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Abstract The long-term effects of SARS-CoV-2 infection, and their determinants, are still unknown. This study aimed to assess symptoms one year after admission for COVID-19, according to the organ/system involved, and to identify factors. Cross-sectional study with retrospective data collection from March 2020 to February 2021. Inclusion criteria: aged ≥ 18 years and admitted for COVID-19. Exclusion criteria: death, not localized, refusal to participate, cognitive impairment or language barrier. A telephone survey was conducted on long COVID-related symptoms one year after hospital discharge. n = 486. The most frequent symptom groups were neurological (n = 225; 46.3%) and respiratory (n = 201; 41.4%). Multivariable analysis showed that a history of anxiety was significantly associated with psychiatric symptoms (ORa = 2.04, 95%CI = 1.02–4.06), fibromyalgia/chronic fatigue with general symptoms (ORa = 11.59, 95%CI = 1.47–9.34) and obesity with respiratory (ORa 1.90, 95%CI = 1.27–2.83) and musculoskeletal symptoms (ORa 1.96, 95%CI = 1.30–2.96). Male sex was associated with a significantly lower risk of neurological (ORa 0.64, 95%CI = 0.44–0.93), respiratory (ORa 0.45, 95%CI = 0.31–0.67), general (ORa 0.43, 95%CI = 0.29–0.63), psychiatric (ORa 0.34, 95%CI = 0.22–0.51), musculoskeletal (ORa 0.47, 95%CI = 0.32–0.70), dermatological (ORa 0.24, 95%CI = 0.14–0.42) and digestive (ORa 0.38, 95%CI = 0.20–0.73) symptoms. Advanced age (≥ 71 years) also had a protective effect against general (ORa 0.60, 95%CI = 0.39–0.95), psychiatric (ORa 0.39, 95%CI = 0.23–0.64), and dermatological (ORa 0.47, 95%CI = 0.24–0.92) symptoms. Patients admitted for SARS-CoV-2 infection frequently experience symptoms at one year, especially neurological and respiratory symptoms. Female sex, obesity, a history of anxiety and fibromyalgia/chronic fatigue were independent risk factors for presenting symptoms. Advanced age acted as a protective factor.

This article examines the impact of income level on family care organizations in Mexico to elucidate how families apportion care responsibilities according to their economic standing. The study design employed a quantitative approach, utilizing two distinct methodologies to construct two indices: one representing the time devoted to care and the other representing care transferred to the market. Factor analysis converts minutes and hours into a time index and transforms the number of domestic workers and health and hospital expenses into a market index. A regression model estimates the effect of income on these indices, aiming to analyze the relationship between income and spending on health and services and between income and time spent on home care. The results are based on data from the National Household Income and Expenditure Survey (ENIGH) 2010–2020, using a nationally representative sample of 81 thousand dwellings. The data analysis concluded that households with higher incomes spend a more significant proportion of their expenditure on domestic care-paid services and have greater access to professional care. In contrast, lower-income households face significant challenges due to their limited financial resources and the higher demands for unpaid care.

Introduction Gaps in antimicrobial resistance (AMR) surveillance and control, including implementation of national action plans (NAPs), are evident internationally. Countries’ capacity to translate political commitment into action is crucial to cope with AMR at the human–animal–environment interface.Methods We employed a two-stage process to understand opportunities and challenges related to AMR surveillance and control at the human–animal interface in Argentina. First, we compiled the central AMR policies locally and mapped vital stakeholders around the NAP and the national commission against bacterial resistance. Second, we conducted qualitative interviews using a semistructured questionnaire covering stakeholders’ understanding and progress towards AMR and NAP. We employed a mixed deductive–inductive approach and used the constant comparative analysis method. We created categories and themes to cluster subthemes and determined crucial relationships among thematic groups.Results Crucial AMR policy developments have been made since 1969, including gradually banning colistin in food-producing animals. In 2023, a new government decree prioritised AMR following the 2015 NAP launch. Our qualitative analyses identified seven major themes for tackling AMR: (I) Cultural factors and sociopolitical country context hampering AMR progress, (II) Fragmented governance, (III) Antibiotic access and use, (IV) AMR knowledge and awareness throughout stakeholders, (V) AMR surveillance, (VI) NAP efforts and (VII) External drivers. We identified a fragmented structure of the food production chain, poor cross-coordination between stakeholders, limited surveillance and regulation among food-producing animals and geographical disparities over access, diagnosis and treatment. The country is moving to integrate animal and food production into its surveillance system, with most hospitals experienced in monitoring AMR through antimicrobial stewardship programmes.Conclusion AMR accountability should involve underpinning collaboration at different NAP implementation levels and providing adequate resources to safeguard long-term sustainability. Incorporating a multisectoral context-specific approach relying on different One Health domains is crucial to strengthening local AMR surveillance.

