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ObjectiveTo examine the patterns of care for octogenarian head and neck cancer patients.MethodsAll newly diagnosed patients aged 80 years or older, who presented at our centre between June 2018 and October 2020, were included.ResultsThe total number of patients was 42. The median Charlson Comorbidity Index was 5 (range, 4–9). The larynx was the most common subsite (n = 12). Twenty-nine patients (66 per cent) were diagnosed at disease stage IV. Squamous cell carcinoma was the most common histology (86 per cent). Twenty-six patients (62 per cent) had radical treatment and 16 (38 per cent) had palliative treatment. The estimated six-month and one-year overall survival rates for the radical and palliative treatment cohorts were 92.3 per cent and 42.9 per cent (p = 0.001) and 65.4 per cent and 15.4 per cent (p = 0.003), respectively.ConclusionThis study provides useful information on octogenarian patients with head and neck cancer. This information may help in conducting prospective studies, especially those focusing on older patients with head and neck cancer, in order to define the ideal care of this patient population.

In this report, we present a rare case of solid silicone implant displacement to the contralateral side after aesthetic gluteal augmentation, a phenomenon that has never been reported before in the literature. A 29-year-old woman with a history of gluteal augmentation 9 months previously and soft tissue infection presented for a consultation due to 3 days of sudden progressive pain in the right gluteus with erythema and edema, without a history of trauma. Displacement of the left gluteal implant to the right gluteal pocket was shown by magnetic resonance imaging. Because the patient refused implant removal, the decision was made to perform capsulotomy, to reconstruct the gluteal pockets, and to preserve the implants. The patient showed a satisfactory early and late postoperative course. Possible causes of this complication include poor surgical technique, with insufficient tissue preservation to keep the pockets apart, and the presence of seroma or hematoma that favored an infectious process, thereby leading to deterioration of the dissected soft tissues with dehiscence of the wound favoring the displacement of the implant.

Background: The current spread of carbapenemase-producing Enterobacterales (CPE) is a great concern. Methods: We recovered 198 CPE from 162 patients admitted in our Hospital (March 2014-March 2016) during the R-GNOSIS European Project. Microbiological features and plasmid characteristics of CPE recovered from patients co-colonized with multiple CPE were studied. Findings: Thirty patients (18.5%; CI 95%= 12.5%–24.5%) presented co-colonization with multiple CPE producing the same (CPE-SC) (15.4%) or a different carbapenemase (CPE-DC) (4.3%). OXA-48 (83.3%) was the most frequent carbapenemase, followed by VIM-1 (26.7%), NDM-1 (10%) and KPC-3 (3.3%). CPE-DC-patients had longer admissions [63 days (20–107)] than the other patients. Moreover, hospital stay until CPE detection was lower [9 days (5–14)] (p = 0.0052) in CPE-SC-patients than in those with a single colonization; 56% showed co-colonization in the first positive sample, although most of them had previous admissions and had received multiple antibiotic treatments. CPE were more frequently recovered in clinical samples from co-colonized [CPE-DC (28.6%), CPE-SC (24%)] patients than from patients with a single CPE (15.2%). Among CPE-SCOXA-48 [80% (p = 0.11)], K. pneumoniae [88% (p = 0.006)] and E. coli [84% (p

Here we describe an outbreak due to NDM-1+CTX-M-15+DHA-1-producing Klebsiella pneumoniae (NDM-1-Kp) in Spain related to a patient previously admitted to a healthcare centre in an endemic area (Pakistan). Nine colonised patients were detected in the Neurosurgery ward between September 2015 and February 2016 during the R-GNOSIS European Project. NDM-1-Kp isolates from clinical samples were also recovered in three of these patients. Surveillance culture at admission was negative in the index case, but NDM-1-Kp colonisation was detected 27 days later after receiving antibiotic treatment. Co-colonisation with a second NDM-1-Kp isolate was identified in this patient 61 days post-admission. Overall length of stay (LOS = 75 days) (P0.01) and LOS until carbapenemase detection (LOS-1 = 36 days) was longer in NDM-1-Kp carriers than in patients with other carbapenemase-producing Enterobacterales. Intervention strategies were implemented after the outbreak declaration and NDM-1-Kp transmission was contained. Among the NDM-1-Kp isolates, two clones [ST437 (index case and Patient 2) and ST101 (index case and Patients 3-9)] with different IncFIB NDM-1-containing plasmids were identified. Whole-genome sequencing revealed a high content of antimicrobial resistance genes in both isolates in addition to a large number of virulence factors. Colonisation with other epidemic (OXA-48-ST11-K. pneumoniae and VIM-1-ST54-K. pneumoniae) and non-epidemic (VIM-1-ST908-K. pneumoniae and VIM-ST431-Escherichia coli) clones was also detected in two NDM-1 carriers. Implementation of adequate infection control measures and uninterrupted active surveillance programmes for detecting patients with a low colonisation status are crucial to prevent the introduction and dissemination of NDM-type enzymes in our region.

