The comfort perception in the critically ill patient from the Kolcaba theoretical model.

BACKGROUND: The stay in a critical care unit (CCU) has a serious impact on physical condition causing numerous discomfort factors such as pain or difficulty in communicating. All of these are associated with possible sequelae following discharge from the Intensive Care Unit (ICU) named post-ICU syndrome. The Kolcaba Comfort Theory allows, from a holistic approach, to identify care needs from the patient's perspective using instruments such as the General Comfort Questionnaire (GCQ). OBJECTIVES: To determine the comfort level of patients admitted to the CCU using the GCQ of Kolcaba and to identify the discomfort factors. METHODS: Cross-sectional descriptive observational prospective study. POPULATION: 580 patients admitted to adult CCU of two high complexity hospitals from June 2015 to March 2020 with stay ≥24 h were interviewed. Descriptive analysis, Student's t-test and ANOVA and multivariate analysis were performed using SPSS v26 and STATA v16. RESULTS: The mean age was 52,62 (16,21), 357 (61,6%) were male and 434 (74,8%) were believers. The type of admission was planned in 322 (55,5%) and the most prevalent reason for admission was surgical 486 (83,8%). The median pain score (NRS) was 3,00 [0-4] and severity score (APACHE II) was 13,26 (5,89), the median length of stay was 4,00 [2-7] days. The mean comfort level was 3,02 (0,31) showing the highest value Reanimation 3.02 (0.30) and the lowest Trauma and Emergency Unit 2.95 (0.38). Statistically significant differences were found between the units in the comfort level of patients >65 years of age (p = 0.029). The Relief comfort type obtained the lowest mean 2.81 (0.33) and the physical context 2.75 (0.41) in the three units. In the multivariate analysis, statistically significant differences were found between the comfort level and the pain level: no pain (p = 0,000) OR 4,361 CI [2,184-8,707], mild pain (p = 0,000) OR 4,007 CI [2,068-7,763], moderate pain (p = 0,007) OR 2,803 CI [1,328-5,913], and the APACHE II score equal to or greater than 10 (p = 0,000) OR 0,472 CI [0,316-0,705]. CONCLUSIONS: The comfort level showed high scores in all three units. The physical and environmental contexts and the relief comfort type negatively affected the perception of comfort. The variables that explained comfort were pain and severity of illness. The evaluation of comfort from the patient's perspective through the GCQ could be considered an indicator of quality of nursing interventions.

The Frequency of Germline BRCA and Non-BRCA HR-Gene-Variants in a Cohort of Pancreatic Cancer Patients.

Germline DNA alterations affecting homologous recombination pathway genes have been associated with pancreatic cancer (PC) risk. BRCA2 is the most studied gene and affects the management of PC patients and their families. Even though recent reports have suggested a similar role of germline ATM pathogenic variants (PV) in familial PC, there is still a disagreement between experts on how it could affect patient management given the lack of proper PC risk estimates. We retrospectively analyzed the germline data of 257 PC patients among whom nearly 50% were sporadic cases. We showed similar frequencies of BRCA2 (4.9%) and ATM (4.4%) PV or likely pathogenic variants, which were not related to familial history. Based on our findings and that of the literature, we suggest including ATM gene among the panel of genes analyzed in PC patients pending the publication of prospective studies.

The impact of insomnia disorder on adult attention-deficit/hyperactivity disorder severity: A six-month follow-up study.

