Search

To evaluate the economic impact in Spain derived from the introduction of the XEN®63 implant as a surgical alternative in the management of primary open angle glaucoma (POAG) with or without cataract in refractory patients.A budget impact analysis was designed to estimate the costs of surgical treatment of POAG from the perspective of the Spanish National Health System (NHS), over a time horizon of 1 year. The comparators considered (trabeculectomy, deep non-penetrating sclerectomy, Ahmed valve, iStent inject, Preserflo® microshunt and XEN®45) correspond to those used in Spanish public clinical practice. For the calculation of the target population, market shares and resource use in terms of follow-up visits, additional procedures and post-surgery complications, data from the literature were used and validated with a panel of 4 experts. Unit costs (€ 2021) were obtained from the ESALUD database.The inclusion of XEN®63 could generate savings of €2,569,737 after one year since its introduction, derived from savings in the cost of the implant and procedure (-€423,120; -0.7%), follow-up visits (-€777,407; -4.5%), additional procedures (-€1,048,145; -20.6%) and post-surgery complications (-€321,065; -14.2%).The incorporation of XEN63®in the surgical arsenal for the treatment of refractory POAG with and without cataracts could generate savings for the NHS. more...

To measure by consensus the level of innovation and its potential within the physical medicine and rehabilitation (PMR) medical specialists.Three consecutive techniques are applied using digital tools for consensus among professionals, first synchronously to a group of 17 professionals; posteriorly extended to a group of 169 professionals who participate asynchronously and the third technique is done synchronously with 25 physiatrists.The analysis of the consensus done by the PMR physicians on the innovation potential of the group during October and November 2020 shows: starting situation, strengths and weaknesses, as well as their innovation priorities.PMR physicians believe that innovation could improve the cost-effectiveness of their departments, and could increase their clinical efficiency, also that to innovate they need a close relationship with the industry. more...

Resumen La pandemia de COVID-19 es un desafío para el manejo de las patologías no COVID como la enfermedad linfática y el lipedema. La Telemedicina puede evitar la propagación del coronavirus. Se necesita un sistema que nos ayude a determinar la prioridad clínica y la selección de la asistencia presencial o telemática para cada paciente y la forma de realizarlas durante la pandemia. El Grupo Español de Linfología (GEL) ha realizado un documento de consenso con recomendaciones basadas en la bibliografía y experiencia clínica, como guía de práctica clínica en el manejo de anomalías linfáticas y lipedema durante la pandemia de COVID-19. Estas recomendaciones deben adaptarse a las características del paciente, las condiciones locales de los centros y las decisiones de los profesionales de la salud. Es un documento de criterios mínimos, sujeto a modificaciones según evolucione la pandemia, los conocimientos científicos y las instrucciones de las autoridades sanitarias. more...

Obesity is characterized by hypertrophy and hyperplasia of adipose tissue, which have been related to the development of hypoxia and insulin resistance. On the other hand, caveolin-1 (Cav-1), one of the main proteins of caveolae, promotes insulin receptor (IR) phosphorylation and the subsequent activation of insulin signaling. In this work we investigated the effect of hypoxia on Cav-1 regulation and the status of insulin signaling in 3T3-L1 adipocytes. Our results showed that hypoxia inhibited adipogenesis and insulin signaling in adipocytes. Furthermore, 48 h of hypoxia reduced insulin-induced glucose uptake while increased basal glucose uptake. This result was consistent with the upregulation of glucose transporter GLUT1 and the downregulation of GLUT4, which also showed defective translocation to plasma membrane when adipocytes were stimulated with insulin. In addition, the expression of caveolae-related proteins was reduced by hypoxia and chromatin immunoprecipitation assay demonstrated that Cav-1 transcription was directly regulated by HIF-1. These results strengthen the role of caveolae in insulin signaling and help to explain adipocyte response to hypoxia. more...

