Neuromonitoring depth of anesthesia and its association with postoperative delirium

Delirium after surgery or Postoperative delirium (POD) is an underdiagnosed entity, despite its severity and high incidence. Patients with delirium require a longer hospital stay and present more postoperative complications, which also increases hospital costs. Given its importance and the lack of specific treatment, multifactorial preventive strategies are evidenced based. Our hypothesis is that using general anaesthesia and avoiding the maximum time in excessively deep anaesthetic planes through BIS neuromonitoring device will reduce the incidence of postoperative delirium in patients over the age of 65 and their hospitalization stay. Patients were randomly assigned to two groups: The visible BIS group and the hidden BIS neuromonitoring group. In the visible BIS group, the depth of anaesthesia was sustained between 40 and 60, while in the other group the depth of anaesthesia was guided by hemodynamic parameters and the Minimum Alveolar Concentration value. Patients were assessed three times a day by research staff fully trained during the 72 h after the surgery to determine the presence of POD, and there was follow-up at 30 days. Patients who developed delirium (n = 69) was significantly lower in the visible BIS group (n = 27; 39.1%) than in the hidden BIS group (n = 42, 60.9%; p = 0.043). There were no differences between the subtypes of delirium in the two groups. Patients in the hidden BIS group were kept for 26.6 ± 14.0 min in BIS values < 40 versus 11.6 ± 10.9 min (p < 0.001) for the patients in the visible BIS group. The hospital stay was lower in the visible BIS group 6.56 ± 6.14 days versus the 9.30 ± 7.11 days (p < 0.001) for the hidden BIS group, as well as mortality; hidden BIS 5.80% versus visible BIS 0% (p = 0.01). A BIS-guided depth of anaesthesia is associated with a lower incidence of delirium. Patients with intraoperative neuromonitoring stayed for a shorter time in excessively deep anaesthetic planes and presented a reduction in hospital stay and mortality

The starburst-active galactic nucleus connection in the merger galaxy Mrk 938: An infrared and X-ray view

Mrk 938 is a luminous infrared (IR) galaxy in the local Universe believed to be the remnant of a galaxy merger. It shows a Seyfert 2 nucleus and intense star formation according to optical spectroscopic observations. We have studied this galaxy using new Herschel far-IR imaging data in addition to archival X-ray, UV, optical, near-IR and mid-IR data. Mid- and far-IR data are crucial to characterize the starburst contribution, allowing us to shed new light on its nature and to study the coexistence of active galactic nuclei (AGN) and starburst activity in the local Universe. The decomposition of the mid-IR Spitzer spectrum shows that the AGN bolometric contribution to the mid-IR and total IR luminosity is small [Lbol(AGN)/LIR ? 0.02], which agrees with previous estimations. We have characterized the physical nature of its strong IR emission and constrained it to a relatively compact emitting region of ?2 kpc. It is in this obscured region where most of the current star formation activity is taking place as expected for luminous IR galaxies. We have used Herschel imaging data for the first time to constrain the cold dust emission with unprecedented accuracy. We have fitted the integrated far-IR spectral energy distribution and derived the properties of the dust, obtaining a dust mass of 3 × 107 M . The far-IR is dominated by emission at 35 K, consistent with dust heated by the ongoing star formation activityThanks to F. Schweizer for kindly providing the optical image of Mrk 938, to J. Gallimore for providing the MIPS SED data, and to H. Krimm and W. Baumgartner for the analysis of the BAT ob- servations. PE, AA-H and MP-S acknowledge support from the Spanish Plan Nacional de Astronom ́ıa y Astrof ́ısica under grant AYA2009-05705-E. AA-H and MP-S acknowledge support under grant AYA2010-21161-C02-01. MP-S acknowledges support from the CSIC under grant JAE-Predoc-2007. AMP-G acknowledges support by the Spanish Plan Nacional de Astronom ́ıa y Astrof ́ısica under the grant AYA2008-06311-CO2-01. CRA acknowledges fi- nancial support from STFC (ST/G001758/1) and from the Span- ish Ministry of Science and Innovation (MICINN) through project Consolider-Ingenio 2010 Programme grant CSD2006-00070: First Science with the GTC. MP acknowledges Junta de Andaluc ́ıa and Spanish Ministry of Science and Innovation through projects PO8- TIC-03531 and AYA2010-15169. PACS has been developed by a consortium of institutes led by MPE (Germany) and including UVIE (Austria); KU Leuven, CSL, IMEC (Belgium); CEA, LAM (France); MPIA (Germany); INAF- IFSI/OAA/OAP/OAT, LENS, SISSA (Italy) and IAC (Spain). This development has been supported by the funding agencies BMVIT (Austria), ESA-PRODEX (Belgium), CEA/CNES (France), DLR (Germany), ASI/INAF (Italy) and CICYT/MCYT (Spain). SPIRE has been developed by a consortium of institutes led by Cardiff University (UK) and including University of Lethbridge (Canada); NAOC (China); CEA, LAM (France); IFSI, University of Padua (Italy); IAC (Spain); Stockholm Observatory (Sweden); Imperial College London, RAL, UCL-MSSL, UKATC, University of Sus- sex (UK) and Caltech, JPL, NHSC, University of Colorado (USA). This development has been supported by national funding agencies: CSA (Canada); NAOC (China); CEA, CNES, CNRS (France); ASI (Italy); MCINN (Spain); SNSB (Sweden); STFC (UK) and NASA (USA). This work is based on observations made with the Spitzer Space Telescope, which is operated by the Jet Propulsion Labo- ratory, California Institute of Technology, under NASA contract 1407

