Association between depressive symptoms and disability in older adults of 12 high Andean communities from Peru.

OBJECTIVE: Our objective was to evaluate the association between depressive symptoms and disability in older adults residing in 12 high Andean communities in Peru. MATERIAL AND METHODS: We carried out a secondary data analysis of a cross-sectional study that included older adults (60 years or older) from 12 high Andean communities in Peru from 2013 to 2019. Depressive symptoms were defined as a score of two or more in the abbreviated Geriatric Depression Scale, while disability was defined as a score of less than 95 in the Barthel index. We also included sociodemographic characteristics, medical and personal history, and functional and performance-based tests. We used crude and adjusted Poisson regression models to evaluate the association of interest and estimated prevalence ratios (PR) with their respective 95% confidence intervals (95% CI). RESULTS: We included 442 older adults with a mean age of 73 ± 6.9 in the analysis; 63.1% (n = 279) were women, and 79.9% (n = 353) had no education or incomplete primary school. 50.9% (n = 225) of the participants had depressive symptoms, and 49.8% (n = 220) had disability. The adjusted Poisson regression model showed that depressive symptoms increased the probability of disability (adjusted PR = 1.67; 95% CI: 1.34-2.08; p < 0.001) in older adults living at high altitude. CONCLUSIONS: Depressive symptoms was associated with a greater probability of disability in older adults living at high altitude. Longitudinal studies are needed for better understanding of this association in high altitude populations along with timely interventions to reduce the impact of both geriatric syndromes.

Effect of organic and conventional farming on soil bacterial diversity of pecan tree (Carya illinoensis K. Kosh) orchard across two phenological stages.

We described the bacterial diversity of walnut grove soils under organic and conventional farming. The bacterial communities of rhizospheric and nonrhizospheric soils of pecan tree (Carya illinoensis K. Koch) were compared considering two phenological stages (sprouting and ripening). Sixteen operational taxonomic units (OTUs) were identified significantly more abundant according to the plant development, only one according to the farming condition, and none according to the soil origin. The OTUs specificaly abundant according to plant development included Actinobateria (2) and Betaproteobacteria (1) related OTUs more abundant at the sprouting stage, while at the fruit ripening (FR) stage the more abundant OTUs were related to Actinobacteria (6), Alphaproteobacteria (6), and unclassified Bacteria (1). The Gaiellaceae OTU18 (Actinobacteria) was more abundant under conventional farming. Thus, our study revealed that the plant development stage was the main factor shaping the bacterial community structure, while less influence was noticed for the farming condition. The bacterial communities exhibited specific metabolic capacities, a large range of carbon sources being used at the FR stage. The identified OTUs specifically more abundant represent indicators providing useful information on soil condition, potential tools for the management of soil bacterial communities.

Administering copper reduces hyper-excitability generated by penicillin G in motor cortex neurons from rat brain slices.

Recording synaptic activity of layer III neurons from motor cortex slices, which was provoked by stimulating layer IV, generated synaptic responses of the field potential (FP) that went from mean 100 µV to 600 µV when the stimulus was increased up to twice the threshold. Administering 100 µM or 200 µM of copper, increased the responses to mean 800 µV and 820 µV, respectively. The response to 200 µM was not significantly greater than that to 100 µM. However, all FP responses were significantly lower to a copper concentration of 500 µM. The basal FP was slowly restored by removing the copper with Krebs-Ringer(K-R), resulting in similar characteristics to those observed before copper administration. Then, neurons were perfused with penicillin (2000 UI) to increase cortical excitability and to assess the depressing effect of high concentrations of copper. Administering 500 µM of copper significantly reduced the activity generated by penicillin, while removing by wash(K-R) penicillin and copper generated FP responses similar to those obtained at baseline. Our data indicate that depending on the concentration, copper can behave as an activating or blocking agent for cortical activity.

Agomelatine for the treatment of patients with fibromyalgia and depressive symptomatology: an uncontrolled, 12-week, pilot study.

