Fungal Planet description sheets: 1478-1549.

Novel species of fungi described in this study include those from various countries as follows: Australia, Aschersonia mackerrasiae on whitefly, Cladosporium corticola on bark of Melaleuca quinquenervia, Penicillium nudgee from soil under Melaleuca quinquenervia, Pseudocercospora blackwoodiae on leaf spot of Persoonia falcata, and Pseudocercospora dalyelliae on leaf spot of Senna alata. Bolivia, Aspicilia lutzoniana on fully submersed siliceous schist in high-mountain streams, and Niesslia parviseta on the lower part and apothecial discs of Erioderma barbellatum on a twig. Brazil, Cyathus bonsai on decaying wood, Geastrum albofibrosum from moist soil with leaf litter, Laetiporus pratigiensis on a trunk of a living unknown hardwood tree species, and Scytalidium synnematicum on dead twigs of unidentified plant. Bulgaria, Amanita abscondita on sandy soil in a plantation of Quercus suber. Canada, Penicillium acericola on dead bark of Acer saccharum, and Penicillium corticola on dead bark of Acer saccharum. China, Colletotrichum qingyuanense on fruit lesion of Capsicum annuum. Denmark, Helminthosphaeria leptospora on corticioid Neohypochnicium cremicolor. Ecuador (Galapagos), Phaeosphaeria scalesiae on Scalesia sp. Finland, Inocybe jacobssonii on calcareous soils in dry forests and park habitats. France, Cortinarius rufomyrrheus on sandy soil under Pinus pinaster, and Periconia neominutissima on leaves of Poaceae. India, Coprinopsis fragilis on decaying bark of logs, Filoboletus keralensis on unidentified woody substrate, Penicillium sankaranii from soil, Physisporinus tamilnaduensis on the trunk of Azadirachta indica, and Poronia nagaraholensis on elephant dung. Iran, Neosetophoma fici on infected leaves of Ficus elastica. Israel, Cnidariophoma eilatica (incl. Cnidariophoma gen. nov.) from Stylophora pistillata. Italy, Lyophyllum obscurum on acidic soil. Namibia, Aureobasidium faidherbiae on dead leaf of Faidherbia albida, and Aureobasidium welwitschiae on dead leaves of Welwitschia mirabilis. Netherlands, Gaeumannomycella caricigena on dead culms of Carex elongata, Houtenomyces caricicola (incl. Houtenomyces gen. nov.) on culms of Carex disticha, Neodacampia ulmea (incl. Neodacampia gen. nov.) on branch of Ulmus laevis, Niesslia phragmiticola on dead standing culms of Phragmites australis, Pseudopyricularia caricicola on culms of Carex disticha, and Rhodoveronaea nieuwwulvenica on dead bamboo sticks. Norway, Arrhenia similis half-buried and moss-covered pieces of rotting wood in grass-grown path. Pakistan, Mallocybe ahmadii on soil. Poland, Beskidomyces laricis (incl. Beskidomyces gen. nov.) from resin of Larix decidua ssp. polonica, Lapidomyces epipinicola from sooty mould community on Pinus nigra, and Leptographium granulatum from a gallery of Dendroctonus micans on Picea abies. Portugal, Geoglossum azoricum on mossy areas of laurel forest areas planted with Cryptomeria japonica, and Lunasporangiospora lusitanica from a biofilm covering a biodeteriorated limestone wall. Qatar, Alternaria halotolerans from hypersaline sea water, and Alternaria qatarensis from water sample collected from hypersaline lagoon. South Africa, Alfaria thamnochorti on culm of Thamnochortus fraternus, Knufia aloeicola on Aloe gariepensis, Muriseptatomyces restionacearum (incl. Muriseptatomyces gen. nov.) on culms of Restionaceae, Neocladosporium arctotis on nest of cases of bag worm moths (Lepidoptera, Psychidae) on Arctotis auriculata, Neodevriesia scadoxi on leaves of Scadoxus puniceus, Paraloratospora schoenoplecti on stems of Schoenoplectus lacustris, Tulasnella epidendrea from the roots of Epidendrum × obrienianum, and Xenoidriella cinnamomi (incl. Xenoidriella gen. nov.) on leaf of Cinnamomum camphora. South Korea, Lemonniera fraxinea on decaying leaves of Fraxinus sp. from pond. Spain, Atheniella lauri on the bark of fallen trees of Laurus nobilis, Halocryptovalsa endophytica from surface-sterilised, asymptomatic roots of Salicornia patula, Inocybe amygdaliolens on soil in mixed forest, Inocybe pityusarum on calcareous soil in mixed forest, Inocybe roseobulbipes on acidic soils, Neonectria borealis from roots of Vitis berlandieri × Vitis rupestris, Sympoventuria eucalyptorum on leaves of Eucalyptus sp., and Tuber conchae from soil. Sweden, Inocybe bidumensis on calcareous soil. Thailand, Cordyceps sandindaengensis on Lepidoptera pupa, buried in soil, Ophiocordyceps kuchinaraiensis on Coleoptera larva, buried in soil, and Samsoniella winandae on Lepidoptera pupa, buried in soil. Taiwan region (China), Neophaeosphaeria livistonae on dead leaf of Livistona rotundifolia. Türkiye, Melanogaster anatolicus on clay loamy soils. UK, Basingstokeomyces allii (incl. Basingstokeomyces gen. nov.) on leaves of Allium schoenoprasum. Ukraine, Xenosphaeropsis corni on recently dead stem of Cornus alba. USA, Nothotrichosporon aquaticum (incl. Nothotrichosporon gen. nov.) from water, and Periconia philadelphiana from swab of coil surface. Morphological and culture characteristics for these new taxa are supported by DNA barcodes. Citation: Crous PW, Osieck ER, Shivas RG, et al. 2023. Fungal Planet description sheets: 1478-1549. Persoonia 50: 158- 310. https://doi.org/10.3767/persoonia.2023.50.05.