Objective Increase in population's longevity has led to considerable efforts worldwide on physical therapy aging research. The aim of this study is to identify which are the main scientific journals, as well as the most productive authors, institutions and keywords related to the journals, that have published about physical therapy and aging. Methods Original articles published from 1990 to 2014 were retrieved from the bibliographic database Science Citation Index Expanded of Web of Science Core Collection. After standardization of the bibliographic information, a series of bibliometric indicators was obtained regarding authors, institutions, citation and keywords of the core journals using bibliometric software. The PAJEK network analysis program was used for graphic representation. Results A total of 2,237 original articles are included in this analysis. The number of identified journals is 573, with an average growth of publishing journals throughout the studied period of 9.41%. Bradford's distribution shows 12 core journals, out of which 41.67% have published constantly all throughout the 25-year period, being the most productive one Physical Therapy. Fritz, Julie M is the most productive author, and University of Sydney the most productive institution. The keyword exercise is used in an outstanding way. Conclusions The productivity trends provided an indication of the greater scientific interest of physical therapy in aging as a line of research. Collectively, the data indicated that physical therapy-specific journals are being consolidated but non-specific are still a significant research source, and that a fundamental element of their research includes exercise and movement.

Contribute to improve the coverage of statistics in the higher education and make more youngsters that have the academic merits have access to the Honduras Autonomous National University, UNAH, reason that motivated the municipal authorities of the city halls that make the Valle de Sesecapa in the western part of the country, the living forces in that zone and the Western Regional Universitary Center (CUROC), add efforts to put in functioning the Telecenter UNAH-CUROC Ocotepeque, that is currently benefiting more than 100 youngsters of that sector of the Honduran territory. The telecenter of the UNAH in Ocotepeque, has as origin the request for the creation of a Higher technological institute, that the living forces of the western zone, requested to the CUROC, as the central node of the educational web of the UNAH in the western of the country. To this initiative was added the association of city halls of Valle de Sesecapa (AMVAS). The renovation of the social commitment of the UNAH with the society, the succesful experience of the functioning of the telecenter in Gracias, Lempira, by the CUROC and the responsibility assumed by the city halls of Ocotepeque, Concepcion, Santa Fe and Sinuapa and its citizens, showed that through this experience of the telecenter of Ocotepeque, that the united effort of the academy, the local governments and the civil society assure the answers to the socioeconomic and cultural needs of the communities. In 2014, that effort is traduced in the achievement of 87 graduated youngsters of the different high schools of Ocotepeque, study in the telecenter of the UNAH in Ocotepeque the careers of degree in Pedagogy and the Technical in Microfinances, both in the virtual modality. The process and the achievements of this dream and shared work are exposed in the following article. UNAH INNOV@ No 4 2015 page 11-18

Background: QRS distortion is an electrocardiographic (ECG) sign of severe ongoing ischemia in the setting of ST-segment elevation acute myocardial infarction (STEMI). We sought to evaluate the association between the degree of QRS distortion and myocardium at risk and final infarct size, measured by cardiac magnetic resonance (CMR). Methods: A total of 174 patients with a first anterior STEMI reperfused by primary angioplasty were prospectively recruited. Pre-reperfusion ECG was used to divide the study population into three groups according to the absence of QRS distortion (D0) or its presence in a single lead (D1) or in 2 or more contiguous leads (D2 +). Myocardium at risk and infarct size were determined by CMR one week after STEMI. Multiple regression analysis was used to study the association of QRS distortion with myocardium at risk and infarct size, with adjustment for relevant clinical and ECG variables. Results: 101 patients (58%) were in group D0, 30 (17%) in group D1, and 43 (25%) in group D2 +. Compared with group D0, presence of QRS distortion (groups D2 + and D1) was associated with a significantly adjusted larger extent of myocardium at risk (group D2 +: absolute increase 10.4%, 95% CI 6.1-14.8%, p < 0.001; group D1: absolute increase 3.3%, 95% CI 1.3-7.9%, p = 0.157) and larger infarct size (group D2 +: absolute increase 10.1%, 95% CI 5.5-14.7%, p < 0.001; group D1: absolute increase 4.9%, 95% CI 0.08-9.8%, p = 0.046). Conclusions: Distortion in the terminal portion of the QRS complex on pre-reperfusion ECG in two or more leads is independently associated with larger myocardium at risk and infarct size in the setting of primary angioplasty-reperfused anterior STEMI. QRS distortion in only one lead is independently associated with larger infarct size in this setting. Our findings suggest that QRS distortion analysis could be included in risk-stratification of patients presenting with anterior STEMI.

Introduction The utility of CAD/CAM technology in the treatment of mandibular defects has been demonstrated, allowing effective analysis, diagnosis and treatment for bone defects, however the high cost and sometimes the difficult access to this technology limits its use. Materials and methods: observational descriptive cross-sectional study in which craniofacial bone defects were analyzed with emphasis at the mandibular level, with free 3D reconstruction software, determining characteristics of the population and bone defect. A management workflow is proposed and some cases analyzed are presented. Results 50 patients with craniofacial bone defects were collected over a one year period. Mandibular defects account for 44% of the total sample, the majority of cases involving more than one mandibular area; the most affected areas were the body and parasymphysis; the average bone defect size was 36mmx56 mm × 15 mm. The proposed low cost workflow allows multidisciplinary work with industrial design teams to ensure the best treatment for the patient. Conclusions It is possible to implement low-cost management of mandibular defects. The multidisciplinary work between reconstructive surgeons, industrial design and biomedical engineering is useful for the treatment of patients.

