CAMKK2 is upregulated in primary human osteoarthritis and its inhibition protects against chondrocyte apoptosis.

OBJECTIVE: To investigate the role of calcium/calmodulin-dependent protein kinase kinase 2 (CAMKK2) in human osteoarthritis. MATERIALS AND METHODS: Paired osteochondral plugs and articular chondrocytes were isolated from the relatively healthier (intact) and damaged portions of human femoral heads collected from patients undergoing total hip arthroplasty for primary osteoarthritis (OA). Cartilage from femoral plugs were either flash frozen for gene expression analysis or histology and immunohistochemistry. Chondrocyte apoptosis in the presence or absence of CAMKK2 inhibition was measured using flow cytometry. CAMKK2 overexpression and knockdown in articular chondrocytes were achieved via Lentivirus- and siRNA-mediated approaches respectively, and their effect on pro-apoptotic and cartilage catabolic mechanisms was assessed by immunoblotting. RESULTS: CAMKK2 mRNA and protein levels were elevated in articular chondrocytes from human OA cartilage compared to paired healthier intact samples. This increase was associated with elevated catabolic marker matrix metalloproteinase 13 (MMP-13), and diminished anabolic markers aggrecan (ACAN) and type II collagen (COL2A1) levels. OA chondrocytes displayed enhanced apoptosis, which was suppressed following pharmacological inhibition of CAMKK2. Levels of MMP13, pSTAT3, and the pro-apoptotic marker BAX became elevated when CAMKK2, but not its kinase-defective mutant was overexpressed, whereas knockdown of the kinase decreased the levels of these proteins. CONCLUSIONS: CAMKK2 is upregulated in human OA cartilage and is associated with elevated levels of pro-apoptotic and catabolic proteins. Inhibition or knockdown of CAMKK2 led to decreased chondrocyte apoptosis and catabolic protein levels, whereas its overexpression elevated them. CAMKK2 may be a therapeutic target to prevent or mitigate human OA.

Telomere length dynamics over 10-years and related outcomes in patients with COPD.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) has been proposed as a disease of accelerated aging. Several cross-sectional studies have related a shorter telomere length (TL), a marker of biological aging, with COPD outcomes. Whether accelerated telomere shortening over time relates to worse outcomes in COPD patients, is not known. METHODS: Relative telomere length (T/S) was determined by qPCR in DNA samples from peripheral blood in 263 patients at baseline and up to 10 years post enrolment. Yearly clinical and lung function data of 134 patients with at least two-time measures of T/S over this time were included in the analysis. RESULTS: At baseline, T/S inversely correlated with age (r = - 0.236; p < 0.001), but there was no relationship between T/S and clinical and lung function variables (p > 0.05). Over 10 years of observation, there was a median shortening of TL of 183 bp/year for COPD patients. After adjusting for age, gender, active smoking and mean T/S, patients that shortened their telomeres the most over time, had worse gas exchange, more lung hyperinflation and extrapulmonary affection during the follow-up, (PaO2 p < 0.0001; KCO p = 0.042; IC/TLC p < 0.0001; 6MWD p = 0.004 and BODE index p = 0.009). Patients in the lowest tertile of T/S through the follow-up period had an increased risk of death [HR = 5.48, (1.23-24.42) p = 0.026]. CONCLUSIONS: This prospective study shows an association between accelerated telomere shortening and progressive worsening of pulmonary gas exchange, lung hyperinflation and extrapulmonary affection in COPD patients. Moreover, persistently shorter telomeres over this observation time increase the risk for all-cause mortality.

Predictive Value of Clinical and Magnetic Resonance Image Findings in the Diagnosis of Meniscal and Anterior Cruciate Ligament Injuries.

