Neurodevelopmental Outcomes of Infants Younger Than 90 Days Old Following Enterovirus and Parechovirus Infections of the Central Nervous System

Enteroviruses (EVs) and human parechoviruses (HPeVs) are a major cause of central nervous system (CNS) infection in young infants. They have been implicated in neurodevelopmental delay, however limited data are available. The aim of this study is to describe the clinical outcome of young infants and to assess and compare the medium-term neurodevelopment following CNS infections caused by EV and HPeV. A multicentre observational ambispective study was conducted between May 2013 and March 2018. Children under 3 months of age with EV or HPeV CNS infection excluding encephalitis were included. Infants were contacted 1 year after the acute infection and their neurological development was evaluated using the Ages and Stages Questionnaire-3 (ASQ-3). If any area assessed was abnormal during the first round of tests, a second round was completed 6 to 12 months later. Forty-eight young infants with EV and HPeV CNS infection were identified: 33 (68.8%) were positive for EV and 15 (31.3%) for HPeV. At first assessment 14 out of 29 EV (48.3%) and 3 out of 15 HPeV (20%) positive cases presented some developmental concern in the ASQ-3 test. EV-positive infants showed mild and moderate alteration in all domains analyzed and HPeV-positive infants showed mild alterations only in gross and fine motor domains. Significant alterations in communication were observed in EV-positive but not in HPeV-positive infants (31 vs. 0%, p = 0.016). At second assessment 4 out of 13 EV-positive patients (30.8%) showed mild to moderate concerns in communication and gross motor function domains and 3 out of 13 (23.1%) showed significant concern in fine motor function. Although CNS infections without associated encephalitis are generally assumed to be benign our study shows that at a median age of 18 months almost half of the EV-infected infants (48.3%) and 20% of HPeV-positive infants presented some developmental concern in the ASQ-3 test. We recommend monitor the neurological development of infants during the first years of life after HPeV CNS infection and especially after EV CNS infection, even in mild cases, for an early intervention and stimulation of psychomotor development if necessary.This study was partially supported by grant from Instituto de Salud Carlos III (number PI18CIII/00017).S

Effectiveness of an educational intervention about inhalation technique in healthcare professionals in primary care: a cluster randomized trial

Incorrect inhalation technique (IT) is an important issue for COPD patients and healthcare professionals. Studies in which counseling is carried out with healthcare professionals beforehand so that they can properly educate their patients are required. The present trial is to assess the improvement in the performance of the IT in subjects with COPD and prescribed inhaled therapy after the implementation of an educational intervention conducted by their general practitioners. A cluster randomized clinical trial was conducted. A total of 286 COPD patients received scheduled inhalation therapy from 27 general practices in 7 primary care centers. A teach-back educational intervention was implemented for both healthcare professionals and patients. The primary outcome of this study was the performance of the correct IT. It is considered a good technique if all steps in the inhalation data sheet are correctly performed. The secondary outcomes were assessed using forced spirometry, the basal dyspnea index, the Medical Research Council dyspnea scale, SGRQ, and EuroQoL5D-5L. A one-year follow-up was conducted using an intention-to-treat analysis. After the intervention, incorrect IT was observed in 92% of professionals and patients, with rates reaching 50% and 69.2%, respectively. The effectiveness in patients was significant, with a number needed to treat of 2.14 (95% CI 1.79-2.66). Factors related to correct IT in patients included the type of intervention, length of intervention (>25 min), good pulmonary function, age (youngest ≤65, oldest >83), and less limitation of activity due to dyspnea. There was no relation with the cluster. This study shows the effectiveness of direct inhaler technique training provided by a trained professional on an appropriate timescale, aiming to help subjects improve their performance using the teach-back method. This could be an encouraging intervention to improve medication adherence and health promotion in people with COPD.This research project was funded by Fondo de Investigaciones Sanitarias (FIS), Instituto de Salud Carlos III (PI-0170-2013), Spain, and II Plan Propio de Investigación, Transferencia y Divulgación Científica de la Universidad de Malaga, Spain

