Common variations in estrogen-related genes are associated with severe large-joint osteoarthritis: a multicenter genetic and functional study

OBJECTIVE: Several lines of evidence suggest that estrogens influence the development of osteoarthritis (OA). The aim of this study was to explore the association of two common polymorphisms within the aromatase (CYP19A1) and estrogen receptor (ER) alpha (ESR1) genes with severe OA of the lower limbs. METHODS: The rs1062033 (CYP19A1) and rs2234693 (ESR1) single nucleotide polymorphisms were genotyped in 5528 individuals (3147 patients with severe hip or knee OA, and 2381 controls) from four centres in Spain and the United Kingdom. Gene expression was measured in femoral bone samples from a group of patients. RESULTS: In the global analysis, both polymorphisms were associated with OA, but there was a significant sex interaction. The GG genotype at rs1062033 was associated with an increased risk of knee OA in women [odds ratio (OR) 1.23; P=0.04]. The CC genotype at rs2234693 tended to be associated with reduced OA risk in women (OR 0.76, P=0.028, for knee OA; OR=0.84, P=0.076 for hip OA), but with increased risk of hip OA in men (OR 1.28; P=0.029). Women with unfavourable genotypes at both loci had an OR of 1.61 for knee OA (P=0.006). The rs1062033 genotype associated with higher OA risk was also associated with reduced expression of the aromatase gene in bone. CONCLUSIONS: Common genetic variations of the aromatase and ER genes are associated with the risk of severe OA of the large joints of the lower limb in a sex-specific manner. These results are consistent with the hypothesis that estrogen activity may influence the development of large-joint OA

Evolution of the use of corticosteroids for the treatment of hospitalised COVID-19 patients in Spain between March and November 2020: SEMI-COVID national registry

Objectives: Since the results of the RECOVERY trial, WHO recommendations about the use of corticosteroids (CTs) in COVID-19 have changed. The aim of the study is to analyse the evolutive use of CTs in Spain during the pandemic to assess the potential influence of new recommendations. Material and methods: A retrospective, descriptive, and observational study was conducted on adults hospitalised due to COVID-19 in Spain who were included in the SEMI-COVID- 19 Registry from March to November 2020. Results: CTs were used in 6053 (36.21%) of the included patients. The patients were older (mean (SD)) (69.6 (14.6) vs. 66.0 (16.8) years; p < 0.001), with hypertension (57.0% vs. 47.7%; p < 0.001), obesity (26.4% vs. 19.3%; p < 0.0001), and multimorbidity prevalence (20.6% vs. 16.1%; p < 0.001). These patients had higher values (mean (95% CI)) of C-reactive protein (CRP) (86 (32.7-160) vs. 49.3 (16-109) mg/dL; p < 0.001), ferritin (791 (393-1534) vs. 470 (236- 996) µg/dL; p < 0.001), D dimer (750 (430-1400) vs. 617 (345-1180) µg/dL; p < 0.001), and lower Sp02/Fi02 (266 (91.1) vs. 301 (101); p < 0.001). Since June 2020, there was an increment in the use of CTs (March vs. September; p < 0.001). Overall, 20% did not receive steroids, and 40% received less than 200 mg accumulated prednisone equivalent dose (APED). Severe patients are treated with higher doses. The mortality benefit was observed in patients with oxygen saturation </=90%. Conclusions: Patients with greater comorbidity, severity, and inflammatory markers were those treated with CTs. In severe patients, there is a trend towards the use of higher doses. The mortality benefit was observed in patients with oxygen saturation </=90%

Testing the Effect of Relative Pollen Productivity on the REVEALS Model : A Validated Reconstruction of Europe-Wide Holocene Vegetation

Reliable quantitative vegetation reconstructions for Europe during the Holocene are crucial to improving our understanding of landscape dynamics, making it possible to assess the past effects of environmental variables and land-use change on ecosystems and biodiversity, and mitigating their effects in the future. We present here the most spatially extensive and temporally continuous pollen-based reconstructions of plant cover in Europe (at a spatial resolution of 1° × 1°) over the Holocene (last 11.7 ka BP) using the 'Regional Estimates of VEgetation Abundance from Large Sites' (REVEALS) model. This study has three main aims. First, to present the most accurate and reliable generation of REVEALS reconstructions across Europe so far. This has been achieved by including a larger number of pollen records compared to former analyses, in particular from the Mediterranean area. Second, to discuss methodological issues in the quantification of past land cover by using alternative datasets of relative pollen productivities (RPPs), one of the key input parameters of REVEALS, to test model sensitivity. Finally, to validate our reconstructions with the global forest change dataset. The results suggest that the RPPs.st1 (31 taxa) dataset is best suited to producing regional vegetation cover estimates for Europe. These reconstructions offer a long-term perspective providing unique possibilities to explore spatial-temporal changes in past land cover and biodiversity

Adjunctive moxifloxacin in the treatment of generalized aggressive periodontitis patients: clinical and microbiological results of a randomized, triple-blind and placebo-controlled clinical trial

