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Twenty-one samples of winery and distillery effluents were collected from different Spanish winery and distillery industries. Electrical conductivity, pH, redox potential, density, organic charge (chemical oxygen demand, biological oxygen demand, total, volatile and suspended solids, oxidisable organic C and polyphenols) and contents of plant nutrients and heavy metals were analysed. The aim of this work was to study the composition of these effluents and to find relationships which would make it possible to use easily determined parameters to estimate their composition. The winery wastewater (WW) and vinasse (V) showed an acidic pH, a high organic load and notable polyphenol, macronutrient, micronutrient and heavy metal contents. Some of these properties are not compatible with agricultural requirements; therefore, conditioning treatment of these liquid wastes is necessary to produce a safe, stable and easily manageable end product. Generally, in both effluent types, significant correlations were found between easily analysable parameters, such as suspended, volatile and total solids, pH, electrical conductivity, density and redox potential, and most of the parameters studied. The linear regression equations obtained permitted an immediate characterisation of the WW and V samples using these parameters. [ABSTRACT FROM AUTHOR]

The aim of this study was to obtain further knowledge on electrical conductivity (EC) of milk as a tool for detecting mastitis in goats. The effect of farm, parity, stage of lactation, and health status of the glands on EC, and the somatic cell count (SCC) of milk was analyzed. Additionally, relationships between EC and chemical composition and SCC were studied. Finally, characteristics of EC and SCC (sensitivity and specificity) as diagnostic tests used to detect mastitis were studied. One hundred and five Murciano-Granadina goats were enrolled in the study. Milk samples (by gland) were collected monthly for 7 mo on 3 farms in the southeastern Spain. To establish the health status, milk samples were aseptically collected before milking by gland. Foremilk (by gland) was collected to analyze EC, SCC, and chemical composition. Glands were classified according to the health status as free of mastitis, bacterial mastitis, or unspecific mastitis. The effects of farm, parity, and stage of lactation, as well as the interactions between health status and parity, parity and stage of lactation, and health status and stage of lactation were associated with EC. Changes in the milk's chemical composition (particularly of chloride ions) explained most of the variance in EC (R = 0.91). The strongest association between EC and SCC was found at SCC >2 x 106 cells/mL (r = 0.42). The use of a single EC threshold for all animals and farms for detecting mastitis led to limited results for mastitis detection, which, in any case, favors negative predictive values over positive predictive values. This study revealed that factors, other than the health status, affecting EC hamper the use of an EC threshold for mastitis detection with sufficient specificity on all animals. Any detection system based on EC of milk should consider these factors, as well as specific variations for each of the animals. [ABSTRACT FROM AUTHOR]

Abstract: The effects on different physico-chemical, chemical and biological soil properties of the incorporation of different organic materials into a calcareous vineyard soil were studied in an experiment during three growing seasons. The organic materials used were sheep manure and four composts derived from the treatment of winery and distillery wastes. A multivariate technique, factor analysis (FA), was also used for interpreting the data obtained from the samplings carried out throughout the three vine growing seasons. The application of the organic materials induced an increase in the activity of the soil microorganisms and in the soil macro and micronutrient contents, as well as a slow release of inorganic N. Through FA of the soil properties studied, three factors that explained 74.7% of the variability were established and the effects of the treatments after the whole experimental period were assessed. [Copyright &y& Elsevier]

