Understanding the genomic heterogeneity of North African Imazighen: from broad to microgeographical perspectives.

The strategic location of North Africa has led to cultural and demographic shifts, shaping its genetic structure. Historical migrations brought different genetic components that are evident in present-day North African genomes, along with autochthonous components. The Imazighen (plural of Amazigh) are believed to be the descendants of autochthonous North Africans and speak various Amazigh languages, which belong to the Afro-Asiatic language family. However, the arrival of different human groups, especially during the Arab conquest, caused cultural and linguistic changes in local populations, increasing their heterogeneity. We aim to characterize the genetic structure of the region, using the largest Amazigh dataset to date and other reference samples. Our findings indicate microgeographical genetic heterogeneity among Amazigh populations, modeled by various admixture waves and different effective population sizes. A first admixture wave is detected group-wide around the twelfth century, whereas a second wave appears in some Amazigh groups around the nineteenth century. These events involved populations with higher genetic ancestry from south of the Sahara compared to the current North Africans. A plausible explanation would be the historical trans-Saharan slave trade, which lasted from the Roman times to the nineteenth century. Furthermore, our investigation shows that assortative mating in North Africa has been rare.

Reverse Shoulder Arthroplasty or Nothing for Patients with Displaced Proximal Humeral Fractures. A Randomized Controlled Trial.

BACKGROUND: The benefits of reverse shoulder arthroplasty compared to nonoperative treatment for patients presenting with complex proximal fractures have been rarely explored. The aim of this prospective study was to compare the functional results of reverse shoulder arthroplasty with those of nonsurgical treatment in patients with displaced proximal humeral fractures. METHODS: A multicentric prospective randomized control trial of patients older than 70 years who sustained an acute proximal humeral fracture (3 or 4 parts), with less than 3 weeks of evolution, and had no previous condition or surgery on the affected shoulder was conducted. Patients were randomly assigned to the intervention group (implantation of a reverse shoulder arthroplasty and tuberosities reattachment) or the control group (nonoperative treatment). Functional outcome was assessed using the Constant-Murley score (CMS) at the 1-year follow-up. Complications and reinterventions were considered secondary outcomes. The power of the study relied on the inclusion of 81 patients to recognize a statistically significant difference of 10 points between CMS scores in the groups. Analysis was performed based on the intention to treat principle. RESULTS: Eighty-one patients were randomized to surgical treatment or nonoperative treatment, while 66 patients completed the 1-year follow-up evaluation. There was no significant difference between the groups in terms of age (76.1 yo vs 77.43 yo, p=0.43), sex (81.08% women in the surgical group vs 84.09% in the nonoperative group, p=0.72), or type of fracture according to Neer's classification system (p=0.06). At the 1-year follow-up, the group assigned to undergo the intervention had better functional outcomes than the nonoperative treatment group (mean CMS; 61.24, SD: 13.33 versus mean CMS: 52.44, SD: 16.22, p0.02), with a mean difference of 8.84 points, 95% CI [1.57, 16.11]. Two patients in the intervention group (6.5%) suffered major complications (periprosthetic joint infection and axillary nerve palsy). No major complications were observed in the nonoperative group. One patient in the intervention group underwent secondary surgery for a periprosthetic joint infection. CONCLUSIONS: Treatment with reverse shoulder arthroplasty provides superior functional outcomes compared with conservative treatment for patients presenting with an acute proximal humeral fracture. The difference in CMS is close to the clinically significant thresholds, and some harms are associated with the operative treatment.

Reduced mitochondrial respiratory capacity in patients with acute episodes of bipolar disorder: Could bipolar disorder be a state-dependent mitochondrial disease?

