Automatic Detection of Nuclear Spins at Arbitrary Magnetic Fields via Signal-to-Image AI Model.

Quantum sensors leverage matter's quantum properties to enable measurements with unprecedented spatial and spectral resolution. Among these sensors, those utilizing nitrogen-vacancy (NV) centers in diamond offer the distinct advantage of operating at room temperature. Nevertheless, signals received from NV centers are often complex, making interpretation challenging. This is especially relevant in low magnetic field scenarios, where standard approximations for modeling the system fail. Additionally, NV signals feature a prominent noise component. In this Letter, we present a signal-to-image deep learning model capable of automatically inferring the number of nuclear spins surrounding a NV sensor and the hyperfine couplings between the sensor and the nuclear spins. Our model is trained to operate effectively across various magnetic field scenarios, requires no prior knowledge of the involved nuclei, and is designed to handle noisy signals, leading to fast characterization of nuclear environments in real experimental conditions. With detailed numerical simulations, we test the performance of our model in scenarios involving varying numbers of nuclei, achieving an average error of less than 2 kHz in the estimated hyperfine constants.

Rate of obesity within a mixed-breed group of horses in Ireland and their owners' perceptions of body condition and useability of an equine body condition scoring scale.

BACKGROUND: Equine obesity is a significant health and welfare concern. The proportion of domestic horse populations that are overweight are as high as 45%. As the primary decision-makers for their horses' care, owners are theoretically ideally placed to identify whether their horses are appropriately conditioned, however, research in other countries has shown that many owners are unable to accurately judge their horse's body condition. In this study, through the comparison of body condition scoring (BCS) performed by an expert and the horse owners and interviews with owners, we aimed to identify the proportion of horses that were overweight or obese, to assess the accuracy of horse owners' BCS assessment both prior to and after receiving information and instructions on body condition scoring, and to identify common themes amongst owners' views regarding BCS assessment and the Henneke BCS system. RESULTS: Forty-five percent of the horses in this study were overweight or obese. The agreement between the owners and an equine veterinarian regarding the horses' BCS was fair to good both prior to (κ = .311, P < 0.001; ICC = .502, P < 0.001) and after (κ = .381, P < 0.001; ICC = .561, P < 0.001) receiving information and instructions on scoring. Three quarters of the owners who took part in the study did not use any method of monitoring their horse's body condition. Thematic analysis of owner responses was varied, with the most common theme being an awareness of the need to monitor or make changes to their horse's condition with responses in this theme split between owners who felt in control and those who did not. Owner feedback on the utility and useability of the scorning system was that it was useful however parts are too technical or need improvement. CONCLUSIONS: Equine obesity is a significant problem in this population in Ireland. Horse owners' ability to accurately judge their horse's condition does not improve with provision of instructions on body condition scoring. These results combined with owners' feedback on the Henneke BCS system indicate that it is not a tool that can be reliably used by owners.

Correction: Maskato et al. Prospective Feasibility and Revalidation of the Equine Acute Abdominal Pain Scale (EAAPS) in Clinical Cases of Colic in Horses. Animals 2020, 10, 2242.

The authors wish to make the following corrections to this paper [...].

Concentration of amikacin sulphate in synovial fluid when given in combination with dexamethasone phosphate in intravenous regional limb perfusion in standing horses.

Eight horses underwent IVRLP at two occasions through a 23-gauge 2 cm long butterfly catheter. Regional anaesthesia of the ulnar, median and medial cutaneous antebrachial nerves was performed prior, and an 8 cm rubber tourniquet was placed on the proximal radius for 30 minutes following the infusion. The first infusion consisted of 2 g of amikacin sulphate and 10 mg of dexamethasone phosphate diluted with 0.9% NaCl to a total volume of 100 ml. The second perfusion was performed after a 2-week washout period, the same protocol was used but without dexamethasone phosphate. Synovial fluid samples were collected from the metacarpophalangeal joint at T = 0, 0.5, 2, 12, 24 and 36 h post-infusion. Synovial fluid amikacin sulphate concentrations were determined by use of liquid chromatography/tandem mass-spectrometry. All horses (n = 8) remained healthy throughout the study, and no adverse effects associated with the study were encountered. No statistically significant differences were found in synovial fluid amikacin sulphate concentrations between the treatment and the control group at any of the time points. In conclusion, dexamethasone phosphate can be used in IVRLP concomitantly with amikacin sulphate in cases of distal limb inflammation and pain without decreasing the synovial fluid concentration of amikacin sulphate.

