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Background: Lipoprotein(a) [Lp(a)] is a proatherogenic particle associated with increased cardiovascular risk. It is mainly genetically determined; so, the aim of our study is to evaluate the levels of Lp(a) in the relatives of a prospective cohort of patients who have suffered from an acute coronary syndrome (ACS) with Lp(a) ≥ 50 mg/dL. Methods: We conducted a multicenter prospective study, in which consecutive patients who had suffered from an ACS and presented Lp(a) ≥ 50 mg/dL and their first-degree relatives were included. Results: We included 413 subjects, of which 56.4% were relatives of the patients. Family history of early ischemic heart disease was present in 57.5%, and only 20.6% were receiving statin treatment. The family cohort was younger (37.5 vs. 59.1 years; p < 0.001), and 4% had ischemic heart disease and fewer cardiovascular risk factors. Mean Lp(a) levels were 64.9 mg/dL, 59.4% had levels ≥ 50 mg/dL, and 16.1% had levels ≥ 100 mg/dL. When comparing the patients with respect to their relatives, the mean level of Lp(a) was lower but without significant differences regarding the levels of LDLc, ApoB, and non-HDL. However, relatives with Lp(a) ≥ 50 mg/dL, had values similar to the group of patients with ACS (96.8 vs. 103.8 mg/dL; p = 0.18). No differences were found in Lp(a) levels in relatives based on the other lipid parameters. Conclusions: Overall, 59.4% of the first-degree relatives of patients who suffered from an ACS with Lp(a) ≥ 50 mg/dL also had elevated levels. Relatives with elevated Lp(a) had similar levels as patients.

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In recent decades, life expectancy has been increasing significantly. In this scenario, health interventions are necessary to improve prognosis and quality of life of elderly with cardiovascular risk factors and cardiovascular disease. However, the number of elderly patients included in clinical trials is low, thus current clinical practice guidelines do not include specific recommendations. This document aims to review prevention recommendations focused in patients ≥ 75 years with high or very high cardiovascular risk, regarding objectives, medical treatment options and also including physical exercise and their inclusion in cardiac rehabilitation programs. Also, we will show why geriatric syndromes such as frailty, dependence, cognitive impairment, and nutritional status, as well as comorbidities, ought to be considered in this population regarding their important prognostic impact.

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This revision describes in detail the different diagnostic techniques of catheter-related infection, both in terms of catheter removal and preservation. Culture techniques based on catheter withdrawal are classified depending on the detection of extraluminal and/or intraluminal colonization, and new methodologies are described. In general, the most important recommendations are: (a) do not send for culture catheter tips without suspicion of infection, (b) Maki's technique is the standard for detecting extraluminal colonization, (c) take 2 pairs of peripheral blood cultures before starting antibiotic treatment, (d) use skin and connections/connectors cultures for the conservative diagnosis due to their high negative predictive value (Gram and culture), and (e) take differential quantitative blood cultures though all catheter lumens and through a peripheral vein

Esta revisión describe con detalle las diferentes técnicas diagnósticas de infección relacionada con el catéter, tanto con la retirada como con la conservación del mismo. Las técnicas de cultivo basadas en la retirada del catéter se clasifican en base a la detección de colonización extraluminal, intraluminal, o ambas, asimismo, se describen nuevas metodologías. De forma general, las recomendaciones más importantes son: a) no enviar para cultivo puntas de catéter retiradas sin sospecha de infección, b) la técnica de Maki es el estándar válido de detección de colonización extraluminal, c) tomar 2 parejas de hemocultivos de sangre periférica antes de iniciar tratamiento antibiótico, d) utilizar cultivos de piel y conexiones/conectores para el diagnóstico conservador por su alto valor predictivo negativo (Gram y cultivo), y e) extraer hemocultivos cuantitativos diferenciales por todas las luces del catéter y por vena periférica

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This revision describes in detail the different diagnostic techniques of catheter-related infection, both in terms of catheter removal and preservation. Culture techniques based on catheter withdrawal are classified depending on the detection of extraluminal and/or intraluminal colonization, and new methodologies are described. In general, the most important recommendations are: (a) do not send for culture catheter tips without suspicion of infection, (b) Maki's technique is the standard for detecting extraluminal colonization, (c) take 2 pairs of peripheral blood cultures before starting antibiotic treatment, (d) use skin and connections/connectors cultures for the conservative diagnosis due to their high negative predictive value (Gram and culture), and (e) take differential quantitative blood cultures though all catheter lumens and through a peripheral vein.

