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Background: Foot morphology in children is a crucial factor influencing multiple aspects of their physical development. Between the ages of 5 and 10 years, the critical period of child development is when the movement and stability patterns are consolidated that can affect their long-term physical performance and quality of life. The aim of this study is to analyze how the type of foot influences different physical characteristics, laxity, strength, motor tests, and baropodometric variables in children aged 5 to 10 years. Methods: A cross-sectional study involving 196 children was conducted. Different physical characteristics, laxity, strength, motor tests, and baropodometric variables of the sample were analyzed for age and Foot Posture Index (FPI). Results: Differences in all variables were examined by age and FPI. Statistical analysis showed a moderate to high correlation (r > 0.6, p < 0.01) between FPI and the relaxed calcaneal stance position (RCSP) test. Some significant differences were also found in variables related to foot pronation and supination. These results provide valuable information for understanding differences in motor and functional development during childhood and pre-adolescence. Conclusions: The findings highlight the variability in physical and functional development between age and foot type groups, highlighting the importance of considering these differences in the assessment and management of foot-related conditions and biomechanics in childhood. Foot type significantly influences children’s growth and development.

Background: The usefulness of thiopurines has been poorly explored in pouchitis and other pouch disorders. Objective: To evaluate the effectiveness and safety of azathioprine as maintenance therapy in inflammatory pouch disorders. Design: This was a retrospective and multicentre study. Methods: We included patients diagnosed with inflammatory pouch disorders treated with azathioprine in monotherapy. Effectiveness was evaluated at 1 year and in the long term based on normalization of stool frequency, absence of pain, faecal urgency or fistula discharge (clinical remission), or any improvement in these symptoms (clinical response). Endoscopic response was evaluated using the Pouchitis Disease Activity Index (PDAI). Results: In all, 63 patients were included [54% males; median age, 49 (28–77) years]. The therapy was used to treat pouchitis ( n = 37) or Crohn’s disease of the pouch ( n = 26). The rate of clinical response, remission and non-response at 12 months were 52%, 30% and 18%, respectively. After a median follow-up of 23 months (interquartile range 11–55), 19 patients (30%) were in clinical remission, and 45 (66%) stopped therapy. Endoscopic changes were evaluated in 19 cases. PDAI score decreased from 3 (range 2–4) to 1 (range 0–3). In all, 21 patients (33%) presented adverse events and 16 (25%) needed to stop therapy. Conclusion: Azathioprine may be effective in the long term for the treatment of inflammatory pouch disorders and could be included as a therapeutic option.

Approximately 90% of patients with arthritis exhibit forefoot deformities, including deformities within the metatarsophalangeal and proximal interphalangeal joints. Current pharmacological treatment with Disease Modifying Antirheumatic Drugs (DMARDs) consists of two groups: synthetic drugs (sDMARDs) and biological drugs (bDMARDs). The objective of our study was to investigate foot anthropometry changes in RA patients based on the administered treatment over a five-year period Method: A longitudinal analysis was conducted with RA patients who were grouped based on their pharmacological treatment. The pharmacological treatment groups were categorized into (I) methotrexate (MTX), (II) MTX plus biological treatments (including all variables), (III) biological treatment alone, and (IV) a miscellaneous group comprising patients with diverse treatments, including patients for whom various drugs had failed or who had not achieved remission with pharmacological treatment. For the anthropometric measurements, a foot measurement platform validated by McPoil et al. was used. Post hoc analyses with Bonferroni correction were performed to identify pairwise differences between the treatment groups while controlling for Type I errors due to multiple comparisons. Results: In the period from 2018 to 2023, significant changes were observed in several foot measurements. For instance, the MTX group showed a statistically significant increase in left heel width (p = 0.026). The MTX group experienced a slight increase in left foot length, while the Biologics and MTX + Bio groups exhibited more substantial increases in both maximum medial arch height and midfoot width. Conclusions: Different RA treatments can have a significant impact on foot structure over a five-year period, showing notable changes in heel width and overall foot morphology. Combined treatments with MTX and biologics potentially offer better management of RA.

Abstract This dataset is a result of the collaboration between the University of A Coruña and the University Hospital of A Coruña. It contains information about 531 women diagnosed with HER2+ breast cancer, treated with potentially cardiotoxic oncologic therapies. These treatments can cause cardiovascular adverse events, including cardiac systolic dysfunction, the development of which has important clinical and prognostic implications. The availability of good predictors may enable early detection of these cardiac problems. Variables such as age, weight and height are available for each patient, as well as some measures obtained from echocardiography, a technique used prior and during the treatment to check the structure and function of the heart. Among them, there is a functional variable that measures the myocardial velocity during the cardiac cycle. For patients that experienced cancer therapy-related cardiac dysfunction during the treatment period, time until its appearance is known. This dataset aims to enable the scientific community in conducting new research on this cardiovascular side effect.

Objectives: To investigate the efficacy of the assessment methods that are used to diagnose posterior tibialis tendon dysfunction (PTTD) and investigate how the results of these assessments can be used to instruct non-surgical treatments. Design: Systematic review. Data sources: Searches were conducted up to January 2023 in the PubMed, Scopus, Science Direct, Embase, Web of Science and Lilacs databases. Study eligibility criteria: Studies which included patients over 18 years of age, diagnosed with PTTD, which describe the assessments used to aid in the non-surgical treatment of PTTD in comparison with another type of assessment. All types of studies apart from protocols, letters to editor and other systematic reviews and meta-analysis were included. Study appraisal and synthesis methods: Two blinded reviewers performed screening, data extraction, and methodological quality assessments using the QUADAS-2. Results: A total of 15 observational studies were included in the review. Assessment methods included were verbal assessments, physical examinations, and imaging (magnetic resonance imaging (MRI), ultrasound (US), and radiographs). The single-heel rise test was a commonly mentioned physical examination, showing reliability in one study but contradicting in another. MRI was frequently described as the “gold standard”. However, US showed both comparable accuracy and advantages compared to MRI, such as cost-effectiveness and real-time examinations. Conclusions: There are many assessment methods described in the literature and, due to the lack of accuracy of the tests, a mixture of tests should be used to assess PTTD. The parameters from the tests can provide a diagnosis of PTTD, but do not offer detail on how they assist the non-surgical treatment of the condition.

