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Background: The aim was to evaluate the reinforcement of the standard therapy with hyperimmune plasma (HP) in Coronavirus-19 disease (COVID-19) patients. Methods: Open-label, multicenter, randomized clinical trial performed in three hospitals in the Balearic Islands. Non-severe COVID-19 hospitalized patients with clinical time evolution equal to/less than 7 days were included, and randomized in: plasma group (PG) (n = 37), receiving 600 mL divided into two doses from convalescent plasma donor, administered on days 1 and 2 after the enrollment; and control group (CG) (n = 17). Primary outcome was the time for clinical improvement within 21 days, defined as patient achievement of categories 8, 7, and 6 in the Adaptive COVID-19 Treatment Trial scale (ACTT). The trial was terminated early due to the impossibility of recruitment due to the pandemic. Results: PG presented better scores on the ACTT scale at 7 days after HP infusion, whereas CG was needed 14 days to achieve similar results. The plasma infusion was safe. Conclusions: Despite the tendency observed in the plasma group to achieve slightly earlier better physical condition compared with the standard treatment alone. The administration of HP has been shown to be a safe therapy. No robust evidence was found to affirm a therapeutic effect of the early administration of two infusions of HP for non-severe COVID-19 infected patients. The interpretation is limited by the early termination of the trial, which resulted in a small sample size.

Objetivo: Determinar el impacto de la fractura de cadera en la calidad de vida relacionadacon la salud de las personas mayores de 65 años institucionalizadas, comparando su estadocognitivo y su autonomía para las actividades básicas de la vida diaria.Metodología: Este estudio comparativo se realizó en residencias de la provincia deZaragoza, con un muestreo consecutivo de pacientes mayores que habían sufrido unafractura de cadera durante el periodo de estudio (de abril de 2021 a noviembre 2021). Seregistraron datos sociodemográficos y clínicos (anteriores y posteriores a la fractura decadera) en una única visita para la realización de la entrevista en aquellos participantes quehabían finalizado su rehabilitación. Las variables cualitativas recogidas fueron: sexo, IMC,osteoporosis, estado civil, A.T.A y A.T.D de la fractura, y nivel de estudios; las variablescuantitativas: edad, peso, talla, IMC, barthel inicial y final, cuestionario de salud SF-12,Escala visual analógica.Resultados: Se incluyó a 34 participantes con una edad media de 84,15 años (DT +/- 6,91),el 75 % eran mujeres y el 25 % hombres. Según los resultados del test Mini Mental StateExamination, se comparó dos grupos (Grupo Minimental normal y el grupo Minimentalleve-moderado). Se excluyeron a 12 pacientes por demencia y 2 pacientes abandonaron; 9de los participantes se incluyeron en el grupo Minimental normal y 11 en el grupominimental leve- moderado. No existieron diferencias significativas entre ambos grupos. coDiscusión: Los resultados relacionaron el índice de masa corporal y el nivel de estudios, y elnivel de estudios y el deterioro cognitivo. Posiblemente, la ausencia de diagnóstico deosteoporosis influyó en la fractura de cadera. Y el dolor, podría haber sido un condicionanteen la recuperación física en los pacientes con deterioro cognitivo. En cuanto a la autonomíapara las actividades básicas de la vida diaria después de la fractura de cadera y de larehabilitación, el resultado fue casi significativo ( Barthel final ptécnica para los desplazamientos el 100% de las personas con deterioro cognitivo.Conclusión: La fractura de cadera en personas mayores con deterioro cognitivoinstitucionalizadas, condiciona una peor calidad de vida comparada con la población sindeterioro cognitivo. Con un importante problema social, consecuencias para la salud eimpacto económico. Se destaca las necesidades de esta población para la mejora de suautonomía y calidad de vida. Para una futura línea de investigación, pudiendo incluirresidencias de toda la comunidad autónoma de Aragón.Palabras clave: "personas mayores", "disfunción cognitiva", "fracturas de cadera", "calidad devida", "rehabilitación".

