Influencia de la infusión contínua de insulina subcutánea en el control de la diabetes tipo 1 en niños

Diabetes mellitus type 1 is the most frequent endocrinological chronic disease during childhood. Self-care and the knowledge about this disease are the facts that are directly related to the reduction of health costs as well as the improvement of the life quality. The continuous subcutaneous insulin infusion pump (CSII) emulates the normal physiology and eliminates the need of continuous injections, remaining to determinate if this treatment contributes positively to the self-control of the diabetes.Didactic Materials and Methods: Retrospective cohort study. The data collection is made by a survey based on the NOC’s “Conocimiento: control de la diabetes” (Knowledge: diabetes control) and “Autocontrol diabetes” (Diabetes self-care) of all the children with continuous subcutaneous insulin infusion pump (CSII) at the health area number 2 from the Region of Murcia, as well as to their homologous with multiple injection. To draw the results, the statistic program SPSS v21, was the one used.Results: The study subjects have an average age of 11 years, being the 60% male and 40% female. Statistical significance was not obtained concerning to the level of knowledge, self-control and HbA1c values between the exposed group (CSII) and nonexposed group (multiple injection), except for the diet monitoring, where there was obtained a connection with the CSII treatment  (p=0.037). The age was also related to a knowledge increasement (p=0.001).Conclusion: Households units with children under 7 years with multiple injections should have a more intense training in order to reduce the anxiety and doubts of the parents.La diabetes mellitus tipo 1 es la enfermedad crónica endocrinológica más frecuente en la edad pediátrica. El autocuidado y el conocimiento sobre la enfermedad  están relacionados con la reducción en costes en salud y con una mejora en la calidad de vida. La bomba de infusión s continua de insulina subcutánea (ICIS) imita la fisiología normal y elimina la necesidad de inyecciones repetidas, quedando por determinar si este tratamiento favorece el autocontrol de la diabetes. Material y Métodos: Estudio de Cohortes retrospectivo.La recogida de datos se realiza  a través de un cuestionario basado en los NOC “Conocimiento: control de la diabetes” y “Autocontrol diabetes” a todos los niños con ICIS del área II de salud de la Región de Murcia, así como a sus homólogos de inyecciones múltiples. Para la determinación de resultados se utilizó el programa estadístico SPSS v.21.Resultados: Los sujetos del estudio tienen una edad media de 11 años, siendo 60% hombres y el 40% mujeres. No se obtuvieron diferencias estadísticamente significativas con respecto al nivel de conocimientos, autocontrol  y valores de HbA1c entre el grupo de expuestos (ICIS) y no expuestos (inyecciones múltiples), excepto en el siguimiento de la dieta, donde si se obtuvo relación con el tratamiento con ICIS (p=0.037)  . La edad también  se relacionó con un aumento en los conocimientos (p=0.001).Conclusión: Las unidades familiares con menores de 7 años con inyecciones múltiples, deberán tener una formación más intensa sobre todo dirigida a disminuir la ansiedad y dudas de los padres.

Prevalence and Clinical Characteristics of SARS-CoV-2 Confirmed and Negative Kawasaki Disease Patients During the Pandemic in Spain

Introduction: COVID-19 has a less severe course in children. In April 2020, some children presented with signs of multisystem inflammation with clinical signs overlapping with Kawasaki disease (KD), most of them requiring admission to the pediatric intensive care unit (PICU). This study aimed to describe the prevalence and clinical characteristics of KD SARS-CoV-2 confirmed and negative patients during the pandemic in Spain. Material and Methods: Medical data of KD patients from January 1, 2018 until May 30, 2020 was collected from the KAWA-RACE study group. We compared the KD cases diagnosed during the COVID-19 period (March 1-May 30, 2020) that were either SARS-CoV-2 confirmed (CoV+) or negative (CoV-) to those from the same period during 2018 and 2019 (PreCoV). Results: One hundred and twenty-four cases were collected. There was a significant increase in cases and PICU admissions in 2020 (P-trend = 0.001 and 0.0004, respectively). CoV+ patients were significantly older (7.5 vs. 2.5 yr) and mainly non-Caucasian (64 vs. 29%), had incomplete KD presentation (73 vs. 32%), lower leucocyte (9.5 vs. 15.5 × 109) and platelet count (174 vs. 423 × 109/L), higher inflammatory markers (C-Reactive Protein 18.5vs. 10.9 mg/dl) and terminal segment of the natriuretic atrial peptide (4,766 vs. 505 pg/ml), less aneurysm development (3.8 vs. 11.1%), and more myocardial dysfunction (30.8 vs. 1.6%) than PreCoV patients. Respiratory symptoms were not increased during the COVID-19 period. Conclusion: The KD CoV+ patients mostly meet pediatric inflammatory multisystem syndrome temporally associated with COVID-19/multisystem inflammatory syndrome in children criteria. Whether this is a novel entity or the same disease on different ends of the spectrum is yet to be clarified

