Dysautonomia and small fiber neuropathy in post-COVID condition and Chronic Fatigue Syndrome.

BACKGROUND: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and post-COVID condition can present similarities such as fatigue, brain fog, autonomic and neuropathic symptoms. METHODS: The study included 87 patients with post-COVID condition, 50 patients with ME/CFS, and 50 healthy controls (HC). The hemodynamic autonomic function was evaluated using the deep breathing technique, Valsalva maneuver, and Tilt test. The presence of autonomic and sensory small fiber neuropathy (SFN) was assessed with the Sudoscan and with heat and cold evoked potentials, respectively. Finally, a complete neuropsychological evaluation was performed. The objective of this study was to analyze and compare the autonomic and neuropathic symptoms in post-COVID condition with ME/CFS, and HC, as well as, analyze the relationship of these symptoms with cognition and fatigue. RESULTS: Statistically significant differences were found between groups in heart rate using the Kruskal-Wallis test (H), with ME/CFS group presenting the highest (H = 18.3; p ≤ .001). The Postural Orthostatic Tachycardia Syndrome (POTS), and pathological values in palms on the Sudoscan were found in 31% and 34% of ME/CFS, and 13.8% and 19.5% of post-COVID patients, respectively. Concerning evoked potentials, statistically significant differences were found in response latency to heat stimuli between groups (H = 23.6; p ≤ .01). Latency was highest in ME/CFS, and lowest in HC. Regarding cognition, lower parasympathetic activation was associated with worse cognitive performance. CONCLUSIONS: Both syndromes were characterized by inappropriate tachycardia at rest, with a high percentage of patients with POTS. The prolonged latencies for heat stimuli suggested damage to unmyelinated fibers. The higher proportion of patients with pathological results for upper extremities on the Sudoscan suggested a non-length-dependent SFN.

Expansion of the basic knowledge on the inheritance of characters that allow the development of new maize breeding techniques / Expansión de los conocimientos básicos de la herencia de caracteres que posibiliten desarrollar nuevas técnicas de mejoramiento en maíz

ABSTRACT In order to increase the efficiency of maize hybrid seed production it is necessary to achieve a high grain yield to reduce production costs. This goal requires an expansion of the basic knowledge of the inheritance of characters in order to develop new breeding techniques to improve experimental materials with hard endosperm (flint). The balanced lethal system allows to study the relative contribution of different chromosome segments to hybrid vigour due to the heterozygosity of certain chromosome segments while the rest of the genome becomes homocygotic through continuous selfing. In this way, these segments can be transferred to inbred lines in order to increase grain yield or tassel size (to increase pollen production). The goal of this study was to transfer a heterotic segment by using a balanced lethal system regulated line (BLS14), through crosses and backcrosses, to S5 flint lines derived from two commercial hybrids, ACA 2000 and Cóndor with closed pedigree, with the objective of increase grain yield or tassel size for pollen production. The analysis of variance (ANOVA) and principal components analysis (PCA) showed a significant improvement in grain yield and tassel size in the S5 flint lines of both commercial hybrids, carrying the heterotic segment of the BLS14 line.

RESUMEN Para incrementar la eficiencia en la producción de semillas híbridas en maíz se necesitan altos rendimientos con un correlativo bajo costo de producción. Esto requiere una expansión de los conocimientos básicos de la herencia de caracteres que posibiliten desarrollar nuevas técnicas de mejoramiento sobre materiales experimentales de textura dura (flint). Los sistemas de letales balanceados permiten estudiar la contribución relativa de distintos segmentos heteróticos en el vigor híbrido dado que permiten lograr la heterocigosis cuasipermanente de una porción del genomio, mientras el resto del genoma se vuelve homocigota por autofecundaciones sucesivas. Estos sistemas pueden ser transferidos a líneas endocriadas para incrementar el rendimiento del grano y el tamaño de la panoja para aumentar la producción de polen. El objetivo de este trabajo fue incorporar un segmento heterótico de una línea regulada por un sistema de letales balanceados (BLS14), mediante cruzamiento y retrocruza, a líneas S5 derivadas de dos híbridos comerciales, ACA 2000 y Cóndor, de pedigree cerrado, con textura dura (flint), con la finalidad de aumentar el rendimiento en grano o el tamaño de la panoja para la producción de polen. Los análisis de variancia (ANOVA) y de componentes principales (ACP) mostraron un incremento significativo en el rendimiento del grano y el tamaño de la panoja de las líneas S5 de ambos híbridos comerciales, portando cada una de ellas el segmento heterótico proveniente de la línea BLS14.

