The role of biochar and green compost amendments in the adsorption, leaching, and degradation of sulfamethoxazole in basic soil.

The fate of the antibiotic sulfamethoxazole in amended soils remains unclear, moreover in basic soils. This work aimed to assess the adsorption, leaching, and biodegradation of sulfamethoxazole in unamended and biochar from holm oak pruning (BC)- and green compost from urban pruning (CG)-amended basic soil. Adsorption properties of the organic amendments and soil were determined by adsorption isotherms of sulfamethoxazole. The leachability of this antibiotic from unamended (Soil) and BC- (Soil + BC) and GC- (Soil + GC) amended soil was determined by leaching columns using water as solvent up to 250 mL. Finally, Soil, Soil + BC, and Soil + GC were spiked with sulfamethoxazole and incubated for 42 days. The degradation rate and microbial activity were periodically monitored. Adsorption isotherms showed poor adsorption of sulfamethoxazole in unamended basic soil. BC and CG showed good adsorption capacity. Soil + BC and Soil + GC increased the sulfamethoxazole adsorption capacity of the soil. The low sulfamethoxazole adsorption of Soil produced quick and intense sulfamethoxazole leaching. Soil + BC reduced the sulfamethoxazole leaching, unlike to Soil + GC which enhanced it concerning Soil. The pH of adsorption isotherms and leachates indicate that the anion of sulfamethoxazole was the major specie in unamended and amended soil. CG enhanced the microbial activity of the soil and promoted the degradability of sulfamethoxazole. In contrast, the high adsorption and low biostimulation effect of BC in soil reduced the degradation of sulfamethoxazole. The half-life of sulfamethoxazole was 2.6, 6.9, and 11.9 days for Soil + GC, Soil, and Soil + BC, respectively. This work shows the benefits and risks of two organic amendments, BC and GC, for the environmental fate of sulfamethoxazole. The different nature of the organic carbon of the amendments was responsible for the different effects on the soil.

Estrategias en atención primaria frente a la covid-19. Liderazgo y resolución enfermera / Strategies in primary care against covid-19. Leadership and nurse resolution

La pandemia de la COVID-19 ha significado un reto para el sistema sanitario. La atención primaria ha tenido que reestructurarse para dar atención a los pacientes con sintomatología compatible con COVID-19 y al resto de patologías previas de siempre. Se han establecido estrategias con el objetivo de reducir el riesgo, para los pacientes y el personal, de la exposición innecesaria a posibles fuentes de infección por COVID-19. En el CAP de Can Trias (Viladecavalls), se optó por la creación de la consulta respiratorio-COVID enfermera de atención a los pacientes que presentan síntomas compatibles con COVID-19, donde la enfermera los valora y explora, y determina si resuelve el problema de salud o deriva al médico u otro dispositivo.Se evaluó la consulta respiratorio-COVID enfermera, mostrando una alta capacidad resolutiva y un bajo índice de reconsulta en la Gestión Enfermera de la Demanda (GED) de los pacientes con clínica compatible con COVID-19.La experiencia pone de manifiesto el gran potencial, autonomía y capacidad de adaptación de las enfermeras, siendo una oportunidad de consolidar y potenciar su valía y competencias. (AU)

The COVID-19 pandemic has been a challenge for the public health system. Primary care had to be restructured to treat patients with COVID-19 symptoms, as well as continue treating the usual pathologies. Strategies were set up in order to minimise risks of unnecessary exposure to possible sources of COVID-19 infection, for patients and health workers alike. In the primary care centre CAP de Can Trias (Viladecavalls), a special consultation of COVID-respiratory nurse care was put into place for patients with clinical symptoms compatible with COVID, where the nurse would observe, asses, and determine if the health issue can be resolved, or if they need further medical attention. This system was evaluated, which proved to have a high-resolution capacity, and a low rate of a second medical assessment in the Nurse Demand Management (GED) of patients with clinical symptoms compatible with COVID-19. Experience has proven the great potential, autonomy, and adaptability of the nursing team, having also become an opportunity to consolidate and boost their worth and proficiency. (AU)

