[SARS-CoV-2 pandemic and assisted reproduction]. / Pandemia del SARS-CoV-2 y reproducción asistida.

The pandemic caused by the new SARS-CoV-2 virus has led to a process of adaptation to the new situation by society as a whole and, therefore, by assisted reproduction centres. After the acute phase of the health crisis, when activity was drastically reduced, cycles have resumed, guided by the recommendations of scientific societies.In this article, a review is presented of all the published information regarding the virus and the reproductive system, pointing out the presence of angiotensin-converting enzyme 2 (ACE2) in the female and male reproductive system, at the testicular, ovarian, endometrial and embryonic levels. In addition, a comparative analysis is carried out between the recommendations of the scientific societies regarding the screening of infection, performance standards, and general laboratory measurements.

Esophageal lesions detected during small bowel capsule endoscopy : incidence, diagnostic and therapeutic impact.

BACKGROUND: Nowadays, capsule endoscopy is the first-line procedure for the visualization of the small bowel. Although it was primarily designed with this goal, it may also identify other segments of the gastrointestinal tract. The aim of the current study is to evaluate the incidence of esophageal abnormalities detected in patients undergoing small bowel capsule endoscopy and its impact on patient management. PATIENTS AND METHODS: This study is a retrospective analysis of data from 2217 consecutive capsule endoscopy procedures performed at a single tertiary-care centre between January 2008 and February 2016. Patient baseline characteristics, esophageal lesions, diagnosis and management before and after capsule endoscopy were recorded and a descriptive analysis was then performed. RESULTS: 2217 patients were finally included in the analysis. 1070 were male (48.2%) and the mean age was 56.1 ± 19.5 years (12-93). Obscure gastrointestinal bleeding (52.3%) and inflammatory bowel disease (18.3%) were the main procedure indications. Esophageal abnormalities were detected in 105 out of 2217 patients (4.7%). The most common lesions detected were peptic esophagitis (58.1%) and esophageal varices (17.1%). This information had a clinical/diagnostic impact of 3.3% and a therapeutic impact of 3.2%. CONCLUSION: Capsule endoscopy detects not only small bowel lesions, but also significant esophageal lesions that may be overlooked during initial gastroscopy. Therefore, all images of the esophagus should be read during small bowel capsule endoscopy, since it could provide relevant information that may result in changes on patient´s management.

Reverse transcription loop-mediated isothermal amplification assays for rapid identification of eastern and western strains of bluetongue virus in India.

Bluetongue virus (BTV) infects all ruminants, including cattle, goats and camelids, causing bluetongue disease (BT) that is often severe in naïve deer and sheep. Reverse-transcription-loop-mediated-isothermal-amplification (RT-LAMP) assays were developed to detect eastern or western topotype of BTV strains circulating in India. Each assay uses four primers recognizing six distinct sequences of BTV genome-segment 1 (Seg-1). The eastern (e)RT-LAMP and western (w)RT-LAMP assay detected BTV RNA in all positive isolates that were tested (n=52, including Indian BTV-1, -2, -3, -5, -9, -10, -16, -21 -23, and -24 strains) with high specificity and efficiency. The analytical sensitivity of the RT-LAMP assays is comparable to real-time RT-PCR, but higher than conventional RT-PCR. The accelerated eRT-LAMP and wRT-LAMP assays generated detectable levels of amplified DNA, down to 0.216 fg of BTV RNA template or 108 fg of BTV RNA template within 60-90min respectively. The assays gave negative results with RNA from foot-and-mouth-disease virus (FMDV), peste des petits ruminants virus (PPRV), or DNA from Capripox viruses and Orf virus (n=10), all of which can cause clinical signs similar to BT. Both RT-LAMP assays did not show any cross-reaction among themselves. The assays are rapid, easy to perform, could be adapted as a 'penside' test making them suitable for 'front-line' diagnosis, helping to identify and contain field outbreaks of BTV.

Influence of mitral regurgitation on the response to captopril therapy for congestive heart failure caused by idiopathic dilated cardiomyopathy.

To assess the influence of mitral regurgitation (MR) on the response to captopril therapy for congestive heart failure (CHF), 30 patients with idiopathic dilated cardiomyopathy in New York Heart Association functional class III were studied. Left ventricular end-diastolic diameter and stroke volume were measured by Doppler echocardiography, and exercise tolerance by exercise testing before and at 1, 3 and 12 months after treatment. Patients were classified into 2 groups: those with (n = 14) and those without (n = 16) MR. No significant differences were observed between the 2 groups in pretreatment studies. Exercise tolerance increased significantly in the group with MR (p less than 0.001) during the year of follow-up, from 514 +/- 193 seconds at baseline study to 671 +/- 178 seconds (p less than 0.0005) at 1 month, 688 +/- 127 seconds (p less than 0.0005) at 3 months and 690 +/- 108 seconds (p less than 0.01) at 12 months. The group without MR had no significant changes. Stroke volume increased significantly only in the MR group during follow-up (p less than 0.01), changing from 43 +/- 9 ml at baseline study to 52 +/- 11 ml (p less than 0.01) at 1 and 49 +/- 11 ml (p less than 0.01) at 3 months. At 12 months the increase was not statistically significant. Left ventricular end-diastolic diameter decreased more in the group with than without MR, although the differences were not significant. Thus, the presence of dynamic MR appears to be an important factor in the therapeutic response to captopril therapy for CHF.

