Impacto de la ecografía volumétrica portátil en el sondaje vesical por retención urinaria en una unidad de medicina interna

Aim: To estimate the impact of the use of portable bladder volumetric ultrasound on bladder catheterization due to suspicion of urinary retention in an internal medicine unit. Methodology: Study of retrospective cohorts, comparing the cohort exposed to the availability of bladder ultrasound, with the not exposed the previous year. All records in the Electronic Medical Record (EHR) of short-term permanent bladder catheters in adult patients admitted to the Internal Medicine hospitalization unit of the University Hospital Fundación Alcorcón (HUFA) during the years 2015 and 2016 were analyzed. The urinary retention frequency is estimated as the cause of the catheterization after the device has been incorporated into the unit and compared with the frequency of catheterization during the same period of the previous year in the same unit. It is estimated that the impact of having this device on the urinary retention frequency is the reason for the catheterization. Results: 134 catheters are included in 113 patients, 62 in the group without ultrasound and 72 in the group with ultrasound. The frequency of catheterizations due to retention is reduced from 47.5% to 21.4% after introducing the ultrasound unit into the unit. This represents a 50% reduction (adjusted RR=0.48; CI95%:0.27-0.84, p=0.01) in the frequency of urinary catheterization for suspected urinary retention.Objetivo: Estimar el impacto que el uso de ecógrafo vesical tiene en los sondajes vesicales por sospecha de retención urinaria de una unidad de Medicina interna.Metodología: Estudio de cohortes retrospectivas, comparando la cohorte expuesta a la disponibilidad del ecógrafo vesical, con la no expuesta el año previo. Se analizan todos los registros en la Historia Clínica Electrónica (HCE) de sondajes vesicales permanentes de corta duración en pacientes adultos que ingresaron en la unidad de hospitalización de Medicina Interna del Hospital Universitario Fundación Alcorcón (HUFA) durante los años 2015 y 2016. Se estima la frecuencia de retención urinaria como causa del sondaje después de la incorporación del dispositivo en la unidad y se compara con la frecuencia en sondajes durante el mismo periodo del año anterior en la misma unidad. Se estima el impacto que disponer de este dispositivo tiene en la frecuencia de retención urinaria como motivo del sondaje.Resultados: Se incluyen 134 sondajes en 113 pacientes, 62 en el grupo sin ecógrafo y 72 en el grupo con ecógrafo. La frecuencia de sondajes por retención se reduce del 47.5% al 21.4% después de introducir el ecógrafo en la unidad. Esto supone una reducción del 50% (RR ajustado= 0.48; IC95%:0.27-0.84, p=0.01) en la frecuencia de sondaje vesical por sospecha de retención urinaria

A review of temporomandibular joint disease (TMJD). Part II : clinical and radiological semiology. Morbidity processes

The clinical signs and symptoms of greatest semiologic value in temporomandibular joint disease (TMJD) are muscle pain, joint pain, limitations in mandibular movement, and joint sounds. Imaging studies of the joint are very useful for establishing the diagnosis and for discarding other disease processes, though in many cases diagnostic error results from the detection of a large proportion of patients with alterations in the imaging studies but with no associated clinical manifestations. Panoramic X-rays and magnetic resonance imaging are the most commonly used complementary techniques for diagnosing TMJD. MRI may be regarded as the imaging technique of choice, particularly when studying the soft tissues. Biochemical evaluation of the joint synovial fluid has improved our understanding of TMJD pathogenesis, though to date such parameters have not been extended to clinical practice. Myofascial pain with positive painful palpation of the masticatory muscles; joint disc displacements with reduction characterized by the presence of opening or opening and closing clicks; disc displacements without reduction characterized by limitations in oral aperture; and osteoarthritis / osteoarthrosis characterized by the auscultation of friction sounds during mandibular movement, are the morbidity processes most often seen in the context of TMJD. The present study offers a review of the semiology and morbidity processes of the temporomandibular joint

Review of temporomandibular joint pathology. Part I : classification, epidemiology and risk factors

