The molecular epidemiology of SARS-CoV-2 in the Pityusic Islands shows multiple introductions and fast replacements of variants in a touristic worldwide hot spot

The public health emergency caused by the Covid-19 outbreak in March 2020 encouraged worldwide initiatives to monitor the genetic diversity and features of the SARS-CoV-2 circulating variants, mainly based on the genomic surveillance. However, due to the impossibility to carry out extensive sequencing in resource-limited hospitals, other PCR-based strategies could be applied to efficiently monitor the circulating variants without the need to greatly expand the sequencing capacity. In our case, overpassing the technical limitations inherent to a second level hospital, we were able to characterize the weekly distribution of SARS-CoV-2 by the RT-qPCR amplification patterns visualization, single nucleotide polymorphism genotyping, and sequencing of randomly selected samples. All these molecular approaches allowed us to trace the epidemiology of SARS-CoV-2 viruses circulating in Ibiza and Formentera (Balearic Islands, Spain) during the third to the sixth pandemic waves (January 2021-July 2022), in which three major lineages that were considered as VOCs (Alpha, Delta, and Omicron), and many other non-VOC variants were detected and tracked.

Hepatitis C virus fitness can influence the extent of infection-mediated epigenetic modifications in the host cells

Introduction

Cellular epigenetic modifications occur in the course of viral infections. We previously documented that hepatitis C virus (HCV) infection of human hepatoma Huh-7.5 cells results in a core protein-mediated decrease of Aurora kinase B (AURKB) activity and phosphorylation of Serine 10 in histone H3 (H3Ser10ph) levels, with an affectation of inflammatory pathways. The possible role of HCV fitness in infection-derived cellular epigenetic modifications is not known.

Methods

Here we approach this question using HCV populations that display a 2.3-fold increase in general fitness (infectious progeny production), and up to 45-fold increase of the exponential phase of intracellular viral growth rate, relative to the parental HCV population.

Results

We show that infection resulted in a HCV fitness-dependent, average decrease of the levels of H3Ser10ph, AURKB, and histone H4 tri-methylated at Lysine 20 (H4K20m3) in the infected cell population. Remarkably, the decrease of H4K20m3, which is a hallmark of cellular transformation, was significant upon infection with high fitness HCV but not upon infection with basal fitness virus.

Discussion

Here we propose two mechanisms ─which are not mutually exclusive─ to explain the effect of high viral fitness: an early advance in the number of infected cells, or larger number of replicating RNA molecules per cell. The implications of introducing HCV fitness as an influence in virus-host interactions, and for the course of liver disease, are warranted. Emphasis is made in the possibility that HCV-mediated hepatocellular carcinoma may be favoured by prolonged HCV infection of a human liver, a situation in which viral fitness is likely to increase.

Impact of mobilization in patients with short-term mechanical circulatory support such as Levitronix® CentriMag as a bridge to heart transplantation

INTRODUCTION

Despite the benefits of mobilisation in the critical patient, the evidence in patients with Levitronix® CentriMag as a bridge to heart transplantation (HT) is scarce. The objective of this study is to analyze the impact of mobility on these patients.

METHODS

Retrospective observational study of patients who received a HT with Levitronix® CentriMag admitted between 2010 and 2019 to a tertiary hospital. Degree of mobility and nutritional status were assessed at the time of HT. Outcomes including infections, length of hospital admission and mortality were evaluated.

RESULTS

27 patients were included and divided in two groups according to degree of mobility (22 with low mobility and 5 with high mobility). 90-day survival after HT was 63.6% in patients with low mobility and 80% in high mobility group; no statistically significant differences were observed. No differences were observed regarding ICU discharge after HT at 30 days. Nevertheless, lower albumin levels were observed in low mobility group (24,5 g/L (IQR: 23-30) vs 33 g/L (IQR: 26-36); p = .029). Invasive mechanical ventilation (IMV) post HT was longer in patients with low mobility (p = .014). There were no significant differences in appearance of pressure ulcers, or post HT infections among mobility groups.

CONCLUSIONS

Patients with high mobility had a shorter time of IMV and a better nutritional status. No complications were observed associated to mobility. No differences were observed between the degree of mobility and 90-day mortality, ICU stay or post HT adverse events.

Blunted Pain Modulation Response to Induced Stress in Women with Fibromyalgia with and without Posttraumatic Stress Disorder Comorbidity: New Evidence of Hypo-Reactivity to Stress in Fibromyalgia?

There is evidence regarding the presence of alterations in both the stress response and the endogenous pain modulation systems of people with fibromyalgia (FM). However, research on pain modulation under induced stress on FM patients is scarce and contradictory. The present study analyzes stress-induced changes in pain and intolerance thresholds among FM patients, examining the possible existence of differences linked to PTSD comorbidity and gaining insights into the role of cardiovascular reactivity. Eighteen women diagnosed with FM and comorbid PTSD (FM + PTSD), 18 women diagnosed with FM and no PTSD (FM-PTSD), and 38 healthy women (HC) were exposed to the Social Stress Test task. Pressure pain thresholds and intolerance thresholds were measured before and during stress induction, and after a recovery period, while systolic blood pressure and heart rate were simultaneously recorded. Overall, while pain thresholds decreased during stress and recovery for HC, no significant changes were observed for women with FM. The intolerance threshold decreased for HC during stress, but was maintained at basal level during recovery. FM-PTSD women exhibited a delayed response, with a drop at recovery. For FM + PTSD, tolerance levels remained unchanged. In addition, cardiovascular reactivity did not seem to explain these results. This performance of the pain modulation system seems to follow the same pattern of hypoactive responsiveness under stressors that has previously been observed in FM patients on the autonomic and neuroendocrine axes. Such a hypoactive pattern may involve a non-adaptive response that may contribute to the development and maintenance of chronic pain.

