Approach to non-compressive myeloneuropathy through a rendezvous of 11 cases from an Indian backdrop.

Introduction: Myeloneuropathy is a diagnosis ascribed to disorders that concomitantly affect the spinal cord and peripheral nerves. Recognizing this syndrome may sometimes be arduous, even for the most consummate clinicians, because symptomatology can mimic either spinal cord or peripheral nerve disease. Besides, examination findings suggest a predominantly myelopathic or neuropathic picture. This article reports a rendezvous of rare cases of clinically diagnosed myeloneuropathy with different etiological backgrounds and therapeutic responses. Methods: Eleven cases of non-compressive myeloneuropathy were admitted to the Department of General Medicine of Burdwan Medical College and Hospital, Burdwan, West Bengal, India, between May 2018 and May 2022. Results: We report the cases of 11 patients (6 men and 5 women) who presented with myeloneuropathy of different etiologies (vitamin B12, copper, and vitamin E deficiencies, organophosphate poisoning, chronic alcohol abuse, illicit substances abuse, anti-thyroid peroxidase/anti-thyroglobulin antibody-related neurologic disorder responsive to steroids, Sjögren syndrome, chikungunya infection, paraneoplastic, and hereditary). Conclusion: Meticulous historical analysis, careful clinical examination, and apposite utilization and interpretation of biochemical, electrophysiological, and neuroimaging findings are sine-qua-non for an accurate and consistent approach to evaluating a suspected case of myeloneuropathy, facilitating early treatment and recovery. Differential identification of these disorders needs an in-depth perception of the mode of onset of symptoms, the course of progression of the disease, the pattern of myelopathic/neuropathic findings, and recognition of other neurological or systemic manifestations. For untroubled understanding, etiologies of myeloneuropathies should be subdivided into a few broad categories, e.g., metabolic (nutritional), toxic (toxin-induced), infectious, inflammatory (immune-mediated), paraneoplastic, and hereditary disorders.

Introducción: La mieloneuropatía es un síndrome que afecta concomitantemente la médula espinal y los nervios periféricos. Reconocerlo a veces puede ser arduo, incluso para los médicos más experimentados, porque la sintomatología puede simular una enfermedad de la médula espinal o de los nervios periféricos. Además, los hallazgos del examen sugieren un cuadro predominantemente mielopático o neuropático. Este artículo describe una serie de casos raros de mieloneuropatía de distintas causas y con respuestas terapéuticas distintas. Métodos: Once casos de mieloneuropatía no compresiva fueron ingresados en el Departamento de Medicina General del Burdwan Medical College, and Hospital, Burdwan, Bengala Occidental, India, entre mayo de 2018 y mayo de 2022. Resultados: Presentamos 11 pacientes (seis hombres y cinco mujeres) con mieloneuropatía de diferentes etiologías (deficiencias de vitamina B12, cobre y vitamina E, intoxicación por organofosforados, abuso crónico de alcohol, abuso de sustancias ilícitas, trastorno neurológico relacionado con anticuerpos anti-tiroglobulina / antiperoxidasa tiroidea que responde a esteroides, síndrome de Sjögren, infección por chikungunya, paraneoplásico y hereditario). Conclusión: El análisis meticuloso de la historia y del examen clínico, así como la utilización e interpretación adecuadas de los hallazgos bioquímicos, electrofisiológicos y de neuroimagen son condiciones sine qua non para un enfoque preciso y consistente para evaluar un caso sospechoso de mieloneuropatía, lo que facilita el tratamiento temprano y su recuperación. El diagnóstico diferencial de esta patología requiere un conocimiento del modo de inicio de los síntomas, su progresión, el patrón de hallazgos mielopáticos/neuropáticos y el reconocimiento de otras manifestaciones neurológicas o sistémicas. Las etiologías de las mieloneuropatías deben subdividirse en trastornos metabólicos (nutricionales), tóxicos (inducidos por toxinas), infecciosos, inflamatorios (mediados por mecanismos inmunitarios), paraneoplásicos y hereditarias.

Thrombotic Event Prevention in Patients Undergoing Posterior Lumbar Arthrodesis: our experiencie. A retrospective case series study. / Prevención de eventos trombóticos en pacientes sometidos a cirugía de artrodesis lumbar por vía posterior: experiencia en nuestro centro. Estudio retrospectivo de casos.