Platelet transfusion, both prophylactic and therapeutic, is a key element in modern medicine. Currently, the standard platelet product for clinical use is platelet concentrates at room temperature (20-24°C) under gentle agitation. As this temperature favors bacterial growth, storage is limited to 5-7 days, which result in high wastage rate, and complicates inventory and product availability at remote areas. Frozen and/or cold storage would ameliorate those disadvantages by reducing the risk of bacterial contamination and by extending the product shelf-life to weeks or even years. Consequently, the usefulness in transfusion medicine of platelet cryopreservation and refrigeration, two old and scarcely used platelet storage approaches, is reemerging. Indeed, there have been substantial recent research efforts to characterize both cold and cryopreserved platelets. Most recent studies indicate that cryopreserved and cold platelets display a pro-coagulant profile that may produce the rapid hemostatic response which is needed in bleeding patients. Thus, it seems appropriate that blood banks and blood transfusion centers explore the possibility of split platelet inventories consisting of platelets stored at room temperature and cryopreserved and cold-stored platelets.

Background and objective: Functional properties of essential oils are attributed to their components, many of which exhibit antimicrobial activity against pathogenic and spoilage microorganisms in a wide variety of foods. However, essential oils are unstable compounds; therefore, they can be encapsulated for a better protection and increase of functionality. In this work, antimicrobial activities of oregano, thyme and clove leave essential oils (non-encapsulated and nanoencapsulated) were assessed against Escherichia coli ATCC 29922, Salmonella typhimurium ATCC 14028 and Staphylococcus aureus ATCC 25923 using emulsification. Material and methods: The essential oils were characterized based on their physicochemical properties. Nanoemulsions were prepared, using 5% (w w-1) of essential oils, and then characterized based on their physical properties, stability and encapsulation efficiency. The microdilution antimicrobial assay was carried out to assess minimum inhibitory concentration and minimum bactericidal concentration of the essential oils and their nanoemulsions. Data from physical properties of the essential oils and physical properties, stability and encapsulation efficiency of the nanoemulsions were statistically analyzed. Results and conclusion: Antimicrobial activity of the essential oils showed decreases in minimum inhibitory concentration by 27-60% for the nanoencapsulated oils, compared to nonencapsulated oils. Nanoencapsulated and nonencapsulated oregano essential oils exhibited the lowest minimum inhibitory concentration and minimum bactericidal concentration values. Based on the results, nanoencapslulated essential oils may further be used in various foods to avoid microbial contaminations. Conflict of interest: The authors declare no conflict of interest.

The combination of pathogen reduction technologies (PRTs) and cryopreservation can contribute to building a safe and durable platelet (PLT) inventory. Information about cryopreserved riboflavin and UV light-treated PLTs is scarce.Twenty-four buffy coat (BC) PLT concentrates were grouped into 12 type-matched pairs, pooled, and divided into 12 non-PRT-treated control units and 12 riboflavin and UV light PRT-treated test units. Both were cryopreserved with 5% DMSO and stored at -80°C for 1 year. The cryopreservation method used was designed to avoid the formation of aggregates. PLT variables (PLT recovery, swirling, pH, MPV, and LDH) and hemostatic function measured by thromboelastography (TEG) were analyzed before cryopreservation (day 1) and post-cryopreservation at day 14 and months 3, 6, and 12 of storage at -80°C. The analyses were carried out within 1-h post-thaw.No aggregates were found in either PLT group at any time. Swirling was observed in both groups. MPV increased and mean pH values decreased over time (p .001), but the mean pH value was never below 6.4 in either group after 12 months of storage at -80°C. PLT recovery was good and clotting time became significantly shorter over the storage period in both groups (p .001).Our cryopreservation and thawing method prevented aggregate formation in cryopreserved riboflavin-UV-light-treated PLTs, which exhibited good recovery, swirling, pH 6.4, and procoagulant potential, as evidenced by a reduced clotting time after 12 months of storage at -80°C. The clinical relevance of these findings should be further investigated in clinical trials.

