Documenting adaptations to an evidence-based intervention in 58 resource-variable pediatric oncology hospitals across implementation phases.

Background: Adaptation of evidence-based interventions (EBIs) often occurs when implemented in new local contexts and settings. It is unclear, however, during which phase of implementation adaptations are most frequently made and how these changes may impact the fidelity, effectiveness, and sustainability of the EBI. Pediatric Early Warning Systems (PEWS) are EBIs for early identification of deterioration in hospitalized children with cancer.

The p.(Cys150Tyr) variant in CSRP3 is associated with late-onset hypertrophic cardiomyopathy in heterozygous individuals.

Introduction And Objectives: Up to 50% of patients with hypertrophic cardiomyopathy (HCM) show no disease-causing variants in genetic studies. Mutations in CSRP3 have been associated with HCM, but evidence supporting pathogenicity is inconclusive. In this study, we describe an HCM cohort with a missense variant in CSRP3 (p.

[Drinking water quality and safety].

The purpose of drinking water legislation is to guarantee the quality and safety of water intended for human consumption. In the European Union, Directive 98/83/EC updated the essential and binding quality criteria and standards, incorporated into Spanish national legislation by Royal Decree 140/2003. This article reviews the main characteristics of the aforementioned drinking water legislation and its impact on the improvement of water quality against empirical data from Catalonia.

Binding studies and anion-selective electrodes with neutral isophthalamide-based receptors.

Two acyclic isophthalamide-based hosts have been synthesised and their anion binding properties have been evaluated by (1)H-NMR titrations. Different binding modes have been detected for the series of tested anions. The attachment of aminomethylpyrrole groups resulted in an improved binding selectivity.

New carbazolo[1,2-a]carbazole derivative as ionophore for anion-selective electrodes: remarkable recognition towards dicarboxylate anions.

A new carbazolo[1,2-a]carbazole derivative was synthesized by expanding the binding cavity to explore the possibility of hosting larger anions such as dicarboxylate anions. The compound was incorporated as an ionophore into a membrane for an anion-selective electrode. The response of the electrode was evaluated for oxalate, malonate, succinate, glutarate and adipate in terms of calibration characteristics (slope, limit of detection and linear range of the response), response time, repeatability, reproducibility and selectivity.

Use of a new ziprasidone-selective electrode in mixed solvents and its application in the analysis of pharmaceuticals and biological fluids.

The construction and characterization of a new ion-selective electrode for the determination of the antipsychotic ziprasidone in mixed solvents is presented. The electrode contains a plasticized polymeric membrane based on a ziprasidone-tetraphenylborate ion-exchanger. The influence of membrane composition on the electrode response towards ziprasidone in hydroalcoholic solutions was studied.

Host and viral genetic correlates of clinical definitions of HIV-1 disease progression.

Background: Various patterns of HIV-1 disease progression are described in clinical practice and in research. There is a need to assess the specificity of commonly used definitions of long term non-progressor (LTNP) elite controllers (LTNP-EC), viremic controllers (LTNP-VC), and viremic non controllers (LTNP-NC), as well as of chronic progressors (P) and rapid progressors (RP).

Methodology And Principal Findings: We re-evaluated the HIV-1 clinical definitions, summarized in Table 1, using the information provided by a selected number of host genetic markers and viral factors.

Combined antiretroviral treatment and heterosexual transmission of HIV-1: cross sectional and prospective cohort study.

Objective: To estimate the risk and probability of heterosexual transmission of HIV-1 from infected people taking combined antiretroviral treatment.

Design: Cross sectional and prospective cohort studies.

Setting: HIV clinic in Madrid, Spain.

Reducing sexual risk behavior among steady heterosexual serodiscordant couples in a testing and counseling program.

Objective: To assess the effect of an HIV counseling and testing program targeting steady heterosexual serodiscordant couples.

Methods: We studied 564 couples who attended a sexually transmitted infections/HIV clinic in Madrid in the period 1989 to 2007 and participated in couples counseling and testing. Sociodemographic, epidemiologic, clinical, and behavioral information of both partners was obtained before testing the nonindex partner.

A combination of defective DNA and protective host factors are found in a set of HIV-1 ancestral LTNPs.

