Adult respiratory distress syndrome (ARDS) due to omeprazole-induced drug reaction with eosinophilia and systemic symptoms (DRESS): Case report and review of the literature.

Eosinophilia in not an uncommon findings in the intensive care unit (ICU); however, DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms) syndrome, which is characterized by a hypersensitivity reaction to drugs and manifests as eosinophilia, systemic involvement and maculopapular erythematous rash 2-6 weeks after exposure to the offending drug, is an exceptional occurrence. We present the first case described in the literature of DRESS syndrome with pulmonary involvement in the form of interstitial pneumonitis and persistent adult respiratory distress syndrome (ARDS) secondary to proton pump inhibitors (PPI). The patient made a good recovery after withdrawal of the offending drug and long-term treatment with systemic corticosteroids. We also present a systematic review of all cases of DRESS with pulmonary involvement in the form of interstitial pneumonitis and cases of PPI-induced DRESS published to date; none of these describe pulmonary involvement.

Superoxidase dismutases (SODs) in the European eel: Gene characterization, expression response to temperature combined with hormonal maturation and possible migratory implications.

Superoxide dismutases (SODs) are antioxidant enzymes that protect cells from oxidation. Three SODs have been identified in mammals, but there is limited information in teleosts. This study investigates SODs in the European eel and their expression patterns during testis maturation. Phylogenetic and synteny analyses revealed SODs paralogs and their evolution in vertebrates. The eel possesses one SOD1 and two SOD2/3 (a and b), indicating SOD2 and SOD3 duplication in elopomorphs. SODs expression were then evaluated in various male and female tissues. SOD1 is more expressed in females, while SOD2a and SOD2b dominate brain-pituitary-gonad tissues in both sexes. SOD3a showed predominant expression in the ovary and the male livers, whereas SOD3b was found in the pituitary and brain of both sexes. The effects of different maturation protocols (standard hormonal treatment vs. same protocol preceded with cold seawater pre-treatment) on SODs expression during testis maturation were evaluated. Salinity increase at the onset of standard treatment at 20 °C, simulating early migration, upregulated SOD1, SOD2a, and SOD2b, coinciding with spermatogonia type A differentiated cells dominance. Thereafter, SOD2a and SOD3a decreased, while SOD2b increased during hormonal treatment-induced spermatogenesis. Pre-treatment with seawater at 10 °C, mimicking the conditions at the beginning of the seawater migration, downregulated SOD1 but increased SOD3a expression. Finally, the standard hormonal treatment, replicating spawning at higher temperatures, downregulated SOD1 in eels without any pre-treatment while SOD2a expression increased in pre-treated eels. This study revealed tissue-specific, sex-dependent, and maturation-related SOD expression patterns, predicting SODs dynamic expression profiles during their reproductive migration.

Purtscher-like retinopathy following carotid angioplasty and stenting in the treatment of severe carotid stenosis.

We present a case of Purtscher-like retinopathy (PLR) following carotid angioplasty and stenting (CAS). A 56-year-old man with a history of severe stenosis of the left carotid artery and treated by CAS refers acute and painless visual loss on the left eye (OS) 48 h after the procedure. Funduscopic examination showed cotton wool spots and intraretinal hemorrhages confined to the peripapillary and posterior pole of the OS. The optical coherence tomography (OCT) showed retinal thickening and hyperintense lesions in the inner nuclear layer retina.

Impact on physical function of the +AGIL Barcelona program in community-dwelling older adults with cognitive impairment: an interventional cohort study.