BACKGROUND: Bipolar disorder (BD) is a chronic and recurrent disease characterized by acute mood episodes and periods of euthymia. The available literature postulates that a biphasic dysregulation of mitochondrial bioenergetics might underpin the neurobiology of BD. However, most studies focused on inter-subject differences rather than intra-subject variations between different mood states. To test this hypothesis, in this preliminary proof-of-concept study, we measured in vivo mitochondrial respiration in patients with BD during a mood episode and investigated differences compared to healthy controls (HC) and to the same patients upon clinical remission. METHODS: This longitudinal study recruited 20 patients with BD admitted to our acute psychiatric ward with a manic (n = 15) or depressive (n = 5) episode, and 10 matched HC. We assessed manic and depressive symptoms using standardized psychometric scales. Different mitochondrial oxygen consumption rates (OCRs: Routine, Leak, electron transport chain [ETC], Rox) were assessed during the acute episode (T0) and after clinical remission (T1) using high-resolution respirometry at 37°C by polarographic oxygen sensors in a two-chamber Oxygraph-2k system in one million of peripheral blood mononuclear cells (PMBC). Specific OCRs were expressed as mean ± SD in picomoles of oxygen per million cells. Significant results were adjusted for age, sex, and body mass index. RESULTS: The longitudinal analysis showed a significant increase in the maximal oxygen consumption capacity (ETC) in clinical remission (25.7 ± 16.7) compared to the acute episodes (19.1 ± 11.8, p = 0.025), and was observed separately for patients admitted with a manic episode (29.2 ± 18.9 in T1, 22.3 ± 11.9 in T0, p = 0.076), and at a trend-level for patients admitted with a depressive episode (15.4 ± 3.9 in T1 compared to 9.4 ± 3.2 in T0, p = 0.107). Compared to HC, significant differences were observed in ETC in patients with a bipolar mood episode (H = 11.7; p = 0.003). Individuals with bipolar depression showed lower ETC than those with a manic episode (t = -3.7, p = 0.001). Also, significant differences were observed in ETC rates between HC and bipolar depression (Z = 1.000, p = 0.005). CONCLUSIONS: Bioenergetic and mitochondrial dysregulation could be present in both manic and depressive phases in BD and, importantly, they may restore after clinical remission. These preliminary results suggest that mitochondrial respiratory capacity could be a biomarker of illness activity and clinical response in BD. Further studies with larger samples and similar approaches are needed to confirm these results and identify potential biomarkers in different phases of the disease.

Nursing evaluation of pediatric preoperative anxiety: a qualitative study / Avaliação de enfermagem da ansiedade pré-operatória pediátrica: um estudo qualitativo? / Evaluación enfermera de la ansiedad prequirúrgica pediátrica: estudio cualitativo

Abstract Objective: to explore and describe how perioperative nurses assess and interpret the child's behavior before entering the operating room, identifying the strategies they use to reduce anxiety and the proposals for improvements. Method: descriptive qualitative study using semi-structured interviews and participant observation of daily routines. Thematic analysis of data. This study follows the recommended criteria for publication of articles of the qualitative methodology Consolidated Criteria for Reporting Qualitative Research. Results: four topics emerged from the data: a) assessment of anxiety or close communication with the child and their family; b) evaluating what was observed; c) managing anxiety and d) improving the assessment or proposals for improvements in daily practice. Conclusion: nurses assess anxiety in their daily practice through observation using their clinical judgment. The nurse's experience is decisive for the appropriate assessment of the preoperative anxiety in child. Insufficient time between waiting and entering the operating room, lack of information from child and their parents about the surgical procedure, and parental anxiety make it difficult to assess and properly manage anxiety.

Resumo Objetivo: explorar e descrever como as enfermeiras perioperatórias avaliam e interpretam o comportamento da criança antes de entrar na sala de cirurgia, identificando as estratégias que utilizam para minimizar a ansiedade e as propostas de melhoria. Método: estudo qualitativo descritivo utilizando entrevistas semiestruturadas e observação participante das rotinas diárias. Análise temática dos dados. O estudo segue os critérios recomendados para publicação de artigos da metodologia qualitativa Consolidated Criteria for Reporting Qualitative Research. Resultados: quatro temas emergiram dos dados: a) avaliação da ansiedade ou comunicação próxima com a criança e sua família; b) analisando o que foi observado; c) controlando a ansiedade e d) melhorando a avaliação ou propostas de melhoria na prática diária. Conclusão: as enfermeiras avaliam a ansiedade em sua prática diária por meio da observação e usando julgamento clínico. A experiência da enfermeira é decisiva na avaliação adequada da ansiedade pré-operatória da criança. A falta de tempo entre a espera e o momento de entrar na sala de cirurgia, a escassez de informação que a criança e os pais têm sobre o processo cirúrgico e a ansiedade dos pais, dificultam a avaliação e o controle adequado da ansiedade.

Resumen Objetivo: explorar y describir cómo las enfermeras perioperatorias evalúan e interpretan el comportamiento del niño antes de entrar a quirófano, identificando las estrategias que utilizan para minimizar la ansiedad y las propuestas de mejora. Método: estudio cualitativo descriptivo mediante entrevistas semiestructuradas y observación participante de las rutinas diarias. Análisis temático de los datos. El estudio sigue las recomendaciones de criterios para la publicación de artículos de metodología cualitativa Consolidated Criteria for Reporting Qualitative Research. Resultados: cuatro temas surgieron de los datos: a) evaluación de la ansiedad o comunicación estrecha con el niño y su familia; b) valorando lo observado; c) manejando la ansiedad y d) mejorando la evaluación o propuestas de mejora para la práctica diaria. Conclusión: enfermeras evalúan la ansiedad en su práctica diaria de forma observacional utilizando el juicio clínico. La experiencia de la enfermera es determinante en la adecuada evaluación de la ansiedad prequirúrgica del niño. La falta de tiempo entre la espera y el momento de entrar a quirófano, la mala información que tiene el niño y los padres sobre el proceso quirúrgico y la ansiedad de los padres dificultan la evaluación y el manejo correcto de la ansiedad.

