Previous Vitamin D Supplementation and Morbidity and Mortality Outcomes in People Hospitalised for COVID19: A Cross-Sectional Study.

Aim: The study aim was to assess the association of vitamin D supplementation before hospital admission and severe outcomes in subjects admitted for COVID-19. Methods: We performed a cross-sectional analysis of pseudonymised medical record data from subjects admitted to the Hospital de la Santa Creu i Sant Pau (Barcelona, Spain) for COVID-19 during March and April 2020. The composite primary study outcome was defined as death and/or invasive mechanical ventilation (IMV). Association between risk factors and study outcomes was evaluated by bivariate analysis, followed by logistic regression analysis. Results: In total, 1,267 persons were hospitalised during the observation period. Overall, 14.9% of the subjects were on active vitamin D supplementation treatment before admission. The subjects in the vitamin D group were significantly older than subjects without vitamin D supplementation. We observed higher rates of the primary outcome (death and/or IMV) among the persons with previous use of vitamin D (30.1 vs. 22.9% in those not receiving treatment). In the bivariate analysis, previous use of vitamin D was positively associated with death and/or IMV [odds ratio (OR): 1.45 95% CI: 1.03; 2.04]; however, after adjustment for other risk factors this association disappeared (OR: 1.09 95%CI: 0.65; 1.81). Conclusion: We did not find an association between vitamin D supplementation before hospital admission and death and/or IMV in subjects admitted for COVID-19. The age and the burden of age-associated comorbidities were independently associated with the in-hospital events.

[Diagnostic efficiency of renal ultrasound after the first urine infection in infants]. / Rentabilidad diagnóstica de la ecografía renal tras la primera infección de orina en los lactantes.

INTRODUCTION: Several authors question the performance of systematic renal ultrasound after first urinary tract infection (UTI) in young children, given the high sensitivity of prenatal ultrasounds to detect major malformations and the low prevalence of clinical relevant findings. The aims of this study are to evaluate the yield of renal ultrasound performed after the first UTI in patients aged less than 2 years and to analyse potential risk factors (RF) of altered renal ultrasound. PATIENTS AND METHODS: Retrospective study, including patients aged less than 2 years diagnosed with UTI in the Emergency Department between July 2013 and December 2014. Patients with an underlying nephro-urological pathology, previous UTIs and those without prenatal or post-infection renal ultrasound were excluded. Altered renal ultrasound was defined as the presence of dilated urinary tract or structural abnormalities. Potential RF analysed were: male, age less than 3 months, presence of fever and microorganism other than Escherichia coli. Univariate and multivariate logistic regression were performed. RESULTS: A total of 306 patients were included. Altered renal ultrasound was found in 35 cases (11.4%; 95% CI 8.3-15.5): 24 (68.6%) urinary tract dilation, and 11 (31%) structural abnormalities. Among the cases with altered ultrasound, 68.6% were male, 51.4% were younger than 3 months, 74.3% were febrile, and 31.4% were caused by microorganisms other than E. coli, compared to 45% (P=.009), 31.7% (P=.021), 78.2% (P=.597) and 10% (P=.001) of cases with normal ultrasound. In the multivariate analysis, age less than 3 months (OR 2.1; 95% CI 1.0-4.3, P=.05) and microorganism other than E. coli (OR 3.8; 95% CI 1.7-8.7, P=.002) remained as RF. CONCLUSIONS: The yield of renal ultrasound after the first UTI is low. Its indication should be individualised according to the presence of RF: age less than 3 months and microorganism other than E. coli.

Benefits of mindfulness meditation in reducing blood pressure and stress in patients with arterial hypertension.

The objective of this randomized controlled trial is to evaluate the benefits of mindfulness meditation in controlling ambulatory blood pressure (BP) and the impact of the intervention on anxiety, stress and depression levels in a Mediterranean population. Twenty-four and 18 patients [n = 42; mean age 56.5 (7.7) years; similar men and women proportions] with high-normal BP or grade I hypertension were enrolled to an intervention and a control group, respectively. For 2 h/week over 8 weeks, the intervention group received mindfulness training and the control group attended health education talks. The patients attended pre-intervention, week 4, week 8 and week 20 follow-up visits. 61.9% of the patients had anxiety, 21.4% depression, 19.0% were smokers and 14.2% were diabetic (no significant differences between the 2 groups). At baseline, the intervention group had non-significant higher clinically measured BP values, whereas both groups had similar ambulatory BP monitoring (ABPM) values. At week 8, the intervention group had statistically significant lower ABPM scores than the control group (124/77 mmHg vs 126/80 mmHg (p < 0.05) and 108/65 mmHg vs 114/69 mmHg (p < 0.05) for 24-h and night-time systolic BP (SBP), respectively) and also had lower clinically measured SBP values (130 mmHg vs 133 mmHg; p = 0.02). At week 20 (follow-up), means were lower in the intervention group (although not statistically significant). Improvements were observed in the intervention group in terms of being less judgemental, more accepting and less depressed. In conclusion, by week 8 the mindfulness group had lower clinically measured SBP, 24-h SBP, at-rest SBP and diastolic BP values.

