Prevalence of asthma in Catalonia (Spain): a retrospective, large-scale population-based study.

BACKGROUND AND OBJECTIVE: Asthma epidemiology reports an estimated global prevalence of about 4.3-8.6% in adults, with last differences among geographical regions. This study analyses a more significant population of asthma patients (473,737 individuals).To study the prevalence of medical diagnosis of asthma, overall and by age, gender, and disease severity, as well as comorbidities and type 2 biomarkers, and undergo medical treatments of a retrospective population-based asthma cohort from Catalonia (Spain). METHODS: Individuals with a diagnosis of asthma established by medical records at different healthcare levels (primary, hospital, and emergency) from the Catalan Health System (CHS) were included. Socio-demographic characteristics, prevalence, overall and by age and gender, disease severity, comorbidities, and biomarkers of type-2 inflammation were evaluated, together with appropriate medical treatment. RESULTS: The overall diagnosed asthma prevalence in the population of Catalonia was 6.3%, where patients mainly had mild asthma (5.3%) and were significantly higher in females (6.8%) than males (5.7%). By age groups, asthma was more prevalent in boys and young men adults; however, being more prevalent in females above the age of 30y. The prevalence of severe asthma was 0.4%, 42.6% had uncontrolled asthma, and a high proportion (84.2%) were under systemic corticosteroid prescription. As expected, SABAs were the most prescribed drug (62.6%), followed by systemic corticosteroids (43.3%). More than half (53.8%) of patients showed type 2 inflammation. CONCLUSION: Asthma prevalence in Catalonia is similar to other areas studied in Spain, with a high prevalence in women and of T2 asthma.

Prevalence of Atopic Dermatitis in the adult population of Catalonia (Spain): a retrospective, large-scale population-based study.

BACKGROUND AND OBJECTIVES: Studies on the prevalence of Atopic Dermatitis (AD) for the adult cohort in general-based populations are scarce worldwide. We performed a retrospective population-based observational cohort study of 537,098 adult patients diagnosed with AD in Catalonia (Spain), a larger population than in previous studies. To study the prevalence of AD generally by age, gender, disease severity, multi-morbidities, and serum total Immunoglobin E (tIgE) and undergo appropriate medical treatment (AMT) for the Catalan population. METHODS: Adult individuals (≥18 years old) diagnosed with AD by medical records at different health care levels (primary, hospital, emergency) from the Catalan Health System (CHS) were included. Statistical analyses were conducted to evaluate socio-demographic characteristics, prevalence, multi-morbidities, serum tIgE and AMT. RESULTS: The overall diagnosed AD prevalence in the adult Catalan population was 8.7%, being higher for the non-severe (8.5%) than for the severe (0.2%) populations and females (10.1%) than males (7.3%). Topical corticosteroids were the most prescribed drug (66.5%), and the use of all prescribed treatments was higher in severe AD patients, especially systemic corticosteroids (63.8%) and immunosuppressant agents (60.7%). More than half (52.2%) of severe AD patients reported serum tIgE ≥ 100 KU/L, and higher values were observed for those with multi-morbidities. Acute bronchitis (13.7%), allergic rhinitis (12.1%), and asthma (8.6%) were the most frequent comorbid respiratory diseases. CONCLUSIONS: Our study provides new and robust evidence of AD´s prevalence and related characteristics in adults using a large-scale population-based study and a more significant cohort of individuals.

Prevalence of Chronic Rhinosinusitis with Nasal Polyps in Catalonia (Spain): a retrospective, large-scale population-based study.

