Estimation of the prevalence of latent tuberculosis infection in patients with moderate to severe plaque psoriasis in Spain: The Latent study.

BACKGROUND AND OBJECTIVE: Anti-tumor necrosis factor therapy for moderate to severe psoriasis can increase the risk of active tuberculosis in patients who have latent tuberculosis infection (LTBI). The main objective of this study was to estimate the prevalence of LTBI in patients with moderate to severe plaque psoriasis being treated in dermatology clinics in Spain. MATERIAL AND METHOD: Non-interventional, cross-sectional, national epidemiological study conducted in Spain in 2011-2012. Patients with moderate to severe plaque psoriasis were included if they had undergone at least one tuberculin skin test (TST) and/or been evaluated with an interferon-γ release assay (IGRA) based on enzyme-linked immunosorbent assay (QuantiFERON(®) TB Gold In-Tube) in the 2 years preceding the study. RESULTS: Data for 440 patients were valid for analysis. In total, 97.7% of the patients had undergone a TST, with a positive result in 23%. Of the 238 patients in whom the initial result was negative, 5% converted to positive on re-testing for a booster effect. IGRA results were available for 16.8%, 20.5% of them positive. Two of the patients with positive IGRA results had a negative TST. The prevalence of LTBI in the whole sample was 26.6%. The degree of concordance between the TST and the IGRA was moderate (κ=0.516; P<.001). CONCLUSIONS: The prevalence of LTBI in this study was similar to previous estimates for Spain.

Urinary tract symptoms and erectile function in patients at risk of prostate cancer.

INTRODUCTION AND OBJECTIVE: We estimate that more tan 63000 prostate biopsies are performed in our country each year. There are no functional status data of those patients and if there is a relationship between biopsy result and functional status. In order to solve that question we have performed this study. MATERIAL AND METHOD: 1,128 prostate biopsies were included. Patients fill in the IPSS, IIEF-5 and ICIQ-SF questionnaires before the prostate biopsy was performed. A prospective data collection of clinical, pathological and questionnaires results was done. A descriptive analysis was carried out. IPSS and IIEF-5 results were categorized. Results were compared depending on the biopsy result. In the subgroup of patients with prostate cancer, questionnaires results were stratify according to the clinical risk group. RESULTS: The mean age of the sample was 65. Prostate cancer detection rate was 32,71%, 52,2% of the sample had mild lower urinary tract symptoms (LUTS) and 13,4% had severe LUTS at the time of the biopsy. Regarding the impact of LUTS on quality of life (QOL), only 12,6% showed a perfect QOL. More than 50 percent of patients suffered from some degree of erectile dysfunction at the time of the biopsy. According to ICIQ-SF, 24% of the sample experienced some kind of urinary incontinence, although it is true that most of them classified it as small amount. Patients with a positive biopsy had a lower IPSS and IIEF-5 average score. There were no differences in the prostate cancer detection rate stratified by the severity of LUTS. CONCLUSIONS: Patients undergoing prostate biopsy have, with a high probability, LUTS. Approximately 50% suffer from some degree of erectile dysfunction and 24% had some kind of urinary leakage.

Nephrometry scores: interobserver reproducibility and perioperative factors prediction.

OBJECTIVES: To validate the relation of the nephrometry scores in a series of patients who underwent partial nephrectomy with perioperative parameters and the urologist-radiologist reproducibility. MATERIAL AND METHODS: A retrospective study of open and laparoscopic partial nephrectomy patients performed between 2005 and 2012 registered in prospective filled out database. An urologist and a radiologist calculated the R.E.N.A.L., PADUA and C-index for 86 patients. We carried out a comparative study of the results using the Spearman and Pearson correlation indexes. RESULTS: Distribution according to the complexity of the tumors with the RENAL calculation was: 42 (49%) low, 35 (41%) moderated and 9 (11%) high complexity. According to PADUA: 35 (41%) low complexity, 32 (37%) intermediate and 19 (22%) high. No statistically significant correlation was found for the appearance of operative complications and the pathology results in case of RENAL and PADUA. A correlation was found in the case of PADUA in relation to the warm ischemia time. Positive correlation according to Spearman's index was found in RENAL, PADUA and C-index between urologist and radiologist evaluations. CONCLUSIONS: Nephrometry scores can be a useful tool to plan the surgical technique or approach. However, it is not clear if they are really predictors of surgical or pathologic parameters. The correlation between the urologist and radiologist seems to be sufficient to recommend their use by both specialties.