Realización y comunicación de resultados de test de autodiagnóstico de antígenos SARS- CoV-2 bajo supervisión en farmacia de Cantabria / Performance and communication of results of self-diagnostic test for SARS-CoV-2 antigens under supervision in pharmacies in Cantabria

JUSTIFICACIÓN: la Consejería de Sanidad del Gobierno de Cantabria y el Colegio Oficial de Farmacéuticos de Cantabria colaboran en estrategias para asegurar la trazabilidad de resultados positivos de test de autodiagnóstico de antígenos SARS-COV-2 a través de las farmacias comunitarias. En enero de 2022, ambas entidades han iniciado un procedimiento mediante el cual la realización del test bajo supervisión por el profesional farmacéutico en farmacia es considerado para el diagnóstico de confirmación de infección activa, y los resultados positivos del test se consideran casos COVID-19 confirmados.OBJETIVOS: •Realizar in situ en la farmacia, o acompañar a la población que lo solicite, test de autodiagnóstico de antígenos SARS-COV-2 •Comunicar el resultado obtenido a la Consejería de Sanidad mediante la Aplicación móvil Plataforma CAÑIA. •Informar a los usuarios sobre la actuación a seguir según el resultado obtenido.MATERIAL Y MÉTODOS: la población susceptible de solicitar el test es toda persona que en riesgo de haber adquirido infección por SARS-COV-2 por presentar síntomas compatibles de COVID-19 o haber tenido contacto con un positivo. Las farmacias que participan voluntariamente se identifican con un cartel informativo, y comunican los resultados al Servicio Cántabro de Salud (SCS) mediante la aplicación móvil Cañía, de uso exclusivo para profesionales sanitarios, que mediante tecnología de inteligencia artificial realiza la lectura del resultado del test y de la identidad de la persona y la carga automáticamente en el sistema del SCS. Si el resultado es positivo, el paciente entra directamente en el circuito de Atención Primaria y de Farmacovigilancia del SCS. Si el resultado es negativo, el paciente puede descargar durante 48 horas un certificado a través del SCS. (AU)

Comunicación de incidencias con la medicación entre farmacias de Cantabria y Servicios de Farmacia de Atención Primaria del Servicio Cántabro de Salud / Communication of medication incidents between pharmacies in Cantabria and the Primary Care Pharmacy Services of the Cantabrian Health Service

