Alzheimer’s Disease Dementia Guidelines for Diagnostic Testing: A Systematic Review

Alzheimer’s disease dementia (AD dementia) is one of the most common neurodegenerative diseases worldwide, with a growing incidence during the last decades. Clinical diagnosis of cognitive impairment and presence of AD biomarkers have become important issues for early and adequate treatment. We performed a systematic literature search and quality appraisal of AD dementia guidelines, published between 2005 and 2011, which contained diagnostic recommendations on AD dementia. We also analyzed diagnostic recommendations related to the use of brief cognitive tests, neuropsychological evaluation, and AD biomarkers. Of the 537 retrieved references, 15 met the selection criteria. We found that Appraisal of Guidelines Research and Evaluation (AGREE)-II domains such as applicability and editorial independence had the lowest scores. The wide variability on assessment of quality of evidence and strength of recommendations were the main concerns identified regarding diagnostic testing. Although the appropriate methodology for clinical practice guideline development is well known, the quality of diagnostic AD dementia guidelines can be significantly improved

Analysis of porcine MUC4 gene as a candidate gene for prolificacy QTL on SSC13 in an Iberian × Meishan F2 population

Background: Reproductive traits, such as prolificacy, are of great interest to the pig industry. Better understanding of their genetic architecture should help to increase the efficiency of pig productivity through the implementation of marker assisted selection (MAS) programmes. Results: The Mucin 4 (MUC4) gene has been evaluated as a candidate gene for a prolificacy QTL described in an Iberian × Meishan (Ib × Me) F2 intercross. For association analyses, two previously described SNPs (DQ124298:g.243A>G and DQ124298:g.344A>G) were genotyped in 347 pigs from the Ib × Me population. QTL for the number of piglets born alive (NBA) and for the total number of piglets born (TNB) were confirmed on SSC13 at positions 44 cM and 51 cM, respectively. The MUC4 gene was successfully located within the confidence intervals of both QTL. Only DQ124298:g.344A>G MUC4 polymorphism was significantly associated with both NBA and TNB (P-value < 0.05) with favourable effects coming from the Meishan origin. MUC4 expression level was determined in F2 sows displaying extreme phenotypes for the number of embryos (NE) at 30-32 days of gestation. Differences in the uterine expression of MUC4 were found between high (NE ≥ 13) and low (NE ≤ 11) prolificacy sows. Overall, MUC4 expression in high prolificacy sows was almost two-fold increased compared with low prolificacy sows. Conclusions: Our data suggest that MUC4 could play an important role in the establishment of an optimal uterine environment that would increase embryonic survival during pig gestation

Polítiques sanitàries per a la població immigrant en el context nacional i internacional

Health policy; ImmigrationPolítica sanitaria; InmigraciónPolítica sanitària; ImmigracióInforme que analiza las experiencias nacionales y internacionales en políticas sanitarias para la inmigración, evaluando sus ventajas y limitaciones para extraer posibles enseñanzas para la implantación en Cataluña. Se estructura en tres partes: la primera es una introducción sobre el estado de salud, el acceso a los servicios sanitarios de los colectivos inmigrantes, la evolución del derecho a la salud en el ámbito nacional y internacional y las implicaciones para la población inmigrante. La segunda parte describe los objetivos y la metodología del estudio. La tercera pare presenta los resultados, la discusión y conclusiones.Informe que analitza les experiències nacionals i nternacionals en polítiques sanitàries per a la immigració, avaluant-ne les avantatges i limitacions per extreure’n possibles ensenyances per a la implantació a Catalunya. S’estructura en tres parts: la primera fa una introducció sobre l’estat de salut, l’accés als serveis sanitaris dels col·lectius immigrants, l’evolució del dret a la salut en l’àmbit nacional i internacional i les implicacions per a la població immigrant. La segona part descriu els objectius i metodologia de l’estudi. La tercera part presenta els resultats i la discussió i conclusions

