Residential building and occupant vulnerability to pyroclastic density currents in explosive eruptions

International audienceA major hazard during the eruption of explosive volcanoes is the formation of pyroclastic density currents (PDCs). Casualties and physical building damage from PDCs are caused by the temperature, pressure, and particle load of the flow. This paper examines the vulnerability of buildings and occupants to the forces imposed by PDCs along with associated infiltration of PDC particle and gas mixtures into an intact building. New studies are presented of building and occupant vulnerability with respect to temperature, pressure, and ash concentration. Initial mitigation recommendations are provided

Modelling expected physical impacts and human casualties from explosive volcanic eruptions

A multi-hazard, multi-vulnerability impact model has been developed for application to European volcanoes that could significantly damage human settlements. This impact model is based on volcanological analyses of the potential hazards and hazard intensities coupled with engineering analyses of the vulnerability to these hazards of residential buildings in four European locations threatened by explosive volcanic eruptions. For a given case study site, inputs to the model are population data, building characteristics, volcano scenarios as a series of hazard intensities, and scenarios such as the time of eruption or the percentage of the population which has been evacuated. Outputs are the rates of fatalities, seriously injured casualties, and destroyed buildings for a given scenario. These results are displayed in a GIS, thereby presenting risk maps which are easy to use for presenting to public officials, the media, and the public. Technical limitations of the model are discussed and future planned developments are considered. This work contributes to the EU-funded project EXPLORIS (Explosive Eruption Risk and Decision Support for EU Populations Threatened by Volcanoes, EVR1-2001-00047). </p><p style='line-height: 20px;'>&nbsp;</p

Alergia a la proteína de leche de vaca en la infancia: microbiota, hidrolizados y tolerancia

Trabajo presentado al XIII Workshop Sociedad Española de Microbiota, Probióticos y Prebióticos, celebrado en Valencia (España), del 7 la 9 de junio de 2022.Introducción La alergia a proteínas de leche de vaca (APLV) es la alergia alimentaria más frecuente en la infancia, habiéndose descrito posibles relaciones con la microbiota intestinal y con el tipo de alimentación. El objetivo de este trabajo es profundizar en el estudio de la microbiota intestinal en menores de un año con APLV y su relación con la adquisición de tolerancia y dieta, comparando muestras al diagnóstico y a los 6 meses de seguimiento con dieta de exclusión láctea. Metodología Se reclutaron 22 pacientes diagnosticados con APLV (14 mediados por IgE y 8 no mediados) y un grupo control de 25 niños sanos. Se recogieron muestras de heces y se realizó un análisis metataxonómico del ADNr 16S y de las regiones ITS de bifidobacterias por secuenciación. Se evaluaron las características clínico-epidemiológicas de los pacientes y se realizó un seguimiento a los 6 meses para evaluar tolerancia y el uso de distintas fórmulas terapéuticas de sustitución alimentaria. Resultados Se detectó un mayor porcentaje de secuencias pertenecientes al filo Actinobacteria (¿60%) en controles frente a casos (¿30%) al diagnóstico. Además, el patrón de abundancias relativas de bifidobacterias fue diferente entre controles y pacientes no mediados por IgE, con una menor proporción de B. longum en estos últimos. Tras la dieta de exclusión, sólo 3 de los pacientes, que estaban tomando distintos tipos de fórmulas terapéuticas, adquirió tolerancia, de los cuales 2 eran casos no mediados por IgE. Conclusiones En los pacientes APLV no IgE mediada se observaron perfiles microbianos distintos de los lactantes sanos, encontrándose a su vez en este grupo una mayor tolerancia al cabo de 6 meses. En tratamiento y seguimiento de la APLV la determinación de la microbiota intestinal puede ser clave para establecer posibles vínculos con la adquisición de tolerancia y el tipo de hidrolizado

Higher Adherence to the Mediterranean Dietary Pattern Is Inversely Associated With Severity of COVID-19 and Related Symptoms: A Cross-Sectional Study

