Pain extent is associated with Central Sensitization Inventory but not widespread pressure pain sensitivity or psychological variables in women with fibromyalgia.

OBJECTIVE: To investigate the relationship between pain extent, as a clinical sign of central sensitization, and clinical, psychological, and pressure sensitivity in women with fibromyalgia syndrome (FMS). METHOD: In this study, 126 females with FMS completed demographic (age, gender, body mass index, height, weight), clinical (pain history, and pain intensity at rest and during daily living activities), psychological (depression and anxiety levels), and neurophysiological [pressure pain threshold (PPT)] assessments. The Central Sensitization Inventory (CSI) was also used to collect self-reported symptoms of sensitization. Pain extent and frequency maps were obtained from pain drawings using customized software. After conducting a multivariable correlation analysis to determine the relationships between variables, a stepwise linear regression model analysis was performed to identify variables associated with pain extent. RESULTS: Pain extent was positively associated with age (r = 0.17), years with pain (r = 0.27), pain during daily life activities (r = 0.27), and CSI (r = 0.42) (all p < 0.05). The stepwise regression analysis revealed that 27.8% of the pain extent was explained by CSI, age, and years with pain. CONCLUSIONS: This study found that larger pain extent was associated with self-reported outcomes, i.e. CSI, but not neurophysiological outcomes, i.e. PPTs, of sensitization in women with FMS. Older age and a longer history with pain symptoms were also associated with larger pain extent.

Development of Novel Management Tools for Phortica variegata (Diptera: Drosophilidae), Vector of the Oriental Eyeworm, Thelazia callipaeda (Spirurida: Thelaziidae), in Europe.

Lachryphagous males of Phortica variegata (Fallén, 1823) are gaining increasing attention in Europe, as they act as vectors of the nematode Thelazia callipaeda Railliet & Henry, 1910, causal agent of thelaziosis, an emergent zoonotic disease. Currently, there are no effective control strategies against the vector, and surveillance and monitoring rely on time-consuming and nonselective sampling methods. Our aim was to improve the knowledge about the population dynamics and the chemical ecology of the species. A total of 5,726 P. variegata flies (96.4% males and 3.6% females, mostly gravid) were collected in field experiments during June-September of 2020 in an oak forest in northern Spain. Our results indicate that 1) by means of sweep netting a significantly higher number of captures were found both around the collector´s body and in the air than at ground level; 2) a positive relationship was detected between the abundance of Phortica flies and temperature, with two significant peaks of abundance at 24 and 33°C; 3) the blend of red wine and cider vinegar was the most attractive bait; 4) yellow traps captured fewer flies compared to black and transparent traps; and 5) a significant reduction toward vinegar and wine was detected in presence of the phenolic monoterpenoid carvacrol. In addition, all the males (n = 690) analyzed by both molecular detection and dissection resulted negative for the presence of T. callipaeda larvae. Overall, these findings provide a better understanding of the vector in terms of monitoring and management strategies.

Efectos del vendaje neuromuscular en el error de posicionamiento articular cervical: Un estudio piloto / Effects of neuromuscular taping on the cervical joint position sense error: A pilot study

Objetivos El objetivo principal de este estudio piloto es comparar los cambios en el error de posicionamiento articular cervical (EPAC) entre tres grupos de intervención. El objetivo secundario es analizar las diferencias de las intervenciones sobre el EPAC en presencia o ausencia de dolor cervical crónico. Material y métodos Se incluyó en el estudio una muestra de 15 participantes sin dolor cervical y una muestra de 15 personas con dolor cervical crónico. Cada una de las muestras fue asignada de manera aleatoria a uno de los tres grupos de intervención: un grupo experimental (aplicación de vendaje neuromuscular con tensión del 25%), un grupo placebo (aplicación de vendaje neuromuscular sin tensión) y un grupo control (sin aplicación de vendaje neuromuscular). Se realizó un análisis estadístico para examinar las diferencias dentro de los grupos, entre los grupos y entre muestras. Resultados No se encontraron diferencias estadísticamente significativas (p > 0,05) tras las intervenciones dentro de ningún grupo en ninguna de las dos muestras. No se observaron diferencias estadísticamente significativas entre grupos dentro de la misma muestra (p > 0,05) ni entre muestras (p > 0,05). Conclusiones Los resultados del presente estudio piloto sugieren que la aplicación de vendaje neuromuscular con o sin tensión no inducen cambios diferentes a la ausencia de su aplicación en sujetos sanos ni en aquellos con dolor cervical. Futuros estudios son necesarios para objetivar la ausencia de cambios clínicos, utilizando una mayor muestra y mayor número de intervenciones y mediciones en el tiempo (AU)

