Estudio preliminar de la efectividad de la terapia asistida con perros en personas de la tercera edad

IntroductionAnimal-assisted therapy is increasingly present in several educational and health areas. The aim of this study is to assess the effectiveness of such interventions in the elderly population living in residential settings.Materials and methodsA 12-week dog-assisted intervention program was designed, with 16 participants from a nursing home divided into an experimental group and a control group.ResultsSeveral physical and psychological variables were assessed before and after the intervention. While there were no significant differences in the control group, the experimental group improved significantly after participating in the program.DiscussionThe results support the hypothesis that animal-assisted interventions may be beneficial for residents in elderly care homes.     

Efectividad de la vacuna antigripal en la prevención de la gripe en personas mayores de 65 años

IntroductionInfluenza is one of the diseases with the greatest epidemiological impact and of maximum relevance in the management of health services. The flu vaccine can have great variability each season, so our objective was to find out the effectiveness of the flu vaccine for the 2017/2018 season for the prevention of severe cases of flu in people over 65 years of age in a 385-bed acute general hospital.Material and methodStudy of cases and controls. All hospitalized patients with laboratory-confirmed influenza older than 65 years during the 2017/2018 season were included. Those who met the criteria for a severe case of influenza were considered cases. Those who did not meet the severity criteria were considered controls. Factors associated with the development of severe influenza were calculated.ResultsThe median age was 68 years (SD 91.87). The attack rate was 0.23 per hundred inhabitants and the vaccine effectiveness was 38%. The vaccinated and unvaccinated groups were different in terms of age (p < 0.0481). Vaccination status against severe influenza was found to be an independent protective factor (OR = 0.840; 0.746-0.913).ConclusionsThe effectiveness of influenza vaccination provided greater protection against infection and reduced the severity of influenza in older hospitalized patients. These findings should be taken into account to improve vaccination strategies and achieve better vaccination coverage in the population at risk.     

Importancia de la vigilancia oftalmológica durante el tratamiento de la enfermedad invasora por Candida

BackgroundInvasive Candida disease (ICD) is the most common cause of endogenous endophthalmitis. There are two characteristic ocular signs: Candida chorioretinitis defined as retina and choroid lesions without vitreal involvement, and Candida endophthalmitis defined as chorioretinitis with extension into the vitreous with characteristic fluffy balls. The most common visual symptoms are blurred vision and floaters.AimsTo define in which patients with ICD a surveillance ophthalmoscopic examination should be done.MethodsWe searched the PubMed/Medline data base Candida endophthalmitis in adult and paediatric patients with ICD.Results and conclusionsThe need of ophthalmoscopic examination in patients with ICD is controversial, partly due to the fact that early antifungal treatment leads to a significant decrease of endogenous Candida endophthalmitis. Routine ophthalmoscopic examination seems of little value in patients with positive blood culture, with early implementation of antifungal treatment, without symptoms of ocular infection and without impairment of the level of consciousness during the episode. However, ophthalmoscopic examination should be performed in children with candidemia and critically ill patients with documented ICD, in the second week of treatment, especially in echinocandin treatment.     

Évaluation de la tomoscintigraphie de perfusion pulmonaire couplée à la tomodensitométrie dans la prédiction de la fonction respiratoire postopératoire

IntroductionThe aim of our study was to evaluate the performances of pulmonary perfusion single photon emission computed tomography-computed tomography (SPECT-CT) with semi-automatic analysis for preoperative assessment for lung cancer.Materiel and methodThirty-five patients underwent preoperative lung perfusion scintigraphy (planar and SPECT-CT acquisition) from august 2016 to December 2017. Predicted postoperative forced expiratory volume in one second (ppoFEV1 and FEV1) by both methods were compared between each other and with the actual FEV1 measured 3 months after surgery. We also evaluated interobserver reproductibility of SPECT-CT semi-automatic segmentation software and the concordance of the data simulating reductions of 30 and 50% of acquisition time.ResultsFor 30 lobectomies and 5 pneumonectomies, the mean ppoFEV1 was 69%, a difference with actual ppoFEV1 of ?8% for SPECT-CT and ?6.77% for planar (P < 0,001). Both methods were well correlated, correlation coefficient was 0,827, 95% CI [0.686–0.909] but underestimated the actual poppFEV1. For SPECT-CT, interobserver reproducibility was excellent for pulmonary and lobar evaluation. The lobar functions, without 30 and 50% of the time acquisition, had absolute difference < 3% in comparison to native data.DiscussionWe did not prove SPECT-CT superiority on planar scintigraphy, actual FEV1 being difficult to predict because of confounding factors. But this exam could be useful before lobectomy and in cases of heterogeneous perfusion. Easily made, this method is reproducible even on data simulating a reduction of 50% of time acquisition.     

