Functional performance recovery after individualized nutrition therapy combined with a patient-tailored physical rehabilitation program versus standard physiotherapy in patients with long COVID: a pilot study.

BACKGROUND: Long COVID is suggested to be present in 14 to 43% of COVID 19-survivors. Literature on this new condition states a need for a multidisciplinary approach including physical exercise and nutrition. The aim of the current pilot study is to investigate the feasibility of the proposed protocol to prepare for a randomized controlled study that addresses the effectiveness of a personalized multimodal treatment compared to standard physiotherapy. METHODS: This is a protocol of the UNLOCK (Nutrition and LOComotoric rehabilitation in long COVID) study, a pragmatic, single center, randomized controlled pilot trial with two groups. Patients with persisting symptoms related to a SARS-CoV-2 infection will receive either standard physiotherapy or a personalized multimodal treatment for a period of 12 weeks, consisting of individualized physical exercise program combined with individualized nutritional therapy. They will be followed-up at 6, 12, and 18 weeks after randomization. DISCUSSION: A multidisciplinary approach for dealing with long COVID is needed. Because of the lack of clear data and the fact that this is a very heterogenic group, we aim to prepare and optimize a randomized controlled study that addresses the effectiveness of a personalized multimodal treatment. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05254301 (since February 24, 2022).

Fatigue in NTSB investigations 2013-2019: evidence of accidents and injuries.

This study updates the prevalence of operator fatigue as a causative factor in accidents investigated by the National Transportation Safety Board (NTSB) and the associated injury severity in fatigue-related accidents. In total, 394 investigations were analyzed and 12% of them identified fatigue. The prevalence of fatigue varied among the transportation modes, ranging from 28% of aviation to 7% of marine. Most fatigue-related accidents (48%) occurred during late night or morning. Compared to non-fatigued operators, fatigued operators were more involved in severe or fatal injuries (odds ratio [OR] 2.30; 95% confidence interval [CI] [1.66, 2.95]) and injuries to non-operators (OR 3.32; 95% CI [2.70, 3.95]). Obstructive sleep apnea (OSA) was identified as a probable cause, contributing cause or finding in 15% of fatigue-related accidents, and in 85.7% of these accidents the operator met OSA screening criteria. Thus, opportunities remain for preventing fatigue-related accidents, including through more systematic operator screening for OSA.

Protective Effect of Glycomacropeptide on the Atopic Dermatitis-Like Dysfunctional Skin Barrier in Rats.

The maintenance of a healthy skin barrier is crucial to prevent and treat atopic dermatitis (AD) lesions and avoid infections. Glycomacropeptide (GMP) is a bioactive peptide that has demonstrated promising results as an anti-inflammatory and antipruritic therapy for experimental AD. This study aimed to analyze the effect of GMP on impaired cutaneous barrier-related signs in a rat model of AD lesions. AD-like dermatitis was induced on the skin by repeated topical applications of 2,4-dinitrochlorobenzene, and animals were orally administered GMP before or after AD induction. The expression of skin structural proteins and antimicrobial peptides (AMPs) was evaluated by immunoblot or immunohistochemistry, epidermal thickening was evaluated by histochemistry, the level of IFN-γ and changes in the microbiota were evaluated by quantitative polymerase chain reaction, and the quantity of fecal short-chain fatty acids (SCFAs) was evaluated by gas chromatography. GMP administration significantly increased filaggrin, ß-defensin 2, and cathelicidin-related AMP expression in AD-like lesions. Involucrin expression was not modified. In GMP-treated animals, epidermal thickening and IFN-γ expression were strongly reduced in damaged skin. GMP treatment impacted the skin microbiota and prevented Staphylococcus aureus colonization, which is associated with AD. In addition, high levels of Bifidobacterium were detected in the feces of GMP-treated animals, and the acetic acid and butyric acid contents increased in animals prophylactically administered GMP. These results suggest that GMP markedly prevents or reverses skin barrier damage in rat AD-like lesions through a bifidogenic effect that induces fecal SCFA production with prolonged treatment. Our findings provide evidence that GMP may represent an optimum strategy for the therapy of the dysfunctional cutaneous barrier in AD.

Tequila Agave Bagasse Hydrolysate for the Production of Polyhydroxybutyrate by Burkholderia sacchari.

Tequila agave bagasse (TAB) is the fibrous waste from the Tequila production process. It is generated in large amounts and its disposal is an environmental problem. Its use as a source of fermentable sugars for biotechnological processes is of interest; thus, it was investigated for the production of polyhydroxybutyrate (PHB) by the xylose-assimilating bacteria Burkholderia sacchari. First, it was chemically hydrolyzed, yielding 20.6 g·L-1 of reducing sugars, with xylose and glucose as the main components (7:3 ratio). Next, the effect of hydrolysis by-products on B. sacchari growth was evaluated. Phenolic compounds showed the highest toxicity (> 60% of growth inhibition). Then, detoxification methods (resins, activated charcoal, laccases) were tested to remove the growth inhibitory compounds from the TAB hydrolysate (TABH). The highest removal percentage (92%) was achieved using activated charcoal (50 g·L-1, pH 2, 4 h). Finally, detoxified TABH was used as the carbon source for the production of PHB in a two-step batch culture, reaching a biomass production of 11.3 g·L-1 and a PHB accumulation of 24 g PHB g-1 dry cell (after 122 h of culture). The polymer structure resulted in a homopolymer of 3-hydroxybutyric acid. It is concluded that the TAB could be hydrolyzed and valorized as a carbon source for producing PHB.

