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Hospital de Órbigo, Spain

Oliva Dominguez M.,Servicio de Otorrinolaringologia | Bartual Magro J.,Servicio de Otorrinolaringologia | Roquette Gaona J.,Hospital Universitario Of Puerto Real | Bartual Pastor J.,Catedratico de ORL
Acta Otorrinolaringologica Espanola | Year: 2013

Introduction and objectives: The power spectral density can be used to find a hidden behaviour in a physical system. We studied postural behaviour in a healthy population, by means of power spectral density, and compared it with a situation of complete immobility. Methods: A group of healthy volunteers carried out the modified Clinical Test for Sensory Interaction in Balance. A fibre optic gyroscope device was used to record the data. We compared the power spectral density in these tests and with another recording where the device was motionless. We looked for significant differences using the ANOVA test. Results: A power peak appeared at 8.4. Hz in all static tests. The static group showed significant differences with all the other tests. We found no statistically significant differences when visual input discriminated between 2 tests. There were statistically significant differences for the proprioceptive input. Conclusions: Brief movements are needed to maintain the quiet stance. The distinctive feature of these movements is a fundamental frequency at 1.4. Hz and a harmonic frequency at 8.4. Hz. Proprioceptive input is essential for balance. © 2012 Elsevier España, S.L.

Grau T.,Hospital Universitario Doce Of Octubre | Bonet A.,Hospital Universitario Of Girona | Minambres E.,Hospital Universitario Marques Of Valdecilla | Pineiro L.,Hospital Universitario Of Girona | And 8 more authors.
Critical Care Medicine | Year: 2011

Objective: The aim of this study was to assess the clinical efficacy of alanine-glutamine dipeptide-supplemented total parenteral nutrition defined by the occurrence of nosocomial infections. Secondary parameters included Sequential Organ Failure Assessment score, hyperglycemia and insulin needs, intensive care unit and hospital length of stay, and 6-month mortality. Design: Multicenter, prospective, double-blind, randomized trial. Setting: Twelve intensive care units at Spanish hospitals. Patients: One hundred twenty-seven patients with Acute Physiology and Chronic Health Evaluation II score >12 and requiring parenteral nutrition for 5-9 days. Intervention: Patients were randomized to receive an isonitrogenous and isocaloric total parenteral nutrition or alanine-glutamine dipeptide-supplemented total parenteral nutrition. Nutritional needs were calculated: 0.25 g N/kg-1/d -1 and 25 kcal/kg/d. The study group received 0.5 g/kg/d of glutamine dipeptide and the control total parenteral nutrition group a similar amount of amino acids. Hyperglycemia was controlled applying an intensive insulin protocol with a target glycemia of 140 mg/dL. Measurements and Main Results: The two groups did not differ at inclusion for the type and severity of injury or the presence of sepsis or septic shock. Caloric intake was similar in both groups. Preprotocol analysis showed that treated patients with alanine-glutamine dipeptide-supplemented total parenteral nutrition had lesser nosocomial pneumonia, 8.04 vs. 29.25 episodes-‰ days of mechanical ventilation (p = .02), and urinary tract infections, 2.5 vs. 16.7 episodes-‰ days of urinary catheter (p = .04). Intensive care unit, hospital, and 6-month survival were not different. Mean plasmatic glycemia was 149 ± 46 mg/dL in the alanine-glutamine dipeptide-supplemented total parenteral nutrition group and 155 ± 51 mg/dL in the control total parenteral nutrition group (p < .04), and mean hourly insulin dose was 4.3 ± 3.3 IU in the alanine-glutamine dipeptide-supplemented total parenteral nutrition group and 4.7 ± 3.7 IU in control total parenteral nutrition group (p < .001). Multivariate analysis showed a 54% reduction of the amount of insulin for the same levels of glycemia in the alanine-glutamine dipeptide-supplemented total parenteral nutrition group. Conclusions: Total parenteral nutrition supplemented with alanine-glutamine in intensive care unit patients is associated with a reduced rate of infectious complications and better glycemic control. Copyright © 2011 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins.

In recent years it has been observed that there is a high level of severe mental disorder within the Spanish prison system. A one year descriptive and transversal study of the psychiatric health care demand in the prisons Puerto I, II and III of Puerto de Santa Maria (Cádiz). Of the 128 patients studied, the psychiatric diagnostics with highest prevalence were personality disorders (F60-69) at 35.16%, the next group was psychosis (F20-29) at 25.78%, and in third place mental and behaviour disorders due to use of psychotropic substances (F10-19) at 16.41%. 46.09% suffered conditions which are categorised as severe mental disorders. This study confirms the high levels of severe mental disorder in prisons located in the area of the Puerto Real Hospital. We are making efforts to improve on psychiatric health care provided to these patients by working closely with the Prison system.

Chinchilla N.,University of Cadiz | Carrera C.,University of Cadiz | Duran A.G.,University of Cadiz | Macias M.,Hospital Universitario Of Puerto Real | And 2 more authors.
Phytochemistry Reviews | Year: 2013

Aloe barbadensis Miller is a plant that is native to North and East Africa and has accompanied man for over 5,000 years. The aloe vera plant has been endowed with digestive, dermatological, culinary and cosmetic virtues. On this basis, aloe provides a range of possibilities for fascinating studies from several points of view, including the analysis of chemical composition, the biochemistry involved in various activities and its application in pharmacology, as well as from horticultural and economic standpoints. The use of aloe vera as a medicinal plant is mentioned in numerous ancient texts such as the Bible. This multitude of medicinal uses has been described and discussed for centuries, thus transforming this miracle plant into reality. A summary of the historical uses, chemical composition and biological activities of this species is presented in this review. The latest clinical studies involved in vivo and in vitro assays conducted with aloe vera gel or its metabolites and the results of these studies are reviewed. © Springer Science+Business Media 2013.

Garcia Urena M.A.,Henares Hospital | Feliu X.,Hospital General de Igualada | Velasco M.A.,Hospital Universitario Of Puerto Real | Revuelta S.,Hospital Marques de Valdecilla | And 5 more authors.
Hernia | Year: 2011

Introduction: Investigation in the field of inguinal hernia surgery is now focused on postoperative pain. The extended use of lightweight meshes and alternative methods of fixation may play a relevant role in the reduction of pain. In this study, a new self-gripping lightweight polypropylene mesh is tested. Methods: A multicentric, observational study was scheduled to prospectively evaluate this new mesh. Ten centers agreed to participate. Only primary, type 1 or 2 uncomplicated hernias in adults were included. The mesh was placed as a Lichtenstein procedure without any fixation. A complete pain questionnaire was followed at 1 week, and at 1, 3 and 6 months postoperatively. The principal goal of the study was to evaluate maximum pain score at 6 months. Pain was assessed by a visual analog scale. A total of 256 patients were operated. Mean operative time was 35.6 min; 76.2% of patients were operated in an ambulatory setting. Results: There were a few postoperative complications: 2 wound infections, 17 seromas, 21 hematomas, 6 orchitis. The incidence of acute pain was 27.3% at week 1 and 7.5% at month 1. The incidence of chronic pain was 3.6% at month 3 and 2.8% at month 6. No recurrences or long-term complications were observed. Conclusion: This self-gripping mesh can be used safely in type 1 and 2 primary, uncomplicated inguinal hernia with minimal morbidity and most patients under ambulatory setting. The registered incidence of chronic pain is lower than 3%. © 2011 Springer-Verlag.

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