Adaptación cultural al español del instrumento de evaluación de funcionalidad física en Unidad de Paciente Crítico: “The Chelsea Critical Care Physical Assessment Tool (CPAx)”

Las Unidades de Cuidados Intensivos (UCI), presentan una sobrevida cada vez mayor de los pacientes que ingresan a ellas, donde se ven enfrentados a una nueva entidad fisiopatológica llamada Debilidad Muscular Adquirida en UCI (DAUCI). Algunos test desarrollados para la evaluación de función motriz, que permiten objetivar la progresión del paciente, son la escala de fuerza muscular del Medical Research Council (MRC), el Functional status score for the intensive care unit (FSS-ICU) y el “Chelsea Critical Care Physical Assessment Tool (CPAx). La ventaja del CPAx radica en que este test incluye mayor información asociada al funcionamiento humano como recomienda la OMS, incorporando tanto el componente ventilatorio (que también se ve deteriorado por DAUCI) como neuromuscular lo que permite al profesional kinesiólogo tener una herramienta objetiva más completa del nivel funcional del paciente. Para que sea confiable, todo test debe ser validado en el país donde quiere aplicarse, pero antes de esto debe ser adaptado culturalmente. El objetivo de este trabajo fue efectuar la adaptación transcultural (AT) al español del test de funcionalidad física de aplicación kinésica CPAx. Se utilizó el proceso establecido por Beaton y cols que incluye la formación de un comité de expertos multidisciplinario que da una visión integral a la adaptación y una prueba piloto en que kinesiólogos de UCI sin capacitación previa del test lo lean, posteriormente lo apliquen y entreguen sus observaciones. Conclusiones: Realizar la AT permite dimensionar la importancia que tiene cada una de las etapas de este proceso. El test es el mismo, equivalente al original, pero contiene nuestras características culturales y condiciones técnicas, que lo hace ser comprensible y aplicable en nuestro país. Esta adaptación transcultural también es útil a nivel latinoamericano; para los países de habla hispana que quieran validarlo tenerlo adaptado al español, hace el proceso menos complejo. Palabras clave: Evaluación funcional, Unidad de cuidados intensivos, CPAx, adaptación transcultural

Phase I clinical trial in healthy adults of a nasal vaccine candidate containing recombinant hepatitis B surface and core antigens

SummaryBackgroundThe nasal vaccine candidate (NASVAC), comprising hepatitis B virus (HBV) surface (HBsAg) and core antigens (HBcAg), has been shown to be highly immunogenic in animal models.MethodsA phase I double-blinded, placebo-controlled randomized clinical trial was carried out in 19 healthy male adults with no serologic markers of immunity/infection to HBV. This study was aimed at exploring the safety and immunogenic profile of nasal co-administration of both HBV recombinant antigens. The trial was performed according to Good Clinical Practice guidelines. Participants ranged in age from 18 to 45 years and were randomly allocated to receive a mixture of 50μg HBsAg and 50μg HBcAg or 0.9% physiologic saline solution, as a placebo, via nasal spray in a five-dose schedule at 0, 7, 15, 30, and 60 days. A total volume of 0.5ml was administered in two dosages of 125μl per nostril. Adverse events were actively recorded 1h, 6h, 12h, 24h, 48h, 72h, 7 days and 30 days after each dose. Anti-HBs and anti-HBc titers were evaluated using corresponding ELISA kits at days 30 and 90.ResultsThe vaccine candidate was safe and well tolerated. Adverse reactions included sneezing (34.1%), rhinorrhea (12.2%), nasal stuffiness (9.8%), palate itching (9.8%), headache (9.8%), and general malaise (7.3%). These reactions were all self-limiting and mild in intensity. No severe or unexpected events were recorded during the trial. The vaccine elicited anti-HBc seroconversion in 100% of subjects as early as day 30 of the immunization schedule, while a seroprotective anti-HBs titer (≥10IU/l) was at a maximum at day 90 (75%). All subjects in the placebo group remained seronegative during the trial.ConclusionThe HBsAg–HBcAg vaccine candidate was safe, well tolerated and immunogenic in this phase I study in healthy adults. To our knowledge, this is the first demonstration of safety and immunogenicity for a nasal vaccine candidate comprising HBV antigens

7th Drug hypersensitivity meeting: part two

No abstract availabl

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

The use of porcine digestible peptides and their continuity effect in nursery pigs