BACKGROUND: Older adults with cognitive impairment (CI) have higher multimorbidity and frailty prevalence, lower functional status and an increased likelihood to develop dementia, non-cognitive deficits, and adverse health-related events. +AGIL, a real-world program for frail older adults in a primary care area of Barcelona, is a pragmatic, multi-component and integrated intervention implemented since 2016. It includes physical activity, nutrition, sleep hygiene, revision and adequacy of pharmacological treatment, detection of undesired loneliness and screening for CI; to improve physical function in community-dwelling older adults. We aimed to assess the + AGIL longitudinal impact on physical function among community-dwelling frail older persons with CI. METHODS: An interventional cohort study included data from all the + AGIL consecutive participants from July 2016 until March 2020. Based on the comprehensive geriatric assessment, participants were offered a tailored multi-component community intervention, including a 10-week physical activity program led by an expert physical therapist. Physical performance was measured at baseline, three and six months follow-up. The pre-post impact on physical function was assessed by paired sample t-test for repeated samples. Linear mixed models were applied to analyze the + AGIL longitudinal impact. P-values < 0.05 were considered statistically significant. RESULTS: 194 participants were included (82 with CI, based on previous diagnosis or the Mini-COG screening tool), 68% women, mean age 81.6 (SD = 5.8) yo. Participants were mostly independent in Activities of Daily Living (mean Barthel = 92.4, SD = 11.1). The physical activity program showed high adherence (87.6% attended ≥ 75% sessions). At three months, there was a clinically and statistically significant improvement in the Short Physical Performance Battery (SPPB) and its subcomponents in the whole sample and after stratification for CI [CI group improvements: SPPB = 1.1 (SD = 1.8) points, gait speed (GS) = 0.05 (SD = 0.13) m/s, Chair stand test (CST)=-2.6 (SD = 11.4) s. Non-CI group improvements: SPPB = 1.6 (SD = 1.8) points, GS = 0.08 (SD = 0.13) m/s, CST=-6.4 (SD = 12.1) seg]. SPPB and gait speed remained stable at six months in the study sample and subgroups. CI had no significant impact on SPPB or GS improvements. CONCLUSION: Our results suggest that older adults with CI can benefit from a multidisciplinary integrated and comprehensive geriatric intervention to improve physical function, a component of frailty.

Birdlife, a tourist attraction for the southern portion of Bacalar Lagoon, Quintana Roo, Mexico.

The Bacalar Lagoon (BL) in Quintana Roo, Mexico; is an area of high interest due to its tourist potential. However, the changes in landuse patterns, urbanization, extensive cattle ranching and rapidly expanding agriculture, have generated negative impacts on areas of adjacent plan communities and wildlife habitats. The objective of this study has to evaluate the level of vegetation conservation in the southern portion of the BL through the avifauna present in sites with contrasting degrees of conservation. Additionally, change "and their habitat preference(s) in the different communities" to and their habitat use preferences in the different communities. To evaluate the level of conservation of the BL, field visits and botanical collections were carried out to identify species. For the counting and identification of birds, monthly surveys were made through coastal tours along the cenote Xul-ha in 2.5 km transects. Four transects were established: two for sites characterized as semi-conserved and two with disturbed sites. A total richness of 40 taxa was observed, which corresponds to 8.1% of the Quintana Roo avifauna and 32% to wetland birds (125 species). The species accumulation curves indicated that semi-conserved and disturbed sites tend to reach asymptotes and with a coverage percentage greater than 90%. In terms of diversity and community structure, no significant differences were observed. However, the semi-conserved and disturbed sites each have 11 unique species and share 18 species. The LB has an intermediate diversity of bird species compared to studies at the Mexican level, the habitat is important for the conservation of birdlife; as it functions as a reservoir of diversity. Strategies has been suggested that promote sustainable tourism, support the restoration of natural vegetation; and facilitate the economic development of the region.

Association between depressive and anxious symptoms with cognitive function and quality of life in drug-resistant epilepsy.

•Depressive/anxious disorders and cognitive impairment are frequent comorbidities in epilepsy and have a more deleterious effect in DRE.•Studies concerning the relationship between anxiety and depression and cognitive performance in DRE are scarce.•Higher scores in HADS are associated with lower QOLIE-31 scores and might be considered as predictors of QOL in DRE.•A relationship between anxious and depressive symptoms -measured with HADS and SCL-90R- and cognition might not exist.•There remains an unexplored study area regarding this relationship which requires more attention to improve the assessment of DRE.

Mathematical birth of Early Afterdepolarizations in a cardiomyocyte model.

Early Afterdepolarizations (EADs) are abnormal behaviors that can lead to cardiac failure and even cardiac death. In this paper we investigate the occurrence and development of these phenomena in a reduced Luo-Rudy cardiac model. Through a comprehensive dynamical analysis, we map out the distinct patterns observed in the parametric plane, differentiating between normal beats without EADs and pathological beats with EADs. By examining the bifurcation structure of the model, we elucidate the dynamical elements associated with these patterns and their transitions. Using a fast-slow analysis, we explore the emergence and evolution of EADs in the model. Notably, our approach combines the two commonly used fast-slow approaches (1-slow-2-fast and 2-slow-1-fast), and we show how both approaches together provide a more complete understanding of this phenomenon.