Simultaneous microwave-assisted extraction of bioactive compounds from aged garlic.

In this work, the simultaneous extraction of bioactives (organosulfur compounds, such as S-allyl-L-cysteine (SAC), carbohydrates, such as neokestose and neonystose, and total phenolic compounds) from aged garlic has been optimized for the first time to obtain multifunctional extracts for further application as food ingredients. Analytical methods using liquid chromatography coupled to mass spectrometry (HPLC-MS) and by hydrophilic interaction liquid chromatography with evaporative light scattering detection (HILIC-ELSD) were also previously optimized. High sensitivity (limits of detection between 0.013 and 0.77 µg mL-1) and appropriate repeatability (< 12%) and accuracy (> 92%) for the analysis of bioactives were achieved. After selecting water as the extraction solvent and microwave-assisted extraction (MAE) as the most efficient technique, operation conditions were optimized using a Box-Behnken experimental design (60 min; 120 °C; 0.05 g mL-1; 1 cycle) to maximize the content of bioactives from different aged garlic samples. Regarding organosulfur compounds, only SAC (traces-2.32 mg g-1 dry sample) and cycloalliin (1.23-3.01 mg g-1 dry sample) were detected in all samples, while amino acids such as arginine (0.24-3.45 mg g-1 dry sample) and proline (0.43-3.91 mg g-1 dry sample) were, in general, the most abundant. Bioactive carbohydrates (from trisaccharides to nonasaccharides) were only detected in fresh garlic and aged garlic processed under mild conditions, whereas all garlic extracts showed antioxidant activity. The developed MAE methodology is shown as a successful alternative to other procedures for the simultaneous extraction of aged garlic bioactives intended by the food and nutraceutical industries, among others.

Brain fog of post-COVID-19 condition and Chronic Fatigue Syndrome, same medical disorder?

BACKGROUND: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is characterized by persistent physical and mental fatigue. The post-COVID-19 condition patients refer physical fatigue and cognitive impairment sequelae. Given the similarity between both conditions, could it be the same pathology with a different precipitating factor? OBJECTIVE: To describe the cognitive impairment, neuropsychiatric symptoms, and general symptomatology in both groups, to find out if it is the same pathology. As well as verify if the affectation of smell is related to cognitive deterioration in patients with post-COVID-19 condition. METHODS: The sample included 42 ME/CFS and 73 post-COVID-19 condition patients. Fatigue, sleep quality, anxiety and depressive symptoms, the frequency and severity of different symptoms, olfactory function and a wide range of cognitive domains were evaluated. RESULTS: Both syndromes are characterized by excessive physical fatigue, sleep problems and myalgia. Sustained attention and processing speed were impaired in 83.3% and 52.4% of ME/CFS patients while in post-COVID-19 condition were impaired in 56.2% and 41.4% of patients, respectively. Statistically significant differences were found in sustained attention and visuospatial ability, being the ME/CFS group who presented the worst performance. Physical problems and mood issues were the main variables correlating with cognitive performance in post-COVID-19 patients, while in ME/CFS it was anxiety symptoms and physical fatigue. CONCLUSIONS: The symptomatology and cognitive patterns were similar in both groups, with greater impairment in ME/CFS. This disease is characterized by greater physical and neuropsychiatric problems compared to post-COVID-19 condition. Likewise, we also propose the relevance of prolonged hyposmia as a possible marker of cognitive deterioration in patients with post-COVID-19.

Estimation of ocular axial length with optometric parameters is not accurate.

