Estudio de los efectos del tratamiento con Análogos de las Prostaglandinas sobre las propiedades biomecánicas corneales

Bolívar de Miguel, Gema codirectorINTRODUCCIÓN: El objetivo es evaluar si el tratamiento tópico con análogos de las prostaglandinas (PGs) en pacientes con glaucoma primario de ángulo abierto (GPAA) o hipertensión ocular (HTO) produce cambios en las propiedades viscoelásticas de la córnea y si dichos cambios pueden artefactuar la medida de la presión intraocular (PIO). MATERIAL Y MÉTODOS: - Estudio transversal: incluye 390 pacientes con GPAA o HTO en tratamiento con PGs. Se les realizó TAG, paquimetría ultrasónica, Campo Visual (CV) y ORA. - Estudio prospectivo A, con 68 ojos recién diagnosticados de GPAA o HTO evaluados mediante TAG, paquimetría ultrasónica, CV y ORA, antes y 6 meses después de iniciar tratamiento con PGs. - Estudio prospectivo B, se evaluaron las propiedades biomecánicas corneales y la PIO en 67 ojos recién diagnosticados de GPAA o HTO mediante TAG, ORA y Corvis ST, realizados antes de iniciar el tratamiento con PGs, a los 3 y a los 6 meses. - Además, se incluyeron tres análisis intermedios. RESULTADOS: En el estudio transversal encontramos una fuerte y significativa correlación entre la PIOg (Presión intraocular correlacionada-Goldmann) y la PIOcc (Presión intraocular Corneo-Compensada) (p=0.0001, r2=0.9). Respecto a los estudios prospectivos sólo encontramos una correlación estadísticamente significativa de la desviación media (DM) del CV con la HC (p=0.003, r2=0.16) y con el ECC (p=0.03, r2=0.08) en los pacientes con GPAA. La PIOcc fue significativamente mayor que la PIO GAT en los GPAA (p=0.002), mientras que no se encontraron diferencias significativas entre ambos tonómetros en los HTO (p=0.5). No encontramos ninguna diferencia estadísticamente significativa en la medida del descenso de PIO tras tratamiento entre PIO GAT y PIOcc, mientras que el descenso de PIO medido mediante Corvis ST fue estadísticamente diferente (p=0.0001). La HC aumentó significativamente (p=0.0001), y este incremento se correlacionó significativamente con la HC basal (p=0.0001, r=0.64, r2=0.41). Sin embargo, el incremento de la HC no se correlacionó con el descenso de la PIO GAT. Finalmente, encontramos cambios estadísticamente significativos tras 6 meses de tratamiento con PGs en varios de los parámetros medidos mediante Corvis ST. La magnitud del descenso de PIOcorvis (ΔPIOcorvis) se correlacionó de forma significativa con el AT1 (p=0.001, r2=0.98), AT2 (p=0.0001, r2=0.52) y con la DA (p=0.001, r2=0.61). CONCLUSIONES: El estudio de la córnea de pacientes glucomatosos, mediante Corvis ST y ORA, muestra que el tratamiento con PGs induce cambios en las propiedades biomecánicas corneales. En estos pacientes la PIOg, medida por ORA, no se puede considerar equivalente a la PIO TAG y la medida de descenso de PIO inducido por PGs es diferente dependiendo del tonómetro usado. Encontramos una correlación entre la HC y el ECC con la severidad del daño campimétrico en pacientes recién diagnosticados de GPAA. Además, las PGs producen cambios en la HC y en algunos de los parámetros biomecánicos medidos por Corvis ST que no se correlacionan de forma significativa con el efecto de la bajada de PIO GAT tras 6 meses de tratamiento. Estos cambios sugieren un efecto directo de las PGs independiente del descenso de PIO TAG inducido por ellas

Impact of climate change on berthing areas in ports of the Balearic Islands: adaptation measures

Climate change generates impacts on coastal areas due to sea-level rise and potential modifications in wave and storm surge patterns. Since harbours are located in littoral areas, they will experience different impacts associated to such processes. In this paper, the effects of climate change on port berthing areas in terms of operability are quantified. The study is focused on the ports of the Balearic Islands (Western Mediterranean Sea) and analyses the loss of operability due to the reduction of freeboard in berthing structures and the potential variation in agitation within these harbours during the 21st century, considering two different climate scenarios (RCP4.5 and RCP8.5) and two-time horizons (2045 and 2100). In addition, adaptation measures to address such impacts are proposed and their cost estimated. The results indicate that climate change will not generate significant changes in wave agitation due to negligible variations in wave patterns under future scenarios. On the contrary, sea-level rise will cause huge increases of inoperability for berthing structures due to insufficient freeboard: 10.5% under RCP4.5 or 20.5% under RCP8.5 in 2045, increasing to 57.1% (RCP4.5) and even 83.2% (RCP8.5) in 2100.This study was supported by PIMA ADAPTA-Balears Project funded by Conselleria de Transició Energética, Sectors Productius i Memòria Democràtica and Conselleria de Mobilitat i Habitatge, Govern Balear, and by the project PLEC2021-007810 funded by MCIN/AEI/10.13039/501100011033 and by the European Union “Next Generation EU”/PRTR”.Peer ReviewedPostprint (published version

