Understanding for Prevention: Qualitative and Quantitative Analyses of Suicide Notes and Forensic Reports

Suicide risk is associated with vulnerabilities and specific life events. The study’s objective was to explore the relevance of data from forensic documentation on suicide deaths to the design of person-centered preventive strategies. Descriptive and thematic analyses were conducted of forensic observations of 286 deaths by suicide, including some with suicide notes. Key findings included the influence of health-and family-related adverse events, emotional states of loss and sadness, and failures of the health system to detect and act on signs of vulnerability, as confirmed by the suicide notes. Forensic documentation provides useful information to improve the targeting of preventive campaigns.Partial funding for open access charge: Universidad de Málag

In Vivo

In recent years, technology has allowed the development of new diagnostic techniques which allow real-time, in vivo, noninvasive evaluation of morphological changes in tissue. This study compares and correlates the images and findings obtained by high-definition optical coherence tomography (HD-OCT) and reflectance confocal microscopy (RCM) with histology in normal healthy oral mucosa. The healthy lip mucosa of ten adult volunteers was imaged with HD-OCT and RCM. Each volunteer was systematically evaluated by RCM starting in the uppermost part of the epithelium down to the lamina propia. Afterwards, volunteers were examined with a commercially available full-field HD-OCT system using both the “slice” and the “en-face” mode. A “punch” biopsy of the lower lip mucosa was obtained and prepared for conventional histology. The architectural overview offered by “slice” mode HD-OCT correlates with histologic findings at low magnification. In the superficial uppermost layers of the epithelium, RCM imaging provided greater cellular detail than histology. As we deepened into the suprabasal layers, the findings are in accordance with physiological cellular differentiation and correlate with the images obtained from conventional histology. The combined use of these two novel non-invasive imaging techniques provides morphological imaging with sufficient resolution and penetration depth, resulting in quasihistological images

Fluorescent C-NanoDots for rapid detection of BRCA1, CFTR and MRP3 gene mutations

This is a post-peer-review, pre-copyedit version of an article published in Microchimica Acta. The final authenticated version is available online at: http://dx.doi.org/10.1007/s00604-019-3386-9The authors report on a fluorometric method for the rapid detection of BRCA1, CFRT and MRP3 gene mutations. These are associated with breast cancer, cystic fibrosis and autoimmune hepatitis diseases, respectively. Carbon nanodots with blue fluorescence (with excitation/emission maxima at 340/440 nm) were synthesized and characterized, and their interactions with DNA were investigated. Changes in the fluorescence intensity following interaction with ssDNA and dsDNA were used for specific DNA sequence of BRCA1, CFRT and MRP3 genes detection. The response to DNAs is linear up to 200 nM and the detection limit is 270 pM. The assay selectivity allows the detection of single gene mutations. Under optimum conditions, the assay can rapidly discriminate between wild type and mutated samplesCAM projects: TRANSNANOAVANSENS-CM (S2018/NMT-4349) and MAD2D-CM Program. MEIC projects: CTQ2017-84309-C2-1-R and MAT2015-71879-P. We thank the Confocal Microscopy and Flow Cytometry Services of CBMS

Cholemic Nephropathy: Hyperbilirubinemia and its Impact on Renal Function

Cholemic nephropathy represents a spectrum of renal injury, from proximal tubulopathy to intrarenal bile cast formation, found in patients with severe liver dysfunction. It is caused by hyperbilirubinemia, usually in jaundiced patients. Acute kidney injury is one of the most important complications in patients with end-stage liver disease. The relationship between liver disease and renal impairment, especially the effect of hyperbilirubinemia on renal tissue and renal function, has not been fully elucidated. These considerations deem necessary for nephrologists, when performing a clinical evaluation of patients with liver diseases, for the implementation of an integrated medical approach. This review focuses on the current knowledge on cholemic nephropathy with emphasis on the role of hyperbilirubinemia on renal impairment. The treatment strategies and outcome are also discussed

Model for predicting academic performance in virtual courses through supervised learning

Since virtual courses are asynchronous and non-presential environments, the following of student tasks can be a hard work. Virtual Education and Learning Environments (VELE) often provide tools for this purpose (Zaharia et al. in Commun ACM 59(11):56-65, 2016, [1]). In Moodle, some plugins take information about students’ activities, providing statistics to the teacher. This information may not be accurate with respect to leadership ability or risk of abandonment. The use of artificial neural networks (ANNs) can help predict student behavior and draw conclusions at early stages of the learning process in a VELE. This paper proposes a plugin for Moodle that analyzes social metrics through graph theory. This article outlines the advantages of integrating an ANN into this development that complements the use of the graph to provide rich conclusions about student performance in a Moodle virtual course

