BODE-Index vs HADO-Score in Chronic Obstructive Pulmonary Disease: Which one to use in general practice?

<p>Abstract</p> <p>Background</p> <p>Forced expiratory volume in one second (FEV₁) is used to diagnose and establish a prognosis in chronic obstructive pulmonary disease (COPD). Using multi-dimensional scores improves this predictive capacity.Two instruments, the BODE-index (<b>B</b>ody mass index, <b>O</b>bstruction, <b>D</b>yspnea, <b>E</b>xercise capacity) and the HADO-score (<b>H</b>ealth, <b>A</b>ctivity, <b>D</b>yspnea, <b>O</b>bstruction), were compared in the prediction of mortality among COPD patients.</p> <p>Methods</p> <p>This is a prospective longitudinal study. During one year (2003 to 2004), 543 consecutively COPD patients were recruited in five outpatient clinics and followed for three years. The endpoints were all-causes and respiratory mortality.</p> <p>Results</p> <p>In the multivariate analysis of patients with FEV₁< 50%, no significant differences were observed in all-cause or respiratory mortality across HADO categories, while significant differences were observed between patients with a lower BODE (less severe disease) and those with a higher BODE (greater severity). Among patients with FEV₁≥ 50%, statistically significant differences were observed across HADO categories for all-cause and respiratory mortality, while differences were observed across BODE categories only in all-cause mortality.</p> <p>Conclusions</p> <p>HADO-score and BODE-index were good predictors of all-cause and respiratory mortality in the entire cohort. In patients with severe COPD (FEV₁< 50%) the BODE index was a better predictor of mortality whereas in patients with mild or moderate COPD (FEV₁≥ 50%), the HADO-score was as good a predictor of respiratory mortality as the BODE-index. These differences suggest that the HADO-score and BODE-index could be used for different patient populations and at different healthcare levels, but can be used complementarily.</p

Metabolomic-Based Noninvasive Serum Test to Diagnose Nonalcoholic Steatohepatitis: Results From Discovery and Validation Cohorts

Nonalcoholic fatty liver disease (NAFLD) is the most common type of chronic liver disease worldwide and includes a broad spectrum of histologic phenotypes, ranging from simple hepatic steatosis or nonalcoholic fatty liver (NAFL) to nonalcoholic steatohepatitis (NASH). While liver biopsy is the reference gold standard for NAFLD diagnosis and staging, it has limitations due to its sampling variability, invasive nature, and high cost. Thus, there is a need for noninvasive biomarkers that are robust, reliable, and cost effective. In this study, we measured 540 lipids and amino acids in serum samples from biopsy-proven subjects with normal liver (NL), NAFL, and NASH. Using logistic regression analysis, we identified two panels of triglycerides that could first discriminate between NAFLD and NL and second between NASH and NAFL. These noninvasive tests were compared to blinded histology as a reference standard. We performed these tests in an original cohort of 467 patients with NAFLD (90 NL, 246 NAFL, and 131 NASH) that was subsequently validated in a separate cohort of 192 patients (7 NL, 109 NAFL, 76 NASH). The diagnostic performances of the validated tests showed an area under the receiver operating characteristic curve, sensitivity, and specificity of 0.88 +/- 0.05, 0.94, and 0.57, respectively, for the discrimination between NAFLD and NL and 0.79 +/- 0.04, 0.70, and 0.81, respectively, for the discrimination between NASH and NAFL. When the analysis was performed excluding patients with glucose levels >136 mg/dL, the area under the receiver operating characteristic curve for the discrimination between NASH and NAFL increased to 0.81 +/- 0.04 with sensitivity and specificity of 0.73 and 0.80, respectively. Conclusion: The assessed noninvasive lipidomic serum tests distinguish between NAFLD and NL and between NASH and NAFL with high accuracy.Supported by the National Institutes of Health Blueprint for Neuroscience Research (R01AT001576 to S.C.L., J.M.M.), Agencia Estatal de Investigacion of the Ministerio de Economia, Industria y Competitividad (SAF2014-52097R to J.M.M.), CIBER Hepatic and Digestive Diseases and Instituto de Salud Carlos III (PIE14/0003 to J.M.M.), Etorgai 2015-Gobierno Vasco (ER-2015/00015 to R.M., I.M.A., C.A., A.C.), Plan de Promocion de la Innovacion 2015-Diputacion Foral de Bizkaia (6/12/IN/2015/00131 to A.C., C.A.), National Institute of Diabetes and Digestive and Kidney Diseases (RO1DK81410 to A.J.S.), and Czech Ministry of Health (RVO VFN64165 to L.V.)