BACKGROUND AND OBJECTIVES: The longitudinal relationship between insomnia disorder and adult attention-deficit/hyperactivity disorder (ADHD) has been scarcely investigated. This study aimed to evaluate the relationship between the remission of insomnia disorder and adult ADHD clinical severity, psychiatric and medical comorbidities, and the health-related quality of life (HRQoL) in a 6-month follow-up. METHODS: Ninety-two adult patients with ADHD and insomnia disorder (52.2% males; mean age 39.5 ± 11.0 years) were comprehensively assessed at baseline, 3 months, and 6 months of a follow-up period. The evaluation included semi-structured interviews (for ADHD and comorbidity assessment), the Pittsburgh Sleep Quality Index, Insomnia Severity Index, and Epworth Sleepiness Scale. The diagnosis of ADHD and insomnia disorder was performed according to DSM-5 criteria. At baseline and follow-up, psychoeducation/sleep hygiene and, if necessary, pharmacological were prescribed for insomnia. RESULTS: Eighty-seven patients completed the 6-month follow-up. Insomnia disorder remission was reported in 72.4% of cases and was related to a greater improvement in ADHD symptoms and severity throughout the follow-up period. Additionally, an improvement in psychiatric comorbidities and better HRQoL were associated with insomnia disorder remission. CONCLUSION: The current study highlights that the treatment of insomnia disorder in ADHD adult patients may have an important role in the outcome of ADHD therapeutic approaches by reducing their severity.

Outcome of kidney transplant in primary, repeat, and kidney-after-nonrenal solid-organ transplantation: 15-year analysis of recent UNOS database.

The number of nonrenal solid-organ transplants increased substantially in the last few decades. Many of these patients develop renal failure and receive kidney transplantation. The aim of this study was to evaluate patient and kidney allograft survival in primary, repeat, and kidney-after-nonrenal organ transplantation using national data reported to United Network for Organ Sharing (UNOS) from January 2000 through December 2014. Survival time for each patient was stratified into the following: Group A (comparison group)-recipients of primary kidney transplant (178 947 patients), Group B-recipients of repeat kidney transplant (17 819 patients), and Group C-recipients of kidney transplant performed after either a liver, heart, or lung transplant (2365 patients). We compared survivals using log-rank test. Compared to primary or repeat kidney transplant, patient and renal allograft survival was significantly lower in those with previous nonrenal organ transplant. Renal allograft and patient survival after liver, heart, or lung transplants are comparable. Death was the main cause of graft loss in patients who had prior nonrenal organ transplant.

Clearance of Hepatitis C Virus Prior to Lung Transplantation: A Case Report.

Hepatitis C virus (HCV) continues to be considered a relative contraindication to lung transplantation due to concerns of progression of liver disease with the introduction of immunosuppression. Since the recent introduction of effective antiviral therapy for HCV, new approaches in the management of the HCV-positive recipient are being utilized in liver transplantation to clear HCV pre- and post-transplant. Herein, we report use of ledipasvir/sofosbuvir for HCV clearance prior to lung transplantation in a patient with usual interstitial pneumonia. Listing for transplant was delayed until completion of HCV treatment, and he subsequently required extracorporeal membrane oxygenation as a bridge to transplantation due to progressive hypoxia. With antiviral cure rates exceeding 90%, HCV should no longer be considered a relative contraindication to lung transplant, and timing of antiviral treatment should consider the progressive nature of the recipient's lung disease.

Controversias en trombofilia / Controversies in thrombophilia

No disponible

Insecticidal activity of a Moroccan strain of Streptomyces phaeochromogenes LD-37 on larvae, pupae and adults of the Mediterranean fruit fly, Ceratitis capitata (Diptera: Tephritidae).

The Mediterranean fruit fly (medfly), Ceratitis capitata, is considered the most important fruit pest worldwide. Its management is mainly based on the use of chemical insecticides. Although these conventional pesticides are effective at high doses, they cause considerable human health and environment problems. Thus, the aim of this study was to assess insecticidal activity of Moroccan actinobacteria against C. capitata. A total of 12 preselected actinobacteria isolated from various Moroccan habitats were screened for their insecticidal activity against larvae, pupae and adults of C. capitata. Four actinobacteria isolates were significantly active against the first-instar larvae, and nine were active against the medfly adult, while no significant mortality was obtained against the third-instar larval and pupal stages. Among the selected isolates, the biological screening revealed that strain Streptomyces LD-37, which showed 99.4% similarity with Streptomyces phaeochromogenes, exhibited the maximal corrected larval mortality of 98%. Moreover, the isolates AS1 and LD-37 showed the maximum significant corrected mortality against adults of 32.5 and 28.2%, respectively. The crude extract obtained from a fermented culture of strain S. phaeochromogenes LD-37 was separated into six fractions by thin layer chromatography. Fractions F3 and F4 caused a significant corrected larval mortality of 66.7 and 53.3%, respectively; whereas the maximum reduction in adult emergence was obtained with fraction F4. This finding could be useful for utilizing S. phaeochromogenes LD-37 as an alternative to chemical insecticides in pest management of C. capitata.

