Dos casos atípicos con un mismo resultado final: exéresis de trombo intracavitario

We present two atypical cases of intracavitary thrombus formation, due to their localization, clinical course and patients’ co-morbidities. In both cases cardiac magnetic resonance was the best non-invasive diagnostic tool (“single shot” technique) to establish a correct diagnosis.Se presentan dos casos de trombos intracavitarios atípicos por su localización, evolución y antecedentes de los pacientes. En ambas situaciones la resonancia magnética cardíaca fue determinante para establecer un diagnóstico adecuado

Proyectiles en ventrículo derecho. ¿Sin puerta de entrada?

The presence of intracardiac foreign bodies and their treatment are still a controversial issue given the variety of locations, the different clinical manifestations and the prognostic implications. The number of published cases in which there is no direct entrance site of the foreign body to the cardiac cavities, diagnosing or assuming theirembolization, is much more limited. We present the case of an adult male with cervical firearm wound, and two foreign bodies in the right ventricle without a direct entry door.La presencia de cuerpos extraños intracardiacos y su tratamiento suponen todavía un tema controvertido dada la variedad de localizaciones en las que se puede presentar y las diferentes manifestaciones clínicas e implicaciones pronósticas de cada una de ellas. El número de casos publicados en los que no existe puerta de entrada directa del cuerpo a las cavidades cardiacas, diagnosticando o asumiendo su embolización a distancia, es mucho más reducido. Presentamos el caso de un varón adulto con herida cervical por arma de fuego y dos cuerpos extraños alojados en ventrículo derecho sin puerta de entrada directa

Endothelial dysfunction is an early indicator of sepsis and neutrophil degranulation of septic shock in surgical patients

Producción CientíficaBackground: Stratification of the severity of infection is currently based on the Sequential Organ Failure Assessment (SOFA) score, which is difficult to calculate outside the ICU. Biomarkers could help to stratify the severity of infection in surgical patients. Methods: Levels of ten biomarkers indicating endothelial dysfunction, 22 indicating emergency granulopoiesis, and six denoting neutrophil degranulation were compared in three groups of patients in the first 12 h after diagnosis at three Spanish hospitals. Results: There were 100 patients with infection, 95 with sepsis and 57 with septic shock. Seven biomarkers indicating endothelial dysfunction (mid-regional proadrenomedullin (MR-ProADM), syndecan 1, thrombomodulin, angiopoietin 2, endothelial cell-specific molecule 1, vascular cell adhesion molecule 1 and E-selectin) had stronger associations with sepsis than infection alone. MR-ProADM had the highest odds ratio (OR) in multivariable analysis (OR 11·53, 95 per cent c.i. 4·15 to 32·08; P = 0·006) and the best area under the curve (AUC) for detecting sepsis (0·86, 95 per cent c.i. 0·80 to 0·91; P < 0·001). In a comparison of sepsis with septic shock, two biomarkers of neutrophil degranulation, proteinase 3 (OR 8·09, 1·34 to 48·91; P = 0·028) and lipocalin 2 (OR 6·62, 2·47 to 17·77; P = 0·002), had the strongest association with septic shock, but lipocalin 2 exhibited the highest AUC (0·81, 0·73 to 0·90; P < 0·001). Conclusion: MR-ProADM and lipocalin 2 could be alternatives to the SOFA score in the detection of sepsis and septic shock respectively in surgical patients with infection.Instituto de Salud Carlos III (grants PI15/01959, PI15/01451 and PI16/01156

Differences in clinical features and mortality in very old unvaccinated patients (≥ 80 years) hospitalized with COVID-19 during the first and successive waves from the multicenter SEMI-COVID-19 Registry (Spain)