Objectives To determine the effect of bovine lactoferrin on prevention of late-onset sepsis (LOS) and neurodevelopment delay. Study design Randomized, double-blind, controlled trial in neonates with a birth weight of 500-2000 g in 3 neonatal units in Lima, Peru, comparing bovine lactoferrin 200 mg/kg/day with placebo administered for 8 weeks. The primary outcome was the first episode of culture-proven LOS or sepsis-associated death. Neurodevelopment delay was assessed by the Mullen Scales at 24 months corrected age. Results Of the 414 infants enrolled, 209 received bovine lactoferrin and 205 received placebo. LOS or sepsis-associated death occurred in 22 infants (10.5%) in the bovine lactoferrin group vs 30 (14.6%) in the placebo group; there was no difference after adjusting for hospital and birth weight; hazard ratio 0.73 (95% CI, 0.42-1.26). For infants with birth weights of Conclusions Supplementation with bovine lactoferrin did not decrease the incidence of sepsis in infants with birth weights of Trial registration ClinicalTrials.gov : NCT01525316 .

To summarize and classify the most recent and relevant microbiological studies for each type of skin and soft tissue infection (SSTI).Following Infectious Diseases Society of America and Food and Drug Administration classifications of SSTIs, we differentiate between two large groups, the superficial or uncomplicated infections and the complicated infections with deep involvement. It is not usually necessary to obtain microbiological samples in uncomplicated infections, except in cases of recurrences or for epidemiological control purposes. In the case of complicated infections, the samples are of two different types: those obtained from the affected area (surgical samples, punctures of abscesses or swabs) and systemic samples (i.e. blood cultures). The clinical condition also determines the type of samples to be obtained. In cases of systemic involvement, blood cultures are mandatory. For immunocompromised patients, who may present atypical infections, detection of antigens, serologies or molecular biology techniques may be helpful. The rapid diagnosis is currently the goal to be pursued by implementing techniques such as matrix assisted laser desorption ionization-time of flight, commercial real-time PCR or the promising metagenomics.Microbiological diagnosis is one of the cornerstones of the management of SSTIs. Prompt obtaining and processing of the necessary samples, depending on the clinical situation of the patient, is of relevance in the decision-making process. Rapid and fluid reporting of the results (identification, mechanisms of resistance and antibiogram) will improve the management of these patients.

[Purpose]: The purpose of this paper is to analyse the degree of accessibility of a set of electronic journals that are hosted on widely used online scientific journal publishing platforms and whose content quality has already been certified. Two studies were performed, in which the accessibility of the selected platforms was studied in 2011 and 2016. [Design/methodology/approach]: The research was performed on publishing platforms than hosted more than 20 journals about human behaviour and factors that may influence it. The evaluation was carried out following the methodology described by the Web Accessibility Initiative in their Website Accessibility Conformance Evaluation Methodology. [Findings]: The results show that, in spite of an improvement in accessibility, all the analysed electronic consultation platforms contain errors that could hinder their users’ access to their content. The incidence of errors found varies considerably among platforms. As the user interface of each platform analysed is common to all the online scientific electronic journals it hosts, the results obtained are valid for all other journals hosted on a given platform. [Research limitations/implications]: Obtained results were valid in the date and time the websites were analysed. Changes made on the websites since then make that the results of an accessibility analysis would be different. [Practical implications]: Analysed platforms would require taking steps to ensure their accessibility. [Social implications]: Users with disabilities cannot use these platforms appropriately due to the accessibility problems found. The lack of web accessibility also has implications regarding visibility of published articles and common users. [Originality/value]: This work offers a systematic analysis that includes manual accessibility evaluation, which has not been performed in scientific article publishing platforms to the extent presented in this paper. Articles found in the literature perform automatic analyses, which lack the depth of a manual one. Besides, when manual accessibility analysis is performed, usually the home page of a platform or journal alone is considered., The work was supported by the National R+D+I of the Ministry of Economy and Competitiveness of the Spanish Government, Spain (CSO2015-65594-C2-2-R) and Basque Country Government (IT980-16).

OBJECTIVETo compare the epidemiology, clinical characteristics, and mortality of patients with bloodstream infections (BSI) caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (ESBL-EC) versus ESBL-producing Klebsiella pneumoniae (ESBL-KP) and to examine the differences in clinical characteristics and outcome between BSIs caused by isolates with CTX-M versus other ESBL genotypesMETHODSAs part of the INCREMENT project, 33 tertiary hospitals in 12 countries retrospectively collected data on adult patients diagnosed with ESBL-EC BSI or ESBL-KP BSI between 2004 and 2013. Risk factors for ESBL-EC versus ESBL-KP BSI and for 30-day mortality were examined by bivariate analysis followed by multivariable logistic regression.RESULTSThe study included 909 patients: 687 with ESBL-EC BSI and 222 with ESBL-KP BSI. ESBL genotype by polymerase chain reaction amplification of 286 isolates was available. ESBL-KP BSI was associated with intensive care unit admission, cardiovascular and neurological comorbidities, length of stay to bacteremia >14 days from admission, and a nonurinary source. Overall, 30-day mortality was significantly higher in patients with ESBL-KP BSI than ESBL-EC BSI (33.7% vs 17.4%; odds ratio, 1.64; P=.016). CTX-M was the most prevalent ESBL subtype identified (218 of 286 polymerase chain reaction-tested isolates, 76%). No differences in clinical characteristics or in mortality between CTX-M and non–CTX-M ESBLs were detected.CONCLUSIONSClinical characteristics and risk of mortality differ significantly between ESBL-EC and ESBL-KP BSI. Therefore, all ESBL-producing Enterobacteriaceae should not be considered a homogeneous group. No differences in outcomes between genotypes were detected.CLINICAL TRIALS IDENTIFIERClinicalTrials.gov. Identifier: NCT01764490.Infect Control Hosp Epidemiol 2018;39:660–667

