Paciente con lesión medular cervical y vértigo posicional paroxístico benigno tratado con maniobras de reposición de partículas / Patient with cervical spinal cord injury and benign paroxysmal positional vertigo treated with particle repositioning maneuvers

El vértigo posicional paroxístico benigno (VPPB) se caracteriza por episodios cortos y bruscos de vértigo cuando la cabeza se mueve en posiciones específicas. El tratamiento son las terapias de reposición de partículas. En general el VPPB es subdiagnosticado, no reportado y por lo tanto no es tratado de forma adecuada. Presentamos el caso de un paciente con lesión medular y VPPB. Paciente de 72 años que sufre una fractura de C5 y como resultado una lesión medular C5 AIS C que necesitó la fijación quirúrgica. En la unidad de lesionados medulares se documentó VPPB del conducto semicircular lateral izquierdo y se trató mediante el uso de terapias de reposición específicas; el paciente mejoró progresivamente y pudo concluir el tratamiento rehabilitador. Las unidades de lesión medular con acceso a unidades de rehabilitación vestibular pueden realizar el diagnóstico y tratamiento específico del VPPB, minimizando los riesgos para el paciente.(AU)

Benign paroxysmal positional vertigo (BPPV) is characterized by short, sudden episodes of vertigo when the head moves in specific positions. The treatment is particle repositioning maneuvers. BPPV usually is underdiagnosed, unreported and therefore not adequately treated. We present the case of a patient with spinal cord injury and BPPV. A 72-year-old patient who suffered a C5 fracture with spinal cord injury C5 AIS C that required surgical fixation. In the spinal cord injury unit BPPV of the left lateral semicircular canal was documented and treated using specific repositioning maneuvers, the patient progressively improved and was able to complete the rehabilitation treatment. The spinal cord injury unit with access to vestibular rehabilitation units can carry out the diagnosis and specific treatment of BPPV, minimizing the risks for the patient.(AU)

[Patient with cervical spinal cord injury and benign paroxysmal positional vertigo treated with particle repositioning maneuvers]. / Paciente con lesión medular cervical y vértigo posicional paroxístico benigno tratado con maniobras de reposición de partículas.

Benign paroxysmal positional vertigo (BPPV) is characterized by short, sudden episodes of vertigo when the head moves in specific positions. The treatment is particle repositioning maneuvers. BPPV usually is underdiagnosed, unreported and therefore not adequately treated. We present the case of a patient with spinal cord injury and BPPV. A 72-year-old patient who suffered a C5 fracture with spinal cord injury C5 AIS C that required surgical fixation. In the spinal cord injury unit BPPV of the left lateral semicircular canal was documented and treated using specific repositioning maneuvers, the patient progressively improved and was able to complete the rehabilitation treatment. The spinal cord injury unit with access to vestibular rehabilitation units can carry out the diagnosis and specific treatment of BPPV, minimizing the risks for the patient.

Predictive factors of destination at discharge after spinal cord injury.

INTRODUCTION: One of the main goals of the rehabilitation of patients with spinal cord injury (SCI) is the reintegration of the individual to their family, social, and work setting. The objective of this study was to identify the factors that determine the discharge destination after a traumatic spinal cord injury. MATERIAL AND METHODS: We conducted a retrospective descriptive study of 305 patients with SCI who completed the rehabilitation treatment at the spinal injury unit of Hospital Insular de Gran Canaria between 2001 and 2018. RESULTS: During the study period, we observed an increase in the number of patients referred to long-term care centres, from 9.14% between 2001 and 2010 to 18.4% between 2011 and 2018 (P < .01). Of 20 variables that presented a significant association with destination at discharge in the univariate study, 7 presented a significant association in the multivariate study: age (OR: 1.05; 95% CI, 1.02-1.08), living with a partner (OR: 0.26; 95% CI, 0.09-0.76), residing on another island (OR: 3.57; 95% CI, 1.32-9.63), smoking (OR: 3.44; 95% CI, 1.26-9.44), diabetes (OR: 6.51; 95% CI, 1.46-29.02), history of psychiatric disorders (OR: 3.79; 95% CI, 1.31-10.93), and scores on the Spinal Cord Independence Measure-III (SCIM-III) (OR: 0.48; 95% CI, 0.33-0.69). CONCLUSIONS: Our findings identified advanced age, living on the island of Tenerife, not being married, smoking, type 2 diabetes mellitus, history of psychiatric disorders, and low SCIM-III scores as predictive factors of referral to a long-term care centre in patients with traumatic SCI in the Canary Islands.