BACKGROUND: Studies on the prevalence of chronic rhinosinusitis (CRS) with nasal polyps (NP) in general-based populations are scarce in Europe and worldwide. We performed a retrospective population-based observational cohort study of 30,189 adult patients diagnosed with NP in Catalonia (Spain). METHODOLOGY: Adult individuals (≤18 years old) with a diagnosis of NP established by medical records at different health care levels (primary, hospital, and emergency) from the Catalan Health System (CHS) were included. Socio-demographic characteristics, prevalence, overall and by age and gender, disease severity, multi-morbidities, and biomarkers of type-2 inflammation were evaluated, together with appropriate medical treatment (AMT) and Endoscopic Sinus Surgery (ESS). RESULTS: In general population and severity sub-populations, the overall diagnosed NP prevalence was 0.49% and higher for males than females (0.60% vs 0.39%, p less than 0.0016). The prevalence for the severe NP population was 0.12%. The NP prevalence increased with age, the highest being at ≤60 years old for both gender and severity groups. Asthma (40.1%), acute rhinosinusitis (41.1%), and allergic rhinitis (32.1%) were among the most frequent comorbid respiratory diseases. ESS was performed in 15.4% of NP patients. Type 2 inflammation was present in 83.8% of the NP population and was more frequent in severe than non-severe (87.1% vs 82.7%, p less than 0.0001) patients and in those with respiratory multi-morbidities (91%). CONCLUSIONS: This is the first large-scale population-based NP epidemiology study conducted in Spain, including severity based on undergoing medical and surgical treatment and type 2 inflammation. Although the prevalence data are lower than in previous European studies, the large NP cohort studied represents an essential strength of the results.

Roadmap on biology in time varying environments.

Biological organisms experience constantly changing environments, from sudden changes in physiology brought about by feeding, to the regular rising and setting of the Sun, to ecological changes over evolutionary timescales. Living organisms have evolved to thrive in this changing world but the general principles by which organisms shape and are shaped by time varying environments remain elusive. Our understanding is particularly poor in the intermediate regime with no separation of timescales, where the environment changes on the same timescale as the physiological or evolutionary response. Experiments to systematically characterize the response to dynamic environments are challenging since such environments are inherently high dimensional. This roadmap deals with the unique role played by time varying environments in biological phenomena across scales, from physiology to evolution, seeking to emphasize the commonalities and the challenges faced in this emerging area of research.

Structural, chemical and mechanical study of TiAlV film on UHMWPE produced by DC magnetron sputtering.

Ultra High Molecular Weight Polyethylene (UHMWPE), with a semi-trapezoidal topography, and glass samples were coated with a TiAlV film using magnetron sputtering in order to study its structure, chemical composition and the adhesion film properties on the polymer surfaces. The magnetron sputtering is a PVD technique that depending on the deposited parameter produces a coating with structural, chemical and specific topographic characteristics that increase the electrical, mechanical, optical and biological surface properties of the organic compounds. The quantities of Vanadium (V) and Aluminum (Al) were similar to that of Ti64 alloy. The metallic film obtained presents α-Ti phase structure with a (200) preferential orientation. The TiAlV film on polymeric surfaces with semi-trapezoidal topography exhibit irregularities and uncoated zones but on the glass, the metallic coating was smooth and continuous. The scratch tests were carried out using an incremental load configuration with a Tribotechnic scratch tester equipment. The metallic film decreased the viscoelastic recovering of the polymeric surface but increased the load capacity. The metallic film did not present complete delamination but fractures and small zones of coating detachment were observed on all the scratch tracks.

The influence of education on the access to childhood immunization: the case of Spain.

BACKGROUND: In order to enhance childhood vaccination uptake and the health consequences for the whole society, there is a need to study predictors that might help in understanding parents' behaviour in relation to childhood vaccination schemes. The aim of this paper is to assess whether parental education has an influence on their children's public health-care use in terms of visits for vaccinations, and thus evaluate whether more educated parents use public health resources more frequently in childhood immunization schedules. METHODS: The setting was the region of Catalonia in the north-east of Spain. Three different databases, containing information about 11,415 individuals corresponding to 79,905 observations, were merged and linked: 1) observational and longitudinal administrative data for adults and children in Catalonia; 2) a database containing information on the vaccination of children in relation to the public health programme called the "Healthy Child Programme"; and 3) the governmental vaccination registration. The presence of an education gradient was explored using a logistic regression. Children's health-care use was modelled using a logistic procedure. RESULTS: The greater the mothers' educational attainment level, the higher the probability of being vaccinated in this immunization programme. The presence of an age profile for vaccinations showed that less educated parents visit their GPs more frequently for immunizations when their children are below the age of six, but that pattern is completely the opposite after that age. Hence, for children aged between six and 16, more educated parents are more likely to ensure their children are immunized. Likewise, systematic vaccinations are more likely for those parents with a lower educational attainment level. CONCLUSIONS: This paper evidenced the presence of an education gradient for specific preventive care through the public health system and visits to the GP without any particular disease or advice for specific vaccinations.