This article estimates the effect of the School Breakfast Program (SBP) on overweight and obese Mexican children aged five to eleven living in a poor and marginalized rural context during 2012-2019. Using data from the 2012, 2016, 2018, and 2019 National Health and Nutrition Surveys (ENSANUT), as well as propensity score matching techniques, this research compares the usual food intake of a group of children enrolled on the SBP with a control group that were not. The results indicate that SBP recipients include more overweight children, and that these consume unhealthy foods, including sugary drinks, snacks, sweets, and desserts, more frequently than those in the control group. There was no significant difference in the children’s obesity between the two groups. These findings highlight the need for a more comprehensive school breakfast program, that is connected to the food and nutritional security approach and is designed and implemented according to each Mexican region’s specific alimentary requirements and socioeconomic needs.

Introducción: la muerte súbita se trata de un evento fatal e imprevisible. Realizada la autopsia y estudios complementarios, en ausencia de otros hallazgos que expliquen la causa de muerte, se clasifica como muerte súbita inexplicada. Siendo recomendable en estos casos realizar análisis genéticos, especialmente con metodologías de secuenciación de siguiente generación, las que permiten explicar un porcentaje importante de estos casos. Objetivo: analizar las publicaciones más relevantes sobre secuenciación de siguiente generación, aplicada a la autopsia molecular, para determinar aquellas muertes súbitas inexplicables relacionadas a cardiomiopatías y canalopatías. Metodología: se realizó la búsqueda en PubMed del Instituto Nacional de Salud usando palabras clave en inglés y español: NGS, muerte súbita, autopsia molecular y sus combinaciones. Además, se realizaron búsquedas en OMIN y ClinVar relacionada a las diferentes afecciones cardiacas relacionadas a muerte súbita. Los criterios de inclusión: artículos completos en español e inglés de libre acceso, con antigüedad máxima de diez años, realizados en cualquier área geográfica y que trataran sobre la temática. Resultados: para secuenciación de siguiente generación, muerte súbita se encontraron más de 22000 y 65000 publicaciones, respectivamente. En cambio, al combinar las palabras clave se recuperaron 74 trabajos, según los criterios de inclusión y objetivo del trabajo se revisaron 67 artículos. La aplicación de las plataformas de secuenciación en la investigación de casos de muerte súbita tomo auge en el 2014 y en poco tiempo, demostraron su versatilidad para el análisis de una gran cantidad de genes simultáneamente, de forma rápida y a bajo costo. Conclusiones: las patologías asociadas a muerte súbita son múltiples, complejas y pueden generar fenotipos variables que dificultan el análisis genético de las mismas. Las plataformas de secuenciación de siguiente generación son sumamente útiles en los casos de muerte súbita inexplicada, además permiten la identificación de variantes genéticas en familiares para la implementación de medidas preventivas.

