YdbH and YnbE form an intermembrane bridge to maintain lipid homeostasis in the outer membrane of Escherichia coli.

The outer membrane (OM) of didermic gram-negative bacteria is essential for growth, maintenance of cellular integrity, and innate resistance to many antimicrobials. Its asymmetric lipid distribution, with phospholipids in the inner leaflet and lipopolysaccharides (LPS) in the outer leaflet, is required for these functions. Lpt proteins form a transenvelope bridge that transports newly synthesized LPS from the inner membrane (IM) to OM, but how the bulk of phospholipids are transported between these membranes is poorly understood. Recently, three members of the AsmA-like protein family, TamB, YhdP, and YdbH, were shown to be functionally redundant and were proposed to transport phospholipids between IM and OM in Escherichia coli. These proteins belong to the repeating ß-groove superfamily, which includes eukaryotic lipid-transfer proteins that mediate phospholipid transport between organelles at contact sites. Here, we show that the IM-anchored YdbH protein interacts with the OM lipoprotein YnbE to form a functional protein bridge between the IM and OM in E. coli. Based on AlphaFold-Multimer predictions, genetic data, and in vivo site-directed cross-linking, we propose that YnbE interacts with YdbH through ß-strand augmentation to extend the continuous hydrophobic ß-groove of YdbH that is thought to shield acyl chains of phospholipids as they travel through the aqueous intermembrane periplasmic compartment. Our data also suggest that the periplasmic protein YdbL prevents extensive amyloid-like multimerization of YnbE in cells. We, therefore, propose that YdbL has a chaperone-like function that prevents uncontrolled runaway multimerization of YnbE to ensure the proper formation of the YdbH-YnbE intermembrane bridge.

[Educational interventions in childhood asthma: A systematic review]. / Intervenciones educativas en asma infantil: Una revisión sistemática.

OBJECTIVE: To analyze educational interventions in pediatric asthmatic patients to achieve an adequate inhalation technique and improve their self-management. DESIGN: Systematic review based on the PRISMA recommendations. DATA SOURCES: Pubmed, Scopus, Cuiden, Web of Science and Google Scholar databases were reviewed. STUDY SELECTION: Sixteen articles published between 2014 and 2021 were included, with access to full text, languages: English, French and Spanish and pediatric population: 0-18 years. DATA EXTRACTION: Two thousand three hundred and thirteen children were participated. The variables analyzed were: level of care, type of intervention, correct performance of the inhalation technique, follow-up of the technique, delivery of written recommendations, professional-educator category, variables related to respiratory pathology, school absenteeism, quality of life and economic costs. RESULTS: The health care level was primary, hospital and community care, where specialist doctors, nurses and pharmacists stood out as educators. The most prevalent educational interventions are on-site demonstration and delivery of recommendations or multimedia interventions. Several articles report that asthma education is not carried out correctly, others state that their technique improves after the intervention, but most of them highlight the importance of periodic review of the technique. CONCLUSIONS: The authors report improvement in the inhalation technique in all of them, as well as greater self-management of the disease and adherence to treatment. It is necessary to intensify the education of patients in the correct handling of the devices, and the follow-up and subsequent review to optimize the control of the disease.

The inner membrane protein YhdP modulates the rate of anterograde phospholipid flow in Escherichia coli.

The outer membrane (OM) of Gram-negative bacteria is a selective permeability barrier that allows uptake of nutrients while simultaneously protecting the cell from harmful compounds. The basic pathways and molecular machinery responsible for transporting lipopolysaccharides (LPS), lipoproteins, and ß-barrel proteins to the OM have been identified, but very little is known about phospholipid (PL) transport. To identify genes capable of affecting PL transport, we screened for genetic interactions with mlaA*, a mutant in which anterograde PL transport causes the inner membrane (IM) to shrink and eventually rupture; characterization of mlaA*-mediated lysis suggested that PL transport can occur via a high-flux diffusive flow mechanism. We found that YhdP, an IM protein involved in maintaining the OM permeability barrier, modulates the rate of PL transport during mlaA*-mediated lysis. Deletion of yhdP from mlaA* reduced the rate of IM transport to the OM by 50%, slowing shrinkage of the IM and delaying lysis. As a result, the weakened OM of ∆yhdP cells was further compromised and ruptured before the IM during mlaA*-mediated death. These findings demonstrate the existence of a high-flux diffusive pathway for PL flow in Escherichia coli that is modulated by YhdP.

