Clonally Diverse Methicillin and Multidrug Resistant Coagulase Negative Staphylococci Are Ubiquitous and Pose Transfer Ability Between Pets and Their Owners

Sixty-eight owners and 66 pets, from 43 unrelated pet-owning households were screened for methicillin-resistant coagulase negative staphylococci (MRCoNS), potential cases of MRCoNS interspecies transmission (IT), and persistence. MRCoNS isolates were identified by microbiological and molecular tests. MLST-based phylogenetic analysis was performed in Staphylococcus epidermidis isolates. Antimicrobial susceptibility was evaluated using phenotypic and molecular methods. SCCmec type and the presence of biofilm-related ica locus was PCR-tested. Isolates suspected for MRCoNS IT cases were subjected to SmaI-PFGE analysis and individuals from positive households were followed-up for 1 year for carriage dynamics (every 3 months, T0–T4). Nineteen MRCoNS isolates from owners (27.9%) and 12 from pets (16.7%) were detected, coming from 20 households (46.5%). S. epidermidis was predominant (90 and 67% of human and animal strains, respectively), showing high phylogenetic diversity (16 STs among 24 strains). Methicillin-resistant S. epidermidis (MRSE) strains belonged to CC5 (75%), CC11 (12.5%), singleton S556 (8.3%), and S560 (4.17%). Significant host-associated differences were observed for resistance to aminoglycosides, co-trimoxazole, chloramphenicol (higher in animal isolates) and tetracycline (higher among human strains). Multidrug resistance (MDR) was common (68.4%) and associated with human strains. Great diversity of ccr and mec complexes were detected, most strains being non-typeable, followed by SCCmecIV and V. Over one third of isolates (most from owners), carried the ica locus, all MRSE CC5. Two sporadic IT cases (T0) were identified in owners and dogs from two households (4.7%), with diverse interspecies-exchanged clones detected along the sampling year, especially in dogs. A comparative analysis of all MRCoNS, with all nasal coagulase positive staphylococci (CoPS) recovered from the same individuals at T0, revealed that CoPS alone was predominant in owners and pets, followed by co-carriage of CoPS and MRCoNS in owners but single MRCoNS in pets. Statistical analyses revealed that owners are more prone to co-carriage and that co-existence of IT cases and co-carriage are positively interrelated. MRCoNS from healthy owners and their pets are genetically heterogeneous MDR strains that are spread in the community. Therefore, pets also contribute to the dissemination of successful human clones. Owner-pet inhabitancy increases the risk for staphylococcal temporal concomitance with its subsequent risk for bacterial infection and genetic exchange

Programas de carga en la tendinopatía aquílea:revisión sistemática

La tendinopatía aquílea es un síndrome clínico que se caracteriza por presentar dolor, inflamación y discapacidad funcional. Además de diversos factores externos e internos, la carga mecánica desempeña un papel fundamental; cuando no se respetan los períodos de descanso del tendón y se ve sometido a cargas repetitivas se produce un desequilibrio entre síntesis y degradación de colágeno, desencadenándose esta tendinopatía. Los programas de carga (excéntricos, concéntricos, isométricos, HSR) con diferentes tipos de ejercicios son la opción con mejor evidencia para su tratamiento frente a otras terapias pasivas.<br /

Estructura europea para la supervisión y el seguimiento de hábitats: aproximación metodológica para España

