Picaduras y mordeduras de animales

Under the heading of this subject we deal with stings by arthropods, making reference to the differences that exist between the stings of wasps and bees, commenting on the composition of the poisons and the different local and general reactions that are caused by such stings. Also discussed are the stings/bites caused by scorpions, spiders, ticks, and marine animals, with the clinical picture they provoke and the treatment that must be administered. Finally, snakebites are considered, with reference to the most frequent types of ophidia to be found in Navarra, how to differentiate between the bites of snakes and vipers, the different clinical pictures they provoke and the treatment to be applie

Analysis of the Genetic Parameters for Dairy Linear Appraisal and Zoometric Traits: A Tool to Enhance the Applicability of Murciano-Granadina Goats Major Areas Evaluation System

Selection for zoometrics defines individuals’ productive longevity, endurance, enhanced productive abilities and consequently, their long-term profitability. When zoometric analysis is aimed at large highly selected populations or in those at different levels of selection, linear appraisal systems (LAS) provide a timely response. This study estimates genetic and phenotypic parameters for zoometric/LAS traits in Murciano-Granadina goats, estimating genetic and phenotypic correlations among all traits, and determining whether major area selection would be appropriate or if adaptability strategies may need to be followed. Heritability estimates for the zoometric/LAS traits were low to high, ranging from 0.09 to 0.43, and the accuracy of estimation has improved after decades, rendering standard errors negligible. Scale inversion of specific traits may need to be performed before major areas selection strategies are implemented. Genetic and phenotypic correlations suggests that negative selection against thicker bones and higher rear insertion heights indirectly results in the optimization of selection practices in the rest of the traits, especially those in the structure, capacity and mammary system major areas. The integration and implementation of the strategies proposed within the Murciano-Granadina breeding program maximizes selection opportunities and the sustainable international competitiveness of the Murciano-Granadina goat in the dairy goat breed panorama

Optimization and Validation of a Linear Appraisal Scoring System for Milk Production-Linked Zoometric Traits in Murciano-Granadina Dairy Goats and Bucks

Implementing linear appraisal systems (LAS) may reduce time, personnel and resource costs when performing large-scale zoometric collection. However, optimizing complex zoometric variable panels and validating the resulting reduced outputs may still be necessary. The lack of cross-validation may result in the loss of accuracy and value of the practices implemented. Special attention should be paid when zoometric panels are connected to economically-relevant traits such as dairy performance. This methodological proposal aims to optimize and validate LAS in opposition to the traditional measuring protocols routinely implemented in Murciano-Granadina goats. The sample comprises 41,323 LAS and traditional measuring records from 22,727 herdbook-registered primipara does, 17,111 multipara does and 1485 bucks. Each record includes information on 17 linear traits for primipara/multipara does and 10 traits for bucks. All zoometric parameters are scored on a nine-point scale. Cronbach’s alpha values suggest a high internal consistency of the optimized variable panels. Model fit, variability explanation power and predictive power (mean square error (MSE), Akaike (AIC)/corrected Akaike (AICc) and Bayesian information criteria (BIC), respectively) suggest the model comprising zoometric LAS scores performs better than traditional zoometry. Optimized reduced models are able to capture variability for dairy-related zoometric traits without noticeable detrimental effects on model validity properties

TyG Index change is more determinant for forecasting type 2 diabetes onset than weight gain

Abstract: The risk of type 2 diabetes associated with obesity appears to be influenced by other metabolic abnormalities, and there is controversy about the harmless condition of the metabolically healthy obese (MHO) state. The aim of this study is to assess the risk of diabetes and the impact of changes in weight and in triglyceride-glucose index (TyG index), according to the metabolic health and obesity states. We analyzed prospective data of the Vascular Metabolic CUN cohort, a population-based study among a White European population (mean follow-up, 8.9 years). Incident diabetes was assessed in 1923 women and 3016 men with a mean age at baseline of 55.33 13.68 and 53.78 12.98 years old. A Cox proportional-hazard analysis was conducted to estimate the hazard ratio (HR) of diabetes on metabolically healthy nonobese (MHNO), metabolically healthy obese, metabolically unhealthy nonobese (MUNO), and metabolically unhealthy obese (MUO). A continuous standardized variable (z-score) was derived to compute the HR for diabetes per 1-SD increment in the body mass index (BMI) and the TyG index. MHO, MUNO, and MUO status were associated with the development of diabetes, HR of 2.26 (95% CI: 1.25–4.07), 3.04 (95% CI: 1.69– 5.47), and 4.04 (95% CI: 2.14–7.63), respectively. MUNO individuals had 1.82 greater risk of diabetes compared to MHO subjects (95% CI: 1.04–3.22). The HRs for incident diabetes per 1-SD increment in BMI and TyG indexes were 1.23 (95% CI: 1.04–1.44) and 1.54 (95% CI: 1.40–1.68). The increase in BMI did not raise the risk of developing diabetes among metabolically unhealthy subjects, whereas increasing the TyG index significantly affect the risk in all metabolic health categories. Metabolic health is more important determinant for diabetes onset than weight gain. The increase in weight does not raise the risk of developing diabetes among metabolically unhealthy subjects

