 1998 and 2006. The three studies followed a similar methodology, using the WHO diagnosis criteria and indications, except for the assessment of fluorosis, which was measured with the "Thylstrup and Fejerskov" index. The examining dentists were trained and calibrated in an area with high endemic fluorosis. The three studies took a sample of 1000 students for each age group. At 7 years of age, the decayed, and filled teeth (dft) varied from 1.42 in 1991 to 1.14 in 1998 and 1.37 in 2006. At 12 years of age, the Decayed, Missing, and Filled Teeth (DMFT) went from 1.86 to 1.21 and 1.51 in the three studies respectively and the significant caries index (SiC) went from 4.28 to 3.15 and 3.72. At this age, the Filled Rate rose from 24.05% in 1991 to 30.43% in 1998 and to 37.20% in 2006. In relation to fluorosis, at 12 years of age the percentage of healthy or fluorosis-free schoolchildren in the Canary Islands between the first and the second studies went down from 73% to 61.3% and went up to 78.5% in 2006, with a noticeable fall in the prevalence of children with severe and moderate fluorosis. Despite the fluctuations of caries shown in the three studies, at 12 years of age the Canary Islands have remained in the low level of caries of the WHO classification from 1991 up to now. The evolution in the prevalence of dental fluorosis shows the effect of the measures taken, 10 years after they were started.

Evolution of caries and fluorosis in schoolchildren of the Canary Islands (Spain): 1991, 1998, 2006

No disponible

The aim of this work is to assess the evolution of caries and fluorosis prevalence and indices at 7 and 12 years of age in the Canary Islands through three cross epidemiological studies conducted in 1991, 1998 and 2006.The three studies followed a similar methodology, using the WHO diagnosis criteria and indications, except for the assessment of fluorosis, which was measured with the “Thylstrup and Fejerskov” index. The examining dentists were trained and calibrated in an area with high endemic fluorosis. The three studies took a sample of 1000 students for each age group. At 7 years of age, the decayed, and filled teeth (dft) varied from 1.42 in 1991 to 1.14 in 1998 and 1.37 in 2006. At 12 years of age, the Decayed, Missing, and Filled Teeth (DMFT) went from 1.86 to 1.21 and 1.51 in the three studiesrespectively and the significant caries index (SiC) went from 4.28 to 3.15 and 3.72. At this age, the Filled Rate rose from 24.05% in 1991 to 30.43% in 1998 and to 37.20% in 2006. In relation to fluorosis, at 12 years of age the percentage of healthy or fluorosis-free schoolchildren in the Canary Islands between the first and the second studies went down from 73% to 61.3% and went up to 78.5% in 2006, with a noticeable fall in the prevalence of children with severe and moderate fluorosis.Despite the fluctuations of caries shown in the three studies, at 12 years of age the Canary Islands have remained in the low level of caries of the WHO classification from 1991 up to now. The evolution in the prevalence of dental fluorosis shows the effect of the measures taken, 10 years after they were started (AU)

Atoxoplasma spp. infection in captive canaries (Serinus canaria).

Clinical signs, histopathological and ultrastructural findings associated with Atoxoplasma spp. natural infection in captive canaries (Serinus canaria) are described. Intracytoplasmic Atoxoplasma-like protozoa were found in the liver and lung. In the liver, protozoa were found in hepatocytes and Kupffer's cells and were associated with granulomatous hepatitis and a marked bile duct hyperplasia. An usual finding was the presence of infected mononuclear cells adhered to the endothelium of the blood vessels in lung. The diagnosis was confirmed by ultrastructural examination of reprocessed paraffin-embedded tissues.

Desinfección de superficies en el hospital / Disinfection of surface in the Hospital

Este artículo, revis el uso de desinfectantes para la desinfcción de suelos y otras superficies de amterial no crítico en el hospital. Basados en la bilbografia, hemos evaluado la necesidad de la desinfección de las superficies ambientales hospitalaias. De acuerdo con los conocimientos científicos actuaes y teniendo en cuenta la compleja naturaleza de los factores de riesgo de la infección nosocomial, los smilares porcntajes de nfección cuando se realiza limpieza o desinfección del suelo y la peligrosidad de los desnfectantes para el personal sanitario, concluimos que la desinfeccin es razonable para desinfectar el suelo y conveniente para otras superficies ambientaes (mesitas de noche, cuñas, aparatos de tensión…) (AU)

Review of the use of disifectants on the floor and other surfaces of non-critical material in the hospital (AU)

Apoptosis of thymocytes in experimental African Swine Fever virus infection.

This paper report on the lesions occurred in the thymus in experimental acute African swine fever (ASF). Twenty-one pigs were inoculated with the highly virulent ASF virus (ASFV) isolate Spain-70. Animals were slaughtered from 1 to 7 days post infection (dpi). Three animals with similar features were used as controls. Thymus samples were fixed in 10% buffered formalin solution for histological and immunohistochemical study and in 2.5% glutaraldehyde for ultrastructural examination. For immunohistochemical study, the avidin-biotin-peroxidase complex (ABC) technique was used to demonstrate viral protein 73 and porcine myeloid-histiocyte antigen SWC3 using specific monoclonal antibodies. Cell apoptosis was evaluated by the TUNEL assay. Blood samples were taken daily from all pigs and were used for leukocyte counts. The results of this study show a severe thymocyte apoptosis not related to the direct action of ASFV on these cells, but probably to a quantitative increase in macrophages in the thymus and their activation. A decrease in the percentage of blood lymphocytes was observed at the same time No significant vascular changes were observed in the study. With these results we suggest that ASFV infection of the thymus does not seem to play a critical role in the acute disease. Although severe apoptosis was observed, animals died because of the severe lesions found in the other organs.

