Idiopathic inflammatory myopathies linked to vaccination against SARS-CoV-2: a systematic review.

The COVID-19 pandemic represents a global health problem, which has been mitigated by the opportune introduction of vaccination programs. Although we already know the benefit that vaccines provide, these are not exempt from adverse events which can be mild to deadly, such as idiopathic inflammatory myopathies, in which a temporal association has not been defined. It is for this reason that we carried out a systematic review of all reported cases of vaccination against COVID-19 and myositis. To identify previously reported cases of idiopathic inflammatory myopathies associated with vaccination against SARS-CoV-2 we registered this protocol on the website of PROSPERO with identification number CRD42022355551. Of the 63 publications identified in MEDLINE and 117 in Scopus, 21 studies were included, reporting 31 cases of patients with vaccination-associated myositis. Most of these cases were women (61.3%); mean age was 52.3 years (range 19-76 years) and mean time of symptom onset post-vaccination was 6.8 days. More than half of the cases were associated with Comirnaty, 11 cases (35.5%) were classified as dermatomyositis, and 9 (29%) as amyopathic dermatomyositis. In 6 (19.3%) patients another probable trigger was identified. Case reports of inflammatory myopathies associated with vaccination have heterogeneous presentations without any specific characteristics: as a consequence, it is not possible to ensure a temporal association between vaccination and the development of inflammatory myopathies. Large epidemiological studies are required to determine the existence of a causal association.

Aflatoxins, hydroxylated metabolites, and aflatoxicol from breast muscle of laying hens.

Aflatoxins (AF) are toxic fungal secondary metabolites that are pathological to animals and humans. This study identified and quantified AF (AFB(1), AFB(2), AFG(1), AFG(2)) and their hydroxylated metabolites (AFM(1), AFM(2), AFP(1)) and aflatoxicol (AFL) from laying hen breast muscles. Aflatoxins pass from cereal feed to the laying hen tissues, causing economic losses, and from there to humans. To detect the passage of AF from feed to hen breast muscle tissues, an experiment that included 25 Hy-Line W36 121-wk-old hens was performed for 8 d. Hens in individual cages were distributed into 3 groups: a control group, with feed free of AFB(1), and 2 experimental groups, with feed spiked with 2 AFB(1) dosages: 30 µg·kg(-1) (low) or 500 µg·kg(-1) (high). The daily feed consumption per hen was recorded and afterward hens were euthanized and breast muscles were collected, weighed, and dried individually. Aflatoxins were extracted by 2 chemical methods and quantified by HPLC. Both methods were validated by lineality (calibration curves), recovery percentage (>80%), limit of detection, and limit of quantification. The AF (µg·kg(-1)) averages recovered in control breast muscles were as follows: AFB(1) (18); AFG(1), AFM(2), and AFL (0); AFG(2) (1.3); AFM(1) (52), and AFP1 (79). Hens fed with feed spiked with 30 µg·kg(-1) of AFB(1) had AFG(1) (16); AFG(2) (72); AFM(1) (0); AFM(2) (18); AFP(1) (145); and AFL (5 µg·kg(-1)). Hens with feed spiked with 500 µg·kg(-1) of AFB(1) had AFG(1) (512); AFG(2) (7); AFM(1) (4,775); AFM(2) (0); AFP(1) (661); and AFL (21 µg·kg(-1)). The best AF extraction method was Qian and Yang's method, modified by adding additional AF from both Supelclean LC18 SPE columns; its limit of detection (0.5 ng·mL(-1)) was lower compared with that of Koeltzow and Tanner, which was 1 ng·mL(-1).

[Risks, phenotypes and comparison between treatments according to guidelines GOLD and GesEPOC in primary care]. / Riesgos, fenotipos y comparación de tratamiento de EPOC en atención primaria según guías GOLD y GesEPOC.

