Factores asociados con la mortalidad por SARS-CoV-2 en la población mayor de 75 años de la Comunidad de Madrid

Objetivo

Pacientes y métodos

Resultados

Conclusión

Factors associated with mortality due to SARS-CoV-2 in the population over 75 years of age in the Community of Madrid

Objective

Various studies have identified factors associated with risk of mortality in patients with SARS-CoV-2 infection. However, their sample size has often been limited and their results partially contradictory. This study evaluated factors associated with COVID-19 mortality in the population of Madrid over 75 years of age, in infected patients, and in hospitalized patients up to January 2021.

Patients and Methods

This population-based cohort study analyzed all residents of the Community of Madrid born before January 1, 1945 who were alive as of December 31, 2019. Demographic and clinical data were obtained from primary care electronic medical records (PC-Madrid), data on hospital admissions from the Conjunto Mínimo Básico de Datos (CMBD, Minimum Data Set), and data on mortality from the Índice Nacional de Defunciones (INDEF, National Death Index). Data on SARS-CoV-2 infection, hospitalization, and death were collected from March 1, 2020 to January 31, 2021.

Results

A total of 587,603 subjects were included in the cohort. Of them, 41,603 (7.1%) had confirmed SARS-CoV-2 infection, of which 22,362 (53.7% of the infected individuals) were hospitalized and 11,251 (27%) died. Male sex and age were the factors most closely associated with mortality, though many comorbidities also had an influence. The associations were stronger in the analysis of the total population than in the analysis of infected or hospitalized patients. Mortality among hospitalized patients was lower during the second wave (33.4%) than during the first wave (41.2%) of the pandemic.

Conclusion

Age, sex, and numerous comorbidities are associated with risk of death due to COVID-19. Mortality in hospitalized patients declined notably after the first wave of the pandemic.

Doublecortin in the Fish Visual System, a Specific Protein of Maturing Neurons

Simple Summary

Doublecortin (DCX) is an essential protein in the development of the central nervous system and in lamination of the mammalian cortex. It is known that the expression of DCX is restricted to newborn neurons. The visual system of teleost fish has been postulated as an ideal model since it continuously grows throughout the animal’s life. Here, we report a comparative expression analysis of DCX between two teleost fish species as well as a bioinformatic analysis with other animal groups. Our results demonstrate that DCX is very useful for identifying new neurons in the visual systems of Astatotilapia burtoni, but is absent in Danio rerio.

Abstract

Doublecortin (DCX) is a microtubule associated protein, essential for correct central nervous system development and lamination in the mammalian cortex. It has been demonstrated to be expressed in developing—but not in mature—neurons. The teleost visual system is an ideal model to study mechanisms of adult neurogenesis due to its continuous life-long growth. Here, we report immunohistochemical, in silico, and western blot analysis to detect the DCX protein in the visual system of teleost fish. We clearly determined the expression of DCX in newly generated cells in the retina of the cichlid fish Astatotilapia burtoni, but not in the cyprinid fish Danio rerio. Here, we show that DCX is not associated with migrating cells but could be related to axonal growth. This work brings to light the high conservation of DCX sequences between different evolutionary groups, which make it an ideal marker for maturing neurons in various species. The results from different techniques corroborate the absence of DCX expression in zebrafish. In A. burtoni, DCX is very useful for identifying new neurons in the transition zone of the retina. In addition, this marker can be applied to follow axons from maturing neurons through the neural fiber layer, optic nerve head, and optic nerve.

Complete Genome Sequence of the Plant-Pathogenic Fungus Colletotrichum lupini

Colletotrichum is a fungal genus (Ascomycota, Sordariomycetes, Glomerellaceae) that includes many economically important plant pathogens that cause devastating diseases of a wide range of plants. In this work, using a combination of long- and short-read sequencing technologies, we sequenced the genome of Colletotrichum lupini RB221, isolated from white lupin (Lupinus albus) in France during a survey in 2014. The genome was assembled into 11 nuclear chromosomes and a mitochondrial genome with a total assembly size of 63.41 Mb and 36.55 kb, respectively. In total, 18,324 protein-encoding genes have been predicted, of which only 39 are specific to C. lupini. This resource will provide insight into pathogenicity factors and will help provide a better understanding of the evolution and genome structure of this important plant pathogen.[Formula: see text] Copyright © 2021 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license.

