Non-invasive ventilation in obesity hypoventilation syndrome without severe obstructive sleep apnoea

Background Non-invasive ventilation (NIV) is an effective form of treatment in patients with obesity hypoventilation syndrome (OHS) who have concomitant severe obstructive sleep apnoea (OSA). However, there is a paucity of evidence on the efficacy of NIV in patients with OHS without severe OSA. We performed a multicentre randomised clinical trial to determine the comparative efficacy of NIV versus lifestyle modification (control group) using daytime arterial carbon dioxide tension (PaCO2) as the main outcome measure. Methods Between May 2009 and December 2014 we sequentially screened patients with OHS without severe OSA. Participants were randomised to NIV versus lifestyle modification and were followed for 2 months. Arterial blood gas parameters, clinical symptoms, health-related quality of life assessments, polysomnography, spirometry, 6-min walk distance test, blood pressure measurements and healthcare resource utilisation were evaluated. Statistical analysis was performed using intention-to-treat analysis. Results A total of 365 patients were screened of whom 58 were excluded. Severe OSA was present in 221 and the remaining 86 patients without severe OSA were randomised. NIV led to a significantly larger improvement in PaCO2 of -6 (95% CI -7.7 to -4.2) mm Hg versus -2.8 (95% CI -4.3 to -1.3) mm Hg, (p<0.001) and serum bicarbonate of -3.4 (95% CI -4.5 to -2.3) versus -1 (95% CI -1.7 to -0.2 95% CI) mmol/L (p<0.001). PaCO2 change adjusted for NIV compliance did not further improve the inter-group statistical significance. Sleepiness, some health-related quality of life assessments and polysomnographic parameters improved significantly more with NIV than with lifestyle modification. Additionally, there was a tendency towards lower healthcare resource utilisation in the NIV group. Conclusions NIV is more effective than lifestyle modification in improving daytime PaCO2, sleepiness and polysomnographic parameters. Long-term prospective studies are necessary to determine whether NIV reduces healthcare resource utilisation, cardiovascular events and mortality

The anthracological sequence of the Parco cave (Alòs de Balaguer, Spain): Landscapes and firewood management among the last hunter-gatherers

10.1016/j.anthro.2013.08.00

Selection of antimicrobial frog peptides and temporin-1DRa analogues for treatment of bacterial infections based on their cytotoxicity and differential activity against pathogens

Cationic, amphipathic, α‐helical host‐defense peptides (HDPs) that are naturally secreted by certain species of frogs (Anura) possess potent broad‐spectrum antimicrobial activity and show therapeutic potential as alternatives to treat infections by multi‐drug resistant pathogens. Fourteen amphibian skin peptides and twelve analogues of temporin‐1DRa were studied for their antimicrobial activities against clinically relevant human or animal skin infection‐associated pathogens. For comparison, antimicrobial potencies of frog skin peptides against a range of probiotic lactobacilli were determined. We used the VITEK 2 system to define a profile of antibiotic susceptibility for the bacterial panel. The minimal inhibitory concentration (MIC) values of the naturally occurring temporin‐1DRa, CPF‐AM1, alyteserin‐1c, hymenochirin‐2B, and hymenochirin‐4B for pathogenic bacteria were 3‐ to 9‐fold lower than the values for the tested probiotic strains. Similarly, temporin‐1DRa and its [Lys4], [Lys5] and [Aib8] analogues showed 5‐ to 6.5‐fold greater potency against the pathogens. In the case of PGLa‐AM1, XT‐7, temporin‐1DRa and its [D‐Lys8] and [Aib13] analogues, no apoptosis or necrosis was detected in human peripheral blood mononuclear cells at concentrations below or above the MIC. Given the differential activity against commensal bacteria and pathogens, some of these peptides are promising candidates for further development into therapeutics for topical treatment of skin infection

Archeologisch vooronderzoek

onderzoeksrappor

Technical-economic management of ruminant farms in Navarra: trends, evolution and prospects

Ponencia presentada a la 51 Reunión Científica de la SEEP celebrada en la Escuela Superior de Ingenieros Agrónomos de la Universidad Pública de Navarra entre el 14 y el 18 de mayo de 2012.Los Institutos Técnicos y de Gestión comenzaron a trabajar en 1981 en el análisis y asesoramiento de gestión a las explotaciones ganaderas de Navarra. En una primera etapa la información recogida para este objetivo fue de carácter técnico fundamentalmente y, posteriormente, se amplió tanto el volumen de información recopilada como el ámbito de estudio, pasando de trabajar con el rebaño a trabajar con la explotación en su conjunto. En la actualidad se dispone de series de datos desde 1986 que permiten estudiar la evolución de la productividad, los precios, los costes y los resultados de las diferentes especies de ganadería de rumiantes y en sus diferentes orientaciones productivas (OP). Las principales de entre ellas que existen en Navarra son: i) vacuno de leche (VL), ii) vacuno de carne (VC), iii) ovino de leche (OL), iv) ovino de carne (OC). En este trabajo se repasan, en primer lugar, los censos y la tipología de las explotaciones. Posteriormente, utilizando los resultados de gestión técnico-económica y analizando tanto su evolución en el pasado como la situación actual, se hace un recorrido por los principales factores que inciden sobre las diferentes estrategias adoptadas por los ganaderos y sobre la rentabilidad de su actividad. Para terminar, se presenta una propuesta y algunos resultados de los nuevos enfoques que se están desarrollando desde INTIA para que la gestión pueda ofrecer un diagnóstico de las explotaciones ganaderas más integral y más adaptado a las exigencias futuras.The Technical and Management Institutes started to work in 1981 in the advice and analysis of farm’s management in Navarra. In a first stage, the information collected for this purpose was technical, mainly to increase both the volume of information and the study area, going from working at the herd level to the farm level. Data set collected from 1986 till nowadays of different ruminant species and productive orientations, allows the study of the evolution of the productivity, the prices and the costs of i) dairy cattle, ii) beef, iii) dairy sheep and iv) sheep meat. In this paper we review, first, the evolution of censuses and the typology of farms. Using the technical-economic management results we analyze the evolution, the current situation, the main factors that affect the different strategies adopted by farmers, and the profitability of their business. Finally, we present a proposal and some results of new approaches that INTIA is beginning to work in order to adapt ruminant livestock management to future requirements