Spanish primary care in pediatric trauma (AITP) consensus: An AITP checklist. / Consenso AITP español: Una lista de verificación AITP.

INTRODUCTION: The course in Primary Care in Pediatric Trauma (ATIP in Spanish) has been taught in Spain since 1997, and there are currently 9 accredited training centers. Care of polytraumatized pediatric patients often takes place in an environment conducive to errors resulting from forgetfulness, which is why checklists - mnemonic tools widely used in industry and medicine - are particularly useful to avoid such errors. Although several checklists exist for pediatric trauma care, none have been developed within the setting of our course. MATERIALS AND METHODS: The criteria for being selected as an expert in Primary Care in Pediatric Trauma were agreed upon with the scientific polytrauma committee of the Spanish Pediatric Surgery Society. The items that make up the checklist were obtained from a review of the literature and consultation with selected experts, using the Delphi Technique. RESULTS: 10 experts representing the 9 groups or training centers in Primary Care in Pediatric Trauma were selected, and a 28-item checklist was drawn up in accordance with their design recommendations. CONCLUSIONS: With the consensus of all the groups, a checklist for the treatment of polytraumatized pediatric patients was drawn up using the Delphi Technique, an essential requirement for the dissemination of this checklist, which should be adapted and validated for use in each healthcare center.

INTRODUCCION: El curso de Asistencia Inicial al Trauma Pediátrico se imparte en España desde 1997, existiendo en la actualidad 9 centros formadores acreditados. La asistencia al paciente pediátrico politraumatizado se produce muchas veces en un ambiente proclive al error por olvido, por lo que las listas de verificación, como herramientas mnemotécnicas de amplia difusión en la industria y en medicina, serían especialmente útiles para evitarlos. Aunque existen varias listas de verificación para la asistencia al traumatismo pediátrico, ninguna se ha desarrollado en el entorno de nuestro curso. MATERIAL Y METODOS: Se acordaron los criterios para ser seleccionado como experto en Asistencia Inicial al Trauma Pediátrico con la comisión científica de politrauma de la Sociedad Española de Cirugía Pediátrica. Los ítems para formar la lista de verificación se obtuvieron a partir de una revisión bibliográfica y de la consulta a los expertos seleccionados, empleando un método Delphi. RESULTADOS: Se seleccionaron 10 expertos que representan los 9 grupos o centros formadores en Asistencia Inicial al Trauma Pediátrico y se elaboró una lista de verificación con 28 ítems, siguiendo sus recomendaciones de diseño. CONCLUSIONES: Se diseñó una lista de verificación para el manejo del paciente pediátrico politraumatizado, con el consenso de todos los grupos empleando un método Delphi, requisito fundamental para facilitar la difusión de esta lista. Sería preciso adaptar y validar dicha lista para su uso en cada centro asistencial.

Consenso AITP español: Una lista de verificación AITP / Spanish primary care in pediatric trauma (AITP) consensus: An AITP checklist

Introducción: El curso de Asistencia Inicial al Trauma Pediátricose imparte en España desde 1997, existiendo en la actualidad 9 centrosformadores acreditados. La asistencia al paciente pediátrico politraumatizado se produce muchas veces en un ambiente proclive al errorpor olvido, por lo que las listas de verificación, como herramientasmnemotécnicas de amplia difusión en la industria y en medicina, serían especialmente útiles para evitarlos. Aunque existen varias listas deverificación para la asistencia al traumatismo pediátrico, ninguna se hadesarrollado en el entorno de nuestro curso. Material y métodos: Se acordaron los criterios para ser seleccionado como experto en Asistencia Inicial al Trauma Pediátrico con lacomisión científica de politrauma de la Sociedad Española de CirugíaPediátrica. Los ítems para formar la lista de verificación se obtuvierona partir de una revisión bibliográfica y de la consulta a los expertosseleccionados, empleando un método Delphi. Resultados. Se seleccionaron 10 expertos que representan los 9grupos o centros formadores en Asistencia Inicial al Trauma Pediátri-co y se elaboró una lista de verificación con 28 ítems, siguiendo susrecomendaciones de diseño. Conclusiones: Se diseñó una lista de verificación para el manejodel paciente pediátrico politraumatizado, con el consenso de todos losgrupos empleando un método Delphi, requisito fundamental para facilitarla difusión de esta lista. Sería preciso adaptar y validar dicha lista parasu uso en cada centro asistencial.(AU)