There is a well defined policy requirement for a practical and reproducible procedure for surveillance and monitoring of habitats in Spain that can subsequently be fitted into a European framework. Any such procedure also needs to incorporate records of the Spanish habitat classification. A procedure is described that will satisfy those requirements and has been field tested both in Spain and in Europe. Rigorous rules and training are required; otherwise changes from baseline records cannot reliably be separated from background noise. The procedure uses the classical plant life forms long used in biogeography and is based on their statistical relationship with the environment. This relationship has been validated statistically and the procedure has also been tested in the field in all European environmental zones and widely in Spain. 130 General Habitat Categories are defined and these are enhanced in the field by recording environmental, site and management qualities to produce a flexible database that can then be interrogated. The rules for mapping the habitats mean that they can be used for descriptive purposes or for monitoring. In conjunction with stratification and subsequent sampling, national estimates of stock and change can then be produced. Finally, based on the previous experience of SISPARES, a methodological scheme is proposed for adapting the approach to Spain. The proposal will allow links to be made between European scale surveillance and monitoring to those already obtained for Spain.en Espa&ntilde;a pol&iacute;ticas bien definidas que demandan procedimientos pr&aacute;cticos y reproducibles para llevar a cabo la supervisi&oacute;n y seguimiento de los h&aacute;bitats, de modo que subsecuentemente puedan ajustarse al marco Europeo. Cualquier procedimiento de estas caracter&iacute;sticas necesita poder incorporar datos registrados de la clasificaci&oacute;n espa&ntilde;ola de h&aacute;bitats. Aqu&iacute; se describe un procedimiento que satisface dichos requisitos y que ha sido probado tanto en Espa&ntilde;a como en el resto de Europa. El m&eacute;todo exige reglas rigurosas y entrenamiento de campo; si no los cambios en los registros b&aacute;sicos no se podr&aacute;n separar de manera fiable de los errores subjetivos cometidos durante la toma de datos. El procedimiento utiliza las cl&aacute;sicas formas de vida, ampliamente utilizadas en estudios biogeogr&aacute;ficos y est&aacute; basado en sus relaciones con el medio ambiente. Esta relaci&oacute;n ha sido validada estad&iacute;sticamente y el procedimiento ha sido probado en el campo en todas las zonas ambientales de Europa. En Espa&ntilde;a, se han definido 130 Categor&iacute;as Generales de H&aacute;bitats y se han verificado en el campo mediante el registro de atributos ambientales, estacionales y de manejo, de forma que puedan ser incluidas en una base de datos suficientemente flexible. Las directrices para la cartograf&iacute;a de h&aacute;bitats posibilitan su uso descriptivo y permiten su seguimiento. Al mismo tiempo, con la estratificaci&oacute;n y subsecuente muestreo, es posible hacer estimaciones nacionales de existencias y de cambios Finalmente, basados en las experiencias previas de SISPARES, se propone un esquema metodol&oacute;gico para adaptar BIOHAB a Espa&ntilde;a. La propuesta permitir&aacute; conectar los resultados a escala Europea de supervisi&oacute;n y seguimiento con los obtenidos a escala espa&ntilde;ola

Impact of the COVID-19 Lockdown on Ophthalmological Assistance in the Emergency Department at a Spanish Primary Level Hospital.

Purpose. To analyze the changes in ophthalmological emergencies during the COVID-19 pandemic lockdown at a Spanish primary level hospital. Methods. The number and type of emergencies attended in the emergency department of Hospital Universitario del Henares between March 10 and August 31, 2020 (COVID-19 cohort) were compared with the emergencies attended during the same period of 2019 (pre-COVID-19 cohort). Data on the diagnosis, patient age, and gender was retrospectively collected from the electronic medical records of the hospital. The different diagnoses were organized into “clusters,” which include those conditions that affect the same ocular tissue and that have similar clinical expression. Results. The number of ophthalmological emergencies during the study period was 841, compared to 1343 during the same month of 2019, which represents a reduction of 37.4%. The percentage reduction in each cluster was as follows: conjunctiva (−65.4%), cornea (−35.8%), uveitis (−3.6%), eyelid and orbital and lacrimal (−35.5%), strabismus (−60%), neuro-ophthalmology (−11.8%), retina (−10.6%), cataract (+16.4%), glaucoma (−37%), and miscellaneous (−45.1%). The number of people seen with viral conjunctivitis decreased by −87.1% compared to 2019. Patients with complications due to conjunctivitis also decreased: patients with pseudomembranes dropped from 16 to 4 cases and patients with corneal subepithelial infiltrates from 9 to 3 cases. Conclusions. Most diagnostic clusters showed a similar decrease. Clusters that included vision-threating conditions (retina, neuro-ophthalmology, and uveitis) remained mostly stable. During the COVID-19 lockdown, the diagnosis of adenoviral conjunctivitis decreased nearly 10 times. This fact may represent a decrease in the transmission of these infections.post-print1182 K

