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Coronavirus disease 2019 (COVID-19) is a serious respiratory illness caused by SARS-CoV-2. There is controversy about whether their immunosuppressive status is a risk factor or a protective factor for developing severe disease. We report herein the clinical outcome of three family members that had COVID-19 infection, presenting with and without different risk factors that have been described in more severe disease. Paradoxically, the patient with more risks of developing a severe disease, a 64-year-old woman, 2-years liver transplant recipient under treatment with tacrolimus, presented a similar outcome compared to the two other members of the family. She showed shorter hospitalization time, similar clinical outcome with fewer oxygen needs. The present clinical observation raises the question about the possible beneficial effect of tacrolimus in patients with COVID-19. Indeed, tacrolimus (FK-506) have an inhibitory effect on human coronaviruses by: 1) an antiviral effect by binding to the FK-506-binding proteins (FKBP) with a subsequent inhibition of their peptidyl-prolyl cis/trans isomerase (PPIase) activity, which seems to be important for the coronavirus life cycle; and 2) regulating the immune response by the inhibition of the activity of the nuclear factor of activated T-cells (NFAT) required for immunosuppression. The present observation states that liver recipients' patients with COVID-19 may not have worse outcomes when compared with other patients that have COVID-19 risk factors and puts in evidence the two mechanisms related to tacrolimus.

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INTRODUCTION: Primary objective of the study was to assess the relative weighting between benefit in survival time (SV), benefit in quality of life (QoL) and willingness to experience adverse events (AEs), in patient preferences for chemotherapy treatment. MATERIALS AND METHODS: We included cancer patients with current or past systemic treatment of cancer (STC) as well as physicians placed as hypothetical patients. Participants filled a choice-based conjoint analysis questionnaire with 19 choices among three STC scenarios with variable amounts of benefit in SV or QoL and different types AEs. RESULTS: One hundred patients (50 on curative and 50 on palliative intention treatment) and 114 physicians (61 oncologists and 53 non-oncologists) were included and asked about their preferred chemotherapy treatment. The relative weighting (sum 100%) of SV-QoL-AEs for making the choice in the 100 patients was SV35%-CV33%-AEs31% what was not significantly different from a random distribution (Goodness of fit Chi square P = 0.91) just as it was not for both subgroups, palliative (SV37%-QoL29%-AEs34%; GoF Chi square P = 0.55) and curative (SV34%-QoL36%-AEs30%; GoF Chi square P = 0.73) treatment. The observed distribution in the group of 114 physicians (SV46%-QoL31%-AEs23%) was significantly different from a random distribution (GoF Chi square P = 0.018) just as it was for both subgroups, medical oncologists (SV48%-QoL29%-AEs23%; GoF Chi square P = 0.006) and non-medical oncologists (SV44%-QoL33%-AEs23%; GoF Chi square P = 0.04). CONCLUSIONS: The three attributes (SV, QoL, and AEs) are considered in the same way by cancer patients to make choices on their STC. On the contrary, when placed as hypothetical patients, physicians prefer for themselves those treatments that provide more SV.

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RESUMEN Introducción: El NutriScore es una herramienta diseñada con el objetivo de simplificar la información que aporta el etiquetado nutricional de los alimentos. Clasifica los alimentos en cinco colores que van desde el verde (más saludable) hasta el rojo (menos saludable). Estos colores están asociados a cinco letras (A/B/C/D/E). Los estudiantes universitarios pasan muchas horas en las facultades y tienen un consumo elevado de snacks y refrescos Objetivos: Calcular el NutriScore de los alimentos y bebidas disponibles en las máquinas expendedoras de las facultades de la Universidad Complutense de Madrid y obtener datos de los hábitos de consumo de los estudiantes de dicha universidad. Material y Métodos: El estudio ha sido realizado en 16 facultades y la biblioteca universitaria analizando los alimentos y bebidas de las máquinas expendedoras de dichas facultades en marzo de 2019. Se calculó la puntuación de cada uno y según la puntuación obtenida se clasificaron en una de las cinco categorías. 146 estudiante rellenaron una encuesta sobre la frecuencia de consumo y tipo de productos preferidos de las máquinas expendedoras. Resultados: Se clasificaron 143 alimentos y 53 bebidas que estaban disponibles en máquinas expendedoras. Los alimentos se distribuyeron: A 4,2%, B 4,2%, C 21,6%, D 53% y E 47% y las bebidas: A 1,9%, B 9,4%, C 13,2%, D 35,9% y E 39,6%. Los estudiantes consumen algún producto de las maquinas expendedoras fundamentalmente cuando tienen hambre, en momentos entre horas y eligiendo agua como primera opción seguido de refrescos azucarados como bebidas y bollería industrial seguido de patatas fritas como snacks más consumidos Conclusión: Aunque la universidad debería desarrollar una función en la promoción de un estado de vida saludable, las máquinas expendedoras de las facultades ofrecen un número muy elevado de productos con baja calidad nutricional.

