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Introduction Psychiatric comorbidity has a significant impact on the patient’s overall health, with an increased risk of death for those patients with mental-physical comorbidity (Tan et al., 2021). This impacts, among other things, the average hospital stay of a patient with psychiatric comorbidity. For example, an American study shows that psychiatric comorbidity was associated with greater inpatient utilization, including the risk of additional hospitalizations, days of stay, and hospitalization charges (Sayers et al., 2007). Our study aims to confirm these results in patients admitted to a general hospital for any cause and presenting psychiatric comorbidity. Objectives To compare the mean length of stay of patients admitted to a general hospital for any cause according to whether they have psychiatric comorbidity or not. Methods We made a descriptive retrospective study through the use of electronic medical records. The drug use history and average day of hospitalization were obtained for all patients admitted to the inpatient service of a general hospital during a 3-year period. Results The mean length of stay was longer in patients with psychiatric comorbidity (mean = 9.87 days, SD = 15.45) than in patients without psychiatric comorbidity (mean = 5.23 days, SD = 7.16), the difference being statistically significant for the analysis of variance with a small effect size (F = 18.2; p < 0.001, η²=0.038). The assumption of the equality of variances of the two groups is not fulfilled (Levene F = 29.0; p < 0.01) so Welch’s nonparametric test was applied, whose results do not modify those obtained. N Mean SD SE No psychiatric comorbidity 296 5.23 7.16 0.416 Psychiatric comorbidity 238 9.87 15.45 1.002 Conclusions Our results are in line with other studies, showing a longer mean length of stay in those patients admitted for any cause and with associated psychiatric comorbidity. This highlights the importance of having an integrated psychiatry service in a general hospital, as Bronson points out, where they find a shorter mean length of stay in units that have integrated, proactive psychiatric care (Bronson et al., 2019). References Bronson, B. D., Alam, A., & Schwartz, J. E. (2019). The Impact of Integrated Psychiatric Care on Hospital Medicine Length of Stay: A Pre-Post Intervention Design With a Simultaneous Usual Care Comparison. Psychosomatics. Sayers, S. L., Hanrahan, N., Kutney, A., Clarke, S. P., Reis, B. F., & Riegel, B. (2007). Psychiatric comorbidity and greater hospitalization risk, longer length of stay, and higher hospitalization costs in older adults with heart failure. Journal of the American Geriatrics Society. Tan, X. W., Lee, E. S., Toh, M., Lum, A., Seah, D., Leong, K. P., Chan, C., Fung, D., & Tor, P. C. (2021). Comparison of mental-physical comorbidity, risk of death and mortality among patients with mental disorders - A retrospective cohort study. Journal of psychiatric research. Disclosure of Interest None Declared

Introduction We present the case of a 41-year-old male patient with multiple psychiatric diagnoses, he was diagnosed with agenesis of the corpus callosum, which explains his clinical presentation. Objectives The objective is to carry out a brief review of the symptoms associated with the agenesis of the corpus callosum. Methods The patient has been diagnosed with ADHD, cyclothymia, depressive anxiety disorder and social phobia. He has been treated with a multitude of drugs such as antidepressants, anxiolytics, stimulants and even low-dose antipsychotics. Despite the pharmacological treatments received, as well as the therapies, the patient’s functionality has progressively worsened, to the point of restricting going out of the home or maintaining a stable job. Biographical data were collected, including psychomotor retardation and inappropriate laughter. He showed mannerisms such as fluttering and low frustration tolerance. He was slow to respond to his name and showed little affective resonance with his sister and parents. Restrictive interests, especially with English culture, for which he later studied English philology. On the other hand, his mother explains that he had no symbolic play and that, from early childhood, he had difficulties in relationships with peers. Due to the aforementioned clinical manifestations, the functional worsening and the examination carried out in the consultation room, it was decided to extend the study with a brain MRI, where an agenesis of the corpus callosum was observed. Results Agenesis of the corpus callosum is a malformation of the central nervous system, which affects one in every 4000 births. It can be partial or complete, and occurs between the 7th-20th week of gestation. Agenesis of the corpus callosum presents with a triad of symptoms: - Reduced interhemispheric communication of sensory-motor information. - Increased information processing time - Difficulty in abstract thinking. This triad causes difficulties not only cognitively, but also socially. There is difficulty in integrating and learning new verbal and visual information. Tendency to literalism, with difficulty in understanding double meanings. They also have difficulty understanding non-verbal language and reading emotions, which makes interaction with peers difficult. All these symptoms can sometimes be confused with symptoms compatible with Autism Spectrum Disorder. Conclusions After the diagnosis and after focusing the patient’s treatment on the most limiting symptoms of his daily life, an integrated approach was initiated, not only at a pharmacological level, with the use of antidepressants and anxiolytics, but also from a psychotherapeutic point of view, working on those areas in which the patient is most dysfunctional. He was accompanied in the disability application process, as well as helped in the search for associations for adults with ASD, finding there the answer to his symptoms and difficulties. Disclosure of Interest None Declared

