Sequestration of Defenses against Predators Drives Specialized Host Plant Associations in Preadapted Milkweed Bugs (Heteroptera: Lygaeinae).

AbstractHost plant specialization across herbivorous insects varies dramatically, but while the molecular mechanisms of host plant adaptations are increasingly known, we often lack a comprehensive understanding of the selective forces that favor specialization. The milkweed bugs (Heteroptera: Lygaeinae) are ancestrally associated with plants of the Apocynaceae from which they commonly sequester cardiac glycosides for defense, facilitated by resistant Na+/K+-ATPases and adaptations for transport, storage, and discharge of toxins. Here, we show that three Lygaeinae species independently colonized four novel nonapocynaceous hosts that convergently produce cardiac glycosides. A fourth species shifted to a new source of toxins by tolerating and sequestering alkaloids from meadow saffron (Colchicum autumnale, Colchicaceae). Across three milkweed bug species tested, feeding on seeds containing toxins did not improve growth or speed of development and even impaired growth and development in two species, but sequestration mediated protection of milkweed bugs against two natural predators: lacewing larvae and passerine birds. We conclude that physiological preadaptations and convergent phytochemistry facilitated novel specialized host associations. Since toxic seeds did not improve growth but either impaired growth or, at most, had neutral effects, selection by predators on sequestration of defenses, rather than the exploitation of additional profitable dietary resources, can lead to obligatory specialized host associations in otherwise generalist insects.

Optimized Route for the Fabrication of MnAlC Permanent Magnets by Arc Melting.

The rare-earth-free MnAlC alloy is currently considered a very promising candidate for permanent magnet applications due to its high anisotropy field and relatively high saturation magnetization and Curie temperature, besides being a low-cost material. In this work, we presented a simple fabrication route that allows for obtaining a magnetically enhanced bulk τ-MnAlC magnet. In the fabrication process, an electric arc-melting method was carried out to melt ingots of MnAlC alloys. A two-step solution treatment at 1200 °C and 1100 °C allowed us to synthesize a pure room-temperature ε-MnAlC ingot that completely transformed into τ-MnAlC alloy, free of secondary phases, after an annealing treatment at 550 °C for 30 min. The Rietveld refinements and magnetization measurements demonstrated that the quenched process produces a phase-segregated ε-MnAlC alloy that is formed by two types of ε-phases due to local fluctuation of the Mn. Room-temperature hysteresis loops showed that our improved τ-MnAlC alloy exhibited a remanent magnetization of 42 Am2/kg, a coercive field of 0.2 T and a maximum energy product, (BH)max, of 6.07 kJ/m3, which is higher than those reported in previous works using a similar preparation route. Experimental evidence demonstrated that the synthesis of a pure room-temperature ε-MnAlC played an important role in the suppression of undesirable phases that deteriorate the permanent magnet properties of the τ-MnAlC. Finally, magnetic images recorded by Lorentz microscopy allowed us to observe the microstructure and magnetic domain walls of the optimized τ-MnAlC. The presence of magnetic contrasts in all the observed grains allowed us to confirm the high-quality ferromagnetic behavior of the system.

Increased chemerin serum levels in hyperandrogenic and normoandrogenic women from Argentina with polycystic ovary syndrome.

AIM: To assess serum chemerin levels and investigate the association of chemerin with the hyperandrogenic and normoandrogenic phenotypes of Polycystic Ovary Syndrome (PCOS) and with the metabolic status of the analyzed population. MATERIAL AND METHODS: A cross-sectional study was conducted on 106 women with PCOS and 60 healthy controls from Argentina. Patients were classified as showing a hyperandrogenic or normoandrogenic phenotype. Participants underwent anthropometric and clinical evaluation and markers of cardiovascular risk, insulin resistance, metabolic syndrome (MS), and serum chemerin levels were assessed. RESULTS: PCOS patients showed increased levels of chemerin. In adjusted models for age and body mass index (BMI), chemerin was associated with markers of metabolic status. The analysis of chemerin levels considering the cutoff values of BMI, homeostatic model of insulin sensitivity (HOMA-IR) and TG/HDL marker showed that PCOS patients always presented higher levels of chemerin than controls. PCOS group showed increased chemerin levels independently of the presence of MS. CONCLUSION: PCOS patients always showed increased levels of chemerin independently of their phenotype and presence of overweight, as well as higher levels of chemerin than controls when considering the cutoff values of HOMA-IR and TG/HDL. Therefore, argentine women with PCOS display increased chemerin levels independently of their metabolic or androgenic status.

Lipid Accumulation Product (LAP) and Visceral Adiposity Index (VAI) as Markers of Insulin Resistance and Metabolic Associated Disturbances in Young Argentine Women with Polycystic Ovary Syndrome.