INTRODUCTION: Agomelatine, a melatonin agonist and selective 5-HT2C antagonist, is a novel antidepressant with sleep-enhancing properties. The purpose of this study was to assess the efficacy and tolerability of agomelatine among patients with fibromyalgia and depression. METHODS: 23 patients with fibromyalgia and depressive symptomatology received 25-50 mg of agomelatine daily for 12 weeks. The primary outcome measure was the change of the Beck depression inventory score. Secondary outcome measures included the hospital anxiety and depression scale, Pittsburgh sleep quality index, Fibromyalgia Impact Questionnaire, short-form health survey, brief pain inventory and patient's global impression scale. RESULTS: Agomelatine significantly improved depression, global fibromyalgia severity and pain intensity but effect sizes were small. No improvement was seen in sleep quality. Patients categorized as responders to treatment had milder disease severity than non-responders. Agomelatine therapy was well tolerated and patients only reported mild and transient side effects. DISCUSSION: Agomelatine slightly improved depressive and fibromyalgia symptomatology but did not improve sleep quality. Our data do not support agomelatine as a first-line treatment option for the treatment of fibromyalgia and depression.

Effects on the accelerating electron bunches due to the presence of sulfur hexafluoride or air in the linac waveguide.

Sulfur hexafluoride gas (SF6) is used as a dielectric insulator in the acceleration process of certain medical linear accelerator waveguides. Nevertheless, some innovative development and investigation cases require intervention in the linear accelerator or, specifically, on the waveguide, which could affect the sealing of the device. In this regard, vacuum sealing systems can be compromised, affecting the properties of the radiation beams produced. The presence of sulfur hexafluoride or air inside the VARIAN 6/100 waveguide was investigated under different pressure conditions and non-uniform electric fields, adapting Monte Carlo simulation techniques for modeling radiation transport coupled with electric fields. Obtained results indicated the suitability of the proposed approach, while comparisons with theoretical approaches and experimental evidence supported the model's consistency.

[Delayed cognitive impairment in patients with aortic stenosis treated with surgical valve replacement and transcatheter aortic valve implantation: a comparative study]. / Deterioro cognitivo tardío en pacientes con estenosis aórtica tratados con sustitución valvular quirúrgica y con implantación transcatéter de válvula aórtica: estudio comparativo.

INTRODUCTION: Cognitive impairment secondary to cerebrovascular events is a common complication of aortic valve replacement interventions. Our aim is to study the deterioration profile of patients who have undergone surgical valve replacement or transcatheter valve implantation (TAVI) and whether it differs according to the intervention they underwent and their baseline risk factors. PATIENTS AND METHODS: We conducted a prospective observational study with two non-equivalent groups of patients (TAVI group and surgical group) Intergroup comparisons were carried out in several cognitive domains, with a baseline assessment and follow-up measurements six and 12 months after the intervention. RESULTS: The TAVI group performed less well than the surgical group in executive and visuospatial functions, with scores partially determined by age (p < 0.01) and prior intellectual level (Pearson prior intelligence quotient-scalar test means: 0.665; p < 0.001). Mean scores at the three measurement points indicate a decline in executive function performance at six months, which is restored at 12 months. Sustained increases in memory were recorded at both time points, while visuospatial function and naming showed no subsequent recovery of the baseline levels. These trends are similar in both groups. CONCLUSION: The results obtained do not confirm the appearance of a specific process of post-intervention neurocognitive impairment in complicated aortic stenosis. The deterioration profile does not show any significant differences between groups, but is more evident in TAVI patients, due to the influence of variables related to sample selection.

