The development of anemia is associated to poor prognosis in NKF/KDOQI stage 3 chronic kidney disease

BACKGROUND: Anemia is a common condition in CKD that has been identified as a cardiovascular (CV) risk factor in end-stage renal disease, constituting a predictor of low survival. The aim of this study was to define the onset of anemia of renal origin and its association with the evolution of kidney disease and clinical outcomes in stage 3 CKD (CKD-3). METHODS: This epidemiological, prospective, multicenter, 3-year study included 439 CKD-3 patients. The origin of nephropathy and comorbidity (Charlson score: 3.2) were recorded. The clinical characteristics of patients that developed anemia according to EBPG guidelines were compared with those that did not, followed by multivariate logistic regression, Kaplan-Meier curves and ROC curves to investigate factors associated with the development of renal anemia. RESULTS: During the 36-month follow-up period, 50% reached CKD-4 or 5, and approximately 35% were diagnosed with anemia (85% of renal origin). The probability of developing renal anemia was 0.12, 0.20 and 0.25 at 1, 2 and 3 years, respectively. Patients that developed anemia were mainly men (72% anemic vs. 69% non-anemic). The mean age was 68 vs. 65.5 years and baseline proteinuria was 0.94 vs. 0.62 g/24h (anemic vs. non anemic, respectively). Baseline MDRD values were 36 vs. 40 mL/min and albumin 4.1 vs. 4.3 g/dL; reduction in MDRD was greater in those that developed anemia (6.8 vs. 1.6 mL/min/1.73 m2/3 years). These patients progressed earlier to CKD-4 or 5 (18 vs. 28 months), with a higher proportion of hospitalizations (31 vs. 16%), major CV events (16 vs. 7%), and higher mortality (10 vs. 6.6%) than those without anemia. Multivariate logistic regression indicated a significant association between baseline hemoglobin (OR=0.35; 95% CI: 0.24-0.28), glomerular filtration rate (OR=0.96; 95% CI: 0.93-0.99), female (OR=0.19; 95% CI: 0.10-0.40) and the development of renal anemia. CONCLUSIONS: Renal anemia is associated with a more rapid evolution to CKD-4, and a higher risk of CV events and hospitalization in non-dialysis-dependent CKD patients. This suggests that special attention should be paid to anemic CKD-3 patients.

El implante de condrocitos autólogos en la red sanitaria pública de Andalucía. Resultados tras 6 años de circuito asistencial.

Objective: To asses the results of Autologous Chondrocyte Implantation (ACI) whith periosteal patch and To propagate the care circuits existing about in Andalusia. Material and Methods: From its of ficial licence in 2005, the tissue bank and the Virgen de la Victoria Hospital from Málaga, performed the ACI in the Andalusian public health system. 16 patients has been operated between 2006-2013, whith medium follow-up 47,6 months (6 months-6 years), from public hos- pitals throughout Andalucia, managed by hospital admission source and destination. Physiologically younger patients were selected (<50 años), with singles, > 2cm2 symptomatics chondral lesions, in stables and well aligned knees. ACI was used as res- cue procedure after microfracture ́s failure except osteochondritis dissecans. To assess the results the Concinnati score and the Short Form 36 (SF-36) score were used. A descriptive analysis was performed and non-parametric tests were used to establish correlations and compare results. Results: In 15 patients with more than one year of follow-up: 14 men(87.5%) and 2women (14.5%), medium age 28.2 years old (min 17 max 43), the lesion was located into de femoral condyle, mostly in the internal one (81,2%) with medium size 2,7cm2(2-4,2). We founded significant improvement (p<0,001), both daily activities ( 89,3% preop. limitatión - 9% postop), as in the sports (90,2% preop limitatión - 38% postop) and the exploration of the knee (67,7% hpatological findings preop- 13,3%postop). The SF-36 score improved in all categories, over all in mental health (p> 0,01). The patient satisfaction was high or very high in 12 of the 15 patients ( 80%), and low in 3 patients. Conclusions: ACI improve quality of life and knee function in femoral condyle chondral lesions. The case ́s selection and the collaboration with Tissue Bank, allows us to create care circuits for treatment of patients from other provinces in the Public Sanitary Health System in Andalucia. It is necessary to increase the experience with this type of therapy, consolidating multicenter workgroups that provide strength to the conclusions.

