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Thrombotic thrombocytopenic purpura (TTP) is a rare life-threatening thrombotic microangiopathy (TMA) characterized by the severe deficiency of ADAMTS13 activity (

Roberto Bernabeu-Mora,1,2 Françesc Medina-Mirapeix,2 Eduardo Llamazares-Herrán,3 Gloria García-Guillamón,2 Luz María Giménez-Giménez,2 Juan Miguel Sánchez-Nieto1,4 1Division of Pneumology, Hospital Morales Meseguer, 2Department of Physical Therapy, University of Murcia, Murcia, 3Department of Physical Therapy, Alcala University, Alcala de Henares, 4Department of Intern Medical, University of Murcia, Murcia, Spain Background: Limited mobility is a risk factor for developing chronic obstructive pulmonary disease (COPD)-related disabilities. Little is known about the validity of the Short Physical Performance Battery (SPPB) for identifying mobility limitations in patients with COPD. Objective: To determine the clinical validity of the SPPB summary score and its three components (standing balance, 4-meter gait speed, and five-repetition sit-to-stand) for identifying mobility limitations in patients with COPD.Methods: This cross-sectional study included 137 patients with COPD, recruited from a hospital in Spain. Muscle strength tests and SPPB were measured; then, patients were surveyed for self-reported mobility limitations. The validity of SPPB scores was analyzed by developing receiver operating characteristic curves to analyze the sensitivity and specificity for identifying patients with mobility limitations; by examining group differences in SPPB scores across categories of mobility activities; and by correlating SPPB scores to strength tests.Results: Only the SPPB summary score and the five-repetition sit-to-stand components showed good discriminative capabilities; both showed areas under the receiver operating characteristic curves greater than 0.7. Patients with limitations had significantly lower SPPB scores than patients without limitations in nine different mobility activities. SPPB scores were moderately correlated with the quadriceps test (r>0.40), and less correlated with the handgrip test (r

From fertilization until the onset of gastrulation the early mammalian embryo undergoes a dramatic series of changes that converts a single fertilized cell into a remarkably complex organism. Much attention has been given to the molecular changes occurring during this process, but here we will review what is known about the changes affecting the mitochondria and how they impact on the energy metabolism and apoptotic response of the embryo. We will also focus on understanding what quality control mechanisms ensure optimal mitochondrial activity in the embryo, and in this way provide an overview of the importance of the mitochondria in determining cell fitness during early mammalian development.

Bernabeu-Mora R, Medina-Mirapeix F, Llamazares-Herrán E, et al. Int J Chron Obstruct Pulmon Dis. 2015;10:619–2626. Page 2626, Acknowledgments section, the text “The authors wish to thank the patients and personnel of the hospital unit for their cooperation during the course of this study. The study was supported by medical manager of AstraZeneca Pharmaceutical Spain, S.A. and Maite Pérez.” Should read “The authors wish to thank the patients and personnel of the hospital unit for their cooperation during the course of this study. The study was supported by medical manager AstraZeneca Pharmaceutical Spain, S.A. Maite Pérez, Pfizer and Menarini.”Read the original article

BACKGROUNDS: AUDIPOC is a nationwide clinical audit that describes the characteristics, interventions and outcomes of patients admitted to Spanish hospitals because of an exacerbation of chronic obstructive pulmonary disease (ECOPD), assessing the compliance of these parameters with current international guidelines. The present study describes hospital resources, hospital factors related to case recruitment variability, patients' characteristics, and adherence to guidelines. METHODOLOGY/PRINCIPAL FINDINGS: An organisational database was completed by all participant hospitals recording resources and organisation. Over an 8-week period 11,564 consecutive ECOPD admissions to 129 Spanish hospitals covering 70% of the Spanish population were prospectively identified. At hospital discharge, 5,178 patients (45% of eligible) were finally included, and thus constituted the audited population. Audited patients were reassessed 90 days after admission for survival and readmission rates. A wide variability was observed in relation to most variables, hospital adherence to guidelines, and readmissions and death. Median inpatient mortality was 5% (across-hospital range 0-35%). Among discharged patients, 37% required readmission (0-62%) and 6.5% died (0-35%). The overall mortality rate was 11.6% (0-50%). Hospital size and complexity and aspects related to hospital COPD awareness were significantly associated with case recruitment. Clinical management most often complied with diagnosis and treatment recommendations but rarely (

