De-escalating axillary management after neoadjuvant chemotherapy in breast cancer: The ratio of positive sentinel lymph nodes matters.

BACKGROUND: De-escalation of axillary surgery in breast cancer (BC) patients diminishes sequelae without compromising cancer outcomes. Surgical management of the axilla is challenging after neoadjuvant treatment. We aimed to identify the factors associated with residual axillary disease amenable to lymphadenectomy in patients with positive sentinel lymph node biopsy (SLNB). METHODS: We conducted a retrospective observational study in Hospital 12 de Octubre (Spain). We included BC patients with positive SLNB who underwent axillary dissection after neoadjuvant chemotherapy. Univariate and multivariate logistic regression models were performed to identify independent predictors of residual axillary disease. We estimated the ratio of positive nodes in SLNB and assessed the diagnostic validity of this ratio in relation to residual axillary disease. RESULTS: We included 103 patients in the study. Residual axillary disease was identified in 54 patients (52.4%). Clinically node positive status at diagnosis (OR = 18.3, 95%CI: 4.0-83.6) and a ratio of positive nodes in SLNB ≥0.5 (OR = 6.5, 95%CI 41.7-23.7) were associated with residual axillary disease. The sensitivity and negative predictive value of a ratio of positive nodes in SLNB ≥0.5 were 87% (95%CI 75.1%-94.6%) and 75% (95%CI 55.1%-89.3%), respectively. CONCLUSIONS: In our study, for patients with positive SLNB after neoadjuvant chemotherapy, stage N+ at diagnosis and a ratio of positive nodes in SLNB ≥0.5 were independent risk factors of positive residual axillary disease. This ratio is a feasible measure with a good diagnostic validity for residual axillary disease and could be used as a guiding factor in the surgical management of these patients.

Dissociable Contributions of Basolateral Amygdala and Ventrolateral Orbitofrontal Cortex to Flexible Learning Under Uncertainty.

Reversal learning measures the ability to form flexible associations between choice outcomes with stimuli and actions that precede them. This type of learning is thought to rely on several cortical and subcortical areas, including the highly interconnected orbitofrontal cortex (OFC) and basolateral amygdala (BLA), and is often impaired in various neuropsychiatric and substance use disorders. However, the unique contributions of these regions to stimulus- and action-based reversal learning have not been systematically compared using a chemogenetic approach particularly before and after the first reversal that introduces new uncertainty. Here, we examined the roles of ventrolateral OFC (vlOFC) and BLA during reversal learning. Male and female rats were prepared with inhibitory designer receptors exclusively activated by designer drugs targeting projection neurons in these regions and tested on a series of deterministic and probabilistic reversals during which they learned about stimulus identity or side (left or right) associated with different reward probabilities. Using a counterbalanced within-subject design, we inhibited these regions prior to reversal sessions. We assessed initial and pre-/post-reversal changes in performance to measure learning and adjustments to reversals, respectively. We found that inhibition of the ventrolateral orbitofrontal cortex (vlOFC), but not BLA, eliminated adjustments to stimulus-based reversals. Inhibition of BLA, but not vlOFC, selectively impaired action-based probabilistic reversal learning, leaving deterministic reversal learning intact. vlOFC exhibited a sex-dependent role in early adjustment to action-based reversals, but not in overall learning. These results reveal dissociable roles for BLA and vlOFC in flexible learning and highlight a more crucial role for BLA in learning meaningful changes in the reward environment.

Seasonality of coastal upwelling trends in the Mauritania-Senegalese region under RCP8.5 climate change scenario.