Myopia is a worldwide major public concern, aside from the visual disturbance needing optical correction, myopia may be associated with open angle glaucoma, retinal detachment and myopic maculopathy. The higher the myopia the higher the risk for retinal associated comorbidities, and the axial length is the more important measure to estimate risk of visual impairment. Recently a formula to predict axial length using spherical equivalent and keratometry was proposed, with the intention of categorizing the risk of visual impairment with Tideman et al. classification. PURPOSE: To evaluate the accuracy of an axial length prediction formula in a Colombian population 8-17 years old. METHODS: Children from MIOPUR study with optical biometer axial length measure (AL), manifest refraction and keratometry were included in the analysis. Predicted axial length (PAL) was calculated with the prediction formula. A Bland-Altman assessment was conducted, and the concordance correlation coefficient was measured. Proposed classification of AL to establish risk of visual loss was used with measured AL and with PAL. The percentage of eyes misclassified was then established. RESULTS: A total of 2129 eyes were included in the analysis. Mean difference of axial length (actual AL minus PAL) was -0.516 mm (-1.559 mm - 0.528 mm). Concordance correlation coefficient (CCC) of 0.656 (IC95 0.636-0.675) was found between the real AL and PAL. PAL differed from measured AL by 1 mm or more in 16.58 %, and by 2 mm or more, in 0.61 % of the eyes. In myopic eyes, PAL was in average 0.426 mm longer than the AL actually measured with CCC of 0.714 (IC95 0.666-0.761). PAL differed from measured AL by 1 mm or more in 21.92 %, and by 2 mm or more, in 0.45 % of the myopic eyes. The study revealed that 15.03 % of all eyes, and 29.81 % of myopic eyes, were misclassified when PAL was used. CONCLUSIONS: The proposed axial length prediction formula was not accurate, and it did not adequately classify risk of visual impairment in myopic eyes in a group of Colombian children. We consider that it is not possible to predict the axial length based only on optometric data, such as the corneal radius of curvature and the spherical equivalent. This is very possibly related to the variability of crystalline lens power within a population.

Evaluating the impacts of agricultural land management practices on water resources: A probabilistic hydrologic modeling approach.

Evaluating the effectiveness of agricultural land management practices in minimizing environmental impacts using models is challenged by the presence of inherent uncertainties during the model development stage. One issue faced during the model development stage is the uncertainty involved in model parameterization. Using a single optimized set of parameters (one snapshot) to represent baseline conditions of the system limits the applicability and robustness of the model to properly represent future or alternative scenarios. The objective of this study was to develop a framework that facilitates model parameter selection while evaluating uncertainty to assess the impacts of land management practices at the watershed scale. The model framework was applied to the Lake Creek watershed located in southwestern Oklahoma, USA. A two-step probabilistic approach was implemented to parameterize the Agricultural Policy/Environmental eXtender (APEX) model using global uncertainty and sensitivity analysis to estimate the full spectrum of total monthly water yield (WYLD) and total monthly Nitrogen loads (N) in the watershed under different land management practices. Twenty-seven models were found to represent the baseline scenario in which uncertainty of up to 29% and 400% in WYLD and N, respectively, is plausible. Changing the land cover to pasture manifested the highest decrease in N to up to 30% for a full pasture coverage while changing to full winter wheat cover can increase the N up to 11%. The methodology developed in this study was able to quantify the full spectrum of system responses, the uncertainty associated with them, and the most important parameters that drive their variability. Results from this study can be used to develop strategic decisions on the risks and tradeoffs associated with different management alternatives that aim to increase productivity while also minimizing their environmental impacts.

Despistaje de aneurisma de aorta abdominal en Atención Primaria / Abdominal aneurism screening in Primary Care

Objetivos. Obtener el porcentaje de aneurismas de aorta abdominal (AAA) detectados en varones entre 65 y 74 años en un centro de salud mediante ecografía y describir la distribución de factores de riesgo en la muestra. En relación con la presencia de aneurismas, determinar cuántos se diagnostican en el hospital y las dudas diagnósticas. Pacientes y método. Estudio transversal realizado entre septiembre de 2014 y febrero de 2015 en un centro de salud. Del total de 212 pacientes seleccionados aleatoriamente, se realizó entrevista clínica y ecografía a 115 varones, de entre 65-74 años, de los 171 que cumplían criterios de inclusión. Se realizó la captación mediante llamada telefónica. Las variables cuantitativas se estudiaron mediante medidas de tendencia central y de dispersión, y las cualitativas, mediante frecuencias absolutas y relativas. Resultados. El porcentaje hallado de AAA infrarrenal en la muestra fue de 2,6% [IC 95% 0,54-7,4]. El 51,3% tenían HTA y el 76,1% eran fumadores o exfumadores. Los 3 AAA hallados, uno con duda diagnóstica, fueron confirmados en el Hospital Universitario Fundación Jiménez Díaz. No hubo pérdidas. En la muestra, todos los pacientes con AAA eran fumadores activos y tenían al menos otro factor de riesgo. Conclusión. El porcentaje del 2,6% de pacientes con AAA fue menor del esperado (4%), pero superior a la prevalencia encontrada en los estudios en los que no se tenía en cuenta el tabaco como criterio de inclusión (AU)