Diagnóstico incidental del cáncer de vejiga en España. Estudio observacional a nivel nacional / Incidental diagnosis of bladder cancer in a national observational study in Spain

Introducción El cáncer de vejiga (CV) es una neoplasia frecuente en España. Los objetivos de este estudio fueron: identificar la proporción de pacientes diagnosticados de CV de forma incidental o tras la presentación de síntomas en un periodo contemporáneo en España; comparar las características demográficas, clínicas y patológicas entre estos grupos. Métodos El presente fue un análisis retrospectivo de un estudio observacional multicéntrico realizado en 26 hospitales del Sistema Nacional de Salud español, incluyendo a todos los nuevos diagnósticos de CV en 2011. El estudio representó 21,5% de la población española y los hospitales fueron seleccionados de forma proporcional a las regiones españolas para asegurar una muestra representativa. Los pacientes fueron categorizados según el diagnóstico de cáncer incidental o tras la presentación sintomática y se analizaron las características demográficas, patológicas y clínicas basales. Resultados En los 26 hospitales españoles incluidos en el estudio, se diagnosticaron 2.472 casos de CV, de los cuales 308 (12,5%) fueron diagnosticados de forma incidental y 2.164 (87,5%) tras la presentación de síntomas. No se observaron diferencias entre los pacientes diagnosticados incidentalmente frente a los sintomáticos en términos demográficos o de comorbilidades evaluadas. En comparación con los tumores de vejiga con diagnostico posterior a la presentación de síntomas, los diagnósticos incidentales tenían más probabilidades de ser tumores papilares, significativamente más pequeños y de tener una citología positiva/sospechosa. Además, los tumores de vejiga diagnosticados incidentalmente tenían menos probabilidades de ser músculo-invasivos (11,7 vs. 25%, p < 0,01) y de ser agresivos en el estudio patológico, con 33,6% de grado 3 vs. 50,1% (p < 0,01). Conclusiones Identificamos un porcentaje significativo (12,5%) de nuevos diagnósticos de CV realizados de forma incidental en una muestra representativa de la población española (AU)

Introduction Bladder cancer (BC) is a common malignancy in Spain. The aims of this study were: to identify the proportion of patients diagnosed with BC incidentally or after symptomatic presentation in a contemporary period in Spain; to compare demographic, clinical, and pathologic characteristics between these groups. Methods This was a retrospective analysis of a multi-centre observational study of 26 hospitals in the Spanish National Health System of all BCs newly diagnosed in 2011. The study represented 21.5% of the Spanish population and hospitals were selected in proportion to Spain's regions to ensure a representative sample. Patients were categorized by whether the cancer was diagnosed incidentally or after symptomatic presentation and baseline demographic, pathologic, and clinical characteristics were analyzed. Results 2472 were newly diagnosed with BC at the 26 participating Spanish hospitals with 308 (12.5%) of cases diagnosed incidentally and 2164 (87.5%) diagnosed after symptomatic presentation. No differences were observed between patients diagnosed incidentally vs. symptomatically in terms of demographics or measured co-morbidities. Compared to symptomatically diagnosed bladder tumours, those diagnosed incidentally were more likely to have a papillary appearance, to be significantly smaller, and less likely to have positive/suspicious cytology. Additionally, incidentally diagnosed bladder tumours were less likely to be muscle-invasive (11.7% vs. 25.0%, P < .01) nor aggressive at pathology, with 33.6% Grade 3 compared to 50.1%, (P < .01). Conclusions We identified a significant percentage (12.5%) of new bladder cancer diagnosis made incidentally in a representative sample of the Spanish population. These tumours exhibited less aggressive pathologic characteristics than their symptomatic counterparts (AU)

Clinical relevance of interictal dysphoric disorder and its impact on quality of life in drug-resistant epilepsy.

OBJECTIVE: This study aims to assess the prevalence of Interictal Dysphoric Disorder (IDD) in drug-resistant epilepsy (DRE) and to describe its clinical and psychopathological profile, including personality, as well as its impact on quality of life (QOL). METHOD: A retrospective cross-sectional study from an Epilepsy Unit from January 2007 to December 2017. All patients were diagnosed with DRE. Patients underwent a battery of tests (HADS, SCL-90R, PDQ-4+, QOLIE-31) and a psychiatrist assessed the presence of Axis-I disorders and IDD. Statistical procedures were carried out using R-4.0.1 software. RESULTS: A total of 282 patients were included. A statistically significant association was found between IDD and mood and anxiety disorders (p < 0.001 and p < 0.05 respectively), and between IDD and higher scores in all HADS and SCL-90-R items compared to subjects without IDD (p < 0.001). A statistically significant association was also found between IDD and obsessive-compulsive, borderline and depressive personality disorder (p < 0.05). Scores in all QOLIE-31 items except for 'medication effects' were significantly lower in subjects with IDD compared with subjects without IDD (p < 0.001). CONCLUSIONS: In DRE, IDD subjects show differences in the psychopathological profile and QOL scores compared to subjects without a diagnosis of IDD. An early diagnosis of IDD could facilitate prompt interventions which might positively impact QOL.

