The Nutrition in Early Life and Asthma (NELA) birth cohort study: Rationale, design, and methods.

BACKGROUND: Primary prevention strategies for asthma are lacking. Its inception probably starts in utero and/or during the early postnatal period as the developmental origins of health and disease (DOHaD) paradigm suggests. OBJECTIVES: The main objective of Nutrition in Early Life and Asthma (NELA) cohort study is to unravel whether the following factors contribute causally to the developmental origins of asthma: (1) maternal obesity/adiposity and foetal growth; (2) maternal and child nutrition; (3) outdoor air pollution; (4) endocrine disruptors; and (5) maternal psychological stress. Maternal and offspring biological samples are used to assess changes in offspring microbiome, immune system, epigenome and volatilome as potential mechanisms influencing disease susceptibility. POPULATION: Randomly selected pregnant women from three health areas of Murcia, a south-eastern Mediterranean region of Spain, who fulfilled the inclusion criteria were invited to participate at the time of the follow-up visit for routine foetal anatomy scan at 19-22 weeks of gestation, at the Maternal-Fetal Medicine Unit of the "Virgen de la Arrixaca" University Clinical Hospital over a 36-month period, from March 2015 to April 2018. DESIGN: Prospective, population-based, maternal-child, birth cohort study. METHODS: Questionnaires on exposures and outcome variables were administered to mothers at 20-24 gestation week; 32-36 gestation week; and delivery. Children were surveyed at birth, 3 and 18 months of age and currently at 5 years. Furthermore, physical examinations were performed; and different measurements and biological samples were obtained at these time points. PRELIMINARY RESULTS: Among the 1350 women invited to participate, 738 (54%) were finally enrolled in the study and 720 of their children were eligible at birth. The adherence was high with 612 children (83%) attending the 3 months' visit and 532 children (72%) attending the 18 months' visit. CONCLUSION: The NELA cohort will add original and unique knowledge to the developmental origins of asthma.

AMH in combination with SHBG for the diagnosis of polycystic ovary syndrome.

Serum Anti-Müllerian hormone (AMH) level could be useful for the diagnosis of polycystic ovary syndrome (PCOS). We evaluated the hormonal status in women for the diagnosis of PCOS. A total of 77 PCOS women and 106 healthy women were enrolled in this study. Serum AMH, gonadotropins [luteinising hormone (LH) and follicle-stimulating hormone (FSH)], oestradiol, testosterone (total and free), 4-androstenedione (ANDST), dehydroepiandrosterone sulphate, sex hormone binding globulin (SHBG), prolactin, thyroid-stimulating hormone and insulin levels were measured in all enrolled women. Our data showed that insulin, LH, testosterone, ANDST and AHM levels were significantly higher in the PCOS group and FSH and SHBG levels were lower in the PCOS group. In Receiver operating characteristic analysis, the combination of AMH with SHBG showed higher area under curves (AUC) for PCOS diagnosis with an AUC of 0.843 and a specificity of 81.1% and a sensitivity of 72.7%. Our results suggest that a combination of serum AMH and SHBG levels could be used as a diagnostic biomarker of PCOS. Impact statement What is already known on this subject? Women with PCOS have an increased risk of hypertension, altered glucose metabolism and probably an increased lifetime risk of cardiovascular diseases. There is no consensus on the diagnostic criteria for PCOS. This leads to many patients with PCOS are being undiagnosed. It is known that AMH plays a role in the follicular status of PCOS and serum AMH level is increased significantly in women with PCOS compared with normo-ovulatory women. This is why several studies have suggested the inclusion of AMH as a diagnostic criterion in PCOS. What do the results of this study add? Extensive epidemiological data is available which demonstrates an association between higher AMH levels and PCOS, but there was no information available about the combination of AMH level with other hormones and PCOS. This is the first study that has investigated the association of AMH and SHBG, together, with PCOS. Our results suggest that serum AMH and SHBG level in combination could represent a useful and practical test to screen the general population for PCOS. What are the implications of these findings for clinical practice and/or further research? Many PCOS women in the general population are undiagnosed due to lack of consensus in diagnostic criteria. Therefore, the importance of identifying women with PCOS due to the need for follow-up in short and long-term health risk.

Testosterone Replacement Therapy in Deficient Patients With Chronic Heart Failure: A Randomized Double-Blind Controlled Pilot Study.

