Gravidez e Epilepsia

Epilepsy is common among women of childbearing age. Maternal-fetal risk is slightly superior to general population, resulting from antiepileptic drugs' teratogenicity and seizures. Optimized disease control and screening for medication's adverse effects are crucial parts of prenatal care. Most pregnant women require chronic therapy to prevent seizures; definition of an effective and least teratogenic regime should be performed preconceptionally. Sodium valproate is the most teratogenic drug; teratogenicity also increases with polytherapy and medication dosage. Labour should take place in a qualified obstetrical and neonatal centre. Usually breastfeeding is safe. Regarding contraception, consider interactions between enzyme-inducing antiepileptics drugs and hormonal contraceptivesinfo:eu-repo/semantics/publishedVersio

Pharmacological Primary Cardiovascular Prevention and Subclinical Atherosclerosis in Men: Evidence from the Aragon Workers' Health Study.

The objective of this study is to describe the profile of primary preventive treatment for cardiovascular disease in adult males and to analyze the association between treatment profile and subclinical atherosclerosis. We selected male workers who had undergone ultrasound imaging and had no previous history of cardiovascular disease (n = 2138). Data on the consumption of primary cardiovascular drugs from the previous year were obtained. We performed bivariate analyses to compare patient characteristics according to cardiovascular treatment and the presence of subclinical atherosclerosis, and logistic regression models to explore the association between these two variables. Among participants with no personal history of cardiovascular disease, subclinical atherosclerosis was present in 77.7% and 31.2% had received some form of preventive treatment. Of those who received no preventive treatment, 73.6% had subclinical atherosclerosis. Cardiovascular preventive treatment was associated only with CACS > 0 (odds ratio (OR), 1.37; 95% confidence interval (95% CI), 1.06-1.78). Statin treatment was associated with a greater risk of any type of subclinical atherosclerosis (OR, 1.73) and with CACS > 0 (OR, 1.72). Subclinical atherosclerosis existed in almost 75% of men who had no personal history of cardiovascular disease and had not received preventive treatment for cardiovascular disease

Self-rated health and educational level in Spain: Trends by autonomous communities and gender (2001-2012)

Objetivo Conocer la evolución de la prevalencia de mala salud percibida en España por comunidades autónomas (CC.AA.) para el periodo 2001-2012, las diferencias por sexo y edad, y la influencia del nivel educativo. Método Estudio transversal de la Encuesta Nacional de Salud de 2001 a 2011-12, y de la Encuesta Europea de 2009. Se realizó un estudio descriptivo por sexo, edad, nivel educativo y C.A. de residencia ajustado por edad. Se utilizaron análisis de regresión logística para estudiar la evolución temporal y conocer la asociación entre el nivel educativo y la salud percibida, calculando su capacidad predictiva mediante el estadístico C. Resultados La prevalencia de mala salud percibida fue mayor en las mujeres con nivel educativo bajo y mejoró en las de nivel educativo alto (18,6% en 2001 y 14,6% en 2012). La mayor prevalencia de mala salud percibida se observó en Andalucía, Canarias, Galicia y Murcia, con diferencias por sexo. El nivel educativo bajo se asoció con una peor salud percibida en la mayoría de las CC.AA., con buena capacidad predictiva. En todas las CC.AA., excepto Asturias, existió una mayor percepción de mala salud en las mujeres que en los hombres. En España, la prevalencia de mala salud percibida se mantuvo sin cambios en el periodo analizado, pero mejoró en Baleares, Cataluña y Madrid. Conclusiones En España existen diferencias en la prevalencia de mala salud percibida por CC.AA. Aunque no varía en el periodo analizado, se observan desigualdades en su evolución según el nivel educativo y el sexo, que podrían conllevar un aumento de las desigualdades en mujeres según el nivel educativo. Objective To identify the trend in self-rated health in Spain by autonomous communities (AC) in the period 2001-2012, as well as differences by gender and age, and the influence of educational level. Methods A cross sectional study was carried out using data from the National Health Surveys from 2001 to 2011-12 and the 2009 European Survey. A descriptive analysis was conducted that included gender, age, educational level, and the AC of residence. Logistic regression analyses were developed to explore the temporal trend and the association between educational level and self-rated health. The predictive capacity of the model was calculated using the C statistic. Results The prevalence of low self-rated health was higher in women with low educational level. Self-rated health improved in women with high educational level (2001:18.6% vs. 2012:14.6%). The highest prevalence of low self-rated health was observed in Andalusia, the Canary Islands, Galicia and Murcia, with differences by gender. Low educational level was associated with low self-rated health in most AC, with good predictive capacity. In all AC except Asturias, low self-rated health was more frequent in women than in men. In Spain, the prevalence of self-rated health showed no variations in the period analyzed and improved in the Balearic Islands, Catalonia, and Madrid. Conclusions The prevalence of self-rated health in Spain differed by AC. Although health was unchanged during the period considered, inequalities were found in its temporal trend by educational level and gender, which could lead to an increase in health inequalities in women according educational level

