Follicular conjunctivitis caused by Chlamydia trachomatis in an infant Saharan population: molecular and clinical diagnosis

Aims: To ascertain the prevalence of acute trachoma as a supposed endemic disease among infants in the Saharan refugee camps of Tindouf (Algeria) and to evaluate the efficacy of treatment with a single dose of azithromycin. Methods: 527 children aged between 3 and 17 were evaluated in the camp schools in October 2001. All the children were clinically and microbiologically examined, including slit lamp checks of anterior segment and two conjunctival swabs, one for the detection of membrane lipopolysaccharide by quick immunoassay test Clearview Chlamydia MF and the other for the detection of specific DNA by chlamydia plasmid specific polymerase chain reaction (PCR) assay. After examination, a single dose of azithromycin was administered to each child. One month later samples from positive children and 12 random negative children by the first PCR were taken to perform a new PCR assay. Results: Chlamydia trachomatis was suspected in 2.47% of the children, papillary hypertrophy being the most frequently seen clinical sign. Scarring changes secondary to trachoma were detected in 11.7% of the children. Only four cases (0.8%) were positive to the immunoassay test and 12 cases (2.27%) were positive by PCR. After treatment a second PCR was performed on positive children and they were negative of chlamydia DNA amplification. However, one child who was negative and received the treatment was positive in the second PCR assay. Conclusion: Acute trachoma prevalence is much lower than expected among infants in this Saharan population. The possible reasons could be the recent improvements in hygiene and health care. Cicatricial trachoma is more frequent. The Clearview immunoassay test has very low sensitivity in the detection of this disease. A single dose of azithromycin is sufficient to treat chlamydial conjunctivitis. However, a programme of improvement in hygiene and health care is necessary to prevent re-infectio

Human resource practices and performance in small Spanish wineries, and their evolution with age and size

This research aims to cover the existing gap in knowledge regarding human resource management practices in winery businesses. Three of the most important practices in this field - recruitment and selection, training and development, and remuneration - and their relationship with performance in small family and non-family wineries as well as the differences in those businesses' behaviours according to their age and size were analysed. The analysis was based on a 2016 database containing 339 Spanish wine sector SMEs, and a multivariate Bayesian regression methodology was applied. The results demonstrate a lower level of human resource management practices in small family businesses and a stronger relationship with performance than in non-family businesses. The results also show that human resource management varies according to the age and size of the company, indicating an inverted U-shaped relationship with size. On the one hand, these results highlight the importance of human resource practices in the environment of a small winery. These practices have not usually been considered as drivers of performance in small family firms. On the other hand, the results can be useful for the managers of such firms, both in the wine industry and in general, as they highlight the human resource practices that could improve the performance of those entities. The paper contributes to filling the existing gap in the literature related to small family businesses. Esta pesquisa visa cobrir a lacuna existente no conhecimento sobre práticas de gestão de recursos humanos em empresas vinícolas. Foram analisadas três das práticas mais importantes neste campo - recrutamento e seleção, treino e desenvolvimento, e remuneração - e sua relação com o desempenho em pequenas adegas, familiares e não familiares, bem como as diferenças no comportamento dessas empresas de acordo com a sua idade e a sua dimensão. A análise foi baseada num banco de dados de 2016 contendo 339 PME do setor vinícola espanhol, tendo sido aplicada a metodologia de regressão bayesiana multivariada. Os resultados demonstram um nível mais baixo de práticas de gestão de recursos humanos em pequenas empresas familiares e uma relação mais forte com o desempenho do que em empresas não familiares. Relatam também que a gestão de recursos humanos varia de acordo com a idade e a dimensão da empresa, encontrando uma relação em U invertido com a dimensão. Por um lado, estes resultados destacam a importância das práticas de recursos humanos no ambiente de uma pequena adega. Estas práticas não têm sido geralmente consideradas como motores de desempenho em pequenas empresas familiares. Por outro lado, os resultados podem ser úteis para os gerentes de tais empresas, tanto na indústria do vinho como na indústria em geral, pois destacam as práticas de recursos humanos que podem melhorar o desempenho dessas entidades. O artigo contribui para preencher a lacuna existente na literatura relativamente às pequenas empresas familiares

The competitive advantage in business, capabilities and strategy. What general performance factors are found in the Spanish wine industry?

The wine sector in Europe has undergone a major change of trend in recent years, especially in Spain. On the one hand, the surface area has been reduced, but the production has been maintained by restructurings and improvements made in exploitation techniques. On the other hand, consumption has diminished causing a significant increase in competition. The Spanish wine sector is formed mainly by small and medium-sized firm, which is representative of the size of existing companies in Europe. This article aims to analyze the relationships between the competitive strategy, resources and capabilities of the firms, analyzing their technological and managerial capabilities, with business performance. 339 companies of the wine sector in Spain have been studied, differentiating between individual firms, cooperatives and mercantile companies. The results reveal that resources and capabilities along with strategies define competitive advantage, but their relationship and importance is different for each type of company