BACKGROUND: Anterior Cruciate Ligament (ACL) injuries may be accompanied by associated injuries such as meniscal injuries. Clinical evaluation alone may at times miss the diagnosis of ACL injury and one or more associated injuries. However, an adjuvant diagnostic tool such as an MRI of the knee may be unaffordable to some patients. The goal of this study was to compare the sensitivity, specificity and predictive value of clinical and magnetic resonance image (MRI) findings in the diagnosis of anterior cruciate ligament and meniscal injuries. METHODS: This was a prospective study. The cases of ACL injury recruited had a magnetic resonance imaging of the injured knee, and knee arthroscopy done. The clinical, magnetic resonance imaging and arthroscopic diagnostic findings were all noted. The sensitivity, specificity, positive predictive value and negative predictive values of clinical and MRI findings were compared, with arthroscopic findings as gold standard. RESULTS: A total of seventy-seven patients were recruited for the study. There were fifty-four males and twenty three females. The results of the tests of the sensitivity, specificity, positive predictive value and negative predictive value of clinical diagnosis and MRI when compared with arthroscopy findings, in detecting meniscal and anterior cruciate ligament injuries were as follows: For Clinical evaluation; Anterior Cruciate ligament: 81%, 80%, 86% and 76%; Medial Meniscus: 84%, 77%, 84% and 93%; and Lateral Meniscus: 85%, 77%, 85% and 82% respectively. For MRI: Anterior Cruciate Ligament (ACL): 87%, 89%, 93% and 78% ; Medial Meniscus: 87% 79%, 70% and 82%; and the Lateral Meniscus: 70%, 76% 73% and 72%. CONCLUSION: The specificity, sensitivity and predictive value of clinical and MRI findings were comparable in relation to the diagnosis of ACL and Medial Meniscus tears. However, the values of these parameters were better with clinical examination than with MRI in relation to the diagnosis of lateral meniscus tears.

IFITM3 and severe influenza virus infection. No evidence of genetic association.

Influenza virus infection (IVI) is typically subclinical or causes a self-limiting upper respiratory disease. However, in a small subset of patients IVI rapidly progresses to primary viral pneumonia (PVP) with respiratory failure; a minority of patients require intensive care unit admission. Inherited and acquired variability in host immune responses may influence susceptibility and outcome of IVI. However, the molecular basis of such human factors remains largely elusive. It has been proposed that homozygosity for IFITM3 rs12252-C is associated with a population-attributable risk of 5.4 % for severe IVI in Northern Europeans and 54.3 % for severe H1N1pdm infection in Chinese. A total of 148 patients with confirmed IVI were considered for recruitment; 118 Spanish patients (60 of them hospitalized with PVP) and 246 healthy Spanish individuals were finally included in the statistical analysis. PCR-RFLP was used with confirmation by Sanger sequencing. The allele frequency for rs12252-C was found to be 3.5 % among the general Spanish population. We found no rs12252-C homozygous individuals in our control group. The only Spanish patient homozygous for rs12252-C had a neurological disorder (a known risk factor for severe IVI) and mild influenza. Our data do not suggest a role of rs12252-C in the development of severe IVI in our population. These data may be relevant to recognize whether patients homozygous for rs12252-C are at risk of severe influenza, and hence require individualized measures in the case of IVI.

Ultrasound prevalence and characteristics of incidental thyroid lesions in Nigerian adults.

AIM/OBJECTIVE: Thyroid lesions are common and range from the incidental, asymptomatic, small solitary nodule to the large and partly intrathoracic masses. Thyroid lesions that are not palpable but identified by radiological imaging for unrelated symptoms are defined as incidentalomas of the thyroid gland. OBJECTIVE: The aim of this study was to determine the ultrasound prevalence of thyroid incidentalomas and describe the ultrasound characteristics of such detected incidentalomas in Nigerian adults. METHODS: This was a prospective study that examined 340 subjects over a period of 6 months. They were selected randomly from volunteers and patients presenting for ultrasound examination of other parts of the body. The subjects had their necks examined by palpation and ultrasound in the department of Radiology, University College Hospital, Ibadan, using a General Electric LogicP5 ultrasound machine with a 6-10 MHz linear transducer. Any incidentaloma detected was classified using the 'Thyroid Imaging Reporting and Data System' (TIRADS) classification. RESULTS: Three hundred and forty (340) subjects comprising of 153 males and 187 females were examined. The ultrasound prevalence of thyroid incidentalomas was 22.4%. Thyroid incidentalomas were more common in females than males but this was not statistically significant. The prevalence of thyroid incidentaloma significantly increased with age up to the seventh decade. Majority of the lesions were solitary, homogenous and cystic. CONCLUSION: The ultrasound prevalence of thyroid incidentalomas documented in the study area is high (22.4%) and they were commoner in women and older subjects. Majority of the lesions, 41 (53.95%) were classified as TIRADS 2 (benign lesions).

Water entrepreneurship and financialisation: Complexities for the attainment of SDG in sub-Saharan Africa.