Polycystic ovary syndrome (PCOS) is an endocrine disorder. PCOS women are at high risk of developing insulin resistance (IR) and cardiovascular disorders since young age. We aimed to study the reliability of lipid accumulation product (LAP) and visceral adiposity index (VAI) as markers of metabolic disturbances (MD) associated with IR in young reproductive aged PCOS patients. We also evaluated the association between LAP and VAI and the presence of hyperandrogenism. In a cross-sectional study, 110 PCOS patients and 88 control women (18-35 years old) were recruited. PCOS patients were divided into 2 groups, as hyperandrogenic and non-hyperandrogenic considering the signs of hyperandrogenism (clinical or biochemical). Anthropometric measurements were taken and blood samples collected. Metabolic and anthropometric characteristics and their association with IR and associated MD were evaluated and LAP and VAI were calculated. LAP and VAI were compared with TC/HDL-c and TG/HDL-c to define the best markers of MD in this population. Independently of the phenotype, young PCOS patients showed high IR and dyslipidemia. Both LAP and VAI showed to be more effective markers to assess MD and IR in these young women than TG/HDL-c or TC/HDL-c [cut-off values: LAP: 18.24 (sensitivity: 81.43% specificity: 73.49%), positive predictive value (PPV): 75.0%, negative predictive value (NPV): 77.27%, VAI: 2.19 (sensitivity: 81.16% specificity: 72.15% PPV: 74.65% NPV: 72.22%)]. LAP and VAI are representative markers to assess MD associated with IR in young PCOS patients. All PCOS patients, independently of their androgenic condition, showed high metabolic risk.

Design, Manufacturing and Acoustic Assessment of Polymer Mouthpieces for Trombones.

Brass instruments mouthpieces have been historically built using metal materials, usually brass. With the auge of additive manufacturing technologies new possibilities have arisen, both for testing alternative designs and for using new materials. This work assesses the use of polymers for manufacturing trombone mouthpieces, specifically PLA and Nylon. The acoustical behavior of these two mouthpieces has been compared with the obtained from a third one, built from brass. Both additive and subtractive manufacturing techniques were used, and the whole manufacturing process is described. The mouthpieces were acoustically assessed in an anechoic chamber with the collaboration of a professional performer. The harmonic analysis confirmed that all the manufactured mouthpieces respect the harmonic behavior of the instrument. An energy analysis of the harmonics revealed slight differences between the mouthpieces, which implies differences in the timbre of the instrument. Although these subtle differences would not be acceptable when performing with the instrument in an orchestra, they could be perfectly valid for early learners, personal rehearsals or any kind of alternative performance.

Biogeographical Relationships and Diversity in the Peruvian Flora Reported by Hipólito Ruiz and José Pavón: Vegetation, Uses and Anthropology.

The Royal Spanish Botanical Expedition to the Viceroyalty of Peru in the 18th century was one of the most important European expeditions to American territories. Using the herbarium sheets of Ruiz and Pavón (Royal Botanical Garden of Madrid) and their edited works, manuscripts and expedition diaries, we have constructed a database of the collected and observed flora, which has served as the basis for a map containing all of the Peruvian localities of the expedition. Based on the method of bioclimatic belts and our own observations, we have deduced to which type of vegetation the flora studied in the expedition belongs. The uses of the flora per locality were studied, as well as the ethnic groups involved in the different localities. By using a Principal Component Analysis, we have obtained the distribution of the bioclimatic belts whose vegetation was the most explored. In order to observe the bioclimatic tendency of plant uses, a Detrended Correspondence Analysis (DCA) was conducted to identify the distribution of localities with the highest frequencies of plant uses. The expedition's explorations focused on the most humid areas of the thermo- and mesotropical belts, from where a large number of plants with practical uses were obtained.

Return to exercise after COVID-19. Statement of the Mexican Society of Cardiology / Retorno al ejercicio después de COVID-19. Posicionamiento de la Sociedad Mexicana de Cardiología

The coronavirus disease 2019 (COVID-19) was declared a pandemic on March 11, 2020; one consequence has been the increase in sedentary lifestyle and reduction of sports activity. Exercise benefits the immune defense system especially in older adults; it is recommended to keep a distance of 1.5 meters between people, and if walking or jogging is carried out, the space must be up to 5 and 10 meters respectively. The reported cases are mostly mild up to 80% and can be critical in up to 4.7%; the risk factors are well known, hypertension, diabetes and previous heart disease. Severe or critical cases present as symptoms of acute respiratory distress syndrome, and in the case of cardiovascular disease, they mainly occur as myopericarditis, acute coronary syndromes, cardiogenic shock, thrombotic events, among others. Returning to exercise after recovery from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is always recommended, however it will depend on the clinical picture what measures should be taken prior to its onset, and it is in moderate cases and especially in the severe ones where the evaluation and prescription prior to returning to exercise or sport should be guided by medical personnel experts in cardiopulmonary rehabilitation, especially in athletes.

