Lipid Metabolism and Epigenetics Crosstalk in Prostate Cancer

Prostate cancer (PCa) is the most commonly diagnosed malignant neoplasm in men in the Western world. Localized low-risk PCa has an excellent prognosis thanks to effective local treatments; however, despite the incorporation of new therapeutic strategies, metastatic PCa remains incurable mainly due to disease heterogeneity and the development of resistance to therapy. The mechanisms underlying PCa progression and therapy resistance are multiple and include metabolic reprogramming, especially in relation to lipid metabolism, as well as epigenetic remodelling, both of which enable cancer cells to adapt to dynamic changes in the tumour. Interestingly, metabolism and epigenetics are interconnected. Metabolism can regulate epigenetics through the direct influence of metabolites on epigenetic processes, while epigenetics can control metabolism by directly or indirectly regulating the expression of metabolic genes. Moreover, epidemiological studies suggest an association between a high-fat diet, which can alter the availability of metabolites, and PCa progression. Here, we review the alterations of lipid metabolism and epigenetics in PCa, before focusing on the mechanisms that connect them. We also discuss the influence of diet in this scenario. This information may help to identify prognostic and predictive biomarkers as well as targetable vulnerabilities

Experience in the Management of Patients Diagnosed with Esophageal Atresia and its Postsurgical Complications in the Neonatal Intensive Care Unit

Introducción: la atresia esofágica (AE) tiene una incidencia estimada de 1 en 3000-4500 nacidos vivos, con mayor frecuencia en recién nacidos prematuros. La etiología es multifactorial y genética. El diagnóstico prenatal es crucial, y su confirmación postnatal se realiza clínicamente y mediante estudios de imagen. El tratamiento es quirúrgico, con tasas de supervivencia del 90%. Se asocia con síndromes como VACTERL o CHARGE. Materiales y Métodos: estudio descriptivo, observacional, transversal y retrospectivo, realizado en pacientes con AE admitidos en una unidad neonatal de enero de 2016 a enero de 2021. Se emplearon métodos de estadística descriptiva y el software SPSS para el análisis de los datos. Resultados: se analizaron 40 expedientes. El 95% presentó AE tipo III. El 10% tuvo asociación VACTERL. Las complicaciones postquirúrgicas incluyeron neumonía (57.5%) y traqueomalacia (30%). La mortalidad fue del 5%. Discusión: los resultados concuerdan con la literatura respecto a incidencia, tipos de AE y asociaciones. Las complicaciones postquirúrgicas son similares, destacando la neumonía. Se destaca la importancia del diagnóstico prenatal para mejorar la gestión y reducir la morbimortalidad. La clasificación pronóstica es útil para estratificar riesgos. Conclusión: este estudio contribuye a la comprensión de la AE y destaca la necesidad de una gestión multidisciplinaria para mejorar los resultados a largo plazo.Introduction: Esophageal atresia (EA) has an estimated incidence of 1 in 3000-4500 live births, with a higher frequency in premature newborns. The etiology is multifactorial and genetic. Prenatal diagnosis is crucial, and postnatal confirmation is done clinically and through imaging studies. The treatment is surgical, with survival rates of 90%. It is associated with syndromes such as VACTERL or CHARGE. Materials and Methods: Descriptive, observational, cross-sectional, and retrospective study conducted on patients with EA admitted to a neonatal unit from January 2016 to January 2021. Descriptive statistical methods and the SPSS software were used for data analysis. Results: 40 records were analyzed. 95% had type III EA. 10% had VACTERL association. Post-surgical complications included pneumonia (57.5%) and tracheomalacia (30%). Mortality was 5%. Discussion: Results align with the literature regarding incidence, types of EA, and associations. Post-surgical complications are similar, with pneumonia being noteworthy. The importance of prenatal diagnosis is emphasized to enhance management and reduce morbidity and mortality. Prognostic classification is useful for risk stratification. Conclusion: This study contributes to understanding EA and emphasizes the need for multidisciplinary management to improve long-term outcomes

Hugo Chávez: una década en el poder

Una década de Hugo Chávez Frías y su proyecto político en Venezuela trajo consigo un cambio de paradigmas que llama la atención de la sociedad en general. Este libro es el resultado del esfuerzo conjunto de un grupo de académicos de distintas nacionalidades que desde sus líneas de investigación realizan análisis que le brindan al lector elementos para comprender de manera global lo que significa una década de gobierno del Presidente Chávez en Venezuela.Este libro es el resultado del esfuerzo conjunto de un grupo de académicos de distintas nacionalidades que desde sus líneas de investigación realizan análisis que le brindan al lector elementos para comprender de manera global lo que significa una década de gobierno del Presidente Chávez en Venezuela

