Endoscopic transorbital approach bone pillars: a comprehensive stepwise anatomical appraisal.

OBJECTIVE: The endoscopic superior eyelid transorbital approach has garnered significant consideration and gained popularity in recent years. Detailed anatomical knowledge along with clinical experience has allowed refinement of the technique as well as expansion of its indications. Using bone as a consistent reference, the authors identified five main bone pillars that offer access to the different intracranial targeted areas for different pathologies of the skull base, with the aim of enhancing the understanding of the intracranial areas accessible through this corridor. METHODS: The authors present a bone-oriented review of the anatomy of the transorbital approach in which they conducted a 3D analysis using Brainlab software and performed dry skull and subsequent cadaveric dissections. RESULTS: Five bone pillars of the transorbital approach were identified: the lesser sphenoid wing, the sagittal crest (medial aspect of the greater sphenoid wing), the anterior clinoid, the middle cranial fossa, and the petrous apex. The associations of these bone targets with their respective intracranial areas are reported in detail. CONCLUSIONS: Identification of consistent bone references after the skin incision has been made and the working space is determined allows a comprehensive understanding of the anatomy of the approach in order to safely and effectively perform transorbital endoscopic surgery in the skull base.

Quality of lean body mass and jump capacity in high performance young basketball players lean body mass and jump capacity.

The lean body mass (LBM) components have been suggested as important predictors of anaerobic performance, which is highly involved in basketball. We explored with descriptive cross-sectional design the relationship between anaerobic performance and full molecular and cellular body composition profile in young male basketball players. Twenty-one players (age = 16.8 ± 1.6 years; body mass = 76.3 ± 15.7 kg, height = 189.3 ± 12.6 cm) were recruited, 11 elite and 10 local level. Participants were evaluated on multicomponent body composition [LBM, appendicular lean soft tissue (ALST), bone mineral content (BMC), total body water (TBW), intracellular water (ICW) and extracellular water (ECW)] and field-based anaerobic performance (vertical jump, linear sprint, and handgrip strength). The stepwise regression analyses adjusted for confounders showed significant relationships of whole-body and regional body composition components with handgrip and jump performance (P ≤ 0.03). Prediction models combining body composition variables assessed by bioimpedance analysis (BIA) and double-energy X-ray absorptiometry (DXA) revealed that lean mass and hydration ratios (ICW/ECW and ECW/TBW) were strongly associated with jump performance (CMJ and CMJ25kg), independently of the competition level (P < 0.01). The novel finding in this study was that water quality (ICW/ECW) and water distribution (ECW/TBW, ICW) of total and regional LBM were the main predictors of vertical jump capacity in young basketball players.

Evaluation of Tropane Alkaloids in Teas and Herbal Infusions: Effect of Brewing Time and Temperature on Atropine and Scopolamine Content.

Atropine and scopolamine belong to the tropane alkaloid (TA) family of natural toxins. They can contaminate teas and herbal teas and appear in infusions. Therefore, this study focused on analyzing atropine and scopolamine in 33 samples of tea and herbal tea infusions purchased in Spain and Portugal to determine the presence of these compounds in infusions brewed at 97 °C for 5 min. A rapid microextraction technique (µSPEed®) followed by high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) was used to analyze the selected TAs. The results showed that 64% of the analyzed samples were contaminated by one or both toxins. White and green teas were generally more contaminated than black and other herbal teas. Of the 21 contaminated samples, 15 had concentrations above the maximum limit for liquid herbal infusions (0.2 ng/mL) set by Commission Regulation (EU) 2021/1408. In addition, the effects of heating conditions (time and temperature) on atropine and scopolamine standards and naturally contaminated samples of white, green, and black teas were evaluated. The results showed that at the concentrations studied (0.2 and 4 ng/mL), there was no degradation in the standard solutions. Brewing with boiling water (decoction) for 5 and 10 min allowed for higher extraction of TAs from dry tea to infusion water.

Land uses in cities and their impacts on the water quality of urban freshwater blue spaces in the Pampean region (Argentina).

