Patients Discharged with Home Enteral Nutrition from a Third-Level Hospital in 2018

Patients who, during admission, begin to use enteral nutrition (EN) and do not recover adequate oral intake need proper planning prior to discharge. The present study is a descriptive analysis of patients discharged with EN from our hospital in 2018. In all, the study included 141 patients (50.3% male) with an average age of 76.18 14 years with the most frequent reasons for enteral support being neurological disease (71.3%) and ear, nose, and throat (ENT) and maxillofacial surgery (17.02%) (others accounted for 11.68%). In these two groups, di erences were observed in both the average age (77 vs. 70.5 years) and sex of patients—mostly women (58%) in the first group and men (70%) in the second. Overall, the access routes used were nasogastric tube (76.4%), and percutaneous endoscopic gastrostomy (18.4%); 67.1% of the episodes ended by 30 June, 60.6% of patients died (47% of neurological patients), and 39.3% patients recovered function of the oral passage (85% of surgical/head and neck tumor). The duration of support was as follows: 1–3 months, 32%; 6–12 months, 26.9%; more than 12 months, 18.5%. This indicated some frequent and clearly di erentiated profiles in the patients studied, which may contribute to better care and support in order to maintain long-term treatment

Review of real-life teduglutide experience

Background: teduglutide is an agonist of glucagon-related peptide (aGLP2) effective as a treatment for patients with short bowel syndrome (SBS), an entity that affects quality of life, usually requires home parenteral nutrition (HPN) and generates significant health costs. The objective of the present narrative review was to assess the real-life experience reported with teduglutide.Methods and results: in real life, one meta-analysis and studies published with 440 patients indicate that Teduglutide is effective after the period of intestinal adaptation after surgery, reducing the need for HPN and in some cases even allowing it to be suspended. The response is heterogeneous, increasing progressively up to 2 years after the start of treatment and reaching 82 % in some series. The presence of colon in continuity is a negative predictor of early response, but a positive predictive factor for the withdrawal of HPN. The most common side effects are gastrointestinal in the early stages of treatment. There are late complications related to the stoma or the occurrence of colon polyps, although the frequency of the latter is very low. In adults, data on improved quality of life and cost-effectiveness are scarce.Conclusions: teduglutide is effective and safe and data from pivotal trials for the treatment of patients with SBS are confirmed in real life and can reduce or even stop HPN in some cases. Although it seems cost-effective, more studies are needed to identify those patients with the greatest benefit

Physical fitness and shapes of subcortical brain structures in children

“This is an accepted version of an article published by CAMBRIDGE UNIV PRESS in British Journal of Nutrition on September 2019, available at: doi: 10.1017/S0007114516001239.”A few studies have recently reported that higher cardiorespiratory fitness is associated with higher volumes of subcortical brain structures in children. It is however unknown how different fitness measures relate to shape of subcortical brain nuclei. We aimed to examine the association of the main health-related physical fitness components with shape of subcortical brain structures in a sample of 44 Spanish children aged 9.7±0.2 years from the NUHEAL project. Cardiorespiratory fitness, muscular strength and speed-agility were assessed using valid and reliable tests (ALPHA-fitness test battery). Shape of the subcortical brain structures was assessed by magnetic resonance imaging, and its relationship with fitness was examined after controlling for a set of potential confounders using a partial correlation permutation approach. Our results showed that all physical fitness components studied were significantly related to shape of subcortical brain nuclei. These associations were both positive and negative, indicating that a higher level of fitness in childhood is related to both expansions and contractions in certain regions of Accumbens, Amygdala, Caudate, Hippocampus, Pallidum, Putamen and Thalamus. Cardiorespiratory fitness was mainly associated with expansions, whereas handgrip was mostly associated with contractions in the structures studied. Future randomized controlled trials will confirm or contrast our findings, demonstrating whether changes in fitness modify the shape of brain structures and the extent to which those changes influence cognitive function.This work was supported by the Commission of the European Community’s 7th Framework Programme (FP7/2008-2013), Grant agreement no. 212652 (NUTRIMENTHE Project); within the 6th Framework Programme, Contract no. 007036 (EARNEST Project); and supported in part by the Commission of the European Community with in the 5th Framework Programme, Contract no. QLK1-CT-1999-00888 (NUHEAL project). This publication is the work of the authors and does not necessarily reflect the views of the Commission of the European Community. Research by A.C. is funded by a Spanish Ministry of Economy and Competitiveness grant (State Secretariat for Research, Development and Innovation Secretary, PSI2012-39292). F.B.O. is supported by a grant from the Spanish Ministry of Science and Innovation – MINECO - (RYC-2011-09011) and C.C.S. by a grant from the Spanish Ministry of Economy and Competitiveness (BES-2014-068829). Funders had no role in the design, analysis or writing of this article

Inactivation of human plasma alters the structure and biomechanical properties of engineered tissues

