Immunogenicity of BNT162b2 vaccine after two and three doses in health personnel and institutionalized elderly people not infected with SARS-CoV-2

OBJECTIVE

The aim of our research was to compare the evolution of the immune response induced by the BNT162b2 vaccine after the administration of two and three doses in healthcare personnel and in institutionalized elderly people (>65 years of age) without previous SARS-CoV-2 infection.

MATERIAL AND METHODS

A prospective observational study was carried out on a convenience sample made up of health workers and institutionalized elderly people, measuring antibodies against S and N proteins of SARS-CoV-2 two and six months after receiving the second vaccine dose, as well as two months after receiving the third dose.

RESULTS

A significant reduction of the anti-S humoral immune response was reported six months after the second dose of vaccine in both health workers and residents. The administration of a third dose of vaccine induced a significant increase in this antibody response in both investigated groups reaching a similar proportion of responders two months after this third dose.

CONCLUSIONS

Humoral immunity induced by two doses of the BNT162b2 vaccine in persons without prior SARS-CoV-2 infection wanes over time. The administration of a third dose significantly increases anti-S antibodies being highly recommended, especially in people over 65 years of age.

Analysis of diagnostic tests in patients with dry eye and hypothyroidism: an observational study

PURPOSE

Colombia is a country with a high prevalence of hypothyroidism, approximately 18.5% compared to the rest of Latin American countries, which is estimated at 10%. That is why in the ophthalmology consultation we find a large proportion of patients with this disease and who also present symptoms of dry eye. When conducting a search in the medical literature, most publications refer to the clinical presentation of dry eye in hyperthyroidism, which is why the main objective of this study is to evaluate tear function tests in the diagnosis of dry eye in patients with hypothyroidism.

METHODS

This is an observational, cross-sectional study carried out in the period between May and December 2019 in the ocular surface unit of the Ophthalmic Technology Center (CTO) in Bogotá. The tests of: OSDI test (Ocular Surface Disease Index), Schirmer type I, tear meniscus height, NiBUT, Osmolarity, Ferning test, Lisamine Green test of 59 patients with Dry Eye Disease (DED) and history of hypothyroidism.

RESULTS

Schirmer type I and NiBUT tests were the parameters that presented the highest percentage of severity, while lissamine green staining and meniscometry showed a tendency to normality.

CONCLUSIONS

The population of this study presents a mixed type dry eye without epithelial cell damage.

Prevalence of depression in Europe using two different PHQ-8 scoring methods

Introduction

The prevalence of depression based on the Patient Health Questionnaire-8 (PHQ-8) may vary depending on the scoring method.

Objectives

1) To describe the prevalence of depression in Europe using two PHQ-8 scoring methods. 2) To identify the countries with the highest prevalence according to each method.

Methods

Data from 27 countries included in the European Health Survey (EHIS-2) for the year 2014/2015 were used (n=258,888). All participants who completed the PHQ-8 were included. The prevalence of depression and its 95% Confidence Interval (95%CI) were calculated overall for the whole of Europe and for each country using a PHQ-8≥10 cut-off point and the PHQ-8 algorithm scoring method. Weights derived from the complex sample design were considered for their calculation.

Results

The overall prevalence of depression for all Europe was lower using the PHQ-8>=10 cut-off point (6.38%, 95%CI 6.24-6.52) than the PHQ-8 algorithm (7.01%, 95%CI, 6.86-7.16). Using the PHQ-8≥10 cut-off point, the highest prevalence was observed in Iceland (10.33%, 95%CI, 9.33-11.32), Luxembourg (9.74%, 95%CI, 8.76-10.72) and Germany (9.24%, 95%CI, 8.82-9.66). Using the PHQ-8 algorithm the highest rates were observed in Hungary (10.99%, 95%CI,10.14-11.84), Portugal (10.63%, 95%CI, 9.96-11.29) and Iceland (9.80%, 95%CI, 8.77-10.83).

Conclusions

There is variability in the prevalence of depression rates in Europe according to the PHQ-8 scoring method. These findings suggest the necessity of identify the method of choice for each country comparing with a gold standard measure (clinical diagnosis). Countries with consistent higher prevalence of depression based on PHQ-8 regardless of scoring method deserve further study.

Disclosure

This work has been funded by CIBERESP (ESP21PI05)

The effect of frequency modulation on the FSR of a Fabry-Perot cavity using an Optical Spectrum Analyser

It is presented a study of the dependence between the free spectral range (FSR) and the cavity length in Fabry-Perot interferometers. Furthermore, the effect of frequency modulation on the FSR is studied when an optical spectrum analyser (OSA) is used as an interrogator. For low frequency range it is possible to observe this behaviour in the OSA and using an appropriate processing signal it is possible to use the white light interferometry technique.

Prevalence of Major Depressive Episode in 27 European Countries

Background

Information about the prevalence of current Major Depressive Episode (MDE) across European countries is essential for its monitoring and for the development of evidence- based mental health policies. The aims were to: 1) estimate the prevalence of MDE by country in Europe; and 2) assess variations in prevalence between countries.

Methods

Data from participants of 27 countries that completed the questionnaire of the second wave of the European Health Interview Survey (EHIS-2) were analysed (n = 258,888). The prevalence of MDE was quantified using the Patient Health Questionnaire-8 (PHQ-8) with a cut-off score of ≥ 10. Prevalence and 95% Confidence Intervals (CI) were estimated for each country. Variation in prevalence (country vs the rest) was evaluated using bivariable and multivariable negative binomial regression models considering the specific country as the main explanatory variable. From these models, crude Prevalence Ratios (PR) and adjusted Prevalence Ratios (aPR) were obtained.