Objectives The main aim of this pilot study is to compare changes in Joint Position Sense Error (JPSE) between three intervention groups. The secondary aim is to analyse the differences of the interventions on JPSE in the presence and absence of pain. Material and methods A sample with fifteen healthy subjects and another sample with fifteen patients with chronic neck pain were included in this study. Each sample was randomly assigned to one of the intervention groups: an experimental group (25% neuromuscular taping with tension), a placebo group (neuromuscular taping with no tension), and a control group (with no neuromuscular taping). Statistical analyses were performed to assess the effects within groups, between groups and between samples. Result No statistically significant differences (p > 0.05) were found after interventions in either group, neither the healthy sample nor the patient sample. No statistically significant differences were found between groups within the same sample (p > 0.05), or between samples (p > 0.05). Conclusions The results from the present pilot study suggest that the application of neuromuscular taping with or without tension does not induce JPSE changes compared to not applying it in healthy patients or those with neck pain. Further research is needed to determine the absence of clinical effect, with a larger sample, a greater number of interventions and measurements over time (AU)

Eficacia de la Terapia de la Conciencia Corporal Basal (TCCB o BBAT) en pacientes con trastorno mental: una revisión sistemática / Efficacy of Basic Body Awareness Therapy (BBAT) in patients with mental disorders: A systematic review

Objetivo Realizar una revisión sistemática sobre la aplicación de la Terapia de la Conciencia Corporal Basal (TCCB o BBAT) así como la calidad metodológica de la investigación realizada en pacientes con trastornos mentales. Métodos Se realizó una búsqueda sistemática en las bases de datos PubMed, ScienceDirect, Cochrane, Web of Science y Scopus publicados en los últimos 10 años. La calidad de los ensayos clínicos se evaluó mediante la escala PEDro. Resultados Entre los artículos revisados, 13 cumplieron los criterios de elegibilidad, de los cuales 11 fueron incluidos en el estudio tras su lectura completa. De los tres ensayos clínicos incluidos en la revisión, dos obtuvieron 7 puntos en la escala PEDro de calidad metodológica y uno obtuvo 5. Se analizó la eficacia de la terapia TCCB como terapia complementaria individual y/o grupal a otras intervenciones en pacientes con trastornos alimentarios, enfermedad cerebrovascular, depresión, esquizofrenia y trastorno de estrés postraumático evaluando variables resultado específica para cada patología. Conclusión La TCCB parece ser una opción prometedora como tratamiento complementario en pacientes con trastornos mentales. Sin embargo, no puede determinarse su eficacia clínica por carencia de estudios experimentales con nivel de evidencia alto y por lo tanto, son necesarios más estudios con tamaños muestrales mayores y metodológicamente correctos (AU)

Objective To perform a systematic review of published articles about the Basic Body Awareness Therapy (BBAT) and its methodological quality in populations with mental disorders. Methods A systematic review was carried out in the databases PubMed, ScienceDirect, Cochrane, Web of Science and Scopus including studies published less than 10 years ago. The methodological quality of the controlled clinical trials was assessed using the PEDro scale. Results Thirteen articles met the eligibility criteria, of which eleven were included in the study after full reading. From the three controlled clinical trials included in this revision, two obtained a score of 7 points on the PEDro scale for methodological quality and one obtained a score of 5. We assessed the efficacy of the BBAT as individual and/or group complementary therapy in patients with food intake disorders, stroke, depression, schizophrenia and post-traumatic stress disorder evaluating specific outcomes for each disease. Conclusion The BBAT method is suggested as a promising complementary treatment option for patients with mental disorders. However, its clinical efficacy cannot be determined due to the lack of high-evidence level experimental studies, therefore further methodologically correct research is needed with larger sample sizes (AU)