Abundant isolated remains of vertebrate fossils were recovered in 1980 in Middle Triassic strata (Muschelkalk Facies) of Canales de Molina (Guadalajara, Spain). However, none of them was figured or described in detail. The careful study of these fossils is performed here. The eosauropterygian remains from Canales de Molina are described and figured in detail, and compared with the Iberian record of Eosauropterygia. The study of these elements allows us to identify abundant eosauropterygian remains, including vertebrae, teeth, femora, and a partial humerus. This humerus presents a combination of characters traditionally considered as exclusive affinity of the genus Nothosaurus. Other relatively large elements from this site are also compatible with the bones of this genus. Isolated teeth and a neural arch are identified as belonging to indeterminate nothosaurs. The other elements studied here are poorly informative, and can be only assigned to indeterminate members of Eosauropterygia of small to medium size. The presence of Nothosaurus or a related form is confirmed in Canales de Molina. Other fossils from the site do not allow to assess if more taxa are present. more...

Se describe un enfermo afecto de enfermedad de Lyme, con expresión neurológica del tipo meningoradiculitís línfocitaria (Síndrome de Bannwarth), sin antecedentes de picadura ni eritema crónico migrans. Evolución febril prolongada, con parálisis facial bilateral. El título de anticuerpos para Borrelia burgdorferi fue elevado en suero y LCR. Los cambios licuorales indicaban una producción intratecal de inmunoglobulinas (presencia de células plasmáticas e inmunoblastos; relación IgG-LCR: IgG -suero muy elevada, en comparación con la albúmina- LCR: albúmina-suero, según el diagrama de Reiber; y presenciade bandas oligoclonales). La respuesta terapéutica a dosis elevadas de penicilina fue resolutiva. Al segundo día de tratamiento presentó una uveitis que se resolvió con corticoides. more...

The Upper Cretaceous outcrops of Armuna (Segovia Province, Spain) yielded relatively abundant material of vertebrates during prospection and excavation in the second half of the 1980s. However, little has been published on these remains. A new analysis of the specimens from this upper Campanian site reveals the presence of some clades in the site for the first time (e.g., Dortokidae, Anguimorpha, Mosasauroidea). Furthermore, the material of the clades previously recognized there has been reviewed and described in more detail, with some previous systematic attributions confirmed and others refuted. Consequently, a relatively high local diversity has been identified. New taxa (i.e., a member of Anguimorpha and a eusuchian crocodyliform) are identified in Armuna, coexisting with other taxa previously described in other sites from the Iberoarmorican Realm. The vertebrates from Armuna confirm that the fauna from the Upper Cretaceous of the Iberian Peninsula is composed of a mixture of European endemic clades and lineages shared with other continents such as North America (e.g., anguimorphs) and Africa (e.g., bothremydids). © 2015 Elsevier Ltd. more...

Recent research suggests that growth differentiation factor 11 (GDF11) could reverse age-related diseases and that its blood concentration decreases with age. This poses plasma from young donors as a therapeutic GDF11 source to treat age-related diseases. In addition, the tissue source of circulating GDF11 remains unknown. We analysed GDF11 levels in paired samples of serum, plasma and platelet lysate (PL) from 23 volunteers. Plasma and PL were collected by plateletpheresis. Here, we show that GDF11 is highly concentrated in platelets and that the circulating levels reported in previous studies could be biased as a result of serum sample manipulation. more...

BACKG ROUND: There is emerging evidence suggesting the role of peripheral blood leukocytes in the pathogenesis of obesity and related diseases. However, few studies have taken a genome-wide approach to investigating gene expression profiles in peripheral leukocytes between obese and lean individuals with the consideration of obesity-related shifts in leukocyte types.METHOD: We conducted this study in 95 African Americans (AAs) of both genders (age 14-20 years, 46 lean and 49 obese). Complete blood count with differential test (CBC) was performed in whole blood. Genome-wide gene expression analysis was obtained using the Illumina HumanHT-12 V4 Beadchip with RNA extracted from peripheral leukocytes. Out of the 95 participants, 64 had neutrophils stored. The validation study was based on real-time PCR with RNA extracted from purified neutrophils.RESULTS: CBC test suggested that, in males, obesity was associated with increased neutrophil percentage (P = 0.03). Genome-wide gene expression analysis showed that, in males, the majority of the most differentially expressed genes were related to neutrophil activation. Validation of the gene expression levels of ELANE (neutrophil elastase) and MPO (myeloperoxidase) in purified neutrophils demonstrated that the expression of these two genes-important biomarkers of neutrophils activation-were significantly elevated in obese males (P = 0.01 and P = 0.02, respectively).CONCLUSION: The identification of increased neutrophil percentage and activation in obese AA males suggests that neutrophils have an essential role in the pathogenesis of obesity-related disease. Further functional and mechanistic studies on neutrophils may contribute to the development of novel intervention strategies reducing the burden associated with obesity-related health problems. more...

