Combining different bacteria in vaccine formulations enhances the chance for antiviral cross-reactive immunity: a detailed in silico analysis for influenza A virus

Bacteria are well known to provide heterologous immunity against viral infections through various mechanisms including the induction of innate trained immunity and adaptive cross-reactive immunity. Cross-reactive immunity from bacteria to viruses is responsible for long-term protection and yet its role has been downplayed due the difficulty of determining antigen-specific responses. Here, we carried out a systematic evaluation of the potential cross-reactive immunity from selected bacteria known to induce heterologous immunity against various viruses causing recurrent respiratory infections. The bacteria selected in this work were Bacillus Calmette Guerin and those included in the poly-bacterial preparation MV130: Streptococcus pneumoniae, Staphylococcus aureus, Staphylococcus epidermidis, Klebisella pneumoniae, Branhamella catarrhalis and Haemophilus influenzae. The virus included influenza A and B viruses, human rhinovirus A, B and C, respiratory syncytial virus A and B and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Through BLAST searches, we first identified the shared peptidome space (identity ≥ 80%, in at least 8 residues) between bacteria and viruses, and subsequently predicted T and B cell epitopes within shared peptides. Interestingly, the potential epitope spaces shared between bacteria in MV130 and viruses are non-overlapping. Hence, combining diverse bacteria can enhance cross-reactive immunity. We next analyzed in detail the cross-reactive T and B cell epitopes between MV130 and influenza A virus. We found that MV130 contains numerous cross-reactive T cell epitopes with high population protection coverage and potentially neutralizing B cell epitopes recognizing hemagglutinin and matrix protein 2. These results contribute to explain the immune enhancing properties of MV130 observed in the clinic against respiratory viral infections

Economic appraisal of the impact of the ban on the use of lead in gasoline on the intellectual quotient of 7-8 years old in the Community of Madrid

Fundamentos: la evaluación económica de las repercusiones sanitarias de las políticas públicas es difícil y escasa. El objetivo del presente estudio fue cuantificar monetariamente los beneficios de la reducción del plomo en la sangre de los niños de 7-8 años en la Comunidad de Madrid (España), derivada de la prohibición del plomo en las gasolinas. Métodos: se calculó la disminución de puntos de cociente intelectual (CI), utilizando dos estudios realizados en niños de 7 a 8 años según los valores de plomo en sangre que presentaban: media geométrica de 3,8 μg/dL en 1995 y 0,9 μg/dL en 2010. La mejoría neta de CI se midió en términos de capacidad de producción ganada a lo largo de la vida laboral, siguiendo los métodos de Schwartz y Salkiver. Resultados: la reducción de los niveles de plomo en sangre de estos niños evitó perder entre 135.391 y 144.153 puntos de CI. La valoración económica actual de estos puntos en términos de capacidad de producción ganada a lo largo de la vida laboral de estos sujetos se estimó en un rango entre 626,4 y 865,4 millones de euros (valor 2009). Conclusiones: las cifras de beneficios económicos encontradas derivadas de la medida de prohibición de uso de plomo en las gasolinas son importantes en términos sociales.Background: the repercussions on health of public policies are hard to assess from an economic point of view, which is why this is rarely done. The purpose of this study was to financially quantify the benefits of reducing blood lead levels in children aged 7-8 years in the Community of Madrid (Spain) as a result of the ban on the use of lead in gasoline. Methods: the decrease the intellectual quotient (IQ) points was calculated through two studies on children aged 7-8 years according to their blood lead levels. A geometric mean of 3.8 μg/dl was obtained in the 1995 study and of 0.9 μg/dl in the 2010 study. The net increase in IQ was measured in terms of productivity gained throughout the working life as per the methods of Schwartz and Salkever. Results: the decrease in blood lead levels in these children prevented a loss of between 135,391 and 144,153 IQ points; the current economic valuation of these points in terms of the productivity gained throughout the working life of this cohort of children was estimated to fall within the €626.4m- €865.4m range (2009). Conclusions: the figures of the economic benefits derived from the decision to ban leaded gasoline are very high

Adaptación de la asignatura Alimentación y Nutrición pediátrica al espacio Virtual

En este proyecto se pretende adaptar los contenidos existentes y crear contenidos nuevos para un entorno virtual, crear presentaciones PowerPoint con locución y vídeo y crear una autoevaluación aplicable a través del Campus Virtual

Fatores de risco associados aos níveis de chumbo no sangue das crianças da Comunidade de Madrid em 2010

