Characterization of PAHs bound to ambient ultrafine particles around runways at an international airport

The impact of airport activities on air quality, is not sufficiently documented. In order to better understand the magnitude and properly assess the sources of emissions in the sector, it is necessary to establish databases with real data on those pollutants that could have the greatest impact on both health and the environment. Particulate matter (PM), especially ultrafine particles, are a research priority, not only because of its physical properties, but also because of its ability to bind highly toxic compounds such as polycyclic aromatic hydrocarbons (PAHs). Samples of PM were collected in the ambient air around the runways at Barajas International Airport (Madrid, Spain) during October, November and December 2021. Samples were gathered using three different sampling systems and analysed to determine the concentration of PAHs bound to PM. A high-volume air sampler, a Berner low-pressure impactor, and an automated off-line sampler developed in-house were used. The agreement between the samplers was statistically verified from the PM and PAH results. The highest concentration of PM measured was 31 μg m-3, while the concentration of total PAH was 3 ng m-3, both comparable to those recorded in a semi-urban area of Madrid. The PAHs showed a similar profile to the particle size distribution, with a maximum in the 0.27-0.54 μm size range, being preferentially found in the submicron size fractions, with more than 84% and around 15-20% associated to UFPs. It was found that the ratio [PAHs(m)/PM(m)] was around 10-4 in the warmer period (October), whereas it more than doubled in the colder months (November-December). It is significant the shift in the relative distribution of compounds within these two periods, with a notable increase in the 5 and 6 ring proportions in the colder period. This increase was probably due to the additional contribution of other external sources, possibly thermal and related to combustion processes, as supported by the PAH diagnostic ratios.

3D phantom for image quality assessment of mammography systems

Objective.To present an innovative approach for the design of a 3D mammographic phantom for medical equipment quality assessment, estimation of the glandular tissue percentage in the patient's breast, and emulation of microcalcification (μC) breast lesions.Approach.Contrast-to noise ratio (CNR) measurements, as well as spatial resolution and intensity-to-glandularity calibrations under mammography conditions were performed to assess the effectiveness of the phantom. CNR measurements were applied to different groups of calcium hydroxyapatite (HA) and aluminum oxide (AO)μCs ranging from 200 to 600μm. Spatial resolution was characterized using an aluminum plate contained in the phantom and standard linear figures of merit, such as the line spread function and modulation transfer function (MTF). The intensity-to-glandularity calibration was developed using an x-ray attenuation matrix within the phantom to estimate the glandular tissue percentage in a breast with a compressed thickness of 4 cm.Main results.For the prototype studied, the minimum confidence level for detecting HAμCs is 95.4%, while for AOμCs is above 68.3%. It was also possible to determine that the MTF of the commercial mammography machine used for this study at the Nyquist frequency is 41%. Additionally, a one-to-one intensity-to-glandularity calibration was obtained and verified with Monte-Carlo simulation results.Significance.The phantom provides traditional arrangements presented in accreditation phantoms, which makes it competitive with available devices, but excelling in regarding affordability, modularity, and inlays distribution. Moreover, its design allows to be positioned in close proximity to the patient's breast during a medical screening for a simultaneous x-ray imaging, such that the features of the phantom can be used as reference values to specify characteristics of the real breast tissue, such as proportion of glandular/adipose composition and/orμC type and size lesions.

Emerging Hyalomma lusitanicum: From identification to vectorial role and integrated control

In the Mediterranean basin, the tick species Hyalomma lusitanicum Koch stands out among other species of the Hyalomma genus due to its wide distribution, and there is great concern about its potential role as a vector and/or reservoir and its continuous expansion to new areas because of climate warming and human and other animal movements. This review aims to consolidate all the information on H. lusitanicum, including taxonomy and evolution, morphological and molecular identification, life cycle, sampling methods, rearing under laboratory conditions, ecology, hosts, geographical distribution, seasonality, vector role and control methods. The availability of adequate data is extremely relevant to the development of appropriate control strategies in areas where this tick is currently distributed as well as in new areas where it could become established in the near future.

Magnetic resonance in patients with cardiovascular devices. SEC-GT CRMTC/SEC-Heart Rhythm Association/SERAM/SEICAT consensus document

Magnetic resonance has become a first-line imaging modality in various clinical scenarios. The number of patients with different cardiovascular devices, including cardiac implantable electronic devices, has increased exponentially. Although there have been reports of risks associated with exposure to magnetic resonance in these patients, the clinical evidence now supports the safety of performing these studies under specific conditions and following recommendations to minimize possible risks. This document was written by the Working Group on Cardiac Magnetic Resonance Imaging and Cardiac Computed Tomography of the Spanish Society of Cardiology (SEC-GT CRMTC), the Heart Rhythm Association of the Spanish Society of Cardiology (SEC-Heart Rhythm Association), the Spanish Society of Medical Radiology (SERAM), and the Spanish Society of Cardiothoracic Imaging (SEICAT). The document reviews the clinical evidence available in this field and establishes a series of recommendations so that patients with cardiovascular devices can safely access this diagnostic tool.

Detection of cytomegalovirus in bronchoalveolar lavage fluid from immunocompromised patients with pneumonitis by viral culture and DNA quantification

PURPOSE

To compare the detection of human cytomegalovirus (HCMV) in bronchoalveolar lavage (BAL) fluid by viral culture and quantitative polymerase chain reaction (qPCR), and to establish a viral load threshold that can identify cases of HCMV replication indicative of pneumonitis. There is currently no universal viral load cut-off to differentiate between patients with and without pneumonitis, and the interpretation of qPCR results is challenging.

