Usefulness of severity scales for cardiogenic shock in-hospital mortality. Proposal for a new prognostic model.

Cardiogenic shock (CS) is a condition comprising multiple etiologies, which associates high mortality rates. Some scoring systems have been shown to be good predictors of hospital mortality in patients admitted to Critical Care Units (CCU). The main objective of this study is to analyze their usefulness and validity in a cohort of CS patients. METHODS: Observational unicentric study of a cohort of CS patients. SOFA, SAPS II and APACHE II scores were calculated in the first 24 h of CCU admission. RESULTS: 130 patients with CS were included. SOFA, SAPS II and APACHE II scores revealed good discrimination for hospital mortality: (AUC) ROC values (AUC: 0.711, 0.752 and 0.742 respectively; P = .6). Calibration, estimated by the Hosmer-Lemeshow test, was adequate in all cases. Acute coronary syndrome, lactate serum values, SAPS II score and vasoactive inotropic score (VIS) were found to be independent predictors for mortality, upon ICU admission. With these variables, a specific prognostic indicator was developed (SAPS-2-LIVE), which improved predictive capability for mortality in our series (AUC) ROC, 0.825 (95% CI 0.752-0.89). CONCLUSION: In this contemporary CS cohort, the aforementioned scores have been shown to have good predictive ability for hospital mortality. These findings could contribute to a more accurate risk stratification in CS.

Impacto de la variabilidad intrapaciente en la concentración sanguínea de anticalcineurínicos en los resultados del trasplante cardiaco / Impact of intrapatient blood level variability of calcineurin inhibitors on heart transplant outcomes

Introducción y objetivos: El objetivo es estudiar el impacto clínico de la variabilidad intrapaciente (VIP) de la concentración sanguínea de los anticalcineurínicos en el trasplante cardiaco, pues la información actual es escasa. Métodos: Se analizó retrospectivamente a pacientes de edad≥18 años con un trasplante cardiaco realizado entre 2000 y 2014 y con supervivencia≥1 año. La VIP se valoró mediante el coeficiente de variación de concentraciones entre los meses 4 a 12 postrasplante. El compuesto de rechazo, mortalidad o pérdida del injerto y la mortalidad o pérdida del injerto 1-5 años tras el trasplante se analizaron mediante regresión de Cox. Resultados: Se estudió a 1.581 receptores (edad, 56 años; mujeres, 21%), tratados con ciclosporina (790 pacientes) o tacrolimus (791 pacientes). En el análisis multivariable, un coeficiente de variación> 27,8% tendió a asociarse con el compuesto de rechazo/mortalidad (HR=1,298; IC95%, 0,993-1,695; p=0,056) y con la mortalidad (HR=1,387; IC95%, 0,979-1,963; p=0,065) a los 5 años. La asociación con el rechazo fue significativa al analizar a la población sin rechazos durante el primer año del trasplante (HR=1,609; IC95%, 1,129-2,295; p=0,011). El tacrolimus tuvo menos VIP que la ciclosporina, junto con unos mejores resultados por la menor influencia de la VIP. Conclusiones: La VIP de los anticalcineurínicos, especialmente con la inmunosupresión basada en el tacrolimus, se asocia solo marginalmente con los resultados a medio plazo del trasplante cardiaco, aunque puede tener influencia en los pacientes más estables durante el primer año tras el trasplante (AU)

Introduction and objectives: Intrapatient blood level variability (IPV) of calcineurin inhibitors has been associated with poor outcomes in solid-organ transplant, but data for heart transplant are scarce. Our purpose was to ascertain the clinical impact of IPV in a multi-institutional cohort of heart transplant recipients. Methods: We retrospectively studied patients aged ≥18 years, with a first heart transplant performed between 2000 and 2014 and surviving≥ 1 year. IPV was assessed by the coefficient of variation of trough levels from posttransplant months 4 to 12. A composite of rejection or mortality/graft loss or rejection and all-cause mortality/graft loss between years 1 to 5 posttransplant were analyzed by Cox regression analysis. Results: The study group consisted of 1581 recipients (median age, 56 years; women, 21%). Cyclosporine immediate-release tacrolimus and prolonged-release tacrolimus were used in 790, 527 and 264 patients, respectively. On multivariable analysis, coefficient of variation> 27.8% showed a nonsignificant trend to association with 5-year rejection-free survival (HR, 1.298; 95%CI, 0.993-1.695; P=.056) and with 5-year mortality (HR, 1.387; 95%CI, 0.979-1.963; P=.065). Association with rejection became significant on analysis of only those patients without rejection episodes during the first year posttransplant (HR, 1.609; 95%CI, 1.129-2.295; P=.011). The tacrolimus-based formulation had less IPV than cyclosporine and better results with less influence of IPV. Conclusions: IPV of calcineurin inhibitors is only marginally associated with mid-term outcomes after heart transplant, particularly with the tacrolimus-based immunosuppression, although it could play a role in the most stable recipients (AU)