Acknowledgments The authors are grateful to Echevarne Laboratories for the coagulation experiments and to Gloria Carmona and Rosario Sánchez Pernaute as well as all members of the Unidad de Producción y Reprogramación Celular (UPRC) for technical help and support. All figures were created through BioRender.com accessed on 1 September 2021.Funding This research was funded by the Spanish Plan Nacional de Investigación Científica, Desarrollo e Innovación Tecnológica (I+D+i) from Ministerio de Ciencia, Innovación y Universidades (Instituto de Salud Carlos III), grants FIS PI17/0391, RTC-2017- 6658-1, PI20/0317 and ICI19/00024 (BIOCLEFT), co-financed by Fondo Europeo de Desarrollo Regional ERDF-FEDER, European Union and PE-0395-2019 from Consejería de Salud y Familias, Junta de Andalucía, Spain.Fibrin is widely used for tissue engineering applications. The use of blood derivatives, however, carries a high risk of transmission of infectious agents, necessitating the application of pathogen reduction technology (PRT). The impact of this process on the structural and biomechanical properties of the final products is unknown. We used normal plasma (PLc) and plasma inactivated by riboflavin and ultraviolet light exposure (PLi) to manufacture nanostructured cellularized fibrin-agarose hydrogels (NFAHs), and then compared their structural and biomechanical properties. We also measured functional protein C, prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) and coagulation factors [fibrinogen, Factor (F) V, FVIII, FX, FXI, FXIII] in plasma samples before and after inactivation. The use of PLi to manufacture cellularized NFAHs increased the interfibrillar spacing and modified their biomechanical properties as compared with cellularized NFAH manufactured with PLc. PLi was also associated with a significant reduction in functional protein C, FV, FX, and FXI, and an increase in the international normalized ratio (derived from the PT), APTT, and TT. Our findings demonstrate that the use of PRT for fibrin-agarose bioartificial tissue manufacturing does not adequately preserve the structural and biomechanical properties of the product. Further investigations into PRT-induced changes are warranted to determine the applications of NFAH manufactured with inactivated plasma as a medicinal product.Spanish Plan Nacional de Investigación Científica, Desarrollo e Innovación Tecnológica (I+D+i) from Ministerio de Ciencia, Innovación y Universidades (Instituto de Salud Carlos III), grants FIS PI17/0391, RTC-2017- 6658-1, PI20/0317 and ICI19/00024 (BIOCLEFT)Fondo Europeo de Desarrollo Regional ERDF-FEDEREuropean UnionPE-0395-2019 from Consejería de Salud y Familias, Junta de Andalucía, Spai

Hippocampal pallium and map-like memories through vertebrate evolution

The hippocampus in humans and other mammals is essential for episodic and relational memories. Comparative evidence indicates that a hippocampal pallium homologue is present in birds, reptiles, amphibians, ray-finned fishes, cartilaginous fishes and agnathans. Some of their characteristics, such as the topological position and the pattern of connectivity, appear remarkably well conserved. We review here substantial data showing that in all the vertebrate groups studied up to date, from fish to mammals, the hippocampus plays a fundamental role in spatial memory. In these vertebrates groups, the hippocampal pallium homologue is involved in the use of map-like, relational representations of the objective space that provide stable allocentric frames of reference, thus allowing flexible navigation. These similarities suggest a common evolutionary ancestry and indicate that the functional properties of the hippocampus appear early in the vertebrate phylogenesis and are retained through the independent evolution of the vertebrate lineages.Ministerio de Economía y Competitividad de España PSI2011-2748

The NADYA-SENPE Home Enteral Nutrition registry in Spain: years 2018 and 2019

Objetivo: exponer los resultados del registro de nutrición enteral domiciliaria (NED) de los años 2018 y 2019 del Grupo NADYA-SENPE. Material y métodos: se recopilaron los pacientes introducidos en el registro desde el 1 de enero al 31 de diciembre de 2018 y en las mismas fechas para 2019, procediendo al análisis descriptivo y analítico de los datos. Resultados: en el año 2018 se registraron 4756 pacientes activos con una tasa de prevalencia de 101,79 pacientes/millón de habitantes; en 2019 fueron 4633 con una tasa de prevalencia de 98,51 pacientes/millón de habitantes. Procedían de 46 hospitales. Fueron el 51,3 % los varones registrados y la edad mediana fue de 71,0 años en ambos periodos. El diagnóstico más frecuente fue el de enfermedad neurológica que cursa con afagia o disfagia severa (58,7 % y 58,2 %), respectivamente. La causa principal de finalización de los episodios fue el fallecimiento. Los pacientes pediátricos registrados fueron 116 en 2018 y 115 en 2019. Las niñas representaron el 57,8 % y 59,1 %, respectivamente, en cada uno de los periodos. La edad mediana de inicio de la NED fue de 5 y 7 meses. El grupo diagnóstico más registrado (42,2 % y 42,6 %) se englobó dentro del grupo de otras patologías, seguido de la enfermedad neurológica que cursa con afagia o disfagia severa de los niños (41,4 % y 41,7 %). Se alimentaban a través de gastrostomía el 46,6 % y 46,1 %, respectivamente, en cada uno de los periodos. Conclusiones: el registro de NED del grupo NADYA-SENPE sigue operativo de forma ininterrumpida desde sus inicios. El número de pacientes registrados y el de hospitales participantes permanece estable en el último bienio analizado.Aim: to present the results of the Spanish home enteral nutrition (HEN) registry of the NADYA-SENPE group for the years 2018 and 2019. Material and methods: from January 1, 2018 to December 31, 2019 the home enteral nutrition registry was recorded, and afterwards a further descriptive and analytical analysis was done. Results: in 2018, 4756 active patients were registered and the prevalence was 101.79 patients per one million inhabitants; in 2019 there were 4633 patients with a prevalence of 98.51 patients per one million inhabitants. They originated in 46 hospitals: 51.3 % were male, and median age was 71.0 years in both periods. The most frequent diagnosis was a neurological disorder that presents with aphagia or severe dysphagia — 58.7 % and 58.2 %, respectively. The main cause of episode termination was death. A total of 116 pediatric patients were registered in 2018 and 115 in 2019. Females represented 57.8 % and 59.1 %, respectively, in each of the periods. Median age at the beginning of HEN was 5 and 7 months. The most commonly recordered diagnostic group (42.2 % and 42.6 %) was included within the other pathologies group, followed by neurological disorders that present with aphagia or severe dysphagia in 41.4 % and 41.7 % of children. The route of administration was gastrostomy in 46.6 % and 46.1 %, respectively, in each of the periods. Conclusions: the NED registry of the NADYA-SENPE group continues to operate uninterruptedly since its inception. The number of registered patients and the number of participating hospitals remained stable in the last biennium analyzed

