Republica mista, dirigida a D. Francisco de Sandoval Duque de Lerma, ... Parte primera

(Al fin): En Madrid, Por Iuan Flamenco, MDCI

Structural, Functional and Neurochemical Cortical Brain Changes Associated with Chronic Low Back Pain

Chronic low back pain (CLBP) is one of the most prevalent musculoskeletal disorders, being one of the leading contributors to disability worldwide and involving an important economic and social burden. Up to 90% of CLBP is non-specific (not associated with specific injuries), with a chronicity expectation estimated at 10%. Currently, motivational and emotional central circuits are being investigated due to their role in CLBP persistency and chronification. Therefore, this narrative review aimed to summarize the evidence regarding the cortical brain changes described for proposing novel multidisciplinary approaches. Novel advances in neuroimaging techniques demonstrated structural (e.g., decrease in the grey matter located at the dorsolateral prefrontal cortex), functional (e.g., connectivity impairments in those areas involved in pain processing), and neurochemical changes (e.g., decrease in cerebral metabolites). In addition, significant changes were found in the primary somatosensory and motor cortex, contributing to the alteration of low back muscles activation and functio

Role of biological and non biological factors in congestive heart failure mortality: PREDICE-SCORE: A clinical prediction rule

Background: Congestive heart failure (HF) is a chronic, frequent and disabling condition but with a modifiable course and a large potential for improving. The aim of this project was to develop a clinical prediction model of biological and non biological factors in patients with first diagnosis of HF that facilitates the risk-stratification and decision-making process at the point of care. Methods and Results: Historical cohort analysis of 600 patients attended at three tertiary hospitals and diagnosed of a first episode of HF according Framingham criteria. There were followed 1 year. We analyzed sociodemographic, clinical and laboratory data with potential prognostic value. The modelling process concluded into a logistic regression multivariable analysis and a predictive rule: PREDICE SCORE. Age, dependency for daily basic activities, creatinine clearance, sodium levels at admission and systolic dysfunction diagnosis (HF with left ventricular ejection fraction < 40%) were the selected variables. The model showed a c-statistic of 0.763. PREDICE Score, has range of 22 points to stratifications of 1-year mortality. Conclusions: The follow-up of 600 patients hospitalized by a first episode of congestive HF, allowed us to obtain a predictive 1 year mortality model from the combination of demographic data, routine biochemistry and easy handling social and functional variables at the point of care. The variables included were non-invasive, undemanding to collect, and widely available. It allows for risk stratification and therapeutical targeting and may help in the clinical decisions process in a sustainable way

Expert panel consensus recommendations for diagnosis and treatment of secondary osteoporosis in children

Background: Osteoporosis incidence in children is increasing due to the increased survival rate of patients suffering from chronic diseases and the increased use of drugs that can damage bones. Recent changes made to the definition of childhood osteoporosis, along with the lack of guidelines or national consensuses regarding its diagnosis and treatment, have resulted in a wide variability in the approaches used to treat this disease. For these reasons, the Osteogenesis Imperfecta and Childhood Osteoporosis Working Group of the Spanish Society of Pediatric Rheumatology has sounded the need for developing guidelines to standardize clinical practice with regard to this pathology. Methods: An expert panel comprised of 6 pediatricians and 5 rheumatologists carried out a qualitative literature review and provided recommendations based on evidence, when that was available, or on their own experience. The level of evidence was determined for each section using the Oxford Centre for Evidence-based Medicine (CEBM) system. A Delphi survey was conducted for those recommendations with an evidence level of IV or V. This survey was sent to all members of the SERPE. All recommendations that had a level of agreement higher or equal to 70% were included. Results: Fifty-one recommendations, categorized into eight sections, were obtained. Twenty-four of them presented an evidence level 4 or 5, and therefore a Delphi survey was conducted. This was submitted electronically and received a response rate of 40%. All recommendations submitted to the Delphi round obtained a level of agreement of 70% or higher and were therefore accepted. Conclusion: In summary, we present herein guidelines for the prevention, diagnosis and treatment of secondary childhood osteoporosis based on the available evidence and expert clinical experience. We believe it can serve as a useful tool that will contribute to the standardization of clinical practice for this pathology. Prophylactic measures, early diagnosis and a proper therapeutic approach are essential to improving bone health, not only in children and adolescents, but also in the adults they will become in the future

High MICs for Vancomycin and Daptomycin and Complicated Catheter-Related Bloodstream Infections with Methicillin-Sensitive Staphylococcus aureus

We investigated the prognostic role of high MICs for antistaphylococcal agents in patients with methicillin-sensitive Staphylococcus aureus catheter-related bloodstream infection (MSSA CRBSI). We prospectively reviewed 83 episodes from 5 centers in Spain during April 2011 June 2014 that had optimized clinical management and analyzed the relationship between E-test MICs for vancomycin, daptomycin, oxacillin, and linezolid and development of complicated bacteremia by using multivariate analysis. Complicated MSSA CRBSI occurred in 26 (31.3%) patients; MICs for vancomycin and daptomycin were higher in these patients (optimal cutoff values for predictive accuracy = 1.5 mu g/mL and 0.5 mu g/mL). High MICs for vancomycin (hazard ratio 2.4, 95% CI 1.2-5.5) and daptomycin (hazard ratio 2.4, 95% CI 1.1-5.9) were independent risk factors for development of complicated MSSA CRBSI. Our data suggest that patients with MSSA CRBSI caused by strains that have high MICs for vancomycin or daptomycin are at increased risk for complications

Executive summary. diagnosis, treatment and prophylaxis of influenza virus infection. Consensus statement of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), the Spanish Society of Pediatric Infectious Diseases (SEIP), the Spanish Association of Vaccinology (AEV), the Spanish Society of Family and Community Medicine (SEMFYC) and the Spanish Society of Preventive Medicine, Public Health and Health Management (SEMPSPGS)

