COVID-19 in donation and transplant.

SARS-CoV-2 infection has had a major impact on donation and transplantation. Since the cessation of activity two years ago, the international medical community has rapidly generated evidence capable of sustaining and increasing this neccesary activity. This paper analyses the epidemiology and burden of COVID-19 in donation and transplantation, the pathogenesis of the infection and its relationship with graft-mediated transmission, the impact of vaccination on donation and transplantation, the evolution of donation in Spain throughout the pandemic, some lessons learned in SARS-CoV-2 infected donor recipients with positive PCR and the applicability of the main therapeutic tools recently approved for treatment among transplant recipients.

Bebé con alopecia anular y costras persistentes / Annular Hair Loss and Persistent Crusting in a Baby

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Tumor de larga evolución con patrón «en copos de nieve» / Snow Falling Sign in a Long-Standing Tumor

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Enhancing biohydrogen production from Agave tequilana bagasse: Detoxified vs. Undetoxified acid hydrolysates.

The aim of this work was to compare the biohydrogen production potential of undetoxified and detoxified acid hydrolysates from A. tequilana bagasse. Detoxification was carried out with activated carbon at different concentrations and pH values. Results indicated that pH was not a significant variable, while the lowest evaluated concentration of activated carbon (1% p/v) significantly promoted the highest removal of acetic acid (89%) with minimal losses of fermentable sugars. Regarding dark fermentation experiments, central composite designs were used to optimize COD and pH variables for both substrates, undetoxified and detoxified hydrolysates (activated carbon 1% p/v and pH 0.6). At optimal conditions, the detoxified hydrolysate produced 33% more biohydrogen than the undetoxified one. Hydrogen molar yields were 1.71 and 1.23 mol H2/molsugar, respectively. This improvement was correlated to changes in metabolic byproducts, since the detoxified hydrolysate produced only acetic and butyric acids, while lactic acid was detected in the undetoxified hydrolysate.

Anaerobic ammonium oxidation linked to sulfate and ferric iron reduction fuels nitrogen loss in marine sediments.

Availability of fixed nitrogen is a pivotal driver on primary productivity in the oceans, thus the identification of key processes triggering nitrogen losses from these ecosystems is of major importance as they affect ecosystems function and consequently global biogeochemical cycles. Denitrification and anaerobic ammonium oxidation coupled to nitrite reduction (Anammox) are the only identified marine sinks for fixed nitrogen. The present study provides evidence indicating that anaerobic ammonium oxidation coupled to the reduction of sulfate, the most abundant electron acceptor present in the oceans, prevails in marine sediments. Tracer analysis with 15N-ammonium revealed that this microbial process, here introduced as Sulfammox, accounts for up to 5 µg 15N2 produced g-1 day-1 in sediments collected from the eastern tropical North Pacific coast. Raman and X-ray diffraction spectroscopies revealed that elemental sulfur and sphalerite (ZnFeS) were produced, besides free sulfide, during the course of Sulfammox. Anaerobic ammonium oxidation linked to Fe(III) reduction (Feammox) was also observed in the same marine sediments accounting for up to 2 µg 15N2 produced g-1 day-1. Taxonomic characterization, based on 16S rRNA gene sequencing, of marine sediments performing the Sulfammox and Feammox processes revealed the microbial members potentially involved. These novel nitrogen sinks may significantly fuel nitrogen loss in marine environments. These findings suggest that the interconnections among the oceanic biogeochemical cycles of N, S and Fe are much more complex than previously considered.

Knowledge of asthma and anaphylaxis among teachers in Spanish schools

Introduction: Allergic diseases affect 15-20% of the paediatric population in the industrialised world. Most educational centres in Spain do not have health professionals among their staff, and the teachers are in charge of child care in school. The advisability of specific training of the teaching staff should be considered, with the introduction of concrete intervention plans in the event of life-threatening emergencies in schools. Material and methods: Evaluation of the training needs constitutes the first step in planning an educational project. In this regard, the Health Education Group of the Spanish Society of Clinical Immunology, Allergology and Paediatric Asthma (Grupo de Educación Sanitaria de la Sociedad Española de Inmunología Clínica, Alergología y Asma Pediátrica [SEICAAP]) assessed the knowledge of teachers in five Spanish Autonomous Communities, using a self-administered questionnaire specifically developed for this study. The data obtained were analysed using the SPSS statistical package. Results: A total of 2479 teachers completed the questionnaire. Most of them claimed to know what asthma is, and almost one half considered that they would know how to act in the event of an asthma attack. This proportion was higher among physical education teachers. Most would not know how to act in the case of anaphylaxis or be able to administer the required medication. In general, the teachers expressed interest in receiving training and in having an interventional protocol applicable to situations of this kind. Discussion: It is important to know what the training requirements are in order to develop plans for intervention in the event of an emergency in school. Teachers admit a lack of knowledge on how to deal with these disorders, but express a wish to receive training (AU)

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Up-flow anaerobic sediment trapped (UAST) reactor as a new configuration for the enrichment of anammox bacteria from marine sediments.