La enfermedad por coronavirus 2019 (COVID-19) fue declarada pandemia el 11 de marzo de 2020; una consecuencia ha sido el incremento en el sedentarismo y la reducción de la actividad deportiva. El ejercicio beneficia el sistema inmunitario de defensa, especialmente en adultos mayores. Se recomienda guardar distancia de 1.5 metros entre personas, y si se realiza caminata o trote, el espacio debe ser de hasta 5 y 10 metros respectivamente. Los casos reportados son en su mayoría leves hasta en un 80%, y pueden ser críticos hasta en 4.7%; los factores de riesgo son bien conocidos: hipertensión, diabetes y enfermedad cardiaca previa. Los casos graves o críticos se presentan como cuadros de síndrome de distrés respiratorio agudo y ante afección cardiovascular cursan principalmente como miopericarditis, síndromes coronarios agudos, choque cardiogénico y eventos trombóticos, entre otros. El ejercicio después de la recuperación de infección por coronavirus 2 del síndrome respiratorio agudo grave (SARS-CoV-2) siempre está recomendado, sin embargo, dependerá del cuadro clínico qué medidas se deben tomar previo a su inicio, y es en casos moderados y especialmente en los graves donde la evaluación y prescripción previa al retorno al ejercicio o deporte debe ser guiada por personal médico experto en rehabilitación cardiopulmonar, en especial en deportistas.

Low Range of Shoulders Horizontal Abduction Predisposes for Shoulder Pain in Competitive Young Swimmers.

The prevalence of shoulder pain (SP) among competitive swimmers is high, and may profoundly restrict their ability to compete. This prospective cohort study investigated the association between 3 blocks of performance factors (anthropometric characteristics, sport experience and training regimen) and the presence of SP. The aims of the present study were: (a): to determine the profile of shoulder flexibility in young swimmers, (b) to analyze whether a restricted range of movement (ROM) could be a predictor of subsequent SP in young swimmers. 24 competitive young swimmers were measured in the 2016 pre-season. Measures of passive maximal shoulder extension (SE), flexion (SF), horizontal abduction (SHAB), abduction (SAB), horizontal adduction (SHADD), external (SER) and internal (SIR) rotation ROMs were taken. SP was prospectively monitored during the subsequent season using questionnaires. The data was analyzed via a binary logistic regression and ROC curves were calculated. At the follow-up, 16 swimmers (50%) had developed unilateral SP. Only reduced SHAB ROM was associated with SP [SP group 36.6° vs. pain-free group 41.5°; p = 0.005, d = -0.96 (moderate effect sizes)]. Using the coordinates of the curves, the angle of SHAB ROM that most accurately identified individuals at risk of developing SP was determined to be 39° (sensibility 0.656 and 0.375 specificity). Swimmers with limited ROM (≤39°) have 3.6 times higher risk of developing SP than swimmers with normal ROM (>39°). This study clearly shows that low range of SHAB is a risk factor for developing SP in competitive young swimmers. In the studied data, a SHAB range of 39° was found to be the most appropriate cut-off point for prognostic screening.

MLL amplification in acute myeloid leukemia.

The chromosomal alterations at 11q23 that involve the mixed-lineage leukemia gene (MLL, HTRX1, HRX, ALL1) are one of the most common cytogenetic abnormalities in acute leukemia and have been associated with a poor prognosis. Given that not all MLL alterations are seen under conventional cytogenetics or fluorescence in situ hybridization (FISH), it is very important to use molecular techniques to determine the cause of alteration. In this study, we describe two cases of AML in which FISH analysis showed a high-level 11q23 amplification, to confirm if this overexpression may be accompanied by partial tandem duplication of the MLL gene (MLL-PTD). Both patients showed complex karyotype and an unfavorable clinical course. The 11q23 region characterization included conventional cytogenetics, FISH, and comparative genomic hybridization analysis to study the expression patterns of several oncogenes located within the amplified region and detection of partial tandem duplication of the MLL gene by reverse-transcription polymerase chain reaction (RT-PCR) and sequencing. MLL-PTD were detected in the two patients. Moreover, patient 1 showed amplification of the MLL flanking region. Our data suggest that molecular methods such as RT-PCR or sequencing should be used to detect MLL alterations, and that amplification of MLL locus may be extended to its flanking region.