Selective suppression of {112} anatase facets by fluorination for enhanced TiO2 particle size and phase stability at elevated temperatures

Generally, anatase is the most desirable TiO₂ polymorphic phase for photovoltaic and photocatalytic applications due to its higher photoconductivity and lower recombination rates compared to the rutile phase. However, in applications where temperatures above 500 °C are required, growing pure anatase phase nanoparticles is still a challenge, as above this temperature TiO₂ crystallite sizes are larger than 35 nm which thermodynamically favors the growth of rutile crystallites. In this work, we show strong evidence, for the first time, that achieving a specific fraction (50%) of the {112} facets on the TiO₂ surface is the key limiting step for anatase-to-rutile phase transition, rather than the crystallite size. By using a fluorinated ionic liquid (IL) we have obtained pure anatase phase crystallites at temperatures up to 800 °C, even after the crystallites have grown beyond their thermodynamic size limit of ca. 35 nm. While fluorination by the IL did not affect {001} growth, it stabilized the pure anatase TiO₂ by suppressing the formation of {112} facets on anatase particles. By suppressing the {112} facets, using specific concentrations of fluorinated ionic liquid in the TiO₂ synthesis, we controlled the anatase-to-rutile phase transition over a wide range of temperatures. This information shall help synthetic researchers to determine the appropriate material conditions for specific applications.

Straw Competition and Wheat Root Endophytism of Trichoderma gamsii T6085 as Useful Traits in the Biological Control of Fusarium Head Blight

Trichoderma gamsii T6085 has been investigated for many years as a beneficial isolate for use in the biocontrol of Fusarium head blight (FHB) of wheat caused primarily by Fusarium graminearum. Previous work focused on application of T6085 to wheat spikes at anthesis, whereas application to soil before or at sowing has received limited attention. In the present study, the competitive ability of T6085 on plant residues against F. graminearum was investigated. Results showed a significant reduction of wheat straw colonization by the pathogen and of the development of perithecia, not only when T6085 was applied alone but also in the presence of a F. oxysporum isolate (7121), well known as a natural competitor on wheat plant residues. T6085 was able to endophytically colonize wheat roots, resulting in internal colonization of the radical cortex area, without reaching the vascular system, as confirmed by confocal microscopy. This intimate interaction with the plant resulted in a significant increase of the expression of the plant defense-related genes PAL1 and PR1. Taken together, competitive ability, endophytic behavior, and host resistance induction represent three important traits that can be of great use in the application of T6085 against FHB not only on spikes at anthesis but potentially also in soil before or at sowing.

In vivo dosimetry in low-voltage IORT breast treatments with XR-RV3 radiochromic film

PURPOSE

The objectives of the study were to establish a procedure for in vivo film-based dosimetry for intraoperative radiotherapy (IORT), evaluate the typical doses delivered to organs at risk, and verify the dose prescription.

MATERIALS AND METHODS

In vivo dose measurements were studied using XR-RV3 radiochromic films in 30 patients with breast cancer undergoing IORT using the Axxent® device (Xoft Inc.). The stability of the radiochromic films in the energy ranges used was verified by taking measurements at different depths. The stability of the scanner response was tested, and 5 different calibration curves were constructed for different beam qualities. Six pieces of film were placed in each of the 30 patients. All the pieces were correctly sterilized and checked to ensure that the process did not affect the outcome. All calibration and dose measurements were analyzed using the Radiochromic.com software application.

RESULTS

The doses were measured for 30 patients. The doses in contact with the applicator (prescription zone) were 19.8 ± 0.9 Gy. In the skin areas, the doses were as follows: 1-2 cm from the applicator, 1.86 ± 0.77 Gy; 2-5 cm, 0.73 ± 0.14 Gy; and greater than 5 cm, 0.28 ± 0.17 Gy. The dose delivered to the pectoral muscle (tungsten shielding disc) was 0.51 ± 0.27 Gy.

