Differences between migrants and Spanish-born population through the HIV care cascade, Catalonia: an analysis using multiple data sources.

Migrants are considered a key group at risk for HIV infection. This study describes differences between migrants and the Spanish-born population as they progress through the HIV care cascade in Catalonia, Spain. This study found that among people reached by prevention activities, migrants had a higher number of barriers to access HIV testing services than Spanish-born people, driven primarily by shared risk factors. Between 2001 and 2013, 9829 new HIV diagnoses were reported in Catalonia, the proportion of migrants increasing from 24% in 2001 to 41% in 2013. Compared with Spanish-born people, migrants had a higher proportion of women at diagnosis (24·6% vs. 16·7%), and were younger (median age of 33 vs. 37). The most frequent at-risk population was MSM (men who have sex with men) in both migrants and Spanish-born people, (40% and 43%, respectively), although there were significant differences by region of origin. People from sub-Saharan Africa had the highest proportion of late diagnosis (63·7%). Compared with the Spanish-born population, migrants on follow-up had a lower proportion of people on antiretroviral therapy (ART) (93·7% vs. 90·8%, P < 0·001) and with viral suppression (87·2% vs. 82·9%, P < 0·001). Migrants have higher number of barriers to access HIV testing services, lower retention rates and proportions on ART as compared with Spanish-born people, these differences not being uniform between migrants from different regions.

Increase in gonorrhoea among very young adolescents, Catalonia, Spain, January 2012 to June 2013.

Between January 2012 and June 2013, 27 sexually transmitted infections were reported in adolescents aged 13-15 years in Catalonia, Spain. In the first half of 2013, there were nine cases of gonorrhoea, while in the same period of 2012, there was one. In June 2013, two gonorrhoea cases aged 13-14 years, linked to a common source through a social network, were reported. The public health response should be adapted to this vulnerable population.

Recent trends in sexually transmitted infections among adolescents, Catalonia, Spain, 2012-2017.

Monitoring sexually transmitted infections (STIs) in adolescents is essential to inform STI prevention strategies at primary and secondary levels in this key population. We aim to describe recent trends in STIs among adolescents and to analyse their socio-demographic and behavioural characteristics in Catalonia, Spain between 2012 and 2017. Data on Chlamydia trachomatis (CT) infection, gonorrhoea and syphilis cases aged from 13 to 19 years reported to the Catalan Mandatory Notifiable System from 2012 to 2017 were analysed. Diagnosis rates were calculated and a descriptive analysis was performed. Between 2012 and 2017, CT infection, gonorrhoea and syphilis cases reported among adolescents aged 13-19 years accounted for more than one-eleventh of all reported cases in Catalonia. The rate of the three nationally-notifiable STIs increased dramatically among adolescents. CT infection rates rose from 13 to 144.1 per 100,000 adolescents between 2012 and 2017, an increase of 1007%; gonorrhoea cases increased by 246% (from 13.4 to 45.4/100,000) and syphilis cases increased by 247% (from 1.7 to 5.9/100,000). Gonorrhoea and syphilis cases affected mainly males while CT infection cases were mostly in females (84%). Adolescents are being increasingly affected by CT infection, gonorrhoea and syphilis. A broader array of intervention strategies aimed at adolescents should be reinforced through strong prevention campaigns, improved sexual health information, as well as encouragement of regular offers of STI screening by healthcare providers.

[Compensatory sweating after upper thoracic sympathectomy. Prospective study of 123 cases]. / Sudación compensatoria secundaria a la simpaticólisis torácica superior. Estudio prospectivo de 123 casos.

OBJECTIVE: The most unpleasant consequence of upper thoracic sympathectomy is compensatory sweating (CS). De-pending on the series, the incidence of CS ranges from 24% to 85%. The aim of this study was to determine the relation between CS and the following factors: distribution of hyperhidrosis, procedure performed (unilateral, synchronic bilateral, or sequential bilateral), and number of sympathetic ganglia eliminated. In addition, the degree of patient satisfaction was recorded as objectively as possible. PATIENTS AND METHODS: Prospective study of 123 patients who underwent upper thoracic sympathectomy for palmar and/or axillary hyperhidrosis between 1 January, 1996 and 1 June, 2002 at our unit. All patients completed a questionnaire on symptoms 8 weeks before and after surgery to deter-mine postoperative changes in distribution of the hyperhidrosis and the overall degree of satisfaction on a scale of 0 to 4. RESULTS: The sensation of CS was reported by 86.1% of the patients. When asked to relate this sensation to changes in sweating intensity in specific parts of the body, 46.54% reported CS and 48.37% no change. The trunk was the only region where statistically significant increases in CS occurred; in the feet, a decrease in sweating was noted. No differences in CS were observed with respect to the type of surgery or the number of sympathetic ganglia eliminated. The overall results were considered very satisfactory or quite satisfactory by 84.55% of the patients, while 4.88% were very dissatisfied. CONCLUSIONS: Although CS is a side effect of upper thoracic sympathectomy, not all patients are affected by it. Significant CS occurs mainly in the back, chest, and abdomen. Neither the type of intervention nor the number of ganglia eliminated has an effect on CS. This side effect notwithstanding, overall satisfaction with the treatment is very satisfactory given that the palmar hyperhidrosis is eliminated.