Production of Sorbitol via Hydrogenation of Glucose over Ruthenium Coordinated with Amino Styrene-co-maleic Anhydride Polymer Encapsulated on Activated Carbon (Ru/ASMA@AC) Catalyst.

Sorbitol, a product primarily derived from glucose hydrogenation, has extensive applications in the pharmaceutical, chemical and other industries. Amino styrene-co-maleic anhydride polymer encapsulated on activated carbon (Ru/ASMA@AC) catalysts were developed for efficient glucose hydrogenation and were prepared and confined Ru by coordination with styrene-co-maleic anhydride polymer (ASMA). Through single-factor experiments, optimal conditions were determined to be 2.5 wt.% ruthenium loading and a catalyst usage of 1.5 g, 20% glucose solution at 130 °C, reaction pressure of 4.0 MPa, and a stirring speed of 600 rpm for 3 h. These conditions achieved a high glucose conversion rate of 99.68% and a sorbitol selectivity of 93.04%. Reaction kinetics testing proved that the hydrogenation of glucose catalyzed by Ru/ASMA@AC was a first-order reaction, with a reaction activation energy of 73.04 kJ/mol. Furthermore, the catalytic performance of the Ru/ASMA@AC and Ru/AC catalysts for glucose hydrogenation were compared and characterized by various detection methods. The Ru/ASMA@AC catalyst exhibited excellent stability after five cycles, whereas the traditional Ru/AC catalyst suffered from a 10% decrease in sorbitol yield after three cycles. These results suggest that the Ru/ASMA@AC catalyst is a more promising candidate for high-concentration glucose hydrogenation due to its high catalytic performance and superior stability.

Current expert opinion and attitudes to optimize telemedicine and achieve control in patients with asthma in post-pandemic era: The COMETA consensus.

OBJECTIVE: To collect perspectives and explore consensus for expert recommendations related to asthma control and the use of telemedicine among professionals who manage patients with asthma. DESIGN: A Delphi-like questionnaire was designed to analyse the level of agreement about several recommendations formulated by an expert scientific committee about asthma control and the use of telemedicine with this purpose. A dedicated scientific committee validated the questionnaire, which included questions about the participants' profile and the use of technological tools at a personal level or in clinical practice. The experts expressed their agreement with a Likert-scale of 9 values: 1-3 was considered no agreement, 4-6 neutral, and 7-9 agreement. A rate ≥70% with the same answer was considered consensus. SITE: The questionnaire was programmed and distributed as an internet-based survey. PARTICIPANTS: A pre-selected sample of 75 experts with experience in telemedicine (pulmonology, allergology, family medicine, nursing and community pharmacy) responded to a Delphi-like questionnaire composed by six questions and 52 items. INTERVENTIONS: Consultation was performed in two consecutive waves: the first wave was carried out from 12th of July to 8th of September of 2021; the second wave, from 25th of October to 12th of November of 2021. MAIN MEASUREMENTS: Three questions about asthma control (actions for achieving or maintaining control of asthma at every visit, current problems that affect asthma control, and potential solutions to offset such problems), and three questions about the impact of telemedicine in asthma control (potential benefits of telemedicine, and potential reticence about telemedicine among both patients and healthcare professionals) were included. RESULTS: From the 52 items inquired, 35 were agreed by consensus. The actions for achieving or maintaining control of asthma, the problems that affect asthma control, and their potential solutions were agreed by consensus. The potential benefits of telemedicine were validated by consensus. None of the potential reservations of patients about telemedicine were validated, while five out of 14 potential reservations of healthcare professionals were agreed by consensus. CONCLUSIONS: The COMETA consensus provides a current picture of the main problems for achieving asthma control, the benefits and the reservations about the use of telemedicine in the Spanish setting, and offers solutions. A wide interest in implementing telemedicine has been observed, although current limitations need to be overcome.

