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Objective: Oropharyngeal dysphagia is caused by difficulty in bolus preparation and transport from the mouth to the oesophagus; this may result in malnutrition and aspiration pneumonia. It has a high prevalence in head and neck cancer patients. The objective of this study is to reduce these complications using a new protocol of diagnosis and evaluation of oropharyngeal dysphagia. Method: This is a prospective study developed in a secondary hospital. All patients diagnosed with head and neck cancer in 2021 and 2022 are subjected to this protocol: an oropharyngeal dysphagia screening test, a swallowing-related quality of life questionnaire and a flexible endoscopic evaluation of swallow. Results: A total of 72 evaluations are reported using this protocol, before and after cancer treatment, and only 1 presents with aspiration pneumonia. Conclusion: Using this protocol, the incidence of aspiration pneumonia can be reduced, and diet recommendations can be given earlier in order to maintain a patient's nutritional requirements. [ABSTRACT FROM AUTHOR]

The stratification of the risk of CMV infection in lung transplantation (LT) is carried out by the serological IgG for CMV of the donor and the recipient (D/R). However, it has been observed that some R+ have a lack of CMV-specific cellular response in kidney transplantation with a higher probability of infection after transplantation. The aim of this study is to assess the agreement between CMV IgG serology and CMV-specific cellular response in LT recipients prior to transplantation. Prospective and multicenter study (3 LT programs and 1 research laboratory) involving 121 patients in the waiting list for a LT. CMV immunoglobulin G (IgG) levels and CMV specific T cell ELISPOT against CMV pp65 and IE-1 antigens was determined. ELISPOT results have been categorized following a previous classification regarding the risk of CMV infection in kidney transplant patients: High risk (IE1 ELISPOT ≤25 spots/300,000 cells and pp65 ELISPOT ≤130 spots/300,000 cells) and low risk (IE1 ELISPOT >25 spots/300,000 cells and pp65 ELISPOT >130 spots/300,000 cells). Intermediate risk when IE1 ELISPOT ≤25 spots/300,000 cells or pp65 ELISPOT ≤130 spots/300,000 cells. One hundred and four (86.0%) patients were R+ for CMV. Discordant immunological responses were observed. In particular, from those R+, 28.8% showed weak ELISPOT responses against IE-1 (IE1 ≤25 spots/300,000 cells) and 39.4% against pp65 CMV antigens (pp65 ≤130 spots/300,000 cells). Conversely, all seronegative patients did not respond to either IE1 or pp65. Using such ELISPOT-based CMV infection-risk stratification, 53.8% were classified as low risk, 24% as intermediate risk and more importantly, 22.1% as high risk of CMV infection after transplantation. Over 20% of R+ LT candidates display weak CMV-specific cellular immune responses and could be considered as having higher risk of infection after transplantation despite detectable serological memory against CMV. This study was sponsored and funded by MSD Spain [ABSTRACT FROM AUTHOR]

Wildfire suppression management is usually based on fast control of all ignitions, especially in highly populated countries with pervasive values-at-risk. To minimize values-at-risk loss by improving response time of suppression resources it is necessary to anticipate ignitions, which are mainly caused by people. Previous studies have found that human-ignition patterns change spatially and temporally depending on socio-economic activities, hence, the deployment of suppression resources along the year should consider these patterns. However, full suppression capacity is operational only within legally established fire seasons, driven by past events and budgets, which limits response capacity and increases damages out of them. The aim of this study was to assess the temporal definition of fire seasons from the perspective of human-ignition patterns for the case study of Spain, where people cause over 95% of fires. Humans engage in activities that use fire as a tool in certain periods within a year, and in locations linked to specific spatial factors. Geographic variables (population, infrastructures, physiography and land uses) were used as explanatory variables for human-ignition patterns. The changing influence of these geographic variables on occurrence along the year was analysed with day-by-day logistic regression models. Daily models were built for all the municipal units in the two climatic regions in Spain (Atlantic and Mediterranean Spain) from 2002 to 2014, and similar models were grouped within continuous periods, designated as ignition-based seasons. We found three ignition-based seasons in the Mediterranean region and five in the Atlantic zones, not coincidental with calendar seasons, but with a high degree of agreement with current legally designated operational fire seasons. Our results suggest that an additional late-winter-early-spring fire season in the Mediterranean area and the extension of this same season in the Atlantic zone should be re-considered for operational purposes in the future. [ABSTRACT FROM AUTHOR]

