Evolution of the use of corticosteroids for the treatment of hospitalised COVID-19 patients in Spain between March and November 2020: SEMI-COVID national registry

Objectives: Since the results of the RECOVERY trial, WHO recommendations about the use of corticosteroids (CTs) in COVID-19 have changed. The aim of the study is to analyse the evolutive use of CTs in Spain during the pandemic to assess the potential influence of new recommendations. Material and methods: A retrospective, descriptive, and observational study was conducted on adults hospitalised due to COVID-19 in Spain who were included in the SEMI-COVID- 19 Registry from March to November 2020. Results: CTs were used in 6053 (36.21%) of the included patients. The patients were older (mean (SD)) (69.6 (14.6) vs. 66.0 (16.8) years; p < 0.001), with hypertension (57.0% vs. 47.7%; p < 0.001), obesity (26.4% vs. 19.3%; p < 0.0001), and multimorbidity prevalence (20.6% vs. 16.1%; p < 0.001). These patients had higher values (mean (95% CI)) of C-reactive protein (CRP) (86 (32.7-160) vs. 49.3 (16-109) mg/dL; p < 0.001), ferritin (791 (393-1534) vs. 470 (236- 996) µg/dL; p < 0.001), D dimer (750 (430-1400) vs. 617 (345-1180) µg/dL; p < 0.001), and lower Sp02/Fi02 (266 (91.1) vs. 301 (101); p < 0.001). Since June 2020, there was an increment in the use of CTs (March vs. September; p < 0.001). Overall, 20% did not receive steroids, and 40% received less than 200 mg accumulated prednisone equivalent dose (APED). Severe patients are treated with higher doses. The mortality benefit was observed in patients with oxygen saturation </=90%. Conclusions: Patients with greater comorbidity, severity, and inflammatory markers were those treated with CTs. In severe patients, there is a trend towards the use of higher doses. The mortality benefit was observed in patients with oxygen saturation </=90%

Effects of the change in the duration of daylight on manifestation of heat in andalusian mares

Following the traditional method of exploitation, for a period of four years 165 Spanish-bred mares were observed. The heats. per month from January to June and the gestation rates in each month were determined. The number of mares on heat in January was 26.6 and increased with the daily increase of ligth. The higest gestation rate was obtained in the month of March (53.8°), in the remaining months it was 43% which was the mean fertlity per cycle. In order to increase the fertility rate from 60.6% to 80% it is indispensable that, apart from taking advantage of the months of January to June, i.e. mating season of 180 days, modern reproduction techniques should be used so that the mares which are not pregnant start having 5 to 6 cycles as against the two and a half cycles shown at present.Siguiendo el método de explotación tradicional, se ha controlado, durante un período de 4 años, un total de 165 yeguas de raza española. Se han determinado los celos que han manifestado, por meses, desde enero a julio, y las tasas de gestación de cada mes. El número de yeguas en celo, en enero, fue del 26.6; y aumenta con el incremento diario de la luz. La tasa de gestación más alta se consigue en el mes de marzo (53.8%) y en los otros meses se aproxima al 43%, y coincide con la media de fertilidad por ciclos. Para aumentar la tasa de fertilidad, del 60.6% al 80%, es imprescindible, además, aprovechar los meses de enero y junio; es decir: una temporada de cubrición de unos 180 días, y utilizar técnicas modernas de reproducción, para que las yeguas que vayan quedando vacías manifiesten de 5 a 6 ciclos, frente a los dos ciclos de media que ahora muestran

Effect of exercise of gradually increased intensity on some blood parameters in untrained spanish foals