The relevance of caseous lymphadenitis as a cause of culling in adult sheep

Four hundred and ninety-eight culled sheep received at the Ruminant Clinical Service of the Veterinary Faculty of Zaragoza, Spain, were examined in life and after humanitarian sacrifice in order to reach the final diagnosis of the cause of culling and to evaluate the presence of caseous lymphadenitis (CLA) lesions. One hundred and forty-seven of the 498 studied animals (29.52%) showed CLA compatible lesions that were subsequently confirmed by Corynebacterium pseudotuberculosis isolation. One hundred and seven of the 147 CLA affected animals presenting the visceral clinical form of the disease (72.79%), while only 32 animals were affected by the superficial form (21.77%). In addition, eight animals were found to be affected in both the visceral and the superficial presentations (5.44%). Eighty-four of the 147 CLA-affected animals (57.14%) did not show any concurrent disease, considering, in this case, CLA the main cause of culling (84/498: 16.87%). In the superficial presentation, the retropharyngeal lymph node, as a sole lesion, was the most frequently affected (13/32: 40.63%). Further, in the visceral form of the disease, 85.06% of the affected animals had the lesions located in the respiratory system (91/107: 85.06%). CLA was revealed as an important cause of culling in sheep production

Photoactivity improvement of TiO2 electrodes by thin hole transport layers of reduced graphene oxide

Nanostructured TiO2 and graphene-based materials constitute components of actual interest in devices related to solar energy conversion and storage. In this work, we show that a thin layer of electrochemically reduced graphene oxide (ECrGO), covering nanostructured TiO2 photoelectrodes, can significantly improve the photoactivity. In order to understand the working principle, ECrGO/TiO2 photoelectrodes with different ECrGO thicknesses were prepared and studied by a set of photoelectrochemical measurements. Methanol in alkaline conditions was employed as effective hole acceptor probe to elucidate the electronic phenomena in the electrode layers and interfaces. These studies underline the hole accepting properties of ECrGO and reveal the formation of a p-n junction at the interface between ECrGO and TiO2. It is shown for the first time that the resulting space charge region of about 10 nm defines the operational functionality of the ECrGO layer. Films thinner than the space charge region act as hole transport layer (HTL), which efficiently transfers holes to the liquid interface thus leading to enhanced photoactivity. Thicker films however act as hole blocking layer (HBL), resulting in a systematic decrease of the photoactivity. The finding of a thickness dependent threshold value for the operation of ECrGO as HTL and HBL is of general interest for the fabrication of optoelectronic devices with improved performance

Algoritmo de actuación en la farmacia comunitaria para optimizar la utilización de estatinas

INTRODUCCIÓN: Pacientes en tratamiento con estatinas suelen presentar numerosos problemas relacionados con la medicación, no solo de seguridad sino también de necesidad y de efectividad. OBJETIVO: Proponer un algoritmo de actuación del farmacéutico comunitario en la dispensación de estatinas para optimizar la utilización de este grupo de medicamentos. MATERIAL Y MÉTODOS: Recogida de datos (cuestionario) en farmacia comunitaria (3 meses) en pacientes con prescripción de estatinas. Determinación de presión arterial, IMC, perímetro abdominal y cálculo del riesgo cardiovascular (RCV) (tablas SCORE y REGICOR). RESULTADOS: Se incluyen 48 pacientes. Se evidencia falta de control del colesterol (25%) y de la presión arterial (48%). Se deriva al médico el 21% que tiene la presión arterial >140/90 mm Hg y no están diagnosticados. También se derivan al médico cuando la falta de adherencia no es la causa de la inefectividad (29%) o cuando no tienen RCV alto (38%) que justifique la necesidad de estatina. En los restantes se detecta necesidad de información/educación y se interviene. Se han realizado un total de 145 intervenciones enel 90% de pacientes incluidos. En base a estos resultados se propone un algoritmo simplificado de actuación en la dispensación de estatinas. CONCLUSIONES: El grupo de pacientes tratados con estatinas es susceptible de actuación por parte del farmacéutico comunitario, que, mediante un algoritmo de actuación sencillo, puede detectar durante la dispensación numerosos problemas relacionados con la medicación e intervenir para mejorar el uso y la efectividad de estos fármacos

Utilización de montelukast en población pediátrica: estudio en tres farmacias comunitarias

Objetivo: El objetivo de este trabajo es analizar, desde tres farmacias comunitarias, el uso que se está haciendo de montelukast en la población pediátrica. Método: Estudio observacional de prescripción de montelukast realizado en tres oficinas de farmacia en niños (≤15 años) a los que se dispensó el fármaco; la recopilación de datos de los pacientes (edad, patologías, régimen de dosificación, duración del tratamiento, medicación asociada) se hizo a través de encuesta. Se remitió al médico cuando se detectó un tratamiento inadecuado, para su revisión. Resultados: Se recogieron un total de 75 prescripciones médicas. Sólo el 36% de los niños eran asmáticos; de ellos, al 70% se les pautó montelukast como terapia inicial, y el 45% no seguían las recomendaciones de la Guía Española para el Manejo del Asma. El 64% de los niños no eran asmáticos y estaban recibiendo montelukast fuera de indicación (off-label) (44% rinitis alérgica, 56% bronquiolitis), el 21% de ellos en monoterapia y el resto en combinación con otros fármacos. Conclusiones: Se está haciendo un uso fuera de indicación de montelukast en niños no asmáticos con rinitis alérgica o bronquiolitis, y en este último caso no existe evidencia de efectividad. El uso inadecuado podría acarrear problemas de seguridad para los pacientes. Se evidencia la necesidad de proporcionar información independiente a los profesionales sanitarios sobre el papel de montelukast en la terapéutica

