Epidemiology, molecular characterisation and antimicrobial susceptibility of Neisseria gonorrhoeae isolates in Madrid, Spain, in 2016.

With the aim to elucidate gonococcal antimicrobial resistance (AMR)-risk factors, we undertook a retrospective analysis of the molecular epidemiology and AMR of 104 Neisseria gonorrhoeae isolates from clinical samples (urethra, rectum, pharynx and cervix) of 94 individuals attending a sexually transmitted infection clinic in Madrid (Spain) from July to October 2016, and explored potential links with socio-demographic, behavioural and clinical factors of patients. Antimicrobial susceptibility was determined by E-tests, and isolates were characterised by N. gonorrhoeae multi-antigen sequence typing. Penicillin resistance was recorded for 15.4% of isolates, and most were susceptible to tetracycline, cefixime and azithromycin; a high incidence of ciprofloxacin resistance (~40%) was found. Isolates were grouped into 51 different sequence types (STs) and 10 genogroups (G), with G2400, ST5441, ST2318, ST12547 and G2992 being the most prevalent. A significant association (P = 0.015) was evident between HIV-positive MSM individuals and having a ciprofloxacin-resistant strain. Likewise, a strong association (P = 0.047) was found between patient age of MSM and carriage of isolates expressing decreased susceptibility to azithromycin. A decrease in the incidence of AMR gonococcal strains and a change in the strain populations previously reported from other parts of Spain were observed. Of note, the prevalent multi-drug resistant genogroup G1407 was represented by only three strains in our study, while the pan-susceptible clones such as ST5441, and ST2318, associated with extragenital body sites were the most prevalent.

Health-related quality of life in caregivers of patients with Alzheimer's disease. / Calidad de vida relacionada con la salud en cuidadores de pacientes con enfermedad de Alzheimer.

INTRODUCTION: Informal caregivers of patients with Alzheimer's disease (AD) have a poor health-related quality of life (HRQOL). HRQOL is an increasingly common user-focused outcome measure. We have evaluated HRQOL longitudinally in caregivers of AD patients at baseline and at 12 months. METHODS: Ninety-seven patients diagnosed with AD according to the NINCDS-ADRDA (National Institute of Neurological and Communicative Disorders and Stroke, and Alzheimer's Disease and Related Disorders Association) and their 97 respective primary caregivers were included in the study. We analysed the following data at the baseline visit: sociodemographic data of both patients and carers, patients' clinical variables, and data related to the healthcare provided to patients by carers. HRQOL of caregivers was measured with the SF-36 questionnaire at baseline and 12 months later. RESULTS: At 12 months, primary caregivers scored lower in the 8 subscales of the SF-36 questionnaire; differences were statistically significant in all dimensions except for 'physical function' and 'social function'. Baseline scores in our sample were lower than those of the general population. 'Vitality' is the dimension that presented the lowest scores. CONCLUSION: HRQOL in caregivers of patients with Alzheimer's disease deteriorates over time and is poorer than that of the age- and sex-matched general population.

Longitudinal evaluation using FP-CIT in patients with parkinsonism.

OBJECTIVE: To assess a group of patients with parkinsonism using serial studies with FP-CIT, basically the initial false negative results. METHODS: Restrospective study of 92 patients (55 men and 37 women) who had undergone 2 different FP-CIT studies because of discrepancies between study results and clinical progression. The mean elapsed time between the studies was 26 months (SD: 6). We performed a semi-quantitative study using the patient's clinical history and the available literature to analyse discrepant cases with a normal initial study and subsequent pathological findings. RESULTS: A total of 184 studies were completed for 92 patients; 11 of those 92 showed discrepancies between initial and subsequent studies. Among the 11 discrepant cases, 7 showed a normal initial study and pathological findings at a later date. Analysis of the predominant clinical features that might explain this behaviour revealed that 4 of these 7 subjects presented tremor-dominant parkinsonism. Regarding the rest, 1 presented early stage parkinsonism and was treated with antidopaminergic agents; 1 was classified as probable multisystem atrophy type C, and the third showed clinical signs of atypical parkinsonism without any causes of those signs being identified. CONCLUSIONS: Serial FP-CIT studies are unnecessary in the large majority of cases, but they may be justifiable in certain clinical situations.