Objectives The aim of this review was to identify the potential intrinsic and extrinsic risk factors (RFs), associated factors (AFs) and consequences of developing calcaneal apophysitis (CA).Design Systematic review.Data sources Cochrane Library, Embase, Medline Ovid, PubMed, Web of Science and Evidence, searched from inception to April 2021.Eligibility criteria We included cohort, case–control and cross-sectional studies that were conducted in patients younger than 18 years who were exposed to RFs or who presented with factors associated with developing CA. Studies in languages other than English or Spanish were excluded.Data extraction and synthesis Two reviewers worked independently to evaluate the risk of bias of included studies. The Newcastle–Ottawa Scale (adapted version) was used.Results A total of 736 studies were identified and 11 observational studies fully met the inclusion criteria, including 1265 participants with a mean age of 10.72 years. Four studies identified extrinsic factors, 10 identified intrinsic factors and three identified both. The extrinsic and intrinsic RFs, AFs and consequences of CA include limitation of ankle dorsiflexion, foot alignment, stiffness and mobility of the midfoot, plantar pressures and ground reaction force, body mass index, age, gender, presence of other osteochondroses and practice of sport. The risk of bias varied, being either moderate or low.Conclusions Regarding the factors and consequences associated with CA (Sever’s disease), ankle dorsiflexion limitation is the most frequent intrinsic factor studied, followed by peak plantar pressures and foot malalignment. However, disagreements between the investigators of the included studies were found; in some cases, there is a lack of unanimity between different studies as to which factors are considered to be RFs, AFs and consequences.PROSPERO registration number CRD42021246366.

Background: Low-Dye tape (LDT) is a short-term treatment for plantar fasciitis, where external stabilization by means of the tape improves kinetics, kinematics, pain level, and electromyography (EMG). Purpose: The purpose of this study was to compare the EMG of the medial gastrocnemius (MG) and changes in arch height (AH) based on the type of foot. Methods: A total of 30 subjects participated in this study; they walked on a treadmill barefoot and when taped, where the average activity and changes in AH were measured over a 30 s period. The statistical intraclass correlation coefficient (ICC) to test for reliability was calculated, and the Wilcoxon test was determined for measures of EMG and AH. Results: The reliability of the values of EMG was almost perfect. The data show that there was an increase in height in the comparison of the moment pre-baseline walking and post-taped walking on neutral feet (5.61 ± 0.46 vs. 5.77 ± 0.39 cm, p < 0.05), on pronated feet (5.67 ± 0.57 vs. 6.01 ± 0.53 cm, p < 0.001) and on supinated feet (5.97 ± 0.36 vs. 6.28 ± 0.27 cm, p < 0.05). In the MG, EMG activity decreased significantly in the taped condition compared to the baseline condition in neutral subjects (0.0081 ± 0.016 vs. 0.076 ± 0.016 mV, p < 0.05) and in pronated subjects (0.081 ± 0.022 vs. 0.068 ± 0.025 mV, p < 0.05). Conclusions: It was demonstrated that with the use of LDT, there was an improvement in the average activity in the MG in pronated and neutral feet. All foot types improved in arch height with the use of tape.

Ulcerative colitis, one of the phenotypic patterns of inflammatory bowel disease, should be considered a progressive disease with an increased risk of complications if intestinal inflammation is not adequately controlled. The advent of new lines of treatment for this condition has changed and expanded the therapeutic goals to modify its natural history and evolution. The concept of “disease clearance” in ulcerative colitis aims to achieve clinical and biological remission as well as mucosal healing (endoscopic, histological, and in future molecular) in these patients. This review provides the available data on each of the goals of disease clearance in ulcerative colitis to be considered for application in clinical practice in the coming years.

BackgroundData on coronavirus disease 2019 (COVID-19) incidence in patients with multiple sclerosis (MS) during the first wave have been published but are scarce for the remaining waves. Factors associated with COVID-19 infection of any grade are also poorly known. The aim of this study was to analyze the incidence, clinical features, and risk factors for COVID-19 infection of any grade in patients with MS (pwMS) during waves 1–5.MethodsThis study prospectively analyzes the cumulative incidence of COVID-19 from the first to the fifth waves by periodic case ascertainment in pwMS followed at the University Hospital of Getafe (UHG). Global and stratified cumulative incidence was calculated. Logistic regression models were used to estimate the weight of selected variables as risk and prognostic factors.ResultsWe included 431 pwMS, of whom 86 (20%) were infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The overall cumulative incidence of confirmed cases was similar to that of Madrid (13,689 vs. 13,307 per 100,000 habitants) but 3 times higher during the first wave and slightly lower from the second to the fifth waves. The majority (86%) of pwMS developed mild forms of COVID-19. Smoking was the only factor associated with a decreased risk of SARS-CoV2 infection of any grade [odds ratio (OR) 0.491; 95% CI 0.275–0.878; p = 0.017]. Risk factors associated with severe forms were Expanded Disability Severity Scale (EDSS) ≥3.5 (OR 7.569; 95% CI 1.234–46.440) and pulmonary disease (OR 10.763; 95% CI 1.27–91.254).ConclusionThe incidence of COVID-19 was similar in this MS cohort to the general population. Smoking halved the risk of being infected. Higher EDSS and pulmonary comorbidity were associated with an increased risk of severe forms.

Necroptosis is a form of cell death characterized by membrane rupture via MLKL oligomerization, although mechanistic details remain unclear. Here, the authors show that MLKL ubiquitylation of K219 facilitates high-order membrane assembly and subsequent rupture, promoting cytotoxicity.

Stainless steel implants are suitable candidates for bone replacement due to their cytocompatibility and mechanical resistance, but they suffer from lack of bioactivity and are prone to bacterial infections. Accordingly, to overcome those limitations, in this study we developed by electrophoretic deposition (EPD), an innovative surface coating made of (i) zein, a natural fibroblast-friendly polymer, (ii) bioactive glass, a pro-osteogenic inorganic material and (iii) copper containing bioactive glass, an antibacterial and pro-angiogenic material. FESEM images confirmed that porous, uniform and free of cracks coatings were obtained by EPD; moreover, coatings were resistant to mechanical stress as demonstrated by the tape test, resulting in a 4B classification of adhesion to the substrate. The coatings were cytocompatible as indicated by metabolism evaluation of human fibroblasts, endothelial cells and mature or progenitor osteoblasts cultivated in direct contact with the specimens. They also maintained pro-osteogenic properties towards undifferentiated progenitor cells that expressed osteogenic genes after 15 days of direct cultivation. Copper conferred antibacterial properties as biofilm formation of the joint pathogens Staphylococcus aureus, Staphylococcus epidermidis and Escherichia coli was significantly reduced in comparison with copper-free coatings (p

