Accelerated long-term forgetting in resected and seizure-free temporal lobe epilepsy patients

Episodic memory impairments caused by temporal lobe epilepsy (TLE) are well documented in the literature. Standard clinical episodic memory tests typically include a 30-min delayed recall test. However, in the past decade, it has become apparent that this standard test does not capture the full range of memory problems in TLE patients. Some patients perform well on a standard 30-min delayed recall test, but show Accelerated Long-term Forgetting (ALF) after 24 h. Although ALF has been investigated in patients with different types of epilepsy, current research on resected TLE patients is missing. In the present study, resected TLE patients were compared to a control group matched on initial learning. They showed normal performance on verbal recall after 30 min, but impairments became apparent after one week. Moreover, the significant interaction between participant group and memory test delay demonstrated that the patients indeed showed an acceleration in forgetting. Furthermore, ALF was present in both left and right resected TLE patients, which contradicts the presence of material-specific hemispheric differences in ALF. In addition, ALF was observed in seizure-free resected TLE patients, thereby demonstrating that this factor is not crucial for long-term memory deficits. The outcome shows that clinicians are likely to underestimate memory deficits in resected TLE patients and, therefore, advocates for the inclusion of ALF tests in standard clinical batteries for both pre- and post-surgery testing sessions

Marketing sensorial en el sector de los supermercados españoles: Un análisis de los cinco sentidos en el punto de venta

En el siguiente documento abordaremos el concepto de marketing sensorial a través de los cinco sentidos en el sector de los supermercados españoles, más concretamente en sus tiendas físicas. Dada la cantidad de acciones de marketing que recibimos cada vez que vamos a comprar a estos establecimientos, despierta nuestra curiosidad conocer cuáles son estas acciones y cómo las llevan a cabo en cada cadena de supermercados, además de saber qué piensan o sienten los consumidores de todo esto.Para conseguir todo lo anteriormente nombrado, a continuación revisaremos qué dicen varios de los autores expertos en el marketing sensorial con el objeto de conocer, de una manera más profunda, qué es este concepto, su evolución y qué acciones pueden usarse a través de los cinco sentidos en los supermercados. Después, realizaremos una investigación de mercados cualitativa para comprobar cómo aplican lo anterior en los establecimientos estudiados y conocer qué piensan los consumidores de estas acciones. La investigación estará formada por una observación de los distintos supermercados y un Focus group, junto con un pequeño experimento, a los consumidores para conocer más de cerca el marketing sensorial.<br /

Estudio epidemiológico y molecular de Blastocystis sp. en el Área Sanitaria 3 de Zaragoza-España