METHODS

176 consecutive BAL samples from immunosuppressed hosts with signs and/or symptoms of respiratory infection were prospectively studied by viral culture and qPCR.

RESULTS

Concordant results were obtained in 81.25% of the BAL samples. The rest were discordant, as only 34% of the qPCR-positive BAL samples were positive by culture. The median HCMV load was significantly higher in culture-positive than in culture-negative BAL samples (5,038 vs 178 IU/mL). Using a cut-off value of 1,258 IU/mL of HCMV in BAL, pneumonia was diagnosed with a sensitivity of 76%, a specificity of 100%, a VPP of 100% and VPN of 98%, and HCMV was isolated in 100% of the BAL cultures.

CONCLUSION

We found that a qPCR-negative was a quick and reliable way of ruling out HCMV pneumonitis, but a positive result did not always indicate clinically significant replication in the lung. However, an HCMV load in BAL fluid of ≥1,258 IU/mL was always associated with disease, whereas <200 IU/mL rarely so.

Survival analysis of productive life in Florida dairy goats using a Cox proportional hazards model

Longevity is an economically important trait, since extending the functional life of a doe would allow us to keep the most productive females in the herd as long as possible, and this could result in the increased profitability of dairy farms. Thus, the objectives of this study were to determine the most important factors that influence the length of productive life (LPL) of female Florida goats and to estimate its genetic additive variance using a Cox proportional hazards model. The data consisted of 70,695 productive life records from 25,722 Florida females kidding between 2006 and 2020. A total of 19,495 does had completed their productive life while 6227 (24.2%) does had censored information. The pedigree contained information on 56,901 animals. The average censoring age and average failure age after first kidding for LPL were 36 and 47 months respectively. The model included, as time-independent effects, the age at first kidding and the interaction between herd, year and season of birth of the doe, and as time-dependent effects, the age at kidding, the interaction between herd, year and season of kidding, the within-herd class of milk production deviation, and the interaction between the lactation number and the stage of lactation. All fixed effects had a significant effect on LPL (p < 0.05). Does with older ages at the first kidding and an earlier age at kidding were at higher risk of being culled. A large difference among herds was observed in terms of culling risk, which highlighted the importance of adequate management practices. Also, high-producing does were less likely to be culled. The estimate of the additive genetic variance was 1.844 (in genetic standard deviation), with a heritability estimate of 0.58 ± 0.012. The results of this study are expected to contribute to the development of a genetic model for genetic evaluation of the length of the productive life of Spanish dairy goat breeds.

¿Modula el efecto del feedback la percepción de competencia del entrenador?

El objetivo fue analizar el efecto de diferentes tipos de feedback sobre variables psicológicas y de rendimiento en función de la percepción del deportista de la competencia del entrenador. Se realizó un estudio de caso con 33 futbolistas asignados aleatoriamente a tres condiciones experimentales (feedback positivo, negativo y ausencia de feedback). Se midieron velocidad y precisión de lanzamientos a portería, valoración de competencia, competencia percibida, motivación autónoma y vitalidad subjetiva. Se empleó un nivel ? de 0,05 para los análisis. El grupo feedback positivo exhibió niveles más altos de valoración de competencia, competencia percibida, motivación autónoma y bienestar, que los de feedback negativo y ausencia de feedback, en sujetos con alta percepción de competencia del entrenador. Este efecto no se observó en aquellos con baja percepción de competencia del entrenador. La percepción del jugador sobre la competencia del entrenador podría ser un factor en la modulación de las diferencias generadas en cuanto al tipo de feedback.

Removal of emerging pollutants by a 3-step system: Hybrid digester, vertical flow constructed wetland and photodegradation post-treatments

The removal of emerging pollutants from municipal wastewater was studied for the first time using a three-step pilot-scale system: 1) hybrid digester (HD) as first step, 2) subsurface vertical flow constructed wetland (VF) as second step, and 3) photodegradation (PD) unit as third step or post-treatment. The HD and VF units were built and operated in series with effluent recirculation at pilot scale. For the PD post-treatment, three alternatives were studied at lab-scale, i) UVC irradiation at 254 nm (0.5 h exposure time), ii) UVA irradiation at 365 nm using a TiO₂-based photocatalyst and iii) sunlight irradiation using a TiO₂-based photocatalyst, the last two for 1 and 2 h. Alternative iii) was also tested at pilot-scale. Degradation of nine compounds was evaluated: acetaminophen (ACE), caffeine (CAF), carbamazepine (CBZ), ketoprofen (KET), ibuprofen (IBU), diclofenac (DCL), clofibric acid (ACB), bisphenol A (BPA), and sotalol (SOT). Overall, the HD-VF-UVC system completely removed (>99.5 %) ACE, CAF, KET, IBU, DCL and ACB, and to a lesser extent SOT (98 %), BPA (83 %) and CBZ (51 %). On the other hand, the HD-VF-UVA/TiO₂ system (at 2 h) achieved >99.5 % removal of ACE, CAF, KET, IBU and DCL while ACB, BPA, CBZ and SOT were degraded by 83 %, 81 %, 78 % and 68 %, respectively. Working also at 2 h of exposure time, in summer conditions, the HD-VF-Sol/TiO₂ system achieved >99.5 % removal of ACE, CAF, KET, IBU, DCL and ACB, and to a minor extent BPA (80 %), SOT (74 %) and CBZ (69 %). Similar results, although slightly lower for SOT (60 %) and CBZ (59 %), were obtained in the pilot sunlight plus TiO₂ catalyst unit. However, the use of sunlight irradiation with a TiO₂-based photocatalyst clearly showed lower removal efficiency in autumn conditions (i.e., 47 % SOT, 31 % CBZ).