Ejercicios físicos terapéuticos domiciliarios en la atención a pacientes con fibromialgia durante la COVID-19 / Home therapeutic physical exercises in the care of patients with fibromyalgia during COVID-19

Introducción: El ejercicio físico sistemático constituye una herramienta indispensable para el tratamiento de los pacientes con fibromialgia, y más aún en la etapa de COVID-19. Objetivo: Constatar la eficacia de los ejercicios físicos terapéuticos domiciliarios en la atención a pacientes con fibromialgia durante la COVID-19. Métodos: Se realizó un prexperimento, con una muestra intencional de 20 pacientes con fibromialgia. Se utilizó el cuestionario de impacto de fibromialgia para conocer el impacto general de la enfermedad y la escala analógica visual del dolor para determinar la intensidad del dolor. Se conoció por medio de los exámenes físicos la condición física de los pacientes. Se aplicó la prueba no paramétrica de McNemar y Wilcoxon para identificar cambios producidos en los pacientes mediante la aplicación de ejercicios físicos terapéuticos domiciliarios. Resultados: El promedio de edad fue de 47,85 años, con predominio del sexo femenino (95,0 por ciento). Al inicio de la investigación las puntuaciones del cuestionario de impacto de fibromialgia determinaron que el 85,0 por ciento de los pacientes tenían un impacto moderado y severo de la enfermedad. La escala analógica visual del dolor evidenció que los pacientes padecían dolor moderado y severo. La evaluación de los exámenes físicos demostró que en su mayoría los pacientes tenían una condición física inadecuada. Después de implementado los ejercicios físicos terapéuticos domiciliarios se demostró una mejoría de los parámetros evaluados, evidenciado mediante la estadística inferencial a través de la prueba McNemar ya que los resultados estuvieron a un nivel inferior (p = 0,005). Los resultados de Z de Wilcoxon tuvieron una significación bilateral de 0,000. Conclusiones: Se evidenciaron cambios significativos en los pacientes con fibromialgia. Los ejercicios físicos terapéuticos domiciliarios fueron efectivos en los pacientes con fibromialgia durante el aislamiento por la COVID-19(AU)

Introduction: Systematic physical exercise constitutes an indispensable tool for the treatment of patients with fibromyalgia: and even more so in the COVID-19 stage. Objective: To verify the effectiveness of home therapeutic physical exercises in the care of patients with fibromyalgia during COVID-19. Methods: A pre-experiment was conducted with a purposive sample of 20 patients with fibromyalgia. A general characterization of the sample was performed. The Fibromyalgia Impact Questionnaire was used to know the general impact of the pathology and the Visual Analog Scale to determine the intensity of the patients' pain. Physical tests were used to determine the physical condition of the sample. The McNemar and Wilcoxon non-parametric test was applied to identify changes produced in the patients through the application of home therapeutic physical exercises. Results: The average age was 47.85 years with a predominance of the female sex (95.0 percent). At the beginning of the research, the Fibromyalgia Impact Questionnaire scores showed that 85.0 percent of the patients were in moderate and severe impact of the disease, as well as the Visual Analog Scale, which showed that the patients were in moderate and severe pain. The evaluation of the physical tests showed that most of the patients were in inadequate physical condition. After implementing the home therapeutic physical exercises, an improvement of the evaluated parameters was demonstrated, thus evidenced by the contracting of inferential statistics through McNemar since the results were at a lower level for p=0.005 and the Wilcoxon Z results resulted in a bilateral significance of 0.000. Conclusions: It is concluded that the results obtained evidenced significant changes in fibromyalgia patients, which can be said that home therapeutic physical exercises were effective in fibromyalgia patients during isolation by COVID-19(AU)

[Nitrogenous content in parenteral nutrition: a four-year experience in a general hospital. Critically-ill patient specificity].

INTRODUCTION: There have been several studies focusing on caloric intake during the last years, while protein content relevance has been underestimated. Some recent evidence has shown that protein deficiency has also an impact on patient outcomes. We have studied the nitrogen (N) content in parenteral nutrition (PN) bags administered to adult patients in a Spanish tertiary level hospital for four years. MATERIAL AND METHODS: Patients who received parenteral nutrition in the general ward and Intensive Care Unit (ICU) were recorded. Caloric and protein content were registered and adjusted to weight and length of stay. Data were compared among three group of patients: those in the general ward, those in the ICU and those requiring renal replacement therapy (RRT). The one-factor analysis of variance (ANOVA) test was used after checking data normality and homoscedasticity. RESULTS: There was an increase in the mean g N/stay year after year (p < 0.01) from 14 to 15.5 g, with a decrease in non-protein caloric content (p < 0.001) from 111.6 to 101.8 kcal/g N. The range was established from 4.1 to 32.6 g. PN diets with ≥ 18 g N% ranged from 12.8% (2010) to 19.6% (2013). There were significant differences among the groups when comparing the variable g N/stay (p < 0.0001): 13.5 general ward vs15.9 ICU patients vs17.6 ICU with RRT, also when referring to adjusted weight. CONCLUSIONS: According to most recent recommendations nitrogen has been provided in higher amounts than previously, especially in critical care patients with RRT.

[Cardiovascular risk associated with the use of non steroidal anti-inflammatory drugs: cohort study]. / Riesgo cardiovascular asociado al consumo de antiinflamatorios no esteroideos: estudio de cohortes retrospectivo en un área de salud, 2008-2012.

