Impact of telemedicine on assisted reproduction treatment in the public health system.

AIM: Telemedicine has helped to make health care more efficient. However, to date no studies have measured its impact on infertility and fertility healthcare. We assessed the potential care benefits and clinical advantages of an initiative implementing electronic patient portal (EPP) for patients scheduled to undergo assisted reproduction treatment, to reduce waiting times for medical consultation and treatment. METHODS: This was designed as a retrospective cohort study. The experimental group comprised 1972 referral requests received by the assisted reproduction unit of our institution between 2015 and 2016, which were included in the group receiving telemedicine, while the control group was defined by 283 requests received in 2013, all of which were assigned face-to-face care. RESULTS: We found a statistically significant reduction in the experimental group in terms of the days elapsed between the receipt of the assessment request and the first outpatient visit (68 days vs. 180 days, p<.001). Time to initiation of treatment was also significantly lower in this group (169 days vs. 229 days; p<.001). The experimental group contained around 7 times as many patients receiving treatment as the control group. No differences were observed in the pregnancy rate (29.9% vs. 31.1%; p=.77) or in the complication rate (3.2% vs. 0%; p=.16). CONCLUSIONS: Use of telemedicine in electronic portal patient form reduces the total waiting time involved in patient requests for infertility treatment and indirectly increases the number of patients treated, causing no negative impact on treatment outcome.

Gestación multifetal yatrogénica / Iatrogenic multifetal pregnancy

Los embarazos múltiples ocurren de forma espontánea, en una de cada 90 gestaciones en el caso de las gemelares, y en una de cada 8.100 en las triples. Sin embargo, desde el desarrollo de las unidades de reproducción humana se ha identificado un incremento del 52% de gestaciones gemelares y del 404% en las de mayor orden. Ante la elevada morbimortalidad perinatal y materna de estos embarazos y con el fin de incrementar las posibilidades de supervivencia de los fetos resultantes y minimizar la morbilidad a largo plazo en los recién nacidos, surge la embriorreducción selectiva. A pesar de ser una técnica rentable, puede implicar compromisos éticos y es un procedimiento no exento de riesgos. Por todo esto, consideramos que la actitud más eficaz ante las gestaciones múltiples es su prevención primaria (AU)

Multiple pregnancies spontaneously occur in one out of 90 pregnancies for twins and in one out of 8,100 for triplets. However, since the introduction of human reproduction units, there has been a 52% increase in twins, and a 404% increase in high-order pregnancies. Given the high perinatal and maternal morbidity and mortality in these pregnancies, selective embryo reduction was developed to increase fetal survival and reduce long-term morbidity in neonates. Although effective, this procedure represents a technical and ethical challenge for the practitioner. Consequently, we believe that the most effective approach to multifetal pregnancies is primary prevention (AU)

Hematoma subcapsular hepático, una complicación infrecuente de los estados hipertensivos del embarazo / Subcapsular hepatic hematoma: a rare complication of hypertension in pregnancy

El hematoma subcapsular hepático es una infrecuente y grave complicación de los estados hiperten-sivos del embarazo que debe sospecharse ante un cuadro clínico sugerente y confirmarse mediante tomografía computarizada abdominal. Esto permitirá actuar con rapidez ante su posible rotura y así mejorar la elevada morbimortalidad maternofetal asociada (AU)

Subcapsular hepatic hematoma is an infrequent and severe complication of hypertension in pregnancy and should be suspected when there are clinical signs compatible with this diagnosis, which should be confirmed by abdominal computed tomography. Prompt diagnosis and treatment are important to avoid rupture, thus improving the high associated maternal and fetal morbidity and mortality (AU)

Conclusiones del Simposium 2007 de la Sociedad Española de Medicina Oral sobre “Xerostomía. Síndrome de Boca Seca. Boca Ardiente” / Conclusions of 2007 Simposium by the Spanish Society of Oral Medicine; on "Xerostomia. Dry Mouth Syndrome. Burning Mouth"

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Disostosis con afectación de miembros. Hallazgosultrasonográficos en el síndromede roberts / Dysostosis with limb involvement. Ultrasonographic findings in roberts' syndrome

