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The EU biodiversity strategy for 2030 sets out a framework of commitments and actions to tackle the main drivers of biodiversity loss. Such framework needs to be built on a whole-of-society approach to biodiversity protection, mobilizing private and public funding. In this context, our goal was estimating societal support and preferences about some basic wildlife management principles, which may be useful to inform EU decision-makers about societal priorities and other additional funding sources for wildlife conservation. A discrete choice experiment was conducted by 2415 inhabitants in six European countries (Spain, France, Italy, UK, Germany, Sweden), including residents in both rural (47% of respondents) and urban areas. Our findings reveal a clear pattern across western Europe with similar trends along the studied countries, and even between rural and urban citizens, on some basic wildlife management principles. According to our survey, payments for environmental services contribute to achieving a higher well-being from European citizens in any of the prospective wildlife programs considered, which suggests it is an acceptable tool to share out funds for biodiversity conservation. In addition, managing scarce species is preferred over managing too abundant species; management in forest, agricultural and aquatic habitats is prioritized over that in urban landscapes; and management in protected areas is preferred over management in non-protected ones. These findings suggest that there is a common culture in Europe related to the management of wildlife even when considering citizens with contrasted ways of life: rural vs urban citizens from northern to southwestern Europe. Overall, this study may help in the design of wildlife management policies that maximize societal acceptability and gather higher support.
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Animais Selvagens , Conservação dos Recursos Naturais , Animais , Estudos Prospectivos , Europa (Continente) , Ecossistema , BiodiversidadeRESUMO
The extraordinary population growth of certain ungulate species is increasingly a concern in agroforestry areas because overabundance may negatively affect natural environments and human livelihoods. However, society may have negative perceptions of killing wildlife to reduce their numbers and mitigate damage. We used an online survey that included a choice experiment to determine Spanish citizens' (n = 190) preferences toward wildlife population control measures related to negative effects of ungulate overabundance (negative impacts on vegetation and other wildlife species and disease transmission to livestock) in 2 agroforestry national parks in Spain. We used latent-class and willingness-to-pay in space models to analyze survey results. Two percent of respondents thought a national park should have no human intervention even if lack of management may cause environmental degradation, whereas 95% of respondents favored efforts to reduce damage caused by overabundant ungulate species. We estimated human well-being losses of survey respondents when sustainable effects of deer overabundance on the environment became unsustainable effects and well-being gains when sustainable effects transitioned to no visible effects. We found that the type of wildlife-control program was a very relevant issue for the respondents; indirect control in which killing was avoided was the preferred action. Sixty-six percent of respondents agreed with the option of hunters paying for culling animals to reduce ungulate impacts rather than management cost coming out of taxes, whereas 19% of respondents were against this option and willing to pay for other solutions in national parks. Our results suggest that killing wildlife in national parks could be a socially acceptable tool to manage overabundance problems in certain contexts, but it could also generate social conflicts.
Soluciones para las Actitudes Sociales hacia el Control Letal de la Fauna en Parques Nacionales Resumen El extraordinario crecimiento de ciertas poblaciones de ungulados es cada vez más preocupante en las áreas agroforestales ya que la sobreabundancia puede afectar negativamente al ambiente natural y el sustento humano. Sin embargo, la sociedad puede percibir negativamente el exterminio de fauna para reducir sus números y mitigar el daño. Usamos una encuesta en línea que incluía un experimento de elección para determinar las preferencias de los ciudadanos españoles (n = 190) por las medidas de control poblacional relacionadas con los efectos negativos de la sobreabundancia de ungulados (impactos negativos sobre la vegetación y otras especies silvestres y el contagio de enfermedades al ganado) en dos parques nacionales agroforestales de España. Usamos la clase latente y la disposición para pagar dentro modelos espaciales para analizar los resultados de la encuesta. El 2% de los respondientes creyó que un parque nacional no debería tener intervención humana, incluso si la falta de manejo pudiera causar una degradación ambiental. Mientras tanto, el 95% de los respondientes estuvieron a favor de los esfuerzos para reducir el daño causado por la sobreabundancia de ungulados. Cuando los efectos sustentables sobre el ambiente de la sobreabundancia de venados se convertían en efectos insostenibles, los estimamos como pérdidas de bienestar humano para los respondientes de la encuesta; cuando los efectos sustentables transitaron hacia la nula visibilidad de efectos, los estimamos como ganancias de bienestar. Descubrimos que el tipo de programa de control de fauna era un tema muy relevante para los respondientes; el control indirecto, en el que se evita el exterminio, fue la acción preferida por los respondientes. El 66% de los respondientes estuvo de acuerdo con la opción de que los cazadores paguen por sacrificar animales para reducir el impacto de los ungulados en lugar de que el costo del manejo provenga de los impuestos, mientras que el 19% de los respondientes estuvo en contra de esta opción y dispuesto a pagar por otras soluciones en los parques nacionales. Nuestros resultados sugieren que el exterminio de vida silvestre en los parques nacionales podría ser una herramienta socialmente aceptable para manejar problemas de sobreabundancia en ciertos contextos, pero también podría generar algunos conflictos sociales.
