Relatively few studies have examined the incidence of anaphylaxis in the general population. To report the incidence of anaphylaxis among the general population of the city of Alcorcon, Spain, using ...various public health care databases. Episodes of anaphylaxis were recovered using validated alphanumeric strings in different fields of electronic clinical records used in the different public health settings in the city of Alcorcon (primary care, Emergency Department, hospitalized patients and Allergy Outpatient Clinic). Patients with anaphylaxis were tracked across the different clinical settings in Alcorcon. The incidence of anaphylaxis in Alcorcon was 103.37 episodes per 100 000 person-years (total standardized incidence rate of 112.2). There was a peak of 313.58 episodes in the 0-4 years age group and a different distribution of incidence rates (although non-significant) among different age groups between male patients and female patients. In most age groups, incidence tended to be higher for female patients aged over 10 years. Patients were attended at two or more levels in 76.78% of episodes, and a new evaluation was often made at a primary care centre (71.43%), Allergy Outpatient Clinic (75.6%), or both after the episode (58.93%). This study revealed a higher rate of anaphylaxis than that in previous studies, although this incidence rate is probably lower than the real incidence rate. Studies exploring potential methodological, genetic and environmental factors accounting for these higher rates of anaphylaxis are required.
Summary
Background
Relatively few studies have examined the incidence of anaphylaxis in the general population.
Objective
To report the incidence of anaphylaxis among the general population of the ...city of Alcorcon, Spain, using various public health care databases.
Methods
Episodes of anaphylaxis were recovered using validated alphanumeric strings in different fields of electronic clinical records used in the different public health settings in the city of Alcorcon (primary care, Emergency Department, hospitalized patients and Allergy Outpatient Clinic). Patients with anaphylaxis were tracked across the different clinical settings in Alcorcon.
Results
The incidence of anaphylaxis in Alcorcon was 103.37 episodes per 100 000 person‐years (total standardized incidence rate of 112.2). There was a peak of 313.58 episodes in the 0–4 years age group and a different distribution of incidence rates (although non‐significant) among different age groups between male patients and female patients. In most age groups, incidence tended to be higher for female patients aged over 10 years. Patients were attended at two or more levels in 76.78% of episodes, and a new evaluation was often made at a primary care centre (71.43%), Allergy Outpatient Clinic (75.6%), or both after the episode (58.93%).
Conclusion and Clinical Relevance
This study revealed a higher rate of anaphylaxis than that in previous studies, although this incidence rate is probably lower than the real incidence rate. Studies exploring potential methodological, genetic and environmental factors accounting for these higher rates of anaphylaxis are required.
Aims
Although patients with syncope and bundle branch block (BBB) are at high risk of developing atrio-ventricular block, syncope may be due to other aetiologies. We performed a prospective, ...observational study of the clinical outcomes of patients with syncope and BBB following a systematic diagnostic approach.
Methods and results
Patients with ≥1 syncope in the last 6 months, with QRS duration ≥120 ms, were prospectively studied following a three-phase diagnostic strategy: Phase I, initial evaluation; Phase II, electrophysiological study (EPS); and Phase III, insertion of an implantable loop recorder (ILR). Overall, 323 patients (left ventricular ejection fraction 56 ± 12%) were studied. The aetiological diagnosis was established in 267 (82.7%) patients (102 at initial evaluation, 113 upon EPS, and 52 upon ILR) with the following aetiologies: bradyarrhythmia (202), carotid sinus syndrome (20), ventricular tachycardia (18), neurally mediated (9), orthostatic hypotension (4), drug-induced (3), secondary to cardiopulmonary disease (2), supraventricular tachycardia (1), bradycardia-tachycardia (1), and non-arrhythmic (7). A pacemaker was implanted in 220 (68.1%), an implantable cardioverter defibrillator in 19 (5.8%), and radiofrequency catheter ablation was performed in 3 patients. Twenty patients (6%) had died at an average follow-up of 19.2 ± 8.2 months.
Conclusion
In patients with syncope, BBB, and mean left ventricular ejection fraction of 56 ± 12%, a systematic diagnostic approach achieves a high rate of aetiological diagnosis and allows to select specific treatment.
