Measurement properties of the EQ-5D-Y administered through a smartphone app in children with asthma: a longitudinal questionnaire study.

BACKGROUND: Asthma impacts children's physical, emotional, and psychosocial Health-Related Quality of Life (HRQL). The EQ-5D-Y is a generic econometric instrument developed to measure HRQL in children. OBJECTIVE: Evaluation of feasibility, validity, reliability, and responsiveness of EQ-5D-Y descriptive system and utility index to allow the assessment of HRQL in children with asthma, aged 8-11 years (self-response version) or under 8 years old (proxy-response version). METHODS: We used data from baseline to 10 months of follow-up of an observational, prospective study of children with persistent asthma recruited by pediatricians in Spain (2018-2020). HRQL instruments were administered through a smartphone application: ARCA app. The EQ-5D-Y is composed of a 5-dimension descriptive system, a utility index ranging from 1 to - 0.5392, and a general health visual analogue scale (EQ-VAS). The Pediatric Asthma Impact Scale (PROMIS-PAIS) includes 8 items, providing a raw score. Construct validity hypotheses were stated a priori, and evaluated following two approaches, multitrait-multimethod matrix and known groups' comparisons. Reliability and responsiveness subsamples were defined by stability or change in EQ-VAS and the Asthma Control Questionnaire (ACQ), to estimate the intraclass correlation coefficient (ICC) and the magnitude of change over time. RESULTS: The EQ-5D-Y was completed at baseline for 119 children (81 self-responded and 38 through proxy response), with a mean age of 9.1 (1.7) years. Mean (SD) of the EQ-5D-Y utility index was 0.93 (0.11), with ceiling and floor effects of 60.3% and 0%, respectively. Multitrait-multimethod matrix confirmed the associations previously hypothesized for the EQ-5D-Y utility index [moderate with PROMIS-PAIS (0.38) and weak with ACQ (0.28)], and for the EQ-5D-Y dimension "problems doing usual activities" [moderate with the ACQ item (0.35) and weak with the PROMIS-PAIS item (0.17)]. Statistically significant differences were found in the EQ-5D-Y between groups defined by asthma control, reliever inhalers use, and second-hand smoke exposure, with mostly moderate effect sizes (0.45-0.75). The ICC of the EQ-5D-Y utility index in the stable subsamples was high (0.81 and 0.79); and responsiveness subsamples presented a moderate to large magnitude of change (0.68 and 0.78), though without statistical significance. CONCLUSIONS: These results support the use of the EQ-5D-Y as a feasible, valid, and reliable instrument for evaluating HRQL in children with persistent asthma. Further studies are needed on the responsiveness of the EQ-5D-Y in this population.

Opportunistic omnivory impairs the use of the Atlantic blue crab Callinectes sapidus as a trace metal biomonitor in invaded Mediterranean coastal waters.

The contribution of non-indigenous species to the transfer of contaminants in invaded food webs represents an active research area. Here we measured trace metals and CN stable isotopes in five populations of the invasive Atlantic blue crab Callinectes sapidus and in baseline bivalve species from Spain, Italy and Greece. They were used to estimate trophic transfer effects and the trophic position and isotopic niche of C. sapidus. Maximum trophic transfer effects occurred where the crab showed the largest isotopic niches and highest trophic positions; furthermore, the consistency of trace metal profiles between bivalves and crabs co-varied with the trophic position of the latters. Omnivory may influence the success of an invasive species, but also limit its effectiveness for biomonitoring. However, our results indicated that stable isotopes analysis provides a clarifying background where to cast patterns of contamination of the blue crab as well as of other omnivorous biomonitor species.

Impact of treatment adherence and inhalation technique on asthma outcomes of pediatric patients: a longitudinal study.

