High sensitivity and negative predictive value of the DETECT algorithm for an early diagnosis of pulmonary arterial hypertension in systemic sclerosis : application in a single center

Pulmonary arterial hypertension (PAH) is one of the most relevant causes of death in systemic sclerosis. The aims of this study were to analyse the recently published DETECT algorithm comparing it with European Society of Cardiology/European Respiratory Society (ESC/ERS) 2009 guidelines: as screening of PAH; (2) identifying median pulmonary arterial pressure (mPAP) ≥21 mmHg; and (3) determining any group of pulmonary hypertension (PH). Eighty-three patients fulfilling LeRoy's systemic sclerosis diagnostic criteria with at least right heart catheterization were studied retrospectively. Clinical data, serological biomarkers, echocardiographic and hemodynamic features were collected. SPSS 20.0 was used for statistical analysis. According to right heart catheterization findings, 35 patients with PAH and 28 with no PH met the standards for DETECT algorithm analysis: 27.0% of patients presented with functional class III/IV. Applying DETECT, the sensitivity was 100%, specificity 42.9%, the positive predictive value 68.6% and the negative predictive value 100%, whereas employing the ESC/ERS guidelines these were 91.4%, 85.7%, 88.9% and 89.3%, respectively. There were no missed diagnoses of PAH using DETECT compared with three patients missed (8.5%) using ESC/ERS guidelines. The DETECT algorithm also showed greater sensitivity and negative predictive value to identify patients with mPAP ≥21 mmHg or with any type of PH. The DETECT algorithm is confirmed as an excellent screening method due to its high sensitivity and negative predictive value, minimizing missed diagnosis of PAH. DETECT would be accurate either for early diagnosis of borderline mPAP or any group of PH

Modeling discards in Trawling Mediterranean Northern Alboran Sea Fishery

Target and Bycatch species metrics estimated from fishery-dependent data were explored to assess their use in governance of habitat conservation in respect to fisheries. Fishing data collected by onboard observers in otter-trawl boats between 2011 and 2012 at monthly sampling frequency in the Alboran Sea (Western Mediterranean) were used to build maps of sensitivity to fishing stress. Maps were drawn by means kriging interpolation techniques of biomass and abundance (Catch Per Unit of Effort, CPUE) in kilogram and number per fishing hour of blue whiting (Micromesistius poutassou), European hake (Merluccius merluccius), and red mullets (Mullus barbatus and Mullus surmuletus) target species, seabreams (Pagellus acarne, Pagellus bogaraveo, and Pagellus erythrinus), and mackerels (Trachurus mediterraneus, Trachurus trachurus, and Trachurus picturatus) bycatch species and Bogue (Boops boops) bycatch discarded species. Modelling discards by means Generalised Additive Models (GAMs) use environmental (sea surface temperature and chlorophyll-a from satellite data and NAO climatic index); spatial (latitude, longitude, depth and port) and temporal (season, haul duration, moon phase), as well as technical (boat length and power) explanatory variables. The main causes of discards, for both target and bycatch species, are associated to the seasonality of the recruitment and the changes on the spatial distribution of habitat preferences along their ontogeny. Environmental variables did not reveal significant effects, showing that operational oceanography standard products must be not enough to assess discards, and therefore products providing information on specific ecological processes to discards must be designed with this purpose. In Bycatch species, such as sea breams, mackerels and bogue, discards were also highly dependent of the port and boat (fleet/boat strategies, power, etc, and market preferences). The higher discards corresponded to these bycatch pelagic or bentho-pelagic species. Keywords: Discards, Otter-trawl fisheries, fishery conservation, operational oceanography, spatial modelin

Lung Transplant Improves Survival and Quality of Life Regardless of Telomere Dysfunction

Introduction: Fibrotic interstitial lung diseases (ILDs) are the first indication for lung transplantation (LT). Telomere dysfunction has been associated with poor post-transplant outcomes. The aim of the study was to evaluate the morbi-mortality and quality of life in fibrotic ILDs after lung transplant depending on telomere biology. Methods: Fibrotic ILD patients that underwent lung transplant were allocated to two arms; with or without telomere dysfunction at diagnosis based on the telomere length and telomerase related gene mutations revealed by whole-exome sequencing. Post-transplant evaluation included: (1) short and long-term mortality and complications and (2) quality of life. Results: Fifty-five percent of patients that underwent LT carried rare coding mutations in telomerase-related genes. Patients with telomere shortening more frequently needed extracorporeal circulation and presented a higher rate of early post-transplant hematological complications, longer stay in the intensive care unit (ICU), and a higher number of long-term hospital admissions. However, post-transplant 1-year survival was higher than 80% regardless of telomere dysfunction, with improvement in the quality of life and oxygen therapy withdrawal. Conclusions: Post-transplant morbidity is higher in patients with telomere dysfunction and differs according to elapsed time from transplantation. However, lung transplant improves survival and quality of life and the associated complications are manageable

