The use of lysed microalgae in the diet of carnivorous fish can increase the bioavailability of proteins and bioactive compounds, such as unsaturated fatty acids or vitamins in the digestive tract. ...These are essential molecules for the proper physiological development of fish in aquaculture. However, some antinutritional components and other undesirable molecules can be released from an excess of microalgae supplied, compromising the integrity of the intestine. The inclusion of small amounts of hydrolized microalgae in the fish diet can be a good strategy to avoid negative effects, improving the availability of beneficial compounds. Nannochloropsis gaditana is an interesting microalgae as it contains nutraceuticals. Previous studies reported beneficial effects after its inclusion in the diet of Sparus aurata, a widely cultured species in Europe and in all Mediterranean countries. However, administration of raw microalgae can produce intestinal inflammation, increased intestinal permeability, bacterial translocation and disturbance of digestion and absorption processes. The aim of this study was to evaluate changes in the intestinal microbiota and barrier stability of S. aurata fed with low inclusion (5%) hydrolysed N. gaditana. Intestinal microbiota was analyzed using Illumina MiSeq technology and libraries were constructed using variable regions V3-V4 of 16S rDNA molecules. Analysis were based in the identification, quantification and comparison of sequences. The predictive intestinal microbial functionality was analyzed with PICRUSt software. The results determined that the intestinal microbiota bacterial composition and the predictive intestinal microbiota functionality did not change statistically after the inclusion of N. gaditana on the diet. The study of gene expression showed that genes involved in intestinal permeability and integrity were not altered in fish treated with the experimental diet. The potential functionality and bacterial taxonomic composition of the intestinal microbiota, and the expression of integrity and permeability genes in the intestine of the carnivorous fish S. aurata were not affected by the inclusion of hydrolysed 5% N. gaditana microalgae.
Background and importanceParenteral nutrition (PN) is a high-risk medication. Its compounding is a complex process that must be controlled and evaluated periodically. Pharmacy staff involved must ...present appropiate technical skills and perfect knowledge of aseptic technique and preparation aspects.Aim and objectivesTo objectively evaluate the PN compounding process by pharmacy staff, using a specifically designed checklist.Material and methodsEach pharmacy technician (PT) was evaluated by an experienced pharmacist through direct visual inspection, using a checklist containing 57 items: 29 related to aseptic technique and 28 regarding compounding. Each item scored 1 point; final evaluation score was calculated on a 0–10 scale.PT were divided in two groups: with experience (PN compounding for >6 months) and without experience.A descriptive analysis was performed using measures of central tendency, dispersion and position for quantitative variables, and frequency distribution for qualitative variables.Results30 operators were examined, 19 with experience and 11 without experience (the results are in Table 1).Abstract 3PC-006 Table 1 Global (average; minimum; maximum) Aseptic technique (average; minimum; maximum) PN compounding (average; minimum; maximum) With experience 7.9±1.09; 5.2; 9.2 8.5±1.14; 5.9; 10 7.3±1.53; 3.6; 9.4 Without experience 7.2±1.0; 5.9; 8 8.9±0.5; 7.9; 9.7 4.8±1.5; 2.3; 7 Total 7.65±1.0; 5.2; 9.2 8.6±0.94; 5.9; 10 6.3±1.92; 2.3; 9.4 Total number of errors was 307. Error prevalence was 18%. The most frequent errors involved: electrolyte addition sequence (10.7%); stable intermediate admixtures (7.8%); mixing after additions (7.2%); renew/disinfect gloves (5.9%); mix glucose and lipids without amino acids (5.5%); inspect intermediate/final admixtures (5.5%); mix incompatible electrolytes (phosphate-calcium, phosphate-magnesium, magnesium-calcium) (4.23%). Most relevant considered errors were related to incompatibilities/correct mixing of components, visual control, use of gloves and disinfection processes.Conclusion and relevanceEvaluation of PN compounding through a checklist containing the key elements allowed us to objectively detect errors and areas of improvement. Our study revealed a lack of training in compounding aspects, more than in aseptic technique, that was greater in those PT without experience. This study enabled us to implement a targeted training plan to improve staff qualifications and therefore quality/safety of PN.References and/or acknowledgementsConflict of interestNo conflict of interest