Freshwater blue spaces (FBS), such as ponds, are key elements of the urban landscape and are under strong anthropogenic pressure. Land-use types and diversity may exert a negative or positive impact on FBS' water quality depending on their nature and arrangement. The information available in this respect is remarkably scarcer for water bodies in the Global South than for the north. Thus, we aim to identify and quantify the land-use types in a 500-m buffer zone of urban ponds in the Pampean region (Argentina) to assess their impact on water quality. We based our study on 15 FBS located in neighborhoods of Buenos Aires province during cold and warm seasons. We analyzed physical, chemical, and biological variables, and estimated water conditions by means of water quality indexes (WQIs) and quality guidelines. We quantified the dominant land-use type and the diversity of uses in the ponds' buffer zones, and evaluated their relationships with WQIs. Our results showed that WQIs were negatively related to a high proportion of residential areas in the adjacent zone, while positively to recreational ones. The diversity of land uses did not influence the water quality. We propose a new WQIpond with fewer key response variables, and as sensitive as the currently used WQIobjetive. We conclude that water quality from urban ponds in the Pampean region can be affected by dominant land-use type in the adjacent area but also the quality of their water supply sources (superficial and/or underground), clandestine wastewater discharges, and non-point pollution.

Improved Analytical Approach for Determination of Tropane Alkaloids in Leafy Vegetables Based on µ-QuEChERS Combined with HPLC-MS/MS.

This work presents an optimized methodology based on the miniaturization of the original QuEChERS (µ-QuEChERS) followed by liquid chromatography coupled to mass spectrometry (HPLC-MS/MS) for the determination of tropane alkaloids (TAs), atropine, and scopolamine in leafy vegetable samples. The analytical methodology was successfully validated, demonstrating quantitation limits (MQL) ≤ 2.3 ng/g, good accuracy, and precision, with recoveries between 90-100% and RSD ≤ 13% for both analytes. The method was applied to the analysis of TA-producing plants (Brugmansia versicolor, Solandra maxima, and Convolvulus arvensis). High concentrations of scopolamine were found in flowers (1771 mg/kg) and leaves (297 mg/kg) of B. versicolor. The highest concentration of atropine was found in flowers of S. maxima (10.4 mg/kg). Commercial mixed leafy vegetables contaminated with B. versicolor and S. maxima were analysed to verify the efficacy of the method, showing recoveries between 82 and 110% for both analytes. Finally, the method was applied to the analysis of eighteen samples of leafy vegetables, finding atropine in three samples of mixed leafy vegetables, with concentrations of 2.7, 3.2, and 3.4 ng/g, and in nine samples with concentrations ≤MQL. In turn, scopolamine was only found in a sample of chopped Swiss chard with a concentration ≤MQL.

Green extraction approach based on µSPEed® followed by HPLC-MS/MS for the determination of atropine and scopolamine in tea and herbal tea infusions.

A high throught methododology based on a green extraction technique, µSPEed®, followed by high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) has been proposed for the analysis of atropine and scopolamine in tea and herbal tea infusions. For this, a digiVOL® Digital Syringe was used with different sorbents and working conditions to obtain a fast and efficient µSPEed® extraction. The best performance was achieved with a PS/DVB sorbent phase, sample loading of 5 × 500 µL and elution with 2 × 100 µL aliquots of methanol. The strategy based on µSPEed® followed by HPLC-MS/MS was validated, attaining quantitation limits lower than 0.15 ng mL-1 and recoveries between 94 and 106% for both analytes and applied to seventeen tea and herbal tea infusions. Fourteen infusions showed contamination with one or both analytes above the maximum content legislated (sum of atropine and scopolamine < 0.2 ng mL-1).

Mesostructured Silicas as Cation-Exchange Sorbents in Packed or Dispersive Solid Phase Extraction for the Determination of Tropane Alkaloids in Culinary Aromatics Herbs by HPLC-MS/MS.

In this work, Hexagonal Mesoporous Silica (HMS) and Santa Barbara Amorphous-15 (SBA-15) mesostructured silicas were synthesized and functionalized with sulfonic acid groups. The materials (HMS-SO3− and SBA-15-SO3−) were evaluated as strong cation exchange sorbents for sample extract clean-up, by solid phase extraction (SPE) and dispersive solid phase extraction, to determine atropine (At) and scopolamine (Sc) in commercial culinary aromatic herbs. Under optimized conditions, 0.25 g of sample was subject to solid−liquid extraction with acidified water (pH 1.0), and good recovery percentages were achieved for At and Sc using 75 mg of HMS-SO3− in SPE as the clean-up stage, prior to their determination by HPLC-MS/MS. The proposed method was validated in a thyme sample showing recoveries in the range of 70−92%, good linearity (R2 > 0.999), adequate precision (RSD ≤ 14%) and low limits (MDL 0.8−2.2 µg/kg and MQL 2.6−7.2 µg/kg for both analytes). Sixteen aromatic herbs samples (dried thyme, basil and coriander leaves) were analysed and At was found in fourteen samples over an interval of <5−42 µg/kg, whereas Sc was found in three of the sixteen samples studied (between <5−34 µg/kg). The amount of At and Sc found in some analysed samples confirms the importance of setting maximum levels of At and Sc in culinary aromatic herbs.

