El implante de condrocitos autólogos en la red sanitaria pública de Andalucía. Resultados tras 6 años de circuito asistencial.

Objective: To asses the results of Autologous Chondrocyte Implantation (ACI) whith periosteal patch and To propagate the care circuits existing about in Andalusia. Material and Methods: From its of ficial licence in 2005, the tissue bank and the Virgen de la Victoria Hospital from Málaga, performed the ACI in the Andalusian public health system. 16 patients has been operated between 2006-2013, whith medium follow-up 47,6 months (6 months-6 years), from public hos- pitals throughout Andalucia, managed by hospital admission source and destination. Physiologically younger patients were selected (<50 años), with singles, > 2cm2 symptomatics chondral lesions, in stables and well aligned knees. ACI was used as res- cue procedure after microfracture ́s failure except osteochondritis dissecans. To assess the results the Concinnati score and the Short Form 36 (SF-36) score were used. A descriptive analysis was performed and non-parametric tests were used to establish correlations and compare results. Results: In 15 patients with more than one year of follow-up: 14 men(87.5%) and 2women (14.5%), medium age 28.2 years old (min 17 max 43), the lesion was located into de femoral condyle, mostly in the internal one (81,2%) with medium size 2,7cm2(2-4,2). We founded significant improvement (p<0,001), both daily activities ( 89,3% preop. limitatión - 9% postop), as in the sports (90,2% preop limitatión - 38% postop) and the exploration of the knee (67,7% hpatological findings preop- 13,3%postop). The SF-36 score improved in all categories, over all in mental health (p> 0,01). The patient satisfaction was high or very high in 12 of the 15 patients ( 80%), and low in 3 patients. Conclusions: ACI improve quality of life and knee function in femoral condyle chondral lesions. The case ́s selection and the collaboration with Tissue Bank, allows us to create care circuits for treatment of patients from other provinces in the Public Sanitary Health System in Andalucia. It is necessary to increase the experience with this type of therapy, consolidating multicenter workgroups that provide strength to the conclusions.

Incremento de la participación de Atención Primaria en la asistencia al virus de la inmunodeficiencia humana: opinan los profesionales de las unidades hospitalarias.

AIM To determine the opinions of infectious diseases professionals on the possibilities of monitoring patients with HIV in Primary Care. DESIGN Qualitative study using in-depth interviews. LOCATION Infectious Diseases Unit in the University Hospital "Virgen de la Victoria" in Málaga. PARTICIPANTS Health professionals with more than one year experience working in infectious diseases. A total of 25 respondents: 5 doctors, 15 nurses and 5 nursing assistants. METHOD Convenience sample. Semi-structured interviews were used that were later transcribed verbatim. Content analysis was performed according to the Taylor and Bogdan approach with computer support. Validation of information was made through additional analysis, expert participation, and feedback of part of the results to the participants. RESULTS Hospital care professionals considered the disease-related complexity of HIV, treatment and social aspects that may have an effect on the organizational level of care. Professionals highlighted the benefits of specialized care, although opinions differed between doctors and nurses as regards follow up in Primary Care. Some concerns emerged about the level of training, confidentiality and workload in Primary Care, although they mentioned potential advantages related to accessibility of patients. CONCLUSIONS Physicians perceive difficulties in following up HIV patients in Primary Care, even for those patients with a good control of their disease. Nurses and nursing assistants are more open to this possibility due to the proximity to home and health promotion in Primary Care.

La consulta de terapia antitrombótica: progresando hacia la Enfermería de Práctica Avanzada.

There is currently around one million people receiving oral anticoagulants in Spain. The drug most used is acenocoumarol, which requires coagulation monitoring to ensure that the patient is within its normal therapeutic range. Patients usually start this treatment in a hospital clinic and, when they are stabilised, they are referred to primary care, where they are followed-up by their community nurses. The usual practice is that nurses are responsible for changes in the dose when the patients are outside the range. This practice is not performed by hospital nurses, despite having sufficient experience and knowledge to adequately manage these types of patients. An Advanced Nursing Practice model has been introduced into the Haematology management unit of the Hospital Universitario Virgen de la Victoria, Málaga. This involves various aspects of attention and care of patients on anticoagulant therapy, and includes adjusting the doses of their treatment following a catalogue of therapeutic and diagnostic ranges.

Caracterización geográfica de los aceites de oliva vírgenes de la denominación de origen protegida ’Les Garrigues’ por su perfil de ácidos grasos

Se ha analizado el perfil de ácidos grasos en 190 muestras de aceite de oliva virgen de la DOP Les Garrigues (Lleida) de tres campañas consecutivas (1995/96, 1996/97 y 1997/98). Se ha encontrado que la mayor variabilidad entre los ácidos grasos es debida a aspectos relacionados con la climatología de la campaña oleícola y con la procedencia de los aceites. El análisis de componentes principales ha permitido obtener dos componentes principales que explican más del 80 % de la variabilidad observada. La representación de los aceites según sus componentes principales, permite separar aceites procedentes de dos subzonas con diferencias agroclimáticas. Se ha aplicado un análisis discriminante paso a paso y se ha obtenido una función que ha permitido clasificar correctamente en la subzona de procedencia más del 83 % de los 188 aceites. El modelo ha sido validado con 20 muestras de aceites procedentes de la campaña 1998/99, habiéndose clasificado correctamente el 84,6 % de las muestras.

La diocésis de Querétaro en la solemne coronación de su augusta madre Santa María de Guadalupe y décima peregrinación al santuario del Tepeyac, en 13 de octubre de 1895.

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La vierge légende sacrée en quatre scénes de Ch. Grandmougin; musique de J. Massenet

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La Madre de Dios, Madre de los hombres

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La aparición de Nstra. Señora de Guadalupe de México.

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La estrella del norte de México, historia de la milagrosa imagen de María Stma. de Guadalupe, escrita en el siglo XVII

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La hija de Nazareth : poema religioso dividido en diez y ocho cantos, desde la Concepción de María Santísima hasta su gloriosa Asunción, con la salutación del Ave María

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La pintura humana sobrepuesta en el lienzo guadalupano: estudio en contestación a una carta correctoria

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La causa guadalupana : los últimos veinte años (1875-1895), conel final de la coronación de la celeste imagen del Tepeyac

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La aparición de Nuestra Señora de Guadalupe de México, comprobadacon documentos históricos y defendida de las impugnaciones que se le han hecho

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Memorandum de la solemne velada literaria habida en el Colegio del Sagrado Corazón de Jesús de Pátzcuaro el 9 de dbre. de 1899 para celebrar la coronación de Nuestra Señora de la Salud

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Visita de Ntra. Sra. de la Salud, que se venera en su ermita extramuros de la ciudad de León.

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