Estudio de la calidad microbiológica en residuos sanitarios de pequeños productores

Al objeto de contribuir a una armonización normativa, con criterios científicos tendentes a clarificar y simplificar la gestión de los residuos sanitarios, hemos procedio a la catalogación y análisis microbiológico, respectivamente, de dos series de muestras de residuos sanitarios, depositados en contenedores para recogida selectiva de Residuos Biosanitarios Especiales (RBE), procedentes de pequeños productores, concretamente de 98 centros médicos de diferentes especialidades. Para la catalogación de los residuos de 239 contenedores, procedimos a su segregación de dos grupos: A.- Residuos Biosanitarios Especiales, según la definición de RBE más consensuada, esto es, la que aparece en el Proyecto CLINHOS (Feliu et al., 1993). En nuestro caso básicamente, estos residuos estaban constituidos por material punzante o cortante o por líquidos corporales en volumen superior a 100 ml, fundamentalmente sangre. B.- Residuos inespecíficos, considerando a todos aquellos que no se acogen a la definición de RBE, es decir, vendas, gasas, torundas, algodón, guantes de látex, papel, plásticos, envoltorios, cubrecabezas, etc.Los resultados de esta catalogación han revelado la existencia de un porcentaje significativo de residuos que no se encuadran en la definición de RBE. Este porcentaje varía en función del tipo de centro generador, así como el volumen del contenedor del que proceden, encontrando centros que generan hasta un 90% de residuos que no se corresponden con la definición de RBE. Estos resultados ponen de manifiesto la incorrecta segregación de estos desechos, dando lugar a un incremento innecesario en los costes de gestión.El análisis microbiológico -bacteriológico y fúngico- se realizó sobre 293 muestras procedentes de 146 contenedores de RBE. Globalmente, estos recuentos han sido inferiores a los obtenidos por otros autores consultados, trabajando tanto sobre residuos procedentes de hospitales, como de pequeños productores así como residuos sólidos urbanos (RSU). Por tanto, y según nuestro estudio, caracteriza a estos residuos una gran variabilidad tanto en su composición -sobre todo por una inadecuada segregación- como en su calidad microbiológica, demostrándose que se trata de un material con menor carga microbiana que los RSU. Se ponde de manifiesto a la necesidad de optimizar la utilización de estos contenedores y aplicar tratamientos de esterilización sólo a los residuos en los que esté justificado, con el fin de evitar sobrecostes de gestión, para lo cual resulta imprescindible una armonización normativa al respect

Estudio de tumores de la cavidad nasal y senos paranasales del perro mediante tomografía computarizada

En 8 perros se estudiaron imágenes de tomografía computarizada (TC), analizando la extensión de tumores de cavidad nasal y/o senos paranasales. La técnica resultó especialmente útil en animales con descarga nasal crónica, protrusión del globo ocular, ceguera de origen central o signos de disfunción neurológica por afectación de porciones rostrales del encéfalo.

Mortality due to COVID-19 in Spain and its association with environmental factors and determinants of health

The objective of this study was to identify which air pollutants, atmospheric variables and health determinants could infuence COVID-19 mortality in Spain. This study used information from 41 of the 52 provinces in Spain (from Feb. 1, to May 31, 2021). Generalized Linear Models (GLM) with Poisson link were carried out for the provinces, using the Rate of Mortality due to COVID-19 (CM) per 1,000,000 inhabitants as dependent variables, and average daily concentrations of PM10 and NO2 as independent variables. Meteorological variables included maximum daily temperature (Tmax) and average daily absolute humidity (HA). The GLM model controlled for trend, seasonalities and the autoregressive character of the series. Days with lags were established. The relative risk (RR) was calculated by increases of 10 g/m3 in PM10 and NO2 and by 1 ℃ in the case of Tmax and 1 g/m3 in the case of HA. Later, a linear regression was carried out that included the social determinants of health.The authors would like to thank the Carlos III Health Institute for their fnancial support Project ENPY 221/20. This work was carried out with funds of the ENPY 221/20 project

Liver X Receptor Activation with an Intranasal Polymer Therapeutic Prevents Cognitive Decline without Altering Lipid Levels

