¿Tiene el tratamiento previo con inhibidores de la 5-alfa reductasa repercusión en la enucleación prostática con láser holmium? Resultados de un estudio prospectivo observacional y revisión de la literatura / Evaluating the effects of preoperative treatment with 5-alpha reductase inhibitors in holmium laser enucleation of the prostate

Introducción y objetivos Los pacientes tratados con HoLEP frecuentemente han recibido tratamientos previos, incluyendo los inhibidores de la 5-alfa-reductasa (5ARI). Nuestro objetivo es evaluar el efecto del tratamiento previo con 5ARI en los parámetros perioperatorios y del postoperatorio immediato en pacientes tratados con HoLEP. Materiales y métodos Se ha llevado a cabo un estudio retrospectivo utilizando una base de datos recogida prospectivamente, de todos los pacientes tratados con HoLEP en nuestro centro entre enero de 2017 y enero de 2023. Se han analizado los gramos de resección, la eficiencia de enucleación y morcelación (gramos enucleados/tiempo de enucleación y gramos de morcelación/tiempo de morcelación), las complicaciones postoperatorias, el tiempo de hospitalización y el descenso de hemoglobina. Resultados Se han incluido 327 pacientes; 173 de ellos (52,9%) fueron tratados con 5ARI. Entre los parámetros perioperatorios estudiados para determinar la eficiencia no se encontraron diferencias. No se observaron diferencias en las complicaciones peri o postoperatorias, estancia hospitalaria o descenso de hemoglobina. Conclusiones El uso de 5ARI no tuvo repercusión en el postoperatorio immediato de los pacientes tratados con HoLEP. En nuestra cohorte el uso de 5ARI no ha demostrado alterar la eficiencia quirúrgica, ni en la enucleación ni en la morcelación. Futuros estudios multicéntricos serán necesarios para corroborar estos hallazgos. (AU)

Introduction and aim Patients treated with HoLEP are frequently treated with previous treatments, including 5-alpha-reductase inhibitors (5-ARIs). We investigated the impact of pretreatment with 5-ARIs on perioperative and immediate postoperative parameters in patients treated with HoLEP. Material and Methods A retrospective study was performed using a prospectively collected database including all patients treated with HoLEP at our center between January 2017 and January 2023. The resected tissue weight, enucleation and morcellation efficiency (enucleation weight/time and morcellation weight/ time), postoperative complications, hospital stay and hemoglobin drop have been analyzed. Results A total of 327 patients were included. Of these, 173 (52.9%) were treated with 5-ARIs. No differences were found among the perioperative parameters investigated to determine efficiency. No differences were observed in peri- or postoperative complications, hospital stay or hemoglobin drop. Conclusions Therapy with 5-ARIs had no impact on the immediate postoperative outcomes of patients treated with HoLEP. In our cohort, we observed that the use of 5-ARIs did not affect surgical efficiency, enucleation or morcellation. Further multicenter studies will be necessary to validate these findings. (AU)

Effectiveness of a specific follow up program for the management of the mental components of post-intensive care syndrome and chronic pain after COVID-19: results from the PAIN-COVID randomized clinical trial.

BACKGROUND: Critical COVID-19 survivors are at risk of developing Post-intensive Care Syndrome (PICS) and Chronic ICU-Related Pain (CIRP). We determined whether a specific care program improves the quality of life (QoL) of patients at risk of developing PICS and CIRP after COVID-19. METHODS: The PAIN-COVID trial was a parallel-group, single-centre, single-blinded, randomized controlled trial. The intervention consisted of a follow up program, patient education on PICS and pain, and a psychological intervention based on Rehm's self-control model in patients with abnormal depression scores (≥8) in the Hospital Anxiety and Depression Scale (HADS) at the baseline visit. QoL was evaluated with the 5-level EQ 5D (EQ 5D 5 L), mood disorders with the HADS, post-traumatic stress disorder (PTSD) with the PCL-5 checklist, and pain with the Brief Pain Inventory short form, the Douleur Neuropathique 4 questionnaire, and the Pain Catastrophizing Scale. The primary outcome was to determine if the program was superior to standard-of-care on the EQ visual analogue scale (VAS) at 6 months after the baseline visit. The secondary outcomes were EQ VAS at 3 months, and EQ index, CIRP incidence and characteristics, and anxiety, depression, and PTSD at 3 and 6 months after baseline visits. CONCLUSIONS: This program was not superior to standard care in improving QoL in critical COVID-19 survivors as measured by the EQ VAS. However, our data can help establish better strategies for the study and management of PICS and CIRP in this population. TRIAL REGISTRATION: # NCT04394169, registered on 5/19/2020.

