Transcorneal Permeation in a Corneal Device of Non-Steroidal Anti-Inflammatory Drugs in Drug Delivery Systems

This work is focused on the ex vivo study of corneal permeation of two anti-inflammatory drugs: diclofenac, and flurbiprofen (as a model of hydrophilic and lipophilic drug, respectively) loaded to cyclodextrins or polymeric nanoparticles in order to determine differences in their corneal permeation against free drug or commercial eye drops. These studies were carried out in a corneal device designed and developed in our laboratory. In this work the habitual conditions for the permeation studies were modified to reproduce the behaviour when eye drops were administered. For this reason a new tetracompartmental pharmacokinetic model was developed. The complex formation of diclofenac with cyclodextrins and the flurbiprofen loaded to polymeric nanoparticles has been shown as effective procedures to remarkably increase the bioavailability of the anti-inflammatory drugs. The efficiency of polymeric nanoparticles of Poly (D-L lactic-coglycolyc) acid and poly-ε-caprolacton as intraocular targeting of NSAIDs has also been proved, being the latter polymer more effective to increase the flurbiprofen corneal permeation. The apparent corneal permeability coefficient of samples has been calculated getting a low permeation values for free drugs

Underground CO2 storage: Approach for favourable formations in Ebro Basin and storage capacity estimation

El almacenamiento geológico profundo (AGP) es una de las iniciativas que, en el ámbito internacional, está cobrando mayor relevancia para reducir las emisiones antropogénicas de CO2 a la atmósfera. En territorio español, el estudio de las posibilidades de AGP de CO2 se está canalizando a través del Proyecto Singular Estratégico “Tecnologías avanzadas de generación, captura y almacenamiento de CO2” del MEC y, como una parte de este proyecto, se han estudiado las posibilidades que ofrece la Cuenca del Ebro de cara al almacenamiento definitivo de CO2, mediante la reinterpretación de la información de sondeos del Archivo Nacional de Hidrocarburos, gestionado por el IGME. Se han seleccionado una serie de formaciones que, por sus características relativas a disposición, extensión, profundidad y porosidad, podrían constituir un futuro almacenamiento, prestando también especial atención a las formaciones sello, que garantizarían la estanqueidad de los diferentes almacenes. Se proporciona una estimación de la capacidad de almacenamiento de cada formación, que si bien es aproximada, si puede ser un dato útil para la toma de decisiones futuras.Deep geological storage (DGS) is one of the more relevant international initiatives in order to eliminate or reduce the anthropogenic CO2 emissions to the atmosphere. The study of the possibilities of DGS of CO2 inside Spanish territory is being performed through the Strategic Singular Project “CO2 generation,capture and storage advanced technologies”, of the MEC. The potential final storage of CO2 in Ebro Basin, has been studied through reinterpretation of deep boreholes information from the National Hydrocarbons Archive, managed by IGME. A number of formations have been selected that, by their position, extent, depth and porosity, could be a future storage. The study has also been conducted considering the characteristics of the geological formations above the CO2 storage formations so as to guarantee the sealing of the storage. The study includes the approximate estimation of the storage capacity for each formation, which can be useful in future decision making.Depto. de Mineralogía y PetrologíaFac. de Ciencias GeológicasTRUEpu

Wheat yield prediction in Andalucía using MERIS Terrestrial Chlorophyll Index (MTCI) time series