Non-organ-specific autoimmunity in adult 47,XXY Klinefelter patients and higher-grade X-chromosome aneuploidies.

Current literature regarding systemic autoimmune diseases in X-chromosome aneuploidies is scarce and limited to case reports. Our aim was to evaluate the frequency of anti-nuclear (ANAs), extractable nuclear (ENA), anti-double-stranded DNA (dsDNAs), anti-smooth muscle (ASMAs) and anti-mitochondrial (AMAs) antibodies in a large cohort of adults with Klinefelter's syndrome (KS, 47,XXY) and rare higher-grade sex chromosome aneuploidies (HGAs) for the first time. Sera from 138 X-chromosome aneuploid patients [124 adult patients with 47,XXY KS and 14 patients with HGA (six children, eight adults)] and 50 age-matched 46,XY controls were recruited from the Sapienza University of Rome (2007-17) and tested for ANAs, ENAs, anti-dsDNAs, ASMAs and AMAs. Non-organ-specific immunoreactivity was found to be significantly higher in patients with 47,XXY KS (14%) than in the controls (2%, p = 0.002). Among all the antibodies investigated, only ANAs were observed significantly more frequently in patients with 47,XXY KS (12.1%) than in the controls (2%, p = 0.004). No anti-dsDNA immunoreactivity was found. Stratifying by testosterone replacement therapy (TRT), non-organ-specific autoantibody frequencies were higher in TRT-naive (p = 0.01) and TRT-treated groups than in controls. No patients with HGA were found positive for the various autoantibodies. Non-organ-specific autoantibodies were significantly present in 47,XXY adult patients. Conversely, HGAs did not appear to be target of non-organ-specific immunoreactivity, suggesting that KS and HGAs should be considered as two distinct conditions. The classification and diagnosis of systemic autoimmune diseases is frequently difficult. To support a correct clinical evaluation of KS disease and to prevent eventual secondary irreversible immune-mediated damages, we highlight the importance of screening for non-organ-specific autoimmunity in Klinefelter's syndrome.

[What not to do in the therapeutic management of bronchial asthma. Delphi consensus recommendations for physicians who treat asthma]. / Qué no se debe hacer en el manejo terapéutico del asma bronquial. Recomendaciones por consenso Delphi para los médicos que tratan el asma.

Asthma is one of the most prevalent diseases in Spain, yet despite the great diagnostic and therapeutic advances made in this field, health outcomes suggest that up to 80% of patients do not have their asthma well controlled. Although the causes of this situation are diverse, there are some practices among the professionals who treat asthma that are not conducive to improving health outcomes in this disease. Our working group has prepared this document in order to remind clinicians of a series of basic guidelines, aligned with current guidelines and recent literature, and agreed by a multidisciplinary expert panel using Delphi methodology. These recommendations about what not to do in the management of asthma in the adult patient are structured into four areas: diagnosis, monitoring, treatment and prevention of exacerbations.

Large-scale identification of trans-translation substrates targeted by tmRNA in Aeromonas veronii.