The comparative environmental studies on the modernization of irrigation systems are generally based on different areas with different characteristics (soil, dominant crops, crop management, or even weather conditions), not allowing for comparing the environmental effects in the same pre- and post-modernized irrigation district. Thus, there is a need to analyze the effect of the modernization process through the use of actual, detailed data from the same irrigation district.The Violada Irrigation District (VID; 5234 ha, widely studied since the 1980s), with 92% of the surface modernized in 2008-09 form gravity to pressurized irrigation, offers an ideal scenario to evaluate the environmental implications of irrigation modernization.The main tools for this evaluation have been (i) the water balance in the VID, to characterize the main irrigation water flows and their concentrations in salts and N, (ii) the soil water balance, to determine the main crops consumption [corn, alfalfa and cereal actual evapotranspiration (ETa)]; and (iii) the farmers surveys to establish fertilization and cropping practices. With all this information under both systems, the differences between the water and nitrogen use efficiencies for the main crops have been established for surface and sprinkler irrigation.Comparing periods with similar crop patterns, dominated by corn, the modernization reduced the water abstraction for irrigation, decreased irrigation return flows and increased the consumptive use by the crops. Altogether, the modernization left more high-quality water available for other uses in the basin.The irrigation and fertilization management also changed considerably with the modernization, allowing for lower doses with higher frequencies, and increasing the crop yields. Corn (the main crop in VID) showed the highest decrease in nitrogen fertilization. Nevertheless, the total nitrogen inputs to the system slightly increased due to the introduction of double crops. Thus, the corn increased water use efficiency and the nitrogen use efficiency.The salt and nitrogen loads exported decreased after modernization, due to the reduced irrigation return flows. Under surface irrigation, the salts leaching was mainly produced during the irrigation season while under sprinkler irrigation, it took place all the year-round, avoiding the higher salt loads to the water bodies during the period of lower flow, when their environmental impact would be higher.On the basis of the results obtained, it can be concluded that the modernization of the irrigation system caused a decrease in the flow restored to the basin, reduced the irrigation water depletion and preserved water quality globally. In this way, modernization leaves more water available for further uses and reduces the irrigation return flows and the pollutant loads associated with them. Finally, it was inferred that the salt and nitrogen loads emitted from the VID depend mainly on the irrigation system, and secondly, in regard to nitrogen only, on the prevailing crops.

Background Pathogen reduction technology (PRT) enhances blood component safety, but its implementation is hampered by loss of blood quality and cost. Study design and methods A retrospective study was conducted to investigate the efficacy, safety, and cost of 9673 riboflavin and ultraviolet light-treated platelet (PLT) transfusions given to 1211 patients during a 3-year period. The results were compared with the efficacy, safety, and cost of 6424 nontreated PLT transfusions administered to 1500 patients during a 3-year comparison period before PRT implementation. Results Despite a similar PLT transfusion dose per unit for both periods (pre-PRT period 3.26 vs. PRT period 3.19), the mean number of PLT concentrates per patient (4.2 vs. 7.8; p = 0.006) and the total dose of PLTs received by patients were higher in the PRT period (13.6 vs. 24.8; p = 0.0002). Hematology and medical and surgical patient categories had the highest PLT use per patient. However, febrile (2.5% vs. 1.2%; p = 0.02) and allergic (0.16% vs. 0.08%; p = 0.01) reactions were lower during the PRT period. The blood center saved €284,805.58 due to a reduction of outdated PLTs from 16.8% to 0.72% after PRT implementation. Conclusions Although PRT can improve PLT safety, it can increase the amount of PLTs required for transfusion in some patient categories. The cost of PRT can be partially offset by the savings associated with a lower rate of PLT outdates. This cost reduction can be a key factor in settings where inventory management is challenged by a high percentage of wasted PLTs due to outdating.

BACKGROUND: Pathogen reduction technology (PRT) may damage platelet (PLT) components. To study this, metabolic activity and haemostatic function of buffy coat (BC) PLT concentrates, with or without riboflavin and UV light PRT treatment, were compared. MATERIAL AND METHODS: Twenty-four BC PLT concentrates, leukoreduced and diluted in additive solution, were grouped into 12 type-matched pairs, which were pooled and divided into 12 non-PRT-treated BC PLT concentrates (control units) and 12 riboflavin and UV PRT-treated BC PLT concentrates (test units). Haemostatic function and metabolic parameters were monitored by thrombelastography at days 1, 3, 7 and 14 post collection in both PLT groups. RESULTS: Loss of PLT discoid shape, glucose consumption, lactate production, and decrease in pH were greater in the PRT-treated PLTs than in control PLTs over time (p

