868 research outputs found
Validation of a Questionnaire to Assess the Perception of Women with Atopic Dermatitis in Family Planning
Introduction: Atopic dermatitis (AD) is a highly frequent chronic inflammatory skin
disease. It is important to know how women with AD approach family planning together with
their disease. The aim of the present research is to develop and validate a questionnaire for women
diagnosed with AD in order to measure their level of desire and gestational information. Materials
and Methods: A multicenter cross-sectional study was conducted. Women between 18 and 45 years
old with mild, moderate, and severe forms of the disease were included and disease-free controls. An
exploratory factorial analysis of the primary components and varimax rotation was used to measure
the validity of the construct. Cronbach’s α was used to measure the reliability of the individual
scales and the global questionnaire. Results: In total, 150 valid questionnaires were included. The
final questionnaire consisted of 23 items that converged on six factors. The six scales had adequate
reliability: “Pregnancy” (Cronbach’s alpha = 0.95), “Conception” (Cronbach’s alpha = 0.93), “Concern-
information” (Cronbach’s alpha = 0.82), “Breastfeeding” (Cronbach’s alpha = 0.81), “Sexual life”
(Cronbach’s alpha = 0.79), and “Family planning” (Cronbach’s alpha = 0.67). The total Cronbach’s
alpha of the questionnaire was 0.94. Discussion: This questionnaire is the first specific measurement
instrument developed for women with AD of childbearing age that has demonstrated adequate levels
of reliability and construct validity. We consider it useful and valuable to study aspects such as family
planning in this patient profile, and that can influence their decision to have offsprin
Predictive simulations for plasma scenarios in the SMART tokamak
The SMall Aspect Ratio Tokamak (SMART) is a new spherical machine that is currently being constructed at the University of Seville (Mancini et al., 2021; Agredano-Torres et al., 2021). The operation of SMART will cover three different phases reaching an inductive plasma current (IP) of more than 500 kA, a toroidal magnetic field (BT) of 1 T and a pulse length of 500 ms (Mancini et al., 2021; Agredano-Torres et al., 2021). The main goal of the SMART tokamak is to study high plasma confinement regimes in a broad triangularity range (-0.5≤δ≤0.5) (Doyle et al., 2021; Doyle et al., 2021). While in phase 1 the ohmic heating alone is expected to provide enough power to access the H-mode, in phase 2 and phase 3 the access to the H-mode will be ensured by applying Neutral Beam Injection (NBI) as external heating system. The NBI will consist of one injector at 25 keV and 1 MW of power. The overall design of the NBI, including injection geometry, energy and power have been optimized using the ASCOT5 code (Hirvijoki et al., 2021). The SMART scenarios have been developed with the help of the free boundary equilibrium solver code FIESTA (Cunningham, 2013) coupled to the linear time independent, rigid plasma model RZIP (Lazarus et al., 1990) to calculate the target equilibria for all the different operational phases. To assess the feasibility of those scenarios, predictive modelling needs to be included to evaluate properly the evolution of the temperatures, density profiles for both electrons and ions. To this extent, the 1.5D transport code ASTRA (Pereverzev and Yushmanov, 2002) has been used including models for the ohmic current, bootstrap current and current driven by NBI. This contribution discusses the electron and ion density and temperature profiles obtained for various scenarios for phase 1 and 2 and presents the design study of the NBI.his work received funding from the Fondo Europeo de Desarollo Regional (FEDER) by the European Commission under grant agreement numbers IE17-5670 and US-15570. The authors gratefully acknowledge the financial support of the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (grant agreement No. 805162).Peer reviewe
SELNET clinical practice guidelines for bone sarcoma
Bone sarcoma are infrequent diseases, representing < 0.2% of all adult neoplasms. A multidisciplinary management within reference centers for sarcoma, with discussion of the diagnostic and therapeutic strategies within an expert multidisciplinary tumour board, is essential for these patients, given its heterogeneity and low frequency. This approach leads to an improvement in patient's outcome, as demonstrated in several studies. The Sarcoma European Latin-American Network (SELNET), aims to improve clinical outcome in sarcoma care, with a special focus in Latin-American countries. These Clinical Practice Guidelines (CPG) have been developed and agreed by a multidisciplinary expert group (including medical and radiation oncologist, surgical oncologist, orthopaedic surgeons, radiologist, pathologist, molecular biologist and representatives of patients advocacy groups) of the SELNET consortium, and are conceived to provide the standard approach to diagnosis, treatment and follow-up of bone sarcoma patients in the Latin-American context
Planificación y diseño de recursos para poner en marcha la versión on-line del Máster oficial las TIC en Educación
Memoria ID-0180. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2014-2015
Role of age and comorbidities in mortality of patients with infective endocarditis
[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality.
[Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk.
[Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality.
[Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group
CIBERER : Spanish national network for research on rare diseases: A highly productive collaborative initiative
Altres ajuts: Instituto de Salud Carlos III (ISCIII); Ministerio de Ciencia e Innovación.CIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research
Incidence, Clinical Characteristics and Management of Inflammatory Bowel Disease in Spain : Large-Scale Epidemiological Study
(1) Aims: To assess the incidence of inflammatory bowel disease (IBD) in Spain, to describe the main epidemiological and clinical characteristics at diagnosis and the evolution of the disease, and to explore the use of drug treatments. (2) Methods: Prospective, population-based nationwide registry. Adult patients diagnosed with IBD-Crohn's disease (CD), ulcerative colitis (UC) or IBD unclassified (IBD-U)-during 2017 in Spain were included and were followed-up for 1 year. (3) Results: We identified 3611 incident cases of IBD diagnosed during 2017 in 108 hospitals covering over 22 million inhabitants. The overall incidence (cases/100,000 person-years) was 16 for IBD, 7.5 for CD, 8 for UC, and 0.5 for IBD-U; 53% of patients were male and median age was 43 years (interquartile range = 31-56 years). During a median 12-month follow-up, 34% of patients were treated with systemic steroids, 25% with immunomodulators, 15% with biologics and 5.6% underwent surgery. The percentage of patients under these treatments was significantly higher in CD than UC and IBD-U. Use of systemic steroids and biologics was significantly higher in hospitals with high resources. In total, 28% of patients were hospitalized (35% CD and 22% UC patients, p < 0.01). (4) Conclusion: The incidence of IBD in Spain is rather high and similar to that reported in Northern Europe. IBD patients require substantial therapeutic resources, which are greater in CD and in hospitals with high resources, and much higher than previously reported. One third of patients are hospitalized in the first year after diagnosis and a relevant proportion undergo surgery
Correction : Chaparro et al. Incidence, Clinical Characteristics and Management of Inflammatory Bowel Disease in Spain: Large-Scale Epidemiological Study. J. Clin. Med. 2021, 10, 2885
The authors wish to make the following corrections to this paper [...]
Effectiveness and risk factors for virological outcome of darunavir-based therapy for treatment-experienced HIV-infected patients
Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2
The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality
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