Social Health and Its Influence on Metabolic Health Among a Rural Population: A Cross-Sectional Study.

The aim of this study was to estimate the prevalence of metabolic syndrome (MetS) in a Spanish rural population and assess differences in prevalence according to loneliness level, social isolation, and social support. This is a cross-sectional study of 310 patients. MetS was defined by National Cholesterol Education Program-Third Adult Treatment Panel. The UCLA (University of California, Los Angeles) Loneliness Scale, Multidimensional Scale of Social Support, and Lubben Social Network Scale were used to assess loneliness, perceived social support, and social isolation. Almost half of the participants fulfilled MetS diagnosis criteria. Subjects with MetS showed significantly higher levels of loneliness, less social support, and greater social isolation. Systolic blood pressure was significantly higher in socially isolated rural adults. Environmental factors may play a key role in the prevalence of MetS, so specific screening and prevention programs could help health professionals prevent the increasing rates of MetS in rural populations under these socially specific conditions of vulnerability.

The 5-STS is a prognostic factor of sub-acute stroke patients who will not become community walkers at discharge from rehabilitation.

BACKGROUND: The recovery of community ambulation is a common concern among individuals after stroke. OBJECTIVES: (1) To develop a potential readily applicable prognostic model able to correctly discriminate stroke patients who will not become independent community walkers at discharge; (2) To investigate the effects of early reassessment during the first month of treatment on the prediction accuracy of this model. METHODS: This was a prospective cohort study. A consecutive sample of 80 patients at ≤60 days poststroke were assessed at baseline of outpatient physical rehabilitation and reassessed one month later. Non-functional community ambulation was measured. RESULTS: Seventy-four patients were followed until discharge. Of these, 47 patients were non-functional community walkers at discharge. A prediction model based on baseline performance in the five repetition sit-to-stand [5-STS] test was able to discriminate those patients of the sample (Area-under-curve = 0.956), and again with data from reassessment (AUC = 0.952). A time of 21 s at baseline was a highly prognostic cut-off point for discrimination (sensitivity = 87.2% and 85.1%). The combined use of baseline and reassessment data improved sensitivity (98.1%)CONCLUSION:Early findings of the 5-STS among stroke patients is an independent prognostic factor associated with independent community walking at discharge. It could discriminate individuals who will not become community walkers at discharge.

Variation in perceived health across gender, working status, educational level, and regional health care expenditure in Spain (2014-2017).

A gender perspective was used to analyze whether and how education, unemployment, and per capita public health expenditure were associated with perceived health among the Spanish population between the years 2014 and 2017. Using multilevel methodologies (looking at year, individual, and region) and linear and logistic specifications, we analyzed longitudinal microdata files from the Survey on Living Conditions. The results suggest that women with lower educational levels tend to report worse health than their more educated counterparts. On the other hand, women's bad health was not associated with unemployment, unlike men's. Regional per capita public health expenditure was not associated with perceived health in either men or women.

Prognostic value of balance performance for improvements of community ambulation among stroke patients: a cohort study.

BACKGROUND: Despite the positive impact of improving the level of community ambulation among stroke patients, little prognostic research has focused on this indicator. AIM: To investigate the prognostic value of the side-by-side, semi-tandem, and tandem standing balance positions and the five-sit-stand (5STS) test for discriminating patients undergoing physical rehabilitation who improve level of functional ambulation and predicting transition time. DESIGN: A cohort study with assessments repeated monthly until discharge for classifying patients in a community ambulation class. SETTING: A neurological rehabilitation unit of a hospital in Spain. POPULATION: A consecutive sample of 109 stroke patients (68.5±12.0 years) was screened and included within four months post stroke. Of them no one refused, 3 died, and 5 were lost earlier to transition or discharge. METHODS: Balance tests, the 5STS and gait speed were measured at the center at baseline and monthly until discharge. Transition from household or limited community ambulation to a higher ambulatory capacity or class. Area under the curve (AUC) were used to compare discriminative abilities of the tests and Cox regression analysis to evaluate the association between the tests and time of transition. RESULTS: For household non-ambulators, the semi-tandem was the best discriminative test (AUC=0.850) and the three balance tests showed an association with time to transition. Among the limited community ambulators, the 5STS test also revealed discriminative ability (AUC: 0.822 [0.63-1.00]), with a good prognostic cut-off (14.8 seconds) and association with time to transition (Hazard Ratio: 1.22; 95%CI: 1.05-1.43). CONCLUSIONS: Semi-tandem and the 5STS tests can discriminate patients who improve level of functional ambulation and predict transition times within three months in non-ambulators and limited community ambulation patients, respectively. CLINICAL REHABILITATION IMPACT: The semi-tandem and the 5STS tests can be performed easily in clinical settings to predict improvement of functional ambulation level in patients following stroke.

