Nasal cannula use during polysomnography in children aged under three with suspected sleep apnea

Acord transformatiu CRUE-CSICObjective: Early diagnosis of obstructive sleep apnea (OSA) in children is important. The use of a nasal cannula as an airflow sensor during polysomnography has not been evaluated in younger children. The study aims to evaluate the use of nasal cannula in detecting respiratory events in children under three with suspected OSA during daytime nap studies. Methods: A total of 185 patients were prospectively included. Respiratory events were scored using nasal cannula alone, thermistor alone, and both methods simultaneously as the airflow sensor. Agreement and diagnostic accuracy were assessed. Results: One hundred and seventy-two children were finally analyzed and 110 (64.0%) presented OSA. Total sleep time with an uninterpretable signal was longer with the nasal cannula than with the thermistor (17.8% vs 1.9%; p < 0.001), and was associated with poor sensor tolerance and adenotonsillar hypertrophy. In the estimation of the apnea-hypopnea index, the nasal cannula showed lower agreement than the thermistor with the joint use of the two sensors (intraclass correlation coefficient: 0.79 vs 0.996 with thermistor). Compared with the thermistor, the nasal cannula presented lower sensitivity for detecting OSA (82.7% vs 95.5%) and a lower negative predictive value (76.5% vs 92.4%). Overall, fewer children were diagnosed with severe OSA with the nasal cannula (19.8% vs 30.8% with the thermistor, and 32.6% with both). Conclusions: In children under the age of three, the ability of the nasal cannula to detect obstructive events was relatively low. Therefore, other non-invasive measurements for identifying respiratory events during sleep may be of additional value

La comunicación empresarial en la Web 2.0. Estrategias para la gestión efectiva de la reputación corporativa

CEOs must face a new economic cycle known as the «reputation economy». In this context, it is particularly important the proper management of corporate reputation and brand image. To this purpose, the essen­tial key used by most of the companies is the on-line communication, reached through the development of Web 2.0 and its new tools (such as social media), which help compa­nies to attract the attention of the stakehol­ders and to interact with them. It is important that company executives should try to adapt the company’s strategies to this new economic environment in order to be competitive, so they must pay espe­cial attention in the developing of the on-line communications strategy. It is highly recommended that this strate­gy rules under the seven pillars of corpora­te communication, which are distinctiveness, integration, ongoing, social use, user frien­dly, exhaustive, and concrete. To these seven pillars, it is recommended to add a new pillar: the measurement.Los líderes empresariales se enfrentan a un nuevo paradigma económico llamado «la economía de la reputación». En este contexto cobra especial relevancia la correcta gestión de la reputación corporativa y de la imagen de marca. Para ello, el elemento clave con el que cuentan las empresas es la comunicación on-line, ya que, gracias al desarrollo de la Web 2.0, las empresas tienen a su disposición nuevas herramientas (los medios sociales) para llamar la atención de los stakeholders o grupos de interés e interactuar con los mismos. Resulta de vital importancia que los empresarios se adapten a este nuevo entorno para ser competitivos, para lo que deben poner énfasis en la estrategia comunicacional on-line. Es muy recomendable que esta estrategia siga la línea de los siete pilares de la comunicación corporativa, que son diferenciación, integración, continuidad, uso social, usabilidad, exhaustividad y concreción. A estos siete pilares, se propone la inclusión de uno nuevo: la medición

Analysis of the psychometric properties of the Sense of Coherence scale (SOC‑13) in patients with cardiovascular risk factors: a study of the method efects associated with negatively worded items

Purpose: The objectives of this study were to analyze the psychometric properties of the Sense of Coherence scale (SOC-13), determine the role of the method efect in the performance of the instrument, and identify the relationship with health perception, quality of life, and sleep quality in patients at cardiovascular risk. Methods: The fnal sample consisted of 293 patients at cardiovascular risk, with a mean age of 61.9 years (SD=8.8), 49.8% of whom were women. The SOC-13, the Patient Health Questionnaire (PHQ-9), and the Medical Outcomes Study-Sleep Scale (MOS-Sleep) were administered. In addition, the participant’s self-perceived health and quality of life were also evaluated. All analyses were carried out with SPSS 26.0 and EQS 6.1 statistical software. Results: The results showed adequate reliability for the SOC-13, with a Cronbach’s alpha of .789. The ft of the structures was not adequate in any of the cases (.26 to .62 for one factor, .26 to.73 for three factors, .20 to .54 for one second-order factor, and .25, .42, and .54 for three frst-order factors). The three structure models showed an improved ft when adding a latent factor resulting from the method efect (.6 to .85 for one factor, .11 to.90 for three factors, and .11 to .96 for one second-order factor). Moreover, positive correlations were found with health perception, perceived quality of life, and perceived sleep quality. Conclusion: The SOC-13 is a suitable instrument for patients with cardiovascular risk in Spain, and it is also an indica‑ tor of health perception, quality of life, and perceived quality of sleep. Control of the method efect improves the ft of the instrument’s structure. As a future direction, it is recommended to conduct new studies in this and other samples and using diferent versions of the SOC. Trial registration: International Standard Randomized Controlled Trial Number: ISRCTN76069254, 08/04/2015 retro‑ spectively registered.This work has been granted from Fondo de Investigaciones Sanitarias of Insti‑ tuto de Salud Carlos III (PI13/01477) of the Spanish Government cofnanced by FEDER-Unión Europea (“Una manera de hacer Europa”) and by Department of Social, Developmental and Educational Psychology, Faculty of Education Sciences, University of Huelva. The funding sources had not involvement in the study design, in the collection, analysis and interpretation of data, in the writing of the article and in the decision to submit it for publication