Factores asociados a la mejoría funcional en pacientes con lesión medular traumática cervical / Factors associated with functional improvement in patients with cervical spinal cord injuries

Objetivo Determinar los factores que influyen en la mejoría funcional de un lesionado medular cervical traumático durante la hospitalización. Material y métodos Se ha realizado un estudio retrospectivo donde se han incluido los pacientes que han sufrido una lesión medular cervical traumática aguda y que han concluido un programa de rehabilitación en la Unidad de Lesionados Medulares de Canarias entre 2001 y 2018. Para medir la mejoría funcional se ha realizado una valoración del SCIM III al ingreso y al alta. Resultados El 88% de los 141 pacientes de nuestra muestra han sido hombres: pacientes de edad avanzada, con antecedentes de consumo de alcohol, las lesiones completas y de mayor gravedad en la Escala de ASIA han tenido menores resultados funcionales. El tiempo desde la lesión hasta el ingreso en la unidad, el tiempo de estancia hospitalaria y el tiempo desde la lesión al alta hospitalaria han tenido una relación significativa con la mejoría funcional. Conclusiones En pacientes con edad avanzada y con antecedentes de consumo de alcohol las lesiones completas y de mayor gravedad en la Escala de ASIA han tenido menores resultados funcionales. Por otro lado, el ingreso precoz ha sido fundamental para obtener mejores resultados funcionales y se ha relacionado con estancias hospitalarias más cortas (AU)

Objective To determine the factors influencing functional improvement of cervical spinal cord injuries during hospital admission. Material and methods We performed a retrospective study of patients with an acute cervical spinal cord injury who had completed a rehabilitation programme in the Spinal Cord Injuries Unit of the Canary Islands between 2001 and 2018. To measure functional improvement, we administered the Spinal Cord Independence Measure III (SCIM III) on admission and at discharge. Results Of the 141 patients in our sample, 88% were men. Worse functional results were observed in older patients, those with a history of alcohol consumption, complete lesions and those with more severe lesions on the ASIA scale. Factors significantly associated with functional improvement were the interval between injury and admission to the unit, length of hospital stay, and the interval between injury and hospital discharge. Conclusions Older patients, as well as those with a history of alcohol intake, complete lesions and greater severity on the ASIA scale, had worse functional outcomes. In contrast, early admission was crucial to obtain better functional outcomes and was associated with shorter hospital stays (AU)

[Factors associated with functional improvement in patients with cervical spinal cord injuries]. / Factores asociados a la mejoría funcional en pacientes con lesión medular traumática cervical.

OBJECTIVE: To determine the factors influencing functional improvement of cervical spinal cord injuries during hospital admission. MATERIAL AND METHODS: We performed a retrospective study of patients with an acute cervical spinal cord injury who had completed a rehabilitation programme in the Spinal Cord Injuries Unit of the Canary Islands between 2001 and 2018. To measure functional improvement, we administered the Spinal Cord Independence Measure III (SCIM III) on admission and at discharge. RESULTS: Of the 141 patients in our sample, 88% were men. Worse functional results were observed in older patients, those with a history of alcohol consumption, complete lesions and those with more severe lesions on the ASIA scale. Factors significantly associated with functional improvement were the interval between injury and admission to the unit, length of hospital stay, and the interval between injury and hospital discharge. CONCLUSIONS: Older patients, as well as those with a history of alcohol intake, complete lesions and greater severity on the ASIA scale, had worse functional outcomes. In contrast, early admission was crucial to obtain better functional outcomes and was associated with shorter hospital stays.