Valor pronóstico de la TcPO2 en la cicatrización de lesiones en pie diabético tras revascularización / TcPO 2 prognostic value of healing in diabetic foot after revascularization

INTRODUCCIÓN: La medición de la presión transcutánea de oxígeno (TcPO2) es una herramienta útil en el diagnóstico vascular no invasivo, además de ser una prueba con valor pronóstico de cicatrización de úlceras vasculares antes y después de la revascularización. OBJETIVO: Nuestro estudio tiene como objetivo hallar el valor umbral de TcPO2 más fiable para predecir la cicatrización, así como valorar si el ascenso de la TcPO2 tras una revascularización es un buen predictor de buena evolución tras la misma en pacientes diabéticos isquémicos con úlceras isquémicas. MATERIAL Y MÉTODOS: Realizamos un estudio retrospectivo de la base de datos de la Unidad de Pie Diabético del Hospital Universitario Fundación de Alcorcón, mantenida prospectivamente. Se reclutaron pacientes diabéticos con ulceración y criterios de isquemia crítica, sobre los que se realizó TcPO2 pre y posrevascularización. Se registró el tipo de lesión (clasificación de TEXAS), tipo de revascularización, éxito de cicatrización y tiempo hasta la misma. RESULTADOS: Se encontraron 18 pacientes, el 72% eran varones y el 28% mujeres. La edad media fue de 68 años, el 94,7% eran hipertensos, el 73,7% tenían dislipidemia y el 63,2% presentaban retinopatía. Se realizaron en total 19 revascularizaciones, de las cuales 13 fueron endovasculares, 4 bypass y 2 procedimientos híbridos. El ITB no fue valorable en el 68%. Se obtuvo una tasa de cicatrización del 53% y una mediana de tiempo hasta la misma de 103 días. La media de los valores preoperatorios de TcPO2 en cicatrizados y no cicatrizados fue de 14,6 ± 9,40 y 18,6 ± 12,93 mm Hg respectivamente (p = 0,4404). Los niveles postoperatorios fueron de 40,8 ± 10,85 mm Hg en cicatrizados y de 23,5 ± 13,27 mm Hg en no cicatrizados (p = 0,0063). Mediante el análisis de las curva ROC determinamos que cifras de TcPO2 superiores o iguales a 35 mm Hg eran cifras superiores o indicadores de buen pronóstico para la cicatrización. El incremento de la TcPO2 por encima de 15 mm Hg es un factor de buen pronóstico tras la revascularización en el pie diabético. CONCLUSIONES: La TcPO2 es una herramienta útil para determinar el valor pronóstico en la cicatrización del paciente diabético con isquemia crítica, especialmente en pacientes con presiones parciales no valorables. El valor umbral de buen pronóstico de cicatrización se sitúa, según nuestro estudio, en una cifra ≥ 35 mm Hg. También es factor de buen pronóstico el incremento de la TcPO2 por encima de 15 mm Hg respecto del valor basal tras la revascularización

