Morbilidad física y deterioro cognoscitivo en pacientes médicos hospitalizados

Objetivo: Estudiar relación entre morbilidad física de pacientes médicos ingresados en Medicina Interna y Neumologia H.C.U "Lozano Blesa" y su correlación con deterioro cognoscitivo, así como relacionar con éste la pluripatología y la gravedad somática medida con el Indice Acumulado de Enfermedad (IAE) y el Indice de Gravedad (IG). Relacionar variables sociodemográficas con la función cognoscitiva y con las diferentes patologías físicas estudiadas .Relacionar ítems Mini-Mental con IAE y con IG.Hipótesis: se hallará una prevalencia del 20% de deterioro cognoscitivo así como relación estadísticamente significativas entre patología cardiaca, vascular y respiratoria con bajo rendimiento de la función cognitiva. Planteamos que el deterioro cognoscitivopuede encontrarse más relacionado con pluripatología que con gravedad, esperando encontrar determinados items del Mini-Mental que se relacionen significativamente con dicha pluripatología y diversas enfermedades consideradas en el estudio.Material y Métodos: estudio descriptivo transversal. Mayores de edad. Pertenecientes al estudio "Comorbilidad depresiva en enfermos con patología somática hospitalizados y seguidos en atención primaria: prevalencia, cronificación, afectación de la calidad de vida, costes sanitarios y mortalidad" que hayan completado el MEC-30. Instrumentos medida: MEC-30; Indice Acumulativo de Enfermedad (IAE); Índice de Gravedad (IG); Criterios de diagnóstico Psiquiátrico: CM-10; Criterios diagnósticos de enfermedad somática: CIE-9. Criterios de exclusión: Menores de 18 años. Cualquier tipo de comorbilidad (CIE-10: F10-F19; F20-F29; F70-F79). Comorbilidad con otras categorías psiquiátricas CIE-10, sólo si éstas son el primer diagnóstico.Resultados: prevalencia de deterioro cognoscitivo del 24,7%. La puntuación media en el MEC es de 25,52. Tras análisis bivariante se confirma la relación estadísticamente significativa ente las variables sociodemográficas estudiadas (edad, sexo, nivel instrucción y estado civil) y déficit cognoscitivo. Hallamos relación significativa entre patología respiratoria y musculoesquelética y bajo rendimiento en el MEC-30. No se confirma la relación para el resto de patologías. Se observa la relación inversa entre pluripatología (IAE) y rendimiento en el Mini-Mental y no con la gravedad individual somática. Tras análisis multivariante solo se halla significación para edad y bajo nivel de instrucción. Como novedad de nuestro estudio se relaciona por primera vez los ítems del MEC con la pluripatología, gravedad y diversas patologías físicas incluidas en el IAE abriendo así futuras líneas de investigación en el campo de la psiquiatría y la medicina preventiva. Sugerimos que en la detección precoz del deterioro cognoscitivo en hospitales, se incluya el MEC en la batería de pruebas ante cualquier enfermo con tres ó más enfermedades aunque no cumplan criterios de gravedad.<br /

Identification of the water stress level in olive trees during pit hardening using the trunk growth rate indicator.

Water scarcity is generating an increasing interest in deficit irrigation scheduling. The trunk diameter fluctuations are daily cycles that have been suggested as tools for irrigation scheduling. The trunk growth rate (TGR) was suggested as the best indicator for olive trees during pit hardening. The aim of this work is to clarify how the TGR could be used to identify water stress levels. The experiment was performed during the 2017 season, in a commercial, super-high-density orchard in Carmona (Seville, Spain). Four different irrigation treatments were performed according to midday stem water potential values and TGR. The data obtained were very variable and both indicators presented a wide range of water status throughout the season. The maximum trunk diameter data clearly showed the pattern of the trees water status but the comparison between treatments and the identification of the water stress level was not possible. The average TGR was linked to the midday stem water potential, but with a minimum amount of data. Irrigation scheduling based on the average TGR was difficult because of the great increases in some daily TGR values. For clarity, the pool of data was grouped by midday stem water potential. These water stress levels were characterized using the weekly frequency of TGR values. The increase of water stress reduced the frequency of values between -0.1 and 0.3mm day-1 from 60% to less than 25%. Moderate water stress levels increased the percentage of values lower than -0.3mm day-1 from 7% to 37%. The most severe water stress conditions increased the TGR values between -0.3 and -0.1mm day-1 from 16% up to 22%.IRNASINSTITUTO DE LA GRASACSI