A total of 552 entire male and female nursery pigs were selected to be used in 2 different experiments that aimed to study if milk ingredients can be replaced by highly preferred protein sources (Exp. 1) and if pre- and postnatal exposure of those protein ingredients through the maternal diet may increase pig performance (Exp. 2). In Exp. 1, 240 pigs were separated after weaning (28 d) into 2 groups depending on the presence of lactose in their diets. Pigs (n = 120) fed diets with the precence of lactose (lactose +) were given prestarter (0-14 d) and starter (15-33 d) diets with 142 and 50 g/kg of sweet milk whey, respectively; the lactose-free group (n = 120) was offered an isoenergetic diet with 20 g/kg of porcine-digestible peptides (PDP; Palbio 62SP; Bioiberica S.A., Palafolls, Spain) and wheat replacing sweet milk whey. Choice and 1-feeder tests were performed in another group of animals (n = 72) to evaluate the preference and acceptance for both diets. Pigs preferred (P = 0.039) the lactose+ over the lactose-free diet after a 30-min choice test and consumed more (P = 0.001) lactose+ than lactose-free diet in a 1-feeder test. However, no difference (P > 0.467) in performance was observed between groups for the entire nursery period. In Exp. 2, 120 animals were obtained from sows that, during late gestation (14 d) and lactation (28 d), were fed diets containing 20 g/kg of PDP and another 120 animals were obtained from sows fed an isoenergetic diet without PDP inclusion. Placenta samples were collected at farrowing to assess the volatile compounds present in the placental fluid of sows. After weaning, all pigs received a feed containing 20 g/kg of PDP in the prestarter and starter diets. A principal components analysis of the total volatile compounds showed the exclusive presence of sulfur-containing compounds and a higher presence of terpene compounds in the placental fluid of PDP-supplemented sows. In addition, pigs coming from sows fed diets supplemented with PDP tended to show a higher ADFI (P = 0.07) and ADG (P = 0.06) than did pigs coming from control sows during the 15 to 33 d after-weaning period. These results suggest that dietary incorporation of sweet milk whey may be replaced by a specific protein source without affecting performance of pigs after weaning. However, more experiments are needed to elucidate the mechanism for the sow's diets' influence over pig's performance.Spanish Government (MCI) PET2008_0002 Chilean research fellowships "Becas Chile" (Santiago, Chile) Nutrition and Care Division of Bioiberica (Palafolls, Spain

Acquisition of flavour preferences in pigs through interactions with conspecifics that had previously consumed flavoured protein solutions

It is known that pigs can acquire flavour preferences by brief social interactions with conspecifics that previously consumed a flavoured solid feed. However, there is no information about whether a flavoured solution could support flavour preferences through social transmission. Ninety-six pigs (49 days old) were housed in 12 pens (8 pigs/pen). Four animals per pen were randomly selected to act as observers and four as demonstrators. Demonstrator animals were temporarily moved to an empty pen where a protein solution was offered (porcine digestive peptides (PDPs), 4% weight/volume) with the addition of 0.075% aniseed (six pens) or garlic (six pens) powdered artificial flavours for 30 min. Afterwards, demonstrators were returned to interact with observer animals for 30 min. A choice test (30 min) between aniseed and garlic PDP was performed for each observer group after the interaction. Observers showed a higher intake of solutions previously consumed by their demonstrator conspecifics (648v. 468 ml; SEM 61.36,P< 0.05). As with flavoured solid feeds, protein solutions containing artificial flavours can create preferences in pigs for those flavours through social transmission from conspecifics.Spanish Government (MCI) PET2008_0002 Chilean Government research fellowships 'Becas Chile

Producción de leche de cabra criolla según número ordinal del parto

Se comparó la producción de leche en cabras de primera, segunda y tercera lactancia, manejadas en un sistema de explotación tradicional extensivo. El estudio se realizó entre julio de 1983 y marzo de 1984, en un predio de la V Región, Provincia de San Felipe. Se trabajó con un grupo de 26 cabras distribuidas según número ordinal del parto, en tres categorías: 9 de primero, 10 de segundo y 7 de tercer parto. En base a los registros individuales, se calculó para cada animal la producción láctea acumulada en kg, la producción diaria promedio de leche y la duración promedio de la lactancia por grupo. Los resultados se describen en base a pro­medios, desviación estándar, coeficiente de varia­ción y máximos y mínimos. Las diferencias en pro­ducción de leche según lactancia, se determinaron por análisis de varianza, estandarizándose la pro­ducción láctea a 36 semanas.La producción láctea acumulada promedio fue de 126,8 kg, 149,6 kg y 145,6 kg en las cabras de primero, segundo y tercer parto, no existiendo di­ferencias significativas (p  0,05). La producción diaria de leche promedio fue de 0,503 kg, 0,625 kg y 0,575 kg en primera, segunda y tercera lactancia. La duración promedio de la lactancia fue de 249,3, 239,0 y 250,1 días para cada una de las lactancias.Se concluye que las cabras de primera lactancia tienden a producir menos leche que las de segunda y tercera; la producción de leche es un parámetro altamente variable lo que justificaría el empleo de un mayor número de repeticiones y que las mayo­res diferencias se producirían entre la cuarta y sép­tima semanas.AbstractFirst, second and third milking of goats under traditional extensive management were compared in San Felipe, Chile. The study started on July 1983 and finished on March 1984, and was performed using nine, ten and seven goats on each milking category respec­tively. Individual records were used to estimate accumulated milk production (kg), avera­ge daily production (kg) and average enduration (days) on each group. The results were stadistically described.There were not significant differences (p  0.05) of milk production, average daily production and enduration among groups. The results of accumulated milk production were 126,77 kg, 149,58 kg and 145,48 kg for the first, second and third milking respec­tively. The average daily production were 0,503 kg, 0,625 kg and 0,575 kg respectively, whereas the average enduration of milkings in the same groups were 249.33, 239. 00 and 250.14 days