Polygenic Markers in Patients Diagnosed of Autosomal Dominant Hypercholesterolemia in Catalonia: Distribution of Weighted LDL-c-Raising SNP Scores and Refinement of Variant Selection

Hipercolesterolèmia familiar; Aterosclerosi; Puntuació de risc genèticFamilial hypercholesterolemia; Atherosclerosis; Genetic risk scoresHipercolesterolemia familiar; Aterosclerosis; Puntuaciones de riesgo genéticoFamilial hypercholesterolemia (FH) is associated with mutations in the low-density lipoprotein (LDL) receptor (LDLR), apolipoprotein B (APOB), and proprotein convertase subtilisin/kexin 9 (PCSK9) genes. A pathological variant has not been identified in 30–70% of clinically diagnosed FH patients, and a burden of LDL cholesterol (LDL-c)-raising alleles has been hypothesized as a potential cause of hypercholesterolemia in these patients. Our aim was to study the distribution of weighted LDL-c-raising single-nucleotide polymorphism (SNP) scores (weighted gene scores or wGS) in a population recruited in a clinical setting in Catalonia. The study included 670 consecutive patients with a clinical diagnosis of FH and a prior genetic study involving 250 mutation-positive (FH/M+) and 420 mutation-negative (FH/M−) patients. Three wGSs based on LDL-c-raising variants were calculated to evaluate their distribution among FH patients and compared with 503 European samples from the 1000 Genomes Project. The FH/M− patients had significantly higher wGSs than the FH/M+ and control populations, with sensitivities ranging from 42% to 47%. A wGS based only on the SNPs significantly associated with FH (wGS8) showed a higher area under the receiver operating characteristic curve, and higher diagnostic specificity and sensitivity, with 46.4% of the subjects in the top quartile. wGS8 would allow for the assignment of a genetic cause to 66.4% of the patients if those with polygenic FH are added to the 37.3% of patients with monogenic FH. Our data indicate that a score based on 8 SNPs and the75th percentile cutoff point may identify patients with polygenic FH in Catalonia, although with limited diagnostic sensitivity and specificityThis research was funded by the Instituto de Salud Carlos III (ISCIII), and Fondo Europeo de DesarrolloRegional (FEDER) “Una manera de hacer Europa”, grants PI14/01648 (to F.B.-V. and J.M.M.-C.) and PI18/00164(to F.B.-V.), as well as by Fundacióla Maratóde TV3 grant 20152431 (to F.B.-V.), Centro de Investigación Biomédicaen Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), and Centro de Investigación Biomédicaen Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN). CIBERDEM and CIBEROBN are ISCIII project

Análisis de la evaluación única y continuada en Biofarmacia y Farmacocinética-I

Podeu consultar la Setena trobada de professorat de Ciències de la Salut completa a: http://hdl.handle.net/2445/43352La construcción del Espacio Europeo de Educación Superior (EEES) tiene como objetivo disponer de un espacio abierto en el que no existan obstáculos a la movilidad de estudiantes, titulados, profesores y personal de administración. El sistema se articula en torno al reconocimiento de titulaciones y otras calificaciones de educación superior, la transparencia (un sistema de titulaciones comprensibles y comparables organizado en tres ciclos) y la cooperación europea en la garantía de la calidad Ante este gran reto, la enseñanza universitaria ha tenido que reorganizarse y los planes de estudio de cada facultad han tenido que adaptarse a las nuevas exigencias del EEES. Además las metodologías docentes centran su interés en un seguimiento más tutorizado del alumno, para garantizar su aprendizaje, no sólo en la adquisición de conocimientos sino también de competencias