Experiencia de aprendizaje basado en proyectos como estrategia en el desarrollo de las competencias del área de ciencia y tecnología de los estudiantes del nivel secundario de la I.E.E 20849 - José Faustino Sánchez Carrión

El estudio trató de determinar la influencia de la experiencia de aprendizaje basado en proyectos (ABP) como estrategia de mejora de las competencias del área de ciencia y tecnología de los estudiantes del nivel secundario de la I.E.E 20849 - José Faustino Sánchez Carrión. La metodología utilizada fue de tipo aplicada de nivel explicativo, de enfoque cuantitativo y diseño cuasi experimental. Se trabajó con una población de 48 estudiantes del 4° de media, pertenecientes a dos salones; 24 de la sección A y 24 de la B. Por razones de accesibilidad, se trabajó con toda la población, para cumplir con el diseño se consideró el salón A como GE y el B como GC. La técnica de recolección de datos fue La Prueba y como instrumento la Rúbrica de evaluación. Para el análisis se usó los programas MS Excel y SPSS V. 25 y para probar la hipótesis el estadístico “U de Mann-Whitney”. Los resultados descriptivos presentados mediante frecuencias y porcentajes, muestran diferencias notables en cuanto a las calificaciones antes y después en cada grupo estudiado, obteniendo mayor logro de las competencias, indaga, explica, diseña y construye en el grupo experimental. Los resultados inferenciales dieron como resultado un p valor (0,00) < 0.05 (error alfa establecido) por lo cual se acepta la hipótesis de la investigadora de que existe influencia de la estrategia aplicada en el logro de las competencias. Se concluye que el ABP tiene influencia directa y significativa en el logro de las competencias, indaga, explica, diseña y construye de los estudiantes de la población en estudio

Megestrol Acetate as a Treatment for Anorexia in Hemodialysis Patients

Background: The aim of this study was to evaluate the effectiveness of megestrol acetate as a treatment for anorexia in hemodialysis patients.Materials and Methods: From 1st January 2008 to 31st December 2010, 29 patients in our Hemodialysis Unit were treated with megestrol acetate (initial dose: 160 mg / day) for anorexia associated with a decrease in dry body weight. Sixteen patients had a protein-energy wasting syndrome.Results: Appetite improved in 25 patients, but the initial dose of megestrol acetate had to be increased in 8 patients. At three months, there was an increase in dry body weight (63.4 vs 61.9 kg, p=0.002), serum albumin level (3.98 vs 3.77 g/dl, p&lt;0.001), serum creatinine level (10.5 vs 9.6 mg/dl, p=0.016) and protein catabolic rate (1.21 vs 0.98 g / kg / day, p &lt; 0.001). The response was independent of the cause of anorexia. A bioelectrical impedance analysis, carried out in 9 patients, showed that treatment with megestrol acetate increased the body cell mass and changed the distribution of body water by increasing intracellular water. The megestrol acetate treatment was well-tolerated and no patients left the study due to side effects or adverse reactions.Conclusions: Megestrol acetate improves appetite and nutritional parameters in anorexic patients treated with maintenance hemodialysis

Gambling disorder duration and cognitive behavioural therapy outcome considering gambling preference and sex

Gambling Disorder (GD) is a behavioural addiction that leads to high level of clinical distress and, in general, it is characterized by enduring symptomatology that presents high rates of chronicity. However, there is high variability of illness duration among patients who seek treatment for GD. Previous studies reported mixed results about the relevance of illness duration in GD treatment outcome. However, there are different profiles of patients who are diagnosed with GD. For this reason, this study aimed to evaluate the effect of illness duration in the treatment outcome of different profiles of GD patients according to their gambling preference and sex. The sample were 1699 patients diagnosed with GD. All patients received cognitive-behavioural therapy in a group format. Treatment outcome was evaluated in terms of relapsing to gambling behaviours and dropout from treatment. Results showed higher probability of poor outcome in the first years of the disorder for strategic gambling compared to non-strategic or mixed forms of gambling. Moreover, women also showed higher probability of poor outcomes than men since the first stages of the disorder. This study draws attention to the relevance of illness duration in the treatment outcome of specific profiles of GD patients. In particular, patients who presented a preference for strategic forms of gambling and women who are diagnosed with GD would have a higher risk of poor treatment outcomes since the first stages of the disorder. These results highlight the importance of an early intervention in these patients in order to prevent the chronicity of the disorder

