Trends in the Epidemiology of Leishmaniasis in the City of Barcelona (1996-2019)

Background: Leishmaniasis is a neglected zoonosis produced by 20 different flagellated parasites of the Leishmania genus, a protozoan transmitted to humans and other vertebrates by the bite of dipteran insects of the Phlebotominae subfamily. It is endemic in Mediterranean countries and the number of cases is expected to increase due to climate change and migration. Prioritizing public health interventions for prevention and control is essential. The objective was to characterize the epidemiology and temporal trends in the incidence of human leishmaniasis in the city of Barcelona, between the years 1996 and 2019. Methods: A population-based, analytical observational study among residents in the city of Barcelona was conducted of all the cases of leishmaniasis reported between 1996 and 2019 to the Public Health Agency. The epidemiological survey contains clinical, diagnostic, and epidemiological data, including contact with suspicious mammals or insects. Annual incidence-rates were calculated by sex, age, and country of origin. Chi-square tests were used to assess association between studied risk factors, periods of time and type of leishmaniasis. Results: During the study period a total of 177 cases of leishmaniasis were reported in Barcelona, being 74.6% (n = 132) of the total cases in Spanish born, although within the foreign-born population the incidence was higher. Median age was 34 years (IQR = 10-48) and 121 (66.8%) were male. The main type was cutaneous (46%) followed by visceral (35.1%). The cumulative incidence was 0.47 per 100,000 inhabitants, with the highest incidence found in 2017 (1.60 per 100,000 inhabitants). A higher incidence was observed in the 0-4-year-old group (1.73 per 100,000 inhabitants), but increased during the study period for all age groups. There was an increase of foreign origin cases, and a decrease in the number of cases associated to any immunosuppression. Conclusion: In Barcelona, leishmaniasis incidence continues to be higher in people under 5 years of age, and 25-64 years old males, but it has also increased in population from foreign country of birth. There is an increase of the cases since 2016, probably due to the changes in the notification system, increasing the diagnosis of cutaneous leishmaniasis. Improvements in the current surveillance system are needed. Notification of the disease, vector, and reservoir control activities are also essential for the control of the disease

In vitro and in vivo activity of a new small-molecule inhibitor of HDAC6 in mantle cell lymphoma

Cancer origin and development is associated not only with genetic alterations, but also with the disturbance of epigenetic profiles.1 In this regard, the tumoral epigenome is characterized by both specific and general shifts in the DNA methylation and histone-modification landscapes.1 However, in contrast to genetic disruption, the effect of epigenetic modifications or marks may potentially be reversed by the use of drugs that target enzymes involved in adding, removing or signaling DNA methylation and histone modifications.1 This basic knowledge has been adopted into clinical practice, and inhibitors of histone deacetylases and DNA demethylating agents have been approved for use in the therapy of hematologic malignancies, such as cutaneous T-cell lymphoma and myelodysplastic syndrome, respectively.2 Other promising epigenetic drugs include inhibitors of histone methyltransferases,2 histone demethylases,2 histone kinases,3 and bromodomain proteins that interfere with the 'reading' of acetylated histone residues

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Estrategia de desarrollo de rupatadina solución oral en niños de 2 a 5 años con rinitis alérgica: la farmacocinética poblacional como herramienta para la optimización del diseño de ensayos clínicos