Introduction: The current literature has not yet provided a definitive conclusion on the best emergency groin hernia repair. The aim of this study was first to compare the short and long-term outcomes between open preperitoneal and anterior approach in emergency groin hernia repair and second to identify risk factors for postoperative complications, mortality, and recurrence.Materials and Methods: This retrospective cohort study included patients who underwent emergency groin hernia repair between January 2010 and December 2018. Short and long-term outcomes were analyzed comparing approach and repair techniques. The predictors of complications and mortality were investigated using multivariate logistic regression. Cox regression multivariate analysis were used to explore risk factors of recurrence.Results: A total of 316 patients met the inclusion criteria. The most widely used surgical techniques were open preperitoneal mesh repair (34%) and mesh plug (34%), followed by Lichtenstein (19%), plug and patch (7%) and tissue repair (6%). Open preperitoneal mesh repair was associated with lower rates of recurrence (p = 0.02) and associated laparotomies (p < 0.001). Complication and 90-day mortality rate was similar between the techniques. Multivariable analysis identified patients aged 75 years or older (OR, 2.08; 95% CI, 1.14–3.80; p = 0.016) and preoperative bowel obstruction (OR, 2.11; 95% CI, 1.20–3.70; p = 0.010) as risk factors for complications and Comprehensive Complication Index ≥26.2 as risk factor for 90-day mortality (OR, 44.76; 95% CI, 4.51–444.59; p = 0.01). Female gender was the only risk factor for recurrence.Conclusion: Open preperitoneal mesh repair may be superior to other techniques in the emergency setting, because it can avoid the morbidity of associated laparotomies, with a lower long-term recurrence rate.

There hasn't been a previous case report of the anterior interosseous nerve injury secondary to the presence of the muscle of Gantzer in a patient with myasthenia gravis in literature before. The anterior interosseous nerve compressive syndrome, also known as Kiloh-Nevin syndrome, is a rare disorder comprising less than 1% of all upper limb neuropathies. Establishing the etiology of anterior interosseous nerve compressive syndrome is challenging because of the lack of specific clinical findings or testing. Herein is the case of a 46 years-old male presented with left eye ptosis, ophthalmoparesis, diplopia, and right-hand weakness. On physical examination, the Pinch Grip test was positive. Electromyography studies showed neurogenic atrophy in the muscles innervated by the anterior interosseous nerve, as well as a pathological decrement of the muscle action potential of more than 10% on repetitive nerve stimulation. Concluding that the presence of the Gantzer muscle caused anterior interosseous nerve compressive syndrome was mainly a diagnosis of exclusion, after careful consideration of other possible etiologies including carpal tunnel syndrome, cervical radiculopathy, and Parsonage-Turner Syndrome. Even though anterior interosseous nerve compressive syndrome is very rare, clinical suspicion ought to arise in the presence of weak radial flexor digitorum profundus and flexor pollicis longus muscles. This case highlights the importance of a thorough medical history, a meticulous physical examination, and particularly the significance of electromyography studies in diagnosing different neuropathological entities. When appropriate, these steps offer information crucial to the differential diagnosis and eventual surgical management, assisting physicians in making informed and accurate treatment decisions.