TITLE: Deterioro cognitivo tardío en pacientes con estenosis aórtica tratados con sustitución valvular quirúrgica y con implantación transcatéter de válvula aórtica: estudio comparativo.Introducción. El deterioro cognitivo secundario a eventos cerebrovasculares es una complicación frecuente en las intervenciones de reemplazo de válvula aórtica. Nuestro objetivo es el estudio del perfil de deterioro de los pacientes sometidos a reemplazo valvular quirúrgico o implantación de prótesis transcatéter (TAVI) y si éste resulta diferente según la intervención a la que son sometidos y los factores de riesgo basales. Pacientes y métodos. Estudio observacional prospectivo, con dos grupos no equivalentes de pacientes (grupo TAVI y grupo quirúrgico). Se realizaron comparaciones intergrupo en varios dominios cognitivos, con una evaluación basal y mediciones de seguimiento seis y 12 meses después la intervención. Resultados. El grupo TAVI presentó resultados inferiores al grupo quirúrgico en funciones ejecutivas y visuoespaciales, puntuaciones parcialmente determinadas por la edad (p < 0,01) y el nivel intelectual previo (Pearson cociente intelectual previo-medias escalares en los test: 0,665; p < 0,001). La media de puntuaciones en los tres momentos de medición indica una disminución del rendimiento en funciones ejecutivas a los seis meses, que se recupera a los 12 meses. En memoria se registraron incrementos sostenidos en ambos momentos, en tanto que la función visuoespacial y la denominación no mostraron recuperación posterior de los niveles basales. Estas tendencias son similares en los dos grupos. Conclusión. Los resultados obtenidos no confirman la instauración de un proceso específico de deterioro neurocognitivo postintervención en la estenosis aórtica complicada. El perfil de deterioro no presenta diferencias significativas entre los grupos, pero es más evidente en los pacientes con TAVI, debido a la influencia de las variables de selección de la muestra.

Kanamycin treatment in the pre-symptomatic stage of a Drosophila PD model prevents the onset of non-motor alterations.

Parkinson's disease (PD) is a neurodegenerative disorder characterized by motor alterations, which is preceded by a prodromal stage where non-motor symptoms are observed. Over recent years, it has become evident that this disorder involves other organs that communicate with the brain like the gut. Importantly, the microbial community that lives in the gut plays a key role in this communication, the so-called microbiota-gut-brain axis. Alterations in this axis have been associated to several disorders including PD. Here we proposed that the gut microbiota is different in the presymptomatic stage of a Drosophila model for PD, the Pink1B9 mutant fly, as compared to that observed in control animals. Our results show this is the case: there is basal dysbiosis in mutant animals evidenced by substantial difference in the composition of midgut microbiota in 8-9 days old Pink1B9 mutant flies as compared with control animals. Further, we fed young adult control and mutant flies kanamycin and analyzed motor and non-motor behavioral parameters in these animals. Data show that kanamycin treatment induces the recovery of some of the non-motor parameters altered in the pre-motor stage of the PD fly model, while there is no substantial change in locomotor parameters recorded at this stage. On the other hand, our results show that feeding young animals the antibiotic, results in a long-lasting improvement of locomotion in control flies. Our data support that manipulations of gut microbiota in young animals could have beneficial effects on PD progression and age-dependent motor impairments. This article is part of the Special Issue on "Microbiome & the Brain: Mechanisms & Maladies".

Clinical and economic impact of rapid reporting of bacterial identification and antimicrobial susceptibility results of the most frequently processed specimen types.

Inappropriate antibiotic prescriptions are associated with an increase in healthcare costs and a decrease in the quality of care. The aim of this study was to measure the clinical and economic impact of rapid microbiological reporting on the specimens most frequently processed by the Microbiology Laboratory. The Vitek® 2 system (bioMérieux) was used for identification and susceptibility testing. Only hospitalized patients with bacterial infections were included. Two groups were established, a historical control group (results available the day following the analysis) and an intervention group (results available the same day of the analysis). Specimens studied and the median length of time from the introduction of the microorganism in the Vitek® 2 until microbiological report were as follows: wound and abscess (control = 23.5 h, intervention = 9.5 h, p < 0.001), blood (control = 23.5 h, intervention = 9.2 h, p < 0.001), and urine (control = 23.4 h, intervention = 9.3 h, p < 0.001). Outcome parameters were hospital stay and mortality rates. Hospital costs were calculated. The mortality rates did not differ significantly between the two groups. Faster reporting of identification and antimicrobial susceptibility results was associated with a significant reduction in hospital stay and in overall costs for those patients from whom wound, abscess, and urine specimens were analyzed. However, the antimicrobial results of blood culture isolates did not lead to significant clinical or financial benefits.

Dosimetry of tumor targeting imaging by convergent X-ray beam as compared with nuclear medicine.