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is an underdiagnosed pathology with a high morbidity and mortality. Diagnosis and follow-up are mostly carried out in primary care (PC). The objective of our study is to classify COPD patients according to GOLD 2019 and GesEPOC 2017 guidelines. As secondary objectives, to analyze the type of risk and to describe and compare the prescribed treatment with that recommended by the guidelines. MATERIAL AND METHODS: Multicenter cross-sectional observational study in seven Health Care centers. 637 COPD patients between 35 and 85years old were included. RESULTS: The mean age was 70.3years old, 84.6% had comorbidities and 43.5% were active smokers. The mean post-bronchodilator FEV1 was 61.92% (SD: 17.42). Most are patients with mMRC=1 (43.8%), 57.8% CAT<10. Mild BODEx index (75.7%). GoldA was the majority (47.7%). The most frequent phenotype was non-exacerbator (61.1%). 25% were ACOs. 56.2% were low-risk patients. 20.6% had not been prescribed any treatment, LABA +LAMA +CI (19.6%), LAMA +LABA (16.5%) and LAMA (16.3%). If we compare the treatments that the patients have prescribed, with the one is recommended by GOLD, we obtain that 61% coincide with moderate concordance, while if we compare with GesEPOC, 53.8% coincide with weak concordance. 73.4% of the treatments coincide between both documents (moderate agreement). CONCLUSIONS: COPD patients treated in PC are low risk, mild and non-exacerbators. If we compare the treatments that the patients have prescribed, with what is recommended by GOLD and GesEPOC, we find a moderate and weak concordance, respectively.

Encapsulation of bioactive peptides: a strategy to improve the stability, protect the nutraceutical bioactivity and support their food applications.

In recent decades, bioactive peptides have become an emerging field of interest in the scientific community as well as the food, pharmaceutical, and cosmetics industries. A growing body of research indicates that consumption of bioactive peptides may play a vital role in health through their broad spectrum of bioactivity such as antioxidant, antihypertensive, antimicrobial, anti-inflammatory, immunomodulatory, and anti-proliferative activities. In addition, bioactive peptides can be used as food preservatives due to their antimicrobial and antioxidant activities. However, some factors limit their nutraceutical and commercial applications, including easy chemical degradation (e.g., pH, enzymatic), food matrix interaction, low water-solubility, hygroscopicity, and potential bitter taste. Bearing that in mind, the encapsulation of bioactive peptides in different materials can help overcome these challenges. Studies have demonstrated that encapsulation of bioactive peptides increases their bioactivity, improves their stability, sensory properties, increases solubility, and decreases hygroscopicity. However, there is limited scientific evidence about the bioavailability and food matrix interactions of encapsulated peptides. Besides, the diverse colloidal systems used to encapsulate bioactive peptides have shown stability and good encapsulation efficiency. This review provides an overview of current advances in the encapsulation of bioactive peptides, considering the technology, developments, and innovations in the last lustrum.

Reduction and oxidation kinetics of NiWO4 as an oxygen carrier for hydrogen storage by a chemical looping process.

NiWO4 with a volumetric storage density (VSD) of 496 g L-1 was studied to evaluate its H2 storage potential as an oxygen carrier under a chemical looping (CL) process scheme. The material was synthesized by precipitation and calcined at 950 °C for 5 hours in air. Characterization consisted in XRD, BET surface area, SEM and EDS analysis. NiWO4 hydrogen storage reduction-oxidation evaluation was performed by TGA using 5% v H2/Ar and 2.2% v H2O/Ar at 800 °C. Global kinetics for the reduction step was studied from 730 to 870 °C using 2 to 5% v of H2/Ar. While oxidation kinetics was examined from 730 to 870 °C using 0.8 to 2.2% v H2O/Ar. A hydrogen storage multicycle stability test was performed by exposing NiWO4 to 17 consecutive redox cycles. XRD results of the synthesized material indicate NiWO4 as the only crystalline phase. Fully reduced material found only W and Ni species, while reoxidation led back to NiWO4. BET surface area of synthesized material was 4.25 m2 g-1. SEM results showed fresh NiWO4 composed of non-porous large particles (1-5 µm). After reduction, the material shown a porous coral-like morphology with particles between 50 to 100 nm. EDS analysis results confirmed the compositions of the reduced (Ni + W) and fully oxidized NiWO4 species, respectively. Oxygen carrier reaction conversions for both reduction and regeneration steps were 100%. Global kinetic studies indicate a first order reaction for the two reduction steps and during oxidation, with activation energies of 22.1, 48.4 and 53.4 kJ mol-1 for the two reduction and oxidation steps, respectively. NiWO4 multicycle stability test shown no loss of VSD and fast reduction and oxidation kinetics under the studied conditions after seventeen consecutive redox cycles, which confirms the potential of this material with respect to current oxygen carriers reported in the literature for hydrogen storage applications.