Real world evidence of adjuvant trastuzumab in HER2 positive early breast cancer.

Adjuvant trastuzumab in HER2+ breast cancer reduces recurrence and mortality, and has been the standard treatment since 2006. The objective was to analyze health outcomes in the real world. Observational, retrospective study of patients with HER2+ breast cancer, stages I-III, treated with adjuvant trastuzumab in the past 15 years in only one center and for the first time in Spain. Survival was analyzed according to the number of cycles and cardiotoxicity. Two hundred and seventy-five HER2positive patients (18.60%) out of 1479 received adjuvant (73%) or neoadjuvant/adjuvant (26%) trastuzumab, concomitantly (90%) or sequentially (10%) with chemotherapy. The probability of overall and disease-free survival (OS and DFS) at 5 years was 0.93 (95% CI 0.89-0.96), and 0.88 (95% CI 0.83-0.92). The number of cases with a significant and asymptomatic decrease in ventricular ejection fraction and heart failure were 54 (19.64%) and 12 (4.36%), respectively. Sixty-eight patients (24.70%) received 16 or fewer cycles, especially those older than 65 (OR 0.371, 95% CI 0.152-0.903; p = 0.029) and with cardiotoxicity (OR 15.02, 95% CI 7.437-30.335; p < 0.001). The risk of cardiotoxicity was associated with having received radiotherapy (OR 0.0362, 95% CI 0.139-0.938; p = 0.037). Arterial hypertension (HR 0.361, 95% CI 0.151-0.863, p = 0.022), neoadjuvant treatment (HR 0.314, 95% CI 0.132-0.750, p = 0.009) and cardiotoxicity (HR 2.755, 95% CI 1.235-6.143, p = 0.013) maintained significant association with OS. Only neoadjuvant treatment maintained a significant association with DFS (HR 0.437, 95% CI 0.213-0.899, p = 0.024). The effectiveness of neoadjuvant and adjuvant trastuzumab can be considered comparable to those of clinical trials. In the real world, factors such as age, hypertension, radiotherapy, neoadjuvant treatment, and cardiotoxicity should be taken into consideration to optimize outcomes.

Potentially harmful elements pollute soil and vegetation around the Atrevida mine (Tarragona, NE Spain).

Mining activity is one of the main sources to pollute soil, water and plants. An analysis of soil and plant samples around the Atrevida mining area in Catalonia (NE Spain) was preformed to determine potentially harmful elements (PHEs). Soil and plant samples were taken at eight locations around the mining area. The topsoil (0-15 cm) samples were analysed for physico-chemical properties by standard methods, by ICP-MS for Cd, Co, Cr, Cu, Fe, Ni, Pb and Zn, and were microwave-digested. Plant, root and shoot samples were digested separately, and heavy metals were analysed by AAS. Translocation factor (TF), biological concentration factor (BCF) and biological accumulation factor (BAF) were determined to assess the tolerance strategies developed by native species and to evaluate their potential for phytoremediation purposes. Soil pH was generally acid (5.48-6.72), with high soil organic matter (SOM) content and a sandy loamy or loamy texture. According to the agricultural soil values in southern Europe, our PHEs concentrations exceeded the toxicity thresholds. The highest root content of the most studied PHEs appeared in Thymus vulgaris L. and Festuca ovina L., while Biscutella laevigata L. accumulated more PHEs in shoots. The TF values were > 1 in B. laevigata L., but BAF obtained < 1, except Pb. B. laevigata L., and can be considered potentially useful for phytoremediation for having the capacity to restrict the accumulation of large PHEs amounts in roots and Pb translocation to shoots.

Machine learning models for estimating contamination across different curbside collection strategies.