INTRODUCTION: The measurement of transcutaneous oxygen pressure (TcPO2) is a useful tool in non-invasive vascular diagnosis, as well as being a valuable prognostic test of vascular ulcer healing before and after revascularization. OBJECTIVE: The aim of this study was to determine the most reliable TtPO2 cut-off value for predicting healing, as well as to find out if the increase in the TcPO2 after revascularization can be predictor of a good outcome after this intervention in diabetic patients with ischemic ulcers. MATERIAL AND METHODS: A retrospective study was performed using the prospectively maintained data base of the Diabetic Foot Unit of the Hospital Universitario Fundación de Alcorcón. Diabetic patients with ulceration and critical ischemia criteria were included, particularly those that had TcPO2 performed before and after revascularization, successful wound healing and time to healing. RESULTS: A total of 18 patients were found, of whom 72% were males and 28% females. The mean age was 68 years, with 94.7% hypertension, 73.7% dyslipidemia, and 63.2% retinopathy. A total of 19 revascularizations were performed, of which 13 were endovascular, 4 bypass, and 2 hybrid procedures. The ankle-brachial index was not assessable in 68%. A healing rate of 53% and a median time to healing of 103 days were obtained. The mean preoperative TcPO2 values in healed and non-healed was 14.6 ± 9.40 and 18.6 ± 12.93 mm Hg, respectively (P = .4404). The mean postoperative levels of TcPO2 were 40.8 ± 10.85 mm Hg in healed and 23.5 ± 13.27 mmHg in non-healed (P = .0063). Using ROC curve analysis, it was determined that TcPO2 levels equal to or greater than 35 mmHg were indicators of a good prognosis for wound healing. An increase in the TcPO2 above 15 mm Hg is a factor of a good prognosis after revascularization of diabetic foot. CONCLUSIONS: TcPO2 is a useful tool for determining the prognostic value in wound healing in the diabetic patient with critical ischemia, particularly in patients with non-assessable partial pressures. The cut-off for a good prognosis of wound healing, according to this study, is equal to or greater than 35 mm Hg. An increase in the TcPO2 above 15 mm Hg from the baseline value is also a factor of a good prognosis after revascularization

Dynamic laryngeal narrowing during exercise: a mechanism for generating intrinsic PEEP in COPD?

INTRODUCTION: Patients with COPD commonly exhibit pursed-lip breathing during exercise, a strategy that, by increasing intrinsic positive end-expiratory pressure, may optimise lung mechanics and exercise tolerance. A similar role for laryngeal narrowing in modulating exercise airways resistance and the respiratory cycle volume-time course is postulated, yet remains unstudied in COPD. The aim of this study was to assess the characteristics of laryngeal narrowing and its role in exercise intolerance and dynamic hyperinflation in COPD. METHODS: We studied 19 patients (n=8 mild-moderate; n=11 severe COPD) and healthy age and sex matched controls (n=11). Baseline physiological characteristics and clinical status were assessed prior to an incremental maximal cardiopulmonary exercise test with continuous laryngoscopy. Laryngeal narrowing measures were calculated at the glottic and supra-glottic aperture at rest and peak exercise. RESULTS: At rest, expiratory laryngeal narrowing was pronounced at the glottic level in patients and related to FEV1 in the whole cohort (r=-0.71, p<0.001) and patients alone (r=-0.53, p=0.018). During exercise, glottic narrowing was inversely related to peak ventilation in all subjects (r=-0.55, p=0.0015) and patients (r=-0.71, p<0.001) and peak exercise tidal volume (r=-0.58, p=0.0062 and r=-0.55, p=0.0076, respectively). Exercise glottic narrowing was also inversely related to peak oxygen uptake (% predicted) in all subjects (r=-0.65, p<0.001) and patients considered alone (r=-0.58, p=0.014). Exercise inspiratory duty cycle was related to exercise glottic narrowing for all subjects (r=-0.69, p<0.001) and patients (r=-0.62, p<0.001). CONCLUSIONS: Dynamic laryngeal narrowing during expiration is prevalent in patients with COPD and is related to disease severity, respiratory duty cycle and exercise capacity.

Seminal androgens, oestradiol and progesterone in oligoasthenoteratozoospermic men with varicocele.

