Variaciones en la incidencia de bronquiolitis tras la aparición del SARS-CoV-2 / Variations in the incidence of bronchiolitis after the onset of SARS-CoV-2

Introducción. Durante la temporada 2020-2021 se ha asistido a una disminución de la incidencia de hospitalizaciones por bronquiolitis. Los cambios en la evolución de la pandemia de SARS-CoV-2 y en la aplicación de medidas preventivas podrían relacionarse con un aumento de la incidencia de bronquiolitis grave durante la temporada 2021-2022. Objetivo. Determinar la incidencia de hospitalizaciones por bronquiolitis en un hospital terciario durante la temporada 2021-2022 y compararla con temporadas previas. Método. Estudio epidemiológico de tipo observacional, descriptivo y ambispectivo. A través de la base de datos de un hospital terciario, se compararon la incidencia, la etiología y los indicadores de gravedad de las hospitalizaciones por bronquiolitis. Se analizaron 3 cohortes en época epidémica: la temporada 2020-2021 y la 2021-2022 (prospectivas); y la temporada 2018-2019 (retrospectiva). También se analizó una cohorte prospectiva entre los meses de abril y octubre de 2021. Resultados. La incidencia acumulada de hospitalizaciones fue de 113,6/10.000 niños menores de 2 años en la temporada pre-covídica; de 3,6/10.000 en la temporada 2020-2021; y de 65,7/10.000 en la temporada 2021-2022. El porcentaje de ingresos en UCIP fue de 36,6%, 0 % y 30,8%, respectivamente. La incidencia acumulada de hospitalizaciones en el periodo no epidémico fue de 60,8/10.000, precisando ingreso en UCIP el 19%. El microorganismo más frecuente fue el virus respiratorio sincitial en todas las cohortes. Conclusiones. La incidencia durante los meses típicamente epidémicos de bronquiolitis bajó drásticamente la temporada en la que apareció el SARS-CoV-2, aumentando notablemente el año posterior, aunque sin alcanzar la incidencia previa a la pandemia. Se ha observado una incidencia alta de casos de bronquiolitis entre abril y octubre de 2021 (AU)

Introduction. A decrease has been observed during the 2020-2021 season in the incidence of hospitalizations for bronchiolitis. Changes in the evolution of the SARS-CoV-2 pandemic and in the application of preventive measures could be related to an increase in the incidence of severe bronchiolitis during the 2021-2022 season. Objective. To determine the incidence of bronchiolitis hospitalizations in a tertiary hospital during the 2021-2022 season and to compare it with previous seasons. Method. An observational, descriptive and ambispective epidemiological study. A tertiary hospital database was used to compare the incidence, etiology, and severity indicators of bronchiolitis hospitalizations. 3 cohorts were analyzed in epidemic times: the 2020-2021 season and the 2021-2022 season (prospective); and the 2018-2019 season (retrospective). A prospective cohort between the months of April and October 2021 was also analyzed. Results. The cumulative incidence of hospitalizations was 113.6/10,000 children under 2 years of age in the pre-covid season; 3.6/10,000 in the 2020-2021 season; and 65.7/10,000 in the 2021-2022 season. The percentage of admissions in PICU was 36.6%, 0% and 30.8%, respectively. The cumulative incidence of hospitalizations in the non-epidemic period was 60.8/10,000, with 19% requiring admission to the PICU. The most frequent microorganism was the respiratory syncytial virus in all cohorts. Conclusions. The incidence during the typically epidemic months of bronchiolitis drastically decreased the season in which SARS-CoV-2 appeared, noticeably increasing the next year, although without reaching the pre-pandemic incidence. A high incidence of bronchiolitis cases was observed between April and October 2021 (AU)

Characterization of the genomic responses in early Senegalese sole larvae fed diets with different dietary triacylglycerol and total lipids levels.