[Background] Bloodstream infections (BSIs) due to ESBL-producing Enterobacteriaceae (ESBL-E) are frequent yet outcome prediction rules for clinical use have not been developed. The objective was to define and validate a predictive risk score for 30 day mortality., [Methods] A multinational retrospective cohort study including consecutive episodes of BSI due to ESBL-E was performed; cases were randomly assigned to a derivation cohort (DC) or a validation cohort (VC). The main outcome variable was all-cause 30 day mortality. A predictive score was developed using logistic regression coefficients for the DC, then tested in the VC., [Results] The DC and VC included 622 and 328 episodes, respectively. The final multivariate logistic regression model for mortality in the DC included age >50 years (OR = 2.63; 95% CI: 1.18–5.85; 3 points), infection due to Klebsiella spp. (OR = 2.08; 95% CI: 1.21–3.58; 2 points), source other than urinary tract (OR = 3.6; 95% CI: 2.02–6.44; 3 points), fatal underlying disease (OR = 3.91; 95% CI: 2.24–6.80; 4 points), Pitt score >3 (OR = 3.04; 95 CI: 1.69–5.47; 3 points), severe sepsis or septic shock at presentation (OR = 4.8; 95% CI: 2.72–8.46; 4 points) and inappropriate early targeted therapy (OR = 2.47; 95% CI: 1.58–4.63; 2 points). The score showed an area under the receiver operating curve (AUROC) of 0.85 in the DC and 0.82 in the VC. Mortality rates for patients with scores of, [Conclusions] We developed and validated an easy-to-collect predictive scoring model for all-cause 30 day mortality useful for identifying patients at high and low risk of mortality., This study was funded by: the Ministerio de Economía y Competitividad, Instituto de Salud Carlos III co-financed by the European Development Regional Fund ‘A way to achieve Europe’ ERDF, the Spanish Network for Research in Infectious Diseases (REIPI RD12/0015), FIS grant PI10/02021 and FIS grant PI14/01832. B. G. G., J. R. B., A. P. and Y. C. also received funds from the COMBACTE-CARE project, Innovative Medicines Initiative (IMI), the European Union’s Seventh Framework Programme (FP7/2007-2013) and in-kind contributions from EFPIA companies. R. A. B. was also supported in part by funds and/or facilities provided by the Cleveland Department of Veterans Affairs, the Veterans Affairs Merit Review Program and the Geriatric Research Education and Clinical Center VISN 10 (VISN 10 GRECC), and the NIAID of the NIH under award numbers R01AI072219 and R01AI063517.

Resumen Introduccion y objetivos La Sociedad Espanola de Cardiologia celebra anualmente un congreso nacional en el que se presentan numerosas comunicaciones. Sin embargo, se desconoce si posteriormente se publican como articulos y en que revistas. Nuestro objetivo es identificar el grado de publicacion de estas comunicaciones y analizar sus caracteristicas bibliometricas. Metodos Se selecciono aleatoriamente una muestra de 300 comunicaciones presentadas de forma oral durante los congresos de 2002, 2005 y 2008. La identificacion de los trabajos publicados se realizo mediante busqueda en las bases de datos Science Citation Index-Expanded, Scopus , Indice Medico Espanol e Indice Bibliografico Espanol en Ciencias de la Salud. Resultados De las 300 comunicaciones, 115 derivaron en 147 articulos publicados (el 38,33% de publicacion). El congreso que obtuvo un mayor indice de publicaciones fue el de 2005 (43%). El mayor numero correspondio al area de cardiologia pediatrica/cardiopatias congenitas (58,8%). El mayor porcentaje de trabajos se publico a los 2 anos de la celebracion del congreso (30,61%). Los articulos se han publicado en 57 revistas, de las que han pblicado el mayor numero de articulos Revista Espanola de Cardiologia (n = 55; 37,41%) y European Heart Journal (n = 8; 5,44%). Conclusiones El alto porcentaje de articulos publicados en revistas de la mitad superior de la categoria Cardiac and Cardiovascular System del Journal Citation Reports (83%) se puede considerar un indicador objetivo de la calidad de las comunicaciones presentadas en estos congresos. Que mas de un 60% de las comunicaciones no se publique priva a la comunidad cientifica de unos resultados potencialmente interesantes.

