Universal scaling of the osmotic pressure for dense, quasi-two-dimensionally confined polymer melts reveals transitions between fractal dimensions

A scaling law for the osmotic pressure of quasi-two-dimensional polymer melts as a function of concentration is obtained, which shows fractal characteristics. Structural properties such as the chains' contour length and their inner-monomer pair distribution function display fractal scaling properties as well. These predictions are confirmed with mesoscale numerical simulations. The chains are swollen and highly entangled, yet Flory's exponent is always ν = 1/2. The melt can be considered a fluid of "blobs" whose size becomes renormalized in terms of the contour's length while the fractal dimension df increases monotonically between 5/4 and 2, as the monomer concentration is increased. The semidilute scaling of the pressure is recovered when df = 1. Our results agree with recent experiments and with numerical reports on quasi-2d melts. This work provides a new paradigm to study and interpret thermodynamic and structural data in low-dimensional polymer melts, namely as fractal macromolecular objects.

Association between missense variants of uncertain significance in the CHEK2 gene and hereditary breast cancer: a cosegregation and bioinformatics analysis

Inherited mutations in the CHEK2 gene have been associated with an increased lifetime risk of developing breast cancer (BC). We aim to identify in the study population the prevalence of mutations in the CHEK2 gene in diagnosed BC patients, evaluate the phenotypic characteristics of the tumor and family history, and predict the deleteriousness of the variants of uncertain significance (VUS). A genetic study was performed, from May 2016 to April 2020, in 396 patients diagnosed with BC at the University Hospital Lozano Blesa of Zaragoza, Spain. Patients with a genetic variant in the CHEK2 gene were selected for the study. We performed a descriptive analysis of the clinical variables, a bibliographic review of the variants, and a cosegregation study when possible. Moreover, an in-depth bioinformatics analysis of CHEK2 VUS was carried out. We identified nine genetic variants in the CHEK2 gene in 10 patients (two pathogenic variants and seven VUS). This supposes a prevalence of 0.75% and 1.77%, respectively. In all cases, there was a family history of BC in first- and/or second-degree relatives. We carried out a cosegregation study in two families, being positive in one of them. The bioinformatics analyses predicted the pathogenicity of six of the VUS. In conclusion, CHEK2 mutations have been associated with an increased risk for BC. This risk is well-established for foundation variants. However, the risk assessment for other variants is unclear. The incorporation of bioinformatics analysis provided supporting evidence of the pathogenicity of VUS.

The effective interfacial tensions between pure liquids and rough solids: a coarse-grained simulation study

The effective solid-liquid interfacial tension (SL-IFT) between pure liquids and rough solid surfaces is studied through coarse-grained simulations. Using the dissipative particle dynamics method, we design solid-liquid interfaces, confining a pure liquid between two explicit solid surfaces with different roughness degrees. The roughness of the solid phase is characterized by Wenzel's roughness factor and the effective SL-IFT is reported as a function of it also. Two solid-liquid systems, different from each other by their solid-liquid repulsion strength, are studied to measure the effects caused by the surface roughness on the calculation of . It is found that the roughness changes the structure of the liquid, which is observed in the first layer of liquid near the solid. These changes are responsible for the effective SL-IFT increase, as surface roughness increases. Although there is a predominance of surface roughness in the calculation of it is found that the effective SL-IFT is directly proportional to the magnitude of the solid-liquid repulsion strength. The insights provided by these simulations suggest that the increase of Wenzel's roughness factor increases the number of effective solid-liquid interactions between particles, yielding significant changes in the local values of the normal and tangential components of the pressure tensor.