Barreras y facilitadores para la implementación de la toma de decisiones compartidas en oncología: percepciones de los pacientes / Barriers and facilitators to implementing shared decision-making in oncology: patient perceptions

Objetivo. Conocer, desde el punto de vista del paciente oncológico, quién tomó la decisión sobre su tratamiento, así como las principales barreras y facilitadores que permiten la implementación de la toma de decisiones compartidas (TDC). Material y métodos. Estudio transversal y de asociación a partir de un cuestionario autoadministrado a pacientes oncológicos seleccionados mediante muestreo casual en diferentes consultas oncológicas y periodos aleatorios. Ciento ocho pacientes proporcionaron datos analizables. La información recogida fue sobre variables sociodemográficas y clínicas, sobre quién tomó la decisión sobre el tratamiento y el grado de acuerdo o desacuerdo con diferentes barreras y facilitadores. Resultados. El 38,1% de los pacientes afirmó haber tomado la decisión de manera compartida con su médico. Barreras como el tiempo, la dificultad de comprensión, el paternalismo, la falta de comunicación fluida y el disponer de información previa y frecuentemente errónea influyeron en la implicación en la toma de decisiones. Sin embargo, disponer o no de instrumentos suficientes de ayuda a la decisión o el interés del paciente por participar no influyeron. En lo referente a los facilitadores, la motivación del médico, su percepción de mejora y el interés del enfermo tuvieron una influencia positiva. La excepción la constituyó la posibilidad de incentivar económicamente a los médicos. Conclusiones. La nula o escasa participación percibida por los pacientes oncológicos en las decisiones sobre su salud hace necesario introducir mejoras en el modelo de atención sanitaria que permitan superar barreras y promover una actitud más participativa en el paciente (AU)

Objective. To determine, from the point of view of the oncological patient, who made the decision about their treatment, as well as the major barriers and facilitators that enabled Shared Decision Making to be implemented. Material and methods. A cross-sectional, descriptive, sand association study using a self-report questionnaire to selected cancer patients, with casual sampling in different oncology clinics and random time periods. A total of 108 patients provided analysable data. The information was collected on sociodemographic and clinical variables, who made the decision about treatment, and level of agreement or disagreement with various barriers and facilitators. Results. More than one-third (38.1%) of patients claimed to have participated in shared decision making with their doctor. Barriers such as, time, the difficulty of understanding, the paternalism, lack of fluid communication, and having preliminary and often erroneous information influenced the involvement in decision-making. However, to have or not have sufficient tools to aid decision making or the patient's interest to participate had no effect. As regards facilitators, physician motivation, their perception of improvement, and the interest of the patient had a positive influence. The exception was the possibility of financial incentives to doctors. Conclusions. The little, or no participation perceived by cancer patients in decisions about their health makes it necessary to introduce improvements in the health care model to overcome barriers and promote a more participatory attitude in the patient (AU)

[Shared decision making from the perspective of the cancer patient: participatory roles and evaluation of the process]. / La toma de decisiones compartidas desde la perspectiva del paciente oncológico: roles de participación y valoración del proceso.

BACKGROUND: In Spain there is no clear knowledge about the degree to which Shared Decision Making (SDM) is carried out in the normal practice of oncology. Our article analyses the preferred role and the perceived role of oncological patients and measures the SDM process from their perspective. MATERIAL AND METHODS: Descriptive transversal study using a self-conducted questionnaire with patients with different types of cancer. To evaluate the role preferred and perceived by the patient we used The Control Preference Scales (CPS) and to measure SDM we used The nine-item Shared Decision Making Questionnaire (SDM-Q-9). RESULTS: Out of the 132 patients surveyed, only 118 provided analysable data. No evidence was found that sex, age, educational level or type of tumour affected the preferred role or the perceived role. Only 59.3% was in agreement with the role exercised. All of those who preferred a passive role achieved this (21.2%), while out of those who wanted a shared role (78.8%), this was achieved by only 48.39% while the remaining 51.61% played a passive role. None preferred or played an active role. The set of patients evaluated the SDM process with a score of 41.07±5.94, on a scale of 0 to 100, with the highest score of 61.39 ± 13.24 reached by urological patients. CONCLUSIONS: Our study found no evidence that, from the point of view of the oncological patient, the SDM model is being implemented in practice.