This study explores the potential of water financialisation and entrepreneurship in sub-Saharan Africa (SSA) to supplant the traditional responsibility of national, state, and local governments in providing public water supply, aligning with SDG Goals. Despite its typical association with the global north, a shifting landscape reveals emerging financial actors and multinational companies playing a more prominent role, prompting governance and accountability inquiries. Given the dearth of investment and persisting challenges in SSA's water infrastructure, the burgeoning involvement of financial actors and capital management entities in the water cycle seems inevitable. However, this trend raises concerns about exacerbating global water stress. Through qualitative methods, the study engaged 50 SSA participants via open-ended questionnaires, analysed using thematic analysis. The findings underscore a nuanced perspective. While acknowledging the potential of water financialisation and entrepreneurship to drive essential investment in SSA's water sector, the research emphasizes the irreplaceable role of government in policy execution and safeguarding citizens' well-being. Government intervention remains crucial to ensuring equitable water access and sustainability. Additionally, the analysis suggests that overemphasizing water financialisation could divert attention from critical infrastructural and technological advancements needed in SSA's water sector. This underscores the necessity of a balanced and comprehensive approach to address the multifaceted challenges surrounding water availability, governance, and sustainability in the region.

Comparative study of BCR-ABL1 quantification: Xpert assay, a feasible solution to standardization concerns.

The level of BCR-ABL1 reached after treatment with tyrosine kinase inhibitors is an effective marker of the therapeutic response and a good survival predictor in chronic myeloid leukemia (CML) patients. However, no agreement has yet been achieved about either the standardization of the technique to determine BCR-ABL1 or the interpretation of the results. The aim of this study was to compare the method currently recommended by the European Leukemia Net, which includes the application of a conversion factor to express the results in international scale, with an automated method (Xpert BCR-ABL™, Cepheid). BCR-ABL1 transcript quantification was performed in 117 samples from CML patients in two different laboratories by both methods, and the results were compared by statistical procedures. A high linear correlation was obtained in the results between the two methods. The concordance at logarithmic intervals reached 62 %. When the major molecular response (MMR) was analyzed, 85 % agreement was achieved. The automated method provides reproducible results and does not show significant differences compared with the traditional method. As a clinical tool, Xpert correctly classified the patients in MMR and can be considered a useful alternative for the molecular follow-up of CML patients.

Temporal evolution of linear alkylbenzene sulfonates and heavy metals in sludge from wastewater treatment plant.

Five homologues of linear alkylbenzene sulfonates (LAS)-LAS C-10, LAS C-11, LAS C-12, and LAS C-13 and total LAS-were monitored during a one-year period in primary, secondary, and digested sludge to evaluate their presence and temporal evolution. Extraction of LAS was carried out using microwaves energy, and determination was performed using high-performance liquid chromatographic- fluorescence (HPLC-FL). The results showed that concentrations of total LAS were between 9 337 mg/kg(-1) dry matter for primary sludge and 33.3 mg/kg(-1)(DM) for secondary sludge. Concentrations of total LAS were greater than 2 113 mg/kg(-1) in primary and digested sludge and were less than 260 mg/kg(-) in secondary sludge. On the other hand, the highest concentrations of LAS in primary sludge were found in summer, probably because of lack of rain during those months. Concentrations tend to be constant throughout the year in digested sludge. In addition heavy metals also were analyzed. Heavy metals, including zinc, copper, nickel, lead, and chromium are persistent environmental contaminants that cannot be destroyed. Biomagnification through the food-chain and potential accumulation in human tissues can cause both human health and environmental concerns. Concern regarding total heavy metal content of sludge limits sludge recycling for use on agricultural lands. This paper presents a comparative study of wastewater sludge that are going to be used as fertilizer based on the requirements of legislation proposed in the European Union. This research found that concentrations of total LAS in digested sludge are higher than the limits established in the proposed new draft.

[Virtual consultations in Traumatology and Orthopaedic Surgery]. / Consultas virtuales en Traumatología y Cirugía Ortopédica.

