Una actualización en el protocolo en cáncer de próstata metastásico hormonosensible / Hormone sensitive protocol for metastatic prostate cancer, an update

Revisar y actualizar los últimos protocolos en cáncer de próstata metastásico hormonosensible para mejorar su manejo clínico en la práctica clínica. Realizar un análisis de los datos y los protocolos más recientes en el cáncer de próstata metastásico hormonosensible según paneles de expertos en este ámbito. Actualmente se necesita un grupo de consenso nominal para unificar y mejorar las recomendaciones para el manejo de pacientes sensibles con cáncer de próstata metastásico. Este documento unifica y mejora el manejo de los pacientes con cáncer de próstata metastásico hormonosensible, con una metodología que combina datos cuantitativos y cualitativos, y basada en la participación de un amplio comité científico designado por la Asociación Española de Urología (AU)

To review and update last protocols in hormone sensitive metastatic prostate cancer for improving clinical management in routine. Evidence analysis available about recent updates protocols in hormone sensitive metastatic prostate cancer according to expert panel of clinicians about this field. A nominal consensus group for unify and improve the recommendations to the management of sensitive metastatic prostate cancer patients is currently needed. This document unifies and improve the management of patients with hormone sensitive metastatic prostate cancer, with a methodology that combines data quantitative and qualitative and based on the participation of a broad scientific committee appointed by the Spanish Association of Urology (AU)

Hormone sensitive protocol for metastatic prostate cancer, an update.

To review and update last protocols in hormone sensitive metastatic prostate cancer for improving clinical management in routine. Evidence analysis available about recent updates protocols in hormone sensitive metastatic prostate cancer according to expert panel of clinicians about this field. A nominal consensus group for unify and improve the recommendations to the management of sensitive metastatic prostate cancer patients is currently needed. This document unifies and improve the management of patients with hormone sensitive metastatic prostate cancer, with a methodology that combines data quantitative and qualitative and based on the participation of a broad scientific committee appointed by the Spanish Association of Urology.

Comparative cost analysis of cervical cancer screening programme based on molecular detection of HPV in Spain.

BACKGROUND: HPV cervical cancer screening (CCS) must use validated HPV tests based on the molecular detection of either viral mRNA (Aptima HPV Assay-AHPV) or DNA. AHPV has demonstrated the same cross-sectional and longitudinal sensitivity for the detection of HSIL/CIN2+ lesions but with greater specificity than HPV-DNA tests. The study aimed to estimate the total costs of a CCS with a primary HPV test based on the detection of mRNA compared to DNA in women aged 35-65 years for the National Health System. METHODS: A decision-tree-based model to estimate the cost of the CCS until the first colposcopy was designed based on Spanish CCS guidelines. The total cost (€, 2019) for CCS with AHPV or DNA tests (HC2 and Cobas) was calculated, including HPV test, liquid-based cytology (LBC) and colposcopy, for a population of 7,263,529 women aged 35-65 years (assuming 70% coverage). Clinical inputs derived from a literature review were validated by a multidisciplinary expert panel. Data from head-to-head studies between different HPV tests were selected. RESULTS: The use of AHPV showed reduction of 290,541 (- 35%) and 355,913 (- 40%) LBC compared to HC2 or Cobas, respectively. Furthermore, AHPV avoided 151,699 (- 47%) colposcopies versus HC2 and 151,165 (- 47%) versus Cobas. The total cost of CCS was € 282,747,877 with AHPV, € 322,587,588 with HC2 and € 324,614,490 with Cobas. Therefore, AHPV savings € - 39,839,711 versus HC2 and € - 41,866,613 versus Cobas. CONCLUSIONS: Assuming that 70% of women from 35 to 65 years attend the CCS programme, the cost of screening up to the first colposcopy using AHPV would provide cost savings of up to € 41.9 million versus DNA tests in Spain.

Virtual quad zygoma implant placement using cone beam computed tomography: sufficiency of malar bone volume, intraosseous implant length, and relationship to the sinus according to the degree of alveolar bone atrophy.

