Impact of mediterranean diet promotion on environmental sustainability: a longitudinal analysis.

OBJECTIVE: This article aims to estimate the differences in environmental impact (greenhouse gas [GHG] emissions, land use, energy used, acidification and potential eutrophication) after one year of promoting a Mediterranean diet (MD). METHODS: Baseline and 1-year follow-up data from 5800 participants in the PREDIMED-Plus study were used. Each participant's food intake was estimated using validated semi-quantitative food frequency questionnaires, and the adherence to MD using the Dietary Score. The influence of diet on environmental impact was assessed through the EAT-Lancet Commission tables. The influence of diet on environmental impact was assessed through the EAT-Lancet Commission tables. The association between MD adherence and its environmental impact was calculated using adjusted multivariate linear regression models. RESULTS: After one year of intervention, the kcal/day consumed was significantly reduced (-125,1 kcal/day), adherence to a MD pattern was improved (+0,9) and the environmental impact due to the diet was significantly reduced (GHG: -361 g/CO2-eq; Acidification:-11,5 g SO2-eq; Eutrophication:-4,7 g PO4-eq; Energy use:-842,7 kJ; and Land use:-2,2 m2). Higher adherence to MD (high vs. low) was significantly associated with lower environmental impact both at baseline and one year follow-up. Meat products had the greatest environmental impact in all the factors analysed, both at baseline and at one-year follow-up, in spite of the reduction observed in their consumption. CONCLUSIONS: A program promoting a MD, after one year of intervention, significantly reduced the environmental impact in all the factors analysed. Meat products had the greatest environmental impact in all the dimensions analysed.

Early sustained unresponsiveness after short-course egg oral immunotherapy: a randomized controlled study in egg-allergic children.

BACKGROUND: No studies have evaluated the potential of egg oral immunotherapy (egg-OIT) to induce sustained unresponsiveness after discontinuing therapy following short-term treatments. OBJECTIVE: We assessed the efficacy of short-course egg-OIT to induce sustained unresponsiveness. METHODS: Sixty-one egg-allergic children, 5 to 17 years old, with positive double-blind placebo-controlled food challenge (DBPCFC) to dehydrated egg white (EW) were randomized to receive egg-OIT (OITG) for 3 months (maintenance dose one undercooked egg every 48 hours) or to continue egg avoidance diet (control group, CG) for 4 months. Children who completed egg-OIT avoided egg for 1 month. At 4 months, both groups underwent a DBPCFC. OITG participants who passed this challenge were instructed to add egg to their diet ad libitum. Immune markers were studied at different time points. RESULTS: Ninety-three percent (28/30) of OITG children were desensitized in a median of 32.5 days (IQR, 14 days). At 4 months, 1/31 (3%) in CG passed DBPCFC and 11/30 (37%) of OITG (95% CI, 14 to 51%; P = 0.003), all of them were consuming egg at 36 months. A decrease in EW, OVA and OVM skin test results and OVA-specific IgE (sIgE) levels was observed on OITG at 4 months (P = 0.001). EW-, OVA- and OVM-sIgE levels prior to the start of egg avoidance diet were lower in OITG children who passed DBPCFC at 4 months than in those who did not pass it. EW- and OVM-sIgE showed the best diagnostic performance in predicting DBPCFC result at 4 months. Levels above optimal EW-sIgE cut-off of 7.1 kU/L indicated 90% probability of failing DBPCFC. CONCLUSION: This is the first demonstration of sustained unresponsiveness with a three-month egg-OIT protocol. Almost all treated subjects were desensitized and 37% achieved sustained unresponsiveness. EW-sIgE levels at the end of treatment predicted sustained unresponsiveness. This protocol shows a new approach to OIT for egg-allergic children.

First-principles study of the interaction between NO and large carbonaceous clusters modeling the soot surface.