Blastocystis sp. está considerado uno de los parásitos más prevalentes en muestras fecales humanas en todo el mundo. En el presente trabajo se ha realizado un estudio epidemiológico y molecular para investigar su prevalencia y diversidad genética en pacientes con síntomas gastrointestinales pertenecientes al área sanitaria 3 de Zaragoza-España y diagnosticados en el Servicio de Microbiología y Parasitología del Hospital Clínico Universitario Lozano Blesa de esta ciudad. Por una parte, se ha realizado un estudio de casos y controles (1:9.89, ~ 10) en el que se analizaron un total de 6.087 muestras fecales recogidas en 3.682 pacientes entre el 1 de enero y 31 de diciembre de 2018, investigando la presencia de Blastocystis sp. y otros patógenos intestinales mediante técnicas microscópicas y microbiológicas. En todos los pacientes se recogieron además variables demográficas, antoprométricas y médicas, con el fin de determinar su posible asociación con la infección por Blastocystis sp. Tras el diagnóstico microscópico se ha detectado una elevada prevalencia de este microorganismos (9,2%), siendo el parásito más prevalente en la zona de estudio y el único identificado en la mayoría de pacientes infectados. Se ha observado que la probabilidad de estar infectado es signficativamente mayor en individuos de bajo peso y en aquéllos que procedían de América Central y del Sur, y especialmente de Africa. Entre las variables asociadas positivamente a la infección por Blastocystis sp. también se incluyen determinados síntomas gastrointestinales (dolor abdominal, anorexia, halitosis), junto con la presencia de eosinofilia relativa, co-infecciones con bacterias patógenas, padecimiento de diabetes tipo 2 o administración de determinados tratamientos inmunosupresores. Por el contrario, no se observó una relación estadística con otros síntomas como presencia de diarrea o fiebre, ni tampoco con procesos como el síndrome de colon irritable.En una segunda fase se ha realizado un estudio molecular de las muestras positivas a Blastocystis sp. con el fin de identificar los subtipos del parásito circulantes en la población objeto de estudio e investigar su filogenia, diversidad genética y grado de homología con aislados de origen humano y animal depositados en GenBank®. Para ello se ha utilizado un protocolo de PCR que amplifica un fragmento del gen de SSU-rRNA de ~ 479bp. Este fragmento contiene una región variable que permite el subtipado tras secuenciación Sanger y posibilita el análisis filogenético. En total se identificaron cuatro subtipos, incluyendo las variantes ST3 (34,7%) y ST2 (34,1%), junto con dos subtipos minoritarios (ST1 y ST4) que fueron observados con idéntica frecuencia (15,6% cada uno). En algunos pacientes se identificaron infecciones mixtas en los subtipos ST1 y ST2, que fueron evidenciadas por la presencia de picos dobles en trazos de los cromatogramas, lo que indica que un mismo hospedador puede estar infectado por múltiples subtipos. El análisis de las secuencias también ha revelado la presencia de alelos de Blastocystis sp. no descritos previamente, siendo destacable que algunas secuencias fueron idénticas a otras de origen humano y especialmente de diversas especies animales depositadas en GenBank®, lo que apoyaría el carácter zoonótico potencial de este parásito. Finalmente, cabe destacar los hallazgos del estudio filogenético por Neighbor Joining, que revela la alta variabilidad de los subtipos ST1 y ST2, lo que sugiere su origen polifilético o un proceso evolutivo más largo en el tiempo. La variabilidad es por el contrario mucho menor en las secuencias de subtipos ST3 y especialmente ST4, lo que apoyaría su origen monofilético y transmisión más reciente a humanos. El objetivo de este trabajo de investigación es profundizar en el conocimiento de la epidemiología clínica y molecular de la infección por Blastocystis sp., mediante un estudio de casos y controles en pacientes con síntomas gastrointestinales pertenecientes al área sanitaria 3 de Zaragoza, utilizando para ello técnicas microscópicas y moleculares. <br /

Je li privatnost informacija zaštićena u neonatalnoj jedinici intenzivnog liječenja? Opservacijska studija

Respecting patients’ intimacy and confidentiality can be a challenge in the neonatal intensive care units (NICUs) designed according to traditional standards (e.g. a single big room with a number of cots and incubators located close one to another). Concerned about this topic, two members of the team designed a study to check the quality of the confidentiality in the NICU area, and identify opportunities for improvement. This is an observational study performed for a period of one month. The observed team was not aware of being observed. During observation time, a total of 147 hours, 25 confidentiality violation situations were encountered. Twelve (48%) were comments, spoken with a loud voice, about the patients in the NICU area or in adjacent areas, 24% (6/25) were related to the privacy issues due to leaving medical documentation or computer screens available for anybody to see or informing parents in a way that could be heard by parents of other babies, 12% (3/25) were phone conversations about patients in a loud voice, 4% (1/25) were answering questions to parents or relatives about other babies. The medical and personal information of the patients in the NICU is often exposed and shared with parents of other patients and nonrelated professionals. The architectural design of the traditional NICUs, some socio-cultural issues in South European countries, and the difficulties in changing attitudes are the critical points to focus on to start a quality educational project to protect the right to intimacy and confidentiality of vulnerable children and parents admitted to the NICUs.Poštovanje privatnosti i povjerljivosti pacijenata može biti izazov u neonatalnim jedinicama intenzivnog liječenja (NJIL) koje su dizajnirane prema tradicionalnim standardima (npr. jedna velika soba s određenim brojem krevetića i inkubatora smještenih jedni blizu drugih). Zabrinuti zbog ove teme, dva člana tima osmislila su studiju koja će provjeriti kvalitetu povjerljivosti u neonatalnim jedinicama intenzivnog liječenja i pronaći mogućnosti za poboljšanje. Ova opservacijska studija provodi se tijekom jednog mjeseca. Tim koji je bio promatran nije bio svjestan našeg promatranja. Tijekom vremena promatranja, ukupno 147 sati, primijećeno je ukupno 25 situacija u kojima je prekršena povjerljivost. Bilo je dvanaest (48 %) komentara koji su bili glasnije izgovoreni o pacijentima u neonatalnim jedinicama intenzivnog liječenja ili u bližoj okolini, 24 % (6/25) situacija odnosilo se na pitanja privatnosti, bilo zbog ostavljanja medicinske dokumentacije ili računala bez nadzora ili zbog informiranja roditelja, tako da su ih mogli čuti i roditelji druge novorođenčadi, 12 % (3/25) su bili telefonski razgovori o pacijentima i to glasnijim tonom glasa, 4 % (1/25) su bili odgovori na pitanja roditelja ili rodbine o drugoj novorođenčadi-pacijentima. Medicinski i osobni podaci pacijenata na odjelu NJIL-a često su izloženi i podijeljeni s roditeljima drugih pacijenata i profesionalcima koji nisu ni u kakvoj vezi s tim pacijentima. Arhitektonski dizajn tradicionalnih jedinica NJIL-a, neka sociokulturna pitanja u južnoeuropskim zemljama i poteškoće u promjeni stavova kritične su točke na koje se treba usredotočiti kako bi se pokrenuo kvalitetan obrazovni projekt za zaštitu prava na intimu i povjerljivost ranjive djece i roditelja koji borave na odjelu NJIL-a