Activity and foraging behaviour of the hoverfly Eristalinus aeneus (Scopoli, 1763) in protected cultivation of mango (Mangifera indica L.)

The hoverfly Eristalinus aeneus is an important pollinator of crops and wild plants. However, there is a lack of detailed information about its foraging behaviour and its potential as a managed pollinator of mango. Given the growing economic importance of protected cultivation of mango, our aim is to study the flight activity and foraging behaviour of E. aeneus on this crop. Eristalinus aeneus displayed a bimodal daily activity, with peaks during mid-morning and mid-afternoon. The activity was maintained over a wide range of temperature (from 17.8 up to 37.4°C), light intensity (from 8.2 up to 57.4 klux) and relative humidity (from 19.0 up to 88.8%). The syrphids were active most of the time in this crop, and we observed five different types of activity: foraging (67%), resting (17%), flying (10%), grooming (4%) and walking (2%). This hoverfly visited hermaphrodite flowers more often than male flowers. On average, it visited 36.46 ± 13.92 flowers per 5 min, with a higher number of floral visits for nectar feeding. The duration of the visits to hermaphrodite and male flowers was similar but pollen-feeding visits lasted longer (6.44 s per flower) than nectar-feeding ones (5.51 s per flower). The highest number of visits to mango inflorescences was observed during the morning, but the longest visits occurred at midday. The implication of these results for the potential use of E. aeneus as a managed pollinator in protected cultivation of mango is discussed.

Seasonal Dynamics of Fleas (Siphonaptera: Pulicidae, Ceratophyllidae and Leptopsyllidae) on Oryctolagus cuniculus in a Meso-Mediterranean Area of Central Spain

Flea infestations of wild rabbits were examined monthly in central Spain in a meso-Mediterranean area for 5 yr. A total of 1,180 wild rabbits were trapped and 7,022 fleas were collected from them. Overall, the prevalence was 74.1% with a mean flea index of 5.95 fleas per rabbit. Four flea species were identified: Spilopsyllus cuniculi (Dale, 1878) was the most abundant species (accounting for 74.3% of fleas collected) followed by Xenopsylla cunicularis (Smit, 1957), Odontopsyllus quirosi (Gil Collado, 1934), and Nosopsyllus fasciatus (Bosc, 1800) (18.9, 6.7, and 0.1%, respectively). The highest prevalence was observed in S. cuniculi (48.6%) followed by X. cunicularis, O. quirosi, and N. fasciatus (34.3, 20.0, and 0.6%, respectively). Odontopsyllus quirosi and S. cuniculi were mainly collected from autumn to spring with the peak of infestation in winter, while X. cunicularis was mainly found from spring to autumn with maximum levels of infestation during the summer months. The relevance of these findings is discussed.

Analysis of strain sensitivity under flexural load of 3D printed carbon nanotube-doped epoxy circuits

A 3D printing system able to print circuits of conductive epoxy resin doped with carbon nanotubes (CNTs) is proposed. Different simple circuits, more specifically lines and strain gauge patterns, made of resins reinforced with 0.3, 0.5, 0.8 and 1 wt% of CNTs were printed on the surface of glass fiber laminates. It was observed that increasing the CNT content reduced the wettability of the printed circuits on the glass fiber substrate. In every case the contact angle was far below 90°. Furthermore, the strain sensing capabilities were analyzed under a flexural load. The results showed that the sensitivity increased with CNT content (with gauge factor values from 1.5 to 2.5) as a result of the prevalent effect of well-dispersed areas due to a reduction in the tunneling distance. On the other hand, the strain gauges showed a lower sensitivity (around 20%-40% less, depending on the condition) compared with line circuits due to localized compressive effects. Furthermore, good repeatability of the strain sensors was proved during cycling tests, with similar baseline and peak values for the electrical resistance in each cycle. Therefore, the proposed materials have a high potential for applications in structural health monitoring.

Postictal suppression in electroconvulsive therapy (ECT) according to sex, age, diagnosis and treatment phase

Introduction

Postictal suppression (PSI) is considered a key feature for ECT’s outcomes because higher values have been correlated with clinical efficacy. However, little is known about the demographic factors influencing this parameter.

Objectives

To analyze the influence of sex, age, diagnosis and treatment phase on ECT efficacy measured with PSI value.

Methods

3251 ECT sessions were performed on 182 patients during two years at a university hospital. PSI was retrospectively analyzed comparing it according to sex (male, female), age, main diagnosis (major depressive disorder [MDD], bipolar disorder [BD], schizoaffective disorder [SZA], schizophrenia [SCZ]) and treatment phase (acute [a-ECT], continuation [c-ECT], maintenance [m-ECT]).

