Checklist para pacientes con diabetes mellitus tipo 2 en consulta telemática

Las circunstancias actuales provocadas por la COVID-19 nos obligan a los profesionales de atención primaria a idear nuevas formas de garantizar la atención sanitaria de nuestros pacientes con diabetes tipo 2 (DM2). Existen evidencias que respaldan la eficacia de la telemedicina en el control glucémico de los pacientes con DM2. Ante la rápida adaptación de la práctica clínica al uso de la telemedicina, el Grupo de Trabajo de Diabetes de la Sociedad Española de Medicina Familiar y Comunitaria (SemFyC) optó por elaborar un documento de consenso plasmado en un algoritmo de actuación/seguimiento telemático en la atención de los pacientes con DM2.Palabras clave: Telemedicina, Diabetes mellitus tipo 2, COVID-19     

Psychopathological dimensions in first-episode psychoses. From the trunk to the branches and leaves

BACKGROUND: Dimensional frameworks for structuring psychopathology have been formulated in recent years to overcome classification problems of categorical approaches. However, few studies have addressed the dilemma of hierarchy within symptoms or dimensions in psychosis. METHODS: This study was designed to examine the hierarchical structure of psychopathological dimensions in first episode psychosis. The sample consisted of 94 first-episode patients psychosis. An exhaustive psychopathological assessment was carried out using the AMDP-system. Consecutive principal component analyses of AMDP symptoms, determining 'a priori' the number of factors to be extracted, were carried out. RESULTS: Following the track of the resulting factor analyses, a 'vertical hierarchical' framework was achieved. Our schema organized dimensions in a series of echelons in which lower tiers are subsumed as subsets of those assigned to higher ranks. In addition, a final model comprising 10 dimensions provided an 'horizontal' and multidimensional structure comprising all relevant psychopathological dimensions in first-episode psychosis. CONCLUSIONS: This study confirmed to a great extent the existence of a hierarchical organization within psychopathological dimensions in 'first-episode' psychosis. The present 'hierarchical and multidimensional' model of psychopathological dimensions allows for selection of the level of complexity of 'candidate phenotypes' to use in neurobiological research of psychosis.     

Inactivated PCV2 one shot vaccine applied in 3-week-old piglets: improvement of production parameters and interaction with maternally derived immunity

The present study describes the effects of a commercially available vaccine against Porcine circovirus type 2 (PCV2) on clinical, pathological and virological outcomes of 3-week-old piglets from two farms with a clinical history of postweaning multisystemic wasting syndrome (PMWS). The study was a controlled, double-blinded, parallel group (1:1) and randomized trial (with a negative control) involving a total of 1239 animals. The study period comprised from weaning age (time of vaccination or PBS inoculation) until the first shipment of pigs to the slaughterhouse. The vaccine product was able to reduce clinical signs, PCV2 viral load in sera and faeces, and overall mortality in nurseries and fattening units. Moreover, average daily gain was significantly higher in vaccinated versus non-vaccinated piglets during the trial period. On the other hand, it was shown that maternally derived antibodies interfered with the development of an active humoral immune response after PCV2 vaccination.     

Pharmacokinetic and pharmacodynamic profiles of danofloxacin administered by two dosing regimens in calves infected with Mannheimia (Pasteurella) haemolytica

The pharmacokinetics and pharmacodynamics of danofloxacin in calves with induced Mannheimia (Pasteurella) haemolytica pneumonia were evaluated. Calves received either saline as an intravenous (IV) bolus or danofloxacin (0.738 mg/kg of body weight) administered as either a single IV bolus or a 36-h continuous IV infusion. Blood samples and bronchial secretions were collected before and at predetermined times over 48 h following the start of treatment. Calves were assessed clinically throughout, and lung consolidation was assessed at necropsy. Bronchial secretions and lung tissue were cultured for M. haemolytica. Bolus administration of danofloxacin produced a high maximum drug concentration-to-MIC ratio (C(max):MIC) of 14.5 and a time period of 9.1 h when plasma danofloxacin concentrations exceeded the MIC (T>MIC). Following danofloxacin infusion, the C(max):MIC was low (2.3), with a long T>MIC (33.3 h). The area under the curve-to-MIC ratios were 43.3 and 49.1 for the bolus and infusion administrations, respectively. The single bolus of danofloxacin was more effective than the same dose administered by continuous infusion, as indicated by a significantly lower (P < 0.05) number of animals with M. haemolytica in bronchial secretions after treatment and lower rectal temperatures in the 24 h after the start of treatment. Thus, danofloxacin exhibited concentration-dependent antimicrobial activity in cattle with respiratory disease caused by M. haemolytica.     