"Els reptes ètics i pràctics en la realització d'estudis clínics en nens, ha ocasionat que no es disposi de suficients estudis en aquest grup d'edat. La farmacocinètica poblacional és una eina que pot ajudar a minimitzar les dificultats que presenten aquest tipus d'estudis, ajudant a elaborar dissenys d'extracció òptims que minimitzin la molèstia i ajudin a l'acceptació d'aquests estudis. L'objectiu d'aquesta tesi va ser optimitzar el disseny d'un estudi en pacients de 2 a 5 anys amb rinitis al·lèrgica per estudiar la farmacocinètica i la farmacodinàmia de rupatadina 1mg / ml solució oral. Per a tal propòsit es va desenvolupar un model farmacocinètic poblacional a partir de dades disponibles a nens de 6 a 11 anys emprant el programa específic NONMEM. Aquest model es va utilitzar per determinar la dosi i el disseny d'extracció de les mostres farmacocinètiques, és a dir, el mínim de mostres necessàries, així com els punts temporals d'extracció de mostres de sang per a poder estudiar la farmacocinètica en nens de 2 a 5 anys. D'aquesta manera es va dissenyar i va executar l'estudi en nens de 2 a 5 anys amb la dosi i el disseny obtingut, proporcionant dades de farmacocinètica, seguretat i eficàcia. Posteriorment, es van ajuntar les dades farmacocinètiques dels dos grups d'edat pediàtrics, i es va desenvolupar un model farmacocinètic poblacional de rupatadina en nens entre 2-11 anys. A partir de les concentracions predites pel model es van calcular mitjançant mètodes no compartimentals els valors de Cmax, AUC i t1 / 2 per a ambdós grups de població pediàtrica. La farmacocinètica de rupatadina es va descriure adequadament amb un model bicompartimental amb absorció de primer ordre. La farmacocinètica de rupatadina solució oral (1mg/mL) en nens de 2 a 11 anys depèn del pes, ja que l'aclariment de rupatadina és més gran a mesura que augmenta el pes dels nens. Les dosis emprades en l'estudi clínic van mostrar que la rupatadina en aquest grup d'edat és segura i es tolera bé, i que redueix els símptomes del 5TSS als 14 i 28 dies de tractament respecte al valor basal. La informació farmacocinètica obtinguda, juntament amb les dades de seguretat i eficàcia en nens de 2 a 5 anys, han servit per plantejar una recomanació de dosi en aquest grup d'edat per al tractament de la rinitis al·lèrgica: 5 mg ≥25 kg; 2,5 mg ≥10 kg, que ha estat satisfactòriament avaluada per les agències reguladores.""Los retos éticos y prácticos en la realización de estudios clínicos en niños, ha ocasionado que no se disponga de suficientes estudios en este grupo de edad. La farmacocinética poblacional es una herramienta que puede ayudar a minimizar las dificultades que presentan este tipo de estudios, ayudando a elaborar diseños de extracción óptimos que minimicen la molestia y ayuden a la aceptación de estos estudios. El objetivo de esta tesis fue optimizar el diseño de un estudio en pacientes de 2 a 5 años con rinitis alérgica para estudiar la farmacocinética y la farmacodinamia de rupatadina 1mg/mL solución oral. Para tal propósito se desarrolló un modelo farmacocinético poblacional a partir de datos disponibles en niños de 6 a 11 años empleando el programa específico NONMEM. Este modelo se utilizó para determinar la dosis y el diseño de extracción de las muestras farmacocinéticas, es decir, el mínimo de muestras necesarias, así como los puntos temporales de extracción de muestras sanguíneas para poder estudiar la farmacocinética en niños de 2 a 5 años. De este modo se diseñó y ejecutó el estudio en niños de 2 a 5 años con la dosis y el diseño obtenido, proporcionando datos de farmacocinética, seguridad y eficacia. Posteriormente, se juntaron los datos farmacocinéticos de los dos grupos de edad pediátricos, y se desarrolló un modelo farmacocinético poblacional de rupatadina en niños entre 2-11 años. A partir de las concentraciones predichas por el modelo se calcularon mediante métodos no compartimentales los valores de Cmax, AUC y t1/2 para ambos grupos de población pediátrica. La farmacocinética de rupatadina se describió adecuadamente con un modelo bicompartimental con absorción de primer orden. La farmacocinética de rupatadina solución oral (1mg/mL) en niños de 2 a 11 años depende del peso, ya que el aclaramiento de rupatadina es mayor a medida que aumenta el peso de los niños. Las dosis empleadas en el estudio clínico mostraron que la rupatadina en este grupo de edad es segura y se tolera bien, y que reduce los síntomas del 5TSS a los 14 y 28 días de tratamiento respecto al valor basal.La información farmacocinética obtenida, junto con los datos de seguridad y eficacia en niños de 2 a 5 años, han servido para plantear una recomendación de dosis en este grupo de edad para el tratamiento de la rinitis alérgica: 5 mg ≥25 kg; 2,5 mg ≥10 kg, que ha sido satisfactoriamente evaluada por las agencias regulatorias."The ethical and practical challenges in conducting clinical studies in children, has caused that there are not enough studies available in this age group. Population pharmacokinetics is a tool that can help minimize the difficulties presented by these types of studies, helping to develop optimal sample extraction designs that minimize discomfort and help the acceptance of these studies. The objective of this thesis was to optimize the design of a study in patients aged 2 to 5 years with allergic rhinitis to study the pharmacokinetics and pharmacodynamics of rupatadine 1mg/mL oral solution. For this purpose, a population pharmacokinetic model was developed based on data available in children aged 6 to 11 years using the specific NONMEM program. This model was used to determine the dose and design of the extraction of pharmacokinetic samples, that is, the minimum number of samples needed, as well as the time points of blood sample collection to be able to study pharmacokinetics in children aged 2 to 5 years. In this way, the study was designed and executed in children aged 2 to 5 years with the dose and design obtained, providing data on pharmacokinetics, safety and efficacy. Subsequently, the pharmacokinetic data of the two pediatric age groups were collected, and a population pharmacokinetic model of rupatadine was developed in children aged 2-11 years. From the concentrations predicted by the model, the values ​​of Cmax, AUC and t1/2 for both pediatric population groups were calculated using non-compartmental methods. The pharmacokinetics of rupatadine were adequately described with a two-compartment model with first-order absorption. The pharmacokinetics of rupatadine oral solution (1mg / mL) in children aged 2 to 11 years depend on weight, since the clearance of rupatadine is greater as the weight of children increases. The doses used in the clinical study showed that rupatadine in this group of age is safe and well tolerated, and that it reduces the symptoms of 5TSS at 14 and 28 days of treatment with respect to baseline. The pharmacokinetic information obtained, together with safety and efficacy data in children aged 2 to 5 years have served to propose a dose recommendation in this age group for the treatment of allergic rhinitis: 5 mg ≥25 kg; 2.5 mg ≥10 kg, which has been satisfactorily evaluated by regulatory agencies