Assuntos
Cervos , Parques Recreativos , Animais , Animais Selvagens , Atitude , Conservação dos Recursos Naturais , Humanos , EspanhaRESUMO
BACKGROUND: Hemodialysis patients have historically experienced diminished access to care and increased adverse outcomes after natural disasters. Although "early dialysis" in advance of a storm is promoted as a best practice, evidence for its effectiveness as a protective measure is lacking. Building on prior work, we examined the relationship between the receipt of dialysis ahead of schedule before the storm (also known as early dialysis) and adverse outcomes of patients with end-stage renal disease in the areas most affected by Hurricane Sandy. STUDY DESIGN: Retrospective cohort analysis, using claims data from the Centers for Medicare & Medicaid Services Datalink Project. SETTING & PARTICIPANTS: Patients receiving long-term hemodialysis in New York City and the state of New Jersey, the areas most affected by Hurricane Sandy. FACTOR: Receipt of early dialysis compared to their usual treatment pattern in the week prior to the storm. OUTCOMES: Emergency department (ED) visits, hospitalizations, and 30-day mortality following the storm. RESULTS: Of 13,836 study patients, 8,256 (60%) received early dialysis. In unadjusted logistic regression models, patients who received early dialysis were found to have lower odds of ED visits (OR, 0.75; 95% CI, 0.63-0.89; P=0.001) and hospitalizations (OR, 0.77; 95% CI, 0.65-0.92; P=0.004) in the week of the storm and similar odds of 30-day mortality (OR, 0.80; 95% CI, 0.58-1.09; P=0.2). In adjusted multivariable logistic regression models, receipt of early dialysis was associated with lower odds of ED visits (OR, 0.80; 95% CI, 0.67-0.96; P=0.01) and hospitalizations (OR, 0.79; 95% CI, 0.66-0.94; P=0.01) in the week of the storm and 30-day mortality (OR, 0.72; 95% CI, 0.52-0.997; P=0.048). LIMITATIONS: Inability to determine which patients were offered early dialysis and declined and whether important unmeasured patient characteristics are associated with receipt of early dialysis. CONCLUSIONS: Patients who received early dialysis had significantly lower odds of having an ED visit and hospitalization in the week of the storm and of dying within 30 days.
Assuntos
Tempestades Ciclônicas , Planejamento em Desastres , Diálise Renal , Idoso , Idoso de 80 Anos ou mais , Feminino , Hospitalização , Humanos , Falência Renal Crônica/mortalidade , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , New Jersey , New York , Diálise Renal/normas , Fatores de TempoRESUMO
Human-wildlife conflicts (HWC) are increasing and are potentially harmful to both people and wildlife. Understanding the current and potential distribution of wildlife species involved in HWC, such as carnivores, is essential for implementing management and conservation measures for such species. In this study, we assessed both the current distribution and potential distribution (forecast) of the Egyptian mongoose (Herpestes ichneumon) in the central part of the Iberian Peninsula. We acquired data concerning mongoose occurrences through an online questionnaire sent to environmental rangers. We used the municipality level as the sampling unit because all municipalities within the study area were covered at least by one ranger. Using the information provided by rangers (i.e. occurrences in their municipalities), we constructed environmental favourability distribution models to assess current and potential mongoose distribution through current distribution models (CDM) and ecological models (EM), respectively. >300 rangers participated in the survey and mongooses were reported in a total of 181 of 921 municipalities studied. The CDM model showed a current distribution mainly concentrated on the western part of the study area, where intermediate-high favourability values predominated. The EM model revealed a wider potential distribution, including the south-east part of the study area, which was also characterised by intermediate-high favourability values. Our predictions were verified using independent data, including confirmation of mongoose reproduction by rangers, reports by other experts, and field sampling in some areas. Our innovative approach based on an online survey to rangers coupled with environmental favourability models is shown to be a useful methodology for assessing the current distribution of cryptic but expanding wildlife species, while also enabling estimations of future steps in their expansion. The approach proposed may help policy decision-makers seeking to ensure the conservation of expanding wildlife species, for example, by designing awareness campaigns in areas where the target species is expected to arrive.
