May Measurement Month 2017: an analysis of blood pressure screening in Spain-Europe.

May Measurement Month 2017 is a global initiative aimed at raising awareness of high blood pressure (BP) and to act as a temporary solution to the lack of screening programs worldwide, in which Spain participated actively. The primary objective was to raise awareness and increase control of BP in Spain. An opportunistic cross-sectional survey of volunteers aged ≥18 was set up in May 2017. Following the design of the International Society of Hypertension, data were collected from the 17 autonomous communities in which Spain is divided, mainly in community pharmacies, primary care centres and some hypertension (HT) units, and cardiovascular departments in hospitals. No additional training of volunteers was necessary. A total of 3849 individuals were screened. After multiple imputation, our data showed that 1923 (50.0%) had HT. In those not receiving antihypertensive medication, 17.5% were hypertensives, in individuals receiving antihypertensive medication, 33.9% had uncontrolled BP. May Measurement Month 2017 was the largest BP screening campaign undertaken in Spain. In total, 17.5% of people with HT did not receive medication. One-third of hypertensive participants receiving treatment did not have their BP controlled. These results confirm that an opportunistic screening can identify a significant number of subjects with and untreated and inadequately treated BP

Una motivadora sorpresa. Evaluación de la percepción de los pacientes y facultativos en una unidad de alergia.

La satisfacción de los pacientes se considera como un importante componente de la calidad de la atención sanitaria. Se presenta como clave conocer el significado de las percepciones que tienen los pacientes sobre la atención que reciben. Existen diferentes metodologías para medir la satisfacción del paciente, de carácter cualitativo, otras cuantitativas y otras una mezcla de ambas, cada método con sus ventajas e inconvenientes. Una de las herramientas más utilizadas son las que se basan en el uso de cuestionarios. Tanto los cuestionarios autoadministrados a los pacientes como los cumplimentados mediante entrevista personal son dos de los métodos más frecuentemente utilizados por los profesionales de los servicios de salud. Evaluar la percepción de la atención recibida en consultas externas en la unidad de Alergia entre pacientes y facultativos. Evaluar las siguientes dimensiones de la calidad: seguridad clínica, confianza (trato), confidencialidad, intimidad, información, estructura, visión global, accesibilidad) Área sanitaria integrada con 700 camas de hospitalización de agudos, referencia para 300.000 habitantes. El servicio de Alergia, con 4 facultativos, realiza una actividad en consultas externas que representa el 10% de la actividad total. Estudio transversal descriptivo mediante cuestionario autoadministrado simultáneo a facultativos y pacientes que acuden a la consulta de Alergología. A partir de la encuesta validada por el Servicio de Salud, se evaluaron y contrastaron en las dimensiones citadas a partir de indicadores corporativos. Análisis descriptivo de las respuestas y Chi-cuadrado para el contraste de hipótesis de variables cualitativas. Paquete estadístico SPSS Statistics 15.0. La dimensión confianza (trato) (“cómo considera el trato dado/ recibido”) presentó diferencias significativas (p 0,01) entre la opinión de los pacientes (n=40) y el personal médico (n=46). En concreto, los pacientes evalúan como muy bien en el 87,5% y facultativos en el 63%. En el resto de dimensiones, a pesar de no encontrar diferencias significativas, roza la excelencia (muy bien) las siguientes dimensiones: -Seguridad clínica de la atención recibida: pacientes (72.5%), facultativos (54.3%). -Intimidad: para pacientes 70%, médicos (61%) -Información: para pacientes alcanza muy bien en el 72.5% y facultativos (61%) Además el paciente evaluó la accesibilidad en la obtención de la consulta externa (32% señala demora inferior a 90 días) y la espera en sala de espera más del 55% son atendidos antes de 30 minutos. La visión global de la atención recibida fue para pacientes 65%, facultativos (61%). En concreto, el 93% de los pacientes recomendaría la atención recibida a otros pacientes. El paciente valora con mayores puntuaciones todos los ítems frente a nuestra propia opinión como personal sanitario que realizamos la valoración con porcentajes más bajosComunicación electrónica presentada en: XXXIV Congreso de la Sociedad Española de Calidad Asistencial (SECA), XXI Congreso de la Sociedad Andaluza de Calidad Asistencial (SADECA) celebrado en Córdoba del 19 al 21 de octubre de 2016

Oral vaccination with heat inactivated Mycobacterium bovis activates the complement system to protect against tuberculosis