Synovial Concentration of Trimethoprim-Sulphadiazine Following Regional Limb Perfusion in Standing Horses.

The aim of this study was to investigate the safety and pharmacokinetics of trimethoprim-sulphadiazine administered via intravenous regional limb perfusion (IVRLP) into the cephalic vein. According to the hypothesis, the drug could be administered without adverse effects and the synovial concentrations would remain above the minimum inhibitory concentration (MIC) for trimethoprim-sulphadiazine (0.5 and 9.5 µg/mL) for 24 h. Ten (n = 10) horses underwent cephalic vein IVRLP with an Esmarch tourniquet applied for 30 min. Four grams (4 g) of trimethoprim-sulphadiazine (TMP-SDZ) were diluted at 0.9% NaCl for a total volume of 100 mL. Synovial fluid and blood samples were obtained immediately before IVRLP and at 0.25, 0.5, 2, 6, 12 and 24 h after the initiation of IVRLP. Trimethoprim and sulphadiazine concentrations were determined using a method based on liquid chromatography/tandem mass spectrometry. The Cmax (peak drug concentration) values were 36 ± 31.1 and 275.3 ± 214.4 µg/mL (TMP and SDZ). The respective tmax (time to reach Cmax) values were 20 ± 7.8 and 26.4 ± 7.2 min. The initial synovial fluid concentrations were high but decreased quickly. No horse had synovial concentrations of trimethoprim-sulphadiazine above the MIC at 12 h. Severe vasculitis and pain shortly after IVRLP, lasting up to one week post-injection, occurred in five out of 10 horses. In conclusion, IVRLP with trimethoprim-sulphadiazine cannot be recommended due to the low concentrations of synovial fluid over time and the frequent severe adverse effects causing pain and discomfort in treated horses. Thus, in cases of septic synovitis with bacteria sensitive to trimethoprim-sulphadiazine, other routes of administration should be considered.

Intraincisional medical grade honey decreases the prevalence of incisional infection in horses undergoing colic surgery: A prospective randomised controlled study.

BACKGROUND: Medical grade honey has previously been described as a prophylactic treatment for wounds. Local prophylactic treatment may be valuable in preventing post-operative incisional infections in horses undergoing colic surgery but has not been evaluated. OBJECTIVES: To establish whether medical grade honey gel, applied on the linea alba intraoperatively, decreases the prevalence of incisional infections in horses undergoing colic surgery with no associated adverse effects. STUDY DESIGN: Prospective blinded randomised controlled clinical study. METHODS: Horses older than 4 months that underwent colic surgery between May 2017 and December 2018 and survived for >2 weeks were included in the study. Horses were allocated 1:1 to treatment or control by block randomisation. In the treatment group, following closure of the linea alba, medical grade honey gel (L-Mesitran Soft® ) was placed in the incision followed by apposition of subcutaneous tissue and skin. Information regarding the incision and post-operative complications was obtained at five time points (24 hours, 48 hours, 5 days, 14 days and 3 months). RESULTS: Eighty-nine horses were included in the study. No adverse effects associated with treatment were observed. Horses in the treatment group had a lower rate of incisional infection compared with the control group (8.2% vs. 32.5%, P = .02). The protective effect of MGH had a calculated adjusted odds ratio (OR) of 0.2 (95% CI:0.07-0.8, P = .03). The number of patients required to receive treatment to prevent one case of incisional infection (NNEB) was 4.7. Risk factors associated with infection included: younger age (OR = 27, 95% CI: 2.3 to 306, P = .008) and diarrhoea 48 hours post-operatively (OR = 20, 95% CI: 1.5 to 277, P = .02). MAIN LIMITATIONS: Follow-up was performed by different veterinary surgeons, hence not completely uniform. CONCLUSION: Local prophylactic treatment with medical grade honey gel in the abdominal incision during surgery is safe and may significantly decrease the prevalence of incisional infections in horses undergoing colic surgery.