Background and AimsAdherence to the Mediterranean diet (MD) has been associated with a decreased risk of developing a variety of chronic diseases that are comorbidities in COVID-19 patients. However, its association to the severity and symptoms of COVID-19 are still unknown. This study aimed to examine the association between adherence to the MD pattern and COVID-19 severity and symptoms in Iranian hospitalized patients.MethodsIn this cross-sectional study, 250 COVID-19 patients aged 18 to 65 were examined. We employed a food frequency questionnaire (FFQ) to obtain data on dietary intake of participants in the year prior to their COVID-19 diagnosis. COVID-19 severity was determined using the National Institutes of Health's Coronavirus Disease 2019 report. Additionally, symptoms associated with COVID-19, inflammatory markers, and other variables were evaluated. The scoring method proposed by Trichopoulou et al. was used to assess adherence to the MD.ResultsThe participants' mean age was 44.1 ± 12.1 years, and 46% of them had severe COVID-19. Patients who adhered more closely to the MD had lower serum C-reactive protein levels (7.80 vs. 37.36 mg/l) and erythrocyte sedimentation rate (14.08 vs. 42.65 mm/h). Those with the highest MD score were 77% less likely to have severe COVID-19 after controlling for confounding variables. The MD score was also found to be inversely associated with COVID-19 symptoms, including dyspnea, cough, fever, chills, weakness, myalgia, nausea and vomiting, and sore throat.ConclusionHigher adherence to the MD was associated with a decreased likelihood of COVID-19 severity and symptoms, as well as a shorter duration of hospitalization and convalescence, and inflammatory biomarkers

Serotype-specific mortality from invasive Streptococcus pneumoniae disease revisited

BACKGROUND: Invasive infection with Streptococcus pneumoniae (pneumococci) causes significant morbidity and mortality. Case series and experimental data have shown that the capsular serotype is involved in the pathogenesis and a determinant of disease outcome. METHODS: Retrospective review of 464 cases of invasive disease among adults diagnosed between 1990 and 2001. Multivariate Cox proportional hazard analysis. RESULTS: After adjustment for other markers of disease severity, we found that infection with serotype 3 was associated with an increased relative risk (RR) of death of 2.54 (95% confidence interval (CI): 1.22–5.27), whereas infection with serotype 1 was associated with a decreased risk of death (RR 0.23 (95% CI, 0.06–0.97)). Additionally, older age, relative leucopenia and relative hypothermia were independent predictors of mortality. CONCLUSION: Our study shows that capsular serotypes independently influenced the outcome from invasive pneumococcal disease. The limitations of the current polysaccharide pneumococcal vaccine warrant the development of alternative vaccines. We suggest that the virulence of pneumococcal serotypes should be considered in the design of novel vaccines

Hydroxychloroquine is associated with a lower risk of polyautoimmunity: data from the RELESSER Registry

OBJECTIVES: This article estimates the frequency of polyautoimmunity and associated factors in a large retrospective cohort of patients with SLE. METHODS: RELESSER (Spanish Society of Rheumatology Lupus Registry) is a nationwide multicentre, hospital-based registry of SLE patients. This is a cross-sectional study. The main variable was polyautoimmunity, which was defined as the co-occurrence of SLE and another autoimmune disease, such as autoimmune thyroiditis, RA, scleroderma, inflammatory myopathy and MCTD. We also recorded the presence of multiple autoimmune syndrome, secondary SS, secondary APS and a family history of autoimmune disease. Multiple logistic regression analysis was performed to investigate possible risk factors for polyautoimmunity. RESULTS: Of the 3679 patients who fulfilled the criteria for SLE, 502 (13.6%) had polyautoimmunity. The most frequent types were autoimmune thyroiditis (7.9%), other systemic autoimmune diseases (6.2%), secondary SS (14.1%) and secondary APS (13.7%). Multiple autoimmune syndrome accounted for 10.2% of all cases of polyautoimmunity. A family history was recorded in 11.8%. According to the multivariate analysis, the factors associated with polyautoimmunity were female sex [odds ratio (95% CI), 1.72 (1.07, 2.72)], RP [1.63 (1.29, 2.05)], interstitial lung disease [3.35 (1.84, 6.01)], Jaccoud arthropathy [1.92 (1.40, 2.63)], anti-Ro/SSA and/or anti-La/SSB autoantibodies [2.03 (1.55, 2.67)], anti-RNP antibodies [1.48 (1.16, 1.90)], MTX [1.67 (1.26, 2.18)] and antimalarial drugs [0.50 (0.38, 0.67)]. CONCLUSION: Patients with SLE frequently present polyautoimmunity. We observed clinical and analytical characteristics associated with polyautoimmunity. Our finding that antimalarial drugs protected against polyautoimmunity should be verified in future studies

Microbiota intestinal y alergia a las proteínas de la leche de vaca en la infancia. ¿Tenemos novedades?

