Systemic inflammation and residual viraemia in HIV-positive adults on protease inhibitor monotherapy: a cross-sectional study.

Increased levels of markers of systemic inflammation have been associated with serious non-AIDS events even in patients on fully suppressive antiretroviral therapy. We explored residual viremia and systemic inflammation markers in patients effectively treated with ritonavir-boosted protease inhibitor monotherapy (PImono)

Snapshot of macroalgae and fish assemblages in temperate reefs in the Southern European Atlantic Ecoregion

Most of the biodiversity studies in the South European Atlantic Shelf ecoregion are limited to shallow subtidal or intertidal habitats, while deeper reef habitats, also of relevant ecological importance, are particularly understudied. Macroalgal communities, associated fauna, and sea surface temperature were studied in deep reefs (25-30 m) at two locations in this ecoregion: Parcel, North of Portugal (41 degrees N), and Tarifa, Southern Spain (35 degrees N). Specifically, algal assemblages were assessed using biomass collection and associated ichthyofauna was assessed using visual census techniques using scuba. Seawater surface temperature was higher (>3 degrees C) in the southern region-Tarifa, compared to the northern region-Parcel. Our survey revealed 18 fish species and 23 algae species. The highest abundance of cold-water species (both macroalgae and fish species) was recorded in Parcel and warm-water species were dominant in Tarifa. In light of climate global trends, both regions might experience biodiversity shifts towards tropicalization. Current knowledge on their biodiversity is imperative to further evaluate potential shifts.info:eu-repo/semantics/publishedVersio

Thyroid Lobectomy vs Total Thyroidectomy for Low Risk Papillary Thyroid Cancer: A Systematic Review

INTRODUCTION: The 2015 American Thyroid Association (ATA) guidelines called for consideration of thyroid lobectomy as an acceptable surgical treatment for small and less aggressive papillary thyroid cancers (PTC) with no clinical evidence of metastasis or extrathyroidal extension. Extent of surgery however, remains controversial. METHODS: A systematic literature review was performed on Pubmed, EMBASE, Scopus and Cochrane Library databases using a combination of the keywords: papillary thyroid carcinoma, lobectomy, completion thyroidectomy and guidelines during the years 2012 to 2017. Eight retrospective studies comparing lobectomy to total thyroidectomy on 1,294 patients with low risk PTC were included for analysis. Studies were grouped according to the major themes: survival and completion thyroidectomy. RESULTS: Compared to lobectomy, total thyroidectomy does not confer a survival advantage in low risk PTC. Despite appropriate preoperative risk stratification approximately 30% of thyroid lobectomy candidates will require completion thyroidectomy. CONCLUSIONS: The 2015 ATA guidelines encourage personalization of care for patients with low risk PTC including a more conservative approach to initial extent of surgery and administration of radioactive iodine. A significant proportion of patients treated with lobectomy may require completion procedures for loco regional disease control, but which may not pose a negative impact in overall survival. Risks and benefits should be discussed carefully with patients. Future research considering outcomes such as complication rates, recurrence free survival, need for completion thyroidectomy, and long-term follow-up is warranted

Local Government, Taxes, and Guns: Successful Policy Innovation in Three Colombian Cities

This paper evaluates transformative policy innovations with respect to security and taxation in the three main Colombian cities: Bogotá, Medellín, and Cali. In the first two, such policies were associated with huge success. Elsewhere we (Gutiérrez et al. 2009) have tagged these transformation processes as ‘urban/metropolitan miracles’. The term comes from the fact that both common citizens and pundits considered these to be extremely unlikely, that they were fast, and that they were large-scale. We argue, that the success of Bogotá and Medellín was the result of a set of institutional underpinnings basically related to the 1991 constitution; the opening of a window of opportunity for new political actors; and, as a result, the formation of a new government coalition and ‘governance formula’. Anti-particularism was a language related to political demands— linked organically with the pro-1991 constitution movement—which became effective .../urban security, state building, public policies

Risky Alcohol Consumption and Associated Health Behaviour Among HIV-Positive and HIV-Negative Patients in a UK Sexual Health and HIV Clinic: A Cross-Sectional Questionnaire Study

Alcohol misuse has been associated with negative consequences among HIV-positive patients. Data on real prevalence of risky alcohol consumption among the HIV-positive population in the UK are lacking. A cross-sectional questionnaire study using standardised validated instruments among HIV-positive (n = 227) and HIV-negative (n = 69) patients was performed. The prevalence of risky alcohol consumption (AUDIT) and associations with depressive symptoms (PHQ-9), problematic drug use (DUDIT), adherence to ART (CASE Adherence Index), sexual behaviour and demographic characteristics were assessed among both patient groups independently. A quarter (25.1%) of HIV-positive patients and 36.1% of HIV-negative patients reported risky alcohol consumption (AUDIT-score ≥ 8). In the multivariable analysis among HIV-positive patients depressive symptoms (p = 0.03) and problematic drug use (p = 0.007) were associated with risky alcohol consumption. Among HIV-negative patients these associations were not present. Risky alcohol consumption among HIV-positive patients is prevalent, and together with depressive symptoms and problematic drug use, may influence HIV-disease progression and patients’ wellbeing

