Navigating job satisfaction in family firms during crisis.

Occupational health is one of the aspects significantly affected during crisis periods. It is essential to learn about the factors that improve organizational capacity in coping with such shocks. This study investigates how the working environment of a family business influences job satisfaction during crises. Conducting a survey with 516 employees at the peak of the pandemic, the research utilizes structural equation analysis, revealing that family business environments can mitigate burnout, enhance affective commitment, and consequently, boost job satisfaction. The study highlights the need to manage burnout and utilize resources, such as employee commitment, for family firms to sustain job satisfaction amidst disruptions. It deepens the comprehension of family businesses' crisis response, emphasizing the significance of human resource commitment and management. The investigation illuminates the dynamic interplay between the work environment, employee well-being, and organizational resilience, providing valuable insights for both theoretical understanding and practical application.

A Suitable HPLC-MS/MS Methodology for the Detection of Oxytetracycline, Enrofloxacin, and Sulfachloropyridazine Residues in Lettuce Plants.

Oxytetracycline (OTC), enrofloxacin (EFX), and sulfachloropyridazine (SCP) are critically important antimicrobials (AMs) in both human and veterinary medicine, where they are widely used in farm animals. Lettuce has become a matrix of choice for studying the presence of residues of these AMs in plants, as the concentrations of residues detected in lettuce can range from ng to mg. While several analytical methodologies have been developed for the purpose of detecting AMs in lettuce, these currently do not detect both the parent compound and its active metabolites or epimers, such as in the case of ciprofloxacin (CFX) and 4-epi-oxitetracycline (4-epi-OTC), which also pose a risk to public health and the environment due to their AM activity. In light of this situation, this work proposes an analytical method that was developed specifically to allow for the detection of OTC, 4-epi-OTC, EFX, CFX, and SCP in a lettuce matrix. This method uses acetonitrile, methanol, 0.5% formic acid, and McIlvaine-EDTA buffer as extraction solvents, and dispersive solid-phase extraction (dSPE) for the clean-up. The analytes were detected using a liquid chromatography technique coupled to mass spectrometry (HPLC-MS/MS). Parameters such as the specificity, linearity, recovery, precision, limit of detection, and limit (LOD) of quantification (LOQ) were calculated according to the recommendations established in the European Union decision 2021/808/EC and VICH GL2: Validation of analytical procedures. The LOQ for the analytes OTC, 4-epi-OTC, CFX, and SCP was 1 µg·kg-1, whereas for EFX, it was 5 µg·kg-1 dry weight. All calibration curves showed a coefficient of determination (R2) of >0.99. The recovery levels ranged from 93.0 to 110.5% and the precision met the acceptance criteria, with a coefficient of variation of ≤14.02%. Therefore, this methodology allows for the precise and reliable detection and quantification of these analytes. The analysis of commercial samples confirmed the suitability of this method.

Job-demand and family business resources in pandemic context: How they influence burnout and job satisfaction.

This research aims to explore how work demands and resource variables affect the burnout and satisfaction of employees of family businesses in the context of the pandemic (COVID-19) and the moderation effect of fear of COVID-19 on this relationship. A sample of 214 Chilean family business employees is used for hypotheses testing. Results indicate that the demands and resources partially explain the burnout and satisfaction of employees of family firms during the pandemic. Employees' fear of COVID-19 moderates the relationship between resources-demands and burnout-job satisfaction in family firms. This work contributes to understanding how these organizations can manage adverse scenarios to survive and continue operations.

Feasibility and validation of the targeted axillary dissection technique in the axillary staging of breast cancer after neoadjuvant therapy: Definitive results.