The aim of this study was to design and implement a Seroprevalence Map based on Business Intelligence for Mycoplasma gallisepticum (M. gallisepticum) in broilers in Comunidad Valenciana (Spain). To obtain the serological data we analysed 7363 samples from broiler farms over 30 days of age over the course of two years (3813 and 3550 samples in 2009 and 2010, respectively, from 189 and 193 broiler farms in 2009 and 2010, respectively). Data were represented on a map of Comunidad Valenciana to include geographical information of flock location and to facilitate the monitoring. Only one region presented with average ELISA titre values of over 500 in the 2009 period, indicating previous contact with M. gallisepticum in broiler flocks. None of the other regions showed any pressure of infection, indicating a low seroprevalence for M. gallisepticum. In addition, data from this study represent a novel tool for easy monitoring of the serological response that incorporates geographical information. [ABSTRACT FROM AUTHOR]

Background: The colorectal cancer screening programme (BCSP) obtains excellent participation rate, reflected in early detection and treatment of pre & malignant lesions, objectifying a downward trend in incidence & mortality rates Objectives: To compare invitation coverage and impact on participation with faecal immunochemical test (FIT) pre&post pandemic. To compare the participation rate in Primary Care Units (UAP) in which the invitation and FIT pickup was interrupted with those that were not, in order to design prioritization strategies in the face of another lockdown Methods: Retrospective cohort study of invitations from 2018-2020. Indicators of coverage and participation rate to COVID 19, during the interruption due to lockdown, and subsequent invitations sent out without interruption afterwards. Data analysis R version 4.0.1 stats and MKinfer Results: 40% of the planned invitations were taken up (81,097/200,000) showing a decrease in participation rate (71.9/68.8%) P≤ 0.05 95% CI(2.79-3.52), with significant differences in all groups by age and sex. In the comparative analysis between UAPs that interrupted test collection in March resumed in June or when the invitation was made without interruption (September to December), higher participation rates were observed in the group that did not interrupt the screening (68.1/69.8%) P≤ 0.05 95%CI (1.18-2.23), with differences in all groups of age and sex. In order to reorganize the activity, agreements were made:1)prioritization of screening colonoscopies, 2)reduce the burden of follow-up colonoscopies based on the evidence. Advanced lesions, has passed from 1 to 3ys, and only the resection in piecemeal ≥ 20mm sessile is done in under 1y Conclusions: The Covid-19 pandemic has affected the BCSP with a decrease in scheduled invitations, but only a slight decrease in the participation rate. The impact is lower if the collection of FIT samples is not interrupted. If a new lockdown is needed, we will not stop the collection of FITs Key messages: The Covid-19 pandemic has affected the BCSP adn will impact in incidence and mortality of CRC. The impact is lower if the collection of FIT samples is not interrupted. [ABSTRACT FROM AUTHOR]

Reported here is an unusual cluster of non-invasive infections caused by an emm28 Streptococcus pyogenes strain resistant to bacitracin, erythromycin and clindamycin detected in Santander, Spain. Since one of the characteristics of group A streptococci is their almost uniform susceptibility to bacitracin, this finding was unusual, and a search for bacitracin-resistant Streptococcus pyogenes strains was conducted in two other distant cities of Spain (Madrid and San Sebastian) where their presence was confirmed. These strains were frequently associated with erythromycin- and clindamycin-resistance, and most of them belonged to a unique emm28 T28, 5T52 clone. [ABSTRACT FROM AUTHOR]

