Capacitors Based on Polypyrrole Nanowire Electrodeposits.

The electrochemical polymerization of polypyrrole nanowires is carried out using potentiodynamic and galvanostatic methods in order to enhance the performance of the modified electrodes as capacitor devices. The electrochemical, spectroscopic, and morphological properties are determined through cyclic voltammetry, Raman spectroscopy and scanning electron microscopy, respectively, corroborating the presence of PPy-nw in dimensions of 30 nm in diameter. Characterization as a capacitor revealed that the nanowire structure enhances key parameters such as specific capacitance with 60 times greater value than bulk polymer modification, in addition to a significant increase in stability. In this way, it is verified that electrodes modified with polypyrrole nanowires obtained in situ by electrochemical methods constitute an excellent candidate for the development of capacitors.

Ag@Au bimetallic nanoparticles: an easy and highly reproducible synthetic approach for photocatalysis.

An Ag@Au bimetallic nanoparticle (BNP) formulation was developed in this work. The proposed formulation was developed using photochemical and chemical methods and non-toxic reagents, showing high reproducibility and homogeneity. The synthesized BNPs have an average size of 7 nm, a core-shell-like structure (silver core and gold shell), high colloidal and long-term stability, and superior catalytic activity under darkness and white light irradiation conditions when evaluating the reduction of 4-nitrophenol to 4-aminophenolate, with respect to the monometallic Ag and Au counterparts. Furthermore, BNP concentrations as low as 2 nM were required to reach 100% conversions in less than 30 minutes. Therefore, considering future applications, the high surface-to-volume ratio of the prepared BNPs coupled with their well-defined optical properties makes them a great candidate for developing heterogeneous catalyzer materials to be applicable under sunlight as an environmentally friendly catalytic system.

Transcriptional response of Fusarium oxysporum and Neocosmospora solani challenged with amphotericin B or posaconazole.

Some species of fusaria are well-known pathogens of humans, animals and plants. Fusarium oxysporum and Neocosmospora solani (formerly Fusarium solani) cause human infections that range from onychomycosis or keratitis to severe disseminated infections. In general, these infections are difficult to treat due to poor therapeutic responses in immunocompromised patients. Despite that, little is known about the molecular mechanisms and transcriptional changes responsible for the antifungal resistance in fusaria. To shed light on the transcriptional response to antifungals, we carried out the first reported high-throughput RNA-seq analysis for F. oxysporum and N. solani that had been exposed to amphotericin B (AMB) and posaconazole (PSC). We detected significant differences between the transcriptional profiles of the two species and we found that some oxidation-reduction, metabolic, cellular and transport processes were regulated differentially by both fungi. The same was found with several genes from the ergosterol synthesis, efflux pumps, oxidative stress response and membrane biosynthesis pathways. A significant up-regulation of the C-22 sterol desaturase (ERG5), the sterol 24-C-methyltransferase (ERG6) gene, the glutathione S-transferase (GST) gene and of several members of the major facilitator superfamily (MSF) was demonstrated in this study after treating F. oxysporum with AMB. These results offer a good overview of transcriptional changes after exposure to commonly used antifungals, highlights the genes that are related to resistance mechanisms of these fungi, which will be a valuable tool for identifying causes of failure of treatments.

Construction of a simple thermoluminescence and optically stimulated luminescence reader for luminescence dosimetry research.

This work describes the construction of a simple thermoluminescence (TL) and optically stimulated luminescence (OSL) reader using commercial components such as temperature and power controllers for thermal stimulation, as well as green laser diodes (532 nm) for optical stimulation. To evaluate the performance of the equipment, TL measurements were carried out on the built equipment and Risø TL/OSL reader using Al2O3:C chip dosimeters. Both measurements showed the same glow curve with two TL peaks, one with low intensity at 85 °C and the other with high intensity at 220 °C. OSL measurements in Al2O3:C chips showed a well-behaved exponential decay signal and linear behavior of OSL intensity for doses between 2 and 10 mGy with a rough calculation of minimum detection dose of ∼2 µGy.

Relationship between photo-physical and electrochemical properties of D-π-A compounds regarding solar cell applications. 1. Substituent type effect in photovoltaic performance.