Complicaciones infecciosas relacionadas con la asistencia circulatoria mecánica de corta duración en candidatos a trasplante cardiaco urgente / Infectious complications associated with short-term mechanical circulatory support in urgent heart transplant candidates

Introducción y objetivos: El uso de dispositivos de asistencia circulatoria mecánica de corta duración como puente a trasplante es frecuente en España. Se desconocen la epidemiología y la repercusión de las complicaciones infecciosas en estos pacientes. Métodos: Descripción sistemática de la epidemiología y análisis de la repercusión pronóstica de las complicaciones infecciosas en un registro multicéntrico retrospectivo de pacientes tratados con dispositivos de asistencia circulatoria mecánica de corta duración como puente a trasplante cardiaco urgente entre 2010 y 2015 en 16 hospitales españoles. Resultados: Se estudió a 249 pacientes; 87 (34,9%) de ellos tuvieron un total de 102 infecciones. La vía respiratoria fue la localización más frecuente (n=47; 46,1%). En 78 casos (76,5%) se obtuvo confirmación microbiológica; se aislaron en total 100 gérmenes causales, con predominio de bacterias gramnegativas (n=58, 58%). Los pacientes con complicaciones infecciosas presentaron mayor mortalidad durante el periodo de asistencia circulatoria mecánica (el 25,3 frente al 12,3%; p=0,009) y menor probabilidad de recibir un trasplante (el 73,6 frente al 85,2%; p=0,025) que los pacientes sin infección. La mortalidad posoperatoria tras el trasplante fue similar en ambos grupos (con infección, el 28,3%; sin infección, el 23,4%; p=0,471). Conclusiones: Los pacientes tratados con dispositivos de asistencia circulatoria mecánica de corta duración como puente al trasplante cardiaco están expuestos a un alto riesgo de complicaciones infecciosas, las cuales se asocian con una mayor mortalidad en espera del órgano (AU)

Introduction and objectives: Short-term mechanical circulatory support is frequently used as a bridge to heart transplant in Spain. The epidemiology and prognostic impact of infectious complications in these patients are unknown. Methods: Systematic description of the epidemiology of infectious complications and analysis of their prognostic impact in a multicenter, retrospective registry of patients treated with short-term mechanical devices as a bridge to urgent heart transplant from 2010 to 2015 in 16 Spanish hospitals. Results: We studied 249 patients, of which 87 (34.9%) had a total of 102 infections. The most frequent site was the respiratory tract (n=47; 46.1%). Microbiological confirmation was obtained in 78 (76.5%) episodes, with a total of 100 causative agents, showing a predominance of gram-negative bacteria (n=58, 58%). Compared with patients without infection, those with infectious complications showed higher mortality during the support period (25.3% vs 12.3%, P=.009) and a lower probability of receiving a transplant (73.6% vs 85.2%, P=.025). In-hospital posttransplant mortality was similar in the 2 groups (with infection: 28.3%; without infection: 23.4%; P=.471). Conclusions: Patients supported with temporary devices as a bridge to heart transplant are exposed to a high risk of infectious complications, which are associated with higher mortality during the organ waiting period (AU)

Current Situation and Prognostic Evolution of Combined Heart-lung Transplantation in a European Union Country.

Background: This study aims to evaluate the entire experience in heart-lung transplantation (HLTx) in a country of the European Union with 47 million inhabitants according to the etiologies that motivated the procedure. Methods: A retrospective study on 1,751 consecutive transplants (HLTx: 78) was performed from 1990 to 2020 in two centers. Overall survival, adjusted for clinical profile and etiological subgroups, was compared. 7 subgroups were considered: 1) Cardiomyopathy with pulmonary hypertension (CM + PH). 2) Eisenmenger syndrome. 3) Congenital heart disease (CHD). 4) Idiopathic pulmonary arterial hypertension (IPAH). 5) Cystic fibrosis. 6) Chronic obstructive pulmonary disease (COPD)/Emphysema. 7) Diffuse interstitial lung disease (ILD). Results: Early mortality was 44% and that of the rest of the follow-up was 31%. There were differences between HTLx and HTx in survival, also comparing groups with a similar clinical profile with propensity score (p= 0.04). Median survival was low in CM + PH (18 days), ILD (29 days) and CHD (114 days), intermediate in Eisenmenger syndrome (600 days), and longer in IPAH, COPD/Emphysema and cystic fibrosis. Conclusion: HLTx has a high mortality. The etiological analysis is of the utmost interest to make the most of the organs and improve survival.