Design issues for population growth models.

We briefly review and discuss design issues for population growth and decline models. We then use a flexible growth and decline model as an illustrative example and apply optimal design theory to find optimal sampling times for estimating model parameters, specific parameters and interesting functions of the model parameters for the model with two real applications. Robustness properties of the optimal designs are investigated when nominal values or the model is mis-specified, and also under a different optimality criterion. To facilitate use of optimal design ideas in practice, we also introduce a website for generating a variety of optimal designs for popular models from different disciplines.

Application of the Doehlert design to optimize the signal obtained in photochemically induced fluorescence for the determination of eight phenylureas.

This work describes the optimization of a photochemically induced method for the detection of eight phenylureas has been developed by response surface methodology (RSM). These pesticides do not show native fluorescence but they were photolyzed into strongly fluorescent photoproducts under UV irradiation. The effect of the main variables affecting the yield of the photoderivatization reaction, and hence the fluorescence intensity, such as solvent, UV irradiation time and pH were optimized for each pesticide. A Doehlert design was applied in order to obtain maximum intensity fluorescence using response surface methodology. In general, a maximum was found for all pesticides using MeOH as organic solvent, except for diuron, whereas the effect of pH and irradiation time was different, according to each pesticide. Finally, the addition of beta-cyclodextrin upon the photochemically induced fluorescence intensity was investigate. The fluorescence intensity was only improved for monolinuron at a concentration of 4 x 10(-3) M of beta-cyclodextrin.

Intranets: las tecnologías de información y comunicación en función de la organización / Intranets: information and communication technologies in function of an organization

La intranet es una de las tecnologías más poderosas que pueden utilizarse en una organización, si se aplica de forma adecuada. Su diseño e implementación, en función de los objetivos organizacionales, provee a la institución de una herramienta fundamental para la gestión de la información que tributa a la gestión del conocimiento, y para la comunicación interna, que permite mejorar y agilizar la dinámica organizacional. Sin embargo, esto sólo es posible cuando los empleados participan activamente en su mantenimiento y actualización. Se realiza un acercamiento a esta tecnología, a partir de su definición conceptual y su caracterización en el contexto de las organizaciones. Se analiza su visión como herramienta para la gestión de la información y como medio de comunicación.

The intranet is one of the most powerful technologies than can be used in an organization, if it is adequately applied. Its design and implementation, oriented towards organizational objectives, provide the institution with a fundamental tool for the management of the information that contributes to knowledge management, and for the internal communication that permits to improve and to speed up organizational dynamics. Nevertheless, this is only possible when the employees participate actively in its maintenance and updating. An approach to this technology is carried out, starting from its conceptual definition and characterization in the context of the organizations. It is analyzed as a tool for the information management and as a communication medium.

Solid-phase total synthesis of trunkamide A(1).

Marine organisms are a rich source of novel, biologically active compounds. Herein, the solid-phase total synthesis of trunkamide A, currently in preclinical trials, is presented. Trunkamide A contains a thiazoline heterocycle and two residues of Ser and Thr with the hydroxy function modified as reverse prenyl (rPr). Cornerstones of the synthesis are as follows: (i) solid-phase peptide chain elongation using a quasi-orthogonal protecting scheme with tert-butyl and fluorenyl based groups, on a chlorotrityl resin; (ii) concourse of HOAt-based coupling reagents; and (iii) cyclizations in solution. Furthermore, the following synthetic steps are discussed: (i) preparation of the reverse prenyl derivatives of Ser and Thr; (ii) introduction of precursor of thiazoline as a protected amino thionoacid derivative; and (iii) formation of the thiazoline ring with DAST. All these features make this strategy particularly suitable for the large-scale synthesis of trunkamide A and other peptides containing the same motifs.

[Nursing report for patient discharge. A practical service experience]. / Informe de enfermería al alta. Una experiencia en la práctica asistencial.

