Awareness, treatment and control of hypertension: Trend from population-based surveys conducted in a low-middle income country

Aim: To estimate and determine temporal trends for awareness, treatment and control of hypertension in adults from the urban area in Colombia. Methods: We conducted two population-based surveys (years 2010 and 2015) in the Metropolitan Area of Bucaramanga-Santander, Colombia, using the WHO STEPwise approach. Participants were asked to provide demographic, socioeconomic and cardiovascular risk factors data. Blood pressure (BP) was measured twice using an automated device. Hypertension was defined as a systolic BP≥140 mmHg, a diastolic BP≥90 mmHg or self-reported antihypertensive treatment. We estimated age, sex, and socioeconomic status (SES) adjusted prevalence ratios (PR), with 2010 as the reference survey, using poisson regression and correcting standard errors by clustering. Results: We evaluated 1,136 (mean age: 35.7 years; 43% male) and 872 (mean age:37.7 years; 41% male) adults from the 2010 and 2015 surveys, respectively. There were a larger proportion of individuals sampled from low SES in the 2015 as compared to the 2010 survey (93.6% vs. 70.9%). Overall, prevalence of hypertension was 16.4% (95%CI: 14.8 – 17.9): It increased significantly with age (from 2.4% among individuals 15-19 years old to 41.1% among individuals 50 years and older; p-trend<0.001) but did not differed by sex (17.8% in men vs. 15.4% in women) or year (16.1% vs. 16.6% in 2010 and 2015, respectively). Overall, prevalence of awareness, treatment and control of hypertension were 65.0%, 84.1%, and 62.2%, respectively. Although awareness and control increased from 2010 to 2015 (PR=1.05 and PR=1.12, respectively), only the prevalence of treatment showed a statistically significant increment of 11% (PR=1.11; 95%IC: 1.01 – 1.24). Implication: The STEPwise is a suitable surveillance strategy to estimate the burden of cardiovascular risk factors in low-middle income countries. Our results are consistent with national data from urban areas and show for the first time a short-time improvement in antihypertensive coverage

De la heurística del contenido a la atomización del profesional

Internet es un sistema, un medio de transporte a través del cual se establece la comunicación entre aparatos, pero es también un espacio virtual de expresiones, una especie de ágora donde los usuarios de las diferentes máquinas lanzan discursos, mensajes, ideas; construyen un hábitat digital para sus experiencias de participación. Los individuos conectados a la red conducen en una autopista en la que manejan sus propias realidades. En esta superficie de testimonios, el periodismo ocupa un área de redefiniciones. Se exploran objetivos, complejidades, formas narrativas, cualidades y características, teorías, en definitiva, la naturaleza de cada elemento de la cadena comunicativa lineal. Se examinan patrones y modelos buscando un discurso que arrope las normas de una perfecta distribución y composición de contenidos. El método heurístico en la construcción informativa para comunicarse con un público fragmento, con un público átomo

Oral lichen planus and its relationship with systemic diseases. A review of evidence

Oral lichen planus (OLP) is one of the most common dermatological diseases which are present in the oral cavity. It is a chronic autoimmune, mucocutaneous disease that affects the oral mucosa as well as the skin, genital mucosa and other sites. Review the relevant information to OLP and its relationship with systemic diseases. Searches were carried out in the Medline/PubMed, Lilacs, Bireme, BVS, and SciELO databases by using key-words. After an initial search that provided us with 243 papers, this number was reduced to 78 from the last seven years. One of the first criteria adopted was a selective reading of the abstracts of articles for the elimination of publications that presented less information regarding the subject proposed for this work. All the selected articles were read in their entirety by all of the authors, who came to a consensus about their level of evidence. The Scottish Intercollegiate Guidelines Network (SIGN) criteria were used as the criteria of methodological validation. Only 9 articles showed an evidence level of 1+, 2+, 3 or 4, as well as a recommendation level of A, B, C or D. Three of them were non-systematic reviews, one was a cohort study and only one was a controlled clinical trial. Three of the studies were case series, with respective sample sizes of 45, 171 and 633 patients. Several factors have been associated with OLP. Patients with OLP are carriers of a disease with systemic implications and may need the care of a multidisciplinary team. The correct diagnosis of any pathology is critical to making effective treatment and minimizes iatrogenic harm. For OLP is no different, taking into account its association with numerous systemic diseases that require special attention from health professionals. Periodic follow-up of all patients with OLP is recommended