Proceso de atención de enfermería a un paciente pediátrico en el transcurso de una biopsia renal / Nursing care process to a paediatric patient during a renal biopsy

DESCRIPCIÓN DEL CASO: Paciente de 13 años que ingresa en hospital de tercer nivel, procedente de consultas externas de Nefrología pediátrica del mismo hospital para biopsia renal, al sufrir, en valoraciones anteriores, episodios de hematurias microscópicas persistentes, macroscópicas intermitentes y proteinuria en rango nefrótico. DESCRIPCIÓN DEL PLAN DE CUIDADOS: La unidad de enfermería pediátrica del hospital estableció un plan de cuidados inicial al ingreso y postquirúrgico ajustados a la patrones funcionales de Marjory Gordon, considerando los patrones relacionados con temor en el niño, ansiedad y cavilación de la familia, resultando de estos hechos la activación del protocolo de acogida, aumento del nivel de estrés debido a modificación ingesta alimentos, aumentar el afrontamiento en la fase postquirúrgica así como dolor, riesgo de infección, disconfort, sobrepeso por alimentación insana y hematurias postbiopsia. EVALUACIÓN DEL PLAN: Durante el ingreso hospitalario de 4 días previo a la biopsia se le realizaron pruebas bioquímicas de sangre y orina de 24 horas y estudio de anemia. Los progenitores se mostraban muy interesados por la evolución de las pruebas y como contener la ansiedad y tener calmado al hijo debido al conocimiento de que le harían una punción. Mientras se encontraba hospitalizado no cumplía los requisitos nutricionales. Al día siguiente de la biopsia fue dado de alta con unas pautas para comenzar con una alimentación más sana. CONCLUSIONES: La taxonomía NANDA/NOC/NIC permite trabajar en la enfermería basada en los hallazgos, dando respuesta a las necesidades reales de los pacientes para contribuir a mejorar la práctica clínica

CLINICAL CASE: A 13-year-old patient admitted to a third-level hospital from paediatric nephrology outpatient clinics for a renal biopsy after suffering, in previous evaluations, episodes of intermittent macroscopic and persistent microscopic haematuria and nephrotic-range proteinuria. DESCRIPTION OF THE CARE PLAN: The hospital paediatric nursing unit established an initial care plan on admission and after surgery adjusted to Gordon's functional patterns, considering the patterns related to fear in the child, anxiety and family melancholy, resulting in the activation of the reception protocol, increased stress level due to food intake modification, increased coping in the post-surgical phase as well as pain, risk of infection, discomfort, overweight due to unhealthy eating and post-biopsy haematuria. EVALUATION OF THE CARE PLAN: During the 4-day hospital stay prior to the biopsy, 24-hour blood and urine biochemical tests and anemia study were performed. The parents were very interested in the evolution of the tests and how to contain anxiety and keep the child calm due to the knowledge that they would do a blood puncture. While he was hospitalized, he did not meet the nutritional requirements. The day after the biopsy, he was discharged with guidelines to start a healthier diet. CONCLUSIONS: The NANDA/NOC/NIC taxonomy allows working in nursing based on findings, responding to the real needs of patients to help improve clinical practice

