Three-month functional prognosis of patients hospitalised due to acute ischaemic stroke in Aragon: regional analysis of the impact of COVID-19.

INTRODUCTION: The COVID-19 pandemic has had an impact on ischaemic stroke management, with a reported decrease in hospital admissions, and even disruptions in healthcare and increased in-hospital mortality. However, there is a lack of evidence on the impact of the pandemic on functional prognosis. The aim of this study is to analyse the effect of the COVID-19 pandemic on the 3-month functional outcomes of patients hospitalised due to acute ischaemic stroke in Aragon (Spain). METHODS: We reviewed the data of all patients admitted due to ischaemic stroke to any hospital in our regional healthcare system between 30 December 2019 and 3 May 2020. We compared modified Rankin Scale scores and mortality at 3 months in patients hospitalised before and after the declaration of a state of emergency due to the COVID-19 pandemic. RESULTS: In total, 318 patients with acute ischaemic stroke met our inclusion criteria. No differences were observed between periods in global or specific characteristics, with the exception of a higher proportion of patients older than 80 years during the first period (42.2% vs 29.0%, P = .028). In the comparative analysis, we found no significant differences in mortality (12.3 vs 7.9, P = .465) or in the proportion of patients with modified Rankin Scale scores ≤ 2 (57.7% vs 57.1%, P = .425) at 3 months. CONCLUSION: To our knowledge, this is the first study to analyse the impact of COVID-19 pandemic on the 3-month functional outcomes of patients with ischaemic stroke. In our region, there has been no increase in rates of mortality or disability at 3 months in patients admitted due to ischaemic stroke during the pandemic.

[Three-month functional prognosis of patients hospitalised due to acute ischaemic stroke in Aragon: Rregional analysis of the impact of COVID-19]. / Pronóstico funcional a 3 meses de pacientes hospitalizados por ictus isquémico agudo en Aragón: análisis regional de la repercusión de la COVID-19.

Introduction: The COVID-19 pandemic has had an impact on ischaemic stroke management, with a reported decrease in hospital admissions, and even disruptions in healthcare and increased in-hospital mortality. However, there is a lack of evidence on the impact of the pandemic on functional prognosis. The aim of this study is to analyse the effect of the COVID-19 pandemic on the 3-month functional outcomes of patients hospitalised due to acute ischaemic stroke in Aragon (Spain). Materil and methods: We reviewed the data of all patients admitted due to ischaemic stroke to any hospital in our regional healthcare system between 30 December 2019 and 3 May 2020. We compared modified Rankin Scale scores and mortality at 3 months in patients hospitalised before and after the declaration of a state of emergency due to the COVID-19 pandemic. Results: In total, 318 patients with acute ischaemic stroke met our inclusion criteria. No differences were observed between periods in global or specific characteristics, with the exception of a higher proportion of patients older than 80 years during the first period (42.2% vs. 29.0%, P=.028). In the comparative analysis, we found no significant differences in mortality (12.3 vs. 7.9, P=.465) or in the proportion of patients with modified Rankin Scale scores ≤ 2 (57.7% vs. 57.1%, P=.425) at 3 months. Conclusion: To our knowledge, this is the first study to analyse the impact of COVID-19 pandemic on the 3-month functional outcomes of patients with ischaemic stroke. In our region, there has been no increase in rates of mortality or disability at 3 months in patients admitted due to ischaemic stroke during the pandemic.

Corea secundaria a encefalitis estriatal por anticuerpos CV2/CRMP5. Descripción de un caso y revisión de la literatura / Chorea secondary to striatal encephalitis due to anti-CV2/CRMP5 antibodies. Case description and review of the literature

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Effects of dietary fat saturation on fatty acid composition and gene transcription in different tissues of Iberian pigs.

