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101. Variability in the recommendations for the clinical management of osteoporosis

Author

Sanfélix-Genovés J, Catalá-López F, Sanfélix-Gimeno G, Hurtado I, Baixauli C, and Peiró S

Abstract

Background and objective: Analysis of the variability in the recommendations of the main guidelines and clinical documents for the management of osteoporosis. Material and method: Searches were carried out in PubMed. Google, web pages of national and international scientific societies related to the management of osteoporosis, and agencies that develop guidelines. We analyzed guidelines and clinical documents that included recommendations for the indication of bone densitometry and/or pharmacological treatment, which could influence the management of osteoporosis in the Spanish National Health System, which have been published between 2006 and 2012. Results: We included 12 documents. Eleven recommend performing bone densitometry upon assessing women risk factors, but the number and type of risk factors vary between documents: 6 recommend its implementation to all women over 65 years, 4 in men aged 65-70 years, and 3 when there is radiological suspicion of osteoporosis. There is agreement on the recommendations on the indication for densitometry to monitor drug response. In primary prevention, all national documents combined risk factors and densitometric osteoporosis and 3 of them recommend individual assessment according to risk factors. Most of the international guidelines require the calculation of risk with the FRAX (R) tool. In secondary prevention, all documents recommend treatment in cases of hip or clinical vertebral fracture; in men, and for the rest of fractures, the recommendations are heterogeneous. Conclusions: Overall there is a high variability in the recommendations of guidelines and other documents for the management of osteoporosis. (C) 2012 Elsevier Espana, S.L All rights reserved.

Published
2014

102. Impact on the Population of Different Bone Mineral Density Testing Criteria and Appropriateness of Densitometries in the ESOSVAL Cohort, Spain

Author

Hurtado I, Sanfélix-Gimeno G, Baixauli-Pérez C, Peiró S, and Sanfélix-Genovés J

Abstract

Context: There is little consensus regarding which individuals should be recommended for bone mineral density (BMD) testing, a situation that could eventually affect the appropriateness of routine clinical practice. Objectives: The aim of this study was to estimate the impact on the population of the application of the BMD testing criteria provided by the National Osteoporosis Guideline Group (NOGG), National Osteoporosis Foundation (NOF), and Osteoporosis Canada and to assess the appropriateness of the BMD tests currently performed. Design: A cross-sectional study was conducted using the baseline data of the ESOSVAL cohort. Participants: Participants included 11 035 men and women aged 50 years old and over attending primary health care centers in the Valencia region, Spain (2009-2010). Main Outcome and Measures: BMD testing by dual-energy X-ray absorptiometry was recorded. Results: Of the 10 710 people included in the study, 1617 (15.1%; 95% confidence interval [ CI]: 14.4-15.8) received a BMD test. When applying the NOGG criteria, BMD testing would be recommended in 17.4% (95% CI: 16.7-18.1) of individuals, whereas this percentage would rise to 74.6% (95% CI: 73.7-75.4) and 80.1% (95% CI: 79.4-80.9) when using the Osteoporosis Canada and the NOF criteria, respectively. Regarding the appropriateness of the BMD tests performed in the ESOSVAL cohort, 40.7% (95% CI: 38.3-43.1), 86.0% (95% CI: 84.3-87.7), and 82.2% (95% CI: 80.3-84.1) of individuals having a BMD test met the NOGG, NOF, and the Canadian guidelines criteria, respectively. Of the tests performed, 40.7% would be deemed as appropriate, whereas 10.7% would be considered inappropriate. Conclusions: The impact on the population of the different recommendations is enormous, varying from 17% to 80% of the population over 50 who would be tested. Although in men it seems that a clinical rationale exists between the presence of risk factors and the rates of BMD testing, this pattern does not seem to exist in women. One in 10 of the densitometric tests performed were inappropriate according to all the guidelines.

Published
2014

103. Opportunistic infections and AIDS malignancies early after initiating combination antiretroviral therapy in high-income countries