AIM: to study the feasibility and value of "Targeted Axillary Dissection" (TAD) in cN1 breast cancer (BC) patients undergoing neoadjuvant chemotherapy (NACT), in order to avoid unnecessary axillary lymph node dissection (ALND). MATERIALS AND METHODS: Design: Prospective observational study. INCLUSION CRITERIA: Patients with histologically confirmed cN1 staging BC and treated with NACT between January 2016 and August 2019 who accomplished clinical response. METHOD: Fine-Needle Aspiration (FNA) positive axillary nodes were marked with a metallic clip prior to neoadjuvant treatment. All patients were summited to TAD and ALND. Analysis of data: We performed [1]: a feasibility analysis of clinical, radiological and pathological variables, as well as difficulties and complications of the TAD [2]; a diagnostic test study of the sentinel lymph node biopsy (SLNB), clipped lymph node biopsy (BCLIP) and their combination (TAD), using ALND as the Gold Standard. RESULTS: 60 patients were included. 43 patients (71.7%) had a complete clinical lymph node response to NACT. Neither limitations nor complications in clip placement were found. Intraoperative location of the clipped node was problematic in 7 cases (11.7%). The pathological complete response rate (pCR) was 30.5% (18 patients) and ypN0 staging rate was 38.3% (23 patients). Sensitivity values of each technique were: SLNB: 80.9% (95%CI: 61.8-100); BCLIP: 80.8% (95%CI: 63.7-97.8); TAD: 92.6% (95%CI: 80.9-100) with negative predictive values of: SLNB: 84.6% (95%CI: 68.8-100); BCLIP: 81.0% (95%CI: 63.7-97.8); TAD: 91.3% (95%CI: 77.6-100). CONCLUSION: TAD is feasible and valid to rule out axillary metastatic involvement in cN1 breast cancer patients who respond to NACT.

Development of a predictive score of axillary lymph node dissection based on targeted axillary dissection in patients with breast cancer diagnosis, affected lymph nodes, and neoadjuvant treatment.

AIM: To determine predictive factors of axillary lymph node dissection (ALND) results in breast cancer (BC) patients undergoing neoadjuvant chemotherapy (NACT), and subsequent staging using Targeted Axillary Dissection (TAD). MATERIAL AND METHOD: Case-control study between January 2016 and August 2019. Patients with BC, cN1 staging, marked with a metallic clip prior to NACT, and subsequently staged with TAD and ALND were included. They were divided into 2 groups: ALND patients with or without metastatic involvement (group 1 and group 2, respectively). We carried out a univariate analysis comparing clinical, radiological, surgical and pathological variables, and a logistic regression, (dependent variable: positive result of ALND; independent variables: number of suspicious lymph nodes in diagnostic ultrasound, positive hormone receptors, HER2 positive, complete clinical-radiological response to NACT, positive TAD, and biopsy of ≤2 nodes in TAD). A score for prediction of a metastatic ALND was proposed, with an internal validation study. RESULTS: 60 patients were included: Group 1: 33 (55.0%); Group 2: 27 (45.0%). Tumor size (Odds Ratio (OR) = 1.67; 95%CI 1.02-2.74), number of suspected nodes in ultrasound (OR = 2.20; 95%CI 1.01-4, 77), HER2 positive (OR 0.04; 95%CI 0.003-0.54), clinical-radiological response to NACT (OR = 0.07; 95%CI 0.01-0.75), and positive TAD (OR 15.48; 95%CI 1.68-142.78) were independent predictors of a positive result in ALND. We developed a "positive ALND predictive score", with good calibration (Hosmer-Lemeshow test: p = 0.65), and discrimination (AUC = 0.93; 95% CI 0, 87-0.99), with highest Youden index (0.7) at cut-off point of 17% risk of positive ALND (sensitivity = 100%; specificity = 70%). CONCLUSION: Tumor size, number of suspected nodes, positive HER2, response to NACT, and metastatic TAD are independent predictors of ALND. The predictive score for positive ALND would be a good indicator to safely omit ALND.