Objectives. To obtain the percentage of abdominal aortic aneurism (AAA) determined in men between 65-74 years old in a health centre using ultrasound, and to describe the distribution of risk factors in the whole sample and in patients with aneurism, as well as determining how many AAA are confirmed at the hospital and those cases of uncertain diagnosis. Patients and Method. A cross-sectional study conducted on patients included from September 2014 to February 2015. From a total of 212 randomised patients, a clinical interview and abdominal ultrasound were performed on 115 men, aged 65 to 74, telephone-recruited from a total of 171 that fulfilled inclusion criteria. Results. An infra-renal AAA was found in 2.6% of the sample (95% CI 0.54-7.4). Just over half (51.3%) of the sample had arterial hypertension, and 76.1% were smokers or former smokers. The 3 AAA found, one of which had an initial doubtful diagnosis, were confirmed by the Hospital Universitario Fundación Jiménez Díaz. There were no losses. All of the patients with AAA were active smokers and had at least one other risk factor. Conclusion. The percentage of infra-renal AAA in the sample was lower than expected, but higher than the percentage found in other studies that did not consider smoking in the inclusion criteria (AU)

[Abdominal aneurism screening in Primary Care]. / Despistaje de aneurisma de aorta abdominal en Atención Primaria.

OBJECTIVES: To obtain the percentage of abdominal aortic aneurism (AAA) determined in men between 65-74 years old in a health centre using ultrasound, and to describe the distribution of risk factors in the whole sample and in patients with aneurism, as well as determining how many AAA are confirmed at the hospital and those cases of uncertain diagnosis. PATIENTS AND METHOD: A cross-sectional study conducted on patients included from September 2014 to February 2015. From a total of 212 randomised patients, a clinical interview and abdominal ultrasound were performed on 115 men, aged 65 to 74, telephone-recruited from a total of 171 that fulfilled inclusion criteria. RESULTS: An infra-renal AAA was found in 2.6% of the sample (95% CI 0.54-7.4). Just over half (51.3%) of the sample had arterial hypertension, and 76.1% were smokers or former smokers. The 3 AAA found, one of which had an initial doubtful diagnosis, were confirmed by the Hospital Universitario Fundación Jiménez Díaz. There were no losses. All of the patients with AAA were active smokers and had at least one other risk factor. CONCLUSION: The percentage of infra-renal AAA in the sample was lower than expected, but higher than the percentage found in other studies that did not consider smoking in the inclusion criteria.

La sexualidad en adolescentes de riesgo. Comunidad de Madrid 2013-2014 / Sexuality in adolescents of risk groups autonomous. Community of Madrid 2013-2014

La sexualidad es un componente esencial de la personalidad. Durante la adolescencia -de 10 a 19 años- se producen cambios físicos, psíquicos y hormonales que junto a las transformaciones sociales, favorecen el inicio de conductas de riesgo. A pesar de los esfuerzos realizados para mejorar la salud sexual y reproductiva en los adolescentes y jóvenes españoles por parte de las familias y la sociedad, ellos continúan siendo vulnerables frente a los embarazos y las ITS. Nuestra investigación tiene lugar en el Centro de Primera Acogida de Protección ‘Hortaleza’ que pertenece al Instituto Madrileño de la Familia y el Menor, donde ingresan los/las adolescentes españoles e inmigrantes bajo la condición de guarda o tutela con edades comprendidas desde los 14,9 años hasta los 17,9 años, en la Comunidad de Madrid. Nuestro objetivo es describir las variables cuantitativas de los/las adolescentes ingresados en el centro durante el periodo 2013-2014 y analizar las variables cualitativas de las menores que acudieron a la Consulta de Planificación Familiar (AU)

Sexuality is an essential part of personality. During adolescence -10 to 19 years of age- several physical, psychic, and hormonal changes take place. These changes, together with social transformations, give rise to risk behaviour. In spite of the efforts made by the families and the society to improve the sexual and reproductive health of Spanish youths, they are still vulnerable to unplanned pregnancy and STDs. Our research was carried out in the institution Preliminary Reception Centre for Protection ‘Hortaleza’, which belongs to the Institute for the Child and Family in Madrid, where Spanish and immigrant children and teenagers between the ages of 14.9 and 17.9 are received under custody or tutelage. Our aim is to describe the quantitative variables for adolescents admitted in the Centre between 2013 and 2014 and analyse the qualitative variables for the girls under the age of 18 who turned to our Family Planning Counselling (AU)

Assessment of the reproducibility of oligoclonal IgM band detection for its application in daily clinical practice.

