Estudio observacional retrospectivo de eventos adversos asociados al tratamiento de COVID-19 / Retrospective observational study of adverse events associated with the treatments used for COVID-19

Objetivos: Cuantificar y clasificar los eventos adversos (EA) asociados a los tratamientos empleados para la COVID-19. Describir los medicamentos empleados y su frecuencia de utilización. Material y métodos: Estudio retrospectivo, unicéntrico, que incluye pacientes adultos con infección confirmada por SARS-CoV-2 con fecha de ingreso hospitalario entre el 13/03/2020 y 13/04/2020 y con fecha de alta o exitus anterior a 31/05/2020. El período de estudio fue el ingreso y los 30 días posteriores al alta. Se registraron datos demográficos, clínicos, relativos al tratamiento y a los EA. Se categorizó la probabilidad de causalidad del fármaco mediante el algoritmo de Karch y Lasagna modificado. Resultados: Se incluyeron 183 pacientes de los cuales en el 51% se registró algún evento adverso. Se utilizaron hasta 9 fármacos diferentes. La combinación más utilizada fue hidroxicloroquina más azitromicina (57,5%). Se notificaron 142 EA durante el ingreso, siendo los más prevalentes los trastornos hematológicos (24,6%) y gastrointestinales (15,5%). Un 29,6% son producidos probable o posiblemente por fármacos usados para el tratamiento de la COVID-19. El medicamento que produjo más reacciones adversas fue el lopinavir-ritonavir (25% de pacientes). Se detectaron 7 interacciones farmacológicas que produjeron alargamiento del intervalo QT del electrocardiograma. En el período de estudio, la prevalencia de tromboembolismo es del 13,1%. Conclusiones: Casi un tercio de los eventos adversos registrados durante la primera fase de la pandemia, pudieron ser debidos a los tratamientos empleados. La profilaxis anticoagulante adecuada y evitar las interacciones, son las principales claves para evitar problemas relacionados con medicamentos en los pacientes con COVID-19. (AU)

Objectives: Quantify and classify adverse events (AE) associated with the treatments used for COVID-19. Describe the medication used and its frequency of use. Material and methods: A retrospective, single-center study, including adult patients with confirmed SARS-CoV-2 infection, hospital admission date between March 13th, 2020 and April 13th, 2020 and with a discharge or death date prior to May 31st, 2020. The study period was from the admission date and until 30 days after discharge. Demographic data, clinical data, treatment and adverse events were recorded. The probability of drug causality was categorized using the modified Karch and Lasagna algorithm. Results: 183 patients were included of which 51% had some adverse event. Up to 9 different drugs were used. The most used combination was hydroxychloroquine plus azithromycin (57.5%). 142 AE were reported during admission, being haematological (24.6%) and gastrointestinal (15.5%) disorders the most prevalent. 29.6% are probably or possibly produced by drugs used for the treatment of COVID-19. The drug that caused the most adverse reactions was lopinavir-ritonavir (25% of patients). Seven drug interactions were detected that produced lengthening of the QT interval of the electrocardiogram. In the study period, the prevalence of thromboembolism is 13.1%. Conclusions: Almost a third of the adverse events registered during the first phase of the pandemic could be due to the treatment used. Adequate anticoagulant prophylaxis and avoiding interactions are the main keys to prevent drug-related problems in patients with COVID-19. (AU)

Accumulation, distribution pattern and potential contamination of sulphur in vineyard soils of the Valdepeñas protected denomination origin.

Soil is the basis for almost all global agriculture and the medium in which most terrestrial biological activity occurs. Viticulture represents an important agricultural practice in the Castilla-La Mancha (CLM) community. In this region, there are several protected denominations of origin (PDO), the largest being Valdepeñas. This paper describes the accumulation pattern of sulphur (S) in the vineyard soils of this PDO. Samples were collected from 90 vineyard soil profiles. Sulphur content was determined using an X-ray Fluorescence spectrometer in the solid mode on a powdered aliquot of each sample. The results indicated that the total S in soils varied from 0.54 to 6.90 (g·kg-1) in surface soil (0-30 cm) and from 0.39 to 2.80 (g·kg-1) on the subsurface layer (30-80 cm). When comparing the mean values of surface horizons to the subsurface horizons, S content lowered as soil depth increased. Kurtosis exceeded 45 % in all cases, which indicates a wide variability of concentrations. These findings can be explained by the continuous fertiliser and fungicide applications (and therefore S) in these production systems. Using the geoaccumulation index (Igeo), most soils were included in Class 0 (Igeo <0) and were, thus, S uncontaminated; only a few points can be considered pollutants. The obtained results should contribute to extend the scarce existing database on S in Mediterranean regions like that herein studied.

