Decreased quality of live and treatment satisfaction in patients with latent autoinmune diabetes of the adult

Objectives. Our main aim was to assess the quality of life (QoL) and treatment satisfaction (TS) of subjects with LADA (latent autoimmune diabetes of the adult) and compare these measures with those of patients with other diabetes types, i.e., type 1 (T1DM) and type 2 diabetes mellitus (T2DM). Methods. This was a cross-sectional study with a total of 48 patients with LADA, 297 patients with T2DM and 124 with T1DM. The Audit of Diabetes-Dependent Quality of Life (ADDQoL-19) questionnaire and the Diabetes Treatment Satisfaction Questionnaire (DTSQ) were administered. Relevant clinical variables were also assessed. The data analysis included comparisons between groups and multivariate linear models. Results. The LADA patients presented lower diabetes-specific QoL (p D 0:045) and average weighted impact scores (p D 0:007) than the T2DM patients. The subgroup of LADA patients with diabetic retinopathy (DR) who were treated with insulin had a lowerADDQoLaverage weighted impact score than the other diabetic groups. Although the overall measure of TS was not different between the LADA and T2DM (pD0:389) and T1DM (pD0:091) groups, the patients with LADA showed a poorer hyperglycemic frequency perception than the T2DM patients (p<0:001) and an improved frequency of hypoglycemic perception compared with the T1DM patients (pD0:021). Conclusions. The current findings suggest a poorer quality of life, especially in terms of DRand insulin treatment, among patients with LADA compared with those withT1DM and T2DM. Hyperglycemia frequency perception was also poorer in the LADA patients than in the T1DM and T2DM patients. Further research with prospective studies and a large number of patients is necessary.This study was supported by grant PS09/01035 and PI12/00183 from the Instituto de Salud Carlos III, Ministry of Economy and Competitiveness, Spain. CIBERDEM is an initiative from Instituto de Salud Carlos III (Plan Nacional de I+D+I and Fondo Europeo de Desarrollo Regional). MGC holds a predoctoral fellowship from the Ministerio de Educación, Cultura y Deporte (FPU15/03005)

Poorer Quality of Life and Treatment Satisfaction is Associated with Diabetic Retinopathy in Patients with Type 1 Diabetes without Other Advanced Late Complications

Diabetic retinopathy (DR) may potentially cause vision loss and affect the patient's quality of life (QoL) and treatment satisfaction (TS). Using specific tools, we aimed to assess the impact of DR and clinical factors on the QoL and TS in patients with type 1 diabetes. This was a cross-sectional, two-centre study. A sample of 102 patients with DR and 140 non-DR patients were compared. The Audit of Diabetes-Dependent Quality of Life (ADDQoL-19) and Diabetes Treatment Satisfaction Questionnaire (DTSQ-s) were administered. Data analysis included bivariate and multivariable analysis. Patients with DR showed a poorer perception of present QoL (p = 0.039), work life (p = 0.037), dependence (p = 0.010), and had a lower average weighted impact (AWI) score (p = 0.045). The multivariable analysis showed that DR was associated with a lower present QoL (p = 0.040), work life (p = 0.036) and dependence (p = 0.016). With regards to TS, DR was associated with a higher perceived frequency of hypoglycaemia (p = 0.019). In patients with type 1 diabetes, the presence of DR is associated with a poorer perception of their QoL. With regard to TS, these subjects also show a higher perceived frequency of hypoglycaemia.This study was supported by the Catalan Diabetes Association (Beca d’Educació Terapèutica 2015), Spain. Additional support from grants PI12/00183 and PI15/00625 from the Instituto de Salud Carlos III (Ministry of Economy and Competitiveness, Spain) to DM is acknowledged. CIBERDEM is an initiative from the Instituto de Salud Carlos III (Plan Nacional de I + D + I and Fondo Europeo de Desarrollo Regional). M.G.-C. holds a predoctoral fellowship from the Ministerio de Educación, Cultura y Deporte, FPU15/03005

Protocolo de actuación médica para el tratamiento del hematoma subdural crónico

Introducción: El hematoma subdural crónico tiene una elevada incidencia dado el envejecimiento poblacional y su tratamiento depende de múltiples factores. Objetivo: Describir el protocolo de actuación médica neuroquirúrgica en el hematoma subdural crónico. Métodos: Se elaboró un protocolo de actuación médica mediante una investigación cualitativa con enfoque participativo, en el periodo comprendido entre el 1ro mayo al 30 de junio de 2020. Se realizó la triangulación de los datos y se diseñó el protocolo, que fue sometido al consenso colectivo de los especialistas del servicio, mediante la técnica cualitativa del grupo nominal. Se realizaron las modificaciones sugeridas en las que hubo consenso y se sometió a la aprobación del Consejo Científico del Hospital Universitario "General Calixto García". Resultados: Fue aprobado el protocolo y se inició su aplicación en septiembre de 2020. Se aplicará durante tres años consecutivos, para evaluar los resultados del mismo y validar su utilidad si la evaluación es satisfactoria. Conclusiones: La aplicación de un protocolo de actuación médica dirigido a la adecuada selección de los pacientes que se beneficiarán con la evacuación quirúrgica del hematoma o con el tratamiento conservador, podría reducir tanto la mortalidad posoperatoria por esta entidad, como por las intervenciones que no modificarán el curso natural de la enfermedad y ahorrar los recursos invertidos en la atención de estos pacientes