2011-2020 trends of urban and regional ammonia in and around Barcelona, NE Spain

It is well established that in environments where NH₃ abundance is limiting in secondary PM_2.5 generation, a reduction of NH₃ emissions can result in an important contribution to air quality control. However, as deduced from open data published by the European Environmental Agency, the availability of measurements of NH₃ concentrations is very scarce, with very few countries in Europe reporting data consistently for extensive periods, this being especially true for urban background sites. In this framework, simultaneous multi-site measurements were carried out in NE (Northeast) Spain from 2011 to 2020, using diffusion tubes. The highest NH₃ concentrations were recorded at the traffic site (5.3 μgm^-3 on average), followed by those measured at the urban background site (2.1 μgm^-3). Mean concentrations at the mountain site were 1.6 μgm^-3, while the lowest concentrations were recorded at the regional site (0.9 μgm^-3). This comparison highlights traffic emissions as an important source of NH₃. A statistically significant time trend of this pollutant was observed at the urban background site, increasing by 9.4% per year. A season-separated analysis also revealed a significant increasing trend at the mountain site during summer periods, probably related with increasing emissions from agricultural/livestock activities. These increases in NH₃ concentrations were hypothesized to be responsible for the lack of a decreasing trend of NO₃^- concentrations at the monitoring sites, in spite of a markedly reduction of NO₂ during the period, especially at the urban background. Thus, this would in turn affect the effectiveness of current action plans to abate fine aerosols, largely made up of secondary compounds. Actions to reduce NH₃ concentrations at urban backgrounds are challenging though, as predicting NH₃ is subjected to a high uncertainty and complexity due to its dependence on a variety of factors. This complexity was clearly indicated by the application of a decision tree algorithm to find the parameters better predicting NH₃ at the urban background under study. O₃, NO, NO₂, CO, SO₂ and OM + EC concentrations, together with meteorological indicators, were used as independent variables, obtaining no combination of parameters evidently able to predict significant differences in NH₃ concentrations, with a coefficient of determination between real and predicted measurements lower than 0.50. This emphasizes the need for highly temporally and spatially resolved NH₃ measurements for an accurate design of abatement actions.

Mutism. What to expect?

Introduction

Mutism is the inability or unwillingness to speak, resulting in an absence or marked paucity of verbal output. Mutism is a common manifestation of psychiatric, neurological, and drug-related illnesses. Psychiatric disorders associated with mutism include schizophrenia, affective disorders, conversion reactions, dissociative states, and dementias. Neurological disorders causing mutism affect the basal ganglia, frontal lobes, or the limbic system.

Objectives

Outline the importance of setting a differential diagnosis of mutism in the Emergency Room.

Methods

Review of scientific literature based on a relevant clinical case.

Results

Male, 58 years old. He has lived in a residence for 3 months due to voluntary refusal to ingest. Diagnosed with paranoid personality disorder. He is refered to the Emergency Service due to sudden mutism. During this day, he has been stable and suitable with a good functionality. For 3 hours he is mutist, oppositional attitude and stiff limbs, refusing to obey simple orders. Hyperalert and hyperproxia. Not staring. After ruling out organic pathology: normal blood tests, negative urine toxins and cranial CT without alterations, he was admitted to Psychiatry for observation and, finally, he was diagnosed with Psychotic Disorder NOS.

Conclusions

Mutism most often occurs in association with other disturbances in behavior, thought processes, affect, or level of consciousness. The most common disorder of behavior occurring with mutism is catatonia. The differential diagnosis of mutism is complex. In some cases the diagnosis will be clarified only by careful observation and after a neurological evaluation. Published studies show neurological disorders presenting with mutism can be misdiagnosed as psychiatric.

Disclosure

No significant relationships.

Differences in picture naming between children with cochlear implants and children with typical hearing

Increase in the auditory abilities of children with cochlear implants (CIs) has led to an improvement in naming tasks, although divergent results are still being reported; this strongly suggests that further studies are needed. The study aims to compare the responses in a picture-naming activity between the complete population of children aged 5 to 7 with cochlear implants in Catalonia -Spain- (N = 31), without developmental problems, and a matched sample of 31 children with typical hearing. A picture-naming task was used to assess their lexical naming abilities. The results show that children with CIs provide more non-responses, they produce fewer words correctly, they require a longer reaction time and they commit more picture-naming errors than children with typical hearing. The auditory age does significantly affect the results, but not the type of implant. In spite of the hearing gain achieved with the cochlear implant and the listening experience progressively achieved in distinct contexts, further explicit work on lexical naming in speech-therapy intervention is clearly required.

