Cardiovascular Screening Practices and Statin Prescription Habits in Patients with Psoriasis among Dermatologists, Rheumatologists and Primary Care Physicians.

Patients with psoriasis have a higher prevalence of cardiovascular risk factors. This study evaluated cardiovascular screening practices and statin prescribing habits among dermatologists, rheumatologists and primary care physicians (PCPs) through an online questionnaire, which was distributed through the Spanish scientific societies of the above-mentioned specialties. A total of 299 physicians (103 dermatologists, 94 rheumatologists and 102 PCPs) responded to the questionnaire. Of these, 74.6% reported screening for smoking, 37.8% for hypertension, 80.3% for dyslipidaemia, and 79.6% for diabetes mellitus. Notably, only 28.4% performed global screening, defined as screening for smoking, hypertension, dyslipidaemia, and diabetes mellitus by the same physician, and 24.4% reported calculating 10-year cardiovascular disease (CVD) risk, probably reflecting a lack of comprehensive cardiovascular risk assessment in these patients. This study also identified unmet needs for awareness of cardiovascular comorbidities in psoriasis and corresponding screening and treatment recommendations among PCPs. Of PCPs, 61.2% reported not being aware of the association between psoriasis and CVD and/or not being aware of its screening recommendations, and 67.6% did not consider psoriasis as a risk-enhancing factor when deciding on statin prescription. Thirteen dermatologists (12.6%) and 35 rheumatologists (37.2%) reported prescribing statins. Among those who do not prescribe, 49.7% would be willing to start their prescription.post-print492 K

Transplantation of Human-Fetal-Spinal-Cord-Derived NPCs Primed with a Polyglutamate-Conjugated Rho/Rock Inhibitor in Acute Spinal Cord Injury

NPC transplantation; Cell priming; Human fetal neural precursorTrasplante de NPC; Cebado celular; Precursor neuronal fetal humanoTrasplantament de NPC; Cebament cel·lular; Precursor neuronal fetal humàNeural precursor cell (NPC) transplantation represents a promising therapy for treating spinal cord injuries (SCIs); however, despite successful results obtained in preclinical models, the clinical translation of this approach remains challenging due, in part, to the lack of consensus on an optimal cell source for human neuronal cells. Depending on the cell source, additional limitations to NPC-based therapies include high tumorigenic potential, alongside poor graft survival and engraftment into host spinal tissue. We previously demonstrated that NPCs derived from rat fetal spinal cords primed with a polyglutamate (PGA)-conjugated form of the Rho/Rock inhibitor fasudil (PGA-SS-FAS) displayed enhanced neuronal differentiation and graft survival when compared to non-primed NPCs. We now conducted a similar study of human-fetal-spinal-cord-derived NPCs (hfNPCs) from legal gestational interruptions at the late gestational stage, at 19–21.6 weeks. In vitro, expanded hfNPCs retained neural features, multipotency, and self-renewal, which supported the development of a cell banking strategy. Before transplantation, we established a simple procedure to prime hfNPCs by overnight incubation with PGA-SS-FAS (at 50 μM FAS equiv.), which improved neuronal differentiation and overcame neurite-like retraction after lysophosphatidic-acid-induced Rho/Rock activation. The transplantation of primed hfNPCs into immune-deficient mice (NU(NCr)-Foxn1nu) immediately after the eighth thoracic segment compression prompted enhanced migration of grafted cells from the dorsal to the ventral spinal cord, increased preservation of GABAergic inhibitory Lbx1-expressing and glutamatergic excitatory Tlx3-expressing somatosensory interneurons, and elevated the numbers of preserved, c-Fos-expressing, activated neurons surrounding the injury epicenter, all in a low percentage. Overall, the priming procedure using PGA-SS-FAS could represent an alternative methodology to improve the capabilities of the hfNPC lines for a translational approach for acute SCI treatment.This research was funded by Fundació Marató TV3 2017/refs.20172230, 20172231, Agencia Valenciana de Innovación (AVI) (INNVAL10/19/047 and Grants RTI2018-095872-B-C21 and PDI2021-1243590B-I00/ERDF funded by MCIN/AEI//10.13039/501100011033 and by ERDF A way of making Europe). This project was also funded by Project 964562 (RISEUP), H2020 FetOpen program

Clinical and functional characteristics of individuals with alpha-1 antitrypsin deficiency: EARCO international registry

