Safety of Low-Dose Oral Minoxidil in Patients With Hypertension and Arrhythmia: A Multicenter Study of 264 Patients.

BACKGROUND AND OBJECTIVE: Systemic adverse effects (AE) are a major concern of low-dose oral minoxidil (LDOM) treatment, especially in patients with arterial hypertension or arrhythmia. The objective of this study was to evaluate the safety of LDOM in patients with hypertension or arrhythmia. PATIENTS AND METHODS: Retrospective multicenter study of patients with hypertension or arrhythmia treated with LDOM for any type of alopecia. RESULTS: A total of 254 patients with hypertension [176 women (69.3%) and 78 men (30.7%)] with a mean age of 56.9 years (range 19-82) were included. From them, the dose of LDOM was titrated in 128 patients, allowing the analysis of 382 doses. Patients were receiving a mean of 1.45 (range 0-5) antihypertensive drugs. Systemic AE were detected in 26 cases (6.8%) and included lightheadedness (3.1%), fluid retention (2.6%), general malaise (0.8%), tachycardia (0.8%) and headache (0.5%), leading to LDOM discontinuation in 6 cases (1.5%). Prior treatment with doxazosin (P<0.001), or with three or more antihypertensive drugs (P=0.012) was associated with a higher risk of discontinuation of LDOM. CONCLUSIONS: LDOM treatment showed a favorable safety profile in patients with hypertension or arrhythmia, similar to general population.

Safety of Low-Dose Oral Minoxidil in Patients With Hypertension and Arrhythmia: A Multicenter Study of 264 Patients. / [Artíulo traducido] Seguridad de minoxidil oral a dosis bajas en pacientes con hipertensión o arritmias: estudio multicéntrico de 264 pacientes.

BACKGROUND AND OBJECTIVE: Systemic adverse effects (AE) are a major concern of low-dose oral minoxidil (LDOM) treatment, especially in patients with arterial hypertension or arrhythmia. The objective of this study was to evaluate the safety of LDOM in patients with hypertension or arrhythmia. PATIENTS AND METHODS: Retrospective multicenter study of patients with hypertension or arrhythmia treated with LDOM for any type of alopecia. RESULTS: A total of 254 patients with hypertension [176 women (69.3%) and 78 men (30.7%)] with a mean age of 56.9 years (range 19-82) were included. From them, the dose of LDOM was titrated in 128 patients, allowing the analysis of 382 doses. Patients were receiving a mean of 1.45 (range 0-5) antihypertensive drugs. Systemic AE were detected in 26 cases (6.8%) and included lightheadedness (3.1%), fluid retention (2.6%), general malaise (0.8%), tachycardia (0.8%) and headache (0.5%), leading to LDOM discontinuation in 6 cases (1.5%). Prior treatment with doxazosin (P<0.001), or with three or more antihypertensive drugs (P=0.012) was associated with a higher risk of discontinuation of LDOM. CONCLUSIONS: LDOM treatment showed a favorable safety profile in patients with hypertension or arrhythmia, similar to general population.

Spanish Version of Teenagers’ Quality of Life (T-QoL) for Adolescents with Skin Diseases: Translation, Cultural Adaptation and Validation / Adaptación cultural y validación de la versión española del Teenagers’ Quality of Life (T-QoL): cuestionario para adolescentes con enfermedades de la piel

