[HYPNOSTRESS study: Interest of medical hypnosis in the evaluation of perceived stress and the experience of hospitalization in an internal medicine department]. / Étude HYPNOSTRESS : intérêt de l'hypnose médicale dans l'évaluation du stress ressenti et le vécu d'une hospitalisation dans un service de médecine interne.

BACKGROUND: Patients with chronic illnesses, especially rare autoimmune and/or systemic diseases associated with significant diagnostic uncertainty, have a representation of their illness and a sometimes prolonged hospitalization experience that can be traumatic and anxiety-provoking. OBJECTIVE: The aim of this study was to evaluate the impact of a non-medicinal medical hypnosis intervention in reducing the stress state and improving the experience of patients hospitalized in an internal medicine department. METHODS: We conducted a prospective study of 24 patients hospitalized in the Internal Medicine Department of Lille University Hospital in 2023. Twelve patients received a non-drug medical hypnosis intervention known as the "place of safety" (case group) and were compared with 12 patients who did not (control group). Stress was assessed by the STAI questionnaire and hospitalization experience by a satisfaction questionnaire. RESULTS: The 24 patients, 13 of whom were women, had a mean age of 55±17 years at inclusion. On admission to hospital, the median STAI-ETAT between the two groups was 43.5 (38.0; 56.6) in the case group versus 42.0 (37.0; 48.5) in the control group (P=0.45). In the case group, the median STAI-ETAT questionnaire taken immediately after the hypnosis session was significantly lower than at the start of hospitalization (30.0 [25.5; 36.5] vs. 43.5 [38.0; 56.5] P=0.003), indicating a significant reduction in stress. At the end of hospitalization, there was also a significant persistence of the median significant reduction between cases and controls (29.5 [26.5; 35.0] for cases vs. 41.5 [33.5; 45.5] for controls P=0.002). Experience of hospitalization was better in the case group (median 5.0 [4.5; 5.0] vs. 4.0 [4.0; 4.5], P=0.016). CONCLUSION: This study suggests that medical hypnosis is a promising non-medicinal supportive intervention for reducing perceived stress and improving the experience of stress in patients hospitalized on an internal medicine ward.

Transforming a public university hospital and its area of influence into a comprehensive resource in response to the COVID-19 pandemic.

INTRODUCTION AND OBJECTIVES: The outbreak of COVID-19 has overwhelmed healthcare systems all over the world. The aim of this article is to describe the process of transforming the Vall d'Hebron University Hospital, the second largest hospital in Spain, into a COVID-19 centre coordinating response to the pandemic in its reference area. MATERIALS AND METHODS: The study draws on the experience of the authors in transforming the hospital into a comprehensive resource in response to the COVID-19 pandemic. The strategy is based on four central strategies: early planning, coordination of all healthcare agents in its reference area, definition of clear leadership roles, and the organisation of care based on multidisciplinary teams with minimal recruitment of new staff. RESULTS: The transformation strategy enabled the hospital to cope with the surge in patients without exceeding its capacity. During the response phases, which amounted to a period of 57 days, 3106 patients consulted the ER and 2054 were admitted, 346 of whom were treated at the ICU. To accommodate the number of adult COVID-19 patients, adult ICU availability was progressive increased by 371%, and ordinary beds increased by 240. A total of 671 staff members went on sick leave after testing positive for COVID-19. CONCLUSION: The transformation experience of the hospital provides insight into how effectively adapt the structures and functioning of large hospitals. The relevance of territorial coordination during the pandemic is stressed as an effective strategy that contributed coping the pandemic.

Utilidad pronóstica de las puntuaciones de fallo multiorgánico y del índice inotrópico en el postoperatorio de trasplante cardiaco en niños / Prognostic utility of the multiorgan failure scores and inotropic index in the postoperative of cardiac transplantation in children

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Genetic structure and evidence of anthropogenic effects on wild populations of two Neotropical catfishes: baselines for conservation.