Estudio de calidad de vida y adherencia al tratamiento en pacientes de 2 a 16 años con diabetes mellitus tipo 1 en Andalucía / Study of the quality of life and adherence to treatment in patients from 2 to 16 years-old with type 1 diabetes mellitus in Andalusia, Spain

INTRODUCCIÓN: La diabetes mellitus 1 es la segunda enfermedad crónica y el trastorno endocrino-metabólico más frecuente en la infancia. Se estima una prevalencia entre 1,1 y 1,4/1000 menores de 15 años. En Andalucía la prevalencia es mayor (1,7 por mil). El objetivo del estudio es analizar la calidad de vida y adherencia al tratamiento, centrándonos en la población pediátrica de Andalucía. MÉTODOS: Estudio analítico observacional transversal multicéntrico. La muestra fue de 178 pacientes de seis hospitales con Endocrinología Pediátrica. A cada paciente se le entregaron dos cuestionarios; la encuesta de calidad de vida (PedsQL versión 3.0) y adherencia al tratamiento SCI-R. Además, se recogieron datos demográficos, clínicos, del control metabólico, y complicaciones. RESULTADOS: Se obtuvieron niveles altos tanto en la adherencia como en la calidad de vida. La primera se relacionó de forma inversa con la edad y la HbA1c, aunque el coeficiente fue tan bajo que no permite sacar conclusiones significativas. La calidad de vida se asoció con el uso de sistema de monitorización continua de glucosa en tiempo real (MCG-TR) integrado con ISCI, así como con menos hipoglucemias graves y complicaciones renales. La HbA1c media fue 7,1%. El 12,9% de los pacientes usaban ISCI. El 83,2% empleaban exclusivamente la glucemia capilar, mientras que el 16,8% usaba algún dispositivo de monitorización de glucosa intersticial. CONCLUSIONES: Se trata del primer estudio realizado en Andalucía que analiza la calidad de vida en pacientes pediátricos. Los resultados muestran niveles altos de adherencia y de calidad de vida, además de un buen control metabólico

INTRODUCTION: Diabetes mellitus 1 is the second most frequent chronic disease, and the most frequent endocrine-metabolic disorder in childhood. The estimated prevalence is between 1.1 and 1.4 / 1000 children under 15 years years-old. In Andalusia the prevalence is higher (1.7 per thousand). The objective of the study is to evaluate health-related quality of life (HRQoL) and adherence to treatment, specifically in the paediatric population of Andalusia. METHODS: A multicentre cross-sectional observational analytical study was conducted on a sample of 178 patients from six hospitals with a Paediatric Endocrinology Unit. Each patient received two questionnaires; quality of life (PedsQL version 3.0) and adherence to the self-care recommendations (SCI-R) treatment. The demographic, clinical, metabolic control data, and possible complications were also collected. RESULTS: High levels were obtained in both adherence and health-related quality of life (HRQoL). Adherence was inversely related to age and HbA1c. The health-related quality of life (HRQoL) was associated with the use of a continuous real-time glucose monitoring system (MCG-TR) combined with continuous subcutaneous insulin infusion (CSII), as well as with a lower number of severe hypoglycaemia and renal complications. The mean HbA1c was 7.1%. 12,9% of patients used ISCI. 83.2% used capillary glycemia exclusively, while 16.8% used some interstitial glucose monitoring device. CONCLUSIONS: This is the first study in Andalusia that analyzes the health-related quality of life (HRQoL) of pediatric patients. The results show high levels of adherence and health-related quality of life (HRQoL), as well as good metabolic control

[Study of the quality of life and adherence to treatment in patients from 2 to 16 years-old with type 1 diabetes mellitus in Andalusia, Spain]. / Estudio de calidad de vida y adherencia al tratamiento en pacientes de 2 a 16 años con diabetes mellitus tipo 1 en Andalucía.

