Efecto del tipo genético y la maduración sobre la retención de agua en carne de toros castrados

La capacidad de retención de agua en crudo (CRAr) y en cocinado (CRAc) fue determinada en carne madurada a 7, 14 y 21 días post mórtem. Los músculos Longissimus dorsi (LD) y Semitendi-nosus (ST) de 164 machos castrados provenientes del cruce de machos de las razas Simmental, Normanda, Blanco Orejinegro, Braunvieh, Guzerat, Brahman Blanco, Brahman Rojo, Limousin y Romosinuano con hembras Brahman blanco. Para el parámetro CRAr en LD se presentó significancia de los factores tipo genético y maduración y en ST del factor maduración. Para el parámetro de CRAc en LD fue significativo el factor tipo genético y para ST ninguno de los dos factores fue significativo. No existieron interacciones significativas de los dos factores evaluados. Lo ideal es someter a tiempos cortos de maduración ambos músculos y tener en cuenta el tipo genético al cual pertenece el individuo con el fin de minimizar las pérdidas de exudado.

Multifunctional PLA-PHB/cellulose nanocrystal films: processing, structural and thermal properties

Cellulose nanocrystals (CNCs) synthesized from microcrystalline cellulose by acid hydrolysis were added into poly(lactic acid)-poly(hydroxybutyrate) (PLA-PHB) blends to improve the final properties of the multifunctional systems. CNC were also modified with a surfactant (CNCs) to increase the interfacial adhesion in the systems maintaining the thermal stability. Firstly, masterbatch pellets were obtained for each formulation to improve the dispersion of the cellulose structures in the PLA-PHB and then nanocomposite films were processed. The thermal stability as well as the morphological and structural properties of nanocomposites was investigated. While PHB increased the PLA crystallinity due to its nucleation effect, well dispersed CNC and CNCs not only increased the crystallinity but also improved the processability, the thermal stability and the interaction between both polymers especially in the case of the modified CNCs based PLA-PHB formulation. Likewise, CNCs were better dispersed in PLA-CNCs and PLA-PHB-CNCs, than CNC.

Prevalence and management of anaemia in patients with non-myeloid cancer undergoing systemic therapy: a Spanish survey

BACKGROUND

The present study aimed to provide updated data on anaemia prevalence and management in cancer patients undergoing systemic therapy in Spain.

METHODS

This was a multicenter, observational, cross-sectional study performed in 2008. Eligible patients were ≥18 years, with non-myeloid malignancies treated with systemic therapy [chemotherapy (CT), hormonal therapy or immunotherapy]. Anaemia was defined according to WHO as haemoglobin (Hb) < 12 g/dL.

RESULTS

The study included 214 patients with a median age of 63 years (range 20-91), 58 % women, 73 % with solid tumours, and 79 % with advanced disease. CT was used in 91 % of patients (26 % with platinum compounds), hormonal therapy in 8.5 %, and immunotherapy in 8.5 %. In our study, 48.1 % of patients [95 % confidence interval (CI) 45.2-58.6] showed anaemia (31 % symptomatic): 42.0 % mild (10 ≤ Hb ≤ 11.9 g/dL), 5.6 % moderate (8 ≤ Hb ≤ 9.9 g/dL), and 0.5 % severe (Hb < 8 g/dL). A higher prevalence was observed in patients treated with CT (51 vs. 20 %, p = 0.01), platinum-based CT (70 vs. 47 %, p = 0.01) or palliative CT (61 vs. 39 %, p = 0.003). Anaemia was also more frequent in patients with more than three lines of CT (83 %) and in the fourth or subsequent CT cycle (58 %). Management in the previous 4 weeks in patients with anaemia was: 62 % did not receive treatment (92 % mild), 24 % received erythropoiesis-stimulating agents (ESAs), 14 % received iron and 8.7 % received transfusion.

CONCLUSIONS

In Spanish hospitals, about half of patients with non-myeloid malignancies undergoing systemic therapy fulfilled anaemia criteria (87 % mild). Approximately two-third of patients with anaemia do not receive specific treatment and ESA use is below current guidelines.

RADStation3G: a platform for cardiovascular image analysis integrating PACS, 3D+t visualization and grid computing

RADStation3G is a software platform for cardiovascular image analysis and surgery planning. It provides image visualization and management in 2D, 3D and 3D+t; data storage (images or operational results) in a PACS (using DICOM); and exploitation of patients' data such as images and pathologies. Further, it provides support for computationally expensive processes with grid technology. In this article we first introduce the platform and present a comparison with existing systems, according to the platform's modules (for cardiology, angiology, PACS archived enriched searching and grid computing), and then RADStation3G is described in detail.

Effect of the calcium to phosphorus ratio on the setting properties of calcium phosphate bone cements

α-Tricalcium phosphate (α-TCP) has become the main reactant of most experimental and commercial ceramic bone cements. It has calcium-to-phosphorus (Ca/P) ratio of 1.50. The present study expands and reports on the microstructures and mechanical properties of calcium phosphate (CP) cements containing sintered monolithic reactants obtained in the interval 1.29 < Ca/P < 1.77. The study focuses on their cement setting and hardening properties as well as on their microstructure and crystal phase evolution. The results showed that: (a) CP-cements made with reactants with Ca/P ratio other than 1.50 have longer setting and lower hardening properties; (b) CP-cements reactivity was clearly affected by the Ca/P ratio of the starting reactant; (c) reactants with Ca/P < 1.50 were composed of several phases, calcium pyrophosphate and α- and β-TCP. Similarly, reactants with Ca/P > 1.50 were composed of α-TCP, tetracalcium phosphate and hydroxyapatite; (d) only the reactant with Ca/P = 1.50 was monophasic and was made of α-TCP, which transformed during the setting into calcium deficient hydroxyapatite; (e) CP-cements developed different crystal microstructures with specific features depending on the Ca/P ratio of the starting reactant.

