63 research outputs found

    Campanya de Branded Content per a la promoció del petit comerç de moda del barri del Raval de Barcelona

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    Aquest projecte de fi de grau consisteix en la creació d'una campanya de Branded Content per promocionar el petit comerç de moda del barri del Raval de Barcelona. Aquesta campanya també proposa divulgar contingut d'interès cultural del Raval de Barcelona, proporcionant una nova perspectiva sobre el negoci de la cultura a la capital catalana. El projecte també es proposa fidelitzar el públic al qual ens dirigim a través d'aquesta tendència de comunicació, el fashion film, un format d'Advertainment que genera un vincle emocional entre les marques i el consumidor.Este proyecto de fin de grado consiste en la creación de una campaña de Branded Content para promocionar el pequeño comercio de moda del barrio del Raval de Barcelona. Esta campaña también propone divulgar contenido de interés cultural del Raval de Barcelona, proporcionando una nueva perspectiva sobre el negocio de la cultura en la capital catalana. El proyecto también se propone fidelizar al público al que nos dirigimos a través de esta tendencia de comunicación, el fashion film, un formato de Advertainment que genera un vínculo emocional entre las marcas y el consumidor.This final degree project consists of creating a Branded Content campaign to promote the small fashion trade located in the Raval district of Barcelona. This campaign also proposes to publish content of cultural interest of the Raval of Barcelona, providing a new perspective on the culture business in the Catalan capital. The project also aims to promote engagement to the public we are targeting through this trend of communication, the fashion film, an Advertainment format that creates an emotional link between the brands and the consumers

    Leishmaniasis and tumor necrosis factor alpha antagonists in the mediterranean basin. A switch in clinical expression

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    TNF-α blockers therapy; Leishmaniasis; Retrospective observational studyTerapia con bloqueadores de TNF-α; Leishmaniasis; Estudio observacional retrospectivoTeràpia bloquejadora de TNF-α; Leishmaniosi; Estudi observacional retrospectiuBACKGROUND: Tumor necrosis factor alpha (TNF-α) blockers are recognized as a risk factor for reactivation of granulomatous infections. Leishmaniasis has been associated with the use of these drugs, although few cases have been reported. METHODOLOGY: We performed a retrospective observational study including patients with confirmed leishmaniasis acquired in the Mediterranean basin that were under TNF-α blockers therapy at the moment of the diagnosis. Patients diagnosed in our hospital from 2008 to 2018 were included. Moreover, a systematic review of the literature was performed and cases fulfilling the inclusion criteria were also included. PRINCIPAL FINDINGS: Forty-nine patients were analyzed including nine cases from our series. Twenty-seven (55.1%) cases were male and median age was 55 years. Twenty-five (51%) patients were under infliximab treatment, 20 (40.8%) were receiving adalimumab, 2 (4.1%) etanercept, one (2%) golimumab and one (2%) a non-specified TNF-α blocker. Regarding clinical presentation, 28 (57.1%) presented as cutaneous leishmaniasis (CL), 16 (32.6%) as visceral leishmaniasis (VL) and 5 (10.2%) as mucocutaneous leishmaniasis (MCL). All VL and MCL patients were treated with systemic therapies. Among CL patients, 13 (46.4%) were treated with a systemic drug (11 received L-AmB, one intramuscular antimonials and one miltefosine) while 14 (50%) patients were given local treatment (13 received intralesional pentavalent antimonials, and one excisional surgery). TNF-α blockers were interrupted in 32 patients (65.3%). After treatment 5 patients (10.2%) relapsed. Four patients with a CL (3 initially treated with local therapy maintaining TNF-α blockers and one treated with miltefosine) and one patient with VL treated with L-AmB maintaining TNF-α blockers. CONCLUSIONS: This data supports the assumption that the blockage of TNF-α modifies clinical expression of leishmaniasis in endemic population modulating the expression of the disease leading to atypical presentations. According to the cases reported, the best treatment strategy would be a systemic drug and the discontinuation of the TNF-α blockers therapy until clinical resolution

    Parasitemia Levels in Trypanosoma cruzi Infection in Spain, an Area Where the Disease Is Not Endemic: Trends by Different Molecular Approaches