Utilización de servicios sanitarios en ancianos (España 2006-2012): influencia del nivel de salud y de la clase social

Objetivo Conocer la utilización de servicios sanitarios de Atención Primaria (AP), Atención Especializada (AE), hospitalizaciones, Hospital de Día y Urgencias, y la hiperfrecuentación en ancianos en España, analizando la influencia del estado de salud, sexo, clase social y evolución temporal. Diseño Estudio transversal en 2 fases. Emplazamiento España. Participantes Personas encuestadas en la Encuesta Nacional de Salud 2006 y 2011-12. Mediciones principales Como variables de salud se utilizaron la salud percibida y diagnosticada (número y tipo de diagnósticos). La clase social se obtuvo a partir de la última ocupación del sustentador principal (clases manuales y no manuales). Se realizaron análisis de regresión logística, ajustando por sexo, edad, nivel de salud, clase social y año, calculando su capacidad predictiva. ResultadosEl porcentaje de población mayor que utiliza consultas médicas descendió en el periodo estudiado. Las mujeres trabajadoras manuales presentaron la mayor prevalencia de mala salud (mala salud percibida en el 2006: 70,6%). La mala salud se asoció a mayor utilización de servicios sanitarios. La salud percibida fue mejor predictor de utilización de servicios y de hiperfrecuentación que la diagnosticada, con la mayor capacidad predictiva para AE (C = 0,676). Los ancianos de clases sociales bajas utilizaron con más frecuencia AP y Urgencias, mientras que la utilización de AE y Hospital de Día fue mayor en clases altas. Conclusiones Existen diferencias en salud y utilización de servicios sanitarios en mayores según clase social. Resulta necesario prestar atención a la salud percibida como predictor de la utilización de servicios sanitarios y revisar la accesibilidad-equidad de nuestros servicios

Frequency and type of adverse analytical findings in athletics: Differences among disciplines.

Athletics is a highly diverse sport that contains a set of disciplines grouped into jumps, throws, races of varying distances, and combined events. From a physiological standpoint, the physical capabilities linked to success are quite different among disciplines, with varying involvements of muscle strength, muscle power, and endurance. Thus, the use of banned substances in athletics might be dictated by physical dimensions of each discipline. Thus, the aim of this investigation was to analyse the number and distribution of adverse analytical findings per drug class in athletic disciplines. The data included in this investigation were gathered from the Anti-Doping Testing Figure Report made available by the World Anti-Doping Agency (from 2016 to 2018). Interestingly, there were no differences in the frequency of adverse findings (overall, 0.95%, range from 0.77 to 1.70%) among disciplines despite long distance runners having the highest number of samples analysed per year ( 9812 samples/year). Sprinters and throwers presented abnormally high proportions of adverse analytical findings within the group of anabolic agents (p < 0.01); middle- and long-distance runners presented atypically high proportions of findings related to peptide hormones and growth factors (p < 0.01); racewalkers presented atypically high proportions of banned diuretics and masking agents (p = 0.05). These results suggest that the proportion of athletes that are using banned substances is similar among the different disciplines of athletics. However, there are substantial differences in the class of drugs more commonly used in each discipline. This information can be used to effectively enhance anti-doping testing protocols in athletics.post-print1.911 K

Partially Supersymmetric Composite Higgs Models

We study the idea of the Higgs as a pseudo-Goldstone boson within the framework of partial supersymmetry in Randall-Sundrum scenarios and their CFT duals. The Higgs and third generation of the MSSM are composites arising from a strongly coupled supersymmetric CFT with global symmetry SO(5) spontaneously broken to SO(4), whilst the light generations and gauge fields are elementary degrees of freedom whose couplings to the strong sector explicitly break the global symmetry as well as supersymmetry. The presence of supersymmetry in the strong sector may allow the compositeness scale to be raised to ~10 TeV without fine tuning, consistent with the bounds from precision electro-weak measurements and flavour physics. The supersymmetric flavour problem is also solved. At low energies, this scenario reduces to the "More Minimal Supersymmetric Standard Model" where only stops, Higgsinos and gauginos are light and within reach of the LHC.Comment: 28 pages. v2 minor changes and Refs. adde