Results

The overall prevalence of current MDE in Europe was 6.38% (6.24%-6.52%). The country with the lowest prevalence was the Czech Republic (2.58%, 2.14%-3.02%) and the country with highest prevalence Iceland (10.33%, 9.33%-11.32%). In all the countries (except for Finland and Croatia) prevalence was higher in women than in men. The countries with the highest aPR were Germany (aPR: 1.80, 95% CI: 1.71-1.89) and Luxembourg (aPR: 1.50, 95% CI: 1.35-1.66), while Slovakia (aPR: 0.28, 95% CI: 0.24-0.33) and the Czech Republic (aPR: 0.32, 95% CI: 0.27-0.38) exhibited the lowest aPR.

Conclusions

Considerable variability in the prevalence of MDE by country in Europe was observed without a clear pattern. These results serve as baseline for monitoring the prevalence of MDE at a European level and suggest a need for developing preventive strategies against depression, particularly in those countries identified with the highest prevalence.

Key messages

The results of this study show that the overall prevalence of MDE is high (6.38%), with important variation across countries (ranging from 2.58% in the Czech Republic to 10.33% in Iceland). The results found could serve as a reference for the monitoring of MDE in Europe and for the development of screening and preventive strategies both at European level as well as at a country level.

Sensor Noise in LISA Pathfinder: In-Flight Performance of the Optical Test Mass Readout

We report on the first subpicometer interferometer flown in space. It was part of ESA's Laser Interferometer Space Antenna (LISA) Pathfinder mission and performed the fundamental measurement of the positional and angular motion of two free-falling test masses. The interferometer worked immediately, stably, and reliably from switch on until the end of the mission with exceptionally low residual noise of 32.0_{-1.7}^{+2.4}  fm/sqrt[Hz], significantly better than required. We present an upper limit for the sensor performance at millihertz frequencies and a model for the measured sensitivity above 200 mHz.

Prevalence of SARS-CoV-2 infection in general practitioners and nurses in primary care and nursing homes in the Healthcare Area of León and associated factors

Objective

To evaluate the prevalence of and factors associated with SARS-CoV-2 infection in general practitioners and nurses from primary care centers and nursing homes in the Healthcare Area of León (Spain).

Materials and methods

Cross-sectional study in a convenience sample of professionals from 30 health centers and 30 nursing homes from the primary care management division of the Healthcare Area of Leon. The work center, type of profession, COVID-19 infection, level of exposure, compliance with preventive measures, isolation (if required) and diagnostic tests carried out were collected. The determination of infection was made by differentiated rapid diagnostic test (dRDT), using a finger-stick whole-blood sample. The association of variables with infection was assessed by multivariable non-conditional logistic regression. The true prevalence of SARS-CoV-2 infection was calculated according to two scenarios for RDT (Sensitivity = 0.6 and Specificity = 0.985; Sensitivity = 0.8 and Specificity = 1).

Results

The true prevalence of SARS-CoV-2 infection was between 4.9% and 11.0%. The observed prevalence was 5.9% and was higher in nursing homes than in primary care centers (9.5% vs. 5.5%). No statistically significant differences were observed by sex, type of professional, level of exposure or compliance with preventive measures.

Conclusions

The prevalence of SARS-CoV-2 infection in this group is low. A high number of professionals remain susceptible to SARS-CoV-2 infection and therefore protective measures should be taken, especially for professionals working in nursing homes.

Cost–benefit analysis of funding smoking cessation before surgery

Background

Smoking at the time of surgery is associated with postoperative complications. Quitting smoking before surgery is linked to fewer complications during the hospital stay. This work analysed whether a smoking cessation intervention before surgery is economically worthwhile when funded by the National Health System (NHS) in Spain.

Methods

The economic analysis considered costs and benefits of the intervention to the NHS for the year 2016. The population who would benefit comprised adult smokers who were ready to quit and for whom surgery requiring admission to hospital was planned. The intervention, a combination of medical counselling and use of a smoking cessation drug which should occur 12 weeks before surgery, considered one attempt only to quit smoking. Benefits were costs avoided by averting postoperative complications if cessation was successful. The analysis compared the net economic outcome (benefit minus cost of intervention) and the return on investment, for intervention funded by the NHS versus the current situation without funding.

Results

Smoking cessation increased by 21·7 per cent with funding; the rate was 32·5 per cent when funded versus 10·7 per cent without funding, producing 9611 extra quitters. The cost per averted smoker was €1753 with a benefit of €503, achieving a net economic benefit of €4·8 million per year. Given the annual cost of the intervention (€17·4 million, of which €5·6 million (32·5 per cent) represents drugs), the return on investment was 28·7 per cent annually, equivalent to €1·29 per €1 of investment.

Conclusion

From the perspective of the Spanish NHS, the benefit of funding smoking cessation before surgery, in terms of healthcare cost savings, appears to greatly outweigh the costs.