Potencial de la levadura oleaginosa Clavispora lusitaniae Hi2 en la conversión de residuos agroindustriales a lípidos

BackgroundSingle-cell oils obtained from oleaginous microorganisms by using lignocellulosic waste hydrolysates are an alternative for producing biodiesel.AimsTo isolate a yeast strain able to produce lipids from centrifuged nejayote (CN), hydrolyzed nejayote solids (HNS) and hydrolyzed sugarcane bagasse (HSB).MethodsIn order to identify the yeasts recovered, 26S ribosomal DNA was sequenced. The metabolic profile was assessed by using API20C AUX strips. The nutritional characterization of CN, HNS and HSB was performed by quantifying reducing sugars, total carbohydrates, starch, protein and total nitrogen. The biomass and lipid production ability were evaluated by performing growth kinetics of Clavispora lusitaniae Hi2 in combined culture media.ResultsSix oleaginous yeast strains were isolated and identified, selecting C. lusitaniae Hi2 to study its lipids production by using nejayote. The C. lusitaniae Hi2 strain can use glucose, xylose, arabinose, galactose and cellobiose as carbon sources. Cultures of C. lusitaniae Hi2 presented the best biomass (5.6±0.28 g/L) and lipid production (0.99±0.09 g/L) at 20 h of incubation with the CN:HNS media in the 25:75 and 50:50 ratios, respectively.ConclusionsThe use of CN, HNS and HSB for the growth of C. lusitaniae Hi2 is an option to take advantage of these agro-industrial residues and generate compounds of biotechnological interest.     

Prevalencia y perfil de la persona frágil en la isla de La Palma

IntroductionPopulation ageing requires that health and social systems focus their attention on identifying frailty in the elderly. In the Canary Islands, there are no studies to determine the prevalence of frailty among its population. The objective of this study is to determine the prevalence and profile of frailty in the island of La Palma, Canary Islands, Spain.Material and methodA cross-sectional study was conducted to estimate the prevalence and the profile of frailty. The sample were residents over 70 years old, valued by the Fried criteria, and taking into account other related factors. The prevalence is offered with a confidence interval of 95% and is compared with that of other Spanish populations. To determine the profile, a simple comparison of variables was made, followed by using them in logistic regression models. All the tests were bilateral at a P≤0.05 level.ResultsThe prevalence of frailty in people over 70 years was estimated at 20% (17-23%). This prevalence shows differences with those of other Spanish populations. The factors that showed a relationship with frailty were, being female, widowed, living alone, low physical activity, cognitive impairment, depression, polymedication, and adverse clinical history. Multivariate analysis identifies factors associated with the frailty variables related to marital status, co-existence, polypharmacy, depressive states, and lack of physical exercise.ConclusionsThe elderly population of La Palma have greater frailty compared to that described in other regions of Spain, with their profile being that of a widowed person, with depression, polymedicated, living alone, and not exercising.     

