Determination of fundic accommodation in gastric emptying scintigraphy. Evaluation of its clinical usefulness.

AIM: Gastric emptying scintigraphy is used to assess patients with symptoms of dyspepsia or gastroparesis. An alteration of fundus accommodation may explain these symptoms. The aim of this study was to determine the accommodation in gastric emptying scintigraphy studies performed in our institution. MATERIAL AND METHODS: 50 patients (43 children) referred for gastric emptying assessment were evaluated. After fasting for 8 h, and following international guidelines, egg labeling was performed with 37 mBq of [99mTc]Tc-DTPA and administration of standardized food. Areas of interest were defined in the stomach at different times, and the corresponding retention percentages were calculated. Considering the image at time zero, gastric accommodation was qualitatively and quantitatively assessed, calculating the ratio between proximal stomach counts and total counts. RESULTS: Of the 50 patients studied, 32 had normal emptying, 10 had slowed emptying and 8 had accelerated emptying. Within the group of patients with normal emptying, 8 had altered accommodation (25%) and another 8 in the group with abnormal emptying (44%). Applying the ROC curve analysis to quantitative values, the most appropriate cut-off value was 0.785 with p < 0.001, sensitivity 82.4% and specificity 100%. CONCLUSION: Gastric emptying scintigraphy in addition to determining motility, made it possible to assess both qualitatively and quantitatively the distribution of the radiotracer in the stomach and thus, indirectly, the accommodation in the fundus. It provided added diagnostic information in a simple manner, without protocol changes and allowing more specific treatments to be assessed.

The African introgression of Murciano Granadina goats has a Moroccan origin and displays remarkable levels of inter-individual variability.

There is evidence that Murciano Granadina (MG), the most important caprine dairy breed in Spain, has been introgressed by African goats, but the precise geographic origin of such introgression has not been identified yet. Moreover, an accurate estimate of the magnitude of this African introgression is lacking, since current estimates are based on small numbers of sampled individuals. The aim of our work was to tackle these two issues by genotyping 500 MG goats with the Goat SNP50 BeadChip and comparing their genotypes with those of reference populations from Spain (Bermeya), France (Saanen), Morocco (Barcha, Draa, Ghazalia, Noire de Atlas, Nord, Moroccan), Egypt (Barki, Oasis, Saidi), Algeria (Arabia, Makatia, M'Zabite, Kabyle), Tunisia (Tunisian native breeds) and Sudan (Desert, Nilotic, Taggar). The population of 500 MG goats was subdivided into 10 datasets of 50 individuals to ensure that sample sizes of the target (MG) and reference populations are balanced. Performance of an unsupervised ADMIXTURE analysis demonstrated that MG goats have a North African ancestry, with an average proportion of 4.4 ± 2.3%. Next, we did a supervised ADMIXTURE analysis that revealed that the Moroccan genetic component reaches a proportion of 4.01 ± 3.9% in MG goats, while the Algerian (0.001 ± 0.001%), Egyptian (0.2 ± 0.1%), Sudanese (0.1 ± 0.1%) and Tunisian (0.3 ± 0.4%) components are present in extremely small proportions. The historical circumstances of this introgression event are currently unknown, but several plausible scenarios are outlined. Moreover, our results show considerable inter-individual heterogeneity regarding the magnitude of the Moroccan introgression of MG goats (0%- 12% depending on the MG data set under analysis). This result implies that reliable estimates about the introgression of autochthonous livestock by exotic breeds can only be obtained by extensively sampling target populations.

The Gut Microbiota characterization of a World-Class Mountain Trail runner during a complete competition season: a case report.

In the present case study, the gut microbiota (GM) profile of a male Elite Mountain Runner (34 years, 171cm, 59 kg, VO2max: 92 mL·min-1 ·kg-1) was analyzed over 5 months competitive period (6 samples). The GM diversity increased through the season coinciding higher levels to the peak performance and shorter and longer race (42 vs. 172 km) produced different phenotypic GM changes. Shorter race promoted the elevation of protective bacteria related to positive benefits (higher production of short-chain fatty acids (SCFAs), lactate resynthesis, mucin degraders). In contrast, longer race promoted an elevation of opportunistic pathogenic bacteria while reducing protective commensal bacteria. The present findings indicate that a higher resilience of the GM after competitions may support rapid recovery from maximal exercise. The GM analyses pre- and post-competition could represent a rapid indicator for the (patho)physiological impact of exercise and provide information on gut health and recovery time needed.

What do we know About the Usefulness of 18F-FDG PET-CT for the Management of Invasive Fungal Infection? An International Survey.