Evernia prunastri lichen as a source of bioactive glucans with potential for topical applications.

Microwave hydrothermal treatment was selected to extract valuable fractions with bioactive and gelling properties from Evernia prunastri lichen with potential for topical applications. The impact of the extraction processing conditions on the soluble extracts, mucilage fraction and residual solid phase was analyzed within a lichen global valorization approach. A particular stress was made on the thermo-rheological and structural characteristics of the extracted glucan and galactomannan polymers, the corresponding gelled matrices, and their cosmetic feasibility. Results revealed that the proposed microwave-assisted treatment showed a relevant influence on the phytochemical features of the aqueous soluble extracts, accounting the major protein content at 120 °C and the enhanced antioxidant and anti-tyrosinase properties at 140 °C. Extracts at 200 °C showed the highest anti-inflammatory (COX-1 and COX-2 inhibition) efficacies. The biopolymer analyses indicated that those recovered after lichen hydrothermal treatment at 160 °C featured a good extraction performance, the highest molecular weight, apparent viscosity, and antiproliferative potential. The thermo-rheological properties of the corresponding matrices formulated at 10 % and 60 or 80 °C exhibited the strongest and most thermo-reversible characteristics, as well as antifreezing feasibility. Another advantage of the selected fractions was the absence of skin irritation according to the in vitro skin irritation assay.

Microwave-assisted extraction of Ulva spp. including a stage of selective coagulation of ulvan stimulated by a bio-ionic liquid.

Microwave-assisted hydrothermal processing was proposed to recover high valuable compounds with antioxidant and gelling features from Ulva spp. green seaweed. The influence of the extraction conditions on the solubles, ulvan fraction and residual solid phase was studied to achieve a global valorization of the seaweed. A particular emphasis was placed on the selective coagulation of ulvan stimulated by a bio-ionic liquid during the extraction process. The achieved outcomes indicated that the selected microwave treatment exhibited a notable impact on the phytochemical properties of the soluble extracts, with the highest values of sulfate and protein content at 160 °C, and the highest antioxidant features at 200 °C. The most prominent molecular weight distributions were also identified for systems hydrothermal treated at 160 °C. The ulvan analyses showed that those extracted after microwave treatment at 160 °C showed the highest yields, molecular weight and the strongest gel features from the rheological point of view. The presence of the chloride chlorine during the extraction process favored the ulvan performance and the enhancement of the corresponding viscoelastic properties.

Spray-drying microencapsulation of tea extracts using green starch, alginate or carrageenan as carrier materials.

Tea industry generates many by-products which could be used to produce and incorporate bioactive tea extracts (TE) into nutraceuticals, cosmetics and/or clinical applications. However, sensibility to external factors is a major disadvantage hindering its utilization. This study deals with the implementation and characterization of suitable biopolymer delivery systems based on starch, carrageenan or alginate, as microencapsulation, to stabilize and protect TE through innovative thin-carbohydrate-coated formulations. TE were spray-dried and microencapsulated in recycled carrier materials (alginate, carrageenan or starch). Product yields varied from 55 to 58%. High microencapsulation and loading efficiencies were achieved (60-93% and 65-84%, respectively). Antioxidant capacity varied from 32 to 46 g Trolox/100 g extract, within different carrier-systems; which also showed promising rheological and UV-protective properties when transformed into gels. Total phenolic content, particle-size distribution, HPSEC-analysis, SEM-analysis and FTIR-analysis were also performed. In sum, this paper characterizes and discusses the high potential of these recycled carbohydrate-coated microparticles for future applications.

