Conocimiento previo sobre fisioterapia de estudiantes de nuevo ingreso y comparación entre españoles y franceses: estudio observacional de base poblacional en Cataluña / Previous knowledge about Physiotherapy and comparison between Spanish and French new-entry students: a population-based observational study in Catalonia

Antecedentes y objetivo Evaluar el conocimiento previo sobre fisioterapia de los estudiantes de nuevo ingreso, analizando diferencias entre españoles y franceses. Material y métodos Estudio observacional, multicéntrico, transversal. Criterios de inclusión: mayores de edad inscritos en primer curso de grado único de fisioterapia. Los datos se recogieron mediante cuestionario y se analizaron mediante tests de Mann-Whitney y X2/Fisher. Resultados La muestra fue de 861 estudiantes (460 españoles y 401 franceses). Las ramas más citadas fueron la deportiva (47,2%), pediátrica (37,4%) y general (36,5%). Hubo diferencia estadísticamente significativa en el número de ramas citadas, con superioridad en los franceses (0,71 puntos). Los estudiantes franceses citaron significativamente más fisioterapia cardíaca, respiratoria, deportiva, geriátrica, neurológica, pediátrica, y urgencias/Unidad de Cuidados Intensivos (UCI), mientras que los españoles la educación o formación, osteopatía, preventiva, uroginecológica y veterinaria. Los centros sanitarios representaron el lugar de trabajo más enunciado (93,4%), seguido de las consultas privadas (61,7%), centros deportivos (54,7%) e instituciones geriátricas (33,6%). Los españoles citaron más lugares de trabajo (0,14 puntos). Los centros deportivos, sanitarios, sociales/cívicos, los entornos laborales y con animales y las instituciones educativas fueron significativamente más nombradas por los españoles, mientras que los franceses citaron más las consultas privadas y los domicilios. Conclusiones Los estudiantes franceses enumeraron significativamente más ramas de la fisioterapia, mientras que los españoles citaron más lugares de trabajo (próximo a la significancia estadística). Los franceses destacan significativamente más las consultas privadas y domicilios y ramas como la neurológica, pediátrica, deportiva, respiratoria o geriátrica (AU)

Background and objective To assess pre-existing knowledge about Physiotherapy and to analyze potential differences between new-entry students from Spain and France. Material and methods Observational, multicenter, cross-sectional study. Inclusion criteria: age 18 + years and enrolled in first year of a single degree in Physiotherapy. Data was collected via questionnaire and analized by Mann-Whitney and Chi-squared or Fisher tests. Results The sample consisted of 861 students (460 Spain and 401 France). The most mentioned branches were sports (47.2%), pediatric (37.4%) and general (36.5%). A statistically significant difference was found in the number of branches mentioned, with French students being ahead (0.71 points). Physiotherapy branches such as cardiac, respiratory, sports, geriatric, neurologic, pediatric, emergencies/ICU were mentioned significantly more by the French. Spanish students more frequently mentioned education, osteopathy, preventive, urogynecologic and veterinarian. Healthcare centers were the most cited (93.4%) workplaces, followed by outpatient clinics (61.7%), sports facilities (54.7%) and geriatric settings (33.6%). The Spanish mentioned more places than the French (0.14 points). Sports centers, healthcare settings, social/civic, workplace, places with animals and educational institutions were significantly more cited by Spanish students. French students cited outpatient private clinics and home visits more frequently. Conclusions French students cited a statistically significant higher number of branches of physiotherapy, while Spanish students cited a greater number of workplaces (close to statistical significance). Workplaces such as private consultations and in-home physiotherapy were mentioned significantly more by the French, and so were branches such as neurology, pediatrics, sports, respiratory or geriatrics (AU)

How much have we learned from time-lapse in clinical IVF?

Can the time-lapse system (TLS) identify the best embryo for transfer? Although there are several studies that support this hypothesis, more research is required to improve the quality of the current evidence and also to assess live birth rate, miscarriage, stillbirth or clinical pregnancy in order to choose between a TLS or conventional incubation. In addition, although some authors report on effectiveness and safety in the use of TLS monitoring of embryo development in vitro, other authors that have not found relevant differences between the two systems for the culture and subsequence embryo selection. On the other hand, TLS has emerged as a novel technology and has been introduced into clinical practice in many laboratories to perform embryo morphology evaluation and study developmental kinetics in ART. However, most studies only assess blastocyst formation or implantation rate as the primary end-point and additional data are required, for example, about live birth, monozygotic twinning rates and health problems. Furthermore, the features of populations studies are varied; for example, female and male age, seminal characteristics and female factor. The embryo culture conditions and culture medium used also vary. For this review, a search of PubMed was conducted to retrieve relevant studies regarding use of TLS in embryo incubation and selection, and compare them with standard embryo culture and evaluation.