The objective of this study was to investigate the malar bone volume and length that a zygomatic implant can engage, and the relationship to the sinus according to the degree of alveolar bone atrophy. A three-dimensional evaluation was performed using cone beam computed tomography scans from 23 patients with a totally edentulous maxilla; quad zygoma implants were virtually placed. The predictor variable was the amount of malar bone volume and length that a zygomatic implant can engage. The primary outcome variable was the relationship to the sinus according to the degree of alveolar bone atrophy. Other variables were the residual alveolar bone height to the floor of the sinus and the nasal cavity. The mean volume of malar bone engaged in this sample of 92 zygomatic implants was 0.19±0.06cm3. The implant had an extrasinus path in 60.9% of cases, a parasinus path in 25%, and an intrasinus path in 14.1%. The results suggest that the average volume of malar bone engaged by a zygomatic implant is constant regardless of implant position and the degree of alveolar bone atrophy. As alveolar atrophy increases, the trajectory of the implant becomes more parasinus and intrasinus. The examiners were able to find enough bone to adequately distribute the implants in all cases.

A multistrategic approach in the development of sourdough bread targeted towards blood pressure reduction.

Rising prevalence of hypertension is pushing food industry towards the development of innovative food products with antihypertensive effects. The aim was to study the effect of reduced sodium content and 21% addition of wholemeal wheat sourdough (produced by Lactobacillus brevis CECT 8183 and protease) on proximate composition, γ-aminobutyric acid (GABA) and peptide content of wheat bread. Angiotensin converting enzyme I (ACE) inhibitory and antioxidant activities were also evaluated. Sodium replacement by potassium salt did not affect chemical composition and biological activities of bread. In contrast, GABA and peptides <3 kDa contents in sourdough bread (SDB) were 7 and 3 times higher, respectively, than the observed in control. ACE inhibitory and antioxidant activities of the peptide fraction < 3 kDa from SDB was 1.7 and 2.6-3.0 times higher than control. Therefore, the combination of reduced sodium content with enriched concentrations of bioactive compounds in bread making may provide interesting perspectives for development of innovative breads towards blood pressure reduction.

Changes in bread consumption and 4-year changes in adiposity in Spanish subjects at high cardiovascular risk.

The effects of bread consumption change over time on anthropometric measures have been scarcely studied. We analysed 2213 participants at high risk for CVD from the PREvención con DIeta MEDiterránea (PREDIMED) trial to assess the association between changes in the consumption of bread and weight and waist circumference gain over time. Dietary habits were assessed with validated FFQ at baseline and repeatedly every year during 4 years of follow-up. Using multivariate models to adjust for covariates, long-term weight and waist circumference changes according to quartiles of change in energy-adjusted white and whole-grain bread consumption were calculated. The present results showed that over 4 years, participants in the highest quartile of change in white bread intake gained 0·76 kg more than those in the lowest quartile (P for trend = 0·003) and 1·28 cm more than those in the lowest quartile (P for trend < 0·001). No significant dose-response relationships were observed for change in whole-bread consumption and anthropometric measures. Gaining weight (>2 kg) and gaining waist circumference (>2 cm) during follow-up was not associated with increase in bread consumption, but participants in the highest quartile of changes in white bread intake had a reduction of 33 % in the odds of losing weight (>2 kg) and a reduction of 36 % in the odds of losing waist circumference (>2 cm). The present results suggest that reducing white bread, but not whole-grain bread consumption, within a Mediterranean-style food pattern setting is associated with lower gains in weight and abdominal fat.

Assessment of three methods for multilocus fragment typing of Cryptosporidium parvum from domestic ruminants in north west Spain.

The performance of three different methods, capillary electrophoresis (CE), high resolution slab-gel electrophoresis and sequencing, for PCR fragment size analysis of two Cryptosporidium parvum microsatellite regions, ML1 and ML2, was investigated by analysing 27 isolates from calves and 14 from lambs. To assess genetic variability of this protozoan in domestic ruminants in north west Spain, results were combined with sequence analysis of the 60 kDa glycoprotein (GP60) gene creating a multilocus type and analysed by farm and host species. CE showed greater overall typability (T), discriminatory power and ease of use than slab-gel electrophoresis and sequencing which were both affected by PCR stutter, especially at ML2. CE fragment sizes were consistently 4 bp longer compared to sequencing which is considered the gold standard for allele sizing but which gave the lowest typability; CE sizes were therefore adjusted. Only three alleles were identified at the ML1 locus (ML1-238, ML1-229 and ML1-226). The ML2 locus was more polymorphic and eight alleles were found (ML2-235, ML2-233, ML2-231, ML2-229, ML2-227, ML2-225, ML2-201 and ML2-176). Adjusted ML1 and ML2 CE fragment sizes were combined with GP60 subtype for 37 of the 41 C. parvum isolates which were typable at all three loci (T=0.90): nine multilocus types (MLTs) were identified. The discriminatory power of the 3-locus typing method was 0.83. Greater genetic variability was observed in calf isolates (7 MLTs) than in those from lambs (4 MLTs) although more calf isolates were studied. The most common MLT in cattle was MLT1 (ML1-238, ML2-231, GP60 subtype IIaA15G2R1), while MLT3 (ML1-238, ML2-227, GP60 IIaA16G3R1) was predominant in lambs. Our findings demonstrate that high discrimination can be achieved by means of multilocus typing. CE appears to be an economic and rapid option for performing microsatellite fragment size analysis offering good typability, discrimination and ease of use but may require calibration to sequenced standards.

