Recommendations for the prevention of healthcare-associated infections in nursing homes

Nursing homes (NH) conceptually should look as much like a home as possible. However NH have unquestionable similarities with a nosocomium as they are places where many patients with underlying diseases and comorbidities accumulate. There is evidence of transmission of microorganisms between residents and between residents and caregivers. We have not found any recommendations specifically aimed at the prevention of nosocomial infections in NH by the major Public Health Agencies and, therefore, the Health Sciences Foundation (Fundación de Ciencias de la Salud) has convened a series of experts and 14 Spanish scientific societies to discuss recommendations that could guide NH personnel in establishing written programs for the control and reduction of these infections. The present document is the result of these deliberations and contains suggestions for establishing such control programs on a voluntary and flexible basis in NH. We also hope that the document can help the health authorities to encourage this control activity in the different territorial areas of Spain. In our opinion, it is necessary to draw up a written plan and establish the figure of a coordinator or person responsible for implementing these projects. The document includes measures to be implemented and ways of quantifying the reality of different problems and of monitoring the impact of the measures established.

3D printing of PLA:CaP:GO scaffolds for bone tissue applications

Graphene oxide (GO) has attracted increasing interest for biomedical applications owing to its outstanding properties such as high specific surface area, ability to bind functional molecules for therapeutic purposes and solubility, together with mechanical resistance and good thermal conductivity. The combination of GO with other biomaterials, such as calcium phosphate (CaP) and biodegradable polymers, presents a promising strategy for bone tissue engineering. Presently, the development of these advanced biomaterials benefits from the use of additive manufacturing techniques, such as 3D printing. In this study, we develop a 3D printed PLA:CaP:GO scaffold for bone tissue engineering. First, GO was characterised alone by XPS to determine its main bond contributions and C : O ratio. Secondly, we determined the GO dose which ensures the absence of toxicity, directly exposed in vitro (human osteoblast-like cells MG-63) and in vivo (zebrafish model). In addition, GO was microinjected in the zebrafish to evaluate its effect on immune cells, quantifying the genetic expression of the main markers. Results indicated that the GO tested (C : O of 2.14, 49.50% oxidised, main bonds: C-OH, C-O-C) in a dose ≤0.25 mg mL^-1 promoted MG63 cells viability percentages above 70%, and in a dose ≤0.10 mg mL^-1 resulted in the absence of toxicity in zebrafish embryos. The immune response evaluation reinforced this result. Finally, the optimised GO dose (0.10 mg mL^-1) was combined with polylactic acid (PLA) and CaP to obtain a 3D printed PLA:CaP:GO scaffold. Physicochemical characterisation (SEM/EDS, XRD, FT-Raman, nano-indentation) was performed and in vivo tests confirmed its biocompatibility, enabling a novel approach for bone tissue-related applications.

A-18 MRI-based Post-Concussive Syndrome (PCS) Index: No Differences between Athletes and Non-Athletes

Purpose: To evaluate for differences in patients with post-concussive syndrome from sports-related versus non-sports related mTBI using a machine-learning algorithm of MRI data. Methods: For this retrospective study, we explored the MRI records of 28 Athletes (17 M, 11F) and 16 non-Athletes (6 M, 10F) with a history of concussion and clinical PCS, and 73 no concussed reference controls (26 M,47F). All subjects were between 19 and 35-years in age. The MRI studies were done in a clinical 3 T MRI scanner. MPRAGE, DTI-FA and DTI-ADC images were used to extract radiomics features from automatically segmented MRI structures of the brain. After that, the radiomic features were processed to extract the MRI-PCS Index (Qmetrics Technologies, Rochester, NY). MRI-PCS Index is an Artificial-Intelligence (AI) derived holistic evaluation of brain health that ranges from 0.0 to 1.0. The index indicates the degree of signal/structural abnormalities found in the brain tissue of a concussed subject when compared to a non-concussed subject; hence it provides an objective measurement of PCS. Results: The sports played by the athletes were mainly football, hockey, lacrosse, and soccer while non-Athletes were mainly concussed in motor vehicle accidents. Athletes MRI-PCS Index was similar to non-Athletes (0.78 vs 0.78, p = 0.89) and both indexes were very different to the reference control (MRI-PCS Index = 0.23, IQR = 0.10–0.38, p < 0.001). Conclusions: The MRI-PCS Index, an objective measurement of structural brain health, indicated that subjects that suffer from PCS present similar MRI abnormality burden regardless of whether the mTBI was related to sports injuries or other trauma.

