Seguridad cardiovascular de los nuevos fármacos para el tratamiento agudo y preventivo de la migraña: gepantes y ditanes / Cardiovascular safety of new drugs for the acute and preventive treatment of migraine: gepants and ditans

Introducción: La migraña es una patología neurológica prevalente caracterizada por ataques de cefalea incapacitantes. En las últimas décadas se han desarrollado nuevos fármacos específicos para el tratamiento agudo y preventivo de la migraña basados en su fisiopatología. Entre éstos se encuentran los antagonistas del péptido relacionado con el gen de la calcitonina (CGRP) (gepantes) y los agonistas selectivos del receptor serotoninérgico 5-HT1F (ditanes). El CGRP es un neuropéptido liberado por los terminales trigeminales que actúa como vasodilatador, provoca inflamación neurógena y, con ello, generación del dolor y sensibilización en la migraña. Posee, además, una potente acción vasodilatadora y participa en la regulación cardiovascular, razón por la cual se están llevando a cabo numerosos estudios que evalúan la seguridad vascular de actuar contra el CGRP. La alta selectividad de los ditanes para el receptor serotoninérgico 5-HT1F con una baja afinidad para otros receptores serotoninérgicos parece traducirse en un bajo o nulo efecto vasoconstrictor, que es mediado por la activación de los receptores 5-HT1B. Desarrollo: Nuestro objetivo es revisar la seguridad cardiovascular demostrada por estos nuevos fármacos para el tratamiento de la migraña analizando la evidencia publicada. Realizamos una búsqueda bibliográfica en la base de datos PubMed y una revisión de los ensayos clínicos publicados en clinicaltrial.gov. Incluimos revisiones bibliográficas, metaanálisis y ensayos clínicos en español e inglés. Analizamos los efectos adversos cardiovasculares informados. Conclusiones: Basándonos en los resultados hasta ahora publicados, podemos concluir que el perfil de seguridad cardiovascular de estos nuevos tratamientos es favorable. Para confirmar estos resultados son necesarios estudios de seguridad a más largo plazo.(AU)

Introduction: Migraine is a prevalent neurological condition characterised by disabling headache attacks. In recent decades, new drugs have been developed specifically for the acute and preventive treatment of migraine based on its pathophysiology. These include calcitonin gene-related peptide (CGRP) antagonists (CGRP) (gepants) and selective serotoninergic 5-HT1F receptor agonists (ditans). CGRP is a neuropeptide released by trigeminal terminals that acts as a vasodilator, causes neurogenic inflammation and thus generates pain and sensitisation in migraine. It also has a powerful vasodilatory action and is involved in cardiovascular regulation, which is why numerous studies are under way to assess the vascular safety of acting against CGRP. The high selectivity of ditans for the serotoninergic 5-HT1F receptor with a low affinity for other serotoninergic receptors seems to translate into little or no vasoconstrictor effect, which is mediated by the activation of 5-HT1B receptors. Development: The aim of our study is to review the cardiovascular safety demonstrated by these new drugs for the treatment of migraine by analysing the evidence published to date. We conducted a literature search in the PubMed database and a review of clinical trials published at clinicaltrial.gov. We included literature reviews, meta-analyses and clinical trials in English and Spanish. We analysed reported cardiovascular adverse effects. Conclusions: Based on the results published to date, we can conclude that the cardiovascular safety profile of these new treatments is favourable. Longer-term safety studies are needed to confirm these results.(AU)

[Cardiovascular safety of new drugs for the acute and preventive treatment of migraine: gepants and ditans]. / Seguridad cardiovascular de los nuevos fármacos para el tratamiento agudo y preventivo de la migraña: gepantes y ditanes.

INTRODUCTION: Migraine is a prevalent neurological condition characterised by disabling headache attacks. In recent decades, new drugs have been developed specifically for the acute and preventive treatment of migraine based on its pathophysiology. These include calcitonin gene-related peptide (CGRP) antagonists (CGRP) (gepants) and selective serotoninergic 5-HT1F receptor agonists (ditans). CGRP is a neuropeptide released by trigeminal terminals that acts as a vasodilator, causes neurogenic inflammation and thus generates pain and sensitisation in migraine. It also has a powerful vasodilatory action and is involved in cardiovascular regulation, which is why numerous studies are under way to assess the vascular safety of acting against CGRP. The high selectivity of ditans for the serotoninergic 5-HT1F receptor with a low affinity for other serotoninergic receptors seems to translate into little or no vasoconstrictor effect, which is mediated by the activation of 5-HT1B receptors. DEVELOPMENT: The aim of our study is to review the cardiovascular safety demonstrated by these new drugs for the treatment of migraine by analysing the evidence published to date. We conducted a literature search in the PubMed database and a review of clinical trials published at clinicaltrial.gov. We included literature reviews, meta-analyses and clinical trials in English and Spanish. We analysed reported cardiovascular adverse effects. CONCLUSIONS: Based on the results published to date, we can conclude that the cardiovascular safety profile of these new treatments is favourable. Longer-term safety studies are needed to confirm these results.

