Search

IntroductionThe detection of pancreatic autoantibodies in first-degree relatives of patients with type 1 diabetes (T1D) is considered a risk factor for disease. Novel available immunotherapies to delay T1D progression highlight the importance of identifying individuals at risk who might benefit from emerging treatments. The objective was to assess the autoimmunity in first-degree relatives of patients with T1D, estimate the time from autoimmunity detection to the onset of clinical diabetes, and identify the associated risk factors.MethodsRetrospective multicenter study of 3,015 first-degree relatives of patients with T1D recruited between 1992 and 2018. Pancreatic autoantibodies (IAA, GADA, IA2A, and ZnT8A) were determined by radioimmunoassay, starting the analyses at diagnosis of the proband. All those with positive autoimmunity and normal fasting blood glucose without clinical symptoms of diabetes were followed up in the study. The progression rate to T1D was assessed according to sex, relationship with the proband, age at autoimmunity detection, type/number of autoantibodies, and HLA-DRB1 genotype. Cox proportional-hazard models and Kaplan–Meier survival plots were used for statistical analyses.ResultsAmong the relatives, 21 progenitors [43.7 years (IQR: 38.1–47.7)] and 27 siblings [7.6 years (IQR: 5.8–16.1)] had positive autoantibodies. Of these, 54.2% (95% CI: 39.2%–68.6%) developed T1D (age at autoimmunity detection 11 months to 39 years) in a median of 5 years (IQR: 3.6–8.7; ranged from 0.9 to 22.6 years). Risk factors associated with faster progression to T1D were multiple autoimmunity and

Introduction: The assessment of white blood cell (WBC) count and polymorphonuclear cell (PMN) percentage in synovial fluid can help in the diagnosis of acute postoperative peri-prosthetic joint infection (PJI). Their cutoff values, which would differ from those for chronic PJI, have not yet been determined in acute postoperative PJI. The aim of this study was (1) to analyse studies reporting the optimal cutoff values for WBC count and the PMN percentage in synovial fluid and (2) to determine which is the best diagnostic tool for acute postoperative PJI. Methods: We performed a systematic review (SR) of primary studies analysing WBC count and the PMN percentage for diagnosis of acute postoperative PJI. A search was performed in MEDLINE and EMBASE. We studied the risk of bias and quality assessment. We extracted data on cutoff values, sensitivity, specificity, positive and negative predictive value, area under the curve, and accuracy. We calculated the diagnosis odds ratio (DOR), performed the meta-analysis and summarized receiver operating curves (sROCs) for WBC count and the PMN percentage. Results: We included six studies. WBC count showed a DOR of 123.61 (95 % CI: 55.38–275.88), an sROC with an area under the curve (AUC) of 0.96 (SE: 0.009) and a Q index of 0.917. The PMN percentage showed a summary DOR of 18.71 (95 % CI: 11.64–30.07), an sROC with an AUC 0.88 (SE: 0.018) and a Q index of 0.812. Conclusion: We concluded that WBC count and the PMN percentage are useful tests for the diagnosis of acute PJI; WBC is the more powerful of the two. Studies centred on other synovial fluid biomarkers not yet studied could help in this diagnosis.

Abstract Introduction Similar Patient-Reported Outcomes (PROs) at diagnosis for localized prostate cancer among countries may indicate that different treatments are recommended to the same profile of patients, regardless the context characteristics (health systems, medical schools, culture, preferences…). The aim of this study was to assess such comparison. Methods We analyzed the EPIC-26 results before the primary treatment of men diagnosed of localized prostate cancer from January 2017 onwards (revised data available up to September 2019), from a multicenter prospective international cohort including seven regions: Australia/New Zealand, Canada, Central Europe (Austria / Czech Republic / Germany), United Kingdom, Italy, Spain, and the United States. The EPIC-26 domain scores and pattern of three selected items were compared across regions (with Central Europe as reference). All comparisons were made stratifying by treatment: radical prostatectomy, external radiotherapy, brachytherapy, and active surveillance. Results The sample included a total of 13,483 men with clinically localized or locally advanced prostate cancer. PROs showed different domain patterns before treatment across countries. The sexual domain was the most impaired, and the one with the highest dispersion within countries and with the greatest medians’ differences across countries. The urinary incontinence domain, together with the bowel and hormonal domains, presented the highest scores (better outcomes) for all treatment groups, and homogeneity across regions. Conclusions Patients with localized or locally advanced prostate cancer undergoing radical prostatectomy, EBRT, brachytherapy, or active surveillance presented mainly negligible or small differences in the EPIC-26 domains before treatment across countries. The results on urinary incontinence or bowel domains, in which almost all patients presented the best possible score, may downplay the baseline data role for evaluating treatments’ effects. However, the heterogeneity within countries and the magnitude of the differences found across countries in other domains, especially sexual, support the need of implementing the PRO measurement from diagnosis.