Comparative evaluation of physicochemical profile and bioactive properties of red edible seaweed Chondrus crispus subjected to different drying methods.

Dehydration of the edible seaweed Chondrus crispus was performed by freeze-drying, conventional oven-drying and emerging microwave hydrodiffusion and gravity (MHG). In this work, the drying kinetics and modelling, estimating specific energy consumption and environmental impact of distinct processes were tested. Color and microstructural features of the dried macroalgae were also evaluated, as well as their nutritive characterization, chemical profile and bioactive potential (antioxidant and antimicrobial activities). Moreover, collected liquid phases from both the defrosted and MHG treated samples were also characterized. All methodologies provided solid phases with an adequate final moisture content. MHG significantly reduced the needed time, specific energy consumption and environmental impact, providing C. crispus with intermediate color and histological structure characteristics. Overall, this trend was also defined to tested chemical parameters and bioactivities. MHG provided aqueous extracts with potential bioactive compounds from this red alga, increasing the efficiency of this drying method.

Chondrus crispus treated with ultrasound as a polysaccharides source with improved antitumoral potential.

Ultrasound-assisted extraction was used to recover gelling biopolymers and antioxidant compounds from Chondrus crispus with improved biological potential. The optimal processing conditions were evaluated using a Box-Behnken design, and the impact on the biological and thermo-rheological properties of the carrageenan fraction and on the bioactive features of the soluble extracts were studied. The optimum extraction parameters were defined by extraction time of ~34.7 min; solid liquid ratio of ~2.1 g/100 g and ultrasound amplitude of ~79.0% with a maximum power of 1130 W. The dependent variables exhibited maximum carrageenan yields (44.3%) and viscoelastic modulus (925.9 Pa) with the lowest gelling temperatures (38.7 °C) as well as maximum content of the extract in protein (22.4 mg/g), gallic acid (13.4 mg/g) and Trolox equivalents antioxidant capacity (182.4 mg TEAC/g). Tested hybrid carrageenans exhibited promising biological activities (% of growth inhibition around 91% for four human cancer cellular lines: A549; A2780; HeLa 229; HT-29).

Microwave hydrothermal processing of Undaria pinnatifida for bioactive peptides.

Microwave hydrothermal processing was employed to obtain valuable gelling or bioactive fractions from U. pinnatifida, assessing the processing conditions following a biorefinery concept. It was identified a relevant impact on the antioxidant properties, sulfate, protein and oligosaccharides content, with the highest values above 200 °C, although the maximum in fucose was obtained at 160 °C. The lowest temperature involved the highest minerals and sulfate content of the solid phases. Rheology indicated that hydrothermal treatment at 160 °C is adequate to extract alginates with structural and viscoelastic properties similar to those commercially available. The incorporation of the hydrothermal residual solids in the proposed alginate matrices favored the development of systems with potential non-food applications applications. Selected extracts, after an intensification stage using ultrasound, featured interesting biological activities for two human cancer cell lines (A2780; HeLa 229) with percentage of cellular inhibition > 83 and 57%, without positive effects on A549 and HCT-116.

Eco-friendly extraction of Mastocarpus stellatus carrageenan for the synthesis of gold nanoparticles with improved biological activity.

Carrageenan was extracted from Mastocarpus stellatus using hot water extraction under atmospheric and pressurized conditions. The influence of heating temperature during a non-isothermal heating profile up to temperatures in the range 70-190 °C was studied to evaluate the extraction yields and properties of the carrageenan fraction. Under the selected conditions (130 °C), extracted carrageenan (CMs) was used for the green synthesis of gold nanoparticles (AuNPs). After the optimization of the reaction conditions, the synthesized gold nanoparticles (Au@CMs) were characterized by UV-Vis spectroscopy, Z potential measurements, electron microscopy, and X-ray diffraction analysis, which confirmed the formation of spherical, polycrystalline, and negatively charged nanoparticles with a mean diameter of 14.3 ± 2.1 nm. The study conducted by scanning transmission electron microscopy, energy dispersive X-ray analysis and mapping confirmed the presence of carrageenan stabilizing AuNPs. Finally, Fourier transformed infrared spectroscopy was performed to analyze the functional groups of CMs involved in the reduction and stabilization of AuNPs. The selective cytotoxicity and the antioxidant activity of the Au@CMs were evaluated in different cell lines and compared to the CMs. Au@CMs showed an improved antioxidant capacity in cells under oxidative stress and the induction of apoptosis in a monocytic cell line, while no antitumor effect was observed in a lung endothelial cell line.

