The Temporary Incapacity (TI) register as a complementary system to traditional epidemiological surveillance during the COVID-19 pandemic in Spain.

INTRODUCTION: During the COVID-19 pandemic, a set of social measures were adopted for the preservation of business activity and the protection of workers. One of these measures was issuing the Temporary Disability (TD) for COVID-19 cases, close contacts, and especially vulnerable workers. OBJETIVE: This study analyzes whether the TD registry could be used as a complementary source to traditional epidemiological surveillance. METHODS: A longitudinal study of time series was carried out with a cross-correlation analysis of TD and COVID-19 cases reported to the National Epidemiological Surveillance Network (RENAVE). The analysis included six pandemic waves between 10/03/2020 and 31/12/2021 in Spain. Cross-correlation coefficients (r) were calculated using a time lag of -14 days. RESULTS: During the study period, 2,253,573 TD processes were recorded in Spain and 4,894,802 COVID-19 cases were reported to RENAVE. Significant positive correlations were observed at time lags of -7, -10, and -14, indicating that TD notification preceded RENAVE notification. In the first and sixth pandemic waves, TD notification preceded RENAVE by 12 and 7 days, respectively. Negative correlations between the two series were observed in the second and fourth waves, coinciding with a lower number of reported cases. In the third and fifth waves, TD notification also preceded RENAVE (lags -1, -5 and -14, -7, respectively). CONCLUSIONS: The results confirm the usefulness of TD registry as a complementary system to traditional epidemiological surveillance in Spain, by detecting COVID-19 cases in the 7, 10, and 14 days prior. A better positive correlation is observed in waves where more cases were reported.

Effect of Different Levels of Extruded Coffee (Coffea arabica) Pulp Flour on the Productive Performance and Intestinal Morphometry of Cobb 500 Broiler Chickens.

Coffee pulp is a by-product of the coffee industry. Due to conventional management techniques, it represents a severe environmental problem due to its negative impact on the soil (anaerobic fermentation and pH changes), water sources (the infiltration of pollutants into streams, acidification of water sources, and modification of microorganisms), and biodiversity (soil microbiology, fish, crustaceans, and other vertebrates). Therefore, it is essential to develop protocols for the treatment of this waste so that it can be used again in other productive activities under the circular economy approach. This means that all the waste from a production process can be reused, can generate value for the benefit of the producer, and, in turn, mitigate the environmental impact. The objective of this study was to evaluate the replacement of 5 levels of wheat bran (WB) with extruded coffee pulp flour (ECPF) as an alternative to a conventional fiber source in broiler finisher diets. A total of 300 Cobb 500 chickens in the finishing phase were assessed in the study, grouped in 5 treatments: T1, a conventional diet or control treatment (100% WB and 0% ECPF), T2 (75% WB and 25% ECPF), T3 (50% WB and 50% ECPF), T4 (25% WB and 75% ECPF), and T5 (0% WB and 100% ECPF). Feed intake, weight gain, feed conversion ratio (FCR), and intestinal morphometry (villus length: VL, villus width: VW, crypt depth: CD, villus height/crypt depth ratio: V/C, and villus surface area: VSA) were evaluated at the level of the duodenum, jejunum, and ileum. Feed intake decreased correspondingly as the ECPF in the diet was increased, with statistical differences (p < 0.01) between their averages; the most significant weight gain (834.61 g) was evidenced with the T2 treatment, this being statistically different (p < 0.01) from T4 and T5; similarly, the best FCR (1.58) was evidenced with the T2 treatment, followed by the control treatment T1 (with 1.64); however, they were not statistically different (p > 0.05). All treatment results were similar to the VL control samples in the three intestinal portions, except for the T5 in the jejunum, which showed statistical differences from the control. In VW, the treatment results were similar to the control samples of the jejunum and ileum; however, in the duodenum, the T5 results showed the highest value (172.18 µm), being statistically different (p < 0.05) from the other treatments being evaluated. For CD, it was only in the duodenum that the T2 and T3 treatments were similar to the control. Likewise, for V/C in the duodenum, only the T2 results were similar to the control. There was no significant difference in the VSA among the different treatment groups. T2 showed better production parameters without altering the intestinal villi. In conclusion, ECPF is a potential input for use to replace up to 25% of WB in the feed of broilers in the finishing phase.

The effect of corticosterone on the acquisition of Pavlovian conditioned approach behavior is dependent on sex and vendor.

Cues in the environment become predictors of biologically relevant stimuli, such as food, through associative learning. These cues can not only act as predictors but can also be attributed with incentive motivational value and gain control over behavior. When a cue is imbued with incentive salience, it attains the ability to elicit maladaptive behaviors characteristic of psychopathology. We can capture the propensity to attribute incentive salience to a reward cue in rats using a Pavlovian conditioned approach paradigm, in which the presentation of a discrete lever-cue is followed by the delivery of a food reward. Upon learning the cue-reward relationship, some rats, termed sign-trackers, develop a conditioned response directed towards the lever-cue; whereas others, termed goal-trackers, approach the food cup upon lever-cue presentation. Here, we assessed the effects of systemic corticosterone (CORT) on the acquisition and expression of sign- and goal-tracking behaviors in male and female rats, while examining the role of the vendor (Charles River or Taconic) from which the rats originated in these effects. Male and female rats from Charles River had a greater tendency to sign-track than those from Taconic. Administration of CORT enhanced the acquisition of sign-tracking behavior in males from Charles River and females from both vendors. Conversely, administration of CORT had no effect on the expression of the conditioned response. These findings demonstrate a role for CORT in cue-reward learning and suggest that inherent tendencies towards sign- or goal-tracking may interact with this physiological mediator of motivated behavior. Highlights: Male and female rats from Charles River exhibit more sign-tracking relative to those from Taconic.Corticosterone increases the acquisition of sign-tracking in male rats from Charles River.Corticosterone increases the acquisition of sign-tracking in female rats, regardless of vendor.There is no effect of corticosterone on the expression of sign-tracking behavior in either male or female rats.

Duplicación del colédoco asociado a unión biliopancreática anómala: Reporte de caso / Common bile duct duplication associated with anomalous biliopancreatic junction: A case report

Introducción. La duplicación del colédoco es una anomalía congénita poco frecuente. En la mayoría de los casos este defecto se asocia a cálculos en la vía biliar, unión pancreatobiliar anómala, pancreatitis, cáncer gástrico o colangiocarcinoma. Por esta razón, el diagnóstico y el tratamiento temprano son importantes para evitar las complicaciones descritas a futuro. Métodos. Se presenta el caso de una paciente de 30 años, con antecedente de pancreatitis aguda, con cuadro de dolor abdominal crónico, a quien se le realizaron varios estudios imagenológicos sin claro diagnóstico. Fue llevada a manejo quirúrgico en donde se documentó duplicación del colédoco tipo II con unión pancreatobiliar anómala. Resultados. Se hizo reconstrucción de las vías biliares y hepatico-yeyunostomía, con adecuada evolución postoperatoria y reporte final de patología sin evidencia de tumor. Conclusión. El diagnóstico se hace mediante ecografía endoscópica biliopancreática, colangiorresonancia o colangiopancreatografía retrógrada endoscópica. El tratamiento depende de si está asociado o no a la presencia de unión biliopancreática anómala o cáncer. Si el paciente no presenta patología neoplásica, el tratamiento quirúrgico recomendado es la resección del conducto con reconstrucción de las vías biliares.

Introduction. Double common bile duct is an extremely rare congenital anomaly. This anomaly may be associated with bile duct stones, anomalous biliopancreatic junction, pancreatitis, bile duct cancer, or gastric cancers. Thus, early diagnosis and treatment is important to avoid complications. Clinical case. We report a rare case of double common bile duct associated with an anomalous biliopancreatic junction in a 30-year-old female, with prior history of acute pancreatitis, who presented with chronic abdominal pain. She underwent several imaging studies, without clear diagnosis. She was taken to surgical management where duplication of the type II common bile duct was documented with anomalous pancreatobiliary junction. Results. Reconstruction of the bile ducts and hepatico-jejunostomy were performed, with adequate postoperative evolution and final pathology report without evidence of tumor. Conclusion. Diagnosis is usually performed by an endoscopic ultrasound, magnetic resonance cholangiopancrea-tography, or endoscopic retrograde cholangiopancreatography. Treatment depends on the presence of anomalus biliopancreatic junction or concomitant cancer. In cases without associated malignancy, resection of bile duct and biliary reconstruction is the recommended surgical treatment.

Design and Validation of a Clinical Outcome Measure for Adolescents and Adult Patients with Spinal Muscular Atrophy: SMA Life Study Protocol.

INTRODUCTION: The objective of this study is to develop a clinical tool for the evaluation and follow-up of adolescent and adult patients with 5q spinal muscular atrophy (SMA) and to design its validation. METHODS: This prospective, non-interventional study will be carried out at five centres in Spain and will include patients aged 16 years or older with a confirmed diagnosis of 5q SMA (biallelic mutation of the survival motor neuron 1 [SMN1] gene). A panel of experts made up of neurologists, physiatrists and Spanish patients' association (FundAME), participated in the design of the clinical tool. Physicians will administer the tool at three time points (baseline, 12 months and 24 months). Additionally, data from other questionnaires and scales will be collected. Once recruitment is achieved, an interim statistical analysis will be performed to assess its psychometric properties by applying Rasch analysis and classical statistical tests. RESULTS: The tool will consist of up to 53 items to assess functional status from a clinical perspective in seven key dimensions (bulbar, respiratory, axial, lower, upper, fatigability and other symptoms), which will be collected together with objective clinical measures (body mass index, forced vital capacity, pinch strength and 6-minute walk test). CONCLUSIONS: The validation of this tool will facilitate the clinical evaluation of adult and adolescent patients with SMA and the quantification of their response to new treatments in both clinical practice and research.

Different Safety Pattern of an Inactivated SARS-CoV-2 Vaccine (CoronaVac®) According to Age Group in a Pediatric Population from 3 to 17 Years Old, in an Open-Label Study in Chile.

During the COVID-19 pandemic, the importance of vaccinating children against SARS-CoV-2 was rapidly established. This study describes the safety of CoronaVac® in children and adolescents between 3- and 17-years-old in a multicenter study in Chile with two vaccine doses in a 4-week interval. For all participants, immediate adverse events (AEs), serious AEs (SAEs), and AEs of special interest (AESIs) were registered throughout the study. In the safety subgroup, AEs were recorded 28 days after each dose. COVID-19 surveillance was performed throughout the study. A total of 1139 individuals received the first and 1102 the second dose of CoronaVac®; 835 were in the safety subgroup. The first dose showed the highest number of AEs: up to 22.2% of participants reported any local and 17.1% systemic AE. AEs were more frequent in adolescents after the first dose, were transient, and mainly mild. Pain at the inoculation site was the most frequent AE for all ages. Fever was the most frequent systemic AE for 3-5 years old and headache in 6-17 years old. No SAEs or AESIs related to vaccination occurred. Most of the COVID-19 cases were mild and managed as outpatients. CoronaVac® was safe and well tolerated in children and adolescents, with different safety patterns according to age.

Nebivolol in oral subacute treatment prevents cardiac post-ischemic dysfunction in rats, but hyperthyroidism reduces this protection: mechanisms involved.

Nebivolol could prevent dysfunction in patients suffering myocardial ischemia. However, influence of hyperthyroidism is not known. Consequences and mechanisms of nebivolol treatment were investigated in isolated hearts from euthyroid (EuT) and hyperthyroid (HpT) rats. Rats were orally treated during 1 week with 20 mg/kg/day nebivolol (O-Neb), 30 mg/kg/day atenolol (O-Ate), or not treated (C). Isolated perfused hearts were exposed to global ischemia and reperfusion (I/R) inside a flow calorimeter. Left diastolic ventricular pressure, developed contractile pressure (P), and total heat rate (Ht) were continuously measured, while infarct size was measured after 2-h R. EuT-C and HpT-C hearts developed similarly low post-ischemic contractile recovery and economy (P/Ht). Nebivolol totally prevented dysfunction and reduced infarction size in EuT hearts, but partially improved recovery in HpT rat hearts. Contrarily, oral atenolol totally prevented dysfunction in HpT hearts but partially in EuT hearts. Nebivolol effects were reversed by perfusing L-NAME in both conditions, but partially reduced by aminoguanidine in HpT. However, L-NAME increased P and P/Ht recoveries in EuT-C and HpT-C rat hearts, as well as melatonin. Oral nebivolol prevented post-ischemic dysfunction and infarction in EuT hearts due to adrenergic ß1 blockade and activation of iNOS and/or eNOS, but the effect was attenuated in HpT hearts by excessive iNOS-dependent nitrosative pathways.

Perfil de pacientes adultos hospitalizados por COVID-19 antes y después de la introducción de las vacunas contra SARS-CoV-2 / Profile of adult patients hospitalized with COVID-19 before and after the introduction of vaccines against SARS-CoV-2

INTRODUCCIÓN: La introducción progresiva de vacunas contra SARS-CoV-2 a partir de 2021, priorizando grupos de mayor edad, podría implicar un cambio en el perfil de pacientes hospitalizados por COVID-19 en el tiempo. OBJETIVO: Comparar las características y evolución de pacientes adultos hospitalizados por COVID-19 en un período anterior en 2020 (PER1) y otro posterior al inicio de la vacunación masiva contra SARS-CoV-2 (PER2). PACIENTES Y MÉTODOS: Se registró edad, género, comorbilidades, complicaciones y evolución de los pacientes hospitalizados por COVID-19 en una clínica privada, en Santiago, Chile. Se calculó el puntaje de gravedad y riesgo nutricional. RESULTADOS: En PER2, los pacientes fueron de menor edad, pero con comorbilidades similares al PER1, excepto por mayor malnutrición por exceso. Los pacientes del PER2 no vacunados requirieron más ventilación mecánica (38,9 vs. 14,3%, p = 0,03) y evolucionaron más gravemente (puntaje 6) que aquellos adecuadamente inmunizados (puntaje 5, p = 0,048). Las variables que más predijeron mortalidad fueron edad > 60 años (OR 28.995) y presencia de riesgo nutricional (OR 5.246). DISCUSIÓN: El cambio en el perfil y evolución de los pacientes hospitalizados con COVID-19 está asociado con la secuencia de priorización de vacunas contra SARS-CoV-2, cuyo efecto redujo las hospitalizaciones y gravedad de COVID-19 en adultos mayores.

BACKGROUND: During the COVID-19 pandemic, the early prioritization of SARS-CoV-2 vaccines for older adults may have affected the characteristics of hospitalized COVID-19 patients over time. AIM: To compare the clinical characteristics and outcomes of adult patients admitted for COVID-19 before (PER1) and after (PER2) the initiation of mass vaccination for SARS-CoV-2. METHODS: Data on age, gender, comorbidities, complications, and outcomes of adult patients hospitalized for COVID-19 in a private clinic of Santiago, Chile, were collected. Scores for COVID-19 severity and nutritional risk were calculated. RESULTS: In PER2, patients were younger but had similar comorbidities, except for a higher prevalence of overweight and obesity compared to PER1. Unvaccinated COVID-19 patients in PER2 required more invasive ventilatory support (38.9% vs. 14.3%, p = 0.03) and had a higher severity score (six) than vaccinated patients (five, p = 0.048). The variables that best predicted mortality were age > 60 years (OR 28,995) and the presence of nutritional risk (OR 5,246). DISCUSSION: Changes in the profile and outcomes of hospitalized patients during the COVID-19 pandemic are associated with the prioritization of SARS-CoV-2 vaccines and their protective effect in reducing hospitalizations and disease severity in older adults.

Photoreduction of Anthracenes Catalyzed by peri-Xanthenoxanthene: a Scalable and Sustainable Birch-Type Alternative.

The typical Birch reduction transforms arenes into cyclohexa-1,4-dienes by using alkali metals, an alcohol as a proton source, and an amine as solvent. Capitalizing on the strong photoreductive properties of peri-xanthenoxanthene (PXX), herein we report the photocatalyzed "Birch-type" reduction of acenes by employing visible blue light irradiation at room temperature in the presence of air. Upon excitation at 405 or 460 nm in the presence of a mixture of N,N-diisopropylethylamine (DIPEA) and trifluoromethanesulfonimide (HNTf2 ) in DMSO, PXX photocatalyzes the selective reduction of full-carbon acene derivatives (24-75 %). Immobilization of PXX onto polydimethylsiloxane (PDMS) beads (PXX-PDMS) allowed the use of the catalyst in heterogeneous batch reactions, giving 9-phenyl-9,10-dihydroanthracene in high yield (68 %). The catalyst could easily be recovered and reused, with no notable drop in performance observed after five reaction cycles. Integration of the PXX-PDMS beads into a microreactor enabled the reduction of acenes under continuous-flow conditions, thereby validating the sustainability and scalability of this heterogeneous-phase approach.

Factors Impacting the Use or Rejection of Hearing Aids-A Systematic Review and Meta-Analysis.

PURPOSE: To examine the prevalence of adherence to hearing aids and determine their rejection causes. METHODS: This study was conducted according to the Preferred Reporting terms for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We performed an electronic search using PubMed, BVS, and Embase. RESULTS: 21 studies that met the inclusion criteria were selected. They analyzed a total of 12,696 individuals. We observed that the most common causes for positive adherence to hearing aid use included having a higher degree of hearing loss, patients being aware of their condition, and requiring the device in their daily life. The most common causes for rejection were the lack of perceived benefits or discomfort with the use of the device. The results from the meta-analysis show a prevalence of patients who used their hearing aid of 0.623 (95% CI 0.531, 0.714). Both groups are highly heterogeneous (I2 = 99.31% in each group, p < 0.05). CONCLUSIONS: A significant proportion of patients (38%) do not use their hearing aid devices. Homogeneous multicenter studies using the same methodology are needed to analyze the causes of rejection of hearing aids.

Vértigo posicional paroxístico benigno y enfermedad de Menière: análisis retrospectivo / Benign paroxysmal positional vertigo and Menière's disease: retrospective analysis

Introducción y objetivo: El Vértigo Posicional Paroxístico Benigno (VPPB) es más frecuente dentro del subgrupo de pacientes con Enfermedad de Menière (EM). El presente estudio tiene como objetivo describir las características clínicas tanto del VPPB como de la EM cuando se encuentran asociados. Método: Realizamos un análisis retrospectivo de 22 pacientes con EM diagnosticados de VPPB entre el 1999 y el 2021 en el Complejo Asistencial Universitario de Salamanca. Se recogieron variables clínicas, tanto de las características del VPPB como de la EM. Resultados: En nuestra base de datos, el 66,66 % de los 22 pacientes eran mujeres con una edad media de 59,33 años. El canal semicircular afecto con más frecuencia fue el posterior derecho. En cuanto al VPPB, un 19% se trata de VPPB multicanal, en casi la mitad (47,62%) se tuvieron que realizar más de tres maniobras para solucionarlo y tardó más de un mes en resolverse en más de la mitad (57,14%). Por otro lado, la EM era bilateral en el 19% de los pacientes, con un tiempo de evolución desde el diagnóstico de más de tres años en el 71,42%. Un tercio de los pacientes había presentado más de 10 crisis en los últimos seis meses, y fluctuación en la audición. En base a estos resultados, parece que los pacientes con EM avanzada tienen más probabilidades de presentar VPPB y con peor resultado en su tratamiento. Conclusión: La aparición conjunta del VPPB y la EM podría afectar al pronóstico de ambas patologías por separado. (AU)

Introuction and objective: Benign Paroxysmal Positional Vertigo (BPPV) is more frequent within the subgroup of patients with Menière's Disease (MD). The present study aims to describe the clinical characteristics of both BPPV and MD, when they are associated. Method: We carried out a retrospective analysis of 22 patients with MD diagnosed with BPPV between 1999 and 2021 at the University Assistance Complex of Salamanca. Clinical variables were collected, both from the characteristics of BPPV and MD. Results: In our database, 66.66% of the 22 patients were women with a mean age of 59.33 years. The most frequently affected semicircular canal was the posterior right. Regarding BPPV, 19% are multichannel BPPV, in almost half (47.62%) more than three maneuvers had to be performed to solve it and it took more than a month to resolve it in more than half (57.14%). On the other hand, MD was bilateral in 19% of patients, with a time since diagnosis of more than three years in 71.42%. A third of the patients had presented more than 10 crises in the last six months, and fluctuation in hearing. Based on these results, it appears that patients with advanced MD are more likely to have BPPV and have a worse treatment outcome. Conclusion: The joint appearance of BPPV and MD could affect the prognosis of both pathologies separately. (AU)

Early Diagnosis of Central Disorders Mimicking Horizontal Canal Cupulolithiasis.

BACKGROUND: Horizontal Canal Cupulolithiasis (hc-BPPV-cu) can mimic a pathology of central origin, so a careful examination is essential to prevent misdiagnosis. METHODS: Retrospective cross-sectional cohort study of 45 patients suffering from suspected hc-BPPV-cu. We recorded whether patients first presented through an ENT Emergency Department (ED) or through an Outpatient Otolaryngology Clinic (OC). RESULTS: We found statistically significant differences (p < 0.05) between the OC versus the ED in relation to the time between symptom onset and first assessment (79.7 vs. 3.6 days, respectively), the number of therapeutic maneuvers (one maneuver in 62.5% vs. 75.9%, and more than one in 25.1% vs. 13.7%), and multi-canal BPPV rate (43.8% vs. 3.4%). hc-BPPV-cu did not resolve in 2 patients (12.5%) from the OC and in 3 (10.3%) from de ED, all of which showed central pathology. DISCUSSION: There are no prior studies that analyze the approach to hc-BPPV-cu in the ED. The benefits of early specialist input are early identification of central positional nystagmus, a decrease in symptom duration, reduced number of therapeutic maneuvers required for symptom resolution, and lower rates of iatrogenic multi-canal BPPV. CONCLUSION: A comprehensive approach to hc-BPPV-cu in the ED allows both more effective treatment and early identification of central disorder mimics.

On-Farm Health Screening Needs of Immigrant Dairy Workers in the Texas Panhandle and South Plains.

The objective of this pilot study was to determine the health needs of dairy farm workers and the feasibility of on-farm health risk screenings in the Texas Panhandle and South Plains. A cross-sectional study design was used to collect survey responses concerning health needs, occupational, and economic characteristics among 300 dairy workers between April 2020 and July 2021. Participants were predominantly immigrant Hispanic (88.8%) males (83.0%) of approximately 34.4 (SD 9.9) years of age, worked 6.0 (SD 0.4; Range 3-7) days a week and 9.9 (SD 1.5; Range 6-13) hours a day, earning a mean hourly rate of $13.40 (SD $2.80). Participants reported interest in attending on-farm health risk screenings (93.8%) as well as receiving a COVID-19 vaccine if it became available (86.4%). Health service categories were ranked from: (1st "most important") preventative care (Mean Rank 2.3), (2nd) laboratory and diagnostic care (Mean Rank 2.6), (3rd) nutritional and physical fitness support (Mean Rank 2.8), (4th) mental health care (Mean Rank 3.4), and (5th) workplace interventions (Mean Rank 3.6). Participants reported obtaining health information predominantly from internet searches (32.0%) and social media (17.7%). Findings suggest there is need and interest for on-farm health risk screenings and education among immigrant dairy workers in the Texas Panhandle-South Plains region. Addressing known barriers to health should be paramount to the organization of on-farm health risk screenings.

The impact of a two-year long COVID-19 public health restriction program on mechanical thrombectomy outcomes in a stroke network.

OBJECTIVE: The purpose of this study was to evaluate the impact of COVID-19 pandemic public health restrictions on our drip and ship mechanical thrombectomy program in Santiago Chile. MATERIALS AND METHODS: This was a retrospective analysis of a prospectively collected database comparing two cohorts, one during a two-year period before COVID-19 and the second during the two years of the pandemic at our metropolitan stroke program. RESULTS: A total of 100 patients were included in the pre COVID-19 cohort (cohort 1) and 121 in the COVID-19 cohort (cohort 2). There was a significant difference between cohorts, with older patients, different occlusion sites and higher door to arterial puncture time during the COVID-19 period. A non-significant trend for worse 90-day outcomes and higher mortality was present in cohort 2. There were no statistical differences in safety treatment parameters. CONCLUSIONS: COVID-19 pandemic has had a measurable impact on our mechanical thrombectomy program. Results showed similarities to other reported Latin American series, where less robust health systems could adapt less efficiently compared to developed countries. After two years of public health restrictions, there were changes in the treatment population characteristics, delay in some internal management metrics and a non-significant trend to worse 90-day outcomes and higher mortality.

Tratamientos psicológicos para la adicción a videojuegos en adolescentes y adultos jóvenes: una revisión sistemática / Psychological Treatments for Video Game Adicction in Adolescents and Young Adults: a Systematic Review

La adicción a los videojuegos constituye un problema relevante, pues se encuentra vinculado a numerosas alteraciones psicosociales. El objetivo de este trabajo fue conocer los tratamientos psicológicos para la adicción mencionada y determinar su eficacia. Se realizó una búsqueda bibliográfica en 7 bases de datos. Se obtuvo 2.355 artículos, de los que 21 cumplieron los criterios de inclusión. Se examinaron las características de los participantes, el diseño de los estudios, el riesgo de sesgo y la calidad de los estudios, el método de diagnóstico, el tipo de intervención y los efectos de las intervenciones. La Terapia Cognitivo Conductual (TCC) ha sido ampliamente estudiada, encontrándose disminuciones significativas en las variables contempladas (reducción de la sintomatología y/o tiempo de juego) en la mayoría de los estudios analizados. Sin embargo, la falta de rigurosidad en los diseños empleados y los sesgos asociados, impide ubicarla en la categoría de tratamientos bien establecidos según las normas APA. No obstante, existen indicios experimentales prometedores de que estas intervenciones pueden alcanzar los niveles de eficacia postulados. Esto mismo ocurre con los tratamientos catalogados como otros enfoques de tratamiento, a pesar de que estos todavía se encuentran en una fase experimental. Por esta razón, es necesario que investigaciones futuras superen las limitaciones metodológicas propias de los estudios realizados hasta el momento. (AU)

Video game addiction is a relevant problem, as it is linked to numerous psychosocial disorders. The objective of this work was to know the psychological treatments for the aforementioned addiction and to determine their effectiveness. A bibliographic search was carried out in 7 databases. 2,355 articles were obtained, of which 21 met the inclusion criteria. Participant characteristics, study design, risk of bias and quality of studies, method of diagnosis, type of intervention, and effects of interventions were examined. Cognitive-Behavioral Therapy (CBT) has been widely studied, finding significant decreases in the variables contemplated (reduction of symptoms and/or playing time) in most of the studies analyzed. However, the lack of rigor in the designs used and the associated biases make it impossible to place it in the category of well-established treatments according to the APA standards. However, there is promising experimental evidence that these interventions can achieve the postulated levels of efficacy. The same is true for treatments listed as other treatment approaches, even though these are still in an experimental phase. For this reason, future research needs to overcome the methodological limitations of the studies carried out to date. (AU)

Analyzing the role of reoperation in recurrent glioblastoma: a 15-year retrospective study in a single institution.

BACKGROUND: Multiple treatment options at glioblastoma progression exist, including reintervention, reirradiation, additional systemic therapy, and novel strategies. No alternative has been proven to be superior in terms of postprogression survival (PPS). A second surgery has shown conflicting evidence in the literature regarding its prognostic impact, possibly affected by selection bias, and might benefit a sparse subset of patients with recurrent glioblastoma. The present study aims to determine the prognostic influence of salvage procedures in a cohort of patients treated in the same institution over 15 years. METHODS: Three hundred and fifty patients with confirmed primary glioblastoma diagnosed and treated between 2005 and 2019 were selected. To examine the role of reoperation, we intended to create comparable groups, previously excluding all diagnostic biopsies and patients who were not actively treated after the first surgery or at disease progression. Uni- and multivariate Cox proportional hazards regression models were employed, considering reintervention as a time-fixed or time-dependent covariate. The endpoints of the study were overall survival (OS) and PPS. RESULTS: At progression, 33 patients received a second surgery and 84 were treated with chemotherapy only. Clinical variables were similar among groups. OS, but not PPS, was superior in the reintervention group. Treatment modality had no impact in our multivariate Cox regression models considering OS or PPS as the endpoint. CONCLUSIONS: The association of reoperation with improved prognosis in recurrent glioblastoma is unclear and may be influenced by selection bias. Regardless of our selective indications and high gross total resection rates in second procedures, we could not observe a survival advantage.

Safety and Non-Inferiority Evaluation of Two Immunization Schedules with an Inactivated SARS-CoV-2 Vaccine in Adults: A Randomized Clinical Trial.

Several vaccines have been developed to control the COVID-19 pandemic. CoronaVac®, an inactivated SARS-CoV-2 vaccine, has demonstrated safety and immunogenicity, preventing severe COVID-19 cases. We investigate the safety and non-inferiority of two immunization schedules of CoronaVac® in a non-inferiority trial in healthy adults. A total of 2302 healthy adults were enrolled at 8 centers in Chile and randomly assigned to two vaccination schedules, receiving two doses with either 14 or 28 days between each. The primary safety and efficacy endpoints were solicited adverse events (AEs) within 7 days of each dose, and comparing the number of cases of SARS-CoV-2 infection 14 days after the second dose between the schedules, respectively. The most frequent local AE was pain at the injection site, which was less frequent in participants aged ≥60 years. Other local AEs were reported in less than 5% of participants. The most frequent systemic AEs were headache, fatigue, and myalgia. Most AEs were mild and transient. There were no significant differences for local and systemic AEs between schedules. A total of 58 COVID-19 cases were confirmed, and all but 2 of them were mild. No differences were observed in the proportion of COVID-19 cases between schedules. CoronaVac® is safe, especially in ≥60-year-old participants. Both schedules protected against COVID-19 hospitalization.

Hearing loss in vestibular schwannoma

Introducción y objetivo: La hipoacusia es uno de los síntomas más frecuentes en el debut de un schwannoma vestibular (SV). El objetivo de este estudio es analizar la pérdida auditiva en pacientes con SV y determinar en qué medida se relaciona con el tamaño tumoral. Método: Se lleva a cabo un estudio retrospectivo observacional en 291 pacientes diagnosticados de SV entre 1995 y 2017 en el servicio de Otorrinolaringología y Cirugía Cervicofacial del Hospital Clínico Universitario de Salamanca analizándose diferentes datos pre y postoperatorios de los pacientes así como hallazgos radiológicos y quirúrgicos.Resultados: El síntoma más frecuente de consulta es la hipoacusia unilateral progresiva (31.6%). La asociación entre el tamaño del SV y la hipoacusia no es estadísticamente significativa (p=0.099).Conclusiones: La pérdida auditiva producida por un SV no es patrimonio de ningún estadio, aunque las pérdidas severas y profundas son más indicativas de neurinomas grados III-IV, y ante una pérdida auditiva leve o audición normal tendremos con más probabilidad un neurinoma grado I-II. (AU)