Isolation and characterization of a Bacillus velezensis D‑18 strain, as a potential probiotic in European seabass aquaculture

Author's accepted version (postprint)This is an Accepted Manuscript of an article published by Springer in Probiotics and Antimicrobial Proteins on 03/04/2021Available online: https://link.springer.com/content/pdf/10.1007/s12602-021-09782-8.pdfWithin the food-producing sectors, aquaculture is the one that has developed the greatest growth in recent decades, currently representing almost 50% of the world’s edible fish. The diseases can affect the final production in intensive aquaculture; in seabass, aquaculture vibriosis is one of the most important diseases producing huge economical losses in this industry. The usual methodology to solve the problems associated with the bacterial pathology has been the use of antibiotics, with known environmental consequences. This is why probiotic bacteria are proposed as an alternative fight against pathogenic bacteria. The aim of this study was to analyse a strain of Bacillus velezensis D-18 isolated from a wastewater sample collected from a fish farm, for use as probiotics in aquaculture. The strain was evaluated in vitro through various mechanisms of selection, obtaining as results for growth inhibition by co-culture a reduction of 30%; B. velezensis D-18 was able to survive at 1.5-h exposure to 10% seabass bile, and at pH 4, its survival is 5% and reducing by 60% the adhesion capacity of V. anguillarum 507 to the mucus of seabass and in vivo by performing a challenge. Therefore, in conclusion, we consider B. velezensis D-18 isolate from wastewater samples collected from the farms as a good candidate probiotic in the prevention of the infection by Vibrio anguillarum 507 in European seabass after in vitro and biosafety assays.acceptedVersio

Pattern of trunk diameter fluctuations of almond trees in deficit irrigation scheduling during the first seasons

Irrigation needs in mature almond orchards are very high. Although almond trees grow in rainfed conditions, the yield response is very sensitive to irrigation. Continuous monitoring of the water status could be an adequate tool to optimize deficit irrigation. In this sense, trunk diameter fluctuations appeared as a very promising indicator at the beginning of the century, but few data have been published. The aim of this work is to check threshold values of maximum daily shrikage (MDS) and identify possible limitations to their use in commercial orchards. The experiment was performed in a commercial farm in Dos Hermanas (Seville, Spain) during the 2017 season on a 7-years-old orchard (cv Vairo). The irrigation treatments were Control (100% ETc), sustained deficit irrigation (SDI) with a maximum seasonal irrigation of 100 mm and two regulated deficit treatments (RDI). Both RDI treatments (RDI-1 and RDI-2) were scheduled using the signal of maximum daily shrinkage (signal) and the midday stem water potential (SWP). In RDI-1, full irrigation conditions were provided before kernel filling and during postharvest, using the threshold values suggested in the bibliography. During kernel filling, the water stress level was designed to be -1.5 MPa (SWP) and 1.75 (signal). RDI-2 trees were irrigated using the same scheduling as RDI-1, but target water stress values were higher in kernel filling (-2 MPa and 2.75) and with a maximum seasonal amount of water of 100 mm. SWP in Control trees was near the McCutchan and Shackel baseline for most of the season. None of the deficit treatments reached the signal values suggested. Moreover, the signal values were almost equal between treatments, with no water stress effect. The trunk growth rate (TGR) presented clear differences depending on the water status

