Search

Jessica González, 1 Pilar Rivera-Ortega, 1 Macarena Rodríguez-Fraile, 2 Patricia Restituto, 3 Inmaculada Colina, 4 María de los Desamparados Calleja, 5 Ana B Alcaide, 1 Aránzazu Campo, 1 Juan Bertó, 1 Luis Seijo, 6 Maria Teresa Pérez-Warnisher, 6 Javier J Zulueta, 1 Nerea Varo, 3 Juan P de-Torres 7 1Pulmonary Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain; 2Nuclear Medicine Department, Clínica Universidad de Navarra, Pamplona, Spain; 3Biochemistry Department, Clínica Universitaria de Navarra, Pamplona, Spain; 4Department of Internal Medicine, Clínica Universidad de Navarra, Pamplona, Spain; 5Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, Pamplona, Spain; 6Pulmonary Department, Clínica Universidad de Navarra, Madrid, Spain; 7Respirology Division, Queen’s University, Kingston, ON, CanadaCorrespondence: Jessica GonzálezPulmonary department, Hospital Universitari Arnau de Vilanova, Lleida, SpainEmail jgonzalezgutierrez@gmail.comRationale: Emphysema and osteoporosis are tobacco-related diseases. Many studies have shown that emphysema is a strong and independent predictor of low bone mineral density (BMD) in smokers; however, none of them explored its association with different emphysema subtypes.Objective: To explore the association between the different emphysema subtypes and the presence of low bone mineral density in a population of active or former smokers with and without chronic obstructive pulmonary disease (COPD).Methods: One hundred and fifty-three active and former smokers from a pulmonary clinic completed clinical questionnaires, pulmonary function tests, a low-dose chest computed tomography (LDCT) and a dual-energy absorptiometry (DXA) scans. Subjects were classified as having normal BMD or low BMD (osteopenia or osteoporosis). Emphysema was classified visually for its subtype and severity. Logistic regression analysis explored the relationship between the different emphysema subtypes and the presence of low BMD adjusting for other important factors.Results: Seventy-five percent of the patients had low BMD (78 had osteopenia and 37 had osteoporosis). Emphysema was more frequent (66.1 vs 26.3%, p=< 0.001) and severe in those with low BMD. Multivariable analysis adjusting for other significant cofactors (age, sex, FEV 1, and severity of emphysema) showed that BMI (OR=0.91, 95% CI: 0.76– 0.92) and centrilobular emphysema (OR=26.19, 95% CI: 1.71 to 399.44) were associated with low BMD.Conclusion: Low BMD is highly prevalent in current and former smokers. BMI and centrilobular emphysema are strong and independent predictors of its presence, which suggests that they should be considered when evaluating smokers at risk for low BMD.Keywords: emphysema, COPD, low bone mineral density, osteopenia, osteoporosis; smokers

Additional file 1. Additional Tables.

Objective To determine the economically justifiable price (EJP) of cenobamate to become a cost-effective alternative compared with third-generation anti-seizure medications in the treatment of focal-onset seizures (FOS) in adult patients with drug-resistant epilepsy (DRE) in Spain. Methods Cost-effectiveness analysis compared cenobamate with brivaracetam, perampanel, eslicarbazepine acetate, and lacosamide. Markov model simulation of treatment pathway over a 60-year time horizon is presented. We determined the effectiveness and quality-adjusted life-years (QALYs) of health status and disutilities associated with treatment-related adverse events. Acquisition costs and use of medical resources were obtained from published literature and expert opinion. Base-case of cenobamate's EJP calculated applying a willingness-to-pay (WTP) threshold of euro21,000/QALY. Analyses were performed at different thresholds, including dominant price scenario. Result robustness was assessed through sensitivity analyses. Results Base-case shows that cenobamate's daily EJP of euro7.30 is cost-effective for a threshold of euro21,000/QALY. At a daily price of euro5.45, cenobamate becomes dominant over all treatment alternatives producing cost-savings for the national health system (NHS). Sensitivity analyses supported the robustness of base-case findings. Conclusions Treatment with cenobamate produces incremental clinical benefit over third-generation ASMs, and at the base-case, EJP could represent a cost-effective option for the adjunctive treatment of FOS in adult patients with DRE in Spain.