Introduction: The course in Primary Care in Pediatric Trauma(ATIP in Spanish) has been taught in Spain since 1997, and there arecurrently 9 accredited training centers. Care of polytraumatized pedi-atric patients often takes place in an environment conducive to errorsresulting from forgetfulness, which is why checklists –mnemonic toolswidely used in industry and medicine– are particularly useful to avoidsuch errors. Although several checklists exist for pediatric trauma care,none have been developed within the setting of our course. Materials and methods: The criteria for being selected as an expertin Primary Care in Pediatric Trauma were agreed upon with the scientific polytrauma committee of the Spanish Pediatric Surgery Society.The items that make up the checklist were obtained from a review ofthe literature and consultation with selected experts, using the DelphiTechnique. Results: 10 experts representing the 9 groups or training centers inPrimary Care in Pediatric Trauma were selected, and a 28-item checklistwas drawn up in accordance with their design recommendations.Conclusions: With the consensus of all the groups, a checklist forthe treatment of polytraumatized pediatric patients was drawn up usingthe Delphi Technique, an essential requirement for the disseminationof this checklist, which should be adapted and validated for use in eachhealthcare center.(AU)

Impact of dapagliflozin on cardiac remodelling in patients with chronic heart failure: The DAPA-MODA study.

AIMS: Dapagliflozin improves the prognosis of patients with heart failure (HF), regardless of left ventricular ejection fraction (LVEF). However, its effect on cardiac remodelling parameters, specifically left atrial (LA) remodelling, is not well established. METHODS AND RESULTS: The DAPA-MODA trial (NCT04707352) is a multicentre, single-arm, open-label, prospective and interventional study that aimed to evaluate the effect of dapagliflozin on cardiac remodelling parameters over 6 months. Patients with stable chronic HF receiving optimized guideline-directed therapy, except for any sodium-glucose cotransporter 2 inhibitor, were included. Echocardiography was performed at baseline, 30 and 180 days, and analysed by a central core-lab in a blinded manner to both patient and time. The primary endpoint was the change in maximal LA volume index (LAVI). A total of 162 patients (64.2% men, 70.5 ± 10.6 years, 52% LVEF >40%) were included in the study. At baseline, LA dilatation was observed (LAVI 48.1 ± 22.6 ml/m2 ) and LA parameters were similar between LVEF-based phenotypes (≤40% vs. >40%). LAVI showed a significant reduction at 180 days (-6.6% [95% confidence interval -11.1, -1.8], p = 0.008), primarily due to a decrease in reservoir volume (-13.8% [95% confidence interval -22.5, -4], p = 0.007). Left ventricular geometry improved with significant reductions in left ventricular mass index (-13.9% [95% confidence interval -18.7, -8.7], p < 0.001), end-diastolic volume (-8.0% [95% confidence interval -11.6, -4.2], p < 0.001) and end-systolic volume (-11.9% [95% confidence interval -16.7, -6.8], p < 0.001) at 180 days. N-terminal pro-B-type natriuretic peptide (NT-proBNP) showed a significant reduction at 180 days (-18.2% [95% confidence interval -27.1, -8.2], p < 0.001), without changes in filling Doppler measures. CONCLUSION: Dapagliflozin administration in stable out-setting patients with chronic HF and optimized therapy results in global reverse remodelling of cardiac structure, including reductions in LA volumes and improvement in left ventricular geometry and NT-proBNP concentrations.

Complete and simultaneous removal of ionic silver and silver nanoparticles by using an ionic liquid supported on a magnetic nanoparticle core.

The global pandemic situation due to COVID-19 has given rise to the massive use of disinfectant products, many of them based on silver atoms. After the use of these products, the silver passes into the aqueous effluents, becoming an emerging contaminant in waters. In this work, a novel procedure for the total and simultaneous removal of ionic and nanomeric silver in aqueous samples is introduced, employing magnetic nanoparticles wrapped with an ionic liquid (Fe3O4@IL) as a removal agent. Experimental variables such as pH, contact time, temperature, as well as pollutant and removal agent doses were studied to achieve the total elimination, exhibiting exceptional conditions for the removal of different concentrations of silvers species in water. The approach achieves 100% removal efficiency for the simultaneous removal of both silver species, goal not achieved previously. Also, 100% removal efficiency is reached for the both species separately, since ionic silver is adsorbed onto the Fe3O4, while nanomeric silver is extracted in the IL. Particularly, for concentrations within the range 50-200 µg L-1, total removal efficiency was reached for a wide range of temperatures and a pH range 7-9, achieved in just 15 min, for all cases. Additionally, the doses of Fe3O4@IL employed to remove all concentrations of silver were 13.7 mg. Characterization of Fe3O4@IL surfaces before and after the process was performed by means of Field Effect Scanning Electron Microscopy and Energy Dispersive X-ray Spectroscopy. Fe3O4@IL was recycled by employing 100 µL of 1% HNO3 solution, allowing its use for 10 additional silver removal cycles without loss of efficiency. The study of adsorption kinetics and equilibrium isotherms reveal a Freundlich-type adsorption, which suggests affinity between sites in the complex surface of Fe3O4@IL, and Elovich kinetics, indicative of chemisorption onto a heterogeneous surface, while the temperature shows no effect on the results.