First-principles calculations are performed to characterize the NO adsorption on large carbonaceous clusters modeling the surface of soot. Adsorption on the face and on the edges of perfect and defective clusters is considered in the calculations. It is shown that the first situation corresponds to physisorption and requires taking into account long-range dispersion interactions in the calculations. In contrast, interaction of NO with the unsaturated edge of a defective cluster leads preferentially to a C-N rather than to a C-O chemical binding. This indicates that soot may be an efficient sink for NO in the troposphere only if it contains a high number of unsaturated carbon atoms. From a more fundamental point of view, this study also clearly evidences that quantum calculations have to be carefully conducted when considering the interaction between radical species and carbonaceous surfaces. Problems encountered with the choice of the functional used in density functional theory approaches as well as with the size of the basis set, spin multiplicity, and spin contamination have to be systematically addressed before any relevant conclusion can be drawn.

[Translated article] Efficacy of transplantation of lipoaspired mesenchymal stem cells in the treatment of chronic rotator cuff tears. Experimental model in rats.

BACKGROUND AND AIM: Rotator cuff tears emerge in approximately 30% of the population over 60 years of age. Arthroscopic surgical treatment of these lesions is the treatment of choice, however, despite the improved repair techniques, the rate of re-tears ranges between 11 and 94%. Therefore, researchers seek to improve the biological healing process through the use of different alternatives such as mesenchymal stem cells (MSCs). Our objective is to evaluate the efficacy of a cellular therapy drug made from allogeneic stem cells derived from adipose tissue in a rat model of chronic rotator cuff injury. MATERIAL AND METHODS: The supraspinatus lesion was created in 48 rats for subsequent suturing at 4 weeks. MSCs in suspension were added to 24 animals after suturing, and HypoThermosol-FRS® (HTS) to 24 animals as a control group. Histology (Åström and Rausing scale) and the maximum load, displacement and elastic constant of the supraspinatus tendon were analysed in both groups 4 months after the repair. RESULTS: No statistically significant differences were found in the histological score comparing the tendons treated with MSCs with respect to the tendons treated with HTS (P=0.811) nor in the results of maximum load (P=0.770), displacement (P=0.852) or elastic constant (P=0.669) of the tendon in both groups. CONCLUSIONS: The addition of adipose-derived cells in suspension to the repair of a chronic cuff injury does not improve the histology or biomechanics of the sutured tendon.

Efficacy of transplantation of lipoaspired mesenchymal stem cells in the treatment of chronic rotator cuff tears. Experimental model in rats. / Eficacia del trasplante de células madre mesenquimales de lipoaspirado en el tratamiento de lesiones crónicas del manguito rotador. Modelo experimental en ratas.

BACKGROUND AND AIM: Rotator cuff tears emerge in approximately 30% of the population over 60 years of age. Arthroscopic surgical treatment of these lesions is the treatment of choice, however, despite the improved repair techniques, the rate of re-tears ranges between 11 and 94%. Therefore, researchers seek to improve the biological healing process through the use of different alternatives such as mesenchymal stem cells (MSCs). Our objective is to evaluate the efficacy of a Cellular Therapy Drug made from allogeneic stem cells derived from adipose tissue in a rat model of chronic rotator cuff injury. MATERIAL AND METHODS: The supraspinatus lesion was created in 48 rats for subsequent suturing at 4 weeks. MSCs in suspension were added to 24 animals after suturing, and HypoThermosol-FRS® (HTS) to 24 animals as a control group. Histology (Åström and Rausing scale) and the maximum load, displacement and elastic constant of the supraspinatus tendon were analyzed in both groups 4 months after the repair. RESULTS: No statistically significant differences were found in the histological score comparing the tendons treated with MSCs with respect to the tendons treated with HTS (P=.811) nor in the results of maximum load (P=.770), displacement (P=.852) or elastic constant (P=.669) of the tendon in both groups. CONCLUSIONS: The addition of adipose-derived cells in suspension to the repair of a chronic cuff injury does not improve the histology or biomechanics of the sutured tendon.

Analysis of deep brain stimulation of the subthalamic nucleus (STN-DBS) in patients with monogenic PRKN and LRRK2 forms of Parkinson's disease.