Analysis of the accuracy of actuation electronics in the laser interferometer space antenna pathfinder

The Laser Interferometer Space Antenna Pathfinder (LPF) main observable, labeled Δg, is the differential force per unit mass acting on the two test masses under free fall conditions after the contribution of all non-gravitational forces has been compensated. At low frequencies, the differential force is compensated by an applied electrostatic actuation force, which then must be subtracted from the measured acceleration to obtain Δg. Any inaccuracy in the actuation force contaminates the residual acceleration. This study investigates the accuracy of the electrostatic actuation system and its impact on the LPF main observable. It is shown that the inaccuracy is mainly caused by the rounding errors in the waveform processing and also by the random error caused by the analog to digital converter random noise in the control loop. Both errors are one order of magnitude smaller than the resolution of the commanded voltages. We developed a simulator based on the LPF design to compute the close-to-reality actuation voltages and, consequently, the resulting actuation forces. The simulator is applied during post-processing the LPF data.

LISA Pathfinder Performance Confirmed in an Open-Loop Configuration: Results from the Free-Fall Actuation Mode

We report on the results of the LISA Pathfinder (LPF) free-fall mode experiment, in which the control force needed to compensate the quasistatic differential force acting on two test masses is applied intermittently as a series of "impulse" forces lasting a few seconds and separated by roughly 350 s periods of true free fall. This represents an alternative to the normal LPF mode of operation in which this balancing force is applied continuously, with the advantage that the acceleration noise during free fall is measured in the absence of the actuation force, thus eliminating associated noise and force calibration errors. The differential acceleration noise measurement presented here with the free-fall mode agrees with noise measured with the continuous actuation scheme, representing an important and independent confirmation of the LPF result. An additional measurement with larger actuation forces also shows that the technique can be used to eliminate actuation noise when this is a dominant factor.

Beyond the Required LISA Free-Fall Performance: New LISA Pathfinder Results down to 20 μHz

In the months since the publication of the first results, the noise performance of LISA Pathfinder has improved because of reduced Brownian noise due to the continued decrease in pressure around the test masses, from a better correction of noninertial effects, and from a better calibration of the electrostatic force actuation. In addition, the availability of numerous long noise measurement runs, during which no perturbation is purposely applied to the test masses, has allowed the measurement of noise with good statistics down to 20  μHz. The Letter presents the measured differential acceleration noise figure, which is at (1.74±0.05)  fm s^{-2}/sqrt[Hz] above 2 mHz and (6±1)×10  fm s^{-2}/sqrt[Hz] at 20  μHz, and discusses the physical sources for the measured noise. This performance provides an experimental benchmark demonstrating the ability to realize the low-frequency science potential of the LISA mission, recently selected by the European Space Agency.

The NRF2 transcription factor plays a dual role in colorectal cancer: A systematic review

Background

Colorectal cancer is one of the most common cancers worldwide, and is influenced by the interplay of various factors, including a very strong genetic component. For instance, incorrect mitochondrial biogenesis is correlated with increased risk of developing colorectal cancer. Thus, it is important to understand the consequences of changes in both the expression and the correct function of the transcription factors that regulate mitochondrial biogenesis, namely NRF2.

Objectives

The main objective of this paper is to characterise the relationship between NRF2 and colorectal cancer by compiling data from an exhaustive literature search.

Methods

Information was obtained by defining specific search terms and searching in several databases. After a strict selection procedure, data were tabulated and the relationships between articles were assessed by measuring heterogeneity and by constructing conceptual maps.

Results and discussion

We found a general consensus in the literature that the presence of oxidizing agents as well as the inhibition of the NRF2 repressor Keap1 maintain NRF2 expression at basal levels. This predominantly exerts a cytoprotective effect on cells and decreases risk of colorectal cancer. However, if NRF2 is inhibited, protection against external agents disappears and risk of colorectal cancer increases. Interestingly, colorectal cancer risk is also increased when NRF2 becomes overexpressed. In this case, the increased risk arises from NRF2-induced inflammation and resistance to chemotherapy.

Conclusion

The proper basal function of NRF2 and Keap1 are essential for preventing oncogenic processes in the colon. Consequently, any disruption to the expression of these genes can promote the genesis and progression of colon cancer.

Charge-Induced Force Noise on Free-Falling Test Masses: Results from LISA Pathfinder

We report on electrostatic measurements made on board the European Space Agency mission LISA Pathfinder. Detailed measurements of the charge-induced electrostatic forces exerted on free-falling test masses (TMs) inside the capacitive gravitational reference sensor are the first made in a relevant environment for a space-based gravitational wave detector. Employing a combination of charge control and electric-field compensation, we show that the level of charge-induced acceleration noise on a single TM can be maintained at a level close to 1.0  fm s^{-2} Hz^{-1/2} across the 0.1-100 mHz frequency band that is crucial to an observatory such as the Laser Interferometer Space Antenna (LISA). Using dedicated measurements that detect these effects in the differential acceleration between the two test masses, we resolve the stochastic nature of the TM charge buildup due to interplanetary cosmic rays and the TM charge-to-force coupling through stray electric fields in the sensor. All our measurements are in good agreement with predictions based on a relatively simple electrostatic model of the LISA Pathfinder instrument.

Aortography Delays Surgery of CT Proven Acute Traumatic Rupture of the Thoracic Aorta

A case of acute traumatic rupture of the thoracic aorta was diagnosed by dynamic CT. Angiographic confirmation was required, delaying surgical repair and contributing to the fatal outcome. If reliable findings of acute traumatic rupture of the thoracic aorta are shown by CT, we question the usefulness of angiographic confirmation in such cases.

