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Ochratoxin A (OTA), zearalenone (ZEN), and deoxynivalenol (DON) are mycotoxins whose exposure is associated with various adverse health effects, including cancer and renal disorders, estrogenic effects, and immunosuppressive and gastrointestinal disorders, respectively. Infants (<2 years) are the most vulnerable group to mycotoxins, representing a unique combination of restricted food consumption types, low body weight, lower ability to eliminate toxins, and more future years to accumulate toxins. This study aimed to estimate the infant́s exposure to OTA, DON, and ZEN due to the consumption of milk formula and baby cereals in Chile. Milk formula samples (n = 41) and baby cereals (n = 30) were collected and analyzed using commercial ELISA kits for OTA, DON, and ZEA determination. Exposure was assessed by the Estimated Daily Intake (EDI) approach (mean and worst-case scenario, WCS) with the levels found in a modified Lower Bound (mLB) and Upper Bound (UB); ideal consumption (<6m, 7-12 m, and 13-24 m); adjusted by the weight of each group. The risk was estimated by comparing the EDI with a reference tolerable daily intake or by the margin of exposure (MOE) in the case of OTA. DON and OTA occurrence in infant formula were 34 % and 41 %, respectively. The co-occurrence between these mycotoxins was 22 %. Mycotoxin contents were below LOQ values except for OTA determined in one sample (0.29 ng/ml). No milk formulae were contaminated with ZEN. In the case of baby cereals, the occurrences were 17 % for OTA, 30 % for DON, and 7 % for ZEN, all below LOQ. Co-occurrence was seen in two samples between ZEN and OTA. According to exposure calculations, the MOE for OTA was less than 10,000 in all models for milk formula between 0 to 12 months of age and in the UB and WCS for cereal consumption. Health concerns were observed for DON in the WCS and UB for milk consumption in all ages and only in the UB WCS for cereal consumption. Considering the high consumption of milk formula in these age groups, regulation of OTA and other co-occurring mycotoxins in infant milk and food is strongly suggested., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

While most episodes of community-acquired pneumonia are caused by Streptococcus pneumoniae and respiratory viruses, other atypical pathogens can also be responsible for lung infections. The Infectious Diseases Service of the Lausanne University Hospital (CHUV) organizes an annual meeting aimed at general practitioners, during which interesting clinical cases are presented. In this article, we summarize five cases of community-aquired respiratory infection due to atypical pathogens that were presented during the 2023 meeting, each with a particular teaching point. Although these infections are rare, expanding the differential diagnosis in cases of suboptimal response to therapy or particular exposures is warranted., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

Mangroves are a challenging ecosystem for the microorganisms that inhabit them, considering they are subjected to stressful conditions such as high and fluctuating salinity. Metagenomic analysis of mangrove soils under contrasting salinity conditions was performed at the mouth of the Ranchera River to the Caribbean Sea in La Guajira, Colombia, using shotgun sequencing and the Illumina Hiseq 2500 platform. Functional gene analysis demonstrated that salinity could influence the abundance of microbial genes involved in osmoprotectant transport, DNA repair, heat shock proteins (HSP), and Quorum Sensing, among others. In total, 135 genes were discovered to be linked to 12 pathways. Thirty-four genes out of 10 pathways had statistical differences for a p-value and FDR < 0.05. UvrA and uvrB (nucleotide excision repair), groEL (HSP), and secA (bacterial secretion system) genes were the most abundant and were enriched by high salinity. The results of this study showed the prevalence of diverse genetic mechanisms that bacteria use as a response to survive in the challenging mangrove, as well as the presence of various genes that are recruited in order to maintain bacterial homeostasis under conditions of high salinity., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Polygalacturonase (PG) is an important hydrolytic enzyme involved in pectin disassembly and the subsequent textural changes during fruit ripening. Although the interaction of fungal PGs with other proteins has been documented, the interaction of plant PGs with other plant proteins has not yet been studied. In this study, the molecular mechanisms involved in raspberry fruit ripening, particularly the polygalacturonase (RiPG) interaction with polygalacturonase inhibiting protein (RiPGIP) and substrate, were investigated with a structural approach. The 3D model of RiPG2 and RiPGIP3 was built using a comparative modeling strategy and validated using molecular dynamics (MD) simulations. The RiPG2 model structure comprises 11 complete coils of right-handed parallel β-helix architecture, with an average of 27 amino acid residues per turn. The structural model of the RiPGIP3 displays a typical structure of LRR protein, with the right-handed superhelical fold with an extended parallel β-sheet. The conformational interaction between the RiPG2 protein and RiPGIP3 showed that RiPGIP3 could bind to the enzyme and thereby leave the active site cleft accessible to the substrate. All this evidence indicates that RiPG2 enzyme could interact with RiPGIP3 protein. It can be a helpful model for evaluating protein-protein interaction as a potential regulator mechanism of hydrolase activity during pectin disassembly in fruit ripening., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