Cobertura de la vacunación antigripal en los farmacéuticos comunitarios: razones aportadas y absentismo relacionado. Predisposición a vacunar a la población

Introducción: la vacuna antigripal está indicada entre el personal sanitario, aunque la cobertura antigripal en farmacéuticos comunitarios españoles actualmente se desconoce. Este trabajo pretende averiguar esta cobertura, las causas de los farmacéuticos para vacunarse o no de la gripe, el absentismo laboral que les ocasiona, si recomiendan la vacunación antigripal entre los grupos de riesgo y su disposición a administrarla en la farmacia. Métodos: estudio descriptivo transversal mediante un cuestionario online destinado a farmacéuticos comunitarios de toda España. Se realizó un análisis descriptivo de las variables estudiadas y de la asociación entre la vacunación y las variables cualitativas (test Chi-cuadrado y Fisher) y cuantitativas (ANOVA). Resultados: se obtuvo una tasa de respuesta del 9,4 % (n=1.436). Los farmacéuticos refirieron vacunarse en torno al 30 % en las tres temporadas estudiadas (2016-2019), siendo del 31-35,8 % (IC95 %) en la temporada 2018-2019. Ser titular/cotitular de la farmacia, la experiencia profesional, la edad, vacunarse para evitar la gripe y/o por responsabilidad, y vacunarse en temporadas anteriores son factores asociados a vacunarse (p<0,05). Ser socio de SEFAC también lo es. El absentismo por gripe en la temporada 2018-2019 fue del 9,5 %. Los farmacéuticos que más dijeron vacunarse recomiendan más la vacuna que los que no, y tendrían mayor predisposición a administrarla (p<0,05). Conclusiones: la cobertura vacunal antigripal entre los farmacéuticos comunitarios es baja a pesar del absentismo que les causa. Facilitar la vacunación a los farmacéuticos podría incrementar su cobertura. Los farmacéuticos recomiendan la vacunación contra la gripe a los pacientes de riesgo y estarían dispuestos a vacunar en farmacias autorizadas

Tranexamic Acid in Pertrochanteric Femoral Fracture: Is it a Safe Drug or Not?

AbstractBackground:There is a high incidence of blood transfusion following hip fractures in elderly patients.Aim:The aim of this study is to evaluate the effectiveness and complications of use of tranexamic acid in proximal femur nailing surgery.Materials and methods:Our sample group consisted of 90 patients suffering from pertrochanteric fractures surgically treated with osteosynthesis with SupernailGT(LimaCorporate). The classification system AO/OTA was used to divide the fractures into 31A1 (n=45) and 31A2 (n=45). The patients were divided into two groups: 47 patients were administered 15 mg of tranexamic acid per kg (group A) and 43 patients were administered placebo (group B). Blood counts were monitored daily to evaluate the rate of anemia. As a safety criterion, we monitored the possible occurrence of vascular events, symptomatic or not, over the 8 weeks post-surgery. Markers predicting mortality and deep venous thrombosis (DVE) were also monitored (fibrinogen D-dimer).Results:Blood loss occurring post-surgery can be influenced by numerous factors that are not linked to the use or non-use of tranexamic acid. While closely monitoring hemoglobin levels daily, we observed that 42% of the patients in group A required blood transfusion as opposed to 60% in group B. The results of the markers predicting mortality (alpha1-acid glycoprotein; albumin LDL) and those of DVE were not statistically significant between the two groups in this study (p>0.05).Conclusion:Based on this study, the use of tranexamic acid was statistically significant in reducing post-surgery blood loss

Determinants of Progression and Regression of Subclinical Atherosclerosis Over 6 Years.