The progressive accumulation of amyloid-beta (Aβ) in specific areas of the brain is a common prelude to late-onset of Alzheimer's disease (AD). Although activation of liver X receptors (LXR) with agonists decreases Aβ levels and ameliorates contextual memory deficit, concomitant hypercholesterolemia/hypertriglyceridemia limits their clinical application. DMHCA (N,N-dimethyl-3β-hydroxycholenamide) is an LXR partial agonist that, despite inducing the expression of apolipoprotein E (main responsible of Aβ drainage from the brain) without increasing cholesterol/triglyceride levels, shows nil activity in vivo because of a low solubility and inability to cross the blood brain barrier. Herein, we describe a polymer therapeutic for the delivery of DMHCA. The covalent incorporation of DMHCA into a PEG-dendritic scaffold via carboxylate esters produces an amphiphilic copolymer that efficiently self-assembles into nanometric micelles that exert a biological effect in primary cultures of the central nervous system (CNS) and experimental animals using the intranasal route. After CNS biodistribution and effective doses of DMHCA micelles were determined in nontransgenic mice, a transgenic AD-like mouse model of cerebral amyloidosis was treated with the micelles for 21 days. The benefits of the treatment included prevention of memory deterioration and a significant reduction of hippocampal Aβ oligomers without affecting plasma lipid levels. These results represent a proof of principle for further clinical developments of DMHCA delivery systems.Fil: Navas Guimaraes, Maria Eugenia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Juan; Argentina. Universidad Catolica de Cuyo. Facultad de Ciencias Medicas. Instituto de Investigacion En Ciencias Biomedicas.; ArgentinaFil: Lopez Blanco, Roi. Universidad de Santiago de Compostela; EspañaFil: Correa, Juan. Universidad de Santiago de Compostela; EspañaFil: Fernandez Villamarin, Marcos. Universidad de Santiago de Compostela; EspañaFil: Bistue Millon, Maria Beatriz. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Juan; Argentina. Universidad Catolica de Cuyo. Facultad de Ciencias Medicas. Instituto de Investigacion En Ciencias Biomedicas.; ArgentinaFil: Martino Adami, Pamela Victoria. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones Bioquímicas de Buenos Aires. Fundación Instituto Leloir. Instituto de Investigaciones Bioquímicas de Buenos Aires; ArgentinaFil: Morelli, Laura. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones Bioquímicas de Buenos Aires. Fundación Instituto Leloir. Instituto de Investigaciones Bioquímicas de Buenos Aires; ArgentinaFil: Kumar, Vijay. University of Colorado; Estados UnidosFil: Wempe, Michael F.. University of Colorado; Estados UnidosFil: Cuello, A. C.. McGill University; CanadáFil: Fernandez Megia, Eduardo. Universidad de Santiago de Compostela; EspañaFil: Bruno, Martin. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Juan; Argentina. Universidad Catolica de Cuyo. Facultad de Ciencias Medicas. Instituto de Investigacion En Ciencias Biomedicas.; Argentin

¿A poluição do ar e as variáveis meteorológicas influenciam a mortalidade por Covid-19? Estudo comparativo de séries temporais entre a primeira e a segunda vaga em nove províncias espanholas