The aim of this study was to identify factors related to lip cancer (LC) considering individual characteristics and sociodemographic factors. A case-control study was carried out in the province of Granada (Andalusia, southern Spain). The cases were 105 males with squamous-cell carcinoma of the lip, diagnosed between 1987 and 1989 (aged 20-70 years) and identified by means of a population-based Cancer Registry. As controls, a randomised populational sample of 239 males, stratified by age, was used. Multiple logistic regression analysis showed that risk factors are lifetime cumulative tobacco consumption and alcohol consumption. An interaction was found between alcohol consumption and the smoking habit (leaving the cigarette on the lip): OR=23.6; 95% CI: 3.9-142.0. Other risk factors identified are clear eyes (OR=3.5; CI: 95% 1.5-8.0), sun exposure early in life and cumulative sun exposure during outdoor work (OR=11.9; 95%: CI: 1.3-108.9), and skin reaction to sun exposure (Fitzpatrick levels). Another interaction was found between skin reaction and a previous history of common sporadic warts (OR=4.4; 95% CI: 1.01-19.1). We conclude that LC is related to phenotype, skin reaction to sun exposure, cumulative and early sunlight exposure, and tobacco and alcohol consumption, as well as a low educational level. Leaving the cigarette on the lip is predictive of LC risk irrespective of cumulative tobacco consumption. [ABSTRACT FROM AUTHOR]

Examines the natural selection on a vertical environmental gradient of the intertidal snail Littorina saxatilis in Galicia, Spain. Factors influencing the partial reproductive isolation between the morphs; Maintenance of the amount of gene flow for neutral isozyme loci; Emphasis on the important proportion of fecundity variability.

Introduction: A 38-year-old woman with a diagnosis of Paranoid Schizophrenia who, while being treated with oral Aripiprazole, becomes pregnant. No medical history of interest. Psychiatric history: one hospital admission in 2009, subsequent follow-up in day hospital for 3 months, and outpatient follow-up without relapses until today. Current treatment: Aripiprazole 20 mg (half a tablet for breakfast and half a meal). Objectives: The aim of this case report is to show that Aripiprazole at low doses could be use in pregnancy, always under medical supervision and with informed consent, in psychotic disorders. Methods: Case report and literature review. Results: Being under regular outpatient follow-up and under treatment with 20 mg of Aripiprazole orally, the patient becomes pregnant. Risks and benefits of continuing or discontinuing the treatment were explained, and she finally accepts, by informed consent, to continue with the treatment. The delivery was completed and without complications. She has decided to start artificial lactation because she is continuing the prescribed treatment. Conclusions: There are no trials in well-controlled and adequate pregnant women with Aripiprazole. In this case, we contacted SITTE (Service of telephone information of teratogens in Spain) who informed both, patient and therapist, of the possible risks and benefits, and together decided their continuation. Artificial lactation is recommended in this cases. [ABSTRACT FROM AUTHOR]

Introduction: 38-year-old woman diagnosed with Bipolar disorder who becomes pregnant on treatment with Levomepromazine and at week 23 it is changed to Olanzapine. No medical history of interest. Psychiatric history: 3 hospital admissions, the last one was last year (serious episode with psychotic symptoms), since then, she takes Levomepromazine 75 mg a day and now she receives an outpatient follow-up. Objectives: The aim of this case report is to show that Olanzapine at low doses could be use in pregnancy, always under medical supervision and with informed consent, in psychotic disorders. Methods: Case report and literature review Results: Patient and psychiatrist contact SITTE (Telephone information service of teratogens in Spain) who suggests a change to another antipsychotic. Risks and benefits are evaluated, and it is decided to switch to Olanzapine in the 23rd week of gestation. Since then, she has been taking half a tablet of Olanzapine 25 mg orally. The birth has not had complications. The patient has decided to breastfeed her baby. Conclusions: Currently, Olanzapine is classified as FDA category C, despite not having adequate and controlled studies in humans. Nevertheless, it is accepted to keep the treatment during pregnancy in cases of severe Bipolar disorder such as this, since the benefits, both for the mother and the fetus, are greater than the possible risks. Artificial breastfeeding is recommended in these cases. [ABSTRACT FROM AUTHOR]

