Background
Psoriasis is a very prevalent systemic chronic inflammatory disease. Major cardiovascular events are the main cause of mortality in these patients which suggests an association between ...psoriasis and traditional cardiovascular risk factors.
Objective
To identify classic cardiovascular risk factors and metabolic syndrome (MS) in patients with psoriasis, their possible association with its severity and compare it with the non‐psoriatic population.
Methods
This is an observational and cross‐sectional population study in Lleida (Spain) from a joint hospital/primary care database.
Results
The database comprised 398 701 individuals. There were 6868 cases registered as psoriasis (1.7%), and 499 of them (7.3%) were classified as moderate–severe psoriasis. Patients with psoriasis had a higher prevalence of traditional cardiovascular risk factors than non‐psoriatic population: diabetes mellitus 2 (13.9% vs 7.4%, OR 2.01), dyslipidaemia (28.8% vs 17.4%, OR 1.92), arterial hypertension (31.2% vs 19.0%, OR 1.93), obesity (33.7% vs 28.1%, OR 1.30), altered fasting basal glycaemia (21.4% vs 15.1%, OR 1.54), low cholesterol HDL (38.1% vs 32.3%, OR 1.29), hypertriglyceridaemia (45.7% vs 35.2%, OR 1.55) and high waist circumference (75.7% vs 72.3%, OR 1.19). MS was more prevalent in psoriatic patients (28.3% vs 15.1%, OR 2.21), and cardiovascular risk factors were similar between psoriasis severity groups. Psoriatic patients had a higher prevalence of ischaemic heart disease (3.3% vs 1.8%, OR 1.87) and vascular cerebral accidents (1.8% vs 1.2%, OR 1.55). A model for MS showed a significant nonlinear relationship with age and sex and significant differences between patients with and without psoriasis.
Conclusion
We found statistically significant differences in relation to the prevalence of cardiovascular risk factors, MS and major cardiovascular events in psoriatic patients. However, differences were not seen between psoriasis severity groups. Our work reinforces the need for a multidisciplinary approach and close monitoring of cardiovascular risk factors in these patients to prevent a cardiovascular event.
Background
SARS‐CoV‐2, the COVID‐19 causative agent, has infected millions of people and killed over 1.6 million worldwide. A small percentage of cases persist with prolonged positive RT‐PCR on ...nasopharyngeal swabs. The aim of this study was to determine risk factors for prolonged viral shedding amongst patient’s basal clinical conditions.
Methods
We have evaluated all 513 patients attended in our hospital between 1 March and 1 July. We have selected all 18 patients with prolonged viral shedding and compared them with 36 sex‐matched randomly selected controls. Demographic, treatment and clinical data were systematically collected.
Results
Global median duration of viral clearance was 25.5 days (n = 54; IQR, 22–39.3 days), 48.5 days in cases (IQR 38.7–54.9 days) and 23 days in controls (IQR 20.2–25.7), respectively. There were not observed differences in demographic, symptoms or treatment data between groups.
Chronic rhinosinusitis and atopy were more common in patients with prolonged viral shedding (67%) compared with controls (11% and 25% respectively) (P < 0.001 and P = 0.003). The use of inhaled corticosteroids was also more frequent in case group (P = 0.007). Multivariate analysis indicated that CRS (odds ratio OR, 18.78; 95% confidence interval 95%CI, 3.89–90.59; P < 0.001) was independently associated with prolonged SARS‐CoV‐2 RNA shedding in URT samples, after adjusting for initial PCR Ct values.
Conclusion
We found that chronic rhinosinusitis and atopy might be associated with increased risk of prolonged viral shedding. If confirmed in prospective trials, this finding might have clinical implications for quarantine duration due to increased risk of pandemic spread.