Studying the electrochemical characteristics is an important step for determining interactions between molecules and the chemical environment. Moreover, the electrochemical evaluation of dyes is highly needed to establish the behavior of electro-active chemical species inside dye-sensitized solar cells (DSSCs). Four compounds, M8-1, M8-2, M8-O1, and M8-O2 (with a common organic structure (E)-2-cyano-3-(5-((E)-2-(9,9-diethyl-7-(phenylamino)-9H-fluoren-2-yl)vinyl)thiophen-2-yl)acrylic acid), are studied in two solvents, tetrahydrofuran (THF) and dimethylsulfoxide (DMSO). Among the studied compounds, M8-1 has highlighted characteristics compared with the others: its ground and excited states oxidation potential are the highest (1.14 and -1.22 V, respectively). Also, it shows the lowest energy gap between the excited state oxidation potential and the TiO2 conduction band. Relating to the substituent effect, the shorter the length, the higher the energetic difference in the electronic transition (M8-1 and 2). Comparing characteristics through quantum chemistry, the values obtained in DMSO are the most predictable. The injection energies signal that M8-1 is the best injector. The performances in solar cells are measured in three TiO2 materials: Degussa (D-TiO2), active opaque (A-TiO2), and transparent (T-TiO2). The IPCE results show the A > T > D average tendency, and the family of substituted alkyl has higher values than the alcoxyl one. Furthermore, in the first family the methyl substituent has a higher value than the ethyl one. M8-1 has the highest IPCE value, on average. In terms of efficiency, the alkyl substituted family again has higher values than the alcoxyl family. On average, the methyl substituent has a higher value than the ethyl one in both families. M8-1 has the highest efficiency value.

Congenital CLN8 disease of neuronal ceroid lipofuscinosis: a novel phenotype. / Enfermedad CLN8 congenita de lipofuscinosis neuronal ceroidea: un nuevo fenotipo.

INTRODUCTION: CLN8 disease is one of the thirteen recognized genetic types of neuronal ceroid lipofuscinosis, a group of neurodegenerative lysosomal storage disorders, most frequent in childhood. A putative 286 amino acids transmembrane CLN8 protein with unknown function is affected. Pathological variants in the CLN8 gene were associated with two different phenotypes: variant late-infantile in individuals from many countries worldwide, and epilepsy progressive with mental retardation, appearing in Finnish and Turkish subjects. CASE REPORT: The girl showed psychomotor delay and dementia since birth, tonic-clonic seizures, myoclonus, ataxia with cerebellar atrophy, and early death at 12 years old. Electron microscopy of the skin showed mixed GROD, curvilinear, fingerprint cytosomes and mitochondrial hypertrophy. Two pathological DNA variants in the CLN8 gene (exon 2 c.1A>G; p.?/ exon 3 c.792C>G; p.Asn264Lys) were found confirming a compound heterozygous genotype. CONCLUSION: This case is the Latin American index for a new congenital phenotype of the CLN8 disease. The congenital phenotype has to be added to the clinical spectrum of the CLN8 disease. The suspicion of CLN8 disease should be genetically sustained in challenging cases of a neurodegenerative syndrome with psychomotor delay since birth, speech difficulty and seizures. The course includes ataxia, cerebellar atrophy, and early death.

TITLE: Enfermedad CLN8 congenita de lipofuscinosis neuronal ceroidea: un nuevo fenotipo.Introduccion. La enfermedad CLN8 es uno de los 13 tipos geneticos reconocidos de lipofuscinosis neuronal ceroidea, un grupo de trastornos neurodegenerativos de acumulacion lisosomica, los mas frecuentes en la infancia. La causan mutaciones en la proteina transmembrana CLN8 de 286 aminoacidos, cuya funcion se desconoce. Las variantes patologicas en el gen CLN8 se asociaron con dos fenotipos diferentes: la variante infantil tardia en individuos de diversos paises alrededor del mundo, y la epilepsia progresiva con retraso mental, que aparece en pacientes finlandeses y turcos. Caso clinico. Niña que mostro retraso psicomotor y demencia desde el nacimiento, convulsiones tonicoclonicas, mioclonia, ataxia con atrofia cerebelosa y muerte temprana a los 12 años. La microscopia electronica de la piel mostro una mezcla de citosomas con patrones de depositos osmiofilicos granulares, curvilineos y de «huella digital¼, y mitocondrias hipertrofiadas. Se encontraron dos variantes patologicas de ADN en el gen CLN8 (exon 2 c.1A>G; p.?/ exon 3 c.792C>G; p.Asn264Lys), lo que confirmo un genotipo heterocigoto compuesto. Conclusion. Este es el caso indice en America Latina para el nuevo fenotipo congenito de la enfermedad CLN8. La sospecha de esta patologia deberia sustentarse geneticamente en casos de sindrome neurodegenerativo con retraso psicomotor desde el nacimiento, dificultad del habla y convulsiones. El curso clinico incluye ataxia, atrofia cerebelosa y muerte temprana.

