[Impact of the COVID-19 pandemic: The point of view of patient associations]. / Impacto de la pandemia por COVID-19: El punto de vista de las asociaciones de pacientes.

INTRODUCTION AND OBJECTIVES: The COVID-19 pandemic is causing great social and health impact. We need to involve patients in identifying their new needs in this situation. The aim of this study was to assess the perception of organisations associated with the Spanish Patients' Forum regarding the pandemic. MATERIAL AND METHODS: A descriptive cross-sectional study using an online survey. Organisations associated with the FEP participated over the second half of May 2020. The questionnaire was pre-assessed by professionals and patients. The subject areas were overall effect of the pandemic, impact, the role of patient associations, limitations, and challenges. A descriptive analysis of the quantitative variables and a content analysis of the qualitative information were performed. RESULTS: The participation rate was 88.7%. The respondents highlighted the impact of the pandemic on the quality of life and well-being of patients and their families. They also reported the effect of the baseline disease and delay in treatment and testing. The pandemic has also affected patient associations. CONCLUSIONS: The pandemic has had an impact at the level of healthcare and other spheres of society. Patients' health, quality of life and use of health services have been affected. The need is highlighted to involve patients, their families, and legal representatives in the search for solutions adapted to the current needs of these groups.

Acute physiological responses to castration-related pain in piglets: the effect of two local anesthetics with or without meloxicam.

Methods to reduce castration-related pain in piglets are still issues of concern and interest for authorities and producers. Our objectives were to estimate the effectiveness of two protocols of local anesthesia (lidocaine and the combination of lidocaine+bupivacaine) as well as the use of meloxicam as a postoperative analgesic in alleviating castration-related pain, measured by acute physiological responses. Eight groups (15 piglets/group) were included in the study: (1) castration without anesthesia or analgesia, without meloxicam (TRAD WITHOUT), (2) castration without anesthesia or analgesia, but with meloxicam (TRAD WITH), (3) handling without meloxicam (SHAM WITHOUT), (4) handling with meloxicam (SHAM WITH), (5) castration after local anesthesia with lidocaine but without meloxicam (LIDO WITHOUT), (6) castration after local anesthesia with lidocaine and meloxicam (LIDO WITH), (7) castration after local anesthesia with lidocaine+bupivacaine without meloxicam (LIDO+BUPI WITHOUT), (8) castration after local anesthesia with lidocaine+bupivacaine and meloxicam (LIDO+BUPI WITH). Acute physiological responses measured included skin surface temperature and serum glucose and cortisol concentrations. On days 4 and 11 post-castration BW was recorded and average daily gain was calculated over this period. Furthermore, piglet mortality was recorded over the 11-day post-castration period. Administration of local anesthetic or meloxicam did not prevent the decrease in skin surface temperature associated with castration. Lidocaine reduced the increase in glucose concentration associated with castration. For castrated pigs, the joint use of lidocaine and meloxicam caused a significant decrease in cortisol concentration; the combination of intratesticular lidocaine and bupivacaine did not seem to be more effective than lidocaine alone. No effect of treatments on mortality and growth were detected.

Smoking affects the oral glucose tolerance test profile and the relationship between glucose and HbA1c in gestational diabetes mellitus.

