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Con el objetivo de integrar de manera efectiva los entornos virtuales en las prácticas de Microbiología, se ha analizado la eficacia de las prácticas en formato virtual en comparación con el presencial en la asignatura de Microbiología del Grado de Podología. Tras elegir el formato práctico presencial o virtual, los alumnos realizaron voluntariamente cuestionarios de conocimientos previos y posteriores a las prácticas, con el fin de evaluar su rendimiento. Asimismo, se evaluó el compromiso y satisfacción de los estudiantes. La mayoría de los alumnos eligieron realizar las prácticas en formato presencial, mostrando un mayor compromiso y participación en los cuestionarios. Ambos grupos experimentaron una mejora en el rendimiento, sin diferencias significativas entre formatos. Los estudiantes que participaron en las prácticas expresaron un alto nivel de satisfacción en ambos formatos. Las prácticas virtuales suponen una alternativa adecuada a las prácticas presenciales en la enseñanza de Microbiología., With the aim of effectively integrating virtual environments in Microbiology practices, theeffectiveness of virtual versus face-to-face practices in the Microbiology course of the Degree inPodiatry was analysed. After choosing the face-to-face or virtual practical format, studentsvoluntarily completed pre- and post-practicum knowledge questionnaires to evaluate theirperformance. Students' commitment and satisfaction were also evaluated. Most students chose tocomplete the practices in the face-to-face format and showed a higher level of engagement andparticipation in the questionnaires. Both groups showed improved performance with no significantdifferences between the formats. Students who participated in the practices expressed an elevatedlevel of satisfaction in both formats. Virtual practices are a viable alternative to face-to-face practicesin Microbiology teaching, Depto. de Medicina, Fac. de Medicina, TRUE, pub

Despite the advantages of surgical handrub in terms of the ease of application and effectiveness, chlorhexidine (CHG)-based hand scrubbing remains the preferred method for surgical hand preparation. However, it does not systematically meet the non-inferiority requirement of the European norm (EN) 12791 with respect to n-propanol (the reference product) and does not provide the sustained efficacy expected for these long-lasting agents. Commercially available alcohol-based products have also failed to demonstrate sustained efficacy according to EN 12791. Multi-step protocols enhance the efficacy of hand scrubbing, yet their extended disinfection duration might diminish their allure for healthcare professionals. In this study, we show that hand scrubbing with CHG 4% followed by a 1 min rubbing with the novel formulation of ethanol (Et) 70%/CHG 3% plus 0.3% potassium sorbate food additive (PS) meets the non-inferiority requirement and demonstrates sustained efficacy when tested according to EN 12791. The immediate and 3 h effect of this protocol was significantly higher than that of n-propanol and the homologous disinfection protocol without PS (CHG 4% hand scrub plus Et 70%/CHG 3% rub), demonstrating that the inclusion of PS confers a notable residual effect. We speculate that this non-volatile ingredient acts synergistically with CHG. This promising combination represents an alternative method for the development of new disinfection strategies., Depto. de Medicina, Fac. de Medicina, Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub

Depto. de Enfermería, Depto. de Medicina, Fac. de Enfermería, Fisioterapia y Podología, Fac. de Medicina, TRUE, pub

Introduction: This study explores effects of pH and inoculum size on imipenem versus tigecycline activity against E. coli, B. fragilis and E. faecalis, both in individual and mixed cultures. Methods: MIC/MBCs (mg/L) of tigecycline and imipenem were 0.12/≥ 16 and 4/4 for E. coli, 0.12/0.5 and ≥ 16/≥ 16 for B. fragilis, and 0.12/≥ 16 and 2/≥ 16 for E. faecalis, respectively. Killing curves in supplemented Brucella broth were performed at pH 7 or 5.8, with two final inocula (≈ 105 or ≈ 107 cfu/ml) of each isolate (individual cultures) and with 1:1:1 mixed inocula. Tubes were 48 h incubated at 37 ºC in anaerobiosis. Final concentrations (estimated concentrations in colon) were 1.50 mg/L for tigecycline and 26.40 mg/L for imipenem, with antibiotic-free curves as controls. Experiments were performed in triplicate. Results: Imipenem showed inoculum effect against E.coli and B. fragilis, with reductions in initial inocula in experiments with standard inocula contrasting with increases in experiments with high inocula (both individual and mixed cultures). Against E. faecalis no inoculum effect for imipenem was observed in individual cultures, with marked reductions in initial inocula regardless inoculum size. However in mixed experiments the indirect protection of E. faecalis by the two gramnegatives resulted in bacterial regrowth. This protection was inoculum-dependant since it occurred with high but not with standard inocula. Tigecycline reduced initial inocula of the three isolates regardless culture type (individual/mixed) or experimental conditions (pH/inocula size), with lower reductions for the tolerant E. faecalis. Conclusion: Carbapenemase activity was inoculum-dependant for self-protection and indirect protection of E. faecalis., Depto. de Medicina, Fac. de Medicina, TRUE, pub

The benefit of autologous platelet-rich plasma (PRP) treatment is still under discussion. Variations in PRP products, consequence of the lack of a standardised protocol for the multitude of commercially available blood separation systems and the lack of knowledge of the optimal composition of PRP or its suitability for the proposed indication are some of the reasons behind clinical inconsistencies. The impact of inter-subject variability in PRP has received less attention in comparison. The purpose of this study was to determine the inter-subject variability, based on age, in the concentrates prepared by a new blood concentration system. Twenty-six healthy volunteers of both genders (29-93 years) were enrolled. Whole blood (WB) was collected from each participant to prepare PRP using the Easy PRP kit. Platelets and white blood cells (WBC) from WB and PRP were analysed after split population by age; patients younger than 65 years (n = 13) and patients ≥65 years old (n = 13). Among the demographic characteristics tested, only age was significantly different between the groups. Cell capture efficiency of the system was specific for each type of blood cell and identical for both age groups. Platelets and WBC in PRP were higher than in WB (P < .001). In WB, platelets and WBC concentrations were significantly lower in older group (P ≤ .035). These differences persisted in the prepared PRP (P ≤ .004). The ageing of population has a strong influence on the haematocrit and therefore on the composition of PRP. Because the efficiency of blood separator system seems to be constant across individuals, the inter-subject haematocrit variability based on age could be used as a predictor of resulting PRP. The clinical application of PRP should be restricted to the specific cell capture capacity of the different commercial devices., Depto. de Medicina, Fac. de Medicina, TRUE, pub

A crossover trial was conducted to compare hand rub and hand scrub-brush methods for reducing bacterial loads when using propan-1-ol-60% according to European regulations. Both methods significantly reduced the bacterial load immediately after antisepsis, but only the hand rub method achieved significant bacterial load reduction 3 hours after the procedure., Depto. de Medicina, Fac. de Medicina, TRUE, pub