Transfer-messenger RNA (tmRNA) is ubiquitous in bacteria, acting as the core component for the trans-translation system that contributes to label the aberrantly synthesized peptides for degradation and to release the stalled ribosomes. Deletion of tmRNA causes a variety of phenotypes related to important physiological processes in bacteria. To illustrate the molecular mechanism of the versatility of tmRNA in aquatic pathogen Aeromonas veronii, we mutated the C-terminal nucleotides of tmRNA (MutmRNA) for encoding a tag containing six histidine residues (His6tag), so as to capture and enrich the trans-translation substrates from the cell lysates through a Ni2+-NTA affinity chromatograph. The results showed that the concentrated substrates were detected as distinct and specific bands in western blotting using anti-His antibody, demonstrating that specific defective mRNAs were frequently and intensively rescued by trans-translation during the translation process in A. veronii. The substrates were analyzed by LC-MS/MS and further identified by searching a theoretically constructed database specific for A. veronii. Total of 24 potential substrates were identified, with various functions involved in metabolism, as well as structure and signal-based cellular events. Among the identified substrates, PspA and AsmA were labeled by Flag, and expressed in the presence of the modified trans-translation system in E. coli. Their labelings with MutmRNA were validated by purification through Ni2+-NTA column followed by western blotting using anti-Flag antibody. This study provided the most abundant set of endogenous targets for tmRNA in A. veronii, and facilitated further investigations about the molecular mechanism and signal pathway of tmRNA-mediated trans-translation.

Assessment of the Prevalence of Non-Organ-Specific Autoantibodies in Egyptian Patients with HCV.

The relation between non-organ specific autoantibodies (NOSA) and hepatitis C virus (HCV) infection has been investigated within different communities resulting in different prevalence rates and patterns. The purpose of this study was to investigate the prevalence of some NOSA such as RF-IgG, ANA, ASMA, and LKM-1 in Egyptian patients with HCV group as compared with Egyptian healthy controls group. A total of 186 HCV positive serum samples in addition to 81 samples from healthy control were screened for the presence of some common autoantibodies (RF-IgG, ANA, ASMA, and LKM-1) using ELISA technique for ANA, ASMA, and LK-1 while RF-IgG was assayed by latex agglutination technique. The presence of these autoantibodies was tested in relation to some demographic variables and viral titers. Associations were assessed using logistic regression analysis adjusted for potential confounders. Among patients, 100 (53.7%) of 186 and 6 (7.4%) of 81 healthy control group were positive for at least one autoantibody. Furthermore, 2 patients (1%) were positive for three autoantibodies, whereas 22 patients (11.7%) were positive for 2 autoantibodies. The most prevalent autoantibody in anti-HCV-positive group was RF-IgG (87, 46.7%) followed by ASMA (26, 14%). The frequency of autoantibodies was bit higher in women as compared to men. Taken together, this study reports a non-significant difference in prevalence of NOSA between patients with HCV infection and healthy individuals except for ASMA. Likewise, no significant difference was found in prevalence of such autoantibodies when correlated with some demographic variables.

[Association between the use of short-acting bronchodilators and the risk of hospitalization for asthma in a real-life clinical practice population cohort]. / Asociación entre la utilización de broncodilatadores de corta duración y el riesgo de hospitalización por asma en condiciones de práctica clínica habitual en una cohorte poblacional.

OBJECTIVE: To determine the number of short-acting beta-agonists (SABA) canisters dispensed in a pharmacy during one year that is associated with higher asthma hospitalization risk in the same period in patients with active asthma. Multi-centre cross-sectional descriptive design. LOCATION: Primary care, MAJORICA cohort including sociodemographic, clinical and electronic prescription system data coded during clinical practice from 68,578 patients with COPD and asthma in the Balearic Islands. PARTICIPANTS: A total of 7,648 patients older than 18 years with active asthma, who got any SABA canister from the pharmacy during the 2014-2015 period were included. COPD patients were excluded. MAIN MEASUREMENTS: Asthma hospitalization, respiratory medication, tobacco, co-morbidities, age and gender. RESULTS: Mean age 47 years, 38% women, 23.2% active smokers. Seventy-seven patients (1%) were admitted for asthma exacerbation in the study period. Patients who received more than 8 SABA containers per year increased the risk of hospitalization (OR 2.81; 95% CI 1.27-6.24). Severity by therapeutic step and amount of inhaled corticosteroids, as well as heart failure and sleep apnea were also significantly associated with hospitalization. CONCLUSIONS: There is a significant association between the risk of hospitalization and the higher number of SABA canisters dispensed from the pharmacy. The number of canisters/year that best defines a higher risk of hospitalization is≥8 and could be used to identify asthma at risk.