Epidemiological and clinical features of Kawasaki disease in Spain over 5 years and risk factors for aneurysm development. (2011-2016): KAWA-RACE study group

Background: Kawasaki disease (KD) is an acute self-limited systemic vasculitis of unknown etiology affecting mainly children less than 5 years of age. Risk factors for cardiac involvement and resistance to treatment are insufficiently studied in non-Japanese children. Objective: This study aimed to investigate the epidemiology, clinical features and risk factors for resistance to treatment and coronary artery lesions (CAL) in KD in Spain. Methods: Retrospective study (May 2011-June 2016) of all patients less than 16 years of age diagnosed with KD included in KAWA-RACE network (84 Spanish hospitals). Results: A total of 625 cases were analyzed, 63% were males, 79% under 5 year-olds and 16.8% younger than 12 months. On echocardiographic examination CAL were the most frequent findings (23%) being ectasia the most common (12%). Coronary aneurysms were diagnosed in 9.6%, reaching 20% in infants under 12 months (p 900,000 cells/mm3, maximum temperature 10 days and fever before treatment ≥ 8 days as independent risk factors for developing coronary aneurysms. Conclusions: In our population, children under 12 months develop coronary aneurysms more frequently and children with KD with anemia and leukocytosis have high risk of cardiac involvement. Adding steroids early should be considered in those patients, especially if the treatment is not started before 8 days of fever. A score applicable to non-Japanese children able to predict the risk of aneurysm development and IVIG resistance is necessary

Usos y abusos de las TIC en adolescentes. : Decálogo para centros educativos, familias y jóvenes

Esta guía es un instrumento de difusión, concienciación, formación y debate que se puede utilizar en los centros escolares, organizaciones de educación no formal (centros cívicos, centros de ocio, entidades y asociaciones juveniles, clubes deportivos, etc.), contextos familiares y otros contextos donde haya jóvenes. Su pretensión es completar, mediante un enfoque diferenciado de otras guías existentes, algunos aspectos que la investigación realizada han evidenciado. La guía se basa en los resultados del trabajo de investigación 'Usos y abusos de las Tecnologías de la Información y la Comunicación en adolescentes' desarrollado durante el curso académico 2012-13 por el Equipo de Desarrollo Organizacional (EDO) de la Universitat Autònoma de Barcelona, y financiado por Fundación Mapfre (Ayudas a la Investigación 2012

Supercritical CO2 extraction applied toward the production of a functional beverage from wine

El pdf del artículo es la versión pre-print.-- et al.Supercritical CO2 extraction has been proved to be a potential tool in the recovery of aroma compounds from different natural sources and in the removal of ethanol from aqueous solutions. In this work, both ideas are combined to develop a two-step process toward the production of a low-alcohol beverage from wine, but maintaining the aroma and the antioxidant activity similar to that of the original wine. First, the recovery of aroma from wine was attained in a countercurrent packed column (white and red wines were investigated) using very low CO2/wine ratios. Then, the aroma-free wine recovered from the bottom of the extraction column was dealcoholized by applying different extraction conditions. The results obtained from these studies permit the design of a two-step countercurrent CO2 extraction process at 9.5 MPa and 313 K, in which the different CO2/wine ratios employed in each step lead to the recovery of aroma or the removal of ethanol. The two-step process was applied to rose wine and the low-alcohol beverage obtained proved to have similar antioxidant activity and similar aroma profile to that of the original wine. © 2011 Elsevier B.V. All rights reserved.The authors gratefully acknowledge the financial support from the Comunidad Autónoma de Madrid (ALIBIRD, project number S-505/AGR-0153) the Ministerio de Ciencia e Innovación (project AGL2007-64198/ALI), Spain and Miguel Torres S.A. (Proyect CENIT HIGEA CEN-20072003).Peer Reviewe

Influence of continuous subcutaneous insulin infusion in the control of type 1 diabetes in children