Erythropoietin in children with hemolytic uremic syndrome: a pilot randomized controlled trial.

BACKGROUND: The efficacy of recombinant human erythropoietin (rHuEPO) in sparing red blood cell (RBC) transfusions in children with hemolytic uremic syndrome related to Shiga toxin-producing Escherichia coli (STEC-HUS) is uncertain. METHODS: We conducted a pilot randomized controlled open trial between December 2018 and January 2021. Children were randomized to the intervention (subcutaneous rHuEPO 50 U/kg three times weekly until discharge + RBC transfusion if hemoglobin ≤ 7 g/dL and/or hemodynamic instability) or to the control arm (RBC transfusion if hemoglobin ≤ 7 g/dL and/or hemodynamic instability). Primary outcome was the number of RBC transfusions received during hospitalization. Secondary outcomes were to explore whether baseline EPO levels were adequate to the degree of anemia, to correlate selected acute phase parameters with the number of RBC transfusions, and to assess possible adverse events. RESULTS: Twelve patients per arm were included; they were comparable at recruitment and throughout the disease course. Median number of RBC transfusions was similar between groups (1.5, p = 0.76). Most patients had baseline EPO levels adequate to the degree of anemia, which did not correlate with the number of transfusions (r = 0.19, p = 0.44). Conversely, baseline (r = 0.73, p = 0.032) and maximum lactic dehydrogenase levels (r = 0.78, p = 0.003), creatinine peak (r = 0.71, p = 0.03) and dialysis duration (r = 0.7, p = 0.04) correlated significantly with RBC requirements. No side effects were recorded. CONCLUSION: In children with STEC-HUS, the administration of rHuEPO did not reduce the number of RBC transfusions. Larger studies addressing higher doses and similar severity of kidney failure at rHuEPO initiation (e.g. at start of dialysis) are warranted. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03776851. A higher resolution version of the Graphical abstract is available as Supplementary information.

Occurrence and Chemistry of Tropane Alkaloids in Foods, with a Focus on Sample Analysis Methods: A Review on Recent Trends and Technological Advances.

Tropane alkaloids (TAs) are natural toxins produced by different plants, mainly from the Solanaceae family. The interest in TAs analysis is due to the serious cases of poisoning that are produced due to the presence of TA-producing plants in a variety of foods. For this reason, in recent years, different analytical methods have been reported for their control. However, the complexity of the matrices makes the sample preparation a critical step for this task. Therefore, this review has focused on (a) collecting the available data in relation to the occurrence of TAs in foods for human consumption and (b) providing the state of the art in food sample preparation (from 2015 to today). Regarding the different food categories, cereals and related products and teas and herbal teas have been the most analyzed. Solid-liquid extraction is still the technique most widely used for sample preparation, although other extraction and purification techniques such as solid-phase extraction or QuEChERS procedure, based on the use of sorbents for extract or clean-up step, are being applied since they allow cleaner extracts. On the other hand, new materials (molecularly imprinted polymers, mesostructured silica-based materials, metal-organic frameworks) are emerging as sorbents to develop effective extraction and purification methods that allow lower limits and matrix effects, being a future trend for the analysis of TAs.

Development and validation in Ecuador of the EPD Questionnaire, a diabetes-specific patient-reported experience and outcome measure: A mixed-methods study.