BACKGROUND: Since the clinical trial VIGOR, in which the use of rofecoxib was proved to be connected to a larger number of cardiovascular accidents, an increase of cardiovascular diseases connected to the use of non Steroidal Anti-Inflammatory Drugs has been observed. This study intends to evaluate cardiovascular impact related to the use of non steroidal anti-inflammatory drugs in a Health Care Area in Castilla La Mancha (Spain). METHOD: A retrospective observational study of clinical cohort during 5 years is done in which all patients older than 18 years (n = 116 686) was included. The statistical analysis was done estimating the incidence of acute coronary syndrome in relation to the exposure time. The risk associated with the consumption of non-steroidal anti-inflammatory drugs was made by Poisson regression adjusting by sex and age. Calculation of the Daily Inhabitants Doses by means of the Defined Daily Doses, through DIGITALIS program of pharmaceutical consumption. RESULTS: The connection between acute coronary syndrome and the use of anti-inflammatory drugs was positive (RR 3,64; IC95% 2,94 a 4,52; p<0,001). The cardiovascular risk was higher en alkanones (RR 18; IC95% 2,53 a 127; p=0,004), followed by propionoicos as ibuprofen (RR 2,58; IC95% 2,16 a 3,69; p<0,001), it is also the only group that is time-dependent. Thirdly arylacetic (RR 1,88; IC95% 1,6 a 2,22; p<0,001) and finally the coxib (RR 1,55; IC95% 1,25 a 1,92; p<0,001), in others antiinflammatory no increased cardiovascular risk was observed. CONCLUSIONS: The use of non steroidal anti-inflammatory drugs has been connected to a higher risk of cardiovascular accidents, suggesting that not during prolonged or high-dose or should take.

Extractos de los documentos de posicionamientos y recomendaciones mexicanas en enfermedades cardiovasculares y COVID-19 / Excerpts from the documents of Mexican positions and recommendations in cardiovascular diseases and COVID-19

Resumen Se presentan las recomendaciones en las cuales la Sociedad Mexicana de Cardiología (SMC) en conjunto con la Asociación Nacional de Cardiólogos de México (ANCAM), así como diferentes asociaciones médicas mexicanas vinculadas con la cardiología, después de una revisión y análisis exhaustivo y consensuado sobre los tópicos relacionados con las enfermedades cardiovasculares en la pandemia de COVID-19, se analizan posturas científicas y se dan recomendaciones responsables sobre medidas generales a los pacientes, con cuidados personales, alimentación saludable, actividad física regular, acciones en caso de paro cardiorrespiratorio, la protección del paciente y del personal de salud así como las indicaciones precisas en el uso de la imagen cardiovascular no invasiva, la prescripción de medicamentos, cuidados en tópicos específicos como en la hipertensión arterial sistémica, insuficiencia cardiaca, arritmias y síndromes coronarios agudos, además de hacer énfasis en los procedimientos de electrofisiología, intervencionismo, cirugía cardiaca y en la rehabilitación cardiaca. El interés principal es brindar a la comunidad médica una orientación general sobre el quehacer en la práctica cotidiana y pacientes con enfermedades cardiovasculares en el escenario esta crisis epidemiológica sin precedentes de COVID-19.

Abstract The recommendations in which the Mexican Society of Cardiology (SMC) in conjunction with the National Association of Cardiologists of Mexico (ANCAM) as well as different Mexican medical associations linked to cardiology are presented, after a comprehensive and consensual review and analysis of the topics related to cardiovascular diseases in the COVID-19 pandemic. Scientific positions are analyzed and responsible recommendations on general measures are given to patients, with personal care, healthy eating, regular physical activity, actions in case of cardio-respiratory arrest, protection of the patient and health personnel as well as precise indications in the use of non-invasive cardiovascular imaging, prescription of medications, care in specific topics such as systemic arterial hypertension, heart failure, arrhythmias and acute coronary syndromes, in addition to emphasizing electrophysiology, interventionism, cardiac surgery and in cardiac rehabilitation. The main interest is to provide the medical community with a general orientation on what to do in daily practice and patients with cardiovascular diseases in the setting of this unprecedented epidemiological crisis of COVID-19.

[Efficacy of Helicobacter pylori eradication in non-ulcer dyspepsia]. / Eficacia de la erradicación de Helicobacter pylori en la dispepsia no ulcerosa.