Prospective Feasibility and Revalidation of the Equine Acute Abdominal Pain Scale (EAAPS) in Clinical Cases of Colic in Horses.

Assessment of the severity of pain in colic cases is subjective. The Equine Acute Abdominal Pain Scale (EAAPS), previously validated using film clips of horses with colic, was tested for feasibility and revalidated in both medical and surgical colic cases in Israel and the UK. Feasibility qualities evaluated were quickness and ease-of-use. Pain in 231 horses, presented for colic, was assessed by 35 participants; 26 in the UK and 9 in Israel. Without prior training, participants assessed the severity of pain using two scales; the EAAPS and a visual analogue scale (VAS). Convergent validity comparing the EAAPS to the VAS was substantial, discriminant validity was good, and predictive validity for surgical treatment was similar to the VAS, but for mortality, the VAS was significantly better. No participants reported the EAAPS to be "very slow" or "very difficult" to use. The mode reported was "quick"/"very quick" and "easy"/"very easy" to use, though in less than 10% of cases, it was reported to be a little less quick or easy. More experienced first-time users found it significantly quicker to use than less experienced participants. In conclusion, the EAAPS is the only equine pain assessment scale that has been tested and found to demonstrate good feasibility for use in the referral hospital setting.

Time to Peak Concentration of Amikacin in the Antebrachiocarpal Joint Following Cephalic Intravenous Regional Limb Perfusion in Standing Horses.

OBJECTIVE: The aim of this study was to determine the time (Tmax) to the maximum concentration (Cmax) of amikacin sulphate in synovial fluid of the radiocarpal joint (RCJ) following cephalic intravenous regional limb perfusion (IVRLP) using 2 g of amikacin sulphate. METHODS: Cephalic IVRLP was performed with 2 g of amikacin sulphate diluted in 0.9% NaCl to a total volume of 100 mL in six healthy adult mixed breed mares. An Esmarch's rubber tourniquet was applied for 30 minutes and the antibiotic solution was infused through a 23-gauge butterfly catheter. Synovial fluid was collected from the RCJ prior to the infusion and at 5, 10, 15, 20, 25 and 30 minutes after completion of IVRLP. The tourniquet was removed after the last arthrocentesis. Synovial fluid amikacin sulphate concentrations were determined by liquid chromatography/tandem mass spectrometry. RESULTS: The calculated mean Tmax occurred at 15 minutes (range: 10-20 minutes) post-perfusion. The highest synovial fluid amikacin sulphate concentration was noted at 10 minutes in 2 horses, 15 minutes in 2 horses and 20 minutes in 2 horses. The highest mean concentration was 1023 µg/mL and was noted at 20 minutes. Synovial mean concentrations were significantly different between 15 and 30 minutes. CLINICAL SIGNIFICANCE: In this study no Tmax occurred after 20 minutes; thus, 30 minutes of tourniquet application time appear to be excessive. The 20 minutes duration of tourniquet application appears sufficient for the treatment of the RCJ in cephalic IVRLP using 2 g amikacin sulphate in a total volume of 100 mL.

Daboia (Vipera) palaestinae Envenomation in 123 Horses: Treatment and Efficacy of Antivenom Administration.

