Mejora en el manejo de las cistitis en atención primaria después de la implementación de una intervención multimodal simple

Primary health care; Urinary tract infections; Urine cultureAtención primaria; Infecciones del tracto urinario; UrocultivoAtenció primària; Infeccions del tracte urinari; UrocultiuObjective We assessed the impact of the implementation of a simple multifaceted intervention aimed at improving management of cystitis in primary care. Design Quality control before and after study. Site Primary care centres in Barcelona city provided by the Catalonian Institute of Health. Participants The multifaceted intervention consisted of (1) creation of a group with a leader in each of the primary care centres, out of hours services, sexual and reproductive centres, and home visit service, (2) session on management of cystitis in each centre, (3) result feedback for professionals, and (4) provision of infographics for professionals and patients with urinary tract infections. Interventions started in November 2020 and ended in the summer of 2021. Main measurements Variation in the prescription of first-line antibiotics, usage of antibiotics, and request for urine cultures before and after this intervention. Results Training sessions took place in 93% of the centres. The use of first-line therapies cystitis increased by 6.4% after the intervention (95% confidence interval [CI], 5.7–7.1%). The use of nitrofurantoin in recurrent cystitis increased, mainly in out of hours service (8.7%; 95% CI, 5.2–12.2%). Urine cultures were more frequently requested after the intervention for recurrent cystitis in both primary care centres and out of hours services, with a 7.2% increase [95% CI, 5.9–8.5%), but also for uncomplicated urinary tract infections (3.1%; 95% CI, 1.8–4.4%). Conclusions A low-intensity multifaceted intervention on management of cystitis, with strong institutional support, resulted in a better choice of antibiotic in antibiotic prescribing, but the intervention had less impact on the adequacy of urine cultures.Objetivo Evaluamos el impacto de una intervención multimodal en la mejora del manejo de las cistitis en atención primaria. Diseño Estudio de calidad antes-después. Emplazamiento Centros de atención primaria de la ciudad de Barcelona proporcionados por el Institut Català de la Salut. Participantes La intervención multimodal consistió en: (1) creación de un grupo de trabajo con líderes en cada uno de los equipos de atención primaria, servicios de urgencias, centros de atención sexual y reproductiva y servicio de atención domiciliaria, (2) sesión formativa sobre el manejo de las infecciones del tracto urinario en cada centro, (3) retorno de resultados a profesionales, y (4) difusión de infografías a profesionales y pacientes. Las intervenciones comenzaron en noviembre de 2020 y finalizaron en verano de 2021. Mediciones principales Variación en la prescripción de antibióticos de primera línea, uso de antibióticos y solicitud de urocultivos antes y después de esta intervención. Resultados Las sesiones de formación se realizaron en el 93% de los centros. La selección de fármacos de primera línea en cistitis aumentó en un 6,4% después de la intervención (intervalo de confianza [IC] 95%: 5,7-7,1%). El uso de nitrofurantoína en cistitis recurrente aumentó, principalmente en servicios de urgencias (8,7%; IC 95%: 5,2-12,2%). Las solicitudes de urocultivos aumentaron después de la intervención en equipos de atención primaria y servicios de urgencias en cistitis recurrentes (7,2%; IC 95%: 5,9-8,5%), pero también en cistitis simples (3,1%; IC 95%: 1,8-4,4%). Conclusiones Una intervención multimodal de baja intensidad sobre el manejo de las cistitis junto con el apoyo institucional explícito mejoró claramente la selección de antibióticos, pero tuvo menos impacto en la adecuación de los urocultivos

Micro-CT evaluation of bone grow concept of an implant with microstructured backtaper crestally and sub-crestally placed. Preliminary study in New Zealand rabbits tibia at one month

