Breast-feeding as protective factor against bronchopulmonary dysplasia in preterm infants

Breast-feeding is associated with fewer comorbidities in very-low-birth-weight (VLBW) preterm infants. Bronchopulmonary dysplasia (BPD) of VLBW infants is a multifactorial pathology in which nutritional aspects may be of special importance. The aim of this study is to determine, in a cohort of VLBW infants, whether breast milk nutrition is associated with a reduced prevalence and severity of BPD. A retrospective study was conducted to record the intake of mother's own milk (MOM), pasteurised donor human milk or preterm formula milk in the first 2 weeks of postnatal life of 566 VLBW newborns at our hospital during the period January 2008-December 2021. After applying the relevant exclusion criteria, data for 489 VLBW infants were analysed; 195 developed some degree of BPD. Moderate or severe BPD is associated with less weight gain. Moreover, the preferential ingestion of breast milk in the first and second postnatal weeks had effects associated with lower OR for BPD, which were statistically demonstrable for mild (OR 0·16; 95 % CI 0·03, 0·71) and severe (OR 0·08; 95 % CI 0·009, 0·91) BPD. Breast-feeding during the first weeks of postnatal life is associated with a reduced prevalence of BPD, which is frequently associated with less weight gain as a result of greater respiratory effort with greater energy expenditure

Probiotics in very-low-birth-weight newborns

Some studies have reported a decreased incidence of enterocolitis necrotizing after supplementation with probiotics. However, few studies have considered the equivalence or otherwise of different strains in preventing enterocolitis necrotizing in newborns. A prospective observational study was conducted in a cohort of 291 VLBW newborns, designed to assess the prevalence of enterocolitis necrotizing after receiving supplementation with the probiotic Inforan® (Berna Biotech, Madrid, Spain) 250 mg capsules containing 109 colony forming units (CFU) Lactobacillus acidophilus (ATCC 4356) and 109 CFU Lactobacillus. bifidum (ATCC 15696) (European Medicines Agency, 2014); Bivos® (Ferring, Madrid, Spain) containing Lacticaseibacillus rhamnosus (LGG) (ATCC 53103) (109 CFU); or no probiotic. Statistical analysis was performed using multivariant regression with days of parenteral nutrition, NICU stay, oxygenotherapy and chorioamnionitis. 173 VLBW newborns received probiotic supplementation, 65 received Infloran® and 108 Bivos®. In 72 VLBW newborns no probiotic was administered. We observed a significant association between reduction of necrotizing enterocolitis ≥ grade 2 and probiotic use. For Infloran® OR 0.174 (CI 95% 0.032, 0.936), for Bivos® OR 0.196 (CI95% 0.053, 0.732). Although both probiotics are associated with a lower prevalence of necrotizing enterocolitis in VLBW newborns, the comparison between Infloran® or Bivos® does not show significant differences

Daño por isquemia-reperfusión durante el trasplante cardíaco experimental. Evaluación del papel citoprotector de la trimetazidina

Introducción y objetivos. El objetivo de este trabajo fueanalizar el daño por isquemia-reperfusión mediado por radicales libres que se produce durante el trasplante cardíaco y eva-luar el posible efecto citoprotector de la trimetazidina (TMZ). Material y método. Se realizaron 21 trasplantes cardíacos ortotópicos en cerdos. Dividimos los experimentos en 2 grupos: A (n = 11), en el que se realizó una protección miocárdica estándar, y B (n = 10), en el que se administró TMZ en la cardioplejía empleada para parar el corazón donante (TMZ, 10¿5 mol/l), como pretratamiento intravenosodel receptor (TMZ, 2,5 mg/kg) y como parte de la cardio-plejía infundida en el receptor antes de despinzar la aorta(TMZ, 10¿5 mol/l). Se tomaron muestras de sangre del senocoronario del receptor en 3 momentos: basal, isquemia y reperfusión. Se determinó la concentración de malonildial-dehído como marcador de peroxidación lipídica y de variosantioxidantes: glutatión peroxidasa, glutatión reductasa,superóxido dismutasa, a-tocoferol, retinol y estado de antioxidantes totales. Resultados. Durante la isquemia-reperfusión aumentóla producción de malonildialdehído y la actividad de losantioxidantes enzimáticos, mientras que el retinol disminuyó. El incremento de malonildialdehído y de la actividad de la glutatión peroxidasa entre el momento basal y la reperfusión fue significativamente mayor en el grupo A. Conclusiones. Durante el trasplante se incrementó progresivamente el nivel de peroxidación lipídica y se activaronlos sistemas antioxidantes intracelulares. La TMZ ejerció un efecto citoprotector y limitó el daño por isquemia-reperfusión generado por los radicales libres, además de modificar el patrón de reacción de parte de los sistemas de defensa

Indole Tryptophan Metabolism and Cytokine S100B in Children with Attention-Deficit/Hyperactivity Disorder: Daily Fluctuations, Responses to Methylphenidate, and Interrelationship with Depressive Symptomatology.

