La miopatia de captura també afecta als sisons

La miopatia de captura causa lesions musculars molt greus als mamífers i a algunes aus salvatges, com a conseqüència de l'estrès que pateixen en veure's capturats. Un equip d'investigadors ha descrit ara per primera vegada aquesta malaltia en el sisó, un ocell present a les planes de Lleida, al qual han estudiat durant dos anys.La miopatía de captura causa lesiones musculares muy graves a losmamíferos y aves salvajes, como consecuencia del estrés que sufren alverse capturados. Un equipo de investigadores ha descrito ahora porprimera vez esta enfermedad en un sisón, un ave presente en lasplanicies de Lérida, al cual han estudiado durante dos año

Capture Myopathy in Little Bustards after Trapping and Marking

Four little bustards (Tetrax tetrax) (one adult and three juvenile males), captured with leg nooses and fitted with a backpack radiotag, died after capture. The first bird was found after 16 days with its left foot caught in the harness and died after 1 day. The other birds showed symptoms of capture myopathy after release, such as the difficulty or inability to fly and/or walk. They died after 5, 6, and 8 days, respectively. At necropsy, muscles affected in all cases were those from the legs, and these were diffusely pale and dull, with a soft friable texture. Microscopically these muscles had multiple foci of myofiber fragmentation, loss of striation, and necrosis; a mononuclear cell infiltrate was observed in muscle from two birds. These findings suggest the little bustard is susceptible to capture myopathy and that caution should be exercised during its capture and handling

Statins and new-onset atrial fibrillation in a cohort of patients with hypertension: analysis of electronic health records, 2006-2015

Atrial Fibrillation; Electronic Health Records; HypertensionFibrilación atrial; Registros Electrónicos de Salud; HipertensiónFibril·lació atrial ; Registres Electrònics de Salut; HipertensióHypertension is the most prevalent risk factor for new-onset atrial fibrillation (AF). But few studies have addressed the effect of statins on the incidence of this arrhythmia in patients with hypertension. This study aimed to evaluate the effect of statins on new-onset of this arrhythmia in a hypertensive population, accounting for AF risk. Data from the Information System for the Development of Research in Primary Care was used to recruit a retrospective cohort of ≥55-year-old hypertensive individuals with no ischemic vascular disease, in 2006-2007, followed up through 2015. The effect of initiating statin treatment on new-onset atrial fibrillation was assessed with Cox proportional hazards models adjusted by the propensity score of receiving statin treatment, in the overall study population and stratified by AF risk. Of 100 276 included participants, 9814 initiated statin treatment. The AF incidence per 1000 person-years (95% confidence interval) was 12.5 (12.3-12.8). Statin use associated with a significant (9%) reduction in AF incidence. Differences in absolute AF incidence were higher in the highest AF risk subgroup, and the estimated number needed to treat to avoid one case was 720. The relative effect was poor, similar across groups, and non-significant, as was the association of statins with adverse effects. We found a limited protective effect of statins over new-onset AF in this hypertensive population with no ischemic vascular disease. If there is no further indication, hypertensive patients would not benefit from statin use solely for AF primary prevention

What outcomes are important to patients with mild cognitive impairment or Alzheimer's disease, their caregivers, and health-care professionals? A systematic review

Introduction: Clinical trials involving patients with Alzheimer’s disease (AD) continue to try to identify disease-modifying treatments. Although trials are designed to meet regulatory and registration requirements, many do not measure outcomes of the disease most relevant to key stakeholders. Methods: A systematic review sought research that elicited information from people with AD, their caregivers, and health-care professionals on which outcomes of the disease were important. Studies published in any language between 2008 and 2017 were included. Results: Participants in 34 studies described 32 outcomes of AD. These included clinical (memory, mental health), practical (ability to undertake activities of daily living, access to health information), and personal (desire for patient autonomy, maintenance of identity) outcomes of the disease. Discussion: Evidence elicited directly from the people most affected by AD reveals a range of disease outcomes that are relevant to them but are not commonly captured in clinical trials of new treatments.</br