BACKGROUND: Recent data support 18F-FDG PET-CT for the management of infections in immunocompromised patients, including invasive fungal infection (IFI). However, its role is not well established in clinical practice. We performed an international survey to evaluate the knowledge of physicians about the usefulness of 18F-FDG PET-CT in IFI, in order to define areas of uncertainty. METHODS: An online survey was distributed to infectious diseases working groups in December 2023-January 2024. It included questions regarding access to 18F-FDG PET-CT, knowledge on its usefulness for IFI and experience of the respondents. A descriptive analysis was performed. RESULTS: 180 respondents answered; 60.5% were Infectious Diseases specialists mainly from Spain (52.8%) and Italy (23.3%). 84.4% had access to 18F-FDG PET-CT at their own center. 85.6% considered that 18F-FDG PET-CT could be better than conventional tests for IFI. In the context of IFI risk, 81.1% would consider performing 18F-FDG PET-CT to study fever without a source and around 50% to evaluate silent lesions and 50% to assess response, including distinguishing residual from active lesions. Based on the results of the follow-up 18F-FDG PET-CT, 56.7% would adjust antifungal therapy duration. 60% would consider a change in the diagnostic or therapeutic strategy in case of increased uptake or new lesions. Uncovering occult lesions (52%) and diagnosing/excluding endocarditis (52.7%) were the situations in which 18F-FDG PET-CT was considered to have the most added value. There was a great variability in responses about timing, duration of uptake, the threshold for discontinuing treatment or the influence of immune status. CONCLUSION: Although the majority considered that 18F-FDG PET-CT may be useful for IFI, many areas of uncertainty remain. There is a need for protocolized research to improve IFI management.

Results of the implementation of the DP-TRANSFERS project in Catalonia: A translational method to improve diabetes screening and prevention in primary care.

INTRODUCTION: DP-TRANSFERS is a translational lifestyle intervention project, which follows a previous protocol described in the DE-PLAN-CAT study. OBJECTIVE: Analyze the feasibility of reproducing the intensive intervention and estimating the effect of translation in real conditions of clinical practice in primary care. METHODOLOGY: Implementation of the face-to-face group intervention adjusted to 2 years. After screening, the intervention consisted of a basic module and a continuity module. Stratifying by clusters (health centers), a representative sample (centers, professionals and participants) was evaluated (FINDRISC > 11 and/or prediabetes) from 2016 to 2020. The effect of the intervention on the incidence of diabetes was analyzed. RESULTS: The intervention, feasible in 95 of 123 centers, involved 343 of 647 professionals. Of 2381 subjects screened, 1713 participated in the basic module, with 1186 participants completing the first year and 776 completing the second. 121 participants (7.06%) were diagnosed with diabetes: 77 (4.49%) during the first year; 44 (2.57%) during the second. The bivariate analysis showed that those subjects in whom diabetes affected differed in: previous glycemic status, A1c, HDL-cholesterol, FINDRISC score and adherence to the Mediterranean diet, and in the differences between the beginning and end of the study of: body weight, BMI and abdominal circumference. CONCLUSIONS: The intensive intervention substantially reduced (23.6%) the incidence of diabetes compared to that previously estimated in standardized intervention. The following acted as protective factors: a better glycemic status, lower baseline risk, elevated HDL-cholesterol, or achieving a reduction in weight or abdominal circumference during the study.

Reproductive parameters of Oreochromis mossambicus in Laguna de Los Patos, Cumaná, Venezuela.

A total of 381 specimens of the tilapia Oreochromis mossambicus collected monthly from May 2017 to May 2018 in the Laguna de Los Patos, Cumaná, Venezuela, to evaluate reproductive parameters of this non-native species. Significant differences were found in relation to average height and weight between males and females, with the highest values in males. The sex ratio was 1:1.5 (males:females), which deviates significantly from the expected 1:1 ratio. The mean length of sexual maturity (Lm50) was 18.0 cm in females and 20.1 cm in males, reflecting that females mature at smaller sizes than males. The monthly variations of the gonadosomatic index (GSI) and the stages of sexual maturity show two reproductive peaks during the study, in October 2017 and April 2018, coinciding with the rainy and dry seasons in the region respectively. The condition factor (CF) showed significant differences between months, but not between sexes, with an average of 1.87 in females and 1.84 in males. The average absolute fecundity was 921 ± 604.6 eggs per fish, with a relative fecundity of 8.36 ± 3.09 eggs per gram of fish. Differences in oocyte size in mature females confirm that the species can spawn repeatedly over a period, which is considered an important factor for the establishment of tilapia in non-native environments.

