Assisted Reproductive Techniques in Multiple Sclerosis: Recommendations from an Expert Panel

Introduction Multiple sclerosis (MS) is mainly diagnosed in women of reproductive age. However, there is a paucity of guidelines jointly prepared by neurologists and gynaecologists on managing women with MS and the desire for motherhood. Therefore, in this review we propose recommendations for such cases, with an particular focus on those requiring assisted reproductive techniques (ART). Methods A group of seven MS experts (4 neurologists and 3 gynaecologists) came together for three discussion sessions to achieve consensus. Results The recommendations reported here focus on the importance of early preconception counselling, the management of disease-modifying therapies before and during ART procedures, important considerations for women with MS regarding ART (intrauterine insemination, in vitro fertilisation and oocyte cryopreservation) and the paramount relevance of multidisciplinary units to manage these patients. Conclusions Early preconception consultations are essential to individualising pregnancy management in women with MS, and an early, well-planned, spontaneous pregnancy should be the aim whenever possible. The management of women with MS and the desire for motherhood by multidisciplinary units is warranted to ensure appropriate guidance through the entire pregnancy.Merck, S.L.U., Madrid, Spain, an affiliate of Merck KGaA funded this work without participating in its design, data analysis or manuscript preparation. Merck, S.L.U also funded the journal’s Rapid Service Fee

Occupational Heat Exposure and Breast Cancer Risk in the MCC-Spain Study

[EN] Background: Mechanisms linking occupational heat exposure with chronic diseases have been proposed. However, evidence on occupational heat exposure and cancer risk is limited. Methods: We evaluated occupational heat exposure and female breast cancer risk in a large Spanish case-control study. We enrolled 1,738 breast cancer cases and 1,910 frequency-matched population controls. A Spanish job-exposure matrix, MatEmEsp, was used to assign estimates of the proportion of workers exposed (P >= 25% for at least 1 year) and work time with heat stress (wet bulb globe temperature ISO 7243) for each occupation. We used three exposure indices: ever versus never exposed, lifetime cumulative exposure, and duration of exposure (years). We estimated ORs and 95% confidence intervals (CI), applying a lag period of 5 years and adjusting for potential confounders. Results: Ever occupational heat exposure was associated with a moderate but statistically significant higher risk of breast cancer (OR 1.22; 95% CI, 1.01-1.46), with significant trends across categories of lifetime cumulative exposure and duration (P-trend = 0.01 and 0.03, respectively). Stronger associations were found for hormone receptor-positive disease (OR ever exposure = 1.38; 95% Cl, 1.12-1.67). We found no confounding effects from multiple other common occupational exposures; however, results attenuated with adjustment for occupational detergent exposure. Conclusions: This study provides some evidence of an association between occupational heat exposure and female breast cancer risk.SIThis study was partially funded by the “Accion Transversal del Cancer,” approved by the Spanish Ministry Council on October 11, 2007; the Instituto de Salud Carlos III-FEDER (PI08/1770, PI08/1359, PI09/00773, PI09/01286, PI09/01903, PI09/02078, PI09/01662, PI11/01403, PI11/01889, and PI12/00265); the Fundación Marqués de Valdecilla (API 10/09); the Junta de Castilla y León (LE22A10-2); the Consejería de Salud of the Junta de Andalucía (2009-S0143); the Conselleria de Sanitat of the Generalitat Valenciana (AP_061/10); the Recercaixa (2010ACUP 00310); the Regional Government of the Basque Country; the Consejería de Sanidad de la Región de Murcia; the European Commission grants FOOD-CT-2006–036224-HIWATE; the Spanish Association Against Cancer (AECC) Scientific Foundation; the Catalan Government DURSI grant 2014SGR647; the Secretariat for Universities and Research of the Ministry of Business and Knowledge of the Government of Catalonia (2017SGR1085); the Fundación Caja de Ahorros de Asturias; and the University of Oviedo. M.C. Turner is funded by a Ramón y Cajal fellowship (RYC-2017-01892) from the Spanish Ministry of Science, Innovation and Universities and co-funded by the European Social Fund. The authors acknowledge support from the Spanish Ministry of Science and Innovation through the “Centro de Excelencia Severo Ochoa 2019–2023” Program (CEX2018-000806-S) and support from the Generalitat de Catalunya through the CERCA Program. Statistical assistance provided by Ana Espinosa Morano was greatly appreciated

Revisión de 13 especies de la familia Triatominae (Hemiptera: Reduviidae) vectores de la enfermedad de Chagas, en México