Optimizing the performance of catalytic traps for hydrocarbon abatement during the cold-start of a gasoline engine.

A key target to reduce current hydrocarbon emissions from vehicular exhaust is to improve their abatement under cold-start conditions. Herein, we demonstrate the potential of factorial analysis to design a highly efficient catalytic trap. The impact of the synthesis conditions on the preparation of copper-loaded ZSM-5 is clearly revealed by XRD, N2 sorption, FTIR, NH3-TPD, SEM and TEM. A high concentration of copper nitrate precursor in the synthesis improves the removal of hydrocarbons, providing both strong adsorption sites for hydrocarbon retention at low temperature and copper oxide nanoparticles for full hydrocarbon catalytic combustion at high temperature. The use of copper acetate precursor leads to a more homogeneous dispersion of copper oxide nanoparticles also providing enough catalytic sites for the total oxidation of hydrocarbons released from the adsorption sites, although lower copper loadings are achieved. Thus, synthesis conditions leading to high copper loadings jointly with highly dispersed copper oxide nanoparticles would result in an exceptional catalytic trap able to reach superior hydrocarbon abatement under highly demanding operational conditions.

Efecto de la conservación de la leche humana sobre su actividad antioxidante / Effect of human milk storage on their antioxidant activity

En ocasiones, es necesaria la extracción y almacenamiento de la leche materna en refrigeración o congelación, con frecuencia relacionado con recién nacidos pretérmino (RNPT) o madres que se incorporan al trabajo. Se recomienda administrarla recién extraída, refrigerada durante un máximo de 72-96 horas, o congelada un máximo de 6 meses. El estrés oxidativo es un desequilibrio entre los agentes oxidantes y las defensas antioxidantes; está directamente implicado en diversas patologías propias del RNPT, como la retinopatía de la prematuridad, la displasia broncopulmonar, la enterocolitis necrosante o la encefalopatía hipóxico-isquémica. La leche materna es rica en sustancias antioxidantes, y presenta una mayor actividad antioxidante que las fórmulas artificiales. Esta riqueza es mayor en el calostro, y a menor edad gestacional. Diversos estudios han demostrado que el almacenamiento de la leche humana puede alterar sus propiedades antioxidantes. Se produce un incremento significativo de los productos de la peroxidación de los lípidos (malondialdehído [MDA]) y una disminución de la actividad de la enzima antioxidante glutatión peroxidasa (GPx) con la refrigeración y, en menor grado, con la congelación. El incremento del MDA y el descenso de la actividad GPx es proporcional a la duración de la congelación, y mayor a -20 que a -80 ºC. Incluso en congelación, la concentración de MDA en la leche materna es significativamente menor que en las fórmulas artificiales. Concluimos que la conservación en frío de la leche materna disminuye sus propiedades antioxidantes, en mayor medida durante almacenamientos prolongados y a temperaturas más altas. Por ello, en el caso de la leche materna almacenada para los recién nacidos enfermos o prematuros, es preferible congelar que refrigerar, y es mejor hacerlo durante el menor tiempo y a las más bajas temperaturas posibles. En el caso de las madres que se incorporan al trabajo, esta recomendación es más relativa (lactantes más maduros). Aun así, pese a las pérdidas por el almacenamiento, la leche materna sigue siendo de mejor calidad que los sucedáneos (AU)

