Molecular epidemiology of enterovirus 71, coxsackievirus A16 and A6 associated with hand, foot and mouth disease in Spain

Producción CientíficaHand, foot and mouth disease (HFMD) is a childhood illness frequently caused by genotypes belonging to the enterovirus A species, including coxsackievirus (CV)-A16 and enterovirus (EV)-71. Between 2010 and 2012, several outbreaks and sporadic cases of HFMD occurred in different regions of Spain. The objective of the present study was to describe the enterovirus epidemiology associated with HFMD in the country. A total of 80 patients with HFMD or atypical rash were included. Detection and typing of the enteroviruses were performed directly in clinical samples using molecular methods. Enteroviruses were detected in 53 of the patients (66%). CV-A6 was the most frequent genotype, followed by CV-A16 and EV-71, but other minority types were also identified. Interestingly, during almost all of 2010, CV-A16 was the only causative agent of HFMD but by the end of the year and during 2011, CV-A6 became predominant, while CV-A16 was not detected. In 2012, however, both CV-A6 and CV-A16 circulated. EV-71 was associated with HFMD symptoms only in three cases during 2012. All Spanish CV-A6 sequences segregated into one major genetic cluster together with other European and Asian strains isolated between 2008 and 2011, most forming a particular clade. Spanish EV-71 strains belonged to subgenogroup C2, as did most of the European sequences circulated. In conclusion, the recent increase of HFMD cases in Spain and other European countries has been due to a larger incidence of circulating species A enteroviruses, mainly CV-A6 and CV-A16, and the emergence of new genetic variants of these viruses

La Tradició codicològica i litúrgica de l'homiliari carolingi de Luculentius a Catalunya : la recensió catalana: inventari i homilies recuperades

L'homiliari carolingi de Luculentius, que fou escrit a la darreria del segle IX, possiblement a Italià, tingué a Catalunya una gran difusió que contrasta amb la migrada tradició italiana. Aquesta obra de l'enigmàtic Luculentius, que a la Catalunya Vella fou designada amb els noms tipològics de Collectaneum i Dispositus, només la transmeten completa dos homiliaris copiats, l'any 956/957, al monestir de Sant Cugat del Vallès, vora Barcelona. La seva tradició codicològica a Catalunya, i el seu abast librari i geogràfic queden reflectits en els homiliaris de l'ofici diví i, particularment, en els nous noranta-cinc fragments de còdexs localitzats, quaranta d'ells copiats entre els anys 925/950 i el primer quart del segle XI, que transmeten una recenssió pròpia o família catalana de Luculentius. És una recenssió a tenir en compte en l'edició crítica de Luculentius i de la qual editem les tres primeres homilies que manquen en els còdexs de Sant Cugat del Vallès.The carolingian homiliary of Luculentius, written in the end of 9th century, possibly in Italy, had a wide diffusion in Catalonia contrasting with a rather reduced italian tradition. This work of an enigmatic Luculentius, designated in Catalonia with the tipoligical names of Collectaneum and Dispositus, is contained complete in only two homiliaries copied on 956/957 at the monastery of Sant Cugat del Vallès, near Barcelona. Its codicological tradition in Catalonia and its library and geographical range is attested through the Divine Office homiliaries and, particularly, through the newly identified ninety-five codex fragments, forty of them copied between 925/950 and the first quarter of 11th century, transmitting an own catalan recension or catalan family of the Luculentius. This is a recension to be taken into account for the critical edition of the Luculentius, from which we edit here the three first homilies, absent from Sant Cugat codexs

Shared goals for mental health research: what, why and when for the 2020s

Mental health problems bring substantial individual, community and societal costs and the need for innovation to promote good mental health and to prevent and treat mental health problems has never been greater. However, we know that research findings can take up to 20 years to implement. One way to push the pace is to focus researchers and funders on shared, specific goals and targets. We describe a consultation process organised by the Department of Health and Social Care and convened by the Chief Medical Officer to consider high level goals for future research efforts and to begin to identify UK-specific targets to measure research impact. The process took account of new scientific methods and evidence, the UK context with a universal health care system (the NHS) and the embedded research support from the National Institute for Health Research Clinical Research Network, as well as the views of individual service users and service user organisations. The result of the consultation is a set of four overarching goals with the potential to be measured at intervals of three, five or ten years

The burden of community-acquired pneumonia in the elderly: the Spanish EVAN-65 Study

BACKGROUND: Community-acquired pneumonia (CAP) is generally considered a major cause of morbidity and mortality in the elderly. However, population-based data are very limited and its overall burden is unclear. This study assessed incidence and mortality from CAP among Spanish community-dwelling elderly. METHODS: Prospective cohort study that included 11,240 individuals aged 65 years or older, who were followed from January 2002 until April 2005. Primary endpoints were all-cause CAP (hospitalised and outpatient) and 30-day mortality after the diagnosis. All cases were radiographically proved and validated by checking clinical records. RESULTS: Incidence rate of overall CAP was 14 cases per 1,000 person-year (95% confidence interval: 12.7 to 15.3). Incidence increased dramatically by age (9.9 in people 65–74 years vs 29.4 in people 85 years or older), and it was almost double in men than in women (19.3 vs 10.1). Hospitalisation rate was 75.1%, with a mean length-stay of 10.4 days. Overall 30-days case-fatality rate was 13% (15% in hospitalised and 2% in outpatient cases). CONCLUSION: CAP remains as a major health problem in older adults. Incidence rates in this study are comparable with rates described in Northern Europe and America, but they largely doubled prior rates reported in other Southern European regions