Carotid atherosclerosis: clinical-histological correlation in vulnerable plaques

Objetivos: Caracterizar histológicamente placas humanas carotídeas vulnerables para plantear nuevas opciones diagnósticas y terapéuticas mediante la aplicación de nanomateriales en pacientes asintomáticos. Métodos: Se incluyeron tres pacientes varones, con enfermedad carotidea e indicación quirúrgica (endarterectomía). Las placas fueron teñidas con hematoxilina-eosina, tricrómico de Masson, picrosirius y orceína. Se analizaron histológicamente, determinando su remodelamiento, núcleo lipídico, infiltración inflamatoria, presencia de células espumosas, calcificación y neovascularización con hemorragia. Se realizo un análisis estadístico comparativo del porcentaje de fibrosis, así como de su intensidad por tercios entre las muestras e intramuestra. Resultados: A nivel clínico, la placa 1 era sintomática, correspondía a un paciente con antecedente de accidente isquémico transitorio, el paciente 2 presentaba un aneurisma carotideo con gran trombo mural y la placa 3 era asintomática. A nivel histológico, las placas 1 y 2 se asociaban con un estadio más evolucionado que la placa 3. Las placas 1 y 2 presentaron ruptura de su pared, intenso infiltrado de macrófagos, abundante calcificación y neovascularización con hemorragia intraplaca. Las placas carotídeas diferían principalmente en el grado de fibrosis. En concreto, la placa 3 destacó por la presencia de células espumosas migrando hacia el núcleo lipídico y la formación de líneas de calcificación. El estudio estadístico mostró una notable fibrosis de la placa 1 (5,4%), siendo inferior en la placa 3 (2,51%) y en la 2 (1,84%). Así mismo, se observaron diferencias estadísticamente significativas al comparar el tercio inferior de las placas 1 y 3, y en el análisis intramuestra de la placa 2. Conclusiones: El presente estudio permitió determinar las características histológicas de placas vulnerables que se pueden asociar con la manifestación de síntomas clínicos. Estos hallazgos, sugieren un conocimiento potencial para el desarrollo de nuevas opciones diagnósticas y terapéuticas que mejoren las herramientas actualmente disponibles.Objectives: Histological characterization of vulnerable human carotid plaques to propose new diagnostic and therapeutic options through the application of tissue engineering strategies in asymptomatic patients. Methods: In this study three male patients were included who presented carotid disease with surgical criteria (classic endarterectomy). The plaques were stained with hematoxylin-eosin, Masson’s trichrome, picrosirius and orcein. All samples were histologically analyzed to study remodeling capability, lipid nucleus, inflammatory infiltration, presence of foam cells, calcification, neovascularization and intraplaque hemorrhage. In addition, we performed a comparative statistical analysis of the fibrosis percentage, as well as its intensity by thirds between samples and intra-sample. Results: Clinical analysis revealed that Plaque 1 was syntomathic, trigging a stroke. Plaque 2 set up a carotid aneurism with a large mural thrombus. Plaque 3 was asynthomatic. Histologycal analysis from Plaques 1 and 2 determined they had developed a more advanced stage than Plaque 3. Plaques 1 and 2 were rupture plaques with a severe macrophages infiltrated and overall calcification and neovascularization with hemorrage. All plaques differed in the degree of fibrosis. At Plaque 3 foams cells were standing out, migrating to lipidic nucleous, as well as calcification lines. Statistic analysis presented a notorious Plaque 1 fibrosis (5,4%), below Plaque 3 (2,51%), and Plaque 2 (1,84%). They were statistically significant differences between the lower third of Plaques 1 and, 3, and at intra-sample analysis of Plaque 2. Conclusions: The present study allowed us to determine the histological characteristics of vulnerable plaques that can be associated with the manifestation of clinical symptoms. These findings suggest a potential knowledge for the development of new diagnostic and therapeutic options that improve clinical currently available tools

Efecto de un anticoccidial natural a base de saponinas de Yucca schidigera y Trigonella foenum-graecum sobre el control de coccidiosis en pollos de carne