In 1986, a new syndrome was described in Taiwan secondary to hypervirulent K. pneumoniae (hvKP), and its main feature was the ability to cause severe infection in young and immunocompetent hosts. Their virulence is explained by the efficient acquisition of iron and an increase in capsule production, which confer the characteristic hypermucoviscous phenotype. Most of these cases have been described in Asia and subsequently spread to America and Europe, where their prevalence is much lower. We present four cases of bacteremia and liver abscesses secondary to hypervirulent K. pneumoniae, two of them associated with endophthalmitis. K. pneumoniae isolates recovered from two of the patients belonged to capsular serotype K1 (genes wzx_K1 and magA), while the other two were K2 (gene wzy_K2). Both of the K1 isolates were classified into a ST23, and isolates of serotype K2 belonged to the ST375 and ST881 clones.In Europe, hvKP isolates are less frequently recovered, mostly associated with Asian citizens or travelers, which was not the case in our patients. K1 capsular serotype is a major cause of primary liver abscess and secondary septic embolus, and K2 is associated with secondary liver abscess. Although these hypervirulent variants usually affect immunocompetent patients as in our cases, diabetes mellitus is a major risk factor for the most invasive cases, with concomitant poor prognosis. Identification of hypervirulent K. pneumoniae serotypes K1 and K2 should be considered as part of the microbiological diagnosis of community-acquired liver abscess due to their clinical implications. Keywords: Hypermucoviscous Klebsiella pneumoniae, Liver abscess, Community acquired infection, MLST

Antibiotic resistance has been recognized as a worldwide problem. Our aim was to assess the perceptions of Spanish residents about antibiotic use and resistance.An online cross-sectional survey was conducted on all resident doctors in five teaching hospitals (September to November 2010). A link to the questionnaire was e-mailed to 844 doctors. The questionnaire collected demographical characteristics, residents' knowledge about microorganisms of known clinical relevance, their habits in the antibiotic prescription process, and their perceptions on the activities aimed to improve antibiotic use.We received 279 responses corresponding to 33.05% of all targeted residents. The response rate was higher among junior than among senior residents (39.95% vs. 26.12%; p0.05). Residents of all hospitals, specialties and seniority mostly considered that antimicrobial resistance was a significant problem at national level (94.3%), at their institution (91.3%), and for their daily practice (83.8%). Residents considered their training regarding antibiotics insufficient, although up to 86.5% had prescribed antibiotics in the last month. They preferred the availability of local antibiotic guidelines (65%), specific teaching sessions, specific antimicrobial management teams or readily accessible advice from a group or an infectious diseases specialist, to improve antibiotic prescribing, rather than other restrictive interventions.Most residents at the hospitals surveyed believed that antibiotic resistance was a serious problem. The results of this survey provided very important information to optimize adherence to Antimicrobial Stewardship Programs (ASPs). Educational strategies and non-restrictive aids are the most valuable interventions, which ASPs should capitalize on to improve antimicrobial prescription.

Resumen Fundamento y objetivo La poblacion atendida por los servicios de Medicina Interna en Espana tiene una edad creciente, pero desconocemos la prevalencia de los factores de riesgo vascular y su grado de control, asi como sus diferencias segun el tipo de hospital o de consulta. Pacientes y metodo Estudio epidemiologico, transversal y multicentrico en pacientes ≥ 18 anos. Participaron 290 investigadores de las 17 comunidades autonomas. Se determino el tipo de hospital y de consulta. La presion arterial se considero controlada si era Resultados Se analizaron 2.704 pacientes (54% varones), con una edad media (DE) de 64,1 (14,5) anos. El 93% tenia algun factor de riesgo: hipertension 73,9%, dislipidemia 59,5%, obesidad abdominal 43,4%, diabetes 39,5%. El 50,0% tenia alguna lesion de organo diana, el 46,7% alguna enfermedad clinica asociada y el 71,2% un riesgo vascular alto o muy alto. El control de los factores de riesgo fue: hipertension 33,8%, colesterol LDL 40,8% y diabetes 50,7%. No existieron diferencias relevantes segun el tipo de hospital o de consultas. Conclusiones Mas del 90% de los enfermos atendidos en las consultas hospitalarias de Medicina Interna presenta algun factor de riesgo vascular, independientemente del tipo de consulta u hospital. El control de los factores de riesgo es reducido.

Teen pregnancy remains a public health concern particularly among Latinos, whose pregnancy rate of 83.5 per 1000 girls constitutes one of the highest rates of teen pregnancy among all ethnic and racial groups in the United States. To enhance the effectiveness of interventions for diverse Latino populations in the US, it is crucial to assess the community’s understanding of the etiology of the problem of adolescent pregnancy and to implement programs that reflect the local community’s beliefs and preferences. We present findings from six focus groups held with parents (n = 18), teachers (n = 23) and school stakeholders (n = 8) regarding teen pregnancy prevention among Latino youth at a high school located in a large, Midwestern city. Two investigators analyzed data iteratively using a template organizing approach. A consensus emerged across the groups regarding content that emphasized respect for oneself and one’s family, a focus on personal and shared responsibility in reproductive health behavior, information about the “realities” or consequences associated with engaging in sexual activity, and information about contraceptives. The strong request from participants to include a parental education component reflects the community’s belief that parents play a crucial, protective role in the socialization and development of adolescent sexual behavior, a view that is supported by empirical research. Findings highlight the importance of involving local school communities in identifying adolescent pregnancy prevention strategies that are responsive to the community’s cultural values, beliefs, and preferences, as well as the school’s capacity and teacher preferences.