[EN] There is a relationship between net primary production of wheat and vegetation indices obtained from satellite imaging. Most wheat production studies use the Normalised Difference Vegetation Index (NDVI) to estimate the production and yield of wheat and other crops. On the one hand, few studies use the MERIS Terrestrial Chlorophyll Index (MTCI) to determine crop yield and production on a regional level. This is possibly due to a lack of continuity of MERIS. On the other hand, the emergence of Sentinel 2 open new possibilities for the research and application of MTCI. This study has built two empirical models to estimate wheat production and yield in Andalusia. To this end, the study used the complete times series (weekly images from 2006–2011) of the MTCI vegetation index from the Medium Resolution Imaging Spectrometer (MERIS) sensor associated with the Andalusian yearbook for agricultural and fishing statistics (AEAP—Anuario de estadísticas agrarias y pesqueras de Andalucía). In order to build these models, the optimal development period for the plant needed to be identified, as did the time-based aggregation of MTCI values using said optimal period as a reference, and relation with the index, with direct observations of production and yield through spatial aggregation using coverage from the Geographic Information System for Agricultural Parcels (SIGPAC—Sistema de información geográfica de parcelas agrícolas) and requests for common agricultural policy (CAP) assistance. The obtained results indicate a significant association between the MTCI index and the production and yield data collected by AEAP at the 95% confidence level (R2 =0.81 and R2 =0.57, respectively).[ES] Existe una relación entre la producción primaria neta del trigo y los índices de vegetación obtenidos de imágenes de satélite. Con frecuencia se utiliza el NDVI (Normalized Difference Vegetation Index) para la estimación de producción y rendimiento de trigo y otros cultivos. Sin embargo, hay pocas investigaciones que utilicen el índice MTCI (MERIS Terrestrial Chlorophyll Index) para conocer el rendimiento y la producción de los cultivos a una escala regional posiblemente debido a la falta de continuidad del sensor MERIS. No obstante, la posibilidad del cálculo de MTCI a partir de Sentinel 2 abre nuevas oportunidades para su aplicación e investigación. En esta investigación se han generado dos modelos empíricos de estimación de producción y rendimiento de trigo en Andalucía. Para ello, se ha empleado la serie temporal completa (imágenes semanales de 2006 a 2011) del índice de vegetación MTCI del sensor satelital MERIS (Medium Resolution Imaging Spectrometer) asociada a los datos de producción y rendimiento del Anuario de estadísticas agrarias y pesqueras de Andalucía (AEAP). Para la creación de estos modelos ha sido necesaria la identificación del periodo óptimo del desarrollo de la planta, la agregación temporal de los valores MTCI usando ese momento óptimo como referencia, relacionar ese índice con observaciones directas de producción y rendimiento a través de agregaciones espaciales mediante la utilización de coberturas SIGPAC y las solicitudes de ayudas PAC, caracterizar la variación del índice en función del año de cultivo y relacionarlo con los datos estadísticos. Los resultados obtenidos indican una correlación estadísticamente significativa (p-valor < 0,05) entre el índice MTCI y los datos de producción y rendimiento recogidos por AEAP (R2=0,81 y 0,57, respectivamente).Agradecemos la financiación obtenida de MINECO (Proyectos BIA2013-43462-P, CSO2014-51994-P) y de la Junta de Andalucía (Grupo Investigación RNM177).Egea-Cobrero, V.; Rodriguez-Galiano, V.; Sánchez-Rodríguez, E.; García-Pérez, M. (2018). Estimación de la cosecha de trigo en Andalucía usando series temporales de MERIS Terrestrial Chlorophyll Index (MTCI). Revista de Teledetección. (51):99-112. https://doi.org/10.4995/raet.2018.8891SWORD9911251Ahmed, B.M., Tanakamaru, H., Tada, A. 2010. Application of remote sensing for estimating crop water requirements, yield and water productivity of wheat in the Gezira Scheme. International Journal of Remote Sensing, 31(16), 4281-4294. https://doi.org/10.1080/01431160903246733Arévalo-Barroso, A. 1992. Atlas Nacional de España. Sección II. Grupo 9. Recuperado el 5 de noviembre de 2016, a partir de http://www.ign.es/ane/ane1986-2008/Asseng, S., Ewert, F., Martre, P., Rötter, R.P., Lobell, D.B., Cammarano, D., … Zhu, Y. 2014. Rising temperatures reduce global wheat production. Nature Climate Change, 5(2), 143-147. https://doi.org/10.1038/nclimate2470Atanasova, N., Todorovski, L., Džeroski, S., Kompare, B. 2008. Application of automated model discovery from data and expert knowledge to a real-world domain: Lake Glumsø. Ecological Modelling, 