ABSTRACT Introduction: NutriScore is a tool designed with the aim of simplify the information of the nutritional composition obtained from the labelling. It classify foods in five colors ranging from green (healthier) to red (less healthy). These colors are associated with five letters (A/B/C/D/E). University students spend many hours in faculties and have a high consumption of snacks and beverages. Objective: We aimed to examine the nutritional value of foods sold in vending machines of the Complutense University of Madrid, by calculating the nutriscore and to obtain data of the snacking habits of the students of this university. Methods: The study was conducted in sixteen universities and in the university library of the Complutense University of Madrid. One hundred and forty six undergraduate university students volunteered to complete a questionnaire to assess frequency of consumption and snack choices of vending machines. Results: We analized 143 snacks and 53 beverages. Snacks were: A 4,2%, B 4,2%, C 21,6%, D 53% y E 47% and beverages A 1,9%, B 9,4%, C 13,2%, D 35,9% y E 39,6%. The students use them when they are hungry and between meals. Water was the first option followed by sugary soft drinks as beverages and processed baked goods followed by chips as more consumed snacks. Conclusión: Although the university should play a role in promoting a healthy lifestyle, the vending machines of the faculties offer a very high number of products with low nutritional quality. group, we can conclude that DTC in acromegaly does not have a worse evolution.

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OBJECTIVES: The aim was to describe pregnancy outcomes after Zika virus (ZIKV) infection in a non-endemic region. METHODS: According to the Spanish protocol issued after the ZIKV outbreak in Brazil in 2015, all pregnant women who had travelled to high-burden countries were screened for ZIKV. Serological and molecular tests were used to identify ZIKV-infected pregnant women. They were classified as confirmed ZIKV infection when reverse transcription (RT) PCR tested positive, or probable ZIKV infection when ZIKV immunoglobulin M and/or immunoglobulin G and ZIKV plaque reduction neutralization tests were positive. Women found positive using molecular or serological tests were prospectively followed-up with ultrasound scans and neurosonograms on a monthly basis until delivery; magnetic resonance imaging and amniotic fluid testing were performed after signed informed consent. Samples of placenta, and fetal and neonatal tissues were obtained. RESULTS: Seventy-two pregnant women tested positive for ZIKV infection: ten were confirmed by RT-PCR, and 62 were probable cases based on serological tests. The prevalence of adverse perinatal outcomes was 33.3% (three out of nine, 95% CI 12.1-64.6%): two cases of congenital ZIKV syndrome (CZS) and one miscarriage, all born to women infected in the first trimester of gestation. All ZIKV-confirmed women had persistent viraemias beyond 2 weeks (median 61.50 days; IQR 35.50-80.75). Amniotic fluid testing was only positive in the two fetuses with anomalies. CONCLUSION: The prevalence of perinatal adverse outcomes for women with ZIKV-confirmed infection was 33.3%. Amniocentesis for ZIKV RT-PCR is recommended when fetal abnormalities are found. Intensive prenatal and postnatal follow-up of ZIKV-infected pregnancies is advised in confirmed cases.

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Considering the lack of resources in health centers located in rural zones, a part of Colombian population goes affected by the quality of the health Service received. If this is added the low level socioeconomic of some rural population, it is generated a geographic vulnerability. For that reason in this work is presented a Service Oriented Architecture that has as objective support health centers with low technical resources with technology that allows a physical rehab attention independently of the localization of patient and health professional. By way of this, a distributed system it is proposed, using a dispersed communication media like the internet. It is planned to make a modeling process based on a formal tool like the Petri Nets to assure the definition of the services, assistant dispositive teleoperation and the integration and coordination of the system.

Considerando la falta de recursos en centros de salud ubicados en zonas rurales, una parte de la población colombiana se ve afectada por la calidad del Servicio de Salud recibido. Si se suma el bajo nivel socioeconómico de cierta población rural, se genera una vulnerabilidad geográfica. Por ello en este trabajo se presenta una Arquitectura Orientada a Servicios que tiene como objetivo apoyar centros de salud con bajos recursos técnicos con tecnología que permita una atención física de rehabilitación independientemente de la ubicación del paciente y profesional de la salud. De esta manera, se propone un sistema distribuido, utilizando un medio de comunicación disperso como Internet. Para asegurar la definición de los servicios, el asistente de teleoperación dispositiva y la integración y coordinación del sistema, se planea realizar un proceso de modelización basado en una herramienta formal como las redes de Petri.

Considerando a falta de recursos em centros de saúde localizados em zonas rurais, uma parte da população colombiana vê-se afetada pela qualidade do Serviço de Saúde recebido. Ao somar-se o baixo nível socioeconómico de alguma população rural, gera-se uma vulnerabilidade geográfica. Por isso neste trabalho apresenta-se uma arquitetura orientada a serviços que tem como objetivo apoiar centros de saúde com baixos recursos técnicos com tecnologia que permite uma atenção física de reabilitação independentemente da localização do paciente e profissional da saúde. Desta maneira, propõe-se um sistema distribuído, utilizando um médio de comunicação disperso como Internet. Para assegurar a definição dos serviços, o assistente de tele operação dispositiva e a integração e coordenação do sistema, planeja-se realizar um processo de modelização baseado numa ferramenta formal como as redes de Petri.

