Estimating human leishmaniasis burden in Spain using the capture-recapture method, 2016-2017

Leishmaniasis is endemic and a mandatory reporting disease in Spain since 1982. However, between 1996 and 2014, surveillance on public health was decentralized and only some autonomous regions monitored the disease. The aim of this study is to estimate the incidence of leishmaniasis and to evaluate the extent of underreporting in Spain. A capture-recapture (CRC) study was conducted to calculate the incidence of human leishmaniasis using reports from the National Surveillance Network (RENAVE) and the Hospital Discharge Records of the National Health System (CMBD) for 2016 and 2017. During the study period, 802 cases were reported to RENAVE and there were 1,149 incident hospitalizations related to leishmaniasis. The estimated incidence rates through the CRC study were 0.79 per 100,000 inhabitants for visceral leishmaniasis (VL), 0.88 (cutaneous leishmaniasis (CL)) and 0.12 (mucocutaneous leishmaniasis (MCL)) in 2016 and 0.86 (VL), 1.04 (CL) and 0.12 (MCL) in 2017. An underreporting of 14.7-20.2% for VL and 50.4-55.1% for CL was found. The CRC method has helped us to assess the sensitivity and representativeness of leishmaniasis surveillance in Spain, being a useful tool to assess whether the generalization of leishmaniasis surveillance throughout the Spanish territory achieves a reduction in underreporting.S

Testing for Vitamin D in High-Risk COPD in Outpatient Clinics in Spain: A Cross-Sectional Analysis of the VITADEPOC Study

Background: Vitamin D deficiency has been associated with an accelerated deterioration in lung function and increased exacerbations in chronic obstructive pulmonary disease (COPD). 25(OH) vitamin D levels have been indicated as a potentially useful marker for adverse results related to COPD. Methods: VITADEPOC is a cross-sectional clinical study recruiting consecutive patients with high-risk COPD. The objective of our study was to investigate vitamin D determination frequency in patients with high-risk COPD in clinical practice at outpatient clinics in Spain and to describe the factors associated with vitamin D testing. We also aimed to determine the frequency of vitamin D deficiency in these patients. Results: Only 51 (44%) patients underwent vitamin D determination and 33 (28.4%) had received vitamin D supplements in clinical practice. The patients who underwent testing for vitamin D in clinical practice were more often women (58.8% vs. 26.2%, p < 0.001) with comorbidities such as osteoporosis (19.6% vs. 6.2%, p < 0.001) or chronic renal failure (7.8% vs. 0%, p < 0.001) and with exacerbator phenotype (55% vs. 32.3%, p = 0.015). A total of 63 (54.3%) patients had serum vitamin D levels <20 ng/mL at the inclusion visit. Of these, 29 (46%) had serum vitamin D levels <12 ng/mL (severe deficiency). Having a history of inhaled corticosteroids (OR 3.210, p < 0.016), being treated with a cycle of systemic corticosteroids (OR 2.149, p < 0.002), and having a lower physical activity level (OR 3.840, p < 0.004) showed a statistically significant positive association with vitamin D deficiency. Conclusion: The testing of vitamin D levels in patients with high-risk COPD treated at outpatient respiratory clinics in Spain is infrequent. However, when tested, a severe deficiency is detected in one in four patients. Efforts to optimize case detection in COPD are needed.Depto. de MedicinaFac. de MedicinaTRUESociedad Madrileña de Neumología y Cirugía TorácicaResearch Pharma S.Lpu

