Tipología de las heridas atendidas en atención primaria: estudio transversal multicéntrico / Typology of wounds treated in primary care: Multicenter cross-sectional study

Introducción La atención a personas con heridas cutáneas es un importante problema de salud que afecta la calidad de vida de los pacientes y de su familia y tiene un gran impacto socioeconómico. Conocer la situación del problema es el primer paso para el planteamiento de diferentes abordajes sanitarios. En nuestro territorio, desde 2010 no se ha realizado ningún tipo de seguimiento sobre las heridas que tratamos, por lo que planteamos conocer la tipología y las características de las heridas activas en población asistida por atención primaria. Métodos Estudio descriptivo transversal multicéntrico realizado en una zona metropolitana de Cataluña en equipos de atención primaria y en residencias. Los participantes fueron todos los pacientes con heridas activas. Se utilizó un registro realizado por enfermeras referentes del paciente. Se realizó un análisis descriptivo de los datos. Resultados Participaron 1.978 personas, que presentaron 2.471 heridas. La prevalencia global fue del 0,22%. En pacientes domiciliarios la prevalencia fue del 3,58%, y en residencias, del 6,56%. El 46,5% fueron lesiones agudas y el 53,4% crónicas, con un tamaño medio de 3,13cm. De las heridas crónicas, 345 (26,2%) tenían una evolución superior a un año. Las lesiones más prevalentes fueron las úlceras venosas en los equipos de atención primaria y las lesiones por presión categoríaII en los centros residenciales. Conclusiones Los resultados de este estudio presentan una realidad objetiva sobre las lesiones que son atendidas en atención primaria, tanto en centros de atención primaria, en domicilio o en residencias, así como su descripción (AU)

Background The care of people with skin wounds is an important health problem, that affect the quality of life of patients and their families, and has a great socioeconomic impact. Knowing the situation of the problem is the first step for different health approaches. In our territory since 2010 no type of follow-up has been carried out on the wounds that we are treating, we propose to know the typology and characteristics of active wounds in the population assisted by Primary Care. Methods Multicenter cross-sectional descriptive study carried out in a metropolitan area of Catalonia in Primary Care Teams and residences. Participants were all patients with active wounds. A record made by the patient's referring nurses was used. A descriptive analysis of the data was performed. Results About 1,978 people participated, presenting 2,471 injuries. The overall prevalence was 0.22%. At home patients, the prevalence was 3.58% and in nursing homes, 6.56%. Of all the lesions, 46.5% were acute and 53.4% chronic, the mean size was 3.13cm. Of the chronic wounds, 345 (26.2%) had an evolution of more than 1year. The most prevalent injuries were venous ulcers in Primary Care Teams and categoryII pressure injuries in residential centers. Conclusions The results of this study present an objective reality about the injuries that are treated in primary care, both in Primary Care Centers, homes or residences, as well as their description (AU)

[Typology of wounds treated in primary care: Multicenter cross-sectional study]. / Tipología de las heridas atendidas en atención primaria: estudio transversal multicéntrico.

BACKGROUND: The care of people with skin wounds is an important health problem, that affect the quality of life of patients and their families, and has a great socioeconomic impact. Knowing the situation of the problem is the first step for different health approaches. In our territory since 2010 no type of follow-up has been carried out on the wounds that we are treating, we propose to know the typology and characteristics of active wounds in the population assisted by Primary Care. METHODS: Multicenter cross-sectional descriptive study carried out in a metropolitan area of Catalonia in Primary Care Teams and residences. Participants were all patients with active wounds. A record made by the patient's referring nurses was used. A descriptive analysis of the data was performed. RESULTS: About 1,978 people participated, presenting 2,471 injuries. The overall prevalence was 0.22%. At home patients, the prevalence was 3.58% and in nursing homes, 6.56%. Of all the lesions, 46.5% were acute and 53.4% chronic, the mean size was 3.13cm. Of the chronic wounds, 345 (26.2%) had an evolution of more than 1year. The most prevalent injuries were venous ulcers in Primary Care Teams and categoryII pressure injuries in residential centers. CONCLUSIONS: The results of this study present an objective reality about the injuries that are treated in primary care, both in Primary Care Centers, homes or residences, as well as their description.