The CARBA-MAP study: national mapping of carbapenemases in Spain (2014–2018)

Introduction:Infections caused by carbapenem-resistant Enterobacterales (CRE) and carbapenem-resistant Pseudomonas aeruginosa, including isolates producing acquired carbapenemases, constitute a prevalent health problem worldwide. The primary objective of this study was to determine the distribution of the different carbapenemases among carbapenemase-producing Enterobacterales (CPE, specifically Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae complex, and Klebsiella aerogenes) and carbapenemase-producing P. aeruginosa (CPPA) in Spain from January 2014 to December 2018.Methods: A national, retrospective, cross-sectional multicenter study was performed. The study included the first isolate per patient and year obtained from clinical samples and obtained for diagnosis of infection in hospitalized patients. A structured questionnaire was completed by the participating centers using the REDCap platform, and results were analyzed using IBM SPSS Statistics 29.0.0.Results: A total of 2,704 carbapenemase-producing microorganisms were included, for which the type of carbapenemase was determined in 2692 cases: 2280 CPE (84.7%) and 412 CPPA (15.3%), most often using molecular methods and immunochromatographic assays. Globally, the most frequent types of carbapenemase in Enterobacterales and P. aeruginosa were OXA-48-like, alone or in combination with other enzymes (1,523 cases, 66.8%) and VIM (365 cases, 88.6%), respectively. Among Enterobacterales, carbapenemase-producing K. pneumoniae was reported in 1821 cases (79.9%), followed by E. cloacae complex in 334 cases (14.6%). In Enterobacterales, KPC is mainly present in the South and South-East regions of Spain and OXA-48-like in the rest of the country. Regarding P. aeruginosa, VIM is widely distributed all over the country. Globally, an increasing percentage of OXA-48-like enzymes was observed from 2014 to 2017. KPC enzymes were more frequent in 2017–2018 compared to 2014–2016.Discussion: Data from this study help to understand the situation and evolution of the main species of CPE and CPPA in Spain, with practical implications for control and optimal treatment of infections caused by these multi-drug resistant organisms

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Mullite-refractory metal (Mo, Nb) composites

Two refractory metals were chosen as a second phase to fabricate mullite-metal composites: (a) molybdenum which is thermodynamically compatible with mullite up to 1650 °C and (b) niobium, a metal which is solid state incompatible with mullite giving rise to compounds such as NbO and Nb5Si3 which are both electrical conductors and more oxidation resistant than the Nb metal. The mullite-refractory metal electrically conductive composites with a content of metal (30-50 vol%) were obtained by a wet-processing route and subsequent hot pressing at 1650 °C. The effect of Mo particle size and volume fraction on the mechanical properties (σf, damage resistance, crack growth resistance i.e., R-curve behaviour, etc.) and wear resistance of the mullite-Mo composites have been assessed. Additionally these composites could be machined by electro discharge machining (EDM) technique. In the case of mullite-Nb system mullite-Al2O3-Nb5Si3-NbO composites showed electrically conducting properties. Its microstructural feature, mechanical properties (σf and R-curve behaviour) and EDM were studied and compared with the results obtained for the mullite-Mo system.This work was supported by EU under project reference FP6-515784-2, by the Spanish Ministry of Science and Technology under projects numbers MAT2003-04199-C02 and MAT2006-10249-C02-01. J.F.B. has been supported by Ministry of Science and Technology and CSIC under the “Ramón y Cajal” Program co-financed by European Social Fund. M. Díaz has been supported by Spanish Ministry of Education and Science and CSIC under I3P Program financed by European Social Fund

Bactericidal ZnO glass-filled thermoplastic polyurethane and polydimethyl siloxane composites to inhibit biofilm-associated infections

