Prevalence of electrocardiographic alterations in athletes associated with cardiovascular risk parameters / Prevalencia de alteraciones electrocardiográficas en deportistas asociadas a parametros de riesgo cardiovascular

Sport induces cardiac adaptations that are manifested with specific electrocardiographic alterations. This study was carried out in view of the need to identify the relationship between these electrocardiographic alterations with cardiovascular and demographic variables and physical exercise performed. Methodology: a descriptive cross-sectional study in 370 individuals, 211 men and 159 women (36 ± 13 years) that were distributed in three groups: male athletes, female athletes, and non-athlete men and women. Results: 51.08% of the studied subjects presented electrographic alterations, more frequent in athletes. Demographic and cardiovascular variables and the time of physical exercise performed were significantly associated with certain electrocardiographic alterations; the risk of presenting any of the alterations in athletes could be estimated based on the variables set out. Conclusion: There are associations between specific electrocardiographic alterations and cardiovascular, demographic and type of exercise variables that could classify athletes according to cardiovascular risk profiles (AU)

El deporte induce adaptaciones cardiacasque se manifiestan con alteraciones electrocardiográficas.Este estudio se realizóante la necesidad de identificar la relación existente entre estas alteraciones electrocardiográficas con variablescardiovasculares, demográficas y tiempo de ejerciciofísico. Metodología: estudio descriptivotrasversal en 370 individuos, 211 hombres y 159 mujeres (36 ±13 años)que se distribuyeron en tres grupos, hombres deportistas, mujeresdeportistas, yhombres y mujeres no deportistas.Resultados:El 51,08% de los sujetos estudiados presentaron alteraciones electrográficas, siendo más frecuentes en deportistas.Determinadas alteraciones electrocardiográficasen deportistas; se asociaron significativamente a las variables planteadaspudiendo estimar el riesgo de presentar alguna de las alteraciones electrocardiográficas en función de estas variables. Conclusión:Existen asociaciones entrealteraciones electrocardiográficas y variables cardiovasculares, demográficas y tiempo de ejercicio realizado que podrían clasificar a los deportistas según perfiles de riesgo cardiovascular (AU)

Contribution of nursing students to clinical settings: A multi center cross sectional study.

AIMS: To describe the contribution of nursing students to clinical settings based on the perceptions of nurse preceptors and to examine whether certain characteristics of nurses' professional activity are associated with a positive perception of nursing students. BACKGROUND: Most clinical agencies receive many nursing students each year, who acquire clinical competencies under the guidance of a registered nurse preceptor. However, there is limited evidence of the contributions made by nursing students during clinical placements. METHODS: A multi-center cross-sectional study was carried out between June and December 2019. A convenience sample of Registered Nurses (n = 927) was recruited from four public hospitals in Spain. The Nursing Student Contributions to Clinical Settings' questionnaire was used. In addition, sociodemographic, work and teaching activity variables were collected. Multivariable logistic regression was used to determine the variables associated with positive student contributions. RESULTS: The nursing student contributions were deemed favorable by 70.7% of the nurse preceptors, mainly because the nursing students are future professionals who know the center, support the development of the nurses' teaching role and constitute a link between the health center and the university. Certain professional characteristics of the Registered Nurses were significantly associated with a positive perception of the contributions of nursing students: having daily coffee breaks (Odds ratio: 2.60; 95% Confidence interval:1.27-5.32), high levels of professional satisfaction (Odds ratio: 2.13; 95% Confidence interval:1.21-3.75) and work in medical-surgical units (Odds ratio: 1.62; 95% Confidence interval: 1.08-2.41). In contrast, nurses with greater work experience (≥ 30 years) (Odds ratio: 0.48; 95% Confidence interval: 0.27-0.85) and who worked at units where 10 or more students perform clinical practice (Odds ratio: 0.57; 95% Confidence interval: 0.36-0.90) were associated with a lower probability of positive perceptions. CONCLUSIONS: In Spain, the contributions made by nursing students to clinical settings are favorable, both for the nursing profession and for healthcare institutions. Their contributions are influenced by the professional characteristics of the Registered Nurses, as well as the environment and the teaching activity within the units.

Neuropilin-2 regulates androgen-receptor transcriptional activity in advanced prostate cancer.

