Structure-Antitumor Activity Relationships of Aza- and Diaza-Anthracene-2,9,10-Triones and Their Partially Saturated Derivatives.

The 1,8-Diazaanthracene-2,9,10-triones, their 5,8-dihydro derivatives, and 1,8-diazaanthracene-2,7,9,10-tetraones, structurally related to the diazaquinomycin family of natural products, were synthesized in a regioselective fashion employing Diels-Alder strategies. These libraries were studied for their cytotoxicity in a variety of human cancer cell lines in order to establish structure-activity relationships. From the results obtained, we conclude that some representatives of the 1,8-diazaanthracene-2,9,10-trione framework show potent and selective cytotoxicity against solid tumors. Similar findings were made for the related 1-azaanthracene-2,9,10-trione derivatives, structurally similar to the marcanine natural products, which showed improved activity over their natural counterparts. An enantioselective protocol based on the use of a SAMP-related chiral auxiliary derived was developed for the case of chiral 5-substituted 1,8-diazaanthracene-2,9,10-triones, and showed that their cytotoxicity was not enantiospecific.

Real-World Experience in Extracorporeal Photopheresis for Adults with Graft-versus-Host Disease.

Extracorporeal photopheresis (ECP) has shown efficacy in treating graft-versus-host disease (GVHD). We aim to summarize eight years of real-world experience with off-line ECP in our institution, in order to validate this treatment schedule and analyze predictive factors. All consecutive adult patients with steroid-dependent or steroid-refractory GVHD undergoing off-line ECP were included in this single-center retrospective study. ECP was performed with a Spectra Optia device, processing 1 total blood volume, at a twice-weekly frequency for acute GVHD (aGVHD) and once weekly for chronic GVHD (cGVHD), and tapered individually according to clinical response. The cumulative incidence of response, including complete response (CR) and partial response (PR), were compared among patients grouped by different baseline, apheresis, and disease characteristics. Between January 2015 and May 2022, a total of 1382 ECP procedures were proposed for 82 patients. No incidents were reported in 97% of the ECP sessions. GVHD responded in 78% of patients (aGVHD: 57% CR and 4% PR; cGVHD, 39% CR and 48% PR). Overall survival was statistically greater for aGVHD patients who responded to ECP compared to those who did not respond (67.5% versus 26% at 1 year; P = 0.037). Severity was an independent predictor of response in aGVHD, whereas the absence of mouth involvement and lower lymphocyte counts in the apheresis product correlated with a higher response in cGVHD. Our findings support the effectiveness of this treatment schedule for GVHD. Further investigation is required to identify ECP-specific predictive factors, given that findings are not homogeneous across studies.

The #Rights4metoo Scale: a tool to monitor compliance with the convention on the rights of persons with disabilities / La escala #YoTambién Tengo Derechos: Una herramienta para monitorizar la convención sobre los derechos de las personas con discapacidad

There is a lack of psychometrically validated tools to evaluate the extent to which people with intellectual disability (ID) truly exercise their rights in all areas of their lives. The aim of this article is to provide evidence about the usefulness and reliability of the pilot version of the #Rights4MeToo Scale, an instrument based on the Quality of Life Supports Model. The scale can be self-reported by people with ID or hetero-reported by family members or professionals. First, through a qualitative study with self-advocates with ID, we provide evidence about the need and usefulness of this tool to understand and monitor compliance with the Convention on Rights of Persons with Disabilities (CRPD). Next, we present preliminary data on the internal consistency of the items that make up the pilot version, analyzing the responses of 1,200 people with ID, family members, and professionals. The #Rights4MeToo Scale will make it possible to conduct national studies on compliance with the CRPD, not to mention international comparative studies when the scale is adapted to the legal and cultural context of other countries. (AU)