Real-world evidence in Alzheimer’s disease: the ROADMAP Data Cube

INTRODUCTION:The ROADMAP project aimed to provide an integrated overview of European real-world data on Alzheimer's disease (AD) across the disease spectrum. METHODS:Metadata were identified from data sources in catalogs of European AD projects. Priority outcomes for different stakeholders were identified through systematic literature review, patient and public consultations, and stakeholder surveys. RESULTS:Information about 66 data sources and 13 outcome domains were integrated into a Data Cube. Gap analysis identified cognitive ability, functional ability/independence, behavioral/neuropsychiatric symptoms, treatment, comorbidities, and mortality as the outcomes collected most. Data were most lacking in caregiver-related outcomes. In general, electronic health records covered a broader, less detailed data spectrum than research cohorts. DISCUSSION:This integrated real-world AD data overview provides an intuitive visual model that facilitates initial assessment and identification of gaps in relevant outcomes data to inform future prospective data collection and matching of data sources and outcomes against research protocols

Individuals With SARS-CoV-2 Infection During the First and Second Waves in Catalonia, Spain: Retrospective Observational Study Using Daily Updated Data

Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Epidemiologia; ComparacióCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Epidemiología; ComparaciónCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Epidemiology; ComparisonA description of individuals with SARS-CoV-2 infection comparing the first and second waves could help adapt health services to manage this highly transmissible infection.Objective: We aimed to describe the epidemiology of individuals with suspected SARS-CoV-2 infection, and the characteristics of patients with a positive test comparing the first and second waves in Catalonia, Spain. Methods: This study had 2 stages. First, we analyzed daily updated data on SARS-CoV-2 infection in individuals from Girona (Catalonia). Second, we compared 2 retrospective cohorts of patients with a positive reverse-transcription polymerase chain reaction or rapid antigen test for SARS-CoV-2. The severity of patients with a positive test was defined by their admission to hospital, admission to intermediate respiratory care, admission to the intensive care unit, or death. The first wave was from March 1, 2020, to June 24, 2020, and the second wave was from June 25, 2020, to December 8, 2020.Results: The numbers of tests and cases were lower in the first wave than in the second wave (26,096 tests and 3140 cases in the first wave versus 140,332 tests and 11,800 cases in the second wave), but the percentage of positive results was higher in the first wave than in the second wave (12.0% versus 8.4%). Among individuals with a positive diagnostic test, 818 needed hospitalization in the first wave and 680 in the second; however, the percentage of hospitalized individuals was higher in the first wave than in the second wave (26.1% versus 5.8%). The group that was not admitted to hospital included older people and those with a higher percentage of comorbidities in the first wave, whereas the characteristics of the groups admitted to hospital were more alike.This work was supported by grants from the European Union ERDF funds (Network for Prevention and Health Promotion in Primary Care, RedIAPP–CARDIOCAT; RD16/0007/0004) and from the Agency for Management of University and Research Grants (AGAUR; 2017-SGR 1146). We thank Eric Tornabell for his technical support. We also thank all health care professionals for their ceaseless work to care for COVID-19 patients in this pandemic

Improving interMediAte Risk management. MARK study

<p>Abstract</p> <p>Background</p> <p>Cardiovascular risk functions fail to identify more than 50% of patients who develop cardiovascular disease. This is especially evident in the intermediate-risk patients in which clinical management becomes difficult. Our purpose is to analyze if ankle-brachial index (ABI), measures of arterial stiffness, postprandial glucose, glycosylated hemoglobin, self-measured blood pressure and presence of comorbidity are independently associated to incidence of vascular events and whether they can improve the predictive capacity of current risk equations in the intermediate-risk population.</p> <p>Methods/Design</p> <p>This project involves 3 groups belonging to REDIAPP (RETICS RD06/0018) from 3 Spanish regions. We will recruit a multicenter cohort of 2688 patients at intermediate risk (coronary risk between 5 and 15% or vascular death risk between 3-5% over 10 years) and no history of atherosclerotic disease, selected at random. We will record socio-demographic data, information on diet, physical activity, comorbidity and intermittent claudication. We will measure ABI, pulse wave velocity and cardio ankle vascular index at rest and after a light intensity exercise. Blood pressure and anthropometric data will be also recorded. We will also quantify lipids, glucose and glycosylated hemoglobin in a fasting blood sample and postprandial capillary glucose. Eighteen months after the recruitment, patients will be followed up to determine the incidence of vascular events (later follow-ups are planned at 5 and 10 years). We will analyze whether the new proposed risk factors contribute to improve the risk functions based on classic risk factors.</p> <p>Discussion</p> <p>Primary prevention of cardiovascular diseases is a priority in public health policy of developed and developing countries. The fundamental strategy consists in identifying people in a high risk situation in which preventive measures are effective and efficient. Improvement of these predictions in our country will have an immediate, clinical and welfare impact and a short term public health effect.</p> <p>Trial Registration</p> <p>Clinical Trials.gov Identifier: <a href="http://www.clinicaltrials.gov/ct2/show/NCT01428934">NCT01428934</a></p