Background: Overweight (OW) and childhood obesity (OB) may cause foot problems and affect one’s ability to perform physical activities. The study aimed to analyze the differences in descriptive characteristics, foot type, laxity, foot strength, and baropodometric variables by body mass status and age groups in children and, secondly, to analyze the associations of the BMI with different physical variables by age groups in children. Methods: A descriptive observational study involving 196 children aged 5–10 years was conducted. The variables used were: type of foot, flexibility, foot strength and baropodometric analysis of plantar pressures, and stability by pressure platform. Results: Most of the foot strength variables showed significant differences between the normal weight (NW), OW and OB groups in children aged between 5 and 8. The OW and OB groups showed the highest level of foot strength. In addition, the linear regression analyses showed, in children aged 5 to 8 years, a positive association between BMI and foot strength (the higher the BMI, the greater the strength) and negative association between BMI and stability (lower BMI, greater instability). Conclusions: Children from 5 to 8 years of age with OW and OB show greater levels of foot strength, and OW and OB children from 7 to 8 years are more stable in terms of static stabilometrics. Furthermore, between 5 and 8 years, having OW and OB implies having more strength and static stability.

Disruption of the lipid profile is commonly found in patients with inflammatory bowel disease (IBD). Lipoprotein lipase (LPL) is a key molecule involved in triglyceride metabolism that plays a significant role in the progression of atherosclerosis. In this study, our aim was to study whether serum LPL levels are different in IBD patients and controls and whether IBD features are related to LPL. This was a cross-sectional study that encompassed 405 individuals; 197 IBD patients with a median disease duration of 12 years and 208 age- and sex-matched controls. LPL levels and a complete lipid profile were assessed in all individuals. A multivariable analysis was performed to determine whether LPL serum levels were altered in IBD and to study their relationship with IBD characteristics. After the fully multivariable analysis, including cardiovascular risk factors and the changes in lipid profile that the disease causes itself, patients with IBD showed significantly higher levels of circulating LPL (beta coefficient 196 (95% confidence interval from 113 to 259) ng/mL, p < 0.001). LPL serum levels did not differ between Crohn’s disease and ulcerative colitis. However, serum C-reactive protein levels, disease duration, and the presence of an ileocolonic Crohn’s disease phenotype were found to be significantly and independently positively related to LPL. In contrast, LPL was not associated with subclinical carotid atherosclerosis. In conclusion, serum LPL levels were independently upregulated in patients with IBD. Inflammatory markers, disease duration and disease phenotype were responsible for this upregulation.

BackgroundPrevious studies comparing immigrant ethnic groups and native patients with IBD have yielded clinical and phenotypic differences. To date, no study has focused on the immigrant IBD population in Spain.MethodsProspective, observational, multicenter study comparing cohorts of IBD patients from ENEIDA-registry who were born outside Spain with a cohort of native patients.ResultsWe included 13,524 patients (1,864 immigrant and 11,660 native). The immigrants were younger (45 ± 12 vs. 54 ± 16 years, p < 0.001), had been diagnosed younger (31 ± 12 vs. 36 ± 15 years, p < 0.001), and had a shorter disease duration (14 ± 7 vs. 18 ± 8 years, p < 0.001) than native patients. Family history of IBD (9 vs. 14%, p < 0.001) and smoking (30 vs. 40%, p < 0.001) were more frequent among native patients. The most prevalent ethnic groups among immigrants were Caucasian (41.5%), followed by Latin American (30.8%), Arab (18.3%), and Asian (6.7%). Extraintestinal manifestations, mainly musculoskeletal affections, were more frequent in immigrants (19 vs. 11%, p < 0.001). Use of biologics, mainly anti-TNF, was greater in immigrants (36 vs. 29%, p < 0.001). The risk of having extraintestinal manifestations [OR: 2.23 (1.92–2.58, p < 0.001)] and using biologics [OR: 1.13 (1.0–1.26, p = 0.042)] was independently associated with immigrant status in the multivariate analyses.ConclusionsCompared with native-born patients, first-generation-immigrant IBD patients in Spain were younger at disease onset and showed an increased risk of having extraintestinal manifestations and using biologics. Our study suggests a featured phenotype of immigrant IBD patients in Spain, and constitutes a new landmark in the epidemiological characterization of immigrant IBD populations in Southern Europe.

Paediatric flexible flatfoot (PFF) is a very common condition and a common concern among parents and various healthcare professionals. There is a multitude of conservative and surgical treatments, with foot orthoses (FO) being the first line of treatment due to their lack of contraindications and because the active participation of the child is not required, although the evidence supporting them is weak. It is not clear what the effect of FO is, nor when it is advisable to recommend them. PFF, if left untreated or uncorrected, could eventually cause problems in the foot itself or adjacent structures. It was necessary to update the existing information on the efficacy of FO as a conservative treatment for the reduction in signs and symptoms in patients with PFF, to know the best type of FO and the minimum time of use and to identify the diagnostic techniques most commonly used for PFF and the definition of PFF. A systematic review was carried out in the databases PubMed, EBSCO, Web of Science, Cochrane, SCOPUS and PEDro using the following strategy: randomised controlled trials (RCTs) and controlled clinical trials (CCTs) on child patients with PFF, compared to those treated with FO or not being treated, assessing the improvement of signs and symptoms of PFF. Studies in which subjects had neurological or systemic disease or had undergone surgery were excluded. Two of the authors independently assessed study quality. PRISMA guidelines were followed, and the systematic review was registered in PROSPERO: CRD42021240163. Of the 237 initial studies considered, 7 RCTs and CCTs published between 2017 and 2022 met the inclusion criteria, representing 679 participants with PFF aged 3–14 years. The interventions of the included studies differed in diagnostic criteria, types of FO and duration of treatment, among others. All articles conclude that FO are beneficial, although the results must be taken with caution due to the risk of bias of the included articles. There is evidence for the efficacy of FO as a treatment for PFF signs and symptoms. There is no treatment algorithm. There is no clear definition for PFF. There is no ideal type of FO, although all have in common the incorporation of a large internal longitudinal arch.

