Mental impact of Covid-19 among Spanish healthcare workers. A large longitudinal survey.

AIMS: Longitudinal data on the mental health impact of the coronavirus disease 2019 (Covid-19) pandemic in healthcare workers is limited. We estimated prevalence, incidence and persistence of probable mental disorders in a cohort of Spanish healthcare workers (Covid-19 waves 1 and 2) -and identified associated risk factors. METHODS: 8996 healthcare workers evaluated on 5 May-7 September 2020 (baseline) were invited to a second web-based survey (October-December 2020). Major depressive disorder (PHQ-8 ≥ 10), generalised anxiety disorder (GAD-7 ≥ 10), panic attacks, post-traumatic stress disorder (PCL-5 ≥ 7), and alcohol use disorder (CAGE-AID ≥ 2) were assessed. Distal (pre-pandemic) and proximal (pandemic) risk factors were included. We estimated the incidence of probable mental disorders (among those without disorders at baseline) and persistence (among those with disorders at baseline). Logistic regression of individual-level [odds ratios (OR)] and population-level (population attributable risk proportions) associations were estimated, adjusting by all distal risk factors, health care centre and time of baseline interview. RESULTS: 4809 healthcare workers participated at four months follow-up (cooperation rate = 65.7%; mean = 120 days s.d. = 22 days from baseline assessment). Follow-up prevalence of any disorder was 41.5%, (v. 45.4% at baseline, p < 0.001); incidence, 19.7% (s.e. = 1.6) and persistence, 67.7% (s.e. = 2.3). Proximal factors showing significant bivariate-adjusted associations with incidence included: work-related factors [prioritising Covid-19 patients (OR = 1.62)], stress factors [personal health-related stress (OR = 1.61)], interpersonal stress (OR = 1.53) and financial factors [significant income loss (OR = 1.37)]. Risk factors associated with persistence were largely similar. CONCLUSIONS: Our study indicates that the prevalence of probable mental disorders among Spanish healthcare workers during the second wave of the Covid-19 pandemic was similarly high to that after the first wave. This was in good part due to the persistence of mental disorders detected at the baseline, but with a relevant incidence of about 1 in 5 of HCWs without mental disorders during the first wave of the Covid-19 pandemic. Health-related factors, work-related factors and interpersonal stress are important risks of persistence of mental disorders and of incidence of mental disorders. Adequately addressing these factors might have prevented a considerable amount of mental health impact of the pandemic among this vulnerable population. Addressing health-related stress, work-related factors and interpersonal stress might reduce the prevalence of these disorders substantially. Study registration number: NCT04556565.

Four-month incidence of suicidal thoughts and behaviors among healthcare workers after the first wave of the Spain COVID-19 pandemic.

Healthcare workers (HCW) are at high risk for suicide, yet little is known about the onset of suicidal thoughts and behaviors (STB) in this important segment of the population in conjunction with the COVID-19 pandemic. We conducted a multicenter, prospective cohort study of Spanish HCW active during the COVID-9 pandemic. A total of n = 4809 HCW participated at baseline (May-September 2020; i.e., just after the first wave of the pandemic) and at a four-month follow-up assessment (October-December 2020) using web-based surveys. Logistic regression assessed the individual- and population-level associations of separate proximal (pandemic) risk factors with four-month STB incidence (i.e., 30-day STB among HCW negative for 30-day STB at baseline), each time adjusting for distal (pre-pandemic) factors. STB incidence was estimated at 4.2% (SE = 0.5; n = 1 suicide attempt). Adjusted for distal factors, proximal risk factors most strongly associated with STB incidence were various sources of interpersonal stress (scaled 0-4; odds ratio [OR] range = 1.23-1.57) followed by personal health-related stress and stress related to the health of loved ones (scaled 0-4; OR range 1.30-1.32), and the perceived lack of healthcare center preparedness (scaled 0-4; OR = 1.34). Population-attributable risk proportions for these proximal risk factors were in the range 45.3-57.6%. Other significant risk factors were financial stressors (OR range 1.26-1.81), isolation/quarantine due to COVID-19 (OR = 1.53) and having changed to a specific COVID-19 related work location (OR = 1.72). Among other interventions, our findings call for healthcare systems to implement adequate conflict communication and resolution strategies and to improve family-work balance embedded in organizational justice strategies.