Envenomation by venomous snakes is life threatening for horses. However, the efficacy of available treatments for this occurrence, in horses, has not yet been adequately determined. The aim of this study was to describe the treatments provided in cases of Daboia palaestinae envenomation in horses and to evaluate the safety and efficacy of antivenom administration. Data regarding 123 equine snakebite cases were collected over four years from 25 veterinarians. The majority of horses were treated with procaine-penicillin (92.7%), non-steroidal anti-inflammatory drugs (82.3%), dexamethasone (81.4%), tetanus toxoid (91.1%) and antivenom (65.3%). The time interval between treatment and either cessation or 50% reduction of local swelling was linearly associated with case fatality (p < 0.001). The overall mortality rate was 20.3%. Treatment with procaine-penicillin was significantly associated with reduced mortality (OR = 0.11). Three horse-derived antivenom products were available during the study period, of which the horses were administered different brands of varying dosages. Administration of the recommended dosage of any of the aforementioned products led to a significant decrease in mortality (p = 0.014), even in severe cases (scoring 2 or greater on the equine snakebite severity scale). No adverse reactions were reported. The results of this study show that species-specific D. palaestinae antivenom administered at the manufacturer-recommended dosage is effective in significantly reducing mortality in cases of envenomation in horses.

The antigenic variability of HCV in viral HLA-Ag binding is related to the activation of the host immune response.

Our previous data show that hepatitis C virus (HCV) genotype 1 patients expressing the HLA-DQB1 * 0301 allele have a combined response probability of 69%, while the remaining 31% do not respond, probably because the HCV immunodominant epitope (IE) against the DQB1 * 0301 allele is mutated. HCV IE (region sequenced in NS3 is a region encoding aa 1253-1272) from 37 patients (21 Sustained Virological Response, SVR; 16 non-SVR) HLA-DQB1 * 0301+, were analysed by pyrosequencing. In vitro cultures were also determined by CD4+ proliferation, using non-mutated IE (wild-type synthetic peptide) and synthetic mutated peptide. The pyrosequencing study revealed 34 different haplotypes. The SVR patients had fewer haplotypes (P = 0.07), mutations/haplotypes (P = 0.01) and polymorphic sites (P = 0.02) than non-SVR. Three polymorphic sites were associated with the non-SVR patients: haplotype 7 (L5P); haplotype 11 (L7P); and haplotype 15, (L15S) (P = 0.02). The in vitro study (n = 7) showed that in 4/7 patients (Group 1) the CD4+ proliferation obtained with wild-type synthetic peptide was higher than that obtained with the negative control and with the synthetic mutated peptide (P = 0.039). However, in the remaining 3/7 patients (Group 2) this pattern was not observed (P = 0.7). Our findings suggest that HLA-DQB1 * 0301+ patients with high antigenic variability in HCV IE (NS31253-1272) have a lower SVR rate, due to reduced CD4+ proliferation as a result of incorrect viral HLA-Ag binding.

Daboia (Vipera) palaestinae envenomation in horses: Clinical and hematological signs, risk factors for mortality and construction of a novel severity scoring system.

Daboia palaestinae is the most common venomous snake in Israel and an important cause of envenomations in humans and animals. Although specific antivenom is produced from horses, little documentation exists regarding the characteristics of envenomed horses. This survey was constructed to describe the clinical, hematological and biochemical characteristics of D. palaestinae envenomation in horses, to identify risk factors for fatality and to construct a prognostic snakebite severity scale (SSS) to be used by veterinarians in the field. Data regarding 123 equine snakebite cases were collected over four years. Clinical signs most frequently described were local swelling (100%), tachycardia (67%), increased respiratory effort (62%), bite marks (44%) and reduced appetite (50%). Blood samples were collected at initial presentation from 23 of these horses. Hematological and biochemical abnormalities described in the majority of the sampled cases included leukocytosis (52%), neutrophilia (78%), increased creatine phosphokinase (77%), hypoproteinemia (50%), decreased total carbon dioxide (54%), and hyperphosphatemia (54%). The overall case fatality rate was 20.3% (25/123 horses). Risk factors associated with increased mortality (P < 0.05) were body weight below 200 kg, hind limb envenomation, severity of local swelling, mental status, respiratory effort, bleeding disorders, dehydration, basophilia, monocytosis, bilirubinemia, hypocalcemia and hyperphosphatemia. These risk factors were used to construct an SSS adapted for the assessment of envenomed horses in the field, consisting of seven dichotomous parameters. A cutoff value of 1.5 predicted mortality with 95% sensitivity and 68% specificity. In the future, this tool could assist clinicians with case management and communication with owners.

