Quality of life and persistent symptoms after hospitalization for COVID-19. A prospective observational study comparing ICU with non-ICU patients.

BACKGROUND: Hospitalized COVID-19 patients are prone to develop persistent symptoms and to show reduced quality of life following hospital admission. METHODS: Prospective cohort study of COVID-19 patients admitted to a hospital from March 1 to April 30, 2020. The primary outcome was to compare health related quality of life and persistent symptoms six months after hospital admission, of COVID-19 patients who required ICU admission with those who did not. RESULTS: Among the 242 patients hospitalized during the defined period of time, 44 (18.2%) needed ICU admission. Forty (16.5%) patients died during hospital admission. Two hundred and two (83.5%) patients were discharged alive from the hospital. At six months, 183 (75.6%) patients completed the questionnaires (32 ICU patients and 151 non ICU patients). Ninety-six (52.4%) reported decreased quality of life and 143 (78.1%) described persistent symptoms. More ICU patients showed worsening of their quality of life (71.9% vs 43.7%, P=0.004). There were no differences in the proportion of patients with persistent symptoms between ICU and non ICU patients (87.5% vs 76.2%, P=0.159). ICU patients showed more frequently dyspnea on exertion (78.1% vs 47.7%, P=0.02), dyspnea on light exertion (37.5% vs 4.6%, P<0.001), and asthenia (56.3 vs 29.1, P=0.003). CONCLUSIONS: Survivors of COVID-19 needing hospitalization had persistent symptoms and a decline in the quality of life. ICU patients referred a large decrease of their quality of life compared with non ICU patients.

[Quality of life and persistent symptoms after hospitalization for COVID-19. A prospective observational study comparing ICU with non-ICU patients]. / Calidad de vida y síntomas persistentes tras hospitalización por COVID-19. Estudio observacional prospectivo comparando pacientes con o sin ingreso en UCI.

Background: Hospitalized COVID-19 patients are prone to develop persistent symptoms and to show reduced quality of life following hospital admission. Methods: Prospective cohort study of COVID-19 patients admitted to a hospital from March 1 to April 30, 2020. The primary outcome was to compare health related quality of life and persistent symptoms six months after hospital admission, of COVID-19 patients who required ICU admission with those who did not. Results: Among the 242 patients hospitalized during the defined period of time, 44 (18.2%) needed ICU admission. Forty (16.5%) patients died during hospital admission. Two hundred and two (83.5%) patients were discharged alive from the hospital. At six months, 183 (75.6%) patients completed the questionnaires (32 ICU patients and 151 non ICU patients). Ninety-six (52.4%) reported decreased quality of life and 143 (78.1%) described persistent symptoms. More ICU patients showed worsening of their quality of life (71.9 vs. 43.7%, P = 0.004). There were no differences in the proportion of patients with persistent symptoms between ICU and non ICU patients (87.5 vs. 76.2%, P = 0.159). ICU patients showed more frequently dyspnea on exertion (78.1 vs. 47.7%, P = 0.02), dyspnea on light exertion (37.5 vs. 4.6%, P < 0.001), and asthenia (56.3 vs. 29.1, P = 0.003). Conclusions: Survivors of COVID-19 needing hospitalization had persistent symptoms and a decline in the quality of life. ICU patients referred a large decrease of their quality of life compared with non ICU patients.

Recent epidemiological trends in extrapulmonary TB in Galicia, Spain.

OBJECTIVE: To describe the epidemiological trends and characteristics of extrapulmonary tuberculosis (EPTB) in Galicia, Spain, from 2000 to 2019.METHODS: This was a retrospective cohort study based on data from the Galician TB information system.RESULTS: Of the total number of TB cases (n = 15,871), 5,428 (34.2%) had EPTB. The absolute number of cases and incidence of EPTB decreased dramatically (from 480 cases and 17.8 cases/100,000 in 2000, to 172 and 6.4 cases/100,000 in 2019, respectively), with a mean annual decrease of respectively 64% and 4.7% for absolute cases and incidence rates. The risk for EPTB was higher in men than in women (RR 3.86, 95% CI 3.66-4.07). The most frequent age group was 15-44 years (2,234 patients, 41.2%); overall reductions per age group were 82% (0-14 years), 75% (15-44 years), 44% (45-64 years) and 63% (≥65 years), with statistically significant differences. The most frequently locations were the pleura (1,916 cases; 35.3%) and the lymph nodes (1,504; 27.7%).CONCLUSION: The incidence of EPTB in Galicia has decreased significantly in the last 20 years. The epidemiological characteristics have not changed, except for the number of patients with risk factors. This improvement of EPTB epidemiological trends coincides with the implementation of the programme for the prevention and control of TB, which suggests that it has been very effective in the control of the EPTB.