Scientific literature on Web usability is presented by the bibliometric analysis of published Science and Scopus database articles available on the Web. We analyzed the productivity, temporal distribution and scientific production by authors, institutions, countries and journals. There has been a growing trend in the number of articles published, confirming the consolidation and progress in web usability research.

[Purpose]: The purpose of this study to investigate the evolution and current status of peer-reviewed publications concerning generic drugs during the past few decades. [Methods]: Scientific articles about generic drugs published until 2012 were retrieved through the PubMed/MEDLINE database, and a content analysis was performed. [Findings]: Our study revealed an increasing number of publications on generics since 1984. Statins, antiretroviral therapies, and antiepileptics, followed by immunosuppressants and antithrombotic agents, were the most common therapeutic drug categories. [Implications]: Almost 60% of the generics detailed in studies indexed in MEDLINE were acting on the cardiovascular system as anti-infectives and on the nervous system, which is not surprising considering the leading causes of death and disability worldwide., This study was supported by grant CS02015-65594-C2-2-R from the Spanish Ministry of Economy and Competitiveness.

Resumen Introduccion y objetivos La Sociedad Espanola de Cardiologia convoca anualmente becas para financiar proyectos de investigacion en el campo de las enfermedades cardiovasculares. Nuestro objetivo es identificar la repercusion de estas inversiones durante el periodo 2000-2006 a partir de los articulos derivados de las becas y publicados en revistas cientificas. Metodos Utilizando los datos de identificacion de cada proyecto como terminos de busqueda, se recuperaron todos los articulos derivados de estas becas en las bases de datos del Indice Medico Espanol, el Indice Bibliografico Espanol en Ciencias de la Salud, el Science Citation Index-Expanded y Scopus. Los articulos se sometieron a un analisis estadistico descriptivo en relacion con la tipologia de las becas, la evolucion anual de su numero y de su importe, el sexo y las instituciones de los becados. Resultados Se concedieron 207 becas con un importe total de 3.270.877 € y una dotacion media anual de 467.268 €. De ellas, 123 (59,42%) aportaron publicaciones derivadas. El promedio de articulos publicados por beca concedida ha sido de 1,12, y de 1,9 si se tiene en cuenta unicamente las becas que dieron lugar a publicaciones. Conclusiones Durante el periodo 2000-2006, la Sociedad Espanola de Cardiologia/Fundacion Espanola del Corazon destino casi 500.000 € anuales a financiar becas de investigacion y asi contribuir a luchar contra las enfermedades cardiovasculares. Casi el 60% de las becas han aportado publicaciones derivadas, 231 articulos. El 73% de los articulos se publicaron en revistas extranjeras y el 91,34%, en revistas espanolas o extranjeras con factor de impacto en el Journal Citation Reports.

Evaluating the Information Architecture in an already deployed website is not an easy task. Most evaluation techniques are focused on examining system usability, but this is not the only factor that influences IA. The main technique that deals with IA in already deployed web environments is the Navigation Stress Test (NST). A new methodology makes this technique more informative by taking NST beyond simple notation on paper. This work proposes the use of NST combined with other usability testing techniques such as Thinking Aloud and a usability questionnaire. Eye tracking also has been used to supplement the information obtained from applied techniques. This new methodology has been tested by analyzing a series of websites belonging to Spanish public university libraries. The results of this study show the validity of the approach used, as well as the value that this approach and the use of Eye tracking bring to the analysis of IA compared to traditional NST

The main fields of research in Library Science and Documentation are identified by quantifying the frequency of appearance and the analysis of co-occurrence of the descriptors assigned to 11,273 indexed works in the Library and Information Science Abstracts (LISA) database for the 2004–2005 period. The analysis made has enabled three major core research areas to be identified: World Wide Web, Libraries and Education. There are a further 12 areas of research with specific development, one connected with the library sphere and another 11 connected with the World Wide Web and Internet: Networks, Computer Security, Information technologies, Electronic Resources, Electronic Publications, Bibliometrics, Electronic Commerce, Computer applications, Medicine, Searches and Online Information retrieval.

The aim of this paper is to present the bibliometric indicators for Revista Espanola de Cardiologia that were obtained from the “Potential impact factor of Spanish medical journals in 2001” study financed by the Spanish Ministerio de Educacion, Cultura y Deporte. Citations to Revista Espanola de Cardiologia , its national and international impact factor, and its immediacy index were calculated with methods similar to those used by the Institute for Scientific Information. National indicators were based only on citations from 87 Spanish journals considered source journals, whereas international indicators were calculated on the basis of citations from both national journals and foreign source journals in the Science Citation Index. Revista Espanola de Cardiologia obtained a national impact factor of 0.719 and an international impact factor of 0.837, placing it at the head of the ranking of Spanish medical journals.