Mechanisms modulating foam cell formation in the arterial intima: exploring new therapeutic opportunities in atherosclerosis.

In recent years, the role of macrophages as the primary cell type contributing to foam cell formation and atheroma plaque development has been widely acknowledged. However, it has been long recognized that diffuse intimal thickening (DIM), which precedes the formation of early fatty streaks in humans, primarily consists of lipid-loaded smooth muscle cells (SMCs) and their secreted proteoglycans. Recent studies have further supported the notion that SMCs constitute the majority of foam cells in advanced atherosclerotic plaques. Given that SMCs are a major component of the vascular wall, they serve as a significant source of microvesicles and exosomes, which have the potential to regulate the physiology of other vascular cells. Notably, more than half of the foam cells present in atherosclerotic lesions are of SMC origin. In this review, we describe several mechanisms underlying the formation of intimal foam-like cells in atherosclerotic plaques. Based on these mechanisms, we discuss novel therapeutic approaches that have been developed to regulate the generation of intimal foam-like cells. These innovative strategies hold promise for improving the management of atherosclerosis in the near future.

Cross-cultural adaptation and psychometric evaluation of the Spanish version of the Knowledge and Attitudes of Pain questionnaire (KNAP) in physiotherapists.

BACKGROUND: Healthcare providers' attitudes and beliefs can influence how patients with persistent musculoskeletal pain are treated. A biopsychosocial approach is more effective than a purely biomedical approach. Ensuring healthcare professionals have appropriate pain science education (PSE) is essential for successful treatment outcomes. OBJECTIVE: To validate the Spanish version of the Knowledge and Attitudes of Pain (KNAP-SP) questionnaire among Spanish physiotherapists and students and analyze its psychometric properties. METHODS: From May to October 2022, two independent teams adapted the KNAP questionnaire from English to both European and Hispanic-Spanish. A cross-sectional validation study was conducted with 517 physiotherapists examining internal consistency (Cronbach's alpha), structural validity (exploratory factor analysis), and construct validity (hypothesis testing). Longitudinal analyses assessed test-retest reliability (intraclass correlation coefficient [ICC2,1; n = 63]) and responsiveness following a PSE intervention using Receiver Operating Characteristic (ROC) curve analysis and hypothesis testing (n = 70). RESULTS: The KNAP-SP showed strong internal consistency [overall α coefficient = 0.86; domain 1 (α = 0.82); domain 2 (α = 0.70)], explaining 32.3% of the variance. Construct validity was supported by 75% of the hypotheses. Test-retest reliability was high (ICC2,1 = 0.84). KNAP-SP's responsiveness was confirmed by ROC analysis (area under the curve [AUC] = 0.87 [95% CI: 0.79-0.96, p-value <.01]) and accepting 75% of prior hypotheses. The minimal clinically important change was 6.96 points. No floor or ceiling effects were detected. CONCLUSIONS: The KNAP-SP, with robust psychometric properties and successful adaptation and validation, is a valuable tool for assessing pain knowledge and attitudes among Spanish-speaking physiotherapists.

Prevalence of squamous gastric disease in Colombian equids at slaughter: A postmortem comparative study among horses, donkeys and mules.

Equine Gastric Ulcer Syndrome (EGUS) occurs with variable prevalence in horses, donkeys, and mules. Due to the particularities of the mucous membranes, the syndrome is made up of Squamous Gastric Disease (ESGD) and Glandular Gastric Disease (EGGD). Given the multifactorial nature and multiple classification systems of the syndrome, significant differences have been reported between prevalence studies performed ante mortem, which are even more remarkable when compared with postmortem evaluations. This study aimed to determine the presence and grade of squamous gastric disease in horses, donkeys and mules immediately after slaughter. The postmortem examination considered the inspection of the squamous region (cardia, dorsal fundus, and margo plicatus) and the classification of the observed lesions. The general prevalence of ESGD in the entire population of study was 83.3 % (78 %, 89 %, and 83 % for horses, donkeys, and mules, respectively), compromising the margo plicatus in all cases. 75 % had more than 5 lesions and 50 % had deep lesions, lesions of varying severity and/or evidence of recent/active bleeding. The prevalence of ESGD was similar in horses, donkeys, and mules subjected to similar handling conditions prior to slaughter, including long-distance traveling, fasting, and stress factors.

Home-Based Trimodal Prehabilitation in Patients with Peritoneal Carcinomatosis Undergoing Cytoreductive Surgery: Effect on Functional Walking Capacity and Skeletal Muscle Mass.