Monitoring of RAS mutant clones in plasma of patients with RAS mutant metastatic colorectal cancer

Purpose

Some patients with histologically confirmed primary mCRC and mutated RAS reported undetectable RAS mutant clones in plasma after receiving anti-VEGF treatment. The aim was to prospectively assess it with its potential therapeutic implications.

Methods

RAS mutant genes in solid biopsy (before first-line treatment: FOLFOX/CAPOX + bevacizumab) were compared in liquid biopsy (before second-line treatment: panitumumab + FOLFIRI), using Idylla™ system. Discordant results between solid/liquid biopsies were assessed by the next-generation sequencing (NGS) test (solid/liquid biopsies).

Results

Twenty-three patients were assessed (seven had RAS mutant discrepancies between solid/liquid biopsies). The NGS test confirmed that 3/23 (13%) patients had undetectable RAS mutant clones in liquid biopsy and 3/23 (13%) presented discrepancies in solid biopsy (Idylla™ system vs. NGS test).

Conclusion

Thirteen percentage of patients had undetectable RAS mutant clones in liquid biopsy after first-line treatment. However, some discrepancies between solid and liquid biopsies have been observed. These results suggest a need to improve accuracy of RAS analyses, especially in solid biopsies.

Immune treatment in COVID-19

Current immune treatment directed to avoid viral replication relies mainly in convalescent plasma and monoclonal antibodies (mAbs). No clinical benefit for convalescent plasma has been reported in a meta-analysis and systematic review compared to standard of care. MAbs are recombinant proteins capable to bind with SARS-CoV-2 preventing its entrance into cells. Several mAbs have shown reduction in viral load and/ or progression of the disease such as casirivimab-imdevimab, bamlanivimab-etesevimab and sotrovimab. After the apparition of Omicron variant, it has been reported that sotrovimab retained its activity whereas the other two combinations exhibited loss of neutralizing activity. Several aspects as the target population, timing and doses, serological patient status and evolution of variants still require attention, monitorization and further studies for knowledge gaps.

SUPERIOR GLUTEAL ARTERY PSEUDOANEURYSM: TWO CASES REPORT AND REVIEW OF THE LITERATURE

INTRODUCTION

Gluteal pseudoaneurysms are extremely rare and respond to pelvic trauma, penetrating wounds, inflammation or infection in the gluteal region.

CLINICAL CASES

Two men, 73 and 82 years respectively, who presented gluteal pseudoanerysm after drainage of perianal abscess the first one and after trauma the second one. In both cases the diagnosis was made by imaging tests (doppler ultrasound that was completed with computed tomographic angiography). The first one was successfully treated by ultrasound-guided injection of thrombin at the pseudoaneurysm sac. However, secondary treatment with thrombin injection and coil embolization was performed due to pseudoaneurysm reperfusion. The second one was successfully treated by embolization with hydrocoils through contralateral percutaneous femoral access as well as thrombin injection by direct ultrasound-guided puncture.

DISCUSSION

The incidence, presentation and surgical strategy are discussed. Current literature is also reviewed.

CONCLUSION

Ultrasound scan is the first diagnostic test, computed tomographic angiography can give more topographic information. We found selective percutaneous embolization to be the treatment of choice. Open surgical treatment should be reserved for selected cases.

P–492 Knowledge about reproductive health among cohort of oocyte donors in Spain

Study question

What degree of reproductive health knowledge have oocyte donors?

Summary answer

The results of this study reveal that although oocyte donors are aware of the risks of possible fertility disorders, reproductive health knowledge is insufficient

What is known already

Sterility affects approximately 15% of the population of reproductive age, that is, young people. However, the information that young people have about fertility is scarce. Gamete donors are a group especially involved in reproductive issues since they help many people to solve their fertility problems and must undergo numerous tests before being accepted as such. However, there are no studies in Spain that deal with the knowledge that young people and, more specifically, donors, have about reproductive health and fertility

Study design, size, duration

A prospective, cross-sectional multicenter study including oocyte donors at ten fertility clinics performing gamete donation treatment in Spain. During a 2-month period (September-October 2020), 63 donors aged between 19 and 35 years old were recruited consecutively and a total of 63 oocyte donors were included as sample population. Most of them (78%) had not donated before

Participants/materials, setting, methods

54% oocyte donors had secondary education and 43% have achieved university studies. Participants anonymously completed a questionnaire containing 41 questions divided into three sections: sociodemographic characteristics (11 items), knowledge on fertility and reproduction (22 items) and with a Likert scale, response to determine general reproductive health information as well as known risks for fertility disorders (8 items).