BACKGROUND AND OBJECTIVE: The relationship between Helicobacter pylori infection and functional dyspepsia (FD) is disputed. Although there is a greater prevalence of infection by H. pylori in subjects with non-ulcer dyspepsia than in healthy subjects, results regarding the eradication of infection have been inconclusive so far in terms of disease improvement. In this study, we administered eradicating treatment to a group of patients with both FD and infection by H. pylori to determine the possible beneficial effect of such a treatment. Thus, our objective was to study the effectiveness of eradication therapy for H. pylori in the clinical course of FD. PATIENTS AND METHOD: This was a randomized, double-blind study in 93 consecutive patients diagnosed with FD and infection by H. pylori who received eradicating treatment with omeprazol, amoxicillin and clarythromicin for 7 days (group A, n = 47) vs. placebo, amoxicillin and clarythromicin for 7 days (group B, n = 46). We analyzed the clinical evolution of the disease within the following 9 months. RESULTS: Both groups of treatment were comparable concerning all the variables studied except for the consumption of alcohol, with a greater prevalence in group A, yet no patient consumed more than 40 g per day. The average age of patients was 42 (18-65). Eradication of H. pylori occurred in 65.9% of patients in group A and 4.3% of patients in group B. 40% of all patients included in the study had improved symptoms. In 60.6% of patients whose infection was eradicated, their symptoms improved, as opposed to 25% of patients whose infection was not eradicated (p = 0.001). Among patients whose symptoms improved following eradication, 70% had had an FD duration of less than 3 years and in 30% FD had lasted for more than 3 years (p < 0.05). CONCLUSIONS: The eradication of H. pylori in patients with short-lasting FD may lead to a significant clinical benefit, especially in those whose duration of symptoms is below 3 years.

Low dose of bisphenol A impairs the reproductive axis of prepuberal male rats.

The objective of the present work was to study the effect of a low dose of bisphenol A (BPA), on the reproductive axis of prepuberal male rats exposed to the endocrine disruptor (ED) during gestation and lactation period. Wistar-mated rats were treated with either 0.1 % ethanol or BPA in their drinking water until their offspring were weaned at the age of 21 days. The estimated average dose of exposure to dams was approximately 3 µg/kg/day of BPA. The pups were sacrificed on the 35th day of life. Body weight was measured during the development and at the moment of the sacrifice; testicular and seminal vesicles weight and their respective relative weights were also measured. LH, FSH and testosterone were determined and histological studies of testicular tissue were also performed. Body weight at the moment of the sacrifice was significantly higher in the group exposed to BPA; testicular weight decreased significantly; seminal vesicles weight and relative weights of testes and seminal vesicles were not modified by treatment. LH and FSH serum levels increased significantly after treatment, meanwhile testosterone showed no significant changes. Histological studies showed the lumen of seminal tubes reduced by the presence of immature cells of the spermatic lineage. Our results suggest that pre- and early postnatal exposure to a low dose of BPA disrupts the normal function of the reproductive axis in prepuberal male rats. The effects of the ED may be exerted at different levels of the axis and may be dependent on the dose, manner of administration, and the moment of exposure to the disruptor.

Infornut® Process; improves accessibility to diagnosis and nutritional support for the malnourished hospitalized patient; impact on management indicators; two-year assessment.

INTRODUCTION: The high prevalence of disease-related hospital malnutrition justifies the need for screening tools and early detection in patients at risk for malnutrition, followed by an assessment targeted towards diagnosis and treatment. At the same time there is clear undercoding of malnutrition diagnoses and the procedures to correct it Objectives: To describe the INFORNUT program/ process and its development as an information system. To quantify performance in its different phases. To cite other tools used as a coding source. To calculate the coding rates for malnutrition diagnoses and related procedures. To show the relationship to Mean Stay, Mortality Rate and Urgent Readmission; as well as to quantify its impact on the hospital Complexity Index and its effect on the justification of Hospitalization Costs. MATERIAL AND METHODS: The INFORNUT® process is based on an automated screening program of systematic detection and early identification of malnourished patients on hospital admission, as well as their assessment, diagnoses, documentation and reporting. Of total readmissions with stays longer than three days incurred in 2008 and 2010, we recorded patients who underwent analytical screening with an alert for a medium or high risk of malnutrition, as well as the subgroup of patients in whom we were able to administer the complete INFORNUT® process, generating a report for each. Other documentary coding sources are cited. From the Minimum Basic Data Set, codes defined in the SEDOMSENPE consensus were analyzed. The data were processed with the Alcor-DRG program. Rates in ‰ of discharges for 2009 and 2010 of diagnoses of malnutrition, procedure and procedures-related diagnoses were calculated. These rates were compared with the mean rates in Andalusia. The contribution of these codes to the Complexity Index was estimated and, from the cost accounting data, the fraction of the hospitalization cost seen as justified by this activity was estimated. RESULTS: RESULTS are summarized for both study years. With respect to process performance, more than 3,600 patients per year (30% of admissions with a stay > 3 days) underwent analytical screening. Half of these patients were at medium or high risk and a nutritional assessment using INFORNUT® was completed for 55% of them, generating approximately 1,000 reports/year. Our coding rates exceeded the mean rates in Andalusia, being 3.5 times higher for diagnoses (35‰); 2.5 times higher for procedures (50‰) and five times the rate of procedurerelated diagnoses in the same patient (25‰). The Mean Stay of patients coded with malnutrition at discharge was 31.7 days, compared to 9.5 for the overall hospital stay. The Mortality Rate for the same patients (21.8%) was almost five times higher than the mean and Urgent Readmissions (5.5%) were 1.9 times higher. The impact of this coding on the hospital Complexity Index was four hundredths (from 2.08 to 2.12 in 2009 and 2.15 to 2.19 in 2010). This translates into a hospitalization cost justification of 2,000,000; five to six times the cost of artificial nutrition. CONCLUSIONS: The process facilitated access to the diagnosis of malnutrition and to understanding the risk of developing it, as well as to the prescription of procedures and/or supplements to correct it. The interdisciplinary team coordination, the participatory process and the tools used improved coding rates to give results far above the Andalusian mean. These results help to upwardly adjust the hospital Complexity Index or Case Mix-, as well as to explain hospitalization costs.

