Impacto de la infección materna asintomática por SARS-CoV-2 sobre el crecimiento fetal / Impact of asymptomatic maternal SARS-CoV-2 infection on foetal growth

Introducción: La repercusión de la infección asintomática por SARS-CoV-2 sobre el crecimiento fetal no ha sido bien establecida. El objetivo de este estudio fue determinar si existe un incremento del riesgo de retraso de crecimiento intrauterino en gestaciones con una infección asintomática por SARS-CoV-2 durante el embarazo. Material y métodos: Estudio retrospectivo caso-control en gestantes con feto pequeño para la edad gestacional o restricción del crecimiento intrauterino. Los grupos se constituyeron según el percentil de peso al nacimiento. El antecedente de infección por SARS-CoV-2 ha sido definido por la presencia de IgG en el momento del ingreso hospitalario para el parto. Resultados: No se encontraron diferencias significativas entre el grupo control y el grupo caso en cuanto a anticuerpos IgG positivos (11,5 vs. 8,8%). Tampoco se registraron diferencias en la prematuridad ni el tipo de parto. Conclusiones: La infección asintomática por SARS-CoV-2 durante el embarazo no parece afectar al crecimiento fetal.(AU)

Introduction: The impact of asymptomatic infection by SARs-CoV-2 on foetal growth has not been described. The purpose of our study is to determine whether there is an increased risk of foetal growth restriction in pregnancies in which asymptomatic or mild infection by SARS-CoV-2 has been detected. Material and methods: Retrospective case-control study with a subset of pregnant women with a small for gestational age foetus. Groups were established according to birth weight percentile. Previous SARS-CoV-2 infection was defined by positive antibodies obtained on admission to hospital for delivery. Results: No statistically significant differences between controls and cases were recorded in terms of positive IgG antibodies (11.5 vs. 8.8%). There were no premature births or significant differences in the date or type of delivery. Conclusions: Asymptomatic infection by SARs-CoV-2 during pregnancy does not seem to affect foetal growth.(AU)

Actuaciones del farmacéutico sobre la demanda de medicamentos a través del servicio de indicación farmacéutica: INDICA+PRO Implantación (2020-2021) / Pharmacist actions on medicines demand through the pharmaceutical indication service: INDICA+PRO Implementation (2020-2021)

JUSTIFICACIÓN: en España, las especialidades farmacéuticas publicitarias sólo están disponibles a través de la farmacia comunitaria (FC). Desde 2019, Foro de Atención Farmacéutica en Farmacia Comunitaria (Foro AF-FC) incluye la demanda de medicamento para un síntoma menor a través del servicio de indicación farmacéutica (SIF) y lo simboliza como “Deme esto para…”. El estudio INDICA+PRO Implantación tiene como objetivo implantar el SIF protocolizado en la FC española incluyendo ambas vías de entrada al servicio (consulta de síntoma menor y demanda de medicamento para el mismo).OBJETIVOS: describir la demanda de medicamentos para un síntoma menor atendidas por el farmacéutico comunitario a través del SIF.MATERIAL Y MÉTODOS: el estudio realizado utiliza un diseño híbrido de efectividad-implantación tipo 3 durante 14 meses inicialmente. La intervención implantada constaba de: procedimiento general del SIF establecido por Foro AF-FC, protocolos consensuados entre sociedades médicas (Semergen y SemFyC), asociaciones farmacéuticas (SEFAC y MICOF) y universidad (GIAF-UGR) específicos para 31 síntomas menores incluidos en una plataforma digital (SEFAC e_XPERT®) y la formación y el seguimiento de los farmacéuticos. Se consideraron los pacientes que acudían a FC demandando un medicamento para un síntoma menor incluido en el estudio (dermatológico, digestivo, relacionado con el dolor, respiratorio u otro). Todos los pacientes recibían seguimiento 10 días tras la consulta en FC.RESULTADOS: 14083 consultas fueron registradas por 687 farmacéuticos pertenecientes a 518 FC. Mayor número de consultas por síntoma menor (84,6 %, n=11911) que por demanda de un medicamento concreto fueron atendidas a través del SIF (15,4 %, n=2172). Entre aquellos pacientes que demandaron un medicamento, el 7,7 % (n=168) fueron derivados al médico. (AU)

Impacto de la notificación de positivos por SARS-COV2 en el servicio de indicación farmacéutica en la farmacia / Impact of reporting SARS-COV2 positives on the pharmacy pharmacy dispensing service