Ultrasound monitoring of the setting of calcium-based bone cements

In this study, the setting of calcium-sulphate (CS) and -phosphate (CP) based bone cements (BCs) was monitored by ultrasound. The objective was to link acoustic and material properties of ceramic-based BCs from the early stages of the cement curing process. The powder phase of the CS-cement consisted of CS hemihydrate; the CP-cement was a mixture of alpha-tricalcium phosphate, CS dihydrate and hydroxyapatite. For the CS-cement, the acoustic impedance z (c)(t), the speed of sound c (c)(t) and the density ρ(c)(t) were measured at the interval of liquid-to-powder ratios LPRs from 0.20 to 3.00 ml/g. For the CP-cement, the acoustic characteristics obtained were the z (c)(t) and the reflection coefficient R (p,c)(t), and the LPRs ranged from 0.30 to 0.40 ml/g. The resulting acoustic properties indicated that CP- and CS-cements exhibited distinctly different curing behaviour; while CS-cement expanded, CP-cement shrank with time.

Conservative surgical treatment for toxic megacolon due to Clostridium difficile infection in a transplanted pediatric patient

Severe disease caused by Clostridium difficile is frequently encountered in transplant recipients and carries a high mortality. Numerous studies have been published on this subject in the adult population, but few in the pediatric setting. A 4-year-old boy who had undergone heart transplant 20 months earlier was admitted to the pediatric intensive care unit after humoral rejection. Seven days after admission, he developed septic shock, abdominal distension, and paralytic ileus without diarrhea. Pseudomembranous colitis due to C. difficile was confirmed by microbiological and radiological studies. Despite treatment with rectal vancomycin and intravenous metronidazole, the patient did not improve and required decompressive laparotomy; because of the poor subsequent clinical course, terminal ileostomy and cecostomy were performed in a second operation. Recovery was satisfactory, and surgical reconstruction of intestinal tract was performed 3 months later without complications. Although early surgery with total colectomy is indicated, when there is a poor response to medical treatment in cases of C. difficile toxic megacolon, the case we present responded favorably to a conservative surgical approach that enabled intestinal integrity to be restored 3 months later. In the pediatric population, less aggressive therapeutic options should be considered, as they have benefits on the subsequent quality of life of the patient.

Epidemiology and prognostic determinants of bacteraemic biliary tract infection

OBJECTIVES

To determine the epidemiology of bacteraemia due to biliary tract infection (BTI) and to identify independent predictors of mortality.

METHODS

This study was part of a bloodstream infection surveillance study that prospectively collected data on consecutive patients with bacteraemia in our institution from 1991 to 2010. BTI was the confirmed source of 1373 patients with bacteraemia, and the independent prognostic factors of 30 day mortality were determined.

RESULTS

The mean age of patients with biliary sepsis was 71 years (± 14 years). The most frequent comorbidities were biliary lithiasis and solid-organ cancer [484 cases (35%) and 362 cases (26%), respectively]. The BTI was healthcare-associated in 33% of patients. Shock and mortality accounted for 209 and 126 cases, respectively (15% and 9%). The most frequent microorganisms isolated were Escherichia coli (749, 55%), Klebsiella spp. (240, 17%), Enterococcus spp. (171, 12%), Pseudomonas aeruginosa (86, 6%) and Enterobacter spp. (63, 5%). There were 47 (3%) cefotaxime-resistant (CTX-R) E. coli or Klebsiella spp. Inappropriate empirical antibiotic treatment was an independent factor associated with mortality (OR 1.4, 95% CI 1.1-1.7). Inappropriate empirical treatment was more frequent in P. aeruginosa and CTX-R Enterobacteriaceae bacteraemia. These microorganisms were significantly more common in patients with previous antibiotic therapy, solid-organ cancer or transplantation and in healthcare-associated bacteraemia.

CONCLUSIONS

In patients with bacteraemic BTI, inappropriate empirical therapy was more frequent in P. aeruginosa and CTX-R Enterobacteriaceae infection and was associated with a higher mortality rate. In patients with bacteraemia due to BTI and solid-organ cancer or transplantation, healthcare-associated infection or previous antibiotic treatment, initial therapy with piperacillin/tazobactam or a carbapenem would be advisable.

[Factors associated with dementia caregivers' preference for institutional care]

INTRODUCTION

The prevalence of dementia is growing in Spain, and so is the number of caregivers who are considering the institutionalization of their relatives. The purpose of this study is to identify which variables are associated with caregivers' desire for institutionalization their dementia relatives.

PATIENTS AND METHODS

Informal caregivers of 243 individuals suffering from dementia were interviewed. Predisposing variables (sociodemographic and contextual variables), stressors (dementia-related and caregiving-related aspects), appraisals (of circumstances and caregivers' role), resources (personal and community-based resources) and the desire to institutionalize were evaluated.

RESULTS

Over half of the caregivers (52.6%) indicated that they had some desire to institutionalize their relatives with dementia. Stepwise regression analysis revealed that caregivers' consideration to institutionalize was associated with being a male caregiver, not being the spouse of the dementia patient, and with a higher consideration and higher use of community-based formal resources (short-term nursing home use, adult day care centres and psycho-stimulation).

CONCLUSIONS

Assessing and using formal resources outside their homes help caregivers overcome barriers that keep them from considering the institutionalization of their relatives. The difficulty in considering institutionalizing their relatives is more evident among spouses, who have stronger attachments with the dementia patients, especially among females, who probably feel obliged to continue developing caregiver roles because of their gender.