Ratio of Women with POP Using Pessary, Improvement in Urination and Quality of Life

Introduction: Pelvic organ prolapse (POP) has a general incidence of > 10% in the female population of the Western world. The pessary is a silicone device, it is inserted into the vagina to provide support to the pelvic organs. It is used as a conservative treatment to improve prolapse symptoms. Objective: To evaluate urination among women with a pessary and women without a pessary and to evaluate the effectiveness of pessary treatment in pelvic organ prolapse with voiding difficulties. Material and Methods: A prospective and quasi-experimental observational study of an analytical nature was conducted. It will consist of analyzing the results of treatment with vaginal pessaries in women with POP. A total of 60 women were chosen as a sample of the study, 50% were placed with the pessary. PGI test and uroflujometry were used. Results: The placement of pessary shows how there is a significant correlation between the quality of life of women and urination Conclusions: There is a relationship between the improvement of the quality of life and the improvement of the mycological dynamics of women in pessary treatment. However, the improvement in the quality of life cannot be attributed solely to the improvement of urinary flow, but also to the well-being caused by the reduction of POP (AU)

Introducción: El prolapso de órganos pélvicos (POP)presenta una incidencia general de > 10% en la poblaciónfemenina del mundo occidental. El pesario es un dispositivo de silicona, se introduce en la vagina para proveer soporte a los órganos pélvicos. Se utiliza como tratamientoconservador para mejorar los síntomas del prolapso.Objetivo: Evaluar las micciones entre las mujeres conpesario y las mujeres sin pesario y evaluar la efectividad deltratamiento del pesario en los prolapsos de órganos pélvicosque tienen dificultad miccionalMaterial y Métodos: Se llevó a cabo un estudioobservacional prospectivo y cuasi experimental, de carácter analítico. Consistirá en analizar los resultados detratamiento mediante pesarios vaginales en mujeres conPOP. Un total de 60 mujeres fueron elegidas como muestradel estudio, al 50% se les colocó el pesario. Se utilizó eltest PGI y la uroflujometría.Resultados: La colocación del pesario muestra comoexiste una correlación significativa entre la calidad de vidade las mujeres con POP y las micciones.Conclusiones: Existe relación entre la mejora de lacalidad de vida y la mejora de las dinámicas miccionalesde las mujeres en tratamiento con pesario. Sin embargo,la mejora de la calidad de vida no se puede atribuir únicamente a la mejora del flujo urinario, sino también al bienestar provocado por la reducción del POP (AU)

[Relevance of empirical antibiotic treatment in the evolution of prosthetic joint infection treated with implant retention]. / Relevancia del tratamiento antibiótico empírico en la evolución de la infección de prótesis articular tratada con retención del implante.

OBJECTIVE: Several factors have been associated with the prognosis of prosthetic joint infection (PJI) treated with surgical debridement, antibiotic therapy, and implant retention (DAIR). There is no evidence about the right empirical antibiotic treatment when the causal microorganism is not still identified. METHODS: We conducted a retrospective observational study in patients with PJI treated with DAIR between 2009 and 2018 in our center. We analyze the risk factors related with their prognosis and the influence of active empirical antibiotic therapy against causative microorganisms in final outcomes. RESULTS: A total of 80 PJI cases treated with DAIR, from 79 patients (58.7% women, mean age 76.3 years), were included in the study period. Among the cases in which empirical antibiotic therapy were active against the causative microorganisms, the success rate was 46/65 (69.2%) vs 1/15 when not (6.7%, OR 31.5, p = 0.001). Factors related to the success or failure of the DAIR were analyzed with multivariate analysis. We found that active empirical antibiotic treatment remained statistically significant as a good prognostic factor (OR 0.04, p <0.01). CONCLUSIONS: Empirical antibiotic treatment could be an important factor in the prognosis of PJI treated with DAIR. To identify cases at risk of infection by multidrug resistant microorganisms could be useful to guide empirical antibiotic therapy.