Psicoexposoma: una perspectiva holística más allá de la salud y la enfermedad

Antecedentes: el concepto de exposoma surgió como una estrategia para impulsar el estudio exhaustivo de las exposiciones ambientales a lo largo de la vida del individuo y su impacto en la salud. El desarrollo de dispositivos electrónicos para obtener datos de geolocalización, biológicos o biomarcadores de exposición y los avances en las ciencias “ómicas” y en bioinformática permiten la recopilación y el análisis masivo de datos muy diversos. Objetivo: proponer el término psicoexposoma en línea con el concepto de exposoma generado desde las ciencias ambientales. Método: se llevó a cabo una revisión de la literatura para buscar la inclusión de términos psicológicos asociados al concepto de exposoma. Se discute la justificación de un enfoque de psicoexposición para las ciencias psicológicas. Resultados: los términos psicología, psiquiatría o enfermedades neurológicas son escasos en el enfoque del exposoma. La experiencia en el control de variables ambientales sitúa al psicólogo en un punto de partida ventajoso para realizar estudios de psicoexposoma. Conclusión: la psicología puede aprovechar tanto las ciencias de la exposición como las ciencias “ómicas” para crear un enfoque integrado de psicoexposición que pueda ayudar a descifrar la etiología de los trastornos psicológicos y a promover la salud mental del individuo.Background: The concept of the exposome has emerged as a new strategy for studying all environmental exposures throughout an individual’s life and their impact on human health. Nowadays, electronic devices are available to collect data about an individual’s geolocation, biological function, or exposure biomarkers. The appearance of “omic” sciences and advances in bioinformatics have allowed massive data-gathering and analysis from various scientific fields. Objective: to propose the term Psychoexposome in line with the concept of the exposome from the field of environmental sciences. Method: a literature review of psychological terms associated with the exposome concept was carried out and the rationale and benefits of a psychoexposme approach for psychological sciences is discussed. Results: the terms psychology, psychiatry and neurological diseases are scarce in the exposome approach. A long tradition in psychology of performing epidemiological studies and in the study of multifactorial influences traits places psychologists at an advantageous starting point for conducting psychoexposome studies. Conclusion: psychology may take advantage from both exposome and omic sciences to create an integrated psychoexposome approach that may help in deciphering the etiology of psychological disorders and improving people’s mental health

Severe COVID-19 Illness and α1-Antitrypsin Deficiency: COVID-AATD Study

Background: Epidemiologic studies have reported that the geographical distribution of the prevalence of allelic variants of serine protein inhibitor-A1 (SERPINA1) and severe cases of COVID-19 were similar. Methods: A multicenter, cross-sectional, observational study to evaluate the frequency of alpha-1 antitrypsin deficiency (AATD) in patients with COVID-19 and whether it was associated with having suffered severe COVID-19. Results: 2022 patients who had laboratory-confirmed SARS-CoV-2 infection. Mutations associated with AATD were more frequent in severe COVID versus non-severe (23% vs. 18.8%, p = 0.022). The frequency of Pi*Z was 37.8/1000 in severe COVID versus 17.5/1000 in non-severe, p = 0.001. Having an A1AT level below 116 was more frequent in severe COVID versus non-severe (29.5% vs. 23.1, p = 0.003). Factors associated with a higher likelihood of severe COVID-19 were being male, older, smoking, age-associated comorbidities, and having an A1AT level below 116 mg/dL [OR 1.398, p = 0.003], and a variant of the SERPINA1 gene that could affect A1AT protein [OR 1.294, p = 0.022]. Conclusions: These observations suggest that patients with AATD should be considered at a higher risk of developing severe COVID-19. Further studies are needed on the role of A1AT in the prognosis of SARS-CoV-2 infection and its possible therapeutic role

Does News Platform Matter? Comparing Online Journalistic Role Performance to Newspaper, Radio, and Television

The shifting role of journalism in a digital age has affected long-standing journalistic norms across media platforms. This has reinvigorated discussion on how work in online newsrooms com-pares to other platforms that differ in media affordances and forms. Still, more studies are needed on whether those differences trans-late into distinct practices, especially when examining cross-national studies. Based on a content analysis of 148,474 stories produced by 365 media organizations from 37 countries, this article compares the performance of journalistic roles in online newsrooms to three other types of media—TV, radio, and print. The paper analyzes if journalistic roles present themselves differently across platforms, and if these differences are constant or they vary across countries. Results show that there are measurable differences in role perfor-mance in online journalism compared to other platforms. Platform had a significant impact, particularly in terms of service and info-tainment orientation, while the implementation of roles oriented toward public service was more similar. Additionally, country dif-ferences in the relationship between role performance and plat-forms mainly emerged for roles that enable political influence on news coverage, with differences in the relationship between online vs. traditional platforms appearing to be distinct features of the specific political system

Does news platform matter? : comparing online journalistic role performance to newspaper, radio, and television