High Frequency of Smell and Taste Dysfunction in Health Care Professionals With COVID-19 Working in Allergy Departments.

INTRODUCTION AND OBJECTIVE: Since the early stages of the novel coronavirus 2019 (SARS-CoV-2) outbreak, smell and/or taste dysfunction (STD) has been reported in 5% to 88% of COVID-19 patients. Objective: We aimed to assess STD in health care professionals (HCPs), mainly allergists, affected by COVID-19. We carried out a survey to evaluate the association between STD and its severity and demographic characteristics, symptoms, comorbidities, and hospital admission. METHODS: We designed a 15-item questionnaire comprising various sections, as follows: demographics, diagnostic characteristics, STD patterns, medication use, and comorbidities. The questionnaire was developed using Google forms. It was distributed to members of the Spanish Society of Allergology and Clinical Immunology (SEAIC) and sent via social media to be completed by HCPs with COVID-19. RESULTS: The survey was completed by HCPs (n=234), of whom 76.5% were aged ≤55 years and 73.5% were female. STD was detected in 74.4% of respondents, of whom 95.6% reported moderate-severe impairment. Mean time until recovery of taste dysfunction was 21.6 (24.0) days in HCPs aged ≤55 years and 33.61±26.2 days in those aged >55 years (P=.019). Analysis stratified by severity of STD showed that more than a half of COVID-19 patients presented severe loss of smell. Older age (>55 years) was associated with fever, anorexia, lower frequency of headache, and longer persistence of taste dysfunction. CONCLUSION: STD is a common symptom in COVID-19, even as a unique or preceding symptom. HCPs who reported smell dysfunction were younger than those not affected with STD. Taste dysfunction may imply more systemic involvement in COVID-19-positive HCPs.

High Frequency of Smell and Taste Dysfunction in Health Care Professionals With COVID-19 Working in Allergy Departments

Background: Since the early stages of the novel coronavirus 2019 (SARS-CoV-2) outbreak, smell and/or taste dysfunction (STD) has beenreported in 5% to 88% of COVID-19 patients.Objective: We aimed to assess STD in health care professionals (HCPs), mainly allergists, affected by COVID-19. We carried out a survey toevaluate the association between STD and its severity and demographic characteristics, symptoms, comorbidities, and hospital admission.Methods: We designed a 15-item questionnaire comprising various sections, as follows: demographics, diagnostic characteristics, STDpatterns, medication use, and comorbidities. The questionnaire was developed using Google forms. It was distributed to members of theSpanish Society of Allergology and Clinical Immunology (SEAIC) and sent via social media to be completed by HCPs with COVID-19.Results: The survey was completed by HCPs (n=234), of whom 76.5% were aged ≤55 years and 73.5% were female. STD was detected in74.4% of respondents, of whom 95.6% reported moderate-severe impairment. Mean time until recovery of taste dysfunction was 21.6 (24.0)days in HCPs aged ≤55 years and 33.61±26.2 days in those aged >55 years (P=.019). Analysis stratified by severity of STD showed thatmore than a half of COVID-19 patients presented severe loss of smell. Older age (>55 years) was associated with fever, anorexia, lowerfrequency of headache, and longer persistence of taste dysfunction.Conclusion: STD is a common symptom in COVID-19, even as a unique or preceding symptom. HCPs who reported smell dysfunctionwere younger than those not affected with STD. Taste dysfunction may imply more systemic involvement in COVID-19–positive HCPs. (AU)