[How to improve the quality of healthcare services and patient safety by adopting strategies from the aviation sector?]

BACKGROUND AND OBJECTIVE

The World Health Organization recognizes patient safety as a priority as part of its global strategy to improve the quality of health services. However, several initiatives need to be integrated and systematized to increase the reliability of healthcare systems. This article discusses several management strategies developed in the aviation sector that have led to a drastic decrease in the accident rate. The aim is to describe each strategy and contrast them with their application in the healthcare sector.

METHODS

Different results and recommendations from the literature and institutions such as the World Health Organization and the International Civil Aviation Organization were consulted and compiled. A synthesis of the identified strategies was made, highlighting examples of their application and impact.

RESULTS

Five key strategies were identified: 1) no-blame incident reporting systems, 2) systematic use of checklists, 3) recurrent training and use of simulation, 4) management of fatigue and work schedules, and 5) management of teamwork.

CONCLUSIONS

The strategies from the aviation sector are presented as a valuable reference for improving patient safety and the quality of healthcare services. They should be consolidated and harmoniously integrated into the design and management of health systems.

Regulation of growth-related genes by nutrition in paralarvae of the common octopus (Octopus vulgaris)

The common octopus (Octopus vulgaris) is a species of great interest to the aquaculture industry. However, the high mortalities registered during different phases of the octopus lifecycle, particularly the paralarvae stage, present a challenge for commercial aquaculture. Improvement of diet formulation is seen as one way to reduce mortality and improve growth. Molecular growth-markers could help to improve rearing protocols and increase survival and growth performance; therefore, over a hundred orthologous genes related to protein balance and muscle growth in vertebrates were identified for the common octopus and their suitability as molecular markers for growth in octopus paralarvae explored. We successfully amplified 14 of those genes and studied their transcription in paralarvae either fed with artemia, artemia + zoea diets or submitted to a short fasting-refeeding procedure. Paralarvae fed with artemia + zoea had higher growth rates compared to those fed only with artemia, as well as a significant increase in octopus mtor (mtor-L) and hsp90 (hsp90-L) transcription, with both genes also up-regulated during refeeding. Our results suggest that at least mtor-L and hsp90-L are likely linked to somatic growth in octopus paralarvae. Conversely, ckip1-L, crk-L, src-L and srf-L had expression patterns that did not match to periods of growth as would be expected based on similar studies in vertebrates, indicating that further research is needed to understand their function during growth and in a muscle specific context.

Social withdrawal and suicide risk: A descriptive study

Introduction

Social withdrawal is a major health problem that has been related with higher morbidity and mortality rates. There are few studies about the relationship between suicidal behavior and social isolation.

Aim

To describe the existence of suicidal risk in subjects with social isolation.

Method

Participants were 187 subjects referred to a Crisis Resolution Home Treatment because of social isolation. The inclusion criteria were: home isolation, avoiding of social situations and relationships, for at least 6 months. Suicide risk was assessed by the item of the Severity of Psychiatric Illness, dividing in four groups (from absence to high suicide risk). Socio-demographic and clinical data were also analysed.

Results

Most cases (n = 132, 70.5%) had absence of suicide risk. They were predominantly young males in all groups. There were no statistically significant differences in sociodemographic or clinical variables. The mean age at onset of social isolation was lower in the high suicide risk group, having lower socially withdrawn period. This group had also lower rates of child abuse and suicide attempt history. The more frequent diagnosis in all groups was psychotic, affective and anxiety disorders. Those cases with mild and high suicide risk needed more frequently hospitalization.

