35 research outputs found

    Validation of the Spanish version of the Franciscan Hospital for Children Oral Health-Related Quality of Life questionnaire

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    The Franciscan Hospital for Children Oral Health-Related Quality of Life questionnaire (FHC-OHRQOL-Q) is an instrument designed specifically for parents and caregivers of patients with special needs that has not yet been applied in Spain. The aim of this study was to adapt it to Spanish and evaluate its reliability and validity in patients with intellectual disability (ID) treated under general anesthesia. The study was conducted in two different stages: a) cross-cultural adaptation of the original questionnaire, and b) cross-sectional study on 100 parents and caregivers who completed the piloted FHC-OHRQOL-Q. The patients were examined according to the WHO methodology. Dental treatments performed were recorded. Statistical tests were used to evaluate reliability (internal consistency) and validity (content, criterion, construct and discriminant) of the instrument. The mean age was 24 years (range=4-71 years). The most frequent causes of ID were psychomotor retardation (25%) and cerebral palsy (24%). The items most frequently answered by parents and caregivers were eating and nutrition problems (80%) and bad breath/taste (57%). Reliability (Cronbach?s alpha coefficient) was considered excellent (alpha=0.80-0.95). The analysis of the factorial validity yielded similar results to the original questionnaire. The high response rate of items (>96%) allowed content validity. Criterion validity was confirmed by a significant correlation with questions on oral health and oral well-being. Discriminant validity was demonstrated by the significant association of ?21.5 years of age with worse oral symptoms (p=0.034) and parental concerns (p=0.005), DMFT index ?3 with daily life problems (p=0.02), ?4 decayed teeth with daily life problems (p=0.001), and >2 dental extractions with oral symptoms (p=0.000), daily life problems (p=0.002) and parent´s perceptions (p=0.043). The FHC-OHRQOL-Q in Spanish is a reliable and valid instrument to apply in clinical practice to evaluate the impact of OHRQOL in mostly adult patients with ID, accessible to Spanish-speaking parents and caregivers

    Single versus tandem autologous stem-cell transplantation in patients with newly diagnosed multiple myeloma and high-risk cytogenetics. A retrospective, open-label study of the PETHEMA/Spanish Myeloma Group (GEM)

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    Tandem ASCT has been suggested as a valid approach to improve the prognosis of patients with MM and HR cytogenetic. In this observational, retrospective study, 213 patients with newly diagnosed MM and HR cytogenetic in 35 hospitals from the Spanish Myeloma Group underwent single or tandem ASCT between January 2015 and December 2019 after induction with VTD/VRD. HR cytogenetic was defined as having ≥1 of the following: del17p, t(4;14), t(14;16) or gain 1q21. More patients in the tandem group had R-ISS 3 and >1 cytogenetic abnormality at diagnosis. With a median follow-up of 31 months (range, 10–82), PFS after single ASCT was 41 months versus 48 months with tandem ASCT (p = 0.33). PFS in patients with del17p undergoing single ASCT was 41 months, while 52% of patients undergoing tandem ASCT were alive and disease free at 48 months. In conclusion, tandem ASCT partly overcomes the bad prognosis of HR cytogenetic

    The impact from survey depth and resolution on the morphological classification of galaxies

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    We consistently analyse for the first time the impact of survey depth and spatial resolution on the most used morphological parameters for classifying galaxies through non-parametric methods: Abraham and Conselice-Bershady concentration indices, Gini, M20moment of light, asymmetry, and smoothness. Three different non-local data sets are used, Advanced Large Homogeneous Area Medium Band Redshift Astronomical (ALHAMBRA) and Subaru/XMMNewton Deep Survey (SXDS, examples of deep ground-based surveys), and Cosmos Evolution Survey (COSMOS, deep space-based survey). We used a sample of 3000 local, visually classified galaxies, measuring their morphological parameters at their real redshifts (z ~ 0). Then we simulated them to match the redshift and magnitude distributions of galaxies in the non-local surveys. The comparisons of the two sets allow us to put constraints on the use of each parameter for morphological classification and evaluate the effectiveness of the commonly used morphological diagnostic diagrams. All analysed parameters suffer from biases related to spatial resolution and depth, the impact of the former being much stronger. When including asymmetry and smoothness in classification diagrams, the noise effects must be taken into account carefully, especially for ground-based surveys. M20 is significantly affected, changing both the shape and range of its distribution at all brightness levels. We suggest that diagnostic diagrams based on 2-3 parameters should be avoided when classifying galaxies in ground-based surveys, independently of their brightness; for COSMOS they should be avoided for galaxies fainter than F814 = 23.0. These results can be applied directly to surveys similar to ALHAMBRA, SXDS and COSMOS, and also can serve as an upper/lower limit for shallower/deeper ones.Ministerio de Economía y Competitividad AYA2010-15169, AYA2013-42227-P, AYA2013-4318