Abstract This study aimed to assess the role of multifocal visual-evoked potentials (mfVEPs) as a guiding factor for clinical conversion of radiologically isolated syndrome (RIS). We longitudinally followed a cohort of 15 patients diagnosed with RIS. All subjects underwent thorough ophthalmological, neurological and imaging examinations. The mfVEP signals were analysed to obtain features in the time domain (SNRmin: amplitude, Latmax: monocular latency) and in the continuous wavelet transform (CWT) domain (bmax: instant in which the CWT function maximum appears, Nmax: number of CWT function maximums). The best features were used as inputs to a RUSBoost boosting-based sampling algorithm to improve the mfVEP diagnostic performance. Five of the 15 patients developed an objective clinical symptom consistent with an inflammatory demyelinating central nervous system syndrome during follow-up (mean time: 13.40 months). The (SNR min ) variable decreased significantly in the group that converted (2.74 ± 0.92 vs. 4.07 ± 0.95, p = 0.01). Similarly, the (b max ) feature increased significantly in RIS patients who converted (169.44 ± 24.81 vs. 139.03 ± 11.95 (ms), p = 0.02). The area under the curve analysis produced SNR min and b max values of 0.92 and 0.88, respectively. These results provide a set of new mfVEP features that can be potentially useful for predicting prognosis in RIS patients.

Background RCTs provide the scientific basis upon which treatment decisions are made. To facilitate critical review, it is important that methods and results are reported transparently. The aim of this study was to explore transparency in surgical RCTs with respect to trial registration, disclosure of funding sources, declarations of investigator conflicts and data‐sharing. Methods This was a cross‐sectional review of published surgical RCTs. Ten high‐impact journals were searched systematically for RCTs published in years 2009, 2012, 2015 and 2018. Four domains of transparency were explored: trial registration, disclosure of funding, disclosure of investigator conflicts, and a statement relating to data‐sharing. Results Of 611 RCTs, 475 were eligible for analysis. Some 397 RCTs (83.6 per cent) were registered on a trial database, of which 190 (47·9 per cent) had been registered prospectively. Prospective registration increased over time (26 per cent in 2009, 33·0 per cent in 2012, 54 per cent in 2015, and 72·7 per cent in 2018). Funding disclosure was present in 55·0, 65·0, 69·4 and 75·4 per cent of manuscripts respectively. Conflict of interest disclosure was present in 49·5, 89·1, 94·6 and 98·3 per cent of manuscripts across the same time periods. Data‐sharing statements were present in only 15 RCTs (3·2 per cent), 11 of which were published in 2018. Conclusion Trial registration, disclosure of funding and disclosure of investigator conflicts in surgical RCTs have improved markedly over the past 10 years. Disclosure of data‐sharing plans is exceptionally low. This may contribute to research waste and represents a target for improvement.

T cells can be activated by a small, two-digit, number of antigen peptide molecules even though the receptor for antigen (TCR) is of low affinity. Here the authors present evidence that all TCRs within a nanocluster can become activated when only a subset is bound to antigen.

Since 1975, about 165,000 people from Western Sahara are living as refugees in the Sahara Desert near Tindouf (Algeria). Available water resources come from deep boreholes located up to tens of kilometers away from the settlements of the population, bulk water is treated in reverse osmosis plants and by chlorination systems and, after, distributed through a network of taps and water tankers. Water supply system complexity and extreme conditions force the elaboration of a Water Safety Plan, aiming to guarantee appropriate provision and quality of water. The plan follows a risk assessment methodology and establishes control mechanisms to minimize risk impacts, which are compiled in six action protocols for infrastructures and water quality monitoring. As a novel contribution, the proposed methodology developed in the refugee camps incorporates besides the conventional water quality assessment concepts, the analysis of the volume of supplied water, linked with some water-washed diseases. Since the end of 2014, those protocols have begun to be applied obtaining results that have a positive effect on the life quality of refugees.