El proceso de Transición Energética y la implantación exponencial de tecnologías de generación renovable está generando algunos confl ictos sociales y económicos en el territorio. Estos confl ictos están dando pie a movilizaciones ciudadanas y movimientos políticos en contra de las instalaciones de energías renovables (fotovoltaica y eólica) en zonas rurales. El debate actualmente abierto, en grandes líneas, enfrenta la protección del territorio y la defensa del mundo rural, contra la transición del modelo productivo de energía a uno basado en tecnologías renovables instaladas en grandes plantas de generación. Sin embargo, existen múltiples casos donde el desarrollo se ha realizado de la mano del territorio, cuidando la gobernanza del proceso y la distribución de los benefi cios. Aquí desarrollamos los casos de instalación de energías renovables en Muras (Lugo), Revilla-Vallejera (Burgos), Sant Jordi (Castelló), un proceso de escucha en el Matarraña aragonés y una modalidad de contratos de arrendamiento agrario, donde diferentes acciones y políticas implementadas por parte de todos los actores han facilitado la aceptación de la implantación de energías renovables. Así, analizando buenas prácticas, podemos replicar acciones exitosas que garanticen el desarrollo de una Transición Energética justa, equilibrada y rápida, la cual requiere de consensos políticos, buenas prácticas empresariales y de la complicidad ciudadana.

Introducción: El aumento en la sensibilidad de las técnicas empleadas ha permitido la obtención de perfiles genéticos a partir de trazas de ADN que se hayan depositado mediante contacto antes, durante o después de la comisión de los hechos investigados. Por otro lado, la contaminación accidental de los indicios biológicos, con la consecuente interpretación errónea de los resultados genéticos, tienen importantes consecuencias en el proceso judicial. Debido a ello, minimizar las contaminaciones que se pueden generar durante algunas de las fases de recolección o análisis genético, como así también la detección de estos eventos, es una prioridad para los laboratorios forenses. Objetivo: analizar las publicaciones más relevantes respecto a las trazas de ADN, los diferentes tipos de transferencia y contaminación que se pueden obtener en una evidencia. Metodología: se realizó la búsqueda en PubMed, del Instituto Nacional de Salud (NIH), y Google Académico usando las palabras clave en español e inglés: ADN de toque, Transferencia de ADN, Contaminación, Trazas, DNA-TTPR, Persistencia del ADN, Perfiles genéticos contaminados. Resultados: se encontraron más de 500 trabajos relacionados a la temática propuesta en esta revisión. El criterio de selección fue el número de citas, el enfoque y el impacto de estos. Se analizaron 71 artículos donde evaluaron la composición de las muestras de contacto y el origen del material genético que contienen. Además, de las metodologías de recolección, análisis de dichas muestras, la importancia que tiene la transferencia y contaminación del ADN en distintos escenarios posibles. Conclusión: existe riesgo de transferencia de ADN que puede conducir a resultados erróneos, por lo tanto, es importante asegurar la actualización de los procedimientos de la práctica y brindar la capacitación adecuada para garantizar que el personal policial y del que recolecta indicios sea consciente de los riesgos de contaminación y de los diferentes mecanismos de transferencia de material genético.

Resumen: A pesar de los múltiples avances en el tratamiento de la insuficiencia cardíaca, tanto aguda como crónica, todavía no existe un equivalente al trasplante cardíaco como tratamiento a largo plazo para la insuficiencia cardíaca terminal. Sin embargo, el trasplante está limitado por la escasez y la calidad de los injertos. La protección miocárdica es un factor indispensable para la función del injerto y está relacionada con el fallo primario del injerto agudo y crónico. La preservación del corazón donado alcanza 4-6 h utilizando isquemia fría, soluciones de preservación y sistemas de trasporte estándar con hielo. Se han explorado varias opciones en los últimos años y se han desarrollado estrategias novedosas para optimizar la preservación del injerto y potencialmente aumentar el grupo de donantes. Dentro de estos dispositivos destacan el SherpaPakTM Cardiac Transport System (Paragonix), que proporciona una temperatura de almacenamiento más fiable y clínicamente aceptable en comparación con el almacenamiento convencional, pudiendo así disminuir el daño cardíaco y el fallo primario del injerto, y el Organ Care System (OSCTM, TransMedics), que realiza una perfusión normotérmica ex vivo tras la extracción, pudiendo realizar una evaluación in situ del órgano tras la extracción y recuperar órganos marginales. En esta revisión analizamos la práctica actual en la obtención de órganos, así como los nuevos dispositivos que permiten mejorar y ampliar la preservación. Abstract: Despite multiple advances in the treatment of heart failure, both acute and chronic, there is still no equivalent to heart transplantation as long-term treatment for end-stage heart failure. However, transplantation is limited by the scarcity and quality of grafts. Myocardial protection is an indispensable factor for graft function, and it is related to acute and chronic primary graft failure. The donor heart can be preserved for 4-6 hours using cold ischaemia, preservation solutions, and standard ice transport systems. Several options have been explored in recent years and cutting-edge strategies have been developed to optimize graft preservation and potentially increase the donor pool. Notable among these devices are the SherpaPakTM Cardiac Transport System (Paragonix), which provides a more reliable and clinically acceptable storage temperature compared to conventional storage, thus potentially decreasing cardiac damage and primary graft failure, and the Organ Care System (Transmedics) which performs ex vivo normothermic perfusion after extraction, being able to perform an in-situ evaluation of the organ after extraction and retrieve marginal organs. In this review, we analyse current practice in organ procurement as well as the new devices that improve and extend preservation.