The aim of this study was to evaluate the effect of a natural anticoccidial based on saponins from Yucca schidigera and Trigonella foenum-graecumen in the control of coccidiosis in broilers. It was used 75 1-day-old chicks from the Cobb 500 line, randomly distributed in three treatments: DBSA (base diet without addition of anticoccidial), DBAN (base diet with addition of natural anticoccidial), DBQI (base diet with addition of chemical anticoccidial - ionophore) with five repetitions and five chicks per experimental unit. The birds were inoculated on day 14 with 15 times the recommended dose of the live vaccine (Coccivac-D) which contains Eimeria acervulina, E. maxima, E. mivati, E. tenella, E. necatrix, E. brunetti, E. hagani and E. praecox to induce the disease. The variables oocyst count per gram of faeces (ROpgh), intestinal lesions and various productive parameters were evaluated. The values ​​of ROpgh were similar for DBAN and DBQI peaking at the seventh week (328.8 and 455.8 Opgh, respectively), and then decreasing. Intestinal lesions on days 10, 20 and 28 post-infection and the productive parameters at the end of the study were similar for both treatments, but significantly better than the DBSA control. It is concluded that the saponins from Y. schidigera and T. foenum-graecum can efficiently replace chemical anticoccidials in bird feeds. &nbsp;El objetivo del estudio fue evaluar el efecto de un anticoccidial natural a base de saponinas procedentes de Yucca schidigera y Trigonella foenum-graecumen en el control de coccidiosis en pollos de carne. Se utilizaron 75 pollos machos de la línea Cobb 500 de un día de edad, distribuidos al azar en tres tratamientos: DBSA (dieta base sin adición de anticoccidial), DBAN (dieta base con adición de anticoccidial natural), DBQI (dieta base con adición de anticoccidial químico - ionóforo) con cinco repeticiones y cinco aves por unidad experimental. Los pollos fueron inoculados en día 14 con 15 veces la dosis recomendada de la vacuna viva (Coccivac-D), que contiene Eimeria acervulina, E. maxima, E. mivati, E. tenella, E. necatrix, E. brunetti, E. hagani y E. praecox para inducir la enfermedad. Se evaluaron las variables recuento de ooquistes por gramo de heces (ROpgh), lesiones intestinales y diversos parámetros productivos. Los valores de ROpgh fueron similares para DBAN y DBQI llegando a su pico a la séptima semana (328.8 y 455.8 Opgh, respectivamente), para luego disminuir. Las lesiones intestinales los días 10, 20 y 28 pos-infección y los parámetros productivos al final del estudio fueron similares para ambos tratamientos, pero significativamente mejores que el control DBSA. Se concluye que las saponinas procedentes de Y. schidigera y T. foenum-graecum pueden remplazar eficientemente a los anticoccidiales químicos en la alimentación de las aves

Recomendaciones para gestantes con diabetes: conclusiones del Consenso reunido por convocatoria del Comité de Diabetes y Embarazo de la SAD

La diabetes gestacional es una alteración de la tolerancia a la glucosa con severidad variable que comienza o es reconocida por primera vez durante el embarazo en curso. Esta definición es válida independientemente del tratamiento que requiera, de si se trata de una diabetes previa al embarazo que no fue diagnosticada, o si la alteración del metabolismo hidrocabonado persiste al concluir la gestación. El presente trabajo, realizado por Consenso en el Comité de Diabetes y Embarazo de la Sociedad Argentina de Diabetes, actualiza los criterios diagnósticos de la diabetes gestacional, así como también el tratamiento, seguimiento y control de la patología tanto durante la gestación, como en el parto y el puerperio.Fil: Faingold, María Cristina.Fil: Lamela, C..Fil: Gheggi, María Soledad. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Lapertosa, Silvia.Fil: Di Marco, Ingrid.Fil: Basualdo, María Natalia.Fil: Rovira, Marta Graciela. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Centro de Estudios Farmacológicos y Botánicos. Universidad de Buenos Aires. Facultad de Medicina. Centro de Estudios Farmacológicos y Botánicos; ArgentinaFil: Jawerbaum, Alicia Sandra. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Centro de Estudios Farmacológicos y Botánicos. Universidad de Buenos Aires. Facultad de Medicina. Centro de Estudios Farmacológicos y Botánicos; ArgentinaFil: Glatstein, Lucia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Centro de Estudios Farmacológicos y Botánicos. Universidad de Buenos Aires. Facultad de Medicina. Centro de Estudios Farmacológicos y Botánicos; ArgentinaFil: López, C..Fil: Caamaño, A..Fil: Salcedo, L..Fil: Rodríguez, María Elena.Fil: Alvariñas J.

COPD Clinical Control: predictors and long-term follow-up of the CHAIN cohort

CHAIN Study Investigators.[Background] Control in COPD is a dynamic concept that can reflect changes in patients’ clinical status that may have prognostic implications, but there is no information about changes in control status and its long-term consequences.[Methods] We classified 798 patients with COPD from the CHAIN cohort as controlled/uncontrolled at baseline and over 5 years. We describe the changes in control status in patients over long-term follow-up and analyze the factors that were associated with longitudinal control patterns and related survival using the Cox hazard analysis.[Results] 134 patients (16.8%) were considered persistently controlled, 248 (31.1%) persistently uncontrolled and 416 (52.1%) changed control status during follow-up. The variables significantly associated with persistent control were not requiring triple therapy at baseline and having a better quality of life. Annual changes in outcomes (health status, psychological status, airflow limitation) did not differ in patients, regardless of clinical control status. All-cause mortality was lower in persistently controlled patients (5.5% versus 19.1%, p = 0.001). The hazard ratio for all-cause mortality was 2.274 (95% CI 1.394–3.708; p = 0.001). Regarding pharmacological treatment, triple inhaled therapy was the most common option in persistently uncontrolled patients (72.2%). Patients with persistent disease control more frequently used bronchodilators for monotherapy (53%) at recruitment, although by the end of the follow-up period, 20% had scaled up their treatment, with triple therapy being the most frequent therapeutic pattern.[Conclusions] The evaluation of COPD control status provides relevant prognostic information on survival. There is important variability in clinical control status and only a small proportion of the patients had persistently good control. Changes in the treatment pattern may be relevant in the longitudinal pattern of COPD clinical control. Further studies in other populations should validate our results.[Trial registration] Clinical Trials.gov: identifier NCT01122758.This study has been funded by AstraZeneca.Peer reviewe