This study investigates a novel approach to controlling biofilms of the most frequent pathogens implicated in the etiology of biomaterials-associated infections. New bactericidal filler based on a non-toxic glass, belonging to B2O3-SiO2-Al2O3-Na2O-ZnO system, was used to formulate composites of the most widely used polymers in biomedical applications [i.e. thermoplastic polyurethane (TPU) and polydimethyl siloxane (PDMS)], with varying percentage by weight of the bactericidal glass (5, 15, 25, 35, 50%). Glass-filled polymer composites show dramatically restricted bacterial colonisation and biofilm formation. They exhibit time- and dose-dependent killing, with maximal action at 5 days. The highest activity was found against S.epidermidis biofilm (99% of reduction), one of the most common cause of nosocomial infections. The tensile properties of the obtained glass-filled composites are comparable with the literature data concerning polymeric biomaterials for medical implants and devices. In addition, all the materials presented in this research, revealed an excellent biocompatibility. This was disclosed by cell viability values above 70%, none alteration on erythrocyte membrane or cell functionality in contact with materials (haemolytic index 0–2%), and absence of interferences in blood coagulation (intrinsic, extrinsic and final pathways).Depto. de MedicinaFac. de MedicinaTRUEpu

Analysis of the upconversion processes of Nd3+ ions in transparent YAG ceramics

Optical properties of Nd3+ ions in YAG transparent ceramics have been analysed. The samples were prepared by a high temperature (1650 and 1680 °C) sintering followed by hot isostatic pressing (HIP) at 1650 or 1700 °C in order to obtain a well-homogeneous diffusion of the ions and functional transparency. The emission and luminescence decay curves from the 4F3/2 metastable laser level of these samples are very similar to the ones obtained on crystal samples grown with the Czochralski method. However, excitation upconversion spectra obtained detecting at 590 nm for the transparent ceramic samples present important differences compared to the bulk YAG crystal, which can be explained by a change in the upconversion mechanism involved and the different arrangements of the Nd3+ ions in the YAG matrix. The analysis of the upconversion excitation spectra is shown to be a good method to detect the differences between the positions occupied by the Nd3+ ions in different matrices.Authors thank Ministerio de Economía y Competitividad of Spain (MINECO) within The National Program of Materials (MAT2010-21270-C04-02/-03/-04), The Consolider-Ingenio 2010 Program (MALTA CSD2007-0045, www.malta-consolider.com). We also thank The Governments of Spain and India for the award of a project within the Indo-Spanish Joint Programme of Cooperation in Science and Technology (PRI-PIBIN-2011-1153/DST-INT-Spain-P-38-11) and ICV-CSIC for the use of the microraman system.Peer Reviewe

Isolation and characterization of a Bacillus velezensis D‑18 strain, as a potential probiotic in European seabass aquaculture

Within the food-producing sectors, aquaculture is the one that has developed the greatest growth in recent decades, currently representing almost 50% of the world’s edible fish. The diseases can affect the final production in intensive aquaculture; in seabass, aquaculture vibriosis is one of the most important diseases producing huge economical losses in this industry. The usual methodology to solve the problems associated with the bacterial pathology has been the use of antibiotics, with known environmental consequences. This is why probiotic bacteria are proposed as an alternative fight against pathogenic bacteria. The aim of this study was to analyse a strain of Bacillus velezensis D-18 isolated from a wastewater sample collected from a fish farm, for use as probiotics in aquaculture. The strain was evaluated in vitro through various mechanisms of selection, obtaining as results for growth inhibition by co-culture a reduction of 30%; B. velezensis D-18 was able to survive at 1.5-h exposure to 10% seabass bile, and at pH 4, its survival is 5% and reducing by 60% the adhesion capacity of V. anguillarum 507 to the mucus of seabass and in vivo by performing a challenge. Therefore, in conclusion, we consider B. velezensis D-18 isolate from wastewater samples collected from the farms as a good candidate probiotic in the prevention of the infection by Vibrio anguillarum 507 in European seabass after in vitro and biosafety assays