Assuntos
Conservação dos Recursos Naturais , Animais , Conservação dos Recursos Naturais/métodos , Herpestidae , Distribuição Animal , Animais Selvagens , Espanha , Monitoramento Ambiental/métodos , EcossistemaRESUMO
A new regulation has led to the prohibition of recreational hunting on estates located within Spanish National Parks (NPs). Before the ban, eleven NPs in Spain had already reported negative ecological consequences associated with high densities of wild ungulates. The new situation that has occurred after the ban signifies that policies with which to control populations of wild ungulates in NPs, most of which do not have a sufficient natural capacity to regulate populations, depend exclusively on the parks' authorities. The banning of recreational hunting implies a series of social, ecological, economic and logistic challenges. The control of wild ungulate populations in NPs requires: i) the legal basis for culling; ii) social acceptance as regards removing animals and the extractive procedures employed in NPs; iii) the long-term monitoring of wild ungulates and the damages that they cause, and iv) sufficient financial and human resources. A more integrated management and policy plan is, therefore, required, which should be supported by two pillars: i) the sustainability of natural resources and the conservation of functional environments, and ii) providing society with explanations regarding the need to manage wild ungulates. In order to bridge the potential gap between these key pillars, it is important to involve stakeholders in the decision-making processes concerning wild ungulate management. The forthcoming changes in Spanish NPs provide a promising opportunity to make a substantial improvement to wild ungulate management in these protected areas. This management approach could, moreover, serve as an example and be transferred to other protected spaces.
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Animais Selvagens , Parques Recreativos , Animais , Humanos , Caça , Conservação dos Recursos Naturais/métodos , MamíferosRESUMO
Zoonotic emerging diseases (ZEDs) are increasing and may deeply impact human wellbeing, but our recent survey of public opinion in six European countries (n = 2415 participants) suggests a low concern among Europeans about the risk associated with ZEDs. This contrasts with Europeans' high awareness of climate change risks, which was confirmed by our survey. Given the increasing risk of ZEDs, it is therefore essential to increase Europeans' awareness of their impacts. In addition, our study suggests that Europeans may be more likely to support sustainable environmental policies that would reduce the risk associated with ZEDs, consequently improving the human wellbeing.
Assuntos
Zoonoses , Animais , Humanos , Zoonoses/epidemiologia , Zoonoses/prevenção & controle , Inquéritos e Questionários , Europa (Continente)RESUMO
Mycotoxins are natural food and feed contaminants produced by several molds. The primary mode of exposure in humans and animals is through mixtures. Aflatoxin B1 (AFB1) and sterigmatocystin (STER) are structurally related mycotoxins that share the same biosynthetic route. Few in vivo genotoxicity assays have been performed with STER. In the present genotoxicity study, Wistar rats were dosed orally with STER (20 mg/kg b.w.), AFB1 (0.25 mg/kg b.w.) or a mixture of both in an integrated micronucleus (bone marrow) and comet study (liver and kidney). STER was dosed at the highest feasible dose in corn oil. No increase in the percentage of micronuclei in bone marrow was observed at any condition. Slight DNA damage was detected in the livers of animals treated with AFB1 or the mixture (DNA strand breaks and Fpg (Formamidopyrimidine DNA glycosylase)-sensitive sites, respectively). Plasma, liver, and kidney samples were analyzed with LC-MS/MS demonstrating exposure to both mycotoxins. General toxicity parameters (organs absolute weight, biochemistry, and histopathology) were not altered either individually or in the mixture. The overall absence of individual genotoxicity did not allow us to set any type of interaction in the mixture. However, a possible toxicokinetic interaction was observed.