212(1-2), 92- 98. https://doi.org/10.1016/j.ecolmodel.2007.10.032Atzberger, C. 2013. Advances in Remote Sensing of Agriculture: Context Description, Existing Operational Monitoring Systems and Major Information Needs. Remote Sensing, 5(2), 949-981. https://doi.org/10.3390/rs5020949Becker-Reshef, I., Justice, C., Sullivan, M., Vermote, E., Tucker, C., Anyamba, A., … Doorn, B. 2010. Monitoring Global Croplands with Coarse Resolution Earth Observations: The Global Agriculture Monitoring (GLAM) Project. Remote Sensing, 2(6), 1589-1609. https://doi.org/10.3390/rs2061589Boissard, P., Guérif, M., Pointel, J.G., Guinot, J.P. 1989. Application of SPOT data to wheat yield estimation. Advances in Space Research, 9(1), 143-154. https://doi.org/10.1016/0273-1177(89)90479-1Boken, V.K., Shaykewich, C.F. 2002. Improving an operational wheat yield model using phenological phase-based Normalized Difference Vegetation Index. International Journal of Remote Sensing, 23(20), 4155-4168. https://doi.org/10.1080/014311602320567955CAPDER. 2012. Seguimiento de los mercados de cereales y oleaginosas. Consejería de Agricultura, Pesca y Desarrollo Rural (CAPDER). Secretaría General Técnica. Servicio de Publicaciones y Divulgación. Junta de Andalucía.CAPDER. 2015. Anuario de estadísticas agrarias y pesqueras de Andalucía. Recuperado a partir dehttp://www.juntadeandalucia.es/organismos/agriculturapescaydesarrollorural/consejeria/sobreconsejeria/estadisticas/paginas/agrarias-anuario. html [Último acceso: junio de 2018].Chahbi, A., Zribi, M., Lili-Chabaane, Z., Duchemin, B., Shabou, M., Mougenot, B., Boulet, G. 2014. Estimation of the dynamics and yields of cereals in a semi-arid area using remote sensing and the SAFY growth model. International Journal of Remote Sensing, 35(3), 1004-1028. https://doi.org/10.1080/ 01431161.2013.875629Curtis, T., Halford, N. G. 2014. Food security: the challenge of increasing wheat yield and the importance of not compromising food safety. Annals of Applied Biology, 164(3), 354-372. https://doi.org/10.1111/aab.12108Dash, J., Curran, P. 2007. Relationship between the MERIS vegetation indices and crop yield for the state of South Dakota, USA. Proc. Envisat Symposium.Dash, J., Jeganathan, C., Atkinson, P.M. 2010. The use of MERIS Terrestrial Chlorophyll Index to study spatio-temporal variation in vegetation phenology over India. Remote Sensing of Environment, 114(7), 1388-1402. https://doi.org/10.1016/j. rse.2010.01.021Dempewolf, J., Adusei, B., Becker-Reshef, I., Hansen, M., Potapov, P., Khan, A., Barker, B. 2014. Wheat yield forecasting for Punjab Province from vegetation index time series and historic crop statistics. Remote Sensing, 6(10), 9653-9675. https://doi.org/10.3390/rs6109653Dente, L., Satalino, G., Mattia, F., Rinaldi, M. 2008. Assimilation of leaf area index derived from ASAR and MERIS data into CERESWheat model to map wheat yield. Remote Sensing of Environment, 112(4), 1395-1407. https://doi.org/10.1016/j.rse.2007.05.023Duncan, J.M.A., Dash, J., Atkinson, P.M. 2015. Elucidating the impact of temperature variability and extremes on cereal croplands through remote sensing. Global change biology, 21(4), 1541-51. https://doi.org/10.1111/gcb.12660FAOSTAT. 2013. Productos agrícolas. Recuperado 17 de agosto de 2016, a partir de http://ec.europa.eu/eurostat/statistics-explained/index.php/Agricultural_products/es#Fuente_de_los_datos_de_las_tablas_y_los_gr.C3.A1ficos_.28MS_Excel.29Foley, J.A., Ramankutty, N., Brauman, K.A., Cassidy, E.S., Gerber, J.S., Johnston, M., … Zaks, D.P.M. 2011. Solutions for a cultivated planet. Nature, 478(7369), 337-342. https://doi.org/10.1038/ nature10452Fontana, D.C., Potgieter, A.B., Apan, A. 2007. Assessing the relationship between shire winter crop yield and seasonal variability of the MODIS NDVI and EVI images. Applied GIS, 3(7).Huang, J., Sedano, F., Huang, Y., Ma, H., Li, X., Liang, S., … Wu, W. 2016. Assimilating a synthetic Kalman filter leaf area index series into the WOFOST model to improve regional winter wheat yield estimation. Agricultural and Forest Meteorology, 216, 188-202. https://doi.org/10.1016/j.agrformet.2015.10.013Huang, J., Tian, L., Liang, S., Ma, H., Becker-Reshef, I., Huang, Y., … Wu, W. 2015. Improving winter wheat yield estimation by assimilation of the leaf area index from Landsat TM and MODIS data into the WOFOST model. Agricultural and Forest Meteorology, 204, 106-121. https://doi. org/10.1016/j.agrformet.2015.02.001Huang, Y., Zhu, Y., Li, W. L., Cao, W. X., & Tian, Y. C. 2013. Assimilating remotely sensed information with the wheatgrow model based on the ensemble square root filter for improving regional wheat yield forecasts. Plant Production Science, 16(4), 352-364. https://doi.org/10.1626/pps.16.352ITACyL, AEMET, Consejería de Agricultura y