In order to compare the effectiveness of different antipsychotic drugs in the treatment of schizophrenia it is very important to evaluate subjective response and compliance in patient cohorts treated ...according to routine clinical practice.
Outpatients with schizophrenia entered this prospective, naturalistic study when they received a new prescription for an antipsychotic drug. Treatment assignment was based on purely clinical criteria, as the study did not include any experimental intervention. Patients treated with olanzapine, risperidone or haloperidol were included in the analysis. Subjective response was measured using the 10-item version of the Drug Attitude Inventory (DAI-10), and treatment compliance was measured using a physician-rated 4 point categorical scale.
A total of 2128 patients initiated treatment (as monotherapy) with olanzapine, 417 with risperidone, and 112 with haloperidol. Olanzapine-treated patients had significantly higher DAI-10 scores and significantly better treatment compliance compared to both risperidone- and haloperidol-treated patients. Risperidone-treated patients had a significantly higher DAI-10 score compared to haloperidol-treated patients.
Subjective response and compliance were superior in olanzapine-treated patients, compared to patients treated with risperidone and haloperidol, in routine clinical practice. Differences in subjective response were explained largely, but not completely, by differences in incidence of EPS.
TO analyze key word usage in Archivos De Bronconeumología, by comparing words used in the journal to those used in the Index Medicus database within various respiratory system knowledge areas, and to ...determine whether usage has changed over time.
Original articles published in Archivos De Bronconeumología from 1994 through 2001 were reviewed manually to gather the key words used. The list was translated to English and then compared to the medical subject heading (MeSH) terms used in the PubMed Browser.
Seven hundred six original articles published in the study period used a total of 1163 key words. Matches with MeSH terms were found for 62% (n=46) of the key words in smoking research, 48% (n=52) in asthma, 39% (n=82) in respiratory insufficiency and sleep disorders, 60% (n=49) in diagnostic and treatment techniques, 61% (n=35) in tuberculosis, 65% (n=87) in nontuberculous infections, 61% (n=121) in oncology, 60% (n=37) in circulation, 55% (n=47) in pleural diseases, 48% (n=21) in pathophysiology, and 64% (n=68) in interstitial diseases. We did not see a clear tendency in the evolution of the journal's key word usage for the knowledge areas analyzed during the study period. The percentage of matching key words held steady around 50% over the last 3 years.
Respiratory system key words in the knowledge areas we investigated are used correctly in Archivos De Bronconeumología only about 50% of the time.
Analizar las palabras clave utilizadas en las di-ferentes áreas de sistema respiratorio a través de la revista Archivos De Bronconeumología, comparándolas entre sí, determinando su evolución y cotejándolas con las empleadas en el Index Medicus.
Se realizó una revisión manual de los originales publicados en Archivos De Bronconeumología entre los años 1994 y 2001 y se anotó las palabras clave encon-tradas en ellos. Se efectuó una comparación de las palabras clave con las utilizadas por el MeSH Browser de PubMed, para lo que previamente tuvieron que traducirse al inglés.
Se encontraron 706 originales en el período estudiado. En ellos se emplearon un total de 1.163 palabras clave, de las que han resultado correctas, comparadas con las del MeSH, el 62% (n = 46) en tabaquismo, el 48% (n = 52) en asma, el 39% (n = 82) en insuficiencia respiratoria y trastornos del sueño, el 60% (n = 49) en técnicas diagnósti-cas y terapéuticas, el 61% (n = 35) en tuberculosis, el 65% (n = 87) en infecciones no tuberculosas, el 61 % (n = 121) en oncología, el 60% (n = 37) en circulación, el 55% (n = 47) en pleura, el 48% (n = 21) en fisiopatología y el 64% (n = 68) en enfermedades intersticiales. No hemos encontrado una ten-dencia definida en la evolución de las palabras clave a lo largo de los años en las áreas analizadas. El porcentaje de palabras correctas se ha mantenido en torno al 50% en los últimos 3 años.
En las áreas de sistema respiratorio estu-diadas sólo se emplean de una manera correcta alrededor del 50% de las palabras clave.
