Body Composition Changes in Hemodialysis Patients: Implications for Prognosis

Background: Overhydration, inflammation and protein-energy wasting have been related to all-cause mortality in dialysis patients, being lean mass loss, a poor prognostic factor. Objective: to monitor body composition changes (BCC) in hemodialysis (HD) patients and to relate BCC to mortality. Methods: Prospective follow up study: Bioimpedance spectroscopy (BIS) and nutritional parameters were performed every 6 months during three years. Results : Overall data show a significant loss of weight at 12m, 24m, and 36m, with decrease of lean tissue index and phase angle (PA) in each period measured. Fat tissue index (FTI) diminished in the third year’s measurements. End of first year, 41 % of patients gain weight, them at baseline had lower age, higher serum albumin, lower Extracelular/intracellular water index (ECW/ICW) and higher PA, showing a significant FTI increase. Higher baseline PA was gain weight predictor by binary logistic regression. Cox regression analyses: Age, diabetes, HD technique, albumin, ECW/ICW, and PA were mortality predictors in univariate analysis; being PA the main mortality predictor in multivariate analysis. BCC were not associated with mortality. ROC curve: PA higher than 4.85° is protective for mortality. Conclusions: Lean mass loss was the most important change during follow up; we have not observed association between BCC with mortality. PA was the main mortality predictor.S

Juvenile dermatomyositis‐associated calcinosis successfully treated with combined immunosuppressive, bisphosphonate, oral baricitinib and physical therapy

CRUE-CSIC (Acuerdos Transformativos 2022)Depto. de MedicinaFac. de MedicinaTRUEpu

Association Between Preexisting Versus Newly Identified Atrial Fibrillation and Outcomes of Patients With Acute Pulmonary Embolism

Background Atrial fibrillation (AF) may exist before or occur early in the course of pulmonary embolism (PE). We determined the PE outcomes based on the presence and timing of AF. Methods and Results Using the data from a multicenter PE registry, we identified 3 groups: (1) those with preexisting AF, (2) patients with new AF within 2 days from acute PE (incident AF), and (3) patients without AF. We assessed the 90-day and 1-year risk of mortality and stroke in patients with AF, compared with those without AF (reference group). Among 16 497 patients with PE, 792 had preexisting AF. These patients had increased odds of 90-day all-cause (odds ratio [OR], 2.81; 95% CI, 2.33-3.38) and PE-related mortality (OR, 2.38; 95% CI, 1.37-4.14) and increased 1-year hazard for ischemic stroke (hazard ratio, 5.48; 95% CI, 3.10-9.69) compared with those without AF. After multivariable adjustment, preexisting AF was associated with significantly increased odds of all-cause mortality (OR, 1.91; 95% CI, 1.57-2.32) but not PE-related mortality (OR, 1.50; 95% CI, 0.85-2.66). Among 16 497 patients with PE, 445 developed new incident AF within 2 days of acute PE. Incident AF was associated with increased odds of 90-day all-cause (OR, 2.28; 95% CI, 1.75-2.97) and PE-related (OR, 3.64; 95% CI, 2.01-6.59) mortality but not stroke. Findings were similar in multivariable analyses. Conclusions In patients with acute symptomatic PE, both preexisting AF and incident AF predict adverse clinical outcomes. The type of adverse outcomes may differ depending on the timing of AF onset.info:eu-repo/semantics/publishedVersio

Rol enfermero en la valoración de síndromes geriátricos y estado funcional en una consulta de geriatría