Sometimes the extraction and storage of breast milk in refrigerator or freezer is required, frequently associated with preterm newborn or mothers returning to work. It is suggested to offer the milk freshly drawn, refrigerated for up to 72-96 hours, or frozen up to 6 months. Oxidative stress is defined as a disturbance between oxidant agents and antioxidant defences. Oxidative stress is directly involved in various pathologies of preterm infants, such as retinopathy of prematurity, bronchopulmonary dysplasia, necrotizing enterocolitis or hypoxic-ischemic encephalopathy. Breast milk has a large amount of antioxidants and has better antioxidant properties than formula for bottle-feeding. This amount is greater in colostrum, and greater as gestational age decreases. Several studies have shown that human milk storage can damage their antioxidant properties. A significant increase in the products of peroxidation of lipids (malondialdehyde [MDA]) and a decrease in the antioxidant enzyme glutation peroxidase (GPx) activity is observed with refrigeration and, to a lesser degree, with freezing. Increase of MDA levels and decrease in GPx activity is proportional to the duration of freezing, and greater at -20 than -80 °C. Even in freezing, MDA concentration of breast milk is significantly lower than in formula for bottle-feeding. We conclude that cold storage of breast milk decreases its antioxidant properties, mostly during extended storage and at higher temperatures. Therefore, when breast milk is stored for sick or premature newborns, it is preferable to freeze than refrigerate, and it is better in the shortest possible time and at the lowest possible temperatures. For mothers who return to work, this recommendation is not so strong (they are more mature infants). Anyway, despite effects of storage, breast milk is still better quality than substitutes (AU)

CuH-ZSM-5 as hydrocarbon trap under cold start conditions.

Cold start tests are carried out to evaluate the performance of copper-exchanged zeolites as hydrocarbon traps under simulated gasoline car exhaust gases, paying special attention to the role of copper in the performance of these zeolites. It is concluded that the partial substitution of the protons in the parent H-ZSM-5 zeolite is highly beneficial for hydrocarbon trapping due to the formation of selective adsorption sites with specific affinity for the different exhaust components. However, it is also observed that uncontrolled exchanging process conditions could lead to the presence of CuO nanoparticles in the zeolite surface, which seem to block the pore structure of the zeolite, decreasing the hydrocarbon trap efficiency. Among all the zeolites studied, the results point out that a CuH-ZSM-5 with a partial substitution of extra-framework protons by copper cations and without any detectable surface CuO nanoparticles is the zeolite that showed the best performance under simulated cold start conditions due to both the high stability and the hydrocarbon retaining capacity of this sample during the consecutive cycles.

Molecular simulation design of a multisite solid for the abatement of cold start emissions.

A highly effective hydrocarbon (HC) trap for the abatement of cold start HC emissions with specific adsorption sites for the different molecules present in the exhaust gases has been designed by means of molecular simulation tools, and later synthesized.

Long-life vibration-free 4.5 K sorption cooler for space applications.

A breadboard 4.5 K helium sorption cooler for use in vibration-sensitive space missions was developed and successfully tested. This type of cooler has no moving parts and is, therefore, essentially vibration-free. The absence of moving parts also simplifies scaling down of the cooler to small sizes, and it contributes to achieving a very long lifetime. In addition, the cooler operates with limited dc's so that hardly any electromagnetic interference is generated. This cooler is a favorite option for future missions such as ESA's Darwin mission, a space interferometer in which the sensitive optics and detectors can hardly accept any vibration. The system design consists of a hydrogen stage cooling from 80 to 14.5 K and a helium stage establishing 5 mW at 4.5 K. Both stages use microporous activated carbon as the adsorption material. The two cooler stages need about 3.5 W of total input power and are heat sunk at two passive radiators at temperatures of about 50 and 80 K-radiators which are constructed at the cold side of the spacecraft. We developed, built, and tested a demonstrator of the helium cooler. This demonstrator has four sorption compressor cells in two compressor stages. Test experiments on this cooler showed that it performs within all specifications imposed by ESA. The cooler delivered 4.5 mW at 4.5 K with a long-term temperature stability of 1 mK and an input power of 1.96 W. So far, the cooler has operated continuously for a period of 2.5 months and has not shown any sign of performance degradation.

Comparative characterization study of microporous carbons by HRTEM image analysis and gas adsorption.

The present work presents a useful comparison of micropore size distributions (MPSDs) obtained from gas adsorption and image analysis of high-resolution transmission electron micrographs. It is shown that the MPSD obtained for a chemical activated carbon is concordant with that obtained from CO2 adsorption. In addition, this technique has allowed us to obtain the MPSD of a carbon molecular sieve (CMS) prepared in our laboratory by a copyrolysis process, which could only be characterized by CO2 adsorption at 273 K (not by N2 adsorption at 77 K due to diffusional problems). The MPSD obtained by high-resolution transmission electron microscopy (HRTEM) for the CMS is wider than that obtained by CO2 adsorption, suggesting that HRTEM is detecting the closed porosity existing in this sample, which is not accessible to gas adsorption. The existence of closed porosity in the CMS is explained considering the preparation method used. Thus, HRTEM combined with image analysis seems to be useful for structural analysis of narrow micropores including closed porosity.

