Evaluación clínica y hoja de registro de cuidados de enfermería del sistema de control fecal en pacientes críticos

Fecal incontinence in critical patients predisposes them to several complications as: tissue viability problems, infections, or patients well-being effects. This kind of problems could increase average stay hospital, with economic and health system repercussions.The evidence shows that traditional managements of fecal incontinence have adverse outcomes which are unresolved.The Flexi-seal® management system (FMS), reduces these complications, and its effectiveness is based on different studies (Martínez Estadella G et al, 2006), (Ares Sánchez M et al, 2006) (Bordes J et all, 2007), (Pelleschi ME, 2008).It is necessary to describe the insertion technique, and Nursing interventions orientated to patients who need Flexi-seal® management system (FMS), in order to improve Nursing Cares.La incontinencia fecal en los Pacientes Críticos produce una serie de complicaciones como son: el deterioro de la integridad cutánea de la piel, infecciones, alteración en la autoestima del paciente, etc. Esta serie de problemas puede ocasionar un aumento en la media de estancia de los pacientes ingresados con repercusiones sanitarias y económicas.La evidencia científica nos indica que los sistemas tradicionales utilizados para la incontinencia fecal producen diferentes problemas potenciales aún sin solucionar.El sistema de control de la incontinencia fecal Flexi-Seal® FMS (Fig. nº1) produce una reducción de estos problemas y su efectividad está basada en diferentes estudios recientes que así lo demuestran (Martínez Estadella, G. et al, 2006), (Ares Sánchez, M. et al, 2006) (Bordes, J. et al, 2007), (Pelleschi, ME, 2008).Es necesario describir tanto la técnica de inserción como los Cuidados de Enfermería de este nuevo dispositivo de incontinencia fecal

Vitamin D Status in Distinct Types of Ichthyosis: Importance of Genetic Type and Severity of Scaling

Data on vitamin D status of patients with inherited ichthyosis in Europe is scarce and unspecific concerning the genetic subtype. This study determined serum levels of 25-hydroxyvitamin D3 (25(OH)D3) in 87 patients with ichthyosis; 69 patients were additionally analysed for parathyroid hormone. Vitamin D deficiency was pronounced in keratinopathic ichthyosis (n = 17; median 25(OH)D3: 10.5 ng/ml), harlequin ichthyosis (n = 2;7.0 ng/ml) and rare syndromic subtypes (n = 3; 7.0 ng/ml). Vitamin D levels were reduced in TG1-proficient lamellar ichthyosis (n = 15; 8.9 ng/ml), TG1-deficient lamellar ichthyosis (n = 12; 11.7 ng/ml), congenital ichthyosiform erythroderma (n = 13; 12.4 ng/ml), Netherton syndrome (n = 7; 10.7 ng/ml) and X-linked ichthyosis (n = 8; 13.9 ng/ml). In ichthyosis vulgaris 25(OH)D3 levels were higher (n = 10; 19.7 ng/ml). Parathyroid hormone was elevated in 12 patients. Low 25(OH)D3 levels were associated with high severity of scaling (p = 0.03) implicating scaling as a risk factor for vitamin D deficiency. Thus, this study supports our recent guidelines for ichthyoses, which recommend screening for and substituting of vitamin D deficiency

X-chromosome tiling path array detection of copy number variants in patients with chromosome X-linked mental retardation