INTRODUCTION: There is no generalized consensus regarding perioperative prophylaxis of venous thromboembolism (VTE), either on using or timing it in patients undergoing spine surgery. VTE is a current concern because, even though being an uncommon event, it can cause serious complications. The aim of the present study is to propose guidelines for the prevention of thrombotic events in posterior spinal surgery, either as deep vein thrombosis or pulmonary thromboembolism. If the number of patients getting prophylaxis drugs is reduced a subsequent reduction of the incidence of epidural hematoma can be expected. MATERIALS AND METHODS: A number of 235 patients who had undergone posterior spinal arthrodesis in the previous five years were studied. Mechanical thromboprophylaxis measures consisting of compression stockings were applied in all of them. Anticoagulant drugs were also applied whenever risk factors for thrombosis were observed. Early weight-bearing was resumed immediately after surgery. Demographic, clinical, and surgical variables were collected, as well as complications appearing during the follow-up period, that was scheduled at one, two, four, six and twelve months after the surgery. Thrombotic events, if present, were diagnosed by clinical and imaging tests such as ultrasound and CT angiography. RESULTS: From the total 235 patients of this series, one hundred and fifty-three cases met the study inclusion criteria. A total of four thrombotic events appeared, one in the form of deep vein thrombosis and other three in the form of pulmonary thromboembolism. These last patients suffering an embolism died because of it. None of the variables studied had statistical significance for the occurrence of a thrombotic event. All four patients who suffered thrombotic events were receiving anticoagulant drugs, in addition to mechanical compression stockings, because of the presence of risk factors for thrombosis. CONCLUSIONS: By applying the fore mentioned protocol, adequate prevention of thromboembolic events was achieved in this study population of patients undergoing posterior spinal surgery.

Valorisation diagnosis of waste from the decontamination of phosphogypsum leachates through a combined calcium carbonate/hydroxide process.

Phosphogypsum is an industrial waste considered as naturally occurring radioactive material. Stack disposal and exposure to the environmental condition involve the production of acid leachates with high potential pollutant loads as heavy metals and radionuclides. In this study, a sequential neutralisation process was applied for cleaning the generated releases, and the two obtained residues were characterised from the physical-chemical and radiological point of view before their valorisation. The cleaning process was made up of two steps: the first one using calcium carbonate until pH = 3.5, and the second one using calcium hydroxide until pH = 12. The residue obtained in the first step was mostly calcium fluoride, while in the second step most phosphates were precipitated, mainly as hydroxyapatite. The final liquid was treated to reduce pH lower than 9, which is the limit included in the current directive for discharges of liquid effluents into coastal waters. The main conclusion was that the solids from the first step could be valorised as an additive in the manufacture of commercial Portland cements and ceramics, while the solids from the second step could be used as raw material for the phosphoric acid manufacture.

Response of Hypothenemus hampei Ferrari (Coleoptera: Curculionidae: Scolytinae) parasitized by the nematode Metaparasitylenchus hypothenemi Poinar (Tylenchida: Allantonematidae) to different colors of light.

Metaparasitylenchus hypothenemi is a nematode that naturally parasitizes Hypothenemus hampei in a coffee-producing region in Chiapas, Mexico. This study investigated changes in the attraction of parasitized borers to light. We compared the attraction of adult H. hampei females (parasitized and uninfected) to 14 different light wavelengths (350-670 nm) with a control (570 nm, yellow) under laboratory conditions. The response ranges of non-parasitized and parasitized borers were 370-650 nm and 340-650 nm, respectively. The attraction curve showed a similar shape in both borer groups (parasitized and non-parasitized), but a wide wavelength range (380-590 nm) attracted more parasitized than non-parasitized borers. The maximum response of the uninfected borers occurred at 520 nm (green), while parasitized borers exhibited three response peaks (380 nm, violet; 460 nm, blue; 520 nm, green). Parasitized borers were significantly more attracted to green light (520 nm) than to the control. The altered attraction to light in borers parasitized by M. hypothenemi is discussed from the perspective of possible host manipulation and the natural prevalence of this parasite.