The Mauritania-Senegalese upwelling region (MSUR), the southernmost region of the Canary current upwelling system, is well-known for its coastal productivity and the key role it plays in enriching the oligotrophic open ocean through the offshore transport of the upwelled coastal waters. The great ecological and socio-economic importance makes it necessary to evaluate the impact of climate change on this region. Hence, our main objective is to examine the climate change signal over the MSUR with a high resolution regional climate system model (RCSM) forced by the Earth system model MPI-ESM-LR under RCP8.5 scenario. This RCSM has a regional atmosphere model (REMO) coupled to a global ocean model (MPIOM) with high-resolution in the MSUR, which allows us to evaluate the wind pattern, the ocean stratification, as well as the upwelling source water depth, while maintaining an ocean global domain. Under RCP8.5 scenario, our results show that the upwelling favourable winds of the northern MSUR are year-round intensified, while the southern MSUR presents a strengthening in winter and a weakening in March-April. Along with changes in the wind pattern, we found increased ocean stratification in the spring months. In those months southern MSUR presents a shallowing of the upwelling source water depth associated to changes in both mechanisms. However, in winter the whole MSUR shows a deepening of the upwelling source water depth due to the intensification of the upwelling favourable winds, with the increased ocean stratification playing a secondary role. Our results demonstrate the need to evaluate the future evolution of coastal upwelling systems taking into account their latitudinal and seasonal variability and the joint contribution of both mechanisms.

Profile of physical activity and sports professionals working on disability / Perfil de los profesionales de actividad física y deporte que trabajan en discapacidad

The study analyzes the training and job profiles of physical activity and sports professionals who work with people with disabilities in Spain. Using a descriptive, quantitative methodology, standardized questionnaire-based interviews were conducted with 214 people working in this sector. The results indicate that the professionals do not receive quality initial training and when offered various training activities, they prefer to attend courses. An analysis of the employment status shows that most professionals work in companies, many without a formal employment contract or as temporary staff. Adequate initial training and varied continuing education can fulfill the need for professionalization of physical activity and sport for people with disabilities in Spain. (AU)

El estudio analiza el perfil formativo y laboral de las personas que desempeñan funciones laborales de actividad física y deporte con personas con discapacidad en España. La metodología es cuantitativa de corte descriptivo, utilizando la entrevista estandarizada por medio de cuestionario para entrevistar personalmente a 214 personas que trabajaban en este sector. Los resultados muestran que este ámbito de desempeño profesional sigue estando ocupado por personas sin la titulación adecuada en su formación inicial y que, dentro de las actividades de formación permanente, asisten preferentemente a cursos. El análisis de la situación laboral muestra que la mayor parte de las personas trabajan en empresas y un porcentaje significativo de ellas no tiene contrato o es temporal. El estudio muestra la necesidad de profesionalizar la actividad física y el deporte con personas con discapacidad en España partiendo de una adecuada formación inicial y complementada con una sólida y variada formación permanente. (AU)

Semi-Bogomol'nyi-Prasad-Sommerfield sphaleron and its dynamics.

We construct a simple field theory in which a sphaleron, i.e., a saddle-point particle-like solution, forms a semi-BPS state with a background defect that is an impurity. This means that there is no static force between the sphaleron and the impurity. Therefore, such a sphaleron-impurity system is very much like usual BPS multisolitons, however, still possessing an unstable direction allowing for its decay. We study dynamics of the sphaleron in such a system.

Borrasca Filomena: pie de trinchera en España en tiempos de paz / Storm «Philomena»: trench foot in peacetime in Spain

El pie de trinchera es considerada la lesión militar más frecuente no relacionada con el combate y conocemos de su existencia desde tiempos de Napoleón. Sin embargo, esta vasoneuropatía sigue siendo una condición poco conocida y, por ende, un desafío diagnóstico. Con la presentación de dos casos clínicos atendidos en nuestro hospital durante la borrasca Filomena, ocurrida en España en enero del 2021, con Madrid como una de las zonas más afectadas, pretendemos aportar un poco más de conocimiento, en aras de mejorar la identificación de los casos y el correcto manejo terapeútico que, a buen seguro, mejorará el pronóstico de nuestros pacientes, sin olvidar las medidas preventivas. En nuestra experiencia ha sido determinante un riguroso estudio diagnóstico (vascular y electroneurofisiológico) y el tratamiento vasodilatador con bloqueo ciático poplíteo, inhibidores de la 5 fosfodiesterasa y calcioantagonistas dihidropiridínicos.(AU)