Comparison of perceived health status and conventional functional evaluation in stable patients with coronary artery disease.

A cross-sectional study of stable coronary hospital patients was carried out to compare perceived health assessment with conventional clinical measures; 93 consecutive patients were studied, 45 of whom had undergone bypass surgery. Exercise tests and clinical functional classification were obtained together with blind concurrent self-responses to the Nottingham Health Profile (NHP), a measure of distress. Coronary arteriography was available for all patients. Patients with negative exercise tests had lower NHP scores (lower levels of distress) than those with positive or inconclusive tests, especially in the energy, pain and physical mobility NHP dimensions (p less than 0.01). High Spearman correlation coefficients were found between exercise performance and energy (rs = -0.51) and pain (rs = -0.36) scores. This correlation was closer than that found with clinical functional class. In these patients, exercise performance closely correlated with perceived distress. Self-perceived health status measures may improve the evaluation of coronary patients based on clinical assessment alone.

Pharmacokinetics of oxytetracycline after intramuscular administration with lidocaine in sheep, comparison with a conventional formulation.

The pharmacokinetic behaviour of oxytetracycline (OTC) was studied in 11 sheep after intravenous and intramuscular administration at a single dosage of 20 mg kg(-1) bodyweight. A conventional formulation was injected by the intravenous route and two different preparations were administered by the intramuscular route: a conventional formulation (T-100) and an aqueous solution of OTC with lidocaine (1 per cent) (OTC-L). The objective was to determine whether there are differences between both formulations in the disposition kinetics of OTC after intramuscular administration to sheep. After intravenous administration of the conventional formulation, plasma oxytetracycline concentrations were best fitted to an open two-compartment model. Mean apparent volume of distribution was 0.77+/-0.02 litre kg(-1) and the harmonic mean half-life was three hours. The OTC transfer process between central and peripheral compartments was fast and that did not influence the elimination process. After intramuscular administrations of both formulations, half-lives were longer than after intravenous administration (mean values of 14.1 and 58.2 hours for T-100 and OTC-L respectively). In both cases, a biphasic absorption, a 'flip-flop' model and a complete bioavailability were found. OTC-L provided therapeutic plasma concentrations over 0.5 microg ml(-1) (the minimum inhibitory concentration for most susceptible pathogens) for a longer period of time than T-100 (72 hours compared with 36 or 48 hours).

[I. Usefulness of the exertion test and other methods based on the electrocardiogram in chronic ischemic disease]. / I. Utilidad de la prueba de esfuerzo y de otros metodos basados en el electrocardiograma en la cardiopatía isquémica crónica.

Exercise testing still plays an important role in the management of patients with chronic ischemic heart disease, not only in the diagnosis but also in their prognostic and functional evaluation, and in the assessment of effects of the therapy. Moreover, ambulatory electrocardiography, signal averaged electrocardiography and heart rate variability provide useful information for certain groups of patients. This paper reviews the rationale, methodology and indications of the above mentioned procedures applied to chronic ischemic heart disease, with special reference to exercise testing. Recommendations for their use in clinical practice are also made.

Useless diagnostic value of exercise-induced R wave changes in coronary artery disease.

To investigate the usefulness of exercise-induced R wave changes in the diagnosis of coronary artery disease and detection of left ventricular contraction abnormalities, 105 patients were studied. Among 64 patients who had significant coronary artery disease (greater than or equal to 70% narrowing), 43 showed an increase or no change in the R wave amplitude and 55 showed ST segment depression (sensitivity 67 versus 86%). Among 41 patients without significant stenosis, 11 had decreased R wave amplitude and 36 had no change in ST segment (specificity 27 versus 88%). Twenty-five of 64 coronary disease patients had left ventricular contraction abnormalities, and the R wave amplitude changes gave a sensitivity of 80%, specificity of 41% and a predictive value of 47%. There were no differences in the variables of exercise intensity and ejection fraction between patients who had decreased R wave amplitude and those in whom it increased or did not change. We conclude that R wave amplitude change during exercise is not a useful variable for the diagnosis or evaluation of patients with coronary artery disease.