Análisis de alteraciones murarias y modificaciones relacionales en dos áreas del palacio de Pedro I del Alcázar de Sevilla mediante estudio documental y verificación termográfica

The Palace of Peter I, inside the Alcazar of Seville, is an element of great importance in Seville urbanism. This piece of research aims at throwing light on the interventions carried out in the entry halls of the Palace as well as in the Dames’ Courtyard, in order to facilitate a better understanding of how these alterations influenced the complex articulation of the different spaces on the ground floor of the Palace during the 19th century. A study of historical sources, both graphic and written, have been undertaken in order to compare the results with those typical of experimental sciences such as infrared thermography. Data about the openings carried out in the walls and their dimensions as well as the rationale behind those alterations have been identified. These alterations could be related to the wish to improve circulation and lighting, and also to conceptual mistakes as to how the original distribution of the Palace was when built in the 14th century.El palacio de Pedro I, dentro del Real Alcázar de Sevilla, es un elemento de gran importancia en el urbanismo sevillano. Se dirige esta investigación a esclarecer las intervenciones llevadas a cabo en los vestíbulos de entrada al palacio y en la zona este del Patio de las Doncellas, de forma que se pueda comprender cómo influyeron estos cambios en la compleja articulación de los espacios de la planta baja del palacio en el siglo XIX. Se ha realizado un estudio de las fuentes históricas, tanto gráficas como escritas, para comparar resultados con estudios propios de las ciencias experimentales como la termografía infrarroja. Se han obtenido datos sobre las aperturas realizadas en los paramentos y sus dimensiones, junto con las motivaciones para su ejecución que se relacionan con una mejor circulación e iluminación y con conceptos erróneos sobre la distribución inicial del palacio en su construcción en el siglo XIV

Fournier’s Gangrene under Sodium–Glucose Cotransporter-2 Inhibitors Therapy in Gynecological Patients

La gangrena de Fournier (GF) es una patología grave de los tejidos blandos y fascia del perineo y región genital con una alta morbimortalidad. En los últimos años, el antidiabético oral inhibidor de SGLT-2 se ha relacionado con esta entidad. Según las nuevas advertencias de las principales agencias de drogas, se ha iniciado una recopilación de casos para establecer o negar una posible relación causal. La mayoría de estos casos han sido reportados en hombres. Sin embargo, es importante no subestimar esta entidad en el campo ginecológico, ya que es de extrema gravedad y requiere un tratamiento agresivo intenso y rápido basado en cirugía y antibioterapia empírica. Posteriormente son necesarios algunos cuidados que implican la reconstrucción quirúrgica de los defectos introducidos por el desbridamiento. Como resultado de la baja incidencia de FG, los datos de los ensayos clínicos pueden ser insuficientes para evaluar de manera sólida este problema debido al número limitado de participantes. La evidencia del mundo real puede ayudar a aclarar la asociación entre SGLT2i y FG. El objetivo de esta revisión es describir y comparar los casos informados de FG en mujeres diabéticas que recibieron inhibidores de SGLT2 como agentes antiglucemiantesThis research received no external funding. Partial funding for open access charge: Universidad de Málag

Avaluació del Programa Audiència Pública de nois i noies de Barcelona : informe

Sol·licitant de l’informe: Institut Municipal d'Educació (Barcelona)Podeu consultar la versió resum de l'Informe d'avaluació del Programa Audiència Pública de Nois i Noies de Barcelona a: http://hdl.handle.net/11703/10606

Antimicrobial Defined Daily Dose in Neonatal Population: Validation in the Clinical Practice

Paediatric Antimicrobial Defined Daily Dose Study Group KiDDDs.Currently, there is no validated method for estimating antimicrobial consumption in the neonatal population, as it exists for adults using Defined Daily Doses (DDD). In neonatology, although there are different methods, each one with advantages and disadvantages, there is no unified criterion for use. The aim of this study is to validate the neonatal DDD designed as a new standardised form of antimicrobial consumption over this population.M.M.-T. received financial support from the Subprograma Río Hortega, Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Ciencia, Innovación y Universidades, Spain (CM21/00115). The project has been carried out without financial funding but is supported by the Spanish Society of Hospital Pharmacy (SEFH), the Working Group on Pharmaceutical Care in Infectious Diseases of the SEFH (Afinf) and Spanish working group on paediatric pharmacy of the SEFH (gefp).Peer reviewe