BACKGROUND: Testosterone deficiency is associated with heart failure (HF) progression and poor prognosis. Testosterone therapy has been shown to improve exercise capacity in patients with chronic HF, but no trial has evaluated the impact of replacement in patients with demonstrated testosterone deficiency. METHODS: Prospective, randomized, double-blind, placebo-controlled, and parallel-group trial comparing testosterone replacement with placebo in males with chronic HF with reduced ejection fraction (HFrEF) and testosterone deficiency (NCT01813201). Long-acting undecanoate testosterone at a fixed dose of 1000 mg was supplied by intramuscular injection at inclusion and then every 3 months. The placebo group received isotonic saline serum. Patients were randomly allocated 1:1 to testosterone or placebo while receiving optimal medical therapy, and the study was conducted for 12 months. RESULTS: The final sample comprised 29 patients, 15 in the placebo group and 14 in the testosterone group (aged 65 ± 8, 62% with an ischemic etiology, left ventricular ejection fraction [LVEF] 30% ± 6%, 69% New York Heart Association functional [NYHA II]). After 12 months, testosterone replacement increased testosterone levels ( P = .002) but was not associated with benefit in terms of clinical symptoms and functional capacity including NYHA class, Framingham score, Minnesota Living Heart Failure Questionnaire, 6-minute walk test, or LVEF and N-terminal pro-B-type natriuretic peptide levels. No significant side effects associated with testosterone treatment were observed. No effects were found in other hormonal, metabolic, and bone turnover biomarkers. CONCLUSION: In patients with HFrEF and testosterone deficiency, replacement therapy was not associated with any significant improvement.

Valores seriados de galectina-3 a corto plazo en pacientes hospitalizados por insuficiencia cardiaca aguda / Short-term serial measurement of galectin-3 in hospitalized patients with acute heart failure

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Viscoelastic diamine surfactant for stable carbon dioxide/water foams over a wide range in salinity and temperature.

HYPOTHESIS: The viscosity and stability of CO2/water foams at elevated temperature can be increased significantly with highly viscoelastic aqueous lamellae. The slow thinning of these viscoelastic lamellae leads to greater foam stability upon slowing down Ostwald ripening and coalescence. In the aqueous phase, the viscoelasticity may be increased by increasing the surfactant tail length to form more entangled micelles even at high temperatures and salinity. EXPERIMENTS: Systematic measurements of the steady state shear viscosity of aqueous solutions of the diamine surfactant (C16-18N(CH3)C3N(CH3)2) were conducted at varying surfactant concentrations and salinity to determine the parameters for formation of entangled wormlike micelles. The apparent viscosity and stability of CO2/water foams were compared for systems with viscoelastic entangled micellar aqueous phases relative to those with much less viscous spherical micelles. FINDINGS: We demonstrated for the first time stable CO2/water foams at temperatures up to 120 °C and CO2 volumetric fractions up to 0.98 with a single diamine surfactant, C16-18N(CH3)C3N(CH3)2. The foam stability was increased by increasing the packing parameter of the surfactant with a long tail and methyl substitution on the amine to form entangled viscoelastic wormlike micelles in the aqueous phase. The foam was more viscous and stable compared to foams with spherical micelles in the aqueous lamellae as seen with C12-14N(EO)2 and C16-18N(EO)C3N(EO)2.

Phase behavior and interfacial properties of a switchable ethoxylated amine surfactant at high temperature and effects on CO2-in-water foams.

The interfacial properties for surfactants at the supercritical CO2-water (C-W) interface at temperatures above 80°C have very rarely been reported given limitations in surfactant solubility and chemical stability. These limitations, along with the weak solvent strength of CO2, make it challenging to design surfactants that adsorb at the C-W interface, despite the interest in CO2-in-water (C/W) foams (also referred to as macroemulsions). Herein, we examine the thermodynamic, interfacial and rheological properties of the surfactant C12-14N(EO)2 in systems containing brine and/or supercritical CO2 at elevated temperatures and pressures. Because the surfactant is switchable from the nonionic state to the protonated cationic state as the pH is lowered over a wide range in temperature, it is readily soluble in brine in the cationic state below pH 5.5, even up to 120°C, and also in supercritical CO2 in the nonionic state. As a consequence of the affinity for both phases, the surfactant adsorption at the CO2-water interface was high, with an area of 207Å(2)/molecule. Remarkably, the surfactant lowered the interfacial tension (IFT) down to ∼5mN/m at 120°C and 3400 psia (23MPa), despite the low CO2 density of 0.48g/ml, indicating sufficient solvation of the surfactant tails. The phase behavior and interfacial properties of the surfactant in the cationic form were favorable for the formation and stabilization of bulk C/W foam at high temperature and high salinity. Additionally, in a 1.2 Darcy glass bead pack at 120°C, a very high foam apparent viscosity of 146 cP was observed at low interstitial velocities given the low degree of shear thinning. For a calcium carbonate pack, C/W foam was formed upon addition of Ca(2+) and Mg(2+) in the feed brine to keep the pH below 4, by the common ion effect, in order to sufficiently protonate the surfactant. The ability to form C/W foams at high temperatures is of interest for a variety of applications in chemical synthesis, separations, materials science, and subsurface energy production.

Field evidence of social influence in the expression of political preferences: the case of secessionists flags in Barcelona.