Genetic compatibility affects division of labor in the argentine ant linepithema humile.

Division of labor is central to the organization of insect societies. Within-colony comparisons between subfamilies of workers (patrilines or matrilines) revealed genetic effects on division of labor in many social insect species. Although this has been taken as evidence for additive genetic effects on division of labor, it has never been experimentally tested. To determine the relative roles of additive and nonadditive genetic effects (e.g., genetic compatibility, epistasis, and parent-of-origin imprinting effects) on worker behavior, we performed controlled crosses using the Argentine ant Linepithema humile. Three of the measured behaviors (the efficiency to collect pupae, the foraging propensity, and the distance between non-brood-tenders and brood) were affected by the maternal genetic background and the two others (the efficiency to feed larvae and the distance between brood-tenders and brood) by the paternal genetic background. Moreover, there were significant interactions between the maternal and paternal genetic backgrounds for three of the five behaviors. These results are most consistent with parent-of-origin and genetic compatibility effects on division of labor. The finding of nonadditive genetic effects is in strong contrast with the current view and has important consequences for our understanding of division of labor in insect societies.

Inferences about the global scenario of human T-cell lymphotropic virus type 1 infection using data mining of viral sequences

Human T-cell lymphotropic virus type 1 (HTLV-1) is mainly associated with two diseases: tropical spastic paraparesis/HTLV-1-associated myelopathy (TSP/HAM) and adult T-cell leukaemia/lymphoma. This retrovirus infects five-10 million individuals throughout the world. Previously, we developed a database that annotates sequence data from GenBank and the present study aimed to describe the clinical, molecular and epidemiological scenarios of HTLV-1 infection through the stored sequences in this database. A total of 2,545 registered complete and partial sequences of HTLV-1 were collected and 1,967 (77.3%) of those sequences represented unique isolates. Among these isolates, 93% contained geographic origin information and only 39% were related to any clinical status. A total of 1,091 sequences contained information about the geographic origin and viral subtype and 93% of these sequences were identified as subtype “a”. Ethnicity data are very scarce. Regarding clinical status data, 29% of the sequences were generated from TSP/HAM and 67.8% from healthy carrier individuals. Although the data mining enabled some inferences about specific aspects of HTLV-1 infection to be made, due to the relative scarcity of data of available sequences, it was not possible to delineate a global scenario of HTLV-1 infection.

Características de la familia de origen y de la familia formada por las médicas y los médicos de familia de Andalucía.

BACKGROUND The origin and formed family characteristics are related to physician's professional career. The purpose of this study was to know and compare by sex the characteristics of the origin family and formed family of women and men family physician in Andalusia. METHODS Cross sectional and multicenter study. SETTING Urban primary health care centres from Andalusian province capitals. PARTICIPANTS Physician of primary health care centres. INCLUSION CRITERIA at least one year using computerized medical history with the same quota patients. Multistage random sample, 88 primary health care centres and 500 physicians, 50% of both sexes (alpha=5%, power=90%, precision=15%). Postal auto administrated questionnaire. VARIABLES sex, age, tutor of resident in family medicine, last father's activity, last mother's activity, number of brothers or sisters, family situation, last couple's activity (if any), to have or not children. RESULTS 73.6 % responses. In no responses there weren't differences of sex neither tutor of resident in family medicine. Mean age: women physicians 49.5 +/- 4.3 and men physician 51.3 +/- 4.9 (p= or < 0.005). Postgraduate formation in family medicine: 42.2% of women and 33.3% of men (p=0.016). Live alone: 6.1% of women physician and 2.7% men physician (p=0.005). Live alone with children 9.9% of women and 2.2% of men (p=0.005). 16.5% of women and 10.2% of men don t have children (p=0.077). 21.1% of men physician s couples work only at home vs. 0.1% of women physician s couples (p= or < 0.005). 46% of women physician s couples is also physician vs. 22% of men physician s couples (p= or < 0.005). No significant differences registered in parent s activities neither in the number of brother or sisters. CONCLUSION There are no significant differences in physician s origin family. However important differences in the characteristics of formed family are observed in both sexes.

Contribution of recombination to the evolutionary history of HIV.

