Prevalencia de deficiencia de vitamina D y de los factores de riesgo asociados en una cohorte española de adultos infectados por VIH. Efecto del tratamiento antirretroviral

La prevalencia de deficiencia (< 20ng/mL) o insuficiencia (<30ng/mL) de vitamina D en una gran cohorte de pacientes con infección por VIH realizada en España es elevada (44% y 72%, respectivamente), en el rango de lo encontrado en otros países como Holanda, Suiza, Inglaterra y EEUU. Nuestros datos, por tanto, no apoyan que un mayor número de horas de exposición solar en España se corresponda con un incremento en los niveles de vitamina D. Sólo el mayor número de horas de exposición solar estuvo relacionado con un nivel adecuado de vitamina D. Además, en los pacientes con un nivel óptimo de vitamina D, la ingesta de vitamina D era mayor y habían estado con más frecuencia bronceados en el último año. No encontramos relación entre el elevado porcentaje de desnutrición calórica, que aunque ligera presentan los pacientes infectados por VIH, con el nivel de vitamina D. La desnutrición estuvo más asociada con el bajo peso, la inmunosupresión y con la infección crónica por VHC. En un análisis exploratorio de los diferentes tratamientos antirretrovirales, observamos que los pacientes que recibían tratamiento con inhibidores de proteasa potenciados tenían los valores más altos de vitamina D y que la exposición a efavirenz disminuye de forma independiente los niveles de 25(OH)D. Los niveles de vitamina D son más altos en verano y más bajos en primavera e invierno. Debido a los cambios en los niveles de vitamina D con los periodos estacionales, éstos siempre se deben tener en cuenta. Los factores clásicos relacionados con la deficiencia de vitamina D descritos en la población, como el sobrepeso y la pigmentación de la piel también se han encontrado asociados en los pacientes infectados por VIH. La diabetes mellitus fue la comorbilidad que se asoció con un incremento clínicamente importante en la odds de insuficiencia o deficiencia de vitamina D. De acuerdo con nuestros datos, se podrán beneficiar de suplementos de vitamina D los pacientes con sobrepeso, de raza negra que estén expuestos a efavirenz, que se hayan infectado de la infección VIH por transmisión sexual o que tengan la carga viral no suprimida. La exposición a los inhibidores de proteasa, a los ITINAN o al tenofovir se acompaña de un incremento de PTH. Además, tenofovir aumenta la concentración de la fosfatasa alcalina, como marcador de remodelado óseo, de forma independiente a los niveles de vitamina D. Si tenemos en cuenta los beneficios documentados relacionados con el suplemento de la vitamina D en la población general, un aporte adecuado de vitamina D puede ser incluso más importante en los pacientes infectados por VIH, a la vista de sus factores de riesgo adicionales por osteopenia, neoplasias o enfermedad cardiovascular. La asociación entre niveles bajos de 25(OH)D y muchas comorbilidades crónicas que son prevalentes en personas infectadas por VIH, como la diabetes mellitus y la hipertensión arterial, es otro argumento para apoyar la recomendación de determinar sus niveles

Instrumentos de utilidad en el análisis de contenido para la organización de documentos digitales educativos

Las políticas de la Unión Europea para la sociedad de la información están impulsando un modelo educativo basado en adquisición de competencias y el aprendizaje a lo largo de la vida. La eficacia del aprendizaje en este modelo educativo descansa en una educación digital, en la que los recursos digitales estructuren, organicen y representen su contenido acorde con sus potencialidades educativas. La Biblioteconomía y Documentación puede contribuir a su consecución mediante la actualización de sus instrumentos a partir de su diseño conceptual en el análisis documental del contenido. Se analizan tesauros, mapas conceptuales y ontologías, que constituyen diversos sistemas de representación del conocimiento procedentes de diferentes disciplinas, y se realiza una comparativa en cuanto a su eficacia para la organización de contenidos en educación para el espacio digital.The European Union’s Information Society policies are promoting an educational model based on the acquisition of skills and support for lifelong learning. The effectiveness of learning in this educational model lies in digital education, where digital resources structure, organize and represent their contents according to their educational potential. Information Science can play a role here by updating tools and instruments from content analysis conceptual design.Thesauri, concept maps, and ontologies are analyzed, because they are different knowledge representation systems which come from different disciplines. A comparison of these instruments is conducted in terms of their effectiveness in organising educationbased contents in cyberspace.Publicad