Overwhelming genetic heterogeneity and exhausting molecular diagnostic process in chronic and progressive ataxias: facing it up with an algorithm, a gene, a panel at a time.

Ataxias are one of the most frequent complaints in Neurogenetics units worldwide. Currently, more than 50 subtypes of spinocerebellar ataxias and more than 60 recessive ataxias are recognized. We conducted an 11-year prospective, observational, analytical study in order to estimate the frequency of pediatric and adult genetic ataxias in Argentina, to describe the phenotypes of this cohort and evaluate the diagnostic yield of the algorithm used in our unit. We included 334 ataxic patients. Our diagnostic approach was successful in one-third of the cohort. A final molecular diagnosis was reached in 113 subjects. This rate is significantly higher in the subgroup of patients with a positive family history, where the diagnostic yield increased to 55%. The most prevalent dominant and recessive ataxias in Argentina were SCA-2 (36% of dominant ataxias) and FA (62% of recessive ataxias), respectively. Next generation sequencing-based assays were diagnostic in the 65% of the patients requiring these tests. These results provide relevant epidemiological information, bringing a comprehensive knowledge of the most prevalent subtypes of genetic ataxias and their phenotypes in our territory and laying the groundwork for rationally implementing genetic diagnostic programs for these disorders in our country.

Hyaluronic acid capacitation induces intracellular signals modulated by membrane-associated adenylate cyclase and tyrosine kinase involved in bovine in vitro fertilization.

Heparin is the most commonly used in vitro capacitation inducer in the bovine. However, hyaluronic acid (HA) has been recently used for capacitation induction as well as for other reproductive biotechnologies, such as sperm selection and in vitro fertilization (IVF). Our aim was to induce sperm capacitation with heparin or HA in order to study mAC and TK intracellular signals and their relation with cleavage and blastocyst rates after IVF as well as with the oxidative status of the potential bovine embryos. 2,5-dideoxyadenosine and genistein were used as mAC and TK inhibitors, respectively. Sperm capacitation was analyzed using CTC technique, sperm plasma membrane and acrosome integrity were determined using trypan blue stain and differential interference contrast, and mitochondrial activity was evaluated using fluorochrome JC-1. Cleavage rate was analyzed 48h and blastocyst production 7-8 days after IVF, while cytosolic oxidative activity was determined using RedoxSensor Red CC-1 fluorochrome 7h after IVF. When mAC and TK inhibitors were added to sperm samples, only capacitation decreased significantly both in HA and heparin treated samples (P < 0.05), but plasma membrane and acrosome integrity percentages were not affected in any of these groups (P > 0.05). Sperm mitochondrial membrane potential only decreased in heparin treated samples in the presence of both inhibitors (P < 0.05). Oocytes activated with HA sperm treated samples with the addition of 2,5-dideoxyadenosine and genistein presented a lower cytosolic oxidative status than those activated with sperm treated with HA alone (P < 0.05). On the other hand, oocytes activated with heparin treated sperm samples presented a lower cytosolic oxidative status only in the presence of 2,5-dideoxyadenosine (P < 0.05). Therefore, mAC and TK present a differential participation in heparin and HA sperm induced capacitation and mitochondrial function as well as in IVF.

Serial voiding urosonography in posterior urethral valve diagnosis and management in pediatric patients. / Urosonografía miccional seriada en el diagnóstico y manejo de las válvulas de uretra posterior en pacientes pediátricos.