Besides descriptive statistics, statistical analysis was performed with Chi square test. p < 0.05 was considered significant

Main results and the role of chance

In the survey 96.8% of the participants reported that they had already known the tests for fertility disorders.

The increasing age of the women was correctly assessed by the participants of the study as a decisive risk factor for fertility, but it was found that exact knowledge was lacking: the decrease of a woman’s fertility by 39.7% was stated to occur on average at the age of 35–40 and by 30% at 40–45. Nevertheless, 66% of donors considered that fertility preservation should be carried out before the age of 35.

61.1% of the non-university donors reported that fertility can drop as a woman ages due to the decreasing number and quality of the remaining eggs. Among university donors, this percentage increases to 92,6% (p:0,034). Merely 47% of the participants informed what they understood that ovarian reserve is and 47.6% of donors believed that women create new eggs every month.

Regarding the known risk factors for fertility, lifestyle was mentioned most frequently by all participants (91,2%), followed by chemo/radiotherapy (83,8%) and smoking, alcohol, and drugs (82,4%). Concerning the influence of the body mass index on fertility, differences were found between non-university (61%) and university donors (88,9%) (p:0,012).

Limitations, reasons for caution

Financial compensation has been found to be a motivating factor for oocyte donors and therefore one could question the representativeness of the participating oocyte donors. It would be of great interest to explore the significance of the financial compensation further.

Wider implications of the findings: The present study reveals an existing requirement for information among oocyte donors, which is not only important for the success of prevention plans but also provides a foundation for possible strategies for the prevention of fertility disorder.

Trial registration number

Not applicable

P–488 Patients’ attitudes towards the anonymity of gamete donation in Spain

Study question

To what extent do infertility patients in Spain support different forms of anonymity for oocyte and sperm donation?

Summary answer

Most patients who undergo treatment with donated gametes in Spain consider that their children should not know the identity of the donors.

What is known already

Spain has a large tradition of gamete donation, probably influenced by its law that requires gamete donation to be anonymous for the donor and the recipient. Although there is a growing support for openness and identity-release in gamete donation, Spanish Society of Fertility has generated an Anonymity in Donations Framework Document which recommends revelation to the donor-conceived children their biological origin preserving the identity. However, there is no information on what the preferences of the patients are regarding the disclosure of the origins to their children.

Study design, size, duration

A prospective, cross-sectional multicenter study that includes all eleven clinics in Spain and involves women who had used donated gametes. From September to October 2020, a self-administered questionnaire was sent out to a total of 57 women which were asked to indicate their responses on a 7-point Likert. 57 (100%) women anonymously completed the questionnaire.

Participants/materials, setting, methods

The participants were asking for their socio-demographic characteristics, their opinions concerning secrecy or disclosure of the method of conception towards the child, what type of information should the child have access to – identifying or non-identifying – and whether they intend to inform their child and relatives about his/her origin. Statistical analysis was performed with Chi square test for dichotomous variables and one-sample T-Student for Likert items. p < 0.05 was considered significant.

Main results and the role of chance

Unlike homosexual or single women, 60% of heterosexual couples refuse to inform their offspring about the origin of their gametes and 47,5% would not tell anyone.

Patients do not want to know the identity of donors (0,276 p˂0,001) and they consider that knowledge about the origin of the gametes (0,278 p˂0,001) or the identity of the donor (0,178 p˂0,001) is not important to a child.

Patients do not believe that the donor has the right to know the identity of the offspring (0.098 p < 0.001) but they agree with his/her right to anonymity (0.679).

Limitations, reasons for caution

While the multicenter study design and the extraction of a complete time series from the population under study strengthens validity, the study is limited to women, without being able to extrapolate the results to men or children born by gamete donation, which constitutes a limitation.

Wider implications of the findings: The findings of this study can be used as a basis for further discussion between regulators and professionals with respect to anonymity related to donor conception. These opinions should be considered carefully in legal and ethical discussions on gamete donation.