Proteasome stress leads to APP axonal transport defects by promoting its amyloidogenic processing in lysosomes

Alzheimer disease (AD) pathology includes the accumulation of poly-ubiquitylated (also known as poly-ubiquitinated) proteins and failures in proteasome-dependent degradation. Whereas the distribution of proteasomes and its role in synaptic function have been studied, whether proteasome activity regulates the axonal transport and metabolism of the amyloid precursor protein (APP), remains elusive. By using live imaging in primary hippocampal neurons, we showed that proteasome inhibition rapidly and severely impairs the axonal transport of APP. Fluorescence cross-correlation analyses and membrane internalization blockage experiments showed that plasma membrane APP does not contribute to transport defects. Moreover, by western blotting and double-color APP imaging, we demonstrated that proteasome inhibition precludes APP axonal transport by enhancing its endo-lysosomal delivery, where β-cleavage is induced. Taken together, we found that proteasomes control the distal transport of APP and can re-distribute Golgi-derived vesicles to the endo-lysosomal pathway. This crosstalk between proteasomes and lysosomes regulates the intracellular APP dynamics, and defects in proteasome activity can be considered a contributing factor that leads to abnormal APP metabolism in AD.This article has an associated First Person interview with the first author of the paper.Fil: Otero, Maria Gabriela. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Biología Celular y Neurociencia "Prof. Eduardo de Robertis". Universidad de Buenos Aires. Facultad de Medicina. Instituto de Biología Celular y Neurociencia; ArgentinaFil: Fernández Bessone, Iván. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Biología Celular y Neurociencia "Prof. Eduardo de Robertis". Universidad de Buenos Aires. Facultad de Medicina. Instituto de Biología Celular y Neurociencia; ArgentinaFil: Hallberg, Alan Earle. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Biología Celular y Neurociencia "Prof. Eduardo de Robertis". Universidad de Buenos Aires. Facultad de Medicina. Instituto de Biología Celular y Neurociencia; ArgentinaFil: Cromberg, Lucas Eneas. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Biología Celular y Neurociencia "Prof. Eduardo de Robertis". Universidad de Buenos Aires. Facultad de Medicina. Instituto de Biología Celular y Neurociencia; ArgentinaFil: de Rossi, María Cecilia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales; ArgentinaFil: Saez, Trinidad María de Los Milagros. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; ArgentinaFil: Levi, Valeria. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales; ArgentinaFil: Almenar Queralt, Angels. University of California at San Diego; Estados UnidosFil: Falzone, Tomas Luis. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Biología Celular y Neurociencia "Prof. Eduardo de Robertis". Universidad de Buenos Aires. Facultad de Medicina. Instituto de Biología Celular y Neurociencia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentin

Occurrence of Hepatitis E Virus in Pigs and Pork Cuts and Organs at the Time of Slaughter, Spain, 2017

