67 research outputs found

    Clinical and economic burden of respiratory syncytial virus in Spanish children: the BARI study

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    Respiratory syncytial virus (RSV) infection is a major cause of morbidity in children. However, its disease burden remains poorly understood, particularly outside of the hospital setting. Our study aimed to estimate the burden of medically attended acute lower respiratory infection (ALRI) cases potentially related to RSV in Spanish children. Longitudinal data from September 2017 to June 2018 of 51,292 children aged < 5 years old from the National Health‑ care System (NHS) of two Spanish regions were used. Three case definitions were considered: (a) RSV‑specific; (b) RSV‑specific and unspecified acute bronchiolitis (RSV‑specific and Bronchiolitis), and; (c) RSV‑specific and unspecified ALRI (RSV‑specific and ALRI). A total of 3460 medically attended ALRI cases potentially due to RSV were identified, of which 257 (7.4%), 164 (4.7%), and 3039 (87.8%) coded with RSV‑specific, unspecific bronchiolitis, and unspecific ALRI codes, respectively. Medically attended RSV‑specific and ALRI cases per 1000 children was 134.4 in the first year of life, 119.4 in the second, and 35.3 between 2 and 5 years old. Most cases were observed in otherwise healthy children (93.1%). Mean direct healthcare cost per medically attended RSV‑specific and ALRI case was €1753 in the first year of life, €896 in the second, and €683 between 2 and 5 years old. Hospitalization was the main driver of these costs, accounting for 55.6%, 38.0% and 33.4%, in each respective age group. In RSV‑specific cases, mean direct healthcare cost per medically attended case was higher, mostly due to hospitalization: €3362 in the first year of life (72.9% from hospitalizations), €3252 in the second (72.1%), and €3514 between 2 and 5 years old (74.2%). These findings suggest that hospitalization data alone will underestimate the RSV infections requiring medical care, as will relying only on RSV‑specific codes. RSV testing and codification must be improved and preventive solutions adopted, to protect all infants, particularly during the first year of life.The BARI study was funded by Sanofi.Medicin

    Relation between plasma antioxidant vitamin levels, adiposity and cardio-metabolic profile in adolescents: Effects of a multidisciplinary obesity programme

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    Background & aims In vivo and in vitro evidence suggests that antioxidant vitamins and carotenoids may be key factors in the treatment and prevention of obesity and obesity-associated disorders. Hence, the objective of the present study was to determine the relationship between plasma lipid-soluble antioxidant vitamin and carotenoid levels and adiposity and cardio-metabolic risk markers in overweight and obese adolescents participating in a multidisciplinary weight loss programme. Methods A therapeutic programme was conducted with 103 adolescents aged 12–17 years old and diagnosed with overweight or obesity. Plasma concentrations of a-tocopherol, retinol, ß-carotene and lycopene, anthropometric indicators of general and central adiposity, blood pressure and biochemical parameters were analysed at baseline and at 2 and 6 months of treatment. Results Lipid-corrected retinol (P < 0.05), ß-carotene (P = 0.001) and a-tocopherol (P < 0.001) plasma levels increased significantly, whereas lipid-corrected lycopene levels remained unaltered during the treatment. Anthropometric indicators of adiposity (P < 0.001), blood pressure (P < 0.01) and biochemical parameters (P < 0.05) decreased significantly, whereas fat free mass increased significantly (P < 0.001). These clinical and biochemical improvements were related to changes in plasma lipid-corrected antioxidant vitamin and carotenoid levels. The adolescents who experienced the greatest weight loss also showed the largest decrease in anthropometric indicators of adiposity and biochemical parameters and the highest increase in fat free mass. Weight loss in these adolescents was related to an increase in plasma levels of lipid-corrected a-tocopherol (P = 0.001), ß-carotene (P = 0.034) and lycopene (P = 0.019). Conclusions Plasma lipid-soluble antioxidant vitamin and carotenoid levels are associated with reduced adiposity, greater weight loss and an improved cardio-metabolic profile in overweight and obese adolescents

    Excess hospitalizations and mortality associated with seasonal influenza in Spain, 2008-2018

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    Influenza may trigger complications, particularly in at-risk groups, potentially leading to hospitalization or death. However, due to lack of routine testing, influenza cases are infrequently coded with influenza-specific diagnosis. Statistical models using influenza activity as an explanatory variable can be used to estimate annual hospitalizations and deaths associated with influenza. Our study aimed to estimate the clinical and economic burden of severe influenza in Spain, considering such models. The study comprised ten epidemic seasons (2008/2009-2017/2018) and used two approaches: (i) a direct method of estimating the seasonal influenza hospitalization, based on the number of National Health Service hospitalizations with influenza-specific International Classification of Diseases (ICD) codes (ICD-9: 487-488; ICD-10: J09-J11), as primary or secondary diagnosis; (ii) an indirect method of estimating excess hospitalizations and deaths using broader groups of ICD codes in time-series models, computed for six age groups and four groups of diagnoses: pneumonia or influenza (ICD-9: 480-488, 517.1; ICD-10: J09-J18), respiratory (ICD-9: 460-519; ICD-10: J00-J99), respiratory or cardiovascular (C&R, ICD-9: 390-459, 460-519; ICD-10: I00-I99, J00-J99), and all-cause. Means, excluding the H1N1pdm09 pandemic (2009/2010), are reported in this study. The mean number of hospitalizations with a diagnosis of influenza per season was 13,063, corresponding to 28.1 cases per 100,000 people. The mean direct annual cost of these hospitalizations was €45.7 million, of which 65.7% was generated by patients with comorbidities. Mean annual influenza-associated C&R hospitalizations were estimated at 34,894 (min: 16,546; max: 52,861), corresponding to 75.0 cases per 100,000 (95% confidence interval [CI]: 63.3-86.3) for all ages and 335.3 (95% CI: 293.2-377.5) in patients aged ≥ 65 years. We estimate 3.8 influenza-associated excess C&R hospitalizations for each hospitalization coded with an influenza-specific diagnosis in patients aged ≥ 65 years. The mean direct annual cost of the estimated excess C&R hospitalizations was €142.9 million for all ages and €115.9 million for patients aged ≥ 65 years. Mean annual influenza-associated all-cause mortality per 100,000 people was estimated at 27.7 for all ages. Results suggest a relevant under-detected burden of influenza mostly in the elderly population, but not neglectable in younger people. The online version contains supplementary material available at 10.1186/s12879-023-08015-3

