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Objectives: Clinical high-risk of psychosis (CHRp) samples can be heterogeneous, consisting essentially of people with not only psychotic-like experiences but also nonspecific symptoms that may reflect common mental disorders such as depression, anxiety, or substance abuse pathologies. Few studies have attempted to analyze and understand psychosis risk in relation to both environmental (ER) and psychopathological risk (PsR) factors. This study aimed to determine the clinical risk of psychosis in adolescents., Methods: A representative sample of 1824 Spanish adolescents from the general population was evaluated using different scales to thoroughly examine the possible interaction of CHRp with various ER and PsR factors. Partial correlations were calculated to assess the relationships between the variables. A series of hierarchical linear regression models were then used to obtain a CHRp predictor model., Results: The CHRp predictor model indicated that PsR was the most significant determining factor, explaining 22% of the total associated variance of CHRp. However, the ER factor also emerged as a significant predictor of high-risk psychosis (accounting for 9% of the variance)., Conclusions: A predictive model for CHRp in adolescents was found, in which common psychological problems were presented as more determinant risk factors than ER disruptors. Furthermore, certain transdiagnostic processes, such as psychological inflexibility, may play a central role in the development of mental health problems, including psychosis. Specifying the mechanisms underlying the emergence of CHRp in adolescence is the key to optimizing the focus of preventive therapeutic interventions in these early stages., (© 2024 The Author(s). Journal of Clinical Psychology published by Wiley Periodicals LLC.)

Activation of the ATP-gated P2X7 receptor (P2X7R), implicated in numerous diseases of the brain, can trigger diverse responses such as the release of pro-inflammatory cytokines, modulation of neurotransmission, cell proliferation or cell death. However, despite the known species-specific differences in its pharmacological properties, to date, most functional studies on P2X7R responses have been analyzed in cells from rodents or immortalised cell lines. To assess the endogenous and functional expression of P2X7Rs in human astrocytes, we differentiated human-induced pluripotent stem cells (hiPSCs) into GFAP and S100 β-expressing astrocytes. Immunostaining revealed prominent punctate P2X7R staining. P2X7R protein expression was also confirmed by Western blot. Importantly, stimulation with the potent non-selective P2X7R agonist 2',3'-O-(benzoyl-4-benzoyl)-adenosine 5'- triphosphate (BzATP) or endogenous agonist ATP induced robust calcium rises in hiPSC-derived astrocytes which were blocked by the selective P2X7R antagonists AFC-5128 or JNJ-47965567. Our findings provide evidence for the functional expression of P2X7Rs in hiPSC-derived astrocytes and support their in vitro utility in investigating the role of the P2X7R and drug screening in disorders of the central nervous system (CNS)., (© 2023. The Author(s).)

Purpose: To evaluate and compare the efficacy of the hands-eyes-mouth distraction technique (HEM-DT) in reducing anxiety and pain levels and improving the behaviour of pre-school children during inferior alveolar nerve block (IANB) administration to that of the covering patient's vision technique (CPV-T)., Methods: This study included 52 children aged 3-5 years old with primary dentition, no history of receiving local anaesthesia, and whose treatments required an IANB. These children were randomly assigned into two groups: HEM-DT (G1; n = 26) and CPV-T (G2; n = 26). Anxiety and pain levels were assessed using the Facial Image Scale and the Wong-Baker Scale, respectively, while the patient's behaviour was evaluated using the Frankl Behaviour Scale. This study was divided into two sessions including the treatment session (administration of IANB) and the control session (7 days after anaesthesia). Chi-square test, the Mann-Whitney U test and Wilcoxon test were used for statistical analyses., Results: The patients' anxiety levels did not increase 7 days after IANB in G1 (p value = 0.798); however, higher anxiety levels were observed in the G2 group (p value = 0.039). No significant differences in pain levels and behaviour were observed between the groups during administration of anaesthesia (p value > 0.005)., Conclusion: HEM-DT and CPV-T showed efficacy in terms of pain and behaviour during IANB administration. Pre-school children in the HEM-DT group exhibited lower anxiety levels in the control session., Trial Registration Number and Date of Registration: ClinicalTrials.gov (NCT02591797). October 28, 2015., (© 2022. The Author(s), under exclusive licence to European Academy of Paediatric Dentistry.)

Competing Interests: There are no conflicts of interest.