Aberrant transcriptional activity of androgen receptor (AR) is one of the dominant mechanisms for developing of castration-resistant prostate cancer (CRPC). Analyzing AR-transcriptional complex related to CRPC is therefore important towards understanding the mechanism of therapy resistance. While studying its mechanism, we observed that a transmembrane protein called neuropilin-2 (NRP2) plays a contributory role in forming a novel AR-transcriptional complex containing nuclear pore proteins. Using immunogold electron microscopy, high-resolution confocal microscopy, chromatin immunoprecipitation, proteomics, and other biochemical techniques, we delineated the molecular mechanism of how a specific splice variant of NRP2 becomes sumoylated upon ligand stimulation and translocates to the inner nuclear membrane. This splice variant of NRP2 then stabilizes the complex between AR and nuclear pore proteins to promote CRPC specific gene expression. Both full-length and splice variants of AR have been identified in this specific transcriptional complex. In vitro cell line-based assays indicated that depletion of NRP2 not only destabilizes the AR-nuclear pore protein interaction but also inhibits the transcriptional activities of AR. Using an in vivo bone metastasis model, we showed that the inhibition of NRP2 led to the sensitization of CRPC cells toward established anti-AR therapies such as enzalutamide. Overall, our finding emphasize the importance of combinatorial inhibition of NRP2 and AR as an effective therapeutic strategy against treatment refractory prostate cancer.

Prevention of chemotherapy-induced nausea and vomiting in the real-world setting in Spain

Purpose Proper monitoring and management of chemotherapy-induced nausea and vomiting (CINV) with antiemetics is crucial for cancer patients. This study aimed to evaluate the use of antiemetics for the treatment of highly emetogenic chemotherapy (HEC) including carboplatin in the real-world setting in Spain. Methods A representative panel of cancer specialists was asked to collect information about the antiemetic treatments provided to patients receiving chemotherapy. Records formed part of the Global Oncology Monitor© database (Ipsos Healthcare, London, UK). Chemotherapy data were extrapolated using Ipsos Healthcare’s projection methodology. Results A total of 73 experts were finally included. Data from 9519 patients, estimated to be representative of 202,084 patients, were collected. HEC (and carboplatin-based chemotherapy) was administered to 73,118 (36%) patients, cisplatin-based therapy being the most frequent treatment (n = 34,649, 47.38%). Neurokinin-1 receptor antagonists (NK1RAs) alone or in combination were used as prophylaxis for CINV in 14,762 (20%) patients, while the combination of NK1RA with 5-hydroxytryptamine-3 receptor antagonist (5-HT3RAs) and dexamethasone as recommended by the international guidelines was used in 5849 (8%) patients only. No antiemetic prophylaxis was administered to 8.46% of the patients receiving HEC (n = 6189). Physicians classified cisplatin-, anthracycline-cyclophosphamide (AC-), and carboplatin-based regimens as HEC in 63%, 22% and 4% of the cases, respectively. Conclusions The use of NK1RA-containing regimens for CINV prevention in patients treated with HEC was less than expected, suggesting poor adherence to international antiemetic guidelines (AU)

Prevention of chemotherapy-induced nausea and vomiting in the real-world setting in Spain.

PURPOSE: Proper monitoring and management of chemotherapy-induced nausea and vomiting (CINV) with antiemetics is crucial for cancer patients. This study aimed to evaluate the use of antiemetics for the treatment of highly emetogenic chemotherapy (HEC) including carboplatin in the real-world setting in Spain. METHODS: A representative panel of cancer specialists was asked to collect information about the antiemetic treatments provided to patients receiving chemotherapy. Records formed part of the Global Oncology Monitor© database (Ipsos Healthcare, London, UK). Chemotherapy data were extrapolated using Ipsos Healthcare's projection methodology. RESULTS: A total of 73 experts were finally included. Data from 9519 patients, estimated to be representative of 202,084 patients, were collected. HEC (and carboplatin-based chemotherapy) was administered to 73,118 (36%) patients, cisplatin-based therapy being the most frequent treatment (n = 34,649, 47.38%). Neurokinin-1 receptor antagonists (NK1RAs) alone or in combination were used as prophylaxis for CINV in 14,762 (20%) patients, while the combination of NK1RA with 5-hydroxytryptamine-3 receptor antagonist (5-HT3RAs) and dexamethasone as recommended by the international guidelines was used in 5849 (8%) patients only. No antiemetic prophylaxis was administered to 8.46% of the patients receiving HEC (n = 6189). Physicians classified cisplatin-, anthracycline-cyclophosphamide (AC-), and carboplatin-based regimens as HEC in 63%, 22% and 4% of the cases, respectively. CONCLUSIONS: The use of NK1RA-containing regimens for CINV prevention in patients treated with HEC was less than expected, suggesting poor adherence to international antiemetic guidelines.

