Variación biológica de magnitudes bioquímicas, hematológicas y gasometría en atletas

Tesis doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Medicina, Departamento de Medicina. Fecha de lectura: 03-12-201

Educação, política e universidade

The text examines the task that the university must fulfill in the political education of its students. The analysis starts with the political role that the university institution has played since its very origins, as well as the importance of such training to turn the future professionals into true citizens of a democratic society. The main purposes that this formation will have to fulfill in the future are indicated, as well as the obstacles that should be avoided so that the teaching chair does not end up becoming a tribune of political proselytism.El texto examina la tarea que debe cumplir la universidad en la formación política de sus estudiantes. Se parte de la función política que ha desempeñado la institución universitaria desde sus mismos orígenes, así como de la importancia de dicha formación para hacer de los futuros profesionales verdaderos ciudadanos de una sociedad democrática. Se señalan los principales propósitos que deberá cumplir dicha formación, así como los escollos que deberán evitarse para que la cátedra docente no termine convirtiéndose en tribuna de proselitismo político.O texto examina a tarefa que a universidade deve cumprir na educação política dos seus estudantes. Baseia-se na função política que a instituição universitária tem desempenhado desde suas origens, bem como na importância dessa formação para fazer dos futuros profissionais verdadeiros cidadãos de uma sociedade democrática. Os principais propósitos que esta formação terá que cumprir são indicados, assim como os obstáculos que devem ser evitados para que a aula de ensino não termine se tornando uma tribuna de proselitismo político

Effect of pharmacological pupil dilation on measurements and iol power calculation made using the new swept-source optical coherence tomography-based optical biometer

Purpose: to determine whether pupil dilation affects biometric measurements and intraocular lens (IOL) power calculation made using the new swept-source optical coherence tomography-based optical biometer (IOLMaster 700©; Carl Zeiss Meditec, Jena, Germany). Procedures: eighty-one eyes of 81 patients evaluated for cataract surgery were prospectively examined using the IOLMaster 700© before and after pupil dilation with tropicamide 1%. The measurements made were: axial length (AL), central corneal thickness (CCT), aqueous chamber depth (ACD), lens thickness (LT), mean keratometry (MK), white-to-white distance (WTW) and pupil diameter (PD). Holladay II and SRK/T formulas were used to calculate IOL power. Agreement between measurement modes (with and without dilation) was assessed through intraclass correlation coefficients (ICC) and Bland-Altman plots. Results: mean patient age was 75.17 ± 7.54 years (range: 57–92). Of the variables determined, CCT, ACD, LT and WTW varied significantly according to pupil dilation. Excellent intraobserver correlation was observed between measurements made before and after pupil dilation. Mean IOL power calculation using the Holladay 2 and SRK/T formulas were unmodified by pupil dilation. Conclusions: the use of pupil dilation produces statistical yet not clinically significant differences in some IOLMaster 700© measurements. However, it does not affect mean IOL power calculation

Within- and between-subject biological variation data for tumor markers based on the European Biological Variation Study

Postponed access: the file will be available after 2022-05-10Objectives: Reliable biological variation (BV) data are required for the clinical use of tumor markers in the diagnosis and monitoring of treatment effects in cancer. The European Biological Variation Study (EuBIVAS) was established by the EFLM Biological Variation Working Group to deliver BV data for clinically important measurands. In this study, EuBIVAS-based BV estimates are provided for cancer antigen (CA) 125, CA 15-3, CA 19-9, carcinoembryonic antigen, cytokeratin-19 fragment, alpha‐fetoprotein and human epididymis protein 4. Methods: Subjects from five European countries were enrolled in the study, and weekly samples were collected from 91 healthy individuals (53 females and 38 males; 21–69 years old) for 10 consecutive weeks. All samples were analyzed in duplicate within a single run. After excluding outliers and homogeneity analysis, the BVs of tumor markers were determined by CV-ANOVA on trend-corrected data, when relevant (Røraas method). Results: Marked individuality was found for all tumor markers. CYFRA 21-1 was the measurand with the highest index of individuality (II) at 0.67, whereas CA 19-9 had the lowest II at 0.07. The CV I s of HE4, CYFRA 21-1, CA 19-9, CA 125 and CA 15-3 of pre- and postmenopausal females were significantly different from each other. Conclusions: This study provides updated BV estimates for several tumor markers, and the findings indicate that marked individuality is characteristic. The use of reference change values should be considered when monitoring treatment of patients by means of tumor markers.publishedVersio

Experience on how to implement a preanalytical and POCT unit in Madrid’s IFEMA field hospital during this unprecedented COVID-19 emergency