Algoritmo de actuación en la farmacia comunitaria para optimizar la utilización de estatinas

INTRODUCCIÓN: Pacientes en tratamiento con estatinas suelen presentar numerosos problemas relacionados con la medicación, no solo de seguridad sino también de necesidad y de efectividad. OBJETIVO: Proponer un algoritmo de actuación del farmacéutico comunitario en la dispensación de estatinas para optimizar la utilización de este grupo de medicamentos. MATERIAL Y MÉTODOS: Recogida de datos (cuestionario) en farmacia comunitaria (3 meses) en pacientes con prescripción de estatinas. Determinación de presión arterial, IMC, perímetro abdominal y cálculo del riesgo cardiovascular (RCV) (tablas SCORE y REGICOR). RESULTADOS: Se incluyen 48 pacientes. Se evidencia falta de control del colesterol (25%) y de la presión arterial (48%). Se deriva al médico el 21% que tiene la presión arterial >140/90 mm Hg y no están diagnosticados. También se derivan al médico cuando la falta de adherencia no es la causa de la inefectividad (29%) o cuando no tienen RCV alto (38%) que justifique la necesidad de estatina. En los restantes se detecta necesidad de información/educación y se interviene. Se han realizado un total de 145 intervenciones enel 90% de pacientes incluidos. En base a estos resultados se propone un algoritmo simplificado de actuación en la dispensación de estatinas. CONCLUSIONES: El grupo de pacientes tratados con estatinas es susceptible de actuación por parte del farmacéutico comunitario, que, mediante un algoritmo de actuación sencillo, puede detectar durante la dispensación numerosos problemas relacionados con la medicación e intervenir para mejorar el uso y la efectividad de estos fármacos

Utilización de montelukast en población pediátrica: estudio en tres farmacias comunitarias

Objetivo: El objetivo de este trabajo es analizar, desde tres farmacias comunitarias, el uso que se está haciendo de montelukast en la población pediátrica. Método: Estudio observacional de prescripción de montelukast realizado en tres oficinas de farmacia en niños (≤15 años) a los que se dispensó el fármaco; la recopilación de datos de los pacientes (edad, patologías, régimen de dosificación, duración del tratamiento, medicación asociada) se hizo a través de encuesta. Se remitió al médico cuando se detectó un tratamiento inadecuado, para su revisión. Resultados: Se recogieron un total de 75 prescripciones médicas. Sólo el 36% de los niños eran asmáticos; de ellos, al 70% se les pautó montelukast como terapia inicial, y el 45% no seguían las recomendaciones de la Guía Española para el Manejo del Asma. El 64% de los niños no eran asmáticos y estaban recibiendo montelukast fuera de indicación (off-label) (44% rinitis alérgica, 56% bronquiolitis), el 21% de ellos en monoterapia y el resto en combinación con otros fármacos. Conclusiones: Se está haciendo un uso fuera de indicación de montelukast en niños no asmáticos con rinitis alérgica o bronquiolitis, y en este último caso no existe evidencia de efectividad. El uso inadecuado podría acarrear problemas de seguridad para los pacientes. Se evidencia la necesidad de proporcionar información independiente a los profesionales sanitarios sobre el papel de montelukast en la terapéutica

Optilene, a new non-absorbable monofilament is safe and effective for CABG anastomosis. OPTICABG - A prospective international, multi-centric, cohort study

Introduction: Coronary artery bypass grafting (CABG) is performed to improve quality of life and to reduce cardiac-related mortality and morbidity in patients with coronary artery disease (CAD). The aim of the present observational study was to assess the performance of a new suture material (Optilene) for anastomosis construction in CABG surgery using a routine clinical procedure. Performance was assessed using the incidence of major adverse cardiac and cerebrovascular events (MACCE). Methods: The study was designed as an international, multi-centre, prospective cohort study to evaluate the safety and efficacy of a new non-absorbable monofilament for CABG surgery compared to data published in a previous meta-analysis. Optilene suture was used to create the distal and proximal coronary artery anastomoses. The primary endpoint was the cumulative MACCE rate up to discharge. Secondary parameters were intraoperative handling of the suture material and QoL up to 3 months after surgery. Patients were examined 30 days and 3 months postoperatively. Results: In total, 199 patients were enrolled in 3 centres in Europe. The cumulative CABG adverse event rate up to the day of discharge was 3%, in contrast to the 8.46% given by the data generated by Nalysnyk et al. A t-test showed that our CABG rate was significantly lower. QoL significantly increased from preoperatively until 3 months after surgery. Ease of handling the suture material was rated as very good. Conclusion: Optilene suture material represents a safe and effective alternative to existing sutures used in CABG surgery for anastomosis construction