Menarche, pregnancies, and breastfeeding do not modify long-term prognosis in multiple sclerosis

ObjectiveTo investigate the effect of menarche, pregnancies, and breastfeeding on the risk of developing multiple sclerosis (MS) and disability accrual using a multivariate approach based on a large prospective cohort of patients with clinically isolated syndrome (CIS).MethodsA cross-sectional survey of the reproductive information of female participants in a CIS cohort was performed. We examined the relationship of age at menarche with the risk of clinically definite MS (CDMS), McDonald 2010 MS, and Expanded Disability Status Scale (EDSS) 3.0 and 6.0. The effect of pregnancy (before and after CIS) and breastfeeding in the risk of CDMS, McDonald 2010 MS, and EDSS 3.0 was also examined. Univariate and multivariate analyses were performed and findings were confirmed using sensitivity analyses and a propensity score model.ResultsThe data of 501 female participants were collected. Age at menarche did not correlate with age at CIS and was not associated with the risk of CDMS or EDSS 3.0 or 6.0. Pregnancy before CIS was protective for CDMS in the univariate analysis, but the effect was lost in the multivariate model and did not modify the risk of EDSS 3.0. Pregnancy after CIS was protective for both outcomes in univariate and multivariate analyses when pregnancy was considered a baseline variable, but the protective effect disappeared when analyzed as a time-dependent event. Breastfeeding did not modify the risk for the 3 outcomes.ConclusionsThese results demonstrate that menarche, pregnancies, and breastfeeding did not substantially modify the risk of CDMS or disability accrual using a multivariable and time-dependent approach

Identification of Histological Patterns in Clinically Affected and Unaffected Palm Regions in Dupuytren's Disease

Dupuytren's disease is a fibro-proliferative disease characterized by a disorder of the extracellular matrix (ECM) and high myofibroblast proliferation. However, studies failed to determine if the whole palm fascia is affected by the disease. The objective of this study was to analyze several components of the extracellular matrix of three types of tissues—Dupuytren's diseased contracture cords (DDC), palmar fascia clinically unaffected by Dupuytren's disease contracture (NPF), and normal forehand fascia (NFF). Histological analysis, quantification of cells recultured from each type of tissue, mRNA microarrays and immunohistochemistry for smooth muscle actin (SMA), fibrillar ECM components and non-fibrillar ECM components were carried out. The results showed that DDC samples had abundant fibrosis with reticular fibers and few elastic fibers, high cell proliferation and myofibroblasts, laminin and glycoproteins, whereas NFF did not show any of these findings. Interestingly, NPF tissues had more cells showing myofibroblasts differentiation and more collagen and reticular fibers, laminin and glycoproteins than NFF, although at lower level than DDC, with similar elastic fibers than DDC. Immunohistochemical expression of decorin was high in DDC, whereas versican was highly expressed NFF, with no differences for aggrecan. Cluster analysis revealed that the global expression profile of NPF was very similar to DDC, and reculturing methods showed that cells corresponding to DDC tissues proliferated more actively than NPF, and NPF more actively than NFF. All these results suggest that NPF tissues may be affected, and that a modification of the therapeutic approach used for the treatment of Dupuytren's disease should be considered.This work was supported by CTS-115 (Tissue Engineering Group), University of Granada/Spain

The genetic history of Scandinavia from the Roman Iron Age to the present

The authors acknowledge support from the National Genomics Infrastructure in Stockholm funded by Science for Life Laboratory, the Knut and Alice Wallenberg Foundation and the Swedish Research Council, and SNIC/Uppsala Multidisciplinary Center for Advanced Computational Science for assistance with massively parallel sequencing and access to the UPPMAX computational infrastructure. We used resources from projects SNIC 2022/23-132, SNIC 2022/22-117, SNIC 2022/23-163, SNIC 2022/22-299, and SNIC 2021-2-17. This research was supported by the Swedish Research Council project ID 2019-00849_VR and ATLAS (Riksbankens Jubileumsfond). Part of the modern dataset was supported by a research grant from Science Foundation Ireland (SFI), grant number 16/RC/3948, and co-funded under the European Regional Development Fund and by FutureNeuro industry partners.Peer reviewedPublisher PD