Objectives Predictive equations are frequently used to estimate resting energy expenditure (REE) because indirect calorimetry (IC) is not always available and is expensive. The aim of this study was to determine the concordance between the estimation of REE using predictive equations and its measurement by IC. Methods This was an analysis of the registry of indirect calorimetry performed in non-hospitalized participants. Harris–Benedict, FAO/WHO/UNU, Mifflin St. Jeor, and European Society for Clinical Nutrition and Metabolism (ESPEN) equations were used to estimate REE in these individuals. The concordance between measured and estimated REE using real, ideal, and adjusted weight was calculated using the concordance coefficient analysis of Lin and Bland– Altman plots in all participants and in subgroups separated according to their body mass index. Results We retrieved 680 measurements and discarded 247 that did not comply with the inclusion criteria. Thus, we studied 433 participants ages 36 y (29–48 y). Of the participants, 341 were women (79%) and the participants had a body mass index (BMI) of 30 kg/m2 (26.7–33.1 kg/m2). All predictive equations had concordance values 10% ranged from 36% to 87%. The ESPEN equation had the greater proportion of erroneous estimations of REE in all participants and BMI subgroups when real weight was used. Conclusions We observed a low level of concordance between REE estimated using predictive equations and measured by IC. These results should alert clinicians about the inaccuracy of predictive equations.

BACKGROUND Platelets (PLTs) are the blood component most frequently involved in Trypanosoma cruzi transfusion transmission cases reported in the literature, although whole blood (WB) and red blood cells (RBCs) have also been incriminated. However, there is little knowledge of the parasite distribution among blood components. STUDY DESIGN AND METHODS The aim of this study was to investigate in which blood component T. cruzi parasites concentrate the most, after fractionating artificially T. cruzi-infected WB. The T. cruzi parasite load was studied by a specific quantitative real-time polymerase chain reaction (qPCR) in WB, buffy coat (BC), PLT concentrates, RBCs before and after leukoreduction, and plasma (PL). RESULTS The parasite load in WB experimentally infected with 1.5 × 106 parasites (2.78 × 103 parasite equivalents/mL) was unevenly distributed among the separated blood components. The highest level was found in the BC (6.94 × 103 parasite equivalents/mL) and RBCs before leukoreduction by filtration (2.51 × 103 parasite equivalents/mL), after which RBCs presented a 99.9% reduction in parasite levels. Both PL and PLTs, partially leukoreduced by centrifugation but nonfiltered, had low parasite levels, the lowest concentration being in PL. CONCLUSIONS The highest parasite concentration was detected in the BC, followed by RBCs before leukoreduction. There is a notable risk of transfusion-transmitted Chagas disease associated with nonleukoreduced RBCs. Leukoreduction may be an effective prevention strategy for transfusion-transmitted T. cruzi infection, especially in endemic countries and in nonendemic countries with a high rate of immigration from Latin America.

In the Balearic Islands, as in other areas in southern Europe, there are a significant proportion of asymptomatic Leishmania infantum-infected blood donors. Theoretically, these donors may represent an important challenge for blood transfusion safety. However, despite an active search of multiply transfused patients, there have been, so far, no cases of transfusion-transmitted leishmaniasis (TTL) in our region. On the other hand, there is scarce evidence of the TTL in the literature. A review of asymptomatic Leishmania-infected blood donors' studies in endemic areas and TTL reports published in the English literature were performed, to ascertain the factors that determine the real risk of transfusion transmission of Leishmania.

Background Sedentariness may be an important risk factor for sarcopenia. The aim of this work was to assess the association between muscle mass and strength and markers of usual physical activity such as activity energy expenditure and peak oxygen uptake. Methods Young and old participants were assessed measuring body composition by DEXA (double beam X ray absorptiometry), handgrip strength, peak oxygen consumption and workload during an exercise calorimetry in a braked cycle ergometer and a 72 h activity energy expenditure using Actiheart actigraphs. A heart rate/energy expenditure curve derived from the exercise calorimetry was used to calibrate each actigraph. Sarcopenia was defined as having an appendicular fat free mass index below 7.5 kg/m2 and 5.6 kg/m2 in men and women respectively, or a handgrip strength z score below 1, using local normal data or having both parameters below the cutoff points. Results We analyzed data from 192 assessments performed in participants aged 22 to 88 years (106 women). Sarcopenic participants (as determined by muscle mass, strength or both) had a significantly lower peak oxygen uptake and work load and a significantly lower activity energy expenditure. When analyzing lean mass and strength as continuous variables, peak oxygen consumption was a significant predictor of fat free mass in men. Among women, the association was observed only when percentage of muscle mass was expressed as a z score. Conclusions Activity energy expenditure and peak oxygen consumption are associated with a lower muscle mass and the presence of sarcopenia and should be considered as risk factors for this condition.