The effect of two diets, respectively enriched with SFA (S) and PUFA (P), on FA tissue composition and gene expression was studied in fattened Iberian pigs. The FA composition of adipose, muscular and liver tissues was affected by dietary treatment. S group showed higher MUFA and MUFA/SFA ratio and lower PUFA and n-6/n-3 ratio than P group in all analyzed tissues. In muscle and liver the extracted lipids were separated into neutral lipids and polar lipid fractions which showed significantly different responses to the dietary treatment, especially in liver where no significant effect of diet was observed in NL fraction. The expression of six candidate genes related to lipogenesis and FA oxidation was analyzed by qPCR. In liver, stearoyl CoA desaturase (SCD), acetyl CoA carboxylase alpha (ACACA) and malic enzyme 1 (ME1) genes showed higher expression in S group. SCD, ACACA, ME1, and fatty acid synthase (FASN) gene expression levels showed a wide variation across the tested tissues, with much higher expression levels observed in adipose tissue than other tissues. Tissue FA profile and gene expression results support the deposition of dietary FA, the lipogenic effect of dietary saturated fat in liver and the employment of saturated dietary fat for endogenous synthesis of MUFA in all the analyzed tissues.

Rapid chromatographic determination of caseins in milk with photometric and fluorimetric detection using a hydrophobic monolithic column.

Reverse-phase liquid chromatographic methods using a hydrophobic C18 monolithic column and on-line photometric and fluorimetric detection for the determination of the major casein (CN) proteins in milk are presented. The separation of αs1-CN, αs2-CN, ß-CN and κ-CN was achieved in only five minutes. Fluorimetric detection enabled better analytical results than photometric detection. Thus, the dynamic ranges of the calibration graphs and detection limits obtained using fluorimetric detection were (mgmL(-)(1)): αs1-CN (0.74-10.0, 0.22), αs2-CN (0.15-10.0, 0.045), ß-CN (0.68-10.0, 0.20) and κ-CN (0.21-10.0, 0.06). The analytical features of the photometric method, which does not allow the quantification of ß-casein, were (mgmL(-)(1)): αs1-CN (1.5-9.0, 0.45), αs2-CN (1.4-10.0, 0.43) and κ-CN (0.4-9.0, 0.12). Precision data, expressed as relative standard deviation, ranged between 0.6% and 5.3% for the fluorimetric method and between 2.4% and 6.2% for the photometric method. Both methods were applied to the analysis of three different milk samples, obtaining recoveries in the ranges of 86.6-103.2% and 92.0-106.5% using fluorimetric and photometric detection, respectively.

Respuesta histológica completa a la neoadyuvancia en cáncer gástrico avanzado / Histological complete response after neoadjuvant therapy in advanced gastric cancer

Introduction: this article describes the first case in Peru where a patient with an advanced gastric cancer showed pathologic complete response to neoadjuvance indicated due an extensive involvement of paraaortic and celiac trunk lymph nodes. Clinical case: 51 year old female patient, after 4 cycles of chemotherapy, the former with epirubicin, cisplatin and capecitabine and the remaining three with epirubicin, cisplatin and 5-fluorouracil, a complete response was obtained from the tomographic point of view. Later patient underwent total gastrectomy with D2 lymphadenectomy. Microscopic examination of the surgical specimen verified only scar tissue without evidence of malignancy in both, the stomach and the lymph nodes removed. Further we present a review of the relevant medical literature to date.

Introducción: el presente artículo describe el primer caso en el Perú en el que una paciente con cáncer gástrico avanzado ha mostrado respuesta completa histopatológica a neoadyuvancia. Caso clínico: paciente mujer de 51 años con cáncer gástrico con un extenso compromiso ganglionar para-aórtico y a nivel del tronco celíaco. Luego de 4 ciclos de quimioterapia, el primero con epirrubicina, cisplatino y capecitabina y los 3 restantes con epirrubicina, cisplatino y 5-fluoruracilo, se obtiene una respuesta completa desde el punto de vista tomográfico, por ello la paciente fue sometida a gastrectomía total con linfadenectomía D2 verificándose en el examen microscópico de la pieza operatoria sólo tejido cicatricial sin evidencias de neoplasia maligna tanto en el estómago como en los ganglios linfáticos resecados. A propósito del caso se hace una revisión de la literatura médica relevante actualizada.

Modulation of allergic response by gene-environment interaction: olive pollen allergy.