La toma de decisiones compartidas desde la perspectiva del paciente oncológico: roles de participación y valoración del proceso / Shared decision making from the perspective of the cancer patient: participatory roles and evaluation of the process

Fundamento: En España no existe un claro conocimiento sobre el grado en que la Toma de Decisiones Compartidas (TDC) es llevada a la práctica habitual en oncología. Nuestro trabajo analiza el rol preferido y el rol percibido de los pacientes oncológicos y mide el proceso de TDC desde su perspectiva. Material y métodos: Estudio descriptivo transversal mediante cuestionario autoadministrado a pacientes con distintos tipos de cáncer. Para evaluar el rol preferido y percibido por el paciente utilizamos The Control Preference Scales (CPS) y para medir la TDC se utilizó The nine-item Shared Decision Making Questionnaire (SDM-Q-9). Resultados: De los 132 pacientes encuestados, solo 118 proporcionaron datos analizables. No se encontraron evidencias de que el sexo, edad, nivel educativo o tipo de tumor afectaran al rol preferido o al percibido. Solo el 59,3% estaba de acuerdo con el rol ejercido. Todos los que preferían un rol pasivo lo alcanzaban (21,2%), mientras que de los que deseaban uno compartido (78,8%), solo el 48,39% lo lograba y el 51,61% restante desempeñaba uno pasivo. Ninguno prefirió ni ejerció un rol activo. El conjunto de pacientes valoró el proceso de TDC con una puntuación de 41,07±5,94, en una escala de 0 a 100, alcanzando los pacientes urológicos una puntuación máxima de 61,39 ± 13,24. Conclusiones: Nuestro estudio no encuentra evidencias de que, desde el punto de vista del paciente oncológico, el modelo de TDC esté implementado en la práctica (AU)

Background: In Spain there is no clear knowledge about the degree to which Shared Decision Making (SDM) is carried out in the normal practice of oncology. Our article analyses the preferred role and the perceived role of oncological patients and measures the SDM process from their perspective. Material and methods: Descriptive transversal study using a self-conducted questionnaire with patients with different types of cancer. To evaluate the role preferred and perceived by the patient we used The Control Preference Scales (CPS) and to measure SDM we used The nine-item Shared Decision Making Questionnaire (SDM-Q-9). Results: Out of the 132 patients surveyed, only 118 provided analysable data. No evidence was found that sex, age, educational level or type of tumour affected the preferred role or the perceived role. Only 59.3% was in agreement with the role exercised. All of those who preferred a passive role achieved this (21.2%), while out of those who wanted a shared role (78.8%), this was achieved by only 48.39% while the remaining 51.61% played a passive role. None preferred or played an active role. The set of patients evaluated the SDM process with a score of 41.07±5.94, on a scale of 0 to 100, with the highest score of 61.39 ± 13.24 reached by urological patients. Conclusions: Our study found no evidence that, from the point of view of the oncological patient, the SDM model is being implemented in practice (AU)

[Barriers and facilitators to implementing shared decision-making in oncology: Patient perceptions]. / Barreras y facilitadores para la implementación de la toma de decisiones compartidas en oncología: percepciones de los pacientes.

