Empty Urbanism: the bursting of the Spanish housing bubble

The depth of the Spanish housing crisis manifests itself in the collapse of construction activity and in the amount of housing and land stocks. The geography of the crisis shows its widespread nature, and the intensity of the previous bubble explains spatial differences. Resulting from this collapse are some problematic areas of 'empty urbanism'. An enormous land bubble, emerging from the peculiar Spanish urban development model, was a key factor in the impacts - caused by the crisis - on the territory and land-use plans. The crisis has demonstrated the unsustainability of this and the urgency of change in the existing land-use plans

Epidemiological trends of HIV/HCV coinfection in Spain, 2015-2019

Altres ajuts: Spanish AIDS Research Network; European Funding for Regional Development (FEDER).Objectives: We assessed the prevalence of anti-hepatitis C virus (HCV) antibodies and active HCV infection (HCV-RNA-positive) in people living with HIV (PLWH) in Spain in 2019 and compared the results with those of four similar studies performed during 2015-2018. Methods: The study was performed in 41 centres. Sample size was estimated for an accuracy of 1%. Patients were selected by random sampling with proportional allocation. Results: The reference population comprised 41 973 PLWH, and the sample size was 1325. HCV serostatus was known in 1316 PLWH (99.3%), of whom 376 (28.6%) were HCV antibody (Ab)-positive (78.7% were prior injection drug users); 29 were HCV-RNA-positive (2.2%). Of the 29 HCV-RNA-positive PLWH, infection was chronic in 24, it was acute/recent in one, and it was of unknown duration in four. Cirrhosis was present in 71 (5.4%) PLWH overall, three (10.3%) HCV-RNA-positive patients and 68 (23.4%) of those who cleared HCV after anti-HCV therapy (p = 0.04). The prevalence of anti-HCV antibodies decreased steadily from 37.7% in 2015 to 28.6% in 2019 (p < 0.001); the prevalence of active HCV infection decreased from 22.1% in 2015 to 2.2% in 2019 (p < 0.001). Uptake of anti-HCV treatment increased from 53.9% in 2015 to 95.0% in 2019 (p < 0.001). Conclusions: In Spain, the prevalence of active HCV infection among PLWH at the end of 2019 was 2.2%, i.e. 90.0% lower than in 2015. Increased exposure to DAAs was probably the main reason for this sharp reduction. Despite the high coverage of treatment with direct-acting antiviral agents, HCV-related cirrhosis remains significant in this population

High prevalence and diversity of HIV-1 non-B genetic forms due to immigration in southern Spain: A phylogeographic approach

Phylogenetic studies are a valuable tool to understand viral transmission patterns and the role of immigration in HIV-1 spread. We analyzed the spatio-temporal relationship of different HIV-1 non-B subtype variants over time using phylogenetic analysis techniques. We collected 693 pol (PR+RT) sequences that were sampled from 2005 to 2012 from naïve patients in different hospitals in southern Spain. We used REGA v3.0 to classify them into subtypes and recombinant forms, which were confirmed by phylogenetic analysis through maximum likelihood (ML) using RAxML. For the main HIV-1 non-B variants, publicly available, genetically similar sequences were sought using HIV-BLAST. The presence of HIV-1 lineages circulating in our study population was established using ML and Bayesian inference (BEAST v1.7.5) and transmission networks were identified. We detected 165 (23.4%) patients infected with HIV-1 non-B variants: 104 (63%) with recombinant viruses in pol: CRF02_AG (71, 43%), CRF14_BG (8, 4.8%), CRF06_cpx (5, 3%) and nine other recombinant forms (11, 6.7%) and unique recombinants (9, 5.5%). The rest (61, 37%) were infected with non-recombinant subtypes: A1 (30, 18.2%), C (7, [4.2%]), D (3, [1.8%]), F1 (9, 5.5%) and G (12, 7.3%). Most patients infected with HIV-1 non-B variants were men (63%, p < 0.001) aged over 35 (73.5%, p < 0.001), heterosexuals (92.2%, p < 0.001), from Africa (59.5%, p < 0.001) and living in the El Ejido area (62.4%, p<0.001). We found lineages of epidemiological relevance (mainly within Subtype A1), imported primarily through female sex workers from East Europe. We detected 11 transmission clusters of HIV-1 non-B Subtypes, which included patients born in Spain in half of them. We present the phylogenetic profiles of the HIV-1 non-B variants detected in southern Spain, and explore their putative geographical origins. Our data reveals a high HIV-1 genetic diversity likely due to the import of viral lineages that circulate in other countries. The highly immigrated El Ejido area acts as a gateway through which different subtypes are introduced into other regions, hence the importance of setting up epidemiological control measures to prevent future outbreaks