Results

PSI values were 69.76 % (SD 17.05) in women and 70.72 % (SD 16.81) in men without differences between sexes (F=0.979; p=0.607). PSI was correlated with age (r=-0.058; p=0.031). MDD PSI was 70.01 % (SD 16.88), for BD it was 69.48 % (SD 17.00), for SZA it was 68.62 % (SD 17.39), and for SCZ it was 70.73 % (SD 17.18), without differences between diagnosis (F=1.085; p=0.141). According to treatment phase, PSI in the a-ECT was 72.26 % (SD 16.43), in the c-ECT it was 67.83 % (SD 17.53), and in the m-ECT it was 68.47 % (SD 17.02), without differences between phases (F=0.901; p=0.915).

Conclusions

Although there exist statistically significant association between age and PSI it is a negligible correlation with no clinical relevance. Thus, we conclude that neither sex nor age, nor diagnosis, nor treatment phase seem to influence PSI to a relevant degree.

Disclosure

No significant relationships.

Impact of serpentinized peridotite mine waste on the composition and quality of sediments in the Ría de Ortigueira (Galicia, NW Spain)

The Ría de Ortigueira is an environmentally well conserved; however, the sediments show high concentrations of toxic elements. In some zones, the concentrations of Ni (60-1080 mg kg^-1) and Cr (9-567 mg kg^-1) were extremely high, while the concentrations of other toxic elements were within normal ranges. PCA revealed that metal enrichment was due to dumping of waste sludge from a peridotite mine. The study of marine currents showed that the exit of the contaminated waste towards the external zone is restricted by the low energy of the residual currents, and the sludge therefore remains trapped in the internal zones. The potential ecological risk was moderate for all areas of the ría, reaching high values close to the mouth of the river Landoi. Finally, geochemical fractioning showed that most of the metals are associated with Fe oxyhydroxides which can become unstable and release adsorbed or coprecipitated metals, especially Ni.

Automated system for surface photovoltage spectroscopy

This paper details the development of a lab-made experimental setup for surface photovoltage spectroscopy (SPS) measurements using an open-source and Arduino^® microcontroller to control a monochromator and some off-the-shelf electronic components. The experimental setup is interfaced to a computer, where LabVIEW^® based software manages system control and data acquisition. We also report the design of a compact sample holder, simple and easy to manufacture and handle. Results of the application of SPS to the characterization of MoO₃ thin films and semiconductor laser structures are presented to validate the performance of the setup, highlighting the effectiveness of SPS for the characterization of semiconductor materials and devices.

Staphylococcus cohnii endocarditis in native valve

We present a first case of Staphylococcus cohnii endocarditis in an 80-year-old patient with a history of valve regurgitation. Endocarditis by this organism has not been reported previously. The patient declined treatment and died a few days later. When present, S. cohnii endocarditis has a poor prognosis as a result of associated comorbidities and the infection itself.

Urban versus Rural Prevalence of Intestinal Parasites Using Multi-Parallel qPCR in Colombia

Stool samples from 122 children living in an urban slum (n = 72) and rural (n = 50) areas were analyzed using multi-parallel real-time quantitative PCR to determine intestinal prevalence parasites from two communities in Colombia. Findings indicated a prevalence of 86.1% Blastocystis spp., 62.5% Giardia intestinalis, 19.4% Cryptosporidium spp., 19.4% Ascaris lumbricoides, and 5.6% Trichuris trichiura in an urban slum; and 76% Blastocystis spp., 68% G. intestinalis, 20% Entamoeba histolytica, 50% A. lumbricoides, 46% T. trichiura, and 2% Strongyloides stercoralis in rural areas. Polyparasitism was higher in rural (58%) than urban (25%) areas (P = 0.001). Trichuris trichiura burden was higher in the rural area (P = 0.002). Over 40% of helminthic infections in rural areas had a heavy parasite burden by WHO classification. Over half of urban and rural children were infected with G. intestinalis and Blastocystis spp. Our data provide accurate epidemiologic surveillance for public health interventions.

Maternal Mortality in Paraguay tendencies and risk factors: 2004-2015

Background

Maternal mortality remains a serious challenge worldwide, it being part of the Sustainable Development Goals. Progress is tracked through maternal mortality ratios (MMR), which demonstrate the current development of a health system. Our study describes tendencies and factors involved in the MMR in Paraguay, South America.

Methods

A retrospective cross-sectional study was undertaken. Data were extracted from the national system of vital statistics published by the Ministry of Public Health and Social Welfare. MMR was expressed as the number of maternal deaths per 100,000 live births. The causes of maternal deaths were classified according to the CIE-10. The tendency and fluctuations of the variables were analyzed through Pearson and Spearman correlations. A significance level of 5% was established.

Results

During the period of 2004-2015 in Paraguay there was a significant reduction in the tendency of the number of maternal deaths (r= -0.895; p &lt; 0.001) with a decrease of 37.1%; Accordingly, there is a decreased tendency of the MMR (r= -0.929; p &lt; 0.001) with a reduction of 45.4% and an annual mean decrease of 3.95%. It was observed that women aged 40 years and older and women characterized as single possessed a higher MMR, with each group showing 317.7/100 000 and 377.5/100 000, respectively. The 75% of death causes were Postpartum Hemorrhage, Eclampsia, Concurrent maternal deaths, Abortion and Puerperal Sepsis.

Conclusions

Our study showed significant decreased tendency of MMR, although remaining high compared to high income countries. More studies to support this result are recommended due to the difference with international estimates. The main causes of death showed the need to strengthen prenatal follow-up in primary care far from high-complexity hospitals.