SEOM clinical guidelines for anaemia treatment in cancer patients (2020)

Anaemia is defined by the presence of haemoglobin (Hb) levels < 13 g/dL in men and 12 g/dL in women. Up to 39% of cancer patients present it at the time of diagnosis and up to 40% have iron deficiency. Anaemia causes fatigue, functional deterioration and a reduction in the quality of life; it has also been associated with a poorer response to anti-tumour treatment and lower survival. Basic diagnostic tests for anaemia are simple and should be a routine part of clinical practice. These guidelines review the available evidence on the use of different therapies for treating anaemia: erythropoiesis-stimulating agents, iron supplements, and transfusion of blood products (AU)

Evaluation of patient quality care in Spain in prevention of nausea and vomiting induced by chemotherapy.

OBJECTIVE: To characterise current management of chemotherapy-induced nausea and vomiting in Spain, as well as professional adherence to antiemetic guidelines. MATERIALS AND METHODS: Retrospective observational study. A multicenter has been designed including 360 patient case files from 18 hospitals. The involvement of pharmacists and nurses was studied, and also indicators of structure, process, and selected outcomes previously recruited from antiemetic guidelines. RESULTS: We found 94.4% of hospitals used a written protocol for managing chemotherapy-induced nausea and vomiting and only 44.4% had educational programs for patients regarding this. Patients were prescribed antiemetic prophylactic treatment for delayed emesis in varying degree between highly and moderately emetogenic chemotherapy (77.8% and 58.9%, respectively). Dexamethasone was the most prescribed antiemetic drug for patients receiving highly and moderately emetogenic chemotherapy (98.3% and 90%, respectively), followed by ondansetron (68.9% and 95%, respectively). Nursing was more involved than pharmacy units in evaluating emetic risk factors in patients (64.7% vs 21.4%), and tracking symptom onset (88.2% vs 57.1%) and adherence to treatment (94.1% vs 28.6%). Pharmacy units were more involved than nursing in choosing the antiemetic treatment (78.6% vs 47%). CONCLUSIONS: Although antiemetic guidelines were used by all hospitals, there were differences in management of chemotherapy-induced nausea and vomiting. Increased education directed towards patients and oncology professionals is needed to improve adherence.

SEOM clinical guidelines for anaemia treatment in cancer patients (2020).

Anaemia is defined by the presence of haemoglobin (Hb) levels < 13 g/dL in men and 12 g/dL in women. Up to 39% of cancer patients present it at the time of diagnosis and up to 40% have iron deficiency. Anaemia causes fatigue, functional deterioration and a reduction in the quality of life; it has also been associated with a poorer response to anti-tumour treatment and lower survival. Basic diagnostic tests for anaemia are simple and should be a routine part of clinical practice. These guidelines review the available evidence on the use of different therapies for treating anaemia: erythropoiesis-stimulating agents, iron supplements, and transfusion of blood products.

Breakthrough cancer pain: review and calls to action to improve its management.

In this paper, we review the current state of breakthrough cancer pain (BTcP) management. BTcP is a heterogeneous condition and a global problem for cancer patients. It is often managed suboptimally, which results in a negative outcome for patients, healthcare providers, and healthcare systems. Several barriers to the appropriate management of BTcP have been identified. These include, among others, an incomplete definition of BTcP, poor training of healthcare providers and patients alike, a lack of a multidisciplinary approach and the absence of specific protocols and tools. We provide some actions to help physicians and patients improve their approach to BTcP, including specific training, the design of easy-to-use tools for BTcP identification and assessment (such as checklists and pocket-sized cards), individualized treatment, and the use of multidisciplinary teams.

Serological and molecular study of Hepatitis E virus in pediatric patients in Mexico.