A novel reactor configuration for the enrichment of anammox bacteria from marine sediments was developed. Marine sediments were successfully kept inside the bioreactors during the enrichment process by strategically installing traps at different depths to prevent the wash-out of sediments. Three up-flow anaerobic sediment trapped (UAST) reactors were set up (α, ß and ω supplied with 50, 150 and 300mgCa2+/L, respectively). Nitrogen removal rates (NRR) of up to 3.5gN/L-d and removal efficiencies of >95% were reached. Calcium enhanced biomass production as evidenced by increased volatile suspended solids and extracellular polymeric substances. After the long-term operation, dominant families detected were Rhodobacteracea, Flavobacteracea, and Alteromonadacea, while the main anammox genera detected in the three reactors were Candidatus Kuenenia and Candidatus Anammoximicrobium. The UAST reactor is proposed as suitable technology for the enrichment of anammox bacteria applicable for the treatment of saline industrial wastewaters with high nitrogen content.

Knowledge of asthma and anaphylaxis among teachers in Spanish schools.

INTRODUCTION: Allergic diseases affect 15-20% of the paediatric population in the industrialised world. Most educational centres in Spain do not have health professionals among their staff, and the teachers are in charge of child care in school. The advisability of specific training of the teaching staff should be considered, with the introduction of concrete intervention plans in the event of life-threatening emergencies in schools. MATERIAL AND METHODS: Evaluation of the training needs constitutes the first step in planning an educational project. In this regard, the Health Education Group of the Spanish Society of Clinical Immunology, Allergology and Paediatric Asthma (Grupo de Educación Sanitaria de la Sociedad Española de Inmunología Clínica, Alergología y Asma Pediátrica [SEICAAP]) assessed the knowledge of teachers in five Spanish Autonomous Communities, using a self-administered questionnaire specifically developed for this study. The data obtained were analysed using the SPSS statistical package. RESULTS: A total of 2479 teachers completed the questionnaire. Most of them claimed to know what asthma is, and almost one half considered that they would know how to act in the event of an asthma attack. This proportion was higher among physical education teachers. Most would not know how to act in the case of anaphylaxis or be able to administer the required medication. In general, the teachers expressed interest in receiving training and in having an interventional protocol applicable to situations of this kind. DISCUSSION: It is important to know what the training requirements are in order to develop plans for intervention in the event of an emergency in school. Teachers admit a lack of knowledge on how to deal with these disorders, but express a wish to receive training.

Quality of life in caregivers of children with asthma: Validity and reliability of the IFABI-R questionnaire

BACKGROUND: Parents'/caregivers' quality of life is an important aspect to consider when handling paediatric asthma, but there is a paucity of valid and reliable instruments to measure it. The Family Impact of Childhood Bronchial Asthma (IFABI-R) is a recently developed questionnaire to facilitate the assessment of asthma-related parents'/caregivers' quality of life. This study researches the psychometric properties of IFABI-R. METHODS: Parents/main caregivers of 462 children between 4 and 14 years of age with active asthma were included in the sample. IFABI-R was administered on two different occasions and a number of other variables related to the parents'/caregivers' quality of life were measured: child's asthma control, family functioning, and parents'/caregivers' perception of asthma symptoms in the child. IFABI-R evaluative and discriminative properties were analysed, and the minimal important change in the IFABI-R score was identified. RESULTS: IFABI-R showed high internal consistency (Cronbach's alpha = 0.941), cross-sectional construct validity (correlation with the degree of child's asthma control, family functioning and parent/caregiver perception of the child's asthma symptoms), longitudinal construct validity (correlation of changes in the IFABI-R with changes in asthma control and changes in the perception of symptoms), sensitivity to change and test-retest reliability. An absolute change of 0.3 units in IFABI-R related to a minimal significant change in the parents'/caregivers' quality of life. CONCLUSIONS: IFABI-R is a reliable and valid instrument to study the quality of life of parents/caregivers of children with asthma

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Coupling between anammox and autotrophic denitrification for simultaneous removal of ammonium and sulfide by enriched marine sediments.

