Zoo animals as sentinels for Schmallenberg virus monitoring in Spain.

Schmallenberg virus (SBV) is a newly emerged vector-borne pathogen that affects many domestic and wild animal species. A serosurvey was carried out to assess SBV exposure in zoo animals in Spain and to determine the dynamics of seropositivity in longitudinally sampled individuals. Between 2002 and 2019, sera from 278 animals belonging to 73 different species were collected from five zoos (A-E). Thirty-one of these animals were longitudinally sampled at three of these zoo parks during the study period. Seropositivity was detected in 28 (10.1 %) of 278 animals analyzed by blocking ELISA. Specific anti-SBV antibodies were confirmed in 20 (7.2 %; 95 %CI: 4.2-10.3) animals of six different species using virus neutralization test (VNT). The multiple logistic regression model showed that "order" (Artiodactyla) and "zoo provenance" (zoo B; southern Spain) were risk factors potentially associated with SBV exposure. Two (8.7 %) of the 31 longitudinally-sampled individuals showed specific antibodies against SBV at all samplings whereas seroconversion was detected in one mouflon (Ovis aries musimon) and one Asian elephant (Elephas maximus) in 2016 and 2019, respectively. To the best of the author's knowledge, this is the first surveillance conducted on SBV in zoos in Spain. The results confirm SBV exposure in zoo animals in this country and indicate circulation of the virus before the first Schmallenberg disease outbreak was reported in Spain. Surveillance in zoological parks could be a complementary approach to monitoring SBV activity. Further studies are warranted to assess the impact of this virus on the health status of susceptible zoo animals.

A variable presentation of Joubert syndrome: Case report and a brief review.

Joubert syndrome is a rare neurological manifestation usually present in late infancy or early childhood with characteristic episodes of abnormal breathing pattern along with the neurological and other systemic involvement.We report a case of confirmed Joubert syndrome present in the immediate neonatal period with isolated spells of oxygen desaturations not accompanied by the classically described breathing pattern and absent neurological symptoms causing delay in the diagnosis. Isolated oxygen desaturation episodes could be a presenting manifestation of Joubert syndrome in a neonatal period.

Effects of prefabricated and custom-made foot orthoses on skin temperature of the foot soles after running.

OBJECTIVE: Foot orthoses are increasingly used by runners despite the controversy about whether their use can reduce the risk of overuse injuries. Some authors have found modifications in plantar pressures with the use of foot orthoses, which could produce changes in the surface skin temperature of the foot soles. The aim of this study was to analyse the effects of custom-made and prefabricated foot orthoses on the skin temperature of different regions of both foot soles after running. APPROACH: Twenty-four participants carried out a maximal aerobic speed test as a pre-test, and three running tests at the laboratory wearing different foot orthoses conditions (control, prefabricated and custom-made) previously randomized. Skin temperature of four regions of interest of the foot soles was assessed before, immediately after and ten minutes after running. MAIN RESULTS: The use of prefabricated and custom-made foot orthoses did not produce changes on skin temperature of the foot soles neither in absolute temperatures (p > 0.05), nor in temperature variations: between immediately after and before running (p > 0.05), and between ten minutes after and immediately after running (p > 0.05). Otherwise, higher values were found with no insoles than with prefabricated foot orthoses, 10 min after running in relation to before running, in forefoot [mean (standard deviation): 5.6 (2.4) versus 3.7 (2.7) °C; p = 0.02; effect size (ESd) = 0.72], midfoot [3.7 (1.5) versus 2.7 (1.5) °C; p = 0.03; ESd = 0.65] and rearfoot [4.18 (2.05) versus 2.9 (1.82) °C; p = 0.02; ESd = 0.64)]. SIGNIFICANCE: In conclusion, the use of foot orthoses, in general, does not affect the surface skin temperature of the foot soles after an intense run.