Role of VEGF polymorphisms in the susceptibility and severity of interstitial lung disease

The search for biomarkers that can help to establish an early diagnosis and prognosis of interstitial lung disease (ILD) is of potential interest. VEGF polymorphisms have been implicated in the development of several lung disorders. Consequently, we assessed, for the first time, the role of VEGF polymorphisms in the susceptibility and severity of ILD. A total of 436 Caucasian ILD patients (244 with idiopathic interstitial pneumonias (IIPs) and 192 with non-IIP) and 536 ethnically-matched healthy controls were genotyped for VEGF rs833061, rs1570360, rs2010963, rs3025020, and rs3025039 polymorphisms by TaqMan assays. Pulmonary function tests were collected from all the patients. VEGF serum levels were determined by ELISA in a subgroup of patients. No VEGF genotype, allele, carrier, or haplotype differences were found between ILD patients and controls as well as between IIP and non-IIP patients. However, an association of rs1570360 with IIP in women and also with lung function in IIP patients was found. None of the VEGF polymorphisms were associated with VEGF levels. In conclusion, our results suggest that VEGF does not seem to play a relevant role in ILD, although rs1570360 may influence the severity of ILD in women and a worse outcome in IIP patients.Funding: This research was partially supported by a grant from Spanish Society of Pulmonology and Thoracic Surgery (SEPAR 474-2017). S.R.-M. was supported by funds of the RETICS Program (RD16/0012/0009) from the “Instituto de Salud Carlos III” (ISCIII), co-funded by the European Regional Development Fund. V.P.-C. was supported by a pre-doctoral grant from IDIVAL (PREVAL 18/01). B.A.-M. was recipient of a “López Albo” post-residency program funded by Servicio Cántabro de Salud. L.L.-G. was supported by funds from IDIVAL (INNVAL 20/06). O.G. was beneficiary of a grant funded by Xunta de Galicia, Consellería de Educación, Universidade e Formación Profesional and Consellería de Economía, Emprego e Industria (GAIN), GPC IN607B2019/10. R.L.-M. was a recipient of a Miguel Servet type I program fellowship from the ISCIII, co-funded by the ESF, “Investing in your future” (grant CP16/00033)

Recomanacions de retorn d’activitat dels serveis de cardiologia en el procés de desconfinament per COVID-19

Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Servei de cardiologia; Desconfinament; Mesures de proteccióCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Servicio de cardiología; Desconfinamiento; Medidas de protecciónCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Cardiology service; No confinement; Protection measuresAquest document recull les recomanacions de les societats científiques i professionals, per encàrrec del CatSalut i sota la coordinació del Pla Director de Malalties de l’Aparell Circulatori, pel retorn d’activitat de la pràctica clínica en els serveis de cardiologia en l’escenari actual de brot de COVID-19

Dendritic cell deficiencies persist seven months after SARS-CoV-2 infection

Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV)-2 infection induces an exacerbated inflammation driven by innate immunity components. Dendritic cells (DCs) play a key role in the defense against viral infections, for instance plasmacytoid DCs (pDCs), have the capacity to produce vast amounts of interferon-alpha (IFN-α). In COVID-19 there is a deficit in DC numbers and IFN-α production, which has been associated with disease severity. In this work, we described that in addition to the DC deficiency, several DC activation and homing markers were altered in acute COVID-19 patients, which were associated with multiple inflammatory markers. Remarkably, previously hospitalized and nonhospitalized patients remained with decreased numbers of CD1c+ myeloid DCs and pDCs seven months after SARS-CoV-2 infection. Moreover, the expression of DC markers such as CD86 and CD4 were only restored in previously nonhospitalized patients, while no restoration of integrin β7 and indoleamine 2,3-dyoxigenase (IDO) levels were observed. These findings contribute to a better understanding of the immunological sequelae of COVID-19

Gestión del conocimiento: perspectiva multidisciplinaria. Volumen 11

El libro “Gestión del Conocimiento. Perspectiva Multidisciplinaria”, Volumen 11, de la Colección Unión Global, es resultado de investigaciones. Los capítulos del libro, son resultados de investigaciones desarrolladas por sus autores. El libro cuenta con el apoyo de los grupos de investigación: Universidad Sur del Lago “Jesús María Semprúm” (UNESUR), Zulia – Venezuela; Universidad Politécnica Territorial de Falcón Alonso Gamero (UPTAG), Falcón – Venezuela; Universidad Politécnica Territorial de Mérida Kleber Ramírez (UPTM), Mérida – Venezuela; Universidad Guanajuato (UG) - Campus Celaya - Salvatierra - Cuerpo Académico de Biodesarrollo y Bioeconomía en las Organizaciones y Políticas Públicas (C.A.B.B.O.P.P), Guanajuato – México; Centro de Altos Estudios de Venezuela (CEALEVE), Zulia – Venezuela, Centro Integral de Formación Educativa Especializada del Sur (CIFE - SUR) - Zulia - Venezuela, Centro de Investigaciones Internacionales SAS (CIN), Antioquia - Colombia.y diferentes grupos de investigación del ámbito nacional e internacional que hoy se unen para estrechar vínculos investigativos, para que sus aportes científicos formen parte de los libros que se publiquen en formatos digital e impreso