COVIDGR Dataset and COVID-SDNet Methodology for Predicting COVID-19 Based on Chest X-Ray Images.

Currently, Coronavirus disease (COVID-19), one of the most infectious diseases in the 21st century, is diagnosed using RT-PCR testing, CT scans and/or Chest X-Ray (CXR) images. CT (Computed Tomography) scanners and RT-PCR testing are not available in most medical centers and hence in many cases CXR images become the most time/cost effective tool for assisting clinicians in making decisions. Deep learning neural networks have a great potential for building COVID-19 triage systems and detecting COVID-19 patients, especially patients with low severity. Unfortunately, current databases do not allow building such systems as they are highly heterogeneous and biased towards severe cases. This article is three-fold: (i) we demystify the high sensitivities achieved by most recent COVID-19 classification models, (ii) under a close collaboration with Hospital Universitario Clínico San Cecilio, Granada, Spain, we built COVIDGR-1.0, a homogeneous and balanced database that includes all levels of severity, from normal with Positive RT-PCR, Mild, Moderate to Severe. COVIDGR-1.0 contains 426 positive and 426 negative PA (PosteroAnterior) CXR views and (iii) we propose COVID Smart Data based Network (COVID-SDNet) methodology for improving the generalization capacity of COVID-classification models. Our approach reaches good and stable results with an accuracy of [Formula: see text], [Formula: see text], [Formula: see text] in severe, moderate and mild COVID-19 severity levels. Our approach could help in the early detection of COVID-19. COVIDGR-1.0 along with the severity level labels are available to the scientific community through this link https://dasci.es/es/transferencia/open-data/covidgr/.

Antigen characterization from second instars of oestrid bot flies for the detection of anti-Cephenemyia stimulator antibodies by ELISA in roe deer (Capreolus capreolus).

A study to determine the most appropriate antigen for use in the serodiagnosis of Cephenemyia (Diptera: Oestridae) infestation in roe deer (Capreolus capreolus) was carried out using immunoenzymatic tests. Serum samples from 43 roe deer from northern Spain were obtained post-mortem and corresponding numbers of bot fly larvae established. Three antigen complexes were tested, including Cephenemyia stimulator Clark excretory/secretory antigens (CsES), C. stimulator somatic antigens (CsSA) and Oestrus ovis L. (Diptera: Oestridae) excretory/secretory antigens (OoES). In addition, the composition of each antigen was analysed using an electrophoresis system. Cephenemyia stimulator larvae were found in 25% of roe deer; the mean intensity of infection was 24.3 larvae per infested animal. In the antigen analysis, CsSA showed four exclusive bands of molecular weight (17-19, 62, 65 and 67-70 kDa). A positive correlation between immunoglobulin G (IgG) values and total number of larvae was found with CsES and CsSA. The highest sensitivity value, negative predictive value and negative likelihood ratio were obtained using CsES. The highest specificity value, positive likelihood ratio and kappa value were achieved with CsSA. The predictive values of the enzyme-linked immunosorbent assay (ELISA) using CsES and CsSA reached statistical significance and seroprevalence values were 26-44%. The use of ELISA with CsES and CsSA seems promising in the non-invasive diagnosis of Cephenemyia infestation in roe deer.

Relationship between exposure to Fasciola hepatica in roe deer (Capreolus capreolus) and cattle extensively reared in an endemic area.

The aim of this work is to know the prevalence of Fasciola hepatica in 301 roe deer and in 676 beef cattle kept in an endemic area. Detection of antibodies was determined in roe deer using a homemade ELISA with excretory/secretory antigens (FhES) and a recombinant protein (FhrAPS). None of the deer passed eggs by faeces and none flukes in their livers were found. The seroprevalence of F. hepatica was 29% using FhES, with significantly higher values in the oldest ones (36%). Twenty-eight percent of the samples were positive to FhrAPS. Twenty-three percent of the cows eliminated eggs of F. hepatica and the seroprevalence was 67% using FhrAPS. No relationship between the seropositivity values of deer and cattle was demonstrated. The role of wild ruminants as reservoirs of F. hepatica is discussed. We encourage the use of ELISA to know the possibility of exposure to trematodes in wild ruminants.

