DELETERIOUS EFFECT OF HIGH CARNOSINE CONCENTRATIONS IN EXTENDERS DURING SPERM CRYOPRESERVATION IN DOGS / EFECTO DELETÉREO DE ALTAS CONCENTRACIONES DE CARNOSINA EN DILUYENTES DURANTE LA CRIOPRESERVACIÓN ESPERMÁTICA EN PERROS

Cryopreservation is a key process among the canine reproductive biotechnologies. However, during sperm cryopreservation an excessive reactive oxygen species (ROS) generation occurs, leading to decrease in sperm quality. Therefore, several antioxidants were tested during sperm cryopreservation to prevent such effects, however the carnosine it has not used. Carnosine is a protein present in the seminal plasma, and unlike other antioxidants has the ability to remove products of lipid peroxidation (malondialdehyde), which are as harmful as ROS. Thus, the aim of this study was to evaluate the effects of different carnosine concentrations, during sperm cryopreservation in dogs. For this purpose, six dogs in reproductive age were used, and after sperm collection the samples were cryopreserved in Control (tris-citrate egg yolk extender), Carnosine 1mM, 50mM and 100mM groups. After thawing samples were analyzed by computer-assisted analysis of sperm motility, plasma membrane (eosin/nigrosin), acrosome integrity (fast green/rose Bengal), mitochondrial activity, DNA integrity and sperm resistance to oxidative stress (by TBARS). Decrease was observed in motility sperm kinetics (total and progressive motility) and reduced lipid peroxidation products in the group treated with 50mM and 100mM. On the other hand, 1mM was similar to control group. In conclusion, higher carnosine concentration (50 and 100mM) apparently promoted impairment in energy production and consequently was harmful to sperm kinetics. Thus, future studies must be performed using different carnosine concentrations and in association with substrates for glycolysis and oxidative phosphorylation.RESUMENLa criopreservación es un proceso clave entre las biotecnologías reproductivas en caninos. Sin embargo, durante la criopreservación espermática se da una generación excesiva de especies reactivas de oxígeno (ROS), lo que lleva a una disminución en la calidad espermática. Por lo tanto, varios medios de congelación utilizando antioxidantes para evitar tales efectos han sido evaluados, aunque la carnosina todavía no se ha utilizada. La carnosina es una proteína presente en el plasma seminal que a diferencia de otros antioxidantes tiene la habilidad de remover productos de la peroxidación lipídica (malondialdehído), que son tan dañinos como los ROS. Por lo tanto, el objetivo de este estudio fue evaluar los efectos de diferentes concentraciones de carnosina durante la congelación espermática en perros. Para este propósito se utilizaron seis perros en edad reproductiva y después de la colectar los eyaculados, las muestras fueron criopreservadas en un diluyente Control (tris, citrato, yema de huevo), Carnosina 1mM, 50mM y 100 mM. Después del descongelado, las muestras fueron evaluadas mediante el análisis computerizado de la motilidad, integridad de membrana plasmática (eosina / nigrosina), integridad del acrosoma (Fast - green / rosa de Bengala), la actividad mitocondrial (3’3 Diaminobenzidina), la integridad del ADN (SCSA) y la evaluación de la resistencia al estrés oxidativo (TBARS). Se observó una disminución en la cinética de los espermatozoides (motilidad total y progresiva) y una reducción de los productos de la peroxidación lipídica en los grupos tratados con 50 mM y 100mM de carnosina. Por otro lado, el grupo con 1 mM de carnosina fue similar al control. En conclusión, una alta concentración de carnosina (50 y 100mM) parece afectar la producción de energía del espermatozoide y por lo tanto es perjudicial para la cinética del espermatozoide. Por lo tanto, futuros estudios deben realizarse utilizando diferentes concentraciones de carnosina y en asociación con sustratos para la glucólisis y la fosforilación oxidativa

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Revisão sistematizada da literatura e opinião de peritos

Objective: The 3E (Evidence, Expertise, Exchange) Initiative is a multinational effort of rheumatologists aimed at developing evidence-based recommendations addressing specific questions relevant to clinical practice. The objective of the Portuguese contribution for the 3E Initiative was to develop evidence-based recommendations on how to investigate, follow-up and treat undifferentiated peripheral inflammatory arthritis (UPIA) adapted to local reality and develop additional recommendations considered relevant in the national context. Methods: An international scientific committee from 17 countries selected a set of questions concerning the diagnosis and monitoring of UPIA using a Delphi procedure. Evidence-based answers to each question were sought by a systematic literature search, performed in Medline, Embase, the Cochrane Library and ACR/EULAR 2007-2009 meeting abstracts. Relevant articles were reviewed for quality assessment, data extraction and synthesis. In a national meeting, a panel of 63 Portuguese rheumatologists used the evidence which was gathered to develop recommendations, and filled the gaps in the evidence with their expert opinion. Finally, national recommendations were formulated and agreement among the participants was assessed. Results: A total of 54754 references were identified, of which 267 were systematically reviewed. Thirteen national key recommendations about the investigation, follow-up and treatment of UPIA were formulated. One recommendation addressed differential diagnosis and investigations prior to the established operational diagnosis of UPIA, eight recommendations were related to the diagnostic and prognostic value of clinical and laboratory assessments in established UPIA (history and physical examination, acute phase reactants, serologies, autoantibodies, radiographs, magnetic resonance imaging and ultrasound, genetic markers and synovial biopsy), one recommendation highlighted predictors of persistence (chronicity), one addressed monitoring of clinical disease activity in UPIA, one aimed to find an useful method/score to predict a definitive diagnosis and the last one was related to treatment. Conclusion: Portuguese evidence-based recommendations for the management of UPIA in everyday practice were developed. Their dissemination and implementation in daily clinical practice should help to improve practice uniformity and optimize the management of UPIA patients.publishersversionpublishe

Stop Hypertension with SLP/UCM I

El Proyecto Stop Hipertensión con ApS/UCM pretende aportar nuestro granito de arena a la lucha contra la hipertensión arterial (HTA), utilizando una herramienta educativa de aprendizaje en servicio (ApS), que permita a los estudiantes de los Grados en ciencias de la salud de la UCM aprender a la vez que realizan un servicio público. La hipertensión arterial (HTA) es un problema de salud pública y un importante factor de riesgo de padecer enfermedades cardiovasculares (ECV). Su diagnóstico está determinado por la medida de la presión arterial (PA) por lo que es de extrema importancia asegurar una medida fiable y válida. La automedida de la PA (AMPA) consiste en la medida de la PA por el propio paciente o un familiar, habitualmente en su domicilio, y es una herramienta útil para el diagnóstico y control de la HTA. Pero ¿sabemos medirnos de forma correcta la PA? ¿Usamos bien los tensiómetros? ¿Sabemos interpretar los registros de la PA y cuándo consultar al médico? Realizar AMPA correctamente no es fácil y exige un esfuerzo extraordinario de recursos humanos y económicos por parte de los profesionales de Atención Primaria. Por ello son necesarias nuevas estrategias para capacitar a la población en AMPA. Con este Proyecto nos proponemos luchar contra la HTA a través de la metodología educativa de aprendizaje-servicio que combina objetivos académicos con el servicio comunitario. El alumnado de los grados de Ciencias de la Salud de la UCM forman a la población en la correcta AMPA, asesorándoles sobre el uso correcto de los tensiómetros, enseñándoles a interpretar los resultados y alertándoles de cuándo acudir al médico. En el curso 2022-2023, el servicio público se ha dirigido principalmente al colectivo de mayores por ser especialmente vulnerables a padecer ECV en los Ayuntamientos de Coslada, Alcobendas y Alcorcón, y en las residencias Afanias y Neurovida, y a la población general que acuda a la Facultad durante la Semana de la Ciencia CAM/UCM 2022, a la Feria de la Salud de Coslada y a la campaña contra la HTA de la UCM junto con el Servicio de Medicina del Trabajo. Hemos demostrado que este proyecto es una herramienta rentable y efectiva en la lucha contra la HTA, vinculando la salud pública, los recursos de los ayuntamientos y la universidad. Se cubre así una necesidad y servicio social que podría salvar muchas vidas con recursos de bajo costo, cumpliendo con los objetivos del desarrollo sostenible y con los objetivos de la Sociedad Española de Hipertensión (SEH-LELHA) y de la estrategia HEARTS de la OPS/OMS. Los estudiantes se dan cuenta de la realidad de la Salud pública al tener contacto directo con la población, realizando un servicio a la sociedad, y desarrollándose profesionalmente. Agrademos su colaboración a: Los ayuntamientos de Coslada, Alcorcón y Alcobendas de Madrid. Las residencias de mayores Afanias y Neurovida. Las Sociedades científicas SEH-LELHA, SECF y SEAPEC. El Dr. Orduñez, lider de la estrategia HEARTS PAHO/WHO Los colegios profesionales COFM y CODEM. Las empresas River International S.L. (Beurer) and Peroxfarma S.L. (Omrom)Oficina APS UCMDepto. de FisiologíaFac. de FarmaciaTRUEunpu

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study (Intensive Care Medicine, (2021), 47, 2, (160-169), 10.1007/s00134-020-06234-9)

The original version of this article unfortunately contained a mistake. The members of the ESICM Trials Group Collaborators were not shown in the article but only in the ESM. The full list of collaborators is shown below. The original article has been corrected