2011 GOLD Stages of COPD: Transitions, Predictor Factors and Comparison with 2017 GOLD Stages.

Background: Despite wide use of the Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) 2011, little is known about between-stage transitions and what factors predict worsening transitions in patients with chronic obstructive pulmonary disease (COPD). Objective: To investigate the transition frequency between GOLD 2011 stages among patients with stable COPD over a 2-year follow-up, to identify potential non-pulmonary predictor factors for worsening transitions, and to compare transition frequencies between GOLD 2011 stages and the new GOLD 2017 stages. Patients and Methods: We prospectively included 137 patients with stable COPD (mean age, 66.9 ± 8.3 years). GOLD 2011 and GOLD 2017 stages were measured at baseline, 1-year follow-up, and 2-year follow-up. To evaluate non-pulmonary variables as potential predictors of worsening transitions, we used regression models adjusted for sociodemographic, clinical, and pulmonary variables using generalized estimating equations. Results: The study period included 246 opportunities for transition, and 39 worsening transitions occurred within GOLD 2011 stages. Predictors of worsening transitions included BODE index (OR, 1.20; 95% CI, 1.00-1.44), quadriceps strength (OR, 0.87; 95% CI, 0.76-0.99), and limited mobility activities (OR, 1.02; 95% CI, 1.00-1.05). The frequency of worsening transitions for stages B and C differed between GOLD 2011 and GOLD 2017. Stages A and D were the most stable in both classifications. Conclusion: Non-pulmonary factors predicted worsening transitions among the GOLD 2011 stages of COPD severity. The choice of GOLD 2011 versus GOLD 2017 may influence transition identification, especially for stages B and C.

[Structure and metric properties of a questionnaire to measure disability in mobility activities in patients with chronic obstructive pulmonary disease (DIAMO-COPD questionnaire)]. / Estructura y propiedades métricas de un cuestionario para medir discapacidad en las actividades de movilidad en pacientes con enfermedad pulmonar obstructiva crónica (cuestionario DIAMO-EPOC).

OBJECTIVE: The aim of this study was to adapt a disability questionnaire in mobility activities (DIAMO-EPOC) incorporating scales based on the conceptual framework of the International Classification of Functioning, Disability and Health, and to examine its structure, reliability and validity in a cohort of patients with COPD. METHODS: A total of 137 patients with stable COPD were recruited. Two scales of 4 items each were designed and their structure was verified by exploratory factor analysis and multitrait scaling analysis. Additionally, reliability indices (internal consistency and test-retest) were calculated. Construct validity was analysed by known groups and convergence-divergence. RESULTS: The questionnaire had 2 scales, with 4 items each, corresponding to the domains of the International Classification of Functioning, Disability and Health "change and maintain the position of the body" and "walk and move". The reliability and internal consistency of the scales were acceptable and the test-retest was excellent with an ICC of 0.86 and 0.94, respectively. The scales showed a moderate association with dyspnoea, health status and muscle strength and a different score among participants with different physical performance in the Short Physical Performance Battery. CONCLUSIONS: The 2 scales of the DIAMO-EPOC questionnaire are one-dimensional and have a solid internal consistency, test-retest stability and validity, allowing the identification of specific areas of limited mobility in patients with COPD.

Effectiveness of an intervention in multicomponent exercise in primary care to improve frailty parameters in patients over 70 years of age (MEFAP-project), a randomised clinical trial: rationale and study design.

BACKGROUND: Physical activity may reverse frailty in the elderly, but we encounter barriers to the implementation of exercise programs in this population. Our main aim is to evaluate the effect of a multicomponent physical activity program, versus regular medical practice, on reverting pre-frailty status among the elderly, 12 months post-intervention. METHODS: Randomized parallel group multicenter clinical trial located in primary care setting, among non-dependent and pre-frail patients > 70 years old, including 190 patients (95 intervention, 95 control group). INTERVENTION: Multicomponent physical activity program (MEFAP, for its acronym in Spanish) with twelve 1.5 h-weekly sessions comprised of: 1. Informative session; 2. Exercises for improving aerobic resistance, muscle strength, propioception-balance and flexibility; and 3. Handing out of at-home exercise chart (twice/week). Main variable: pre-frailty according to the Fried phenotype. Secondary variables: sociodemographic, clinical and functional variables; exercise program adherence, patient satisfaction with the program and quality of life. We will perform an intention-to-treat analysis by comparing the retrogression from pre-frailty (1 or 2 Fried criteria) to robust status (0 Fried criteria) by the end of the intervention, 6 months and 12 months post-intervention. The accumulated incidence in each group will be calculated, as well as the relative risk (RR) and the number needed to treat (NNT) with their corresponding 95% confidence intervals. Protocol was approved by the Ethics Committee Hospital la Paz. DISCUSSION: Within the context of regular clinical practice, our results will provide evidence regarding the effects of exercise interventions on frailty among pre-frail older adults, a key population given their significant potential for functional, physical, and mental health improvement. TRIAL REGISTRATION: NCT03568084 . Registered 26 June 2018. Date of enrollment of the first participant to the trial: July 2nd 2018.