Genetic diversity and structure of Pseudoplatystoma corruscans and P. reticulatum, large migratory South America catfishes, where overfishing and the construction of numerous dams in their feeding and reproducing areas are affecting their migratory processes negatively, were studied using microsatellites in samples from Paraguay (that comprises the Pantanal biome), and the upper and lower Paraná Basins. Genetic diversity was in accordance to that observed for other large migratory fishes, but the most geographically isolated populations of P. reticulatum and those P. corruscans subject to anthropogenic effects (stocking and dams) showed lower genetic diversity and evidences of bottlenecks compatible with low effective population size. Pseudoplatystoma reticulatum presented subtle genetic differentiation within the Paraguay area, especially between the edges of its distribution. Pseudoplatystoma corruscans, in this same area, presented a quite homogeneous but significant genetic break between the Paraguay and upper Paraná populations, apparently resulting from natural and historical isolation between the basins until recently. These data demonstrates that, although these Pseudoplatystoma spp. are abundant in the Pantanal area, anthropogenic events are leading to negative effects on their populations, particularly in the upper Paraná Basin. Genetic differentiation observed along each species distribution demands conservation actions to preserve each population's biodiversity. These results represent important genetic information using new microsatellite markers and the first genetic study of P. reticulatum covering this area of its native distribution. Data may also contribute to a better understanding of species migration patterns and to be used as a baseline for proper management.

Evolution and conservation of Characidium sex chromosomes.

Fish species exhibit substantial variation in the degree of genetic differentiation between sex chromosome pairs, and therefore offer the opportunity to study the full range of sex chromosome evolution. We used restriction-site associated DNA sequencing (RAD-seq) to study the sex chromosomes of Characidium gomesi, a species with conspicuous heteromorphic ZW/ZZ sex chromosomes. We screened 9863 single-nucleotide polymorphisms (SNPs), corresponding to ~1 marker/100 kb distributed across the genome for sex-linked variation. With this data set, we identified 26 female-specific RAD loci, putatively located on the W chromosome, as well as 148 sex-associated SNPs showing significant differentiation (average FST=0.144) between males and females, and therefore in regions of more recent divergence between the Z and W chromosomes. In addition, we detected 25 RAD loci showing extreme heterozygote deficiency in females but which were in Hardy-Weinberg equilibrium in males, consistent with degeneration of the W chromosome and therefore female hemizygosity. We validated seven female-specific and two sex-associated markers in a larger sample of C. gomesi, of which three localised to the W chromosome, thereby providing useful markers for sexing wild samples. Validated markers were evaluated in other populations and species of the genus Characidium, this exploration suggesting a rapid turnover of W-specific repetitive elements. Together, our analyses point to a complex origin for the sex chromosome of C. gomesi and highlight the utility of RAD-seq for studying the composition and evolution of sex chromosomes systems in wild populations.

Tos ferina: una enfermedad prevenible en aumento. Hospitalización en menores de 5 años en un centro de segundo nivel (periodo 2008-2012) / Pertussis: an increasing preventable disease. Hospital admissions in children in a second level Hospital (period 2008-2012)

Introducción y objetivo: La tos ferina, lejos de estar en proceso de erradicación, presenta una incidencia cada vez más elevada en nuestro medio. Si bien la mortalidad es menor del 1%, la morbilidad es elevada y supone un coste considerable para la sociedad. El objetivo de este trabajo es analizar la incidencia de las hospitalizaciones relacionadas con la tos ferina en niños en un área periférica de Madrid. Métodos: Estudio retrospectivo mediante revisión de la historia clínica electrónica de los pacientes ingresados en el servicio de pediatría con diagnóstico de síndrome pertusoide, desde enero de 2008 hasta diciembre de 2012. Se calcula la tasa de incidencia de hospitalización por síndrome pertusoide y el tiempo medio de la estancia. Resultados: La incidencia de hospitalización fue de 34 casos/100.000 menores de 5 años/año. En 2011 se concentraron más del 25% de los casos, con una incidencia de 68/100.000 menores de 5 años. El 100% de los casos se produjo en menores de 1 año. Más de la mitad de los pacientes tenía historia familiar de la enfermedad. La media (± desviación estándar) de la estancia fue de 6,1 (± 3,5 días). El 6,2% de los pacientes requirió el ingreso en una unidad de cuidados intensivos. No detectamos casos de mortalidad. Conclusiones: La incidencia de hospitalización por tos ferina en menores de 5 años presenta una tendencia ascendente (AU)

Title: Pertussis: an increasing preventable disease. Hospital admissions in children in a second level Hospital (period 2008-2012) Background and aim: Pertussis or whooping cough is far from eradication, and the incidence is increasing in our environment. Although mortality rate is less than 1%, the morbidity is high, and involves a high cost to society. The aim of this study is to estimate the rate of hospital admissions in children due to whooping-cough in a peripheral area in Madrid. Methods: We carried out a retrospective epidemiological survey. Data were obtained by review of clinical electronic history. All hospital discharges in children under 5 (ICD-9-CM 033) between January 2008 and December 2012 were analyzed. We estimated the annual incidence of hospitalization for pertussis and average length of stay. Results: The annual incidence during the period of the study was 34 per 100,000 children under 5. Up to 25% of the cases occurred at 2011. 100% of children were less than 1 year of age; average age: 3.1 months (SD= 1.6). More than half (56%) concerned symptoms in the near-family. Average length of stay was 6.1 days (SD= 3.5). 6.2% of patients needed critical care assistance. There were no mortality cases. Conclusion: Rate of hospital admissions in children under 5 years due to whooping-cough is increasing (AU)

Personality as a predictor of depression symptoms in burn patients: a follow-up study.