We carried out a tour-step test in which exercise was gradually intensified over a distance of 1000 m on a semielliptic sand track, in which the heart rate was 115-125 (120), 140-150(145), 165-175 (170) y 185-195 (190) beats/min and allowed a five minute period of recuperation between each stage of exercise. Samples were taken by puncturing the external jugular vein, prior to exercise. during the first minute following each step and additionally five, ten and fifteen minutes after the last step. For purposes at analysis the samples were divided into two fractions: one containing whole blood in which the pH was studied, and the of her containing plasma, in which the lactate, glucose and electrolytes (sodium, potassium and chloride) were measured. The heart rate was recorder by a Polar Sport Tester monitor composed of a watch, a sensory transmitter and electrodes fitted to the horse"s saddle strap. We found an increase in the average levels of lactate and glucose, which remained constant during the first 15 minutes following exercise. The electrolytes showed some variations with exercise. The sodium and chloride concentrations decreased and the potassium concentration showed a significant increase, reaching its maximum value at a heart rate of 190 beats/mm It returned to base levels 15 minutes after the end of exercise.Se ha realizado una prueba de intensidad creciente, de cuatro escalones, sobre una distancia de 1000 metros, en una pista semielíptica de arena, con una frecuencia cardiaca de 115-125 (120), 140-150 (145), 165-175 (170) y 185.195 (190) lat/min y un período de recuperación entre cada nivel de ejercicio de 5 minutos. La toma de muestras se realizó mediante punción en la vena yugular externa, en reposo, dentro del primer minuto tras cada nivel de ejercicio y a los 5, 10 y 15 minutos de recuperación. Para los análisis, las muestras se dividieron en dos fracciones, una conteniendo sangre entera donde se investigó pH y otra conteniendo plasma donde se midió lactato, glucosa e iones (sodio, potasio, cloro). La frecuencia cardiaca se controló mediante un monitor Polar Sport Tester compuesto por reloj, sensor transmisor y electrodos ajustables a la cincha del caballo. Se observó un incremento en los valores promedios de lactato y glucosa que se mantiene hasta los 15 minutos de finalizar el ejercicio. Los electrólitos muestran variaciones con el ejercicio, mientras que la concentración de sodio y cloro disminuyen respecto al reposo; la concentración de potasio sufre un ascenso significativo con un valor máximo a los 190 lat/min, recuperándose totalmente a los 15 minutos terminada la prueba. Se observa claramente una acidosis provocada por el esfuerzo can valores más bajos de pH a los 15 minutos de recuperación

Efecto de una prueba de ejercicio de intensidad creciente en parametros bioquimicos sanguineos de potros pura raza española sin entrenamiento

Se ha realizado una prueba de intensidad creciente, de cuatro escalones, sobre una distancia de 1000 metros, en una pista semielíptica de arena, con una frecuencia cardiaca de 115-125 (120), 140-150 (145), 165-175 (170) y 185.195 (190) lat/min y un período de recuperación entre cada nivel de ejercicio de 5 minutos. La toma de muestras se realizó mediante punción en la vena yugular externa, en reposo, dentro del primer minuto tras cada nivel de ejercicio y a los 5, 10 y 15 minutos de recuperación. Para los análisis, las muestras se dividieron en dos fracciones, una conteniendo sangre entera donde se investigó pH y otra conteniendo plasma donde se midió lactato, glucosa e iones (sodio, potasio, cloro). La frecuencia cardiaca se controló mediante un monitor Polar Sport Tester compuesto por reloj, sensor transmisor y electrodos ajustables a la cincha del caballo. Se observó un incremento en los valores promedios de lactato y glucosa que se mantiene hasta los 15 minutos de finalizar el ejercicio. Los electrólitos muestran variaciones con el ejercicio, mientras que la concentración de sodio y cloro disminuyen respecto al reposo; la concentración de potasio sufre un ascenso significativo con un valor máximo a los 190 lat/min, recuperándose totalmente a los 15 minutos terminada la prueba. Se observa claramente una acidosis provocada por el esfuerzo can valores más bajos de pH a los 15 minutos de recuperación

Prediction of Cardiovascular Disease by the Framingham‐REGICOR Equation in the High‐Risk PREDIMED Cohort: Impact of the Mediterranean Diet Across Different Risk Strata