Background Teenagers’ Quality of Life (T-QoL) is an age-specific measure to assess QoL of teenagers suffering from different skin diseases. A validated Spanish language version is lacking. We present the translation, cultural adaptation and validation of the T-QoL into Spanish. Methods A prospective study with 133 patients (between 12 and 19 years old), attended at the dermatology department of Toledo University Hospital, Spain (September 2019–May 2020), was carried out for the validation study. The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines were used for the translation and cultural adaptation. We evaluated the convergent validity with the Dermatology Life Quality Index (DLQI), the Children's Dermatology Life Quality Index (CDLQI) and with a Global Question (GQ) on self-assessed disease severity. We also analysed internal consistency and reliability of the T-QoL tool and confirmed its structure with a factor analysis. Results Global T-QoL scores significantly correlated with the DLQI and the CDLQI (r=0.75) and with the GQ (r=0.63). The confirmatory factor analysis showed optimal fit for the bi-factor model and an adequate fit for the correlated three-factor model. Reliability indicators were high (Cronbach's α=0.89; Guttman's Lambda 6 index=0.91; Omega ω=0.91) and test–retest showed a high stability (ICC=0.85). The results were consistent with those found by the authors of the original test. Conclusion Our Spanish version of the T-QoL tool is valid and reliable to assess QoL of Spanish-speaking adolescents with skin diseases (AU)

Antecedentes Teenagers’ Quality of Life (T-QoL) es un cuestionario de calidad de vida específico para adolescentes con enfermedades cutáneas. Hasta el momento, no existe ningún método validado para este fin en español, por lo que presentamos la traducción, adaptación cultural y validación del T-QoL al español. Método Se diseñó un estudio prospectivo con 133 pacientes (entre 12-19 años), atendidos en el Servicio de Dermatología del Hospital Universitario de Toledo, España (septiembre 2019-mayo 2020). Para la traducción y adaptación cultural se utilizaron las guías de la Sociedad Internacional de Farmacoeconomía e Investigación de Resultados (ISPOR). Se evaluó la validez convergente con el Índice de Calidad de Vida en Dermatología (DLQI), el Índice de Calidad de Vida en Dermatología Infantil (CDLQI) y con una Pregunta Global (GQ) sobre la gravedad de la enfermedad autoevaluada. También se analizó la consistencia interna y la fiabilidad de la herramienta T-QoL, y se confirmó su estructura con un análisis factorial. Resultados Las puntuaciones globales de T-QoL se correlacionaron significativamente con el DLQI y el CDLQI (r=0,75) y con la GQ (r=0,63). El análisis factorial mostró un ajuste óptimo para el modelo bifactorial y un ajuste adecuado para el modelo de 3 factores correlacionado. Los indicadores de fiabilidad fueron altos (α de Cronbach=0,89; índice Lambda 6 de Guttman=0,91; Omega ω=0,91) y el test-retest mostró una alta estabilidad (ICC=0,85). Los resultados fueron consistentes con los encontrados por los autores de la prueba original. Conclusiones La versión española del T-QoL es un cuestionario válido y fiable para evaluar la calidad de vida de adolescentes hispanohablantes con enfermedades cutáneas (AU)

[Artículo Traducido] Traducción, adaptación cultural y validación de la versión española del Teenagers’ Quality of Life (T-QoL): cuestionario para adolescentes con enfermedades de la piel / Spanish Version of Teenagers’ Quality of Life (T-QoL) for Adolescents with Skin Diseases: Translation, Cultural Adaptation and Validation

Antecedentes Teenagers’ Quality of Life (T-QoL) es un cuestionario de calidad de vida específico para adolescentes con enfermedades cutáneas. Hasta el momento, no existe ningún método validado para este fin en español, por lo que presentamos la traducción, adaptación cultural y validación del T-QoL al español. Método Se diseñó un estudio prospectivo con 133 pacientes (entre 12-19 años), atendidos en el Servicio de Dermatología del Hospital Universitario de Toledo, España (septiembre 2019-mayo 2020). Para la traducción y adaptación cultural se utilizaron las guías de la Sociedad Internacional de Farmacoeconomía e Investigación de Resultados (ISPOR). Se evaluó la validez convergente con el Índice de Calidad de Vida en Dermatología (DLQI), el Índice de Calidad de Vida en Dermatología Infantil (CDLQI) y con una Pregunta Global (GQ) sobre la gravedad de la enfermedad autoevaluada. También se analizó la consistencia interna y la fiabilidad de la herramienta T-QoL, y se confirmó su estructura con un análisis factorial. Resultados Las puntuaciones globales de T-QoL se correlacionaron significativamente con el DLQI y el CDLQI (r=0,75) y con la GQ (r=0,63). El análisis factorial mostró un ajuste óptimo para el modelo bifactorial y un ajuste adecuado para el modelo de 3 factores correlacionado. Los indicadores de fiabilidad fueron altos (α de Cronbach=0,89; índice Lambda 6 de Guttman=0,91; Omega ω=0,91) y el test-retest mostró una alta estabilidad (ICC=0,85). Los resultados fueron consistentes con los encontrados por los autores de la prueba original. Conclusiones La versión española del T-QoL es un cuestionario válido y fiable para evaluar la calidad de vida de adolescentes hispanohablantes con enfermedades cutáneas (AU)