CONSTANS, a HUB for all seasons: How photoperiod pervades plant physiology regulatory circuits.

How does a plant detect the changing seasons and make important developmental decisions accordingly? How do they incorporate daylength information into their routine physiological processes? Photoperiodism, or the capacity to measure the daylength, is a crucial aspect of plant development that helps plants determine the best time of the year to make vital decisions, such as flowering. The protein CONSTANS (CO) constitutes the central regulator of this sensing mechanism, not only activating florigen production in the leaves but also participating in many physiological aspects in which seasonality is important. Recent discoveries place CO in the center of a gene network that can determine the length of the day and confer seasonal input to aspects of plant development and physiology as important as senescence, seed size, or circadian rhythms. In this review, we discuss the importance of CO protein structure, function, and evolutionary mechanisms that embryophytes have developed to incorporate annual information into their physiology.

Composition and optical properties of (In, Ga)As nanowires grown by group-III-assisted molecular beam epitaxy.

(In, Ga) alloy droplets are used to catalyse the growth of (In, Ga)As nanowires by molecular beam epitaxy on Si(111) substrates. The composition, morphology and optical properties of these nanowires can be tuned by the employed elemental fluxes. To incorporate more than 10% of In, a high In/(In+Ga) flux ratio above 0.7 is required. We report a maximum In content of almost 30% in bulk (In, Ga)As nanowires for an In/(In+Ga) flux ratio of 0.8. However, with increasing In/(In+Ga) flux ratio, the nanowire length and diameter are notably reduced. Using photoluminescence and cathodoluminescence spectroscopy on nanowires covered by a passivating (In, Al)As shell, two luminescence bands are observed. A significant segment of the nanowires shows homogeneous emission, with a wavelength corresponding to the In content in this segment, while the consumption of the catalyst droplet leads to a spectrally-shifted emission band at the top of the nanowires. The (In,Ga)As nanowires studied in this work provide a new approach for the integration of infrared emitters on Si platforms.

Responses of underground air and drip water geochemistry to meteorological factors: A multi-parameter approach in the Rull Cave (Spain).

Our research aims to assess the complex interactions between the elements that constitute and influence a cave system through the analysis of an extensive dataset of climatic and environmental parameters (222Rn, CO2, drip rates, chemical composition, and environmental isotopes) measured in air, water, and solid in the Rull Cave (southeastern Spain). Of particular importance is understanding the effect of rainfall and temperature on water and gas transport through the epikarst and the involved processes. Our results show that the cave gaseous concentration patterns do not only depend on the temperature-caused movement of air masses, but they can also be affected by abundant rainfall. The δ18O and δD composition of cave water also relies on such precipitations for the effective transfer of the rainfall signal into the cave, which can take between 3 and 7 days. The elemental ratios (Sr/Ca and Mg/Ca) show high responsiveness to the water drip rate, hinting that enhanced prior calcite precipitation (PCP) occurs at slower drip rates. Despite this, and regardless of drip rates, calcite saturation indices follow a seasonal variation pattern inversely proportional to the cave air CO2 concentration, while δ13C-DIC is proportional. Our results show how the interlinkage between these multiple components defines the dynamics of the atmosphere-soil-cave system. Cave monitoring is then essential to understand the karstic vadose zone, which is highly sensitive to climatic influence and its changes.

Furfural to Cyclopentanone - a Search for Putative Oligomeric By-products.

We report here on the reductive rearrangement of biomass-derived furfural to cyclopentanone, a promising non-fossil feedstock for fuels and chemicals. An underreported aspect of this reaction is the inevitable formation of heavy byproducts. To mitigate its formation, process condition such as, solvent, catalyst, temperature, acidity, and feed concentration were varied to unravel the chemistry and improve the reaction performance. Water medium was confirmed to play a crucial role, as organic solvents were unable to deliver cyclopentanone or heavy by products. Copper-based catalyst showed the highest selectivity for ring-rearrangement, reaching 50 mol % under the conditions investigated. The main factor influencing the yields of cyclopentanone (CPO), and promote oligomer formation, are the feed concentration and the pH, as high feed concentrations and high acidity facilitate the self-polymerization of furfuryl alcohol (FALC). This was confirmed by dedicated experiments using FALC and the hydroxypentenone intermediate as feed. The concentration challenge could be mitigated by slowly dosing the feed, which increased the desired product yields by 4-12 mol %. Nevertheless, most oligomers appeared to fall in the range of common liquid fuels and could be converted to diesel by hydrodeoxygenation.