In the present study, the capacity of enrichments derived from marine sediments collected from different sites of the Mexican littoral to perform anaerobic ammonium oxidation (anammox) coupled to sulfide-dependent denitrification for simultaneous removal of ammonium and sulfide linked to nitrite reduction was evaluated. Sulfide-dependent denitrification out-competed anammox during the simultaneous oxidation of sulfide and ammonium. Significant accumulation of elemental sulfur (ca. 14-30 % of added sulfide) occurred during the coupling between the two respiratory processes, while ammonium was partly oxidized (31-47 %) due to nitrite limitation imposed in sediment incubations. Nevertheless, mass balances revealed up to 38 % more oxidation of the electron donors available (ammonium and sulfide) than that expected from stoichiometry. Recycling of nitrite, from nitrate produced through anammox, is proposed to contribute to extra oxidation of sulfide, while additional ammonium oxidation is suggested by sulfate-reducing anammox (SR-anammox). The complex interaction between nitrogenous and sulfurous compounds occurring through the concomitant presence of autotrophic denitrification, conventional anammox and SR-anammox may significantly drive the nitrogen and sulfur fluxes in marine environments.

FR-El consumo oral de antiinflamatorios no esteroideos podría disminuir el riesgo de aparición de carcinoma espinocelular cutáneo / RF-Oral Nonsteroidal Anti-inflammatory Drug Use May Reduce the Risk of Cutaneous Squamous Cell Carcinoma

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Quality of life in caregivers of children with asthma: Validity and reliability of the IFABI-R questionnaire.

BACKGROUND: Parents'/caregivers' quality of life is an important aspect to consider when handling paediatric asthma, but there is a paucity of valid and reliable instruments to measure it. The Family Impact of Childhood Bronchial Asthma (IFABI-R) is a recently developed questionnaire to facilitate the assessment of asthma-related parents'/caregivers' quality of life. This study researches the psychometric properties of IFABI-R. METHODS: Parents/main caregivers of 462 children between 4 and 14 years of age with active asthma were included in the sample. IFABI-R was administered on two different occasions and a number of other variables related to the parents'/caregivers' quality of life were measured: child's asthma control, family functioning, and parents'/caregivers' perception of asthma symptoms in the child. IFABI-R evaluative and discriminative properties were analysed, and the minimal important change in the IFABI-R score was identified. RESULTS: IFABI-R showed high internal consistency (Cronbach's alpha=0.941), cross-sectional construct validity (correlation with the degree of child's asthma control, family functioning and parent/caregiver perception of the child's asthma symptoms), longitudinal construct validity (correlation of changes in the IFABI-R with changes in asthma control and changes in the perception of symptoms), sensitivity to change and test-retest reliability. An absolute change of 0.3 units in IFABI-R related to a minimal significant change in the parents'/caregivers' quality of life. CONCLUSIONS: IFABI-R is a reliable and valid instrument to study the quality of life of parents/caregivers of children with asthma.

Impact of CCSVI on cerebral haemodynamics: a mathematical study using MRI angiographic and flow data.

BACKGROUND: The presence of abnormal anatomy and flow in neck veins has been recently linked to neurological diseases. The precise impact of extra-cranial abnormalities such as stenoses remains unexplored. METHODS: Pressure and velocity fields in the full cardiovascular system are computed by means of a global mathematical model that accounts for the relationship between pulsating cerebral blood flow and intracranial pressure. RESULTS: Our model predicts that extra-cranial strictures cause increased pressure in the cerebral venous system. Specifically, there is a predicted pressure increase of about 10% in patients with a 90% stenoses. Pressure increases are related to significant flow redistribution with flow reduction of up to 70% in stenosed vessels and consequent flow increase in collateral pathways. CONCLUSIONS: Extra-cranial venous strictures can lead to pressure increases in intra-cranial veins of up to 1.3 mmHg, despite the shielding role of the Starling resistor. The long-term clinical implications of the predicted pressure changes are unclear.