Background Alpha-1 antitrypsin deficiency (AATD) is a rare disease that is associated with an increased risk of pulmonary emphysema. The European AATD Research Collaboration (EARCO) international registry was founded with the objective of characterising the individuals with AATD and investigating their natural history. Methods The EARCO registry is an international, observational and prospective study of individuals with AATD, defined as AAT serum levels < 11 μM and/or proteinase inhibitor genotypes PI*ZZ, PI*SZ and compound heterozygotes or homozygotes of other rare deficient variants. We describe the characteristics of the individuals included from February 2020 to May 2022. Results A total of 1044 individuals from 15 countries were analysed. The most frequent genotype was PI*ZZ (60.2%), followed by PI*SZ (29.2%). Among PI*ZZ patients, emphysema was the most frequent lung disease (57.2%) followed by COPD (57.2%) and bronchiectasis (22%). Up to 76.4% had concordant values of FEV1(%) and KCO(%). Those with impairment in FEV1(%) alone had more frequently bronchiectasis and asthma and those with impairment in KCO(%) alone had more frequent emphysema and liver disease. Multivariate analysis showed that advanced age, male sex, exacerbations, increased blood platelets and neutrophils, augmentation and lower AAT serum levels were associated with worse FEV1(%). Conclusions EARCO has recruited > 1000 individuals with AATD from 15 countries in its first 2 years. Baseline cross sectional data provide relevant information about the clinical phenotypes of the disease, the patterns of functional impairment and factors associated with poor lung function

Conocimiento del Anticonceptivo de Emergencia o “Píldora del Día Siguiente”, en Estudiantes Universirarios

Introducción. Un embarazo no deseado se ha convertido en un grave problema de salud pública, el cual está estrechamente relacionado con una deficiente educación sexual, adopción de conductas sexuales de riesgo y poco conocimiento de los métodos anticonceptivos de emergencia. Objetivo. Determinar el nivel de conocimiento que tienen los jóvenes universitarios sobre el uso de la píldora del día siguiente, mediante la aplicación de un cuestionario, con la finalidad de tener un referente actual del fenómeno. Metodología. Estudio transversal, descriptivo, se trabajó con 308 estudiantes de la Facultad de Derecho y Química, de una universidad pública. Muestreo fue por conveniencia. Se consideraron alumnos cuyas parejas sexuales fueran del sexo contrario o bien, ambos y que tuvieran vida sexual activa, de quienes se obtuvo consentimiento verbal. Análisis de datos mediante estadística descriptiva usando el programa EXCEL y SPSS. Resultados. Se tuvieron 210 cuestionarios de la Facultad de Derecho y 98 de Química. 58% de los jóvenes fueron mujeres. Del total de participantes, 264 respondieron a la pregunta de si han usado alguna vez la pastilla. De estos, 77.3% sí han recurrido a ella desde que iniciaron su vida sexual. Con respecto al nivel de conocimientos, los alumnos de Derecho, tuvieron 30% de conocimiento regular y malo y en Química 30.6%. Con respecto al género, 31% de los datos erróneos, fueron de las mujeres y 40% de los varones. Conclusiones. Un alto porcentaje de alumnos han usado este medicamento, por lo que es necesario reforzar los conocimientos sobre su correcto uso. &nbsp; Introduction. Unwanted pregnancies have become a serious public health problem, which is closely related to poor sexual education, adoption of risky sexual behaviors and little knowledge of emergency contraceptive methods. Objective. To determine the level of knowledge that young university students have about the use of the morning-after pill, through the application of a questionnaire, in order to have a current frame of reference about this phenomenon. Methodology. Cross-sectional, descriptive study. We worked with 308 students from the College of Law and Chemistry of a public university. We used convenience sampling. We considered students whose sexual partners were of the opposite or same sex, and who were sexually active, and their verbal consent was obtained. Data analysis was conducted through descriptive statistics using EXCEL and the SPSS program. Results. 210 questionnaires were obtained from the College of Law and 98 from Chemistry. 58% of the participants were women. Of the total participants, 264 responded to the question of whether they had ever used the pill. Of these, 77.3% indicated they have resorted to it since they became sexually active. Regarding the level of knowledge, 30% of Law students had average and poor knowledge, and Chemistry students 30.6%. Regarding gender, 31% of those with no knowledge of the pill were women and 40% were men. Conclusion. A high percentage of students have used this medication, so it is necessary to reinforce knowledge about its correct use

Clinical and functional characteristics of individuals with alpha-1 antitrypsin deficiency: EARCO international registry