Influence of HLA class I, HLA class II and KIRs on vertical transmission and chronicity of hepatitis C virus in children.

BACKGROUND & AIM: There is evidence that maternal viral load of HCV during delivery influences the risk for Mother-to-child transmission (MTCT), but this does not explain all cases. We study the role of the immunogenetic profile (HLA, KIRs and KIR-ligand binding) of mothers and children in HCV-MTCT and in chronicity in the children. METHODOLOGY: 79 HCV-RNA (+) mothers and their 98 children were included. 24 children were infected, becoming chronic in 8 cases and clearing in 16. HLA-class-I and II and KIRs were determined by Luminex. RESULTS: MTCT study: The presence of HLA-C1-ligand in mothers and/or their children reduces the risk of transmission (mothers: Pc = 0.011, children: P = 0.033), whereas the presence of HLA-C2C2-ligand in mothers increases it (Pc = 0.011). In children KIR2DL3-HLA-C1 is a protector factor (Pc = 0.011). Chronicity in children study: Maternal DQA1*01 allele (Pc = 0.027), KIR2DS1 (Pc = 0.011) or KIR3DS1 (Pc = 0.011) favours chronicity in the child. The presence of the DQB1*03 allele (Pc = 0.027) and KIR2DS3 (P = 0.056) in the child and homozygosity for KIR3DL1/3DL1 (Pc = 0.011) and for the HLA-Bw4/Bw4 ligand (P = 0.027) is associated with viral clearance, whereas the presence of HLA-Bw6 ligand (P = 0.027), the binding of KIR3DS1-HLA-Bw4 (P = 0.037) and heterozygosity for KIR3DL1/3DS1 (Pc = 0.011) favour viral chronicity. Mother/child allele matching: In the joint HLA analysis, matching was greater between mothers and children with chronic infection vs those who had cleared the virus (67%±4.1 vs 57%±1.2, P = 0.003). CONCLUSIONS: The HLA-C1 ligand in the mother is related to MTCT, while several genetic factors of the mother or child are involved in the chronification or clearance of infection in the child. Matching allelic data is considered to be an indicator of HCV chronicity in the child and can be used as a potential prognostic test. This implies that NK cells may play a previously undocumented role in protecting against MTCT and that both NK cell immunity and adaptive T-cell responses may influence viral clearance in infected children.

Asistencia al niño y adolescente con diabetes. Unidades de referencia en diabetes pediátrica / Treatment of the child and adolescent with type i diabetes: special paediatric diabetes units

El tratamiento intensivo de la diabetes mellitus tipo 1 (DM1) permite retrasar y enlentecer la progresión de las complicaciones crónicas (DCCT 1993). Este tipo de tratamiento en niños y adolescentes con DM1 tiene una complejidad diferente de la de otras etapas de la vida y por ello se necesitan Unidades de Asistencia Especializada en diabetes pediátrica. Se valoran los diferentes documentos y declaraciones sobre los derechos de los pacientes con DM1 y se enfatiza la necesidad de una adecuada asistencia sanitaria. En la última década, se han desarrollado en Europa varios proyectos para establecer una evaluación comparativa del tratamiento de la DM en edad pediátrica con el objetivo de establecer centros hospitalarios con una asistencia muy cualificada en su control. El Grupo de trabajo de Diabetes de la Sociedad Española de Endocrinología Pediátrica ha elaborado este documento con el objetivo de obtener un Consenso Nacional para la asistencia al niño y adolescente con DM1 en «Unidades de Referencia en diabetes pediátrica» y, a su vez, poder asesorar a las administraciones para establecer una Red Nacional dirigida a la asistencia del niño y adolescente con DM y organizar las Unidades de Atención Integral de la diabetes pediátrica en hospitales con nivel de referencia por su calidad asistencial (AU)