The efficacy of four anthelmintics against Calicophoron daubneyi in naturally infected dairy cattle.

The paramphistomicidal activity of four anthelmintics in dairy cattle naturally infected by Calicophoron (Paramphistomum) daubneyi was evaluated. Seventy Friesian adult cows were treated at drying-off (19 albendazole; 23 netobimin; 13 closantel and 15 oxyclozanide), and 21 remained untreated as controls. The anthelmintic efficacy was determined by estimating the faecal egg count reduction (FECR) values for each of the anthelmintics. The reduction in the number of cows shedding eggs in the faeces was also estimated. The C. daubneyi egg-output was not fully suppressed following the administration of any of the parasiticides. The FECR values ranged from 0% to 26% in the cows receiving albendazole or netobimin, with 11-39% of cattle becoming negative after therapy. Better results were achieved with closantel and oxyclozanide, with FECR values of 97-99% and CPCR (cattle positive by coprology reduction) percentages of 85-93%. The observation of a similar efficacy with closantel and oxyclozanide against C. daubneyi led us to recommend the administration of closantel in those countries where oxyclozanide is not available.

Mixed production of filamentous fungal spores for preventing soil-transmitted helminth zoonoses: a preliminary analysis.

Helminth zoonoses are parasitic infections shared by humans and animals, being the soil-transmitted helminths (STHs) mainly caused by roundworms (ascarids) and hookworms. This study was aimed to assess the individual and/or mixed production of two helminth-antagonistic fungi, one ovicide (Mucor circinelloides) and other predator (Duddingtonia flagrans). Fungi were grown both in Petri plates and in a submerged culture (composed by water, NaCl, Na2HPO4 · 12 H2O, and wheat (Triticum aestivum)). A Fasciola hepatica recombinant protein (FhrAPS) was incorporated to the cultures to improve fungal production. All the cultured plates showed fungal growth, without difference in the development of the fungi when grown alone or mixed. High counts of Mucor spores were produced in liquid media cultures, and no significant differences were achieved regarding single or mixed cultures, or the incorporation of the FhrAPS. A significantly higher production of Duddingtonia spores after the incorporation of the FhrAPS was observed. When analyzing the parasiticide efficacy of the fungal mixture, viability of T. canis eggs reduced to 51%, and the numbers of third stage cyathostomin larvae reduced to 4%. It is concluded, the capability of a fungal mixture containing an ovicide (Mucor) and a predator species (Duddingtonia) for growing together in a submerged medium containing the FhrAPS offers a very interesting tool for preventing STHs.

Infection by Paramphistomidae trematodes in cattle from two agricultural regions in NW Uruguay and NW Spain.

The analysis of infection by Paramphistomidae trematodes was conducted in two agricultural regions with different knowledge on this parasitosis. Faecal and blood samples were collected from 374 cattle in Salto (NW Uruguay) where there is a lack of information about paramphistomosis. A total of 429 cattle from Galicia (NW Spain), an area with previous records of infection by gastric flukes, were sampled. Diagnostics of trematodosis was developed by using a copromicroscopic probe and an ELISA with excretory/secretory antigens collected from adult Calicophoron daubneyi (Paramphistomidae) specimens. Results were evaluated according intrinsic and extrinsic factors. In the Uruguay, the percentage of cattle passing Paramphistomidae-eggs by faeces was 7% (95% Confidence Interval 5, 10). A significantly higher prevalence of paramphistomosis in the Hereford × Angus cattle (OR=3.5) was recorded, as observed for the oldest ruminants (>3.5 years). An overall seroprevalence of 29% (25, 34) was obtained by ELISA, with the highest values in the Friesians (OR=3), the youngest bovines (<2.5 years) and dairy cattle (Friesians). Twenty-six percent (22, 30) of the cattle from Spain passed eggs by faeces, and cattle aged 2.5-7 years reached significant highest prevalences. By means of the ELISA, a percentage of 55 cattle (50, 59) had antibodies against the gastric fluke, and the highest seroprevalence was observed among the bovines under 6 years. It is concluded that paramphistomosis is on the increase in cattle from NW Spain, partly due to the absence of an effective treatment against the trematode. There is a need for reducing the risk of infection by Paramhistomidae spp. in cattle from Uruguay, especially by improving their management to avoid exposure to the gastric trematode. Further studies are in progress for identifying the species of Paramphistomidae affecting ruminants in Uruguay.