Some pollutants like PM10, NO2 and O3 are detrimental to people’s health, as numerous studies have shown, and they are related to short-term and long-term mortality. A sample of 9 out of the 52 Spanish provinces was studied. Generalized linear models (GLM) with a Poisson link function were developed during the time periods corresponding to the first and second waves of the daily average values of the independent variables (PM10, NO2 and O3, as atmospheric pollutants, and meteorological variables such as the daily maximum temperature and the absolute humidity) versus the dependent variable (COVID-19 mortality rate, or CMR) during said first and second waves. Statistically significant lags between the independent variables and the dependent variable were established. The associated relative risks were calculated from the estimators obtained in the GLMs, with increases of 10 μg/m3 for atmospheric pollutants, 1°C for the maximum temperature and 1 g/m3 for the absolute humidity. The results show that NO2 has a stronger relationship with the CMR than the other air pollutants. The meteorological variables examined did not show a robust relationship between both waves, which indicates that they played a minor role in the CMR. In conclusion, air pollutants such as to NO2 and PM10 had a statistically significant relationship with the CMR, although it is limited and subordinate to other factors such as the public health measures that were taken, the presence of comorbidities and the age of the patient.Algunos contaminantes como las PM10, el NO2 o el O3 tienen influencia en la salud de las personas, tal y como apuntan numerosos estudios al relacionarse con la mortalidad tanto a corto como a largo plazo. Se estudió una muestra de 9 de las 52 provincias españolas. Se realizaron modelos lineales generalizados (GLM) con link Poisson en los periodos de la primera y segunda ola entre los valores medios diarios de las variables independientes (PM10, NO2 y O3 como contaminantes atmosféricos y variables meteorológicas (temperatura máxima diaria y humedad absoluta)) y la variable dependiente (tasa de mortalidad por COVID-19, TMC) durante la primera y segunda ola. Entre las variables independientes y la dependiente se establecieron los retardos estadísticamente significativos (lag). A partir de los estimadores obtenidos en los GLM se calcularon los riesgos relativos asociados, por aumentos de 10 μg/m3 para los contaminantes atmosféricos, 1 ºC para la temperatura máxima y 1 g/m3 para la humedad absoluta. Los resultados muestran que existe una mayor asociación del NO2 con la TMC que para el resto de los contaminantes atmosféricos. Las variables meteorológicas examinadas no han presentado una asociación robusta entre ambas olas, lo que indica un rol menor en relación a la TMC. En conclusión, la contaminación atmosférica por NO2 y PM10 presentan una asociación estadísticamente significativa con la TMC, aunque limitada y subordinada a otros factores como las medidas de salud pública adoptadas, la presencia de comorbilidades y la edad del paciente.Alguns poluentes como as PM10, o NO2 ou o O3 têm influência na saúde das pessoas, como apontam numerosos estudos, pois estão relacionados com a mortalidade tanto a curto como a longo prazo. Foi estudada uma amostra de 9 das 52 províncias espanholas. Realizaram-se modelos lineares generalizados (GLM) com link Poisson nos períodos da primeira e segunda vagas entre os valores médios diários das variáveis independentes (PM10, NO2 e O3 como poluentes atmosféricos e temperatura máxima diária e humidade como condições meteorológicas) e da variável dependente (taxa de mortalidade por Covid-19, TMC) durante a primeira e segunda vagas. Entre as variáveis independentes e a dependente foram estabelecidos atrasos estatisticamente significativos (lag). A partir dos estimadores obtidos nos GLM calcularam-se os riscos relativos associados, para aumentos de 10 μg/m3 para poluentes atmosféricos, 1 °C para temperatura máxima e 1 g/m3 para humidade absoluta. Os resultados mostram que existe uma maior associação do NO2 com a TMC do que para o resto dos poluentes atmosféricos. As variáveis meteorológicas examinadas não apresentaram uma associação robusta entre ambas as vagas, o que indica um papel menor em relação à TMC. Em conclusão, a poluição atmosférica por NO2 e PM10 apresenta associação estatisticamente significativa com a TMC, embora seja limitada e subordinada a outros fatores como as medidas de saúde pública adotadas, a presença de comorbilidades e a idade do paciente

Retrieval of germinal zone neural stem cells from the cerebrospinal fluid of premature infants with intraventricular hemorrhage

Intraventricular hemorrhage is a common cause of morbidity and mortality in premature infants. The rupture of the germinal zone into the ventricles entails loss of neural stem cells and disturbs the normal cytoarchitecture of the region, compromising late neurogliogenesis. Here we demonstrate that neural stem cells can be easily and robustly isolated from the hemorrhagic cerebrospinal fluid obtained during therapeutic neuroendoscopic lavage in preterm infants with severe intraventricular hemorrhage. Our analyses demonstrate that these neural stem cells, although similar to human fetal cell lines, display distinctive hallmarks related to their regional and developmental origin in the germinal zone of the ventral forebrain, the ganglionic eminences that give rise to interneurons and oligodendrocytes. These cells can be expanded, cryopreserved, and differentiated in vitro and in vivo in the brain of nude mice and show no sign of tumoral transformation 6 months after transplantation. This novel class of neural stem cells poses no ethical concerns, as the fluid is usually discarded, and could be useful for the development of an autologous therapy for preterm infants, aiming to restore late neurogliogenesis and attenuate neurocognitive deficits. Furthermore, these cells represent a valuable tool for the study of the final stages of human brain development and germinal zone biology

Do Air Pollution and Meteorological Variables Have a Bearing on COVID-19 Mortality? Benchmarking of Time Series between the First and Second Waves in Nine Spanish Provinces

