Estudi de les aigües salines a la conca del riu Llobregat i Cardener : implicacions ambientals

L'increment de la salinitat a les aigües subterrànies a prop de la zones de les explotacions mineres salines representa un problema ambiental amb moltes implicacions socio-econòmiques. La part mitja de la conca del riu Llobregat i Cardener és un clar exemple d'aquesta problemàtica. En molts casos l'origen de la salinitat és dubtós, ja que pot provenir del contacte de l'aigua de l'aqüífer amb formacions geològiques salines naturals o per l'afectació de les escombreres produïdes per l'explotació minera de potasses que es troba en aquesta regió. L'objectiu d'aquest treball és demostrar que el Ra pot ser un bon traçador per determinar l'origen de la salinitat de les aigües i complementar les analítiques químiques elementals i dels isòtops del sofre i de l'oxigen del sulfat (δ34SSO4 i δ18OSO4). La presència dels diversos isòtops del Ra en les aigües subterrànies dependrà de la geologia i del temps de residència de l'aigua dins l'aqüífer. L'anàlisi de 12 mostres de la comarca indica que el 226Ra és el millor dels isòtops del Ra que permet diferenciar l'origen de les aigües subterrànies.El incremento de la salinidad en las aguas subterráneas cerca de la zonas de las explotaciones mineras salinas representa un problema ambiental con muchas implicaciones socioeconómicas. La parte media de la cuenca del río Llobregat y Cardener es un claro ejemplo de esta problemática. En muchos casos el origen de la salinidad es dudoso, ya que puede provenir del contacto del agua del acuífero con formaciones geológicas salinas naturales o por la afectación de las escombreras producidas por la explotación minera de potasa que se encuentra en esta región. El objetivo de este trabajo es demostrar que el Ra puede ser un buen trazador para determinar el origen de la salinidad de las aguas y complementar las analíticas químicas elementales y los isótopos del azufre y del oxígeno del sulfato (δ34SSO4 i δ18OSO4). La presencia de los diversos isótopos del Ra en las aguas subterráneas dependerá de la geología y del tiempo de residencia del agua dentro del acuífero. El análisis de 12 muestras de la comarca indica que el 226Ra es el mejor de los isótopos del Ra que permite diferenciar el origen de las aguas subterráneas.The increased salinity in groundwater near the areas of mining salt is a problem with many environmental socio-economic implications. The middle section of the Llobregat and Cardoner river basin is a clear example of this problem. The origin of the salinity is controversial, as it can be related to natural interaction with saline formations, or it could be caused from potash mine tailing in this region. The aim of this paper is to show that Ra is a good tracer to determine the origin of the salinity of the water and complement chemical analyzes and sulphur isotopes of oxygen and sulfate (δ34SSO4 & δ18OSO4). The presence of different isotopes of Ra in groundwater depends on the geology and the residence time of water in the aquifer. The analysis of 12 samples from the region indicates that 226Rn is the best of the Ra isotopes that can discern the origin of groundwater

Estudi de les aigües salines a la conca del riu Llobregat i Cardener : implicacions ambientals

L'increment de la salinitat a les aigües subterrànies a prop de la zones de les explotacions mineres salines representa un problema ambiental amb moltes implicacions socio-econòmiques. La part mitja de la conca del riu Llobregat i Cardener és un clar exemple d'aquesta problemàtica. En molts casos l'origen de la salinitat és dubtós, ja que pot provenir del contacte de l'aigua de l'aqüífer amb formacions geològiques salines naturals o per l'afectació de les escombreres produïdes per l'explotació minera de potasses que es troba en aquesta regió. L'objectiu d'aquest treball és demostrar que el Ra pot ser un bon traçador per determinar l'origen de la salinitat de les aigües i complementar les analítiques químiques elementals i dels isòtops del sofre i de l'oxigen del sulfat (δ34SSO4 i δ18OSO4). La presència dels diversos isòtops del Ra en les aigües subterrànies dependrà de la geologia i del temps de residència de l'aigua dins l'aqüífer. L'anàlisi de 12 mostres de la comarca indica que el 226Ra és el millor dels isòtops del Ra que permet diferenciar l'origen de les aigües subterrànies.El incremento de la salinidad en las aguas subterráneas cerca de la zonas de las explotaciones mineras salinas representa un problema ambiental con muchas implicaciones socioeconómicas. La parte media de la cuenca del río Llobregat y Cardener es un claro ejemplo de esta problemática. En muchos casos el origen de la salinidad es dudoso, ya que puede provenir del contacto del agua del acuífero con formaciones geológicas salinas naturales o por la afectación de las escombreras producidas por la explotación minera de potasa que se encuentra en esta región. El objetivo de este trabajo es demostrar que el Ra puede ser un buen trazador para determinar el origen de la salinidad de las aguas y complementar las analíticas químicas elementales y los isótopos del azufre y del oxígeno del sulfato (δ34SSO4 i δ18OSO4). La presencia de los diversos isótopos del Ra en las aguas subterráneas dependerá de la geología y del tiempo de residencia del agua dentro del acuífero. El análisis de 12 muestras de la comarca indica que el 226Ra es el mejor de los isótopos del Ra que permite diferenciar el origen de las aguas subterráneas.The increased salinity in groundwater near the areas of mining salt is a problem with many environmental socio-economic implications. The middle section of the Llobregat and Cardoner river basin is a clear example of this problem. The origin of the salinity is controversial, as it can be related to natural interaction with saline formations, or it could be caused from potash mine tailing in this region. The aim of this paper is to show that Ra is a good tracer to determine the origin of the salinity of the water and complement chemical analyzes and sulphur isotopes of oxygen and sulfate (δ34SSO4 & δ18OSO4). The presence of different isotopes of Ra in groundwater depends on the geology and the residence time of water in the aquifer. The analysis of 12 samples from the region indicates that 226Rn is the best of the Ra isotopes that can discern the origin of groundwater