INTRODUCCIÓN: el Colegio Oficial de Farmacéuticos de Cantabria (COF Cantabria) ha colaborado con la Consejería de Sanidad del Gobierno de Cantabria para crear un sistema de comunicación directo entre las 279 farmacias comunitarias de Cantabria y los Servicios de Farmacia de Atención Primaria del Servicio Cántabro de Salud (SFAP). El protocolo de comunicación, que comenzó en octubre de 2020 y en marzo de 2022 continúa en activo, constituye una herramienta que las OF han integrado en su práctica diaria para informar y solucionar incidencias relacionadas con la medicación prescrita en receta electrónica.OBJETIVOS: desarrollar e implantar un sistema de comunicación entre las farmacias comunitarias y los SFAP, para resolver incidencias relacionadas con la receta electrónica de los pacientes, asegurando la adherencia al tratamiento farmacológico y contribuyendo a descongestionar la Atención Primaria.MATERIAL Y MÉTODOS: se creó un grupo de trabajo para desarrollar un protocolo de comunicación de incidencias con la medicación, con participantes del COF Cantabria, de la Consejería de Sanidad y de la Gerencia de Atención Primaria del Servicio Cántabro de Salud.RESULTADOS Y DISCUSIÓN: los resultados del seguimiento del protocolo se presentaron a los farmacéuticos/as en febrero de 2021 mediante una conferencia online, durante la cual se debatieron las incidencias más frecuentes y las propuestas para mejorar la comunicación de las mismas. El grado de satisfacción de los farmacéuticos/as con el funcionamiento del protocolo se evaluó mediante una encuesta online de seis preguntas. En las respuestas se observó que un 35,4 % de los farmacéuticos se muestra satisfecho con el funcionamiento y un 29,2 % valora positivamente el tiempo de resolución de incidencias por parte de SFAP. En cuanto a la utilidad para resolver la incidencia respecto al paciente, un 25 % se muestra bastante satisfecho. (AU)

Dispensación colaborativa entre los servicios de farmacia hospitalaria y farmacias comunitarias en el contexto de la COVID-19 / Collaborative dispensing between hospital pharmacy services and community pharmacies in the context of COVID-19

JUSTIFICACIÓN: de marzo a mayo de 2020, se desarrolló una experiencia piloto de continuidad asistencial en la atención farmacéutica de pacientes externos hospitalarios, en la que la medicación hospitalaria se entregaba en la farmacia comunitaria de elección del paciente. En septiembre de 2020 se consolidó dicho procedimiento, según el protocolo “Entrega de Medicación Hospitalaria de Dispensación Ambulatoria -MHDA- por la farmacia comunitaria en el contexto de la COVID-19”, elaborado por la Consejería de Sanidad del Gobierno de Cantabria, el Colegio de Farmacéuticos de Cantabria y la distribución farmacéutica que opera en Cantabria.OBJETIVOS: establecer un protocolo para limitar la presencia en centros hospitalarios de pacientes que recogen sus medicamentos hospitalarios (MH) en los Servicios de Farmacia Hospitalaria (SFH), y sustituirlo por el envío, a través del Distribuidor Farmacéutico (DF), de los MH a Farmacias de Cantabria (FC) que harán la entrega a los pacientes.MATERIAL Y MÉTODOS: las FC reciben, a través del DF, la medicación de cada paciente desde los SFH. Los pacientes seleccionados son previamente contactados e informados por el SFH correspondiente, al que indican la farmacia a la que quieren que se envíe su medicación.RESULTADOS Y DISCUSIÓN: se analizan los datos de febrero a diciembre de 2021. El número total de pacientes a los que se ha entregado MH, a través de las FC es 6832. (El 80 % reside en la provincia y el 20 % en Santander capital).El número de FC que han entregado MH es 222. (El 72 % en la provincia y el 28 % en Santander capital).El número total de entregas de MH realizadas por los SFH ha sido 5644, correspondiendo 5066 al Hospital Universitario Marqués de Valdecilla, 565 al Hospital Sierrallana y 13 al Hospital de Laredo. En cuanto a la DF, Centro Farmacéutico del Norte (CENFARTE) ha realizado 2.447 repartos, Cooperativa Farmacéutica Española (COFARES) 1809 y Cooperativa Farmacéutica Asturiana (COFAS) 1213. (AU)

Novel DNA methylation signatures of tobacco smoking with trans-ethnic effects.