The primary purpose of this study was to determine the accuracy of micro-computed tomography (micro-CT) as a novel tool for the 3D analysis of bone density around dental implants in tibia rabbits. Six male New Zealand rabbits were used in our evaluation. One Copa SKY® (Bredent Medical GmbH & Co. K.G.) with a 3.5 mm diameter by 8.0 mm in length was placed within 12 tibia rabbits divided into two experimental groups: Group A (crestal placement) and Group B (sub-crestal placement). The animals were sacrificed at four weeks. Micro-CT evaluations showed a high amount of bone around all implants in the tibia rabbit bone. There was an increased formation of bone around the Copa SKY implants, mainly in the implants that were placed crestally. The most frequent density found in most implants was a medullary bone formation surrounding the implant; the density three (D3) was the most common type in all implants. The 3D model analysis revealed a mean bone volume (B.V.) of 31.24 ± 1.24% in crestal implants compared with the 43.12 ± 0.43% in sub-crestal implants. The mean actual contact implant to bone (B.I.C.) in the sub-crestal group was 51.76 ± 0.86%, compared to the 42.63 ± 0.75% in the crestal group. Compared to crestal implants, the Copa Sky implant placed sub-crestally allows for the formation of bone on top of the neck, thereby stimulating bone growth in tibia rabbits

Revista del Consejo Superior de Investigaciones Científicas

Alimentación del meloncillo Herpestes ichneumon y de la gineta Genetta genetta en la Reserva Biológica de Doñana, S.O. de la Península Ibérica.Determinación de la edad en Rana perezi Seoane, 1885. Aplicación al análisis del crecimiento somático de poblaciones.Influencias ambientales en la variación del tamaño, forma y peso de los huevos de la collalba rubia (Oenanthe hispanica L.)Características de un coro de sapos corredores (Bufo calamita) en el sureste de España.Estrategias alimentarias del ciervo (Cervus elaphus L.) en Montes de ToledoDistribución de los quirópteros de la provincia de Orense (Noroeste de España).Ecología trófica del lince ibérico en Doñana durante un periodo secoDesarrollo larvario de la rana común (Rana perezi) (anura: ranidae) en charcas temporales del noroeste de la Península Ibérica.Régimen alimenticio del mirlo común (Turdus merula) en el sureste de la Península Ibérica durante el periodo otoño-invierno.Reproducción del gorrión molinero (Passer montanus) en las Islas Canarias.Relación entre la cobertura vegetal y la distribución de nidos en las colonias de pagaza piconegraPeer reviewe

The caudo-ventral pallium is a novel pallial domain expressing Gdf10 and generating Ebf3-positive neurons of the medial amygdala

In rodents, the medial nucleus of the amygdala receives direct inputs from the accessory olfactory bulbs and is mainly implicated in pheromone-mediated reproductive and defensive behaviors. The principal neurons of the medial amygdala are GABAergic neurons generated principally in the caudo-ventral medial ganglionic eminence and preoptic area. Beside GABAergic neurons, the medial amygdala also contains glutamatergic Otp-expressing neurons cells generated in the lateral hypothalamic neuroepithelium and a non-well characterized Pax6-positive population. In the present work, we describe a novel glutamatergic Ebf3-expressing neuronal subpopulation distributed within the periphery of the postero-ventral medial amygdala. These neurons are generated in a pallial domain characterized by high expression of Gdf10. This territory is topologically the most caudal tier of the ventral pallium and accordingly, we named it Caudo-Ventral Pallium (CVP). In the absence of Pax6, the CVP is disrupted and Ebf3-expressing neurons fail to be generated. Overall, this work proposes a novel model of the neuronal composition of the medial amygdala and unravels for the first time a new novel pallial subpopulation originating from the CVP and expressing the transcription factor Ebf3.This work was supported by Grants of the French National Research Agency (Agence Nationale de la Recherche; ANR) [ANR-13-BSV4-0011] and by the French Government through the ‘Investments for the Future’ LABEX SIGNALIFE [ANR-11-LABX-0028-01] to M.S., by the Spanish Government (BFU2007-60263 and BFU2010-17305) to A.F, and by the Medical Research Council (MR/K013750/1) to T.T. N.R.-R. is funded by a postdoctoral fellowship from the Ville de Nice, France (“Aide Individuelle aux Jeunes Chercheurs 2016”).Peer reviewe

Association Between Preexisting Versus Newly Identified Atrial Fibrillation and Outcomes of Patients With Acute Pulmonary Embolism