Ús de l'espai de l'hàbitat en el sisó (Tetrax tetrax) durant el període reproductor: aspectes aplicats a la conservació en hàbitats agraris

[cat] El sisó (Tetrax tetrax) és un ocell estepari que a Europa ocupa principalment ambients agrícoles i està en declivi poblacional a causa, principalment, de la intensificació agrícola. En aquesta tesi s’analitzen aspectes poc coneguts però rellevants per a la conservació sobre l’ecologia i la biologia reproductiva de l’espècie. Primer, s’estudia l’ús de l’hàbitat i de l’espai durant el período reproductor, tant de mascles com de famílies (femelles amb polls) i, després, s’aborden aspectes metodològics sobre la captura i manipulació d’exemplars. S’ha observat que el comportament espacial en el sisó durant el período reproductor és altament variable i dependent de la qualitat de l’hàbitat. En els mascles varia de forma continua entre individus que utilitzen una àrea petita amb un únic centre d’activitat, i mascles que usen una àrea extensa amb 2-5 centres d’activitat. Els mascles tendeixen a concentrar l’àrea vital i a freqüentar hàbitats d’alta qualitat a mesura que l’edat i la posició social incrementen. En les famílies s’han observat dos patrons espacials, un de sedentari, caracteritzat per l´ús d’àrees petites amb hàbitat d’alta qualitat, i un d’erràtic, caracteritzat per l´ús d’àrees extenses, fruit de llargs desplaçaments, amb hàbitat de menor qualitat. Els resultats mostren que els guarets i els cultius de lleguminoses són hàbitats d’alta qualitat per les famílies de sisó, ja que proporcionen alimentació i refugi estable. Els resultats indiquen que els sisons (mascles o femelles) que utilitzen àrees reduïdes són més efectius de cara a la reproducció. Per tant, es pot entendre que l’ús d’àrees petites i d’hàbitat d’alta qualitat correspon a una estratègia òptima de reproducció, i l’adopció d’altres estratègies es deu possiblement a algun tipus de limitació en els recursos. Les femelles de posta més primerenca presenten patrons de moviment sedentari i un èxit reproductor més elevat que les femelles amb postes més tardanes, les quals pateixen l’enduriment de les condicions ambientals causades per la sega del cereal i l’aridesa estival, fet que les obliga a adoptar un patró erràtic. L’èxit reproductor de la població catalana de sisó durant el període 2006-2008 s’ha estimat en 0’27 polls/femella, insuficient per a garantir la viabilitat de la població. Per tal d’augmentar l’èxit reproductor del sisó en pseudoestepes cerealístiques cal implementar mesures de gestió encaminades a reduir la mortalitat dels polls per depredació o manca d’aliment. Cal incrementar la presència de guarets i marges amb vegetació herbàcia permanent o semi-permanent que actuïn com a font d’alimentació i refugi durant la cria. És també recomanable controlar l’ús d’herbicides i pesticides per tal d’afavorir l’abundància d’insectes, així com retardar la sega de cereal per reduir la pèrdua directa de nius i la mortalitat dels polls. Cal extensificar les pràctiques agrícoles i dissenyar noves fórmules que facin compatible la producció agrícola amb la preservació del sisó. En relació amb els aspectes metodològics, no existeix una tècnica de captura genèrica per al sisó, sinó que cal combinar diversos mètodes en funció del període de l’any, del sexe i de l’edat dels individus que es vulguin capturar. S’ha constatat que el sisó és especialment susceptible a patir els efectes adversos de la captura i manipulació dels exemplars, compatibles amb la miopatia de captura. El risc de desenvolupar aquests efectes adversos s’incrementa quan s’allarga el temps de manipulació, quan s’utilitzen xarxes canó i quan es capturen exemplars joves. Per a reduir el risc d’aparició d’efectes adversos es recomana minimitzar el temps de manipulació i no superar els 20 minuts per als animals adults i els 10 minuts per als joves. També prioritzar l’ús de la trampa embut per a la captura de femelles i/o polls i els llaços per a atrapar mascles reproductors.[eng] This thesis deals with the breeding biology of the little bustard Tetrax tetrax in a cereal pseudo-steppe (NE-Spain), and develops methodological issues, which could be relevant for conservation purposes. The ranging behavior on males was highly variable and was mainly determined by the availability and distribution of high-quality habitats. It was also depend on male social dominance, as males tended to reduce and concentrate their home range as age and social status increased, as indicated by the inverse association between range size and display activity. In relation to broods, we identified two main ranging patterns. Early broods concentrated their activity in relatively small areas situated in high-quality habitat, while late broods moved across wider ranges of low-quality habitat. The use of small areas was associated with successful broods. The existence of these two ranging patterns is mainly due to the timing of cereal harvesting in relation to the breeding phenology of each brood. Breeding success in the study area (0’27 chicks/female in 2006-2008) was not enough to guarantee the long term viability of the population. Hence, breeding success of little bustard populations inhabiting cereal pseudo-steppes should be a management priority. We recommend the enhancement of habitat quality, by delaying harvest when possible and by promoting the presence of fallow fields, steppe-scrubland or leguminous crops with vegetation cover during the entire breeding season, in order to increase food and shelter availability in cereal agro-systems. Our results highlight that a combination of trapping methods are needed to capture little bustards for research purposes. We recommend the use of snares to capture displaying males, funnel traps to capture females and/or medium-sized to large chicks, and hand-held nets to catch small chicks. We do not recommend capture in flocks owing to the low capture success and the high occurrence of capture-related disorders. We observed that little bustard is fairly susceptible to capture myopathy. We showed that the occurrence of such disorders could be reduced by keeping handling time below 20 minutes and by avoiding the use of cannon nets, as well as being particularly cautious when capturing or handling juveniles