Introducción: La alta prevalencia de desnutrición hospitalaria relacionada con la enfermedad justifica la necesidad de herramientas de cribado y detección precoz de los pacientes en riesgo de desnutrición, seguido de una valoración encaminada a su diagnóstico y tratamiento. Existe asimismo una manifiesta infracodificación de los diagnósticos de desnutrición y los procedimientos para revertirla. Objetivos: Describir el programa/proceso INFORNUT ® y su desarrollo como sistema de información. Cuantificar el rendimiento en sus diferentes fases. Citar otras herramientas utilizadas como fuente de codificación. Calcular las tasas de codificación de diagnósticos de desnutrición y procedimientos relacionados. Mostrar su relación con Estancia Media, Tasas de Mortalidad y Reingreso urgente; así como cuantificar su impacto en el Índice de Complejidad hospitalario y su efecto en justificación de Costes de Hospitalización. Material y métodos: El proceso INFORNUT® se basa en un programa de cribado automatizado de detección sistemática e identificación precoz de pacientes desnutridos al ingreso hospitalario, así como de su valoración, diagnóstico, documentación e informe. Sobre el total de ingresos con estancias mayores de tres días habidos en los años 2008 y 2010, se contabilizaron pacientes objeto de cribado analítico con alerta de riesgo medio o alto de desnutrición, así como el subgrupo de pacientes a los que se les pudo completar en su totalidad el proceso INFORNUT® llegando al informe por paciente. Se citan otras fuentes documentales de codificación. Del Conjunto Mínimo de la Ba se de Datos se analizaron los códigos definidos en consenso SENPE-SEDOM. Los datos se procesaron con el programa Alcor-GRD. Se calcularon las tasas en ‰ altas dadas para los años 2009 y 2010 de diagnósticos de desnutrición, procedimientos y diagnósticos asociados a procedimientos. Se compararon dichas tasas con las tasas medias de la comunidad andaluza. Se estimó la contribución de dichos códigos en el Índice de Complejidad y, a partir de los datos de contabilidad analítica, se estimó la fracción del coste de hospitalización que se ve justificada por esta actividad. Resultados: Resumimos aquí un resultado para ambos años estudiados. En cuanto al rendimiento del proceso, más de 3.600 pacientes por año (30% de los ingresos con estancia > 3 días) fueron objeto de cribado analítico. La mitad de ellos resultaron de riesgo medio o alto, de los cuales al 55 % se les completó una valoración nutricional mediante INFORNUT®, obteniéndose unos 1.000 informes/ año. Nuestras tasas de codificación superaron a las tasas medias de Andalucía, siendo 3,5 veces superior en diagnósticos (35 ‰); 2,5 veces en procedimientos (50 ‰) y quintuplicando la tasa de diagnósticos asociados a procedimientos en el mismo paciente (25 ‰). La Estancia Media de los pacientes codificados al alta de desnutrición fue de 31,7 días, frente a los 9,5 de global hospitalaria. La Tasa de Mortalidad para los mismos (21,8 %) fue casi cinco veces superior a la media y la de Reingresos "urgentes" (5,5 %) resultó 1,9 veces superior. El impacto de dicha codificación en el Índice de Complejidad hospitalario fue de cuatro centésimas (de 2,08 a 2,12 en 2009 y de 2,15 a 2,19 en 2010). Esto se traduce en una justificación de costes de hospitalización por 2.000.000 ; cinco a seis veces el coste de la nutrición artificial. Conclusiones: El proceso ha facilitado el acceso al diagnóstico de la desnutrición o al conocimiento del riesgo de padecerla, así como a la prescripción de los procedimientos y/o suplementos para remediarla. La coordinación interdisciplinar del equipo, lo participativo del proceso y las herramientas utilizadas mejoran las tasas de codificación hasta resultados muy por encima de la media andaluza. Estos resultados contribuyen a ajustar al alza el IC hospitalario, así como a la justificación de costes de hospitalización.