Actividad de la proteinasa en cepas de Candida albicans aisladas de la cavidad oral de pacientes inmunodeprimidos,con candidiasis oral y sujetos sanos

BackgroundCandida albicans has a variety of virulence factors, including secreted aspartyl proteases, which are determinant factors in the pathogenesis of this yeast in immunocompromised patients.AimsProteinase activity was identified in C. albicans strains isolated from the oral cavity of immunocompromised patients with cancer, diabetes and HIV+, with oral candidiasis and in healthy subjects.MethodsTwo hundred and fifty C. albicans strains were analyzed, distributed in 5 different groups: patients with cancer, diabetes, HIV+, with oral candidiasis and healthy subjects.ResultsProteolytic activity was identified in 46% of the strains from cancer patients, 54% from HIV+ patients, 60% from diabetics, 70% from oral candidiasis patients, and 42% from healthy subjects. Activity was higher in strains from immunocompromised and oral candidiasis patients than in healthy subjects. Differences were observed between the candidiasis-healthy, candidiasis-HIV+, and diabetic-healthy groups. No differences were observed between the oral candidiasis, diabetes and cancer patients, between the diabetes and HIV+ patients, or between the cancer patients, HIV+ patients and healthy subjects.ConclusionsThe present results suggest that although secreted aspartyl proteases are important in the pathogenesis of C. albicans, their activity depends on host conditions.     

El lavado de la aguja aumenta la rentabilidad diagnóstica de la punción-aspiración con aguja fina de tiroides

Background and objectiveNodular thyroid disease is a common condition in our clinical practice, and fine needle aspiration biopsy (FNAB) is the diagnostic procedure of choice. Its main limitation is the number of non-diagnostic samples. Since the Bethesda criteria were implemented in 2007 (a consensus document on the morphologic criteria and diagnostic terminology for interpretation of thyroid cytological samples), a higher prevalence of non-diagnostic FNAB was shown. In addition to the standard technique, we decided to collect and centrifuge the material remaining in puncture needles by washing them in a ThinPrep^® solution, and to assess the increase in the diagnostic yield of FNAB after this change.Patients and methodsSystematic sampling of 168 patients who underwent FNAB at the Nutrition and Endocrinology Department of the Xeral-Cies Hospital (Vigo, Spain) from January 2010 to November 2011. Patients were classified into 2 groups: 75 patients in whom the residual material in the needle was not collected (non-washing group) and 93 patients in whom the material was collected (washing-group). All FNABs were performed by the same endocrinologist. Data are shown as percentage (± standard error) for ordinal variables or as mean (± standard deviation) for quantitative variables. A Chi-square test was used for statistical analysis of comparisons between percentages, and a Student's t test for comparisons between quantitative variables. A value of p < 0.05 was considered statistically significant.ResultsNo significant differences were found between the groups in age, sex, plasma TSH levels or nodule size. The rate of non-diagnostic FNABs was 44% (± 0.06) in the non-washing group and 17.2% (± 0.04%) in the washing group, with a significant difference (p < 0.01).DiscussionCollection and subsequent processing of the residual material in the needle after FNAB significantly decreased the prevalence of non-diagnostic punctures in our patients. Collection of the residual material in the needle in this way is strongly recommended.     

Caracterización de la micobiota aérea en dos depósitos del Archivo Nacional de la República de Cuba

BackgroundThe high relative humidity and temperatures in tropical countries create favorable conditions for development of fungi that are not only a risk to human health but they can also colonize documentary support.AimsTo study the concentration of the airborne fungi in two repositories of the National Archives of the Republic of Cuba, the mycobiota deposited on different photographic supports and maps preserved in these repositories, and to determine the taxonomic characterization of the fungi isolated.MethodsThe air sampling was performed using a sedimentation method, and the supports (6 pictures and 7 maps) were analyzed using moistened sterile swabs.ResultsThe Cladosporium genus was predominant, followed by Aspergillus and Penicillium genera. Filamentous fungi were isolated in all the photos and maps, and yeasts were only isolated from a photographic supports and a map. We identified several species of Aspergillus and Penicillium genera, but Aspergillus niger and Aspergillus flavus predominated. Candida and Rhodotorula were the yeast genera isolated.ConclusionsThe fungal concentration of the air demonstrated that the environments were not contaminated. From the 26 species of filamentous fungi isolated only 5 were detected in the indoor air of the repositories and on one or more of the document supports analyzed (representing a 19.3%). This shows that there is a low ecological relationship between the fungi detected in the indoor air and those that were isolated from the supports studied.     