Intensive treatment of type 1 diabetes mellitus (DM1) delays and slows down the progression of chronic diabetes complications (DCCT 1993). This type of treatment in children and adolescents with DM1 has a different complexity to other stages of life and therefore, needs specialized care units. Various documents and declarations of diabetic patient's rights are evaluated, and the need for an adequate health care is emphasized. In the last decade, several projects have been developed in Europe to create a benchmark treatment of pediatric diabetes, with the aim of establishing hospitals with highly qualified healthcare to control it. The Diabetes Working Group of the Spanish Society for Pediatric Endocrinology (SEEP) has prepared this document in order to obtain a national consensus for the care of children and adolescents with type 1 diabetes in specialist Pediatric Diabetes Units, and at the same time advise Health Care Administrators to establish a national healthcare network for children and adolescents with diabetes mellitus, and organize comprehensive pediatric diabetes care units in hospitals with a reference level in quality of care (AU)

[Treatment of the child and adolescent with type 1 diabetes: special paediatric diabetes units]. / Asistencia al niño y adolescente con diabetes. Unidades de referencia en diabetes pediátrica.

Intensive treatment of type 1 diabetes mellitus (DM1) delays and slows down the progression of chronic diabetes complications (DCCT 1993). This type of treatment in children and adolescents with DM1 has a different complexity to other stages of life and therefore, needs specialized care units. Various documents and declarations of diabetic patient's rights are evaluated, and the need for an adequate health care is emphasized. In the last decade, several projects have been developed in Europe to create a benchmark treatment of pediatric diabetes, with the aim of establishing hospitals with highly qualified healthcare to control it. The Diabetes Working Group of the Spanish Society for Pediatric Endocrinology (SEEP) has prepared this document in order to obtain a national consensus for the care of children and adolescents with type 1 diabetes in specialist Pediatric Diabetes Units, and at the same time advise Health Care Administrators to establish a national healthcare network for children and adolescents with diabetes mellitus, and organize comprehensive pediatric diabetes care units in hospitals with a reference level in quality of care.

Documento consenso del Grupo de Diabetes de la SEEP: Programa de formación para la implantación del tratamiento con infusión subcutánea continua de insulina (ISCI) en pacientes pediátricos con diabetes tipo 1 / Consensus document of the Diabetes Group of the Spanish Society of Pediatric Endocrinology (SEEP): A training program to carry out treatment with continuous subcutaneous insulin infusion (CSII) in pediatric patients with type 1 diabetes

Los avances tecnológicos en los últimos años en el campo de la diabetes han permitido la aplicación de nuevas terapias para nuestros pacientes con el objetivo fundamental de mejorar su control metabólico, la calidad de vida y evitar las hipoglucemias. Esto obliga a establecer protocolos de consenso en el empleo de estas nuevas tecnologías para ser utilizadas por los distintos profesionales implicados en esta enfermedad. Este programa de formación incluye los conocimientos básicos y avanzados, para la utilización de la ISCI (AU)

Recently new technologies for the management of diabetes allow new therapeutic strategies for diabetes patients with the object of improve metabolic control, queality of life and avoid hypoglycaemias. Because physicians must be familiar with new diabetic are devices, new protocols must be establish. This article reports on the Spanish Position Statement for the Diabetes Pediatric Group for the Spanish Pediatric Endocrinology Society (SEEP) on educational program for the treatment of children and adolescent with type 1 diabetes with continuous subcutaneous insulin infusion (AU)

Ketoacidosis at onset of type 1 diabetes mellitus in pediatric age in Spain and review of the literature.