Huntington’s disease (HD) is a neurodegenerative disease for which there is no curative treatment available. Given that the endocannabinoid system is involved in the pathogenesis of HD mouse models, ...stimulation of specific targets within this signaling system has been investigated as a promising therapeutic agent in HD. We conducted a double-blind, randomized, placebo-controlled, cross-over pilot clinical trial with Sativex
®
, a botanical extract with an equimolecular combination of delta-9-tetrahydrocannabinol and cannabidiol. Both Sativex
®
and placebo were dispensed as an oral spray, to be administered up to 12 sprays/day for 12 weeks. The primary objective was safety, assessed by the absence of more severe adverse events (SAE) and no greater deterioration of motor, cognitive, behavioral and functional scales during the phase of active treatment. Secondary objectives were clinical improvement of Unified Huntington Disease Rating Scale scores. Twenty-six patients were randomized and 24 completed the trial. After ruling-out period and sequence effects, safety and tolerability were confirmed. No differences on motor (
p
= 0.286), cognitive (
p
= 0.824), behavioral (
p
= 1.0) and functional (
p
= 0.581) scores were detected during treatment with Sativex
®
as compared to placebo. No significant molecular effects were detected on the biomarker analysis. Sativex
®
is safe and well tolerated in patients with HD, with no SAE or clinical worsening. No significant symptomatic effects were detected at the prescribed dosage and for a 12-week period. Also, no significant molecular changes were observed on the biomarkers. Future study designs should consider higher doses, longer treatment periods and/or alternative cannabinoid combinations.
Clincaltrals.gov identifier: NCT01502046
Nanometric biocompatible Metal-Organic Frameworks (nanoMOFs) are promising candidates for drug delivery. Up to now, most studies have targeted the intravenous route, related to pain and severe ...complications; whereas nanoMOFs for oral administration, a commonly used non-invasive and simpler route, remains however unexplored. We propose here the biofriendly preparation of a suitable oral nanocarrier based on the benchmarked biocompatible mesoporous iron(III) trimesate nanoparticles coated with the bioadhesive polysaccharide chitosan (CS). This method does not hamper the textural/structural properties and the sorption/release abilities of the nanoMOFs upon surface engineering. The interaction between the CS and the nanoparticles has been characterized through a combination of high resolution soft X-ray absorption and computing simulation, while the positive impact of the coating on the colloidal and chemical stability under oral simulated conditions is here demonstrated. Finally, the intestinal barrier bypass capability and biocompatibility of CS-coated nanoMOF have been assessed in vitro, leading to an increased intestinal permeability with respect to the non-coated material, maintaining an optimal biocompatibility. In conclusion, the preservation of the interesting physicochemical features of the CS-coated nanoMOF and their adapted colloidal stability and progressive biodegradation, together with their improved intestinal barrier bypass, make these nanoparticles a promising oral nanocarrier.
Background
At the earliest stages of brain development, the neuroepithelium works as an interdependent functional entity together with cerebrospinal fluid, which plays a key regulatory role in ...neuroepithelial cell survival, replication and neurogenesis; however, the underlying mechanism remains unknown in mammals.
Results
We show the presence of fibroblast growth factor 2 (FGF2) and epidermal growth factor (EGF), in 13.5‐day rat embryo cerebrospinal fluid (eCSF). Immunohistochemical detection of FGF2 expression localized this factor inside neuroepithelial precursors close to the neuroepithelial‐CSF interface, suggesting that FGF2 from eCSF could originate in the neuroepithelium by apical secretion. The colocalization of FGFR1 and FGF2 in some neuroepithelial cells close to the ventricular surface suggests they are target cells for eCSF FGF2. Brain neuroepithelium EGF expression was negative. By using a neuroepithelial organotypic culture, we demonstrate that FGF2 and EGF from eCSF plays a specific role in triggering the self‐renewal and are involved in neurogenetic induction of mesencephalic neuroepithelial precursor cells during rat development.
Conclusions
We propose eCSF as an intercommunication medium for neuroepithelial precursor behavior control during early rat brain development, and the neuroepithelial regulation of FGF2 and EGF presence in eCSF, as a regulative mechanism controlling precursor proliferation and neurogenesis.
Key Findings
We show the presence of Fibroblast Growth Factor (FGF2 and EGF) in 13.5‐day rat embryos cerebro‐spinal fluid (eCSF).
FGF2 expression localized this factor at the apical end of the neuroepithelial precursors in contact with eCSF.
We demonstrate that FGF2/EGF from eCSF plays a specific role in triggering replication and in neurogenesis induction of neuropeithelial cells.
We propose eCSF as a common phylogenetical factor in neuroepithelial precursor behavior during rat brain development.
•First study that uses Sentinel-2 data in all Galicia and Portugal wildfires (> 500 ha) occurred in October 2017.•EFFIS data overestimates burned areas in comparison to Sentinel-2 dNBR index.•EFFIS ...and Sentinel-2 burn severity levels results have a high correlation between them.