English Abstract; Journal Article; INTRODUCTION In the prevention for being overweight and for obesity, much attention is given to the influence of dietary factors, making the joint evaluation with other modifiable factors necessary. OBJECTIVES The aim of this project is to study the association between modifiable factors (physical activity, sedentary lifestyle, and dietary habits) with the prevalence of being overweight or obese in the youth population. METHODS Cross-Sectional study of 1283 school children between the ages of 3 and 16 years old, with measurements of the MBI, dietary habits, physical activity, sedentary lifestyle and family history of being overweight. Physical activity measured in MET was classified according to Pate criteria. RESULTS 22.4% of the boys and 32.9% of the girls were overweight. The presence of a BMI>25 in parents multiplied by 2.4 the risk of being overweight in children (OR CI 95% 1.5-3.7). 63.6% of overweight boys meet physical activity recommendations compared with 52.2% of girls, although in their case, it was greater than the average (45%). Sedentary time was 141 minutes for men and 128 minutes for women, with more sedentary behaviors associated with being overweight, especially in girls over 12 years of age (66.7%). Consuming cereal (OR 0.8) and having five meals per day (OR 0.5) act as protective factors. CONCLUSIONS In subjects with overweight, the levels of physical activity are close to those recommended levels, so which the values of a sedentary lifestyle together with dietary habits (if the parents have overweight) acquire a new relevance in intervention strategies of this problem. Yes Introducción: En la prevención del sobrepeso y la obesidad se presta mucha atención a la influencia de factores dietéticos siendo necesaria su valoración con otros factores modificables. Objetivos: Estudiar la asociación entre factores modificables (actividad física, sedentarismo, y hábitos dietéticos) con la existencia de sobrepeso y obesidad en población infantojuvenil. Métodos: Estudio transversal de 1283 escolares de 3 a 16 años con medición del IMC, hábitos dietéticos, actividad física, sedentarismo y antecedentes familiares de sobrecarga ponderal. La actividad física medida en MET se clasifico según los criterios de Pate. Resultados: El 22,4% de los niños y el 32,9% de las niñas presentaron sobrecarga ponderal. La presencia de IMC>25 en los padres multiplico por 2,4 el riesgo de sobrecarga ponderal en los hijos (IC95% 1,5-3,7). Cumplen con las recomendaciones de actividad física el 63,6% de los niños con sobrecarga ponderal frente al 52,2% en la niñas, aunque en estas resulto ser superior a la media (45%). El tiempo de sedentarismo fue de 141 minutos en niños y 128 en la mujer, el mayor sedentarismo se asocia a sobrecarga ponderal, especialmente en niñas a partir de los 12 años (66.7%). El consumo de cereales (OR 0,8) y realizar cinco comidas al día (OR 0,5) actuan como protectores. Conclusiones: En los niños con sobrecarga ponderal, los niveles de actividad física estan próximos a los recomendados, por lo que los valores de sedentarismo junto con los hábitos alimentarios, especialmente si los padres presentan sobrecarga ponderal, adquieren una mayor relevancia en las estrategias de intervención.