Author

Lodi, Sara, Del Amo, Julia, Moreno, Santiago, Bucher, H. C., Furrer, Hansjakob, Logan, Roger, Sterne, Jonathan, Pérez-Hoyos, Santiago, Jarrín, Inma, Phillips, Andrew, Olson, Ashley, Van Sighem, Ard, Reiss, Peter, Sabin, C., Jose, Sophie, Justice, Amy, Goulet, Joseph, Miró, José M., Ferrer, Elena, Meyer, Laurence, Seng, Rémonie, Vourli, Georgia, Antoniadou, Anastasia, Dabis, Francois, Vandenhede, Mari Anne, Costagliola, Dominique, Abgrall, S., Hernán, Miguel A., Hernan, Miguel, Bansi, L., Hill, T., Dunn, D., Porter, K., Glabay, A., Orkin, C., Thomas, R., Jones, K., Fisher, M., Perry, N., Pullin, A., Churchill, D., Gazzard, B., Nelson, M., Asboe, D., Bulbeck, S., Mandalia, S., Clarke, J., Delpech, V., Anderson, J., Munshi, S., Post, F., Easterbrook, P., Khan, Y., Patel, P., Karim, F., Duffell, S., Gilson, R., Man, S. L., Williams, I., Gompels, M., Dooley, D., Schwenk, A., Ainsworth, J., Johnson, M., Youle, M., Lampe, F., Smith, C., Grabowska, H., Chaloner, C., Ismajani Puradiredja, D., Phillips, A., Walsh, J., Weber, J., Kemble, C., Mackie, N., Winston, A., Leen, C., Wilson, A., Bezemer, D. O., Gras, L. A.J., Kesselring, A. M., Van Sighem, A. I., Zaheri, S., Van Twillert, G., Kortmann, W., Branger, J., Prins, J. M., Kuijpers, T. W., Scherpbier, H. J., Van Der Meer, J. T.M., Wit, F. W.M.N., Godfried, M. H., Reiss, P., Van Der Poll, T., Nellen, F. J.B., Lange, J. M.A., Geerlings, S. E., Van Vugt, M., Pajkrt, D., Bos, J. C., Van Der Valk, M., Grijsen, M. L., Wiersinga, W. J., Brinkman, K., Blok, W. L., Frissen, P. H.J., Schouten, W. E.M., Van Den Berk, G. E.L., Veenstra, J., Lettinga, K. D., Mulder, J. W., Vrouenraets, S. M.E., Lauw, F. N., Van Eeden, A., Verhagen, D. W.M., Van Agtmael, M. A., Perenboom, R. M., Claessen, F. A.P., Bomers, M., Peters, E. J.G., Richter, C., Van Der Berg, J. P., Gisolf, E. H., Schippers, E. F., Van Nieuwkoop, C., Van Elzakker, E. P., Leyten, E. M.S., Gelinck, L. B.S., Pronk, M. J.H., Bravenboer, B., Kootstra, G. J., Delsing, C. E., Sprenger, H. G., Doedens, R., Scholvinck, E. H., Van Assen, S., Bierman, W. F.W., Soetekouw, R., Ten Kate, R. W., Van Vonderen, M. G.A., Van Houte, D. P.F., Kroon, F. P., Van Dissel, J. T., Arend, S. M., De Boer, M. G.J., Jolink, H., Ter Vollaard, H. J.M., Bauer, M. P., Weijer, S., El Moussaoui, R., Lowe, S., Schreij, G., Oude Lashof, A., Posthouwer, D., Koopmans, P. P., Keuter, M., Van Der Ven, A. J.A.M., Ter Hofstede, H. J.M., Dofferhoff, A. S.M., Warris, A., Van Crevel, R., Van Der Ende, M. E., De Vries-Sluijs, T. E.M.S., Schurink, C. A.M., Nouwen, J. L., Nispen Tot Pannerden, M. H., Verbon, A., Rijnders, B. J.A., Van Gorp, E. C.M., Hassing, R. J., Smeulders, A. W.M., Hartwig, N. G., Driessen, G. J.A., Den Hollander, J. G., Pogany, K., Juttmann, J. R., Van Kasteren, M. E.E., Hoepelman, A. I.M., Mudrikova, T., Schneider, M. M.E., Jaspers, C. A.J.J., Ellerbroek, P. M., Oosterheert, J. J., Arends, J. E., Wassenberg, M. W.M., Barth, R. E., Geelen, S. P.M., Wolfs, T. F.W., Bont, L. J., Van Den Berge, M., Stegeman, A., Groeneveld, P. H.P., Alleman, M. A., Bouwhuis, J. W., Barin, F., Burty, C., Duvivier, C., Enel, P., Fredouille-Heripret, L., Gasnault, J., Khuong, M. A., Mahamat, A., Pilorgé, F., Tattevin, P., Salomon, Valérie, Jacquemet, N., Costagliola, D., Grabar, S., Guiguet, M., Lanoy, E., Lièvre, L., Mary-Krause, M., Selinger-Leneman, H., Lacombe, J. M., Potard, V., Bricaire, F., Herson, S., Katlama, C., Simon, A., Desplanque, N., Girard, P. M., Meynard, J. L., Meyohas, M. C., Picard, O., Cadranel, J., Mayaud, C., Pialoux, G., Clauvel, J. P., Decazes, J. M., Gérard, L., Molina, J. M., Diemer, M., Sellier, P., Bentata, M., Honoré, P., Jeantils, V., Tassi, S., Mechali, D., Taverne, B., Bouvet, E., Crickx, B., Ecobichon, J. L., Matheron, S., Picard-Dahan, C., Yeni, P., Berthé, H., Dupont, C., Chandemerle, C., Mortier, E., De Truchis, P., Tisne-Dessus, D., Weiss, L., Salmon, D., Auperin, I., Gilquin, J., Roudière, L., Viard, J. P., Boue, F., Fior, R., Delfraissy, J. F., Goujard, C., Jung, C., Lesprit, Ph, Vittecoq, D., Fraisse, P., Lang, J. M., Rey, D., Beck-Wirth, G., Stahl, J. P., Lecercq, P., Gourdon, F., Laurichesse, H., Fresard, A., Lucht, F., Bazin, C., Verdon, R., Chavanet, P., Arvieux, C., Michelet, C., Choutet, P., Goudeau, A., Maître, M. F., Hoen, B., Eglinger, P., Faller, J. P., Borsa-Lebas, F., Caron, F., Reynes, J., Daures, J. P., May, T., Rabaud, C., Berger, J. L., Rémy, G., Arlet-Suau, E., Cuzin, L., Massip, P., Thiercelin Legrand, M. F., Pontonnier, G., Viget, N., Yasdanpanah, Y., Dellamonica, P., Pradier, C., Pugliese, P., Aleksandrowicz, K., Quinsat, D., Ravaux, I., Tissot-Dupont, H., Delmont, J. P., Moreau, J., Gastaut, J. A., Poizot Martin, I., Retornaz, F., Soubeyrand, J., Galinier, A., Ruiz, J. M., Allegre, T., Blanc, P. A., Bonnet-Montchardon, D., Lepeu, G., Granet-Brunello, P., Esterni, J. P., Pelissier, L., Cohen-Valensi, R., Nezri, M., Chadapaud, S., Laffeuillade, A., Billaud, E., Raffi, F., Boibieux, A., Peyramond, D., Livrozet, J. M., Touraine, J. L., Cotte, L., Trepo, C., Strobel, M., Bissuel, F., Pradinaud, R., Sobesky, M., Cabié, A., Gaud, C., Contant, M., Aubert, V., Barth, J., Battegay, M., Bernasconi, E., Böni, J., Burton-Jeangros, C., Calmy, A., Cavassini, M., Egger, M., Elzi, L., Fehr, J., Fellay, J., Furrer, H., Haerry, D., Fux, C. A., Gorgievski, M., Günthard, H., Hasse, B., Hirsch, H. H., Hösli, I., Kahlert, C., Kaiser, L., Keiser, O., Klimkait, T., Kovari, H., Ledergerber, B., Martinetti, G., Martinez De Tejada, B., Metzner, K., Müller, N., Nadal, D., Pantaleo, G., Rauch, A., Regenass, S., Rickenbach, M., Rudin, C., Schmid, P., Schultze, D., Schöni-Affolter, F., Schüpbach, J., Speck, R., Taffé, P., Tarr, P., Telenti, A., Trkola, A., Vernazza, P., Weber, R., Yerly, S., Casabona, J., Gallois, A., Esteve, A., Podzamczer, D., Murillas, J., Gatell, J. M., Manzardo, C., Tural, C., Clotet, B., Ferrer, E., Riera, M., Segura, F., Navarro, G., Force, L., Vilaró, J., Masabeu, A., García, I., Guadarrama, M., Cifuentes, C., Dalmau, D., Jaen, Agustí, C., Montoliu, A., Pérez, I., Gargoulas, Freyra, Blanco, J. L., Garcia-Alcaide, F., Martínez, E., Mallolas, J., López-Dieguez, M., García-Goez, J. F., Sirera, G., Romeu, J., Jou, A., Negredo, E., Miranda, C., Capitan, M. C., Saumoy, M., Imaz, A., Tiraboschi, J. M., Murillo, O., Bolao, F., Peña, C., Cabellos, C., Masó, M., Vila, A., Sala, M., Cervantes, M., Jose Amengual, Ma, Navarro, M., Penelo, E., Barrufet, P., Bejarano, G., Molina, J., Alvaro, M., Mercadal, J., Fernandez, Juanse, Ospina, Jesus E., Muñoz, M. A., Caro-Murillo, A. M., Sobrino, P., Jarrín, I., Gomez Sirvent, J. L., Rodríguez, P., Aleman, M. R., Alonso, M. M., Lopez, A. M., Hernandez, M. I., Soriano, V., Labarga, P., Barreiro, P., Medrano, J., Rivas, P., Herrero, D., Blanco, F., Vispo, M. E., Martín, L., Ramírez, G., De Diego, M., Rubio, R., Pulido, F., Moreno, V., Cepeda, C., Hervás, Rl, Iribarren, J. A., Arrizabalaga, J., Aramburu, M. J., Camino, X., Rodrí-guez-Arrondo, F., Von Wichmann, M. A., Pascual, L., Goenaga, M. A., Gutierrez, F., Masia, M., Ramos, J. M., Padilla, S., Sanchez-Hellín, V., Bernal, E., Escolano, C., Montolio, F., Peral, Y., Berenguer, J., Lopez, J. C., Miralles, P., Cosín, J., Sanchez, M., Gutierrez, I., Ramírez, M., Padilla, B., Vidal, F., Sanjuan, M., Peraire, J., Veloso, S., Vilades, C., Lopez-Dupla, M., Olona, M., Vargas, M., Aldeguer, J. L., Blanes, M., Lacruz, J., Salavert, M., Montero, M., Cuéllar, S., De Los Santos, I., Sanz, J., Oteo, J. A., Blanco, J. R., Ibarra, V., Metola, L., Sanz, M., Pérez-Martínez, L., Sola, J., Uriz, J., Castiello, J., Reparaz, J., Arriaza, M. J., Irigoyen, C., Moreno, S., Antela, A., Casado, J. L., Dronda, F., Moreno, A., Pérez, M. J., López, D., Gutiérrez, C., Hernández, B., Pumares, M., Martí, P., García, L., Page, C., García, F., Hernández, J., Peña, A., Muñoz, L., Parra, J., Viciana, P., Leal, M., López-Cortés, L. F., Trastoy, M., Mata, R., Justice, A. C., Fiellin, D. A., Rimland, D., Jones-Taylor, C., Oursler, K. A., Titanji, R., Brown, S., Garrison, S., Rodriguez-Barradas, M., Masozera, N., Goetz, M., Leaf, D., Simberkoff, M., Blumenthal, D., Leung, J., Butt, A., Hoffman, E., Gibert, C., Peck, R., Mattocks, K., Braithwaite, S., Brandt, C., Bryant, K., Cook, R., Conigliaro, J., Crothers, K., Chang, J., Crystal, S., Day, N., Erdos, J., Freiberg, M., Kozal, M., Gandhi, N., Gaziano, M., Gerschenson, M., Good, B., Gordon, A., Goulet, J. L., Hernán, M. A., Kraemer, K., Lim, J., Maisto, S., Miller, P., Mole, L., O'Connor, P., Papas, R., Robins, J. M., Rinaldo, C., Roberts, M., Samet, J., Tierney, B., Whittle, J., Babiker, A., Brettle, R., Darbyshire, J., Goldberg, D., Hawkins, D., Jaffe, H., Johnson, A., McLean, K., Pillay, D., Cursley, Adam, Ewings, Fiona, Fairbrother, Keith, Louisa Gnatiuc, S. L., Murphy, Brendan, Douglas, G., Kennedy, N., Pritchard, J., Andrady, U., Rajda, N., Maw, R., McKernan, S., Drake, S., Gilleran, G., White, D., Ross, J., Toomer, S., Hewart, R., Wilding, H., Woodward, R., Dean, G., Heald, L., Horner, P., Glover, S., Bansaal, D., Eduards, S., Carne, C., Browing, M., Das, R., Stanley, B., Estreich, S., Magdy, A., O'Mahony, C., Fraser, P., Hayman, B., Jebakumar, S. P.R., Joshi, U., Ralph, S., Wade, A., Mette, R., Lalik, J., Summerfield, H., El-Dalil, A., France, J. A., White, C., Robertson, R., Gordon, S., McMillan, S., Morris, S., Lean, C., Vithayathil, K., McLean, L., Winter, A., Gale, D., Jacobs, S., Tayal, S., Short, L., Green, S., Williams, G., Sivakumar, K., Bhattacharyya, N. D., Monteiro, E., Minton, J., Dhar, J., Nye, F., De Souza, C. B., Isaksen, A., McDonald, L., Franca, A., William, L., Jendrulek, I., Peters, B., Shaunak, S., El-Gadi, S., Easterbrook, P. J., Mazhude, C., Johnstone, R., Fakoya, A., McHale, J., Waters, A., Kegg, S., Mitchell, S., Byrne, P., Rice, P., Fidler, S., Mullaney, S. A., McCormack, S., David, D., Melville, R., Phillip, K., Balachandran, T., Mabey-Puttock, S., Sukthankar, A., Murphy, C., Wilkins, E., Ahmad, S., Haynes, J., Evans, E., Ong, E., Grey, R., Meaden, J., Bignell, C., Loay, D., Peacock, K., Girgis, M. R., Morgan, B., Palfreeman, A., Wilcox, J., Tobin, J., Tucker, L., Saeed, A. M., Chen, F., Deheragada, A., Williams, O., Lacey, H., Herman, S., Kinghorn, D., Devendra, V. S., Wither, J., Dawson, S., Rowen, D., Harvey, J., Bridgwood, A., Singh, G., Chauhan, M., Kellock, D., Young, S., Dannino, S., Kathir, Y., Rooney, G., Currie, J., FitzGerald, M., Devendra, S., Keane, F., Booth, G., Green, T., Arumainayyagam, J., Chandramani, S., Rajamanoharan, S., Robinson, T., Curless, E., Gokhale, R., Tariq, A., Luzzi, G., Fairley, I., Wallis, F., Smit, E., Ward, F., Loze, B., Morlat, P., Bonarek, M., Bonnet, F., Nouts, C., Louis, I., Reliquet, V., Sauser, F., Biron, C., Mounoury, O., Hue, H., Brosseau, D., Ghosn, J., Rannou, M. T., Bergmann, J. F., Badsi, E., Rami, A., Parrinello, M., Samanon-Bollens, D., Campa, P., Tourneur, M., Desplanques, N., Jeanblanc, F., Chiarello, P., Makhloufi, D., Blanc, A. P., Allègre, T., Baillat, V., Lemoing, V., Merle De Boever, C., Tramoni, C., Sobesky, G., Abel, S., Beaujolais, V., Slama, L., Chakvetadze, C., Berrebi, V., Fournier, I., Gerbe, J., Koffi, K., Augustin-Normand, C., Miailhes, P., Thoirain, V., Brochier, C., Souala, F., Ratajczak, M., Beytoux, J., Jacomet, C., Rouveix, E., Morelon, S., Olivier, C., Lortholary, O., Dupont, B., Maignan, A., Ragnaud, J. M., Raymond, I., Leport, C., Jadand, C., Jestin, C., Longuet, P., Boucherit, S., Sereni, D., Lascoux, C., Prevoteau, F., Sobel, A., Levy, Y., Lelievre, J. D., Lascaux, A. S., Dominguez, S., Dumont, C., Aumâitre, H., Delmas, B., Saada, M., Medus, M., Guillevin, L., Tahi, T., Yazdanpanah, Y., Pavel, S., Marien, M. C., Drenou, B., Beck, C., Benomar, M., Tubiana, R., Ait Mohand, H., Chermak, A., Ben Abdallah, S., Touam, F., Drobacheff, C., Folzer, A., Obadia, M., Prudhomme, L., Bonnet, E., Balzarin, F., Pichard, E., Chennebault, J. M., Fialaire, P., Loison, J., Galanaud, P., Boué, F., Bornarel, D., Six, M., Ferret, P., Batisse, D., Gonzales-Canali, G., Devidas, A., Chevojon, P., Turpault, I., Lafeuillade, A., Cheret, A., Philip, G., Morel, P., Timsit, J., Amirat, N., Brancion, C., Cabane, J., Tredup, J., Stein, A., Ravault, I., Chavanet, C., Buisson, M., Treuvetot, S., Nau, P., Bastides, F., Boyer, L., Wassoumbou, S., Oksenhendeler, E., Bernard, L., Domart, Y., Merrien, D., Greder Belan, A., Gayraud, M., Bodard, L., Meudec, A., Beuscart, C., Daniel, C., Pape, E., Vinceneux, P., Simonpoli, A. M., Zeng, A., Fournier, L., Fuzibet, J. G., Sohn, C., Rosenthal, E., Quaranta, M., Chaillou, S., Sabah, M., Audhuy, B., Schieber, A., Moreau, P., Niault, M., Vaillant, O., Huchon, G., Compagnucci, A., De Lacroix Szmania, I., Richier, L., Lamaury, I., Saint-Dizier, F., Garipuy, D., Drogoul, M. P., Fabre, G., Lambert De Cursay, G., Abraham, B., Perino, C., Lagarde, P., David, F., Roche-Sicot, J., Saraux, J. L., Leprêtre, A., Fampin, B., Uludag, A., Morin, A. S., Bletry, O., Zucman, D., Regnier, A., Girard, J. J., Quinsat, D. T., Heripret, L., Grihon, F., Houlbert, D., Ruel, M., Chemlal, K., Debab, Y., Tremollieres, F., Perronne, V., Slama, B., Perré, P., Miodovski, C., Guermonprez, G., Dulioust, A., Boudon, P., Malbec, D., Patey, O., Semaille, C., Deville, J., Remy, G., Béguinot, I., Chambrin, V., Pignon, C., Estocq, G. A., Levy, A., Duracinsky, M., Le Bras, P., Ngussan, M. S., Peretti, D., Medintzeff, N., Lambert, T., Segeral, O., Lezeau, P., Laurian, Y., Piketty, C., Karmochkine, M., Eliaszewitch, M., Jayle, D., Kazatchkine, M., Colasante, U., Duval, X., Nouaouia, W., Vilde, J. L., Bollens, D., Binet, D., Diallo, B., Fonquernie, L., Lagneau, J. L., Launay, O., Pietrie, M. P., Sicard, D., Stieltjes, N., Michot, J., Bourdillon, F., Obenga, G., Escaut, L., Bolliot, C., Schneider, L., Iguertsira, M., Tomei, C., Dhiver, C., Tissot Dupont, H., Vallon, A., Gallais, J., Gallais, H., Durant, J., Mondain, V., Perbost, I., Cassuto, J. P., Karsenti, J. M., Venti, H., Ceppi, C., Krivitsky, J. A., Bouchaud, O., Honore, P., Delgado, J., Rouzioux, C., Burgard, M., Boufassa, L., Peynet, J., Pérez-Hoyos, S., Del Amo, J., Alvarez, D., Monge, S., Muga, R., Sanvisens, A., Tor, J., Rivas, I., Vallecillo, G., Del Romero, J., Raposo, P., Rodríguez, C., Vera, M., Hurtado, I., Belda, J., Fernandez, E., Alastrue, I., Santos, C., Tasa, T., Juan, A., Trullen, J., Garcia De Olalla, P., Cayla, J., Masdeu, E., Knobel, H., Mirò, J. M., Sambeat, M. A., Guerrero, R., Rivera, E., Marco, A., Quintana, M., Gonzalez, C., Castilla, J., Guevara, M., De Mendoza, C., Zahonero, N., Ortíz, M., Paraskevis, D., Touloumi, G., Pantazis, N., Bakoyannis, G., Gioukari, V., Antoniadou, A., Papadopoulos, A., Petrikkos, G., Daikos, G., Psichogiou, M., Gargalianos-Kakolyris, P., Xylomenos, G., Katsarou, O., Kouramba, A., Ioannidou, P., Kordossis, T., Kontos, A., Lazanas, M., Chini, M., Tsogas, N., Panos, G., Paparizos, V., Leuow, K., Kourkounti, S., Sambatakou, H., Mariolis, I., Skoutelis, A., Papastamopoulos, V., Baraboutis, I., Internal medicine, APH - Aging & Later Life, Pediatric surgery, CCA - Innovative therapy, ICaR - Circulation and metabolism, ICaR - Ischemia and repair, Graduate School, Paediatric Infectious Diseases / Rheumatology / Immunology, Landsteiner Laboratory, AII - Amsterdam institute for Infection and Immunity, Infectious diseases, Global Health, Center of Experimental and Molecular Medicine, APH - Amsterdam Public Health, AII - Inflammatory diseases, and ARD - Amsterdam Reproduction and Development