BACKGROUND: The presence of oligoclonal IgM bands (OCMB) in cerebrospinal fluid (CSF) is an unfavourable prognostic marker in multiple sclerosis. There is no commercial test to investigate OCMB status. However, a sensitive and specific isoelectrofocusing (IEF) and western blot method was described. We aimed to study the inter-centre reproducibility of this technique, a necessary condition for a reliable test to be incorporated into clinical practice. METHODS: The presence of OCMB was analysed by IEF and western blot with prior reduction of pentameric IgM. We assayed the reproducibility of this test in a blinded multicentre study performed in 13 university hospitals. Paired-CSF and serum samples from 52 neurological patients were assayed at every centre. RESULTS: Global analysis rendered a concordance of 89.8% with a kappa value of 0.71. CONCLUSION: These data indicate that OCMB detection by means of IEF and western blot with IgM reduction shows a good interlaboratory reproducibility and thus can be used in daily clinical setting.

The course of inflammatory bowel disease during pregnancy and postpartum: a prospective European ECCO-EpiCom Study of 209 pregnant women.

BACKGROUND: The impact of pregnancy on the course of IBD is still controversial. AIM: To investigate the impact of pregnancy on IBD and to search for factors with potential impact on remission. METHODS: Pregnant IBD women from 12 European countries were enrolled between January 2003 and December 2006 and compared at conception (1:1) with nonpregnant IBD women. Data on disease course were prospectively collected at each trimester during pregnancy and in the postpartum (6 months) using a standardised questionnaire. RESULTS: A total of 209 pregnant IBD women were included: 92 with Crohn's disease (CD; median age 31 years, range 17-40) and 117 with ulcerative colitis (UC; median age 32 years, range 19-42). No statistically significant difference in disease course during pregnancy and postpartum was observed between pregnant and nonpregnant CD women. Longer disease duration in CD and immunosuppressive therapy were found to be risk factors for activity during pregnancy. Pregnant UC women were more likely than nonpregnant UC women to relapse both during pregnancy (RR 2.19; 95% CI: 1.25-3.97, 0.004) and postpartum (RR 6.22; 95% CI: 2.05-79.3, P = 0.0004). During pregnancy, relapse was mainly observed in the first (RR 8.80; 95% CI 2.05-79.3, P < 0.0004) and the second trimester (RR 2.84, 95% CI 1.2-7.45, P = 0.0098). CONCLUSIONS: Pregnant women with Crohn's disease had a similar disease course both during pregnancy and after delivery as the nonpregnant women. In contrast, pregnant women with ulcerative colitis were at higher risk of relapse during pregnancy and in the postpartum than nonpregnant ulcerative colitis women.

Intermittent treatment with mesalazine in the prevention of diverticulitis recurrence: a randomised multicentre pilot double-blind placebo-controlled study of 24-month duration.

BACKGROUND AND AIM: Recurrence of diverticulitis is frequent within 5 years from the uncomplicated first attack, and its prophylaxis is still unclear. We have undertaken a multicentre, randomised, double-blind, placebo-controlled pilot study in order to evaluate the role of mesalazine in preventing diverticulitis recurrence as well as its effects on symptoms associated to diverticular disease. METHODS: Ninety-six patients with the recent first episode of uncomplicated diverticulitis were randomised to receive mesalazine 800 mg twice daily for 10 days every month or placebo for 24 months. The primary efficacy end point was the diverticulitis recurrence at intention to treat analysis. Clinical evaluations were performed using the Therapy Impact Questionnaire (TIQ) for physical condition and quality of life at admission and at 3-month intervals. Treatment tolerability and routine biochemistry parameters as well as the use of additional drugs were also evaluated. RESULTS: Ninety-two patients (mean age, 61.5) completed the study, 45 of whom received mesalazine, and 47, placebo. Diverticulitis relapse incidence in mesalazine-treated group was 5/45 (11%) at the 12th month and 6/45 (13%) at the 24th month; in the placebo-treated group, the correspondent rates were 13% (6/47) and 28% (13/47), respectively. Mean values of TIQ at 24 months were significantly better in mesalazine-treated group than in placebo-treated group (p = 0.02); in addition, average additional drug consumption was significantly lower (-20.4%, p < 0.03) in mesalazine than in placebo. CONCLUSIONS: Diverticulitis recurrence occurred in as many as 28% of patients under placebo within 24 months from the initial episode. Intermittent prophylaxis with mesalazine did not significantly reduce the risk of relapse but induced a significant improvement of patients' physical conditions and significantly lowered the additional consumption of other gastrointestinal drugs.