OBJECTIVES: Report our experience with the use of contrast-enhanced serial voiding urosonography (SVU) for posterior urethral valve (PUV) patient diagnosis and management. MATERIAL AND METHODS: Descriptive retrospective study in 0- to 14-year-old patients with suspected PUV at SVU performed as a first contrast-enhanced urinary tract test with subsequent cystoscopic study. Variables were analyzed using SPSSv22. RESULTS: 18 patients were studied (median age: 6 months). Most patients (15) presented posterior urethral dilatation (mean diameter: 9.56 mm) and a >2 mm gap between proximal and distal urethra. 13 cases had bladder thickening and 9 had VUR. 15 PUV cases, 1 case of distal urethral mucocele, and 1 case of bladder diverticulum obstructing the urethra were diagnosed. Complete PUV resection was performed in 10 patients (66.6%) at the first cystoscopy. The control SVU detected one case of recurrence due to persistence of posterior urethral dilatation. The recurrence case and the 5 incomplete resection cases were treated with a second cystoscopy and resection. The youngest patients required a third resection and cutting balloon dilatation due to residual stenosis. Mean creatinine levels at diagnosis were 0.28 mg/dl. CONCLUSIONS: Serial voiding urosonography (SVU) is a useful complementary test in pediatric patients with posterior urethral valve. Its dynamic nature and its advantages - absence of irradiation, safety, and high sensitivity - make it an ideal imaging test for PUV diagnosis and follow-up.

OBJETIVOS: Comunicar nuestra experiencia con la utilización de la urosonografía miccional seriada (UMS) para el diagnóstico y manejo de pacientes con válvulas de uretra posterior (VUP). MATERIAL Y METODOS: Estudio retrospectivo descriptivo en pacientes entre 0 a 14 años con sospecha de VUP en UMS realizada como primera prueba contrastada de la vía urinaria y con estudio cistoscópico posterior. Las variables se analizaron utilizando SPSSv22. RESULTADOS: Fueron estudiados 18 pacientes (edad mediana de 6 meses). La mayoría de los pacientes (15) presentaban dilatación de la uretra posterior (diámetro medio de 9,56 mm) y diferencia entre uretra proximal y distal mayor de 2 mm. Trece casos tenían engrosamiento vesical y 9 RVU. Se diagnosticaron 15 casos de VUP, 1 caso de mucocele de uretra distal y 1 divertículo vesical que obstruía uretra. Se consiguió resección completa de las VUP en 10 pacientes (66,6%) en la primera cistoscopia. La UMS de control detectó un caso de resección incompleta por persistencia de dilatación de uretra posterior. Este caso y los 5 conocidos con resección incompleta se sometieron a una segunda cistoscopia y resección. El menor de los pacientes requirió una tercera resección y dilatación con balón de corte por estenosis residual. La creatinina media al diagnóstico fue 0,28 mg/dl. CONCLUSIONES: La urosonografía miccional seriada (UMS) es una prueba complementaria útil en pacientes pediátricos con válvulas de uretra posterior. Su carácter dinámico y ventajas: ausencia de irradiación, seguridad y alta sensibilidad; la convierten en una prueba de imagen ideal para el diagnóstico y seguimiento de VUP.

Correction to: Usefulness of Genetic Testing in Hypertrophic Cardiomyopathy: an Analysis Using Real-World Data.

The name of author M. Alejandra Restrepo-Cordoba was parsed incorrectly (in such a way as to suggest that her surname is "Alejandra Restrepo-Cordoba") in this article as published.

[Two decades of experience in endovascular treatment of varicocele in pediatric age]. / Dos décadas de experiencia en el tratamiento endovascular del varicocele en la edad pediátrica.

OBJECTIVES: To present our experience of 23 years in the treatment of varicocele by embolization in pediatric age. MATERIAL AND METHODS: Observational descriptive study of all patients with varicocele treated by embolization after phlebography, by indication of the pediatric surgery service between 1995 and 2017. We performed descriptive statistical analysis and comparison between pain and testicular asymmetry before and after treatment (SPSSv22). RESULTS: Embolization was performed in 113 patients with left varicocele. The mean age of diagnosis was 12.4 years (5.2-15.5). The main clinical manifestations were: incidental finding (46.7%), increase in scrotal volume (28%) and testicular pain (15.9%). 61.5% were grade 3 and 38.5% grade 2. The selective embolization procedure was performed at an average age of 13.6 years (8-18). There were no serious complications of the procedure or reactive hydrocele. The overall success rate of endovascular treatment was 93.8%. In 85 patients (75.2%) a single procedure was performed and in 21, two procedures (18.6%). Only 4 patients required surgical intervention. The pain disappeared in all cases in which it presented and the testicular asymmetry decreased from 44.7% pre-treatment to 21.2% post-treatment (p<0.05). CONCLUSIONS: Endovascular treatment through embolization allows a selective varicocele management, after venous mapping, with an adequate effectiveness, without altering the arterial flow of the testicle or producing hydrocele. It is a minimally invasive treatment that could be considered the first choice in varicoceles of children and adolescents.

