Association between antipsychotic/antidepressant drug treatments and hospital admissions in schizophrenia assessed using a mental health case register.

BACKGROUND: The impact of psychotropic drug choice upon admissions for schizophrenia is not well understood. AIMS: To examine the association between antipsychotic/antidepressant use and time in hospital for patients with schizophrenia. METHODS: We conducted an observational study, using 8 years' admission records and electronically generated drug histories from an institution providing secondary mental health care in Cambridgeshire, UK, covering the period 2005-2012 inclusive. Patients with a coded ICD-10 diagnosis of schizophrenia were selected. The primary outcome measure was the time spent as an inpatient in a psychiatric unit. Antipsychotic and antidepressant drugs used by at least 5% of patients overall were examined for associations with admissions. Periods before and after drug commencement were compared for patients having pre-drug admissions, in mirror-image analyses correcting for overall admission rates. Drug use in one 6-month calendar period was used to predict admissions in the next period, across all patients, in a regression analysis accounting for the effects of all other drugs studied and for time. RESULTS: In mirror-image analyses, sulpiride, aripiprazole, clozapine, and olanzapine were associated with fewer subsequent admission days. In regression analyses, sulpiride, mirtazapine, venlafaxine, and clozapine-aripiprazole and clozapine-amisulpride combinations were associated with fewer subsequent admission days. CONCLUSIONS: Use of these drugs was associated with fewer days in hospital. Causation is not implied and these findings require confirmation by randomized controlled trials.RNC was supported by the Wellcome Trust. EFE was supported by a NARSAD Young Investigator Award. The CPFT Research Database was supported by the UK National Institute of Health Research Cambridge Biomedical Research Centre. The work was conducted within the Behavioural and Clinical Neuroscience Institute, supported by the Wellcome Trust and the UK Medical Research Council.This is the final version of the article. It first appeared from Nature Publishing Group via http://dx.doi.org/10.1038/npjschz.2015.3

Tratamento prévio com adalimumabe reduz lesão pulmonar induzida por ventilação mecânica em um modelo experimental

Objective: To determine whether adalimumab administration before mechanical ventilation reduces ventilator- -induced lung injury (VILI). Methods: Eighteen rats randomized into 3 groups underwent mechanical ventilation for 3 hours with a fraction of inspired oxygen = 0.40% including a low tidal volume group (n = 6), where tidal volume = 8mL/kg and positive end-expiratory pressure = 5cmH2O; a high tidal volume group (n = 6), where tidal volume = 35mL/kg and positive end-expiratory pressure = 0; and a pretreated + high tidal volume group (n = 6) where adalimumab (100ug/kg) was administered intraperitoneally 24 hours before mechanical ventilation + tidal volume = 35mL/ kg and positive end-expiratory pressure = 0. ANOVA was used to compare histological damage (ATS 2010 Lung Injury Scoring System), pulmonary edema, lung compliance, arterial partial pressure of oxygen, and mean arterial pressure among the groups. Results: After 3 hours of ventilation, the mean histological lung injury score was higher in the high tidal volume group than in the low tidal volume group (0.030 versus 0.0051, respectively, p = 0.003). The high tidal volume group showed diminished lung compliance at 3 hours (p = 0.04) and hypoxemia (p = 0,018 versus control). Pretreated HVt group had an improved histological score, mainly due to a significant reduction in leukocyte infiltration (p = 0.003). Conclusion: Histological examination after 3 hours of injurious ventilation revealed ventilator-induced lung injury in the absence of measurable changes in lung mechanics or oxygenation; administering adalimumab before mechanical ventilation reduced lung edema and histological damage.Facultad de Ciencias Médica

Development of a new salmon salting smoking method and process monitoring by impedance spectroscopy