Comparison of Diagnostic Accuracy and Impact of Magnetic Resonance Imaging and Colonoscopy for the Management of Crohn's Disease.

AIMS: The objective of the current study was to compare two patient assessment strategies using colonoscopy and MRI alternatively as first- and second-line examinations. METHODS: Clinical data, endoscopy and magnetic resonance imaging (MRI) examinations of 100 patients diagnosed with ileocolonic Crohn's disease (CD) performed within 1 week were blindly reviewed by 4 clinical investigators. Two investigators evaluated MRI followed by colonoscopy for 50 cases and the same examinations in reverse order for another 50 cases; the other 2 investigators evaluated the same cases switching the order of examinations. The assessments included the likelihood of the presence of inflammation, stenosis, fistula and abscess, and therapeutic recommendations. RESULTS: Information from the first examination was considered sufficient for management in 80% of cases for MRI and only 34% of cases for colonoscopy (p < 0.001). Adding MRI to the information from colonoscopy changed the clinicians' confidence grade in a higher proportion of patients than adding colonoscopy to information from MRI for the diagnosis of disease activity (10 vs 4%, p = 0.03), stenosis (25 vs 9%, p < 0.001), fistula (31 vs 0%, p < 0.001) and internal abscess (27 vs 0%, p < 0.001). Indications for anti-tumour necrosis factor (TNF) therapy (51 vs 37%, F = 0.006), and surgery (12 vs 5%, F = 0.019) were more frequent after MRI than after colonoscopy as first examination. As a second examination, MRI led to change in therapy in a higher proportion of patients than colonoscopy (28 vs 8%, p < 0.001). CONCLUSIONS: In CD, information provided by MRI has a higher impact on patient management than colonoscopy and may be considered as a first-line examination for CD assessment.

[Caregiver burden and social support perceived by patients with chronic obstructive pulmonary disease]. / Sobrecarga del cuidador y apoyo social percibido por pacientes con enfermedad pulmonar obstructiva crónica (EPOC).

OBJECTIVES: To analyse the psycho-emotional state of the primary caregiver, the burden of the usual care in patients with exacerbations of COPD and perceived social support on the part of the patient. MATERIAL AND METHODS: The study included patients and caregivers who came for a specific visit to the COPD clinic of the Chest Diseases Department the Regional Hospital of Malaga. A total of 151 patients with severe/very severe COPD according to the functional classification of severity by Global Initiative for Chronic Obstructive Lung Disease (GOLD) and 96 caregivers were followed-up over a year. The Zarit burden scale (caregiver burden interview) was used, as well as the Duke-UNC questionnaire, validated in Spanish to determine the burden of the caregiver and the social support as perceived by the patient, respectively. The demographic variables recorded were, sex, age, population, cohabitation, relationship and work activity. RESULTS: The mean age of patients was 66.1 ± 9 years versus their caregivers 60.2 ± 11.5 years. All of the patients, of whom 88.1% were males, were occupationally inactive. The large majority (76.8%) were living with a caregiver, generally a wife or daughter. The social support was perceived as normal by 79.5%, and 19% perceived the social support as low. No burden or mild burden was reported by 79.2% with the Zarit questionnaire. CONCLUSIONS: The mean age of the patients, as well as their primary caregivers, was over 60 years of age. The score on perceived social support showed normal values, except for patients who live alone in rural areas. The Zarit questionnaire gave results of mild or no burden. There was no statistically significant correlation between the Zarit questionnaire and the patient health status, rural or urban area, relationship, or age of the caregiver.

Population pharmacokinetics of rifampicin in Mexican patients with tuberculosis.