Zoonotic hepatitis E, mainly caused by hepatitis E virus (HEV) genotype (gt) 3, is a foodborne disease that has emerged in Europe in recent decades. The main animal reservoir for genotype 3 is domestic pigs. Pig liver and liver derivates are considered the major risk products, and studies focused on the presence of HEV in pig muscles are scarce. The objective of the present study was to evaluate the presence of HEV in different organs and tissues of 45 apparently healthy pigs from nine Spanish slaughterhouses (50% national production) that could enter into the food supply chain. Anti-HEV antibodies were evaluated in serum by an ELISA test. Ten samples from each animal were analyzed for the presence of HEV RNA by reverse transcription real-time PCR (RT-qPCR). The overall seroprevalence obtained was 73.3% (33/45). From the 450 samples analyzed, a total of 26 RT-qPCR positive samples were identified in the liver (7/45), feces (6/45), kidney (5/45), heart (4/45), serum (3/45), and diaphragm (1/45). This is the first report on detection of HEV RNA in kidney and heart samples of naturally infected pigs. HEV RNA detection was negative for rib, bacon, lean ham, and loin samples. These findings indicate that pig meat could be considered as a low risk material for foodborne HEV infection.This study was partially supported by the RTA2014-00024-C04 from the Spanish Ministry of Economy and Innovation. NG and DR-L received a research grant by INTERPORC.S

Occurrence of Hepatitis E Virus in Pigs and Pork Cuts and Organs at the Time of Slaughter, Spain, 2017

Zoonotic hepatitis E, mainly caused by hepatitis E virus (HEV) genotype (gt) 3, is a foodborne disease that has emerged in Europe in recent decades. The main animal reservoir for genotype 3 is domestic pigs. Pig liver and liver derivates are considered the major risk products, and studies focused on the presence of HEV in pig muscles are scarce. The objective of the present study was to evaluate the presence of HEV in different organs and tissues of 45 apparently healthy pigs from nine Spanish slaughterhouses (50% national production) that could enter into the food supply chain. Anti-HEV antibodies were evaluated in serum by an ELISA test. Ten samples from each animal were analyzed for the presence of HEV RNA by reverse transcription realtime PCR (RT-qPCR). The overall seroprevalence obtained was 73.3% (33/45). From the 450 samples analyzed, a total of 26 RT-qPCR positive samples were identified in the liver (7/45), feces (6/45), kidney (5/45), heart (4/45), serum (3/45), and diaphragm (1/45). This is the first report on detection of HEV RNA in kidney and heart samples of naturally infected pigs. HEV RNA detection was negative for rib, bacon, lean ham, and loin samples. These findings indicate that pig meat could be considered as a low risk material for foodborne HEV infection.Fil: García, Nerea. Universidad Complutense de Madrid; EspañaFil: Hernández, Marta. Universidad de Burgos; EspañaFil: Gutierrez Boada, Maialen. Universidad de Burgos; EspañaFil: Valero, Antonio. Universidad de Córdoba; EspañaFil: Navarro, Alejandro. Universidad Complutense de Madrid; EspañaFil: Muñoz Chimeno, Milagros. Universidad Carlos III de Madrid. Instituto de Salud; EspañaFil: Fernández Manzano, Alvaro. Universidad Complutense de Madrid; EspañaFil: Escobar, Franco Matias. Universidad Nacional de Río Cuarto. Facultad de Ciencias Exactas, Fisicoquímicas y Naturales. Departamento de Microbiología e Inmunología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba; ArgentinaFil: Martínez, Irene. Universidad Complutense de Madrid; EspañaFil: Bárcena, Carmen. Universidad Complutense de Madrid; EspañaFil: González, Sergio. Universidad Complutense de Madrid; EspañaFil: Avellón, Ana. Universidad Carlos III de Madrid. Instituto de Salud; EspañaFil: Eiros, Jose M.. Hospital Universitario Rio Hortega; EspañaFil: Fongaro, Gislaine. Universidade Federal de Santa Catarina; BrasilFil: Domínguez, Lucas. Universidad Complutense de Madrid; EspañaFil: Goyache, Joaquín. Universidad Complutense de Madrid; EspañaFil: Rodríguez Lázaro, David. Universidad de Burgos; Españ

Trasplante renal en pacientes con infección por virus de la inmunodeficiencia humana (VIH)