Resulta urgente e ineludible contar con herramientas, con adecuadas evidencias de validez y fiabilidad, que permitan evaluar hasta qué punto las personas con discapacidad intelectual (DI) verdaderamente ejercen sus derechos en todos los ámbitos de su vida. El objetivo de este artículo consiste en proporcionar evidencias acerca de la utilidad y la fiabilidad de la versión preliminar de la escala #YoTambién Tengo Derechos, un instrumento diseñado a partir del Modelo de Calidad de Vida y Apoyos. La escala puede ser autoinformada por personas con DI o heteroinformada por familiares o profesionales. Por un lado, mediante un estudio cualitativo con autogestores con DI se proporcionan evidencias acerca de la necesidad y la utilidad de esta herramienta para conocer y monitorizar el cumplimiento de la Convención. Por otro lado, presentamos datos preliminares de la consistencia interna de los ítems, analizando las respuestas de 1.200 personas con DI, familiares y profesionales. La escala #YoTambién Tengo Derechos permitirá llevar a cabo estudios nacionales sobre el cumplimiento de la Convención sobre los Derechos de las Personas con Discapacidad y, con su adaptación al contexto legal y cultural de otros países, estudios comparativos internacionales. (AU)

Drug Allergy Alert System in a Spanish University Hospital: Description and Dynamics of Use.

INTRODUCTION: The drug allergy alert system reduces the frequency of adverse drug events, although it is subjected to collateral effects, since 80-90% of alerts are not real, and a large percentage of alerts are overridden (46.2-96.2%). We reviewed how the alert system is used at University Hospital Fundación Alcorcon (HUFA). METHODS: Data were obtained from the drug allergy alert and the alert overriding notification forms (both in the period 2011-20). We also recorded drug allergy diagnoses at HUFA, drug consumption in primary care in 2016. We calculated the incidence of drug allergy alert activation, temporal trends in use, and correlations between the number of drugs in several datasets. RESULTS: We collected 15,535 alerts. NSAIDs and penicillins were the drugs with the highest number of drug allergy alerts (36.55% and 26.91%, respectively). A correlation was found between the number of drug alerts and the type of drug allergy in HUFA in 2016. Only 6.83% of the alerts were removed, and, of these, 21.77% were reactivated. Approximately 100 overrides were recorded per year from 2016 (6.8% of 8,434 activated alerts during 2014-2020). CONCLUSIONS: The number of drug allergy alerts recorded via the drug allergy alert system of HUFA correlates with the distribution of drug allergy diagnoses in the hospital, although many of the alerts could be false positives (as per current published evidence). We detected a very low frequency of removed alerts (6.83%), a relevant frequency of reactivations (one quarter), and a very low frequency of overrides (6.8%).

Lung ultrasound score severity cut-off points in COVID-19 pneumonia. A systematic review and validating cohort.

Objectives: Our purpose was to establish different cut-off points based on the lung ultrasound score (LUS) to classify COVID-19 pneumonia severity. Methods: Initially, we conducted a systematic review among previously proposed LUS cut-off points. Then, these results were validated by a single-centre prospective cohort study of adult patients with confirmed SARS-CoV-2 infection. Studied variables were poor outcome (ventilation support, intensive care unit admission or 28-days mortality) and 28-days mortality. Results: From 510 articles, 11 articles were included. Among the cut-off points proposed in the articles included, only the LUS > 15 cut-off point could be validated for its original endpoint, demonstrating also the strongest relation with poor outcome (odds ratio [OR] = 3.636, confidence interval [CI] 1.411-9.374). Regarding our cohort, 127 patients were admitted. In these patients, LUS was statistically associated with poor outcome (OR = 1.303, CI 1.137-1.493), and with 28-days mortality (OR = 1.024, CI 1.006-1.042). LUS > 15 showed the best diagnostic performance when choosing a single cut-off point in our cohort (area under the curve 0.650). LUS ≤ 7 showed high sensitivity to rule out poor outcome (0.89, CI 0.695-0.955), while LUS > 20 revealed high specificity to predict poor outcome (0.86, CI 0.776-0.917). Conclusions: LUS is a good predictor of poor outcome and 28-days mortality in COVID-19. LUS ≤ 7 cut-off point is associated with mild pneumonia, LUS 8-20 with moderate pneumonia and ≥20 with severe pneumonia. If a single cut-off point were used, LUS > 15 would be the point which better discriminates mild from severe disease.