The effects of single and repeated exposure to 2.45 GHz radiofrequency fields on c-Fos protein expression in the paraventricular nucleus of rat hypothalamus.

This study investigated the effects of microwave radiation on the PVN of the hypothalamus, extracted from rat brains. Expression of c-Fos was used to study the pattern of cellular activation in rats exposed once or repeatedly (ten times in 2 weeks) to 2.45 GHz radiation in a GTEM cell. The power intensities used were 3 and 12 W and the Finite Difference Time Domain calculation was used to determine the specific absorption rate (SAR). High SAR triggered an increase of the c-Fos marker 90 min or 24 h after radiation, and low SAR resulted in c-Fos counts higher than in control rats after 24 h. Repeated irradiation at 3 W increased cellular activation of PVN by more than 100% compared to animals subjected to acute irradiation and to repeated non-radiated repeated session control animals. The results suggest that PVN is sensitive to 2.45 GHz microwave radiation at non-thermal SAR levels.

La ultrasonografía en el estudio de la patología regional de la mano y la muñeca: [revisión] / Ultrasound in the evaluation of hand and wrist disorders: [review]

La mano y la muñeca son frecuentemente implicadas en síndromes de dolor regional, inflamatorios y degenerativos. La ultrasonografía ha demostrado ser más sensible que los exámenes clínicos y de radiología convencional para la detección de sinovitis y erosiones. También ha podido revelar una participación subclínica en pacientes con artritis crónica. Las indicaciones de la ultrasonografía a nivel de la mano y la muñeca son amplias e incluyen el diagnóstico de la afección articular y el tendón, la patología de poleas, los cambios morfoestructurales a nivel del nervio mediano en el túnel carpiano; puede servir como guía para las infiltraciones, así como para la valoración del tratamiento en pacientes con artritis crónica. El objetivo de esta revisión es mostrar el resultado de las alteraciones más frecuentes en las que la ultrasonografía ha demostrado ser útil.

The hand and wrist are frequently involved by regional pain syndromes, inflammatory and degenerative conditions. Ultrasonography had demonstrated to be more sensitive than both clinical examination and conventional radiology for the detection of synovitis and erosions. It has also able to reveal a subclinical involvement in patients with chronic arthritis. The indications of ultrasonography at hand and wrist level is wide and include: diagnosis of joint and tendon involvement, pulleys pathology, morphostructural changes at median nerve level into to carpal tunnel, guidance for infiltrations into and treatment monitoring in patients with chronic arthritis. The aim of this review is to show the most frequent alterations in which ultrasound has proven useful.

Filicene obtained from Adiantum cuneatum interacts with the cholinergic, dopaminergic, glutamatergic, GABAergic, and tachykinergic systems to exert antinociceptive effect in mice.

In the present study, we describe the antinociceptive effect of filicene, a triterpene isolated from Adiantum cuneatum (Adiantaceae) leaves, in several models of pain in mice. When evaluated against acetic acid-induced abdominal constrictions, filicene (10, 30 and 60 mg/kg, i.p.) produced dose-related inhibition of the number of constrictions, being several times more potent [ID(50)=9.17 (6.27-13.18) mg/kg] than acetaminophen [ID(50)=18.8 (15.7-22.6) mg/kg], diclofenac [ID(50)=12.1(9.40-15.6) mg/kg] and acetylsalicylic acid [ID(50)=24.0(13.1-43.8) mg/kg] in the same doses as those used for the standard drugs. Filicene also produced dose-related inhibition of the pain caused by capsaicin and glutamate, with mean ID(50) values of 11.7 (8.51-16.0) mg/kg and <10 mg/kg, respectively. Its antinociceptive action was significantly reversed by atropine, haloperidol, GABA(A) and GABA(B) antagonists (bicuculline and phaclofen, respectively), but was not affected by L-arginine-nitric oxide, serotonin, adrenergic and the opioid systems. Together, these results indicate that the mechanisms involved in its action are not completely understood, but seem to involve interaction with the cholinergic, dopaminergic, glutamatergic, GABAergic and tachykinergic systems.