This article summarizes the most important advances of recent years in the field of gene-environment interaction in allergic response. It specifically examines sensitization to olive pollen as an example of one of the main causes of allergic disease in the Mediterranean area. The presence of at least 20 proteins with allergic activity has been demonstrated in olive pollen, and 10 of these have been characterized (Ole e 1 to Ole e 10). Ole e 1, which is considered to be the majority allergen (causing sensitization in more than 70% of patients), has been the subject of many studies looking for risk factors and ways to protect against sensitization. Markers of the major histocompatibility complex and other genetic loci associated with the allergic response have been analyzed using population-based, family-based, and functional approaches, which have revealed the involvement of genetic regulation in this type of response. Furthermore, evaluation of environmental factors and their relationship with genetic factors is essential when attempting to understand this type of disease. In this review, we provide examples of how exposure to high doses of olive pollen allergen in a specific genetic context can trigger different allergic conditions (from asthma to nonresponse). We stress the importance of evaluating these factors in order to modulate this response correctly.

Seguimiento no invasivo de los aneurismas periféricos tratados de forma endovascular / Non-invasive follow-up of peripheral aneurysms treated by endovascular means

Objetivo. Valorar la necesidad del seguimiento de la cirugía endovascular en los aneurismas periféricos y los parámetros que se estudian. Pacientes y métodos. Búsqueda bibliográfica de series publicadas y experiencia en nuestro servicio. Resultados. En las series encontradas se observa una mejoría en los resultados, debida sobre todo al desarrollo técnico y la evolución de los dispositivos empleados. Los parámetros estudiados en las distintas series han sido la permeabilidad, la velocidad del flujo en el interior de la endoprótesis, la detección de flujo en el saco aneurismático y los cambios en el diámetro del saco. Se detectaron alteraciones corregibles y asintomáticas hasta en el 20% de los casos. Conclusiones. El seguimiento con eco-Doppler parece justificado por el número de lesiones asintomáticas que detecta. Los parámetros mínimos que se deberían valorar son la permeabilidad, las posibles aceleraciones del flujo intraprotésicas y la existencia de flujo o endofugas en el saco aneurismático

Aim. To evaluate the need for follow-ups in endovascular surgery in peripheral aneurysms and the parameters that are studied. Patients and methods.We conducted a search in the literature for series that have been reported and our own experience in our service. Results. The series that were found showed an improvement in the outcomes, above all due to technical progress and advances made in the devices that are used. The parameters that were studied in the different series were patency, flow velocity inside the stent, detection of flow inside the aneurysmal sac and changes in the diameter of the sac. Correctable and asymptomatic alterations were found in up to 20% of cases. Conclusions. Follow-up using Doppler ultrasound seems to be justified owing to the number of asymptomatic lesions it detects. The minimum parameters that should be appraised are patency, possible accelerations of intraprosthetic flow and the existence of flow or endoleaks in the aneurysmal sac

Cinnamtannin B-1 from bay wood exhibits antiapoptotic effects in human platelets.

Proanthocyanidins, such as cinnamtannin B-1, are polyphenolic compounds with antioxidant activity that induce apoptosis in a number of tumoral cells. We have now investigated the pro- or anti-apoptotic effects of cinnamtannin B-1 in human platelets. Platelet stimulation with thrombin induced cellular apoptosis, as detected by phosphatidylserine exposure and the activation of caspases-3 and -9. Pretreatment for 30 min with cinnamtannin B-1 impaired thrombin-induced apoptosis in platelets. Thrombin has been shown to induce H(2)O(2) generation in platelets, which induced similar apoptotic events than thrombin in these cells. Pretreatment with cinnamtannin B-1 reduced H(2)O(2)-induced phosphatidylserine exposure and caspase activation. Finally, platelet stimulation with thrombin induced translocation of caspases-3 and -9 to the cytoskeletal (Triton-insoluble) fraction, which is important for their activation and the development of apoptotic events. Pretreatment with cinnamtannin B-1 impaired translocation of caspases-3 and -9 to the cytoskeleton and, as a result, procaspases are accumulated in the Triton-soluble fraction. Our results provide evidence for the antiapoptotic actions of cinnamtannin B-1 in human platelets.

Cinnamtannin B-1 from bay wood reduces abnormal intracellular Ca2+ homeostasis and platelet hyperaggregability in type 2 diabetes mellitus patients.

