ESTUDIO DESCRIPTIVO DE LA RESISTENCIA A ANTIBIÓTICOS Y POLÍTICAS PALIATIVAS

En la actualidad el desarrollo de resistencias a antibióticos se considera uno de los problemas más graves en sanidad a nivel mundial. Las causas que favorecen la diseminación de la resistencia a antibióticos son diversas, entre las que destacan el uso inapropiado de los antibióticos y un control deficiente de las infecciones bacterianas (1). La consecuencia de estas resistencias provoca la ineficacia de los tratamientos farmacológicos. Esta situación no sólo compromete la salud humana y animal, sino también el medio ambiente y la economía. El descubrimiento de la penicilina (2) supuso una revolución sanitaria, ya que las infecciones eran la principal causa de mortalidad. Tras la fabricación de antibióticos a nivel industrial dio comiendo el uso descontrolado de estos fármacos. Ante la gravedad de la situación, la Unión Europea insta a los estados miembros a tomar medidas para frenar el desarrollo de las resistencias. En respuesta a esa instancia, en el año 2012 comienza en España una línea de trabajo coordinada por la Agencia Española de Medicamentos y Productos Sanitarios y se desarrolla el Plan Nacional frente a la Resistencia a los Antibióticos (PRAN). El objetivo de estas estrategias es reducir el riesgo de propagación de las resistencias a los antibióticos mediante: formación a profesionales sanitarios y estudiantes, concienciar a los ciudadanos de la gravedad del mal uso de los tratamientos antibióticos e investigación de futuros antibióticos. En este trabajo se ha realizado una búsqueda bibliográfica en fuentes electrónicas de acceso público, con la finalidad de conocer la dimensión actual de la amenaza que suponen las resistencias a los antibióticos y las medidas adoptadas en el marco sanitario, político y social, para prevenir la inefectividad de los antibióticos en el futuro

Hereditary angioedema due to C1 inhibitor deficiency: real-world experience from the Icatibant Outcome Survey in Spain

Bradykinin; Hereditary angioedema; IcatibantBradicinina; Angioedema hereditario; IcatibantBradicinina; Angioedema hereditari; IcatibantBackground The Icatibant Outcome Survey (IOS) is an international registry monitoring the use of icatibant, a bradykinin B2 receptor antagonist indicated for the acute treatment of hereditary angioedema (HAE) attacks. Our goal was to assess disease characteristics and icatibant treatment outcomes in patients with HAE due to C1 inhibitor deficiency (HAE type 1 or 2 (HAE-1/2)) from Spain relative to other countries participating in IOS. Methods Descriptive retrospective analyses of data are reported from 10 centers in Spain vs 51 centers in 12 other participating countries (July 2009 to January 2019). Results No meaningful differences were identified between patients in Spain (n = 119) and patients across other countries (n = 907) regarding median age at symptom onset (15.0 vs 12.0 years) or diagnosis (22.3 vs 20.5 years). Overall HAE attack rates (total attacks/total years of follow-up) were 2.66 in Spain and 1.46 across other countries. Patients in Spain reported fewer severe/very severe HAE attacks before treatment (41.0% vs 45.9%; P < 0.0001) and, for icatibant-treated attacks, longer median time to treatment (2.9 vs 1.0 h), time to attack resolution (18.0 vs 5.5 h), and total attack duration (24.6 vs 8.0 h). Use of androgens for long-term prophylaxis was higher in Spain (51.2% vs 26.7%). Conclusion Patients with HAE-1/2 in Spain reported fewer severe/very severe attacks, administered icatibant later, and had longer-lasting attacks than did patients across other countries in IOS. These differences may indicate varying disease management practices (e.g., delayed icatibant treatment) and reporting. Efforts to raise awareness on the benefits of early on-demand treatment may be warranted.The Icatibant Outcome Survey is funded and supported by Shire International GmbH, a Takeda company, Zurich, Switzerland. Under direction of the authors, Alpa Parmar, PhD, CMPP, Latoya M. Mitchell, PhD, CMPP, and Sophia Shumyatsky, PharmD, CMPP, employees of Excel Medical Affairs, provided writing assistance for this manuscript. Editorial assistance in formatting, proofreading, and copyediting also was provided by Excel Medical Affairs. Takeda Development Center Americas, Inc. provided funding to Excel Medical Affairs, provided funding to Excel Medical Affairs for support in editing this manuscript. The interpretation of the data was made by the authors independently

Angioedema severity and impact on quality of life: Chronic histaminergic angioedema versus chronic spontaneous urticaria

Chronic histaminergic angioedema; Urticaria; Quality of lifeAngioedema histaminérgico crónico; Urticaria; Calidad de vidaAngioedema histaminèrgic crònic; Urticària; Qualitat de vidaThis work was supported by Grants PI16/01304 and #PI20/01536 from the Instituto de Salud Carlos III and the Thematic Networks for Co-operative Research Centers: Reacciones Adversas y Alérgicas network (RD16/0006/0031) from Instituto de Salud Carlos III, cofounded by Fondo Europeo de Desarrollo Regional. The manuscript was edited for English language by American Journal Experts