Diphenylsilane‐Manganese Acetylacetonate Redox Initiating Systems: Toward Amine‐Free and Peroxide‐Free Systems

Room temperature redox initiated free radical polymerization (RFRP), without light, brings a significant breakthrough in the field of materials science including energy conservation, high efficiency, robustness in thick materials/composites, and easy operation. Meanwhile, the current redox initiating systems used are based on toxic aromatic amines and hazardous peroxides (e.g., dibenzoylperoxide). In the present paper, for the first time in literature, new amine‐free, peroxide‐free redox two component (2K) initiating systems comprised of diphenylsilane (DPS, a reducing agent) and manganese acetylacetonate (Mn(acac)3, an oxidizing agent) are proposed. The significance of the system is its applicability under mild conditions (RT, under air). Optical pyrometry measurement results showed that the DPS in combination with Mn(acac)3 exhibited an excellent radical initiating property for benchmark (meth)acrylate monomers, competitive with a well‐established amine/dibenzoyl peroxide reference. Based on electron spin resonance experiments, the initiating chemical mechanisms of RFRP are proposed.     

Extracellular matrix assembly in extreme acidic eukaryotic biofilms and their possible implications in heavy metal adsorption

To evaluate the importance of the extracellular matrix in relation to heavy metal binding capacity in extreme acidic environments, the extracellular polymeric substances (EPS) composition of 12 biofilms isolated from Río Tinto (SW, Spain) was analyzed. Each biofilm was composed mainly by one or two species of eukaryotes, although other microorganisms were present. EPS ranged from 130 to 439 mg g(-1) biofilm dry weight, representing between 15% and the 40% of the total biofilm dry weight (DW). Statistically significant differences (p<0.05) were found in the amount of total EPS extracted from biofilms dominated by the same organism at different sampling points. The amount of EPS varied among different biofilms collected from the same sampling location. Colloidal EPS ranged from 42 to 313 mg g(-1) dry weight; 10% to 30% of the total biofilm dry weight. Capsular EPS ranged from 50 to 318 mg g(-1) dry weight; 5% to 30% of the total biofilm dry weight. Seven of the 12 biofilms showed higher amounts of capsular than colloidal EPS (p<0.05). Total amount of EPS decreased when total cell numbers and pH increased. There was a positive correlation between EPS concentration and heavy metal concentration in the water. Observations by low temperature scanning electron microscopy (LTSEM) revealed the mineral adsorption in the matrix of EPS and onto the cell walls. EPS in all biofilms were primarily composed of carbohydrates, heavy metals and humic acid, plus small quantities of proteins and DNA. After carbohydrates, heavy metals were the second main constituents of the extracellular matrix. Their total concentrations ranged from 3 to 32 mg g(-1) biofilm dry weight, reaching up to 16% of the total composition. In general, the heavy metal composition of the EPS extracted from the biofilms closely resembled the metal composition of the water from which the biofilms were collected.     

Characterization of Candida albicans cell wall antigens with monoclonal antibodies.

The antigenic composition of Candida albicans is very complex. In order to study the antigenic relationship between blastoconidia and germ tubes of C. albicans, we produced several monoclonal antibodies and analyzed their reactivity against cell wall antigens either in intact cells or in cells treated with dithiothreitol. Overall, four types of reactivity were found. Monoclonal antibodies 3D9 and 15C9 stained the germ tubes only when tested by indirect immunofluorescence. However, they showed a different reactivity by immunoblotting. Monoclonal antibody 3D9 reacted with antigens with molecular masses of > 200 and 180 kDa specifically expressed in the germ tube. Monoclonal antibody 15C9 reacted with antigens of 87, 50, and 34 kDa present in the germ tube extract and with antigens of 92, 50, 34, and 32 kDa present in the blastoconidium extract. The reactivity of blastoconidia treated for different times with dithiothreitol with these monoclonal antibodies was also studied by enzyme-linked immunosorbent assay. The reactivity of monoclonal antibody 3D9 did not significantly change during the cell wall extraction. However, the reactivity of monoclonal antibody 15C9 was increased for blastoconidia extracted for 60 min and decreased markedly for blastocondia extracted for 120 min. Monoclonal antibody G3B was nonreactive by indirect immunofluoresence but reacted with antigens of 47 and 38 kDa present in the germ tube extract and with an antigen of 47 kDa present in the blastoconidium extract. Monoclonal antibody B9E stained both morphological phases by indirect immunofluorescence. By immunoblotting, it reacted with antigens of > 70 kDa present in the germ tube extract and with antigens of > 63, 56, 47, and 38 kDa present in the blastoconidium extract. Based on the results presented in this study, four types of antigens are described. Type I antigens are expressed on the outermost layers of the germ tube cell wall only. Type II antigens are expressed both on the germ tube cell wall surface and within the blastoconidium cell wall. Type III antigens are found within the cell wall of both blastoconidia and germ tubes. Type IV antigens are expressed on both the blastoconidium and germ tube surface. Two types more can be hypothesized for antigens expressed on the blastoconidium cell surface and within the germ tube cell wall (type V) and for those expressed on the blastoconidium surface only (type VI).     