INTRODUCTION: Deep brain stimulation of the subthalamic nucleus (STN-DBS) is the most common surgical treatment for Parkinson's disease (PD). Patient selection and genetic background can modify the response to this treatment. The objective of this study was to compare both clinical and pharmacologic response of STN-DBS between patients with monogenic forms of PD and non-mutation carriers with idiopathic PD. METHODS: A retrospective analysis among 23 carriers of genetic mutations (8 PRKN and 15 LRRK2) and 74 patients with idiopathic PD was performed. The study included comparisons of Unified Parkinson's Disease Rating Scale (UPDRS) II and III scores, Schwab and England (S&E) scale values, Hoehn & Yahr (H&Y) stage scores, and equivalent doses of levodopa before and after the surgery (at 6 and 12 months) between both groups. RESULTS: The mean age at the time in which STN-DBS was performed was 59.5 ± 8.6. Linear mixed models showed the absence of statistically significant differences between mutation and non-mutation carriers regarding levodopa doses (p = 0.576), UPDRS II (p = 0.956) and III (p = 0.512) scores, and S&E scale scores (0.758). The only difference between the two groups was observed with respect to H&Y stage in OFF medication/ON stimulation status being lower in genetic PD at 6 months after surgery (p = 0.030). CONCLUSION: Clinical and pharmacological benefit of bilateral STN-DBS is similar in PRKN and LRRK2 mutation carriers and patients with idiopathic PD.

Direct surface plasmon resonance immunosensing of pyraclostrobin residues in untreated fruit juices.

A surface plasmon resonance (SPR) immunoassay for on-line detection of the strobilurin fungicide pyraclostrobin in untreated fruit juices is presented. The analysis of pyraclostrobin residues is accomplished in apple, grape, and cranberry samples by monitoring the recognition events occurring separately in a two-channel home-made SPR biosensor. Covalent coupling of the analyte derivative results in a reversible method, enabling more than 80 measurements on the same sensor surface. Optimization of the immunoassay conditions provides limits of detection as low as 0.16 µg L(-1). The selectivity and reproducibility of the analysis is ensured by studying both non-specific interactions with unrelated compounds and inter-assay coefficients of variation. Excellent recovery ranging from 98 to 103% was achieved by a simple 1:5 dilution of fruit juice with assay buffer before the analysis. The lack of previous cleaning and homogenization procedures reduces the analysis time of a single food sample to only 25 min, including the regeneration cycle.

[Psychopathological disorders and quality of life in patients with brain infarction]. / Trastornos psicopatológicos y calidad de vida en el infarto cerebral.

OBJECTIVES: To study the influence of various factors on the health related quality of life (HRQOL) of patients who have suffered a brain infarction (BI), with special attention to psychopathological disorders (PD). PATIENTS AND METHODS: Prospective observational study on 45 patients admitted due to a BI, evaluated at 4, 12 and 26 weeks of the acute event. Social and demographic data, and medical history were collected; the SF-36 scale was used for the assessment of HRQOL, and the Neuropsychiatric Inventory (NPI), MMSE, Canadian Neurological Scale, Modified Rankin Scale and other instruments for assessing psychopathological, cognitive, neurological and functional status. A linear regression analysis was performed to identify potential predictors of the SF-36 scores at 26 weeks, introducing, as independent variables, medical and psychiatric history, demographic characteristics and the functional, neuropsychological and psychopathological assessments at 4 weeks. RESULTS: Valid predictive models for all the SF-36 domains were obtained, in which a history of pre-morbid depression, higher scores in the NPI and Rankin Scale, and lowest in the Canadian Neurological Scale were the main predictors of a worse HRQOL in the long term. Psychopathology related caregiver's distress (assessed with the NPI) was associated with a lower score in the social function index. CONCLUSIONS: PDs and functional status were the main determinants of HRQOL in patients with BI.

Author Correction: Sex-biased patterns shaped the genetic history of Roma.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Sex-biased patterns shaped the genetic history of Roma.

The Roma population is a European ethnic minority characterized by recent and multiple dispersals and founder effects. After their origin in South Asia around 1,500 years ago, they migrated West. In Europe, they diverged into ethnolinguistically distinct migrant groups that spread across the continent. Previous genetic studies based on genome-wide data and uniparental markers detected Roma founder events and West-Eurasian gene flow. However, to the best of our knowledge, it has not been assessed whether these demographic processes have equally affected both sexes in the population. The present study uses the largest and most comprehensive dataset of complete mitochondrial and Y chromosome Roma sequences to unravel the sex-biased patterns that have shaped their genetic history. The results show that the Roma maternal genetic pool carries a higher lineage diversity from South Asia, as opposed to a single paternal South Asian lineage. Nonetheless, the European gene flow events mainly occurred through the maternal lineages; however, a signal of this gene flow is also traceable in the paternal lineages. We also detect a higher female migration rate among European Roma groups. Altogether, these results suggest that sociocultural factors influenced the emergence of sex-biased genetic patterns at global and local scales in the Roma population through time.