IntroductionThe long-term effects of SARS-CoV-2 are unclear, as are the factors influencing the evolution. Objective: to assess health-related quality of life 1 year after a hospital admission due to COVID-19 and to identify factors that may influence it.Materials and methodsRetrospective observational study in a tertiary hospital from March 2021 to February 2022. Inclusion criteria: ≥18 years old and admitted for SARS-CoV-2 infection. Exclusion criteria: death, not located, refusal to participate, cognitive impairment, and language barrier. Variables: demographic data, medical history, clinical and analytical outcomes during hospital admission, treatment received, and vaccination against SARS-CoV-2 following admission. Participants were interviewed by phone 1 year after admission, using the SF-36 quality of life questionnaire.ResultsThere were 486 included patients. The domains yielding the lowest scores were general health (median 65%, interquartile range [IQR] 45–80), vitality (median 65%, IQR 45–80), and mental health (median 73.5%, IQR 60–100). Multivariable analysis showed that female sex and fibromyalgia/fatigue had a negative influence on all domains. Obesity was associated with worse outcomes in physical functioning, physical role, bodily pain, and vitality. Other factors associated with worse scores were an older age in physical functioning and high age-adjusted Charslon comorbidity in physical functioning and general health. Age was associated with better results in emotional role and High C-reactive protein at admission on vitality.ConclusionOne year after admission for COVID-19, quality of life remains affected, especially the domains of general health, vitality, and mental health. Factors associated with worse outcomes are female sex, fibromyalgia/chronic fatigue, and obesity.

This music score was submitted for the Kaleidoscope 2020 Call for Scores, an open access collaboration with the UCLA Music Library.

This music score was submitted for the Kaleidoscope 2020 Call for Scores, an open access collaboration with the UCLA Music Library.

ABSTRACT: Many studies have been conducted to estimate pregnancy losses between 19 and 34 d after artificial insemination (AI) in dairy cows managed under confinement-based systems, but few studies have examined embryo mortality during this interval in dairy cows managed under gazing systems. The objectives of this prospective cohort study were (1) to assess the diagnostic value of the corpus luteum (CL) blood perfusion (BP) evaluation by Doppler ultrasound (US) to detect nonpregnant cows at 19 to 20 d post-AI, and (2) to assess the rate of potential embryo mortality between 19 to 34 d post-AI. The CL-BP of all cows included in the study (n = 131) was examined on farm by power and color mode of Doppler US and later using an image processing software by a second evaluator. The endometrium thickness and echotexture were evaluated by B-mode US at the same visit to assess if the nonpregnancy diagnosis could be improved at 19 to 20 d post-AI by this additional diagnostic tool. Blood samples were obtained at 19 to 20 d post-AI for progesterone (P4) measurement by chemiluminescence and to determine the mRNA expression of ISG by real-time PCR. Pregnancy diagnosis based on embryo visualization was performed at 33 to 34 d post-AI by US B-mode. In parallel interpretation, ISG15 and MX2 mRNA expression in leukocytes [sensitivity (Se), 100%] were regarded as suitable biomarkers for early pregnancy and were selected for molecular characterization of pregnancy at 19 to 20 d post-AI. At 19 to 20 d post-AI, 61.1% of the cows had positive CL-BP by Doppler US (Se, 98.0%), 62.7% had ISG mRNA expression in leukocytes over the cutoff point (Se, 95.7%), and 50.8% were positive, based on the combination of ISG mRNA expression, CL-BP by Doppler US, and P4 concentration (Se, 100%), and were considered as possible pregnant. At 33 to 34 d, the pregnancy rate was 37.4% diagnosed by the B-mode US. Based on the expression of the selected biomarkers in cows with active CL, we found that 28.1% of the cows could have potentially lost their pregnancy between 19 and 34 d post-AI. The Doppler US color mode showed similar accuracy and a higher negative predictive value than the genes selected as biomarkers. The additional B-mode ultrasound evaluation of the uterine stratum vasculare and the endometrium thickness improved the diagnostic accuracy. Therefore, assessing the CL-BP by Doppler US allowed early detection of nonpregnant cows at 19 to 20 d post-AI. The combination of early CL-BP by Doppler US (d 19 to 20) with early embryo detection by B-mode US (d 33–34) could be used to facilitate earlier rebreeding of dairy cows.