OBJECTIVE: The objective of this study is to analyse the current system of virtual consultations between the levels of Primary and Specialised Care in the field of Traumatology and Orthopaedic Surgery (TOS) in our healthcare area. MATERIAL AND METHOD: A retrospective observational study was carried out on 90 consecutive patients who had a non-face-to-face consultation between 3 January 2017 and 10 February 2017 and subsequently a face-to-face consultation. All the patients belonged to the same healthcare area attached to the Nuestra Señora de Candelaria University Hospital. The data on the diagnostic orientation, medical history provided and complementary tests were evaluated by 2 observers, one with training in Family and Community Medicine and the other with specialised training in TOS, and compared with those obtained in the final face-to-face assessment. RESULTS: The results showed a low inter-judge agreement regarding the diagnostic orientation, anamnesis, exploration and complementary tests provided in the virtual consultation request. It was considered that only 59% for one observer (Family and Community Medicine) and 47.7% for the other (specialised care) had sufficient information for decision-making. Furthermore, 35.2% required more than one face-to-face assessment consultation until diagnosis and in 45.5% it was necessary to request new complementary tests. In 30.7%, there was no concordance in the suggested and final diagnosis. In 51.9%, no therapeutic action other than that carried out by Primary Care was carried out and 34.1% of the patients were referred to the Rehabilitation department. CONCLUSIONS: The current model of virtual consultations in TOS does not seem adequate to respond to this new healthcare model. The number of unnecessary referrals is very high despite the previous virtual assessment by a specialist in TOS. The Family and Community Medicine specialist should have more diagnostic resources and coordination between Primary and Specialised Care is necessary to determine, in the area of TOS, the type of consultations and conditions for which this system should be implemented to obtain adequate coordination and improve communication between both levels of care.

Dyslipidaemia and other cardiovascular risk factors in relation to manifest cardiovascular disease in patients with chronic obstructive pulmonary disease in the Canary Islands. / Relación entre la dislipidemia y otros factores de riesgo cardiovasculares conocidos con la presencia de enfermedad cardiovascular en pacientes con enfermedad pulmonar obstructiva crónica de las Islas Canarias.

INTRODUCTION: Cardiovascular disease has a negative impact on the vital prognosis of patients with chronic obstructive pulmonary disease (COPD), where dyslipidaemia (DLP) and arterial hypertension (AHT) are considered the most prevalent risk factors. The objective of this study was 1) to assess the relationship between diagnosed DLP and cardiovascular disease in COPD patients and compare it with other known cardiovascular risk factors and 2) to determine the relationship between the different cardiovascular comorbidities and the severity groups according to the GOLD 2017 classification. METHODS: A cross-sectional, observational study was performed in 454 outpatients with COPD during their follow up. We calculated the prevalence of each of the cardiovascular comorbidities and the probability of each of the cardiovascular risk factors to occur jointly with a vascular disease (RRij). RESULTS: A total of 66.7% of the patients had DLP, whereby DLP was related to cerebrovascular accidents (CVA) (RRij 1.36, P=.0054), chronic kidney disease (CKD) (RRij 1.34, P=.00023), and peripheral arterial disease (PAD) (RRij 1.38, P=.00015). AHT was mostly related to CVA (RRij 1.41, P=.0014) and CKD (RRij 1.42, P<.0001). Type 2 diabetes mellitus (T2DM) correlated with PAD (RRij 1.90, P=.0001), heart failure (HF) (RRij 1,74, P=.0002), and CKD (RRij 1.76, P<.0001), and obesity was associated with HF (RRij 1.60, P=.0009) and CKD (RRij 1.54, P=.0001). CONCLUSION: DLP was related to CVA, CKD, and PAD. AHT and T2DM are the conditions that mostly relate to HF and CVA.

Floral morphology and development in Quillajaceae and Surianaceae (Fabales), the species-poor relatives of Leguminosae and Polygalaceae.

