Residuos de productos lácteos y de grasa de carne en dos recipientes cerámicos de la Edad del Bronce del Valle Medio del Duero

A través de análisis por cromatografía de gases-espectrometría de masas y del estudio de las reacciones inmunoquímicas de la caseína, se ha logrado identificar el residuo de sendos vasos cerámicos del horizonte inicial de Cogotas I de la provincia de Valladolid: un preparado de leche con cereales y grasa de carne. A partir de ahí, se insiste en la importancia de la actividad ganadera entre las comunidades del Bronce Medio de la Meseta y se considera, asimismo, la posibilidad de que el contenido de tales vasijas "completas" representara una ofrenda entre tantas otras atestiguadas en los "campos de hoyos" cogotianos.Through the application of Gas Chromatography-Mass Spectrometry and the determination of casein based on its immunochemical reactions, residues of animal fats and dairy products have been detected in two Bronze Age (Early Cogotas I culture) pottery vessels from Valladolid. The importance of cattle raising activities among the Middle Bronze Age societies of the Spanish Meseta is assessed here. It is argued that the original contents deposited in these vessels may have been offerings, as is the case with other materials that are found in the Cogotas I pit fields

Different HCV Exposure Drives Specific miRNA Profile in PBMCs of HIV Patients

Micro RNAs (miRNAs) are essential players in HIV and HCV infections, as both viruses modulate cellular miRNAs and interact with the miRNA-mediated host response. We aim to analyze the miRNA profile of HIV patients with different exposure to HCV to explore specific signatures in the miRNA profile of PBMCs for each type of infection. We massively sequenced small RNAs of PBMCs from 117 HIV+ infected patients: 45 HIV+ patients chronically infected with HCV (HIV/HCV+), 36 HIV+ that spontaneously clarified HCV after acute infection (HIV/HCV-) and 36 HIV+ patients without previous HCV infection (HIV). Thirty-two healthy patients were used as healthy controls (HC). Differential expression analysis showed significantly differentially expressed (SDE) miRNAs in HIV/HCV+ (n = 153), HIV/HCV- (n = 169) and HIV (n = 153) patients. We found putative dysregulated pathways, such as infectious-related and PI3K signaling pathways, common in all contrasts. Specifically, putatively targeted genes involved in antifolate resistance (HIV/HV+), cancer-related pathways (HIV/HCV-) and HIF-signaling (HIV) were identified, among others. Our findings revealed that HCV strongly influences the expression profile of PBMCs from HIV patients through the disruption of its miRNome. Thus, different HCV exposure can be identified by specific miRNA signatures in PBMCs.This work has been supported by grants from Institute of Health Carlos III, [PI15CIII/00031 and PI18CIII/00020/ to AFR and VB] and the Foundation Universidad Alfonso X el Sabio-Santander [grant number 1.010.932 to AFR] and the Spanish AIDS Research Network (RD16CIII/0002/0002), and Centro de Investigación Biomédica en Red (CIBER) en Enfermedades Infecciosas (CB21/13/00044). AFR is supported by the Miguel Servet programme from Fondo de Investigación Sanitaria (ISCIII) [CP14/CIII/00010 and CPII20CIII/0001].info:eu-repo/semantics/publishedVersio

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Utilización de materiales multimedia para la elaboración de unidades didácticas y otros trabajos para su aplicación al aula

Trabajo no publicadoEl proyecto se incluye en las actividades desarrolladas por el Centro de Formación del Profesorado e Innovación Educativa de Béjar (Salamanca) con la participación de un total de 9 profesores y ha sido llevado a cabo por el Centro Rural Agrupado 'Ruta de la Plata' de Puerto de Béjar en Salamanca. El objetivo general del proyecto ha sido analizar material multimedia para elaborar unidades didácticas. El proyecto se ha basado en el conocimiento de programas educativos sobre los que se ha elaborado una ficha de catalogación con el fin de poder utilizarlos en la elaboración de unidades didácticas para utilizar con el alumnado.Junta de Castilla y LeónCastilla y LeónES