Assuntos
Aflatoxina B1 , Esterigmatocistina , Ratos , Animais , Humanos , Ratos Wistar , Esterigmatocistina/toxicidade , Aflatoxina B1/toxicidade , Cromatografia Líquida , Espectrometria de Massas em Tandem , Dano ao DNARESUMO
Aflatoxin B1 (AFB1) is the most potent natural carcinogen among mycotoxins. Versicolorin A (VerA) is a precursor of AFB1 biosynthesis and is structurally related to the latter. Although VerA has already been identified as a genotoxin, data on the toxicity of VerA are still scarce, especially at low concentrations. The SOS/umu and miniaturised version of the Ames test in Salmonella Typhimurium strains used in the present study shows that VerA induces point mutations. This effect, like AFB1, depends primarily on metabolic activation of VerA. VerA also induced chromosomal damage in metabolically competent intestinal cells (IPEC-1) detected by the micronucleus assay. Furthermore, results from the standard and enzyme-modified comet assay confirmed the VerA-mediated DNA damage, and we observed that DNA repair pathways were activated upon exposure to VerA, as indicated by the phosphorylation and/or relocation of relevant DNA-repair biomarkers (γH2AX and 53BP1/FANCD2, respectively). In conclusion, VerA induces DNA damage without affecting cell viability at concentrations as low as 0.03 µM, highlighting the danger associated with VerA exposure and calling for more research on the carcinogenicity of this emerging food contaminant.
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Micotoxinas , Micotoxinas/toxicidade , Aflatoxina B1/toxicidade , Mutagênicos/toxicidade , Dano ao DNA , Testes de Mutagenicidade/métodosRESUMO
In recent decades, a higher prevalence, persistence, and severity of cow's milk protein allergy (CMPA) have been observed. Different hypotheses have been proposed in relation to potential responsible mechanisms, with emphasis on the role of the microbiota in the induction and maintenance of immune tolerance as well as the importance of establishing a healthy microbiota in an early manner through the promotion of breastfeeding, vaginal delivery, rational use of antibiotics and proton pump inhibitors, along with an early introduction of varied foods. The use of probiotics and allergenspecific immunotherapy (AIT) come up as the treatment strategies with the greatest evidence in favor of tolerance acquisition. The objective of this review was to describe the information currently available about the immune mechanisms involved in CMPA, the role of microbiota, and future treatment perspectives.
En las últimas décadas, se ha observado una mayor prevalencia, persistencia y gravedad de la alergia a la proteína de leche de vaca (APLV). Se han postulado diversas hipótesis respecto a posibles mecanismos responsables, con énfasis en el papel de la microbiota en la inducción y el mantenimiento de la tolerancia inmunitaria, así como la importancia del establecimiento temprano de una microbiota saludable a través de la promoción de la lactancia materna, el parto por vía vaginal, el uso racional de antibióticos e inhibidores de la bomba de protones, junto con la introducción temprana y variada de alimentos. La utilización de probióticos y la inmunoterapia específica para alérgenos (ITA) emergen como las estrategias terapéuticas con más evidencia a favor para la adquisición de tolerancia. El objetivo de esta revisión ha sido describir la información actual respecto a los mecanismos inmunitarios involucrados en la APLV, el papel de la microbiota y las perspectivas futuras en el tratamiento.
Assuntos
Hipersensibilidade a Leite , Probióticos , Animais , Aleitamento Materno , Bovinos , Feminino , Humanos , Tolerância Imunológica , Lactente , ConhecimentoRESUMO
Local communities surrounding wildlife corridors and natural reserves often face challenges related to human-wildlife coexistence. To mitigate the challenges and ensure the long-term conservation of wildlife, it is important to engage local communities in the design of conservation strategies. By conducting 480 face-to-face interviews in 30 villages along and adjacent to the Selous-Niassa Wildlife Corridor (Tanzania), we quantified farmers' preferences for farm-based measures to mitigate African elephant damage using choice experiments. Results show that farmers considered no action the least preferred option, revealing that they are open to trying different measures. The most preferred management strategy matched with the preferences of wildlife rangers in the area, suggesting low concern about the potential conflicts between stakeholders. However, a latent class model suggests that there are significant differences among responses triggered by farmers' previous experience with elephants, the intensity of the elephant damage, and the socioeconomic situation of the farmer. Results show a marked spatial distribution among respondents, highlighting the benefits of zone management as conflicts were found to be highly context dependent. Understanding the human dimension of conservation is essential for the successful planification and implementation of conservation strategies. Therefore, the development and broad utilization of methodologies to gather specific context information should be encouraged.