Trial registration number

Not applicable

Accumulation of human pharmaceuticals and activity of biotransformation enzymes in fish from two areas of the lower Rio de la Plata Basin

The accumulation of four human pharmaceuticals active compounds (HPhAC) in the muscle of four fish species of the Rio de la Plata Basin were assessed regarding the compound logP and pKa, and fish trophic levels. For Prochilodus lineatus, accumulation was compared to hepatic biotransformation enzymes and fish from two sampling areas with different urbanization degree. Species were the detritivore Prochilodus lineatus, the omnivores Megaleporinus obtusidens and Pimelodus maculatus, and the piscivorous Salminus brasiliensis. Sampling areas were the Inner Rio de la Plata Estuary (RLP), in front of the Buenos Aires Metropolitan Area, and at the Lower Uruguay River (URU), a relatively unpopulated area. Carbamazepine, atenolol, enalapril, and sildenafil concentrations in fish muscle were analyzed by HPLC-MS. EROD, BROD, and GST activities were measured in P. lineatus liver. Average (maximum) concentrations and detection frequency were: Atenolol 24.4 (69.4) μg kg^-1, 60%; carbamazepine 5.5 (45.8) μg kg^-1, 19%; enalapril 7.0 (56.9) μg kg^-1, 28%; sildenafil 17.1 (71.6) μg kg^-1, 56%. Enalapril and sildenafil detection in fish was first-time reported. Atenolol and carbamazepine concentrations were positively correlated. No correlation was observed between HPhAC accumulation and logP or pKa. A potential biomagnification trend was observed for atenolol, showing higher accumulation in S. brasiliensis. HPhACs accumulation was higher for P. lineatus collected at URU, but GST and BROD were significantly higher for individuals sampled at RLP and were positively correlated. A significant negative correlation was observed for enalapril and BROD. The study contributes to the knowledge of the accumulation of HPhACs in fish.

Polarization-independent single-photon switch based on a fiber-optical Sagnac interferometer for quantum communication networks

An essential component of future quantum networks is an optical switch capable of dynamically routing single photons. Here we implement such a switch, based on a fiber-optical Sagnac interferometer design. The routing is implemented with a pair of fast electro-optical telecom phase modulators placed inside the Sagnac loop, such that each modulator acts on an orthogonal polarization component of the single photons, in order to yield polarization-independent capability that is crucial for several applications. We obtain an average extinction ratio of more than 19 dB between both outputs of the switch. Our experiment is built exclusively with commercial off-the-shelf components, thus allowing direct compatibility with current optical communication systems.

Invertebrados continentales de las Islas Columbretes. Nuevas especies

La fauna terrestre de invertebrados del archipiélago protegido de Columbretes es poco conocida. Además, los pocos estudios existentes se centran en su isla principal, Illa Grossa. Aquí presentamos el listado de especies de invertebrados no registradas, hasta el momento, en el archipiélago, resultados obtenidos mediante una combinación de capturas con trampas de caída, avistamientos y recolecciones aleatorias realizadas tanto en Illa Grossa como en otros tres islotes de este archipiélago. Mediante el primer método se recolectaron un total de 14.830 especímenes entre 2008-2011. La mayor cantidad de individuos recolectados mediante este método resultaron ser coleópteros tenebriónidos. Los otros dos métodos proporcionaron 514 registros para el período 2004-2013. En total, se han identificado 45 nuevos taxones correspondientes a 40 géneros y 16 familias. La mayoría de las nuevas especies encontradas no fueron frecuentes a lo largo del período de muestreo. Entre ellas, figuran especies típicas de hábitats antrópicos (p.e. Cydnus aterrimus o Gryllus bimaculatus). Sorprendentemente, también se localizaron en ocasiones especies con capacidades de dispersión limitadas y no presentes en islas pequeñas (p.e. Cebrio superbus).

Liquid Chromatographic Method for the Quantification of Zearalenone in Baby Food and Animal Feed: Interlaboratory Study

An interlaboratory trial for determination of zearalenone (ZON) in baby food and animal feed was conducted. The study involved 39 participants in 16 European Union member states, as well as Turkey, Uruguay, and China, representing a cross-section of industry, and official food control and research institutes. The method is based on immunoaffinity column cleanup followed by high-performance liquid chromatography using fluorimetry (HPLC-Fl). The test portion of the sample is extracted with methanolwater (75 + 25, v/v). The sample extract is filtered, diluted, and passed over an immunoaffinity column. ZON is eluted with methanol. The separation and determination of ZON is performed by reversed-phase HPLC-Fl with an excitation wavelength of 274 nm and an emission wavelength of 446 nm. Test portions of the samples were spiked at levels of 20 and 30 g/kg ZON in baby food and at levels of 100 and 150 g/kg ZON in animal feed. Mean recoveries from each participant ranged from 78 to 119 with an average value of 92 for baby food and from 51 to 122 with an average value of 74 for animal feed. Based on results for spiked samples (blind duplicates at 2 levels), as well as naturally contaminated samples (blind duplicates at 3 levels), the relative standard deviation for repeatability (RSDr) in baby food ranged from 2.8 to 9.0. For animal feed, this value ranged from 5.7 to 9.5. The relative standard deviation for reproducibility (RSDR) in baby food ranged from 8.2 to 13.3, and for animal feed this value ranged from 15.5 to 21.4. The Horwitz ratio (HorRat) in baby food ranged from 0.3 to 0.4, and for animal feed this value ranged from 0.6 to 0.9. The method showed acceptable within-and between-laboratory precision for each matrix, as required by European legislation.

