Clinical Efficacy and Safety of Fanhdi ®, a Plasma-Derived VWF/Factor VIII Concentrate, in von Willebrand Disease in Spain : A Retrospective Study

UDHEBRONTo evaluate the efficacy and safety of a plasma-derived factor VIII concentrate containing von Willebrand Factor (pdVWF/FVIII) in standard clinical practice in von Willebrand Disease (VWD) patients. A retrospective, multicentric, observational study of VWD patients treated with Fanhdi ®, a pdVWF/FVIII concentrate, from January 2011 to December 2017 was conducted at 14 centers in Spain. Efficacy and safety were evaluated for acute bleeding episodes, for prevention of bleeding in surgeries, and for secondary long-term prophylaxis. Seventy-two eligible patients, type 1, 2, 3 VWD (25%/38.9%/36.1%) were treated for spontaneous and traumatic bleeding (140 episodes, n = 41 patients), to prevent surgical bleeding (69 episodes, n = 43 patients); and for secondary long-term prophylaxis (18 programs, n = 13 patients). Replacement therapy with pdVWF/FVIII showed an excellent to good clinical efficacy in 96.7% of the bleeding episodes, 100% during surgical procedures and 100% during prophylaxis. No adverse events (AEs), nor serious AEs related to the product were observed. Fanhdi ® was effective, safe and well tolerated in the management of bleeding episodes, the prevention of bleeding during surgeries, and for secondary long-term prophylaxis in VWD patients

4to. Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad. Memoria académica

Este volumen acoge la memoria académica de la Cuarta edición del Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad, CITIS 2017, desarrollado entre el 29 de noviembre y el 1 de diciembre de 2017 y organizado por la Universidad Politécnica Salesiana (UPS) en su sede de Guayaquil. El Congreso ofreció un espacio para la presentación, difusión e intercambio de importantes investigaciones nacionales e internacionales ante la comunidad universitaria que se dio cita en el encuentro. El uso de herramientas tecnológicas para la gestión de los trabajos de investigación como la plataforma Open Conference Systems y la web de presentación del Congreso http://citis.blog.ups.edu.ec/, hicieron de CITIS 2017 un verdadero referente entre los congresos que se desarrollaron en el país. La preocupación de nuestra Universidad, de presentar espacios que ayuden a generar nuevos y mejores cambios en la dimensión humana y social de nuestro entorno, hace que se persiga en cada edición del evento la presentación de trabajos con calidad creciente en cuanto a su producción científica. Quienes estuvimos al frente de la organización, dejamos plasmado en estas memorias académicas el intenso y prolífico trabajo de los días de realización del Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad al alcance de todos y todas

Time to Switch to Second-line Antiretroviral Therapy in Children With Human Immunodeficiency Virus in Europe and Thailand.

Background: Data on durability of first-line antiretroviral therapy (ART) in children with human immunodeficiency virus (HIV) are limited. We assessed time to switch to second-line therapy in 16 European countries and Thailand. Methods: Children aged <18 years initiating combination ART (≥2 nucleoside reverse transcriptase inhibitors [NRTIs] plus nonnucleoside reverse transcriptase inhibitor [NNRTI] or boosted protease inhibitor [PI]) were included. Switch to second-line was defined as (i) change across drug class (PI to NNRTI or vice versa) or within PI class plus change of ≥1 NRTI; (ii) change from single to dual PI; or (iii) addition of a new drug class. Cumulative incidence of switch was calculated with death and loss to follow-up as competing risks. Results: Of 3668 children included, median age at ART initiation was 6.1 (interquartile range (IQR), 1.7-10.5) years. Initial regimens were 32% PI based, 34% nevirapine (NVP) based, and 33% efavirenz based. Median duration of follow-up was 5.4 (IQR, 2.9-8.3) years. Cumulative incidence of switch at 5 years was 21% (95% confidence interval, 20%-23%), with significant regional variations. Median time to switch was 30 (IQR, 16-58) months; two-thirds of switches were related to treatment failure. In multivariable analysis, older age, severe immunosuppression and higher viral load (VL) at ART start, and NVP-based initial regimens were associated with increased risk of switch. Conclusions: One in 5 children switched to a second-line regimen by 5 years of ART, with two-thirds failure related. Advanced HIV, older age, and NVP-based regimens were associated with increased risk of switch

Lack of a Synergistic Effect on Cardiometabolic and Redox Markers in a Dietary Supplementation with Anthocyanins and Xanthophylls in Postmenopausal Women