Alpha-1 antitrypsin; Phenotypes; RegistryAlfa-1 antitripsina; Fenotipos; RegistroAlfa-1 antitripsina; Fenotips; RegistreBackground Alpha-1 antitrypsin deficiency (AATD) is a rare disease that is associated with an increased risk of pulmonary emphysema. The European AATD Research Collaboration (EARCO) international registry was founded with the objective of characterising the individuals with AATD and investigating their natural history. Methods The EARCO registry is an international, observational and prospective study of individuals with AATD, defined as AAT serum levels < 11 μM and/or proteinase inhibitor genotypes PI*ZZ, PI*SZ and compound heterozygotes or homozygotes of other rare deficient variants. We describe the characteristics of the individuals included from February 2020 to May 2022. Results A total of 1044 individuals from 15 countries were analysed. The most frequent genotype was PI*ZZ (60.2%), followed by PI*SZ (29.2%). Among PI*ZZ patients, emphysema was the most frequent lung disease (57.2%) followed by COPD (57.2%) and bronchiectasis (22%). Up to 76.4% had concordant values of FEV1(%) and KCO(%). Those with impairment in FEV1(%) alone had more frequently bronchiectasis and asthma and those with impairment in KCO(%) alone had more frequent emphysema and liver disease. Multivariate analysis showed that advanced age, male sex, exacerbations, increased blood platelets and neutrophils, augmentation and lower AAT serum levels were associated with worse FEV1(%). Conclusions EARCO has recruited > 1000 individuals with AATD from 15 countries in its first 2 years. Baseline cross sectional data provide relevant information about the clinical phenotypes of the disease, the patterns of functional impairment and factors associated with poor lung function.The International EARCO registry is funded by unrestricted grants of Grifols, CSL Behring, Kamada, pH Pharma and Takeda to the European Respiratory Society (ERS)

Gestational age-based reference ranges for cervical length and preterm birth prediction in triplet pregnancies: an observational retrospective study

Cervical length; Preterm delivery; Triplet pregnancyLongitud cervical; Parto prematuro; Embarazo de trillizosLongitud cervical; Part prematur; Embaràs de trillissosObjectives To develop gestational age-based reference ranges for cervical length in triplet pregnancies. The secondary objective was to assess the performance of cervical length measured between 18 and 20 + 6 days for the prediction of preterm delivery before 28 and 32 weeks, respectively. Methods Observational retrospective study of triplet pregnancies in three Spanish tertiary-care hospitals between 2001 and 2019. Cervical length measurements were consecutively obtained between 15 and 34 weeks of gestation. Pregnancies undergoing multifetal reduction or fetal surgery were excluded. Results Two hundred and six triplet pregnancies were included in the final analysis. There was a quadratic decrease in cervical length with gestational age. The median and fifth centiles for cervical length at 20 weeks were 35 and 13 mm. In the prediction of preterm birth < 28 weeks, for a false positive rate of 5%, and 10%, the detection rates were 40.9%, and 40.9%, respectively, and the prediction of preterm birth < 32 weeks, 22.0% and 26.0%, respectively. Conclusions In triplet pregnancies, cervical length decreases with gestational age. The performance of cervical length at 18–20 + 6 in screening for preterm birth before 28 and 32 weeks is poor

Caso atípico de enfermedad de Kimura en varón de 66 años

Kimura disease should be suspected when there are lymphoid masses or nodules in the head and neck, with subcutaneous cellular tissue involvement and regional lymphadenopathy, with minor inflammation and few systemic symptoms. It is usually associated with blood eosinophilia and elevated serum IgE. Even without treatment, it has a good prognosis, although recurrence is common. We present the case of a 66-year-old Caucasian male with a rapidly appearing laterocervical mass whose final diagnosis was made by biopsy. Biopsy showed mixed findings of Kimura disease and angiolymphoid hyperplasia with eosinophilia (ALHE), once thought to be the same disorder.La enfermedad de Kimura se debe sospechar ante masas o nódulos linfoides en cabeza y cuello, con afectación del tejido celular subcutáneo y linfadenopatías regionales, con poca inflamación y pocos síntomas sistémicos, habitualmente acompañadas de eosinofilia periférica y elevación de IgE sérica. Presenta buen pronóstico incluso sin tratamiento, aunque con tendencia a la recidiva. Se presenta el caso de un varón caucásico de 66 años con una masa laterocervical de rápida aparición cuyo diagnóstico final se realizó con la biopsia, en la que se encontraron hallazgos mixtos con hiperplasia angiolinfoide con eosinofilia (HALE), que antes se pensaba que era la misma entidad

Clinical characteristics of chronic obstructive pulmonary disease in never-smokers: A systematic review