During decades nuclear medicine procedures, based on radiolabeled agents, have proved to be efficient for diseases diagnosis and treatment. Radiation emerging from patient is detected aimed at localizing radiotracer distribution that is further correlated with biochemical/metabolic physiological processes. However, a significant drawback associated with current nuclear medicine procedures implementing radionuclide infusion regards to the inherent absorbed dose as well as radiopharmaceuticals' production, storage and elimination from patient body, thus representing a risk at patient and public health level. In the recent years, alternative methods have been proposed to reduce/eliminate radionuclides in some nuclear medicine procedures. The combination of high atomic number nanoparticles infused within patient body with incident X-ray beam, like tumor targeting and treatment, appears as a potential alternative method capable of theranostics. The process is based on inducing X-ray fluorescence and secondary electrons emission in high atomic number nanoparticles by means of excitation with an external X-ray beam, avoiding employing radioactive substances. The present work reports on the dosimetry performance of both methods, comparing whenever the external convergent X-ray beam alternative may involve less or larger radiation dose levels, according to comparable signal/image quality during the procedure. To this aim, a simplified theoretical model is proposed and associated Monte Carlo simulations are performed in order to compare typical case of nuclear medicine imaging with potential performance of an innovative method, called OXIRIS (Orthovoltage X-ray Induced Radiation and Integrated System), based on convergent X-ray beam exciting high atomic number nanoparticles infused in patient. The obtained results support the proposed alternative method's feasibility, once demonstrated that patient absorbed dose levels are relative similar to those currently used by nuclear medicine procedures, whereas dose to targeted region (tumor) are significantly higher, which may be useful for treatment purposes.

[Neuropsychological profile in patients with myotonic dystrophy type 1: a four-year follow-up study]. / Perfil neuropsicológico en pacientes con distrofia miotónica tipo 1: estudio de seguimiento a cuatro años.

INTRODUCTION: Myotonic dystrophy type 1 (MD1), or Steinert's disease, is a multisystemic disorder of autosomal dominant inheritance, whose adult variant usually presents with multidomain cognitive impairment and affects patients' functionality and quality of life. AIM: To study the four-year history of cognitive functioning in a sample of patients with the adult variant of MD1. PATIENTS AND METHODS: The neurocognitive functions of a sample of 31 patients with MD1 are evaluated, of whom 24 repeat the test administered four years ago in the Neurology Service of the Complejo Hospitalario of Navarra. Data are collected from the cognitive domains that are most related to the deficits that usually present in MD1. RESULTS: The follow-up evaluation found that the visuospatial and visuoconstructive functions and alternating attention of the patients who underwent the study were affected, as was their daily functioning reported by the family. These results are in line with those obtained four years earlier, with no significant deterioration observed between the two measurements. A higher incidence of cognitive impairment was also displayed in 2018, with some cases of progression to dementia in Steinert's disease. CONCLUSION: Neurocognitive progression in MD1 seems to respond to a progressive pattern of degeneration, linked to the functions that are most affected from the beginning of the sequelae phase and which usually correspond to the domains of working memory, alternating attention, and visuospatial and visuoconstructive abilities.

TITLE: Perfil neuropsicológico en pacientes con distrofia miotónica tipo 1: estudio de seguimiento a cuatro años.Introducción. La distrofia miotónica tipo 1 (DM1), o enfermedad de Steinert, es un trastorno multisistémico de herencia autosómica dominante, cuya variante adulta suele cursar con deterioro cognitivo multidominio y afectación de la funcionalidad y la calidad de vida de los pacientes. Objetivo. Estudiar la evolución a cuatro años del funcionamiento cognitivo de una muestra de pacientes con la variante adulta de DM1. Pacientes y métodos. Se evalúan las funciones cognitivas de una muestra de 31 pacientes con DM1, de los cuales 24 repiten la evaluación administrada hace cuatro años en el Servicio de Neurología del Complejo Hospitalario de Navarra. Se recogen datos de los dominios neurocognitivos más relacionados con los déficits de presentación habitual en la DM1. Resultados. La evaluación de seguimiento constató la afectación de las funciones visuoespaciales y visuoconstructivas y de la atención alternante de los pacientes que se sometieron al estudio, así como de su funcionamiento cotidiano informado por la familia. Estos resultados están en línea con los obtenidos cuatro años atrás, sin que se haya objetivado un deterioro significativo entre ambas mediciones. Se demuestra, además, una mayor incidencia de deterioro cognitivo en 2018, con algunos casos de evolución a demencia en la enfermedad de Steinert. Conclusión. La evolución neuropsicológica en la DM1 parece responder a un patrón progresivo, ligado a las funciones que más se afectan desde los inicios de la fase de secuelas y que suelen corresponder a los dominios de memoria de trabajo, atención alternante y habilidades visuoespaciales y visuoconstructivas.