Previous studies have reported the potential emission of nail dust to the indoor air of the podiatrist's workplace during nail drilling procedures. The main objective of this study was to analyse the fungal bioaerosol present in the indoor air of podiatry rooms, including during the nail drilling procedure. Seventeen private clinics were sampled in Madrid during spring and summer. The most prevalent filamentous fungi detected were Cladosporium spp. and Penicillium spp. in both seasons. The presence of Trichophyton rubrum and Trichophyton interdigitale was reported in samples during the drilling procedures, establishing a positive association with the clinical suspicion of onychomycosis (p = 0.002) and the utilization of aspiration systems (p=0.04). The present study concludes that airborne fungal concentrations in podiatrist's clinics are consistent with national and international guidance. Occupational exposure to dermatophytes may briefly occur during definite periods across the daily activity despite the use of dust aspiration systems., Depto. de Medicina, Fac. de Medicina, TRUE, pub

Depto. de Medicina, Fac. de Medicina, TRUE, pub

The aim of the study was to explore the structure and growth dynamics of Staphylococcus aureus resistant to methicillin (MRSA) colonies using semithin sections visualized by light microscope. One S. aureus susceptible to methicillin (MSSA) and one MRSA clinical strains were studied. Colonies in agar plates were embedded in epoxy resin after each incubation period (24 h and 48 h) at 37 degrees . Semithin sections of 0.5 µm were stained with toluidine blue and visualized by light microscope. Microscopically, no structural differences were observed between SASM and SARM colonies but differences were observed in both strains between 24 and 48 h incubation periods. Colonies showed two layers clearly differentiated at 24 h independently of the resistance to methicillin: (A) one basal layer with high density of population in contact with culture media, and (B) one superficial layer with a lower density of population. Colonies showed four layers at 48 h: (A) one basal layer with high density of population; (B) one clear layer constituted by very degraded bacterial remains in which can be observed cocci dispersed with their dyeing properties; (C) one mixed layer constituted by viable bacteria and little degraded bacterial remains (D) one superficial layer with a lower density of population than basal layer. Colonial architecture is a complex and time-dependent process., Depto. de Medicina, Fac. de Medicina, TRUE, pub

Objective: Clinical studies claim that platelet-rich plasma (PRP) accelerates tissue healing due to its high concentration of growth factors and that the combination with leukocytes improves the antimicrobial effect of the concentrate. Most of these studies obtained PRP using different separation systems, and few analyzed the content of the PRP used for treatment. This study characterized the composition of PRP and white blood cells (WBC) from a single donor produced by three commercially available PRP separation systems and two anticoagulated general analytical tubes. Methods: Five patients donated 50 mL of blood, which was processed to produce PRP and WBC using three PRP concentration systems (i.e., Easy PRP Kit, GloPRP, and Wego) and two tubes for general analysis anticoagulated with ethylenediaminetetraacetic acid (EDTA) and citrate. Platelets and WBC in combination with their concentrates were analyzed by automated systems in a clinical laboratory. Results: There were no significant differences in the average concentrations of PRP platelets and WBC between GloPRP and the tubes for general analysis with EDTA and citrate; however, the Easy PRP Kit gave results much superior to the rest of the methods, especially comparing it with the Wego Kit, whose concentrates were especially low, even nonexistent for WBC. Conclusions: The Easy PRP Kit concentrates WBC-rich PRP, resulting in increased WBC concentrations, compared with low WBC-low PRP of GloPRP and general tube methods for EDTA and citrate analysis and the even lower concentration of PRP from the Wego Kit, with the absence of leukocytes, Depto. de Medicina, Fac. de Medicina, TRUE, pub

Objectives: the aims of the study were to explore the activity of total and free (according to protein binding) maximal concentrations achieved in serum after multiple doses of voriconazole 400/200 mg and anidulafungin 200/100 mg against Aspergillus fumigatus and Aspergillus flavus and the human albumin or serum effects on antifungal activity. Material and methods: Time-kill curves were performed with two A. fumigatus and two A. flavus strains at voriconazole and anidulafungin Cmax concentrations using different media: a) RPMI broth (Cmax-RPMI); b) RPMI with human serum (Cmax-HS), and c) RPMI with human albumin (Cmax-HAlb). In parallel, free-drug (fCmax) concentrations considering theoretical protein binding were performed in RPMI broth. Aspergillus metabolic activity was measured by the XTT reduction assay. Results: Voriconazol or voriconazole plus anidulafungin reduced >88.4% the metabolic activity of Aspergillus sp. at Cmax-RPMI and fCmax after 48 h of exposition. Anidulafungin alone showed poor metabolic reductions (<80.1% at Cmax- RPMI and <15% at fCmax). Anidulafungin activity, but not voriconazole activity alone or combined decreased in presence of HS or HAlb (more pronounced in A. flavus strains and HAlb). However, anidulafungin Cmax-HS or Cmax-HAlb against A. fumigatus strains were significantly more active (p<0.05) than fCmax in RPMI. These species and culture medium-dependent impact of human protein binding in the activity of anidulafungin was related to macroscopic and microscopic differences among mycelial mat grown in RPMI, HS or HAlb in whose XTT retention was different. Conclusions: Synergism could not be demonstrated due to the high activity showed by voriconazole. Protein binding has not impact on voriconazole activity and this impact is considerably less than predicted by free concentration extrapolated from theoretical binding rate on anidulafungin. The XTT colorimetric assay needs to be standardized for use with Aspergillus spp. since without DM, Depto. de Medicina, Fac. de Medicina, TRUE, pub

Las infecciones de piel y partes blandas (IPPB), y en particular las infecciones del pie de diabético (IPD), presentan complicaciones diagnósticas y terapéuticas, que a menudo desembocan en complicaciones graves. El objetivo de este estudio fue evaluar la eficacia in vitro de cefditoreno y amoxicilina/ ácido clavulánico frente a los microorganismos típicos de las IPD. Se analizaron muestras clínicas de 40 pacientes con IPPB leves mostrando un predominio de especies de Staphylococcus spp. y Streptococcus spp. Cefditoreno mostró frente al 90% de los aislados una potencia superior a la de la amoxicilina/ácido clavulánico. Estos resultados destacan la utilidad de cefditoreno en el tratamiento empírico de la IPD, aunque sería deseable disponer de un mayor tamaño muestral para una mejor validación., Skin and soft tissue infections (SSTIs), and particularly diabetic-related foot infections (DFI), present diagnostic and therapeutic complexities, often leading to severe complications. This study aims to evaluate the in vitro efficacy of cefditoren and amoxicillin/clavulanic acid against typical DFI pathogens. Clinical samples from 40 patients with mild SSTIs were analyzed, revealing a predominance of Staphylococcus spp. and Streptococcus spp. species. Cefditoren exhibited activity against 90% of isolates, with superior potency over amoxicillin/clavulanic acid. These findings underscore the utility of cefditoren in empirical treatment of DFI, although a larger sample size would be desirable for further validation., Meiji Pharma Spain, Depto. de Medicina, Fac. de Medicina, TRUE, pub