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    Trypanosoma cruzi infection has expanded globally through human migration. In Spain, the mother-to-child route is the mode of transmission contributing to autochthonous Chagas disease (CD); however, most people acquired the infection in their country of origin and were diagnosed in the chronic phase (imported chronic CD). In this context, we assessed the quantitative potential of the Loopamp Trypanosoma cruzi detection kit (Sat-TcLAMP) based on satellite DNA (Sat-DNA) to determine parasitemia levels compared to those detected by real-time quantitative PCRs (qPCRs) targeting Sat-DNA (Sat-qPCR) and kinetoplast DNA minicircles (kDNA-qPCR). This study included 173 specimens from 39 autochthonous congenital and 116 imported chronic CD cases diagnosed in Spain. kDNA-qPCR showed higher sensitivity than Sat-qPCR and Sat-TcLAMP. According to all quantitative approaches, parasitemia levels were significantly higher in congenital infection than in chronic CD (1 × 10-1 to 5 × 105 versus >1 × 10-1 to 6 × 103 parasite equivalents/mL, respectively [P < 0.001]). Sat-TcLAMP, Sat-qPCR, and kDNA-qPCR results were equivalent at high levels of parasitemia (P = 0.381). Discrepancies were significant for low levels of parasitemia and older individuals. Differences between Sat-TcLAMP and Sat-qPCR were not qualitatively significant, but estimations of parasitemia using Sat-TcLAMP were closer to those by kDNA-qPCR. Parasitemia changes were assessed in 6 individual cases in follow-up, in which trends showed similar patterns by all quantitative approaches. At high levels of parasitemia, Sat-TcLAMP, Sat-qPCR, and kDNA-qPCR worked similarly, but significant differences were found for the low levels characteristic of late chronic CD. A suitable harmonization strategy needs to be developed for low-level parasitemia detection using Sat-DNA- and kDNA-based tests. IMPORTANCE: Currently, molecular equipment has been introduced into many health care centers, even in low-income countries. PCR, qPCR, and loop-mediated isothermal amplification (LAMP) are becoming more accessible for the diagnosis of neglected infectious diseases. Chagas disease (CD) is spreading worldwide, and in countries where the disease is not endemic, such as Spain, the parasite Trypanosoma cruzi is transmitted from mother to child (congenital CD). Here, we explore why LAMP, aimed at detecting T. cruzi parasite DNA, is a reliable option for the diagnosis of congenital CD and the early detection of reactivation in chronic infection. When the parasite load is high, LAMP is equivalent to any qPCR. In addition, the estimations of T. cruzi parasitemia in patients living in Spain, a country where the disease is not endemic, resemble natural evolution in areas of endemicity. If molecular tests are introduced into the diagnostic algorithm for congenital infection, early diagnosis and timely treatment would be accomplished, so the interruption of vertical transmission can be an achievable goal.This research was supported by the Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland (WO klob-0003), and the Surveillance Program of Chagas Disease of the National Centre for Microbiology (CNM), Instituto de Salud Carlos III (ISCIII). CNM-ISCIII research team is supported by Fundación Mundo Sano, Spain (MVP 237/19). The ISGlobal research team is supported by the Agència de Gestió d’Ajuts Universitaris i de Recerca AGAUR) (2017 SGR 00924). ISGlobal is a member of the Centres de Recerca de Catalunya (CERCA) Programme, Government of Catalonia (Spain).S

    Acute Chagas disease associated with ingestion of contaminated food in Brazilian western Amazon