Mediación digital y redes sociales : el joven digital

En este trabajo se presenta un resumen de los datos obtenidos de la investigación sobre la relación de jóvenes colombianos entre 14 y 21 años, con las redes sociales y la tecnología, a este grupo nos referiremos en adelante como centennials, se trata de ver desde un punto de vista holístico, la relación de los adolescentes con el uso de estas y del celular, y como han adoptado nuevos comportamientos de consumo en los ámbitos social y personal, a través de la influencia dispositivos móviles y de una amplia variedad de contenidos que pueden consumirse, producirse y compartirse. Este artículo en relación con los textos publicados previamente busca adentrarse en la relación de los centennials con lo digital y ver cómo ha modificado sus estructuras de poder, para ellos lo ejerce quien logra entretener, conectar, ser escuchado en mayor medida, teniendo como contexto especifico el año 2020/2021 inicio y desarrollo de la pandemia COVID-19. Los datos aquí analizados, provienen de estudiantes de instituciones de educación media vocacional y superior, en diferentes ciudades de Colombia, en contraste con investigaciones recientes y teorías de varios autores.#Jóvenes#ComportamientosRequerimientos de sistema: Adobe Acrobat ReaderThis paper presents a summary of the data obtained from the research on the relationship of young Colombians between 14 and 21 years old, with social networks and technology, we will refer to this group from now on as centennials, it is about seeing from a holistic point of view, the relationship of adolescents with the use of these and the cell phone, and how they have adopted new consumer behaviors in the social and personal spheres, through the influence of mobile devices and a wide variety of content that can be consumed, produced and shared. This article, in relation to the texts previously published, seeks to show how the relationship of the centennials with the digital has modified their power structures, for them it is exercised by those who manage to entertain, connect, be heard to a greater extent, having the year 2020 as a specific context / 2021 start and development of the COVID-19 pandemic. The data analyzed here come from students from vocational and higher education institutions in different cities of Colombia, in contrast to recent research and theories of various author

Eficacia de la magnetoterapia y la corriente de alto voltaje pulsada en tendinopatías de hombro. Centro Fisiorehab – 2023

Determina la eficacia de la magnetoterapia y la corriente de alto voltaje pulsada en la recuperación de la funcionalidad del hombro con tendinopatía. La presente investigación es cuasi experimental, cuantitativo, longitudinal y comparativo, cuya muestra estuvo conformada por 28 participantes, de quienes se recolecto la información a través del Cuestionario Constant Score, enfocado en evaluar la funcionalidad del hombro. Los resultados evidenciaron significancia bilateral superior a 0,05, tanto para el caso de magnetoterapia, como para la corriente de alto voltaje pulsada (p=0,438>0,05) y (p=0,371>0,05), respectivamente. Además, el tratamiento de Corriente de alto voltaje pulsada (-29,68%) tuvo una mayor eficacia en tendinopatías de hombro a diferencia del tratamiento con magnetoterapia (-24,45%), reflejándose en cada una de sus dimensiones: disminución del dolor, el tratamiento con Corriente de alto voltaje pulsada (-59,36%) tuvo una mayor eficacia frente al tratamiento con magnetoterapia (-55,36%), actividades de la vida diaria, el tratamiento con corriente de alto voltaje pulsada (54,13%) tuvo una mayor eficacia frente al tratamiento con magnetoterapia (47,34%), balance articular, el tratamiento con corriente de alto voltaje (52,17%) tuvo una mayor eficacia frente al tratamiento con magnetoterapia (62,14%) y fuerza muscular, el tratamiento con Magnetoterapia (147,73%) tiene una mayor eficacia frente al tratamiento con corriente de alto voltaje (137,58%). Se concluye que la eficacia sí existe, es significativa y logra, en consecuencia, tener un efecto positivo dentro de las dimensiones de Constant Score tras aplicarse ambos tratamientos; además, podemos afirmar que la eficacia de la corriente de alto voltaje pulsada es superior al de la magnetoterapia

Studies on clinical and epidemiological factors associated with peripheral neuropathy and severe hyperlactatemia or lactic acidosis in HIV-infected adults exposed to nucleoside analogues reverse transcriptase inhibitors.