A methodology to estimate the extent of areas affected by forest fires, as well as the burn severity levels using Sentinel 2 images (10 and 20 m) is proposed and applied to the fires occurred in October 2017 in Spain and Portugal. An extension larger than 250,000 ha and 4 burn severity levels (low, moderate, high and very high) have been obtained. The comparison with the European Forest Fire Information System (EFFIS), which uses MODIS images (250 m), shows that the methodology improves the area estimate by 10 % in commission area. In terms of burn severity levels, the Separability index (SI) and the Kappa statistic (k) show a high correlation between Sentinel-2 and EFFIS (SI values higher than one in all cases and k higher than 0.69, respectively).
We report on trends in anaphylaxis admissions in the Spanish hospital system during the period 1998–2011. Data on admissions for anaphylaxis were obtained from the Spanish Information System for ...Hospital Data for the period 1998–2011. Patients were selected using the codes for anaphylaxis in the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD‐9‐CM). Poisson regression models were used to estimate incidence rate ratios. We recorded a 1.89‐fold increase in admissions for anaphylaxis in Spanish hospitals during the study period, particularly in patients aged 0–14 years (1.65‐ to 3.22‐fold until 2009 and 4.09‐ to 12.59‐fold until 2011) and in food anaphylaxis in all age groups (2.78‐fold until 2009 and 8.74‐fold until 2011). The incidence of anaphylaxis is perceived as having increased in recent years, especially anaphylaxis caused by food and anaphylaxis affecting the pediatric population.
The aim of this study is to develop a computer-aided diagnosis system to identify subjects at differing stages of development of multiple sclerosis (MS) using multifocal visual-evoked potentials ...(mfVEPs). Using an automatic classifier, diagnosis is performed first on the eyes and then on the subjects.
MfVEP signals were obtained from patients with Radiologically Isolated Syndrome (RIS) (n = 30 eyes), patients with Clinically Isolated Syndrome (CIS) (n = 62 eyes), patients with definite MS (n = 56 eyes) and 22 control subjects (n = 44 eyes). The CIS and MS groups were divided into two subgroups: those with eyes affected by optic neuritis (ON) and those without (non-ON).
For individual eye diagnosis, a feature vector was formed with information about the intensity, latency and singular values of the mfVEP signals. A flat multiclass classifier (FMC) and a hierarchical classifier (HC) were tested and both were implemented using the k-Nearest Neighbour (k-NN) algorithm. The output of the best eye classifier was used to classify the subjects. In the event of divergence, the eye with the best mfVEP recording was selected.
In the eye classifier, the HC performed better than the FMC (accuracy = 0.74 and extended Matthew Correlation Coefficient (MCC) = 0.68). In the subject classification, accuracy = 0.95 and MCC = 0.93, confirming that it may be a promising tool for MS diagnosis.
In addition to amplitude (axonal loss) and latency (demyelination), it has shown that the singular values of the mfVEP signals provide discriminatory information that may be used to identify subjects with differing degrees of the disease.
Peach allergy is highly prevalent in the Mediterranean area; it is persistent and potentially severe, and therefore a prime target for immunotherapy. We aimed to study the efficacy and safety of ...sublingual immunotherapy (SLIT) with a peach extract quantified in mass units for Pru p 3, the peach lipid transfer protein. Randomized, double-blind, placebo-controlled (DBPC) clinical trial. The main efficacy outcome was the change in the response to a DBPC food challenge (DBPCFC) with peach. Secondary efficacy outcomes were the changes in skin prick test (SPT), and in specific immunoglobulin E (IgE) and IgG₄ to Pru p 3. Tolerance was assessed with a careful recording of adverse events. After 6 months of SLIT, the active group tolerated a significantly higher amount of peach (three- to ninefold), presented a significant decrease (5.3 times) in SPT, and a significant increase in IgE and IgG₄ to Pru p 3. No significant changes were observed within the placebo group. Statistically significant inter-group differences were only observed in the SPT and IgG₄ responses. No serious adverse events were reported. Systemic reactions were mild, and observed with a similar frequency in both groups. Local reactions were significantly more frequent in the active group (three times) and 95% of them restricted to the oral cavity. In this first exploratory clinical trial, SLIT for peach allergy seems to be a promising therapeutic option that could modify the clinical reactivity of the patients to peach intake and the underlying immunological response with a good tolerance.
PDF