Contaminated recyclables, which are frequently discarded as waste, pose a significant challenge to the implementation of a circular economy. These contaminated recyclables impede the circulation of resources, resulting in higher processing costs at material recovery facilities (MRFs). Over the past few decades, machine learning (ML) models such as linear regression (LR), support vector machine (SVM), and random forest (RF) have evolved to provide new methods for predicting inbound contamination rates in addition to traditional statistical models. In this study, we applied ML models to predict inbound contamination rates using demographic features from 15 counties in the U.S. with different curbside collection strategies. In general, we found that ML models outperformed linear mixed models. Specifically, SVM models had the highest performance (R2 = 0.75; mean absolute error (MAE) = 0.06), which may be due to their ability to model nonlinear relationships between features and inbound contamination rates. The key predictor was population, with poverty rate being positively correlated and median age negatively correlated with inbound contamination rates. To improve the management of contamination and enhance the implementation of a circular economy, better models are needed to understand and estimate inbound contamination rates as well as identify critical factors in the present and future.

SARS-CoV-2 seroprevalence in workers from a Colombian University Hospital.

BACKGROUND: Antibody (Ab) tests for SARS-CoV-2 virus allows for the estimation of incidence, level of exposure and duration of immunity acquired by a previous infection. In health workers, the hospital setting might convey a greater risk of infection. AIMS: To describe the frequency of immunoglobulin G (IgG) Abs (IgG-Abs) to the SARS-CoV-2 virus among workers at a third-level university hospital in Colombia. METHODS: In this cross-sectional study, we included medical and non-medical personnel with at least one real-time polymerase chain reaction (RT-PCR)/antigen test between March 2020 and March 2021. In April 2021, an IgG-Ab test against SARS-CoV-2 was conducted for all participants and replicated 2 weeks later in a random sample (10%). The frequency of IgG-Abs is presented based on status (positive/negative) and time elapsed since RT-PCR/antigen test (<3 months, 3-6 months, >6 months). RESULTS: We included 1021 workers (80% women, median age 34 years (interquartile range 28-42), 73% medical personnel, 23% with previous positive RT-PCR/antigen). The overall seroprevalence was 35% (95% CI 31.6-37.4, 35% in medical and 33% in non-medical personnel). For those with a previous positive RT-PCR/antigen test, the seroprevalence was 90% (<3 months), 82% (3-6 months) and 48% (>6 months). In participants with a previous negative RT-PCR/antigen test, the seroprevalence was 17% (<3 months), 21% (3-6 months) and 29% (>6 months). CONCLUSIONS: High IgG-Ab positivity was found in hospital personnel, regardless of work activities. The prevalence of detectable Abs differed by previous RT-PCR/antigen status and time elapsed since the diagnostic test.

The use of microplastics as a reliable chronological marker of the Anthropocene onset in Southeastern South America.

Microplastics (MPs) represent an emergent contamination marker. For this reason, we analyzed the vertical distribution of MPs in six sediment cores retrieved from the Patos-Mirim System, the world's largest coastal lagoonal system. The sediment cores span from mid Holocene to present times according to both radiocarbon and lead dating and are located close to both urban/industrial and agricultural regions. We identified a basal pre-disturbance MP-free zone in all cores and an uppermost contaminated 70-cm-zone, where a general increasing trend in MPs content resembling the human anthropization process was recorded. The predominant format of MPs was fiber, followed by fragments. The most commonly identified polymers were rayon, PVC, acrylate, polycarbonate and cellophane. Urban/industrial and agricultural activities were shown as clear sources of MPs, leading to comparable MPs concentration values in the sediment cores. Thus, MPs are collectively a reliable indicator of the Anthropocene onset, and in the Patos-Mirim System the most appropriate chronology can be assigned to the beginning of 1970s, matching the intensification of anthropogenic activities in the area.

Is the RWGS a viable route for CO2 conversion to added value products? A techno-economic study to understand the optimal RWGS conditions.

Understanding the viability of the RWGS from a thermodynamic and techno-economic angle opens new horizons within CO2 conversion technologies. Unfortunately, profitability studies of this technology are scarce in literature and mainly focused on overall conversion and selectivity trends with tangential remarks on energy demands and process costs. To address this research gap, herein we present a comprehensive techno-economic study of the RWGS reaction when coupling with Fischer-Tropsch synthesis is envisaged to produced fuels and chemicals using CO2 as building block. We showcase a remarkable impact of operating conditions in the final syngas product and both CAPEX and OPEX. From a capital investment perspective, optimal situations involve RWGS unit running at low temperatures and high pressures as evidenced by our results. However, from the running cost angle, operating at 4 bar is the most favorable alternative within the studied scenarios. Our findings showcase that, no matter the selected temperature the RWGS unit should be preferentially run at intermediate pressures. Ultimately, our work maps out multiple operating scenarios in terms of energy demand and process cost serving as guideline to set optimal reaction conditions to unlock the potential of the RWGS for chemical CO2 recycling.