BACKGROUND: Smoking remains one of the leading preventable causes of death. Smoking leaves a strong signature on the blood methylome as shown in multiple studies using the Infinium HumanMethylation450 BeadChip. Here, we explore novel blood methylation smoking signals on the Illumina MethylationEPIC BeadChip (EPIC) array, which also targets novel CpG-sites in enhancers. METHOD: A smoking-methylation meta-analysis was carried out using EPIC DNA methylation profiles in 1407 blood samples from four UK population-based cohorts, including the MRC National Survey for Health and Development (NSHD) or 1946 British birth cohort, the National Child Development Study (NCDS) or 1958 birth cohort, the 1970 British Cohort Study (BCS70), and the TwinsUK cohort (TwinsUK). The overall discovery sample included 269 current, 497 former, and 643 never smokers. Replication was pursued in 3425 trans-ethnic samples, including 2325 American Indian individuals participating in the Strong Heart Study (SHS) in 1989-1991 and 1100 African-American participants in the Genetic Epidemiology Network of Arteriopathy Study (GENOA). RESULTS: Altogether 952 CpG-sites in 500 genes were differentially methylated between smokers and never smokers after Bonferroni correction. There were 526 novel smoking-associated CpG-sites only profiled by the EPIC array, of which 486 (92%) replicated in a meta-analysis of the American Indian and African-American samples. Novel CpG sites mapped both to genes containing previously identified smoking-methylation signals and to 80 novel genes not previously linked to smoking, with the strongest novel signal in SLAMF7. Comparison of former versus never smokers identified that 37 of these sites were persistently differentially methylated after cessation, where 16 represented novel signals only profiled by the EPIC array. We observed a depletion of smoking-associated signals in CpG islands and an enrichment in enhancer regions, consistent with previous results. CONCLUSION: This study identified novel smoking-associated signals as possible biomarkers of exposure to smoking and may help improve our understanding of smoking-related disease risk.

Selenium and impaired physical function in US and Spanish older adults.

BACKGROUND: Selenium (Se) is a trace element with a narrow safety margin. OBJECTIVES: To evaluate the cross-sectional and longitudinal dose-response association between Se exposure and measures of impaired physical function and disability in older adults. DESIGN: NHANES 2011-2014 cross-sectional (US, n = 1733, age ≥60 years) and Seniors-ENRICA-2 2017-2019 cross-sectional and longitudinal (Spain, n = 2548 and 1741, respectively, age ≥65 years) data were analyzed. Whole blood and serum Se levels were measured using inductively coupled plasma-mass spectrometry. Lower-extremity performance was assessed with the Short Physical Performance Battery, and muscle weakness with a dynamometer. Incident mobility and agility limitations, and disability in instrumental activities of daily living (IADL) were ascertained with standardized questionnaires. Analyses were adjusted for relevant confounders, including physical activity. Results across studies were pooled using random-effects meta-analysis. RESULTS: Meta-analyzed odds ratios (95% confidence interval) per log2 increase in whole blood Se were 0.54 (0.32; 0.76) for weakness, 0.59 (0.34; 0.83) for impaired lower-extremity performance, 0.48 (0.31; 0.68) for mobility limitations, 0.71 (0.45; 0.97) for agility limitations, and 0.34 (0.12; 0.56) for disability in at least one IADL. Analyses for serum Se in NHANES showed similar results. Findings suggest the inverse association with grip strength is progressive below 140 µg/L (p-value for non-linear trend in the Seniors-ENRICA-2 study = 0.13), and above 140 µg/L (p-value for non-linear trend in NHANES = 0.11). In the Seniors-ENRICA-2 cohort, with a 2.2 year follow-up period, a doubling in baseline Se levels were associated with a lower incidence of weakness [odds ratio (95% confidence interval): 0.45 (0.22; 0.91)], impaired lower-extremity performance [0.63 (0.32; 1.23)], mobility [0.43 (0.21; 0.91)] and agility [0.38 (0.18; 0.78)] limitations. DISCUSSION: In US and Spanish older adults, Se concentrations were inversely associated with physical function limitations. Further studies are needed to elucidate underlying mechanisms.