Semithin sections of colonies of three ATCC strains (Staphylococcus aureus, Escherichia coli, and Candida albicans) showed that their internal structure had specific patterns that evolved over the time. These patterns generally were defined by the presence of different layers composed of microorganisms with variable population densities and dead cells. The observed structures in this study could be explained as a particular form of biofilm with an air-semisolid interface., Depto. de Medicina, Fac. de Medicina, TRUE, pub

The aim of this study was to determine the survival of human pathogens (Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa) in five natural mineral waters (NMWs) with different properties and mineralization levels. Five NMWs from four Spanish spas with different dry residue at 110 °C were used: A = 76,935 mg/L; B = 1,827 mg/L; C = 808.4 mg/L; D = 283.8 mg/L; and E = 170.4 mg/L. An initial inoculum of 1 × 106 colony forming units (cfu)/mL was used for survival studies. Distilled water, chlorinated tap water and Mueller–Hinton broth were used as controls. Colony counts in all different waters were lower than those achieved with Mueller–Hinton broth over all incubation periods. A direct effect between the bacterial survival and the level of mineralization water was observed. The NMW E with low mineralization level along with the radioactive properties showed the highest antibacterial activity among all NMWs., Depto. de Medicina, Depto. de Radiología, Rehabilitación y Fisioterapia, Fac. de Medicina, TRUE, pub

Background Nail disorders are frequent among the geriatric population and unfortunately, repeat avulsionprocedures often result in complications.Objective To utilize a phenol-based total matricectomy technique for permanent nail ablation and evaluate itseffectiveness.Methods We performed total nail ablation on 34 toenails of the hallux (30 patients) with a gauze–phenolapplication technique and evaluated the degree of pain reported by the patient 12 months postoperatively comparedwith the preoperative stage. Furthermore, we evaluated the patients’ satisfaction with the final cosmetic appearanceas well as their satisfaction with the overall procedure.Results All patients reported ‘too much’ or ‘severe’ pain prior to surgery and 94.11% reported ‘no pain’ 12 monthspost-surgery. A vast majority of the patients (82.35%) felt pleased with the cosmetic results and all patients reportedthat they were ‘very satisfied’ or ‘strongly satisfied’ with the procedure when interviewed at their 12 month follow-upexamination.Limitations There were a limited number of participants in this study across an extensive timeframe.Conclusion Phenol-based total nail ablation with specific gauze application is safe, inexpensive and has a highrate of patient satisfaction., Depto. de Enfermería, Depto. de Medicina, Fac. de Enfermería, Fisioterapia y Podología, Fac. de Medicina, TRUE, pub

Objective: To evaluate cefditoren in inducer-substrate combinations to screen for AmpC induction. Methods: 100 clinical isolates (25 P. aeruginosa, 25 E. cloacae, 14 M. morganii, 13 S. marcescens, 12 C. freundii, 7 P. rettgeri, and 4 E. aerogenes) were tested by the Kirby-Bauer disc approximation method using cefditoren and ceftazidime discs as substrates, and cefditoren and imipenem discs as inducers. Results: None of the strains showed induction of AmpC with cefditoren-ceftazidime as inducer-substrate combination. Imipenem-cefditoren as inducer-substrate combination was not useful for evaluating strains of P. aeruginosa since no inhibition zones surrounding the cefditoren disc were found. Among evaluable enterobacteria (those showing substrate inhibition zone), inducible Amp C was detected in 48 out of 63 (76.2%) with cefditoren, and in 33 out of 68 (48.5%) isolates with ceftazidime as substrate. Significantly (p=0.013) higher number of AmpC producers were detected with cefditoren versus ceftazidime (76.2% vs. 48.5%), due to the differences found for E. cloacae (72.8% vs. 21.7%; p=0.0009) and S. marcescens (100% vs. 54.5%; p=0.03). Higher mean reductions of diameters around substrate discs were found for cefditoren (4.17 mm) vs. ceftazidime (3.79 mm), reaching statistical significance (p<0.05) for indol-positive proteae: M. morganii (5.32 mm vs. 3.92 mm) and P. rettgeri (3.47 mm vs. 2.64 mm). Conclusion: Cefditoren showed no induction capability, and when used as substrate (with imipenem as inducer) it offered detection rates of AmpC inducible enterobacteria higher than the imipenem-ceftazidime combination, mainly for Enterobacter spp. and Serratia spp., with higher diameter reductions for indol-positive proteae., Tedec-Meiji Farma S.A., Depto. de Medicina, Fac. de Medicina, TRUE, pub

This study evaluates the dynamic shift in the microbiota at the peri-implant site of titanium (Ti) and zirconia (Zr) implants subjected to experimental peri-implantitis (PI) and, for the first time, of implants made of ceria-stabilized alumina-reinforced zirconia (Ce-TZP/Al), a revolutionary zirconia that is set to play a key role in modern implant dentistry. One- and two-piece (TP) implants, including Ce-TZP/AL TP/G3 glass, were placed bilaterally (six implants/side) in five beagle dogs to mimic a natural vs. ligature-induced PI following a split-mouth design. The experiment spanned 30 weeks from tooth extraction. Both PI models promoted plaque deposition at peri-implant sites. Comparatively, the PI induced by ligatures favored the deposition of anaerobes (p = 0.047 vs. natural). Regardless of the model, the plaque deposition pattern was entirely dependent on the implanted material. Ligated Ti and Zr implant sites accumulated up to 2.14 log CFU/mL unit anaerobic load (p ≤ 0.033 vs. non-ligated implant sites), predominantly comprising obligate anaerobes. Naturally occurring PI induced the deposition of co-occurring networks of obligate anaerobes and less oxygen-dependent bacteria. PI induction favored the enrichment of Ti and Zr sites with bacterial taxa belonging to the orange and red complexes (up to 28% increase naturally and up to 71% in the ligated hemiarch). Anaerobic deposition was significantly lower in ligated Ce-TZP/Al implant sites (p ≤ 0.014 vs. TI and Zr) and independent of the induction model (0.63–1 log units of increase). Facultative bacteria prevailed at Ce-TZP/AL sites. The abundance was lower in the Ce-TZP/AL TP implant. Unlike Ti and Zr sites, taxa from the orange and red complexes were negligible. Biofilms configured at the Ti and Zr sites after ligation-induced PI resemble those found in severe IP. We hypothesize that, although surface properties (surface energy and surface roughness) and physicochemical properties of the substrate play an impo, Unión Europea, Depto. de Medicina, Fac. de Medicina, TRUE, pub