How do women living with HIV experience menopause? Menopausal symptoms, anxiety and depression according to reproductive age in a multicenter cohort

CatedresBackground: To estimate the prevalence and severity of menopausal symptoms and anxiety/depression and to assess the differences according to menopausal status among women living with HIV aged 45-60 years from the cohort of Spanish HIV/AIDS Research Network (CoRIS). Methods: Women were interviewed by phone between September 2017 and December 2018 to determine whether they had experienced menopausal symptoms and anxiety/depression. The Menopause Rating Scale was used to evaluate the prevalence and severity of symptoms related to menopause in three subscales: somatic, psychologic and urogenital; and the 4-item Patient Health Questionnaire was used for anxiety/depression. Logistic regression models were used to estimate odds ratios (ORs) of association between menopausal status, and other potential risk factors, the presence and severity of somatic, psychological and urogenital symptoms and of anxiety/depression. Results: Of 251 women included, 137 (54.6%) were post-, 70 (27.9%) peri- and 44 (17.5%) pre-menopausal, respectively. Median age of onset menopause was 48 years (IQR 45-50). The proportions of pre-, peri- and post-menopausal women who had experienced any menopausal symptoms were 45.5%, 60.0% and 66.4%, respectively. Both peri- and post-menopause were associated with a higher likelihood of having somatic symptoms (aOR 3.01; 95% CI 1.38-6.55 and 2.63; 1.44-4.81, respectively), while post-menopause increased the likelihood of having psychological (2.16; 1.13-4.14) and urogenital symptoms (2.54; 1.42-4.85). By other hand, post-menopausal women had a statistically significant five-fold increase in the likelihood of presenting severe urogenital symptoms than pre-menopausal women (4.90; 1.74-13.84). No significant differences by menopausal status were found for anxiety/depression. Joint/muscle problems, exhaustion and sleeping disorders were the most commonly reported symptoms among all women. Differences in the prevalences of vaginal dryness (p = 0.002), joint/muscle complaints (p = 0.032), and sweating/flush (p = 0.032) were found among the three groups. Conclusions: Women living with HIV experienced a wide variety of menopausal symptoms, some of them initiated before women had any menstrual irregularity. We found a higher likelihood of somatic symptoms in peri- and post-menopausal women, while a higher likelihood of psychological and urogenital symptoms was found in post-menopausal women. Most somatic symptoms were of low or moderate severity, probably due to the good clinical and immunological situation of these women

COVID-19 in hospitalized HIV-positive and HIV-negative patients : A matched study

CatedresObjectives: We compared the characteristics and clinical outcomes of hospitalized individuals with COVID-19 with [people with HIV (PWH)] and without (non-PWH) HIV co-infection in Spain during the first wave of the pandemic. Methods: This was a retrospective matched cohort study. People with HIV were identified by reviewing clinical records and laboratory registries of 10 922 patients in active-follow-up within the Spanish HIV Research Network (CoRIS) up to 30 June 2020. Each hospitalized PWH was matched with five non-PWH of the same age and sex randomly selected from COVID-19@Spain, a multicentre cohort of 4035 patients hospitalized with confirmed COVID-19. The main outcome was all-cause in-hospital mortality. Results: Forty-five PWH with PCR-confirmed COVID-19 were identified in CoRIS, 21 of whom were hospitalized. A total of 105 age/sex-matched controls were selected from the COVID-19@Spain cohort. The median age in both groups was 53 (Q1-Q3, 46-56) years, and 90.5% were men. In PWH, 19.1% were injecting drug users, 95.2% were on antiretroviral therapy, 94.4% had HIV-RNA < 50 copies/mL, and the median (Q1-Q3) CD4 count was 595 (349-798) cells/μL. No statistically significant differences were found between PWH and non-PWH in number of comorbidities, presenting signs and symptoms, laboratory parameters, radiology findings and severity scores on admission. Corticosteroids were administered to 33.3% and 27.4% of PWH and non-PWH, respectively (P = 0.580). Deaths during admission were documented in two (9.5%) PWH and 12 (11.4%) non-PWH (P = 0.800). Conclusions: Our findings suggest that well-controlled HIV infection does not modify the clinical presentation or worsen clinical outcomes of COVID-19 hospitalization