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Liver S9 fraction is usually employed in mutagenicity/genotoxicity in vitro assays, but some genotoxic compounds may need another type of bioactivation. In the present work, an alternative S9 fraction from the kidneys was used for the genotoxicity assessment of 12 mycotoxins with the SOS/umu test. The results were compared with liver S9 fraction, and 2-4 independent experiments were performed with each mycotoxin. The expected results were obtained with positive controls (4-nitroquinoline-N-oxide and 2-aminoanthracene) without metabolic activation or with liver S9, but a potent dose-dependent effect with 4-nitroquinoline-N-oxide and no activity of 2-aminoanthracene with kidney S9 were noticed. Aflatoxin B1 was genotoxic with metabolic activation, the effect being greater with liver S9. Sterigmatocystin was clearly genotoxic with liver S9 but equivocal with kidney S9. Ochratoxin A, zearalenone and fumonisin B1 were negative in all conditions. Trichothecenes were negative, except for nivalenol, 3-acetyldeoxynivalenol, 15-acetyldeoxynivalenol, T-2 and HT-2 toxins, which showed equivocal results with kidney S9 because a clear dose-response effect was not observed. Most of the mycotoxins have been assessed with kidney S9 and the SOS/umu test for the first time here. The results with the positive controls and the mycotoxins confirm that the organ used for the S9 fraction preparation has an influence on the genotoxic activity of some compounds.
Assuntos
Micotoxinas , 4-Nitroquinolina-1-Óxido , Dano ao DNA , Rim , Fígado , Testes de Mutagenicidade/métodos , Mutagênicos/toxicidade , Micotoxinas/toxicidade , EsterigmatocistinaRESUMO
Employing high-voltage Ni-rich cathodes in Li metal batteries (LMBs) requires stabilization of the electrode/electrolyte interfaces at both electrodes. A stable solid-electrolyte interphase (SEI) and suppression of active material pulverization remain the greatest challenges to achieving efficient long-term cycling. Herein, studies of NMC622 (1 mAh cm-2) cathodes were performed using highly concentrated N-methyl-N-propylpyrrolidinium bis(fluorosulfonyl)imide (C3mpyrFSI) 50 mol % lithium bis(fluorosulfonyl)imide (LiFSI) ionic liquid electrolyte (ILE). The resulting SEI formed at the cathode enabled promising cycling performance (98.13% capacity retention after 100 cycles), and a low degree of ion mixing and lattice expansion was observed, even at an elevated temperature of 50 °C. Fitting of acquired impedance spectra indicated that the SEI resistivity (RSEI) had a low and stable contribution to the internal resistivity of the system, whereas active material pulverization and secondary grain isolation significantly increased the charge transfer resistance (RCT) throughout cycling.
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A new material composed of a kaolin base with silver nanoparticles (AgNPs) attached to its surface was developed, as an alternative to antibiotics used as supplements in animal feed. As part of its safety assessment, an in vivo geno-toxicological evaluation of this material was conducted in rats. First, a preliminary dose finding study was carried out to decide the doses to be tested in the main study: 50, 300 and 2000 mg/kg b.w. For the main study, a combined strategy composed of the MN test (TG 474) and the comet assay (TG 489), integrated in a repeated dose 28-day oral toxicity study (TG 407), was performed. A No Observed Adverse Effect Level (NOAEL) of 2000 mg of the silver-kaolin formulation/kg b.w. by oral route, for 28 days, was determined. The silver-kaolin formulation did not induce micronuclei in bone marrow, or DNA strand breaks (SBs) or alkali labile sites (ALS) in liver, spleen, kidney or duodenum at any dose. The modified Fpg comet assay did not reveal oxidized bases in the same tissues at the dose of 2000 mg/kg b.w. Silver was quantified by ICP-MS in all the target organs, confirming the negative results obtained under these conditions.
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The main marketed parts of squid are the mantle, the head with tentacles, and fins. However, when the whole squid does not meet quality standards for human consumption it can be used for broiler feed. The objective of the study was to include giant squid (Dosidicus gigas) meal (GSM) in broiler rations to increase the content of the n-3 fatty acids eicosapentaenoic (EPA), docosapentaenoic (DPA), and docosahexaenoic (DHA) in chicken meat. Two hundred Ross 380 chickens, half male, half female, and one day old, were randomly distributed in a 4x2x2 factorial arrangement. The factors were the treatment (0%, 1.67%, 3.34%, and 5.01% of GSM in the diet), sex, and content of n-3 in the legs with thighs and the breasts. Each treatment had five repetitions with 10 birds each. There were no differences (p > 0.05) in the production parameters for both sexes. The contents of EPA, DPA, and DHA increased in the females and in the legs with thighs (p < 0.05) with GSM. Acceptance for the flavor and texture of meat was higher in the treatment with 1.67% GSM than in the other treatments. It is concluded that GSM is an alternative for increasing the amount of n-3 in chicken meat.