Shifts in Composition and Activity of Oral Biofilms After Fluoride Exposure

Oral diseases are biofilm-mediated diseases caused by imbalances in the ecology of resident microflora. Among them, dental caries (tooth decay) is considered the most common disease worldwide, and toothbrushing, which physically eliminates the oral biofilm, is the most widespread prevention strategy. Although it is well established that fluoride increases enamel resistance to acidic pH and promotes tooth remineralization, its effect on the biofilm bacterial communities' composition and metabolism is not fully understood. We have grown in vitro oral biofilms and used 16S rRNA Illumina sequencing to study the effect of fluoride on DNA- and RNA-based bacterial populations. In addition, a metatranscriptomic approach has also been performed, in which total RNA has been sequenced to study gene expression profiles in the presence/absence of 500 ppm sodium fluoride. Our data show a lower pH drop and a clear shift in total and metabolically active bacterial composition after fluoride exposure. Streptococcus oralis was the species most affected, with a 10-fold reduction in both DNA and RNA samples, whereas Rothia mucilaginosa underwent an 8-fold increase in the DNA and S. salivarius a 4- and 5-fold increase in the RNA and DNA samples, respectively. The metatranscriptomes indicated that fluoride exposure induced a dramatic shutdown of sugar metabolism, including significant under-expression of different sugar transporters, fucosidases, and a pyruvate oxidase, among others. The reduction in saccharolytic organisms and the inhibition of sugar fermentation pathways by fluoride may therefore be considered instrumental for the beneficial effect of fluoride-containing oral hygiene products.

Prevalence of hepatocarcinoma-related hepatitis B virus mutants in patients in grey zone of treatment

BACKGROUND

Antiviral treatment of patients with chronic hepatitis B (CHB) in the grey zone of treatment comands risk management in order to optimize the health outcome. In this sense, the identification of HBV mutants related with an increased risk of hepatocellular carcinoma (HCC) could be useful to identify subpopulations with potential indication of antiviral treatment.

AIM

To analyze the prevalence/persistence of hepatitis B virus (HBV) preS and basal core promoter (BCP)/precore/core variants associated to HCC development in CHB patients in the grey zone.

METHODS

Work was designed as a longitudinal retrospective study, including 106 plasma samples from 31 patients with CHB in the grey zone of treatment: Hepatitis B e antigen negative, HBV-DNA levels between 12-20000 IU/mL, normal or discordant transaminase levels during follow up and mild/moderate necro-inflammatory activity in liver biopsy or Fibroscan (up to 9.5 kPa). Serum HBV-DNA was tested using the Abbott Real Time HBV Assay and the BCP/precore/core and the hepatitis B surface antigen (HBsAg) coding regions were analyzed in positive samples by PCR/bulk-sequencing to identify the HCC-related HBV mutants.

RESULTS

High-risk HCC related mutants were detected in 24 (77%) patients: 19 (61%) in the BCP/precore/core, and 7 (23%) in the HBsAg coding region (2 preS1 and 5 preS2 deletions). The prevalence of preS deletions was genotype-dependent: 3/5 (60%) patients with preS2 deletions and 1/2 with preS1 deletions were infected with the HBV-E genotype. Since HBV-E was the most prevalent in sub-Saharan patients, a correlation between preS deletions and ethnicity was also found: 6/8 (75%) sub-Saharan vs 1/19 (5%) Caucasian patients had preS deletions (P = 0.00016). Remarkably, this correlation was maintained in those patients infected with HBV-A, a minor genotype in sub-Saharan patients: 2/2 patients infected with HBV-A from West Africa vs 0/6 of Caucasian origin had preS deletions. The HCC related variants were the major strains and persisted over time (up to 48 mo). Patients with preS deletions had a significant higher prevalence of F2 fibrosis stage than the negatives (57% vs 10%, P = 0.0078).

CONCLUSION

HBV genetic analysis of selected populations, like sub-Saharans infected with HBV-E/A genotypes, will allow identification of subpopulations with risk of HCC development due to accumulation of high-risk HBV variants, thus commanding their increased clinical surveillance.

A Multicentre and stratified study of the attitude of medical students towards organ donation in Spain

INTRODUCTION

Medical students represent a new generation of medical thought, and if they have a favourable attitude towards organ donation this will greatly encourage its promotion.

OBJECTIVE

To analyse the attitude of medical students in Spanish universities towards the donation of their own organs and to determine the factors affecting this attitude.

MATERIAL AND METHODS

Type of study: A sociological, interdisciplinary, multicentre, and observational study in Spain.

STUDY POPULATION

Students studying a degree in medicine enrolled in Spain (n = 34,000).

SAMPLE SIZE

A sample of 9598 students (confidence of 99% and precision of ±1%), stratified by geographical area and academic year. Instrument of measurement: A validated questionnaire of attitude towards organ donation and transplantation (PCID-DTO RIOS) was self-administered and completed anonymously.