Clast shape-fabric analysis: A comprehensive and efficient methodology to measure particle-orientation data in solid and loose volcaniclastic deposits.

Fabric analysis is essential for understanding the evolution of volcaniclastic deposits. Here we present a comprehensive and efficient methodology, called "Clast shape-fabric analysis," which is part of the Quantitative Textural Analysis (QTA). This methodology combines high-resolution image analysis techniques with geospatial data processing tools. The fabric of a deposit refers to the three-dimensional orientation of the particles with respect to space, where the degree of iso-orientation of the major axes of the particles is taken into account. The process begins with the collection of oriented samples in the field. Then, in the laboratory, the samples are processed to obtain high-resolution images. The final stage involves the analysis of these images using the FabricS program, which combines image processing techniques and circular statistics. An application of the method was made at the Joya Honda Maar in Mexico, where shape-fabric analysis was used to identify the emission centers of pyroclastic materials. In summary, the "Clast shape-fabric analysis" is a reliable, low-cost and high-potential methodology that can be applied in several geoscientific disciplines and other areas of scientific research.•New Methodology for shape-fabric analysis is presented.•The methodology involves field work, laboratory work and image analysis.•Identification of particle orientations in volcaniclastic deposits.

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.

Performance in prognostic capacity and efficiency of the Thoracic Care Suite GE AI tool applied to chest radiography of patients with COVID-19 pneumonia.

OBJECTIVE: Rapid progression of COVID-19 pneumonia may put patients at risk of requiring ventilatory support, such as non-invasive mechanical ventilation or endotracheal intubation. Implementing tools that detect COVID-19 pneumonia can improve the patient's healthcare. We aim to evaluate the efficacy and efficiency of the artificial intelligence (AI) tool GE Healthcare's Thoracic Care Suite (featuring Lunit INSIGHT CXR, TCS) to predict the ventilatory support need based on pneumonic progression of COVID-19 on consecutive chest X-rays. METHODS: Outpatients with confirmed SARS-CoV-2 infection, with chest X-ray (CXR) findings probable or indeterminate for COVID-19 pneumonia, who required a second CXR due to unfavorableclinical course, were collected. The number of affected lung fields for the two CXRs was assessed using the AI tool. RESULTS: One hundred fourteen patients (57.4±14.2 years, 65-57%-men) were retrospectively collected. Fifteen (13.2%) required ventilatory support. Progression of pneumonic extension ≥0.5 lung fields per day compared to pneumonia onset, detected using the TCS tool, increased the risk of requiring ventilatory support by 4-fold. Analyzing the AI output required 26s of radiological time. CONCLUSIONS: Applying the AI tool, Thoracic Care Suite, to CXR of patients with COVID-19 pneumonia allows us to anticipate ventilatory support requirements requiring less than half a minute.

Diseño de un modelo de ronda de seguridad para unidades de cuidados intensivos / Design of a safety round model for intensive care units

