Diagnòstic genètic preimplantacional en estadis embrionaris tardans

La incorporació de la biòpsia de blastocist en la pràctica clínica pot ser considerada com una alternativa vàlida per als cicles de diagnòstic genètic preimplantacional (DGP). La disponibilitat d'un major nombre de cèl·lules obre la possibilitat de realitzar diagnòstics múltiples en paral·lel en el mateix embrió, i es poden detectar teòricament malalties multigèniques o bé combinar diversos tipus de diagnòstic mitjançant FISH i PCR. Els embrions transferits en estadi de blastocist estan subjectes a una doble selecció: genètica i mitjançant el cultiu, i això es veu reflectit en elevades taxes d'implantació, fet que permet reduir el nombre d'embrions a transferir per tal d'evitar gestacions múltiples. Tot i que l'aplicació clínica de la biòpsia de blastocist per al DGP és encara limitada i recent, els bons resultats obtinguts pel que fa a taxes d'implantació i d'embaràs, així com les possibilitats diagnòstiques que obre, suggereixen que es tracta d'una tècnica que esdevindrà més freqüent en el futur.The incorporation of blastocyst biopsy into clinical practice can be considered as a valid alternative when performing PGD. The fact that it makes more material available for analysis is of particular value in those cases where the aim is to diagnose monogenic diseases. The availability of a greater number of cells opens the possibility of performing multiple diagdiagnoses in parallel on the same embryo; these could be used to detect multigenic diseases or for the combined diagnosis of different disorders through diagnostic approaches based on both FISH and PCR. Embryos transferred at the blastocyst stage are subjected to a dual selection process (genetic and through culture) and this is reflected in their greater implantation potential, thus enabling a lower number of embryos to be transferred, which in turn reduces the risk of multiple pregnancy. Although the clinical application of blastocyst biopsy for PGD remains a limited and recent development, the good results in terms of implantation and pregnancy rates obtained so far, as well as the diagnostic possibilities it opens up, suggest that this technique can become more widely used in the early future

Intercanvi d'opinions de lectures

Avui en dia és difícil comentar llibres correctament per diferents motius: la gent del teu entorn no té els mateixos gustos bibliogràfics, cadascú té els seus horaris, i existeix una distància geogràfica, cosa que fa que moltes vegades sigui difícil quedar. Actualment existeixen grups de lectura, però tenen l'inconvenient que els llibres es comenten entre molts usuaris i el fil dels comentaris es perd. Per aquest motiu es vol donar solució aquest problema permetent a la gent comentar en grups de 5 persones un llibre. D'aquesta manera es vol evitar la pèrdua del fil de la conversació. Per utilitzar aquesta aplicació només es necessitarà un navegador web i accés a Internet. L'usuari no s'haurà de preocupar quin sistema operatiu té i es podrà connectar des de qualsevol dispositiu amb accés a Internet. A part, pels desenvolupadors serà fàcil canviar la base de dades si un dia es veuen amb la necessitat de canviar-la, ja que s'utilitza PDO.Hoy en día es difícil comentar libros correctamente por diferentes motivos: la gente de tu entorno no tiene los mismos gustos bibliográficos, cada uno tiene sus horarios, y existe una distancia geográfica, lo que hace que muchas veces sea difícil quedar. Actualmente existen grupos de lectura, pero tienen el inconveniente de que los libros se comentan entre muchos usuarios y el hilo de los comentarios se pierde. Por este motivo se quiere dar solución este problema permitiendo a la gente comentar en grupos de 5 personas un libro. De esta manera se quiere evitar la pérdida del hilo de la conversación. Para utilizar esta aplicación sólo se necesitará un navegador web y acceso a Internet. El usuario no tendrá que preocuparse qué sistema operativo tiene y se podrá conectar desde cualquier dispositivo con acceso a Internet. Aparte, los desarrolladores será fácil cambiar la base de datos si un día se ven en la necesidad de cambiarla, ya que se utiliza PDO.Today it is difficult to write about books properly for several reasons: the people around you do not have the same bibliographic tastes, everyone has their schedules and often makes it difficult to arrange to meet and there is geographical distance. There are reading groups, but have the disadvantage that books discussed among many users and thread of comments is lost. That is why we want to solve this problem by allowing people to comment on a book groups of 5 people. This way we avoid losing the thread of conversation. To use this application you only need a web browser and Internet access. The user does not have to worry about which operating system have and he can connect from any device with Internet access. In addition, developers can change the database easily if one day they need to change it because it uses PDO

El CIDA: 20 años de gestión documental para la investigación en arte contemporáneo