Gestión del conocimiento. Perspectiva multidisciplinaria. Volumen 17

El libro “Gestión del Conocimiento. Perspectiva Multidisciplinaria”, Volumen 17 de la Colección Unión Global, es resultado de investigaciones. Los capítulos del libro, son resultados de investigaciones desarrolladas por sus autores. El libro es una publicación internacional, seriada, continua, arbitrada, de acceso abierto a todas las áreas del conocimiento, orientada a contribuir con procesos de gestión del conocimiento científico, tecnológico y humanístico. Con esta colección, se aspira contribuir con el cultivo, la comprensión, la recopilación y la apropiación social del conocimiento en cuanto a patrimonio intangible de la humanidad, con el propósito de hacer aportes con la transformación de las relaciones socioculturales que sustentan la construcción social de los saberes y su reconocimiento como bien público

Análisis de 150 pacientes trasplantados pulmonares por Enfermedad Pulmonar Intersticial Difusa ( EPID )

Les malalties pulmonars intersticials difuses ( MPID) representen la segona indicación de trasplantamente pulmonar (TP) després del enfisema. El treball és un estudi retrospectiu de 150 malalts sotmesos a un TP per MPID entre agost-1990 i gener de 2010. Es tracta de 86 (57%) homes amb una edad mitja de 49 (r: 20-67) anys. Es van fer 104 (69%) trasplantaments unipulmonares ( TUP) i 46 bipulmonars ( TBP). El diagnòstic més freqüent va ser en 94 ( 63%) malalts la Neumonía intersticial Usual. L’objectiu ha estat establir els resultats significatius en quant a supervivència i ganància funcional del grup. La supervivència del TP en malalts amb MPID és comparable als registres internacionals. Un de cada 6 malalts torna a treballar i la realització d’un TUP o un TBP no suposa més ganància funcional.Las enfermedades pulmonares intersticiales difusas (EPID) constituyen la segunda indicación de trasplante pulmonar (TP) después del enfisema. El trabajo consiste en el estudio retrospectivo de 150 pacientes sometidos a un TP por EPID entre agosto-1990 y Enero 2010. Se trata de 86 (57%) de hombres con una edad media de 49 (r: 20-67) años. Se realizaron 104 (69%) trasplantes unipulmonares ( TUP) y 46 bipulmonares ( TBP). El diagnóstico preoperatorio más frecuente fue en 94 ( 63%) de los pacientes la Neumonía intersticial Usual. El objetivo ha sido establecer resultados significativos en cuanto a la supervivencia y la ganancia funcional en el grupo. La supervivencia del TP en pacientes con EPID es comparable a la de registros internacionales. Uno de cada 6 pacientes vuelve a trabajar y la realización de un TUP o un TBP no implica mayor ganancia funcional

Análisis de 150 pacientes trasplantados pulmonares por Enfermedad Pulmonar Intersticial Difusa ( EPID )

Les malalties pulmonars intersticials difuses ( MPID) representen la segona indicación de trasplantamente pulmonar (TP) després del enfisema. El treball és un estudi retrospectiu de 150 malalts sotmesos a un TP per MPID entre agost-1990 i gener de 2010. Es tracta de 86 (57%) homes amb una edad mitja de 49 (r: 20-67) anys. Es van fer 104 (69%) trasplantaments unipulmonares ( TUP) i 46 bipulmonars ( TBP). El diagnòstic més freqüent va ser en 94 ( 63%) malalts la Neumonía intersticial Usual. L'objectiu ha estat establir els resultats significatius en quant a supervivència i ganància funcional del grup. La supervivència del TP en malalts amb MPID és comparable als registres internacionals. Un de cada 6 malalts torna a treballar i la realització d'un TUP o un TBP no suposa més ganància funcional.Las enfermedades pulmonares intersticiales difusas (EPID) constituyen la segunda indicación de trasplante pulmonar (TP) después del enfisema. El trabajo consiste en el estudio retrospectivo de 150 pacientes sometidos a un TP por EPID entre agosto-1990 y Enero 2010. Se trata de 86 (57%) de hombres con una edad media de 49 (r: 20-67) años. Se realizaron 104 (69%) trasplantes unipulmonares ( TUP) y 46 bipulmonares ( TBP). El diagnóstico preoperatorio más frecuente fue en 94 ( 63%) de los pacientes la Neumonía intersticial Usual. El objetivo ha sido establecer resultados significativos en cuanto a la supervivencia y la ganancia funcional en el grupo. La supervivencia del TP en pacientes con EPID es comparable a la de registros internacionales. Uno de cada 6 pacientes vuelve a trabajar y la realización de un TUP o un TBP no implica mayor ganancia funcional