LA OBSERVACIÓN SOCIOLÓGICA DEL SISTEMA DE TRATAMIENTO DE ENFERMEDADES

La consulta médica, la formación del personal de salud y los procesos salutogenéticos son algunos de los temas clásicos del análisis sociológico centrado en el sistema de tratamiento de enfermedades (STE) (1-11). Entre la gran diversidad de teorías sociológicas desde las que pueden emprenderse investigaciones sobre el STE, se considera que la teoría de los sistemas sociales, desarrollada por el sociólogo alemán Niklas Luhmann (12,13), establece que la estructura de la sociedad moderna se caracteriza por el desarrollo de diversos sistemas especializados, que permiten reducir la complejidad de la vida cotidiana debido al rendimiento diferenciado de sistemas como la economía, la política, el derecho, el arte y la medicina (13,14).   El despliegue de cada uno de estos sistemas propicia la coevolución histórica y semántica de sistemas organizacionales e interacción, que en conjunto, constituyen el entorno recíproco, de este modo, cada uno de ellos constituyen prerrequisitos evolutivos para que los otros sistemas sociales puedan desempeñar sus respectivas funciones; no obstante, la especialización de cada uno de estos sistemas representa, a su vez, riesgos y peligros para el resto de ellos, de modo que no hay homeostasis social que haga posible la coordinación de estos sistemas hacia un mismo fin (13).   A pesar de los distintos esfuerzos iniciados desde hace algunos años para lograr la interdisciplinariedad o la cooperación inter e intraorganizacional, en el caso del STE no sea logrado, al menos desde la teoría sociológica, una coordinación de esfuerzos de diferentes sistemas sociales para garantizar la salud de la mayoría de la población de un país determinado, debido a que cada uno de esos sistemas sociales funcionalmente diferenciados busca cumplir con su función independientemente de las funciones de otros sistemas sociales, de modo que la sociedad actual sea funcionalmente diferenciada tiene serias implicaciones para cada uno de sus sistemas, pues el cumplimiento de sus respectivas funciones origina una policontextualidad, al aumentar los riesgos y peligros que deben hacer frente con sus respectivos códigos binarios, como el caso del STE enfermo/sano (8,9,13)

Balance analysis in adolescents based on a motion capture platform

An assessment of the level of balance in adolescents was done, using motion capture technologies (IMOCAP). The sample was 7 peoples, to whom a pre-test and then a post-test and intervention program were applied. The duration of the intervention program was 11 weeks, with a weekly basic gymnastics’ session of 120 minutes. A diagnosis of anthropometric factors was carried out on characteristics such as size, with an average of 1.62 cm. (SD = 0.059), weight, with an average of 54.12 kg. (SD = 6.89) and age, with an average of 15 years with SD = 1.11. Consecutively, a pre-test for static balance was applied, using IMOCAP. An intervention program was designed, with the aim of improving corporal stability. Afterwards, the post-test was applied using IMOCAP. There was an improvement in the execution of basic gymnastic movements and greater stability was perceived. This was confirmed by the results registered by the instructor and the measurements generated by IMOCAP, which indicated a lesser degree of inclination and rotation of the torso in the post-test (+/- 7.35° and 3.7° on average) for the three body axes. Most of the basic gymnastic movements help to improve body stability, corroborated by a high-precision, reliable platform with quantifiable result-delivery

Basic gymnastics program to support the improvement of body stability in adolescents

Context: The objective of this research was the creation and implementation of a gymnastic program to improve the level of balance in high school students. Method: A diagnosis was made using the direct observation technique and a pre-test by implementing a motion capture platform for the analysis of balance in order to obtain a quantitative and qualitative assessment of the study group. Subsequently, a basic gymnastics program was formed and implemented for a period of 12 weeks. Finally, the impact of the program was evaluated by means of a post-test using the motion capture platform that allowed obtaining a quantitative data and it was contrasted with the field diary by triangulation technique to verify the progress in the level of balance in the students. Results: The quantitative analysis showed improvement in balance on the three-body axes with an average of +/- 5.23°. Furthermore, according to the observations made in the field diaries for each session, they showed that the basic exercises of educational gymnastics, as they were practiced, improved body control. Conclusion: The gymnastic movements practiced within the proposed program caused constant imbalance responses, which originated a positive stimulation in the systems involved in stability improving kinaesthetic awareness, spatial coordination, and postural tonicity in the research group