Pathology of the temporomandibular joint (TMJ) affects an important part of the population, though it is not viewed as a public health problem. Between 3-7% of the population seeks treatment for pain and dysfunction of the ATM or related structures. The literature reports great variability in the prevalence of the clinical symptoms (6-93%) and signs (0-93%), probably as a result of the different clinical criteria used. In imaging studies it is common to observe alterations that have no clinical expression of any kind. Radiographic changes corresponding to osteoarthrosis are observed in 14- 44% of the population. Age is a risk factor, though with some particularities. In elderly patients there is an increased prevalence of clinical and radiological signs, though also a lesser prevalence of symptoms and of treatment demands than in younger adults. Approximately 7% of the population between 12 and 18 years of age is diagnosed with mandibular pain-dysfunction. Temporomandibular dysfunction (TMD) is more frequent in females. No clear relationship has been established between occlusal alterations and TMJ disease. Only disharmony between centric relation and maximum intercuspidation, and unilateral crossbite, have demonstrated a certain TMJ disease-predictive potential. Both local and systemic hyperlaxity has been postulated as a possible cause of TMD. Parafunctional habits and bruxism are considered risk factors of TMD with odds ratios (ORs) of up to 4.8. Psychophysiological theory holds stress as a determinant factor in myofascial pain. Genetic factors and orthodontic treatment have not been shown to cause TMD

Volatile compounds, sensory quality and ice morphology in falling-film and block freeze concentration of coffee extract

Coffee extract was freeze-concentrated through block and falling-film techniques. Solute retention and concentration efficiency were determined after one stage of these processes. Ice morphology was characterized through image analysis. Preservation of volatile compounds was determined through GC–MS. The effect of coffee extract on flavour was determined after freeze concentration through sensory evaluation. Solute occlusion was higher for falling-film than for block freeze-concentration, with an average distribution coefficient of 0.45 and 0.29, respectively. The ice crystal size was lower for the falling-film technique; this explains the higher solute occlusion. The dewatering capacity was higher for the falling-film technique, as this process is faster than block freeze-concentration. The most abundant volatile compounds of the coffee extracts were preserved after freeze concentration with both techniques. In the same way, no differences were found in most of the sensory attributes of the freeze-concentrated extract obtained using both techniques. Our results confirm the benefits of the block and falling-film freeze concentration techniques in preserving the quality of coffee extracts.Postprint (author's final draft

Prevalencia del patrón dactilar en los dermatoglifos de estudiantes universitarios de Jalisco, México

fingerprinting is the sci ence that allows the identification of people through the study of the impressions of the papillary ridges of the fingertips. Despite its importance, in Mexico the data published on the frequency of the fingerprint date back to 1966. The studied sample consisted of 66 women and 34 male university students of Jalisco following the classification of Juan Vucetich. The results obtained showed that the fingerprint pattern with more frequency in right thumb in men was whorl (52.9%) and in women external loop (48.5%); left thumb whorls (52.9%) in men and (54.5%) in women; men's right index the internal loop (44.1%), and women (43.9%), left index internal loop in men and women (55.9%); middle finger, right hand, in both genders external loop (88.2%) men and (77.3%) women, and in middle finger, left hand in both genders, inner loop (79.4%) men and (71.2%) women; right ring in men whorl (47.1%), women inner loop (51.5%), in left ring in both genders inner loop (55.9%) men and (56.1%) women; and on the right pinky in b oth genders external loop (85.3%) men and women (78.8%), in left pinky in both genders inner loop (97.1%) men and (84.8%) women. Comparing fingerprint by gender with X2 there were only statistically significant differences p = 0.0029 in fingerprint pattern "arc". Data not currently reported in any other study in the Mexican population

Osteonecrosis of the jaws by intravenous bisphosphonates and osteoradionecrosis : a comparative study