Contiene 3 ficheros adicionales con información suplementaria.-- et al.[Background] Aproximately 5–10% of cases of mental retardation in males are due to copy number variations (CNV) on the X chromosome. Novel technologies, such as array comparative genomic hybridization (aCGH), may help to uncover cryptic rearrangements in X-linked mental retardation (XLMR) patients. We have constructed an X-chromosome tiling path array using bacterial artificial chromosomes (BACs) and validated it using samples with cytogenetically defined copy number changes. We have studied 54 patients with idiopathic mental retardation and 20 controls subjects.[Results] Known genomic aberrations were reliably detected on the array and eight novel submicroscopic imbalances, likely causative for the mental retardation (MR) phenotype, were detected. Putatively pathogenic rearrangements included three deletions and five duplications (ranging between 82 kb to one Mb), all but two affecting genes previously known to be responsible for XLMR. Additionally, we describe different CNV regions with significant different frequencies in XLMR and control subjects (44% vs. 20%).[Conclusion] This tiling path array of the human X chromosome has proven successful for the detection and characterization of known rearrangements and novel CNVs in XLMR patients.The authors thank the "Genoma España" and Genome Canada joint R+D+I projects in human health, plants and aquiculture; the former "Departament d'Universitats i Societat de la Informació" (DURSI) and the "Departament de Salut", from the Catalan Autonomous Government (2005SGR00008 - Generalitat de Catalunya); the Instituto de Salud Carlos III (PI041126, CIBER-ESP), the EU's Sixth Framework Programme [FP6-2005-LIFESCIHEALTH-7; ANEUPLOIDY No. 037627] and Fundación Areces (U-2006-FARECES-O).Peer reviewe

La apertura de Gijón al futuro: La revisión limitada del Catálogo Monumental

[EN] Gijón, also known as Xixón, is an important city that rivals Oviedo, the historical capital of the Autonomous Region and Principality of Asturias (Spain), in historical demographic and economic terms. It has traditionally been a port and, more recently, an industrial city, which experienced very rapid population growth and with little planning. After the industrial crisis of the 80s, the city wanted to become a tourist location more than an industrial harbor. Both its privileged location and the historical urban heritage that still remain are corner stones to make this change possible. However, the late and strict legislation (improvised to protect the last remains of a previously uncontrolled development) impeded a necessary urban re-design in order to shelter the new touristic supplies. This paper proposes some urban solutions to selectively modify the catalogue according with the cultural and touristic potentials of the city. These solutions were agreed by the working group set up by Gijón City Council and ERDU (Estudio de Renovación y Desarrollos Urbanos -Urban Renovation and Development Studio).[ES] Gijón, también conocida como Xixón, es una ciudad importante que rivaliza con Oviedo, la capital histórica de la Comunidad Autónoma y Principado de Asturias (España), en términos demográficos y económicos históricos. Ha sido tradicionalmente un puerto y, más recientemente, una ciudad industrial, que experimentó un crecimiento muy rápido de la población y con poca planificación. Después de la crisis industrial de los años 80, la ciudad quería llegar a ser un lugar turístico más de un puerto industrial. Tanto su ubicación privilegiada como lo que se conserva de su rico patrimonio histórico, son piedras angulares para hacer posible este cambio. Sin embargo, la legislación tardía y estricta (improvisada para proteger los últimos restos de un desarrollo incontrolado anterior) impidió un re-diseño urbano necesario para albergar a los nuevos suministros turísticos. Este documento propone algunas soluciones urbanas para modificar selectivamente el catálogo de acuerdo con los potenciales culturales y turísticos de la ciudad. Estas soluciones fueron acordados por el grupo de trabajo creado por el AyuntamientoLatorre, J.; Sola, J. (2016). Opening Gijón to Future: The Limited Revision of the Official Urban Catalogue. VLC arquitectura. Research Journal. 3(2):149-172. doi:10.4995/vlc.2016.5747.SWORD14917232Ábalos, I-aki. Naturaleza y artificio. El ideal pintoresco en la arquitectura y el paisajismo contemporáneos. Barcelona: Gustavo Gili, 2009.Ayús y Rubio, Manuel. Régimen Jurídico de los Entornos de Protección de los Bienes de Interés Cultural. Alicante: Universidad de Alicante, 2013.Bermúdez Sánchez, Javier, El derecho de propiedad: límites derivados de la protección arqueológica. Editorial Madrid: Montecorvo SA., 2003.Calles Oyarbide, I-igo and Álvarez Areces, Miguel Ángel. Paisajes de la industrialización asturiana. Gijón: Editorial TREA y Principado de Asturias, 2009.Cortina Frade, Isidoro. Catálogo histórico y monumental de Gijón: San Julián de Lavandera, San Juan de Fano y Santa Eulalia de Baldornón. Oviedo: Ayuntamiento de Oviedo, 1981.García García, María Jesús. La conservación de los inmuebles históricos a través de técnicas urbanísticas y rehabilitadoras. Pamplona: Editorial Aranzadi, 2000.González-Varas Ibá-ez, Santiago. La rehabilitación urbanística. Pamplona: Editorial Aranzadi, 1998.Llordén Mi-ambres, Moisés. The Economic and Urban Development of Gijón in the 19th and 20th centuries. Oviedo: Universidad de Oviedo, 1994.Pi-era, Luis Miguel. Las calles de Gijón. Historia de sus nombres. Gijón: Ayuntamiento de Gijón, 2005.Sánchez Mesa Martínez, Leonardo. La restauración inmobiliaria en la regulación del patrimonio histórico. Pamplona: Editorial Aranzadi, 2004.Sendín García, Manuel Ángel. Las transformaciones en el paisaje urbano de Gijón (1834-1939). Oviedo: Real Instituto de Estudios Asturianos, 1995