BACKGROUND AND AIMS: Molecular phylogenies have suggested a new circumscription for Fabales to include Leguminosae, Quillajaceae, Surianaceae and Polygalaceae. However, recent attempts to reconstruct the interfamilial relationships of the order have resulted in several alternative hypotheses, including a sister relationship between Quillajaceae and Surianaceae, the two species-poor families of Fabales. Here, floral morphology and ontogeny of these two families are investigated to explore evidence of a potential relationship between them. Floral traits are discussed with respect to early radiation in the order. METHODS: Floral buds of representatives of Quillajaceae and Surianaceae were dissected and observed using light microscopy and scanning electron microscopy. KEY RESULTS: Quillajaceae and Surianaceae possess some common traits, such as inflorescence morphology and perianth initiation, but development and organization of their reproductive whorls differ. In Quillaja, initiation of the diplostemonous androecium is unidirectional, overlapping with the petal primordia. In contrast, Suriana is obdiplostemonous, and floral organ initiation is simultaneous. Independent initiation of five carpels is common to both Quillaja and Suriana, but subsequent development differs; the antesepalous carpels of Quillaja become fused proximally and exhibit two rows of ovules, and in Suriana the gynoecium is apocarpous, gynobasic, with antepetalous biovulate carpels. CONCLUSIONS: Differences in the reproductive development and organization of Quillajaceae and Surianaceae cast doubt on their potential sister relationship. Instead, Quillaja resembles Leguminosae in some floral traits, a hypothesis not suggested by molecular-based phylogenies. Despite implicit associations of zygomorphy with species-rich clades and actinomorphy with species-poor families in Fabales, this correlation sometimes fails due to high variation in floral symmetry. Studies considering specific derived clades and reproductive biology could address more precise hypotheses of key innovation and differential diversification in the order.

Floral morphology and development in Quillajaceae and Surianaceae (Fabales), the species-poor relatives of Leguminosae and Polygalaceae.

BACKGROUND AND AIMS: Molecular phylogenies have suggested a new circumscription for Fabales to include Leguminosae, Quillajaceae, Surianaceae and Polygalaceae. However, recent attempts to reconstruct the interfamilial relationships of the order have resulted in several alternative hypotheses, including a sister relationship between Quillajaceae and Surianaceae, the two species-poor families of Fabales. Here, floral morphology and ontogeny of these two families are investigated to explore evidence of a potential relationship between them. Floral traits are discussed with respect to early radiation in the order. METHODS: Floral buds of representatives of Quillajaceae and Surianaceae were dissected and observed using light microscopy and scanning electron microscopy. KEY RESULTS: Quillajaceae and Surianaceae possess some common traits, such as inflorescence morphology and perianth initiation, but development and organization of their reproductive whorls differ. In Quillaja, initiation of the diplostemonous androecium is unidirectional, overlapping with the petal primordia. In contrast, Suriana is obdiplostemonous, and floral organ initiation is simultaneous. Independent initiation of five carpels is common to both Quillaja and Suriana, but subsequent development differs; the antesepalous carpels of Quillaja become fused proximally and exhibit two rows of ovules, and in Suriana the gynoecium is apocarpous, gynobasic, with antepetalous biovulate carpels. CONCLUSIONS: Differences in the reproductive development and organization of Quillajaceae and Surianaceae cast doubt on their potential sister relationship. Instead, Quillaja resembles Leguminosae in some floral traits, a hypothesis not suggested by molecular-based phylogenies. Despite implicit associations of zygomorphy with species-rich clades and actinomorphy with species-poor families in Fabales, this correlation sometimes fails due to high variation in floral symmetry. Studies considering specific derived clades and reproductive biology could address more precise hypotheses of key innovation and differential diversification in the order.

Meconium peritonitis in Nigerian children.

BACKGROUND: Meconium peritonitis is a rare disease with a fatal outcome. In Nigeria and Africa, there are only the occasional case reports on the subject matter. METHODS: This is a 10-year retrospective study of all patients with meconium peritonitis treated at the University of Maiduguri Teaching Hospital, Maiduguri, Borno State, the Lagos University Teaching Hospital, Lagos State, Obafemi Awolowo University Teaching Hospitals complex, Ile-Ife, Osun State and the Federal Medical Centre Gombe, Gombe State, Nigeria. RESULTS: There were 10 neonates comprising 6 girls and 4 boys. The median age at presentation was 4 days (range 2-6 days). Six of the mothers of the children with meconium peritonitis had a supervised antenatal care and 4 had antenatal ultrasonography but meconium peritonitis was missed. The most common clinical presentation was abdominal distension at birth in 9 of 10 patients. The abdominal X-rays showed calcification and homogenous opacity in 4 patients and pneumoperitoneum in 2 patients. At laparotomy, all the patients had inflammatory adhesion bands and matted bowel loops. The generalized type was the commonest form observed (7 patients) and giant pseudocyst was noted in 2 patients. The commonest sites of perforation were the ileum in 4 patients and jejunum in 3 patients. In one patient the perforation had sealed at laparotomy. Intestinal obstruction was the commonest cause of meconium peritonitis in 7 of 10 patients. In the remaining 3 patients the cause is unknown. The commonest procedure performed was resection and anastomosis (4 patients). The mortality rate was high (50%). CONCLUSION: Our data revealed the rarity of meconium peritonitis and intestinal obstruction as the commonest cause. It is recommended that in patients with an unidentifiable cause a rectal biopsy should be done to rule out Hirschsprung's disease. Early diagnosis, proper operative procedure and meticulous post-operative care should improve their survival.