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Opportunistic infection, AIDS-Related Opportunistic Infections, Immunology, Population, Retinitis, HIV Infections, Article, 17 Psychology And Cognitive Sciences, Young Adult, Immune reconstitution inflammatory syndrome, Antiretroviral Therapy, Highly Active, Neoplasms, Virology, Internal medicine, medicine, Humans, Immunology and Allergy, education, Inverse probability weighting, Aged, education.field_of_study, business.industry, Developed Countries, Incidence, Progressive multifocal leukoencephalopathy, Hazard ratio, HIV, virus diseases, 11 Medical And Health Sciences, Middle Aged, 06 Biological Sciences, medicine.disease, United States, Europe, Infectious Diseases, Anti-Retroviral Agents, Unmasking, Female, Cytomegalovirus retinitis, business
Abstract

Background: There is little information on the incidence of AIDS-defining events which have been reported in the literature to be associated with immune reconstitution inflammatory syndrome (IRIS) after combined antiretroviral therapy (cART) initiation. These events include tuberculosis, mycobacterium avium complex (MAC), cytomegalovirus (CMV) retinitis, progressive multifocal leukoencephalopathy (PML), herpes simplex virus (HSV), Kaposi sarcoma, non-Hodgkin lymphoma (NHL), cryptococcosis and candidiasis.Methods: We identified individuals in the HIV-CAUSAL Collaboration, which includes data from six European countries and the US, who were HIV-positive between 1996 and 2013, antiretroviral therapy naive, aged at least 18 years, hadCD4+ cell count and HIV-RNA measurements and had been AIDS-free for at least 1 month between those measurements and the start of follow-up. For each AIDS-defining event, we estimated the hazard ratio for no cART versus less than 3 and at least 3 months since cART initiation, adjusting for time-varying CD4+ cell count and HIV-RNA via inverse probability weighting.Results: Out of 96 562 eligible individuals (78% men) with median (interquantile range) follow-up of 31 [13,65] months, 55 144 initiated cART. The number of cases varied between 898 for tuberculosis and 113 for PML. Compared with non-cART initiation, the hazard ratio (95% confidence intervals) up to 3 months after cART initiation were 1.21 (0.90-1.63) for tuberculosis, 2.61 (1.05-6.49) for MAC, 1.17 (0.34-4.08) for CMV retinitis, 1.18 (0.62-2.26) for PML, 1.21 (0.83-1.75) for HSV, 1.18 (0.87-1.58) for Kaposi sarcoma, 1.56 (0.82-2.95) for NHL, 1.11 (0.56-2.18) for cryptococcosis and 0.77 (0.40-1.49) for candidiasis.Conclusion: With the potential exception of mycobacterial infections, unmasking IRIS does not appear to be a common complication of cART initiation in high-income countries.