Aims: We analyze the possible clinical differences between bone jaw exposed areas in ONJ (osteonecrosis of the jaws) and ORN (osteoradionecrosis). Patients and method: Group 1 was composed with 53 ONJ cases and group 2 with 20 ORN cases. In both groups we analyzed, the major size of the exposed bone areas, the number of exposed areas, the location on the jaws and the presence of others associated and severe complications, such as skin fistulas and jaw fractures. We also investigated the possible local aetiology or trigger factor of the lesions. Results: The major size of the bone exposed areas was 2.29±2.02(mean ± std.dev) in group 1 and 2.7±2.9 (mean ± std.dev) in group 2 (p>0.05). The number of exposed areas was 1.8±1.34 (mean ± std.dev) in group 1 and 1.2±0.55 (mean ± std.dev) in group 2 (p>0.05). There were more fractures in the second group (20%) (p<0.05), and skin fistulas (35%) (p<0.05). We found more patients in group 1 in which the dental extraction was the local aetiology of the bone necrosis (35 cases, 66.03%), while in group 2 there were 8 (40%) (p<0.05). Conclusions: In our study with ONJ there were not differences in the major size of the bone exposed areas, but there were more lesions per patient than in group with ORN. The severity of the complications, such as jaw fractures and skin fistulas were higher in ORN, and in this group it was more frequent the spontaneous lesions than in the ONJ where it is more frequent following dental extractions

Intra and interrater reliability of the Minimental State Exmination (MMSE) and Montréal Cognitive Assessment (MoCA test) applied by health personnel in training

Introducción: en el proceso del diagnóstico neuropsicológico, los instrumentos de tamizaje cognitivo, son una herramienta útil en la identificación de cambios mentales del sujeto, en momentos puntuales o a través del tiempo. Su uso se fundamenta en el análisis psicométrico. Objetivo: determinar el acuerdo inter e intra-observador en el MoCA test y el MMSE, aplicado por profesores y estudiantes en procesos de entrenamiento de tamización cognitiva. Materiales y métodos: a los estudiantes y profesores en entrenamiento en la puntuación del MoCA test y el MMSE, se les presentó un video en dos sesiones, con un intervalo de 5 meses, mostrando el desempeño de dos adultos mayores, respondiendo el MoCA test y el MMSE, previo consentimiento informado. Se compararon los puntajes dados en las dos sesiones por los sujetos en entrenamiento, con los de ellos mismos (intra-observador), usando el coeficiente de concordancia y correlación de Lin(rho) y con los del grupo restante (inter-observador) usando el coeficiente de correlación intra-clase (ICC). Resultados: participaron 46 evaluadores. Se encontró alta confiabilidad inter-observador para el MoCA (ICC=0.86), pero baja para el MMSE (ICC=0.24) y baja confiabilidad intra-observador tanto para el MoCA (rho paciente 1=0.012 y rho paciente 2=0.152) como para el MMSE (rho paciente 1=0.008 y rho paciente 2=0.012). Aunque los puntajes difirieron, las clasificaciones diagnósticas realizadas por los evaluadores fueron similares a las del patrón de oro. Conclusión: la correcta aplicación del test, requiere varios entrenamientos, y aunque hubo pocas diferencias entre los puntajes, los errores cuando se está cerca del punto de corte propuesto, aumentan el riesgo de sesgo.Introduction: The instruments for screening cognitive functions, applied to subjects in clinical settings and research, are useful for determining if this person has any trouble in cognition or show changes in the time. The usefulness of these instruments is defined with the evaluation of their psychometrics properties. Objective: This study allows to determine the intra and inter-observer agreement, when the MoCA test and MMSE were applied by a group in training process Materials and methods: The study group who attended two training sessions, with an interval of 5 months, scored the MoCA test and MMSE, from two patients which were filmed responding the tests, previous infor¬med consent signature. We compared how close were the scores of participants among themselves by con¬cordance correlation coefficient of Lin (rho) and with those given from the others by intra-class correlation coefficients (ICC). Results: In total, 46 participants were included. Intra-rater reliability was high for MoCA test (ICC = 0.86), but it was poor for MMSE (ICC=0.24). Inter-rater was poor for MoCA test (rho patient 1= 0.012, rho patient 2= 0.152) and MMSE (rho patient 1 = 0.008, rho patient 2 = 0.012). Although the scores between participants and gold standard were different, the diagnoses were similar. Conclusion:The correct scoring of the test, requires several trainings to clinical and research groups, and although they can be found few differences between scores applied by non-expert personnel, if the scores mistakenly given, are close to the cut-of point proposed for each test, the bias increase