Objetivos: Establecer diferentes puntos de corte basados en el Lung Ultrasound Score (LUS) para clasificar la gravedad de la neumonía COVID-19. Métodos: Inicialmente, realizamos una revisión sistemática entre los puntos de corte LUS propuestos previamente. Estos resultados fueron validados por una cohorte prospectiva unicéntrica de pacientes adultos con infección confirmada por SARS-CoV-2. Las variables analizadas fueron la mala evolución y la mortalidad a los 28 días. Resultados: De 510 artículos, se incluyeron 11. Entre los puntos de corte propuestos en los artículos incluidos, solo LUS > 15 pudo ser validado para su objetivo original, demostrando también la relación más fuerte con mala evolución (odds ratio [OR] = 3,636, intervalo de confianza [IC] 1,411-9,374). Respecto a nuestra cohorte, se incluyeron 127 pacientes. En estos pacientes, el LUS se asoció estadísticamente con mala evolución (OR = 1,303, IC 1,137-1,493) y con mortalidad a los 28 días (OR = 1,024, IC 1,006-1,042). LUS > 15 mostró el mejor rendimiento diagnóstico al elegir un único punto de corte en nuestra cohorte (área bajo la curva 0,650). LUS ≤ 7 mostró una alta sensibilidad para descartar mal resultado (0,89, IC 0,695-0,955), mientras que LUS > 20 reveló gran especificidad para predecir mala evolución (0,86, IC 0,776-0,917). Conclusiones: LUS es un buen predictor de mala evolución y mortalidad a 28 días en COVID-19. LUS ≤ 7 se asocia con neumonía leve, LUS 8-20 con neumonía moderada y ≥ 20 con neumonía grave. Si se utilizara un único punto de corte, LUS > 15 sería el que mejor discriminaría la enfermedad leve de la grave.

Lung ultrasound score severity cut-off points in COVID-19 pneumonia. A systematic review and validating cohort / Puntos de corte de gravedad del Lung Ultrasound Score en la neumonía COVID-19. Revisión sistemática de la literatura y cohorte de validación

Objectives Our purpose was to establish different cut-off points based on the lung ultrasound score (LUS) to classify COVID-19 pneumonia severity. Methods Initially, we conducted a systematic review among previously proposed LUS cut-off points. Then, these results were validated by a single-centre prospective cohort study of adult patients with confirmed SARS-CoV-2 infection. Studied variables were poor outcome (ventilation support, intensive care unit admission or 28-days mortality) and 28-days mortality. Results From 510 articles, 11 articles were included. Among the cut-off points proposed in the articles included, only the LUS>15 cut-off point could be validated for its original endpoint, demonstrating also the strongest relation with poor outcome (odds ratio [OR]=3.636, confidence interval [CI] 1.411–9.374). Regarding our cohort, 127 patients were admitted. In these patients, LUS was statistically associated with poor outcome (OR=1.303, CI 1.137–1.493), and with 28-days mortality (OR=1.024, CI 1.006–1.042). LUS>15 showed the best diagnostic performance when choosing a single cut-off point in our cohort (area under the curve 0.650). LUS≤7 showed high sensitivity to rule out poor outcome (0.89, CI 0.695–0.955), while LUS>20 revealed high specificity to predict poor outcome (0.86, CI 0.776–0.917). Conclusions LUS is a good predictor of poor outcome and 28-days mortality in COVID-19. LUS≤7 cut-off point is associated with mild pneumonia, LUS 8–20 with moderate pneumonia and ≥20 with severe pneumonia. If a single cut-off point were used, LUS>15 would be the point which better discriminates mild from severe disease (AU)

Objetivos Establecer diferentes puntos de corte basados en el Lung Ultrasound Score (LUS) para clasificar la gravedad de la neumonía COVID-19. Métodos Inicialmente, realizamos una revisión sistemática entre los puntos de corte LUS propuestos previamente. Estos resultados fueron validados por una cohorte prospectiva unicéntrica de pacientes adultos con infección confirmada por SARS-CoV-2. Las variables analizadas fueron la mala evolución y la mortalidad a los 28 días. Resultados De 510 artículos, se incluyeron 11. Entre los puntos de corte propuestos en los artículos incluidos, solo LUS>15 pudo ser validado para su objetivo original, demostrando también la relación más fuerte con mala evolución (odds ratio [OR]=3,636, intervalo de confianza [IC] 1,411-9,374). Respecto a nuestra cohorte, se incluyeron 127 pacientes. En estos pacientes, el LUS se asoció estadísticamente con mala evolución (OR=1,303, IC 1,137-1,493) y con mortalidad a los 28 días (OR=1,024, IC 1,006-1,042). LUS>15 mostró el mejor rendimiento diagnóstico al elegir un único punto de corte en nuestra cohorte (área bajo la curva 0,650). LUS≤7 mostró una alta sensibilidad para descartar mal resultado (0,89, IC 0,695-0,955), mientras que LUS>20 reveló gran especificidad para predecir mala evolución (0,86, IC 0,776-0,917). Conclusiones LUS es un buen predictor de mala evolución y mortalidad a 28 días en COVID-19. LUS≤7 se asocia con neumonía leve, LUS 8-20 con neumonía moderada y ≥20 con neumonía grave. Si se utilizara un único punto de corte, LUS>15 sería el que mejor discriminaría la enfermedad leve de la grave (AU)