AIMS: Current smokers in the general population have a lower 2 h plasma glucose after an oral glucose tolerance test (OGTT) and a higher HbA1c than non-smokers, but the relationships between OGTT/HbA1c and smoking status have not been addressed in pregnancy. We analysed glycaemic measurements in women with gestational diabetes mellitus in relation to smoking status. METHODS: We performed a review of the prospectively collected database of the diabetes and pregnancy clinic. We included women with gestational diabetes mellitus and a singleton pregnancy who delivered between 1986 and 2006. Bivariate and multivariate analyses were used to evaluate patient characteristics in relation to smoking status. RESULTS: A total of 2361 women met the inclusion criteria: 556 (23.5%) were active smokers, 266 (11.3%) quit during pregnancy and 1539 (65.2%) were non-smokers. Most baseline characteristics were similar across groups. Diagnostic OGTT was performed at a gestational age of [median (25th, 75(th) centiles)] 29 weeks (26, 33). Women who smoked at the beginning of pregnancy had a higher 1-h plasma glucose than non-smokers [11.8 (11, 12.7), 11.6 (11, 12.6) and 11.5 (10.8, 12.5) mmol/l, for active smokers, those who quit during pregnancy and non-smokers, respectively, P < 0.001] and a lower 3-h plasma glucose [7.3 (5.9, 8.4), 7.6 (6.4, 8.7) and 8.0 (6.8, 9.0) mmol/l, respectively, P < 0.001]. HbA1c was higher in women who smoked at the beginning of pregnancy. Multiple regression analysis confirmed the independent association of smoking status with HbA1c and OGTT plasma glucose. CONCLUSIONS: In women with gestational diabetes mellitus who smoke at the beginning of pregnancy, the shape of the OGTT is consistent with accelerated glucose absorption, and HbA1c is higher than expected for glycaemic values.

Single shot spinal anaesthesia with hypobaric bupivacaine for hip fracture repair surgery in the elderly. Randomized, double blinded comparison of 3.75 mg vs. 7.5 mg / Anestesia subaracnoidea con dosis única con bupivacaína hipobárica para la fractura de cadera del anciano. Estudio aleatorizado, doble ciego comparando 3,75mg y 7,5mg

Background. Arterial hypotension is the most frequent adverse effect of subarachnoid anaesthesia in the elderly sustaining a femoral proximal fracture. Decreasing the local anaesthetic dose reduces the incidence of hypotension but shortens sensory block duration that could be insufficient in some surgical procedures. Sensory block duration could be prolonged using hypobaric local anaesthetics. We evaluated whether low hypobaric bupivacaine doses were adequate for this type of surgery while maintaining the haemodynamic stability. Methods. A prospective, randomized, double blinded study was designed. Patients over 65 years old, sustaining traumatic hip fracture, were assigned to one of two groups: B0.5 group, hypobaric bupivacaine 7.5 mg 5 mg/ml (control group), and B0.25 group, hypobaric bupivacaine 3.75 mg 2.5 mg/ml (study group). After subarachnoid injection, sensory level and motor blockade degree were registered, as were blood pressure, and heart rate at basal time and at 2, 5, 10, 15, 20 and 30 min after injection. The doses of vasopressor needed were registered as well. Surgical conditions and the duration of the surgical procedure-whether rescue analgesia or anaesthesia was needed-and sensory level regression to T12, were registered as well. Results. Sixty four patients was the calculated sample size. The study was stopped in an interim analysis because an elevated number of patients in the B0.25 group needed iv rescue anaesthesia. In the analyzed cases, blood pressure was significantly lower in the B0.5 group at the 15 and 30 min measurements. Vasopressor drugs needs were similar between groups [ephedrine accumulated mean (SD) doses 11.4 (5.2) mg vs. 9.1 (2.7) mg, p = 0.045)]. Sensory block regression to T12 was faster in the B0.25 group, [(mean (SD) 68.2 (29.0) min vs. 112.8 (17.3) min in the B0.5 group, p < 0.05]. Five out of 19 patients in the B0.25 group needed intravenous anaesthesia rescue before surgery started. Conclusion. Lowering hypobaric bupivacaine dose to 3.75 mg in subarachnoid anaesthesia for hip fracture repair surgery in elderly patients decrease intraoperative blood pressure, but in an important number of patients intravenous anaesthesia rescue was needed and preclude recommendation (AU)