Background There are very few published reports about the use and safety of pathogen reduction technology (PRT) based on riboflavin and UV light for platelet (PLT) transfusion in children. Study design and methods A two-part study was conducted: 1) a study investigating the safety of PLTs treated with riboflavin and UV light-PRT transfused to 379 children and 1,980 adults over a 5-year period; 2) an observational study evaluating the efficacy of PLT use in 132 neonates transfused with PRT-treated PLT compared with 99 neonates receiving standard PLTs over two 5-year periods. Results The rate of adverse reactions related to transfusions with PRT-treated PLTs was found to be slightly higher in adults than in children, although not statistically significant (0.19% vs. 0.12%; p = 0.85). All PLT transfusion events in children were mild. From 2013 to 2017, 379 children received 4,236 riboflavin and UV light-treated PLTs. Hemato-oncology patients received the most PLT transfusions (61.2%), followed by critically ill children in the Pediatric Intensive Care Unit (PICU) (24.6%), and neonates in the Neonatal Intensive Care Unit (NICU) (10.5%). A significant increase in PLT transfusions was found in 132 neonates transfused with 458 PRT-treated PLTs compared with 99 neonates receiving 176 standard PLTs, measuring PLT use/patient (p = 0.031) and total PLT dose/patient (p = 0.041). Conclusions Riboflavin and UV light-based PRT for PLTs seems to be safe for children. Neonates required a higher number of PLT transfusions when these were PRT-treated rather than standard. A long-term follow-up for chronically transfused children and randomized clinical trials are needed.

Monoclonal gammopathy of undetermined significance (MGUS) is a plasma cell dyscrasia that can progress to malignant multiple myeloma (MM). Specific molecular biomarkers to classify the MGUS status and discriminate the initial asymptomatic phase of MM have not been identified. We examined the serum peptidome profile of MGUS patients and healthy volunteers using MALDI-TOF mass spectrometry and developed a predictive model for classifying serum samples. The predictive model was built using a support vector machine (SVM) supervised learning method tuned by applying a 20-fold cross-validation scheme. Predicting class labels in a blinded test set containing randomly selected MGUS and healthy control serum samples validated the model. The generalization performance of the predictive model was evaluated by a double cross-validation method that showed 88% average model accuracy, 89% average sensitivity and 86% average specificity. Our model, which classifies unknown serum samples as belonging to either MGUS patients or healthy individuals, can be applied to clinical diagnosis. © 2018 Barceló et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited., We are grateful to Dr. A. Gutierrez for his support and assistance in serum sample collection. We also thank C. Serret for helpful assistance in serum sample collection. We are indebted to Dr. N. Matamoros for valuable discussions on clinical issues and to Dr. J. Merino for his useful help in data analysis. The authors would like to acknowledge and thank HUSE (University Hospital Son Espases), Biobank HUSE and “Fundacio´ Banc de Sang i Teixits de les Illes Balears” (Balearic Islands Blood Bank) for providing serum samples used in this work, and the “Servicios Cientificote´cnicos” (UIB) for their assistance in providing the infrastructure to conduct the study.