Morphological, barrier, and mechanical properties of banana starch films reinforced with cellulose nanoparticles from plantain rachis.

The main aim of the present study was to characterize banana starch films reinforced with nanoparticles from plantain rachis. Nanoparticles were obtained by acid hydrolysis and sonication, exhibiting a mean hydraulic diameter of about 60 nm. Scanning electron microscopy micrographs showed that the nanoparticle thickness ranged between 9.8 and 22.3 nm. The thermal gravimetric analysis showed that nanoparticles are thermally stable for temperatures up to 340 °C. Films were made for different fractions of nanoparticles (0.0, 1.75, 2.5, and 4.0%) relative to total solids, and glycerol was used as a plasticizer. The influence of the addition of nanoparticles to starch films on the morphology, water vapor permeability (WVP), and mechanical properties of the nanocomposites films was explored. Cellulose nanoparticles reduced the WVP, and increased the tensile strength and flexibility of the starch films. FTIR analysis of films was used to show that nanoparticles improved the molecular organization of starch chains. It was proposed that nanoparticles acted as a crosslinked for starch chains via hydrogen bonding effects.

Planetary ball-mill as a versatile tool to controlled potato starch modification to broaden its industrial applications.

Pure potato starch has been modified by high-energy-ball-milling as a function of energy supplied, aiming to obtain products for different possibilities of industrial application. Burgios's equation has been used to calculate the energy supplied. The effect of the milling has been followed by a characterization of the starch morphology, crystallinity, solubility, swelling, retrogradation, viscosity, apparent viscosity, functional groups, and reducing sugar concentration. The high-energy-ball-milling not only changes the physical properties but also induces the mechanolysis of potato starch, breaking the glycosidic linkages of the starch molecules. A representation of the possible mechanism of starch mechanolysis is proposed. Three stages of the transformation of potato starch through high-energy ball-milling can be identified. Each of these stages generates starch with properties that can be used in different industrial applications.

[Echocardiographic diagnosis of obstructive intermittent dysfunction of a mitral disc prosthetic valve]. / Diagnóstico ecocardiográfico de disfinción por obstrucción intermitente de prótesis de disco mitral.

Echocardiographic findings in six patients with obstructive intermittent dysfunction of mechanical disc prosthetic mitral valve (OIPD) are described. All with a clinical picture of gradual installation and progressive dyspnea of several weeks of evolution. TTE with Bd recordings were performed in all of them with "oriented" M mode from apical 4/C view. The findings were compared with a control group of 14 patients with normal prosthetic valves. In the group of OIDP, all patients displayed a variable delay in the opening of the prosthetic disc, registered as a "protodiastolic step" in M mode. In three patients, the dysfunction was due to a thrombus. In two, due to pannus. Three were operated. One with thrombolysis. In two, the treatment consisted of heparin and increased oral anticoagulation. None die during the acute handling of the intermittent dysfunction. Two patients died: one seven months later due to cardiac failure and the other a year later due to prosthetic rethrombosis. In patients with mechanical prosthetic valve in mitral valve position and progressive dyspnea, the presence of a variable delay in the opening of the prosthesis is diagnostic of OIDP and requires urgent handling with thrombolysis or surgery.