[EN] In this work two objectives were proposed: (i) to optimize a new salmon salting smoking method using vacuum packaging and (ii) to evaluate the application of impedance spectroscopy (IS) to the on-line monitoring of the process. Different processing conditions were evaluated (4 smoke flavoring (SF) salt concentrations, 3 salting times, salting in vacuum or in air). Physico-chemical analyses and IS measurements were performed with three different sensors during the process. Salting with 16 g SF salt/100 g fish in vacuum packaging provided smoked salmon similar to products currently available on the market. This new method has the advantages of reducing processing times and waste. IS measurements were carried out by three different electrodes. The most appropriate sensor for process monitoring was a needle electrode, with which robust prediction models for NaCl content, moisture and a,,, during the salting smoking process were obtained. The results showed the potential of IS as a rapid on-line monitoring method of the salmon salting smoking process. (C) 2012 Elsevier Ltd. All rights reserved.The authors gratefully acknowledge the financial support for the work reported here received from the Generalitat Valenciana (GV/2011/098) and the Universitat Politecnica de Valencia (UPV) (PAID-06-09-2940). A. Fuentes would like to thank the Campus de Excelencia Internacional at the UPV for its support. The proof-reading of this paper was funded by the UPV, Spain.Rizo Párraga, AM.; Fuentes López, A.; Fernández Segovia, I.; Masot Peris, R.; Alcañiz Fillol, M.; Barat Baviera, JM. (2013). Development of a new salmon salting smoking method and process monitoring by impedance spectroscopy. LWT - Food Science and Technology. 51(1):218-224. https://doi.org/10.1016/j.lwt.2012.09.025S21822451

Bulk TiCxN1-x-15%Co cermets obtained by direct spark plasma sintering of mechanochemical synthesized powders

TiCxN1-x-15 wt.%Co cermets were obtained by a mechanically induced self-sustaining reaction (MSR) and sintered by spark plasma sintering (SPS) technique at different temperatures (1200-1400 degrees C) for 1 min in vacuum under a uniaxial load of 80 MPa. The evolution of microstructure and mechanical properties was investigated. SPS allowed high densification with limited grain growth at a relatively low temperature. Material sintered at 1300 degrees C showed a good combination of mechanical properties with Vickers hardness of 17.1 +/- 0.5 GPa, fracture toughness of 5.51 +/- 0.29 MPa m(1/2) and bending strength of 904 +/- 12 MPa. Lower sintering temperature resulted in a decrease in bending strength due to poor cohesion between the ceramic and binder phases. An increase in sintering temperature would allow tailoring the cermet microstructure and, therefore, adjusting the Vickers hardness/fracture toughness relation. Crown Copyright (C) 2012 Published by Elsevier Ltd. All rights reserved.This work was supported by the Spanish Government under grant (MAT2011-22981), which is financed in part by the European Regional Development Fund of 2007-2013. A. Borrell acknowledges the Spanish Ministry of Science and Innovation for her "Juan de la Cierva" contract (JCI-2011-10498).Borrell Tomás, MA.; Salvador Moya, MD.; Rocha, VG.; Fernandez, A.; Angel Aviles, M.; Gotor, FJ. (2012). Bulk TiCxN1-x-15%Co cermets obtained by direct spark plasma sintering of mechanochemical synthesized powders. Materials Research Bulletin. 47(12):4487-4490. https://doi.org/10.1016/j.materresbull.2012.09.066S44874490471

Antibióticos empíricos para la neumonía adquirida en la comunidad en pacientes adultos: Una revisión sistemática y un metaanálisis en red