WHAT IS KNOWN AND OBJECTIVE: Rifampicin (RIF) shows wide variability in its pharmacokinetics. The purpose of this study was to develop and validate a population pharmacokinetic model to characterize the inter- and intra-individual variability in pharmacokinetic parameters of RIF in Mexican patients. METHODS: Ninety-four patients receiving antituberculosis therapy participated in this prospective study. Plasma concentration-time data were described using a one-compartment model with lag time, absorption and first-order elimination. The potential influence of demographic and clinical characteristics of the patients, and the pharmaceutical formulation (A, B, C and D) on the pharmacokinetics parameters, was evaluated by non-linear mixed-effect modelling (nonmem). Seventy-seven additional patients participated in the validation of the model. RESULTS AND DISCUSSION: The final population pharmacokinetic model obtained was as follows: apparent clearance CL/F = 8·17 L/h (1·40 as high for males), apparent distribution volume V(d)/F = 50·1 L (1·29 as high for males), absorption rate constant K(aA) = 0·391/h, K(aB,C,D) = 2·70/h, relative bioavailability F(A) = 0·468, F(B,C,D) = 1, lag time in the absorption phase T(lag) = 0·264 h. The final model improved the precision on the parameter estimates (CL/F, V(d) /F and K(a) by 31·9%, 16·7% and 92·9%, respectively). The residual variability was 27·3%. WHAT IS NEW AND CONCLUSION: Gender was associated with changes in CL/F and V(d) /F whereas the pharmaceutical formulation was associated with changes in F and altered the K(a) . The validation data set showed that the model could be used in clinical practice for Bayesian dose adjustment of RIF in TB patients.

Compounds derived from endophytes: a review of phytochemistry and pharmacology.

OBJECTIVE: Endophytes, microorganisms that reside in the tissues of living plants, are a promising source of novel compounds with biological activity, or an alternative source of compounds originally isolated from higher plants. The intent of this review is to provide insights into their occurrence in nature, the products that they make, and how some of these organisms are beginning to show some potential for human use. METHODS: Information for analysis of endophytic microorganisms was obtained from libraries and Internet scientific databases such as Scirus, Google Scholar, CAB-Abstracts, MedlinePlus, PubMed, SciFinder, Scopus and Web of Science. RESULTS: Many of the compounds reported here were isolated exclusively from endophytes in culture, while other compounds had been previously reported as chemical constituents of higher plants. A survey of the literature shows endophytic microorganisms are mainly known for their alkaloids with cytotoxic, chemopreventive, anti-metastatic and antitumor properties used in the treatment of several types of cancer. The studies of these alkaloids highlight the existence of various potential leads for the development of novel anti-cancer agents. Modern pharmacology studies demonstrated that their crude extracts and active compounds possess wide pharmacological actions, especially for anti-microbial drug discovery, with neuroprotective, antioxidant, nematicidal, antiplasmodium, anti-inflammatory activities. AIM OF THE REVIEW: This review summarizes the up-to-date and comprehensive information on compounds from endophytes fungi from 1995 to 2011 that relates to 313 compounds isolated from endophytic microorganisms, together with the botany, phytochemistry, pharmacology and toxicology, and discusses possible trends and the scope for future research of endophytes.

Low sex ratio in children of professional basketball players in Spain.

The aim of this study was to ascertain the variations in the reproductive sex ratio (number of men to number of women) among male professional basketball players in Spain. This retrospective, cross-sectional study is based on a survey conducted in the Spanish professional basketball leagues during the season 2009-2010. A total of 172 professional basketball players completed an anonymous survey. Forty-seven of the respondents had offspring, with a total of 61 children: 70% girls and 30% boys, with a sex ratio value of 0.42. Thirty-three basketball players were Caucasian (CAU), with 44 children, nine boys and 35 girls (sex ratio = 0.26). Fourteen were black, of African heritage (AFR), with 17 children, nine boys and eight girls, (sex ratio = 1.12). Differences (P < 0.01) were found in offspring sex ratio values for all basketball players (sex ratio = 0.42) and for CAU group (sex ratio = 0.26) when compared with the general Spanish population (sex ratio = 1.06). Moreover, a significant seasonal variation was observed in CAU offspring sex ratio during the first quarter compared with the rest of the year (0.66 versus 0.12) (P < 0.03). In conclusion, a significant increase in the sex ratio value in favour of female offspring was observed in the group of CAU professional basketball players.