Evaluating the effects of preoperative treatment with 5-alpha reductase inhibitors in holmium laser enucleation of the prostate.

INTRODUCTION AND AIM: Patients treated with HoLEP are frequently treated with previous treatments, including 5-alpha-reductase inhibitors (5-ARIs). We investigated the impact of pretreatment with 5-ARIs on perioperative and immediate postoperative parameters in patients treated with HoLEP. MATERIAL AND METHODS: A retrospective study was performed using a prospectively collected database including all patients treated with HoLEP at our center between January 2017 and January 2023. The resected tissue weight, enucleation and morcellation efficiency (enucleation weight/time and morcellation weight/ time), postoperative complications, hospital stay and hemoglobin drop have been analyzed. RESULTS: A total of 327 patients were included. Of these, 173 (52.9%) were treated with 5-ARIs. No differences were found among the perioperative parameters investigated to determine efficiency. No differences were observed in peri- or postoperative complications, hospital stay or hemoglobin drop. CONCLUSIONS: Therapy with 5-ARIs had no impact on the immediate postoperative outcomes of patients treated with HoLEP. In our cohort, we observed that the use of 5-ARIs did not affect surgical efficiency, enucleation or morcellation. Further multicenter studies will be necessary to validate these findings.

Are farmers motivated to select for heat tolerance? Linking attitudinal factors, perceived climate change impacts, and social trust to farmers' breeding desires.

This study provides an understanding of dairy farmers' willingness to include heat tolerance in breeding goals and the modulating effect of sociopsychological factors and farm profile. A survey instrument including a choice experiment was designed to specifically address the trade-off between heat tolerance and milk production level. A total of 122 farmers across cattle, goat, and sheep farms were surveyed face-to-face. The results of the experiment show that most farmers perceive that heat stress and climate change are increasingly important problems, and that farming communities should invest more in generating knowledge and resources on mitigation strategies. However, we found limited initial support for selection for heat tolerance. This attitude changed when farmers were presented with objective information on the benefits and limitations of the different breeding choices, after which most farmers supported selection for heat tolerance, but only if doing so would compromise milk production gains to a small extent. Our results show that farmers' selection choices are driven by the interactions between heat stress risk perception, attitudes toward breeding tools, social trust, the species reared, and farm production level. In general, farmers willing to support selection of heat-tolerant animals are those with positive attitudes toward genetic values and genomic information and a strong perception of climate change and heat stress impacts on farms. On the contrary, negative support for selection for heat tolerance is found among farmers with high milk production levels; high trust in farming magazines, livestock farmers' associations, and veterinarians; and low trust in environmental and animalist groups.

Improving the prediction of the fatty acid profile of olive oils by considering statistically relevant harvests and agro-climatic variables.

BACKGROUND: Fatty acids are the major components in extra virgin olive oil, and they are considered as a quality parameter to its authentication. As fraudulent practices are the most important problem in this sector, fast, reliable and cost-effective techniques, such as Raman spectroscopy, have been successfully applied, in combination with chemometrics, to determine the fatty acid profile of oils. RESULTS: The huge amount of information provided by Raman spectra is reduced in a few orthogonal components of principal component analysis (PCA). The goodness-of-fit of the statistical models including only these PCA factors is considerably increased by introducing dummy variables, associated with the harvest, and some agro-climatic variables (temperature, humidity, wind speed, radiation, precipitation and evapotranspiration). Many of these additional variables are statistically relevant in models using either the global sample or subsamples of Andalusian provinces or olive varieties. CONCLUSIONS: The regression models using only Raman spectral information are clearly improved by the consideration of harvesting time and agro-climatic data, a useful result as trade standard applying to olive oils limits values for disaggregated fatty acids to authenticate olive oils. Nevertheless, the effect (or the statistical relevance) of these variables depends on the specific type of fatty acid, geographical region (province) or olive variety. © 2019 Society of Chemical Industry.