IntroductionThe use of three-dimensional (3D) reconstruction and printing technology, together with extended reality applied to advanced heart failure adult patients with complex anatomy, is rapidly spreading in clinical practice. We report practical experience with application to acute and chronic heart failure: planning and performing mechanical circulatory device insertion or heart transplantation.MethodsFrom November 2019 until February 2022, 53 3D virtual biomodels were produced for intervention planning (using Virtual/Augmented Reality and/or 3D printing), following a specific segmentation and preprocessing workflow for biomodelling, in patients with advanced heart failure due to structural heart disease or cardiomyopathies. Four of those patients were complex cases requiring mechanical circulatory support implant procedures in our center.ResultsOne short-term and three long-term ventricular assist device system were successfully clinically implanted after application of this technique. In other two cases with extremely high procedural risk, visualized after application of this multimodality imaging, heart transplantation was elected.Conclusion3D printing based planning and virtual procedure simulation, are of great importance to select appropriate candidates for mechanical circulatory support in case of complex patient anatomy and may help to diminish periprocedural complications. Extended reality represents a perspective tool in planification of complex surgical procedures or ventricular assist device insertion in this setting.

Intro: Argentina is one of South America's leading milk and pork producers, yet the data for antimicrobial usage and resistance in these sectors is extremely limited. Here we report third-generation cephalosporin resistance (3GC-R) rates among E. coli from pigs and dairy cattle in two Argentinian regions (La Plata and Rio Cuarto) and the resistance mechanisms found. Methods: Samples were from effluent and faecally-contaminated near-animal environments collected using sterile boot-socks, submerged in 10x w/v PBS and made to 25% v/v glycerol; 20μL was spread on Chromagar-3GCR. Up to two 3GC- R isolates representing each positive sample were sequenced (Illumina) following deduplication at farm level using multiplex β-lactamase gene PCR. Findings: A total of 413 samples across 40 pig farms (291 La Plata, 122 Rio Cuarto) and 404 samples across 30 dairy cattle farms (286 La Plata, 118 Rio Cuarto) were collected. In La Plata, 29.7% of cattle and 51.2% of pig samples were positive for 3GC-R E. coli. In Rio Cuarto, resistance was more prevalent: 55.1% and 77.9% positivity in cattle and pig samples, respectively. Sequencing 131 representative 3GC-R isolates revealed a wide range of 3GC-R mechanisms, dominated by CTX-M variants (73% of isolates); specificity at the level of animal species was seen. CMY-2 accounted for 3GC-R in 24.4% of pig but only 4.4% of dairy isolates (χ2=8.14, p=0.004). 25.6% of pig isolates but only 8.9% of dairy carried CTX-M-8 (χ2=5.17, p=0.02). 6.9% of pig but 40% of dairy isolates carried CTX-M-15 (χ2=21.5, p

