European registry on helicobacter pylori management: Effectiveness of first and second-line treatment in Spain

The management of Helicobacter pylori infection has to rely on previous local effectiveness due to the geographical variability of antibiotic resistance. The aim of this study was to evaluate the effectiveness of first and second-line H. pylori treatment in Spain, where the empirical prescription is recommended. A multicentre prospective non-interventional registry of the clinical practice of European gastroenterologists concerning H. pylori infection (Hp-EuReg) was developed, including patients from 2013 until June 2019. Effectiveness was evaluated descriptively and through a multivariate analysis concerning age, gender, presence of ulcer, proton-pump in-hibitor (PPI) dose, therapy duration and compliance. Overall, 53 Spanish hospitals were included, and 10, 267 patients received a first-line therapy. The best results were obtained with the 10-day bismuth single-capsule therapy (95% cure rate by intention-to-treat) and with both the 14-day bismuth-clarithromycin quadruple (PPI-bismuth-clarithromycin-amoxicillin, 91%) and the 14-day non-bismuth quadruple concomitant (PPI-clarithromycin-amoxicillin-metronidazole, 92%) therapies. Second-line therapies were prescribed to 2448 patients, with most-effective therapies being the triple quinolone (PPI-amoxicillin-levofloxacin/moxifloxacin) and the bismuth-levofloxacin quadruple schemes (PPI-bismuth-levofloxacin-amoxicillin) prescribed for 14 days (92%, 89% and 90% effective-ness, respectively), and the bismuth single-capsule (10 days, 88.5%). Compliance, longer duration and higher acid inhibition were associated with higher effectiveness. “Optimized” H. pylori therapies achieve over 90% success in Spain

Imigração e saúde: a (in)acessibilidade das mulheres imigrantes aos cuidados de saúde

A utilização dos serviços de saúde pelas populações imigrantes tem vindo a ser considerado um dos mais importantes indicadores da sua integração nas so- ciedades receptoras (Dias e col., 2009). No entanto, o conhecimento em torno da qualidade e da eficácia do acesso dos/as imigrantes aos cuidados de saúde, especialmente no que respeita às mulheres imigran- tes, é ainda escasso em Portugal (Fonseca e col., 2005). Embora os estudos nacionais tenham vindo, nas últimas décadas, a procurar traçar os diferentes perfis sociais das mulheres imigrantes em Portugal, sobretudo no que concerne às suas relações fami- liares ou laborais (Wall e col., 2005), a investigação no domínio da saúde é ainda parca e exclusora de uma análise centrada no género ou interseccional. Neste texto apresenta-se uma reflexão sobre os de- terminantes que condicionam a (in)acessibilidade das mulheres imigrantes aos cuidados de saúde, enfatizando-se os fatores que poderão estar a agir no sentido contrário à sua integração neste setor

Health care for irregular migrants: pragmatism across Europe. A qualitative study

<p>Abstract</p> <p>Background</p> <p>Health services in Europe face the challenge of delivering care to a heterogeneous group of irregular migrants (IM). There is little empirical evidence on how health professionals cope with this challenge. This study explores the experiences of health professionals providing care to IM in three types of health care service across 16 European countries.</p> <p>Results</p> <p>Semi-structured interviews were conducted with health professionals in 144 primary care services, 48 mental health services, and 48 Accident & Emergency departments (total n = 240). Although legal health care entitlement for IM varies across countries, health professionals reported facing similar issues when caring for IM. These issues include access problems, limited communication, and associated legal complications. Differences in the experiences with IM across the three types of services were also explored. Respondents from Accident & Emergency departments reported less of a difference between the care for IM patients and patients in a regular situation than did respondents from primary care and mental health services. Primary care services and mental health services were more concerned with language barriers than Accident & Emergency departments. Notifying the authorities was an uncommon practice, even in countries where health professionals are required to do this.</p> <p>Conclusions</p> <p>The needs of IM patients and the values of the staff appear to be as important as the national legal framework, with staff in different European countries adopting a similar pragmatic approach to delivering health care to IM. While legislation might help to improve health care for IM, more appropriate organisation and local flexibility are equally important, especially for improving access and care pathways.</p