Circulating microparticles are associated with clinical severity of persistent ST-segment elevation myocardial infarction complicated with cardiogenic shock.

BACKGROUND: Cardiogenic shock (CS) is the leading cause of death in patients admitted for acute myocardial infarction (MI). Despite the recent advances in reperfusion and medical treatment mortality remains unacceptably high. Whether cells of the blood compartment in CS-patients are activated and release microparticles (cMPs) that may be both messengers and biomarkers of cell damage is not known. We aimed to investigate the cMP subtypes and parental activated cells of ST-elevation MI (STEMI)-patients complicated by CS and that of non-CS STEMI-patients (non-CS) in order to identify a cMP signature that could aid CS patient's risk stratification. METHODS: Clinically-characterized STEMI-patients with and without CS (36/group) were included. Treatment was delivered according to guidelines and included primary percutaneous coronary intervention. cMPs were characterized by triple-labeling flow cytometry using Annexin V and cell surface-specific monoclonal antibodies. RESULTS: Increased levels of leukocyte-derived (neutrophil and granulocyte origin) and platelet-derived cMPs were detected in CS compared to non-CS patients. A signature of cMPs derived from platelets, leukocytes, and endothelium discriminated CS-patients (AUC of 0.743±0.059 [95% CI: 0.628-0.859], P<0.0001) and predicted mortality in CS (AUC of 0.869±0.06 [95% CI: 0.750-0.988], P<0.0001). In CS-patients, a higher number of platelet- and monocyte-cMPs and of tissue factor-rich cMPs associated to worse myocardial blush grade and thrombolysis in myocardial infarction flow. CONCLUSIONS: cMPs derived from proinflammatory and prothrombotic cells were found to be elevated in CS-patients. In treated as per guidelines CS patients, granulocytes and neutrophils remained activated and actively shed cMPs. These cMPs were biomarkers of adverse prognosis in CS. TRANSLATIONAL ASPECT: Increased levels of leukocyte and platelet-derived circulating microparticles (cMPs) are found in cardiogenic shock (CS) patients as compared to non-CS patients. In CS-patients, a higher number of platelet- and monocyte-cMPs and a higher number of tissue factor-rich cMPs were associated to worse myocardial reperfusion. A specific prothrombotic and proinflammatory cMPs signature in cardiogenic shock (CS) patients is a potential discriminator and survival prognostic biomarker for CS, which could aid management and improve clinical outcomes.

Inflammatory Bowel Disease: Joint Management in Gastroenterology and Dermatology. / Enfermedad inflamatoria intestinal: abordaje conjunto digestivo-dermatológico.

Inflammatory bowel disease (IBD) is a complex entity that includes Crohn disease and ulcerative colitis. It is characterized by a chronic proinflammatory state of varying intensity that often leads to considerable morbidity. In the last decade, several therapeutic targets have been identified that are susceptible to the use of biological agents, including anti-tumor necrosis factor alpha antibodies, which are associated with paradoxical psoriasiform reactions in 5% of patients. Decision-making in the management of these cases requires close collaboration between the dermatologist and gastroenterologist. Inflammatory bowel disease is also associated with various other dermatologic and rheumatologic manifestations, and presents a genetic and pathogenic association with psoriasis that justifies both the interdisciplinary approach to these patients and the present review.

Availability and use of neighborhood resources by older people with osteoarthritis: Results from the European Project on OSteoArthritis.

This study examines the availability and use of neighborhood resources in relation to clinical lower limb osteoarthritis (LLOA) in older participants from six European countries. Of the 2757 participants (65-85 years), 22.7% had LLOA. Participants with LLOA made more use of places to sit (OR=2.50; CI: 1.36-4.60 in the UK), and less use of parks and walking areas (OR=0.30; CI: 0.12-0.75 in Sweden), compared to participants without LLOA, particularly in countries with high availability of resources. The results suggest that specific features of the environment impact the use of neighborhood resources by older adults with LLOA.

Impact of clinical osteoarthritis of the hip, knee and hand on self-rated health in six European countries: the European Project on OSteoArthritis.

PURPOSE: Osteoarthritis (OA) has been shown to be associated with decreased physical function, which may impact upon a person's self-rated health (SRH). Only a few studies have examined the association between OA and SRH in the general population, but to date none have used a clinical definition of OA. The objectives are: (1) To examine the cross-sectional association between clinical OA and fair-to-poor SRH in the general population; (2) To examine whether this association differs between countries; (3) To examine whether physical function is a mediator in the association between clinical OA and SRH. METHODS: Baseline data of the European Project on OSteoArthritis (EPOSA) were used, which includes pre-harmonized data from six European cohort studies (n = 2709). Clinical OA was defined according to the American College of Rheumatology criteria. SRH was assessed using one question: How is your health in general? Physical function was assessed using the Western Ontario and McMaster Universities OA Index and Australian/Canadian OA Hand Index. RESULTS: The prevalence of fair-to-poor SRH ranged from 19.8 % in the United Kingdom to 63.5 % in Italy. Although country differences in the strength of the associations were observed, clinical OA of the hip, knee and hand were significantly associated with fair-to-poor SRH in five out of six European countries. In most countries and at most sites, the association between clinical OA and fair-to-poor SRH was partly or fully mediated by physical function. CONCLUSIONS: Clinical OA at different sites was related to fair-to-poor SRH in the general population. Most associations were (partly) mediated by physical functioning, indicating that deteriorating physical function in patients with OA should be a point of attention in patient care.

Evolución del consumo de fármacos específicos para la demencia en la comunidad autónoma de Madrid durante el periodo 2002-2012 / Consumption trends for specific drugs used to treat dementia in the region of Madrid (Spain) from 2002 to 2012

Introducción: El análisis del consumo de fármacos en grandes grupos poblacionales permite ver tendencias de consumo y comparar diferentes ámbitos. Objetivo: Analizar la tendencia temporal de consumo y costes de fármacos específicos para la demencia en la comunidad autónoma de Madrid (CAM) y comparar por grupos de edad y sexo. Métodos: Estudio descriptivo, seleccionando anticolinesterásicos (N06DA) y memantina (N06DX01) dispensados en la CAM del 2002 al 2012 con cargo al Sistema Nacional de Salud. El consumo se calculó analizando la evolución de las dosis diarias definidas (DDD), con incrementos totales y anuales. El coste se estimó por precio de DDD. Para comparar el consumo por edad y sexo, se calcularon las DDD por 100 habitantes-día. Resultados: Del 2002 al 2012 se multiplicó por 6 el consumo de fármacos para la demencia. El 76,70% de los fármacos consumidos en este periodo fueron anticolinesterásicos y el 23,30% memantina. La evolución del coste estimado se multiplicó por 5,7 en 11 años (por 4 considerando utilización de fármacos genéricos). En 2012, el 2,42% de los mayores de 65 años consumió anticolinesterásicos (2,82% mujeres, 1,83% hombres) y el 0,90% memantina (1,10% mujeres, 0,61% hombres). El consumo aumentó hasta los 86-90 años (5,84% en anticolinesterásicos; 2,33% en memantina), disminuyendo posteriormente. Conclusiones: El consumo de anticolinesterásicos y memantina aumentó progresivamente, sin alcanzar en 2012 cifras equivalentes a la prevalencia poblacional de demencia. Las medidas de contención de gasto farmacéutico pueden frenar el aumento del coste, aunque este volverá a crecer si persiste la misma tendencia temporal de consumo

Introduction: Analysing drug consumption in large population groups lets us observe consumption trends and compare them between different settings. Objective: to analyse the time trends for consumption and costs of specific drugs used to treat dementia in the region of Madrid (Spain) and compare trends by sex and age cohort. Methods: Descriptive study of cholinesterase inhibitors (N06DA) and memantine (N06DX01) dispensed in Madrid between 2002 and 2012 and covered by the Spain's national health system. Consumption was calculated by analysing changes in DDD (defined daily doses) to find total and yearly increases. The cost was estimated based on DDD price. To compare consumption rates by age and sex, we calculated DDD per 100 inhabitants/day. Results: Between 2002 and 2012, consumption of drugs used to treat dementia increased sixfold. During this period, cholinesterase inhibitors accounted for 76.70% of the drugs consumed and memantine, 23.30%. The estimated cost rose by a by a factor of 5.7 over 11 years (or by a factor of 4 taking into account the use of generic drugs). In 2012, 2.42% of the patients aged 65 or over consumed cholinesterase inhibitors (women 2.82%, men 1.83%) and 0.90% consumed memantine (women 1.10%, men 0.61%). Consumption increased in age cohorts up to 86 to 90 (5.84% for cholinesterase inhibitors and 2.33% for memantine) and declined thereafter. Conclusions: Consumption of cholinesterase inhibitors and memantine gradually increased, but consumption in 2012 did not reach levels equivalent to dementia prevalence figures. Pharmaceutical expenditure restraint measures may temporarily slow the cost increase temporarily but if the same trend of consumption persists, costs will rise

Consumption trends for specific drugs used to treat dementia in the region of Madrid (Spain) from 2002 to 2012.