The surface adhesion of bacterial cells and the in vivo biocompatibility of a new ceramic–metal composite made of zirconium dioxide and tantalum were evaluated. Within the framework of an in vitro study using the crystal violet staining and colony counting methods, a relatively similar adhesion of Streptococcus oralis to the 3Y-TZP/Ta biocermet (roughness Ra = 0.12 ± 0.04 µm) and Ti-Al6-V4 titanium alloy (Ra = 0.04 ± 0.01 µm) was found. In addition, in an in vivo preliminary study focused on the histological analysis of a series of rods implanted in the jaws of beagle dogs for a six-month period, the absence of any fibrous tissue or inflammatory reaction at the interface between the implanted 3Y-TZP/Ta biocermets and the new bone was found. Thus, it can be concluded that the developed ceramic–metal biocomposite may be a promising new material for use in dentistry., Ministry of Science and Higher Education (Rusia), Depto. de Medicina, Fac. de Medicina, TRUE, pub

2023 Acuerdos transformativos CRUE, The current study aimed to evaluate the dispersal of solution and microbes (aerosol) in the clinical environment during treatment with Low-frequency contact ultrasonic debridement (LFCUD) with or without suction attachment in patients with diabetic foot ulcers (DFUs). We performed 20 treatments in 10 patients divided into two groups to receive the proposed LFCUD modalities. We measured the microbial load of the environment pre-treatment (sample M1), during treatment with each LFCUD modality (sample M2) and post-treatment (sample M3). The use of LFCUD debridement without a suction attachment results in significantly higher immediate contamination of the clinic environment than the suction attachment, particularly during the procedure (1.70 ± 0.98 log 10 CFU/mL versus 0.77 ± 0.85 log 10 CFU/mL, p = 0.035). When suction is not applied, there are statistically significant differences depending on whether the DFUs are neuropathic or neuroischemic, finding a greater number of microorganisms with high loads in neuropathic DFUs. We found a statistically significant positive correlation between wound area (r = 0.450, p = 0.047) and TBI (r = 0.651, p = 0.006) with the bacterial load during the LFCUD. Based on our results, we recommend using the personal protective equipment required to protect staff members and patients during treatment with LFCUD and using a suction attachment where clinically possible to reduce clinic environmental pollution, especially in neuropathic DFUs and those with larger areas., Depto. de Enfermería, Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub, APC financiada por la UCM

The aim of the study was to determine the presence of human papillomavirus (HPV) in patients with intractable plantar keratosis (IPK) by comparing the histopathological findings of biopsies. A prospective, observational, and concordance study was carried out. Three different specimens were taken from each IPK. A first punch was sent for histopathological examination, and a second punch and a superficial skin scraping were both sent for HPV polymerase chain reaction (PCR) and type determination. A total of 51 patients were included. From the histopathological examination, it was determined that 35 (68.6%) samples were diagnosed as warts and 16 (31.3%) as keratosis. However, the presence of HPV was confirmed by PCR in 49 (96.1%) and in 42 (82.4%) samples obtained by punch and superficial scraping, respectively. In the 49 PCR‐positive samples, the most common HPV types were HPV1, HPV2, HPV27, HPV57, and HPV65, accounting for 81.6% of the samples. In conclusion, this study demonstrates that HPV infection and IPK lesions are very closely related. Although we cannot confirm that HPV is the cause of the development of IPK, the high prevalence of HPV observed in these lesions calls for a change to the procedures for managing IPK., Depto. de Medicina, Fac. de Medicina, TRUE, pub

Few studies have checked the impact of the hormonal/immunological dimorphism of patients on the cellular composition of platelet-rich plasma products (PRP). Whole blood (WB) from 26 volunteers was concentrated using a device previously characterized. Platelet and white blood cell (WBC) counts in WB and PRP were compared between genders, and after the population was split into pre (≤50 years)- and post (>50 years)-menopausal ages. In WB, platelet–total WBC densities were comparable in men and women. The phagocytic cell composition differed (p ≤ 0.04). After dividing by ages, phagocytic cell discrepancies were linked to women > 50 years (p ≤ 0.05), and differences emerged in lymphocyte counts (lower in >50 years groups, within and between genders, p ≤ 0.05). In PRP, densities were significantly higher, but the PRP/WB ratios varied according to blood cell (lower for phagocytic cells) and between subjects (more favorable at a lower density of a particular blood cell in WB). This “system compensatory efficiency” reduced/reverted PRP differences in the leukocyte composition between genders/age–sex groups in WB. In PRP, neutrophils were higher in younger men than older women (p < 0.05). WB lymphocyte differences between age–sex groups persisted. Age is a more determining factor than sex in the preparation of PRP. Post-menopause, sexual dimorphism strongly influences the composition of leukocytes, also conditioned by the capture efficiency of the system., Depto. de Enfermería, Depto. de Medicina, Fac. de Enfermería, Fisioterapia y Podología, Fac. de Medicina, TRUE, pub

Background: Over-supination processes of the foot and ankle involving peroneus longus (PL) damage during running sports have been treated conservatively with passive control tools, such as tapes, braces, or external ankle supports, but the effect of orthoses with typical lateral wedging orthoses (TLWO) on the muscular activity of PL during running remains unclear. Here we investigate the effects of innovative medial cushioning orthoses (IMCO) on PL activity during the full running gait cycle. In addition, we wished to ascertain the effects of innovative medial cushioning orthoses (IMCO) on PL activity during running. Methods: Thirty-one healthy recreational runners (mean age 34.5 ± 3.33) with neutral foot posture index scores, were selected to participate in the present study. They ran on a treadmill at 9 km/h wearing seven different orthoses (NRS, IMCO 3 mm, IMCO 6 mm, IMCO 9 mm, TLWO 3 mm, TLWO 6 mm and TLWO 9 mm), randomly performed on the same day while electromyographic activity of the PL muscle was recorded. Statistical intraclass correlation coefficient (ICC) to test reliability was carried out and the Wilcoxon test with Bonferroni’s correction was developed to analyze the differences between the conditions. Results: the reliability of all assessments showed data higher than 0.81, that is, “almost perfect reliability”; all EMG PL values wearing either TLWO or IMCO showed a statistically significant reduction versus NRS during the fully analyzed running gait cycle; the highest difference was set on NRS 23.08 ± 6.67 to TLWO 9 mm 17.77 ± 4.794 (p < 0.001). Conclusions: Muscular EMG activity of the PL during the full running gait cycle decreases when wearing either TLWO or IMCO relative to NRS; therefore, these orthoses could be prescribed to treat the strain and overload pathologies of PL. In addition, IMCO—as it less thick, compared with TLWO—can be used when aiming to achieve better running economy., Depto. de Enfermería, Depto. de Medicina, Fac. de Enfermería, Fisioterapia y Podología, Fac. de Medicina, TRUE, pub