Vectors of Trypanosoma cruzi, parasite responsible for Chagas disease, are divided in intradomestic, peridomestic andsylvatic. The intradomestic are Triatoma barberi and Triatoma dimidiata, two species that represent the highest healthrisk among the Mexican population. Triatoma dimidiata is a species found mainly inside human habitats, but inYucatan, it corresponds to the peridomicile vectors. Also in the peridomicile most of Chagas disease vectors arefound: Meccus bassolsae, M. longipennis, M. mazzottii, M pallidipennis, M. phyllosomus, M picturata, Triatomagerstaeckeri, T mexicana, T rubida, Dipetalogaster máxima (the last two are in the process of becoming adapted tothe domicile), Panstrongylus rufotuberculatus which occasionally enters the domicile in its adult stage, and Rhodniusprolixus, which is practically controlled in the country. Peridomestic vectors are of lower risk in the transmissiondynamics, as compared to the intradomestic ones. For the control of the intradomestic vectors, health educationprograms, improvements of housing, and the use of pesticides are essential To control the peridomestic vectors, healtheducation programs are required, as well as the use of mosquito nets on doors and windows and around beds, asidefrom cementing the stone wall fences.Los transmisores de Trypanosoma cruzi, flagelado causante de la enfermedad, se dividen en intradomiciliados,peridomiciliados y silvestres. Entre los intradomiciliados se encuentran, Triatoma barberi y Triatoma dimidiata, queson los que representan un mayor riesgo para la Salud Pública, en México. Aunque Triatoma dimidiata se encuentraprincipalmente dentro de la vivienda, en Yucatán tiene un comportamiento peridomiciliar, dentro de este grupo seencuentran la mayoría de los transmisores de la enfermedad de Chagas Meccus longipennis, M. mazzottii, M.pallidipennis, M. phyllosomus, M. picturatus, Triatoma gerstaeckeri, T. mexicana, T. rubida, Dipetalogaster máxima,Panstrongylus rufotuberculatus y Rhodnius prolixus. Los transmisores peridomiciliados son de menor riesgo en ladinámica de transmisión comparados con los intradomiciliados. Para el control de los transmisores intradomiciliados,se deben emplear programas de educación para la salud, mejoramiento de vivienda e insecticidas; mientras que paralos vectores visitantes o peridomiciliados, son necesarios programas de educación para la salud, uso de mosquiteros,pabellones y cementación de las bardas de piedra

Risk and outcomes of COVID-19 in patients with multiple sclerosis

Background and purpose Limited information is available on incidence and outcomes of COVID-19 in patients with multiple sclerosis (MS). This study investigated the risks of SARS-CoV-2 infection and COVID-19-related outcomes in patients with MS, and compared these with the general population. Methods A regional registry was created to collect data on incidence, hospitalization rates, intensive care unit admission, and death in patients with MS and COVID-19. National government outcomes and seroprevalence data were used for comparison. The study was conducted at 14 specialist MS treatment centers in Madrid, Spain, between February and May 2020. Results Two-hundred nineteen patients were included in the registry, 51 of whom were hospitalized with COVID-19. The mean age ± standard deviation was 45.3 ± 12.4 years, and the mean duration of MS was 11.9 ± 8.9 years. The infection incidence rate was lower in patients with MS than the general population (adjusted incidence rate ratio = 0.78, 95% confidence interval [CI] = 0.70–0.80), but hospitalization rates were higher (relative risk = 5.03, 95% CI = 3.76–6.62). Disease severity was generally low, with only one admission to an intensive care unit and five deaths. Males with MS had higher incidence rates and risk of hospitalization than females. No association was found between the use of any disease-modifying treatment and hospitalization risk. Conclusions Patients with MS do not appear to have greater risks of SARS-CoV-2 infection or severe COVID-19 outcomes compared with the general population. The decision to start or continue disease-modifying treatment should be based on a careful risk–benefit assessment.post-print996 K

Population-based multicase-control study in common tumors in Spain (MCC-Spain): rationale and study design