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Introducción. El objetivo del estudio fue conocer los datos relativos al diagnóstico microbiológico de la tuberculosis en la provincia de Soria, así como analizar la rentabilidad diagnóstica de las técnicas utilizadas y la utilización del laboratorio de microbiología en lo que concierne a la tuberculosis. Métodos. Se diseñó un estudio observacional, descriptivo y retrospectivo, incluyendo todos los pacientes con tuberculosis de cualquier localización que tuviesen su residencia en la provincia de Soria. El periodo de estudio abarcó los casos diagnosticados entre 1994 y 2013 realizando seguimiento durante 24 meses tras el inicio del tratamiento. Resultados. Se detectaron 337 pacientes durante el periodo estudiado. En más del 3% de los pacientes no se envió ninguna muestra al laboratorio de microbiología, porcentaje que ascendió al 23% en tuberculosis osteoarticulares y 33% en tuberculosis linfáticas. Se obtuvo confirmación microbiológica en el 80% y la baciloscopia fue positiva en el 32%. Las muestras se sembraron en medios sólidos y líquidos; el 10% de las cepas sólo se aislaron en un tipo de medio. El porcentaje de cepas resistentes a isoniazida fue de 2,9%, se detectó una cepa multirresistente (0,3%) y una cepa con resistencia únicamente a rifampicina (0,3%). De todos los pacientes bacilíferos con seguimiento, no se envió ninguna muestra para estudiar la negativización en el 36%. Conclusión. Destaca la necesidad de mantener el cultivo combinado en medios líquidos y sólidos. Es necesario potenciar el uso del laboratorio de microbiología, enviando todas las posibles muestras diagnósticas y realizando controles bacteriológicos de seguimiento para objetivar la curación

Introduction. The aim of the study was to describe the bacteriological diagnosis of the tuberculosis in the province of Soria (Spain), as well as to analyse the techniques diagnostic performance and the use of the microbiology laboratory regarding tuberculosis. Methods. An observational, descriptive and retrospective study was designed, including all patients with tuberculosis of any location that had their residence in the province of Soria. The period of study included patients diagnosed between 1994 and 2013 and a 24 months follow-up after the beginning of treatment was realized. Results. A total of 337 patients were detected during the studied period. No sample was sent to the microbiology laboratory in more than 3% of the patients (23% in skeletal tuberculosis and 33% in lymphatic tuberculosis). Bacteriological confirmation was obtained in 80% and 32% were smear-positive. Specimens were culture on solid and in liquid media; 10% of the strains were only isolated in one type of media. There were 2.9% isoniazid-resistant strains, 0.3% multi-drug resistant strains, and 0.3% rifampicin-resistant strains. A total of 36% of smear-positive pulmonary tuberculosis patients had no specimens sent for a follow-up study. Conclusion. It is essential to combine the use of a liquid and a solid medium. Physicians should be encouraged to submit specimens for mycobacteriological diagnostic and follow-up

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Elongated flexuous plant viral nanoparticles (VNPs) represent an interesting platform for developing different applications in nanobiotechnology. In the case of potyviruses, the virion external surface is made up of helically arrayed domains of the viral structural coat protein (CP), repeated over 2000 times, in which the N- and C-terminal domains of each CP are projected toward the exterior of the external virion surface. These characteristics provide a chemical environment rich in functional groups susceptible to chemical conjugations. We have conjugated Candida antarctica lipase B (CALB) onto amino groups of the external surface of the potyvirus turnip mosaic virus (TuMV) using glutaraldehyde as a conjugating agent. Using this approach, TuMV virions were transformed into scaffolds for CALB nanoimmobilization. Analysis of the resulting structures revealed the formation of TuMV nanonets onto which large CALB aggregates were deposited. The functional enzymatic characterization of the CALB-bearing TuMV nanonets showed that CALB continued to be active in the nanoimmobilized form, even gaining an increased relative specific activity, as compared to the non-immobilized form. These novel virus-based nanostructures may provide a useful new approach to enzyme nanoimmobilization susceptible to be industrially exploited.