The report for Medical Release Certificates which nurses fill out for patients after a period of hospitalization is one of the indispensable requirements that guarantee the continuity of treatment. Nursing professionals have the obligation to develop the mechanisms which allow for their services to be provided to the general public in an integrated, continuous manner. On the other hand, health service clients demand rapid, individualized, high quality treatment. Health service administrators, echoing these demands, pursue interdepartmental coordination and efficiency from health service system. This purpose of this article is to supply regulated information to the patient and his/her family as well as to health professionals which will serve as a guide while filling out the hospital medical release certificate. To this end, by means of a consensus among groups of experts, a document for medical release certificate reports, emission circuits, transfer of forms and their filing was elaborated. Furthermore, an attempt was made to introduce these reports as a habitual part in the procedures nurses follow while treating patients. The document designed and the circuits correspond to, in reality, the needs for regulated information. Other organizations have not stated any inconveniences to accepting this document and nurses are filling out these reports as the final part of the treatment process they lend to their patients. This document and its procedures guarantee its availability to all interested parties while increasing and accelerating interprofessional communication; in addition, this information is differentiated according to the needs of the receiver.

Determination of miconazole in pharmaceutical creams using internal standard and second derivative spectrophotometry.

A simple method is proposed for miconazole determination in pharmaceutical creams, based on extraction and second derivative spectrophotometry. In the presence of sodium lauryl sulfate (0.5%) and sulphuric acid (0.4 mol l(-1)), the miconazole and internal standard (IS) (methylene blue) were extracted to 100 microl of methylene chloride. The organic phase was evaporated in the nitrogen stream and the dry residue was dissolved in methanol (1.5 ml). The analytical signal was obtained as the ratio between second derivative absorbances measured at 236.9 nm (miconazole) and at 663.2 nm (IS). The use of IS in such multi-stage procedure enabled quite good analytical performance in calibration range 50.0 400 mg l(-1): linear correlation coefficient 0.9995, precision (measured as CV for ten replicates) at 50.0 mg l(-1) and at 400 mg l(-1) of miconazole was 1.5 and 0.5% respectively. Four commercial pharmaceutical creams were analyzed and the results obtained were in good agreement with the results obtained by reversed-phase high performance liquid chromatography (HPLC).

Improving orientation in head injured adults by repeated practice, multi-sensory input and peer participation.

The efficacy of using antecedent control procedures (practice, multi-sensory input and peer participation) in facilitating orientation to person, place and time with two survivors of traumatic brain injuries were tested in two studies. In the first investigation, a 23-year-old male was treated by presenting the orientation questions orally while being shown questions on written flashcards. Results suggest that correct responses to orientation questions only occurred when flashcards were coupled with oral questioning. The participant responded correctly to nearly 100% of all orientation questions within 2 weeks of initiating flashcards. In the second study, a 19-year-old male was asked to respond in writing to 20 orientation questions in a small group. The group had a leader and 4 TBI patients. Following this, group members who correctly answered the orientation questions, took turns reading orientation questions and providing the correct responses.

Esophageal electrocardiography: a new technology revives an old technique.

This study evaluates the clinical use of an easily swallowed bipolar electrode for recording an esophageal electrocardiogram (ECG). Fourteen patients were selected for bedside diagnosis (ECG group) because of arrhythmias difficult to evaluate using a standard 12-lead ECG. A second group of 27 non-selected patients scheduled for routine 24-hour ambulatory electrocardiographic recordings (ambulatory ECG group) had an esophageal ECG recorded as the "third channel." All 14 patients (100%) in the ECG group had excellent-quality tracings, and the esophageal ECG was diagnostic in 12 cases (86%). Of 27 patients in the ambulatory ECG group, 19 (70%) had fairly good to excellent-quality 24-hour esophageal pill tracings, with the esophageal ECG contributing to correct arrhythmia diagnosis in 11 patients (41%). It is concluded that this easily swallowed esophageal electrode provides an excellent-quality short-term ECG and often permits proper arrhythmia diagnosis in selected patients with arrhythmias. Good-quality 24-hour esophageal ambulatory electrocardiographic recordings can also be obtained that contribute to arrhythmia diagnosis in a limited number of unselected patients, and should be even more clinically useful in carefully selected patients.