The psychosocial burden of hidradenitis suppurativa: the patients' perspectives

We designed a qualitative study to interview 12 patients with Hidradenitis Suppurativa. This was done by means of a semistructured interview. Questions on quality of life, the impact of their skin disease on family, friends, work, intimate relationships, treatments, etc. were asked. Patients consented to be interviewed and to be video taped to facilitate the transcription of the interviews. The interviews lasted between 30 and 60 minutes and were carried out by a psychologist and a social worker. The dermatologist had previously seen the patients and filled in a form with the Hurley Stage, years of evolution and treatment..

Use of floating PV plants for coordinated operation with hydropower plants: Case study of the hydroelectric plants of the Sao Francisco River basin

[EN] In recent years, the Brazilian electricity sector has seen a considerable reduction in hydroelectric production and an increase in dependence on the complementation of thermoelectric power plants to meet the energy demand. This issue has led to an increase in greenhouse gas emissions, which has intensified climate change and modified rainfall regimes in several regions of the country, as well as increased the cost of energy. The use of floating PV plants in coordinated operation with hydroelectric plants can establish a mutual compensation between these sources and replace a large portion of the energy that comes from thermal sources, thereby reducing the dependence on thermoelectric energy for hydropower complementation. Thus, this paper presents a procedure for technically and economically sizing floating PV plants for coordinated operation with hydroelectric plants. A case study focused on the hydroelectric plants of the Sao Francisco River basin, where there has been intense droughts and increased dependence on thermoelectric energy for hydropower complementation. The results of the optimized design show that a PV panel tilt of approximately 3 degrees can generate energy at the lowest cost (from R $298.00/MWh to R$312.00/MWh, depending on the geographical location of the FLOATING PV platform on the reservoir). From an energy perspective, the average energy gain generated by the hydroelectric plant after adding the floating PV generation was 76%, whereas the capacity factor increased by 17.3% on average. In terms of equivalent inflow, the PV source has a seasonal profile that compliments the natural inflow of the river. Overall, the proposed coordinated operation could replace much of the thermoelectric generation in Brazil.The authors would like to thank the Brazilian National Council for Scientific and Technological Development (Conselho Nacional de Desenvolvimento Científico e Tecnológico, CNPq; in Portuguese) for granting a productivity in research scholarship to Prof. Regina Mambeli Barros (PQ2, Process number: 301986/2015-0) and Prof. Geraldo Lúcio Tiago Filho and to the Brazilian Coordination for the Improvement of Higher Education Personnel (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Capes; in Portuguese) for granting the Master of Science scholarship to Naidion Motta Silvério and the Doctorate scholarship to Ivan Felipe da Silva dos Santos.Silverio, N.; Barros, R.; Tiago Filho, GL.; Redón-Santafé, M.; Silva Dos Santos, IF.; De Mello Valerio, VE. (2018). Use of floating PV plants for coordinated operation with hydropower plants: Case study of the hydroelectric plants of the Sao Francisco River basin. Energy Conversion and Management. 171:339-349. https://doi.org/10.1016/j.enconman.2018.05.095S33934917

Modifiable risk factors associated with prediabetes in men and women: A cross-sectional analysis of the cohort study in primary health care on the evolution of patients with prediabetes

Background: Prediabetes is a high-risk state for diabetes development, but little is known about the factors associated with this state. The aim of the study was to identify modifiable risk factors associated with the presence of prediabetes in men and women. Methods: Cohort Study in Primary Health Care on the Evolution of Patients with Prediabetes (PREDAPS-Study) is a prospective study on a cohort of 1184 subjects with prediabetes and another cohort of 838 subjects without glucose metabolism disorders. It is being conducted by 125 general practitioners in Spain. Data for this analysis were collected during the baseline stage in 2012. The modifiable risk factors included were: smoking habit, alcohol consumption, low physical activity, inadequate diet, hypertension, dyslipidemia, and obesity. To assess independent association between each factor and prediabetes, odds ratios (ORs) were estimated using logistic regression models. Results: Abdominal obesity, low plasma levels of high-density lipoprotein cholesterol (HDL-cholesterol), and hypertension were independently associated with the presence of prediabetes in both men and women. After adjusting for all factors, the respective ORs (95% Confidence Intervals) were 1.98 (1.41-2.79), 1.88 (1.23-2.88) and 1.86 (1.39-2.51) for men, and 1.89 (1.36-2.62), 1.58 (1.12-2.23) and 1.44 (1.07-1.92) for women. Also, general obesity was a risk factor in both sexes but did not reach statistical significance among men, after adjusting for all factors. Risky alcohol consumption was a risk factor for prediabetes in men, OR 1.49 (1.00-2.24). Conclusions: Obesity, low HDL-cholesterol levels, and hypertension were modifiable risk factors independently related to the presence of prediabetes in both sexes. The magnitudes of the associations were stronger for men than women. Abdominal obesity in both men and women displayed the strongest association with prediabetes. The findings suggest that there are some differences between men and women, which should be taken into account when implementing specific recommendations to prevent or delay the onset of diabetes in adult population