Backgrounds: AUDIPOC is a nationwide clinical audit that describes the characteristics, interventions and outcomes of patients admitted to Spanish hospitals because of an exacerbation of chronic obstructive pulmonary disease (ECOPD), assessing the compliance of these parameters with current international guidelines. The present study describes hospital resources, hospital factors related to case recruitment variability, patients' characteristics, and adherence to guidelines. Methodology/Principal Findings: An organisational database was completed by all participant hospitals recording resources and organisation. Over an 8-week period 11,564 consecutive ECOPD admissions to 129 Spanish hospitals covering 70% of the Spanish population were prospectively identified. At hospital discharge, 5,178 patients (45% of eligible) were finally included, and thus constituted the audited population. Audited patients were reassessed 90 days after admission for survival and readmission rates. A wide variability was observed in relation to most variables, hospital adherence to guidelines, and readmissions and death. Median inpatient mortality was 5% (across-hospital range 0-35%). Among discharged patients, 37% required readmission (0-62%) and 6.5% died (0-35%). The overall mortality rate was 11.6% (0-50%). Hospital size and complexity and aspects related to hospital COPD awareness were significantly associated with case recruitment. Clinical management most often complied with diagnosis and treatment recommendations but rarely (, This work was supported by Fondo de Investigacion Sanitaria (FIS), Instituto de Salud Carlos III, Ministerio de Ciencia e Innovacion (PI 08/90129, PI 90486, PI08/90578, PI 07/90503, PI 08/90251, PI 07/90516, PI 08/90529, PI 07/90309, PI 08/90457, PI 08/90129, PI 07/90721, PI 08/90550, PI08/90447, PI07/90403, PI 08/90486), Spanish Respiratory Society (SEPAR) and CIBER de Enfermedades Respiratorias (CIBERES). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Journal Article; OBJECTIVES To assess the relationship between life styles and eating habits with the overweight and obesity prevalence in a Spanish adult population. METHODS A population-based, cross-sectional study conducted on 2640 subjects older than 15 years, in Cádiz (Spain). Surveys were conducted in subjects' homes to obtain life styles, eating habits, and anthropometric data. Logistic regression has been used to study the association between the life style variables and overweight and obesity. RESULTS Prevalence of overweight and obesity in Cadiz is 37% and 17%, respectively; higher in males and increases with age. BMI has an inverse relationship with educational level (PR = 2.3, 1.57-2.38). The highest levels of obesity are associated with daily alcohol consumption (PR = 1.39, 1.29-1.50), greater consumption of television,and sedentary pursuit (PR 1.5, 1.07-1.24). A lower prevalence of obesity is observed among those with active physical activity (10.9% vs 21.6%), with differences between sex. Following a slimming diet is more frequent in the obese and in women but dedicate more hours than men to passive activities. In men is greater the consumption of alcohol, high energy foods and snacks. Overweight and obesity is associated with the male sex (OR = 3.35 2.75-4.07), high consumption of alcohol (OR = 1.38 1.03-1.86) and watching television (OR = 1.52 1.11-2.07), and foods likes bread and cereals (OR = 1.47 1.13-1.91). Exercise activities is a protective factor (OR = 0.76 0.63-0.98). CONCLUSIONS Life styles factors associated with overweight and obesity present different patterns in men and women and is necessary to understand them to identify areas for behavioural intervention in overweight and obesity patients. Yes Resumen Objetivo: Valorar la relación existente entre estilos de vida y hábitos alimentarios con la prevalencia de sobrepeso y obesidad en una población adulta española. Método: Estudio transversal de base poblacional realizado en 2.640 adultos mayores de 15 años en Cádiz(España). El estudio se llevó a cabo en el domicilio de los sujetos, recogiéndose mediante una encuesta los hábitos alimentarios y características de los estilos de vida. Resultados: La prevalencia de sobrepeso y obesidad en Cádiz es de 37% y 17% respectivamente, mayor en varones e incrementándose con la edad. El IMC muestra una relación inversa con el nivel educativo (RP = 2,3, 1,57- 2,38). Los mayores niveles de obesidad se asocian al consumo diario de alcohol (RP = 1,39, 1,29-1,50), mayor consumo de televisión y hábitos sedentarios (RP = 1,5, 1,07-1,24). Las menores cifras de prevalencia de obesidad se observan en los sujetos con una mayor actividad física (10,9% frente a 21,6%), aunque con diferencias entre sexos. Las mujeres dedican más horas que los hombres a actividades pasivas. Seguir dietas de adelgazamientos es mas frecuente en sujetos obesos y en mujeres. En hombres es mayor el consumo de alcohol, alimentos con elevado contenido calórico y comer entre horas. La presencia de sobrepeso y la obesidad se asocia con el sexo masculino (OR = 3,35 2,75-4,07), elevado consumo de alcohol (OR = 1,38 1,03-1,86) y televisión (OR = 1,52 1,11- 2,07), y con mayores consumos de alimentos del grupo de cereales y pan (OR = 1,47 1,13-1,91). La actividad física se comporta como factor protector (OR = 0,76 0,63-0,98). Conclusiones: Los estilos de vida asociados con el sobrepeso y la obesidad presentan diferentes patrones en hombres y mujeres. Es necesario estudiarlos para identificar áreas de intervención en pacientes con sobrepeso y obesidad.