CONCLUSIONS

The study demonstrated the viability of XR-RV3 films for in vivo dose measurement in the dose and energy ranges applied in a complex procedure, such as breast IORT. The doses in organs at risk were far below the tolerances for cases such as those studied.

Reverse Semi-Combustion Driven by Titanium Dioxide-Ionic Liquid Hybrid Photocatalyst

Unprecedented metal-free photocatalytic CO2 conversion to CO (up to 228±48 μmol g-1 h-1) was displayed by TiO2@IL hybrid photocatalysts prepared by simple impregnation of commercially available P25-titanium dioxide with imidazolium-based ionic liquids (ILs). The high activity of TiO2@IL hybrid photocatalysts was mainly associated to (i) TiO2@IL red shift compared to the pure TiO2 absorption, and thus a modification of the TiO2 surface electronic structure; (ii) TiO2 with IL bearing imidazolate anions lowered the CO2 activation energy barrier. The reaction mechanism was postulated to occur via CO2 photoreduction to formate species by the imidazole/imidazole radical redox pair, yielding CO and water.

Combined Comparative Genomics and Gene Expression Analyses Provide Insights into the Terpene Synthases Inventory in Trichoderma

Trichoderma is a fungal genus comprising species used as biocontrol agents in crop plant protection and with high value for industry. The beneficial effects of these species are supported by the secondary metabolites they produce. Terpenoid compounds are key players in the interaction of Trichoderma spp. with the environment and with their fungal and plant hosts; however, most of the terpene synthase (TS) genes involved in their biosynthesis have yet not been characterized. Here, we combined comparative genomics of TSs of 21 strains belonging to 17 Trichoderma spp., and gene expression studies on TSs using T. gamsii T6085 as a model. An overview of the diversity within the TS-gene family and the regulation of TS genes is provided. We identified 15 groups of TSs, and the presence of clade-specific enzymes revealed a variety of terpenoid chemotypes evolved to cover different ecological demands. We propose that functional differentiation of gene family members is the driver for the high number of TS genes found in the genomes of Trichoderma. Expression studies provide a picture in which different TS genes are regulated in many ways, which is a strong indication of different biological functions.

Portuguese consensus document for the management of alpha-1-antitrypsin deficiency

Alpha-1-antitrypsin deficiency (AATD) is a genetic autosomal codominant disorder caused by mutations in SERPINA1 gene. It is one of the most prevalent genetic disorders, although it remains underdiagnosed. Whereas at international level there are several areas of consensus on this disorder, in Portugal, inter-hospital heterogeneity in clinical practice and resources available have been adding difficulties in reaching a diagnosis and in making therapeutic decisions in this group of patients. This raised a need to draft a document expressing a national consensus for AATD. To this end, a group of experts in this field was created within the Portuguese Pulmonology Society - Study group on AATD, in order to elaborate the current manuscript. The authors reviewed the existing literature and provide here general guidance and extensive recommendations for the diagnosis and management of AATD that can be adopted by Portuguese clinicians from different areas of Medicine. This article is part of a supplement entitled "Portuguese consensus document for the management of alpha-1-antitrypsin deficiency" which is sponsored by Sociedade Portuguesa de Pneumologia.