Anaphylaxis: Mediators, Biomarkers, and Microenvironments.

The life-threatening nature of anaphylactic reactions has increased interest in discovering new biomarkers that could improve diagnosis and prevention. However, the diverse nature of the clinical features and the etiology and pathogenesis of anaphylaxis hinder the identification of valuable molecular indicators of disease. Most studies on anaphylaxis focus on the immune system. Anaphylactic reactions are characterized primarily by IgE-mediated activation of mast cells and basophils and release of mediators. Determination of serum tryptase levels is the main in vitro test used to confirm the reaction, although there are no biomarkers that can predict it. Nevertheless, recent research has postulated that alternative pathways, cell types, and systems are involved. Consequently, various molecular products have been explored and considered potential biomarkers, although none of them are yet used in clinical practice. The products that are altered in patients with anaphylaxis include vasoactive agents, proteases, proteoglycans, lipids, interleukins, cytokines, products of the complement-contact and coagulation systems, circulating proteins, extracellular vesicles, microRNAs, and metabolites. The recognition of biological processes and molecular pathways affecting the microenvironments involved in anaphylaxis will considerably improve clinical practice and the identification of better molecular markers. We offer a broad review of the various mediators described in anaphylaxis, consider their usefulness as potential biomarkers of this pathological event, and examine their role in the molecular basis of the reaction.

Traumatismo torácico con lesión de grandes vasos del tórax: características, tratamiento y variables asociadas a mortalidad / Thoracic trauma with injury to the great vessels of the chest: characteristics, treatments and variables associated with mortality

Resumen Introducción: Las lesiones de grandes vasos del tórax por traumatismo torácico (TTLGV) son un grupo heterogéneo de lesiones con alta morbimortalidad que constituyen un 0,3-10% de los hallazgos en el traumatismo torácico (TT). Objetivos: Describir características, tratamientos y variables asociadas a mortalidad en pacientes hospitalizados con TTLGV. Material y Métodos: Estudio analítico-observacional. Período enero-1981 y diciembre-2020. Revisión de protocolos de TT prospectivos y fichas clínicas. Se clasificaron los TTLGV según American Association for the Surgery of Trauma (AAST), se calcularon índices de gravedad del traumatismo: Injury Severity Score (ISS), Revised Trauma Score Triage (RTS-T) y Trauma Injury Severity Score (TRISS). Se realizó análisis univariado y multivariado con cálculo de Odds Ratio (OR) para variables asociadas a mortalidad. Se usó SPSS25®, con pruebas UMann Whitney y chi-cuadrado, según corresponda. Resultados: de un total 4.577 TT, 97 (2,1%) cumplieron criterios de inclusión. Hombres: 81 (91,8%), edad promedio: 32,3 ± 14,8 años. TT penetrante: 65 (67,0%). Lesión de arterias axilo-subclavias en 39 (40,2%) y aorta torácica en 31 (32,0%) fueron las más frecuentes. Fueron AAST 5-6: 39 (40,2%). Tratamiento invasivo: 87 (89,7%), de éstos, en 20 (20,6%) reparación endovascular, 14 (14,4%) de aorta torácica. Cirugía abierta en 67 (69,1%). Mortalidad en 13 (13,4%), fueron variables independientes asociadas a mortalidad el shock al ingreso (OR 6,34) e ISS > 25 (OR 6,03). Conclusión: En nuestra serie, los TTLGV fueron más frecuentemente de vasos axilo-subclavios y aorta torácica. El tratamiento fue principalmente invasivo, siendo la cirugía abierta el más frecuente. Se identificaron variables asociadas a mortalidad.