INTRODUCTION AND OBJECTIVES: Cases of viral hepatitis reported in Mexico are typically identified as hepatitis A, B and C. However, unspecified cases are reported annually. Hepatitis E virus (HEV) is an emergent agent that causes a self-limiting infection that can evolve to chronic in immunosuppressed individuals. In Mexico, HEV genotype 2 is considered endemic, though it's the prevalence is not well known. Therefore, the present study was designed to determine the prevalence of HEV among patients at the "Hospital Infantil de Mexico Federico Gomez". MATERIALS AND METHODS: The study included 99 patients, anti-HEV antibody (IgG and IgM) were detected by indirect ELISA and viral genome was identified using RT-PCR technique. Two PCR products of positive cases were sequenced. RESULTS: ELISA results were positive in 3% and 6%, for IgG and IgM respectively, 54.5% prevalence was found by PCR. Low lymphocyte count (p<0.05) and malnutrition (p<0.005) were significant factors for high PCR prevalence and could increase the possibility of infection. Two samples were sequenced and confirmed the presence of HEV genotype 3. CONCLUSIONS: This report reveals the incidence of HEV in pediatric patients in Mexico. Moreover, the identification of HEV genotype 3 in human samples suggests a potential zoonotic risk that requires further research.

Predictors of Diabetic Foot Reulceration beneath the Hallux.

AIMS: To evaluate the factors that predict reulceration beneath the hallux in people with a history of diabetic foot ulceration. METHODS: A prospective study conducted between January 2012 and December 2014 was performed in a diabetic foot unit to assess the risk factors associated with hallux reulceration. Sixty patients with diabetic neuropathy and a history of previous ulcer were consecutively included. Sociodemographic factors and comorbidities plus the biomechanical and radiographic factors were obtained. Follow-up on participants was conducted every month, and they wore offloading therapeutic footwear and custom-made insoles. Hallux reulceration during the follow-up period was assessed as the main outcome measure in the study. RESULTS: Patients were followed up during 29 (14.2-64.4) months. Twenty-nine patients (52%) developed a new ulceration: 9 patients (31%) in the hallux and 20 (69%) in other locations. Functional hallux limitus (p = 0.005, 95% CI (2.097-73.128), HR 12.384) and increased body mass index (p = 0.044, 95% CI (1.003-1.272), HR 1.129) were associated with the hallux ulceration-free survival time in the multivariate Cox model. CONCLUSIONS: Obesity and the presence of functional hallux limitus increase the probability of developing hallux reulceration in patients with diabetic neuropathy and a history of ulcers.

Study of macro and microelements in fish from the Cienfuegos Bay. Relationship with its content in sediments.

Thirteen microelements (Al, As, Cd, Co, Cr, Cu, Fe, Li, Mn, Ni, Ti, V, and Zn) and four macroelements (Ca, K, Mg, and Na) were determined in the edible muscle tissue of fish in Cienfuegos Bay. Eight species, Albula vulpes, Diapterus rhombeus, Gerres cinereus, Haemulon carbonarium, Haemulon sciurus, Micropogonias furnieri, Kyphosus sectatrix, and Lutjanus cyanopterus were studied. The total concentrations and extracted concentrations using HCl were also determined in sediments. The quality of the analysis was guaranteed by validating the used analytical methods with certified reference materials of fish and sediments. The high content of macroelements confirmed the importance of fish as a valuable source of food for the local population. New information is provided on bioaccumulation of toxic elements As, Cd, Cu, Zn, and Cr in fish of the bay, with concentrations that overcame the local or international maximum allowable levels for human consumption in most samples analyzed. A high correlation between the content of toxic elements As, Cd, Zn, and macroelement K in fish and its concentration extracted from sediments using the HCl extraction method was observed.

Accreditation and certification of hospital quality: different or similar? / Acreditación y certificación de calidad hospitalaria ¿diferentes o similares? / Acreditação e certificação da qualidade hospitalar ¿diferentes ou similares?

The external evaluation and management of hospital quality are two intimately related aspects of the same phenomenon: the need to improve the quality of health services and provide confidence of this quality to all stakeholders. The objective of this study is to analyze the hospital accreditation programs and ISO 9001 quality management and certification schemes of health institutions, as well as to identify the benefits of each of them, their similarities and differences. Hospital accreditations and ISO 9001 certifications are important instruments to improve the health service quality and to give confidence to the society about the health care provider. Both guide management strategies to improve service quality and patient safety. They differ in some aspects: accreditation is based on the best practices of the quality of the medical assistance and have a more technical character. The ISO 9001 standard is more process oriented and constitutes a suitable framework for incorporating the requirements of hospital accreditation programs and existing international methodologies for risk management in health institutions.