Background: The delimitation of the clinical high risk of psychosis (CHRp) is characterized by the wide variety of symptoms assessed from different approaches from the onset of psychosis. This study aimed to create a systematic procedure for an effective and accurate earlydetection of CHRp in educational settings., Method: A representative sample of 1,824 adolescents (average age, 15.79; 53.8%, women) was used to develop an online assessment system and a new 3-track, 3-level algorithm that combines symptoms of the main risk approaches: ultra-high risk (UHR), basic symptoms (BS), and anomalies in the subjective self-experience (ASE) with functional deficit., Results: The acceptability and feasibility of the online screening system were confirmed by the data. Of the total participants, 68 (3.7%) were identified as high-risk and 417 (22.9%) were identified as moderate, which also supports the functionality of the proposed algorithm., Conclusions: The system indicates a dynamic model of progression of the different symptoms in the early stages of psychosis, and it may constitute a first line of identification for severe mental disorders in young people in the earliest stages, allowing application of initial preventive measures.

Background: Over the last 20-30 years social trends, educational and parenting patterns, and the ethical and legal factors guiding them have led to the revaluation and even abandonment of some traditionally used behavior guidance techniques (BGTs)., Aims: To profile the professionals providing specialized pediatric treatments in Spain and understand changes in their preferences and use of basic BGTs, and the evolution of these preferences., Settings and Design: A cross-sectional, descriptive, and correlational study was designed., Methods: One hundred and twenty-six dentists completed a previously validated survey., Statistical Analysis: Descriptive statistics and Chi-square tests were performed to analyze the questionnaire data., Results: The most common BGTs were "Tell/Show/Do" (98%) and positive reinforcement (92.1%), and the most abandoned BGT was: "hand-over-mouth" (15%), because it was rejected by parents and because of potential legal problems and psychological consequences for the patients. Of note, 37% of the professionals allowed the patient's parents to be present during the treatment., Conclusions: There has been a notable decrease in the use of certain BGTs in Spain, especially hand-over-mouth and voice control, because they are becoming less socially acceptable as the way society relates to and educates children changes., Competing Interests: None

Aim: To establish the relationship between dental erosion prevalence in children aged 6-14 and all the aetiological factors that lead to the development of the lesions., Materials and Methods: Study design: A correlational cross-sectional study of a sample of 400 Valencian children was conducted. First, a questionnaire was completed to analyse the patients' health status, their dietary and oral hygiene habits, the kind of school they attended and their parents' academic level. Then, a clinical exploration of the permanent dentition was done, calculating the BEWE index and the risk of erosion for each patient., Results: The prevalence of dental erosion of the studied sample was 22.3%. A positive correlation was observed between the presence of dental erosion and the frequent intake of fruit juices, carbonated and isotonic drinks (p<0.05), presenting a higher correlation if the liquid was kept in the mouth before swallowing. Aetiological factors such as the use of inhalers in patients with asthma (p=0.006), frequency of vomiting and regurgitation (p<0.001), frequent swimmers (p<0.001) or a low socioeconomic status (p<0.05) were also positively associated to the development of erosive lesions., Statistics: A descriptive and inferential statistical analysis was performed, using the Mann-Whitney U and the Kruskal-Wallis tests in the latter., Conclusion: The results of this study suggest that the frequent intake of fruit juices, carbonated and isotonic drinks, the use of inhalers and belonging to a low socioeconomic level family are factors positively associated to the development of erosive lesions.

Background: Micronutrients, an umbrella term used to collectively describe vitamins and trace elements, are essential components of nutrition. Those requiring alternative forms of nutrition support are dependent on the prescribed nutrition regimen for their micronutrient provision. The purpose of this paper is to assist clinicians to bridge the gap between the available guidelines' recommendations and their practical application in the provision of micronutrients via the parenteral route to adult patients., Methods: Based on the available evidenced-based literature and existing guidelines, a panel of multidisciplinary healthcare professionals with significant experience in the provision of parenteral nutrition (PN) and intravenous micronutrients developed this international consensus paper., Results: The paper addresses 14 clinically relevant questions regarding the importance and use of micronutrients in various clinical conditions. Practical orientation on how micronutrients should be prescribed, administered, and monitored is provided., Conclusion: Micronutrients are a critical component to nutrition provision and PN provided without them pose a considerable risk to nutrition status. Obstacles to their daily provision-including voluntary omission, partial provision, and supply issues-must be overcome to allow safe and responsible nutrition practice., (© 2019 American Society for Parenteral and Enteral Nutrition.)

