18 research outputs found
Centennial-scale vegetation and North Atlantic Oscillation changes during the Late Holocene in the southern Iberia
High-reso CE to lution pollen analysis, charcoal, non-pollen palynomorphs and magnetic susceptibility have been analyzed in the sediment record of a peat bog in Sierra Nevada in southern Iberia. The study of these proxies provided the reconstruction of vegetation, climate, fire and human activity of the last âŒ4500 cal yr BP. A progressive trend towards aridification during the late Holocene is observed in this record. This trend is interrupted by millennial- and centennial-scale variability of relatively more humid and arid periods. Arid conditions are recorded between âŒ4000 and 3100 cal yr BP, being characterized by a decline in arboreal pollen and with a spike in magnetic susceptibility. This is followed by a relatively humid period from âŒ3100 to 1600 cal yr BP, coinciding partially with the Iberian-Roman Humid Period, and is indicated by the increase of Pinus and the decrease in xerophytic taxa. The last 1500 cal yr BP are characterized by several centennial-scale climatic oscillations. Generally arid conditions from âŒ450 to 1300 CE, depicted by a decrease in Pinus and an increase in Artemisia, comprise the Dark Ages and the Medieval Climate Anomaly. Since ⌠1300 to 1850 CE pronounced oscillations occur between relatively humid and arid conditions. Four periods depicted by relatively higher Pinus coinciding with the beginning and end of the Little Ice Age are interrupted by three arid events characterized by an increase in Artemisia. These alternating arid and humid shifts could be explained by centennial-scale changes in the North Atlantic Oscillation and solar activity
Paleoclimate reconstruction of the last 36 kyr based on branched glycerol dialkyl glycerol tetraethers in the Padul palaeolake record (Sierra Nevada, southern Iberian Peninsula)
Quantitative continental climate reconstructions covering the last glacial cycle from the Iberian Peninsula are scarce. In order to fill this gap, we obtained for the first time a high-resolution mean annual air temperature (MAAT) record based on the distribution of specific bacterial membrane lipids (i.e., branched glycerol dialkyl glycerol tetraethers; brGDGTs) from the last 36.0-4.7 kyr palaeolake record recovered by the Padul-15-05 sedimentary core (Padul, Sierra Nevada, southern Iberia). The fractional abundance of the three major groups of GDGTs present in the Padul sediments, GDGT-0, crenarchaeol and the summed brGDGTs, is comparable with that of other shallow and small (Peer reviewe
Effectiveness and Safety of the Sequential Use of a Second and Third Anti-TNF Agent in Patients with Inflammatory Bowel Disease: Results from the Eneida Registry
Background: The effectiveness of the switch to another anti-tumor necrosis factor (anti-TNF) agent is not known. The aim of this study was to analyze the effectiveness and safety of treatment with a second and third anti-TNF drug after intolerance to or failure of a previous anti-TNF agent in inflammatory bowel disease (IBD) patients. Methods: We included patients diagnosed with IBD from the ENEIDA registry who received another anti-TNF after intolerance to or failure of a prior anti-TNF agent. Results: A total of 1122 patients were included. In the short term, remission was achieved in 55% of the patients with the second anti-TNF. The incidence of loss of response was 19% per patient-year with the second anti-TNF. Combination therapy (hazard ratio [HR], 2.4; 95% confidence interval [CI], 1.8-3; P < 0.0001) and ulcerative colitis vs Crohn''s disease (HR, 1.6; 95% CI, 1.1-2.1; P = 0.005) were associated with a higher probability of loss of response. Fifteen percent of the patients had adverse events, and 10% had to discontinue the second anti-TNF. Of the 71 patients who received a third anti-TNF, 55% achieved remission. The incidence of loss of response was 22% per patient-year with a third anti-TNF. Adverse events occurred in 7 patients (11%), but only 1 stopped the drug. Conclusions: Approximately half of the patients who received a second anti-TNF achieved remission; nevertheless, a significant proportion of them subsequently lost response. Combination therapy and type of IBD were associated with loss of response. Remission was achieved in almost 50% of patients who received a third anti-TNF; nevertheless, a significant proportion of them subsequently lost response
Management of multidrug resistant Gram-negative bacilli infections in solid organ transplant recipients: SET/GESITRA-SEIMC/REIPI recommendations
Solid organ transplant (SOT) recipients are especially at risk of developing infections by multidrug resistant (MDR) Gram-negative bacilli (GNB), as they are frequently exposed to antibiotics and the healthcare setting, and are regulary subject to invasive procedures. Nevertheless, no recommendations concerning prevention and treatment are available. A panel of experts revised the available evidence; this document summarizes their recommendations: (1) it is important to characterize the isolateÂŽs phenotypic and genotypic resistance profile; (2) overall, donor colonization should not constitute a contraindication to transplantation, although active infected kidney and lung grafts should be avoided; (3) recipient colonization is associated with an increased risk of infection, but is not a contraindication to transplantation; (4) different surgical prophylaxis regimens are not recommended for patients colonized with carbapenem-resistant GNB; (5) timely detection of carriers, contact isolation precautions, hand hygiene compliance and antibiotic control policies are important preventive measures; (6) there is not sufficient data to recommend intestinal decolonization; (7) colonized lung transplant recipients could benefit from prophylactic inhaled antibiotics, specially for Pseudomonas aeruginosa; (8) colonized SOT recipients should receive an empirical treatment which includes active antibiotics, and directed therapy should be adjusted according to susceptibility study results and the severity of the infection.J.T.S. holds a research contract from the FundaciĂłn para la FormaciĂłn e InvestigaciĂłn de los Profesionales de la Salud de Extremadura (FundeSalud), Instituto de Salud Carlos III. M.F.R. holds a clinical research contract âJuan RodĂ©sâ (JR14/00036) from the Spanish Ministry of Economy and Competitiveness, Instituto de Salud Carlos III
Nutrición parenteral domiciliaria en España 2018. Informe del Grupo de Nutrición Artificial Domiciliaria y Ambulatoria NADYA
Objetivo: comunicar los datos de nutrición parenteral domiciliaria (NPD) obtenidos del registro del grupo NADYA-SENPE (www.nadya-senpe.com) del año 2018.