RESULTS

The questionnaire completion rate was 95.7% (n = 9.275). 80% were in favour of donation, 2% against and 18% were undecided. The following main variables were related to a favourable attitude: being of the female sex (Odds Ratio = 1.739); being in the sixth year of the degree (OR = 2.506); knowing a donor (OR = 1.346); having spoken about the subject with one's family (OR = 2.132) and friends (OR = 1.333); having a family circle that is in favour, more specifically, having a father (OR = 1.841), mother (OR = 2.538) or partner in favour (OR = 2.192); being a blood donor (OR = 2.824); acceptance of the mutilation of the body if it were necessary (OR = 2.958); and being an atheist or an agnostic (OR = 1.766).

CONCLUSIONS

Spanish medical students generally have a favourable attitude towards organ donation, although 20% are not in favour.

[Treatment of attention-deficit/hyperactivity disorder in clinical practice. A retrospective study]

Attention deficit hyperactivity disorder (ADHD) is a complex and heterogeneous neurodevelopmental disorder, of a chronic nature, of multifactorial etiology, mainly due to genetic and environmental factors. We conducted a retrospective analytical study of the t herapeutic management of children diagnosed with ADHD. A sample of 82 children diagnosed with ADHD (74.4% children and 25.6% girls) was studied. 96.3% of the cases presented some associated disorder. Pharmacological treatment was the treatment of choice (90.2%). 46.0% received immediate release methylphenidate, 51.4% sustained release methylphenidate and atomoxetine was only prescribed in 2.7% of patients. 20.3% of the sample abandoned pharmacological treatment at some point. Pharmacological treatment was the most frequent option in our sample, and methylphenidate immediate release the drug of choice for treatment initiation. The alternatives to stimulants are used in very low percentage of the patient. No significant differences were found between the type of treatment regarding the subtype of ADHD or gender, but we found significant difference in relation with the age of onset of treatment.

Data on sensory profile of green Spanish-style table olives studied by Quantitative Descriptive Analysis

This article contains processed data related to the research published in “Sensory profile of green Spanish-style table olives according to cultivar and origin” [1]. It provides information on the physicochemical characteristics of the analysed samples and the results of the multivariate analysis used in the above-commented paper. Particularly, it includes: i) the values of pH, titratable acidity, combined acidity, and NaCl for batches according to samples, ii) the scores given to each descriptor by the panelists according to samples, iii) the histogram of the overall scores for descriptor, iv) the boxplot of descriptors over samples, v) the effect of samples and contribution of panelists to the interaction sample∙panelist, vi) correlation between the panelists and the whole panel, vii) panelist performance, viii) panel repeatability, ix) sensory profile of samples (spider graph), x) adjusted means for descriptor according to samples, xi) prevalence of descriptors on samples, xii) product effect as assessed by p-value.

Do Spanish Medical Students Understand the Concept of Brain Death?

Objective:

To analyze the level of understanding of the brain death concept among medical students in universities in Spain.

Methods:

This cross-sectional sociological, interdisciplinary, and multicenter study was performed on 9598 medical students in Spain. The sample was stratified by geographical area and academic year. A previously validated self-reported measure of brain death knowledge (questionnaire Proyecto Colaborativo Internacional Donante sobre la Donación y Transplante de Organos) was completed anonymously by students.

Results:

Respondents completed 9275 surveys for a completion rate of 95.7%. Of those, 67% (n = 6190) of the respondents understood the brain death concept. Of the rest, 28% (n = 2652) did not know what it meant, and the remaining 5% (n = 433) believed that it did not mean that the patient was dead. The variables related to a correct understanding of the concept were: (1) being older ( P < .001), (2) studying at a public university ( P < .001), (3) year of medical school ( P < .001), (4) studying at one of the universities in the south of Spain ( P = .003), (5) having discussed donation and transplantation with the family ( P < .001), (6) having spoken to friends about the matter ( P < .001), (7) a partner’s favorable attitude toward donation and transplantation ( P < .001), and (8) religious beliefs ( P < .001).

Conclusions:

Sixty-seven percent of medical students know the concept of brain death, and knowledge improved as they advanced in their degree.

Data on fatty acid profiles of green Spanish-style Gordal table olives studied by compositional analysis

This article contains processed data related to the research published in “Tentative application of compositional data analysis to fatty acid profiles of green Spanish-style Gordal table olives” (Garrido-Fernández et al., 2018) [1]. It provides information on the implementation of compositional data analysis (CoDa) to the fatty acid profiles of Spanish-style Gordal table olives vs the use of conventional statistical analysis (data composition expressed in percentages). Particularly, it includes: i) the matrix of the sequential binary partition used for the balance estimation and the isometric log-ratio transformation (ilr) of the fatty acid profiles, ii) correlation among the diverse fatty acids expressed in percentages and their significances, iii) the ilr transformed values (coordinates in the Euclidean space) obtained following the sequential binary partition previously detailed, iv) the graphical presentation in the Simplex (ternary centred plot) of the treatments as a function of the four fatty acids with the higher log-ratio variances, and v) segregation of treatments based on Cluster Analysis.

Is the adjustable TVA mesh effective for the long-term treatment of female stress incontinence?