Conclusions

Social isolated people attended by CRHT do not have high frequency of suicide risk. Cases with higher suicide risk are younger and have a shorter period of isolation. The absence of child abuse history or previous suicide attempts contrasts with previous suicidal behavior research. These data can be influenced by the characteristics of functioning of CRHT and the small sample size.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Effect of the pulsation type (alternate or simultaneous) on milk yield and health status of the mammary gland of Murciano-Granadina goats

Recent research into how the pulsation type affects goat milking concluded that alternate pulsation (AP) and simultaneous pulsation (SP) similarly affect the milking efficiency (milking duration and milking fractioning) and teat end condition after milking when both pulsations are employed in short-term experiments. However, the use of SP in high pipeline milking machines led to higher vacuum fluctuations, which, in the long term, may entail a potential risk factor for the mammary gland health status. The aim of this work was to study how AP and SP affect the milk yield, mammary gland health status, and milk composition of goats in the long term, during a complete lactation period, in a high pipeline milking machine. With this objective, 100 Murciano-Granadina goats with similar parturition dates (4 ± 1 postpartum weeks) were divided into 2 similar groups (50 goats per group) according their parity, milk yield, mammary gland health status, and milking duration (after a 15-d pre-experimental period). Throughout the experimental period (7 mo), one group was milked using SP and the other group using AP. Every month, samplings were carried out of the variables related to sanitary status of the mammary gland, milk fractioning, milking duration, average and maximum milk flows, milk composition, teat end status, vacuum fluctuations at the short milk tube during milking, and pulsation tests. Results showed that the use of SP in a high pipeline milking machine showed higher vacuum fluctuations without involving any difference in the other variables studied. We concluded that the use of AP in the milking of Murciano-Granadina goats offers little improvement of the milking performance and increases the investment required for installation and maintenance of the milking machines.

Effect of the reaction medium on the characteristics of silanized titanium dioxide particles: Differences obtained in the Zeta potential data and infrared spectra

In this document we present the differences in the Zeta potential and in the Infrared spectra data obtained from the characterization of silanized titanium dioxide particles, using two different solvents as reaction media: ethanol and toluene. Also, we provide micrographs of transmission electron microscopy in order to show morphological differences between the analyzed samples.

Imported malaria in children in Madrid, Spain, 2007-2013

BACKGROUND

The majority of malaria cases diagnosed in Europe in the last few years have occurred in people living in non-endemic areas travelling back to their home country to visit friends and relatives (VFRs). Children account for 15-20% of imported malaria, with known higher risk of severe disease.

MATERIAL AND METHODS

A retrospective multicentre study was conducted in 24 hospitals in Madrid (Spain) including patients under 16 years diagnosed with malaria (2007-2013).

RESULTS

A total of 149 episodes in 147 children were reported. Plasmodium falciparum was the species most commonly isolated. Twenty-five patients developed severe malaria and there was one death related to malaria. VFR accounted for 45.8% of our children. Only 17 VFRs had received prophylaxis, and 4 of them taken appropriately. They presented more frequently with fever (98% vs. 69%), a longer time with fever (55 vs. 26%), delay in diagnosis of more than three days (62 vs. 37%), and more thrombocytopenia (65 vs. 33%) than non-VFRs, and with significant differences (p<0.05).

CONCLUSIONS

VFRs represent a large proportion of imported malaria cases in our study. They seldom took adequate prophylaxis, and delayed the visit to the physician, increasing the length of fever and subsequent delaying in diagnosis. Appropriate preventive measures, such as education and pre-travel advices should be taken in this population.

Anti-inflammatory effect of dialysable leucocyte extract in a rat model of osteoarthritis: histopathological and molecular characterization

OBJECTIVES

To evaluate the effect of dialysable leucocyte extract (DLE) on pro- and anti-inflammatory profiles in a rat model of osteoarthritis (OA).

METHOD

Forty-eight male Wistar rats were divided into three groups: normal rats without treatment, OA rats treated with placebo, and OA rats treated with DLE. After treatment, the animals were killed to obtain cartilage for histological analysis and to determine the expression of pro- and anti-inflammatory cytokines by reverse transcription multiplex polymerase chain reaction (RT-MPCR) and immunohistofluorescence analyses.