TITLE: Seguridad cardiovascular de los nuevos fármacos para el tratamiento agudo y preventivo de la migraña: gepantes y ditanes.Introducción. La migraña es una patología neurológica prevalente caracterizada por ataques de cefalea incapacitantes. En las últimas décadas se han desarrollado nuevos fármacos específicos para el tratamiento agudo y preventivo de la migraña basados en su fisiopatología. Entre éstos se encuentran los antagonistas del péptido relacionado con el gen de la calcitonina (CGRP) (gepantes) y los agonistas selectivos del receptor serotoninérgico 5-HT1F (ditanes). El CGRP es un neuropéptido liberado por los terminales trigeminales que actúa como vasodilatador, provoca inflamación neurógena y, con ello, generación del dolor y sensibilización en la migraña. Posee, además, una potente acción vasodilatadora y participa en la regulación cardiovascular, razón por la cual se están llevando a cabo numerosos estudios que evalúan la seguridad vascular de actuar contra el CGRP. La alta selectividad de los ditanes para el receptor serotoninérgico 5-HT1F con una baja afinidad para otros receptores serotoninérgicos parece traducirse en un bajo o nulo efecto vasoconstrictor, que es mediado por la activación de los receptores 5-HT1B. Desarrollo. Nuestro objetivo es revisar la seguridad cardiovascular demostrada por estos nuevos fármacos para el tratamiento de la migraña analizando la evidencia publicada. Realizamos una búsqueda bibliográfica en la base de datos PubMed y una revisión de los ensayos clínicos publicados en clinicaltrial.gov. Incluimos revisiones bibliográficas, metaanálisis y ensayos clínicos en español e inglés. Analizamos los efectos adversos cardiovasculares informados. Conclusiones. Basándonos en los resultados hasta ahora publicados, podemos concluir que el perfil de seguridad cardiovascular de estos nuevos tratamientos es favorable. Para confirmar estos resultados son necesarios estudios de seguridad a más largo plazo.

Criobiopsia en toracoscopia médica: A propósito de un caso con un diagnóstico infrecuente / Cryobiopsy in medical thoracoscopy: a case with an infrequent diagnosis

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Derrame pleural secundario a absceso hepático amebiano / Pleural effusion secondary to amebic liver abscess

La amebiasis es una enfermedad infecciosa causada por el protozoo E. hystolitica con múltiples manifestaciones clínicas. La afectación torácica es la segunda localización extraintestinal más frecuente tras la hepática. Presentamos un caso de derrame pleural secundario a un absceso hepático amebiano y realizamos una revisión de esta entidad poco frecuente

Amebiasis is an infectious disease caused by the protozoan E. hystolitica with multiple clinical manifestations. Chest involvement is the second most frequent extraintestinal location after the liver. We present a case of pleural effusion secondary to an amebic liver abscess and we review this rare entity

Intervenciones para reducir el impacto de la práctica dual en el sector público de salud / Interventions to reduce the impact of dual practice in the public health sector

INTRODUCCIÓN La práctica dual (trabajadores que se desempeñan en el sector público y privado) tiene impacto en los servicios de salud en términos de calidad y costos. Sin embargo, la efectividad de políticas de regulación no ha sido demostrada. MÉTODOS Realizamos una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES Identificamos tres revisiones sistemáticas que en conjunto incluyeron 23 estudios primarios, de los cuales, todos corresponden a estudios observacionales. Concluimos que no está claro si las intervenciones para reducir las consecuencias negativas de la práctica dual en el sistema de salud son efectivas porque la certeza de la evidencia disponible es muy baja.

INTRODUCTION Dual practice (i.e. workers who work in the public and private sector) has an impact on health services in terms of quality and costs. However, the effectiveness of regulatory policies has not been proven. METHODS We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS We identified three systematic reviews that included 23 primary studies overall, of which all correspond to observational studies. We concluded it is not clear whether the interventions to reduce the negative consequences of dual practice in the health system are effective because the certainty of the available evidence is very low.

The impact of extrusion on the nutritional composition, dietary fiber and in vitro digestibility of gluten-free snacks based on rice, pea and carob flour blends.