UNLABELLED: DKA at diagnosis of T1DM is a life-threatening situation that represents the main cause of morbidity and mortality in pediatric patients with T1DM. OBJECTIVE: To determine whether the occurrence and severity of DKA at diagnosis of T1DM has suffered any changes in recent years in the Spanish paediatric population. PATIENTS AND METHODS: Data from 1169 patients with T1DM under 15 years of age was retrospectively studied (2004 -2008) for the presence and severity of DKA at the onset of T1DM, and compared to previous available studies in Spain. This study is multicentric, nationwide with eleven major Paediatric Diabetes Units involved. RESULTS: Complete data were available from 1151 patients (98%). Frequency of DKA was 39.5%, which is not significantly different from previous Spanish studies. 33.8%, children of 0-4.9 years of age, 40.8% aged 5-10.9 and 25.2% aged 11-14.9 years. Mean age of patients with DKA was significantly lower than the one of patients without DKA (7.44 +/- 4.10 versus 8.47 +/- 3.63 years). Mild DKA was occurring more frequently than moderate and severe forms (47.8%, versus 34.4% versus 17.8%, p<0.0001). Incidence of severe DKA was significantly higher in children under 4.9 years of age, especially in those younger than 2 years (p<0.001). Severe DKA led to complications in three children (cerebral oedema [n=1]), cerebral infarction (n=1) and femoral vein thrombosis (n=1). CONCLUSION: Frequency of DKA at diagnosis of T1DM in Spain is still high although most cases were mild. Children under 2 years of age seem to be at increased risk for severe DKA.

Histological and immunohistochemical assessment of liver biopsies in morbidly obese patients.

AIMS: To study liver lesions in morbidly obese patients who underwent liver biopsy at the time of bariatric surgery to define histological lesions, especially inflammatory infiltrate, diagnostic categories and the possible influence of gender in this respect. METHODS AND RESULTS: 110 biopsies (36 males-M- and 76 females -F-) were evaluated and categorised, according to the NAS (NAFLD -non alcoholic fatty liver disease- Activity Score) system and other criteria, as non-NAFLD (15.5%, F predominance), non-alcoholic steatohepatitis (NASH) (16.5%, M predominance), non-alcoholic hepatosteatosis (NAHS) (21%, F predominance) and, the most numerous group, NASH-borderline (NASH-BORD) (47%), with three subgroups, characterised by centrozonal lesions, portal area preferential involvement or affecting both areas. The predominant form of hepatocytesteatosis was mixed with a multivesicular component that was present in most cases with fibroinflammatory portal involvement. Nuclear glycogenosomes were found in greater number of biopsies in patients in the third and sixth decades. Portal inflammation was present in a large number of cases (M predominance); the application of immunohistochemical techniques (myeloperoxidase and CD68 antibodies) to evaluate lobular inflammation revealed "surgical hepatitis" in one third of the cases, and the presence of microgranulomas (CD68+) (M predominance), which were more abundant with increasing lesion severity. CONCLUSIONS: Portal inflammation and multivesicular hepatocytesteatosis are highly prevalent in morbidly obese patients. This study identifies a new subtype of NASH-BORD characterized by centrizonal and porto-periportal area involvement and the existence of liver biopsies without steatosis. CD68+ microgranulomas constitute an unequivocal marker of lobular inflammation in surgical biopsies and of lesion severity, which is gender-related.

Practical diagnosis of red cell disorders in southern Spain.

BACKGROUND: Hereditary red cell disorders are associated with a protective effect against malaria, which results in an increased prevalence in malaria-endemic areas. Migratory flows from these areas are resulting in a marked increase in such abnormalities in Southern Spain. METHODS: All hemoglobin disorders diagnosed between 1997 and 2010 have been recorded. Since 2008, we have performed systematic screening for hemoglobinopathies on African patients. A high-pressure liquid chromatography system was used as screening method for structural hemoglobinopathies and for separation of hemoglobin (Hb) F and A(2). RESULTS: We detected 666 cases in patients of foreign origin and 308 in native Spanish patients. Thalassemias (thal) are the most frequent disorders amongst the local population: ß-thal minor, 57.1% (176/308); α-thal, 18.2% (56/308), and δß-thal, 7.8% (24/308). In ethnic minorities, there is a huge variety of hemoglobinopathies: heterozygous Hb S, 45% (300/666); heterozygous Hb C, 15% (100/666); ß-thal minor, 13.7% (91/666); α-thal, 10.2% (68/666); Hb SS in 14 patients, and Hb CC in 9 patients. Of the native patients, 14 were found to have Hb AS and 9 Hb AC. CONCLUSION: Given the modern migratory flows, greater knowledge of these disorders is needed by all medical staff, and new practical and cost/time-effective diagnostic approaches have to be devised.