Calcium phosphate product is associated with subclinical carotid atherosclerosis in type 2 diabetes

Aims. To assess whether circulating 25-hydroxyvitamin D3 (25OHD) and mineral metabolism-related factors (serum phosphate, calcium, and parathormone) are associated with subclinical carotid atherosclerosis (SCA), defined as the presence of carotid atherosclerotic plaques (main study outcome), in patients with type 2 diabetes mellitus (T2DM) without kidney disease or previous cardiovascular disease. Methods. We undertook a post hoc analysis of a cross-sectional study in adults with T2DM in whom we evaluated SCA. A total of 303 subjects with T2DM were included. Clinical variables and carotid ultrasound imaging were obtained. Results. We found no association of 25OHD with the presence of SCA. However, calcium phosphate (CaP; mg2/dL2) product was positively associated with the presence of carotid plaques (ORadj = 1.078; 95% CI: 1.017–1.142). An inverse association was observed between higher levels of 25OHD (≥30 ng/mL versus <20 ng/mL concentrations) and common carotid intima-media thickness (cIMT; mm) (βadj ± SE = −0.055 ± 0.024). We conclude that the CaP product is independently associated with the presence of established subclinical carotid atherosclerosis in patients with T2DM.This study was supported by Grants PS09/01035 and PI15/ 00625 from Instituto de Salud Carlos III, Ministry of Economy and Competitiveness, Spain. CIBERDEM is an initiative from Instituto de Salud Carlos III (Plan Nacional de I+D+I and Fondo Europeo de Desarrollo Regional). Minerva Granado-Casas holds a predoctoral fellowship from Ministerio de Educación, Cultura y Deporte, FPU15/03005

The landscape of expression and alternative splicing variation across human traits

Understanding the consequences of individual transcriptome variation is fundamental to deciphering human biology and disease. We implement a statistical framework to quantify the contributions of 21 individual traits as drivers of gene expression and alternative splicing variation across 46 human tissues and 781 individuals from the Genotype-Tissue Expression project. We demonstrate that ancestry, sex, age, and BMI make additive and tissue-specific contributions to expression variability, whereas interactions are rare. Variation in splicing is dominated by ancestry and is under genetic control in most tissues, with ribosomal proteins showing a strong enrichment of tissue-shared splicing events. Our analyses reveal a systemic contribution of types 1 and 2 diabetes to tissue transcriptome variation with the strongest signal in the nerve, where histopathology image analysis identifies novel genes related to diabetic neuropathy. Our multi-tissue and multi-trait approach provides an extensive characterization of the main drivers of human transcriptome variation in health and disease.This study was funded by the HumTranscriptom project with reference PID2019-107937GA-I00. R.G.-P. was supported by a Juan de la Cierva fellowship (FJC2020-044119-I) funded by MCIN/AEI/10.13039/501100011033 and ‘‘European Union NextGenerationEU/PRTR.’’ J.M.R. was supported by a predoctoral fellowship from ‘‘la Caixa’’ Foundation (ID 100010434) with code LCF/BQ/DR22/11950022. A.R.-C. was supported by a Formación Personal Investigador (FPI) fellowship (PRE2019-090193) funded by MCIN/AEI. R.C.-G. was supported by an FPI fellowship (PRE2020-092510) funded by MCIN/AEI. M.M. was supported by a Ramon y Cajal fellowship (RYC-2017-22249).Peer ReviewedPostprint (published version

Glycolytic shift during West Nile virus infection provides new therapeutic opportunities

Background Viral rewiring of host bioenergetics and immunometabolism may provide novel targets for therapeu‑ tic interventions against viral infections. Here, we have explored the effect on bioenergetics during the infection with the mosquito‑borne flavivirus West Nile virus (WNV), a medically relevant neurotropic pathogen causing out‑ breaks of meningitis and encephalitis worldwide. Results A systematic literature search and meta‑analysis pointed to a misbalance of glucose homeostasis in the cen‑ tral nervous system of WNV patients. Real‑time bioenergetic analyses confirmed upregulation of aerobic glycolysis and a reduction of mitochondrial oxidative phosphorylation during viral replication in cultured cells. Transcriptom‑ ics analyses in neural tissues from experimentally infected mice unveiled a glycolytic shift including the upregula‑ tion of hexokinases 2 and 3 (Hk2 and Hk3) and pyruvate dehydrogenase kinase 4 (Pdk4). Treatment of infected mice with the Hk inhibitor, 2‑deoxy‑D‑glucose, or the Pdk4 inhibitor, dichloroacetate, alleviated WNV‑induced neuroinflammation. Conclusions These results highlight the importance of host energetic metabolism and specifically glycolysis in WNV infection in vivo. This study provides proof of concept for the druggability of the glycolytic pathway for the future development of therapies to combat WNV pathology.This study was supported by the Spanish Ministry of Science and Innovation AEI/10.13039/501100011033 under Grants PID2019‑105117RR‑C21 (to MAMA) and PID2019‑105117RR‑C22 (to MJPP), PID2020‑119195RJ‑I00 (to NJO), by Synergistic Projects Community of Madrid under grant NUTRISION‑CM/Y2020/ BIO‑6350 (to ARM), and by the European Commission—NextGenerationEU through CSIC’s Global Health Platform (PTI Salud Global). PMC was sup‑ ported by an FPI fellowship from AEI/10.13039/501100011033 under Grant PRE2020‑093374. The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publicationPeer reviewe

