La liberación de troponina cardiaca T después de 60 min. de ejercicio aeróbico no está mediada por la modalidad de ejercicio

La liberación del marcador cardíaco Troponina T, que tiene una estrecha relación con la lesión del miocardio, se produce durante el ejercicio por causas que aún no están claras. En este trabajo se expone que la liberación de la troponina T durante 3 pruebas de ejercicio aeróbico (60 minutos) no depende de que tipo de prueba sea. Lo que más influye en el grado de liberación de la Troponina T es la variabilidad entre sujetos y factores subjetivos a cada persona

Forecasting of poor visibility episodes in the vicinity of Tenerife Norte Airport

Aviation safety is a priority that may be compromised by adverse weather conditions. This is the case for poor visibility in the vicinity of airports, which can pose a risk during takeoff and landing. For airports that are prone to fog because of their location, an accurate forecast of poor-visibility episodes is vital. However, the forecasting of low clouds is still a challenge in numerical weather prediction, especially when an airport is near complex terrain for which the use of non-hydrostatic mesoscale models is mandatory. All these factors are present at Tenerife Norte Airport, which is commonly affected by poor visibility from low clouds related to persistent trade winds and moist flows from the Atlantic Ocean. In this paper, several methods for estimating visibility based on mesoscale model outputs are tested. Use of the HARMONIE-AROME model is encouraged because of its excellent performance in the detection of poor-visibility episodes (False Alarm Ratio = 0.34–0.38; Frequency Of Misses = 0.22–0.38, depending on the model version and method used). In addition, the use of satellite application facilities is proposed for the nowcasting of low clouds affecting the airport area. Specifically, we used products that estimate cloud type, cloud top altitude, and integrated water vapor content in the boundary layer. Finally, an application is presented for the monitoring of weather conditions in real time to estimate poor-visibility risk.This work was supported by the Aeronautics Annual Plan 2018 of AEMET

Mejora de la predicción de la visibilidad en el aeropuerto de Tenerife Norte (GCXO)

Presentación realizada en el Foro de Usuarios Aeronáuticos, celebrado el 27 de febrero de 2019 en los Servicios Centrales de AEMET en Madrid

Foveal remodeling of retinal microvasculature in Parkinson’s disease

[EN] Background: Retinal microvascular alterations have been previously described in Parkinson’s disease (PD) patients using optical coherence tomography angiography (OCT-A). However, an extensive description of retinal vascular morphological features, their association with PD-related clinical variables and their potential use as diagnostic biomarkers has not been explored. Methods: We performed a cross-sectional study including 49 PD patients (87 eyes) and 40 controls (73 eyes). Retinal microvasculature was evaluated with Spectralis OCT-A and cognitive status with Montreal Cognitive Assessment. Unified PD Rating Scale and disease duration were recorded in patients. We extracted microvascular parameters from superficial and deep vascular plexuses of the macula, including the area and circularity of foveal avascular zone (FAZ), skeleton density, perfusion density, vessel perimeter index, vessel mean diameter, fractal dimension (FD) and lacunarity using Python and MATLAB. We compared the microvascular parameters between groups and explored their association with thickness of macular layers and clinical outcomes. Data were analyzed with General Estimating Equations (GEE) and adjusted for age, sex, and hypertension. Logistic regression GEE models were fitted to predict diagnosis of PD versus controls from microvascular, demographic, and clinical data. The discrimination ability of models was tested with receiver operating characteristic curves. Results: FAZ area was significantly smaller in patients compared to controls in superficial and deep plexuses, whereas perfusion density, skeleton density, FD and lacunarity of capillaries were increased in the foveal zone of PD. In the parafovea, microvascular parameters of superficial plexus were associated with ganglion cellinner plexiform layer thickness, but this was mainly driven by PD with mild cognitive impairment. No such associations were observed in controls. FAZ area was negatively associated with cognition in PD (non-adjusted models). Foveal lacunarity, combined with demographic and clinical confounding factors, yielded an outstanding diagnostic accuracy for discriminating PD patients from controls. Conclusion: Parkinson’s disease patients displayed foveal microvascular alterations causing an enlargement of the vascular bed surrounding FAZ. Parafoveal microvascular alterations were less pronounced but were related to inner retinal layer thinning. Retinal microvascular abnormalities helped discriminating PD from controls. All this supports OCT-A as a potential non-invasive biomarker to reveal vascular pathophysiology and improve diagnostic accuracy in PD.This study was partially co-funded by the Instituto de Salud Carlos III through the projects PI14/00679 and PI16/00005 (co-funded by European Regional Development Fund/European Social Fund “A way to make Europe”/“Investing in your future”), and by the Department of Health of the Basque Government through the projects “2019111100” and “2020333033”

Fabry Nephropathy: An Evidence-Based Narrative Review.