In the mature central nervous system (CNS), oligodendrocytes provide support and insulation to axons thanks to the production of a myelin sheath. During their maturation to myelinating cells, oligodendroglial precursors (OPCs) follow a very precise differentiation program, which is finely orchestrated by transcription factors, epigenetic factors and microRNAs (miRNAs), a class of small non-coding RNAs involved in post-transcriptional regulation. Any alterations in this program can potentially contribute to dysregulated myelination, impaired remyelination and neurodegenerative conditions, as it happens in multiple sclerosis (MS). Here, we identify miR-125a-3p, a developmentally regulated miRNA, as a new actor of oligodendroglial maturation, that, in the mammalian CNS regulates the expression of myelin genes by simultaneously acting on several of its already validated targets. In cultured OPCs, over-expression of miR-125a-3p by mimic treatment impairs while its inhibition with an antago-miR stimulates oligodendroglial maturation. Moreover, we show that miR-125a-3p levels are abnormally high in the cerebrospinal fluid of MS patients bearing active demyelinating lesions, suggesting that its pathological upregulation may contribute to MS development, at least in part by blockade of OPC differentiation leading to impaired repair of demyelinated lesions.

Introduction: The ferric chloride intoxication is frequently caused by accident. Its toxicity is generally underrated, which can lead to fatal evolution or irreversible consequences. In this case, the caustic condition of the substance is related to the toxic properties of iron., Case Presentation: A 36-year-old male patient arrives by ambulance indicating sensory deterioration. He presents erosive injuries in the buccal cavity and in the oropharynx, brownish teeth and metabolic acidosis. Toxicology tests and ferritin blood dosage are requested, which show a result from 1400 mg/dl. The symptoms are interpreted as acute iron intoxication. Due to the unfavorable evolution of his condition, an abdominal and pelvic CT scan are performed, which show extensive pneumoperitoneum and free fluid in the abdominal cavity. An exploratory laparotomy, a total gastrectomy with esophagostomy and feeding jejunostomy, washing and drainage due to perforated gastric necrosis caused by caustic ingestion are performed., Discussion: In our country, there is a high rate of intoxication caused by iron compounds, although it is not statistically measured. Nevertheless, the ferric chloride intoxication is extremely infrequent. The ingestion of this product leads to complications, which are associated with the iron concentration and its condition as a caustic agent., Conclusions: The surgical indications in the presence of intoxication caused by iron compounds are: stomach evacuation of iron, gastric necrosis, perforation or peritonitis and stenosis. Early or prophylactic gastrectomy is contraindicated. However, if complications that require immediate surgical intervention arise, there should be no hesitation and the corresponding procedure should be performed.

Introduction: Aluminum (Al) is a toxic element which may contaminate pharmaceutical products used as individual components to prepare total parenteral nutrition mixtures (TPN)., Objectives: 1) to determine Al levels in the individual components used to prepare TPN mixtures; 2) to compare detected Al levels with those imposed by international regulations (FDA); 3) to calculate the total amount of Al administered to adult and children receiving those typical TPN mixtures., Methods: Al was determined by Inductively Coupled Plasma- Atomic Emission Spectrometry (ICP-OES) (Perkin Elmer OPTIMA 5100 DV) in 44 individual products, from different labs and lots, belonging to 16 components available in Argentina: dextrose and amino acids for adult formulas and for pediatric formulas: lípids; potassium chloride; sodium chloride, magnesium sulfate; sodium phosphate; calcium gluconate; sodium glycerophosphate, zinc sulfate; multitrace elements; steril water (ampoules and great volume presentations)., Results: Al levels were detected in 43 of the 44 the studied components, except sterile water. The components of large volume presented between 249 y 1,580 μg Al/ L, between 4 and 180 times FDA established levels (25 μg Al/ L). Small volume components presented Al levels between 85 y 4,909 g/ L, not declared in labels., Conclusions: The highest amounts of Al were detected in calcium gluconate, sodium phosphate and multitrace elements. 2) Usually prescribed TPN mixtures would have higher Al levels than those accepted by FDA regulation; 3) The highest aluminum concentration was provided by dextrose, amino acids and lipids in adult TPN mixtures. In neonate TPN mixtures, Al highest amounts were provided by dextrose and calcium gluconate. The calculated concentration of Al in TPN mixtures was higher than those stipulated by international regulation (5 μg Al/kg (body weight)/ d). It would be advisable for manufacturers to declare the content of aluminum in the label, with the aim of avoiding toxicities which would compromise the critical patients' evolution., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)