IgE cross-reactivity between house dust mite allergens and Ascaris lumbricoides antigens

BACKGROUND: Common antigens between intestinal parasites and environmental allergens may play a role in the modulation of allergic immune responses. There is a growing interest in investigating cross-reactivity between common helminths and dust mites affecting humans, particularly in the tropics. OBJECTIVE: This study examined the cross-reactivity between the human roundworm Ascaris lumbricoides (Al) and three house dust mite (HDM) species. METHODS: Specific serum IgE levels to HDM species Blomia tropicalis (Bt), Dermatophagoides pteronyssinus (Dp), and Dermatophagoides farinae (Df ); and Al extracts among allergic (n=100) and ascariasis (n=60) subjects were measured through enzyme-linked immunosorbent assay (ELISA). IgE-reactive components of HDM and Al extracts were detected through Western-Blot Analysis. Cross-reactivity between HDMs and Al was determined by ELISA inhibition using HDM and Al-specific sera from allergic (n=15) and ascariasis (n=15) subjects. The IgE-binding capacity of a recombinant paramyosin peptide (Blo t 11-fD) to allergic (n=50) and ascariasis (n=50) subjects' sera were likewise determined. RESULTS: Among allergic subjects, 70% exhibited Al-specific positive IgE-reactivity, while 20-28% of ascariasis subjects demonstrated HDM-specific positive IgE-reactivity. Multiple IgE-reactive components of HDM allergens (14-240 kDa) and Al antigens (15-250 kDa) were detected, indicating multi-allergen sensitization among the subjects tested. Al antigens can inhibit up to 92% of HDM-specific IgE-reactivity among allergic subjects, while up to 54% of Al-specific IgE-reactivity among ascariasis subjects was inhibited by HDM allergens. Positive rBlo t 11-fD-specific IgE reactivity was observed in 80% of the allergic subjects and 46% of the ascariasis subjects. CONCLUSIONS: This study showed the presence of multiple cross-reactive antigens in HDM and Al extracts. Identification of these molecules may provide basis for designing novel diagnostic and therapeutic strategies. The potential role of paramyosin as a specific cross-reactive allergen present in HDMs and Al has been shown.

Estado actual y recomendaciones sobre la utilización de los sistemas de monitorización continua de glucosa en niños y adolescentes con diabetes mellitus tipo 1 / Current status and recommendations on the use of continuous blood glucose monitoring systems in children and adolescents with type 1 diabetes mellitus

Los métodos de medición de la glucemia han presentado un gran avance en la última década con la aparición de los sistemas de monitorización continua de la glucosa (SMCG) que miden los niveles de glucosa en el líquido intersticial y ofrecen información sobre patrones y tendencias de los niveles de la glucemia pero no sustituyen el autocontrol de la glucemia capilar. La mejoría del control de la diabetes utilizando los SMCG depende de la motivación y formación recibida por el paciente y familia, así como de la continuidad en su uso. Debido al gran desarrollo y la amplia utilización en la práctica clínica de estos sistemas, el grupo de diabetes de la Sociedad Española de Endocrinología Pediátrica ha elaborado un documento de consenso para su indicación y uso en la edad pediátrica. Existe un número limitado de ensayos clínicos en población pediátrica sobre el uso de esta tecnología. Se necesitan más datos para poder valorar su impacto sobre el control metabólico (AU)

Glucose monitoring methods have made great advances in the last decade with the appearance of the continuous glucose monitoring systems (CGMS) that measure the glucose levels in the interstitial liquid, providing information about glucose patterns and trends, but do not replace the self-monitoring of capillary glucose. Improvement in diabetes control using the CGMS depends on the motivation and training received by the patient and family and on the continuity in its use. Due to the development and widespread use of these systems in clinical practice, the diabetes group of the Sociedad Española de Endocrinología Pediátrica has drafted a document of consensus for their indication and use in children and adolescents. Only a limited number of trials have been performed in children and adolescent populations. More data are needed on the use of this technology in order to define the impact on metabolic control (AU)