Autochthonous Crimean–Congo Hemorrhagic Fever in Spain Negredo, Anabel; de la Calle-Prieto, Fernando; Palencia-Herrejón, Eduardo ...
New England journal of medicine/The New England journal of medicine,
07/2017, Letnik:
377, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Crimean–Congo hemorrhagic fever is a widely distributed tickborne illness. In this report, transmission in Spain is identified, increasing the geographic distribution of this pathogen.
Abstract
Background
The actual usefulness of CV risk factor assessment in the prognostic evaluation of cancer patients treated with cardiotoxic treatment remains largely unknown.
Design
Prospective ...multicenter study in patients scheduled to receive anticancer therapy related with moderate/high cardiotoxic risk.
Methods
A total of 1324 patients underwent follow-up in a dedicated cardio-oncology clinic from April 2012 to October 2017. Special care was given to the identification and control of CV risk factors. Clinical data, blood samples and echocardiographic parameters were prospectively collected according to protocol, at baseline before cancer therapy and then at 3 weeks, 3 months, 6 months, 1 year, 1.5 years and 2 years after initiation of cancer therapy.
Results
At baseline, 893 patients (67.4%) presented at least 1 risk factor, with a significant number of patients newly diagnosed during follow-up. Individual risk factors were not related with worse prognosis during a 2-year follow-up. However, a higher Systemic Coronary Risk Estimation (SCORE) was significantly associated with higher rates of severe cardiotoxicity and all-cause mortality HR 1.79 (95% CI 1.16–2.76) for SCORE 5–9 and HR 4.90 (95% CI 2.44–9.82) for SCORE ≥10 when compared with patients with lower SCORE (0–4).
Conclusions
This large cohort of patients treated with a potentially cardiotoxic regimen showed a significant prevalence of CV risk factors at baseline and significant incidence during follow-up. Baseline cardiovascular risk assessment using SCORE predicted severe cardiotoxicity and all-cause mortality. Therefore, its use should be recommended in the evaluation of cancer patients.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): This study was partially funded by the Fondo Investigaciones Sanitarias (Spain), Centro de Investigaciόn Biomédica en Red Cardiovascular CIBER-CV (Spain)
Abstract
We address the problem of optimally identifying all kilonovae detected via gravitational-wave emission in the upcoming LIGO/Virgo/KAGRA observing run, O4, which is expected to be sensitive ...to a factor of ∼7 more binary neutron star (BNS) alerts than previously. Electromagnetic follow-up of all but the brightest of these new events will require >1 m telescopes, for which limited time is available. We present an optimized observing strategy for the DECam during O4. We base our study on simulations of gravitational-wave events expected for O4 and wide-prior kilonova simulations. We derive the detectabilities of events for realistic observing conditions. We optimize our strategy for confirming a kilonova while minimizing telescope time. For a wide range of kilonova parameters, corresponding to a fainter kilonova compared to GW170817/AT 2017gfo, we find that, with this optimal strategy, the discovery probability for electromagnetic counterparts with the DECam is ∼80% at the nominal BNS gravitational-wave detection limit for O4 (190 Mpc), which corresponds to an ∼30% improvement compared to the strategy adopted during the previous observing run. For more distant events (∼330 Mpc), we reach an ∼60% probability of detection, a factor of ∼2 increase. For a brighter kilonova model dominated by the blue component that reproduces the observations of GW170817/AT 2017gfo, we find that we can reach ∼90% probability of detection out to 330 Mpc, representing an increase of ∼20%, while also reducing the total telescope time required to follow up events by ∼20%.
Background
Mesenchymal stem cells may offer therapeutic potential for asthma due to their immunomodulatory properties and host tolerability, yet prior evidence suggests that bloodborne progenitor ...cells may participate in airway remodeling. Here, we tested whether mesenchymal stem cells administered as anti‐inflammatory therapy may favor airway remodeling and therefore be detrimental.
Methods
Adipose tissue‐derived mesenchymal stem cells were retrovirally transduced to express green fluorescent protein and intravenously injected into mice with established experimental asthma induced by repeat intranasal house dust mite extract. Controls were house dust mite‐instilled animals receiving intravenous vehicle or phosphate‐buffered saline‐instilled animals receiving mesenchymal stem cells. Data on lung function, airway inflammation, and remodeling were collected at 72 h after injection or after 2 weeks of additional intranasal challenge.
Results
The mesenchymal stem cells homed to the lungs and rapidly downregulated airway inflammation in association with raised T‐helper‐1 lung cytokines, but such effect declined under sustained allergen challenge despite a persistent presence of mesenchymal stem cells. Conversely, airway hyperresponsiveness and contractile tissue underwent a late reduction regardless of continuous pathogenic stimuli and inflammatory rebound. Tracking of green fluorescent protein did not show mesenchymal stem cell integration or differentiation in airway wall tissues.
Conclusions
Therapeutic mesenchymal stem cell infusion in murine experimental asthma is free of unwanted pro‐remodeling effects and ameliorates airway hyper‐responsiveness and contractile tissue remodeling. These outcomes support furthering the development of mesenchymal stem cell‐based asthma therapies, although caution and solid preclinical data building are warranted.