Assessment of the quality of patient information sheets and informed consent forms for clinical trials at a hospital neurology service.

BACKGROUND AND PURPOSE: Clinical trials (CTs) aimed at vulnerable groups, such as patients with mental disorders, create ethical complexity. The patient information sheet (PIS) should provide all of the information about the CT that is relevant to the subject's decision to participate. After being informed, the subject will decide freely whether to take part in the CT and will read and sign the informed consent form (ICF). The objective was to assess the quality of PISs/ICFs from a hospital neurology service. The assessment was made using validated and reliable checklists of the information included in the PISs/ICFs of CTs with medicinal products. METHODS: The study comprised analyses of compliance with the checklists of 21 PISs and ICFs reviewed/approved during 2016-2017 by a medicinal research ethics committee. RESULTS: All PISs/ICFs were from multicenter CTs sponsored by pharmaceutical companies in different therapeutic areas, mainly Parkinson's (52.4%) and Alzheimer's (38.1%) diseases. The PISs from the neurology service demonstrated good compliance (≥80%) with the checklist, whereas ICFs should be improved. Sponsors omitted some relevant information, such as the study title or that the participant be informed of any information arising from the research that may be relevant to the subject's health, although this information may be in the PIS. CONCLUSIONS: The PISs/ICFs of CTs of medicinal products that are currently used need improvement. PISs and ICFs should be separate documents for each CT. In particular, the PISs/ICFs should consider the criteria related to the decision of participants, protect their rights and ensure that the information received is complete.

Gold Nanoparticle-Assisted Virus Formation by Means of the Delivery of an Oncolytic Adenovirus Genome.

Oncolytic adenoviruses are a therapeutic alternative to treat cancer based on their ability to replicate selectively in tumor cells. However, their use is limited mainly by the neutralizing antibody (Nab) immune response that prevents repeated dosing. An alternative to facilitate the DNA access to the tumor even in the presence of anti-viral Nabs could be gold nanoparticles able to transfer DNA molecules. However, the ability of these nanoparticles to carry large DNA molecules, such as an oncolytic adenovirus genome, has not been studied. In this work, gold nanoparticles were functionalized with different amounts of polyethylenimine to transfer in a safe and efficient manner a large oncolytic virus genome. Their transfer efficacy and final effect of the oncolytic virus in cancer cells are studied. For each synthesized nanoparticle, (a) DNA loading capacity, (b) complex size, (c) DNA protection ability, (d) transfection efficacy and (e) cytotoxic effect were studied. We observed that small gold nanoparticles (70-80 nm in diameter) protected DNA against nucleases and were able to transfect the ICOVIR-15 oncolytic virus genome encoded in pLR1 plasmid. In the present work, efficient transgene RNA expression, luciferase activity and viral cytopathic effect on cancer cells are reported. These results suggest gold nanoparticles to be an efficient and safe vector for oncolytic adenovirus genome transfer.

Application of dielectric spectroscopy to unravel the physiological state of microorganisms: current state, prospects and limits.

Microbial physiology is an essential characteristic to be considered in the research and industrial use of microorganisms. Conventionally, the study of microbial physiology has been limited to carrying out qualitative and quantitative analysis of the role of individual components in global cell behaviour at a specific time and under certain growth conditions. In this framework, groups of observable cell physiological variables that remain over time define the physiological states. Recently, with advances in omics techniques, it has been possible to demonstrate that microbial physiology is a dynamic process and that, even with low variations in environmental culture conditions, physiological changes in the cell are provoked. However, the changes cannot be detected at a macroscopic level, and it is not possible to observe these changes in real time. As an alternative to solve this inconvenience, dielectric spectroscopy has been used as a complementary technique to monitor on-line cell physiology variations to avoid long waiting times during measurements. In this review, we discuss the state-of-the-art application of dielectric spectroscopy to unravel the physiological state of microorganisms, its current state, prospects and limitations during fermentation processes. Key points • Summary of the state of the art of several issues of dielectric spectroscopy. • Discussion of correlation among dielectric properties and cell physiological states. • View of the potential use of dielectric spectroscopy in monitoring bioprocesses.