Fruits and vegetables are pivotal for a healthy diet due partly to their content in bioactive compounds. It is for this reason that we conducted a parallel study to unravel the possible effect on cardiometabolic parameters of the ingestion of anthocyanins, xanthophylls, or both groups of bioactives together in postmenopausal women. Seventy-two postmenopausal women were randomized into an 8-month parallel study: a group consuming 60 mg/day anthocyanins (Group A), a group consuming 6 mg lutein and 2 mg zeaxanthin per day (Group X), and a third group consuming a combination of anthocyanins and xanthophylls in the same amounts (Group A+X). Non-targeted metabolomic analysis was done in plasma samples at baseline and after the 8-month intervention by HPLC-QTOF-MS. Inflammatory, antioxidant, and cardiometabolic parameters were measured at the beginning of the study and after 4 and 8-months intervention. Compared with baseline values, none of the 8-month treatments significantly (p < 0.05) changed systolic or diastolic blood pressure (BP), plasma C-reactive protein, interleukin 6, vascular cell adhesion molecule-1, intercellular adhesion molecule-1, monocyte chemoattractant protein-1 or matrix metalloproteinases 2 and 9. Only plasma glucose levels were significantly decreased by treatment A+X after 8 months, and the plasma metabolomic profile was clearly affected by all three dietary supplementations after 8 months. In parallel, there was an increase, also for the three groups, in the plasma ferric reducing antioxidant power value that did not show any synergistic effect between the two groups of bioactives. Postmenopausal women could benefit from an increase in anthocyanins and xanthophylls intake, through the consumption of fruits and vegetables rich in these two types of compounds. Accordingly, plasma glucose and, above all, the reducing power in plasma, could be improved

Impact of the International Nosocomial Infection Control Consortium's multidimensional approach on rates of ventilator-associated pneumonia in 14 intensive care units in 11 hospitals of 5 cities within Argentina

Background: To analyze the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional approach (IMA) on ventilator-associated pneumonia (VAP) rates in 11 hospitals within 5 cities of Argentina from January 2014-April 2017. Methods: A multicenter, prospective, before–after surveillance study was conducted through the use of International Nosocomial Infection Control Consortium Surveillance Online System. During baseline, we performed outcome surveillance of VAP applying the definitions of the Centers for Disease Control andPrevention's National Healthcare Safety Network. During intervention, we implemented the IMA, which included a bundle of infection prevention practice interventions, education, outcome surveillance, process surveillance, feedback on VAP rates and consequences, and performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed using a logistic regression model to estimate the effect of the intervention. Results: We recorded 3,940 patients admitted to 14 intensive care units. At baseline, there were 19.9 VAPs per 1,000 mechanical ventilator (MV)-days—with 2,920 MV-days and 58 VAPs, which was reduced during intervention to 9.4 VAPs per 1,000 MV-days—with 9,261 MV-days and 103 VAPs. This accounted for a 52% rate reduction (incidence density rate, 0.48; 95% confidence interval, 0.3-0.7; P.001). Conclusions: Implementing the IMA was associated with significant reductions in VAP rates in intensive care units within Argentina.Fil: Rosenthal, Victor Daniel. International Nosocomial Infection Control Consortium; ArgentinaFil: Desse, Javier. Sanatorio San Cayetano; ArgentinaFil: Maurizi, Diego Marcelo. Hospital Privado del Sur; Argentina. Hospital Municipal Doctor Leónidas Lucero; ArgentinaFil: Chaparro, Gustavo Jorge. No especifíca;Fil: Orellano, Pablo Wenceslao. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Tecnológica Nacional. Facultad Regional San Nicolás; ArgentinaFil: Chediack, Viviana. Policlínico Central Unión Obrera Metalúrgica; ArgentinaFil: Cabrera, Rafael. No especifíca;Fil: Golschmid, Daniel. Hospital Privado Raul Matera; ArgentinaFil: Silva, Cristina Graciela. No especifíca;Fil: Vimercati, Julio Cesar. No especifíca;Fil: Stagnaro, Juan Pablo. Instituto Central de Medicina; ArgentinaFil: Perez, Ivanna. Clínica San Cayetano; ArgentinaFil: Spadaro, María Laura. Hospital Privado Raul Matera; ArgentinaFil: Montanini, Adriana Miriam. Hospital Municipal Doctor Leónidas Lucero; ArgentinaFil: Pedersen, Dina. Hospital Municipal Doctor Leónidas Lucero; ArgentinaFil: Paniccia, Teresa Laura. Hospital Municipal Doctor Leónidas Lucero; ArgentinaFil: Ríos Aguilera, Ana María. Hospital Privado del Sur; ArgentinaFil: Cermesoni, Raul. Hospital Privado del Sur; ArgentinaFil: Mele, Juan Ignacio. Hospital Privado del Sur; ArgentinaFil: Alda, Ernesto. Hospital Privado del Sur; ArgentinaFil: Paldoro, Analía Edith. No especifíca;Fil: Ortta, Agustín Román. No especifíca;Fil: Cooke, Bettina. No especifíca;Fil: García, María Cecilia. No especifíca;Fil: Obed, Mora Nair. No especifíca;Fil: Domínguez, Cecilia Verónica. Policlínico Central Unión Obrera Metalúrgica; ArgentinaFil: Saúl, Pablo Alejandro. Policlínico Central Unión Obrera Metalúrgica; ArgentinaFil: Rodríguez del Valle, María Cecilia. Hospital Zonal General de Agudos Dr Ricardo Gutiérrez; ArgentinaFil: Bianchi, Alberto Claudio. Hospital Zonal General de Agudos Dr Ricardo Gutiérrez; ArgentinaFil: Alvarez, Gustavo. Instituto Central de Medicina; ArgentinaFil: Pérez, Ricardo. Instituto Central de Medicina; ArgentinaFil: Oyola, Carolina. No especifíca

