Transmission of Hepatitis C Virus during Computed Tomography Scanning with Contrast

Six cases of acute hepatitis C related to computed tomography scanning with contrast were identified in 3 hospitals. A patient with chronic hepatitis C had been subjected to the same procedure immediately before each patient who developed acute infection. Viral molecular analysis showed identity between isolates from cases with acute and chronic hepatitis C

La Morbiditat com a mesura dels trastorns crònics en una cohort representativa de la població de Catalunya (estudi COHESCA)

Títol obtingut de la portada digitalitzadaConsultable des del TDXIntroducció: La morbiditat entesa com la presència de múltiples trastorns crònics (TC) en una mateixa persona esdevé un problema de salut cada vegada més rellevant degut tant a l'envelliment que s'observa en les poblacions de països anomenats desenvolupats, com a l'augment de la prevalença dels TC en aquest sector de la població. La morbiditat es pot mesurar com a Multimorbiditat (sumatori del nombre de TC presents en un individu), com a Comorbiditat (co-occurrència de TC en individus ja diagnosticats d'una malaltia determinada) o com a Índex de comorbiditat (mesura que combina tant el nombre com la gravetat dels TC) Objectiu: Determinar les diferències de la supervivència d'una cohort representativa de la població no institucionalitzada de Catalunya entre els anys 1994 i 1998 segons la presència de morbiditat declarada. Mètodes: L'estudi COHESCA (Cohort de l'Enquesta de Salut de Catalunya 94) es va establir a partir del seguiment dels 15.000 participants des de la data realització de l'enquesta l'any 1994 fins el final del seguiment (data de defunció o 31.12.1998). L'estat vital es va obtenir mitjançant la connexió amb el Registre de Mortalitat de Catalunya. A l'anàlisi es van incloure aquells individus que a l'inici del seguiment tenien entre 40 i 84 anys (3.105 homes i 3.536 dones). Es va obtenir un índex de comorbiditat com el sumatori de tots els TC declarats multiplicat pel pes corresponent a cada risc relatiu de morir de cada un dels TC. Es van ajustar models de regressió logística per obtenir els riscos relatius (RR) de morir i els seus intervals de confiança del 95%(IC 95%) segons les categories de multimorbilitat i comorbilitat. Pel càlcul del RR i IC 95% segons les categories de l'índex de comorbiditat es va utilitzar un model de riscos proporcionals de Cox on l'escala de temps va ser l'edat (entrades retardades). La bondat d'ajust del model va ser valorada basant-nos en la calibració (a partir de la detecció de diferències no estadísticament significatives entre la mortalitat esperada i la observada mitjançant l'estadístic de Hosmer-Lemeshow) i la discriminació (analitzada usant l'àrea sota la corba ROC) tant en la cohort de desenvolupament com en la de validació (cohort de l'enquesta de salut de Barcelona-00). Es va ajustar per classe social, hàbit tabàquic, consum d'alcohol, activitat física i estat de salut autopercebut. Totes les anàlisis es van realitzar estratificades per sexe. Resultats: En les dades de l'estudi COHESCA després de 5 anys de seguiment, l'efecte del número de TC sobre la mortalitat en ambdós sexes no mostren un increment significatiu del risc de morir a mesura que augmenta el número de TC. En aquells individus ja diagnosticats d'embòlia s'ha obtingut un augment del risc de morir en ambdós sexes, per cada malaltia addicional i per cada any d'edat. A mesura que augmenta la puntuació de l'índex de comorbiditat, el risc de morir augmenta tant en homes com en dones. Aquest índex ha mostrat una bona calibració i discriminació en ambdós sexes. En la cohort de validació, l'índex de comorbiditat ha mostrat també una bona calibració en els homes, però no en les dones, i una bona discriminació en la cohort de validació en ambdós sexes. Discussió: En estudis de seguiment és necessari incloure la morbiditat per diversos motius: per controlar el seu efecte confusor i millorar la seva validesa interna, per detectar possibles modificacions sobre el risc de morir, per utilitzar-los com mesura resum millorant a la vegada l'eficiència estadística i pel seu paper clau com a mesura predictora del risc de morir. L'elecció d'una de les mesures dels trastorns crònics dependrà de diferents aspectes com són els objectius plantejats, el disseny de l'estudi, la font d'obtenció de les dades, la variable resultat d'interès, la validesa de la mesura i la seva capacitat predictiva. En concret, l'ús d'un índex de comorbiditat comporta diferents avantatges: usar una variable resum enlloc de diversos models per explicar l'efecte de cada trastorn crònic en la mortalitat incrementant l'eficiència de l'anàlisi, usar un instrument validat que simplifica el procés de selecció de les variables i a més permet la comparabilitat amb altres estudis. La discriminació del nostre índex és lleugerament millor a la de diferents índexs pronòstics basats en adaptacions de l'índex de comorbiditat de Charlson, malgrat que els diferents índexs consideren múltiples diagnòstics mèdics i marcadors bioquímics de malalties, diferents poblacions d'estudi, diferents metodologies i diferents variables d'ajustament.Introduction: The presence of multiple chronic diseases in the same individual has currently become a relevant public health problem for two reasons: the aging of population in developed countries and the increasing prevalence of chronic conditions related to older people. Morbidity could be measured as a multimorbidity (simple summing up of the number of chronic diseases present in one individual), as a comorbidity (co-occurrence of specific diseases in addition to an index disease of interest) or as a comorbidity index (a measure that summarizes the number and severity of chronic diseases in the same person) Objective: To determine survival differences in a representative cohort of the non-institutionalised population of Catalonia during the period 1994-1998 by the presence of self-reported morbidity, in both men and women, adjusting by demographics, life styles and selfperceived health. Methods: The COHESCA Study (Catalan Health Interview Survey Follow-up Study) was based on the 1994 Catalan Health Interview Survey. 15000 individuals were traced since the beginning of the follow-up (interview date) to the end of the follow-up (death date or December 31st 1998). The vital status was established by record-linkage with data from Mortality Register from 1994 to 1998. The analysis was restricted to subjects aged 40-84 years at the initial interview (3105 men and 3536 women) The co-morbidity index was obtained by means of addition of all self-declared chronic conditions multiplied by weight of each relative risk of death by each chronic condition. We adjusted a logistic regression model in order to obtain the relative risk of death (RR) and its 95% confidence interval (95%CI ) by the categories of multimorbidity and comorbidity. We fitted Cox proportional risk model with staggered entries for age (time scale) in order to calculate RR of death and 95% CI by the categories of comorbidity index. We assessed the predictive accuracy of the final model by looking at calibration (by comparing the predicted mortality with the actual mortality by means of the Hosmer- Lemeshow statistic) and discrimination (using the area under the ROC curves) in the development as well as in the validation cohort (Barcelona Health Interview Cohort 2000). All the analysis was stratified by sex and adjusted by social class, tobacco and alcohol consumption, physical activity and self-perceived health. Results: After 5 years follow-up, we have not detected an increase of the risk of death together with the number of chronic diseases (multimorbidity) in both sexes, in the sense that no more chronic conditions mean more mortality. In those individuals suffering from stroke we have obtained an increase in the risk of death, in both sexes, together with an increase of the risk of death for each additional selected disease and for each additional year of age. Moreover, the risk of death increases along with the co-morbidity index score in both sexes. The index shows a good calibration and discrimination in both sexes. In the validation cohort, we obtained a good calibration among men but not in women and a good discrimination in both sexes. Discussion: In follow-up studies, it is necessary to take the presence of chronic diseases into account for different reasons: to control as a potential confounder improving its internal validity; to detect possible effect modification on the risk of death; to increase statistical efficiency of the analysis; and finally for its key role as a mortality predictor. To choose one of the 3 morbidity measures could depend on different aspects as the objectives of the study, the study design itself, the source of data, the outcome variable, the validity of the measure and its predictive accuracy. Specifically, to use a comorbidity index implied different advantages: to use it as a summary variable and consequently to increase the analysis statistical efficiency; a more simplified variable selection process or an easier comparable tool with other existing studies. The discrimination of our index was slightly better than that of other adaptations of Charlson co-morbidity index. Those prognostic indices consider multiple medical diagnoses and biochemical markers of diseases, different target populations, different methodologies, and different adjusting variables