Introduction: Attention deficit hyperactivity disorder (ADHD) is the most frequent neurodevelopmental disorder and must be considered a public health priority because of its functional repercussions in school, family, and social settings. Health empowerment is an innovative model of care for patients with chronic diseases based on self-management education. Our goal is to evaluate the effectiveness of empowerment using coaching within a multimodal treatment plan in paediatric patients with ADHD. Material and methods: Descriptive open prospective study. We included children between 6 and 12 years old belonging to patient association in a suburban area of the Region of Madrid. We evaluated the situation before and after 5 cost-free coaching sessions using the Conners Questionnaire, Dundee difficult times of day scale, and satisfaction scales. Results: We included 49 patients (73.5% males) with an average age of 8.5 years. The ADHD hyperactive-impulsive subtype was present in 63.3% and 77.6% had some type of comorbidity. All were treated with methylphenidate and their clinical course was poor. Clinical improvements were observed in 79.6% with a 34.6% mean reduction in symptoms (SD 11.1), and improvements remained stable at 6 months follow-up after coaching. We reached a satisfaction level of 7.8 out of 10 (SD 1.7), and 95.9% of the participants recommended this treatment to other families. Conclusions: Our results provide information on the potential benefits of coaching as complementary treatment for ADHD. Resumen: Introducción: El trastorno por déficit de atención e hiperactividad (TDAH) es el trastorno del neurodesarrollo más frecuente y debe ser considerado un problema de primer orden de salud pública por sus repercusiones funcionales a nivel escolar, familiar y social. Empoderar en salud es un modelo innovador en el cuidado de pacientes con enfermedades crónicas, basado en la educación de automanejo. Nuestro objetivo es valorar la eficacia de empoderar mediante coaching, dentro de un plan de tratamiento multimodal en pacientes pediátricos con TDAH. Material y métodos: estudio descriptivo, abierto y prospectivo. Incluimos a niños de entre 6 y 12 años pertenecientes a una asociación de pacientes de un área suburbana de la Comunidad de Madrid. Valoramos la situación previa y posterior a 5 sesiones gratuitas de coaching mediante el Cuestionario de conducta de Conners de dificultades a lo largo del día (D-DTODS) y escalas de satisfacción. Resultados: Incluimos a 49 pacientes, el 73,5% varones, con una edad media de 8,5 años. El 63,3% tenía TDAH subtipo hiperactivo/impulsivo y el 77,6% algún tipo de comorbilidad. Todos tratados con metilfenidato y mala evolución clínica. El 79,6% mejoró clínicamente, con una reducción media ± DT de los síntomas del 34,6 ± 11,1% y mantenida en el 79,6% tras 6 meses de seguimiento post coaching. Alcanzamos un nivel de satisfacción de 7,8 ± 1,7 sobre 10 y el 95,9% recomendó el tratamiento a otras familias. Conclusiones: Nuestros resultados aportan información sobre los posibles beneficios del coaching como tratamiento asociado en el TDAH. Keywords: Empowerment, Coaching, Attention deficit hyperactivity disorder, Hyperactivity, Attention deficit, Psychostimulants, Palabras clave: Empoderar, Coaching, Trastorno por déficit de atención e hiperactividad, Hiperactividad, Déficit de atención, Psicoestimulantes