OBJECTIVETo analyze outcomes and factors related to mortality among very elderly trauma patients admitted to intensive care units (ICUs) participating in the Spanish trauma ICU registry. DESIGNA ...multicenter nationwide registry. Retrospective analysis. November 2012-May 2017. SETTINGParticipating ICUs. PATIENTSTrauma patients aged ≥80 years. INTERVENTIONSNone. MAIN VARIABLES OF INTERESTThe outcomes and influence of limitation of life sustaining therapy (LLST) were analyzed. Comparisons were established using the Wilcoxon test, Chi-squared test or Fisher's exact test as appropriate. Multiple logistic regression analysis was performed to analyze variables related to mortality. A p-value <0.05 was considered statistically significant. RESULTSThe mean patient age was 83.4±3.3 years; 281 males (60.4%). Low-energy falls were the mechanisms of injury in 256 patients (55.1%). The mean ISS was 20.5±11.1, with a mean ICU stay of 7.45±9.9 days. The probability of survival based on the TRISS methodology was 69.8±29.7%. The ICU mortality rate was 15.5%, with an in-hospital mortality rate of 19.2%. The main cause of mortality was intracranial hypertension (42.7%). The ISS, the need for first- and second-tier measures to control intracranial pressure, and being admitted to the ICU for organ donation were independent mortality predictors. LLST was applied in 128 patients (27.9%). Patients who received LLST were older, with more severe trauma, and with more severe brain injury. CONCLUSIONSVery elderly trauma ICU patients presented mortality rates lower than predicted on the basis of the severity of injury.
Reverse total shoulder arthroplasty (RTSA) has recently become an option for the treatment of proximal humerus fractures (PHFs) or as a salvage procedure after failure of another treatment. The ...purpose of this study was to compare primary RTSA with delayed RTSA in the treatment of displaced PHFs.
A retrospective cohort study was conducted on patients with PHFs who were treated between May 2013 and December 2021 with primary or delayed RTSA after failure of conservative treatment or osteosynthesis. Clinical data were withdrawn from our local computerized database. Complications, active range of motion, as well as the functional outcome were recorded at the end of the follow-up period. Differences between clinical outcomes were analyzed using a logistic regression analysis.
A total of 70 individuals were included in this study (41 primary RTSA and 29 delayed RTSA). The mean of follow-up time was of 112 and 60 months, respectively. There were no differences between groups regarding fracture type according Neer Classification, ASA score or the presence of complications. Q-DASH and Oxford Shoulder scores were significantly better when patients underwent a primary RTSA (49.8 vs 31.4, p = 0.006 and 37.2 vs 27.5, p = 0.004 respectively). In addition, primary RTSA achieved more degrees of flexion and abduction than delayed RTSA (96.8 vs 72.9, p < 0.001 and 94.1 vs 69.3, p < 0.001 respectively).
Primary RTSA for PHFs achieved better functional outcomes and a wider range of motion when compared with delayed RTSA. However, primary and delayed RTSA have similar complication and reintervention rates.
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Calibration is an operation whose main objective is to know the metrological status of a measurement system. Nevertheless, in analytical sciences, calibration has special connotations since it is the ...basis to do the quantification of the amount of one or more components (analytes) in a sample, or to obtain the value of one or more analytical parameters related with that quantity. Regarding this subject, the aim of analytical calibration is to find an empiric relationship, called measurement function, which permits subsequently to calculate the values of the amount (
x-variable) of a substance in a sample, from the measured values on it of an analytical signal (
y-variable). In this paper, the metrological bases of analytical calibration and quantification are established and, the different work schemes and calibration methodologies, which can be applied depending on the characteristic of the sample (analyte
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matrix) to analyse, are distinguished and discussed. Likewise, the different terms and related names are clarified. A special attention has been paid to those analytical methods which use separation techniques, in relation with its effect on calibration operations and later analytical quantification.