[Educational needs of parents of hemophiliac children: An approach to comprehensive care]. / Necesidades educativas de padres de niños hemofílicos: Una aproximación hacia el cuidado integral.

INTRODUCTION: In Chile, hemophilia was incorporated into the System of Explicit Health Guarantees (GES), which ensures access to treatment and financial protection for these patients. To support patients and their families, educational programs have been proposed that focus on managing possible complications of the pathology, first aid, and prophylaxis, however, there are no educational instances focused on the needs of the patients. OBJECTIVE: To know the educational needs of parents with hemophilic chil dren and adolescents regarding contents, people, place, methodology, and stage of the illness. Sub jects and Method: Descriptive qualitative study of 15 parents with hemophilic children in outpatient care. For the data collection, we used a semi-structured interview with five open questions, aimed at the search for educational needs such as what (contents), how (methodology), when (moment), who (person), and where (place) is education needed. For data analysis, were used the Berelson's content analysis technique. To guarantee the scientific validity of the qualitative results, the methodological rigor criteria of Guba and Lincoln were used. RESULTS: The most frequent educational needs reported by parents include content such as venipuncture training, injury prevention, pathophysiological as pects of the disease, among others; with methodology developed in group workshops and guided by a peer; in a comfortable and familiar place; in three stages of the disease's development (diagnosis, blee ding events, and development of autonomous activities), and provided by professionals and peers. CONCLUSION: Knowledge of educational needs is the basis for the creation of an educational program that guides the comprehensive care of hemophilic children and their parents.

Oclusión de la arteria central de la retina como complicación postransfusional de glóbulos rojos / Central retinal artery occlusion as a post-transfusion complication of red blood cells

Mujer de 32 años con antecedente de miomatosis uterina y metrorragias a repetición durante seis meses que condicionan una concentración de hemoglobina de 6,5 g/dL con requerimiento de transfusión de eritrocitos. Presentó una hora postransfusión, pérdida visual súbita e indolora del ojo derecho (OD) sin otra sintomatología, siendo remitida al departamento de Neuro-oftalmología. Al ingreso su agudeza visual corregida fue movimiento de manos en OD y 0,6 en el izquierdo (OI). El segmento anterior fue normal, salvo un defecto pupilar aferente relativo en OD. Funduscópicamente el OD resaltó una retina pálida difusa con mancha rojo cereza, compatible con oclusión de la arteria central de la retina, OI normal. Se intentó manejo sin mejoría. Los estudios oculares corroboraron isquemia retiniana en OD. Durante la evaluación sistémica los estudios de neuroimágenes, paneles autoinmunes y hematológicos fueron negativos, por lo que se atribuyó dicha complicación a la transfusión de glóbulos rojos (AU)

A 32-year-old woman presented with a history of uterine myomatosis and repeated bleeding for 6 months. This produced a haemoglobin concentration of 6.5 g/dL, with a requirement for a red blood cell transfusion. One hour after the transfusion, she presented with a sudden and painless loss of vision in the right eye (RE). As she had no other symptoms, she was referred to the Neuro-Ophthalmology Department. On admission, her corrected visual acuity was hand movement in RE, and 0.6 in the left eye (LE). The anterior segment was unremarkable, except for a relative afferent pupillary defect in RE. In the fundus examination, the RE showed a diffuse pale retina with a cherry spot, consistent with occlusion of the central artery of the retina. Management was attempted but with no improvement. The studies corroborated retinal ischaemia in RE. During the systemic evaluation, the neuroimaging, autoimmune and haematology studies were negative, thus this complication was attributed to the red blood cell transfusion (AU)

SARS-CoV-2-Specific Memory T Lymphocytes From COVID-19 Convalescent Donors: Identification, Biobanking, and Large-Scale Production for Adoptive Cell Therapy.