Factors associated with late presentation of HIV infection in Catalonia, Spain.

We sought to describe the prevalence, trends and factors associated with late diagnosis of HIV infection between 2001 and 2008 in Catalonia, Spain. Adults over 13 years of age with available CD4 cell counts, who were notified to the Catalonia Voluntary HIV Surveillance System between January 2001 and December 2008, were included in the study. Late presentation for HIV infection was defined as a CD4 cell count <350 cells/µL or with an AIDS-defining condition at presentation. Multivariable logistic regression was used to identify factors independently associated with late diagnosis of HIV. Of the 4651 newly diagnosed HIV-infected individuals with available CD4 counts, 2598 (55.9%) were diagnosed late. The proportion of people with a late diagnosis decreased from 60.4% in 2001 to 50% in 2008, a significant trend (P < 0.001). Older age, male gender, foreign birth, heterosexuality and injecting drug use were independent risk factors for late diagnosis. Strategies to actively promote HIV testing to populations at risk of late diagnosis of HIV or those never attending health systems should be implemented.

[Purification and properties of dipeptidyl amino-peptidase I from chicken liver (author's transl)]. / Purificación y propiedades de la dipeptidil aminopeptidasa I de hígado de pollo.

Dipeptidyl aminopeptidase I (E.S. 3.4.14.1) from chicken liver was purified by the following steps: homogenization at pH 5, thermic precipitation, acetone fractionation and Sephadex G-100, DEAE-cellulose and organomercurial-Sepharose column fractionations. The purified enzyme appears to be homogeneous by polyacrylamide gel electrophoresis at both pH 4.5 and 8.3 and has an isoelectric point of 5.7 +/- 0.05. The molecular weight of the enzyme reale 167,000 +/- 17,000 on the Sephadex G-150 column chromatography. The optimum pH for hydrolysis of Gly-Phe-p-nitroanilide (GPNA) and Gly-Phe-B-naphthylamide was 5.8. The value of Km for the hydrolysis of GPNA was estimated at 3.3 mM. The enzyme required halide ions for activity and was activated by thiol reagents (dithiothreitol, cysteine and 2-mercaptoethanol). Accordingly, DAP I was inhibited by thiol-blocking reagents (PCMB, IAA, Hg2+). The enzyme oxidation with oxygen current was fostered by chloride anion (50 nM); nevertheless the activity was recovered when cysteine was present in the incubation mixture; the latter, besides, seems to perform as enzyme protector.

[Acid proteinase of chicken liver. Purification and properties (author's transl)]. / Proteasa ácida de hígado de pollo. Purificación y propiedades.

A method for purifying the haemoglobinolitic activity to acid pH in chicken liver is described. The purified preparation contains cathespin D activity since it is inhibited by diazoacetyl-DL-norleucine methylester in the presence of cupric ions, while thiol-enzyme reagents do not affect it. The molecular weight of the enzyme is approximately 40,000--45,000 and the pH optimum against haemoglobin and bovine serum albumin is 3.5-3.7. The rate of degradation of albumin and casein is much less than that of haemoglobin. Cathepsin D preparations with different purification degrees, exhibit a similar percentage of activation at acid pH; the highest activation is observed at pH 3.1-3.3.

[Acid proteases from chicken liver. Cooperative hydrolysis of proteins (author's transl)]. / Proteasas ácidas de hígado de pollo. Hidrólisis cooperativa de proteínas.

Purified preparations of cathepsin D, BANA-hydrolase activity and dipeptidil aminopeptidase I from chicken liver, show a cooperative effect in the protein hydrolysis (acid-denatured haemoglobin and bovine serum albumin and native bovine serum albumin) at pH 5.0. The nature of the protein substrates determines their sensitivity to enzymatic digestion. The action of cathepsin D on proteins, in contrast which the BANA-hydrolase activity, releases polypeptides with high molecular weight, with scant--NH2 groups which can be valued by the ninhydrin method. These peptide fragments can then be further degraded by the protease BANA-hydrolase and the dipeptidil aminopeptidase I which is not active towards intact proteins.

[alpha-n-benzoylarginine-2-naphthylamide-amidohydrolase activity in chicken liver (author's transl)]. / Actividad alpha-N-benzoilarginina-2-naftilamidohidrolasa de hígado de pollo.

The enzyme activity from chicken liver that hydrolizes alpha-N-benzoil-DL-arginine-2-naphthylamide (BANA) has been separated into three active fractions by chromatography on Sephadex G-100 and DEAE-cellulose. The enzyme in Fraction FEA has a molecular weight greater than or equal to 100,000. The other two enzymes in Fractions FE1B and FE2B have a molecular weight around 23,000 and are separated by DEAE-cellulose chromatography. The BANA-hydrolase of fraction FE2B is unstable at pH alkaline and activates trypsinogen, in contrast with the enzyme of fraction FEB1. Both are thiol enzymes which behave analogously against activators (cysteine, dithiotreitol and 2-mercaptoethanol) and inhibitors (PCMB, IAA, N-ethylmaleimide, Cu2+, Hg2+ and Zn2+).