A new morphologic classification of the alveolar ridge after distraction osteogenesis in human patients. A 17 years retrospective case series study.

BACKGROUND: To perform a morphologic classification based on the results of bone augmentation after a distraction osteogenesis. MATERIAL AND METHODS: Thirty-four (34) patients (24 women and 10 men; mean age, 47.1 years (SD=9.5); age range, 23 to 62 years) underwent a total of 42 alveolar ridge distractions before the placement of a total of 89 dental implants. Ridge bone morphology was evaluated as the main ordinal variable. Chi-squared, Kruskal-Wallis and ANOVA one-way test were used. RESULTS: Category I (30.95%): consisted of wide alveolar rim and no bone defects Category II (28.57%): wide alveolar rim, lateral bone surface concavity. Category III (23.81%): narrow alveolar rim, lateral bone surface concavity. Category IV (2.38 %): distraction transport segment forming a bridge, without bone formed beneath and requiring guided bone regeneration. Category V (9.52%): return of the transport segment to its initial position due to the reverse rotation of the distractor screw. Category VI (4.76 %): distraction transport segment completely lost. Subcategory D (28.57%), consisted of lingual deviation of the distraction axis, occurring in any of the categories I to IV. More men (76.9 %) presented with category I (p<0.001). The use of the chisel resulted mainly in categories I and II (69.4 %) (p<0.001). GBR was only required in 23.1 % of the cases in Category I (p=0.011). The bone height achieved decreases as the category increases, due to the accompanying osteogenic limitations (p<0.001). The implants placed in category I were longer 11.5 ± 0.9 mm (CI95% 10.9-11.9 mm) compared to those placed in category III with a length of 10.4 ± 1.5 mm (CI95% 9.5-11.4 mm) (p=0.035). CONCLUSIONS: The alveolar ridge after distraction osteogenesis could be divided into six morphologic categories which provide a useful basis for decision-making regarding implant placement.

Differential hepatic oxidative status in steers with divergent residual feed intake phenotype.

Oxidative stress occurs when oxidant production exceeds the antioxidant capacity to detoxify the reactive intermediates or to repair the resulting damage. Feed efficiency has been associated with mitochondrial function due to its impact on cell energy metabolism. However, mitochondria are also recognized as a major source of oxidants. The aim of this study was to determine lipid and protein oxidative stress markers, and gene and protein expression as well as activity of antioxidant enzymes in the liver of steers of divergent residual feed intake (RFI) phenotypes. Hereford steers (n = 111) were evaluated in post-weaning 70 days standard test for RFI. Eighteen steers exhibiting the greatest (n = 9; high-RFI) and the lowest (n = 9; low-RFI) RFI values were selected for this study. After the test, steers were managed together under grazing conditions until slaughter when they reached the slaughter body weight. At slaughter, hepatic samples were obtained, were snap-frozen in liquid nitrogen and stored at -80°C until analyses. Hepatic thiobarbituric acid reactive species and protein carbonyls were greater (P = 0.05) and hepatic 4-hydroxynonenal protein adducts tended (P = 0.10) to be greater for high- than low-RFI steers. Hepatic gene expression glutathione peroxidase 4, glutamate-cysteine ligase catalytic subunit and peroxiredoxin 5 mRNA was greater (P ≤ 0.05) and glutathione peroxidase 3 mRNA tended (P = 0.10) to be greater in low- than high-RFI steers. Hepatic protein expression and enzyme activity of manganese superoxide dismutase and glutathione peroxidase enzyme activity tended (P ≤ 0.10) to be greater for low- than high-RFI steers. High-efficiency steers (low-RFI) probably had better hepatic oxidative status which was strongly associated with greater antioxidant ability near to the oxidant production site and, therefore, reduced oxidative stress of the liver. Decreased hepatic oxidative stress would reduce maintenance requirements due to a lower protein and lipid turnover and better efficiency in the use of energy.

Periconceptional undernutrition modifies endocrine profiles and hepatic gene expression in sheep.

