Effect of remote ischaemic conditioning on clinical outcomes in patients with acute myocardial infarction (CONDI-2/ERIC-PPCI): a single-blind randomised controlled trial.

BACKGROUND: Remote ischaemic conditioning with transient ischaemia and reperfusion applied to the arm has been shown to reduce myocardial infarct size in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). We investigated whether remote ischaemic conditioning could reduce the incidence of cardiac death and hospitalisation for heart failure at 12 months. METHODS: We did an international investigator-initiated, prospective, single-blind, randomised controlled trial (CONDI-2/ERIC-PPCI) at 33 centres across the UK, Denmark, Spain, and Serbia. Patients (age >18 years) with suspected STEMI and who were eligible for PPCI were randomly allocated (1:1, stratified by centre with a permuted block method) to receive standard treatment (including a sham simulated remote ischaemic conditioning intervention at UK sites only) or remote ischaemic conditioning treatment (intermittent ischaemia and reperfusion applied to the arm through four cycles of 5-min inflation and 5-min deflation of an automated cuff device) before PPCI. Investigators responsible for data collection and outcome assessment were masked to treatment allocation. The primary combined endpoint was cardiac death or hospitalisation for heart failure at 12 months in the intention-to-treat population. This trial is registered with ClinicalTrials.gov (NCT02342522) and is completed. FINDINGS: Between Nov 6, 2013, and March 31, 2018, 5401 patients were randomly allocated to either the control group (n=2701) or the remote ischaemic conditioning group (n=2700). After exclusion of patients upon hospital arrival or loss to follow-up, 2569 patients in the control group and 2546 in the intervention group were included in the intention-to-treat analysis. At 12 months post-PPCI, the Kaplan-Meier-estimated frequencies of cardiac death or hospitalisation for heart failure (the primary endpoint) were 220 (8·6%) patients in the control group and 239 (9·4%) in the remote ischaemic conditioning group (hazard ratio 1·10 [95% CI 0·91-1·32], p=0·32 for intervention versus control). No important unexpected adverse events or side effects of remote ischaemic conditioning were observed. INTERPRETATION: Remote ischaemic conditioning does not improve clinical outcomes (cardiac death or hospitalisation for heart failure) at 12 months in patients with STEMI undergoing PPCI. FUNDING: British Heart Foundation, University College London Hospitals/University College London Biomedical Research Centre, Danish Innovation Foundation, Novo Nordisk Foundation, TrygFonden

303-308Changes on Levels of Essential Trace Elements in Selenium Naturally Enriched Milk

Abstract Selenium (Se) enrichment improves milk functional nutrient content enhancing its nutritive value and providing health benefits. This Se enriched milk can be considered as "nutraceutical" or "functional food". However, this benefit should not affect negatively other milk properties, such as its trace element contents. Holstein-Friesian cows diets were supplemented with increasing Se dosages in order to obtain on-farm Se enriched milk, and trace metals content including Co, Cu, I, Se and Zn were determined in these milk samples. Our results showed that Se milk supplementation did not affect negatively other trace element levels in milk, obtaining a functional food designed to allow consumers to drink enriched milk close to their natural state. No effect was detected on Co, I and Zn at any Se supplementation dosages. However, Cu level decreased when Se concentration in milk was higher than 100 ng/g

Modelling a quantitative ensilability index adapted to forages from wet temperate areas

Forage ensilability mainly depends on dry matter (DM), water soluble carbohydrates (WSC) and buffer capacity (BC) values at harvest time. According to these parameters, and based on a collection of 208 forages of known ensilability characteristics including short and long term meadows for grazing, italian ryegrass, maize, triticale, soybean, faba bean crops, and samples coming from cereal-legume associations, the objective of this study has been to define a quantitative ensilability index (EI) based on a relationship between DM, WSC and BC contents at harvest date, adapted to the characteristics of fodder from wet temperate areas. For this purpose, a discriminant procedure was used to define this EI based on a linear combination of DM, WSC and BC of forages at harvest time. The quantitative calculated indexes distinguish five successive ranges of ensilability: high ensilability (EI > +28), medium high ensilability (+9 < EI . +28), medium ensilability (.28 < EI . +9), medium low ensilability (.47 . EI . .28) and low ensilability (EI < .47). This quantitative index was externally evaluated and 100% of samples were successfully classified