Trends and outcome of neoadjuvant treatment for rectal cancer: A retrospective analysis and critical assessment of a 10-year prospective national registry on behalf of the Spanish Rectal Cancer Project

Introduction: Preoperative treatment and adequate surgery increase local control in rectal cancer. However, modalities and indications for neoadjuvant treatment may be controversial. Aim of this study was to assess the trends of preoperative treatment and outcomes in patients with rectal cancer included in the Rectal Cancer Registry of the Spanish Associations of Surgeons. Method: This is a STROBE-compliant retrospective analysis of a prospective database. All patients operated on with curative intention included in the Rectal Cancer Registry were included. Analyses were performed to compare the use of neoadjuvant/adjuvant treatment in three timeframes: I)2006–2009; II)2010–2013; III)2014–2017. Survival analyses were run for 3-year survival in timeframes I-II. Results: Out of 14, 391 patients, 8871 (61.6%) received neoadjuvant treatment. Long-course chemo/radiotherapy was the most used approach (79.9%), followed by short-course radiotherapy ± chemotherapy (7.6%). The use of neoadjuvant treatment for cancer of the upper third (15-11 cm) increased over time (31.5%vs 34.5%vs 38.6%, p = 0.0018). The complete regression rate slightly increased over time (15.6% vs 16% vs 18.5%; p = 0.0093); the proportion of patients with involved circumferential resection margins (CRM) went down from 8.2% to 7.3%and 5.5% (p = 0.0004). Neoadjuvant treatment significantly decreased positive CRM in lower third tumors (OR 0.71, 0.59–0.87, Cochrane-Mantel-Haenszel P = 0.0008). Most ypN0 patients also received adjuvant therapy. In MR-defined stage III patients, preoperative treatment was associated with significantly longer local-recurrence-free survival (p < 0.0001), and cancer-specific survival (p < 0.0001). The survival benefit was smaller in upper third cancers. Conclusion: There was an increasing trend and a potential overuse of neoadjuvant treatment in cancer of the upper rectum. Most ypN0 patients received postoperative treatment. Involvement of CRM in lower third tumors was reduced after neoadjuvant treatment. Stage III and MRcN + benefited the most

Pharmacist role in the nutrition area at the European level

Una vez licenciado, el farmacéutico puede optar por un elevado número de salidas profesionales, tanto en el sector público al servicio de los diferentes cuerpos y administraciones, como en el sector privado. Los perfiles profesionales más frecuentes del farmacéutico pueden englobarse en 4 modalidades: Oficina de Farmacia (Farmacia Comunitaria), Farmacia Hospitalaria, Distribución e Industria Farmacéutica o Análisis y Salud Pública. A nivel de oficina de farmacia, el farmacéutico, junto a la dispensación de medicamentos, ejerce un destacado papel como asesor y consejero de salud. Las estadísticas desvelan que una de cada cuatro personas que entran en una farmacia no adquiere medicamentos, sino que sólo pide un consejo sanitario, incluyendo asesoría sobre dietas, alimentación y nutrición. Además, la aparición en los últimos años de complementos alimenticios, de venta en farmacia, hace que el farmacéutico deba formarse y comportarse como profesional en lo que respecta a temas de nutrición. Otra salida profesional, como la inspección Farmacéutica, incluye la supervisión de agua y alimentos no animales, por lo que el farmacéutico debe tener un amplio conocimiento sobre la legislación, sanidad y análisis de alimentos. Por otro lado, la industria farmacéutica incluye una amplia variedad de salidas profesionales, incluyéndose dirección técnica, control de calidad y de fabricación, gestión comercial, documentación científica o análisis. La industria agroalimentaria ha experimentado importantes cambios en las últimas décadas, exigiendo profesionales en la materia, como dietistas o analistas bromatológicos, dentro de un equipo multidisciplinar. En este sentido, el farmacéutico, a través del nuevo grado en Farmacia, debe adquirir una base sólida en el campo de la nutrición y bromatología. Así, las competencias recogidas en la Orden CIN/2137/2008 ponen de manifiesto la importancia de la formación del futuro farmacéutico en el ámbito de la alimentación.Once graduated, the pharmacist can choose a high number of professional skills, both in public and private sectors. The most frequent professional skills of the pharmacist can be included in 4 different fields: Pharmacy Office (Communitary Pharmacy), Hospital Pharmacy, Distribution and Pharmaceutical Industry or Analysis and Public Health. At the pharmacy office level, the pharmacist, along with the medicines dispensation, exercises an out-standing role as health adviser. The statistics reveal that 25% of the pharmacy customers do not acquire medicines, but they only ask for a sanitary advice, including nutrition and dietetic consultations. Moreover, in the last years nutritive supplements have been included within the pharmaceutical sales. Thus, the pharmacist should be formed about nutritional topics. Another professional skill, like the pharmaceutical inspection, includes drinkable water and non-animal foodstuffs analyses. Then, the pharmacist should have a wide knowledge on legislation, health and food analysis. On the other hand, the pharmaceutical industry includes a wide variety of professional skills, including technical direction, quality control, commercial management, scientific documentation or analysis. Finally, the agro-alimentary industry has experienced important changes in the last decades, demanding professionals in the matter, like dietitians or food analysts. In this sense, the pharmacist, across the new degree in Pharmacy, must acquire a solid base in the nutrition and bromatology field. Therefore, the competences gathered in the Disposition CIN / 2137/2008 reveals the importance of the formation of the future pharmacist in the nutrition area