Therapeutic approaches to the challenge of neuronal ceroid lipofuscinoses.

The Neuronal Ceroid Lipofuscinoses (NCLs) are lysosomal storage diseases (LSDs) affecting the central nervous system (CNS), with generally recessive inheritance. They are characterized by pathological lipofuscin-like material accumulating in cells. The clinical phenotypes at all onset ages show progressive loss of vision, decreasing cognitive and motor skills, epileptic seizures and premature death, with dementia without visual loss prominent in the rarer adult forms. Eight causal genes, CLN10/CTSD, CLN1/PPT1, CLN2/TPP1, CLN3, CLN5, CLN6, CLN7/MFSD8, CLN8, with more than 265 mutations and 38 polymorphisms (http://www.ucl.ac.uk/ncl) have been described. Other NCL genes are hypothesized, including CLN4 and CLN9; CLCN6, CLCN7 and possibly SGSH are under study. Some therapeutic strategies applied to other LSDs with significant systemic involvement would not be effective in NCLs due to the necessity of passing the blood brain barrier to prevent the neurodegeneration, repair or restore the CNS functionality. There are therapies for the NCLs currently at preclinical stages and under phase 1 trials to establish safety in affected children. These approaches involve enzyme replacement, gene therapy, neural stem cell replacement, immune therapy and other pharmacological approaches. In the next decade, progress in the understanding of the natural history and the biochemical and molecular cascade of events relevant to the pathogenesis of these diseases in humans and animal models will be required to achieve significant therapeutic advances.

Relative bioavailability of rifampicin in a three-drug fixed-dose combination formulation.

SETTING: In a previous monitoring study of rifampicin (RMP) in tuberculosis (TB) patients treated with a generic formulation of a three-drug fixed-dose combination (3FDC), very low RMP levels were found. This led us to investigate the bioavailability of the product. OBJECTIVE: To investigate the relative bioavailability of RMP from a generic 3FDC formulation used in the Mexican health care system, in comparison to the reference product, in healthy volunteers. DESIGN: Two-period, two-sequence crossover study. RESULTS: Mean pharmacokinetic parameter values obtained for the test and reference product were respectively 3.13 ± 2.01 µg/ml and 9.95 ± 2.66 µg/ml for peak plasma concentration (C(max)), 15.51 ± 9.77 µg.h/ml and 58.03 ± 16.1 µg.h/ml for area under the concentration (AUC) time curve to the last measurable concentration (AUC(0-12h)) and 17.92 ± 10.66 and 68.43 ± 22.39 µg.h/ml for AUC up to time infinity (AUC(0-∞)). The test/reference ratio of the means (90%CI) was 25.36% (17.33-37.10) for C(max), 21.25% (14.61-30.89) for AUC(0-12h) and 22.08% (15.44-31.56) for AUC(0-∞). These results did not meet the criteria for bioequivalence. CONCLUSION: The test product displayed delayed absorption and markedly inferior RMP bioavailability in comparison to the reference product. RMP-containing generic formulations should only be used if their bioavailability has been evaluated to ensure interchangeability with the reference product and to avoid the risk of markedly inferior RMP exposure through the use of such a product.

[Body composition in chronic kidney disease patients and haemodialysis]. / Composición corporal en pacientes con insuficiencia renal crónica y hemodiálisis.