El problema de la estadificación axilar en el cáncer de mama tras quimioterapia neoadyuvante. Papel de la disección axilar dirigida y tipos de marcadores ganglionares / The problem of axillary staging in breast cancer after neoadjuvant chemotherapy. Role of targeted axillary dissection and types of lymph node markers

La disección axilar dirigida (DAD) consiste en una nueva técnica de estadificación axilar que combina la biopsia selectiva del ganglio centinela (BSGC) y la biopsia del ganglio marcado con clip (BCLIP) en la misma cirugía, para reestadificar a las pacientes con cáncer de mama con ganglios axilares positivos tratadas mediante quimioterapia neoadyuvante (QTNA). Para su realización, previo a la QTNA, se punciona el ganglio metastásico de manera ecoguiada y se deja un marcador en su interior, para biopsiarlo de manera dirigida en la cirugía posterior. Existen numerosos marcadores: desde clips de acero, titanio o ácido poliglicólico hasta semillas de radioyodo o ferromagnéticas, que difieren en su método de localización y recuperación (arpón, sonda de detección gamma, o sonda magnética). El objetivo de este trabajo es realizar una revisión sistemática del estado actual de la DAD, así como explicar las diferentes técnicas y tipos de marcaje axilar, con base en la evidencia disponible

Targeted axillary dissection (TAD) consists of a new axillary staging technique that combines sentinel lymph node biopsy (SLNB) and clipped lymph node biopsy (CLNB) in the same surgery, in order to re-stage patients with breast cancer and positive axillary lymph nodes undergoing neoadjuvant chemotherapy (NAQT). Prior to the NAQT, the affected lymph node is punctured and a solid marker is left inside echo-guided, in order to biopsy it in the subsequent surgery. There are numerous types of markers: metallic (steel, titanium or polyglycolic acid clips), radioiodine or ferromagnetic seeds, which differ in the method of location (wire, gamma-detection or magnetic probe). The aim of this study is to perform a systematic review about the current status of the TAD, as well as to explain the different techniques and types of axillary marking, based on the current available evidence

The problem of axillary staging in breast cancer after neoadjuvant chemotherapy. Role of targeted axillary dissection and types of lymph node markers. / El problema de la estadificación axilar en el cáncer de mama tras quimioterapia neoadyuvante. Papel de la disección axilar dirigida y tipos de marcadores ganglionares.

Targeted axillary dissection (TAD) consists of a new axillary staging technique that combines sentinel lymph node biopsy (SLNB) and clipped lymph node biopsy (CLNB) in the same surgery, in order to re-stage patients with breast cancer and positive axillary lymph nodes undergoing neoadjuvant chemotherapy (NAQT). Prior to the NAQT, the affected lymph node is punctured and a solid marker is left inside echo-guided, in order to biopsy it in the subsequent surgery. There are numerous types of markers: metallic (steel, titanium or polyglycolic acid clips), radioiodine or ferromagnetic seeds, which differ in the method of location (wire, gamma-detection or magnetic probe). The aim of this study is to perform a systematic review about the current status of the TAD, as well as to explain the different techniques and types of axillary marking, based on the current available evidence.

Fluorescent DTPA-Silk Fibroin Nanoparticles Radiolabeled with 111In: A Dual Tool for Biodistribution and Stability Studies.

This work aims to provide an effective and novel dual tool for the biodistribution studies of biopolimeric nanoparticles by using modified silk fibroin nanoparticles as a model. This is an indispensable step in the evaluation of the applicability of biopolymeric nanoparticles as drug delivery systems. In this work, we report a new facile method for radiolabeling silk fibroin nanoparticles conjugated to the chelating agent diethylenetriamine pentaacetic acid and tagged with fluorescein isothiocyanate. Nanoparticles were characterized by means of dynamic light scattering, scanning electron microscopy, and infrared and fluorescence spectroscopy. The in vitro studies included stability in biological media and evaluation of the cytotoxicity of the nanoparticles in a cell culture. The in vivo study was focused on a scintigraphic study over 24 h conducted on New Zealand rabbits, after intra-articular injection of [111In]In-nanoparticles containing 8.03 ± 0.42 MBq. Biodistribution of the nanoparticles was also assessed ex vivo by fluorescence microscopy of post mortem biopsied organs. This radiolabeling method was reproducible and robust with high radiolabeling efficiency (∼80%) and high specific activity suitable for in vivo studies. Radiolabeled nanoparticles, having a hydrodynamic radius of 113.2 ± 2.3 nm, a polydispersity index of 0.101 ± 0.015, and a Z-potential of -30.1 ± 2.0 mV, showed an optimum retention in the articular space, without activity clearance up to 24 h post injection. Thus, an easy and robust radiolabeling method has been developed, and its applicability is demonstrated in vitro and in vivo studies, showing its value for future investigation of silk fibroin nanoparticles as versatile and stable (steady) local drug delivery systems for consideration as a therapeutic option, particularly in the treatment of joint disorders.