Background: Thoracic great vessel injuries in thoracic trauma (TTGVI) are a heterogeneous group of injuries with high morbimortality that constituting 0.3-10% of the findings in thoracic trauma (TT). Aim: To describe characteristics, treatments and variables associated with mortality in hospitalized patients with TTGVI. Methods: Observational-analytical study. Period January-1981 and December-2020. Review of prospective TT protocols and clinical records. TTGVI were classified according to American Association for the Surgery of Trauma (AAST), trauma severity index were calculated: Injury Severity Score (ISS), Revised Trauma Score Triage (RTS-T) and Trauma Injury Severity Score (TRISS). Univariate and multi- variate analysis was performed with calculation of Odds Ratio (OR) for variables associated with mortality. SPSS25® was used, with U Mann Whitney and chi-squared tests, as appropriate. Results: From a total of 4.577 TT in the period, 97 (2.1%) met the inclusion criteria. Males: 81 (91.8%), mean age: 32.3 ± 14.8 years. Penetrating TT: 65 (67.0%). Axillary-subclavian artery lesions in 39 (40.2%) and thoracic aorta in 31 (32.0%) were more frequent. AAST 5-6: 39 (40.2%). Invasive treatment: 87 (89.7%), of these, in 20 (20.6%) endovascular repair, 14 (14.4%) of thoracic aorta. Open surgery in 67 (69.1%). Mortality in 13 (13.4%), shock on admission was independently associated with mortality (OR 6.34) and ISS > 25 (OR 6.03). Conclusión: In our series, TTGVI were more frequent in axillary-subclavian vessels and thoracic aorta. Treatment was mainly invasive, with open surgery being the most frequent. Variables associated with mortality were identified.

Allergen Profile of London Plane Tree Pollen: Clinical and Molecular Pattern in Central Spain.

BACKGROUND AND OBJECTIVES: Platanus acerifolia (London plane tree) is a deciduous tree of the Platanaceae family. Sensitization to this plant varies with geography. Madrid, located in central Spain, has one of the highest London plane tree pollen concentration levels on the Iberian Peninsula. We evaluated both the clinical characteristics and the molecular sensitization pattern of patients with allergy to London plane tree pollen in the region of Madrid. METHODS: Thirty-eight patients allergic to London plane tree pollen were selected according to their clinical symptoms and positive results in skin prick testing and/or specific IgE determination. Serum was collected, and allergen components were evaluated using immunodetection techniques as well as ImmunoCAP. The IgE-binding proteins detected were identified and characterized using mass spectrometry. RESULTS: Analysis of serum samples from allergic patients revealed 9 IgE-binding bands in London plane tree pollen extract. Among these, the 45-kDa protein, which corresponded to Pla a 2, was detected in 76.3% of patients. However, the 18-kDa (Pla a 1) and 9-kDa (Pla a 3) bands were detected in 44.7% and 23.7% of sera, respectively. These results were confirmed using purified proteins. Characterization of the allergen revealed the 27-kDa protein to be glutathione-S-transferase. CONCLUSIONS: The molecular profile of patients sensitized to London plane tree pollen differs from that reported in studies from other locations. In the population we studied, the prevalence of Pla a 2 was higher than that of Pla a 1 and Pla a 3. In addition, the minor allergen previously referred to as Pla a 4 was characterized as glutathione-S-transferase.

Allergen Profile of London Plane Tree Pollen: Clinical and Molecular Pattern in Central Spain