BACKGROUND: Nutritional alterations are highly prevalent among patients with chronic kidney diseases stage 5 who receive haemodialysis therapy. Body composition alterations are directly related to an increased morbidity and mortality. Nutritional assessment represents a cardinal intervention oriented to improve the outcome and survival in chronic renal patients. OBJECTIVE: To evaluate body composition in a mexican population with chronic kidney disease stage 5 and haemodialysis therapy. METHODS: Prospective, descriptive and transversal study. Free fatty mass (FFM) and fatty mass (FM) were evaluated by means of bioelectric impedance (BIE), anthropometrics measures (MPA) and dual-energy x-ray absorptiometry (DEXA). RESULTS: 20 patients were evaluated (12 females and 8 males). Mean age was 51.9 +/- 19.3 years. Mean weight was 59.5 +/- 10.5 kg and mean body mass index was 24.9 +/- 3.1 kg/m(2). Mean FFM values were 42.4 +/- 8.6 kg (MPA), 43.6 +/- 8.9 kg (DEXA) y 42.8 +/- 10.2 kg (IBE). Mean FM values: 17.2 +/- 6.2 kg (MPA), 15.9 +/- 6.9 kg (DEXA) and 16.9 +/- 6.9 kg (IBE). Correlation coefficients between the three methods were: FFM, 0.982 (MPA vs IBE), 0.963 (MPA vs DEXA) y 0.947 (IBE vs DEXA). Fatty mass: 0.975 (MPAvs IBE), 0.925 (MPA vs DEXA) y 0.898 (IBE vs DEXA). CONCLUSION: In the studied population, fatty mass was increased and FFM was within the reference ranges. There was not evidence of protein malnutrition. MPA and BIE are practical and useful tools to evaluate body composition in mexican chronic kidney disease patients who receive haemodialysis therapy. The results obtained by means of MPA and BIE correlated with results obtained by DEXA.

Receptor for advanced glycation end products in donor lungs is associated with primary graft dysfunction after lung transplantation.

Development of primary graft dysfunction (PGD) is associated with poor outcomes after transplantation. We hypothesized that Receptor for Advanced Glycation End-products (RAGE) levels in donor lungs is associated with the development of PGD. Furthermore, we hypothesized that RAGE levels would be increased with PGD in recipients after transplantation. We measured RAGE in bronchoalveolar lavage fluid (BALf) from 25 donors and 34 recipients. RAGE was also detected in biopsies (transbronchial biopsy) from recipients with and without PGD. RAGE levels were significantly higher in donor lungs that subsequently developed sustained PGD versus transplanted lungs that did not display PGD. Donor RAGE level was a predictor of recipient PGD (odds ratio = 1.768 per 0.25 ng/mL increase in donor RAGE level). In addition, RAGE levels remained high for 14 days in those recipients that developed severe graft dysfunction. Recipients may be at higher risk for developing PGD if they receive transplanted organs that have higher levels of soluble RAGE prior to explantation. Moreover, the clinical and pathologic abnormalities associated with PGD posttransplantation are associated with increased RAGE expression. These findings also raise the possibility that targeting the RAGE signaling pathway could be a novel strategy for treatment and/or prevention of PGD.

An integrated strategy for the diagnosis of neuronal ceroid lipofuscinosis types 1 (CLN1) and 2 (CLN2) in eleven Latin American patients.

The neuronal ceroid lipofuscinoses (NCLs) are a family of progressive neurodegenerative diseases that are characterized by the cellular accumulation of ceroid lipofuscin-like bodies. NCL type 1 (CLN1) and type 2 (CLN2) are caused by deficiencies of the lysosomal enzymes palmitoyl-protein thioesterase 1 (PPT-1) and tripeptidyl peptidase 1 (TPP-1), respectively. In this study, 118 Latin American patients were examined for NCL using an integrated multidisciplinary program. This revealed two patients affected by CLN1 and nine by CLN2. Both CLN1 patients had a juvenile-onset phenotype with mutation studies of one patient demonstrating the known mutation p.Arg151X and a novel mutation in intron 3, c.363-3T>G. Six of the CLN2 patients presented with the 'classical' late-infantile phenotype. The remaining three patients, who were siblings, presented with a 'protracted' phenotype and had a higher level of residual TPP-1 activity than the 'classical' CLN2 patients. Genotype analysis of the TPP1 gene in the 'classical' CLN2 patients showed the presence of the known mutation p.Arg208X and the novel mutations p.Leu104X, p.Asp276Val, and p.Ala453Val. The siblings with the 'protracted' phenotype were heterozygous for two known TPP1 mutations, p.Gln66X and c.887-10A>G. This multidisciplinary program is also being used to diagnose other NCL types.