INTRODUCTION: The global prevalence of diabetes in 2019 in adults was estimated to be 9.3%. This study developed in Ecuador, for the first time, instruments to assess patient-reported outcomes and experiences. METHODS: The Experiences of the Person with Diabetes (EPD) Questionnaire is a diabetes-specific instrument. A mixed-methods study was conducted. First, a qualitative item development phase that included four focus groups and six semi-structured interviews with patients was conducted in different rural and urban areas of Ecuador to obtain information on culture, beliefs, demographics, diet and social perspectives. A second quantitative phase for psychometric validation was carried out in primary care settings of rural and urban areas of Ecuador. RESULTS: Forty-two and four hundred and eighty-nine participants were included in each phase, respectively. The item development phase resulted in a questionnaire of 44 items (23 for perceived outcomes and 21 for experiences). In the validation study, most participants were women (58%) and from urban areas (57%). Exploratory factor analysis revealed three dimensions for each instrument. Outcomes instrument dimensions were symptoms and burnout, worries and fears and social limitations. Experiences instrument dimensions were information, patient-centred care and care delivery. Cronbach's α values of the total score and dimensions were high, ranging between .81 and .93 in both instruments. Confirmatory factor analysis showed an acceptable fit of the data. CONCLUSION: The EPD Questionnaire is probably the first instrument developed to assess patient-reported experiences and perceived outcomes in a middle-income country that included patients to capture all dimensions relevant for the intended population. Its psychometric properties are robust and could provide valuable information for clinicians and policymakers in the region. PATIENT OR PUBLIC CONTRIBUTION: The development of these instruments has taken into consideration patients and the public since their conception. A qualitative approach gathered relevant information related to the cultural, social and economic burden of different populations in Ecuador. Before validation, a pilot test was carried out with users of the National Health Services to obtain their perspectives and insights of the developed instrument. Finally, during the data analysis, we have given special consideration to social variables such as rural and urban populations.

Spiritual care in critically ill patients during COVID-19 pandemic.

INTRODUCTION: Spiritual care has a positive influence when patients are subjected to serious illnesses, and critically ill situations such as the case of the COVID-19 pandemic. PURPOSE: The purpose of this study was to investigate the perceptions and attitudes of nurses working at critical care units and emergency services in Spain concerning the spiritual care providing to patients and families during the COVID-19 pandemic. METHODS: A qualitative investigation was carried out using in-depth interviews with 19 ICU nursing professionals. FINDINGS: During the pandemic, nurses provided spiritual care for their patients. Although they believed that spirituality was important to help patients to cope with the disease, they do not had a consensual definition of spirituality. Work overload, insufficient time and lack of training were perceived as barriers for providing spiritual healthcare. DISCUSSION: These results support the role of spirituality in moments of crisis and should be considered by health professionals working in critical care settings.

Simultaneous Determination of Furanic Compounds and Acrylamide in Insect-Based Foods by HPLC-QqQ-MS/MS Employing a Functionalized Mesostructured Silica as Sorbent in Solid-Phase Extraction.

Insect-based products are novel foods (NF) that merit careful study. For this reason, in this work a method has been developed for the simultaneous analysis of four food processing contaminants (FPC), acrylamide (AA), 5-hydroxymethylfurfural, (HMF), 5-methylfurfural (MF) and furfural (F), in insect-based products (bars, crackers and flours) by high-performance liquid chromatography coupled to triple quadrupole mass spectrometry (HPLC-QqQ-MS/MS). The method consisted of a solid-liquid extraction (SLE) with acidified water, followed by solid-phase extraction (SPE), using 100 mg of a sorbent based on mesostructured silica with a large pore functionalized with amino groups (SBA-15-LP-NH2). The analytical method was properly optimized and validated in a representative bar sample of pineapple & coconut with cricket flour (Ins-B-Pine-Coco) showing good accuracy, with recoveries ranging from 70-101% for the four analytes and adequate precision (RSD < 9%). Good linearity (R2 ≥ 0.995) and low method quantification limits for AA (between 1.3-1.4 µg/g), F (between 7.9-8.8 µg/g), MF (between 3.1-6.5 µg/g) and HMF (between 1.5-3.3 µg/g) were also obtained in all samples studied. The proposed method was successfully applied in eleven insect-based foods. Results revealed that insect-based bars can be a good alternative to traditional cereal bars to reduce dietary exposure to HMF; but, in order to reduce the exposure to AA, alternative formulations must be evaluated in the design of innovative insect-based crackers.

The Importance of Biological Maturation and Years of Practice in Kayaking Performance.

Previous canoe sprint studies evaluated the best paddlers of their categories. This investigation aimed to identify the importance of biological maturation and athletes' experience in kayaking performance and observe possible differences regarding anthropometry, years of practice, and performance. Eighty under 14 years of age (U14) and fifty under 16 years of age (U16) kayakers aged 13.40 ± 0.54 and 15.25 ± 0.61 years were evaluated. Kayakers were assessed for anthropometry (body mass (kg); stretch stature (cm); and sitting height (cm)), performance (time at 3000 m for U14 and 5000 m for U16 kayakers), and somatic maturation (predicted adult height (PAH) and maturity offset). In the U14 kayakers, years of practice, sitting height, and maturity offset showed significant differences (p < 0.05) between the Top10 and Middle, and Middle and Bottom10 performance times. Significantly higher (p < 0.05) sitting heights were identified between the Top10 and Middle U16 kayakers. Significant differences (p < 0.05) were observed for maturity offset and PAH% between the Top10 and Middle groups compared to the Bottom10 group. In conclusion, this research shows differences in the maturity status of young U14 and U16 kayakers, identifying that the more biologically mature individuals, with more years of specific practice, achieved better performances.