Nursing evaluation of pediatric preoperative anxiety: a qualitative study.

OBJECTIVE: to explore and describe how perioperative nurses assess and interpret the child's behavior before entering the operating room, identifying the strategies they use to reduce anxiety and the proposals for improvements. METHOD: descriptive qualitative study using semi-structured interviews and participant observation of daily routines. Thematic analysis of data. This study follows the recommended criteria for publication of articles of the qualitative methodology Consolidated Criteria for Reporting Qualitative Research. RESULTS: four topics emerged from the data: a) assessment of anxiety or close communication with the child and their family; b) evaluating what was observed; c) managing anxiety and d) improving the assessment or proposals for improvements in daily practice. CONCLUSION: nurses assess anxiety in their daily practice through observation using their clinical judgment. The nurse's experience is decisive for the appropriate assessment of the preoperative anxiety in child. Insufficient time between waiting and entering the operating room, lack of information from child and their parents about the surgical procedure, and parental anxiety make it difficult to assess and properly manage anxiety.

Genomic Insights into the Population History of the Resande or Swedish Travelers.

The Resande are a minority ethnic group in Sweden, who were characterized by an itinerant way of life, and they have been suggested to originate from the mixture between Swedish and Romani populations. Because the population history of the Resande has been scarcely studied, we analyzed genome-wide genotype array data from unrelated Resande individuals in order to shed light on their origins and demographic history for the first time from a genetic perspective. Our results confirm the Romani-related ancestry of this population and suggest an admixture event between a Romani-like population and a general Swedish-like population that occurred approximately between the mid-18th and mid-19th centuries, two centuries after the arrival of the first historically reported Romani families in Sweden. This inferred date suggests that the Romani group involved in the admixture is related to the pre-18th-century arrivals of Romani in Scandinavia. In addition, a reduction in the population size is detected previous to the admixture event, suggesting a subtle signal of isolation. The present work constitutes a step forward toward a better representation of ethnic minorities and underrepresented groups in population genetic analyses. In order to know in more detail the complete history of human populations, it is time to focus on studying populations that have not been previously considered for a general scenario and that can provide valuable information to fill in the gaps that still remain uncovered.

Porcine Circovirus 3 Detection in Aborted Fetuses and Stillborn Piglets from Swine Reproductive Failure Cases.

Porcine circovirus 3 (PCV-3) has been widely detected in healthy and diseased pigs; among different pathologic conditions, the strongest evidence of association comes from reproductive disease cases. However, simple viral detection does not imply the causality of the clinical conditions. Detection of PCV-3 within lesions may provide stronger evidence of causality. Thus, this study aimed to assess the frequency of PCV-3 detection in tissues from fetuses/stillborn piglets in cases of reproductive problems in domestic swine, as well as the histopathologic assessment of fetal tissues. Fetuses or stillborn piglets from 53 cases of reproductive failure were collected and analyzed by PCV-3 qPCR. The presence of porcine reproductive and respiratory syndrome virus (PRRSV), porcine circovirus 2 (PCV-2), and porcine parvovirus 1 (PPV1) was also checked. PCV-3 qPCR positive samples with a high viral load were tested by PCV-3 in situ hybridization (ISH), sequenced, and phylogenetically analyzed. PCV-3 DNA was detected in 18/53 (33.9%) reproductive failure cases and in 16 of them PCV-3 was the only pathogen found. PCV-2 DNA was found in 5/53 (9.4%), PRRSV RNA in 4/53 (7.5%) and PPV1 was not detected. Four out of the six PCV-3 qPCR-positive cases with Ct value <30 were positive when tested by ISH. In these samples, PCV-3 was detected within mild histopathologic lesions, such as arteritis and periarteritis in multiple tissues. The present work emphasizes the need to include PCV-3 as a potential causative agent of reproductive failure in swine.

Emotional impact of the Covid-19 pandemic on healthcare workers in one of the most important infection outbreaks in Europe.