Consumers and the food industry are demanding healthier products. Expanded snacks with a high nutritional value were developed from different rice, pea and carob flour blends. The proximate composition, starch (total and resistant), amylose and amylopectin, dietary fiber (soluble and insoluble) contents, and the in vitro protein digestibility of different rice-legume formulations, were evaluated before and after the extrusion process. Compared with the corresponding non-extruded blends (control), the extrusion treatment did not change the total protein content, however, it reduced the soluble protein (61-86%), the fat (69-92%) and the resistant starch contents (100%). The total starch content of all studied blends increased (2-19%) after extrusion. The processing increased the in vitro protein digestibility, reaching values around 88-95% after extrusion. Total dietary fiber was reduced around 30%, and the insoluble fraction was affected to a larger extent than the soluble fraction by the extrusion process. Because of its balanced nutritional composition, high dietary fiber content, as well as low energy density, these novel gluten-free snack-like foods could be considered as functional foods and a healthier alternative to commercially available gluten-containing or gluten-free and low nutritional value snacks.

Novel fiber-rich lentil flours as snack-type functional foods: an extrusion cooking effect on bioactive compounds.

Novel snack-type functional foods based on extruded lentil flours could convey the related health benefit of their bioactive compounds, provide a gluten-free alternative to consumers, and potentially increase the consumption of pulses. Extrusion treatment promoted an increase in galactopinitol, ciceritol, raffinose, stachyose and total α-galactoside content, in most lentil flours. As α-galactosides may act as prebiotics, they could convey beneficial effects to human and monogastric animals. Conversely, extrusion significantly (p < 0.05) reduced the inositol hexaphosphate content to less phosphorylated phytates (inositol pentaphosphate and inositol tetraphosphate), which provide health effects. The gluten-free formulation (control formulation #3) presented the highest significant (p < 0.05) drop in the inositol hexaphosphate of 14.7-fold decrease, but had a large increase in inositol pentaphosphate, due to extrusion processing. These two results are desirable in the finished product. Extrusion also caused a significant (p < 0.05) reduction in the trypsin content and completely inactivated lectin, in all processed samples.

Evaluation of food consumption and dietary patterns in Spain by the Food Consumption Survey: updated information.

BACKGROUND/OBJECTIVES: The Food Consumption Survey (FCS), conducted for over 20 years by the Spanish Ministry of Agriculture, Fisheries and Food (MARM), is the most reliable source of data to evaluate the food consumption and dietary patterns of Spain. The aim of this study was to assess population food availability per capita per day, which allows the calculation of energy and nutrient intake and comparison with the Recommended Nutrient Intakes for the Spanish population. In addition, different markers of the quality of the diet have been evaluated. SUBJECTS/METHODS: The sample consisted of consumption and distribution data, obtained from the nationwide representative FCS for the period 2000-2006. A two-stage sampling method was applied, where in the first stage the units to be sampled were towns or local entities, and in the second stage households that were going to be part of the final sample from those entities were selected. Units consisted of towns or local entities in the national territory. The sample size was 619 selected entities. Units in the second stage were households from the selected towns (8200 homes). The data allowed the calculation of energy and nutrient intakes, using food composition tables. The quality of the diet was also evaluated: the adequacy of the diet in meeting the recommended intakes for energy and nutrients; energy profile; dietary fat quality; dietary protein quality; nutrient density; and Mediterranean diet adequacy indices. The present data were compared with previous data obtained by our research group in 1964, 1981 and 1991. RESULTS: Using the most recent data, average intake comprised milk and derivatives (379 g/person/day), fruit (310 g/person/day), vegetables and greens (302 g/person/day), cereals and derivatives (214 g/person/day), meat and meat products (179 g/day), fish (100 g/person/day), oil and fat (48 g/person/day), precooked food (34 g/person/day), eggs (32 g/person/day), and legumes and pulses (11.9 g/person/day). There was also a high consumption of non-alcoholic beverages (433 g/person/day) and alcoholic beverages (247 g/person/day). In consequence, meat and meat product consumption was higher than the recommendations, whereas for cereals and their derivatives, vegetables and greens, fruit, and legumes and pulses, consumption was below recommendations for the Spanish population. Some staple and traditional Mediterranean foods (bread, potatoes and olive oil) showed a dramatic decline when compared with data from Household Budget Surveys in 1964 data. Energy intake declined by about 300 kcal/person/day, when compared with the 1964 mean consumption. Insufficient nutrient intakes were found in the young adult population for zinc and folic acid in both sexes, and for iron in women, when compared with dietary reference values. CONCLUSIONS: Food consumption patterns in Spain and energy and nutrient intakes have changed markedly in the last 40 years, differing at present from the traditional and healthy Mediterranean diet.