Age and Training-Related Changes on Body Composition and Fitness in Male Amateur Cyclists.

Master athletes are considered as a model of healthy aging because they can limit the age-related decline of physiological abilities compared to sedentary individuals. The main objective of this study is to analyze age-related changes and annual training on body composition (BC) and cardiorespiratory fitness (CRF) parameters. The participants in this retrospective cross-sectional study were 176 male cyclists, aged 40-60 years. BC was evaluated through anthropometric measurements and CRF was determined by an incremental cycle ergometer test to exhaustion. A comparative study between age groups was carried out through a one-way ANOVA test and the associations between the variables were assessed by Spearman's correlation coefficients and multiple regression analysis to estimate the performance. Training was generally associated with a decrease in both body weight and body fat (p < 0.05). A decrease in resting heart rate was observed as a vagal effect of kilometers cycled per year (p < 0.05). Kilometers cycled per year were associated with an increase in peak power output, which was larger in the master 40 group (p < 0.05) with a non-significant upward in VO2max (p > 0.05). In the performance prediction model, the included variables explained 52% of the variance. In summary, the changes induced by age were minimal in BC and negligible in CRF, whereas HR decreased with age. Training load was generally associated with a decrease in body weight, BMI and body fat percentage that was particularly notable in the abdominal skin folds. A decrease in HRrest was observed as a vagal effect due to kilometers cycled per year, and age did not seem to have a significant effect. The annual cycling kilometers were associated with to high PPO that is greater in the M40 group and a non-significant upward trend in VO2max.

Sulfonic Acid-Functionalized SBA-15 as Strong Cation-Exchange Sorbent for Solid-Phase Extraction of Atropine and Scopolamine in Gluten-Free Grains and Flours.

A novel method was developed and applied to the determination of the most representative tropane alkaloids (TAs), atropine and scopolamine, in gluten-free (GF) grains and flours by HPLC-MS/MS. Accordingly a suitable sample treatment procedure based on solid-liquid extraction (SLE) and followed by strong cation-exchange solid-phase extraction (SCX-SPE) was optimized. SBA-15 mesostructured silica functionalized with sulfonic acids was evaluated as sorbent. The proposed method was fully validated in sorghum flour showing good accuracy with recoveries in the range of 93-105%, good linearity (R2 > 0.999) and adequate precision (RSD < 20%). Low method quantification limits (MQL) were obtained (1.5 and 2.4 µg/kg for atropine and scopolamine, respectively) and no matrix effect was observed thanks to the extraction and clean-up protocol applied. The method was applied to 15 types of GF samples of pseudocereals (buckwheat, quinoa and amaranth), cereals (teff, corn and blue corn, sorghum and millet) and legumes (red and green lentil, chickpea and pea). Atropine was found above the MQL in eight of them, with values between 7 and 78 µg/kg, while scopolamine was only found in teff flour, its concentration being 28 µg/kg. The method developed is an interesting tool for determining TAs in a variety of samples of GF grains and flours.

Predictive Performance Models in Long-Distance Runners: A Narrative Review.

Physiological variables such as maximal oxygen uptake (VO2max), velocity at maximal oxygen uptake (vVO2max), running economy (RE) and changes in lactate levels are considered the main factors determining performance in long-distance races. The aim of this review was to present the mathematical models available in the literature to estimate performance in the 5000 m, 10,000 m, half-marathon and marathon events. Eighty-eight articles were identified, selections were made based on the inclusion criteria and the full text of the articles were obtained. The articles were reviewed and categorized according to demographic, anthropometric, exercise physiology and field test variables were also included by athletic specialty. A total of 58 studies were included, from 1983 to the present, distributed in the following categories: 12 in the 5000 m, 13 in the 10,000 m, 12 in the half-marathon and 21 in the marathon. A total of 136 independent variables associated with performance in long-distance races were considered, 43.4% of which pertained to variables derived from the evaluation of aerobic metabolism, 26.5% to variables associated with training load and 20.6% to anthropometric variables, body composition and somatotype components. The most closely associated variables in the prediction models for the half and full marathon specialties were the variables obtained from the laboratory tests (VO2max, vVO2max), training variables (training pace, training load) and anthropometric variables (fat mass, skinfolds). A large gap exists in predicting time in long-distance races, based on field tests. Physiological effort assessments are almost exclusive to shorter specialties (5000 m and 10,000 m). The predictor variables of the half-marathon are mainly anthropometric, but with moderate coefficients of determination. The variables of note in the marathon category are fundamentally those associated with training and those derived from physiological evaluation and anthropometric parameters.