Tumor necrosis factor-alpha inhibitor treatment for sarcoidosis

Sarcoidosis is a chronic multisystem disease of unknown etiology, characterized by noncaseating granulomatous infiltration of virtually any organ system. Treatment is often undertaken in an attempt to resolve symptoms or prevent progression to organ failure. Previous studies have suggested a prominent role for tumor necrosis factor-alpha (TNF-α) in the inflammatory process seen in sarcoidosis. TNF-α and interleukin-1 are released by alveolar macrophages in patients with active lung disease. Corticosteroids have proved to be efficacious in the treatment of sarcoidosis, possibly by suppressing the production of TNF-α and other cytokines. Three agents are currently available as specific TNF antagonists: etanercept, infliximab, and adalimumab. Although data from noncomparative trials suggest that all three have comparable therapeutic effects in rheumatoid arthritis, their effects in a granulomatous disease such as sarcoidosis are less consistent. In this review, current data on the effectiveness are summarized

Personality disorders and emotional variables in patients with lupus

El lupus eritematoso sistémico (LES) es una enfermedad de carácter autoinmune que afecta principalmente a mujeres en edad fértil. Los síntomas más comunes de los pacientes incluyen dolor articular, erupciones cutáneas, cansancio o fatiga y dificultad en la respiración. Aunque el curso de la enfermedad es crónico, evoluciona normalmente en forma de brotes, que se alternan con periodos de remisión relativa. Si bien la etiología es desconocida, se sabe que existe una base genética predisponente y diversos factores ambientales que pueden actuar como desencadenantes. Entre éstos destacan la luz ultravioleta, las infecciones (especialmente virales), el embarazo y diversos fármacos. Además, diferentes variables psicológicas se han relacionado con la exacerbación de la enfermedad, de las cuales una de las más frecuentes es el estrés. Distintos estudios han mostrado que el estrés cotidiano produce un incremento en la sintomatología lúpica. Asimismo, los pacientes con lupus padecen también diversos trastornos psiquiátricos asociados a su enfermedad, cuya prevalencia oscila entre 20 y 66%, y se relaciona con una peor calidad de vida y una peor evolución y posesión de antecedentes psiquiátricos. En referencia concreta a las alteraciones de personalidad, investigaciones anteriores han hallado la existencia de una “tríada de personalidad” característica en pacientes con lupus, en que la depresión, la histeria y la hipocondriasis son sus componentes. Por lo anterior, el objetivo de este estudio ha sido comprobar la posible existencia de trastornos de la personalidad y su relación con otros trastornos afectivos en pacientes con lupus.Systemic lupus erythematosus (SLE), a prototype of the autoimmune diseases, is a multi-systemic disease characterized by an alteration in the immunological response, where the production of antibodies is directed against nuclear antigens, thus affecting many organs and systems. The course of this disease includes a wide range of clinical manifestations, different anatomo-pathological findings, and a series of immunological abnormalities. It is characterized by outbreaks and remissions. SLE can be manifested by general malaise, fever, fatigue, weight loss, skin rashes or joint inflammation, anemia, inflammation of the lymphatic glands, lowering of the defenses against infection, and cardiac, kidney, pulmonary and neurological alterations. In chronic dermatological lupus, only the skin is affected; this condition can present rash erythemas, etc. The recent introduction of new immunological diagnostic methods (antinuclear antibodies, anti-DNA antibodies, complementary fraction, etc.) has made it possible to recognize less severe forms of the disease, as well as its outbreaks and therapeutic guidelines. Different psychological variables have been associated with the exacerbation of the disease; one of the most notable is stress, and many patients with lupus also suffer diverse psychiatric and personality disorders associated with the disease, with a prevalence oscillating between 20% and 60%. Furthermore, these alterations have been associated with a lower quality of life, poorer evolution and psychiatric antecedents. In the specific case of personality alterations, previous research has found the existence of a “triad of personality” characteristics in patients with lupus. Depression, hysteria and hypochondria are the factors making up this triad. However, it has not been shown whether these personality disorders are just another symptom of the disease or a consequence of the emotional disorders produced by it. The purpose of this study was to test the possible existence of personality disorders and their relationship with other affective disorders in SLE

Differential protein expression in peripheral blood mononuclear cells (PBMCs) on patients withd systemic lupus erythematosus (SLE)