BACKGROUND AND OBJECTIVES: The Covid-19 pandemic has put healthcare professionals around the world in an unprecedented challenge. This may cause some emotional difficulties and mental health problems. The aim of the present study was to analyze the emotional status among the health care workers form the Hospital of Igualada (Barcelona), while they were facing with Covid-19 in one of the most affected regions in all of Europe. PATIENTS AND METHODS: A total of 395 participants were included in the study. A cross-sectional assessment was carried out between the months of March and April. Information about anxiety, depression, and stress was gathered. We also collected demographic data and concerning potentially stressful factors. RESULTS: A significant proportion of professionals reported symptoms of anxiety (31.4%) and depression (12.2%) from moderate to severe intensity. Symptoms of acute stress were reported by 14.5% of participants. We performed a regression analysis, which explained the 30% of the variance associated with the degree of emotional distress (R²â€¯= 0.30). The final model reveals that females (or young males), who are working in the frontline as nursing assistants, caretakers or radiology technicians, with the uncertainty of a possible infection, the perception of inadequate protection measures and having experienced the death of a close person by Covid-19, showed a heightened risk of experiencing psychological distress. CONCLUSIONS: Coping with the Covid-19 pandemic caused a significant impact on emotional status of healthcare workers involved in this study.

ANTECEDENTES Y OBJETIVO: La actual pandemia de Covid-19 ha puesto a los profesionales sanitarios de todo el mundo ante un desafío sin precedentes. Esto les ha podido causarles dificultades emocionales y problemas de salud mental. El objetivo del presente estudio fue analizar el estado emocional de los trabajadores del Hospital de Igualada (Barcelona), mientras se enfrentaban a uno de los focos de contagio más importantes de Europa. PACIENTES Y MÉTODOS: Se incluyó a un total de 395 trabajadores. Se realizó una evaluación transversal entre los meses de marzo y abril. Se recogió información sobre síntomas de ansiedad, depresión, estrés. También se recogieron datos demográficos y sobre factores potencialmente estresantes. RESULTADOS: Un porcentaje significativo de profesionales reportó síntomas de ansiedad (71.6%) y depresión (60.3%). El 14.5% informó de síntomas de estrés agudo. Se realizó un análisis de regresión que explicó el 30% de la variancia asociada al nivel de malestar emocional (R²â€¯= 0.30). Los factores de riesgo asociados a mayor malestar psicológico fueron el hecho de ser mujer (o hombre joven), trabajar como auxiliar de enfermería, celador o técnico de radiología, estar en contacto directo con pacientes Covid-19, no haber realizado la PCR, tener la sensación de no contar con los elementos de protección personales y haber experimentado la muerte de una persona cercana por Covid-19. CONCLUSIONES: El afrontamiento inicial de la situación de crisis asociada a la pandemia del Covid-19, tuvo un importante impacto emocional en los profesionales sanitarios analizados.

Impacto emocional de la pandemia de Covid-19 en los trabajadores sanitarios de uno de los focos de contagio más importantes de Europa / Emotional impact of the Covid-19 pandemic on healthcare workers in one of the most important infection outbreaks in Europe

ANTECEDENTES Y OBJETIVO: La actual pandemia de Covid-19 ha puesto a los profesionales sanitarios de todo el mundo ante un desafío sin precedentes. Esto les ha podido causar dificultades emocionales y problemas de salud mental. El objetivo del presente estudio fue analizar el estado emocional de los trabajadores del Hospital de Igualada (Barcelona), mientras se enfrentaban a uno de los focos de contagio más importantes de Europa. PACIENTES Y MÉTODOS: Se incluyó a un total de 395 trabajadores. Se realizó una evaluación transversal entre los meses de marzo y abril. Se recogió información sobre síntomas de ansiedad, depresión, estrés. También se recogieron datos demográficos y sobre factores potencialmente estresantes. RESULTADOS: Un porcentaje significativo de profesionales reportó síntomas de ansiedad (71,6%) y depresión (60,3%). El 14,5% informó de síntomas de estrés agudo. Se realizó un análisis de regresión que explicó el 30% de la variancia asociada al nivel de malestar emocional (Ry = 0,30). Los factores de riesgo asociados a mayor malestar psicológico fueron el hecho de ser mujer (o hombre joven), trabajar como auxiliar de enfermería, celador o técnico de radiología, estar en contacto directo con pacientes Covid-19, no haber realizado la PCR, tener la sensación de no contar con los elementos de protección personales y haber experimentado la muerte de una persona cercana por Covid-19. CONCLUSIONES: El afrontamiento inicial de la situación de crisis asociada a la pandemia de Covid-19 tuvo un importante impacto emocional en los profesionales sanitarios analizados