We assessed the occurrence of aflatoxin M 1 (AFM 1 ) in urine in a sample of the MAUCO population-based cohort (n = 120) using an enzyme-linked immune sorbent assay (ELISA) kit specially designed for the analysis of AFM 1 in urine. We found AFM 1 in the urine of 59% of the participants (> limit of detection), with 12% of the samples being over the limit of quantification. The mean of the quantifiable samples was 0.66 (± 0.35) ng/mg adjusted creatinine, ranging from 0.31 to 1.39 ng/mg creatinine. The mean probable daily intake (PDI) of AFB 1 was 0.23 (± 0.37) ng/kg bw according to the upper bound (UB), being significantly higher in women and 0.14 (± 0.23) ng/kg bw in the modified lower bound (mLB) approach, ranging from 0.01 to 1.98 ng/kg bw. The risk of AFB 1 was assessed with the margin of exposure (MOE) approach estimated at 2800 in the mean mLB and 1733 in the mean UB. According to the MOE values obtained in this study, aflatoxin B 1 exposure must be considered a public health concern and must be taken as a priority for food risk management., (© 2022. The Author(s) under exclusive licence to Society for Mycotoxin (Research Gesellschaft für Mykotoxinforschung e.V.) and Springer-Verlag GmbH Germany, part of Springer Nature.)

Mycotoxins are unavoidable contaminants produced by fungi in food, especially grains. This study aimed to measure the occurrence and levels of total aflatoxins (AFs); ochratoxin A (OTA); zearalenone (ZEN); fumonisins B1, B2, and B3 (FUM); deoxynivalenol (DON); and T-2/HT-2 toxins in the four most commonly consumed breakfast cereals in Chile and to assess mycotoxin exposure and risk in children aged 2 to 13 years due to cereal consumption. In this study, a total of 110 batches with three subsamples of the four brands were sampled in supermarkets from November 2019 to June 2021. Samples were analyzed by Veratox ® ELISA (Neogen). Exposure was assessed by estimated daily intake (EDI) considering the levels found in a modified lower bound (mLB) and upper bound (UB). Risk was estimated by margin of exposure (MOE) in the case of OTA and AFs and hazard quotient (HQ) for the rest of the mycotoxins. No T2/HT2 toxins were detected. Few samples had quantifiable levels of ZEN, FUM, and DON except for brand 1, with a mean (standard deviation, SD) of 54 (20), 1552 (351), and 706 (218) ng/g, respectively. In addition, three FUM samples and one DON sample had values over the Chilean regulation. Brands 2, 3, and 4 had quantifiable levels of AFs, with mean (SD) values of 1.3 (0.1), 2.1 (0.6), and 1.9 (0.4) ng/g, respectively. Brand 3 had quantifiable levels of OTA, with a mean (SD) of 2.3 (0.4) ng/g. Estimated exposure indicated a risk of AFs in all scenarios, and of FUM for brand 1 consumption, OTA and DON for brand 3 consumption, and OTA for brand 4 consumption in the mLB worst-case scenario. In general, mycotoxin levels were below the Chilean regulatory limits, but most of them were above the EU regulation for processed cereal-based food in young children. Because the risk was higher in the 2- to 5-year-old children, we recommend special regulations for this group in Chile.