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    Funding Information: We would like to thank the following institutions for all the support they accorded: Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Amazonas Health Surveillance Foundation Dr. Rosimary Costa Pinto (FVS‐RCP/AM), the Municipal Health Departments of the affected by the outbreaks and Fundação de Amparo à Pesquisa do Estado do Amazonas for their financial support in acquiring materials for the molecular detection of the parasite. We would also like to thank the public health surveillance teams and the patients who agreed to participate in this study. Publisher Copyright: © 2023 Belgian Society of Tropical Medicine and the Prince Leopold Institute of Tropical Medicine.Objective: To describe clinical, epidemiological and management information on cases of acute Chagas disease (ACD) by oral transmission in the state of Amazonas in western Amazon. Methods: Manual and electronic medical records of patients diagnosed with ACD at the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD) were included. Results: There were 147 cases of acute CD registered from 10 outbreaks that occurred in the state of Amazonas between 2004 and 2022. The transmission pathway was through oral route, with probable contaminated palm fruit juice (açaí and/or papatuá), and involved people from the same family, friends or neighbours. Of 147 identified cases, 87 (59%) were males; cases were aged 10 months to 82 years. The most common symptom was the febrile syndrome (123/147; 91.8%); cardiac alterations were present in 33/100 (33%), (2/147; 1.4%) had severe ACD with meningoencephalitis, and 12 (8.2%) were asymptomatic. Most cases were diagnosed through thick blood smear (132/147; 89.8%), a few (14/147; 9.5%) were diagnosed by serology and (1/147; 0.7%) by polymerase chain reaction (PCR) and blood culture. In all these outbreaks, 74.1% of the patients were analysed by PCR, and Trypanosoma cruzi TcIV was detected in all of them. No deaths were recorded. The incidence of these foci coincided with the fruit harvest period in the state of Amazonas. Conclusion: The occurrence of ACD outbreaks in the Amazon affected individuals of both sexes, young adults, living in rural and peri-urban areas and related to the consumption of regional foods. Early diagnosis is an important factor in surveillance. There was a low frequency of cardiac alterations. Continuous follow-up of most patients was not carried out due to difficulty in getting to specialised centres; therefore, little is known about post-treatment.publishersversioninpres

    El Miocè inferior de la conca del Vallès-Penedès : un registre excepcional dels canvis climàtics i faunístics

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    Altres ajuts: CERCA Programme/Generalitat de Catalunya. Les tasques de camp es van poder dur a terme gràcies al suport del Departament de Cultura de la Generalitat de Catalunya (projecte 2014/100584) i la National Geographic Society (beca d'exploració ref. 9640-15).Les intervencions paleontològiques recents han mostrat que el registre de vertebrats continentals del Miocè inferior de la conca del Vallès-Penedès és molt més ric i continu del que es pensava. Avui dia es coneixen una vintena de jaciments que han lliurat tant microvertebrats com macrovertebrats. Els nostres estudis biostratigràfics han permès una datació precisa dels diferents jaciments i també dels principals esdeveniments faunístics i climàtics

    Protocolo de cribado, diagnóstico y tratamiento de la enfermedad de Chagas en mujeres embarazadas latinoamericanas y en sus hijos