Floral morphology and development in Quillajaceae and Surianaceae (Fabales), the species-poor relatives of Leguminosae and Polygalaceae.

BACKGROUND AND AIMS: Molecular phylogenies have suggested a new circumscription for Fabales to include Leguminosae, Quillajaceae, Surianaceae and Polygalaceae. However, recent attempts to reconstruct the interfamilial relationships of the order have resulted in several alternative hypotheses, including a sister relationship between Quillajaceae and Surianaceae, the two species-poor families of Fabales. Here, floral morphology and ontogeny of these two families are investigated to explore evidence of a potential relationship between them. Floral traits are discussed with respect to early radiation in the order. METHODS: Floral buds of representatives of Quillajaceae and Surianaceae were dissected and observed using light microscopy and scanning electron microscopy. KEY RESULTS: Quillajaceae and Surianaceae possess some common traits, such as inflorescence morphology and perianth initiation, but development and organization of their reproductive whorls differ. In Quillaja, initiation of the diplostemonous androecium is unidirectional, overlapping with the petal primordia. In contrast, Suriana is obdiplostemonous, and floral organ initiation is simultaneous. Independent initiation of five carpels is common to both Quillaja and Suriana, but subsequent development differs; the antesepalous carpels of Quillaja become fused proximally and exhibit two rows of ovules, and in Suriana the gynoecium is apocarpous, gynobasic, with antepetalous biovulate carpels. CONCLUSIONS: Differences in the reproductive development and organization of Quillajaceae and Surianaceae cast doubt on their potential sister relationship. Instead, Quillaja resembles Leguminosae in some floral traits, a hypothesis not suggested by molecular-based phylogenies. Despite implicit associations of zygomorphy with species-rich clades and actinomorphy with species-poor families in Fabales, this correlation sometimes fails due to high variation in floral symmetry. Studies considering specific derived clades and reproductive biology could address more precise hypotheses of key innovation and differential diversification in the order.

Control de calidad en nutrición parenteral neonatal, empleando como método validado el análisis bioquímico / Quality control in neonatal parenteral nutrition, using biochemical analysis as a validated method

Objetivos: El objetivo de este estudio es describir el método empleado como control de calidad en las nutriciones parenterales de neonatos en un hospital de tercer nivel, así como realizar un análisis estadístico de los resultados del mismo.Material y métodos: En nuestro centro se realiza un análisis bioquímico de los niveles de glucosa, potasio y calcio de todas las nutriciones parenterales neonatales como método de control de calidad. Dicho análisis se realiza mediante técnicas previamente validadas. Se evaluaron todas las nutriciones parenterales neonatales elaboradas durante el periodo comprendido entre julio de 2018 y noviembre de 2019. Todas las mezclas analizadas contenían lípidos. Para el análisis estadístico de los resultados se consideró un ±10% sobre la concentración teórica como margen de aceptación.Resultados: Se analizaron 950 mezclas y se obtuvieron las rectas de regresión lineal para establecer la correlación entre el valor teórico y real de los componentes analizados.Conclusiones: Destaca la importancia que tiene el establecimiento de un control de calidad de las nutriciones parenterales neonatales, para la detección y prevención de errores durante la preparación de las mismas y previamente a su dispensación. (AU)

Objectives: We aimed to describe the method used as neonatal parenteral nutrition quality control in a third level hospital, as well as to carry on a statistical analysis of its results.Methods: In our center, a biochemical analysis of glucose, potassium and calcium levels of all neonatal parenteral nutrition is performed as a quality control method. This analysis is carried out using previously validated techniques. All neonatal parenteral nutrition prepared during the period between July 2018 and November 2019 were evaluated. All the mixtures analyzed contained lipids. For the statistical analysis of the results, ±10% of the theoretical concentration was considered as the acceptance margin.Results: 950 mixtures were analyzed and linear regression lines were obtained to establish the correlation between the theoretical and real value of the analyzed components.Conclusions: In conclusion, the importance of establishing quality control of neonatal parenteral nutrition is highlighted, for the detection and prevention of errors during their preparation and prior to their dispensing. (AU)