Introduction Mirror exposure therapies (MET) have been proposed to reduce symptomatology in patients with Anorexia Nervosa. However, most MET protocols or related studies do not specify the patients’ distance to the mirror, or when they do so, such a distance may differ significantly (from 0,5 to 3 meters). Such modifications of mirror positioning could imply variations in patients’ fixation patterns on different body parts (i.e., attentional bias between weight-related and non-weight related body parts), since previous studies shown that dissociated neural systems (either in left or right cerebral hemispheres) are involved in the attentional patterns and scanning strategies depending on the distance (i.e., in near and far space). Furthermore, as the body-related attentional bias (AB) has been shown to be a part of the maintenance mechanism of AN symptomatology, any modification of attentional patterns due to mirror’s distance variations may influence the efficacy of MET. Objectives This study aims to use Virtual Reality (VR) and Eye-Tracking (ET) technologies to precisely analyse the effect of the distance to the mirror on the attentional patterns. Methods 137 female college students were immersed in a VR environment in which they could look in the mirror at their respective avatars created from the measurements and photos of their real bodies. The mirror was positioned at 3.30m in front of the participants in “group 1” (n1 = 54), and at 1.54m in front of the participants in “group 2” (n2 = 83). Eye-Tracking feature and OGAMA software (Freie Universität, Berlin, Germany) were used to record and process the visual attentional pattern of each participant, during a 30-second free viewing task at her avatar. Complete Fixation Time (CFT) was assessed as the fixation time difference between weight- and non-weight- related body parts, defined from the weight scale of the PASTAS questionnaire. Independent Sample t-Test was conducted to analyse CFT mean difference between both groups. Results Independent Samples t-Test shows statistically significant CFT mean difference (F (1, 135) = 1.571, p < 0.001, 95% IC [1717; 5581]) between both groups. While fixation pattern of the group positioned further to the mirror (group 1) was more focused on weight-related body parts (CFT mean = 2282ms, SD = 809), the fixation pattern of the group positioned closer to the mirror (group 2) was more focused on non-weight-related body parts (CFT mean = -1367ms, SD = 587). Conclusions This study shows new opportunities to use VR and ET technologies to precisely analyse the variations of fixation patterns as a function of mirror position in MET. Such information may contribute to adapt and develop new MET’s protocols for AN patients, optimizing the distance to the mirror. It also underscores the importance of specifying the distance to the mirror in MET-related studies to improve replicability. Disclosure of Interest None Declared

Background: Chronic Urticaria (CU) is a debilitating disease whose treatment is mainly symptomatic. UCREX study aimed to identify CU patients’ profile, disease management and quality-of-life (QoL) in daily clinical practice in Spain. Methods: Observational, 12-months prospective, multicenter study, included de novo or established CU patients attending to dermatology/allergy consultations in 39 Spanish hospitals. Main variables: Urticaria Activity Score (UAS), UAS over 7 days (UAS7). Secondary variables: CU-QoL Questionnaire (CU-Q2oL), EuroQol-5 dimensions (EQ-5D), Medical Outcomes Study Sleep (MOS-Sleep) scale, Hospital Anxiety and Depression Scale (HADS). Results: 361 patients included. Of them, 176 (48.8%) considered for the main objective analysis. Mean age (SD) of 46.6 (14.2) years and 71.8% women. The year prior to inclusion, most patients (57.1%) were treated with non-sedating H1-antihistamines (NS-H1AH). At baseline, mean (SD) 3.6 (6.8) visits were registered to primary care. Mean (SD) UAS7 at baseline was 14.3 (11.0) and CU-Q2oL 24.1 (17.0) which tended to improve by 8.6 (9.7) and 13.9 (15.0), respectively, at 12-months. MOS-Sleep and EQ-5D remained steady during the study, except pain/discomfort and anxiety/depression which went from 58.7% and 49.6% to 29.6% and 26.9%, respectively. At baseline, HADS showed a mean (SD) anxiety of 8.7 (4.5) and depression 5.1 (4.4), decreasing to 7.0 (4.3) and 4.7 (4.3), respectively, at 12-months. Conclusions: Although most CU patients are treated with NS-H1AH, disease activity is still important, negatively affecting patients’ QoL, work activity and healthcare resources use. An appropriate disease management could be the basis for symptoms control, QoL improvement and resources optimization. Resumen: Antecedentes: La urticaria crónica (UC) es una enfermedad debilitante cuyo tratamiento es principalmente sintomático. El estudio UCREX tuvo como objetivo identificar el perfil de los pacientes con UC, el manejo de la enfermedad y la calidad de vida (CdV) en la práctica clínica diaria en España. Métodos: Estudio observacional, prospectivo, multicéntrico de 12 meses, que incluyó pacientes con UC de novo o establecida que acudieron a la consulta de dermatología/alergología de 39 hospitales españoles. Las variables principales fueron: el Urticaria Activity Score (UAS) y el UAS por siete días (UAS7). Las variables secundarias fueron: el cuestionario de CdV de urticaria crónica (CU-Q2oL), el EuroQol-5 Dimensiones (EQ-5D), la escala Medical Outcomes Study Sleep (MOS-Sleep) y la escala hospitalaria de ansiedad y depresión (HADS). Resultados: Se incluyeron 361 pacientes, de los cuales 176 (48,8%) formaron parte del análisis del objetivo principal. La edad media (DE) fue de 46,6 (14,2) años y el 71,8% eran del sexo femenino. El año anterior al periodo de inclusión de los pacientes, la mayoría de ellos (57,1%) se habían tratado con antihistamínicos H1 no sedantes (AHNS-H1). En la basal, se registró una media (DE) de 3,6 (6,8) de visitas a atención primaria. La media (DE) del UAS7 en la basal fue de 14,3 (11,0) y del CU-Q2oL 24,1 (17,0), observándose una tendencia en la mejoría en 8,6 (9,7) y 13,9 (15,0), respectivamente, a los 12 meses. El MOS-Sleep y el EQ-5D se mantuvieron estables durante el estudio, excepto por el dolor/malestar y la ansiedad/depresión que pasaron de 58,7 y 49,6% a 29,6 y 26,9%, respectivamente. En situación basal, el HADS mostró una ansiedad media (DE) de 8,7 (4,5) y una depresión de 5,1 (4,4), disminuyendo respectivamente a 7,0 (4,3) y 4,7 (4,3) a los 12 meses. Conclusiones: Aunque la mayoría de los pacientes son tratados con AHNS-H1, la actividad de la enfermedad sigue siendo importante, afectando negativamente a su CdV, su actividad laboral y repercutiendo negativamente en el uso de recursos sanitarios. Un manejo adecuado de la enfermedad podría ser la base para alcanzar el control de los síntomas, la mejora de la CdV y la optimización de los recursos sanitarios necesarios.