[Healthcare resources for asthma management at primary care level: Asthmabarometer Project]. / Recursos asistenciales en atención primaria para manejo del asma: proyecto Asmabarómetro.

OBJECTIVE: The objective of this study was to describe the current provision of basic resources for asthma management in Primary Health Care (PHC). DESIGN: Cross-sectional study, with an ad hoc quantitative survey. LOCATION AND PARTICIPANTS: A total of 380 primary healthcare physicians in Spain. INTERVENTIONS AND MAIN MEASUREMENTS: Analysis of perceptions of management and use of basic human, organisational and material resources to ensure appropriate care provision to asthma patients. RESULTS: Survey respondents stated that their centre did not have a consultant doctor (64%) or nurse (62%) in respiratory disease. Almost all (92%) of the centres have spirometers, of which 70% have peak flow meters, and 93% have placebo inhalers. In the last year, respondents have received specific theoretical/practical training from the centre (46%), and by third parties (83%). More than three-quarters (78%) of the centres has educational material available for patients. There is no specific healthcare protocol in 36% of the centres, and 43% had no referral protocol. A clinical interview is conducted to monitor the patient (90%), but there are no validated questionnaires to measure therapeutic adherence (85%), or a checklist to check inhalation technique (83%). Differences are observed in the relevant variables in the analysis of each Spanish Autonomous Community. CONCLUSIONS: Access to certain resources in the care of patients with asthma is limited in aspects of coordination between levels, varied according to Spanish Autonomous Community, and improved in most health resources in Asthma.

Compliance with the clinical guidelines for managing asthma by primary care physicians: An ambispective observational study. / Seguimiento de las guías españolas para el manejo del asma por el médico de atención primaria: un estudio observacional ambispectivo.

OBJECTIVE: To assess the degree of compliance with the recommendations of the 2009 and 2015 versions of the Spanish guidelines for managing asthma (Guía Española para el Manejo del Asma [GEMA]) and the effect of this compliance on controlling the disease. MATERIAL AND METHODS: We conducted an observational ambispective study between September 2015 and April 2016 in which 314 primary care physicians and 2864 patients participated. RESULTS: Using retrospective data, we found that 81 of the 314 physicians (25.8%; 95% CI 21.3-30.9) stated that they complied with the GEMA2009 recommendations. At the start of the study, 88 of the 314 physicians (28.0%; 95% CI 23.4-33.2) complied with the GEMA2015 recommendations. Poorly controlled asthma (OR, 0.19; 95% CI 0.13-0.28) and persistent severe asthma at the start of the study (OR, 0.20; 95% CI 0.12-0.34) were negatively associated with having well-controlled asthma by the end of the follow-up. In contrast, compliance with the GEMA2015 recommendations was positively associated with a greater likelihood that the patient would have well-controlled asthma by the end of the follow-up (OR, 1.70; 95% CI 1.40-2.06). CONCLUSIONS: Low compliance with the clinical guidelines for managing asthma is a common problem among primary care physicians. Compliance with these guidelines is associated with better asthma control. Actions need to be taken to improve primary care physician compliance with the asthma management guidelines.

Clinical characteristics and severity of COVID-19 among Mexican adults.