Early complete hydatidiform moles contain inner cell mass derivatives.

In four cases of early complete hydatidiform moles, confirmed to be androgenetic in origin by DNA studies, we have identified nonchorionic inner cell mass derived structures which are not commonly observed in specimens of later gestational age. These structures include nucleated red blood cells, endothelial cells, stromal macrophages, amnion and yolk sac. The latter four structures were confirmed by specific immunocytochemical stains. Recognition that such structures can accompany complete hydatidiform moles has both theoretical and practical significance. From a theoretical perspective, it demonstrates that the maternal genome is not required for the initiation of amniogenesis, development of the yolk sac, vasculogenesis, or hematopoiesis. From a practical perspective it emphasizes that complete hydatidiform moles, with their markedly increased risk of subsequent choriocarcinoma, cannot be excluded based on the finding of "fetal structures."

Cytogenetic analysis of spontaneous abortions: comparison of techniques and assessment of the incidence of confined placental mosaicism.

Cytogenetic studies on spontaneous abortions traditionally have used one of two methodologies, direct preparations or long-term culture, to determine the chromosome constitution of either the cytotrophoblast or villous stroma, respectively. Few studies have utilized both techniques simultaneously to compare the relative efficiencies of each method and to assess the contribution of confined placental mosaicism (CPM). The present report summarizes cytogenetic studies on 691 consecutive spontaneous abortions using long-term culture, direct preparations, or both. All 691 cases were analyzed by long-term culture and 177 cases were analyzed using both long-term culture and direct preparations. The results indicate that the two methods have similar success rates, 82% for long-term culture and 76% for direct preparation; however, the proportion of normal females was significantly increased in the culture method, presumably attributable to maternal contamination. In 107 cases, results were obtained from both methods with 22 discrepancies identified. However, most of these involved a 46,XX result in culture, consistent with maternal contamination in the cultured preparation. Therefore, to estimate the proportion of CPM we excluded cases with a 46,XX result in culture and found four (6.1%) of the remaining 65 cases to be consistent with CPM. These cases consisted of normal or mosaic aneuploid cytotrophoblast and non-mosaic aneuploid villous stroma. These studies suggest that each method has specific advantages in the analysis of spontaneous abortions. Direct preparations are less prone to maternal contamination, but certain chromosome abnormalities are more likely to be identified using long-term culture.

Prevalence of developmental and inflammatory lesions in nonmolar first-trimester spontaneous abortions.

The management of patients with first-trimester spontaneous abortions is handicapped by two problems: difficulty in recognizing conceptions that abort because of abnormal karyotypes and an incomplete understanding of what causes abortions with normal karyotypes. Our goals in this study were to define features useful in distinguishing normal from abnormal karyotype and to identify pathological processes contributing to abortions with a normal karyotype. The study population consisted of 668 well-characterized first-trimester spontaneous abortions derived from a larger study of 1,054 consecutively karyotyped spontaneous abortions. Clinical factors increased in specimens with normal karyotype were maternal age younger than 20 years (P=.0003) and autoimmune markers (P=.0474). Developmental features associated with abnormal karyotype were developmental stage less than 6 weeks (P=.0017), hydropic villi greater than 1 mm (P=.0004), and villi with two or more dysmorphic features (P=.0001). Developmental stage greater than 11.5 weeks was increased with normal karyotype (P=.0001). Histological features increased in specimens with a normal karyotype were chronic intervillositis (P=.0003), increased perivillous fibrin deposition with intermediate trophoblast (P=.0006), decidual plasma cells (P=.0040), deciduitis without plasma cells (P=.0660), and chronic villitis (P=.1581). Overall, 19% of samples with a normal karyotype versus 8% with abnormal karyotype had one or more of these findings (P < .0001). Autoimmune markers, chronic intervillositis, and increased perivillous fibrin with intermediate trophoblast all had positive predictive values greater than 85% for normal karyotype, whereas dysmorphic villi had a positive predictive value of 90% for abnormal karyotype. Patients with recurrent spontaneous abortion and normal karyotype were more likely to have one or more of the histological features listed above (31%) than patients with normal karyotype and no prior abortions (13%) and patients with recurrent abortion and abnormal karyotype (11%).