Background Teenagers’ Quality of Life (T-QoL) is an age-specific measure to assess QoL of teenagers suffering from different skin diseases. A validated Spanish language version is lacking. We present the translation, cultural adaptation and validation of the T-QoL into Spanish. Methods A prospective study with 133 patients (between 12 and 19 years old), attended at the dermatology department of Toledo University Hospital, Spain (September 2019–May 2020), was carried out for the validation study. The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines were used for the translation and cultural adaptation. We evaluated the convergent validity with the Dermatology Life Quality Index (DLQI), the Children's Dermatology Life Quality Index (CDLQI) and with a Global Question (GQ) on self-assessed disease severity. We also analysed internal consistency and reliability of the T-QoL tool and confirmed its structure with a factor analysis. Results Global T-QoL scores significantly correlated with the DLQI and the CDLQI (r=0.75) and with the GQ (r=0.63). The confirmatory factor analysis showed optimal fit for the bi-factor model and an adequate fit for the correlated three-factor model. Reliability indicators were high (Cronbach's α=0.89; Guttman's Lambda 6 index=0.91; Omega ω=0.91) and test–retest showed a high stability (ICC=0.85). The results were consistent with those found by the authors of the original test. Conclusion Our Spanish version of the T-QoL tool is valid and reliable to assess QoL of Spanish-speaking adolescents with skin diseases (AU)

Spanish Version of Teenagers' Quality of Life (T-QoL) for Adolescents with Skin Diseases: Translation, Cultural Adaptation and Validation. / [Artículo Traducido] Traducción, adaptación cultural y validación de la versión española del Teenagers' Quality of Life (T-QoL): cuestionario para adolescentes con enfermedades de la piel.

BACKGROUND: Teenagers' Quality of Life (T-QoL) is an age-specific measure to assess QoL of teenagers suffering from different skin diseases. A validated Spanish language version is lacking. We present the translation, cultural adaptation and validation of the T-QoL into Spanish. METHODS: A prospective study with 133 patients (between 12 and 19 years old), attended at the dermatology department of Toledo University Hospital, Spain (September 2019-May 2020), was carried out for the validation study. The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines were used for the translation and cultural adaptation. We evaluated the convergent validity with the Dermatology Life Quality Index (DLQI), the Children's Dermatology Life Quality Index (CDLQI) and with a Global Question (GQ) on self-assessed disease severity. We also analysed internal consistency and reliability of the T-QoL tool and confirmed its structure with a factor analysis. RESULTS: Global T-QoL scores significantly correlated with the DLQI and the CDLQI (r = 0.75) and with the GQ (r = 0.63). The confirmatory factor analysis showed optimal fit for the bi-factor model and an adequate fit for the correlated three-factor model. Reliability indicators were high (Cronbach's α = 0.89; Guttman's Lambda 6 index = 0.91; Omega ω = 0.91) and test-retest showed a high stability (ICC = 0.85). The results were consistent with those found by the authors of the original test. CONCLUSION: Our Spanish version of the T-QoL tool is valid and reliable to assess QoL of Spanish-speaking adolescents with skin diseases.

Spanish Version of Teenagers' Quality of Life (T-QoL) for Adolescents with Skin Diseases: Translation, Cultural Adaptation and Validation.