[Self-perception, colonic transit and characteristics of subjects seeking medical care for constipation in Mexico.]. / Autopercepción, tránsito colónico y características de sujetos que consultan por estreñimiento en México.

OBJECTIVES: Subjects seeking medical care for constipation were evaluated to find out: a) how they describe their complaint, b) their symptoms and colonic transit (CT) time, and c) determine what factors may allow to detect colonic inertia (CI) or obstructive defecation (OD). MATERIAL AND METHODS Patients demographics and medical history were collected and the modular Rome III questionnaire was applied. A screening CT with radioopaque markers was performed in all subjects. Those with an abnormal result underwent a multiple-pellet CT . Factors associated with CI and OD were analyzed. RESULTS: 105 patients were enrolled (92 females, mean age 36.7 years). Seventy patients described constipation as a bowel movement involving straining or being less frequently than expected (67%). The screening CT was normal in 79 patients (75%). Multiple-pellet CT was performed in 23 patients (9 normal, CI in 6, OD in 8). Irritable bowel syndrome (IBS) criteria were met by 79 subjects (75%) and functional constipation by 26 (25%). A greater proportion of patients with CI or OD had attended the Emergency Room, used suppositories or enemas and interfered their activities due to constipation, during the previous year to the survey (p<0.05). CONCLUSIONS: Most patients described constipation as straining or lower frequency (67%) than expected. CT was normal in 84% of the patients, but it detected 6 cases of CI and 8 of OD. Patients that attended the Emergency Room, used suppositories or enemas and those whom activities were interfered turned out with CI or OD more frequently.

Liver transplantation for neurologic Wilson's disease: reflections on two cases within a mexican cohort.

BACKGROUND: Liver transplantation (LT) in Wilson s disease (WD) is mostly indicated when progressing liver disease or acute liver failure occurs. In patients with neurological manifestations, this procedure has not gained wide acceptance based on previous reports of dismal prognosis. OBJECTIVE: To describe a Mexican cohort of pa- tients with WD with special focus on LT in patients with deteriorating neurological manifestations. MATERIAL AND METHODS: Patients with confirmed WD and their first-degree relatives were evaluated at the hepatology clinic of a tertiary referral hospital. Attention was placed on therapy and outcome. RESULTS: Eleven patients were followed for a period of up to 80 months (7 probands and 4 affected family members), 10 patients having hepatic manifestations and 4 having neuro psychia- tric phenomena. Pharmacologic treatment was uniform in most patients, and LT was indicated in 2 cases because of deteriorating neurological status. These patients had total remission of their neurological manifestations with marked improvement on imaging studies. CONCLUSIONS: Follow-up and pharmacologic treatment was flawed by several adverse conditions present in our population. Patients with progressing neurological disease had a favorable outcome after LT, a similar response to the one reported by several authors. In conclusion, LT should be strongly considered for the treatment of these patients.

[What people mean by constipation? A general population based-study.]. / ¿Qué se entiende por estreñimiento? Un estudio en población abierta.

INTRODUCTION: The word "constipation" is used by people to refer multiple symptoms such as infrequent stools, hard stools, excessive straining and feeling of incomplete evacuation. This variability is a confounding factor and may induce discrepancies between doctors and patients. AIM: to evaluate among the general population of 6 different cities of Mexico, what is meant by constipation. MATERIAL AND METHODS: A cross-sectional study was performed in the cities of Veracruz, Tampico, Tuxtepec, Colima, Puebla and San Luis Potosi (representing 4 geographical areas of Mexico). All subjects answer a questionnaire that assesses self-perception of constipation with the question: Do you consider yourself constipated? Frequency and stool form (Bristol), symptoms and associated factors to constipation were also evaluated. Rome III criteria for functional constipation (FC) and irritable bowel syndrome with constipation (IBS-C) were applied. RESULTS: One thousand and forty one subjects were evaluated (mean age 35 +/- 15 years), 657 (63%) women. In our study, 87% (n = 907) had a bowel movement at least every 48 hours and most of them (67%) have stools type 3-4. Thirty four percent (n = 356) of subjects considered to have constipation, of whom 73 (21%) met criteria for FC, 65 (18%) for IBS-C and 218 subjects (61%) did not meet diagnostic criteria. The symptom that best defines constipation was straining (47%). Correlation and concordance between self-perception and the Rome criteria was 0.14 (p = 0.61). CONCLUSIONS: In our population, 61% of subjects who perceived symptoms of constipation are not really constipated according to the criteria of Rome.