Risk factors for central nervous system tumors in children: New findings from a case-control study

Background: Central nervous system tumors (CNS) are the most frequent solid tumor in children. Causes of CNS tumors are mainly unknown and only 5% of the cases can be explained by genetic predisposition. We studied the effects of environmental exposure on the incidence of CNS tumors in children by subtype, according to exposure to industrial and/or urban environment, exposure to crops and according to socio-economic status of the child. Methods: We carried out a population-based case-control study of CNS tumors in Spain, covering 714 incident cases collected from the Spanish Registry of Childhood Tumors (period 1996–2011) and 4284 controls, individually matched by year of birth, sex, and autonomous region of residence. We built a covariate to approximate the exposure to industrial and/or urban environment and a covariate for the exposure to crops (GCI) using the coordinates of the home addresses of the children. We used the 2001 Census to obtain information about socio-economic status (SES). We fitted logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (95%CIs). Results: The results for all CNS tumors showed an excess risk (OR = 1.37; 95%CI = 1.09–1.73) for SES, i.e., children living in the least deprived areas had 37% more risk of CNS tumor than children living in the most deprived areas. For GCI, an increase of 10% in crop surface in the 1-km buffer around the residence implied an increase of 22% in the OR (OR = 1.22; 95%CI = 1.15–1.29). Children living in the intersection of industrial and urban areas could have a greater risk of CNS tumors than children who live outside these areas (OR = 1.20; 95%CI = 0.82–1.77). Living in urban areas (OR = 0.90; 95%CI = 0.65–1.24) or industrial areas (OR = 0.96; 95%CI = 0.81–1.77) did not seem to increase the risk for all CNS tumors together. By subtype, Astrocytomas, Intracranial and intraspinal embryonal tumors, and other gliomas showed similar results. Conclusion: Our results suggest that higher socioeconomic status and exposure to crops could increase the risk of CNS tumors in children

Aβ oligomers promote oligodendrocyte differentiation and maturation via integrin β1 and Fyn kinase signaling

Alzheimer´s disease (AD) is characterized by a progressive cognitive decline that correlates with the levels of amyloid β-peptide (Aβ) oligomers. Strong evidences connect changes of oligodendrocyte function with the onset of neurodegeneration in AD. However, the mechanisms controlling oligodendrocyte responses to Aβ are still elusive. Here, we tested the role of Aβ in oligodendrocyte differentiation, maturation, and survival in isolated oligodendrocytes and in organotypic cerebellar slices. We found that Aβ peptides specifically induced local translation of 18.5-kDa myelin basic protein (MBP) isoform in distal cell processes concomitant with an increase of process complexity of MBPexpressing oligodendrocytes. Aβ oligomers required integrin β1 receptor, Src-family kinase Fyn and Ca2+/CaMKII as effectors to modulate MBP protein expression. The pharmacological inhibition of Fyn kinase also attenuated oligodendrocyte differentiation and survival induced by Aβ oligomers. Similarly, using ex vivo organotypic cerebellar slices Aβ promoted MBP upregulation through Fyn kinase, and modulated oligodendrocyte population dynamics by inducing cell proliferation and differentiation. Importantly, application of Aβ to cerebellar organotypic slices enhanced remyelination and oligodendrocyte lineage recovery in lysolecithin (LPC)-induced demyelination. These data reveal an important role of Aβ in oligodendrocyte lineage function and maturation, which may be relevant to AD pathogenesis.This study was supported by the Basque Government (fellowship to T.Q.-L.), University of the Basque Country (UPV/EHU; fellowship to C.O.-S.), CIBERNED and MINECO (fellowship to A.G.-B. FPU17/04891; M.P.S.-R. SAF2013-45084-R and SAF2016-75292-R). We thank S. Marcos, A. Martinez, and L. Escobar for technical assistance