Rúbrica elaborada per avaluar la Competència “Pensament Reflexiu” (PR)

Projecte: 2016PID-UB/028[cat] El projecte en el qual s’emmarca aquest instrument respon a una comunitat de pràctica com a base del treball cooperatiu, el desenvolupament professional interdisciplinari i la millora de la pràctica docent a partir d’una xarxa entre els membres integrants procedents de cinc universitats (UB, UAB, UCLM, UBU i UVEG- La Florida Universitaria). Fruit d’aquest treball, es va aprofundir en el marc teòric sobre les activitats d’ensenyament i d’aprenentatge reflexiu a la Universitat a través de les metodologies narratives. Això va permetre l’elaboració de dispositius per facilitar el pensament reflexiu sobre el procés de construcció del coneixement, l’aprenentatge realitzat i el desenvolupament competencial per part de l’alumnat en el marc de les diferents assignatures implicades en el projecte. Paral.lelament, va permetre el disseny d’un sistema d’avaluació formativa coherent amb les tasques d’aprenentatge proposades, en forma de rúbriques. La proposta de la definició de pensament reflexiu com a competència comuna, així com de les dimensions i els indicadors amb els corresponents nivells de domini és el que es presenta en el present document.[spa] El proyecto en el cual se enmarca este instrumento responde a una comunidad de práctica como base del trabajo cooperativo, el desarrollo profesional interdisciplinario y la mejora de la práctica docente a partir de una red entre los miembros integrantes procedentes de cinco universidades (UB, UAB, UCLM, UBU y UVEG- La Florida Universitaria). Fruto de este trabajo, se profundizó en el marco teórico sobre las actividades de enseñanza y de aprendizaje reflexivo en la Universidad a través de las metodologías narrativas. Esto permitió la elaboración de dispositivos para facilitar el pensamiento reflexivo sobre el proceso de construcción del conocimiento, el aprendizaje realizado y el desarrollo competencial por parte del alumnado en el marco de las diferentes asignaturas implicadas en el proyecto. Paralelamente, permitió el diseño de un sistema de evaluación formativa coherente con las tareas de aprendizaje propuestas, en forma de rúbricas. La propuesta de la definición de pensamiento reflexivo como competencia común, así como de las dimensiones y los indicadores con los correspondientes niveles de dominio se presenta a continuación.Recurs elaborat en el marc del projecte concedit a la convocatòria de Projecte d’innovació docent del Programa de Millora i Innovació Docent, “El pensament reflexiu i el desenvolupament competencial a l'educació superior” (2016PID-UB/028)

Fruit and Vegetable Consumption is Inversely Associated with Plasma Saturated Fatty Acids at Baseline in Predimed Plus Trial