RESUMEN La valoración geriátrica integral es una herramienta básica en el modelo de atención multidisciplinar al paciente anciano. Objetivos: los objetivos de este estudio son evaluar el estado funcional de los pacientes visitados en una consulta de geriatría hospitalaria de un hospital terciario, conocer la prevalencia de los síndromes geriátricos mayores y valorar la percepción de su calidad de vida. Metodología: Estudio descriptivo prospectivo en el que se incluyeron 260 pacientes mayores de 70 años que acudieron a una consulta de geriatría. A todos ellos se les realizó una valoración geriátrica integral que incluye una evaluación funcional, cognitiva y de percepción de la calidad de vida. También se recogieron los síndromes geriátricos mayores. Resultados: La población analizada tenía una buena capacidad funcional. Los síndromes geriátricos eran muy prevalentes, especialmente en el subgrupo de mayores de 81 años, siendo la polifarmacia el más destacado. Los pacientes con más síndromes geriátricos tenían una peor percepción de la calidad de vida. Conclusión: Los síndromes geriátricos eran muy prevalentes en la población analizada y se asocian a una mala percepción de la calidad de vida. El rol enfermero en su detección e implementación de actividades preventivas y terapéuticas puede mejorar la calidad de vida de estos ancianos

La biblioteca bilingüe, centro base de investigación, autoaprendizaje y disfrute de nuestro colegio

La finalidad principal de este proyecto es crear una biblioteca escolar con recursos en inglés y en español que contribuya a fomentar el interés por la lectura y la búsqueda de información en distintos soportes. Los objetivos son incorporar fondos a la biblioteca y, entre ellos, creaciones literarias de los alumnos; promover la autonomía en la consulta de fuentes de información; responsabilizar a los alumnos del cuidado de los libros, materiales y mobiliario; crear un ambiente adecuado para la lectura, la investigación y el autoaprendizaje; implicar a toda la comunidad educativa; proporcionar fondos a las bibliotecas de aula; y colaborar con otras instituciones en el fomento de la lectura. Entre las actividades se encuentran la decoración de la biblioteca y la organización de sus fondos; la formación de alumnos con el fin de que colaboren en la biblioteca; y la realización de concursos, actividades de animación a la lectura, cuentacuentos y exposiciones. Además, se crean materiales para la biblioteca como carteles y murales, fichas de lectura y de préstamo, carnés, tejuelos y marca páginas. Los alumnos también elaboran cuentos, poesías, dibujos, redacciones, adivinanzas, recetarios y álbumes de fotografías. Se incluyen imágenes y muestras de todos ellos.Madrid (Comunidad Autónoma). Consejería de Educación. Dirección General de Ordenación AcadémicaMadridMadrid (Comunidad Autónoma). Subdirección General de Formación del Profesorado. CRIF Las Acacias; General Ricardos 179 - 28025 Madrid; Tel. + 34915250893ES

Immobilization of Candida rugosa lipase and some properties of the immobilized enzyme

Lipase (triacylglycerol ester hydrolase, E.C.3.1.1.3) from Candida rugosa has been immobilized on commercially available microporous polypropylene. The enzyme was rapidly adsorbed on the support, and more than 60% of the soluble activity disappeared from the medium after 1 min of incubation at room temperature. A recovery of immobilized activity of 21% was obtained when the wet preparation was immediately assayed with olive oil at the end of the immobilization protocol. The activity of the immobilized enzyme drastically decreased with the loss of water of the preparation. Pretreatment of the support with organic solvents significantly increased the recovered immobilized activity. Our results strongly suggest that the soluble lipase could exist in different aggregation forms depending on the pH of the medium. At acidic pH, the relative proportion of high-molecular-weight forms of the enzyme is higher than at pH 7.0, suggesting that the lipase would be also immobilized in different aggregation forms depending on the pH used in the immobilization procedure. Crosslinking of the adsorbed enzyme with glutaraldehyde diminished its activity but increased the stability of the lipase against the washing-out effect of Triton X-100. Data on the most relevant catalytic properties of the soluble and immobilized enzyme, such as optimum pH and temperature as well as ranges of stability, kinetic parameters, and activation energy for the hydrolysis of olive oil and p-nitrophenyl acetate, are reported.This work was partially supported by grants from the Spanish Ministry of Industry, Commerce and TourismPeer reviewe