[Nutritional planning of menus of public schools of the community of Madrid]. / Planificación nutricional de los menús escolares para los centros públicos de la Comunidad de Madrid.

Some nutritional unbalances have been observed in menus served at dining rooms of schools from the Community of Madrid (CM): small portions, inter-day variations up to 50% of energy intake, unbalances in caloric and lipidic profiles, little variety, lack of parental information, etc. The Education Council of the CM considered necessary to plan and regulate the basic conditions that menus of these dinning rooms should meet. The Spanish Nutrition Foundation (FEN) and the Nutrition Department of the Complutense University of Madrid (UCM) were put in charge of elaborating the bases to develop the Regulation (BOCM 24-05-01, 10-09-02). Collective catering companies were called for a tender to provide menus adapted to such Regulation. This work describes the adaptation of programmed dietary schemes of officially approved companies and mainly the impact on energy and nutritional content of menus and their adaptation to the recommended caloric and lipidic profiles. So far, a random sample of 171 schools with dining rooms (more than 37,000 schoolboys) has been visited by nutritionists, with no previous announcement, to control served menus. For this, at each centre a duplicate of the portion served that day was gathered. The energy and nutrient content was determined and the fatty acid composition was analysed. The adaptation to the Regulation by catering companies has substantially improved the menus as compared to previous times: more presence of vegetables, better quality of fat and less amount of fat and proteins at the expense of carbohydrates.

Planificación nutricional de los menús escolares para los centros públicos de la Comunidad de Madrid / Nutritional planning of menus of public schools of the Community of Madrid

En los menús servidos en los comedores de los colegios públicos de la Comunidad de Madrid (CM) se venían detectando algunos desequilibrios nutricionales: cantidades insuficientes, desviaciones interdías de hasta el 50% de energía, desequilibrio en los perfiles calórico y lipídico, poca variedad, desinformación de los padres, etc. La Consejería de Educación de la CM, consideró necesario planificar y regular las condiciones básicas que deben reunir los menús para dichos comedores. La Fundación Española de la Nutrición (FEN) junto con el Departamento de Nutrición de la UCM, fueron los encargados de elaborar las bases para desarrollar la Normativa (BOCM 24-05-01, 10-09-02). Se convocó a las empresas de restauración colectiva a un concurso para el suministro de menús adaptados a dicha Normativa. En este trabajo se describe la adaptación a las pautas dietéticas programadas de las empresas homologadas y, principalmente, su repercusión en el aporte energético y nutricional de los menús así como la adecuación a los perfiles calórico y lipídico recomendados. Además, y hasta el momento, una muestra aleatoria de 171 centros, con servicio de comedor (más de 37.000 escolares), han sido visitados, sin anuncio previo de la fecha, por nutriólogos para llevar a cabo el control de los menús servidos. Para ello, en cada centro se recogió la porción duplicada del menú servido ese día. Se determinó su contenido en energía y nutrientes y se analizó su composición en ácidos grasos. La adaptación por parte de las empresas de restauración a la normativa fijada ha mejorado sustancialmente los menús respecto a periodos anteriores: mayor presencia de verduras y hortalizas, mejor calidad de la grasa y menor cantidad de grasas y proteínas a expensas de hidratos de carbono (AU)

Some nutritional unbalances have been observed in menus served at dining rooms of schools from the Community of Madrid (CM): small portions, inter-day variations up to 50% of energy intake, unbalances in caloric and lipidic profiles, little variety, lack of parental information, etc. The Education Council of the CM considered necessary to plan and regulate the basic conditions that menus of these dinning rooms should meet. The Spanish Nutrition Foundation (FEN) and the Nutrition Department of the Complutense University of Madrid (UCM) were put in charge of elaborating the bases to develop the Regulation (BOCM 24-05-01, 10-09-02). Collective catering companies were called for a tender to provide menus adapted to such Regulation. This work describes the adaptation of programmed dietary schemes of officially approved companies and mainly the impact on energy and nutritional content of menus and their adaptation to the recommended caloric and lipidic profiles. So far, a random sample of 171 schools with dining rooms (more than 37,000 schoolboys) has been visited by nutritionists, with no previous announcement, to control served menus. For this, at each centre a duplicate of the portion served that day was gathered. The energy and nutrient content was determined and the fatty acid composition was analysed. The adaptation to the Regulation by catering companies has substantially improved the menus as compared to previous times: more presence of vegetables, better quality of fat and less amount of fat and proteins at the expense of carbohydrates (AU)

Concentraciones plasmáticas de carotenos y vitaminas antioxidantes en personas de edad avanzada: influencia del tabaquismo. Proyecto HALE / Plasma concentrations of carotene and antioxidant vitamins in elderly people: the influence of smoking. HALE project