Syndrome coronavirus 2 (SARS-CoV-2) pandemic is causing a second outbreak significantly delaying the hope for the virus' complete eradication. In the absence of effective vaccines, we need effective treatments with low adverse effects that can treat hospitalized patients with COVID-19 disease. In this study, we determined the existence of SARS-CoV-2-specific T cells within CD45RA- memory T cells in the blood of convalescent donors. Memory T cells can respond quickly to infection and provide long-term immune protection to reduce the severity of COVID-19 symptoms. Also, CD45RA- memory T cells confer protection from other pathogens encountered by the donors throughout their life. It is of vital importance to resolve other secondary infections that usually develop in patients hospitalized with COVID-19. We found SARS-CoV-2-specific memory T cells in all of the CD45RA- subsets (CD3+, CD4+, and CD8+) and in the central memory and effector memory subpopulations. The procedure for obtaining these cells is feasible, easy to implement for small-scale manufacture, quick and cost-effective, involves minimal manipulation, and has no GMP requirements. This biobank of specific SARS-CoV-2 memory T cells would be immediately available "off-the-shelf" to treat moderate/severe cases of COVID-19, thereby increasing the therapeutic options available for these patients.

Central retinal artery occlusion as a post-transfusion complication of red blood cells. / Oclusión de la arteria central de la retina como complicación postransfusional de glóbulos rojos.

A 32-year-old woman presented with a history of uterine myomatosis and repeated bleeding for 6 months. This produced a haemoglobin concentration of 6.5 g/dL, with a requirement for a red blood cell transfusion. One hour after the transfusion, she presented with a sudden and painless loss of vision in the right eye (RE). As she had no other symptoms, she was referred to the Neuro-Ophthalmology Department. On admission, her corrected visual acuity was hand movement in RE, and 0.6 in the left eye (LE). The anterior segment was unremarkable, except for a relative afferent pupillary defect in RE. In the fundus examination, the RE showed a diffuse pale retina with a cherry spot, consistent with occlusion of the central artery of the retina. Management was attempted but with no improvement. The studies corroborated retinal ischaemia in RE. During the systemic evaluation, the neuroimaging, autoimmune and haematology studies were negative, thus this complication was attributed to the red blood cell transfusion.

[Detection of adverse events in thyroid and parathyroid surgery using trigger tool and Minimum Basic Data Set (MBDS)]. / Detección de eventos adversos en la cirugía tiroidea y paratiroidea utilizando la herramienta trigger y el Conjunto Mínimo de Datos Básicos (CMBD).

OBJECTIVES: To compare the ability of the trigger tool) and the Minimum Basic Data Set (MBDS) in detecting adverse events (AE) in hospitalized surgical patients with thyroid and parathyroid disease. METHODS: A descriptive, cross-sectional observational study, retrospective and cross-sectional study was conducted from May 2014 to April 2015 analysing retrospectively data on of patients submitted to thyroidectomy and parathyroidectomy in order to detect AE through the identification of triggers (an event often associated to an AE) and the MBDS. triggers and AE were located by systematic review of clinical documentation. The MBDS was got from the data base. Once an AE was detected, it was characterized. RESULTS: 203 AE were identified in 251 patients, being the 90.04% detected by trigger tool and 10.34% by MBDS. 126 patients had at least one AE (50.2%). Without the cases in which uncontrolled pain was the only AE, the percentage of patients that suffering AE was 38.65%. 187 AE were considered preventable and 16 AE were considered unpreventable. The trigger tool and the MBDS demonstrated a sensitivity of 91.27 and 13.49%, a specificity of 4.8 and 100%, a positive predictive value of 49,15 and 100%, and a negative predictive value of 35.29 and 53.42%, respectively. The triggers with more predictive power in AE detection were «antiemetic administration¼ and «calcium administration¼. CONCLUSIONS: Trigger tool shows higher sensitivity for detecting AE than the MBDS. All the detected AE were considered low severity and most of them were preventable.

Evolución y tendencias de un programa de resonancia magnética cardiaca pediátrica en un hospital terciario durante 14 años / Evolution and trends in a pediatric cardiac magnetic resonance imaging program in a tertiary hospital over a 14-year period