Las manos de los trabajadores de la salud son el vehículo más común para la transmisión de patógenos asociados a la asistencia sanitaria. La higiene de manos es la principal medida para prevenir la propagación de la resistencia a los antimicrobianos y para la reducción de estas infecciones. Sin embargo, el cumplimiento de los trabajadores sanitarios con las prácticas óptimas de higiene de manos sigue siendo insuficiente en la mayoría de los entornos. Uno de los objetivos de la seguridad del paciente es minimizar la transmisión de infecciones relacionadas con a la atención sanitaria, y de esta manera aumentar la seguridad de la atención al paciente a largo plazo. La evidencia científica estableció el uso estándar de la asepsia y antisepsia quirúrgica para determinar la seguridad de la práctica quirúrgica. Las infecciones del sitio quirúrgico (ISQ) contribuyen de manera importante a la morbilidad y la mortalidad en la atención posquirúrgica. La prevención de la infección quirúrgica se basa en la optimización de los factores de paciente y el uso de una variedad de medidas farmacológicas y no farmacológicas. La antisepsia de las manos sigue siendo la piedra angular de la asepsia quirúrgica para eliminar los microorganismos transitorios de la piel y reducir la microbiota residente. Actualmente, la antisepsia preoperatoria está soportada por el uso de cinco principios activos, alcohol, clorhexidina, yodo/yodóforos, paraclorometaxilenol y triclosán, pero no está claro qué producto o combinación antiséptica es más efectiva para prevenir la transmisión de las bacterias patógenas...

Las manos de los trabajadores de la salud son el vehículo más común para la transmisión de patógenos asociados a la asistencia sanitaria. La higiene de manos es la principal medida para prevenir la propagación de la resistencia a los antimicrobianos y para la reducción de estas infecciones. Sin embargo, el cumplimiento de los trabajadores sanitarios con las prácticas óptimas de higiene de manos sigue siendo insuficiente en la mayoría de los entornos. Uno de los objetivos de la seguridad del paciente es minimizar la transmisión de infecciones relacionadas con a la atención sanitaria, y de esta manera aumentar la seguridad de la atención al paciente a largo plazo. La evidencia científica estableció el uso estándar de la asepsia y antisepsia quirúrgica para determinar la seguridad de la práctica quirúrgica. Las infecciones del sitio quirúrgico (ISQ) contribuyen de manera importante a la morbilidad y la mortalidad en la atención posquirúrgica. La prevención de la infección quirúrgica se basa en la optimización de los factores de paciente y el uso de una variedad de medidas farmacológicas y no farmacológicas. La antisepsia de las manos sigue siendo la piedra angular de la asepsia quirúrgica para eliminar los microorganismos transitorios de la piel y reducir la microbiota residente. Actualmente, la antisepsia preoperatoria está soportada por el uso de cinco principios activos, alcohol, clorhexidina, yodo/yodóforos, paraclorometaxilenol y triclosán, pero no está claro qué producto o combinación antiséptica es más efectiva para prevenir la transmisión de las bacterias patógenas..., The hands of healthcare workers are often related to pathogens transmission in healthcare settings. Hand hygiene is a simple and effective measure to reduce nosocomial infections and to prevent the spread of antimicrobial resistance, but the adherence of healthcare workers to these preventive practices, remains insufficient. Long term safety of patient care increases by minimizing the transmission of health care-related infections. Scientific evidence establishment the standard use of surgical asepsis and antisepsis to guarantee the safety of surgical practice.Surgical site infections (SSIs) significantly contribute to morbidity and mortality in postoperative care. Prevention of surgical infection relies on optimization of patient factors and the use of a variety of pharmacological and non-pharmacological measures. Hand antisepsis continues to be a cornerstone of aseptic technique in surgery to eliminate transient microorganisms and reduce resident flora of the skin. Currently, there are mainly five products marketed to perform preoperative antisepsis that contain alcohol, chlorhexidine, iodine / iodophors, parachloromethaxylenol and Triclosán. However, it is not clear which antiseptic hand washing product is most effective in preventing the transmission of pathogenic bacteria...

[Abstract] Few studies have checked the impact of the hormonal/immunological dimorphism of patients on the cellular composition of platelet-rich plasma products (PRP). Whole blood (WB) from 26 volunteers was concentrated using a device previously characterized. Platelet and white blood cell (WBC) counts in WB and PRP were compared between genders, and after the population was split into pre (≤50 years)- and post (>50 years)-menopausal ages. In WB, platelet-total WBC densities were comparable in men and women. The phagocytic cell composition differed (p ≤ 0.04). After dividing by ages, phagocytic cell discrepancies were linked to women > 50 years (p ≤ 0.05), and differences emerged in lymphocyte counts (lower in >50 years groups, within and between genders, p ≤ 0.05). In PRP, densities were significantly higher, but the PRP/WB ratios varied according to blood cell (lower for phagocytic cells) and between subjects (more favorable at a lower density of a particular blood cell in WB). This "system compensatory efficiency" reduced/reverted PRP differences in the leukocyte composition between genders/age-sex groups in WB. In PRP, neutrophils were higher in younger men than older women (p < 0.05). WB lymphocyte differences between age-sex groups persisted. Age is a more determining factor than sex in the preparation of PRP. Post-menopause, sexual dimorphism strongly influences the composition of leukocytes, also conditioned by the capture efficiency of the system.

Antibiotic resistance in Streptococcus pneumoniae has increased worldwide, making fluoroquinolones an alternative therapeutic option. Fluoroquinolones inhibit the type II DNA topoisomerases (topoisomerase IV and gyrase). In this study we have evaluated the in vivo activity of seconeolitsine, an inhibitor of topoisomerase I. Levofloxacin (12.5 to 50 mg/kg) or seconeolitsine (5 to 40 mg/kg) were administered every 12 h during two days in mice infected with a serotype 8-resistant strain. At 48 h, a 70% protection was obtained with seconeolitsine (40 mg/kg; p < 0.001). However, survival with levofloxacin was 20%, regardless of the dose. In addition, seconeolitsine decreased bacteremia efficiently. Levofloxacin had higher levels in serum than seconeolitsine (Cmax of 14.7 vs. 1.6; p < 0.01) and higher values of area under the serum concentration-time curve (AUC0-12h of 17.3 vs. 5; p < 0.01). However, seconeolitsine showed higher levels of time to peak concentration and elimination half-life. This is consistent with the higher binding of seconeolitsine to plasma proteins (40% and 80% when used at 1 µg/mL and 50 µg/mL, respectively) in comparison to levofloxacin (12% at 5 µg/mL and 33% at 50 µg/mL). Our results suggest that seconeolitsine would be a promising therapeutic alternative against pneumococcal isolates with high fluoroquinolone resistance levels., Ministerio de Economía, Industria y Competitividad, Depto. de Medicina, Fac. de Medicina, TRUE, pub

