Contaminating viral sequences in high-throughput sequencing viromics: a linkage study of 700 sequencing libraries.

OBJECTIVES: Sample preparation for high-throughput sequencing (HTS) includes treatment with various laboratory components, potentially carrying viral nucleic acids, the extent of which has not been thoroughly investigated. Our aim was to systematically examine a diverse repertoire of laboratory components used to prepare samples for HTS in order to identify contaminating viral sequences. METHODS: A total of 322 samples of mainly human origin were analysed using eight protocols, applying a wide variety of laboratory components. Several samples (60% of human specimens) were processed using different protocols. In total, 712 sequencing libraries were investigated for viral sequence contamination. RESULTS: Among sequences showing similarity to viruses, 493 were significantly associated with the use of laboratory components. Each of these viral sequences had sporadic appearance, only being identified in a subset of the samples treated with the linked laboratory component, and some were not identified in the non-template control samples. Remarkably, more than 65% of all viral sequences identified were within viral clusters linked to the use of laboratory components. CONCLUSIONS: We show that high prevalence of contaminating viral sequences can be expected in HTS-based virome data and provide an extensive list of novel contaminating viral sequences that can be used for evaluation of viral findings in future virome and metagenome studies. Moreover, we show that detection can be problematic due to stochastic appearance and limited non-template controls. Although the exact origin of these viral sequences requires further research, our results support laboratory-component-linked viral sequence contamination of both biological and synthetic origin.

Prevalence and distribution of hepatitis C virus genotypes in Spain during the 2000-2015 period (the GEHEP 005 study).

We report the largest study on the prevalence and distribution of HCV genotypes in Spain (2000-2015), and we relate them with clinical, epidemiological and virological factors. Patients from 29 hospitals in 10 autonomous communities (Andalusia, Aragon, Castilla-Leon, Catalonia, Galicia, Canary Islands, Madrid Community, Valencian Community, Murcia Region and Basque Country) have been studied. Annual distribution of HCV genotypes and subtypes, as well as gender, age, transmission route, HIV and/or HBV coinfection, and treatment details were recorded. We included 48595 chronically HCV-infected patients with the following characteristics: median age 51 years (IQR, 44-58), 67.9% male, 19.1% HIV-coinfected, 23.5% HBV-coinfected. Parenteral transmission route was the most frequent (58.7%). Genotype distribution was 66.9% GT1 (24.9% subtype 1a and 37.9% subtype 1b), 2.8% GT2, 17.3% GT3, 11.4% GT4 and 0.1% GT5 and 0.02% GT6. LiPA was the most widely HCV genotyping test used (52.4%). HCV subtype 1a and genotypes 3 and 4 were closely associated with male gender, parenteral route of infection and HIV and HBV coinfection; in contrast, subtype 1b and genotype 2 were associated with female gender, nonparenteral route and mono-infection. Age was related to genotype distribution, and different patterns of distribution and biodiversity index were observed between different geographical areas. Finally, we describe how treatment and changes in transmission routes may have affected HCV genotype prevalence and distribution patterns. We present the most recent data on molecular epidemiology of hepatitis C virus in Spain. This study confirms that genotype distributions vary with age, sex, HIV and HBV coinfection and within geographical areas and epidemiological groups.

Dermatitis de contacto por sensibilización a alérgenos del caucho y aplicación de apósito plástico en aerosol / No disponible

No disponible

[Study of the nutritional status of elders in Cantabria]. / Estudio del estado nutricional de los ancianos de Cantabria.

INTRODUCTION: Population ageing is a main concern under the biosanitary point of view. AIM: To assess the nutritional status of people 65 year-old and older in Cantabria (Spain) METHOD: A total of 1605 persons were studied by means of the MNA (Mini Nutritional Assessment); a) by primary care (59.9% in the unit, and 4.7% at home) and, b) in nursing homes (35.4%). RESULTS: Nutritional score (NS) was 23.4 ± 4.1 for women and 24.4 ± 4 in males (p < 0.001). We emphasize the fact that 22.3% of people studied in the nursing homes were malnourished or at risk of malnutrition, compared with 14.2% of those studied at the unit, and only 3.3% of the home visited elders. The correlation between the value of the NS and the subjective estimation of nutrition status showed a high value (0.65). We emphasize the negative correlation (-0.53) between BNI value and the incidence of skin lesions. CONCLUSION: Our results highlight the importance of identifying malnutrition or its risk in elders in order to prevent the negative consequences of this deficiency.

