V Conferencia Española de Consenso sobre el tratamiento de la infección por Helicobacter pylori

Helicobacter pylori infection is very common in the Spanish population and represents the main cause of chronic gastritis, peptic ulcer, and gastric cancer. The last iteration of Spanish consensus guidelines on H. pylori infection was conducted in 2016. Recent changes in therapeutic schemes along with increasing supporting evidence were key for developing the V Spanish Consensus Conference (May 2021). Fourteen experts performed a systematic review of the scientific evidence and developed a series of recommendations that were subjected to an anonymous Delphi process of iterative voting. Scientific evidence and the strength of the recommendation were classified using GRADE guidelines. An eradication therapy, when prescribed empirically, is considered acceptable when it reliably achieves, or preferably surpass, 90% cure rates. Currently, only quadruple therapies (with or without bismuth) and generally lasting 14 days, accomplish this goal in first- and second-line therapies. A non-bismuth quadruple concomitant regimen (proton pump inhibitor, clarithromycin, amoxicillin, and metronidazole) or a quadruple bismuth-based combination (proton pump inhibitor, bismuth, tetracycline, and metronidazole), are recommended as first-line regimens. Rescue therapies after eradication failure and management of H. pylori infection in peptic ulcer disease were also reviewed.     

Characteristics of globus pallidus internus local field potentials in generalized dystonia patients with TWNK mutation

ObjectiveWe focused on a rare gene mutation causing dystonia in two siblings who received globus pallidus internus deep brain stimulation (GPi-DBS). The aim was to characterize the relationship between neuronal activity patterns and clinical syndromes.MethodsWhole exome sequencing was applied to identify the TWNK (previous symbol C10orf2) mutation; Two siblings with TWNK mutation presented as generalized dystonia with rigidity and bradykinesia; four other sporadic generalized dystonia patients underwent GPi-DBS and local field potentials (LFPs) were recorded. Oscillatory activities were illustrated with power spectra and temporal dynamics measured by the Lempel-Ziv complexity (LZC).ResultsNormalized power spectra of GPi LFPs differed between patients with TWNK mutation and dystonia over the low beta bands. Patients with TWNK mutation had higher low beta power (15–27 Hz, unpaired t-test, corrected P < 0.0022) and lower LZC (15–27 Hz, unpaired t-test, P < 0.01) than other patients with generalized dystonia. On the other hand, the TWNK mutation patients showed decreased low frequency and beta oscillation in the GPi after DBS, as well as improved movement performance.ConclusionThe LFPs were different in TWNK mutation dystonia siblings than other patients with generalized dystonia, which indicate the abnormal LFPs were related to symptoms rather than specific disease. In addition, the inhibited effect on oscillations also provided a potential evidence for DBS treatment on rare movement disorders.SignificanceThis study could potentially aid in the future development of adaptive DBS via rare disease LFPs comparison.     

Rapid Decline in Online Search Queries for Hip and Knee Arthroplasties Concurrent With the COVID-19 Pandemic

BackgroundIn response to the coronavirus disease 2019 (COVID-19) pandemic, US hospitals have canceled elective surgeries. This decline in total joint arthroplasty (TJA) revenue may place financial strain on hospitals. Our goal was to quantify the impact of COVID-19 on the public interest in elective TJA.MethodsThe Google Search Volume Index (GSVI) identified the terms “knee replacement,” “hip replacement,” and “orthopedic surgeon” as the most common to describe TJA. The term “elective surgery cancellation” was also analyzed. Weekly GSVI data were extracted between 04-01-2015 and 04-04-2020. Time series analysis was conducted and state GSVI values were compared with COVID-19 prevalence and unemployment claims.ResultsThe relative public interest in elective TJA has sharply declined since the WHO declaration of COVID-19 as a global pandemic. Between 03-01-2020 and 03-29-2020, the popularity of searches for “knee replacement”, “hip replacement,” and “orthopedic surgeon” dropped by 62.1%, 52.1%, and 44.3%, respectively. A concurrent spike was observed for the term “elective surgery cancellation.” California, New Hampshire, Maine, and Nevada showed a low relative rate for TJA searches, and the highest increase in unemployment claims.ConclusionThe onset of COVID-19 correlates with declining relative popularity of searches related to elective TJA. Higher volume of COVID-19 cases in certain states may correspond with lower relative search popularity, although this correlation remains unclear. These results portend the possibility of a decline in elective TJA case volume, further straining hospitals. Further research is required to inform stakeholders how best to proceed and determine any sustained effects from the current diminished relative interest in TJA.Level of EvidenceLevel III.     

SCI源期刊近5年关于针刺偏头痛的RCT类研究

目的:通过分析SCI源论文为今后的临床研究提供借鉴、参考;方法:通过Pub Med数据库检索近5年偏头痛的SCI源论文,分析其中的临床治疗类论文(即RCT类论文),进行归纳整理、总结分析。结果:①SCI源论文中假针刺组的设置没有统一的标准,具有随意性;②SCI源论文中对针刺治疗偏头痛疗效有客观指标进行评估;③针刺的安全性及紧急治疗需要列入考虑。结论:针刺治疗对照组的设置仍需进一步的考量与完善。客观评价指标的出现是一大进步,但检查指标还需要更多的试验甚至多中心的试验进行验证。     

Assessing sialic acid content in food by hydrophilic chromatography-high performance liquid chromatography

We have established a novel hydrophilic chromatography (HILIC)-high performance liquid chromatography (HPLC) method to assess sialic acid content in food products. Single-factor and response surface methodologies (RSM) were used to systematically optimize the hydrolysis conditions of the food samples to extract the maximum amount of sialic acid. Chromatographic conditions were also adjusted. In foods containing sialic acid, we observed a strong linear relationship between sialic acid and peak area, ranging from 5 to 100 μg/mL (R² = 0.9998). The lowest detectable sialic acid concentration (RSN = 3) was 0.2 μg mL⁻¹, and the method detection limit was 0.02mg kg⁻¹. Sample recovery ranged from 95.85% to 99.78%, with an RSD of 1.46% (n = 6). Thus, the described method can be applied to the study of sialic acid content in foods.     

Target specific effects of direct current stimulation in schizo-obsessive disorder: A case report

Transcranial direct current stimulation (tDCS) is a type of non-invasive brain stimulation technique that is explored as an add-on treatment for the alleviation of symptoms across the diverse symptom domains in neuropsychiatric disorders. In psychiatry, data is emerging on the effects of tDCS as an add-on treatment in schizophrenia as well as obsessive-compulsive disorder (OCD). But despite high prevalence, the effectiveness of tDCS in co-morbid schizophrenia and OCD is lacking. This case report for the first time examines the clinical utility with target-specific effects of the add-on tDCS in a patient diagnosed with schizo-obsessive disorder.