The main objective of the present study was to determine the relationship between kinesiophobia and pain (general and foot pain), foot function, and disease activity in patients with rheumatoid arthritis (RA). A total of 124 interviews were carried out with participants with RA. Participants were recruited from the Hospital Universitario Virgen de las Nieves de Granada in Spain. Interviews took place in January 2021. Participants completed the following questionnaires during an appointment with their rheumatologist: Foot Function Index (FFI), Tampa Scale for Kinesiophobia (TSK-11), and the Visual Analogue Scale Pain foot (VAS Pain). Furthermore, the Simplified Disease Activity Index (SDAI) was used to measure disease activity. Of the 124 participants, 73% were women, and their mean age was 59.44 years (SD 11.26 years). In the statistical analysis, positive linear correlations (p < 0.001) were obtained between the variables TSK-11 and VAS (related to general pain or foot pain) and FFI (in its three subscales). Additionally, a negative correlation between the TSK-11 and the educational background was shown. This study provided information about the relationship between foot function and pain with different levels of kinesiophobia in patients with RA. Additionally, the educational background of the patient was considered a predictor of whether or not a patient suffered from kinesiophobia.

Background: In 2020 Spain launched an official campaign, #EsteVirusLoParamosUnidos, aimed at uniting the entire country through citizen cooperation, in order to combat Covid-19. The objective of this research has been to analyse how this Twitter campaign revealed the feelings expressed by Spanish citizens. Methods: The research is based on a composite design that triangulates, from a theoretical model, a quantitative analysis and a qualitative analysis. Results: Of the 7,357 tweets in the sample, 72.32% were found to be retweets. Four content families were extracted which relate to politics, education, messages to society and the defence of occupational groups. The feelings expressed ranged from those of unity, admiration and support to those of discontent and criticism of issues regarding the health situation. Conclusions: The development of networked socio-political and technical measures, which enabled citizen participation, facilitated the development of new patterns of interaction between national or regional governments and digital citizens. This increased citizens’ possibilities of influencing the public agenda and, therefore, strengthening citizen engagement regarding specific situations.

La desnutrición es un síndrome de alto impacto, porque es donde se materializa la enfermedad y su evolución. Esta genera repercusiones físicas y psicológicas en el paciente, así como psicológicas en la familia y en el equipo asistencial. La finalidad de este artículo es analizar la importancia de la nutrición del paciente, el abordaje integral y la repercusión en la esfera emocional no solo del paciente, sino del núcleo familiar. Luego del control de los síntomas urgentes, en orden de importancia, se maneja el resto de los síntomas físicos, los emocionales y el aspecto nutricional. La nutrición engloba lo físico y lo emocional. Para ello se considera primordial realizar un diagnóstico situacional, con base en la comunicación como herramienta fundamental. Se debe tener claro el objetivo, y acompañar en las diferentes etapas al paciente y la familia, brindando herramientas para el adecuado manejo de la evolución del paciente y su contexto.

Objective: We tested the hypothesis that an enhanced bowel preparation strategy (EBS) improves colonic cleansing in patients at high risk for inadequate bowel cleansing (HRI).Methods: This prospective randomized clinical trial included consecutive HRI patients referred for outpatient colonoscopy between February and October 2019. HRI was considered if patients scored >1.225 according to a previously validated bowel-cleansing predictive score. HRI patients were randomized (1:1) to a low-volume conventional bowel cleansing strategy (CBS) (1-day low residue diet (LRD) plus 2 L of polyethylene glycol (PEG) plus ascorbic acid) or to an EBS (3-day LRD plus 10 mg oral bisacodyl plus 4 L PEG). The Boston Bowel Preparation Scale (BBPS) was used to assess the quality of cleanliness. Intention-to-treat (ITT) and per protocol (PP) analyses were performed. A sample size of 130 patients per group was estimated to reach a 15% difference in favor of EBP.Results: A total of 253 HRI patients were included (mean age 69.8 ± 9.5 years, 51.8% women). No statistically significant differences were found in the BBPS scale between the two groups in the ITT analysis (CBS 76.8% vs. EBS 79.7%, P = 0.58) or PP analysis (CBS 78% vs. EBS 84.3%, P = 0.21), risk difference 2.9% (95% CI−7.26 to 39.16) in the ITT analysis, or risk difference 6.3% (95% CI−3.48 to 16.08) in PP analysis. No differences in preparation tolerance, compliance, adverse effects, or colonoscopy findings were found.Conclusion: EBS is not superior to CBS in hard-to-prepare patients. (EUDRACT: 2017-000787-15, NCT03830489).Clinical Trial Registration:www.ClinicalTrials.gov, identifier NCT03830489.

Potassium is basic for life. All living organisms require high amounts of intracellular potassium, which fulfils multiple functions. To reach efficient potassium homeostasis, eukaryotic cells have developed a complex and tightly regulated system of transporters present both in the plasma membrane and in the membranes of internal organelles that allow correct intracellular potassium content and distribution. We review the information available on the pathogenic yeast Candida albicans. While some of the plasma membrane potassium transporters are relatively well known and experimental data about their nature, function or regulation have been published, in the case of most of the transporters present in intracellular membranes, their existence and even function have just been deduced because of their homology with those present in other yeasts, such as Saccharomyces cerevisiae. Finally, we analyse the possible links between pathogenicity and potassium homeostasis. We comment on the possibility of using some of these transporters as tentative targets in the search for new antifungal drugs.

Introduction Rheumatoid arthritis (RA) involves changes to foot structure and function, and there is an association between RA and foot pain. This pain affects those patient’s physical activity and experience of daily living. While there is clinical evidence for the value of foot orthoses (FO) on foot pain, there is a wide range of FO available and there is little evidence on the relative benefits of one orthoses type over another, especially in terms of their impact on physical activity and associated well-being. The aim of this study is to compare physical activity, general and foot health and foot health experiences in people with RA when wearing three different types of FO.Methods and analysis A randomised controlled trial with three arms will compare the effects of (1) custom FO made using a direct adaptation technique, (2) custom FO made through a digital design and production process and (3) prefabricated orthoses. The primary outcome is physical activity measured using a GENEActiv bracelet. Secondary outcomes will be pain, function and disability and associated foot and general health evaluated using existing questionnaires. Semistructured interviews will identify patients’ experiences of the orthoses and living with RA.Ethics and dissemination The study has been approved by the Portal de Ética de la Investigación Biomédica de Andalucía ethical committee (SPAR-001). The results will be disseminated regardless of the magnitude or direction of effect.Trial registration number NCT03170947; Pre-results.