Estudio del estado nutricional de los ancianos de Cantabria / Study of the nutritional status of elders in Cantabria

Introducción: El envejecimiento de la población representa uno de los retos más importantes desde el punto de vista biosanitario Objetivo: Valorar el estado nutricional de las personas de 65 y más años de Cantabria. Métodos: Un total de 1605 personas fueron evaluadas por medio del MNA; a) en atención primaria (59,9% en la consulta y 4,7% en domicilios) y, b) en residencias de ancianos (35,4%).Resultados: La puntuación nutricional (PN) obtenida de la suma de los ítems del MNA fue 23,4 ± 4,1 para las mujeres y 24,4 ± 4 en los varones (p < 0,001). Destaca el hecho de que el 22,3% de las personas estudiadas en residencias está malnutrida o en riesgo de malnutrición, frente al 14,2% de las que acuden a consulta, y sólo el3,3% de las estudiadas en su domicilio. La correlación entre los valores de la PN y la apreciación subjetiva del estado de nutrición mostró un valor elevado (0,65). Destacamos la correlación negativa (-0,53) entre los valores del IMC y la incidencia de lesiones cutáneas. Conclusiones: Nuestros resultados indican la importancia de la identificación de la desnutrición o su riesgo, en personas mayores, por las consecuencias negativas que presenta este estado carencial (AU)

Introduction: Population ageing is a main concern under the biosanitary point of view. Aim: To assess the nutritional status of people 65 year old and older in Cantabria (Spain) Method: A total of 1605 persons were studied by means of the MNA (Mini Nutritional Assessment); a) by primary care (59.9% in the unit, and 4.7% at home) and, b) in nursing homes (35.4%).Results: Nutritional score (NS) was 23.4 ± 4.1 for women and 24.4 ± 4 in males (p < 0.001). We emphasize the fact that 22.3% of people studied in the nursing homes were malnourished or at risk of malnutrition, compared with 14.2% of those studied at the unit, and only 3.3% of the home visited elders. The correlation between the value of the NS and the subjective estimation of nutrition status showed a high value (0.65).We emphasize the negative correlation (-0.53) between BNI value and the incidence of skin lesions. Conclusion: Our results highlight the importance of identifying malnutrition or its risk in elders in order to prevent the negative consequences of this deficiency (AU)

Mycobacteriophages as versatile tools for genetic manipulation of mycobacteria and development of simple methods for diagnosis of mycobacterial diseases.

Tuberculosis, caused by Mycobacterium tuberculosis, is responsible for over two million deaths per year worldwide. Due to its long doubling time (18 h), the microbiological detection of M. tuberculosis by conventional methods takes up to one month, unless the number of bacilli in the biological sample is high enough. Thus, drug resistance assessment requires at least one month for obtaining the primary culture and another month to determine its susceptibility to antimycobacterial drugs. Moreover, for a long time, the lack of genetic tools for mycobacteria has been a barrier for undertaking studies aimed at understanding the mechanisms of drug resistance and drug target identification, being all these topics of utmost importance considering the increase in the number of drug-resistant clones and the few therapeutic options available. Mycobacteriophages are promising as a novel source of genetic elements for mycobacteria manipulation, as well as for the development of versatile, simple, fast and cheap methods for drug resistance assessment of M. tuberculosis clinical isolates. We herein describe the background related to the use of mycobacteriophages, with emphasis placed on their utilization for drug resistance analysis in our country.

Mycobacteriophages as versatile tools for genetic manipulation of mycobacteria and development of simple methods for diagnosis of mycobacterial diseases / Micobacteriófagos como herramientas versátiles para la manipulación genética y el desarrollo de métodos simples para el diagnóstico de enfermedades micobacterianas

Tuberculosis, caused by Mycobacterium tuberculosis, is responsible for over two million deaths per year worldwide. Due to its long doubling time (18 h), the microbiological detection of M. tuberculosis by conventional methods takes up to one month, unless the number of bacilli in the biological sample is high enough. Thus, drug resistance assessment requires at least one month for obtaining the primary culture and another month to determine its susceptibility to antimycobacterial drugs. Moreover, for a long time, the lack of genetic tools for mycobacteria has been a barrier for undertaking studies aimed at understanding the mechanisms of drug resistance and drug target identification, being all these topics of utmost importance considering the increase in the number of drug-resistant clones and the few therapeutic options available. Mycobacteriophages are promising as a novel source of genetic elements for mycobacteria manipulation, as well as for the development of versatile, simple, fast and cheap methods for drug resistance assessment of M. tuberculosis clinical isolates. We herein describe the background related to the use of mycobacteriophages, with emphasis placed on their utilization for drug resistance analysis in our country.

