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Background: The age is an important prognostic factor in patients with acute myocardial infarction.

The European Space Agency (ESA) Science Programme Committee (SPC) selected CHEOPS (Characterizing Exoplanets Satellite) in October 2012 as the first Small-class mission (S1) within the Agency’s Scientific Programme. It is considered as a pilot case for implementing “small science missions” in the agency with the following requirements: science driven mission selected through an open Call; an implementation cycle, from the Call to launch, drastically shorter than for Medium-class (M) and Large-class (L) missions; a strict cost-cap to ESA, with possibly higher Member States involvement than for M or L missions. The CHEOPS mission is devoted to the characterization of known exoplanets orbiting bright stars, achieved through the precise measurement of exoplanet radii using the technique of transit photometry. It was adopted for implementation in February 2014 as a partnership between the ESA Science Programme and Switzerland, with a number of other Member States delivering significant contributions to the instrument development and to operations. The CHEOPS instrument is an optical Ritchey-Chrétien telescope with 300 mm effective aperture diameter and a large external baffle to minimize straylight. The compact CHEOPS spacecraft (approx. 300 kg, 1.5 m size), based on a flight-proven platform, will orbit the Earth in a dawn-dusk Sun Synchronous Orbit at 700 km altitude. CHEOPS completed the Preliminary Design Review at the end of September 2014, and passed the Critical Design Review in May 2016. In the course of 2017, flight platform and payload have been integrated and tested, and then followed by satellite level activities, targeting flight readiness by the end of year 2019. Implementation and validation of the ground segment, which is composed of the MOC (Mission Operations Centre), located in Torrejón (Madrid, Spain) and the SOC (Science Operations Centre), located at the University of Geneva (Switzerland) was achieved in parallel. CHEOPS will be launched as a secondary passenger on a Soyuz from Kourou by end of 2019. The paper describes the latest CHEOPS development status, focusing on the activities for verification and validation of the satellite and the system at large, including the ground segment and the activities in preparation for S/C launch and its operations. Additional details can be found on the ESA and UBE websites referred in [8].

ESA Science Programme Committee (SPC) selected CHEOPS as the first small class science mission in 2012. CHEOPS is considered as a pilot case for the implementation of “small science missions” and its success is key for the continuation of fast-paced, small missions. The mission has been developed and brought into a flight readiness state within 5-6 years from selection, which is about half the time of other ESA missions. This paper focuses on the CHEOPS payload and its predicted capabilities. The 300mm effective aperture Ritchey-Chretien telescope provided by the CHEOPS consortium has been tested and characterized on ground in a 2 months calibration campaign after the qualification for flight. The results have led to performance estimations, which are discussed here. We show that the performance requirements in flight are expected to be met by the instrument. A preview is given towards the 2 months lasting In Orbit Commissioning (IOC) phase of the CHEOPS payload after LEOP and platform check-out. The activities in orbit range from dark current measurements, PSF characterization and parasitic stray light determination to AOCS and instrument performance verifications to science validation using reference transits.

Introduction: Our aims were to investigate the adherence to national guidelines of initial antiretroviral therapy (ART) in the Spanish multicenter CoRIS cohort during the years 2010-2015, to identify the reasons for the prescription of nonrecommended treatments, and to explore the role of institutional constraints to guideline compliance. Methods: ART regimens were classified as recommended, alternative or nonrecommended according to the guidelines. Physicians were asked the reasons for prescribing nonrecommended regimens. Factors associated with the prescription of non recommended regimens were assessed using multivariable logistic regression. Results: During the study period, 586 (10.7%) of 5479 patients who started ART were given a regimen not recommended in the guidelines. The most frequent reasons for prescribing nonrecommended regimens were: enrolment in clinical trials (43.3%), comorbidities and/or interactions (10.2%), pregnancy (8.7%), and cost (7.7%). Among 37 participating centers, 16 (43%), treating 3561 patients, reported limitations related with the cost of ART, and 20 (54%), treating 1365 patients, reported restrictions for prescribing at least one recommended antiretroviral. In multivariable analysis, a higher risk of receiving nonrecommended regimens was associated with male gender, HIV acquisition by heterosexual transmission, low viral loads, initiation of treatment during the years 2011 to 2015, and initiation of treatment in a center with restricted access to at least one antiretroviral drug. Conclusions: Compliance to clinical guidelines was high. A high proportion of centres reported cost limitations for ART or restricted access to at least one recommended antiretroviral drug, with a significant impact on the choice of initial regimens. (C) 2019 Elsevier Espafia, S.L.U. and Sociedad Espaliola de Enfermedades Infecciosas y Microbiologia Clinica. All rights reserved.