WITHDRAWN: [Telemedicine in the physical medicine and rehabilitation outpatient clinic: Reality and future. Consensus document of the Spanish Society of Rehabilitation and Physical Medicine]. / Telemedicina en las consultas de medicina física y rehabilitación: realidad y futuro. Documento de consenso de la Sociedad Española de Rehabilitación y Medicina Física.

The Publisher regrets that this article is an accidental duplication of an article that has already been published in Rehabilitación (Madr), 55 (2021) 167-70, https://doi.org/10.1016/j.rh.2020.12.004. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal

Analysis of moisture desorption isotherms of eggplant (Solanum melongena).

Sorption isotherms of eggplant were determined employing, as experimental technique, a static gravimetric method, using saturated salt solutions to achieve the equilibrium. The experiments were carried out at different temperatures (20, 35, 50 and 65 °C). The sorption isotherms can be classified, according to Brunauer's classification, as type II or III depending on temperature. Equilibrium moisture content data were correlated by two models usually applied to foodstuffs (Brunauer--Emmet--Teller (BET) and Halsey). BET model was employed to determine monolayer moisture content (0.121 kg/kg d.b.). Halsey model was selected by the goodness of fitting. Experimental data were analyzed by a thermodynamic approach to obtain some properties as net isosteric heat, equilibrium heat and differential and net integral entropy. The differential enthalpy and entropy decreased with increasing moisture content and satisfied the compensation theory. The net integral enthalpy and entropy showed maximum values (≈31 kJ/mol and ≈88 J/mol.K) at 0.093 (kg/kg d.b.) of moisture content.

[Quantitative evaluation of SPECT with FP-CIT. Importance of the reference area]. / Valoración cuantitativa del SPECT con FP-CIT. Importancia del área de referencia.

OBJECTIVE: The aim of this study is to compare several uptake indexes between specific and non-specific activity to determine the existence of degenerative Parkinsonism according to different reference areas. MATERIAL AND METHODS: A total of 46 patients (23 men and 23 women), randomly selected from individuals referred to our center with a movement disorder, were included in the study. Mean age was 70.2 ± 10.2 years (41-87). The uptake indexes were obtained through the areas of interest (ROIs) located in the striate (specific uptake) and other reference ROIs located in areas with different concentrations of serotonin receptors: low-cerebellum, medium-occipital cortex and high-midbrain. RESULTS: A high linear correlation was found between indexes having low and medium concentration of serotonin receptors. The ROC curve analysis shows an area under the curve of 0.874, 0.886 and 0.739 and regression coefficients of 5.41, 6.62 and 3.41, respectively for the striatum/cerebellum (E/C), striatum/occipital (E/O) and striatum midbrain (E/M) indexes. Optimal cutoff for E/O (1.35), index with the best behavior, provides a sensitivity of 0.84 and specificity of 0.89. CONCLUSION: The reference area selected may alter the predictive power of the different indexes to determine the existence of a degenerative Parkinsonism.

Valorisation of Camellia sinensis branches as a raw product with green technology extraction methods.