The Future We Want: a Learning Experience to Promote SDGs in Higher Education from the United Nations and University of Valencia

This article shares the strategy for mainstreaming the Sustainable Development Goals (SDGs) at the University of Valencia (UV), which, although limited in its scale, may compel other Higher Education Institutions to think in technological and social progress aligned with the 2030 Agenda. It explicates a process driven by the UV, on the occasion of the 75th anniversary of the United Nations (UN), and in collaboration with the Service for Geospatial, Information, and Telecommunications Technologies from the UN Support Base in Valencia (Spain) to prepare the online event: ¿The United Nations We Want¿. It was the culmination of a collaborative project between students and faculties from different scientific, technological, social, legal, humanistic, and health disciplines that structure the University of Valencia. The intention was that new generations experience the role they can have to shape the future we want, while the university community as a whole can become part of transformative institutional change that draws on both top-down and bottom-up strategies in pursuit of Education for Sustainable Development

Angioedema severity and impact on quality of life: Chronic histaminergic angioedema versus chronic spontaneous urticaria

Histamine-mediated angioedema is the most frequent form of angioedema. It is classified as idiopathic histaminergic acquired angioedema (IH-AAE)1 when allergies and other causes have been excluded and a positive treatment response to antihistamines, corticosteroids, or omalizumab has been reported. Idiopathic histaminergic acquired angioedema may occur in isolation, when it is termed chronic histaminergic angioedema (CHA), or it may be associated with wheals in chronic spontaneous urticaria angioedema (CSU-AE). The term CHA is equivalent to IH-AAE and mast cell-mediated angioedema. However, this term reflects the chronic and recurrent course of the disease. Therefore, we propose that the term CHA be internationally discussed in the following guidelines. Chronic spontaneous urticaria is classically characterized by the presence of recurrent episodes of wheals (hives) with or without angioedema for at least 6 weeks.2 Chronic histaminergic angioedema is typically considered a subtype of CSU without wheals. However, a recent study3 found several features that differentiate CHA from CSU, which suggests that CHA is a separate entity. Quality of life (QoL) studies specifically for CHA patients have not been performed, and their QoL has been assessed only in the context of CSU-AE

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

Spatiotemporal Characteristics of the Largest HIV-1 CRF02_AG Outbreak in Spain: Evidence for Onward Transmissions

Background and Aim: The circulating recombinant form 02_AG (CRF02_AG) is the predominant clade among the human immunodeficiency virus type-1 (HIV-1) non-Bs with a prevalence of 5.97% (95% Confidence Interval-CI: 5.41–6.57%) across Spain. Our aim was to estimate the levels of regional clustering for CRF02_AG and the spatiotemporal characteristics of the largest CRF02_AG subepidemic in Spain.Methods: We studied 396 CRF02_AG sequences obtained from HIV-1 diagnosed patients during 2000–2014 from 10 autonomous communities of Spain. Phylogenetic analysis was performed on the 391 CRF02_AG sequences along with all globally sampled CRF02_AG sequences (N = 3,302) as references. Phylodynamic and phylogeographic analysis was performed to the largest CRF02_AG monophyletic cluster by a Bayesian method in BEAST v1.8.0 and by reconstructing ancestral states using the criterion of parsimony in Mesquite v3.4, respectively.Results: The HIV-1 CRF02_AG prevalence differed across Spanish autonomous communities we sampled from (p &lt; 0.001). Phylogenetic analysis revealed that 52.7% of the CRF02_AG sequences formed 56 monophyletic clusters, with a range of 2–79 sequences. The CRF02_AG regional dispersal differed across Spain (p = 0.003), as suggested by monophyletic clustering. For the largest monophyletic cluster (subepidemic) (N = 79), 49.4% of the clustered sequences originated from Madrid, while most sequences (51.9%) had been obtained from men having sex with men (MSM). Molecular clock analysis suggested that the origin (tMRCA) of the CRF02_AG subepidemic was in 2002 (median estimate; 95% Highest Posterior Density-HPD interval: 1999–2004). Additionally, we found significant clustering within the CRF02_AG subepidemic according to the ethnic origin.Conclusion: CRF02_AG has been introduced as a result of multiple introductions in Spain, following regional dispersal in several cases. We showed that CRF02_AG transmissions were mostly due to regional dispersal in Spain. The hot-spot for the largest CRF02_AG regional subepidemic in Spain was in Madrid associated with MSM transmission risk group. The existence of subepidemics suggest that several spillovers occurred from Madrid to other areas. CRF02_AG sequences from Hispanics were clustered in a separate subclade suggesting no linkage between the local and Hispanic subepidemics

Allergy to grape: a case report

We report a case of a 5-year-old child who suffered an oral allergy syndrome and lip angiedema after eating grapes. We obtained a positive prick test with commercial grape extract and a positive prick-by-prick test with pulp and peel of fresh white grape (Moscatel variety) and pulp and peel of blue grape. Sodium dodecyl sulphate-polyacrylamide gel electrophoresis followed by immunoblotting revealed specific immunoglobulin E (IgE) antibodies in the patient's serum against a 94,000 molecular-weight antigenic band. Lip open challenge was positive