Published
2014

104. Opportunistic infections and AIDS malignancies early after initiating combination antiretroviral therapy in high-income countries

Author

Lodi, S. Del Amo, J. Moreno, S. Bucher, H.C. Furrer, H. Logan, R. Sterne, J. Pérez-Hoyos, S. Jarrín, I. Phillips, A. Olson, A. Van Sighem, A. Reiss, P. Sabin, C. Jose, S. Justice, A. Goulet, J. Miró, J.M. Ferrer, E. Meyer, L. Seng, R. Vourli, G. Antoniadou, A. Dabis, F. Vandenhede, M.-A. Costagliola, D. Abgrall, S. Hernán, M.A. Hernan, M. Bansi, L. Hill, T. Sabin, C. Dunn, D. Porter, K. Glabay, A. Orkin, C. Thomas, R. Jones, K. Fisher, M. Perry, N. Pullin, A. Churchill, D. Gazzard, B. Nelson, M. Asboe, D. Bulbeck, S. Mandalia, S. Clarke, J. Delpech, V. Anderson, J. Munshi, S. Post, F. Easterbrook, P. Khan, Y. Patel, P. Karim, F. Duffell, S. Gilson, R. Man, S.-L. Williams, I. Gompels, M. Dooley, D. Schwenk, A. Ainsworth, J. Johnson, M. Youle, M. Lampe, F. Smith, C. Grabowska, H. Chaloner, C. Ismajani Puradiredja, D. Bansi, L. Hill, T. Phillips, A. Sabin, C. Walsh, J. Weber, J. Kemble, C. Mackie, N. Winston, A. Leen, C. Wilson, A. Bezemer, D.O. Gras, L.A.J. Kesselring, A.M. Van Sighem, A.I. Zaheri, S. Van Twillert, G. Kortmann, W. Branger, J. Prins, J.M. Kuijpers, T.W. Scherpbier, H.J. Van Der Meer, J.T.M. Wit, F.W.M.N. Godfried, M.H. Reiss, P. Van Der Poll, T. Nellen, F.J.B. Lange, J.M.A. Geerlings, S.E. Van Vugt, M. Pajkrt, D. Bos, J.C. Van Der Valk, M. Grijsen, M.L. Wiersinga, W.J. Brinkman, K. Blok, W.L. Frissen, P.H.J. Schouten, W.E.M. Van Den Berk, G.E.L. Veenstra, J. Lettinga, K.D. Mulder, J.W. Vrouenraets, S.M.E. Lauw, F.N. Van Eeden, A. Verhagen, D.W.M. Van Agtmael, M.A. Perenboom, R.M. Claessen, F.A.P. Bomers, M. Peters, E.J.G. Richter, C. Van Der Berg, J.P. Gisolf, E.H. Schippers, E.F. Van Nieuwkoop, C. Van Elzakker, E.P. Leyten, E.M.S. Gelinck, L.B.S. Pronk, M.J.H. Bravenboer, B. Kootstra, G.J. Delsing, C.E. Sprenger, H.G. Doedens, R. Scholvinck, E.H. Van Assen, S. Bierman, W.F.W. Soetekouw, R. Ten Kate, R.W. Van Vonderen, M.G.A. Van Houte, D.P.F. Kroon, F.P. Van Dissel, J.T. Arend, S.M. De Boer, M.G.J. Jolink, H. Ter Vollaard, H.J.M. Bauer, M.P. Weijer, S. El Moussaoui, R. Lowe, S. Schreij, G. Oude Lashof, A. Posthouwer, D. Koopmans, P.P. Keuter, M. Van Der Ven, A.J.A.M. Ter Hofstede, H.J.M. Dofferhoff, A.S.M. Warris, A. Van Crevel, R. Van Der Ende, M.E. De Vries-Sluijs, T.E.M.S. Schurink, C.A.M. Nouwen, J.L. Nispen Tot Pannerden, M.H. Verbon, A. Rijnders, B.J.A. Van Gorp, E.C.M. Hassing, R.J. Smeulders, A.W.M. Hartwig, N.G. Driessen, G.J.A. Den Hollander, J.G. Pogany, K. Juttmann, J.R. Van Kasteren, M.E.E. Hoepelman, A.I.M. Mudrikova, T. Schneider, M.M.E. Jaspers, C.A.J.J. Ellerbroek, P.M. Oosterheert, J.J. Arends, J.E. Wassenberg, M.W.M. Barth, R.E. Geelen, S.P.M. Wolfs, T.F.W. Bont, L.J. Van Den Berge, M. Stegeman, A. Groeneveld, P.H.P. Alleman, M.A. Bouwhuis, J.W. Barin, F. Burty, C. Duvivier, C. Enel, P. Fredouille-Heripret, L. Gasnault, J. Khuong, M.A. Mahamat, A. Pilorgé, F. Tattevin, P. Salomon, V. Jacquemet, N. Abgrall, S. Costagliola, D. Grabar, S. Guiguet, M. Lanoy, E. Lièvre, L. Mary-Krause, M. Selinger-Leneman, H. Lacombe, J.M. Potard, V. Bricaire, F. Herson, S. Katlama, C. Simon, A. Desplanque, N. Girard, P.M. Meynard, J.L. Meyohas, M.C. Picard, O. Cadranel, J. Mayaud, C. Pialoux, G. Clauvel, J.P. Decazes, J.M. Gerard, L. Molina, J.M. Diemer, M. Sellier, P. Bentata, M. Honoré, P. Jeantils, V. Tassi, S. Mechali, D. Taverne, B. Bouvet, E. Crickx, B. Ecobichon, J.L. Matheron, S. Picard-Dahan, C. Yeni, P. Berthé, H. Dupont, C. Chandemerle, C. Mortier, E. De Truchis, P. Tisne-Dessus, D. Weiss, L. Salmon, D. Auperin, I. Gilquin, J. Roudière, L. Viard, J.P. Boué, F. Fior, R. Delfraissy, J.F. Goujard, C. Jung, C. Lesprit, Ph. Vittecoq, D. Fraisse, P. Lang, J.M. Rey, D. Beck-Wirth, G. Stahl, J.P. Lecercq, P. Gourdon, F. Laurichesse, H. Fresard, A. Lucht, F. Bazin, C. Verdon, R. Chavanet, P. Arvieux, C. Michelet, C. Choutet, P. Goudeau, A. Maître, M.F. Hoen, B. Eglinger, P. Faller, J.P. Borsa-Lebas, F. Caron, F. Reynes, J. Daures, J.P. May, T. Rabaud, C. Berger, J.L. Rémy, G. Arlet-Suau, E. Cuzin, L. Massip, P. Thiercelin Legrand, M.F. Pontonnier, G. Viget, N. Yasdanpanah, Y. Dellamonica, P. Pradier, C. Pugliese, P. Aleksandrowicz, K. Quinsat, D. Ravaux, I. Tissot-Dupont, H. Delmont, J.P. Moreau, J. Gastaut, J.A. Poizot-Martin, I. Retornaz, F. Soubeyrand, J. Galinier, A. Ruiz, J.M. Allegre, T. Blanc, P.A. Bonnet-Montchardon, D. Lepeu, G. Granet-Brunello, P. Esterni, J.P. Pelissier, L. Cohen-Valensi, R. Nezri, M. Chadapaud, S. Laffeuillade, A. Billaud, E. Raffi, F. Boibieux, A. Peyramond, D. Livrozet, J.M. Touraine, J.L. Cotte, L. Trepo, C. Strobel, M. Bissuel, F. Pradinaud, R. Sobesky, M. Cabié, A. Gaud, C. Contant, M. Aubert, V. Barth, J. Battegay, M. Bernasconi, E. Böni, J. Bucher, H.C. Burton-Jeangros, C. Calmy, A. Cavassini, M. Egger, M. Elzi, L. Fehr, J. Fellay, J. Furrer, H. Haerry, D. Fux, C.A. Gorgievski, M. Günthard, H. Hasse, B. Hirsch, H.H. Hösli, I. Kahlert, C. Kaiser, L. Keiser, O. Klimkait, T. Kovari, H. Ledergerber, B. Martinetti, G. Martinez De Tejada, B. Metzner, K. Müller, N. Nadal, D. Pantaleo, G. Rauch, A. Regenass, S. Rickenbach, M. Rudin, C. Schmid, P. Schultze, D. Schöni-Affolter, F. Schüpbach, J. Speck, R. Taffé, P. Tarr, P. Telenti, A. Trkola, A. Vernazza, P. Weber, R. Yerly, S. Casabona, J. Gallois, A. Esteve, A. Podzamczer, D. Murillas, J. Gatell, J.M. Manzardo, C. Tural, C. Clotet, B. Ferrer, E. Riera, M. Segura, F. Navarro, G. Force, L. Vilaró, J. Masabeu, A. García, I. Guadarrama, M. Cifuentes, C. Dalmau, D. Jaen, À. Agustí, C. Montoliu, A. Pérez, I. Gargoulas, F. Blanco, J.L. Garcia-Alcaide, F. Martínez, E. Mallolas, J. López-Dieguez, M. García-Goez, J.F. Sirera, G. Romeu, J. Jou, A. Negredo, E. Miranda, C. Capitan, M.C. Saumoy, M. Imaz, A. Tiraboschi, J.M. Murillo, O. Bolao, F. Peña, C. Cabellos, C. Masó, M. Vila, A. Sala, M. Cervantes, M. Jose Amengual, Ma. Navarro, M. Penelo, E. Barrufet, P. Bejarano, G. Molina, J. Guadarrama, M. Alvaro, M. Mercadal, J. Fernandez, J. Ospina, J.E. 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Vinceneux, P. Simonpoli, A.M. Zeng, A. Fournier, L. Fuzibet, J.G. Sohn, C. Rosenthal, E. Quaranta, M. Dellamonica, P. Chaillou, S. Sabah, M. Audhuy, B. Schieber, A. Moreau, P. Niault, M. Vaillant, O. Huchon, G. Compagnucci, A. De Lacroix Szmania, I. Richier, L. Lamaury, I. Saint-Dizier, F. Garipuy, D. Gastaut, J.A. Drogoul, M.P. Poizot Martin, I. Fabre, G. Lambert De Cursay, G. Abraham, B. Perino, C. Lagarde, P. David, F. Roche-Sicot, J. Saraux, J.L. Leprêtre, A. Fampin, B. Uludag, A. Morin, A.S. Bletry, O. Zucman, D. Regnier, A. Girard, J.J. Quinsat, D.T. Heripret, L. Grihon, F. Houlbert, D. Ruel, M. Chemlal, K. Caron, F. Debab, Y. Tremollieres, F. Perronne, V. Lepeu, G. Slama, B. Perré, P. Miodovski, C. Guermonprez, G. Dulioust, A. Boudon, P. Malbec, D. Patey, O. Semaille, C. Deville, J. Remy, G. Béguinot, I. Galanaud, P. Boue, F. Chambrin, V. Pignon, C. Estocq, G.A. Levy, A. Delfraissy, J.F. Goujard, C. Duracinsky, M. Le Bras, P. Ngussan, M.S. Peretti, D. Medintzeff, N. Lambert, T. Segeral, O. Lezeau, P. Laurian, Y. Weiss, L. Buisson, M. Piketty, C. Karmochkine, M. Batisse, D. Eliaszewitch, M. Jayle, D. Tisne-Dessus, D. Kazatchkine, M. Leport, C. Colasante, U. Jadand, C. Jestin, C. Duval, X. Nouaouia, W. Boucherit, S. Vilde, J.L. Girard, P.M. Bollens, D. Binet, D. Diallo, B. Meyohas, M.C. Fonquernie, L. Lagneau, J.L. Salmon, D. Guillevin, L. Tahi, T. Launay, O. Pietrie, M.P. Sicard, D. Stieltjes, N. Michot, J. Sobel, A. Levy, Y. Bourdillon, F. Lascaux, A.S. Lelievre, J.D. Dumont, C. Dupont, B. Obenga, G. Viard, J.P. Maignan, A. Vittecoq, D. Escaut, L. Bolliot, C. Bricaire, F. Katlama, C. Schneider, L. Herson, S. Simon, A. Iguertsira, M. Stein, A. Tomei, C. Ravaux, I. Dhiver, C. Tissot Dupont, H. Vallon, A. Gallais, J. Gallais, H. Gastaut, J.A. Drogoul, M.P. Fabre, G. Dellamonica, P. Durant, J. Mondain, V. Perbost, I. Cassuto, J.P. Karsenti, J.M. Venti, H. Fuzibet, J.G. Rosenthal, E. Ceppi, C. Quaranta, M. Krivitsky, J.A. Bentata, M. Bouchaud, O. Honore, P. Sereni, D. Lascoux, C. Delgado, J. Rouzioux, C. Burgard, M. Boufassa, L. Peynet, J. Pérez-Hoyos, S. Del Amo, J. Alvarez, D. Monge, S. Muga, R. Sanvisens, A. Clotet, B. Tor, J. Bolao, F. Rivas, I. Vallecillo, G. Del Romero, J. Raposo, P. Rodríguez, C. Vera, M. Hurtado, I. Belda, J. Fernandez, E. Alastrue, I. Santos, C. Tasa, T. Juan, A. Trullen, J. Garcia De Olalla, P. Cayla, J. Masdeu, E. Knobel, H. Mirò, J.M. Sambeat, M.A. Guerrero, R. Rivera, E. Guerrero, R. Marco, A. Quintana, M. Gonzalez, C. Castilla, J. Guevara, M. De Mendoza, C. Zahonero, N. Ortíz, M. Paraskevis, D. Touloumi, G. Pantazis, N. Bakoyannis, G. Gioukari, V. Antoniadou, A. Papadopoulos, A. Petrikkos, G. Daikos, G. Psichogiou, M. Gargalianos-Kakolyris, P. Xylomenos, G. Katsarou, O. Kouramba, A. Ioannidou, P. Kordossis, T. Kontos, A. Lazanas, M. Chini, M. Tsogas, N. Panos, G. Paparizos, V. Leuow, K. Kourkounti, S. Sambatakou, H. Mariolis, I. Skoutelis, A. Papastamopoulos, V. Baraboutis, I. The HIV-CAUSAL Collaboration