La tuberculosis, enfermedad causada por el bacilo Mycobacterium tuberculosis, es responsable de más de dos millones de muertes anuales en el mundo. Debido a su largo tiempo de duplicación (18 h), la detección bacteriológica de M. tuberculosis por métodos convencionales necesita de un mes o aun más, a menos que el número de bacilos en la muestra clínica sea suficientemente alto. Por consiguiente, se necesita un mínimo de dos meses para determinar la resistencia de este microorganismo a las drogas antituberculosas: uno para obtener el cultivo primario y otro para ensayar la sensibilidad frente a aquellas. La falta de herramientas para la manipulación genética de micobacterias ha dificultado la identificación de los blancos de acción de las drogas y el estudio de los mecanismos de resistencia a éstas, tópicos de la mayor relevancia dado el aumento mundial del número de aislamientos clínicos multirresistentes y las pocas opciones terapéuticas disponibles. Los micobacteriófagos son considerados nuevas herramientas para la manipulación de las micobacterias, así como para el desarrollo de métodos simples, rápidos y económicos para determinar la sensibilidad a drogas de los aislamientos clínicos de M. tuberculosis. En esta revisión se describen los antecedentes del uso de micobacteriófagos con énfasis en su utilización para el análisis de resistencia a drogas antituberculosas en nuestro país.

Níveis glicêmicos de jejum alterados e relação com tolerância à glicose diminuída e síndrome metabólica em idosos

Foram estudados 100 pacientes com idade superior a 65 anos, sendo 79 mulheres e 21 homens, com média de idade de 74,5 anos, divididos em dois grupos: 47 com glicemia de jejum normal (GJN), ou seja, com níveis glicêmicos de 70 a 99 mg/dl, e 53 com valores de glicemia entre 100 e 110 mg/dl, valores anteriormente considerados normais e que foram reclassificados pela Sociedade Brasileira de Diabetes, em glicemia de jejum alterada (GJA). Foram excluídos os doentes que tinham glicemia de jejum superior a 110 mg/dl, e os portadores de diabetes mellitus tipo 2. Todos os pacientes foram submetidos ao teste oral de tolerância à glicose (TOTG) com 75 g de glicose, sendo considerados alterados aqueles com valores após 120 mim acima de 140 mg/dl; realizadas as dosagens de colesterol tota, HDL-c, triglicérides; verificado pressão arterial, circunferência abdominal (CA), peso e altura para cálculo de IMC. Para caracterização da SM foram empregadas as recomendações da Federação Internacional de Diabetes. O estudo estatístico constou do teste de Mann Whitney para comparação entre os grupos GJN e GJA, quanto às variáveis quantitativas: idade, HDL-colesterolemia, trigliceridemia, TOTG, CA e IMC. Foi empregado também o teste de associação pela estatística 2 para comparação entre os grupos GJN e GJA quanto ao gênero, hipertensão arterial, TOTG e SM

Relação entre níveis glicêmicos de jejum e síndrome metabólica em pacientes idosos portadores de tolerância à glicose diminuída

Estudados 50 pacientes de ambos os sexos, com idade igual ou superior a 65 anos, portadores de tolerância à glicose diminuída, isto é, pacientes que foram submetidos ao teste oral de tolerância à glicose (TOTG) com 75g de glicose e que apresentaram valores após 120 min acima de 140 mg/dl. Os pacientes foram divididos em dois grupos: 16 com glicemia de jejum normal (GJN), ou seja, com níveis glicêmicos de 70 a 99 mg/dl, e 34 com glicemia de jejum entre 100 e 110 mg/dl, valores anteriormente considerados normais e que foram reclassificados pela Sociedade Brasileira de Diabetes como glicemia de jejum alterada (GJA). Para o diagnóstico de síndrome metabólica foram adotadas as recomendações da Federação Internacional de Diabetes (IDF). O tratamento estatístico empregado foi o teste exato de Fisher para avaliar a associação entre a síndrome metabólica e glicemia de jejum. A proporção da presença de síndrome metabólica foi maior no grupo de pacientes com glicemia de jejum entre 100 e 110 mg/dl, devendo ser estes pacientes melhor avaliados quanto à presença de outros fatores de risco cardiovascular como dislipidemia, hipertensão e cintura abdominal

Níveis glicêmicos de jejum alterados e relação com tolerância à glicose diminuída e síndrome metabólica em idosos / Impaired fasting glucose levels and relationship with impaired glucose tolerance and metabolic syndrome in elderly

Foram estudados 100 pacientes com idade superior a 65 anos, sendo 79 mulheres e 21 homens, com média de idade de 74,5 anos, divididos em dois grupos: 47 com glicemia de jejum normal (GJN), ou seja, com níveis glicêmicos de 70 a 99 mg/dl, e 53 com valores de glicemia entre 100 e 110 mg/dl, valores anteriormente considerados normais e que foram reclassificados pela Sociedade Brasileira de Diabetes, em glicemia de jejum alterada (GJA). Foram excluídos os doentes que tinham glicemia de jejum superior a 110 mg/dl, e os portadores de diabetes mellitus tipo 2. Todos os pacientes foram submetidos ao teste oral de tolerância à glicose (TOTG) com 75 g de glicose, sendo considerados alterados aqueles com valores após 120 mim acima de 140 mg/dl; realizadas as dosagens de colesterol tota, HDL-c, triglicérides; verificado pressão arterial, circunferência abdominal (CA), peso e altura para cálculo de IMC. Para caracterização da SM foram empregadas as recomendações da Federação Internacional de Diabetes. O estudo estatístico constou do teste de Mann Whitney para comparação entre os grupos GJN e GJA, quanto às variáveis quantitativas: idade, HDL-colesterolemia, trigliceridemia, TOTG, CA e IMC. Foi empregado também o teste de associação pela estatística 2 para comparação entre os grupos GJN e GJA quanto ao gênero, hipertensão arterial, TOTG e SM (AU)

Relação entre níveis glicêmicos de jejum e síndrome metabólica em pacientes idosos portadores de tolerância à glicose diminuída / Relation between fasting glucose levels and metabolic syndrome in elderly patients with impaired glucose tolerance

Estudados 50 pacientes de ambos os sexos, com idade igual ou superior a 65 anos, portadores de tolerância à glicose diminuída, isto é, pacientes que foram submetidos ao teste oral de tolerância à glicose (TOTG) com 75g de glicose e que apresentaram valores após 120 min acima de 140 mg/dl. Os pacientes foram divididos em dois grupos: 16 com glicemia de jejum normal (GJN), ou seja, com níveis glicêmicos de 70 a 99 mg/dl, e 34 com glicemia de jejum entre 100 e 110 mg/dl, valores anteriormente considerados normais e que foram reclassificados pela Sociedade Brasileira de Diabetes como glicemia de jejum alterada (GJA). Para o diagnóstico de síndrome metabólica foram adotadas as recomendações da Federação Internacional de Diabetes (IDF). O tratamento estatístico empregado foi o teste exato de Fisher para avaliar a associação entre a síndrome metabólica e glicemia de jejum. A proporção da presença de síndrome metabólica foi maior no grupo de pacientes com glicemia de jejum entre 100 e 110 mg/dl, devendo ser estes pacientes melhor avaliados quanto à presença de outros fatores de risco cardiovascular como dislipidemia, hipertensão e cintura abdominal (AU)

Reservorios venosos centrales totalmente implantables, tipo Port-A-Cath, en pacientes oncológicos: revisión de Complicaciones / Totally implantable central venous devices (Port-A-Cath) in oncological patients: review of complications