Introduction: We present the protocol of a large population-based case-control study of 5 common tumors in Spain (MCC-Spain) that evaluates environmental exposures and genetic factors. Methods: Between 2008-2013, 10,183 persons aged 20-85 years were enrolled in 23 hospitals and primary care centres in 12 Spanish provinces including 1,115 cases of a new diagnosis of prostate cancer, 1,750 of breast cancer, 2,171 of colorectal cancer, 492 of gastro-oesophageal cancer, 554 cases of chronic lymphocytic leukaemia (CLL) and 4,101 population-based controls matched by frequency to cases by age, sex and region of residence. Participation rates ranged from 57% (stomach cancer) to 87% (CLL cases) and from 30% to 77% in controls. Participants completed a face-to-face computerized interview on sociodemographic factors, environmental exposures, occupation, medication, lifestyle, and personal and family medical history. In addition, participants completed a self-administered food-frequency questionnaire and telephone interviews. Blood samples were collected from 76% of participants while saliva samples were collected in CLL cases and participants refusing blood extractions. Clinical information was recorded for cases and paraffin blocks and/or fresh tumor samples are available in most collaborating hospitals. Genotyping was done through an exome array enriched with genetic markers in specific pathways. Multiple analyses are planned to assess the association of environmental, personal and genetic risk factors for each tumor and to identify pleiotropic effects. Discussion: This study, conducted within the Spanish Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), is a unique initiative to evaluate etiological factors for common cancers and will promote cancer research and prevention in Spain.The study was partially funded by the “Accion Transversal del Cancer”, approved on the Spanish Ministry Council on the 11th October 2007, by the Instituto de Salud Carlos III-FEDER (PI08/1770, PI08/0533, PI08/1359, PS09/00773, PS09/01286, PS09/01903, PS09/02078, PS09/01662, PI11/01403, PI11/01889, PI11/00226, PI11/01810, PI11/02213, PI12/00488, PI12/00265, PI12/01270, PI12/00715, PI12/00150), by the Fundación Marqués de Valdecilla (API 10/09), by the ICGC International Cancer Genome Consortium CLL, by the Junta de Castilla y León (LE22A10-2), by the Consejería de Salud of the Junta de Andalucía (PI-0571), by the Conselleria de Sanitat of the Generalitat Valenciana (AP 061/10), by the Recercaixa (2010ACUP 00310), by the Regional Government of the Basque Country by European Commission grants FOOD-CT- 2006-036224-HIWATE, by the Spanish Association Against Cancer (AECC) Scientific Foundation, by the The Catalan Government DURSI grant 2009SGR1489

Síntesis de benzopiran-2-onas y estudio de su actividad antifúngica Síntesis de benzopiran-2-onas y estudio de su actividad antifúngica

  En este trabajo se presenta el estudio de síntesis, caracterización y aplicación catalítica de hidróxidos doble laminares y Iodo en la obtención de benzopiran-2-onas. En esta metodología de síntesis se analizó la ventaja de utilizar la radiación infrarroja como fuente de energía comparándola con el calentamiento convencional. Otro punto descrito, es el estudio de los derivados de benzopiran-2-onas como moléculas con actividad antifúngica utilizando como modelo el hongo fitopatógeno Sclerotium cepivorum. El hidróxido doble laminar con una proporción molar X = 0.36 (X = Al/Al+Mg) fue el más eficiente en la reacción de Knoevenagel, mientras que el Iodo (0.4 mmol) fue un catalizador eficiente en la reacción de Pechmann. Al comparar los análisis de las diferentes fuentes de calentamiento utilizadas, se observó que la radiación infrarroja requiere menor tiempo de reacción en comparación con el calentamiento convencional. Los derivados de benzopiran-2-onas 3a-d presentaron efecto antifúngico a concentraciones mayores a 1.33 μg/μL hasta por 30 días.  The synthesis, characterization and catalytic effect of layered double hydroxides and iodine for the benzopyran-2-ones preparation were investigated. In this procedure the advantage was analyzed both the infrared irradiation as energy source and the conventional heating. Another important point described in this work, is the study of those derived of benzopyran-2-ones like molecules with antifungal activity using the plant pathogen fungi Sclerotium cepivorum. The layered double hydroxide with a molar propor­tion X = 0.36 (X = Al/Al+Mg) was the most efficient in the Knoevenagel reaction, on the other hand the Iodine (0.4 mmol) it was an efficient catalyst in the reaction of Pechmann. When comparing the different heating sources used, the infrared requires smaller time of reaction than the conventional method. Those derived of benzopyran-2-ones 3a-d pre­sented effect antifungal at concentrations higher than 1.33 μg/μL until for 30 days.</p

A revision of thirteen species of Triatominae (Hemiptera: Reduviidae) vectors of Chagas disease in Mexico

Vectors of Trypanosoma cruzi, parasite responsible for Chagas disease, are divided in intradomestic, peridomestic and sylvatic. The intradomestic are Triatoma barberi and Triatoma dimidiata, two species that represent the highest health risk among the Mexican population. Triatoma dimidiata is a species found mainly inside human habitats, but in Yucatan, it corresponds to the peridomicile vectors. Also in the peridomicile most of Chagas disease vectors are found: Meccus bassolsae, M. longipennis, M. mazzottii, M pallidipennis, M. phyllosomus, M picturata, Triatoma gerstaeckeri, T mexicana, T rubida, Dipetalogaster máxima (the last two are in the process of becoming adapted to the domicile), Panstrongylus rufotuberculatus which occasionally enters the domicile in its adult stage, and Rhodnius prolixus, which is practically controlled in the country. Peridomestic vectors are of lower risk in the transmission dynamics, as compared to the intradomestic ones. For the control of the intradomestic vectors, health education programs, improvements of housing, and the use of pesticides are essential To control the peridomestic vectors, health education programs are required, as well as the use of mosquito nets on doors and windows and around beds, aside from cementing the stone wall fences