Triclosan 0.5% by scrubbing does not meet the UNE-EN12791 criteria to be used in the surgical hand preparation (SHP). Triclosan 0.5% by scrubbing followed by ethanol 70% hand rubbing is suitable without the additional characteristic of sustained effect. This limited effectiveness implies that triclosan should be avoided in SHP given the restrictions on its use in consumer antiseptic products. The trial was registered at ClinicalTrials.gov (ID: NCT04538365)., Depto. de Medicina, Fac. de Medicina, TRUE, pub

CRUE-CSIC (Acuerdos Transformativos 2021), The methods that are used for the diagnostic confirmation of human papillomavirus (HPV) include excisional biopsy and histopathological studies or polymerase chain reaction (PCR). They are invasive, laborious, and subject to ethical restrictions due to the benign nature of these warts. This study aims to analyse the accuracy of noninvasive swab samples to diagnose plantar warts. Fifty plantar warts were included in the study. Skin swabs and hyperkeratosis skin scales were collected from each wart. Multiplex PCR was performed to detect and type the HPVs. The prevalence of HPV in this study was 90% when the sample was obtained using the wart scraping method and 94% when it was obtained using swabs and the new method. In 45 of the 45 positive samples (sensitivity: 100%), the result between the wart scab and wart swab were almost identical. The genotyping result was identical in all 46 patients who had a positive result using both methods. The swab method appears to be a simple and accurate technique to diagnose plantar warts due to HPV. It is a noninvasive technique that could be performed even by inexperienced professionals and in patients with pain or a fear of needles., Depto. de Enfermería, Depto. de Medicina, Fac. de Enfermería, Fisioterapia y Podología, Fac. de Medicina, TRUE, pub

Actualmente, se producen innumerables situaciones en las que el contacto que tienen las manos de los sanitarios con los enfermos acaba provocando de manera directa o indirecta una infección. En consecuencia, estas infecciones, provocan un ingreso hospitalario de mayor duración, una subida del coste para los sistemas de salud, agravamiento de la salud de los pacientes y en los peores casos la pérdida de vidas. Estas infecciones se producen por factores relacionados con la atención sanitaria, pero también están íntimamente relacionadas con factores económicos, geográficos, culturales además de las creencias de las distintas sociedades. A pesar de ello, gran parte de las infecciones se pueden evitar. Una de las soluciones más sencillas es la correcta higiene de las manos. Aún así, muchos de los profesionales sanitarios, omiten o realizan incorrectamente este acto. Un acto que reduciría drásticamente el número de infecciones en todo el planeta. Según las investigaciones sobre el incumplimiento de esta sencilla medida, se ha observado que se necesitan nuevos proyectos para promocionar, con cienciar y educar a los profesionales sanitarios en esta materia. Por ello nace: el Primer Desafío Global de la Seguridad del Paciente de la Organización Mundial de la Salud (OMS), “Una Atención Limpia es una Atención más segura”, cuyo fin último es mejorar los procedimientos y protocolos de la atención sanitaria. La Nueva Guía Global sobre la Higiene de Manos en la Atención de la salud, se elaboró con las aportaciones de más de un centenar de expertos mundiales de gran relevancia. Se puso en práctica en diversas zonas del planeta; desde países desarrollados con hospitales equipados con la última tecnología como en países en vías de desarrollo con pequeños consultorios obsoletos. Finalmente, esta guía vio la luz en 2009...

Actualmente, se producen innumerables situaciones en las que el contacto que tienen las manos de los sanitarios con los enfermos acaba provocando de manera directa o indirecta una infección. En consecuencia, estas infecciones, provocan un ingreso hospitalario de mayor duración, una subida del coste para los sistemas de salud, agravamiento de la salud de los pacientes y en los peores casos la pérdida de vidas. Estas infecciones se producen por factores relacionados con la atención sanitaria, pero también están íntimamente relacionadas con factores económicos, geográficos, culturales además de las creencias de las distintas sociedades. A pesar de ello, gran parte de las infecciones se pueden evitar. Una de las soluciones más sencillas es la correcta higiene de las manos. Aún así, muchos de los profesionales sanitarios, omiten o realizan incorrectamente este acto. Un acto que reduciría drásticamente el número de infecciones en todo el planeta. Según las investigaciones sobre el incumplimiento de esta sencilla medida, se ha observado que se necesitan nuevos proyectos para promocionar, con cienciar y educar a los profesionales sanitarios en esta materia. Por ello nace: el Primer Desafío Global de la Seguridad del Paciente de la Organización Mundial de la Salud (OMS), “Una Atención Limpia es una Atención más segura”, cuyo fin último es mejorar los procedimientos y protocolos de la atención sanitaria. La Nueva Guía Global sobre la Higiene de Manos en la Atención de la salud, se elaboró con las aportaciones de más de un centenar de expertos mundiales de gran relevancia. Se puso en práctica en diversas zonas del planeta; desde países desarrollados con hospitales equipados con la última tecnología como en países en vías de desarrollo con pequeños consultorios obsoletos. Finalmente, esta guía vio la luz en 2009..., Currently, there are innumerable situations in which the contact that the hands of the toilets have with the patients ends up causing an infection directly or indirectly. Consequently, these infections cause a longer hospital stay, an increase in the cost for health systems, worsening patients health and in the worst cases the loss of life. These infections are caused by factors related to health care, but they are also intimately related to economic, geographical, cultural factors in addition to the beliefs of different societies. Despite this, much of the infections can be avoided. One of the simplest solutions is the correct hand hygiene. Even so, many of the health professionals incorrectly omit or perform this act. An act that would drastically reduce the number of infections across the planet. According to investigations on the breach of this simple measure, it has been observed that new projects are needed to promote, raise awareness and educate health professionals in this area. Therefore, the First Global Patient Safety Challenge of the World Health Organization (WHO), “A Clean Care is a Safer Care”, whose ultimate goal is to improve health care procedures and protocols. The New Global Guide on Hand Hygiène in Health Care was prepared with the contributions of more than a hundred world experts of great relevance. It was implemented in various areas of the planet; from developed countries with hospitals equipped with the latest technology as in developing countries with small obsolete offices. Finally, this guide saw the light in 2009...