We studied viral evolution in three HIV-1 ancestral patients from a group of LTNPs; although some minor sequences showing viral evolution were detected in all patients, the extremely low viral evolution of their viruses was shown by the phylogenetic analysis of the env sequences. Complete nucleotide sequencing of viral DNA showed the major presence of deletions. In two patients, deletions of 1088 and 228 nucleotides mapped to 5' LTR-gag region; in the other, a 247 nucleotide deletion was positioned in pol gene up to the vif ORF.

Application of a trazodone-selective electrode to pharmaceutical quality control and urine analyses.

A trazodone-selective electrode for application in pharmaceutical quality control and urine analysis was developed. The electrode is based on incorporation of a trazodone-tetraphenylborate ion exchanger in a poly(vinyl chloride) membrane. The electrode showed a fast, stable and Nernstian response over a wide trazodone concentration range (5 x 10(-5)-1 x 10(-2) M) with a mean slope of 59.

Plasma viral load threshold for sustaining intrahost HIV type 1 evolution.

The objective of the present study was to determine if natural suppression of plasma viremia below the detection limit of commercial assays (50-80 copies HIV-1 RNA/ml) can contain the HIV-1 evolution. HIV-1 quasispecies complexity in PBMC DNA was assessed in the env gene at two time points in 14 long-term nonprogressors (LTNPs). Sequence changes consistent with viral evolution was found in all patients with a median plasma RNA viral load >100 copies/ml.

Coinfection and superinfection in patients with long-term, nonprogressive HIV-1 disease.

Human immunodeficiency virus 1 (HIV-1) dual infections are considered important because they have been related to AIDS progression. We identified dual infections in 2 patients with long-term, nonprogressive HIV-1 disease; the first patient was diagnosed as being already coinfected, on the basis of the first sample analyzed, but a previous superinfection could not be excluded; the second patient was diagnosed as having a superinfection, on the basis of the 9-year difference between the viral dating of the 2 strains. Dual infections occur in patients with long-term, nonprogressive disease, with no immediate clinical manifestations.

Intranasal immunization with a dominant T-cell epitope peptide of a major allergen of olive pollen prevents mice from sensitization to the whole allergen.

Mucosal tolerance induction with vaccines based on peptides representing T-cell epitopes of allergens is a promising way for treating allergic diseases. Ole e 1 is the main allergen of olive pollen, which is an important cause of allergy in Mediterranean countries. The aim of this study was to evaluate the ability of the peptide T109-K130 containing a dominant T-cell epitope of Ole e 1, to modulate the allergen-specific immune response in a prophylactic mouse model.

Lack of temporal structure in the short term HIV-1 evolution within asymptomatic naïve patients.

HIV-1 evolution in the envelope gene (env) was analyzed in four asymptomatic antiretroviral therapy naïve patients with typical and slow disease progression rates. In typical progressors, viral populations were monophyletic and two distinct evolutionary patterns were observed. In one patient, HIV-1 evolution displayed a strong temporal structure similar to the consistent pattern previously described.

Effectiveness of highly active antiretroviral therapy in reducing heterosexual transmission of HIV.

Highly active antiretroviral therapy (HAART) has been shown to be highly effective in reducing plasma levels of HIV RNA; therefore, these treatments could diminish the risk of transmission. We analyzed 393 steady heterosexual couples, of which one partner had been previously diagnosed with HIV infection (index case) and where the nonindex partner reported his or her sexual relationship with the index case as the unique risk exposure. These couples were consecutively enrolled in the period 1991 through 2003 when the nonindex partners took their first HIV test.

Flow injection spectrophotometric determination of ofloxacin in pharmaceuticals and urine.

A sensitive and fast flow-injection spectrophotometric method for the determination of ofloxacin is proposed. The method is based on the formation of a yellow complex between ofloxacin and Fe (III), in sulphuric medium. The influence of FI and chemical variables were studied.

A subset of human immunodeficiency virus type 1 long-term non-progressors is characterized by the unique presence of ancestral sequences in the viral population.