Introducción. Los carotenos y las vitaminas antioxidantes se asocian con un menor riesgo de aterosclerosis y enfermedad coronaria. Hay estudios que apoyan que el hábito tabáquico modifica el estado nutricional de estos micronutrientes. En este estudio se analizan las concentraciones plasmáticas de los carotenos y las vitaminas antioxidantes en varones y mujeres no fumadores, ex fumadores y fumadores. Pacientes y métodos. Se seleccionó aleatoriamente para participar en el estudio base (1988-1989) del proyecto SENECA (Survey in Europe on Nutrition and the Elderly, a Concerted Action), de la Unión Europea, a 2.200 habitantes de 19 ciudades europeas, Hamme (Bélgica), Roskilde (Dinamarca), Chateau Renault-Amboise, Haguenau y Romans (Francia), Markopoulo (Grecia), Anogia-Archanes (Creta), Monor (Hungría), Padua, Fara Sabina-Magliano y Sabina-Poggio Mirteto (Italia), Culemborg (Países Bajos), Elverum (Noruega), Vila Franca de Xila (Portugal), Betanzos (España), Yverdon-les-Bains, Burdorf y Bellinzona (Suiza), 1.091 varones y 1.109 mujeres, nacidos entre 1913 y 1918. El hábito tabáquico fue valorado usando un cuestionario estandarizado y categorizado en no fumadores, ex fumadores y fumadores. Se llevó a cabo una extracción de sangre y en laboratorios centrales determinaron los marcadores bioquímicos: concentraciones plasmáticas de carotenos, retinol y *-tocoferol con cromatografía líquida de alta presión (HPLC), y del ácido fólico mediante radioinmunoanálisis. El análisis estadístico de los datos se llevó a cabo con el programa R-SIGMA 2. Resultados. Los varones fumadores presentaron concentraciones (P50) más bajas de carotenos (0,34 µmol/l; p 30 µmol/l y cocientes de vitamina E/colesterol > 5,2 mmol/mol, con efectos protectores frente a enfermedades cardiovasculares según distintos estudios epidemiológicos entre los no fumadores que entre los fumadores. Conclusiones. A la vista de estos resultados la primera medida terapéutica debe ir dirigida al cese del consumo de tabaco. Los fumadores deberían consumir una dieta rica en frutas y vegetales con elevado contenido en vitaminas antioxidantes que les permitiera igualar el estado nutricional de estos micronutrientes al del grupo de los no fumadores

Introduction. Carotene and antioxidant vitamins are associated with lower arteriosclerotic risk and coronary disease. This association is supported by studies showing that smoking modifies the nutritional status of these micronutrients. Plasma levels of carotene and antioxidant vitamins in non-smokers, former smokers, and current smokers were analysed. Patients and methods. 2,200 elderly inhabitants 1,091 men, 1,109 women born between 1913 and 1918 of 19 European towns: Hamme (Belgium); Roskilde (Denmark); Chateau Renault-Amboise, Haguenau and Romans (France); Markopoulo (Greece); Anogia-Archanes (Crete); Monor (Hungary); Padua, Fara Sabina-Magliano Sabina-Poggio Mirteto (Italy); Culemborg (The Netherlands); Elverum (Norway); Vila Franca de Xila (Portugal); Betanzos (Spain); Yverdon-les-bains, Burdorf and Bellinzona (Switzerland) were randomly selected to participate in the baseline study (1988-1989) of the SENECA project (Survey in Europe on Nutrition and the Elderly, a Concerted Action) from the European Union. Smoking was assessed using a standardised questionnaire and categorised as-non, former and current smoker. Blood samples were collected and biochemical parameters: plasma levels of carotene, retinol and a-tocopherol by HPLC and folic acid by radioimmuno assay kits were measured at central laboratories, according to a strictly standardised methodology. Statistical analysis was perfomed out using the R-SIGMA 2 programme. Results. Male current smokers had levels (P50) of carotene (0.34 µmol/l; p < 0.001) and retinol (1.98 µmol/l; p < 0.01) lower than non-smokers (0.53; 2.0 µmol/l), respectively, whereas intermediate levels were observed in former smokers; carotene was the strongest parameter related to smoking consumption (r = -0.170; p < 0.006; Spearman). The marginal and deficient levels were less prevalent among non-smokers. a-tocopherol levels over 30 µmol/l or a-tocopherol/cholesterol ratios over 5.2 mmol/mol, with protective effects against cardiovascular disease, were more prevalent among non-smokers than current smokers. Conclusions. According to the results, smoking cessation would be the first measure advised. Current smokers, even former smokers, would require a diet rich in fruit and vegetables with a high antioxidant vitamin content, which would allow them to achieve the same nutritional status as non-smokers

Synaptic behaviour of hexaploid wheat haploids with different effectiveness of the diploidizing mechanism.