Objetivo: El objetivo principal de este metaanálisis en red es identificar el antibiótico empírico (Em-ATB) con mayor probabilidad de ser el mejor (HPBB) en términos de (1) tasa de curación y (2) tasa de mortalidad en pacientes hospitalizados con neumonía adquirida en la comunidad (NAC) . Método: Criterios de inclusión: (1) pacientes adultos (>16 años) diagnosticados de NAC que requirieron hospitalización; (2) aleatorizados a al menos dos Em-ATB diferentes, (3) que informen de la tasa de curación y (4) que estén escritos en inglés o español. Criterios de exclusión: (1) protocolo de antibióticos ambiguo y (2) publicados exclusivamente en formato resumen o carta. Fuentes de datos: Medline, Embase, Cochrane y revisiones de citas desde el 1 de enero de 2000 hasta el 31 de diciembre de 2018. Riesgo de sesgo: Herramienta de Cochrane. Calidad de la revisión sistemática (RS): A MeaSurement Tool to Assess systematic Reviews-2. Certeza de la evidencia: Grading of Recommendations Assessment, Development and Evaluation. Análisis estadísticos: método frecuentista realizado con la biblioteca 'netmeta', paquete R. Resultados: se incluyeron 27 ensayos controlados aleatorizados (ECA) de las 41.307 citas seleccionadas inicialmente. En cuanto al riesgo de sesgo, más de una cuarta parte de los estudios presentaron riesgo bajo y ningún estudio presentó riesgo alto en todos los dominios. La calidad de la RS es moderada. Para la curación, se construyeron dos redes. Así, dos Em-ATB tienen la HPBB: cetarolina 600 mg (dos veces al día) y piperacilina 2000 mg (dos veces al día). Para la mortalidad, se construyeron tres redes. Así, tres Em-ATB tienen la HPBB: ceftriaxona 2000 mg (una vez al día) más levofloxacino 500 (dos veces al día), ertapenem 1000 mg (dos veces al día) y amikacina 250 mg (dos veces al día) más claritromicina 500 mg (dos veces al día). La certeza de la evidencia para cada resultado es moderada. Conclusiones: Para la tasa de curación, ceftarolina y piperacilina son las opciones con la HPBB. Sin embargo, para la tasa de mortalidad, las opciones son ceftriaxona más levofloxacino, ertapenem y amikacina más claritromicina. Parece necesario realizar un ECA que compare los tratamientos con el HPBB para cada evento (curación o mortalidad) (CRD42017060692).Objective: The main aim of this network meta-analysis is to identify the empiric antibiotic (Em-ATB) with the highest probability of being the best (HPBB) in terms of (1) cure rate and (2) mortality rate in hospitalised patients with community acquired pneumonia (CAP) . Method: Inclusion criteria: (1) adult patients (>16 years old) diagnosed with CAP that required hospitalisation; (2) randomised to at least two different Em-ATBs, (3) that report cure rate and (4) are written in English or Spanish. Exclusion criteria: (1) ambiguous antibiotics protocol and (2) published exclusively in abstract or letter format. Data sources: Medline, Embase, Cochrane and citation reviews from 1 January 2000 to 31 December 2018. Risk of bias: Cochrane's tool. Quality of the systematic review (SR): A MeaSurement Tool to Assess systematic Reviews-2. Certainity of the evidence: Grading of Recommendations Assessment, Development and Evaluation. Statistical analyses: frequentist method performed with the 'netmeta' library, R package. Results: 27 randomised controlled trials (RCTs) from the initial 41 307 screened citations were included. Regarding the risk of bias, more than one quarter of the studies presented low risk and no study presented high risk in all domains. The SR quality is moderate. For cure, two networks were constructed. Thus, two Em-ATBs have the HPBB: cetaroline 600 mg (two times a day) and piperacillin 2000 mg (two times a day). For mortality, three networks were constructed. Thus, three Em-ATBs have the HPBB: ceftriaxone 2000 mg (once a day) plus levofloxacin 500 (two times a day), ertapenem 1000 mg (two times a day) and amikacin 250 mg (two times a day) plus clarithromycin 500 mg (two times a day). The certainity of evidence for each results is moderate. Conclusion: For cure rate, ceftaroline and piperaciline are the options with the HPBB. However, for mortality rate, the options are ceftriaxone plus levofloxacin, ertapenem and amikacin plus clarithromycin. It seems necessary to conduct an RCT that compares treatments with the HPBB for each event (cure or mortality) (CRD42017060692)

Judíos y redes personales en Tierra de Campos durante la segunda mitad del siglo XV: un Cuaderno de Minutas de Avecindamientos de Villalón