La diabetes mellitus tipo 1 es la enfermedad crónica endocrinológica más frecuente en la edad pediátrica. El autocuidado y el conocimiento sobre la enfermedad están relacionados con la reducción en costes en salud y con una mejora en la calidad de vida. La bomba de infusión s continua de insulina subcutánea (ICIS) imita la fisiología normal y elimina la necesidad de inyecciones repetidas, quedando por determinar si este tratamiento favorece el autocontrol de la diabetes. Material y Métodos: Estudio de Cohortes retrospectivo.La recogida de datos se realiza a través de un cuestionario basado en los NOC “Conocimiento: control de la diabetes” y “Autocontrol diabetes” a todos los niños con ICIS del área II de salud de la Región de Murcia, así como a sus homólogos de inyecciones múltiples. Para la determinación de resultados se utilizó el programa estadístico SPSS v.21. Resultados: Los sujetos del estudio tienen una edad media de 11 años, siendo 60% hombres y el 40% mujeres. No se obtuvieron diferencias estadísticamente significativas con respecto al nivel de conocimientos, autocontrol y valores de HbA1c entre el grupo de expuestos (ICIS) y no expuestos (inyecciones múltiples), excepto en el siguimiento de la dieta, donde si se obtuvo relación con el tratamiento con ICIS (p=0.037) . La edad también se relacionó con un aumento en los conocimientos (p=0.001). Conclusión: Las unidades familiares con menores de 7 años con inyecciones múltiples, deberán tener una formación más intensa sobre todo dirigida a disminuir la ansiedad y dudas de los padres.Diabetes mellitus type 1 is the most frequent endocrinological chronic disease during childhood. Selfcare and the knowledge about this disease are the facts that are directly related to the reduction of health costs as well as the improvement of the life quality. The continuous subcutaneous insulin infusion pump (CSII) emulates the normal physiology and eliminates the need of continuous injections, remaining to determinate if this treatment contributes positively to the self-control of the diabetes. Didactic Materials and Methods: Retrospective cohort study. The data collection is made by a survey based on the NOC’s “Conocimiento: control de la diabetes” (Knowledge: diabetes control) and “Autocontrol diabetes” (Diabetes self-care) of all the children with continuous subcutaneous insulin infusion pump (CSII) at the health area number 2 from the Region of Murcia, as well as to their homologous with multiple injection. To draw the results, the statistic program SPSS v21, was the one used. Results: The study subjects have an average age of 11 years, being the 60% male and 40% female. Statistical significance was not obtained concerning to the level of knowledge, self-control and HbA1c values between the exposed group (CSII) and nonexposed group (multiple injection), except for the diet monitoring, where there was obtained a connection with the CSII treatment (p=0.037). The age was also related to a knowledge increasement (p=0.001). Conclusion: Households units with children under 7 years with multiple injections should have a more intense training in order to reduce the anxiety and doubts of the parents

Influencia de la infusión contínua de insulina subcutánea en el control de la diabetes tipo 1 en niños

Diabetes mellitus type 1 is the most frequent endocrinological chronic disease during childhood. Self-care and the knowledge about this disease are the facts that are directly related to the reduction of health costs as well as the improvement of the life quality. The continuous subcutaneous insulin infusion pump (CSII) emulates the normal physiology and eliminates the need of continuous injections, remaining to determinate if this treatment contributes positively to the self-control of the diabetes.Didactic Materials and Methods: Retrospective cohort study. The data collection is made by a survey based on the NOC’s “Conocimiento: control de la diabetes” (Knowledge: diabetes control) and “Autocontrol diabetes” (Diabetes self-care) of all the children with continuous subcutaneous insulin infusion pump (CSII) at the health area number 2 from the Region of Murcia, as well as to their homologous with multiple injection. To draw the results, the statistic program SPSS v21, was the one used.Results: The study subjects have an average age of 11 years, being the 60% male and 40% female. Statistical significance was not obtained concerning to the level of knowledge, self-control and HbA1c values between the exposed group (CSII) and nonexposed group (multiple injection), except for the diet monitoring, where there was obtained a connection with the CSII treatment  (p=0.037). The age was also related to a knowledge increasement (p=0.001).Conclusion: Households units with children under 7 years with multiple injections should have a more intense training in order to reduce the anxiety and doubts of the parents.La diabetes mellitus tipo 1 es la enfermedad crónica endocrinológica más frecuente en la edad pediátrica. El autocuidado y el conocimiento sobre la enfermedad  están relacionados con la reducción en costes en salud y con una mejora en la calidad de vida. La bomba de infusión s continua de insulina subcutánea (ICIS) imita la fisiología normal y elimina la necesidad de inyecciones repetidas, quedando por determinar si este tratamiento favorece el autocontrol de la diabetes. Material y Métodos: Estudio de Cohortes retrospectivo.La recogida de datos se realiza  a través de un cuestionario basado en los NOC “Conocimiento: control de la diabetes” y “Autocontrol diabetes” a todos los niños con ICIS del área II de salud de la Región de Murcia, así como a sus homólogos de inyecciones múltiples. Para la determinación de resultados se utilizó el programa estadístico SPSS v.21.Resultados: Los sujetos del estudio tienen una edad media de 11 años, siendo 60% hombres y el 40% mujeres. No se obtuvieron diferencias estadísticamente significativas con respecto al nivel de conocimientos, autocontrol  y valores de HbA1c entre el grupo de expuestos (ICIS) y no expuestos (inyecciones múltiples), excepto en el siguimiento de la dieta, donde si se obtuvo relación con el tratamiento con ICIS (p=0.037)  . La edad también  se relacionó con un aumento en los conocimientos (p=0.001).Conclusión: Las unidades familiares con menores de 7 años con inyecciones múltiples, deberán tener una formación más intensa sobre todo dirigida a disminuir la ansiedad y dudas de los padres.

