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Objectives: Compliance in outpatients with gastrointestinal (GI) malabsorption is key in nutritional treatment. The objective of this study was to assess compliance in patients with GI impairment and malnutrition taking a high-calorie, high-protein, peptide-based oral nutritional supplement (ONS-PBD)., Methods: A prospective, multicenter, observational study was conducted in 19 medical sites in Spain where ONS-PBD were prescribed as standard of care. Patients consumed ONS-PBD daily for 12 wk. Compliance was calculated as the percentage consumed of the prescribed amount of ONS per day., Results: A total of 90 adult patients were included in the study, of whom 64 completed the 12-wk regimine. Mean compliance was 78.8% ± 24.5%. Risk of malnutrition decreased in 56.3% of patients at 12 wk, as measured with the malnutrition universal screening tool. A reduction in abdominal pain was observed and stool consistency improved, with a mean of 54.7% and 27.5%, respectively. Improvements in quality of life and a decrease in percentage of patients with severe functional impairment were observed., Conclusions: These data show that ONS-PBD compliance in malnourished patients with GI symptoms is high, reducing GI symptoms and improving patients' nutritional status., (Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)

Introduction: Introduction: malnutrition in cancer patients can lead to a reduction in patient quality of life, increased morbidity and mortality, and associated healthcare costs. Objective: to analyze nutritional interventions in the different phases of the oncological process, integrating the needs of patients and those of healthcare professionals. Material and methods: "Design Thinking" techniques were used to address the analysis of the current situation and identify key aspects. Thirteen professionals from 8 public health centers (endocrinology and nutrition, medical and radiotherapy oncology, primary care (PC), nursing and dietetics) participated in the study. Results: nutritional screening is not carried out in a systematic way in the different phases of the oncological process, and there is no universal consensus on the protocols for action and nutritional intervention. A wide compliance with the pathways and referral times of the selected processes has been observed. In the therapeutic phase, there is the possibility of consulting the Clinical Nutrition and Dietetics Unit (UNCYD) and 75 % have specific referral protocols. The nurse case manager is present in all hospitals and in PC. Patient access to the center psychologist was possible in 87 % of the hospitals. Participation of the UNCYD in Tumor Committees was low (only in 25 % of the centers). In all centers there is some kind of collaboration and support by patient associations and the School of Patients, especially in the therapeutic and the control and follow-up phases. Conclusions: variations are observed between the different hospitals and areas in Andalusia, both in terms of means and structures and in activities and procedures. Key points have been selected and prioritized to improve nutritional care in oncology.