Targeted prevention of common mental health disorders in university students: randomised controlled trial of a transdiagnostic trait-focused web-based intervention

Background: A large proportion of university students show symptoms of common mental disorders, such as depression, anxiety, substance use disorders and eating disorders. Novel interventions are required that target underlying factors of multiple disorders.<p></p> Aims: To evaluate the efficacy of a transdiagnostic trait-focused web-based intervention aimed at reducing symptoms of common mental disorders in university students.<p></p> Method: Students were recruited online (n = 1047, age: M = 21.8, SD = 4.2) and categorised into being at high or low risk for mental disorders based on their personality traits. Participants were allocated to a cognitive-behavioural trait-focused (n = 519) or a control intervention (n = 528) using computerised simple randomisation. Both interventions were fully automated and delivered online (trial registration: ISRCTN14342225). Participants were blinded and outcomes were self-assessed at baseline, at 6 weeks and at 12 weeks after registration. Primary outcomes were current depression and anxiety, assessed on the Patient Health Questionnaire (PHQ9) and Generalised Anxiety Disorder Scale (GAD7). Secondary outcome measures focused on alcohol use, disordered eating, and other outcomes.<p></p> Results: Students at high risk were successfully identified using personality indicators and reported poorer mental health. A total of 520 students completed the 6-week follow-up and 401 students completed the 12-week follow-up. Attrition was high across intervention groups, but comparable to other web-based interventions. Mixed effects analyses revealed that at 12-week follow up the trait-focused intervention reduced depression scores by 3.58 (p<.001, 95%CI [5.19, 1.98]) and anxiety scores by 2.87 (p = .018, 95%CI [1.31, 4.43]) in students at high risk. In high-risk students, between group effect sizes were 0.58 (depression) and 0.42 (anxiety). In addition, self-esteem was improved. No changes were observed regarding the use of alcohol or disordered eating.<p></p> Conclusions This study suggests that a transdiagnostic web-based intervention for university students targeting underlying personality risk factors may be a promising way of preventing common mental disorders with a low-intensity intervention

A new small-bodied azhdarchoid pterosaur from the Lower Cretaceous of England and its implications for pterosaur anatomy, diversity and phylogeny