Resiliencia en las personas mayores durante la primera ola pandémica de la COVID-19 en Chile: una perspectiva desde los determinantes sociales de la salud

ObjectiveTo assess the association between social determinants of health (SDH) and resilience in older people during the first period of confinement in the COVID-19 pandemic in Chile.Materials and methodsAn observational study with a cross-sectional design was conducted using a nationally representative survey data-set. In this survey, using a systematic randomization process, a subsample of people aged ≥60 years from the community were interviewed by telephone during the first wave of the COVID-19 pandemic in Chile. Resilience was assessed using the Brief Resilient Coping Scale (BRCS) and depressive symptoms using the Patient Health Questionnaire (PHQ-9) scale. The SDH considered were: age, sex, educational level, employment status, social isolation, loneliness, discontent with housing and health care needs.ResultsA total sample of 582 persons was obtained. The mean age was 71 years (SD: 7.64; 69% women). A significant association was obtained between low resilience and the following conditions: loneliness (OR: 1.776 [95% CI: 1.146–2.751]), high risk of social isolation (OR: 1.667 [95% CI: 1.149-2.419]), and depressive symptoms (OR: 2.602 [95% CI: 1.795-3.774]). Female gender was a protective factor (OR: 0.589 [95% CI: 0.406-0.855]).ConclusionThe SDH, such as loneliness and social isolation, are factors associated with low resilience in older people during the COVID-19 pandemic and may be taken into account in planning public health intervention strategies.     

La desesperanza como predictora de la soledad en adultos mayores

Background and objectiveHopelessness is characterized by a set of negative cognitive schemas about the future, conceptualized on the basis of three dimensions: affective, motivational and cognitive. This construct is linked to loneliness, the incidence of which in older adults is increasingly high. The aim of this research is to test whether hopelessness factors predict levels of loneliness in older adults.Material and methods138 non-institutionalized persons from Valencia city between 65-90 years old participated, with a mean age of 73.67 (SD = 4.8), and 59.4% were women. The Beck Hopelessness Scale (BHS) and University of California Los Angeles Loneliness Scale (UCLA) were administered to assess participants.ResultsThe motivational and cognitive factors acted as statistically significant predictors of loneliness, while the affective factor was not presented as a significant factor. The final model obtained an R² adj = .442, F(3, 87) = 23.97, p < .001.ConclusionsLoneliness is a phenomenon of great concern in the field of gerontology due to its high incidence and impact. The results indicate that hopelessness, specifically loss of motivation and negative expectations about the future, are critical issues for the development of feelings of loneliness in older adults. Thus, it is relevant to pay attention to these variables in order to apply loneliness prevention programs.     

Desarrollo y validación de un instrumento observacional para la evaluación del bienestar en personas con demencia desde la perspectiva de la atención centrada en la persona: Listado de Indicadores de Bienestar

IntroductionWithin the context of Person Centred Care, the present paper shows the creation and validation process of an observational tool for the assessment of the wellbeing of people with dementia, from a perspective that seeks to highlight the effects that the physical and social environment have on the person, and how these are reflected in the well-being.MethodsThe List of Wellbeing Indicators (LIBE) was created following an inductive iterative process with professionals from different disciplines, until the validated version was reached. It was then validated in two successive studies with a sample of 79 people with dementia. Discrimination capacity of the scale indicators, internal consistency, inter-rater reliability, and convergent and divergent validity were determined.ResultsAn internal consistency of Cronbach́s alpha 0.81 was obtained. The inter-rater reliability, analysing intraclass correlation coefficient (ICC) within the 3 raters, was significant for all the indicators in the tool, with scores between 0.59-1.00. Convergent validity was studied comparing scores in each LIBE indicator with scores in each QUALID indicator, and some significant associations were found between response categories in both tools. For the discriminant validity, the scores obtained in each LIBE indicator were compared with the scores in each PAINAD-Sp item, and no significant associations were found.ConclusionLIBE offers an observational measure of behaviours that can be considered well-being indicators in people with dementia living in residential care. LIBE is a valid and reliable tool that offers a different perspective of measuring a construct that has been infrequently explored in dementia population. Is also an easy to apply tool, with different uses (clinical, intervention, research), and applicable for professionals of several disciplines.     