Introduction: We aimed to evaluate the longitudinal relationships, both at between- and within-person levels, that adherence to inhaled corticosteroid-based maintenance treatment and inhalation technique present with symptom control, exacerbations, and health-related quality of life (HRQoL) in children and adolescents with asthma. Methods: Participants (6-14 years old) from the ARCA (Asthma Research in Children and Adolescents) cohort-a prospective, multicenter, observational study (NCT04480242)-were followed for a period from 6 months to 5 years via computer-assisted telephone interviews and a smartphone application. The Medication Intake Survey-Asthma (MIS-A) was administered to assess the implementation stage of adherence, and the Inhalation Technique Questionnaire (InTeQ) was used to assess the five key steps when using an inhaler. Symptom control was measured with the Asthma Control Questionnaire (ACQ), and HRQL was measured with the EQ-5D and the Patient-Reported Outcomes Measurement Information System-Pediatric Asthma Impact Scale (PROMIS-PAIS). Multilevel longitudinal mixed models were constructed separately with symptom control, exacerbation occurrence, EQ-5D, and PROMIS-PAIS as the dependent variables. Results: Of the 360 participants enrolled, 303 (1,203 interviews) were included in the symptom control and exacerbation analyses, 265 (732) in the EQ-5D, and 215 (617) in the PROMIS-PAIS. Around 60% of participants were male subjects, and most of them underwent maintenance treatment with inhaled corticosteroids plus long-acting ß-agonists in a fixed dose (73.3%). Within-person variability was 83.6% for asthma control, 98.6% for exacerbations, 36.4% for EQ-5D, and 49.1% for PROMIS-PAIS. At the within-person level, patients with higher adherence had better symptom control (p = 0.002) and HRQoL over time (p = 0.016). Patients with a better inhalation technique reported worse HRQoL simultaneously (p = 0.012), but they showed better HRQoL in future assessments (p = 0.012). The frequency of reliever use was associated with symptom control (p < 0.001), exacerbation occurrence (p < 0.001), and HRQoL (p = 0.042); and boys were more likely to present better symptom control and HRQoL than girls. Conclusion: Our results confirm longitudinal associations at the within-person level of the two indicators of quality use of inhalers: for adherence to maintenance treatment with symptom control and HRQoL, and for the inhalation technique with HRQoL. Although treatment adherence was shown to be excellent, a third of the participants reported a suboptimal inhalation technique, highlighting the need for actions for improving asthma management of the pediatric population.

Isotopic Overlap of Invasive and Native Consumers in the Food Web of Lake Trasimeno (Central Italy).

An advanced characterization of the trophic niche of non-indigenous species (NIS) may provide useful information on their ecological impact on invaded communities. Here, we used carbon and nitrogen stable isotopes to estimate pairwise niche overlaps between non-indigenous and native consumers in the winter food web of Lake Trasimeno (central Italy). Overall, a relatively low pairwise overlap of isotopic niches was observed between NIS and native species. The only exception was the Louisiana crayfish Procambarus clarkii, which showed a relatively high and diffuse overlap with other native invertebrates. Our findings highlighted a high niche divergence between non-indigenous and native species in Lake Trasimeno, suggesting a potentially low degree of interspecific competition that may facilitate coexistence and, in turn, limit the strength of impacts. The divergent results obtained for the Louisiana crayfish indicate that additional control measures for this invasive species are needed to mitigate its impact on the Lake Trasimeno system.

Montelukast in paediatric asthma and allergic rhinitis: a systematic review and meta-analysis.