Key messages

Our study describes the situation on Maternal Mortality in a developing country, showing the importance of health care access and prenatal follow up for preventable complications. Our work showed the urgent need for more studies about abortion prevalence and also to determine the cause of higher MMR on single women in our country.

THU0305 PREVALENCE AND CLINICAL OUTCOME OF INTERSTITIAL LUNG DISEASE IN ANCA ASSOCIATED VASCULITIS

Background:

Lung involvement is frequent in ANCA-associated vasculitis (AAV). Classical lung manifestations consist of capillaritis with lung haemorrhage, inflammatory infiltrates and nodules. Interstitial lung disease (ILD) is increasingly recognized among patients with AAV. However, little is known concerning risk factors and clinical course of these patients.

Objectives:

The aim of our study was to characterize the prevalence and clinical course of ILD in patients with AAV.

Methods:

We have performed a clinical retrospective single-centre observational analysis (1990-2019) of all patients with the diagnosis of microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA) diagnosed according to 2018 Draft Classification Criteria for GPA and MPA1. Demographic, clinical and immunologic data were reviewed. Radiologic pattern of ILD were assessed by high-resolution-CT. Main outcome evaluated was overall-all survival.

Results:

The study population consisted of 123 patients, 56% female, aged 59.3±18.2 years old at the time of diagnosis. Clinical diagnosis was of MPA in 54% of patients and GPA in 46%. While 108 (88%) ANCA positive patients had PR3 (n=25) or MPO (n=83), 15 (12%) patients had negative or atypical ANCA. Any lung involvement was present in 82 (71%) and ILD was identified in 24 (20%) of all patients. ILD pattern was of usual interstitial pneumonia (UIP) in 12 patients, non-specified interstitial pneumonia (NSIP) in 9 and chronic organizing pneumonia (OP) in 3. There was an association between the presence of ILD and ANCA specificity: MPO were present in 100% of patients with UIP and in 75% of patients with NSIP/OP (p=0.017). Bronchiectasis were more prevalent among patients with ILD (19/24; p<0.001). During the median follow-up time period of 68 (23-126) months, mortality was of 42% among patients with ILD-AAV compared with 11% in no ILD-AAV (log-rank p=0.0001). On the multivariate Cox regression model, ILD was an independent predictor of mortality HR 2.95 (95%CI 1.09-7.96; p=0.033).

Conclusion:

ILD is a frequent manifestation of MPA and GPA patients. The presence of ILD, particularly UIP, is associated with ANCA-MPO and is a predictor of mortality. Therefore, a better management of fibrotic lung involvement in AAV is warranted.

References:

[1]Robson JC, Grayson PC, Ponte C, et al. Draft classification criteria for the ANCA associated vasculitides. Ann Rheum Dis 2018;77 (suppl 2):60-1.

Disclosure of Interests:

João Fernandes Serodio: None declared, José Hernández-Rodríguez: None declared, Georgina Espígol-Frigolé: None declared, Marco Alba: None declared, Javier Marco-Hernández: None declared, Marcelo Sánchez: None declared, Fernanda Hernández-González: None declared, Jacobo Sellarés: None declared, Maria C. Cid Grant/research support from: Kiniksa Pharmaceuticals, Consultant of: Janssen, Abbvie, Roche, GSK, Speakers bureau: Vifor, Sergio Prieto-González: None declared

Analysis of minimally invasive sacrocolpopexy with 24-hour hospital stay for the treatment of pelvic organ prolapse

OBJECTIVES

The objective of this study is to analyze the impact (in terms of safety and saving of hospital costs) of the implementation of a new protocol for the correction of pelvic organ prolapse (POP) by minimally invasive sacrocolpopexy (MISC) with 24-hour hospital stay.

MATERIAL AND METHODS

Prospective observational study of the first 78 MISC procedures performed consecutively. 46 procedures (59%) were performed with 24-hour hospital stay, and 32 (41%) required more than 24hours. The postoperative complications were determined for each group: visits to the Emergency Department, reoperations, and the average cost per procedure regarding hospital stay and ER visits. The cost model was established according to the data of the Analytical Accounting System of the Jiménez Díaz Foundation Hospital and of the Official State Gazette of Madrid.

RESULTS

There were no differences regarding intraoperative or postoperative complications between both groups. The number of visits to the Emergency Department, reinterventions or hospital re-admissions was lower in the 24-hour hospital stay group, without reaching statistical significance. The implementation of the MISC protocol with 24-hour hospital stay represented a saving of 607.91€ per procedure in hospital costs.

CONCLUSIONS

Correction of the POP with MISC with a 24-hour hospital discharge policy was feasible and safe in at least 59% of the patients, with similar complications, visits to the Emergency Department or hospital readmission rates.

Optical and electrical properties of MoO2 and MoO3 thin films prepared from the chemically driven isothermal close space vapor transport technique

Chemically-driven isothermal close space vapour transport was used to prepare pure MoO₂ thin films which were eventually converted to MoO₃ by annealing in air. According to temperature-dependent Raman measurements, the MoO₂/MoO₃ phase transformation was found to occur in the 225 °C-350 °C range while no other phases were detected during the transition. A clear change in composition as well as noticeable modifications of the band gap and the absorption coefficient confirmed the conversion from MoO₂ to MoO₃. An extensive characterization of these two pure phases was carried out. In particular, a procedure was developed to determine the dispersion relation of the refractive index of MoO₂ from the shift of the interference fringes of the used SiO₂/Si substrate. The obtained data of the refractive index was corrected taking into account the porosity of the samples calculated from elastic backscattering spectrometry. The Debye temperature and the residual resistivity were extracted from the electrical resistivity temperature dependence using the Bloch-Grüneisen equation. MoO₃ converted samples presented a very high resistivity and a typical semiconducting behavior. They also showed intense and broad luminescence spectra composed by several contributions whose temperature behavior was examined. Furthermore, surface photovoltage spectra were taken and their relation with the photoluminescence is discussed.