Neurorehabilitation and apps: A systematic review of mobile applications. / Apps en neurorrehabilitación. Una revisión sistemática de aplicaciones móviles.

INTRODUCTION: Mobile health or mHealth, defined as the provision of health information or healthcare by means of mobile devices or tablets, is emerging as a major game-changer for patients, care providers, and investors. An app is a program with special characteristics installed on a small mobile device, either a tablet or smartphone, with which the user interacts via a touch-based interface. The purpose of the app is to facilitate completion of a certain task or assist with daily activities. OBJECTIVE: The aim of this study was to conduct a systematic review of published information on apps directed at the field of neurorehabilitation, in order to classify them and describe their main characteristics. MATERIAL AND METHODS: A systematic review was carried out by means of a literature search in biomedical databases and other information sources related to mobile applications. Apps were classified into five categories: health habits, information, assessment, treatment, and specific uses. CONCLUSIONS: There are numerous applications with potential for use in the field of neurorehabilitation, so it is important that developers and designers understand the needs of people with neurological disorders so that their products will be valid and effective in light of those needs. Similarly, professionals, patients, families, and caregivers should have clear criteria and indicators to help them select the best applications for their specific situations.

Chemometric study of Andalusian extra virgin olive oils Raman spectra: Qualitative and quantitative information.

Authentication of extra virgin olive oil (EVOO) is an important topic for olive oil industry. The fraudulent practices in this sector are a major problem affecting both producers and consumers. This study analyzes the capability of FT-Raman combined with chemometric treatments of prediction of the fatty acid contents (quantitative information), using gas chromatography as the reference technique, and classification of diverse EVOOs as a function of the harvest year, olive variety, geographical origin and Andalusian PDO (qualitative information). The optimal number of PLS components that summarizes the spectral information was introduced progressively. For the estimation of the fatty acid composition, the lowest error (both in fitting and prediction) corresponded to MUFA, followed by SAFA and PUFA though such errors were close to zero in all cases. As regards the qualitative variables, discriminant analysis allowed a correct classification of 94.3%, 84.0%, 89.0% and 86.6% of samples for harvest year, olive variety, geographical origin and PDO, respectively.

Evaluation of hippuric acid content in goat milk as a marker of feeding regimen.

Organic producers, traders, and consumers must address 2 issues related to milk: authentication of the production system and nutritional differentiation. The presence of hippuric acid (HA) in goat milk samples has been proposed as a possible marker to differentiate the feeding regimen of goats. The objective of this work is to check the hypothesis that HA could be a marker for the type of feeding regimen of goats by studying the influence of production system (conventional or organic) and feeding regimen (with or without grazing fodder). With this purpose, commercial cow and goat milk samples (n=27) and raw goat milk samples (n=185; collected from different breeds, localizations, and dates) were analyzed. Samples were grouped according to breed, feeding regimen, production system, and origin to compare HA content by ANOVA and honestly significant difference Tukey test at a confidence level of ≥95%. Hippuric acid content was obtained by analyzing milk samples with capillary electrophoresis. This method was validated by analyzing part of the samples with HPLC as a reference technique. Sixty-nine raw goat milk samples (of the total 158 samples analyzed in this work) were quantified by capillary electrophoresis. In these samples, the lowest average content for HA was 7±3 mg/L. This value corresponds to a group of conventional raw milk samples from goats fed with compound feed. The highest value of this group was 28±10 mg/L, corresponding to goats fed compound feed plus grass. Conversely, for organic raw goat milk samples, the highest concentration was 67±14 mg/L, which corresponds to goats fed grass. By contrast, the lowest value of this organic group was 26±10 mg/L, which belongs to goats fed organic compounds. Notice that the highest HA average content was found in samples from grazing animals corresponding to the organic group. This result suggests that HA is a good marker to determine the type of goats feeding regimen; a high content of HA represents a diet based mainly or exclusively on eating green grass (grazing), independently of the production system. Hence, this marker would not be useful for the actual organic policies to distinguish organic milk under the current regulations, because organic dairy ruminants can be fed organic compound feed and conserved fodder without grazing at all.