Resultado funcional de la cirugía multinivel en pacientes con parálisis cerebral, Instituto Teletón Santiago-Chile / Functional results in single event multilevel surgery in cerebral palsy patients, Teletón Institute Santiago-Chile, 2010-2013

The single event multilevel surgery (SEMLS) is a procedure preferably for patients with cerebral palsy (CP), including several orthopedic surgeries in one surgical time, and involves at least two levels joints of lower extremities, seeking to optimize gait. It is based on biomechanical principles provided by the gait lab (GL). Objective: To evaluate the impact of SEMLS in the gait of patients with CP spastic diplegia, one year after surgery. Patients and Methods: Retrospective study with review of medical records of 61 patients undergoing SEMLS. 23 out of 61 subjects accomplished the inclusion criteria. GL data before and after surgery was summarized in Gait deviation index (GDI), cadence and velocity, as well as functional mobility scale (FMS). Patients were categorized in two groups according to the Gross motor function classification system (GMFCS) as “A” for I-II GMFCS and “B” for III GMFCS. Statistical comparison was performed using Wilcoxon test. Results: The average SEMLS include 6.19 procedures per patient. Overall, significant variations in GDI (p < 0.0001) and cadence (p < 0.007) were found. In the subgroup A, there were significant changes in all GL variables (p < 0.009). In subgroup B, a significant effect was only found for GDI. Although FMS showed improvement, it was not statistically significant for 50 m and 500 m, in both subgroups and the total population (14 patients). Conclusion: Significant improvement was seen in CP spastic diplegic patients, for both cadence and GDI after one year SEMLS, particularly in the subgroup with independent walking...

La cirugía multinivel (CMN), es un procedimiento usado preferentemente en pacientes con parálisis cerebral (PC) que reúne varias cirugías ortopédicas en un tiempo quirúrgico involucrando como mínimo dos niveles articulares de extremidades inferiores, buscando optimizar la marcha. Se basa en principios biomecánicos aportados por el laboratorio de marcha (LM). Objetivo: Evaluar el impacto de CMN en la marcha de pacientes con PC tipo diplejía espástica, a un año postcirugía. Pacientes y Método: Estudio de cohorte única, retrospectivo. Se revisaron fichas de 61 pacientes intervenidos con CMN, 23 cumplieron los criterios de inclusión. Se obtuvo datos de LM pre y a un año postoperatorio, resumidos en cadencia del paso, velocidad, Gait Deviation Index (GDI), y Functional Mobility Scale (FMS); los sujetos se dividieron en subgrupos: “A” con Gross Motor Function Clasification System (GMFCS) I-II y “B” con GMFCS III. Se realizó comparación estadística mediante test de Wilcoxon con p < 0,05. Resultados: En promedio se realizaron 6,19 procedimientos quirúrgicos por paciente. En el grupo total se obtuvo variaciones significativas en GDI (p < 0,0001) y cadencia (p < 0,007). En el subgrupo A hay variaciones significativas en todas las variables de marcha (p < 0,009). En subgrupo B hay variaciones significativas sólo en GDI. Para la escala FMS existió mejoría, sin significancia estadística en 50 m y 500 m, en los 14 pacientes examinados y en los subgrupos. Conclusión: Se observa mejoría en la marcha de pacientes PC tipo diplejía espástica, en cadencia y GDI, tras un año post CMN, particularmente en el subgrupo A, con marcha independiente...

FR-Terapia de mantenimiento con ciclosporina en pauta de fin de semana para psoriasis moderada / Weekend Ciclosporin Maintenance Therapy for Moderate Psoriasis

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A mathematical model for filtration and macromolecule transport across capillary walls.

Metabolic substrates, such as oxygen and glucose, are rapidly delivered to the cells of large organisms through filtration across microvessels walls. Modelling this important process is complicated by the strong coupling between flow and transport equations, which are linked through the osmotic pressure induced by the colloidal plasma proteins. The microvessel wall is a composite media with the internal glycocalyx layer exerting a strong sieving effect on macromolecules, with respect to the external layer composed by the endothelial cells. The physiological structure of the microvessel is represented as the superimposition of two membranes with different properties; the inner membrane represents the glycocalyx, while the outer membrane represents the surrounding endothelial cells. Application of the mass conservation principle and thermodynamic considerations lead to a model composed of two coupled second-order ordinary differential equations for the hydrostatic and osmotic pressures, one, expressing volumetric mass conservation and the other, which is non-linear in the unknown osmotic pressure, expressing macromolecules mass conservation. Despite the complexity of the system, the assumption that the properties of the layers are piece-wise constant allows us to obtain analytical solutions for the two pressures. This solution is in agreement with experimental observations, which contrary to common belief, show that flow reversal cannot occur in steady-state conditions unless the hydrostatic pressure in the lumen drops below physiologically plausible values. The observed variations of the volumetric flux and the solute mass flux in case of a significant reduction of the hydrostatic pressure at the lumen are in qualitative agreement with observed variations during detailed experiments reported in the literature. On the other hand, homogenising the microvessel wall into a single-layer membrane with equivalent properties leads to a very different distribution of pressure across the microvessel walls, not consistent with observations.