I.D.-L. is supported by the [FI_B 00256] from the FI-AGAUR Research Fellowship Program, Generalitat de Catalunya and M.M.-M is supported by the FPU17/00513 grant. a.-H. is supported by the [CD17/00122] grant and S.K.N. is supported by a Canadian Institutes of Health Research (CIHR) Fellowship. We also thank all the volunteers for their participation in and the personnel for their contribution to the PREDIMED-Plus trial. This research was funded by CiCYT [AGL2016-75329-R] and CIBEROBN from the Instituto de Salud Carlos III, ISCIII from the Ministerio de Ciencia, Innovacion y Universidades, (AEI/FEDER, UE), Generalitat de Catalunya (GC) [2017SGR196]. The PREDIMED-Plus trial was supported by the official Spanish Institutions for funding scientific biomedical research, CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and Instituto de Salud Carlos III (ISCIII), through the Fondo de Investigacion para la Salud (FIS), which is co-funded by the European Regional Development Fund (four coordinated Fondo de Investigaciones Sanitarias projects lead by J.S.-S. and J.V., including the following projects: PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI14/00972, PI14/00728, PI14/01471, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732, PI17/00926 and PI19/00781), the Especial Action Project entitled Implementacion y evaluacion de una intervencion intensiva sobre la actividad fisica Cohorte PREDIMED-Plus grant to J.S.-S., European Research Council (Advanced Research Grant 2014-2019, 340918) to M.a.M.-G., the Recercaixa grant to J.S.-S. (2013ACUP00194), grants from the Consejeria de Salud de la Junta de Andalucia (PI0458/2013, PS0358/2016, and PI0137/2018), a grant from the Generalitat Valenciana (PROMETEO/2017/017), a SEMERGEN grant, Fundacio la Marato de TV3 (PI044003), 2017 SGR 1717 from Generalitat de Catalunya, a CICYT grant provided by the Ministerio de Ciencia, Innovacion y Universidades (AGL2016-75329-R), and funds from the European Regional Development Fund (CB06/03 and CB12/03). Food companies Hojiblanca (Lucena, Spain) and Patrimonio Comunal Olivarero (Madrid, Spain) donated extra virgin olive oil, and the Almond Board of California (Modesto, CA, USA), American Pistachio Growers (Fresno, CA, USA), and Paramount Farms (Wonderful Company, LLC, Los Angeles, CA, USA) donated nuts. J.K. was supported by the "FOLIUM" program within the FUTURMed project entitled Talent for the medicine within the future from the Fundacio Institut d'Investigacio Sanitaria Illes Balears. This call was co-financed at 50% with charge to the Operational Program FSE 2014-2020 of the Balearic Islands. This work is partially supported by ICREA under the ICREA Academia programme to J.S.-S.Scope: Plasma fatty acids (FAs) are associated with the development of cardiovascular diseases and metabolic syndrome. The aim of our study is to assess the relationship between fruit and vegetable (F&V) consumption and plasma FAs and their subtypes. Methods and Results: Plasma FAs are assessed in a cross-sectional analysis of a subsample of 240 subjects from the PREDIMED-Plus study. Participants are categorized into four groups of fruit, vegetable, and fat intake according to the food frequency questionnaire. Plasma FA analysis is performed using gas chromatography. Associations between FAs and F&V consumption are adjusted for age, sex, physical activity, bodymass index (BMI), total energy intake, and alcohol consumption. Plasma saturated FAs are lower in groups with high F&V consumption (-1.20 mg cL−1 [95% CI: [-2.22, - 0.18], p-value = 0.021), especially when fat intake is high (-1.74 mg cL−1 [95% CI: [-3.41, -0.06], p-value = 0.042). Total FAs and n-6 polyunsaturated FAs tend to be lower in high consumers of F&V only in the high-fat intake groups. Conclusions: F&V consumption is associated with lower plasma saturated FAs when fat intake is high. These findings suggest that F&V consumption may have different associations with plasma FAs depending on their subtype and on the extent of fat intake.Generalitat de Catalunya FI_B 00256Canadian Institutes of Health Research (CIHR)Consejo Interinstitucional de Ciencia y Tecnologia (CICYT)European Commission AGL2016-75329-RCIBEROBN from the Instituto de Salud Carlos III ISCIII from the Ministerio de Ciencia, Innovacion y Universidades, (AEI/FEDER, UE)Generalitat de Catalunya 2017SGR196CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn)Instituto de Salud Carlos III (ISCIII), through the Fondo de Investigacion para la Salud (FIS)European Commission PI13/00673 PI13/00492 PI13/00272 PI13/01123 PI13/00462 PI13/00233 PI13/02184 PI13/00728 PI13/01090 PI13/01056 PI14/01722 PI14/00636 PI14/00618 PI14/00696 PI14/01206 PI14/01919 PI14/00853 PI14/01374Especial Action Project entitled Implementacion y evaluacion de una intervencion intensiva sobre la actividad fisica Cohorte PREDIMED-Plus grantEuropean Research Council (ERC) European Commission 340918Recercaixa grant 2013ACUP00194Junta de Andalucia PI0458/2013 PS0358/2016 PI0137/2018Generalitat Valenciana European Commission PROMETEO/2017/017SEMERGEN grant, Fundacio la Marato de TV3 PI044003Generalitat de Catalunya 2017 SGR 1717Ministerio de Ciencia, Innovacion y Universidades AGL2016-75329-R"FOLIUM" program within the FUTURMed project within Fundacio Institut d'Investigacio Sanitaria Illes BalearsICREA under the ICREA Academia programmeThe European Regional Development Fund PI17/01347 PI17/00525 PI17/01827 PI17/00532 PI17/00215 PI17/01441 PI17/00508 PI17/01732 PI17/00926 PI19/00781 CB06/03 CB12/03European Commission PI14/00972 PI14/00728 PI14/01471 PI16/00473 PI16/00662 PI16/01873 PI16/01094 PI16/00501 PI16/00533 PI16/00381 PI16/00366 PI16/01522 PI16/01120 PI17/00764 PI17/01183 PI17/00855 FPU17/00513 CD17/0012

