Nuevas tecnologías de ayuda en el proceso de internacionalización de PYMES.

Impacto de las tecnologías disruptivas basadas en ''internet of value'' en cada uno de los procesos que componen la internacionalización de una empresa. El proyecto pretende ser un soporte para empresas que quieran optimizar sus recursos y esfuerzos en este apartado de la gestión empresarial

Management of Allergic Diseases During COVID-19 Outbreak

Coronavirus infections; Rhinitis, Allergic; Drug hypersensitivityInfecciones por coronavirus; Rinitis alérgica; Hipersensibilidad medicamentosaInfeccions per coronavirus; Rinitis al·lèrgica; Hipersensibilitat medicamentosaPurpose of review: The coronavirus disease 2019 (COVID-19) has challenged healthcare system capacities and safety for health care workers, reshaping doctor-patient interaction favoring e-Health or telemedicine. The pandemic situation may make difficult to prioritize patients with allergies diseases (AD), face-to-face evaluation, and moreover concern about the possible COVID-19 diagnosis, since COVID-19 shared many symptoms in common with AD. Being COVID-19 a novel disease, everyone is susceptible; there are some advances on vaccine and specific treatment. We evaluate existing literature on allergic diseases (AD): allergic rhinitis, asthma, food allergy, drug allergy, and skin allergy, and potential underlying mechanisms for any interrelationship between AD and COVID-19. Recent findings: There is inconclusive and controversial evidence of the association between AD and the risk of adverse clinical outcomes of COVID-19. AD patients should minimize hospital and face-to-face visits, and those who have used biologics and allergen immunotherapy should continue the treatment. It is essential to wear personal protective equipment for the protection of health care workers. Social distancing, rational use of facemasks, eye protection, and hand disinfection for health care workers and patients deserve further attention and promotion. Teleconsultation during COVID-19 times for AD patients is very encouraging and telemedicine platform can provide a reliable service in patient care

COVID-19 as a turning point in the need for specialized units for the sense of smell

Coronavirus infections; Olfaction disorders; OtolaryngologistsInfecciones por coronavirus; Trastornos del olfato; OtorrinolaringólogosInfeccions per coronavirus; Trastorns olfactius; OtorinolaringologiaThe high prevalence of olfactory dysfunction (OD) by SARS-CoV-2 has revealed the lack of specialized units [1,2]. The main objective is to know the new olfactory units (OU) since the COVID-19 pandemic, and to evaluate the tests used for diagnosis, management and treatment of OD and providing up-to-date data on the current practice in Spain. Due to the increase in COVID-19 and other diseases related to OD, the creation of new OUs is necessary, considering that OD is a predictive symptom of these diseases that affects all ages [3]. To our knowledge this is the first study on OU and no studies were found in other countries. A prospective cross-sectional study, carried out by means of a survey that contains 17 items (supplementary file 1). The survey was developed by 6 experts and was distributed to all members of Spanish ENT and Allergy societies through the Google platform. We considered the "OU" to be a team (ENT or Allergist) with the infrastructure and staff to perform the assigned functions (validated test, well ventilated cabin with controlled humidity and temperature). Statistical analysis was performed with STATA using Shapiro Wilk test, chi-2 test and Spearman correlation analysis. Finally, 136 facilities were included (112/82.4% otolaryngologist and 24/17.6% allergists)

Interaction between Dietary Vitamin D3 and Vitamin K3 in Gilthead Seabream Larvae (Sparus aurata) in Relation to Growth and Expression of Bone Development-Related Genes

Vitamins D and K are essential fat-soluble nutrients that intervene in bone development processes among other biological functions. The present study is aimed at investigating the potential combined effect of dietary supplementation with vitamin D3 (cholecalciferol) and vitamin K3 (menadione) in gilthead seabream (Sparus aurata) larvae. For that purpose, seabream diets were supplemented with different combinations of vitamin D3/vitamin K3 (mg/kg diet) as follows: 0.00/0, 0.06/70, 0.06/170, 0.13/70, 0.13/170, 0.40/70, and 0.40/170. Feeding gilthead seabream larvae (22 days post hatch) for 21 days with the diets supplemented with 0.06-0.13 mg/kg vitamin D3 and 70 mg/kg vitamin K3 (diets 0.06/70 and 0.13/70) led to the highest larval growth and survival and the highest expression of important biomarkers of both bone development and health, such as bmp2, osx, and mgp, and calcium homeostasis, such as pthrp and casr. However, the increased supplementation with both vitamins at 0.40 mg/kg vitamin D3 and 170 mg/kg vitamin K3 (diet 0.40/170) reduced larval growth and survival, downregulated bmp2 and pthrp expressions, and upregulated osx and mgp, causing an unbalance in the relative expression of these genes. The results of the present study have shown the interaction between vitamin D3 supplementation and vitamin K3 supplementation in larval performance and gene expression related to bone development and calcium homeostasis, denoting the significance of a correct balance between both vitamins in larval diets.publishedVersio