A randomized multicenter study comparing seawater washes and carmellose artificial tears eyedrops in the treatment of dry eye syndrome

Manuel Diaz-Llopis,1&ndash;5 Maria Dolores Pinazo-Duran,2,3,6&ndash;9 Loreto Diaz-Gui&ntilde;on,5 Miriam Rahhal-Ortu&ntilde;o,10 Mercedes Perez-Ramos,8,9 Rosabel Bosch,8,9 Roberto Gallego-Pinazo,11,12 Rosa Dolz-Marco,11,12 Teresa Diaz-Gui&ntilde;on,5 Mar&iacute;a Diaz,1,5 Francisco Javier Romero,13 Angel Cisneros10 1University of Valencia, Valencia, Spain; 2Ophthalmology Unit, Faculty of Medicine, University of Valencia, Valencia, Spain; 3Molecular Ophthalmology Unit, Faculty of Medicine, University of Valencia, Valencia, Spain; 4Conseller&iacute;a de Sanitat (Valencian Regional Health Ministry), Valencian Autonomous Government, Valencia, Spain; 5IOVA &ndash; Valencia Ophthalmology Institute, Valencia, Spain; 6Hospital Universitario Doctor Peset, Valencia, Spain; 7Santiago Grisol&iacute;a Eye Research Laboratory, FISABIO, Valencia, Spain; 8Specialised Medical Centre Alboraya, Valencia, Spain; 9Specialised Medical Centre Monteolivete, Valencia, Spain; 10Department of Ophthalmology, La Fe Hospital, Valencia, Spain; 11IMED Hospital, Valencia, Spain; 12Oftalvist Clinic, Valencia, Spain; 13European University of Valencia, Valencia, Spain Purpose: To investigate the safety and efficacy of sterile isotonic seawater washes vs standard treatment with carmellose artificial tears in dry eye syndrome (DES). Patients and methods: This is a randomized multicenter prospective study with 12 weeks of follow-up. A group of patients with DES (N=60) were treated with seawater spray (Quinton&reg;) five times daily, and another similar group (N=60) were treated with carmellose artificial tears eyedrops (Viscofresh&reg; 0.5%) five times a day. The parameters studied and measured were as follows: Ocular Surface Disease Index questionnaire score, Schirmer I test (without anesthesia) score, tear osmolarity (TearLab&reg;), tear breakup time, tear meniscus height (meniscography OCT), fluorescein corneal staining score (National Eye Institute scale), lissamine green conjunctival staining score, and levels of IL-1 beta and IL-6 in tears (Luminex&reg; 200). Results: In the group treated with seawater, symptoms decreased by 68%, and the decrease was 26% statistically superior to the group treated with carmellose artificial tears eyedrops (P&lt;0.001). Levels of IL-1 beta and IL-6 in tears significantly decreased in the seawater group compared to the carmellose artificial tears group (19%/17% vs 52%/51%) (P&lt;0.001). There were no statistically significant differences in the other measured parameters. There were no cases of poor tolerance or side effects. Conclusion: Administration of seawater is more effective than treatment with carmellose artificial tears in reducing symptoms and pro-inflammatory molecules (IL-1 beta and IL-6) in tears of patients with DES. Keywords: dry eye syndrome, isotonic seawater, artificial tears, carmellose, IL-1 beta, IL-6, quality of lif