The impact of exercise duration and intensity on the release of cardiac biomarkers.

Numerous studies have observed cardiac biomarker release with prolonged exercise. Despite this, we are unsure as to the constituent aspects of any given exercise bout that may be important in promoting cardiac biomarker release. This study examined the influence of exercise duration and intensity on the appearance of cardiac biomarkers. Twenty-one subjects ran for 45, 90 and 180 min at 85% and 95% of their individual anaerobic threshold on six different days randomized. Cardiac troponin I (cTnI) and N-terminal pro-brain natiuretic peptide (NT-proBNP) were assayed from blood samples collected before, 30 min and 3 h post-exercise. NT-proBNP was elevated after all exercise trials (range before: 21-32; range post: 38-67 ng/L). Peak post-exercise concentrations of NT-proBNP were associated with exercise duration (P=0.049), but not exercise intensity (P=0.451). cTnI was elevated after all exercise trials (range before: 0.007-0.011; range post: 0.008-0.021 µg/L). Peak post-exercise concentrations of cTnI were associated with exercise duration (P=0.003) and intensity (P=0.037). Data suggest that while both cTnI and NT-proBNP increased after all exercise trials, the mediating effect of duration influenced both NT-proBNP and cTnI while intensity influenced only cTnI.

Análisis científico de diferentes métodos de entrenamiento en el fútbol sala / Scientific analysis of practice methods used in futsal

El control de la carga de entrenamiento es necesario, siendo la variable del tiempo la más utilizada para su control. Este estudio pretende aportar datos fisiológicos a partir de diferentes sesiones basadas en el empleo de metodologías integrales y determinar si cumplen con los objetivos previstos. El presente estudio se ha realizado durante la temporada 2005-06 y han participado todos los jugadores del DKV fútbol sala, equipo que milita en la División de Honor del fútbol sala español. Se realizaron las siguientes pruebas: Examen médico-deportivo, evaluación antropométrica, prueba de esfuerzo máximo continuo y 4 sesiones de entrenamiento con diferentes objetivos condicionales. Los parámetros analizados han sido frecuencia cardiaca, lactatemia y ergoespirométricos. El análisis estadístico ha sido descriptivo por encontrarnos en una fase piloto de investigación. De los datos obtenidos podemos concluir que: el entrenamiento integrado es válido para conseguir los objetivos marcados. La heterogeneidad de los jugadores hace que la aplicación de un mismo método y carga de entrenamiento provo que diferentes respuestas fisiológicas. El entrenamiento integrado reduce la máxima intensidad de trabajo a la que el jugador debe ser demandado. Para establecer los parámetros de trabajo los métodos clásicos pueden ser tomados como referencia, pero deben ser adaptados a la lógica interna de cada modalidad deportiva. La gran dificultad en la planificación de las cargas de trabajo en los deportes de equipo es saber unir todos los factores influyentes en la mejora del juego, dentro de un proceso lógico y ordenado (AU)