Intra-catheter leukocyte culture to monitor hemodialysis catheter colonization. A prospective study to prevent catheter-related bloodstream infections.

The most serious problem related to the use of tunneled catheters in hemodialysis is bacteremia. The aim of this study was to detect hemodialysis catheter colonization and, establish a preemptive therapy based on a catheter antibiotic lock in order to prevent development of catheter-related bloodstream infections. During a 24-month period, all patients with tunneled catheters in our hemodialysis unit were evaluated by extracting a through-catheter leukocyte culture every 15 days.There were 28 episodes of catheter colonization occurring in 13 patients (2.2 colonization episodes per 1000 catheter patient-days). At the time of colonization, catheters had been in place for a mean of 562 days (range: 16 to 1475 days). Coagulase negative staphylococci (CNS) were the most common microorganisms to be isolated. A preemptive therapy consisting in teicoplanin locks (10 mg/mL) for 21 days was able to eradicate catheter colonization in 89% of the cases when CNS were isolated. However, relapse of colonization occurred in 61.2% of these cases. The mean duration of catheter use was 239 days (range: 9 to 483 days) after treatment of a colonization episode. The incidence of catheter-related bloodstream infection in our population was 0.78 episodes per 1000 catheter patient-days (IC 95%: 0.374-1.434). This study shows the utility of intra-catheter leukocyte culture for early detection of hemodialysis catheter colonization. Moreover, it establishes that the eradication of biofilm-related CNS is possible without the removal of the catheter, thus enabling a longer catheter lifespan.

Theory, simulation and experiments for precise deflection control of radiotherapy electron beams.

Conventional radiotherapy is mainly applied by linear accelerators. Although linear accelerators provide dual (electron/photon) radiation beam modalities, both of them are intrinsically produced by a megavoltage electron current. Modern radiotherapy treatment techniques are based on suitable devices inserted or attached to conventional linear accelerators. Thus, precise control of delivered beam becomes a main key issue. This work presents an integral description of electron beam deflection control as required for novel radiotherapy technique based on convergent photon beam production. Theoretical and Monte Carlo approaches were initially used for designing and optimizing device´s components. Then, dedicated instrumentation was developed for experimental verification of electron beam deflection due to the designed magnets. Both Monte Carlo simulations and experimental results support the reliability of electrodynamics models used to predict megavoltage electron beam control.

Deterioro cognitivo tardío en pacientes con estenosis aórtica tratados con sustitución valvular quirúrgica y con implantación transcatéter de válvula aórtica: estudio comparativo / Delayed cognitive impairment in patients with aortic stenosis treated with surgical valve replacement and transcatheter aortic valve implantation: a comparative study

Introducción El deterioro cognitivo secundario a eventos cerebrovasculares es una complicación frecuente en las intervenciones de reemplazo de válvula aórtica. Nuestro objetivo es el estudio del perfil de deterioro de los pacientes sometidos a reemplazo valvular quirúrgico o implantación de prótesis transcatéter (TAVI) y si éste resulta diferente según la intervención a la que son sometidos y los factores de riesgo basales. Pacientes y métodos Estudio observacional prospectivo, con dos grupos no equivalentes de pacientes (grupo TAVI y grupo quirúrgico). Se realizaron comparaciones intergrupo en varios dominios cognitivos, con una evaluación basal y mediciones de seguimiento seis y 12 meses después la intervención. Resultados El grupo TAVI presentó resultados inferiores al grupo quirúrgico en funciones ejecutivas y visuoespaciales, puntuaciones parcialmente determinadas por la edad (p < 0,01) y el nivel intelectual previo (Pearson cociente intelectual previo-medias escalares en los test: 0,665; p < 0,001). La media de puntuaciones en los tres momentos de medición indica una disminución del rendimiento en funciones ejecutivas a los seis meses, que se recupera a los 12 meses. En memoria se registraron incrementos sostenidos en ambos momentos, en tanto que la función visuoespacial y la denominación no mostraron recuperación posterior de los niveles basales. Estas tendencias son similares en los dos grupos. Conclusión Los resultados obtenidos no confirman la instauración de un proceso específico de deterioro neurocognitivo postintervención en la estenosis aórtica complicada. El perfil de deterioro no presenta diferencias significativas entre los grupos, pero es más evidente en los pacientes con TAVI, debido a la influencia de las variables de selección de la muestra. (AU)