Forma atípica de presentación de la enfermedad de Whipple. Reporte de un caso

Whipple’s disease is a systemic, chronic and curable pathology caused by a grampositive bacterium called Tropheryma whipplei. The most common clinical manifestations are chronic diarrhea, abdominal pain, weight loss and joint symptoms. We present a case of a 76-year-old patient with Whipple’s disease with digestive and joint involvement that was diagnosed after a study in a lymph node biopsy.La enfermedad de Whipple es una patología sistémica, crónica y curable causada por una bacteria grampositiva denominada Tropheryma whipplei. Las manifestaciones clínicas más habituales son diarrea crónica, dolor abdominal, pérdida de peso y síntomas articulares. A continuación presentamos un caso de un paciente de 76 años con enfermedad de Whipple con afectación digestiva y articular que se diagnosticó tras el estudio en una biopsia ganglionar

Alfabetización en la información y bibliotecas escolares: una experiencia en la comunidad de Madrid

Una tarea muy ligada a la labor del documentalista, desde una perspectiva histórica, ha sido el apoyo a las políticas de alfabetización, del mismo modo ha sido una constante en España el empeño por establecer las Bibliotecas Escolares en el sistema educativo. La Sociedad de la Información y sus medios para acceder y representar el conocimiento ha desarrollado un nuevo modo de leer y escribir, una nueva alfabetización más próxima al quehacer documentalista, information literacy, alfabetización de la información. En esta comunicación realizamos una semblanza de la Hª de las Bibliotecas Escolares en nuestro país y exponemos las líneas de trabajo y los primeros resultados del Seminario de Investigación y aplicación experimental “Las Bibliotecas Escolares y la Alfabetización en la Información.A task closely linked to the work of the specialist in documentation sciences, from a historical perspective, has been the support to the policy of literacy, and, in the same way, the determination in Spain to set up School Libraries in the educational system. The Information Society and its means to accede and represent knowledge has developed a new pattern for reading and writing, a new education closer to the chore of the documentation sciences, “Information Literacy”, education of the information. In this communication we tackle a biographical out line of the history of School Libraries in our country and we lay out the working lines and the first results of the Seminary of Research and experimental application School Libraries and information literacy. The interest of this contribution lies in offering a group working vision between entities far from each other at times, School and University. From the research in progressive line, Information Literacy we show the very important role that the Documentation can play in a School Library completely adapted to the new technological environments and to the increasing needs of the community of users and generated by the Knowledge SocietyPublicad

Development of a controlled vocabulary for learning objects' functional description in an educational repository

Proceeding of: Metadata for Knowledge and Learning (DC 2006). October 3-6, 2006. Colima, MexicoThis paper presents the development of a controlled vocabulary for functional description in an educational repository project which has adopted a DC application profile. The vocabulary, organized according to the identified functions of educational documents and learning objects' components, permits their retrieval and reuse to be improved.The DOTEINE Project has been financed by the Spanish Interministerial Commission of Science & Technology (CICYT, ref. BSO2003-04895). The IACORIE Project has been financed by the Regional Government of Madrid (Comunidad de Madrid, ref. 06/HSE/0165/2004).Publicad

Effects of Tetrodotoxin in Mouse Models of Visceral Pain

Visceral pain is very common and represents a major unmet clinical need for which current pharmacological treatments are often insufficient. Tetrodotoxin (TTX) is a potent neurotoxin that exerts analgesic actions in both humans and rodents under different somatic pain conditions, but its effect has been unexplored in visceral pain. Therefore, we tested the effects of systemic TTX in viscero-specific mouse models of chemical stimulation of the colon (intracolonic instillation of capsaicin and mustard oil) and intraperitoneal cyclophosphamide-induced cystitis. The subcutaneous administration of TTX dose-dependently inhibited the number of pain-related behaviors in all evaluated pain models and reversed the referred mechanical hyperalgesia (examined by stimulation of the abdomen with von Frey filaments) induced by capsaicin and cyclophosphamide, but not that induced by mustard oil. Morphine inhibited both pain responses and the referred mechanical hyperalgesia in all tests. Conditional nociceptor‑specific Nav1.7 knockout mice treated with TTX showed the same responses as littermate controls after the administration of the algogens. No motor incoordination after the administration of TTX was observed. These results suggest that blockade of TTX-sensitive sodium channels, but not Nav1.7 subtype alone, by systemic administration of TTX might be a potential therapeutic strategy for the treatment of visceral pain.R. González-Cano was supported by a postdoctoral grant from the Contratos-Puente Research Program of the University of Granada. M.A. Tejada was supported by a predoctoral grant from the University of Granada. F. R. Nieto was supported by a postdoctoral Juan de la Cierva grant (Spanish Goverment). This study was partially supported by grant GREIB (CEB-005) from the University of Granada and grant CTS 109 from the Junta de Andalucía