El síndrome de Roberts, también conocido como síndrome pseudotalidomídico(1), síndrome SC (iniciales de dos hermanos afectos) o síndrome SCfocomelia, es una rara disostosis(2) de herencia autosómica recesiva con una gran variedad de manifestaciones clínicas. De todas ellas las más características son la presencia de retraso en el crecimiento pre y postnatal, las anomalías craneofaciales y las reducciones simétricas de los miembros de diversa gravedad(3).En el estudio genético, aparecen alteraciones que afectan a la heterocromatina de las regiones pericéntricas y NOR de la mayoría de los cromosomas. Estas regiones presentan un aspecto hinchado, probablemente como resultado de la repulsión de las cromátides en estas zonas, lo que se traduce en separación prematura de los centrómeros durante la profase y la metafase(4).Esta separación prematura de los centrómeros se conoce con el nombre de efecto Roberts(4,5) (AU)

Relation of acidity and sensory quality with sterol content of olive oil from stored fruit.

Composition of the sterol fraction, fatty acid, acidity, and the sensorial evaluation of virgin olive oils were studied in two eastern Spanish varieties grown and processed under the same conditions. Fruits were stored at 5 degrees C and ambient temperature for different times. During fruit storage, there was no significant variation (P = 0.05) in fatty acid composition. However, the sterol composition of the oil varied markedly (in particular, there was an increase in stigmasterol), acidity increased, and there was a very significant decrease in sensorial quality. The stigmasterol content presented a high correlation with the acidity and sensory evaluation (P < 10(-)(6)). The total sterol content increased gradually with olive storage time. Oils with stigmasterol greater than campesterol are graded to a low level (lampant). It is of interest that sensorial quality is revealed by stigmasterol content, a fact unknown until now.

Surgical solutions to periodontal complications of orthodontic therapy.

Collaboration of various specialists has become essential in pediatric dental practice. In orthodontics, this collaboration is completely necessary when the patient presents periodontal problems. Even in healthy patients, who do not suffer from periodontal disease, periodontal complications may occur during treatment with fixed appliances. Two cases of young patients, in which periodontal procedures were used to complement the results of orthodontic treatment are presented.

Effect of various compounds on virgin olive oil stability measured by Rancimat.

Phenolic and orthodiphenolic compounds together with carotenoids, tocopherols, pigments, and fatty acids were tested for their antioxidant effect in 79 samples of virgin olive oils cv. Picual and Hojiblanca. A linear regression based on the oleic/linoleic ratio and the contents of phenols and tocopherols showed a good correlation (adjusted-R(2) = 0.91) with the stability measured by Rancimat, later verified with an external text set (adjusted-R(2) = 0.95). A tentative study on the percentage contribution of each chemical variable to stability is discussed. The contribution of phenolic and orthodiphenolic compounds was around 51%, the composition of fatty acids 24%, and in less percentage alpha-tocopherol, carotenoids, and chlorophylls. No effect, or very little, was shown by beta- and gamma-tocopherols.

Effect of olive ripeness on the oxidative stability of virgin olive oil extracted from the varieties picual and hojiblanca and on the different components involved.

The initial stability of virgin olive oil depends on various factors, among which are the variety and the degree of fruit ripeness. The former, which genetically determines the composition of the olive and its oil, also marks, to some extent, its stability. However, oil stability changes as the olive ripens, so it is obvious that the degree of ripeness is an important factor. The oils were obtained by the Abencor system. Acidity, peroxide index, UV absorption at 232 and 270 nm, sensory analysis, fatty acid composition, tocopherols, phenolic compounds, orthodiphenolic compounds, sterols, pigments, and oxidative stability were determined, and the results were analyzed statistically. During ripening there was a decrease in all of the parameters studied except linoleic acid, Delta-5-avenasterol, and oil content, which increased. Virgin oils showed very good correlation between stability and the concentrations of total phenols, o-diphenols, tocopherols, chlorophyll pigments and carotenoids, linoleic and linolenic acids, total sterols, beta-sitosterol, and Delta-5-avenasterol.

[Peroxidases and ethylene formation in olive tree leaves]. / Peroxidasas y formación de etileno en hojas de olivo.

The loss of intercellular peroxidases from olive tree leaf sections subjected to isoelectric focusing correlates well with the capacity of the referred sections to convert 1-aminocyclopropane-1-carboxylic acid (ACC) into ethylene. Both activities are compared in leaves of different ages (according to their position on the branch) and it is found that they follow a parallel course. The inhibition of the capacity to convert ACC into ethylene in homogenized olive tree leaves is due to inhibitors release. The results, in relation to other authors' reports, are discussed.