Impulso de la seguridad del paciente a partir del contrato programa de centro / Boost for patient safety with the centre agreement program

Objetivo. Identificar y definir un conjunto mínimo y normalizado de objetivos de seguridad en el contrato programa de centro (CPC) de la Comunidad de Madrid, cuya implantación y seguimiento permita garantizar la mejora de la calidad asistencial y la seguridad del paciente en Atención Primaria. Material y métodos. El elemento clave es el CPC elaborado con el modelo EFQM como referente. Metodológicamente, se han seguido las etapas del ciclo de mejora. En la planificación, se ha incluido en el CPC objetivos normalizados de seguridad. El seguimiento de los indicadores se ha realizado con una aplicación informática. Resultados. En el CPC 2009 se han definido 12 objetivos de seguridad y 21 indicadores. En todos los criterios del modelo se ha contemplado la inclusión de algún objetivo de seguridad. Destacamos los siguientes resultados: en el criterio de procesos, la cobertura del programa del polimedicado es del 59,22%, en el 93% de las consultas se utiliza solución bioalcohólicas y el 89% de los Centros de Salud (CS) realizan control y mantenimiento de carros de parada. En comunicación, se han notificado 1.096 errores de medicación en toda la Comunidad de Madrid, 239 reacciones adversas a medicamentos y 1.945 incidentes de seguridad. En el criterio 6, clientes, el 66,22% de los INR están en rango. Se ha obtenido 19,46 DHD osteoporosis en mujeres de 45-65 años y 16,9 DHD neurolépticos en personas mayores. El indicador referente a BEERS es del 11,9%. Se han adoptado una 1,19 medidas de seguridad por CS. En resultados personas, el 14,44% de los profesionales se han formado en calidad y seguridad del paciente. Con la aplicación e-SOAP los CS conocen resultados para adoptar mejoras. Se han introducido mejoras en el CPC 2010. Conclusiones. Con el CPC elaborado con el modelo EFQM como referente, se han implantado y seguido indicadores de seguridad de forma sistematizada en los CS de la Comunidad de Madrid. Se han generalizado buenas prácticas que garantizan la seguridad del paciente, y se ha empezado a evaluar el impacto de la atención sanitaria prestada en Atención Primaria con la medición de indicadores que la evidencia científica revela que afectan a la seguridad del paciente(AU)

Objective. To identify and define a minimum and standard set of safety objectives in the Centre Agreement Program (CAP) of the Community of Madrid, the introduction of which has led to improved follow-up and an improvement in quality of care and patient safety in Primary Care. Material and Methods. The key element is the Centre Agreement Program developed with the EFQM model as a reference. Methodologically, this project has followed the steps set out in the PDCA cycle., Standardised safety objectives were included in the CAP during the planning phase. Indicators have been monitored by the e-SOAP application. Results. We have identified 12 safety goals and 21 indicators. All the criteria of the model included some safety objectives. We highlight the following results: in the criteria relating to processes, the program cover of patients who were on several medications was 59.22%, a bio-alcohol solution was used in 93% of health facilities, 89% of Health Centres had performed a control and maintenance of vital emergency equipment. As regards communication, 1096 medication errors were notified throughout the Community of Madrid. There were 239 adverse reactions to medication and 1945 safety incidents were reported. In criterion 6, 66.22% of INR determinations were within range. There were 19.46 defined daily doses (DDD) for women of 45-65 years, and 16.9 DDD of neuroleptics in the elderly population. The indicator related to minimising drugs considered inappropriate in the elderly (Beers) was 11.9%. An average of 1.19 safety measures were adopted per Centre. For Criterion 7, 14.44% of professionals had been trained in quality and patient safety. By implementing e-SOAP, Health Centres can know their results in order to implement improvements. In addition, improvements have been set up in the 2010 CAP. Conclusions. With the development of the CAP using the EFQM model as a benchmark, safety indicators have been implemented and monitored systematically in the Health Centres of the Community of Madrid. Best practices that ensure patient safety have been extended and we have begun to evaluate the impact of the health care provided in Primary Care with the measurement of indicators that the scientific evidence reveals affect patient safety(AU)

[Boost for patient safety with the centre agreement program]. / Impulso de la seguridad del paciente a partir del contrato programa de centro.