BACKGROUND: Teenagers' Quality of Life (T-QoL) is an age-specific measure to assess QoL of teenagers suffering from different skin diseases. A validated Spanish language version is lacking. We present the translation, cultural adaptation and validation of the T-QoL into Spanish. METHODS: A prospective study with 133 patients (between 12 and 19 years old), attended at the dermatology department of Toledo University Hospital, Spain (September 2019-May 2020), was carried out for the validation study. The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines were used for the translation and cultural adaptation. We evaluated the convergent validity with the Dermatology Life Quality Index (DLQI), the Children's Dermatology Life Quality Index (CDLQI) and with a Global Question (GQ) on self-assessed disease severity. We also analysed internal consistency and reliability of the T-QoL tool and confirmed its structure with a factor analysis. RESULTS: Global T-QoL scores significantly correlated with the DLQI and the CDLQI (r=0.75) and with the GQ (r=0.63). The confirmatory factor analysis showed optimal fit for the bi-factor model and an adequate fit for the correlated three-factor model. Reliability indicators were high (Cronbach's α=0.89; Guttman's Lambda 6 index=0.91; Omega ω=0.91) and test-retest showed a high stability (ICC=0.85). The results were consistent with those found by the authors of the original test. CONCLUSION: Our Spanish version of the T-QoL tool is valid and reliable to assess QoL of Spanish-speaking adolescents with skin diseases.

Injectable, Drug-Eluting Nanocrystals Prevent Fibrosis and Stricture Formation In Vivo.

BACKGROUND & AIMS: Tissue fibrosis results from uncontrolled healing responses leading to excessive mesenchymal cell activation and collagen and other extracellular matrix deposition. In the gastrointestinal tract, fibrosis leads to narrowing of the lumen and stricture formation. A drug treatment to prevent fibrosis and strictures in the gastrointestinal tract would be transformational for patient care. We aimed to develop a stricture treatment with the following characteristics and components: a small molecule with strong antifibrotic effects that is delivered locally at the site of the stricture to ensure correct lesional targeting while protecting the systemic circulation, and that is formulated with sustained-release properties to act throughout the wound healing processes. METHODS: A high-throughput drug screening was performed to identify small molecules with antifibrotic properties. Next, we formulated an antifibrotic small molecule for sustained release and tested its antifibrotic potential in 3 animal models of fibrosis. RESULTS: Sulconazole, a US Food and Drug Administration-approved drug for fungal infections, was found to have strong antifibrotic properties. Sulconazole was formulated as sulconazole nanocrystals for sustained release. We found that sulconazole nanocrystals provided superior or equivalent fibrosis prevention with less frequent dosing in mouse models of skin and intestinal tissue fibrosis. In a patient-like swine model of bowel stricture, a single injection of sulconazole nanocrystals prevented stricture formation. CONCLUSIONS: The current data lay the foundation for further studies to improve the management of a range of diseases and conditions characterized by tissue fibrosis.

Assessing the link between farming systems and biodiversity in agricultural landscapes: Insights from Galicia (Spain).