All-cause mortality in the cohorts of the Spanish AIDS Research Network (RIS) compared with the general population: 1997Ł2010

Abstract Background: Combination antiretroviral therapy (cART) has produced significant changes in mortality of HIVinfected persons. Our objective was to estimate mortality rates, standardized mortality ratios and excess mortality rates of cohorts of the AIDS Research Network (RIS) (CoRIS-MD and CoRIS) compared to the general population. Methods: We analysed data of CoRIS-MD and CoRIS cohorts from 1997 to 2010. We calculated: (i) all-cause mortality rates, (ii) standardized mortality ratio (SMR) and (iii) excess mortality rates for both cohort for 100 personyears (py) of follow-up, comparing all-cause mortality with that of the general population of similar age and gender. Results: Between 1997 and 2010, 8,214 HIV positive subjects were included, 2,453 (29.9%) in CoRIS-MD and 5,761 (70.1%) in CoRIS and 294 deaths were registered. All-cause mortality rate was 1.02 (95% CI 0.91-1.15) per 100 py, SMR was 6.8 (95% CI 5.9-7.9) and excess mortality rate was 0.8 (95% CI 0.7-0.9) per 100 py. Mortality was higher in patients with AIDS, hepatitis C virus (HCV) co-infection, and those from CoRIS-MD cohort (1997. Conclusion: Mortality among HIV-positive persons remains higher than that of the general population of similar age and sex, with significant differences depending on the history of AIDS or HCV coinfection

Effect of reafforestation by coniferes in natural biotopes of middle and south Navarra (Northern Spain)

Volume: 94Start Page: 491End Page: 50

Formación y sensibilización de familias en la prevención de drogodependencias : tercer nivel

Trabajo realizado por varios profesores del Departamento de Ciencias de la Educación de la Universidad de Burgos. Las unidades didácticas que lo componen van dirigidas a un curso para padres y madres sobre prevención de drogodependencias en la familia que se llevó a cabo durante los cursos 1999-2000 y 2000-2001 en varios institutos de enseñanza secundaria públicos y concertados de Burgos. El objetivo de este tercera fase busca ejercitar de forma activa los procedimientos planteados en las dos primeras con el fin de proveer a los padres de respuestas adecuadas ante situaciones de interacción comunes.Ayuntamiento de BurgosCastilla y LeónES

Formación y sensibilización de familias en la prevención de drogodependencias : segundo nivel

Trabajo realizado por varios profesores del Departamento de Ciencias de la Educación de la Universidad de Burgos. Las unidades didácticas que lo componen van dirigidas a un curso para padres y madres sobre prevención de drogodependencias en la familia que se llevó a cabo durante los cursos 1999-2000 y 2000-2001 en varios institutos de enseñanza secundaria públicos y concertados de Burgos. Los objetivos son: destacar la importancia de la construcción de una autoestima positiva como elemento preventivo ante la presión de algunos entornos sociales; estudiar los componentes que intervienen en la comunicación y las técnicas de mayor utilidad para favorecerla; apreciar el papel de la comunicación en el seno de la familia para conocer cómo evolucionan los hijos y valorar la importancia de construir y mantener un canal de comunicación eficaz que permita ayudar a los hijos en todo tipo de circunstancias, especialmente las más graves; responsabilizarse del clima familiar y aceptar el papel de modelos de relación que los padres ejercen tanto cuando asumen esta función y la planifican de forma consciente como cuando actúan espontáneamente siguiendo pautas que aprendieron de sus propios padres. Trabajo no publicado.Ayuntamiento de BurgosCastilla y LeónES

Una experiencia en proyectos europeos de ámbito educativo

Resumen basado en el de los autoresParticipan en el proyecto las Universidades del País Vasco, Perugia, Klaipeda, Gazi, y PitestiSe presenta un proyecto otorgado bajo la convocatoria Erasmus + KA2, más específicamente "Cooperación para la innovación y el intercambio de buenas prácticas". Un total de cinco universidades de Turquía, España, Lituania, Rumania e Italia están involucradas en el proyecto, que tiene una duración de 3 años y cuenta con profesores y estudiantes de todos los niveles (es decir, Grado, Máster y Doctorado) en el ámbito de las energías renovables desde diferentes puntos de vista, centrándose en temas correspondientes a los principales intereses de los socios.ES