Pomegranate ( Punica granatum ) is a non-climacteric fruit with a high antioxidant content in arils and peels, of which 92% are anthocyanins and tannins. However, it is susceptible to chilling injury (CI), a physiological disorder concentrated in the peel, which can affect the organoleptic quality of the fruit. To understand the effects of modified atmosphere and ethylene in responses to stress on the antioxidant quality of the fruit and composition of fatty acids in the peel under CI conditions, the exogenous ethylene treatments (0.5, 1.0, and 1.5 μg L -1 ), 1-methylcyclopropene (1-MCP; 1 μl L -1 ), modified atmosphere packaging (MAP: XTend™ bags), combined strategy MAP/1-MCP, and package in macroperforated bags (MPB-control treatment) were evaluated. The assay was performed in cold conditions (2 ± 1°C; 85% RH) to stimulate damage and was sampled for 120 days (+3 days at 20°C). During cold storage, CI symptoms began at 20 days in MPB and at 60 days for all treatments with exogenous ethylene; CI symptoms were delayed up to 120 days in MAP, 1-MCP, and the combined MAP/1-MCP treatment. Damage was concentrated in the peel. Ethylene and MPB-control treatments induced significant electrolyte leakage, lipid peroxidation, and oxidative damage. In contrast, MAP alone or in combination with 1-MCP successfully delayed CI symptoms. However, no significant differences were observed between treatments in fatty acid content, e.g., in the peel, oleic acid, linoleic acid, palmitic acid, but a significant loss was noted after 60 days of storage. Cold storage caused an increase in anthocyanin concentration in the peel and arils, increasing up to 12 times in the peel of the fruit treated with ethylene at the final stage of storage (120 days + 3 days at 20°C), with non-significant differences in the tannin content in the peel. During long-term cold storage of pomegranate, MAP and 1-MCP treatments delay and reduce the appearance of CI symptoms. This long cold storage induces an important decrease in the unsaturated/saturated fatty acid ratio, which is not reversed by any postharvest treatment. A higher unsaturated/saturated fatty acid ratio after 1-MCP treatments showed a protective effect in peel tissues. In addition, it was possible to increase the concentration of anthocyanins in the peel of cold-storage pomegranates treated with ethylene., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Valdenegro, Fuentes, Bernales, Huidobro, Monsalve, Hernández, Schelle and Simpson.)

Introduction: The prevalence of pathologies that generate chronic pain is high (10-40%), as is the use of opioids. In Colombia, these drugs rank among the first in terms of prescriptions and the number of deaths related to their consumption is rising (0.71/1,000,000 inhabitants). This study seeks to characterise opioid-related problems (ORP) and the variables associated with their resolution., Materials and Methods: It is a study based on secondary information. Incidences were calculated using Ministry of Health data and characteristics related to non-recoverable adverse reactions (ADRs) were determined., Results: Altogether 4,437 problems were identified in 3,063 patients (39.51%, male), adults (45 years old; IQR: 29-62). The most common opioids were tramadol (46.49%, 5 mg; IQR: 5-5) and morphine (19.65%, 3 mg; IQR: 2.6-5). The majority of ORP were ADRs (93.15%) and of these, 32.28% were severe. Women had proportionally more gastrointestinal and neurological disorders, while men had a higher frequency of vascular, psychiatric, urinary and haematological problems (p < 0.05). These reactions did not resolve in 8.39%, and prognosis was associated with oral administration - odds ratio (OR): 9.24; 95% confidence interval (CI 95%): 6.36-13.42; severity (OR: 3.96; CI 95%: 2.71-5.76); age (OR: 1.01; CI 95%: 1.001-1.01); weak opioids (OR: 0.57; CI 95%: 0.4-0.84); and neurological-cardiovascular reactions (OR: 0.36; CI 95%: 0.21-0.61)., Conclusions: Interventions to optimise the prescription of opioids should be encouraged to prevent ADRs with poor prognosis. Studies should be conducted to further investigate the impact of gender and route of administration on the occurrence of ADRs, as well as the severity of skin and gastrointestinal problems, which may be underestimated.