Abstract: The shifting role of journalism in a digital age has affected long-standing journalistic norms across media platforms. This has reinvigorated discussion on how work in online newsrooms compares to other platforms that differ in media affordances and forms. Still, more studies are needed on whether those differences translate into distinct practices, especially when examining cross-national studies. Based on the second wave of the Journalistic Role Performance (JRP) project, this article reports the findings of a content analysis of 148,474 stories produced by 365 media organizations from 37 countries, comparing the performance of journalistic roles in online newsrooms to three other types of media—TV, radio, and print. The paper analyzes if journalistic roles present themselves differently across platforms, and if these differences are constant or they vary across countries. Results show that there are measurable differences in role performance in online journalism compared to other platforms. Platform had a significant impact, particularly in terms of service and infotainment orientation, while the implementation of roles oriented toward public service was more similar. Additionally, country differences in the relationship between role performance and platforms mainly emerged for roles that enable political influence on news coverage, with differences in the relationship between online vs. traditional platforms appearing to be distinct features of the specific political system

The impact of conversion on the risk of major complication following laparoscopic colonic surgery: an international, multicentre prospective audit.

This is the peer reviewed version of the following article: The and E. S. o. C. c. groups (2018). "The impact of conversion on the risk of major complication following laparoscopic colonic surgery: an international, multicentre prospective audit." Colorectal Disease 20(S6): 69-89., which has been published in final form at https://doi.org/10.1111/codi.14371. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.BACKGROUND: Laparoscopy has now been implemented as a standard of care for elective colonic resection around the world. During the adoption period, studies showed that conversion may be detrimental to patients, with poorer outcomes than both laparoscopic completed or planned open surgery. The primary aim of this study was to determine whether laparoscopic conversion was associated with a higher major complication rate than planned open surgery in contemporary, international practice. METHODS: Combined analysis of the European Society of Coloproctology 2017 and 2015 audits. Patients were included if they underwent elective resection of a colonic segment from the caecum to the rectosigmoid junction with primary anastomosis. The primary outcome measure was the 30-day major complication rate, defined as Clavien-Dindo grade III-V. RESULTS: Of 3980 patients, 64% (2561/3980) underwent laparoscopic surgery and a laparoscopic conversion rate of 14% (359/2561). The major complication rate was highest after open surgery (laparoscopic 7.4%, converted 9.7%, open 11.6%, P < 0.001). After case mix adjustment in a multilevel model, only planned open (and not laparoscopic converted) surgery was associated with increased major complications in comparison to laparoscopic surgery (OR 1.64, 1.27-2.11, P < 0.001). CONCLUSIONS: Appropriate laparoscopic conversion should not be considered a treatment failure in modern practice. Conversion does not appear to place patients at increased risk of complications vs planned open surgery, supporting broadening of selection criteria for attempted laparoscopy in elective colonic resection

An international multicentre prospective audit of elective rectal cancer surgery; operative approach versus outcome, including transanal total mesorectal excision (TaTME)

IntroductionTransanal total mesorectal excision (TaTME) has rapidly emerged as a novel approach for rectal cancer surgery. Safety profiles are still emerging and more comparative data is urgently needed. This study aimed to compare indications and short-term outcomes of TaTME, open, laparoscopic, and robotic TME internationally.MethodsA pre-planned analysis of the European Society of Coloproctology (ESCP) 2017 audit was performed. Patients undergoing elective total mesorectal excision (TME) for malignancy between 1 January 2017 and 15 March 2017 by any operative approach were included. The primary outcome measure was anastomotic leak.ResultsOf 2579 included patients, 76.2% (1966/2579) underwent TME with restorative anastomosis of which 19.9% (312/1966) had a minimally invasive approach (laparoscopic or robotic) which included a transanal component (TaTME). Overall, 9.0% (175/1951, 15 missing outcome data) of patients suffered an anastomotic leak. On univariate analysis both laparoscopic TaTME (OR 1.61, 1.02-2.48, P=0.04) and robotic TaTME (OR 3.05, 1.10-7.34, P=0.02) were associated with a higher risk of anastomotic leak than non-transanal laparoscopic TME. However this association was lost in the mixed-effects model controlling for patient and disease factors (OR 1.23, 0.77-1.97, P=0.39 and OR 2.11, 0.79-5.62, P=0.14 respectively), whilst low rectal anastomosis (OR 2.72, 1.55-4.77, P<0.001) and male gender (OR 2.29, 1.52-3.44, P<0.001) remained strongly associated. The overall positive circumferential margin resection rate was 4.0%, which varied between operative approaches: laparoscopic 3.2%, transanal 3.8%, open 4.7%, robotic 1%.ConclusionThis contemporaneous international snapshot shows that uptake of the TaTME approach is widespread and is associated with surgically and pathologically acceptable results