Ganadería de la Junta de Castilla y León. 2016. Boletín de predicción de cosechas de Castilla y León. Recuperado 25 de octubre de 2016, a partir de https://cosechas.itacyl.es/es/inicioJégo, G., Pattey, E., Liu, J. 2012. Using Leaf Area Index, retrieved from optical imagery, in the STICS crop model for predicting yield and biomass of field crops. Field Crops Research, 131, 63-74. https://doi. org/10.1016/j.fcr.2012.02.012Johnson, M.D., Hsieh, W.W., Cannon, A.J., Davidson, A., Bédard, F. 2016. Crop yield forecasting on the Canadian Prairies by remotely sensed vegetation indices and machine learning methods. Agricultural and Forest Meteorology, 218-219, 74-84. https://doi.org/10.1016/j.agrformet.2015.11.003Kouadio, L., Duveiller, G., Djaby, B., El Jarroudi, M., Defourny, P., Tychon, B. 2012. Estimating regional wheat yield from the shape of decreasing curves of green area index temporal profiles retrieved from MODIS data. International Journal of Applied Earth Observation and Geoinformation, 18(1), 111- 118. https://doi.org/10.1016/j.jag.2012.01.009Kowalik, W., Dabrowska-Zielinska, K., Meroni, M., Raczka, T.U., de Wit, A. 2014. Yield estimation using SPOT-VEGETATION products: A case study of wheat in European countries. International Journal of Applied Earth Observation and Geoinformation, 32(1), 228-239. https://doi.org/10.1016/j.jag.2014.03.011Kumar, M. 2016. Impact of climate change on crop yield and role of model for achieving food security. Environmental Monitoring and Assessment, 188(8), 1-14. https://doi.org/10.1007/s10661-016-5472-3Lobell, D.B., Schlenker, W., Costa-Roberts, J. 2011. Climate trends and global crop production since 1980. Science, 333(6042), 616-20. https://doi.org/10.1126/science.1204531MAGRAMA. 2015. Encuesta sobre Superficies y Rendimientos Cultivos (ESYRCE) de 2004 a 2015. Recuperado a partir de http://www.magrama. gob.es/es/estadistica/temas/estadisticas-agrarias/ agricultura/esyrce/resultados-de-anos-anteriores/ default.aspxMika, J., Kerényi, J., Rimóczi-Paál, A., Merza, Á., Szinell, C., Csiszár, I. 2002. On correlation of maize and wheat yield with NDVI: Example of Hungary (1985-1998). Advances in Space Research, 30(11), 2399-2404. https://doi.org/10.1016/S0273- 1177(02)80288-5Padilla, F.L.M., Maas, S.J., González-Dugo, M.P., Mansilla, F., Rajan, N., Gavilán, P., Domínguez, J. 2012. Monitoring regional wheat yield in Southern Spain using the GRAMI model and satellite imagery. Field Crops Research, 130, 145-154. https://doi.org/10.1016/j.fcr.2012.02.025Rawson, H.M., Macpherson, H.G. 2001. Trigo regado: manejo del cultivo. FAO.Reeves, M.C., Zhao, M., Running, S.W. 2005. Usefulness and limits on MODIS GPP for estimating wheat yield. International Journal of Remote Sensing, 26(7), 1403-1421. http://doi.org/10.1080/ 01431160512331326567Rembold, F., Atzberger, C., Savin, I., Rojas, O. 2013. Using Low Resolution Satellite Imagery for Yield Prediction and Yield Anomaly Detection. Remote Sensing, 5(4), 1704-1733. https://doi.org/10.3390/rs5041704Ren, J., Chen, Z., Zhou, Q., Tang, H. 2008. Regional yield estimation for winter wheat with MODIS-NDVI data in Shandong, China. International Journal of Applied Earth Observation and Geoinformation, 10(4), 403- 413. https://doi.org/10.1016/j.jag.2007.11.003Salazar, L., Kogan, F., Roytman, L. 2007. Use of remote sensing data for estimation of winter wheat yield in the United States. International Journal of Remote Sensing, 28(17), 3795-3811. https://doi.org/10.1080/01431160601050395Tadesse, T., Senay, G.B., Berhan, G., Regassa, T., Beyene, S. 2015. Evaluating a satellitebased seasonal evapotranspiration product and identifying its relationship with other satellitederived products and crop yield: A case study for Ethiopia. International Journal of Applied Earth Observation and Geoinformation, 40, 39-54. http://doi.org/10.1016/j.jag.2015.03.006Vazifedoust, M., van Dam, J.C., Bastiaanssen, W.G. M., Feddes, R.A. 2009. Assimilation of satellite data into agrohydrological models to improve crop yield forecasts. International Journal of Remote Sensing, 30(10), 2523-2545. https://doi.org/10.1080/01431160802552769Wall, L., Larocque, D., Léger, P.M. 2008. The early explanatory power of NDVI in crop yield modelling. International Journal of Remote Sensing, 29(8), 2211-2225. https://doi.org/ 10.1080/01431160701395252Wu, C., Niu, Z., Tang, Q., Huang, W., Rivard, B., Feng, J. 2009. Remote estimation of gross primary production in wheat using chlorophyllrelated vegetation indices. Agricultural and Forest Meteorology, 149(6), 1015-1021. https://doi.org/10.1016/j.agrformet.2008.12.007Zhang, S., Liu, L. 2014. The potential of the MERIS Terrestrial Chlorophyll Index for crop yield prediction. Remote Sensing Letters, 5(8), 733-742. https://doi.org/10.1080/2150704X.2014.96373