Influenza virus infections in infants aged less than two years old

[ES] Introducción: Las infecciones por virus influenza son una importante causa de morbilidad en lactantes. El cuadro clínico es inespecífico y a menudo se infraestima la importancia de lagripe en los menores de 2 años. El objetivo del estudio fue describir las infecciones con firmadas por virus influenza en niños menores de 2 años atendidos en un hospital de segundo nivel. Como objetivo secundario, se pretende comparar las infecciones por gripe en lactantes hospitalizados con las infecciones por virus respiratorio sincitial (VRS) en la misma población. Pacientes y métodos: Estudio descriptivo prospectivo de las infecciones con firmadas por virus influenza en los niños menores de 2 años hospitalizados por fiebre o infección respiratoria entre 1991 y 2003. Para el diagnóstico virológico se realizó inmunofluorescencia y reacción en cadena de la poli merasa en el aspirado nasofaríngeo. Se describen las características clínicas de los pacientes. Se realiza una comparación con un grupo de lactantes de similares características ingresados por infección por VRS. Resultados: Se describen 100 lactantes hospitalizados con infección por virus influenza. Las infecciones gripales supusieron el 4,1 % de los pacientes hospitalizados por procesos respiratorios o fiebre. Se aisló virus influenza tipo A en el 83 % de los casos, tipo B en el 12 % y tipo C en el 5 %. La edad media fue 8,3 +/- 5,9 meses, y los diagnósticos más fre cuentes fueron bronquiolitis en el 38 %, sibilancias recurrentes en el 25%, infección respiratoria de vías altas en el 19% y neumonía en el 9%. Presentaron fiebre superior a 38 °C el 83% de los niños e infiltrado radiológico el 65%. Presentaron hipoxia el 44 % de los niños. En los niños menores de 6 meses la fiebre fue menos frecuente (p = 0,049), y en los diagnósticos predominaron las infecciones respiratorias de vías altas (p = 0,01). Los niños afectados de infección por virus influenza tu vieron mayor edad (p = 0,002), presentaron con mayor frecuencia fiebre (p 38 degrees C was present in 83% of the patients. Radiologic infiltrate was found in 65% of the children. Oxygen saturation less then 95% was present in 44%. In children under 6 months of age fever was less frequent (p = 0.049) and upper respiratory tract infection was more frequent (p = 0.01). Patients with influenza virus infection were older (p = 0.002), more frequently presented fever (p < 0.0001) and radiologic infiltrate (p < 0.001) than infants with RSV infection. Bronchiolitis was more frequent in the RSV group (p = 0.006). Conclusions: Influenza infection is a major cause of respiratory tract disease in hospitalized infants. It is an etiologic cause of bronchiolitis, recurrent wheezing, and fever and radiologic consolidations are frequent. Clinical presentation is milder in children under 6 month of age. The characteristics of influenza infection differ substantially from those of RSV infection.S

Traditional and new strategies in the primary prevention of eating disorders: a comparative study in Spanish adolescents

Ignacio J&amp;aacute;uregui Lobera1, Pilar Le&amp;oacute;n Lozano2, Patricia Bola&amp;ntilde;os R&amp;iacute;os3, Juan Romero Candau2, Gregorio S&amp;aacute;nchez del Villar y Lebreros4, M Teresa Morales Mill&amp;aacute;n1,5, M Teresa Monta&amp;ntilde;a Gonz&amp;aacute;lez1,5, Lourdes Andr&amp;eacute;s Mart&amp;iacute;n2, Isabela Justo Villalobos2, Nuria Vargas S&amp;aacute;nchez21&amp;Aacute;rea de Nutrici&amp;oacute;n y Bromatolog&amp;iacute;a, Universidad Pablo de Olavide; 2Colegio Oficial de Farmac&amp;eacute;uticos; 3Instituto de Ciencias de la Conducta; 4Instituto de Ense&amp;ntilde;anza Secundaria &amp;ldquo;Murillo&amp;rdquo;; 5Facultad de Farmacia, Universidad de Sevilla, Sevilla, SpainBackground: Research conducted to date into the primary prevention of eating disorders (ED) has mainly considered the provision of information regarding risk factors. Consequently, there is a need to develop new methods that go a step further, promoting a change in attitudes and behavior in the target population.Objective: This study describes an adaptation of the Girls&amp;rsquo; Group model to the Spanish context, the main objective being to compare two types of intervention, ie, one based on this model and the other following the traditional approach of providing information. The ultimate aim was to implement a prevention program that reduces the risk factors and boosts the protection factors that have been empirically shown to be related to ED.Methods: On the basis of previous research on the primary prevention of ED, and taking into account recognized risk and protective factors, the following topics were addressed: nutritional aspects; self-esteem; coping strategies; the ideal image of what is attractive and role of the media; and body image. The total sample (174 girls and 197 boys) was divided into 12 work groups, six for the intervention group (one school) and six for the control group (two schools). School-based input (intervention group) was provided by a pharmacist, a psychologist, a qualified nutritionist/dietician, and specialist support staff (psychologists and/or educators) and teachers of the three schools.Results: Participation in the intervention group reduced body dissatisfaction (F = 13.41; P &amp;lt; 0.01), the drive to thinness (F = 10.79; P &amp;lt; 0.01), and the influence of the media with respect to the esthetic body shape model (F = 13.90; P &amp;lt; 0.01), while self-esteem (F = 7.34; P &amp;lt; 0.01) and the use of coping strategies (F = 13.74; P &amp;lt; 0.01) both improved. There was also an improvement in the eating habits of participants, with better outcomes being achieved when intervening with females.Conclusions: The present study shows that in the primary prevention of eating disorders, better outcomes are achieved by new models which target the attitudes and behavior of adolescents rather than focusing solely on the provision of risk information to raise awareness.Keywords: coping strategies, adolescence, primary prevention, eating disorders, positive psycholog

