Identificación y cuantificación del efecto fin de semana y festivos en la atención del síndrome coronario agudo en el Sistema Nacional de Salud / The effect of weekends and public holidays on the care of acute coronary syndrome in the Spanish National Health System

Introducción y objetivos Analizar si el ingreso en fin de semana o festivo (IFSF), frente al ingreso en días laborables, influye en el tratamiento (angioplastia, intervención coronaria percutánea [ICP]) y los resultados (mortalidad hospitalaria) de los pacientes hospitalizados por síndrome coronario agudo en el Sistema Nacional de Salud. Métodos Estudio observacional retrospectivo de pacientes ingresados por infarto agudo de miocardio con elevación del segmento ST (IAMCEST) o con síndrome coronario agudo sin elevación del segmento ST (SCASEST) en los hospitales del Sistema Nacional de Salud durante el periodo 2003-2018. Resultados Se seleccionaron 438.987 episodios de IAMCEST y 486.565 de SCASEST, de los cuales fueron IFSF el 28,8 y el 26,1% respectivamente. El IFSF se mostraba como un factor de riesgo de mortalidad hospitalaria en los modelos ajustados por riesgo del IAMCEST (OR=1,05; IC95%, 1,03-1,08; p<0,001) y del SCASEST (OR=1,08; IC95%, 1,05-1,12; p <0,001). La tasa de ICP en el IAMCEST fue más de 2 puntos porcentuales mayor en los pacientes ingresados en días laborables durante el periodo 2003-2011 y similar o incluso más baja en 2012-2018, sin cambios significativos para el SCASEST. El IFSF se mostró como factor de riesgo estadísticamente significativo tanto para el IAMCEST como para el SCASEST. Conclusiones El IFSF puede aumentar el riesgo de muerte hospitalaria en un 5% (IAMCEST) y un 8% (SCASEST). La persistencia del riesgo de mayor mortalidad hospitalaria tras ajustar por la realización de ICP y las demás variables explicativas probablemente indique dficiencias en el tratamiento durante el fin de semana respecto de los días laborables (AU)

Introduction and objectives To analyze whether admission on weekends or public holidays (WHA) influences the management (performance of angioplasty, percutaneous coronary intervention [PCI]) and outcomes (in-hospital mortality) of patients hospitalized for acute coronary syndrome in the Spanish National Health System compared with admission on weekdays. Methods Retrospective observational study of patients admitted for ST-segment elevation myocardial infarction (STEMI) or for non–ST-segment elevation acute coronary syndrome (NSTEACS) in hospitals of the Spanish National Health system from 2003 to 2018. Results A total of 438 987 episodes of STEMI and 486 565 of NSTEACS were selected, of which 28.8% and 26.1% were WHA, respectively. Risk-adjusted models showed that WHA was a risk factor for in-hospital mortality in STEMI (OR, 1.05; 95%CI,1.03-1.08; P < .001) and in NSTEACS (OR, 1.08; 95%CI, 1.05-1.12; P < .001). The rate of PCI performance in STEMI was more than 2 percentage points higher in patients admitted on weekdays from 2003 to 2011 and was similar or even lower from 2012 to 2018, with no significant changes in NSTEACS. WHA was a statistically significant risk factor for both STEMI and NSTEACS. Conclusions WHA can increase the risk of in-hospital death by 5% (STEMI) and 8% (NSTEACS). The persistence of the risk of higher in-hospital mortality, after adjustment for the performance of PCI and other explanatory variables, probably indicates deficiencies in management during the weekend compared with weekdays (AU)

Gasto sanitario público y mortalidad por COVID-19 en España y en Europa / Public healthcare expenditure and COVID-19 mortality in Spain and in Europe

Objetivo Analizar la asociación entre el gasto sanitario público per cápita y la tasa de mortalidad poblacional por COVID-19 en Europa y en España. Material y métodos Se utilizó el coeficiente de correlación de Pearson. Asimismo, se contrastaron los promedios de TMP-COVID-19 entre países y comunidades autónomas con mayor y menor GSPpc que el promedio. Resultados No se halló correlación, en los países europeos, entre el gasto sanitario público per cápita y la tasa de mortalidad poblacional por COVID-19 (r: 0,3; p = 0,14), ni en las comunidades autónomas (r: 0,03; p = 0,91). Tampoco se encontraron diferencias significativas en el contraste de la tasa de mortalidad poblacional por COVID-19 por grupos de gasto sanitario público per capita. Conclusiones La asociación entre «bajo» gasto sanitario público y malos resultados en España en la crisis de la COVID-19 no está sustentada en la evidencia disponible. Los aumentos de financiación de la sanidad pública deberían destinarse a las reformas estructurales para aumentar su eficiencia social (AU)