This study investigated whether a 22-day period of undernutrition (half maintenance) could affect maternal endocrine responses and liver gene expression during early pregnancy (day 7). Thirty-five ewes were fed 1.5 (n = 15) or 0.5 (n = 20) their maintenance requirements and slaughtered on day 7 of the oestrus cycle or pregnancy (oestrus = day 0). Insulin, IGF, leptin and non-esterified fatty acids (NEFA) were determined on days -14, 0 and 7. Transcripts of the IGF family and adipokines receptors were determined in the liver by real-time RT-PCR. Underfed animals presented lower body weight and body condition, greater plasma concentration of NEFA, and lower plasma concentrations of leptin, insulin and IGF1 compared to adequately fed animals. Underfed ewes presented greater hepatic expression of IGFBP2 than well-fed ewes, but tended to have lesser expression of IGFBP5. While no effect of undernutrition on IGFBP4 and ADIPOR2 mRNA expressions was observed, they were increased by pregnancy in underfed animals. This study shows that undernutrition modifies endocrine profiles and hepatic gene expression of IGFBP2 and 5. The pregnancy status increased hepatic gene expression of IGFBP4 and ADIPOR2 mRNA in undernourished ewes.

Potential of Spartina maritima in restored salt marshes for phytoremediation of metals in a highly polluted estuary.

Sedimentary abiotic environment, and concentration and stock of nine metals were analyzed in vegetation and sediments to evaluate the phytoremediation capacity of restored Spartina maritima prairies in the highly polluted Odiel Marshes (SW Iberian Peninsula). Samples were collected in two 10 -m long rows parallel to the tidal line at two sediments depths (0-2 cm and 2-20 cm). Metal concentrations were measured by inductively coupled plasma spectroscopy. Iron, aluminum, copper, and zinc were the most concentrated metals. Every metal, except nickel, showed higher concentration in the root zone than at the sediment surface, with values as high as ca. 70 g Fe kg(-1). The highest metal concentrations in S. maritima tissues were recorded in its roots (maximum for iron in Spartina roots: 4160.2 +/- 945.3 mg kg(-1)). Concentrations of aluminum and iron in leaves and roots were higher than in superficial sediments. Rhizosediments showed higher concentrations of every metal than plant tissues, except for nickel. Sediment metal stock in the first 20 cm deep was ca. 170.89 t ha(-1). Restored S. maritima prairies, with relative cover of 62 +/- 6%, accumulated ca. 22 kg metals ha(-1). Our results show S. maritima to be an useful biotool for phytoremediation projects in European salt marshes.

Association of SNP of neuropeptide Y, leptin, and IGF-1 genes with residual feed intake in confinement and under grazing condition in Angus cattle.

In this study we quantify and compare the phenotypic variation in residual feed intake (RFI) in 2 groups of Angus female calves: one carrying simultaneously putative favorable allelic variants (SNP) of neuropeptide Y, leptin, and IGF-1 genes (VAL group) and another devoid of such alleles (CON group). We performed 2 sequential trials: under confinement feeding a high-concentrate diet and under grazing condition. In confinement, 38 purebred Angus female calves [mean age and BW of 247 d (SD = 15) and 186 kg (SD = 33.2), respectively] were offered a total mixed ration diet (60:40 concentrate: alfalfa hay, as fed) ad libitum during 57 d. Dry matter intake was estimated from the difference between offered and refused feed; BW was recorded every 2 wk. Under grazing, 12 heifers from each group were ranked by BW and RFI and randomly assigned to 4 pasture paddocks. Heifers were continuously stocked at high-quality, high-herbage-mass mixed pasture. Herbage DMI was determined using the n-alkane technique. Different models were used to determine RFI: models that use phenotypic data [RFI as described by Koch et al. (1963; RFIK) and RFI as described by ME (RFIME)] and models that use standards feeding data [RFI estimated by Fan et al. (1995; RFIF) and RFI in which the expected DMI was derived from equations in Standing Committee on Agriculture (1990; RFISCA)]. Least squares mean values (SE) of DMI (kg/d), metabolizable energy intake (MEI; Mcal/d), ADG (kg), RFIK (kg DM/d), and feed conversion ratio (FCR; kg DMI/kg ADG) for VAL and CON genotype groups were 6.65 and 6.89 (0.49), 16.7 and 17.4 (1.44), 1.24 and 1.24 (0.03), -0.11 and 0.11 (0.09), and 5.8 and 5.8 (0.14), respectively, in the confinement trial. In the grazing trial least squares mean values (SE) of herbage DMI (kg/d), ADG (kg), MEI (Mcal/d), RFIK, and FCR of VAL and CON groups were 8.76 and 10.93 (0.71), 1.4 and 1.37 (0.05), 25.5 and 31.7 (2.09), -1.02 and 1.02 (0.42), and 6.41 and 6.96 (0.46), respectively. Genotyped groups tended to differ in DMI (P = 0.10), in MEI (P = 0.06), and in RFIK (P = 0.10), differed in RFIF (P = 0.010), and did not differ in ADG or FCR during confinement. During grazing, genotyped groups differed in DMI (P = 0.005), in MEI (P = 0.006), and in RFIK (P = 0.002) but did not differ in ADG and FCR. Our results demonstrate a strong association between these 3 SNP and RFI when animals were grazing on a high-quality, high-availability pasture, whereas a weak effect was observed under confinement.