    PREDICCIÓN DE LAS NECESIDADES HÍDRICAS CON UNA SEMANA DE ANTELACIÓN MEDIANTE TELEDETECCIÓN Y METEOROLOGÍA EN LA FINCA EXPERIMENTAL DEL CENTER PARA CULTIVOS DE MAÍZ

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    [ES] Determinar las necesidades hídricas que los cultivos demandarán a corto plazo juega un papel fundamental en la gestión de explotaciones agrícolas de regadío. De su precisión depende la obtención de mejores rendimientos productivos, económicos y medioambientales. La experiencia llevada a cabo en la finca experimental de la DGDRPF – CENTER del MAGRAMA, obtuvo la predicción de las necesidades hídricas con una semana de antelación durante todo el periodo de monitorización. Basados en la ecuación del coeficiente de cultivo único (Kc), de la metodología FAO56, se predijo la evapotranspiración del cultivo (ETc) en parcelas de maíz en regadío. Para ello, se emplearon técnicas meteorológicas que predijeron la evapotranspiración de referencia (ETo), y técnicas de teledetección basadas en secuencias temporales de índices de vegetación (IV) mediante las cuales se predijo el Kc. Los resultados obtenidos produjeron una ligera sobre estimación de la ETc a final de campaña (8%). Paralelamente, los riegos aplicados fueron validados externamente mediante el empleo de sondas de humedad. En resumen, la experiencia proporcionó resultados adecuados con un bajo número de recursos. Así, la programación del riego se realizó mediante la combinación de técnicas de teledetección y meteorológicas.Garrido-Rubio, J.; González Gómez, L.; Arellano Alcazar, I.; Madurga Del Cura, C.; Navarro Comalrena De Sobregrau, M.; López Tapia, J.; Calera Belmonte, A. (2015). PREDICCIÓN DE LAS NECESIDADES HÍDRICAS CON UNA SEMANA DE ANTELACIÓN MEDIANTE TELEDETECCIÓN Y METEOROLOGÍA EN LA FINCA EXPERIMENTAL DEL CENTER PARA CULTIVOS DE MAÍZ. En XXXIII CONGRESO NACIONAL DE RIEGOS. Valencia 16-18 junio de 2015. Editorial Universitat Politècnica de València. https://doi.org/10.4995/CNRiegos.2015.1496OC

    Solitary waves for linearly coupled nonlinear Schrodinger equations with inhomogeneous coefficients

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    Motivated by the study of matter waves in Bose-Einstein condensates and coupled nonlinear optical systems, we study a system of two coupled nonlinear Schrodinger equations with inhomogeneous parameters, including a linear coupling. For that system we prove the existence of two different kinds of homoclinic solutions to the origin describing solitary waves of physical relevance. We use a Krasnoselskii fixed point theorem together with a suitable compactness criterion.Comment: 16 page

    Cut-offs and response criteria for the Hospital Universitario la Princesa Index (HUPI) and their comparison to widely-used indices of disease activity in rheumatoid arthritis

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    Objective To estimate cut-off points and to establish response criteria for the Hospital Universitario La Princesa Index (HUPI) in patients with chronic polyarthritis. Methods Two cohorts, one of early arthritis (Princesa Early Arthritis Register Longitudinal PEARL] study) and other of long-term rheumatoid arthritis (Estudio de la Morbilidad y Expresión Clínica de la Artritis Reumatoide EMECAR]) including altogether 1200 patients were used to determine cut-off values for remission, and for low, moderate and high activity through receiver operating curve (ROC) analysis. The areas under ROC (AUC) were compared to those of validated indexes (SDAI, CDAI, DAS28). ROC analysis was also applied to establish minimal and relevant clinical improvement for HUPI. Results The best cut-off points for HUPI are 2, 5 and 9, classifying RA activity as remission if =2, low disease activity if >2 and =5), moderate if >5 and <9 and high if =9. HUPI''s AUC to discriminate between low-moderate activity was 0.909 and between moderate-high activity 0.887. DAS28''s AUCs were 0.887 and 0.846, respectively; both indices had higher accuracy than SDAI (AUCs: 0.832 and 0.756) and CDAI (AUCs: 0.789 and 0.728). HUPI discriminates remission better than DAS28-ESR in early arthritis, but similarly to SDAI. The HUPI cut-off for minimal clinical improvement was established at 2 and for relevant clinical improvement at 4. Response criteria were established based on these cut-off values. Conclusions The cut-offs proposed for HUPI perform adequately in patients with either early or long term arthritis
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