[ES] Algunos contaminantes como las PM10, el NO2 o el O3 tienen influencia en la salud de las personas, tal y como apuntan numerosos estudios al relacionarse con la mortalidad tanto a corto como a largo plazo. Se estudió una muestra de 9 de las 52 provincias españolas. Se realizaron modelos lineales generalizados (GLM) con link Poisson en los periodos de la primera y segunda ola entre los valores medios diarios de las variables independientes (PM10, NO2 y O3 como contaminantes atmosféricos y variables meteorológicas (temperatura máxima diaria y humedad absoluta)) y la variable dependiente (tasa de mortalidad por COVID-19, TMC) durante la primera y segunda ola. Entre las variables independientes y la dependiente se establecieron los retardos estadísticamente significativos (lag). A partir de los estimadores obtenidos en los GLM se calcularon los riesgos relativos asociados, por aumentos de 10 μg/m3 para los contaminantes atmosféricos, 1ºC para la temperatura máxima y 1 g/m3 para la humedad absoluta. Los resultados muestran que existe una mayor asociación del NO2 con la TMC que para el resto de los contaminantes atmosféricos. Las variables meteorológicas examinadas no han presentado una asociación robusta entre ambas olas, lo que indica un rol menor en relación a la TMC. En conclusión, la contaminación atmosférica por NO2 y PM10 presentan una asociación estadísticamente significativa con la TMC, aunque limitada y sub[EN] Some pollutants like PM10, NO2 and O3 are detrimental to people’s health, as numerous studies have shown, and they are related to short-term and long-term mortality. A sample of 9 out of the 52 Spanish provinces was studied. Generalized linear models (GLM) with a Poisson link function were developed during the time periods corresponding to the first and second waves of the daily average values of the independent variables (PM10, NO2 and O3, as atmospheric pollutants, and meteorological variables such as the daily maximum temperature and the absolute humidity) versus the dependent variable (COVID-19 mortality rate, or CMR) during said first and second waves. Statistically significant lags between the independent variables and the dependent variable were established. The associated relative risks were calculated from the estimators obtained in the GLMs, with increases of 10 μg/m3 for atmospheric pollutants, 1°C for the maximum temperature and 1 g/m3 for the absolute humidity. The results show that NO2 has a stronger relationship with the CMR than the other air pollutants. The meteorological variables examined did not show a robust relationship between both waves, which indicates that they played a minor role in the CMR. In conclusion, air pollutants such as to NO2 and PM10 had a statistically significant relationship with the CMR, although it is limited and subordinate to other factors such as the public health measures that were taken, the presence of comorbidities and the age of the patient.[PT] Alguns poluentes como as PM10, o NO2 ou o O3 têm influência na saúde das pessoas, como apontam numerosos estudos, pois estão relacionados com a mortalidade tanto a curto como a longo prazo. Foi estudada uma amostra de 9 das 52 províncias espanholas. Realizaram-se modelos lineares generalizados (GLM) com link Poisson nos períodos da primeira e segunda vagas entre os valores médios diários das variáveis independentes (PM10, NO2 e O3 como poluentes atmosféricos e temperatura máxima diária e humidade como condições meteorológicas) e da variável dependente (taxa de mortalidade por Covid-19, TMC) durante a primeira e segunda vagas. Entre as variáveis independentes e a dependente foram estabelecidos atrasos estatisticamente significativos (lag). A partir dos estimadores obtidos nos GLM calcularam-se os riscos relativos associados, para aumentos de 10 μg/m3 para poluentes atmosféricos, 1 °C para temperatura máxima e 1 g/m3 para humidade absoluta. Os resultados mostram que existe uma maior associação do NO2 com a TMC do que para o resto dos poluentes atmosféricos. As variáveis meteorológicas examinadas não apresentaram uma associação robusta entre ambas as vagas, o que indica um papel menor em relação à TMC. Em conclusão, a poluição atmosférica por NO2 e PM10 apresenta associação estatisticamente significativa com a TMC, embora seja limitada e subordinada a outros fatores como as medidas de saúde pública adotadas, a presença de comorbilidades e a idade do paciente

Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers Withdrawal Is Associated with Higher Mortality in Hospitalized Patients with COVID-19

Our main aim was to describe the effect on the severity of ACEI (angiotensin-converting enzyme inhibitor) and ARB (angiotensin II receptor blocker) during COVID-19 hospitalization. A retrospective, observational, multicenter study evaluating hospitalized patients with COVID-19 treated with ACEI/ARB. The primary endpoint was the incidence of the composite outcome of prognosis (IMV (invasive mechanical ventilation), NIMV (non-invasive mechanical ventilation), ICU admission (intensive care unit), and/or all-cause mortality). We evaluated both outcomes in patients whose treatment with ACEI/ARB was continued or withdrawn. Between February and June 2020, 11,205 patients were included, mean age 67 years (SD = 16.3) and 43.1% female; 2162 patients received ACEI/ARB treatment. ACEI/ARB treatment showed lower all-cause mortality (p < 0.0001). Hypertensive patients in the ACEI/ARB group had better results in IMV, ICU admission, and the composite outcome of prognosis (p < 0.0001 for all). No differences were found in the incidence of major adverse cardiovascular events. Patients previously treated with ACEI/ARB continuing treatment during hospitalization had a lower incidence of the composite outcome of prognosis than those whose treatment was withdrawn (RR 0.67, 95%CI 0.63-0.76). ARB was associated with better survival than ACEI (HR 0.77, 95%CI 0.62-0.96). ACEI/ARB treatment during COVID-19 hospitalization was associated with protection on mortality. The benefits were greater in hypertensive, those who continue