Buckling of swelling gels.

The patterns arising from the differential swelling of gels are investigated experimentally and theoretically as a model for the differential growth of living tissues. Two geometries are considered: a thin strip of soft gel clamped to a stiff gel, and a thin corona of soft gel clamped to a disk of stiff gel. When the structure is immersed in water, the soft gel swells and bends out of plane leading to a wavy periodic pattern whose wavelength is measured. The linear stability of the flat state is studied in the framework of linear elasticity using the equations for thin plates. The flat state is shown to become unstable to oscillations above a critical swelling rate and the computed wavelengths are in quantitative agreement with the experiment.

Clustering of solutions in the random satisfiability problem.

Using elementary rigorous methods we prove the existence of a clustered phase in the random K-SAT problem, for K > or = 8. In this phase the solutions are grouped into clusters which are far away from each other. The results are in agreement with previous predictions of the cavity method and give a rigorous confirmation to one of its main building blocks. It can be generalized to other systems of both physical and computational interest.

Imagen de la neurocisticicercosis por tomografía computada en los niños / CR imaging of neurocysticercosis in children

Revisaron los expedientes clínicos y estudios de Tomografía Computada (TC) de 71 pacientes con diagnóstico de neurocisticercosis con el fin de valorar la edad de presentación, los síntomas predominantes, la utilidad de la TC y el tipo de lesión más frecuente. La edad de los pacientes estuvo en el rango de 1 a 18 años por lo que se infiere que la edad no excluye el diagnóstico. Se encontró que los síntomas clínicos más comunes fueron las crisis convulsivas y la cefalea. La CT fue anormal en 93 por ciento de los pacientes lo que confirma que este estudio sigue siendo de gran utilidad, sobre todo en países en desarrollo en donde no se cuenta con resonancia magnética. La lesión que predominó fue la parenquimatosa y de ésta, la variedad encefalítica, lo que concuerda con lo informado en la literatura

Preliminary phytochemical and pharmacological studies of Aleurites moluccana leaves [L.] Willd.

In the present work we have investigated the analgesic activity of various extracts prepared from Aleurites moluccana leaves by using the writhing test in mice. The results showed that the hydroalcoholic extract and the hexane fraction exhibit potent antinociceptive action. We have also isolated and identified some chemical constituents from the hexane fraction. In addition, the nature of substances present in ethyl acetate and butanol fractions were evaluated by TLC. Such fractions revealed the presence of phenolic compounds. Chromatographic procedures carried out with hexane fraction revealed the presence of n-hentriacontane, α-amyrin, ß-amyrin, stigmasterol, ß-sitosterol and campesterol, which were identified by spectroscopic data and HRGC or HRGC/MS techniques. The compounds considerably inhibited acetic acid-induced abdominal constrictions, being more efficacious than aspirin and paracetamol. In addition, preliminary HPLC analysis indicated, using a UV detector, one main constituent in alcoholic extract.

Early detection of neurological manifestations in achondroplasia.

Achondroplasia (ACh) is the most frequent bone dysplasia. The mode of inheritance is autosomal dominant. The incident of neurological complications ranges between 20% and 47%; frequently the symptoms are subtle but are due to such serious conditions as cervicomedullary compressive syndromes, syringomyelia or hydrocephalus; thus, the early identification of this disorder is very important. We made a prospective study of 39 patients (20 female, 19 male) with ACh; their ages ranged from 3 months to 17 years (mean 4 years and 6 months). All patients had hypotonia and psychomotor delay; 3 had recurrent apnea, 1 developed radicular syndrome and 1 had leg paresthesias. The CT scan was normal in 5, 20 had cortical atrophy and 18 communicating hydrocephalus; we identified foramen magnum abnormalities in 28 patients, and reduced craniocervical junction with cervicomedullary compression in 6. Myelography and myelotomography demonstrated spinal compression in 12 patients. The MRI showed cervicomedullary infarct in 1, syringomyelia in 2 and diastematomyelia in 1. The somatosensory evoked responses (SSER) were very useful in the early identification of brain stem and spinal abnormalities. We concluded that the neurological manifestations of pediatric patients with ACh are frequent and very important, demanding comprehensive clinical evaluation even in asymptomatic patients, especially those with severe hypotonia or SSER alterations.