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    Malaltia de Chagas; Dones embarassades llatinoamericanes; Salut maternoinfantilEnfermedad de Chagas; Mujeres embarazadas latinoamericanas; Salud maternoinfantilChagas disease; Latin american pregnant women; Maternal and child healthLa malaltia de Chagas (MCH) continua sent un problema important de salut pública. L’OMS estima que en el món hi ha 8 milions de persones infectades per Trypanosoma cruzi, la majoria a l’Amèrica Llatina. En països no endèmics, com és el cas del nostre entorn, l’MCH s’observa en persones infectades que provenen de països endèmics o en infants nascuts en països no endèmics, però la mare dels quals ha estat infectada (transmissió congènita). A Catalunya, per tal de fer el control i la vigilància de l’MCH, l’any 2010 es va posar en marxa el Programa de prevenció i control de la malaltia de Chagas congènita a Catalunya, coordinat pel Departament de Salut i que inclou el diagnòstic, el control, el seguiment i el tractament de l’MCH congènita dirigits a les dones embarassades i als seus fills. En el marc del Programa, es va elaborar el Protocol de cribratge i diagnòstic de malaltia de Chagas en dones embarassades llatinoamericanes i en els seus fills, que es va editar el 2010. Aquest document va ser fruit de l’esforç conjunt de professionals sanitaris experts en la malaltia, de diferents societats científiques i de professionals del Departament de Salut de la Generalitat de Catalunya, amb el suport del Grup de Treball de Països No Endèmics i del Departament de Control de Malalties Tropicals Oblidades de l’OMS. El Protocol que es presenta, a més d’incloure les mateixes línies que la primera edició, disposa d’actualitzacions de diferents aspectes clínics, de diagnòstic i de vigilància epidemiològica basats en l’experiència i l’evidència observades durant aquests vuit anys del Programa de prevenció i control de la malaltia de Chagas congènita a Catalunya. Durant aquests darrers anys, s’ha reforçat la perspectiva de salut pública en el Programa, en el qual han participat un gran nombre de professionals de la xarxa assistencial i agents comunitaris de salut amb l’objectiu de reduir l’efecte de la transmissió vertical de l’MCH a Catalunya. La primera part del document recull les característiques clíniques de l’MCH que, encara que és d’aparició relativament recent en el nostre entorn, gràcies a la informació facilitada tant en l’àmbit sanitari com en l’àmbit comunitari durant els últims anys, ha deixat de ser una malaltia oblidada i desconeguda a Catalunya. En els darrers anys, els avenços i l’experiència en el nostre entorn en el diagnòstic de l’MCH ens han fet arribar a un consens sobre la utilització de mètodes directes moleculars, tal com es descriu en aquest Protocol. Així mateix, la concreció de dades epidemiològiques sobre prevalença d’infecció i incidència de casos de la malaltia ha millorat molt gràcies a la vigilància i notificació de dades recollides en el marc del Programa de prevenció i control de la malaltia de Chagas congènita a Catalunya pels professionals que formen part del Grup de Treball de la Malaltia de Chagas Congènita. En aquest aspecte i per tal de millorar-ne el control s’han incorporat els metges de família i salut comunitària, ja que són uns dels professionals clau que es troben més propers als pacients. Un aspecte fonamental que es desprèn d’aquest document i del funcionament del Programa és la multidisciplinarietat. El repte del sistema de salut i de la vigilància de la salut pública és la coordinació i el treball dels professionals de diferents àmbits sanitaris, com poden ser els ginecòlegs, els microbiòlegs, els llevadors, els pediatres d’atenció primària i hospitalària, els metges de família i salut comunitària, el personal d’infermeria, els infectòlegs, els epidemiòlegs i els agents de salut comunitària que treballen de manera conjunta per a l’assoliment de l’objectiu plantejat. El present Protocol constitueix un document eminentment pràctic, mitjançant el qual els professionals sanitaris disposen dels elements essencials per a la realització del cribratge en la dona embarassada. A partir d’aquest Protocol s’espera també aconseguir la detecció i el tractament precoç dels casos d’MCH en la població pediàtrica, nadons i altres fills a Catalunya, amb l’objectiu últim de millorar la salut maternoinfantil a Catalunya.La enfermedad de Chagas (ECH) sigue siendo un problema importante de salud pública. La OMS estima que en el mundo hay 8 millones de personas infectadas por Trypanosoma cruzi, la mayoría en América Latina. En países no endémicos, como es el caso de nuestro entorno, la ECH se observa en personas infectadas que provienen de países endémicos o en niños nacidos en países no endémicos, pero cuya madre ha sido infectada (transmisión congénita). En Cataluña, para hacer el control y la vigilancia de la ECH, en 2010 se puso en marcha el Programa de prevención y control de la enfermedad de Chagas congénita en Cataluña, coordinado por el Departamento de Salud y que incluye el diagnóstico, el control, el seguimiento y el tratamiento de la ECH congénita dirigidos a las mujeres embarazadas y a sus hijos. En el marco del Programa, se elaboró el Protocolo de cribado y diagnóstico de enfermedad de Chagas en mujeres embarazadas latinoamericanas y en sus hijos, que se editó en 2010. Este documento fue fruto del esfuerzo conjunto de profesionales sanitarios expertos en la enfermedad, de diferentes sociedades científicas y de profesionales del Departamento de Salud de la Generalidad de Cataluña, con el apoyo del Grupo de Trabajo de Países No Endémicos y del Departamento de Control de Enfermedades Tropicales Olvidadas de la OMS. El Protocolo que se presenta, además de incluir las mismas líneas que la primera edición, dispone de actualizaciones de diferentes aspectos clínicos, de diagnóstico y de vigilancia epidemiológica basados en la experiencia y la evidencia observadas durante estos ocho años del Programa de prevención y control de la enfermedad de Chagas congénita en Cataluña. Durante estos últimos años, se ha reforzado la perspectiva de salud pública en el Programa, en el que han participado un gran número de profesionales de la red asistencial y agentes comunitarios de salud con el objetivo de reducir el efecto de la transmisión