El pronóstico de la infección por VIH ha mejorado tras introducir el tratamiento antirretroviral de gran actividad (TARGA), no contraindicando actualmente el trasplante renal (TR). La nefropatía asociada al VIH (HIVAN) es la principal causa de enfermedad crónica terminal (ERCT) en pacientes VIH a nivel mundial. Los criterios de inclusión para TR de pacientes VIH son multidisciplinares: no infecciones oportunistas; CD4>200; carga viral indetectable. Material y métodos. Revisión de historias clínicas de 14 pacientes infectados por VIH receptores de un primera lo injerto renal (2001-2019),seleccionadossegúnrecomendacionesdelasguíasespañolasyamericanas.Lainmunosupresiónserealizósegúnlaprácticahabitualennuestropaís.TARGAseinicióinmediatamentetrasTR.Resultados.LaprincipalcausadeERCTfuelaglomerulonefritis(N=6;42,9%)seguidadeHIVAN(N=4;28,6%).El71,4%(N=10)seencontrabanenhemodiálisisprevioalTRysólo1pacientesetrasplantóensituacióndeprediálisis.Desdeelpuntodevistainmuno-virológico,lamedianadeCD4fue458células/μLytodoslospacientespresentabancargaviralindetectable.El92,9%(N=13)recibíaTARGApreTR.2pacientesprecisarontrasplantectomíaprecozyfueroneliminadosdelanálisisposterior.Conunamedianadeseguimientode61,0meses,el58,3%(7/12)delospacientespresentóunafunciónretrasadadelinjertoyel33,3%(4/12)rechazoagudo.Lamedianadecreatininaalos3mesesyenlaúltimafechadeseguimientofue1,3mg/dL(RIC0,8)y2,1(RIC7,1)respectivamente.Lasupervivenciadelinjertoydelpacientea1y3añosfuede75,0%y100%;y67,0%y89,0%,respectivamente.Conclusión.ElTResunaalternativaterapéuticasegurayefectivaenpacientesseleccionadosconVIH.TheprognosisofHIVinfectionhasimprovedwiththeintroductionofhighlyactiveantiretroviraltherapy(HAART),beingnolongeracontraindicationtotransplantation(KT).HIV-associatednephropathy(HIVAN)isthemostcommoncauseofend-stagerenaldisease(ESRD)amongHIV-infectedpatientsworldwide.TheconsensuscriteriafortheselectionofHIVpatientsfortransplantationaremultidisciplinary:noopportunisticinfections;CD4count>200;undetectableviralload.Materialandmethods.Reviewoftheclinicalchartsof14HIV-infected,recipientsofaprimaryrenalallograft(2001-2019).InclusioncriteriamettheAmericanandSpanishguidelinerecommendations.Immunosuppressiveprotocolfollowedroutinepracticeinourcountry.HAARTwasstartedduringimmediatepost-KT.Results.ThemainESRDetiologywasglomerulonephritis (6;42.9%)followedbyHIVAN(4;28.6%).RegardingrenalsubstitutivetreatmentpriortoKT,themajoritywereonhemodialysis(10;71.4%).InonepatientKTwaspre-emptive.MedianCD4countwas458cells/μLandallpatientspresentedundetectableviralload.13(92.9%)wereonHAARTpriortoKT.Twopatientsunderwentearlytransplantectomy,theremainingpatientswerefollowedforamedianof61.0months(3.7to106.2months).Delayedgraftfunctionandacuterejectionratewere58.3%(7/12)and33.3%(4/12)respectively.Mediancreatininelevelsat3monthsandatthelastfollow-upwere1.3mg/dL(IQR0.8)and2.1mg/dL(IQR7.1)respectively.Graftandpatientsurvivalat1and3yearswererespectively75.0%and100%;and67.0%and89%.Conclusions.KTcanbesafeandeffectiveinselectedHIV-infectedpatient

Perfil clínico de los pacientes tratados con evolocumab en unidades hospitalarias de nefrología en España

Describir las características clínicas de los pacientes tratados con evolocumab, las razones del inicio de la terapia y los efectos del tratamiento en la fase inicial de disponibilidad de evolocumab en las unidades de nefrología de España

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe