Short-term effects of fine particulate matter from biomass combustion and Saharan dust intrusions on emergency hospital admissions due to mental and behavioural disorders, anxiety and depression in Spain.

Climate change is affecting both the frequency and scale of wildfires, as well as the increase in the number of days with Saharan dust intrusions. Traditionally, studies have focused on the extent to which the increase in fine particulate matter (PM) has had an impact on cardio-respiratory diseases, but (apart from PM) not on how the meteorological and pollution conditions in these situations affect other diseases, such as those linked to mental health. This study therefore sought to ascertain how daily mean PM10, PM 2.5, NO2, O3 concentrations and daily maximum temperature in heat waves influence daily emergency hospital admissions in Spain caused by mental and behavioural disorders, depression and anxiety on days with PM from biomass combustion and/or Saharan dust intrusions, as compared to days without such conditions, across the period 2009-2018. Our results indicate that on days on which there is biomass combustion, PM concentrations have a statistically significant effect on emergency admissions due to mental disorders, probably related with the toxicity of these particles. Yet on days with intrusions of Saharan dust rather than PM, it is the other variables considered in the analysis that are most closely linked to these types of admissions. The results of this study thus point to the need to implement public health prevention plans which take into account the joint effect of various environmental risk factors that act synergistically in given situations.

Short-term effects of tropospheric ozone and other environmental factors on emergency admissions due to pregnancy complications: A time-series analysis in the Madrid Region.

Air pollution has been linked to adverse neonatal outcomes, mainly in the case of prolonged exposures. This study focuses on the short-term effects on maternal health. We conducted a retrospective ecological time-series study in the Madrid Region covering the period 2013-2018. The independent variables were mean daily concentrations of tropospheric ozone (O3), particulate matter (PM10/PM2.5) and nitrogen dioxide (NO2), as well as noise levels. The dependent variables were daily emergency hospital admissions due to complications in pregnancy, childbirth and the puerperium. Poisson generalised linear regression models were fitted to quantify the relative and attributable risks, controlling for trend, seasonality, the autoregressive nature of the series, and a number of meteorological factors. There were 318 069 emergency hospital admissions due to obstetric complications across the 2191 days of study. Of this total: 13 164 (95%CI: 9930-16 398) admissions were attributable to exposure to O3, the only pollutant to show a statistically significant (p < 0.05) association with admissions due to hypertensive disorders; and 10 575 (95%CI: 3573-17 566) admissions were attributable to daytime noise levels, while admissions due to hyperemesis gravidarum and vomiting were related to exposure to night noise. Other pollutants which also displayed statistically significant associations were: NO2 concentrations, with admissions due to vomiting and preterm labour; PM10 concentrations, with premature rupture of membranes: and PM2.5 concentrations, with total complications. Exposure to a range of air pollutants, and ozone in particular, is associated with a higher number of emergency hospital admissions due to gestational complications. Hence, surveillance of environmental effects on maternal health should be intensified, and plans and strategies to minimise these should be drawn up.

How heat waves, ozone and sunlight hours affect endocrine and metabolic diseases emergency admissions? A case study in the region of Madrid (Spain).

BACKGROUND: Studies which analyse the joint effect of acoustic or chemical air pollution variables and different meteorological variables on neuroendocrine disease are practically nonexistent. This study therefore sought to analyse the impact of air pollutants and environmental meteorological variables on daily unscheduled admissions due to endocrine and metabolic diseases in the Madrid Region from January 01, 2013 to December 31, 2018. MATERIAL AND METHODS: We conducted a longitudinal, retrospective, ecological study of daily time series analysed by Poisson regression, with emergency neuroendocrine-disease admissions in the Madrid Region as the dependent variable. The independent variables were: mean daily concentrations of PM10, PM2.5, NO2 and O3; acoustic pollution; maximum and minimum daily temperatures; hours of sunlight; relative humidity; wind speed; and air pressure above sea level. Estimators of the statistically significant variables were used to calculate the relative risks (RRs). RESULTS: A statistically significant association was found between the increase in temperatures in heat waves, RR: 1.123 95% CI (1.001-1.018), and the number of emergency admissions, making it the main risk factor. An association between a decrease in sunlight and an increase in hospital admissions, RR: 1.005 95% CI (1.002 1.008), was likewise observed. Similarly, ozone, in the form of mean daily concentrations in excess of 44 µg/m3, had an impact on admissions due to neuroendocrine disease, RR: 1.010 95% CI (1.007-1.035). The breakdown by sex showed that in the case of women, NO2 was also a risk factor, RR: 1.021 95% CI (1.007-1.035). CONCLUSION: The results obtained in this study serve to identify risk factors for this disease, such as extreme temperatures in heat waves, O3 or NO2. The robust association found between the decrease in sunlight and increase in hospital admissions due to neuroendocrine disease serves to spotlight an environmental factor which has received scant attention in public health until now.

Short-term impact of noise, other air pollutants and meteorological factors on emergency hospital mental health admissions in the Madrid region.

BACKGROUND: A number of environmental factors, such as air pollution, noise in urbanised settings and meteorological-type variables, may give rise to important effects on human health. In recent years, many studies have confirmed the relation between various mental disorders and these factors, with a possible impact on the increase in emergency hospital admissions due to these causes. The aim of this study was to analyse the impact of a range of environmental factors on daily emergency hospital admissions due to mental disorders in the Madrid Autonomous Region (MAR), across the period 2013-2018. METHODOLOGY: Longitudinal ecological time series study analysed by Generalised Linear Models with Poisson regression, with the dependent variable being daily Emergency Hospital Mental Health Admissions (EHMHA) in the MAR, and the independent variable being mean daily concentrations of chemical pollutants, noise levels and meteorological variables. RESULTS: EHMHA were related statistically significantly in the short term with diurnal noise levels. Relative risks (RRs) for total admissions due to mental disorders and self-inflicted injuries, in the case of diurnal noise was RR: 1.008 95%CI (1.003 1.013). Admissions attributable to diurnal noise account for 5.5% of total admissions across the study period. There was no association between hospital admissions and chemical air pollution. CONCLUSION: Noise is a variable that shows a statistically significant short-term association with EHMHA across all age groups in the MAR region. The results of this study may serve as a basis for drawing up public health guidelines and plans, which regard these variables as risk factors for mental disorders, especially in the case of noise, since this fundamentally depends on anthropogenic activities in highly urbanised areas with high levels of traffic density.

Short-term effects of air pollution and noise on emergency hospital admissions in Madrid and economic assessment.

INTRODUCTION: The aim of this study was to study the effect of air pollution and noise has on the population in Madrid Community (MAR) in the period 2013-2018, and its economic impact. METHODS: Time series study analysing emergency hospital admissions in the MAR due to all causes (ICD-10: A00-R99), respiratory causes (ICD-10: J00-J99) and circulatory causes (ICD-10: I00-I99) across the period 2013-2018. The main independent variables were mean daily PM2.5, PM10, NO2, 8-h ozone concentrations, and noise. We controlled for meteorological variables, Public Holidays, seasonality, and the trend and autoregressive nature of the series, and fitted generalised linear models with a Poisson regression link to ascertain the relative risks and attributable risks. In addition, we made an economic assessment of these hospitalisations. RESULTS: The following associations were found: NO2 with admissions due to natural (RR: 1.007, 95% CI: 1.004-1.011) and respiratory causes (RR: 1.012, 95% CI: 1.005-1.019); 8-h ozone with admissions due to natural (RR: 1.049, 95% CI: 1.014-1.046) and circulatory causes (RR: 1.088, 95% CI: 1.039-1.140); and diurnal noise (LAeq7-23h) with admissions due to natural (RR: 1.001, 95% CI: 1.001-1.002), respiratory (RR: 1.002, 95% CI: 1.001-1.003) and circulatory causes (RR: 1.003, 95% CI: 1.002-1.005). Every year, a total of 8246 (95% CI: 4580-11,905) natural-cause admissions are attributable to NO2, with an estimated cost of close on €120 million and 5685 (95% CI: 2533-8835) attributed to LAeq7-23h with an estimated cost of close on €82 million. CONCLUSIONS: Nitrogen dioxide, ozone and noise are the main pollutants to which a large number of hospitalisations in the MAR are attributed, and are thus responsible for a marked deterioration in population health and high related economic impact.

Does the meteorological origin of heat waves influence their impact on health? A 6-year morbidity and mortality study in Madrid (Spain).

BACKGROUND: In Spain, two synoptic-scale conditions influence heat wave formation. The first involves advection of warm and dry air masses carrying dust of Saharan origin (North African Dust (NAF) = 1). The second entails anticyclonic stagnation with high insolation and stability (NAF) = 0). Some studies show that the meteorological origin of these heat waves may affect their impact on morbidity and mortality. OBJECTIVE: To determine whether the impact of heat waves on health outcomes in Madrid (Spain) during 2013-2018 varied by synoptic-scale condition. METHODOLOGY: Outcome data consist of daily mortality and daily hospital emergency admissions (morbidity) for natural, circulatory, and respiratory causes. Predictors include daily maximum and minimum temperatures and daily mean concentrations of NO2, PM10, PM2.5, NO2, and O3. Analyses adjust for insolation, relative humidity, and wind speed. Generalized linear models were performed with Poisson link between the variables controlling for trend, seasonality, and auto-regression in the series. Relative Risks (RR) and Attributable Risks (AR) were determined. The RRs for mortality attributable to high temperatures were similar regardless of NAF status. For hospital admissions, however, the RRs for hot days with NAF = 0 are higher than for days with NAF = 1. We also found that atmospheric pollutants worsen morbidity and mortality, especially PM10 concentrations when NAF = 1 and O3 concentrations when NAF = 0. RESULTS: The effect of heat waves on morbidity and mortality depends on the synoptic situation. The impact is greater under anticyclonic stagnation conditions than under Saharan dust advection. Further, the health impact of pollutants such as PM10 and O3 varies according to the synoptic situation. CONCLUSIONS: Based on these findings, we strongly recommend prevention plans to include data on the meteorological situation originating the heat wave, on a synoptic-scale, as well as comprehensive preventive measures against the compounding effect of high temperatures and pollution.

Technological variables influencing the growth and stability of a silage inoculant based on spray-dried lactic acid bacteria.

AIMS: To investigate the influence of different culture media and fermentation conditions on growth performance and viability of three lactic acid bacteria (LAB) strains with potential as silage inoculants, and to optimize spray-drying in order to enhance survival to dehydration and storage stability. METHODS AND RESULTS: In house-formulated MRS was a suitable low-cost culture medium for Lactobacillus plantarum Hv75, Pediococcus acidilactici 3903 and L. buchneri B463. Uncontrolled pH biomass production conferred enhanced stability during storage at 4°C after spray-drying. The use of whey protein concentrate 35 (WPC)-maltodextrin (M) as matrix, inlet temperature of 145-150°C and air flow rate of 601 l h-1 was adequate for the production of dehydrated LAB. According to the desirability function, at this optimized condition, moisture content, yield and solubility were predicted to be 3·96, 73·68 and 90·36% respectively. Those conditions also showed a decrease of 0·855 log CFU per gram after drying, no loss in viability at 4°C for 6 months and 1 log CFU per gram reduction at 25°C. CONCLUSIONS: Stable and economically feasible dehydrated LAB cultures were obtained using alternative culture media, fermentation under uncontrolled pH and optimizing spray-drying process conditions through the desirability function method. SIGNIFICANCE AND IMPACT OF THE STUDY: Our results can be utilized for efficient production and commercialization of several dry LAB.

A meta-analysis on the effectiveness of homofermentative and heterofermentative lactic acid bacteria for corn silage.

AIMS: This meta-analysis aims to assess the effect of lactic acid bacteria (LAB) inoculation on fermentation parameters, microbiological composition and aerobic stability of corn silage. METHODS AND RESULTS: Databases (PubMed, ScienceDirect and Scopus) were searched from 1980 to 2017. The criteria for inclusion were: randomized and controlled experiments using corn silage and published in peer-reviewed journals. The meta-analysis showed that LAB supplementation increased pH, acetate and propionate concentrations, and decreased acid detergent fibre, water-soluble carbohydrates and ammoniacal nitrogen (NH3 -N) compared to controls in the pooled raw mean difference random effect model. In addition, inoculation reduced counts of yeasts and moulds, increased LAB counts and markedly improved aerobic stability in corn silage. However, results indicated that the effect of inoculants may differ depending on the administration of homofermentative or heterofermentative LAB. CONCLUSIONS: For the development of functional bacterial inoculants, both types of LAB should be used. SIGNIFICANCE AND IMPACT OF THE STUDY: To our knowledge, this is the first meta-analysis to compare the application of homofermentative and heterofermentative LAB for corn silage.

Study of the effects of spray drying in whey-starch on the probiotic capacity of Lactobacillus rhamnosus 64 in the gut of mice.

AIMS: To evaluate the effects of spray drying of Lactobacillus rhamnosus 64 on its capacity to modulate the gut immune response and on the attenuation of TNBS-induced colitis in mice. METHODS AND RESULTS: Lactobacillus rhamnosus 64 was spray dried in cheese whey-starch solution and administered to mice for 3, 6 or 10 consecutive days. Peritoneal macrophage phagocytic activity, secretory IgA levels in the small intestinal fluid and TNFα, IFNγ, IL-10, IL-6 and IL-2 levels in homogenates of the small and large intestine were determined. The effects of spray drying were also evaluated in an acute model of Trinitrobenzenesulfonic acid (TNBS)-induced colitis. A shift in the regulation of immune parameters, particularly the cytokine profile, was observed for mice treated with the spray-dried culture, compared to the profile observed in animals that received the strain as fresh culture (FC). The spray-dried culture of L. rhamnosus 64 showed anti-inflammatory properties in murine model of TNBS-induced colitis. CONCLUSIONS: The spray-drying process of L. rhamnosus 64 in whey-starch modified its immunomodulating capacity in healthy animals and conferred enhanced protection in an in vivo model of inflammation. SIGNIFICANCE AND IMPACT OF THE STUDY: Probiotic capacity can be affected by spray drying in relation to the properties observed for the strain as an overnight FC. This fact should be taken into account when producing the culture for its application in the industry.

Trapping and manipulation of microparticles using laser-induced convection currents and photophoresis.

In this work we demonstrate optical trapping and manipulation of microparticles suspended in water due to laser-induced convection currents. Convection currents are generated due to laser light absorption in an hydrogenated amorphous silicon (a:Si-H) thin film. The particles are dragged towards the beam's center by the convection currents (Stokes drag force) allowing trapping with powers as low as 0.8 mW. However, for powers >3 mW trapped particles form a ring around the beam due to two competing forces: Stokes drag and thermo-photophoretic forces. Additionally, we show that dynamic beam shaping can be used to trap and manipulate multiple particles by photophotophoresis without the need of lithographically created resistive heaters.

Comunicación bidireccional entre el sistema inmune y neuroendocrino a través de la hormona de crecimiento, prolactina y hepcidina / Bidirectional communication between neuroendocrine and immune systems through growth hormone, prolactin and hepcidin

Se ha planteado que la hormona de crecimiento (GH) y la Prolactina (PRL) pueden intervenir en procesos infecciosos como inmunomoduladores vía receptores específicos; revelando una conexión entre el sistema inmune y el sistema endocrino en los tejidos, donde actúan como citoquinas a través de diferentes rutas de señalización. Igualmente, la hepcidina (HAMP), hormona producida en los hepatocitos como respuesta al exceso de hierro y a estímulos inflamatorios, es considerada un enlace entre el metabolismo del mineral, la defensa del hospedero y los procesos inflamatorios, debido a su capacidad de privar del hierro a los microorganismos. Se sugiere que en un proceso infeccioso, la síntesis, secreción y regulación de GH ocurre a través de la producción de citoquinas como factor de necrosis tumoral alfa (TNF-α) e interleuquina-1 beta (IL-1β), las cuales actúan en el hipotálamo, estimulando la liberación ya sea de la hormona liberadora de somatotropina o de somatostatina; por otro lado, se ha reportado que células linfoides, incluyendo linfocitos T y B y células dendríticas, producen GH, PRL biológicamente activa con propiedades inmunoreguladoras.

It has been proposed that growth hormone (GH) and prolactin (PRL) may act as immunomodulators in infectious processes via specific receptors, revealing a connection between the immune and endocrine systems in the tissues where they act as cytokines through different signaling pathways. Similarly, hepcidin (HAMP), a hormone produced in hepatocytes in response to excess iron and inflammatory stimuli, is considered a link between mineral metabolism, host defense and inflammatory processes because of its ability to deprive microorganisms of iron. It is suggested that in an infectious process, synthesis, and regulation of GH secretion occurs through the production of cytokines such as necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β), which act in the hypothalamus by stimulating the release of either somatostatin or somatotropin hormones; on the other hand, it has been reported that lymphoid cells including T and B lymphocytes and dendritic cells produce GH, and biologically active PRL with immunoregulatory properties.

Suitability of buttermilk for fermentation with Lactobacillus helveticus and production of a functional peptide-enriched powder by spray-drying.

AIM: To ferment buttermilk, a low-cost by-product of the manufacture of butter, with a proteolytic strain of Lactobacillus helveticus, to enhance its value by the production of a functional peptide-enriched powder. METHODS AND RESULTS: Buttermilk was fermented with Lact. helveticus 209, a strain chosen for its high proteolytic activity. To enhance the release of peptidic fractions, during fermentation pH was kept at 6 by using NaOH, Ca(CO)(3) or Ca(OH)(2). Cell-free supernatant was recovered by centrifugation, supplemented or not with maltodextrin and spray-dried. The profile of peptidic fractions released was studied by RP-HPLC. The lactose, Na and Ca content was also determined. The powder obtained was administered to BALB/c mice for 5 or 7 consecutive days, resulting in the proliferation of IgA-producing cells in the small intestine mucosa of the animals. CONCLUSIONS: Buttermilk is a suitable substrate for the fermentation with Lact. helveticus 209 and the release of peptide fractions able to be spray-dried and to modulate the gut mucosa in vivo. SIGNIFICANCE AND IMPACT OF THE STUDY: A powder enriched with peptides released from buttermilk proteins, with potential applications as a functional food additive, was obtained by spray-drying. A novel use of buttermilk as substrate for lactic fermentation is reported.

Role of L-arginine, a substrate of nitric oxide biosynthesis, on intestinal ischemia-reperfusion in rabbits.

To study whether treatment with L-arginine (ARG), a substrate of nitric oxide biosynthesis, attenuates intestinal dysfunction caused by ischemia (I) and reperfusion (R), rabbits treated with ARG (100 mgxkg(-1), intravenously) or saline solution (SS) prior to I (60 minutes) by occlusion of superior mesenteric artery and/or during R (120 minutes). After I or I/R, 2-cm jejunal segments were isolated and mounted in an organ bath to study of neurogenic contractions stimulated by electrical pulses or KCl using a digital recording system. Thin jejunal slices were stained (hematoxylin and eosin) for analysis by optical microscopy. Compared to the sham group, jejunal contractions were similar in I + ARG, but reduced in I + SS, I/R + SS, and I/R + ARG groups. The jejunal enteric nerves were damaged in I + SS, I/R + SS, and I/R + ARG, but not in I + ARG group, suggesting that ARG can attenuate intestinal dysfunctions due to I, but not to R.