Dielectric property measurements as a method to determine the physiological state of Kluyveromyces marxianus and Saccharomyces cerevisiae stressed with furan aldehydes.

Cell physiology parameters are essential aspects of biological processes; however, they are difficult to determine on-line. Dielectric spectroscopy allows the on-line estimation of viable cells and can provide important information about cell physiology during culture. In this study, we investigated the dielectric property variations in Kluyveromyces marxianus SLP1 and Saccharomyces cerevisiae ERD yeasts stressed by 5-hydroxymethyl-2-furaldehyde and 2-furaldehyde during aerobic growth. The dielectric properties of cell permittivity, specific membrane capacitance (Cm), and intracellular conductivity (σIn) were considerably affected by furan aldehydes in the same way that the cell population, viability, cell size, substrate consumption, organic acid production, and respiratory parameters were. The yeasts stressed with furan aldehydes exhibited three physiological states (φ): adaptation, replicating, and nonreplicating states. During the adaptation state, there were small and stable signs of permittivity, Cm, and σIn; additionally, no cell growth was observed. During the replicating state, cell growth was restored, and the cell viability increased; in addition, the permittivity and σIn increased rapidly and reached their maximum values, while the Cm decreased. In the nonreplicating state, the permittivity and σIn were stable, and Cm decreased to its minimum value. Our results demonstrated that knowing dielectric properties allowed us to obtain information about the physiological state of the cells under control and stressed conditions. Since the permittivity, Cm, and σIn are directly associated with the physiological state of the yeast, these results should contribute to a better understanding of the stress response of yeasts and open the possibility to on-line monitor and control the physiological state of the cell in the near future.

Fermentative capabilities of native yeast strains grown on juices from different Agave species used for tequila and mezcal production.

The Asparagaceae family is endemic from America, being the Agave genus the most important. The Agave species possess economic relevance and are use as raw material to produce several distilled alcoholic beverages, as bacanora, tequila, and mezcal. The fermentation process has been carry out either spontaneously or by adding a selected yeast strain. The latter is generally responsible for the production of ethanol and volatile compounds. This study comprised five Agave species (A. angustifolia, A. cupreata, A. durangensis, A. salmiana, and A. tequilana) and eight endogenous yeast strains: five of them were non-Saccharomyces (Torulaspora delbrueckii, Zygosaccharomyces bisporus, Candida ethanolica, and two Kluyveromyces marxianus) and three Saccharomyces cerevisiae strains. The results showed that the S. cerevisiae strains were not able to grow on A. durangensis and A. salmiana juices. The Kluyveromyces marxianus strains grew and fermented all the agave juices and displayed high ethanol production (48-52 g L-1) and volatile compounds. The ethanol production was higher on A. angustifolia juice (1.1-2.8-fold), whereas the volatile compound was dependent on both yeast strain and the Agave species. The use of endogenous non-Saccharomyces yeast strains is feasible, as they may outperform S. cerevisiae regarding the production of fermented beverages from agave plants with a high content of ethanol and aromatic compounds. Graphical abstract.

Chemotherapy and PARP inhibitors in heavily pretreated BRCA1/2 mutation ovarian cancer (BMOC) patients.