OBJECTIVES

To assess the long-term safety and efficacy of the adjustable TVA mesh in treating stress urinary incontinence.

MATERIAL AND METHODS

Pseudoexperimental study, before and after, conducted in a university urology department. Eighty-two patients were invited to participate from January 2002 to March 2005. Thirty-two patients agreed to participate and were implanted an adjustable TVA mesh. The preoperative study included a medical history review, physical examination with full bladder, flowmetry, residue study, complete urodynamic study and the self-administered questionnaires I-QoL and ICIQ-SF. In the postoperative assessment, the PGI-I questionnaire was added, but a complete urodynamic study was not performed.

RESULTS

Twenty-nine (90.6%) and 28 (87.5%) patients were continent in the stress test at 1 and 10 years, respectively. Twenty (62.5%) and 16 (50%) patients had no urine escape at 1 and 10 years, respectively. Twenty-eight (87.5%) and 25 (78%) patients were satisfied 1 and 10 years after the surgery, respectively. Twenty-eight (87.5%) and 21 (62.5%) patients had a good quality of life at 1 year and at 10 years, respectively. There were no significant complications at the end of the study period.

CONCLUSIONS

Treatment of stress urinary incontinence with the TVA mesh presented a high degree of objective healing and satisfaction at 10 years, with no severe adverse effects. The study showed that satisfaction does not always mean total continence but rather it reflects the improvement of symptoms and consequent quality of life.

Lateral-based Anterior Vaginal Wall Flap in the Treatment of Female Urethral Stricture: Efficacy and Safety

BACKGROUND

Female urethral stricture is a rare condition. Different types of urethroplasty have been described. However, high quality studies are sparse. The most common technique used-the Blandy's technique-has resulted in our cases in a retrusive meatus and an inward urinary stream.

OBJECTIVE

To show the efficacy and safety of an alternative vaginal wall flap urethroplasty.

DESIGN, SETTING, AND PARTICIPANTS

A cross-sectional observational study was undertaken in a single University Hospital. Nine female patients previously diagnosed with urethral stricture at our institution underwent open surgery from 1993 to 2015. They were contacted and agreed to undergo a medical examination.

SURGICAL PROCEDURE

A ventral lateral-based anterior vaginal wall flap urethroplasty inspired by the Orandi technique for male urethroplasty was performed.

MEASUREMENTS

A chart review was performed.

RESULTS AND LIMITATIONS

The mean age was 56 yr (41-78 yr). The mean follow-up was 80.7 mo (12-198). All patients had relief of symptoms. The meatus of all patients stayed in an orthotopic position without any impact on the direction of the urinary stream. The average caliber of the urethra increased from 10.8 Fr (6-18 Fr) to ≥20 Fr. Peak flow improved from a mean of 6.8ml/s (3-11ml/s) to 21ml/s (14-35ml/s). No patient developed stricture recurrence or de novo stress urinary incontinence. There were no other immediate or delayed complications. All patients achieved a better score on the Patient Global Impression of Improvement questionnaire.

CONCLUSIONS

Our study, with the same limitations that the few studies published in this field had, that is the few patients included, demonstrates that lateral anterior vaginal wall flap urethroplasty is an effective technique, offering durable results without apparent complications.

PATIENT SUMMARY

We studied an alternative surgical technique for the treatment of female urethral stricture. We conclude that it is safe and effective with no apparent complications and good long-term results.

The level of acceptance of spanish medical students of the transplantation of solid organs from animals: a stratified and multicentre study

INTRODUCTION

Research into the transplantation of solid organs from animals (xenotransplantation) is generating interest and curiosity given that this could be a way of resolving the shortage in transplant organs. However, the fact is that currently xenotransplantation is far from becoming a clinical practice.

OBJECTIVE

To analyse the attitude of medical students from Spanish universities towards the donation of organs from animals and to determine the factors affecting their attitudes.

MATERIAL AND METHODS

TYPE OF STUDY

A sociological, interdisciplinary, observational and multicentre study in Spain.

STUDY POPULATION

Students enrolled on the medical degree in Spain (n = 34 000).

SAMPLE SIZE

A sample of 9598 students (a confidence level of 99% and precision of ± 1%) stratified by geographical area and academic year. Instrument of measurement: A validated questionnaire of attitude towards organ xenotransplantation (PCID-XenoTx RIOS) which was self-administered and completed anonymously.

RESULTS

A completion rate of 95.7% (n = 9275) was obtained. If the results of xenotransplantation were as good as in human donation, 81% (n = 7491) would be in favour, 3% (n = 308) against and 16% (n = 1476) undecided. The following variables affected this attitude: sex (P < 0.001); academic year (P < 0.001); discussion of transplantation with one's family (P < 0.001) and friends (P < 0.001); the opinion of one's partner (P < 0.001); the respondent's attitude towards organ donation (P < 0.001); religion (P < 0.001); and participation in altruistic activities (P < 0.001). The following variables persisted in the multivariate analysis: (1) being a female (OR = 1.794; P < 0.001); (2) academic year (OR = 2.487; P < 0.001); (3) having spoken about the issue with one's family (OR = 1.200; P = 0.019); (4) the favourable opinion of one's partner (OR = 1.526; P = 0.028); (5) an attitude in favour of donation (OR = 2.087; P < 0.001); (6) being an atheist/agnostic, (OR = 2.5; P < 0.001); and (7) a belief that one's religion is in favour of transplantation (OR = 1.317; P = 0.005).