Consenso para la mejora de la atención integral de los pacientes con insuficiencia cardíaca aguda: versión resumida / Consensus for improving the comprehensive care of patients with acute heart failure: summarised version

El propósito de este documento de consenso fue alcanzar un acuerdo entre expertos sobre la atención multidisciplinar de los pacientes con insuficiencia cardíaca aguda. A partir de una revisión narrativa sobre la atención a estos pacientes y de un análisis crítico de los procedimientos asistenciales, se identificaron las carencias y mejoras potenciales y se formalizó un documento de recomendaciones para optimizar el abordaje clínico y terapéutico de la insuficiencia cardíaca aguda, validado mediante una sesión grupal presencial dirigida con técnicas participativas. El resultado del proceso es un conjunto de 36 recomendaciones formuladas por expertos de la Sociedad Española de Cardiología, la Sociedad Española de Medicina Interna y la Sociedad Española de Urgencias y Emergencias, orientadas a optimizar el reto asistencial que supone la atención de los pacientes con insuficiencia cardíaca aguda en el contexto del actual Sistema Nacional de Salud (AU)

The purpose of this consensus document was to reach an agreement among experts on the multidisciplinary care of patients with acute heart failure. Starting with a narrative review of the care provided to these patients and a critical analysis of the healthcare procedures, we identified potential shortcomings and improvements and formalised a document on recommendations for optimising the clinical and therapeutic approach for acute heart failure. This document was validated through an in-person group session guided using participatory techniques. The process resulted in a set of 36 recommendations formulated by experts of the Spanish Society of Cardiology, the Spanish Society of Internal Medicine and the Spanish Society of Urgent and Emergency Care. The recommendations are designed to optimise the healthcare challenge presented by the care of patients with acute heart failure in the context of Spain's current National Health System (AU)

Consensus for improving the comprehensive care of patients with acute heart failure: summarised version.

The purpose of this consensus document was to reach an agreement among experts on the multidisciplinary care of patients with acute heart failure. Starting with a narrative review of the care provided to these patients and a critical analysis of the healthcare procedures, we identified potential shortcomings and improvements and formalised a document on recommendations for optimising the clinical and therapeutic approach for acute heart failure. This document was validated through an in-person group session guided using participatory techniques. The process resulted in a set of 36 recommendations formulated by experts of the Spanish Society of Cardiology, the Spanish Society of Internal Medicine and the Spanish Society of Urgent and Emergency Care. The recommendations are designed to optimise the healthcare challenge presented by the care of patients with acute heart failure in the context of Spain's current National Health System.

Long-term effects of graduated compression stockings on cardiorespiratory performance.

The use of graduated compression stockings (GCS) in sport has been increasing in the last years due to their potential positive effects for athletes. However, there is little evidence to support whether these types of garments actually improve cardiorespiratory performance. The aim of this study was to examine the cardiorespiratory responses of GCS during running after three weeks of regular use. Twenty recreational runners performed three tests on different days: test 1) - a 5-min maximal effort run in order to determine the participants' maximal aerobic speed; and tests 2) and 3) - a fatigue running test of 30 minutes at 80% of their maximal aerobic speed with either GCS or PLACEBO stockings at random. Cardiorespiratory parameters (minute ventilation, heart rate, relative oxygen consumption, relative carbon dioxide production, ventilatory equivalents for oxygen and carbon dioxide, and oxygen pulse) were measured. Before each test in the laboratory, the participants trained with the randomly assigned stockings (GCS or PLACEBO) for three weeks. No significant differences between GCS and PLACEBO were found in any of the cardiorespiratory parameters. In conclusion, the present study provides evidence that running with GCS for three weeks does not influence cardiorespiratory parameters in recreational runners.

Effects of graduated compression stockings on skin temperature after running.