This study aimed to assess seminal androgens, oestradiol, progesterone levels in oligoasthenoteratozoospermic (OAT) men with varicocele (Vx). In all, 154 men with matched age and body mass index were investigated that were divided into healthy fertile controls (n = 35), OAT men with Vx (n = 55), OAT men without Vx (n = 64). They were subjected to assessment of semen parameters, seminal levels of testosterone (T), androstenedione (A), 5α-androstane-3 α,17 ß-diol (3 α-diol), oestradiol (E2 ), 17-hydroxyprogesterone (17-OHP) and progesterone (P). Seminal levels of T and A were significantly decreased where seminal levels of 3 α-diol, E2 , 17-OHP, P were significantly higher in OAT men with/without Vx compared with fertile controls. Sperm count, sperm motility and sperm normal forms percentage demonstrated significant positive correlation with seminal T and A and significant negative correlation with seminal 3 α-diol, E2 , P. It is concluded that in fertile men, seminal T and A are significantly increased and seminal 3 α-diol, E2 , 17-OHP, P are significantly decreased compared with infertile OAT men with/without Vx. Association of Vx demonstrated a nonsignificant influence on these hormonal levels in OAT cases. Sperm count, sperm motility and sperm normal forms demonstrated significant positive correlation with seminal T, A and significant negative correlation with seminal 3 α-diol, E2 , P.

Assessment of a sexual coercion prevention program for adolescents.

This study's focus is to evaluate a sexual coercion prevention program in adolescents. Using a before-and-after design with both a treatment group (n = 93) and a control group (n = 76), an intervention of seven sessions was completed. Said sessions included such content as conceptualizing sexual freedom, sexual coercion and voluntary consent, analyzing different sexual coercion tactics and the contexts in which they occur, empathy toward the victim, and developing abilities to avoid risky situations. Other risk factors for coercive behavior and sexual victimization are explored as well, such as alcohol use, sexist attitudes and inadequate communication, among others. The intervention's results include a decrease in stereotypical beliefs about the opposite sex and increased empathy toward victims of sexual coercion. These changes were maintained with the passage of time. Also, in the treatment group, a more acute decline was observed in the proportion of young people engaging in sexually coercive behaviors, This article emphasizes the importance, necessity and efficacy of such interventions, and discusses and analyzes possible improvements to the program for its future implementation.

Control of potato soft rot caused by Pectobacterium carotovorum and Pectobacterium atrosepticum by Moroccan actinobacteria isolates.

Pectobacterium carotovorum and Pectobacterium atrosepticum are dreadful causal agents of potato soft rot. Actually, there are no efficient bactericides used to protect potato against Pectobacterium spp. Biological control using actinobacteria could be an interesting approach to manage this disease. Thus, two hundred actinobacteria isolated from Moroccan habitats were tested for their ability to inhibit in vitro 4 environmental Pectobacterium strains and the two reference strains (P. carotovorum CFBP 5890 and P. atrosepticum CFBP 5889). Eight percent of these isolates were active against at least one of the tested pathogens and only 2% exhibited an antimicrobial activity against all tested Pectobacterium strains. Four bioactive isolates having the greatest pathogen inhibitory capabilities and classified as belonging to the genus Streptomyces species through 16S rDNA analysis were subsequently tested for their ability to reduce in vivo soft rot symptoms on potato slices of Bintje, Yukon Gold, Russet and Norland cultivars caused by the two pathogens P. carotovorum and P. atrosepticum. This test was carried out by using biomass inoculums and culture filtrate of the isolates as treatment. Among these, strain Streptomyces sp. OE7, reduced by 65-94% symptom severity caused by the two pathogens on potato slices. Streptomyces OE7 showed a potential for controlling soft rot on potato slices and could be useful in an integrated control program against potato soft rot pathogens in the objective to reduce treatments with chemical compounds.