Infection in the elderly is a huge issue whose treatment usually has partial and specific approaches. It is, moreover, one of the areas where intervention can have the most success in improving the ...quality of life of older patients. In an attempt to give the widest possible focus to this issue, the Health Sciences Foundation has convened experts from different areas to produce this position paper on Infection in the Elderly, so as to compare the opinions of expert doctors and nurses, pharmacists, journalists, representatives of elderly associations and concluding with the ethical aspects raised by the issue. The format is that of discussion of a series of pre-formulated questions that were discussed by all those present. We begin by discussing the concept of the elderly, the reasons for their predisposition to infection, the most frequent infections and their causes, and the workload and economic burden they place on society. We also considered whether we had the data to estimate the proportion of these infections that could be reduced by specific programmes, including vaccination programmes. In this context, the limited presence of this issue in the media, the position of scientific societies and patient associations on the issue and the ethical aspects raised by all this were discussed.
A 90-day experiment was conducted to evaluate the effects of practical diets with different lipid contents on survival, growth performance and whole-body composition of juvenile tench (Tinca tinca). ...Five-month-old juveniles (34.48±0.77mm total length, 0.382±0.08g weight) were fed practical diets with different lipid contents: 6.5%, 8.5%, 10%, 12%, 14%, 15.5% or 18%. Survival rates ranged from 96.7% to 100%. The highest growth was obtained with diets containing 8.5, 10 and 12% lipid. The five intermediate lipid contents (between 8.5% and 15.5%) caused lower FCRs (1.27–1.38). The percentages of fish with externally visible deformities were around 12%, with no significant differences due to the dietary lipid level. The relation among fatty acid profiles of the diets, body composition, growth performance of juveniles and requirements of other fish species is discussed.
•Useful information for the development of a practical diet for tench culture is provided.•A minimum suitable lipid content in the diet for juvenile tench has been determined.•Relation among fatty acid profiles of the diets, body composition and growth performance of juvenile tench are provided.
The aim of this article is to share theoretical and methodological reflections on a project on feminist epistemologies and health activism. Based on the analysis of 12 life stories and 1 group ...interview, an approach based on ethnographic fiction is proposed through the creation of a serial story in podcast format. This approach helps in generating emotions to facilitate understanding and awareness of the issues raised and in showing everyday practices as ways of constructing knowledge. It also avoids turning life stories into academic artifacts with little transformational capacity.
To compare the severity of pulmonary embolism (PE) and the long-term complications between patients with and without COVID-19, and to investigate whether the tools for risk stratification of death ...are valid in this population.
We retrospectively included hospitalized patients with PE from 1 January 2016 to 31 December 2022. Comparisons for acute episode characteristics, risk stratification of the PE, outcomes, and long-term complications were made between COVID and non-COVID patients.
We analyzed 116 (27.5%) COVID patients and 305 (72.4%) non-COVID patients. In patients with COVID-19, the traditional risk factors for PE were absent, and the incidence of deep vein thrombosis was lower. COVID patients showed significantly higher lymphocyte count, lactate dehydrogenase, lactic acid, and D-dimer levels. COVID patients had PE of smaller size (12.3% vs. 25.5% main pulmonary artery, 29.8% vs. 37.1% lobar, 44.7% vs. 29.5% segmental and 13.2% vs. 7.9% subsegmental, respectively; p < 0.001), less right ventricular dysfunction (7.7% vs. 17.7%; p = 0.007) and higher sPESI score (1.66 vs. 1.11; p < 0.001). The need for mechanical ventilation was significantly higher in COVID patients (8.6% vs. 1.3%; p < 0.001); However, the in-hospital death was less (5.2% vs. 10.8%; p = 0.074). The incidence of long-term complications was lower in COVID cohort (p < 0.001). PE severity assessed by high sPESI and intermediate and high-risk categories were independently associated with in-hospital mortality in COVID patients.
The risk of in-hospital mortality and the incidence of long-term complications were lower in COVID-19. The usual tools for risk stratification of PE are valid in COVID patients.
The aim of this article is to share theoretical and methodological reflections on a project on feminist epistemologies and health activism. Based on the analysis of 12 life stories and 1 group ...interview, an approach based on ethnographic fiction is proposed through the creation of a serial story in podcast format. This approach helps in generating emotions to facilitate understanding and awareness of the issues raised and in showing everyday practices as ways of constructing knowledge. It also avoids turning life stories into academic artifacts with little transformational capacity.
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