Genetic diversity of the Spanish apple genetic resources using SSRs

The Spanish Program of Plant Genetic Resources integrates, among others, the collections located at Public University of Navarre, Centro de Investigaciones Agrarias de Mabegondo, Cabildos (Tenerife, La Palma and Gran Canaria), University of Lleida, Estación Experimental de Aula Dei-CSIC and CITA of Aragon. Those collections include mainly local cultivars from their respective regions, covering most of the Spanish apple-growing areas. Though some previous studies about the genetic variability of apple genetics resources from Spain were already performed, a complete analysis is needed in order to evaluate the complete diversity of Malus spp. in Spain. For doing that, the Spanish Government funded the project ¿Harmonization of the methodology of characterization, assessment of genetic diversity and definition of the core collection of the apple germplasm conserved in Spanish genebanks¿. In total, we have evaluated 1206 accessions using standardized methodologies, with SSR markers and morphological descriptors. SSR fingerprinting was performed with 13 SSR markers. SSR profiles were obtained independently and allele sizes were compared using a common set of cultivars selected as references. Results showed 601 genotypes for 1206 accessions. Most of the genotypes (438) were identified only in one accession. The other 163 genotypes were repeated in two to 81 accessions (involving 767 accessions in total). The harmonization of morphological descriptors will allow us to determine if the accessions with the same genotype are synonymies or closely related individuals. Results of this study highlight the interest of coordinated actions in order to optimize the management of germplasm collections and to evaluate the complete genetic diversity of Malus spp. in Spain.Peer Reviewe

Maternal serum adipokines and inflammatory markers at late gestation and newborn weight in mothers with and without gestational diabetes mellitus

Objectives: Maternal obesity increases the risk of gestational diabetes mellitus (GDM) and is positively correlated with neonatal obesity increasing the risk of adiposity in both young and adult offspring. Maternal secreted factors from adipose tissue such as adipokines and inflammatory cytokines may regulate fetal growth. This study investigated associations between maternal adipokines and inflammatory markers at late gestation, and neonatal anthropometric characteristics in mothers with and without GDM. Material and methods: The study included 65 women with GDM and 65 pregnant women with normal glucose tolerance evaluated at the time of term elective Caesarean section. Adiponectin, leptin, resistin, adipsin, neutrophil gelatinase-associated lipocalin (NGAL), nerve growth factor (NGF), monocyte chemotactic protein-1 (MCP-1) and tumor necrosis factor-alpha (TNF-alpha) concentrations were measured in maternal serum by the multiplex immunoassay using Magpix technology. C-reactive protein (CRP) was measured with a particle-enhanced turbidimetric immunoassay and neonatal anthropometric variables were assessed. The association of birthweight with individual biomarkers was analyzed using multivariate logistic regression adjusted for maternal factors. Results: Adiponectin, leptin, resistin, adipsin, NGAL and NGF were not significantly associated with higher birthweight. The maternal factors in association with higher birthweight observed in GDM were CRP, MCP-1 and TNF-alpha levels. Regression analysis showed that TNF-alpha was an independent risk factor for higher birthweight (p = 0.046). Conclusions: These results suggest an involvement of maternal inflammatory markers at late gestation and fetal growth in mothers with GDM, and that TNF-alpha could play a major role

Identificación y distribución temporal de transiciones tropicales en el Océano Atlántico Norte

Ponencia presentada en: XII Congreso de la Asociación Española de Climatología celebrado en Santiago de Compostela entre el 19 y el 21 de octubre de 2022.Este trabajo esta parcialmente financiado por los proyectos de investigación PID2019-105306RB-I00 (IBERCANES) and CGL2016-78702 (SAFEFLIGHT). Este trabajo también tiene el apoyo de los Proyectos Especiales del ECMWF SPESMART y SPEVALE. Carlos Calvo-Sancho y Javier Díaz Fernández agradece el contrato otorgado por el Ministerio de Ciencia e Innovación – Programa FPI (PRE2020-092343 y BES-2017-080025, respectivamente)