En estos 20 años, el trabajo realizado por el Centro Internacional de Documentación Artística Vicente Aguilera Cerni de Vilafamés (CIDA) ha dado como fruto un fondo documental esencial para conocer el panorama artístico de la segunda mitad del siglo xx. Los documentos cedidos por Vicente Aguilera que dieron origen al CIDA, junto con aquellos cedidos por el MACVAC, otros artistas y críticos de arte, han sido recopilados y gestionados para ponerlos a disposición de los usuarios y facilitar su consulta, convirtiéndose en un recurso para la investigación del arte.In these 20 years, the work done by the CIDA (International Art Documentation Centre Vicente Aguilera Cerni of Vilafamés) has produced as a result a documentary collection essential to the understanding of the art scene of the second half of the twentieth century. The documents that gave rise to the creation of CIDA (donated by Vicente Aguilera),along with the ones transferred from the MACVAC, other artists and art critics, have been compiled and managed in order to make them available to users, thus becoming a resource for art research

Adherence to Direct Oral Anticoagulants in Patients With Non-Valvular Atrial Fibrillation: A Cross-National Comparison in Six European Countries (2008–2015)

Anticoagulants; Europe; Non valvular atrial fibrillationAnticoagulants; Europa; Fibril·lació auricular no valvularAnticoagulantes; Europa; Fibrilación auricular no valvularAims: To describe and compare the adherence to different direct oral anticoagulants (DOACs) in eight European databases representing six countries. Methods: Longitudinal drug utilization study of new users (≥18 years) of DOACs (dabigatran, rivaroxaban, apixaban) with a diagnosis of non-valvular atrial fibrillation (2008–2015). Adherence was examined by estimating persistence, switching, and discontinuation rates at 12 months. Primary non-adherence was estimated in BIFAP and SIDIAP databases. Results: The highest persistence rate was seen for apixaban in the CPRD database (81%) and the lowest for dabigatran in the Mondriaan database (22%). The switching rate for all DOACs ranged from 2.4 to 13.1% (Mondriaan and EGB databases, respectively). Dabigatran had the highest switching rate from 5.0 to 20.0% (Mondriaan and EGB databases, respectively). The discontinuation rate for all DOACs ranged from 16.0 to 63.9% (CPRD and Bavarian CD databases, respectively). Dabigatran had the highest rate of discontinuers, except in the Bavarian CD and AOK NORDWEST databases, ranging from 23.2 to 64.6% (CPRD and Mondriaan databases, respectively). Combined primary non-adherence for examined DOACs was 11.1% in BIFAP and 14.0% in SIDIAP. There were differences in population coverage and in the type of drug data source among the databases. Conclusion: Despite the differences in the characteristics of the databases and in demographic and baseline characteristics of the included population that could explain some of the observed discrepancies, we can observe a similar pattern throughout the databases. Apixaban was the DOAC with the highest persistence. Dabigatran had the highest proportion of discontinuers and switchers at 12 months in most databases (EMA/2015/27/PH).The project has received support from the European Medicines Agency under the Framework service contract (nr EMA/2015/27/PH) with regard to the reopening of competition no. 3. K. Janhsen (Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448 Witten, Germany (UW/GH)) and A. Heeke (AOK NORDWEST, Kopenhagener Straße 1, 44269 Dortmund, Germany). R. Gerlach and M. Tauscher (National Association of Statutory Health Insurance Physicians of Bavaria, Elsenheimerstr. 39, MD-80687 Munich, Germany). The authors from the BIFAP database would like to acknowledge the excellent collaboration of the primary care general practitioners and pediatricians, and also the support of the regional governments to the database. This study is based in part on data from the ‘base de datos para la investigación Farmacoepidemiológica en Atención Primaria’ (BIFAP) fully financed by the Spanish Agency on Medicines and Medical Devices (AEMPS). The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the EMA (European Medicines Agency) or one of its committees or working parties, or AEMPS (Agencia Española de Medicamentos y Productos Sanitarios). The authors thank Alethea Charlton for her support reviewing and editing the English. The authors thank SIDIAP (Sistema d’informació per al Desenvolupament de Investigació en Atenció Primària) for providing the data with respect to CPRD, approval of the study protocol was granted by the Independent Scientific Advisory Committee of the Medicines and Healthcare Products Regulatory Agency (protocol 17_089R)

Indications related to antidepressant prescribing in the Nivel-PCD database and the SIDIAP database

Altres ajuts: Acord transformatiu CRUE-CSICAntidepressant drug consumption has increased, mainly in the elderly. This trend could be explained by the use for indications other than depression. We aimed to describe the indications related to antidepressant drug new users in two primary care settings

Impact of the 2018 revised Pregnancy Prevention Programme by the European Medicines Agency on the use of oral retinoids in females of childbearing age in Denmark, Italy, Netherlands, and Spain: an interrupted time series analysis