The aim of this work was to evaluate the genomic responses of premetamorphic sole larvae (9 days post-hatching, dph) fed diets with different lipid and triacylglycerol (TAG) content. For this purpose, two diets with high (rotifers enriched with a fish oil-based emulsion; referred to as HTAG) and low (rotifers enriched with a krill oil-based emulsion; LTAG) levels of total lipids and TAG were evaluated. Lipid class and fatty acid (FA) profiles, histological characterization of intestine, liver and pancreas and expression patterns using RNA-seq were determined. Discriminant analysis results showed that larvae could be clearly differentiated on the basis of their FA profile as a function of the diet supplied until 9dph although no difference in growth was observed. RNA-seq analysis showed that larvae fed HTAG activated coordinately the transcription of apolipoproteins (apob, apoa4, apoc2, apoe, and apobec2) and other related transcripts involved in chylomicron formation, likely to facilitate proper lipid absorption and delivery. In contrast, larvae fed LTAG showed higher mRNA levels of several pancreatic enzymes (try1a, try2, cela1, cela3, cela4, chym1, chym2, amy2a and pnlip) and appetite modulators (agrp1) and some intra- and extracellular lipases. Moreover, KEGG analysis also showed that several transcripts related to lipid metabolism and glycolysis were differentially expressed with a higher abundance in larvae fed LTAG diet. All these data suggest that early larvae were able to establish compensatory mechanisms for energy homeostasis regulating key molecules for FA and TAG biosynthesis, FA uptake and intracellular management of TAG and FA to warrant optimal growth rates.

In vivo genotoxicity and stress defences in three flatfish species exposed to CuSO4.

We have used the comet assay to analyse, after 3h, 24h and 6 days, the genotoxic effect in vivo of applying a single intraperitoneal injection of CuSO4, at a concentration of 2mg/kg, to adult specimens of Solea senegalensis, Dicologlossa cuneata and Scophthalmus rhombus. Metals content (Cu, Zn and Cd) in liver was also measured. The activity of key stress defences was evaluated by analysing antioxidant enzyme activity (catalase (CAT), superoxide dismutase (SOD), total glutathione peroxidase (t-GPX), glutathione reductase (GR), glucose-6-phosphate dehydrogenase (G6PDH) and 6-phosphogluconate dehydrogenase (6PGDH)), metallothionein (MT) and heat shock proteins (HSP70 and HSP60). The results show that CuSO4 intake generates high and cumulative levels of genotoxicity throughout the 6 days in all 3 species. After 6 days, metals content detected in specimens showed significant differences from controls. Inter-species differences were detected in enzyme activity (P<0.05). A clear response to CuSO4 was detected only in S. rhombus, with an increase of MT and a decrease of HSPs. Variations in antioxidant defence levels and their comparative responses to the stress-inducing agent are discussed.

Manía secundaria tras traumatismo craneal / Secondaty mania after head injury

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[The work situation of specialists in family and community medicine educated in Asturias]. / Situación laboral de los especialistas en medicina familiar y comunitaria formados en Asturias.

OBJECTIVE: To find out the employment situation and the career level of family doctors (FD) trained through residency in Asturias. DESIGN: A descriptive crossover study carried out with a self-filled questionnaire returned by mail. SETTING: All of Spain. PARTICIPANTS: FDs trained through residency in Asturias up to 1993. MEASUREMENTS AND MAIN RESULTS: 178 (89%) of the 200 FDs located replied. 8 who had not finished their course were excluded. Between 1979 and 1983 42 people began their training (24.7%); 42(24.7%) between 1984 and 1987; and 86 (50.5%) between 1988 and 1991. 96 worked in health centres (56.4%); 30 in hospital casualty (17.6%); 9 in administration and management (5.2%); 16 were unemployed (9.4%) and 8 in other posts (4.7%). 49 FD had a permanent post (28.8%); 32 of these had started their training before 1984. 63 (37.5%) chose family and community medicine (FCM) as a vocation. Of these, 26 began their training between 1979 and 1983, 17 between 1984 and 1987 and 20 after 1988. A significant relationship was found between starting training in 1984 or before and choosing FCM as a vocation; and also between starting FCM training in 1984 or before and having a stable job. CONCLUSIONS: The more recent FCM students had less vocational motivation for their choice of FCM and greater difficulty in obtaining a stable job, which may lead to progressive disenchantment with FCM.