Génesis y período vital del Frontón Recoletos

The Recoletos Pelota Court is a unique model of architectural harmony, created in collaboration by the architect Secundino Zuazo and the engineer Eduardo Torroja. This paper examines the evolution of the Recoletos project from its initial conception in April 1935 to the finalisation of the plans in September of the same year, how the design was implemented and adapted during the phase of construction, and the variety of uses acquired by the building over the course of its lifetime. Though restored after the damage suffered during the Spanish civil war, the structure was finally demolished in 1973, resulting in the loss of one of the most important buildings in contemporary Spanish architecture. The study explores the collaboration between two different disciplines and their successive refinements of the design to achieve an intimate harmony of form, function and structure that transformed the architectural space of the building. Finally, it illustrates the ultimate versatility of a structure conceived for a specific use.El artículo analiza un singular paradigma arquitectónico, el Frontón Recoletos, fruto de la colaboración entre el arquitecto Secundino Zuazo y el ingeniero Eduardo Torroja. Se plantea describir el proceso de ideación, entre el proyecto inicial de abril de 1935 y la elaboración definitiva en septiembre del mismo año, así como ilustrar las permanencias y mutaciones de la obra durante la fase de ejecución. Del mismo modo, el relato de su ciclo vital ilustra la diversidad de usos que acogió. Dañado durante la guerra civil, se reconstruye para desaparecer en 1973. Se pierde así una de las piezas más significativas de la arquitectura española contemporánea. El texto muestra la colaboración entre dos disciplinas que, mediante sucesivas aproximaciones, transforman substancialmente el espacio arquitectónico fusionando armónicamente forma, función y estructura, a la par que pone de relieve la naturaleza versátil de una pieza que fue ideada con un marcado carácter de especialización

Reconstrucción del ligamento cruzado anterior con plastia mixta de semitendinoso y fibra de Kennedy-Lad

—Se han evaluado los resultados de la reconstrucción del ligamento cruzado anterior (LCA) con una plastia mixta de tendón del semitendinoso y fibra sintética de KennedyLAD en veinticinco pacientes con un mínimo de dos años de seguimiento postoperatorio (media de treinta y ocho meses). Se trataba en todos los casos de lesiones crónicas donde la cirugía consistió en la reconstrucción del LCA y meniscectomías parciales cuando fueron necesarias. La evaluación se llevó a cabo mediante pruebas funcionales (Lysholm) y clínicas (Marshall), pruebas de estabilidad manual (Lachman, pivot, cajón neutro anterior), medidas instrumentales de estabilidad con artrómetro (KT-1000), índice de actividad y apreciación subjetiva. Los datos indican que el comportamiento de la plastia es adecuado en el 92% de los casos proporcionando a los pacientes una función articular satisfactoria en su vida diaria incluyendo la actividad deportiva.The authors assess the results of the anterior cruciate ligament (ACL) reconstruction by means of a semitendinous tendon and Kennedy LAD composite graft. Minimum followup has been two years (mean of thirty eight months). In every cases the lesion was considered as chronic and surgery consisted of ACL reconstruction and partial meniscectomy if neccessary. Studies performed to asses the results included: functional (Lysholm) and clinical (Marshall) tests, manual stability tests (Lachman, pivot-shift, neutral anterior drawer), instrumented stability measurement (KT-1000 arthrometer), activity score and subjective patient self-assessment. The data collected indicate that the performance of the composite graft is adequate in 92% of the cases, allowing the patients a satisfactory knee joint function in their daily life including sporting activities

Predicting long-term disease control in transplant-ineligible patients with multiple myeloma: impact of an MGUS-like signature