INTRODUCTION: Diabetes mellitus 1 is the second most frequent chronic disease, and the most frequent endocrine-metabolic disorder in childhood. The estimated prevalence is between 1.1 and 1.4 / 1000 children under 15 years years-old. In Andalusia the prevalence is higher (1.7 per thousand). The objective of the study is to evaluate health-related quality of life (HRQoL) and adherence to treatment, specifically in the paediatric population of Andalusia. METHODS: A multicentre cross-sectional observational analytical study was conducted on a sample of 178 patients from six hospitals with a Paediatric Endocrinology Unit. Each patient received two questionnaires; quality of life (PedsQL version 3.0) and adherence to the self-care recommendations (SCI-R) treatment. The demographic, clinical, metabolic control data, and possible complications were also collected. RESULTS: High levels were obtained in both adherence and health-related quality of life (HRQoL). Adherence was inversely related to age and HbA1c. The health-related quality of life (HRQoL) was associated with the use of a continuous real-time glucose monitoring system (MCG-TR) combined with continuous subcutaneous insulin infusion (CSII), as well as with a lower number of severe hypoglycaemia and renal complications. The mean HbA1c was 7.1%. 12,9% of patients used ISCI. 83.2% used capillary glycemia exclusively, while 16.8% used some interstitial glucose monitoring device. CONCLUSIONS: This is the first study in Andalusia that analyzes the health-related quality of life (HRQoL) of pediatric patients. The results show high levels of adherence and health-related quality of life (HRQoL), as well as good metabolic control.

Estudio de costes directos de la diabetes mellitus tipo 1 en pacientes entre 2 y 16 años en Andalucía / Study of direct costs of type 1 diabetes mellitus in Andalusian patients aged 2-16 years

Introducción: La diabetes mellitus tipo 1 es la segunda enfermedad crónica y el trastorno endocrino-metabólico más frecuente en la infancia. El objetivo de este estudio es realizar una estimación del coste directo de la diabetes mellitus tipo 1 en Andalucía, en pacientes pediátricos. Metodología: Se trata de un estudio descriptivo, observacional multicéntrico realizado durante 6 meses consecutivos de 2017-2018, partiendo de una muestra de 220 pacientes, procedentes de 6 centros hospitalarios de Andalucía. Se recogieron variables demográficas, variables relacionadas con el control metabólico, uso de sistemas de monitorización continua de glucosa, hemoglobina glucosilada media, episodios de hipoglucemias graves o cetoacidosis, comorbilidades y complicaciones existentes, así como los costes directos sanitarios; englobando los costes de medicación, materiales, determinaciones analíticas, pruebas complementarias y los relacionados con la asistencia sanitaria tanto hospitalaria como extrahospitalaria. Resultados: Se obtuvo una muestra de 178 pacientes. La edad media al diagnóstico fue de 6 años y los años de evolución de la enfermedad de 4,69 (0,29 DE) años. La hemoglobina glucosilada media fue de 7,06%, encontrándose el 25% por encima de 7,5%. El coste medio anual estimado por paciente fue de 4.720,4 €. El derivado de las insulinas (2.212,9 €) y el material para la administración de la misma y monitorización de la glucemia (1.518 €) supusieron el mayor porcentaje del gasto (79,1%). No se detecta asociación entre el control metabólico, comorbilidades y el coste de la enfermedad. Conclusión: Este estudio demuestra un coste directo asociado a la DM en edad pediátrica en Andalucía de aproximadamente 4.700 € por paciente

Introduction: Type 1 Diabetes Mellitus (T1DM) is the second leading chronic disease and the most common endocrine-metabolic disorder in childhood. The study objective was to estimate the direct cost of T1DM in pediatric patients in Andalusia. Methodology: A descriptive, observational, multicenter study was conducted during six consecutive months of 2017-2018 on a sample of 220 patients from 6 hospitals in Andalusia. Variables collected included demographic characteristics, metabolic control parameters, glucose levels, use of continuous monitoring systems, mean HbA1c levels, episodes of severe hypoglycemia and ketoacidosis, comorbidities and complications, as well as direct healthcare costs, including costs of drugs, materials, laboratory tests, and supplemental tests, as well as those derived from both inpatient and outpatient care. Results: The study sample consisted of 178 patients. Mean age at diagnosis was 6 years, and mean disease duration was 4.69 (0.29 SD) years. Mean HbA1c level was 7.06%, and 25% of patients had values higher than 7.5%. The estimated annual cost per patient was € 4,720.4. Cost derived from use of insulins (€ 2,212.9) and materials for insulin administration and blood glucose monitoring (€ 1,518) accounted for greatest proportion of cost (79.1%). No association was found between metabolic control, comorbidities, or complications and cost of disease. Conclusion: This study has shown a direct cost associated to T1DM in Andalusian children of approximately € 4,700 per patient

Study of direct costs of type 1 diabetes mellitus in Andalusian patients aged 2-16 years. / Estudio de costes directos de la diabetes mellitus tipo 1 en pacientes entre 2 y 16 años en Andalucía.