Niveles séricos de PAPP-A y beta-hCG en el primer trimestre del embarazo como predictores de resultados obstétricos desfavorables en el Hospital Universitario Nuestra Señora de Candelaria / Serum levels of PAPP-A and beta-hCG in the first trimester of pregnancy as predictors of unfavourable obstetric outcomes at Hospital Universitario Nuestra Señora de Candelaria

Muchos estudios han documentado la asociación entre valores bajos de PAPP-A y β-hCG en el suero materno durante el primer trimestre, así como efectos materno-fetales adversos.Para valorar dicha relación, en nuestro medio se llevó a cabo un análisis retrospectivo de casos y controles anidado en una cohorte de pacientes con embarazo único en quienes se realizó el cribado del primer trimestre entre 2017 y 2018. Se consideraron casos aquellas pacientes con niveles de MoM PAPP-A y/o β-hCG iguales o inferiores al percentil 5, y como controles a una muestra aleatorizada de pacientes con niveles séricos por encima de dicho percentil.El análisis de nuestros resultados demostró que en los grupos con niveles bajos de MoM PAPP-A y MoM β-hCG se observó un mayor riesgo de desarrollar crecimiento intrauterino restringido que en el grupo control (OR: 2,7 y 3,17, respectivamente). En el grupo MoM PAPP-A≤p5 también se obtuvo un riesgo 3,8 veces superior de estados hipertensivos del embarazo (IC: 1,94-7,83) y 7,9 veces mayor de muerte fetal anteparto (IC:1,09-217,4). Estas dos variables no resultaron estadísticamente significativas en el grupo MoM β-hCG ≤p5.Nuestros hallazgos confirmaron que los niveles bajos de PAPP-A y β-hCG en el suero de las gestantes se asoció con un riesgo elevado de desarrollar complicaciones obstétricas, por lo que podrían utilizarse para la detección precoz de las mismas y prevención de malos resultados obstétricos.

Many studies have documented the association between low PAPP-A and β-hCG values in maternal serum during the first trimester and adverse maternal-foetal effects.To assess this relationship a retrospective analysis of cases and controls was carried out, based on a cohort of patients with a single pregnancy who underwent first-trimester screening between 2017 and 2018. For the group of cases, patients with MoM levels PAPP-A and/or β-hCG equal to or below the 5th percentile were selected. The control group was obtained by making a randomized selection of all patients with MoM PAPP-A levels and/or β-hCG above that percentile.The analysis of our results showed that in groups with low levels of MoM PAPP-A and MoM β- hCG, we observed a higher risk of developing restricted intrauterine growth than in the control group (OR: 2.7 and 3.17, respectively). In the MoM PAPP-A ≤p5 group we also obtained a 3.8-foldhigher risk of global hypertensive states of pregnancy (CI: 1.94-7.83) and 7.9-fold higher risk of antepartum foetal death (CI: 1.09- 217.4). These two variables were not statistically significant in the MoM β-hCG ≤p5 group.Our findings confirmed that low levels of PAPP-A and β-hCG in the serum of pregnant women are associated with a high risk of developing obstetric complications, so they could be used for their early detection and the prevention of poor obstetric results.

Host Specificity of Ascochyta spp. Infecting Legumes of the Viciae and Cicerae Tribes and Pathogenicity of an Interspecific Hybrid.