Subjects
virus diseases
Abstract

Background: There is little information on the incidence of AIDS-defining events which have been reported in the literature to be associated with immune reconstitution inflammatory syndrome (IRIS) after combined antiretroviral therapy (cART) initiation. These events include tuberculosis, mycobacterium avium complex (MAC), cytomegalovirus (CMV) retinitis, progressive multifocal leukoencephalopathy (PML), herpes simplex virus (HSV), Kaposi sarcoma, non-Hodgkin lymphoma (NHL), cryptococcosis and candidiasis. Methods: We identified individuals in the HIV-CAUSAL Collaboration, which includes data from six European countries and the US, who were HIV-positive between 1996 and 2013, antiretroviral therapy naive, aged at least 18 years, hadCD4+ cell count and HIV-RNA measurements and had been AIDS-free for at least 1 month between those measurements and the start of follow-up. For each AIDS-defining event, we estimated the hazard ratio for no cART versus less than 3 and at least 3 months since cART initiation, adjusting for time-varying CD4+ cell count and HIV-RNA via inverse probability weighting. Results: Out of 96 562 eligible individuals (78% men) with median (interquantile range) follow-up of 31 [13,65] months, 55 144 initiated cART. The number of cases varied between 898 for tuberculosis and 113 for PML. Compared with non-cART initiation, the hazard ratio (95% confidence intervals) up to 3 months after cART initiation were 1.21 (0.90-1.63) for tuberculosis, 2.61 (1.05-6.49) for MAC, 1.17 (0.34-4.08) for CMV retinitis, 1.18 (0.62-2.26) for PML, 1.21 (0.83-1.75) for HSV, 1.18 (0.87-1.58) for Kaposi sarcoma, 1.56 (0.82-2.95) for NHL, 1.11 (0.56-2.18) for cryptococcosis and 0.77 (0.40-1.49) for candidiasis. Conclusion: With the potential exception of mycobacterial infections, unmasking IRIS does not appear to be a common complication of cART initiation in high-income countries. © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Published
2014

109. System to control indoor air quality in energy efficient buildings

Author

Garcia Mandayo, Gemma, Gonzalez-Chavarri, Jurgi, Hammes, Emily, Newton, Hannah, Castro-Hurtado, I., Ayerdi, I., Knapp, Helmut, Sweetman, Andrew, Hewitt, C. N., Castaño, E., Garcia Mandayo, Gemma, Gonzalez-Chavarri, Jurgi, Hammes, Emily, Newton, Hannah, Castro-Hurtado, I., Ayerdi, I., Knapp, Helmut, Sweetman, Andrew, Hewitt, C. N., and Castaño, E.

Abstract

This work looks at monitoring air quality in indoor environments through the integration of several sensing technologies into a single robust, reliable and cheap detection platform, which shares air pre-conditioning and electronics. Target gases and detection limits have been set according to recommendations of different agencies in Europe and the US. The system has reached detection limits stated by the OSHA (Occupational Safety and Health Administration) for benzene. The pre-conditioning fluidic platform has also been designed, simulated, fabricated and tested with sensors so the gas flow has been optimized. Field tests in real buildings are being carried out to contrast current measurement procedures and results with the obtained using the device under development. The main aim of the system is to control HVAC (Heat Ventilation and Air Conditioning) in energy-efficient way while keeping a high air quality standard inside the building.

Published
2015

114. Prevalence, Determinants, and Inappropriateness of Calcium Supplementation Among Men and Women in a Spanish Mediterranean Area: Cross-Sectional Data From the ESOSVAL Cohort

Author

Sanfélix-Gimeno G, Sanfélix-Genovés J, Rodriguez-Bernal CL, Peiró S, and Hurtado I

Abstract

Recently, safety concerns about calcium supplementation have arisen. In this situation, ensuring appropriateness of use is highly important. We aimed to describe the use of calcium and vitamin D supplements, the factors related to it, and to assess the appropriateness of calcium prescription among men and women aged 50 years or older. We performed a cross-sectional study in 2009-2010 including 11,035 adults who belong to the ESOSVAL cohort and attend 272 primary healthcare centers in the Valencia region of Spain. Criteria for the inappropriateness of calcium prescription, based on guidelines and recent evidence, were: excessive or insufficient daily total intake (diet plus supplements), excessive single doses of supplements, excessive or insufficient association with vitamin D, and overall inappropriateness. Calcium and/or vitamin D were prescribed to about 17% of the population. Older age, antiosteoporotic treatment, use of glucocorticoids, and a diagnosis of osteoporosis were related to prescription. The presence of other secondary causes of osteoporosis determined supplementation only in men. Calcium dietary intake was not related to the prescription of supplements. Among calcium users, 85.8% met at least one criterion of inappropriate prescription; 29% had an inappropriate daily total intake mainly resulting from excessive consumption (>2000mg/day); 53.8% of patients were given calcium supplements in quantities higher than 500mg per dose; and 38.9% of individuals receiving calcium supplements had inappropriate (absent or below 800 UI/day) vitamin D supplementation (all of them at high risk). In conclusion, we found high inappropriateness of calcium supplementation, mainly because of calcium overdosing, and also to undertreatment and underdosing of vitamin D in high-risk patients. Physicians should be encouraged to assess calcium dietary intakes before supplementation, recommending intake from food whenever possible, and to prescribe low calcium doses and high vitamin D doses when given in fixed-dose combinations, or vitamin D alone when calcium is not necessary. (c) 2013 American Society for Bone and Mineral Research.