OBJECTIVE: To identify and define a minimum and standard set of safety objectives in the Centre Agreement Program (CAP) of the Community of Madrid, the introduction of which has led to improved follow-up and an improvement in quality of care and patient safety in Primary Care. MATERIAL AND METHODS: The key element is the Centre Agreement Program developed with the EFQM model as a reference. Methodologically, this project has followed the steps set out in the PDCA cycle., Standardised safety objectives were included in the CAP during the planning phase. Indicators have been monitored by the e-SOAP application. RESULTS: We have identified 12 safety goals and 21 indicators. All the criteria of the model included some safety objectives. We highlight the following results: in the criteria relating to processes, the program cover of patients who were on several medications was 59.22%, a bio-alcohol solution was used in 93% of health facilities, 89% of Health Centres had performed a control and maintenance of vital emergency equipment. As regards communication, 1096 medication errors were notified throughout the Community of Madrid. There were 239 adverse reactions to medication and 1945 safety incidents were reported. In criterion 6, 66.22% of INR determinations were within range. There were 19.46 defined daily doses (DDD) for women of 45-65 years, and 16.9 DDD of neuroleptics in the elderly population. The indicator related to minimising drugs considered inappropriate in the elderly (Beers) was 11.9%. An average of 1.19 safety measures were adopted per Centre. For Criterion 7, 14.44% of professionals had been trained in quality and patient safety. By implementing e-SOAP, Health Centres can know their results in order to implement improvements. In addition, improvements have been set up in the 2010 CAP. CONCLUSIONS: With the development of the CAP using the EFQM model as a benchmark, safety indicators have been implemented and monitored systematically in the Health Centres of the Community of Madrid. Best practices that ensure patient safety have been extended and we have begun to evaluate the impact of the health care provided in Primary Care with the measurement of indicators that the scientific evidence reveals affect patient safety.

Isolation of potentially useful antigens from cyathostomin third-stage larvae by using a fast protein liquid chromatography one-step method.

Three major protein complexes (51, 29, and 15 kDa, named P1 to P3, respectively) were resolved by gel filtration of the excretory/secretory antigens collected from a mixture of horse cyathostomin third-stage larvae (L3s). The potential application for the detection of infected horses was assessed with an enzyme-linked immunosorbent assay (ELISA) by the comparison of the serological and copromicroscopical results. The value of the area under the receiver operating characteristic (ROC) curve was higher than 0.9 when the three peaks were used. Elevated values (>90%) for the sensitivity, specificity, and the positive-likelihood ratio were also observed for all the antigen complexes. A significant increment in the IgG antibody levels 4 weeks prior to the observation of eggs in the feces of weanlings naturally infected was recorded. Our results indicate that the evaluation of chemotherapy is possible by using immunoenzymatic probes and fast protein liquid chromatography (FPLC)-purified antigens. Data collected in the present investigation indicate that FPLC isolation offers a very helpful one-step method for collecting antigens with diagnostic potential to be employed in immunoenzymatic probes.

Prevalence of mixed trematode infections in an abattoir receiving cattle from northern Portugal and north-west Spain.