BACKGROUND: According to the reported cases of transfusion-acquired Trypanosoma cruzi infection, the risk of T. cruzi transfusion transmission appears to be higher with platelet (PLT) products than with other blood components. The aim of this study was to investigate by quantitative real-time polymerase chain reaction (qPCR) the parasitic load detected in leukoreduced plasma and PLT concentrates collected by apheresis from seropositive T. cruzi blood donors and compare them with peripheral whole blood (WB). STUDY DESIGN AND METHODS: During 2011 to 2013, a prospective study was carried out in a group of blood donors originating from Chagas-endemic areas but who are now living on the island of Majorca, Spain. Leukoreduced plasma and PLT concentrates were collected by apheresis from seropositive blood donors with detectable parasitemias in peripheral WB. RESULTS: Seropositivity was found in 23 of 1201 donors studied (1.9%), and T. cruzi DNA with less than 1 parasite equivalent/mL was detected in peripheral WB in 60.86% (14 of 23) of these. The study in blood components obtained by apheresis from these donors showed that T. cruzi DNA with a mean 6SD parasitic load of 5.33 66.12 parasite equivalents/mL was detected in 100% of the PLT concentrate samples. Parasite DNA was undetectable in the extract taken from plasma collected from donors with a positive qPCR in peripheral WB. CONCLUSION: The higher parasitic load found in PLT concentrates compared to plasma and peripheral WB would explain the higher transfusion transmission risk of Chagas disease associated with PLT transfusions described in the reported cases of transfusion-acquired T. cruzi infection. A s a result of globalization and immigration, emerging blood-borne pathogens such as Trypanosoma cruzi, the causal agent of Chagas disease, are gaining importance in nonendemic countries. 1-3 The 20 cases associated with transfusion transmission of T. cruzi reported in North America and Spain between 1987 and 2011 were all related to platelet (PLT) concentrates or whole blood (WB), some of which had even been leukoreduced and irradiated. 4 In these cases, transfusion transmission was confirmed using hemoculture, polymerase chain reaction (PCR), or serology to study the presence of parasites in blood from transfused patients. The retrospective study of the blood component or WB donors involved in these donations was in all cases carried out by serology and, additionally in some cases, using PCR to search for parasite DNA. No

Henriquez, S, Monsalves-Alvarez, M, Jimenez, T, Barrera, G, Hirsch, S, de la Maza, MP, Leiva, L, Rodriguez, JM, Silva, C, and Bunout, D. Effects of two training modalities on body fat and insulin resistance in postmenopausal women. J Strength Cond Res 31(11): 2955-2964, 2017-Our objective was to compare the effects of a low-load circuit resistance training protocol and usual aerobic training in postmenopausal women. Postmenopausal women with at least 1 feature of the metabolic syndrome were randomly allocated to a low-load circuit resistance training protocol or traditional aerobic training in a braked cycle ergometer. The intervention consisted in supervised sessions lasting 40 minutes, 3 times per week, during 6 months. At baseline and at the end of the intervention, fasting serum lipid levels, serum interleukin 6, C-reactive protein, 8 isoprostanes, and insulin resistance (assessed through QUICKI and HOMA-IR) were measured. Body fat was measured by double-beam X-ray absorptiometry and by computed tomography densitometric quantification at lumbar 3 vertebral level. Twenty-one women aged 58 (54-59) years were allocated to aerobic training and 21 women aged 55 (52-61) years were allocated to the low-load circuit resistance training protocol. Eighteen and 16 women in each group completed the 6 months training period. Women in both groups experienced significant reductions in blood pressure, total body, subcutaneous, and intraabdominal body fat. Reductions in total cholesterol and triacylglycerol levels were also observed. No changes in insulin resistance indexes, 8 isoprostanes, C-reactive protein, or interleukin 6 were observed in either group. No significant differences between treatment groups were observed in any of the measured parameters. We conclude that low-load circuit resistance training and aerobic training resulted in the same reductions in body fat and serum lipid levels.

Background Pathogen inactivation (PI) technology for blood components enhances blood safety by inactivating viruses, bacteria, parasites, and white blood cells. Additionally, PI for platelet (PLT) components has the potential to extend PLT storage time from 5 to 7 days. Study Design and Methods A retrospective analysis was conducted into the percentage of outdated PLT components during the 3 years before and after the adoption of PLT PI technology in our institution. The PLT transfusion dose for both pre-PI and post-PI periods was similar. A retrospective analysis to study clinical safety and component utilization was also performed in the Balearic Islands University Hospital. Results As a result of PI implementation in our institution, the PLT production cost increased by 85.5%. However, due to the extension of PLT storage time, the percentage of outdated PLT units substantially decreased (−83.9%) and, consequently, the cost associated with outdated units (−69.8%). This decrease represented a 13.7% reduction of the initial cost increase which, together with the saving in blood transportation (0.1%), led to a saving of 13.8% over the initial cost. Therefore, the initial 85.5% increase in the cost of PLT production was markedly reduced to 71.7%. The mean number of PLT concentrates per patient was similar during both periods. Conclusions The extension of PLT storage time can substantially contribute to reducing the financial impact of PI by decreasing the percentage of outdated PLTs while improving blood safety. Since the adoption of PI, there have been no documented cases of PLT transfusion–related sepsis in our region.