Validation of KDRI/KDPI for the selection of expanded criteria kidney donors. / Validación del KDRI/KPDI para la selección de donantes renales con criterios expandidos.

INTRODUCTION: KDRI / KDPI are tools use in kidney donor evaluation. It has been proposed as a substitute of, or complementary to preimplantation renal biopsy. These scores has not been validated in Spain. OBJECTIVE: 1) To investigate the concordance between KDPI and histological scores (preimplantation renal biopsy) and 2) To assess the relationship between KDRI, KDPI and histological score on graft survival in the expanded criteria donors group. METHODOLOGY: Retrospective cohort study from 1 January 1998 until 31 December 2010. RESULTS: During the study 120 donors were recruited, that resulted in 220 preimplantation renal biopsies. 144 (65%) grafts were considered suitable for kidney transplantation. 76 (34.5%) were discarded. Median follow up has been 6.4 years (sd 3.9). Median age 63.1 years (sd 8.2), males (145; 65.9%), non-diabetic (191; 86.8%) and without another cardiovascular risk factors (173; 78.6%). 153 (69.5%) donors died of cerebrovascular disease. There were significant differences in KDRI/KDPI score in both groups 1.56/89 (sd 0.22) vs 1.66/93 (sd 0.15), p<0.01). The KDPI showed moderate concordance and correlation with the histological score (AUC 0.64 / correlation coefficient 0.24, p <0.01). KDPI (HR 24.3, p<0.01) and KDRI (HR 23.3, p<0.01) scores were associated with graft survival in multivariate analysis. CONCLUSION: 1) KPDI and histological scores show moderate concordance. The utility of both scores as combined tools it has to be determined. 2) KDPI score, and especially KDRI score, are valid for estimating graft survival and combined with the biopsy can help to individualized decision making in the expanded criteria donors pool.

Pseudohypoaldosteronism types I and II: little more than a name in common.

Pseudohypoaldosteronism (PHA) comprises a diverse group of rare diseases characterized by sodium and potassium imbalances incorrectly attributed to a defect in aldosterone production. Two different forms of PHA have been described, type I (PHAI) and type II (PHAII). PHAI has been subclassified into renal and systemic. Given the rarity and heterogeneity of this group of disorders we report three patients who carry PHA and a brief revision of current literature focused on the comparative analysis of PHAI and PHAII. Cases 1 and 2 presented with hyponatremia, hyperkalemia, metabolic acidosis and elevated plasma aldosterone and plasma renin activity in the neonatal period. Sequence analysis of the NRC2 gene demonstrated a novel heterozygous c.403C>T mutation in case 1 and a complete deletion in case 2, confirming the diagnosis of renal PHAI. Case 3 was a 4-year-old with hypertension, hyperkalemia, metabolic acidosis, normal plasma aldosterone and decreased plasma renin activity. Sequence analysis of the CUL3 gene demonstrated a previously unreported heterozygous c.1377+2T>3 mutation, confirming the diagnosis of PHAII-E. We highlight the importance of the determination of plasma aldosterone and plasma renin activity in the context of persistent sodium and potassium imbalances in children.

Varicela neonatal / Neonatal varicella

El presente trabajo revisa las consecuencias clínicas de la infección por el virus varicela-zoster durante el embarazo. El niño puede adquirir la infección intraútero, en el periparto o postnatal, y resultar en una variedad de síndromes clínicos, que van desde infección asintomática hasta severa infección, con alto índice de mortalidad y significativa morbilidad a largo plazo. Mayormente es un trastorno ligero en la niñez, mientras tiende a ser más severa en el adulto. Puede ser fatal especialmente en recién nacidos y personas inmunodeprimidas.Si la madre desarrolla el rash entre 4 y 5 días antes del parto ó 2 días después, se produce la varicela neonatal generalizada, y ocurrirá la muerte en 20(por ciento) de los casos afectados. Hay un particular interés en aprender más acerca de las consecuencias de la varicela materna para el niño

[Evaluation of the results of surgery treatment for female stress urinary incontinence with the ICIQ-UI SF questionnaire]. / Evaluación del resultado del tratamiento quirúrgico de la incontinencia urinaria de esfuerzo en la mujer mediante el cuestionario ICIQ-UI SF.