IR irradiation to remove a sub-aerial biofilm from granitic stones using two different laser systems: An Nd: YAG (1064 nm) and an Er:YAG (2940 nm)

A sub-aerial biofilm (SAB) developed on a granite commonly found in the built cultural heritage of the NW Iberian Peninsula was extracted with 2 different IR irradiations using an Nd:YAG laser at 1064 nm and an Er:YAG laser at 2940 nm. The methodology was based on the application of only one scan in order to evaluate the effect of the laser cleaning operated by applying different consecutive laser scanning and the suitability of these lasers as quick tools. The aim of this comparative study was twofold. The first goal was to find the most satisfactory level of extraction by comparing the results obtained by the different laser sources (IR wavelengths). The other aim was to investigate the by-effects induced by both lasers on each granite-forming mineral. Evaluations were made using stereomicroscopy, Fourier transform infrared spectroscopy, Raman spectroscopy and scanning electron microscopy with energy-dispersive x-ray spectroscopy. The results were interpreted in terms of SAB extraction and damage induced on the granite. The results showed that the Nd:YAG laser achieved the most successful level of cleaning, because it extracted the most SAB, while causing the least amount of damage to the surfaces. Regardless of the fluence applied, the Er:YAG laser did not completely extract the SAB in only one scan; in addition, a more intense melting of biotite grains was found, producing amorphous fusion crusts and losing the distinction of the cleavage planes.

Tunable entanglement distillation of spatially correlated down-converted photons

We report on a new technique for entanglement distillation of the bipartite continuous variable state of spatially correlated photons generated in the spontaneous parametric down-conversion process (SPDC), where tunable non-Gaussian operations are implemented and the post-processed entanglement is certified in real-time using a single-photon sensitive electron multiplying CCD (EMCCD) camera. The local operations are performed using non-Gaussian filters modulated into a programmable spatial light modulator and, by using the EMCCD camera for actively recording the probability distributions of the twin-photons, one has fine control of the Schmidt number of the distilled state. We show that even simple non-Gaussian filters can be finely tuned to a ∼67% net gain of the initial entanglement generated in the SPDC process.

Evaluación de la eficacia de algunos fármacos para el tratamiento de la hepatozoonosis canina

La hepatozoonosis canina es una enfermedad parasitaria, adquirida por la ingestión de garrapatas infectadas con protozoarios del género Hepatozoon (H). Hepatozoon canis y Hepatozoon americanum son las dos especies que pueden infectar al perro. La presentación clínica de la infección con Hepatozoon canis es muy variable, pudiendo ser asintomática o manifestarse con signos de enfermedad leves a severos. Los exámenes hematológicos revelan ligera anemia no regenerativa, marcada leucocitosis neutrofílica con desvío a la izquierda y monocitosis en los casos de hepatozoonosis clínica. El diagnóstico se realiza mediante la visualización mediante el microscopio óptico de los gamontes en neutrófilos y monocitos en frotis de sangre coloreados. No existe, hasta el momento, un tratamiento eficaz para esta parasitosis. El fármaco más utilizado es el dipropionato de imidocarb, aunque con resultados variables. El objetivo de este trabajo fue evaluar tres opciones terapéuticas para la erradicación de Hepatozoon spp. de la sangre de perros infectados. Se utilizaron 18 perrosparasitados naturalmente y se evaluaron tres fármacos: dipropionato de imidocarb, toltrazuril y espiramicina. En todos los perros tratados disminuyó el promedio de infección, presentando similares valores medios de leucocitos infectados. El análisis estadístico arrojó una diferencia significativa solo en el tratamiento de la parasitosis con dipropionato de imidocarb. En virtud de los resultados obtenidos con los tratamientos llevados a cabo con los diferentes fármacos, se concluye que ninguno es totalmente efectivo para la desaparición del parásito de la sangre, siendo el dipropionato de imidocarb el de mejor comportamiento.