Incidencia del ejercicio físico y el entrenamiento vibratorio sobre la amplitud de movimiento de mujeres con fibromialgia / Influence of physical exercise and whole body vibration on flexibility in women with fibromyalgia

Objetivo. En la presente investigación hemos planteado como objetivos principales, por un lado, valorar el efecto del ejercicio físico y el entrenamiento vibratorio sobre la amplitud de movimiento en mujeres con fibromialgia (FM) y, por otro, determinar si existe alguna relación entre dicha variable y el dolor y la rigidez. Método. La muestra estuvo constituida por un total de cuarenta y seis mujeres (edad: 58,2 ± 8,5 años; peso: 72,1 ± 9,6 kg; altura: 156,9 ± 6,1 cm) diagnosticadas con FM. Los participantes fueron divididos aleatoriamente en tres grupos: ejercicio físico y entrenamiento vibratorio (WBV + EJ; n = 15); ejercicio físico sin vibraciones (EJ; n = 15) y un grupo control (GC; n = 16). Los grupos WBV + EJ y EJ realizaron dos sesiones semanales de ejercicio físico durante 8 semanas. Además, los integrantes de WBV + EJ realizaron 3 sesiones semanales de entrenamiento vibratorio (30 Hz, 4 mm). Las pruebas de evaluación incluyeron el test de sit and reach (variable principal), la valoración del número de tender points (TP) y una escala analógica visual (VAS) para determinar la rigidez. Resultados. Los resultados derivados del análisis intra e intergrupo no mostraron diferencias significativas en la rigidez o el número de TP, si bien, la prueba de sit and reach mostró una mejora estadísticamente significativa en WBV + EJ (58%; p < 0,05). El análisis correlacional mostró una relación inversa (r = -0,55; p < 0,05) entre el sit and reach y el número de TP. Conclusión. Como conclusión, podemos indicar que los datos obtenidos en la presente investigación han mostrado los efectos significativos del entrenamiento vibratorio sobre la amplitud de movimiento en mujeres con FM, aunque el número de TP o la rigidez no se vieron afectados en ningún caso(AU)

Objective. The main aim of this investigation was twofold: first to evaluate the effects of exercise and whole body vibration training on flexibility in women with fibromyalgia (FM) and determine whether these improvements are related to symptom severity (stiffness and bodily pain). Method. Forty-six women (mean ± sd, age: 58.2 ± 8.5 years; weight: 72.1 ± 9.6 kg; height: 156.9 ± 6.1 cm) with FM were randomized into one of three groups: exercise and whole body vibration (WBV) training group (WBV + EX; n = 15), exercise training group (EX), and usual-care control group (CG). WBV + EX and EX groups carried out two sessions per week of exercise training for 8 weeks. In addition, WBV + EX group performed 3 vibration-training (30 Hz, 4 mm) sessions per week. Outcome assessed included sit and reach test (primary outcome), tender points (TP) evaluation, and a visual analog scale (VAS) was used to determine the stiffness level. Results. Results showed no statistical intra and intergroup differences in stiffness or the number of TP. However, a significant increment in the sit and reach performance was observed in WBV + EX (58%; p < 0.05). Moreover, correlation analysis showed an inverse and significant relationship (r = -0.55; p < 0.05) between sit and reach and number of TP in WBV+EX group. Conclusion. In conclusion, exercise and WBV seems to be effective on flexibility in women with FM. However, the number of TP and stiffness was not modified after the intervention(AU)

Development of an integrated electrochemical biosensor for sucrose and its implementation in a continuous flow system for the simultaneous monitoring of sucrose, fructose and glucose.

An integrated amperometric sucrose biosensor involving a 3-mercaptopropionic acid (MPA) self-assembled monolayer (SAM)-modified gold disk electrode (AuE) and coimmobilization of the enzymes invertase (INV) and fructose dehydrogenase (FDH) as well as the redox mediator tetrathiafulvalene (TTF) by means of a dialysis membrane is reported. Amperometry in stirred solutions at a detection potential of +0.10 V provided a linear calibration plot for sucrose over the 1.2 × 10(-6)-3.0 × 10(-3) mol L(-1) concentration range, with a limit of detection of 3.6 × 10(-7) mol L(-1). The practical usefulness of the biosensor was demonstrated by determining sucrose in condensed milk and in an infant food reference material with good results. Additionally, the biosensor was implemented together with commercial fructose and glucose amperometric biosensors in a continuous flow system to perform the multiplexed quantification of sucrose, fructose and glucose in a single experiment. The operational characteristics of the biosensors in this novel flow system were evaluated and their applicability was demonstrated through the simultaneous determination of the three sugars in the above-mentioned reference material.