OBJETIVOS: 1) Revisar la actividad del programa de resonancia magnética cardiaca (RMC) de nuestro hospital desde su inicio hasta la actualidad; 2) evaluar la evolución del número de pacientes, estudios bajo anestesia, estudios con contraste (angiografía y realce tardío) y patologías representativas, y 3) estimar la tendencia de los mismos parámetros evaluados. MATERIAL Y MÉTODOS: El programa de RMC pediátrica de nuestro hospital comenzó el 14 de febrero de 2005. Revisamos los estudios hasta el 31 de diciembre de 2018. Los casos son incluidos en una tabla de cálculo que incluye sexo, fecha de nacimiento, fecha de exploración, clínica, diagnóstico radiológico, secuencias realizadas y anestesia. Obtenemos datos por años de la edad de los pacientes, la realización de estudios bajo anestesia, realización de angiografía por resonancia magnética con contraste, estudios de realce tardío y estudios posquirúrgicos. También valoramos la evolución de un grupo de patologías representativas: coartación aórtica, tetralogía de Fallot, D-transposición de las grandes arterias, correcciones univentriculares, síndrome del corazón izquierdo hipoplásico, retornos venosos pulmonares anómalos y miocardiopatías. Realizamos gráficos de barras, evolución de las medias y curvas logarítmicas de tendencia. RESULTADOS: El número total de casos fue 2.606. Se registró un incremento gradual del número de casos. La media de edad de los pacientes fue de 12,5 años y también se incrementó a lo largo del periodo; el 42% de los casos se realizaron con anestesia. En el 57,6% de los casos se realizó angio-RM con contraste, y en el 42,13%, estudio de realce tardío. La coartación aórtica ha representado la patología más frecuente (16,39%), aunque su número ha descendido paulatinamente a lo largo del periodo, y también lo ha hecho el corazón izquierdo hipoplásico. La patología del miocardio (7,25% de casos) ha aumentado paulatinamente, hasta representar el 9,35% en 2018. CONCLUSIÓN: A lo largo de estos 14 años, la patología estudiada, el tipo de pacientes y la técnica empleada han ido variando, con un aumento del número de pacientes y de su edad, una disminución de los estudios de angio-RM, y cambios en la prevalencia de los distintos grupos de patologías

OBJECTIVES: 1. To review the activity in our hospital's pediatric cardiac magnetic resonance imaging (cMRI) program from its inception to the present.2. To evaluate changes in the number of patients, in the number of studies done under anesthesia, in the number of studies done with contrast material (magnetic resonance angiography (MRA) and delayed enhancement), and in representative diseases studied.3. To estimate trends in the parameters evaluated in objective 2. MATERIAL AND METHODS: The pediatric cMRI program at our hospital started on February 14, 2005. We assessed cMRI studies done between the inception of the program and December 31, 2018. The cases were entered in a calculation table that included sex, date of birth, date of examination, clinical presentation, radiologic diagnosis, sequences done, and anesthesia. For each year, we obtained data about patients' age, studies done under anesthesia, contrast-enhanced MRA, delayed enhancement studies, and postoperative studies. We also evaluated the evolution of the number of patients studied for a group of representative diseases (coarctation of the aorta; tetralogy of Fallot; dextro-transposition of the great arteries; corrections of univentricular heart; hypoplastic left heart syndrome; anomalous pulmonary venous return; and cardiomyopathy). We analyzed these data with bar graphs, evolutions of means, and logarithmic trend curves. RESULTS: A total of 2606 cases were included. The number of cases per year increased gradually. The mean age of all patients was 12.5 years, and the age of the patients studied also increased during the 14-year period. Anesthesia was used in 42%. Contrast-enhanced MRA was done in 57.6% and delayed enhancement in 42.13%. The most common condition was aortic coarctation (16.39%), although the frequency of aortic coarctation and hypoplastic left heart syndrome decreased slightly during the period. By contrast, the frequency of cardiomyopathy (7.25% of cases) increased slightly, to the point where it represented 9.35% in 2018. CONCLUSION: During the 14-year period in which pediatric cMRI has been done at our hospital, the conditions studied, the type of patients, and the techniques used has varied; the number of patients and patients' age has increased, where as the frequency of MRA studies has decreased. The prevalence of the different conditions studied has also changed

Manifestaciones neurooftalmológicas del síndrome de POEMS / Neuro-ophthalmological manifestations of POEMS syndrome