Studies on mitochondrial dysfunction in HIV-infected adults exposed to anti-retroviral therapy. A significant proportion of HIV-infected patients who require anti-retroviral therapy are or have been exposed to nucleoside analogue reverse transcriptase inhibitors (NRTIs). It has been consistently suggested that most of the NRTI-attributed adverse drug reactions (ADR) are due to mitochondrial dysfunction. In a sub-analysis of a large randomised clinical trial (Delta) the incidence of peripheral neuropathy (PN) was constant over time in all study arms, which does not support the hypothesis of cumulative toxicity previously proposed for NRTI-induced ADR. Patients taking zidovudine (AZT)/zalcitabine (ddC) combination were more likely to develop PN than patients on AZT monotherapy (RH= 2.30 95%CI= 1.62 - 3.28). The incidence of PN among patients exposed to zidovudine/didanosine (AZT/ddl) combination was not different from that observed in patients on AZT. In a multi-centre case-control study including 110 cases of lactic acidosis (LA) or severe hyperlactataemia (HL) patients with < 200 CD4 cell/pl were more likely to develop HL/LA than patients with higher levels of CD4 cells (OR=3.44 95%CI= 1.64 - 7.22). Female patients were found to be at higher risk for HULA than men (OR= 4.75 95%CI= 1.96 - 11.53). Patients exposed to either d4T, ddl or the combination of these two were four to six times more likely to develop HL/LA than patients taking other NRTIs based combinations. Interestingly, cases of HL/LA were exposed to d4T for shorter periods of time than controls. Almost 10 % of the cases included in the study were asymptomatic at the time of diagnosis. All these symptom-free cases had blood lactate ranging between 5 and 7 mmol/l. Therefore, case definitions for HL or LA based on clinical presentation may underestimate the magnitude of the problem

Interaction strength between different grazers and macroalgae mediated by ocean acidification over warming gradients

Since the past century, rising CO2 levels have led to global changes (ocean warming and acidification) with subsequent effects on marine ecosystems and organisms. Macroalgae-herbivore interactions have a main role in the regulation of marine community structure (top-down control). Gradients of warming prompt complex non-linear effects on organism metabolism, cascading into altered trophic interactions and community dynamics. However, not much is known on how will acidification and grazer assemblage composition shape these effects. Within this context, we aimed to assess the combined effects of warming gradients and acidification on macroalgae-herbivore interactions, using three cosmopolitan species, abundant in the Iberian Peninsula and closely associated in nature: the amphipod Melita palmata, the gastropod Gibbula umbilicalis, and the green macroalga Ulva rigida. Under two CO2 treatments (triangle CO2 similar or equal to 450 mu atm) across a temperature gradient (13.5, 16.6, 19.9 and 22.1 degrees C), two mesocosm experiments were performed to assess grazer consumption rates and macroalgae-herbivore interaction, respectively. Warming (Experiment I and II) and acidification (Experiment II) prompted negative effects in grazer's survival and species-specific differences in consumption rates. M. palmata was shown to be the stronger grazer per biomass (but not per capita), and also the most affected by climate stressors. Macroalgae-herbivore interaction strength was markedly shaped by the temperature gradient, while simultaneous acidification lowered thermal optimal threshold. In the near future, warming and acidification are likely to strengthen top-down control, but further increases in disturbances may lead to bottom-up regulated communities. Finally, our results suggest that grazer assemblage composition may modulate future macroalgae-herbivore interactions. (C) 2017 Elsevier Ltd. All rights reserved.Peer reviewe

Risk factors for fatality in HIV-infected patients with dideoxynucleoside-induced severe hyperlactataemia or lactic acidosis.

BACKGROUND: Lactic acidosis (LA) and severe hyperlactataemia (HL) are infrequent but serious complications of antiretroviral therapy that have been associated with a high fatality rate. METHODS: In a multinational retrospective cohort study, LA was defined as arterial blood pH5 mmol/l. Logistic regression was used to identify factors associated with fatality. Sensitivity and specificity of different case definitions as predictors of death were compared. RESULTS: The overall case-fatality rate was 19/110 (17.3%), but among acidotic patients it was 33% (16/49 cases). There were 10 asymptomatic patients and none of them died as a consequence of the event. The median lactate for fatal, non-fatal and all patients was 8.3 mmol/l (IQR 7.2-13.1), 6.4 mmol/l (IQR 5.4-7.8) and 6.7 mmol/l (IQR 5.5-8.1), respectively. After adjusting for age and current CD4(+) T-cell count, lactate >7 mmol/l (OR 6.27, 95% CI 1.13-34.93), blood bicarbonate 18 mmol/l, 95% CI 1.33-75.65) and concurrent opportunistic infections (OR 8.69, 95% CI 1.45-52.22) were independently associated with case fatality. Blood lactate >7 mmol/l showed a sensitivity of 84% for fatality with a specificity of 60%, whereas bicarbonate 7 mmol/l and blood bicarbonate <18 mmol/l appear to predict death and might help clinicians in selecting patients who may benefit from more intense monitoring