Disability and its influence in nutritional assessment tools in elderly people living in nursing homes

Introduction: Poor nutritional status is associated with increased morbidity and mortality, especially in older people. Objective: The aim of this study was to assess nutritional status in elderly nursing home residents with different nutritional test, and to determine which parameters used for nutritional assessment can be carried out in this population, which usually have a high prevalence of functionally dependent residents. Methods: A cross-sectional study was performed in 383 elderly. The nutritional assessment tools used were the Mini Nutritional Assessment (MNA), the new ESPEN consensus definition of malnutrition, and the tool for Controlling Nutritional Status (CONUT). Moreover, the ability to perform basic activities of daily living was assessed with the Barthel index (BI). Results: According to BI, 78.9% had a total dependence and only 20.9% could be weighed and heighed. The prevalence of malnutrition with MNA, ESPEN and CONUT was 21.3%, 17.6% and 20.7%, respectively. The agreement between MNA vs ESPEN criteria was moderate (?= 0.483), but with CONUT was low. Conclusions: Nursing homes had a high percentage of totally dependent residents. This high degree of functional dependence made difficult to obtain some anthropometric parameters such as weight and height, which are essential to carry out most nutritional tests. MNA, CONUT and the new ESPEN criteria of malnutrition showed a high prevalence of malnutrition and risk of malnutrition in subjects in which they could be performed. Introducción: un estado nutricional deficiente está asociado con un incremento de la morbilidad y la mortalidad, especialmente en personas ancianas. Objetivo: el objetivo de este estudio fue evaluar el estado nutricional en ancianos institucionalizados en residencias geriátricas mediante diferentes test nutricionales, y determinar qué parámetros utilizados en la valoración nutricional pueden ser realizados en esta población. Métodos: se llevó a cabo un estudio transversal en 383 ancianos. Las herramientas de valoración nutricional empleadas fueron el Mini Nutritional Assessment (MNA), el nuevo consenso de definición de malnutrición, y el CONUT. Además, la capacidad de realizar las actividades básicas de la vida diaria fue evaluada con el índice de Barthel. Resultados: según el índice de Barthel, hasta un 78, 9% de los residentes tenía una dependencia total, y en solo el 20, 9% se pudo determinar el peso y la talla. La prevalencia de malnutrición con MNA, el consenso de ESPEN y CONUT fueron 21, 3%, 17, 2% y 20, 7%, respectivamente. La concordancia (kappa) entre el MNA y el ESPEN fue moderada (? = 0, 483), pero con CONUT fue baja. Conclusiones: en las residencias geriátricas públicas existe un elevado porcentaje de ancianos totalmente dependientes. Este alto grado de dependencia funcional dificulta la obtención de algunos parámetros antropométricos como el peso y la talla, que son esenciales para llevar a cabo la mayoría de los test de valoración nutricional. El MNA, el CONUT y los nuevos criterios de desnutrición de la ESPEN mostraron una elevada prevalencia de desnutrición y de riesgo de desnutrición en esta población de ancianos institucionalizados, en aquellos en los que fue posible realizarlos

Estudio y caracterización de algunas 5-E-aldoximino-4-glucosilaminopirimidinas

La reacción de 1,6-dihidro-5-formil-4-β-D-(2 ', 3 ' 4 ', 6 '-tetra-O-acetil)-glucopiranosilamino-1-metil-2-metoxi-6-oxopirimidina con exceso de ClH.H2NOH permite aislar 5-E-aldoximino derivado como único producto. La estructura del mismo ha sido establecida en base a pruebas químicas y espectroscópicas.The reaction between 1,6-dihydro-S-formil-4- β -D-(tetra-O-acetyl}glucopyranosylamino-l-methyl-2-methoxy-6-oxo-pyrimidine and an excess of ClH.H2 NOH yields S-E-aldoximine derivative as the only producto On the basis of its chemical behaviour and espectroscopic data we propose its structure