Abstract Subjects with first-episode psychosis experience substantial deficits in social cognition and metacognition. Although previous studies have investigated the role of profiles of individuals in social cognition and metacognition in chronic schizophrenia, profiling subjects with first-episode psychosis in both domains remains to be investigated. We used latent profile analysis to derive profiles of the abilities in 174 persons with first-episode psychosis using the Beck’s Cognitive Insight Scale, the Faces Test, the Hinting Task, the Internal, Personal and Situational Attributions Questionnaire, and the Beads Task. Participants received a clinical assessment and a neuropsychological assessment. The best-fitting model was selected according to the Bayesian information criterion (BIC). We assessed the importance of the variables via a classification tree (CART). We derived three clusters with distinct profiles. The first profile (33.3%) comprised individuals with low social cognition. The second profile (60.9%) comprised individuals that had more proneness to present jumping to conclusions. The third profile (5.7%) presented a heterogeneous profile of metacognitive deficits. Persons with lower social cognition presented worse clinical and neuropsychological features than cluster 2 and cluster 3. Cluster 3 presented significantly worst functioning. Our results suggest that individuals with FEP present distinct profiles that concur with specific clinical, neuropsychological, and functional challenges. Each subgroup may benefit from different interventions.

Abstract Background Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality worldwide despite correct antibiotic use. Corticosteroids have long been evaluated as a treatment option, but heterogeneous effects on survival have precluded their widespread implementation. We aimed to evaluate whether corticosteroids might improve clinical outcomes in patients with severe CAP and high inflammatory responses. Study design and methods We analyzed two prospective observational cohorts of patients with CAP in Barcelona and Rome who were admitted to intensive care with a high inflammatory response. Propensity score (PS) matching was used to obtain balance among the baseline variables in both groups, and we excluded patients with viral pneumonia or who received hydrocortisone. Results Of the 610 patients admitted with severe CAP, 198 (32%) received corticosteroids and 387 had major criteria for severe CAP. All patients had a baseline serum C-reactive protein above 15 mg/dL. Patients who received corticosteroids were more commonly male, had more comorbidities (e.g., cancer or chronic obstructive pulmonary disease), and presented with significantly higher sequential organ failure assessment scores. Eighty-nine patients met major severity criteria (invasive mechanical ventilation and/or septic shock) and were matched per group. Twenty-eight-day mortality was lower among patients receiving corticosteroids (16 patients, 18%) than among those not receiving them (28 patients, 31%; p = 0.037). After PS matching, corticosteroid therapy reduced the 28-day mortality risk in patients who met major severity criteria (hazard ratio (HR) 0.53, 95% confidence interval (CI) 0.29–0.98) (p = 0.043). In patients who did not meet major severity criteria, no benefits were observed with corticosteroid use (HR 0.88 (95%CI 0.32–2.36). Conclusions Corticosteroid treatment may be of benefit for patients with CAP who have septic shock and/or a high inflammatory response and requirement for invasive mechanical ventilation. Corticosteroids appear to have no impact on mortality when these features are not present.