OBJETIVOS: Presentar nuestra experiencia de 23 años en el tratamiento del varicocele mediante embolización en la edad pediátrica. MATERIAL Y METODOS: Estudio descriptivo observacional de todos los pacientes con varicocele tratados mediante embolización previa flebografía, por indicación del servicio de cirugía pediátrica entre los años 1995 a 2017. Realizamos análisis estadístico descriptivo y comparación entre dolor y asimetría testicular previa y posterior al tratamiento (SPSSv22). RESULTADOS: Se realizó embolización en 113 pacientes con varicocele izquierdo. La edad media de diagnóstico fue de 12,4 años (5,2-15,5). Las manifestaciones clínicas principales fueron: hallazgo incidental (46,7%), aumento de volumen escrotal (28%) y dolor testicular (15,9%). El 61,5% eran de grado 3 y el 38,5% de grado 2. El procedimiento de embolización selectiva se realizó a una edad media de 13,6 años (8-18). No se presentaron complicaciones graves del procedimiento ni hidrocele reactivo. En 85 pacientes (75,2%) se realizó un único procedimiento y en 21, dos procedimientos (18,6%). La tasa de éxito global del tratamiento endovascular fue de 93,8%. Solo 4 pacientes requirieron intervención quirúrgica. El dolor desapareció en todos los casos en que se presentaba y la asimetría testicular disminuyó del 44,7% pretratamiento al 21,2% postratamiento (p<0,05). CONCLUSIONES: El tratamiento endovascular mediante embolización permite un manejo selectivo del varicocele, previo mapeo venoso, con una adecuada efectividad, sin alterar el flujo arterial del testículo ni producir hidrocele. Es un tratamiento poco invasivo que se puede considerar de primera elección en varicoceles de niños y adolescentes.

Head-space gas chromatography coupled to mass spectrometry for the assessment of the contamination of mayonnaise by yeasts.

Head-space (HS) gas chromatography (GC) coupled to mass spectrometry (MS) is proposed for the assessment of the contamination of mayonnaise as an alternative to plate counting, which is the technique commonly used for evaluating microbial contamination. More specifically, this method was applied in the detection of Candida metapsilosis and Zygosaccharomyces bailii, both of great importance in term of food spoilage since they are resistant to many of the common methods of food preservation. Different chemometric models were investigated using the data obtained by GC-MS (m/z profile, area of the chromatographic peaks and entire chromatographic profile), in order to obtain the highest classification success. The best results were obtained using the chromatographic profile (success rate of 92%). Contaminated samples could also be classified according to the concentration of yeast, obtaining a success rate of 87.5%. Finally, a chemometric model was constructed in an attempt to differentiate between strains.

A simple device for headspace sorptive extraction prior to gas chromatography-mass spectrometry analysis.

A device for headspace sorptive extraction (HSSE) combined with gas chromatography separation and mass spectrometry detection (GC-MS) is presented. The gadget is based on a simple magnetic disk that permits the stir bar to be placed at the top of the sample vial. The complete surface of the coated stir bar is exposed to the headspace atmosphere, and the movement of the bar caused by the magnetic stirrer in the liquid sample facilitates the sorption process. The final consequence is increased sensitivity and repeatability when compared with a glass-made comercial device for the same purpose. Successful determination of ten chlorobenzenes in waters testifies the good performance of the new device.

[Video-urodynamic evaluation with cystosonography for the study of lower urinary tract dysfunction and other uropathies in children]. / Videourodinamia con cistosonografía para estudio de la disfunción miccional y otras uropatías en niños.

OBJECTIVES: To assess the utility of a new modality of video-urodynamic for study of lower urinary tract dysfunction and other uropathies in kids, replacing voiding cystourethrography by echo-enhanced cystosonography, without ionizing radiations. MATERIAL AND METHODS: Prospective study with simultaneous performance of filling cystometry and cystosonography in 43 kids during the last two years. The sonographic contrast was infused trough the urodynamic catheter. RESULTS: 18 girls and 25 boys, with an average age of 6.18 years (between 2 months and 14 years). The most frequent indication was micturition disfunction in boys and vesicoureteral reflux follow-up in girls. 60,5% presented urodynamic alterations, predominating low bladder accommodations (N = 9), mixed detrusor overactivity (N = 5) and bladder sphincter dyssynergia (N = 4). 15 children had vesicoureteral reflux: 8 passive, 5 active (associated with contractile activity of the detrusor or in the voiding phase) and two mixed. Urethral pathology was seen in two males (urethral valves and stenosis) and two girls (spinning top urethra). A statistically significant relationship was found between the presence of vesicoureteral reflux and other variables: bladder capacity (t = 4.98; p <0.005), detrusor activity (t = 3; p = 0.005), sex (t = 2.543; p = 0.015) and high post-void residual volume (t = 3.75; p <0.005), so that it was more frequent in girls with big bladders, with detrusor activity and high post-void residue. CONCLUSIONS: Cystosonography can replace conventional cystourethrography as an imaging test associated with urodynamics. With this type of exploration we have been able to indicate the treatment to our patients, subjecting them to a single catheterization and without exposing them to ionizing radiation.