Trench foot is considered the most common non-combat related military injury and we have known of its existance since Napoleon’s time. However, this vasoneuropathy remains a poorly understood condition and, therefore, a diagnostic challenge. With the report of 2 clinical cases treated in our hospital during Filomena storm, which occurred in Spain in January 2021, with Madrid as one of the most affected areas, we intend to contribute a little more knowledge, in order to improve cases identification and the correct management that, surely will improve our patients prognosis, without forgetting preventive measures. In our experience, a rigorous diagnostic study (vascular and electroneurophysiological) and a vasodilatador treatment with sciatic popliteal block, 5-phosphodiesterase inhibitors and dihydropyridine calcium antagonists have been decisive.(AU)

Liaison psychiatry before and after the COVID-19 pandemic.

INTRODUCTION: the COVID-19 pandemic had an impact on hospital admissions. The clinical profiles of patients referred to liaison psychiatry teams (LPT) remained stable over the last few decades. We postulate changes in patient profiles due to the COVID-19 pandemic. MATERIALS AND METHODS: a total of 384 patients admitted to a tertiary care University Hospital in Madrid (Spain) and referred to LPTs were recruited. Patients referred 5 months before and after the first admission for COVID-19 were included. Clinical and sociodemographic characteristics were collected, and non-parametric hypothesis contrast tests were used to study possible differences between both periods. RESULTS: patients referred during the pandemic were significantly older (U = 2.006; p = .045), most of them were admitted to medical hospitalization units (χ2 (2) = 5.962; p = 015), and with a different reason for admission. There was an increase in the rate of adjustment disorders (χ2 (1) =7.893; p = 005) and delirium (χ2 (1) =9.413; p = 002), as well as psychiatric comorbidity (χ2 (2) = 9.930; p = .007), and a reduction in the proportion of patients treated for substance misuse (χ2 (5) = 19.152; p = .002). The number of deaths increased significantly (χ2 (1) = 6.611; p = .010). In persons over 65 years inappropriate prescription was significantly lower (χ2 (1) = 8.200; p = .004). CONCLUSIONS: the pandemic had an impact on the activity of the LPTs due to the change in the clinical profile and evolution of referred patients, maintaining standards of care that are reflected through prescription.

Asociación entre la dieta de la población vegana y la autopercepción del estado periodontal en Lima Metropolitana / Association between diet of the vegan population and self-perception of periodontal state in Metropolitan Lima

Objetivo: determinar la asociación entre la dieta vegana y la autopercepción del estado periodontal en una población vegana de Lima Metropolitana, Perú. Materiales y métodos: un total de 240 personas (120 veganas y 120 no veganas) fueron encuestadas en este estudio durante los meses de agosto a diciembre del año 2020 de manera virtual. Para evaluar la autopercepción del estado periodontal y los hábitos de higiene oral se utilizó el autorreporte de enfermedad periodontal, que se encuentra validado con una alfa de Cronbach de 0,77. Además se registraron otras variables como la edad, el sexo, el nivel socioeconómico, el grado de estudio y el consumo de tabaco. Se utilizó la regresión de Poisson con estimador robusto de la varianza para la asociación de las variables y se reportaron razones de prevalencia en un modelo crudo y ajustado. El nivel de confianza fue del 95 % y el de significancia fue de p < 0,05. Resultados y conclusiones: se encontró asociación estadísticamente significativa entre la apariencia de encías rojizas y/o hinchadas (RP = 0,67; IC 95 %: 0,25-0,54) y la mala percepción del estado de las encías (RP = 0,43; IC 95 %: 0,33-0,56) con la dieta vegana. Por último, para la dimensión del sangrado de encías durante el cepillado no se observaron diferencias estadísticamente significativas entre las personas veganas y las no veganas (AU)