[spa] El virus de la gripe ha acompañado al ser humano desde tiempo inmemorial, en forma de epidemias anuales y pandemias ocasionales. Se trata de una infección respiratoria con múltiples repercusiones sobre la vida de las personas a nivel individual y social, así como una importante sobrecarga para el sistema sanitario. El presente documento de consenso surge de la colaboración de diversas sociedades científicas españolas implicadas en la atención de la infección por virus de la gripe. Las conclusiones extraídas se han fundamentado en las evidencias de mayor calidad disponibles en la literatura científica y, en su defecto, en la opinión de los expertos convocados. En el documento de consenso se abordan los aspectos clínicos, microbiológicos, terapéuticos y preventivos (respecto de la prevención de la transmisión y en relación con la vacunación) de la gripe, tanto para población pediátrica como para adultos. Este documento de consenso pretende ayudar a facilitar el abordaje clínico, microbiológico y preventivo de la infección por virus de la gripe y, consecuentemente, a disminuir sus importantes consecuencias sobre la morbimortalidad de la población.[eng]The influenza virus has accompanied humans since time immemorial, in the form of annual epidemics and occasional pandemics. It is a respiratory infection with multiple repercussions on people's lives at an individual and social level, as well as representing a significant burden on the health system. This Consensus Document arises from the collaboration of various Spanish scientific societies involved in influenza virus infection. The conclusions drawn are based on the highest quality evidence available in the scientific literature and, failing that, on the opinion of the experts convened. The Consensus Document addresses the clinical, microbiological, therapeutic, and preventive aspects (with respect to the prevention of transmission and in relation to vaccination) of influenza, for both adult and pediatric populations. This Consensus Document aims to help facilitate the clinical, microbiological, and preventive approach to influenza virus infection and, consequently, to reduce its important consequences on the morbidity and mortality of the population

España en Europa - Europa en España (1986-2006)

Aquesta publicació té per objectiu oferir un balanç dels primers vint anys des de l'adhesió d'Espanya a l'Europa comunitària en termes de «europeïtzació», una formulació que és objecte de creixent atenció per part dels estudiosos del procés d'integració europea. Per això s'analitzen tant la incidència d'Espanya a la Unió Europea com la d'aquesta en el sistema institucional, els processos polítics i les polítiques públiques espanyoles. El resultat reflecteix el grau creixent de simbiosi que, amb alguns matisos, s'ha anat generant entre ambdós nivells al llarg d'aquests anys.La presente publicación tiene por objetivo ofrecer un balance de los primeros veinte años desde la adhesión de España a la Europa comunitaria en términos de «europeización», una formulación que es objeto de creciente atención por parte de los estudiosos del proceso de integración europea. Para ello se analizan tanto la incidencia de España en la Unión Europea como la de ésta en el sistema institucional, los procesos políticos y las políticas públicas españolas. El resultado refleja el grado creciente de simbiosis que, con algunos matices, se ha ido generando entre ambos niveles a lo largo de estos años

Herramienta integral y de bajo coste para el desarrollo de prácticas remotas para las asignaturas de Ciencias e Ingeniería

Los laboratorios remotos, en los que los alumnos interactúan con los dispositivos reales a través de Internet, incrementa el tiempo de uso de dichos dispositivos por parte de los alumnos y el número de pruebas que pueden realizar durante las experiencias. Sin embargo, para implementarlos, los docentes habitualmente tienen que saber utilizar una serie de tecnologías diferentes, que dificultan su puesta en marcha y mantenimiento. Para paliar estos problemas, en este Proyecto de Innovación y Mejora de la Calidad Docente (PIMCD) se ha desarrollado una nueva metodología desde la que se centraliza la puesta en marcha de todo el laboratorio desde una única herramienta (Easy JavaScript Simulations, EJsS), que sirve tanto para gestionar el código mediante el que se interactúa con los dispositivos, el servidor que da acceso remoto a la práctica, y la interfaz gráfica con la que los alumnos interactúan con los dispositivos. Además, es importante resaltar que es una metodología de bajo coste, ya que desde el punto de vista del proceso de conversión de un laboratorio presencial ya existente en uno remoto, solo necesita una Raspberry PI para desplegar todo el software del laboratorio. Además, en este proyecto también se presentan un conjunto de experiencias desarrolladas con las mismas, que ya están siendo utilizadas por los alumnos en diferentes asignaturas de Ingeniería Electrónica de Comunicaciones y un nuevo laboratorio remoto de Robótica que se pondrá en marcha el curso que viene

HuR/ELAVL1 drives malignant peripheral nerve sheath tumor growth and metastasis

Cancer cells can develop a strong addiction to discrete molecular regulators, which control the aberrant gene expression programs that drive and maintain the cancer phenotype. Here, we report the identification of the RNA-binding protein HuR/ELAVL1 as a central oncogenic driver for malignant peripheral nerve sheath tumors (MPNSTs), which are highly aggressive sarcomas that originate from cells of the Schwann cell lineage. HuR was found to be highly elevated and bound to a multitude of cancer-associated transcripts in human MPNST samples. Accordingly, genetic and pharmacological inhibition of HuR had potent cytostatic and cytotoxic effects on tumor growth, and strongly suppressed metastatic capacity in vivo. Importantly, we linked the profound tumorigenic function of HuR to its ability to simultaneously regulate multiple essential oncogenic pathways in MPNST cells, including the Wnt/β-catenin, YAP/TAZ, RB/E2F, and BET pathways, which converge on key transcriptional networks. Given the exceptional dependency of MPNST cells on HuR for survival, proliferation, and dissemination, we propose that HuR represents a promising therapeutic target for MPNST treatment