Low glomerular filtration rate is a risk factor for ribavirin-associated anaemia in old patients with chronic hepatitis C.

Elderly patients with chronic hepatitis C have a reduced responsiveness to antiviral therapy with Peg-interferon and ribavirin. The dose reduction or the discontinuation of ribavirin due to the occurrence of anaemia is one of the most important causes for the low sustained viral response observed in older patients. We aimed to evaluate the relationship between baseline renal function and the early onset of ribavirin-associated anaemia in older (≥60 years) patients. Using data from 348 patients with chronic hepatitis C consecutively treated with peg-interferon plus ribavirin, we investigated which factors were associated with the occurrence of anaemia in elderly patients (≥60 years). Ribavirin-induced anaemia occurred in 40.5% of patients. Older patients showed a rate of anaemia significantly higher than younger patients (51.5% vs 36.3%; P = 0.009). Consequently, the rate of ribavirin dose reduction or discontinuation due to anaemia was 35.1% in older patients and 23.5% in younger patients (P = 0.029). A significantly higher proportion of older patients had a low baseline glomerular filtration rate (GFR) compared with younger patients (56.7% vs 27.1%; P < 0.001). At the multivariate regression analysis, low baseline GFR (<70 mL/min) was associated with an increased risk of ribavirin-associated anaemia only in the older patients (OR: 3.526; 95% CI: 1.385-8.979; P = 0.008). In this subset, baseline GFR was significantly correlated with both absolute (r = -0.320; P < 0.001) and relative (r = -0.324; P < 0.001) haemoglobin decrease within the first 8 weeks of treatment. In patients aged >60 years, a low pre-treatment GFR was strongly associated with the risk to develop ribavirin-related anaemia with consequent reduction in ribavirin doses.

The Atlantic-Mediterranean watershed, river basins and glacial history shape the genetic structure of Iberian poplars.

Recent phylogeographic studies have elucidated the effects of Pleistocene glaciations and of Pre-Pleistocene events on populations from glacial refuge areas. This study investigates those effects in riparian trees (Populus spp.), whose particular features may convey enhanced resistance to climate fluctuations. We analysed the phylogeographic structure of 44 white (Populus alba), 13 black (Populus nigra) and two grey (Populus x canescens) poplar populations in the Iberian Peninsula using plastid DNA microsatellites and sequences. We also assessed fine-scale spatial genetic structure and the extent of clonality in four white and one grey poplar populations using nuclear microsatellites and we determined quantitative genetic differentiation (Q(ST) ) for growth traits in white poplar. Black poplar displayed higher regional diversity and lower differentiation than white poplar, reflecting its higher cold-tolerance. The dependence of white poplar on phreatic water was evidenced by strong differentiation between the Atlantic and Mediterranean drainage basins and among river basins, and by weaker isolation by distance within than among river basins. Our results suggest confinement to the lower river courses during glacial periods and moderate interglacial gene exchange along coastlines. In northern Iberian river basins, white poplar had lower diversity, fewer private haplotypes and larger clonal assemblies than in southern basins, indicating a stronger effect of glaciations in the north. Despite strong genetic structure and frequent asexual propagation in white poplar, some growth traits displayed adaptive divergence between drainage and river basins (Q(ST) >F(ST)), highlighting the remarkable capacity of riparian tree populations to adapt to regional environmental conditions.

Utility of oligoclonal IgG band detection for MS diagnosis in daily clinical practice.

An early and accurate diagnosis of multiple sclerosis (MS) is very important, since it allows early treatment initiation, which reduces the activity of the disease. Oligoclonal IgG band (OCGB) detection is a good ancillary tool for MS diagnosis. However, it was argued that its usefulness was limited by the high interlaboratory variability. In the last years, different techniques for OCGB detection have appeared. We performed a blinded aleatorized multicenter study in 19 Spanish hospitals to assess the accuracy and reproducibility of OCGB detection in this new scenario. We studied cerebrospinal fluid (CSF) and serum samples from 114 neurological patients. Every hospital contributed to the study with triplicated pairs of CSF and serum samples of six patients and analyzed 18 different samples. Global analysis rendered a sensitivity of 92.1%, a specificity of 95.1% and a Kappa value of 0.81. This shows that current techniques for OCGB detection have good accuracy and a high interlaboratory reproducibility and thus, represent a good tool for MS diagnosis. When we analyzed separately the different techniques used for OCGB detection, the highest concordance was observed in western blot with alkaline phosphatase detection (kappa=0.91). This indicates that high sensitivity techniques improve the reproducibility of this assay.