CONCLUSIONS

Spanish medical students have a favourable attitude towards xenotransplantation. This willingness and interest could be a decisive platform for the development and strengthening of research, both for centres with a pre-clinical xenotransplantation programme and new healthcare centres.

Mineral and sensory profile of seasoned cracked olives packed in diverse salt mixtures

This work studies the effect of packing cracked seasoned olives with NaCl, KCl, and CaCl(2) mixture brines on their mineral nutrients and sensory attributes, using RSM methodology. The Na, K, Ca, and residual natural Mn contents in flesh as well as saltiness, bitterness and fibrousness were significantly related to the initial concentrations of salts in the packing solution. This new process led to table olives with a significantly lower sodium content (about 31%) than the traditional product but fortified in K and Ca. High levels of Na and Ca in the flesh led to high scores of acidity and saltiness (the first descriptor) and bitterness (the second) while the K content was unrelated to any sensory descriptor. The new presentations using moderate proportions of alternative salts will therefore have improved nutritional value and healthier characteristics but only a slightly modified sensory profile.

Presence of the most abundant ionic species and their contribution to PM2.5 mass, in the city of Guadalajara, Jalisco (Mexico)

Ambient PM2.5 samples were taken at 24 h intervals at two sites (Centro and Miravalle) in the city of Guadalajara from January to June 2008. The Centro site is located in the downtown, while the Miravalle site is located in an industrial zone south of the downtown. For both sites the higher concentrations of PM2.5 were between January and May. High correlation coefficients between sulfate, nitrate and ammonium of 0.95, 0.92 and 0.91, respectively, showed low variations in the concentrations of these species in the city. It was estimated that sulfate, nitrate and ammonium represented almost 47% of the PM2.5 mass in June at the Centro site, but in general the contributions in the other months were less than 21%, while at Miravalle this percentage was between 7.7% and 27.6%.

Attitudes toward living kidney donation in transplant hospitals: a Spanish, Mexican, and Cuban multicenter study

INTRODUCTION

Living donor kidney (LKD) transplantation provides better results than deceased donor donation, involving minimum risk for the donor. However, LKD donation rates are low in most countries. We analyzed attitudes toward LKD in transplant hospitals in Spain, Mexico, and Cuba.

MATERIALS AND METHODS

Data were obtained from five transplant hospitals through the International Collaborative Program "Proyecto Donante Vivo, Murcia" in three countries: Spain (n = 1168), Mexico (n = 903), and Cuba (n = 202). The random sample (2273 employees) was stratified according to job category. The instrument used to evaluate attitude was a validated questionnaire. Statistical analysis included Student t test, the chi(2) test, and multivariate analysis.

RESULTS

Eighty eight percent (n = 2002) of Spanish, Mexican, and Cuban transplant hospital personnel were in favor of related LKD and 24% nonrelated LKD (n = 555). Attitudes were more favorable among centers in Cuba 97% (n = 195), followed by Mexico 88% (n = 793) and by Spain 87% (n = 1014; P < .001). According to job category, 91% (n = 617) of physicians were in favor, 88% (n = 543) of nurses, 85% (n = 198) of health care assistants, and 85% (n = 198) of auxiliary personnel. Attitudes were related to variables of: attitude toward deceased donation (P < .001), discussion about organ donation and transplantation (P < .001), concern about body mutilation after donation (P = .001), a possible need for a transplant in the future (P < .001), and attitude toward living liver donation (P < .001).

CONCLUSIONS

Attitudes toward LKD in Hispanic/Latin Transplant Hospitals were favorable and could encourage an increase in LKD in the coming years assuming suitable sociopolitical and economic condition, as well as support from nephrologists.

Evaluation of a combined anaerobic and aerobic system for the treatment of slaughterhouse wastewater

A laboratory scale anaerobic/aerobic (An/Ar) system, comprising an anaerobic filter (AF) coupled to an aerobic sequential batch reactor (SBR), was developed to treat wastewater from a slaughterhouse. The AF operated with organic loadings (OL) from 3.7 to 16.5 kg m(-3) d(-1) and a hydraulic retention time (HRT) ranging from 16 to 72 h. The efficiency of chemical oxygen demand (COD) removal was between 50 and 81% and was shown to be related inversely to the value of the OL. The production rate of methane was in the region of 411 mL per g of COD removed. On the other hand, the degradation of organic matter (OM) by an aerobic pathway in the SBR followed first-order kinetics with regard to OM concentration; 85% of the remaining OM from the AF was eliminated within 6 h of aeration, and over 95% of total OM was eliminated as COD within 9 h. The optimal treatment conditions in this system were found at OL = 11.0 kg m-3 d(-1) and HRT = 24 h in the AF, whereas the SBR was most efficient at 9 h of aeration.

Ozonation of azo dye in a semi-batch reactor: a determination of the molecular and radical contributions

Azo dye ozonation was carried in a semi-batch reactor to evaluate both the molecular and radical contributions of ozone on the dye decay. From two mass balance equations, the simultaneous determination of mass transfer, self-decomposition and solubility parameters of ozone were determined; thus establishing the steady state conditions in the experimental system. The results of kinetic studies showed that the decay of azo dye was a pseudo-first-order reaction with respect to dye concentration and the overall rate constant increased with an increase in the pH, however declined with an increase in the dye concentration. Furthermore, from the overall rate constants obtained at various pH values a mathematical analysis of dye decay was performed, which provides a practical new method to quantify the radical and molecular contributions in the ozonation of azo dyes.