    The impact from survey depth and resolution on the morphological classification of galaxies

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    We consistently analyse for the first time the impact of survey depth and spatial resolution on the most used morphological parameters for classifying galaxies through non-parametric methods: Abraham and Conselice-Bershady concentration indices, Gini, M20moment of light, asymmetry, and smoothness. Three different non-local data sets are used, Advanced Large Homogeneous Area Medium Band Redshift Astronomical (ALHAMBRA) and Subaru/XMMNewton Deep Survey (SXDS, examples of deep ground-based surveys), and Cosmos Evolution Survey (COSMOS, deep space-based survey). We used a sample of 3000 local, visually classified galaxies, measuring their morphological parameters at their real redshifts (z ~ 0). Then we simulated them to match the redshift and magnitude distributions of galaxies in the non-local surveys. The comparisons of the two sets allow us to put constraints on the use of each parameter for morphological classification and evaluate the effectiveness of the commonly used morphological diagnostic diagrams. All analysed parameters suffer from biases related to spatial resolution and depth, the impact of the former being much stronger. When including asymmetry and smoothness in classification diagrams, the noise effects must be taken into account carefully, especially for ground-based surveys. M20 is significantly affected, changing both the shape and range of its distribution at all brightness levels. We suggest that diagnostic diagrams based on 2-3 parameters should be avoided when classifying galaxies in ground-based surveys, independently of their brightness; for COSMOS they should be avoided for galaxies fainter than F814 = 23.0. These results can be applied directly to surveys similar to ALHAMBRA, SXDS and COSMOS, and also can serve as an upper/lower limit for shallower/deeper ones.MP acknowledge financial support from JAE-Doc programme of the Spanish National Research Council (CSIC), co-funded by the European Social Fund. This research was supported by the Junta de Andalucia through project TIC114, and the Spanish Ministry of Economy and Competitiveness (MINECO) through projects AYA2010-15169, AYA2013-42227-P, and AYA2013-43188-P.Peer Reviewe

    The ALHAMBRA survey: reliable morphological catalogue of 22 051 early- and late-type galaxies

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    Advanced Large Homogeneous Area Medium Band Redshift Astronomical (ALHAMBRA) is photometric survey designed to trace the cosmic evolution and cosmic variance. It covers a large area of ~4 deg2 in eight fields, where seven fields overlap with other surveys, allowing us to have complementary data in other wavelengths. All observations were carried out in 20 continuous, medium band (30 nm width) optical and 3 near-infrared (JHK) bands, providing the precise measurements of photometric redshifts. In addition, morphological classification of galaxies is crucial for any kind of galaxy formation and cosmic evolution studies, providing the information about star formation histories, their environment and interactions, internal perturbations, etc. We present a morphological classification of >40 000 galaxies in the ALHAMBRA survey. We associate to every galaxy a probability to be early type using the automated Bayesian code GALSVM. Despite of the spatial resolution of theALHAMBRAimages (~1 arcsec), for 22 051 galaxies, we obtained the contamination by other type of less than 10 per cent. Of those, 1640 and 10 322 galaxies are classified as early-(down to redshifts ~0.5) and late-type (down to redshifts ~1.0), respectively, with magnitudes F613W ≤ 22.0. In addition, for magnitude range 22.0 < F613W ≤ 23.0, we classified other 10 089 late-type galaxies with redshifts ≤1.3.We show that the classified objects populate the expected regions in the colour-mass and colour-magnitude planes. The presented data set is especially attractive given the homogeneous multiwavelength coverage available in the ALHAMBRA fields, and is intended to be used in a variety of scientific applications. The low-contamination catalogue (<10 per cent) is made publicly available with this paper. © 2013 The Authors Published by Oxford University Press on behalf of the Royal Astronomical Society.This research was supported by the Junta de Andalucía through projects PO8-TIC-03531 and TIC114, the Spanish Ministry of Economy and Competitiveness (MINECO) through projects AYA2006-14046, AYA2010-15169, AYA2010-22111-C03-02, AYA2011-29517-C03-01, and the Generalitat Valenciana through project GV/Prometeo 2009/064. MP acknowledges financial support from JAE-Doc program of the Spanish National Research Council (CSIC), co-funded by the European Social Fund.Peer Reviewe