Type 2 diabetes mellitus induces a number of cardiovascular disorders, including platelet hyperactivity and hyperaggregability, which is associated to an increased oxidant production and abnormal cytosolic Ca2+ mobilization. In the present study, we have investigated the effect of cinnamtannin B-1 obtained from bay wood on oxidants production, Ca2+ mobilization and aggregation in platelets from type 2 diabetic donors. Pretreatment of platelets with cinnamtannin B-1 reversed the enhanced oxidants production and Ca2+ mobilization, including Ca2+ entry, evoked by thapsigargin plus ionomycin or thrombin, observed in platelets from diabetic subjects, so that in the presence of cinnamtannin B-1 Ca2+ entry was similar in platelets from healthy and diabetic subjects. In addition, cinnamtannin B-1 reduced thrombin-induced aggregation in platelets from type 2 diabetic subjects. We conclude that cinnamtannin B-1 exerts an effective antioxidant action in platelets from patients with type 2 diabetes mellitus and reverses the enhanced Ca2+ mobilization and hyperaggregability.

Effectiveness of different adjuvants in stimulating Dichelobacter nodosus antibody in sheep vaccinated against ovine footrot.

This research consists of an evaluation of the effectiveness of different substances administered as adjuvants in the stimulation of humoral immune response induced by the vaccine composed of strains A1, A2 and C of Dichelobacter nodosus. To do this, a total of 120 Merino sheep were vaccinated and revaccinated. These sheep were selected from a farm located in the region of Extremadura (Spain), and they were divided into 12 groups of 10 animals each. An additional group with 10 sheep was used as control. The immune response (titre of antibodies) was determined by agglutination tests and ELISA. The most pronounced immune response was obtained by the use of Freund's incomplete adjuvant and aluminium hydroxide as adjuvants.

Estudio observacional, prospectivo y multicéntrico del tratamiento ambulatorio de la trombosis venosa en fase aguda en el sector femoropopliteotibial / A prospective observational and multicentre study of the treatment of acute-phase venous thrombosis in the femoral -popliteal-tibial region in outpatients

Introducción. El tratamiento de la trombosis venosa (TVP) mediante heparina fraccionada de bajo peso molecular (HBPM) ha facultado que diversos grupos hayan iniciado su tratamiento deforma extrahospitala-ria. Objetivos. Evaluar la eficacia y seguridad del tratamiento extrahospitalario de la TVP en fase aguda y la efectividad y tolerabilidad de la HBPM (tinzaparina). Pacientes y métodos. Estudio observacional, prospectivo y multicéntrico (15 hospitales) sobre 122 pacientes: 57, 4 por ciento mujeres y 42,6 por ciento varones, con una edad media de 60,9 años. Los criterios de inclusión fueron: TVP en el sector femoropopliteotibial, y los de exclusión: TVP primaria o recidivante en el sector iliocavo, edad superior a 75 años, patología sistémica grave y alergia documentada a la tinzaparina. Los criterios de valoración de la eficacia y la seguridad fueron: intercurrencia de complicaciones (embolismo pulmonar, episodios de sangrado), progresión de la trombosis, parámetros clínicos (edema) y de calidad de vida SF-12 (escala EVA). Para la evaluación de las reacciones adversas se empleó la clasificación WHOART. El período medio de tratamiento fue de 11,6 días. Resultados. a) Eficacia: intercurrencia trombótica, 0 por ciento; embolismo pulmonar no fatal: 1(0,82 por ciento; ingresos hospitalarios: 4 (3,2 por ciento); perímetro de la extremidad: regresión de 26,6 a 24,7 cm (supramaleolar) y de 39,2 a 37,1 cm (infracondíleo; p < 0,001); puntuación media de la escala de dolor: inicial, 5,3 y final: 3,3 (p < 0, 001). b) Seguridad: 11 pacientes (9 por ciento) presentaron signos de sangrado, motivo de ingreso en uno. Seis (4,9 por ciento) presentaron algún tipo de reacción adversa, ninguna calificada como grave. En el 33,3 por ciento su relación con el fármaco se consideró como posible, y en el 66,7 por ciento, como muy probable. c) Aceptabilidad: el 82 por ciento de los pacientes se mostraron satisfechos con el tratamiento. Conclusiones. El estudio demuestra la eficacia y seguridad de la estrategia terapéutica que se llevó a cabo (AU)

Aetiology of ovine footrot in the Portuguese region of Alto Alentejo.