Introduction: Lead is a toxic element for humans, with children being the most vulnerable population.Objective: To find out the risk factors associated to the existing blood lead levels (BLLs) of children in the Community of Madrid, after 9 years of lead being banned in gasoline.Methods: A cross-sectional study was carried out in 2010 with a sample of 85 children, less than 15 years of age, recruited via the outpatients’ service of the Pediatrics Department of the Hospital Clínico San Carlos in Madrid. Routine blood tests provided the opportunity for determining other blood parameters. Lead levels were measured using electrothermal-atomization atomic absorption spectrometry with the Zeeman-effect background correction. In addition, a survey was undertaken directed to the parents for gathering information about a series of socioeconomic and environmental variables.Results: The arithmetic mean of the BLLs in the children was 1.1 μg/dL (SD=0.7 μg/dL) with a range from 0.1 μg/dL to 3.4 μg/dL. The geometric mean was 0.9 μg/dL (SD= 1.1 μg/dL). The risk factors associated to these BLLs are the following: playing in the street; low educational level of the parents; leisure activities of one of the parents linked to lead; tobacco smoking of the father; and drinking tap water.Conclusions: The BLLs of the children in the Community of Madrid have decreased, but there are still sociodemographic and environmental risk factors associated to the present levels.Introducción: El plomo es un elemento tóxico para el hombre, siendo los niños la población más vulnerable.Objetivo: Conocer los factores de riesgo asociados a los niveles de plomo en sangre existente en niños de la Comunidad de Madrid tras 9 años de prohibición del plomo en las gasolinas. Métodos: Estudio transversal realizado en el año 2010 en el que se incluyeron 85 niños de ambos sexos, menores de 15 años reclutados en consulta ambulatoria del Servicio de Pediatría del Hospital Clínico San Carlos de Madrid. Se aprovechó la extracción de sangre para la determinación de otros parámetros sanguíneos. El plomo se midió por espectrometría de absorción atómica con atomización electrotérmica y corrección de fondo por efecto Zeeman. Además se pasó una encuesta a los padres recogiéndose toda una serie de variables socioeconómicas y ambientales.Resultados: La media aritmética de plomo en sangre encontrada en los niños ha sido de 1,1 μg/dL (DE=0,7 μg/dL) con un rango desde 0,1 μg/dL hasta 3,4 μg/dL. La media geométrica es de 0,9 μg/dL (DE= 1,1 μg/dL). Los factores de riesgo asociados a estos niveles son: jugar en la calle, bajo nivel de estudios del padre como de la madre, las aficiones ligadas al plomo de alguno de los padres, el consumo de tabaco del padre y beber agua del grifo.Conclusiones: Los niveles de plomo en la sangre de los niños de la Comunidad de Madrid se han reducido pero siguen existiendo factores de riesgo sociodemográficos ya ambientales asociados a estos niveles.  Introdução: O chumbo é um elemento tóxico para os seres humanos, sendo as crianças as mais vulneráveis.Objetivo: Conhecer os fatores de risco associados aos níveis de chumbo existentes no sangue das crianças da comunidade de Madrid, após 9 anos de proibição de chumbo na gasolina.Métodos: Estudo transversal realizado em 2010 que incluiu 85 crianças de ambos os sexos, com menos de 15 anos, selecionadas na consulta externa do Serviço de Pediatria do Hospital Clínico San Carlos em Madrid. Para a deteção dos níveis de chumbo foram aproveitadas amostras de sangue destinadas à determinação de outros parâmetros. O chumbo foi medido por espectrometria de absorção atómica com atomização eletrotérmica e correção de fundo por efeito Zeeman. Conjuntamente, realizou-se um questionário aos pais para recolher uma série de variáveis socioeconómicas e ambientais.Resultados: A média aritmética de chumbo no sangue encontrado nas crianças foi de 1,1 μg/dl (SD=0,7 μg/dl), com um intervalo de 0,1 μg/dl a 3,4 μg/dl. A média geométrica é de 0,9 μg/dl (SD=1,1 μg/dl). Os fatores de risco associados aos níveis apresentados são: o brincar na rua, o baixo nível de escolaridade dos pais, as atividades de lazer de um dos pais relacionadas com o chumbo, os hábitos tabágicos do pai e o consumo de água da rede pública.Conclusões: Os níveis de chumbo no sangue das crianças da Comunidade de Madrid reduziram, contudo subsistem fatores de risco sociodemográficos e ambientais associados a estes níveis

Hospital emergency room diagnosis of acute appendicitis in patients aged 2 to 20 years: the INFURG-SEMES score from the emergency infections study of the Spanish Society of Emergency Medicine