It is necessary to control the total amount of practice sessions. Time control used on each task is actually the method more often used. This study tries to provide physiological facts using different sessions based on different training methods with specific game situations. The main target is to improve on different physiological aspects and to show that they can achieve settled goals. The study took place during the 2005-06 seasons. DKV’s players, which play in the first league in Spain, were involved in the study. They took the following test: medical sport, anthropometric, running or treadmill and 4 practice sessions with different target. Heart rate, lactates and maximum oxygen consumption were analyzed. Considering that we are in the first phase of the investigation the statistical analysis has given us a lot of information. With the data obtained we can conclude that: integrated training will help to achieve the settled goals. We obtained different physiological response on each player applying the same method and using the same amount of practice sessions. Integrated training reduces to the maximum the intensity of work to which the players is exposed to. Classic methods can be used as references in order to establish the work parameters, but these parameters must be adjusted to each sport. The major problem that we found when planning the amount of practice sessions in team sports is to know how to bond all the factors that will help us improve the game, always trying to follow a logical and well organized pattern (AU)

Cryptosporidium species and subtype analysis from dairy calves in Spain.

Faecal specimens from 287 diarrhoeic calves younger than 21 days, collected over a 2-year period (2006-2007) from 82 dairy cattle farms in 14 provinces across the north of Spain, were examined for the presence of Cryptosporidium oocysts. Overall, 63 farms (76.8%) and 166 calves (57.8%) tested positive by microscopy. In order to elucidate the genetic diversity, selected positive specimens from 149 calves originating from 61 farms in the 14 provinces were examined by genotyping and subtyping techniques. Cryptosporidium parvum was the only species identified by PCR-RFLP of SSU rDNA from all 149 isolates and sequencing of a subset of 50 isolates, except for 2 specimens that were identified as C. bovis. Sequence analyses of the glycoprotein (GP60) gene revealed that most C. parvum isolates (98%) belonged to the subtype family IIa and 2 isolates were identified as the novel subtype IIdA23G1. Subtype IIaA15G2R1 was the most common and widely distributed (80.3% of the 61 farms), followed by subtype IIaA16G3R1 (14.7%), whereas the remaining IIa subtypes (IIaA16G2R1, IIaA17G2R1, IIaA18G3R1, IIaA19G3R1) were restricted to 1-3 farms. All these C. parvum IIa subtypes have previously been described in human patients, indicating that most isolates from diarrhoeic calves in northern Spain have zoonotic potential.

Improved postprandial response and feeling of satiety after consumption of low-calorie muffins with maltitol and high-amylose corn starch.

The aim of this study was to determine the postprandial glucose (GR), insulin (IR), and triglyceride response as well as the satiety response (SR) to low-calorie muffins (LCMs) and to compare them to those of conventional plain muffins (PMs) and bread. The LCMs had a lower fat content, their sugar was replaced by maltitol, and wheat flour was partially replaced by high-amylose corn starch. We used bread as a reference to calculate glycemic (GI), insulinemic (II), and satiety indices (SI). Seven men and 7 women (33 +/- 7.8 y; body mass index = 25.8 +/- 2.9) were studied in a randomized crossover design and were given either bread, an LCM, or a PM during 3 different occasions. Plasma glucose, insulin, and triglyceride concentrations were periodically measured for 2 h after consumption. We used the same design in a separate assay to evaluate SR by means a subjective questionnaire. The results show that LCMs reduced the IR by 30% (P= 0.03) and lipemic response by 50% (P < 0.001) compared to PMs. GR was only found to be significantly different between bread and LCMs (52% lower in LCM; P= 0.03), with PMs in an intermediate position. The SR of LCMs is similar to bread and higher than PMs (191%; P= 0.02). We concluded that LCMs are a product with a very low GI with better postprandial and SRs than PMs. These metabolic properties are useful in normal and overweight persons. However, further research is needed on the effects of this type of products in individuals with impaired glucose tolerance.

Flotillin-1 localization on sporozoites oF Eimeria tenella.

In an attempt to identify parasite surface components involved in the interaction with the host cell, the present research focuses on the rafts of Eimeria tenella that might be involved in the host cell invasion process. To that end, this study was undertaken to investigate the expression of flotillin-1, which is an important component and marker of lipid rafts at the plasma membrane of sporozoites of E. tenella. The expression of this plasma membrane protein was identified by an antibody that specifically reacts with flotillin- and was studied by electron microscopy. Flotillin-1 was found to occur in patches on the surface of E. tenella sporozoites. Immunoblot analysis of the total proteins of the sporozoites showed only 1 band of approximately 48 kDa. This indicates that the antibody exclusively recognized the molecules of flotillin-1 expressed on the surface of E. tenella sporozoites. The presence of flotillin-1 on the cellular membrane of sporozoites predominantly at the apical tip suggests that flotillin-1 belongs to the invasion machinery of E. tenella.