BACKGROUND Atherosclerosis is a systemic disease that frequently begins early in life. However, knowledge about the temporal disease dynamics (ie, progression or regression) of human subclinical atherosclerosis and their determinants is scarce. OBJECTIVES This study sought to investigate early subclinical atherosclerosis disease dynamics within a cohort of middle-aged, asymptomatic individuals by using multiterritorial 3-dimensional vascular ultrasound (3DVUS) imaging. METHODS A total of 3,471 participants from the PESA (Progression of Early Subclinical Atherosclerosis) cohort study (baseline age 40-55 years; 36% female) underwent 3 serial 3DVUS imaging assessments of peripheral arteries at 3-year intervals. Subclinical atherosclerosis was quantified as global plaque volume (mm3) (bilateral carotid and femoral plaque burden). Multivariable logistic regression models for progression and regression were developed using stepwise forward variable selection. RESULTS Baseline to 6-year subclinical atherosclerosis progression occurred in 32.7% of the cohort (17.5% presenting with incident disease and 15.2% progressing from prevalent disease at enrollment). Regression was observed in 8.0% of those patients with baseline disease. The effects of higher low-density lipoprotein cholesterol (LDL-C) and elevated systolic blood pressure (SBP) on 6-year subclinical atherosclerosis progression risk were more pronounced among participants in the youngest age stratum (Pinteraction = 0.04 and 0.02, respectively). CONCLUSIONS Over 6 years, subclinical atherosclerosis progressed in one-third of middle-age asymptomatic subjects. Atherosclerosis regression is possible in early stages of the disease. The impact of LDL-C and SBP on subclinical atherosclerosis progression was more pronounced in younger participants, a finding suggesting that the prevention of atherosclerosis and its progression could be enhanced by tighter risk factor control at younger ages, with a likely long-term impact on reducing the risk of clinical events. (Progression of Early Subclinical Atherosclerosis [PESA; also PESA-CNIC-Santander]; NCT01410318).S

Promising hit compounds against resistant trichomoniasis: Synthesis and antiparasitic activity of 3-(ω-aminoalkoxy)-1-benzyl-5-nitroindazoles

A series of 11 3-(ω-aminoalkoxy)-1-benzyl-5-nitroindazoles (2–12) has been prepared starting from 1-benzyl-5-nitroindazol-3-ol 13, and evaluated against sensitive and resistant isolates of the sexually transmitted protozoan Trichomonas vaginalis. Compounds 2, 3, 6, 9, 10 and 11 showed trichomonacidal profiles with IC50 < 20 µM against the metronidazole-sensitive isolate. Moreover, all these compounds submitted to cytotoxicity assays against mammalian cells exhibited low non-specific cytotoxic effects, except compounds 3 and 9 which displayed moderate cytotoxicity (CC50 = 74.7 and 59.1 µM, respectively). Those compounds with trichomonacidal effect were also evaluated against a metronidazole-resistant culture. Special mention deserve compounds 6 and 10, which displayed better IC50 values (1.3 and 0.5 µM respectively) than that of the reference drug (IC50 MTZ = 3.0 µM). The high activity of these compounds against the resistant isolate reinforces the absence of cross-resistance with the reference drug. The remarkable trichomonacidal results against resistant T. vaginalis isolates suggest the interest of 3-(ω-aminoalkoxy)-1-benzyl-5-nitroindazoles to be considered as good prototypes to continue in the development of new drugs with enhanced trichomonacidal activity, aiming to increase the non-existent drugs to face clinical resistance efficiently for those patients in whom therapy with 5-nitroimidazoles is contraindicated

Cardiac Insulin Resistance in Subjects With Metabolic Syndrome Traits and Early Subclinical Atherosclerosis.