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Natural antioxidant in vegetables, and in some animals have been studied by their action in the protection of a considerable number of diseases, such as, certain types of cancer, cardiovascular diseases, and age-related macular degeneration. Experimental evidences suggest that these compounds are important for protecting biological macro-molecules against oxidative damage. The search of new and more efficient antioxidants appears to be directed with carotenoids which have demonstrated that their consumption may reduce the incidence of certain diseases. In addition they represent a provitamin A source, and their actual antioxidant activity in the cell by participating in the neutralization of reactive oxygen species, and nitrogen produced, as a part of the cellular metabolism. This paper is focused to review basic and clinical aspects of investigations which have been associated with the intake of carotenoids with cancer, heart diseases, and age-related macular degeneration; the above all, we have tried to identify basic concepts of the role of the carotenoids and their metabolism; after that, we have reviewed clinical evidence that show how the intake of carotenoids reduces certain diseases. Finally, we discuss some of the results of investigation.
Assuntos
Antioxidantes/farmacologia , Doenças Cardiovasculares/prevenção & controle , Carotenoides/farmacologia , Alimento Funcional , Degeneração Macular/prevenção & controle , Neoplasias/prevenção & controle , Antioxidantes/administração & dosagem , Carotenoides/administração & dosagem , Humanos , Espécies Reativas de OxigênioRESUMO
Humans are widely exposed to a great variety of mycotoxins and their mixtures. Therefore, it is important to design strategies that allow prioritizing mycotoxins based on their toxic potential in a time and cost-effective manner. A strategy combining in silico tools (Phase 1), including an expert knowledge-based (DEREK Nexus®, Lhasa Limited, Leeds, UK) and a statistical-based platform (VEGA QSAR©, Mario Negri Institute, Milan, Italy), followed by the in vitro SOS/umu test (Phase 2), was applied to a set of 12 mycotoxins clustered according to their structure into three groups. Phase 1 allowed us to clearly classify group 1 (aflatoxin and sterigmatocystin) as mutagenic and group 3 (ochratoxin A, zearalenone and fumonisin B1) as non-mutagenic. For group 2 (trichothecenes), contradictory conclusions were obtained between the two in silico tools, being out of the applicability domain of many models. Phase 2 confirmed the results obtained in the previous phase for groups 1 and 3. It also provided extra information regarding the role of metabolic activation in aflatoxin B1 and sterigmatocystin mutagenicity. Regarding group 2, equivocal results were obtained in few experiments; however, the group was finally classified as non-mutagenic. The strategy used correlated with the published Ames tests, which detect point mutations. Few alerts for chromosome aberrations could be detected. The SOS/umu test appeared as a good screening test for mutagenicity that can be used in the absence and presence of metabolic activation and independently of Phase 1, although the in silico-in vitro combination gave more information for decision making.
Assuntos
Sistemas Inteligentes , Testes de Mutagenicidade , Micotoxinas/toxicidade , Relação Quantitativa Estrutura-Atividade , Ativação Metabólica , Animais , Dano ao DNA , Masculino , Micotoxinas/química , Ratos Sprague-Dawley , Salmonella typhimuriumRESUMO
INTRODUCTION: Background & aims: the last large multicenter study on disease-related malnutrition (DRM) in Spain (the PREDyCES study) showed a 23.7 % prevalence of malnutrition, according to the Nutritional Risk Screening (NRS-2002) tool. The main objective of the SeDREno study was to assess the prevalence of hospital malnutrition upon admission, according to GLIM criteria, ten years later. Methods: a cross-sectional, observational, multicenter study in standard clinical practice, conducted in 17 hospitals during a period of five to seven days. Patients were initially screened using the Malnutrition Universal Screening Tool (MUST), and then assessed using the GLIM criteria for diagnosis and severity grading. Results: a total of 2,185 patients, 54.8 % males, mean age 67.1 (17.0) years (50.2 % aged ≥ 70 years), were evaluated. Malnutrition was observed in 29.7 % of patients according to GLIM criteria (12.5 % severe, 17.2 % moderate). In patients ≥ 70 years malnutrition was observed in 34.8 %. The clinical conditions significantly associated with a higher prevalence of malnutrition were dysphagia (47.6 %), cognitive impairment (43.4 %), cancer (39.1 %), gastrointestinal disease (37.7 %), diabetes (34.8 %), and cardiovascular disease (33.4 %). The multivariate analysis revealed that gender, BMI, diabetes, cancer, gastrointestinal disorders, and polypharmacy were the main independent factors associated with DRM. Malnutrition was associated with an increase in length of hospital stay and death (p < 0.001). Conclusions: DRM in admitted patients has increased in Spain in the last 10 years paralleling ageing of the population. In the SeDREno study almost one in three patients are malnourished. A systematic assessment of nutritional status allows early detection and implementation of nutritional interventions to achieve a better clinical outcome.
