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BackgroundIn the last few years, pertussis has re-emerged worldwide. The aim of this article is to study how the incidence of the disease has evolved in Barcelona city over a 16-year period, and determine which factors are associated with the evolution of the disease. We discuss the causes of the observed changes considering different possibilities such as vaccination coverage, vaccine effectiveness, increased surveillance or the effect of the current economic recession.MethodsWe performed a cross-sectional, observational, population-based descriptive study using data for the 2000-2015 period from the notifiable diseases register maintained by Barcelona Public Health Agency. We used Poisson regression to compute adjusted odds ratios (aOR) and their corresponding 95% confidence intervals (CI).ResultsA total of 1791 cases were registered. The incidence of the disease increased throughout the city from 2011 onwards. While children under 1year of age had the highest-incidence and were the most at risk (aOR=27.18, CI:23.51-31.44), we found that the age of affected children was higher in the last years. Incidence proportion (PRR) was lower among foreign-born children than native children (PRR=0.43 CI:0.32-0.58). In the whole-cell vaccine period (2000-2004), the percentage of cases under 1year of age who received the vaccine was lower than in 2005-2015 when the acellular vaccine was used (p=0.01), suggesting a lower efficacy of the acellular vaccine. However, vaccination coverage in children under 6years remained high (90%), and there were no significant year-to-year variations (p=0.757). Moreover, there did not appear to be any significant restrictions in medical care. According to the index of disposable household income (DHI), pertussis incidence increased from 2011 onwards in all neighbourhoods and remained higher in those with lower DHI.ConclusionsThe noteworthy increase in pertussis incidence does not seem to be due to the economic recession, but to other factors here described.

After 3 years of mild gases emissions, the Ubinas volcano entered in a new eruptive phase on September 2nd, 2013. The MIROVA system (a space-based volcanic hot-spot detection system), allowed us to detect in near real time the thermal emissions associated with the eruption and provided early evidence of magma extrusion within the deep summit crater. By combining IR data with plume height, sulfur emissions, hot spring temperatures and seismic activity, we interpret the thermal output detected over Ubinas in terms of extrusion rates associated to the eruption. We suggest that the 2013–2014 eruptive crisis can be subdivided into three main phases: (i) shallow magma intrusion inside the edifice, (ii) extrusion and growing of a lava plug at the bottom of the summit crater coupled with increasing explosive activity and finally, (iii) disruption of the lava plug and gradual decline of the explosive activity. The occurrence of the 8.2 Mw Iquique (Chile) earthquake (365 km away from Ubinas) on April 1st, 2014, may have perturbed most of the analyzed parameters, suggesting a prompt interaction with the ongoing volcanic activity. In particular, the analysis of thermal and seismic datasets shows that the earthquake may have promoted the most intense thermal and explosive phase that culminated in a major explosion on April 19th, 2014. These results reveal the efficiency of space-based thermal observations in detecting the extrusion of hot magma within deep volcanic craters and in tracking its evolution. We emphasize that, in combination with other geophysical and geochemical datasets, MIROVA is an essential tool for monitoring remote volcanoes with rather difficult accessibility, like those of the Andes that reach remarkably high altitudes.

CKD and CKD-related mineral and bone disorders (CKD-MBDs) are associated with high cardiovascular and mortality risks. In randomized clinical trials (RCTs), no single drug intervention has been shown to reduce the high mortality risk in dialysis patients, but several robust secondary analyses point toward important potential beneficial effects of controlling CKD-MBD-related factors and secondary hyperparathyroidism. The advent of cinacalcet, which has a unique mode of action at the calcium-sensing receptor, represented an important step forward in controlling CKD-MBD. In addition, new RCTs have conclusively shown that cinacalcet improves achievement of target levels for all of the metabolic abnormalities associated with CKD-MBD and may also attenuate the progression of vascular and valvular calcifications in dialysis patients. However, a final conclusion on the effect of cinacalcet on hard outcomes remains elusive. Tolerance of cinacalcet is limited by frequent secondary side effects such as nausea, vomiting, hypocalcemia and oversuppression of parathyroid hormone, which may cause some management difficulties, especially for those lacking experience with the drug. Against this background, this review aims to summarize the results of studies on cinacalcet, up to and including the publication of the recent ADVANCE and EVOLVE RCTs, as well as recent post hoc analyses, and to offer practical guidance on how to improve the clinical management of the most frequent adverse events associated with cinacalcet, based on both currently available information and personal experience. In addition, attention is drawn to less common secondary effects of cinacalcet treatment and advisable precautions.

Artículo online El objetivo del presente artículo es facilitar a los funcionarios y equipo técnico de las diferentes instancias del Ministerio de Salud, nivel nacional, regional y local, vinculados a la Estrategia Sanitaria de Alimentación y Nutrición Saludable, información analizada del Sistema de Información del Estado Nutricional – SIEN, para la toma de decisiones que contribuyan a mejorar estos resultados.

The ARIA (Allergic Rhinitis and its Impact on Asthma) guidelines proposed a classification for allergic rhinitis based on the duration of symptoms (intermittent or persistent) rather than on the time of allergen exposure (seasonal or perennial). There had been no placebo-controlled, randomized, clinical trial of desloratadine (DL) in patients with persistent allergic rhinitis to date.To assess the efficacy and safety of DL in patients with persistent allergic rhinitis based on the ARIA classification.Patients 12 years of age and older with persistent allergic rhinitis were assessed over 85 days of treatment with DL 5 mg once daily (n = 360) or placebo (n = 356). The primary endpoint was the AM/PM reflective total 5-symptom score (T5SS) averaged over days 1-29. Secondary endpoints included AM/PM instantaneous T5SS and individual symptoms, therapeutic response, symptom severity assessed by a visual analogue scale and quality of life.The mean reduction in AM/PM reflective T5SS was significantly greater with DL than placebo over days 1-29 (-3.76 vs. -2.87, p0.001) and on each individual day (p0.05). The mean AM instantaneous T5SS was significantly reduced with DL compared with placebo as early as day 2 (-1.90 vs. -1.46; p0.001). The therapeutic response and improvement in quality of life were significantly greater with DL than placebo (p0.001 for each). The frequency of treatment-related adverse events was low and similar between DL (10.0%) and placebo (8.4%).This study showed DL to be effective and safe in the treatment of persistent allergic rhinitis.

The evaluations in the development of the treatment to be able to recover the motor activity, it is considered of utmost importance in the rehabilitation of lower limbs, the state of the art allows us to evaluate various techniques and commercial products available for the evaluation of the movement and with emphasis on the members inferior, commercial products have the disadvantage of the high cost, which does not allow small medical offices to be able to implement these types of solutions, in this paper we propose a mechanism to evaluate the movements of lower limbs at a very low cost, the The proposal is based on equipment and components that are commonly used, economical and easily acquired; One of its main components is the passive marker that is composed of "expanded polystyrene" that has a half-sphere shape and is placed in the joint to be analyzed, complements the solution a video camera and a recording unit that records the video at least about 30 images per second. As a computational tool, Matlab software and its image processing library were used, where various algorithms could be designed to obtain a graph of the movement of the markers based on the video image. In the tests carried out, it was possible to register and analyze the movement, considering the member and the joint that you want to study, in that concept it was possible to register a side view of the person at the moment you are walking and therefore the joint is related to the marker. The proposed methodology is applicable for a single reference plane, if you want to analyze several reference planes simultaneously, it is necessary to increase the number of cameras, we conclude with the presentation of the conclusions that were obtained when conducting the investigation as well as indicating the How to scale the solution.