ABSTRACT: Poor udder health status can have a detrimental effect on milk yield and reproductive performance, leading to reductions in the dairy farm profit. The objective of this retrospective longitudinal study was to assess the associations of somatic cell count (SCC) with daily milk yield and reproductive performance. A database with 1,930,376 lactations from 867 Argentinean grazing dairy herds records collected for 14 years was used. The association of the evolution of SCC (healthy vs. new case vs. cured vs. chronic; with 150,000 SCC/mL as threshold) and of the severity of SCC [mild (150,000­–400,000 SCC/mL) vs. moderate (400,000–1,000,000 SCC/mL) vs. severe (>1,000,000 SCC/mL)] with the odds for conception were estimated. Finally, the associations of the linear score of SCC (LS-SCC) with daily milk yield were estimated depending on parity and milk production quartile. The odds ratios (CI 95%) for conception at first service were 0.921 (0.902–0.941), 0.866 (0.848–0.884), and 0.842 (0.826–0.859) for the new case, cured, and chronic cows compared with healthy cows, respectively. Also, the odds ratios (CI 95%) for conception were 0.902 (0.881–0.925), 0.837 (0.808–0.866) and 0.709 (0.683–0.736) for mild, moderate and severe cases compared with healthy cows, respectively. An increase of one point of LS-SCC was associated with decreases of 0.349, 0.539, and 0.676 kg in daily milk yield for first-, second-, and third-lactation cows, respectively. In conclusion, SCC is negatively associated with the risk for conception and with daily milk yield in grazing dairy cows. This negative relationship with conception is higher when SCC increase occurs after the service date and it is influenced by severity of mastitis, and in the case of milk yield, the negative association is influenced by parity, milk production quartile, and severity of mastitis.

This article examines the impact of income level on family care organizations in Mexico to elucidate how families apportion care responsibilities according to their economic standing. The study design employed a quantitative approach, utilizing two distinct methodologies to construct two indices: one representing the time devoted to care and the other representing care transferred to the market. Factor analysis converts minutes and hours into a time index and transforms the number of domestic workers and health and hospital expenses into a market index. A regression model estimates the effect of income on these indices, aiming to analyze the relationship between income and spending on health and services and between income and time spent on home care. The results are based on data from the National Household Income and Expenditure Survey (ENIGH) 2010–2020, using a nationally representative sample of 81 thousand dwellings. The data analysis concluded that households with higher incomes spend a more significant proportion of their expenditure on domestic care-paid services and have greater access to professional care. In contrast, lower-income households face significant challenges due to their limited financial resources and the higher demands for unpaid care. [ABSTRACT FROM AUTHOR]

BackgroundPain management at the end of life is a fundamental aspect of care and can improve patients' quality of life. Interventional approaches may be underutilized for pediatric cancer patients.ObjectiveTo describe a single institution's 10 years of experience with regional pain management at the end of life in pediatric oncology.MethodsA retrospective cohort study of 27 patients with pediatric cancer who died between April 2011 and December 2021 and received continuous nerve block (CNB) catheters or single-shot nerve blocks (SSBs) during their last three months of life. The type of blocks, analgesic efficacy, and palliative care involvement were evaluated.ResultsTwenty-two patients (81.5%) had solid tumor diagnoses, including carcinomas, sarcomas, and neuroblastoma. Most (59%) patients received CNB catheters, and 12 patients (44%) received SSBs for pain control. The mean pain score decreases for CNB catheters and SSBs after interventions were −2.5 and −2.8, respectively, on an 11-point scale. Decreases in opioid patient-controlled analgesia dosing requirements were noted in 56% of patients with CNB catheters; likewise, in 25% of patients with SSBs at 24 h and in 8% at 5 days after interventions. Nearly all patients had PC involvement and received care from pain specialists (96% and 93%, respectively). Twenty-three (85%) had physician orders for scope of treatment orders completed before death.ConclusionRegional pain control interventions can be effective and safe for relieving regional pain and suffering in dying children and young adults. The collaboration between palliative care and pain management specialists at the end of life can help alleviate suffering and improve quality of life.