Within human immunodeficiency virus type 1 (HIV-1)-infected patients, there are those who have been infected for more than 10 years with a CD4+ cell count of >500 cells microl(-1) and who remain asymptomatic without antiretroviral therapy; these patients are designated long-term non-progressors (LTNPs). In a set of 16 LTNPs, viral dating, DNA viral load, quasispecies heterogeneity and antibody (Ab) titres against gp160 and beta2 microglobulin (beta2m) were determined. Plasma viral RNA and CD4+ and CD8+ T-cell numbers were estimated in more than three samples per patient.

Co-existence of recent and ancestral nucleotide sequences in viral quasispecies of human immunodeficiency virus type 1 patients.

In human immunodeficiency virus type 1 (HIV-1) infection, the presence of divergent nucleotide sequences within a quasispecies has been associated with double infections or samples from different times or from different tissue compartments. The authors analysed HIV-1 proviral quasispecies from PBMC of three untreated Spanish patients displaying highly divergent nucleotide sequences without evidence of double infection. The origin of these nucleotide sequences was determined by phylogenetic analysis and by dating of the different groups using a genetic divergence versus sampling year plot from a set of Spanish samples.

[Prevalence of hepatitis B virus infection and needs of vaccination in high risk populations].

Background And Objective: We aimed to evaluate the serological status of hepatitis B virus (HBV) and the vaccination's needs among high risk populations.

Patients And Method: Cross sectional study of subjects first attending a HIV diagnosis clinic in Madrid during 2000-2002. Patients who had not been vaccinated for HBV were classified according to the serological markers as active infection (HBsAg+), past infection (anti-HBc+ and HBsAg) or susceptible (anti-HBc).

Experience of rofecoxib in patients with osteoarthritis previously treated with traditional non-steroidal anti-inflammatory drugs in Spain: results of phase 2 of the VICOXX study.

Objectives: To compare patient and physician attitudes to osteoarthritis (OA) treatment with rofecoxib or traditional non-steroidal anti-inflammatory drugs (tNSAIDs).

Methods: A 6-month prospective study involving 562 OA patients enrolled at 29 Spanish primary-care centres. Patients were continued on established tNSAID therapy for the first 3 months then switched to rofecoxib 12.

Management pattern for patients with osteoarthritis treated with traditional non-steroidal anti-inflammatory drugs in Spain prior to introduction of Coxibs.

Objective: To investigate the use of traditional non-steroidal anti-inflammatory drugs (tNSAIDs) in the management of osteoarthritis (OA) in primary care in Spain and to quantify patient and physician satisfaction with tNSAID therapy.

Methods: A 6-month retrospective, observational study conducted in 29 Spanish primary-care centres shortly before the first introduction of selective COX-2 inhibitors (Coxibs).

Results: A total of 897 patients with a mean age 66 +/- 9 years and radiologically documented OA were included: most (76%) were women.

Determination of irbesartan in the presence of hydrochlorothiazide by derivative spectrophotometry.

A first-derivative spectrophotometric method for the determination of irbesartan (IRB) alone and in the presence of hydrochlorothiazide (HCT) is described. Measurements are made at the zero-crossing wavelength at 263.0 nm for IRB.

Evaluating the risk of HIV transmission through unprotected orogenital sex.

We analysed a cohort of heterosexual HIV- serodiscordant couples with the aim of evaluating the risk of transmission ascribed to unprotected orogenital intercourse. A total of 135 seronegative individuals (110 women and 25 men), whose only risk exposure to HIV was unprotected orogenital sex with their infected partner, registered 210 person-years of follow-up. After an estimated total of over 19,000 unprotected orogenital exposures with the infected partner not a single HIV seroconversion occurred.

Different evolutionary patterns are found within human immunodeficiency virus type 1-infected patients.

In order to study the evolution in vivo of human immunodeficiency virus type 1 (HIV-1) in patients with normal clinical evolution, six individuals were selected from a group of 46 patients followed for 1 to 4 years. Patients were selected not by clinical progression characteristics but on the basis of virus genetic variability, as analysed by heteroduplex mobility assay and RNase A mismatch cleavage method. Two patients displayed a homogeneous virus population, two showed very heterogeneous quasispecies and two presented two distinct variants within the virus population.