Resumen: Introducción: El trastorno por déficit de atención e hiperactividad (TDAH) es el trastorno del neurodesarrollo más frecuente y debe ser considerado un problema de primer orden de salud pública por sus repercusiones funcionales a nivel escolar, familiar y social. Empoderar en salud es un modelo innovador en el cuidado de pacientes con enfermedades crónicas, basado en la educación de automanejo. Nuestro objetivo es valorar la eficacia de empoderar mediante coaching, dentro de un plan de tratamiento multimodal en pacientes pediátricos con TDAH. Material y métodos: estudio descriptivo, abierto y prospectivo. Incluimos a niños de entre 6 y 12 años pertenecientes a una asociación de pacientes de un área suburbana de la Comunidad de Madrid. Valoramos la situación previa y posterior a 5 sesiones gratuitas de coaching mediante el Cuestionario de conducta de Conners de dificultades a lo largo del día (D-DTODS) y escalas de satisfacción. Resultados: Incluimos a 49 pacientes, el 73,5% varones, con una edad media de 8,5 años. El 63,3% tenía TDAH subtipo hiperactivo/impulsivo y el 77,6% algún tipo de comorbilidad. Todos tratados con metilfenidato y mala evolución clínica. El 79,6% mejoró clínicamente, con una reducción media ± DT de los síntomas del 34,6 ± 11,1% y mantenida en el 79,6% tras 6 meses de seguimiento post coaching. Alcanzamos un nivel de satisfacción de 7,8 ± 1,7 sobre 10 y el 95,9% recomendó el tratamiento a otras familias. Conclusiones: Nuestros resultados aportan información sobre los posibles beneficios del coaching como tratamiento asociado en el TDAH. Abstract: Introduction: Attention deficit hyperactivity disorder (ADHD) is the most frequent neurodevelopmental disorder and must be considered a public health priority because of its functional repercussions in school, family, and social settings. Health empowerment is an innovative model of care for patients with chronic diseases based on self-management education. Our goal is to evaluate the effectiveness of empowerment using coaching within a multimodal treatment plan in paediatric patients with ADHD. Material and methods: Descriptive open prospective study. We included children between 6 and 12 years old belonging to patient association in a suburban area of the Region of Madrid. We evaluated the situation before and after 5 cost-free coaching sessions using the Conners Questionnaire, Dundee difficult times of day scale, and satisfaction scales. Results: We included 49 patients (73.5% males) with an average age of 8.5 years. The ADHD hyperactive-impulsive subtype was present in 63.3% and 77.6% had some type of comorbidity. All were treated with methylphenidate and their clinical course was poor. Clinical improvements were observed in 79.6% with a 34.6% mean reduction in symptoms (SD 11.1), and improvements remained stable at 6 months follow-up after coaching. We reached a satisfaction level of 7.8 out of 10 (SD 1.7), and 95.9% of the participants recommended this treatment to other families. Conclusions: Our results provide information on the potential benefits of coaching as complementary treatment for ADHD. Palabras clave: Empoderar, Coaching, Trastorno por déficit de atención e hiperactividad, Hiperactividad, Déficit de atención, Psicoestimulantes, Keywords: Empowerment, Coaching, Attention deficit hyperactivity disorder, Hyperactivity, Attention deficit, Psychostimulants

Entre las principales causas de la reducción progresiva y sin dolor de la apertura bucal en pacientes jóvenes, se encuentra la denominada hipertrofia del proceso coronoideo. Se trata de una patología secundaria a la elongación anormal del proceso coronoideo por el crecimiento del hueso que provoca una alteración mecánica al abrir la boca. Presentamos nuestra experiencia con la recogida de 5 casos clínicos.

Se aborda el estudio comparativo entre las masas de Pinus uncinata Ram., localizadas en la parroquia La Massana de Andorra y en el Pirineo catalán, desde la perspectiva de su potencial papel protector frente a aludes. La base de datos dasométricos se obtuvo, en el primer caso, de un inventario ad hoc, y en el segundo, de la información proporcionada por el Tercer Inventario Forestal Nacional. Los resultados sugieren que las masas de ambos entornos geográficos ofrecen aspectos comunes en cuanto a que muestran tendencia hacia la irregularidad, con una regeneración no ligada a las otras variables de masa y con una espesura poco condicionada por el gradiente altitudinal y que escasamente incide en la mortalidad. Las diferencias advertidas se centran en que en las masas de Cataluña se aprecia menores niveles de espesura, aunque aparecen estructuras capitalizadas en existencias volumétricas ausentes en Andorra, y que de modo general, ofrecen peores características en cuanto a su papel protector frente al desencadenamiento de avalanchas.