Medicina de Urgencias Tomo 2

Public health represents one of the greatest challenges in society, which is why it is essential to strengthen the links of scientific cooperation between the academy and the community under a common premise: guarantee the health of the population. In Ecuador, public health faces a historical challenge framed by two edges: the health crisis due to the Covid-19 pandemic and the shortcomings of the social system. This leads to thinking about both the importance of the problem and its possible solutions. Despite this, it is undeniable to affirm that all health personnel share a common ideology and the same commitment, guaranteeing the health of the population.   Obviously it is not an easy task due to social uncertainty and the possible appearance of new diseases; however, it is based on a common denominator: basing decisions on the available scientific evidence or what is known as evidence-based medicine. The generation of new knowledge and the use of the best available scientific evidence is the only hope for solving the health problems that afflict the population. In this way, Emergency Medicine seeks to be a timely and practical clinical-therapeutic reference point for emerging regional circumstances, using updated international management guidelines as references and emphasizing evidence-based medicine. We are sure that it will be an invaluable contribution for health professionals.   Emergency Medicine, in its two volumes, is a work carried out by teachers, students and medical and related specialists, from the Medicine and Nursing career of the Catholic University of Cuenca, Azogues Campus. In addition, it has the contribution of other medical specialists with extensive professional experience and contributes with 52 chapters that address clinical, surgical, pediatric, and gynecological-obstetric pathologies that require timely management in the emergency room. At the same time, this work addresses topics of current interest such as medicolegal aspects of emergency care, urgent complications in HIV infections, use of antimicrobials in emergencies, dose adjustment in patients with kidney failure; and, a special chapter on SARS-CoV-2: diagnostic-therapeutic management.La salud pública representa uno de los retos más grandes en la sociedad, razón por lo cual es fundamental que se robustezcan los vínculos de cooperación científica entre la academia y la colectividad bajo una premisa común: garantizar la salud de la población. En Ecuador, la salud pública afronta un reto histórico enmarcado en dos aristas: la crisis sanitaria debido a la pandemia por Covid-19 y las carencias del sistema social. Esto conduce a pensar tanto en la trascendencia del problema como en sus posibles soluciones. A pesar de aquello, resulta innegable afirmar que todo el personal sanitario comparte una ideología en común y el mismo compromiso, garantizar la salud de la población. Evidentemente no constituye una tarea fácil debido a la incertidumbre social y a la posible aparición de nuevas enfermedades; sin embargo, se basa en un denominador común: asentar las decisiones en la evidencia científica disponible o lo que se conoce como medicina basada en la evidencia. La generación de nuevo conocimiento y la utilización de la mejor evidencia científica disponible constituye la única esperanza para resolver los problemas de salud que aquejan a la población. De esta forma, Medicina de Urgencias busca ser un referente clínico- terapéutico, oportuno y práctico, de las circunstancias emergentes regionales, tomando como referencias guías de manejo internacionales actualizadas y haciendo hincapié en la medicina basada en la evidencia. Estamos seguros que será un aporte de carácter invaluable para los profesionales de la salud. Medicina de urgencias, en sus dos volúmenes, es una obra realizada por docentes, estudiantes y especialistas médicos y afines, de la carrera de Medicina y Enfermería de la Universidad Católica de Cuenca, Sede Azogues. Además, cuenta con el aporte de otros médicos especialistas con amplia trayectoria profesional y aporta con 52 capítulos que abordan patologías clínicas, quirúrgicas, pediátricas, y gíneco-obstétricas, que requieren manejo oportuno en la sala de emergencias.  Al mismo tiempo, la presente obra aborda temáticas de interés actual como aspectos médico legales de la atención en urgencias, complicaciones urgentes en las infecciones por VIH, uso de antimicrobianos en emergencias, ajuste de dosis en pacientes con insuficiencia renal; y, un capítulo especial sobre el SARS-CoV-2: manejo diagnóstico-terapéutico