BackgroundPeanut-allergic patients from the Mediterranean region are predominantly sensitized to the lipid transfer protein (LTP) Ara h 9, and the peach LTP Pru p 3 seems to be the primary sensitizer. However, LTP sensitization in peanut allergy is not a predictive marker for clinically relevant symptoms.ObjectiveWe aimed to identify sequential epitopes of IgE and IgG4 from Pru p 3 and Ara h 9 in peach-allergic patients sensitized to peanuts. We also sought to determine the differences in IgE and IgG4 binding between patients who had developed peanut allergy and those tolerating peanuts.MethodsA total of 46 peach-allergic patients sensitized to peanuts were selected. A total of 35 patients were allergic to peanuts (peanut-allergic group) and 11 were tolerant to peanuts (peanut-tolerant group). We measured sIgE and sIgG4 in peanut, peach, and their recombinant allergen (Ara h 1, Ara h 2, Ara h 3, Ara h 8, and Ara h 9) with fluorescence enzyme immunoassay. We examined the IgE and IgG4 binding to sequential epitopes using a peptide microarray corresponding to linear sequences of the LTPs Ara h 9 and Pru p 3 with a library of overlapping peptides with a length of 20 amino acids (aa) and an offset of 3 aa.ResultsThe frequency and the intensity of IgE recognition of Ara h 9 and Pru p 3 peptides were higher in the peanut-tolerant group than in the peanut-allergic group. We found four Ara h 9 peptides (p4, p14, p21, and p25) and four Pru p 3 peptides (p1, p3, p21, and p24) with a significantly elevated IgE recognition in peanut-tolerant patients. Only one peptide of Ara h 9 (p4) recognized by IgG4 was significantly elevated in the peanut-tolerant group. The IgG4/IgE ratio of Ara h 9 peptide 4 was significantly higher in peanut-tolerant patients than in peanut-allergic patients, while no significant differences were observed in the IgG4/IgE ratio of this peptide in Pru p 3.ConclusionAlthough we found significant differences in IgE and IgG4 recognition of Ara h 9 and Pru p 3 between peanut-tolerant and peanut-allergic patients (all of whom were allergic to peach), polyclonal IgE peptide recognition of both LTPs was observed in peach-allergic patients tolerating peanuts. However, the IgG4 blocking antibodies against Ara h 9 peptide 4 could provide an explanation for the absence of clinical reactivity in peanut-tolerant peach-allergic patients. Further studies are needed to validate the usefulness of IgG4 antibodies against Ara h 9 peptide 4 for peanut allergy diagnosis.

Se ha realizado el análisis mineralógico a través de las propiedades espectrales desarrolladas por muestras de suelos y sedimentos del borde noroccidental de la Cuenca del Duero. Las absorciones producidas por los óxidos y oxihidróxidos de hierro (hematites y goethita, principalmente) están localizadas en zonas del VNIR (400-1200 nm), mientras que las bandas de absorción presentes en los espectros del SWIR (1200-2500 nm) están relacionadas con la composición química de minerales arcillosos. Los espectros de reflectancia medidos en laboratorio han sido normalizados aplicando los métodos del Continuum Removal (CR) y la segunda derivada (SD). Este último puede resolver la superposición de bandas al cuantificar sutiles inflexiones de la curva. Esto ha permitido examinar las bandas de absorción por separado midiendo los parámetros geométricos desarrollados en ellas. La proporción de los minerales influye en la respuesta espectral y, por tanto, en los valores de los parámetros. Se han realizado correlaciones lineales entre estos valores y la proporción de las diferentes fases minerales obtenidas por difracción de rayos X. De los parámetros estudiados, la correlación entre la posición del centro de banda (BC) en la máxima absorción alrededor de longitudes de onda de 890-960 nm y la profundidad del rasgo de absorción a 470 nm (D470) ha permitido realizar una estimación relativa de la proporción de hematites/goethita. En cuanto a la distribución de los diferentes minerales de arcilla, se ha podido establecer una correlación entre la proporción de caolinita y la profundidad de las bandas de absorción a 1415 y 2210 nm, y en los rasgos de absorción cercanos a 1390 y 2160 nm, analizados en SD.