MicroMundo: an approach to One Health by Service-Learning integrating diverse educational levels

MicroMundo es la adaptación a Aprendizaje-Servicio (ApS) de la estrategia de crowdsourcing y ciencia ciudadana internacional Tiny Earth. Su objetivo de servicio esencial es acercar la cultura científica, la perspectiva One Health y la investigación biomédica a la sociedad, poniendo el foco en jóvenes estudiantes para fomentar la vocación por formación en Grados STEM y por la investigación. La pandemia de COVID-19 y sus consecuencias han puesto de manifiesto la urgencia de acercar la cultura científica en el ámbito de la Biomedicina y la Salud Pública a la sociedad e implicar en esta tarea a nuestros estudiantes. Pero también la pandemia ha impuesto cambios en nuestro esquema de trabajo durante este curso, lo que nos ha obligado a trabajar on-line en lugar de llevar a cabo las características actividades experimentales de aprendizaje activo en las que se fundamenta el proyecto en condiciones normales. Manteniendo los mismos objetivos, las intervenciones en los 20 Colegios e Institutos en los que hemos realizado el proyecto se han enfocado en la elaboración de materiales divulgativos e intervenciones en la comunidad por parte de los jóvenes estudiantes, de manera coordinada por nuestros estudiantes universitarios y la organización de un Simposio on-line de ámbito nacional donde se expusieron y compartieron las diversas iniciativas. La elevada participación en el Simposio, de inscripción gratuita (más de 500 inscritos) y la calidad de las 69 ponencias propuestas, la mayoría de manera conjunta por alumnos de instituto y universitarios, avala el enorme éxito de la iniciativa virtual y la consecución de objetivos. El material generado (videojuegos, entornos educativos virtuales, paisajes de aprendizaje, escape rooms, videos, campañas en Instagram o Tik Tok, blogs, etc) será muy valioso como material de apoyo en sucesivas ediciones de MicroMundo. Todo este material se irá divulgando en el portal www.esmisionposible.com las redes sociales @EsMisionPosible, gestionados por el proyecto. En resumen, consideramos que nuestro proyecto que implica tanto a estudiantes y profesores de centros educativos de Educación Secundaria y Bachillerato en la CAM a, como a profesores y estudiantes universitarios de los ámbitos de Sanidad Humana, Animal y Medioambiental de manera transversal e interfacultativa, ha afrontado con éxito el reto de adaptar el proyecto a la situación epidemiológica, reforzándolo con actividades no presenciales orientadas a consolidar una comunidad MicroMundo virtual en la que los estudiantes pueden compartir sus experiencias en la divulgación del problema de la resistencia y el fomento de la investigación para el descubrimiento de nuevos antimicrobianos.Depto. de Genética, Fisiología y MicrobiologíaDepto. de Microbiología y ParasitologíaDepto. de Sanidad AnimalFac. de Ciencias BiológicasFac. de FarmaciaFac. de VeterinariaTRUEOficina Universitaria ApS UCMsubmitte

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care