The present study evaluated the effectiveness of a drug-free unit (DFU) in reducing the use of substances by incarcerated adult offenders, and to analyze changes in the addiction severity index, motivation, and personality caused by the program. This is an external evaluation, with an ex post facto design with repeated measures. Eighty-seven prisoners from the DFU were evaluated during the first year of residence in the program. Most are young men, polydrug addicts and mainly serving sentences for public health crimes and property offenses. There is need of psychiatric treatment at the baseline, with 85% comorbid personality disorders. Motivation for treatment is low, and remains stable over 12 month's duration of the study. The DFU was found to have a significant effect in reducing the use of drugs by offenders and to improve the drug and family composite scores, also reducing scores on personality scales. However, it fails to change medical and psychiatric scores, so that the need for intervention in these areas is underscored.

The composition of human milk is the main base for the development of infant formulas concerning its macronutrients and micronutrients contents and bioactive compounds. Technological advances in the composition of human milk have identified a great number of bioactive compounds such as prebiotics which are responsible for immunological protection and the prevention of different pathologies. In order to achieve similar benefits, they are part of the contents of infant formulas.

Objectives: To study the interrelationship between serum Interleukin-6 (IL-6), serum Interleukin-6 soluble Receptor (IL-6 sR), C-Reactive Protein (C-RP), plasmatic Zinc levels (PlZn) and their response in relation to Zn administered by TPN, in critical patients., Methods: 17 patients, receiving TPN as a consequence of acute pancreatitis (n = 4) or after a major abdominal surgery due to intestinal cancer (n = 7), intestinal fístula (n = 3), intestinal obstruction (n = 2) or intestinal íleus (n = 1) were studied. At the beginning (To) and at the end of the TPN administration (6-21 days) serum IL-6 and IL-6 sR were determined by ELISA; C-RP ultrasensitive (C-RP us) by inmunoturbidimetric method; Zn was determined in TPN and in plasma by Atomic Absorption Spectrometry. Characteristics of the patients were (mean +/- SD and ranges): age: 60.6 +/- 11.7 (37-77) years; BMI (kg/m(2)): 26.0 +/- 3.4 (19.9-34.0)., Results: The results (mean +/- standard deviation and ranges) were: Zn provided by TPN (mg/d): 6.1 +/- 2.0 (range 2.8 to 10.8). Biochemical levels were, at To and Tf, respectively: (mean+/-SD and ranges) were at To y Tf, respectively: Zn Pl (microg/dl): 104 +/- 46 (35-177); 120 +/- 55 (52-229); IL-6 (pg/mL) 93 +/- 74 (10-262); 117 +/- 180 (7-761); IL6sR (pg/mL): 1,012 +/- 322 (589-1855); 1,269 +/- 451 (631-2195); C-RP us (mg/L): 71 +/- 63 (2-196); 65 +/- 43 (0-137). There was no correlation between variations of IL6, IL6sR, C-RP, PlZn levels and the daily amount of Zn administered in the TPN mixtures. Two patients presented a bad evolution; they received 4.2 and 5.2 md/d of Zn and showed an increase of IL6 levels, maintained high levels of IL6sR but C-RP levels decreased., Conclusions: the range of 2.8 to 10.8 mg/d of Zn administered in TPN mixtures did not exacerbate the inflammatory response.

Objectives: Complications resulting from zinc and copper deficiency, or adverse effects from excessive zinc and copper intake should be avoided during total parenteral nutrition (TPN). This study was conducted on critically ill patients requiring TPN to determine the relationship between the zinc and copper levels of the TPN mixtures, patients' clinical progression, and changes in plasma levels of zinc, serum levels of copper, and erythrocyte levels of zinc and copper., Patients and Methods: 29 adult critically ill patients following pancreatitis or after a major abdominal surgery were studied. Zinc and copper levels in TPN, plasmatic zinc levels, copper serum levels and erythrocyte levels of zinc and copper were determined at the onset and at the end of the treatment (5-21 days) (using Atomic Absorption Spectrometry)., Results: The mean+/-standard deviation (and ranges in parenthesis) of zinc and copper levels in TPN were (microg/mL): zinc: 4.2+/-1.7 (1.8 a 9.3); copper: 0.94+/-0.66 (0.1 a 3.1). Biochemical parameters at the onset and at the end of the treatment were, respectively: (microg/mL): plasmatic zinc: 80+/-45 (29-205) and 122+/-56 (37-229); erythrocyte zinc: 2,300+/-1,070 (790-5,280) and 2,160+/-920 (790-4,440); serum copper (microg/dL): 124+/-35 (62-211) and 128+/-41 (60- 238); erythrocyte copper (microg/dl): 72+/-39 (4-183) and 70+/-41 (9-156). Plasmatic and erythrocyte zinc levels did not correlated neither at the onset nor at the end of the treatment. Changes in erythrocyte zinc levels correlated with daily administered zinc (mg/d) in the parenteral nutrition (r=0.38). Serum copper and erythrocyte copper showed significant correlation at the onset (p=0.0005) and at the end of treatment (p=0.008). Changes of serum or erythrocyte copper levels showed a significant correlation with daily administered copper (r=0.31 and 0.26, respectively)., Conclusions: These results show that: 1) determination of erythrocyte zinc and copper levels in these critically ill patients would help to control zinc and copper administration levels in TPN and avoid adverse effects; 2) TPN Zn levels should be less than 8.1 mg/d, and 3) TPN Cu levels higher than 1.2 mg/d would not be recommended.

Information on prevalence, type of problems on psychomotor development (PPD) and conceptions of the professionals and parents that take part of a screening project was obtained by implementing a national screening test for PPD in 839 apparently healthy children aged 0-5 years attending three health centers in San Isidro. Parents and professionals conceptions about the test and programme were studied with qualitative research approach. The test was administered by three previously trained pediatricians. General failure rate was 20.0%. Out of a total number of 170 children failing the test and referred to hospital for diagnosis and treatment, only 96 complied and went through a series of studies carried out by a multidisciplinary team for diagnosis, classified according to DSM-IV: global developmental delay: 60 children, pervasive disorders: 11, communication disorders: 10, motor disorders: 6 (2 children with cerebral palsy), attention deficit disorders: 5, attachment disorders: 2, normal children: 3. Co-morbidity was present in 22 affected children. Forty-three per cent of children failing the test did not comply with the indication of hospital referral or did not complete the studies. Qualitative investigation helped to understand the key role played by parents and professionals participating in the screening process. The fact that there are now 96 children with developmental disorders under treatment, supports the validity of the screening procedure implemented.

Objectives: 1) to determine zinc and copper levels of contamination in the individual component solutions used to prepare the pediatric total parenteral nutrition mixtures in Argentina; 2) to compare zinc and copper amounts prescribed by the physician with the true amount given to a neonate weighing 1.2 kg and to a child weighing 10 kg, who would receive total parenteral nutrition formulas prepared with those component solutions., Materials and Methods: Zn and Cu were determined by atomic absorption spectrophotometry in 59 individual solutions belonging to 14 components chosen between the commercial products available in Argentina., Results: zinc and copper, as contaminants, were found neither in the sterile water, nor in the potassium chloride or in the vitamin solutions. Zinc, but no copper, was detected in sodium chloride, manganese sulfate, chromium chloride and seleniose acid solutions. Zinc and copper were detected in dextrose, amino acids, calcium gluconate and lipid solutions at variable levels. Zinc sulfate solutions contained between 90.4% and 140% of the declared content and a variable contamination with copper. Copper sulfate solutions presented between 4% and 18% less the declared copper concentration and a variable contamination with zinc. Dextrose and lipid solutions presented the highest amount of zinc and copper. Therefore, the total parenteral mixtures prepared with the analyzed solutions must have had an excess of zinc and copper in relation to the prescription: ranging between 103% and 161% and between 7%-426% higher than the Zn and Cu amounts prescribed for neonates, respectively; the excess in the total parenteral nutrition for a child weighing 10 kg would ranged between 105% and 189% and between 7%-365% higher than the prescribed for Zn and Cu, respectively., Conclusions: 1) Nine components presented Zn and five Cu, both of them not declared in the label; 2) the usually prescribed total parenteral nutrition mixtures must have had a zinc and copper amount higher than the prescribed one according to international recommendations; 3) those figures would be safe in patients without complications, but it would be harmful in renal failure, hepatic compromise or colestasis mainly in pediatric patients; 4) It would be advisable to declare in the label the true content of zinc and copper, with the aim to avoid deficiencies and excess which would compromise the evolution of pediatric patients.