Prevalence of the partial molar phenotype in triploidy of maternal and paternal origin.

Triploid partial moles are at risk for trophoblastic neoplasia, yet the prevalence, parent of origin, and evolution of the partial molar phenotype amongst all triploids remains controversial. We determined parental origin by polymerase chain reaction (PCR) analysis, stage of development by gross and histological criteria, and partial molar status according to strict diagnostic criteria for all triploids identified amongst 1,054 consecutively karyotyped spontaneous abortions. Triploidy was detected in 64 of 832 successfully karyotyped specimens. Complete data were collected in 59 cases. Diandric origin was found in 39 specimens, and 20 of these fulfilled all four criteria for partial mole (trophoblast hyperplasia, dimorphic population of large and small villi, villous hydrops greater than 0.5 mm, and irregular villous contour). We separated the 19 diandric triploids not fulfilling all criteria for partial mole into four groups: specimens of early developmental stage, which we believed represented developing ("early") partial moles (n = 3), cases of late developmental stage, which we believed represented involuting ("ancient") partial moles (n = 4), cases showing some but not all criteria for partial mole (n = 7), and specimens with few if any criteria suggestive of partial mole (n = 5). In triploids of digynic origin (n = 20), developmental stage was significantly lower, fetal tissue was more frequently identified, and all specimens showed well-preserved fetal red blood cells. Digynic triploids occasionally showed irregular contour, dimorphic villi, and a mild form of trophoblast hyperplasia but never showed hydropic degeneration and were never suspicious for partial mole.

Very early complete hydatidiform mole.

Recent trends toward early pregnancy ultrasound have led to evacuation of complete hydatidiform moles at a stage before the development of diffuse trophoblast hyperplasia and villous cavitation. Absence of these recognized diagnostic criteria can lead to misdiagnosis and subsequent trophoblastic neoplasia. The authors identified a case of very early complete hydatidiform mole (VECM) on review of a previous curettage specimen when the patient presented 4 weeks later with increasing human chorionic gonadotropin (HCC) titers and the typical histological features of complete mole on a subsequent curettage. DNA studies on this index case and three subsequent similar specimens confirmed the diagnosis of complete hydatidiform mole using polymerase chain reaction (PCR) amplification of eight microsatellite markers on microdissected maternal and villous tissue. VECM were compared with spontaneous abortions and elective terminations of a similar gestational age to develop diagnostic criteria. Five cardinal diagnostic features were identified: redundant bulbous terminal villi, hypercellular villous stroma, a labyrinthine network of vinous stromal canaliculi, focal cytotrophoblast and syncytiotrophoblast hyperplasia on both villi and the undersurface of the chorionic plate, and enlarged hyperchromatic implantation site trophoblast.

Misleading postevent information and memory for events: arguments and evidence against memory impairment hypotheses.

The claim that a person's memory for an event may be altered by information encountered after the event has been influential in shaping current conceptions of memory. The basis for the claim is a series of studies showing that subjects who are given false or misleading information about a previously witnessed event perform more poorly on tests of memory for the event than subjects who are not misled. In this article we argue that the available evidence does not imply that misleading postevent information impairs memory for the original event, because the procedure used in previous studies is inappropriate for assessing effects of misleading information on memory. We then introduce a more appropriate procedure and report six experiments using this procedure. We conclude from the results that misleading postevent information has no effect on memory for the original event. We then review several recent studies that seem to contradict this conclusion, showing that the studies do not pose problems for our position. Finally, we discuss the implications of our conclusions for broader issues concerning memory.