Predictive capacity of prodromal symptoms in first-episode psychosis of recent onset

BACKGROUND

Both the nature and number of a wide range of prodromal symptoms have been related to the severity and type of psychopathology in the psychotic phase. However, at present there is an incomplete picture focused mainly on the positive pre-psychotic dimension.

AIM

To characterize the prodromal phase retrospectively, examining the number and nature of prodromal symptoms as well as their relationship with psychopathology at the onset of first-episode psychosis.

METHODS

Retrospective study of 79 patients experiencing a first-episode psychosis of less than 1 year from the onset of full-blown psychosis. All patients were evaluated with a comprehensive battery of instruments including socio-demographic and clinical questionnaire, IRAOS interview, PANSS, stressful life events scale (PERI) and WAIS/WISC (vocabulary subtest). Bivariate associations and multiple regression analysis were performed.

RESULTS

Regression models revealed that several prodromal dimensions of IRAOS (delusions, affect, language, behaviour and non-hallucinatory disturbances of perception) predicted the onset of psychosis, with positive (22.4% of the variance) and disorganized (25.6% of the variance) dimensions being the most widely explained.

CONCLUSION

In addition to attenuated positive symptoms, other symptoms such as affective, behavioural and language disturbances should also be considered in the definitions criteria of at-high-risk people.

Deterioration of nutritional status of patients with locally advanced cervical cancer during treatment with concomitant chemoradiotherapy

BACKGROUND

In Mexico, 80% women with cervical cancer are diagnosed at locally advanced stages and are treated with concomitant chemoradiotherapy. The treatment modality and catabolic state confer a nutritional risk. The present study aimed to thoroughly evaluate the nutritional status and change in body composition of locally advanced cervical cancer (LACC) patients throughout treatment.

METHODS

An observational prospective study, carried out at the Mexican National Cancer Institute, included 55 LACC patients. Nutritional status was evaluated before, during and after treatment, using anthropometric, dietary and biochemical measurements. Body composition was analysed using computed tomography images obtained at the time of diagnosis and approximately 4 months after treatment completion. Clinical outcomes were associated with changes in body composition.

RESULTS

At the time of diagnosis, no patients were clinically malnourished, although 33.3% presented sarcopenia and most were overweight; by the end of treatment, 69% became clinically malnourished and 58% were sarcopenic. Average weight loss was 7.4 kg (P = 0.001). Adequacy of energy intake was reduced to 54%, obtained predominantly from carbohydrates. By the week 9, 62.8% patients became anemic and 34.5% had low albumin levels. Body composition analysis revealed that patients lost both, muscle and adipose tissues, although 27% patients were muscle depleted by the end of treatment. Patients who lost ≥10% skeletal muscle presented a higher tumour recurrence (hazard ratio = 2.957, P = 0.006) and a tendency towards diminished overall survival (hazard ratio = 2.572, not significant).

CONCLUSIONS

The nutritional status of cervical cancer patients deteriorates during treatment with concomitant chemoradiotherapy and, most importantly, muscle loss impacts the clinical outcome of patients.

Impact of pretransplant CMV-specific T-cell immune response in the control of CMV infection after solid organ transplantation: a prospective cohort study

INTRODUCTION

Although solid organ transplant (SOT) recipients with pretransplant serology for cytomegalovirus (CMV-R+) are considered at intermediate risk for CMV infection post transplantation, CMV infection remains a major cause of morbidity in this population. We prospectively characterized whether having pretransplant CMV-specific cellular immunity is independently associated with controlling infection after transplantation in R + SOT recipients.

METHODS

A prospective cohort of consecutive R + SOT recipients that received pre-emptive treatment for CMV infection was monitored after transplantation and variables were recorded during the follow-up. The cytomegalovirus-specific T-cell immune response was characterized by intracellular cytokine staining and viral loads determined using real-time PCR.

RESULTS

One hundred and thirty-five R + SOT recipients were included (67 kidney, 64 liver, four liver-kidney). Only one-third of the patients (42; 31.85%) had CMV-specific T-cell immunity (CD8⁺CD69⁺INF-γ⁺ T cells >0.25%) before transplantation. Patients with negative pretransplant immunity had more CMV infection (49, 52.7% vs. 15, 35.7%; p 0.07) and received more antiviral therapy than those with immunity (32, 34.4% vs. 6, 14.3%, p 0.016). Having CMV specific immunity was an independent factor for protection from developing viraemia ≥2000 IU/mL (OR 0.276, 95% CI 0.105-0.725, p < 0.01) and lower administration of treatment (OR 0.398, 95% CI 0.175-0.905, p 0.028). Only patients with no pretransplant CMV-specific T-cell response were diagnosed with CMV-disease (8, 8.6% vs. 0, 0%, p 0.05).