Antecedentes: Desde el inicio de la pandemia por el nuevo coronavirus (SARS-CoV-2), la afectación del sentido del olfato y del gusto seha descrito entre el 5% y 88% de la población afecta por COVID-19.Objetivo: Evaluar la alteración del gusto y del olfato en profesionales sanitarios afectos por COVID-19, en relación a parámetros degravedad, características demográficas, síntomas, comorbilidades e ingreso hospitalario.Métodos: Se diseñó un cuestionario de 15 elementos, con las siguientes secciones: demografía, características diagnósticas, patronesde alteración de olfato y del gusto, uso de medicación y efectos adversos asociados y comorbilidades. Dicho cuestionario fue difundidopor las redes sociales de la Sociedad Española de Alergología e Inmunología Clínica, dirigido específicamente a profesionales sanitarios.Resultados: 234 profesionales completaron la encuesta (73,5% mujeres). El 76,5% de los encuestados era ≤55 años. Hubo afectacióndel olfato y/o gusto en el 74,4% de los encuestados. La persistencia media de alteración del gusto fue 21,6± 24,0 días en ≤55 años yde 33,6±26,2 días en >55 años (p=0,019). Ser mayor de 55 años se asociaba estadísticamente con fiebre, anorexia, menos cefalea ymayor persistencia de afectación del gusto.Conclusión: Los profesionales sanitarios que declararon haber padecido SD eran más jóvenes que los que no presentaron STD. La afectacióndel olfato y/o del gusto es un síntoma común entre los profesionales sanitarios con COVID-19 y puede ser patente en fases iniciales ocomo único síntoma en pacientes ≤55 años. La afectación del gusto puede implicar más síntomas sistémicos. (AU)

"Influence of diet on mood and social cognition: a pilot study".

Recently, a relationship has been observed between nutrition and social cognition. In this aspect, several dietary patterns, or even some probiotics, have been reported as social cognition modulators. However, to date, no studies have reported the effects of specific nutrients. Our aim was to evaluate the relationship between dietary macronutrients and the processing of social and affective information. Participants were undergraduates from the University of Extremadura (Badajoz, Spain) aged 21.3 ± 2.9 years., with a BMI of 22.8 ± 3.9 (kg m-2). The students' social cognition and diet were analysed through questionnaires and a dietary record. The diets were analysed with DIAL v.1.18® software (Alce Ingeniería®). The participants filled out the WHO-5 well-being index, Beck's anxiety inventory, Beck's depression inventory, ruminative response scale (RSS), Leiden index of depression sensitivity (LEIDS-r), empathy quotient (EQ), and interpersonal reactivity index (IRI). To analyse the data, nutrients were grouped through principal component analysis (PCA) into lipids, carbohydrates and proteins. Additionally, we assayed if these principal components were associated with psychological questionnaire scores using multiple linear regression analyses. The dietary pattern differed from the traditional Mediterranean diet due to high intake of proteins and saturated fatty acids. Regarding social cognition and macronutrients, we found a positive association between lipids, specifically cholesterol, and the Perspective-Taking Scale (an IRI component). Carbohydrates influenced the RSS, indicating that complex carbohydrates may be a risk factor for depression. Moreover, the brooding factor, a component of the RRS, was negatively affected by dietary carbohydrates and proteins, specifically by fiber and aspartate. Diet may influence several variables related to social cognition and mood. Particularly, a low-cholesterol diet rich in fiber, complex carbohydrates, and aspartate apparently provides benefits, improving the processing of social and affective information and psychic well-being.

Clinical and anatomopathological features of eosinophilic oesophagitis in children and adults.

INTRODUCTION: Eosinophilic oesophagitis (EoE) is a chronic clinical-pathological disorder with an immunological basis characterised by symptoms of oesophageal dysfunction and, histologically, eosinophilic inflammation. OBJECTIVE: To evaluate the clinical characteristics and differences in children and adults diagnosed with EoE in a tertiary level hospital. METHOD: Descriptive, retrospective and cross-sectional study. We randomly selected 40 children and 40 adults diagnosed with EoE between 2009 and 2016. The patient characteristics were analysed by means of epidemiological, clinical, diagnostic and therapeutic variables. RESULTS: The average age at diagnosis was 10 years (children) and 34 years (adults), with a higher frequency in males. The majority were sensitised to aeroallergens (77.5% children vs. 82.5% adults) and foods (75% children vs. 82.5% adults). Statistically significant differences were detected in sensitisation to fruits (p=0.007) and grains (p<0.001). Differences were observed in impaction (22.5% children vs. 82.5% adults), dysphagia (42.5% children vs. 77.5% adults) and abdominal pain (25% children vs. 7.5% adults). Endoscopy showed that children had a higher frequency of exudates (92.5%) and adults, trachealisation (50% vs. 5%) and stenosis (17.5% vs. 2.5%). Statistically significant differences were found in treatment with topical corticosteroids (30% children vs. 77.5% adults), with a variable positive response. 77.5% of the patients received elimination diets. CONCLUSIONS: Statistically significant differences were observed between the paediatric and adult populations in the food sensitisation profiles, clinical manifestations, endoscopic findings and treatments received. This is a complex pathology that calls for a multidisciplinary team and would require new non-invasive techniques to facilitate its management.