Objective: to determine the association between vegan diet and self-perceived periodontal status in a vegan population of Metropolitan Lima, Peru. Materials and methods: a total of 240 people (120 vegans and 120 non-vegans) were surveyed in this study during the months of August to December 2020 in a virtual way. To evaluate self-perception of periodontal status and oral hygiene habits, the self-report of periodontal disease was used, which is validated with a Cronbach's alpha of 0.77. In addition, other variables such as age, sex, socioeconomic level, educational level, and tobacco consumption were registered. A Poisson regression with robust variance estimator was used both for the association of variables, and prevalence ratios were reported in a crude and adjusted model. The confidence level was 95 % and the significance level was p < 0.05. Results and conclusions: a statistically significant association was found between the appearance of reddish and/or swollen gums (PR = 0.67; 95 % CI: 0.25-0.54) and poor perception of the state of the gums (PR = 0.43; 95 % CI: 0.33-0.56) with the vegan diet. Finally, for the gum bleeding dimension during brushing, no statistically significant differences were observed between vegans and non-vegans (AU)

Prevalence and seasonal variation of Fasciola hepatica in slaughtered cattle: the role of climate and environmental factors in Mexico.

The objective of this study is to determine the prevalence of Fasciola hepatica infection in cattle slaughterhouses, as well as its association with climatic/environmental factors (derived from satellite data), seasonality and climate regions in two states in Mexico. Condemned livers from slaughtered animals were obtained from three abattoirs in the states of Puebla and Veracruz. The overall prevalence of the parasite in cattle between January and December of 2017 was 20.6% (1407 out of 6834); the highest rate of condemnation was observed in Veracruz (26.3%; tropical climate), and the lowest rate was found in Puebla (15.5%; temperate climate). The seasonal prevalence of fluke infection was 18.6%, 14.8% and 28.4% during the wet season, and 17.1%, 12.4% and 22.8% during the dry season in the three abattoir sites, located in the districts of Zacatlán, Teziutlán and Ciudad Alemán, respectively. Liver condemnations due to bovine fasciolosis were prevalent in the Zacatlán, Teziutlán and Ciudad Alemán districts during summer, autumn and summer, respectively. Using generalized estimating equations analysis, we determined six variables - rainfall (wet/dry), land surface temperature day, land surface temperature night, normalized difference vegetation index, seasonality and climate regions (temperate/tropical) - to be significantly associated with the prevalence of condemned livers. Climate region was the variable most strongly associated with F. hepatica infection (odds ratio (OR) 266.59; 95% confidence interval (CI): 241.90-353.34), followed by wet and dry seasons (OR 25.56; 95% CI: 20.56-55.67).

Development of a hybrid cell for energy production.

This study focuses on the development of a new hybrid biological material to be applied in the production of electrical energy. These organo-metallic cells are constituted by cyanobacteria (Fischerella muscicola) and silver nanoparticles (AgNPs). AgNPs were obtained by green synthesis using the extract of the fruit of theBerberis halliiplant as reducing agent with two different concentrations of silver nitrate (AgNO3), 1 and 10 mM. The morphology, physicochemical and electrical properties of the cyanobacteria with and without AgNPs were evaluated. To verify the efficacy of this new material, and the effect of the medium used, Nitrofoska or BG-11, the growth kinetics was evaluated by UV-vis up tot= 63 d with and without renewal of the culture medium and O2/CO2exchange. Through morphological characterizations ofFischerella muscicolait was possible to identify the presence of an associated bacterium identified using molecular techniques asPseudomona guguanensithat could act as a supporting organism in the growth of this cyanobacteria. The studies carried out did not shown cell toxicity for the cultures that have AgNPs and on the other hand, it was observed that the hybrid cells (Cy-AgNPs) are electron carriers recording an increase of up to 57% and 18% in their electrical potential with BG-11 and Nitrofoska culture media, respectively and an increase in the anodic current peak of 6.5% of Cy-AgNPs respect to onlyF. musicola.