Background: The usefulness of cardiovascular disease (CVD) predictive equations in different populations is debatable. We assessed the efficacy of the Framingham‐REGICOR scale, validated for the Spanish population, to identify future CVD in participants, who were predefined as being at high‐risk in the PREvención con DIeta MEDiterránea (PREDIMED) study—a nutrition‐intervention primary prevention trial—and the impact of adherence to the Mediterranean diet on CVD across risk categories. Methods and Results: In a post hoc analysis, we assessed the CVD predictive value of baseline estimated risk in 5966 PREDIMED participants (aged 55–74 years, 57% women; 48% with type 2 diabetes mellitus). Major CVD events, the primary PREDIMED end point, were an aggregate of myocardial infarction, stroke, and cardiovascular death. Multivariate‐adjusted Cox regression was used to calculate hazard ratios for major CVD events and effect modification from the Mediterranean diet intervention across risk strata (low, moderate, high, very high). The Framingham‐REGICOR classification of PREDIMED participants was 25.1% low risk, 44.5% moderate risk, and 30.4% high or very high risk. During 6‐year follow‐up, 188 major CVD events occurred. Hazard ratios for major CVD events increased in parallel with estimated risk (2.68, 4.24, and 6.60 for moderate, high, and very high risk), particularly in men (7.60, 13.16, and 15.85, respectively, versus 2.16, 2.28, and 3.51, respectively, in women). Yet among those with low or moderate risk, 32.2% and 74.3% of major CVD events occurred in men and women, respectively. Mediterranean diet adherence was associated with CVD risk reduction regardless of risk strata (P>0.4 for interaction). Conclusions: Incident CVD increased in parallel with estimated risk in the PREDIMED cohort, but most events occurred in non–high‐risk categories, particularly in women. Until predictive tools are improved, promotion of the Mediterranean diet might be useful to reduce CVD independent of baseline risk

Dietary α-linolenic acid, marine ω-3 fatty acids, and mortality in a population with high fish consumption: Findings from the PREvención con DIeta MEDiterránea (PREDIMED) Study

12 Páginas.-- 6 Tablas.-- 1 FiguraBackground-Epidemiological evidence suggests a cardioprotective role of α-linolenic acid (ALA), a plant-derived ω-3 fatty acid. It is unclear whether ALA is beneficial in a background of high marine ω-3 fatty acids (long-chain n-3 polyunsaturated fatty acids) intake. In persons at high cardiovascular risk from Spain, a country in which fish consumption is customarily high, we investigated whether meeting the International Society for the Study of Fatty Acids and Lipids recommendation for dietary ALA (0.7% of total energy) at baseline was related to all-cause and cardiovascular disease mortality. We also examined the effect of meeting the society's recommendation for long-chain n-3 polyunsaturated fatty acids (≥500 mg/day). Methods and Results-We longitudinally evaluated 7202 participants in the PREvención con DIeta MEDiterránea (PREDIMED) trial. Multivariable-adjusted Cox regressionmodels were fitted to estimate hazard ratios. ALA intake correlated towalnut consumption (r=0.94). During a 5.9-y follow-up, 431 deaths occurred (104 cardiovascular disease, 55 coronary heart disease, 32 sudden cardiac death, 25 stroke). The hazard ratios formeeting ALArecommendation (n=1615, 22.4%) were 0.72 (95% CI 0.56-0.92) for all-causemortality and 0.95 (95% CI 0.58-1.57) for fatal cardiovascular disease. The hazard ratios formeeting the recommendation for long-chain n-3 polyunsaturated fatty acids (n=5452, 75.7%) were 0.84 (95% CI 0.67-1.05) for all-causemortality, 0.61 (95% CI 0.39-0.96) for fatal cardiovascular disease, 0.54 (95% CI 0.29-0.99) for fatal coronary heart disease, and 0.49 (95% CI 0.22-1.01) for sudden cardiac death. The highest reduction in all-cause mortality occurred in participants meeting both recommendations (hazard ratio 0.63 [95% CI 0.45-0.87]). Conclusions-In participants without prior cardiovascular disease and high fish consumption, dietary ALA, supplied mainly by walnuts and olive oil, relates inversely to all-cause mortality, whereas protection from cardiac mortality is limited to fish-derived long-chain n-3 polyunsaturated fatty acids.This study was funded in part by Instituto de Salud Carlos III (ISCIII) (Spanish Ministry of Economy) through grants RTIC G03/140, RTIC RD 06/0045, Centro Nacional de Investigaciones Cardiovasculares CNIC 06/2007, ISCIII FIS PS09/01292, the Spanish Ministry of Science and Innovation (MICINN) AGL2010‐22319‐C03‐02 and AGL2009‐13906‐C02‐02, and an unrestricted grant from the California Walnut Commission. Sala‐Vila holds a Miguel Servet I fellowship from the Ministry of Economy and Competitiveness through the ISCIII