Disease control; Multiple myeloma; BiomarkersControl de la malaltia; Mieloma múltiple; BiomarcadorsControl de la enfermedad; Mieloma múltiple; BiomarcadoresDisease control at 5 years would be a desirable endpoint for elderly multiple myeloma (MM) patients, but biomarkers predicting this are not defined. Therefore, to gain further insights in this endpoint, a population of 498 newly diagnosed transplant-ineligible patients enrolled in two Spanish trials (GEM2005MAS65 and GEM2010MAS65), has been analyzed. Among the 435 patients included in this post-hoc study, 18.6% remained alive and progression free after 5 years of treatment initiation. In these patients, overall survival (OS) rate at 10 years was 60.8% as compared with 11.8% for those progressing within the first 5 years. Hemoglobin (Hb) ≥ 12 g/dl (OR 2.74, p = 0.001) and MGUS-like profile (OR 4.18, p = 0.005) were the two baseline variables associated with long-term disease-free survival. Upon including depth of response (and MRD), Hb ≥ 12 g/dl (OR 2.27) and MGUS-like signature (OR 7.48) retained their predictive value along with MRD negativity (OR 5.18). This study shows that despite the use of novel agents, the probability of disease control at 5 years is still restricted to a small fraction (18.6%) of elderly MM patients. Since this endpoint is associated with higher rates of OS, this study provides important information about diagnostic and post-treatment biomarkers helpful in predicting the likelihood of disease control at 5 years

Reconstructing the impact of human activities in a NW Iberian Roman mining landscape for the last 2500 years

This article was made available through the Brunel Open Access Publishing Fund.Little is known about the impact of human activities during Roman times on NW Iberian mining landscapes beyond the geomorphological transformations brought about by the use of hydraulic power for gold extraction. We present the high-resolution pollen record of La Molina mire, located in an area intensely used for gold mining (Asturias, NW Spain), combined with other proxy data from the same peat core to identify different human activities, evaluate the strategies followed for the management of the resources and describe the landscape response to human disturbances. We reconstructed the timing and synchronicity of landscape changes of varying intensity and form occurred before, during and after Roman times. An open landscape was prevalent during the local Late Iron Age, a period of relatively environmental stability. During the Early Roman Empire more significant vegetation shifts took place, reflected by changes in both forest (Corylus and Quercus) and heathland cover, as mining/metallurgy peaked and grazing and cultivation increased. In the Late Roman Empire, the influence of mining/metallurgy on landscape change started to disappear. This decoupling was further consolidated in the Germanic period (i.e., Visigothic and Sueve domination of the region), with a sharp decrease in mining/metallurgy but continued grazing. Although human impact was intense in some periods, mostly during the Early Roman Empire, forest regeneration occurred afterwards: clearances were local and short-lived. However, the Roman mining landscape turned into an agrarian one at the onset of the Middle Ages, characterized by a profound deforestation at a regional level due to a myriad of human activities that resulted in an irreversible openness of the landscape. © 2014 The Authors

ALBAYZIN 2018 spoken term detection evaluation: a multi-domain international evaluation in Spanish

[Abstract] Search on speech (SoS) is a challenging area due to the huge amount of information stored in audio and video repositories. Spoken term detection (STD) is an SoS-related task aiming to retrieve data from a speech repository given a textual representation of a search term (which can include one or more words). This paper presents a multi-domain internationally open evaluation for STD in Spanish. The evaluation has been designed carefully so that several analyses of the main results can be carried out. The evaluation task aims at retrieving the speech files that contain the terms, providing their start and end times, and a score that reflects the confidence given to the detection. Three different Spanish speech databases that encompass different domains have been employed in the evaluation: the MAVIR database, which comprises a set of talks from workshops; the RTVE database, which includes broadcast news programs; and the COREMAH database, which contains 2-people spontaneous speech conversations about different topics. We present the evaluation itself, the three databases, the evaluation metric, the systems submitted to the evaluation, the results, and detailed post-evaluation analyses based on some term properties (within-vocabulary/out-of-vocabulary terms, single-word/multi-word terms, and native/foreign terms). Fusion results of the primary systems submitted to the evaluation are also presented. Three different research groups took part in the evaluation, and 11 different systems were submitted. The obtained results suggest that the STD task is still in progress and performance is highly sensitive to changes in the data domain.Ministerio de Economía y Competitividad; TIN2015-64282-R,Ministerio de Economía y Competitividad; RTI2018-093336-B-C22Ministerio de Economía y Competitividad; TEC2015-65345-PXunta de Galicia; ED431B 2016/035Xunta de Galicia; GPC ED431B 2019/003Xunta de Galicia; GRC 2014/024Xunta de Galicia; ED431G/01Xunta de Galicia; ED431G/04Agrupación estratéxica consolidada; GIU16/68Ministerio de Economía y Competitividad; TEC2015-68172-C2-1-