OBJECTIVE: To determine, from the point of view of the oncological patient, who made the decision about their treatment, as well as the major barriers and facilitators that enabled Shared Decision Making to be implemented. MATERIAL AND METHODS: A cross-sectional, descriptive, sand association study using a self-report questionnaire to selected cancer patients, with casual sampling in different oncology clinics and random time periods. A total of 108 patients provided analysable data. The information was collected on sociodemographic and clinical variables, who made the decision about treatment, and level of agreement or disagreement with various barriers and facilitators. RESULTS: More than one-third (38.1%) of patients claimed to have participated in shared decision making with their doctor. Barriers such as, time, the difficulty of understanding, the paternalism, lack of fluid communication, and having preliminary and often erroneous information influenced the involvement in decision-making. However, to have or not have sufficient tools to aid decision making or the patient's interest to participate had no effect. As regards facilitators, physician motivation, their perception of improvement, and the interest of the patient had a positive influence. The exception was the possibility of financial incentives to doctors. CONCLUSIONS: The little, or no participation perceived by cancer patients in decisions about their health makes it necessary to introduce improvements in the health care model to overcome barriers and promote a more participatory attitude in the patient.

Clinical significance and outcome of Aeromonas spp. infections among 204 adult patients.

The objectives of this investigation were to analyze the clinical patterns, risk groups, prognostic factors, and mortality of infections caused by Aeromonas spp. This was a retrospective study of adult patients with Aeromonas spp. isolates attended at the Hospital del Mar in Barcelona, Spain, between January 2006 and December 2012. Epidemiological data, antimicrobial susceptibility, clinical patterns, underlying illnesses, type of infection, admission to the intensive care unit (ICU), number of episodes, coinfection, antimicrobial therapy, and evolution were analyzed. A total of 221 clinical samples from 204 patients were positive for Aeromonas spp. The mean age of the patients was 67.6 years. The main clinical form of presentation was gastrointestinal (78.4%). Malignancy was the main risk group in 69 (33.8%) patients, and 48 (23.5%) were previously healthy. Twenty-one patients (10.3%) were admitted to the ICU. Infections were acquired in the hospital in 52.5% of the patients, and 28.9% were polymicrobial. The overall mortality (after 1 year of follow-up from the first positive culture) was 26.5%. Univariate analysis identified an association between increased mortality and the following variables: age ≥80 years, hospitalization, admission to the ICU, malignancy, extraintestinal infection, and appropriate antimicrobial therapy. In the multivariate analysis, age ≥80 years [odds ratio (OR), 4.37 [95% confidence interval (CI), 1.68-11.35; p = 0.002]], admission to the ICU (OR, 6.59 [95% CI, 2.17-19.99; p = 0.001]), and malignancy (OR, 3.62 [95% CI, 1.32-9.90; p = 0.012]) were significantly associated with mortality. Aeromonas infections are mainly gastrointestinal. The 1-year follow-up mortality rate was high. Old age (age ≥80 years), admission to the ICU, and malignancy were identified as independent risk factors for mortality.

Apps for Radiation Oncology. A Comprehensive Review.

INTRODUCTION: Software applications executed on a smart-phone or mobile device ("Apps") are increasingly used by oncologists in their daily work. A comprehensive critical review was conducted on Apps specifically designed for Radiation Oncology, which aims to provide scientific support for these tools and to guide users in choosing the most suited to their needs. MATERIAL AND METHODS: A systematic search was conducted in mobile platforms, iOS and Android, returning 157 Apps. Excluding those whose purpose did not match the scope of the study, 31 Apps were methodically analyzed by the following items: Objective Features, List of Functionalities, Consistency in Outcomes and Usability. RESULTS: Apps are presented in groups of features, as Dose Calculators (7 Apps), Clinical Calculators (4), Tools for Staging (7), Multipurpose (7) and Others (6). Each App is presented with the list of attributes and a brief comment. A short summary is provided at the end of each group. DISCUSSION AND RECOMMENDATIONS: There are numerous Apps with useful tools at the disposal of radiation oncologists. The most advisable Apps do not match the more expensive. Three all-in-one apps seem advisable above all: RadOnc Reference (in English), Easy Oncology (in German) and iOncoR (in Spanish). Others recommendations are suggested for specific tasks: dose calculators, treatment-decision and staging.

Mechanical properties and in vitro biological response to porous titanium alloys prepared for use in intervertebral implants.