[Autopsy: reflection of intrahospital mortality]. / La autopsia, espejo de la mortalidad Intrahospitalaria.

Autopsies have long been viewed as a biased source of information with regard to the mortality statistics that prevail in the hospital and community. This bias could be of either a demographic or clinical nature. Our objective was to define the autopsy characteristics from the National Cancer Institute of Mexico and determine how representative they were of hospital mortality. Age, sex, place of residence, socioeconomic status, and tumor location were obtained from the Hospital Mortality Registry (1985 and 1987). During these two years, 451 deaths were registered; in 290 of these cases (64.3%), an autopsy was performed. Discrepancies of 9.8 percent were found between autopsy diagnosis and mortality registry data. Our results indicate that autopsy examinations effectively reflect total hospital mortality, and represent a useful tool for epidemiological cancer studies in Mexico. Furthermore, we believe that mortality statistics should be based on autopsy results.

Mixed medullary-papillary carcinoma of the thyroid: a previously unrecognized variant of thyroid carcinoma.

Two unusual medullary carcinomas of the thyroid gland and their metastases contained a population of cells (20% to 25%) with the characteristic clear nuclei of papillary carcinoma. The predominant component of the tumors exhibited the typical growth pattern and cytologic features of medullary carcinoma with abundant amyloid deposits. The cells with clear nuclei lined follicle-like or tubular structures. In both the primary and the metastatic lesions, immunoreactive thyroglobulin was demonstrated only in the cells with clear nuclei, while calcitonin, carcinoembryonic antigen, and neuron-specific enolase were present only in cells of the predominant medullary carcinomatous component. Moreover, intense and diffuse staining for cytokeratin was seen only in the cells with clear nuclei, but not in those of the major medullary carcinomatous component. These findings suggest the existence of a distinctive variant of mixed medullary-papillary carcinoma that can be recognized with routine stains.

Manifestaciones gastrointestinales de la epidermolisis bulosa distrófica recesiva / Gastrointestinal manifestations of recessive dystrophic epidermolysis bullosa

Se presentan ocho niños con manifestaciones gastrointestinales secundarias a epidermolisis bulosa distrófica recesiva, como enfermedad de base. Las lesiones en orden de frecuencia fueron estenosis esofágica de grado y extensión variable en seis, historia de lesiones ampollosas de repetición en ocho, constipación en cinco y fusión de la lengua al piso de la boca (anquiloglosia) en dos. Se conluye que la lesión principal y más temida es la estenosis esofágica. Epidermolisis bulosa distrófica recesiva

Quiste del colédoco: informe de un caso clásico y revisión de literatura / Cystic dilatation of the choledochus: report of a classical case and review of the literature

Se presenta un caso típico de dilatación quística del conducto calédoco. Se analiza el cuadro clínico a las diferentes edades, los diagnósticos diferenciales y el abordaje de estudio

[Budd Chiari syndrome in 3 brothers. Diagnosis in 2 by phlebography]. / Síndrome de Budd Chiari en tres hermanos. Demostración por flebografía en dos.

Three patients with Budd-Chiari Syndrome, belonging to the same family are presented. The diagnosis was made through phlebography in 2 cases, and by atuopsy in the other one. There is not report in the medical literature of familiar appearance of this syndrome. The importance of roentgenographic studies in order to make the diagnosis is emphasized. Genetic studies were not performed and its contribution to develop such vascular changes in unknown. Some considerations about the environment influence are discussed.