Is fibromyalgia a cause of arthroscopic subacromial decompression failure? / ¿Es la fibromialgia causa de fracaso de una descompresión subacromial artroscópica?

Isolated arthroscopic subacromial decompression (IASD) is a widely used surgical procedure with high success rates. However, up to 25% of patients experience residual pain. It is unclear whether aberrant central nervous system processing of pain as described in fibromyalgia (FM) could have a detrimental effect on outcomes. To test this hypothesis, the authors conducted a retrospective case- control study of patients undergoing IASD. MATERIAL AND METHODS: Between 2008 and 2015, 26 patients with preoperative diagnosis of fibromyalgia and an IASD procedure were identified. Six patients were lost to follow-up. Each fibromyalgia patient was matched with one control patient (n=20) recruited from the remainder with IASD. Outcomes were assessed by DASH score (Disability Arm Shoulder and Hand), Constant (CS), relative Constant score (rCS) and Visual Analogue Scale (VAS). Patient satisfaction was determined with a single 2-level question. Failure of the IASD was defined as persistent pain (VAS>3) at last follow-up. RESULTS: The average age of the sample was FM/Control group 51/48, with a mean follow-up of 36/42 months respectively. Both groups exhibited significant clinical improvement in the pain VAS, DASH and rCS at final follow-up (P<.001) compared with the preoperative scores. Mean postoperative scores FM/Control group were: Constant 63.5/74 (P=.07), rCS 82/88 (P=.18), DASH 38.9/20.7 (P=.009), VAS 3.8/2.8 (P=.2). Eighty-five percent of patients in the control group were satisfied with the surgery compared with 55% in the FM group (P=.03). Failure of the procedure was 60% in the FM group, and 30% in the control group (P=.056). CONCLUSIONS: Fibromyalgia can be considered a prognostic factor of a poor postoperative outcome after an IASD. However the clinical improvement experienced by these patients over their preoperative situation leads us to recommend their surgical treatment when indicated.

Repair of rotator cuff injuries using different composites. / Reparación de las lesiones crónicas del manguito rotador mediante diferentes compuestos.

AIM: Rotator cuff repairs have shown a high level of re-ruptures. It is hypothesised that the use of rhBMP-2 in a carrier could improve the biomechanical and histological properties of the repair. MATERIAL AND METHODS: Controlled experimental study conducted on 40 rats with section and repair of the supraspinatus tendon and randomisation to one of five groups: Group 1 (control) only suture; Group 2 (double control), suture and alginate-chitin carrier; Group 3 (alginate-control), the rhBMP-2 was added to the alginate; Group 4 (chitin-control) application of the rhBMP-2 to the chitin, and Group 5 (double sample): The two components of the carrier (alginate and chitin) have rhBMP-2. A biomechanical and histological analysis was performed at 4 weeks. RESULTS: A gap was observed in all cases 4 weeks after supraspinatus detachment. The re-rupture rate was 7.5%, with 20% of them in the control-alginate Group. Histologically the best results were obtained in the double sample group: 4.5 (3.3-5.0). Double sample were also able to support higher loads to failure: 62.9N (59.8 to 69.4) with lower rigidity 12.7 (9.7 to 15.9). CONCLUSIONS: The use of alginate-chitin carrier with rhBMP-2 improves the biomechanical and histological properties of the repair site in a chronic rotator cuff tear.

Patient reported activities after reverse total shoulder arthroplasty in rotator cuff arthropathy patients. / Actividades de vida afectadas en pacientes tras artroplastia total inversa de hombro en el contexto de artropatía de manguito rotador.