Catheter-associated infections still represent a challenging thread because of the likelihood of biofilm formation. The aim of this work was the surface modification of catheters to immobilize lysozyme and acylase under mild conditions while preserving antimicrobial and anti-quorum sensing performances. Glycidyl methacrylate (GMA) was grafted onto poly(vinyl chloride) (PVC) catheters by a pre-irradiation method. The effects of monomer concentration, pre-irradiation dose, reaction time, monomer concentration and reaction temperature were investigated. The grafting process was monitored using FTIR-ATR spectroscopy, differential scanning calorimetry, thermogravimetric analysis, and swelling data. Lysozyme was directly immobilized onto PVC-g-GMA maintaining the hydrolytic activity, which hindered Staphylococcus aureus adhesion. For acylase immobilization, the PVC-g-GMA catheters were reacted with ethylenediamine and glutaraldehyde in order to facilitate acylase covalent binding. Free acylase in solution demonstrated notably capability to act as quorum sensing inhibitor, as observed using Chromobacterium violaceum as biosensor, by degrading a wide variety of acylated homoserine lactones (AHLs), including those produced by Pseudomonas aeruginosa and Acinetobacter baumannii. Acylase-immobilized PVC-g-GMA catheters were challenged against degradation of AHLs and the activity monitored using both the biosensor and HPLC-MS. Relevantly, the functionalized catheters completely degraded all tested AHL signals, opening new ways of preventing biofilm formation on medical devices., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Medical devices decorated with salicylic acid-based polymer chains (polymeric prodrug) that slowly release this anti-inflammatory and anti-biofilm drug at the implantation site were designed. A "grafting from" method was implemented to directly grow chains of a polymerizable derivative of salicylic acid (2-methacryloyloxy-benzoic acid, 2MBA) onto polypropylene (PP). PP was modified both at bulk and on the surface with poly(2MBA) by means of an oxidative pre-irradiation method ((60)Co source), in order to obtain a grafted polymer in which salicylic acid units were linked by means of labile ester bonds. The grafting percent depended on absorbed dose, reaction time, temperature and monomer concentration. The functionalized films were analyzed regarding structure (FTIR-ATR, SEM-EDX, fluorescence microscopy), temperature stability (TGA), interaction with aqueous medium (water contact angle and swelling), pH-responsive release and cytocompatibility (fibroblasts). In the obtained poly(2MBA)-grafted biomaterial, poly(2MBA) behaved as a polymeric prodrug that regulates salicylic acid release once in contact with aqueous medium, showing pH-dependent release rate., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Objectives: Description of the retroperitoneoscopic approach in the conventional pyeloplasty for ureteropelvic junction obstruction in children., Material and Methods: From 1998 pyeloplasty assisted by retroperitoneoscopic approach (PARA) was performed in 30 patients., Technique: Position in latero-dorsal decubitus and incision of 1 cm in angle costolumbar. We made retroperitoneoscopic space by ball dissection technique and 11 mm Hg pressure. The ureteropelvic junction was extracted through the incision of the port. The UPJ was resected in all patients and Anderson-Hynes pyeloplasty with double PDS 6/0 continuous sutures was performed. In all patients a drainage type Penrose in perirenal space was used. In the last 18 patients a 4F double-J stent was placed. The mean follow-up time was 42 months (range between 6 and 84 months). Operative time, hospital stay, handling of postoperative pain and the postoperative studies have been revised., Results: In all the cases the retroperitoneoscopic approach was good for the identification and dissection of the ureteropelvic junction facilitating the extraction and reconstruction (pyeloplasty) through the mini-incision of the entrance port. The mean operative time was 90 min. (range between 65 and 128 min). We highlight the absence of intraoperative complications. The only postoperative complication has been a pyohydronephrosis in a patient not having internal drainage that was solved by percutaneous pyelostomy and didn't need reintervention. The postoperative handling of the pain was good by means of caudal locorregional anesthesia or by infiltration of the wound with local anesthesic and a dose of Ibuprofeno previous to leave the hospital. The mean hospital stay was 2 days (1-3 days) excluding the complicated case. Postoperative diuretic renograms at the 6 and 18 have shown absence of obstruction in all cases. In the long term follow-up, in 1 case nephrectomy was performed., Conclusions: The PARA for UPJ obstruction is a safe and effective procedure with the advantage of a minimal invasive approach that facilitates the reconstruction of the ureteropielic junction. Reduces operative time and hospital stay, with appropriate postoperative results. In our experience PARA constitutes an alternative to the conventional pyeloplasty and laparoscopic pyeloplasty in the pediatric age.

Nine boys, aged 11-13 years with left varicocele grade II or III, were treated by percutaneous embolization of internal spermatic vein at the General Yagüe hospital in the last four years. The procedure was performed under local anesthesia. Percutaneous selective retrograde left spermatic venography was done via the right transfemoral vein. For embolization, sclerosing agents were used in eight cases and coil in one. Follow-up ranged from six months to four years. The control clinical examination and ultrasonographic evaluation showed treatment was successful in eight cases (89%) and persistence of a left varicocele in one case (11%). No serious complications were observed and the mean duration of hospital stay was 1.6 days. The safety, efficacy and feasibility of percutaneous embolization are discussed.

Presentation of 6 cases of congenitally short urethra seen in our Unit. The rarity of such malformation, as well as the difficulties to arrive to a presurgical diagnosis are emphasized. Also, review of surgical techniques described in the literature. Contribution of our experience in the use of the urethra's dissecting and elevating technique. We considered this the choice procedure except in extreme cases due to the good results obtained, fewer technical difficulties and lower risk of complications.

Hypoplasia of penis which is frequently associated with hipospadias is important when a surgical treatment of this malformation is to undertaken. The decision to increase the dimensions of the penis before surgery by means of hormone treatments is based on good surgical results obtained in very young patients with hypoplasia. The authors have conducted a study involving 76 boys with hipospadias over a period of four years. One group of 37 boys was treated with corionic gonadotrophines by injection during a period of eight weeks. The second group of 39 boys was treated with testosterone cream (2%) topically during one month. Measurements were taken before and after the treatments using four parameters, and the boys were separated according to age. The results showed a more favorable response to testosterone cream in comparison to the injections of corionic gonadotrophines.