    Soy Niña

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    Este libro pretende contribuir al reencuentro de la educación con esas finalidades que verdaderamente importan a una niña o un niño: ser feliz, jugar, vivir juntos y (no) aprender. Para ello hemos puesto el arte, nuestras experiencias y el saber acumulado al servicio del disfrute, el cuestionamiento, el análisis crítico y la construcción común de un presente deseable. Un texto colaborativo coordinado por Ignacio Calderón Almendros y realizado por alumnado de Educación y Cambio Social en el Grado en Educación Infantil de la Universidad de Málaga

    European Registry on Helicobacter pylori Management: Effectiveness of First and Second-Line Treatment in Spain

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    The management of Helicobacter pylori infection has to rely on previous local effectiveness due to the geographical variability of antibiotic resistance. The aim of this study was to evaluate the effectiveness of first and second-line H. pylori treatment in Spain, where the empirical prescription is recommended. A multicentre prospective non-interventional registry of the clinical practice of European gastroenterologists concerning H. pylori infection (Hp-EuReg) was developed, including patients from 2013 until June 2019. Effectiveness was evaluated descriptively and through a multivariate analysis concerning age, gender, presence of ulcer, proton-pump inhibitor (PPI) dose, therapy duration and compliance. Overall, 53 Spanish hospitals were included, and 10,267 patients received a first-line therapy. The best results were obtained with the 10-day bismuth single-capsule therapy (95% cure rate by intention-to-treat) and with both the 14-day bismuth-clarithromycin quadruple (PPI-bismuth-clarithromycin-amoxicillin, 91%) and the 14-day non-bismuth quadruple concomitant (PPI-clarithromycin-amoxicillin-metronidazole, 92%) therapies. Second-line therapies were prescribed to 2448 patients, with most-effective therapies being the triple quinolone (PPI-amoxicillin-levofloxacin/moxifloxacin) and the bismuth-levofloxacin quadruple schemes (PPI-bismuth-levofloxacin-amoxicillin) prescribed for 14 days (92%, 89% and 90% effectiveness, respectively), and the bismuth single-capsule (10 days, 88.5%). Compliance, longer duration and higher acid inhibition were associated with higher effectiveness. "Optimized" H. pylori therapies achieve over 90% success in Spain