Background Atrial fibrillation (AF) may exist before or occur early in the course of pulmonary embolism (PE). We determined the PE outcomes based on the presence and timing of AF. Methods and Results Using the data from a multicenter PE registry, we identified 3 groups: (1) those with preexisting AF, (2) patients with new AF within 2 days from acute PE (incident AF), and (3) patients without AF. We assessed the 90-day and 1-year risk of mortality and stroke in patients with AF, compared with those without AF (reference group). Among 16 497 patients with PE, 792 had preexisting AF. These patients had increased odds of 90-day all-cause (odds ratio [OR], 2.81; 95% CI, 2.33-3.38) and PE-related mortality (OR, 2.38; 95% CI, 1.37-4.14) and increased 1-year hazard for ischemic stroke (hazard ratio, 5.48; 95% CI, 3.10-9.69) compared with those without AF. After multivariable adjustment, preexisting AF was associated with significantly increased odds of all-cause mortality (OR, 1.91; 95% CI, 1.57-2.32) but not PE-related mortality (OR, 1.50; 95% CI, 0.85-2.66). Among 16 497 patients with PE, 445 developed new incident AF within 2 days of acute PE. Incident AF was associated with increased odds of 90-day all-cause (OR, 2.28; 95% CI, 1.75-2.97) and PE-related (OR, 3.64; 95% CI, 2.01-6.59) mortality but not stroke. Findings were similar in multivariable analyses. Conclusions In patients with acute symptomatic PE, both preexisting AF and incident AF predict adverse clinical outcomes. The type of adverse outcomes may differ depending on the timing of AF onset.info:eu-repo/semantics/publishedVersio

Conservación y manejo de los recursos naturales en un medio semiárido: Parque Natural "Cabo de Gata-Níjar" (Almería, SE España)

The importante of the only European Natural Park under a seiiiiarid cliniate together with the management uridertaken by the Andalusian Government is arialyzed. The Natural Park «Cabo de Gata-Níjarn is located in the semiarid southeast of the Iberian Peninsula, spreading over 34.000 Ha of iiiainland and one nautical mile along iis 40 km ol coast. I t is noteworthy its geological singularity, both from an Iberian and European view. due to its voleanic origin. Its flora has a great chorological value, being indeed the coniiection point between North-African aiid European flora (it has a 30 % of Ibero-Northafrican eridemisms), its local endeniisms being outstanding. such as Linaria tuher~~ulutcDr . A. Sutton, Atruc?vlis 1 iritinii Franco, AirtirrhirirSe analizan los valores del único Parque Natural europeo sometido a un clima semiárido así como la gestión llevada a cabo por el organismo oficial encargado de su manejo ambiental. El Parque: Natural Cabo de Gata-Níjar se encuentra situado en el sureste semiárido de la Península Ibérica, abarca una extensión de 34.000 Has. de superficie terrestre y una superficie marítima de una milla marina a lo largo de sus 45 km. de costa. Geológicamente es un espacio singular, tanto a nivel peninsular como europeo, debido a su origen volcánico. Flonsticamente tiene un gran valor corológico, constituyendo el enlace entre la flora del Norte de África y la Europea (presenta un 20 % de endemismos iberonorteafricanos), destacando sus endemismos locales Linaria tuberculata D. A. Sutton, Aiructylis rutinii Franco, Atztirrhinutn charidemi Lange. Diatzrhus charidemi Pau, Teucrium charidemi Sandwitch, Ulex ciznescens Lange, Verbascum charidemi Murbeck y Androcymbium europaeum (Lange) K. Richter. Entre la fauna asociada a sus ecosistemas destacan las comunidades orníticas de las estepas mediterráneas, con especies tan interesantes como Chersophilus duponi'i Vieillot, 1820 y Rucanetes githagineus M. H. C. Lichtenstein, 1823, y las de ambientes acuáticos, siendo uno de los puntos de nidificación del flamenco (Phoenicoprerus ruher L., 1758) en la Península Ibérica. El medio marino es muy rico y diverso (el catálogo de especies se sitúa en la actualidad en unas 1.400), las comunidades son típicamente mediterráneas aunque es el último punto del litoral del Mediterráneo peninsular con influencia de las aguas atlánticas; destacan los arrecifes de vermétidos formados por el gasterópodo Detzdropoma perraeum (Monterosato, 1884), la presencia de la lapa Patella ferrugitiea Cmelin, 1791 y las interesantes poblaciones del madreporario Astroides calycularis (Pallas, 1776) en su límite de distribución. La gestion realizada por la Agencia del Medio Ambiente de la Junta de Andalucía, tanto en labores de conservación como de uso de los recursos naturales del Parque Natural ofrece un balance francaniente positivo, a pesar de que el 83 % de su superficie es de propiedad privada. La labor realizada compreride aspectos de vigilancia. dotación de infraestructuras, uso público, conservación e investigación. Así mismo se indican los principales objetivos a lograr eii el próximo cuatrienio. Concluirnos con nuestra propuesta de inclusión como Reserva de la Biosfera dentro del programa Mari and the Biosphere de la United Nations Educational Scientific and Cultural Orgaiiization, de este singular Espacio Natural Protegido