Ideal cardiovascular health and inflammation in European adolescents: The HELENA study

Background and aims Inflammation plays a key role in atherosclerosis and this process seems to appear in childhood. The ideal cardiovascular health index (ICHI) has been inversely related to atherosclerotic plaque in adults. However, evidence regarding inflammation and ICHI in adolescents is scarce. The aim is to assess the association between ICHI and inflammation in European adolescents. Methods and results As many as 543 adolescents (251 boys and 292 girls) from the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study, a cross-sectional multi-center study including 9 European countries, were measured. C-reactive protein (CRP), complement factors C3 and C4, leptin and white blood cell counts were used to compute an inflammatory score. Multilevel linear models and multilevel logistic regression were used to assess the association between ICHI and inflammation controlling by covariates. Higher ICHI was associated with a lower inflammatory score, as well as with several individual components, both in boys and girls (p < 0.01). In addition, adolescents with at least 4 ideal components of the ICHI had significantly lower inflammatory score and lower levels of the study biomarkers, except CRP. Finally, the multilevel logistic regression showed that for every unit increase in the ICHI, the probability of having an inflammatory profile decreased by 28.1% in girls. Conclusion Results from this study suggest that a better ICHI is associated with a lower inflammatory profile already in adolescence. Improving these health behaviors, and health factors included in the ICHI, could play an important role in CVD prevention

Brucellosis vaccines: assessment of Brucella melitensis lipopolysaccharide rough mutants defective in core and O-polysaccharide synthesis and export

The brucellae are facultative intracellular bacteria that cause brucellosis, one of the major neglected zoonoses. In endemic areas, vaccination is the only effective way to control this disease. Brucella melitensis Rev 1 is a vaccine effective against the brucellosis of sheep and goat caused by B. melitensis, the commonest source of human infection. However, Rev 1 carries a smooth lipopolysaccharide with an O-polysaccharide that elicits antibodies interfering in serodiagnosis, a major problem in eradication campaigns. Because of this, rough Brucella mutants lacking the O-polysaccharide have been proposed as vaccines. METHODOLOGY/PRINCIPAL FINDINGS: To examine the possibilities of rough vaccines, we screened B. melitensis for lipopolysaccharide genes and obtained mutants representing all main rough phenotypes with regard to core oligosaccharide and O-polysaccharide synthesis and export. Using the mouse model, mutants were classified into four attenuation patterns according to their multiplication and persistence in spleens at different doses. In macrophages, mutants belonging to three of these attenuation patterns reached the Brucella characteristic intracellular niche and multiplied intracellularly, suggesting that they could be suitable vaccine candidates. Virulence patterns, intracellular behavior and lipopolysaccharide defects roughly correlated with the degree of protection afforded by the mutants upon intraperitoneal vaccination of mice. However, when vaccination was applied by the subcutaneous route, only two mutants matched the protection obtained with Rev 1 albeit at doses one thousand fold higher than this reference vaccine. These mutants, which were blocked in O-polysaccharide export and accumulated internal O-polysaccharides, stimulated weak anti-smooth lipopolysaccharide antibodies. CONCLUSIONS/SIGNIFICANCE: The results demonstrate that no rough mutant is equal to Rev 1 in laboratory models and question the notion that rough vaccines are suitable for the control of brucellosis in endemic areas

RICORS2040 : The need for collaborative research in chronic kidney disease

Chronic kidney disease (CKD) is a silent and poorly known killer. The current concept of CKD is relatively young and uptake by the public, physicians and health authorities is not widespread. Physicians still confuse CKD with chronic kidney insufficiency or failure. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. Thus health authorities may consider CKD a non-issue: very few persons eventually need KRT and, for those in whom kidneys fail, the problem is 'solved' by dialysis or kidney transplantation. However, KRT is the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated ageing and premature death. The cut-off points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature death. CKD is the most prevalent risk factor for lethal coronavirus disease 2019 (COVID-19) and the factor that most increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality that is 10- to 100-fold higher than similar-age peers, and life expectancy is shortened by ~40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth greatest global cause of death by 2040 and the second greatest cause of death in Spain before the end of the century, a time when one in four Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded Centres for Biomedical Research (CIBER) network structure in Spain. Realizing the underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020-2030 was launched by the American Association of Kidney Patients and the European Kidney Health Alliance. Leading Spanish kidney researchers grouped in the kidney collaborative research network Red de Investigación Renal have now applied for the Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS) call for collaborative research in Spain with the support of the Spanish Society of Nephrology, Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true