Background: The life expectancy of HIV-infected individuals has dramatically improved with potent antiretroviral therapies. However, organ-specific toxicities of some antiretrovirals and persistent inflammation and immune activation due to residual virus replication account for a high burden of age-associated comorbidities in the HIV population. Methods: The prevalence of overt cardiovascular, renal and bone diseases as well as their major risk factors were cross-sectionally examined during the year 2014 in the VACH cohort, a large nationwide population of HIV-infected individuals in Spain. Results: A total of 10,897 HIV-infected patients were examined. Seventy-one point four percent were male and the mean age was 48 years. Mean time since HIV diagnosis was 15.8 years and mean time on antiretroviral therapy was 13.1 years. The proportion of patients with undetectable viral load was 87.1%, whereas 65.7% had CD4 counts >500 cells/mm(3). Overall, cardiovascular, renal and bone disease were recorded in 4.7%, 5.9% and 2.8%, respectively. The prevalence of major risk factors was as follows: smoking 51.3%, alcohol abuse 7.8%, overweight/obesity 42.2%, diabetes 19.9%, dyslipidaemia 72.6%, hypertension 25.6%, and osteoporosis 11.1%. In the subset of patients older than 55 years-old (18%), all figures for overt disease and their major risk factors were significantly greater. Conclusion: Major age-related medical conditions and most of their risk factors are highly prevalent in HIV-infected individuals on long-term antiretroviral therapy in Spain. Preventive actions, including careful selection of antiretroviral agents, should be prioritized in the ageing HIV population. (C) 2018 Elsevier Espana, S.L.U. and Sociedad Espanola de Enfermedades Infecciosas y Microbiologia Clinica. All rights reserved.

We compared time to treatment change (TC), viral suppression (VS) and change in CD4 + T-cell counts of first-line antiretroviral regimens (ART).

The continuous increase in our knowledge of HIV medicine and antiretroviral treatment has led us to draft specific consensus documents focused on topics other than antiretroviral therapy, such as treatment of opportunistic diseases, pre- and post-exposure prophylaxis, metabolic abnormalities, treatment of HBV or HCV coinfection, treatment of patients coinfected with tuberculosis, osteoporosis, kidney disorders, and cardiovascular risk. Accordingly, the AIDS Study Group (GeSIDA) of the Spanish Society of Infectious Diseases and Clinical Microbiology has promoted the drafting of this consensus document on the control and monitoring of adult patients infected with HIV. The document provides recommendations on the initial evaluation and subsequent monitoring of HIV-infected patients that will prove useful for all professionals involved in the management of this infection. (C) 2018 Elsevier Espana, S.L.U. and Sociedad Espanola de Enfermedades lnfecciosas y Microbiologia Clinica. All rights reserved.

Background: The use of combination antiretroviral therapy has led to dramatic improvements in the life expectancy of HIV-infected persons. As result, the HIV population is aging and increasingly facing illnesses typically seen in the elderly, such as chronic kidney disease (CKD). Methods: A retrospective longitudinal study was conducted using data from years 2010 and 2014 in all HIV-infected persons enrolled at the Spanish VACH cohort. We analyzed the prevalence and the predictive factors for developing CKD (estimated glomerular filtration rate, eGFR < 60 mL/min/1.73 m(2)). Results: The CKD prevalence at baseline was 456/8968, 5.1% [4.6-5.6%]. Of 8512 HIV-positive individuals examined without CKD at baseline (73.7% male, median age 44 years-old), 2.15% developed CKD (eGFR < 60 mL/min/1.73 m(2)). The odds ratios [95%Cl] for the independent predictive factors identified were gender (male) 0.54 [0.39-0.75], age (per year) 1.08 [1.07-1.10], AIDS diagnosis 1.40 [1.03-1.91], protease inhibitor-based regimens 1.49 [1.10-2.02], hypertension 1.37 [0.94-1.99], diabetes 1.84 [1.33-2.55] and history of cardiovascular events 1.66 [0.96-2.86]. Conclusions: The prevalence and risk factors for CKD and its progression are high in the VACH cohort. Thus, preventive measures such as control of hypertension, diabetes and obesity, as well as efforts for avoiding exposure to nephrotoxic drugs, including some antiretrovirals, are warranted in this aging HIV population. (C) 2019 Sociedad Espanola de Nefrologia. Published by Elsevier Espana, S.L.U.

There have been few studies conducted on the efficacy and safety of specific immunotherapy with allergen extracts of fungi compared with other allergen extracts, and there are no data on the major allergen Alt a 1 of the fungus Alternaria alternata.

Patients with HIV infection have a higher cardiovascular risk than the general population. The identification of patients with high CVR, the implementation of preventive measures and the control of modifiable risk factors, especially in patients on antiretroviral therapy should be part of the management of HIV infection. This document updates the recommendations published in 2014, mainly regarding lipid, glucose, arterial hypertension alterations and cardiovascular risk (CVR). The objective of metabolic monitoring is A1 C