Global phylogeography and ancient evolution of the widespread human gut virus crAssphage

Microbiomes are vast communities of microorganisms and viruses that populate all natural ecosystems. Viruses have been considered to be the most variable component of microbiomes, as supported by virome surveys and examples of high genomic mosaicism. However, recent evidence suggests that the human gut virome is remarkably stable compared with that of other environments. Here, we investigate the origin, evolution and epidemiology of crAssphage, a widespread human gut virus. Through a global collaboration, we obtained DNA sequences of crAssphage from more than one-third of the world's countries and showed that the phylogeography of crAssphage is locally clustered within countries, cities and individuals. We also found fully colinear crAssphage-like genomes in both Old-World and New-World primates, suggesting that the association of crAssphage with primates may be millions of years old. Finally, by exploiting a large cohort of more than 1,000 individuals, we tested whether crAssphage is associated with bacterial taxonomic groups of the gut microbiome, diverse human health parameters and a wide range of dietary factors. We identified strong correlations with different clades of bacteria that are related to Bacteroidetes and weak associations with several diet categories, but no significant association with health or disease. We conclude that crAssphage is a benign cosmopolitan virus that may have coevolved with the human lineage and is an integral part of the normal human gut virome

Phylodynamic and Phylogeographic Profiles of Subtype B HIV-1 Epidemics in South Spain

Since 1982, HIV-1 epidemics have evolved to different scenarios in terms of transmission routes, subtype distribution and characteristics of transmission clusters. We investigated the evolutionary history of HIV-1 subtype B in south Spain.We studied all newly diagnosed HIV-1 subtype B patients in East Andalusia during the 2005-2012 period. For the analysis, we used the reverse transcriptase and protease sequences from baseline resistance, and the Trugene® HIV Genotyping kit (Siemens, Barcelona, Spain). Subtyping was done with REGA v3.0. The maximum likelihood trees constructed with RAxML were used to study HIV-1 clustering. Phylogeographic and phylodynamic profiles were studied by Bayesian inference methods with BEAST v1.7.5 and SPREAD v1.0.6.Of the 493 patients infected with HIV-1 subtype B, 234 grouped into 55 clusters, most of which were small (44 clusters ≤ 5 patients, 31 with 2 patients, 13 with 3). The rest (133/234) were grouped into 11 clusters with ≥ 5 patients, and most (82%, 109/133) were men who have sex with men (MSM) grouped into 8 clusters. The association with clusters was more frequent in Spanish (p = 0.02) men (p< 0.001), MSM (p<0.001) younger than 35 years (p = 0.001) and with a CD4+ T-cell count above 350 cells/ul (p<0.001). We estimated the date of HIV-1 subtype B regional epidemic diversification around 1970 (95% CI: 1965-1987), with an evolutionary rate of 2.4 (95%CI: 1.7-3.1) x 10-3 substitutions/site/year. Most clusters originated in the 1990s in MSMs. We observed exponential subtype B HIV-1 growth in 1980-1990 and 2005-2008. The most significant migration routes for subtype B went from inland cities to seaside locations.We provide the first data on the phylodynamic and phylogeographic profiles of HIV-1 subtype B in south Spain. Our findings of transmission clustering among MSMs should alert healthcare managers to enhance preventive measures in this risk group in order to prevent future outbreaks

Hydrolysis of lactose and transglycosylation of selected sugar alcohols by LacA β-galactosidase from Lactobacillus plantarum WCFS1

The production, biochemical characterization, and carbohydrate specificity of LacA β-galactosidase (locus lp_3469) belonging to the glycoside hydrolase family 42 from the probiotic organism Lactobacillus plantarum WCFS1 are addressed. The β-d-galactosidase activity was maximal in the pH range of 4.0-7.0 and at 30-37 °C. High hydrolysis capacity toward the β(1 → 4) linkages between galactose and glucose (lactose) or fructose (lactulose) was found. High efficiency toward galactosyl derivative formation was observed when lactose and glycerol, xylitol, or erythritol were used. Galactosyl derivatives of xylitol were characterized for the first time as 3-O-β-d-galactopyranosyl-xylitol and 1-O-β-d-galactopyranosyl-xylitol, displaying high preference of LacA β-galactosidase for the transfer of galactosyl residues from lactose to the C1 or C3 hydroxyl group of xylitol. These results indicate the feasibility of using LacA β-galactosidase for the synthesis of different galactosyl-polyols, which could be promising candidates for beneficial and appealing functional and technological applications such as novel prebiotics or hypocaloric sweeteners.This work has been financed by the Spanish Ministry of Economy, Industry and Competitiveness (Projects AGL2017- 84614-C2-1-R and AGL2017-84614-C2-2-R)