Fabry disease (FD) is a rare, X-linked disorder caused by mutations in the GLA gene encoding the enzyme α-galactosidase A. Complete or partial deficiency in this enzyme leads to intracellular accumulation of globotriaosylceramide (Gb3) and other glycosphingolipids in many cell types throughout the body, including the kidney. Progressive accumulation of Gb3 in podocytes, endothelial cells, epithelial cells, and tubular cells contribute to the renal symptoms of FD, which manifest as proteinuria and reduced glomerular filtration rate leading to renal insufficiency. A correct diagnosis of FD, although challenging, has considerable implications regarding treatment, management, and counseling. The diagnosis may be confirmed by demonstrating the enzyme deficiency in males and by identifying the specific GLA gene mutation in male and female patients. Treatment with enzyme replacement therapy, as part of the therapeutic strategy to prevent complications of the disease, may be beneficial in stabilizing renal function or slowing its decline, particularly in the early stages of the disease. Emergent treatments for FD include the recently approved chaperone molecule migalastat for patients with amenable mutations. The objective of this report is to provide an updated overview on Fabry nephropathy, with a focus on the most relevant aspects of its epidemiology, diagnosis, pathophysiology, and treatment options.S

Quantitative analysis of dysautonomia in patients with autonomic dysreflexia

Autonomic dysreflexia (AD) is a life-threatening condition for individuals with cervical or high-thoracic spinal cord injury (SCI). The profile of autonomic dysfunction in AD using validated clinical autonomic tests has not been described so far, although it could be useful to identify SCI patients at greater risk of developing AD non-invasively. With this objective, 37 SCI patients (27% female) were recruited, and hemodynamic and cardiac parameters were continuously monitored to determine the presence of AD, defined as an increase of systolic blood pressure of 20 mmHg or higher after bladder filling with saline. Then, standard autonomic function testing was performed, including Deep Breathing, Valsalva Manoeuvre and Tilt Table Test. Finally, baroreflex sensitivity (BRS), and spectral analysis of heart rate and blood pressure variability were measured at rest. Catecholamines and vasopressin levels were also measured at supine and upright positions. The severity of SCI was assessed through clinical and radiological examinations. AD was observed in 73.3% of SCI patients, being 63.6% of them asymptomatic during the dysreflexive episode. AD patients displayed a drop in sympathetic outflow, as determined by decreased noradrenalin plasma levels, reduced sympathovagal balance and increased BRS. In line with decreased sympathetic activity, the incidence of neurogenic orthostatic hypotension was higher in AD patients. Our results provide novel evidence regarding the autonomic dysfunction in SCI patients with AD compared to non-AD patients, posing non-invasively measured autonomic parameters as a powerful clinical tool to predict AD in SCI patients

Retinal thickness predicts the risk of cognitive decline in Parkinson's disease

Objective: To analyze longitudinal changes of retinal thickness and their predictive value as biomarkers of disease progression in idiopathic Parkinson’s disease (iPD). Methods: Patients with Lewy body diseases (LBDs) were enrolled and prospectively evaluated at 3 years, including patients with iPD (n=42), dementia with Lewy bodies (DLB, n=4), E46K-SNCA mutation carriers (n=4) and controls (n=17). All participants underwent Spectralis retinal optical coherence tomography and Montreal Cognitive Assessment (MoCA), and Unified Parkinson’s Disease Rating Scale (UPDRS) score was obtained in patients. Macular ganglion-inner plexiform layer complex (GCIPL) and peripapillary retinal nerve fiber layer (pRNFL) thickness reduction rates were estimated with linear mixed models. Risk ratios were calculated to evaluate the association between baseline GCIPL and pRNFL thickness and the risk of subsequent cognitive and motor worsening, using clinically meaningful cut-offs. Results: GCIPL thickness in the parafoveal region (1- to 3-mm ring) presented the largest reduction rate. The annualized atrophy rate was 0.63 µm in iPD patients and 0.23 µm in controls (p<0.0001). iPD patients with lower parafoveal GCIPL and pRNFL thickness at baseline presented an increased risk of cognitive decline at 3 years (RR 3.49, 95% CI 1.10 – 11.1, p=0.03 and RR 3.28, 95% CI 1.03 – 10.45, p=0.045, respectively). We did not identify significant associations between retinal thickness and motor deterioration. Interpretation: Our results provide evidence of the potential use of OCT-measured parafoveal GCIPL thickness to monitor neurodegeneration and to predict the risk of cognitive worsening over time in iPD