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

One-year changes in fruit and vegetable variety intake and cardiometabolic risk factors changes in a middle-aged Mediterranean population at high cardiovascular risk

Background and aims Previous studies have shown beneficial associations between fruit and vegetable (FV) consumption and cardiometabolic risk factors. However, variety in FV, which may play an important role on cardiovascular health due to the different nutrient and phytochemical content among the different groups and subgroups of FV has been poorly investigated. We longitudinally investigated associations between 1-year changes in variety and quantity of FV and concurrent changes in cardiometabolic risk factors in elderly subjects with overweight/obesity and metabolic syndrome. Methods a one-year data longitudinal analysis of 6647 PREDIMED-plus study participants (48% women) was conducted. Data were collected at baseline, six months and 1-year of follow-up. Variety and quantity of FV were estimated using a food frequency questionnaire and continuous scores for variety were created based on items/month of FV. Linear mixed-models adjusted for potential confounders were performed to estimate associations (β-coefficients and 95% confidence interval) between 1-year changes in FV variety and/or quantity and concurrent changes in cardiometabolic risk factors. Results Two points increment in the FV variety score over one year was associated with a concurrent decrease in glucose (−0.33 mg/dL (0.58, −0.07)), body weight (−0.07 kg (−0.13, −0.02)) and waist circumference (WC) (−0.08 cm (−0.16, −10.01)). An increment of 100 g/d of FV over one year was associated with a concurrent decrease in triglycerides (−0.50 mg/dL (−0.93, −0.08)), glucose (−0.21 mg/dL (−0.32, −0.11)), body weight (−0.11 kg (−0.15, −0.07)) and WC (−0.10 cm (−0.14, −0.06)) over 1-year. Changes in FV consumption which led to higher quantity and variety over one year were associated with downward changes in glucose (−1.26 mg/dL (−2.09, −0.43)), body weight (−0.40 kg (−0.58, −0.23)) and WC (−0.50 cm (−0.73, −0.28)). Conclusion Greater variety, in combination with higher quantity of FV was significantly associated with a decrease in several cardiometabolic risk factors among elderly subjects at high cardiovascular risk

Advanced Ovarian Cancer during Pregnancy. Tumour Evolution Analysis and Treatment Approach

Background: The possible presence of malignant adnexal mass should be considered during pregnancy. For this reason, it is important to keep in mind such possibility while performing routine obstetric ultrasounds to diagnose asymptomatic ovarian cancer in the early stages. Case presentation: 27-year-old pregnant patient with a known adnexal tumour occurring at week 20 and enlarged supraclavicular lymph nodes of 3 cm size who was diagnosed with metastases from low-grade papillary serous ovarian carcinoma. The patient, obstetricians, neonatologists and oncologists agreed on initiating neoadjuvant chemotherapy and performing an elective C-section at week 34. She gave birth to a female infant weighing 2040 g who is currently in good health, and continues receiving follow-up care by a medical oncologist. Conclusions. An early diagnosis of gynaecologic malignancies during pregnancy is of critical importance because, although they are very rare, managing and treating carcinomas at an early stage allow us to increase maternal and fetal well-being and to offer more alternatives to our patients