Premorbid personality and psychopathological dimensions in first-episode psychosis

BACKGROUND: Broadening our knowledge of the relationship between personality and psychopathological dimensions in psychosis would provide insights into the nature of their underlying pathophysiology. Research, to date, has been carried out in chronic samples and the possibility that the personality assessment may have been contaminated by the psychotic episode cannot be ruled out. The aim of this study was to examine the relationships between personality and psychopathology in a 'first-episode psychosis' sample using a dimensional approach. METHOD: Premorbid personality dimensions of 94 consecutively admitted 'first-episode psychosis' patients were assessed through the information collected from parents or a close biological relative. A semi-structured interview (Premorbid Assessment Schedule; [Tyrer, P., 1988. Personality Disorders: Diagnosis, management and course. Wright, London]) was used by a rater, blind to the patients' psychopathological symptoms. Associations between dimensions of premorbid personality and psychopathology were examined through Pearson correlation coefficients. RESULTS: The negative dimension was strongly associated with higher scores on the schizoid dimension. Additionally, trends towards significant direct associations were found between the negative dimension and both the passive-dependent and the schizotypic dimensions, between the hostility/suspiciousness dimension and both sociopathic and passive-dependent dimensions, and between the manic dimension and the obsessional dimension. Canonical correlation analysis demonstrated that premorbid personality dimensions explained 17% of the variance of psychopathological dimensions. CONCLUSIONS: Our results suggest that premorbid personality dimensions may shape the expression of psychosis. Moreover, we hypothesize that certain personality dimensions, such as the schizoid dimension, should be considered nonspecific risk factors for expression of higher levels of negative symptomatology at the beginning of psychosis.     

Cardiometabolic Risk Profiles in Patients With Impaired Fasting Glucose and/or Hemoglobin A1c 5.7% to 6.4%: Evidence for a Gradient According to Diagnostic Criteria: The PREDAPS Study

It has been suggested that the early detection of individuals with prediabetes can help prevent cardiovascular diseases. The purpose of the current study was to examine the cardiometabolic risk profile in patients with prediabetes according to fasting plasma glucose (FPG) and/or hemoglobin A1c (HbA1c) criteria.Cross-sectional analysis from the 2022 patients in the Cohort study in Primary Health Care on the Evolution of Patients with Prediabetes (PREDAPS Study) was developed. Four glycemic status groups were defined based on American Diabetes Association criteria. Information about cardiovascular risk factors–body mass index, waist circumference, blood pressure, cholesterol, triglycerides, uric acid, gamma-glutamyltransferase, glomerular filtration–and metabolic syndrome components were analyzed. Mean values of clinical and biochemical characteristics and frequencies of metabolic syndrome were estimated adjusting by age, sex, educational level, and family history of diabetes.A linear trend (P < 0.001) was observed in most of the cardiovascular risk factors and in all components of metabolic syndrome. Normoglycemic individuals had the best values, individuals with both criteria of prediabetes had the worst, and individuals with only one–HbA1c or FPG–criterion had an intermediate position. Metabolic syndrome was present in 15.0% (95% confidence interval: 12.6–17.4), 59.5% (54.0–64.9), 62.0% (56.0–68.0), and 76.2% (72.8–79.6) of individuals classified in normoglycemia, isolated HbA1c, isolated FPG, and both criteria groups, respectively.In conclusion, individuals with prediabetes, especially those with both criteria, have worse cardiometabolic risk profile than normoglycemic individuals. These results suggest the need to use both criteria in the clinical practice to identify those individuals with the highest cardiovascular risk, in order to offer them special attention with intensive lifestyle intervention programs.