Los determinantes sociales de la salud como factores pronósticos de la insuficiencia cardiaca

Introducción: Los determinantes sociales son la principal causa de las desigualdades en salud, las personas con un nivel socioeconómico y cultural más bajo tienen peores niveles de salud y una esperanza de vida menor. La insuficiencia cardiaca es una de las enfermedades más prevalentes en Europa y Estados Unidos, y a pesar de los avances en el tratamiento en los últimos años la mortalidad sigue siendo elevada. El objetivo de esta revisión es analizar si los determinantes sociales actúan modificando el pronóstico de la insuficiencia cardiaca.Métodos: Realizamos una revisión sistemática exploratoria para obtener una visión general de la cantidad y el tipo de investigación que hay disponible. Se hizo una búsqueda bibliográfica en las bases de datos PubMed y Embase y se realizó la selección de los estudios que cumplían los criterios de inclusión según la relevancia sobre el tema a estudio. Se presentaron los resultados en forma de tablas y texto para ampliar la información.Resultados: Analizamos en profundidad un total de 12 estudios, la mayoría de ellos realizados en Estados Unidos, y pudimos ver la asociación entre varios determinantes sociales de la salud y el pronóstico de la insuficiencia cardiaca. El nivel educativo insuficiente, la raza negra, el estado civil (estar soltero/a), y ser vulnerables socialmente se asociaron a un peor pronóstico con mayor riesgo de hospitalización y mortalidad. Las mujeres tenían mayor riesgo de ser vulnerables, pero hubo resultados que discrepan sobre el pronóstico, al igual que para la edad, la privación socioeconómica y los ingresos económicos. Estos dos últimos determinantes se midieron según diferentes índices y escalas.Conclusiones: Los determinantes sociales de la salud, como la raza/etnia, el estado civil, el género, el nivel educativo, la edad o el nivel económico, actúan como factores pronósticos de la insuficiencia cardiaca, teniendo peor pronóstico aquellos que se encuentran en una posición socioeconómica desfavorecida.<br /

TFG en Ingeniería Química: Un trampolín al mercado laboral

En este proyecto de innovación docente, se pretende mejorar la empleabilidad de los estudiantes tras la realización del Trabajo Fin de Grado e incrementar la motivación de los mismos por el emprendimiento. Para ello, han realizado actividades por parte de agentes provenientes de la Industria Química y expertos en emprendimiento y herramientas digitales

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

Expression of MALT1 oncogene in hematopoietic stem/progenitor cells recapitulates the pathogenesis of human lymphoma in mice

Chromosomal translocations involving the MALT1 gene are hallmarks of mucosa-associated lymphoid tissue (MALT) lymphoma. To date, targeting these translocations to mouse B cells has failed to reproduce human disease. Here, we induced MALT1 expression in mouse Sca1(+)Lin(-) hematopoietic stem/progenitor cells, which showed NF-κB activation and early lymphoid priming, being selectively skewed toward B-cell differentiation. These cells accumulated in extranodal tissues and gave rise to clonal tumors recapitulating the principal clinical, biological, and molecular genetic features of MALT lymphoma. Deletion of p53 gene accelerated tumor onset and induced transformation of MALT lymphoma to activated B-cell diffuse large-cell lymphoma (ABC-DLBCL). Treatment of MALT1-induced lymphomas with a specific inhibitor of MALT1 proteolytic activity decreased cell viability, indicating that endogenous Malt1 signaling was required for tumor cell survival. Our study shows that human-like lymphomas can be modeled in mice by targeting MALT1 expression to hematopoietic stem/progenitor cells, demonstrating the oncogenic role of MALT1 in lymphomagenesis. Furthermore, this work establishes a molecular link between MALT lymphoma and ABC-DLBCL, and provides mouse models to test MALT1 inhibitors. Finally, our results suggest that hematopoietic stem/progenitor cells may be involved in the pathogenesis of human mature B-cell lymphomas

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

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

Diversity and distribution of Anostraca in temporary ponds in Western Africa with description of a new species of Streptocephalus Baird, 1852 (Pancrustacea: Branchiopoda: Streptocephalidae)

Three genera of Anostraca have been recorded so far in Senegal: Streptocephalus Baird, 1852, Branchinella Sayce, 1903 and Artemia Leach, 1819. The occurrence of the previously recorded freshwater species in Senegal have been confirmed in this work, namely Streptocephalus zeltneri Daday, 1910, S. sudanicus Daday, 1910 and Branchinella (Branchinellites) chudeaui (Daday, 1910). New records and the description of a new species are given. The new species, Streptocephalus wolof sp. nov., has been recognized through molecular (mitochondrial and nuclear markers) and morphological (egg shape) data. The adult stage of this new species is morphologically indistinguishable to its closely related species Streptocephalus zeltneri, suggesting the existence of two cryptic species in Senegal. Finally, some taxonomic comments on the genus Streptocephalus are presented.Peer reviewe

Unexpected High Incidence of Human Herpesvirus-6 Encephalitis after Naive T Cell-Depleted Graft of Haploidentical Stem Cell Transplantation in Pediatric Patients

The CD45RA T cell depletion (TCD) method has been used to deplete naive T cells, preventing graft-versus-host disease (GVHD) but preserving memory cells, providing immediate functional T cells with anti-infection, antileukemia, and antirejection effects. We describe a series of 25 consecutive high-risk patients with leukemia who received haploidentical hematopoietic stem cell transplantation (haplo-HSCT) with CD45RA TCD. Each patient received 2 cell products: 1 created by CD34 positive selection and the other through CD45RA depletion from the CD34 negative fraction by a CliniMACS device. CD45RA-depleted haplo-HSCT was well tolerated, with rapid engraftment and low risk of severe acute GVHD and chronic GVHD. Although this treatment achieved a good control of viral reactivations, such as cytomegalovirus and adenovirus, we observed an unexpectedly high rate of limbic encephalitis due to human herpesvirus-6 (HHV-6; 8 cases). Characteristically, the infection appeared early in almost all patients, just after the engraftment. Although no patient died from encephalitis, 1 patient showed neuropsychological sequelae, and another experienced secondary graft failure just after the HHV-6 reactivation