El objetivo de esta revisión fue la de estudiar, describir y recoger las complicaciones relacionadas y derivadas de la utilización de dispositivos implantables de carácter permanente, tipo Port-A-Cath (PAC), en pacientes oncológicos. Durante las últimas décadas, estos dispositivos han experimentado una evolución tecnológica importante de manera que actualmente permiten su utilización de forma repetida, en régimen ambulatorio y para diferentes aplicaciones médicas, (administración de nutrición parenteral, administración de medicamentos o para la simple extracción de muestras sanguíneas). Gracias a esta evolución tecnológica, se ha incrementado la calidad de vida de los pacientes tanto por la mayor facilidad de utilización, como en la reducción del número de ingresos hospitalarios, mejorando así su balance coste/beneficio. Al igual que en cualquier otra técnica médico-quirúrgica, no están exentos de complicaciones derivadas bien del implante, utilización o mantenimiento en el tiempo de estos dispositivos y que es objeto principal de nuestra revisión. Consideramos necesario realizar esta revisión como control interno de las complicaciones surgidas así como herramienta de vigilancia sobre la técnica de implante y en relación con una apreciación subjetiva del incremento de las complicaciones de carácter trombótico en nuestra serie. Mostramos como la estandarización de la técnica de implante y la unificación de criterios a la hora de realizar el mantenimiento de los mismos por parte de los equipos de enfermería parece que reduce el número de complicaciones. Revisada la bibliografía, hemos constatado que nuestras cifras se presentan como buenas o muy buenas en el rango de las complicaciones advertidas y contabilizadas en una revisión de473 historias clínicas de pacientes oncológicos tratados con fármacos quimioterápicos a través de este tipo de dispositivos (AU)

This review, describe and depict the complications related from the use of permanently implantable Port-A-Cath (PAC) devices in oncological patients. These devices have undergone a substantial technological evolution such that they can currently be used repeatedly under an outpatient regime and for different medical applications (administration of parenteral nutrition, medications, or for the simple extraction of blood samples). Thanks to these technological developments, the quality of life of patients has improved from the point of view of ease of use and the reduction of the number of hospital admissions, which thereby also improves its cost-benefit balance. However, just like any other medical technique, these devices are not exempt from complications arising from their implantation, use and maintenance over time. This is the principal matter with which our review concerns itself. We have considered it necessary to carry out this review as an internal control of the complications that arise and of its merit as a tool for overseeing the implantation technique, and in relation to a subjective impression of a greater incidence of thrombotic complications in our series. We demostrate how the standarisation of the implantation technique and the unification of criteria when nursing staff carry out maintenance appears to reduce the number of complications. Having reviewed the bibliography, we conclude that our figures are good or very good for the range of noted and counted complications in a review of 473 clinical records of cancer patients treated with chemotherapy drugs using this type of device (AU)

Estimulación Medular (EEM) en el tratamiento de la enfermedad vascular periférica. Parte II / Spinal Cord Stimulation for peripheral vascular disease treatment

Las técnicas de neuromodulación suponen un abordaje no destructivo y reversible en el tratamiento del dolor. Su utilización se establece como estrategia de control del dolor no controlable dentro de las directrices de la O.M.S. y como alternativa a otras terapias invasivas menores o neuroablatibas que no han sido eficaces o que están contraindicadas. De entre ellas el uso clínico de la estimulación eléctrica medular (EEM) o neuroestimulación, demuestra día a día su utilidad y eficacia en el tratamiento de diferentes síndromes de dolor crónico. Estudios de Cook y cols en 1.976, ya demostraron en sus trabajos la efectividad de esta técnica en la manifestación clínica del dolor isquémico así como en la arterioesclerosis o vasculopatía diabética, o en el dolor isquémico producido por vasoespasmo periférico, en entidades específicas como la Enfermedad de Buerguer, Esclerodermia o Síndrome de Raynaud. Durante la última década, se ha extendido la utilización de la EEM en la cardiopatía isquémica de carácter intratable (angina de pecho refractaria a tratamientos, síndrome “X”,...) y la patología vascular periférica, objeto de esta revisión. Esta técnica se presenta como una de las principales indicaciones con altos niveles de efectividad (80%), tanto en el aspecto clínico por el alivio sintomático que produce, como en los beneficios isquémicos fisiopatológicos que induce la neuroestimulación (AU)