[Prevalence and functional effect of arteriovenous fistula calcifications, evaluated by spiral CT in chronic haemodialysis patients]. / Prevalencia y efecto funcional de las calcificaciones de la fístula arteriovenosa evaluadas mediante TAC helicoidal en pacientes en hemodiálisis crónica.

INTRODUCTION: Vascular calcification is a common finding in patients (pts) with end-stage renal disease (ESRD). OBJECTIVE: The aim of this cross-sectional study was to investigate the prevalence and functional effect of native arteriovenous fistula AVF (feeding artery and/or arterialized vein) calcifications evaluated by spiral computed tomography (CT) in ESRD pts undergoing chronic hemodialysis (HD). PATIENTS AND METHOD: Forty-five upper limb AVF (radial 44.4% or brachial 55.6%, mean duration 65.3 +/- 80.9 months) without evidence of significant stenosis were evaluated by CT in 45 ESRD pts (mean age 63.8 +/- 13.1 yr; sex M: 71.1%, F: 28.9%; mean time on HD 53.1 +/- 51.9 months; diabetic nephropathy 15.6%). All AVF explorations were performed using the same multi-slice spiral CT scanner (HiSpeed Dual machine, GE Medical Systems). The severity of AVF calcifications was quantified by CT using the following criteria: grade I absence of calcifications, grade II isolated calcifications (<10 groups of calcification), grade III moderate calcifications (10-20 groups of calcification) and grade IV diffuse calcifications (>20 groups of calcification). Laboratory parameters analyzed: calcium, phosphorus, parathyroid hormone; calcium x phosphorus product was calculated. The same week of CT scanning, we evaluated AVF function measuring the blood flow rate (QA). We determined QA (1559.3 +/- 980.6 ml/min) by the Delta-H method (ABF-mode, HemaMetrics, USA) using the Crit-Line III monitor (68.9%) or by Doppler ultrasound (31.1%) performed by the same radiologist using a 5-8 MHz linear transducer (Sequoia machine, Siemens-Acuson); mean arterial pressure MAP (94.7 +/- 16.3 mmHg) was recorded simultaneous with QA. RESULTS: Most pts not showed AVF calcification by CT scan (grade I: 27/45, 60%). Forty percent of pts (18/45) demonstrated any degree of AVF calcification (grade II 13.3%, grade III 8.9%, grade IV 17.8%). Pts with brachial AVF showed higher mean QA compared to pts with radial AVF (1899.1 +/- 1131.8 versus 1134.5 +/- 516.4 ml/min, p=0.005), but MAP (91.2 +/- 15.8 versus 99.0 +/- 16.2 mmHg) and the prevalence of AVF calcification (32% versus 50%) were not different between both groups (p=0.11 and p=0.24, respectively). Pts with evidence of any calcification on CT scanning (grade II, III or IV) had higher time on HD (84.6 +/- 63.1 versus 24.6 +/- 20.0 months), higher AVF duration (97.7 +/- 89.3 versus 34.6 +/- 61.2 months) and similar QA (1488.3 +/- 678.9 versus 1606.6 +/- 1148.9 ml/min) compared with pts without AVF calcification (p=0.014, p=0.001 and p=0.69, respectively); no differences in MAP (95.4 +/- 13.8 versus 94.2 +/- 17.9 mmHg), prevalence of brachial AVF (44% versus 63%) or mineral metabolism parameters were found when comparing both groups (for all comparisons, p=NS). The same results were obtained when comparing pts with a high (grade III-IV: 26.7%) and a low (grade I-II: 73.3%) AVF calcification score, or when comparing pts with diffuse (grade IV) and without (grade I) AVF calcification. CONCLUSIONS: 1) The prevalence of AVF calcification by CT scan was 40%. 2) The AVF calcification was related with time on HD and AVF duration. 3) The function of fully developed AVF without stenosis and suitable for routine HD was not impaired by the presence of calcifications.