Beneficial Effect of Short-Term Supplementation of High Dose of Vitamin D3 in Hospitalized Patients With COVID-19: A Multicenter, Single-Blinded, Prospective Randomized Pilot Clinical Trial.

There is now sufficient evidence to support that vitamin D deficiency may predispose to SARS-CoV-2 infection and increase COVID-19 severity and mortality. It has been suggested that vitamin D3 supplementation may be used prophylactically as an affordable and safe strategy that could be added to the existing COVID-19 standard treatment. This multicenter, single-blinded, prospective randomized pilot clinical trial aimed to evaluate the safety, tolerability, and effectiveness of 10,000 IU/day in comparison with 2000 IU/day of cholecalciferol supplementation for 14 days to reduce the duration and severity of COVID-19 in 85 hospitalized individuals. The median age of the participants was 65 years (Interquartile range (IQR): 53-74), most of them (71%) were men and the mean baseline of 25-hydroxyvitamin D (25(OH)D) in serum was 15 ng/ml (standard deviation (SD):6). After 14 days of supplementation, serum 25(OH)D levels were significantly increased in the group who received 10,000IU/day (p < 0.0001) (n = 44) in comparison with the 2,000IU/day group (n = 41), especially in overweight and obese participants, and the higher dose was well tolerated. A fraction of the individuals in our cohort (10/85) developed acute respiratory distress syndrome (ARDS). The median length of hospital stay in these patients with ARDS was significantly different in the participants assigned to the 10,000IU/day group (n = 4; 7 days; IQR: 4-13) and the 2,000IU/day group (n = 6; 27 days; IQR: 12-45) (p = 0.04). Moreover, the inspired oxygen fraction was reduced 7.6-fold in the high dose group (p = 0.049). In terms of blood parameters, we did not identify overall significant improvements, although the platelet count showed a modest but significant difference in those patients who were supplemented with the higher dose (p = 0.0492). In conclusion, the administration of 10,000IU/day of vitamin D3 for 14 days in association with the standard clinical care during hospitalization for COVID-19 was safe, tolerable, and beneficial, thereby helping to improve the prognosis during the recovery process.This work was supported by Fundación Universidad Alfonso X el Sabio (FUAX, Madrid, Spain; ID Project: 1.012.010; ID Project EQA: 925.280); the Coordinated Research Activities at the National Center of Microbiology (Instituto de Salud Carlos III) (COV20_00679) to promote an integrated response against SARS-CoV-2 in Spain (Spanish Ministry of Science and Innovation) that is coordinated by Dr. Inmaculada Casas (WHO National Influenza Center of the CNM); a generous donation provided by Chiesi España, S.A.U. (Barcelona, Spain). The work of Montserrat Torres was financed by the Coordinated Research Activities at the CNM (Instituto de Salud Carlos III) (COV20_00679). The work of Lorena Vigón was supported by a pre-doctoral grant from Instituto de Salud Carlos III (FIS PI16CIII/00034-ISCIII-FEDER). The work of Sara Rodríguez-Mora was financed by NIH grant R01AI143567.S

Developing models for future real-time platforms: Virtual simulation and design of new components and systems for aircraft and remotely piloted aircraft systems

In the development of electrified and other vehicle systems, the modelling and simulation of the vehicle is very important. With these tools the preliminary design, as well as later detailed studies of the systems developed, allow engineers to spend less time on each phase of their projects or address them with an integrated approach. In addition, this integrated approach provides the possibility of building hardware-in-the loop models with all the components required. This vehicle modelling and simulation has gained more interest with the increasing use of a wide variety of RPAS, ranging from light weight micro aircraft to large vehicles of various tons. For this reason, the previously-described building tools are the final objective of the developing models to be used in real-time platform projects. The first step presented in this paper is to build a simulator that reproduces the behaviour of a selected aircraft and validate it. This paper presents the study of the performances and behaviour of an OPV used to validate the simulator developed later. At the end, some preliminary tests and estimations of the performances for the selected OPV with an electric motor are presented