Assessment of a sexual coercion prevention program for adolescents

This study’s focus is to evaluate a sexual coercion prevention program in adolescents. Using a beforeand- after design with both a treatment group (n = 93) and a control group (n = 76), an intervention of seven sessions was completed. Said sessions included such content as conceptualizing sexual freedom, sexual coercion and voluntary consent, analyzing different sexual coercion tactics and the contexts in which they occur, empathy toward the victim, and developing abilities to avoid risky situations. Other risk factors for coercive behavior and sexual victimization are explored as well, such as alcohol use, sexist attitudes and inadequate communication, among others. The intervention’s results include a decrease in stereotypical beliefs about the opposite sex and increased empathy toward victims of sexual coercion. These changes were maintained with the passage of time. Also, in the treatment group, a more acute decline was observed in the proportion of young people engaging in sexually coercive behaviors. This article emphasizes the importance, necessity and efficacy of such interventions, and discusses and analyzes possible improvements to the program for its future implementation (AU)

Este estudio se centra en la evaluación de un programa de prevención de la coerción sexual en adolescentes. Basándonos en un diseño antes-después con grupo de tratamiento (n = 93) y un grupo control (n = 76), se llevaron a cabo siete sesiones de intervención que incluían contenidos como la conceptualización de libertad sexual, coerción sexual y consentimiento voluntario, el análisis de las diferentes estrategias de coerción sexual y sus contextos, la empatía hacia la víctima, el desarrollo de habilidades para evitar situaciones de riesgos. Se abordaron también otros factores de riesgo de los comportamientos coercitivos y la victimización sexual como el uso del alcohol, las actitudes sexistas y la comunicación inadecuada, entre otros. Los resultados de la intervención mostraron un descenso en las creencias estereotipadas hacia el otro sexo y un aumento de la empatía hacia las víctimas. Estos cambios se mantuvieron con el paso del tiempo. Asimismo, se observó un descenso más acusado en la proporción de jóvenes que habían llevado a cabo comportamientos sexualmente coercitivos en el grupo de tratamiento. Este trabajo resalta la importancia, necesidad y eficacia de estas intervenciones, y discute y analiza posibles mejoras de este programa para su futura implementación (AU)

Adaptation and validation of the Spanish version of the Leisure Assessment Inventory.

Participation--defined as engagement in life situations, including leisure and recreational activities--is associated with the improvement of people with disabilities' quality of life. Several specific instruments assess leisure, but none of them has been adapted to the Spanish context. The goal of this study is to adapt and validate the Spanish version of the Leisure Assessment Inventory (LAI; B. A. Hawkins, P. Ardovino, N. B. Rogers, A. Foose, & N. Olsen, 2002 ). The adaptation of the original version of the LAI was carried out through translation and backward translation, and the validity of the instrument was analyzed. Descriptive analyses (means and standard deviations) were conducted for each LAI index. Construct validity was assessed through Pearson's product-moment correlation among the diverse LAI indexes, and convergent-discriminant validity through the correlation of the diverse indexes and the measures of quality of life. Results show that the LAI indexes are valid measures of the attributes of leisure behavior (participation, preference, interest, and barriers). This study provides a valid instrument to assess the participation profile of adults with disabilities in leisure activities.

Revisión de las recomendaciones actuales y protocolos de actuación en prevención del pie diabético / No disponible

No disponible

Calcium- and ROS-mediated defence responses in BY2 tobacco cells by nonpathogenic Streptomyces sp.

AIMS: The early molecular events underlying the elicitation of plant defence reactions by Gram-positive bacteria are relatively unknown. In plants, calcium and reactive oxygen species are commonly involved as cellular messengers of a wide range of biotic stimuli from pathogenic to symbiotic bacteria. In the present work, we checked whether nonpathogenic Streptomyces sp. strains could induce early signalling events leading to defence responses in BY2 tobacco cell suspensions. METHODS AND RESULTS: We have demonstrated that nonpathogenic Streptomyces sp. OE7 strain induced a cytosolic Ca(2+) increase and a biphasic oxidative burst in the upstream signalling events, leading to defence responses in BY2 tobacco cell suspensions. Streptomyces sp. OE7 also elicited delayed intracellular free scopoletin production and programmed cell death. In agreement with scopoletin production, OE7 induced accumulation of PAL transcripts and increased accumulation of transcripts of EREBP1 and AOX genes that are known to be regulated by the jasmonate/ethylene pathway. Transcript levels of PR1b and NIMIN2α, both salicylic acid pathway-linked genes, were not modified. Moreover, Streptomyces sp. OE7 culture filtrates could reduce Pectobacterium carotovorum- and Pectobacterium atrosepticum-induced death of BY2 cells and soft rot on potato slices. CONCLUSIONS: New insights are thus provided into the interaction mechanisms between Streptomyces sp. and plants; Streptomyces sp. could be sensed by plant cells, and through cytosolic Ca(2+) changes and the generation of reactive oxygen species, defence responses were induced. SIGNIFICANCE AND IMPACT OF THE STUDY: These induced defence responses appeared to participate in attenuating Pectobacterium-induced diseases in plants. Thus, Streptomyces sp. OE7 could be a biocontrol agent against Pectobacterium sp.