INTRODUCTION: Obesity, diabetes, hypertension and age have been pointed at as factors that influence on the progression of COVID-19; however, evidence for other conditions is inconclusive. OBJECTIVE: To identify which clinical characteristics are related to COVID-19 severity and to determine whether age acts a modifier of the relationship between cardio-metabolic comorbidities (CMC) and COVID-19 progression. METHOD: Data on ≥ 20-year-old confirmed cases (n = 159,017) were analyzed. Hospitalization, development of pneumonia, intubation requirement, intensive care unit admission and death were the dependent variables in Poisson regression models estimation, whereas the interaction between age and different CMCs were the independent variables. RESULTS: Having CMCs, as well as other comorbidities, was directly related to COVID-19 progression, whereas chronic obstructive pulmonary disease was only related to an increase in the risk of dying. The risk for COVID-19 severity was lower as age was more advanced. Asthma and smoking were not risk factors for the progression of COVID-19. CONCLUSION: In the Mexican population, the risk of COVID-19 progression associated with comorbidities was higher in young adults.

INTRODUCCIÓN: Se ha señalado que factores como obesidad, diabetes, hipertensión y edad influyen en la progresión de COVID-19; sin embargo, la evidencia para otras condiciones no es concluyente. OBJETIVO: Identificar qué antecedentes clínicos están relacionados con la gravedad de COVID-19 y si la edad funge como un modificador de efecto de la relación entre comorbilidades cardiometabólicas (CCM) y progresión de COVID-19. MÉTODO: Se analizaron los datos de casos confirmados ≥ 20 años (n = 155 017). La hospitalización, el desarrollo de neumonía, el requerimiento de intubación, el ingreso a la unidad de cuidados intensivos y la muerte constituyeron las variables dependientes en la estimación de modelos de regresión de Poisson y la interacción entre edad y CCM, las independientes. RESULTADOS: Tener CCM, así como otras comorbilidades, se relacionó directamente con la progresión de COVID-19. El riesgo de gravedad de COVID-19 asociado a las CCM fue menor conforme la edad era mayor. El asma y el tabaquismo no fueron factores de riesgo para la progresión de COVID-19. CONCLUSIÓN: En la población mexicana, el riesgo de progresión de COVID-19 asociada a comorbilidades fue mayor en los adultos jóvenes.

Immunohistochemical examination in arthrofibrosis of the knee joint.

INTRODUCTION: Arthrofibrosis (AF) is the result of increased cell proliferation and synthesis of matrix proteins (collagen I, III, and VI). Especially after invasive knee surgery, e.g., ligament reconstruction or knee replacement, abnormal fibroblast proliferation with pathological periarticular fibrosis can be observed leading to severely limited joint motion. The pathogenesis of AF is currently not fully understood. The present work aims to determine pathogenic factors. MATERIALS AND METHODS: A descriptive, histological and immunohistochemical comparative study was performed on tissue samples of 14 consecutive patients undergoing arthrolysis for joint stiffness due to AF. Seven human autopsy specimens served as control. Samples were stained for expression of relevant markers such as CD68, α-smooth muscle actin (ASMA), beta-catenin, BMP-2 and examined for the histological grade of AF (cell-rich versus cell-poor) and compared to a control. Furthermore, a microscopic evaluation of the samples for cell differentiation and number was performed. RESULTS: Tissue sections of cell-rich fibrosis showed a significantly higher expression of CD68 compared to the control with less than 10% of CD68 positive cells (p = 0.002). In cell-poor fibrosis no statistically significant difference was obvious (p = 0.228). Expression of ASMA in synovia, vessels, cell-rich and cell-poor fibrosis showed median values of 2.00 in the AF group and 1.75 in the control. Both groups differed significantly (p = 0.003). AF tissue showed a significantly difference in expression of ß-catenin (p < 0.001) compared to the control. The overall difference between AF and control group in expression of BMP-2 was also statistically significant (p = 0.002). CONCLUSIONS: Expression of CD68, ASMA, beta-catenin and BMP-2 is significantly increased in AF tissue samples. Based on presented findings, histological evaluation and immunohistochemical assessment of CD68, ASMA, ß-catenin and BMP-2 expression may proof useful to diagnose AF and to analyze AF activity.