Introduction: Transferrin (Tf) exerts a crucial function in the maintenance of systemic iron homeostasis. The expression of the Tf gene is controlled by transcriptional mechanism, although little is known about genetic factors influence. Objective: To study the role of rs3811647 in Tf expression using an in-vitro assay on hepatoma cells. Design and Methods: Hep3B cells were co-transfected with constructs containing A (VarA-Tf-luc) and G (VarG-Tf-luc) variants of rs3811647, using luciferase as a surrogate reporter of Tf expression. Results: Luciferase assays showed a higher intrinsic enhancer activity (p < 0.05) in the A compared with the G variant. In silico analysis of SNP rs3811647 showed that the A allele might constitute a binding site for the transcription factor glucocorticoid receptor (GR). Conclusion: The A allele of SNP rs3811647 increases Tf expression in a manner that might underlie inter-individual variation in serum transferrin levels observed in different population groups.Introducción: La transferrina (Tf) ejerce una función crucial en el mantenimiento de la homeostasis sistémica del hierro. La expresión del gen de la transferrina es controlada a nivel transcripcional, aunque la posible influencia de factores genéticos todavía se desconoce. Objetivo: Estudiar el papel del rs3811647 en la expresión de la transferrina mediante un ensayo in-vitro en células de hepatoma. Diseño y métodos: Células Hep3B fueron co-transfectadas con vectores que contenían las variantes A (VarA-Tf-luc) y G (VarG-Tf-luc) del rs3811647, utilizándose la luciferasa como marcador de la expresión del gen Tf. Resultados: Los ensayos con la luciferasa mostraron un mayor aumento de la expresión del gen Tf en presencia de la variante A comparada con la G (p < 0,05). El análisis in silico del SNP rs3811647 mostró que la presencia del alelo A puede constituir un sitio de unión del receptor de glucocorticoides (GR). Conclusión: El alelo A del SNP rs3811647 incrementa la expresión del gen Tf de modo que podría modular la variación interindividual en los niveles de transferrina sérica observados en diferentes poblaciones.

Los autores estudian una reciente sentencia de la Sala 3ª del Tribunal Supremo en la que se declara la responsabilidad patrimonial de la Administración por la muerte de un paciente preso. Se analizan los argumentos de la Sala desde una perspectiva jurídica, ética, médica y social. Concluyen que: 1: la Administración no está legitimada para imponer tratamientos médicos a los reclusos, salvo que medie riesgo grave y cierto para su vida, incapacidad para decidir o riesgo para la salud de terceros; 2: que la sentencia supone un ataque frontal a la autonomía de los pacientes presos en la toma de decisiones sanitarias que les afecten; 3: que desde un punto de vista médico es discriminatoria, ya que no mide por el mismo rasero a todas las enfermedades crónicas que se pueden dar en prisión y 4: que resulta inasumible en la práctica diaria, porque su estricta aplicación alteraría considerablemente la ya de por sí frágil ordenada convivencia en un centro penitenciario.The authors study a recent Spanish High Court decision declaring liability on the Administration’s part for the death of an inmate in a prison hospital. We analyse the Court’s decision using legal, ethical, medical and social perspectives. The conclusions are that: 1. the Administration has no legitimate right to force a prisoner to take medical treatment, except in circumstances in which there is a grave and definite risk to the patient’s life, or when the patient lacks capacity or when there is the risk of harm to the health of third parties; 2. That in the case of health decision making that might affect a patient, the Court has mounted a frontal attack on the autonomy of patients in prison; 3. That from a medical point of view the decision is discriminatory since it does not apply the same standards of measurement to all chronic illnesses that might be found in the prison context; 4. That it is inapplicable in daily practice due to the fact that its strictness of application would seriously affect the already highly fragile ordered coexistence that exists in a prison.