[Abstract] OBJECTIVE: Clinical studies claim that platelet-rich plasma (PRP) accelerates tissue healing due to its high concentration of growth factors and that the combination with leukocytes improves the antimicrobial effect of the concentrate. Most of these studies obtained PRP using different separation systems, and few analyzed the content of the PRP used for treatment. This study characterized the composition of PRP and white blood cells (WBC) from a single donor produced by three commercially available PRP separation systems and two anticoagulated general analytical tubes. METHODS: Five patients donated 50 mL of blood, which was processed to produce PRP and WBC using three PRP concentration systems (i.e., Easy PRP Kit, GloPRP, and Wego) and two tubes for general analysis anticoagulated with ethylenediaminetetraacetic acid (EDTA) and citrate. Platelets and WBC in combination with their concentrates were analyzed by automated systems in a clinical laboratory. RESULTS: There were no significant differences in the average concentrations of PRP platelets and WBC between GloPRP and the tubes for general analysis with EDTA and citrate; however, the Easy PRP Kit gave results much superior to the rest of the methods, especially comparing it with the Wego Kit, whose concentrates were especially low, even nonexistent for WBC. CONCLUSIONS: The Easy PRP Kit concentrates WBC-rich PRP, resulting in increased WBC concentrations, compared with low WBC-low PRP of GloPRP and general tube methods for EDTA and citrate analysis and the even lower concentration of PRP from the Wego Kit, with the absence of leukocytes

[Abstract] The benefit of autologous platelet-rich plasma (PRP) treatment is still underdiscussion. Variations in PRP products, consequence of the lack of astandardised protocol for the multitude of commercially available blood sepa-ration systems and the lack of knowledge of the optimal composition of PRPor its suitability for the proposed indication are some of the reasons behindclinical inconsistencies. The impact of inter-subject variability in PRP hasreceived less attention in comparison. The purpose of this study was to deter-mine the inter-subject variability, based on age, in the concentrates preparedby a new blood concentration system. Twenty-six healthy volunteers of bothgenders (29-93 years) were enrolled. Whole blood (WB) was collected fromeach participant to prepare PRP using the Easy PRP kit. Platelets and whiteblood cells (WBC) from WB and PRP were analysed after split population byage; patients younger than 65 years (n=13) and patients≥65 years old(n=13). Among the demographic characteristics tested, only age was signifi-cantly different between the groups. Cell capture efficiency of the system wasspecific for each type of blood cell and identical for both age groups. Plateletsand WBC in PRP were higher than in WB (P< .001). In WB, platelets andWBC concentrations were significantly lower in older group (P≤.035). Thesedifferences persisted in the prepared PRP (P≤.004). The ageing of populationhas a strong influence on the haematocrit and therefore on the composition ofPRP. Because the efficiency of blood separator system seems to be constantacross individuals, the inter-subject haematocrit variability based on age couldbe used as a predictor of resulting PRP. The clinical application of PRP shouldbe restricted to the specific cell capture capacity of the different commercialdevices

[Resumo] Introdución: as úlceras do pé diabético infectadas (UPDI) son enfermidades recalcitrantes que son difíciles de controlar. A infiltración de plasma rico en plaquetas (PRP) é beneficiosa para promover a cicatrización natural das feridas, pero a súa composición depende do dispositivo concentrador e do hemograma do suxeito. O papel dos leucocitos é fundamental, controlan a infección e restablecen a curación natural e non se examinou. Obxectivos: determinar a eficacia da PRP rica en leucocitos (LRPRP) en UPDIs e optimizar a terapia; actividade antimicrobiana, variabilidade LRPRP entre sistemas e suxeitos. Probabilidade de éxito. Material e métodos: desenvolvéronse ensaios clínicos e ex vivo para determinar a eficacia antimicrobiana de LRPRP en organismos prevalentes de UPDIs e a variación na composición entre sistemas e suxeitos. Resultados: as concentracións alcanzables de plaquetas e neutrófilos en LRPRP reducen ou conteñen carga orgánica (> 2log CFU/ml, plaquetas) (neutrófilos). O sistema Easy Kit é máis óptimo para obter densidades efectivas, aínda que a calidade celular do PRP-L depende do sistema, do sexo e da idade do suxeito. Conclusións: LRPRP restauraría o proceso de curación natural reducindo a carga de microorganismos. Despois de optimizar a terapia, calquera suxeito independentemente do sexo e a idade beneficiaríase do tratamento., [Resumen] Introducción: Las úlceras de pie diabético infectadas (UPDI) son afecciones recalcitrantes de difícil manejo. La infiltración de plasma rico en plaquetas (PRP) es beneficiosa por fomentar la cicatrización natural de heridas, pero su composición es dependiente del dispositivo concentrador y hemograma del sujeto. El papel de los leucocitos es determinante, controlan la infección y restauran la cicatrización natural, y no ha sido examinado. Objetivos: Determinar la efectividad del PRP rico en leucocitos (LRPRP) en UPDIs y optimizar la terapia; actividad antimicrobiana, variabilidad del LRPRP entre sistemas y sujetos. Probabilidad de éxito. Material y Métodos: Se desarrollaron ensayos clínicos y ex vivo para determinar la eficacia antimicrobiana del PRP-L en organismos prevalentes de UPDIs y la variación de composición entre sistemas y sujetos. Resultados: Concentraciones de plaquetas y neutrófilos alcanzables en LRPRP-reducen la biocarga (>2log UFC/ml, plaquetas) o la contienen (neutrófilos). El sistema Easy Kit es más óptimo para obtener densidades efectivas aunque la calidad celular del PRP-L depende del sistema y del sexo y edad del sujeto. Conclusiones: El LRPRP restauraría el proceso natural de cicatrización por reducción de la biocarga de microrganismos. Tras optimizar la terapia, cualquier sujeto con independencia del sexo y edad, se beneficiaría del tratamiento., [Abstract] Introduction: Infected diabetic foot ulcers (IDFUs) are recalcitrant ulcers with complicated clinical management. Platelet-rich plasma (PRP) infiltration is beneficial by promoting natural wound healing, but its composition is highly dependent on the concentration device and blood count of the subject. The role of leukocytes is decisive, they control infection and restore natural healing but it has not been examined. Objectives: To determine the effectiveness of the PRP rich in leukocytes (LRPRP) in DFIs and to optimize the therapy; antimicrobial activity, LRPRP variability between systems and subjects. Probability of clínical success. Material and Methods: Clinical and ex vivo trials were developed to determine the antimicrobial efficacy of LRPRP in prevalent organisms of DFIsand the compositional variation accordint to systems and subjects. Results: Achievable platelet and neutrophil concentrations in LRPRP reduce (> 2log CFU/ml, platelets) or contain (neutrophils) bioburden. The Easy Kit system is more optimal to obtain effective densities, although the cellular quality of LRPRP depends on the system and the sex and age of the subject. Conclusions: LRPRP would restore the natural healing process by reducing the bioburden of microorganisms. After optimizing therapy, any subject regardless of gender and age would benefit from treatment.

IP13-01530, Objectives: Bacterial viability and enrichment of resistance resulting from three different amikacin administration schedules with respect to haemodialysis (HD) were assessed against three OXA-48-producing Klebsiella pneumoniae isolated during an outbreak in a Spanish hospital. Methods: A previously described two-compartment dynamic system was used. Three possible amikacin administration schedules were simulated: (i) haemodialysis immediately after amikacin infusion (pre-HD); (ii) infusion immediately after haemodialysis (post-HD); and (iii) infusion at 50% interdialytic period. Amikacin standard dose (SD) and double dose (DD) were simulated for each schedule. Values of Cmax/MIC, Cmax/MPC (mutant prevention concentration), AUC0-48h/MIC, AUC0-48h/MPC and %TMSW (percentage of time that the concentration was inside the mutant selection window) were determined with experimental data and were correlated with the area under the bacterial killing curve of the total population and the resistant subpopulation. Results: Both with SD and DD, the pre-HD schedule resulted in increases at 48h in bacterial counts of the total population at the expense of enrichment of pre-existing resistant subpopulations from 12h onwards for all strains. The estimated %TMSW that prevented enrichment of resistant mutants was <61.5%. The AUC0-48h/MPC (with values of ≈40 being associated with countering of increases in resistant subpopulations) was better than the %TMSW as a predictive parameter. Conclusion: This study showed that the longest times concentrations were above the MPC (i.e. highest AUC0-48h/MPC, lowest %TMSW), the lowest enrichment of resistant subpopulations. This implies use of the highest possible amikacin dose (limited by toxicity) and post-HD as the best administration schedule., European Commission, Ministerio de Ciencia y Tecnología (España), Instituto de Salud Carlos III (España), Depto. de Medicina, Fac. de Medicina, TRUE, pub

Se ha planteado como objetivo la mejora de la calidad de la docencia de la Microbiología mediante la actualización de la metodología docente , introduciendo como actividad docente el aprendizaje activo basado en preguntas (inquiry-based learning:IBL) para conseguir mejorar las competencias que deberán adquirir los estudiantes como parte de su formación integral. En este estudio han participado 63 alumnos de Segundo Curso del Grado de Podología de la Universidad Complutense de Madrid (Curso 2017-2018), y se ha calculado el porcentaje de alumnos que participaron en las 4 pruebas (4IBL), 3 pruebas (3 IBL), en 2 (2 IBL), en 1 (1 IBL), y los que no participaron en ninguna y posteriormente se relacionó con las calificaciones obtenidas en la asignatura de Microbiología. Se incluyeron las preguntas IBL que se realizaron en clase en el campus virtual de la asignatura, pero incluyendo la corrección de las mismas.En los alumnos que realizaron alguna prueba IBL se obtuvieron calificaciones mejores que en aquellos que no habían participado en ninguna. Consideramos que el uso del campus virtual unido a la actualización en la metodología docente puede mejorar el rendimiento académico de los estudiantes de Microbiología, Our focus here is to improve teaching methods in University microbiology classes and the development of educational practices that explicit engage students while enhacing how they learn Microbiology. These practices including inquiry-based learning (IBL) in which students are actively engaged in the learning process for improving the skills to be acquired as part of their effective learning . This study included 63 Microbiology students of Second Year Degree in Podiatry at the Complutense University (Academic Year 2017-2018), and calculated the percentage of students who used these resources 4 IBL, 3 IBL , 2IBL , 1IBL , and that did not participate in any and subsequently related to the student performance in the Microbiology exam . The IBL questions that were done in class ,were included in the virtual campus , including the correction .Students who prepared IBL scored higher en exam questions , findings also indicate that this activity can measure learning and improve exam preparation. We believe that the benefits of active learning methods with virtual campus over lecture instruction are consistent and can increases student performance in Microbiology, Depto. de Medicina, Fac. de Medicina, TRUE, pub

Background: This study aimed to estimate the prevalence of methicillin-susceptible and -resistant Staphylococcus aureus (MSSA and MRSA) and methicillin-resistant Staphylococcus epidermidis (MRSE) nasopharyngeal carriage among Doctors of Podiatric Medicine (Podiatrists) and to determine the potential risk factors. Methods: A cross-sectional study was carried out in 2016-2017 among 239 podiatrists in Spain. The presence of MSSA, MRSA, and MRSE was determined by microbiological analysis of nasal exudate and antimicrobial susceptibility was determined. Each podiatrist completed a questionnaire. The questionnaire comprised various parameters such as sex, age, podiatry experience duration, underlying diseases, prior antibiotic treatment, hospitalization during the last year, and use of a protective mask, an aspiration system, or gloves. Results: The prevalence of MSSA, MRSA, and MRSE was 23.0%, 1.3%, and 23.8%, respectively. The MSSA prevalence was higher among podiatrists who did not use an aspiration system (32.3%) compared to those who did (19.3%; p = 0.0305), and among podiatrists with respiratory diseases (36.8%) compared to those without (20.8%; p = 0.0272). The MRSE prevalence was higher among men (33.7%) compared to women (8.6%; p = 0.0089), podiatrists aged ≥50 (38.5%) compared to ≤35 (17.8%; p = 0.0101), and podiatrists with ≥15 (39.3%) compared to ≤5 years of podiatry experience (12.5%; p = 0.0015). Among the S. aureus strains, 84.5% were resistant to penicillin, 22.4% to erythromycin, 20.7% to clindamycin, and 12.7% to mupirocin. The MRSE strains were resistant to penicillin (93.0%), erythromycin (78.9%), and mupirocin (73.7%). Conclusions: The prevalence of S. aureus and S. epidermidis nasal carriage is low among Spanish podiatrists compared to other health professionals., Depto. de Medicina, Fac. de Medicina, TRUE, pub

Background: Chlorhexidine and parachlorometaxylenol (PCMX) are antiseptics recommended for surgical hand antisepsis. To our knowledge, PCMX has not been evaluated for bactericidal efficacy "in vivo. Methods: We conducted a randomized, double-blind, controlled crossover trial to compare the bacterial loads on fingertips and fingernails under laboratory conditions after use of antiseptic test products, including chlorhexidine digluconate 4%, PCMX 3%, and a reference solution of propan-1-ol 60% (P-1). We assessed bacterial load after a prewash with soft soap, immediately after application of an antiseptic, and 3 hours after application and wearing of sterile, powder-free gloves. Our procedures followed those specified by European Norm (EN) 12791 for evaluating surgical hand antiseptics and using cotton swab for fingertips and fingernails. Results: Chlorhexidine digluconate 4% and PCMX 3% did not decrease bacterial load on the hands. The bactericidal performances of chlorhexidine digluconate 4% and PCMX 3% did not differ significantly. Chlorhexidine digluconate 4% and PCMX 3% increased bacterial load on the fingertips after participants had worn gloves for 3 hours. Fingernails had greater bacterial loads than skin on the fingertips. Conclusions: Chlorhexidine digluconate 4% and PCMX 3% had similar bactericidal efficacy, but they failed to meet the EN 12791 efficacy standard. Fingernails should be a particular focus of antisepsis in preparation for surgery.The trial was registered at ClinicalTrials.gov (ID: NCT02500758)., Depto. de Medicina, Fac. de Medicina, TRUE, pub