Prevalencia y efecto funcional de las calcificaciones de la fístula arteriovenosa evaluadas mediante TAChelicoidal en pacientes en hemodiálisis crónica / No disponible

Introducción: se ha objetivado una mayor prevalencia, precocidad, extensión y velocidad de progresión de las calcificaciones vasculares en los pacientes en hemodiálisis crónica (HD) respecto a la población general .Objetivo: investigar la prevalencia y el efecto funcional de les calcificaciones de la fístula arteriovenosa FAVI (arteria nutricia o vena arterializada) evaluadas por TAC helicoidal (TACh) en pacientes en HD. Pacientes y método: cuarenta y cinco FAVI ( radial 44,4% o humeral 55,6%, duración media 65,3 ± 80,9 meses) sin evidencia de estenosis significativa se estudiaron por TACh en 45 pacientes (edad media 63,8 ± 13,1 años; género V: 71,1%, M: 28,9%; tiempo medio en HD 53,1 ±51,9 meses; nefropatía diabética 15,6%). Todas las exploraciones de la FAVI se efectuaron mediante el mismo aparato de TACh multidetector (..) (AU)

Introduction. Vascular calcification is a common finding in patients (pts) with end-stage renal disease(ESRD). Objective. The aim of this cross-sectional study was to investigate the prevalence and functional effect of native arteriovenous fistula AVF (feeding artery and/or arterialized vein) calcifications evaluated by spiral computed tomography (CT) in ESRD pts undergoing chronic hemodialysis (HD). Patients and method. Forty-five upper limb AVF (radial 44.4% or brachial55.6%, mean duration 65.3 ± 80.9 months) without evidence of significant stenos is were evaluated by CT in45 ESRD pts (mean age 63.8 ± 13.1 yr; sex M: 71.1%, F:28.9%; mean time on HD 53.1 ± 51.9 months; diabetic (..) (AU)

Association of serum pepsinogen with atrophic body gastritis in Costa Rica.

Individuals with atrophic gastritis (AG), especially atrophic body gastritis (ABG), are at increased risk of developing gastric cancer. Serum concentrations of pepsinogens (PG) have been proposed as markers for ABG. The aim of this study was to determine the risk factors for AG and ABG and the potential of using serum PG concentrations to detect ABG in a dyspeptic population in Costa Rica, which is one of the countries with the highest incidence and mortality rates of gastric cancer in the world. Seven biopsy specimens, a fasting blood sample and a questionnaire concerning sociodemographic factors were obtained from 501 consecutive dyspeptic patients. The serum PGI level and the PGI/PGII ratios were significantly lower in patients with ABG than in other groups (P<0.000). A cut-off point of 3.4 led to a sensitivity of 91.2% in identifying ABG, a negative predictive value of 98.1%, but a positive predictive value of only 11.2%. Helicobacter pylori were present in 93% of the patients and all those with peptic ulcers were positive. AG was associated with increased age, lower body mass index, high alcohol intake and low fruit consumption. ABG was associated with age, alcohol consumption and PGI/PGII<3.4. In dyspeptic patients with a high prevalence of H. pylori infection, serum PG levels provide an assessment of ABG but it is necessary to introduce other serological and genetic markers in order to achieve a better specificity. Those markers could be serum antibodies to H. pylori-CagA, cytokine gene polymorphisms or others.

Pedro Ara anatomic museum.