Primera transfusión extrahospitalaria en Aragón a paciente COVID-19

Patient’s clinical case, who was blood transfused in an outpatient environment. A narrative bibliographical review has been done about outpatient hospital care and a blood transfusion done in a hospital and outpatient blood transfusion. The clinical case has been explained including the patient’s medical history, the treatment that has been chosen and clinical progress. According to the experience, it is possible to affirm that blood transfusions can be done in an outpatient environment with the support of a multidisciplinary team, following protocols and basing the transfusion on the patient’s safety. The positive clinical progress evidenced how important it is to be in a good environment. The outpatient care improved the physical and mental health, provided a quality doctors and nurses care and reduced the cost to a health system that is already overcharged. To be highlighted, the outpatient care helped the chronic patients to develop a better autonomy due to the fact that they are in an environment where they are in charge.Caso clínico, de una paciente, en el cual se realizó una transfusión fuera del entorno hospitalario. Tras una revisión bibliográfica narrativa sobre la hospitalización a domicilio y las transfusiones intra y extrahospitalarias, se describe el caso clínico incluyendo anamnesis del paciente, justificación del tratamiento elegido y la evolución posterior. Después de la experiencia se pudo afirmar que, mediante la colaboración de un equipo multidisciplinar, es posible realizar transfusiones en medio extrahospitalario cumpliendo todos los protocolos y sin dejar de lado la seguridad para el paciente. La buena evolución de la paciente evidenció la importancia del ambiente. Fue beneficioso para la salud tanto física, como mental, un entorno extrahospitalario, logrando una atención médica y unos cuidados de enfermería de calidad y de menor coste para un sistema sanitario ya sobrecargado. Resaltar que la atención domiciliaria permitió a los pacientes crónicos pluripatológicos una mayor autonomía, ya que están en un ambiente controlado por ellos

Riesgo dietético para la presencia de dislipidemias en escolares

La asociación del consumo de alimentos con la presencia de enfermedades crónicas , en particular con las enfermedades cardiovasculares en niños es limitada . Los factores de riesgo cardiovascular como las dislipidemias, han sido descritos recientemente a edades cada vez más tempranas en los que los niños en edad escolar no han sido la excepción. La dieta de baja calidad es un factor de riesgo que debe ser intervenido y modificado en la población, sobre todo en edades tempranas.Objetivo: Identificar el riesgo dietético por el consumo de alimentos con elevado contenido de azúcares refinados, ácidos grasos saturados y colesterol para la presencia de dislipidemias en escolares. Materiales y métodos: Se diseñó y aplicó una encuesta de frecuencia de consumo de alimentos de riesgo, se calculó el riesgo dietético y se identificaron alteraciones lipídicas en niños. Se utilizó la razón de momios con intervalos de confianza al 95% para la medición del riesgo entre la dieta y las dislipidemias. Resultados: 17% de los escolares de la escuela privada presentaron consumo elevado de colesterol; en la escuela pública 59% presentaron elevado consumo de azúcares refinados, y 29% consumo elevado de ácidos grasos saturados. Las cifras de riesgo de colesterol sérico, triglicéridos y colesterol-LDL se identificaron con mayor frecuencia en los escolares de la institución privada, mientras que las cifras bajas de colesterol-HDL se identificaron con mayor frecuencia en los niños de la escuela pública. 64 escolares con riesgo dietético presentaron al menos un tipo de dislipidemia OR= 0.94; IC 95%, 0.59-1.50. Conclusiones: En ésta población, el consumo elevado de azúcares refinados es el factor de riesgo dietético de mayor frecuencia para la presencia de dislipidemias. La dieta de baja calidad es un factor de riesgo que debe ser modificado en la población, sobre todo en edades temprana

Multi-level immune response network in mild-moderate Chronic Obstructive Pulmonary Disease (COPD)