Children and adolescents with disabilities engage in low levels of moderate-to-vigorous intensity physical activity (MVPA), which may create the onset of a sedentary lifestyle. In light of this, MVPA ...levels must be quantified with a valid tool such as accelerometry. This study aimed to: (i) analyze the accuracy of Evenson cut-points by estimating MVPA and sedentary behavior (SB) in children and adolescents with disabilities; (ii) define new equations to estimate energy expenditure (EE) with the GT3X+ accelerometer in this population and particularly in those with cerebral palsy (CP); (iii) define specific GT3X+ cut-points to estimate MVPA in those with CP.
A total of 23 children and adolescents with disabilities (10 ± 3 years; 44%females) participated in the study. GT3X+-counts and oxygen uptake (VO
) were measured in four laboratory walking conditions.
(i) Evenson cut-points were accurate; (ii) new equations were defined to effectively predict EE; (iii) specific GT3X+ cut-points (VM ≥ 702 counts·min
; Y-Axis ≥ 360 counts·min
) were defined for estimating MVPA levels in children and adolescents with CP.
The use of specific cut-points for ActiGraph GT3X+ seems to be accurate to estimate MVPA levels in children and adolescents with disabilities and, particularly, in those with CP, at least in laboratory conditions.
Quality of education and improvement of school achievement has been linked to students’ cognitive, behavioral and personality trait factors. Several researchers have investigated the correlation ...between these factors and students’ academic performance. Particularly, it is assumed that behavioral and personality factors, such as study habits and self-esteem, have a positive and high relationship with students’ academic achievement. However, research studies have shown a weak and inconsistent linear correlation level. Hence, research about better representation methods is needed. In this article we present and discuss the results from two studies on the influence of study habits and self-esteem on the academic performance of 153 college freshman students. First, we analyzed the linear correlation between our target variables; similar to previous work, we found a weak positive correlation between academic performance and study habits (r=0.283) and self-esteem (r=0.214). In addition, multiple linear regression was used to explain the relationship between these variables; it was found that the independent variables only explain the academic performance in 6.18%. Second, we propose to use K-means, an unsupervised clustering algorithm, as a better method to explain the influence of behavioral and personality factors and students’ academic performance. Through the use of this method: 1) a predictive model of the academic performance is proposed, 2) it was achieved a better representation about the influence among the target variables, and 3) a set of students’ academic profiles was created: low, medium and high. We found that 80% of the students with a high level of self-esteem and study habits (high academic profile) obtained a good or outstanding academic performance; outperforming students within the medium and low academic profiles by a significantly margin.
Background: It has been recently shown that serum aldosterone (SA) levels are correlated with insulin resistance, excess body fat and levels of adipocytokines. Aim: To establish SA levels in patients ...on haemodialysis (HD) and the possible association with excess body fat and/or serum adipocytokine levels. Methods: 28 stable patients on HD. Mean age: 73.7±13.3 years; 53.6% men. Mean time on HD: 40.2± 40.8 months. None were diabetics nor treated with drugs that interfere with the renin-angiotensin-aldosterone-system. 18 patients were anuric. All measurements were performed prior to the midweek HD session. Results: SA levels (median: 28.1; 25th percentile (p25):10.4; 75th percentile (p75):98.6 ng/dl) were above the normal range in 53.6% of patients. Plasma renin activity (PRA) (median: 1.05; p25: 0.16; p75: 3.1 ng/mL/hour) was above the normal range in 21.4% of patients. There were no statistically significant differences in SA levels between anuric and non-anuric, male and female, presence and absence of myocardiopathy. There were no statistically significant correlations of SA levels or PRA with urine volume, residual renal function, dose or time on dialysis. age, or comorbidity. SA levels were positively correlated with PRA (r=000.70; p< 0.0001); body fat mass (r=0.40; p=0.03); leptin (r=0.45; p =0.01); leptin/adiponectin ratio (r=0.52 p=0.005) and negatively with serum adiponectin levels (r=- 0.37; p=0.05). In stepwise multiple regression analysis, the best model to explain SA levels included PRA and LAR (r=0.78; r2=0.60). Conclusions: SA levels were elevated in a high percentage of HD patients. SA levels were correlated with PRA, body fat mass and adipocytokines
This series of 2 articles on dermatopathologic diagnoses reviews conditions in which granulomas form. Part 1 clarifies concepts, discusses the presentation of different types of granulomas and giant ...cells, and considers a large variety of noninfectious diseases. Some granulomatous diseases have a metabolic origin, as in necrobiosis lipoidica. Others, such as granulomatous mycosis fungoides, are related to lymphomas. Still others, such as rosacea, are so common that dermatologists see them nearly daily in clinical practice.
En esta serie de dos artículos realizamos una revisión de las principales entidades dermatopatológicas que cursan con granulomas. Esta primera parte se ha centrado en la aclaración de conceptos, la presentación de los tipos de granulomas y de células gigantes, así como en entidades muy diversas de origen no infeccioso. Algunas de ellas de origen metabólico, como la necrobiosis lipoidica: otras relacionadas con linfomas, como la micosis fungoides granulomatosa; y otras tan extendidas que casi resultan un problema cotidiano en las consultas de dermatología, como la rosácea.
PDF