The generation of titanium foams is a promising strategy for modifying the mechanical properties of intervertebral reinforcements. Thus, the aim of this study was to compare the in vitro biological response of Ti6Al4V alloys with different pore sizes for use in intervertebral implants in terms of the adhesion, proliferation, and differentiation of pre-osteoblastic cells. We studied the production of Ti6Al4V foams by powder metallurgy and the biological responses to Ti6Al4V foams were assessed in terms of different pore interconnectivities and elastic moduli. The Ti6Al4V foams obtained had similar porosities of approximately 34%, but different pore sizes (66 µm for fine Ti6Al4V and 147 µm for coarse Ti6Al4V) due to the sizes of the microsphere used. The Ti6Al4V foams had a slightly higher Young׳s modulus compared with cancellous bone. The dynamic mechanical properties of the Ti6Al4V foams were slightly low, but these materials can satisfy the requirements for intervertebral prosthesis applications. The cultured cells colonized both sizes of microspheres near the pore spaces, where they occupied almost the entire area of the microspheres when the final cell culture time was reached. No statistical differences in cell proliferation were observed; however, the cells filled the pores on fine Ti6Al4V foams but they only colonized the superficial microspheres, whereas the cells did not fill the pores on coarse Ti6Al4V foams but they were distributed throughout most of the material. In addition, the microspheres with wide pores (coarse Ti6Al4V) stimulated higher osteoblast differentiation, as demonstrated by the Alcaline Phosphatase (ALP) activity. Our in vitro results suggest that foams with wide pore facilitate internal cell colonization and stimulate osteoblast differentiation.

Application of the Zero-Order Reaction Rate Model and Transition State Theory to predict porous Ti6Al4V bending strength.

Porous Ti6Al4V samples were produced by microsphere sintering. The Zero-Order Reaction Rate Model and Transition State Theory were used to model the sintering process and to estimate the bending strength of the porous samples developed. The evolution of the surface area during the sintering process was used to obtain sintering parameters (sintering constant, activation energy, frequency factor, constant of activation and Gibbs energy of activation). These were then correlated with the bending strength in order to obtain a simple model with which to estimate the evolution of the bending strength of the samples when the sintering temperature and time are modified: σY=P+B·[lnT·t-ΔGa/R·T]. Although the sintering parameters were obtained only for the microsphere sizes analysed here, the strength of intermediate sizes could easily be estimated following this model.

Initialization of adjuvant hormonal treatment for breast cancer.

The introduction of aromatase inhibitors (AI) has resulted in practice change approaches in the treatment of early breast cancer. In this paper, we analyze the most relevant studies including the ATAC, BIG 1-98, TEAM, MA-17, NSABP B-33, and ABSCG-6 studies. Postmenopausal patients with hormone receptor-positive early breast cancer should be treated with AI for 5 years. For patients who have been initiated with tamoxifen (TAM), switching to an AI to complete 5 years of treatment is also recommended. The results of the extended adjuvant therapy studies recommend the use of an AI (anastrozole, letrozole, or exemestane) after the completion of standard TAM treatment. With regards to premenopausal women, TAM is the recommended adjuvant hormonal treatment for pre- and perimenopausal women. There is no indication for the use of AI in these subgroups of patients. Finally, determination of CYP 2D6 polymorphisms could be considered when choosing the best adjuvant hormonal treatment option.

[Effect of an oral hyperproteic nutritional supplement in malnourished elderly patients in nursing homes]. / Efecto de un suplemento nutricional oral hiperproteico en pacientes desnutridos ubicados en residencias geriátricas.