Background: Platanus acerifolia (London plane tree) is a deciduous tree of the Platanaceae family. Sensitization to this plant varies withgeography. Madrid, located in central Spain, has one of the highest London plane tree pollen concentration levels on the Iberian Peninsula.Objectives: We evaluated both the clinical characteristics and the molecular sensitization pattern of patients with allergy to London planetree pollen in the region of Madrid.Patients and Methods: Thirty-eight patients allergic to London plane tree pollen were selected according to their clinical symptoms andpositive results in skin prick testing and/or specific IgE determination. Serum was collected, and allergen components were evaluatedusing immunodetection techniques as well as ImmunoCAP. The IgE-binding proteins detected were identified and characterized usingmass spectrometry.Results: Analysis of serum samples from allergic patients revealed 9 IgE-binding bands in London plane tree pollen extract. Among these,the 45-kDa protein, which corresponded to Pla a 2, was detected in 76.3% of patients. However, the 18-kDa (Pla a 1) and 9-kDa (Pla a 3)bands were detected in 44.7% and 23.7% of sera, respectively. These results were confirmed using purified proteins. Characterization ofthe allergen revealed the 27-kDa protein to be glutathione-S-transferase.Conclusions: The molecular profile of patients sensitized to London plane tree pollen differs from that reported in studies from otherlocations. In the population we studied, the prevalence of Pla a 2 was higher than that of Pla a 1 and Pla a 3. In addition, the minorallergen previously referred to as Pla a 4 was characterized as glutathione-S-transferase. (AU)

Antecedentes: Platanus acerifolia es un árbol de hoja caduca de la familia Platanaceae. La sensibilización frente a esta planta varía enfunción de la zona geográfica. Madrid, ubicada en el centro de España, tiene uno de los mayores niveles de concentración de polen deeste árbol en la Península Ibérica.Objetivo: Evaluar las características clínicas y los patrones moleculares de sensibilización en pacientes con alergia al plátano de sombraen la región de Madrid.Pacientes y Métodos: Treinta y ocho pacientes alérgicos al polen del plátano de sombra fueron seleccionados de acuerdo con los síntomasclínicos, pruebas cutáneas positivas y/o IgE específica. El suero se recogió y se evaluaron los componentes alérgicos mediante técnicas deinmunodetección, así como ImmunoCAP. Las proteínas que unían IgE fueron identificadas y caracterizadas por espectrometría de masas.Resultados: El análisis de los sueros de los pacientes alérgicos reveló 9 bandas que captaban IgE en los extractos de polen de plátano desombra. Entre estas, la proteína de 45 kDa, correspondiente a Pla a 2, se detectó en el 76,3% de los pacientes. Sin embargo, las bandasde 18 kDa (Pla a 1) y 9 kDa (Pla a 3) fueron reconocidas en el 44,7% y 27,3%, respectivamente. Estos resultados se confirmaron usandoproteínas purificadas. La caracterización de los alérgenos identificó la proteína de 27 kDa como una glutatión S-transferasa.Conclusiones: El perfil molecular de los pacientes sensibilizados al polen del plátano de sombra varía respecto al descrito en estudios deotras localizaciones. Nuestra población muestra una mayor prevalencia de Pla a 2 comparado con Pla a 1 y Pla a 3. Además, el alérgenominoritario previamente denominado Pla a 4 fue caracterizado como una glutatión-S-transferasa. (AU)

Anaphylaxis: Mediators, Biomarkers, and Microenvironments

The life-threatening nature of anaphylactic reactions has increased interest in discovering new biomarkers that could improve diagnosis and prevention. However, the diverse nature of the clinical features and the etiology and pathogenesis of anaphylaxis hinder the identification of valuable molecular indicators of disease. Most studies on anaphylaxis focus on the immune system. Anaphylactic reactions are characterized primarily by IgE-mediated activation of mast cells and basophils and release of mediators. Determination of serum tryptase levels is the main in vitro test used to confirm the reaction, although there are no biomarkers that can predict it. Nevertheless, recent research has postulated that alternative pathways, cell types, and systems are involved. Consequently, various molecular products have been explored and considered potential biomarkers, although none of them are yet used in clinical practice. The products that are altered in patients with anaphylaxis include vasoactive agents, proteases, proteoglycans, lipids, interleukins, cytokines, products of the complement-contact and coagulation systems, circulating proteins, extracellular vesicles, microRNAs, and metabolites. The recognition of biological processes and molecular pathways affecting the microenvironments involved in anaphylaxis will considerably improve clinical practice and the identification of better molecular markers. We offer a broad review of the various mediators described in anaphylaxis, consider their usefulness as potential biomarkers of this pathological event, and examine their role in the molecular basis of the reaction (AU)

Epidemiologic trend of pediatric inflammatory bowel disease in Latin America: The Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN) Working Group.