Assessment of Chemical Inhibitor Addition to Improve the Gas Production from Biowaste

The coexistence of sulphate-reducing bacteria and methanogenic archaea in the reactors during the anaerobic digestion from sulphate-containing waste could favor the accumulation of sulfide on the biogas, and therefore reduce its quality. In this study, the effect of sulphate-reducing bacteria inhibitor (MoO−2 4 ) addition in a two phase system from sulphate-containing municipal solid waste to improve the quality of the biogas has been investigated. The results showed that although SRB and sulphide production decreased, the use of inhibitor was not effective to improve the anaerobic digestion in a two phase system from sulphate-containing waste, since a significant decrease on biogas and organic matter removal were observed. Before MoO−2 4 addition the average values of volatile solid were around 12 g/kg, after 5 days of inhibitor use, those values did exceed to 28 g/kg. Molybdate caused acidification in the reactor and it was according to decrease in the pH values. In relation to microbial consortia, the effect of inhibitor was a decrease in Bacteria (44%; 60% in sulphate-reducing bacteria) and Archaea (38%) population

Current controversies in TNM for the radiological staging of rectal cancer and how to deal with them: results of a global online survey and multidisciplinary expert consensus

Objectives: To identify the main problem areas in the applicability of the current TNM staging system (8th ed.) for the radiological staging and reporting of rectal cancer and provide practice recommendations on how to handle them. Methods: A global case-based online survey was conducted including 41 image-based rectal cancer cases focusing on various items included in the TNM system. Cases reaching < 80% agreement among survey respondents were identified as problem areas and discussed among an international expert panel, including 5 radiologists, 6 colorectal surgeons, 4 radiation oncologists, and 3 pathologists. Results: Three hundred twenty-one respondents (from 32 countries) completed the survey. Sixteen problem areas were identified, related to cT staging in low-rectal cancers, definitions for cT4b and cM1a disease, definitions for mesorectal fascia (MRF) involvement, evaluation of lymph nodes versus tumor deposits, and staging of lateral lymph nodes. The expert panel recommended strategies on how to handle these, including advice on cT-stage categorization in case of involvement of different layers of the anal canal, specifications on which structures to include in the definition of cT4b disease, how to define MRF involvement by the primary tumor and other tumor-bearing structures, how to differentiate and report lymph nodes and tumor deposits on MRI, and how to anatomically localize and stage lateral lymph nodes. Conclusions: The recommendations derived from this global survey and expert panel discussion may serve as a practice guide and support tool for radiologists (and other clinicians) involved in the staging of rectal cancer and may contribute to improved consistency in radiological staging and reporting. Key Points: • Via a case-based online survey (incl. 321 respondents from 32 countries), we identified 16 problem areas related to the applicability of the TNM staging system for the radiological staging and reporting of rectal cancer. • A multidisciplinary panel of experts recommended strategies on how to handle these problem areas, including advice on cT-stage categorization in case of involvement of different layers of the anal canal, specifications on which structures to include in the definition of cT4b disease, how to define mesorectal fascia involvement by the primary tumor and other tumor-bearing structures, how to differentiate and report lymph nodes and tumor deposits on MRI, and how to anatomically localize and stage lateral lymph nodes. • These recommendations may serve as a practice guide and support tool for radiologists (and other clinicians) involved in the staging of rectal cancer and may contribute to improved consistency in radiological staging and reporting

Z' signals in polarised top-antitop final states

We study the sensitivity of top-antitop samples produced at all energy stages of the Large Hadron Collider (LHC) to the nature of an underlying Z' boson, in presence of full tree level standard model (SM) background effects and relative interferences. We concentrate on differential mass spectra as well as both spatial and spin asymmetries thereby demonstrating that exploiting combinations of these observables will enable one to distinguish between sequential Z's and those pertaining to Left-Right symmetric models as well as E6 inspired ones, assuming realistic final state reconstruction efficiencies and error estimates.Comment: 21 pages, 6 colour figures, 10 table

Modeling Trap-Awareness and Related Phenomena in Capture-Recapture Studies

Trap-awareness and related phenomena whereby successive capture events are not independent is a feature of the majority of capture-recapture studies. This phenomenon was up to now difficult to incorporate in open population models and most authors have chosen to neglect it although this may have damaging consequences. Focusing on the situation where animals exhibit a trap response at the occasion immediately following one where they have been trapped but revert to their original naïve state if they are missed once, we show that trap-dependence is more naturally viewed as a state transition and is amenable to the current models of capture-recapture. This approach has the potential to accommodate lasting or progressively waning trap effects