Debaryomyces hansenii yeast represents a promising target for basic and applied biotechnological research It is known that D. hansenii is abundant in sausages and dry-meat products, but information regarding its contribution to their characteristics is blurry and contradictory. The main goal in this review was to define the biological contribution of D. hansenii to the final features of these products. Depending on multiple factors, D. hansenii may affect diverse physicochemical characteristics of meat products. However, there is general agreement about the significant generation of volatile and aromatic compounds caused by the metabolic activities of this yeast, which consequently provide a tendency for improved consumer acceptance. We also summarize current evidence highlighting that it is not possible to predict what the results would be after the inoculation of a meat product with a selected D. hansenii strain without a pivotal previous study. The use of D. hansenii as a biocontrol agent and to manufacture new meat products by decreasing preservatives are examples of exploring research lines that will complement current knowledge and contribute to prepare new and more ecological products.

Recent studies suggest that the beneficial properties provided by sourdough fermentation may be translated to the development of new GF products that could improve their technological and nutritional properties. The main objective of this manuscript is to review the current evidence regarding the elaboration of GF baked goods, and to present the latest knowledge about the so-called sourdough biotechnology. A bibliographic search of articles published in the last 12 years has been carried out. It is common to use additives, such as hydrocolloids, proteins, enzymes, and emulsifiers, to technologically improve GF products. Sourdough is a mixture of flour and water fermented by an ecosystem of lactic acid bacteria (LAB) and yeasts that provide technological and nutritional improvements to the bakery products. LAB-synthesized biopolymers can mimic gluten molecules. Sourdough biotechnology is an ecological and cost-effective technology with great potential in the field of GF products. Further research is necessary to optimize the process and select species of microorganisms robust enough to be competitive in any circumstance.

Abstract Background A strategy of limited preoperative fasting, with carbohydrate (CHO) loading and intraoperative infusion of omega-3 polyunsaturated fatty acids (ω-3 PUFA), has seldom been tried in cardiovascular surgery. Brief fasting, followed by CHO intake 2 h before anesthesia, may improve recovery from CABG procedures and lower perioperative vasoactive drug requirements. Infusion of ω-3 PUFA may reduce occurrences of postoperative atrial fibrillation (POAF) and shorten hospital stays. The aim of this study was to assess morbidity (especially POAF) in ICU patients after coronary artery bypass grafting (CABG)/cardiopulmonary bypass (CPB) in combination, if preoperative fasts are curtailed in favor of CHO loading, and ω-3 PUFA are infused intraoperatively. Methods Fifty-seven patients undergoing CABG were randomly assigned to receive 12.5% maltodextrin (200 ml, 2 h before anesthesia), without infusing ω-3 PUFA (CHO, n = 14); water (200 ml, 2 h before anesthesia), without infusing ω-3 PUFA (controls, n = 14); 12.5% maltodextrin (200 ml, 2 h before anesthesia) plus intraoperative ω-3 PUFA (0.2 mcg/kg) (CHO + W3, n = 15); or water (200 ml, 2 h before anesthesia) plus intraoperative ω-3 PUFA (0.2 mcg/kg) (W3, n = 14). Perioperative clinical variables and mortality were analyzed, examining the incidence of POAF, as well as the need for inotropic vasoactive drugs during surgery and in ICU. Results Two deaths occurred (3.5%), but there were no instances of bronchoaspiration and mediastinitis. Neither ICU stays nor total postoperative stays differed by group (P > 0.05). Patients given preoperative CHO loads (CHO and CHO + W3 groups) experienced fewer instances of hospital infection (RR = 0.29, 95%CI 0.09–0.94; P = 0.023) and were less reliant on vasoactive amines during surgery (RR = 0.60, 95% CI 0.38–0.94; P = 0.020). Similarly, the number of patients requiring vasoactive drugs while recovering in ICU differed significantly by group (P = 0.008), showing benefits in patients given CHO loads. The overall incidence of POAF was 29.8% (17/57), differing significantly by group (P = 0.009). Groups given ω-3 PUFA (W3 and CHO + W3 groups) experienced significantly fewer instances of POAF (RR = 4.83, 95% CI 1.56–15.02; P = 0.001). Conclusion Preoperative curtailment of fasting was safe in this cohort. When implemented in conjunction with CHO loading and infusion of ω-3 PUFA during surgery, expedited recovery from CABG with CPB was observed. Trial registration NCT: 03017001

The information and communication technologies (ICT) has revolutionized education, promoting the development of collaborative work through the use of Web 2.0 tools. In this vein, social networking services gain a special importance. However, the establishment of a collaborative methodology in the university through the use of ICT tools cannot be effective without a good predisposition of students. So, the present investigation aims to know students’ perceptions about collaborative work and social networks. Specifically, the learners are studying Pre-School Education degree at Alicante's University. The goals are focused on knowing students’ attitudes about collaborative work and social networks, knowing their level of experience about these tools, and also analyzing their interest in introducing these tools in the academic world. The instrument for data gathering is a questionnaire. It concludes that the students show a positive attitude towards team work and they are interested in learning to handle some social media.

Background and Objective: Ninety percent of patients with rheumatoid arthritis (RA) feel foot pain during the disease process. Pharmacological treatment of RA has a systematic effect on the body and includes: Nonsteroidal anti-inflammatory drugs, disease-modifying antirheumatic drugs (DMARDs) and biologics. The objective of our review was to examine the impact of biologics on patients with RA ‘foot. Methods and Material: A systematic review of randomized control trials and observational studies that evaluated the efficacy of biologics against other pharmacological treatment, and included a foot outcome measure. The search covered MEDLINE Ovid, Pubmed, CINAHL, Cochrane Library, Evidence Search, and Web of Science. Risk of bias was evaluated using Cochrane guidance and the Newcastle Ottawa Scale adapted version. Results: A total of eight studies fully met the inclusion criteria: Three randomized control trials, and five observational studies were the basis of our review. A total sample of 1856 RA patients with RA treatment participated. The use of biologics was not associated as a risk factor for post-operative surgical site infection or delayed wound healing. The benefits of biologics, in terms of the disease evolution, were assessed using X-ray. Conclusion: Evidence suggests that the use of biologics is not a risk factor for post-operative surgical site infection or delayed wound healing. The use of biologics presents benefits in terms of the disease evolution assessed through X-ray.