OBJETIVOS: Valorar la utilidad de una nueva modalidad de videourodinamia sin radiaciones ionizantes en el estudio de disfunciones miccionales y otras uropatías en niños, sustituyendo cistouretrografía miccional seriada por cistosonografía o urosonografía miccional. MATERIAL Y METODOS: Estudio prospectivo con realización simultánea de cistomanometría de llenado y cistosonografía en 43 niños durante los dos últimos años. El contraste sonográfico fue infundido a través del catéter de urodinamia. RESULTADOS: 18 niñas y 25 niños, con edades de entre 2 meses y 14 años (media de 6,18 años). La indicación más frecuente en los varones fue disfunción miccional y en las niñas seguimiento de reflujo. El 60,5% presentaba alteraciones urodinámicas, predominando baja acomodación vesical (N = 9), hiperactividad del detrusor mixta (N = 5) y disinergia vésico-esfinteriana (N = 4). 15 niños tenían reflujo: 8 pasivos, 5 activos (asociados a actividad contráctil del detrusor o en fase miccional) y dos mixtos. Se vio patología uretral en dos varones (valvas de uretra posterior y estenosis uretral) y dos niñas (uretra en peonza). Se encontró relación estadísticamente significativa entre presencia de reflujo vesicoureteral y otras variables: capacidad vesical (t = 4,98; p <0,005), actividad del detrusor (t = 3; p = 0,005), sexo (t = 2,553; p = 0,015) y residuo postmiccional alto (t = 3,75; p <0,005), siendo más frecuente en niñas con vejigas grandes, con actividad del detrusor y residuo postmiccional alto. CONCLUSIONES: La UMS puede sustituir a la cistouretrografía convencional como prueba de imagen asociada a la urodinamia. Con este tipo de exploración hemos podido indicar un tratamiento a nuestros pacientes, sometiéndolos a un único sondaje y sin exponerlos a radiaciones ionizantes.

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.

Relation between respiratory activity and sperm parameters in boar spermatozoa cryopreserved with alpha-tocopherol and selected by Sephadex.

Our aim was to evaluate the effect of Sephadex filtration on respiratory activity of porcine spermatozoa and its relation with quality and functional sperm parameters. Samples were evaluated regarding oxygen uptake and sperm parameters: motility, plasma and acrosome membrane integrity, capacitation and acrosome reaction induction in vitro, plasma membrane functionality, determined by the hypo-osmotic swelling test (HOST), and lipid peroxidation assessed by thiobarbituric acid assay. Sephadex filtration improved all routine quality parameters (motility, plasma and acrosome membrane integrity) and functional parameters (HOST, in vitro capacitation and true acrosome reaction levels) and produced a significant decrease in cryocapacitation and lipid peroxidation. Oxygen uptake increased in Sephadex samples (41 ± 7%) respect to single washing. Oxygen addition of carbonyl-cyanide-m-chlorophenylhydrazone (CCCP) confirmed mitochondrial coupling in washed and Sephadex samples; showing an increase of 2.6 and 4.2 times for oxygen consumption in single washing and Sephadex ones, respectively. The increase in oxygen uptake with succinate addition with respect to basal oxygen uptake was significantly lower in Sephadex samples (63 ± 25%) than in the washed ones (183 ± 35%). Sephadex samples showed higher mitochondrial activity measured by oxygen consumption and improved quality and functional parameters. Our study recommends this protocol due to the fact that this filtration method removes dead or damaged spermatozoa allowing to obtain cryopreserved boar spermatozoa with optimized fertilizing capacity.

In situ ionic liquid dispersive liquid-liquid microextraction coupled to gas chromatography-mass spectrometry for the determination of organophosphorus pesticides.