Published
2013

115. The Incidence of AIDS-Defining Illnesses at a Current CD4 Count >=200 Cells/ L in the Post-Combination Antiretroviral Therapy Era

Author

Mocroft, A., Furrer, H. J., Miro, J. M., Reiss, P, Mussini, C., Kirk, O., Abgrall, S., Ayayi, S., Bartmeyer, B., Braun, D., Castagna, A., D'Arminio Monforte, A., Gazzard, B., Gutierrez, F., Hurtado, I., Jansen, K., Meyer, L., Munoz, P., Obel, N., Soler-Palacin, P., Papadopoulos, A., Raffi, F., Ramos, J. T., Rockstroh, J. K., Salmon, D., Torti, C., Warszawski, J., De Wit, S., Zangerle, R., Fabre-Colin, C., Kjaer, J., Chene, G., Grarup, J., and Lundgren, J

Subjects
610 Medicine & health, 360 Social problems & social services
Abstract

Background. Few studies consider the incidence of individual AIDS-defining illnesses (ADIs) at higher CD4 counts, relevant on a population level for monitoring and resource allocation. Methods. Individuals from the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) aged ≥14 years with ≥1 CD4 count of ≥200 µL between 1998 and 2010 were included. Incidence rates (per 1000 person-years of follow-up [PYFU]) were calculated for each ADI within different CD4 strata; Poisson regression, using generalized estimating equations and robust standard errors, was used to model rates of ADIs with current CD4 ≥500/µL. Results. A total of 12 135 ADIs occurred at a CD4 count of ≥200 cells/µL among 207 539 persons with 1 154 803 PYFU. Incidence rates declined from 20.5 per 1000 PYFU (95% confidence interval [CI], 20.0–21.1 per 1000 PYFU) with current CD4 200–349 cells/µL to 4.1 per 1000 PYFU (95% CI, 3.6–4.6 per 1000 PYFU) with current CD4 ≥ 1000 cells/µL. Persons with a current CD4 of 500–749 cells/µL had a significantly higher rate of ADIs (adjusted incidence rate ratio [aIRR], 1.20; 95% CI, 1.10–1.32), whereas those with a current CD4 of ≥1000 cells/µL had a similar rate (aIRR, 0.92; 95% CI, .79–1.07), compared to a current CD4 of 750–999 cells/µL. Results were consistent in persons with high or low viral load. Findings were stronger for malignant ADIs (aIRR, 1.52; 95% CI, 1.25–1.86) than for nonmalignant ADIs (aIRR, 1.12; 95% CI, 1.01–1.25), comparing persons with a current CD4 of 500–749 cells/µL to 750–999 cells/µL. Discussion. The incidence of ADIs was higher in individuals with a current CD4 count of 500–749 cells/µL compared to those with a CD4 count of 750–999 cells/µL, but did not decrease further at higher CD4 counts. Results were similar in patients virologically suppressed on combination antiretroviral therapy, suggesting that immune reconstitution is not complete until the CD4 increases to >750 cells/µL.

Published
2013
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116. The Incidence of AIDS-Defining Illnesses at a Current CD4 Count >= 200 Cells/mu L in the Post-Combination Antiretroviral Therapy Era

Author

Mocroft A, Furrer H, Miro J, Reiss P, Mussini C, Kirk O, Abgrall S, Ayayi S, Bartmeyer B, Braun D, Castagna A, Monforte A, Gazzard B, Gutierrez F, Hurtado I, Jansen K, Meyer L, Munoz P, Obel N, Soler-Palacin P, Papadopoulos A, Raffi F, Ramos J, Rockstroh J, Salmon D, Torti C, Warszawski J, de Wit S, Zangerle R, Fabre-Colin C, Kjaer J, Chene G, Grarup J, Lundgren J, and Collaboration Observational HIV Ep

Abstract

Background. Few studies consider the incidence of individual AIDS-defining illnesses (ADIs) at higher CD4 counts, relevant on a population level for monitoring and resource allocation. Methods. Individuals from the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) aged >= 14 years with >= 1 CD4 count of >= 200 mu L between 1998 and 2010 were included. Incidence rates (per 1000 person-years of follow-up [PYFU]) were calculated for each ADI within different CD4 strata; Poisson regression, using generalized estimating equations and robust standard errors, was used to model rates of ADIs with current CD4 >= 500/mu L. Results. A total of 12 135 ADIs occurred at a CD4 count of >= 200 cells/mu L among 207 539 persons with 1 154 803 PYFU. Incidence rates declined from 20.5 per 1000 PYFU (95% confidence interval [CI], 20.0-21.1 per 1000 PYFU) with current CD4 200-349 cells/mu L to 4.1 per 1000 PYFU (95% CI, 3.6-4.6 per 1000 PYFU) with current CD4 >= 1000 cells/mu L. Persons with a current CD4 of 500-749 cells/mu L had a significantly higher rate of ADIs (adjusted incidence rate ratio [aIRR], 1.20; 95% CI, 1.10-1.32), whereas those with a current CD4 of >= 1000 cells/mu L had a similar rate (aIRR, 0.92; 95% CI, .79-1.07), compared to a current CD4 of 750-999 cells/mu L. Results were consistent in persons with high or low viral load. Findings were stronger for malignant ADIs (aIRR, 1.52; 95% CI, 1.25-1.86) than for nonmalignant ADIs (aIRR, 1.12; 95% CI, 1.01-1.25), comparing persons with a current CD4 of 500-749 cells/mu L to 750-999 cells/mu L. Discussion. The incidence of ADIs was higher in individuals with a current CD4 count of 500-749 cells/mu L compared to those with a CD4 count of 750-999 cells/mu L, but did not decrease further at higher CD4 counts. Results were similar in patients virologically suppressed on combination antiretroviral therapy, suggesting that immune reconstitution is not complete until the CD4 increases to >750 cells/mu L.

Published
2013

117. The Incidence of AIDS-Defining Illnesses at a Current CD4 Count >= 200 Cells/mu L in the Post-Combination Antiretroviral Therapy Era

Author

Mocroft, A. Furrer, H. J. Miro, J. M. Reiss, P. Mussini, C. Kirk, O. Abgrall, S. Ayayi, S. Bartmeyer, B. and Braun, D. Castagna, A. Monforte, A. d'Arminio Gazzard, B. and Gutierrez, F. Hurtado, I. Jansen, K. Meyer, L. and Munoz, P. Obel, N. Soler-Palacin, P. Papadopoulos, A. and Raffi, F. Ramos, J. T. Rockstroh, J. K. Salmon, D. and Torti, C. Warszawski, J. de Wit, S. Zangerle, R. and Fabre-Colin, C. Kjaer, J. Chene, G. Grarup, J. Lundgren, J. D. Collaboration Observational HIV Ep

Abstract

Background. Few studies consider the incidence of individual AIDS-defining illnesses (ADIs) at higher CD4 counts, relevant on a population level for monitoring and resource allocation. Methods. Individuals from the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) aged >= 14 years with >= 1 CD4 count of >= 200 mu L between 1998 and 2010 were included. Incidence rates (per 1000 person-years of follow-up [PYFU]) were calculated for each ADI within different CD4 strata; Poisson regression, using generalized estimating equations and robust standard errors, was used to model rates of ADIs with current CD4 >= 500/mu L. Results. A total of 12 135 ADIs occurred at a CD4 count of >= 200 cells/mu L among 207 539 persons with 1 154 803 PYFU. Incidence rates declined from 20.5 per 1000 PYFU (95% confidence interval [CI], 20.0-21.1 per 1000 PYFU) with current CD4 200-349 cells/mu L to 4.1 per 1000 PYFU (95% CI, 3.6-4.6 per 1000 PYFU) with current CD4 >= 1000 cells/mu L. Persons with a current CD4 of 500-749 cells/mu L had a significantly higher rate of ADIs (adjusted incidence rate ratio [aIRR], 1.20; 95% CI, 1.10-1.32), whereas those with a current CD4 of >= 1000 cells/mu L had a similar rate (aIRR, 0.92; 95% CI, .79-1.07), compared to a current CD4 of 750-999 cells/mu L. Results were consistent in persons with high or low viral load. Findings were stronger for malignant ADIs (aIRR, 1.52; 95% CI, 1.25-1.86) than for nonmalignant ADIs (aIRR, 1.12; 95% CI, 1.01-1.25), comparing persons with a current CD4 of 500-749 cells/mu L to 750-999 cells/mu L. Discussion. The incidence of ADIs was higher in individuals with a current CD4 count of 500-749 cells/mu L compared to those with a CD4 count of 750-999 cells/mu L, but did not decrease further at higher CD4 counts. Results were similar in patients virologically suppressed on combination antiretroviral therapy, suggesting that immune reconstitution is not complete until the CD4 increases to >750 cells/mu L.

Published
2013

118. Vertebral fracture risk factors in postmenopausal women over 50 in Valencia, Spain. A population-based cross-sectional study

Author

Sanfélix-Gimeno G, Sanfelix-Genovés J, Hurtado I, Reig-Molla B, and Peiró S

Subjects
Risk factors, Bone mineral density, Osteoporosis, Vertebral fracture
Abstract

Purpose: This study aims to estimate the prevalence of risk factors for osteoporotic vertebral fracture and analyze the possible associations between these factors and the presence of densitometric osteoporosis and prevalent morphometric vertebral fracture. Methods: Data from a population-based cross-sectional sample of 804 postmenopausal women over the age of 50 years old living in the city of Valencia (Spain) were used. The women were interviewed to identify the prevalence of osteoporotic fracture risk factors and underwent a densitometry and a dorsolumbar spine X-ray. Results: The most prevalent risk factors were densitometric osteoporosis (31.7%), history of parental hip fracture (19.4%), hypoestrogenism (19%), and body mass index (BMI) >= kg/m(2) (35.2%). After adjusting for all covariables, densitometric osteoporosis was associated with increased age [odds ratio (OR)(65-69 years): 2.84, 95% confidence interval (CI): 1.75-4.61; OR70-74 years: 4.01, 95% CI: 2.47-6.52; OR75+ years: 5.96, 95% CI: 3.27-10.87] and inversely associated with high BMI (OR25.0-29.9: 0.51, 95% CI: 0.34-0.76; OR >= 30: 0.30, 95% CI: 0.19-0.46). Morphometric vertebral fracture was associated with age (OR65-69 years: 2.04, 95% CI: 1.03-4.05; OR70-74 years: 4.05, 95% CI: 2.11-7.77; OR75+ years: 8.43, 95% CI: 3.97-17.93), poor educational level (OR: 1.70, 95% CI: 1.06-2.72) and with densitometric osteoporosis and BMI >= 30 kg/m(2) (OR: 3.35, 95% CI: 1.85-6.07). Conclusions: The most prevalent osteoporotic fracture risk factors were having a high BMI and the presence of densitometric osteoporosis. A higher risk of morphometric vertebral fracture in women with both low bone mineral density and high BMI was found. This association, if confirmed, has important implications for clinical practice and fracture risk tools. We also found a higher risk in women with a poor educational level. More attention should be addressed to these populations in order to control modifiable risk factors. (C) 2012 Elsevier Inc. All rights reserved.