Systemic lupus erythematosus and exercise

Systemic lupus erythematosus (SLE) is a rheumatic disease characterized by a variety of symptoms, especially fatigue, pain and reduced quality of life. Physical exercise is a useful tool for improving cardiovascular fitness, reducing metabolic abnormalities and fatigue and improving quality of life. However, very few studies have focused on the relationship between SLE and physical exercise. This paper reviews the main SLE symptoms that can be alleviated by exercising, as well as the results of studies seeking to analyse the exercise capacity and physical training possibilities of SLE patients. Considerations for future research are also discussed.

“Gas and Fat Embolic Syndrome” Involving a Mass Stranding of Beaked Whales (Family Ziphiidae) Exposed to Anthropogenic Sonar Signals

A study of the lesions of beaked whales (BWs) in a recent mass stranding in the Canary Islands following naval exercises provides a possible explanation of the relationship between anthropogenic, acoustic (sonar) activities and the stranding and death of marine mammals. Fourteen BWs were stranded in the Canary Islands close to the site of an international naval exercise (Neo-Tapon 2002) held on 24 September 2002. Strandings began about 4 hours after the onset of midfrequency sonar activity. Eight Cuvier's BWs (Ziphius cavirostris), one Blainville's BW (Mesoplodon densirostris), and one Gervais' BW (Mesoplodon europaeus) were examined postmortem and studied histopathologically. No inflammatory or neoplastic processes were noted, and no pathogens were identified. Macroscopically, whales had severe, diffuse congestion and hemorrhage, especially around the acoustic jaw fat, ears, brain, and kidneys. Gas bubble-associated lesions and fat embolism were observed in the vessels and parenchyma of vital organs. In vivo bubble formation associated with sonar exposure that may have been exacerbated by modified diving behavior caused nitrogen supersaturation above a threshold value normally tolerated by the tissues (as occurs in decompression sickness). Alternatively, the effect that sonar has on tissues that have been supersaturated with nitrogen gas could be such that it lowers the threshold for the expansion of in vivo bubble precursors (gas nuclei). Exclusively or in combination, these mechanisms may enhance and maintain bubble growth or initiate embolism. Severely injured whales died or became stranded and died due to cardiovascular collapse during beaching. The present study demonstrates a new pathologic entity in cetaceans. The syndrome is apparently induced by exposure to mid-frequency sonar signals and particularly affects deep, long-duration, repetitive-diving species like BWs.

Sub-Femto-g Free Fall for Space-Based Gravitational Wave Observatories: LISA Pathfinder Results

We report the first results of the LISA Pathfinder in-flight experiment. The results demonstrate that two free-falling reference test masses, such as those needed for a space-based gravitational wave observatory like LISA, can be put in free fall with a relative acceleration noise with a square root of the power spectral density of 5.2±0.1  fm s^{-2}/sqrt[Hz], or (0.54±0.01)×10^{-15}  g/sqrt[Hz], with g the standard gravity, for frequencies between 0.7 and 20 mHz. This value is lower than the LISA Pathfinder requirement by more than a factor 5 and within a factor 1.25 of the requirement for the LISA mission, and is compatible with Brownian noise from viscous damping due to the residual gas surrounding the test masses. Above 60 mHz the acceleration noise is dominated by interferometer displacement readout noise at a level of (34.8±0.3)  fm/sqrt[Hz], about 2 orders of magnitude better than requirements. At f≤0.5  mHz we observe a low-frequency tail that stays below 12  fm s^{-2}/sqrt[Hz] down to 0.1 mHz. This performance would allow for a space-based gravitational wave observatory with a sensitivity close to what was originally foreseen for LISA.

Quantum metropolitan optical network based on wavelength division multiplexing

Quantum Key Distribution (QKD) is maturing quickly. However, the current approaches to its application in optical networks make it an expensive technology. QKD networks deployed to date are designed as a collection of point-to-point, dedicated QKD links where non-neighboring nodes communicate using the trusted repeater paradigm. We propose a novel optical network model in which QKD systems share the communication infrastructure by wavelength multiplexing their quantum and classical signals. The routing is done using optical components within a metropolitan area which allows for a dynamically any-to-any communication scheme. Moreover, it resembles a commercial telecom network, takes advantage of existing infrastructure and utilizes commercial components, allowing for an easy, cost-effective and reliable deployment.

The microbiota of human milk in healthy women

Recent work has shown that human colostrum and milk, which had been traditionally considered sterile, provides a continuous supply of commensal and potential probiotic bacteria to the infant gut. More than 200 different bacterial species, including staphylococci, lactic acid bacteria and bifidobacteria, have been isolated from human milk samples so far, although the cultivable bacterial diversity found in individual samples is much lower (2 to 8 different species per women). Interestingly, the same bacterial strains have been found in both breast milk and infant feces of different mother-infant pairs, confirming the role of human milk on the bacterial colonization of the infant gut. These commensal bacteria could protect the infant gut and direct, at least partly, the maturation of the immune system, among other functions. Different studies suggest that some bacteria present in the maternal gut could reach the mammary gland during late pregnancy and lactation through a mechanism involving gut dendritic cells and macrophages. Thus, modulation of maternal gut microbiota during pregnancy and lactation could have a direct effect on infant health.