Domestic violence as a factor associated to women's health problems

OBJECTIVE: To study the impact of intimate partner violence (IPV) on women's physical and psychological health. DESIGN: Cross-sectional study. SETTING:Primary care centers in 3 Andalusian provinces. PATIENTS: A total of 425 women, aged 18 to 65 years, were recruited following the same randomisation process in 6 primary care centers. MEASUREMENTS: A self-administered structured questionnaire for this study was used to gather the information. As well as sociodemographic variables, the instrument included questions about IPV, physical health indicators (chronic disease and type, lifetime surgeries, days in bed), psychological health (psychological morbidity, use of tranquilizers, antidepressants, pain killers, alcohol and recreational drugs), self-perceived health and social support. RESULTS: Of 425 women, 31.5% ever experienced any type of partner violence. Women experiencing IPV were more likely to suffer a chronic disease. IPV was significantly associated with a number of adverse health outcomes, including spending more than 7 days in bed in the last three months (ORa=2.96; CI 95%, 1.00-8.76), psychological morbidity (ORa=2.68; CI 95%, 1.60-4.49) and worse self-perceived health (ORa=1.89; CI 95%, 1.04-3.43), after controlling for potential confounding variables. CONCLUSION: This study shows that ever experiencing IPV is associated with a worse psychological and self-perceived health. Physical injuries are not the only "evidence" of the presence of IPV. Primary health care professionals are in a privileged position to help women who are abused by their partners.Fuente de financiación: Red Temática de Investigación de Salud y Género (ISCIII) (G03/042) y Red de Investigación en Epidemiología y Salud Pública (C03/09).YesObjetivo. Estudiar el impacto en la salud física y psíquica de la violencia contra la mujer en la pareja. Diseño. Transversal. Emplazamiento. Centros de atención primaria de 3 provincias de la Comunidad Autónoma Andaluza. Participantes. Un total de 425 mujeres de entre 18 y 65 años asistentes a 6 centros. Se eligieron aleatoriamente siguiendo el mismo procedimiento en cada centro. Mediciones principales. Cuestionario estructurado autoadministrado que recoge, además de las variables sociodemográficas, variables relacionadas con el maltrato e indicadores de salud física (presencia de enfermedad crónica y tipo, intervenciones quirúrgicas a lo largo de la vida y días pasados en cama), psíquica (morbilidad psíquica, consumo de tranquilizantes, antidepresivos, analgésicos, alcohol y drogas no legales), salud autopercibida y apoyo social. Resultados. La frecuencia de maltrato fue del 31,5%. Las mujeres víctimas de maltrato presentaron mayor riesgo de padecer enfermedades crónicas. La asociación entre el maltrato y pasar más de 7 días en cama fue estadísticamente significativa (odds ratio [OR] = 2,96; intervalo de confianza [IC] del 95%, 1,00-8,76). El maltrato presentó una asociación significativa con la morbilidad psíquica (OR = 2,68; IC del 95%, 1,60-4,49) y con la salud autopercibida (OR = 1,89; IC del 95%, 1,04-3,43) tras ajustar por otras variables. Conclusiones. Los resultados de este trabajo muestran que el maltrato global se asocia con una peor salud psíquica y una peor salud autopercibida. Las lesiones físicas no son la única «prueba» de la existencia de violencia doméstica. Los profesionales de atención primaria pueden desempeñar un papel esencial para ayudar a las mujeres que sufren abusos de sus pareja

La violencia contra la mujer en la pareja como factor asociado a una mala salud física y psíquica