Dermatophytosis caused by Nannizzia nana in two siblings / Dermatofitosis causada por Nannizzia nana en dos hermanos

Background: Nannizzia nana is a zoophilic dermatophyte that affects animals like pigs, boars and, exceptionally, humans, in whom it causes tinea capitis, as well as tinea corporis and onychomycosis. Case report: Case 1. A previously healthy 8 year-old boy presented to our clinic with a 1-month evolution dermatosis that affected scalp, developing a pseudoalopecic tumor lesion with abundant seropurulent material. The patient had worked in a pig farm. Case 2. A previously healthy 6 year-old girl, sister of the aforementioned child, presented to our clinic with a dermatosis characterized by multiple erythematous-scaly plaques that affected her face, trunk and arms. N. nana was the fungus isolated on culture in both cases. The children were treated with oral griseofulvin and topical ketoconazole that led to clinical and mycological cures. Conclusions: N. nana dermatophytosis, although being rare in humans, can be treated as other cases of dermatophytosis

Antecedentes: Nannizzia nana es un dermatofito zoófilo que habitualmente afecta a animales, como el cerdo, el jabalí y, excepcionalmente, al ser humano, en el cual provoca tiña de la cabeza, tiña corporal y onicomicosis. Casos clínicos: Caso 1: niño sano de 8 años, con dermatosis de un mes de evolución que afectaba al cuero cabelludo con una lesión tumoral seudoalopécica y abundante material seropurulento. Como antecedente, el niño había trabajado en una granja porcina. Caso 2: niña sana de 6 años y hermana del niño del caso anterior, con dermatosis que le afectaba a la cara, el tronco y los brazos con numerosas placas eritematoescamosas. En ambos casos se aisló en cultivo Nannizzia nana. El tratamiento administrado a los niños fue griseofulvina por vía oral y ketoconazol tópico. Se consiguió la curación clínica y micológica. Conclusiones: Las dermatofitosis por N. nana, aunque son raras en el ser humano, pueden ser tratadas como otras dermatofitosis más habituales

Dermatophytosis caused by Nannizzia nana in two siblings.

BACKGROUND: Nannizzia nana is a zoophilic dermatophyte that affects animals like pigs, boars and, exceptionally, humans, in whom it causes tinea capitis, as well as tinea corporis and onychomycosis. CASE REPORT: Case 1. A previously healthy 8 year-old boy presented to our clinic with a 1-month evolution dermatosis that affected scalp, developing a pseudoalopecic tumor lesion with abundant seropurulent material. The patient had worked in a pig farm. Case 2. A previously healthy 6 year-old girl, sister of the aforementioned child, presented to our clinic with a dermatosis characterized by multiple erythematous-scaly plaques that affected her face, trunk and arms. N. nana was the fungus isolated on culture in both cases. The children were treated with oral griseofulvin and topical ketoconazole that led to clinical and mycological cures. CONCLUSIONS: N. nana dermatophytosis, although being rare in humans, can be treated as other cases of dermatophytosis.

Incidencia de prematuros en el Hospital General Naval de Alta Especialidad 2015-2017 / Incidence of premature infants in the High Specialty Naval General Hospital 2015-2017

Resumen Introducción Cada año nacen aproximadamente 15 millones de niños prematuros. Las complicaciones relacionadas son la principal causa de muerte en los menores de cinco años. La tasa de nacimientos prematuros oscila entre el 5 y 18% de los recién nacidos en diferentes países a nivel mundial. Objetivo Conocer la incidencia de recién nacidos prematuros que ingresaron a la Unidad de Cuidados Intensivos Neonatales del Hospital General Naval de Alta Especialidad durante el periodo 2015-2017. Material y métodos Estudio descriptivo y retrospectivo en el que se analizó la información de los nacimientos prematuros en el Hospital General Naval de Alta Especialidad durante el periodo 2015-2017, ingresados en la Unidad de Cuidados Intensivos Neonatales. Resultados En el periodo de estudio hubo 1,855 nacimientos, 383 fueron ingresados a la Unidad de Cuidados Intensivos Neonatales; de éstos, 37% fueron prematuros, con mayor frecuencia de pacientes masculinos (55.9%) y prematuros tardíos (48.2%). Conclusiones Existe una alta incidencia de nacimientos prematuros; el abordaje debe iniciar antes del nacimiento, tomando medidas preventivas para evitar partos pretérmino, y en caso de ser inevitables, adoptar las medidas necesarias para disminuir la mortalidad y las complicaciones de un niño prematuro.

Abstract Introduction Every year, approximately 15 million premature children are born; related complications are the main cause of death in children under five years. The rate of premature births ranges from 5 to 18% of newborns in different countries worldwide. Objective To determine the incidence of premature infants admitted to the Neonatal Intensive Care Unit of the High Specialty Naval General Hospital during 2015-2017. Material and methods A descriptive and retrospective study in which we analyzed the information on premature births in the High Specialty Naval General Hospital during 2015-2017, admitted to the Neonatal Intensive Care Unit. Results During the study period, there were 1,855 births, 383 were admitted to the Neonatal Intensive Care Unit, of which 37% were premature, with a higher frequency of male patients (55.9%) and late preterm (48.2%). Conclusions There is a high incidence of premature births, the approach must begin before birth, taking preventive measures to avoid preterm deliveries and in case it is inevitable, to adopt the necessary measures to reduce the mortality and complications of a premature child.

Rhabdomyolysis as a rare paraneoplastic presentation of acute myeloid leukemia.

We present the case of a 56-year-old man who presented with rhabdomyolysis and was found to have acute myeloid leukemia (AML). Our case is the first to show an association of rhabdomyolysis with AML. Although rhabdomyolysis is likely a very rare clinical presentation of AML, our case raises awareness for workup for AML in patients who present with rhabdomyolysis and other suspicious findings. Both conditions are medical emergencies and require immediate treatment.