INTRODUCTION Cognitive impairment secondary to cerebrovascular events is a common complication of aortic valve replacement interventions. Our aim is to study the deterioration profile of patients who have undergone surgical valve replacement or transcatheter valve implantation (TAVI) and whether it differs according to the intervention they underwent and their baseline risk factors. PATIENTS AND METHODS We conducted a prospective observational study with two non-equivalent groups of patients (TAVI group and surgical group) Intergroup comparisons were carried out in several cognitive domains, with a baseline assessment and follow-up measurements six and 12 months after the intervention. RESULTS The TAVI group performed less well than the surgical group in executive and visuospatial functions, with scores partially determined by age (p < 0.01) and prior intellectual level (Pearson prior intelligence quotient-scalar test means: 0.665; p < 0.001). Mean scores at the three measurement points indicate a decline in executive function performance at six months, which is restored at 12 months. Sustained increases in memory were recorded at both time points, while visuospatial function and naming showed no subsequent recovery of the baseline levels. These trends are similar in both groups. CONCLUSION. The results obtained do not confirm the appearance of a specific process of post-intervention neurocognitive impairment in complicated aortic stenosis. The deterioration profile does not show any significant differences between groups, but is more evident in TAVI patients, due to the influence of variables related to sample selection. (AU)

Prevalence and risk factors of lens opacities in the elderly in Cuenca, Spain.

PURPOSE: To estimate the prevalence of lens opacities in a group of elderly people and evaluate their relation with diverse risk factors. METHODS: Cross-sectional observational study of the cohort of all persons over the age of 64 years from an urban area and a rural nucleus of the province of Cuenca, Spain. Information on sociodemographic parameters and smoking was compiled using a structured questionnaire. A physical examination was made in which weight, height, and waist circumference were measured, and an ophthalmologic examination was made of visual acuity and lens opacities. Cataracts were classified using the method of the WHO cataract group. RESULTS: The study included 1155 subjects out of 1435 elderly persons who were invited to participate (response rate 80.5%). The prevalence of cataract in men was 69.2% and in women, 65.5% (p>0.05). The percentage of persons with aphakia/pseudophakia was 17.8% in men and 17.5% in women (p>0.05). In a logistic regression model, age, obesity of more than 35 kg/m2, and low educational level were associated with the presence of cataract or aphakia/pseudophakia. CONCLUSIONS: The prevalence of cataract in people over 64 years is similar to that of other countries, but the prevalence of subjects with previous surgery for cataracts is the highest reported in the literature. Age, body mass index of more than 35 kg/m2, and low educational level were associated with the probability of having cataracts or undergoing surgery for cataracts.

Biotechnological war against biofilms. Could phages mean the end of device-related infections?

Microorganisms universally attach to surfaces, resulting in biofilm formation. These biofilms entail a serious problem in daily clinical practice because of the great prevalence of implantable device-related infections. Differences in antibiotic activity against planktonic and sessile bacteria may relate to clinical failures in the treatment of biofilm-related infections (BRI). Bacteriophages have several characteristics that make them potentially attractive therapeutic agents in some selected clinical settings, like for example BRI. They are highly specific and very effective in lysing targeted bacteria, moreover, they appear to be safe for humans. Many studies have shown the potential of phages for the treatment of infectious diseases in plants and animals, including infections with highly drug-resistant bacteria. The therapeutic use of bacteriophages, possibly in combination with antibiotics, may be a valuable approach in BRI. However, many important questions still remain that must be addressed before phages can be endorsed for therapeutic use in humans.