BACKGROUND AND OBJECTIVES: The Covid-19 pandemic has put healthcare professionals around the world in an unprecedented challenge. This may cause some emotional difficulties and mental health problems. The aim of the present study was to analyze the emotional status among the health care workers form the Hospital of Igualada (Barcelona), while they were facing with Covid-19 in one of the most affected regions in all of Europe. PATIENTS AND METHODS: A total of 395 participants were included in the study. A cross-sectional assessment was carried out between the months of March and April. Information about anxiety, depression, and stress was gathered. We also collected demographic data and concerning potentially stressful factors. RESULTS: A significant proportion of professionals reported symptoms of anxiety (31.4%) and depression (12.2%) from moderate to severe intensity. Symptoms of acute stress were reported by 14.5% of participants. We performed a regression analysis, which explained the 30% of the variance associated with the degree of emotional distress (Ry = 0.30). The final model reveals that females (or young males), who are working in the frontline as nursing assistants, caretakers or radiology technicians, with the uncertainty of a possible infection, the perception of inadequate protection measures and having experienced the death of a close person by Covid-19, showed a heightened risk of experiencing psychological distress. CONCLUSIONS: Coping with the Covid-19 pandemic caused a significant impact on emotional status of healthcare workers involved in this study

[Emotional impact of the Covid-19 pandemic on healthcare workers in one of the most important infection outbreaks in Europe]. / Impacto emocional de la pandemia de Covid-19 en los trabajadores sanitarios de uno de los focos de contagio más importantes de Europa.

BACKGROUND AND OBJECTIVES: The Covid-19 pandemic has put healthcare professionals around the world in an unprecedented challenge. This may cause some emotional difficulties and mental health problems. The aim of the present study was to analyze the emotional status among the health care workers form the Hospital of Igualada (Barcelona), while they were facing with Covid-19 in one of the most affected regions in all of Europe. PATIENTS AND METHODS: A total of 395 participants were included in the study. A cross-sectional assessment was carried out between the months of March and April. Information about anxiety, depression, and stress was gathered. We also collected demographic data and concerning potentially stressful factors. RESULTS: A significant proportion of professionals reported symptoms of anxiety (31.4%) and depression (12.2%) from moderate to severe intensity. Symptoms of acute stress were reported by 14.5% of participants. We performed a regression analysis, which explained the 30% of the variance associated with the degree of emotional distress (Ry=0.30). The final model reveals that females (or young males), who are working in the frontline as nursing assistants, caretakers or radiology technicians, with the uncertainty of a possible infection, the perception of inadequate protection measures and having experienced the death of a close person by Covid-19, showed a heightened risk of experiencing psychological distress. CONCLUSIONS: Coping with the Covid-19 pandemic caused a significant impact on emotional status of healthcare workers involved in this study.

Actitudes, dudas y conocimientos de los colectivos implicados en la atención del paciente con Alzheimer: resultados de la encuesta del proyecto kNOW Alzheimer / Attitudes, uncertainties and knowledge among the different parties involved in alzheimer’s patients care: findings from the kNOW Alzheimer project survey study

Introducción: La enfermedad de Alzheimer (EA) involucra a colectivos diversos de profesionales y cuidadores. Las actitudes y necesidades de formación en diagnóstico temprano, tratamiento, síntomas conductuales, recursos sociosanitarios y aspectos legales o éticos son desconocidas. Métodos: Estudio observacional transversal tipo encuesta dentro del proyecto kNOW Alzheimer, iniciativa de la SEN, SEGG, SEMERGEN, SEFAC y CEAFA mediante cuestionarios específicos. Cada sociedad invitó a todos sus miembros a cumplimentarlos a través de www.knowalzheimer.com. Resultados: Participaron 114 neurólogos, 113 geriatras, 275 médicos de atención primaria, 328 farmacéuticos y 858 cuidadores. Los retrasos en el diagnóstico se originan en pacientes y cuidadores, el sistema y en los profesionales, que carecen de medios o malinterpretan síntomas tempranos. Persiste el uso del término 'demencia senil'. Profesionales y cuidadores perciben buena eficacia del tratamiento. Se apuesta por el diagnóstico y tratamiento en fase pre-demencia. Hay déficit de formación en el manejo de la conducta. Los profesionales afirman que informan pero los cuidadores se sienten desinformados. Los cuidadores desean conocer cuanto antes si ellos o un familiar padecen Alzheimer. Los síntomas conductuales y la necesidad de restringir actividades son fuentes de sobrecarga. Los farmacéuticos pueden contribuir a la detección y manejo, pero precisan de formación amplia. Hay necesidad de formación en aspectos legales, bioéticos, recursos y acceso a la investigación. Conclusiones: Este proyecto ha permitido obtener información sobre actitudes y dudas de los colectivos involucrados en la atención a la EA, necesidades de formación y puntos de mejora (AU)