Objectives: To study in severe patients that required parenteral nutrition the relationship between Zn and Cu amounts present in formulas, the clinical course and changes in some biochemical parameters (plasmatic and erythrocytic Zn and Cu levels) during the parenteral nutrition therapy., Patients and Methodology: Five adult severe patients were studied, submitted to major abdominal surgery, and that required parenteral nutrition. Determinations were done for: 1) Zinc and copper in parenteral formulas; 2) in patients, at the beginning (T0) and at the end (Tf) of treatment, in erythrocytes: zinc (Zn-E) and cupper (Cu-E); in plasma, zinc (Zn-Pl) and in serum, cupper (Cu-S). Zinc and cupper were determined by means of atomic absorbance spectrometry., Results: mean +/- standard deviation values and ranges (between brackets) were: parenteral formulas (microg/g): zinc: 0.6 +/- 1.1 (2.2 - 7.0); Cupper: 2.4 +/- 0.7 (0.5-3.7). Biochemical parameters: at T0 (n = 5): Zn-E (microg/mL): 21.6 +/- 10.0 (13.6-36.1); Zn-Pl (microg/dL): 88 +/- 72 (29-205); Cu-E (microg/dL): 113 +/- 22 (60-102); Cu-E (microg/dL): 139 +/- 29 (106 +/- 156); Cu-S (microg/dL): 172 +/- 20 (158-195). Individual values compared to reference ones (normal individual from Buenos Aires with adequate nutrition) indicated that the three patients with favorable course normalized Zn-Pl and Zn-E levels. However, Cu-S increased in the three cases and Cu-E in two of them., Conclusions: These results make clear that in the studied patients Zinc levels in parenteral formulas would be adequate to prevent deficiency while Copper levels could be too high.

A study of the protonation of the cycloadducts derived from the dearomatization reaction of lithiated N-alkyl-N-benzyldiphenylphosphinamides has been carried out. The regio- and stereoselectivity of the process has been analyzed in terms of the size of the N-alkyl substituent, the acidity and size of the protonating reagent, and the cosolvent used. The optimization of these variables allowed the preparation of tetrahydrobenzo[c]-1-aza-2lambda(5)-phospholes containing a 1,3-cyclohexadiene or 1,4-cyclohexadiene system with moderate to excellent regio- and stereocontrol. The heterocycles were readily hydrolyzed, affording gamma-(N-alkylamino)diphenylphosphinic acids with the functionalities linked to a cyclohexadiene substructure.

Enteral nutrition is used as a routine therapy in patients with caloric-protein malnutrition, severe dysphagia, major burns, intestinal resection, and enterocutaneous fistulae, as long as a portion of the digestive tract still has an active absorptive function. The administration takes place by means of surgical (ostomies) or non-surgical (nasogastric) tubes. In our country, a significant number of hospitalized patients with various diseases receive this type of nutrition. Given that the colonization of the digestive tract by hospital flora is the first step towards developing intra-hospital infections, the contamination implies serious risks. The objective of this study was to study the most appropriate conditions for the manufacturing, storage and administration of the mixture of nutrients of enteral nutrition, to guarantee nutrition with a lower contamination risk. This study was conducted by the Unit of Nutritional Assistance of the Mater Dei Clinic, by means of bacteriological controls, from January 1991 to December 1992, and in 1993 in which the work systematics were reviewed. The study was prospective, and those solutions whose bacteriological counts were lower than 100.000 colony forming units (CFU), and which showed an absence of enteropathological micro-organisms, were considered acceptable, and those solutions which had a bacteriological count greater than or equal to 100.000 CFU and or the presence of enteropathological micro-organisms, were considered unacceptable. During the first period, "usual working conditions", we analyzed the infra-structure, the personnel, the constituents, and the apparatus used in the manufacturing, for which 36 samples were studied at t0 (moment of preparation). Afterwards, in the second period "special working conditions", we analyzed the manufacturing procedures, the storage and the administration of 103 solutions, corresponding to 36 patients, taking samples at t0 and t24 (after 24 hours of preparing). In the first phase, we found a 53% contamination. In the second phase, 99.03% of the solutions were within the limits of acceptability, and only 0.07% were unacceptable. We conclude that it is necessary to have access to a working area which meets the biosecurity norms, to use sterile technique in the preparation, to prefer pharmacologically sterile products for the preparation, to store the prepared mixture between 4 and 8 degrees C, and to keep it cooled during the administration. Lastly, we saw the need to continuously capacitate the nursing, dietary (ABSTRACT TRUNCATED)