Population-based risk assessment of second primary cancers following a first head and neck cancer: patterns of association and difficulties of its analysis

Purpose The diagnosis of a second primary cancer (SPC) is a major concern in the follow-up of survivors of a primary head and neck cancer (HNC), but the anatomic subsites in the head and neck area are close, making it difficult to distinguish a SPC of a recurrence and therefore register it correctly. Methods We performed a retrospective cohort study using data from two population-based cancer registries in Catalonia, Spain: the Tarragona Cancer Registry and the Girona Cancer Registry. All patients diagnosed with HNC during the period 1994–2013 were registered and followed-up to collect cases of SPC. We analysed the standardized incidence ratio (SIR) and the excess absolute risk (EAR) to determine the risk of second malignancies following a prior HNC. Results 923 SPC were found in a cohort of 5646 patients diagnosed of a first head and neck cancer. Men had an increased risk of a SPC with a SIR of 2.22 and an EAR of 216.76. Women also had an increased risk with a SIR of 2.02 and an EAR of 95.70. We show the risk for different tumour sites and discuss the difficulties of the analysis. Conclusion The risks of a SPC following a prior HNC in Tarragona and Girona are similar to those previously found in other similar cohorts. It would appear to be advisable to make a revision of the international rules of classification of multiple tumours, grouping the sites of head and neck area with new aetiological criteria to better determine and interpret the risks of SPC obtained in these studies (AU)

Population-based risk assessment of second primary cancers following a first head and neck cancer: patterns of association and difficulties of its analysis.

PURPOSE: The diagnosis of a second primary cancer (SPC) is a major concern in the follow-up of survivors of a primary head and neck cancer (HNC), but the anatomic subsites in the head and neck area are close, making it difficult to distinguish a SPC of a recurrence and therefore register it correctly. METHODS: We performed a retrospective cohort study using data from two population-based cancer registries in Catalonia, Spain: the Tarragona Cancer Registry and the Girona Cancer Registry. All patients diagnosed with HNC during the period 1994-2013 were registered and followed-up to collect cases of SPC. We analysed the standardized incidence ratio (SIR) and the excess absolute risk (EAR) to determine the risk of second malignancies following a prior HNC. RESULTS: 923 SPC were found in a cohort of 5646 patients diagnosed of a first head and neck cancer. Men had an increased risk of a SPC with a SIR of 2.22 and an EAR of 216.76. Women also had an increased risk with a SIR of 2.02 and an EAR of 95.70. We show the risk for different tumour sites and discuss the difficulties of the analysis. CONCLUSION: The risks of a SPC following a prior HNC in Tarragona and Girona are similar to those previously found in other similar cohorts. It would appear to be advisable to make a revision of the international rules of classification of multiple tumours, grouping the sites of head and neck area with new aetiological criteria to better determine and interpret the risks of SPC obtained in these studies.

A sustainable approach by using microalgae to minimize the eutrophication process of Mar Menor lagoon.

The present study evaluates the removal capacity of microalgae photobioreactors of environmental pollutants present in wastewater from the dry riverbed El Albujón, as a way to minimize the eutrophication process of the Mar Menor. Particularly, the capacity of four autochthonous microalgae consortia collected from different locations of the salty lagoon to remove emerging contaminants (simazine, atrazine, terbuthylazine, adenosine and ibuprofen), nitrates, and phosphates, was evaluated. Among the four microalgae consortia, consortium 1 was the best in terms of biomass productivity (0.11 g L-1 d-1) and specific growth rate (0.14 d-1), providing 100% removal of emerging contaminants (simazine, atrazine, terbuthylazine, adenosine and ibuprofen), and a maximal reduction and consumption of macronutrients, especially nitrates and phosphates, reaching levels below 28 mg L-1, that is, a decrease of 89.90 and 99.70% of nitrates and phosphates, respectively. Therefore, this consortium (Monoraphidium sp., Desmodesmus subspicatus, Nannochloris sp.) could be selected as a green filter for successful large-scale applications. This study is the first one that combines the successful removal of herbicides, ibuprofen and adenosine as emerging contaminants, and nitrate removal.