Background: Alzheimer’s disease (AD) involves different groups of professionals and caregivers. Their attitudes and needs of training in early diagnosis, treatment, behavioral symptoms, resources, social and legal or ethical aspects are unknown. Methods: Survey study within the project 'kNOW Alzheimer', a SEN, SEGG, SEMERGEN SEFAC and CEAFA initiative, through specific questionnaires. Each Society invited all its members to complete them through www.knowalzheimer.com. Results: Participants were 114 neurologists, geriatricians 113, 275 primary care physicians, 328 pharmacists and 858 caregivers. Delays in diagnosis arise in patients and caregivers, the system and the professionals, who lack the means or misinterpreted early symptoms. The term 'senile dementia' is still in use. Professionals and caregivers perceived good efficacy of treatment. Professionals advocate for diagnosis and treatment in the pre-dementia stage. There is a need for training in behavior management. Practitioners claim they inform but caregivers feel uninformed. Caregivers want to know as soon as possible if they or a family member suffers from AD. Behavioral symptoms and the need to restrict activities are sources of overload. Pharmacists can contribute to detection and management, but require extensive training. There is a need for training on legal aspects, bioethics, resources and access to research. Conclusions: This project has yielded information on attitudes and doubts of the collectives involved in AD care, their training needs and points of improvement (AU)

Molecular Epidemiology and Evolution of Influenza Viruses Circulating within European Swine between 2009 and 2013.

UNLABELLED: The emergence in humans of the A(H1N1)pdm09 influenza virus, a complex reassortant virus of swine origin, highlighted the importance of worldwide influenza virus surveillance in swine. To date, large-scale surveillance studies have been reported for southern China and North America, but such data have not yet been described for Europe. We report the first large-scale genomic characterization of 290 swine influenza viruses collected from 14 European countries between 2009 and 2013. A total of 23 distinct genotypes were identified, with the 7 most common comprising 82% of the incidence. Contrasting epidemiological dynamics were observed for two of these genotypes, H1huN2 and H3N2, with the former showing multiple long-lived geographically isolated lineages, while the latter had short-lived geographically diffuse lineages. At least 32 human-swine transmission events have resulted in A(H1N1)pdm09 becoming established at a mean frequency of 8% across European countries. Notably, swine in the United Kingdom have largely had a replacement of the endemic Eurasian avian virus-like ("avian-like") genotypes with A(H1N1)pdm09-derived genotypes. The high number of reassortant genotypes observed in European swine, combined with the identification of a genotype similar to the A(H3N2)v genotype in North America, underlines the importance of continued swine surveillance in Europe for the purposes of maintaining public health. This report further reveals that the emergences and drivers of virus evolution in swine differ at the global level. IMPORTANCE: The influenza A(H1N1)pdm09 virus contains a reassortant genome with segments derived from separate virus lineages that evolved in different regions of the world. In particular, its neuraminidase and matrix segments were derived from the Eurasian avian virus-like ("avian-like") lineage that emerged in European swine in the 1970s. However, while large-scale genomic characterization of swine has been reported for southern China and North America, no equivalent study has yet been reported for Europe. Surveillance of swine herds across Europe between 2009 and 2013 revealed that the A(H1N1)pdm09 virus is established in European swine, increasing the number of circulating lineages in the region and increasing the possibility of the emergence of a genotype with human pandemic potential. It also has implications for veterinary health, making prevention through vaccination more challenging. The identification of a genotype similar to the A(H3N2)v genotype, causing zoonoses at North American agricultural fairs, underlines the importance of continued genomic characterization in European swine.

Isolation rates, serovars, and toxin genotypes of nicotinamide adenine dinucleotide-independent Actinobacillus pleuropneumoniae among pigs suffering from pleuropneumonia in Spain.

Actinobacillus pleuropneumoniae is the etiologic agent of swine pleuropneumonia, a major production-limiting disease in the pig industry. In the current study, 2,171 lung specimens obtained from pigs housed in 870 Spanish pig farms in regions of substantial pig production were examined. Conventional microbiology, coupled with species-specific polymerase chain reaction, identified 127 biovar 2 isolates, accounting for 25.3% of all A. pleuropneumoniae (n = 502) detected. Most isolates (79%) were recovered as pure primary cultures or as the predominant bacteria from lungs exhibiting lesions typical of acute swine pleuropneumonia. Coagglutination testing identified the isolates as belonging to serovars 2 (4.7%), 4 (4.7%), 7 (68.5%), and 11 (1.6%); however, 26 isolates were nontypeable. All biovar 2 isolates showed genes of the apxII operon alone, which encodes the corresponding ApxII exotoxin, leading to a different gene pattern for isolates in serovars 2, 4, and 11 compared with those of biovar 1. From this survey, it can be concluded that A. pleuropneumoniae biovar 2 infections are common in pigs in Spain, and they may be a common cause of respiratory disease in swine.

