Does Simple “Reassurance” Work in Patients with Medically Unexplained Physical Symptoms?

Escobar discusses a new study examining the impact of reassurance in three groups: patients with medically unexplained physical symptoms compared, healthy controls, and patients with depression

Using positive deviance in the prevention and control of MRSA infections in a Colombian hospital: a time-series analysis

Positive Deviance (PD) is a process to achieve a social and cultural change. This strategy has been used for the control of methicillin-resistant Staphylococcus aureus (MRSA) infection in some health institutions in the United States, but has rarely been adopted in institutions from developing countries where resources are limited. We describe our experience of PD in the control of healthcare-associated infections (HAIs) due to MRSA in a Colombian hospital with the aim of reducing HAI rates through a cultural change in processes. A time-series study was conducted based on the MRSA-HAI rate and the number of months with zero MRSA infections before and after application of PD (2001-2012). On comparing the pre-intervention and intervention periods, the mean overall rates of MRSA-HAI was 0·62 and 0·36, respectively (P = 0·0005); the number of months with zero MRSA-HAIs were 3/70 and 12/74 (odds ratio 0·264, 95% confidence interval 0·078-0·897); the percentage of MRSA-HAIs was 53·2% and 41·0%. These results are consistent with other published data. Implementation of PD was associated with a significant reduction of MRSA-HAIs, it did not involve high costs and the changes have been lasting

Relevance of Qualitative Research Approach in Evaluating Mental Health Interventions among Victims of Violence

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Detection of a new community genotype methicillin-resistant staphylococcus aureus clone that is unrelated to the USA300 clone and that causes pediatric infections in colombia

The dissemination of a clone of community genotype methicillin-resistant Staphylococcus aureus (CG-MRSA) that is related to USA300 has been reported in Latin America. We recently detected isolates of a new clone of CG-MRSA (spa type t1635 and ACME-negative) that was genetically unrelated to the USA300 clone and that causes infections in children in Colombia. This finding indicates the appearance of a new clone of CG-MRSA in our region. Copyright © 2013, American Society for Microbiology

Parkinsonian motor impairment predicts personality domains related to genetic risk and treatment outcomes in schizophrenia

Identifying endophenotypes of schizophrenia is of critical importance and has profound implications on clinical practice. Here we propose an innovative approach to clarify the mechanims through which temperament and character deviance relates to risk for schizophrenia and predict long-term treatment outcomes. We recruited 61 antipsychotic naïve subjects with chronic schizophrenia, 99 unaffected relatives, and 68 healthy controls from rural communities in the Central Andes. Diagnosis was ascertained with the Schedules of Clinical Assessment in Neuropsychiatry; parkinsonian motor impairment was measured with the Unified Parkinson’s Disease Rating Scale; mesencephalic parenchyma was evaluated with transcranial ultrasound; and personality traits were assessed using the Temperament and Character Inventory. Ten-year outcome data was available for ~40% of the index cases. Patients with schizophrenia had higher harm avoidance and self-transcendence (ST), and lower reward dependence (RD), cooperativeness (CO), and self-directedness (SD). Unaffected relatives had higher ST and lower CO and SD. Parkinsonism reliably predicted RD, CO, and SD after correcting for age and sex. The average duration of untreated psychosis (DUP) was over 5 years. Further, SD was anticorrelated with DUP and antipsychotic dosing at follow-up. Baseline DUP was related to antipsychotic dose-years. Further, ‘explosive/borderline’, ‘methodical/obsessive’, and ‘disorganized/schizotypal’ personality profiles were associated with increased risk of schizophrenia. Parkinsonism predicts core personality features and treatment outcomes in schizophrenia. Our study suggests that RD, CO, and SD are endophenotypes of the disease that may, in part, be mediated by dopaminergic function. Further, SD is an important determinant of treatment course and outcome

Synthesis and Characterisation of ASA-PEEK Composites for Fused Filament Fabrication

In this paper, a series of polymer composites made from acrylonitrile-styrene-acrylate (ASA) and poly (ether ether ketone) (PEEK) were manufactured. ASA acts as a polymer matrix while PEEK is loaded in the form of micro-particles that act as a reinforcing filler. The composites were compounded by single screw extrusion and then, different specimens were manufactured either via injection moulding (IM) or fused filament fabrication (FFF). Two different types of PEEK (commercial and reused) in different concentrations (3 and 6 wt.%) were tested and their influence in the mechanical, structural, and thermal properties were studied. It was observed that reused PEEK enhanced the stiffness and tensile strength and thermal stability of the composites both, for injected and printed specimens. This evidences the suitability of these composites as potential candidates as novel materials with enhanced properties following an approach of circular economy

Assessment of oxidative damage to proteins and DNA in urine of newborn infants by a validated UPLC-MS/MS approach

The assessment of oxidative stress is highly relevant in clinical Perinatology as it is associated to adverse outcomes in newborn infants. This study summarizes results from the validation of an Ultra Performance Liquid Chromatography-tandem Mass Spectrometry (UPLC-MS/MS) method for the simultaneous quantification of the urinary concentrations of a set of endogenous biomarkers, capable to provide a valid snapshot of the oxidative stress status applicable in human clinical trials, especially in the field of Perinatology. The set of analytes included are phenylalanine (Phe), para-tyrosine (p-Tyr), ortho-tyrosine (o-Tyr), meta-tyrosine (m-Tyr), 3-NO2-tyrosine (3NO 2-Tyr), 3-Cl-tyrosine (3Cl-Tyr), 2′-deoxyguanosine (2dG) and 8-hydroxy-2′-deoxyguanosine (8OHdG). Following the FDA-based guidelines, appropriate levels of accuracy and precision, as well as adequate levels of sensitivity with limits of detection (LODs) in the low nanomolar (nmol/L) range were confirmed after method validation. The validity of the proposed UPLC-MS/MS method was assessed by analysing urine samples from a clinical trial in extremely low birth weight (ELBW) infants randomized to be resuscitated with two different initial inspiratory fractions of oxygen

Encapsulation of Phenolic Compounds from a Grape Cane Pilot-Plant Extract in Hydroxypropyl Beta-Cyclodextrin and Maltodextrin by Spray Drying

Grape canes, the main byproducts of the viticulture industry, contain high-value bioactive phenolic compounds, whose application is limited by their instability and poorly solubility in water. Encapsulation in cyclodextrins allows these drawbacks to be overcome. In this work, a grape cane pilot-plant extract (GCPPE) was encapsulated in hydroxypropyl beta-cyclodextrin (HP-β-CD) by a spray-drying technique and the formation of an inclusion complex was confirmed by microscopy and infrared spectroscopy. The phenolic profile of the complex was analyzed by LC-ESI-LTQ-Orbitrap-MS and the encapsulation efficiency of the phenolic compounds was determined. A total of 42 compounds were identified, including stilbenes, flavonoids, and phenolic acids, and a complex of (epi)catechin with β-CD was detected, confirming the interaction between polyphenols and cyclodextrin. The encapsulation efficiency for the total extract was 80.5 ± 1.1%, with restrytisol showing the highest value (97.0 ± 0.6%) and (E)-resveratrol (32.7 ± 2.8%) the lowest value. The antioxidant capacity of the inclusion complex, determined by ORAC-FL, was 5300 ± 472 µmol TE/g DW, which was similar to the value obtained for the unencapsulated extract. This formulation might be used to improve the stability, solubility, and bioavailability of phenolic compounds of the GCPPE for water-soluble food and pharmaceutical applications