[Factors associated with asthma in children and adolescents in rural areas of Navarre (Spain)]. / Factores asociados al asma en los niños y adolescentes de la zona rural de Navarra (España).

OBJECTIVES: To determine the factors associated with asthma and asthma-related symptoms in children and adolescents in rural areas of Navarre (Spain). PARTICIPANTS AND METHODS: A cross-sectional study using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire, as well as additional variables, was conducted on 797 children and adolescents. These provided prevalence data on asthma symptoms and associated factors without further diagnostic testing. LOCATION: Primary Care setting, through the basic health areas and in the corresponding education centres. MEASUREMENTS AND RESULTS: The prevalence of referred asthma is 11.7% in children, and 13.4% in adolescents. The prevalence in the female population is 13.7% and in males it is 11.3%. As for the related factors according to the values of OR, an OR=9.5 was found between wheezing and asthma, and an OR=3.5 between recent rhinitis and asthma. As regards recent wheezing, an OR=11.5 was found between awakenings due to wheezing and recent wheezing, and an OR=3.4 between recent rhinitis and wheezing. CONCLUSIONS: Referred asthma is a prevalent disease in children and adolescents in rural areas. It is more prevalent in adolescence and in the female population. Rhinitis and other asthma symptoms are related to asthma and wheezing, as well as the use of emergency services, in the case of asthma.

Role of potassium and pH on the initiation of sperm motility in the European eel.

The role of potassium from the seminal plasma and/or the activation media was examined by selectively removing K+ from this media, and by testing the use of K+ channel inhibitors and a K-ionophore. Sperm motility was measured using a CASA system, intracellular K+ and pH were measured by flow cytometry, and sperm head area was measured by ASMA: Automated Sperm Morphometry Analyses. Sperm motility was notably inhibited by the removal of K+ from the seminal plasma and by treatment with the K+ ionophore valinomycin. This therefore indicates that a reduction of K+ levels in the quiescent stage inhibits further motility. The normal decrease in sperm head area induced by seawater activation was altered by the removal of K+ from the seminal plasma, and an increase in the pHi in the quiescent stage was also induced. Intracellular pH (pHi) was quantitatively measured for the first time in European eel spermatozoa, being 7.2 in the quiescent stage and 7.1 post-activation. Intracellular and external pH levels influenced sperm motility both in the quiescent stage and at activation. The alkalinization of the pHi (by NH4Cl) inhibited sperm motility activation, while acidification (by Na-acetate) did not have any effect. Our results indicate that a pH gradient between the sperm cell and the seminal plasma is necessary for sperm motility activation. The presence of the ion K+ in the seminal plasma (or in the extender medium) is necessary in order to maintain sperm volume, intracellular pH and sperm motility.

[Asthma control in patients attending primary care in Spain (Actis study)]. / Control del asma en pacientes que acuden a consulta de atención primaria en España (estudio ACTIS).

OBJECTIVE: To assess prevalence of non controlled (ACT- Asthma Control Test<20) asthma in real world clinical practice in Spain. DESIGN: Observational, cross-sectional study. LOCATION: 58 primary care centers from 13 Autonomous Communities. PARTICIPANTS: Asthma patients attending physicians office to collect repeat prescriptions for continuous treatment (Group A), or due to symptoms worsening (Group B). MAIN MEASUREMENTS: Socio-demographic characteristics (age, gender, education, smoking history), physician's assessment of asthma severity, current treatment for asthma, co-morbidities, healthcare-related resources utilization (primary care or emergency visits, hospitalizations), labour or school absenteeism, ACT score and treatment adherence. RESULTS: 376 patients from group A and 262 from group B were included, 59% female, mean age 45 years, 21% smokers and time since asthma diagnosis 8.9 years. 87% were on short acting beta-2 agonists, 62% long acting beta-2 agonists with inhaled corticosteroids and 13.8% regular inhaled corticosteroids. Poor asthma control was observed in 75.6% from group B and 23.8% from group A; only 5.3% from group A showed total asthma control (ACT=25). Poorer asthma control was significantly associated with longer disease duration and higher use of resources. CONCLUSIONS: Prevalence of poor asthma control among patients attending due to symptoms worsening continues to be very high even in patients who come to renew their prescription. Poor asthma control is associated to high use of resources and high impact on burden of disease.