INTRODUCCIÓN: el pasado 26 de Enero de 2022, el Colegio Oficial de Farmacéuticos de les Illes Baleares firmó un convenio, de tres de meses prorrogables con la Conselleria de Sanitat del Govern de les Illes Balears para que las farmacias pudieran notificar positivos por el virus SARS-COV2, tras la supervisión de la técnica de realización de test de antígenos. En nuestra farmacia tenemos instaurado un Servicio de Indicación Farmacéutica.OBJETIVO: evaluar y caracterizar a los pacientes notificados en la plataforma PRAG de la Conselleria de Sanitat de les Illes Balears y su derivación al Servicio de Indicación Farmacéutica.MATERIAL Y MÉTODO: se realizan los cursos de Test coronavirus SARS-CoV2 (SEFAC) y se ofrece el Servicio de Indicación Farmacéutica. La Farmacia Sitjar Garí de Llucmajor se adhiere al Programa de Notificación de positivos por SARS-COV2, tras una sesión impartida por el COFIB y adecua la ZAP a las exigencias del Convenio de notificación. Los pacientes acuden con cita previa a la farmacia, el/la farmacéutico/a supervisa la técnica de realización del test de antígenos y notifica el resultado en la plataforma (PRAG) habilitada para ello por el Govern de les Illes Balears. Se registra la indicación de los pacientes con sintomatología en la plataforma: de SEFAC e_XPERT, y posteriormente se realiza una valoración de la intervención. Estudio descriptivo transversal longitudinal realizado por los/as farmacéuticos/as comunitarios/as y registro en una hoja EXCEL durante 3meses para su posterior análisis.RESULTADOS: durante las primeras 6 semanas de implantación se obtienen los primeros resultados de una muestra de 30 pacientes, de los cuales 6 eran menores de edad, 17 tenían edades comprendidas entre 18-65 años y 7 mayores de 65 años De los cuales se recogen los siguientes resultados, 23 pacientes fueron positivos y 7 negativos. 4 pacientes presentaban pauta incompleta de vacunación. 12 pacientes fueron derivados al Servicio de Indicación Farmacéutica. (AU)

[Impact of asymptomatic maternal SARS-CoV-2 infection on foetal growth]. / Impacto de la infección materna asintomática por SARS-CoV-2 sobre el crecimiento fetal.

Introduction: The impact of asymptomatic infection by SARs-CoV-2 on foetal growth has not been described. The purpose of our study is to determine whether there is an increased risk of foetal growth restriction in pregnancies in which asymptomatic or mild infection by SARS-CoV-2 has been detected. Material and methods: Retrospective case-control study with a subset of pregnant women with a small for gestational age foetus. Groups were established according to birth weight percentile. Previous SARS-CoV-2 infection was defined by positive antibodies obtained on admission to hospital for delivery. Results: No statistically significant differences between controls and cases were recorded in terms of positive IgG antibodies (11.5 vs. 8.8%). There were no premature births or significant differences in the date or type of delivery. Conclusions: Asymptomatic infection by SARs-CoV-2 during pregnancy does not seem to affect foetal growth.

Magnetic Biohybrid Vesicles Transported by an Internal Propulsion Mechanism.

Some biological microorganisms can crawl or swim due to coordinated motions of their cytoskeleton or the flagella located inside their bodies, which push the cells forward through intracellular forces. To date, there is no demonstration of synthetic systems propelling at low Reynolds number via the precise actuation of the material confined within an enclosing lipid membrane. Here, we report lipid vesicles and other more complex self-assembled biohybrid structures able to propel due to the advection flows generated by the actuated rotation of the superparamagnetic particles they contain. The proposed swimming and release strategies, based on cooperative hydrodynamic mechanisms and near-infrared laser pulse-triggered destabilization of the phospholipid membranes, open new possibilities for the on-command transport of minute quantities of drugs, fluid or nano-objects. The lipid membranes protect the confined substances from the outside environment during transportation, thus enabling them to work in physiological conditions.

Ultrasound functional evaluation of fetuses with myelomeningocele: study of the interpretation of results.

OBJECTIVE: To assess the reliability of the interpretation of a new technique for the ultrasound evaluation of the level of neurological lesion in fetuses with myelomeningocele. METHODS: Observational study including myelomeningocele fetuses, referred to our center for the sonographic assessment of the fetal lower-limb movements, made and recorded by an expert in Maternal-fetal medicine and a specialist in Rehabilitation. Two observers, with different levels of expertise and blinded to each other's results, interpreted each recorded scan two different times. The agreement for the segmental levels assigned between the observers and the gold standard, the inter-observer and intra-observer reproducibility were tested using the weighed Kappa (wκ) index. RESULTS: Twenty-eight scans were recorded and evaluated. The agreement between the observers and the gold standard remained constant for the expert observer (wκ = 0.82) and increased (wκ = 0.66-wκ = 0.72) for the other one. The inter-observer and the intra-observer variability for the expert observer were wκ = 0.72 and wκ = 0.94, respectively. DISCUSSION: The agreement for the prenatal evaluation of the segmental neurological level was excellent, after a short training period, for observers with different degrees of expertise. The interpretation of this technique is reproducible enough and this supports its value for the prediction of postnatal motor function in myelomeningocele fetuses.