INTRODUCTION AND OBJECTIVE: Reverse total shoulder arthroplasty in rotator cuff arthropathy patients, improves anteversion and abduction, but not rotational, outcomes. The main aim of this study is to determine its repercussions on daily life activities in our patients. MATERIAL AND METHODS: Between 2009 and 2011 we implanted 210 shoulder arthroplasties, 126 of them were reverse total shoulder arthroplasty in a rotator cuff arthropathy context. About 88% were women, with a mean age at time of surgery of 81 years, 95% were retired. The mean follow up was 53 months. The Constant scale, Visual Analogue Scale, Charlson Comorbidity Index, range of motion were measured for each patient and whether they could manage 40 daily life activities by means of a new questionnaire, classifying them according toshoulder functional demand. RESULTS AND DISCUSSION: Mean normalized by sex and age Constant value was 81.2%. Mean Visual Analogue Scale and Charlson Index were 3.56 and 1.69 respectively. Improvement in anteversion and abduction, not in rotational range of motion. Limitation was found in low and high functional demand activities in 20% and 51% respectively, especially those which involved internal rotation. CONCLUSION: Reverse total shoulder arthroplasty treatment for RCA in the elderly, achieves adequate pain management and good functional outcomes. Nevertheless, an important risk of DLA limitation must be accepted in those which involve internal rotation or shoulder high functional demand.

[Tuberculosis in the elderly in a general hospital in the Region of Madrid, 1994-2003]. / Tuberculosis en ancianos en un hospital general de la Comunidad de Madrid, 1994-2003.

INTRODUCTION: Tuberculosis in the elderly is a health problem that is on the increase nowadays in industrialised countries. The aim of this study is to describe epidemiological, clinical and microbiological characteristics of tuberculosis in elderly patients in a general hospital in the Region of Madrid from 1994 to 2003. METHODS: Only microbiologically and/or histopathologically confirmed tuberculosis were studied. Epidemiological, clinical and microbiological variables were analyzed. Microbiological and histopathological laboratory results and medical records were collected. RESULTS: The proportion of cases occurring among the elderly rose from 12.4% between 1994 and 1998 to 17.8% between 1999 and 2003 (p <0.05). A total of 160 tuberculosis cases were studied: 92.5% were microbiologically (culture) confirmed and 7.5% histopathologically confirmed. The average time to culture positivity was 18.8 days (SD: 6.5). 88.7% isolates were susceptible to streptomycin, isoniazid, rifampin, ethambutol, and pyrazinamide. The main locations of tuberculosis were pulmonary (59.4%), ganglionary (11.9%) and genitourinary (10.0%). A positive smear in the sputum was discovered for 52.6% of pulmonary tuberculosis. The most prevalent risk factors were immunosuppression (14.8%) and diabetes mellitus (12.3%). Neither of them were VIH, intravenous drug users or immigrants. 50.7% cases were hospitalized. CONCLUSIONS: Tuberculosis in the elderly is on the increase in our region nowadays. The epidemiological pattern of tuberculosis in the elderly differs from that observed in younger patients. Therefore specific control and prevention strategies are needed in order to reduce tuberculosis incidence in aged populations.

Efficacy of trisodium phosphate solutions in reducing Listeria monocytogenes populations on chicken skin during refrigerated storage.

Chicken skin inoculated with l0(8) CFU/ml of Listeria monocytogenes was dipped for 15 min in sterile water (control) and in 8, 10, or 12% trisodium phosphate (TSP) solutions. Skin samples were stored at 2 degrees C for 5 days, with microbial monitoring on days 0, 1, 3, and 5 after treatment. Compared to the water dip, all TSP treatments significantly (P < 0.05) reduced L monocytogenes populations on chicken skin. The concentration of the TSP was a significant factor in reducing the populations of the bacteria at days 0, 1, 3, and 5 of refrigerated storage. For all sampling times, the best outcomes were attained with the highest TSP concentration studied (12%). Bacterial reductions in counts during the first day of storage were between 1.52 and 2.70 log10 cycles for 8 and 12% TSP-treated samples, respectively. Significantly greater reductions were observed from the third day of refrigerated storage onward. This occurred largely because populations of L. monocytogenes on control samples increased somewhat, but on TSP-treated samples the pathogen remained practically constant. Differences between L monocytogenes counts in skin samples immersed in water and those treated with TSP ranged from 2.10 (8% TSP-treated samples) and 3.63 (12% TSP-treated samples) log10 cycles on day 5 of storage. These results indicated that TSP is effective against L. monocytogenes in chicken meat, especially after several days of refrigerated storage.