Las lesiones del espacio retrorrectal o presacro plantean un amplio diagnóstico diferencial. Una patología típica aunque rara de esta localización son las masas quísticas relacionadas con el desarrollo embrionario, que constituyen las lesiones congénitas presacras más frecuentes en el adulto. De éstas, los quistes epidérmicos y los hamartomas quísticos son las más comunes. Asintomáticas hasta en la mitad de los casos al diagnóstico, las masas quísticas pueden presentar complicaciones infecciosas e incluso degeneración maligna. El diagnóstico inicial se basa en las pruebas de imagen, aunque la caracterización definitiva, de gran importancia dado el riesgo de malignización, viene dada por la anatomía patológica de la pieza quirúrgica. Presentamos dos casos clínicos de lesiones quísticas retrorrectales diagnosticadas en nuestro centro. more...

From ad 711 to 1492, several regions in Iberia were under Muslim ruling. This Al-Andalus civilization generated a large amount of documentation during those centuries. Unfortunately, most of the documents are lost. The surviving Arabic documentary sources have never been studied from a climate perspective. In this paper, we present the first attempt to retrieve climate evidence from them. We studied all the Islamic chronicles (documents written by Islamic historians that narrate the social, political and religious history) available for the period ad 711–1010. It is shown that these sources recorded extreme events with a high temporal and spatial resolution. We identified three severe droughts, ad 748–754, ad 812–823 and ad 867–879, affecting Al-Andalus. We also noticed that the weather in Cordoba during the period ad 971–975 showed a higher frequency of snow and hail than current climate. The possibility of obtaining long continuous series from this type of source seems highly difficult. more...

In the present work the effect of the processing by high hydrostatic pressures (HPP) was assessed as an alternative to the thermal treatment of pasteurization in olive jam. The effects of both treatments on the product after processing were compared and stability during storage under refrigeration was assessed through the characterization of physicochemical, microbiological and sensory aspects. To assess the effect of processing, two HPP treatments (450 and 600MPa) and thermal pasteurization (80 °C for 20 min) were applied, comparing them with the unprocessed product. HPP 600MPa versus the rest of treatments showed a reduction in microorganisms, greater clarity and less browning, and sensory acceptance. The shelf-life of the refrigerated product would indicate the feasibility of the application of the HPP technology for food with similar shelf-life to that obtained with the traditional treatment of pasteurization, but with a better sensory quality.En el presente trabajo se valoró el efecto del procesado por altas presiones hidrostáticas (HPP) como método alternativo al tratamiento térmico de pasteurización en la mermelada de aceitunas. Para ello se comparó el efecto de ambos tratamientos sobre el producto procesado y se evaluó su estabilidad durante el almacenamiento en refrigeración, mediante la caracterización de los aspectos físico-químicos, microbiológicos, y sensoriales. Para evaluar el efecto del procesado, se aplicaron dos tratamientos de HPP (450 y 600MPa) y otro de pasteurización térmica (80 °C durante 20 min), comparándose con el producto no procesado. Las muestras tratadas con HPP 600MPa presentaron, frente al resto de tratamientos una reducción en la presencia de microorganismos, mayor claridad y menor pardeamiento, y una mayor aceptación sensorial. El estudio de la vida útil del producto en refrigeración, indicaría la viabilidad de la aplicación de la tecnología de HPP para obtener alimentos con vida útil similar a la obtenida con el tratamiento tradicional de pasteurización, pero con mejor calidad sensorial. more...