Background: Indole tryptophan metabolites (ITMs), mainly produced at the gastrointestinal level, participate in bidirectional gut-brain communication and have been implicated in neuropsychiatric pathologies, including attention-deficit/hyperactivity disorder (ADHD). Method: A total of 179 children, 5-14 years of age, including a healthy control group (CG, n = 49), and 107 patients with ADHD participated in the study. The ADHD group was further subdivided into predominantly attention deficit (PAD) and predominantly hyperactive impulsive (PHI) subgroups. Blood samples were drawn at 20:00 and 09:00 hours, and urine was collected between blood draws, at baseline and after 4.63 ± 2.3 months of methylphenidate treatment in the ADHD group. Levels and daily fluctuations of ITM were measured by tandem mass spectrometer, and S100B (as a glial inflammatory marker) by enzyme-linked immunosorbent assay. Factorial analysis of variance (Stata 12.0) was performed with groups/subgroups, time (baseline/after treatment), hour of day (morning/evening), and presence of depressive symptoms (DS; no/yes) as factors. Results: Tryptamine and indoleacetic acid (IAA) showed no differences between the CG and ADHD groups. Tryptamine exhibited higher evening values (p

Build above the “million programme”! : Storey extension on top of the “million programme” buildings

Storstadsregionernas växande befolkning, viljan att förtäta förorterna, samt miljonprogrammets stora utbud av standardiserade flerbostadshus i ytterstaden leder oss fram till examensarbetets innehåll: en studie om våningspåbyggnad på miljonprogrammets flerbostadshus. Syftet med examensarbetet är utreda miljonprogrammets potential för en vertikal förtätning. Vertikal förtätning innebär att redan befintlig bebyggelse kompletteras med ytterligare våningsplan. Syftet är även att underlätta för kommande påbyggnadsprojekt genom att lyfta fram svårigheter som ett påbyggnadsprojekt kan medföra, samt beskriva hur en våningspåbyggnad kan utföras. För att nå rapportens syfte ska följande frågeställningar besvaras: 1. Varför ska vi bygga ovanpå miljonprogrammets flerbostadshus? 2. Hur utformas en våningspåbyggnad lämpligast med avseende på stommaterial, byggmetod och installationer? 3. Vad bör särskilt beaktas vid en våningspåbyggnad? Examensarbetet kommer att studera miljonprogrammets potential för en vertikal förtätning i främst Stockholms stads förorter. Flerbostadshusens byggtekniska förutsättningar lyfts fram. Utöver det studeras lämpliga byggmetoder, stommaterial och installationslösningar för en påbyggnad. Examensarbetet avslutas med att belysa vad som särskilt bör beaktas i ett påbyggnadsprojekt. Resultatet av examensarbetet visar att miljonprogrammets flerbostadshus har god potential för en vertikal förtätning. Våningspåbyggnaden utformas lämpligast med planelement av betong om den befintliga konstruktionen tål en tung påbyggnad utan förstärkning. I annat fall konstrueras påbyggnadens stomme lämpligast av planelement av trä för miljonprogrammets flerbostadshus. För att fritt kunna utforma våningspåbyggnadens planlösning bör en balkgrund eller ett installationsgolv installeras. Där kan de nya installationerna till påbyggnaden dras. För att undvika störningar under projektets gång är områdets förutsättningar minst lika viktiga att beakta som den befintliga konstruktionens byggtekniska förutsättningar. Hyresgästernas åsikter och skyddsrumsreglerna ska även beaktas tidigt i ett våningspåbyggnadsprojekt.The growing population in most Swedish conurbations, the desire to densify housing in the suburbs, as well as the suitability of the so called ”the Million Programme” wide range of standardized apartment buildings in the suburbs, led us to the thesis content: a study on storey extension for “the Million Programme” apartment buildings. The aim of the thesis is to facilitate the concept development phase for future storey extension projects and overall, to investigate ”the Million Programme” buildings’ potential for vertical densification. . Vertical densification means supplying additional floors on already existing buildings. To address the purpose of the report, the following questions will be answered: 1. What are the incentives for building on top of ”the Million Programme” apartment buildings? 2. How should a storey extension be designed conveniently concerning construction methods, selection of structural bearing materials and HVAC? 3. What should be considered especially during a storey extension project? The thesis will investigate potential of the buildings of ”the Million Programme” for a vertical densification, mainly in Stockholm’s suburbs. The residential buildings’ technical conditions will be highlighted. In addition, the study will also consider suitable construction methods and structural bearing materials, as well as HVAC solutions for storey extension. The thesis is rounded off by highlighting what should be considered especially during the storey extension project work to avoid or minimize disturbances during the project. The result of the thesis proves that the ”million programme” apartment buildings have good potential for a storey extension. If the existing building allows a massive storey extension without revetments, the storey extension should be made of plan elements of concrete. Otherwise the most appropriate alternative is proven to be plan elements of wood on the “million programme” apartment buildings. To freely be able to design the plan arrangements in the storey extension, an appropriate alternative is to build a beam floor or an installation floor that creates a space between the existing floor and the new floor. This space can be used for the new installations for the storey extension. Our result also proves that the area qualifications are at least as important to observe as the technical qualifications of the existing buildings. Also the opinions of the tenants in the area and shelter regulations are important things to investigate early in the project