Lung ultrasound score severity cut-off points in COVID-19 pneumonia. A systematic review and validating cohort.

OBJECTIVES: Our purpose was to establish different cut-off points based on the lung ultrasound score (LUS) to classify COVID-19 pneumonia severity. METHODS: Initially, we conducted a systematic review among previously proposed LUS cut-off points. Then, these results were validated by a single-centre prospective cohort study of adult patients with confirmed SARS-CoV-2 infection. Studied variables were poor outcome (ventilation support, intensive care unit admission or 28-days mortality) and 28-days mortality. RESULTS: From 510 articles, 11 articles were included. Among the cut-off points proposed in the articles included, only the LUS>15 cut-off point could be validated for its original endpoint, demonstrating also the strongest relation with poor outcome (odds ratio [OR]=3.636, confidence interval [CI] 1.411-9.374). Regarding our cohort, 127 patients were admitted. In these patients, LUS was statistically associated with poor outcome (OR=1.303, CI 1.137-1.493), and with 28-days mortality (OR=1.024, CI 1.006-1.042). LUS>15 showed the best diagnostic performance when choosing a single cut-off point in our cohort (area under the curve 0.650). LUS≤7 showed high sensitivity to rule out poor outcome (0.89, CI 0.695-0.955), while LUS>20 revealed high specificity to predict poor outcome (0.86, CI 0.776-0.917). CONCLUSIONS: LUS is a good predictor of poor outcome and 28-days mortality in COVID-19. LUS≤7 cut-off point is associated with mild pneumonia, LUS 8-20 with moderate pneumonia and ≥20 with severe pneumonia. If a single cut-off point were used, LUS>15 would be the point which better discriminates mild from severe disease.

Prevalencia y grado de control de la diabetes en centros de atención geriátrica / Prevalence and degree of control of diabetes in nursing homes

Objetivos: Determinar la prevalencia y el grado de control de la diabetes mellitus en la población que vive en residencias geriátricas en la zona de L’Hospitalet de Llobregat. Metodología: Estudio descriptivo transversal, multicéntrico, en 4 centros de atención geriátrica y gerontológica vinculados a los centros de atención primaria Santa Eulalia Sur, en L’Hospitalet de Llobregat, Barcelona. Se recogieron variables sociodemográficas, diagnóstico de diabetes, tratamiento farmacológico y patologías concomitantes, el índice de Barthel, el test de Pfeiffer y la escala de Braden. Se realizó un análisis univariante y bivariante relacionando la presencia de diabetes y el control de esta patología con las diferentes variables de estudio. Resultados: La muestra se compuso por 273 casos, con una edad media de 86,9 (± 6,6) años. La prevalencia de diabetes fue del 31,1%. El nivel de dependencia en el índice de Barthel fue de 42,0 ± 31,3 puntos. Un 20,9% presenta un funcionamiento cognitivo normal y un 10,6% tiene un elevado riesgo de padecer úlceras por presión. Los pacientes diagnosticados de diabetes tuvieron mayor riesgo de padecer hipertensión arterial (OR: 2,03; IC95%, 1,07-3,84). Conclusiones:La prevalencia de diabetes en la población geriátrica institucionalizada es elevada. Teniendo en cuenta la edad de estos pacientes, sus comorbilidades y su fragilidad se hace necesario controlar los síntomas y el pronóstico en cuanto a deterioro físico-cognitivo (AU)