[Variability and suitability of anti-asmathic treatment in pediatric primary health care]. / Variabilidad e idoneidad del tratamiento antiasmático en pediatría de atención primaria.

OBJECTIVE: To analyse the use patterns and the characteristics of anti-asmathic prescriptions in pediatric primary health care. DESIGN: Observational and retrospective study. LOCATION: Pediatric primary health care, Asturias, Spain. PARTICIPANTS: Drug prescriptions in respiratory diseases in children (<14years old) during 2011. PRINCIPAL MEASUREMENTS: Data obtained from the billing database of the Regional Health Service of Asturias and analysed by sanitary district and primary health centres, calculating the number of DDD/1.000 children/day (DHD). Clinical records audit in 6 paediatric surgeries of sanitary district V to evaluate the suitability of the drug prescriptions to the current recommendations. RESULTS: The main group were bronchodilators (17.14DHD) with predominance of the inhaled route (14DHD). We observe more use of inhaled corticoids (4.83DHD), with an important use of fluticasone. We considered un-suitable 94.3% oral bronchodilators, and >50% of mepiramine prescriptions. We registered off-label prescriptions, 17.8% of them were about oral salbutamol, being used in children <2years old. CONCLUSIONS: The use of anti-asthmatic drugs in our region is high, maybe it's related to the asthma prevalence. We observed variability between sanitary districts and health centres. The prescription patterns are closed to the current recommendation, except in the case of oral bronchodilators.

Occupational asthma due to chamomile: case report. / Asma professionale da camomilla: descrizione di un caso.

We report the case of a worker employed in the packaging of herb infusions who came to our attention because he was suffering from breathing disorders caused by occupational exposure to chamomile dusts. The diagnostic procedure we followed highlighted a baseline lung function within the normal range, while the skin prick tests and the RAST test were positive to both seasonal aeroallergens and chamomile. To perform a specific bronchial provocation test, the patient was challenged in an exposure chamber with nebulization of an extract from chamomile flowers. This procedure, that we had already applied for other occupational allergens, induced in the patient an immediate bronchospastic type reaction, documented by a 17% reduction of FEV1 from baseline. It also produced a significant increase in bronchial non specific hyperresponsiveness and a remarkable rise of nitric oxide, in comparison with the pre exposure observed values. We concluded for a diagnosis of occupational asthma caused by chamomile.

Sodium affects the sperm motility in the European eel.

The role of seminal plasma sodium and activation media sodium on sperm motility was examined by selectively removing the element from these two media, in European eel sperm. Sperm size (sperm head area) was also measured using an ASMA (Automated Sperm Morphometry Analyses) system, in the different conditions. Intracellular sodium [Na(+)]i was quantitatively analyzed by first time in the spermatozoa from a marine fish species. Measurement of [Na(+)]i was done before and after motility activation, by Flow Cytometry, using CoroNa Green AM as a dye. Sperm motility activation induced an increase in [Na(+)]i, from 96.72mM in quiescent stage to 152.21mM post-activation in seawater. A significant decrease in sperm head area was observed post-activation in seawater. There was a notable reduction in sperm motility when sodium was removed from the seminal plasma, but not when it was removed from the activation media. Sodium removal was also linked to a significant reduction in sperm head area in comparison to the controls. Our results indicate that the presence of the ion Na(+) in the seminal plasma (or in the extender medium) is necessary for the preservation of sperm motility in European eel, probably because it plays a role in maintaining an appropriate sperm cell volume in the quiescent stage of the spermatozoa.