Novedades corológicas y nomenclaturales para la flora vascular de la Sierra de Gredos (Sistema Central), III

In the present paper we present the floristic novelties for the flora of the Sierra de Gredos resulting from the explorations of these mountains and that, mostly, are the result of the field trips of the year 2021. We present 31 chorological novelties, among which we highlight the finding in the Community of Madrid of the restricted endemic Iberodes brassicifolia (Lag.) M. Serrano, R. Carbajal & S. Ortiz. Also relevant are Herniaria hirsuta L., Rosa glauca Pourr. (new for the Spanish Central System) and Rosa coriifolia Fr. (new for Extremadura and the whole of the Sierra de Gredos), as well as Soliva sessilisRuiz & Pav., Trifolium vesiculosumSavi (new for Castilla y León) and Lepidium villarsii Gren. & Godr. subsp. villarsii (new for the Sierra de Gredos). Finally, two new nomenclatural combinations are made in the genus Tephroseris (Rchb.) Rchb.: Tephroseris balbisiana (DC.) Holub subsp. coincy (Rouy) P. Vargas & Luceño, endemic to Gredos range, and Tephroseris balbisiana subsp. elodes (Boiss. ex DC.) P. Vargas & Luceño, endemic to Sierra Nevada

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Spatiotemporal Characteristics of the Largest HIV-1 CRF02_AG Outbreak in Spain: Evidence for Onward Transmissions

Background and Aim: The circulating recombinant form 02_AG (CRF02_AG) is the predominant clade among the human immunodeficiency virus type-1 (HIV-1) non-Bs with a prevalence of 5.97% (95% Confidence Interval-CI: 5.41–6.57%) across Spain. Our aim was to estimate the levels of regional clustering for CRF02_AG and the spatiotemporal characteristics of the largest CRF02_AG subepidemic in Spain.Methods: We studied 396 CRF02_AG sequences obtained from HIV-1 diagnosed patients during 2000–2014 from 10 autonomous communities of Spain. Phylogenetic analysis was performed on the 391 CRF02_AG sequences along with all globally sampled CRF02_AG sequences (N = 3,302) as references. Phylodynamic and phylogeographic analysis was performed to the largest CRF02_AG monophyletic cluster by a Bayesian method in BEAST v1.8.0 and by reconstructing ancestral states using the criterion of parsimony in Mesquite v3.4, respectively.Results: The HIV-1 CRF02_AG prevalence differed across Spanish autonomous communities we sampled from (p &lt; 0.001). Phylogenetic analysis revealed that 52.7% of the CRF02_AG sequences formed 56 monophyletic clusters, with a range of 2–79 sequences. The CRF02_AG regional dispersal differed across Spain (p = 0.003), as suggested by monophyletic clustering. For the largest monophyletic cluster (subepidemic) (N = 79), 49.4% of the clustered sequences originated from Madrid, while most sequences (51.9%) had been obtained from men having sex with men (MSM). Molecular clock analysis suggested that the origin (tMRCA) of the CRF02_AG subepidemic was in 2002 (median estimate; 95% Highest Posterior Density-HPD interval: 1999–2004). Additionally, we found significant clustering within the CRF02_AG subepidemic according to the ethnic origin.Conclusion: CRF02_AG has been introduced as a result of multiple introductions in Spain, following regional dispersal in several cases. We showed that CRF02_AG transmissions were mostly due to regional dispersal in Spain. The hot-spot for the largest CRF02_AG regional subepidemic in Spain was in Madrid associated with MSM transmission risk group. The existence of subepidemics suggest that several spillovers occurred from Madrid to other areas. CRF02_AG sequences from Hispanics were clustered in a separate subclade suggesting no linkage between the local and Hispanic subepidemics

Confirmation of Carex pseudobrizoides Clavaud (Cyperaceae) in the Iberian Peninsula and other contributions to the knowledge of the iberian Carex

This article shows some contributions to the knowledge of the genus Carex (Cyperaceae) in the Iberian Peninsula. Among them we highlight the confirmation of C. pseudobrizoides Clavaud for the Iberian Peninsula (Basque Country). The results of the morphological study carried out to differentiate this species from the closely related C. brizoides L., also present in the territory, are showed. A map of the Iberian distribution of C. praecox Schreb. is provided. C. umbrosa is cited for the first time for the Iberian System, the presence of C. montana L. in this mountain system is rejected, the distribution area of C. riparia in Eastern Andalusia is discussed, and a new chromosome number for C. olbiensis Jord. is reporte