Behavior of hospitalized severe influenza cases according to the outcome variable in Catalonia, Spain, during the 2017-2018 season

Infuenza is an important cause of severe illness and death among patients with underlying medical conditions and in the elderly. The aim of this study was to investigate factors associated with ICU admission and death in patients hospitalized with severe laboratory-confrmed infuenza during the 2017-2018 season in Catalonia. An observational epidemiological case-to-case study was carried out. Reported cases of severe laboratory-confrmed infuenza requiring hospitalization in 2017-2018 infuenza season were included. Mixed-efects regression analysis was used to estimate the factors associated with ICU admission and death. A total of 1306 cases of hospitalized severe infuenza cases were included, of whom 175 (13.4%) died and 217 (16.6%) were ICU admitted. Age 65-74 years and≥ 75 years and having≥ 2 comorbidities were positively associated with death (aOR 3.19; 95%CI 1.19-8.50, aOR 6.95, 95%CI 2.76-1.80 and aOR 1.99; 95%CI 1.12-3.52, respectively). Neuraminidase inhibitor treatment and pneumonia were negatively associated with death. The 65-74 years and≥ 75 years age groups were negatively associated with ICU admission (aOR 0.41; 95%CI 0.23-0.74 and aOR 0.30; 95%CI 0.17-0.53, respectively). A factor positively associated with ICU admission was neuraminidase inhibitor treatment. Our results support the need to investigate the worst outcomes of hospitalized severe cases, distinguishing between death and ICU admission