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OBJECTIVE: To identify the predictive value of LH-FSH ratio in the Polycystic Ovary Syndrome diagnosis and to evaluate its role according PCOS phenotypes. MATERIAL AND METHOD: A descriptive, comparative, observational, prospective study of PCOS patients and its controls. All participants received a questionnaire and underwent a physical and transvaginal ultrasound examination. Blood samples were also collected for analysis of metabolic markers and hormones. PCOS was diagnosed according to Rotterdam criteria. RESULTS: A total of 267 women were included into the study. PCOS was diagnosed in 162 patients. There was statistical difference in: HOMA, 1.43 ± 1.06, 2.09 ± 1.96; Total Testosterone, 0.31 ± 0.14, 0.41 ± 0.19; and free Androgen index, 1.17 ± 1.30, 1.69 ± 1.18; for control and PCOS group, respectively. FSH, 6.55 ± 2.43 in controls and 5.30 ± 1.66 in PCOS patients (p = 0.001); LH, 4.34 ± 2.12 controls, 6.36 ± 4.61 PCOS patients (p = 0.001). LH-FSH ratio was 0.71 ± 0.39 for control group and 1.25 ± 0.85 in PCOS group, p = 0.001. A correlation was observed between LH-FSH ratio and total antral follicle count (p < 0.001) and with insulin resistance (p = 0.022). CONCLUSION: LH-FSH ratio, although it is a valuable test, it is not diagnostic of PCOS. A correlation was found with LH-FSH ratio and insulin resistance but we must not forget about its association with hyperandrogenism.

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An expert group from the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC, for its acronym in Spanish) and the Spanish Society of Medical Oncology (SEOM, for its acronym in Spanish) have reviewed the main aspects to be considered when evaluating patients with solid cancer and infectious complications contained in this article. Recommendations have, therefore, been put forth regarding the prophylaxis of the most prevalent infections in these patients, the use of vaccines, measures to control infection through vascular catheters, and preventing infection in light of certain surgical maneuvers. The following is a revision of the criteria for febrile neutropenia management and the use of colony-stimulating factors and closes with several guidelines for treating the cancer patient with serious infection. The document concludes with a series of measures to control hospital infection.

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Rice is attacked by Steneotarsonemus spinki Smiley, a mite that has dispersed throughout many countries causing important loss on rice production. Rice plants of the variety Morelos A-92 were infested with S. spinki, and its population growth was estimated along plant development. Further, the morphological and histological injuries associated to the mite attack were characterized. The highest infestation level was obtained 13 weeks after plant infestation, with an average of 58.5 mites per plant, predominantly females. Morphological injuries were categorized from level 0 (no injuries from uninfested plants) to level 3, characterized by the highest injuries represented by blotches on the adaxial epidermis of the leaf sheath and on panicles and grains. Plants ranked within levels 0, 1, and 2 for morphological injury did not exhibit clear histological injuries, while those at level 3 exhibited histological injury characterized by destruction of cells of the adaxial epidermis, disorder, color change, and hypertrophy in the mesophyll cells, as well as color change in the abaxial epidermis. Thus, it presented a significant correlation between morphological injuries and mite density level, which can be further adopted to help the control decision-making process for this mite on rice.

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La cistinuria es una enfermedad genética cuya expresión clínica es la formación de cálculos en las vías urinarias. Si bien este tipo de litiasis es poco frecuente se caracteriza por un elevado número de recidivas. En este trabajo, presentamos el caso de una paciente de 24 años con litiasis por cistina, en la que el diagnóstico se logró mediante el hallazgo de cristales de cistina en muestras de orina y la presencia de cistina como único componente de los cálculos expulsados espontáneamente en dos ocasiones y removidos por nefrolitotomía percutánea en una ocasión en un lapso de 6 meses. El tratamiento instaurado consistió en aumento de la ingesta de líquido, dieta con restricción de sodio y proteínas y administración de agentes alcalinizantes para aumentar el pH de la orina. Así mismo queremos mostrar la disponibilidad y el uso a nivel nacional de técnicas laboratoriales especializadas para el diagnóstico y seguimiento de pacientes con cistinuria.

Cystinuria is a genetic disease which clinical expression is the formation of stones in theurinary tract.Even though this kind of lithiasis is rare, it is characterized by a highrecurrence rate. In this work,we present the case of a 24-year-old female patient withcystine lithiasisin whom the diagnosis was made by detection of cystine crystals in urinesamples and the presence of cystine as the only component of kidney stonesspontaneously passed in two episodes and removed by percutaneous nephrolithotomyoncein a period of six months. The treatment measures established were increase of thefluid intake,restricted protein and sodium diet and administrationofalkaline agents toincreaseurinary pH. Wealsoshow the availability and use at national level of specializedlaboratory techniques for the diagnosis and follow-up of cystinuric patients.

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