Objectives: To determine the prevalence and Diabetes control in the population who lives in nursing homes in the L’Hospitalet de Llobregat area. Methodology: Cross-sectional, multi-center descriptive study in four geriatric and gerontological care centers linked to Santa Eulalia Sur primary care centers, in L’Hospitalet de Llobregat, Barcelona. Sociodemographic variables, diagnosis of Diabetes, pharmacological treatment and concomitant pathologies were collected. It includes the Barthel index, Pfeiffer test and Braden scale. A univariate and bivariate analysis was performed, relating the presence of diabetes and the control of this pathology with the different study variables. Results: The sample consisted of 273 cases with an average age of 86,9 (± 6.6) years. The prevalence of diabetes was 31.1%. The level of dependence in the Barthel index was 42.0 ± 31.3 points. 20.9% have normal cognitive functioning and 10.6% have a high risk of pressure ulcers. Patients diagnosed with diabetes have a higher risk of developing arterial hypertension (OR: 2.03; 95%CI, 1.07-3.84). Conclusions: The prevalence of diabetes in the institutionalized geriatric population is high, taking into account the age of these patients, their comorbidities and frailty it is necessary to control the symptoms and the prognosis in terms of physical-cognitive impairment (AU)

Comprehensive appraisal of cardiac motion artefact in optical coherence tomography.

BACKGROUND: The relation between cardiac motion artefact (CMA) in optical coherence tomography (OCT) and the phases of cardiac cycle is unclear. METHODS: Optical coherence tomography pullbacks containing metallic stents were co-registered with angiography and retrospectively analyzed. The beginning of three phases, namely ejection, rapid-inflow and diastasis, was identified in angiography. Rotation, shortening, elongation and repetition were qualitatively labelled as CMA artefacts. Platforms with coaxial longitudinal connectors (ML8 and Magmaris) entered a quantitative sub-study, consisting of measuring the length of their connector at the beginning of each phase. RESULTS: A total of 261 stents (127 patients) were analyzed, including 105 stents for quantitative sub-study. CMA was detected in 61 (23.4%) stents: rotation in 6 (2.3%), shortening in 50 (19.2%), elongation in 51 (19.5%) and repetition in 12 (4.6%). Shortening was always observed during ejection phase, while elongation and repetition were always observed during rapid-inflow. Rotation occurred in both ejection and rapid-inflow phases, while no artefact was reported during diastasis. Longitudinal connectors measured in early ejection phase and in early rapid-inflow phase were shorter and longer, respectively, than those measured in diastasis, irrespective of the presence of CMA in the qualitative assessment. CONCLUSIONS: Cardiac motion artefact is prevalent in OCT studies, but shortening and elongation of vascular structures occur during early ejection and during early rapid-inflow, respectively, to a greater or lesser extent in all cases. Diastasis is free of CMA and hence the period in which longitudinal measurements can be more accurately quantified.

Asthma Control in Patients with Severe Eosinophilic Asthma Treated with Reslizumab: Spanish Real-Life Data.

BACKGROUND: Reslizumab is an anti-interleukin 5 monoclonal antibody that has demonstrated to reduce the risk of severe exacerbations and to improve symptoms, lung function, and quality of life in randomized controlled trials that included patients with severe eosinophilic uncontrolled asthma (SEUA) and a history of severe exacerbations. OBJECTIVE: The aim of the present study was to evaluate the effectiveness of add-on reslizumab in a cohort of patients with SEUA under real-life conditions. METHODS: This was a multi-centre, retrospective, real-life study that included subjects with SEUA treated with reslizumab in 44 asthma units throughout Spain. Eligible patients were those who had received at least one dose of reslizumab as part of normal clinical practice. The primary endpoint was complete asthma control at 52 weeks, defined as absence of severe exacerbations, ACT ≥20 and no maintenance oral corticosteroids (OCS). Demographic, clinical, and functional data were collected at baseline (T0), after four to six months (T1); after 12 months (T2) and beyond 12 months of therapy (T3). RESULTS: Treatment with reslizumab achieved complete asthma control in 40% of the 208 included SEUA patients and led to a significant reduction in exacerbations (from 3.0; IQR: 2.0-4.0 at V0 to 0.0; IQR: 0.0-0.0 at V2), maintenance OCS use (from 54.8% (95% CI: 48.0-61.6 at T0 to 18.5% (95% CI: 12.5-24.5 at T2) and a meaningful improvement in symptoms in the entire treated population: ACT increased from 12.8 ± 4.5 at V0 to 20.0 ± 5.1 at V2 (p < 0.001). Most of the improvement achieved at 12 months was obtained at 4-6 months. The retention (continuation) rate of reslizumab was 75% through 2 years (95CI%: 1.9-2.1). Overall, reslizumab showed an adequate safety profile. CONCLUSION: Reslizumab is an effective therapy for SEUA with adequate safety profile in real-life conditions.