Fundamento y objetivo En 2001 solo 13 revistas medicas espanolas estaban incluidas en elJournal Citation Reports, por lo que se desconoce el factor de impacto (FI) del resto de revistasespanolas. El objetivo es determinar el FI de las principales revistas medicas espanolas, tenien-do en cuenta las citas procedentes de las revistas no incluidas en la cobertura del Science Ci-tation Index Pacientes y metodo Se analizaron las referencias bibliograficas de 1999, 2000 y 2001 de losarticulos citables publicados en 2001 en una seleccion de 87 revistas medicas espanolas in-cluidas en la base de datos nacional Indice Medico Espanol y en alguna otra base de datos in-ternacional. Se calcularon el numero de citas, el FI y el indice de inmediatez de cada revista Resultados Se analizaron 5.388 referencias bibliograficas procedentes de 74 revistas fuente ocitadoras no incluidas en el Journal Citation Reports y se identificaron las revistas citadas. Aestas citas se anadieron las que cada revista habia recibido en Science Citation Index. La revis-ta mas citada fue MEDICINACLINICA, con 768 citas, y las de mayor FI fueron Histology and His-topathology(FI = 1,866), International Journal of Developmental Biology(FI = 1,654) y MEDICI-NACLINICA(FI = 1,125) Conclusiones Este trabajo ha permitido obtener el FI de 87 revistas medicas espanolas y con-firma los resultados obtenidos en trabajos anteriores que mostraron el liderazgo de MEDICINACLINICAen la medicina espanola. Las revistas publicadas en ingles han recibido pocas citas delresto de las espanolas. La falta de impacto en algunas revistas no estanecesariamente relacio-nada con su falta de calidad, merito o relevancia

El objetivo de este trabajo es presentar los indicadores bibliometricos de Revista Espanola de Cardiologia obtenidos del estudio «Factor de impacto potencial de las revistas medicas espanolas en 2001», financiado por el Ministerio de Educacion Cultura y Deporte espanol. Siguiendo una metodologia similar a la que emplea el Institute for Scientific Information, se han obtenido las citas de Revista Espanola de Cardiologia y su factor de impacto e indice de inmediatez nacionales e internacionales. Los indicadores nacionales tienen en cuenta unicamente las citas procedentes de 87 revistas espanolas seleccionadas como fuentes, mientras que para el calculo de los indicadores internacionales se han sumado a las citas anteriores las que proceden de las revistas fuente extranjeras del Science Citation Index. Revista Espanola de Cardiologia ha obtenido un factor de impacto nacional de 0,719 y un factor de impacto internacional de 0,837, lo que la situa en posiciones de liderazgo en la medicina espanola

BinaxNOW® PBP2a rapid immunochromatographic assay is a novel test for the identification of methicillin resistance in Staphylococcus aureus from clinical blood culture samples based on detection of penicillin binding protein 2a. We have evaluated the utility of this assay to do a rapid diagnostic of methicillin susceptibility directly from blood culture bottles after identification of S. aureus in positive bottles by matrix-assisted laser desorption/ionisation time-of-flight (MALDI-TOF) mass spectrometry. Twenty of 21 methicillin-resistant S. aureus (MRSA) samples from blood cultures were positive on direct immunochromatographic testing (sensitivity 95.24%, 95% confidence interval [CI] 74.13% to 99.75%), whereas 37 methicillin-susceptible S. aureus (MSSA) samples were negative (specificity 100%, 95% CI 88.99% to 99.75%). The combined use of MALDI-TOF mass spectrometry and BinaxNOW® PBP2a test is useful for the rapid identification of both MRSA and MSSA from blood cultures.

The spread of multidrug-resistant Enterobacteriaceae related to the production of extended-spectrum β-lactamases (ESBL) and carbapenemases is a serious public health problem worldwide. Microbiological diagnosis and therapy of these infections are challenging and controversial. After the selection of clinically relevant questions, this document provides evidence-based recommendations for the use of microbiological techniques for the detection of ESBL- and carbapenemase-producing Enterobacteriaceae, and for antibiotic therapy for invasive infections caused by these organisms. The absence of randomized-controlled trials is noteworthy, thus recommendations are mainly based on observational studies, that have important methodological limitations, pharmacokinetic and pharmacodynamics models, and data from animal studies. Additionally, areas for future research were identified.

Introduction and objectives The Spanish Society of Cardiology holds an annual national meeting with a large number of presentations but the number of full-text publications resulting from these presentations and the journals accepting these manuscripts is unknown. This study aimed to identify the full-text publication rate of accepted abstracts and to analyze the bibliometric features of subsequent publications. Methods We randomly selected a sample of 300 oral presentations at the meetings of the Spanish Society of Cardiology in 2002, 2005 and 2008. Subsequent publications were identified through the Science Citation Index-Expanded, Scopus, Indice Medico Espanol , and Indice Bibliografico Espanol en Ciencias de la Salud . Results Of 300 abstracts, 115 resulted in 147 full publications, representing a publication rate of 38.33%. The meeting with the highest publication rate (43%) was held in 2005. The subject category with the highest number of publications was Pediatric Cardiology/Congenital Heart Disease (58.8%). Time to full publication was usually 2 years (30.61%). Articles were published in 57 journals. The journals publishing the highest number of articles were Revista Espanola de Cardiologia (n=55; 37.41%) and the European Heart Journal (n=8; 5.44%) . Conclusions The high percentage of articles published in the upper half of journals listed in Journal Citation Reports under the category of cardiac and cardiovascular system (83%) can be taken as an objective quality indicator of the results presented at these meetings. However, more than 60% of the abstracts did not result in full publications, thus depriving the scientific community of potentially interesting results.