Between February 2007 and January 2009, a total of 776 slaughtered animals were examined for the presence of Trematoda in the liver, gall bladder, oesophagus and stomach (rumen and reticulum). Data collected were analysed by the age and breed of the animals. The percentage of cattle from which Trematoda were found was 38 per cent (95 per cent confidence interval [CI] 35 to 41 per cent); 28 per cent (95 per cent CI 25 to 31 per cent) had Fasciola hepatica, 12 per cent (95 per cent CI 10 to 14 per cent) Calicophoron daubneyi and 6 per cent (95 per cent CI 4 to 8 per cent) Dicrocoelium species. A significantly high prevalence of fasciolosis and dicrocoeliosis was observed in cattle over 10 years of age. Autochthonous Rubia Gallega cattle had the highest prevalence of fasciolosis and crossbred cattle had the highest prevalence of dicrocoeliosis (P<0.05). Twenty per cent (95 per cent CI 15 to 25 per cent) of the cattle positive for Fasciola also had Calicophoron species; 10 per cent (95 per cent CI 6 to 14 per cent) also had small liver flukes (Dicrocoelium species).

Ability of the fungus Duddingtonia flagrans to adapt to the cyathostomin egg-output by spreading chlamydospores.

The analysis of the capability of the nematode trapping-fungus Duddingtonia flagrans to adapt to the cyathostomin egg-output in horses was evaluated. Fecal samples from 196 pasturing autochthonous Pura Raza Galega horses were collected from the rectum and then divided according to the egg-output into three groups: ≤ 300, 310-800 and >800 eggs per gram feces. Four doses of chlamydospores (0.1, 0.2, 0.4 and 0.8 × 10(6)/100g feces) were directly spread onto fecal pats on the ground, remaining one without treatment as control. Fecal pats confirmed the presence of gastrointestinal nematode larvae belonging to strongylid cyathostomins (Cyathostomum and Gyalocephalus spp). An overall 94% (95% CI 91, 97) percentage of reduction was obtained, and an increase in the activity of the trapping-fungi simultaneously to the rising in the number of cyathostomin eggs and larvae in the coprocultures was detected. A significantly highest reduction of the cyathostomin L3 in the coprocultures with more than 800 EPG was found, which indicates that Df trapping activity is larvae nematode density-dependant. The present research showed the high biological activity of D. flagrans against nematode larvae can adjust to the cyathostomin egg-output, and underlines its efficacy as a practical method for the control of these parasites in grazing horses.

Oxycodone improves pain control and quality of life in anticonvulsant-pretreated spinal cord-injured patients with neuropathic pain.

STUDY DESIGN: A 3-month follow-up, observational, prospective, multicenter, study in traumatic spinal cord-injured (SCI) patients with neuropathic pain (NP). OBJECTIVES: To assess the effectiveness and safety of oxycodone treatment in SCI patients with anticonvulsants-refractory NP. SETTING: 'Spinal injury follow-up units' throughout Spain. METHODS: Data regarding NP characteristics were collated from male and female adults with traumatic SCI and difficult-to-control central NP of moderate-to-severe intensity (visual analog scale (VAS) ≥4) persisting ≥1 month, who had been para- or tetraplegic for ≥2 months, had been previously treated with anticonvulsants and were now treated with oxycodone. RESULTS: In all, 54 out of the 57 patients recruited were assessable. A total of 81% were men and the mean age was 46.4. Patients were treated with oxycodone, 83% combined with anticonvulsant. Pain intensity (VAS: 7.1 ± 1.3-4.3 ± 1.7) and Lattinen total score (13.2 ± 3-7.7 ± 3.4) decreased significantly (P < 0.001) along the study. No patient got worse regarding pain impact on physical activity and on sleep (Lattinen scale). EQ-5D VAS showed a trend to increase (P = 0.061) and the index of preference values increased significantly from baseline to month 3 (0.26-0.62; P < 0.001). A total of 53.7% patients showed at least one treatment-related adverse event, with constipation being the most frequent one (33.3%). CONCLUSION: Oxycodone treatment, mostly in combination with anticonvulsants, in SCI patients with NP decreases pain intensity, improves health-related quality of life and diminishes the impact of pain on physical activity and sleep.

Application of the analysis of serum antibodies (immunoglobulins M and G) to estimate the seroprevalence of ovine oestrosis and to evaluate the effect of chemotherapy.