This work deals with the study of tea stalks from pruning debris using environmental friendly extraction technology to offer new healthy properties. In the manufacturing tea industry, tea trees require to be pruned every year and most of their remains are discarded as a waste with no economic value. Microwave aqueous extraction and pressurized hot water extraction process (autohydrolysis) were used to recover bioactive compounds from the tea branches. Operating at a fixed solid: liquid ratio (1:15), the effect of the maximum heating temperatures from 140 to 220 °C was studied. Liquid extracts were analysed for total phenolic, oligosaccharides, protein, mineral and heavy metals content, as well as for antioxidant capacity. The antitumoral possibilities were also determined for selected samples. The obtained results indicated that both processes could be used as an alternative to recover bioactive compounds from tea wastes, although microwave-assisted extraction allowed saving time when compared with autohydrolysis processing. The temperature exhibited a relevant effect on the total phenolic content and antioxidant capacity, decreasing with the microwave treatment and increasing with the autohydrolysis temperature. The obtained extracts could be adequate for incorporation in food and non-food fields.

Tailoring hybrid carrageenans from Mastocarpus stellatus red seaweed using microwave hydrodiffusion and gravity.

This work deals with the use of microwave hydrodiffusion and gravity (MHG) for the recovery of hybrid carrageenans with specific mechanical features together with bioactive compounds. For this purpose, Mastocarpus stellatus red seaweed was used as raw material and the most adequate MHG processing conditions were studied. The physicochemical properties of the algae and the corresponding biopolymers, the fundamental characterisation of the bioactive compounds from the extracts (antioxidant capacity, sulfate content, protein content, among others) and the rheological features of the formulated gels were analysed. Results indicated that MHG is an adequate technique for obtaining functional extracts with potential applications in the food and non-food fields. Hybrid carrageenans with a wide range of viscoelastic features were recovered by MHG, saving time compared to conventional methods. The yields obtained for the recovered hybrid carrageenans and bioactive fractions were comparable to those obtained in red algae with conventional techniques.

A green approach for alginate extraction from Sargassum muticum brown seaweed using ultrasound-assisted technique.

Ultrasound assisted aqueous extraction of alginate from Sargassum muticum was proposed to minimize the use of chemicals, high temperatures and prolonged times, with comparable extraction yields to conventional acid/alkali procedures. The alginate, precipitated from the liquors obtained after ultrasound assisted extraction of fucoidan and phlorotannin fractions, and converted to alginic acid sodium salt by a green treatment was characterized by FTIR-ATR, 1H NMR, HPSEC, MALDI-TOF, rheology and citotoxitity. A clear influence of the sonication time was observed on the alginate molar mass, block structure, thermo-rheological and tumoral cell growth inhibition features. All tested hydrogels featured stable and thermo-reversible characteristics.

Breakfast, plasma glucose and beta-hydroxybutyrate, body mass index and academic performance in children from Extremadura, Spain.

OBJECTIVES: Nutritional aspects of breakfast, plasma levels of glucose and beta-hydroxybutyrate, body mass index and academic performance have been studied in urban and rural children (Extremadura, Spain). METHODS: Representative samples of schoolchildren (3 to 12 years old, random cluster-sampling in schools). RESULTS: Children's mean caloric intake with breakfast was 331 kcal. Rural population ingested more carbohydrates (46,9 +/- 12,3% versus 43,3 +/- 13,2% of the total caloric intake) and fewer lipids (40,5 +/- 11,8% versus 43,9 +/- 12,8% of the total caloric intake) than the urban population. Academic performance was significantly better in the children inhabiting the rural zone than in those of the urban zone. The glycaemia was higher in the urban than in the rural children, and that the contrary was the case for the beta-hydroxybutyrate values. Neither glucose nor beta-hydroxybutyrate levels were correlated with academic performance values. BMI was significantly increased in the urban versus rural children. CONCLUSION: The present results emphasize the importance of breakfast and life style in the weight and the academic performance of children.

[Utility of myocardial perfusion scintigraphy in the emergency department for evaluation of patients with chest pain]. / Utilidad de la gammagrafía de perfusión miocárdica para la evaluación de pacientes con dolor torácico en el servicio de urgencias.