An usual elastophagocytic granuloma with involvement of the back: a possible variant of an annular elastolytic giant cell granuloma

Annular elastolytic giant cell granuloma (AEGCG) is a very infrequent granulomatous dermatitis characterized by elastolysis and elastophagocytosis. It usually appears in middle-aged Caucasian women and is normally located in sun-exposed areas.We present a case of a 73-year-old woman with hypertension and type II diabetes, who was admitted to the hospital for an ischemic cerebrovascular accident. She presented with annular and serpiginous skin lesions on her back and arms that had appeared seven months earlier;  a clinical and histological diagnosis of elastophagocytic granuloma was made. Our patient exhibited a florid presentation and a self-limiting course

Induced defenses in olive trees by herbivory mimicry in leaves are modulated by root inoculation with beneficial fungi

1 página - Poster presentado en Iberian Plant Biology 2023. XVIII Portuguese-Spanish Congress on Plant Biology and the XXV Meeting of the Spanish Society of Plant Biology. 9-12 Julio 2023, Braga, Portugal.Plants can activate various defense mechanisms in response to herbivore attack or simulated herbivory such as mechanical wounding. These mechanisms include the expression of resistance related genes and the emission of volatile organic compounds (VOCs). In this study, we investigated the induced defenses in olive (Olea europaea cv. Picual) plants in response to herbivory simulation by mechanical wounding. We confirmed that mechanical stimulation mimicking herbivory wounds efficiently regulated various defense mechanisms and regulatory pathways. Transcriptional analyses by qPCR revealed differential regulation of defense‐related genes. For example, we found a very strong upregulation (+120‐fold change) of the acetone cyanohydrin lyase gene and downregulation of a beta‐1,3‐glucanase gene. Interestingly, root inoculation with the beneficial fungus Trichoderma harzianum modulated the transcriptional regulation of defenses, and increased the expression of HPL gene, coding for a hydroperoxide lyase, involved in VOCs production. Moreover, the herbivory mimic also regulated indirect defences. Phytophagous insects and their natural enemies are attracted to the volatile mixture produced by the plants and use a particular combination of the compounds released for host identification. We detected a change in volatile blends in response to the mechanical wounding. Some compounds known to be involved in the plant defense against chewing insects, such as 1‐heptanol, 2‐nonenal, butanoic acid, hexanoic acid, and pentanoic acid, were only detected in damaged trees. While these compounds contributed in low proportion to the overall blend, it is interesting to note that the main difference was associated to the proportions in which three compounds, belonging to the class known as green leaf volatiles, contributed to global mixes. Thus, hexanal, heptanal and octanal aldehydes, important plant volatiles that contribute to plant defense strategies, had a greater weight in the mixture emitted by the damaged olive trees. Remarkably, inoculation with T. harzianum also had a significant impact on the profiles of the released volatiles, including nonanal aldehyde as a major volatile in the overall blend released after mimicry. Overall, the complex interactions between olive plants, soil microbiota, herbivorous insects, and their natural enemies highlight the importance of studying the role of VOCs and defense genes in orchestrating these interactions, as this information will contribute to developing more sustainable pest management strategies for olive groves.Grant P20‐00139 funded by Consejería de Transformación Económica, Industria, Conocimiento y Universidades, Junta de Andalucía and by “ERDF A way of making Europe

An usual elastophagocytic granuloma with involvement of the back: a possible variant of an annular elastolytic giant cell granuloma

Annular elastolytic giant cell granuloma (AEGCG) is a very infrequent granulomatous dermatitis characterized by elastolysis and elastophagocytosis. It usually appears in middle-aged Caucasian women and is normally located in sun-exposed areas.We present a case of a 73-year-old woman with hypertension and type II diabetes, who was admitted to the hospital for an ischemic cerebrovascular accident. She presented with annular and serpiginous skin lesions on her back and arms that had appeared seven months earlier;  a clinical and histological diagnosis of elastophagocytic granuloma was made. Our patient exhibited a florid presentation and a self-limiting course