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Proyecto de innovación en tutorías para alumnos de ingeniero químico

Resumen tomado de la publicaciónEl proyecto de acción tutorial se ha llevado a cabo en los cinco cursos de la titulación con un doble enfoque. Por una parte se han organizado grupos de tutoría de unos cinco alumnos en los que se han realizado actividades orientadas a mejorar el rendimiento académico, apoyo en la toma de decisiones, mejora del conocimiento que los alumnos tienen sobre la Universidad y los servicios y actividades que pueden realizar. Por otra parte, se han organizado actividades por cursos o varios cursos, para informar sobre temas generales de su interés, facilitar la realización de prácticas y apoyar a los alumnos de último curso en la incorporación al mercado laboral.NavarraUniversidad Pública de Navarra. Biblioteca Universitaria; Campus de Arrosadia; 31006 Pamplona; Tel. +34948169060; Fax +34948169069; [email protected]

Pneumonia treated in the internal medicine department: Focus on healthcare-associated pneumonia

Patients with pneumonia treated in the internal medicine department (IMD) are often at risk of healthcare-associated pneumonia (HCAP). The importance of HCAP is controversial. We invited physicians from 72 IMDs to report on all patients with pneumonia hospitalized in their department during 2weeks (one each in January and June 2010) to compare HCAP with community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP). We analysed 1002 episodes of pneumonia: 58.9% were CAP, 30.6% were HCAP and 10.4% were HAP. A comparison between CAP, HCAP and HAP showed that HCAP patients were older (77, 83 and 80.5years; p<0.001), had poorer functional status (Barthel 100, 30 and 65; p<0.001) and had more risk factors for aspiration pneumonia (18, 50 and 34%; p<0.001). The frequency of testing to establish an aetiological diagnosis was lower among HCAP patients (87, 72 and 79; p<0.001), as was adherence to the therapeutic recommendations of guidelines (70, 23 and 56%; p<0.001). In-hospital mortality increased progressively between CAP, HCAP and HAP (8, 19 and 27%; p<0.001). Streptococcus pneumoniae was the main pathogen in CAP and HCAP. Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA) caused 17 and 12.3% of HCAP. In patients with a confirmed aetiological diagnosis, the independent risk factors for pneumonia due do difficult-to-treat microorganisms (Enterobacteriaceae, P. aeruginosa or MRSA) were HCAP, chronic obstructive pulmonary diseases and higher Port Severity Index. Our data confirm the importance of maintaining high awareness of HCAP among patients treated in IMDs, because of the different aetiologies, therapy requirements and prognosis of this population. © 2011 The Authors. Clinical Microbiology and Infection © 2011 European Society of Clinical Microbiology and Infectious Diseases

Chronic coronary syndromes without standard modifiable cardiovascular risk factors and outcomes: the CLARIFY registry

Background and Aims: It has been reported that patients without standard modifiable cardiovascular (CV) risk factors (SMuRFs—diabetes, dyslipidaemia, hypertension, and smoking) presenting with first myocardial infarction (MI), especially women, have a higher in-hospital mortality than patients with risk factors, and possibly a lower long-term risk provided they survive the post-infarct period. This study aims to explore the long-term outcomes of SMuRF-less patients with stable coronary artery disease (CAD). Methods: CLARIFY is an observational cohort of 32 703 outpatients with stable CAD enrolled between 2009 and 2010 in 45 countries. The baseline characteristics and clinical outcomes of patients with and without SMuRFs were compared. The primary outcome was a composite of 5-year CV death or non-fatal MI. Secondary outcomes were 5-year all-cause mortality and major adverse cardiovascular events (MACE—CV death, non-fatal MI, or non-fatal stroke). Results: Among 22 132 patients with complete risk factor and outcome information, 977 (4.4%) were SMuRF-less. Age, sex, and time since CAD diagnosis were similar across groups. SMuRF-less patients had a lower 5-year rate of CV death or non-fatal MI (5.43% [95% CI 4.08–7.19] vs. 7.68% [95% CI 7.30–8.08], P = 0.012), all-cause mortality, and MACE. Similar results were found after adjustments. Clinical event rates increased steadily with the number of SMuRFs. The benefit of SMuRF-less status was particularly pronounced in women. Conclusions: SMuRF-less patients with stable CAD have a substantial but significantly lower 5-year rate of CV death or non-fatal MI than patients with risk factors. The risk of CV outcomes increases steadily with the number of risk factors