Prevalence and molecular epidemiology of bovine leukemia virus in Colombian cattle

Bovine leukemia virus (BLV) is one of the five agents considered most significant for cattle. It is important to determine the prevalence and molecular epidemiology of BLV throughout the country in order to gain a more thorough understanding of the current situation of BLV and to reveal the possibility of masked genotypes that the primers used by OIE are unable to identify. Blood samples were collected at random from 289 cows distributed in 75 farms across the country. PCR amplification of env, gag and tax gene segments was performed. The obtained amplicons were sequenced and then subjected to phylogenetic analyses. A total of 62% of the cows present at 92% of the farms were BLV-positive for gag fragment. Genotype 1 was exclusively detected by env gene segment when analyzed using previously reported primers. However, tax gene analysis revealed circulation of genotype 6 variants, which were also detected based on env gene analysis with newly designed primers. These results indicate that current genotyping approaches based on partial env sequencing may bias BLV genetic variability approaches and underestimate the diversity of the detected BLV genotypes. This report is one of the first molecular and epidemiological studies of BLV conducted in Colombia, which contributes to the global epidemiology of the virus; it also highlights the substantial impact of BLV on the country's livestock and thus is a useful resource for farmers and government entities

Further progress in the study of epsilon iron oxide in archaeological baked clays

[EN] The occurrence of ε-FeO in archaeological samples that have been subjected to high temperatures is gradually being detected by the use of micrometric structural characterization techniques. This work provides new information by revealing that the ε-FeO is formed as a response to temperature, the aggregation state and the position within the baked clay with respect to the nearest heat source. In addition, depending mainly on the atmospheric environment, the temperature reached by the combustion structure, the distance from the heating source and the particle aggregation, other iron oxide magnetic phases are produced. In the baked clay studied here, hematite is found over the whole range of samples studied but its magnetic contribution is negligible. Magnetite is observed at the sample surface, probably due to local atmospheric environment closest to the combustion source. Maghemite is found at all depths up to 6 cm below the sample surface. ε-FeO has a limited distribution, found within 2–3 cm of the sample surface. Furthermore, the viability of this compound as a palaeofield marker has been evaluated in both archaeological and synthetic samples. The results indicate that ε-FeO is able to register the direction of the magnetic field. Linear palaeointensity plots have been obtained in synthetic samples, although the value of the palaeofield could be, sometimes, overestimated.The authors also acknowledge the financial support from the Spanish Ministry of Science, Innovation and Universities under the projects RTI2018-095856-B-C21, CGL2017-87015-P, CGL2017-92285-EXP, CGL2017-92285-EXP/BTE, MAT2017-86540-C4-1-R, MAT2017-87072-C4-2-P and RTI2018-095303-A-C52, from Comunidad de Madrid NANOFRONTMAG S2013/MIT-2850 and NANOMAGCOST S2018/NMT-4321, and from the European Commission under H2020 frame by AMPHIBIAN Project ID: 720853. APO thanks the Ministry of Economy, Industry and Competitiveness (PTA Contract).Peer reviewe

Propuesta de un sistema espacialmente explícito para evaluar el peligro de incendios

Los incendios forestales suponen un factor muy destacado en la transformación ambiental de buena parte de los ecosistemas terrestres. Tienen impactos globales, afectando a la superficie forestal y a las emisiones de gases de efecto invernadero, y efectos locales, relacionados con la degradación de suelos, erosión, modificación de la dinámica de la vegetación y pérdida de recursos y de vidas humanas. La prevención de incendios resulta cada vez más crítica, para paliar los efectos negativos de los mismos. Se presentan en este trabajo las variables de entrada y el esquema de integración para estimar el peligro de ocurrencia de incendios que se desarrolló en el marco del proyecto Firemap. Se generó información de diversas fuentes, que hacen referencia a variables socio-económicas, así como al estado de los combustibles y las características del territorio, utilizando sistemas de información geográfica (SIG) e imágenes de satélite. Todas las variables se cartografiaron a una resolución espacial de un 1 km2 y se integraron en un servidor web, que estuvo operativo para su evaluación durante el verano de 2007. Se presenta la comparación entre la variación temporal de los índices generados y la ocurrencia observada en la Comunidad de Madrid, una de las regiones del estudio.Forest fires are a major factor of environmental transformation in several ecosystems. Fires have global impacts, affecting forested areas and having an important impact in greenhouse gas emissions. Additionally, fires have local impacts, associated to soil degradation, soil erosion, vegetation dynamics, and lost of lives and properties. Fire prevention is critical to reduce the negative impacts of fire. This paper presents the input variables and the integration scheme developed within the Firemap project (funded under the Spanish Ministry of Science and Technology) to map wildland fire occurrence probability. The project first generated fire risk variables related to several factors of fire ignition or propagation. They were generated from a wide variety of sources using geographic information systems and remote sensing technologies. All variables were mapped at 1 sq km spatial resolution, and were integrated into single indices. The risk system included the development of a dedicated web-mapping server to facilitate the access to the end-users. This service was tested in the summer of 2007 for semi-operational use. The paper presents the first validation results of the danger index, by comparing temporal trends of the different danger components to the fire occurrence in the Madrid region, one of the test sites