Effect of a self-care program on oxidative stress and cognitive function in an older Mexican urban-dwelling population.

OBJECTIVE: To determine the effect of a self-care program on oxidative stress (OxS) and cognitive function in an older, Mexican, urban-dwelling population. DESIGN: A longitudinal and pre-experimental study was carried out in a sample of 79 older healthy, urban-dwelling individuals residing in Mexico City, (62 females and 17 males), of which 71 of them (59 women and 12 males) complied with the entire self-care program. MEASUREMENTS: We measured OxS, cognitive function, the Nagi Disability Scale of physical task functioning, and Instrumental Activities of Daily Living (IADL) prior to and after 2 years of intervention with an active aging program. RESULTS: All older persons adopted healthy, self-care-based lifestyles according to the active aging program to which they were trained, which was associated with a statistically significant improvement of OxS and cognitive function markers on comparing pre- and post-community intervention data. CONCLUSIONS: Our findings suggest that self-care-based healthy lifestyles programs can improve the oxidative stress and cognitive function in urban-dwelling elderly population.

Convulsiones febriles / Febrile seizures

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[The anticonvulsive effect of 4,4-bis(hydroxymethyl)-2-phenyl-2-oxazoline]. / Efecto anticonvulsionante de la 2-fenil-4,4-bis (hidroximetil)-2-oxazolina.

INTRODUCTION: Certain compounds belonging to the family of the 2-aryl oxazolines have been reported to act on the central nervous system with a number of different effects and applications, which make them useful as depressants, anaesthetics, anticonvulsants, and so on. AIMS: Our aim was to study the possible effect of 4,4-bis(hydroxymethyl)-2-phenyl-2-oxazoline (OX), obtained by chemical synthesis using microwaves, in two experimental models of epilepsy. MATERIALS AND METHODS: Two models were used: one involving (repeated stimulation) electroconvulsive shock in mice and the other consisted in inducing audiogenic seizures in Mongolian gerbils. Recordings were performed of the potentials in the dentate gyrus (DG) generated in response to electrical stimulation of the entorhinal cortex in anaesthetised gerbils, using the stereotactic technique. RESULTS: A 150 mg/kg dose of OX lowered the number of electrical pulses required to induce the tonic seizures triggered by the electroshock, as well as their duration. This same dose blocked the seizures induced by audiogenic stimuli in the gerbils and significantly reduced their severity (degrees of seizures) and occurrence. OX diminished, in a dose-dependent manner, the amplitude of the excitatory post-synaptic potential and that of the population spike, triggered by stimulating the entorhinal cortex in the DG. CONCLUSIONS: OX acts as an antiepileptic agent and its mechanism of action could be related to the inhibiting effect it exerts on the entorhinal cortex-DG synapses in the hippocampus.

Efecto anticonvulsionante de la 2-fenil-4, 4-bis (hidroximetil)-2-oxazolina / The anticonvulsive efecto of 4, 4-Bis (Hydroxymethyl)-2-phenyl-2oxazoline

Introduction. Certain compounds belonging to the family of the 2-aryl oxazolines have been reported to act on the central nervous system with a number of different effects and applications, which make them useful as depressants, anaesthetics, anticonvulsants, and so on. Aims. Our aim was to study the possible effect of 4,4-bis(hydroxymethyl)-2-phenyl-2-oxazoline (OX), obtained by chemical synthesis using microwaves, in two experimental models of epilepsy. Materials and methods. Two models were used: one involving (repeated stimulation) electroconvulsive shock in mice and the other consisted in inducing audiogenic seizures in Mongolian gerbils. Recordings were performed of the potentials in the dentate gyrus (DG) generated in response to electrical stimulation of the entorhinal cortex in anaesthetised gerbils, using the stereotactic technique. Results. A 150 mg/kg dose of OX lowered the number of electrical pulses required to induce the tonic seizures triggered by the electroshock, as well as their duration. This same dose blocked the seizures induced by audiogenic stimuli in the gerbils and significantly reduced their severity (degrees of seizures) and occurrence. OX diminished, in a dose-dependent manner, the amplitude of the excitatory post-synaptic potential and that of the population spike, triggered by stimulating the entorhinal cortex in the DG. Conclusions. OX acts as an antiepileptic agent and its mechanism of action could be related to the inhibiting effect it exerts on the entorhinal cortex-DG synapses in the hippocampus (AU)