Using molecular markers for pedigree reconstruction of the greater amberjack (Seriola dumerili) in the absence of parental information

Ensuring appropriate levels of genetic diversity in captive populations is essential to avoid inbreeding and loss of rare alleles by genetic drift. Pedigree reconstruction and parentage analysis in the absence of parental genotypes can be a challenging task that relies in the assignment of sibship relationships among the offspring. Here, we used eight highly variable microsatellite markers and three different assignment methods to reconstruct the most likely genotypes of a parental group of wild Seriola dumerili fish based on the genotypes of six cohorts of their offspring, to assess their relative contributions to the offspring. We found that a combination of the four most variable microsatellites was enough to identify the number of parents and their contribution to the offspring, suggesting that the variability of the markers can be more critical than the number of markers. Estimated effective population sizes were lower than the number of breeders and variable among years. The results suggest unequal parental contribution that should be accounted for breeding programs in the future.

Multifunctional properties of soy milk fermented by Enterococcus faecium strains isolated from raw soy milk

Lactic acid bacteria (LAB) isolated from soy milk were used to produce a multifunctional fermented food. Seven isolates were screened for their ability to produce peptides and free isoflavones in soy milk. The antihypertensive, antioxidant, and anti-inflammatory properties of the resulting fermented soy milks were evaluated in vitro using biochemical assays. Isolates 1-5 were found to be producers of fermented soy milk with angiotensin I converting enzyme inhibitory activity (ACEI). Isolate 3 was found to be a producer of free isoflavones that increased the antioxidant and anti-inflammatory potential of fermented soy milk. LAB isolates 2-5 were submitted to genetic profiling and a characterization scheme. These isolates were identified as Enterococcus faecium , and none of them contained virulence determinants or resistance to antibiotics. In conclusion, this study shows that the application of E. faecium isolate 3 for multifunctional food production from soy milk could be a promising strategy in the prevention therapy against cardiovascular disease.

Score to identify the severity of adult patients with influenza A (H1N1) 2009 virus infection at hospital admission

The objective of this paper was to develop a prognostic index for severe complications among hospitalized patients with influenza A (H1N1) 2009 virus infection. We conducted a prospective observational cohort study of 618 inpatients with 2009 H1N1 virus infection admitted to 36 Spanish hospitals between July 2009 and February 2010. Risk factors evaluated included host-related factors and clinical data at admission. We developed a composite index of severe in-hospital complications (SIHC), which included: mortality, mechanical ventilation, septic shock, acute respiratory distress syndrome, and requirement for resuscitation maneuvers. Six factors were independently associated with SIHC: age >45 years, male sex, number of comorbidities, pneumonia, dyspnea, and confusion. From the β parameter obtained in the multivariate model, a weight was assigned to each factor to compute the individual influenza risk score. The score shows an area under the receiver operating characteristic (ROC) curve of 0.77. The SIHC rate was 1.9 % in the low-risk group, 10.3 % in the intermediate-risk group, and 29.6 % in the high-risk group. The odds ratio for complications was 21.8 for the high-risk group compared with the low-risk group. This easy-to-score influenza A (H1N1) 2009 virus infection risk index accurately stratifies patients hospitalized for H1N1 virus infection into low-, intermediate-, and high-risk groups for SIHC.

Health education home-based program in females with fibromyalgia: a pilot study

The objective of this study was to assess the long- and short-term effects of a multimodal program, specifically designed to be carried out by fibromyalgia syndrome (FMS) patients themselves, after a 12-week period of learning. Thirty female FMS patients volunteered for the study. The learning phase consisted on twelve weekly sessions of an hour, combining muscular resistance and flexibility exercises with techniques of breathing and relaxing, plus a half-hour incentive physiotherapy session. Flexibility, illness impact and pain were assessed at the beginning of the study, at the end of the learning phase and six months afterwards (follow-up). Twenty-one patients completed the programme. At the end of the learning phase, the improvement in the patients' physical condition was significant, as was the impact of the illness. Thirty-three percent of the patients continued training during the follow-up period and kept up the improvements achieved. The self-controlled multimodal programme was efficient in improving flexibility and reducing the impact of the illness in women fibromyalgia patients. However, adherence was poor when patients had to exercise on their own.

Enhanced laser action of Perylene-Red doped polymeric materials

The laser action of Perylene-Red doped in linear, crosslinked, fluorinated and sililated polymeric materials is reported. The purity of dye was found to be a key factor to enhance its solid-state laser behaviour. The samples were transversely pumped at 532 nm, with 5.5 mJ/pulse and 10 Hz repetition rate. Perylene-Red doped copolymers of methyl methacrylate with a 10 vol% proportion of 2,2,2-trifluoroethyl-methacrylate exhibited a lasing efficiency of 26% with a high photostability since the dye laser output remained at the same level after 100,000 pump pulses in the same position of the sample. This lasing behaviour is, to the best of our knowledge, the highest achieved to date for organic, inorganic, and hybrid materials doped with Perylene-Red.

Potential benefits of non-pharmacological therapies in fibromyalgia

Fibromyalgia (FM) is an incurable common syndrome of non-articular origin, and with no effective treatment by now. A great deal of research has sought to assess the efficacy of different therapies, especially non-pharmacological and low-cost ones, in the reduction of the intensity of symptoms. Despite the availability of a wide range of alternative therapies nowadays, there is little scientific evidence of the potential benefits of most of them, with results being contradictories. The purpose of this paper is to review some of the less well known alternative therapies in FM treatment, to describe the more relevant clinical studies published in this matter, and to analyze the potential effects of the main alternative therapies, in order to verify their efficacy.