Estrategia de desarrollo de rupatadina solución oral en niños de 2 a 5 años con rinitis alérgica: la farmacocinética poblacional como herramienta para la optimización del diseño de ensayos clínicos /

Departament responsable de la tesi: Departament de Farmacologia, de Terapèutica i de Toxicologia."Els reptes ètics i pràctics en la realització d'estudis clínics en nens, ha ocasionat que no es disposi de suficients estudis en aquest grup d'edat. La farmacocinètica poblacional és una eina que pot ajudar a minimitzar les dificultats que presenten aquest tipus d'estudis, ajudant a elaborar dissenys d'extracció òptims que minimitzin la molèstia i ajudin a l'acceptació d'aquests estudis.L'objectiu d'aquesta tesi va ser optimitzar el disseny d'un estudi en pacients de 2 a 5 anys amb rinitis al·lèrgica per estudiar la farmacocinètica i la farmacodinàmia de rupatadina 1mg / ml solució oral.Per a tal propòsit es va desenvolupar un model farmacocinètic poblacional a partir de dades disponibles a nens de 6 a 11 anys emprant el programa específic NONMEM. Aquest model es va utilitzar per determinar la dosi i el disseny d'extracció de les mostres farmacocinètiques, és a dir, el mínim de mostres necessàries, així com els punts temporals d'extracció de mostres de sang per a poder estudiar la farmacocinètica en nens de 2 a 5 anys. D'aquesta manera es va dissenyar i va executar l'estudi en nens de 2 a 5 anys amb la dosi i el disseny obtingut, proporcionant dades de farmacocinètica, seguretat i eficàcia.Posteriorment, es van ajuntar les dades farmacocinètiques dels dos grups d'edat pediàtrics, i es va desenvolupar un model farmacocinètic poblacional de rupatadina en nens entre 2-11 anys. A partir de les concentracions predites pel model es van calcular mitjançant mètodes no compartimentals els valors de Cmax, AUC i t1 / 2 per a ambdós grups de població pediàtrica.La farmacocinètica de rupatadina es va descriure adequadament amb un model bicompartimental amb absorció de primer ordre. La farmacocinètica de rupatadina solució oral (1mg/mL) en nens de 2 a 11 anys depèn del pes, ja que l'aclariment de rupatadina és més gran a mesura que augmenta el pes dels nens. Les dosis emprades en l'estudi clínic van mostrar que la rupatadina en aquest grup d'edat és segura i es tolera bé, i que redueix els símptomes del 5TSS als 14 i 28 dies de tractament respecte al valor basal. La informació farmacocinètica obtinguda, juntament amb les dades de seguretat i eficàcia en nens de 2 a 5 anys, han servit per plantejar una recomanació de dosi en aquest grup d'edat per al tractament de la rinitis al·lèrgica: 5 mg ≥25 kg; 2,5 mg ≥10 kg, que ha estat satisfactòriament avaluada per les agències reguladores.""Los retos éticos y prácticos en la realización de estudios clínicos en niños, ha ocasionado que no se disponga de suficientes estudios en este grupo de edad. La farmacocinética poblacional es una herramienta que puede ayudar a minimizar las dificultades que presentan este tipo de estudios, ayudando a elaborar diseños de extracción óptimos que minimicen la molestia y ayuden a la aceptación de estos estudios. El objetivo de esta tesis fue optimizar el diseño de un estudio en pacientes de 2 a 5 años con rinitis alérgica para estudiar la farmacocinética y la farmacodinamia de rupatadina 1mg/mL solución oral. Para tal propósito se desarrolló un modelo farmacocinético poblacional a partir de datos disponibles en niños de 6 a 11 años empleando el programa específico NONMEM. Este modelo se utilizó para determinar la dosis y el diseño de extracción de las muestras farmacocinéticas, es decir, el mínimo de muestras necesarias, así como los puntos temporales de extracción de muestras sanguíneas para poder estudiar la farmacocinética en niños de 2 