Introducción. Algunos compuestos de la familia de las 2- aril-oxazolinas se han descrito como sustancias activas sobre el sistema nervioso central, con efectos y aplicaciones diversas, como depresores, anestésicos, anticonvulsionantes, etc. Objetivo. Estudiar el posible efecto de la 2-fenil-4,4-bis (hidroximetil)-2-oxazolina (OX) obtenida por síntesis química bajo microondas en dos modelos de epilepsia experimental. Materiales y métodos. Se emplearon el modelo de choque electroconvulsivo –por estimulación repetitiva– en ratones y el de crisis audiogénica en el gerbo mongol. Se incluyó el registro de los potenciales del giro dentado (GD) en respuesta a la estimulación eléctrica de la corteza entorrinal en el gerbo anestesiado mediante la técnica estereotáctica. Resultados. La dosis de 150 mg/kg de OX redujo el número de pulsos eléctricos necesarios para inducir la crisis tónica producida por el choque eléctrico, así como su duración. Esta misma dosis bloqueó las crisis inducidas por el estímulo audiogénico en el gerbo y disminuyó significativamente su gravedad (grados de crisis) y aparición. La OX redujo, en forma dependiente de la dosis, la amplitud del potencial postsináptico excitatorio y de la espiga de población, provocada por la estimulación de la corteza entorrinal en el GD. Conclusiones. La OX posee un efecto antiepiléptico cuyo mecanismo podría estar relacionado con su acción inhibitoria sobre la sinapsis corteza entorrinal-GD en el hipocampo (AU)

Total antioxidant levels, gender, and age as risk factors for DNA damage in lymphocytes of the elderly.

During past years, the association of oxidative stress with DNA damage and its possible clinical translation into chronic degenerative illnesses, such as atherosclerosis, cancer, diabetes mellitus and Alzheimer's disease, has been demonstrated. In addition, it has been pointed out that age and gender are factors that influence the generation of DNA damage; however, this is still controversial. We have previously reported the results of a study of 88 subjects older than 60 years of age in whom DNA damage is related with serum levels of total antioxidants. The results of this study demonstrate a greater frequency of DNA damage in elderly persons with normal levels of antioxidants, in addition to males, and in the younger group of subjects, i.e., 60-69 years. In this work, we enlarged our study sample to 160 elderly subjects; in this way, we were able to evaluate the consistency of the influence of total antioxidants, age, and gender on the magnitude and grade of DNA damage in lymphocytes of the elderly. The results demonstrated that 45% of the subjects showed DNA damage, measured by an alkaline unicellular electrophoresis technique (comet assay). Similarly, 62% of the subjects presented low levels of total antioxidant levels measured by a colorimetric method (Randox Kit). A greater percentage of DNA damage was observed in subjects with normal levels of antioxidants (48%) compared with subjects with low levels (43%), although the difference was not statistically significant. The group of subjects 70 years of age or older showed a greater percentage of DNA damage (50%) than the group of subjects of 60-69 years of age (41%). However, the difference was again not statistically significant (P>0.05). With respect to gender, 64% of males and 38% of females had DNA damage with an odds ratio (OR) of 2.86 and a 95% confidence interval (CI) of 1.31-6.32 (P<0.05). In the logistic regression analysis, the interaction of the male sex variables with low antioxidants had an OR of 2.5 (CI 95%, 1.33-4.68; P<0.01). We conclude that the interaction of male sex factors-low levels of antioxidants would justify the indication of antioxidant dietetic supplements.

Vegetación del entorno del Balneario El Paraíso, Manzanera (Teruel) / Vegetation in the surroundings of the El Paraiso Spa in Manzanera (province of Teruel, Spain)

Se estudian los principales aspectos bioclimáticos, biogeográficos y edáficos de los alrededores del Balneario El Paraíso, de Manzanera (Teruel), señalando las comunidades vegetales climatófilas y edafófilas más representativas. Finalmente se incluye una relación de las plantas de uso medicinal utilizadas tanto en el ámbito comarcal como nacional (AU)

Serum leptin levels and blood pressure in the overweight elderly.