Material y métodos: anålisis descriptivo de los datos recogidos de pacientes adultos y pediåtricos con NPD en el registro NADYA-SENPE del 1 de enero al 31 de diciembre de 2018.
Resultados: se registraron 278 pacientes (54, 7% mujeres), 23 niños y 255 adultos, procedentes de 45 hospitales españoles, lo que representa una tasa de prevalencia de 5, 95 pacientes/millĂłn de habitantes/año 2018. El diagnĂłstico mĂĄs frecuente en adultos fue âoncolĂłgico paliativoâ (22, 0%), seguido de âotrosâ. En niños fue la enfermedad de Hirschsprung junto con la enterocolitis necrotizante, con cuatro casos (17, 4%). El primer motivo de indicaciĂłn fue sĂndrome de intestino corto tanto en niños (60, 9%) como en adultos (35, 7%). El tipo de catĂ©ter mĂĄs utilizado fue el tunelizado tanto en niños (81, 0%) como en adultos (41, 1%). Finalizaron 75 episodios, la causa mĂĄs frecuente fue el fallecimiento (52, 0%) y el paso a vĂa oral (33, 3%).
Conclusiones: el nĂșmero de centros y profesionales colaboradores en el registro de pacientes que reciben NPD se mantiene estable, asĂ como las principales indicaciones y los motivos de finalizaciĂłn de la NPD.
Aim: To communicate home parenteral nutrition (HPN) data obtained from the HPN registry of the NADYA-SENPE group (www.nadya-senpe. com) for the year 2018.
Material and methods: Descriptive analysis of the data collected from adult and pediatric patients with HPN in the NADYA-SENPE group registry from January 1st, 2018 to December 31st, 2018.Â
Results: There were 278 patients from 45 Spanish hospitals (54.7% women), 23 children and 255 adults, which represent a prevalence rate of 5.95 patients/million inhabitants/year 2018. The most frequent diagnosis in adults was âpalliative cancerâ (22.0%), followed by âothersâ. In children it was Hirschsprungâs disease together with necrotizing enterocolitis, with four cases (17.4%). The first indication was short bowel syndrome in both children (60.9%) and adults (35.7%). The most frequently used type of catheter was tunneled in both children (81.0%) and adults (41.1%). Ending 75 episodes, the most frequent cause was death (52.0%) and change to oral feeding (33.3%).
Conclusions: The number of centers and collaborating professionals in the registry of patients receiving HPN remains stable, as well as the main indications and reasons for termination of HPN
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Dietary αâLinolenic Acid, Marine Ïâ3 Fatty Acids, and Mortality in a Population With High Fish Consumption: Findings From the PREvenciĂłn con DIeta MEDiterrĂĄnea (PREDIMED) Study
Background: Epidemiological evidence suggests a cardioprotective role of αâlinolenic acid (ALA), a plantâderived Ïâ3 fatty acid. It is unclear whether ALA is beneficial in a background of high marine Ïâ3 fatty acids (longâchain nâ3 polyunsaturated fatty acids) intake. In persons at high cardiovascular risk from Spain, a country in which fish consumption is customarily high, we investigated whether meeting the International Society for the Study of Fatty Acids and Lipids recommendation for dietary ALA (0.7% of total energy) at baseline was related to allâcause and cardiovascular disease mortality. We also examined the effect of meeting the society's recommendation for longâchain nâ3 polyunsaturated fatty acids (â„500 mg/day). Methods and Results: We longitudinally evaluated 7202 participants in the PREvenciĂłn con DIeta MEDiterrĂĄnea (PREDIMED) trial. Multivariableâadjusted Cox regression models were fitted to estimate hazard ratios. ALA intake correlated to walnut consumption (r=0.94). During a 5.9ây followâup, 431 deaths occurred (104 cardiovascular disease, 55 coronary heart disease, 32 sudden cardiac death, 25 stroke). The hazard ratios for meeting ALA recommendation (n=1615, 22.4%) were 0.72 (95% CI 0.56â0.92) for allâcause mortality and 0.95 (95% CI 0.58â1.57) for fatal cardiovascular disease. The hazard ratios for meeting the recommendation for longâchain nâ3 polyunsaturated fatty acids (n=5452, 75.7%) were 0.84 (95% CI 0.67â1.05) for allâcause mortality, 0.61 (95% CI 0.39â0.96) for fatal cardiovascular disease, 0.54 (95% CI 0.29â0.99) for fatal coronary heart disease, and 0.49 (95% CI 0.22â1.01) for sudden cardiac death. The highest reduction in allâcause mortality occurred in participants meeting both recommendations (hazard ratio 0.63 [95% CI 0.45â0.87]). Conclusions: In participants without prior cardiovascular disease and high fish consumption, dietary ALA, supplied mainly by walnuts and olive oil, relates inversely to allâcause mortality, whereas protection from cardiac mortality is limited to fishâderived longâchain nâ3 polyunsaturated fatty acids. Clinical Trial Registration URL: http://www.Controlled-trials.com/. Unique identifier: ISRCTN35739639
Effect of pyric herbivory in a plant community of gorse (Genista scorpius L.) and steppe grass (Macrochloa tenacissima Kunt) in Southeast Spain
Conferencia Invitada presentada en: Fire Ecology Across Boundaries: connecting science and management. Florencia 4-7 octubre (2022