Frailty is a prevalent condition among Canadians; over one million are diagnosed as medically frail, and in the next ten years this number will double. Information and telecommunication technologies can provide a low-cost method for managing frailty more proactively. This study aims to examine the range and extent of information and telecommunication technologies for managing frailty in older adults, their technology readiness level, the evidence, and the associated outcomes. A systematic literature review was conducted. Four databases were searched for studies: Medline, EMBASE, CINAHL, and Web of Science. In total, we included 19 studies (out of 9,930) for the data abstraction. Overall, our findings indicate that (1) the proposed frailty phenotype is the most common ground truth to be used for assessing frailty; (2) the most common uses of information and telecommunication technologies for managing frailty are detection, and monitoring and detection, while interventional studies on frailty are very rare; (3) the five main types of information and telecommunication technologies for managing frailty in older adults are information and telecommunication technology-based platforms, smartphones, telemonitoring (home monitoring), wearable sensors and devices (commercial off-the-shelf), and multimedia formats for online access; (4) the technology readiness level of information and telecommunication technologies for managing frailty in older adults is the "Technology Demonstration" level, i.e., not yet ready to be operated in an actual operating environment; and (5) the level of evidence is still low for information and telecommunication technology studies that manage frailty in older adults. In conclusion, information and telecommunication technologies for managing frailty in the older adult population are not yet ready to be full-fledged technologies for this purpose., Competing Interests: Conflicts of interest The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (copyright: © 2021 Cruz et al.)

The development of caenolestid marsupials (order Paucituberculata) is virtually unknown. We provide here the first description of Caenolestes fuliginosus embryos collected in the Colombian Central Andes. Our sample of four embryos comes from a single female caught during a fieldtrip at Río Blanco (Manizales, Caldas), in 2014. The sample was processed for macroscopic description using a Standard Event System and for histological descriptions (sectioning and staining). The grade of development of the lumbar flexure and coelomic closure differed between embryos, two of them being more advanced than the others (similar to McCrady's stages 30 and 29, respectively). The pericardial and peritoneal cavities were present, the hepatic anlage was organized in hepatic cords, the heart was in its final position, and the mesonephros was functional. Compared to other Neotropical marsupials, an early appearance of the frontonasal-maxillary fusion and the cervical growth (thickness) was observed; however, absorption of the pharyngeal arches into the body and lung development was delayed. Besides these differences, embryos were similar to equivalent stages in Didelphis virginiana and Monodelphis domestica. Previous proposals of litter size of four for C. fuliginosus are supported., (© 2020 Wiley Periodicals, Inc.)

In this article, we introduce the use of a carboxy-functionalized waterborne carbon nanotube ink for the fabrication of an amperometric biosensor aimed at the quantification of β-lactoglobulin. Detection of this protein from cow's milk was performed by a sandwich immunoassay onto printed carbon nanotube electrodes. The electrodes were printed using a carbon nanotube ink modified with polystyrene beads containing a high amount of carboxylic groups for protein immobilization. This strategy showed enhanced sensing performance compared to the use of oxidative treatments for the functionalization of electrodes. These electrodes showed an excellent electrochemical behavior, and proteins could be immobilized on their surface via the carbodiimide reaction. These antibody-immobilized carbon nanotube electrodes allowed for the detection of β-lactoglobulin in sub-ppm concentrations.

Aim: To evaluate analytical and biological characteristics of the Singulex Clarity® cTnI assay, based upon Single Molecule Counting technology., Methods: Assay's analytical sensitivity, precision, linearity, hook effect, cross-reactivity or interference by endogenous and exogenous substances, stability, 99th reference percentile [p99th] in EDTA plasma were evaluated in single or multi-site studies., Results: Detection limit was 0.12 ng/L. Sensitivity was 0.14 ng/L at 20% CV (functional sensitivity) and 0.53 ng/L at 10% CV. Imprecision was 3.16%-10.0% in a multi-lot, single-site study, and 5.5%-12.0% in a single-lot, multi-site study; assay was linear from 0.08 to 25,000 ng/L. No hook effect was observed; any cross-reactivity/interference exceeded the 10%. Healthy subjects were recruited using clinical history, normal NT-proBNP and eGFR (n = 560) or plasma creatinine (n = 535) as inclusion criteria. cTnI was detectable in 96.8% of healthy subjects. The p99th were 8.01 (eGFR used) and 8.15 ng/L (plasma creatinine); both were measured with ≤5.7% CV. Median cTnI were significantly higher in older and male than in young and female subjects., Conclusions: The Singulex Clarity cTnI assay show analytical features and % detection in healthy subjects that improve the corresponding values of most of the existing high-sensitivity cTnI assays., (Copyright © 2018 Elsevier B.V. All rights reserved.)