Haploids of three cultivars of Triticum aestivum (Thatcher, Chris, and Chinese Spring) were obtained from crosses with Zea mays. The level of chromosome pairing at metaphase I and the synaptic behaviour at prophase I was studied. There were differences in the meiotic behaviour of the haploids from different cultivars. Thatcher and Chris haploids had significantly higher levels of pairing at metaphase I than Chinese Spring haploids. This metaphase I pairing was correlated with higher levels of synapsis achieved in the Thatcher and Chris prophase I nuclei than in the Chinese Spring nuclei. Variation in the effectiveness of the diploidizing mechanism among cultivars of wheat is proposed to have a genetic origin and the role of the Ph1 locus in the different haploids is discussed.

[Comparison of 4 anesthetic techniques for in vitro fertilization]. / Comparación de cuatro técnicas anestésicas para fecundación in vitro.

UNLABELLED: Little is known of the effect on oocytes of anesthesia administered during retrieval. The main objective of this study was to compare the prolactin and stress hormone responses to surgical stimulus under 4 anesthetic techniques and to determine whether there is an effect of technique on the number and quality of oocytes retrieved. METHODS: We designed a clinical trial to determine the plasma and follicular levels of prolactin and cortisol in patients in an assisted reproduction program. The patients were randomized to 3 anesthetic groups: general anesthesia, spinal anesthesia, or sedation with alfentanil and midazolam plus paracervical block. Patients were consecutively assigned to the fourth group to receive sedation with remifentanil plus paracervical block. RESULTS: We studied 90 patients. The patients receiving general anesthesia had the greatest increase in prolactin by the end of the procedure. Follicular cortisol increased in the paracervical block group in which remifentanil was used for sedation. The only significant difference between groups was seen for the rate of gestation of 0% in the group receiving sedation with alfentanil and midazolam before a paracervical block. Adverse effects were few with all the techniques. All patients reported a high degree of satisfaction. CONCLUSIONS: Plasma increases in prolactin and hormonal responses to follicular puncture were fully attenuated by spinal anesthesia and partially attenuated by the techniques requiring sedation. None of the anesthetic techniques proved harmful to oocytes or embryos. Nor was the effectiveness of the in vitro fertilization technique affected by any of the anesthetic techniques studied.

Comparación de cuatro técnicas anestésicas para fecundación in vitro / Comparison of 4 anesthetic techniques for in vitro fertilization

El posible efecto de la anestesia administrada para la recuperación de ovocitos, en su funcionalidad, no es bien conocido. El objetivo principal de este trabajo es comparar los efectos sobre la respuesta de la prolactina y de las hormonas de estrés al estímulo quirúrgico de cuatro técnicas anestésicas diferentes y determinar si estas variaciones influyen en el número y calidad de ovocitos METODOLOGÍA: Diseñamos un ensayo clínico para determinar los niveles plasmáticos y foliculares de prolactina (PRL) y cortisol en pacientes programadas para técnicas de reproducción asistida (TRA). Distribución aleatoria en tres de ellos, y consecutiva en el grupo III. Grupo I: Anestesia general; Grupo II: Anestesia espinal; Grupo III: Sedación (remifentanilo)+bloqueo paracervical; Grupo IV: Sedación (alfentanilo+midazolam)+bloqueo paracervical. RESULTADOS: Se estudiaron 90 pacientes. La elevación de PRL es máxima en el grupo I al final del procedimiento. Aumenta el cortisol folicular en el grupo III. No hemos encontrado diferencias entre los grupos en las tasas salvo la tasa de gestación en el grupo IV 0%. Los efectos indeseables fueron escasos con todas las técnicas. Todas las pacientes tienen un elevado grado de satisfacción. CONCLUSIONES: El aumento de prolactina plasmática, respuesta hormonal de las pacientes a la punción folicular, queda totalmente atenuado por la anestesia espinal y parcialmente por la sedación. Ninguna técnica anestésica ha demostrado ser deletérea para los ovocitos ni para los embriones ni ha disminuido la eficacia del procedimiento de fecundación in vitro