PURPOSE OF REVIEW: An improved understanding of how recombination affects the evolutionary history of HIV is crucial to understand its current and future evolution. The present review aims to disentangle the manifold effects of recombination on HIV by discussing its effects on the evolutionary history and the adaptive potential of HIV in the context of concepts from evolutionary genetics and genomics. RECENT FINDINGS: The increasing occurrence of secondary contacts between divergent subtype populations (during coinfection) results in increased observations of recombinants worldwide. Recombination is heterogeneous along the HIV genome. Consequences of recombination of HIV evolution are, in combination with other demographic processes, expected to either homogenize the genetic composition of HIV populations (homogenization) or provide the potential for novel adaptations (diversification). New methods in population genomics allow deep characterization of recombinant genome (the segment composition and origin) and their evolutionary trajectories. SUMMARY: HIV recombinants increase worldwide and invade geographical regions where pure subtypes were previously predominant. This trend is expected to continue in the future, as ease to travel worldwide increases opportunities for recombination between divergent HIV strains. While the effects of recombination in HIV are much researched, more effort is required to characterize current HIV recombinant composition and dynamics. This can be achieved with new population genetic and genomic methods.

Instrumentos de gestión para el Depósito digital de la UAB

El Servei de Biblioteques de la UAB gestiona un dipòsit digital que cobreix les expectatives generades per un dipòsit institucional a la vegada que actua facilitant la consulta de la biblioteca digital pròpia. La naturalesa diversa de les col·leccions, quant a origen i format ens ha obligat a utilitzar eines de gestió específiques per establir els circuits, mètodes i procediments de treball. Volem compartir la nostra experiència, tant a nivell de creació d'un únic dipòsit capaç de gestionar tot el nostre fons digital, com de les opcions de treball intern escollides.

L' atur de llarga durada de les dones majors de 45 anys a Catalunya: una anàlisi exploratòria tenint en compte la classe social i la divisió sexual del treball

This article provides an in-depth study of long-term female unemployment in Catalonia.Long-term unemployment statistics reveal which social groups are most likely to experience difficulty re-entering the labour market. In this case, we found that women are mainly affected by this type of labour exclusion, in particular poorly qualified, working-class women who are aged over 45 and with family responsibilities.The article aims to explore how the overlapping of factors such as gender, age, social class, origin and the division of work based on gender are related to long-term female unemployment. Moreover, we were able to detect which conceptual tools provide us with the production/reproduction paradigm so as to be able to analyse the future of female unemployment. The methodology we used combines quantitative and qualitative approaches. On the one hand, the analysis of secondary statistical data focusing on Catalonia is useful in understanding the situation from a macro-social perspective. On the other hand, an exploratory discussion group enables us to investigate social imaginary practises among unemployed working class women aged over 45. This discussion group was held in Igualada -capital of the Anoia region - an area of Catalonia deeply affected by unemployment in the current economic crisis.

Sobre la identitat dels Matiners a les comarques del N.E. de Catalunya

This study attempts to throw some light on the identity of the Matiners of the regions of north-eastern Catalonia by analizing a notebook which was a register of rebels. This notebook gives the age, geographical origin and profession of the rebels. The War of the matiners (1846-49) was a Catalan rebellion framed within the context of popular opposition to the regime of the moderates, and in the midst of a general crisis. Themen who formed the groups of ((trabucaires)) were particulary young (the problemof recriting must not be forgotten), and came from the country, the crafts, and industry, and were militarized above all in the interior regions

lmplementació i avaluació d'un programa dirigit a I'alfabetització de les mares amb infants estrangers en la seva llengua i en català