The data presented in this article are related to the research article entitled "Expression of two indole-3-acetic acid (IAA)-amido synthetase (GH3) genes during fruit development of raspberry ( Rubus idaeus Heritage)" (Bernales et al., In press). This data article describes the relation of all size variables between them and with the weight showing an increasing trend between length and weight and an inverse relation of fruit firmness and ethylene production during development. In addition, IAA treatment during auxin in-vitro assay showed no significant changes in firmness, a significant increase of ethylene and respiratory production.

Background: Pomegranate (Punica granatum) is a non-climacteric fruit susceptible to chilling injury (CI) at temperatures below 5 °C. To understand the influences of ethylene and modified atmosphere on CI physiological disorders of pomegranate, exogenous ethrel (0.5, 1 and 1.5 µg L -1 ) treatments, 1-methylcyclopropene (1-MCP) (1 µL L -1 ) exposure, packaging in a modified atmosphere (MAP) (XTend™ bags; StePac, São Paulo, Brazil), a MAP/1-MCP combination, and packaging in macro-perforated bags (MPB) were applied. The treated fruits were cold stored (2 ± 1 °C; 85% relative humidity) and sampled during 120 + 3 days at 20 °C., Results: During cold storage, CI symptoms started at 20 days in MPB and at 60 days for all exogenous ethylene treatments, and were delayed to 120 days in MAP, 1-MCP and MAP/1-MCP treatments. MPB and ethylene treatments induced significant electrolyte leakage, oxidative damage, lipid peroxidation, ethylene and CO 2 production, and 1-aminocyclopropane-1-carboxylic acid oxidase activity, without any change in total soluble solids, titratable acidity or skin and aril colours. Conversely, MAP by itself, or in combination with 1-MCP application, effectively delayed CI symptoms., Conclusion: During long-term cold storage of this non-climacteric fruit, ethrel application induced endogenous ethylene biosynthesis, accelerating the appearance of CI symptoms in contrast to the observations made for MAP and 1-MCP treatments. © 2018 Society of Chemical Industry., (© 2018 Society of Chemical Industry.)

Red Raspberry (Rubus idaeus) is traditionally classified as non-climacteric, and the role of ethylene in fruit ripening is not clear. The available information indicates that the receptacle, a modified stem that supports the drupelets, is involved in ethylene production of ripe fruits. In this study, we report receptacle-related ethylene biosynthesis during the ripening of fruits of cv. Heritage. In addition, the expression pattern of ethylene biosynthesis transcripts was evaluated during the ripening process. The major transcript levels of 1-aminocyclopropane-1-carboxylic acid synthase (RiACS1) and 1-aminocyclopropane-1-carboxylic acid oxidase (RiACO1) were concomitant with ethylene production, increased total soluble solids (TSS) and decreased titratable acidity (TA) and fruit firmness. Moreover, ethylene biosynthesis and transcript levels of RiACS1 and RiACO1 were higher in the receptacle, sustaining the receptacle's role as a source of ethylene in regulating the ripening of raspberry., (Copyright © 2015 Elsevier GmbH. All rights reserved.)

PAMAM dendrimers have been widely studied as a novel means for controlled drug delivery; however, computational study of dendrimer-drug complexation is made difficult by the conformational flexibility of dendrimers and the nonspecific nature of the dendrimer-drug interactions. Conventional protocols for studying drug binding have been designed primarily for protein substrates, and, therefore, there is a need to establish new protocols to deal with the unique aspects of dendrimers. In this work, we generate cavities in generation-5 polyamidoamine (PAMAM) dendrimers at selected distances from the center of mass of the dendrimer for the insertion of the model drug: dexamethasone 21-phosphate or Dp21. The complexes are then allowed to equilibrate with distance between centers of mass of the drug and dendrimers confined to selected ranges; the free energy of complexation is estimated by the MM-GBSA (MM, molecular mechanics; GB, generalized Born; SA, surface area) method. For both amine- and modified acetyl-terminated PAMAM at both low and neutral pH, the most favorable free energy of complexation is associated with Dp21 at distance of 15-20 Å from the center of mass of the dendrimer and that smaller or larger distances yield considerably weaker affinity. In agreement with experimental results, we find acetyl-terminated PAMAM at neutral pH to form the least stable complex with Dp21. The greatest affinity is seen in the case of acetyl-terminated PAMAM at low pH, which appears to be due a complex balance of different contributions, which cannot be attributed to electrostatics, van der Waals interactions, hydrogen bonds, or charge-charge interactions alone.