The Neuro-modulation technologies are a not destructive and reversible approach in the treatment of the pain. They are used as a strategy for the control of untreatable pain according to the directives of the OMS and as an alternative of other invasive minor or neuroablatives therapies that have been not effective or that are not indicated. Between them the clinical use of spinal cord stimulation (SCS) has demonstrated its usefulness and efficiency in the treatment of different syndromes of chronic pain. Cook’s and cols. in 1.976, demonstrated in their reports the efficiency of this technique in the clinical manifestation of ischemic pain as well as in the arteriosclerosis, diabetic vasculopaty, or in the ischemic pain related with peripheral vasospasm, in specific pathologies as the Buerguer´s disease, Scleroderma or Raynaud´s syndrome. During the last decade, the utilization of the SCS has spread in the ischemic cardiopathy of untreatable character (refractory angina pectoris, syndrome “X”,…) and vascular peripheral pathology, subject of this review. This technique appears as one of the main indications with high levels of efficiency (80%), so much in the clinical aspect for the symptomatic relief as well as in the ischemic physiopatologic benefits that induces the neuro-estimulation (AU)

[Mechanisms of action of and resistance to rifampicin and isoniazid in Mycobacterium tuberculosis: new information on old friends]. / Mecanismos de acción y de resistencia a rifampicina e isoniacida en Mycobacterium tuberculosis: nueva información sobre viejos conocidos.

Human tuberculosis is still one of the most frequent causes of death worldwide. Despite the implementation of therapeutic regimes combining four drugs, the rise of resistant and multidrug-resistant Mycobacterium tuberculosis strains has compromised their efficacy. Two of the most effective anti-tubercular drugs in use, rifampicin and isoniazid, have been closely studied due to their therapeutic importance. These studies have led to the identification of the genes involved in resistance mechanisms and of those encoding the molecular targets for these drugs. Rifampicin is an inhibitor of the beta-subunit of the RNA polymerase of prokaryotes, including M. tuberculosis. Resistance to rifampicin is mediated by mutations clustered in a small region of the rpoB gene. A fraction of resistant strains showed no mutations in rpoB, suggesting that other mechanisms of resistance, possibly efflux pumps, may exist. Isoniazid is a pro-drug activated by KatG, a catalase-peroxidase. Mutations in katG, the most commonly found in M. tuberculosis clinical isolates, give high levels of resistance. In spite of this, the molecular target for isoniazid is InhA, an enoyl-ACP-reductase involved in the biosynthesis of mycolic acids. Other mutations causing resistance to isoniazid have been mapped to ndh, a gene encoding the NADH dehydrogenase.

Optimization of 4A zeolite synthesis as recovery of wastes from aluminum finishing.

A model representing the synthesis process of 4A zeolite from wastes of aluminum finishing plants was obtained and validated through statistical tests. From this model, the optimum values for the molar ratios SiO2/ Al2O3, Na2O/SiO2 and H2O/Na2O, which define the type and quality of the synthesized zeolite, were estimated for the use of these wastes as raw material. The obtained zeolites could be used as water softeners in the formulation of detergents. The resulting liquors could be reused in the cleaning of the extrusion matrices used for aluminum profiles or recycled for new zeolites synthesis.

Identification of a novel single-nucleotide polymorphism (Val554Ile) and definition of eight common alleles for human IL4RA exon 11.

The interleukin (IL)-4 receptor alpha chain gene (IL4RA) is a polymorphic gene which is reportedly involved in the development of atopy. Of the 14 single-nucleotide polymorphisms (SNP) reported to date in the coding region of IL4RA, 11 are positioned to exon 11. This big exon encodes more than two thirds of the mature protein, including most of the cytoplasmic region. Here we report the identification of a new IL4RA SNP at the first nucleotide of codon 554 (GTA --> ATA) in exon 11, leading to an amino acid substitution from Val to Ile (V554I). Furthermore, we present complete nucleotide sequence data for eight common alleles resulting from combinations of 9 out of the 12 SNP at IL4RA exon 11. Homo- or heterozygous combinations of these eight alleles accounted for all the IL4RA exon 11 genotypes found in Caucasian individuals from our geographical area.

Xanthomonas albilineans Haplotype B Responsible for a Recent Sugarcane Leaf Scald Disease Outbreak in Cuba.

Over the past 3 years, the incidence of sugarcane leaf scald disease (LSD) caused by Xanthomonas albilineans has increased at alarming rates in some Caribbean countries. LSD was in latent phase since 1978, when the disease was reported in Cuba, until February 1998 when typical symptoms were observed in germ plasm collections and in some commercial plantings. More than 150 bacterial isolates from different sugarcane varieties and from different localities were isolated on Wilbrink agar medium and characterized. All isolates had shown similar cultural and biochemical patterns. However, serological differences between isolates from the recent outbreak and the ones obtained prior to 1998 were detected by indirect ELISA testing. Differences between Cuban isolates obtained prior to 1998 and those from the recent outbreak were confirmed by analysis of repetitive DNA sequences dispersed throughout the genome. According to the pattern obtained, the newer isolates were similar to reference strains classified as haplotype B by pulsed field gel electrophoresis (1). It is concluded that the recent outbreak of LSD was caused by a strain different than the ones previously detected in Cuba. Reference: (1) M. J. Davis et al. Phytopathology 87:316, 1997.