Aim During type 1 diabetes (T1D), the medullary thick ascending limb (mTAL) displays an NADPH oxidase-dependent increase in sodium transport, in concert with increased NO production by NO synthase 1 (NOS1) and NOS2. We hypothesized that NOS1- and/or NOS2-derived NO blunts T1D-induced activation of sodium transport in the mTAL. Methods T1D was induced by streptozotocin injection (STZ rats); sham rats received vehicle. Three-to-four weeks later, mTAL were isolated from both groups for assay of nitrite and superoxide production, and O2 consumption in the absence or presence of various inhibitors. Results Apocynin (NADPH oxidase inhibitor) normalized superoxide production and ouabain-sensitive O2 consumption and furosemide-sensitive O2 consumption by mTALs from STZ rats, without altering O2 consumption by mTALs from sham rats. Apocynin also unmasked a T1D-induced increase in nitrite production. NOS inhibition did not alter superoxide production in either group. In sham mTAL, total NOS inhibition, but not isoform-specific inhibition of NOS1 or NOS2, increased ouabain- and furosemide-sensitive O2 consumption, confirming a tonic inhibitory impact of NOS3 on sodium transport. In contrast, neither total nor isoform-specific NOS inhibition altered O2 consumption by STZ mTAL. Apocynin treatment of STZ mTAL unveiled the ability of isoform-specific NOS inhibition to significantly increase O2 consumption, without further increase in O2 consumption with total NOS inhibition. Conclusion Under normal conditions, NOS3-derived NO inhibits sodium transport in the mTAL. T1D dismantles the impact of NOS-mediated inhibition of sodium transport as a result of NADPH oxidase-dependent NO scavenging. Inhibition of NADPH oxidase to preserve NO bioavailability reveals an inhibitory impact of NOS1- and NOS2-derived NO on sodium transport in the mTAL. more...

The records of 5736 general anaesthetics were reviewed to estimate the prevalence of, and identify the risk factors for, the development of regurgitation during anaesthesia in dogs. Regurgitation was defined as the observed passive passage of gastric contents into the oropharynx. Several variables were evaluated using univariable and multivariable logistic regression analysis: breed, body mass, age, sex, type of procedure, expertise of anaesthetist, ASA status, drugs administered, length of surgery and anaesthesia and local techniques performed. Results showed that larger dogs, dogs with ASA status of 3 or higher, dogs undergoing abdominal surgery, imaging procedures or both, longer anaesthetic duration, and dogs receiving medetomidine in comparison to acepromazine and an opioid were more likely to suffer an episode of regurgitation. more...

Both bird and mixed vertebrate–insect (MVI) pollination systems are very rare in Europe and the Mediterranean region. Because MVI can ensure reproduction over a wider range of environmental conditions than when insects are the sole pollinators, under certain circumstances such systems are highly advantageous to plants. Here, we investigated the pollination and some reproductive traits of the Tyrrhenian Scrophularia trifoliata, the only species of the genus possessing two showy dark spots inside the corolla, for which MVI pollination system had been inferred on the basis of limited censuses. We conducted field experiments to study MVI pollination and some reproductive traits and elucidate the role of corolla spots, analysing their ultraviolet pattern, histology and pigments vs the rest of the corolla. The primary pollinators were wasps and passerine birds. Corolla spots absorb UV light, present abundance of anthocyanins and are histologically identical to the rest of the corolla. Control flowers had higher visitation frequency than flowers without spots. S. trifoliata is self-compatible with efficient intrafloral protogyny and herkogamy that prevent self-pollination but not geitonogamy. We confirmed the existence of a mixed bird–insect pollination system in S. trifoliata. This system is found in three other Scrophularia species with large, showy flowers—two Mediterranean (S. grandiflora and S. sambucifolia) and one Macaronesian (S. calliantha). Unlike those species, S. trifoliata has two large spots inside the corolla. These likely operate as nectar guides and their dark coloration is related to abundant anthocyanin content. This article is protected by copyright. All rights reserved. more...