Non-invasive ventilation in obesity hypoventilation syndrome without severe obstructive sleep apnoea

Background Non-invasive ventilation (NIV) is an effective form of treatment in patients with obesity hypoventilation syndrome (OHS) who have concomitant severe obstructive sleep apnoea (OSA). However, there is a paucity of evidence on the efficacy of NIV in patients with OHS without severe OSA. We performed a multicentre randomised clinical trial to determine the comparative efficacy of NIV versus lifestyle modification (control group) using daytime arterial carbon dioxide tension (PaCO2) as the main outcome measure. Methods Between May 2009 and December 2014 we sequentially screened patients with OHS without severe OSA. Participants were randomised to NIV versus lifestyle modification and were followed for 2 months. Arterial blood gas parameters, clinical symptoms, health-related quality of life assessments, polysomnography, spirometry, 6-min walk distance test, blood pressure measurements and healthcare resource utilisation were evaluated. Statistical analysis was performed using intention-to-treat analysis. Results A total of 365 patients were screened of whom 58 were excluded. Severe OSA was present in 221 and the remaining 86 patients without severe OSA were randomised. NIV led to a significantly larger improvement in PaCO2 of -6 (95% CI -7.7 to -4.2) mm Hg versus -2.8 (95% CI -4.3 to -1.3) mm Hg, (p<0.001) and serum bicarbonate of -3.4 (95% CI -4.5 to -2.3) versus -1 (95% CI -1.7 to -0.2 95% CI) mmol/L (p<0.001). PaCO2 change adjusted for NIV compliance did not further improve the inter-group statistical significance. Sleepiness, some health-related quality of life assessments and polysomnographic parameters improved significantly more with NIV than with lifestyle modification. Additionally, there was a tendency towards lower healthcare resource utilisation in the NIV group. Conclusions NIV is more effective than lifestyle modification in improving daytime PaCO2, sleepiness and polysomnographic parameters. Long-term prospective studies are necessary to determine whether NIV reduces healthcare resource utilisation, cardiovascular events and mortality