Recomendaciones sobre el diagnóstico y manejo de la enfermedad pleural y pulmonar por asbesto

[EN] Asbestos is the term used for a set of mineral silicates that tend to break up into fibers. Its use has been associated with numerous diseases affecting the lung and pleura in particular, all of which are characterized by their long period of latency. Asbestos, moreover, has been recognized by the WHO as a Group IA carcinogen since 1987 and its use was banned in Spain in 2002. The publication in 2013 of the 3rd edition of the specific asbestos health monitoring protocol, together with the development of new diagnostic techniques, prompted the SEPAR EROM group to sponsor publication of guidelines, which review the clinical, radiological and functional aspects of the different asbestos-related diseases. Recommendations have also been made for the diagnosis and follow-up of exposed patients. These recommendations were drawn up in accordance with the GRADE classification system.[ES] Asbesto, también conocido en España como amianto, es el término utilizado para nombrar a un conjunto de silicatos minerales que suelen romperse en fibras. Su uso ha comportado la aparición de numerosas enfermedades, especialmente pleuropulmonares, todas ellas caracterizadas por su prolongada latencia. El asbesto es, además, un carcinógeno del grupo IA reconocido por la OMS desde 1987. En España está prohibido desde 2002. La publicación en 2013 de la 3.ª edición del protocolo de vigilancia sanitaria específica del amianto junto con la aparición de nuevas técnicas diagnósticas han motivado al grupo EROM de SEPAR a promover la elaboración de esta normativa que revisa aspectos clínicos, radiológicos y funcionales de las diferentes enfermedades relacionadas. También establece recomendaciones para el diagnóstico y seguimiento de los pacientes expuestos. Dichas recomendaciones han sido establecidas mediante sistema GRADE.Peer reviewe

Validation of two discriminant strategies applied to NIRS data spectra for detection of animal meals in feedstuffs

For developing qualitative or quantitative applications with spectroscopic data, such as near infrared spectroscopy (NIRS), different methodologies have been proposed in the mathematical statistical and computer science literature. Useful chemometrical alternatives have emerged, such as support vector machines (SVM), widely used for modeling multivariate and non-linear systems. These methods are usually compared using the classification performance and the success of results. The aim of the present work was to develop and validate a robust, accurate and fast discriminant methodology based on NIRS data to detect presence of animal meals in feedstuffs. A linear method, modified partial least square (PLS) analysis and one non-linear method (SVM) were studied. Results showed that modified PLS model allows obtaining coefficients of determination for cross validation around 0.97. Applying SVM strategy no false negatives were detected during training step. With both strategies the lowest percentage of misclassified samples on external validation was achieved with SVM, 0% with certified standard samples containing from 0.05% to 4% of animal meals. These results show SVM strategy as a robust method of classification for detecting animal meals in feedstuffs using NIRS methodology.Para el desarrollo de aplicaciones cualitativas o cuantitativas con datos espectroscópicos, como los obtenidos mediante espectroscopia de infrarrojo cercano (NIRS), se han propuesto diferentes metodologías basadas en la estadística matemática y la literatura informática. Entre las alternativas quimiométricas, han surgido las máquinas de vectores soporte (SVM), ampliamente utilizadas para el modelado no linear de sistemas de múltiples variables. Estos métodos quimiométricos de clasificación se evalúan en base al porcentaje de aciertos. El objetivo del presente trabajo ha sido desarrollar y validar una metodología sólida, discriminante, precisa y rápida haciendo uso de la información NIRS para detectar la presencia de harinas animales, prohibidas en piensos compuestos para determinadas especies. Para ello, se evaluaron dos estrategias quimiométricas diferentes, un método lineal modificado basado en mínimos cuadrados parciales y un método de análisis no lineal basado en máquinas de vectores soporte. Los resultados mostraron que el modelo modificado PLS permite obtener coeficientes de determinación para la validación cruzada en torno a 0,97. En lo referente al SVM, con esta estrategia no se detectó ningún falso negativo. Con ambas estrategias el porcentaje más bajo de la clasificación errónea de las muestras en una validación externa se logró con SVM, 0% utilizando muestras patrón certificadas con un contenido en harinas animales entre el 0,05% y el 4%. Los resultados obtenidos han demostrado que la estrategia SVM es el método más robusto de clasificación para la detección de harinas animales en piensos mediante metodología NIRS