Teixint Cultures és un projecte de recerca-acció comunitari que intenta promoure des de I'educació d'adults, I'aprenentatge de la llengua catalana a partir dels recursos Iingüístics que les mares d'origen africà tenen en la seva llengua familiar. El programa atén a mares d'origen immigrat amb fills menors de tres anys no escolaritzats al seu càrrec (la majoria de les quals té altres fills en edat escolar que assisteixen a la tarda a la biblioteca per fer els deures escolars). Tot el projecte esta vehiculat a partir dels contes infantils. De fet, intenta recuperar els contes de tradició oral provinents del continent africà per posteriorment elaborar materials educatius bilingües (en català i en les seves llengües) que es puguin utilitzar com a llibres educatius de consulta, tant per les biblioteques públiques com pels centres educatius. El programa es realitza de forma setmanal, al llarg de dues hores, a la biblioteca pública infantil d'en Massagran de Salt. Les mares expliquen contes i llegendes rellevants de la seva infància en la seva llengua i, a partir de diferents activitats de narració, traducció i dramatització de les històries basades en una metodologia de a dual-language D, elaboren textos escrits i narracions orals en català i en la seva llengua. Posteriorment són les mateixes participants les que editen els contes a I'ordinador i elaboren digitalment un llibre de contes bilingüe. Les sessions s'han registrat en àudio i vídeo i hem estudiat el procés d'implementació del programa i les estratègies multilingües utilitzades per les participants, els educadors i voluntaris. Els resultats evidencien el progrés de les dones en I'aprenentatge del català, la modificació de les seves actituds lingüístiques i de la seva autoimatge, així com I ‘impacte positiu del programa a la comunitat pel que fa al reconeixement dels recursos lingüístics i culturals de les minories ètniques.

Origen i diversificació de les comunitats de rèptils dels deserts del Nord d’Àfrica i Aràbia: els paràsits com a eines filogenètiques

Els deserts constitueixen aproximadament un terç de la superfície terrestre i estan caracteritzats per la seva aridesa extrema. Els Sàhara, la zona àrida més gran del Nord d’Àfrica és, amb diferencia, el desert més gran del mon. Ocupa una extensió de més de 9 milions de kilòmetres quadrats, expandint-se 5500 km a través del nord d’Àfrica, des de l’oceà Atlàntic fins el mar Roig. El desert d’Aràbia es troba a l’est del Sàhara i és aproximadament una octava part més petit. Tot i el seu clima tan extrem, les flores i faunes dels deserts acostumen a ser relativament riques, el que fa que ens preguntem com aquestes biotes han estat adquirides i com es mantenen. En aquest projecte utilitzem els rèptils com a model d’estudi, un dels habitants més comuns dels deserts. El propòsit d’aquest projecte era utilitzar filogènies moleculars de diversos taxons de rèptils dels deserts del nord d’Àfrica i Aràbia per respondre Quan i Com els deserts han adquirit la seva fauna de rèptils endèmica (origen i diversificació), i de quina manera aquestes faunes s’han mantingut fins ara (adaptació). Però més enllà de les dades morfològiques i les eines de filogènia molecular, els paràsits representen una alternativa excitant i innovadora dins del camp de la biologia evolutiva. En aquest sentit, aquest projecte de beca proposava anar més lluny i utilitzar els paràsits com a eina (biological tags) per millor entendre l’historia evolutiva dels seus hostes en base a una aproximació biogeogràfica i co-evolutiva. Els objectius durant aquest primer any de projecte han sigut: 1) Estudiar l’origen i diversificació de la fauna de rèptils endèmica dels deserts del Sàhara i Aràbia, 2) caracteritzar la comunitat d’ecto- haemoparàsits de les espècies d’estudi, 3) posar a punt un estudi comparatiu de la filogeografia i estructuració genètica d’hostes i paràsits.

DIC.CAT. Dona, immigració i ciutadania: les dones marrquines com a generadores de ciutadania a Catalunya

DIC.CAT es centra en les contribucions a la ciutadania que realitzen les dones immigrants marroquines, sobre les quals recauen forts estereotips i imatges que, sovint, les vinculen a la passivitat i a la submissió. Partint d'aquest fet, el projecte analitza el paper d'aquetes dones com a generadores de noves formes de ciutadania a Catalunya, a partir de les seves accions en les esferes pública i privada. El projecte contribueix, d'una banda a ampliar el coneixement teòric sobre la noció de ciutadania, incorporant la dimensió del gènere i partint de la realitat multicultural actual; i de l'altra a aprofundir sobre el rol que estan exercint les doens marroquines estudiades, com agents actius de xsocialització i generadores de canvis en els formes d'exercir la ciutadania en la societat catalana. Destaquen les accions que desenvolupen des de la seva quotidianitat en relació a aspectes com el procés de reagrupació, la incorporació al mercat laboral, la transmissio de valores dins la familia, la relació amb la comunitat d'origen, les motivacions, aspiracions o els projectes professionals i personals propis. Alhora, el projecte vincula aquestes accions amb les que desenvolupen des dels espais públics en els que participen, especialment dins l'àmbit associatiu.

