Burden and risk factors for Pseudomonas aeruginosa community-acquired pneumonia:a Multinational Point Prevalence Study of Hospitalised Patients

Pseudornonas aeruginosa is a challenging bacterium to treat due to its intrinsic resistance to the antibiotics used most frequently in patients with community-acquired pneumonia (CAP). Data about the global burden and risk factors associated with P. aeruginosa-CAP are limited. We assessed the multinational burden and specific risk factors associated with P. aeruginosa-CAP. We enrolled 3193 patients in 54 countries with confirmed diagnosis of CAP who underwent microbiological testing at admission. Prevalence was calculated according to the identification of P. aeruginosa. Logistic regression analysis was used to identify risk factors for antibiotic-susceptible and antibiotic-resistant P. aeruginosa-CAP. The prevalence of P. aeruginosa and antibiotic-resistant P. aeruginosa-CAP was 4.2% and 2.0%, respectively. The rate of P. aeruginosa CAP in patients with prior infection/colonisation due to P. aeruginosa and at least one of the three independently associated chronic lung diseases (i.e. tracheostomy, bronchiectasis and/or very severe chronic obstructive pulmonary disease) was 67%. In contrast, the rate of P. aeruginosa-CAP was 2% in patients without prior P. aeruginosa infection/colonisation and none of the selected chronic lung diseases. The multinational prevalence of P. aeruginosa-CAP is low. The risk factors identified in this study may guide healthcare professionals in deciding empirical antibiotic coverage for CAP patients

The role of versican in the skin ECM and its interaction with hyaluronic acid

Premio Accésit Congreso SIBB 2019The extracellular matrix (ECM) is a structural network that comprises the bulk of the tissues. It acts as a supporting scaffold for the cells to develop their function and plays an active role in many processes such as proliferation and migration. Therefore, the ECM is an interesting object of study for regenerative medicine. In this article we make an extensive review of two key components of the ECM: the glycosaminoglycan Hyaluronic Acid (HA) and the proteoglycan Versican (Ver). These two molecules are present in the skin ECM and play active roles in processes such as differentiation, wound healing, hair follicle cycle and development. Award-winningPremio Accésit Congreso SIBB 2019Peer Reviewe

Clinical guide for diagnosis, treatment and prevention of overweight and obesity in children [Guía clínica para el diagnóstico, tratamiento y prevención del sobrepeso y la obesidad en pediatría.]

The prevalence of overweight has significantly increased thorough the world and Mexico is not an exception considering that the National Survey of Nutrition (1999) showed that 19.5% of scholar children in Mexico have overweight and other survey from Mexico City (ENURBAL, 2002) have shown that 17% in the same range of age are obese. Therefore, this clinical guide pretends to be an instrument for supporting the professionals of health for the diagnosis, treatment and prevention of obesity in children using the levels of medical attention. It is known that the treatment is difficult and it requires a full multidisciplinary team of professionals and that the key of prevention is the modification of the sedentary lifestyle and the decrease of energy intake. This guide was elaborated by pediatricians working in nutrition in public and university institutions, family and general physicians and pediatricians with private practice

Clinical guide for diagnosis, treatment and prevention of overweight and obesity in children [Gu�a cl�nica para el diagn�stico, tratamiento y prevenci�n del sobrepeso y la obesidad en pediatr�a.]

The prevalence of overweight has significantly increased thorough the world and Mexico is not an exception considering that the National Survey of Nutrition (1999) showed that 19.5% of scholar children in Mexico have overweight and other survey from Mexico City (ENURBAL, 2002) have shown that 17% in the same range of age are obese. Therefore, this clinical guide pretends to be an instrument for supporting the professionals of health for the diagnosis, treatment and prevention of obesity in children using the levels of medical attention. It is known that the treatment is difficult and it requires a full multidisciplinary team of professionals and that the key of prevention is the modification of the sedentary lifestyle and the decrease of energy intake. This guide was elaborated by pediatricians working in nutrition in public and university institutions, family and general physicians and pediatricians with private practice

[Socioeconomic, demographic and family dysfunction related to obesity in 6 to 9 year-old children]. [Obesidad en ni�os de 6 a 9 a�os. Factores socioecon�micos, demogr�ficos y disfunci�n familiar.]

To identify the association between family dysfunction and obesity in children six to nine year-old. A case-control study that included children with obesity (cases, n = 64) with body mass index (BMI) > 95th percentile and triceps skinfold (TSF) > 90th percentile; and a control group (n = 120) with BMI < 85th percentile and TSF < 90th percentile was performed. Anthropometric measurements were made and a questionnaire assessing eight areas of family dynamics was applied. We compared the frequency of family dysfunction among cases and controls with the ?2 test and its association with obesity through the odds ratio. The average score of the questionnaire was 80.8 � 11.3 with no differences between groups. The categories "probably dysfunctional" and "dysfunctional" were more common in the obese group but the differences were not significant. The score of the areas "dynamics of parents as a couple" (p = 0.053) and "structure of authority in the family" (p = 0.061) was higher in the control group. Although no association was seen between family dysfunction and obesity, we found a tendency toward obesity in dysfunctional families

[Socioeconomic, demographic and family dysfunction related to obesity in 6 to 9 year-old children]. [Obesidad en niños de 6 a 9 años. Factores socioeconómicos, demográficos y disfunción familiar.]