Case report: Hallucinations as depressive equivalents

We comment the case of a 12 years old girl who started with visual and auditive hallucinations. Hallucinations are not a common symptom between children. They may also be linked to many conditions, some of them with poor outcome as schizophrenia. Symptoms appeared in a short time, after a previous normal development. She talked about a man who followed her and that was always behind, she also had heard some insults of undeterminated voices. These symptoms were just of one-month duration and made her feel anxious and very afraid. After a normal organical study and a first proposal of medication they asked for our consultation. We found that the patient was alone at home every afternoon. Family, from other country, hadn’t any social support, and the father had had to travel away some days before the child began to suffer hallucinations. Suspecting an affective disorder as the basis of anxious symptoms, and hallucinations as a cultural presentation of them, we started with a social intervention mixed with support therapy. After some sessions the patient could talk about her loneliness and fears, disappearing the other symptoms. We will resume this case and literature about other cultural presentations that may difficult diagnosis or treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Cardiovascular morbidity-mortality associated to ankle-brachial index in the general population

BACKGROUND AND OBJECTIVES

Abnormal ankle-brachial index (ABI) is associated with a high risk of cardiovascular disease. This study has aimed to investigate the association between low ABI and risk of cardiovascular death in a general population attended in a primary care center.

PATIENTS AND METHODS

A total of 1,361 volunteers aged between 60 and 79 years without any evidence of peripheral artery disease who attended a primary care center participated in the study. They underwent a complete physical examination, together with standard blood tests and ABI was determined. The participants were contacted by telephone 4 years later and asked about any cardiovascular problems for that period. Causes of death and hospitalization were confirmed in the medical records in the primary care center and/or hospital.

RESULTS

Information was obtained about the clinical evolution of 1,300 participants (mean age 69.9 years, 38.2% men). Mean follow-up was 49.8 months. There were 13 cardiovascular death and 49 major cardiovascular events. Low ABI (<0.9) was associated with a significant higher risk of cardiovascular death (adjusted relative risk 6.83; 95% confidence interval 1.36-34.30, P=.020), and with a higher risk of major cardiovascular events (adjusted relative risk 2.42; 95% confidence interval 0.99-5.91, P=.051). High or uncompressible ABI was not associated with higher cardiovascular risk.

CONCLUSIONS

A low ABI was associated with higher risk of cardiovascular death in the general population followed-up in a primary care center.

Fracturas en el plano coronal del húmero distal

Son lesiones que comprenden las fracturas del cóndilo y/o de la tróclea humeral. Suponen el 1% de las fracturas del codo y el 6% de las fracturas del húmero distal. Las más frecuentes son las fracturas del cóndilo humeral tipo I según la clasificación de Bryan y Morrey. Analizamos 16 casos de este tipo de lesiones tratadas con reducción abierta y osteosíntesis con tornillos y valoramos los resultados funcionales. Obtuvimos la consolidación en el 100 % de los casos con ausencia de dolor o dolor leve. El 87,5 % de los casos presentaron una movilidad activa en flexión entre 120º y 140º, en extensión de –10º a –30º. Prono-supinación completa en 15 casos y un déficit de pronación de 60º y de supinación de 50º en un caso. El 100 % volvieron a su actividad laboral sin restricciones en 11 semanas. En el seguimiento (11,3 meses de media, rango: 4-29), 2 pacientes (12,5%), necesitaron de cirugía por rigidez articular (artrolisis abierta). No hubo ningún caso de necrosis avascular. Subrayamos la importancia de obtener una reducción anatómica suficientemente estable, siendo la osteosíntesis abierta el mejor método para conseguirlo y así permitir la movilización precoz del codo y una la correcta recuperación funcional.

[Ankle-brachial index in patients with diabetes mellitus: prevalence and risk factors]

INTRODUCTION

Diabetic patients have a high cardiovascular morbidity and mortality rate. Ankle brachial index (ABI) is an available, straightforward and reproducible method for the detection of peripheral vascular disease and for improving risk stratification in this population. The objective of our study was to evaluate the prevalence of a low and a pathological ABI in type 2 diabetics older than 60 years and to study the risk factors associated with its development.

PATIENTS AND METHODS

1,360 subjects between 60 and 79 years, 213 of them diabetics, without symptoms of intermittent claudication and who gave their consent to have an ABI measurement in their primary care center were included in the study. Cardiovascular risk factors were evaluated in all participants. An ABI < 0.9 was considered low and a value < 0.9, >or= 1.4 or non-compressible was considered pathological.

