Clinical effectiveness of convalescent plasma in hospitalized patients with COVID-19: a systematic review and meta-analysis

Aims: Given the variability of previously reported results, this systematic review aims to determine the clinical effectiveness of convalescent plasma employed in the treatment of hospitalized patients diagnosed with COVID-19. Methods: We conducted a systematic review of controlled clinical trials assessing treatment with convalescent plasma for hospitalized patients diagnosed with SARS-CoV-2 infection. The outcomes were mortality, clinical improvement, and ventilation requirement. Results: A total of 51 studies were retrieved from the databases. Five articles were finally included in the data extraction and qualitative and quantitative synthesis of results. The overall risk of bias in the reviewed articles was established at low-risk only in two trials. The meta-analysis suggests that there is no benefit of convalescent plasma compared with standard care or placebo in reducing the overall mortality and the ventilation requirement. However, there could be a benefit for the clinical improvement in patients treated with plasma. Conclusion: Current results led to assume that the convalescent plasma transfusion cannot reduce the mortality or ventilation requirement in hospitalized patients diagnosed with SARS-CoV-2 infection. More controlled clinical trials conducted with methodologies that ensure a low risk of bias are still needed. The reviews of this paper are available via the supplemental material section.Fil: Abeldaño Zuñiga, Roberto Ariel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de la Sierra Sur; MéxicoFil: González Villoria, Ruth Ana María. Universidad de la Sierra Sur; MéxicoFil: Elizondo, María Vanesa. Universidad Catolica de Cuyo. Facultad de Ciencias Medicas. Instituto de Investigacion En Ciencias Biomedicas.; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Osorio, Anel Yaneli Nicolás. Universidad de la Sierra Sur; MéxicoFil: Gómez Martínez, David. Universidad de la Sierra Sur; MéxicoFil: Coca, Silvia Mercedes. Universidad de la Sierra Sur; Méxic

Clasificación funcional del paciente anciano en hemodiálisis y su influencia en la individualización del tratamiento

Introducción: La edad de los pacientes en hemodiálisis está aumentando, presentando mayor deterioro. Objetivos: Conocer la situación del paciente ancia­no en hemodiálisis categorizando nuestra población. Ana­lizar la relación entre las escalas de funcio­nalidad, desnutrición y comorbilidad. Material y Método: Estudio descriptivo transversal, pacien­tes 75-95 años. Se midieron: a) Comorbilidad-CHARLSON: alta (>6 puntos). b) Nutrición-MISS: extremadamente des­nutrido (7-10 puntos); moderada-severa (>5-7 puntos); leve-moderada (>2-5 puntos); normonutrido (3 puntos). Resultados: 60 pacientes, 68%(41) hom­bres, edad media 81,85±5,58 años y tiempo HD 49,88±40,29 meses. Etiología más prevalente, diabe­tes mellitus (28%). MIS: 6,01±3,80 puntos. clasificándose 8(13%) normonu­tridos, 24(40%) desnutrición leve-moderada, 10(17%) desnutrición moderada-severa, 13(22%) desnutrición muy severa y 5(8%) extremadamente desnutridos. BARTHEL: 88,16±18,59 puntos, clasificó 32(53%) independientes, 6(10%) dependencia leve, 17(28%) dependencia modera­da, 4(7%) dependencia severa, 1(2%) dependencia total. FRAIL: 1,98±1,32 puntos, clasificó 10(17%) no frágiles, 31(51%) prefrágiles y 19(32%) frágiles. CHARLSON: 10,01±2,20 puntos. Presentando 60(100%) alta comorbilidad. CHARLSON presentó diferencias entre sexo, mayor en hombres (p=0,002). Se encontró alta correlación entre Barthel y Frail (r=0,647,p<0,001), moderada entre MIS y Barthel (r=0,556, p<0,001) y MIS y Frail (r=0,455,p<0,001). Charlson obtuvo peor correlación. Conclusiones: Se evidenció gran deterioro ge­neral del paciente añoso en diálisis, alertando sobre la nece­sidad de realizar tratamientos individualizados enfocados en su recuperación, incluida la propia diálisis

Mortality related to malnutrition and infectious diseases in children under than 5 years in Argentina in the period 2001-2013