Aumento de catecolaminas como posible causa de resistencia a la insulina en pacientes con síndrome de apnea-hipopnea obstructiva de sueño

La resistencia a insulina en pacientes SAHS podría estar vehiculizada por el incremento de actividad simpática secundaria a los fenómenos de apnea-hipopnea. Queremos determinar la actividad simpática y la resistencia a la insulina en pacientes SAHS relacionándolas con la gravedad de dicha condición. Realizamos un estudio de casos y controles sobre una muestra de 86 pacientes con sospecha de SAHS evaluándolos mediante polisomnografía nocturna y análisis sanguíneo (incluyendo niveles basales de catecolaminas). Hemos comprobado una asociación entre SAHS y activación simpática. También observamos una relación entre gravedad del SAHS y resistencia a insulina. La presencia de sobrepeso empeora estos mecanismos.La resistència a insulina en malalts SAHS podria estar vehiculitzada pe un increment d'activitat simpàtica secundaria als fenòmens d'apnea-hipopnea. Volem determinar la activitat simpàtica i la resistència a insulina en malalts SAHS i relacionar-ho en la gravetat de la condició anomenada. Realitzem un estudi de casos i controls sobre una mostra de 86 pacients en sospita de SAHS avaluant-los mitjançant polisomnograma nocturn i anàlisi de sang (nivells bassals de catecolamines inclosos). Hem provat una relació entre gravetat de SAHS i activació simpàtica. També observem una relació entre gravetat de SAHS y resistència a insulina. La presència de sobrepes empitjora estos mecanismes

RT-PCR multiplex para la detección simultánea de las mutaciones FLT3-ITD/NPM-1/AML1-ETO asociadas a Leucemia Mieloide Aguda

La Leucemia Mieloide Aguda (LMA) representa un grupo de neoplasias muy heterogéneo. Las aberraciones citogenéticas detectadas en el momento del diagnóstico son el marcador pronóstico más comúnmente utilizado. Sin embargo, el 20% de los casos de LMA presentan un cariotipo normal. Dentro de este grupo de pacientes la presencia de mutaciones del tipo FLT3-ITD se considera de mal pronóstico. Sin embargo, la presencia de la mutación NMP1 o AML1-ETO se asocia a un mejor pronóstico. En este contexto, el objetivo de este trabajo es el desarrollo de una técnica de diagnóstico molecular hematológico, que permita la detección simultánea de mutaciones para estos tres genes. Hemos desarrollado un método basado en la reacción en cadena de la polimerasa (PCR) que permite amplificar y visualizar simultáneamente estos 3 marcadores tanto desde ARN (un paso) como desde ADNc (dos pasos). De las 28 muestras analizadas, 6 (21,42 %) muestras fueron positivas para FLT3-ITD, 7 para NPM-1 (25%) y otras 4 (14,28) para AML1-ETO. Al comparar ambos métodos (ADNc vs ARN) con métodos convencionales los resultados de las 28 muestras estudiadas fue equivalente en el 100% de los casos, demostrando la robustez de los mismos.Acute Myeloid Leukemia (AML) is a heterogeneous group of neoplasms. The cytogenetic aberrations detected at the time of diagnosis are most commonly used as prognostic marker. However, 20% of AML patients exhibit a normal karyotype. Within this group of patients the presence of FLT3 -ITD mutations type is considered of poor prognosis. However, the presence of AML1 –ETO or NMP-1 or mutation is associated with a better prognosis. In this context, the aim of this work is to develop a technique of molecular diagnostic in hematology, allowing the simultaneous detection of mutations for these three genes. We have developed a method based on PCR that simultaneously amplifies and visualizes these three molecular markers both from RNA (one- step) and from cDNA (step two). Of the 28 samples tested, 6 (21.42%) samples were positive for FLT3 -ITD, 7 for NPM- 1 (25% ) and 4 ( 14,28 ) for AML1 -ETO . When comparing the two methods (cDNA vs RNA) by conventional techniques the obtained results from the 28 samples tested was equivalent in 100% of cases, demonstrating the robustness of this development

A new tool to screen patients with severe obstructive sleep apnea in the primary care setting : a prospective multicenter study

Altres ajuts: Sociedad Española de Neumología y Cirugía Torácica (SEPAR), Societat Catalana de Pneumologia (SOCAP).The coordination between different levels of care is essential for the management of obstructive sleep apnea (OSA). The objective of this multicenter project was to develop a screening model for OSA in the primary care setting. Anthropometric data, clinical history, and symptoms of OSA were recorded in randomly selected primary care patients, who also underwent a home sleep apnea test (HSAT). Respiratory polygraphy or polysomnography were performed at the sleep unit to establish definite indication for continuous positive airway pressure (CPAP). By means of cross-validation, a logistic regression model (CPAP yes/no) was designed, and with the clinical variables included in the model, a scoring system was established using the β coefficients (PASHOS Test). In a second stage, results of HSAT were added, and the final accuracy of the model was assessed. 194 patients completed the study. The clinical test included the body mass index, neck circumference and observed apneas during sleep (AUC 0.824, 95% CI 0.763-0.886, P < 0.001). In a second stage, the oxygen desaturation index (ODI) of 3% (ODI3% ≥ 15%) from the HSAT was added (AUC 0.911, 95% CI 0.863-0.960, P < 0.001), with a sensitivity of 85.5% (95% CI 74.7-92.1) and specificity of 67.8% (95% CI 55.1-78.3). The use of this model would prevent referral to the sleep unit for 55.1% of the patients. The two-stage PASHOS model is a useful and practical screening tool for OSA in primary care for detecting candidates for CPAP treatment. Clinical Trial Registration Registry: ClinicalTrials.gov; Name: PASHOS Project: Advanced Platform for Sleep Apnea Syndrome Assessment; URL: ; Identifier: NCT02591979. Date of registration: October 30, 2015. The online version contains supplementary material available at 10.1186/s12890-022-01827-0

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)

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

Assessment of the psychometric properties of the Spanish version of EORTC QLQ-MY20 and evaluation of health-related quality of Life outcomes in patients with relapsed and/or refractory multiple myeloma in the real-world setting in Spain: results from the CharisMMa study

We evaluated the psychometric properties of the Spanish version of the European Organization for Research and Treatment of Multiple Myeloma (MM) specific quality-of-life (QoL) questionnaire module (QLQ-MY20) in relapsed/refractory MM (RRMM) patients. This was an observational, cross-sectional, multicenter study using EORTC QLQ-C30 and QLQ-MY20 in RRMM patients (ClinicalTrials.gov ID NCT03188536). We assessed the non-response rate, ceiling/floor effects, internal consistency, test-retest reliability, and validity. The study included 276 patients (53.3% males, mean [SD] age of 67.4 [10.5] years). The EORTC QLQ-MY20 showed a low non-response rate, very low ceiling and floor effects, and good internal consistency. The test-retest reliability assessment revealed good temporary stability, the construct validity analysis stated four main factors similar to the ones of the original version, and the criterion validity assessment showed no differences between groups. In conclusion, the Spanish version of EORTC QLQ-MY20 is a reliable and valid tool for assessing QoL in RRMM patients.The study was sponsored and funded by Takeda Farmacéutica España.Peer reviewe

Assessment of the psychometric properties of the Spanish version of EORTC QLQ-MY20 and evaluation of health-related quality of Life outcomes in patients with relapsed and/or refractory multiple myeloma in the real-world setting in Spain: results from the CharisMMa study

We evaluated the psychometric properties of the Spanish version of the European Organization for Research and Treatment of Multiple Myeloma (MM) specific quality-of-life (QoL) questionnaire module (QLQ-MY20) in relapsed/refractory MM (RRMM) patients. This was an observational, cross-sectional, multicenter study using EORTC QLQ-C30 and QLQ-MY20 in RRMM patients (ClinicalTrials.gov ID NCT03188536). We assessed the non-response rate, ceiling/floor effects, internal consistency, test-retest reliability, and validity. The study included 276 patients (53.3% males, mean [SD] age of 67.4 [10.5] years). The EORTC QLQ-MY20 showed a low non-response rate, very low ceiling and floor effects, and good internal consistency. The test-retest reliability assessment revealed good temporary stability, the construct validity analysis stated four main factors similar to the ones of the original version, and the criterion validity assessment showed no differences between groups. In conclusion, the Spanish version of EORTC QLQ-MY20 is a reliable and valid tool for assessing QoL in RRMM patientsEl estudio fue patrocinado y financiado por Takeda Farmacéutica Españ