INTRODUCTION: Nutritional problems develop complications in geriatric patients and increase their morbidity and mortality. Hyperproteic nutritional supplements are one of the options to improve nutritional deficiencies. OBJECTIVES: To assess the beneficial effect and tolerance of one hyperproteic nutritional supplement (Ensure Plus High Protein, Abbott Laboratories, S.A.) in malnourished subjects over 65 years. METHODS: Observational, prospective, open, multicenter study. We included malnourished subjects over 65 years living in nursing homes located in Spain. Malnutrition was considered as GNRI score < 92 or BMI < 19. Before inclusion, we obtained signed informed consent of patients or their relatives. All participants received Ensure Plus High Protein for 8 weeks. The primary endpoints were changes observed in weight, BMI and GNRI. RESULTS: We analyzed 255 evaluable patients valid for intention-to-treat (ITT) analysis and 243 for the per-protocol (PP) analysis; 69% (n = 172) were female and 31% (n = 77) male. The average protein amount administered was 51 g/day. At the end of the study, statistically significant differences (p < 0.001) were found in weight, BMI and GNRI when compared to baseline, both in the ITT and the PP analysis. The average weight increase was (mean +/- SE) 2.86 +/- 0.13 kg for PP analysis; 80% of participants (n = 202) achieved a weight gain > 1 kg and 96 patients (39.5% PP analysis) had a weight gain > 7%. CONCLUSIONS: The addition of a hyperproteic oral nutritional supplement contributes positively in improving the nutritional status of our study malnourished geriatric patients in terms of significant increase in body weight, BMI and GNRI.

Efecto de un suplemento nutricional oral hiperproteico en pacientes desnutridos ubicados en residencias geriátricas / Effect of an oral hyperproteic nutritional supplement in malnourished elderly patients in nursing homes

Introducción: Los problemas nutricionales complican la evolución de los pacientes geriátricos y aumentan su morbilidad y mortalidad. Los suplementos nutricionales hiperproteicos constituyen una de las maneras de mejorar la ingesta nutricional. Objetivos: Determinar el efecto beneficioso y la tolerancia de un suplemento nutricional hiperprotéico (Ensure Plus High Protein®, Abbott Laboratories, S.A.) en sujetos mayores de 65 años diagnosticados de desnutrición. Métodos: Estudio observacional, prospectivo, abierto y multicéntrico. Se incluyeron sujetos > 65 años diagnosticados de desnutrición, ubicados en 59 residencias geriátricas en España. Se consideró desnutrición una puntuación GNRI < 92 ó IMC < 19. Antes de la inclusión, se obtuvo el consentimiento informado firmado de los pacientes o sus familiares. Todos los participantes tomaron Ensure Plus High Protein® durante 8 semanas. Las variables principales de valoración fueron peso, IMC y GNRI. Resultados: Se analizaron 255 pacientes válidos para el análisis ITT y 243 para el análisis PP, 69% (n = 172) mujeres y 31% (n = 77) hombres. La cantidad de proteína media administrada fue 51 gr./día. Al final del estudio, los tres parámetros principales -peso, IMC y GNRI- presentaron diferencias estadísticamente significativas (p < 0,001) con respecto a la visita basal, tanto en el análisis ITT como en el análisis por protocolo. El incremento de peso medio fue de (media ± EE) 2,86 ± 0,13 kg para el análisis PP. El 80% de los participantes (n = 202) consiguió un incremento de peso > 1 kg y 96 pacientes (39,5% análisis PP) obtuvieron una ganancia ponderal > 7%. Conclusiones: La adición de un suplemento nutricional oral hiperproteico contribuye favorablemente en la mejoría del estado nutricional de los pacientes geriátricos malnutridos en estudio en términos de incremento significativo del peso corporal, IMC y GNRI (AU)

Introduction: Nutritional problems develop complications in geriatric patients and increase their morbidity and mortality. Hyperproteic nutritional supplements are one of the options to improve nutritional deficiencies. Objectives: To assess the beneficial effect and tolerance of one hyperproteic nutritional supplement (Ensure Plus High Protein®, Abbott Laboratories, S.A.) in malnourished subjects over 65 years. Methods: Observational, prospective, open, multicenter study. We included malnourished subjects over 65 years living in nursing homes located in Spain. Malnutrition was considered as GNRI score < 92 or BMI < 19. Before inclusion, we obtained signed informed consent of patients or their relatives. All participants received Ensure Plus High Protein® for 8 weeks. The primary endpoints were changes observed in weight, BMI and GNRI. Results: We analyzed 255 evaluable patients valid for intention-to-treat (ITT) analysis and 243 for the per-protocol (PP) analysis; 69% (n = 172) were female and 31% (n = 77) male. The average protein amount administered was 51 g/day. At the end of the study, statistically significant differences (p < 0.001) were found in weight, BMI and GNRI when compared to baseline, both in the ITT and the PP analysis. The average weight increase was (mean ± SE) 2.86 ± 0.13 kg for PP analysis; 80% of participants (n = 202) achieved a weight gain > 1 kg and 96 patients (39.5% PP analysis) had a weight gain > 7%. Conclusions: The addition of a hyperproteic oral nutritional supplement contributes positively in improving the nutritional status of our study malnourished geriatric patients in terms of significant increase in body weight, BMI and GNRI (AU)