Medicina de Urgencias Tomo 2

Public health represents one of the greatest challenges in society, which is why it is essential to strengthen the links of scientific cooperation between the academy and the community under a common premise: guarantee the health of the population. In Ecuador, public health faces a historical challenge framed by two edges: the health crisis due to the Covid-19 pandemic and the shortcomings of the social system. This leads to thinking about both the importance of the problem and its possible solutions. Despite this, it is undeniable to affirm that all health personnel share a common ideology and the same commitment, guaranteeing the health of the population.   Obviously it is not an easy task due to social uncertainty and the possible appearance of new diseases; however, it is based on a common denominator: basing decisions on the available scientific evidence or what is known as evidence-based medicine. The generation of new knowledge and the use of the best available scientific evidence is the only hope for solving the health problems that afflict the population. In this way, Emergency Medicine seeks to be a timely and practical clinical-therapeutic reference point for emerging regional circumstances, using updated international management guidelines as references and emphasizing evidence-based medicine. We are sure that it will be an invaluable contribution for health professionals.   Emergency Medicine, in its two volumes, is a work carried out by teachers, students and medical and related specialists, from the Medicine and Nursing career of the Catholic University of Cuenca, Azogues Campus. In addition, it has the contribution of other medical specialists with extensive professional experience and contributes with 52 chapters that address clinical, surgical, pediatric, and gynecological-obstetric pathologies that require timely management in the emergency room. At the same time, this work addresses topics of current interest such as medicolegal aspects of emergency care, urgent complications in HIV infections, use of antimicrobials in emergencies, dose adjustment in patients with kidney failure; and, a special chapter on SARS-CoV-2: diagnostic-therapeutic management.La salud pública representa uno de los retos más grandes en la sociedad, razón por lo cual es fundamental que se robustezcan los vínculos de cooperación científica entre la academia y la colectividad bajo una premisa común: garantizar la salud de la población. En Ecuador, la salud pública afronta un reto histórico enmarcado en dos aristas: la crisis sanitaria debido a la pandemia por Covid-19 y las carencias del sistema social. Esto conduce a pensar tanto en la trascendencia del problema como en sus posibles soluciones. A pesar de aquello, resulta innegable afirmar que todo el personal sanitario comparte una ideología en común y el mismo compromiso, garantizar la salud de la población. Evidentemente no constituye una tarea fácil debido a la incertidumbre social y a la posible aparición de nuevas enfermedades; sin embargo, se basa en un denominador común: asentar las decisiones en la evidencia científica disponible o lo que se conoce como medicina basada en la evidencia. La generación de nuevo conocimiento y la utilización de la mejor evidencia científica disponible constituye la única esperanza para resolver los problemas de salud que aquejan a la población. De esta forma, Medicina de Urgencias busca ser un referente clínico- terapéutico, oportuno y práctico, de las circunstancias emergentes regionales, tomando como referencias guías de manejo internacionales actualizadas y haciendo hincapié en la medicina basada en la evidencia. Estamos seguros que será un aporte de carácter invaluable para los profesionales de la salud. Medicina de urgencias, en sus dos volúmenes, es una obra realizada por docentes, estudiantes y especialistas médicos y afines, de la carrera de Medicina y Enfermería de la Universidad Católica de Cuenca, Sede Azogues. Además, cuenta con el aporte de otros médicos especialistas con amplia trayectoria profesional y aporta con 52 capítulos que abordan patologías clínicas, quirúrgicas, pediátricas, y gíneco-obstétricas, que requieren manejo oportuno en la sala de emergencias.  Al mismo tiempo, la presente obra aborda temáticas de interés actual como aspectos médico legales de la atención en urgencias, complicaciones urgentes en las infecciones por VIH, uso de antimicrobianos en emergencias, ajuste de dosis en pacientes con insuficiencia renal; y, un capítulo especial sobre el SARS-CoV-2: manejo diagnóstico-terapéutico