Prospective multicenter study of carbapenemase-producing Enterobacteriaceae from 83 hospitals in Spain reveals high in vitro susceptibility to colistin and meropenem

The aim of this study was to determine the impact of carbapenemase-producing Enterobacteriaceae (CPE) in Spain in 2013 by describing the prevalence, dissemination, and geographic distribution of CPE clones, and their population structure and antibiotic susceptibility. From February 2013 to May 2013, 83 hospitals (about 40,000 hospital beds) prospectively collected nonduplicate Enterobacteriaceae using the screening cutoff recommended by EUCAST. Carbapenemase characterization was performed by phenotypic methods and confirmed by PCR and sequencing. Multilocus sequencing types (MLST) were determined for Klebsiella pneumoniae and Escherichia coli. A total of 702 Enterobacteriaceae isolates met the inclusion criteria; 379 (54%) were CPE. OXA-48 (71.5%) and VIM-1 (25.3%) were the most frequent carbapenemases, and K. pneumoniae (74.4%), Enterobacter cloacae (10.3%), and E. coli (8.4%) were the species most affected. Susceptibility to colistin, amikacin, and meropenem was 95.5%, 81.3%, and 74.7%, respectively. The most prevalent sequence types (STs) were ST11 and ST405 for K. pneumoniae and ST131 for E. coli. Forty-five (54.1%) of the hospitals had at least one CPE case. For K. pneumoniae, ST11/OXA-48, ST15/OXA-48, ST405/OXA-48, and ST11/VIM-1 were detected in two or more Spanish provinces. ST11 isolates carried four carbapenemases (VIM-1, OXA-48, KPC-2, and OXA-245), but ST405 isolates carried OXA-48 only. A wide interregional spread of CPE in Spain was observed, mainly due to a few successful clones of OXA-48-producing K. pneumoniae (e.g., ST11 and ST405). The dissemination of OXA-48-producing E. coli is a new finding of public health concern. According to the susceptibilities determined in vitro, most of the CPE (94.5%) had three or more options for antibiotic treatmentFondo de Investigación Sanitaria PI12/01242General de Redes y Centros de Investigación Cooperativa y Ministerio de Economía y Competitividad y Spanish Network for Research in Infectious Diseases REIPI RD12/001

Dysregulation of autophagy in the central nervous system of sheep naturally infected with classical scrapie

Autophagy is a dynamic cellular mechanism involved in protein and organelle turnover through lysosomal degradation. Autophagy regulation modulates the pathologies associated with many neurodegenerative diseases. Using sheep naturally infected with scrapie as a natural animal model of prion diseases, we investigated the regulation of autophagy in the central nervous system (CNS) during the clinical phase of the disease. We present a gene expression and protein distribution analysis of different autophagy-related markers and investigate their relationship with prion-associated lesions in several areas of the CNS. Gene expression of autophagy markers ATG5 and ATG9 was downregulated in some areas of scrapie brains. In contrast, ATG5 protein accumulates in medulla oblongata and positively correlates with prion deposition and scrapie-related lesions. The accumulation of this protein and p62, a marker of autophagy impairment, suggests that autophagy is decreased in the late phases of the disease. However, the increment of LC3 proteins and the mild expression of p62 in basal ganglia and cerebellum, primarily in Purkinje cells, suggests that autophagy machinery is still intact in less affected areas. We hypothesize that specific cell populations of the CNS may display neuroprotective mechanisms against prion-induced toxicity through the induction of PrPSc clearance by autophagy