A telemedicine distributed system for cooperative medical diagnosis

Procceedings of: Eighteenth Annual Symposium on Computer Aplications in Medical Care, november 5-9, 1994, Washington, USA. Edited by Judy G. OzboltTelemedicine is changing the classicalform of health care delivery, dramatically increasing the number of new applications in which some type of distributed synchronous cooperation between health care professionals is required. This paper presents the design and development ofa telemedicine distributed system for cooperative medical diagnosis based on two new approaches: 1) a distributed layered architecture specially designed to add synchronous computer supported cooperative workfeatures either to new or existing medical applications; 2) the definition of a methodological procedure to design graphical user interfaces for telemedicine cooperative working scenarios. The cooperative work is supported by a collaborative toolkit that provides telepointing, window sharing, coordination and synchronization. Finally, we have implemented and installed the telemedicine system in clinical practice between two hospitals, providing teleconferencing facilities for cooperative decision support in haemodynamics studies. This specific implementation and a preliminary evaluation were accomplished under the Research Project FEST "Framework for European Services in Telemedicine" funded by the EU AIM Programme.This work is supported in part by EU - AIM FEST project no. A-201 1, and by grants CICYT TEMA TIC 92-1288-PB and TELEMEDICINA TIC 93-1279-E.Publicad

Primary cardiac fibroma in infants: A case report and review of cases of cardiac fibroma managed through orthotopic heart transplant

Cardiac fibromas (CF) are the second most common cardiac tumors in children. They can be aggressive tumors despite their benign histopathologic nature, accounting for the highest mortality rate among primary cardiac tumors. CF usually show a progressive growth and spontaneous regression is rare. Therefore, a complete surgical excision is the preferred therapeutic approach when patients become symptomatic or if mass-related life-threatening complications are anticipated, even in asymptomatic patients. However, some cases are not good candidates for surgical excision due to the impossibility of preserving a normal cardiac anatomy or function after the tumor resection. Orthotopic heart transplantation (OHT) can be an exceptional but adequate alternative for some giant unresectable CF in children. In this article, we report our experience with the case of a 7-month-old infant with a giant unresectable cardiac fibroma who was successfully managed through OHT.Ye

Novel indolic AMPK modulators induce vasodilatation through activation of the AMPK-eNOS-NO pathway

Endothelial adenosine monophosphate-activated protein kinase (AMPK) plays a critical role in the regulation of vascular tone through stimulating nitric oxide (NO) release in endothelial cells. Since obesity leads to endothelial dysfunction and AMPK dysregulation, AMPK activation might be an important strategy to restore vascular function in cardiometabolic alterations. Here, we report the identification of a novel AMPK modulator, the indolic derivative IND6, which shows affinity for AMPKα1β1γ1, the primary AMPK isoform in human EA.Hy926 endothelial cells. IND6 shows inhibitory action of the enzymatic activity in vitro, but increases the levels of p-Thr174AMPK, p-Ser1177eNOS and p-Ser79ACC in EA.Hy926. This paradoxical finding might be explained by the ability of IND6 to act as a mixed-type inhibitor, but also to promote the enzyme activation by adopting two distinct binding modes at the ADaM site. Moreover, functional assays reveal that IND6 increased the eNOS-dependent production of NO and elicited a concentration-dependent vasodilation of endothelium-intact rat aorta due to AMPK and eNOS activation, demonstrating a functional activation of the AMPK-eNOS-NO endothelial pathway. This kinase inhibition profile, combined with the paradoxical AMPK activation in cells and arteries, suggests that these new chemical entities may constitute a valuable starting point for the development of new AMPK modulators with therapeutic potential for the treatment of vascular complications associated with obesity