Validation of the targeted axillary dissection technique in the axillary staging of breast cancer after neoadjuvant therapy: Preliminary results.

AIM: To study the feasibility and validity of ultrasound-guided pre-chemotherapy marking of metastatic axillary lymph nodes followed by targeted axillary dissection (TAD), in breast cancer patients undergoing neoadjuvant chemotherapy (NACT). MATERIAL AND METHOD: Prospective diagnostic test study conducted between January 2016 and March 2018. Patients with breast cancer and indication for NACT, cN1 or cN2 axillary staging, were included. A clip was placed in the affected lymph node prior to NACT. A sentinel lymph-node biopsy (SLNB) and a clipped lymph-node biopsy (BCLIP) were conducted, followed by axillary lymph node dissection (ALND). Location rate (LR) and negative predictive value (NPV) were evaluated, taking SLNB, BCLIP and their combination (TAD) as evaluated tests and metastatic involvement in the ALND specimen as the gold standard. RESULTS: Twenty-three patients were included in the study. Sentinel lymph node could only be detected in 19 cases (LR = 80.61%), whereas BCLIP was successful in 22 (LR = 95.65%). The sentinel lymph node coincided with the marked lymph node in 14 patients (60.9%). We found a NPV for the SLNB of 0.85 (95%CI: 0.61-1.0), whereas for TAD it was 1.00 (95%CI: 0.74-1.0). CONCLUSION: TAD is a feasible test for axillary restaging after NACT, with a higher success rate than SLNB.

[Descriptive study of healthcare professionals' management of tick bites]. / Estudio descriptivo de la conducta de profesionales de la salud ante el caso de una picadura por garrapata.

INTRODUCTION: Rural primary health centers frequently treat patients with tick bites. This study compares everyday clinical practice at our primary healthcare center to practices recommended by current scientific evidence. PURPOSE: To describe the everyday management of tick bites by different healthcare professionals and to compare this management to evidence-based therapy guidelines. DESIGN: Cross-sectional, descriptive observational study. METHODS: Data was collected through an anonymous self-completed questionnaire. The form was filled out by a consecutive sample of nurses, physicians and pediatricians of the clinical management unit of Medina-Sidonia (Cádiz). RESULTS: Most nurses in the sample group use some type of product to facilitate the extraction of the tick (10 of the 11 surveyed nurses, 90.9%). The most frequently used products were chloroethyl and local anesthetic. In addition, nine nurses use gentle traction with tweezers (81.82%) to remove the tick. In the physician sample group, 3 out of 12 respondents (25%) prescribe antibiotics in all cases and nine stated that they knew which antibiotic should be used as first choice. In both cases, a high number of healthcare providers confirm giving post-extraction advice to patients: 11 in the medical community (91.66%) and nine nurses (81.82%). CONCLUSIONS: We conclude that the performance of the healthcare providers that integrate this study does not closely follow general recommendations for extraction, treatment and follow-up care in patients with tick bites. Therefore, there is a need to improve the level of knowledge to ensure quality care in these instances.