A Mediterranean lifestyle reduces the risk of cardiovascular disease in the “Seguimiento Universidad de Navarra” (SUN) cohort

Background and aims: A healthy lifestyle is essential to prevent cardiovascular disease (CVD). However, beyond dietary habits, there is a scarcity of studies comprehensively assessing the typical traditional Mediterranean lifestyle with a multi-dimensional index. We assessed the association between the Mediterranean lifestyle (measured with the MEDLIFE index including diet, physical activity, and other lifestyle factors) and the incidence of CVD. Methods and results: The “Seguimiento Universidad de Navarra” (SUN) project is a prospective, dynamic and multipurpose cohort of Spanish university graduates. We calculated a MEDLIFE score, composed of 28 items on food consumption, dietary habits, physical activity, rest, social habits, and conviviality, for 18,631 participants by assigning 1 point for each typical Mediterra- nean lifestyle factor achieved, for a theoretically possible final score ranging from 0 to 28 points. During an average follow-up of 11.5 years, 172 CVD cases (myocardial infarction, stroke or cardio- vascular death) were observed. An inverse association between the MEDLIFE score and the risk of primary cardiovascular events was observed, with multivariable-adjusted hazard ratio (HR) Z 0.50; (95% confidence interval, 0.31e0.81) for the highest MEDLIFE scores (14e23 points) compared to the lowest scores (0e9 points), p (trend) Z 0.004. Conclusion: A higher level of adherence to the Mediterranean lifestyle was significantly associ- ated with a lower risk of CVD in a Spanish cohort. Public health strategies should promote the Mediterranean lifestyle to preserve cardiovascular health

Anti-tumour necrosis factor discontinuation in inflammatory bowel disease patients in remission: study protocol of a prospective, multicentre, randomized clinical trial

Background: Patients with inflammatory bowel disease who achieve remission with anti-tumour necrosis factor (anti-TNF) drugs may have treatment withdrawn due to safety concerns and cost considerations, but there is a lack of prospective, controlled data investigating this strategy. The primary study aim is to compare the rates of clinical remission at 1?year in patients who discontinue anti-TNF treatment versus those who continue treatment. Methods: This is an ongoing, prospective, double-blind, multicentre, randomized, placebo-controlled study in patients with Crohn?s disease or ulcerative colitis who have achieved clinical remission for ?6?months with an anti-TNF treatment and an immunosuppressant. Patients are being randomized 1:1 to discontinue anti-TNF therapy or continue therapy. Randomization stratifies patients by the type of inflammatory bowel disease and drug (infliximab versus adalimumab) at study inclusion. The primary endpoint of the study is sustained clinical remission at 1?year. Other endpoints include endoscopic and radiological activity, patient-reported outcomes (quality of life, work productivity), safety and predictive factors for relapse. The required sample size is 194 patients. In addition to the main analysis (discontinuation versus continuation), subanalyses will include stratification by type of inflammatory bowel disease, phenotype and previous treatment. Biological samples will be obtained to identify factors predictive of relapse after treatment withdrawal. Results: Enrolment began in 2016, and the study is expected to end in 2020. Conclusions: This study will contribute prospective, controlled data on outcomes and predictors of relapse in patients with inflammatory bowel disease after withdrawal of anti-TNF agents following achievement of clinical remission. Clinical trial reference number: EudraCT 2015-001410-1

International nosocomial infection control consortium (INICC) report, data summary of 36 countries, for 2004-2009