A new species concept for the clinically relevant Mucor circinelloides complex.

Mucor species are common soil fungi but also known as agents of human infections (mucormycosis) and used in food production and biotechnology. Mucor circinelloides is the Mucor species that is most frequently isolated from clinical sources. The taxonomy of Mucor circinelloides and its close relatives (Mucor circinelloides complex - MCC) is still based on morphology and mating behaviour. The aim of the present study was a revised taxonomy of the MCC using a polyphasic approach. Using a set of 100 strains molecular phylogenetic analysis of five markers (ITS, rpb1, tsr1, mcm7, and cfs, introduced here) were performed, combined with phenotypic studies, mating tests and the determination of the maximum growth temperatures. The multi-locus analyses revealed 16 phylogenetic species of which 14 showed distinct phenotypical traits and were recognised as discrete species. Five of these species are introduced as novel taxa: M. amethystinus sp. nov., M. atramentarius sp. nov., M. variicolumellatus sp. nov., M. pseudocircinelloides sp. nov., and M. pseudolusitanicus sp. nov. The former formae of M. circinelloides represent one or two separate species. In the MCC, the simple presence of well-shaped zygospores only indicates a close relation of both strains, but not necessarily conspecificity. Seven species of the MCC have been implemented in human infection: M. circinelloides, M. griseocyanus, M. janssenii, M. lusitanicus, M. ramosissimus, M. variicolumellatus, and M. velutinosus.

Trombosis aorto-ilíaca en relación con COVID-19: A propósito de un caso / Aortoiliac thrombosis related to COVID-19- A case report

Se presenta un caso de isquemia arterial aguda en extremidad inferior izquierda por trombosis aortoiliaca, en paciente diagnosticada de neumonía bilateral con compromiso respiratorio severo durante la infección por SARS-CoV-2. Se realiza angio TC abdominopélvico ante sospecha de afectación iliofemoral izquierda y femoropoplitea derecha sin factores de riesgo cardioembólicos ni clínica previa de claudicación. A pesar del mal estado general de la paciente con necesidad de aporte de oxígeno a alto flujo se realiza cirugía para salvamento de extremidad. La intervención se realizó bajo anestesia local y en posición anti-Trendelemburg para asegurar la saturación de oxígeno. Se realiza tromboembolectomía iliofemoral de la extremidad sintomática, consiguiendo la recuperación funcional de la extremidad

We present a case of acute arterial ischemia in left lower limb due to aortoiliac thrombosis in a patient with SARS-CoV-2 pneumonia with severe respiratory distress. Abdominal CT angiography was performed with high suspect of left iliofemoral and right femoropopliteal compromise without cardioembolic risk factors nor previous intermittent claudication. Despite patient's poor condition, who needed supplementation of high flow oxygen, a salvage surgery was performed in order to preserve the extremity. The intervention was performed under local anesthesia and reverse Trendelenburg position in order to keep appropriate oxygen saturation. The procedure consisted of mechanical iliofemoral thromboembolectomy of the symptomatic limb achieving functional recovery

Point-of-care lung ultrasound in three neonates with COVID-19.

Since March 2020, the world is involved in the COVID-19 pandemic, a disease caused by a novel virus called SARS-CoV-2. Some authors have described the ultrasonographic findings of COVID-19 pneumonia in adults and children, but data on neonates are lacking. Our objective was to describe the ultrasonographic lung pattern on newborns with SARS-CoV-2 infection during the COVID-19 pandemic. Newborns who tested positive for SARS-CoV-2 PCR in respiratory samples and were evaluated with point-of-care lung ultrasound (LU) from March to April 2020 were included. LU was performed bedside by a single investigator at the time of diagnosis and every 48 h during the first week following diagnosis. Six areas were studied. Three neonates were included. Infants' comorbidities included meconium aspiration syndrome, bronchopulmonary dysplasia, and Hirschsprung's disease. One required mechanical ventilation. No deaths occurred. LU showed B-lines, consolidation, and spared areas. No pneumothorax or pleural effusion was observedConclusions: LU could be of value when managing COVID-19 neonates. We describe the findings of lung ultrasound monitoring during the first week following diagnosis in three neonates with SARS-CoV-2 infection. What is known: • Lung ultrasound (LU) is a useful tool in COVID-19 management in adults. To date, no report on LU and neonates with SARS-CoV-2 infection has been published. What is new: • This study adds evidence about LU findings in neonates with SARS-CoV-2 infection.