First results using a new near-infrared 1% narrow-band filter in the GTC 10.4m telescope to detect galaxies at the dawn of the universe

We present the first results using a new SCHOTT 1% narrow band filter in the near infrared for the CIRCE camera of the 10.4m GTC telescope. The goal of the project is to detect very distant galaxies at the dawn of the Universe. These remote and extremely faint galaxies are selected by their Ly-alpha emission. For this project SCHOTT manufactured a high transmission 11 nm narrow band filter which has been used in the fully cryogenic near-infrared camera CIRCE of the Gran Telescopio Canarias Telescope. A steep interference filter Bandpass with FWHM 11nm centered at 1254nm was coated on a fused silica substrate. The filter achieved excellent maximum transmission and deep out of band blocking. This was achieved by using magnetron sputtering for the filter coating process. We report on the spectral and interferometric results of the filter and the scientific results achieved with a first set of observations

Effectiveness and safety of first-generation protease inhibitors in clinical practice: Hepatitis C virus patients with advanced fibrosis

AIM: To evaluates the effectiveness and safety of the first generation, NS3/4A protease inhibitors (PIs) in clinical practice against chronic C virus, especially in patients with advanced fibrosis. METHODS: Prospective study and non-experimental analysis of a multicentre cohort of 38 Spanish hospitals that includes patients with chronic hepatitis C genotype 1, treatment-nai¨ve (TN) or treatment-experienced (TE), who underwent triple therapy with the first generation NS3/4A protease inhibitors, boceprevir (BOC) and telaprevir (TVR), in combination with pegylated interferon and ribavirin. The patients were treatment in routine practice settings. Data on the study population and on adverse clinical and virologic effects were compiled during the treatment period and during follow up. RESULTS: One thousand and fifty seven patients were included, 405 (38%) were treated with BOC and 652 (62%) with TVR. Of this total, 30% (n = 319) were TN and the remaining were TE: 28% (n = 298) relapsers, 12% (n = 123) partial responders (PR), 25% (n = 260) null-responders (NR) and for 5% (n = 57) with prior response unknown. The rate of sustained virologic response (SVR) by intention-to-treatment (ITT) was greater in those treated with TVR (65%) than in those treated with BOC (52%) (P < 0.0001), whereas by modified intention-to-treatment (mITT) no were found significant differences. By degree of fibrosis, 56% of patients were F4 and the highest SVR rates were recorded in the non-F4 patients, both TN and TE. In the analysis by groups, the TN patients treated with TVR by ITT showed a higher SVR (P = 0.005). However, by mITT there were no significant differences between BOC and TVR. In the multivariate analysis by mITT, the significant SVR factors were relapsers, IL28B CC and non-F4; the type of treatment (BOC or TVR) was not significant. The lowest SVR values were presented by the F4-NR patients, treated with BOC (46%) or with TVR (45%). 28% of the patients interrupted the treatment, mainly by non-viral response (51%): this outcome was more frequent in the TE than in the TN patients (57% vs 40%, P = 0.01). With respect to severe haematological disorders, neutropaenia was more likely to affect the patients treated with BOC (33% vs 20%, P = 0.0001), and thrombocytopaenia and anaemia, the F4 patients (P = 0.000, P = 0.025, respectively). CONCLUSION: In a real clinical practice setting with a high proportion of patients with advanced fibrosis, effectiveness of first-generation PIs was high except for NR patients, with similar SVR rates being achieved by BOC and TVR

Dendritic cell deficiencies persist seven months after SARS-CoV-2 infection

Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV)-2 infection induces an exacerbated inflammation driven by innate immunity components. Dendritic cells (DCs) play a key role in the defense against viral infections, for instance plasmacytoid DCs (pDCs), have the capacity to produce vast amounts of interferon-alpha (IFN-α). In COVID-19 there is a deficit in DC numbers and IFN-α production, which has been associated with disease severity. In this work, we described that in addition to the DC deficiency, several DC activation and homing markers were altered in acute COVID-19 patients, which were associated with multiple inflammatory markers. Remarkably, previously hospitalized and nonhospitalized patients remained with decreased numbers of CD1c+ myeloid DCs and pDCs seven months after SARS-CoV-2 infection. Moreover, the expression of DC markers such as CD86 and CD4 were only restored in previously nonhospitalized patients, while no restoration of integrin β7 and indoleamine 2,3-dyoxigenase (IDO) levels were observed. These findings contribute to a better understanding of the immunological sequelae of COVID-19