Experiencia en manejo anestésico para cirugía no cardiaca en pacientes con asistencias ventriculares / Experience in anaesthetic management of non-cardiac surgery in patients with ventricular assist devices

La insuficiencia cardiaca constituye un cuadro sindrómico de elevada incidencia en la medicina actual. Cuando los síntomas de la insuficiencia cardiaca progresan y se convierten en refractarios, la indicación de trasplante cardiaco es la mejor opción terapéutica. Sin embargo, debido a la escasez de donantes y a las largas listas de espera, muchos de estos pacientes necesitan la implantación de dispositivos de asistencia ventricular como puente a este trasplante, o en algunos casos, cuando el trasplante no es una opción, como terapia definitiva. En este artículo se presenta una serie de 4 casos clínicos en pacientes portadores de dispositivos de asistencia ventricular que precisaron intervención quirúrgica. Tres de ellos estaban asistidos con asistencias de larga duración: 2 EXCOR (pulsátiles y paracorpórea) y un HEARTWARE (no pulsátil e intracorpórea) y el último con una asistencia de corta duración; CentriMag Levitronix biventricular. No existe bibliografía significativa sobre las implicaciones perioperatorias de estos pacientes cuando son sometidos a cirugía urgente o programada. La experiencia en nuestro centro nos lleva a plantear la necesidad de conocer una serie de aspectos: funcionamiento de cada dispositivo, recalcando la correcta colocación de las cánulas durante la cirugía; el manejo apropiado de la medicación, recalcando la importancia de las terapias anticoagulantes y antiagregantes; los cambios fisiopatológicos a nivel cardiopulmonar debidos a la implantación de estos dispositivos; y la importancia de la administración de una correcta antibioterapia. Ante la complejidad que presentan estos casos, la escasa experiencia en este campo y los pocos casos que existen de estas situaciones se recomienda la creación de protocolos para garantizar un manejo correcto de estos

Heart failure (HF) is a syndromic condition with a high incidence in current medicine. When the symptoms of HF progress, and become refractory, cardiac transplant is the best therapeutic option. However, due to the shortage of donors and the long waiting lists, many of those patients are candidates for implantation of ventricular assist devices as a bridge to the cardiac transplant, or when this is not an option, as a definitive therapy. A series of four clinical cases of patients with ventricular assist devices that required surgical intervention, is presented. Three of them were assisted with long-term care: two EXCOR (pulsatile and para-corporeal) and one HEARTWARE (non-pulsatile and intra-corporeal), and the last one with short-term assistance; CentriMag biventricular Levitronix. There is no significant literature on the peri-operative implications of these patients when they undergo urgent or scheduled surgery. The experience in our centre leads us to raise the need to determine a series of aspects: operation of each device, emphasising the correct placement of the cannulas during the surgery; the proper management of any medication, emphasising the importance of anticoagulant and anti-platelet therapies; the Pathophysiological changes at cardiopulmonary level due to the implantation of these devices; and the importance of the administration of a correct antibiotic therapy. Given the complexity of these cases, the limited experience in this field, and the few cases that exist in these situations, it is recommended to create protocols to ensure their proper management

Experience in anaesthetic management of non-cardiac surgery in patients with ventricular assist devices. / Experiencia en manejo anestésico para cirugía no cardiaca en pacientes con asistencias ventriculares.

Heart failure (HF) is a syndromic condition with a high incidence in current medicine. When the symptoms of HF progress, and become refractory, cardiac transplant is the best therapeutic option. However, due to the shortage of donors and the long waiting lists, many of those patients are candidates for implantation of ventricular assist devices as a bridge to the cardiac transplant, or when this is not an option, as a definitive therapy. A series of four clinical cases of patients with ventricular assist devices that required surgical intervention, is presented. Three of them were assisted with long-term care: two EXCOR (pulsatile and para-corporeal) and one HEARTWARE (non-pulsatile and intra-corporeal), and the last one with short-term assistance; CentriMag biventricular Levitronix. There is no significant literature on the peri-operative implications of these patients when they undergo urgent or scheduled surgery. The experience in our centre leads us to raise the need to determine a series of aspects: operation of each device, emphasising the correct placement of the cannulas during the surgery; the proper management of any medication, emphasising the importance of anticoagulant and anti-platelet therapies; the Pathophysiological changes at cardiopulmonary level due to the implantation of these devices; and the importance of the administration of a correct antibiotic therapy. Given the complexity of these cases, the limited experience in this field, and the few cases that exist in these situations, it is recommended to create protocols to ensure their proper management.