Models of social influence have explored the dynamics of social contagion, imitation, and diffusion of different types of traits, opinions, and conducts. However, few behavioral data indicating social influence dynamics have been obtained from direct observation in "natural" social contexts. The present research provides that kind of evidence in the case of the public expression of political preferences in the city of Barcelona, where thousands of citizens supporting the secession of Catalonia from Spain have placed a Catalan flag in their balconies and windows. Here we present two different studies. 1) During July 2013 we registered the number of flags in 26% of the electoral districts in the city of Barcelona. We find that there is a large dispersion in the density of flags in districts with similar density of pro-independence voters. However, by comparing the moving average to the global mean we find that the density of flags tends to be fostered in electoral districts where there is a clear majority of pro-independence vote, while it is inhibited in the opposite cases. We also show that the distribution of flags in the observed districts deviates significantly from that of an equivalent random distribution. 2) During 17 days around Catalonia's 2013 national holiday we observed the position at balcony resolution of the flags displayed in the facades of a sub-sample of 82 blocks. We compare the 'clustering index' of flags on the facades observed each day to thousands of equivalent random distributions. Again we provide evidence that successive hangings of flags are not independent events but that a local influence mechanism is favoring their clustering. We also find that except for the national holiday day the density of flags tends to be fostered in facades located in electoral districts where there is a clear majority of pro-independence vote.

Screening for hazardous drinking in migrant workers in southeastern Spain.

OBJECTIVES: Despite the great impact the migration has had in economic, social and health-related fields, and the repercussions of alcohol consumption on them, few data exist concerning the extent of alcohol consumption in migrant workers. The aims of this study were to identify workers with a hazardous drinking problem by means of a self-reported questionnaire (Alcohol Use Disorders Identification Test-AUDIT) and a biomarker (carbohydrate-deficient transferrin-CDT) and to ascertain associated risk factors. METHODS: A cross-sectional survey was conducted using a random sample of 385 migrant workers, undergoing a routine health examination as part of occupational health services. RESULTS: The results showed that 13.8% (n=53) of the workers were screened as positive with the AUDIT (≥8) and/or CDT (>2.6) and identified as hazardous drinkers and that 53.8% (n=207) were teetotallers. Being a man (OR: 2.0), working in the construction industry (OR: 2.8) or agriculture (OR: 2.2), being resident in Spain for more than 7 years (OR: 2.3) and sharing a house with friends were the factors most closely associated with hazardous drinking. CONCLUSIONS: Prevention-orientated programs, adjusted to the characteristics of each country and the origin of the migrants themselves, should be instituted to modify the drinking habits of migrant workers considered at risk.

Efficacy of advanced discriminating algorithms for screening on iron-deficiency anemia and ß-thalassemia trait: a multicenter evaluation.

For many years, application of RBC indices has been recommended for discriminating between subjects with iron deficiency from those with thalassemia. However, application of the algorithms resulted in only 30% to 40% of subjects being appropriately classified. The aim of the study was to establish the efficacy of algorithms for anemia screening including new hematologic parameters such as percentage of hypochromic and microcytic RBCs and hemoglobin content of reticulocytes. Subjects with iron deficiency anemia (IDA) (n = 142) and subjects with ß-thalassemia (n = 34) were enrolled in a European multicenter study. Apparently healthy subjects were used as a reference group (n = 309). Hemocytometric investigations were performed on a Sysmex XE5000 hematology analyzer. The algorithms for IDA discrimination yielded results for area under the curve, sensitivity, specificity, and positive and negative predictive values of 0.88, 79%, 97%, 74%, and 98%, respectively. The algorithms for ß-thalassemia discrimination revealed similar results (0.86, 74%, 98%, 75%, and 99%, respectively). We conclude that the advanced algorithms, derived from extended RBC parameters provided by the Sysmex XE5000 analyzer, are useful as laboratory anemia screening devices.

Filtros de vena cava inferior: presentación de 28 casos

Introducción: El tromboembolismo pulmonar (TEP) sigue siendo una causa importante de morbilidad y mortalidad en el mundo. Su origen más común es la trombosis venosa profunda (TVP). La anticoagulación y el control de los factores de riesgo son el tratamiento convencional. En un número importante de casos este tratamiento no es suficiente o no es aplicable, por lo cual la interrupción parcial del retorno venoso está indicada. Esta interrupción se puede efectuar mediante la colocación de filtros en la vena cava inferior. Objetivo: Describir la experiencia de la Fundación Santafé de Bogotá (FSFB) en la colaboración de filtros de vena cava inferior. Diseño: Estudio observacional, descriptivo, de una serie de casos. Pacientes y Métodos: Se incluyeron los pacientes a quienes se colocó filtro de vena cava inferior entre 1991 y 1995. Se revisaron las historias, haciendo énfasis en factores de riesgo para TVP-TEP, indicación de la colocación del filtro de vena cava inferior, tipo de filtro y complicaciones. Resultado: Se presentaron 28 casos con las variables descritas. No se presentan datos de seguimiento a mediano y largo plazo.