Host biomarkers for early identification of severe imported Plasmodium falciparum malaria.

BACKGROUND: Severe imported P. falciparum malaria is a source of morbi-mortality in non-endemic regions. WHO criteria don't accurately classify patients at risk of complications. There is a need to evaluate new tools such as biomarkers to better identify patients with severe imported malaria. METHODS: A case-control study was conducted in Barcelona, from January 2011-January 2021. Adult patients with microbiologically confirmed P. falciparum malaria were classified according to WHO criteria. Patients with imported non-malarial fevers were included as controls. In each group, angiopoietin-1 (Ang-1), angiopoietin-2 (Ang-2), soluble triggering receptor expressed on myeloid cells (sTREM-1), C-reactive protein (CRP) and platelets were measured and their concentrations were compared between groups. New groups were made with a modified WHO severity classification and biomarkers' performance was evaluated using multiple imputation models. RESULTS: 131 participants were included: 52 severe malaria, 30 uncomplicated malaria and 49 non-malarial fever cases. All biomarkers except sTREM-1 showed significant differences between groups. Using the modified WHO severity classification, Ang-2 and CRP presented the best AUROC; 0.79 (95%CI 0.64-0.94) and 0.80(95%CI 0.67-0.93). A model combining CRP and Ang-2 showed the best AUROC, of 0.84(95%CI 0.68-0.99), with the highest sensitivity and specificity: 84.6%(95%CI 58.9-98.1) and 77.4% (95%CI 65.9-87.7), respectively. CONCLUSIONS: The combination of Ang-2 and CRP may be a reliable tool for the early identification of severe imported malaria. The use of a rapid prognostic test including the mentioned biomarkers could optimize imported malaria management, with the potential to decrease the rate of complications and hospitalizations in patients with imported malaria.

¿Se debe restringir el ingreso en cuidados intensivos solo a los pacientes más graves? / Should intensive care admission be restricted to the most severely ill patients?

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Factores y posibilidades terapéuticas en hospitalización parcial para adolescentes / The therapeutic potential of adolescent day hospital

El artículo pretende hacer un análisis de las posibilidades terapéuticas que ofrecen los hospitales de día para adolescentes, atendiendo a una dimensión cualitativa inherente a su estructura. En este sentido, veremos cómo se abren grandes posibilidades de trabajo frente a los tratamientos tradicionales, ya sean de tipo cognitivo-conductual, psicodinámico o sistémico. La terapéutica institucional no solo supone la posibilidad de trabajar de manera interdisciplinar e intensiva, sino que también permite vivenciar una experiencia emocional correctora diferenciada de lo que el adolescente repite en su familia y en sus relaciones de objeto interno. Además, si tenemos presente una posible focalización terapéutica institucional articulada con los objetivos terapéuticos individuales y familiares, veremos cómo se amplían todavía más estas posibilidades (AU)

This paper reflects on the therapeutic potential of adolescent day hospitals by focusing on the qualitative features of its particular structure. In a facility of this sort, new opportunities and possibilities of treatment are opened compared to traditional methods such as behavioural, cognitive, psychoanalytical or systemic therapy. Institutional therapeutics. In addition to working in an interdisciplinary and intensive manner, enables the teenager to experience a corrective emotional experience which differs from what he/she repeats in his/her family and internal object relations. A focalized institutional therapeutic intervention, articulated together with individual and family therapeutic objectives, can enhance the therapeutic possibilities of adolescent day hospitals even more (AU)

Síndrome de Austrian / Austrian Syndrome

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Oral health-related quality of life and nutritional status.

OBJECTIVES: This study examines whether oral health-related quality of life (OHRQoL) is associated with malnutrition risk in the elderly. METHODS: A cross-sectional study was designed using a representative sample of Spaniards over 65 years old. Data on sociodemographics and oral health status were gathered by interview and examination. Oral health-related quality of life was evaluated using the Geriatric Oral Health Assessment Index (GOHAI), and malnutrition risk using the Mini Nutritional Assessment (MNA). RESULTS: The final sample included 2,860 elderly, 41.7 percent males and 58.3 percent females, with a mean age of 73.7 +/- 6.8 years. Mean GOHAI score was 52.1 +/- 7.2, with 70.7 percent of the sample needing oral health care according to this index. The mean MNA score was 24.0 +/- 3.31; 3.5 percent of the elderly were malnourished, 31.5 percent were at risk of malnutrition, and 65.0 percent were considered adequately nourished. A strong association was found between mean GOHAI and MNA scores.

[Prevalence of malnutrition in the elderly Spanish population]. / Prevalencia de malnutrición en la población anciana española.

BACKGROUND: Malnutrition in elderly has become an important problem of health, and is associated with an increase of morbidity and mortality in this age group. The aim of this study was to determine the prevalence of malnutrition in the Spanish institutionalized and living home elderly people. SUBJECTS AND METHOD: A sample of 3,460 representative Spanish subjects older than 65 years old were studied (response rate of 96%). Nutritional status was gathered by Mini Nutritional Assessment questionnaire. RESULTS: The prevalence of malnutrition was 3,3% among elderly living at home and 7,7% among institutionalized people. Malnutrition was more prevalent in women and people with a lower income. Increase of malnutrition with age was observed. CONCLUSIONS: The observed prevalence of malnutrition in Spanish non-institutionalized elderly people was similar to observed in another populations. Sex, age and income were associated with a risk of malnutrition