Es presenta un estudi basat en el treball de tres estudiants (17-18 anys) amb necessitats educatives especials als quals se'ls fa una instrucció directa sobre situacions i problemes aritmètics verbals de suma i resta, d'una etapa, mitjançant l'ús d'esquemes visuals. El treball té com a objectiu explorar si influeix en aquests estudiants aquest model d'implementació dels problemes. Els tres estudiants presenten tipologies diferents, per la qual cosa es tracta d'un estudi de tres casos. L'anàlisi de les dades ha mostrat influència positiva en els tres estudiants.

Evolution of resistance to control measures in insect populations is a natural process, and management practices are intended to delay or mitigate resistance when it occurs. During the 2012/13 season the first reports of unexpected damage by Diatraea saccharalis on some Bt maize hybrids occurred in the northeast of San Luis province, Argentina. The affected Bt technologies were Herculex I® (HX-TC1507) and VT3PRO® (MON 89034 × MON 88017*). Event TC1507 expresses Cry1F and event MON 89034 expresses Cry1A.105 and Cry2Ab2, whichr are all Bt proteins with activity against the lepidopterans D. saccharalis and Spodoptera frugiperda (MON 88017 expresses the protein Cry3Bb1 for control of coleopteran insects and the enzyme CP4EPSPS for glyphosate tolerance). The affected area is an isolated region surrounded by sierra systems to the northeast and west, with a hot semi-arid climate, long frost-free period, warm winters, hot dry summers, and woody shrubs as native flora. To manage and mitigate the development of resistance, joint actions were taken by the industry, growers and Governmental Agencies. Hybrids expressing Vip3A protein (event MIR162) and/or Cry1Ab protein (events MON 810 and Bt11) as single or stacked events are used in early plantings to control the first generations of D. saccharalis, and in later plantings date's technologies with good control of S. frugiperda. A commitment was made to plant the refuge, and pest damage is monitored. As a result, maize production in the area is sustainable and profitable with yields above the average.

Introducción: la prevalencia de disfunción tiroidea (DT) en nuestro medio no es bien conocida, siendo, sin embargo, una alteración frecuente. Se consideró de interés para los médicos clínicos poner en su conocimiento la frecuencia de los casos diagnosticados. Siendo la diabetes mellitus (DM) una endocrinopatía bien estudiada en nuestro país, se cotejaron las cifras obtenidas de ambas patologías en la muestra estudiada. Objetivo: establecer la frecuencia de DT en una muestra de pacientes evaluados en estudio preoperatorio de segunda opinión, candidatos a implante de prótesis de rodilla o de cadera de coordinación, bajo cobertura financiera del Fondo Nacional de Recursos (FNR)*, y de DM y compararla con cifras internacionales. Material y método: se obtuvieron datos específicos sobre DT y DM de los pacientes asignados por el FNR al Grupo Asesor Médico (GAM), cuyos integrantes realizaron la evaluación de segunda opinión. Resultados: se incluyeron 1.879 pacientes, de los que 67,2% eran mujeres; el rango de edad fue de 22 a 101 años, con un promedio de 69,7±9,8 años. Se encontró que 17,6% presentaban DT en la muestra total (intervalo de confianza [IC] de 95%: 16,0%-19,5%); de ellos se detectó 22,6% en mujeres y 7,5% en hombres. El 97% de los individuos con DT presentaba hipotiroidismo. Así mismo, se estudió la prevalencia de DM, que representó el 13,5% de la muestra (IC95%: 11,4%-5,2%), correspondiendo 12,9% a mujeres y 14,4% a hombres. Conclusiones: la prevalencia de DT hallada en esta muestra fue de 17,6%, mayor que la hallada para DM, que fue de 13,5%. Otro hallazgo fue la alta frecuencia de sobrepeso y obesidad (83,4%).

El comportamiento disruptivo (CD) en el equipo de salud pone en riesgo la seguridad del paciente y la seguridad del equipo sanitario. Es responsabilidad del sistema sanitario y de los profesionales diagnosticar y gestionar esta situación que impacta negativamente para trabajar en equipo, la salud del personal y los resultados asistenciales. Objetivo: realizar la primera encuesta nacional de CD en el equipo de salud. Establecer la prevalencia, sus desencadenantes y consecuencias. Material y método: el Ministerio de Salud Pública (MSP), mediante la Estrategia Nacional de Seguridad del Paciente, convocó en forma voluntaria a todos los prestadores sanitarios (públicos y privados) a participar de la encuesta con el fin de desarrollar una política pública. La encuesta fue anónima y voluntaria. Demandó un período de cuatro meses (junio de 2013 a setiembre de 2013). Incluyó distribución, realización y devolución. Resultados: participaron 38 prestadores; 4.782 encuestas fueron respondidas por 1.713 (36%) auxiliares de enfermería, 1.040 (22%) médicos y 662 (14%) licenciados de enfermería. El 80% trabaja más de 30 horas semanales. Presenciaron CD 88,5% (4.231) y 60% (2.815) lo sufrieron. Predominó el comentario despectivo sobre colegas (75%) y en gritos agresivos y arrebatos de ira (45%). Es frecuente en un 20% por lo menos una vez por semana. El 71% piensa que los desencadenantes están en el ambiente laboral, predominando la carga de trabajo (47,5%) sobre la remuneración (33%). El 63% identifica problemas personales; 53% identifica estas conductas en sus pares; 20% los pone en riesgo de cometer errores; 42% pensó en cambiar de trabajo, y 6% cambió. Discusión y conclusiones: primera encuesta nacional sobre CD a nivel mundial, única impulsada desde la rectoría sanitaria. El problema es de alta incidencia, disminuye la seguridad y deteriora la transferencia de información y capacidad de trabajar en equipo. Existe una baja percepción del riesgo. La remuneración económica no es el principal desencadenante identificado y el CD surge mayormente entre pares. Impacta sobre la retención de los recursos humanos así como en la seguridad laboral.

Las tecnologías de la información y la comunicación (TIC) han revolucionado la educación, promoviendo el desarrollo del trabajo colaborativo a través del uso de las herramientas de la Web 2.0. En este sentido, cobran especial importancia los servicios de redes sociales. No obstante, el establecimiento en el ámbito universitario de una metodología colaborativa mediante las herramientas TIC no puede ser eficaz sin una buena predisposición por parte del estudiantado. En consecuencia, esta investigación pretende conocer las apreciaciones sobre el trabajo colaborativo y las redes sociales de los alumnos del grado en Educación Infantil de la Universidad de Alicante. Los objetivos tratan de saber las actitudes del alumnado sobre el trabajo colaborativo y las redes sociales, conocer su nivel de experiencia en relación a estas herramientas, así como analizar su interés para introducirlas en el contexto académico. El instrumento de recogida de datos es un cuestionario. Se concluye que los discentes muestran una actitud positiva para trabajar en equipo y que están interesados en aprender a manejar ciertos servicios sociales.