Lower Urinary Tract Symptoms and Urinary Incontinence During Pregnancy.

OBJECTIVE: Lower urinary tract symptoms (LUTS) can frequently be seen in pregnant women. Pregnancy and delivery have been considered as risk factors in the occurrence of pelvic floor dysfunction and determinants of LUTS. The main associated risk factor is parity. In the present study, we aim to determine the frequency of LUTS and urinary incontinence (UI) during pregnancy and the associated risk factors. METHODS: This prospective study was carried out in a total of 250 women during their 28- and 40-gestational week checks. The Urinary Distress Inventory-6, the Incontinence Impact Questionnaire-7, and International Consultation on Incontinence Questionnaire-Short Form were used to determine LUTS and its effect on quality of life. RESULTS: The mean age and gestational age of the participants were 29.41 ± 5.70 year (range 18-44) and 35.45 ± 2.98 weeks (range 28-40), respectively. The prevalence of LUTS was 81.6%. The prevalence of UI during pregnancy was 37.2%. Stress urinary incontinence, urge urinary incontinence and mixed urinary incontinence were diagnosed as 15.6, 4.8 and 16.8%, respectively. We found that advanced age, smoking and multiparity were risk factors associated with incontinence. Incontinence reduced pregnant women's quality of life. CONCLUSIONS: Lower urinary tract symptoms are commonly seen among pregnant women and these symptoms negatively affect the quality of life of pregnant women. Advanced age, smoking and multiparity were risk factors associated with urinary incontinence and LUTS. Obstetricians should be on the lookout for individual urological problems in pregnancy. Resolving any urological issues and cessation of smoking for the affected individuals will help alleviate the problem.

FT-IR and FT-Raman spectra, molecular structure and first-order molecular hyperpolarizabilities of a potential antihistaminic drug, cyproheptadine HCl.

Cyproheptadine hydrochloride (CYP HCl) {4-(5H-dibenzo[a,d]-cyclohepten-5-ylidene)-1-methylpiperidine hydrochloride} is a first-generation antihistamine with additional anticholinergic, antiserotonergic, and local-anesthetic properties. The geometry optimization, Mulliken atomic charges and wavenumber and intensity of the vibrational bands of all of the possible modes of CYP HCl have been calculated using ab initio Hartree-Fock (HF) and density functional theory (DFT) employing the B3LYP functional with the 6-311G(d,p) basis set. We have compared the calculated IR and Raman wavenumbers with experimental data. Quantum-chemical calculations of the geometrical structure, energies, and molecular electrostatic potential and NBO analysis of CYP HCl have been performed using the B3LYP/6-311G(d,p) method. The electric dipole moment (µ), static polarizability (α) and the first hyperpolarizability (ß) values of the title compound have been computed using HF and DFT methods. The study reveals that the antihistaminic pharmacological property of CYP HCl has a large ß value and, hence, may in general have potential applications in the development of non-linear optical materials. The experimental and calculated results for CYP HCl have also been compared with those for mianserin HCl.

Urinary Incontinence in Premenopausal Women: Prevalence, Risk Factors and Impact on Quality of Life.

OBJECTIVES: To determine the prevalence and risk factors of urinary incontinence (UI), and assess its impact on the quality of life (QOL) in premenopausal women. METHODS: In this cross-sectional study, 690 women aged from 18 to 53 were interviewed using a demographic questionnaire and the International Consultation on Incontinence Questionnaire Short Form. RESULTS: The overall prevalence of any UI was 27.2%. Of the 188 women reporting UI the types were: stress 36.7%, urgency 32.4% and mixed 30.9%. The mean value of the age and body mass index (BMI) of the cases with UI was statistically significantly higher than the group without UI (P < 0.01). In the premenopausal women of similar age and BMI the incontinence rate was significantly higher in those who had a normal vaginal delivery than those who had a Cesarean section (P < 0.01). In the logistic regression analysis it was determined that the effect on the occurrence of incontinence was as follows in terms of age, education and number of pregnancies; age > 35 years had an odds ratio of 1.896 (95% confidence interval [CI]:1.29-2.80); the effect of the status of not attending a school or only attending primary school had an odds ratio 1.839 (95% CI: 1.23-2.75) and the number of pregnancies > 2 had an odds ratio 1.495 (95% CI:1.00-2.26). CONCLUSION: Being older than 35, having a low educational level and a gravida greater than two are the independent risk factors in terms of the occurrence of UI in premenopausal women.