ABSTRACT Ascochyta spp. (teleomorphs: Didymella spp.) infect a number of legumes, including many economically important species, and the diseases they cause represent serious limitations of legume production worldwide. Ascochyta rabiei, A. fabae, A. pisi, A. lentis, and A. viciae-villosae are pathogens of chickpea (Cicer arietinum), faba bean (Vicia faba), pea (Pisum sativum), lentil (Lens culinaris), and hairy vetch (V. villosa), respectively. Inoculations in the greenhouse and in growth chambers demonstrated that A. fabae, A. lentis, A. pisi, A. rabiei, and A. viciae-villosae were host specific. Isolates caused no visible disease symptoms on "nonhost" plants (plants other than the hosts they were originally isolated from) but were recovered consistently from inoculated, surface-disinfested, nonhost tissues. Interspecific crosses of A. pisi x A. fabae and A. viciae-villosae x A. lentis produced pseudothecia with viable ascospores, and the hybrid status of the ascospore progeny was verified by the segregation of mating type and amplified fragment length polymorphism (AFLP) markers. Interspecific progeny were morphologically normal in culture but exhibited more phenotypic variation compared with progeny from intraspecific crosses. Mating type and the majority of AFLP markers segregated in Mendelian 1:1 ratios in both intraspecific and interspecific crosses. A total of 11 and 7% of AFLP markers showed segregation distortion among progeny from interspecific crosses and intraspecific crosses, respectively; however, this difference was not significant (P = 0.90). Only 30 of 114 progeny isolates from the A. fabae x A. pisi cross inoculated in the greenhouse caused lesions on pea and only 4 caused disease on faba bean. In all, 15 of 110 progeny isolates were pathogenic to pea and none were pathogenic to faba bean under growth chamber conditions. Although no obvious postzygotic, intrinsic isolating barriers were identified in any of the interspecific crosses, it appears that host specialization may act as both a prezygotic, ecological isolating barrier and a postzygotic, extrinsic, ecological isolating barrier in these fungi. Host specificity, coupled with low pathogenic fitness of hybrids, may be an important speciation mechanism contributing to the maintenance of hostspecific, phylogenetic lineages of these fungi.

Size and metabolic properties of fibers in rat fast-twitch muscles after hindlimb suspension.

Hindlimb suspension (HS) results in whole muscle atrophic and metabolic changes that vary in magnitude in different hindlimb muscles. The present study was designed to investigate these effects in single fibers. Fiber type and size and the activities of two metabolic marker enzymes were determined in a deep (close to the bone) and a superficial (away from the bone) region of the medial gastrocnemius (MG) and the tibialis anterior (TA) of control (CON) and 28-day HS adult female rats. Fibers were classified as dark or light adenosinetriphosphatase (ATPase) based on their qualitative staining reaction for myosin ATPase following alkaline preincubation. Fiber area and succinate dehydrogenase (SDH) and alpha-glycerophosphate dehydrogenase (GPD) activities were determined in tissue sections by use of an image analysis system. After 28 days of HS, the mean body weights of the CON and HS were similar. MG atrophied 28%, whereas TA weight was maintained in the HS. Both dark and light ATPase fibers in the deep region of the MG had smaller cross-sectional areas following HS, with the atrophic response being approximately twice as great in the light ATPase fibers. No significant changes in fiber type composition in either muscle or in fiber sizes in the superficial region of the MG or in either region of the TA were observed. Mean SDH activities of both fiber types were significantly lower in the MG and TA following HS. In contrast, mean GPD activities were either increased or maintained in light and dark ATPase fibers of both muscles in HS. Changes in SDH and GPD activity could not be directly linked to changes in fiber cross-sectional area. In summary, these data suggest an independence of the mechanisms determining muscle fiber size and metabolic adaptations associated with HS.

Association between parasitic intestinal infections and acute or chronic diarrhoea in HIV-infected patients in Caracas, Venezuela.

A cross sectional survey was conducted to determine the association between enteric parasites and diarrhoea in HIV-infected adults in Caracas. Three hundred and four patients were evaluated: 104 had acute diarrhoea, 113 chronic diarrhoea and 87 were controls. Isopora belli infection was associated with acute (P = 0.022) and chronic diarrhoea (P = 0.003), Entamoeba histolytica/dispar infection was also associated with both acute (P = 0.015) and chronic diarrhoea (P = 0.017). Strongyloides stercoralis (P = 0.003), and Cryptosporidium parvum (P = 0.017) infections were associated mainly with chronic episodes. Weight loss (P < 0.001), a non-infectious factor investigated, was significantly associated with diarrhoea. Eosinophilia, a laboratory parameter studied, was found to be associated with strongyloidiasis (P = 0.001), giardiasis (P = 0.001) and isoporiasis (P = 0.003). In summary, the presence of enteric parasites in HIV-infected patients from tropical urban areas with diarrhoea, with or without significant weight loss, must be considered. Similarly, eosinophilia might suggest parasitic infection in these patients.

Determination of paracetamol in dosage forms by non-suppressed ion chromatography.

An ion-chromatography procedure for the simultaneous determination of paracetamol and salicylic acid without suppression using UV detection is proposed. The method is applied to the determination of paracetamol in pharmaceuticals and also permits the quantitation of the total acetylsalicylic acid as salicylic acid.