BACKGROUND: Patients with peritoneal carcinomatosis often suffer from loss of skeletal muscle mass and require extensive surgery. Multimodal prehabilitation may improve physical status but its benefits for these specific patients remain unknown. This study aimed to evaluate the effect of prehabilitation on functional walking capacity and skeletal muscle mass, as well as its association with postoperative complications. PATIENTS AND METHODS: A prospective study of patients with peritoneal carcinomatosis following a home-based trimodal prehabilitation program was carried out. Functional walking capacity was assessed with the 6-min walk test (T6MWT), and by the appendicular skeletal muscle index (ASMI) estimated by bioelectrical impedance analysis. Data were collected at the first medical appointment and on the day before surgery. A 90-day postoperative morbidity was registered according to the Clavien-Dindo classification. RESULTS: A total of 62 patients were included in the analysis. Women were more prevalent (77.4%) and peritoneal metastasis from ovarian origin accounted for 48.4%. Clavien II-V grades occurred in 30 (57.7%) patients. After prehabilitation, functional walking capacity improved by 42.2 m (39.62-44.72 m) compared with baseline data (p < 0.001), but no improvement was observed in the ASMI (p = 0.301). Patients able to walk at least 360 m after prehabilitation suffered fewer Clavien-Dindo II-V postoperative complications (p = 0.016). A T6MWT of less than 360 m was identified as an independent risk factor in the multivariable analysis (OR 3.99; 1.01-15.79 p = 0.048). CONCLUSIONS: This home-based trimodal prehabilitation program improved functional walking capacity but not ASMI scores in patients with peritoneal metastasis before surgery. A T6MWT of less than 360 m was found to be a risk factor for postoperative complications.

[Penicillin allergy: A label that is not forever]. / Alergia a la penicilina: una etiqueta que no es para siempre.

Self-reported penicillin allergy is highly prevalent. Different studies estimate that 10% of the population is labeled as such. This label, confirmed or suspected, forces us to take precautions and replace the antibiotic treatment of choice (frequently beta-lactams) with other 2nd or 3rd choice alternatives with worse overall results: side effects, resistance, costs, etc. The penicillin allergy label, once placed, remains in the medical record. It is only confirmed in less than 5% of patients, either because it has been placed inappropriately or because over time the sensitivity decreases and may disappear. Penicillin Allergy Decision Rule -PEN-FAST- is a validated and simple clinical prediction rule that estimates the risk of presenting an allergic reaction. Its use, together with algorithms that involve primary care in the study and delabeling of low-risk patients, can change our clinical practice.

Ecophysiological responses of Ostreopsis towards temperature: A case study of benthic HAB facing ocean warming.

Reports of the benthic dinoflagellate Ostreopsis spp. have been increasing in the last decades, especially in temperate areas. In a context of global warming, evidences of the effects of increasing sea temperatures on its physiology and its distribution are still lacking and need to be investigated. In this study, the influence of temperature on growth, ecophysiology and toxicity was assessed for several strains of O. cf. siamensis from the Bay of Biscay (NE Atlantic) and O. cf. ovata from NW Mediterranean Sea. Cultures were acclimated to temperatures ranging from 14.5 °C to 32 °C in order to study the whole range of each strain-specific thermal niche. Acclimation was successful for temperatures ranging from 14.5 °C to 25 °C for O. cf. siamensis and from 19 °C to 32 °C for O. cf. ovata, with the highest growth rates measured at 22 °C (0.54-1.06 d-1) and 28 °C (0.52-0.75 d-1), respectively. The analysis of cellular content of pigments and lipids revealed some aspects of thermal acclimation processes in Ostreopsis cells. Specific capacities of O. cf. siamensis to cope with stress of cold temperatures were linked with the activation of a xanthophyll cycle based on diadinoxanthin. Lipids (neutral reserve lipids and polar ones) also revealed species-specific variations, with increases in cellular content noted under extreme temperature conditions. Variations in toxicity were assessed through the Artemia franciscana bioassay. For both species, a decrease in toxicity was observed when temperature dropped under the optimal temperature for growth. No PLTX-like compounds were detected in O. cf. siamensis strains. Thus, the main part of the lethal effect observed on A. franciscana was dependent on currently unknown compounds. From a multiclonal approach, this work allowed for defining specificities in the thermal niche and acclimation strategies of O. cf. siamensis and O. cf. ovata towards temperature. Potential impacts of climate change on the toxic risk associated with Ostreopsis blooms in both NW Mediterranean Sea and NE Atlantic coast is further discussed, taking into account variations in the geographic distribution, growth abilities and toxicity of each species.