Epidemiological and clinical features of Kawasaki disease in Spain over 5 years and risk factors for aneurysm development. (2011-2016): KAWA-RACE study group

KAWA-RACE study group.[Background] Kawasaki disease (KD) is an acute self-limited systemic vasculitis of unknown etiology affecting mainly children less than 5 years of age. Risk factors for cardiac involvement and resistance to treatment are insufficiently studied in non-Japanese children.[Objective] This study aimed to investigate the epidemiology, clinical features and risk factors for resistance to treatment and coronary artery lesions (CAL) in KD in Spain.[Methods] Retrospective study (May 2011-June 2016) of all patients less than 16 years of age diagnosed with KD included in KAWA-RACE network (84 Spanish hospitals).[Results] A total of 625 cases were analyzed, 63% were males, 79% under 5 year-olds and 16.8% younger than 12 months. On echocardiographic examination CAL were the most frequent findings (23%) being ectasia the most common (12%). Coronary aneurysms were diagnosed in 9.6%, reaching 20% in infants under 12 months (p 900,000 cells/mm3, maximum temperature 10 days and fever before treatment ≥ 8 days as independent risk factors for developing coronary aneurysms.[Conclusions] In our population, children under 12 months develop coronary aneurysms more frequently and children with KD with anemia and leukocytosis have high risk of cardiac involvement. Adding steroids early should be considered in those patients, especially if the treatment is not started before 8 days of fever. A score applicable to non-Japanese children able to predict the risk of aneurysm development and IVIG resistance is necessary.CC received a grant from Spanish Society of Paediatric Rheumatology (SERPE), 2015.Peer reviewe

Aprendizaje Intergeneracional en contextos laborales de Instituciones de Educación Superior : Un análisis casos múltiples

Projecte Prunai: Universitat i Aprenentatge IntergeneracionalEl aprendizaje entre personas de edades diferentes supone la base del desarrollo de la sociedad, en general y de las organizaciones, en particular. A lo largo de la historia, el aprendizaje intergeneracional ha tenido lugar en contextos muy diversos (ej., familias, grupos, lugar de trabajo) y mediante procedimientos dispares. El presente informe presenta, en primer lugar, una breve descripción del diseño metodológico de la fase 2 que nos ocupa. En segundo lugar, se presentan los informes individuales para cada uno de los casos analizados. Estos informes individuales describen brevemente la institución, incidiendo especialmente en su situación en los ránquines actuales, ya que, tal y como se explica en el primer informe del proyecto PRUNAI, este elemento constituye el motivo principal de selección

Switching TNF antagonists in patients with chronic arthritis: An observational study of 488 patients over a four-year period

The objective of this work is to analyze the survival of infliximab, etanercept and adalimumab in patients who have switched among tumor necrosis factor (TNF) antagonists for the treatment of chronic arthritis. BIOBADASER is a national registry of patients with different forms of chronic arthritis who are treated with biologics. Using this registry, we have analyzed patient switching of TNF antagonists. The cumulative discontinuation rate was calculated using the actuarial method. The log-rank test was used to compare survival curves, and Cox regression models were used to assess independent factors associated with discontinuing medication. Between February 2000 and September 2004, 4,706 patients were registered in BIOBADASER, of whom 68% had rheumatoid arthritis, 11% ankylosing spondylitis, 10% psoriatic arthritis, and 11% other forms of chronic arthritis. One- and two-year drug survival rates of the TNF antagonist were 0.83 and 0.75, respectively. There were 488 patients treated with more than one TNF antagonist. In this situation, survival of the second TNF antagonist decreased to 0.68 and 0.60 at 1 and 2 years, respectively. Survival was better in patients replacing the first TNF antagonist because of adverse events (hazard ratio (HR) for discontinuation 0.55 (95% confidence interval (CI), 0.34-0.84)), and worse in patients older than 60 years (HR 1.10 (95% CI 0.97-2.49)) or who were treated with infliximab (HR 3.22 (95% CI 2.13-4.87)). In summary, in patients who require continuous therapy and have failed to respond to a TNF antagonist, replacement with a different TNF antagonist may be of use under certain situations. This issue will deserve continuous reassessment with the arrival of new medications. © 2006 Gomez-Reino and Loreto Carmona; licensee BioMed Central Ltd