Differences in Hsp70 expression in the sporozoites of the original strain and precocious lines of Eimeria tenella.

The levels of expression of Heat shock protein 70 (Hsp 70) in sporozoites of a wild-type parent strain and 2 precocious lines of Eimeria tenella, were compared to investigate the relationship between the heat shock proteins expressed by the parasite and virulence of the strain. Hsp70 expression was analyzed in sporozoites by immunohistochemical techniques, immunoblot, and flow cytometric analyses. One band of 70 kDa was identified and the variation of the Hsp70 expression levels was quantified by optical densitometric analyses. The results showed a significant gradual decrease in the Hsp70 expression in sporozoites of E. tenella as attenuation progressed, suggesting that the Hsp70 expressed in the excysted sporozoites of E. tenella might be involved in parasite pathogenicity. In addition, the cytoplasmic distribution of the Hsp70, which was observed in the entire sporozoites of the wild strain, was reduced to the anterior portion in the precocious lines.

Expression of anti-apoptotic factors in cells parasitized by second-generation schizonts of Eimeria tenella and Eimeria necatrix.

Intracellular infections by parasites require a functional anti-apoptotic mechanism for parasite survival within the host cell. The intracellular cycle of Eimeria tenella and Eimeria necatrix in chicken intestinal cells involves the maturation of schizonts within the epithelial cells lining the crypt lumen of the ceca (E. tenella) and jejunum (E. necatrix). After invasion, these cells detach from the epithelial layer and migrate into the underlying connective tissue, where maturation of second-generation schizonts takes place. However, the detached epithelial cells that harbour the parasite and localize in the lamina propia do not undergo apoptosis despite the fact that they are parasitized cells and are located in an inappropriate microenvironment. In this study we consider the hypothesis that E. tenella and E. necatrix may inhibit the host cell apoptosis that accompanies parasite-mediated transformation during late schizogony. To that end, the expression of both NF-kappaB, a transcriptional factor that blocks parasite-induced apoptosis, and bcl-xL, an anti-apoptotic protein induced by NF-kappaB, were studied in the host cell during the maturation of second-generation schizonts. In addition, the expression of the phosphorylated inhibitor of NF-kappaB, p-IkBalpha, was also studied to further confirm NF-kappaB activation. Immunocytochemical techniques, flow cytometric and blott analysis were applied by using polyclonal antibodies that specifically react with bcl-xL, p-IkBalpha, and NF-kappaB to detect these anti-apoptotic proteins in the parasitized cell. Our results offer evidence that both these coccidial species first induce NF-kappaB activation to protect the transformed parasitized cells from apoptosis, allowing the second-generation schizonts to mature, and later, after complete schizonts maturation, cause NF-kappaB inhibition to trigger host cell apoptosis in order to facilitate the escape of merozoites. To determine whether inhibition of the NF-kappaB pathway would induce apoptosis of the host cell, a protease inhibitor (TPCK), which induces apoptosis by mediating inhibition of IkB phosphorylation, was administered to parasitized chickens.

Phenology of the tick, Ixodes ricinus, in its southern distribution range (central Spain).

The abundance, seasonal activity patterns and development rates of the tick Ixodes ricinus (L.) (Acari: Ixodidae), as well as microclimate features of the site of study, are described for a 9-year-long study (1994-2002) in north-central Spain. According to drag captures, larvae had a unimodal activity pattern, with a maximum observed around July-August, whereas nymphs displayed a bimodal pattern (May-June and August-September) with strong dominance of spring activity. An inversion of this pattern, with larger autumn peak, was observed in years with humid summers. Adults showed a small spring peak and a large autumn one. In the later years of the study, a small increase in the adult spring peak of activity was noticed, correlated with mild winters. Over the entire period of study, a clear increase in the total tick abundance was detected. Statistically significant differences between years were observed for some climate variables (saturation deficit, winter temperatures and number of days with temperatures above 6 degrees C), but a consistent and constant pattern of change was not observed in any climate variable. Temperature requirements for developing stages showed a sharp decrease in weeks 35-51 (eggs) and 38-50 (larvae and nymphs), a feature attributed to the presence of the morphogenetic diapause, beginning around September. Development rates obtained under quasi-natural conditions were almost twice those reported for other sites, suggesting an adaptation of this local, largely isolated I. ricinus population. According to drag captures and field-obtained development rates, interchange of nymphs between the two cohorts is common in this site, and seems to be influenced by the winter temperature and the date of larval engorgement.