Varón de 38 años que acude por un cuadro de dos meses de evolución caracterizado por síndrome constitucional, fiebre, poliadenopatías y hepatoesplenomegalia. Además indicó cefalea, visión borrosa bilateral y miodesopsias. La agudeza visual corregida fue de 20/50 y 20/200. El segmento anterior no mostraba alteración. El fondo de ojo evidenció discos sobreelevados y borrados, acompañados de desprendimiento seroso del neuroepitelio mayor en el ojo izquierdo. Los estudios de ambos ojos mostraron un campo visual con aumento de la mancha ciega; la angiografía fluoresceínica mostró hiperfluorescencia tardía discal; el electrorretinograma evidenció compromiso de conos y bastones; el potencial visual detectó alteración en la percepción y la conducción de estímulos. Los estudios de imagen fueron esencialmente normales. Durante su hospitalización presentó paraparesia, insuficiencia renal, endocrinopatía, alteraciones dérmicas y lesiones osteoblásticas con biopsias negativas. Se documentó gammapatía monoclonal, planteándose el diagnóstico de síndrome de POEMS -Polineuropatía, Organomegalia, Endocrinopatía, Gammapatía Monoclonal y alteraciones dermatológicas e iniciándose quimioterapia con dexametasona/melfalán, con buena respuesta a los 3 meses

The cases is presented of a 38 year-old male with a constitutional syndrome, fever, multiple swollen lymph nodes, and hepatosplenomegaly of 2 months onset. There was also mention of headache, bilateral blurred vision, and myiodesopsias. Best correct visual acuity was 20/50 and 20/200. The anterior segment was unremarkable. The fundus of both eyes showed raised and erased discs, accompanied by serous detachment, greater in the left eye. Complementary studies of both eyes showed a visual field with increased blind spot; fluorescein angiography indicated late disc hyperfluorescence. The electroretinogram showed compromise of cones and rods, and the visual evoked potential detected alteration in the perception and conduction of stimuli. The imaging studies were essentially normal. During his hospital admission he presented with paraparesis, renal failure, endocrinopathy, skin alterations, and osteoblastic lesions with negative biopsies. Monoclonal gammopathy was documented, and the diagnosis of POEMS (Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal gammopathy, and Skin changes) syndrome was made. The chemotherapy started with dexamethasone/melphalan, with a good response at 3 months

Neuro-ophthalmological manifestations of POEMS syndrome. / Manifestaciones neurooftalmológicas del síndrome de POEMS.

The cases is presented of a 38 year-old male with a constitutional syndrome, fever, multiple swollen lymph nodes, and hepatosplenomegaly of 2 months onset. There was also mention of headache, bilateral blurred vision, and myiodesopsias. Best correct visual acuity was 20/50 and 20/200. The anterior segment was unremarkable. The fundus of both eyes showed raised and erased discs, accompanied by serous detachment, greater in the left eye. Complementary studies of both eyes showed a visual field with increased blind spot; fluorescein angiography indicated late disc hyperfluorescence. The electroretinogram showed compromise of cones and rods, and the visual evoked potential detected alteration in the perception and conduction of stimuli. The imaging studies were essentially normal. During his hospital admission he presented with paraparesis, renal failure, endocrinopathy, skin alterations, and osteoblastic lesions with negative biopsies. Monoclonal gammopathy was documented, and the diagnosis of POEMS (Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal gammopathy, and Skin changes) syndrome was made. The chemotherapy started with dexamethasone/melphalan, with a good response at 3 months.

Evolution and trends in a pediatric cardiac magnetic resonance imaging program in a tertiary hospital over a 14-year period. / Evolución y tendencias de un programa de resonancia magnética cardiaca pediátrica en un hospital terciario durante 14 años.

OBJECTIVES: 1. To review the activity in our hospital's pediatric cardiac magnetic resonance imaging (cMRI) program from its inception to the present. 2. To evaluate changes in the number of patients, in the number of studies done under anesthesia, in the number of studies done with contrast material (magnetic resonance angiography (MRA) and delayed enhancement), and in representative diseases studied. 3. To estimate trends in the parameters evaluated in objective 2. MATERIAL AND METHODS: The pediatric cMRI program at our hospital started on February 14, 2005. We assessed cMRI studies done between the inception of the program and December 31, 2018. The cases were entered in a calculation table that included sex, date of birth, date of examination, clinical presentation, radiologic diagnosis, sequences done, and anesthesia. For each year, we obtained data about patients' age, studies done under anesthesia, contrast-enhanced MRA, delayed enhancement studies, and postoperative studies. We also evaluated the evolution of the number of patients studied for a group of representative diseases (coarctation of the aorta; tetralogy of Fallot; dextro-transposition of the great arteries; corrections of univentricular heart; hypoplastic left heart syndrome; anomalous pulmonary venous return; and cardiomyopathy). We analyzed these data with bar graphs, evolutions of means, and logarithmic trend curves. RESULTS: A total of 2606 cases were included. The number of cases per year increased gradually. The mean age of all patients was 12.5 years, and the age of the patients studied also increased during the 14-year period. Anesthesia was used in 42%. Contrast-enhanced MRA was done in 57.6% and delayed enhancement in 42.13%. The most common condition was aortic coarctation (16.39%), although the frequency of aortic coarctation and hypoplastic left heart syndrome decreased slightly during the period. By contrast, the frequency of cardiomyopathy (7.25% of cases) increased slightly, to the point where it represented 9.35% in 2018. CONCLUSION: During the 14-year period in which pediatric cMRI has been done at our hospital, the conditions studied, the type of patients, and the techniques used has varied; the number of patients and patients' age has increased, where as the frequency of MRA studies has decreased. The prevalence of the different conditions studied has also changed.