Tinea faciei, is a facial superficial mycosis. The most frequent etiological agents are Microsporum canis, Trichophyton rubrum and T. tonsurans. We report a 40 year-old woman, with an eight days history of an erythematous plaque on her superior right eyelid. Hyphae and dermatophytoma were easily visualized in KOH examination, and Microsporum gypseum was isolated.

Se presenta un estudio basado en el trabajo de tres estudiantes (17-18 años) con necesidades educativas especiales a los que se les hace una instrucción directa sobre situaciones y problemas aritméticos verbales de suma y resta, de una etapa, mediante el uso de esquemas visuales. El trabajo tiene como objetivo explorar si influye en dichos estudiantes este modelo de implementación de los problemas. Los tres estudiantes presentan tipologías diferentes, por lo que se trata de un estudio de tres casos. El análisis de los datos ha mostrado influencia positiva en los tres estudiantes.

Objective: The aim of this article is to present the development of a method of analysis of the process of psychoanalytic psychotherapy with children (MAPPP-C) that is relevant for the study of the psychotherapy process from the perspective of the object relations theory. The process was studied by analysing changes in child patients' anxieties, defence mechanisms, object relations and unconscious phantasies, in each psychoanalytic psychotherapy session and throughout their entire psychotherapy. Method: MAPPP-C is both a qualitative and quantitative method of analysis of child psychoanalytic psychotherapy processes. This article will describe the stages in the de-velopment of the method, how the indicators were determined, the units of analysis in the study, the development of analytical codes, the training of raters in this method and inter-rater reliability and agreement tests. Results: This article describes the tasks that compose MAPPP-C, examples of its application and presents some hypotheses that arose from the analysis of the pilot study. Discussion: The preliminary results show that MAPPP-C is a method that allows one to assess the psychotherapist's interventions and the patient's responses in order to enable the analysis of the psychotherapeutic process. The results of the reliability test of the method will allow it to be applied to other types of psychoanalytic psychotherapy with both children and adults.

Resumen Objetivo: Evaluar en pacientes el dolor posoperatorio asociado al uso de la lima de pasaje, en dientes con y sin vitalidad pulpar. Materiales y métodos: Se analizaron 400 dientes (n=400) con indicación de tratamiento endodóntico, según el criterio de inclusión diseñado para este estudio. Fueron distribuidos en dos grupos de 200 cada uno. Sólo en uno de los grupos se utilizó una lima de pasaje. Todos los tratamientos fueron realizados en una sesión operatoria. Previamente al tratamiento endodóntico, se evaluó la vitalidad pulpar. Posteriormente, se entregó a los 400 pacientes un cuestionario para evaluar la presencia o la ausencia de dolor posoperatorio, 326 de los cuales lo devolvieron correctamente respondido. Resultados: No hubo diferencias estadísticamente significativas entre los dos grupos en cuanto a la presencia de dolor posoperatorio y la vitalidad pulpar (p>0,05). Conclusión: El empleo de la lima de pasaje no incidiría en la presencia de dolor posoperatorio. Palabras clave: Lima de pasaje, endodoncia, foramen, dolor posoperatorio, ápice, vitalidad pulpar. Abstract Aim: To evaluate postoperative pain in patients associated with the use of apical patency in teeth with and without pulp vitality. Materials and methods: Four hundred teeth (n=400) with endodontic treatment indication were analyzed according to the inclusion criteria designed for this study and divided into two groups of 200 each. Apical patency was used only in one of them. All the treatments were performed in one session and pulp vitality was assessed before endodontic treatment. Subsequently, patients were given a questionnaire to assess the presence or absence of postoperative pain. A total of 326 correctly answered questionnaires were returned. Results: There were no statistically significant differences between groups with an without use of patency when postoperative pain and pulp vitality is considered (p>0.05). Conclusions: The use of apical patency does not seem to have a significant impact in postoperative pain. Key words: Apical patency, endodontics, foramen, postoperative pain, apex, pulp vitality.

Se presentan resultados preliminares de un estudio exploratorio acerca de los efectos de la práctica investigativa sobre la práctica clínica; ambas actividades son realizadas por integrantes de una cátedra universitaria cuyo objetivo docente es la enseñanza de una teoría psicoanalítica. Los profesionales psicólogos se desempeñan como docentes de grado y de postgrado, como psicoterapeutas de niños en una unidad asistencial y participan asimismo de una investigación empírica sobre cambio psíquico en niños y cambios en la contención emocional de sus adultos responsables, sobre la base de material clínico recogido en la unidad asistencial. Es un equipo heterogéneo respecto de la experiencia docente, asistencial e investigativa, que incluye estudiantes avanzados y graduados recientes de la carrera de Psicología y profesionales de larga y reconocida trayectoria. Se analizan las respuestas a una pregunta abierta formulada a cada docente-psicoterapeuta-investigador a fin de recabar su percepción respecto de los efectos de su actividad investigativa en su práctica asistencial. En la práctica clínica los docentes-psicoterapeutas-investigadores registran cambios en la percepción y en la organización del material clínico y mayor precisión en sus intervenciones.In this paper we present preliminary results obtained in an exploratory study about research practice effects on clinical practice; both activities are carried out by members of an university chair whose educational objective is tutoring of a psychoanalytic theory. The professional psychologists perform their activities as degree or posdegree teachers, as children psychotherapists in an welfare unit and also participate in an empirical investigation about psychic change in children and changes in the emotional support of their adults in charge, based on the clinical material gathered in the welfare unit. This is an heterogeneous working team regarding the teaching, assisting and research experience that includes both advanced students and recently graduated members of psychology and also professionals of long and recognized trajectory. We analyze the answers given to an open question asked to each teacher- psychotherapist-researcher with the aim of understanding their perception in respect to the effects of their research activity in their assisting practice. In the clinical practice, the teachers-psychotherapistsresearchers observe changes in the perception and in the organization of the clinical material and greater accuracy on their interventions.