[Schizophrenic patients living in the community. Nursing referral]. / Pacientes esquizofrénicos que viven en la comunidad. Derivación a enfermería.

The authors describe the clinical and socio-demograpaphic characteristics of schizophrenic patients who live out in the community. The authors study the clinical profile and the disabilities of those items derived from nursing. To do so, the authors made a random selection from persons diagnosed as schizophrenics who visited one of the five Mental Health Centers in the Sant Joan de Déu Hospital network's Mental Health Services. The authors evaluated sociodemographic characteristics, use of services, disabilities based on WHO-DAS, PANSS psychopathology, and LSP ability to function socially. Of the 231 patients included in this study group, 141 patients followed a psychiatrist only treatment program while 90, or 39%, followed a combined psychiatrist-nurse treatment program. Upon comparing these two groups, the authors observed that those patients who followed a combined treatment program had a higher score on the Negative PANSS test (*p < 0.005) which means they have many more difficulties to adequately carry out social functions in daily life activities. On the other hand, this group had lower scores on the WHO-DAS-IV Total test (*p < 0.001), on the WHO-DAS-IV Occupational Test (*p < 0.001), on the WHO-DAS-IV Familiar Test (*p < 0.005) and on WHO-DAS-IV Personal Care Test (*p < 0.005). The authors did not observe any significant results on the rest of the subscales nor on the LSP test.

Potential uses and benefits of phytosterols in diet: present situation and future directions.

Over the past decade, the possibility of using phytosterols as ingredients in functional foods has led to numerous research studies in relation to their ability to reduce blood cholesterol. Many different types of carriers have been tested, with good results. The main conclusion is that the effective doses were between 1.5 and 3g/day, leading to reductions between 8% and 15% in LDL-cholesterol. The principal mechanism of action is based on interference with the solubilisation of the cholesterol in the intestinal micelles and, thus, absorption is reduced. Work has also been done on the optimal pattern of administration, and it has been found that ingesting phytosterols in a single dose per day or between meals are equally effective methods. The only side effect is that they can interfere with the absorption of carotenoids, but this can be compensated for in the diet or by adding these compounds in appropriate carriers. It has also been reported that phytosterols have anticancer properties and act as immune system modulators. There are several possible future lines of research: alternative sources with a high phytosterol content must be found, industrial processes must be implemented which minimise their loss, phytosterols must be included in food composition tables, the potential of the different types of phytosterols must be discerned, the genetic bases of their action must be elucidated, synergic effects with other compounds must be studied, side effects must be minimised, and the effects of long-term treatment must be defined precisely.

Pacientes esquizofrénicos que viven en la comunidad. Derivación a enfermería / Schizophrenic patients who live out in the community. Derivation to nursing

Se describen las características clínicas y sociodemográficas de los pacientes con esquizofrenia que viven en la comunidad. Se estudia el perfil clínico y de discapacidad de aquellos derivados a enfermería. Para ello se realizó una selección aleatoria de las personas con esquizofrenia que se visitaban en uno de los cinco Centros de Salud Mental de la red de Sant Joan de Déu, Serveis de Salut Mental. Se evaluaron las características sociodemográficas, la utilización de servicios, la discapacidad (WHO-DAS), la psicopatología (PANSS) y el funcionamiento social (LSP).De los 231 pacientes que forman parte del estudio, siguieron tratamiento solamente con su psiquiatra 141 y seguimiento combinado (psiquiatra y enfermería) 90 (39 por ciento). Al comparar los dos grupos, observamos que los pacientes que se derivaron a un seguimiento combinado tienen una puntuación más alta en la PANSS Negativa (*p < 0,005) es decir tienen muchas más dificultades para desenvolverse adecuadamente en las actividades de la vida diaria. Por otro lado, tienen peores puntuaciones en la WHO-DAS-IV Total (*p < 0,001); WHO-DAS-IV Ocupacional (*p < 0,001); WHO-DAS-IV Familiar (*p < 0,005) y WHO-DAS-IV cuidado personal (*p < 0,005). No se observan resultados significativos en el resto de las subescalas ni en el LSP. (AU)

Prevalence and analysis of potential risk factors for Cryptosporidium parvum infection in lambs in Zaragoza (northeastern Spain).