Objective To analyze the association between public health expenditure per capita and the mortality rate due to COVID-19 in Europe and Spain. Material and methods Pearson's correlation coefficient was used to compare and contrast the mortality rate due to COVID-19 between countries and autonomous communities with higher and lower public health expenditure per capita than the mean. Results No correlation between the public health expenditure per capita and the mortality rate due to COVID-19 (r: 0.3; p = 0.14) was found among European countries or Spain's Autonomous Communities (r: 0.03; p = 0.91). No significant differences were found when comparing the mortality rate due to COVID-19 among the public health expenditure per capita groups. Conclusions The available evidence does not support association between «low» public healthcare expenditure and the poor outcomes observed in Spain during the COVID-19 pandemic. Increased funding for the Spanish National Health System should be earmarked for structural reforms to increase its social efficiency (AU)

Public healthcare expenditure and COVID-19 mortality in Spain and in Europe.

OBJECTIVE: To analyze the association between public health expenditure per capita and the mortality rate due to COVID-19 in Europe and Spain. MATERIAL AND METHODS: Pearson's correlation coefficient was used to compare and contrast the mortality rate due to COVID-19 between countries and autonomous communities with higher and lower public health expenditure per capita than the mean. RESULTS: No correlation between the public health expenditure per capita and the mortality rate due to COVID-19 (r: 0.3; p = 0.14) was found among European countries or Spain's Autonomous Communities (r: 0.03; p = 0.91). No significant differences were found when comparing the mortality rate due to COVID-19 among the public health expenditure per capita groups. CONCLUSIONS: The available evidence does not support association between «low¼ public healthcare expenditure and the poor outcomes observed in Spain during the COVID-19 pandemic. Increased funding for the Spanish National Health System should be earmarked for structural reforms to increase its social efficiency.

[Public healthcare expenditure and COVID-19 mortality in Spain and in Europe]. / Gasto sanitario público y mortalidad por COVID-19 en España y en Europa.

OBJECTIVE: To analyze the association between public health expenditure per capita and the mortality rate due to COVID-19 in Europe and Spain. MATERIAL AND METHODS: Pearson's correlation coefficient was used to compare and contrast the mortality rate due to COVID-19 between countries and autonomous communities with higher and lower public health expenditure per capita than the mean. RESULTS: No correlation between the public health expenditure per capita and the mortality rate due to COVID-19 (r: 0.3; p = 0.14) was found among European countries or Spain's Autonomous Communities (r: 0.03; p = 0.91). No significant differences were found when comparing the mortality rate due to COVID-19 among the public health expenditure per capita groups. CONCLUSIONS: The available evidence does not support association between «low¼ public healthcare expenditure and the poor outcomes observed in Spain during the COVID-19 pandemic. Increased funding for the Spanish National Health System should be earmarked for structural reforms to increase its social efficiency.

Spoilage yeasts: What are the sources of contamination of foods and beverages?

Foods and beverages are nutrient-rich ecosystems in which most microorganisms are able to grow. Moreover, several factors, such as physicochemical characteristics, storage temperature, culinary practices, and application of technologies for storage, also define the microbial population of foods and beverages. The yeast population has been well-characterised in fresh and processed fruit and vegetables, dairy products, dry-cured meat products, and beverages, among others. Some species are agents of alteration in different foods and beverages. Since the most comprehensive studies of spoilage yeasts have been performed in the winemaking process, hence, these studies form the thread of the discussion in this review. The natural yeast populations in raw ingredients and environmental contamination in the manufacturing facilities are the main modes by which food contamination occurs. After contamination, yeasts play a significant role in food and beverage spoilage, particularly in the alteration of fermented foods. Several mechanisms contribute to spoilage by yeasts, such as the production of lytic enzymes (lipases, proteases, and cellulases) and gas, utilisation of organic acids, discolouration, and off-flavours. This review addresses the role of yeasts in foods and beverages degradation by considering the modes of contamination and colonisation by yeasts, the yeast population diversity, mechanisms involved, and the analytical techniques for their identification, primarily molecular methods.

Combined effect of antagonistic yeast and modified atmosphere to control Penicillium expansum infection in sweet cherries cv. Ambrunés.