The most common reason for consultation in patients suffering from Vestibular Schwannoma (VS) is progressive hearing loss. The main objective of this study is analyzing the hearing loss in patients with VS and determining the extent to which the tumor grade and the hearing loss are related. Methods: An observational retrospective study was conducted with a sample of 291 patients diag-nosed with VS between 1995 and 2017 in the Department of Otorhinolaryngology and Head and Neck Surgery of the Tertiary Care Primary Center of Salamanca. We analyzed preoperative and postoperative data from patients with VS as well as radiological and surgical findings. Results: The most common reason for consultation at diagnosis was progressive unilateral hearing loss (31.6%). The relationship between the size of the VS and hearing loss in the patients who reported progressive unilateral hearing loss as a reason for consultation was not statistically significant (p=0.099). Conclusion: The most common reason for consultation in VS is progressive unilateral hearing loss. The hearing loss caused by VS does not have a statistically significant association with any tumor grade, although severe and profound hearing loss is more commonly associated with grade III-IV neurinomas, whereas mild hearing loss or normal hearing are more likely in grade I-II tumors. (AU)

Assessing sub-lethal effects of the dinitroaniline herbicide pendimethalin in zebrafish embryos/larvae (Danio rerio).

Pendimethalin is a dinitroaniline herbicide used to control broadleaf weeds by inhibiting the formation of microtubules during cell division. Its use on a variety of crops leads to its potential entry into aquatic environments, but little is known about its sub-lethal toxicity to early developmental stages of aquatic vertebrates. To address this knowledge gap, we assessed the toxicity of pendimethalin to zebrafish embryos and larvae by measuring mortality, developmental abnormalities, oxidative respiration, reactive oxygen species, gene expression, and locomotor activity following exposure to the herbicide throughout early development. Embryos at ~6 h post-fertilization (hpf) were exposed to either a solvent control (0.1% DMSO, v/v), embryo rearing medium (ERM), or one dose of either 1, 2.5, 5, or 25 µM pendimethalin for up to 7-days post fertilization depending on the bioassay. Exposure to 25 µM pendimethalin resulted in high prevalence of spinal curvature, tail malformations, pericardial edema, and yolk sac edema at 4 dpf, while exposure to 5 µM pendimethalin induced pericardial edema and lordosis in the fish exposed over 7 dpf. Exposure to pendimethalin up to 5 µM did not negatively impact oxidative respiration (e.g., basal respiration, oligomycin-induced ATP production) in embryos following a 24-h exposure. Pendimethalin did not induce reactive oxygen species at concentrations of 1-5 µM. Levels of transcripts associated with oxidative respiration and damage response were altered in 7d-larvae; cox1 mRNA was increased in larvae fish exposed to 1 µM while cox5a1 and sod2 mRNA were decreased with 2.5 µM exposure. The Visual Motor Response (VMR) test for light-dark response revealed that larval activity in the dark period was reduced for zebrafish exposed to >1 µM pendimethalin compared to ERM and DMSO solvent control groups. These data inform on the sub-lethal toxicity of pendimethalin to early stages of fish embryos and larvae.

CaMKII activation in early diabetic hearts induces altered sarcoplasmic reticulum-mitochondria signaling.

Prediabetic myocardium, induced by fructose-rich diet (FRD), is prone to increased sarcoplasmic reticulum (SR)-Ca2+ leak and arrhythmias due to increased activity of the Ca2+/calmodulin protein kinase II (CaMKII). However, little is known about the role of SR-mitochondria microdomains, mitochondrial structure, and mitochondrial metabolisms. To address this knowledge gap we measured SR-mitochondrial proximity, intracellular Ca2+, and mitochondrial metabolism in wild type (WT) and AC3-I transgenic mice, with myocardial-targeted CaMKII inhibition, fed with control diet (CD) or with FRD. Confocal images showed significantly increased spontaneous Ca2+ release events in FRD vs. CD WT cardiomyocytes. [3H]-Ryanodine binding assay revealed higher [3H]Ry binding in FRD than CD WT hearts. O2 consumption at State 4 and hydrogen peroxide (H2O2) production rate were increased, while respiratory control rate (RCR) and Ca2+ retention capacity (CRC) were decreased in FRD vs. CD WT isolated mitochondria. Transmission Electron Microscopy (TEM) images showed increased proximity at the SR-mitochondria microdomains, associated with increased tethering proteins, Mfn2, Grp75, and VDAC in FRD vs. CD WT. Mitochondria diameter was decrease and roundness and density were increased in FRD vs. CD WT specimens. The fission protein, Drp1 was significantly increased while the fusion protein, Opa1 was unchanged in FRD vs. CD WT hearts. These differences were prevented in AC3-I mice. We conclude that SR-mitochondria microdomains are subject to CaMKII-dependent remodeling, involving SR-Ca2+ leak and mitochondria fission, in prediabetic mice induced by FRD. We speculate that CaMKII hyperactivity induces SR-Ca2+ leak by RyR2 activation which in turn increases mitochondria Ca2+ content due to the enhanced SR-mitochondria tethering, decreasing CRC.