[Multiple familial osteochondromatosis: presentation of a case]. / Osteocondromatosis múltiple familiar: a propósito de un caso.

Enchondromas are benign cartilage tumours that grow slowly in the bone metaphysis. They may involve solitary or multiple lesions. Enchondromatoses include a heterogeneous group of hardly distinguishable syndromes characterised by the presence of multiple enchondromas that may cause musculoskeletal malformations (secondary to limb shortening), scoliosis, pathological fractures, or pseudoarthrosis. The most dreaded complication, osteochondrosarcoma, occurs in up to 25% of patients. We present the case of a 67-year-old male with no previous diagnosis, requiring attention due to the appearance of a painful tumour in his left hip which degenerated rapidly over the past year. Family history and clinical-radiological data confirmed the diagnosis of Multiple Familial Osteochondromatosis. Although clinical evolution and imaging led to suspect a malignant degeneration (osteochondrosarcoma), this was not confirmed by the histopathological study of the surgical sample.

Calf foetal and early life nutrition on grazing conditions: metabolic and endocrine profiles and body composition during the growing phase.

The aim of this study was to determine the effect of nutrition during foetal and lactation periods on calf growth and body composition, and their association with changes in metabolic and endocrine profiles during the calf first year of life on purebred (Hereford and Angus) and cross-bred (F1) dam offspring. Forty cross-bred calves and their dams (purebred--PU: Hereford and Angus, and cross-bred--CR: F1) were used in a randomized block design with a factorial arrangement of herbage allowance of native pastures (high: Hi-HA and low: Lo-HA), 4 vs. 2.5 kg dry matter/kg body weight (BW) and dam genotype (PU vs. CR). Calf BW and blood samples were collected monthly from birth to 380±15 days of age, and body composition was estimated by the urea dilution technique at weaning (142±15 days) and 380 days. Calf birthweight did not differ among groups but from birth to 380 days, and BW was reduced (p=0.046) in Lo-PU offspring. Although Lo-CR calves achieved similar BW than Hi-PU and Hi-CR offspring, they showed an increased fat in detriment of lean tissue deposition. At birth, plasma total protein was less (p=0.04), while plasma glucose, insulin or IGF-I tended or were greater (p<0.072) in Hi-HA than Lo-HA calves. Greater (p<0.03) plasma total protein and/or glucose concentrations during the first months of lactation were observed in CR offspring associated with the greater dam milk production. Although glucose concentrations did not differ among calf groups after weaning, plasma insulin was greater (p=0.004) in Hi-PU than other groups at 380 days. Consistent with the reduced BW, Lo-PU offspring presented the lowest (p=0.026) plasma IGF-I from birth to 380 days. Herbage allowance of native grasslands during calf foetal and lactation periods interacted with maternal heterosis to affect, in the short and/or long term, calf BW or body composition, and metabolic and endocrine profiles.

CHRNA7 haplotypes are associated with impaired attention in euthymic bipolar disorder.

BACKGROUND: Bipolar disorder (BD) patients show a deficit in sustained attention during euthymic periods. This deficit may be relevant for genetic studies in these patients. The α7 cholinergic receptor plays an important role in attentional deficit in humans and animal models. Moreover, there is evidence suggesting the role of the alpha 7 nicotinic cholinergic receptor subunit gene (CHRNA7) in BD susceptibility. The aim of the present study was to investigate the impact of CHRNA7 in sustained attention performance. METHODS: We studied the association of a promoter variant (-86C/T) and three intronic polymorphisms, rs883473, rs6494223 and rs904952, in the non-duplicated region of CHRNA7 with sustained attention in 143 euthymic BD patients (based on DSM-IV criteria) and 101 healthy subjects. Sustained attention was assessed by the degraded stimulus (DS-CPT) version of Continuous Performance Test. Age, gender, years of education and IQ (WAIS vocabulary subtest) were controlled in the analyses as potential confounders. RESULTS: Several candidate polymorphisms showed significant associations with different measures of the neuropsychological task for bipolar group. The CTCT haplotype was associated with an improvement in the attentional task performance in the BD group (p ≤ 0.025). On the other hand, different low frequency haplotypes showed influence in bipolar attentional performance (p ≤ 0.026). LIMITATIONS: A replication study using larger samples may be required for conclusive results. CONCLUSIONS: Our results point toward a slight association of CHRNA7 genotypes and haplotypes with sustained attention performance in euthymic patients with BD.