African swine fever and classical swine fever: a review of the pathogenesis.

This paper describes major pathogenetic mechanisms of African and Classical Swine Fever virus infections. The interactions between both viruses and the monocyte-macrophage-system result in the release of mediator molecules, which are important for the further progression of the diseases. The causes of the thrombocytopenia and the mechanisms of the haemorrhages, which are characteristic in both infections, are described. Apoptotic cell death is regarded as the predominant cause of lymphopenia in both virus infections.

Classical Swine Fever: pathology of bone marrow.

Twenty pigs were inoculated with a virulent isolate (Quillota strain) of classical swine fever (CSF) virus to determine the chronological development of lesions in bone marrow. Histopathologic, ultrastructural and immunohistochemical (detection of viral antigen gp55, myeloid-histiocyte antigen, CD3 antigen, and FVIII-rag), and morphometric techniques were employed. Viral antigen was detected from 2 days postinfection (dpi) in stromal and haematopoitic cells, and severe atrophy related to apoptosis of haematopoitic cells was observed. Megakaryocytes (MKs) did not show significant changes in number, but there were important qualitative changes including 1) increased numbers of cloud-nuclei MKs, microMKs, apoptotic MKs, and atypical nucleated MKs and 2) decreased number of typical nucleated MKs. Morphometric study of these cells showed a decrease in cytoplasmic area. MK infection was detected from 2 dpi, but in a small percentage of cells. Myeloid cells showed quantitative changes, with an increase in granulocyte numbers. Apoptosis of lymphocytes and viral infection of erythroblasts were also observed. The main changes in stroma were depletion of T lymphocytes in the middle phase of the experiment and macrophages. Viral infection was also observed in these cells. MK lesions suggest dysmegakaryocytopoiesis, which would aggravate the thrombocytopenia already present and could be responsible for it. Granulocyte changes would lead to the appearance of circulating immature forms, whereas lymphocyte apoptosis in bone marrow would contribute to lymphopenia.

Electrospray mass spectra of group 6 (Fischer) carbenes in the presence of electron-donor compounds.

Fischer carbene complexes 1-7 are not ionized under standard electrospray ionization (ESI) conditions. We report here that unsaturated chromium and tungsten (Fischer) carbene complexes can be ionized in an electrospray ion source in the presence of electron-donor compounds such as hydroquinone (HQ) or tetrathiafulvalene (TTF). The addition of these compounds, which seem to act as electron transfer agents, permits the recording and study of their ESI mass spectra in the negative mode of detection. Both chromium and tungsten(0) carbene complexes undergo in the first fragmentation stage a double simultaneous decarbonylation process.

African swine fever: Expression of interleukin-1 alpha and tumour necrosis factor-alpha by pulmonary intravascular macrophages.

To determine, in the acute form of African swine fever (ASF), the relationship between the appearance of pulmonary oedema and viral replication and expression of cytokines by pulmonary intravascular macrophages (PIMs), 14 pigs were inoculated intramuscularly with ASF virus (strain España'70) and killed in pairs on days 1-7 post-inoculation. Samples of lung were examined immunohistochemically and ultrastructurally. The immunohistochemical study was carried out with antibodies against interleukin-1 alpha (IL-1alpha), tumour necrosis factor-alpha (TNF-alpha), viral antigen of ASF (Vp73) and a myeloid marker (SWC3). Viral replication was observed mainly in PIMs, which at the same time showed intense activation, accompanied by the expression of IL-1alpha and TNF-alpha. The occurrence of interstitial oedema, neutrophil sequestration and fibrin microthrombi in septal capillaries coincided with high degrees of cytokine expression by infected PIMs. Alveolar macrophages did not show a significant change in cytokine expression as a result of ASF infection, and viral replication was detected in only a low percentage of these cells.

Synthesis of ferrocene-substituted 2-azetidinones.

The photochemical reaction of alkoxychromium(0)carbene complexes and ferrocene mono- and disubstituted imines formed 2-azetidinones having one or two ferrocene moieties in good yields. Yields decrease when the carbene moiety bears an aminoferrocene moiety attached to the carbene carbon, while complex 9 having the ferrocene directly bonded to the carbene carbon was totally inert in these reactions. Access to beta-lactams with the ferrocene tethered to the C3 position through a methylene group was gained using the lithium enolate derived from ethyl 3-ferrocenylpropanoate. The reaction of this enolate produced two unexpected processes. Thus, 2-azetidinone 15 having an hydroxyl group at the C3 position was obtained together with the expected beta-lactam 14, by reaction of the lithium enolate of ethyl 3-ferrocenylpropenoate and imine 1. Additionally, unsaturated amide 17 was obtained by base-promoted Hoffmann-like breakage of the beta-lactam ring formed in the reaction of the same enolate and imine 2. Oxidation of the anion at the C3 of the 2-azetidinone ring on compound 14, as well as the sterically driven ring-breakage of the C3 anion derived from the nonisolated 2-azetidinone 18, should be responsible for this behavior.