A revision of thirteen species of Triatominae (Hemiptera: Reduviidae) vectors of Chagas disease in Mexico

Vectors of Trypanosoma cruzi, parasite responsible for Chagas disease, are divided in intradomestic, peridomestic and sylvatic. The intradomestic are Triatoma barberi and Triatoma dimidiata, two species that represent the highest health risk among the Mexican population. Triatoma dimidiata is a species found mainly inside human habitats, but in Yucatan, it corresponds to the peridomicile vectors. Also in the peridomicile most of Chagas disease vectors are found: Meccus bassolsae, M. longipennis, M. mazzottii, M pallidipennis, M. phyllosomus, M picturata, Triatoma gerstaeckeri, T mexicana, T rubida, Dipetalogaster máxima (the last two are in the process of becoming adapted to the domicile), Panstrongylus rufotuberculatus which occasionally enters the domicile in its adult stage, and Rhodnius prolixus, which is practically controlled in the country. Peridomestic vectors are of lower risk in the transmission dynamics, as compared to the intradomestic ones. For the control of the intradomestic vectors, health education programs, improvements of housing, and the use of pesticides are essential To control the peridomestic vectors, health education programs are required, as well as the use of mosquito nets on doors and windows and around beds, aside from cementing the stone wall fences.Los transmisores de Trypanosoma cruzi, flagelado causante de la enfermedad, se dividen en intradomiciliados, peridomiciliados y silvestres. Entre los intradomiciliados se encuentran, Triatoma barberi y Triatoma dimidiata, que son los que representan un mayor riesgo para la Salud Pública, en México. Aunque Triatoma dimidiata se encuentra principalmente dentro de la vivienda, en Yucatán tiene un comportamiento peridomiciliar, dentro de este grupo se encuentran la mayoría de los transmisores de la enfermedad de Chagas Meccus longipennis, M. mazzottii, M. pallidipennis, M. phyllosomus, M. picturatus, Triatoma gerstaeckeri, T. mexicana, T. rubida, Dipetalogaster máxima, Panstrongylus rufotuberculatus y Rhodnius prolixus. Los transmisores peridomiciliados son de menor riesgo en la dinámica de transmisión comparados con los intradomiciliados. Para el control de los transmisores intradomiciliados, se deben emplear programas de educación para la salud, mejoramiento de vivienda e insecticidas; mientras que para los vectores visitantes o peridomiciliados, son necesarios programas de educación para la salud, uso de mosquiteros, pabellones y cementación de las bardas de piedra

The "CHARM" Policy Analysis Framework : Evaluation of Policies to Promote Immigrant Students' Resilience

This paper focuses on children with a migration background and conceptualises their migration experience as adversity. The paper adapts the resilience framework to understand how immigrant children can overcome adversity. The paper discusses policy models that can be derived from adopting a resilience approach to the measurement of immigrant students' integration prospects and proposes a policy analysis framework. The "CHARM" framework helps to assess the extent to which destination country policies and practices support the educational and socioemotional well-being of immigrant children. Namely, it evaluates whether policies consider 1) Cumulative adversity; adopt a 2) Holistic approach; consider 3) Adjustment as a dynamic process; identify a 4) Relational development; and implement a 5) Multilevel approach. The paper finally applies the CHARM framework to the education policies of Ontario, Canada and underscores the relevance of applying the CHARM framework across countries and jurisdictions to evaluate education policies that can promote the resilience of immigrant childre

Antecedentes familiares de primer grado como factor de riesgo en el cáncer colorrectal

Objective: To evaluate the association between first-degree family history and colorectal cancer (CRC). Method: We analyzed data from 2857 controls and 1360 CRC cases, collected in the MCC-Spain project. The adjusted odds ratio (OR) and 95% confidence interval (95% CI) of association with the family history of CRC was estimated by non-conditional logistic regression. Result: First-degree relatives doubled the risk of CRC (OR: 2.19; 95% CI: 1.80-2.66), increasing in those with two or more (OR: 4.22; 95% CI: 2.29-7.78) and in those whose relatives were diagnosed before 50 years (OR: 3.24; 95% CI: 1.52-6.91). Regarding the association of the family history with the location, no significant differences were observed between colon and rectum, but there were in the relation of these with the age of diagnosis, having more relatives those diagnosed before 50 years (OR: 4.79; 95% CI: 2.65-8.65). Conclusions: First-degree relatives of CRC increase the chances of developing this tumor, they also increase when the relative is diagnosed at an early age. Therefore, it must be a target population on which to carry out prevention measures. (C) 2021 SESPAS. Published by Elsevier Espana, S.L.U