Introducción: conocer la seguridad de las drogas actualmente disponibles para el tratamiento de las enfermedades reumáticas es muy importante al momento de tomar decisiones terapéuticas objetivas e individualizadas en la consulta médica diaria. Asimismo, datos de la vida real amplían el conocimiento revelado por los ensayos clínicos. Objetivos: describir los eventos adversos (EA) reportados, estimar su frecuencia e identificar los factores relacionados con su desarrollo. Materiales y métodos: se utilizaron datos BIOBADASAR, un registro voluntario y prospectivo de seguimiento de EA de tratamientos biológicos y sintéticos dirigidos en pacientes con enfermedades reumáticas inmunomediadas. Los pacientes son seguidos hasta la muerte, pérdida de seguimiento o retiro del consentimiento informado. Para este análisis se extrajeron datos recopilados hasta el 31 de enero de 2023. Resultados: se incluyó un total de 6253 pacientes, los cuales aportaron 9533 ciclos de tratamiento, incluyendo 3647 (38,3%) ciclos sin drogas modificadoras de la enfermedad biológicas y sintéticas dirigidas (DME-b/sd) y 5886 (61,7%) con DME-b/sd. Dentro de estos últimos, los más utilizados fueron los inhibidores de TNF y abatacept. Se reportaron 5890 EA en un total de 2701 tratamientos (844 y 1857 sin y con DME-b/sd, respectivamente), con una incidencia de 53,9 eventos cada 1000 pacientes/año (IC 95% 51,9-55,9). La misma fue mayor en los ciclos con DME-b/sd (71,1 eventos cada 1000 pacientes/año, IC 95% 70,7-77,5 versus 33,7, IC 95% 31,5-36,1; p

Introducción: El síndrome de DRESS es una reacción mucocutánea y visceral grave provocada por fármacos que puede llegar a provocar la muerte por la afectación de hígado y riñón. Caso Clínico: Varón de 46 años que presentó un exantema generalizado no pruriginoso, junto con fiebre, síntomas digestivos, adenopatías cervicales y sudoración nocturna coincidiendo con la toma previa de alopurinol. Tras el ingreso en el hospital se le diagnostica hepatitis aguda y deterioro de la función renal con oliguria, necesitando realización de hemodiálisis urgente. Tras un tratamiento multidisciplinar entre los servicios de nefrología, digestivo y hematología, el paciente es dado de alta con mejora de su función renal, pero continúa en seguimiento ambulatorio. Conclusiones: El alopurinol, fármaco muy utilizado en la práctica clínica, puede tener reacciones adversas muy graves, poniendo en riesgo la vida del paciente. El síndrome de DRESS, al ser muy poco frecuente, no tiene un tratamiento estandarizado. En el caso concreto de nuestro paciente, una detección temprana, junto a un tratamiento efectivo, con recambios plasmáticos con albúmina, hemodiálisis y corticoides, propiciaron una evolución favorable del paciente, con recuperación de la función renal.

A retrospective longitudinal study assessing the explanatory and predictive capacity of body condition score (BCS) in dairy cows on disease risk at the individual and herd level was carried out. Data from two commercial grazing herds from the Argentinean Pampa were gathered (Herd A = 2100 and herd B = 2600 milking cows per year) for 4 years. Logistic models were used to assess the association of BCS indicators with the odds for anestrus at the cow and herd level. Population attributable fraction (AFP) was estimated to assess the anestrus rate due to BCS indicators. We found that anestrus risk decreased in cows calving with BCS ≥ 3 and losing ≤ 0.5 (OR: 0.07–0.41), and that anestrus rate decreased in cohorts with a high frequency of cows with proper BCS (OR: 0.22–0.45). Despite aggregated data having a good explanatory power, their predictive capacity for anestrus rate at the herd level is poor (AUC: 0.574–0.679). The AFP varied along the study in both herds and tended to decrease every time the anestrous rate peaked. We conclude that threshold-based models with BCS indicators as predictors are useful to understand disease risk (e.g., anestrus), but conversely, they are useless to predict such multicausal disease events at the herd level.