RESULTS

Prevalence of a low ABI in subjects with or without diabetes was 11.3% and 4.3% and prevalence of a pathological ABI was 18.8% and 7%, respectively. Factor associated with a low or pathological ABI were gender, age, duration of diabetes, the type of antidiabetic treatment and the presence of vascular disease in another vascular bed. After multivariate adjustment, only age (OR: 1.15; 95% CI: 1.04-1.27) and duration of diabetes (OR: 1.05; 95% CI: 1.01-1.10) continue being significant. The prevalence of a pathological ABI did not differ between diabetics without vascular disease and non-diabetics with previous cardiovascular disease.

CONCLUSION

The prevalence of a low or pathological ABI is elevated in diabetic subjects and relates with age, duration of diabetes and the presence of vascular disease in another vascular bed.

Effect of environmental temperature on tissue lead accumulation in mice repeatedly treated with lead acetate

The effect of environmental temperature on lead accumulation in tissues of mice repeatedly treated with lead acetate (2 mg/kg per day and 5 mg/kg per day) for 3 or 6 weeks was studied. In blood, kidney and liver, the amount of lead accumulated after 3 weeks of treatment was markedly higher in animals exposed to 22 degrees C than those maintained at 35 degrees C. Conversely, when the treatment was extended to 6 weeks, lead concentrations in the liver and kidney were equal or higher respectively, in the mice exposed to 35 degrees C. In the brain, lead concentration was lower than that found in kidney and liver and it was independent of dose and ambient temperature of lead being higher at 35 degrees C than at 22 degrees C. These results demonstrate that environmental temperature influences the amount of lead accumulated in some rodent tissues, and that the duration of the treatment modifies the effect produced by temperature, suggesting that the changes elicited during the period of acclimation to the hot environment could be responsible for these findings.

Effects of different factors in lead- and cadmium-induced hypothermia in mice

The aim of this study was to investigate the relationship between the hypothermic effect induced by lead or cadmium chloride treatments and the cerebral metal levels attained. Mice were injected intraperitoneally with different doses of lead acetate or cadmium chloride at ambient temperatures of 22 degrees C and 35 degrees C, and rectal temperatures and brain metal levels were determined. At 22 degrees C, doses of lead acetate exceeding 25 mg/kg caused significant hypothermia and a rise of lead levels in the brain; this hypothermic effect was significantly inhibited at 35 degrees C. In mice repeatedly treated with 2 or 5 mg/kg lead acetate and exposed to 22 degrees C or 35 degrees C, no significant changes were observed in body temperature after the repeated exposure, although brain lead levels increased significantly. Cadmium chloride at 22 degrees C produced a significant fall in body temperature, and a rise in brain cadmium levels at doses of 2-4 mg/kg; the decrease in body temperature was partially inhibited at 35 degrees C. The results of the present study suggest that the hypothermic effect elicited by these heavy metals is related to both the level of metal absorbed by the brain and its rate of uptake.

[Elastic system in human gingiva in health and periodontal disease]

We processed 28 samples of human gingiva in health or paradential illness, of 15 patients between 20 to 67 years old. In 306 histologies cuts we made different staining to light microscope. We analyzed presence, distribution, diameter and relations of the elastic, elaunin and oxytalan fibers. The patron of distribution fibrilar of the elastic system gingival was different than other zones of the body. The description had made in three zones of the gingival connective tissue: deep, subpapilar and papilar zones. The elastic fibers had less numerous and larger diameter than the elaunin y oxytalan ones. Their repair was irregular. The elaunin followed the colagen fibers. The oxytalan formed delicates nets in the lodge of connective tissue, inflamatories infiltrates and interfibrilar spaces. They came to the basal membrane perpendicularly or oblicualy, isolated or in little bundles. The fibers of elastic system increased principaly in inflamed gingiva of teeth with overburden, though they supported the low proportion that exist at health gingiva. They appeared at the little vases wall and were increased at zones next to edentate spaces. The analogy and close entail between the elaunin and oxytalan fibers to colagen ones, made think in a relation of reenforcement of colagen, increased at paradential illness.