Little is known of the effect on oocytes of anesthesia administered during retrieval. The main objective of this study was to compare the prolactin and stress hormone responses to surgical stimulus under 4 anesthetic techniques and to determine whether there is an effect of technique on the number and quality of oocytes retrieved. METHODS: We designed a clinical trial to determine the plasma and follicular levels of prolactin and cortisol in patients in an assisted reproduction program. The patients were randomized to 3 anesthetic groups: general anesthesia, spinal anesthesia, or sedation with alfentanil and midazolam plus paracervical block. Patients were consecutively assigned to the fourth group to receive sedation with remifentanil plus paracervical block. RESULTS: We studied 90 patients. The patients receiving general anesthesia had the greatest increase in prolactin by the end of the procedure. Follicular cortisol increased in the paracervical block group in which remifentanil was used for sedation. The only significant difference between groups was seen for the rate of gestation of 0% in the group receiving sedation with alfentanil and midazolam before a paracervical block. Adverse effects were few with all the techniques. All patients reported a high degree of satisfaction. CONCLUSIONS: Plasma increases in prolactin and hormonal responses to follicular puncture were fully attenuated by spinal anesthesia and partially attenuated by the techniques requiring sedation. None of the anesthetic techniques proved harmful to oocytes or embryos. Nor was the effectiveness of the in vitro fertilization technique affected by any of the anesthetic techniques studied

[Age-related changes in the dietary intake of elderly individuals. The Euronut-SENECA study]. / Cambios con la edad en la ingesta dietética de personas de edad avanzada. Estudio Euronut-SENECA.

There are few longitudinal studies linking eating habits, diets, nutritional content and their repercussions on health. For this reason, the European Union's Concerted Action on Nutrition and Health, Euronut, organized an international, multi-centric longitudinal cohort study in 1988 in an attempt to analyze these factors in various food cultures of Europe. This study was given the name SENECA (Survey in Europe on Nutrition and the Elderly: a Concerted Action). To this end, several types of tests were performed: a general questionnaire (collecting information on: personal details, social and demographic status, socio-economic situation, lifestyle and physical activity and dietary or other living habits), a dietary study, anthropometric and biochemical parameters. The present paper has attempted to assess the differences due to gender and age (in the same subjects), for which purpose data has been collated from a group of individuals between 71 and 80 years of age on the quantitative and qualitative food consumption, energy and nutrient intake and their contribution to the recommended daily intake. The four groups of foods most consumed in both parts of the study were: fruit, milk and its derivatives, vegetables, and cereals and their derivatives, during the four years that have elapsed, a significant reduction was seen in the consumption of certain foods, both in the total of the sample and for the distribution by gender. As a result, with a four-year increase in age, i.e. in the second part of the study, a reduction in energy intake was observed to have a considerable impact on the intake of most micronutrients. The percentile distribution shows that there are individuals who consume very small amounts (or nothing at all) of certain foods. High percentages of individuals were seen not to cover the recommended intake.

Cambios con la edad en la ingesta dietética de personas de edad avanzada. Estudio Euronut-SENECA / Are-related changes in the dietary intake of elderly individuals. Euronutseneca study

Existen pocos estudios longitudinales que relacionen hábitos alimentarios, dietas, contenido nutricional y su repercusión en la salud. Por ello, Euronut, la Acción Concertada de la UE sobre Nutrición y Salud, organizó en 1988 un estudio longitudinal, de cohortes, internacional y multicéntrico, para tratar de analizar estos factores en diversas culturas alimentarias europeas. Este estudio recibió el nombre de SENECA (Survey in Europe on Nutrition and the Erdely: a Concerted Action). Para ello, se realizaron varios tipos de pruebas: cuestionario general (recogía información sobre: datos personales, situación sociodemográfica, situación socioeconómica, estilo de vida y actividad física y hábitos de vida y dietéticos), un estudio dietético, parámetros antropométricos y bioquímicos.En este trabajo se han tratado de valorar las diferencias debidas al sexo y la edad (en los mismos sujetos), para lo cual se recoge información sobre el consumo cuantitativo y cualitativo de alimentos, ingesta de energía y nutrientes y su aporte a las ingestas recomendadas, en un grupo de edades comprendidas entre 71 y 80 años.Los cuatro grupos de alimentos más consumidos en ambas partes del estudio fueron frutas, leche y derivados, verduras y hortalizas y cereales y derivados. En los cuatro años transcurridos se observó una disminución significativa en el consumo de algunos alimentos, tanto en el total de la muestra como en la distribución por sexos. Como consecuencia, según aumentó la edad en cuatro años, es decir, en la segunda parte del estudio, se ha observado una disminución de la ingesta energética con repercusión importante en el de la mayoría de los micronutrientes. La distribución en percentiles muestra que existen individuos sin o con un consumo muy bajo de algunos alimentos. Se observaron porcentajes elevados de personas que no cubren las ingestas recomendadas (AU)