A cluster of fever and hypotension on a surgical intensive care unit related to the contamination of plasma expanders by cell wall products of Bacillus stearothermophilus.

OBJECTIVE: To evaluate an outbreak of fever and hypotension after cardiac surgical procedures and the role of polygeline, a plasma expander. DESIGN: Unmatched case-control study. SETTING: A six-bed cardiac surgery intensive care unit (SICU) of the Hospital Clinic of Barcelona (Spain), a 940-bed public teaching hospital. PATIENTS: Eight cases and 25 control patients admitted to the SICU over a 4-week epidemic period. MAIN OUTCOME MEASURES: Development of hypotension (systolic blood pressure < or = 90 mm Hg or a drop of 40 mm Hg from baseline systolic blood pressure) and fever (axillary temperature > 38.5 degrees C) within 24 hours of a cardiac surgical procedure. RESULTS: The single risk factor significantly different between cases and controls was the total volume of polygeline used throughout the surgical procedure for extracorporeal circulation: a median of 1,250 mL (mean, 1,312.5 +/- 842.5 mL) in cases versus 500 mL (mean, 566.0 +/- 159.9 mL) in controls (P = .0029). By multiple logistic regression analysis, polygeline use was the single risk factor significantly related to the outcome (odds ratio, 8.75; CI95, 1.36 to 56.2; P = .01). Neither blood cultures from patients nor cultures of the polygeline used yielded growth of any microorganism. Stopping use of the implicated polygeline lot controlled the outbreak. CONCLUSIONS: Use of polygeline was associated with an outbreak of fever and hypotension in a SICU. Information from the manufacturer indicated the likelihood of contamination of the product with Bacillus stearothermophilus components. The manufacturer has since changed the production and control processes, and no further adverse events have been seen.

Handwashing with soap or alcoholic solutions? A randomized clinical trial of its effectiveness.

BACKGROUND: The effectiveness of an alcoholic solution compared with the standard hygienic handwashing procedure during regular work in clinical wards and intensive care units of a large public university hospital in Barcelona was assessed. METHODS: A prospective, randomized clinical trial with crossover design, paired data, and blind evaluation was done. Eligible health care workers (HCWs) included permanent and temporary HCWs of wards and intensive care units. From each category, a random sample of persons was selected. HCWs were randomly assigned to regular handwashing (liquid soap and water) or handwashing with the alcoholic solution by using a crossover design. The number of colony-forming units on agar plates from hands printing in 3 different samples was counted. RESULTS: A total of 47 HCWs were included. The average reduction in the number of colony-forming units from samples before handwashing to samples after handwashing was 49.6% for soap and water and 88.2% for the alcoholic solution. When both methods were compared, the average number of colony-forming units recovered after the procedure showed a statistically significant difference in favor of the alcoholic solution (P <.001). The alcoholic solution was well tolerated by HCWs. Overall acceptance rate was classified as "good" by 72% of HCWs after 2 weeks use. Of all HCWs included, 9.3% stated that the use of the alcoholic solution worsened minor pre-existing skin conditions. CONCLUSIONS: Although the regular use of hygienic soap and water handwashing procedures is the gold standard, the use of alcoholic solutions is effective and safe and deserves more attention, especially in situations in which the handwashing compliance rate is hampered by architectural problems (lack of sinks) or nursing work overload.

Objective treatment response to endocrine therapy in metastatic prostate cancer.

A ten-year review of 198 patients with Stage D2 prostate cancer identified 13 patients (6.6%) who exhibited objective responses to hormonal treatment, as indicated by regression of a positive bone scan, CT scan, or chest x-ray film. Four patients had complete responses and 9 patients achieved partial responses as judged by the National Prostatic Cancer Project criteria. Median survival for those with objective treatment response has not yet been reached (> 44 months) compared with twenty-four months for the nonresponders (p = 0.00006). Although relatively uncommon, objective treatment response in Stage D2 prostate cancer is correlated with an improved prognosis.