Resumen: Antecedentes: La urticaria crónica (UC) es una enfermedad debilitante cuyo tratamiento es principalmente sintomático. El estudio UCREX tuvo como objetivo identificar el perfil de los pacientes con UC, el manejo de la enfermedad y la calidad de vida (CdV) en la práctica clínica diaria en España. Métodos: Estudio observacional, prospectivo, multicéntrico de 12 meses, que incluyó pacientes con UC de novo o establecida que acudieron a la consulta de dermatología/alergología de 39 hospitales españoles. Las variables principales fueron: el Urticaria Activity Score (UAS) y el UAS por siete días (UAS7). Las variables secundarias fueron: el cuestionario de CdV de urticaria crónica (CU-Q2oL), el EuroQol-5 Dimensiones (EQ-5D), la escala Medical Outcomes Study Sleep (MOS-Sleep) y la escala hospitalaria de ansiedad y depresión (HADS). Resultados: Se incluyeron 361 pacientes, de los cuales 176 (48,8%) formaron parte del análisis del objetivo principal. La edad media (DE) fue de 46,6 (14,2) años y el 71,8% eran del sexo femenino. El año anterior al periodo de inclusión de los pacientes, la mayoría de ellos (57,1%) se habían tratado con antihistamínicos H1 no sedantes (AHNS-H1). En la basal, se registró una media (DE) de 3,6 (6,8) de visitas a atención primaria. La media (DE) del UAS7 en la basal fue de 14,3 (11,0) y del CU-Q2oL 24,1 (17,0), observándose una tendencia en la mejoría en 8,6 (9,7) y 13,9 (15,0), respectivamente, a los 12 meses. El MOS-Sleep y el EQ-5D se mantuvieron estables durante el estudio, excepto por el dolor/malestar y la ansiedad/depresión que pasaron de 58,7 y 49,6% a 29,6 y 26,9%, respectivamente. En situación basal, el HADS mostró una ansiedad media (DE) de 8,7 (4,5) y una depresión de 5,1 (4,4), disminuyendo respectivamente a 7,0 (4,3) y 4,7 (4,3) a los 12 meses. Conclusiones: Aunque la mayoría de los pacientes son tratados con AHNS-H1, la actividad de la enfermedad sigue siendo importante, afectando negativamente a su CdV, su actividad laboral y repercutiendo negativamente en el uso de recursos sanitarios. Un manejo adecuado de la enfermedad podría ser la base para alcanzar el control de los síntomas, la mejora de la CdV y la optimización de los recursos sanitarios necesarios. Abstract: Background: Chronic Urticaria (CU) is a debilitating disease whose treatment is mainly symptomatic. UCREX study aimed to identify CU patients’ profile, disease management and quality-of-life (QoL) in daily clinical practice in Spain. Methods: Observational, 12-months prospective, multicenter study, included de novo or established CU patients attending to dermatology/allergy consultations in 39 Spanish hospitals. Main variables: Urticaria Activity Score (UAS), UAS over 7 days (UAS7). Secondary variables: CU-QoL Questionnaire (CU-Q2oL), EuroQol-5 dimensions (EQ-5D), Medical Outcomes Study Sleep (MOS-Sleep) scale, Hospital Anxiety and Depression Scale (HADS). Results: 361 patients included. Of them, 176 (48.8%) considered for the main objective analysis. Mean age (SD) of 46.6 (14.2) years and 71.8% women. The year prior to inclusion, most patients (57.1%) were treated with non-sedating H1-antihistamines (NS-H1AH). At baseline, mean (SD) 3.6 (6.8) visits were registered to primary care. Mean (SD) UAS7 at baseline was 14.3 (11.0) and CU-Q2oL 24.1 (17.0) which tended to improve by 8.6 (9.7) and 13.9 (15.0), respectively, at 12-months. MOS-Sleep and EQ-5D remained steady during the study, except pain/discomfort and anxiety/depression which went from 58.7% and 49.6% to 29.6% and 26.9%, respectively. At baseline, HADS showed a mean (SD) anxiety of 8.7 (4.5) and depression 5.1 (4.4), decreasing to 7.0 (4.3) and 4.7 (4.3), respectively, at 12-months. Conclusions: Although most CU patients are treated with NS-H1AH, disease activity is still important, negatively affecting patients’ QoL, work activity and healthcare resources use. An appropriate disease management could be the basis for symptoms control, QoL improvement and resources optimization.

Abstract Background Colorectal cancer (CRC) is the second cause of tumour mortality in Spain and Europe. To date, no studies have been conducted in Spain to evaluate the spatial and temporal distribution of the excess risk of death during hospitalisation for CRC. Methods A cohort was constructed of all episodes of hospitalisation in Spain due to CRC (codes 153 and 154 of the International Classification of Diseases, 9th edition, Clinical Modification) during the period 2008–2014, based on the minimum basic data set published by the Ministry of Health. Mortality ratios were calculated per region for each of the years analyzed (spatial or cross-sectional analysis) and during the overall study period, for each region independently (temporal or longitudinal analysis). In the first of these analyses, particular note was taken of the regions and years in which the limits of two and three standard deviations were exceeded. Results Two hundred and fifty eight thousand, nine hundred and twenty seven episodes of CRC were analysed. The patients were predominantly male (60.6%), with an average hospital stay of 13.16 days. Half underwent surgery during admission and on average presented more than six diagnoses at discharge. The spatial analysis revealed mortality ratios that deviated by at least three standard deviations in the following regions: Islas Canarias, Asturias, Valencia, Extremadura, País Vasco and Andalucía. The longitudinal analysis showed that most regions presented one or more years when CRC mortality was at least 15% higher than expected during the period; outstanding in this respect were Asturias, Navarra and La Rioja, where this excess risk was detected in at least 2 years. Conclusions Geographic and temporal patterns of the distribution of the excess risk of mortality from CRC in Spain are described using SMRs. We conclude that during the study period, the geographic pattern of mortality in Spain did not coincide with the excess risk of mortality calculated using the SMR method described by Jarman and Foster. This method of risk estimation can be a useful tool for the study of mortality risk and its spatial variations.