Nine organophosphorus pesticides (OPPs) were determined in environmental waters from different origins using in situ ionic liquid dispersive liquid microextraction (IL-DLLME). This preconcentration technique was coupled to gas chromatography-mass spectrometry (GC-MS) using microvial insert thermal desorption, an approach that uses a thermal desorption injector as sample introduction system. The parameters affecting both the microextraction and sample injection steps were optimized. The proposed method showed good precision, with RSD values ranging from 4.1 to 9.7%, accuracy with recoveries in the 85-118% range, and sensitivity with DLs ranging from 5 to 16 ng L-1.

Condiciones inflamatorias no infecciosas en el contexto de la fiebre de origen desconocido: el ejemplo de enfermedad de Still / Noninfectious inflammatory conditions in the context of fever of unknown origin: the example of adult onset Still's disease

La lista de etiologías en la fiebre de origen desconocido (FOD) es extensa, siendo las infecciones una causa significativa. Aunque en la actualidad, la mayoría de los casos se deben a desórdenes inflamatorios no infecciosos. La enfermedad de Still del adulto (ESA) es una entidad poco frecuente que sólo debe considerarse luego de descartar otras etiologías. El diagnóstico es clínico ya que no se disponen de métodos complementarios específicos. El curso clínico se divide en 3 patrones: monofásico, con curso de semanas o meses, intermitente, en brotes y articular crónico. Los fármacos antiinflamatorios no esteroideos y los glucocorticoides son útiles en la enfermedad aguda; dado que las recaídas son comunes, la necesidad de terapia inmunosupresora es frecuente. (AU)

Many conditions may cause fever of unknown origin (FUO). While infections remain a significant cause, most FUOs are caused by noninfectious inflammatory disorders. Adult onset Still's disease (AOSD) is a rare condition that should be considered only after the exclusion of other disorders that can cause FUO. The diagnosis of AOSD remains clinical as other diagnostic markers are not available yet1. The disease may present with three different patterns: monophasic, intermittent with relapses and chronic articular . Typically, AOSD is treated with NSAIDs and glucocorticoids, however, relapses are frequent ensuing the use of immunosuppressive drugs. (AU)

Empirical treatment of adults with hospital-acquired pneumonia: lights and shadows of the 2016 Clinical Practice ATS/IDSA Guidelines.

Hospital-acquired pneumonia (HAP) is a common cause of nosocomial infection associated with significant morbidity and mortality. New clinical practice guidelines for the management of adults with hospital-acquired pneumonia have been published in 2016 by the Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS). This review focuses on the recent recommendations and their limitations. We also focus on new therapeutic options that might improve the treatment and outcomes of these patients.

Glyoxal and methylglyoxal as urinary markers of diabetes. Determination using a dispersive liquid-liquid microextraction procedure combined with gas chromatography-mass spectrometry.

Glyoxal (GO) and methylglyoxal (MGO) are α-oxoaldehydes that can be used as urinary diabetes markers. In this study, their levels were measured using a sample preparation procedure based on salting-out assisted liquid-liquid extraction (SALLE) and dispersive liquid-liquid microextraction (DLLME) combined with gas chromatography-mass spectrometry (GC-MS). The effect of the derivatization reaction with 2,3-diaminonaphthalene, the addition of acetonitrile and sodium chloride to urine, and the DLLME step using the acetonitrile extract as dispersant solvent and carbon tetrachloride as extractant solvent were carefully optimized. Quantification was performed by the internal standard method, using 5-bromo-2-chloroanisole. The intraday and interday precisions were lower than 6%. Limits of detection were 0.12 and 0.06ngmL-1, and enrichment factors 140 and 130 for GO and MGO, respectively. The concentrations of these α-oxoaldehydes in urine were between 0.9 and 35.8ngg-1 levels (creatinine adjusted). A statistical comparison of the analyte contents of urine samples from non-diabetic and diabetic patients pointed to significant differences (P=0.046, 24 subjects investigated), particularly regarding MGO, which was higher in diabetic patients. The novelty of this study compared with previous procedures lies in the treatment of the urine sample by SALLE based on the addition of acetonitrile and sodium chloride to the urine. The DLLME procedure is performed with a sedimented drop of the extractant solvent, without a surfactant reagent, and using acetonitrile as dispersant solvent. Separation of the analytes was performed using GC-MS detection, being the analytes unequivocal identified. The proposed procedure is the first microextraction method applied to the analysis of urine samples from diabetic and non-diabetic patients that allows a clear differentiation between both groups using a simple analysis.