a 5 años. De este modo se diseñó y ejecutó el estudio en niños de 2 a 5 años con la dosis y el diseño obtenido, proporcionando datos de farmacocinética, seguridad y eficacia. Posteriormente, se juntaron los datos farmacocinéticos de los dos grupos de edad pediátricos, y se desarrolló un modelo farmacocinético poblacional de rupatadina en niños entre 2-11 años. A partir de las concentraciones predichas por el modelo se calcularon mediante métodos no compartimentales los valores de Cmax, AUC y t1/2 para ambos grupos de población pediátrica. La farmacocinética de rupatadina se describió adecuadamente con un modelo bicompartimental con absorción de primer orden. La farmacocinética de rupatadina solución oral (1mg/mL) en niños de 2 a 11 años depende del peso, ya que el aclaramiento de rupatadina es mayor a medida que aumenta el peso de los niños. Las dosis empleadas en el estudio clínico mostraron que la rupatadina en este grupo de edad es segura y se tolera bien, y que reduce los síntomas del 5TSS a los 14 y 28 días de tratamiento respecto al valor basal.La información farmacocinética obtenida, junto con los datos de seguridad y eficacia en niños de 2 a 5 años, han servido para plantear una recomendación de dosis en este grupo de edad para el tratamiento de la rinitis alérgica: 5 mg ≥25 kg; 2,5 mg ≥10 kg, que ha sido satisfactoriamente evaluada por las agencias regulatorias."The ethical and practical challenges in conducting clinical studies in children, has caused that there are not enough studies available in this age group. Population pharmacokinetics is a tool that can help minimize the difficulties presented by these types of studies, helping to develop optimal sample extraction designs that minimize discomfort and help the acceptance of these studies. The objective of this thesis was to optimize the design of a study in patients aged 2 to 5 years with allergic rhinitis to study the pharmacokinetics and pharmacodynamics of rupatadine 1mg/mL oral solution. For this purpose, a population pharmacokinetic model was developed based on data available in children aged 6 to 11 years using the specific NONMEM program. This model was used to determine the dose and design of the extraction of pharmacokinetic samples, that is, the minimum number of samples needed, as well as the time points of blood sample collection to be able to study pharmacokinetics in children aged 2 to 5 years. In this way, the study was designed and executed in children aged 2 to 5 years with the dose and design obtained, providing data on pharmacokinetics, safety and efficacy. Subsequently, the pharmacokinetic data of the two pediatric age groups were collected, and a population pharmacokinetic model of rupatadine was developed in children aged 2-11 years. From the concentrations predicted by the model, the values ​​of Cmax, AUC and t1/2 for both pediatric population groups were calculated using non-compartmental methods. The pharmacokinetics of rupatadine were adequately described with a two-compartment model with first-order absorption. The pharmacokinetics of rupatadine oral solution (1mg / mL) in children aged 2 to 11 years depend on weight, since the clearance of rupatadine is greater as the weight of children increases. The doses used in the clinical study showed that rupatadine in this group of age is safe and well tolerated, and that it reduces the symptoms of 5TSS at 14 and 28 days of treatment with respect to baseline. The pharmacokinetic information obtained, together with safety and efficacy data in children aged 2 to 5 years have served to propose a dose recommendation in this age group for the treatment of allergic rhinitis: 5 mg ≥25 kg; 2.5 mg ≥10 kg, which has been satisfactorily evaluated by regulatory agencies