Abstract Background The purpose of this study is to describe Health-Related Quality of Life (HRQoL) of localized prostate cancer patients in an Active Surveillance (AS) program, and to compare them with those undergoing radical prostatectomy (RP), external-beam radiotherapy (XRT) and brachytherapy (BT). Methods Multi-institutional pooled cross-sectional analysis on patients in an AS protocol: or or

Introduction It is large known that Coronavirus outbreak has had a psychological impact on the general population, specifically on those with a mental disease as Borderline Personality Disorder (BPD) and their relatives. Objectives The aim of the study is to identify and examine the individual and familiar impact of the coronavirus outbreak on patients diagnosed with BPD and their parents. Methods A qualitative research design using focus groups was selected to identify and discuss participants’ experiences, beliefs, perceptions and attitudes. The target population consisted of patients with BPD and their parents. Participants were recruited from the BPD psychiatric service from the Hospital Universitari de la Vall de Hebron (Barcelona, Spain). Data was collected via two focus groups, one with patients with BPD and other with their parents. Content analysis was used to determine categories and themes. Results The qualitative analysis of participants’ perceptions are presented using the following themes: changes and difficulties during lockdown, after lockdown concerns and challenges, general learning, and future needs. Results identify factors associated with the COVID-19 outbreak and other factors already present as family dynamics and individual difficulties. Conclusions Findings have been discussed focusing on individual and familiar impact, and allows us to consider challenges precipitated by the COVID-19 pandemic. The study evidence that a family intervention approach is essential to enhance BPD treatment.

El Prácticum constituye un momento clave en la formación de los futuros maestros. Así lo recogen los planes de estudio vigentes al ampliar su duración y al depositar en este periodo la capacidad de movilizar el desarrollo de determinadas competencias profesionales. En este contexto, la investigación que presentamos pretende mostrar qué percepción tiene el alumnado del Grado de Maestro de Educación Infantil de la Universidad de las Islas Baleares (UIB) sobre las competencias que se adquieren durante las prácticas. Mediante la aplicación de un cuestionario a una misma muestra antes y después del Prácticum, se compara la importancia que los estudiantes otorgan a las competencias y la valoración que hacen de las mismas. Coincidiendo con otros estudios, los datos revelan que las competencias están estrechamente interrelacionadas y que la percepción de los alumnos sobre su adquisición se incrementa tras el período de prácticas, lo que enfatiza la necesidad de profundizar en aquellos factores que determinan su éxito para garantizar una formación inicial de calidad. El estudio aporta beneficios para las prácticas pedagógicas ya que permite al profesorado universitario avanzar en el desarrollo del enfoque competencial, reflexionar y replantearse contenidos, así como valorar el impacto de su docencia más allá de las habilidades y capacidades académicas, incrementando las posibilidades de transferencia de los conocimientos trabajados.

Abstract Background Noninvasive ventilation is used worldwide in many settings. Its effectiveness has been proven for common clinical conditions in critical care such as cardiogenic pulmonary edema and chronic obstructive pulmonary disease exacerbations. Since the first pioneering studies of noninvasive ventilation in critical care in the late 1980s, thousands of studies and articles have been published on this topic. Interestingly, some aspects remain controversial (e.g. its use in de-novo hypoxemic respiratory failure, role of sedation, self-induced lung injury). Moreover, the role of NIV has recently been questioned and reconsidered in light of the recent reports of new techniques such as high-flow oxygen nasal therapy. Methods We conducted a survey among leading experts on NIV aiming to 1) identify a selection of 10 important articles on NIV in the critical care setting 2) summarize the reasons for the selection of each study 3) offer insights on the future for both clinical application and research on NIV. Results The experts selected articles over a span of 26 years, more clustered in the last 15 years. The most voted article studied the role of NIV in acute exacerbation chronic pulmonary disease. Concerning the future of clinical applications for and research on NIV, most of the experts forecast the development of innovative new interfaces more adaptable to patients characteristics, the need for good well-designed large randomized controlled trials of NIV in acute “de novo” hypoxemic respiratory failure (including its comparison with high-flow oxygen nasal therapy) and the development of software-based NIV settings to enhance patient-ventilator synchrony. Conclusions The selection made by the experts suggests that some applications of NIV in critical care are supported by solid data (e.g. COPD exacerbation) while others are still waiting for confirmation. Moreover, the identified insights for the future would lead to improved clinical effectiveness, new comparisons and evaluation of its role in still “lack of full evidence” clinical settings.