Introducción: Las rondas de seguridad (RS) son una herramienta operativa que permite conocer la adherencia a las buenas prácticas, ayuda a identificar riesgos e incidentes en seguridad del paciente (SP), permitiendo implementar acciones de mejora. El objetivo de este trabajo fue el diseño de un procedimiento para realizar RS en una unidad de cuidados intensivos (UCI). Métodos: Elaboración de un listado de verificación para el desarrollo de RS en una UCI mediante técnica de grupo nominal, con la participación de directivos, mandos intermedios y profesionales de diferentes disciplinas y categorías. En primer lugar, un grupo de expertos consensuó, atendiendo a las recomendaciones en buenas prácticas en SP, la definición de ítems, su codificación, los criterios de cumplimiento y el impacto de su incumplimiento. Posteriormente, determinó su viabilidad mediante un estudio transversal a través del pilotaje de 2 RS para ajustar los ítems en condiciones de práctica clínica real. Resultados: Se ha obtenido un modelo de RS específico para UCI mediante un listado de verificación. El grupo de expertos elaboró un primer listado compuesto por 39 ítems de 6 dimensiones esenciales y definió el modo de realización. El tiempo medio de realización de las 2 RS fue de 85minutos, incluyendo el briefing y debriefing posterior. Tras el pilotaje de validación se redujo las dimensiones a 5, se suprimió 3 ítems, se trasladó 2 ítems a otra dimensión y se modificó 3 ítems relativos a infecciones nosocomiales y consentimiento informado. Además, se redefinieron las fuentes de datos, los criterios de cumplimiento y su peso relativo. El listado definitivo fue considerado útil y relevante para mejorar la práctica. Conclusiones: Mediante una metodología de consenso se ha construido un listado de verificación para ser usado en las RS de una UCI. Este modelo puede servir de base para su empleo en servicios asistenciales de similares características.(AU)

Introduction: Safety Rounds (SR) are an operational tool that allow knowing adherence to good practices, help identify risks and incidents in patient safety (PS), allowing improvement actions to be implemented. The objective of this work was the design of a procedure to perform SR in an Intensive Care Unit (ICU). Methods: Preparation of a checklist for the development of SR in the ICU through the nominal group technique, with the participation of managers, middle managers and professionals from different disciplines and categories. In the first place, a group of experts agreed, based on the recommendations on good practices in PS, the definition of items, their coding, the criteria for compliance and the impact of non-compliance. Subsequently, its viability was determined through a cross-sectional study through the piloting of two SRs to adjust the items in real clinical practice conditions. Results: A specific SR model for ICUs has been obtained through a checklist. The group of experts prepared a first list made up of 39 items of 6 essential dimensions and defined the method of implementation. Mean time to complete the two SRs was 85minutes, including the briefing and subsequent debriefing. After the validation pilot, the dimensions were reduced to 5, 3 items were deleted, 2 items were transferred to another dimension and 3 items related to nosocomial infections and informed consent were modified. In addition, the data sources, the compliance criteria and their relative weight were redefined. The final list was considered useful and relevant to improve practice. Conclusions: Through a consensus methodology, a checklist has been built to be used in the RS of an ICU. This model can serve as a basis for its use in healthcare services with similar characteristics.(AU)

Multi-omics for studying and understanding polar life.

Polar ecosystems are experiencing amongst the most rapid rates of regional warming on Earth. Here, we discuss 'omics' approaches to investigate polar biodiversity, including the current state of the art, future perspectives and recommendations. We propose a community road map to generate and more fully exploit multi-omics data from polar organisms. These data are needed for the comprehensive evaluation of polar biodiversity and to reveal how life evolved and adapted to permanently cold environments with extreme seasonality. We argue that concerted action is required to mitigate the impact of warming on polar ecosystems via conservation efforts, to sustainably manage these unique habitats and their ecosystem services, and for the sustainable bioprospecting of novel genes and compounds for societal gain.

Differences and similarities between COVID-19 related-headache and COVID-19 vaccine related-headache. A case-control study. / Diferencias y similitudes entre la cefalea relacionada con la COVID-19 y la cefalea relacionada con la vacuna de la COVID-19. Un estudio de casos y controles.

INTRODUCTION: Headache is a frequent symptom at the acute phase of coronavirus disease 2019 (COVID-19) and also one of the most frequent adverse effects following vaccination. In both cases, headache pathophysiology seems linked to the host immune response and could have similarities. We aimed to compare the clinical phenotype and the frequency and associated onset symptoms in patients with COVID-19 related-headache and COVID-19 vaccine related-headache. SUBJECTS AND METHODS: A case-control study was conducted. Patients with confirmed COVID-19 infection and COVID-19-vaccine recipients who experienced new-onset headache were included. A standardised questionnaire was administered, including demographic variables, prior history of headaches, associated symptoms and headache-related variables. Both groups were matched for age, sex, and prior history of headache. A multivariate regression analysis was performed. RESULTS: A total of 238 patients fulfilled eligibility criteria (143 patients with COVID-19 related-headache and 95 subjects experiencing COVID-19 vaccine related-headache). Patients with COVID-19 related-headache exhibited a higher frequency of arthralgia, diarrhoea, dyspnoea, chest pain, expectoration, anosmia, myalgia, odynophagia, rhinorrhoea, cough, and dysgeusia. Further, patients with COVID-19 related-headache had a more prolonged daily duration of headache and described the headache as the worst headache ever experienced. Patients with COVID-19 vaccine-related headache, experienced more frequently pain in the parietal region, phonophobia, and worsening of the headache by head movements or eye movements. CONCLUSION: Headache caused by SARS-CoV-2 infection and COVID-19 vaccination related-headache have more similarities than differences, supporting a shared pathophysiology, and the activation of the innate immune response. The main differences were related to associated symptoms.