Evaluación de sitios web con información sobre medicamentos / Assessment of websites with information on medicines

ObjetivoIdentificar sitios web con información sobre medicamentos a través de expertos y evaluar su adecuación a códigos de conducta y las recomendaciones de la Organización Mundial de la Salud.DiseñoEstudio transversal de la adecuación a los criterios, a partir de un cuestionario diseñado ad hoc (efectuado independientemente por dos evaluadores). Los sitios web fueron identificados a partir de la técnica Delphi (35 expertos).EmplazamientoSitios web con información sobre medicamentos.Unidad de análisis35 sitios web seleccionados por la técnica Delphi. En la tercera ronda se alcanzó un nivel de estabilidad (variabilidad intercuartílica) aceptable (< 0,05).Mediciones principalesResponsabilidad, transparencia y honestidad, autoría de la información, política editorial, protección de datos personales, actualización de la información y accesibilidad. Se realizó un análisis descriptivo del cumplimiento y se estimó el coeficiente kappa para valorar la concordancia entre evaluadores (criterios de Fleiss).ResultadosDestacan con cumplimiento general alto el National Prescribing Service Limited (NPS), PubMed, British Medical Journal, New England Journal of Medicine, Journal of American Medical Association, The Lancet, Fisterra y National Institute for Health and Clinical Excellence. La dimensión de actualización de la información es la que presentó una menor valoración para los diferentes sitios web.ConclusionesLa calidad de los sitios web sobre medicamentos recomendada por expertos es variable. Sin embargo, hay diversos sitios web de cumplimiento alto, que se detallan en el informe(AU)

AimsTo identify websites with information on medicines and assess, using experts, their adherence to codes of conduct and recommendations by the WHO.DesignCross-sectional study based on an ad hoc designed questionnaire (performed independently by 2 reviewers). The websites were identified by the Delphi technique (35 experts).SettingWebsites with information on medicines.ParticipantsA total of 35 websites selected by the Delphi technique. An acceptable level of stability was achieved in the third round (interquartile variability; <0.05).ResultsThe National Prescribing Service Limited (NPS), PubMed, British Medical Journal, New England Journal of Medicine, Journal of American Medical Association, The Lancet, Fisterra and National Institute for Health and Clinical Excellence stood out with an overall high fulfilment of the questionnaire. The updated information dimension was the lowest evaluation for the different websites.ConclusionsThe quality of the web sites evaluated varied widely. Although there are several websites, which are detailed in the article, with high overall scores(AU)

[Assessment of websites with information on medicines]. / Evaluación de sitios web con información sobre medicamentos.

AIMS: To identify websites with information on medicines and assess, using experts, their adherence to codes of conduct and recommendations by the WHO. DESIGN: Cross-sectional study based on an ad hoc designed questionnaire (performed independently by 2 reviewers). The websites were identified by the Delphi technique (35 experts). SETTING: Websites with information on medicines. PARTICIPANTS: A total of 35 websites selected by the Delphi technique. An acceptable level of stability was achieved in the third round (interquartile variability; <0.05). MAIN MEASUREMENTS: Responsibility, transparency and honesty, authorship of the information, content review policy, privacy and data protection policies, updated information and accessibility. A descriptive analysis of compliance was carried out and the kappa coefficient was estimated to evaluate the agreement between assessors (Fleiss's Criteria). RESULTS: The National Prescribing Service Limited (NPS), PubMed, British Medical Journal, New England Journal of Medicine, Journal of American Medical Association, The Lancet, Fisterra and National Institute for Health and Clinical Excellence stood out with an overall high fulfilment of the questionnaire. The updated information dimension was the lowest evaluation for the different websites. CONCLUSIONS: The quality of the web sites evaluated varied widely. Although there are several websites, which are detailed in the article, with high overall scores.

[Adherence to codes of conduct for biomedical information on the internet in useful websites for pharmacotherapy follow-up]. / Adecuación a los códigos de conducta para información biomédica en internet de sitios web útiles para el seguimiento farmacoterapéutico.