Published
2013

119. Manejo Integral de Agua y Suelo en Centroamérica. Bases científicas para el desarrollo rural comunitario

Author

Algeet Abarquero, Nur, Fernández Moya, Jesús, Lianes Revilla, Elena, Marchamalo Sacristán, Miguel, Martínez Marín, Rubén, Rejas, Juan Gregorio, Alvarado, Alfredo, Abreu, A., Perez, Alexandra, Irias, Alicia, Sanchez, Alexis, Avarela, A., Aguirre, Carmen, Cruz, Mirna, Moreno, Eduardo, Hurtado, I., Calderon, Heyddy, Bonatti, Javier, Fernan, J.C, Olabarri, José, Martínez, Karla, Vammen, Katherine, Madrigal, Luisa, Corrales, Rafael, Schill, S., Salvatierra, Thelma, Delgado, Valeria, and Flores, Yelba

Subjects
Hidrología, Medio Ambiente, Agricultura, Topografía, Silvicultura
Abstract

Este libro recoge los frutos de la colaboración y trabajo conjunto de un grupo de Universidades Iberoamericanas entre 2007 y 2012 el marco de las actividades del Programa de Cooperación Comunidad, Agua y Bosque en Centroamérica (CAB Centroamérica, http://www2.caminos.upm.es/Departamentos/imt/Topografia/Cab/cab.html ). Las actividades se han realizado con el apoyo del Programa de Cooperación Universitaria PCI-AECID IBEROAMÉRICA, de la Dirección de Cooperación para el Desarrollo de la Universidad Politécnica de Madrid y de los fondos propios de las Universidades latinoamericanas, con especial mención a la Universidad de Costa Rica, coordinadora de los trabajos en Centroamérica. El inicio de esta colaboración se produjo en 2007 a partir de la identificación de un objetivo común: profundizar la investigación sobre la dinámica agua-suelo-planta para mejorar la producción y la calidad del agua de los sistemas de abastecimiento comunitarios en Centroamérica.

Published
2012

127. Association of the C677T polymorphism in the methylenetetrahydrofolate reductase gene with breast cancer in a Mexican population

Author

Ramos-Silva, A., primary, Figuera, L.E., additional, Soto-Quintana, O.M., additional, Puebla-Pérez, A.M., additional, Ramírez-Patiño, R., additional, Gutiérrez-Hurtado, I., additional, Carrillo-Moreno, D.I., additional, Zúñiga-González, G.M., additional, Dávalos-Rodríguez, I.P., additional, and Gallegos-Arreola, M.P., additional

Published
2015
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128. Texture Evolution of AZ31 Magnesium Alloy Sheet at High Strain Rates

Author

Dudamell, N. V., Gálvez, F., Hurtado, I., Letzig, D., Pérez-Prado, M. T., Ulacia, I., and Yi, S.

Subjects
010302 applied physics, technology, industry, and agriculture, 02 engineering and technology, magnesium alloy, 021001 nanoscience & nanotechnology, 01 natural sciences, Condensed Matter::Materials Science, 0103 physical sciences, high strain rate, 0210 nano-technology, texture, Sin determinar
Abstract

In the current contribution the mechanical behaviour at high strain rates of AZ31 magnesium alloy sheet is studied. Uniaxial deformation properties were studied by means of tensile split Hopkinson pressure bar (SHPB) at different temperatures. The influence of the strain rate and temperature on the deformation mechanisms was investigated by means of electron backscatter diffraction (EBSD) and neutron diffraction. It is shown that twinning plays an important role on high strain rate deformation of this alloy, even at elevated temperatures. Significant evidence of prismatic slip as a deformation mechanism is observed, also at warm temperatures, leading to the alignment of directions with the tensile axis and to a spread of the intensities of the basal pole figure towards the in-plane direction perpendicular to the tensile axis. The rate of decrease of the CRSS of non-basal systems is observed to be slower than at quasi-static rates. Secondary twinning and pyramidal slip were also outlined for some conditions. At warm temperatures, in contrast to quasi-static range, a generalized dynamic recrystallization is not observed. Moreover, the activation of rotational recrystallization mechanisms is reported

Published
2010

129. Intervención preventiva en lugares de interacción social de hombres que mantienen relaciones sexuales con otros hombres

Author

Hurtado, I, Alastrue, I, de Olalla, PG, Albiach, D, Martin, M, and Perez-Hoyos, S

Subjects
Men who have sex with men, Saunas, Sexually transmitted infections, VIH, HIV, Infecciones de transmisión sexual, Prostitution, Hombres que mantienen sexo con hombres, Sauna, Prostitución
Abstract

Se realizó una intervención en saunas y pisos para contactos sexuales entre hombres que mantienen relaciones sexuales con hombres de Valencia, cuyo objetivo era prevenir la infección por el virus de la inmunodeficiencia humana (VIH) o, en su caso, evitar el retraso en el diagnóstico y facilitar el contacto con los circuitos sanitarios. Se proporcionó información sobre prevención y se efectuó la prueba rápida para el VIH y la sífilis. Se habló con 500 hombres y se realizó la intervención en 171. El 37% de los sujetos en las saunas y de cada en los pisos nunca se había realizado una prueba. La prevalencia del VIH fue del 1,6% (n=2) en las saunas y del 11% en los pisos (n=5); para la sífilis estos porcentajes fueron del 5 y el 2,3%, respectivamente. La intervención permitió detectar la existencia de bolsas de población poco atendidas y muy expuestas, y facilitó el acceso de estos sujetos al sistema sanitario. An intervention in venues for interaction used by men who have sex with men in Valencia (Spain) was performed to prevent human immunodeficiency virus (HIV) infection or avoid delay in diagnosis and to facilitate contact with the health circuit. Information was provided on prevention and a rapid test for HIV and syphilis was performed. We contacted 500 men and the intervention was performed in 171; 37% of the subjects in saunas and one in four of those in prostitution apartments had never been tested. The prevalence of HIV was 1.6% (n=2) in the saunas, and 11% (n=5) in the apartments (n=5). For syphilis, these percentages were 5% and 2.3% respectively. The intervention revealed the existence of highly exposed population groups with low compliance and facilitated access to the health system in these groups.

Published
2010

130. Warm Electromagnetic Forming of AZ31B Magnesium Alloy Sheet

Author

Arroyo, A., Eguiy, I., Gutiérrez, M. A., Hurtado, I., and Ulacia, I.

Subjects
warm forming, electromagnetic forming, magnesium alloy
Abstract

Historically, electromagnetic forming technology has mainly been used to form parts from aluminium and copper alloys due to their excellent electrical conductivity and limited formability by conventional methods. However, little research has been carried out in high strain rate forming of magnesium alloy sheets. Therefore, in the current contribution electromagnetic forming experiments are performed for rolled AZ31B magnesium alloy sheet at different temperatures up to 250°C. Two forming operations are studied in this paper, i.e. drawing and bending operations. The final deformations achieved for the different conditions were measured and the effect of both temperature and discharged energy on deformation is shown. Bending experiments at room temperature were recorded by means of a high speed camera and the springback behaviour at high strain rates is evaluated. In one hand, increasing the forming temperature the yield strength of the material decreases while on the other hand, the electrical conductivity and thus the induced forces are also decreased. It is observed that increasing the forming temperature, for a given discharged energy, the maximum height of the deformed part is decreased. However, increasing the discharged energy at warm temperatures, higher deformation values are achieved without failure. Additionally, bending experiments show that springback effect is also decreased at warm conditions. It is concluded that warm electromagnetic forming is a suitable procedure to manufacture magnesium parts.

Published
2010
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131. Electromagnetic Forming of AZ31B Magnesium Alloy Sheet

Author

Arroyo, A., Hurtado, I., Imbert, J., Salisbury, C. P., Ulacia, I., and Worswick, M. J.

Subjects
formability, electromagnetic sheet metal forming, numerical modelling, magnesium alloy
Abstract

In the first stage of this work, polycrystalline specimens of AZ31B magnesium alloy have been characterized by uniaxial tensile tests at quasi-static and dynamic strain rates at room temperature. The influence of the strain rate is outlined and experimental results were fitted to the parameters of Johnson-Cook constitutive material model. In the second stage of the present study, sheets of AZ31B magnesium alloy have been biaxially formed by electromagnetic forming using different coil and die configurations. Deformation values measured from electromagnetic formed parts are compared to the ones achieved with uniaxial tensile tests and also with the values obtained by conventional forming technologies. Finally, numerical simulations have been carried out using an alternative method for computing the electromagnetic fields in the EMF process simulation, a combination of Finite Element Method (FEM) for conductor parts and Boundary Element Method (BEM) for the surrounding air (or more generally insulators) that is being implemented into commercial code LS-DYNA®.

Published
2008
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132. The Labour Side Agreement in NAFTA: an example to follow?