Efectos de la iluminación natural y artificial en el comportamiento nocturno de la salamanquesa común En este trabajo evaluamos los efectos del grado de iluminación nocturna (fase lunar e iluminación artificial) en la actividad de ejemplares de salamanquesa común (Tarentola mauritanica) de diferentes edades en un ambiente humanizado. Los datos de comportamiento individual se recogieron mediante observación directa y posteriormente se examinaron mediante un análisis lineal generalizado mixto (GLMM, por su sigla en inglés). La presencia de luna aumentó el número de salamanquesas activas. La iluminación artificial redujo el efecto de la luna en el número de salamanquesas activas, pero no en su actividad individual. Además, se observaron más salamanquesas adultas alrededor de fuentes de luz artificial debido a que los individuos de mayor tamaño monopolizaban los mejores lugares de alimentación. La capacidad de utilizar hábitats humanizados iluminados artificialmente, especialmente durante las noches de luna nueva, puede beneficiar la actividad de alimentación en especies de reptiles nocturnos como las salamanquesas.

Magnitud, composición y patrones espaciotemporales de la mortalidad de vertebrados en las carreteras a escala regional A pesar de que los estudios a gran escala sobre mortalidad de animales en las carreteras son complejos, pueden aportar información valiosa para evaluar la incidencia del tráfico en las poblaciones de animales. Durante 22 meses (entre julio de 2009 y junio de 2010 y entre abril de 2011 y marzo de 2012), muestreamos 45 tramos de carretera de 10 km de longitud distribuidos en una zona con una gran diversidad en la región de Andalucía (87.000 km2), en el sur de España. La región se dividió en cinco ecorregiones con diferentes condiciones ambientales y características del paisaje, y se analizaron la magnitud, la composición y los patrones espaciotemporales de la mortalidad de vertebrados (aves, mamíferos, anfibios y reptiles). Usamos datos de atropellos obtenidos durante muestreos mensuales en tramos de carretera con diferentes límite de velocidad, volumen de tráfico, diseño de la carretera y composición del paisaje adyacente. Los animales atropellados fueron distintos en el tiempo y no se distribuyeron aleatoriamente entre ecorregiones ni entre tipos de carretera. En total, los grupos que se encontraron con mayor frecuencia fueron los mamíferos (el 54,4 % de los atropellos registrados) y las aves (el 36,2 %). La tasa de mortalidad observada en estos dos grupos fue mayor en autopistas que en carreteras nacionales o locales, mientras que la mortalidad de anfibios (el 4,6 %) y de reptiles (el 4,3 %) no presentó diferencias entre tipos de carretera. A excepción de los mamíferos, la variación observada de la mortalidad en las carreteras entre las diferentes ecorregiones refleja los patrones de riqueza de especies descritos en las publicaciones científicas. Los atropellos se concentraron en períodos de tiempo relativamente cortos y este patrón se repitió en las dos temporadas de estudio y con respecto a todas las clases de vertebrados. Nuestros resultados proporcionan información de referencia sobre los tipos de carretera, los períodos de tiempo y los taxones con una mayor probabilidad de morir por atropello en una extensa región, lo que supone un paso esencial para la implementación de medidas de mitigación a gran escala.

Objectives: To analyse survival rate after 24 months in consecutive patients with a diagnosis of PE as well as associated factors. Methods: Prospective cohort study during a follow-up period of two years in a series of consecutive patients with PE. Results: During the follow-up period, 34 out of 148 patients died (23%). Factors independently associated with reduced survival rate were: creatinine levels > 2 (OR, 8.8; 95% CI, 1.1 - 70.87), previous neoplasm (OR, 8.8; 95% CI, 3.69 - 20.98), dementia (OR, 6.85; 95% CI, 2.1 - 22.33) and dyslipidemia (OR, 5.07; 95% CI, 1.92 - 13.44). Forty four percent of the patients with dyslipidemia died vs. 20.8% of patients without this condition. Conclusions: In our study dyslipidemia shows as a long-term negative prognostic marker for survival in patients with EP. Resumo: Objetivos: Analisar a taxa de sobrevivência após 24 meses, em pacientes consecutivos com diagnóstico de PE, bem como fatores associados. Métodos: Estudo prospectivo durante um período de seguimento de dois anos em uma série consecutiva de pacientes com PE. Resultados: Durante o período de acompanhamento, 34 dos 148 pacientes morreram (23%). Fatores independentemente associados à reduzida taxa de sobrevivência foram: os níveis de creatinina> 2 (OR, 8,8; 95% CI, 1,1-70,87), neoplasia anterior (OR, 8,8; IC 95%, 3,69-20,98), demência (OR, 6,85; 95% CI, 2,1-22,33) e dislipidemia (OR, 5,07; IC 95%, 1,92-13,44). Quarenta e quatro por cento dos pacientes com dislipidemia morreram contra 20,8% dos pacientes sem essa condição. Conclusões: No nosso estudo, a dislipidemia mostra-se um marcador prognóstico negativo de longo prazo na sobrevida de pacientes com EP. Keywords: Dyslipidemia, Lipid metabolic disorders, Pulmonary embolism, Survival analysis, Venous thromboembolism, Palavras-chave: Dislipidemia, Doenças metabólicas lipídicas, Embolia pulmonar, Análise de sobrevivência, Tromboembolismo venoso

Durant més de quatre dècades, la revista Miscel·lània Zoològica ha publicat prop de 900 articles. Una simple revisió dels continguts d’aquests articles en revela algunes característiques. La faunística i la taxonomia han estat les temàtiques més tractades i els insectes el grup zoològic més estudiat. L’àmbit geogràfic s’ha centrat en la península Ibèrica, principalment Catalunya. L’herència intel·lectual de Miscel·lània Zoològica ha estat recollida per la revista Animal Biodiversity and Conservation des de l’any 2001 i Arxius de Miscel·lània Zoològica a partir del present volum. Ha arribat el moment de començar a escriure la història de Miscel·lània Zoològica.