Plasma donor-derived cell free DNA (dd-cfDNA) has emerged as a potential biomarker for measuring allograft injury after lung transplant. Differences in donor lung mass between single (S) and double (D) lung transplant recipients (LTRs) may impact the amount of circulating dd-cfDNA detected during injury events. The question remains if dd-cfDNA levels should be consistently adjusted when monitored between stable S and D LTRs. We aimed to compare levels of dd-cfDNA in stable LTRs based on S vs D lung status and time post-transplant. Dd-cfDNA was measured in 3 LTR cohorts: 88 from University Health Science Center San Antonio [(UTHSC-SA) 58 D, 29 S] (AlloSure, CareDx), 20 from Memorial Hermann Hospital [(MHH) 19 D, 1 S] (AlloSure), and 100 from Vall d'Hebron Hospital (83 D, 17 S) (real time-PCR to detect informative INDEL polymorphism for each donor/recipient and digital PCR to quantify dd-cfDNA in recipient plasma). LTRs were excluded if they had any donor specific antibodies post-transplant. Dd-cfDNA samples were defined as stable if negative for acute cellular rejection and pulmonary infection within 1-month pre/post-dd-cfDNA draw. Median dd-cfDNA levels were grouped in 3-month buckets. A total of 122 dd-cfDNA samples from UTHSC-SA, 60 from MHH, and 286 from Spain were analyzed. Median dd-cfDNA based on S vs D lung status is shown for UTHSC-SA and MHH in Figure 1A, and Spain in Figure 1B. While there were numerical differences in median dd-cfDNA after 12 months post-transplant, these values were influenced by the low number of S LTRs evaluated. Based on these data, median dd-cfDNA as measured by 2 different assays did not show appreciable differences between stable S and D lung recipients over time. It remains unclear if all dd-cfDNA levels drawn in S LTRs should be automatically corrected for "threshold" clinical decision making. Future analysis including more S LTRs should be conducted. Evaluation of dd-cfDNA in stable LTRs should rely on assessment of patient-specific trends to guide clinical management. [ABSTRACT FROM AUTHOR]

Secondary succession (SS) is one of the main consequences of the abandonment of agricultural and forestry practices in rural areas, causing -among other processes- woody encroachment on former pastures and croplands. In this study we model and monitor the spatial evolution of SS over semi-natural grassland communities in the mountain range of the Pyrenees in Spain, during the last 36 years (1984-2019). Independent variables for 'annual-based' and 'period-based' modeling were drawn from a suite of Surface Reflectance Landsat images, LandTrendr (LT)-algorithm-adjusted images and LT outputs. Support vector machine (SVM) classifiers were trained and tested using all possible variable combinations of all the aforementioned datasets. The best modeling strategy involved yearly time series of LT-adjusted Tasseled Cap Brightness (TCB) and Wetness (TCW) axes as predictors, attaining a F1-score of 0.85, a Matthew Correlation Coefficient (MCC) of 0.67 and an AUC 0.83. Woodlands encroached above 480,000 ha of grasslands and crops during the study period. A model using LT outputs for the whole period also denoted good performance (F1-score = 0.85, MCC = 0.75) and estimated a similar area of woodland expansion (~509,000 ha), but this 'period' approach was unable to provide temporal information on the year or the encroachment dynamics. Our results suggest an overall proportion of 66% for the Pyrenees being affected by SS, with higher intensity in the west-central part, decreasing towards the eastern end. • LandTrendr enhances the monitoring of space-temporal woody encroachment. • 6000 ha/yr have been abandoned in the last decade. • The encroached area represents 66% of the Pyrenean pastures. • Highest Secondary Succession ratios are found in the 1980s. [ABSTRACT FROM AUTHOR]