Objectives To determine whether nutritional risk is associated with the mortality of elderly patients hospitalized with nonvalvular atrial fibrillation (NVAF). Design Prospective, multicenter cohort study. Setting Internal medicine departments in Spain. Participants Inpatients >75 years with NVAF. Measurements We measured the thrombotic and hemorrhagic risk at admission using the CHA2DS2-VASc and HAS-BLED scales, respectively, and the nutritional risk with the controlling nutritional status (CONUT) index. We established 4 degrees of nutritional risk: null (CONUT score 0-1 point), low (2-4 points), moderate (5-8 points) and high (9-12 points). We also conducted a 1-year follow-up. Results We included 449 patients, with a mean age of 85.2(5.2) years. The nutritional risk was null for 70(15.6%) patients, low for 206 45.9%), moderate for 152(33.8%) and high for 21(4.7%). At the end of one year, 177(39.4%) patients had died. The score on the CONUT index was higher for the deceased patients (4.6 vs. 3.6, p

Introducción: la enuresis nocturna (EN) es un problema de salud infantil frecuente, con repercusión personal y social, que requiere un manejo adecuado y personalizado por parte de los profesionales sanitarios. Se ha realizado un estudio cuyo objetivo es establecer la prevalencia de EN en la ciudad de Burgos (España) en población pediátrica entre siete y diez años de edad. Pacientes y métodos: estudio observacional transversal en el que se han obtenido datos de una muestra aleatoria de niños escolarizados entre segundo y quinto curso de Educación Primaria Obligatoria en la ciudad de Burgos mediante la cumplimentación de una encuesta. Resultados: se ha obtenido una prevalencia de EN del 7,3%. La EN es más frecuente en varones, con antecedentes familiares de enuresis nocturna, con algún tipo de enfermedad crónica, que asocian trastornos del sueño y del comportamiento y con bajo rendimiento escolar. Conclusiones: la prevalencia es menor a la de otras poblaciones de características similares. Los niños con EN de Burgos presentan características epidemiológicas semejantes a las de otras poblaciones. La EN es un problema de salud infradiagnosticado en nuestro medio. Introduction: nocturnal enuresis (NE) is a common childhood health condition. This problem causes personal and social repercussion. The health professionals have to make an individualized and adequate management of this problem. The aim of this study is to know the prevalence of NE in children between seven and ten years old of the city of Burgos. Patients and methods: to this end, we have designed an observational and transversal study. We have selected a random sample of school children in Burgos between 2nd and 5th year of Obligatory Primary Education. They have completed a questionnaire. Results: the prevalence of NE was 7.3%. NE is more frequent in males and children with familiar precedents of NE, with some type of chronic illness, with associated disorders of the sleep and behavior and with low academic performance. Conclusions: the prevalence of NE in children in Burgos city is lower than in another child groups of similar characteristics. There is a low diagnosis rate of NE in Burgos city.

Siliceous aggregates are characterized for presenting certain chemical reactivity opposite to the calcium hydroxide liberated in the hydration of the Portland cement. The consequence of this reaction between the aggregate and the components of the intermediate concrete phase is the formation of gels very eager for water that can generate important disruptive pressures in the deeper structure of concrete. We have assessed the potential reactivity of several siliceous aggregates (granites, gneiss, hornfels, granites, quartzite and serpentine) by means of the accelerated method in concrete bars (normalized method) and the superficial reactivity method, observing by scanning electron microscopy (SEM) the formation of silica calcium alkaline gels. On the other hand, we explore the way of minimizing this disruptive reaction employing ground clay bricks and cement type CEM IV UNE-EN 197-1. Los áridos silíceos se caracterizan por reaccionar con el hidróxido cálcico liberado en el proceso de hidratación del cemento, lo que debido a su elevada avidez por el agua genera geles expansivos, que provocan importantes tensiones disruptivas en el seno del hormigón. En este trabajo hemos evaluado la reactividad potencial de varios áridos silíceos (granitos, gneis, corneanas, granitos, cuarcita y serpentina) mediante el método acelerado de barras de mortero (normalizado), y el método de reactividad superficial, observando los geles silicocalcoalcalinos formados mediante microscopía electrónica de barrido (SEM). Por otra parte, aportamos dos vías de minimización de esta reacción disruptiva, empleando ladrillo cerámico molido en un caso, y cemento CEM IV UNE-EN 197-1 en el otro.