There is empirical evidence that having some personality characteristics increases the risk of developing depression. This is the first study which analyses the role of personality dimensions, assessed by the Alternative Five Factor Model, in the development of depressive symptoms in adult burn survivors across time. Participants were 109 adult burn survivors admitted to a Burns Unit. Personality was assessed by the Zuckerman-Kuhlman Personality Questionnaire and depression symptoms by the Beck Depression Inventory. After adjusting by age, gender and burn size, results showed that high Neuroticism-Anxiety (N-Anx) and Aggression-Hostility (Agg-Host) were related to higher depression scores when compared with low N-Anx and Agg-Host groups along the six months follow-up. Moreover, Activity and Impulsive-Sensation Seeking factors were involved in statistically significant different depressive symptom development trajectories during the six months after burn. These findings suggest that personality factors could be used to identify the most vulnerable patients, who could develop severe mood symptoms at different points in their recovery.

Rabdomiolisis aguda: revisión y evaluación del daño renal / Acute rhabdomyolysis: review and rates of renal failure

Introducción: Analizamos a los pacientes atendidos en nuestro hospital con rabdomiolisis, valorando su función renal y las características relacionadas. Material y métodos: Estudio retrospectivo de 2,5 años, en el que se incluyen pacientes menores de 16 años con cifras de creatinfosfocinasa (CPK) >1.000 UI/L. Se excluyeron los menores de 1 mes y los que presentaban una elevación de CPK de origen cardiaco. Definimos daño renal agudo según los criterios RIFLE adaptados a pediatría. Se recogieron diferentes variables clínicas y bioquímicas. Resultados: Se analizaron 55 pacientes (mediana de edad de 8 años) con CPK inicial de 1.826 UI/L (rango: 1.213-4.414). Las causas más frecuentes fueron las miositis virales, la cirugía muscular y las convulsiones. El 15,9% presentó daño renal agudo, que no se relacionó con la causa de rabdomiolisis y se asoció a cifras elevadas de CPK. Ninguno precisó depuración extrarrenal. Conclusiones: El daño renal agudo asociado a rabdomiolisis suele ser leve y más frecuente en los niños con valores más elevados de CPK (AU)

Objectives: To analyze patients with rhabdomyolysis, assessing clinical presentation and prevalence of acute renal failure. Material and methods: We performed a retrospective study of patients younger than 16 years of age with creatine-phospokinase (CPK) levels greater than 1,000 IU/L who were attended at our tertiary pediatric hospital during a 2.5 year period. Neonatal patients and those with elevation of myocardial specific form of CPK were excluded. Acute renal failure was assessed according to RIFLE criteria adapted to pediatric patients. Clinical and laboratory data were collected. Results: A total of 55 patients were included (median age 8 years). The median initial CPK level was 1,826 IU/L (range: 1,213-4,414). The most common etiologies were viral myositis, muscle surgery and seizures. Acute renal failure that was unrelated to the cause of rhabdomyolysis occurred in 15.9% and was related to higher levels of CPK. None of them required renal replacement therapy. Conclusion: Acute renal failure in children is usually mild and it is more likely to happen in children with higher levels of CPK (AU)

Antimicrobial characterization and safety aspects of the bacteriocinogenic Enterococcus hirae F420 isolated from Moroccan raw goat milk.

The F420 strain, isolated from raw goat milk and identified as Enterococcus hirae, was selected because of its strong activity against gram-positive bacteria, including Listeria monocytogenes. Interestingly, the F420 strain lacks the virulence genes and decarboxylase activity of histidine, lysine, and ornithine, and it is susceptible to 11 of 14 tested antibiotics, including vancomycin. The antimicrobial compounds produced by E. hirae F420 strain showed high resistance to heat treatment and to acidic and basic pHs. The MALDI-TOF mass spectrometry analysis coupled with the sequence of peptide and structural gene analysis of one of the purified enterocins showed 100% identity with enterocin P (EntP), previously described in E. faecium strains. The structural gene for EntP is located on a plasmid of 65 kb. Other enterocins with molecular mass higher than 7 kDa were also detected. This is the first report of the production of EntP by E. hirae species naturally occurring in foods. The biotechnological characteristics of the F420 strain and its enterocins indicate their potential for application in the control of L. monocytogenes and other undesirable bacteria in food systems.