TITLE: Diferencias y similitudes entre la cefalea relacionada con la COVID-19 y la cefalea relacionada con la vacuna de la COVID-19. Un estudio de casos y controles.Introducción. La cefalea es un síntoma frecuente en la fase aguda de la enfermedad por coronavirus 2019 (COVID-19) y también uno de los efectos adversos más comunes tras la vacunación. En ambos casos, la fisiopatología de la cefalea parece estar relacionada con la respuesta inmunitaria del huésped y podría presentar similitudes. Nuestro objetivo fue comparar el fenotipo clínico y la frecuencia de los síntomas asociados y los síntomas de inicio en pacientes con cefalea relacionada con la COVID-19 y cefalea relacionada con la vacuna de la COVID-19. Sujetos y métodos. Se realizó un estudio de casos y controles. Se incluyó a pacientes con infección confirmada por COVID-19 y receptores de la vacuna de la COVID-19 que experimentaron un nuevo inicio de cefalea. Se administró un cuestionario estandarizado que incluyó variables demográficas, antecedentes previos de cefaleas, síntomas asociados y variables relacionadas con la cefalea. Ambos grupos se emparejaron por edad, sexo y antecedentes previos de cefaleas. Se realizó un análisis de regresión multivariante. Resultados. Un total de 238 pacientes cumplieron con los criterios de elegibilidad (143 pacientes con cefalea relacionada con la COVID-19 y 95 sujetos con cefalea relacionada con la vacuna de la COVID-19). Los pacientes con cefalea relacionada con la COVID-19 presentaron una mayor frecuencia de artralgia, diarrea, disnea, dolor torácico, expectoración, anosmia, mialgia, odinofagia, rinorrea, tos y disgeusia. Además, los pacientes con cefalea relacionada con la COVID-19 experimentaron una duración diaria más prolongada de la cefalea y describieron la cefalea como la peor que habían experimentado. Los pacientes con cefalea relacionada con la vacuna de la COVID-19 experimentaron con más frecuencia dolor en la región parietal, fonofobia y empeoramiento de la cefalea por movimientos de la cabeza o de los ojos. Conclusión. La cefalea causada por la infección por el SARS-CoV-2 y la cefalea relacionada con la vacunación de la COVID-19 presentan más similitudes que diferencias, lo que respalda una fisiopatología compartida y la activación de la respuesta inmunitaria innata. Las principales diferencias estuvieron relacionadas con los síntomas asociados.

Improvement of Magnetic Saturation in Fe3O4@Y2O3:Eu3+ Nanocomposites Through the Manipulation of Eu3+ Activators.

Fe3O4@Y2O3:Eu3+ nanocomposites and Y2O3:Eu3+ nanophosphors were synthesized using the hydrothermal method. Nanocomposites were analyzed using X-ray diffraction (XRD), Rietveld refinements, Fourier transform infrared spectroscopy (FTIR), Raman spectroscopy, photoluminescence (PL), vibrating sample magnetometer (VSM), and high-resolution transmission electron microscopy (HRTEM). Nanocomposites exhibit superparamagnetic behavior that improves with Eu3+, resulting in increased magnetic saturation. In contrast to Y2O3:Eu3+ nanophosphors, the Fe3O4@Y2O3:Eu3+ nanocomposites display a distinctive characteristic whereby the photoluminescence intensity increases with a reduced concentration of Eu3+. The requirement of increasing the thickness of the Y2O3:Eu3+ outer layer to achieve improved light emission can be circumvented by solely manipulating the concentration of activators, without compromising the magnetic saturation of the nanocomposites. The luminescent and magnetic characteristics of Fe3O4@Y2O3:Eu3+ nanocomposites can be readily optimized using straightforward synthesis parameters, making them promising candidates for potential applications in theranostic medicine.