INTRODUCTION AND AIMS: The primary aim was to explore the epidemiologic trend of pediatric inflammatory bowel disease in Latin America, and the secondary aims were to obtain an overview of the diagnostic/therapeutic focus of the members of the LASPGHAN and examine the relation of case frequency to year, during the study period. MATERIALS AND METHODS: Latin American pediatric gastroenterologists participated in an online survey, conducted through the SurveyMonkey platform, that investigated the yearly frequency of new inflammatory bowel disease patients within the time frame of 2005-2016, their disease variety, the gastrointestinal segments affected, and the diagnostic and treatment methods utilized. The correlation of new case frequency with each study year was evaluated. RESULTS: A total of 607 patients were studied. The diagnoses were ulcerative colitis in 475 (78.3%) cases, Crohn's disease in 104 (17.1%), and inflammatory bowel disease D unclassified in 28 (4.6%). The trend in ulcerative colitis was a lineal increase in the frequency of new cases related to each study year, with a significant correlation coefficient. Pancolitis was found in 67.6% of the patients. The diagnostic methods included clinical data, endoscopy, and biopsies in more than 99% of the cases, and imaging studies were indicated selectively. Drug regimens were limited to 5-aminosalicylic acid derivatives, azathioprine, 6-mercaptopurine, infliximab, and adalimumab. CONCLUSIONS: Pediatric inflammatory bowel disease in Latin America appears to have increased during the years included in the study period, with a predominance of moderate or severe ulcerative colitis. That lineal trend suggests the predictive likelihood of a gradual increase in the coming years, with possible epidemiologic and clinical implications.

Epidemiologic trend of pediatric inflammatory bowel disease in Latin America: The Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN) Working Group. / Tendencia epidemiológica de la enfermedad intestinal inflamatoria en pacientes pediátricos en América Latina: Grupo de Trabajo en Enfermedad Intestinal Inflamatoria, Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica (SLAGHNP).

INTRODUCTION AND OBJECTIVES: The primary aim was to explore the epidemiologic trend of pediatric inflammatory bowel disease in Latin America, and the secondary aims were to obtain an overview of the diagnostic/therapeutic focus of the members of the LASPGHAN and examine the relation of case frequency to year, during the study period. MATERIALS AND METHODS: Latin American pediatric gastroenterologists participated in an online survey, conducted through the SurveyMonkey platform, that investigated the yearly frequency of new inflammatory bowel disease patients within the time frame of 2005 to 2016, their disease variety, the gastrointestinal segments affected, and the diagnostic and treatment methods utilized. The correlation of new case frequency with each study year was evaluated. RESULTS: A total of 607 patients were studied. The diagnoses were ulcerative colitis in 475 (78.3%) cases, Crohn's disease in 104 (17.1%), and inflammatory bowel disease D unclassified in 28 (4.6%). The trend in ulcerative colitis was a lineal increase in the frequency of new cases related to each study year, with a significant correlation coefficient. Pancolitis was found in 67.6% of the patients. The diagnostic methods included clinical data, endoscopy, and biopsies in more than 99% of the cases, and imaging studies were indicated selectively. Drug regimens were limited to 5-aminosalicylic acid derivatives, azathioprine, 6-mercaptopurine, infliximab, and adalimumab. CONCLUSIONS: Pediatric inflammatory bowel disease in Latin America appears to have increased during the years included in the study period, with a predominance of moderate or severe ulcerative colitis. That lineal trend suggests the predictive likelihood of a gradual increase in the coming years, with possible epidemiologic and clinical implications.

[Implementation of the Lean Six Sigma in the improvement of the medication dispensing circuit]. / Implementación Lean Six Sigma en la mejora del circuito de dispensación de medicación.