[A survey regarding the problem of cigarette smoke pollution in a hospital environment]. / Un'indagine conoscitiva sul problema dell'inquinamento da fumo di tabacco in un ambiente ospedaliero.

AIMS: The study aimed to survey smoking habits in a specific environment, namely hospitals, paying special attention to the pediatric sector. METHODS: The survey was carried out using data from questionnaires distributed to all hospital personnel. RESULTS: Of a total of 2425 forms distributed, only 20% were compiled and returned. The most interesting findings to emerge were that in 86% of cases smokers admit to smoking in the presence of others and 10% admit to smoking in the presence of patients. 83% affirm that non-smokers should be protected. The most popular proposal was to create "smoking" rooms inside hospitals. CONCLUSIONS: Almost all smokers say that they are aware of the damage caused by tobacco, but they justify the habit by the fact that "they cannot do without it". Non-smokers feel that health education courses or personal conviction are of little use, and that punitive measures should be introduced for those smoking in hospitals.

[Anti-pseudomonas-specific precipitins as a marker of chronic infection in patients with cystic fibrosis]. / Le precipitine specifiche antipseudomonas come marker di infezione cronica nel paziente fibrocistico.

AIMS: The authors underline the characteristics of Pseudomonas aeruginosa and its methods of action on bronchial mucosa in cystic fibrosis. They then discuss the two concepts of "colonisation" and "chronic infection". METHODS: The level of "infection" was evaluated using an immunoelectrophoretic method involving the precipitation of bands of specific precipitins. A technical description of the method is included. The authors illustrate the use of the method in 78 cases of cystic fibrosis, comparing the positive results obtained using precipitin electrophoresis with the results of direct bacteriological findings. RESULTS: Using the bacteriological criteria, a total of 26.9% of patients were diagnosed as infected, whereas this percentage rose to 32.1% using precipitins. 87.2% of cases were concordant using both methods. CONCLUSIONS: As a practical solution, the authors recommend that the two methods are combined, thus obtaining a marked reduction in the number of false positives with obvious consequences in terms of therapeutic decisions.

[The psychological aspects of asthma in childhood]. / Aspetti psicologici dell'asma in età evolutiva.

BACKGROUND AND AIMS: The hypothesis of an emotional component in asthma has been put forward since antiquity. It is currently explored using a psychodynamic, cognitive-behavioural and systemic-relational approach. This study, carried out using a psychodynamic approach, aimed to identify the psychological aspects of recurrent asthmatic attacks in childhood. METHODS: The study examined 20 subjects, aged between 9 months and 7 years and 11 months, attending the Pneumological Division of the Ospedale Infantile in Turin. The study consisted of the collection of social and personal data regarding the family and clinical and medical history; a semi-structured interview with the mothers, discussed as part of individual supervision regarding the mother-child relationship and the emotive reactions to an asthma attack. RESULTS: Although all subjects had an early onset of manifest asthma, ascertained allergic pathogenesis was only revealed in 30% of children. All cases revealed a lacking and/or conflictual quality in the mother-child relationship, as well as the young patient's difficulty in growing up, implying the acquisition of gradual autonomy. CONCLUSIONS: The authors emphasise the need to focus greater attention on the emotive situation of the child and its parents, in particular those aspects regarding the quality of life under the influence of disease.

Bi-level positive airway pressure (BiPAP) ventilation in an infant with central hypoventilation syndrome.

A 4-month-old baby girl, after a period of apparent good health, began to have aphonia, dyspnea, difficulties with swallowing, cyanosis, apnea, and hypopnea during sleep that resulted in admission to an intensive care unit for intubation and mechanical ventilation. At the age of 9 months she was admitted to our hospital with a possible diagnosis of central hypoventilation syndrome. A polysomnographic study showed apnea and hypopnea (apnea + hypopnea index = 47.1), hypercapnia (mean end-tidal PCO2 89 +/- 15.0 mmHg), and arterial desaturation (mean SaO2 91 +/- 1.7%; lowest SaO2 < 50%; 68% of total sleep time at SaO2 below 93%); the study also showed an absent ventilatory response to CO2, absent cardiac responses to apnea during sleep, and right ventricular hypertrophy. Nocturnal nasal bi-level positive airway pressure (BIPAP), applied initially at 6 cmH2O and gradually increased to 16 cmH2O, caused the sleep-related abnormal respiratory events to disappear. End-tidal PCO2 decreased to 39 mmHg, and SaO2 increased to 94%. After 6 months of nocturnal BiPAP ventricular right hypertrophy reversed and arrested growth and hypotonia normalized. The child has tolerated and has remained on BiPAP support up to her current age of 3 years and continues to use this form of ventilatory assistance without difficulties.