Antecedentes. La hipotensión arterial es el efecto adverso más frecuente de la anestesia subaracnoidea en ancianos con fractura de cadera. La disminución de la dosis de anestésico local hiperbárico disminuye su incidencia, pero acorta la duración del bloqueo sensitivo, que sería insuficiente en ocasiones. La duración se podría prolongar con anestésicos locales hipobáricos, por lo que valoramos si dosis bajas de bupivacaína isobárica eran adecuadas para esta cirugía. Métodos. Estudio prospectivo, aleatorizado, doble ciego. Pacientes con fractura de cadera mayores de 65 años fueron asignados bien al grupo B0.5, 7,5 mg de bupivacaína hipobárica 5 mg/ml (grupo control), o al grupo B0.25, 3,75 mg de bupivacaína isobárica 2,5 mg/ml (grupo de estudio). Tras la inyección subaracnoidea se registraron el bloqueo sensitivo y motor, así como la presión arterial, la frecuencia cardiaca basal y en los minutos 2, 5, 10, 15, 20 y 30, así como las dosis de vasopresores administradas. También lo fueron la factibilidad de la cirugía y su duración, la necesidad de analgesia de rescate y el tiempo de regresión del nivel sensitivo a T12. Resultados. Fueron incluidos 64 pacientes. El estudio fue detenido en un análisis intermedio debido a que un número importante de pacientes en el grupo B0.25 precisaron anestesia intravenosa de rescate. En los casos analizados, la presión arterial fue significativamente menor en el grupo B0.5 en los minutos 15 a 30. Las necesidades de vasopresores fueron similares (dosis media [DE] acumulada de efedrina 11,4 [5,2] frente a 9,1 [2,7] mg, p = 0,045]). La regresión del bloqueo sensitivo a T12 fue más rápida en el grupo B0.25 (media 68,2 [29,0] frente a 112,8 [17,3] min en el grupo B0.5, p < 0,05). Cinco de 19 pacientes en el grupo B0.25 necesitaron rescate con anestesia intravenosa. Conclusión. Aunque produjo menor incidencia de hipotensión arterial intraoperatoria, disminuir la dosis de bupivacaína isobárica a 3,75 mg para anestesia subaracnoidea en ancianos con fractura de cadera fue insuficiente para la cirugía en un número importante de pacientes, por lo que no se puede recomendar (AU)

Single shot spinal anaesthesia with hypobaric bupivacaine for hip fracture repair surgery in the elderly. Randomized, double blinded comparison of 3.75 mg vs. 7.5 mg.

BACKGROUND: Arterial hypotension is the most frequent adverse effect of subarachnoid anaesthesia in the elderly sustaining a femoral proximal fracture. Decreasing the local anaesthetic dose reduces the incidence of hypotension but shortens sensory block duration that could be insufficient in some surgical procedures. Sensory block duration could be prolonged using hypobaric local anaesthetics. We evaluated whether low hypobaric bupivacaine doses were adequate for this type of surgery while maintaining the haemodynamic stability. METHODS: A prospective, randomized, double blinded study was designed. Patients over 65 years old, sustaining traumatic hip fracture, were assigned to one of two groups: B0.5 group, hypobaric bupivacaine 7.5mg 5mg/ml (control group), and B0.25 group, hypobaric bupivacaine 3.75 mg 2.5mg/ml (study group). After subarachnoid injection, sensory level and motor blockade degree were registered, as were blood pressure, and heart rate at basal time and at 2, 5, 10, 15, 20 and 30 min after injection. The doses of vasopressor needed were registered as well. Surgical conditions and the duration of the surgical procedure-whether rescue analgesia or anaesthesia was needed-and sensory level regression to T12, were registered as well. RESULTS: Sixty four patients was the calculated sample size. The study was stopped in an interim analysis because an elevated number of patients in the B0.25 group needed iv rescue anaesthesia. In the analyzed cases, blood pressure was significantly lower in the B0.5 group at the 15 and 30 min measurements. Vasopressor drugs needs were similar between groups [ephedrine accumulated mean (SD) doses 11.4 (5.2) mg vs. 9.1 (2.7) mg, p=0.045)]. Sensory block regression to T12 was faster in the B0.25 group, [(mean (SD) 68.2 (29.0) min vs. 112.8 (17.3) min in the B0.5 group, p<0.05]. Five out of 19 patients in the B0.25 group needed intravenous anaesthesia rescue before surgery started. CONCLUSION: Lowering hypobaric bupivacaine dose to 3.75 mg in subarachnoid anaesthesia for hip fracture repair surgery in elderly patients decrease intraoperative blood pressure, but in an important number of patients intravenous anaesthesia rescue was needed and preclude recommendation.

