Variability and evolution of acute myocardial infarction management in the PRIMVAC Study (Acute myocardial infarction register of Valencia, Alicante and Castellón)

En España existe escasa información sobre la variabilidad interhospitalaria en el tratamiento del infarto agudo de miocardio (IAM) y su evolución temporal. El objetivo de este trabajo es describir el coeficiente de variabilidad (CV) y su evolución en la utilización de trombolíticos, aspirina (AAS), bloqueadores beta e inhibidores de la enzima conversiva de la angiotensina (IECA) en los hospitales del registro PRIMVAC.Data about hospital differences in acute myocardial infarction (AMI) management are scarce in Spain. The aim of this study is to describe the variability in the use of thrombolytic therapy, aspirine (AAS), beta-blockers and angiotensin converting enzyme inhibitors (ACEI) in the management of AMI, and the changes observed along a 4-year period among 12 hospitals participating in the PRIMVAC registry.Medicin

Core components for effective infection prevention and control programmes: new WHO evidence-based recommendations

Abstract Health care-associated infections (HAI) are a major public health problem with a significant impact on morbidity, mortality and quality of life. They represent also an important economic burden to health systems worldwide. However, a large proportion of HAI are preventable through effective infection prevention and control (IPC) measures. Improvements in IPC at the national and facility level are critical for the successful containment of antimicrobial resistance and the prevention of HAI, including outbreaks of highly transmissible diseases through high quality care within the context of universal health coverage. Given the limited availability of IPC evidence-based guidance and standards, the World Health Organization (WHO) decided to prioritize the development of global recommendations on the core components of effective IPC programmes both at the national and acute health care facility level, based on systematic literature reviews and expert consensus. The aim of the guideline development process was to identify the evidence and evaluate its quality, consider patient values and preferences, resource implications, and the feasibility and acceptability of the recommendations. As a result, 11 recommendations and three good practice statements are presented here, including a summary of the supporting evidence, and form the substance of a new WHO IPC guideline

Societal Ethos and Economic Development Organizations in Nicaragua

societal ethos, economic development organizations, revolution, corruption, Nicaragua,

An engineered periosteum for efficient delivery of rhBMP-2 and mesenchymal progenitor cells during bone regeneration

During bone regeneration, the periosteum acts as a carrier for key regenerative cues, delivering osteochondroprogenitor cells and crucial growth factors to the injured bone. We developed a biocompatible, 3D polycaprolactone (PCL) melt electro-written membrane to act as a mimetic periosteum. Poly (ethyl acrylate) coating of the PCL membrane allowed functionalization, mediated by fibronectin and low dose recombinant human BMP-2 (rhBMP-2) (10-25 mu g/ml), resulting in efficient, sustained osteoinduction in vitro. In vivo, rhBMP-2 functionalized mimetic periosteum demonstrated regenerative potential in the treatment of rat critical-size femoral defects with highly efficient healing and functional recovery (80%-93%). Mimetic periosteum has also proven to be efficient for cell delivery, as observed through the migration of transplanted periosteum-derived mesenchymal cells to the bone defect and their survival. Ultimately, mimetic periosteum demonstrated its ability to deliver key stem cells and morphogens to an injured site, exposing a therapeutic and translational potential in vivo when combined with unprecedentedly low rhBMP-2 doses