DISCUSSION

Our results show that having a pretransplant CMV specific T-cell response may be associated with a lower rate of CMV viraemia and less antiviral treatment after transplantation; however, more prospective studies are needed to confirm these findings.

Simvastatin interferes with cancer 'stem-cell' plasticity reducing metastasis in ovarian cancer

Cell plasticity of 'stem-like' cancer-initiating cells (CICs) is a hallmark of cancer, allowing metastasis and cancer progression. Here, we studied whether simvastatin, a lipophilic statin, could impair the metastatic potential of CICs in high-grade serous ovarian cancer (HGS-ovC), the most lethal among the gynecologic malignancies. qPCR, immunoblotting and immunohistochemistry were used to assess simvastatin effects on proteins involved in stemness and epithelial-mesenchymal cell plasticity (EMT). Its effects on tumor growth and metastasis were evaluated using different models (e.g., spheroid formation and migration assays, matrigel invasion assays, 3D-mesomimetic models and cancer xenografts). We explored also the clinical benefit of statins by comparing survival outcomes among statin users vs non-users. Herein, we demonstrated that simvastatin modifies the stemness and EMT marker expression patterns (both in mRNA and protein levels) and severely impairs the spheroid assembly of CICs. Consequently, CICs become less metastatic in 3D-mesomimetic models and show fewer ascites/tumor burden in HGS-ovC xenografts. The principal mechanism behind statin-mediated effects involves the inactivation of the Hippo/YAP/RhoA pathway in a mevalonate synthesis-dependent manner. From a clinical perspective, statin users seem to experience better survival and quality of life when compared with non-users. Considering the high cost and the low response rates obtained with many of the current therapies, the use of orally or intraperitoneally administered simvastatin offers a cost/effective and safe alternative to treat and potentially prevent recurrent HGS-ovCs.

Cost-effectiveness analysis of imaging strategy for an intensive follow-up of patients with American Joint Committee on Cancer stage IIB, IIC and III malignant melanoma

BACKGROUND

Many follow-up guidelines for patients with high-risk melanoma include expensive imaging studies, serum biomarkers and regular visits to the dermatologist, with little attention to cost-effectiveness.

OBJECTIVES

To establish the cost-effectiveness of chest-abdomen-pelvis computed tomography (CT) and brain magnetic resonance imaging (MRI) in a follow-up protocol for patients at high risk of relapse.

METHODS

This was a prospective single-centre cohort study of 290 patients with clinicopathological American Joint Committee on Cancer (AJCC) stage IIB, IIC and III melanoma. Patients had a body CT scan and brain MRI every 6 months and were withdrawn from the study after completing a 5-year follow-up or when metastases were detected. A cost-effectiveness analysis for each follow-up radiological procedure was performed.

RESULTS

Patients underwent 1805 body CT scans and 1683 brain MRIs. Seventy-six metastases (26·2%) were identified by CT or MRI. CT scan was cost-effective in the first 4 years (cost-effectiveness ratio €4710·70-€14 437·10/patient with metastasis); brain MRI was cost-effective during the first year (cost-effectiveness ratio €14 090·60/patient with metastasis). Limitations included lack of survival analysis and comparisons with willingness-to-pay thresholds.

CONCLUSIONS

Six-monthly CT scan of the chest, abdomen and pelvis is a cost-effective technique for the early detection of metastases in the first 4 years of follow-up in patients with AJCC stage IIC and III melanoma, and in the first 3 years in patients with AJCC stage IIB melanoma. In addition, brain MRI has been shown to be cost-effective only in the first year of follow-up in patients with AJCC stage IIC and III melanoma.

Spirocercosis in red fox (Vulpes vulpes) in a natural reserve located in a meso-Mediterranean area

Spirocerca lupi Rudolphi 1809 (Nematoda Spirocercidae) has an indirect cycle involving intermediate and paratenic hosts, having domestic or wild canids as the main definitive hosts. The most frequent pathology affecting dogs is a granulomatous tumor-like growth containing adults in the oesophagus and aorta. There are very few references about the presence of nodules in the stomach. There is scant information about the epidemiology of this disease in wild red foxes in meso-Mediterranean areas. In this work we report on the natural infection of wild red foxes by Spirocerca lupi and the damage produced in the stomach wall in an area where contact with other potential definitive hosts (canids) is very rare. From July 2015 to November 2016, 61 red foxes were sampled. 18.03% of the stomach walls examined had nodules containing Spirocerca lupi adults and eggs. The prevalence of infection was similar for young and adult groups (23.81 and 18.18%; χ2 = 0.25; df = 1; P = 0.6171) and it was higher in females than in males (25.81 versus 10.00%, χ² = 2.58; df = 1; P = 0.1082). The red fox population in the area seems to be well established judging from their age distribution and the fact that they could be captured all year round. It would appear that in the absence of other main definitive host S. lupi population is able to survive just parasitizing red foxes. Pathologic effects of this parasite on red foxes seems to show some differences related to domestic dogs. These results also indicates as predator control programs can maintain suitable host populations with reduced level of infection.

Clinical Significance of Cathepsin D Concentration in Tumor Cytosol of Primary Breast Cancer

Background

Cathepsin D is the proteolytic enzyme most frequently implicated as a prognostic factor in primary breast cancer. In the present study we evaluated by means of an immunoradiometric assay the tumor content of this protease in primary breast cancer, its relationship with tumor-related clinical and pathological parameters, and its prognostic significance in a large series of breast cancer patients.