This paper examines the influence of the loss of reference points for the digital readout in user interaction. This has been done using 5 eBooks from different disciplines, accessed through various consultation platforms. We have examined different aspects of the information architecture of these sites to find out if users are aware of their location in the text during reading and maintaining control to scroll through it. The results indicate the need to design more robust information architectures to overcome the problems of loss of location and convert the digital reading experience into a viable alternative

Objective Reproductive biology is a highly productive area. By analyzing papers published in the major journals in the period 2003–2005, the collaborative patterns were characterized. Design Original research papers published in 2004 in the journals included in the first quartile of the category "Reproductive Biology" of the Journal Citation Reports (2005) were selected. A bibliometric analysis was carried out with the information obtained, thus building up the networks of coauthorship and institutional collaboration. Result(s) A total of 4,702 papers were analyzed, 96.75% signed in collaboration by two or more authors, the authors per paper index being 5.24; 73.73% of the papers were collaborations between institutions. The U.S.A. and the U.K. headed the absolute productivity ranking in number of papers, and adapting the data with respect to the population, Israel, Australia, and other European countries, such as Finland, Belgium, Sweden, and The Netherlands, had notable contributions. Conclusion(s) We identified the networks of authors who publish in the journals with the greatest impact factor. Only some of the most productive institutions have consolidated collaborative relationships with other institutions. We identified the scientific "isolation" of some countries which, although their productivity is high, have a small number of international collaborations.

a b s t r a c t The spread of multidrug-resistant Enterobacteriaceae related to the production of extended-spectrum - lactamases and carbapenemases is a serious public health problem worldwide. Microbiological diagnosis and therapy of these infections are challenging and controversial. Clinically relevant questions were selected and the literature was reviewed for each of them. The information from the selected articles was extracted and recommendations were provided and graded according to the strength of the recommendations and quality of the evidence. The document was opened to comments from the members from the Spanish Society of Infectious Diseases and Clinical Microbiology, which were considered for inclusion in the final version. Evidence-based recommendations are provided for the use of microbiological techniques for the detec- tion of extended-spectrum -lactamases and carbapenemases in Enterobacteriaceae, and for antibiotic therapy for invasive/severe infections caused by these organisms. The absence of randomised controlled trials is noteworthy; thus, recommendations are mainly based on observational studies (that have impor- tant methodological limitations), pharmacokinetic and pharmacodynamics models, and data from animal studies. Additionally, areas for future research were identified.

To the Editor: The effects of influenza A pandemic (H1N1) 2009 virus infection in HIV-infected patients are unknown. We describe an HIV-infected patient with severe pandemic (H1N1) 2009 virus infection. The patient was a 37-year-old, HIV-positive, former intravenous drug user in a methadone-substitution program. She had a history of smoking, hepatitis C, and mild chronic obstructive pulmonary disease not requiring treatment. Since 2007 her viral load had been 300 cells/μL. Severe pandemic (H1N1) 2009 virus infection most commonly produces fever, dyspnea, respiratory distress, and bilateral patchy pneumonia (3), which can initially be interpreted as bacterial pneumonia and consequently treated with antimicrobial drugs (2–7). We believe that the patient reported here first had a community-acquired pneumonia with a rapid response to treatment and that she secondarily had respiratory distress caused by pandemic (H1N1) 2009 virus pneumonia. We cannot confirm whether the pandemic (H1N1) 2009 virus infection was nosocomial or community acquired. The increased creatine kinase and lactate dehydrogenase and lymphopenia in this patient resemble that reported in Mexico by Perez-Padilla et al. (3). Although these laboratory parameters are unspecific, they could serve as an alert to pneumonia caused by pandemic (H1N1) 2009 virus instead of bacteria. The Centers for Disease Control and Prevention (CDC) recommends testing all HIV-infected patients suspected of having pandemic (H1N1) 2009 virus infection (8). The Spanish Ministry of Health and Madrid Department of Health recommends this testing for patients with an erratic outcome from common pneumonia. For HIV-infected patients who meet case definitions for confirmed, probable, or suspected pandemic (H1N1) 2009 virus infection, CDC recommends empiric antiviral drug treatment (8). There are no known contraindications for co-administration of oseltamivir, a neuraminidase inhibitor, with antiretroviral medications; no interactions have been demonstrated (8,9). Although clinical signs and treatment of pandemic (H1N1) 2009 are similar for patients with and without HIV infection, HIV-infected patients with suspected pandemic (H1N1) 2009 virus symptoms should be treated as soon as possible. CDC recommends the use of influenza antiviral drugs, but this recommendation might change as additional data on this therapy for HIV-infected patients become available. At this time, however, we strongly recommend use of antiviral drugs for HIV-infected patients with suspected pandemic (H1N1) 2009 virus.