Fruit decay caused by pathogenic moulds is a major concern in the postharvest quality and shelf life of fruit. Blue mould decay is caused by Penicillium expansum (P. expansum) and is one of the most important postharvest diseases in cherries (Prunus avium L.). Synthetic fungicides are the main medium used to control pathogenic moulds. However, alternative approaches are available for developing safer technologies to control postharvest disease. An integrated approach that combines biological control, using antagonistic yeasts and modified atmosphere packaging (MAP) with cold storage is a promising alternative to synthetic fungicide treatment. In this work, two microperforated films (M10 and M50) and two antagonistic yeast strains (Hanseniaspora opuntiae L479 and Metschnikowia pulcherrima L672) were evaluated for their effectiveness to control the development of P. expansum in wounded cherries stored at 1°C. Results showed that the microperforated films had fungistatic effects, particularly M50, due to the level of CO2 achieved (mean CO2 of 11.2kPa at 35days), and the decrease in disease severity. Antagonistic yeasts, particularly Metschnikowia pulcherrima L672, delayed the development of P. expansum and decreased disease incidence and severity. The combination of MAP and antagonistic yeasts was the most effective approach to control P. expansum, during cold storage.

Yeasts isolated from figs (Ficus carica L.) as biocontrol agents of postharvest fruit diseases.

Fresh fruit is highly perishable during postharvest life, mainly due to fungal growth. Thus, fungal control is an important goal for the fruit industry. In this work, a selection of antagonistic yeasts isolated from fig and breba crops were screened in vitro. The isolated yeasts were challenged with three moulds isolated from decayed figs and breba crops, identified as Penicillium expansum M639 and Cladosporium cladosporioides M310 and M624, and pathogenic moulds Botrytis cinerea CECT20518 and Monilia laxa CA1 from culture collections. Two yeast isolates, Hanseniaspora opuntiae L479 and Metschnikowia pulcherrima L672, were selected for their ability to inhibit the growth of aforementioned moulds. These yeasts reduced the radial growth of moulds on PDA by between 45.23% and 66.09%. Antagonistic activity was associated with the interaction of live yeast cells with moulds. M. pulcherrima L672 apparently parasitised C. cladosporioides isolates. In addition, challenges were assayed using wounded apples and nectarines, with significant reductions in percent infection and lesion size for all moulds tested. To our knowledge, this is the first report identifying H. opuntiae as an antagonist against different pathogenic moulds.

Optimal control in the treatment of retinitis pigmentosa.

Numerous therapies have been implemented in an effort to minimize the debilitating effects of the degenerative eye disease Retinitis Pigmentosa (RP), yet none have provided satisfactory long-term solution. To date there is no treatment that can halt the degeneration of photoreceptors. The recent discovery of the RdCVF protein has provided researchers with a potential therapy that could slow the secondary wave of cone death. In this work, we build on an existing mathematical model of photoreceptor interactions in the presence of RP and incorporate various treatment regiments via RdCVF. Our results show that an optimal control exists for the administration of RdCVF. In addition, our numerical solutions show the experimentally observed rescue effect that the RdCVF has on the cones.

CFTR mutations in three Latin American countries.

We analyzed 192 cystic fibrosis (CF) alleles in three Latin American countries: Mexico, Colombia, and Venezuela. Mutation screening was performed by polymerase chain reaction (PCR) and a reverse dot blot detection kit that enables determination of 16 of the most common CF mutations worldwide. Mutations were detected in 47.9% of the screened CF alleles. The most prevalent CF allele was DeltaF508 (39. 6%). The remaining 16 non-DeltaF508 detectable mutations represented 8.3% of the CF alleles. Among them, the G542X, N1303K, and 3849+10kb C>T were the most common. Although the frequency of DeltaF508 described here is lower than that reported for Caucasian populations, including in Spain, it is remarkable that mutation prevalences found in this study resemble those observed in Spain. Two of these mutations, G542X and 3849+10kb C>T, that were relevant in this analysis, have a particularly high incidence in Spanish communities. The low frequency of DeltaF508 described here may be explained by the Amerindian, Caucasian, and Black admixture that occurred in Latin America after the discovery of the New World, and also by the probable occurrence of mutations contributed by the original natives, which were undetectable in this analysis.

National Bureau of Standards reference materials as organic nutrient standards: a preliminary study.

A preliminary study was conducted to determine if the available National Bureau of Standards (NBS) Standard Reference Materials (SRM) Non-Fat Powdered Milk, Oyster Tissue, Wheat Flour, Rice Flour, Spinach, and Albacore Tuna would be suitable for use as organic nutrient standards. These materials were assayed for folates, total pantothenates, vitamin B6, thiamine, riboflavin, niacin, and protein. Vitamins A, E, D, K, and C were also assayed but, for the most part, were not detected. Based on results from this study, it appears that at least some of the NBS SRMs would be useful as organic nutrient standards.

Reverse phase high pressure liquid chromatographic determination of vitamin K1 in infant formulas.

A reverse phase high pressure liquid chromatographic (HPLC) method for quantitating vitamin K1 in enzymatic hydrolysates of infant formula is described. The vitamin is extracted with n-pentane before determination by isocratic and isothermal reverse phase HPLC. Recovery of vitamin K1 added to 5 infant formulas ranged from 84 to 103%.