Parenchymal trafficking of pleural mesothelial cells in idiopathic pulmonary fibrosis.

Idiopathic pulmonary fibrosis (IPF) is characterised by myofibroblast proliferation leading to architectural destruction. Neither the origin nor the continued proliferation of myofibroblasts is well understood. Explanted human IPF lungs were stained by immunohistochemistry for calretinin, a marker of pleural mesothelial cells (PMCs). Chronic obstructive pulmonary disease (COPD) and cystic fibrosis (CF) lungs acted as controls. The number of PMCs per 100 nucleated cells and per photomicrograph was estimated along with the Ashcroft score of fibrosis. Mouse PMCs expressing green fluorescent protein (GFP) or labelled with nanoparticles were injected into the pleural space of mice given intranasal transforming growth factor (TGF)-ß1. Mouse lungs were lavaged and examined for the presence of GFP, smooth muscle α-actin (α-SMA) and calretinin. Calretinin-positive PMCs were found throughout IPF lungs, but not in COPD or CF lungs. The number of PMCs correlated with the Ashcroft score. In mice, nanoparticle-laden PMCs were recoverable by bronchoalveolar lavage, depending on the TGF-ß1 dose. Fluorescent staining showed α-SMA expression in GFP-expressing PMCs, with co-localisation of GFP and α-SMA. PMCs can traffic through the lung and show myofibroblast phenotypic markers. PMCs are present in IPF lungs, and their number correlates with IPF severity. Since IPF presumably begins subpleurally, PMCs could play a pathogenetic role via mesothelial-mesenchymal transition.

Estudio de prevalencia de la enfermedad arterial periférica y diabetes en España / A study of the prevalence of peripheral arterial disease and diabetes in Spain

Objetivo. Evaluar la prevalencia de la enfermedad arterial periférica (EAP) en pacientes diabéticos y la prevalenciade diabetes en pacientes con enfermedad arterial periférica en España mediante un estudio observacional y decorte transversal. Pacientes y métodos. Medición del índice tobillo-brazo en pacientes diabéticos que acuden a consultasde endocrinología y medición de la glucosa en pacientes que acuden a consultas de cirugía vascular. Los criterios de inclusiónhan sido pacientes de cualquier edad y género que hayan firmado el consentimiento. Se han incluido 2.293 pacientes,477 (20,8%) en consultas de endocrinología y 1.816 (79,2%) en consultas de cirugía vascular. Edad media de 59años en consultas de endocrinología y 68 años en consultas de cirugía vascular. El 53,2 y el 81,5% de varones en consultasde endocrinología y cirugía vascular, respectivamente. El 11,8 y el 15,8% presentaban antecedentes cerebrovasculares,el 19,5 y el 27,9% antecedentes de coronariopatía y el 25,0 y 97,8%, antecedentes de enfermedad arterial periféricaconocida en consultas de endocrinología y cirugía vascular, respectivamente. Resultados. La prevalencia de EAP en consultasde endocrinología fue del 37,3%, el 34,6% leve-moderada y 2,6%, grave. La prevalencia de EAP se incrementabacon la edad, en hombres, presencia de síndrome metabólico y años de evolución de la diabetes. La prevalencia de diabetesen consultas de cirugía vascular fue el 67,6%. La prevalencia de diabetes aumentaba con el índice de masa corporal,en mujeres, y con la presencia del síndrome metabólico. Conclusión. Este estudio confirma la alta prevalencia de EAP ydiabetes en España y marca tendencias para una optimización terapéutica