BACKGROUND: We aim to assess the impact of montelukast on paediatric patients with asthma/allergic rhinitis, measured using patient-reported outcome measures, compared with other treatments or placebo. METHODS: Protocol registration CRD42020216098 (www.crd.york.ac.uk/PROSPERO). MEDLINE and Embase databases were used to conduct the search. Two authors independently selected studies and extracted data, and a third reviewer resolved discrepancies. Meta-analyses were constructed to estimate the standardised mean difference (SMD) using a random-effects model. RESULTS: Out of 3937 articles identified, 49 studies met the inclusion criteria, mostly randomised clinical trials (sample sizes: 21-689 patients). The SMD of change pooled estimators for the global, mental and physical domains of health-related quality of life were not statistically significant. For daytime and night-time symptoms scores, the SMD (95% CI) was in favour of inhaled corticosteroids (-0.12, -0.20- -0.05 and -0.23, -0.41- -0.06, respectively). The pooled estimator for global asthma symptoms was better for montelukast when compared with placebo (0.90, 0.44-1.36). CONCLUSIONS: The synthesis of the available evidence suggests that, in children and adolescents, montelukast was effective in controlling asthma symptoms when compared with placebo, but inhaled corticosteroids were superior in controlling symptoms, especially at night-time. These findings of our systematic review concur with current guidelines for asthma treatment.

Individual and population-scale carbon and nitrogen isotopic values of Procambarusclarkii in invaded freshwater ecosystems.

Background: Freshwater ecosystems are amongst the most threatened habitats on Earth; nevertheless, they support about 9.5% of the known global biodiversity while covering less than 1% of the globe's surface. A number of anthropogenic pressures are impacting species diversity in inland waters and, amongst them, the spread of invasive alien species is considered one of the main drivers of biodiversity loss and homogenisation in freshwater habitats.Crayfish species are widely distributed freshwater invaders and, while alien species introductions occur mostly accidentally, alien crayfish are often released deliberately into new areas for commercial purposes. After their initial introduction, crayfish species can rapidly establish and reach high-density populations as a result of their adaptive functional traits, such as their generalist diet.The Louisiana crayfish Procambarusclarkii (Girard, 1852) is globally considered one of the worst invaders and its impact on recipient freshwater communities can vary from predation and competition with native species, to modification of food webs and habitat structure and introduction of pathogens. Native to the south United States and north Mexico, P.clarkii has been introduced in Europe, Asia and Africa, determining negative ecological and economic impacts in the majority of invaded habitats where it became dominant within the receiving benthic food webs. Due to its flexible feeding strategy, P.clarkii exerts adverse effects at different trophic levels, ultimately affecting the structure and dynamics of invaded food webs. It is, therefore, paramount to evaluate the ecological consequences of P.clarkii invasion and to quantify its impact in a spatially explicit context. New information: In the past decades, the analysis of stable isotopes of carbon, nitrogen and other elements has become a popular methodology in food web ecology. Notably, stable isotope analysis has emerged as a primary tool for addressing applied issues in biodiversity conservation and management, such as the assessment of the trophic ecology of non-indigenous species in invaded habitats. Here, we built two geo-referenced datasets, resolved respectively at the population and individual scale, by collating information on δ13C and δ15N values of P.clarkii within invaded inland waters. The population-scale dataset consists of 160 carbon and nitrogen isotopic values of the Louisiana crayfish and its potential prey, including living and non-living primary producers and benthic invertebrates. The dataset resolved at individual scale consists of 1,168 isotopic records of P.clarkii. The isotopic values included within the two datasets were gathered from 10 countries located in Europe, Asia, Africa and North America, for a total of 41 studies published between 2005 and 2021. To the best of the authors' knowledge, this effort represents the first attempt to collate in standardised datasets the sparse isotopic information of P.clarkii available in literature. The datasets lend themselves to being used for providing a spatially explicit resolution of the trophic ecology of P.clarkii and to address a variety of ecological questions concerning its ecological impact on recipient aquatic food webs.