The analysis of immunoglobulin (Ig) M and IgG serum isotypes as indicators of the presence of Oestrus ovis developmental stages was carried out. A serological survey to discover the seasonal variations in the prevalence of oestrosis in sheep from an oceanic climate area was developed. Six hundred and sixty-nine blood samples were analyzed for the presence of IgM and IgG using an enzyme-linked immunosorbent assay and O. ovis second-stage larvae excretory/secretory antigens. In addition, the effect of an ivermectin-based treatment on the humoral immune response was measured. The percentage of positive animals was 54% for IgM and 55% for IgG. The highest percentages of sheep positive to IgM were recorded in the winter and to IgG in the summer. No animals positive to IgM were detected in the ivermectin-treated sheep. These results seem to underline that oestrosis is a parasitic disease to keep watch for in regions with an oceanic climate. A noninvasive evaluation of the success of chemotherapy seems possible by analyzing the serum IgM response.

A novel second instar Gasterophilus excretory/secretory antigen-based ELISA for the diagnosis of gasterophilosis in grazing horses.

We have developed a novel enzyme-linked immunosorbent assay (ELISA) based on excretory/secretory antigens of second instar Gasterophilus for the diagnosis of gasterophilosis in grazing horses. Between January 2007 and January 2009, two experiments were carried out on free-ranging horses in northwest Spain. During the first year, monthly blood samples were collected from a herd of 25 horses. In the second year, a monthly serological survey was conducted for a total of 398 different horses. All the sera were analyzed by ELISA using excretory/secretory antigens from Gasterophilus intestinalis (GphiL2ES) and Gasterophilus nasalis second-stage larvae (GphnL2ES). Climatic data were collected between January 2007 and January 2009 from local meteorological automated stations to establish the weather pattern in the study area. Observations of Gasterophilus eggs on the horses' hair and third instars passed in the faeces were also done. The kinetics of IgG response decreased against GphiL2ES from January to July, increased slowly from August and rose up to January. After a slight decrease in January, the absorbances against GphnL2ES reduced from April to August, when the lowest values were observed. The IgG values rose until the end of the study in January. Third instars were observed in the faeces in March to May, and Gasterophilus eggs were seen on the horses' hair from June to September. The highest IgG seroprevalences were achieved in winter (January-February; 100%) against both antigens. The lowest percentages of seropositivity were observed in June (3%) to the GphiL2ES, and in July (9%) to the GphnL2ES. The use of antigens from G. intestinalis second-stage larvae was shown to be suitable for diagnosing infestation by G. intestinalis or G. nasalis. We concluded that under oceanic climate conditions, the egg-laying period occurs from late spring, and eggs and first instars are found in the mouth in early summer. During summer the second instars move into the stomach and intestine, where the third-stage larvae remain until the end of winter, when pupation takes place. The adult horse bot fly emerges in the spring. Two treatments for the control of gasterophilosis are suggested: a curative in the summer to eliminate the first instars and a preventive in the autumn to suppress the second instars.

An approach of the laboratory to the field: assessment of the influence of cattle management on the seroprevalence of fascioliasis by using polyclonal- and recombinant-based ELISAs.

A cross-sectional study was conducted to assess the seroprevalence of fascioliasis by immunoenzymatic probes in an endemic area (northwestern Spain). Blood samples were collected from 1,034 cattle (crossbred, Rubia Gallega, and Friesian breeds), and the diagnosis of fascioliasis was carried out by determining both the occurrence of antigenemia and the presence of specific IgG antibodies against a Fasciola hepatica recombinant protein (FhrAPS). The IgG seroprevalence was 65% (95% CI, 62-68) by the FhrAPS-ELISA, and 32% (29-35) exhibited antigenemia; the lowest percentages occurred in the Friesians, and the highest percentages were found in the crossbreds. These results confirm an elevated seroprevalence of fascioliasis that is unexpected considering that most of the cattle livestock (Friesian and Rubia Gallega) receive fasciolicide treatment. The lack of adequate measures on the environment and erratic chemotherapy seem to be responsible for the fact that control of fascioliasis has not improved in the last 10 yr in the area of study.