INTRODUCCIÓN: En los centros de salud rurales se reciben con cierta frecuencia personas afectadas por picadura por garrapata. Hemos querido comparar el trabajo diario del equipo de atención primaria con la evidencia científica actual. Objetivos: Describir los métodos y tratamientos habituales ante una picadura por garrapata en la práctica diaria de los diferentes profesionales que componen la muestra, y compararlos con las recomendaciones generales que aportan mayor evidencia científica. MATERIAL Y MÉTODOS: Se trata de un estudio observacional, descriptivo y transversal, realizado mediante la recolección de datos a través de cuestionario auto cumplimentado anónimo. Este instrumento se aplicó a una muestra consecutiva constituida por enfermeros, médicos y pediatras de la Unidad de Gestión Clínica de Medina Sidonia (Cádiz, España). RESULTADOS: Una gran mayoría de enfermeros usa algún tipo de producto para facilitar la extracción del artrópodo (10 de los 11 encuestados, 90,91%), siendo los más utilizados el cloroetilo y la anestesia local. De ellos, 9 la realizan mediante tracción suave con pinzas (81,82%). De los médicos y pediatras, 3 de los 12 encuestados (25%) prescriben tratamiento antibiótico profiláctico en todos los casos. De los restantes, 9 facultativos afirman conocer cuál es el de elección y su posología. En ambos casos es elevado el número de profesionales que indican dar consejos post extracción, 11 en el colectivo médico (91,66%) y 9 en enfermería (81,82%). CONCLUSIONES: Se concluye que la actuación de los profesionales que han participado en este estudio en muchos aspectos no siguen las recomendaciones actuales para la extracción y tratamiento/seguimiento de pacientes afectados por picadura por garrapata. Por tanto, es necesario aumentar el grado de conocimientos de los mismos para garantizar una asistencia de calidad.

Calcifilaxis: a propósito de tres casos / Calciphylaxis: three-case report

La calcifilaxis o arteriolopatía urémica es una patología que afecta principalmente a pacientes con insuficiencia renal en diálisis, trasplantados renales e hiperparatiroidismo. Se manifiesta con úlceras necróticas intensamente dolorosas en piel. Presentamos tres pacientes con arteriolopatía urémica

Uremic arteriolopathy or calciphylaxis is a condition primarily affecting patients with kidney failure on dialysis, kidney transplant and hyperparathyroidism. It is characterized by intensely painful necrotic skin ulcers. We report three cases with uremic arteriolopathy.

Lupus eritematoso cutáneo. Estudio retrospectivo en 47 pacientes / Cutaneous lupus erythematosus. A retrospective study in 47 patients

El lupus eritematoso (LE) es una enfermedad multisistémica en cuya etiología influyen factores genéticos, ambientales y hormonales. En este trabajo efectuamos un estudio retrospectivo descriptivo de los pacientesmayores de 16 años que consultaron en el Servicio de Dermatología del HIGA SanMartín de La Plata durante el período comprendido entre enero de 2009 y agosto de 2014. Las lesiones mucocutáneas se dividieron según la clasificación de James Gilliam. Se recolectaron datos de edad, género, variantes clínicas y asociación conotras enfermedades autoinmunes. La información se obtuvo a partir de las historias clínicas del Servicio de Dermatología. Nuestro objetivo fue describir las distintas variantes clínicas de LE, establecer su distribución por género, edad y comparar los resultados con la bibliografía. Se evaluó un total de 47 pacientes con diagnóstico de LE. De éstos, el 78,72% fueron mujeres. Del total de pacientes, el 85,1% presentó lesiones específicas. Dentro de éstas (n = 50), 26 correspondieron a la variante de LECC (52%), 15 a LECA (30%) y 9 a LECSA (18%). Entre estos casos destacamos un LED secundario al uso de etanercept y 2 casos de síndrome de Rowell. Las lesiones inespecíficas se presentaron en 33 pacientes, en 7 de ellos fueron la única manifestación cutánea presente. Uno de estos pacientes presentó un lupus ampollar. Dentro de lasasociaciones encontradas, la más frecuente fue el síndrome antifosfolipídico, el cual se manifestó en un paciente con úlceras cutáneas necróticas...

Prevención y tratamiento de las úlceras por presión

Programa de prevención y tratamiento de úlceras por presión iniciado por la Dirección de Enfermería del Hospital Universitario de Bellvitge, en 1991 (AU)