Escape tardío de la bula de filtración a propósito de un caso / Late onset of leaking filtering bleb in a case

Paciente masculino de 48 años, de color de la piel mestizo, al que se le realizó trabeculectomía con antimetabolito en su ojo derecho con daño glaucomatoso avanzado y atrofia óptica glaucomatosa en su ojo izquierdo. Tres años después acude a consulta de seguimiento con escape tardío de la ampolla de filtración, perforación escleral y ligera hipotonía ocular. Surge la disyuntiva entre realizar recubrimiento de la ampolla con trasplante conjuntival autólogo, con el riesgo de elevación posterior de la presión intraocular por encima de su valor meta, y no practicar tratamiento quirúrgico con elevada posibilidad de endoftalmitis. Se realizó el proceder y en el seguimiento se constató un injerto conjuntival bien adaptado y vascularizado, con presión intraocular inferior a 15 mmHg en cada consulta y no progresión del daño glaucomatoso

The case of a 48 years-old male patient was presented. He underwent trabeculectomy with antimetabolites to treat advanced glaucomatous damage in his right eye and optical glaucomatous atrophy in his left eye. After three years, he went to the follow-up medical service with late-onset of leaking filtering bleb, sclera perforation and slight ocular hypotony. The dilemma of covering the bleb with conjunctival autologous graft, with the risk of raised intraocular pressure over the target value o non-performance of the surgical treatment with high possibility of endophthalmitis was present. It was decided to apply the surgical procedure. The follow-up showed a well-adapted and vascularized conjunctival graft and intraocular pressure lower than 15 mm Hg in each medical appointment, without advance in glaucomatous damage

Microscopia confocal de barrido láser y su relación con la morfología de la bula de filtración / Confocal laser scanning microscopy and its association to the morphology of the filtering bleb

Objetivo: describir los hallazgos de la microscopia confocal de barrido láser y su relación con la morfología de la bula de filtración.Métodos: estudio observacional descriptivo de corte transversal en 100 ojos. Se les realizó microscopia confocal de barrido láser con el HRT II y el módulo corneal de Rostock. Se aplicó la prueba de significación estadística de Mc. Nemar para una p=0,05.Resultados: predominó el grupo entre 61 y 80 años de edad (55,8 porciento) y el color de la piel blanca (46,8 porciento). En el grupo de descenso de la presión intraocular en más del 30 porciento se ubicó la mayor cantidad de bulas de todos los tamaños. Las bulas de mediano tamaño fueron las que más disminuyeron las cifras de presión intraocular, con 24 ojos (55,8 porciento, p=0,00), seguidas por las de pequeño tamaño (p=0,14). Las bulas de filtración aplanadas fueron las más frecuentes en 55 porciento de los casos (p=0,00), y 67,4 porciento de estas se ubicaron en el grupo de descenso de presión intraocular de más de 30 porciento (p=0,01). Las bulas medianas presentaron la mayor cantidad de estroma en malla porosa (60 porciento) y de microquistes epiteliales (56 porciento) p=0,00.Conclusiones: la configuración aplanada y el tamaño mediano de la bula de filtración se relacionaron con la presencia de variables histológicas que infieren buen funcionamiento de la bula (microquistes epiteliales y estroma en malla porosa). También se relacionaron con un mayor descenso de la presión intraocular

Objective: to describe the findings in the confocal laser scanning microscopy and its relation with the morphology of the filtering bleb. Methods: cross-sectional, observational and descriptive study of 100 eyes that underwent confocal laser scanning microscopy with the Retinal Heidelberg Tomography and the Rostock corneal module. Mc NemarÆs statistical significance test was made to obtain p=0,05. Results: the 61-80 years old age group (55,8 per cent) and the caucasians predominated. The group of eyes with over 30 per cent decrease of the intraocular pressure showed the highest amount of filtering blebs of all sizes. The medium-size blebs were the ones that decreases the IOP in a higher percentage (24 eyes; 55,8 per cent) for p=0,00, followed by the small blebs (p=0,14). The flat blebs were predominant in 55 per cent of cases (p=0,00) and the 67,4 per cent of them were consistent with the major range of decrease of the intraocular pressure (p=0,01). The medium size blebs presented the major number of stromas in porous mesh (60 per cent), and of epithelial mycrocists (56 per cent) for p=0,00. Conclusions: the flat configuration and the medium size of the blebs were related with the presence of the histological variables that infer adequate function of the filtrating blebs (stroma in porous mesh and epithelial mycrocists). They were also associated with higher decrease of intraocular pressure