Aim The aim of the present study was to evaluate the clinical and microbiological efficacy of moxifloxacin (MOX) in one-stage scaling and root planing (SRP) in treating generalized aggressive periodontitis (GAgP). Materials and Methods Forty subjects were randomly allocated to two treatment groups. The two treatment groups consisted of SRP combined with systemically admi-nistered MOX at the dosage of 400 mg once daily for 7 days or SRP + placebo once daily for 7 days. Subgingival plaque samples were analysed for cultivable bacteria. Results Both groups resulted in significant reduction of probing depth (PD) and clinical attachment level (CAL) compared with baseline (p < 0.0001), and this difference was maintained at 6 months from baseline in both groups. However, subjects receiving MOX showed the greatest improvements CAL, and PD. Subjects in both groups at 6 months displayed the greatest reduction from baseline in frequency of sites with PD =6 mm (p < 0.001), favouring the MOX group. Adjunctive antibiotic protocol reduced subgingival Aggregatibacter actinomycetemcomitans to undetectable levels, after 3 and 6 months, and there was a significant reduction in the levels of Porphyromonas gingivalis and Tannerella forsythia in the MOX group compared to the placebo group. Conclusions The results from this study suggest that moxifloxacin as and adjunct to one-stage full-mouth SRP leads to a better clinical and microbiological advantages compared to mechanical treatment. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

Energy balance and environmental impact analysis of marine microalgal biomass production for biodiesel generation in a photobioreactor pilot plant

12 pages, 6 figures, 6 tablesA life cycle assessment (LCA) and an energy balance analysis of marine microalgal biomass production were conducted to determine the environmental impacts and the critical points of production for large scale planning. The artificial lighting and temperature conditions of an indoor bubble column photobioreactor (bcPBR) were compared to the natural conditions of an equivalent outdoor system. Marine microalgae, belonging to the dinoflagellate and raphidophyte groups, were cultured and the results were compared with published LCA data obtained from green microalgae (commonly freshwater algae). Among the species tested, Alexandrium minutum was chosen as the target marine microalgae for biomass production under outdoor conditions, although there were no substantial differences between any of the marine microalgae studied. Under indoor culture conditions, the total energy input for A. minutum was 923 MJ kg−1 vs. 139 MJ kg−1 for outdoor conditions. Therefore, a greater than 85% reduction in energy requirements was achieved using natural environmental conditions, demonstrating the feasibility of outdoor culture as an alternative method of bioenergy production from marine microalgae. The growth stage was identified as the principal source of energy consumption for all microalgae tested, due to the electricity requirements of the equipment, followed by the construction material of the bcPBR. The global warming category (GWP) was 6 times lower in outdoor than in indoor conditions. Although the energy balance was negative under both conditions, this study concludes with suggestions for improvements in the outdoor system that would allow up-scaling of this biomass production technology for outdoor conditions in the MediterraneanThe authors would like to thank to Comisión Nacional de Investigación Ciencia y Tecnología (CONICYT) from Chile for supporting the scholarship “Beca de Gestión Propia,” which finances the PhD studies of C. Fuentes-Grünewald; and to Spanish Ministry of Science and Innovation for supporting the work of E. Garcés and S. Rossi by the Ramon and Cajal award. The authors would like also to thank S. Fraga for providing the clonal culture AMP4, Laura del Río and Xavi Leal for their help with the experiments, and the Zona Acuarios Experimentales (ZAE) of the ICM-CSIC for the use of their facilities. The authors would like also to thank to project Ecotech SudoeSOE2/P2/E377 for its financial support.Peer reviewe

No Place for a Left-winger: The Historical Relationship Between Football and the FARC in Colombia

This article explores the relationship between the FARC (the Revolutionary Armed Forces of Colombia) and football in Colombia. It argues that until the presidency of Juan Manuel Santos, the FARC had been excluded from being part of the national ‘us’ when celebrating successes of the national men’s football team. In fact, sporting nationalism projects articulated around World Cup successes in 1962, 1990, 1994 and the Copa América in 2001 projected the national football team as being symbolically representative of a nation against an ‘other’ that was Colombia itself. This other was the ‘Narcolombia’ of the FARC, drug traffickers, violence, terrorism and criminality that had become notorious internationally, and was the image most associated with the country. This rhetorical positioning shifted under Santos, when football became a bridge to allow the FARC back into the nation given the political backdrop of the peace negotiations between the government and the FARC

The impact of medical education and networking on the outcome of leukemia treatment in developing countries. The experience of International Consortium on Acute Promyelocytic Leukemia (IC-APL)

Objectives: Several clinical trials conducted in Europe and US reported favorable outcomes of patients with APL treated with the combination of all trans retinoic acid (ATRA) and anthracyclines. Nevertheless, the results observed in developing countries with the same regimen was poorer, mainly due to high early mortality mainly due bleeding. The International Consortium on Acute Promyelocytic Leukemia (IC-APL) is an initiative of the International Members Committee of the ASH and the project aims to reduce this gap through the establishment of international network, which was launched in Brazil, Mexico and Uruguay. Methods: The IC-APL treatment protocol is similar to the PETHEMA 2005, but changing idarubicin to daunorubicin. All patients with a suspected diagnosis of APL were immediately started on ATRA, while bone marrow samples were shipped to a national central lab where genetic verification of the diagnosis was performed. The immunofluorescence using an anti-PML antibody allowed a rapid confirmation of the diagnosis and, the importance of supportive measures was reinforced. Results: The interim analysis of 97 patients enrolled in the IC-APL protocol showed that complete remission (CR) rate was 83% and the 2-year overall survival and disease-free survival were 80% and 90%, respectively. Of note, the early mortality rate was reduced to 7.5%. Discussion: The results of IC-APL demonstrate the impact of educational programs and networking on the improvement of the leukemia treatment outcome in developing countries