Characterization of functional, safety, and probiotic properties of Enterococcus faecalis UGRA10, a new AS-48-producer strain.

Enterococcus faecalis UGRA10, a new AS-48-producer strain, has been isolated from a Spanish sheep's cheese. The inhibitory substance produced by E. faecalis UGRA10 was purified and characterized using matrix-assisted laser desorption ionization-time of flight mass spectrometry, confirming its identity with AS-48 enterocin (7.150 Da). Subsequent genetic analysis showed the existence of the as-48 gene cluster on a plasmid of approximately 70-kb. The UGRA10 strain was examined for safety properties such as enterococci virulence genes, biogenic amine production, and antibiotic resistance. As for most E. faecalis strains, PCR amplification revealed the existence of gene encoding for GelE, Asa1, Esp, EfaA, and Ace antigens and for tyrosine decarboxylase. This strain was sensitive to most of the antibiotics tested, being resistant only to aminoglycosides, lincosamide, and pristinamicins. In addition, UGRA10 developed an ability to form biofilms and to adhere to Caco 2 and HeLa 229 cells. More interestingly, this strain shows a high ability to interfere with the adhesion of Listeria monocytogenes to Caco 2 cells. Altogether, the results suggest that this broad-spectrum bacteriocin-producing strain has biotechnological potential to be developed as a protective agent in food preservation and as a probiotic.

Utilidad de SNOMED CT en el registro de la información clínica / The usefulness of SNOMED CT in recording clinical information

SNOMED CT es una terminología clínica comprensiva y detallda, en español, que puede utilizar para repesentar información puede utlizar para representar información clínica relevante de forma constante. El Hospital Universitario de Fuenlabrada ha adoptado SNOMED CT en sus sitemas de información mediante dos métodos. Se han selecciondo conceptos prioritarios de HCE: problemas, procedimientos, alertas y medicamentos, consturyéndose subconjuntos de los valoresposibles, que son implementados en interfce o como referenica con mapeos a los términos locales, dependiendo de las funcionalidades de las aplicaciones actuaes. Por otra parte, las especificaciones de datos clínicos detallados, como los formularios, se represenan mediante arquetipos y se enlazan con SNOMED CT (AU)

SNOMED CT is a comprehensive and detailed clinical terminology, in Spanish, which can be used to represent clinically relevant information consistently. The Fuenlabrada University Hospital adopted SNOMED CT in their information systems; this paper describes the implementation process and results (AU)

Lactancia materna en la Región de Murcia. ¿Seguimos con el problema? / Maternal breastfeeding in the Region of Murcia, does the

Objetivo: Conocer la prevalencia y la duración de la lactancia materna (LM) en la Región de Murcia. Método: Estudio transversal (junio de 2007), mediante encuestas a madres de niños menores de 24 meses realizadas en centros de vacunación. El ámbito de estudio estuvo comprendido por 77 zonas de salud de 6 áreas sanitarias de la región, y el muestreo fue proporcional al número de niños nacidos en el área. Se recogieron datos sociosanitarios del niño, de la madre y de la alimentación del niño. Se calculó la prevalencia de LM según las categorías definidas por la Organización Mundial de Salud (OMS) y se estudiaron los motivos de no iniciar y de abandonar la LM. Resultados: Se obtuvieron datos de 1.836 niños, con una tasa de respuesta del 95,2%. Al alta del hospital, un total de 1.643 niños (89,7%) fueron alimentados con LM; de éstos, el 76,7% (n= 1.405) lo hicieron sin suplementos nutritivos. Al tercer mes mantenían la LM completa el 44,4% y al sexto mes el 36,3%. La mediana de duración de LM exclusiva fue de 75 días y para la LM parcial de 129 días. Los motivos de no alimentar con LM fueron: enfermedad/ingreso (46,7%), falta de leche (28,6%) y decisión de la madre (19,3%). Entre las causas de abandono, cabe citar las siguientes: hipogalactia e insaciabilidad (29,3%) y escasa ganancia de peso (11%). Las variables que mostraron una asociación estadísticamente significativa (p <0,05) con la LM fueron el peso del niño, el tipo de parto y el área sanitaria, y, en relación con la madre, la edad, la paridad, la actividad laboral, el lugar de procedencia y el nivel de estudios. Conclusiones: Las cifras de LM en la Región de Murcia son similares a las de nuestro entorno, pero se alejan de las recomendadas por la OMS (AU)