Abstract: The aim of this experiment was to study the effect of the application of pig slurry on potential pathogen (total and faecal coliform bacteria) presence in a Typic Xerofluvent soil. The experiment was conducted in field conditions, in the Segura River valley in the South East of Spain. Four treatments, in a fully-randomised design with three replicates per treatment, were established in experimental plots of 16 m2 each. Fertiliser treatments were: MF, mineral fertiliser (with a complex 16N–16P2O5–16K2O) equivalent to 150 kg N ha−1; PSF, organic fertilisation with swine manure slurry, at two different rates (supplying 150 and 210 kg N ha−1), and C, a controlled treatment without fertilisation. A high variability of the concentrations of total and faecal coliforms was observed during the experiment, mainly depends on the time and the treatment. The pig slurry amendment induced the highest initial and also persistent presence of total and faecal coliform bacteria. The higher application rate seemed to induce a long-lasting persistence of the total, but especially the faecal coliform, population in the amended soils compared to the lower rate. In most cases, an increase in the total coliforms content was observed in the soils amended with mineral fertiliser compared to controlled soils, probably due to an increase in soil microorganisms populations. In general, the total coliform bacteria was 2–3 log10 units higher than the faecal ones. Mostly, a tendency to decrease with time was observed in both indicator microorganisms, in all the treatments. [Copyright &y& Elsevier]

Abstract: The contents of available nutrients in pig slurries are not easy to quantify in situ without laboratory facilities, but chemical analyses using standard laboratory methods also take time and are costly and not practical for most farms. Thus, when animal slurries are applied to land, their fertiliser potential is often unknown. In addition, in the last years, the changes in the management of industrial piggeries has changed the nature of the pig slurries vg. decrease of the dry matter content, and consequently the methods and equations used for estimating the nutrient contents in these residues must be checked. In our study, slurry samples were collected from the storage tanks of 36 commercial farms in Southeast Spain. Samples were analysed for pH, electrical conductivity (EC), redox potential (RP), specific density (D), total solids (TS), sedimentable solids (SS), biological oxygen demand (BOD5), chemical oxygen demand (COD), total nitrogen (TKN), ammonium nitrogen (AN), organic nitrogen (ON), and total contents of phosphorus, potassium, calcium and magnesium. Relationships between major nutrient levels of pig slurries and a range of physical and chemical properties were investigated. We also analysed the variability of pig slurries according to the production stage. TKN, AN and K were closely related to EC. The P content in slurries was related more closely to solids-derived parameters such as D. The use of multiple properties to estimate nutrient contents in pig slurries, especially for AN and K, seemed unnecessary due to the limited improvement achieved with an additional property. Therefore, electrical conductivity seemed to be the most appropriate single, easily determined parameter for estimation of total and ammonium nitrogen and potassium in pig slurries, with more than 83% of the variance explained. P seemed to be the worst key nutrient for estimation using any easily determined parameter. [Copyright &y& Elsevier]

Introduction: The association between viral infections and pulmonary exacerbations in children with cystic fibrosis (cwCF) is well established. However, the question of whether cwCF are at a higher risk of COVID-19 or its adverse consequences remains controversial., Methods: We conducted an observational, multicenter, cross-sectional study of cwCF infected by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) between March 2020 and June 2022, (first to sixth COVID-19 pandemic waves) in Spain. The study aimed to describe patients' basal characteristics, SARS-CoV-2 clinical manifestations and outcomes, and whether there were differences across the pandemic waves., Results: During study time, 351 SARS-CoV2 infections were reported among 341 cwCF. Median age was 8.5 years (range 0-17) and 51% were female. Cases were unevenly distributed across the pandemic, with most cases (82%) clustered between November 2021 and June 2022 (sixth wave, also known as Omicron Wave due to the higher prevalence of this strain in that period in Spain). Most cwCF were asymptomatic (24.8%) or presented with mild Covid-19 symptoms (72.9%). Among symptomatic, most prevalent symptoms were fever (62%) and increased cough (53%). Infection occurring along the sixth wave was the only independent risk factor for being symptomatic. Just eight cwCF needed hospital admission. No multisystem inflammatory syndrome, persisting symptoms, long-term sequelae, or deaths were reported., Conclusions: Spanish current data indicate that cwCF do not experience higher risks of SARS-CoV-2 infection nor worse health outcomes or sequelae. Changes in patients' basal characteristics, clinical courses, and outcomes were detected across waves. While the pandemic continues, a worldwide monitoring of COVID-19 in pediatric CF patients is needed., (© 2023 The Authors. Pediatric Pulmonology published by Wiley Periodicals LLC.)