Chemically Modified Variants of Fenofibrate with Antiglioblastoma Potential.

Anticancer effects of a common lipid-lowering drug, fenofibrate, have been described in the literature for a quite some time; however, fenofibrate has not been used as a direct anticancer therapy. We have previously reported that fenofibrate in its unprocessed form (ester) accumulates in the mitochondria, inhibits mitochondrial respiration, and triggers a severe energy deficit and extensive glioblastoma cell death. However, fenofibrate does not cross the blood brain barrier and is quickly processed by blood and tissue esterases to form the PPARα agonist fenofibric acid, which is practically ineffective effective in triggering cancer cell death. To address these issues, we have made several chemical modifications in fenofibrate structure to increase its stability, water solubility, tissue penetration, and ultimately anticancer potential. Our data show that, in comparison to fenofibrate, four new compounds designated here as PP1, PP2, PP3, and PP4 have improved anticancer activity in vitro. Like fenofibrate, the compounds block mitochondrial respiration and trigger massive glioblastoma cell death in vitro. In addition, one of the lead compounds, PP1, has improved water solubility and is significantly more stable when exposed to human blood in comparison to fenofibrate. Importantly, mice bearing large intracranial glioblastoma tumors demonstrated extensive areas of tumor cell death within the tumor mass following oral administration of PP1, and the treated mice did not show any major signs of distress, and accumulated PP1 at therapeutically relevant concentrations in several tissues, including brain and intracranial tumors.

Oxidative stability of a colombian criollo mango (Mangifera indica) drink fortified with peel / Estabilidad oxidativa de una bebida de mango criollo colombiano (Mangifera Indica) fortificada con cáscara

Background: the analysis of the oxidative stability allows to determine the functionality of the antioxidants present in food, over time. Objectives: in this research, a functional mango drink is elaborated and the changes in the antioxidant profile and physicochemical parameters of the drink subjected to accelerated storage conditions are evaluated. Methods: the drink was distributed at 22, 35 and 45°C for 80 days. To monitor oxidative stability, the antioxidant analyzes ABTS, ORAC, mangiferin, total phenols and total carotenoids were performed; in addition, physicochemical properties (pH and °Bx) and L*a*b*coordinates, were monitored. The fit of the data to the Arrhenius model was verified and the shelf life was determined considering a 50% loss in the evaluated attributes, such as the critical limit. Results: the deterioration of the antioxidant attributes and the color at the study temperatures is observed, being more pronounced at 45°C. The least stable attributes are the carotenoids and the b-coordinate, presenting losses greater than 50%. The values of mangiferin exhibit deterioration lower than 40% and similar in the temperatures evaluated. The pH and Brix degrees do not show significant changes. The deterioration reactions are of order one and followed the Arrhenius law, presenting coefficients of determination greater than 0.90. The values of the activation energy (Ea) are within the range reported for fruit juices, standing out the value found for the b* coordinate (44.59 kJ.mol-1). Conclusions: the ORAC units are the chosen attribute to condition the life of the beverage, giving 10 months of useful life at 4°C, however, it is recommended to perform sensory and microbiological analyzes under the same conditions.