[The chronopathology of prion encephalopathies]. / Cronopatología de las encefalopatías priónicas.

INTRODUCTION: Prion encephalopathies are a group of diseases with a hereditary or acquired origin which, after a long asymptomatic period, give rise to rapidly progressing neurological disorders. This progression can only be explained by an exponential growth of the pathogenic protein load, which allows to keep the load in low levels for many years and then to grow swiftly in a few months. DEVELOPMENT: Bearing in mind the knowledge currently available about the pathogenesis of prion diseases and patients' clinical progression, it becomes possible to distinguish several different periods of progression, the length of which can be estimated for each disease by reviewing the series of cases published to date. In general, the infectious prion diseases have a shorter period of latency than the hereditary ones and those caused by insertion of genetic material are associated to shorter latencies and to longer periods of illness than those caused by sporadic mutations. CONCLUSIONS: The rate of growth of the prion load depends essentially on how fast the pathogenic prion protein replicates; nevertheless, this growth is also modulated by other factors, many of which are polymorphisms in certain positions on the gene coding for prion protein or in other genes.

[Cardiopulmonary resuscitation. Support of circulation]. / Reanimación cardiopulmonar. 3. Soporte circulatorio.

Whether the cause is primary or secondary, cardiac arrest requires cardiopulmonary resuscitation techniques in order to avoid brain lesions. Cardiac compressions combined with the control of the air passageway and artificial respiration have made it possible to reverse clinical death status in a patient. In this article, the authors review various proven methods including heart pump, thoracic pump, asynchronous respiration, abdominal contrapulsation, cardiopulmonary resuscitation by means of coughing, MAST, ADC, pneumatic vest, etc. which are currently in use.

[Cardiopulmonary resuscitation. Electric stimulation of the heart]. / Reanimación cardiopulmonar. 4. Estimulación eléctrica cardiaca.

Due to the alteration in contractions coordinated and organized by miocardiac fibers, various types of cardiac stimulation have been designed which became acceptable standard clinical procedures starting in 1947 after the first successful electrical defibrilation was carried out on a human heart. This article includes techniques such as precordial fist percussion, repetitive precordial beating on the thorax, synchronized cardioversion, non-synchronized electrical shocks and pacemakers. Electrical therapy is used in the treatment of potentially fatal cardiac arrhythmia, especially for ventricular tachycardia, ventricular fibrilation, complete heart block, and asystolia.

[Cardiopulmonary resuscitation. General facts and introduction]. / Reanimación cardiopulmonar. Generalidades e introducción.

Cardiopulmonary Resuscitation consists of the integration of treatment for cardiorespiratory arrest as a set of standardized steps, whose objective is to first substitute, and later restore, spontaneous respiration and circulation. This calls for a sequential development; this implies that there are not a series of actions which for prematureness influences their order, but these should be applied sequentially at the right time. There are different criteria among the recommendations by the ERC (European Resuscitation Council) and the AHA (American Heart Association). At the present time, the International Liaison Committee of Resuscitation (ILCOR) has developed a series of recommendations which tries to eliminate these differences, as well as simplify the number of steps necessary to achieve a greater diffusion of these techniques which will lead to a higher number of persons saved. There are also agreements on the incorporation of some terms so we will more frequently read the term Basic Vital Support instead of Basic Cardiopulmonary Resuscitation or Advanced Vital Support instead of Advanced Cardiopulmonary Resuscitation. This article is the first of a series of four articles on cardiopulmonary Resuscitation. The remaining articles will appear in later editions of our magazine.

[Cardiopulmonary resuscitation. Maintenance of the airways and ventilation]. / Mantenimiento de la vía aérea y ventilación.

Oxygen is absolutely necessary for life; gaseous interchange requires the processes of ventilation, perfusion and diffusion. When these fail, we are headed directly for cardiac and/or respiratory arrest. Various techniques are recommended to provide oxygen; there are techniques to open the air tracts and mechanisms to keep these open: and there are mechanisms to facilitate and/or improve ventilation. There definitely are a wide range of means designed to achieve a good level of oxygenation in our tissues.