Background: The most common cystic fibrosis (CF)-causing mutation is deltaF508 (F508del), which is present in 28% of CF Spanish patients. While the literature based on real-life studies on CF patients homozygous F508del treated with lumacaftor/ivacaftor is limited, it demonstrates the need for better strategies to prevent related adverse events (AEs) as well as the development of newer drugs., Methods: We conducted a multicenter, retrospective, observational study to describe the effects of lumacaftor/ivacaftor treatment in real-life in Spain. 20 CF patients were included, all aged 6 and upwards and presented with ppFEV1<40%, chosen from CF units country-wide. For the purposes of the study, they were treated with lumacaftor/ivacaftor 200/125mg two tablets twice a day on a compassionate use programme throughout 2016. The primary endpoint was measured in all of the sample patients. Data were analysed from ppFEV1 at baseline and was measured every 6 months., Results: The mean age was 26.65 (range of 10-45), while the mean ppFEV1 before the treatment was 32.4% and mean BMI was 19.9kg/m 2 . We analysed the changes in ppFEV1 and BMI from baseline during the treatment with lumacaftor/ivacaftor, but no differences were found. However, a moderate association between days of intravenous antibiotic needed and the use of lumacaftor/ivacaftor (p=0.001) was established. Indeed, under the lumacaftor/ivacaftor, patients required 5.8 days of intravenous antibiotic treatment compared to 14.9 days prior to study. Also, severe pulmonary exacerbations requiring hospitalisation were statistically fewer under lumacaftor/ivacaftor treatment (p=0.003). Finally, 75% of the sample presented with AEs, which led 35% of the subjects to discontinue the treatment., Conclusions: While treatment with lumacaftor/ivacaftor resulted in an improvement in the number of pulmonary severe exacerbations, no improvement in ppFEV1 or BMI was found., (Copyright © 2018 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: To assess the incidence of airway obstruction symptoms and the presence of obstructive sleep apnea in children with severe craniofacial anomalies by a proactive screening program using a standard questionnaire and cardiorespiratory polygraphy., Patients and Methods: Children with severe craniofacial anomalies referred to our paediatric airway unit from February 2001 to June 2011 were eligible to be included in this retrospective, single centre study. Symptoms of airway obstruction were proactively investigated using the shorter version of the Pediatric Sleep Questionnaire (PSQ). Obstructive sleep apnea was assessed by means of cardiorespiratory polygraphy. Demographic data and reason for referral were also recorded. Primary outcomes were the prevalence of symptoms of airway obstruction and OSA., Results: 44 children (24 girls) with severe craniofacial anomalies (15 Crouzon, 13 Apert, 9 Goldenhar, 5 Treacher-Collins, 2 Pfeiffer) were included, at a mean age of 5 years (range 8 months to 14 years). Reason for referral was routine follow up in 30 patients and overt OSA symptoms and signs in the remaining 14. PSQ results showed symptoms of airway obstruction in 82% of patients, being snoring the most frequent symptom (64.1%) followed by apneas (33.3%). Polygraphic studies showed inconclusive results in 8 children (18.2%), normal apnea-hypopnea index (AHI) in 16 (36.4%), mild obstructive sleep apnea in 9 (20.4%), moderate in 4 (9.1%) and severe obstructive sleep apnea in 7 (15.9%)., Conclusions: Children with craniofacial anomalies have a high prevalence of symptoms of airway obstruction and obstructive sleep apnea that support a proactive screening strategy in this highly selected population., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)

The New World was ravaged by smallpox for several centuries after the Spanish conquest. Jenner's discovery of the smallpox vaccine made possible the prevention and control of smallpox epidemics. In response to a large outbreak of smallpox in the Spanish colonies, King Charles IV appointed Francisco Xavier de Balmis to lead an expedition that would introduce Jenner's vaccine to these colonies. During the journey, the vaccine was kept viable by passing it from arm to arm in orphaned children, who were brought along expressly for that purpose and remained under the care of the orphanage's director. This expedition was the first large scale mass vaccination of its kind. The historic legacy of this pioneering event in international health should be revisited in the current era of persistent inequalities in global health.

Objectives: Our primary goal was to evaluate the impact on in-hospital mortality rate of adequate empirical antibiotic therapy, after controlling for confounding variables, in a cohort of patients admitted to the intensive care unit (ICU) with sepsis. The impact of adequate empirical antibiotic therapy on early (<3 days), 28-day, and 60-day mortality rates also was assessed. We determined the risk factors for inadequate empirical antibiotic therapy. DESIGN Prospective cohort study., Setting: ICU of a tertiary hospital., Patients: All the patients meeting criteria for sepsis at admission to the ICU., Interventions: None., Measurements and Main Results: Four hundred and six patients were included. Microbiological documentation of sepsis was obtained in 67% of the patients. At ICU admission, sepsis was present in 105 patients (25.9%), severe sepsis in 116 (28.6%), and septic shock in 185 (45.6%). By multivariate analysis, predictors of in-hospital mortality were Sepsis-related Organ Failure Assessment (SOFA) score at ICU admission (odds ratio [OR], 1.29; 95% confidence interval [CI], 1.19-1.40), the increase in SOFA score over the first 3 days in the ICU (OR, 1.40; 95% CI, 1.19-1.65), respiratory failure within the first 24 hrs in the ICU (OR, 3.12; 95% CI, 1.54-6.33), and inadequate empirical antimicrobial therapy in patients with "nonsurgical sepsis" (OR, 8.14; 95% CI, 1.98-33.5), whereas adequate empirical antimicrobial therapy in "surgical sepsis" (OR, 0.37; 95% CI, 0.18-0.77) and urologic sepsis (OR, 0.14; 95% CI, 0.05-0.41) was a protective factor. Regarding early mortality (<3 days), factors associated with fatality were immunosuppression (OR, 4.57; 95% CI, 1.69-13.87), chronic cardiac failure (OR, 9.83; 95% CI, 1.98-48.69) renal failure within the first 24 hrs in the unit (OR, 8.63; 95% CI, 3.31-22.46), and respiratory failure within the first 24 hrs in the ICU (OR, 12.35; 95% CI, 4.50-33.85). Fungal infection (OR, 47.32; 95% CI, 5.56-200.97) and previous antibiotic therapy within the last month (OR, 2.23; 95% CI, 1.1-5.45) were independent variables related to administration of inadequate antibiotic therapy., Conclusions: In patients admitted to the ICU for sepsis, the adequacy of initial empirical antimicrobial treatment is crucial in terms of outcome, although early mortality rate was unaffected by the appropriateness of empirical antibiotic therapy.

Background: The prevalence of asthma has increased from the 1950s to the 1990s. The relationship between diet and asthma is an area of controversy that has never been fully evaluated. Attempts at dietary prevention of asthma have produced conflicting results. We have recently identified allergens from cereals that show cross-reactivity with proteins in grass pollen. An early intake of cereals in the diet during early life might cause IgE sensitization to cereals. It is not known whether such sensitization predisposes the development of allergy to pollen., Methods: To test this hypothesis, a cross-sectional study and an observational case-control analysis of reviewed data were carried out on 16381 patients who had been admitted to our Allergy Unit between 1989 and 1999. All the patients underwent allergy tests to identify asthma risk-factors. All information in our data base was analysed using the SPSS computer system., Results: There has been an increase of 7.8% in incidences of allergic asthma and a 7.3% increase in asthma due to grass pollen in the last decade. Grass-pollen asthma was associated with sensitization to cereals. The early introduction of cereals in the diet of children was found to be a risk factor for grass-pollen asthma (OR = 5.95; 95% CI 3.89-9.10)., Conclusions: These findings document the progression of allergic asthma during a decade in a large sample of people who were influenced by similar environmental conditions and studied with the same diagnostic methods. This study represents the largest database of patients in which a common food is shown to be a risk factor for asthma.