Aplicaciones del SL-OCT en el glaucoma / Applications of the SL-OCT tomography in the management of glaucoma

Se realizó una búsqueda de información actualizada relacionada con el uso y los principios de funcionamiento de la tomografía de coherencia óptica del segmento anterior. Se hizo referencia a los distintos tomógrafos que hoy existen en el mundo, enfatizando en el SL-OCT HEIDELBERG ENGINEERING, con la intención de demostrar su importancia y utilidad en el manejo del glaucoma. Se compara con la biomicroscopia ultrasónica en cuanto a las principales ventajas y desventajas de estos equipos

Updated information on the use and the principles of the optic coherence tomography of the anterior segment was searched for. Reference was made to several tomographs used worldwide, making emphasis on the SL-OCT HEIDELBERG ENGINEERING to demonstrate its significance and usefulness in managing glaucoma. This equipment was compared with the ultrasonic biomicroscopy in terms of main advantages and disadvantages

Consideraciones terapéuticas en el cierre angular primario / Therapeutic options in the primary angle closure

Las opciones de tratamiento en el cierre angular incluyen medicamentos hipotensores oculares, cirugía láser (iridotomía, gonioplastia) y la cirugía incisional (filtrante, remoción del cristalino), en dependencia de la forma clínica de presentación. Dentro de estas, la medicación sistémica, gonioplastia láser, indentación corneal y paracentesis de la cámara anterior han sido efectivas en el control urgente de la presión intraocular. El tratamiento definitivo es la iridotomía periférica, que previene la crisis aguda, pero no la progresión al glaucoma. Posterior al ataque agudo, la cirugía filtrante se relaciona con una mayor probabilidad de complicaciones quirúrgicas y fallo posoperatorio en el control de la presión intraocular. Por otra parte, la facoemulsificación ha mostrado resultados favorables al aumentar la amplitud angular, eliminar el bloqueo pupilar y disminuir la presión intraocular

The therapeutic options for the angle closure glaucoma cover medical treatment with ocular hypotensors, laser surgery (iridotomy, gonioplasty) and incisional surgery (trabeculectomy and lens extraction) depending on the clinical form of the presentation. Medical treatment, laser gonioplasty, corneal indentation and immediate anterior chamber paracentesis are good effective options to immediately stabilize intraocular pressure in acute primary angle closure. The definitive treatment is the laser iridotomy that avoids the acute attack, although progression to glaucoma may occur. After the acute attack, the filtering surgery fails to reduce intraocular pressure and is associated with more surgical complications. Phacoemulsification has shown good results by increasing the angle depth, eliminating the papillary block and reducing the intraocular pressure

Beneficios del sistema Scheimpflug en glaucoma / Benefits of Scheimpflug system for the treatment of glaucoma

Entre los medios diagnósticos que más se han difundido en los últimos años se encuentran los basados en las imágenes de Scheimpflug, como el Pentacam de Oculus Wetzlar de Alemania. Entre sus modelos de evaluación contiene la realización de la paquimetría central y curvatura corneal, así como fórmulas de corrección de la presión intraocular. Permite la medición de la amplitud angular y de la profundidad y volumen de la cámara anterior. Las publicaciones validan la alta reproducibilidad de sus mensuraciones por lo que se ha hecho útil en la evaluación del glaucoma

Scheimpflug´s images as is the case of Oculus Wetzlar´s Pentacam from Germany, are one of the most widely known diagnostic techniques for the evaluation of the anterior segment of the eye. Its evaluating models comprise the central pachymetry and the corneal curvature as well as the correction formulas for the intraocular pressure. It allows the anterior chamber amplitude, volume and depth measurements with high reproducibility, being useful in the evaluation of glaucoma