Background Diverse variables are involved in apheresis platelet collection, processing and storage. This survey shows how these are realized in Spain. Method An analysis of collected data was performed in a questionnaire completed by ten Transfusion Centers (TC) which perform between 50 and 520 apheresis procedures per month. This information comprises the procedures used to collect, inspect and store apheresis platelet concentrates (PC), and quality control data. Results Macroscopic inspection of PC is performed in all TC, especially during the first few hours post-collection and before distribution. The type of processor, duration of post-collection resting periods and temperature from the time of collection until distribution are similar in all TC. In 80% of TC, PC with small and scarce aggregates are distributed to transfusion services. The presence of clumps is influenced by type of processor, female donor, cold ambient temperature and collection of hyperconcentrated platelets, and is often recurrent in the same donor, although some TC have not found any influential variables. Overall, no objective inspection methods are followed, although there are exceptions. The degree of compliance with quality control parameters, such as the number of units studied, mean platelet yield, residual leukocyte counts and pH at expiry date, is acceptable in all TC. Compliance in terms of number of microbiological culture samples is variable. Discussion The usual practice in Spanish TC with respect to the collection, post-collection handling and storage of apheresis PC can be considered uniform, although some specific aspects of analyses should follow more objective methods.

Purpose: To determine if irisin plasma levels are associated with regular physical activity, body composition and metabolic parameters in women subjected to calorie restriction. Subjects and methods: We studied 42 women aged 34 ± 13 years with a body mass index of 27.7 ± 1.8 kg/m2, who were subjected to a calorie restriction for three months. At baseline and at the end of the study, weight, waist and hip circumference, laboratory parameters, body composition by DEXA, resting and activity energy expenditure by indirect calorimetry and 72 hours actigraphy were measured. Fasting serum irisin was quantified using an ELISA kit. Results: After the intervention period, participants lost 1.5 (0.4-3.4) kg and irisin levels did not change. Irisin baseline levels were positively but weakly correlated with the level of physical activity. This association was lost at the end of the intervention. No association was found between irisin levels and body composition or insulin sensitivity or their changes after calorie restriction. No association between serum irisin levels and PGC-1α expression in peripheral blood mononuclear cells and serum irisin was observed. Conclusions: Fasting serum irisin was weakly associated with usual physical activity and did not change after calorie restriction.

In the Balearic Islands, as in other areas of the Mediterranean basin, there is a significant proportion of asymptomatic Leishmania (L.) infantum-infected blood donors, who may represent an important threat to transfusion safety. The Balearic Islands blood bank, located in an area endemic for L. infantum, carried out a study of donors and patients to investigate the impact of this infectious disease on blood safety in the region.Twenty asymptomatic Leishmania-infected blood donors were followed-up between 2008 and 2011 to investigate the evolution of Leishmania infection in asymptomatic carriers. Their blood was periodically tested for anti-Leishmania antibodies by western blot and for Leishmania DNA by quantitative polymerase chain reaction (qPCR). Additionally, the prevalence of L. infantum infection was investigated in a group of 68 multiply transfused patients to ascertain the risk of transfusion-transmitted leishmaniasis (TTL) in the region, taking into account regular blood component production practices such as pre-storage leucodepletion and pathogen reduction technology.All 20 donors remained asymptomatic over the study period (2008-2011). Most donors had repeatedly positive qPCR results, either persistently or intermittently, but showed no symptoms of Leishmaniasis. Levels of parasitaemia were remarkably low in asymptomatic donors, with values ≤1 parasite/mL. Despite multiple transfusions received over 15 years, no transfused patient studied was infected with L. infantum.L. infantum-infected donors can remain asymptomatic for at least 3 years. In our region, no cases of TTL were detected, despite an active search in multiply transfused patients. This seems to be related to two independent variables: (i) a low concentration of the parasite in the peripheral blood of asymptomatic carriers and (ii) the application of methods with proven efficacy against TTL, such as leucodepletion and pathogen reduction technology.