Andesitic rocks produce an alkali-silica reaction with the components of the interstitial phase of concrete. This reaction can be considered as belonging to the slow-kinetic type, since the incongruent dissolution of the rock-forming minerals leads to the late formation of siliceous calc-alkaline gel. As a conquence, the conventional mortar-bar method does not detect such reaction until 90 days later. Las rocas andesíticas producen una reacción álcalis-sílice con los componentes de la fase intersticial del hormigón. Esta reacción puede encuadrarse dentro de las de cinética lenta, ya que la disolución incongruente de los minerales constituyentes de las rocas, da lugar a la formación tardía de geles silicocalco-alcalinos. En consecuencia, la utilización convencional del método de ensayo de barras de mortero no detecta la reacción hasta transcurridos al menos 90 días.

Air-sea CO2 exchange depends on the air-sea CO2 gradient and the gas transfer velocity (k), computed as a function of wind speed. Large discrepancies among relationships predicting k from wind suggest that other processes also contribute significantly to modulate CO2 exchange. Here we report, on the basis of the relationship between the measured gas transfer velocity and the organic carbon concentration at the ocean surface, a significant role of surface organic matter in suppressing air-sea gas exchange, at low and intermediate winds, in the open ocean, confirming previous observations. The potential role of total surface organic matter concentration (TOC) on gas transfer velocity (k) was evaluated by direct measurements of air-sea CO2 fluxes at different wind speeds and locations in the open ocean. According to the results obtained, high surface organic matter contents may lead to lower air-sea CO2 fluxes, for a given air-sea CO2 partial pressure gradient and wind speed below 5 m s−1, compared to that observed at low organic matter contents. We found the bias in calculated gas fluxes resulting from neglecting TOC to co-vary geographically and seasonally with marine productivity. These results support previous evidences that consideration of the role of organic matter in modulating air-sea CO2 exchange may improve flux estimates and help avoid possible bias associated to variability in surface organic concentration across the ocean.

Objetivo: El dolor es una de las causas de consulta más frecuente en los centros de atención primaria. Aproximadamente la mitad de la población sufre crisis de dolor alguna vez al año, y un tercio de la misma sufre dolor crónico. Los objetivos del estudio son describir la incidencia y tipos de problemas relacionados con los medicamentos (PRM) de la terapia antiálgica con fentanilo transdérmico en pacientes hospitalizados, las intervenciones farmacéuticas realizadas, su aceptación por parte de los clínicos y su resolución. También comparar la incidencia de PRM, de intervenciones farmacéuticas, su aceptación y resolución según las variables: servicio clínico y diagnóstico, oncológico o no. Material y método: Evaluación y detección de PRM en pacientes que inician tratamiento con fentanilo transdérmico (FT) en un hospital de tercer nivel. El seguimiento de los pacientes fue de 7 días o superior hasta resolución de los PRM. Para la valoración del dolor se utilizó la Escala Visual Analógica (EVA). Resultados: Se estudiaron 30 pacientes, 129 pacientes-día. Se detectaron un total de 51 PRM. La incidencia de PRM ha sido mayor en pacientes con dolor de origen no oncológico (p

Objetivo: El dolor es una de las causas de consulta más frecuente en los centros de atención primaria. Aproximadamente la mitad de la población sufre crisis de dolor alguna vez al año, y un tercio de la misma sufre dolor crónico. Los objetivos del estudio son describir la incidencia y tipos de problemas relacionados con los medicamentos (PRM) de la terapia antiálgica con fentanilo transdérmico en pacientes hospitalizados, las intervenciones farmacéuticas realizadas, su aceptación por parte de los clínicos y su resolución. También comparar la incidencia de PRM, de intervenciones farmacéuticas, su aceptación y resolución según las variables: servicio clínico y diagnóstico, oncológico o no. Material y método: Evaluación y detección de PRM en pacientes que inician tratamiento con fentanilo transdérmico (FT) en un hospital de tercer nivel. El seguimiento de los pacientes fue de 7 días o superior hasta resolución de los PRM. Para la valoración del dolor se utilizó la Escala Visual Analógica (EVA). Resultados: Se estudiaron 30 pacientes, 129 pacientes-día. Se detectaron un total de 51 PRM. La incidencia de PRM ha sido mayor en pacientes con dolor de origen no oncológico (p

