Microstructural changes in Teruel dry-cured ham during processing.

Dry-cured ham, "Protected Designation of Origin (PDO)" Teruel, is a high quality meat product processed using a traditional dry-curing procedure. The objective of this paper was to study the microstructure of the Biceps femoris and Semimembranosus muscles during "PDO Teruel" dry-cured ham processing using electron microscopy techniques (Cryo-SEM, SEM and TEM). The Semimembranosus and Biceps femoris muscles from raw ham show the typical structure of muscle tissue in meat. The muscle fibres appear firmly attached to one another by the endomysial connective tissue; the myofibrils inside the cells are strongly attached to each other and to the sarcolemma. In raw ham, the typical structural elements that constitute the sarcomere can be observed by TEM. Important microstructural changes are observed following salting; reflected in the fact that the Z-disks inside the myofibrils are no longer in line and there is important degradation of the cell membranes in this stage. At the end of the process, an accumulation of solutes, which could be products from proteolysis occurring mainly in the last stage of ripening, could be observed in both muscles. Thus the proteolysis and dehydratation phenomena that take place during "PDO Teruel" dry-cured ham processing occur at an ultrastructural level, and this is the basis to produce a product with the sensory features appreciated by consumers.

Clinical characteristics and response to newer quinolones in Legionella pneumonia: a report of 28 cases.

Twenty-eight (11.6%) out of 241 Spanish patients enrolled in an international phase III clinical trial of mild to moderate community-acquired pneumonia (CAP) comparing gemifloxacin vs. trovafloxacin were diagnosed of Legionnaires' disease. A definite diagnosis was established by seroconversion in 13 patients of whom only 2 had a positive Legionella urinary antigen. The remaining 15 patients were possible Legionella infections based on a single elevated IgG titer (> or = 1:512). All patients had a radiologically confirmed diagnosis of pneumonia, 5 (19%) patients were older than 65, comorbidity was present in 9 (33%), and 10 (36%) had to be hospitalized. Fifteen patients were treated with oral gemifloxacin (320 mg/day) and 13 with oral trovafloxacin (200 mg/day). Overall, clinical success occurred in 25 (89.3%) patients after 7 days of treatment and only 1 patient needed a 14-day treatment. There were only one adverse event withdrawal and one clinical failure, and no patients died. In light of the favorable clinical outcome, the use of newer fluoroquinolones seems adequate for the treatment of suspected or proven Legionella pneumonia.

Causas de satisfacción y de insatisfacción de los pacientes en hospitales y atención primaria / Causes of patients' satisfaction and dissastisfaction

Introducción: En el sector sanitario se utilizan diferentes aproximaciones metodológicas (tanto cuantitativas como cualitativas) para identificar los aspectos de la atención sanitaria más importantes para los pacientes. Estos estudios han sido utilizados para diseñar instrumentos de evaluación de la satisfacción del paciente, identificando las dimensiones que debían ser evaluadas para conocer mejor sus opiniones. Objetivo: Identificar los aspectos que los pacientes señalan como causa de satisfacción e insatisfacción en diferentes servicios médicos. Método: Diseño cualitativo combinando las técnicas de grupo focal y grupo nominal. En total creamos 20 grupos de trabajo, colaborando 10 hospitales y 4 centros de salud. Sujetos: Participó un total de 171 pacientes que habían sido atendidos en diferentes servicios sanitarios: medicina y cirugía, obstetricia, pediatría, consultas externas y urgencias y centros de atención primaria. Resultados: Los pacientes, independientemente del grupo en el que participaban, consideraron como causas de satisfacción: el trato humano y personalizado, la empatía, la capacidad de respuesta, la calidad de la información recibida y el confort de las instalaciones. Por otro lado, consideraron como causas de insatisfacción: la falta de coordinación del personal sanitario cuando sucedía, las listas de espera y los retrasos en la atención, en obtener los resultados de las diferentes pruebas o en comunicar el diagnóstico. Conclusiones: Empatía, trato y confort son los motivos más frecuentes de "buenas experiencias", mientras que la accesibilidad y ciertos aspectos organizativos son los motivos más citados como causas de insatisfacción (AU)