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Turnip mosaic virus (TuMV) infections affect many Arabidopsis developmental traits. This paper analyzes, at different levels, the development-related differential alterations induced by different strains of TuMV, represented by isolates UK 1 and JPN 1. The genomic sequence of JPN 1 TuMV isolate revealed highest divergence in the P1 and P3 viral cistrons, upon comparison with the UK 1 sequence. Infectious viral chimeras covering the whole viral genome uncovered the P3 cistron as a major viral determinant of development alterations, excluding the involvement of the PIPO open reading frame. However, constitutive transgenic expression of P3 in Arabidopsis did not induce developmental alterations nor modulate the strong effects induced by the transgenic RNA silencing suppressor HC-Pro from either strain. This highlights the importance of studying viral determinants within the context of actual viral infections. Transcriptomic and interactomic analyses at different stages of plant development revealed large differences in the number of genes affected by the different infections at medium infection times but no significant differences at very early times. Biological functions affected by UK 1 (the most severe strain) included mainly stress response and transport. Most cellular components affected cell-wall transport or metabolism. Hubs in the interactome were affected upon infection.

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OBJETIVO: Evaluar si el tratamiento con levotiroxina mejora la capacidad funcional en pacientes con insuficiencia cardíaca crónica clase funcional i-iii de la New York Heart Association e hipotiroidismo subclínico. MÉTODOS: Se incluyeron 163 pacientes ambulatorios con insuficiencia cardíaca crónica estable y con un mínimo de seguimiento de 6 meses. Se realizó un examen clínico y se solicitaron pruebas de laboratorio que incluyeron hormonas tiroideas, ecocardiograma con doppler, ventriculografía radioisotópica y un estudio Holter. La capacidad funcional se evaluó por medio de una caminata de 6min. Se detectaron los pacientes con hipotiroidismo subclínico que recibieron tratamiento sustitutivo y, una vez con valores normales de tirotropina (TSH), se les realizó una nueva caminata de 6min. Se registraron los metros recorridos en cada prueba y se analizó la diferencia de los metros caminados en cada paciente. RESULTADOS: Observamos una prevalencia de hipotiroidismo subclínico del 13% en pacientes con insuficiencia cardíaca. Mientras se encontraban hipotiroideos, los metros recorridos fueron de 292 ± 63, y una vez alcanzados valores normales de TSH, de 350 ± 76. La diferencia en metros fue de 58 ± 11 (p < 0,011). Los pacientes con valores normales de TSH no mostraron diferencias significativas entre las 2 pruebas. CONCLUSIONES: Los pacientes con insuficiencia cardíaca crónica e hipotiroidismo subclínico, una vez eutiroideos, mejoraron de forma significativa su rendimiento físico

AIM: To assess whether levothyroxine treatment improves functional capacity in patients with chronic heart failure (New York Heart Association class i-iii) and subclinical hypothyroidism. METHODS: One hundred and sixty-three outpatients with stable chronic heart failure followed up for at least 6 months were enrolled. A physical examination was performed, and laboratory tests including thyroid hormone levels, Doppler echocardiogram, radionuclide ventriculography, and Holter monitoring were requested. Functional capacity was assessed by of the 6-min walk test. Patients with subclinical hypothyroidism were detected and, after undergoing the s6-min walk test, were given replacement therapy. When they reached normal thyrotropin (TSH) levels, the 6-min walk test was performed again. The distance walked in both tests was recorded, and the difference in meters covered by each patient was analyzed. RESULTS: Prevalence of subclinical hypothyroidism in patients with heart failure was 13%. These patients walked 292 ± 63 m while they were hypothyroid and 350 ± 76m when TSH levels returned to normal, a difference of 58 ± 11 m (P < .011). Patients with normal baseline TSH levels showed no significant difference between the 2 6-min walk tests. CONCLUSIONS: Patients with chronic heart failure and subclinical hypothyroidism significantly improved their physical performance when normal TSH levels were reached