GENETIC VARIABILITY OF THE ZEBU CATTLE BREED (Bos indicus) IN THE DEPARTAMENT OF HUILA, COLOMBIA USING MICROSATELLITE MOLECULAR MARKERS / Variabilidad genética de Zebú (Bos indicus) en el departamento del Huila, Colombia, usando marcadores moleculares por microsatélites

The polymorphism of 11 microsatellites from zebu cattle (Bos indicus) was studied using a commercial multiplex system to estimate genetic variability. Allele frequencies polymorphism information content and heterozygosis were calculated. Allele frequencies revealed that in the analyzed sample the markers were not equally polymorphic. The average allele was 14.2 with the highest values for the TGLA122 microsatellites. The mean heterozygocity was 0.7056 and the polymorphism information content was 0.668. This multiplex analysis could be used for pedigree information and for adequate genetic improvements in breeding programs and paternity test.

Para estimar la variabilidad genética, el polimosfismo de 11 microsatélites de vacunos zebú (Bos indicus) fue estudiado mediante el sistema comercial multiplex system. Se calcularon frecuencias alélicas, contenido de información polimórfica y heterocigosis. Las frecuencias alélicas de la muestra analizada revelan que los marcadores no fueron equitativamente polimórficos. El alelo promedio fue 14,2 con el mayor valor para los microsatélites TGLA122. El promedio de heterocigosidad fue 0,7056 y el contenido de información polimórfica de 0,668. Este tipo de análisis puede ser usado para información de pedigrí y mejoramiento genético en programas de cría y pruebas de paternidad.

Estimación de polimorfismos del gen de leptina bovino en poblaciones de las razas criollas Hartón del Valle, Blanco Orejinegro (BON) y en la raza Brahman / The leptin gene polymorphism, in the populations of Hartón del Valle, Blanco-Orejinegro ( BON) and Brahman cattle

En investigaciones recientes se han identificado algunas regiones entre y adyacentes al gen de leptina, asociadas con diferentes niveles de grasa de la carne en canal, y cuyas frecuencias varíangrandemente de una raza a otra, y de una población a otra. En este trabajo, fueron determinados los polimorfismos para la región 5 UTR. (región que no traduce) y región flanqueante al extremo 3. delgen leptina, utilizando dos microsatélites ST y WD (G18586 y U50365). Fueron evaluados 261 animales de las razas Hartón del Valle (100), Brahman (121) y BON (40). Se encontraron 7 alelos diferentes parael marcador ST y 15 para WD, considerando la población total analizada. Las poblaciones de las razas criollas evaluadas para los marcadores ST y WD, no se encuentran en equilibrio de Hardy- Weinberg. El mayor polimorfismo para el microsatélites ST se encontró en la raza Brahman, que presentó 6 alelos. Para WD fue más polimorfica Hartón del Valle con 15 alelos diferentes. La menos polimórfica fue la raza BON, con 4 alelos para ST y 6 para WD.

Citotoxidad del dytract, en cultivos celulares de fibroblastos / Cytotoxicity of Dyract in cellular cultures of fibroblast

El propósito de este estudio fue el de comparar la citotoxidad del Dyract con el super EBA como materiales de obturación por vía apical, en cultivos de fibroblastos de una línea celular establecida "vero". Se utilizaron en este experimento un total de 183 cultivos celulares, en nueve placas de 24 pozos bajo condiciones de esterilidad en una cámara de flujo laminar; las muestras fueron 95 de Dyract, de material control (super EBA) y 18 de control de células. Se utilizó la prueba de rojo neutro para determinar el grado de citotoxidad de estos materiales a las 24 horas para la citotoxidad aguda y de 3 a 5 días para la citotoxidad mediada por metabolismo. Los resultados fueron estudiados por la prueba de chi 2, encontrando que no hubo diferencia significativa con relación a la citotoxidad de los dos materiales estudiados.