Evaluación de la precisión diagnóstica del sistema Cobas 6800 para la detección de los niveles de viremia del virus de la hepatitis C a partir de muestras de gotas de sangre seca en papel de filtro / Diagnostic test accuracy of the cobas 6800 system for detection of hepatitis c virus viraemia levels from dried blood spots

INTRODUCCIÓN: La infección por el virus de la hepatitis C (VHC) es curable en la mayoría de los casos tratados, siendo actualmente una prioridad diagnosticar a todos los infectados. Para ello se necesitan, especialmente en poblaciones de difícil diagnóstico, métodos diagnósticos simples, como es el uso de muestras de gotas de sangre seca (GSS), como alternativa a la extracción de sangre mediante venopunción. Como paso previo para poder implantarlo como método diagnóstico de detección de pacientes con VHC dentro del Sistema Nacional de Salud se precisa evaluar la precisión diagnóstica en equipos de uso hospitalario habitual. METODOLOGÍA: Se evaluaron in vitro y en ensayo de campo muestras de GSS tras ser procesadas en el equipo Cobas 6800, estableciendo una correlación con el resultado obtenido con sangre completa. Se realizaron pruebas de correlación y de variabilidad intraensayo de la determinación con sangre completa y GSS para cuantificar la carga viral del VHC. RESULTADOS: En muestras de sangre completa, con una carga viral ≥ 3 log10UI/ml, se detectó viremia en todos los casos cuando se utilizaron eluciones de 2 gotas (94 detecciones de 95 eluciones de círculos). El rendimiento con 2 gotas fue menor en muestras con < 3 log 10UI/ml (7/20). La correlación entre la viremia determinada con sangre completa y con GSS fue excelente (máximo con 2 gotas, r2 = 0,906; p < 0,001), con un coeficiente de variación del 0,05%. En práctica clínica habitual con muestras de pacientes analizados (n = 61) se obtuvo igualmente una excelente precisión diagnóstica. CONCLUSIÓN: La determinación de la carga viral mediante GSS, procesando al menos 2 gotas, es un método fiable para el diagnóstico de infección por el VHC. La estandarización del método es factible en nuestro equipo Cobas 6800 local, y nuestros resultados respaldan la incorporación de esta herramienta diagnóstica al Sistema Nacional de Salud para facilitar planes de microeliminación

INTRODUCTION: Because hepatitis C virus (HCV) infection is curable in the majority of cases, the diagnosis of all infected patients has become a priority. In difficult-to-diagnose populations, simpler diagnostic methods are required such as the use of dried blood spots (DBS) as an alternative to blood drawn by venipuncture (VP). Before being able to include it as a HCV diagnostic detection method within the Spanish National Health System, the diagnostic accuracy of standard hospital equipment must be evaluated. METHODOLOGY: DBS samples were evaluated in vitro and in a field test after being processed in the Cobas 6800 system, establishing a correlation with the result by VP. Performance with different viral loads and intra-assay variability was compared. RESULTS: In samples with a viral load of>3 log10IU/ml, viraemia was detected in all cases when at least two blood spot elutions were used (94 detections out of 95 spot elutions). The performance with 2 spots was lower in samples with<3 log10IU/ml (7/20). Correlation between VP and DBS viraemia was excellent (maximum with 2 spots, r2=0.906, P<.001) with a coefficient of variation of 0.05%. In routine clinical practice with specimens from screened subjects (n=61), excellent diagnostic accuracy was also observed. CONCLUSION: Viral load detection using DBS of at least two spots is a reliable method for HCV diagnosis. The standardisation of the method is feasible and our results support the incorporation of this diagnostic tool in Spain's Public Health System

La conductancia de la piel para evaluar el dolor y el estrés durante el cribado de la retinopatía de la prematuridad / Skin conductance to assess pain and stress during retinopathy of prematurity screening

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