Absceso subretiniano por Nocardia en paciente inmunodeprimido: a propósito de un caso / Subretinal abscess due to Nocardia in an immunosuppressed patient: A case report

La nocardiosis sistémica es una enfermedad poco frecuente. Su diseminación por vía hematógena al globo ocular lo es aún todavía más, con muy pocos casos documentados, por lo que su sospecha como posible diagnóstico en caso de absceso subretiniano no es la norma. Sin embargo, con unos antecedentes de inmunodepresión y enfermedad pulmonar, la imagen de fondo de ojo es enormemente indicativa. Presentamos el caso de un varón de 45 años inmunosuprimido, sin clínica pulmonar, que inició con una masa subretiniana que por su evolución es compatible con un absceso, diagnosticado etiológicamente en última instancia mediante vitrectomía como infección por Nocardia cyriacigeorgica, un patógeno emergente. Sumamos así nuestro caso, con sus peculiaridades, a otros para documentar una enfermedad que por su infrecuencia puede ser tardíamente diagnosticada (AU)

Systemic nocardiosis is a rarely occurring pathology, but its hematogenous spread across the eye is even less likely to occur, with only a few recorded cases. Therefore, it is not usually taken into account when a subretinal abscess is being considered for a diagnosis. However, when confronting a case with a history of immunosuppression and pulmonary disease, the examination of the ocular fondo may be a very successful approach. With such aim we introduce the case of a 45-year-old immunosuppressed male, without a history of pulmonary disease, whose subretinal mass evolution is accordant with an abscess. In the end, being etiologically diagnosed by means of a vitrectomy, it was concluded that the abscess was due to an infection of Nocardia cyriacigeorgica, an emergent pathogen. Thus the aforementioned case is to be considered in the present study, along others, in order to shed more light on a disease which may not be readily diagnosed on account of its infrequency (AU)

The MIGREX study: Prevalence and risk factors of sexual dysfunction among migraine patients.

BACKGROUND: Migraine attacks have a high impact on daily activities. There is limited research on the burden of migraine on sexual functioning. OBJECTIVE: To determine the prevalence of sexual dysfunction in patients with migraine and its relationship with migraine features and comorbidities. METHOD: This is a cross-sectional study. We included migraine patients between 18 and 60 years-old from 8 Headache Clinics in Spain. We recorded demographic data and migraine features. Patients fulfilled a survey including comorbidities, Arizona Sexual Experiences Scale, Hospital Anxiety and Depression Scale and a questionnaire about migraine impact on sexual activity. A K-nearest neighbor supervised learning algorithm was used to identify differences between migraine patients with and without sexual dysfunction. RESULTS: We included 306 patients (85.6% women, mean age 42.3±11.1 years). A 41.8% of participants had sexual dysfunction. Sexual dysfunction was associated with being female (OR [95% CI]: 2.42 [1.17-5.00]; p<0.001), being older than 46.5 years (4.04 [2.48-6.59]; p<0.001), having chronic migraine (2.31 [1.41-3.77]; p=0.001), using preventive medication (2.45 [1.35-4.45]; p=0.004), analgesic overusing (3.51 [2.03-6.07]; p<0.001), menopause (4.18 [2.43-7.17]; p<0.001) and anxiety (2.90 [1.80-4.67]; p<0.001) and depression (6.14 [3.18-11.83]; p<0.001). However, only female gender, age, menopause and depression were the statistically significant variables selected in the model to classify migraine patients with or without sexual dysfunction (Accuracy [95% CI]: 0.75 (0.62-0.85), Kappa: 0.48, p=0.005). CONCLUSIONS: Sexual dysfunction is frequent in migraine patients visited in a headache clinic. However, migraine characteristics or use of preventive medication are not directly associated with sexual dysfunction. Instead, risk factors for sexual dysfunction were female gender, higher age, menopause and depression.