Effects of hydroxypropyl-beta-cyclodextrin on the chemical stability and the aqueous solubility of thalidomide enantiomers.

The aim of this work was to study the effect of hydroxypropyl-beta-cyclodextrin on the solubility and stability of thalidomide enantiomers in aqueous solutions for clinical oral administration to be used in HIV-infected children. For this reason racemic thalidomide was added to solutions containing different concentrations of hydroxypropyl-beta-cyclodextrin. True complexes were obtained by using hydroxypropyl-beta-cyclodextrin and the solubility of both thalidomide enantiomers was increased directly depending on the amount of hydroxylpropyl-beta-cyclodextrin in the medium although no enantioselective differences were observed at 37 degrees C. The chemical stability of thalidomide enantiomers is clearly improved by hydroxypropyl-beta-cyclodextrin. No enantioselective degradation of thalidomide was observed in sodium chloride solution (0.9%) samples stored at 6 degrees C for nine days when hydroxypropyl-beta-cyclodextrin was employed as excipient. Therefore a thalidomide solution suitable for oral administration can be prepared by adding hydroxypropyl-beta-cyclodextrin at 10% (w/v).

Aneurisma calcificado de la arteria renal en paciente monorrena, una patología inusual / Renal artery calcified aneurysm in a solytary kidney woman patient, rare pathology

Los aneurismas de la arteria renal son infrecuentes. La prevalencia real de los mismos en la población general es desconocida, aunque se estima que es inferior al 0,4%. Con el uso cada vez mayor de la Angiografía y la Tomografía Computerizada (TC), así como por la mejora en las técnicas de imagen, cada vez se diagnostican con más frecuencia. Las causas más comunes son la displasia fibromuscular y la oclusión arteriosclerótica de la arteria renal. Generalmente no hay una clínica patognomónica de los aneurismas renales, produciendo síntomas inespecíficos como dolor en el costado, hematuria, hipertensión e hipotensión (sospecha de rotura). Presentamos el caso de una paciente monorrena con aneurisma calcificado en la arteria renal

Renal artery aneurysm are uncommon. The true prevalence of renal aneurysms in the general population is unknown (less than 0.4%). Because of more widespread use of Angiography and CT as well as improved imaging techniques, they are diagnosed more frecuently. Fibromuscular dysplasia and arteriosclerotic occlusion of the renal artery are believed to be the most frecuent causes. In general, there are no pathognomonic signs and symptoms of renal aneurysm. Nonspecific complaints include flank pain, hematuria, hypertension and hypotension (suspect rupture of aneurysm). We report a case of a woman with a renal artery calcified aneurysm in a solitary kidney

[Renal artery calcified aneurysm in a female patient with solitary kidney, rare pathology]. / Aneurisma calcificado de la arteria renal en paciente monorrena, una patología inusual.

Renal artery aneurysm are uncommon. The true prevalence of renal aneurysms in the general population is unknown (less than 0.4%). Because of more widespread use of Angiography and CT as well as improved imaging techniques, they are diagnosed more frecuently. Fibromuscular dysplasia and arteriosclerotic occlusion of the renal artery are believed to be the most frecuent causes. In general, there are no pathognomonic signs and symptoms of renal aneurysm. Nonspecific complaints include flank pain, hematuria, hypertension and hypotension (suspect rupture of aneurysm). We report a case of a woman with a renal artery calcified aneurysm in a solitary kidney.

Enfermedades infecciosas emergentes y reemergentes / Emerging and reemerging infectious diseases

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