Molecular techniques based on real-time polymerase chain reaction (qPCR) allow the detection and quantification of DNA but are unable to distinguish between signals from dead or live cells. Because of the lack of simple techniques to differentiate between viable and nonviable cells, the aim of this study was to optimize and evaluate a straightforward test based on propidium monoazide (PMA) dye action combined with a qPCR assay (PMA-qPCR) for the selective quantification of viable/nonviable epimastigotes of Trypanosoma cruzi. PMA has the ability to penetrate the plasma membrane of dead cells and covalently cross-link to the DNA during exposure to bright visible light, thereby inhibiting PCR amplification. Different concentrations of PMA (50–200 μM) and epimastigotes of the Maracay strain of T. cruzi (1 × 105–10 parasites/mL) were assayed; viable and nonviable parasites were tested and quantified by qPCR with a TaqMan probe specific for T. cruzi. In the PMA-qPCR assay optimized at 100 μM PMA, a significant qPCR signal reduction was observed in the nonviable versus viable epimastigotes treated with PMA, with a mean signal reduction of 2.5 logarithm units and a percentage of signal reduction > 98%, in all concentrations of parasites assayed. This signal reduction was also observed when PMA-qPCR was applied to a mixture of live/dead parasites, which allowed the detection of live cells, except when the concentration of live parasites was low (10 parasites/mL). The PMA-qPCR developed allows differentiation between viable and nonviable epimastigotes of T. cruzi and could thus be a potential method of parasite viability assessment and quantification.

Introduction and aim In recent years, there has been a gradual increase in mistransfusion events reported to our Regional Hemovigilance Division. Our objective was to design a transfusion practice nursing survey to study the causes of the increasing mistransfusion rate. Materials and methods Mistransfusion rates between 2007 and 2009 were obtained from the Balearic Island Hemovigilance Division (BIHVD), one of the 17 regional HV divisions in the Spanish Hemovigilance network. The BIHVD designed a transfusion practice nursing survey to study the causes of the increasing mistransfusion rate. Every year, 614 nurses carry out around 47,000 transfusions in our region. Data were collected through voluntary, anonymous, questionnaires which included questions about socio-professional factors, transfusion training and education, together with transfusion practice questions both related and unrelated to guidelines and nurses' attitudes. Multiple regression analysis was used to investigate which mistransfusion prediction factors were most accurate. Results The survey response rate was 363 out of 614 (59.12%). Marked deficits in nurses' education and training and low transfusion frequency had a strong negative impact on the incidence of transfusion errors ( r =−0.70; p =0.01). This is supported by evidence that the performance of well-trained nurses who transfused either daily or weekly and strictly followed transfusion guidelines was associated with a lower mistransfusion rate ( r =−0.93; p Conclusion Nurses' training, education and how frequently a nurse transfuses are the key factors for best transfusion practice in our region. This study illustrates the feasibility of using Hemovigilance resources to investigate the causes of mistransfusion.

Postoperative residual curarization (PORC) is an important complication of neuromuscular blocking drug (NMBD) use. This study evaluates the incidence of PORC in the Postanesthesia Care Unit (PACU), its relation to the type of muscle relaxant and reversal agent used, and its implication in the development of postoperative respiratory complications.A prospective observational study of cohorts was made with 558 patients operated under general anesthesia. Data regarding patient history, muscle relaxation (train-of-four [TOF]) monitoring, type of relaxants and reversal agents used, and TOF upon admission to the PACU was collected. Four groups were established: cisatracurium, cisatracurium-neostigmine, rocuronium, and rocuronium-sugammadex. An evaluation was made on the incidence of PORC (TOF ratio [TOFr]0.9) in PACU, and its relation to the relaxants and reversal agents used and to the development of postoperative respiratory complications - minor and major (pneumonia, atelectasis).From a total of 558 patients, 27.9% presented with PORC. According to the NMBD used and the administration or not of a reversal agent, the incidence of PORC in the four groups was: cisatracurium 34%, cisatracurium-neostigmine 28.6%, rocuronium 34%, and rocuronium-sugammadex 1.15%. The global incidence of minor critical respiratory events (CREs) was 14.5%: cisatracurium 27.5%, cisatracurium-neostigmine 17.4%, rocuronium 10.5%, and rocuronium-sugammadex 2.3%, with statistically significant differences. The global incidence of major CREs was 7.5%, and was significantly higher in patients with TOFr0.9 upon admission to the PACU.PORC in the PACU is associated to a greater incidence of major and minor respiratory complications. The use of rocuronium-sugammadex significantly reduces the incidence of PORC in the PACU.