El uso del Arte en la formación y en la intervención del Trabajo Social: estudio comparado entre España y Portugal

Depto. de Trabajo Social y Servicios SocialesFac. de Trabajo SocialFALSEsubmitte

Diseño y elaboración de bases de datos de consulta on-line de ayuda a la docencia en las Ciencias Sociales

Memoria ID-0197. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2016-2017

Central Pathology Review in SENTIX, a Prospective Observational International Study on Sentinel Lymph Node Biopsy in Patients with Early-Stage Cervical Cancer (ENGOT-CX2)

The quality of pathological assessment is crucial for the safety of patients with cervical cancer if pelvic lymph node dissection is to be replaced by sentinel lymph node (SLN) biopsy. Central pathology review of SLN pathological ultrastaging was conducted in the prospective SENTIX/European Network of Gynaecological Oncological Trial (ENGOT)-CX2 study. All specimens from at least two patients per site were submitted for the central review. For cases with major or critical deviations, the sites were requested to submit all samples from all additional patients for second-round assessment. From the group of 300 patients, samples from 83 cases from 37 sites were reviewed in the first round. Minor, major, critical, and no deviations were identified in 28%, 19%, 14%, and 39% of cases, respectively. Samples from 26 patients were submitted for the second-round review, with only two major deviations found. In conclusion, a high rate of major or critical deviations was identified in the first round of the central pathology review (28% of samples). This reflects a substantial heterogeneity in current practice, despite trial protocol requirements. The importance of the central review conducted prospectively at the early phase of the trial is demonstrated by a substantial improvement of SLN ultrastaging quality in the second-round review

Autonomous cortisol secretion in patients with primary aldosteronism: prevalence and implications on cardiometabolic profile and on surgical outcomes

Purpose: The aim of this study was to evaluate the prevalence of autonomous cortisol secretion (ACS) in patients with primary aldosteronism (PA) and its implications on cardiometabolic and surgical outcomes. Methods: This is a retrospective multicenter study of PA patients who underwent 1 mg dexamethasone-suppression test (DST) during diagnostic workup in 21 Spanish tertiary hospitals. ACS was defined as a cortisol post-DST >1.8 μg/dL (confirmed ACS if >5 μg/dL and possible ACS if 1.8–5 μg/dL) in the absence of spe cific clinical features of hypercortisolism. The cardiometabolic profile was compared with a control group with ACS without PA (ACS group) matched for age and DST levels. Results: The prevalence of ACS in the global cohort of patients with PA (n = 176) was 29% (ACS–PA; n = 51). Ten patients had confirmed ACS and 41 possible ACS. The cardiometabolic profile of ACS–PA and PA-only patients was simil ar, except for older age and larger tumor size of the adrenal lesion in the ACS–PA group. When comparing the ACS–PA group (n = 51) and the ACS group (n = 78), the prevalence of hypertension (OR 7.7 (2.64–22.32)) and cardiovascular events (OR 5.0 (2.29–11.07)) was higher in ACS–PA patients than in ACS patients. The coexistence of ACS in patien ts with PA did not affect the surgical outcomes, the proportion of biochemical cure and clinical cure being similar between ACS–PA and PA-only groups. Conclusion: Co-secretion of cortisol and aldosterone affects almost one-thi rd of patients with PA. Its occurrence is more frequent in patients with larger tumors and advanced age. However, the cardiometabolic and surgical outcomes of patients with ACS–PA and PA-only are similar

CIBERER : Spanish national network for research on rare diseases: A highly productive collaborative initiative

Altres ajuts: Instituto de Salud Carlos III (ISCIII); Ministerio de Ciencia e Innovación.CIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research

CIBERER: Spanish national network for research on rare diseases: A highly productive collaborative initiative

13 páginas,1 figura, 3 tablas, 1 apéndice. Se extraen los autores pertenecientes a The CIBERER network que trabajan en Centros del CSIC del Appendix ACIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research.This study has been funded by Instituto de Salud Carlos III (ISCIII) and Spanish Ministry of Science and InnovationPeer reviewe