Apendicectomía y colecistectomía invisibles: cirugía totalmente laparoscópica por un puerto umbilical (OPUS) / Scarless apendectomy and cholecystectomy: one port transumbilical laparoscopic surgery

Laparoscopic surgery is evolving to less invasive techniques. Thanks to new surgical advances, it is possible to insert into the abdominal cavity multiple instruments through a single device. One option is Triport®. We report two patients who underwent to an appendectomy and a cholecystectomy, respectively, performed through a single umbilical port. The procedures were successfully performed without complications. Patients were treated on an outpatient basis, according to the fast track concept. Therefore, single port laparoscopic transumbilical appendectomy and cholecystectomy are feasible and safe procedures that require proper training and specially designed surgical instruments.

Introducción: La cirugía laparoscópica se enfoca hacia el desarrollo de técnicas cada vez menos invasivas. Con el avance tecnológico es posible introducir a la cavidad abdominal múltiples instrumentos a través de un mismo puerto. Una de las opciones de acceso es el Triport®. Las experiencias con este método han sido procedimientos urológicos, ginecológicos y gastrointestinales. Métodos: Se describen una apendicectomía y una colecistectomía realizadas totalmente por vía laparoscópica a través de un puerto umbilical, utilizando el Triport®. Resultados: Las intervenciones se realizaron en forma exitosa, sin complicaciones intra ni postoperatorias. Ambos pacientes se trataron ambulatoriamente, según el esquema Fast-track de nuestro servicio. Conclusiones: La apendicectomía y colecistectomía por vía laparoscópica a través de un solo puerto transumbilical, son procedimientos factibles y seguros, que requieren de instrumental y entrenamiento adecuados.

A rapid method for detection of catalase-positive and catalase-negative bacteria based on monitoring of hydrogen peroxide evolution at a composite peroxidase biosensor.

The rapid detection of catalase-positive and catalase-negative bacteria in complex culture media has been accomplished by monitoring of hydrogen peroxide consumption or generation with a graphite-Teflon-peroxidase-ferrocene composite electrode. Escherichia coli and Streptococcus pneumoniae have been used as model catalase-positive and catalase-negative bacteria, respectively. Hydrogen peroxide evolution was amperometrically measured at 0.00 V. Experimental conditions, including the working solution composition, the incubation time and the hydrogen peroxide concentration, were optimized. The reusability of the biosensor was improved by placing a nylon membrane on the bioelectrode surface to prevent fouling caused by the bacterial medium. The developed methodology allowed the detection of E. coli and S. pneumoniae at concentration levels of approximately 2x10(6) and 2x10(5) cfu/mL, in assays taking 10 and 15 min, respectively, without any pre-concentration step or pre-enrichment procedure.

Prospective multicenter quality assessment of endotherapy of biliary stones: does center volume matter?

BACKGROUND AND STUDY AIMS: To study the effectiveness of endoscopic treatment for biliary stones in a large case list of patients treated in units with different experience and different workloads in a region of northern Italy. PATIENTS AND METHODS: We prospectively studied 700 patients undergoing endoscopic retrograde cholangiopancreatography or sphincterotomy, in 14 units (> or < 200 examinations/year), for their first treatment of biliary stones. The difficulty of the examinations, the results in terms of clearance of the stones, and the late outcomes (24 months) were recorded. A questionnaire (GHAA-9modified) was administered 24 hours and 30 days after the procedure to measure patient satisfaction. RESULTS: There were six units with a heavy workload and eight with a light schedule. There were 176 (25.1 %) difficult examinations (Schutz grades 3, 4, and 5). Stones were found in 580 (82.9 %) and were cleared in 504 of these patients (86.9 %). No differences were observed in the clearance of stones for the different groups of difficulty and high- and low-volume centers. Over the 24-month follow-up period, 96 patients (13.7 %) complained of recurrent symptoms and 44 (6.3 %) had proof of stones. In all, 603 questionnaires were evaluable and more than 80 % of patients expressed satisfaction. CONCLUSIONS: Our findings confirm the effectiveness of endoscopic treatment of biliary stones. However, the number of patients with symptoms (13.7) after 24 months, with or without persistence of stones, was not insignificant. It is feasible to record patient satisfaction, and in this series patients stated they were satisfied. Criticism mostly concerned pain control and explanations provided before the examination.