Ameliorative effect of black grape juice on systemic alterations and mandibular osteoradionecrosis induced by whole brain irradiation in rats

PURPOSE

Whole brain irradiation (WBI) causes a variety of secondary side-effects including anorexia and bone necrosis. We evaluated the radiomodifying effect of black grape juice (BGJ) on WBI alterations in rats measuring food and water intake, body weight, hemogram, and morphological and histological mandibular parameters.

MATERIALS AND METHODS

Forty male rats (200-250 g) were exposed to eight sessions of cranial X-ray irradiation. The total dose absorbed was 32 Gy delivered over 2 weeks. Four groups were defined: (i) NG: non-irradiated, glucose and fructose solution-supplemented (GFS); (ii) NJ: non-irradiated, BGJ-supplemented; (iii) RG: irradiated, GFS-supplemented; and (iv) RJ: irradiated, BGJ-supplemented. Rats received daily BGJ or GFS dosing by gavage starting 4 days before, continuing during, and ending 4 days after WBI.

RESULTS

RJ rats ingested more food and water and showed less body weight loss than RG rats during the irradiation period. Forty days after WBI, irradiated animals started losing weight again compared with controls as a consequence of masticatory hypofunction by mandibular osteoradionecrosis (ORN). Osteoclastic activity and inflammation were apparent in RG rat mandibles. BGJ was able to attenuate the severity of ORN as well as to improve white and red blood cell counts.

CONCLUSIONS

Fractionated whole brain irradiation induces mandibular changes that interfere with normal feeding. BGJ can be used to mitigate systemic side-effects of brain irradiation and ORN.

Tuberculosis in prisoners and their contacts in Chile: estimating incidence and latent infection

SETTING

Contact investigation of tuberculosis (TB) patients in Chilean prisons.

OBJECTIVE

1) To estimate TB incidence and the prevalence of latent tuberculous infection (LTBI) among prisoners and their contacts; and 2) to determine factors associated with disease transmission.

DESIGN

Cross-sectional study conducted in 46 prisons (51% of the total prison population) to assess the prevalence of and risk factors for LTBI among contacts of prisoners newly diagnosed with pulmonary TB. We used in vitro interferon-gamma release assays to establish LTBI and a questionnaire to address risk factors.

RESULTS

During the 1-year follow-up, we studied 418 contacts of 33 active TB cases. We found high TB incidence (123.9 per 100,000 prisoners) and high LTBI prevalence (29.4%) among contacts. LTBI rates are significantly higher in prison inmates than in non-prisoners (33.2% vs. 15.6%). Male sex, illicit drugs, malnutrition, corticosteroid use, low educational level and sharing a cell with a case increase the risk of LTBI. Multivariate analyses showed that corticosteroid use, duration of incarceration and overcrowding are the most relevant determinants for LTBI among all contacts.

CONCLUSIONS

Our results confirm that incarceration increases the risk of tuberculous infection and TB disease, and that it was associated not only with origin from vulnerable groups, but also with the prison environment. Reinforcing TB control is essential to prevent TB transmission in prisons.

Reduced work/academic performance and quality of life in patients with allergic rhinitis and impact of allergen immunotherapy

Background

Allergic rhinitis (AR) is characterised by burdensome nasal and/or ocular symptoms. This inflammatory disease can be debilitating and thus result in considerable health-related and economic consequences.

Methods

In a cross-sectional study, adult subjects with AR (N = 683) completed three allergy-specific questionnaires that assessed the impact of AR on the work/academic performance, daily activities, health-related quality of life (HRQOL), and satisfaction with allergen immunotherapy (AIT). Regression analyses were used to examine the associations between several clinical variables and the patient-reported outcomes.

Results

Total loss of productivity was 21.0 and 21.2 % for employed and student patients, respectively, whereas the impairment of daily activities was 22.0 %. The mean overall HRQOL score was 1.94 ± 1.29 (on the scale of 0–6 points). Global score for satisfaction with AIT was 65.5 ± 24.8 (on a 0–100 scale). Simple regression analysis found statistically significant associations between loss of work and academic productivity, impairment of daily activities and the type and severity of AR. AIT was a protective factor. The persistent and more severe types of AR and lack of AIT contributed to the worsening of HRQOL.