Agriculture is a major driver of change with manifold impacts on biodiversity and ecosystem services. As social-ecological systems, agricultural landscapes result from the intertwined interaction between farmers and nature, and contribute to several ecosystem services key to human well-being. The social-ecological outcomes of farmlands ultimately reflect the management practices of the dominant farming systems (FS) at the landscape level. However, data-driven research linking agricultural management and biodiversity is still scarce, a knowledge gap limiting our understanding on the impacts of different farming systems on biodiversity at the landscape level. This research contributes to fill this knowledge gap, by being among the few explicitly exploring the relationship between FS and patterns of biodiversity at the landscape level, using as illustrative case the region of Galicia, northwest Spain. Using data from agricultural policies paying agencies, and protected species and habitats data, the following research questions were pursued: (1) Can farm-level data be used to map and characterize different FS at the landscape-level? and, (2) Is the occurrence of specific FS linked with higher levels of biodiversity? Results allowed the identification and characterization of seven different FS distributed across Galicia, which dominance allowed to identify seven landscape types. Moreover, besides depicting the dominance of cattle-based farming systems in Galicia, results showed a gradient of management from the most intensive located in coastal lowlands (west) towards less intensive mountain areas (east). Such gradient of decreasing management intensity matched a gradient of increasing nature value of farmlands, reflected as higher habitat diversity and richness for some of the targeted taxonomic groups. To our knowledge, this research is among the few explicitly addressing the relationship between FS and biodiversity at the landscape level. By highlighting potential links (positive or negative) between specific landscape types and habitats and/or species richness across targeted taxonomic groups, these results constitute a preliminary assessment of the agricultural practices promoting species and habitat richness. Further scrutinizing this assessment can support the identification of farm-level indicators that can be then translated into the design of policies (biodiversity or agriculture-related) fostering biodiversity at several scales of decision making.

Living with a giant, flowering parasite: metabolic differences between Tetrastigma loheri Gagnep. (Vitaceae) shoots uninfected and infected with Rafflesia (Rafflesiaceae) and potential applications for propagation.

MAIN CONCLUSION: Metabolites in Rafflesia-infected and non-infected Tetrastigma were compared which may have applications in Rafflesia propagation. Benzylisoquinoline alkaloids, here reported for the first time in Vitaceae, were abundant in non-infected shoots and may be a form of defense. In Rafflesia-infected shoots, oxylipins, which mediate immune response, were elevated. Endemic to the forests of Southeast Asia, Rafflesia (Rafflesiaceae) is a genus of holoparasitic plants producing the largest flowers in the world, yet completely dependent on its host, the tropical grape vine, Tetrastigma. Rafflesia species are threatened with extinction, making them an iconic symbol of plant conservation. Thus far, propagation has proved challenging, greatly decreasing efficacy of conservation efforts. This study compared the metabolites in the shoots of Rafflesia-infected and non-infected Tetrastigma loheri to examine how Rafflesia infection affects host metabolomics and elucidate the Rafflesia infection process. Results from LC-MS-based untargeted metabolomics analysis showed benzylisoquinoline alkaloids were naturally more abundant in non-infected shoots and are here reported for the first time in the genus Tetrastigma, and in the grape family, Vitaceae. These metabolites have been implicated in plant defense mechanisms and may prevent a Rafflesia infection. In Rafflesia-infected shoots, oxygenated fatty acids, or oxylipins, and a flavonoid, previously shown involved in plant immune response, were significantly elevated. This study provides a preliminary assessment of metabolites that differ between Rafflesia-infected and non-infected Tetrastigma hosts and may have applications in Rafflesia propagation to meet conservation goals.

Quantum Simulation of the Bosonic Creutz Ladder with a Parametric Cavity.

There has been a growing interest in realizing quantum simulators for physical systems where perturbative methods are ineffective. The scalability and flexibility of circuit quantum electrodynamics make it a promising platform for implementing various types of simulators, including lattice models of strongly coupled field theories. Here, we use a multimode superconducting parametric cavity as a hardware-efficient analog quantum simulator, realizing a lattice in synthetic dimensions with complex hopping interactions. The coupling graph, i.e., the realized model, can be programmed in situ. The complex-valued hopping interaction further allows us to simulate, for instance, gauge potentials and topological models. As a demonstration, we simulate a plaquette of the bosonic Creutz ladder. We characterize the lattice with scattering measurements, reconstructing the experimental Hamiltonian and observing important precursors of topological features including nonreciprocal transport and Aharonov-Bohm caging. This platform can be easily extended to larger lattices and different models involving other interactions.

Tocilizumab reduces the risk of ICU admission and mortality in patients with SARS-CoV-2 infection.