Se estudió el efecto de El Niño 1997-1998 sobre la biomasa y tamaño de los mantos de Ulva lactuca L. en la costa noroeste del Golfo de California, del lado opuesto al Canal de Ballenas. Las evaluaciones se realizaron en el mes de mayo (primavera) de 1998 y se compararon con años previos (mayo 1995, 1996 y 2000). La investigación muestra que El Niño 1997-1998 tuvo un efecto negativo sobre el área y biomasa de los mantos estudiados. El área se redujo en 70% y la biomasa en 80% respecto a años previos. Se detectó un recobro completo de estos mantos para el año 2000. Se estudió el crecimiento de esta alga bajo condiciones controladas de laboratorio, pero no se detectó un efecto significativo de la irradiancia sobre el crecimiento. Sin embargo, la temperatura afectó significativamente su crecimiento. A 18°C se detectó el óptimo crecimiento y temperaturas de 14°, 22° y 26°C lo redujeron. Temperaturas de 30°C fueron letales para U. lactuca. doi: https://doi.org/10.22201/igeof.00167169p.2003.42.3.933

The effect of El Niño 1997-1998 on the biomass and size of beds of the green alga Ulva lactuca L., along the northwest coast of the Gulf of California across the Canal de Ballenas, was evaluated in May 1998 and compared with May 1995, 1996 and 2000. The El Niño event (97-98) had a significant negative effect on size and biomass. The percent cover area was reduced by 70%, and biomass by 80%, with respect to previous years. A complete recovery was observed in 2000. Growth of the algae was studied under controlled conditions in the laboratory. No significant effect of irradiance was detected, but temperature did have a significant effect on growth. Optimum growth was found at 18°C. Temperatures of 14°, 22° and 26°C caused reduced growth. A temperature of 30°C was lethal to U. lactuca.

[fr] L'analyse de la gestion du pâturage est une des plus importantes thématiques dans les études de l'organisation de l'espace pour l'usage du bétail. Dans ce travail, on analyse la gestion du pâturage d'une ferme-laiterie caprine, avec l'objectif de caractériser les variations saisonnières annuelles. Trois paramètres ont été utilisés pour analyser la gestion: la journée de pâturage, la longueur du parcours et la vitesse du parcours. Les résultats obtenus montrent l'existence d'une variabilité saisonnière marquée dans la gestion du pâturage, le phénomène est en relation avec la variabilité climatique intra-annuelle de l'environnement méditerranéen. [es] El análisis de la gestión del pastoreo es una de las temáticas de trabajo más importantes dentro de los estudios de planificación del espacio para uso ganadero. En este trabajo se analiza la gestión de pastoreo de una explotación caprina lechera con el objetivo de caracterizar las variaciones estacionales que se suceden a lo largo del año. Se han utilizado tres parámetros para analizar la gestión: duración de la jornada de pastoreo, longitud de los itinerarios y velocidad de pastoreo. Los resultados obtenidos ponen de manifiesto la existencia de una marcada variabilidad estacional en la gestión del pastoreo, fenómeno que se relaciona con la variabilidad climática intraanual de los ambientes de clima mediterráneo.

In order to characterize synaptic involvement in human spongiform encephalopathies, the expression of synaptic vesicle-associated proteins, synaptophysin and synapsin-I, and presynaptic plasma membrane proteins, synaptosomal-associated protein of 25 kDa (SNAP-25) and syntaxin-I, was examined in the brains of four patients who had suffered from sporadic Creutzfeldt–Jakob disease. Nerve cell loss, spongiform degeneration, astrocytosis, and deposition of prion protein (PrP) were observed in the cerebral cortex in every case. Decreased immunoreactivity for synaptophysin, synapsin-I, SNAP-25, and syntaxin-I was observed in the cerebral cortex in every case, thus showing generalized reduction of proteins involved in exocytosis of synaptic vesicles in the brains of patients with spongiform encephalopathy. Upregulation of synaptophysin and SNAP-25, a feature associated with βA4 deposits in Alzheimer's disease (AD), was not observed in association with PrP deposition. The present results indicate that synaptic pathology is a major event in spongiform encephalopathy, and suggest that synaptic loss, together with neuron loss and selective involvement of certain populations of local-circuit neurons, as shown in other studies, may account for the dramatic neurological decay and for the main neurological symptoms in patients with CJD.