OBJECTIVES: The hallmarks of germline(g) and/or somatic(s) BRCA1/2 mutation ovarian cancer (BMOC) patients are increased sensitivity to platinum-based chemotherapy (PCT) and PARP inhibitors (PARPi). There is little information on the effectiveness of chemotherapy in heavily pretreated (≥3 CT lines) g/sBMOC patients. METHODS: g/sBMOC patients who received CT from 2006 to 2016 at 4 cancer centers in Spain were selected. Overall survival (OS) and time to progression (TTP) were calculated with Kaplan Meier and Cox models. RESULTS: 135 g/sBMOC patients were identified (6% sBRCA1/2 mutations). The median number of chemotherapy lines was 2 (1-7). The 6-years OS rate was 69.4% and 71% in BRCA1 or BRCA2 mutation carriers (p = 0.98). A total of 57 (42%) patients had ≥3 CT lines (3-7), which encompassed a total of 155 treatments. The median overall TTP across all treatment lines beyond 2nd line was 10.2 months (CI 95% 8.4-11.9 months). In the platinum-sensitive setting, TTP was improved with PCT plus PARPi (17.1 m), PCT (12.6 m) or PARPi (12.4 m) versus non-PCT (4.9 m; p < 0.001 all comparisons). In the platinum-resistant setting, these differences in TTP were not statistically significant. A multivariate model confirmed that primary platinum-free interval (PFI) > 12 months and exposure to PCT and PARPi associated with improved outcomes. PARPi exposure did not compromise benefit of subsequent CT beyond 2nd relapse. CONCLUSIONS: Heavily pretreated g/sBMOC demonstrated CT sensitivity, including for non-PCT choices. Primary platinum-free interval (PFI) >12 months and exposure to both platinum-based chemotherapy and PARPi associate with improved prognosis in heavily pretreated g/sBMOC patients.

LDL particle size and composition and incident cardiovascular disease in a South-European population: The Hortega-Liposcale Follow-up Study.

BACKGROUND: The association of low-density lipoprotein (LDL) particle composition with cardiovascular risk has not been explored before. The aim was to evaluate the relationship between baseline LDL particle size and composition (proportions of large, medium and small LDL particles over their sum expressed as small-LDL %, medium-LDL % and large-LDL %) and incident cardiovascular disease in a population-based study. METHODS: Direct measurement of LDL particles was performed using a two-dimensional NMR-technique (Liposcale®). LDL cholesterol was assessed using both standard photometrical methods and the Liposcale® technique in a representative sample of 1162 adult men and women from Spain. RESULTS: The geometric mean of total LDL particle concentration in the study sample was 827.2 mg/dL (95% CI 814.7, 839.8). During a mean follow-up of 12.4 ±â€¯3.3 years, a total of 159 events occurred. Medium LDL particles were positively associated with all cardiovascular disease, coronary heart disease (CHD) and stroke after adjustment for traditional risk factors and treatment. Regarding LDL particle composition, the multivariable adjusted hazard ratios for CHD for a 5% increase in medium and small LDL % by a corresponding decrease of large LDL % were 1.93 (1.55, 2.39) and 1.41 (1.14, 1.74), respectively. CONCLUSIONS: Medium LDL particles were associated with incident cardiovascular disease. LDL particles showed the strongest association with cardiovascular events when the particle composition, rather than the total concentration, was investigated. A change in baseline composition of LDL particles from large to medium and small LDL particles was associated with an increased cardiovascular risk, especially for CHD.

Eosinophilic fasciitis in association with hypereosinophilic syndrome in an HIV-infected patient with severe multiorgan involvement

No disponible

[Evolution of patient safety culture in a medium-stay hospital: monitoring indicators]. / Evolución de la cultura de seguridad del paciente en un hospital de media-larga estancia: indicadores de seguimiento.

BACKGROUND: Patient safety is a challenge for health care. The aim of this study is to identify the dimensions with the greatest impact on patient safety culture of healthcare staff in a medium-stay hospital; to asses its evolution over time and to check the sensitivity of monitoring indicators. METHODS: Two cross-sectional studies (2013 to 2015) were conducted. The safety culture assessment tool used was the Spanish version of the "Hospital Survey on Patient Safety" (AHRQ). Outcome variable is high perception of safety (score = 75th percentile). INDEPENDENT VARIABLES: socio-demographic characteristics and perceptions of the evaluated dimensions. The association between variables was quantified by Odds Ratio. RESULTS: The mean of perceived safety was similar in both studies: (7.81 and 7.48, N2013= 66; N2015=92). The best aspects evaluated were: "Supervisor actions" and "Teamwork within unit"; the worst evaluated were: "Staffing", "Management support" and "Teamwork across units". Socio-demographic variables had little significance, while a positive perception in some of the considered dimensions was associated with high perceived safety. The most strongly associated aspects were: "Supervisor actions", "Communication openness" and "Problems in transitions". In the comparative study, indicators based on individual dimensions detected changes better than the assessment of the degree of perceived safety. CONCLUSION: The regular assessment of Patient Safety Culture makes it possible to know the status and evolution of professionals' perceptions. The choice of appropriate indicators optimises the information obtained through these surveys.