Análisis de la calidad lipídica del desayuno en niños de 10 a 12 años; un recurso para la educación nutricional / Analysis of lipid content in breakfast for children 10 to 12 years; a resource for nutritional education

Fundamentos: La dieta de la población infantil requiere unas necesidades nutricionales especiales, ya que en esta etapa coinciden una serie de cambios fisiológicos, emocionales y ambientales que determinarán unas pautas alimentarias que, en muchos casos, serán mantenidas a lo largo de la vida. Por ello, el objetivo de este trabajo de investigación, fue analizar la calidad y el perfil lipídico en el desayuno en la población escolar de la provincia de Badajoz, España. Métodos: Se llevaron a cabo encuesta Recordatorio de 24h autocompletadas diariamente y se midieron los parámetros antropométricos de talla y peso para obtener valores de referencia actualizados para esta población. Resultados: Respecto a los resultados más significativos indicar que la ingesta energética fue menor a la recomendada. Siendo el desayuno de calidad mejorable el que presentó el porcentaje mayor. Así, referente a la ingesta de ácidos grasos mono y poliinsaturados indicar que fue deficitaria en su dieta del desayuno diario. Observándose diferencias estadísticamente significativas (p<0,05) entre las muestras rural y urbana. Conclusiones: Dado los resultados aquí obtenidos podemos concluir con una recomendable intervención educativa en alimentación y nutrición centrada en el consumo de aceite de oliva para la promoción de un desayuno saludable, siendo esta más necesaria en el ámbito urbano (AU)

Background: The diet of children requires special nutritional needs, already at this stage going to match a series of physiological, emotional, and environmental changes that will determine dietary guidelines which, in many cases, be maintained throughout life.Therefore the aim of this research was to analyze quality and lipid profile at breakfast in the child population of the province of Badajoz, Spain. Method: A 24-hour recordatory questionnaires were conducted; and anthropometric parameters of height and weight were measured to obtain updated reference values for this population. Results: With respect to the most significant results indicate that energy intake was lower than recommended. Being upgradeable quality who presented the highest percentage. Thus concerning the intake of mono and polyunsaturated fatty acids indicate that it was deficient in its diet of daily breakfast. Observed statistically significant differences (p<0.05) between the rural and urban groups. Conclusions: Given the results we can conclude with a recommended educational intervention in food and nutrition healthy, focused on the consumption of olive oil for the promotion of a healthy breakfast, being this most necessary in urban areas (AU)

Mould and grass pollen allergy as risk factors for childhood asthma in Zaragoza, Spain.

OBJECTIVE: Examine the prevalence of asthma and associated predictive factors in a group of 468 students. PATIENTS AND METHODS: A descriptive, cross-sectional observational study in a randomly selected population of 468 children aged 10-12, in the city of Zaragoza. We used the ISAAC questionnaire on asthma completed by children under supervision of the investigators. We assessed the genetic risk (family history of asthma) and environmental risks. The risk for atopy was assessed by the presence of positive skin prick tests. RESULTS: 25.3% of the children had symptoms consistent with asthma in the city of Zaragoza. Among them 33.1% reported a history of asthma in close relatives (OR=1.78, p<0.001). The history of hospitalisations for lower respiratory tract illness was strongly associated with the presence of asthma (OR=6.72, p<0.0001). Positive skin tests to Alternaria (OR=2.00, p<0.0001) and grass pollen (OR=1.76, p<0.001) were predictors of asthma. 63.6% of asthmatic children had presented clinical rhinitis in the previous 12 months, compared with 32% of non-asthmatics, and this difference was statistically significant (OR=3.89, p<0.0001). 47% of asthmatics presented with or previously had eczema, whereas only 26.9% of non-asthmatics presented with or previously had these types of lesions (p<0.0001). CONCLUSION: The following are predictors of asthma: History of hospital admissions for lower respiratory tract illness, presence of rhinitis and/or eczema, positive prick test for certain aeroallergens, especially Alternaria and grass pollen, and family history of asthma.

Activity/inactivity circadian rhythm shows high similarities between young obesity-induced rats and old rats.

