Morbilidad psiquiátrica percibida por los médicos generales y prescripción de psicofármacos en la zona sur de Madrid.

Se revisan los resultados de un estudio realizado a través de cuestionarios pasados a unos de cada siete de los 19.961 pacientes que acudieron a las consultas de medicina general del lNSAL UD en dos ambulatorios y cinco consultorios de la zona sur de Madrid durante cinco días para estudiar la prevalencia de diagnósticos psiquiátricos (se utiliza la clasificación ICHPPC-2), la prescripción de psicofármacos y las derivaciones al escalón especializado en salud mental. Se obtienen resultados congruentes con los de otros estudios realizados en nuestro país, en cuanto a porcentaje de pacientes con diagnóstico de trastorno mental (5,34 %), el porcentaje es menor que el hallado en otros países. Se discute la sensibilidad y especificidad de los diagnósticos de los trastornos "menores" por los médicos generales, no se confirma la mayor predisposición de este grupo de pacientes a padecer otro tipo de trastornos, se encuentra bien representado el grupo de pacientes con patología "pesada" y se discuten las pautas de prescripción de psicofármacos

Morbilidad psiquiátrica percibida por los médicos generales y prescripción de psicofármacos en la zona sur de Madrid.

Se revisan los resultados de un estudio realizado a través de cuestionarios pasados a unos de cada siete de los 19.961 pacientes que acudieron a las consultas de medicina general del lNSAL UD en dos ambulatorios y cinco consultorios de la zona sur de Madrid durante cinco días para estudiar la prevalencia de diagnósticos psiquiátricos (se utiliza la clasificación ICHPPC-2), la prescripción de psicofármacos y las derivaciones al escalón especializado en salud mental. Se obtienen resultados congruentes con los de otros estudios realizados en nuestro país, en cuanto a porcentaje de pacientes con diagnóstico de trastorno mental (5,34 %), el porcentaje es menor que el hallado en otros países. Se discute la sensibilidad y especificidad de los diagnósticos de los trastornos "menores" por los médicos generales, no se confirma la mayor predisposición de este grupo de pacientes a padecer otro tipo de trastornos, se encuentra bien representado el grupo de pacientes con patología "pesada" y se discuten las pautas de prescripción de psicofármacos

La ruta del mosaico romano: el sur de hispania (Anadalucía y Algarve)

A Hispânia meridional corresponde ao sul de duas províncias romanas – a Bética (actual Andaluzia) e a Lusitania (Portugal) – que tiveram grande prosperidade económica, desde a época de Augusto até ao final da Antiguidade (finais do século IV). Os mosaicos que decoravam o chão das casas mais ricas aparecidas nos últimos vinte anos nas escavações em cidades – como em Faro/Ossonoba, na Lusitania e em Écija/ Astigi, na Bética – e nas villae rurais que se encontram maioritariamente nos arredores das cidades – como em Cerro da Vila (Vilamoura)e em Milreu (Estoi), no Algarve – demonstram o elevado nível de desenvolvimento económico,social e cultural das duas províncias durante o período compreendido entre os séculos I e IV d.C

Body mass index and disease activity in chronic inflammatory rheumatic diseases: results of the Cardiovascular in Rheumatology (Carma) Project

Objective: Since obesity has been associated with a higher inflammatory burden and worse response to therapy in patients with chronic inflammatory rheumatic diseases (CIRD), we aimed to confirm the potential association between body mass index (BMI) and disease activity in a large series of patients with CIRDs included in the Spanish CARdiovascular in rheuMAtology (CARMA) registry. Methods: Baseline data analysis of patients included from the CARMA project, a 10-year prospective study of patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriatic arthritis (PsA) attending outpatient rheumatology clinics from 67 Spanish hospitals. Obesity was defined when BMI (kg/m2) was >30 according to the WHO criteria. Scores used to evaluate disease activity were Disease Activity Score of 28 joints (DAS28) in RA, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) in AS, and modified DAS for PsA. Results: Data from 2234 patients (775 RA, 738 AS, and 721 PsA) were assessed. The mean ± SD BMI at the baseline visit were: 26.9 ± 4.8 in RA, 27.4 ± 4.4 in AS, and 28.2 ± 4.7 in PsA. A positive association between BMI and disease activity in patients with RA (β = 0.029; 95%CI (0.01- 0.05); p = 0.007) and PsA (β = 0.036; 95%CI (0.015-0.058); p = 0.001) but not in those with AS (β = 0.001; 95%CI (-0.03-0.03); p = 0.926) was found. Disease activity was associated with female sex and rheumatoid factor in RA and with Psoriasis Area Severity Index and enthesitis in PsA. Conclusions: BMI is associated with disease activity in RA and PsA, but not in AS. Given that obesity is a potentially modifiable factor, adequate control of body weight can improve the outcome of patients with CIRD and, therefore, weight control should be included in the management strategy of these patients

Religious transformations in the Middle Ages: towards a new archaeological agenda

The study of religious change in Europe between the collapse of the Roman Empire and the Reformation forms one of the cornerstones of medieval archaeology but has been riven by period, denominational and geographical divisions. This paper lays the groundwork for a fundamental rethink of archaeological approaches to medieval religions, by adopting a holistic framework that places Christian, pagan, Islamic and Jewish case studies of religious transformation in a long-term, comparative perspective. Focused around the analytical themes of ‘hybridity and resilience’ and ‘tempo and trajectories’, our approach shifts attention away from the singularities of national narratives of religious conversion towards a deeper understanding of how religious beliefs, practices and identity were renegotiated by medieval people in their daily lives

Host factor PLAC8 is required for pancreas infection by SARS-CoV-2

Although mounting evidence demonstrated that pancreas is infected by SARS-CoV-2 the severity and pathophysiology of pancreatic COVID-19 disease are still unclear. Here we investigated the consequences of SARS-CoV-2 infection of the pancreas and the role of Placenta-associated protein-8 (PLAC8). Our data showed pancreatic damage in patients who died from COVID-19. Notably, circulating pancreatic enzymes stratified patients according to COVID-19 severity and outcome. PLAC8 expression was associated with SARS-CoV-2 infection in postmortem analysis of COVID-19 patients and functional assays demonstrated the requirement of PLAC8 in SARS-CoV-2 pancreatic infection. Full SARS-CoV-2 infectious virus revealed a requirement of PLAC8 for efficient viral infection of pancreatic cell lines. Finally, we observed colocalization of PLAC8 and SARS-CoV-2 in the pancreas of deceased patients. In conclusion, our data confirm the human pancreas as a SARS-CoV-2 target and demonstrate the requirement of PLAC8 for SARS-CoV-2 pancreatic infection thereby opening new target opportunities for COVID-19-associated pancreatic pathogenesis.N

Brucellosis Vaccines: Assessment of Brucella melitensis Lipopolysaccharide Rough Mutants Defective in Core and O-Polysaccharide Synthesis and Export

Background: 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.This work was funded by the European Commission (Research Contract QLK2-CT-2002-00918) and the Ministerio de Ciencia y Tecnología of Spain (Proyecto AGL2004-01162/GAN)