[Outcomes of respiratory rehabilitation program in lung transplant recipients: a quasi experimental study]. / Resultados de un programa de rehabilitación respiratoria en pacientes receptores de trasplante pulmonar: estudio cuasiexperimental.

INTRODUCTION: Lung transplant (LT) is the ultimate option for end-stage lung diseases. Malnutrition and sarcopenia, common in LT recipients, can be reversible with adequate exercise and nutrition. This study aims to assess changes in physical performance and aerobic capacity after a 10-week rehabilitation program (RP) in LT recipients, as well as to describe the prevalence of sarcopenia and malnutrition before and after RP and their influence on clinically relevant outcomes. MATERIALS AND METHODS: Quasi-experimental study, before and after a 10-week PR in first-time TP recipients, aged over 18 years, from January 2022 to September 2023. Aerobic exercise capacity was assessed through the 6-minute walking test (6MWT) and peak oxygen consumption (VO2peak); and physical performance was measured using the Short Physical Performance Battery (SPPB). Additionally, the prevalence of sarcopenia was described according to the criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2) and malnutrition according to the criteria of the Global Leadership Initiative on Malnutrition (GLIM). RESULTS: Of the 41 patients, 56% had sarcopenia and 80% had malnutrition. After RP, the distance walked in the 6MWT increased by 66.3m (p=0.004) in men and 61m (p=0.001) in women. VO2peak increased in men by a mean of 3.1ml/min/kg (p=0.024). Physical performance improved significantly in both men and women according to the Short Physical Performance Battery (SPPB), with clinically relevant differences of 1.6 pts (p<0.001) and 1.2 pts (p=0.012), respectively. The prevalence of sarcopenia decreased to 24% and malnutrition to 61%. CONCLUSIONS: RP proved to be an effective and safe intervention for LT recipients. In addition to improvements in skeletal muscle strength and exercise capacity, a reduction in the prevalence of sarcopenia and malnutrition was also observed.

Single ZnO Nanowire-Based Gas Sensors to Detect Low Concentrations of Hydrogen.

Low concentrations of hazardous gases are difficult to detect with common gas sensors. Using semiconductor nanostructures as a sensor element is an alternative. Single ZnO nanowire gas sensor devices were fabricated by manipulation and connection of a single nanowire into a four-electrode aluminum probe in situ in a dual-beam scanning electron microscope-focused ion beam with a manipulator and a gas injection system in/column. The electrical response of the manufactured devices shows response times up to 29 s for a 121 ppm of H2 pulse, with a variation in the nanowire resistance appreciable at room temperature and at 373.15 K of approximately 8% and 14% respectively, showing that ZnO nanowires are good candidates to detect low concentrations of H2.

Detección y caracterización cinética de una contaminación por Candida tropicales durante la producción de levadura forrajera / Detection and kinetic characterization of Candida tropicalis contamination during fodder yeast production

Se identificó a Candia tropicalis como el agente causal de una servera contaminación detectada en la producción de levadura forrajera en una fábrica de la región oriental de Cuba. Posteriormente a un detallado diagnóstico en las materias primas y diferentes secciones de la fábrica con el objetivo de identificar el foco y aislar el microorganismo contaminante, se procedió a su identificación mediante comparación de secuencias nucleotídicas de las regiones adyacentes no codificadoras ITS (internacional transcribed spacer) ITS1 a ITS4 de ADN ribosomal (ADNrib) 5,8S. En paralelo, se simuló la multiplicación celular de la cepa de producción, Candida utilis NRRL Y-660, a volumen de laboratorio (2,5l), observándose los mismos efectos negativos detectados a nivel industrial sobre su comportamiento cinético al conducir un cultivo en condiciones aerobias con melazas contaminadas. La identificación y caracterización cinética primaria permitió la adopción de medidas higiénico-sanitarias y de carácter tecnológico restableciéndose la producción a la vez que se adoptó una metodología para la vigilancia profiláctica de futuras contaminaciones(AU)

Candida tropicalis was identified as the etiologic agent of a severe contamination detected on an industrial fodder yeast production at the Cuban eastern region. After a detailed diagnostic task on raw material carried out on different factory sections, protocols to identify the contamination source and to isolate the microorganism were proposed. The identification was by comparison of the internal transcribed spacers ITS1 and ITS4 from 5.8S ribosomal DNA nucleotide sequences. In parallel, propagation of production strain, Candida utilis NRRL Y-660, at lab scale (2.5 l) was performed. Similar results to those observed in the factory concerning to its kinetic behavior in aerobic propagation with contaminated molasses, were detected at this level. The identification and primary kinetic characterization led to the implementation of sanitary and technological measures to bring production at its normal operational conditions as well as the application of prophylactic surveillance methodologies to avoid future contaminations(AU)

Falta de asistencia a las citas programadas en una consulta ambulatoria de geriatría: estudio de casos y controles / Non-attendance at appointments in a geriatric outpatient clinic: a case-control study