Spartina Juncea Willd. nuova specie per la Sardegna

Abstract

SPARTINA JUNCEA WILLD.: A NEW SPECIES FOR SARDINIA. — The Author remarks the presence of a new species for Sardinia: Spartina juncea Willd at the month of Calich pool (Alghero) and on the neighbouring littoral, in a place reflecting its known edaphic necessities « sea dump sands and saltish marshes ».     

Impacto en residencias de la atención centrada en las personas (ACP) sobre la calidad de vida,el bienestar y la capacidad de salir adelante. Estudio transversal

IntroductionThe aging of the population has led to the introduction of qualitative and quantitative changes in healthcare resources, among which are the introduction of models of person-centred care (PCC), although there is a lack of information on their impact. The objective of this study is to assess the impact of a PCC model on the quality of life, well-being and thriving, in people living in nursing homesMethodsCross-sectional study. Population: all persons who lived indefinitely in the two participating centres that gave their consent. Impact of PCC vs. traditional model was assessed in terms of quality of life, well-being and thriving. Effect size was estimated with Cohen d adjusted for health problems, Charlson index, and presence of depression.ResultsOverall participation was 78% (59/77 persons from the conventional centre and 66/88 from the PCC). The people of the PCC centre had better well-being (d = 0.378) and thriving (d = 0.566). No differences were found in quality of life.ConclusionThe PCC model can have a positive impact on well-being and thriving in persons living in nursing homes.     

Mejoría de la inmunidad y la esperanza de vida en ratones maduros,genéticamente deficientes en la síntesis de catecolaminas,tras convivir con controles durante dos meses

IntroductionMice hemizygous in tyrosine hydroxylase (TH-HZ), the limiting enzyme in catecholamine synthesis, show premature immunosenescence, which in females is associated with a shorter lifespan than the corresponding controls (WT). The coexistence of TH-Hz with WT improves the immune function in both males and females in adulthood.ObjectiveTo test whether cohabitation for two months of mature male TH-HZ with WT improves the immune function of the former and whether this impacts the lifespan.Material and methodsMature male ICR-CD1 mice (13 ± 1 months) TH-HZ coexisted with WT (2:4 ratio in each cage) for two months. Peritoneal leukocytes were extracted from all animals at baseline, one month, and two months after cohabitation, and macrophage phagocytic capacity, macrophage and lymphocyte chemotaxis, natural killer (NK) antitumor activity, and lymphoproliferative capacity in response to the mitogens concanavalin A and lipopolysaccharide (LPS) were assessed. The animals were maintained under these conditions until their natural death.ResultsThe TH-HZ, which start, in general, with lower values than the WT in the immune functions studied, improved them after two months of cohabitation, becoming similar to those of the controls. This improvement was already observed in NK activity after one month of cohabitation.The TH-HZ presented lower mean longevity than WT, but when they cohabited with WT, it was similar to the latter.ConclusionThe coexistence of TH-HZ male mice with WT mice for two months at mature age improves these genetically modified animals’ immune response and longevity.     

Impact de la tomographie par émission de positons au 18fluorodésoxyglucose dans la prise en charge des cancers de primitif inconnu

Aim and methodThis retrospective study, performed on 37 patients, gave us the opportunity to evaluate the impact of ¹⁸F-FDG PET/CT for cancer of unknown primary (CUP). We first wanted to study the precision of the exam to detect the primary, after a negative check-up, for the extension of the disease, and to judge the impact of the results on management and survival of those patients.ResultThe PET/CT led to the detection of the primary for 14 patients out of 37, after a negative check-up composed of five exams on average. For 10 patients, the exam allows the detection of supplementary metastases. The management was changed after the exam in more than one third of the patients, but without any significant impact on the time of survival of these patients, for whom the prognostic is usually dismal.ConclusionThe ¹⁸F-FDG PET/CT appears a valuable tool for detection of primary, changing the management of many of the patients. These results must be completed by a prospective study, in particular to judge the impact of exam's results on the survival.     