Antecedentes: el análisis de la estabilidad oxidativa permite determinar la funcionalidad de los antioxidantes presentes en los alimentos, en el tiempo. Objetivo: en esta investigación se elaboró una bebida funcional de mango y se evaluaron los cambios en el perfil antioxidante y los parámetros fisicoquímicos de la bebida sometida a condiciones aceleradas de almacenamiento. Métodos: la bebida se distribuyó a 22, 35 y 45°C durante 80 días. Para hacer el seguimiento de la estabilidad oxidativa, se realizaron los análisis antioxidantes ABTS, ORAC, Mangiferina, Fenoles Totales y Carotenoides totales; además, se realizó seguimiento de las propiedades fisicoquímicas (pH y °Bx) y las coordenadas L*a*b*. Se verificó el ajuste de los datos al modelo de Arrhenius y la vida útil se determinó teniendo en cuenta una pérdida del 50% en los atributos evaluados, como el límite crítico. Resultados: se observó el deterioro de los atributos antioxidantes y el color en las temperaturas de estudio, siendo más pronunciado a 45°C. Los atributos menos estables fueron carotenoides y la coordenada CIELab b*, presentando pérdidas superiores al 50%. Los valores de mangiferina exhibieron un deterioro menor al 40% y similar en las temperaturas evaluadas. El pH y los grados Brix no presentaron cambios significativos. Las reacciones de deterioro fueron de orden uno y siguieron la ley de Arrhenius, presentando coeficientes de determinación mayores a 0,90. Los valores de la energía de activación (Ea) estuvieron dentro del rango reportado para jugos de fruta, destacándose el valor hallado para la coordenada b* (44,59 kJ.mol-1). Conclusión: los valores ORAC estimaron un tiempo de vida útil para la bebida en 10 meses, bajo un almacenamiento a 4°C, sin embargo, se recomienda realizar análisis sensoriales y microbiológicos complementarios, bajo las mismas condiciones.

Revision of "Aemilia" pagana Species-Group (Lepidoptera: Erebidae: Arctiinae), with a Description of a New Endemic Species and Comments on the Conservation Status.

A taxonomical rearrangement of "Aemilia" pagana species-group is proposed: Leucanopsis pagana (Schaus in Proc Zool Soc London 1894:225-243, 1894) comb. nov. and L. ninae (Orfila in Rev Soc Entomol Argent 21:67-70, 1959) comb. nov. A new endemic species from Pampa de Achala, Córdoba, Argentina, closer to both species, is described: Leucanopsis navarroi sp. nov. These three species can be recognized because the color pattern is the darkest among species of Leucanopsis. Characteristics of male genitalia suggest the nomenclatural rearrangement proposed. Leucanopsis pagana comb. nov. has a wide distribution from the center of Brazil to northeastern Argentina, including southern Paraguay. The known distribution and geospatial analysis suggest that this species is not in danger. Leucanopsis ninae comb. nov. is restricted to only one known locality (Villa Gesell, Buenos Aires). The restricted known distribution, the different land use practices, and geospatial analysis suggest that this species could be endangered. Leucanopsis navarroi sp. nov. is endemic to the high plateau present in the center of Argentina called Pampa de Achala. The known distribution and geospatial analysis suggest that this species could be endangered. Further studies are necessary to determine effectively the conservation status of these three species.

Inter-ocular asymmetry of retinal parameters in Caucasian healthy children and young adults measured with optical coherence tomography / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To evaluate retinal parameters in a sample of healthy young Caucasian adults to define the normal or physiological range of inter-ocular asymmetry in this particular age and ethnic group.METHODS:Study sample consisted of 37 Caucasian children and young adults aged between 12 and 23 years (spherical equivalent from-3.00D to + 4.00D,anisometropia ＜ 0.5D and axial length differences ＜0.3mm).Normal inter-ocular asymmetry values were determined and 95％ inter-ocular difference tolerance values were obtained.RESULTS:Statistically significant inter-ocular differences were found in mean (P=0.003) and superior (P=0.008) retinal nerve fiber layer (RNFL) thickness,as well as in central macular thickness (P=0.039),with larger values in the left eye in all instances,and with tolerance limits of inter-ocular asymmetry of-9.00p m to 6.00μ m,-28.00μ m to 9μ m and-39.00μ m to 29.00μ m,respectively.In addition,statistically significant differences were found between males and females in mean thickness of the RNFL in the right eye (P=0.020).CONCLUSION:The exploration of the normal asymmetries of the retina may be an effective approach to further understand myopia onset and progression,which is particularly relevant in this age group.Differences in instrumentation and sample characteristics compromise direct comparison with published research and warrant the need for further studies.