Naringinase is an enzyme complex consisting of a a-L-rhamnopyranosidase (Rha, EC. 3.2.1.40) and ß-D-glucopyranosidase (ßG, EC. 3.2.1.21). a-L-rhamnopyranosidase is an enzyme of considerable importance in food technology for increasing the aroma of fruit juices and alcoholic beverages. It is particularly used for debittering of citrus-juice by the hydrolysis of naringin and hesperidin, however this activity is low in commercial enzyme preparations. The aim of this work is the production of Rha from Aspergillus terreus fermentation using citrus solid waste (CSW), called “pastazzo”, as specific inducer. CSW is rich in fermentable materials such as sugars, in particular rhamnose, in pectins, and in flavanone glycoside as hesperidin and naringin. Rha and ßG have been characterized from a culture ofterreus.

Se ha relacionado el descenso de la actividad antitrombina III (AT-III) durante la circulación extracorpórea (CEC) con la aparición de complicaciones postoperatorias. El objetivo de este trabajo es analizar los cambios intraoperatorios de la AT-III y el efecto del suplemento con dosis bajas de AT-III. Métodos: Se estudiaron dos grupos de 20 sujetos sin resistencia a la heparina. En un grupo se administró un bolus de 10 U/kg de antitrombina (Ambinex, Grifols, Barcelona) transcurridos 15 min de CEC. En el grupo control no se administró antitrombina. Se determinó el tiempo de coagulación activado (TCA), AT-III, dímero D, tiempo de protrombina y plasminógeno tipo tisular (TTPA) en cinco ocasiones durante la intervención: basal; 5 min postheparina; 15 min después de iniciar CEC; 5 min después de administrar antitrombina o placebo y 15 min posprotamina. Se registraron los parámetros demográficos y clínicos. Resultados: En los dos grupos se observó un descenso significativo de la AT-III transcurridos 15 min de CEC (p < 0,001) con valores inferiores al 60% en todos los sujetos. En el grupo tratado con antitrombina se observó una recuperación significativa y mantenida de la AT-III (p < 0,01). En el grupo control la reducción de la AT-III se mantuvo en toda la intervención. No se observaron diferencias significativas en los otros parámetros analíticos ni en la evolución clínica. Conclusiones: La CEC disminuye la AT-III. La administración intraoperatoria de dosis bajas de antitrombina es segura, y logra un aumento significativo de la AT-III, aunque no se han demostrado cambios clínicos significativos ni en los parámetros de anticoagulación/fibrinólisis.

ABSTRACT The equine metabolic syndrome is a condition that can be recognized because of obesity, insulin resistance and laminitis. Genetic factors could play a role in the occurrence of this syndrome. Certain breeds such as ponies (including the South American creole horses) have a lower sensibility to insulin and a higher prevalence of hyperinsulinemia. The environment and management conditions, such as overfeeding and lack of exercise are factors that bring a propensity for obesity. The adipose tissue works as an endocrine organ producing hormones (adipokines or adipocytokines) that affect the horse´s metabolism. The objective of this report is to describe the first case report of a Colombian creole mare with a metabolic syndrome, diagnosed by means of the combined test of glucose-insulin and clinical signs. Early diagnosis of this entity and an adequate treatment are useful for improving the life and the zootechnical conditions of the patient.

Objectives Studies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis.Setting Prospective, international, multicentre, observational cohort study.Participants Patients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative).Primary outcome 30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality.Results This study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p80 years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787).Conclusions Patients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with individualised medical and anaesthetic care, including medical optimisation before theatre. Careful preoperative counselling is needed for those with a proximal femoral fracture and SARS-CoV-2, especially those in the highest risk groups.Trial registration number NCT04323644