Comparaison des performances diagnostiques de la TEP au FNa avec et sans scanner couplé dans la recherche de métastases osseuses

IntroductionPerforming a CT acquisition along with a 18F-Fluoride PET study increases the effective dose delivered to the patient. We evaluated its value in the diagnosis of bone metastases.Material and methodsThree observers retrospectively analyzed 18F-Fluoride PET images (non-attenuation corrected) without CT and attenuation corrected images fused with CT in 50 patients with a cancer. The skeleton was divided into 17 areas. A score of malignancy from 1 to 5 was attributed to each area. An area-based analysis was done as well as a patient-based analysis. For the latter, the score of the area with the highest score was given to each patient. Clinical follow-up of at least 6 months, pathology or other imaging procedures served as gold standard.ResultsFor the three observers, the areas under the ROC curve of the area-based analysis were respectively 0.79, 0.97 and 0.70 without CT and 0.98, 0.98 and 0.96 with CT. The differences were significant (P < 0.05) for observers 1 and 3. The areas under the ROC curve of the patient-based analysis were respectively 0.86, 0.96 and 0.85 without CT and 0.97, 0.98 and 0.99 with CT and there was a significant difference for observer 3.ConclusionPerforming a CT acquisition along with an 18F-Fluoride PET study increases the homogeneity of the results obtained by different observers.     

Récidive biologique de cancer de la prostate : intérêt de la TEP/TDM à la fluorocholine (18F) du corps entier

Case reportA patient was referred to fluorocholine (18F) PET/CT to restage a biological recurrence of his prostate cancer. There was a doubt on local and lymph node recurrence on MRI.ResultPET/CT showed several pelvic foci evocative of local and lymph node recurrence, more extensive than the MRI anomaly without bone lesion; this recurrence was treated by hormone therapy. But FCH PET/CT also revealed a left cerebral focus. Cerebral MRI was therefore performed which confirmed an anomaly evocative of a grade II brain lesion.ConclusionThis observation illustrates the fact that, in case of prostate cancer, a whole-body imaging, including the skull, is useful, even when foci are detected in the pelvis. Several types of cancer take-up fluorocholine (18F): in case of a visceral distant focus in a patient with prostate cancer, the hypothesis of a second primary cancer should be considered.     

Apport de la TEMP–TDM en complément de la scintigraphie osseuse planaire dans la pratique courante du service de médecine nucléaire de Nancy

ObjectiveThe purpose of our study was to evaluate the diagnostic performance of SPECT coupled to computed axial tomography (SPECT–CT) in our daily practice of bone scintigraphy.Subjects and methodsSPECT–CT obtained as a complement to the planar bone scintigraphy in 39 patients were studied. Each type of image was retrospectively read by two differents observers: a nuclear medicine physician who was unaware of SPECT–CT results analysed planar bone scintigraphy, a second one who was unaware of planar bone scintigraphy results analysed SPECT–CT images. In this population of patients, 17 patients were addressed in an oncologic setting. The 22 other patients were addressed for pain of indeterminate origin without neoplasic context.ResultsIn 13% of the cases, SPECT–CT specified the precise location of increased uptake foci seen on planar bone scintigraphy. In 38% of cases, SPECT–CT confirmed a diagnosis suspected by the planar bone scintigraphy. In 10% of cases, SPECT–CT established a diagnosis that was uncertain with planar bone scintigraphy. In 26% of cases, SPECT–CT brought no additional information. Finally in 3% of cases, SPECT–CT proved to be more sensitive than planar images.ConclusionOur study demonstrates the utility of SPECT–CT in the daily practice of bone scintigraphy, this complementary imaging study benefited to 74% of our patients.