INTRODUCTION: Analysing drug consumption in large population groups lets us observe consumption trends and compare them between different settings. OBJECTIVE: to analyse the time trends for consumption and costs of specific drugs used to treat dementia in the region of Madrid (Spain) and compare trends by sex and age cohort. METHODS: Descriptive study of cholinesterase inhibitors (N06DA) and memantine (N06DX01) dispensed in Madrid between 2002 and 2012 and covered by the Spain's national health system. Consumption was calculated by analysing changes in DDD (defined daily doses) to find total and yearly increases. The cost was estimated based on DDD price. To compare consumption rates by age and sex, we calculated DDD per 100 inhabitants/day. RESULTS: Between 2002 and 2012, consumption of drugs used to treat dementia increased sixfold. During this period, cholinesterase inhibitors accounted for 76.70% of the drugs consumed and memantine, 23.30%. The estimated cost rose by a by a factor of 5.7 over 11 years (or by a factor of 4 taking into account the use of generic drugs). In 2012, 2.42% of the patients aged 65 or over consumed cholinesterase inhibitors (women 2.82%, men 1.83%) and 0.90% consumed memantine (women 1.10%, men 0.61%). Consumption increased in age cohorts up to 86 to 90 (5.84% for cholinesterase inhibitors and 2.33% for memantine) and declined thereafter. CONCLUSIONS: Consumption of cholinesterase inhibitors and memantine gradually increased, but consumption in 2012 did not reach levels equivalent to dementia prevalence figures. Pharmaceutical expenditure restraint measures may temporarily slow the cost increase temporarily but if the same trend of consumption persists, costs will rise.

Application of the maximum entropy principle to determine ensembles of intrinsically disordered proteins from residual dipolar couplings.

We present a method based on the maximum entropy principle that can re-weight an ensemble of protein structures based on data from residual dipolar couplings (RDCs). The RDCs of intrinsically disordered proteins (IDPs) provide information on the secondary structure elements present in an ensemble; however even two sets of RDCs are not enough to fully determine the distribution of conformations, and the force field used to generate the structures has a pervasive influence on the refined ensemble. Two physics-based coarse-grained force fields, Profasi and Campari, are able to predict the secondary structure elements present in an IDP, but even after including the RDC data, the re-weighted ensembles differ between both force fields. Thus the spread of IDP ensembles highlights the need for better force fields. We distribute our algorithm in an open-source Python code.

Radiomarcaje y estudios de biodistribución de nanopartículas poliméricas como adyuvantes para la vacunación oftálmica frente a la brucelosis / Radiolabeling and biodistribution studies of polymeric nanoparticles as adjuvants for ocular vaccination against brucellosis

Objetivo. Optimizar el radiomarcaje con 99mTc de nanopartículas de Gantrez® manosiladas y cargadas con el antígeno de Brucella ovis (Man-NP-HS) y llevar a cabo estudios de biodistribución en un ratón tras la administración de las nanopartículas por vía ocular. Material y métodos. Las Man-NP-HS se obtuvieron por el método de desplazamiento del disolvente. Se purificaron, liofilizaron y caracterizaron. A continuación, se marcaron con 74MBq de 99mTcO4− previamente reducido con una disolución ácida de cloruro de estaño, trabajando en ausencia de oxígeno y con un pH final de 4. El rendimiento del marcaje se evaluó mediante TLC. Los estudios de biodistribución se llevaron a cabo en ratones tras la administración oftálmica de la formulación y de un control de 99mTcO4− libre. Para ello, se sacrificaron los animales a las 2 y a las 24h tras la administración ocular y se contaron los órganos en un contador gamma. Resultados. Se obtuvo un rendimiento de marcaje superior al 90%. Los estudios de biodistribución de 99mTc-Man-NP-HS permitieron detectar la actividad concentrada en la mucosa nasal y ocular y el tracto gastrointestinal tanto a las 2 como a las 24h frente a la biodistribución de 99mTcO4− libre que permaneció concentrado en la piel alrededor del ojo y en el tracto gastrointestinal. Conclusión. Los estudios de biodistribución de 99mTc-Man-NP-HS tras la administración oftálmica han permitido demostrar su biodistribución en las mucosas y el tracto gastrointestinal, característica indispensable como sistema de liberación de antígenos a través de la mucosa ocular. Esto, junto con su elevada respuesta inmune, efectiva protección y no virulencia, convierte a estas nanopartículas en una vacuna ideal antibrucelosis (AU)