La evaluación externa y la gestión de la calidad hospitalaria son dos aspectos íntimamente relacionados del mismo fenómeno: la necesidad de mejorar la calidad de los servicios de salud y brindar confianza de esta calidad a todas las partes interesadas. El objetivo de este estudio es analizar los programas de acreditación hospitalaria y los sistemas de gestión y certificación de calidad ISO 9001 de las instituciones sanitarias, así como identificar los beneficios de cada uno de ellos, sus similitudes y diferencias. Las acreditaciones hospitalarias y las certificaciones ISO 9001 son instrumentos importantes para mejorar la calidad del servicio de salud y para dar confianza a la sociedad sobre el proveedor de atención médica. Ambos guían las estrategias de gestión para mejorar la calidad del servicio y la seguridad del paciente. Difieren en algunos aspectos: la acreditación se basa en las mejores prácticas de la calidad de la asistencia médica y tiene un carácter más técnico. La norma ISO 9001 está más orientada al proceso y constituye un marco adecuado para incorporar los requisitos de los programas de acreditación hospitalaria y las metodologías internacionales existentes para la gestión del riesgo en las instituciones de salud.

A avaliação externa e a gestão da qualidade hospitalar são dois aspectos intimamente relacionados do mesmo fenómeno: a necessidade de melhorar a qualidade dos serviços de saúde e brindar confiança desta qualidade a todas as partes interessadas. O objetivo deste estudo é analisar os programas de acreditação hospitalar e os sistemas de gestão e certificação de qualidade ISO 9001 das instituições sanitárias, bem como identificar os benefícios da cada um deles, seus similitudes e diferenças. As acreditações hospitalares e as certificações ISO 9001 são instrumentos importantes para melhorar a qualidade do serviço de saúde e para dar confiança à sociedade sobre o provedor de atenção médica. Ambos guiam as estratégias de gestão para melhorar a qualidade do serviço e a segurança do paciente. Diferem em alguns aspectos: a acreditação baseia-se nas melhores práticas da qualidade da assistência médica e tem um carácter mais técnico. A norma ISO 9001 está mais orientada ao processo e constitui um marco adequado para incorporar os requisitos dos programas de acreditação hospitalar e as metodologias internacionais existentes para a gestão do risco nas instituições de saúde.

Despistaje de infecciones de transmisión vertical durante el embarazo: Toxoplasmosis, VIH, Hepatitis B y C, Sífilis / Screening vertical transmission of infections during pregnancy: Toxoplasmosis, HIV, Hepatitis B and C, Syphilis

El despistaje de infecciones mediante pruebas de laboratorio permite disminuir el riesgo de morbimortalidad perinatales y maternas. El objetivo del estudio fue identificar la presencia de infecciones de transmisión vertical: toxoplasmosis, VIH, sífilis, Hepatitis B y C, durante el periodo noviembre 2013 a mayo 2014. Estudio descriptivo, muestra conformada por 175 embarazadas entre 14 a 43 años, a las cuales se les descarto Toxoplasmosis, Anticuerpos Reagínicos por VDRL cualitativa, VIH, hepatitis B (Anti-HBsAg, HBsAg, anti-Core); hepatitis C (Anticuerpos totales), a través de ultramicroELISA (UMELISA). Los resultados arrojaron Anticuerpos Anti Toxoplasma gondii positivas en 27,4%, donde el 31,2% de estas embarazadas presentaron títulos de anticuerpos de 1/512. Los Anticuerpos Anti-VIH resultaron positivos en 0,6%. El 99,4% mostraron un VDRL No Reactivo. El 38,9% tuvo un resultado positivo para anticuerpos contra el antígeno de superficie de la hepatitis B, los marcadores HBsAg y Anti-Core resultaron negativos en un 100%; el 1,7% fue positivo para anticuerpos totales contra el virus de la Hepatitis C. Se concluye que el despistaje de enfermedades infecciosas que representan factores de riesgo de transmisión vertical en embarazadas, constituye uno de los medios más oportuno para diagnosticar estas patologías y prevenir la morbimortalidad materna e infantil.