High skin temperatures reduce the thermal gradient between the core and the skin and they can lead to a reduction in performance and increased risk of injury. Graduated compression stockings have become popular among runners in the last years and their use may influence the athlete's thermoregulation. The aim of this study was to investigate the effects of graduated compression stockings on skin temperature during running in a moderate indoor environment. Forty-four runners performed two running tests lasting 30min (10min of warm-up and 20min at 75% of their maximal aerobic speed) with and without graduated compressive stockings. Skin temperature was measured in 12 regions of interest on the lower limb by infrared thermography before and after running. Heart rate and perception of fatigue were assessed during the last minute of the running test. Compression stockings resulted in greater increase of temperature (p=0.002 and ES=2.2, 95% CI [0.11-0.45°C]) not only in the body regions in contact (tibialis anterior, ankle anterior and gastrocnemius) but also in the body regions that were not in contact with the garment (vastus lateralis, abductor and semitendinosus). No differences were observed between conditions in heart rate and perception of fatigue (p>0.05 and ES<0.8). In conclusion, running with graduated compression stockings produces a greater increase of skin temperature without modifying the athlete's heart rate and perception of fatigue.

Effect of 3 Weeks Use of Compression Garments on Stride and Impact Shock during a Fatiguing Run.

Excessive and prolonged exposure to impact acceleration during running is associated with increased injury rate. Acute use of compressive garments has been speculated to improve attenuation. However, it is unknown how longer interventions of compressive garments influence attenuation in running. 40 runners trained with compressive and placebo stockings for 3 weeks. Perception of comfort, stride parameters (rate, length) and impact acceleration (head and tibial peak acceleration, magnitude, acceleration rate and attenuation) were measured every 5 min during a fatigue run (30 min at 80% of the individual's maximal aerobic speed). Compressive stockings reduced tibial peak acceleration and magnitude compared to placebo stockings at every minute (p<0.05) except for the initial measurement (p>0.05). Moreover, compressive stockings led to a lower rate of increase in tibial peak acceleration (14%, p<0.005) and magnitude (16%, p<0.001) as a result of the development of fatigue compared to placebo stockings (24% and 26% increase, p=0.014 and p=0.003, respectively). Similar perception of comfort was reported for both garments. Training with compressive stockings for 3 weeks reduced impact acceleration and the rate of increase in acceleration compared to placebo stockings. These findings suggest that compressive stockings may play a protective role by reducing impact accelerations during running.

Influence of foot orthosis customisation on perceived comfort during running.

Although running is associated with many health benefits, it also exposes the body to greater risk of injury. Foot orthoses are an effective strategy to prevent such injuries. Comfort is an essential element in orthosis design since any discomfort alters the runner's biomechanics, compromising performance and increasing the risk of injury. The present study analyses the perceived comfort of three types of orthoses: custom-made, prefabricated and original running shoe insoles. Nine comfort variables for each insole were assessed in a sample of 40 runners. Custom-made and prefabricated insoles were both perceived as significantly more comfortable than the original insoles. The differences were clinically relevant and were potentially causes of modifications in running gait. Although the prefabricated insoles were rated slightly higher than the custom-made insoles, the differences were not statistically significant. This study shows that prefabricated insoles constitute a reasonable alternative to custom-made insoles in terms of comfort. PRACTITIONER SUMMARY: The perceived level of comfort of footwear is considered to be a protective measure of the potential risk of running injuries. We here compared runners' perception of comfort of custom-made and prefabricated orthoses while running. We found that even though custom-made orthoses are closely matched to each individual's foot, such customisation does not necessarily imply greater comfort.

Papel del factor precipitante de un episodio de insuficiencia cardiaca aguda en relación al pronóstico a corto plazo del paciente: estudio PAPRICA / The influence of precipitating factors on short-term prognosis in acute heart failure: the PAPRICA study

Objetivos: Hay pocos estudios que analicen el papel que juegan los factores precipitantes (FPre) en el manejo de la insuficiencia cardiaca aguda (ICA). El estudio PAPRICA pretende analizar la relación entre la identificación de diferentes FPre con la mortalidad precoz y las reconsultas a los 30 días. Método: Estudio retrospectivo, multicéntrico, con seguimiento de cohortes a partir del os datos incluidos en el registro EAHFE (Epidemiology Acute Heart Failure Emergency). Se recogieron datos de todos los episodios de ICA en 8 servicios de urgencias hospitalarios(SUH) españoles durante el mes de abril de 2007. Se recogieron datos del perfil clínico y la evolución a corto plazo (mortalidad y reconsulta a los 30 días). La variable clasificadora del estudio fue la ausencia o presencia conocida de FPre del episodio de ICA. Sólo se recogió un FPre por episodio. Resultados: Se incluyeron 662 casos. El 51,4% de los casos presentaron un FPre. A los30 días se registró una mortalidad del 6,2% y un índice de reconsultas del 26,6%. Los FPre más frecuentes fueron las infecciones (22,2%), las taquiarritmias (13%), la emergencia hipertensiva (4,9%), la transgresión del tratamiento (4,2%), la anemia (3,9%) yla isquemia coronaria (3,7%). En conjunto, no hubo diferencias (..) (AU)