Physicochemical and microbiological profile of packed table olives

The water activity of different commercial products of table olives as well as their physicochemical and microbiological profiles were studied. Average values of water activity were 0.976, 0.977, and 0.990 for green, directly brined, and ripe (by alkaline oxidation) olives, respectively. Mean values of pH were 3.69, 3.92, and 6.52 while salt levels were 5.53, 4.98, and 2.55 for the same commercial products. In some of the commercial products of green and directly brined olives that were examined, a certain level of microorganisms was observed. Most of them were lactic acid bacteria and yeasts, the lactic acid bacteria being more abundant than the yeasts. Traditionally, this flora has not been considered harmful due to its resemblance to that found in natural and spontaneous fermentation. Spore-forming mesophilic aerobes, which can be considered contaminants from ingredient or product handling, were present in only some samples and were always at low levels. However, their detection does not cause any concern regarding safety because there is no reference showing that they can grow in any of the products studied given the physicochemical characteristics found.

Fatty acid and sn-2 fatty acid composition in human milk from Granada (Spain) and in infant formulas

OBJECTIVE

To investigate differences in fatty acid and sn-2 fatty acid composition in colostrum, transitional and mature human milk, and in term infant formulas.

SETTING

Departament de Nutrició i Bromatologia, University of Barcelona, Spain and University Hospital of Granada, Spain.

SUBJECTS

One-hundred and twenty mothers and 11 available types of infant formulas for term infants.

DESIGN

We analysed the fatty acid composition of colostrum (n=40), transitional milk (n=40), mature milk (n=40) and 11 infant formulas. We also analysed the fatty acid composition at sn-2 position in colostrum (n=12), transitional milk (n=12), mature milk (n=12), and the 11 infant formulas.

RESULTS

Human milk in Spain had low saturated fatty acids, high monounsaturated fatty acids and high linolenic acid. Infant formulas and mature human milk had similar fatty acid composition. In mature milk, palmitic acid was preferentially esterified at the sn-2 position (86.25%), and oleic and linoleic acids were predominantly esterified at the sn-1,3 positions (12.22 and 22.27%, respectively, in the sn-2 position). In infant formulas, palmitic acid was preferentially esterified at the sn-1,3 positions and oleic and linoleic acids had higher percentages at the sn-2 position than they do in human milk.

CONCLUSION

Fatty acid composition of human milk in Spain seems to reflect the Mediterranean dietary habits of mothers. Infant formulas resemble the fatty acid profile of human milk, but the distribution of fatty acids at the sn-2 position is markedly different.

[Smith Lemli Opitz Syndrome type II of neonatal diagnosis and review of the most interesting clinical features]

INTRODUCTION

Smith Lemli Opitz syndrome is an autosomal recessive metabolic disease, two forms can be differentiated: type I and type II.

CASE REPORT

We present the clinical case of a female newborn with antecedents of oligoamnios and intrauterine growth retardation who presented a characteristic malformative syndrome, severe neurological impairment, anomalies of the limbs, pyloric stenosis, and renal and cardiac defects. Determination of cholesterol and its precursors by gas chromatography confirmed the clinical diagnosis of a severe form with exitus at six months of age. At the same time a review of the syndrome is presented.

The influence of dietary palmitic acid triacylglyceride position on the fatty acid, calcium and magnesium contents of at term newborn faeces

The distribution of long-chain saturated fatty acids in triglycerides is different in infant formulas to that in human milk. In human milk, palmitic acid is predominantly esterified in the sn-2 position (beta-position) of the triglycerides, whereas in infant formulas, it is esterified mainly in the sn-1,3 positions (alpha,alpha'-positions). The specific distribution of the fatty acids in the triglyceride plays a key role in lipid digestion and absorption. We studied fatty-acid, calcium and magnesium composition in the faeces of three groups of at term newborn infants fed different diets: Group A (n=12) was fed from birth to 2 months with human milk (66% palmitic acid in beta-position), Group B (n=12) was fed with formula alpha (19% palmitic acid esterified in beta-position) for 2 months, and Group C (n=12) was fed with formula alpha during the first month and with formula beta (44.5% palmitic acid in beta-position) during the second month. Samples were taken at the end of the first month (t0) and at the end of the second month (t1). Groups A and C presented significantly lower contents of palmitic acid in faeces at t1 than at t0, whereas in Group B, amounts remained similar. Faecal calcium in Groups A and C decreased in the second month (t1), although the fall was no statistically significant. In Group B, calcium amounts showed no change. We found that infant formula beta when compared with infant formula alpha reduced significantly the contents of total fatty acids and palmitic acid in faeces. We conclude that palmitic acid in beta-position is, therefore, beneficial for term infants.