Acne; Oral retinoids; Pregnancy preventionAcné; Retinoides orales; Prevención del embarazoAcné; Retinoides orals; Prevenció de l'embaràsBackground: In March 2018, the European pregnancy prevention programme for oral retinoids was updated as part of risk minimisation measures (RMM), emphasising their contraindication in pregnant women. Objective: To measure the impact of the 2018 revision of the RMMs in Europe by assessing the utilisation patterns of isotretinoin, alitretinoin and acitretin, contraceptive measures, pregnancy testing, discontinuation, and pregnancy occurrence concomitantly with a retinoid prescription. Methods: An interrupted time series (ITS) analysis to compare level and trend changes after the risk minimisation measures implementation was conducted on a cohort of females of childbearing age (12–55 years of age) from January 2010 to December 2020, derived from six electronic health data sources in four countries: Denmark, Netherlands, Spain, and Italy. Monthly utilisation figures (incidence rates [IR], prevalence rates [PR] and proportions) of oral retinoids were calculated, as well as discontinuation rates, contraception coverage, pregnancy testing, and rates of exposed pregnancies to oral retinoids, before and after the 2018 RMMs. Results: From 10,714,182 females of child-bearing age, 88,992 used an oral retinoid at any point during the study period (mean age 18.9–22.2 years old). We found non-significant level and trend changes in incidence or prevalence of retinoid use in females of child-bearing age after the 2018 RMMs. The reason of discontinuation was unknown in >95% of cases. Contraception use showed a significant increase trend in Spain; for other databases this information was limited. Pregnancy testing was hardly recorded thus was not possible to model ITS analyses. After the 2018 RMM, rates of pregnancy occurrence during retinoid use, and start of a retinoid during a pregnancy varied from 0.0 to 0.4, and from 0.2 to 0.8, respectively. Conclusion: This study shows a limited impact of the 2018 RMMs on oral retinoids utilisation patterns among females of child-bearing age in four European countries. Pregnancies still occur during retinoid use, and oral retinoids are still prescribed to pregnant women. Contraception and pregnancy testing information was limited in most databases. Regulators, policymakers, prescribers, and researchers must rethink implementation strategies to avoid any pregnancy becoming temporarily related to retinoid use.The research leading to these results was conducted as part of the activities of the EU PE&PV (Pharmacoepidemiology and Pharmacovigilance) Research Network which is a public academic partnership coordinated by the Utrecht University, Netherlands. The project has received support from the European Medicines Agency under the Framework service contract nr EMA/2017/09/PE (Lot 4). The content of this manuscript expresses the opinion of the authors and may not be understood or quoted as being made on behalf of or reflecting the position of the European Medicines Agency or one of its committees or working parties

Genome-wide analysis of single nucleotide polymorphisms and copy number variants in fibromyalgia suggest a role for the central nervous system

Fibromyalgia (FM) is a highly disabling syndrome defined by a low pain threshold and a permanent state of pain. The mechanisms explaining this complex disorder remain unclear, and its genetic factors have not yet been identified. With the aim of elucidating FM genetic susceptibility factors, we selected 313 FM cases having low comorbidities, and we genotyped them on the Illumina 1 million duo array. Genotypic data from 220 control women (Illumina 610k array) was obtained for genome-wide association scan (GWAS) analysis. Copy number variants in FM susceptibility were analyzed by array comparative genomic hybridization (aCGH) experiments on pooled samples using the Agilent 2 × 400K platform. No single nucleotide polymorphism (SNP) reached GWAS association threshold, but 21 of the most associated SNPs were chosen for replication in 952 cases and 644 controls. Four of the SNPs selected for replication showed a nominal association in the joint analysis, and rs11127292 (MYT1L) was found to be associated to FM with low comorbidities (P = 4.28 × 10−5, odds ratio [95% confidence interval] = 0.58 [0.44-0.75]). aCGH detected 5 differentially hybridized regions. They were followed up, and an intronic deletion in NRXN3 was demonstrated to be associated to female cases of FM with low levels of comorbidities (P = .021, odds ratio [95% confidence interval] = 1.46 [1.05-2.04]). Both GWAS and aCGH results point to a role for the central nervous system in FM genetic susceptibility. If the proposed FM candidate genes were further validated in replication studies, this would highlight a neurocognitive involvement in agreement with latest reports

Impact of non-invasive mechanical ventilation (niv) in critical patients with influenza (H1N1) PDM09

The use of non-invasive mechanical ventilation (NIV) in patients with influenza A (H1N1)pdm09 admitted to intensive care units (ICU) has been controversial