Relationship between aerobic fitness and quality of life in female fibromyalgia patients

Objective: To determine whether there is a direct link between quality of life and aerobic capacity among female fibromyalgia patients.

Design: Cross-section study.

Setting: University of León.

Subjects: Twenty-nine women belonging to the León Fibromyalgia and Chronic Fatigue Association.

Main measurements: Aerobic capacity and quality of life were measured by means of the Six-Minute Walk Test and the Fibromyalgia Impact Questionnaire. Outcome measures included heart rate and rate of perceived fatigue and dypsnoea.

Results: The average distance walked was 432.8 (61.2) m and the total average Fibromyalgia Impact Questionnaire score was 47.5 (18.9). Only item 1 of the Fibromyalgia Impact Questionnaire, physical function, showed any statistically significant link with the distance walked, which had no statistically significant relationship with any of the variables studied.

Conclusion: The physical fitness of women with fibromyalgia, as determined by the Six-Minute Walk Test and the Fibromyalgia Impact Questionnaire, has no direct relation with quality of life as the patients perceive it.

Characterization of Aerococcus viridans isolates from swine clinical specimens

We present here the biochemical and genetic characterization and antimicrobial susceptibility of 58 isolates of Aerococcus viridans isolated in pure culture from different clinical specimens of normally sterile body sites of pigs. A. viridans isolates were commonly susceptible to beta-lactam antimicrobials and exhibited a great genetic heterogeneity as determined by pulsed-field gel electrophoresis typing. The results indicate that A. viridans might be included in the list of possible etiological agents causing disease in pigs.

Antioxidants do not prevent acrylonitrile-induced toxicity

Several reports have recently described that acrylonitrile (ACN) toxicity resides in its capacity for inducing oxidative stress. ACN can be conjugated with glutathione (GSH), diminishing its cellular content, or being metabolized to cyanide. In the present report, we determine the effect of ACN on the viability of primary-cultured astrocytes as well as the oxidative damage generated by ACN by measuring GSH levels in primary cultured astrocytes. We also analyzed whether the ACN (2.5mM) toxicity could be avoided by using antioxidants such as taurine (5mM), N-acetylcysteine (20 mM), trolox (100 microM), estradiol (10 microM) and melatonin (100 nM-1mM). In this cell culture model, antioxidants were not able to prevent ACN-induced cell damage, with the exception of NAC, confirming that only GSH seems to play a key role in ACN-derived toxicity. Additionally, we measured different parameters of oxidative stress such as catalase activity, lipid peroxidation and GSH concentration, as indicators of the potential oxidative stress mediated by the toxicity of ACN, after exposure of Wistar rats to a concentration of 200 ppm ACN for 14 days. At the concentration assayed, we did not find any evidence of oxidative damage in the brain of ACN-treated rats.

[Morbimortality in carotid endarterectomy]

OBJECTIVE

To assess perioperative and long-term morbidity in patients diagnosed of carotid stenosis submitted to our Department for surgical endarterectomy.

PATIENTS AND METHODS

A retrospective study of 97 endarterectomies performed by six neurosurgeons in 90 patients treated between January 1995 and December 2003. Ten patients were women. Average mean age was 69 years-old (range 38-86). Seven patients were treated bilaterally. Eighty-four stenosis were greater than 70%. Annual number of interventions per surgeon was 3 (range 0-10). The median follow-up was 121 days, (range 8-2106).

RESULTS

Four patients died perioperatively and other 4 ones developed new neurologic deficits. The combined morbidity-mortality rate was 8.9% of the patients and 8.2% of the surgeries. Four patients needed reintervention, because of immediate postoperative new deficit (one) and surgical hematoma (three). Transient peripheral nerve palsy occurred in 8 patients and 21 medical complications were registered. In the long term, 7 patients died (6 because of cancer and 1 because of cardiopathy) and 5 presented neurologic events (3 ipsilateral and 2 in other locations). Last postoperative image control, performed on average after 52 days (0-2832), revealed 7 stenosis of the treated artery.

CONCLUSIONS

Carotid endarterectomy can be safely performed in low-volume centers with acceptable results and reasonable morbidity and mortality rates when simple techniques are used. We consider crucial to evaluate self complications and results in order to improve them.

[Ischemic anterior syndrome and intraocular calcification]

OBJECTIVE/METHODS

We report the case of a sixty-year-old female that following retinal detachment surgery in her left eye, presented with a clinical picture that initially was misdiagnosed as endophthalmitis.

RESULTS/CONCLUSIONS

The patient suffered an anterior ischemic syndrome secondary to the retinal surgery, and accidentally, the presence of an intraocular calcification was discovered. We study the influence of the osteoblastic neoformation in the ischemic process.

Primeros pasos en neuronavegación

INTRODUCTION

We try to evaluate the introduction of a neuronavigation system widely used in a neurosurgical department.

MATERIAL AND METHODS

We analyze the surgical procedures performed since the introduction of a neuronavigator in our hospital, the advantages and the problems related with its use.

RESULTS

From 21/12/00 to 31/12/01, 64 cranial and 5 spinal procedures were performed in our centre with the aid of the BrainLAB neuronavigation system. They were 19.37% of the elective surgeries: 45.7% of cranial and 2.8% of spinal procedures. The accuracy of registration was 1.6 mm; the number of trials for registration was 2.8 on average, although in 3 cases it was not possible; there were disarrangements during 9 surgical procedures (two of them after the lesions were reached). Magnetic resonance imaging (MRI) was used in 54 instances, computerized tomography (CT) in 5, fluoroscopy (Rx) in 1, CT plus MRI in 8, CT plus Rx in 1. Since Z-Touch localization system and software was available, it was used exclusively, disregarding the use of external fiducials.