Background and objective: Few studies have analyzed the impact of precipitating factors on the management of acute heart failure (AHF). The PAPRICA study sought to explore the relationship between identifying the precipitating factor in AHF and the 30-day mortality and emergency department revisit rates after the episode. Methods: Retrospective, multicenter study of AHF cases with follow-up data in the EAHFE registry (Epidemiology of Acute Heart Failure Emergencies). From the records of AHF episodes attended in 8 Spanish emergency departments in April 2007, we extracted the clinical characteristics of each episode and the short-term outcomes (30-day mortality and revisits). Patients were classified by absence or presence of a known precipitating factor for the AHF episode. Only the precipitating factor responsible for the episode was recorded. Results: Data for 662 cases were included. A precipitating factor was registered for 51.4% of the cases. At 30 days, overall mortality was 6.2% and revisits were made by 26.6% of the patients. The most common precipitating factors(..) (AU)

Successful allogeneic hematopoietic stem cell transplantation for acute myelogenous leukemia in a patient with hepatic echinococcal cyst managed by delayed hepatectomy.

We report the case of a patient who underwent cytotoxic chemotherapy and allogeneic hematopoietic stem cell transplantation (HSCT) for acute myelogenous leukemia in the presence of hepatic cystic echinococcal infection. The presence of Echinococcus granulosus infection in an immunocompromised host is extremely rare, with lack of established data regarding optimal management. Successful management of the patient's disease processes required a multidisciplinary approach, which included systemic chemotherapy, HSCT, treatment of chronic graft-versus-host-disease, and elective en bloc resection of the hepatic cyst.

Influencia del vendaje neuromuscular sobre la presión plantar durante la marcha / Influence of the neuromuscular bandage on plantar pressure during walking

Durante los últimos años, la aplicación del vendaje neuromuscular (VN) ha sido empleada en el ámbito deportivo y la rehabilitación. Varios son los beneficios asociados al VN, aunque su influencia y efectos en el patrón de presión plantar es desconocida. En este sentido, mediante el sistema de pedobarografía Biofoot IBV® 6.0 se ha analizado la presión plantar en 5 zonas del pie, así como la cadencia y el tiempo de apoyo. Veintinueve sujetos participaron en el estudio, caminando sobre una cinta rodante a 1 m/s, con/sin VN en peroneos y tríceps sural. Los resultados no mostraron diferencias significativas (p<0,05) en las presiones plantares por el uso del VN en ambos grupos musculares. Tan sólo el efecto de este vendaje aplicado en el tríceps sural durante la marcha mostró un ligero incremento en el tiempo de apoyo (p=0,045) (AU)

Application of the neuromuscular bandage has frequently been used in sports and rehabilitation. There are several benefits associated with this bandage, although its influence and effects on the plantar pressure pattern have not been analyzed. In this sense, our study has analyzed plantar pressure in 5 foot zones with the pedobarographic system Biofoot IBV® 6.0 as well as cadence and contact time. A total of 29 subjects participated in the study, walking on a treadmill at 1 m/s with and without the neuromuscular bandage on the peroneus and triceps surae. The results did not show any significant differences (p<0.05) in plantar pressure using the neuromuscular bandage in both muscle groups. Only the effect of this bandage applied on the triceps surae during walking showed a slight increase in contact time (p=0.045) (AU)

Especies medicinales y tóxicas del género Lepechinia Willd. (Labiatae) en Venezuela / No disponible