Effects of COVID-19 lockdown on the dietary habits and lifestyle in a population in southern Spain: a cross-sectional questionnaire.

BACKGROUND/OBJECTIVE: Few studies have assessed the effect of lockdown on physical activity and eating behaviours in a population from the Autonomous Community of Andalusia in southern Spain. The aim of our study was to describe the effect of COVID-19 pandemic home lockdown on eating habits and lifestyle in the Andalusian population. SUBJECTS/METHODS: A cross-sectional observational study was carried out on a population from southern Spain, Andalusian population. An online questionnaire was shared through social networks and snowball sampling. A total of 1140 people filled in the questionnaire. The questionnaire consisted of 34 items classified into three sections: sociodemographic data, work and leisure activities and questions on food consumption. Each item offered pre- and post-lockdown information. RESULTS: The participants were classified into three age groups: 18-35, 36-65 and over 65. Statistically significant differences were found between the three groups, with the younger age group undergoing greater changes, increasing their physical activity and consumption of fresh food, and decreasing both their consumption of fast food at home and alcohol intake. CONCLUSIONS: These findings suggest that, in the current social and health crisis, the citizens of southern Spain have become aware of the importance of maintaining an appropriate lifestyle to remain healthy, particularly the younger population with less well-consolidated habits.

Acellular Matrix-Induced Chondrogenesis Technique Improves the Results of Chondral Lesions Associated With Femoroacetabular Impingement.

PURPOSE: The study's main objective was to evaluate, in the short-term, the result of the autologous acellular matrix-induced chondrogenesis (AMIC) technique in a selected group of patients with 2-4 cm2 full-thickness chondral lesions, undergoing hip arthroscopy for femoroacetabular impingement (FAI). METHODS: A retrospective single-center Level IV case series of 25 patients (28 hips) who underwent an arthroscopic hip surgery with a liquid acellular collagen matrix. Inclusion criteria for implantation were FAI diagnosis (cam or pincer type), grade IV chondral lesions (Outerbridge size 2-4 cm2); Tönnis stage 0-II, minimum follow-up of 24 months, and 1 year (12-15 months) evaluation with very high field 3-T MRI arthrography. Exclusion criteria were Tönnis III, joint space <2 mm, center-edge angle <20°, and <24 months of follow-up. Clinical assessments involved symptoms duration until surgery, changes in physical and work activity and range of motion, modified Harris Hip Score, reporting percentages of patient acceptable symptomatic state (PASS) and minimal clinically important difference (MCID), pain with a VAS, and level of satisfaction. Radiological assessments: Tönnis stage, articular space, alpha and lateral center edge angle (Wiberg), and generated tissue characteristics at 1 year (based on the MOCART score), through 3-T MRI. RESULTS: 25 patients (28 hips) treated; 19 men and 6 women (mean age: 40.5 years; range: 25-55). Two women underwent joint replacement surgery. Thus, 23 patients (26 hips) were analyzed. At 29 months following surgery (range: 24-48), a significant improvement was obtained in all parameters assessed, focusing on the characteristics of the generated tissue in the MRI (MOCART scores). 95% of the patients met the MCID (improvement >12 points in the modified Harris Hip Score), and 100% scored >74 points, achieving the PASS. Patients' satisfaction was 86.6% (SD 16.4). All patients who practiced sports resumed them. CONCLUSIONS: The liquid AMIC is a safe technique that shows good clinical and radiological outcomes in a 2-year follow-up in patients with femoroacetabular impingement and grade IV acetabular 2-4 cm2 chondral defects. LEVEL OF EVIDENCE: Level IV, retrospective case series.

Impact of Penicillin Allergy Label on Length of Stay and Mortality in Hospitalized Patients through a Clinical Administrative National Dataset.