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Losses produced by virus diseases depend mostly on symptom severity. Turnip mosaic virus (TuMV) is one of the most damaging and widespread potyvirus infecting members of the family Brassicaceae, including Arabidopsis thaliana. We used JPN1 and UK1 TuMV strains to characterize viral infections regarding symptom development, senescence progression, antioxidant response, reactive oxygen species (ROS) accumulation, and transcriptional profiling. Both isolates, despite accumulating similar viral titers, induced different symptomatology and strong differences in oxidative status. Early differences in several senescence-associated genes linked to the ORE1 and ORS1 regulatory networks as well as persistent divergence in key ROS production and scavenging systems of the plant were detected. However, at a later stage, both strains induced nutrient competition, indicating that senescence rates are influenced by different mechanisms upon viral infections. Analyses of ORE1 and ORS1 levels in infected Brassica juncea plants showed a similar pattern, suggesting a conserved differential response to both strains in Brassicaceae spp. Transcriptional analysis of the ORE1 and ORS1 regulons showed similarities between salicylic acid (SA) response and the early induction triggered by UK1, the most severe strain. By means of SA-defective NahG transgenic plants, we found that differential senescence progression and ROS accumulation between strains rely on an intact SA pathway.

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AIM: To assess whether levothyroxine treatment improves functional capacity in patients with chronic heart failure (New York Heart Association class i-iii) and subclinical hypothyroidism. METHODS: One hundred and sixty-three outpatients with stable chronic heart failure followed up for at least 6 months were enrolled. A physical examination was performed, and laboratory tests including thyroid hormone levels, Doppler echocardiogram, radionuclide ventriculography, and Holter monitoring were requested. Functional capacity was assessed by of the 6-min walk test. Patients with subclinical hypothyroidism were detected and, after undergoing the s6-min walk test, were given replacement therapy. When they reached normal thyrotropin (TSH) levels, the 6-min walk test was performed again. The distance walked in both tests was recorded, and the difference in meters covered by each patient was analyzed. RESULTS: Prevalence of subclinical hypothyroidism in patients with heart failure was 13%. These patients walked 292±63m while they were hypothyroid and 350±76m when TSH levels returned to normal, a difference of 58±11m (P<.011). Patients with normal baseline TSH levels showed no significant difference between the 2 6-min walk tests. CONCLUSIONS: Patients with chronic heart failure and subclinical hypothyroidism significantly improved their physical performance when normal TSH levels were reached.

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Performance of a real-time reverse-transcription polymerase chain reaction method for the rapid, simple and reliable detection of porcine teschovirus (PTV) was assessed. The method was based on the use of a set of oligonucleotides consisting of two specific primers and a fluorogenic TaqMan-MGB probe. Reverse transcription and PCR reactions were performed sequentially in one step. As a result the whole procedure was simple and rapid, taking less than 3h for completion. The method reacted in a dose-dependent manner with prototype strains for the eleven known PTV serotypes (PTV1-11), with higher analytical sensitivity than other gel-based RT-PCR methods described, which were performed in parallel to allow for a comparison. The assay did not cross-react with other related viruses or porcine viruses tested. The diagnostic performance of the method was analyzed using a panel of field samples consisting of pig fecal and pig slurry samples. As a conclusion, this technique is adequate and convenient for porcine teschovirus detection, both for diagnosis as well as in environmental investigations.