New Insights into the Role of Macrophages in Adipose Tissue Inflammation and Fatty Liver Disease: Modulation by Endogenous Omega-3 Fatty Acid-Derived Lipid Mediators

Obesity is causally linked to a chronic state of “low-grade” inflammation in adipose tissue. Prolonged, unremitting inflammation in this tissue has a direct impact on insulin-sensitive tissues (i.e., liver) and its timely resolution is a critical step toward reducing the prevalence of related co-morbidities such as insulin resistance and non-alcoholic fatty liver disease. This article describes the current state-of-the-art knowledge and novel insights into the role of macrophages in adipose tissue inflammation, with special emphasis on the progressive changes in macrophage polarization observed over the course of obesity. In addition, this article extends the discussion to the contribution of Kupffer cells, the liver resident macrophages, to metabolic liver disease. Special attention is given to the modulation of macrophage responses by omega-3-PUFAs, and more importantly by resolvins, which are potent anti-inflammatory and pro-resolving autacoids generated from docosahexaenoic and eicosapentaenoic acids. In fact, resolvins have been shown to work as endogenous “stop signals” in inflamed adipose tissue and to return this tissue to homeostasis by inducing a phenotypic switch in macrophage polarization toward a pro-resolving phenotype. Collectively, this article offers new views on the role of macrophages in metabolic disease and their modulation by endogenously generated omega-3-PUFA-derived lipid mediators

Loss of p27 phosphorylation at Ser10 accelerates early atherogenesis by promoting leukocyte recruitment via RhoA/ROCK

Reduced phosphorylation of the tumor suppressor p27(Kip1) (p27) at serine 10 (Ser10) is a hallmark of advanced human and mouse atherosclerosis. Apolipoprotein E-null mice defective for this posttranslational modification (apoE(-/-)p27Ser10Ala) exhibited increased atherosclerosis burden at late disease states. Here, we investigated the regulation of p27 phosphorylation in Ser10 at the very initial stages of atherosclerosis and its impact on endothelial-leukocyte interaction and early plaque formation. Hypercholesterolemia in fat-fed apoE(-/-) mice is associated with a rapid downregulation of p27-phospho-Ser10 in primary endothelial cells (ECs) and in aorta prior to the development of macroscopically-visible lesions. We find that lack of p27 phosphorylation at Ser10 enhances the expression of adhesion molecules in aorta of apoE(-/-) mice and ECs, and augments endothelial-leukocyte interactions and leukocyte recruitment in vivo. These effects correlated with increased RhoA/Rho-associated coiled-coil containing protein kinase (ROCK) signaling in ECs, and inhibition of this pathway with fasudil reduced leukocyte-EC interactions to control levels in the microvasculature of p27Ser10Ala mice. Moreover, apoE(-/-)p27Ser10Ala mice displayed increased leukocyte recruitment and homing to atherosusceptible arteries and augmented early plaque development, which could be blunted with fasudil. In conclusion, our studies demonstrate a very rapid reduction in p27-phospho-Ser10 levels at the onset of atherogenesis, which contributes to early plaque build-up through RhoA/ROCK-induced integrin expression in ECs and enhanced leukocyte recruitment.Spanish Ministry of Economy and Competitivity (MINECO) [SAF2010-16044, SAF2013-46663-R]; Fondo Europeo de Desarrollo Regional (FEDER); Instituto de Salud Carlos III [RD12/0042/0028]; FPU predoctoral fellowship from MINECO; MINECO; Pro-CNIC FoundationS

Norovirus outbreaks in long-term care facilities in Catalonia from 2017 to 2018

Norovirus is the leading cause of outbreaks of acute viral gastroenteritis. We carried out this study to investigate outbreaks in long-term care facilities reported in 2017 and 2018 in Catalonia (Spain). The characteristics of the centers, exposed persons and the genogroups responsible were analyzed. Viral loads were estimated. The attack rate (AR) of the outbreaks studied, and the rate ratio (RR) and the odds ratio (OR) and their 95% confdence intervals as measures of association were calculated. The mean cycle thresholds were compared using the t-test for independent means. We included 30 outbreaks (4631 exposed people). The global AR was 25.93%. The RR of residents vs. staf was 2.28 (95% CI 2.0-2.6). The RR between AR in residents with total or severe dependence vs. residents with moderate, low or no-dependence was 1.23 (95% CI 1.05-1.45). The AR were higher in smaller centers than in larger ones (38.47% vs. 19.25% and RR 2; 95% CI 1.82-2.2). GII was responsible for 70% of outbreaks. No association was found between the genogroup and presenting symptoms (OR 0.96; 95% CI 0.41-2.26). Viral loads were higher in symptomatic than in asymptomatic patients (p = 0.001)

