Cambios en el consumo de tabaco: auge del tabaco de liar e introducción de los cigarrillos electrónicos

ResumenObjetivoValorar los cambios en el consumo de tabaco y estudiar de forma detallada el consumo de tabaco de liar y de cigarrillos electrónicos en la población gallega desde 2007 hasta 2015.MétodosInformación aportada por cinco estudios transversales, independientes, realizados entre 2007 y 2015 en mayores de 15 años (n=8000/año). Se estimaron prevalencias de consumo, acompañadas de sus intervalos de confianza del 95%, global, en función del sexo y en grupo de edad, ámbito de residencia y nivel de estudios.ResultadosLa prevalencia de consumo de tabaco fue del 25,4% en 2007 y del 21,8% en 2015. En 2007, el 1,8% de los fumadores consumían tabaco de liar, y en 2015 eran el 18,6%. El consumo del tabaco de liar entre fumadores aumentó en todos los grupos estudiados. La prevalencia de consumo de cigarrillos electrónicos fue, en 2014 y 2015, del 0,7%. En el ámbito urbano es donde se observan prevalencias más altas de consumo de cigarrillos electrónicos.ConclusiónEntre 2007 y 2015, la prevalencia de consumo de tabaco ha disminuido en Galicia y ha aumentado la prevalencia de fumadores que consumen tabaco de liar. El uso de cigarrillos electrónicos es bajo y más frecuente entre los fumadores, aunque no exclusivo. El auge del tabaco de liar y la introducción de los cigarrillos electrónicos reflejan la importancia de mantener sistemas de vigilancia que puedan identificar de forma inmediata cambios de comportamiento asociados al consumo de tabaco.AbstractObjectiveTo assess changes in smoking prevalence and study roll-your-own (RYO) tobacco and e-cigarette use in the Galician population between 2007 and 2015.MethodsData were obtained from five independent, cross-sectional studies carried out in Galicia (Spain) between 2007-2015 in the population aged 16 and over (n=8,000/year). Prevalence of use was estimated, with 95% confidence intervals, overall, according to sex and by age group, area of residence and level of education.ResultsSmoking prevalence decreased from 25.4% in 2007 to 21.8% in 2015. In 2007, 1.8% of current smokers declared that they had smoked RYO tobacco, compared to 18.6% in 2015. Among smokers, RYO tobacco consumption increased across all demographic groups. In both 2014 and 2015, ever use of e-cigarettes was 0.7%. E-cigarette use was more frequent in urban settings.ConclusionSmoking prevalence decreased in Galicia between 2007 and 2015, and there has been rapid growth in the prevalence of RYO tobacco use. Although smokers are more likely to use e-cigarettes, both former and never smokers declared their use. The boom of RYO cigarettes and the emergence of e-cigarettes highlight the importance of having continuous surveillance systems to identify smoking behavioural changes

How many kids are there with excess weight? What information should be published?