Prenatal ultrasound evaluation of segmental level of neurological lesion in fetuses with myelomeningocele: development of a new technique.

OBJECTIVES: To report our preliminary experience in the use of prenatal ultrasound examination to assess lower-limb movements in fetuses with myelomeningocele. We aimed to determine the accuracy of this method to establish the segmental level of neurological lesion, as this is the best known predictor of the future ability to walk. METHODS: This was a preliminary, observational study including fetuses with myelomeningocele operated on prenatally. The patterns of movements present and absent in the affected fetuses' lower limbs were evaluated systematically by ultrasound examination. According to the known nerve function associated with each muscle group, the segmental level of neurological lesion was established before birth. The agreement for the segmental levels assigned, between the prenatal ultrasound technique and the classical neurological clinical examination after birth (gold standard), was tested using the weighed kappa (wκ) index. RESULTS: Seventy-one fetuses with myelomeningocele were evaluated at the Hospital Universitari Vall d'Hebron. After counseling, the parents opted for prenatal surgery (26 cases), termination of pregnancy (43 cases) or postnatal repair (two cases). Five patients did not fulfil the inclusion criteria for prenatal surgery and three were excluded after birth. In the 18 fetuses that underwent surgery and were analyzed, the agreement between prenatal and postnatal segmental levels assigned was 91.7% for the right limb (wκ = 0.80) and 88.9% for the left limb (wκ = 0.73). CONCLUSIONS: The agreement found between prenatal and postnatal assignment of level of lesion in this preliminary study suggests that neurological sonographic evaluation is feasible before birth. This may provide accurate individualized information about the motor function and future ambulation prognosis of fetuses with myelomeningocele.

Clinical characteristics of patients sensitized to Siberian Hamster

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Sensitive detection of major food allergens in breast milk: first gateway for allergenic contact during breastfeeding.

Food allergy is recognized as a major public health issue, especially in early childhood. It has been hypothesized that early sensitization to food allergens maybe due to their ingestion as components dissolved in the milk during the breastfeeding, explaining reaction to a food, which has never been taken before. Thus, the aim of this work has been to detect the presence of the food allergens in breast milk by microarray technology. We produced a homemade microarray with antibodies produced against major food allergens. The antibody microarray was incubated with breast milk from 14 women collected from Fundación Jiménez Díaz Hospital. In this way, we demonstrated the presence of major foods allergens in breast milk. The analysis of allergens presented in breast milk could be a useful tool in allergy prevention and could provide us a key data on the role of this feeding in tolerance induction or sensitization in children.

A new direct laser photo-induced fluorescence method coupled on-line with liquid chromatographic separation for the simultaneous determination of anilides pesticides.

A new direct laser photo-induced fluorescence high performance liquid chromatography (DL-PIF-HPLC) method is developed for the simultaneous determination of three anilide pesticides, namely carboxin, monalide and propanil. DL-PIF-HPLC uses a tunable Nd:YAG-OPO laser to obtain fluorescent photoproduct(s) and to simultaneously analyze their fluorescence in a short acquisition time with an intensified CCD camera, which improves the selectivity (by choosing the suitable excitation wavelength), increases the sensitivity (due to the high energy of the laser beam) and reduces the time of analysis, relative to the classical PIF methods. However, one of the main drawbacks of PIF methods is the presence of interferences with other compounds, such as other pesticides from the same group yielding similar fluorescent photoproducts, which reduces their selectivity. The analytical interest of DL-PIF-HPLC to avoid these interferences is demonstrated. The DL-PIF spectra, chromatographic conditions and analytical performances of DL-PIF-HPLC are presented for the simultaneous determination of three anilide pesticides. The calibration curves are linear over one order of magnitude and the limits of detection are in the ng mL(-1) range. The new DL-PIF-HPLC system has the advantage to combine the performances of both techniques, DL-PIF and liquid chromatography, and to improve the analysis selectivity.

Allergen characterization of Chia Seeds (Salvia hispanica), a new allergenic food

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Optical quality of the diabetic eye: a review.