BACKGROUND: Leptin is a protein produced by adipocytes that reduces reflex appetite by blocking the Y neuropeptide, thus causing body weight loss. A large percentage of elderly people are reported to exhibit obesity, which may be caused by low leptin serum levels. However, hypertension is a highly prevalent condition in old age. Obesity under these circumstances is an added risk factor due to the presence and severity of hypertension and thus can be related with leptin serum levels. Our objective was to determine the relationship between leptin serum levels and hypertension in obese elderly persons. METHODS: A comparative transverse study was done in a random sample of 61 elderly persons-36 obese and 25 non-obese. Their blood pressure and their leptin serum levels by RIA were measured. RESULTS: Leptin serum levels showed a statistically significant difference (p <0.05) in elderly obese individuals (12.8 +/- 4.4 microg/L vs. 9.8 +/- 4.2 microg/L). Likewise, 45% of obese elderly individuals and 20% of the non-obese were hypertensive with a predominant elevation of the systolic pressure. CONCLUSIONS: The higher serum leptin levels in obese elderly individuals suggests that aging is associated with resistance to leptin and/or to a decrease of receptors for this hormone. The high incidence of hypertension during the aging process is the result of associated obesity (OR = 3.2, CI 0.88-13.14).

DNA damage in lymphocytes of elderly patients in relation with total antioxidant levels.

DNA damage may occur as a result of an imbalance between the production and removal of free radicals, a process in which age plays an outstanding role. The purpose of this study was to analyze the relationship between total antioxidants and DNA damage in a sample of old age people in Mexico City. The sample included a total of 88 subjects, 15 males and 69 females, with a mean age of 65.5 years old (range between 60 and 79 years old), all of whom had lived in Mexico City during the last 10 years and had been diagnosed as clinically healthy. Results showed that 52% of the subjects presented DNA damage in peripheral blood lymphocytes which was assessed through an alkaline unicellular electrophoresis procedure (Comet Test), regardless of total antioxidant serum levels quantified through a colorimetric method (Randox Kit). Higher non-damage occurrences were observed in subjects with low antioxidant levels, a difference that was statistically significant (P < 0.05). Furthermore, the highest incidence of damaged cells was observed in subjects belonging to the 70-years-old-and-above group (P < 0.05). As to the magnitude and intensity of the damage associated to total antioxidant concentrations, a trend toward greater DNA damage in subjects with low serum levels was observed. It is concluded that low antioxidant levels are not always indicative of oxidative strain and therefore should not be considered as predictors of DNA damage in this population.

Determination of fat-soluble vitamins in yogurt by HPLC with electrochemical detection.

A method employing HPLC with electrochemical detection for the rapid and simultaneous determination of vitamins A, D(3) and E is described. The method uses a C-18 reverse phase column and 2.5 mM HAcO-NaAcO in methanol-water (99:1, v/v) solution as the mobile phase. The compounds are quantified using amperometric detection with a glassy carbon electrode at a potential of + 1300 mV (vs. Ag/AgCl) and the results are compared with those obtained using UV detection at a wavelength of 280 nm. The method was successfully applied to the analysis of vitamins A, D(3) and E in yogurt samples. After saponification, fat-soluble vitamins were extracted and the methanolic solution of the extracts was injected directly into the chromatographic system, avoiding the clean-up step which is necessary when no electrochemical detection is used. Good recovery percentages were obtained.

Sensitive high-performance liquid chromatographic assay for praziquantel in plasma, urine and liver homogenates.

A high-performance liquid chromatographic method for the determination of praziquantel in plasma, urine and rat liver homogenates has been developed. It requires 2 ml of biological fluid, an extraction using Sep-Pak cartridges, a 0.05 M phosphate buffer solution (pH 5.0) for equilibrating and washing and ethyl acetate-diisopropyl ether for drug elution. The analysis was performed on an Ultrasphere ODS C18 column with a mobile phase of acetonitrile-water with ultraviolet detection at 217 nm. The results showed that the assay is sensitive (31.2 ng/ml), linear between 0.125 and 4.0 micrograms/ml, precise (coefficient of variation = 10%) and selective with other drugs currently administered with praziquantel.