Jardins per a la salut

Facultat de Farmàcia, Universitat de Barcelona. Ensenyament: Grau de Farmàcia. Assignatura: Botànica farmacèutica. Curs: 2014-2015. Coordinadors: Joan Simon, Cèsar Blanché i Maria Bosch.Els materials que aquí es presenten són el recull de les fitxes botàniques de 128 espècies presents en el Jardí Ferran Soldevila de l’Edifici Històric de la UB. Els treballs han estat realitzats manera individual per part dels estudiants dels grups M-3 i T-1 de l’assignatura Botànica Farmacèutica durant els mesos de febrer a maig del curs 2014-15 com a resultat final del Projecte d’Innovació Docent «Jardins per a la salut: aprenentatge servei a Botànica farmacèutica» (codi 2014PID-UB/054). Tots els treballs s’han dut a terme a través de la plataforma de GoogleDocs i han estat tutoritzats pels professors de l’assignatura. L’objectiu principal de l’activitat ha estat fomentar l’aprenentatge autònom i col·laboratiu en Botànica farmacèutica. També s’ha pretès motivar els estudiants a través del retorn de part del seu esforç a la societat a través d’una experiència d’Aprenentatge-Servei, deixant disponible finalment el treball dels estudiants per a poder ser consultable a través d’una Web pública amb la possibilitat de poder-ho fer in-situ en el propi jardí mitjançant codis QR amb un smartphone

Antimicrobial Defined Daily Dose in Neonatal Population: Validation in the Clinical Practice

Paediatric Antimicrobial Defined Daily Dose Study Group KiDDDs.Currently, there is no validated method for estimating antimicrobial consumption in the neonatal population, as it exists for adults using Defined Daily Doses (DDD). In neonatology, although there are different methods, each one with advantages and disadvantages, there is no unified criterion for use. The aim of this study is to validate the neonatal DDD designed as a new standardised form of antimicrobial consumption over this population.M.M.-T. received financial support from the Subprograma Río Hortega, Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Ciencia, Innovación y Universidades, Spain (CM21/00115). The project has been carried out without financial funding but is supported by the Spanish Society of Hospital Pharmacy (SEFH), the Working Group on Pharmaceutical Care in Infectious Diseases of the SEFH (Afinf) and Spanish working group on paediatric pharmacy of the SEFH (gefp).Peer reviewe

Risk Factors for COVID-19 in Inflammatory Bowel Disease: A National, ENEIDA-Based Case–Control Study (COVID-19-EII)

(1) Scant information is available concerning the characteristics that may favour the acquisition of COVID-19 in patients with inflammatory bowel disease (IBD). Therefore, the aim of this study was to assess these differences between infected and noninfected patients with IBD. (2) This nationwide case-control study evaluated patients with inflammatory bowel disease with COVID-19 (cases) and without COVID-19 (controls) during the period March-July 2020 included in the ENEIDA of GETECCU. (3) A total of 496 cases and 964 controls from 73 Spanish centres were included. No differences were found in the basal characteristics between cases and controls. Cases had higher comorbidity Charlson scores (24% vs. 19%; p = 0.02) and occupational risk (28% vs. 10.5%; p < 0.0001) more frequently than did controls. Lockdown was the only protective measure against COVID-19 (50% vs. 70%; p < 0.0001). No differences were found in the use of systemic steroids, immunosuppressants or biologics between cases and controls. Cases were more often treated with 5-aminosalicylates (42% vs. 34%; p = 0.003). Having a moderate Charlson score (OR: 2.7; 95%CI: 1.3-5.9), occupational risk (OR: 2.9; 95%CI: 1.8-4.4) and the use of 5-aminosalicylates (OR: 1.7; 95%CI: 1.2-2.5) were factors for COVID-19. The strict lockdown was the only protective factor (OR: 0.1; 95%CI: 0.09-0.2). (4) Comorbidities and occupational exposure are the most relevant factors for COVID-19 in patients with IBD. The risk of COVID-19 seems not to be increased by immunosuppressants or biologics, with a potential effect of 5-aminosalicylates, which should be investigated further and interpreted with caution