Purpose. To optimize radiolabeling with 99mTc of mannosylated Gantrez® nanoparticles loaded with the Brucella Ovis antigen (Man-NP-HS) and to carry out biodistribution studies in mice after ocular administration of the nanoparticles. Material and methods. Man-NP-HS nanoparticles were prepared by the solvent displacement method. They were purified, lyophilized and characterized. Following this, they were radiolabeled with 74 MBq of 99mTcO4− previously reduced with an acidic stannous chloride solution, working in absence of oxygen and at a final pH of 4. Radiolabeling yield was evaluated by TLC. Biodistribution studies were carried out in mice after ocular administration of the formulation and control of free 99mTcO4−. To do so, the animals were humanely killed at 2 and 24hours after the ocular administration and activity in organs was measured in a Gamma counter. Results. Radiolabeling yield obtained was greater than 90%. Biodistribution studies of 99mTc-Man-NP-HS showed radioactivity accumulated at 2 and 24hours in nasal and ocular mucosa and gastrointestinal tract, in contrast to biodistribution of free 99mTcO4− that remained concentrated in the skin around the eye and gastrointestinal tract. Conclusion. Biodistribution studies of 99mTc-Man-NP-HS after ocular instillation have made it possible to demonstrate its biodistribution in nasal mucosa and gastrointestinal tract. This characteristic is essential as an antigenic delivery system throughout the ocular mucosa. This, together with its elevated immune response, effective protection and intrinsic avirulence make them a suitable anti-Brucella vaccine candidate (AU)

[Radiolabeling and biodistribution studies of polymeric nanoparticles as adjuvants for ocular vaccination against brucellosis]. / Radiomarcaje y estudios de biodistribución de nanopartículas poliméricas como adyuvantes para la vacunación oftálmica frente a la brucelosis.

PURPOSE: To optimize radiolabeling with (99m)Tc of mannosylated Gantrez(®) nanoparticles loaded with the Brucella Ovis antigen (Man-NP-HS) and to carry out biodistribution studies in mice after ocular administration of the nanoparticles. MATERIAL AND METHODS: Man-NP-HS nanoparticles were prepared by the solvent displacement method. They were purified, lyophilized and characterized. Following this, they were radiolabeled with 74 MBq of (99m)TcO4(-) previously reduced with an acidic stannous chloride solution, working in absence of oxygen and at a final pH of 4. Radiolabeling yield was evaluated by TLC. Biodistribution studies were carried out in mice after ocular administration of the formulation and control of free (99m)TcO4(-). To do so, the animals were humanely killed at 2 and 24hours after the ocular administration and activity in organs was measured in a Gamma counter. RESULTS: Radiolabeling yield obtained was greater than 90%. Biodistribution studies of (99m)Tc-Man-NP-HS showed radioactivity accumulated at 2 and 24hours in nasal and ocular mucosa and gastrointestinal tract, in contrast to biodistribution of free (99m)TcO4(-) that remained concentrated in the skin around the eye and gastrointestinal tract. CONCLUSION: Biodistribution studies of (99m)Tc-Man-NP-HS after ocular instillation have made it possible to demonstrate its biodistribution in nasal mucosa and gastrointestinal tract. This characteristic is essential as an antigenic delivery system throughout the ocular mucosa. This, together with its elevated immune response, effective protection and intrinsic avirulence make them a suitable anti-Brucella vaccine candidate.

Short communication: Biological and genetic characterization of HIV type 1 subtype B and nonsubtype B transmitted viruses: usefulness for vaccine candidate assessment.