vertical del ECH en Cataluña. La primera parte del documento recoge las características clínicas de la ECH que, aunque es de aparición relativamente reciente en nuestro entorno, gracias a la información facilitada tanto en el ámbito sanitario como en el ámbito comunitario durante los últimos años, ha dejado de ser una enfermedad olvidada y desconocida en Cataluña. En los últimos años, los avances y la experiencia en nuestro entorno en el diagnóstico de la ECH nos han hecho llegar a un consenso sobre la utilización de métodos directos moleculares, tal como se describe en el presente Protocolo. Asimismo, la concreción de datos epidemiológicos sobre prevalencia de infección e incidencia de casos de la enfermedad ha mejorado mucho gracias a la vigilancia y notificación de datos recogidos en el marco del Programa de prevención y control de la enfermedad de Chagas congénita en Cataluña por los profesionales que forman parte del Grupo de Trabajo de la Enfermedad de Chagas Congénita. En este aspecto y para mejorar su control se han incorporado los médicos de familia y salud comunitaria, ya que son unos de los profesionales clave que se encuentran más cercanos a los pacientes. Un aspecto fundamental que se desprende de este documento y del funcionamiento del Programa es la multidisciplinariedad. El reto del sistema de salud y de la vigilancia de la salud pública es la coordinación y el trabajo de los profesionales de diferentes ámbitos sanitarios, como pueden ser ginecólogos, microbiólogos, comadrones, pediatras de atención primaria y hospitalaria, médicos de familia y salud comunitaria, personal de enfermería, infectólogos, epidemiólogos y agentes de salud comunitaria que trabajan de manera conjunta para el logro del objetivo planteado. El presente Protocolo constituye un documento eminentemente práctico, mediante el cual los profesionales sanitarios disponen de los elementos esenciales para la realización del cribado en la mujer embarazada. A partir de este Protocolo se espera también conseguir la detección y el tratamiento precoz de los casos de ECH en la población pediátrica, bebés y otros hijos en Cataluña, con el objetivo último de mejorar la salud maternoinfantil en Cataluña.Chagas disease (CHD) continues to be a major public health problem. The WHO estimates that there are 8 million people in the world infected with Trypanosoma cruzi, the majority in Latin America. In non-endemic countries, as is the case in our environment, CHD is seen in infected people who come from endemic countries or children born in non-endemic countries, but whose mother has been infected (congenital transmission). In Catalonia, in order to control and monitor the CHD, in 2010 the Program for the Prevention and Control of Congenital Chagas' Disease in Catalonia was launched, coordinated by the Department of Health and includes diagnosis, control, follow-up and treatment of congenital CHD directed at pregnant women and their children. Within the framework of the Program, the Protocol for the Screening and Diagnosis of Chagas' Disease in Latin American pregnant women and their children was prepared, which was published in 2010. This document was the result of the joint effort of health professionals who are experts in the disease, of different scientific societies and professionals of the Department of Health of the Government of Catalonia, with the support of the Working Group of Non-endemic Countries and the Department of Control of Forgotten Tropical Diseases of WHO. The Protocol that is presented, in addition to including the same lines as the first edition, has updates on different clinical, diagnostic and epidemiological surveillance aspects based on the experience and evidence observed during these eight years of the Prevention and Control Program. Congenital Chagas disease in Catalonia. During these last years, the perspective of public health in the Program has been reinforced, in which a large number of professionals of the health care network and community health agents have participated with the aim of reducing the effect of the vertical transmission of CHD in Catalonia. The first part of the document includes the clinical characteristics of the CHD that, although it is relatively recent in our environment, thanks to the information provided both in the health field and in the community in recent years, has ceased to be a disease forgotten and unknown in Catalonia. In recent years, the advances and experience in our environment in the diagnosis of CHD have led us to reach a consensus on the use of direct molecular methods, as described in this Protocol. Likewise, the specification of epidemiological data on prevalence of infection and incidence of cases of the disease has improved greatly thanks to the monitoring and reporting of data collected within the framework of the Program for the Prevention and Control of Congenital Chagas' Disease in Catalonia by professionals. that are part of the Working Group on Congenital Chagas Disease. In this aspect and to improve their control, family doctors and community health have been incorporated, since they are one of the key professionals who are closest to patients. A fundamental aspect that emerges from this document and the operation of the Program is multidisciplinarity. The challenge of the health system and public health surveillance is the coordination and work of professionals from different health areas, such as gynecologists, microbiologists, midwives, pediatricians of primary and hospital care, family physicians and community health , nurses, infectious disease specialists, epidemiologists and community health workers who work together to achieve the stated objective. This Protocol is an eminently practical document, through which health professionals have the essential elements for carrying out screening in pregnant women. Based on this Protocol, it is also expected to achieve the detection and early treatment of cases of CHD in the pediatric population, babies and other children in Catalonia, with the ultimate goal of improving maternal and child health in Catalonia

    Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

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    The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality
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