Comunicaciones a congreso

Complement component C4 structural variation and quantitative traits contribute to sex-biased vulnerability in systemic sclerosis

Genetic association study; Quantitative trait; Systemic sclerosisEstudi d'associació genètica; Tret quantitatiu; Esclerosi sistèmicaEstudio de asociación genética; Rasgo cuantitativo; Esclerosis sistémicaCopy number (CN) polymorphisms of complement C4 play distinct roles in many conditions, including immune-mediated diseases. We investigated the association of C4 CN with systemic sclerosis (SSc) risk. Imputed total C4, C4A, C4B, and HERV-K CN were analyzed in 26,633 individuals and validated in an independent cohort. Our results showed that higher C4 CN confers protection to SSc, and deviations from CN parity of C4A and C4B augmented risk. The protection contributed per copy of C4A and C4B differed by sex. Stronger protection was afforded by C4A in men and by C4B in women. C4 CN correlated well with its gene expression and serum protein levels, and less C4 was detected for both in SSc patients. Conditioned analysis suggests that C4 genetics strongly contributes to the SSc association within the major histocompatibility complex locus and highlights classical alleles and amino acid variants of HLA-DRB1 and HLA-DPB1 as C4-independent signals.This work was supported by grant RTI2018101332-B-100 funded by MCIN/AEI/10.13039/501100011033 by “ERDF A way of making Europe”, Red de Investigación en Inflamación y Enfermedades Reumáticas (RIER) from Instituto de Salud Carlos III (RD16/0012/0013). This work has received funding from the Innovative Medicines Initiative 1 & 2 Joint Undertaking (JU) under grant agreements No 115565 (PRECISESADS) and No 831434 (3TR). The JU receives support from the European Union’s FP7 and Horizon 2020 research and innovation programs and EFPIA. MAH was supported by the Juan de la Cierva Incorporacion program, grant IJC2018-035131-I funded by MCIN/AEI/10.13039/501100011033. This work is dedicated to the memory of Annette Kerick (1945-2020)

The Effect of Body Fat Distribution on Systemic Sclerosis

Mendelian randomization; Obesity; Systemic sclerosisAleatorización mendeliana; Obesidad; Esclerosis sistémicaAleatorització mendeliana; Obesitat; Esclerosi sistèmicaObesity contributes to a chronic proinflammatory state, which is a known risk factor to develop immune-mediated diseases. However, its role in systemic sclerosis (SSc) remains to be elucidated. Therefore, we conducted a two-sample mendelian randomization (2SMR) study to analyze the effect of three body fat distribution parameters in SSc. As instrumental variables, we used the allele effects described for single nucleotide polymorphisms (SNPs) in different genome-wide association studies (GWAS) for SSc, body mass index (BMI), waist-to-hip ratio (WHR) and WHR adjusted for BMI (WHRadjBMI). We performed local (pHESS) and genome-wide (LDSC) genetic correlation analyses between each of the traits and SSc and we applied several Mendelian randomization (MR) methods (i.e., random effects inverse-variance weight, MR-Egger regression, MR pleiotropy residual sum and outlier method and a multivariable model). Our results show no genetic correlation or causal relationship between any of these traits and SSc. Nevertheless, we observed a negative causal association between WHRadjBMI and SSc, which might be due to the effect of gastrointestinal complications suffered by the majority of SSc patients. In conclusion, reverse causality might be an especially difficult confounding factor to define the effect of obesity in the onset of SSc.This work was supported by grant RTI2018101332-B-100 funded by MCIN/AEI/10.13039/501100011033 and by “ERDF A way of making Europe” funded by the European Union. Red de Investigación en Inflamación y Enfermedades Reumáticas (RIER) from Instituto de Salud Carlos III (RD16/0012/0013). 115565. LB-C was funded by Grant IJC2018-038026-I funded by MCIN/AEI/10.13039/501100011033. MA-H is a recipient of a Miguel Servet fellowship (CP21/00132) from Instituto de Salud Carlos III (Spanish Ministry of Science and Innovation). EL-I was funded by Grant IJC2019-040080-I funded by MCIN/AEI/10.13039/501100011033. GV-M was funded by Grant PRE2019-087586 funded by MCIN/AEI/10.13039/501100011033 and by “ESF Investing in your future”