Methylphenidate ameliorates the homeostatic balance between levels of kynurenines in ADHD children

The kynurenine pathway of tryptophan metabolism has been involved in ADHD We quantified basal levels and daily fluctuations of tryptophan and several kynurenine metabolites, as well as their changes after treatment with methylphenidate (MPH). A total of 179 children were recruited, grouped into ADHD (n = 130) and healthy controls (CG,n = 49). Blood samples were drawn at 20:00 and 09:00 h and only in the ADHD group after 4.63±2.3 months of treatment. Nocturnal urine was collected between both draws. Factorial analysis (Stata12.0) was performed with Groups, Time, Hour of Day and Depressive Symptoms (DS) as factors. MPH significantly increased plasma Kynurenic acid (2.4 ± 1.03/2.78±1.3 ng/mL; baseline/post-treatment, morning; z = 1.96,p<0.05) and Xanthurenic acid (2.39±0.95/2.88±1.19 ng/mL; baseline/post, morning; z = 2.7,p<0.007) levels, both with higher values in the evening. In DS+ patients, MPH caused a pronounced decrease in evening Anthranilic acid [3.08±5.02/ 1.82±1.46 ng/mL, z = 2.68,p = 0.0074] until matching values to other subgroups. In urine, MPH decreased the excretion of both Nicotinamide and Quinolinic acids, but only in the DSsubgroup. The kynurenine pathway may participate in the highly clinical favorable response to MPH. The observed changes could be considered as protective (i.e. increased plasma kynurenic acid vs. decreased quinolinic acid excretion) based on the knowledge of its physiological homeostatic functions.Health Research Fund (FIS; Spanish Ministry of Science and Innovation) FIS-PI07-060

Inadequate use of antibiotics in the covid-19 era: effectiveness of antibiotic therapy

Background: Since December 2019, the COVID-19 pandemic has changed the concept of medicine. This work aims to analyze the use of antibiotics in patients admitted to the hospital due to SARS-CoV-2 infection. Methods: This work analyzes the use and effectiveness of antibiotics in hospitalized patients with COVID-19 based on data from the SEMI-COVID-19 registry, an initiative to generate knowledge about this disease using data from electronic medical records. Our primary endpoint was all-cause in-hospital mortality according to antibiotic use. The secondary endpoint was the effect of macrolides on mortality. Results: Of 13,932 patients, antibiotics were used in 12,238. The overall death rate was 20.7% and higher among those taking antibiotics (87.8%). Higher mortality was observed with use of all antibiotics (OR 1.40, 95% CI 1.21-1.62; p < .001) except macrolides, which had a higher survival rate (OR 0.70, 95% CI 0.64-0.76; p < .001). The decision to start antibiotics was influenced by presence of increased inflammatory markers and any kind of infiltrate on an x-ray. Patients receiving antibiotics required respiratory support and were transferred to intensive care units more often. Conclusions: Bacterial co-infection was uncommon among COVID-19 patients, yet use of antibiotics was high. There is insufficient evidence to support widespread use of empiric antibiotics in these patients. Most may not require empiric treatment and if they do, there is promising evidence regarding azithromycin as a potential COVID-19 treatment

Evaluation and Improvement in Hybrid Methods Cloud Based Implementation. Simulation Models

El proyecto pretendía, por tanto, realizar una evaluación integral de los métodos de innovación docente híbridos, sobre la nube y basados en la filosofía learning by doing que se están empleando, en distintos estudios oficiales a distintos niveles. En la Facultad de Comercio y Turismo, concretamente, a través de los modelos de simulación. Esta evaluación integral se integró en un modelo de establecimiento de objetivos, denominado CEME (Conocimiento, Evaluación, Medidas de Mejora y Extensión de la metodología a otros estudios de la Facultad.Fac. de Comercio y TurismoFALSEUNIVERSIDAD COMPLUTENSE DE MADRIDunpu