    Dendritic cell deficiencies persist seven months after SARS-CoV-2 infection

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    Virgen del Rocío Hospital COVID-19 Working Team José Miguel Cisneros, Sonsoles Salto-Alejandre, Judith Berastegui-Cabrera, Pedro Camacho-Martínez, Carmen Infante-Domínguez, Marta Carretero-Ledesma, Juan Carlos Crespo-Rivas, Eduardo Márquez, José Manuel Lomas, Claudio Bueno, Rosario Amaya, José Antonio Lepe, Jerónimo Pachón, Elisa Cordero, Javier Sánchez-Céspedes, Manuela Aguilar-Guisado, Almudena Aguilera, Clara Aguilera, Teresa Aldabo-Pallas, Verónica Alfaro-Lara, Cristina Amodeo, Javier Ampuero, María Dolores Avilés, Maribel Asensio, Bosco Barón-Franco, Lydia Barrera-Pulido, Rafael Bellido-Alba, Máximo Bernabeu-Wittel, Candela Caballero-Eraso, Macarena Cabrera, Enrique Calderón, Jesús Carbajal-Guerrero, Manuela Cid-Cumplido, Yael Corcia-Palomo, Juan Delgado, Antonio Domínguez-Petit, Alejandro Deniz, Reginal Dusseck-Brutus, Ana Escoresca-Ortega, Fátima Espinosa, Nuria Espinosa, Michelle Espinoza, Carmen Ferrándiz-Millón, Marta Ferrer, Teresa Ferrer, Ignacio Gallego-Texeira, Rosa Gámez-Mancera, Emilio García, Horacio García-Delgado, Manuel García-Gutiérrez, María Luisa Gascón-Castillo, Aurora González-Estrada, Demetrio González, Carmen Gómez-González, Rocío González-León, Carmen Grande-Cabrerizo, Sonia Gutiérrez, Carlos Hernández-Quiles, Inmaculada Concepción Herrera-Melero, Marta Herrero-Romero, Luis Jara, Carlos Jiménez-Juan, Silvia Jiménez-Jorge, Mercedes Jiménez-Sánchez, Julia Lanseros-Tenllado, Carmina López, Isabel López, Álvaro López-Barrios, Luis F. López-Cortés, Rafael Luque-Márquez, Daniel Macías-García, Guillermo Martín-Gutiérrez, Luis Martín-Villén, José Molina, Aurora Morillo, María Dolores Navarro-Amuedo, Dolores Nieto-Martín, Francisco Ortega, María Paniagua-García, Amelia Peña-Rodríguez, Esther Pérez, Manuel Poyato, Julia Praena-Segovia, Rafaela Ríos, Cristina Roca-Oporto, Jesús F. Rodríguez, María Jesús Rodríguez-Hernández, Santiago Rodríguez-Suárez, Ángel Rodríguez-Villodres, Nieves Romero-Rodríguez, Ricardo Ruiz, Zida Ruiz de Azua, Celia Salamanca, Sonia Sánchez, Víctor Manuel Sánchez-Montagut, César Sotomayor, Alejandro Suárez Benjumea & Javier ToralSevere Acute Respiratory Syndrome Coronavirus (SARS-CoV)-2 infection induces an exacerbated inflammation driven by innate immunity components. Dendritic cells (DCs) play a key role in the defense against viral infections, for instance plasmacytoid DCs (pDCs), have the capacity to produce vast amounts of interferon-alpha (IFN-α). In COVID-19 there is a deficit in DC numbers and IFN-α production, which has been associated with disease severity. In this work, we described that in addition to the DC deficiency, several DC activation and homing markers were altered in acute COVID-19 patients, which were associated with multiple inflammatory markers. Remarkably, previously hospitalized and nonhospitalized patients remained with decreased numbers of CD1c+ myeloid DCs and pDCs seven months after SARS-CoV-2 infection. Moreover, the expression of DC markers such as CD86 and CD4 were only restored in previously nonhospitalized patients, while no restoration of integrin β7 and indoleamine 2,3-dyoxigenase (IDO) levels were observed. These findings contribute to a better understanding of the immunological sequelae of COVID-19.This work was supported by Consejeria de Transformacion Economica, Industria, Conocimiento y Universidades Junta de Andalucia (research Project CV20-85418), Consejeria de salud Junta de Andalucia (Research Contract RH-0037-2020 to JV) the Instituto de Salud Carlos III (CP19/00159 to AGV, FI17/00186 to MRJL, FI19/00083 to MCGC, CM20/00243 to APG, and COV20/00698 to support COHVID-GS) and the Red Temática de Investigación Cooperativa en SIDA (RD16/0025/0020 and RD16/0025/0026), which is included in the Acción Estratégica en Salud, Plan Nacional de Investigación Científica, Desarrollo e Innovación Tecnológica, 2008 to 2011 and 2013 to 2016, Instituto de Salud Carlos III, Fondos FEDER. ERM was supported by the Spanish Research Council (CSIC).Peer reviewe

    Compromising between European and US allergen immunotherapy schools: Discussions from GUIMIT, the Mexican immunotherapy guidelines