OBJECTIVE: In some patients the immune response triggered by SARS-CoV-2 is unbalanced, presenting an acute respiratory distress syndrome which in many cases requires intensive care unit (ICU) admission. The limitation of ICU beds has been one of the major burdens in the management around the world; therefore, clinical strategies to avoid ICU admission are needed. We aimed to describe the influence of tocilizumab on the need of transfer to ICU or death in non-critically ill patients. METHODS: A retrospective study of 171 patients with SARS-CoV-2 infection that did not qualify as requiring transfer to ICU during the first 24h after admission to a conventional ward, were included. The criteria to receive tocilizumab was radiological impairment, oxygen demand or an increasing of inflammatory parameters, however, the ultimate decision was left to the attending physician judgement. The primary outcome was the need of ICU admission or death whichever came first. RESULTS: A total of 77 patients received tocilizumab and 94 did not. The tocilizumab group had less ICU admissions (10.3% vs. 27.6%, P=0.005) and need of invasive ventilation (0 vs 13.8%, P=0.001). In the multivariable analysis, tocilizumab remained as a protective variable (OR: 0.03, CI 95%: 0.007-0.1, P=0.0001) of ICU admission or death. CONCLUSIONS: Tocilizumab in early stages of the inflammatory flare could reduce an important number of ICU admissions and mechanical ventilation. The mortality rate of 10.3% among patients receiving tocilizumab appears to be lower than other reports. This is a non-randomized study and the results should be interpreted with caution.

Integration of choline geranate into electrospun protein scaffolds affords antimicrobial activity to biomaterials used for cutaneous wound healing.

Wound healing attempts to maintain homeostasis in the wound while minimizing the risk of infection to the tissue by foreign agents, such as opportunistic bacterial pathogens. Biofilms established by these pathogens are a common cause of chronic infections that slow the healing process. Preparation of skin wound healing devices comprised of electrospun proteins associated with skin have been shown to accelerate the healing process relative to conventional wound dressings. In this work, we have developed electrospinning methods to incorporate the antimicrobial ionic liquid/deep eutectic solvent choline geranate (CAGE) into these devices. Integration of CAGE into the dressing material was verified via 1 H nuclear magnetic resonance spectrometry, and the effect on the material property of the resultant devices were assessed using scanning electron microscopy. CAGE-containing devices demonstrate a concentration-dependent inactivation of exogenously applied solutions of both gram-positive and gram-negative pathogens (Enterococcus sp and Pseudomonas aeruginosa, respectively), but maintain their ability to serve as a compatible platform for proliferation of human dermal neonatal fibroblasts.

Norovirus detection in environmental samples in norovirus outbreaks in closed and semi-closed settings.

BACKGROUND: Environmental surfaces are a potential vehicle for the transmission of norovirus outbreaks in closed and semi-closed settings. Testing of environmental samples may help control outbreaks. AIM: To assess the level of environmental contamination by norovirus in acute gastroenteritis outbreaks in closed or semi-closed settings (nursing homes, schools, kindergartens, youth accommodations, hospitals and social health centres) in the Barcelona region between January 2017 and March 2019. METHODS: A prospective surveillance study was carried out. Environmental samples (529) were collected in 46 of the 50 outbreaks of acute norovirus gastroenteritis from environmental surfaces of common areas, bathrooms and kitchens in closed and semi-closed settings when the outbreak was notified and 10 days later. Instructions for taking environmental samples were distributed to public health inspectors. Norovirus was detected by reverse transcription polymerase chain reaction. FINDINGS: Environmental samples were positive for norovirus in 31 (67.4%) outbreaks. Norovirus was most frequently detected on elevator buttons (4/17, 24%), toilet handles (16/66, 24%) and handrail bars (7/34, 21%). Positive samples from the first sampling were mainly found in bathrooms and greater viral persistence in the second sampling was found on elevator buttons and TV remote controls. Nursing homes were the setting with the most types of environmental surfaces contaminated (82% in first samples and 55% in second samples). CONCLUSION: The probability of virus detection is independent of the time between notification of the outbreak or symptom onset and sample collection. Our results suggest possible defects in cleaning protocols and disinfection in closed and semi-closed settings.