Conclusions

AR (the persistent and more severe form of the disease) has an impact on functional characteristics of adult patients in Spain. AIT might reduce the effect of this disease on the work/academic performance and HRQOL.

Trial registration Retrospectively registered

The improved biological response of shark tooth bioapatites in a comparative in vitro study with synthetic and bovine bone grafts

Autologous bone is considered to be the gold standard for bone tissue regeneration, providing more highly efficient functional responses compared to synthetic materials, and avoiding the rejection risks of allogenic grafts. However, it presents limitations for certain types of surgery due to its high resorption levels and donor site morbidity. Different biphasic synthetic composites, based onnon-apatitic calcium phosphates enriched with apatitic phases-such as hydroxyapatite, and bioderived bone grafts of bovine and porcine origin-are proposed as lower resorption materials due to their higher crystalline structure. The present work proposes two new sources of bioapatites for bone filler applications obtained from the dentine and enameloid of shark teeth, respectively. These bioapatites each present a characteristic apatite-based composition and additional enrichments of specific trace elements, such as magnesium and fluorine, with proven roles in bone metabolism. Their processing and physicochemical characterization (SEM, FT-Raman and XRD) is presented, together with an in vitro evaluation of osteogenic activity compared to a commercial bovine mineralized matrix and synthetic HA/β TCP grafts. The results proved the globular morphology (0.5-1.5 μm) and porosity (~50 μm and ~0.5-1 μm) of shark dentine bioapatites with biphasic composition: apatitic (hydroxyapatite and apatite-(CaF)), non-apatitic (whitlockite), and an apatitic phase (fluorapatite), organized in oriented crystals in enameloid bioapatites. An evaluation of the pre-osteoblast MC3T3-E1 morphology revealed the colonization of pores in dentine bioapatites and an aligned cell growth in the oriented enameloid crystals. A higher proliferation (p  <  0.01) was detected at up to 21 d in both the shark bioapatites and synthetic biphasic graft with respect to the bovine mineralized matrix. Finally, the great potential of porous biphasic dentine bioapatites enriched with Mg and the aligned fluorapatite crystals of enameloid bioapatites in promoting greater osteogenic activity was confirmed with a significantly increased ALP synthesis (p  <  0.01) compared to the commercial grafts.

Phase II study of first-line biweekly docetaxel and cisplatin combination chemotherapy in advanced gastric cancer

PURPOSE

Previous studies have shown that docetaxel and cisplatin, as single agents, are effective and relatively well tolerated in patients with advanced gastric cancer. The aim of this study was to assess efficacy and toxicity of a biweekly regimen of docetaxel plus cisplatin in patients with advanced gastric cancer.

PATIENTS/METHODS

Fifty-five patients with histologically proven advanced gastric cancer with at least 1 measurable lesion and ECOG PS ≤ 2 were enrolled. Patients received docetaxel 50 mg/m(2) and cisplatin 50 mg/m(2) every 2 weeks until progression disease, unbearable toxicity or a maximum of 12 cycles.

RESULTS

In total, 426 cycles were administered (median 8.5 cycles) to 52 evaluable patients. One patient (1.9 %) showed a complete response, while 21 (40.4 %) had partial responses. The objective response rate was 42.3 % (95 % CI 28.9-55.7), the median time to progression was 5.5 months (95 % CI 4.0-7.0), and the median overall survival was 8.9 months (95 % CI 6.0-11.9). The most common grade 3-4 toxicities per cycle were haematological [neutropenia (5.9 %)].

CONCLUSIONS

Biweekly administration of docetaxel and cisplatin in advanced gastric cancer has a manageable toxicity profile and shows a promising antitumour activity as a first-line therapy.

Experience with Guillain-Barré syndrome in a neurological Intensive Care Unit

INTRODUCTION

Guillain-Barré syndrome, an acute polyradiculoneuropathy that presents with weakness and areflexia, is the most common cause of acute flaccid paralysis. In certain patients, respiratory failure is secondary to this disorder, eventually causing patients to require mechanical ventilation and experience additional complications due to diminished respiratory support and related mobility limitations. Prognoses for most of these cases are positive; treatment consists of basic support combined with plasmapheresis or administration of immunoglobulins.

OBJECTIVE

This study sought to describe the socio-demographic, clinical, laboratory and neurophysiological characteristics of patients with Guillain-Barré syndrome who were hospitalised in the Intensive Care Unit of the Neurological Institute of Colombia between 2006 and 2012.

METHODOLOGY

This study presents a case series.