Hydrolysis of animal fats by immobilized Candida rugosa lipase

Lipase (triacylglycerol ester hydrolase, EC 3.1.1.3) from Candida rugosa was immobilized by adsorption on a commercially available microporous polypropylene support of 200- to 400-μm particle size. A contact period of 90 min allowed the highest degrees of hydrolysis to be achieved, particularly in the second and third hydrolysis reactions. The optimal hydrolysis conditions were 0.10 kg enzyme per kilogram fat, 50% (w/v) fat, and 40°C for 24 h. The immobilized enzyme can be repeatedly used and hydrolysis degrees of 90% or higher can be achieved. Of the three animal fats studied, edible pork lard consistently yielded the highest degrees of hydrolysis (95%) in the first hydrolysis reaction and inedible beef tallow the lowest (65%). The immobilized enzyme lost its activity above 45°C. The support could be easily recovered and reused up to 5 times.This work was partially supported by grants from the Spanish Ministry of Industry (CDTI) and the Department of Industry of the Basque Government.Peer reviewe

Kinetic properties of soluble and immobilized Candida rugosa lipase

Immobilized lipase (triacylglycerol ester hydrolase, EC 3.1.1.3) from Candida rugosa has been immobilized on commercially available microporous polypropylene and used for the batch hydrolysis of different animal fats. The effect of the reaction products at concentrations similar to those obtained at 90% hydrolysis, both on soluble and immobilized lipase, was studied. Glycerol showed low inhibitory effect but oleic acid caused 50% inhibition. A mixture of free fatty acids present in the complete hydrolysis of beef tallow inhibited lipase activity more than 70%. The stability of the enzyme (both soluble and immobilized) was highest in the presence of 20% isooctane. The apparent Michaelis constant for each substrate for the soluble enzyme did not change on immobilization.Peer reviewe

Diseño de asignaturas del módulo específico de Latín y Griego del Máster Universitario en profesor de Educación Secundaria y Bachillerato

Memoria ID-099. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2010-2011.Los objetivos de este proyecto eran diseñar algunas asignaturas pertenecientes a los ámbitos del módulo específico, que recoge la Orden ECI/3858/2007: “Aprendizaje y enseñanza”, “Complementos para la Formación” e “Innovación docente e iniciación a la investigación educativa” en Cultura Clásica, Latín y Griego en la Enseñanza Secundaria y el Bachillerato, con el doble fin de completar la formación de nuestros estudiantes en la especialidad atendiendo a aspectos necesarios para el desarrollo de las materias de ESO y Bachillerato recogidas en la legislación vigente (Orden EDU/1046/2007, de 12 de junio por la que se regula la implantación y desarrollo de la Educación Secundaria Obligatoria en la Comunidad de Castilla y León y Decreto 42/2008, de 5 de Junio, por el que se establece el curriculo de Bachillerato en la Comunidad de Castilla y León) y reflexionar sobre la mejor aplicación de los mismos a las necesidades educativas de los adolescentes y jóvenes del s. XXI

Body Composition Changes in Hemodialysis Patients: Implications for Prognosis

Background: Overhydration, inflammation and protein-energy wasting have been related to all-cause mortality in dialysis patients, being lean mass loss, a poor prognostic factor. Objective: to monitor body composition changes (BCC) in hemodialysis (HD) patients and to relate BCC to mortality. Methods: Prospective follow up study: Bioimpedance spectroscopy (BIS) and nutritional parameters were performed every 6 months during three years. Results : Overall data show a significant loss of weight at 12m, 24m, and 36m, with decrease of lean tissue index and phase angle (PA) in each period measured. Fat tissue index (FTI) diminished in the third year’s measurements. End of first year, 41 % of patients gain weight, them at baseline had lower age, higher serum albumin, lower Extracelular/intracellular water index (ECW/ICW) and higher PA, showing a significant FTI increase. Higher baseline PA was gain weight predictor by binary logistic regression. Cox regression analyses: Age, diabetes, HD technique, albumin, ECW/ICW, and PA were mortality predictors in univariate analysis; being PA the main mortality predictor in multivariate analysis. BCC were not associated with mortality. ROC curve: PA higher than 4.85° is protective for mortality. Conclusions: Lean mass loss was the most important change during follow up; we have not observed association between BCC with mortality. PA was the main mortality predictor.S