In this work, we found it appropriate to carry out a study directed towards isolating and identifying the entailed microorganisms which trigger off footrot in sheep, placing special emphasis on the serotipification of the different Dichelobacter nodosus species. With this goal in mind four flocks from the Portuguese region of 'Alto Alentejo' were selected, all of them had one common feature: their main health problem was ovine footrot. We also set out to determine the elastolitic capacity of isolated strict-anaerobic bacteria, in order to be able to clarify the direct involvement of these microorganisms in the outbreak of this infectious process.

Allergy to dermatophagoides in a group of Spanish gypsies: genetic restrictions.

BACKGROUND: Spanish gypsies have traditionally lived as nomads, a reason why few epidemiological studies were done in this ethnic group. However, the high prevalence of asthmatic diseases demonstrated in a population residing in the North of Spain induces us to analyse whether it was due to the influence of genetic loci previously implicated in other population studies as causing the disorders. METHODS: DRB1* and DQB1* HLA class II, TCR-Valpha8.1, FcepsilonRI-beta Rsa I exon 7 and intron 2, TNF-beta (LTalpha-Nco I) and CD14, were tested for association with asthma and atopy by multiple regression analysis, in 5 families comprising 87 individuals. RESULTS: Significant associations were found with DQB1*02 (p = 0.02) and DQB1*0301 (p = 0.008) and elevated levels of total serum IgE. A negative association (p = 0.02) was found between total serum IgE and DRB1*14. FcepsilonRI-beta Rsa I-In2 allele 1 was associated with high levels of total serum IgE (p = 0.04). Levels of Der p 1 IgE antibodies were negatively associated with DRB1*11-DQB1*0301 (p = 0.007), and positively with TCR Valpha-8 allele 1 (p = 0.04) and with FcepsilonRI-beta Rsa I-In2 allele 1 (p = 0.009). CONCLUSIONS: Our results do not show any association between asthma and the genetic loci studied although they do suggest the existence of multiple genetic influences on the allergic response in these families.

Comparison of erythromycin and oxytetracycline for the treatment of ovine footrot.

A microbiological study of 25 cases of ovine footrot was performed. Cultures belonging to Dichelobacter nodosus were isolated in 48% of the sampled animals. The sensitivity of the 99 strict anaerobic bacterial isolates to 5 antibiotics (penicillin G, amoxycillin, spiramycin, erythromycin and oxytetracycline) was studied. The percentage of resistant cultures was in all cases higher than 30%. The efficacy of erythromycin and oxytetracycline in the treatment of ovine footrot was studied. To conduct this test, an intramuscular injection was applied, of one antimicrobial or the other, at the beginning of the treatment. The tolerance of animals to the antimicrobials, the success rate of treatment and the severity of lameness were evaluated. The percentage of animals cured within 15 days was around 75%. In contrast, only 44% improvement was achieved in the lameness. No differences were found between the two antimicrobials in the above indices.

Prenatal diagnosis on fetal cells from maternal blood: practical comparative evaluation of the first and second trimesters.

Objectives- Several attempts have been made to determine the gestational period in which the maximum number of fetal cells can be found in maternal blood and consequently which is the best week in which to perform a reliable non-invasive prenatal diagnosis. Most studies conclude that the number of nucleated red blood cells (NRBC) increases in line with gestation, but the number of cells that are fetal in origin (FNRBC) decreases in the third trimester. The aim of the present study was to make a practical comparative evaluation of the first and second trimesters to ascertain the period in which a greater number of FNRBC can be found of the total number of NRBC identified. Methods- Double density gradient and a posterior positive selection (CD71) by magnetic activated cell sorting (MACS) were employed. In the final fraction, erythroblasts were identified using Kleihauer staining and were studied using the fluorescence in situ hybridization (FISH) interphasic technique. Results- There was a significant difference (p<0.05) between the mean number of FNRBC found in the first and second trimesters. Conclusions- The number of FNRBC increases from the first to the second trimester. It appears that the optimum week in which to perform a reliable non-invasive prenatal diagnosis is around the 15th week.