In the middle decades of the fifteenth century Jews were registered as local citizens in the municipal council records of individual Castilian towns. Traditionally, a citizen was recorded as belonging to a parish or parochial neighborhood within the local political community; this would exclude Jews by definition as they were designated separately as a religious caste. The study of unpublished documents related to the Castilian locale of Villalón –characterized by the economic importance of its fairs promoted by the 4th count of Benavente– in the region of Tierra de Campos during a period of general political disorder, records that the municipal council assigned citizenship to Jews in relation to their community (aljama) through which specific aspects of their lives were regulated, and by which the local council rather than other political instances assumed control of that community. With the help of other primary sources, these documents reveal the suggestion of personal networks in which Jewish physicians play a key role.En las décadas centrales del siglo XV algunos judíos fueron inscritos por las autoridades concejiles como vecinos en distintas localidades castellanas. Tradicionalmente, la vecindad se había caracterizado como una categoría de pertenencia a una comunidad política local, cuya participación estaría vetada a los judíos al considerarlos como una casta religiosa. Partiendo del estudio de documentación inédita relativa a la localidad castellana de Villalón –en un momento de auge de sus ferias impulsadas por el IV conde de Benavente– en Tierra de Campos, durante los años de desorden político general del reino, se propone una interpretación del avecindamiento de judíos que privilegia las relaciones de subordinación de la aljama respecto del concejo. Con ayuda de otras fuentes documentales, se ofrece un esbozo de las redes personales de judíos, subrayando el protagonismo de los médicos

Land- and water-based exercise intervention in women with fibromyalgia: the al-andalus physical activity randomised controlled trial

Background The al-Andalus physical activity intervention study is a randomised control trial to investigate the effectiveness of a land- and water-based exercise intervention for reducing the overall impact of fibromyalgia (primary outcome), and for improving tenderness and pain-related measures, body composition, functional capacity, physical activity and sedentary behaviour, fatigue, sleep quality, health-related quality of life, and cognitive function (secondary outcomes) in women with fibromyalgia. Methods/Design One hundred eighty women with fibromyalgia (age range: 35-65 years) will be recruited from local associations of fibromyalgia patients in Andalucía (Southern Spain). Patients will be randomly assigned to a usual care (control) group (n = 60), a water-based exercise intervention group (n = 60) or a land-based exercise intervention group (n = 60). Participants in the usual care group will receive general physical activity guidelines and participants allocated in the intervention groups will attend three non-consecutive training sessions (60 min each) per week during 24 weeks. Both exercise interventions will consist of aerobic, muscular strength and flexibility exercises. We will also study the effect of a detraining period (i.e., 12 weeks with no exercise intervention) on the studied variables. Discussion Our study attempts to reduce the impact of fibromyalgia and improve patients' health status by implementing two types of exercise interventions. Results from this study will help to assess the efficacy of exercise interventions for the treatment of fibromyalgia. If the interventions would be effective, this study will provide low-cost and feasible alternatives for health professionals in the management of fibromyalgia. Results from the al-Andalus physical activity intervention will help to better understand the potential of regular physical activity for improving the well-being of women with fibromyalgia.This study was supported by the Consejeria de Turismo, Comercio y Deporte (CTCD-201000019242-TRA), the Spanish Ministry of Science and Innovation (I + D + I DEP2010-15639, grants: BES-2009-013442, BES-2011-047133, RYC-2010-05957, RYC-2011-09011), the Swedish Heart-Lung Foundation (20090635), the Spanish Ministry of Education (AP-2009-3173), Granada Research of Excelence Initiative on Biohealth (GREIB), Campus BioTic, University of Granada, Spain and European University of Madrid. Escuela de Estudios Universitarios Real Madrid. 2010/04RM

Imaging of Acute Lung Injury

Acute lung injury (ALI) is the clinical syndrome associated with histopathologic diffuse alveolar damage. It is a common cause of acute respiratory symptoms and admission to the intensive care unit. Diagnosis of ALI is typically based on clinical and radiographic criteria; however, because these criteria can be nonspecific, diagnostic uncertainty is common. A multidisciplinary approach that synthesizes clinical, imaging, and pathologic data can ensure an accurate diagnosis. Radiologists must be aware of the radiographic and computed tomographic findings of ALI and its mimics. This article discusses the multidisciplinary diagnosis of ALI from the perspective of the imager