RESULTS

We surveyed 25 patients (32% female and 68% male) with Guillain-Barré syndrome and an average age of 54 years. Sixty per cent of these patients were admitted between days 3 and 7 after symptom onset; 64% had a history of respiratory infection and 20% had a history of intestinal infection. In addition, 84% of the patients presented with albuminocytological dissociation. We observed the following clinical subtypes of Guillain-Barré syndrome: inflammatory demyelinating polyneuropathy in 32%, acute motor-sensory axonal neuropathy in 28%, acute motor axonal neuropathy in 28%, and Miller Fisher syndrome in 12%.

CONCLUSIONS

In this descriptive study of a group of critical care patients with GBS, results depended on patients' clinical severity at time of admission. Our findings are similar to results published in the international literature.

Assessment of the water self-purification capacity on a river affected by organic pollution: application of chemometrics in spatial and temporal variations

Water pollution caused by organic matter is a major global problem which requires continuous evaluation. Multivariate statistical analysis was applied to assess spatial and temporal changes caused by natural and anthropogenic phenomena along Potrero de los Funes River. Cluster analysis (CA), principal component analysis (PCA) and analysis of variance (ANOVA) were applied to a data set collected throughout a period of 3 years (2010-2012), which monitored 22 physical, chemical and biological parameters. Content of dissolved oxygen in water and biochemical oxygen demand in a watercourse are indicators of pollution caused by organic matter. For this reason, the Streeter-Phelps model was used to evaluate the water self-purification capacity. Hierarchical cluster analysis grouped the sampling sites based on the similarity of water quality characteristics. PCA resulted in two latent factors explaining 75.2 and 17.6 % of the total variance in water quality data sets. Multidimensional ANOVA suggested that organic pollution is mainly due to domestic wastewater run-offs and anthropogenic influence as a consequence of increasing urbanization and tourist influx over the last years. Besides, Streeter-Phelps parameters showed a low reaeration capacity before dam with low concentration of dissolved oxygen. Furthermore, self-purification capacity loss was correlated with the decrease of the Benthic Index. This measurement suggested that biological samplings complement the physical-chemical analysis of water quality.

Key parameters in blood-surface interactions of 3D bioinspired ceramic materials

Direct contact of materials with blood components may trigger numerous processes which ultimately lead to hemolysis, clot formation and recruitment of inflammatory cells. In this study, the blood-surface interactions for two inert bioinspired ceramic scaffolds obtained from natural resources; biomorphic carbon and silicon carbides (bioSiC) from different origins have been studied. The response of the blood in contact with carbon is well known, however little has been identified on the influence of their 3D porous structure. Moreover, to our knowledge, there is no reference in the literature about the hemocompatibility of biomorphic silicon carbide as a porous scaffold. The experimental results showed the surface energy to be crucial to evaluate the hemocompatibility of a material however the surface topography and material porosity are also parameters to be considered. Surface roughness modifies clot formation whereas for protein adsorption total sample porosity seems to be the key parameter to be considered for hydrophilic materials (biomorphic silicon carbides), while the size of the pores determines the hemolytic response.

Purple grape juice as a protector against acute x-irradiation induced alterations on mobility, anxiety, and feeding behaviour in mice

The aim of this work was to test the hypothesis that a moderate intake of organic purple grape juice shows a positive radiomodifier effect over early behavioural damage following acute X-irradiation in mice. Anxiety-, locomotion-, and feeding-related responses to 6 Gy total body X-irradiation (TBI) were studied via open field, Rotarod, and feeding/drinking recording. Thirty-two male mice weighing 25-30 g were grouped according grape juice (J) or water (W) ad libitum drinking and either non-irradiated (N) or irradiated (R). 24 h post-TBI the access frequency to the center and corners of the open field was decreased, and the total stay in the corners increased, in RW vs. NW mice. Anxiety-related parameters decreased in RJ vs. RW mice. Rotarod latency times increased 72 h post-TBI in RJ vs RW mice. No overall changes in food and drink intake were observed along the experimental period. On the irradiation day, bout number was increased and bout duration was decreased in RW mice. The changes were reversed by purple grape juice intake. Grape juice intake before and after TBI can overcome several radiation-induced changes in behaviour within 24-72 hours after sub-lethal X-irradiation. This beneficial effect on short-term anxiety and mobilityrelated activities could probably be included in the list of flavonoid bio-effects. The present findings could be relevant in designing preventive interventions aimed to enhance body defense mechanisms against short-term irradiation damage.