Tuberculosis (TB) remains a pandemic affecting billions of people worldwide, thus stressing the need for new vaccines. Defining the correlates of vaccine protection is essential to achieve this goal. In this study, we used the wild boar model for mycobacterial infection and TB to characterize the protective mechanisms elicited by a new heat inactivated Mycobacterium bovis vaccine (IV). Oral vaccination with the IV resulted in significantly lower culture and lesion scores, particularly in the thorax, suggesting that the IV might provide a novel vaccine for TB control with special impact on the prevention of pulmonary disease, which is one of the limitations of current vaccines. Oral vaccination with the IV induced an adaptive antibody response and activation of the innate immune response including the complement component C3 and inflammasome. Mycobacterial DNA/RNA was not involved in inflammasome activation but increased C3 production by a still unknown mechanism. The results also suggested a protective mechanism mediated by the activation of IFN-γ producing CD8+ T cells by MHC I antigen presenting dendritic cells (DCs) in response to vaccination with the IV, without a clear role for Th1 CD4+ T cells. These results support a role for DCs in triggering the immune response to the IV through a mechanism similar to the phagocyte response to PAMPs with a central role for C3 in protection against mycobacterial infection. Higher C3 levels may allow increased opsonophagocytosis and effective bacterial clearance, while interfering with CR3-mediated opsonic and nonopsonic phagocytosis of mycobacteria, a process that could be enhanced by specific antibodies against mycobacterial proteins induced by vaccination with the IV. These results suggest that the IV acts through novel mechanisms to protect against TB in wild boar

DNA multigene characterization of Fasciola hepatica and Lymnaea neotropica and its fascioliasis transmission capacity in Uruguay, with historical correlation, human report review and infection risk analysis

Fascioliasis is a highly pathogenic zoonotic disease emerging in recent decades, in part due to the effects of climate and global changes. South America is the continent presenting more numerous human fascioliasis endemic areas and the highest Fasciola hepatica infection prevalences and intensities known in humans. These serious public health scenarios appear mainly linked to altitude areas in Andean countries, whereas lowland areas of non-Andean countries, such as Uruguay, only show sporadic human cases or outbreaks. To understand this difference, we characterized F. hepatica from cattle and horses and lymnaeids of Uruguay by sequencing of ribosomal DNA ITS-2 and ITS-1 spacers and mitochondrial DNA cox1, nad1 and 16S genes. Results indicate that vectors belong to Lymnaea neotropica instead of to Lymnaea viator, as always reported from Uruguay. Our correlation of fasciolid and lymnaeid haplotypes with historical data on the introduction and spread of livestock species into Uruguay allow to understand the molecular diversity detected. We study the life cycle and transmission features of F. hepatica by L. neotropica of Uruguay under standardized experimental conditions to enable a comparison with the transmission capacity of F. hepatica by Galba truncatula at very high altitude in Bolivia. Results demonstrate that although L. neotropica is a highly efficient vector in the lowlands, its transmission capacity is markedly lower than that of G. truncatula in the highlands. On this baseline, we review the human fascioliasis cases reported in Uruguay and analyze the present and future risk of human infection in front of future climate change estimations

Demographic, clinical and antibody characteristics of patients with digital ulcers in systemic sclerosis: data from the DUO Registry

OBJECTIVES: The Digital Ulcers Outcome (DUO) Registry was designed to describe the clinical and antibody characteristics, disease course and outcomes of patients with digital ulcers associated with systemic sclerosis (SSc). METHODS: The DUO Registry is a European, prospective, multicentre, observational, registry of SSc patients with ongoing digital ulcer disease, irrespective of treatment regimen. Data collected included demographics, SSc duration, SSc subset, internal organ manifestations, autoantibodies, previous and ongoing interventions and complications related to digital ulcers. RESULTS: Up to 19 November 2010 a total of 2439 patients had enrolled into the registry. Most were classified as either limited cutaneous SSc (lcSSc; 52.2%) or diffuse cutaneous SSc (dcSSc; 36.9%). Digital ulcers developed earlier in patients with dcSSc compared with lcSSc. Almost all patients (95.7%) tested positive for antinuclear antibodies, 45.2% for anti-scleroderma-70 and 43.6% for anticentromere antibodies (ACA). The first digital ulcer in the anti-scleroderma-70-positive patient cohort occurred approximately 5 years earlier than the ACA-positive patient group. CONCLUSIONS: This study provides data from a large cohort of SSc patients with a history of digital ulcers. The early occurrence and high frequency of digital ulcer complications are especially seen in patients with dcSSc and/or anti-scleroderma-70 antibodies

Inhibition of fatty acid desaturation is detrimental to cancer cell survival in metabolically compromised environments.

BACKGROUND: Enhanced macromolecule biosynthesis is integral to growth and proliferation of cancer cells. Lipid biosynthesis has been predicted to be an essential process in cancer cells. However, it is unclear which enzymes within this pathway offer the best selectivity for cancer cells and could be suitable therapeutic targets. RESULTS: Using functional genomics, we identified stearoyl-CoA desaturase (SCD), an enzyme that controls synthesis of unsaturated fatty acids, as essential in breast and prostate cancer cells. SCD inhibition altered cellular lipid composition and impeded cell viability in the absence of exogenous lipids. SCD inhibition also altered cardiolipin composition, leading to the release of cytochrome C and induction of apoptosis. Furthermore, SCD was required for the generation of poly-unsaturated lipids in cancer cells grown in spheroid cultures, which resemble those found in tumour tissue. We also found that SCD mRNA and protein expression is elevated in human breast cancers and predicts poor survival in high-grade tumours. Finally, silencing of SCD in prostate orthografts efficiently blocked tumour growth and significantly increased animal survival. CONCLUSIONS: Our data implicate lipid desaturation as an essential process for cancer cell survival and suggest that targeting SCD could efficiently limit tumour expansion, especially under the metabolically compromised conditions of the tumour microenvironment