The objective of the present study was to compare differences between elderly rats and young obesity-induced rats in their activity/inactivity circadian rhythm. The investigation was motivated by the differences reported previously for the circadian rhythms of both obese and elderly humans (and other animals), and those of healthy, young or mature individuals. Three groups of rats were formed: a young control group which was fed a standard chow for rodents; a young obesity-induced group which was fed a high-fat diet for four months; and an elderly control group with rats aged 2.5 years that was fed a standard chow for rodents. Activity/inactivity data were registered through actimetry using infrared actimeter systems in each cage to detect activity. Data were logged on a computer and chronobiological analysis were performed. The results showed diurnal activity (sleep time), nocturnal activity (awake time), amplitude, acrophase, and interdaily stability to be similar between the young obesity-induced group and the elderly control group, but different in the young control group. We have concluded that obesity leads to a chronodisruption status in the body similar to the circadian rhythm degradation observed in the elderly.

Draft Genome Sequence of Xanthomonas arboricola pv. pruni Strain Xap33, Causal Agent of Bacterial Spot Disease on Almond.

We report the annotated genome sequence of Xanthomonas arboricola pv. pruni strain Xap33, isolated from almond leaves showing bacterial spot disease symptoms in Spain. The availability of this genome sequence will aid our understanding of the infection mechanism of this bacterium as well as its relationship to other species of the same genus.

Análisis del desayuno escolar en la provincia de Badajoz (España) / Analysis of school breakfast in Badajoz (Spain)

Introducción: Un desayuno completo y equilibrado debe aportar la energía, los macro y micronutrientes necesarios para un óptimo rendimiento físico e intelectual durante la mañana y es esencial en las etaas infantil y adolescente. Se considera que un desayuno saludable debe contener lácteos, cereales, frutas. El objetivo de este trabajo fue investigar la calidad y el aporte nutricional del desayuno en escolares de la provincia de Badajoz (España). Métodos: Se ha realizado un estudio transversal en 203 escolares sanos de 3º ciclo de educación primaria (10-12 años). Se analizó la ración del desayuno mediante Recordatorio 24 h y programa DIAL. Resultados: Los resultados de la calidad del desayuno según criterios del estudio enKid 2000 fueron: con buena calidad (completo y saludable) un 38,56%, mejorable calidad un 61,45%, siendo el grupo de frutas y sus derivados el menos consumido. No se observó ningún caso de desayuno de mala calidad. El 32,55% consumió aceite de oliva. El desayuno aportaba como media 409,30 +/- 18,95 kcal, de hidratos de carbono 38,91 +/- 3,21 de proteínas 11,63+/- 0,57 g y de grasa total 19,49 +/-2,97g, de las cuales fueron monoinsaturadas 7,23 +/- 1,44g. No se observaron variaciones estadísticamente significativas entre los escolares urbanos y rurales. Un 75,96% aportaba más de 350 kcal/desayuno y el 51,26+/- 15,78% superó 450 kcal/desayuno. Conclusiones: Los resultados reflejan que un amplio porcentaje de escolares realiza desayunos de calidad mejorable, por lo que sería necesaria la intervención desde el entorno escolar para promocionar el desayuno completo y saludable (AU)

Background: Acomplete and balanced breakfast provides the energy, macronutrients and micronutrients needed for optimal mental and physical performance during the morning essential in child and adolescent stages A healthy breakfast should contain: Dairy, Cereals, Fruits. The aims of this paper was to investigate the quality and Nutritional contribution among school children of the province of Badajoz (Spain). Methods: A cross-sectional study was conducted involving 203 healthy school children attending third cycle of Primary school (10-12yr). Breakfast was analyzed by means of a 24 hours Recall using DIAL system for processing. Results: The results regarding Breakfast quality, based on the enKid 2000 study criteria, were: good quality (complete and healthy) 38.56%, improvable quality 61.45%, with the group fruit products as the least consumed. No cases were classified as Poor breakfast. 32.55% of the sample consumed olive oil. Breakfast provided on average 409.30 +/- 18.95 kcal, carbohydrate 38.91g +/- 3.21, 1.63+/- 0.57g, protein and total fat 19.49 +/- 2.97g, of which 7.23 +(- 1.44g were monounsaturated fats. No statistically significant differences were observed between urban and rural schools, 75.96% supplied more than 350 kcl/breakfast, and 51,26 +/- 15.78% more than 450 kcal/breakfast. Conclusions: Results show that a high proportion os school children have improvable quality breakfast, thus it would be advisable to implement school based interventions aimed to promote a complete and healthy breakfast (AU)

Multiresolution analysis over simple graphs for brain computer interfaces.