Impact of late presentation of HIV infection on short-, mid- and long-term mortality and causes of death in a multicenter national cohort : 2004-2013

To analyze the impact of late presentation (LP) on overall mortality and causes of death and describe LP trends and risk factors (2004-2013). Cox models and logistic regression were used to analyze data from a nation-wide cohort in Spain. LP is defined as being diagnosed when CD4 < 350 cells/ml or AIDS. Of 7165 new HIV diagnoses, 46.9% (CI:45.7-48.0) were LP, 240 patients died.First-year mortality was the highest (aHR = 10.3[CI:5.5-19.3]); between 1 and 4 years post-diagnosis, aHR = 1.9(1.2-3.0); an

How do women living with HIV experience menopause? Menopausal symptoms, anxiety and depression according to reproductive age in a multicenter cohort

CatedresBackground: To estimate the prevalence and severity of menopausal symptoms and anxiety/depression and to assess the differences according to menopausal status among women living with HIV aged 45-60 years from the cohort of Spanish HIV/AIDS Research Network (CoRIS). Methods: Women were interviewed by phone between September 2017 and December 2018 to determine whether they had experienced menopausal symptoms and anxiety/depression. The Menopause Rating Scale was used to evaluate the prevalence and severity of symptoms related to menopause in three subscales: somatic, psychologic and urogenital; and the 4-item Patient Health Questionnaire was used for anxiety/depression. Logistic regression models were used to estimate odds ratios (ORs) of association between menopausal status, and other potential risk factors, the presence and severity of somatic, psychological and urogenital symptoms and of anxiety/depression. Results: Of 251 women included, 137 (54.6%) were post-, 70 (27.9%) peri- and 44 (17.5%) pre-menopausal, respectively. Median age of onset menopause was 48 years (IQR 45-50). The proportions of pre-, peri- and post-menopausal women who had experienced any menopausal symptoms were 45.5%, 60.0% and 66.4%, respectively. Both peri- and post-menopause were associated with a higher likelihood of having somatic symptoms (aOR 3.01; 95% CI 1.38-6.55 and 2.63; 1.44-4.81, respectively), while post-menopause increased the likelihood of having psychological (2.16; 1.13-4.14) and urogenital symptoms (2.54; 1.42-4.85). By other hand, post-menopausal women had a statistically significant five-fold increase in the likelihood of presenting severe urogenital symptoms than pre-menopausal women (4.90; 1.74-13.84). No significant differences by menopausal status were found for anxiety/depression. Joint/muscle problems, exhaustion and sleeping disorders were the most commonly reported symptoms among all women. Differences in the prevalences of vaginal dryness (p = 0.002), joint/muscle complaints (p = 0.032), and sweating/flush (p = 0.032) were found among the three groups. Conclusions: Women living with HIV experienced a wide variety of menopausal symptoms, some of them initiated before women had any menstrual irregularity. We found a higher likelihood of somatic symptoms in peri- and post-menopausal women, while a higher likelihood of psychological and urogenital symptoms was found in post-menopausal women. Most somatic symptoms were of low or moderate severity, probably due to the good clinical and immunological situation of these women

COVID-19 in hospitalized HIV-positive and HIV-negative patients : A matched study