Title: Maternal breastfeeding in the Region of Murcia, does the problem persist? Objective: To study the prevalence and duration of maternal breastfeeding (MB) in the Region of Murcia. Methods: Cross-sectional study (June, 2007). Mothers of infants under 24 months old were surveyed in immunization centers. The study was conducted through the 77 health zones of the 6 health areas of the Region. The sample size was proportion alto the number of newborns in these areas. Breast-fed baby, mother and child feeding social and health data were collected. The MB prevalence was calculated in accordance with the categories defined by the World Health Organization (WHO) and the reasons for not starting and for stopping MB were studied. Results: Data from 1,836 infants (response rate of 95.2%) has been obtained. Upon hospital discharge, the percentage of children fed with MB was of 89.7% (1,643), 76.7% (1,405) of which were breastfed without nourishing supplements. 44.4%of infants exclusively MB at 3 months and 36.3% at 6 months. The median duration of exclusive MB was of 75 days and of129 days for partial MB. The reasons for not being fed by MB were: disease/admission (46.7%), lack of milk (28.6%), and mother’s decision (19.3%). The reasons for discontinuing breastfeeding were: hypogalactia and insatiable appetite (29.3%), and not to put on weight (11%). The variables that showed statistically significant association (p < 0.05) regarding MB were child weight, type of childbirth, and health area, and, regarding the mother, age, parity, occupation, place of origin, and education. Conclusions: The MB figures in the Region of Murcia are similar to those in our environment, but are far from those recommended by the WHO (AU)

Resultados funcionales de las resecciones de la cabeza radial tras su fractura / Functional results of radial head excision after fracture

Objetivo. El propósito de este trabajo fue valorar los resultados de la resección de la cabeza radial en fracturas de dicha estructura anatómica. Material y método. Se han revisado 21 fracturas cerradas de la cabeza radial tratadas quirúrgicamente mediante resección de la misma. La edad media de la serie fue de 55 años, con un 81 por ciento de mujeres. El 90 por ciento fueron fracturas tipo III de Mason, y en en el 81 por ciento no existían lesiones asociadas. El seguimiento medio postquirúrgico fue de 65 meses (24-161).Se realizó valoración funcional del codo y la muñeca según los criterios de Morrey y de Cooney, y radiológicamente se calculó el índice radiocubital distal, el ángulo de transporte del codo y la existencia de cambios degenerativos y calcificaciones en muñeca y codo. Resultados. Todos los casos presentaron migración proximal del radio de 1,43 mm de media y la medición del ángulo de transporte mostró un incremento promedio de 8,8°. Conclusiones. A pesar de los cambios mecánicos producidos, hemos encontrado que la resección de la cabeza radial en adultos alteraba escasamente la función del miembro superior, con más del 85 por ciento de excelentes y buenos resultados (AU)

Preoperative factors influencing the range of movement after total knee arthroplasty for severe osteoarthritis.

We report a prospective study, using multivariate analysis, of the factors which influence the range of movement after total knee arthroplasty in 74 patients with 83 arthroplasties at a mean follow-up of 23.6 months (12 to 41). All the patients had a diagnosis of osteoarthritis, a severely disabled knee with a Knee Society system score of less than 60, varus deformity, no previous surgery to the knee, identical prostheses implanted with a similar surgical technique, and no postoperative complications which may have affected the range of movement. The most important factors which influenced the range of movement after arthroplasty were the preoperative range of flexion and the body-weight of the patient. There was a significant improvement in flexion and reduction of flexion contracture at each successive review up to 12 months after operation. Patients with restricted movement before operation showed a satisfactory gain at final review.

Acute dislocation of the acromioclavicular joint. Traumatic anatomy and the importance of deltoid and trapezius.

We report a prospective study of 46 patients with acute complete dislocation of the acromioclavicular joint. They were all treated by suture of the deltoid and trapezius over the clavicle with no repair of the coracoclavicular ligaments, using only temporary fixation with two wires. At operation 43 patients (93.5%) had damage to the trapezius or deltoid or both. The coracoclavicular ligaments were intact in six (13%). Follow-up was from 2 to 7.9 years (mean 5.8), and at the latest review only five patients (10.9%) had redisplacement, due to premature removal of wires for infection in one, to migration of the wires in another and to partial failure of the muscle repair in three. We consider that the deltoid and trapezius attachments are important clinical stabilizers of the clavicle and that their repair, with reinforcement, is a useful addition to any method of surgical treatment.