Estudio y caracterización de algunas 5-E-aldoximino-4-glucosilaminopirimidinas

The reaction between 1,6-dihydro-5-formil-4-β-D-(tetra-O-acetyl)glucopyranosylamino-1-methyl-2-methoxy-6-oxo-pyrimidine and an excess of ClH.H2NOH yields 5-E-aldoximine derivative as the only product. On the basis of its chemical behaviour and espectroscopic data we propose its structure.La reacción de 1,6-dihidro-5-formil-4-β-D-(2 ', 3 ' 4 ', 6 '-tetra-O-acetil)-glucopiranosilamino-1-metil-2-metoxi-6-oxopirimidina con exceso de ClH.H2NOH permite aislar 5-E-aldoximino derivado como único producto. La estructura del mismo ha sido establecida en base a pruebas químicas y espectroscópicas

UNICORSA: A single and multidisciplinary case-study method for ten subjects in the field of social and legal sciences

El proyecto de innovación docente “UNICORSA: un método del caso común y multidisciplinar para diez asignaturas de las ramas de ciencias sociales y jurídicas”, fue una iniciativa común de cuatro departamentos y seis áreas de conocimiento de la rama de ciencias sociales y jurídicas de la Universidad de Córdoba orientado a aplicar en la práctica los conocimientos teóricos transmitidos por cada una de estas áreas. A tal fin, se creó una empresa ficticia, UNICORSA, que actuó como protagonista de todas las actividades prácticas planteadas por el profesorado participante en sus respectivas asignaturas. Ello permitió un estudio multidisciplinar de las distintas vicisitudes por las que debía pasar dicha empresa en su vida económica, jurídica y social.The teaching innovation project “UNICORSA: a single and multidisciplinary case-study method for ten subjects in the field of social and legal sciences”, was a joint initiative of four departments and six areas in the field of social and legal sciences of the University of Córdoba aiming to implement the technical knowledge transmitted by each of these areas. To this end, UNICORSA, a fictitious company, was created in order to play the main role of all the practical activities proposed by the participating teachers in their respective courses. This led to a multidisciplinary study of the various events that UNICORSA had to go through in its economic, legal and social life. At the end of the term, a seminar entitled “Board of directors of the UNICORSA company” was held and the students involved in the project participated by presenting the solutions (reports) to the cases raised by the teachers in the different subjects. As in any shareholders' meeting, the approval of each of the reports was put to a vote. Among the main results achieved, it is worth highlighting the visibility of the practical application of the theoretical skills and knowledge acquired by the participants, the integration of multidisciplinary knowledge and the improvement of skills when interacting with other people from different training disciplines to achieve a common goal

Effectiveness and safety of first-generation protease inhibitors in clinical practice: Hepatitis C virus patients with advanced fibrosis

AIM: To evaluates the effectiveness and safety of the first generation, NS3/4A protease inhibitors (PIs) in clinical practice against chronic C virus, especially in patients with advanced fibrosis. METHODS: Prospective study and non-experimental analysis of a multicentre cohort of 38 Spanish hospitals that includes patients with chronic hepatitis C genotype 1, treatment-nai¨ve (TN) or treatment-experienced (TE), who underwent triple therapy with the first generation NS3/4A protease inhibitors, boceprevir (BOC) and telaprevir (TVR), in combination with pegylated interferon and ribavirin. The patients were treatment in routine practice settings. Data on the study population and on adverse clinical and virologic effects were compiled during the treatment period and during follow up. RESULTS: One thousand and fifty seven patients were included, 405 (38%) were treated with BOC and 652 (62%) with TVR. Of this total, 30% (n = 319) were TN and the remaining were TE: 28% (n = 298) relapsers, 12% (n = 123) partial responders (PR), 25% (n = 260) null-responders (NR) and for 5% (n = 57) with prior response unknown. The rate of sustained virologic response (SVR) by intention-to-treatment (ITT) was greater in those treated with TVR (65%) than in those treated with BOC (52%) (P < 0.0001), whereas by modified intention-to-treatment (mITT) no were found significant differences. By degree of fibrosis, 56% of patients were F4 and the highest SVR rates were recorded in the non-F4 patients, both TN and TE. In the analysis by groups, the TN patients treated with TVR by ITT showed a higher SVR (P = 0.005). However, by mITT there were no significant differences between BOC and TVR. In the multivariate analysis by mITT, the significant SVR factors were relapsers, IL28B CC and non-F4; the type of treatment (BOC or TVR) was not significant. The lowest SVR values were presented by the F4-NR patients, treated with BOC (46%) or with TVR (45%). 28% of the patients interrupted the treatment, mainly by non-viral response (51%): this outcome was more frequent in the TE than in the TN patients (57% vs 40%, P = 0.01). With respect to severe haematological disorders, neutropaenia was more likely to affect the patients treated with BOC (33% vs 20%, P = 0.0001), and thrombocytopaenia and anaemia, the F4 patients (P = 0.000, P = 0.025, respectively). CONCLUSION: In a real clinical practice setting with a high proportion of patients with advanced fibrosis, effectiveness of first-generation PIs was high except for NR patients, with similar SVR rates being achieved by BOC and TVR