Author

Argerey, P., Baudassé, Thierry, Hurtado, I., Laboratoire d'économie d'Orleans (LEO), Université d'Orléans (UO)-Centre National de la Recherche Scientifique (CNRS), LEO, CNRS, France & IEAPS (Institute of Economic Analysis & Prospectives Studies), and Th. Baudassé & A. Driouchi

Subjects
NAFTA, Labour, example, Side, [SHS.ECO]Humanities and Social Sciences/Economics and Finance, follow, Agreement
Abstract

al Akhawayn University of Ifrane, Morroco

Published
2007

135. The incidence of AIDS-defining illnesses at a current CD4 count ≥ 200 cells/μL in the post-combination antiretroviral therapy era

Author

Mocroft, A, Furrer, H J, Miro, J M, Reiss, P, Mussini, C, Kirk, O, Abgrall, S, Ayayi, S, Bartmeyer, B, Braun, D, Castagna, A, d'Arminio Monforte, A, Gazzard, B, Gutierrez, F, Hurtado, I, Jansen, Karina, Meyer, L, Muñoz, P, Obel, N, Soler-Palacin, P, Papadopoulos, A, Raffi, F, Ramos, J T, Rockstroh, J K, Salmon, D, Torti, C, Warszawski, J, de Wit, S, Zangerle, R, Fabre-Colin, C, Kjaer, J, Chene, G, Grarup, J, Lundgren, J D, Mocroft, A, Furrer, H J, Miro, J M, Reiss, P, Mussini, C, Kirk, O, Abgrall, S, Ayayi, S, Bartmeyer, B, Braun, D, Castagna, A, d'Arminio Monforte, A, Gazzard, B, Gutierrez, F, Hurtado, I, Jansen, Karina, Meyer, L, Muñoz, P, Obel, N, Soler-Palacin, P, Papadopoulos, A, Raffi, F, Ramos, J T, Rockstroh, J K, Salmon, D, Torti, C, Warszawski, J, de Wit, S, Zangerle, R, Fabre-Colin, C, Kjaer, J, Chene, G, Grarup, J, and Lundgren, J D

Abstract

Few studies consider the incidence of individual AIDS-defining illnesses (ADIs) at higher CD4 counts, relevant on a population level for monitoring and resource allocation.

Published
2013

136. The Incidence of AIDS-Defining Illnesses at a Current CD4 Count ≥200 Cells/µL in the Post–Combination Antiretroviral Therapy Era

Author

Mocroft, A, Furrer, H J, Miro, J M, Reiss, P, Mussini, C, Kirk, O, Abgrall, S, Ayayi, S, Bartmeyer, B, Braun, D, Castagna, A, d'Arminio Monforte, A, Gazzard, B, Gutierrez, F, Hurtado, I, Jansen, Karina, Meyer, L, Muñoz, P, Obel, N, Soler-Palacin, P, Papadopoulos, A, Raffi, F, Ramos, J T, Rockstroh, J K, Salmon, D, Torti, C, Warszawski, J, de Wit, S, Zangerle, R, Fabre-Colin, C, Kjaer, J, Chene, G, Grarup, Jesper, Lundgren, J D, EuroCOORD, Opportunistic Infections Working Group on behalf of the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) study in, Mocroft, A, Furrer, H J, Miro, J M, Reiss, P, Mussini, C, Kirk, O, Abgrall, S, Ayayi, S, Bartmeyer, B, Braun, D, Castagna, A, d'Arminio Monforte, A, Gazzard, B, Gutierrez, F, Hurtado, I, Jansen, Karina, Meyer, L, Muñoz, P, Obel, N, Soler-Palacin, P, Papadopoulos, A, Raffi, F, Ramos, J T, Rockstroh, J K, Salmon, D, Torti, C, Warszawski, J, de Wit, S, Zangerle, R, Fabre-Colin, C, Kjaer, J, Chene, G, Grarup, Jesper, Lundgren, J D, and EuroCOORD, Opportunistic Infections Working Group on behalf of the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) study in

Published
2013

137. Characterizing the Computational Power of Energy-Based P Systems

Author

Martínez-del-Amor, MA, Păun, G, Pérez-Hurtado, I, Romero-Campero, FJ, Alhazov, A, Antoniotti, M, Leporati, A, ALHAZOV, ARTIOM, ANTONIOTTI, MARCO, LEPORATI, ALBERTO OTTAVIO, Martínez-del-Amor, MA, Păun, G, Pérez-Hurtado, I, Romero-Campero, FJ, Alhazov, A, Antoniotti, M, Leporati, A, ALHAZOV, ARTIOM, ANTONIOTTI, MARCO, and LEPORATI, ALBERTO OTTAVIO

Abstract

We investigate the computational power of energy-based P systems, a model of membrane systems where a fixed amount of energy is associated with each object and the rules transform single objects by adding or removing energy from them. We answer recently proposed open questions about the power of such systems without priorities associated to the rules, for both sequential and maximally parallel modes. We also conjecture that deterministic energy-based P systems are not computationally complete

Published
2012

138. Influence of texture on the recrystallization mechanisms in an AZ31 Mg sheet alloy at dynamic rates

Author

Dudamell, N.V., Ulacia, I., Galvez Diaz-Rubio, Francisco, Yi, S., Bohlen, J., Letzig, D., Hurtado, I., Pérez Prado, María Teresa, Dudamell, N.V., Ulacia, I., Galvez Diaz-Rubio, Francisco, Yi, S., Bohlen, J., Letzig, D., Hurtado, I., and Pérez Prado, María Teresa

Abstract

An AZ31 rolled sheet alloy has been tested at dynamic strain rates View the MathML source at 250 °C up to various intermediate strains before failure in order to investigate the predominant deformation and restoration mechanisms. In particular, tests have been carried out in compression along the rolling direction (RD), in tension along the RD and in compression along the normal direction (ND). It has been found that dynamic recrystallization (DRX) takes place despite the limited diffusion taking place under the high strain rates investigated. The DRX mechanisms and kinetics depend on the operative deformation mechanisms and thus vary for different loading modes (tension, compression) as well as for different relative orientations between the loading axis and the c-axes of the grains. In particular, DRX is enhanced by the operation of 〈c + a〉 slip, since cross-slip and climb take place more readily than for other slip systems, and thus the formation of high angle boundaries is easier. DRX is also clearly promoted by twinning.

Published
2012

139. Self-Stabilization in Membrane Systems

Author

Martínez-del-Amor, MA, Păun, G, Pérez-Hurtado, I, Romero-Campero, FJ, Alhazov, A, Antoniotti, M, Freund, R, Leporati, A, Mauri, G, ALHAZOV, ARTIOM, ANTONIOTTI, MARCO, LEPORATI, ALBERTO OTTAVIO, MAURI, GIANCARLO, Martínez-del-Amor, MA, Păun, G, Pérez-Hurtado, I, Romero-Campero, FJ, Alhazov, A, Antoniotti, M, Freund, R, Leporati, A, Mauri, G, ALHAZOV, ARTIOM, ANTONIOTTI, MARCO, LEPORATI, ALBERTO OTTAVIO, and MAURI, GIANCARLO

Abstract

In this paper we study a notion of self-stabilization, inspired from biology and engineering. Multiple variants of formalization of this notion are considered, and we discuss how such properties affect the computational power of multiset rewriting systems.

Published
2012

143. Development and feasibility of a scale to assess postoperative recovery: the post-operative quality recovery scale

Author

Royse, CF, Royse CF, Newman S, Chung F, Stygall J, McKay RE, Boldt J, Servin FS, Hurtado I, Hannallah R, Yu B, Wilkinson DJ, Royse, CF, Royse CF, Newman S, Chung F, Stygall J, McKay RE, Boldt J, Servin FS, Hurtado I, Hannallah R, Yu B, and Wilkinson DJ

Abstract

BACKGROUND: Good postoperative recovery is increasingly recognized as an important outcome after surgery. The authors created a new Post-operative Quality Recovery Scale (PQRS) that tracks multiple domains of recovery from immediate to long-term time periods in patients of varying ages, languages, and cultures. METHODS: The parameters of importance to both clinicians and patients were identified. After an initial pilot study of 133 patients, the PQRS was refined. It consists of six domains (physiologic, nociceptive, emotive, activities of daily living, cognitive, and overall patient perspective). An observational study of 701 patients was performed with the refined PQRS to assess its capacity to evaluate and track recovery and to discriminate between patients. It was conducted in eight countries and in five languages, involving patients more than or equal to 6 yr undergoing elective surgery with general anesthesia. Recovery was assessed before surgery and at multiple time periods postoperatively. Recovery was defined as return to baseline values or better. RESULTS: Seven hundred one patients completed the PQRS. Mean completion time was 4.8 (SD 2.8) min. Recovery scores improved with time. Physiologic recovery was complete in 34% of subjects by 40 min. By the third postoperative day, complete recovery was obtained in 11% of cases (all domains): 48.7% nociceptive, 81.8% emotive, 68.8% activities of daily living, and only 33.5% cognitive. Overall, 95.8% of the patients reported that they were "satisfied or totally satisfied" with their anesthetic care. CONCLUSION: The scores on the PQRS demonstrated an improvement over time, consistent with an expected recovery after surgery and anesthesia, and an ability to discriminate between individuals. Many patients had incomplete recovery by the third postoperative day.

Published
2010

149. Association of the tumor necrosis factor-alpha -308G>A polymorphism with breast cancer in Mexican women

Author

Gómez Flores-Ramos, L., primary, Escoto-De Dios, A., additional, Puebla-Pérez, A.M., additional, Figuera-Villanueva, L.E., additional, Ramos-Silva, A., additional, Ramírez-Patiño, R., additional, Delgado-Saucedo, J.I., additional, Salas-González, E., additional, Zúñiga-González, G.M., additional, Alonzo-Rojo, A., additional, Gutiérrez-Hurtado, I., additional, and Gallegos-Arreola, M.P., additional

Published
2013
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