Compounds from multilayer plastic bags cause reproductive failures in artificial insemination.

High levels of reproductive failure were detected in some Spanish sow farms in the Spring of 2010. Regular returns to estrus and variable reductions in litter size were observed. The problem started suddenly and did not appear to be related to the quality of the ejaculates, disease, alterations of body condition or any other apparent reasons. Subsequent studies determined that the problem was the origin of the plastic bags used for semen storage. Chemical analysis of the suspicious bags identified unexpected compounds such as BADGE, a cyclic lactone and an unknown phthalate that leached into the semen at concentrations of 0.2 to 2.5 mg/L. Spermatozoa preserved in these bags passed all of the routine quality control tests, and no differences were observed between storage in the control and suspicious bags (p > 0.05). In vitro fecundation tests and endocrine profiler panel analysis (EPP) did not show any alterations, whereas the in vivo tests confirmed the described failure. This is the first described relationship between reproductive failure and toxic compounds released from plastic bags.

Automatic dosage of hydrogen peroxide in solar photo-Fenton plants: development of a control strategy for efficiency enhancement.

The solar photo-Fenton process is widely used for the elimination of pollutants in aqueous effluent and, as such, is amply cited in the literature. In this process, hydrogen peroxide represents the highest operational cost. Up until now, manual dosing of H(2)O(2) has led to low process performance. Consequently, there is a need to automate the hydrogen peroxide dosage for use in industrial applications. As it has been demonstrated that a relationship exists between dissolved oxygen (DO) concentration and hydrogen peroxide consumption, DO can be used as a variable in optimising the hydrogen peroxide dosage. For this purpose, a model was experimentally obtained linking the dynamic behaviour of DO to hydrogen peroxide consumption. Following this, a control system was developed based on this model. This control system - a proportional and integral controller (PI) with an anti-windup mechanism - has been tested experimentally. The assays were carried out in a pilot plant under sunlight conditions and with paracetamol used as the model pollutant. In comparison with non-assisted addition methods (a sole initial or continuous addition), a decrease of 50% in hydrogen peroxide consumption was achieved when the automatic controller was used, driving an economic saving and an improvement in process efficiency.

Use of a novel double uterine deposition artificial insemination technique using low concentrations of sperm in pigs.

Currently, the three most important non-surgical artificial insemination systems used in pigs are the conventional, the post-cervical (IUI), and the deep-intrauterine (DIUI) methods. In this study, a new system, termed double uterine deposition insemination (DUDI), which combines aspects of both IUI and DIUI, was evaluated. This method used a thinner, shorter and more flexible catheter than those normally used for DIUI and resulted in the deposition of semen post-cervically, approximately half-way along the uterine horn, thus potentially by-passing the threat of 'unilateral' insemination or pregnancy when using sperm of low concentration. The experiment was carried out over 8 weeks on a group of 166 sows, which were divided into seven groups, inseminated with semen of varying concentration, using the conventional system (control group) or by DUDI. There were no significant differences in fertility at day 35 post-insemination between the controls and the various DUDI sub-groups. Only sows inseminated with 500 million viable spermatozoa in a total of 30 mL of fluid using the DUDI system demonstrated decreased total litter sizes when compared to conventional insemination (P<0.001). While conventional insemination normally uses 2.5-3.5 billion sperm, the findings of this study suggest that DUDI can be used under 'field' conditions with sperm concentrations as low as 750 million spermatozoa in 50-30 mL without any detrimental effect on fertility or litter size. DUDI may provide a viable, robust alternative to IUI and DIUI, and has the potential to become incorporated into on-farm insemination systems.