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

Preliminary assay on the radical scavenging activity of olive wood extracts

The dichloromethane and ethanol extracts of Olea europaea wood (picual olive cultivar) were screened for antioxidant activity, determined by the DPPH free radical scavenging assay. The ethanol extract displayed potent antioxidant activity. (c) 2005 Elsevier B.V. All rights reserved

Isolation and identification of radical scavengers in olive tree (Olea europaea) wood

Several extracts of Olea europaea wood (Picual olive cultivar) were obtained with solvents of different polarity and their antioxidant activities determined. The active compounds were detected in fractions of an ethyl acetate extract using HPLC with on-line radical scavenging detection. After applying different separation techniques, hydroxytyrosol, tyrosol, cycloolivil, 7-deoxyloganic acid, oleuropein and ligustroside were isolated and characterized. Hydroxytyrosol showed a higher activity than the natural antioxidant rosmarinic acid in scavenging the DPPH model radical. Cycloolivil and oleuropein showed stronger activities than the synthetic antioxidant BHT against the same radical. Ligustroside, tyrosol and 7-deoxyloganic acid showed little activity. The latter compound has not been previously identified in the genus Olea

La formación de la población adulta en Aragón

Realizar un chequeo a los programas de formación que se ofrecen a la población postescolar en la región aragonesa intentando identificar sus elementos diferenciadores. Identificar los modelos de actuación, sus aspectos metodológicos y organizativos, y conocer las zonas, ámbitos de formación y características de los participantes. Conocer con mayor profundidad la organización y el currículum de la educación de las personas adultas en Aragón. Elaborar un mapa de formación : instituciones, programas, base legal, actuaciones, participantes y profesionales. Confeccionar y analizar un modelo de formación de adultos. Confeccionar un mapa potencial de necesidades de aprendizaje. 1. Fase; 243 cuestionarios de direcciones de institutos, organismos, asociaciones, empresas y centros. 2. Fase; 20 estudios de casos. Dos fases. La primera consiste en una recogida de datos para obtener información acerca de las actuaciones de formación de adultos. El método de trabajo utilizado es el análisis de los datos y la evaluación de los resultados obtenidos del cuestionario remitido a las entidades que desarrollan los diferentes programas. La segunda se caracteriza por primar el enfoque estructural con predominio de las técnicas cualitativas. Utilizan reuniones, guías, cuestionarios específicos y equipos de trabajo. La metodología empleada es el estudio de casos. Entrevistas, documentos, informes, guía, ítems. Porcentajes, coeficiente contingencia, v. de Cramer. 1. La formación de la población adulta tiene un modelo de funcionamiento en el que resalta la interacción entre la posibilidad de oferta (infraestructura, institución) y la demanda (características de los destinatarios). En ese modelo distinguen 3 estilos: titulación académica, competencia laboral, y desarrollo personal; que tienen características curriculares (didácticas y organizativas) peculiares relativas al contexto, la metodología, los recursos, la evaluación, los destinatarios y los profesionales. 2. Cada institución se dirige a un colectivo de población, sin que exista interferencia entre las mismas, salvo en el ámbito laboral que concurren entidades privadas y públicas. 3. La oferta formativa no responde a un estudio muy sistemático de las necesidades. 4. No existe una hilación entre la educación básica y la laboral. 5. La oferta de estudios no es integral y es abundante pero no se recibe en todos los lugares por igual. Sólo llega a las poblaciones con mayor número de habitantes y situadas en unos entornos geográficos muy concretos: próximos a las ciudades y en el trazado de vías de comunicación estratégicas a nivel nacional. 6. La formación permanente y la continua encuentran dificultades; por su dispersión, dinamismo y falta de coordinación.AragónBiblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín, 5 - 3 Planta; 28014 Madrid; Tel. +34917748000; Fax +34917748026; [email protected]