[Adolescence in patients with cystic fibrosis studied by Rorschach test]. / L'adolescenza nei pazienti con fibrosi cistica studiata col test di Rorschach.

BACKGROUND: The majority of patients with cystic fibrosis today reach adulthood. During adolescence, however, many ask themselves questions regarding their possible future realisation. AIMS: The aim of this study, which was performed using the Rorschach test, was to identify areas of particular problems in a group of CF adolescents monitored by the Pneumology Division of Regina Margherita Children's Hospital in Turin: 26 subjects aged between 14 and 18, including 11 females and 15 males. METHODS: The analysis of the test was based on the use of thought, interior resources, instincts and interpersonal relations. The type of intimate resonance was also taken into account and, lastly, a study of the contents was performed using a self-representation grid. RESULTS: The results obtained show a dishomogeneous profile of the development and quality of intellectual processes faced with the intensity of anxiety, mainly loss anxiety, linked to the disease, even if unrelated to its severity. The integration of emotive and instinctual aspects is difficult: mental development towards adult life appears to be impeded by the predominance of regressive modalities. CONCLUSIONS: On the basis of the study performed, it is possible to hypothesise the need for psychological help aimed at achieving a more evolved psychic organisation, possible as part of an overall management programme by the medical and nursing team.

[Personality structure in children with cystic fibrosis studied using Rorschach test]. / La strutturazione della personalità nei bambini con fibrosi cistica studiata col test di Rorschach.

BACKGROUND AND AIMS: The recent positive evolution in the development of cystic fibrosis, resulting in the current prospect of survival, has led to the formation of a new population of chronic patients. The characteristics of the disease and treatment (hereditary, early onset, affecting the alimentary tract and airways) may interfere with personality structuring processes. The aim of the study was to identify the psychopathological risk. METHODS: The study was performed using the Rorschach test in a population of children with cystic fibrosis monitored by the Pneumology Division of the Ospedale Infantile Regina Margherita in Turin: 20 children aged between 7 and 13 years old were included in the study, most of whom had been diagnosed before the age of 2. The analysis of tests was focused on the use of thought, interior resources, instincts and interpersonal relations. A study of the contents was also made using a self-representational grid. RESULTS: The results obtained highlight an inhibitory attitude which cannot be attributed to intellectual insufficiency, but rather to the failed attempt to invest in the intellectual sphere, typical of this age range, owing to the intensity of anguish. Children with cystic fibrosis appear to be at an earlier stage of development, marked by emotive coarctation and the use of adult-type defensive methods, tending towards rationalisation. CONCLUSIONS: Oh the basis of this study, it is possible to detect a danger of disharmonious organisation in the personality structuring process of these children. The hospital must therefore offer adequate psychological support for their psychic evolution.

[New findings in the field of pediatric tuberculosis]. / Novità in campo di tubercolosi infantile.

The Authors explain the news about pediatric tuberculosis; they underline the problems related to microepidemics, to immigration and AIDS increase, and to atypical mycobacteria infections. They also indicate the new diagnostic possibilities in Tb.

[The sweat test. The proposal to revise the concept of the "grey zone"]. / Il test del sudore. Una proposta di revisione del concetto di "zona grigia".

The results of the sweat tests performed in Turin CF Centre in the last four years were reviewed. The opportunity of changing the range of doubt, commonly situated between 40 and 70 mEq/l Cl-, has been considered. The sweat test appears worth to be repeated only for values > 60, unless clinical signs and symptoms persist.

[A clinico-laboratory evaluation of an immunomodulating drug of bacterial derivation]. / Valutazione clinico-laboratoristica di un farmaco immunomodulante di derivazione batterica.

The authors report the results of a study aimed at evaluating the action of an immunomodulating drug of bacterial derivation whose mechanism of action is correlated to both the parietal and ribosomal components of the bacteria capable of stimulating specific and aspecific cell-mediated and humoral immunity. The study reports an increase in IgA-S (in line with other reports), a statistically significant decrease in neutrophilia and the disappearance, in 80% of the cases treated, of salivary bacteria. It is also worth pointing out the reduced IgE fraction. These laboratory results are correlated with a clinical improvement in the subjects treated, all of whom were affected by recurrent catharral or obstructive infections.