Formació en competències bàsiques de persones adultes: la diversitat a l’aula 1. Relats de classe, retalls de vida (I)

Podeu consultar la versió en castellà a: http://hdl.handle.net/2445/33526En qualsevol aula, sigui d’infants, de joves o de persones adultes, tots els alumnes són diferents, amb les seves peculiaritats a l’hora d’aprendre i amb tot un bagatge de sabers (coneixements, saber fer i saber estar) acumulats al llarg de la seva trajectòria vital; per tant, trobem diferències notables (lògiques i necessàries) entre uns i altres. Però mentre hi ha una abundant literatura sobre el treball de les diferències a l’aula en primària i secundària, és a dir, en la infància i l’adolescència, no és fàcil trobar reflexions i pràctiques sistematitzades o bones pràctiques sobre la gestió de les diferències en els cursos o tallers destinats a persones adultes. La bibliografia és molt reduïda, les poques revistes especialitzades contenen nombrosos articles que reflexionen sobre la diversitat des de diferents angles, però amb poques descripcions de recursos o limitats a aspectes molt concrets. Per aquesta raó, un grup de professionals de la formació de persones adultes, des de pràctiques i camps molt diversos —aprenentatge del català per a adults, escoles d’adults, centres cívics, centres penitenciaris o entitats del tercer sector—, però amb aquesta realitat compartida, hem posat en comú les experiències que hem dut a terme en el nostre treball a l’aula o a qualsevol espai educatiu, per tal de pensar-hi, veure’n els clarobscurs i que aquestes reflexions i relats serveixin per compartir-les amb altres companys..

Formación en competencias básicas de personas adultas: la diversidad en el aula 1. Relatos de clase, retazos de vida (I)

[Grup de treball]: Xavier Aranda, Mònica Díaz, Alfons Formariz (coord), Marta Martínez, Bep Masdeu, Natàlia Núñez, Isis Sáinz. [Relats]: Xavier Aranda, Eva Bayarri, Bea Boneu, Mònica Díaz, Alfons Formariz, Gabriel González, Emma Guasch, César Herranz, Marta Martínez, Bep Masdeu, Elisabet Moreras, Natàlia Núñez, Isis SainzPodeu consultar la versió en català a: http://hdl.handle.net/2445/33525En cualquier aula, sea de niños, de jóvenes o de personas adultas, todos los alumnos son diferentes, con sus peculiaridades a la hora de aprender y con todo un bagaje de saberes (conocimientos, saber hacer y saber estar) acumulados a lo largo de su trayectoria vital; por lo tanto, encontramos diferencias notables (lógicas y necesarias) entre unos y otros. Pero mientras hay una abundante literatura sobre el trato de las diferencias en las aulas de primaria y secundaria, es decir, en la infancia y la adolescencia, no es fácil encontrar reflexiones y prácticas sistematizadas o buenas prácticas sobre la gestión de las diferencias en los cursos o talleres destinados a personas adultas. La bibliografía es muy reducida, las pocas revistas especializadas contienen numerosos artículos que reflexionan sobre la diversidad desde diferentes ángulos, pero con pocas descripciones de recursos o limitadas a aspectos muy concretos. Por esta razón, un grupo de profesionales de la formación de personas adultas, desde prácticas y campos muy variados —escuelas de adultos, centros cívicos, aprendizaje de catalán para adultos, centros penitenciarios o entidades del tercer sector—, pero con esta realidad compartida, hemos puesto en común las experiencias que hemos llevado a cabo en nuestro trabajo en el aula o en cualquier espacio educativo, para reflexionar sobre nuestra práctica, ver sus claroscuros y que estas reflexiones y relatos sirvan para compartirlos con otros compañeros

Trends in the Epidemiology of Leishmaniasis in the City of Barcelona (1996–2019)