Effects of dietary vitamin D3 levels on survival, mineralization, and skeletal development of gilthead seabream (Sparus aurata) larvae

Vitamin D is an essential fat soluble micronutrient that helps in growth, bone development, calcium homeostasis and other metabolic process. The study on effect of vitamin D3 in marine fish larvae were very scarce irrespective of species. The present study determines the impacts of dietary vitamin D3 on growth performance, calcium absorption, mineralization, and skeletal anomalies during the development of gilthead seabream (Sparus aurata) larvae was assessed until 47 days post hatching. Diets containing four levels of vitamin D3 (0, 25, 30, 384 μg kg−1 or 11.6, 1000, 1200, 15,360 IU kg−1) were formulated to determine the effect of vitamin D3 at deficient, excess, and optimum levels. The gilthead seabream larvae in the present study fed with this wide range of vitamin D3 presented a constant growth with all the diets but presented signs of toxicity in excess level, affecting the survival, calcium uptake, and bone biomarker mechanism in larvae, which resulted in increased skeletal anomalies and mortality. An increase of dietary vitamin D3 up to 384 μg kg−1 significantly raised the whole body vitamin D3 content, calcium, and phosphorus intake and increased the incidence of skeletal anomalies, particularly cranial anomalies. The appearance of skeletal anomalies in larvae fed 384 μg kg−1 vitamin D3 was in association with the upregulation of bmp2, alp, and oc gene expression. However, larvae fed 0, 25, 30 μg kg−1 vitamin D3 showed higher survival than the group fed 384 μg kg−1 vitamin D3. Meanwhile vitamin D3 deficient diet 0 μg kg−1 presented with lower mineralization rate and increase incidence of maxillary anomaly. Thus, the current study revealed the evidence of vitamin D3 deficiency as well as toxicity in gilthead seabream larvae during the developmental process and conclude that the recommended dietary vitamin D3 level for gilthead seabream larvae may range between 25 and 30 μg kg−1 which improves larval survival, calcium and phosphate level and vertebral mineralization with reduced incidence of skeletal anomalies in gilthead seabream larva

Severity and duration of allergic conjunctivitis: are they associated with severity and duration of allergic rhinitis and asthma?

Comorbiditat al·lèrgica; Conjuntivitis al·lèrgica; Malaltia respiratòria al·lèrgicaAllergic comorbidity; Allergic conjunctivitis; Allergic respiratory diseaseComorbilidad alérgica; Conjuntivitis alérgica; Enfermedad respiratoria alérgicaObjective. The association of allergic conjunctivitis (AC) with rhinitis and/or asthma is poorly understood. The objective of this study was to apply the Consensus Document for Allergic Conjunctivitis (DECA) criteria for the classification of AC to a population of patients with AC to assess the association between the severity and duration of AC and rhinitis and/or asthma. Methods. Patients with ocular symptoms of AC who participated in the 'Alergológica 2015' study were included. The demographics, classification according to the DECA criteria, etiology, and comorbidities were evaluated by age groups (less or equal than 14 and greater than 14 years). Results. A total of 2,914 patients (age range, 1-90 years) were included in the "Alergológica 2015" study. Of these, 965 patients (33.1%) were diagnosed with AC (77.5% > 14 years). AC was classified as severe, moderate, or mild in 1.8%, 46.4%, and 51.8%, respectively; and as intermittent or persistent in 51.6% and 48.4% of the patients. AC alone occurred in 4% of patients. AC was mainly associated with rhinitis (88.4%), asthma (38.2%), food allergy (8.3%) and atopic dermatitis (3.5%). In allergic respiratory disease rhinitis preceded AC and asthma developed later. The severity and duration of AC was significantly associated with severity and duration of rhinitis (p less than 0.001 for both age groups) and asthma (p less than 0.001 only in adults). Conclusions. The application of the new DECA classification for AC reveals a direct relationship between AC, rhinitis and asthma respect to severity and duration. These relationships suggest that AC should be considered an integral part of the "one airway, one disease" hypothesis