OBJECTIVE Experimental evidence suggests that metabolic syndrome (MetS) is associated with changes in cardiac metabolism. Whether this association occurs in humans is unknown. RESEARCH DESIGN AND METHODS 821 asymptomatic individuals from the Progression of Early Subclinical Atherosclerosis (PESA) study (50.6 [46.9-53.6] years, 83.7% male) underwent two whole-body 18F-fluorodeoxyglucose positron emission tomography-magnetic resonance (18F-FDG PET-MR) 4.8 ± 0.6 years apart. Presence of myocardial 18F-FDG uptake was evaluated qualitatively and quantitatively. No myocardial uptake was grade 0, while positive uptake was classified in grades 1-3 according to target-to-background ratio tertiles. RESULTS One hundred fifty-six participants (19.0%) showed no myocardial 18F-FDG uptake, and this was significantly associated with higher prevalence of MetS (29.0% vs. 13.9%, P < 0.001), hypertension (29.0% vs. 18.0%, P = 0.002), and diabetes (11.0% vs. 3.2%, P < 0.001), and with higher insulin resistance index (HOMA-IR, 1.64% vs. 1.23%, P < 0.001). Absence of myocardial uptake was associated with higher prevalence of early atherosclerosis (i.e., arterial 18F-FDG uptake, P = 0.004). On follow-up, the associations between myocardial 18F-FDG uptake and risk factors were replicated, and MetS was more frequent in the group without myocardial uptake. The increase in HOMA-IR was associated with a progressive decrease in myocardial uptake (P < 0.001). In 82% of subjects, the categorization according to presence/absence of myocardial 18F-FDG uptake did not change between baseline and follow-up. MetS regression on follow-up was associated with a significant (P < 0.001) increase in myocardial uptake. CONCLUSIONS Apparently healthy individuals without cardiac 18F-FDG uptake have higher HOMA-IR and higher prevalence of MetS traits, cardiovascular risk factors, and early atherosclerosis. An improvement in cardiometabolic profile is associated with the recovery of myocardial 18F-FDG uptake at follow-up.The PESA study is funded by the Centro Nacional de Investigaciones Cardiovasculares (CNIC) and Santander Bank. B.I. is supported by the European Commission (grant numbers 819775 and 945118), by the Spanish Ministry of Science and Innovation (PID2019- 110369RB-I00), and by the Red Madrilena de ~ Nanomedicina en Imagen Molecular-Comunidad de Madrid (S2017/BMD-3867 RENIM-CM). A.D. is an Alfonso Martin Escudero fellow and is scientifically supported by La Caixa Foundation. The CNIC is supported by the Instituto de Salud Carlos III (ISCIII), the Ministerio de Ciencia e Innovacion (MCIN), and the Pro CNIC Foundation, and is a Severo Ochoa Center of Excellence (grant CEX2020-001041-S funded by MICIN/AEI/ 10.13039/501100011033).S

Neoadjuvant Chemotherapy plus Interval Cytoreductive Surgery with or without Hyperthermic Intraperitoneal Chemotherapy (NIHIPEC) in the Treatment of Advanced Ovarian Cancer: A Multicentric Propensity Score Study

Simple Summary Advanced ovarian cancer (Stages III-IV) continues to be one of the gynecological tumors with the highest mortality. Standard treatment consists of debulking surgery and subsequent adjuvant chemotherapy. Recently, some authors have postulated that the administration of hyperthermic chemotherapy during surgery could increase the survival of patients, especially in cases in which chemotherapy had already been administered before surgery to reduce tumor volume. Our study is important because it collects data from 11 tertiary hospitals in Spain, and the data are subjected to a statistical technique that reproduces the data that we would find in a prospective study but using retrospective data (propensity score matching). It also offers a current view of the status of ovarian cancer treatment in our country.Abstract Introduction: Epithelial ovarian cancer (EOC) is primarily confined to the peritoneal cavity. When primary complete surgery is not possible, neoadjuvant chemotherapy (NACT) is provided; however, the peritoneum-plasma barrier hinders the drug effect. The intraperitoneal administration of chemotherapy could eliminate residual microscopic peritoneal tumor cells and increase this effect by hyperthermia. Intraperitoneal hyperthermic chemotherapy (HIPEC) after interval cytoreductive surgery could improve outcomes in terms of disease-free survival (DFS) and overall survival (OS). Materials and Methods: A multicenter, retrospective observational study of advanced EOC patients who underwent interval cytoreductive surgery alone (CRSnoH) or interval cytoreductive surgery plus HIPEC (CRSH) was carried out in Spain between 07/2012 and 12/2021. A total of 515 patients were selected. Progression-free survival (PFS) and OS analyses were performed. The series of patients who underwent CRSH or CRSnoH was balanced regarding the risk factors using a statistical analysis technique called propensity score matching. Results: A total of 170 patients were included in each subgroup. The complete surgery rate was similar in both groups (79.4% vs. 84.7%). The median PFS times were 16 and 13 months in the CRSH and CRSnoH groups, respectively (Hazard ratio (HR) 0.74; 95% CI, 0.58-0.94; p = 0.031). The median OS times were 56 and 50 months in the CRSH and CRSnoH groups, respectively (HR, 0.88; 95% CI, 0.64-1.20; p = 0.44). There was no increase in complications in the CRSH group. Conclusion: The addition of HIPEC after interval cytoreductive surgery is safe and increases DFS in advanced EOC patients