Diabetes mellitus is a metabolic disorder characterized by the presence of chronic hyperglycaemia. Several structural, morphological, and physiological changes in each of ocular component have been described in detail during the past decades. Due to these abnormalities, the diabetic patient undergoes a degradation of the retinal image by an increase of higher ocular aberrations and ocular scattering coming from mainly tear film, cornea, and crystalline lens. This review aims to provide an overview of current knowledge about the effects of diabetes mellitus in these optical phenomena and its consequence on the visual quality of the diabetic patient.

Molecular characterization of contact urticaria in patients with melon allergy.

BACKGROUND: The relevance of contact allergy to plant-related food has recently emerged. Oral allergy syndrome is one of the most characteristic symptoms of fruit allergy, although it also causes systemic reactions. Plant-food allergy is increasing at the same time as pollen allergy, and fruit-induced allergic contact urticaria could be rising as well. OBJECTIVES: The present study was carried out in order to investigate whether one particular primary melon-peel allergen is responsible for contact urticaria. METHODS: Fourteen patients presenting with contact urticaria after touching melon peel were evaluated. A melon-peel extract was prepared and analysed by immunoblotting using the patients' sera. Molecular characterization of IgE-binding bands was performed using mass spectrometry. Melon-peel lipid transfer protein (LTP) was purified. Inhibition studies and contact challenge with the protein were performed to confirm IgE reactivity to the purified allergen. RESULTS: An IgE-binding band of ~8-9 kDa was observed in an immunoblotting assay with all the patients' sera and was identified as an LTP. The melon-peel LTP was purified in two chromatography steps. Inhibition studies confirmed LTP as a major allergen in patients with melon-peel contact urticaria. Contact challenge with melon-peel LTP was performed in five patients, all of whom had positive results, exhibiting itchy erythema and hives in the area of contact. CONCLUSIONS: This study confirmed our previous findings that melon-peel LTP is a major allergen and is responsible for contact allergy. This knowledge may be used to improve both diagnosis and treatment of patients allergic to melon.

Determination of phenylurea pesticides by direct laser photo-induced fluorescence.

A direct Laser Photo-Induced Fluorescence (DL-PIF) method is developed for the determination of two phenylurea pesticides, namely fenuron and diflubenzuron. The DL-PIF method uses a tunable Nd:YAG-OPO Laser to obtain the photoproduct(s) and to simultaneously analyse their fluorescence in a short acquisition time on an intensified CCD camera. Compared to classical PIF methods, the use of a tunable laser improves the selectivity (by choosing the suitable excitation wavelength), increases the sensitivity (due to the high energy of the beam) and also reduces the time of analysis. The analytical performances of this method for the determination of both pesticides are satisfactory in comparison to other classical PIF methods published for the determination of phenylurea pesticides. The calibration curves were linear over one order of magnitude and the limits of detection were in the ng mL(-1) range. Satisfactory recoveries were obtained in the analysis of both pesticides in river and sea water spiked samples.

Identification of sole parvalbumin as a major allergen: study of cross-reactivity between parvalbumins in a Spanish fish-allergic population.

BACKGROUND: Fish allergy is becoming an important health problem in Spain, a country with the third highest level of fish consumption after Japan and Portugal. The most common fish allergens are parvalbumins. In our area, the most widely consumed fish species are lean, such as whiff (Lepidorhombus whiffiagonis) and sole (Solea solea). Adverse reactions to fish are usually related to these species, a fact that is largely unknown to allergists in other countries. OBJECTIVE: The aim of this study was to identify and purify the major allergen implicated in allergic response to sole and evaluate the IgE cross-reactivity of purified parvalbumins from whiff and sole, which are phylogenetically close, and more distant species (i.e. cod and salmon). METHODS: Eighteen Spanish fish-allergic patients with a positive history of type I allergy to fish were recruited from the clinic. Total protein extracts and purified parvalbumins from whiff and sole were tested for their IgE-binding properties by combining two-dimensional Western blotting and mass spectrometry. The extent of cross-reactivity between these parvalbumins along with cod and salmon parvalbumins was investigated by IgE ELISA inhibition assay. RESULTS: An IgE-binding spot of approximately 14 kDa was identified as parvalbumin and confirmed as a major allergen in sole extract, which is recognized by almost 70% of the patients. Whiff parvalbumin was recognized by 83.4% of the patients. High cross-reactivity was determined for all purified parvalbumins by IgE inhibition assay. CONCLUSIONS AND CLINICAL RELEVANCE: Sole and whiff parvalbumin were confirmed as major allergens. The parvalbumins of sole, whiff, cod and salmon were highly cross-reactive, thus suggesting a high amino acid sequence identity between them.