A 3’-UTR polymorphism in soluble epoxide hydrolase gene Is associated with acute rejection in renal transplant recipients

Antecedentes y finalidad: Los ácidos epoxyeicosatrienoic (EETs) son metabolitos del ácido araquidónico que desempeñan una función protectora contra procesos perjudiciales que pueden ocurrir después de re-oxigenación del injerto. Decidimos investigar si la presencia de polimorfismos funcionales en el gen que codifica el epóxido hidrolasa soluble (EPHX2), que metaboliza EETs a menos compuestos activos, pueden jugar un papel importante en el resultado del trasplante renal. Métodos En un grupo de 259 receptores caucásicos de trasplante renal y 183 donantes fallecidos, se determinó la presencia de tres EPHX2 común, a saber, los SNPs rs41507953 (K55R), rs751141 (R287Q) y rs1042032 A/G. Las asociaciones con los parámetros de la función del injerto y la incidencia de rechazo agudo fueron investigados retrospectivamente durante el primer año después del injerto mediante regresión logística, ajustándose a las variables clínicas y demográficas. Resultados Los portadores del genotipo rs1042032 GG muestran significativamente menor tasa de filtración glomerular estimada (eGFR) (38.15 ± 15.57 vs. 45.99 ± 16.05; p = 0,04) y mayores valores de creatinina sérica (1,57 ± 0,58 vs. 1,30 ± 0,47 g/dL; p=0.02) un año después del injerto, en comparación con los pacientes portadores del alelo A wildtype. El mismo genotipo GG también se asoció a un mayor riesgo de rechazo agudo. Curiosamente, esta asociación fue observada por el genotipo de ambos destinatarios [o =6.34 (1.35-29.90); p = 0,015] y donantes [OR = 5.53 (1.10 - 27.80); p=0,042]. Un modelo estadístico incluyendo ambos genotipos junto con otras variables demográficas y clínicas significativas se tradujo en un aumento de la importancia de la asociación con los receptores del genotipo [OR=8,28 (1.21-74.27); p=0,031]. Conclusiones Nuestros resultados indican que la variabilidad genética en el gen metabolizante de EETs, EPHX2, pueden tener un impacto significativo en los resultados del trasplante renal de donante fallecido.Background and Purpose: Epoxyeicosatrienoic acids (EETs) are arachidonic acid metabolites that play a protective role against damaging processes that may occur after re-oxygenation of the graft. We aimed to investigate whether the presence of functional polymorphisms in the gene encoding soluble epoxy hydrolase (EPHX2), which metabolizes EETs to less active compounds, may play a role in the outcome of renal transplantation. Methods In a group of 259 Caucasian renal transplant recipients and 183 deceased donors, we determined the presence of three common EPHX2 SNPs, namely rs41507953 (K55R), rs751141 (R287Q) and rs1042032 A/G. Associations with parameters of graft function and the incidence of acute rejection were retrospectively investigated throughout the first year after grafting by logistic regression adjusting for clinical and demographic variables. Results Carriers of the rs1042032 GG genotype displayed significantly lower estimated glomerular filtration rate (eGFR) (38.15 ± 15.57 vs. 45.99 ± 16.05; p = 0.04) and higher serum creatinine values (1.57 ± 0.58 vs. 1.30 ± 0.47 g/dL; p=0.02) one year after grafting, compared to patients carrying the wildtype A-allele. The same GG genotype was also associated to increased risk of acute rejection. Interestingly, this association was observed for the genotype of both recipients [OR =6.34 (1.35-29.90); p = 0.015] and donors [OR = 5.53 (1.10- 27.80); p=0.042]. A statistical model including both genotypes along with other meaningful demographic and clinical variables resulted in an increased significance for the association with the recipients’ genotype [OR=8.28 (1.21-74.27); p=0.031]. Conclusions Our results suggest that genetic variability in the EETs-metabolizing gene, EPHX2, may have a significant impact on the outcome of deceased-donor renal transplantation.• Asociación para el Estudio y la Prevención de las Enfermedades Renales (ASEPER), Badajoz • Junta de Extremadura, Consejería de Economía, Comercio e Innovación: Proyecto GR10022 • Red de Investigación Renal - REDINREN (Instituto de Salud Carlos III – Fondo Europeo de Desarrollo Regional – FEDER) : Ayudas a Eliecer Coto García, Carmen Díaz Corte y Carlos López LarreapeerReviewe

Guía de gestión integrada de plagas: mango

Coordinadores: Ángel Martín Gil y Gregoria Aranda Aranda