Methodological Adaptation to EHEA of the of Instrumental Techniques subject of Pharmacy degree at the University of Barcelona

En el plan de estudios del Grado de Farmacia de la Universidad de Barcelona, la asignatura de Técnicas Instrumentales se imparte en el cuarto semestre, después de haber cursado Física, Fisicoquímica y Química Analítica. El equipo docente de la asignatura está integrado por once profesores que mediante trabajo colaborativo y adecuada coordinación organizan la docencia de la misma que se distribuye en clases teóricas y prácticas Con el objetivo de adaptar la asignatura a las necesidades del Espacio Europeo de Educación Superior, se distribuyó en tres Bloques: I, Técnicas Espectroscópicas; II, Técnicas Electroquímicas y III, Técnicas de Separación. Las actividades teórico-prácticas se han planificado de manera secuencial. Así se inicia el ciclo con las clases teóricas del Bloque I y a continuación de manera paralela se imparten las clases prácticas del Bloque I y las clases teóricas del Bloque II y así sucesivamente, de manera que se termina la docencia con las prácticas del último Bloque. En este proceso adquiere especial relevancia tanto la formación práctica en el laboratorio como el trabajo tutorizado que debe realizar el estudiante. Se realiza un proceso de evaluación continuada teórico/práctico en cada uno de los Bloques. Se da especial relevancia a la adquisición de habilidades y destrezas que permitan una correcta realización de las prácticas de laboratorio, es decir la integración de los contenidos específicos a la aplicación de las diferentes técnicas instrumentales, la resolución de los cálculos numéricos y la interpretación de los resultados.In the new syllabus of the Pharmacy degree at the University of Barcelona, the subject Analytical Techniques is taught at the fourth semester, after the subjects Physics, Physical chemistry and Analytical chemistry. The teaching team of this subject is integrated by eleven teachers that by means of collaborative work and an appropriate coordination, organize the docent activity into practical and theoretical classes. With the aim to adapt this subject to the requirements of the European space for higher education, it has been designed in three blocs: I. Spectroscopic techniques, II. Electrochemical techniques and, III. Separation techniques, by planning the theoretical and practical activities in a sequential manner. Therefore, the cycle begins with the theory of the first bloc followed with the practice corresponding to it together with the theory of the second bloc, and so on. The course ends with the practical part of the third bloc. In this process is of great importance the tutorial work that the student should do. The evaluation of the theory and of the practical part of each bloc is done in a continuous way paying special focus on the acquisition of abilities and handiness that will allow the correct performance in the laboratory. In summary, the integration of the specific contents to the application of the different instrumental techniques, the resolution of the numerical calculations and the interpretation of the results.Este trabajo ha estado subvencionado por los Proyectos: "Adaptació metodològical a l'Espai Europeu d'Educació Superior del projecte docent del Departament de Fisicoquímica per a la implementaió del nou grau de Farmàcia", nº 2009QMD00207. Programa "Millora de la qualitat docenta les universitats de Catalunya" - MQD2009 de la Generalitat de Catalunya". "Bones pràctiques d0avaluació continuada a la UB". Programa del 2009: Ajuts a projectes dìnnovació docent de la Universitat de Barcelon

Association between Use of Enhanced Recovery after Surgery Protocol and Postoperative Complications in Total Hip and Knee Arthroplasty in the Postoperative Outcomes Within Enhanced Recovery after Surgery Protocol in Elective Total Hip and Knee Arthroplasty Study (POWER2)