Liquid biopsy: a non-invasive approach for Hodgkin lymphoma genotyping

The Hodgkin lymphoma (HL) genomic landscape is hardly known due to the scarcity of tumour cells in the tissue. Liquid biopsy employing circulating tumour DNA (ctDNA) can emerge as an alternative tool for non-invasive genotyping. By using a custom next generation sequencing (NGS) panel in combination with unique molecule identifiers, we aimed to identify somatic variants in the ctDNA of 60 HL at diagnosis. A total of 277 variants were detected in 36 of the 49 samples (73·5%) with a good quality ctDNA sample. The median number of variants detected per patient was five (range 1–23) with a median variant allele frequency of 4·2% (0·84–28%). Genotyping revealed somatic variants in the following genes: SOCS1 (28%), IGLL5 (26%), TNFAIP3 (23%), GNA13 (23%), STAT6 (21%) and B2M (19%). Moreover, several poor prognosis features (high LDH, low serum albumin, B-symptoms, IPI ≥ 3 or at an advanced stage) were related to significantly higher amounts of ctDNA. Variant detection in ctDNA by NGS is a feasible approach to depict the genetic features of HL patients at diagnosis. Our data favour the implementation of liquid biopsy genotyping for the routine evaluation of HL patients.This work was partially supported by the Instituto de Salud Carlos III (ISCIII), Spanish Ministry of Economy and Competitiveness CIBERONC-CB16/12/00233, and “Una manera de hacer Europa” (Innocampus; CEI-2010-1-0010)”, the Health Council of the Junta de Castilla y León (GRS2037/A/19) (GRS1845/A/18) and private Gilead (GLD/18/00063). MGA is supported with a grant from the Accelerator consortia (Cancer Research UK; C355/A26819). CJ and AM are supported by the ISCII (CD19/00030 and FI19/00320). MES is supported by Contrato Miguel Servet tipo II (CPII18/00028). MA is financed by CIBER-CB16/12/00233. All Spanish funding is co-sponsored by the European Union FEDER program

Propuesta de un sistema espacialmente explícito para evaluar el peligro de incendios

Los incendios forestales suponen un factor muy destacado en la transformación ambiental de buena parte de los ecosistemas terrestres. Tienen impactos globales, afectando a la superficie forestal y a las emisiones de gases de efecto invernadero, y efectos locales, relacionados con la degradación de suelos, erosión, modificación de la dinámica de la vegetación y pérdida de recursos y de vidas humanas. La prevención de incendios resulta cada vez más crítica, para paliar los efectos negativos de los mismos. Se presentan en este trabajo las variables de entrada y el esquema de integración para estimar el peligro de ocurrencia de incendios que se desarrolló en el marco del proyecto Firemap. Se generó información de diversas fuentes, que hacen referencia a variables socio-económicas, así como al estado de los combustibles y las características del territorio, utilizando sistemas de información geográfica (SIG) e imágenes de satélite. Todas las variables se cartografiaron a una resolución espacial de un 1 km2 y se integraron en un servidor web, que estuvo operativo para su evaluación durante el verano de 2007. Se presenta la comparación entre la variación temporal de los índices generados y la ocurrencia observada en la Comunidad de Madrid, una de las regiones del estudio.Forest fires are a major factor of environmental transformation in several ecosystems. Fires have global impacts, affecting forested areas and having an important impact in greenhouse gas emissions. Additionally, fires have local impacts, associated to soil degradation, soil erosion, vegetation dynamics, and lost of lives and properties. Fire prevention is critical to reduce the negative impacts of fire. This paper presents the input variables and the integration scheme developed within the Firemap project (funded under the Spanish Ministry of Science and Technology) to map wildland fire occurrence probability. The project first generated fire risk variables related to several factors of fire ignition or propagation. They were generated from a wide variety of sources using geographic information systems and remote sensing technologies. All variables were mapped at 1 sq km spatial resolution, and were integrated into single indices. The risk system included the development of a dedicated web-mapping server to facilitate the access to the end-users. This service was tested in the summer of 2007 for semi-operational use. The paper presents the first validation results of the danger index, by comparing temporal trends of the different danger components to the fire occurrence in the Madrid region, one of the test sites