Museums where anatomical pieces are exhibited are disappearing. The advance of the computer together with the advance of conventional and three-dimensional radiology makes the organs to be exposed without practicing dissection and the virtual images replace the real ones in the educational process. Some current laws that restrict the use of corpses and fetuses for obituary and exhibition studies have also contributed to the tendency. The anatomical museum, today named Pedro Ara, was founded in December 1920 and it exhibits anatomic works from the embryonic stage to old age, contributing unbeatable teachings to the medical sciences and the general public. The museum is located in the Angel Roque Suarez Anatomic Institute in the Clinical National Hospital which depends on the National University of Cordoba. It is visited daily by hundreds of people from all over the world. The museum owns 1211 pieces that combine ethical, scientific, aesthetical and educational values achieving a realization that received international acknowledgement. The most valuable exhibited work is 'Old man's head' made by Professor Pedro Ara in 1928-1929 (Figure 1), which, owing to its high quality, is in an impeccable and unharmed condition despite being exhibited for 80 years. Other authors, such as Professor Humberto Fracassi, also enriched the museum with their work and we, convinced that it favors and will favor our human formation and professional training, have the privilege of being their heirs and the responsibility of being their followers.

Hidropesía fetal secundaria a infección por parvovirus B19 / Hydrops fetalis secondary to parvovirus B19 infection

La infección intrauterina por parvovirus (B19) se asocia con hidropesía fetal no inmune, aborto espontáneo y muerte fetal. Las recientes mejoras en el diagnóstico de la infección por parvovirus y la disponibilidad de la transfusión intrauterina han reducido mucho la incidencia de pérdida fetal tras la exposición materna. Presentamos un caso de hidropesía fetal no inmune diagnosticado por ecografía prenatal en la semana 21 de gestación asociada a hipertensión arterial materna, edemas y proteinuria. La cordocentesis demostró la presencia de parvovirus en sangre fetal mediante PCR. La gestación finalizó en aborto terapéutico debido al empeoramiento del estado materno

Intrauterin infection with parvovirus B19 is associated with non-immune hydrops fetalis, spontaneous abortion and fetal death. Recent improvements in diagnosing parvovirus infections and the availability of intrauterine transfusion have reduced the overall rate of fetal loss after maternal exposure. We present a case of non-immune hydrops fetalis diagnosed by antenatal ultrasound at 21 weeks of gestation associated with maternal hypertension, edemas and proteinuria. Cordocentesis demonstrated by PCR in fetal blood the presence of parvovirus. The pregnancy finished in therapeutic miscarriage due to the worsening maternal status

Prevalencia del virus de hepatitis C y factores de riesgo asociado en el personal de salud del Hospital IVSS Dr. Miguel Pérez Carreño / Prevalence of the hepatitis C. like viruse and risk factors associate to health personnel of the IVSS Dr. Miguel Pérez Carreño hospital

Objetivo evaluar la prevalencia del Anti-VHC en el personal de salud del Hospital IVSS Dr. Miguel Pérez Carreño, asimismo determinar los factores de riesgo asociados. Se observó una prevalencia del 2.11 por ciento para Anti-VHC en la muestra estudiada; siendo el sexo femenino el predominante. El grupo de edad más frecuente fue entre 40 a 46 años de edad con un 44.44 por ciento (n=8). Los factores de riesgo que tuvieron mayor frecuencia fueron: Intervenciones odontológicas, antecedentes quirúrgicos, pinchazos accidentales, enfermedad hepática familiar y transfusiones sanguíneas. Siendo las transfusiones sanguíneas y los trabajos odontológicos estadísticamente significativos

A recombinant envelope protein from Dengue virus purified by IMAC is bioequivalent with its immune-affinity chromatography purified counterpart.

Semi-purified DEN-4 envelope protein, obtained in Pichia pastoris, was capable of generating neutralising and protecting antibodies after immunisation in mice. Here we compared two purification processes of this recombinant protein using two chromatographic steps: immune-affinity chromatography and immobilised metal ion adsorption chromatography (IMAC). The protein purified by both methods produced functional antibodies reflected by titres of haemagglutination inhibition and neutralisation. IMAC could be used as an alternative for high scale purification.