OBJECTIVE: Lean Six Sigma (LSS) methodology is used to increase productivity and to improve performance, by eliminating processes that do not add value to the customer, as well as reducing variability. In recent years, its application in healthcare sector is increasing in order to improve the efficiency of processes. The aim of this study was to evaluate the results obtained in terms of efficiency in the medication dispensing circuit, after application of LSS methodology. MATERIAL AND METHODS: A multidisciplinary team was created in order to analyse and improve the medication dispensing circuit. The main tools used in LSS methodology were the DMAIC cycle (Define, Measure, Analyse, Improve and Control), SIPOC diagram (Suppliers, Inputs, Process, Outputs, and Customers), a root-cause analysis; a survey to determine the "Customer's voice" about the circuit; and the cost of each task in terms of staff time. Two Pilot Nursing Units (Thoracic Surgery and Cardiology) were selected to introduce the improvement actions. The main analysed variables were: urgent medication orders per day, and percentage of medication orders made online. RESULTS: After the application of LSS methodology, a significant reduction was found in urgent medicament orders per day in both nursing units, and a significant improvement in the electronic processing of urgent orders. The performance of medication dispensing circuit was increased from 60% (1.76 sigma) during initial data analysis, to 93% (3 sigma) in Thoracic Surgery, and from 71% (2.11 sigma) to 81% (2.4 sigma) in Cardiology. Six months after the implementation of improvements, the performance values were increased to 94% (3.1 sigma) and 93% (3 sigma), respectively. Estimated cost savings related to staff were 798.2 € (266 € per month) after implementation, ascending to 2, 228.5 € (371.4 € per month) after 6months. CONCLUSION: The use of LSS methodology has improved the performance of medication dispensing circuits, reducing costs in terms of staff time, and obtaining satisfactory results.

Efecto del conflicto decisional sobre el control del asma en escolares de 10 a 14 años / Effect of decisional conflict on the control of asthma in scholars from 10 to 14 years old

INTRODUCCIÓN: La cantidad de pacientes asmáticos que asisten al sistema público de salud es cada vez mayor, no obstante, la tasa de adherencia al tratamiento es muy baja, siendo los adolescentes quienes presentan mayor porcentaje de abandono al tratamiento, inasistencia a sus controles y gran conflicto decisional (CD). El OBJETIVO de este estudio fue evaluar el efecto de la aplicación de consejerías sobre el CD en relación al tratamiento del asma y el nivel de control de su enfermedad. MATERIALES Y MÉTODOS: Estudio pre-experimental que reclutó a 32 niños asmáticos entre 10 a 14 años de edad del policlínico respiratorio infantil del hospital Carlos Van Buren de Valparaíso. Solo 15 niños estuvieron dispuestos a participar en el estudio quienes completaron la totalidad de las sesiones de consejería. Para determinar el grado de CD de su patología, se aplicó la Escala de Conflicto Decisional de Ottawa; y para el nivel del control del asma, se usó la Escala Global Initiative for Asthma (GINA). RESULTADOS: La edad media del grupo de niños fue de 12,06 ± 1,16 años. Finalizada la intervención, el nivel de control de asma se mantuvo y la media del CD disminuyó de 34,05 ± 4,59 a 18,02 ± 3,01 puntos (p < 0,05; t de Student para muestras pareadas). Un 73,3% de los pacientes disminuyó su nivel de conflicto decisional. CONCLUSIÓN: Las consejerías de apoyo decisional demostraron tener efectos positivos en la población estudiada.

INTRODUCTION: The number of asthmatic patients attending the public health system is increasing. However, the rate of adherence to treatment is very low. Adolescents have the largest percentage of abandonment to treatment, lack of control and a great decisional conflict (DC). The OBJECTIVE of this study was to evaluate the effect of the application of counseling on the DC in relation to asthma treatment and the level of control of their disease. MATERIALS AND METHODS: Pre-experimental study that recruited 32 asthmatic children from 10 to 14 years-old, from the children's respiratory outpatients clinic of Carlos Van Buren hospital in Valparaíso, Chile. Only 15 children were willing to participate in the study and completed all of the counseling sessions. To determine the degree of DC of its pathology, the Ottawa Decision Conflict Scale was applied; and for the Asthma Control level, the Global Initiative for Asthma Scale (GINA) was used. RESULTS: Mean children age was 12.06 ± 1.16 years-old. After the intervention, the level of Asthma Control was maintained and the mean of the DC decrease from 34.05 ± 4.59 to 18.02 ± 3.01 points (p < 0.05; paired Student's t-test). 73.3% of the patients lowered their level of decisional conflict. CONCLUSION: The counseling of decision support proved to have positive effects on the population studied.