Experiencia del Servicio de Medicina Hiperbárica en el tratamiento con oxigenoterapia hiperbárica de pacientes COVID-19 / Lessons identified by the Hyperbaric Departament about the treatment for COVID-19 patients with hyperbaric oxygentherapy

Durante el periodo inicial de la pandemia de COVID-19, y debido a la saturación del sistema asistencial se planteó administrar tratamiento con oxigenoterapia hiperbárica (OHB) a pacientes con PCR + para COVID-19 o con alta sospecha clínica, radiológica y analítica en el Servicio de Medicina Hiperbárica (SMHB) del Hospital Central de la Defensa «Gómez Ulla» (HCD). OBJETIVOS: asistir a pacientes que no respondían a tratamiento, así como comprobar la eficacia de la OHB como una herramienta útil para el tratamiento del COVID-19. MATERIAL Y MÉTODOS: Se valoraron 11 peticiones de tratamiento con OHB, de pacientes procedentes de plantas COVID-19 y UCI, de los cuales finalmente se trataron únicamente a 6 pacientes. Se procedió al tratamiento en cámara multiplaza, entre 1,6 y 2 atmósferas de presión absoluta (ATA) y tiempo de exposición entre 90 y 105 minutos, con la presencia en todo momento de acompañante. Se diseñaron protocolos de protección biológica respiratoria y de contacto frente al coronavirus. Se realizaron controles analíticos y pruebas de imagen. Resultado y conclusiones: Se completaron 35 sesiones de tratamiento. Los pacientes recibieron entre 1 y 14 sesiones No se produjo ningún caso de infección entre los sanitarios del servicio. Los pacientes que por su estado pudieron recibir más de 5 sesiones de OHB tuvieron una mejor evolución clínica. Se observaron reflejos de desaturación postratamiento con OHB

During the first period of the COVID-19 pandemic and due to saturation of the health care system, it was necessary to treat with hyperbaric oxygen therapy (HBO) (in the Hyperbaric Medicine Service at the Defence Central Hospital «Gómez Ulla» (HCD)), some patients with PCR (+) for COVID -19, or with clinical, radiological or analytical high indicative data. OBJECTIVES: to treat patients without positive answer to regular treatment and to check the effectiveness of HBO as useful therapy for COVID-19. MATERIAL AND METHOD: There were valued 11 requests for treatment from COVID-9 wards and the Intensive Care Department. Eventually 6 of those patients were treated. These patients were treated in a multiplace hyperbaric chamber between 1.6 and 2 ATAs and for 90 to 105 minutes of time, with ancillary personnel inside the chamber the whole sessions. There were also developed security protocols to prevent COVID-19 infection. Image and analytics controls were followed. RESULTS AND CONCLUSIONS: 35 sessions of treatment were completed. The patients received from 1 to 14 sessions. It did not happen any case of infection on the medical personnel of the HBO Department. The patients which (due to their physical status) could receive 5 or more sessions had a better clinical evolution. Some desaturation reflexes were observed

Isquemia arterial aguda en pacientes con infección por COVID-19 / Acute arterial ischemia in patients with COVID 19 infection

La infección por el nuevo coronavirus SARS-COV-2 (COVID-19) y declarada pandemia mundial por la OMS, ha demostrado en algunos pacientes ser una enfermedad altamente trombogénica, tanto venosa como arterial, generando trombosis venosa profunda, embolismo pulmonar y cuadros de isquemia aguda, tanto en pacientes sin patología previa como con ellas. Se presentan cuatro casos de pacientes atendidos en el Hospital Gómez Ulla de Madrid durante la pandemia. Se compara su presentación clínica y evolución con otras series similares