Objetivo: identificar las causas y los factores relacionados con la falta de asistencia a una consulta hospitalaria con el objetivo de plantear medidas correctoras. Pacientes y método: estudio prospectivo de casos y controles. Durante un período de 5 meses se recogieron todos los casos de falta de asistencia a la consulta ambulatoria de geriatría del Complejo Hospitalario de Cáceres. De las 135 faltas de asistencia se completó la entrevista telefónica en 97 casos (35 primeras consultas y 62 sucesivas) y se seleccionó a 97 controles con igual distribución. Se realizó una encuesta telefónica en la que se interrogó sobre el motivo de la consulta y la enfermedad principal, así como sobre la situación funcional, cognitiva y social. También se recogieron los motivos de la falta de asistencia y de que no se anulara la cita. Resultados: los pacientes que no acudieron a las citas programadas vivían más lejos del hospital (31,3 +- 33,68 frente a 20,78 +- 26,69; p = 0,05) y tenían peor situación funcional (p = 0,045); en el subgrupo de consultas sucesivas presentaban mayor grado de deterioro cognitivo (p = 0,04). Las principales causas de falta de asistencia fueron: ingreso hospitalario (20,6%), olvido de la cita (16,5%), fallecimiento (13,4%) y falta de comunicación de la cita o del cambio (10,3%). Conclusiones: los pacientes que no acudieron a la consulta programada presentaron como factores de riesgo para ello: vivir más lejos del centro hospitalario y tener una peor situación funcional; en el subgrupo de consultas sucesivas se observó un mayor deterioro cognitivo. Las causas de las citas fallidas son diversas pero, a priori, permiten desarrollar medidas para su corrección

Objective: to identify the causes and factors related to non-attendance at hospital appointments with the aim of proposing remedial measures. Patients and method: a prospective case-control study was performed. All cases of non-attendance at the outpatient clinic of the Geriatric Unit at Cáceres Hospital were recorded over a 5-month period. There were 135 cases of appointment failure and a telephone interview was completed in 97 cases (35 first and 62 follow-up appointments), whilst 97 controls, with an equal distribution, were selected. A telephone survey was carried out inquiring about: reason for the appointment, main illness, and cognitive, social and functional status. The reasons for non-attendance and failure to cancel the appointment were also recorded. Results: the patients who did not keep their appointments lived further from the hospital (31.3 +- 33.68 vs 20.78 +- 26.69; p = 0.05) and had a worse functional status (p = 0.045); within the subgroup of missed follow-up appointments there was a greater degree of cognitive deterioration (p = 0.04). The main causes of non-attendance were: admission to hospital (20.6%), forgetting the appointment (16.5%), death (13.4%), not being notified of the appointment, or of it being changed (10.3%). Conclusions: risk factors found to be related to appointment failure were: living further from the hospital and having a worse functional status; within the subgroup of missed follow-up appointments a greater degree of cognitive deterioration was detected. The causes of appointment failure are varied but, a priori, it should be possible to develop remedial measures

Escala Global de Deterioro. ¿Es fiable su realización mediante entrevista telefónica? / The Global Deterioration Scale. Can it be reliably performed over the telephone?

Objetivo: Evaluar la fiabilidad de la Escala Global de Deterioro (GDS), realizada mediante entrevista telefónica, para graduar el deterioro cognitivo. Método: Estudio prospectivo en el que entrevistadores médicos realizaron la escala GDS vía telefónica a pacientes, o cuidadores de pacientes, que iban a acudir a la consulta de la unidad de geriatría. Posteriormente, se evaluaba en la consulta a dichos pacientes graduándose el deterioro mediante la GDS de forma ciega. Se presenta un análisis descriptivo de los pacientes estudiados y del nivel de fiabilidad de la escala, valorando el grado de acuerdo entre los resultados obtenidos mediante entrevista telefónica y los de consulta (patrón de referencia). Resultados: Se analizaron 72 pacientes (77,8 por ciento mujeres). La edad media fue 79,33 años (límites: 64-98). En cerca del 70 por ciento de las entrevistas telefónicas respondió un familiar o el cuidador. La distribución por grados de la GDS (1-7) vía telefónica frente a consulta fue, respectivamente, del 43,1-37,5 por ciento, del 12,5-15,3 por ciento, del 5,6-19,4 por ciento, del 19,4-9,7 por ciento, del 12,5-6,9 por ciento y del 6,9-11,1 por ciento; no hubo casos con grado 7. El porcentaje de acuerdo fue del 58 por ciento, y el índice kappa ponderado, del 63 por ciento. Conclusión: Los resultados indican que el nivel de fiabilidad de la escala GDS, realizada vía telefónica, no es bueno para graduar el deterioro cognitivo (AU)

[Studer's type ileal neobladder. Study of complications and continence]. / Neovejiga ileal tipo Studer. Estudio de las complicaciones y de la continencia.

Analysis of early and late post-surgical complications in 44 cases of Studer's type bladder replacement due to carcinoma of the bladder performed over a 6-year period. Follow-up ranges between 6 months and 6 years. 4 patients died during the post-operative (9.09%): 1 myocardial infarction, 1 pulmonary embolism and 2 intestinal fistula. 28 patients (63.64%) had post-operative complications: 4 GI fistula (9.09%) 5 ileus (11.36%), 2 GI bleeding (4.54%), 1 ureteral fistula (2.27%), 1 ureteral stenosis, 6 urethro-intestinal fistula (13.36%), 1 tubular necrosis, 1 ruptured ureteral catheter, 5 wound infections (11.36%), 12 urine infections (27.27%), 6 sepsis (13.63%), 1 lymphocele, 1 evisceration and 2 eventrations. Repeat surgery was required in 6 cases. Within 6 months from discharge, 7 of 40 patients (17.5%) had some complication: 3 acute pyelonephritis, 4 episodes of acidosis-dehydration and 1 ureter stenosis. After 6 months, 7 of 38 patients (18.4%) had complications: 1 acidosis, 3 vesical lithiasis, 2 ureteral stenosis and 1 urethro-intestinal, plus 2 cases of chronic urinary retention. Daytime continence was 97.2% and nighttime continence 30%; after 6 months evolution, no further changes were seen.