Planktonic and benthic incubations (bare and Posidonia oceanica vegetated sediments) were performed at monthly intervals from March 2001 to October 2002 in a seagrass vegetated area of the Bay of Palma (Mallorca, Spain). Results showed a contrast between the planktonic compartment, which was on average near metabolic balance (-4.6±5.9 mmol O2 m-2 d -1) and the benthic compartment, which was autotrophic (17.6±8.5 mmol O2 m-2 d-1). During two cruises in March and June 2002, planktonic and benthic incubations were performed at several stations in the bay to estimate the whole-system metabolism and to examine its relationship with partial pressure of CO-2 (pCO-2) and apparent oxygen utilisation (AOU) spatial patterns. Moreover, during the second cruise, when the residence time of water was long enough, net ecosystem production (NEP) estimates based on incubations were compared, over the Posidonia oceanica meadow, to rates derived from dissolved inorganic carbon (DIC) and oxygen (O2) mass balance budgets. These budgets provided NEP estimates in fair agreement with those derived from direct metabolic estimates based on incubated samples over the Posidonia oceanica meadow. Whereas the seagrass community was autotrophic, the excess organic carbon production therein could only balance the planktonic heterotrophy in shallow waters relative to the maximum depth of the bay (55 m). This generated a horizontal gradient from autotrophic or balanced communities in the shallow seagrass-covered areas, to strongly heterotrophic communities in deeper areas of the bay. It seems therefore that, on an annual scale in the whole bay, the organic matter production by the Posidonia oceanica may not be sufficient to fully compensate the heterotrophy of the planktonic compartment, which may require external organic carbon inputs, most likely from land.

Analizamos secuencias genÛmicas de variantes mexi- canas del HPV-16, 18, 31 y 35. Entre 112 muestras HPV-16 se detectaron catorce variantes E y 98 AA. Entre 15 muestras HPV-18, trece E y dos africanas. Se construyeron árboles filogenÈticos con las varian- tes del HPV-31 y 35. En 46 asilados HPV-31 se detectaron 35 cambios nucleotÌdicos. En 27 muestras HPV-35 se detectaron once mutaciones. La alta prevalencia de las variantes carcinogÈnicas AA del HPV- 16 y la extensiva diversidad de las variantes del HPV18, 31 y 35, con propiedades patogÈnicas, originan la posibilidad de que la variaciÛn intratÌpica contribuya a la alta carga de c·ncer cervical en MÈxico.

In this article we describe the eMinerals mini grid, which is now running in production mode. Thisis an integration of both compute and data components, the former build upon Condor, PBS and thefunctionality of Globus v2, and the latter being based on the combined use of the Storage ResourceBroker and the CCLRC data portal. We describe how we have integrated the middleware components,and the different facilities provided to the users for submitting jobs within such an environment. We willalso describe additional functionality we found it necessary to provide ourselves.

La herbivoría en aves es una estrategia poco común. Solo el 3% de las aves actuales consumen plantas como fuente de energía. Tanto la composición química de las plantas como las restricciones asociadas al vuelo y digestión en aves pueden explicar el reducido número de pequeños endotermos, como las aves, que son herbívoros. Nuestro objetivo es explicar como las aves herbívoras satisfacen sus requerimientos nutricionales y energéticos cuando consumen dietas extremadamente pobres. Para lo cual nos centramos en Phytotoma rara (Phytotomidae), posiblemente el ave herbívora más pequeña. Phytotoma rara presenta numerosas características, como el rápido tiempo de transito, un efectivo rompimiento de la pared celular, y la alta y constante actividad de las enzimas digestivas, que le permiten disponer de nutrientes y energía celulares, sin los costos energéticos asociados al desarrollo de estructuras anatómicas de fermentación bacteriana o lentos tiempos de transito. Estos son posiblemente adaptaciones cruciales en la evolución de la herbivoría en aves pequeñas. Herbivory is a rare strategy in birds. Only 3% of extant birds exploit plant material as an energy source. Both plant chemical composition and bird constraints associated to flight and digestion may explain why herbivory is so scarce in small endotherms such as birds. Here we tackle the question of how herbivorous birds meet energy/nutrient requirements when feeding on extremely poor diets. We focus on Phytotoma rara (Phytotomidae), possibly the smallest herbivorous bird. From our mini-review we conclude that several features such as the fast passage rates, an effective physical breakdown of cell walls, and constant and high activities of digestive enzymes make available the highly nutritious cell contents to the small herbivore, without the energy costs of anatomical structures for bacterial fermentation or slow passage rates. These are possible crucial adaptations in the evolution of herbivory in small birds.