An epidemiologic study was carried out to investigate the prevalence of and to identify factors associated with the risk of Cryptosporidium infection in sheep in Zaragoza (northeastern Spain). Faecal samples from 583 lambs aged from 1 day to 3 months and 205 ewes older than 1 year were collected at 89 farms in the two regions of the province of Zaragoza with the highest sheep population (Zaragoza and Ejea de los Caballeros). In every sheep farm, data of the factors potentially associated with the likelihood of C. parvum infection were analysed: geographical location, season, size of herd, number of lambs in the herd at sampling time, lambing period, cleaning of lambing area and presence of diarrhoeic lambs in the farm. C. parvum oocysts were identified by using the Ziehl-Neelsen technique in 344 lambs (59%) from 75 farms (84.4%). Infected lambs ranged from less than 7 days to 90 days of age, although the percentage of animals shedding oocysts peaked at 8-14 days of age (76.2%). Statistical analysis showed that infection rates were significantly higher in lambs aged between 1 and 21 days (66.4%) than in those aged between 22 and 90 days (23%) (P<0.0001, chi(2)). Analysis of correlation between excretion of oocysts and diarrhoea revealed a relationship in all age groups and the probability of presenting diarrhoea was significantly higher for lambs shedding oocysts (86.3%) than for those which did not excrete the parasite (32.2%) (P<0.0001, chi(2)). Similarly, cryptosporidial infection rates were significantly higher in diarrhoeic (79.4%) than in non-diarrhoeic lambs (22.4%). Furthermore, infection intensity was correlated with the presence of clinical symptoms. Presence of diarrhoeic lambs in the farm was the only factor significantly associated with an increased risk of infection since the percentage of herds testing positive was significantly higher in farms with diarrhoeic lambs (91.3%) than in those without cases of neonatal diarrhoea (12.5%) (P<0.0001, chi(2)). Factors associated with a decreased risk of C. parvum infection in lambs included low numbers of lambs in the farm and cleaning of the lambing area. Additionally, lambs 8-14 days of age were less likely to be infected at the first lambing period and in spring/autumn. Cryptosporidial infection was also detected in 16 ewes (7.8%) which excreted few oocysts and without diarrhoea.

Serum antibody response and Cryptosporidium parvum oocyst antigens recognized by sera from naturally infected sheep.

The response of specific serum immunoglobulins (IgG, IgM and IgA) and the major antigens of Cryptosporidium parvum recognized by these isotypes were investigated by using enzyme-linked immunosorbent assay and immunoblot techniques in lambs and ewes naturally infected throughout an outbreak of cryptosporidiosis. Serum samples were collected from 20 lambs the first day they showed diarrhoea (D1), and Days 11 and 22, in addition to single serum samples from 17 of their dams. Serum anti-C. parvum IgG, IgM and/or IgA antibodies were detected in lambs as early as Day 1. Levels of IgM antibodies remained steady from D1 to D11 and increased at D22, whereas the IgG response decreased from D1 to D11 and subsequently increased. In contrast, IgA antibodies rapidly fell from D1 and all lambs were seronegative at D11 and D22. The highest levels of specific antibodies were detected in sera from ewes. In fact, all ewes were seropositives for IgM and IgA isotypes and most (16/17) showed positive levels of IgG. Four protein fractions (37-39, 42-48, 51-57 and 60-69 kDa) were the most frequently recognized by IgG and IgM from lamb sera. A low molecular weight fraction (12-14 kDa) reacting with IgG and IgA in most lamb sera was scarcely recognized by IgM and three broad bands were frequently recognized by IgA antibodies (23-25, 51-57 and 90-95 kDa). The recognition pattern of 23-25 kDa peptides by IgA from lamb sera clearly increased with the age. Peptides of 42-48, 51-57, 60-69 and 71-78 kDa were most frequently recognized by IgG and IgM from ewe sera. In relation to IgA antibodies from ewe sera, a frequent immunoreactivity was found with proteins in the intervals between 12 and 22 kDa as well as between 32 and 34 kDa and practically all sera reacted with fractions from 42 to 95 kDa.