Embryo cryopreservation procedures have been highly developed to support in vitro fertilization techniques, but the clinical results have not met initial expectations. Many variables influence the ...outcome of the embryo cryopreservation procedure. Exposure to classical freezing media does not affect further embryo development. Therefore, the first crucial step seems to be embryo thermal behavior during the freezing/thawing procedure. With the aim of avoiding thermal oscillations to the embryos due to liquid nitrogen injection into the freezing chamber, we have developed a straw thermal stabilizer (STS) cryopreservation accessory that when adapted to a programmable biological freezer offers a more exact control of the straws temperature and also a greater reproducibility of the freezing process. The STS incorporates a seeding mechanism controlled by specially designed software. For the biological assays, 2-cell mouse embryos were cooled until seeding at -7 degrees C or frozen to -120 degrees C using 1.5 M 1,2-propanediol and 0.1 M sucrose. As control groups, embryos were either untreated or were exposed to cryoprotectants, developing to blastocyst at rates of 90.8 and 88.4%, respectively. The embryos cooled until seedling or subjected to the complete freezing procedure developed into blastocysts at rates of 95.7 and 82.8%, respectively, disregarding the effect of the cryoprotectant exposure. These results show a substantial improvement in cryopreservation with no loss in embryo development due to the seeding procedure.
Abstract
Funding Acknowledgements
No conflicts of interest
INTRODUCTION
Evidence has shown that obesity, expressed as high body mass index (BMI), is associated with the development of atrial ...fibrillation(AF). However, the relationship between BMI and recurrence of AF after catheter ablation(CA) remains controversial. Understanding this relationship, may help in regard to patient(p) counseling and management before and after CA.
Purpose
To evaluate single center AF recurrences after pulmonary vein isolation according to BMI status. Secondary endpoints were to compare the influence of other comorbilitys such as pulmonar disease or obstructive sleep apnea(OSA)
METHODS
We included 114p with AF(54,5 ± 9,6 years; male 75,4%; paroxysmal 70,2%; persistent 29,8%) treated with first time radiofrequency ablation between 2013 and 2018. On the basis of the baseline BMI, patients were categorized into 2 groups: normal/overweigth (BMI < 30kg/m2) and obese(BMI≥30kg/m2).
RESULTS
There was no significant difference between the majority of baseline characteristics of the groups (table 1), however patients with BMI≥30 were more likely to sufferd OSA(34% vs 8,2%:p = 0,001), to have larger left atrial (diameter > 40mm: 70,5% vs 46,3%;p = 0,004), and persistent AF (43,4% vs 18%; p 0,004). During 12 months of follow-up AF recurred in 34p (29,8%), the freedom from AF was significantly higher in the BMI < 30 group (48p(80%) vs 31(58,5%), p = 0,015). Multivariate analysis including variables of type of AF, OSA, BMI, left atrial size, ejection fraction, and hypertension demonstrated that BMI was the strongest predictor of being freedom from recurrent AF (OR = 0.35, 95% CI: 0,11–0,81, P = 0.014). A serious complication occurred in 6p(5,3%), with no relationship to BMI.
CONCLUSION
This study suggest that tight association between obesity and AF recurrence after ablation may be partly due to other concomitant conditions which in turn are more frequent in obese patients like OSA, left atrial size and presence of persistent AF.
Abstract Table 1
Randomized clinical trials and meta-analyses have not demonstrated any statistically significant differences between teicoplanin and vancomycin with regard to efficacy. A cost-minimization analysis ...was conducted to compare the economical impact of the treatment with vancomycin and teicoplanin in intensive care patients. Information on resource utilization was retrospectively collected from 100 consecutive clinical histories of patients hospitalized in a Spanish Intensive Care Unit, who had been given a glycopeptide antibiotic (50 teicoplanin and 50 vancomycin) for the treatment of a suspected or proven infection. Although personnel, material, and monitoring costs were higher in the vancomycin group, the acquisition costs and the total costs were much lower in this group, so the resulting total costs per day were 5508 ptas (33 euros) for vancomycin-treated patients and 9893 ptas (59.5 euros) for teicoplanin-treated patients. The savings with vancomycin for a 10-day course of treatment would be approximately 40 697 ptas (244.5 euros) per patient. Results were consistent for a variety of conditions that were included in the sensitivity analysis.
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