Fundamentos: En los estudios epidemiológicos, nohay consenso sobre cuáles son las referencias que se deben emplear para caracterizar el estado ponderal de los escolares después de estimar su índice de masa corporal. El objetivo de este trabajo fue valorar como influyen diferentes criterios en la caracterización del estado ponderal de escolares gallegos de 6 a 15 años e identificar el criterio que mejor caracteriza la obesidad central. Métodos: Estudio transversal en una muestra de7.438 escolares de 6 a 15 años representativa por sexo y edad. Se estimó la prevalencia de obesidad central y debajo peso, normopeso, sobrepeso y obesidad utilizandolos criterios de referencia de la Organización Mundialde la Salud (OMS), Cole, Orbegozo-2011 y del estudio Enkid. Para identificar el criterio que mejor caracterizala obesidad central se calcularon valores predictivos positivos de obesidad y negativos de sobrepeso y obesidad. Resultados: La caracterización de los escolares en función de su estado ponderal varió en función de la referencia empleada con estimaciones que oscilaban en 20,4 puntos porcentuales cuando se comparaba el exceso de peso según criterios de la OMS, 41,5%, y Enkid, 21,1%.El criterio que presentó mejor capacidad predictiva de obesidad central fue el propuesto por Cole. Conclusiones: La variabilidad que se observa en la caracterización del estado ponderal de los escolares aso-ciada al uso de distintos criterios de referencia es muy importante. Si se considera a la obesidad central como indicador de exceso de peso, la referencia de Cole es la que mejor caracteriza a los escolares, ya que es la que tiene mejor capacidad predictivaBackground: In epidemiological studies, there is no consensus on which references should be used to characterize the weight status of schoolchildren after estimating their body mass index. The aim of this study is to evaluate the influence that different criteria have on the charac-terization of the weight status of Galician schoolchildrenfrom 6 to 15 years old and to identify the criterion thatbest characterizes central obesity. Methods: Cross-sectional study on a sample of 7.438 school children representative by sex and age of the Galician population of 6 to 15 year olds. The prevalence of central obesity and underweight, normal weight, overweight and obesity was estimated using the reference standards of the World Health Organization (WHO), Cole, Orbegozo-2011 and the Enkid study. In order to identify the criterion that best characterizes central obesity, the positive predictive values of obesity and the negative ones of overweight and obesity were calculated. Results: The characterization of school children according to their weight status was different depending on the reference used with estimates that vary by 20.4 percentage points being prevalence of excess weight using WHO references 41.5% while with Enkid it is 21.1%.The reference with the best predictive capacity of central obesity was those proposed by Cole. Conclusions: The variability observed in the characterization of the weight status of school children associated with the use of different reference criteria is very important. If central obesity is a good indicator of excess of weight, the reference proposed by Cole would be the one with the best capacity to characterize the child and youth population, related to the best predictive capacityS

A prospective study of lung disease in a cohort of early rheumatoid arthritis patients

Lung disease is common in patients with rheumatoid arthritis (RA). The onset of lung involvement in RA is not well known. The objective is to describe the features and evolution of lung involvement in early RA, its relationship with disease activity parameters, smoking and treatments. Consecutive patients with early RA without respiratory symptoms were included and tracked for 5 years. Lung assessment included clinical, radiological and pulmonary function tests at diagnosis and during follow-up. Peripheral blood parameters (erythrocyte sedimentation rate, C reactive protein, rheumatoid factor and anti-citrullinated peptide autoantibodies) and scales of articular involvement, such as DAS28-CRP, were evaluated. 40 patients were included and 32 completed the 5-year follow up. 13 patients presented lung involvement in the initial 5 years after RA diagnosis, 3 of them interstitial lung disease. Significant decrease of diffusion lung transfer capacity of carbon monoxide over time was observed in six patients, 2 of them developed interstitial lung disease. DLCO decrease was correlated with higher values of CRP and ESR at diagnosis. Methotrexate was not associated with DLCO deterioration or lung disease development. Subclinical progressive lung disease correlates with RA activity parameters. Smoking status and methotrexate were not associated with development or progression of lung disease

A novel strategy based on genomics and specific PCR reveals how a multidrug resistant Mycobacterium tuberculosis strain became prevalent in Equatorial Guinea 15 years after its emergence.

OBJECTIVE: Molecular epidemiology techniques in tuberculosis (TB) can identify high-risk strains that are actively transmitted. We aimed to implement a novel strategy to optimize the identification and control of multidrug-resistant (MDR) TB in a specific population. METHODS: We developed a strain-specific PCR tailored from whole genome sequencing (WGS) data to track a specific MDR prevalent strain in Equatorial Guinea (EG-MDR). RESULTS: The PCR was applied prospectively on remnants of GeneXpert reaction mixtures owing to the lack of culture facilities in Equatorial Guinea. In 147 (93%) of 158 cases, we were able to differentiate between infection by the EG-MDR strain or by any other strain and found that 44% of all rifampicin-resistant TB cases were infected by EG-MDR. We also analysed 93 isolates obtained from Equatorial Guinea 15 years ago, before MDR-TB had become the problem it is today. We found that two of the scarce historical MDR cases were infected by EG-MDR. WGS revealed low variability-six single nucleotide polymorphisms acquired by this strain over 15 years-likely because of the lack in the country of a specific program to treat MDR-TB. CONCLUSIONS: Our novel strategy, which integrated WGS analysis and strain-specific PCRs, represents a low-cost, rapid and transferable strategy that allowed a prospective efficient survey and fast historical analysis of MDR-TB in a population

Small-area models to assess the geographical distribution of tobacco consumption by sex and age in Spain