Direct determination by high-performance liquid chromatography of sn-2 monopalmitin after enzymatic lipase hydrolysis

An alternative method to determine the sn-2 monopalmitin in infant formulas was developed and validated. This method offers many advantages over the traditional methods. It follows the official method in the first steps, purification of the fat or oil through an alumina column, and subsequently the triglycerides are incubated with pancreatic lipase in order to obtain the sn-2 monoglycerides. In traditional methods the sn-2 monoglycerides are separated by preparative thin-layer chromatography and then, the 2-monoglycerides are converted into the corresponding fatty acid methyl esters and analysed by gas chromatography. In our method, separation, quantification and identification of the sn-2 monoglycerides were achieved by high-performance liquid chromatography with evaporative light-scattering detection. The detection limit (0.19 microg), quantification limit (0.38 microg), linearity range (r=0.999, range 1-200 microg) and precision (SD=1.10) show the suitability of the proposed method. This method is faster, cheaper and simple and does not consume large quantities of reagents and materials.

Diversity of free-living prokaryotes from a deep-sea site at the Antarctic Polar Front

To contribute to the understanding of deep-sea planktonic communities, we explored the prokaryotic diversity of a 3000 m deep site at the Antarctic Polar Front using molecular methods. Bacterial 16S rDNA-amplified sequences corresponded to the as yet uncultivated groups SAR11, within the alpha-Proteobacteria, and SAR324, within the delta-Proteobacteria, as well as to the gamma-Proteobacteria, Cytophagales, Planctomyces, Gram-positives, and the group of environmental sequences SAR406. Among them, gamma-proteobacterial sequences were the most abundant and diverse. Within Archaea, and using six different primer sets for 16S rDNA amplification, only euryarchaeotal sequences were retrieved. Most of them clustered with the Thermoplasma-related marine groups II and III, but some corresponded to a recently described group of marine sequences emerging at the base of haloarchaea. Our data suggest that gamma-Proteobacteria and Euryarchaeota may be dominant elements in terms of genetic diversity of the two prokaryotic domains in this deep-sea pelagic area.

Archaeal Biodiversity in Crystallizer Ponds from a Solar Saltern: Culture versus PCR

The culturable haloarchaeal diversity in a crystallizer pond from a solar saltern has been analyzed and compared with the biodiversity directly retrieved by analysis of rRNA genes amplified from the environment. Two different sets of culture conditions have been assayed: solid medium with yeast extract as carbon source and liquid media with either yeast extract or a mixture of fishmeal, Spirulina sp., and Artemia salina. Seventeen colonies grown on plates with yeast extract incubated at 30 degrees C were analyzed by 16S rDNA partial sequencing. Sixteen were closely related to haloarchaea of the genus Halorubrum; 13 of them to Halorubrum coriense, a haloarchaeon isolated from a solar saltern pond in Australia, which had not been previously isolated from the pond analyzed in this study; and one to Haloarcula marismortui. Liquid cultures were analyzed by ribosomal internal spacer analysis (RISA) and partial sequencing of the 16SrRNA genes. A total of 18 sequences were analyzed, 15 corresponding to RISA bands obtained from cultures, and 3 from the environmental sample used as inoculum. Thirteen sequences obtained from cultures were related to several Halorubrum species, and 2 to Haloarcula. One of the clones obtained directly from the environmental sample was distantly related to a Natronobacterium, whereas two were related to SPhT, the phylotype most frequently retrieved from this environment by culture independent techniques. Our results show an extremely low diversity for the haloarchaea retrieved by cultivation even when modifications to the standard technique are introduced.

A novel haloarchaeal-related lineage is widely distributed in deep oceanic regions

During our study of the 16S rRNA gene sequence-based archaeal diversity of a deep-sea site located at a 3,000 m depth at the Antarctic Polar Front, we detected several phylotypes ascribed to already known Group II and III Euryarchaeota, and a cluster of distinct sequences that branched off at the base of haloarchaea. The position of this lineage (marine Group IV) was very robust using distance (neighbour-joining) and maximum-likelihood methods. Subsequently, we designed specific primers for the detection of this archaeal group in other marine environments using polymerase chain reaction amplification and sequence comparison. Group IV archaea were found in the Antarctic area (across a gradient from the Southern ocean to the South Atlantic), and also in North Atlantic and Mediterranean waters. In all oceanic locations, Group IV archaea were never detected in surface waters, but were vertically distributed in the deepest part of the water column.

Comparison of two direct methods for the determination of fatty acids in infant feces

We have validated and compared two direct methods for the determination of fatty acids in feces by capillary gas chromatography. Method I consisted of esterification of fatty acids using acetyl chloride. Method II used boron trifluoride-methanol as esterification reagent. The two methods were assayed with and without previous freeze-drying of the fecal sample. We found that the two methods could be carried out without sample freeze-drying. Precision and recovery rates were determined and the results were satisfactory. Both methods gave similar results, but Method II has certain advantages over Method I, such as speed, safety, and better recovery rates.

[Essential tremor: a review of pathogenic mechanisms]

INTRODUCTION

Essential tremor (ET) is the commonest involuntary movement observed and is seen when a given posture is maintained. Although it does not affect life expectancy, it may cause considerable functional disability and serious psychological effects in the affected person.