Background: Leishmaniasis is a neglected zoonosis produced by 20 different flagellated parasites of the Leishmania genus, a protozoan transmitted to humans and other vertebrates by the bite of dipteran insects of the Phlebotominae subfamily. It is endemic in Mediterranean countries and the number of cases is expected to increase due to climate change and migration. Prioritizing public health interventions for prevention and control is essential. The objective was to characterize the epidemiology and temporal trends in the incidence of human leishmaniasis in the city of Barcelona, between the years 1996 and 2019. Methods: A population-based, analytical observational study among residents in the city of Barcelona was conducted of all the cases of leishmaniasis reported between 1996 and 2019 to the Public Health Agency. The epidemiological survey contains clinical, diagnostic, and epidemiological data, including contact with suspicious mammals or insects. Annual incidence-rates were calculated by sex, age, and country of origin. Chi-square tests were used to assess association between studied risk factors, periods of time and type of leishmaniasis. Results: During the study period a total of 177 cases of leishmaniasis were reported in Barcelona, being 74.6% (n = 132) of the total cases in Spanish born, although within the foreign-born population the incidence was higher. Median age was 34 years (IQR = 10–48) and 121 (66.8%) weremale. The main type was cutaneous (46%) followed by visceral (35.1%). The cumulative incidence was 0.47 per 100,000 inhabitants, with the highest incidence found in 2017 (1.60 per 100,000 inhabitants). A higher incidence was observed in the 0–4-year-old group (1.73 per 100,000 inhabitants), but increased during the study period for all age groups. There was an increase of foreign origin cases, and a decrease in the number of cases associated to any immunosuppression. Conclusion: In Barcelona, leishmaniasis incidence continues to be higher in people under 5 years of age, and 25–64 years old males, but it has also increased in population from foreign country of birth. There is an increase of the cases since 2016, probably due to the changes in the notification system, increasing the diagnosis of cutaneous leishmaniasis. Improvements in the current surveillance system are needed. Notification of the disease, vector, and reservoir control activities are also essential for the control of the disease.Peer reviewe

Merging Field and High-Resolution Satellite Chlorophyll Data in Mediterranean Coastal Waters: Setbacks and Benefits

med 2018, 11-12 December 2018, Frascati, Rome, ItalyIn addition to their ecological and environmental value, coastal areas are of major economic and social importance. Therefore, they are one of the marine environments most affected by anthropogenic pressures, in the form of high population densities and intense human activities. Anthropogenic pressures produce an excess of nutrients which are delivered to coastal waters, triggering phytoplanktonic growth and the eutrophication process, thus decreasing water quality. Several policies have been enacted in Europe with the aim of restoring and protecting waters, such as the Water Framework Directive (WFD; 2000/60/EC) and the Marine Strategy Framework Directive (MSFD; 2000/60/EC). This aim involves combatting the negative effects of eutrophication, which necessitates the assessment of its impact through chlorophyll-a concentration. Until now, these assessments have been based mainly on field data. However, satellite data of the new generation high-resolution missions are now readily available, such as that of Sentinel-2 (10-60m) of the European Space Agency. Therefore, an opportunity is given to assimilate field and satellite data to model the structure and functioning of coastal waters. Our aim is to set up an operational system for monitoring the quality of coastal waters based on the synergy between satellite observations and in situ data. As a first step to achieve it, we present here a case study from the Catalan coast, which is representative of the NW Mediterranean coast. In this area, under the National Catalan Coastal Water Monitoring Program, chlorophyll-a concentration is sampled monthly or quarterly at 268 stations, located along 400km of coastline and at three distances from the shore (0, 1000 and 5000m). The objective of this study is to merge this field data with the same kind of data provided by Sentinel-2. Specifically, we are interested to check whether the data from these two sources 1) agree between them from 2015 to 2018, and 2) can be assimilated into a regional model. The main setbacks to be solved in this case study are related to the higher spatial variability of Mediterranean coastal waters compared with other coastal areas due to their specific characteristics. This variability is intensified near the coastline (<500m from the shore), where the chlorophyll algorithm should be adjusted for turbid and clear neighbouring areas and corrected for sea bottom interferences, especially sea grasses and macro algae. Results will allow us to 1) improve the scientific knowledge regarding the structure and functioning of the Catalan coastal zone, 2) provide an improved assessment of eutrophication for this area, and 3) suggest recommendations related to the zone¿s management. At the same time, the findings will be useful for fulfilling the requirements of the WFD, in relation with the Biological Quality Element Phytoplankton, and of the MSFD, in relation with the Descriptor 5 - Eutrophication. Therefore, these results will be very valuable for the involved administrations: the Catalan Water Agency, the Spanish Environmental Ministry and the European Commission. Future work will provide chlorophyll maps of the Catalan coast in an operational way and extend the procedure to provide full coverage of Mediterranean coastal watersPeer Reviewe