El presente documento busca analizar las tendencias de mortalidad por desnutrición y por causas infecciosas en menores de cinco años durante el período 2001-2013 en la Argentina. Para ello se construyeron tasas de mortalidad por cada 100.000 recién nacidos en los menores de 1 año y por cada 100.000 niños en las edades de 1-4 años. Las tendencias se analizaron por modelos de regresión de Poisson. Los principales resultados muestran que las tasas de mortalidad en menores de 1 año y en niños de 1-4 años presentaron una tendencia descendente en los años analizados (p< 0,01), con excepción de la mortalidad por enfermedades infecciosas de origen respiratorio en el grupo de 1-4. La cobertura de seguro de salud del niño se comportó como factor protector para el riesgo de morir (p<0,01). El documento concluye que las tendencias de mortalidad descendieron entre los años 2001-2013, mientras que la cobertura de seguro de salud es un factor protector para esa mortalidad.This document seeks to analyze trends in mortality from malnutrition and infectious diseases in children under five years during the period 2001-2013 in Argentina, and to identify the association between health insurance coverage and the risk of dying from selected causes. To this end, mortality rates were built per 100,000 newborns in children under 1 year and per 100,000 children in aged 1-4 years. Trends were analyzed by Poisson regression models. The main results show that mortality rates in children under 1 year and children aged 1-4 years showed a downward trend in analyzed years (p<0.01), except for mortality from infectious diseases of respiratory origin in the group aged 1-4 years. The health insurance coverage of children behaved as a protective factor for the risk of death (p<0.01). The document concludes that mortality trends decreased between the years 2001-2013, while health insurance coverage is a protective factor for mortalityFil: Abeldaño Zuñiga, Roberto Ariel. Universidad de la Sierra Sur; MéxicoFil: Fanta Garrido, Javiera. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones "Gino Germani"; ArgentinaFil: González Villoria, Ruth Ana María. Universidad de la Sierra Sur; MéxicoFil: Castellanos Ospina, Oscar Augusto. Dirección de Censos y Demografía; ColombiaFil: Quiroga, Daniel Esteban. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Catamarca. Facultad de Cs.econom.y Administración. Instituto de Invest. Estadísticas y Demograficas; Argentina. Universidad Nacional de Catamarca. Facultad de Humanidades; Argentin

Inter-rater reliability assessment for the new-born screening quality assurance

IntroductionTo ensure the quality of the new-born screening (NBS), our laboratory reviewed the analytical procedure to detect subjective steps that may represent a risk to the patient. Two subjective activities were identified in the extra-analytical phases: the classification of dried blood spots (DBS) according to their quality and the assignment of haemoglobin patterns. To keep these activities under control, inter-rater studies were implemented. This study aimed to evaluate the inter-rater reliability and the effectiveness of the measures taken to improve the agreement between observers, to assure NBS results’ quality. Materials and methodsDried blood spots specimens were used for the inter-rater studies. Ten studies were performed to assess DBS quality classification, and four to assess the assignment of haemoglobin patterns. Krippendorff’s alpha test was used to estimate inter-rater reliability. Causes were investigated when alpha values were below 0.80. ResultsFor both activities, the reliability obtained in the first studies was inadequate. After investigation, we detected that the criterion to classify a DBS as scant was not consolidated, and also a lack of consensus on whether or not to report Bart’s haemoglobin depending on its percentage. Alpha estimates became higher once the training was reinforced and a consensus about the appropriate criteria to be applied was reached. ConclusionInter-rater reliability assessment helped us to ensure the quality of subjective activities that could add variability to NBS results. Furthermore, the evolution of the alpha value over time allowed us to verify the effectiveness of the measures adopted

Definición de un proceso de gestión de la innovación docente en la Universidad de Salamanca sobre la base de un sistema integral de gestión del conocimiento

Memoria ID-0045. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2015-2016

Antitumor Necrosis Factor Agents to Treat EndoscopicPostoperative Recurrence of Crohn’s Disease: A Nationwide Study With Propensity-Matched Score Analysis

INTRODUCTION:Patients with Crohn's disease experiencing endoscopic postoperative recurrence (POR) may benefit from antitumor necrosis factor (TNF) agents but scarce data on this are available. Our aim was to assess the efficacy of anti-TNF in improving mucosal lesions in patients with endoscopic POR.METHODS:Multicenter, retrospective, study of patients with Crohn's disease who underwent therapy with anti-TNF agents for endoscopic POR (Rutgeerts score > i1). Treatment outcomes were assessed by the findings in the last ileocolonoscopy performed after anti-TNF therapy was initiated. Endoscopic improvement and remission were defined as any reduction in the baseline Rutgeerts score and by a Rutgeerts score < i2, respectively.RESULTS:A total of 179 patients were included, 83 were treated with infliximab and 96 with adalimumab. Median time on anti-TNF therapy at the last endoscopic assessment was 31 months (interquartile range, 13-54). Endoscopic improvement was observed in 61%, including 42% who achieved endoscopic remission. Concomitant use of thiopurines and treatment with infliximab were associated with endoscopic improvement (odds ratio [OR] 2.15, 95% confidence interval [CI] 1.04-4.46; P = 0.03, and OR 2.34, 95% CI 1.18-4.62; P < 0.01, respectively) and endoscopic remission (OR 3.16, 95% CI 1.65-6.05; P < 0.01, and OR 2.01, 95% CI 1.05-3.88; P = 0.04, respectively) in the multivariable logistic regression analysis. These results were confirmed in a propensity-matched score analysis.DISCUSSION:In patients with endoscopic POR, anti-TNF agents improve mucosal lesions in almost two-thirds of the patients. In this setting, concomitant use of thiopurines and use of infliximab seem to be more effective in improving mucosal lesions.Fiorella Canete received a research grant from the Societat Catalana de Digestologia

Implantación de un sistema integral de gestión del conocimiento para los procesos de innovación docente de la Universidad de Salamanca

Memoria ID-0312. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2014-2015

Implantación de un sistema integral de gestión del conocimiento para los procesos de innovación docente de la Universidad de Salamanca

Memoria ID-0312. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2014-2015

CIBERER : Spanish national network for research on rare diseases: A highly productive collaborative initiative

Altres ajuts: Instituto de Salud Carlos III (ISCIII); Ministerio de Ciencia e Innovación.CIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research