The results of a surveillance study conducted by the International Nosocomial Infection Control Consortium (INICC) from January 2004 through December 2009 in 422 intensive care units (ICUs) of 36 countries in Latin America, Asia, Africa, and Europe are reported. During the 6-year study period, using Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN; formerly the National Nosocomial Infection Surveillance system [NNIS]) definitions for device-associated health care-associated infections, we gathered prospective data from 313,008 patients hospitalized in the consortium's ICUs for an aggregate of 2,194,897 ICU bed-days. Despite the fact that the use of devices in the developing countries' ICUs was remarkably similar to that reported in US ICUs in the CDC's NHSN, rates of device-associated nosocomial infection were significantly higher in the ICUs of the INICC hospitals; the pooled rate of central line-associated bloodstream infection in the INICC ICUs of 6.8 per 1,000 central line-days was more than 3-fold higher than the 2.0 per 1,000 central line-days reported in comparable US ICUs. The overall rate of ventilator-associated pneumonia also was far higher (15.8 vs 3.3 per 1,000 ventilator-days), as was the rate of catheter-associated urinary tract infection (6.3 vs. 3.3 per 1,000 catheter-days). Notably, the frequencies of resistance of Pseudomonas aeruginosa isolates to imipenem (47.2% vs 23.0%), Klebsiella pneumoniae isolates to ceftazidime (76.3% vs 27.1%), Escherichia coli isolates to ceftazidime (66.7% vs 8.1%), Staphylococcus aureus isolates to methicillin (84.4% vs 56.8%), were also higher in the consortium's ICUs, and the crude unadjusted excess mortalities of device-related infections ranged from 7.3% (for catheter-associated urinary tract infection) to 15.2% (for ventilator-associated pneumonia). Copyright © 2012 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved

Análisis de subpoblaciones monocitarias y su asociación con el riesgo cardiovascular. Hallazgo de nuevos biomarcadores séricos: SDF1 y MMP-12

En la actualidad, la prevalencia de las enfermedades cardiovasculares (ECV) es de 108,7 millones de personas, presentando una incidencia anual de 19,9 millones de casos nuevos en la Unión Europea (UE), siendo mayor en mujeres. A día de hoy las ECV siguen siendo la principal causa de muerte en los países miembros de la UE, sumando un total de 2,2 millones en mujeres y 1,9 millones en hombres, lo que representa un 47% y 39% de las muertes totales respectivamente (1). En nuestro país, las ECV también representan la principal causa de mortalidad con aproximadamente 120.000 muertes al año, siendo la razón de una de cada 4 muertes en varones y una de cada 3 en mujeres. Si bien, en varones la enfermedad coronaria aguda encabeza la lista, en mujeres lo presenta el accidente cerebrovascular (2)

Estilo de vida mediterráneo y enfermedad cardiovascular en la cohorte SUN "Seguimiento Universidad de Navarra"

El objetivo principal de este estudio ha sido analizar la asociación entre el índice MEDLIFE y el riesgo de enfermedad cardiometabólica en la cohorte SUN. Las enfermedades cardiovasculares (ECV) constituyen un conjunto de procesos que afectan al corazón y al sistema circulatorio y cuya causa subyacente más frecuente es el desarrollo de arteriosclerosis en las arterias de mediano y gran calibre. Sabemos actualmente que el proceso arteriosclerótico es un proceso inflamatorio crónico de la pared arterial que se va desarrollando a lo largo de la vida y que clínicamente puede no manifestarse durante mucho tiempo. De hecho, habitualmente solo la enfermedad avanzada causa síntomas, pudiendo llegar a ser en ocasiones una muerte súbita la primera manifestación de la enfermedad. A nivel mundial las enfermedades cardiovasculares han representado durante años la causa principal de mortalidad. El 85% de las muertes causadas por enfermedad cardiovascular se deben a eventos cardíacos y a accidentes cerebrovasculares. Hay que tener en cuenta que un tercio de estas muertes ocurren de manera prematura en menores de 70 años. Se estima que para el año 2030, 23,6 millones de personas morirán anualmente por enfermedades cardiovasculares

Análisis de subpoblaciones monocitarias y su asociación con el riesgo cardiovascular. Hallazgo de nuevos biomarcadores séricos: SDF1 y MMP-12

En la actualidad, la prevalencia de las enfermedades cardiovasculares (ECV) es de 108,7 millones de personas, presentando una incidencia anual de 19,9 millones de casos nuevos en la Unión Europea (UE), siendo mayor en mujeres. A día de hoy las ECV siguen siendo la principal causa de muerte en los países miembros de la UE, sumando un total de 2,2 millones en mujeres y 1,9 millones en hombres, lo que representa un 47% y 39% de las muertes totales respectivamente (1). En nuestro país, las ECV también representan la principal causa de mortalidad con aproximadamente 120.000 muertes al año, siendo la razón de una de cada 4 muertes en varones y una de cada 3 en mujeres. Si bien, en varones la enfermedad coronaria aguda encabeza la lista, en mujeres lo presenta el accidente cerebrovascular (2)