BACKGROUND: Penicillin allergy is a common problem in the management of infectious diseases. The aim of this study was to determine the impact of penicillin allergy on length of hospital stay (LOHS) among hospitalized adult patients and on in-hospital mortality at a national level. METHODS: A retrospective cohort study of adult patients discharged from the Spanish Hospital System between 2006 and 2015 was conducted using the Minimum Basic Data Set (MBDS). We compared LOHS and in-hospital mortality of adult patients whose records contained penicillin allergy code V14.0 (International Classification of Diseases, Ninth Revision, Clinical Modification) as a secondary diagnosis, with a random sample without such a code. RESULTS: We identified 981,291 admissions with code V14.0, which corresponded to 2.63% of all hospitalizations. Adults patients with a penicillin allergy label were significantly older than patients without such a label, with a median of 70 years (interquartile range [IQR]: 51-80) versus 63 years (IQR: 40-77). The proportion of women and the prevalence of infectious diseases were higher in the group with a penicillin allergy label (61.40% vs. 53.84%; 34.04% vs. 30.01%; respectively). We found a higher median Elixhauser-Van Walraven score in hospitalized patients with an allergy label. The median LOHS for hospitalizations with a penicillin allergy label (5 [IQR: 2-9]) was significantly longer than that in those without such a label (4 [IQR: 2-9]). Multivariate analysis showed an increase in LOHS due to the penicillin allergy label (odds ratio [OR] [95% confidence interval [CI]: 1.061 [1.057-1.065]) and a decrease in mortality in penicillin allergy records (OR [95% CI]: 0.834 [0.825-0.844]). CONCLUSION: In our study, the prevalence of a penicillin allergy label in hospitalized patients, using the MBDS, is low. Hospitalizations with an allergy label was associated with a longer LOHS. However, penicillin-allergic patients did not show higher mortality rates. Inaccurate reporting of penicillin allergies may have an impact on healthcare resources.

Self-Care by Muslim Women during Ramadan Fasting to Protect Nutritional and Cardiovascular Health.

The practice of Ramadan involves a series of changes in lifestyle, mainly in eating habits. The research aim of this study is to determine the prevalence of overweight-obesity, the degree of compliance with dietary recommendations and the effects of religious fasting on cardiovascular health among a population of Muslim women living in Melilla, a Spanish city in North Africa. A follow-up cohort study was conducted on 62 healthy adult women (33.6 ± 12.7 years). Anthropometric and body composition parameters were obtained using bioimpedance and dietary records. All of the participants were overweight or obese, especially due to the non-compliance with dietary recommendations; however, more than 60% considered their weight was appropriate or even low. By the end of Ramadan, the women's body mass index and fat component values had fallen significantly (p < 0.001), but this loss was later recovered. Dietary records revealed an excessive consumption of lipids and sodium, and the presence of a high waist-to-hip ratio. All of these factors are related to cardiovascular risk. In conclusion, promoting nutritional health and encouraging year-round self-care among adult Muslim women is necessary in order to ensure healthy fasting during Ramadan.

Identification of the type of stent with three-dimensional optical coherence tomography: the SPQR study.

BACKGROUND: The ability of optical coherence tomography (OCT) to identify specific types of stent has never been systematically studied. AIMS: The aim of this study was to test the accuracy of OCT imaging to identify patterns of stent platform and subsequently identify the type of stent implanted. METHODS: Consecutive patients from six international centres were retrospectively screened, searching for OCT studies with metallic stents or scaffolds. The sample was analysed by two blinded operators, applying a dedicated protocol in four steps to identify the type of stent: 1) 3D and automatic strut detection (ASD), 2) 3D tissue view, 3) longitudinal view with ASD, 4) mode "stent only" and ASD. RESULTS: A series of 212 patients underwent OCT in the study centres, finding 294 metallic stents or scaffolds in 146 patients. The protocol correctly identified 285 stents (96.9%, kappa 0.965), with excellent interobserver agreement (kappa 0.988). The performance tended to be better in recently implanted stents (kappa 0.993) than in stents implanted ≥3 months before (kappa 0.915), and in pullback speed 18 mm/s as compared with 36 mm/s (kappa 0.969 vs 0.940, respectively). CONCLUSIONS: The type of stent platform can be accurately identified in OCT by trained analysts following a dedicated protocol, combining 3D-OCT, ASD and longitudinal view. This might be clinically helpful in scenarios of device failure and for the quantification of apposition. The blinding of analysts in OCT studies should be revisited.