Indirect effects of paediatric conjugate vaccines on invasive pneumococcal disease in older adults

Objectives: The aim of this study was to assess the indirect effect of paediatric 13-valent pneumococcal conjugate vaccine (PCV13) vaccination on people ≥65 years of age with invasive pneumococcal disease (IPD) in Catalonia and to determine factors predictive of mortality. Methods: During 2014-2016, 1285 IPD cases were reported to the Public Health Agency of Catalonia. The indirect effect of paediatric PCV13 vaccination was calculated by comparing the incidence rate (IR) in 2016 (PCV13 year) with that in 2009 (pre-PCV13). Predictors of mortality were determined using multivariate logistic regression. Results: Comparing 2016 and 2009, IPD decreased by 19% (IR 40.1 and 32.5 per 100 000 person-years, respectively). PCV13 serotypes decreased by 57% (IR 23.7 and 10.1), while non-PCV13 serotypes increased by 36% (IR 16.4 and 22.4). During 2014-2016, the mortality rate was 17.5%, and mortality was associated with age ≥85 years (adjusted odds ratio (aOR) 2.91, 95% confidence interval (CI) 1.89, 4.48), meningitis (aOR 2.29, 95% CI 1.25, 4.19), non-focal bacteraemia (aOR 3.73, 95% CI 2.00, 6.94), and ≥1 high-risk condition (aOR 1.89, 95% CI 1.08, 3.32). PPV23non13 serotypes were associated with lower mortality than PCV13 serotypes (aOR 0.54, 95% CI 0.34, 0.86). Conclusions: The incidence of IPD in people ≥65 years of age decreased after the introduction of paediatric PCV13, and this was due to a reduction in PCV13 serotypes, although an increase in non-PCV13 serotypes was observed. Mortality was associated with age, meningitis, non-focal bacteraemia, ≥1 high-risk condition, and PCV13 serotypes

Timeline of Adverse Events during Immune Checkpoint Inhibitors for Advanced Melanoma and Their Impacts on Survival

Immune-related adverse events (irAEs) are frequent and could be associated with improved response to immune checkpoint inhibitors (ICIs). A prospective cohort of advanced melanoma patients receiving ICI as first-line therapy was retrospectively reviewed (January 2011-February 2019). A total of 116 of 153 patients presented with at least one irAE (75.8%). The most frequent irAEs were dermatological (derm irAEs, 50%), asthenia (38%), and gastrointestinal (29%). Most irAEs appeared within the first 90 days, while 11.2% appeared after discontinuation of the therapy. Mild grade 1-2 derm irAEs tended to appear within the first 2 months of therapy with a median time of 65.5 days (IQR 26-139.25), while grade 3-4 derm irAEs appeared later (median 114 days; IQR 69-218) and could be detected at any time during therapy. Only derm irAE occurrence was related to improved survival (HR 6.46). Patients presenting derm irAEs showed better 5-year overall survival compared to those with no derm irAEs (53.1% versus 24.9%; p < 0.001). However, the difference was not significant when adjusting for the duration of therapy. In conclusion: the timeline of immune-related-AEs differs according to the organ involved. The (apparent) improved survival of patients who present derm AEs during immunotherapy could be partially explained by longer times under treatment

Multiple chemical sensitivity worsens quality of life and cognitive and sensorial features of sense of smell

Test 24/BAST-24), sinonasal symptoms (visual analogue scale/VAS 0-100 mm), and quality of life (Quick Environmental Exposure and Sensitivity Inventory/QEESI) were assessed. Multiple chemical sensitivity patients showed a significant impairment in smell identification (19 ± 12 %; p > 0.05) and forced choice (62 ± 18 %; p > 0.05), but not in smell detection (96 ± 4 %) compared to the control group. Multiple chemical sensitivity patients reported more odours as being intense and irritating and less fresh and pleasant when compared with the control group. Patients scored a high level (40-100) on QEESI questionnaire (symptom severity, chemical intolerances, other intolerances, life impact). In MCS patients, total symptom intensity (VAS/0-700 mm) score was 202 ± 135, while disease severity score was 80 ± 23. The most frequent symptoms were itching and posterior rhinorrhea. Multiple chemical sensitivity patients have an impairment in smell cognitive abilities (odour identification and forced choice, but not for detection) with increased smell hypersensitivity and poor quality of life

Immunoglobulin G as a Milk Allergen

Immunoglobulin G; Anaphylaxis; CaseinInmunoglobulina G; Anafilaxis; CaseínaImmunoglobulina G; Anafilaxi; Caseïn