INTRODUCTION: Type 1 Diabetes Mellitus (T1DM) is the second leading chronic disease and the most common endocrine-metabolic disorder in childhood. The study objective was to estimate the direct cost of T1DM in pediatric patients in Andalusia. METHODOLOGY: A descriptive, observational, multicenter study was conducted during six consecutive months of 2017-2018 on a sample of 220 patients from 6 hospitals in Andalusia. Variables collected included demographic characteristics, metabolic control parameters, glucose levels, use of continuous monitoring systems, mean HbA1c levels, episodes of severe hypoglycemia and ketoacidosis, comorbidities and complications, as well as direct healthcare costs, including costs of drugs, materials, laboratory tests, and supplemental tests, as well as those derived from both inpatient and outpatient care. RESULTS: The study sample consisted of 178 patients. Mean age at diagnosis was 6 years, and mean disease duration was 4.69 (0.29 SD) years. Mean HbA1c level was 7.06%, and 25% of patients had values higher than 7.5%. The estimated annual cost per patient was € 4,720.4. Cost derived from use of insulins (€ 2,212.9) and materials for insulin administration and blood glucose monitoring (€ 1,518) accounted for greatest proportion of cost (79.1%). No association was found between metabolic control, comorbidities, or complications and cost of disease. CONCLUSION: This study has shown a direct cost associated to T1DM in Andalusian children of approximately € 4,700 per patient.

Oxygen sensing using microrobots.

We present a luminescence oxygen sensor incorporated in a wireless intraocular microrobot for minimally-invasive diagnosis. This microrobot can be accurately controlled in the intraocular cavity by applying magnetic fields. The microrobot consists of a magnetic body susceptible to magnetic fields and a sensor coating. This coating embodies Pt(II) octaethylporphine (PtOEP) dyes as the luminescence material and polystyrene as a supporting matrix, and it can be wirelessly excited and read out by optical means. The sensor works based on quenching of luminescence in the presence of oxygen. The excitation and emission spectrum, response time, and oxygen sensitivity of the sensor were characterized using a spectrometer. A custom device was designed and built to use this sensor for intraocular measurements with the microrobot. Due to the intrinsic nature of luminescence lifetimes, a frequency-domain lifetime measurement approach was employed. An alternative sensor implementation using poly(styrene-co-maleic anhydride) (PS-MA) and PtOEP was successfully demonstrated with nanospheres to increase sensor performance.

Estado de salud bucal en niños con diagnóstico de VIH-SIDA en la Fundación EUDES de Medellín: presentación de casos y revisión de la literatura / Oral health status of HIV-AIDS diagnosed children at the EUDES foundation of Medellin: report of cases and review of the literature

El VIH-SIDA es una enfermedad infectocontagiosa que compromete el sistema inmunológico con múltiples manifestaciones, algunas de ellas en boca. El propósito de este estudio fue realizar una revisión bibliográfica de la literatura reciente sobre el tema y describir el estado de salud bucal de nueve niños menores de 10 años con VIH-SIDA albergados en la Fundación EUDES de Medellín, identificando la historia de caries dental, nivel de higiene bucal, lesiones de tejidos blandos y tipo y frecuencia de medicamentos usados y su relación con los hallazgos clínicos. La información se obtuvo mediante la revisión de la historia clínica y el examen bucal. Fue evidente la deficiente higiene bucal (evaluada mediante el índice de Silness y Loe) y contradictoriamente un bajo índice de caries y enfermedad gingival. En los tejidos blandos se observaron lesiones tipo úlceras de origen idiopático, lengua vellosa de color negro verdoso y atrofia de papilas. Prevalecen las pigmentaciones en mucosas y las gingivitis localizada. La mayoría de las lesiones encontradas parecen originadas por efectos secundarios de los medicamentos y no entidades asociadas a la condición sistémica del paciente