There are few longitudinal studies linking eating habits, diets, nutritional content and their repercussions on health. For this reason, the European Union’s Concerted Action on Nutrition and Health, Euronut, organized an international, multi-centric longitudinal cohort study in 1988 in an attempt to analyze these factors in various food cultures of Europe. This study was given the name SENECA (Survey in Europe on Nutrition and the Elderly: a Concerted Action). To this end, several types of tests were performed: a general questionnaire (collecting information on: personal details, social and demographic status, socio-economic situation, lifestyle and physical activity and dietary or other living habits), a dietary study, anthropometric and biochemical parameters. The present paper has attempted to assess the differences due to gender and age (in the same subjects), for which purpose data has been collated from a group of individuals between 71 and 80 years of age on the quantitative and qualitative food consumption, energy and nutrient intake and their contribution to the recommended daily intake. The four groups of foods most consumed in both parts of the study were: fruit, milk and its derivatives, vegetables, and cereals and their derivatives, during the four years that have elapsed, a significant reduction was seen in the consumption of certain foods, both in the total of the sample and for the distribution by gender. As a result, with a four-year increase in age, i.e. in the second part of the study, a reduction in energy intake was observed to have a considerable impact on the intake of most micronutrients. The percentile distribution shows that there are individuals who consume very small amounts (or nothing at all) of certain foods. High percentages of individuals were seen not to cover the recommended intake (AU)

Activities of daily living in the Spanish elderly. Association with mortality.

The ability to manage basic activities of daily living (ADL) is a significant predictor for being housebound, placement in a nursing home and death. The aim of the study was to assess the capacity to perform activities of daily living in the Spanish sample (30 men and 49 women aged 80-85 y) from SENECA's Finale study (1999) and changes respect to the same sample ten years ago. The total ADL score (assessed by 16 questions) and the partials (mobility ADLm and self-care ADLc) show that the total ADL average in 1999 has been 23.9+/-10.2 (p<0.05) and 25.3+/-9.6 (p<0.001), being in 1989, 18.8+/-4.4 and 19.9+/-4.8 for men and women respectively. The ADL score from deceased subjects participating in 1989 was significantly worse (p<0.01 in men and p<0.001 in women) than ADL score from survivor subjects. Activities of daily living as a measurement of functionality decline with increasing age and in our study a better ADL score was found as survival factor.

The synaptic behaviour of the wild forms of Triticum turgidum and T. timopheevii.

Different wild allopolyploid species of Triticeae show extensive bivalent formation at zygotene while a considerable number of multivalents is present in cultivated polyploid wheats. To study the chromosome behaviour at early meiotic stages in wild forms of tetraploid wheats Triticum turgidum and T timopheevii (2n = 4x = 28) we have analysed the synaptic pattern in fully traced spread nuclei at mid- and late zygotene and at pachytene of wild accessions of these species. The mean number of synaptonemal complex (SC) bivalents at mid-zygotene ranged from 12.22 to 13.14 among the accessions studied indicating a strong restriction of synapsis initiation to homologous chromosomes. The mean of bivalents increased at pachytene because of the transformation of multivalents into bivalents. Ring bivalents observed at metaphase I support that SC bivalents were formed by homologous chromosomes. The average values of SC bivalents at mid-zygotene in the wild forms are much higher than the average values observed in the cultivated tetraploid wheats but similar to that of a mutant line of T turgidum with a duplication that includes Ph1, the major homoeologous pairing suppressor locus. These results suggest that the efficiency of the mechanism operating in the homologous recognition for synapsis is higher in wild wheat populations than in cultivated varieties. Apparently, a relatively detrimental modification of the pairing regulating genetic system accompanied the domestication of the wild wheat forms.

Purification and characterization of a phytate-degrading enzyme from germinated faba beans (Vicia faba Var. Alameda).

A phytate-degrading enzyme was purified approximately 2190-fold from germinated 4-day-old faba bean seedlings to apparent homogeneity with a recovery of 6% referred to the phytase activity in the crude extract. It behaves as a monomeric protein of a molecular mass of approximately 65 kDa. The phytate-degrading enzyme belongs to the acidic phytases. It exhibits a single pH optimum at 5.0. Optimal temperature for the degradation of sodium phytate is 50 degrees C. Kinetic parameters for the hydrolysis of sodium phytate are K(M) = 148 micromol L(-1) and k(cat) = 704 s(-1) at 35 degrees C and pH 5.0. The faba bean phytase exhibits a broad affinity for various phosphorylated compounds and hydrolyzes phytate in a stepwise manner. The first hydrolysis product was identified as D/L-myo-inositol(1,2,3,4,5)pentakisphosphate.