La alfabetización en información en la formación universitaria: instrumentos para la evaluación y diagnóstico de competencias informacionales sobre contenidos educativos virtuales

ColmeSIBD2006Ponencia presentada en el 4º Simposium Internacional de Bibliotecas Digitales, Málaga 21-23 junio 200

Changes in the immune response against SARS-CoV-2 in individuals with severe COVID-19 treated with high dose of vitamin D

Main cause of severe illness and death in COVID-19 patients appears to be an excessive but ineffectual inflammatory immune response that may cause severe acute respiratory distress syndrome (ARDS). Vitamin D may favour an anti-inflammatory environment and improve cytotoxic response against some infectious diseases. A multicenter, single-blind, prospective, randomized clinical trial was approved in patients with COVID-19 pneumonia and levels of 25-hydroxyvitamin D (25(OH)D) of 14.8 ng/ml (SD: 6.18) to test antiviral efficacy, tolerance and safety of 10,000 IU/day of cholecalciferol (vitamin D3) for 14 days, in comparison with 2000 IU/day. After supplementation, mean serum 25(OH)D levels increased to 19 ng/ml on average in 2000 IU/day versus 29 ng/ml in 10,000 IU/day group (p < 0.0001). Although levels of inflammatory cytokines were not modified by treatment with 10,000 IU/day, there was an increase of anti-inflammatory cytokine IL-10 and higher levels of CD4+ T cells, with predominance of T central memory subpopulation. Cytotoxic response against pseudotyped SARS-CoV-2 infected cells was increased more than 4-fold in patients who received 10,000 IU/day. Moreover, levels of IFNγ were significantly higher in this group. Beneficial effect of supplementation with 10,000 IU/day was also observed in participants who developed ARDS and stayed at the hospital for 8.0 days, whereas those who received 2000 IU/day stayed for 29.2 days (p = 0.0381). Administration of high doses of vitamin D3 as adjuvant of the standard care treatment during hospitalization for COVID-19 may improve the inflammatory environment and cytotoxic response against pseudotyped SARS-CoV-2 infected cells, shortening the hospital stay and, possibly, improving the prognosis.We greatly appreciate all the patients for their participation in this study. We thank the excellent secretarial assistance of Mrs Olga Palao at the Centro Nacional de Microbiología (CNM, Instituto de Salud Carlos III). The authors also acknowledge María C. de la Cruz at Unidad Central de Apoyo a la Investigación Clínica y Ensayos Clínicos (Instituto de Investigación Sanitaria Gregorio Marañon; IiSGM) for her advice and assistance related to the clinical research with medicines. This work was supported by the Coordinated Research Activities at CNM (Instituto de Salud Carlos III) (COV20_00679) to promote an integrated response against SARS-CoV-2 in Spain (Spanish Ministry of Science and Innovation) that is coordinated by Dr Inmaculada Casas (WHO National Influenza Center of the CNM); the Spanish Ministry of Science and Innovation (PID2019–110275RB-I00); the Spanish AIDS Research Network RD16CIII/0002/0001 that is included in Acción Estratégica en Salud, Plan Nacional de Investigación Científica, Desarrollo e Innovación Tecnológica 2016–2020, Instituto de Salud Carlos III, European Region Development Fund (ERDF) and Fundación Universidad Alfonso X el Sabio (FUAX, Madrid, Spain; Reference 1012010). The work of Montserrat Torres is financed by the Coordinated Research Activities at the CNM (Instituto de Salud Carlos III) (COV20_00679). The work of María Rosa López-Huertas and Sara Rodríguez-Mora is financed by NIH grant R01AI143567. The work of Lorena Vigón is supported by a pre-doctoral grant from Instituto de Salud Carlos III (FIS PI16CIII/00034-ISCIII-FEDER). The work of Fernando Ramos Martín is financed by the Spanish Ministry of Science and Innovation (PID2019–110275RB-I00). Drug Cholecalciferol (vitamin D) used in the study was donated by Italfarmaco Group (Cholecalciferol 25,000IU/2,5 ml oral solution). Italfarmaco Group had no role in the design and conduct of the study, in the collection, management, analysis, and interpretation of the data, or the preparation, review, or approval of the manuscript.S