Amino acid uptake by wild and commercial yeasts in single fermentations and co-fermentations.

Musts require nitrogen-containing compounds in order to ensure yeast development. This study examined the nitrogen-nutrient requirements of two commercial yeasts and three wild strains isolated from inoculated fermentations. The results showed that wild strains generally consumed lower amounts of amino acids than commercial yeasts. Most amino acids were assimilated during the exponential growth phase; only a few - including asparagine and histidine - were metabolized until the end of fermentation. The study also sought to determine whether industrial drying affected yeast nitrogen requirements.

Trichuris suis and Trichuris trichiura are different nematode species.

In this paper, a morphological and biometrical study by optical microscopy and scanning electronic microscopy (SEM) of Trichuris suis isolated from different hosts (Sus scrofa domestica and Sus scrofa scrofa) and Trichuris trichiura isolated from chimpanzee, has been carried out. Our results demonstrate the existence of typical pericloacal papillae in both species. Biometrical parameters of T. suis and T. trichiura overlapped but males and females of T. trichiura tended to be shorter and thinner than those of T. suis. Our results suggest that T. suis and T. trichiura cannot be differentiated using standard procedures as morphological and biometrical determinations. Thus, the ITS1-5.8S-ITS2 region of the ribosomal DNA was sequenced to allow a differentiation between T. suis and T. trichiura on genetic level. The ITS1 and ITS2 sequences derived from T. trichiura eggs isolated from feces of primates (Colobus guereza kikuyensis and Nomascus gabriellae) showed clear differences to the respective sequences of T. suis derived from eggs of different porcine hosts. The 5.8S gene was similar between the two species. Sequences obtained from different populations of the same species showed no significant differences indicating that the ITS1-5.8S-ITS2 sequences reported in this study are representative for T. trichiura and T. suis, respectively. Phylogenetic relationships have been determined attending to the ITS1 and ITS2 sequences from different species of the genus Trichuris. In conclusion, T. trichiura and T. suis are considered to be closely related but genetically different species. Both species can be easily and reliably distinguished by a PCR-RFLP analysis of the ITS1 and ITS2 sequences with different restriction enzymes.

Application of PCR-TTGE and PCR-RFLP for intraspecific and interspecific characterization of the genus Saccharomyces using actin gene (ACT1) primers.

In this work the actin gene was used to establish phylogenetic relationships of wider and more diffuse species of the genus Saccharomyces in food ecology by temporal temperature gradient electrophoresis (TTGE) and amplified restriction fragment length polymorphism (RFLP) analysis. Results for DNA RFLP analysis varied considerably, and some enzymes showed a high intra- and interspecific power; however, comparison of experimental results with those provided by the National Center for Biotechnology Information database disclosed a number of interesting variations. Only some experimental results matched the theoretical ones. A theoretical study of melting temperatures using available information from partial sequences of the actin gene was done. Several Saccharomyces species and strains could be distinguished using different TTGE melting points. Some degree of discrimination was achieved under different conditions, in that the Saccharomyces strains tested were separated into groups like the results obtained by PCR-RFLP.

Cytochrome oxidase subunit 1 and mitochondrial 16S rDNA sequences of Trichuris skrjabini (Tricocephalida: Trichuridae).

The partial mitochondrial cytochrome c-oxidase subunit 1 gene (cox 1) and partial mitochondrial 16S ribosomal DNA of Trichuris skrjabini (Baskakov 1924) isolated from Capra hircus have been amplified and sequenced. The analyses of multiple sequence alignments of mitochondrial 16S rDNA and cox 1 of T. skrjabini revealed high homology with those of Trichinella species. For the first time, the mitochondrial DNA gene sequences of one species of trichurid nematode have been cited.