Novedades corológicas para la flora vascular de la Sierra de Gredos (Sistema Central), II

In the present paper, 43 chorological novelties for Gredos range (Central System, Spain) are showed. These citations are the result of the works leaning to the elaboration of the sierra de Gredos vascular flora catalogue. Some of them pose relevant disjunctions regarding their known Iberian distribution, as the cases of Myosotis hervei Sennen, Cyperus brevifolius (Rottb.) Hassk. and Rosa vosagiaca N.H.F. Desp. Other taxa imply novelties for the Spanish Central System, Gredos range or Ávila province. Moreover, we provide new citations of threatened taxa, with interest towards their conservation, namely Puccinellia pungens (Pau) Paunero. Eventually, some taxonomical considerations about species of difficult delimitation have been made, e. g. Delphinium halteratum-gracile and Sedum albumgypsicola complexesEn el presente artículo se citan 43 novedades corológicas para la sierra de Gredos (Sistema Central, España) que son fruto de los trabajos conducentes a la elaboración del catálogo de la flora vascular de la sierra de Gredos. Algunas suponen relevantes disyunciones con respecto al área ibérica conocida, como los casos de Myosotis hervei Sennen, Cyperus brevifolius (Rottb.) Hassk. y Rosa vosagiaca N.H.F. Desp. Otros táxones suponen novedades para el Sistema Central, la sierra de Gredos o la provincia de Ávila. Se aportan así mismo nuevas citas de táxones de interés de cara a su conservación, como es el caso de Puccinellia pungens (Pau) Paunero. Por último, se realizan algunas consideraciones taxonómicas sobre plantas de difícil delimitación como los complejos Delphinium halteratum-gracile y Sedum album-gypsicola

How do women living with HIV experience menopause? Menopausal symptoms, anxiety and depression according to reproductive age in a multicenter cohort

CatedresBackground: To estimate the prevalence and severity of menopausal symptoms and anxiety/depression and to assess the differences according to menopausal status among women living with HIV aged 45-60 years from the cohort of Spanish HIV/AIDS Research Network (CoRIS). Methods: Women were interviewed by phone between September 2017 and December 2018 to determine whether they had experienced menopausal symptoms and anxiety/depression. The Menopause Rating Scale was used to evaluate the prevalence and severity of symptoms related to menopause in three subscales: somatic, psychologic and urogenital; and the 4-item Patient Health Questionnaire was used for anxiety/depression. Logistic regression models were used to estimate odds ratios (ORs) of association between menopausal status, and other potential risk factors, the presence and severity of somatic, psychological and urogenital symptoms and of anxiety/depression. Results: Of 251 women included, 137 (54.6%) were post-, 70 (27.9%) peri- and 44 (17.5%) pre-menopausal, respectively. Median age of onset menopause was 48 years (IQR 45-50). The proportions of pre-, peri- and post-menopausal women who had experienced any menopausal symptoms were 45.5%, 60.0% and 66.4%, respectively. Both peri- and post-menopause were associated with a higher likelihood of having somatic symptoms (aOR 3.01; 95% CI 1.38-6.55 and 2.63; 1.44-4.81, respectively), while post-menopause increased the likelihood of having psychological (2.16; 1.13-4.14) and urogenital symptoms (2.54; 1.42-4.85). By other hand, post-menopausal women had a statistically significant five-fold increase in the likelihood of presenting severe urogenital symptoms than pre-menopausal women (4.90; 1.74-13.84). No significant differences by menopausal status were found for anxiety/depression. Joint/muscle problems, exhaustion and sleeping disorders were the most commonly reported symptoms among all women. Differences in the prevalences of vaginal dryness (p = 0.002), joint/muscle complaints (p = 0.032), and sweating/flush (p = 0.032) were found among the three groups. Conclusions: Women living with HIV experienced a wide variety of menopausal symptoms, some of them initiated before women had any menstrual irregularity. We found a higher likelihood of somatic symptoms in peri- and post-menopausal women, while a higher likelihood of psychological and urogenital symptoms was found in post-menopausal women. Most somatic symptoms were of low or moderate severity, probably due to the good clinical and immunological situation of these women

Role of age and comorbidities in mortality of patients with infective endocarditis.

The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups: A total of 3120 patients with IE (1327  There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in th