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La tularemia es una enfermedad descrita en España desde hace una década. El presente estudio analiza los casos en los que se sospechó tularemia, así como los casos probables y los casos confirmados de esta enfermedad en la provincia de Soria, en comparación con los datos referidos a la tularemia en Castilla y León. Estos casos, salvo uno esporádico, se agrupan en 2 brotes epidémicos (años 1997–1998 y años 2007–2008). Métodos Se estudiaron todos los pacientes (53) con sospecha clínica de tularemia entre los años 1997 y 2008 (estudio retrospectivo de los años 1997 a 1999). El estudio microbiológico se realizó por serología (63 sueros), cultivo de sangre (10 muestras) y cultivo de líquido de absceso de adenopatía (una muestra). Resultados Durante 10 años se diagnosticaron 19 casos de tularemia en Soria: un caso esporádico en 1996, 5 casos en el brote de 1997–1998 y 13 casos en el brote de 2007–2008. El 95% de los casos tuvo contacto con liebres. La forma clínica más frecuente fue la forma ulceroganglionar (62%). Trece casos se definieron como probables (el 68% con título alto de anticuerpos) y 6 casos se definieron como confirmados (el 32%), 2 por aislamiento de la bacteria y 4 por seroconversión. Conclusión Los casos de tularemia en la provincia de Soria comparten idénticas características clínicas y epidemiológicas (formas ulceroganglionares, manipulación de liebres) con el brote de los años 1997–1998 en la comunidad de Castilla y León y se diferencian de los casos del brote de los años 2007–2008 en la comunidad (predominio de las formas tifoideas de la enfermedad y relación con el aumento de la población de topillos) (AU)

Introduction Tularemia is a zoonotic disease that has been regularly reported in Spain since 1997. This study analyzes suspected, probable, and confirmed cases of tularemia in the province of Soria, and compares them with tularemia cases recorded in the autonomous community of Castilla y Léon, which, with the exception of 1 sporadic case, occurred in 2 epidemic outbreaks in 1997/1998 and 2007/2008. Methods We studied all patients (53) with signs and symptoms of tularemia in the period of 1997 to 2008. Sixty-three serum samples from these patients were tested by a microagglutination assay for antibodies against Francisella tularensis; additionally 10 blood cultures and 1 culture of abscess exudate from an enlarged lymph node were carried out. Results Over the last decade, 19 cases of tularemia have been diagnosed in Soria (1 sporadic case in 1996, 5 associated with an outbreak reported in 1997/98 and 13 associated with an outbreak occurring in 2007/08). In 95% of the cases, previous contact with hares was reported. The ulceroglandular type was most frequently (62%) observed. F. tularensis was isolated on blood culture in 2 cases. The remaining patients were diagnosed by serology (4 confirmed cases, 13 probable cases). Conclusion The cases of tularemia documented in Soria showed clinical and epidemiological features (predominant ulceroglandular clinical presentation and previous contact with hares) identical to the 1997/98 tularemia outbreak in Castilla y Léon, but contrasted with the 2007/08 outbreak in Castilla y León where typhoidal clinical forms of the disease and a relationship with an increased rodent population (Mycrotus spp) were predominant (AU)

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Molecular markers linked to phenotypically important traits are of great interest especially when traits are difficult and/or costly to be observed. In tomato where a strong focus on resistance breeding has led to the introgression of several resistance genes, resistance traits have become important characteristics in distinctness, uniformity and stability (DUS) testing for Plant Breeders Rights (PBR) applications. Evaluation of disease traits in biological assays is not always straightforward because assays are often influenced by environmental factors, and difficulties in scoring exist. In this study, we describe the development and/or evaluation of molecular marker assays for the Verticillium genes Ve1 and Ve2, the tomato mosaic virus Tm1 (linked marker), the tomato mosaic virus Tm2 and Tm2 ( 2 ) genes, the Meloidogyne incognita Mi1-2 gene, the Fusarium I (linked marker) and I2 loci, which are obligatory traits in PBR testing. The marker assays were evaluated for their robustness in a ring test and then evaluated in a set of varieties. Although in general, results between biological assays and marker assays gave highly correlated results, marker assays showed an advantage over biological tests in that the results were clearer, i.e., homozygote/heterozygote presence of the resistance gene can be detected and heterogeneity in seed lots can be identified readily. Within the UPOV framework for granting of PBR, the markers have the potential to fulfil the requirements needed for implementation in DUS testing of candidate varieties and could complement or may be an alternative to the pathogenesis tests that are carried out at present.

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