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    Background: Allergen immunotherapy (AIT) has a longstanding history and still remains the only disease-changing treatment for allergic rhinitis and asthma. Over the years 2 different schools have developed their strategies: the United States (US) and the European. Allergen extracts available in these regions are adapted to local practice. In other parts of the world, extracts from both regions and local ones are commercialized, as in Mexico. Here, local experts developed a national AIT guideline (GUIMIT 2019) searching for compromises between both schools. Methods: Using ADAPTE methodology for transculturizing guidelines and AGREE-II for evaluating guideline quality, GUIMIT selected 3 high-quality Main Reference Guidelines (MRGs): the European Academy of Allergy, Asthma and Immunology (EAACI) guideines, the S2k guideline of various German-speaking medical societies (2014), and the US Practice Parameters on Allergen Immunotherapy 2011. We formulated clinical questions and based responses on the fused evidence available in the MRGs, combined with local possibilities, patient's preference, and costs. We came across several issues on which the MRGs disagreed. These are presented here along with arguments of GUIMIT members to resolve them. GUIMIT (for a complete English version, see Supplementary data) concluded the following: Results: Related to the diagnosis of IgE-mediated respiratory allergy, apart from skin prick testing complementary tests (challenges, in vitro testing and molecular such as species-specific allergens) might be useful in selected cases to inform AIT composition. AIT is indicated in allergic rhinitis and suggested in allergic asthma (once controlled) and IgE-mediated atopic dermatitis. Concerning the correct subcutaneous AIT dose for compounding vials according to the US school: dosing tables and formula are given; up to 4 non-related allergens can be mixed, refraining from mixing high with low protease extracts. When using European extracts: the manufacturer's indications should be followed; in multi-allergic patients 2 simultaneous injections can be given (100% consensus); mixing is discouraged. In Mexico only allergoid tablets are available; based on doses used in all sublingual immunotherapy (SLIT) publications referenced in MRGs, GUIMIT suggests a probable effective dose related to subcutaneous immunotherapy (SCIT) might be: 50–200% of the monthly SCIT dose given daily, maximum mixing 4 allergens. Also, a table with practical suggestions on non-evidence-existing issues, developed with a simplified Delphi method, is added. Finally, dissemination and implementation of guidelines is briefly discussed, explaining how we used online tools for this in Mexico. Conclusions: Countries where European and American AIT extracts are available should adjust AIT according to which school is followed

    Seven-versus 14-day course of antibiotics for the treatment of bloodstream infections by Enterobacterales: a randomized, controlled trial

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    [Objective] To prove that 7-day courses of antibiotics for bloodstream infections caused by members of the Enterobacterales (eBSIs) allow a reduction in patients' exposure to antibiotics while achieving clinical outcomes similar to those of 14-day schemes.[Methods] A randomized trial was performed. Adult patients developing eBSI with appropriate source control were assigned to 7 or 14 days of treatment, and followed 28 days after treatment cessation; treatments could be resumed whenever necessary. The primary endpoint was days of treatment at the end of follow-up. Clinical outcomes included clinical cure, relapse of eBSI and relapse of fever. A superiority margin of 3 days was set for the primary endpoint, and a non-inferiority margin of 10% was set for clinical outcomes. Efficacy and safety were assessed together with a DOOR/RADAR (desirability of outcome ranking and response adjusted for duration of antibiotic risk) analysis.[Results] 248 patients were assigned to 7 (n = 119) or 14 (n = 129) days of treatment. In the intention-to-treat analysis, median days of treatment at the end of follow-up were 7 and 14 days (difference 7, 95%CI 7–7). The non-inferiority margin was also met for clinical outcomes, except for relapse of fever (–0.2%, 95%CI –10.4 to 10.1). The DOOR/RADAR showed that 7-day schemes had a 77.7% probability of achieving better results than 14-day treatments.[Conclusions] 7-day schemes allowed a reduction in antibiotic exposure of patients with eBSI while achieving outcomes similar to those of 14-day schemes. The possibility of relapsing fever in a limited number of patients, without relevance to final outcomes, may not be excluded, but was overcome by the benefits of shortening treatments.This work received technical support from the Spanish Network of Research in Infectious Diseases (REIPI) and the Spanish Clinical Research Network (SCReN) of the Instituto de Salud Carlos III, Ministerio de Economía y Competitividad, Spanish Government (PT13/0002/0010).Peer reviewe
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