Introduction: Complete and accurate data on smoking prevalence at a local level would enable health authorities to plan context-dependent smoking interventions. However, national health surveys do not generally provide direct estimates of smoking prevalence by sex and age groups at the subnational level. This study uses a small-area model-based methodology to obtain precise estimations of smoking prevalence by sex, age group and region, from a population-based survey. Methods: The areas targeted for analysis consisted of 180 groups based on a combination of sex, age group (15-34, 35-54, 55-64, 65-74, and ≥75 years), and Autonomous Region. Data on tobacco use came from the 2017 Spanish National Health Survey (2017 SNHS). In each of the 180 groups, we estimated the prevalence of smokers (S), ex-smokers (ExS) and never smokers (NS), as well as their coefficients of variation (CV), using a weighted ratio estimator (direct estimator) and a multinomial logistic model with random area effects. Results: When smoking prevalence was estimated using the small-area model, the precision of direct estimates improved; the CV of S and ExS decreased on average by 26%, and those of NS by 25%. The range of S prevalence was 11-46% in men and 4-37% in women, excluding the group aged ≥75 years. Conclusions: This study proposes a methodology for obtaining reliable estimates of smoking prevalence in groups or areas not covered in the survey design. The model applied is a good alternative for enhancing the precision of estimates at a detailed level, at a much lower cost than that involved in conducting large-scale surveys. This method could be easily integrated into routine data processing of population health surveys. Having such estimates directly after completing a health survey would help characterize the tobacco epidemic and/or any other risk factor more precisely.Instituto de Salud Carlos III (ISCIII), reference: PI19/00288, co-funded by the European Union. The sponsors did not participate in the study in any way.S

Combined Approach to Stroke Thrombectomy Using a Novel Short Flexible Aspiration Catheter with a Stent Retriever

Background: Large-bore aspiration catheters enabling greater flow rates and suction force for mechanical thrombectomy might improve outcomes in patients with stroke secondary to large-vessel occlusion. Complete or near-complete reperfusion after a single thrombectomy pass (first-pass effect) is associated with improved clinical outcomes. We assessed the efficacy and safety of novel MIVI Q™ aspiration catheters in combination with stent-retriever devices. Methods: We retrospectively analyzed demographics, procedure characteristics, and clinical data from consecutive patients with acute anterior large-vessel occlusion treated with a combined approach using MIVI Q™ aspiration catheters and stent retrievers. Reperfusion was defined according to the modified thrombolysis in cerebral infarction (mTICI) score. Clinical outcomes were measured by the National Institute of Health Stroke Scale (NIHSS) and modified Rankin scale (mRS) scores. Results: We included 52 patients (median age, 75 y IQR: 64-83); 31 (59.6%) women; 14 (26.9%) with terminal internal carotid artery occlusions, 26 (50%) middle cerebral artery (MCA) segment M1 occlusions, and 12 (23.1%) MCA segment M2 occlusions; median NIHSS score at admission was 19 (IQR: 13-22). After the first pass, 25 (48%) patients had mTICI ≥ 2c. At the end of the procedure, 47 (90.4%) had mTICI ≥ 2b and 35 (67.3%) had mTICI ≥ 2c. No serious device-related adverse events were observed. Symptomatic intracranial hemorrhage developed in 1 patient. Mean NIHSS score was 13 at 24 h and 5 at discharge. At 90 days, 24 (46.2%) patients were functionally independent (mRS 0-2). Conclusion: This preliminary study found good efficacy and safety for MIVI Q™ aspiration catheters used in combination with stent-retriever devices

Productive Performance of Sheep in an Agropastoral System on the Coast of Oaxaca, Mexico

Objective: To determine the prolificacy and weight of lambs at birth (BW) in twogenotypes of hair sheep within an agropastoral system on the coast of Oaxaca, Mexico,and to evaluate the effect of two sources of selenium on the performance of lambs fromsaid system during the fattening phase.Design/Methodology/Approach: The study was carried out in an agropastoral system(coconut palm and Cynodon dactylon grass) in Río Grande, Oaxaca. Two experimentswere conducted; the first studied 58 ewes distributed in a completely randomized design(CRD) with factorial arrangement of 2x2x3, and focused on the following fixed effects:genotype, number of births, and body condition (BC). The measured variables wereprolificacy and BW. The second experiment studied 23 lambs of 4 months in age thatwere offspring of the females in experiment 1. They were distributed in a CRD withthree treatments: T1, without selenium provided; T2, with barium selenate provided; T3,with selenomethionine provided. The dependent variables were daily weight gain(DWG), dry material consumption (DMC), and feed conversion (FC). Results: The Pelibuey ewes with one and two births and the Black Belly ewes with onebirth demonstrated the highest averages in prolificacy (P?0.05). The lowest averages(P?0.05) were detected in ewes with BC 4 irrespective of number of births. The BW wasaffected (P?0.05) by genotype; Black Belly lambs weighed 680 g (P?0.05) more thatPelibuey lambs. The DWG, DMC and FC behaved similarly (P?0.05) betweentreatments and their general averages were 0.114 kg day -1 , 0.679 kg day -1 , and 6.18,respectively.Study Limitations/Implications: In the agropastoral system, the BC of ewes limitstheir reproductive performance. The weight of the lambs at the start of fatteningdetermines their performance during fattening.Findings/Conclusions: In the agropastoral system, Pelibuey and Black Belly femalespresent adequate prolificacy averages and BW; however, it is very important that theyremain within BC 3. Neither of the two sources of selenium improves DWG, DMC, andFC of lambs fattened in pens in the agropastoral system

An enduring rapidly moving storm as a guide to Saturn’s Equatorial jet’s complex structure

Saturn has an intense and broad eastward equatorial jet with a complex three-dimensional structure mixed with time variability. The equatorial region experiences strong seasonal insolation variations enhanced by ring shadowing, and three of the six known giant planetary-scale storms have developed in it. These factors make Saturn's equator a natural laboratory to test models of jets in giant planets. Here we report on a bright equatorial atmospheric feature imaged in 2015 that moved steadily at a high speed of 450 ms(-1) not measured since 1980-1981 with other equatorial clouds moving within an ample range of velocities. Radiative transfer models show that these motions occur at three altitude levels within the upper haze and clouds. We find that the peak of the jet ( latitudes 10 degrees N to 10 degrees S) suffers intense vertical shears reaching + 2.5 ms(-1) km(1), two orders of magnitude higher than meridional shears, and temporal variability above 1 bar altitude level. Palabras claveThis work is based on observations and analysis from Hubble Space Telescope (GO/DD program 14064), Cassini ISS images (NASA pds), and Calar Alto Observatory (CAHA-MPIA). A.S.-L. and UPV/EHU team are supported by the Spanish projects AYA2012-36666 and AYA2015-65041-P with FEDER support, Grupos Gobierno Vasco IT-765-13, Universidad del Pais Vasco UPV/EHU program UFI11/55, and Diputacion Foral Bizkaia (BFA). We acknowledge the contribution of Saturn images by T. Olivetti, M. Kardasis, A. Germano, A. Wesley, P. Miles, M. Delcroix, C. Go, T. Horiuchi and P. Maxon. We also acknowledge the wind model data provided by J. Friedson

The Absence of Caspase-8 in the Dopaminergic System Leads to Mild Autism-like Behavior

In the last decade, new non-apoptotic roles have been ascribed to apoptotic caspases. This family of proteins plays an important role in the sculpting of the brain in the early stages of development by eliminating excessive and nonfunctional synapses and extra cells. Consequently, impairments in this process can underlie many neurological and mental illnesses. This view is particularly relevant to dopamine because it plays a pleiotropic role in motor control, motivation, and reward processing. In this study, we analyze the effects of the elimination of caspase-8 (CASP8) on the development of catecholaminergic neurons using neurochemical, ultrastructural, and behavioral tests. To do this, we selectively delete the CASP8 gene in cells that express tyrosine hydroxylase with the help of recombination through the Cre-loxP system. Our results show that the number of dopaminergic neurons increases in the substantia nigra. In the striatum, the basal extracellular level of dopamine and potassium-evoked dopamine release decreased significantly in mice lacking CASP8, clearly showing the low dopamine functioning in tissues innervated by this neurotransmitter. This view is supported by electron microscopy analysis of striatal synapses. Interestingly, behavioral analysis demonstrates that mice lacking CASP8 show changes reminiscent of autism spectrum disorders (ASD). Our research reactivates the possible role of dopamine transmission in the pathogenesis of ASD and provides a mild model of autism