OBJECTIVES: To assess adherence to four codes of conduct in websites providing information useful for pharmacotherapy follow-up. METHODS: We performed a descriptive study of adherence to quality criteria in 19 websites. These sites had been identified in a previous study as being those most frequently used by pharmacists. A descriptive analysis was performed and the kappa coefficient was calculated to evaluate interrater concordance (Fleiss' criteria for evaluation of the kappa index). RESULTS: The most highly rated source of clinical practice guidelines and that which adhered most closely to the 4 codes of conduct was Fisterra. The websites most highly rated in reviews and secondary sources were the Cochrane Library and PubMed. The most highly rated journals were JAMA and the BMJ, followed by Atención Primaria and Medicina Clínica. Among drug information guides, the highest scores were obtained by BOT and Martindale's. The highest rated drug bulletins were the Boletín Terapéutico Andaluz and Butlletí Groc. The most highly rated agency was the World Health Organization. The journals with the lowest scores were Pharmaceutical Care and Seguimiento Farmacoterapéutico followed by the Spanish Internacional Vademecum MediMedia-Medicom. According to Fleiss's criteria, interrater concordance was acceptable for the 4 codes. CONCLUSIONS: The quality of the web sites evaluated varied widely, although most received scores of more than 60 points (out of 100) in the 4 codes of conduct used for evaluation.

Adecuación a los códigos de conducta para información biomédica en internet de sitios web útiles para el seguimiento farmacoterapéutico / Objetivos: Evaluar la adecuación de los sitios web destinados a proporcionar información para la realización de seguimiento farmacoterapéutico a 4 códigos de conducta

Objetivos: Evaluar la adecuación de los sitios web destinados a proporcionar información para la realización de seguimiento farmacoterapéutico a 4 códigos de conducta. Métodos: Estudio descriptivo del cumplimiento de los criterios de calidad de 19 sitios web seleccionados por ser los de mayor utilización por los farmacéuticos en un estudio previo. Se realizó un análisis descriptivo y se estimó el coeficiente kappa para valorar la concordancia entre evaluadores (criterios de Fleiss) . Resultados y conclusiones: Fisterra fue la página mejor valorada en los 4 códigos, y la fuente de acceso a guías clínicas mejor calificada. La Cochrane Library y Pubmed las mejor valoradas en revisiones y fuentes secundarias. JAMA y British Medical Journal fueron las revistas mejor calificadas seguidas de Atención Primaria y Medicina Clínica. Entre los vademécums, el BOT y el Martindale obtuvieron las mejores calificaciones y el Boletín Terapéutico Andaluz y el Butlletí Groc recibieron altas calificaciones de entre los boletines de medicamentos. La Organización Mundial de la Salud fue la agencia mejor calificada. Los sitios con menor calificación fueron Pharmaceutical Care, Seguimiento Farmacoterapéutico y el Vademécum Internacional España MediMedia-Medicom. La concordancia entre evaluadores fue aceptable para los 4 códigos. Conclusiones: La calidad de los sitios web que utilizan los farmacéuticos es muy variable, aunque la mayoría superan los 60 puntos (sobre 100) en los 4 códigos de conducta usados en la evaluación

Objectives: To assess adherence to four codes of conduct in websites providing information useful for pharmacotherapy follow-up. Methods: We performed a descriptive study of adherence to quality criteria in 19 websites. These sites had been identified in a previous study as being those most frequently used by pharmacists. A descriptive analysis was performed and the kappa coefficient was calculated to evaluate interrater concordance (Fleiss' criteria for evaluation of the kappa index). Results: The most highly rated source of clinical practice guidelines and that which adhered most closely to the 4 codes of conduct was Fisterra. The websites most highly rated in reviews and secondary sources were the Cochrane Library and PubMed. The most highly rated journals were JAMA and the BMJ, followed by Atención Primaria and Medicina Clínica. Among drug information guides, the highest scores were obtained by BOT and Martindale's. The highest rated drug bulletins were the Boletín Terapéutico Andaluz and Butlletí Groc. The most highly rated agency was the World Health Organization. The journals with the lowest scores were Pharmaceutical Care and Seguimiento Farmacoterapéutico followed by the Spanish Internacional Vademecum MediMedia-Medicom. According to Fleiss's criteria, interrater concordance was acceptable for the 4 codes. Conclusions: The quality of the web sites evaluated varied widely, although most received scores of more than 60 points (out of 100) in the 4 codes of conduct used for evaluation

El asma inducida por esfuerzo / No disponible

El AIE es una enfermedad consultancial al asma, que se manifiesta en el 12% de la población general cuando realiza un ejercicio intenso. Esta es una enfermedad infradiagnosticada e infratratada, fácilmente tratable o prevenible. Los resultados de la terapia son muy positivos a corto plazo, porque mejoran la calidad de vida en el niño, y a largo plazo, porque previene complicaciones pulmonares en la edad adulta (AU)

No disponible