DISCUSSION AND CONCLUSIONS

In our experience, neuronavigation needs extra time, but it helps in the election of the best position for the surgical approach, reduces the time required for scalp incision and craniotomy planning, and is useful for the opening of the dura and the corticectomy. As the operation proceeds, we found it less truhstworthy and necessary. The Z-touch system frees the imaging from the surgery. Its use in spinal operation is scarce and with limited results in our practice. We found the neuronavigation useful, and we employ it on a regular basis in every cranial procedure whenever it is possible.

[Spontaneous resolution of an acute subdural hematoma]

Acute postraumatic subdural hematoma is known to have bad prognosis. Traditionally, its treatment consisted in urgent surgical evacuation. Rapid spontaneous resolution of the hematoma has been infrequently observed. We report a case of a patient with an acute traumatic subdural hematoma which disappeared without surgery. CT-scan showed a left-sided subdural hematoma with marked mass effect. A low density layer, which implied involvement of CSF in the subdural space, was observed between the hematoma and the inner wall of the skull. We think that the spontaneous resolution of the hematoma was due to the dilution and washing-out by the CSF through an arachnoid tear. Another suggested mechanism in the literature is blood redistribution in the subdural space. Selected patients with an acute subdural hematoma can be managed with conservative treatment.

Effectiveness of tuberculosis control programmes in prisons, Barcelona 1987-2000

SETTING

Different bodies have emphasised the need for prisons to implement and evaluate their own tuberculosis prevention and control programmes (TPCP), with the aims of evaluating TPCP in Barcelona prisons and obtaining conclusions that would allow any necessary modifications to be introduced to improve their effectiveness.

METHODS

An assessment was carried out for the period 1987-2000, using the exhaustive retrospective method. The quantitative indicators used were defined in the same way as those employed by the Barcelona TPCP, which were taken as the gold standard. The assessment studied trends in the indicators and evaluated the impact by comparing the results with the gold standard.

RESULTS

Statistically significant trends (P < 0.0001) were found for incidence rates, infection prevalence, treatment adherence rates among smear-positive cases and percentage of cases on directly observed treatment (DOT). When impact was assessed, only the decline in the average annual incidence rate (25.2%) and desired rates of adherence among smear-positives (> or = 95% since 1993) achieved the proposed objectives.

CONCLUSIONS

The observed decline in incidence shows that when programmes are based on reducing diagnostic delay, controlling adherence using DOT and tracing contacts, tuberculosis control among the prisons is effective.

[Surgical treatment of patients with spinal infection]

INTRODUCTION

The surgical treatment of spinal infection, relegated because of the development of more effective antibiotherapy and the fear of associated morbidity, is springing up again with the increase of new patients with weakening pathology.

MATERIAL AND METHODS

The clinical records of 27 patients submitted to surgery because of spinal infection between January 1990 and December 1999 at our service have been retrospectively studied. They were assessed with the Frankel and Karnofsky clinical scales, and the radiological angulation of the spine.

RESULTS

Male (n = 17) and dorsal lesions (n = 14) predominate. Most of patients presented with pain, and 13 had neurological compromise. 29 operations were performed on the 27 patients. One of them was previously operated upon before the period considered, that procedure has been excluded. The total surgeries performed were 5 simple and 4 instrumented laminectomies, 6 simple corpectomies, 10 corpectomies with anterior instrumentation and 4 with posterior instrumentation. One patient died, there was not definitive morbidity and any patient deteriorated on clinical scales although radiology was not always improved.

DISCUSSION AND CONCLUSIONS

The aggressive treatment of spinal infection is indicated when conservative means are insufficient. Surgery permits a better recovery of the neurological deficit, and prevents spinal deformity and pain produced by the disease.

Glutamate induces oxidative stress not mediated by glutamate receptors or cystine transporters: protective effect of melatonin and other antioxidants

Glutamate is responsible for most of the excitatory synaptic activity and oxidative stress induction in the mammalian brain. This amino acid is increased in the substantia nigra in parkinsonism due to the lack of dopamine restraint to the subthalamic nucleus. Parkinson's disease also shows an increase of iron levels in the substantia nigra and a decrease of glutathione, the antioxidant responsible for the ascorbate radical recycling. Considered together, these facts could make the antioxidant ascorbate behave as a pro-oxidant in parkinsonism. Since both glutamate and ascorbate are present in the synaptosomes and neurons of substantia nigra, we tested 1) if glutamate is able to induce oxidative stress independently of its excitatory activity, and 2) if ascorbate may have synergistic effects with glutamate when these two molecules co-exist. Brains were homogenized in order to disrupt membranes and render membrane receptors and intracellular signaling pathways non-functional. In these homogenates glutamate induced lipid peroxidation, indicating that this amino acid also may cause oxidative stress not mediated by its binding to glutamate receptors or cystine transporters. Ascorbate also induced lipid peroxidation thus behaving as a pro-oxidant. Both substances together produced an additive effect but they did not synergize. Given that melatonin is a potent physiological antioxidant with protective effects in models of neurotoxicity, we tested the role of this secretory product on the pro-oxidant effect of both compounds given separately or in combination. We also checked the protective ability of several other antioxidants. Pharmacological doses of melatonin (millimolar), estrogens, pinoline and trolox (micromolar) prevented the oxidant effect of glutamate, ascorbate, and the combination of both substances. Potential therapeutic application of these results is discussed.