Introduction Chronic Obstructive Pulmonary Disease (COPD) is the third cause of death worldwide. While tobacco smoking is a key risk factor, COPD also occurs in never-smokers (NS). However, available evidence on risk factors, clinical characteristics, and natural history of the disease in NS is scarce. Here, we perform a systematic review of the literature to better describe the characteristics of COPD in NS. Methods We searched different databases following the PRISMA guidelines with explicit inclusion and exclusion criteria. A purpose-designed quality scale was applied to the studies included in the analysis. It was not possible to pool the results due to the high heterogeneity of the studies included. Results A total of 17 studies that met the selection criteria were included, albeit only 2 of them studied NS exclusively. The total number of participants in these studies were 57,146 subjects, 25,047 of whom were NS and 2,655 of the latter had NS-COPD. Compared to COPD in smokers, COPD in NS is more frequent in women and older ages, and is associated with a slightly higher prevalence of comorbidities. There are not enough studies to understand if COPD progression and clinical symptoms in NS are different to that of ever-smokers. Conclusions There is a significant knowledge gap on COPD in NS. Given that COPD in NS account for about a third of all COPD patients in the world, particularly in low-middle income countries, and the decrease in tobacco consumption in high income countries, understanding COPD in NS constitutes a public-health priorityThis work was supported by the Instituto de Salud Carlos III (ISCIII)/PI20/00476/Cofinanciado Unión Europea (UE-FEDER) and Grupo de referencia competitiva Xunta de GaliciaS

First-trimester screening for pre-eclampsia and small for gestational age: A comparison of the gaussian and Fetal Medicine Foundation algorithms

Preeclampsia d'inici precoç; Primer trimestreEarly-onset pre-eclampsia; First trimesterPreeclampsia de inicio precoz; Primer trimestreObjective Pre-eclampsia (PE) and small for gestational age (SGA) can be predicted from the first trimester. The most widely used algorithm worldwide is the Fetal Medicine Foundation (FMF) algorithm. The recently described Gaussian algorithm has reported excellent results although it is unlikely to be externally validated. Therefore, as an alternative approach, we compared the predictive accuracy for PE and SGA of the Gaussian and FMF algorithms. Methods Secondary analysis of a prospective cohort study was conducted at Vall d'Hebron University Hospital (Barcelona) with 2641 singleton pregnancies. The areas under the curve for the predictive performance for early-onset and preterm PE and early-onset and preterm SGA were calculated with the Gaussian and FMF algorithms and subsequently compared. Results The FMF and Gaussian algorithms showed a similar predictive performance for most outcomes and marker combinations. Nevertheless, significant differences for early-onset PE prediction favored the Gaussian algorithm in the following combinations: mean arterial blood pressure (MAP) with pregnancy-associated plasma protein A, MAP with placental growth factor, and MAP alone. Conclusions The first-trimester Gaussian and FMF algorithms have similar performances for PE and SGA prediction when applied with all markers within a routine care setting in a Spanish population, adding evidence to the external validity of the FMF algorithm

Reference values for interleukin-6 in the amniotic fluid of asymptomatic pregnant women

Amniocentesis; Interleukin-6; Intra-amniotic inflammationAmniocentesi; Interleucina-6; Inflamació intraamniòticaAmniocentesis; Interleucina-6; Inflamación intraamnióticaIntroduction Nowadays, proinflammatory factors are considered to play an important role in the pathophysiology of threatened preterm labor or chorioamnionitis. The aim of this study was to establish the normal reference range for interleukin-6 (IL-6) levels in the amniotic fluid and to identify factors which may alter this value. Material and methods Prospective study in a tertiary-level center including asymptomatic pregnant women undergoing amniocentesis for genetic studies from October 2016 to September 2019. IL-6 measurements in amniotic fluid were performed using a fluorescence immunoassay with microfluidic technology (ELLA Proteinsimple, Bio Techne). Maternal history and pregnancy data were also recorded. Results This study included 140 pregnant women. Of those, women who underwent termination of pregnancy were excluded. Therefore, a total of 98 pregnancies were included in the final statistical analysis. The mean gestational age was 21.86 weeks (range: 15–38.7) at the time of amniocentesis, and 38.6 weeks (range: 30.9–41.4) at delivery. No cases of chorioamnionitis were reported. The log10 IL-6 values follow a normal distribution (W = 0.990, p = 0.692). The median, and the 5th, 10th, 90th, and 95th percentiles for IL-6 levels were 573, 105, 130, 1645, and 2260 pg/mL, respectively. The log10 IL-6 values were not affected by gestational age (p = 0.395), maternal age (p = 0.376), body mass index (p = 0.551), ethnicity (p = 0.467), smoking status (p = 0.933), parity (p = 0.557), method of conception (p = 0.322), or diabetes mellitus (p = 0.381). Conclusions The log10 IL-6 values follow a normal distribution. IL-6 values are independent of gestational age, maternal age, body mass index, ethnicity, smoking status, parity and method of conception. Our study provides a normal reference range for IL-6 levels in the amniotic fluid that can be used in future studies. We also observed that normal IL-6 values were higher in the amniotic fluid than in serum.Some of the authors are members of the European Reference Network on Rare Congenital Malformations and Rare Intellectual Disability ERN-ITHACA (EU Framework Partnership Agreement ID: 3HP-HP-FPA ERN-01-2016/739516)