Method

The study comprised 1033 women with histologically established invasive breast cancer. Cathepsin D was measured in cytosol samples by means of an immunoradiometric assay to determine the total amount of cathepsin D (52 kDa, 48 kDa and 34 kDa). Evaluation of relapse-free survival and cause-specific survival was performed in the group of 1003 patients without evidence of metastasis at the time of initial diagnosis. The median follow-up of the patients who were free of recurrence was 54 months.

Results

Cathepsin D levels showed a wide range among the studied tumors (n=1033; median (range) 41 (0.9–2504) pmol/mg protein). Statistical analysis showed that the median cathepsin D levels were considerably higher in large tumors (T2–4) than in smaller ones (T1) (p=0.017), as well as in node-positive than in node-negative tumors (p=0.004). Cathepsin D levels were also higher in ductal tumors than in the other histological types (p=0.001), as well as in moderately or poorly differentiated tumors (p<0.001). Likewise, the median value of the protease was significantly higher in ER or PgR-positive tumors than in hormone receptor-negative ones (p=0.011 and p=0.004, respectively), as well as in aneuploid tumors than in diploid tumors (p=0.029). Multivariate analysis demonstrated that elevated cathepsin D levels (>59 pmol/mg protein) were notably associated with a shorter cause-specific survival in the whole group of patients with breast cancer, as well as in the subgroup of node-positive patients (p<0.05).

Conclusions

This study suggests that elevated intratumoral cathepsin D levels may identify a subset of node-positive breast cancer patients showing a high probability of earlier death.

Erratum: Optoacoustic response of gold nanorods in soft phantoms using high-power diode laser assemblies at 870 and 905 nm: erratum

[This corrects the article on p. 1430 in vol. 8, PMID: 28663839.].

Incidence and evolution of sepsis-induced cardiomyopathy in a cohort of patients with sepsis and septic shock

OBJETIVE

The aim of this study was to establish the incidence of septic cardiomyopathy (SM) in patients with sepsis and septic shock, to describe its characteristics and testing its evolution.

DESIGN

Prospective cohort study.

PARTICIPANTS

We included 57 consecutive patients admitted to Intensive Care Unit, who met criteria of sepsis and septic shock.

PRINCIPAL VARIABLES OF INTEREST

Clinical and biochemical variables were analyzed. An echocardiogram was performed in the first 24hours of admission, determining myocardial function parameters, and if the patients had left ventricular ejection fraction (LVEF)<50%) a second echocardiogram was performed.

AMBIT

Intensive medical and surgical Care Service for Adults in University Hospital.

RESULTS

The mean age of the patients was 62,1±16,3 years. 58% were males. 22.8% had left ventricular dysfunction. The mean LVEF in patients with MS was lower than those without SM (34.1±10.6 vs 60.7±6.94%, P<.001), with complete recovery, in survivors, after the acute event (LVEF at discharge 56.1±6.3%, P=.04). Patients with SM had higher levels of procalcitonin (47.1±35.4 vs 18.9±24.5; P=.02) and higher score on the Sequential Organ Failure Assessment (SOFA score) (9.91±3.82 vs 7.47±3.41; P=.037). Mortality was not significantly different between both groups [4 (30.8%) vs 4 (9.1%); P=.07].

CONCLUSIONS

SM is not uncommon and is related to a higher scores on the severity scales. In the survivors, LVEF normalized after the recovery of the acute event.

Rotura espontánea del aparato extensor secundaria a artrosis de la articulación radiocubital distal

Objetivo: Presentar los resultados funcionales de pacientes no reumáticos, intervenidos por roturas del aparato extensor con artrosis de la articulación radiocubital distal. Valorar la influencia de la varianza y la luxación dorsal del cúbito en estos pacientes.

Material y método: Estudio retrospectivo de los casos de rotura atraumática del aparato extensor a nivel de la articulación radio-cubital distal intervenidos en el periodo 2002-2012. Se recogen variables sociodemográficas, estudio radiológico centrado en análisis de factores desencadenantes: artropatía, morfología de la articulación, presencia de subluxación de la cabeza cubital y varianza cubital. Se descarta la enfermedad reumática mediante estudio analítico. Se detalla la técnica quirúrgica realizada según la presencia de factores desencadenantes y el número de tendones afectos. Se valora el resultado funcional por medio de la escala TAM, Quick-DASH y el dolor según la escala EVA.

Resultados: Se identifican 8 casos de rotura espontánea del aparato extensor por artrosis en la articulación radio-cubital distal. Media de edad 73 años (66-81). Seguimiento medio 5 años (212). En 7 casos se observa afectación tendinosa múltiple, principalmente los encargados de los dedos medio, anular y meñique. En el estudio radiológico destaca la presencia de una varianza cubital minus en 3 casos. Resultado funcional según escala TAM: bueno en 5 casos y regular en 3 casos. EVA media de 2. Quick-DASH 21.7.

Conclusiones: Los pacientes presentan a medio-largo plazo un resultado funcional aceptable utilizando la escala TAM y el cuestionario Quick-DASH, con un dolor residual leve según la escala EVA. Todos los pacientes mantienen o mejoran su TAM comparados con su exploración preoperatoria, obteniendo un resultado bueno en el 62.5% de los casos. No es necesaria la presencia de una varianza plus o subluxación de la cabeza para desencadenar la rotura puesto que se observan 3 casos con varianza minus y sin subluxación.