Predicción de dependencia en ancianos atendidos en atención primaria = Prediction of dependency in the elderly attended in primary health care

Objective: To identify the elderly population attended in primary health care with more risk of becoming dependent for activities of daily living. Methods: A longitudinal study, based on data recorded in the medical record of people from 75 years old. We constructed a Cox models to determine the risk of becoming dependent on the follow up. The discrimination capacity of the model was estimated with the concordance index. Results: The model showed as predictors of dependency: the mental impairment, according to the Pfeiffer test, severe (HR: 3,02; 95% CI 2,03-4,49) or moderate (HR: 1,35; 95% CI 1,08 to 1,68), homecare situation (HR: 1,82; 95% CI 1,44 to 2,31) and to have recorded history of falls (HR: 1,51; 95% CI 1,20 to 1,90). The C index of the derivation model was 0,72 (95% CI 0,68 to 0,76). Conclusions: The model accurately predicts patients most likely to be dependentObjetivo principal: Identificar a la población anciana atendida en atención primaria con más riesgo de ser dependiente para las actividades de la vida diaria. Metodología: estudio longitudinal, basado en datos registrados en la historia clínica informatizada de personas a partir de 75 años. Se construyó un modelo de Cox para determinar el riesgo de devenir dependiente en el seguimiento y se estimó su capacidad de discriminación. Resultados principales: el modelo mostró como variables predictoras de dependencia el deterioro mental severo (HR: 3,02; 95% IC 2,03-4,49) o moderado (HR: 1,35; 95% IC 1,08-1,68) según el test de Pfeiffer, tener la condición de atención domiciliaria (HR: 1,82; 95% IC 1,44-2,31) y tener historia de caídas registradas (HR: 1,51; 95% IC 1,20-1,90). El índice C del modelo fue de 0,72 (95% IC 0,68-0,76). Conclusión principal: El modelo predice de forma precisa aquellos pacientes con más probabilidad de ser dependiente