In 2011, NASN conducted a needs assessment to identify and analyze member demographic trends and identify priorities for current members. Ninety-five percent of survey respondents were currently registered nurses, 1% were licensed practical nurses, 3% were advance practice registered nurses, and 1% had other types of licensure. School nurses ages ranged between 21 and 66+ years of age with the highest concentration of school nurses (63%) older than 51 years of age. Thirty-one percent of respondents were nationally certified through the National Board for the Certification of School Nurses. Eighty-three percent had a bachelor's degree or higher. Fifteen percent had a master's in nursing, and another 15% held a master's in another field. Nine percent of respondents had an associate's degree in nursing and 4% had a registered nurse diploma as their highest level of education. The typical NASN member is a female, registered nurse with a bachelor's degree who is over the age of 50.

The NASN membership is fairly consistent. The majority of NASN members are female; NASN members share a common interest in the specialty of school nursing. The majority of members are involved in one of the following areas: school nurse services, school nurse administration or supervision, and regional or state nurse consultant within the educational system. School nursing practice varies among survey participants; there are school nurses who have spent as little as one year specifically practicing school nursing and those who have spent as much as 36 years or more. Eighty-three percent (83%) of NASN members are employed by public school districts, salaries among members vary between $19,000 or less per year and $129,999 or more per year. NASN members serve students in different geographical areas; school nurses may care for students in urban, suburban, rural, reservations, and overseas (DOD, military) areas. Nonetheless, some school nurses may care for students in more than one geographical area. Twenty-eight percent (28%) of NASN members provide school nursing services to students in elementary school. Student-to-school nurse ratios vary among members; in some areas school nurses may care for 125 students or fewer to as many as 5,100 students or more. NASN members spend most of their time caring for episodic minor illness and injury (headache, pain, hay fever, pm medication, etc.), acute injury and illness, health screenings (vision, hearing, body mass index), and chronic health (case management, care plans, emergency plans, and 504). In addition, there is a consensus on the resources that would most allow school nurses to deliver safer care to their students to include assistance with administrative tasks, lowering student-to-school nurse ratios, and funding for projects. NASN members place a high priority in continuing education programs, especially in topics pertaining to direct student services, such as mental health, chronic health care, and acute illness. NASN members value the reading resources such as the electronic

Objective: To analyse differences attributable to the sex of the doctor and of the patient in the activities and content of the clinic appointment in Primary Attention., Design: Analysis of interaction, in terms of activities and content, in 157 clinic appointments. SITE. General medical consultations in four Primary Attention Public Health Centres., Patients: Those who used the health services on the day of the study., Intervention: Tape recording of the appointments., Main Measurements and Results: The interviews were recorded. There were shown to be differences according to the sex of the doctor and of the patient in terms of the development and content of the interviews. The style of the woman doctor involved longer interviews with greater social content; in general sameness of sex (doctor and patient) led to greater mutual complementation in the interviews., Conclusions: It has been shown that there are differences in the activities and content of the clinic appointments in Primary Attention which depend on the sex of the patient and doctor.

Objective: To describe and assess the social and psychic overload which falls on those who care for chronically ill patients confined to their homes., Design: Qualitative study, with semi-structured interviews. SITE: Primary care in the public sector, in an urban context., Patients or Others Participants: Those caring for the chronically ill, confined to their homes, and who are included in the home care programme of a General Medicine office., Intervention: Semi-structured interview and analysis of the clinical history. Data were obtained concerning: 1. The general characteristics of the patient; 2. General characteristics of the carer; and 3. Social activities, family relationships and both physical and psychological health of the carers., Main Results: 12 patients were studied. Two of these had no carer. In the remaining ten cases, the carer was a member of the immediate family. Only one carer was male. In 60% of cases the carer showed dysfunction in relation to the family. There were social repercussions in 70% of the cases and psychiatric morbidity in 50%., Conclusion: Care of the chronically ill patient confined to the home carries with it a serious social and psychological burden, which falls essentially on the wife or daughter.