Síndrome de ovario poliquístico: fenotipos y enfermedad cardiovascular / Polycystic ovary syndrome: Phenotypes and cardiovascular disease

Introducción: El síndrome de ovario poliquístico (SOP) es una endocrinopatía que afecta a mujeres en edad reproductiva, frecuentemente asociado a insulinorresistencia (IR) y riesgo cardiovascular (RCV). El criterio de Rotterdam distingue 4 fenotipos: 3 presentan hiperandrogenismo clínico y/o bioquímico (HA) y uno es normo-androgénico (NHA). Por ser un síndrome heterogéneo, es necesario identificar a las pacientes con mayor RCV. Dos nuevos marcadores han sido propuestos para evaluarlo: el índice de adiposidad abdominal (VAI) y el producto de acumulación lipídica (LAP). Objetivo: Evaluar los marcadores LAP y VAI como predictores de IR y su correlación con los parámetros de RCV en relación con los fenotipos SOP. Metodología: Se estudió a 130 pacientes con SOP entre 18 y 36 años, clasificadas en 2 grupos: HA y NHA según la presencia de hiperandrogenismo clínico y/o bioquímico. Se evaluaron parámetros de RCV según ATP III: circunferencia de cintura (CC), glucemia, HDL, triglicéridos (TG) y presión arterial. Se calcularon: LAP = (CC [cm] - 58) * TG (mmol/l) y VAI = (CC [cm]/[36,58 + (1,89 * IMC [kg/m²]] * [TG [mg/dl]/0,81] * [1,52/HDL-c [mg/dl]]). Se realizaron curvas ROC/área bajo la curva para establecer valores de corte de LAP y VAI para la identificación de IR, análisis de correlación con parámetros de RCV y de las diferencias entre fenotipos, tomando como significativo p < 0,05. Resultados: Los valores de corte establecidos para definir IR fueron de 14,02 para LAP (especificidad: 93,22%; sensibilidad: 93,94%) y de 2,17 para VAI (especificidad: 91,38%; sensibilidad: 87,88). Dichos marcadores correlacionaron con marcadores de IR (HOMA-IR, QUICKI e índice glucosa/insulina) y presentaron una correlación positiva con TG, CC y negativa con HDL. El análisis entre fenotipos no reveló diferencias en la presencia de SM, IR o factores de RCV. Conclusión: LAP y VAI serían buenos predictores de IR y RCV asociado en pacientes jóvenes con SOP. El análisis de los parámetros entre fenotipos HA y NHA indica que ambos presentan similar riesgo metabólico y de desarrollar enfermedad cardiovascular.

Introduction: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting women of reproductive age. It is associated with insulin resistance (IR) and high cardiovascular risk (CVR). According to the Rotterdam consensus, four PCOS phenotypes could be established: three with clinical and/or biochemical hyperandrogenism (HA), and one non-hyperandrogenic (NHA). It is necessary to identify which of these patients are at risk of metabolic disturbances and CVR. Two indexes: lipid accumulation product (LAP) and visceral adiposity index (VAI) have been suggested as reliable markers of IR and CVR in PCOS. Objective: The present study aims to assess the reliability of LAP and VAI as IR markers in a young local population of PCOS patients. Their association with CVR parameters is also evaluated. Methodology: LAP and VAI were calculated in 130 PCOS patients. The PCOS patients were divided in two groups as HA and NHA, taking into account the signs of hyperandrogenism (clinical or biochemical). An evaluation was also made of the metabolic and anthropometric characteristics of the population and their association with CVR and IR. Results: Both LAP and VAI showed to be effective markers to asses CVR and IR in these PCOS women (cutoff values: LAP: 14.02 (sensitivity: 93.94% specificity: 93.22%) VAI: 2.17 (sensitivity: 87.88% specificity: 91.38%). There was a positive correlation of both markers with abdominal circumference and triglycerides (TG), and negative with HDL-cholesterol. The risk of IR and metabolic disturbances was similar in both phenotypes (NHA versus HA). Conclusion: Our data show that both LAP and VAI are representative markers for assessing IR and associated CVR in PCOS patients. These results also suggest that the NHA phenotype in the population studied shows the same risk of metabolic disturbances and cardiovascular disease when compared to HA phenotypes.

Label-free detection of biomolecular interactions using BioLayer interferometry for kinetic characterization.

The analysis of biomolecular interactions is key in the drug development process. Label-free biosensor methods provide information on binding, kinetics, concentration, and the affinity of an interaction. These techniques provide real-time monitoring of interactions between an immobilized ligand (such as a receptor) to an analyte in solution without the use of labels. Advances in biosensor design and detection using BioLayer Interferometry (BLI) provide a simple platform that enables label-free monitoring of biomolecular interactions without the use of flow cells. We review the applications of BLI in a wide variety of research and development environments for quantifying antibodies and proteins and measuring kinetics parameters.