Ecotypic variations in phosphoenolpyruvate carboxylase activity of the cordgrass Spartina densiflora throughout its latitudinal distribution range.

This study compared the specific activity of phosphoenolpyruvate carboxylase (PEPC) of Spartina densiflora Brongn., collected from four populations along its latitudinal distribution range. Spartina densiflora is a halophyte with C(4) photosynthesis that has a very wide latitudinal distribution, from Patagonia to the southwest Iberian Peninsula. The basis of intraspecific differences in PEPC activity were analysed by recording the phosphorylation state and amount of the enzyme, comparing leaf anatomy and evaluating leaf gas exchange. S. densiflora individuals from Patagonia had 60% higher PEPC specific activity than plants from the other three populations due to higher levels of PEPC protein that coincided with lower activation mediated by phosphorylation, yielding similar net photosynthesis rate (c. 29 micromol CO(2)xm(-2)xs(-1)). Patagonian plants had a higher area of photosynthetic mesophyll relative to total chlorophyll than plants from north Argentina and the southwest Iberian Peninsula. Ecotypic differentiation in PEPC activity and leaf anatomy were found, distinguishing a higher-latitude ecotype from lower-latitude populations. The higher PEPC protein levels of the Patagonian ecotype seemed to be a response to lower light activation level of the enzyme, as judged by the low PEPC phosphorylation state.

Ultrastructural characteristics of blood cells of juvenile loggerhead sea turtles (Caretta caretta).

Ultrastructural characteristics of erythrocytes, heterophils, eosinophils, lymphocytes, monocytes and thrombocytes of the loggerhead sea turtle (Caretta caretta) were evaluated, using blood samples from 15 healthy juvenile animals. Except for the eosinophils, the rest of the white blood cells from loggerhead turtles had similar ultrastructural characteristics compared with blood cells from other sea turtle species. Eosinophils from loggerhead turtles were homogeneous in size, and no crystalline structures were observed within the granules. This paper provides an ultrastructural characterization of blood cells of loggerhead sea turtles, as a reference for future haematological studies of this species.

Progressive supranuclear palsy-like parkinsonism resulting from occupational exposure to lead sulphate batteries.

A 53-year-old man who had worked for 17 years manufacturing car batteries, with overt exposure to lead, developed a clinical picture initially characterized by signs of parkinsonism, followed by atypical signs such as loss of memory, reduction of eye movement, dysarthria, chorea-like dyskinesia and sexual impotence. The diagnosis of atypical parkinsonism was eventually changed to progressive supranuclear palsy-like parkinsonism. The patient was treated with various anti-Parkinson's disease drugs, including levodopa, with modest improvement. The symptoms deteriorated progressively, leading to permanent occupational disability with noticeable limitation of daily activities. Toxicological studies revealed abnormally high blood levels of lead. Discontinuation of lead exposure was followed first by clinical stabilization and then steady improvement. This case confirms recent reports that link exposure to lead and its compounds with degenerative diseases of the central nervous system, such as Parkinson's disease.

Morphologic and cytochemical characteristics of blood cells of juvenile loggerhead sea turtles (Caretta caretta).

A morphologic classification based on the cytochemical characteristics of blood cells of 35 juvenile loggerhead sea turtles (Caretta caretta) is described. Cytochemical stains included benzidine peroxidase, chloroacetate esterase, alpha-naphthyl butyrate esterase (with and without sodium fluoride), acid phosphatase (with and without tartaric acid), Sudan black B, periodic acid-Schiff, and toluidine blue. The morphologic characteristics of erythrocytes were similar to those reported in green turtles. Six types of white blood cells were identified: heterophils, eosinophils, basophils, lymphocytes, monocytes and thrombocytes. Except for the basophils, the rest of the white blood cells from loggerhead turtles had different cytochemical characteristics compared to blood cells from other sea turtle species. The leukocyte differential count was different from that reported for other sea turtle species. Heterophils were the most numerous leukocytes from these loggerhead turtles, followed by lymphocytes, eosinophils, monocytes and basophils. This paper provides a morphologic classification of blood cells of loggerhead sea turtles that is useful for veterinary surgeons involved in sea turtle conservation.