ObjetivoEstudiar el impacto en la salud física y psíquica de la violencia contra la mujer en la pareja.DiseñoTransversal.EmplazamientoCentros de atención primaria de 3 provincias de la Comunidad Autónoma Andaluza.ParticipantesUn total de 425 mujeres de entre 18 y 65 años asistentes a 6 centros. Se elisieron aleatoriamente sisuiendo el mismo procedimiento en cada centro.Mediciones principalesCuestionario estructurado autoadministrado que recose, además de las variables sociodemográficas, variables relacionadas con el maltrato e indicadores de salud física (presencia de enfermedad crónica y tipo, intervenciones quirúrgicas a lo largo de la vida y días pasados en cama), psíquica (morbilidad psíquica, consumo de tranquilizantes, antidepresivos, analgésicos, alcohol y drogas no legales), salud autopercibida y apoyo social.ResultadosLa frecuencia de maltrato fue del 31,5%. Las mujeres víctimas de maltrato presentaron mayor riesgo de padecer enfermedades crónicas. La asociación entre el maltrato y pasar más de 7 días en cama fue estadísticamente significativa (odds ratio [OR] = 2,96; intervalo de confianza [IC] del 95%, 1,00-8,76). El maltrato presentó una asociación significativa con la morbilidad psíquica (OR = 2,68; IC del 95%, 1,60-4,49) y con la salud autopercibida (OR = 1,89; IC del 95%, 1,04-3,43) tras ajustar por otras variables.ConclusionesLos resultados de este trabajo muestran que el maltrato global se asocia con una peor salud psíquica y una peor salud autopercibida. Las lesiones físicas no son la única "prueba" de la existencia de violencia doméstica. Los profesionales de atención primaria pueden desempeñar un papel esencial para ayudar a las mujeres que sufren abusos de sus parejas.ObjectiveTo study the impact of intimate partner violence (IPV) on women's physical and psychological health.DesignCross-sectional study.SettingPrimary care centers in 3 Andalusian provinces.PatientsA total of 425 women, aged 18 to 65 years, were recruited following the same randomisation process in 6 primary care centers.MeasurementsA self-administered structured questionnaire for this study was used to gather the information. As well as sociodemographic variables, the instrument included questions about IPV, physical health indicators (chronic disease and type, lifetime surgeries, days in bed), psychological health (psychological morbidity, use of tranquilizers, antidepressants, pain killers, alcohol and recreational drugs), self-perceived health and social support.ResultsOf 425 women, 31.5% ever experienced any type of partner violence. Women experiencing IPV were more likely to suffer a chronic disease. IPV was significantly associated with a number of adverse health outcomes, including spending more than 7 days in bed in the last three months (ORa=2.96; CI 95%, 1.00-8.76), psychological morbidity (ORa=2.68; CI 95%, 1.60-4.49) and worse self-perceived health (ORa=1.89; CI 95%, 1.04-3.43), after controlling for potential confounding variables.ConclusionsThis study shows that ever experiencing IPV is associated with a worse psychological and self-perceived health. Physical injuries are not the only «evidence» of the presence of IPV. Primary health care proffessionals are in a privileged position to help women who are abused by their partners

Dissociation between blood pressure reduction and fall in proteinuria in primary renal disease: a randomized double-blind trial

OBJECTIVEGuidelines recommend lower threshold and goal blood pressure (BP) for patients with proteinuria. BP reduction could be accompanied by a different fall in proteinuria depending of the antihypertensive drug. The objective was to compare proteinuria reduction when BP is lowered to the same level with different drugs.DESIGNProspective, randomized, double-blind, controlled trial.SETTING12 Spanish centres.PATIENTSA total of 119 patients with primary renal disease, blood pressure > 130/85 mmHg, proteinuria > 1 g/day, and creatinine clearance > or = 50 ml/min.INTERVENTIONAfter a 4-week run-in placebo period, patients were randomized to: atenolol 50 mg/day; trandolapril 2 mg/day; verapamil 240 mg/day or verapamil 180 + trandolapril 2 mg/day combination; forced double-dose titration was carried out at the 4th week. Treatment duration was 6 months.OUTCOME MEASURESChanges in BP, 24 h proteinuria, serum albumin and calcium.RESULTSBP was significantly reduced with the four treatments [SBP/DBP (mmHg]: atenolol 12.2/9.9; trandolapril 12.9/9.3; verapamil 8.2/7.9 and verapamil + trandolapril 13.6/11.3) without differences between them. A significant fall in proteinuria was seen in the trandolapril, 40.2% [95% confidence interval (CI) 24.3-56.2%], and verapamil + trandolapril groups, 48.5% (95% CI, 31.7-64.3%) accompanied with increases in serum albumin (trandolapril: from 3.86 +/- 0.64 to 4.03 +/- 0.67 g/dl; verapamil + trandolapril: from 4.15 +/- 0.58 to 4.40 +/- 0.51 g/dl).CONCLUSIONSIn patients with proteinuric primary renal disease, adequate dose titration of antihypertensive drugs may provide a substantial BP reduction. Only angiotensin-converting enzyme inhibitor (trandolapril) treatment, alone or better combined with verapamil, reduces proteinuria and increases serum albumin