Cadmium body burden and increased blood pressure in middle-aged American Indians: the Strong Heart Study.

Cadmium (Cd) is an environmental pollutant that has been associated with cardiovascular disease in populations, but the relationship of Cd with hypertension has been inconsistent. We studied the association between urinary Cd concentrations, a measure of total body burden, and blood pressure in American Indians, a US population with above national average Cd burden. Urinary Cd was measured using inductively coupled plasma mass spectrometry, and adjusted for urinary creatinine concentration. Among 3714 middle-aged American Indian participants of the Strong Heart Study (mean age 56 years, 41% male, 67% ever-smokers, 23% taking antihypertensive medications), urinary Cd ranged from 0.01 to 78.48 µg g-1 creatinine (geometric mean=0.94 µg g-1) and it was correlated with smoking pack-year among ever-smokers (r2=0.16, P<0.0001). Participants who were smokers were on average light-smokers (mean 10.8 pack-years), and urinary Cd was similarly elevated in light- and never-smokers (geometric means of 0.88 µg g-1 creatinine for both categories). Log-transformed urinary Cd was significantly associated with higher systolic blood pressure in models adjusted for age, sex, geographic area, body mass index, smoking (ever vs never, and cumulative pack-years) and kidney function (mean blood pressure difference by lnCd concentration (ß)=1.64, P=0.002). These associations were present among light- and never-smokers (ß=2.03, P=0.002, n=2627), although not significant among never-smokers (ß=1.22, P=0.18, n=1260). Cd was also associated with diastolic blood pressure among light- and never-smokers (ß=0.94, P=0.004). These findings suggest that there is a relationship between Cd body burden and increased blood pressure in American Indians, a population with increased cardiovascular disease risk.

Kinesioterapia respiratoria en pediatría / Respiratory physiotherapy

La kinesiterapia respiratoria, es una especialidad terapéutica que tiene el rol principal de prevenir y tratar las complicaciones pulmonares de forma sencilla, sin incorporar recursos sofisticados en su ejecución. Su objetivo es optimizar la función respiratoria para lograr un adecuado intercambio de gases y mejorar la relación ventilación perfusión. Para esto se efectuan maniobras de permeabilización bronquiales, que cobran especial valor en la infancia, dado que este grupo etáreo, presenta mayor producción de secreciones y una VA de conducción muy estrecha, ambos elementos predisponen a obstrucciones que deben ser manejadas cuando se amerite. La kinesiterapia, también incluye otras técnicas como ejercicios respiratorios, movilización, posicionamientos, maniobras de reexpansión pulmonar asociados con dispositivos especialmente adaptados para este objetivo. En este escrito, se dan las bases de esta terapia física, con énfasis en la edad pediátrica, junto a la descripción global y específica de las principales técnicas, que el pediatra debiese conocer.

Chest physioterapy is a therapeutic specialty that aims to prevent and treat lung complications without adding sophisticated resources for his execution as its main role. Its goal is to optimize the pulmonary function to achieve appropriate gaseous exchange and to improve ventilation/perfusion ratio. To this end airway clearance techniques are performed, these techniques are of special value during childhood, since this age group present higher quantities of secretions and very narrow conducting airways, both elements predispose to obstructions that must be handle if the case merits. Chest physioterapy also include others techniques as deep breathing, early movilizations, lung recruitment maneuvers with specially adapted devices. This paper set the stage of this pshysical therapy with emphasis in pediatric age, adding a global and specific description of the main techniques that the pediatritian should know.