Infarctus cérébraux artériels d'origine hématologique : expérience lausannoise et revue de la littérature

RÉSUMÉ Introduction. Les hémopathies représentent une cause rare d'accident vasculaire cérébral (AVC), faisant l'objet de peu de publications, mais sont très fréquemment recherchées après un AVC par de coûteux bilans dont la rentabilité reste à définir. Matériel et Méthodes. Dans le registre lausannois des AVC, nous nous sommes intéressés de façon rétrospective aux dossiers des patients hospitalisés entre 1979 et 2001 pour un premier AVC ischémique artériel, dont la cause a été attribuée à une pathologie hématologique. Sur 4 697 patients, 22 (0,47 p. 100) ont vu leur AVC imputé à l'une des causes hématologiques suivantes : maladie de Vaquez , polyglobulie secondaire , thrombocytémie essentielle , thrombocytose secondaire , myélome multiple , MD , déficit en protéine S , syndrome anticorps antiphospholipides , hyperhomocystéinémie . Chaque hémopathie retrouvée a donné lieu à une revue de la littérature. Conclusion. À la lumière de ces données, nous concluons qu'une formule sanguine représente un bilan hématologique de dépistage suffisant pour l'immense majorité des patients hospitalisés pour un premier AVC artériel ischémique. Les recherches d'anticorps antiphospholipides, de thrombophilies héréditaires et d'hyperhomocystéinémie peuvent être limitées à des cas sélectionnés. SUMMARY Cerebral infarction of arterial origin and haematological causation: the Lausanne experience and a review of the literature. Introduction. Hematological diseases are seldom found as the etiology of ischemic strokes, but are frequently investigated by expensive laboratory tests after a first cerebral vascular event. Methods. In the Lausanne Stroke Registry, we retrospectively reviewed the cases of patients hospitalized between 1979 and 2001 for a first ischemic arterial stroke which was attributed to a hematological etiology. Of 4697 patients, 22 (0.47 per cent) had a stroke due to one of the following hematological pathology: polycythemia vera, secondary polycythemia, essential thrombocytemia, secondary thrombocytosis, multiple myeloma, CIVD, protein S deficiency, antiphospholipid antibody syndrome, moderate homocysteinemia. A literature review was undertaken for each hemopathy. Conclusion. In light of the results of these data, we concluded that a complete blood count provides sufficient hematological screening for the majority of patients hospitalized for an arterial stroke. The antiphospholipid antibody syndrome is a rare cause of cerebral infarction, which needs to be investigated in young patients, in cases of multiple or recurring stroke or in the presence of a typical history. Inherited thrombophilias are not a significant risk factor for arterial cerebral infarction and their investigation is only warranted for a sub-group of young patients with a cryptogenic stroke, in which group the prevalence is slightly increased. Moderate homocysteinemia must be considered as a cerebrovascular risk factor of minor importance, but potentially treatable by a substitution of vitamin B12, B 6 and folates. The efficacy of this substitution in the prevention of cardiovascular events needs yet to be demonstrated.

Itinéraires de formation et lignes biographiques

This paper proposes an analysis of training courses and their connection to other biographical lines, by highlighting their evolution according to social origin and gender. The variable of having received a diploma does not fully explain the longitudinal characteristics of the courses: the social inequalities prove to be also inequalities from the point of view of the followed itinerary. The range of available trajectories as well as the possibility of deviating in order to fulfil a custom trajectory depends on the social characteristics. The training course is connected to other biographical lines, in particular the family and the profession.

Disability Rights Guide for Iowans, August 2004

Individuals with disabilities have civil rights protection similar to that provided to individuals on the basis of race, sex, national origin, and religion. The advent of the Americans with Disabilities Act has improved these protections and brought this issue into the forefront. This book is not intended to be a legal translation of state or federal laws. Its purpose is to assist people with disabilities in understanding their rights. Please consult the Code of Iowa, the appropriate federal laws or an attorney if you need a legal interpretation.