BACKGROUND: Pterosaurs have been known from the Cretaceous sediments of the Isle of Wight (southern England, United Kingdom) since 1870. We describe the three-dimensional pelvic girdle and associated vertebrae of a small near-adult pterodactyloid from the Atherfield Clay Formation (lower Aptian, Lower Cretaceous). Despite acknowledged variation in the pterosaur pelvis, previous studies have not adequately sampled or incorporated pelvic characters into phylogenetic analyses. METHODOLOGY/PRINCIPAL FINDINGS: The new specimen represents the new taxon Vectidraco daisymorrisae gen. et sp. nov., diagnosed by the presence of a concavity posterodorsal to the acetabulum and the form of its postacetabular process on the ilium. Several characters suggest that Vectidraco belongs to Azhdarchoidea. We constructed a pelvis-only phylogenetic analysis to test whether the pterosaur pelvis carries a useful phylogenetic signal. Resolution in recovered trees was poor, but they approximately matched trees recovered from analyses of total evidence. We also added Vectidraco and our pelvic characters to an existing total-evidence matrix for pterosaurs. Both analyses recovered Vectidraco within Azhdarchoidea. CONCLUSIONS/ SIGNIFICANCE: The Lower Cretaceous strata of western Europe have yielded members of several pterosaur lineages, but Aptian pterosaurs from western Europe are rare. With a pelvis length of 40 mm, the new animal would have had a total length of c. 350 mm, and a wingspan of c. 750 mm. Barremian and Aptian pterodactyloids from western Europe show that small-bodied azhdarchoids lived alongside ornithocheirids and istiodactylids. This assemblage is similar in terms of which lineages are represented to the coeval beds of Liaoning, China; however, the number of species and specimens present at Liaoning is much higher. While the general phylogenetic composition of western European and Chinese communities appear to have been approximately similar, the differences may be due to different palaeoenvironmental and depositional settings. The western Europe pterodactyloid record may therefore be artificially low in diversity due to preservational factors

Severe infections and infection-related mortality in a large series of haploidentical hematopoietic stem cell transplantation with post-transplant cyclophosphamide

Severe infections and their attributable mortality are major complications in recipients of allogeneic hematopoietic stem cell transplantation (alloSCT). We herein report 236 adult patients who received haploSCT with PTCy. The median follow-up for survivors was 37 months. The overall incidence of bloodstream infections by gram-positive and gram-negative bacteria at 37 months was 51% and 46%, respectively. The incidence of cytomegalovirus infection was 69%, while Epstein Barr virus infections occurred in 10% of patients and hemorrhagic cystitis in 35% of cases. Invasive fungal infections occurred in 11% at 17 months. The 3-year incidence of infection-related mortality was 19%. The median interval from transplant to IRM was 3 months (range 1-30), 53% of IRM occurred >100 days post-haploSCT. Risk factors for IRM included age >50 years, lymphoid malignancy, and developing grade III-IV acute GvHD. Bacterial infections were the most common causes of IRM (51%), mainly due to gram-negative bacilli BSI. In conclusion, severe infections are the most common causes of NRM after haploSCT with PTCy, with a reemergence of gram-negative bacilli as the most lethal pathogens. More studies focusing on the severe infections after haploSCT with PTCy and differences with other types of alloSCT in adults are clearly warranted

Methyl-β-Cyclodextrins Preferentially Remove Cholesterol from the Liquid Disordered Phase in Giant Unilamellar Vesicles

Methyl-β-cyclodextrins (MβCDs) are molecules that are extensively used to remove and to load cholesterol (Chol) from artificial and natural membranes; however, the mechanism of Chol extraction by MβCD from pure lipids or from complex mixtures is not fully understood. One of the outstanding questions in this field is the capability of MβCD to remove Chol from lipid domains having different packing. Here, we investigated the specificity of MβCD to remove Chol from coexisting macrodomains with different lipid packing. We used giant unilamellar vesicles (GUVs) made of 1,2-dioleoylphosphatidylcholine:1,2-dipalmitoylphatidylcholine:free cholesterol, 1:1:1 molar ratio at 27°C. Under these conditions, individual GUVs present Chol distributed into lo and ld phases. The two phases can be distinguished and visualized using Laurdan generalized polarization and two-photon excitation fluorescence microscopy. Our data indicate that MβCD removes Chol preferentially from the more disordered phase. The process of selective Chol removal is dependent on the MβCD concentration. At high concentrations, MβCD also removes phospholipids

A novel β-glucan produced by Paenibacillus polymyxa JB115 induces nitric oxide production in RAW264.7 macrophages

The effect of extracellular β-(1→3), (1→6)-glucan, produced by Paenibacillus polymyxa JB115, on nitric oxide (NO) production in RAW264.7 macrophages was investigated. β-glucan induced the production of NO by RAW264.7 macrophages in a concentration- and time-dependent manner. Moreover, β-glucan stimulation increased the mRNA expression of iNOS, COX-2 and IL-6 in RAW264.7 macrophages in a concentration-dependent manner