Comparative features of the epidemiology of multiple sclerosis and Parkinson's disease: environmental factors of potential etiological importance.

Multiple sclerosis (MS) and Parkinson's disease (PD) are diseases of unknown cause. The etiology of MS is usually considered to be due to a number of potential biological agents while the etiology of PD is usually associated with toxic agents. Despite these differences, both pathologies have strong epidemiological similarities. A comparative analysis is performed of the epidemiology of MS and PD. Potential causal factors for PD may include dopamine-like pharmacological agents. It is proposed that potential causal agents such as certain drugs plus certain vaccines could explain rationally the epidemiology of MS. Ecology and genetics could not be the appropriate lines of research in the etiology of MS/PD because they are supported only in part by the epidemiology.

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Concurrencia de síndromes paraneoplásicos neurológicos, en paciente afecta de cáncer de mama y metástasis cerebral: revisión de la literatura / Concurrence of neurologic paraneroplastic syndromes in a woman with brain metastatic breast cancer: review of the literature

Los Síndromes paraneoplásicos neurológicos sonentidades complejas, de difícil diagnóstico, y quepueden afectar a cualquier parte del sistemanervioso. El descubrimiento de nuevos antígenosonconeuronales y su relación con las alteracionesinmunológicas asociadas están ayudando a undiagnóstico precoz. La asociación con el carcinomade mama es infrecuente. Presentamos el caso de unapaciente de 62 años, diagnosticada de carcinoma demama izquierda, mastectomizada y tratada conquimioterapia adyuvante. Presentó recidiva, conmetástasis cerebelosa resecada quirúrgicamente ytratada con radioterapia. Se complicó con cuadromiasteniforme de tipo Lambert-Eaton, disfunciónautonómica y posterior encefalítis límbica con comairreversible. La aplicación de los nuevos criteriosdiagnósticos, los descubrimientos moleculares y larealización de ensayos clínicos terapeúticos,podrían mejorar las expectativas en estas pacientes

Neurological paraneoplastic syndromes arecomplex entities of difficult diagnosis. They canlocate in any part of the nervous system producingimportant neurological dysfunctions. The discoveryof new specific anti-neuronal antibodies and theirrelation with the associated immunologicalalterations help to make an early diagnosis.Association with breast cancer is not frequent. Wepresent the case of a 62-year old patient with leftbreast carcinoma that had been treated bymastectomy and adjuvant chemotherapy one yearbefore. She relapsed with cerebellum metastasesand was treated by surgery and radiotherapy. Thepicture was complicated with a Lambert-Eaton-likemyasthenic syndrome, neuroplastic sensoryneuronopathy, limbic encephalitis and irreversiblecoma. The application of new diagnostic criteria,the molecular discoveries and the performance oftherapeutic clinical trials could better the lifeexpectancy of these patients

Engineering of an oenological Saccharomyces cerevisiae strain with pectinolytic activity and its effect on wine.

A pectinolytic industrial yeast strain of Saccharomyces cerevisiae was generated containing the S. cerevisiae endopolygalacturonase gene (PGU1) constitutively expressed under the control of the 3-phosphoglycerate kinase gene (PGK1) promoter. The new strain contains DNA derived exclusively from yeast and expresses a high polygalacturonic acid hydrolyzing activity. Yeast transformation was carried out by an integrative process targeting a dispensable upstream region of the acetolactate synthase locus (ILV2), which determines sulfometuron methyl resistance. Microvinification assays were performed on white and red musts with the transformed UCLMS-1M strain and with the same strain untransformed. It was found that the changes in the pectic polysaccharide contents did not directly affect the taste or flavor of the wine. From the data reported, it is deduced that the chief advantage of using the modified strain is that it improves the yield of must/wine extraction, while it also positively affects some variables relating to appearance.