Importance: The Enhanced Recovery After Surgery (ERAS) care protocol has been shown to improve outcomes compared with traditional care in certain types of surgery. Objective: To assess the association of use of the ERAS protocols with complications in patients undergoing elective total hip arthroplasty (THA) and total knee arthroplasty (TKA). Design, Setting, and Participants: This multicenter, prospective cohort study included patients recruited from 131 centers in Spain from October 22 through December 22, 2018. All consecutive adults scheduled for elective THA or TKA were eligible for inclusion. Patients were stratified between those treated in a self-designated ERAS center (ERAS group) and those treated in a non-ERAS center (non-ERAS group). Data were analyzed from June 15 through September 15, 2019. Exposures: Total hip or knee arthroplasty and perioperative management. Sixteen individual ERAS items were assessed in all included patients, whether they were treated at a center that was part of an established ERAS protocol or not. Main Outcomes and Measures: The primary outcome was postoperative complications within 30 days after surgery. Secondary outcomes included length of stay and mortality. Results: During the 2-month recruitment period, 6146 patients were included (3580 women [58.2%]; median age, 71 [interquartile range (IQR), 63-76] years). Of these, 680 patients (11.1%) presented with postoperative complications. No differences were found in the number of patients with overall postoperative complications between ERAS and non-ERAS groups (163 [10.2%] vs 517 [11.4%]; odds ratio [OR], 0.89; 95% CI, 0.74-1.07; P =.22). Fewer patients in the ERAS group had moderate to severe complications (73 [4.6%] vs 279 [6.1%]; OR, 0.74; 95% CI, 0.56-0.96; P =.02). The median overall adherence rate with the ERAS protocol was 50.0% (IQR, 43.8%-62.5%), with the rate for ERAS facilities being 68.8% (IQR, 56.2%-81.2%) vs 50.0% (IQR, 37.5%-56.2%) at non-ERAS centers (P <.001). Among the patients with the highest and lowest quartiles of adherence to ERAS components, the patients with the highest adherence had fewer overall postoperative complications (144 [10.6%] vs 270 [13.0%]; OR, 0.80; 95% CI, 0.64-0.99; P <.001) and moderate to severe postoperative complications (59 [4.4%] vs 143 [6.9%]; OR, 0.62; 95% CI, 0.45-0.84; P <.001) and shorter median length of hospital stay (4 [IQR, 3-5] vs 5 [IQR, 4-6] days; OR, 0.97; 95% CI, 0.96-0.99; P <.001). Conclusions and Relevance: An increase in adherence to the ERAS program was associated with a decrease in postoperative complications, although only a few ERAS items were individually associated with improved outcomes

Epidemiological trends of HIV/HCV coinfection in Spain, 2015-2019

Altres ajuts: Spanish AIDS Research Network; European Funding for Regional Development (FEDER).Objectives: We assessed the prevalence of anti-hepatitis C virus (HCV) antibodies and active HCV infection (HCV-RNA-positive) in people living with HIV (PLWH) in Spain in 2019 and compared the results with those of four similar studies performed during 2015-2018. Methods: The study was performed in 41 centres. Sample size was estimated for an accuracy of 1%. Patients were selected by random sampling with proportional allocation. Results: The reference population comprised 41 973 PLWH, and the sample size was 1325. HCV serostatus was known in 1316 PLWH (99.3%), of whom 376 (28.6%) were HCV antibody (Ab)-positive (78.7% were prior injection drug users); 29 were HCV-RNA-positive (2.2%). Of the 29 HCV-RNA-positive PLWH, infection was chronic in 24, it was acute/recent in one, and it was of unknown duration in four. Cirrhosis was present in 71 (5.4%) PLWH overall, three (10.3%) HCV-RNA-positive patients and 68 (23.4%) of those who cleared HCV after anti-HCV therapy (p = 0.04). The prevalence of anti-HCV antibodies decreased steadily from 37.7% in 2015 to 28.6% in 2019 (p < 0.001); the prevalence of active HCV infection decreased from 22.1% in 2015 to 2.2% in 2019 (p < 0.001). Uptake of anti-HCV treatment increased from 53.9% in 2015 to 95.0% in 2019 (p < 0.001). Conclusions: In Spain, the prevalence of active HCV infection among PLWH at the end of 2019 was 2.2%, i.e. 90.0% lower than in 2015. Increased exposure to DAAs was probably the main reason for this sharp reduction. Despite the high coverage of treatment with direct-acting antiviral agents, HCV-related cirrhosis remains significant in this population