We determined the bioavailability of vitamin E from self-assembly structures in patients with diagnosed chronic pancreas insufficiency. Vitamin E solubilized in dispersed inverted bicontinuous cubic phase and in micellar formulation was delivered directly to the small intestine by tube-feeding. A cross-over study with randomization of 6 subjects and 2 treatments including a combined dose of 18 mg (27 IU) of vitamin E (RRR-[5,7-methyl-(2H6)]-?-tocopherol) and 27 mg (27 IU) vitamin E acetate (RRR-[5-methyl-2H3]-?-tocopheryl acetate) was applied over a time period of 1 h. Plasma samples were collected for 56 h and analyzed by liquid chromatography–mass spectrometry. Appearance of labeled tocopherols originating from the treatment started at 25 h and reached Cmax (0.6–4.6 ?M depending on subject) in the 7–9 h window. From the Tmax onwards, both forms of tocopherols diminished slowly to 30–50% of their maxima within 56 h. Strong inter-individual variation was observed in the plasma appearance curves (relative standard deviation varied between 38–45%). No significant discrimination was found between the absorption of free or acetylated forms of deuterated ?-tocopherol confirming that application of acetylated ?-tocopherol provides the same bioavailability as free ?-tocopherol. This observation is valid in both dispersed inverted bicontinuous cubic phase and micellar formulations. Furthermore, since the area-under-the-curve values from cubic phase and from micellar formulations are similar, the cubic phase formulation could represent an alternative delivery system for lipophilic micronutrients in conditions or studies where polysorbate-based micelles cannot be generated.

Imperialismo cultural (Bourdieu), Ojos imperiales (Pratt), Cultura del imperio (Said). Hace unos años que en el campo de las Ciencias Sociales y en particular en ciertas aproximaciones a la antropología y sociología de los denominados "estudios culturales" y "poscoloniales" ha reaparecido una palabra, un concepto olvidado e incluso anatemizado durante las últimas dos décadas: imperialismo. No vamos a detenernos aquí en las implicancias de esta reaparición de una noción tan cara al pensamiento crítico. Nos interesa iniciar este trabajo colectivo partiendo del señalamiento que realiza la cita de Bourdieu, la cual intenta proponer respecto del campo académico que dicho imperialismo cultural opera mediante cierta fetichización prevaleciente en los usos instrumentales de conceptos y categorías de análisis en las Ciencias Sociales. Desde dicho campo, nos concentraremos específicamente en las producciones de la Antropología Social y nos detendremos a modo de ejemplo en sus prácticas domésticas nacionales.

Resumen El objetivo de este trabajo fue analizar la morfología apical de las raíces mesiales de los primeros molares inferiores de una población del norte de la República Argentina. Se utilizaron para este estudio 500 primeros molares inferiores, cuyos ápices fueron observados al M.E.B. Se analizaron la cantidad de forámenes, presencia o ausencia de foraminas accesorias, diámetros principales mayor y menor de cada foramen y la forma y desviación del foramen apical respecto al ápice anatómico. Los resultados demostraron que existe un alto porcentaje de ápices radiculares que terminaron en un solo foramen y el menor porcentaje que terminaron en cinco forámenes. Se halló una gran cantidad de foraminas que comunican el conducto radicular con periodonto. El diámetro promedio de los forámenes fue de 0,31 mm, y un setenta por ciento (70%) de forámenes no terminaban en el ápice. La anatomía apical de las raíces mesiales de los primeros molares inferiores de esta población presenta grandes variaciones complejas. Palabras clave: foramen apical, ápice anatómico, morfología, molar inferior. Abstract The aim of this study was to analyze the apical morphology of the mesial roots of lower first molars of a population from Northern Argentina. Five hundred mandibular first molars were observed using scanning electron microscopy (SEM) and the number of foramina, the presence or absence of accessory foramina, major foramen diameters and shape and apical foramen deviation from the anatomic apex were registered. Results showed a high percentage of root tips ending in a single apical foramen and some ending on five apical foramens. A large number of accessory foramina connecting the root canal with the periodontal ligament were observed. The apical foramen average diameter was 0.31 mm, and 70% of apical foramen did not end in the anatomic apex. Apical anatomy of the mesial roots of mandibular first molars of this population varies greatly. Key words: apical foramen, anatomic apex morphology, lower molar.

Se describen las actividades de un Servicio de Psicología Clínica de Niños, las características demográficas y psicopatológicas de la población asistida y se informan resultados del trabajo de investigación realizado en colaboración entre dos cátedras de la Facultad de Psicología de la U. B.A. Se analizaron los protocolos de diagnóstico de 75 niños entre 6 y 12 años de edad que reciben asistencia psicoterapéutica en el Servicio, derivados por escuelas y juzgados en razón de problemas de conducta. Se seleccionaron indicadores que permitan diferenciar las manifestaciones de violencia según respondan a trastornos del carácter, a expresiones de rasgos psicóticos y a síntomas neuróticos como respuestas a situaciones traumáticas del ambiente (situaciones de pérdida). Se buscó, asimismo, detectar indicadores de riesgo suicida en esa población. Los resultados preliminares indican que en la población asistida, proveniente de hogares carenciales de sectores populares del Gran Buenos Aires, predominan conductas violentas como expresión de trastornos del carácter (trastorno disocial de inicio infantil, DSMIV); en menor proporción se registran las manifestaciones de desestructuraciones psicóticas y de síntomas neuróticos. Se observó riesgo potencial de acting out y de conductas autodestructivas inquietantes en los dos primeros casos.

Abstract Objective: To assess postoperative clinical data considering the association of preoperative fasting with carbohydrate (CHO) loading and intraoperative infusion of omega-3 polyunsaturated fatty acids (ω-3 PUFA). Methods: 57 patients undergoing coronary artery bypass grafting (CABG) were randomly assigned to receive 12.5% maltodextrin (200 mL, 2 h before anesthesia), (CHO, n=14); water (200 mL, 2 h before anesthesia), (control, n=14); 12.5% maltodextrin (200 mL, 2 h before anesthesia) plus intraoperative infusion of ω-3 PUFA (0.2 g/kg), (CHO+W3, n=15); or water (200 mL, 2 h before anesthesia) plus intraoperative infusion of ω-3 PUFA (0.2 g/kg), (W3, n=14). The need for vasoactive drugs was analyzed, in addition to postoperative inflammation and metabolic control. Results: There were two deaths (3.5%). Patients in CHO groups presented a lower incidence of hospital infection (RR=0.29, 95% CI 0.09-0.94; P=0.023), needed fewer vasoactive drugs during surgery and ICU stay (P