DEVELOPMENT

ET is a heterogeneous clinical condition. Its physiopathology is still not known, is very complex and involves many mechanisms, both structural and biochemical, although as yet there is no theory to include them all. In view of what is known at present, it may be accepted that there is a central oscillator at olive-cerebellar-thalamic-cortical-spinal level, which is the primary generator of ET, modulated by a peripheral component. The tremor results from interaction between increased central excitability and peripheral regulation, which in turn reinforces the central overactivity. It may also be that the monoaminergic system (catecholaminergic and serotoninergic), adrenoreceptors (especially the B2 muscular adreno-receptors) and the bodily structure itself, amongst other factors, may influence the pathogenic mechanism of ET. It is likely that there is a multifactorial genetic disorder which predetermines this physiopathogenic process, although this has not yet been determined.

CONCLUSIONS

In this paper we review the various hypotheses and existing knowledge related to the aetiopathogenesis of TE.

[A review of the pathogenesis of the hallucinatory state. A description of four case]

INTRODUCTION

A hallucination is a sensorial experience occurring in the absence of external stimuli. It may show as psychological or organic disorders. The main causes are lesions of the central nervous system and of the sensorial organs. The hallucination may present with or without critical perception but always appears to be a real experience.

CLINICAL CASE

We describe four patients diagnosed as having hallucinations secondary to known lesions. The first two had visual hallucinations and cerebral ischaemia, the first in the dorso-lateral region of the medulla oblongata and the second in the left parietal lobe. The other two had peripheral sensorial defects. The third patient had simultaneously an ophthalmic disorder and visual hallucinations, and the fourth had chronic hypoacusia and auditory hallucinations. All showed structured sensorial hallucinations with critical appraisal of these hallucinations.

CONCLUSIONS

In this paper we review the pathogenesis of the organic hallucinatory state. The main mechanisms are proposed: by means of liberation (destruction of inhibitory structures) and by means of irritation (anomolous excitation of cerebral structures). Also we point out the difference between a hallucination and psychiatric disorders, mainly in three aspects: presence of the known organic lesion, critical appraisal of the perception in spite of it appearing as real to the patient, and the absence of associated psychiatric pathology.

[Incidence of glioblastoma multiforme in Aragon and La Rioja. An epidemiological survey]

The aim of this work has been to evaluate the epidemiologic data in a series of 157 patients operated for glioblastoma multiforme in Aragón and La Rioja, during a period of 15 years. We haven't analyzed the cases that weren't operated on, because of the localization of the tumor or the bad situation of the patient. All the patients have an anatomopathologic confirmation. We have studied a total of 795 patients operated for a cerebral or cerebellar tumor. The glioblastoma multiforme was the third type of tumor in frequency, after the meningioma and the astrocytoma. In the different groups of age the peak incidence was between the 50 and 59 years old, followed the group between 60 to 69. 153 cases appeared in adults and only 4 cases were found below the age of 20. The right hemisphere was the most frequently affected. Males were more often affected than females, with 96 cases (61.14%) in males and 61 cases (38.85%) in females. We couldn't find a significative relation between the presence of the tumor and the profession or another personal antecedent of the patients.

[Biopercular lesion with inverse dissociation]

Foix-Chavany-Marie Syndrome or anterior opercular syndrome constitutes the cortical form of pseudobulbar palsy. Its most common etiology is stroke in the region of either operculum. Clinically it can be characterized by severe dysarthria and facio-pharyngo-glosso-masticatory dysplasia with automatic-voluntary dissociation. An inversion of this classical dissociation can be seen in patients with emotional paralysis in the face, in whom asymmetry of emotional expression but conservation of voluntary movement can be seen. The lesional topography of this inverse dissociation corresponds to the supplementary motor area. both processes support the existence of an anatomical base which is different for emotional movements and voluntary types. We describe the clinical case of a 65 year old woman with a history of breast cancer who presented a subacute and progressive clinical picture of dysphagia and severe dysarthria. Upon neurological examination slight velo-palato-pharyngea was noticed; most relevant was paralysis of the facial muscles for either emotional or automatic movements while voluntary innervation was maintained. Neuroradiological studies show the presence of brain metastasis located in both Roland opercula. Although the neuroanatomic bases for automatic-voluntary dissociation remain unclear, our case lends weight to the evidence that impulses for voluntary and emotional movements originate in different cortical areas or else take a different route through the brain. We have been unable to find any cases of biopercular lesion with inverse dissociation described in the literature we reviewed.

[Thyroid ophthalmopathy ad a unique clinical manifestation of thyrotoxicosis]

Thyroid ophthalmopathy (TO) or Graves ophthalmopathy embraces a broad range of eye abnormalities which up to 90% of patients with hyperthyroidism (HT) are affected with. In some 10% of TO patients, this may begin oligosymptomatically, often with double vision and with neither clinical nor biochemical signs of thyroid disease. It is imperative to carry out a differential diagnosis with countless other causes for double vision and other eye socket processes. Ophthalmopathy may also occur in patients with hypothyroidism and for this reason some authors prefer to refer to it as dysthyroid orbitopathy. We present four cases of TO in which double vision was the first clinical sign of TO which in one case became severe, in two cases preceded hyperthyroid symptomatology and in the remaining case happened after hyperthyroidism had been corrected. The most valuable diagnostic test was orbit computerised tomography (CT) scan, which proved positive in all cases, and that, along with clinical tests and thyroid function data, confirmed a diagnosis of TO. All initially improved with corticosteroids although none completely regained eye movement during the time they were under supervision. The same happens in about 50% of patients who do not respond to treatment either with corticosteroids or with radiotherapy, and response is usually incomplete in those who do so respond.