Aim. To evaluate the prevalence of peripheral arterial disease (PAD) in diabetic patients and the prevalenceof diabetes in patients with PAD in Spain by means of an observation-based cross-sectional study. Patients and methods.The method chosen for this analysis was to measure the ankle-brachial index in diabetic patients who visited endocrinologydepartments and also the measurement of glucose levels in patients who visited vascular surgery. Eligibility criteriawere patients of any age and gender who signed the consent documents. In all, 2293 patients were included, 477(20.8%) in visits to the endocrinology department and 1816 (79.2%) in visits to vascular surgery. The mean age ofpatients was 59 years old in endocrinology and 68 years old in visits to vascular surgery. Males accounted for 53.2%and 81.5% of the visits to endocrinology and vascular surgery, respectively. A history of cerebrovascular events waspresent in 11.8 and 15.8%, 19.5 and 27.9% had a history of heart disease and 25.0 and 97.8% had a history of knownperipheral arterial disease, in endocrinology and vascular surgery, respectively. Results. The prevalence of PAD amongthose who visited endocrinology was 37.3%, 34.6% of which were mild-moderate and 2.6% were severe. The prevalenceof PAD increased with age, in males, in the presence of metabolic syndrome and with the number of years since the onsetof diabetes. The prevalence of diabetes in vascular surgery patients was 67.6%. The prevalence of diabetes increasedwith body mass index, in females, and in the presence of metabolic syndrome. Conclusions. This study confirms the highprevalence of PAD and diabetes in Spain and establishes guidelines to be followed for the optimisation of therapy

Seguimiento de la cirugía endovascular en la patología isquémica de los miembros inferiores / No disponible

No disponible

Monitorización intraoperatoria y perioperatoria con eco-Doppler. Sector carotídeo / Intraoperative and perioperative monitoring with Doppler ultrasound. The carotid segment

Los defectos técnicos de la cirugía carotídea pueden causar estenosis, embolización, acodamientos y trombosis y, por tanto, aumentar la tasa de complicaciones neurológicas. Por ello, la realización de una endarterectomía técnicamente perfecta debe ser el objetivo prioritario durante el procedimiento. El control intraoperatorio con eco-Doppler permite diagnosticar defectos importantes que podrían resultar en estenosis y oclusión carotídea en ausencia de señales externas que hagan sospechar su existencia y, por tanto, resulta imprecindible para conocer posibles déficit técnicos y corregirlos. Además, con una precisa evaluación intraoperatoria y un correcto seguimiento, podemos conocer la historia natural de la reestenosis y los factores relacionados con su aparición. En este artículo describimos las características del eco-Doppler y la metodología del control intraoperatorio de la endarterectomía carotídea, los tipos de defectos que detecta y su importancia e innovadoras aplicaciones en el tratamiento endovascular de la estenosis carotídea

Technical shortcomings in carotid surgery can cause stenosis, embolisation, kinks and thrombosis and, hence, give rise to an increased rate of neurological complications. The prime objective throughout the procedure should therefore be that of performing a technically perfect endarterectomy. Intraoperative control with Doppler ultrasound recording makes it possible to diagnose important defects that could lead to stenosis or carotid occlusion in the absence of external signals that cause the clinician to suspect their existence. It is thereforeessential in order to detect possible technical deficiencies and to correct them. Furthermore, a precise intraoperative assessment and correct follow-up provide us with knowledge about the natural history of the restenosis and the factors related to its appearance. In this paper we describe the characteristics of Doppler ultrasound and the methodology used for intraoperative control of carotid endarterectomies, the types of defects that can be detected and its importance and innovative applications in the endovascular treatment of carotid stenosis