Las especies medicinales y tóxicas del género Lepechinia Willd. en Venezuela son Lepechinia bullata (Kunth) Epling y Lepechinia schiedeana (Schleghtd) Vatke, las dos viven en alta montaña. Se han encontrado diferencias en la composición del aceite esencial y en el indumento de la hoja

Lepechinia bullata (Kunth) Epling and Lepechinia schideana (Schleghtd) Watke are the medicinal and toxic species of genus WiIld in Venezuela, both live in high mountain and they have some differences in the composition of the essential oil and some differences in the indument of leaves

Aplicación parcial de la metodología Q.F.D. en el diseño de colchonetas para la gimnasia / Partial implementation of the Q.F.D. methodology for gymnastic mats desing

El presente estudio ha permitido identificar y jerarquizar por orden de importancia, las necesidades y los problemas que gimnastas y entrenadores encuentran actualmente en las colchonetas de gimnasia artística, así como también, analizar si las distintas normativas en materia de colchonetas: E.N 12503 y F.I.G. 2000, establecen criterios y metodología de ensayo para dichos aspectos. Para ello, se empleó de manera parcial la metodología Q.F.D., junto con una herramienta denominada “paneles de usuarios y expertos”. Los resultados muestran como los aspectos más importantes en las colchonetas para gimnasia son la amortiguación, la absorción de energía, la estabilidad, los acabados de la superficie y la facilidad de limpieza y transporte. Sin embargo, se observa cómo, pese a la existencia distintas normas, distintos aspectos no son analizados tales como la velocidad de recuperación tras el impacto (relacionado con la absorción de energía) y el comportamiento areaelástico de la superficie (relacionado con la estabilidad), lo cual podría ser motivo de lesión durante la recepción del gimnasta (AU)

This research allows us to identify and arrange in order of importance the needs and problems gymnasts and coaches currently face with regard to gymnastic mats. It also helps us analyze if the different standards regarding mats: E.N. European Standard 12503 and F.I.G. International Gymnastics Federation. 2000, establish any criteria and tests on that score. To achieve this aim, the Q.F.D. methodology was partially implemented, together with a tool called ‘User panel’. The results show that the most important features of gymnastic mats are cushioning, shock absorption, deflection and surface finish. They must also be easy to clean and portable. Nevertheless, it is observed that in spite of the different existing regulations, several aspects such as resilience after the impact (related to shock absorption) and aerolastic behaviour of the surface (related to deflection) are not analysed, which could mean the cause of injuries during gymnasts landing (AU)

Síndrome de secreción inadecuada de hormona antidiurética secundario a carbamacepina / No disponible

No disponible

[Delays before and after arrival at the hospital in the treatment of strokes]. / Retraso extrahospitalario e intrahospitalario en el tratamiento del ictus.

INTRODUCTION: Only a minority of patients with acute stroke are eligible for fibrinolysis, and the main reason for this is that time runs out and goes beyond the therapeutic window. The chief delay occurs prior to arrival at the hospital, but there is also a nosocomial delay, which has received far less attention. AIMS: The purpose of our study was to describe the data on delays occurring before and after arrival at the hospital in a sample of patients with acute stroke, and to analyse possible associated factors, including the overload on health care services in the Emergency department, an aspect that has not previously been evaluated. PATIENTS AND METHODS: Epidemiological data, times of delays before and after entering the hospital, means of transport used and the health care workload in the Emergency department of the day of admission were collected for all the stroke patients admitted to the Stroke Unit of the Hospital General Universitario de Alicante throughout the period under study. RESULTS: From an initial sample of 460 patients, 423 were finally included in the study, with a mean delay before and after admission to hospital of 3.99 and 2.36 hours, respectively. Use of an ambulance and the haemorrhagic and transient ischemic attack subtypes were linked to a shorter delay before reaching the hospital, and arrival during the night shift was the only factor associated to a longer delay once inside the hospital. CONCLUSIONS: In our environment, there is a need to establish strategies aimed at shortening the times stroke patients take to reach the hospital and the time that elapses before they are attended.