[Comparison of the "Trigger" tool with the minimum basic data set for detecting adverse events in general surgery]. / Comparación de la herramienta Trigger con el conjunto mínimo básico de datos (CMBD) para la detección de eventos adversos en cirugía general.

INTRODUCTION: Surgery is a high risk for the occurrence of adverse events (AE). The main objective of this study is to compare the effectiveness of the Trigger tool with the Hospital National Health System registration of Discharges, the minimum basic data set (MBDS), in detecting adverse events in patients admitted to General Surgery and undergoing surgery. MATERIAL AND METHODS: Observational and descriptive retrospective study of patients admitted to general surgery of a tertiary hospital, and undergoing surgery in 2012. The identification of adverse events was made by reviewing the medical records, using an adaptation of "Global Trigger Tool" methodology, as well as the (MBDS) registered on the same patients. Once the AE were identified, they were classified according to damage and to the extent to which these could have been avoided. The area under the curve (ROC) were used to determine the discriminatory power of the tools. The Hanley and Mcneil test was used to compare both tools. RESULTS: AE prevalence was 36.8%. The TT detected 89.9% of all AE, while the MBDS detected 28.48%. The TT provides more information on the nature and characteristics of the AE. The area under the curve was 0.89 for the TT and 0.66 for the MBDS. These differences were statistically significant (P<.001). CONCLUSIONS: The Trigger tool detects three times more adverse events than the MBDS registry. The prevalence of adverse events in General Surgery is higher than that estimated in other studies.

Quistes sinoviales lumbares: presentación de una serie de 10 casos y revisión de la literatura / Lumbar synovial cysts: presentation of a series of 10 cases and literature review

Introducción. Los quistes sinoviales lumbares son una causa infrecuente de dolor lumbar y radicular, aunque cada vez se describen con más frecuencia en la literatura. Objetivo. Analizar el tratamiento y resultados quirúrgicos de los quistes sinoviales lumbares intervenidos en nuestro centro en un período de 5 años. Material y métodos. Se realizó un estudio retrospectivo de pacientes tratados quirúrgicamente en nuestro servicio entre agosto de 2009 y septiembre de 2014, empleando la escala visual analógica para seguimiento clínico durante el año posterior a la cirugía. Resultados. Tras el tratamiento quirúrgico (exéresis del quiste con o sin artrodesis instrumentada con tornillos transpediculares), de 10 pacientes (5 mujeres y 5 varones) de edades comprendidas entre los 50 y 80 años (edad media 70,2 años), la evolución clínica fue satisfactoria en el 80% de ellos con resolución de su sintomatología. Conclusiones. Los quistes sinoviales lumbares deben ser considerados en el diagnóstico diferencial de pacientes con dolor lumbar y radicular. La mayoría de estos pacientes están en la 6.a década de la vida y presentan generalmente una espondilopatía degenerativa lumbar. En la actualidad, se recomienda la exéresis de los quistes sinoviales con artrodesis instrumentadas con tornillos transpediculares, ya que se considera que el aumento de movilidad podría ser una de las causas de su aparición; aunque todavía se necesitan más estudios al respecto, de ahí el interés de este trabajo (AU)

Introduction. Although they are freqqently described in the literature, lumbar synovial cysts are a relative uncommon cause of low back and radicular leg pain. Objective. To evaluate the treatment and surgical outcomes of the lumbar synovial cysts operated on in our hospital during a 5 year period. Material and methods. A retrospective study was conducted on patients surgically treated in our department from August 2009 to September 2014, using a visual analogue scale for the clinical follow-up in the first year after surgery. Results. After the surgical treatment (surgical removal of the synovial cyst with or without instrumented arthrodesis with transpedicular screws) of 10 patients (5 female and 5 male) with a mean age of 70.2 years (range 50-80), the clinical outcome was satisfactory in 80% of the patients, with the resolving of their symptoms. Conclusions. Lumbar synovial cysts have to be considered in the differential diagnosis in patients with low back and radicular leg pain. The majority of the patients are in their sixties and have lumbar degenerative spondylopathy. Nowadays, surgical resection of the lumbar synovial cysts and spinal fusion are the recommended treatment, because it is thought that the increased movement of the spine is one to the causes of the cyst formation. More studies are still needed, hence the relevance of this article (AU)