Family firms in Iberoamerican countries

This article is (c) Emerald Group Publishing and permission has been granted for this version to appear in http://www.unavarra.es/academica-e. Emerald does not grant permission for this article to be further copied/distributed or hosted elsewhere without the express permission from Emerald Group Publishing Limited.The purpose of this paper is to introduce the special issue on family firms in Iberoamerican countries. The special issue aims at enlarging our understanding of the uniqueness of family firms by providing new evidence from Iberoamerican countries about this widespread organizational type. The paper concludes by highlighting some areas in which the authors believe devoting more energy and resources, with new evidence from other samples, may be favourable to advancing the family business field

Norovirus outbreaks in long-term care facilities in Catalonia from 2017 to 2018

Norovirus is the leading cause of outbreaks of acute viral gastroenteritis. We carried out this study to investigate outbreaks in long-term care facilities reported in 2017 and 2018 in Catalonia (Spain). The characteristics of the centers, exposed persons and the genogroups responsible were analyzed. Viral loads were estimated. The attack rate (AR) of the outbreaks studied, and the rate ratio (RR) and the odds ratio (OR) and their 95% confidence intervals as measures of association were calculated. The mean cycle thresholds were compared using the t-test for independent means. We included 30 outbreaks (4631 exposed people). The global AR was 25.93%. The RR of residents vs. staff was 2.28 (95% CI 2.0–2.6). The RR between AR in residents with total or severe dependence vs. residents with moderate, low or no-dependence was 1.23 (95% CI 1.05–1.45). The AR were higher in smaller centers than in larger ones (38.47% vs. 19.25% and RR 2; 95% CI 1.82–2.2). GII was responsible for 70% of outbreaks. No association was found between the genogroup and presenting symptoms (OR 0.96; 95% CI 0.41–2.26). Viral loads were higher in symptomatic than in asymptomatic patients (p = 0.001).This study was funded by Instituto de Salud Carlos III through the project PI16/02005 (Co-funded by European Regional Development Fund “Investing in your future”) and the Catalan Agency for the Management of Grants for University (AGAUR Grant No. 2017/SGR 1342). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication

The Effect of Eight-Week Functional Core Training on Core Stability in Young Rhythmic Gymnasts: A Randomized Clinical Trial

All data files are available from the figshare database: https://doi.org/10.6084/m9.figshare.16810885.v1 (accessed on 29 January 2022)[Abstract] It is suggested that core stability (CS) might improve rhythmic gymnasts' performance. Nevertheless, the effect of core stability training (CST) in CS performance is not clear. Purpose: Evaluating the effect of an eight-week functional CST on young rhythmics gymnasts' CS performance. Method: A sample of 45 young female rhythmic gymnasts from a competitive team (age = 10.5 ± 1.8 years, height = 144.1 ± 10.6 cm, weight 38.2 ± 8.9 kg, peak height velocity (PHV) = 12.2 ± 0.6 years) participated in the study. The participants were randomly allocated into the control group (CG) and experimental group (EG) and completed pre-tests and post-tests of specific CS tests using a pressure biofeedback unit (PBU). The CS was assessed by the bent knee fall out (BKFO), the active straight leg raise (ASLR) tests and the pelvic tilt test, all performed on the right and left sides. The EG (n = 23) performed an eight-week functional CST program based on rhythmic gymnastics (RG) technical requirements added to the traditional RG training sessions. Meanwhile, the CG (n = 22) received the traditional RG training sessions. Results: Mixed model analysis showed non-significant interaction effects; however, the ANOVA omnibus test showed a time effect (p < 0.05) in right BKFO (F1,42 = 4.60; p = 0.038) and both pelvic tilt tests (right F1,42 = 22.01, p < 0.001; left F1,42 = 19.13, p < 0.001). There were non-significant interaction effects. The fixed effects estimated parameters for right BKFO showed that both groups had less pressure variation after intervention compared with pre-intervention (β = -1.85 mmHg, 95%CI = [-3.54 to -0.16], t42 = -2.14, p = 0.038). Furthermore, the left pelvic tilt (β = 37.0 s, 95%CI = [20.4 to 53.6], t42 = 4.37, p < 0.001) improved 8.9 s more than the right pelvic tilt (β = 28.1 s, 95%CI = [16.3 to 39.8], t42 = 4.69, p < 0.001) considering both groups together. Conclusions: Adding a functional CST to regular training showed a trend in improving the performance of CS-related variables, which could help improve RG-specific performance. Coaches working with rhythmic gymnasts should consider adding a functional CST to regular training to improve CS performance leading to increased specific RG performance.https://doi.org/10.6084/m9.figshare.16810885.v