BACKGROUND AND OBJECTIVE: Our objective was to evaluate the sensitivity to change of the Spanish version of the ICIQ-UI SF. PATIENTS AND METHOD: Prospective study of 71 women with a diagnosis of Stress urinary incontinence (UI) treated with tension free vaginal tape. All had urodynamic diagnostic of Stress UI and ICIQ-UI SF score at the moment of inclusion and after treatment. RESULTS: According to the post-treatment urodynamic evaluation, 45 patients were cured (63.4%). According to the ICIQ-UI SF, 37 patients (52.9%) were cured. Post-treatment scores were lower than pre-treatment ones. Post-treatment scores of cured patients were lower than those of non cured (p < 0.005). The agreement between the ICIQ-UI SF score and the urodynamic evaluation was moderate. CONCLUSIONS: The ICIQ-UI SF questionnaire shows sensitivity to change.

Potential Sources of Resistance for Melon to Nonpersistently Aphid-borne Viruses.

Two hundred and sixty-eight Cucumis melo and wild relative accessions were evaluated for resistance to Cucumber mosaic virus (CMV), Papaya ringspot virus strain W (PRSV-W), Watermelon mosaic virus (WMV), and Zucchini yellow mosaic virus (ZYMV). Symptom development and systemic infection based on double antibody sandwich enzyme-linked immunosorbent assays were monitored. Sources of resistance were scarce. However, a number of them were found among the C. melo accessions tested. Thus, the accession C-189 behaved similarly to PI 161375 and showed resistance to "common" CMV strains although it was infected by a "song" type CMV. For WMV, the accessions C-768 and C-425, although infected, exhibited very mild symptoms, and recovery from infection occurred in some occasions in the former. A similar trait was also found in C-105, although in this case symptoms rarely appear and part of the plants are not infected. In addition, C-105 was highly resistant to virus transmission by Aphis gossypii, similarly to PI 161375. Accessions C-885 and C-769 exhibited resistance to PRSV-W, WMV, and ZYMV; therefore they are potential sources of multiple resistance. Resistance traits were also found in wild relatives that could be exploited when interspecific barriers with C. melo can be circumvented.

Fracturas con retardo en la consolidación ósea o pseudoartrosis: tratamiento no invasivo con electroestimulación galvánica transcutánea / Non invasive treatment by galvanic transcutaneous stimulation for delayed union or non union fractures

Objetivo. Evaluar el grado de consolidación ósea en pacientes con retardo en la consolidación o pseudoartrosis, tratados con electroestimulación galvánica transcutánea. Material y métodos. Estudio comparativo realizado en 18 pacientes con diagnóstico de retardo en la consolidación o pseudoartrosis, divididos en dos grupos aleatorios A y B. Se evaluaron inicialmente parámetros radiológicos y clínicos de consolidación ósea. El Grupo A recibió electroestimulación galvánica transcutánea por 10 minutos diarios durante 42 sesiones. El grupo B actuó como grupo control, ambos grupos realizaron programa de casa. Al término del estudio se evaluaron nuevamente los parámetros clínicos y radiológicos y se analizaron con la prueba exacta de Fisher con una p < de 0.05. Resultados. El periodo de evolución de la postura al tratamiento fue de tres hasta 80 meses con un promedio de 18.11 meses, 16 de los 18 pacientes con antecedentes de uno a cinco procedimientos quirúrgicos con evolución tórpida. El grupo A presentó siete de nueve pacientes con mejoría radiológica. En el grupo B sólo uno de nueve pacientes presentó mejoría radiológica. Conclusiones. 1) El grupo que recibió electroestimulación galvánica transcutánea mostró mejoría radiológica y clínica significativa en comparación con el grupo control. 2) La electroestimulación galvánica favorece la consolidación ósea acelerando el proceso natural de consolidación. 3) La electroestimulación galvánica transcutánea es un método no invasivo para el tratamiento de retardo en la consolidación y la pseudoartrosis, que permite ser utilizado en pacientes ambulatorios evitando un deterioro físico mayor.

Tomato Yellow Leaf Curl Virus-Is Causes a Novel Disease of Common Bean and Severe Epidemics in Tomato in Spain.

Field surveys were conducted in the autumn of 1997 in the main tomato (Lycopersicon esculentum)-growing regions of southern Spain following a severe tomato yellow leaf curl epidemic in tomato. Tomato yellow leaf curl virus (TYLCV)-Is was found to have spread to all regions and to coexist with TYLCV-Sr, which has been present since 1992. TYLCV-Is was also shown to be the causal agent of bean leaf crumple, a novel disease that has caused severe economic losses in fresh-market common bean (Phaseolus vulgaris) crops of southern Spain since September 1997. The disease was reproduced by infecting beans with cloned TYLCV-Is obtained from infected tomato plants collected in Almería. This is the first report of bean leaf crumple disease and the first report of a geminivirus in bean from Spain.