The screening for infection diseases in pregnancy by laboratory tests can reduce the risk of perinatal and maternal morbidity and mortality. The objective of this study was to identify the presence of vertically transmitted infections: toxoplasmosis, HIV, syphilis, hepatitis B and C, for the period November 2013 to May 2014. Descriptive study, the sample consisted of 175 pregnant women between 14 to 43 years, women who were discarded for Toxoplasmosis, Reaginic Antibodies by qualitative VDRL, HIV, hepatitis B (Anti-HBsAg Anti-HBsAg, anti-Core); hepatitis C (Total antibodies), through ultramicroELISA (UMELISA). The results showed 27.4% positive for Anti- Toxoplasma gondii antibodies, with 31.2% of these pregnant women having antibody titers of 1/512. Anti-HIV antibodies were positive by 0.6%. 99.4% showed Nonreactive VDRL. 38.9% were positive for antibodies against the hepatitis B surface antigen, the markers HBsAg and anti-Core were negative by 100%; 1.7% were positive for total antibodies against Hepatitis C. It is concluded that the screening of infectious diseases that represent risk factors for vertically transmission infections during pregnancy, is one of the most appropriate tools to diagnose these diseases and prevent maternal and infant morbidity and mortality.

Mouse Embryo Compaction.

Compaction is a critical first morphological event in the preimplantation development of the mammalian embryo. Characterized by the transformation of the embryo from a loose cluster of spherical cells into a tightly packed mass, compaction is a key step in the establishment of the first tissue-like structures of the embryo. Although early investigation of the mechanisms driving compaction implicated changes in cell-cell adhesion, recent work has identified essential roles for cortical tension and a compaction-specific class of filopodia. During the transition from 8 to 16 cells, as the embryo is compacting, it must also make fundamental decisions regarding cell position, polarity, and fate. Understanding how these and other processes are integrated with compaction requires further investigation. Emerging imaging-based techniques that enable quantitative analysis from the level of cell-cell interactions down to the level of individual regulatory molecules will provide a greater understanding of how compaction shapes the early mammalian embryo.

Forefoot ulcer risk is associated with foot type in patients with diabetes and neuropathy.

AIMS: To stratify the ulceration risk according to the foot morphology in people with diabetes and a history of forefoot neuropathic ulceration. METHODS: A cross-sectional study was performed on 139 neuropathic individuals with diabetes and previous forefoot ulcers between January 2012 and February 2014. Foot position of the participants was evaluated by using the foot-posture index. A multivariate analysis adjusted for confounding variables was performed with the ulceration risk factors that were found in the univariate analysis. RESULTS: Two hundred and fifty-eight feet were analysed, 104 (40.3%) feet had a history of ulceration on the forefoot and 154 (59.7%) feet had no previous ulceration. Two positive tests of neuropathy (p<0.001; CI[1.961-6.249] OR 3.500), presence of deformities (p=0.043; CI[1.020-3.599] OR 1.916) and foot type (p=0.039) showed an association with ulceration risk in multivariate analyses. Pronated feet showed a higher risk of ulceration than supinated feet (p=0.011; CI[1.253-5.708] OR 2.675), while significant differences between neutral and supinated feet were not found (p=0.221; CI[0.719-2.753] OR 1.476). CONCLUSIONS: A pronated foot has a higher risk of ulceration on the forefoot in neuropathic people with deformities and diabetes mellitus. Foot type should be evaluated in people at risk of ulceration.

Seasonal changes in prescribing of long-acting beta-2-agonists-containing drugs.

BACKGROUND: For patients with asthma, COPD, or asthma-COPD overlap syndrome (ACOS), inter-country comparisons of seasonal changes in drug prescriptions are scarce or missing. Hence, we aimed to compare seasonal changes in prescription rates of long-acting beta-2-agonist (LABA) in four European countries. METHODS: A common study protocol was applied to six health care databases (Germany, Spain, the Netherlands (2), and the UK (2)) to calculate age- and sex-standardized point prevalence rates (PPRs) of LABA-containing prescriptions by the 1st of March, June, September, and December of each year during the study period 2002-2009. Seasonal variation of PPRs was quantified using seasonal indexes (SIs; based on the ratio-to-moving-average-method) and SIs averaged over the study period (aSI) stratified by sex, age, and indication (asthma, COPD, or ACOS). RESULTS: There was a moderate seasonal change in LABA-containing prescriptions which was more pronounced in asthma or COPD patients compared to ACOS patients. For asthma and ACOS patients, highest seasonal variation was found for patients living in Spain (aSI: 87.3-110.7, aSI: 93.2-103.1) whereas for COPD highest seasonal variation was revealed for the NPCRD database (the Netherlands) (aSI: 92.2-105.6). Regarding age and sex, highest seasonal variation was found in Spanish boys under 10 years of age having a diagnosis of asthma. CONCLUSIONS: By applying a common analysis in six databases, we could observe moderate overall seasonal changes in LABA-containing prescription rates in patients with asthma, COPD, or ACOS.