To fight the virus SARS-CoV-2 spread to Europe from China and to give support to the collapsed public health system, the Spanish Health Authorities developed a field hospital located in the facilities of Madrid exhibition centre (IFEMA) to admit and treat patients diagnosed with SARS-CoV-2 infectious disease (COVID-19). The Department of Laboratory Medicine of La Paz University Hospital in Madrid (LMD-HULP) was designated to provide laboratory services. Due to the emergency, the IFEMA field hospital had to be prepared for patient admission in less than 1 week and the laboratory professionals had to collaborate in a multidisciplinary group to assure that resources were available to start on time. The LMD-HULP participated together with the managers in the design of the tests portfolio and the integration of the healthcare information systems (IS) (hospital IS, laboratory IS and POCT management system). Laboratorians developed a strategy to quickly train clinicians and nurses on test requests, sample collection procedures and management/handling of the POCT blood gas analyser both by written materials and training videos. The IFEMA´s preanalytical unit managed 3782 requests, and more than 11,000 samples from March 27th to April 30th. Furthermore, 1151 samples were measured by blood gas analysers. In conclusion, laboratory professionals must be resilient and have to respond timely in emergencies as this pandemic. The lab’s personnel selection, design and monitoring indicators to maintain and further improve the quality and value of laboratory services is crucial to support medical decision making and provide better patient care

Within- and between-subject biological variation data for serum zinc, copper and selenium obtained from 68 apparently healthy Turkish subjects

Postponed access: the file will be available after 2022-10-22Objectives: Trace elements (TrEL) are nutritionally essential components in maintaining health and preventing diseases. There is a lack of reliable biological variation (BV) data for TrELs, required for the diagnosis and monitoring of TrEL disturbances. In this study, we aimed to provide updated within- and between-subject BV estimates for zinc (Zn), copper (Cu) and selenium (Se). Methods: Weekly serum samples were drawn from 68 healthy subjects (36 females and 32 males) for 10 weeks and stored at −80 °C prior to analysis. Serum Zn, Cu and Se levels were measured using inductively-coupled plasma mass spectrometry (ICP-MS). Outlier and variance homogeneity analyses were performed followed by CV-ANOVA (Røraas method) to determine BV and analytical variation estimates with 95% CI and the associated reference change values (RCV) for all subjects, males and females. Results: Significant differences in mean concentrations between males and females were observed, with absolute and relative (%) differences for Zn at 0.5 μmol/L (3.5%), Cu 2.0 μmol/L (14.1%) and Se 0.06 μmol/L (6.0%). The within-subject BV (CVI [95% CI]) estimates were 8.8% (8.2–9.3), 7.8% (7.3–8.3) and 7.7% (7.2–8.2) for Zn, Cu and Se, respectively. Within-subject biological variation (CVI) estimates derived for male and female subgroups were similar for all three TrELs. Marked individuality was observed for Cu and Se. Conclusions: The data of this study provides updated BV estimates for serum Zn, Cu and Se derived from a stringent protocol and state of the art methodologies. Furthermore, Cu and Se display marked individuality, highlighting that population based reference limits should not be used in the monitoring of patients.publishedVersio

The European Biological Variation Study (EuBIVAS): Biological Variation Data for Coagulation Markers Estimated by a Bayesian Model.

Abstract Background For biological variation (BV) data to be safely used, data must be reliable and relevant to the population in which they are applied. We used samples from the European Biological Variation Study (EuBIVAS) to determine BV of coagulation markers by a Bayesian model robust to extreme observations and used the derived within-participant BV estimates [CVP(i)] to assess the applicability of the BV estimates in clinical practice. Method Plasma samples were drawn from 92 healthy individuals for 10 consecutive weeks at 6 European laboratories and analyzed in duplicate for activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen, D-dimer, antithrombin (AT), protein C, protein S free, and factor VIII (FVIII). A Bayesian model with Student t likelihoods for samples and replicates was applied to derive CVP(i) and predicted BV estimates with 95% credibility intervals. Results For all markers except D-dimer, CVP(i) were homogeneously distributed in the overall study population or in subgroups. Mean within-subject estimates (CVI) were <5% for APTT, PT, AT, and protein S free, <10% for protein C and FVIII, and <12% for fibrinogen. For APTT, protein C, and protein S free, estimates were significantly lower in men than in women ≤50 years. Conclusion For most coagulation markers, a common CVI estimate for men and women is applicable, whereas for APTT, protein C, and protein S free, sex-specific reference change values should be applied. The use of a Bayesian model to deliver individual CVP(i) allows for improved interpretation and application of the data

Biological variation data for lipid cardiovascular risk assessment biomarkers:A systematic review applying the biological variation data critical appraisal checklist (BIVAC)