INTRODUCCIÓN: Antecedentes y objetivos: el último gran estudio multicéntrico sobre desnutrición relacionada con la enfermedad (DRE) en España (el estudio PREDyCES) mostró una prevalencia de desnutrición del 23,7 % según la herramienta Nutritional Risk Screening (NRS-2002). El principal objetivo del estudio SeDREno fue evaluar la prevalencia de la desnutrición hospitalaria al ingreso según los criterios GLIM diez años después. Métodos: estudio transversal, observacional, multicéntrico, según la práctica clínica estándar, realizado en 17 hospitales durante un período de cinco a siete días. Los pacientes fueron evaluados inicialmente con la herramienta de detección universal de desnutrición (MUST) y luego con los criterios GLIM para el diagnóstico de DRE y la clasificación de la gravedad. Resultados: se evaluaron 2185 pacientes, con un 54,8 % de varones una edad media de 67,1 (17,0) años (50,2 % ≥ 70 años). Se observó desnutrición en el 29,7 % de los pacientes según los criterios GLIM (12,5 % grave, 17,2 % moderada). Entre los pacientes ≥ 70 años se observó desnutrición en el 34,8 %. Las condiciones clínicas asociadas significativamente con una mayor prevalencia de desnutrición fueron la disfagia (47,6 %), el deterioro cognitivo (43,4 %), el cáncer (39,1 %), las enfermedades gastrointestinales (37,7 %), la diabetes (34,8 %) y la patología cardiovascular (33,4 %). El análisis multivariante reveló que el sexo, el IMC, la diabetes, el cáncer, los trastornos gastrointestinales y la polimedicación eran los principales factores independientes asociados a la DRE. La desnutrición se asoció a un aumento de la duración de la estancia hospitalaria y la muerte (p < 0,001). Conclusiones: la DRE en pacientes ingresados ha aumentado en España en los últimos 10 años en paralelo con el aumento del envejecimiento de la población. En el estudio SeDREno, casi uno de cada tres pacientes está desnutrido. La evaluación sistemática del estado nutricional permite la detección e implementación precoces de intervenciones nutricionales para lograr un mejor resultado clínico.
Assuntos
Desnutrição/diagnóstico , Qualidade da Assistência à Saúde/normas , Idoso , Índice de Massa Corporal , Feminino , Humanos , Doença Iatrogênica/epidemiologia , Masculino , Desnutrição/epidemiologia , Pessoa de Meia-Idade , Estado Nutricional , Prevalência , Indicadores de Qualidade em Assistência à Saúde/estatística & dados numéricos , Qualidade da Assistência à Saúde/estatística & dados numéricos , Espanha/epidemiologiaRESUMO
BACKGROUND: Cervical corpectomy is a common procedure in spondylosis. It is normally a well-tolerated surgery and clinical improvement is widely described. However, it is associated with potential risky complications (subsidence, clinical deterioration, vertebral artery injury...); thus, a judicious surgical indication and a good technique are required. METHODS: We revised retrospectively the clinical evolution and complications of 71 spondylotic corpectomies in a series of 100 consecutive patients operated on due to different ethiological causes from January 2001 to September 2007 at our hospital. RESULTS: Among the 71 cases, a single-level corpectomy was performed in 46 cases and a two level in 25. The graft we used was a titanium mesh filled with bone from the removed vertebra in 69 cases and a telescopic cage in two additional cases. We stabilized the construction with a locking plate. The presurgical clinical status of patients, according to the Nurick grading scale was as follows: 30 patients were grade 0, 12 were grade 1, eight were grade 2, 14 were grade 3, five were grade 4 and two were grade 5. After decompression, 41 patients were considered cured, three were grade 1, seven were grade 2, 11 were grade 3, seven were grade 4 and one was grade 5. One patient died in the postoperative period. Globally, 44 (62%) patients achieved good or excellent results (grades 0-1), 15 (21%) remained as previously (grade >1), six (8%) improved partially and five (7%) worsened. Forty (95%) grades 0 and 1 patients became cured, and four (50%), four (31%) and two (28%) grades 2, 3 and 4-5, respectively, experienced a postsurgical improvement. Significant complications occurred in 18 (25%) patients. The most significant were: hardware failure (n = 7), subsidence in five cases (one required intervention) and incorrect screw placement in two (one required intervention); permanent dysphagia (n = 4) and dysphonia (n = 1); postsurgical neurological worsening in three cases (two improved and one remained grade 4); vertebral artery injury in one case; and an urgent evacuation of a prevertebral hematoma. One patient died due to respiratory disturbances. CONCLUSIONS: Cervical corpectomy is efficient for spinal cord decompression, especially when anterior components (disk osteophyte, OPLL...) bulge in the spinal cord. A three or more level corpectomy was not considered in this series since they may be associated to high rate morbidity. We found that this decompression led to better clinical results in patient grades 0 and 1 and to poorer results as myelopathy progressed. Among complications, subsidence was the most frequent specific one, but since it was rarely associated with symptoms, the majority of patients were successfully treated conservatively.