Due to the extraordinary degree of genetic diversity of HIV-1 and the structural complexity of its envelope glycoproteins, designing an effective vaccine is difficult, requiring the development of viral reagents to assess vaccine-elicited neutralizing antibodies. The aim of this study was to improve on our previously developed panel of HIV-1 strains of different genetic forms, focusing on strains from acute and recently acquired infections as the most representative of the transmitted viruses. HIV-1 primary isolates were expanded in peripheral blood mononuclear cells. Viral stocks of 40 ml each were produced. Syncytium-inducing (SI) phenotype, coreceptor use, and TCID(50)/ml were determined. Near full-length HIV-1 genomes were amplified by RT-nested PCR in four overlapping segments. Phylogenetic analyses were performed with neighbor-joining trees and bootscanning. Forty-four HIV-1 strains were included in the panel. Twenty-four (54.1%) strains were from early infections (16 acute and 8 recent); of them, 21 (87%) were sexually transmitted. NSI/R5 phenotype was detected in 37 (84.1%) viruses and SI/R5,X4 in another 7 (15.9%). TCID(50)/ml ranged between 10(4) and 10(6.6). Twelve different genetic forms constituted this panel: subtypes A1, B, C, F1, and G; circulating recombinant forms CRF02_AG, CRF14_BG, and CRF24_BG; and unique recombinant forms CRF02_AG/A3, BF1, CRF12_BF/B, and DF1G. In conclusion, in this study, we report the development of a comprehensive and well-characterized panel of HIV-1 isolates for assessing neutralization in HIV vaccine research. This panel is available for distribution through the Programme EVA Centre for AIDS Reagents, National Institute for Biological Standard and Control (NIBSC).

Incidence of non-B subtypes of HIV-1 in Galicia, Spain: high frequency and diversity of HIV-1 among men who have sex with men.

An increase in HIV transmission among men who have sex with men (MSM) has been reported in eight regions of Spain from 2003 to 2007. In order to study the incidence of HIV-1 genetic forms in Galicia, northwest of Spain, in particular the spread of HIV-1 variants among MSM, 93 newly diagnosed HIV-1 patients, including those with acute and recently acquired infections, were studied for a year from August 2008 to August 2009. Thirty eight (41%) were MSM. Of them, nine (24%) were infected by non-B viruses, including seven different genetic forms. The analysis of transmission clusters showed that 23 (60%) MSM grouped in different clusters and mostly in large clusters. Resistance mutations were detected in six (16%) MSM.

Higroma quístico cervical en el primer trimestre. Resultados perinatales / Cervical cystic hygroma in the first trimester. Perinatal results

Objetivos: Valorar la evolución antenatal y perinatal de fetos con diagnóstico de higroma quístico cervical. Material y métodos: Se estudió a 33 gestantes con diagnóstico de higroma quístico cervical fetal. A las mujeres que decidieron seguir el embarazo se les realizó estudio cromosómico, valoración morfológica y seguimiento del higroma. Resultados: En nuestra casuística, encontramos una evidente asociación con cromosomopatía (7 [37%] de 19 fetos, con cariotipo confirmado), aunque probablemente el número de fetos con anomalías cromosómicas sea mayor. Por el contrario, únicamente 10 (30%) gestaciones con el diagnóstico de higroma quístico cervical tuvieron un resultado perinatal satisfactorio. Conclusiones: En el caso del higroma quístico cervical, su relativamente fácil diagnóstico, la extensión de los estudios ecográficos y su asociación frecuente a cromosomopatías conducen a la mayoría de las parejas a la interrupción voluntaria del embarazo; no obstante, si se hace el diagnóstico de ausencia de anomalías cromosómicas, ausencia de malformaciones y regresión, se podría considerar un resultado perinatal satisfactorio (AU)

Objectives: To evaluate the prenatal course and perinatal outcomes of fetuses diagnosed with cervical cystic hygroma. Material and methods: A total of 33 pregnant women diagnosed with fetuses with cervical cystic hygroma were studied. Those who decided to continue with their pregnancies underwent a chromosome study, morphological evaluation, and follow-up of the hygroma. Results: In our casuistics, we found a clear association with chromosome disease (seven out of the 19 fetuses with confirmed karyotype [37%]), although the number of fetuses with chromosomal abnormalities is probably higher. In contrast, 10 pregnant women (30%) with a diagnosis of cervical cystic hygroma had a satisfactory perinatal outcome. Conclusions: Because cystic hygroma is relatively easy to diagnose, ultrasonography is widely used and an association with chromosome disease is frequent, most couples choose voluntary interruption of the pregnancy. However, if chromosomal abnormalities and malformations are absent and there is a tendency to regression, a satisfactory perinatal outcome can be considered (AU)