Background: Biological variation (BV) data can be used to set analytical performance specifications (APS) for lipid assays. Poor performance will impact upon the efficacy of international guidelines for cardiovascular risk assessment (CVR) and relevant clinical decision limits. This systematic review applies the Biological Variation Data Critical Appraisal Checklist (BIVAC) to published studies of BV of CVR biomarkers enabling metanalysis of the data. Methods: Studies of BV of total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides and apolipoproteins A1 and B, retrieved using a systematic literature search, were evaluated and graded using the BIVAC. Meta-analysis of CVI and CVG estimates were performed utilizing weightings based upon BIVAC grades and the width of the data confidence intervals. Results: Applying the BIVAC, ten publications were graded as D, 43 as C, 5 as B and 1 as A (fully compliant). A total of 196 CVI and 87 CVG estimates were available for the different lipid measurands. The meta-analysis-derived BV data estimates were generally concordant with those in the online 2014 BV database. Conclusions: Application of BIVAC identifies BV data suitable for many important applications including setting APS. Additionally, this review identifies a need for new BIVAC compliant studies to deliver BV reference data in different subpopulations

Filosofía y personalismo en un mundo en crisis: tomo 1

164 p.Esta obra se ocupa de serias reflexiones sobre aspectos críticos de la realidad en el mundo actual. ¿Cómo combatir el materialismo y el individualismo hedonista y egocéntrico en un mundo globalizado? ¿Es el diálogo intercultural una posibilidad de abordaje para comprender las distintas situaciones, acontecimientos y hechos con los que se cuestiona y se contrasta la existencia del hombre en el siglo XXI? Sus autores consideran que la poesía, el hecho religioso, la espiritualidad, el cuidado de sí mismo, el pensar filosófico, las formas del arte, el reconocimiento de las emociones y de los sentimientos, la construcción de un proyecto vital en la clave de una cultura de vida que redunde en al acto educativo, conducen a un elevado encuentro con el ser personal.Prólogo. Francisco José Gómez-Ortiz 1. El sentido religioso y la poesía de Giacomo Leopardi en Luigi Giussani. William Fernando Puentes-González, Jaime Édgar Gutiérrez-Orozco 2. El cultivo de la persona a partir del cuidado de sí mismo. Jaime Montero-Anzola 3. La filosofía como orientación en época de crisis: lecturas actuales de Ortega y Marías. Nieves Gómez-Álvarez 4. Persona y mundo en crisis: Las acciones humanas y los horizontes personales desde el personalismo. Édgar Javier Garzón-Pascagaza 5. La persona frente a un mundo en crisis: El arte de frente a la persona y su realidad social. Sandra Ligia Ramírez-Orozco 6. Los sentimientos y su significado: una búsqueda por la esencia de la noción de persona en Charles Taylor. Carlos Rubén Gélvez-Higuera 7. Universidad católica y cultura de la vida. Dalia Jaqueline Santa Cruz-Vera 8. Un personalismo encarnado en el corazón: Aportes de Dietrich von Hildebrand. Víctor Manuel Díaz-Soto 9. La ipseidad des-en-mascarada: exterioridad, alteridad y apertura del otro en Lévinas y Derrida. Julia Urabayen, Jorge León-Casero 10. La expresión literaria como medio de conocimiento antropológico en la filosofía de Karol Wojtyla. Carmen González 11. Proyecto vital o de la felicidad en el pensamiento de Julián Marías. Ana María Araújo-castro Conclusione

La normativa IEC para sistemas eólicos e híbridos aislados, y la utilización de tecnologías de medición remota: aplicación en contexto patagónico

Se presentan los aspectos más relevantes de la normativa IEC (Comisión Electrotécnica Internacional) en lo relativo a sistemas eólicos en general incluyendo la reciente incorporación de Sensores Remotos (RSDs), los de baja potencia en particular y la normativa que rige los sistemas híbridos aislados basados en energía renovable para electrificación rural. Uno de los aspectos de la IEC 61400-2 (ensayo de duración) en los sistemas eólicos baja potencia se puede llevar adelante utilizando como base la normativa para medición de curva de potencia IEC 61400-12-1 en su Anexo H para Pequeñas Turbinas Eólicas (PTEs). Si dicho sistema combina además alimentación por fuentes fotovoltaicas, se lo encuadra como caso híbrido práctico para electrificación de comunidades aisladas bajo la norma IEC 62257, identificando la tipología particular que sin embargo es aplicable a un número importante de sistemas similares en la zona patagónica austral.This work presents relevant aspects of the IEC standards relating to wind turbine systems in their design and testing, with emphasis in low power systems (IEC 61400-2) and also the possibility of using (in latest IEC61400-12-1, ed 2017) LIDAR or other RSD (Remote Sensing Devices) to simplify wind measurements in case of power curve or AEP estimation. Also assessed are the rural electrification standards collectively known as the IEC 62257 standards, with emphasis in renewable energy deployment for isolated systems.Asociación Argentina de Energías Renovables y Medio Ambiente (ASADES