Assuntos
Vértebras Cervicais/cirurgia , Procedimentos Neurocirúrgicos/instrumentação , Procedimentos Neurocirúrgicos/métodos , Complicações Pós-Operatórias/fisiopatologia , Espondilose/cirurgia , Adulto , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Neurocirúrgicos/efeitos adversos , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Radiografia , Estudos Retrospectivos , Espondilose/diagnóstico por imagem , Espondilose/patologiaRESUMO
INTRODUCTION: Food allergies affect mostly children in their first years of life. Epidemiological data obtained in Argentina are scarce. OBJECTIVES: To determine offending foods and describe the prevalence and characteristics of patients with food allergy in an Argentine pediatric population. PATIENTS AND METHODS: Observational, retrospective, crosssectional study on patients younger than 18 years. RESULTS: A total of 321 patients were included; food allergy was confirmed in 64 % (207) of cases. An immunoglobulinE-mediated mechanism was observed in 53% (109); cow's milk protein allergy, in 68 % (140); egg allergy, in 20 % (41); and anaphylaxis as clinical manifestation, in 12 % (24). The overall prevalence of food allergy was 0.87 % (95 % confidence interval: 0.7-0.9). CONCLUSIONS: The overall prevalence of food allergy was 0.87%. Cow's milk was the main allergen, even among adolescents.
Introducción: Las alergias al imentarias afectan, mayoritariamente, a los niños en los primeros años de vida. Existen escasos datos epidemiológicos en nuestro país. Objetivos: Determinar los agentes causales, describir la prevalencia y características de los pacientes con alergia alimentaria en una población pediátrica argentina. Pacientes y métodos: Estudio retrospectivo observacional, de corte transversal, de pacientes menores de 18 años. Resultados: Se incluyeron 321 pacientes; se confirmó alergia alimentaria en un 64 % (207) de los casos. El 53 % (109) presentó mecanismo mediado por inmunoglobulina E; el 68 % (140), alergia a las proteínas de la leche de vaca; el 20 % (41), alergia al huevo, y el 12% (24), anafilaxia como manifestación clínica. La prevalencia global de alergia alimentaria fue del 0,87 % (IC 95 %: 0,7-0,9). Conclusiones: La prevalencia global de alergia alimentaria fue del 0,87 %. La leche de vaca resultó el principal alérgeno incluso en adolescentes.
Assuntos
Hipersensibilidade Alimentar , Adolescente , Animais , Bovinos , Criança , Pré-Escolar , Hipersensibilidade a Ovo , Feminino , Hipersensibilidade Alimentar/epidemiologia , Humanos , Lactente , Recém-Nascido , Hipersensibilidade a Leite/epidemiologia , Prevalência , Estudos RetrospectivosRESUMO
Three hydrated double layered vanadium oxides, namely Na0.35V2O5·0.8(H2O), K0.36(H3O)0.15V2O5 and (NH4)0.37V2O5·0.15(H2O), were obtained by using mild hydrothermal conditions. Their delta type structural frameworks were solved by high-resolution synchrotron X-ray powder diffraction and the interlayer spacings were interpreted from difference Fourier maps. The inter-slab distances are modulated by the water content and the special arrangements of the alkali and ammonium cations. The XPS measurements denote mixed valence systems with high contents of V4+ ions up to 40%. The monitoring of the V4+ EPR signal over time suggests a reduction of the electronic delocalization on account of the partial oxidation to V5+. The electrochemical performance of the active phases is strongly conditioned by the vacuum-drying process of the electrodes, showing better capacity retention when vacuum is not applied. In situ X-ray diffraction shows a structural mechanism of contraction/expansion of the bilayers upon lithium insertion/extraction where the alkali ions behave as structural stabilizers. Galvanostatic cycling at very low current density implies migration of the alkali "pillars" triggering the collapse of the structure.