Experimental and theoretical investigations of 4-chloro-N-(2-methoxyphenyl)benzamidoxime.

4-Chloro-N-(2-methoxyphenyl) benzamidoxime (CMB) has been synthesized and characterized by X-ray diffraction, (1)H NMR, (13)C NMR, FT-IR and FT-Raman spectra. The X-ray study showed that CMB has a Z configuration, due to the strong intramolecular N-H···O hydrogen bond and centrosymmetric dimer form due to intermolecular O-H···N' and O-H···O' hydrogen bonds. The 2-methoxyphenyl and 4-chlorophenyl rings are twisted from the mean plane of the hydroxyamidine group by 33.09 (1) and 44.89 (1)°, respectively. The optimized molecular structure and vibrational frequencies have been calculated with DFT (B3LYP) method by using a 6-311G(d,p) basis set. The (1)H and (13)C NMR chemical shifts were calculated by the gauge-including atomic orbital (GIAO) method with the B3LYP/6-311G (d,p) level. A comparison between experimental and calculated theoretical results indicate that the density functional B3LYP method provided satisfactory results for predicting IR, Raman, (1)H NMR and (13)C NMR spectra properties.

Molecular structure, FT-IR, FT-Raman, NMR studies and first order molecular hyperpolarizabilities by the DFT method of mirtazapine and its comparison with mianserin.

Mirtazapine (±)-1,2,3,4,10,14b-hexahydro-2-methylpyrazino(2,1-a)pyrido(2,3-c)(2)benzazepine is a compound with antidepressant therapeutic effects. It is the 6-aza derivative of the tetracyclic antidepressant mianserin (±)-2-methyl-1,2,3,4,10,14b-hexahydrodibenzo[c,f]pyrazino[1,2-a]azepine. The FT-IR and FT-Raman spectra of mirtazapine have been recorded in 4000-400 cm(-1) and 3500-10 cm(-1), respectively. The optimized geometry, energies, nonlinear optical properties, vibrational frequencies, (13)C, (1)H and (15)N NMR chemical shift values of mirtazapine have been determined using the density functional theory (DFT/B3LYP) method. A comparison of the experimental and theoretical results of mirtazapine indicates that the density-functional B3LYP method is able to provide satisfactory results for predicting vibrational and NMR properties. The experimental and calculated results for mirtazapine have also been compared with mianserin.

Immune regulation of procalcitonin: a biomarker and mediator of infection.

Procalcitonin (PCT) has recently emerged as a powerful biomarker for an early and accurate diagnosis of bacterial infection. Here we summarize our current understanding of the expression pathways of PCT, its potential cellular sources including immune cells, and factors inducing its secretion. Also addressed is the significance of increased blood PCT concentration, which may allow this molecule not only to act as a clinical biomarker but also as an active participant in the development and progression of infectious processes. Experimental approaches to delineate a better understanding of PCT functions, molecular pathways that modulate its expression and therapeutic opportunities to curtail its biological actions are discussed, as well.

Theoretical and vibrational studies of 4,5-diphenyl-2-2 oxazole propionic acid (oxaprozin).

The molecular structure, linear and nonlinear optical properties, and electronic properties of 4,5-diphenyl-2-2 oxazole propionic acid (oxaprozin) as a monomer were investigated by using Hartree-Fock (HF) and density functional theory (DFT) calculations that used 6-31G(d,p) basis set. The first-order hyperpolarizability of oxaprozin (OXA) was found to be 1.117 x 10(-30) esu. The structure of oxaprozin dimer with HF/6-31G(d) level caused by the shifts of O-H and CO bands in the vibrational spectra of oxaprozin were also studied. Moreover, these calculated frequencies of oxaprozin dimer were compared with the solid FT-IR and FT-Raman spectra. The theoretical frequencies and infrared intensities were showed a good agreement with experimental data.