Producción de leche de cabra criolla según número ordinal del parto

Se comparó la producción de leche en cabras de primera, segunda y tercera lactancia, manejadas en un sistema de explotación tradicional extensivo. El estudio se realizó entre julio de 1983 y marzo de 1984, en un predio de la V Región, Provincia de San Felipe. Se trabajó con un grupo de 26 cabras distribuidas según número ordinal del parto, en tres categorías: 9 de primero, 10 de segundo y 7 de tercer parto. En base a los registros individuales, se calculó para cada animal la producción láctea acumulada en kg, la producción diaria promedio de leche y la duración promedio de la lactancia por grupo. Los resultados se describen en base a pro­medios, desviación estándar, coeficiente de varia­ción y máximos y mínimos. Las diferencias en pro­ducción de leche según lactancia, se determinaron por análisis de varianza, estandarizándose la pro­ducción láctea a 36 semanas.La producción láctea acumulada promedio fue de 126,8 kg, 149,6 kg y 145,6 kg en las cabras de primero, segundo y tercer parto, no existiendo di­ferencias significativas (p  0,05). La producción diaria de leche promedio fue de 0,503 kg, 0,625 kg y 0,575 kg en primera, segunda y tercera lactancia. La duración promedio de la lactancia fue de 249,3, 239,0 y 250,1 días para cada una de las lactancias.Se concluye que las cabras de primera lactancia tienden a producir menos leche que las de segunda y tercera; la producción de leche es un parámetro altamente variable lo que justificaría el empleo de un mayor número de repeticiones y que las mayo­res diferencias se producirían entre la cuarta y sép­tima semanas.AbstractFirst, second and third milking of goats under traditional extensive management were compared in San Felipe, Chile. The study started on July 1983 and finished on March 1984, and was performed using nine, ten and seven goats on each milking category respec­tively. Individual records were used to estimate accumulated milk production (kg), avera­ge daily production (kg) and average enduration (days) on each group. The results were stadistically described.There were not significant differences (p  0.05) of milk production, average daily production and enduration among groups. The results of accumulated milk production were 126,77 kg, 149,58 kg and 145,48 kg for the first, second and third milking respec­tively. The average daily production were 0,503 kg, 0,625 kg and 0,575 kg respectively, whereas the average enduration of milkings in the same groups were 249.33, 239. 00 and 250.14 days

Release of nanoparticles in the environment and catalytic converters ageing

A Three-Way Catalyst (TWC) contains a cordierite ceramic monolith coated with a layer of Al2 O3, Cex Zr1−x O2 and platinoids mixture. Under standard operation, the platinoid concentration decreases, exposing the remaining washcoat structure. After that particle release stage, the sintering process follows where the crystalline Cex Zr1−x O2 solution is broken and begins to separate into ZrO2 and CeO2 phases. ZrO2 is released to the environment as micro and nanoparticles, while a small amount of CeO2 generates a new Alx Ce1−x O2 composite. The main effect of Ce capture is the growth in the size of the polycrystal structure from 86.13 ± 16.58 nm to 225.35 ± 69.51 nm. Moreover, a transformation of cordierite to mullite was identified by XRD analysis. Raman spectra showed that the oxygen vacancies (Vö) concentration decreased as Cex Zr1−x O2 phases separation occurred. The SEM-EDS revealed the incorporation of new spurious elements and microfractures favouring the detachment of the TWC support structure. The release of ultrafine particles is a consequence of catalytic devices overusing. The emission of refractory micro to nanocrystals to the atmosphere may represent an emerging public health issue underlining the importance of implementing strict worldwide regulations on regular TWCs replacement. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]