Reservorio venoso subcutáneo en pacientes oncológicos terminales. Experiencia en un equipo de atención domiciliaria / No disponible

Objetivo: describir el perfil del paciente oncológico terminal con reservorio venoso subcutáneo (RVS) en un equipo de atención domiciliaria; exponer los procedimientos para los que se ha utilizado; conocer las complicaciones tardías asociadas. Métodos: estudio descriptivo prospectivo de enfermos atendidos en un equipo de atención domiciliaria. En todos los pacientes se valoró: edad, sexo y tipo de tumor. En aquellos con RVS se registró: motivo de implantación, procedimientos y complicaciones asociadas. Resultados: se evaluaron 488 pacientes. De ellos, 71 (14,5%) eran portadores de RVS. Respecto al total de población atendida, la edad media delos pacientes con RVS fue menor (55 vs. 68 años; p < 0,005) y el porcentaje de mujeres era mayor (56,3%). Los tumores más frecuentes fueron: mama (31%), gástrico (18,3%) y pulmón (15,5%). El reservorio fue utilizado para extracción de muestras sanguíneas, administración de medicación y nutrición parenteral domiciliaria (NPD). Se detectaron 5 complicaciones en 4 pacientes: acodamiento del catéter (1), flebitis (1) e infección (3 episodios en 2 pacientes con nutrición parenteral domiciliaria). No se detectó ningún caso de obstrucción. Conclusiones: el perfil de usuario de RVS encontrado en nuestro trabajo es el de una mujer joven con neoplasia de mama. Los reservorios fueron utilizados para extracción de muestras sanguíneas, administración de medicación y NPD. Las complicaciones observadas son muy escasas y en ningún caso obligaron a la retirada del catéter. La utilización de un protocolo de cuidados del catéter puede minimizar las complicaciones y facilitar el uso de estos reservorios (AU)

Objective: to describe the profile of the patient with terminal cancer who carries a central venous subcutaneous system (CVS) in a team of domiciliary care; to discuss the procedures for those who have one; to know late complications. Methods: a descriptive market study of patients cared for by a home care team. For all patients, age, sex and type of tumor were assessed. In those with CVS the reason for implantation, procedures, and associated complications were recorded. Results: 488 patients were evaluated. Of them, 71 (14.5%) were CVS carriers. With regard to the whole study population, mid-age patients with CVS were a minority (55 vs. 68 years; p < 0.005) and the percentage of women was higher (56.3%). The most frequent tumors were: breast (31%), gastric (18.3%) and lung (15.5%). The system was used for the extraction of blood samples, administration of medication and home parenteral nutrition (HPN). Five complications were detected in 4 patients: blocked catheter (1), phlebitis (1) and infection (3 episodes in 2 patients with HPN). No case of obstruction was detected. Conclusions: the CVS user profile found in our work is that of a young woman with breast cancer. Systems were used for drawing blood samples, and administering medication and HPN. Complications were few and in no case led to catheter withdrawal. Using a protocol for catheter care can minimize complications and facilitate the use of these systems (AU)

[Nutritional score risk for mortality in critically ill patients (NSRR: Nutritional Score Risk Research)]. / Puntaje de detección de riesgo nutricional para mortalidad en pacientes críticamente enfermos (NSRR: Nutritional Score Risk Research).

AIM: The aim of our study has been applying a nutritional score risk to mortality in a group of patients who are in the Intensive Care Unit with or without previous disease. PATIENTS AND INTERVENTIONS: a prospective randomized study is designed. PLACE: At the intensive care units. PATIENTS: 228 admitted patients since april 2004 to december 2006 were included. The surveys were filled by the near relative who lived with the patient and/or ignorance of its pattern of food ingestion during the newspaper the survey was discarded. Critically ill patients were selected at random with pathologies (neurocritical, sepsis, trauma, patients, obstetrics critics, etc.) in 2 units of adult intensive cares. INTERVENTIONS: Dialogue with the families. VARIABLES: The selected nutritional score (NSR) which is elaborated for greater patients of 65 years now is modified to be used in intensive care unit, it is a questionnaire that can be very useful in the detection of initial nutritional risk of the critically ill patients. RESULTS: Our study demonstrated that the alterations of the NSR can be observed in all ages, established by not having a direct correlation between the age and the found NSR (r = 0.15, p = 0.018). This supports the concept of use of the NSR in the adult ages that are admitted in the intensive care unit. In addition, was found that suffering chronic diseases that alter the conditions of ingestion if would feed suitable is an isolated parameter significant to increase the death probability if the patient is in the ICU (p = 0.002). CONCLUSION: Patients with a high NSR at admittion to the intensive care unit for acute pathology are under risk to mortality by nutritional risk.