RESULTS

Histological analysis revealed that OA cartilage from rats treated with DLE displayed similar characteristics to non-OA cartilage from the control group. The OA cartilage treated with placebo showed alterations in the cellular architecture and in chondrocyte cluster formation. Analysis of cytokine expression by RT-MPCR showed that OA cartilage from DLE-treated rats expressed platelet-derived growth factor (PDGF), interferon (IFN)-γ, and fibroblast growth factor (FGF)-2, similar to non-OA cartilage from the control group. However, OA cartilage from rats treated with placebo expressed interleukin (IL)-1, PDGF, and I kappa B (IκB). Confocal immunodetection of FGF-2, PDGF, and non-phosphorylated IκB showed that they were distributed in the cytoplasm of most chondrocytes in OA cartilage from DLE-treated rats whereas no nuclear factor kappa B (NF-κB) expression was observed in the nuclei. Instead, in OA cartilage from the placebo group, only weak FGF-2 staining was observed, PDGF and IκB were not detected, and NF-κB was strongly observed in both cytoplasm and nuclei.

CONCLUSIONS

Our findings suggest that DLE treatment modifies the OA process, promoting the expression of anti-inflammatory cytokines and diminishing the inflammatory effects, avoiding the nuclear translocation of NF-κB in chondrocytes.

Non-covalent stacking interactions directing the structural and photophysical features of mono- and dinuclear cyclometalated palladium(ii) complexes

Cyclometallated Pd(ii) complexes with different stackings show emission in solid state in relationship to them.

A Focused Screen Identifies Antifolates with Activity on Mycobacterium tuberculosis

Antifolates are widely used to treat several diseases but are not currently used in the first-line treatment of tuberculosis, despite evidence that some of these molecules can target Mycobacterium tuberculosis (Mtb) bacilli in vitro. To identify new antifolate candidates for animal-model efficacy studies of tuberculosis, we paired knowledge and tools developed in academia with the infrastructure and chemistry resources of a large pharmaceutical company. Together we curated a focused library of 2508 potential antifolates, which were then tested for activity against live Mtb. We identified 210 primary hits, confirmed the on-target activity of potent compounds, and now report the identification and characterization of 5 hit compounds, representative of 5 different chemical scaffolds. These antifolates have potent activity against Mtb and represent good starting points for improvement that could lead to in vivo efficacy studies.

Effects of droperidol and ondansetron on dispersion of ventricular repolarization: A randomized double-blind clinical study in anesthetized adult patients

BACKGROUND AND OBJECTIVE

Droperidol and ondansetron prolong QT interval, a circumstance that has raised some concerns regarding the possibility of inducing torsades de pointes (TdP). However drug-induced spatial dispersion of ventricular repolarization has been shown to be the principal arrhythmogenic substrate for TdP. The aim of this study is to explore the effects of droperidol and ondansetron on the dispersion of repolarization, measured using the T peak-to-end interval (Tp-e) and Tp-e/QT and Tp-e/RR(1/2) ratios in surgical anesthetized patients.

METHODS

A randomized, double-blind study carried out on sixty-three adult patients without cardiac disease or factors favoring QT prolongation and undergoing non-cardiac surgery were randomly assigned to the droperidol or ondansetron group. Under propofol anesthesia, a 12-lead EKG was obtained, and 1.25mg droperidol or 4mg ondansetron was injected. Five minutes later, a new 12-lead EKG was recorded. EKG analyses were independently performed by two cardiologists blinded to the state of the traces or group allocation. QT, RR and Tp-e intervals were measured by averaging five successive beats in leadII (QT) or V5 (Tp-e). The mean value for each measurement was calculated for statistical analysis.

RESULTS

Thirty-two patients (19 women) received droperidol, and 31 (22 women) ondansetron. Droperidol and ondansetron prolonged the QTcF interval (Fridericia formula) by 6.8 and 7.2ms (mean values) respectively, but neither droperidol nor ondansetron increased the Tp-e interval or Tp-e/QT and Tp-e/RR(1/2) ratios.