The infection caused by the novel coronavirus SARS-COV-2 (COVID-19) which was declared global pandemic by the WHO has showed to be a highly thrombotic disease in some patients, presenting with venous and arterial complications such as deep vein thrombosis, pulmonary embolism and acute ischemia affecting patients with and without previous diseases. We describe four cases of COVID-19 patients treated in Gomez Ulla Hospital of Madrid during the pandemic. Clinical manifestations and outcome are compared with other similar series

A population perspective on the use of external beam radiotherapy in Catalonia, Spain.

PURPOSE: To assess the use of external beam radiotherapy in Catalonia (Spain), overall and by health management area. METHODS: We assessed radiotherapy treatments in a cohort of patients diagnosed with cancer from 2009 to 2011, using the population-based cancer registries in Girona and Tarragona. Participants had to have a minimum follow-up of 5 years from the time the cancer registry database was linked to the catalan health service database for financing radiation oncology. Outcomes included the proportion of patients receiving radiotherapy within 1 and 5 years of diagnosis. A log-binomial model was used to assess age-related trends in the use of radiotherapy by tumour site. Finally, we calculated the standardized utilization rate and 95% confidence intervals by health management area covered by the radiation oncology services, using indirect methods. RESULTS: At 1 and 5 years from diagnosis, 21.4 and 24.4% of patients, respectively, had received external beam radiotherapy. Patients aged 40-64 years had the most indications for the treatment, and there was a negative correlation between the patients' age and the use of radiotherapy for most tumour sites (exceptions were cervical, thyroid, and uterine cancers). There were no statistically significant differences in the use of radiotherapy according to th health management area. CONCLUSIONS: Population-based data show that external beam radiotherapy is underutilized in Catalonia. This situation requires a careful analysis to understand the causes, as well as an improvement of the available resources, oriented toward achieving realistic targets for the optimal use of external beam radiotherapy in our country.

Bioavailable phytoprostanes and phytofurans from Gracilaria longissima have anti-inflammatory effects in endothelial cells.

BACKGROUND: An array of bioactive compounds with health-promoting effects has been described in several species of macroalgae. Among them, phytoprostanes (PhytoPs) and phytofurans (PhytoFs), both autoxidation products of α-linolenic acid, have been seen to exert immunomodulatory and antiinflammatory activities in vitro. The purpose of this study was to explore the bioaccesibility, bioavailability, and bioactivity of PhytoPs and PhytoFs obtained from the edible red algae Gracilaria longissima, and to gain insight into the anti-inflammatory activity of their bioavailable fraction in human endothelial cells. METHODS: The PhytoPs and PhytoFs profile and concentration of G. longissima were determined by UHPLC-QqQ-MS/MS. Algal samples were processed following a standardised digestion method including gastric, intestinal, and gastrointestinal digestion. The bioavailability of the PhytoPs and PhytoFs in the characterized fractions was assessed in a Caco-2 cell monolayer model of the intestinal barrier. The inflammation response of these prostaglandin-like compounds in human endothelial cells, after intestinal absorption, was investigated in vitro. RESULTS: Simulated digestions significantly reduced the concentration of PhytoPs and PhytoFs up to 1.17 and 0.42 µg per 100 g, respectively, on average, although permeability through the Caco-2 cell monolayer was high (up to 88.2 and 97.7%, on average, respectively). PhytoP and PhytoF-enriched extracts of raw algae impaired the expression of ICAM-1 and IL-6 inflammation markers. The inflammation markers progressed in contrast to the relative concentrations of bioactive oxylipins, suggesting pro- or anti-inflammatory activity on their part. In this aspect, the cross-reactivity of these compounds with diverse receptors, and their relative concentration could explain the diversity of the effects found in the current study. CONCLUSIONS: The results indicate that PhytoPs and PhytoFs display complex pharmacological profiles probably mediated through their different actions and affinities in the endothelium.