CatedresObjectives: We compared the characteristics and clinical outcomes of hospitalized individuals with COVID-19 with [people with HIV (PWH)] and without (non-PWH) HIV co-infection in Spain during the first wave of the pandemic. Methods: This was a retrospective matched cohort study. People with HIV were identified by reviewing clinical records and laboratory registries of 10 922 patients in active-follow-up within the Spanish HIV Research Network (CoRIS) up to 30 June 2020. Each hospitalized PWH was matched with five non-PWH of the same age and sex randomly selected from COVID-19@Spain, a multicentre cohort of 4035 patients hospitalized with confirmed COVID-19. The main outcome was all-cause in-hospital mortality. Results: Forty-five PWH with PCR-confirmed COVID-19 were identified in CoRIS, 21 of whom were hospitalized. A total of 105 age/sex-matched controls were selected from the COVID-19@Spain cohort. The median age in both groups was 53 (Q1-Q3, 46-56) years, and 90.5% were men. In PWH, 19.1% were injecting drug users, 95.2% were on antiretroviral therapy, 94.4% had HIV-RNA < 50 copies/mL, and the median (Q1-Q3) CD4 count was 595 (349-798) cells/μL. No statistically significant differences were found between PWH and non-PWH in number of comorbidities, presenting signs and symptoms, laboratory parameters, radiology findings and severity scores on admission. Corticosteroids were administered to 33.3% and 27.4% of PWH and non-PWH, respectively (P = 0.580). Deaths during admission were documented in two (9.5%) PWH and 12 (11.4%) non-PWH (P = 0.800). Conclusions: Our findings suggest that well-controlled HIV infection does not modify the clinical presentation or worsen clinical outcomes of COVID-19 hospitalization

Prediction of long-term outcomes of HIV-infected patients developing non-AIDS events using a multistate approach

Outcomes of people living with HIV (PLWH) developing non-AIDS events (NAEs) remain poorly defined. We aimed to classify NAEs according to severity, and to describe clinical outcomes and prognostic factors after NAE occurrence using data from CoRIS, a large Spanish HIV cohort from 2004 to 2013. Prospective multicenter cohort study. Using a multistate approach we estimated 3 transition probabilities: from alive and NAE-free to alive and NAE-experienced ("NAE development"); from alive and NAE-experienced to death ("Death after NAE"); and from alive and NAE-free to death ("Death without NAE"). We analyzed the effect of different covariates, including demographic, immunologic and virologic data, on death or NAE development, based on estimates of hazard ratios (HR). We focused on the transition "Death after NAE". 8,789 PLWH were followed-up until death, cohort censoring or loss to follow-up. 792 first incident NAEs occurred in 9.01% PLWH (incidence rate 28.76; 95% confidence interval [CI], 26.80-30.84, per 1000 patient-years). 112 (14.14%) NAE-experienced PLWH and 240 (2.73%) NAE-free PLWH died. Adjusted HR for the transition "Death after NAE" was 12.1 (95%CI, 4.90-29.89). There was a graded increase in the adjusted HRs for mortality according to NAE severity category: HR (95%CI), 4.02 (2.45-6.57) for intermediate-severity; and 9.85 (5.45-17.81) for serious NAEs compared to low-severity NAEs. Male sex (HR 2.04; 95% CI, 1.11-3.84), ag

Effectiveness of the combination elvitegravir/cobicistat/tenofovir/emtricitabine (EVG/COB/TFV/FTC) plus darunavir among treatment-experienced patients in clinical practice : A multicentre cohort study

Background: The aim of this study was to investigate the effectiveness and tolerability of the combination elvitegravir/cobicistat/tenofovir/emtricitabine plus darunavir (EVG/COB/TFV/FTC + DRV) in treatment-experienced patients from the cohort of the Spanish HIV/AIDS Research Network (CoRIS). Methods: Treatment-experienced patients starting treatment with EVG/COB/TFV/FTC + DRV during the years 2014-2018 and with more than 24 weeks of follow-up were included. TFV could be administered either as tenofovir disoproxil fumarate or tenofovir alafenamide. We evaluated virological response, defined as viral load (VL) < 50 copies/ml and < 200 copies/ml at 24 and 48 weeks after starting this regimen, stratified by baseline VL (< 50 or ≥ 50 copies/ml at the start of the regimen). Results: We included 39 patients (12.8% women). At baseline, 10 (25.6%) patients had VL < 50 copies/ml and 29 (74.4%) had ≥ 50 copies/ml. Among patients with baseline VL < 50 copies/ml, 85.7% and 80.0% had VL < 50 copies/ml at 24 and 48 weeks, respectively, and 100% had VL < 200 copies/ml at 24 and 48 weeks. Among patients with baseline VL ≥ 50 copies/ml, 42.3% and 40.9% had VL < 50 copies/ml and 69.2% and 68.2% had VL < 200 copies/ml at 24 and 48 weeks. During the first 48 weeks, no patients changed their treatment due to toxicity, and 4 patients (all with baseline VL ≥ 50 copies/ml) changed due to virological failure. Conclusions: EVG/COB/TFV/FTC + DRV was well tolerated and effective in treatment-experienced patients with undetectable viral load as a simplification strategy, allowing once-daily, two-pill regimen with three antiretroviral drug classes. Effectiveness was low in patients with detectable viral loads