Anales de Edafología y Agrobiología Tomo 40 Número 3-4

Suelos. Mineralogenesis de arcillas de suelos forestales del Centro-oeste de España. 11. Sierra de Francia, por Mª A. Vicente Hernández y M. Sánchez Camazano.-- Suelos podsólicos y podsoles de la sierra de Urbasa. l. Morfología y datos analiticos, por Rosa Mana Val Legaz y Jaime Iñiguez Herrero.-- Suelos podsólicos y podsoles de la sierra de Urbasa. II. Mineralogía de arcillas, micromorfología y genesis, por Rosa María Val Legaz y Jaime Iñiguez Herrero.-- Consideraciones acerca de la acidificación de los suelos de la zona húmeda española a través de la vegetación, por R.M. Calvo de Anta y F. Díaz Fierros Viqueira.-- Suelos del valle de Ulzama (Navarra). Ultisoles. I Morfología, propiedades químicas y clasificación, por Elisa Barragan y Jaime Iñiguez.--Palexerolls de la provincia de Murcia, por L. J. Alias y C. Pérez Sirvent.-- Estudio de algunos calcixerolls de la provincia de Albacete, por L. J. Alias y C. Pérez Sirvent.-- Aplicación de los modelos de Gouy-Chapman y Stem a suelos con carga va- riable. Andosuelos, por Jaime Iñiguez Herrero y Rosa María Val Legaz.-- Nematodos encontrados en los suelos de la provincia de Guadalajara, por Mª Cristina Zancada y A. BellO.-- Mineralogía de la fracción arcilla en suelos de las sierras de Gredas y Gata. III. Grupo SpodosolOstalf, por M. T. García-González, J. García Vicente y M.P. Riesco.-- Mineralogía de la fracción arcilla en suelos de las sierras de Gredas y Gata. IV. Grupo Spodosol Orthod, por M. T. García-González, l. García Vicente y M.P. Riesco.-- Fertilidad de Suelos.-- Interferencias producidas por el Cl2 Ba-Tea en la determinación conjunta de sodio y potasio, por fotometría de Llama, por Ramón Madrid Vicente y Asunción Roig Garcra Ferrández.-- Fraccionamiento de Boro en suelos calizos, mediante un sistema de electroultrafiltración (EUF), por A. Gárate, C. Cadahía y O. Carpena.-- Acción de los insecticidas: Diazinon, Fention y Carbofuran sobre el "Nematodo de los dtricos" Tylenchulus Semipenetrans Cobb, 1913, por Elisa Valcarce.-- Susceptibilidad de las larvas del "Nematodo de los cítricos" Tylenchulus semipenetrans Cobb, 1913, a los herbicidas Limiron y Dapalon, por Elisa Valcarcel.-- Influencia del carbonato y contenido de arcilla sobre la relación Q/1 del P en suelos, por B. Eleizalde.-- Adsorción de fosfato en suelos calizos. l. Ajuste a distintas Isotermas: Parametros de adsorción, por M.C. Bolarin, F. Santa Cruz, F.G. Fernández y M. Romero.-- Adsorción de fosfato en suelos calizos. II. Correlaciones entre parametros de adsorción y algunas características del suelo, por F. Santa Cruz, M.C. Bolarin, M. Caro y M. Romero.-- Evoluciones, durante las etapas de la floración primaveral, del fósforo de diferentes fracciones orgánicas en flores de Citrus limonum fisiologicamente normales, por Mª Parra y A. Ortuño.-- Estudio de las evoluciones del fósforo de diferentes fracciones en flor de me- locotonero Jeronimo II, durante las distintas etapas de la floración, por Mª Parra.-- Simultaneous measurement of C02 and 0 2 evolution in plant respirometry, por A. J. Sánchez-Raya, M. Gómez y A. Leal.-- Estudio de algunos de los factores nutricionales que modifican la calidad de la proteína en el grano de trigo. l. Influencia de la cantidad de fertilización nitrogenada aplicada en cobertera y de la variedad empleada, por Luis Recalde Manrique y Julio López Gorgé.-- Estudio de algunos de los factores nutricionales que modifican la cantidad de la proteína en el grano de trigo. II. Interacción entre la fertilización nitrogenada aplicada en cobertera y las aplicaciones de azufre elemental por vía foliar, por Luis Recalde Manrique y Julio López Gorgé. Injerto en Hipocotilo de plántulas de castaño, por Mª Luisa Vieitez y Ana Mª Vieltez.-- 647 Efecto espeCÍfico de cloruros sobre la nutrición nitrogenada de plantas jovenes de tomate por Francisco García-Garda y Angel de Luque Escalona.-- Estudio de la fertilización diferenciada en la vid. I. Evolución del nitrogeno total, nitrogeno proteico, aminoacidos libres y prolina, por L. Catalina, R. Sarmiento, R. Romero, V. Valpuesta y C. Mazuelos.-- Predicción de temperaturas medias diarias, por María Dolores Menéndez Furones.-- Notas.-- BibliografíaPeer reviewe