CONCLUSION

At antiemetic doses, neither ondansetron (4mg) nor droperidol (1.25mg) increases the dispersion of ventricular repolarization in healthy adult patients anesthetized with propofol.

Genetic relationships among American donkey populations: insights into the process of colonization

This study presents the first insights into the genetic diversity and structure of the American donkey metapopulation. The primary objectives were to detect the main structural features underlying variability among American donkey populations, identify boundaries between differentiated gene pools, and draw the main colonization pathways since the introduction of donkeys into America in the 15th century. A panel of 14 microsatellite markers was applied for genotyping 350 American donkeys from 13 countries. The genetic structure of this metapopulation was analysed using descriptive statistics and Bayesian model-based methods. These populations were then compared to a database containing information on 476 individuals from 11 European breeds to identify the most likely ancestral donor populations. Results showed the presence of two distinct genetic pools, with confluence of the two in Colombia. The southern pool showed a unique genetic signature subsequent to an older founder event, but lacked any significant influence of modern gene flow from Europe. The northern pool, conversely, may have retained more ancestral polymorphisms and/or have experienced modern gene flow from Spanish breeds. The Andalusian and, to a lesser extent, the Catalan breeds have left a more pronounced footprint in some of the American donkey populations analysed.

Coatings of nanostructured pristine graphene-IrOx hybrids for neural electrodes: Layered stacking and the role of non-oxygenated graphene

The need to enhance charge capacity in neural stimulation-electrodes is promoting the formation of new materials and coatings. Among all the possible types of graphene, pristine graphene prepared by graphite electrochemical exfoliation, is used in this work to form a new nanostructured IrOx-graphene hybrid (IrOx-eG). Graphene is stabilized in suspension by IrOx nanoparticles without surfactants. Anodic electrodeposition results in coatings with much smaller roughness than IrOx-graphene oxide. Exfoliated pristine graphene (eG), does not electrodeposit in absence of iridium, but IrOx-nanoparticle adhesion on graphene flakes drives the process. IrOx-eG has a significantly different electronic state than graphene oxide, and different coordination for carbon. Electron diffraction shows the reflection features expected for graphene. IrOx 1-2 nm cluster/nanoparticles are oxohydroxo-species and adhere to 10nm graphene platelets. eG induces charge storage capacity values five times larger than in pure IrOx, and if calculated per carbon atom, this enhancement is one order magnitude larger than the induced by graphene oxide. IrOx-eG coatings show optimal in vitro neural cell viability and function as cell culture substrates. The fully straightforward electrochemical exfoliation and electrodeposition constitutes a step towards the application of graphene in biomedical systems, expanding the knowledge of pristine graphene vs. graphene oxide, in bioelectrodes.

Cytocompatibility of a matrix of methylated cassava starch and chitosan

Starches can be used to form edible or biodegradable films, and recently modified starches have been used to form self-supporting films by casting from aqueous solution. In this work, we aimed to propose a novel starch-based composite biomaterial matrix for use in biomedical applications, especially tissue engineering. The goal of the study was to evaluate the cytocompatibility of composite hydrogels of methylated starch and chitosan, using glutaraldehyde as the cross-linker. Commercial cassava starch with high purity (96.69%) was methylated with dimethyl sulfate in order to obtain a rigid material that could possibly render stronger mechanical properties to chitosan hydrogels. Therefore, methylated starch was mixed with a solution of chitosan and the cross-linking was induced by the addition of glutaraldehyde, allowing the formation of hydrogel films which were visualized under scanning electron microscopy. The method of fabrication was optimized based on the capacity of the cells to attach to the material and proliferate. After thorough washes with ethanol and saline solution, human fibroblasts were seeded on top of the gels and allowed to grow for 3 to 5 days. Cell viability was measured using an (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) MMT assay, and cell morphology was visualized by light microscopy. It was found that cells were viable at every time point, with their metabolic activity comparable to the controls (tissue culture plastic and chitosan alone), as well as clear cell–matrix interactions. Moreover, an increase in the metabolic activity over time indicated the capacity of the material to support cell proliferation. The proposed methylated starch–chitosan system is an excellent matrix that allows cell adhesion and could thereby be further assessed as a scaffold for tissue engineering.