Trabajo presentado en el XLVI Congreso de la Sociedad Española de Inmunología Clínica, Alergología y Asma Pediátrica, celebrado en Oviedo (España), del 5 al 7 de mayo de 2022Objetivo / Caso Clínico: Introducción: Se ha demostrado la existencia de relaciones entre la microbiota y alergias alimentarias durante los dos primeros años de vida, siendo la alergia a proteínas de la leche de vaca (APLV) la más frecuente. Nuestro objetivo fue analizar características clínico-epidemiológicas y la microbiota intestinal según el mecanismo inmunológico tratando de buscar asociaciones que faciliten el manejo en APLV. Material y Métodos / Caso Clínico: Descripción del caso: Estudio descriptivo, multicéntrico con una cohorte de APLV menores de un año reclutados al diagnóstico a lo largo de un año en tres hospitales. Grupo control de lactantes sanos de 6 meses reclutados en centros de atención primaria. Criterios de exclusión: alergias alimentarias/enteropatía, antibiótico/ corticoide/probiótico el mes previo, gastroenteritis, síndrome de enterocolitis inducida por proteínas. Resultados / Caso Clínico: Comentarios: 47 participantes: 14 IgE, 8 no IgE y 25 controles. No diferencias significativas en sexo, parto, somatometría o tipo de lactancia, pero sí en la media de edad; siendo en IgE 6.45 meses y 3.38 en no IgE. Los síntomas más frecuentes fueron los cutáneos en IgE (78.6%) y el reflujo gastroesofágico en no IgE (75%). En IgE mediados, el 71, 4% fue positivo a seroproteínas frente a un 57, 1% a caseína. Se observaron diferencias significativas en la composición de la microbiota en la abundancia relativa del filo Bacteroidetes (17% en IgE, 6.9% en no IgE y 9.6% en controles). El filo Actinobacterias se encontró en mayor proporción en controles (60.9%) frente a casos. Conclusiones: Además de evaluar las características clínico-epidemiológicas de menores de 1 año con diagnóstico de APLV en nuestra región, se ha realizado un estudio comparativo de la microbiota intestinal con controles sanos, encontrándose diferencias entre las poblaciones microbianas en función de la fisiopatología de la APLV que refuerzan la interacción entre alergia alimentaria y microbiota intestinal en lactantes y nos permitirán mejorar el abordaje clínico y la intervención en los distintos casos de APL

The comparative responsiveness of Hospital Universitario Princesa Index and other composite indices for assessing rheumatoid arthritis activity

Objective To evaluate the responsiveness in terms of correlation of the Hospital Universitario La Princesa Index (HUPI) comparatively to the traditional composite indices used to assess disease activity in rheumatoid arthritis (RA), and to compare the performance of HUPI-based response criteria with that of the EULAR response criteria. Methods Secondary data analysis from the following studies: ACT-RAY (clinical trial), PROAR (early RA cohort) and EMECAR (pre-biologic era long term RA cohort). Responsiveness was evaluated by: 1) comparing change from baseline (Delta) of HUPI with Delta in other scores by calculating correlation coefficients; 2) calculating standardised effect sizes. The accuracy of response by HUPI and by EULAR criteria was analyzed using linear regressions in which the dependent variable was change in global assessment by physician (Delta GDA-Phy). Results Delta HUPI correlation with change in all other indices ranged from 0.387 to 0.791); HUPI's standardized effect size was larger than those from the other indices in each database used. In ACT-RAY, depending on visit, between 65 and 80% of patients were equally classified by HUPI and EULAR response criteria. However, HUPI criteria were slightly more stringent, with higher percentage of patients classified as non-responder, especially at early visits. HUPI response criteria showed a slightly higher accuracy than EULAR response criteria when using Delta GDA-Phy as gold standard. Conclusion HUPI shows good responsiveness in terms of correlation in each studied scenario (clinical trial, early RA cohort, and established RA cohort). Response criteria by HUPI seem more stringent than EULAR''s