To identify the association between family dysfunction and obesity in children six to nine year-old. A case-control study that included children with obesity (cases, n = 64) with body mass index (BMI) > 95th percentile and triceps skinfold (TSF) > 90th percentile; and a control group (n = 120) with BMI < 85th percentile and TSF < 90th percentile was performed. Anthropometric measurements were made and a questionnaire assessing eight areas of family dynamics was applied. We compared the frequency of family dysfunction among cases and controls with the χ2 test and its association with obesity through the odds ratio. The average score of the questionnaire was 80.8 ± 11.3 with no differences between groups. The categories "probably dysfunctional" and "dysfunctional" were more common in the obese group but the differences were not significant. The score of the areas "dynamics of parents as a couple" (p = 0.053) and "structure of authority in the family" (p = 0.061) was higher in the control group. Although no association was seen between family dysfunction and obesity, we found a tendency toward obesity in dysfunctional families

MAGIC very large zenith angle observations of the Crab Nebula up to 100 TeV

Aims. We measure the Crab Nebula γ-ray spectral energy distribution in the ~100 TeV energy domain and test the validity of existing leptonic emission models at these high energies. Methods. We used the novel very large zenith angle observations with the MAGIC telescope system to increase the collection area above 10 TeV. We also developed an auxiliary procedure of monitoring atmospheric transmission in order to assure proper calibration of the accumulated data. This employs recording optical images of the stellar field next to the source position, which provides a better than 10% accuracy for the transmission measurements. Results. We demonstrate that MAGIC very large zenith angle observations yield a collection area larger than a square kilometer. In only ~ 56 h of observations, we detect the γ-ray emission from the Crab Nebula up to 100 TeV, thus providing the highest energy measurement of this source to date with Imaging Atmospheric Cherenkov Telescopes. Comparing accumulated and archival MAGIC and Fermi/LAT data with some of the existing emission models, we find that none of them provides an accurate description of the 1 GeV to 100 TeV γ-ray signal

Prevalence and risk factors for Enterobacteriaceae in patients hospitalized with community-acquired pneumonia

Background and objective Enterobacteriaceae (EB) spp. family is known to include potentially multidrug-resistant (MDR) microorganisms, and remains as an important cause of community-acquired pneumonia (CAP) associated with high mortality. The aim of this study was to determine the prevalence and specific risk factors associated with EB and MDR-EB in a cohort of hospitalized adults with CAP. Methods We performed a multinational, point-prevalence study of adult patients hospitalized with CAP. MDR-EB was defined when >= 3 antimicrobial classes were identified as non-susceptible. Risk factors assessment was also performed for patients with EB and MDR-EB infection. Results Of the 3193 patients enrolled with CAP, 197 (6%) had a positive culture with EB. Fifty-one percent (n = 100) of EB were resistant to at least one antibiotic and 19% (n = 38) had MDR-EB. The most commonly EB identified were Klebsiella pneumoniae (n = 111, 56%) and Escherichia coli (n = 56, 28%). The risk factors that were independently associated with EB CAP were male gender, severe CAP, underweight (body mass index (BMI) < 18.5) and prior extended-spectrum beta-lactamase (ESBL) infection. Additionally, prior ESBL infection, being underweight, cardiovascular diseases and hospitalization in the last 12 months were independently associated with MDR-EB CAP. Conclusion This study of adults hospitalized with CAP found a prevalence of EB of 6% and MDR-EB of 1.2%, respectively. The presence of specific risk factors, such as prior ESBL infection and being underweight, should raise the clinical suspicion for EB and MDR-EB in patients hospitalized with CAP

Human immunodeficiency virus continuum of care in 11 european union countries at the end of 2016 overall and by key population: Have we made progress?

Background. High uptake of antiretroviral treatment (ART) is essential to reduce human immunodeficiency virus (HIV) transmission and related mortality; however, gaps in care exist. We aimed to construct the continuum of HIV care (CoC) in 2016 in 11 European Union (EU) countries, overall and by key population and sex. To estimate progress toward the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 target, we compared 2016 to 2013 estimates for the same countries, representing 73% of the population in the region. Methods. A CoC with the following 4 stages was constructed: number of people living with HIV (PLHIV); proportion of PLHIV diagnosed; proportion of those diagnosed who ever initiated ART; and proportion of those ever treated who achieved viral suppression at their last visit. Results. We estimated that 87% of PLHIV were diagnosed; 92% of those diagnosed had ever initiated ART; and 91% of those ever on ART, or 73% of all PLHIV, were virally suppressed. Corresponding figures for men having sex with men were: 86%, 93%, 93%, 74%; for people who inject drugs: 94%, 88%, 85%, 70%; and for heterosexuals: 86%, 92%, 91%, 72%. The proportion suppressed of all PLHIV ranged from 59% to 86% across countries. Conclusions. The EU is close to the 90-90-90 target and achieved the UNAIDS target of 73% of all PLHIV virally suppressed, significant progress since 2013 when 60% of all PLHIV were virally suppressed. Strengthening of testing programs and treatment support, along with prevention interventions, are needed to achieve HIV epidemic control