Non-motor symptom burden in patients with Parkinson's disease with impulse control disorders and compulsive behaviours : results from the COPPADIS cohort

The study was aimed at analysing the frequency of impulse control disorders (ICDs) and compulsive behaviours (CBs) in patients with Parkinson's disease (PD) and in control subjects (CS) as well as the relationship between ICDs/CBs and motor, nonmotor features and dopaminergic treatment in PD patients. Data came from COPPADIS-2015, an observational, descriptive, nationwide (Spain) study. We used the validated Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale (QUIP-RS) for ICD/CB screening. The association between demographic data and ICDs/CBs was analyzed in both groups. In PD, this relationship was evaluated using clinical features and treatment-related data. As result, 613 PD patients (mean age 62.47 ± 9.09 years, 59.87% men) and 179 CS (mean age 60.84 ± 8.33 years, 47.48% men) were included. ICDs and CBs were more frequent in PD (ICDs 12.7% vs. 1.6%, p < 0.001; CBs 7.18% vs. 1.67%, p = 0.01). PD patients had more frequent previous ICDs history, premorbid impulsive personality and antidepressant treatment (p < 0.05) compared with CS. In PD, patients with ICDs/CBs presented younger age at disease onset, more frequent history of previous ICDs and premorbid personality (p < 0.05), as well as higher comorbidity with nonmotor symptoms, including depression and poor quality of life. Treatment with dopamine agonists increased the risk of ICDs/CBs, being dose dependent (p < 0.05). As conclusions, ICDs and CBs were more frequent in patients with PD than in CS. More nonmotor symptoms were present in patients with PD who had ICDs/CBs compared with those without. Dopamine agonists have a prominent effect on ICDs/CBs, which could be influenced by dose

MARIBNO project: Structure of the NorthWest Iberian margin: influence of inherited tectonics in the Alpine extension and inversion

X Congreso Geológico de España, 5-7 Julio 2021, Vitoria - GasteizLa zona noroeste de Iberia reúne rasgos geológicos excepcionales relacionados con el desarrollo de un margen continental hiperextendido cerca de un punto triple y la posterior inversión tectónica parcial. Es una zona de gran interés para el estudio del papel de la herencia tectónica y la posterior inversión en márgenes continentales extensionales, pero hay un gran déficit de información. Todo esto sienta las bases del proyecto anfibio MARIBNO (PGC2018-095999-B-I00) donde a lo largo de 2021 y 2022 se adquirirán sísmica marina de reflexión multicanal 2D (~4000 km), sísmica de gran ángulo en 3 transectos tierra-mar (~600 km), batimetría multihaz, grav-mag y sísmica de alta resolución. Se complementará en tierra con adquisición de datos grav-mag y varias campañas de cartografía geológica. Los objetivos se centran en el estudio de la estructura cortical, el control tectónico ejercido por estructuras previas a las etapas alpinas y la cartografía y caracterización de los dominios corticales aunando criterios geológicos y geofísicos.Todo esto sienta las bases del proyecto anfibio MARIBNO (PGC2018-095999-B-I00) donde a lo largo de 2021 y 2022 se adquirirán sísmica marina de reflexión multicanal 2D (~4000 km), sísmica de gran ángulo en 3 transectos tierra-mar (~600 km), batimetría multihaz, grav-mag y sísmica de alta resolución

New insights into the genetic etiology of Alzheimer's disease and related dementias.

Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele

Autoantibodies against type I IFNs in patients with life-threatening COVID-19

Interindividual clinical variability in the course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is vast. We report that at least 101 of 987 patients with life-threatening coronavirus disease 2019 (COVID-19) pneumonia had neutralizing immunoglobulin G (IgG) autoantibodies (auto-Abs) against interferon-w (IFN-w) (13 patients), against the 13 types of IFN-a (36), or against both (52) at the onset of critical disease; a few also had auto-Abs against the other three type I IFNs. The auto-Abs neutralize the ability of the corresponding type I IFNs to block SARS-CoV-2 infection in vitro. These auto-Abs were not found in 663 individuals with asymptomatic or mild SARS-CoV-2 infection and were present in only 4 of 1227 healthy individuals. Patients with auto-Abs were aged 25 to 87 years and 95 of the 101 were men. A B cell autoimmune phenocopy of inborn errors of type I IFN immunity accounts for life-threatening COVID-19 pneumonia in at least 2.6% of women and 12.5% of men