La infección por Escherichia coli productor de toxina Shiga (STEC) es causa de diarrea con o sin sangre, colitis hemorrágica y síndrome urémico hemolítico (SUH) en humanos. El objetivo de este trabajo fue validar una técnica de PCR múltiple para el diagnóstico de STEC basado en la detección de los genes stx1, stx2 y rfbO157. La validación de la técnica se realizó en dos laboratorios independientes, en forma paralela. Se determinó rango de trabajo, selectividad y robustez. Se evaluó el desempeño de la técnica al combinar distintas concentraciones de dos cepas con diferentes factores de virulencia. El rango de trabajo dependió de la cepa analizada, los valores máximos y mínimos fueron 6,6 x 107 y 1,0 x 104 UFC/50 µl. El límite de detección fue de 1,0 x 104 UFC/50 µl y el límite de corte de 1,0 x 105 UFC/50 µl. La robustez fue óptima al modificar diferentes variables. Se obtuvo 100% de inclusividad, exclusividad, precisión analítica, valor predictivo positivo y valor predictivo negativo. No se observó interferencia al combinar distintas concentraciones de los factores de virulencia blanco de la reacción. La técnica validada es una alternativa apropiada para la detección y confirmación de STEC O157 y no-O157 a partir de cultivos bacterianos.Shiga toxin-producing Escherichia coli (STEC) cause non-bloody or bloody diarrhea, hemorrhagic colitis and hemolytic uremic syndrome (HUS) in humans. The aim of the present study was to validate a multiplex PCR for the STEC diagnosis based on the detection of stx1, stx2 and rfbO157 genes. The multiplex PCR validation was carried out in two independent laboratories in a parallel way. Work range, selectivity and robustness were established. The PCR performance was evaluated using different concentrations of two STEC strains harboring different target genes. The work range depended on the strain analyzed, the maximum and the minimum values were 6.6 x 107 and 1.0 x 104 CFU/50 µl. The detection limit was 1.0 x 104 CFU/50 µl and the cut limit 1.0 x 105 CFU/50 ml. A good robustness was observed when different variables were introduced. Inclusivity, exclusivity, positive predictivity, negative predictivity and analytical accuracy were of 100%. Interference was not shown when different concentrations of STEC strains, carrying different genes, were used. The validated technique is an appropriate alternative for detection and confirmation of STEC O157 and non-O157 strains from bacterial cultures.

طی نمونه‌برداری‌های انجام‌شده از زنبورهای پارازیتویید در استان مازندران، گونه Alloxysta pleuralis (Cameron, 1879) از خانواده Figitidae به عنوان پارازیتویید شته Aphis gossypii Glover روی درخت نارنج، Citrus aurantium L. (Rutaceae)، در شهرستان جویبار جمع‌آوری و شناسایی شد. این زنبور پارازیتویید برای اولین‌بار از ایران گزارش می‌شود.

Determinar la calidad y eficacia del primer analizador hematológico que incorpora hematología convencional con tres detectores fluorescentes (rojo, naranja, y verde) en el diagnóstico hematológico de rutina comparado con citometría de flujo convencional. Demostrar el apoyo que esta tecnología aporta al tratamiento del paciente.

Cada vez está cobrando mayor valor la etiología vírica de la CIN (neoplasia intrae- .pitelial cervical), concretamente el papel oncogénico dei papovavirus. Entre los DNA vírus se ha atribuído papel oncogénico ai herpes simple virus (HSV-2), papovavirus (HPV). citomegalovirus (CMV) y es cuestionable la acción de los retrovirus. EI concepto de condiloma ha cambiado totalmente en los últimos doce anos. En 1975 la única infección por papovavirus humano (HPV) dei tracto genital que se conocía era el condiloma acuminado, afectando principalmente la vulva y mucho más raramente el cérvix.

El Á guila Imperial Ibérica es una de las aves más amenazadas de extinción del mundo. Actualmente, la población mundial de la especie está estimada en un poco más de 200 parejas. Todas ellas se encuentran en territorio peninsular español, en los bosques mediterráneos del cuadrante suroccidental, repartidas en una serie de subpoblaciones de pequeño tamaño (menos de 30 parejas) con un nivel de intercambio medio‐bajo, estando algunas de ellas claramente aisladas. Este tipo de distribución es típicamente inestable y paso previo habitual de los procesos de extinción. Entre las principales amenazas a la especie se encuentran la disminución de las poblaciones de conejo, que constituye su principal presa, y la mortalidad por electrocución en tendidos eléctricos.