OBJECTIVE: To evaluate diagnostic efficacy of rest myocardial perfusion scintigraphy in the detection of acute coronary syndrome in patients with chest pain and non diagnostic electrocardiogram, comparing it with reference techniques, in Emergency Department. MATERIAL AND METHODS: Myocardial perfusion scintigraphy was carried out in 40 patients with those defined characteristics in the Emergency Department, administering the radiopharmaceutical in the next 6 hours after the pain was over. All subjects followed routine diagnostic and treatment management. Final diagnosis of coronary disease was established by coronariography and/or stress perfusion myocardial scintigraphy. Patients were followed up for 9-12 months. RESULTS: Myocardial perfusion scintigraphy showed a negative predictive value of 96,15 % (CI 95 %: 86.84-100.00). The main limitation of its application was breast and diaphragmatic attenuation phenomenon, given that correction algorithms were not available. Global kappa coefficient was 0.78 when to compared interobserver agreement. CONCLUSION: Rest myocardial perfusion scintigraphy is a safe and efficient test in the screening of patients with chest pain suggestive of angor with non-diagnostic ECG in Emergency Department, and also provides prognostic information and risk stratification.

[Diagnostic accuracy of FP-CIT SPECT in patients with parkinsonism]. / Utilidad diagnóstica de la SPECT con FP-CIT en el estudio de pacientes con parkinsonismo.

OBJECTIVE: To determine the diagnostic accuracy of FP-CIT SPECT in entities with and without presynaptic involvement of the nigral-striatal dopaminergic pathway in a large group of patients with movement disorders, evaluating the usefulness of quantitative analysis. MATERIALS AND METHODS: A group of 183 consecutive patients clinically diagnosed as either having or not having degenerative Parkinsonism. These results were then contrasted with those of FP-CIT SPECT to determine the diagnostic accuracy of the procedure. The specific binding index was evaluated with ROC curves. RESULTS: FP-CIT SPECT was highly accurate in the diagnosis of neurodegenerative Parkinsonism (sensitivity: 95 %, specificity: 90 %). Most of the false positive results arose in patients with vascular Parkinsonism and the false negative results in patients with Parkinson disease. ROC curve analysis of semiquantitative evaluation had a sensitivity of 83 % and specificity of 82 % with an optimal cut-off of 1.44. The area under the curve was not significantly different between patients 60 years (0.899 vs 0.884) of age. CONCLUSIONS: FP-CIT SPECT has a high degree of diagnostic accuracy for striatal dopaminergic involvement. No significant changes in diagnostic accuracy were seen with respect to patient age.

Phase diagrams of hybrid carrageenans extracted from Ahnfeltiopsis devoniensis and Chondrus crispus.

NaCl and KCl phase diagrams of two kappa/iota-hybrid carrageenans (KI) are established, and the rheological properties of obtained solutions and gels are reported. KI were extracted from Ahnfeltiopsis devoniensis and Chondrus crispus seaweeds and showed different chemical composition, 48 mol% of kappa carrageenan (K) and 52 mol% of iota carrageenan (I), and 78 mol% of K and 22 mol% of I, respectively. Phase diagrams are systematically compared those of blends of commercial K and I (K+I) showing equivalent chemical compositions. Results confirm that KI clearly differ from mixtures of K and I. K+I form gels at lower polysaccharide concentration and ionic strength, and exhibit gel separation from a liquid phase when large amount (>0.1 mol/L) of KCl is used. In contrast, no syneresis was found in KI gels formed under similar conditions. Both KI and K+I gels are strain hardening, and show a concentration scaling of the elasticity with exponents ranging from 1.1 to 3.2 depending on the type of salt and ionic strength. The strain at break of KI gels does not show salt specificity and is similar to the strain at break of K+I gels in KCl under similar salt and polysaccharide concentrations. K+I gels in NaCl are more fragile than in KCl, thus showing salt specificity.