Background: Chronic Obstructive Pulmonary Disease (COPD) is associated with an abnormal pulmonary and systemic immune response to tobacco smoking. Yet, how do immune cells relate within and between these two biological compartments, how the pulmonary infiltrate influences the lung transcriptome, and what is the role of active smoking vs. presence of disease is unclear. Methods: To investigate these questions, we simultaneously collected lung tissue and blood from 65 individuals stratified by smoking habit and presence of the disease. The immune cell composition of both tissues was assessed by flow cytometry, whole lung transcriptome was determined with Affymetrix arrays, and we used Weighted Gene Co-expression Network Analysis (WGCNA) to integrate results. Results: Main results showed that: (1) current smoking and the presence of COPD were both independently associated with a reduction in the proportion of lung T cells and an increase of macrophages, specifically those expressing CD80 + CD163+; (2) changes in the proportion of infiltrating macrophages, smoking status or the level of airflow limitation were associated to different WGCNA modules, which were enriched in iron ion transport, extracellular matrix and cilium organization gene ontologies; and, (3) circulating white blood cells counts were correlated with lung macrophages and T cells. Conclusions: Mild-moderated COPD lung immune infiltrate is associated with the active smoking status and presence of disease; is associated with changes in whole lung tissue transcriptome and marginally reflected in blood

Safety of Obtaining an Extra Biobank Kidney Biopsy Core

Biobank; Chronic kidney disease; Kidney biopsyBiobanco; Enfermedad renal cronica; Biopsia renalBiobanc; Malaltia renal crònica; Biòpsia de ronyóBackground and objectives: Kidney biopsy (KB) is the “gold standard” for the diagnosis of nephropathies and it is a diagnostic tool that presents a low rate of complications. Nowadays, biobank collections of renal tissue of patients with proven renal pathology are essential for research in nephrology. To provide enough tissue for the biobank collection, it is usually needed to obtain an extra kidney core at the time of kidney biopsy. The objective of our study is to evaluate the complications after KB and to analyze whether obtaining an extra core increases the risk of complications. Material and methods: Prospective observational study of KBs performed at Vall d’Hebron Hospital between 2019 and 2020. All patients who accepted to participate to our research biobank of native kidney biopsies were included to the study. Clinical and laboratory data were reviewed and we studied risk factors associated with complications. Results: A total of 221 patients were included, mean age 56.6 (±16.8) years, 130 (58.8%) were men, creatinine was 2.24 (±1.94) mg/dL, proteinuria 1.56 (0.506–3.590) g/24 h, hemoglobin 12.03 (±2.3) g/dL, INR 0.99 (±0.1), and prothrombin time (PT) 11.86 (±1.2) s. A total of 38 patients (17.2%) presented complications associated with the procedure: 13.1% were minor complications, 11.3% (n = 25) required blood transfusion, 1.4% (n = 3) had severe hematomas, 2.3% (n = 5) required embolization, and 0.5% (n = 1) presented arterio-venous fistula. An increased risk for complication was independently associated with obtaining a single kidney core (vs. 2 and 3 cores) (p = 0.021). Conclusions: KB is an invasive and safe procedure with a low percentage of complications. Obtaining an extra kidney core for research does not increase the risk of complications during the intervention, which remains low in concordance with previously published reports.The authors are current recipients of research grant from Red de Investigación Renal (REDINREN, RD16/0009/0030). (RICORS, RD21/0005/0016)

COVID-19 infection and renal injury: where is the place for acute interstitial nephritis disease?

COVID-19; Nefritis tubulointersticial aguda; Biòpsia de ronyóCOVID-19; Nefritis tubulointersticial aguda; Biopsia de riñónCOVID-19; Acute tubulointerstitial nephritis; Kidney biopsyNovel coronavirus disease infection (coronavirus disease 2019, COVID-19) was declared a global pandemic in March 2020 and since then has become a major public health problem. The prevalence of COVID-19 infection and acute kidney injury (AKI) is variable depending on several factors such as race/ethnicity and severity of illness. The pathophysiology of renal involvement in COVID-19 infection is not entirely clear, but it could be in part explained by the viral tropism in the kidney parenchyma. AKI in COVID-19 infection can be either by direct invasion of the virus or as a consequence of immunologic response. Diverse studies have focused on the effect of COVID-19 on glomerulonephritis (GN) patients or the ‘novo’ GN; however, the effect of COVID-19 in acute tubulointerstitial nephritis (ATIN) has been scarcely studied. In this article, we present five cases with different spectrums of COVID-19 infection and ATIN that may suggest that recent diagnosis of ATIN is accompanied by a worse clinical prognosis in comparison with long-term diagnosed ATIN.This research was funded by ISCIIII-FEDER and ISCIII-RETICS REDinREN, grant number PI17/00257, PI21/01292, RD16/0009/0030, and RICORS RD21/0005/0016. Enfermedad Glomerular Compleja del Sistema Nacional de Salud (CSUR), enfermedades glomerulares complejas