Indicaciones de los opioides en el dolor de espalda no neoplásico / No disponible

La mayoría de los pacientes con dolor crónico de espalda van a conseguir alivio con las terapias habituales, gracias a los importantes avances tanto en medios diagnósticos como de tratamiento. Sin embargo, un número pequeño, pero significativo, de pacientes seguirá experimentando dolor crónico a pesar de estas medidas, y en muchos casos precisarán opioides para controlarlo. Este sigue siendo un tema controvertido, y aunque es difícil determinar la relación del beneficio (eficacia) y el riesgo (tolerancia, abuso, adicción), podemos asegurar, según nuestra experiencia, que el beneficio es bueno y el riesgo pequeño. Los opioides estarían indicados en el dolor de espalda crónico severo, refractario a todas las terapias, con un diagnóstico probado, que produzca una reducción significativa de la calidad de vida, siempre que la situación psicosocial del paciente sea estable y el dolor sensible a opioides. Es importante realizar una valoración integral de estos pacientes, y tener en cuenta una serie de consideraciones antes de iniciar una terapia con opioides. La presentación de efectos secundarios, tolerancia, abuso o adicción, no representan un obstáculo para la utilización de este tratamiento. La vía de administración de elección de opioides es la oral, sin embargo la infusión continua espinal, o el fentanilo transdérmico presentan importantes ventajas. La posibilidad de conseguir alivio del dolor y mejorar la funcionalidad y la calidad de vida, justificaría la utilización de opioides en los pacientes con dolor de espalda crónico severo, refractario a todas las terapéuticas (AU)

Most patients with chronic back pain will achieve some relief with the standard therapies, thanks to the major advances both in diagnostic and therapeutic techniques. However, a small but significant number of patients will continue to have chronic pain despite such measures and in many cases they will require opiates for the management of their pain. This is still a controversial issue, and although it is difficult to determine the balance between benefit (effectiveness) and risk (tolerance, abuse, addiction), we can state, based on our experience, that the benefit is good and the risk small. Opiates would be indicated for severe chronic back pain refractory to other therapies, with a proven diagnosis and being the cause of a significant worsening of quality of life, provided that the psychosocial situation of the patient is stable and the pain is sensitive to opiates. It is important to performan integral assessment of such patients and to take into account some considerations before starting an opiate therapy. The development of side effects, tolerance, abuse or addiction is not a barrier for the use of this treatment. The best route of administration for opiates is the oral one; however, spinal continuous infusion or transdermal fentanile provide significant benefits. The ability to achieve immediate pain relief and to improve the functionality and quality of life of the patient, justifies the use of opiates in patients with severe chronic back pain refractory to other therapies (AU)

Atención psiquiátrica infanto-juvenil a la población inmigrante: estudio descriptivo en un distrito de Madrid / Child and adolescent psychiatric assistance to the inmigrant population: a descriptive study in a district of Madrid

Objetivo: analizar las características cuantitativas y cualitativas de los menores inmigrantes de un distrito de Madrid con alto porcentaje de inmigración. Metodología: Investigamos el número total y las edades de los menores inmigrantes tensados en el distrito. En la población total atendida por problemas de salud mental de 1995 a 1998, se recogen la proporción de inmigrantes y su distribución por sexo, edad y diagnóstico. Resultados: la población inmigrante supuso 5,88 por ciento del total de pacientes. Los sujetos que demandaron atención con mayor frecuencia fueron varones, de 12-18 años de edad, de primera generación y de origen iberoamericano. La patología más frecuentemente diagnosticada fueron los trastornos emocionales infantiles, neuróticos y adaptativos. Conclusiones: La demanda de la población inmigrante fue mayor respecto a la de la población general, con un aumento progresivo con el transcurso de los años. Esto hace necesario un estudio de los factores que influyen en la psicopatología y tratamiento de las minorías étnicas (AU)