OBJECTIVE: Multiresolution analysis (MRA) offers a useful framework for signal analysis in the temporal and spectral domains, although commonly employed MRA methods may not be the best approach for brain computer interface (BCI) applications. This study aims to develop a new MRA system for extracting tempo-spatial-spectral features for BCI applications based on wavelet lifting over graphs. APPROACH: This paper proposes a new graph-based transform for wavelet lifting and a tailored simple graph representation for electroencephalography (EEG) data, which results in an MRA system where temporal, spectral and spatial characteristics are used to extract motor imagery features from EEG data. The transformed data is processed within a simple experimental framework to test the classification performance of the new method. MAIN RESULTS: The proposed method can significantly improve the classification results obtained by various wavelet families using the same methodology. Preliminary results using common spatial patterns as feature extraction method show that we can achieve comparable classification accuracy to more sophisticated methodologies. From the analysis of the results we can obtain insights into the pattern development in the EEG data, which provide useful information for feature basis selection and thus for improving classification performance. SIGNIFICANCE: Applying wavelet lifting over graphs is a new approach for handling BCI data. The inherent flexibility of the lifting scheme could lead to new approaches based on the hereby proposed method for further classification performance improvement.

Tryptophan-enriched cereal intake improves nocturnal sleep, melatonin, serotonin, and total antioxidant capacity levels and mood in elderly humans.

Melatonin and serotonin rhythms, which exhibit a close association with the endogenous circadian component of sleep, are attenuated with increasing age. This decrease seems to be linked to sleep alterations in the elderly. Chrononutrition is a field of chronobiology that establishes the principle of consuming foodstuffs at times of the day when they are more useful for health, improving, therefore, biorhythms and physical performance. Our aim was to analyze whether the consumption of cereals enriched with tryptophan, the precursor of both serotonin and melatonin, may help in the reconsolidation of the sleep/wake cycle and counteract depression and anxiety in 35 middle-aged/elderly (aged 55-75 year) volunteers in a simple blind assay. Data were collected for 3 weeks according to the following schedule: The control week participants consumed standard cereals (22.5 mg tryptophan in 30 g cereals per dose) at breakfast and dinner; for the treatment week, cereals enriched with a higher dose of tryptophan (60 mg tryptophan in 30 g cereals per dose) were eaten at both breakfast and dinner; the posttreatment week volunteers consumed their usual diet. Each participant wore a wrist actimeter that logged activity during the whole experiment. Urine was collected to analyze melatonin and serotonin urinary metabolites and to measure total antioxidant capacity. The consumption of cereals containing the higher dose in tryptophan increased sleep efficiency, actual sleep time, immobile time, and decreased total nocturnal activity, sleep fragmentation index, and sleep latency. Urinary 6-sulfatoxymelatonin, 5-hydroxyindoleacetic acid levels, and urinary total antioxidant capacity also increased respectively after tryptophan-enriched cereal ingestion as well as improving anxiety and depression symptoms. Cereals enriched with tryptophan may be useful as a chrononutrition tool for alterations in the sleep/wake cycle due to age.

Comparative genomics to bridge Vicia faba with model and closely-related legume species: stability of QTLs for flowering and yield-related traits.

This study presents the development of an enhanced map in faba bean. The map contains 258 loci, mostly gene-based markers, organized in 16 linkage groups that expand 1,875 cM, with an average inter-marker distance of 7.26 cM. The combination of EST-derived markers with a number of markers physically located or previously ascribed to chromosomes by trisomic segregation, allowed the allocation of eight linkage groups (229 markers), to specific chromosomes. Moreover, this approach provided anchor points to establish a global homology among the faba bean chromosomes and those of closely-related legumes species. The map was used to identify and validate, for the first time, QTLs controlling five flowering and reproductive traits: days to flowering, flowering length, pod length, number of seeds per pod and number of ovules per pod. Twelve QTLs stable in the 2 years of evaluation were identified in chromosomes II, V and VI. Comparative mapping suggested the conservation of one of the faba bean genomic regions controlling the character days to flowering in other five legume species (Medicago, Lotus, pea, lupine, chickpea). Additional syntenic co-localizations of QTLs controlling pod length and number of seeds per pod between faba bean and Lotus japonicus are likely. The new genetic map opens the way for further translational studies between faba bean and related legume species, and provides an efficient tool for breeding applications such as QTL analysis and marker-assisted selection.