Objetivo. Derivar una escala clínico-analítica diagnóstica de apendicitis aguda (AA) en pacientes entre 2 y 20 años atendidos por dolor abdominal con sospecha de AA en servicios de urgencias hospitalarios (SUH), y comparar su capacidad diagnóstica con la Escala de Alvarado (EA). Métodos. Estudio observacional de cohorte prospectivo que incluyó de forma consecutiva pacientes entre 2 y 20 años con dolor abdominal sospechoso de AA de menos de 72 horas de evolución atendidos en 4 SUH españoles entre junio y diciembre de 2014. Se recogieron datos demográficos, clínicos, analíticos (recuento leucocitario, fórmula y proteína C reactiva) y radiológicos (ecografía y/o TC) y, si procedía, quirúrgicos. La variable resultado principal fue el diagnóstico final de AA en los 14 días desde la visita índice. Resultados. Se incluyeron 331 pacientes con edad media de 11,8 (DE 3,8) años, siendo 175 (52,9%) hombres. Ciento dieciséis (35,0%) tuvieron diagnóstico final de AA. La escala INFURG-SEMES incluye sexo masculino, dolor en fosa ilíaca derecha a la exploración, dolor a la percusión, dolor al caminar, presencia de neutrofilia y proteína C reactiva elevada. El área bajo la curva (ABC) de la característica operativa del receptor (COR) de dicha escala fue 0,84 (IC 95% 0,79-0,88) y para la EA 0,77 (IC95% 0,72-0,82) siendo la diferencia estadísticamente significativa (p = 0,002). Conclusiones. La escala INFURG-SEMES podría ser una herramienta de ayuda para el diagnóstico de AA en los pacientes entre 2 y 20 años atendidos con dolor abdominal sospechoso de apendicitis en los SUH, y ha mostrado una mayor capacidad discriminativa que la EA

Predictors of Response to Exclusive Enteral Nutrition in Newly Diagnosed Crohn´s Disease in Children: PRESENCE Study from SEGHNP

Exclusive enteral nutrition (EEN) has been shown to be more effective than corticosteroids in achieving mucosal healing in children with Crohn´s disease (CD) without the adverse effects of these drugs. The aims of this study were to determine the efficacy of EEN in terms of inducing clinical remission in children newly diagnosed with CD, to describe the predictive factors of response to EEN and the need for treatment with biological agents during the first 12 months of the disease. We conducted an observational retrospective multicentre study that included paediatric patients newly diagnosed with CD between 2014–2016 who underwent EEN. Two hundred and twenty-two patients (140 males) from 35 paediatric centres were included, with a mean age at diagnosis of 11.6 ± 2.5 years. The median EEN duration was 8 weeks (IQR 6.6–8.5), and 184 of the patients (83%) achieved clinical remission (weighted paediatric Crohn’s Disease activity index [wPCDAI] 15 mg/L and ileal involvement tended to respond better to EEN. EEN administered for 6–8 weeks is effective for inducing clinical remission. Due to the high response rate in our series, EEN should be used as the first-line therapy in luminal paediatric Crohn’s disease regardless of the location of disease and disease activityS

Oropharyngeal dysphagia, an underestimated disorder in pediatrics

Oropharyngeal dysphagia is a rather frequent clinical entity in patients with neurological problems that can lead to serious complications such as aspiration pneumonia and other disorders like dehydration or malnutrition due to feeding difficulties. It should be suspected in children with splitting of food intake or prolonged feeding, coughing or choking during feeding, continuous drooling or repeated respiratory symptoms. For the diagnosis, apart from the examination of swallowing, additional tests can be run like the water-swallowing test, the viscosity-volume test (which determines what kind of texture and how much volume the patient is able to tolerate), a fiberoptic endoscopy of swallowing or a videofluoroscopic swallow study, which is the gold standard for the study of swallowing disorders. It requires a multidisciplinary approach to guarantee an adequate intake of fluids and nutrients with minimal risk of aspiration. If these two conditions cannot be met, a gastrostomy feeding may be necessary

Relationship between serum selenium, sociodemographic variables, other trace elements and lipid profile in an adult Spanish population

Depto. de MedicinaFac. de Trabajo SocialTRUEpu

Medición de la efectividad de las presentaciones en las clases magistrales y en las exposiciones de trabajos avanzados de estudiantes

Valoración de las presentaciones realizadas con funciones avanzadas de PowerPoint, tanto por los profesores para impartir sus clases en los estudios de Grado y Máster, como por los estudiantes con trabajos de asignaturas como exposiciones previas a sus Trabajos Fin de Máster (TFM) y Tesis DoctoralesDepto. de Salud Pública y Materno - InfantilDepto. de Estadística y Ciencia de los DatosFac. de MedicinaFac. de Estudios EstadísticosFALSEsubmitte