The sterol-sensing domain of Patched protein seems to control Smoothened activity through Patched vesicular trafficking

The Hedgehog (Hh) family of signaling molecules function as organizers in many morphogenetic processes. Hh signaling requires cholesterol in both signal-generating and -receiving cells, and it requires the tumor suppressor Patched (Ptc) in receiving cells in which it plays a negative role. Ptc both blocks the Hh pathway and limits the spread of Hh. Sequence analysis suggests that it has 12 transmembrane segments, 5 of which are homologous to a conserved region that has been identified in several proteins involved in cholesterol homeostasis and has been designated the sterol-sensing domain (SSD). In the present study, we show that a Ptc mutant with a single amino acid substitution in the SSD induces target gene activation in a ligand-independent manner. This mutant Ptc(SSD) protein shows dominant-negative activity in blocking Hh signaling by preventing the downregulation of Smoothened (Smo), a positive effector of the Hh pathway. Despite its dominant-negative activity, the mutant Ptc protein functioned like the wild-type protein in sequestering and internalizing Hh. In addition, we show that Ptc(SSD) preferentially accumulates in endosomes of the endocytic compartment. All these results suggest a role of the SSD of Ptc in mediating the vesicular trafficking of Ptc to regulate Smo activity.

[Intracranial epidural abscess in a newborn secondary to skin catheter]

Intracranial epidural abscesses are uncommon lesions, being more frequents in older children and adults. They commonly arise as a result of direct extension of a preexisting infection and rarely present with focal deficit. We present a case of a 11-days old preterm infant who developed an intracranial epidural abscess as a result of an infected scalp vein catheter. The diagnosis was made on the basis of the cranial ultrasound and CT scan images. An identified strain of Enterococcus faecium was cultured from all the samples. The patient underwent a right frontal craniotomy with drainage of the abscess and a 2-week total course of intravenous antibiotics was administrated. CT scan imaging 3 week after the procedure demonstrated no evidence of residual lesion. When present, a scalp vein catheter, in absence of others predisponing factors, must be considered as an etiologic agent for an intracranial epidural abscess in this age-group.

Steady state responses to multiple amplitude-modulated tones: an optimized method to test frequency-specific thresholds in hearing-impaired children and normal-hearing subjects

OBJECTIVE

To evaluate, using statistical methods, the usefulness of the binaural multiple frequency auditory steady state responses (MF SSRs) for objective, frequency-specific audiometry in a large sample of hearing-impaired children and normal-hearing subjects.

DESIGN

The MF SSRs were recorded in a sample of 43 hearing-impaired children (86 ears) and 40 normal-hearing young adults (80 ears). Simultaneous carrier tones (0.5, 1, 2, and 4 kHz) modulated in amplitude at different rates (77 to 105 Hz) were presented binaurally (TDH 49 earphones) at variable intensities (110 to 20 dB SPL). For each subject the response thresholds (RTHs) at 0.5, 1, 2, and 4 kHz, were determined automatically (F test) and compared with the corresponding behavioral thresholds (BTHs).

RESULTS

In the normal-hearing subjects, RTHs were detectable, on average, between 11 and 15 dB above the BTH. These differences were significantly smaller in the hearing-impaired (5 to 13 dB). Also a close correspondence was found between the subjective and objective audiogram curves in both groups. The within subject Spearman correlation coefficients calculated between the two curves, were in most cases above the significance cut off point (p < 0.05). Also in 1-way repeated measures analysis of variance, the overall error in the estimation of the audiogram (vector across frequency of absolute distances between the curves) did not differ significantly from zero.

CONCLUSIONS

The binaural MF SSR was proven to be a valid technique for the estimation of an objective audiogram, in a large sample of hearing-impaired children and normal-hearing subjects. With this method, frequency-specific thresholds at 0.5, 1, 2, and 4 kHz could be determined in all subjects (and both ears) with no appreciable loss in accuracy and a considerable reduction in testing time (average recording time = 21 minutes) when compared with other frequency-specific techniques.

bgs2+, a sporulation-specific glucan synthase homologue is required for proper ascospore wall maturation in fission yeast

The formation of the ascospore cell wall of Schizosaccharomyces pombe requires the co-ordinated activity of enzymes involved in the biosynthesis of its components, such as glucans. We have cloned the bgs2+ gene. bgs2+ belongs to the glucan synthase family of S. pombe and is homologous to the Saccharomyces cerevisiae FKS1 and FKS2 genes. Deletion or overexpression of this gene does not lead to any apparent defect during vegetative growth, but homozygous bgs2Delta diploids do show a sporulation defect. Although meiosis takes place normally, ascospores are unable to mature, and their wall differs from that of wild-type ascospores. Moreover, bgs2Delta zygotes were not able to release ascospores spontaneously, and the ascospores were unable to germinate. We show that expression of bgs2+ is restricted to sporulation and that a bgs2-green fluorescent protein (GFP) fusion protein localizes to the ascospore envelope. The glucan synthase activity in sporulating diploids bearing a bgs2 deletion was diminished in comparison with that of the wild-type diploids, a fact that underscores the importance of the bgs2+ gene and glucan synthesis for the proper formation and maturation of the ascospore wall.