[Health personnel assessment about medical order entry systems of pharmacologic treatments in hospitalized patients]

OBJECTIVE

to evaluate health personnel perceptions about medical order entry systems concerning the effect on workflow, medication errors risk and assessment of its potential advantages.

MATERIAL AND METHODS

A cross-section opinion interview was conducted in a tertiary care hospital. Questionnaire consisted of three sections: perception of its effect on workflow, influence on medication error risk and assessment of potential advantages. We also asked them to assess drawbacks and provide suggestions about this prescription system.

RESULTS

76 health professionals were interviewed (58 physicians, 9 pharmacists and 9 nurses). They were satisfied mainly due to decrease the workload (85.5%; IC 95%: 75.58-92.55). They thought that the main characteristics that contribute to reduce medication errors are clinical decision supports related to predefined aspects which the program provided by default. Among potential benefits of medical order entry systems, legibility and warnings triggered by the program (98.7%; IC 95%: 92.90-99.97 and 97,4%; IC 95%: 90.81-99.68 respectively) were the most valuable. High technology dependence, IT failures and lack of infrastructure and medication therapy discontinuities at times of transition between different hospitals' units were the main drawbacks considered. The most repeated suggestion was related to the improvement of links between other health informatics applications used in the hospital.

CONCLUSION

health personnel were highly satisfied with the CPOE system, which is considered to be effective and safe. Technology dependence and IT failures were the main disadvantages reported. According to them, a greater coordination and unification of all software applications available in the hospital would be desirable.

[Measuring patient satisfaction and identifying opportunities for improvement in the preparation of bariatric surgery patients]

OBJECTIVE

To evaluate the satisfaction of patients candidates for bariatric surgery with the performance of a group training program prior to surgery, identifying opportunities for improvement in the program and evaluating participants satisfaction following their implementation.

METHOD

An "ad hoc" designed survey was used, addressed to assess opinions on different aspects of the program, overall satisfaction and identification of areas for improvement. The survey was administered to two groups of patients: the first after one year of implementation of the program to identify suggestions for improvement, and the second after one year of the implementation of the improvement. A total of 112 patients were assessed, 66 in the first pass of the questionnaire and 46 in the second. Both groups were homogeneous in demographic variables

RESULTS

The main improvement detected was expert patients in the preparation of the program. After implantation, slight changes in the ratings of the questions were produced, that were not significant. Overall satisfaction rose from 9.5 to 9.74 out of 10. The other proposals for improvement were to improve audiovisuals and to fit the room furniture to the characteristics of the patients.

CONCLUSIONS

The very high satisfaction levels obtained are usual in studies on hospital satisfaction, our results still being above the studies consulted, as well as in levels of excellence. This prevents statistically significant differences being found. There were no significant differences in the results before and after implementation of improvement. Continuous assessment allows new possibilities for improvement.

Relationship between bacterial load, morbidity and cagA gene in patients infected by Helicobacter pylori

One hundred and seventy-six biopsies of the gastric corpus and antrum from 97 patients were processed using classical and molecular methods in order to study the relationship between the factor cagA of Helicobacter pylori, bacterial load and morbidity. Bacterial load in patients with cagA was greater than in patients without it, both in the antrum and corpus (p<0.01). There was a statistically significant association between cagA and consumption of proton pump inhibitors (adjusted odds ratio 3.11). Haemorrhage of the upper digestive tract was more associated with bacterial load than with the cagA gene (adjusted odds ratio 2.34 and 1.12, respectively), but none of these associations yielded statistical significance.