CD5L, Macrophage Apoptosis Inhibitor, Was Identified in Epicardial Fat-Secretome and Regulated by Isoproterenol From Patients With Heart Failure.

OBJECTIVES: Neurohormonal dysfunction, which can regulate epicardial fat activity, is one of the main promoters of atrial fibrillation (AF) in patients with heart failure (HF). Our aim was to study the epicardial fat mediators for AF in patients with HF and its catecholaminergic regulation. METHODS: We have included 29 patients with HF who underwent cardiac surgery and were followed up for 5 years. Released proteins by epicardial adipose tissue (EAT) after isoproterenol treatment were identified by nano-high-performance liquid chromatography (HPLC) and triple time-of-flight (TOF) analysis. Common and differential identified proteins in groups of patients with AF before and after surgery were determined by the FunRich tool. Plasma and epicardial fat biopsy proteins were quantified by western blot. RESULTS: Our results identified 17 common released proteins by EAT, after isoproterenol treatment, from HF patients who suffered AF or developed new-onset AF during follow-up. Mostly, they were involved on inflammatory response and extracellular matrix. One of them was CD5L, a macrophage apoptosis inhibitor. Its secretion by isoproterenol treatment was validated on western blot. The CD5L levels on epicardial fat were also higher in the group of male patients who present or develop AF (0.44 ± 0.05 vs. 0.18 ± 0.15; p < 0.016). However, there were no differences regarding plasma levels. CONCLUSION: Our results suggest the role of epicardial fat CD5L as a mediator of AF and its possible paracrine effect by catecholaminergic activity.

Apple bagasse as a substrate for the propagation of Patagonian wine yeast biomass.

AIMS: A culture medium based on apple bagasse was designed and tested as a substrate for biomass production of conventional and unconventional native wine yeasts. METHODS AND RESULTS: The physicochemical characterization of the apple bagasse was carried out and its potential utility as a constituent of a complete culture medium for the production of yeast biomass was analysed using the experimental statistical designs. Growth parameters of conventional and nonconventional Patagonian wine yeasts were analysed with Placket-Burman designs and response surface methodology, comparing in each assay the apple bagasse substrate with the commonly used substrate for biomass development, cane molasses. Culture media composition was optimized and models were validated. CONCLUSIONS: This study demonstrates that, both from a nutritional and from an economic point of view, apple bagasse constitutes a more advantageous substrate than cane molasses for the propagation of native yeasts from Patagonia. SIGNIFICANCE AND IMPACT OF THE STUDY: We used an alternate carbon-rich material, generously available in our region, originally generated as fruit industrial waste, to transform it into a source of sustainable, economically profitable and environmentally friendly energy resource.

Pliocene-Pleistocene ecological niche evolution shapes the phylogeography of a Mediterranean plant group.

Estimating species ability to adapt to environmental changes is crucial to understand their past and future response to climate change. The Mediterranean Basin has experienced remarkable climatic changes since the Miocene, which have greatly influenced the evolution of the Mediterranean flora. Here, we examine the evolutionary history and biogeographic patterns of two sedge sister species (Carex, Cyperaceae) restricted to the western Mediterranean Basin, but with Pliocene fossil record in central Europe. In particular, we estimated the evolution of climatic niches through time and its influence in lineage differentiation. We carried out a dated phylogenetic-phylogeographic study based on seven DNA regions (nDNA and ptDNA) and fingerprinting data (AFLPs), and modelled ecological niches and species distributions for the Pliocene, Pleistocene and present. Phylogenetic and divergence time analyses revealed that both species form a monophyletic lineage originated in the late Pliocene-early Pleistocene. We detected clear genetic differentiation between both species with distinct genetic clusters in disjunct areas, indicating the predominant role of geographic barriers limiting gene flow. We found a remarkable shift in the climatic requirements between Pliocene and extant populations, although the niche seems to have been relatively conserved since the Pleistocene split of both species. This study highlights how an integrative approach combining different data sources and analyses, including fossils, allows solid and robust inferences about the evolutionary history of a plant group since the Pliocene.