Background: Old age is one of the most important risk factors for severe COVID-19. Few studies have analyzed changes in the clinical characteristics and prognosis of COVID-19 among older adults before the availability of vaccines. This work analyzes differences in clinical features and mortality in unvaccinated very old adults during the first and successive COVID-19 waves in Spain. Methods This nationwide, multicenter, retrospective cohort study analyzes unvaccinated patients >= 80 years hospitalized for COVID-19 in 150 Spanish hospitals (SEMI-COVID-19 Registry). Patients were classified according to whether they were admitted in the first wave (March 1-June 30, 2020) or successive waves (July 1-December 31, 2020). The endpoint was all-cause in-hospital mortality, expressed as the case fatality rate (CFR). Results Of the 21,461 patients hospitalized with COVID-19, 5,953 (27.7%) were >= 80 years (mean age [IQR]: 85.6 [82.3-89.2] years). Of them, 4,545 (76.3%) were admitted during the first wave and 1,408 (23.7%) during successive waves. Patients hospitalized in successive waves were older, had a greater Charlson Comorbidity Index and dependency, less cough and fever, and met fewer severity criteria at admission (qSOFA index, PO2/FiO2 ratio, inflammatory parameters). Significant differences were observed in treatments used in the first (greater use of antimalarials, lopinavir, and macrolides) and successive waves (greater use of corticosteroids, tocilizumab and remdesivir). In-hospital complications, especially acute respiratory distress syndrome and pneumonia, were less frequent in patients hospitalized in successive waves, except for heart failure. The CFR was significantly higher in the first wave (44.1% vs. 33.3%; -10.8%; p = 95 years (54.4% vs. 38.5%; -15.9%; p < 0.001). After adjustments to the model, the probability of death was 33% lower in successive waves (OR: 0.67; 95% CI: 0.57-0.79). Conclusions Mortality declined significantly between the first and successive waves in very old unvaccinated patients hospitalized with COVID-19 in Spain. This decline could be explained by a greater availability of hospital resources and more effective treatments as the pandemic progressed, although other factors such as changes in SARS-CoV-2 virulence cannot be ruled out

Cellular and humoral functional responses after BNT162b2 mRNA vaccination differ longitudinally between naive and subjects recovered from COVID-19

We have analyzed BNT162b2 vaccine-induced immune responses in naive subjects and individuals recovered from coronavirus disease 2019 (COVID-19), both soon after (14 days) and later after (almost 8 months) vaccination. Plasma spike (S)-specific immunoglobulins peak after one vaccine shot in individuals recovered from COVID-19, while a second dose is needed in naive subjects, although the latter group shows reduced levels all along the analyzed period. Despite how the neutralization capacity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mirrors this behavior early after vaccination, both groups show comparable neutralizing antibodies and S-specific B cell levels late post-vaccination. When studying cellular responses, naive individuals exhibit higher SARS-CoV-2-specific cytokine production, CD4+ T cell activation, and proliferation than do individuals recovered from COVID-19, with patent inverse correlations between humoral and cellular variables early post-vaccination. However, almost 8 months post-vaccination, SARS-CoV-2-specific responses are comparable between both groups. Our data indicate that a previous history of COVID-19 differentially determines the functional T and B cell-mediated responses to BNT162b2 vaccination over time.C.d.F., J.G.-P., and J.A. are supported by Instituto de Salud Carlos III (ISCII). We thank JM Ligos and Cytek Biosciences for their technical support. Research in E.L.-C.’s lab was supported by Fundación Familia Alonso, Santander Bank, Real Seguros, Fundación Mutua Madrileña, Fundación Uria, Fundación La Caixa, and Ayuntamiento de Madrid.S

Healthcare workers hospitalized due to COVID-19 have no higher risk of death than general population. Data from the Spanish SEMI-COVID-19 Registry

Aim To determine whether healthcare workers (HCW) hospitalized in Spain due to COVID-19 have a worse prognosis than non-healthcare workers (NHCW). Methods Observational cohort study based on the SEMI-COVID-19 Registry, a nationwide registry that collects sociodemographic, clinical, laboratory, and treatment data on patients hospitalised with COVID-19 in Spain. Patients aged 20-65 years were selected. A multivariate logistic regression model was performed to identify factors associated with mortality. Results As of 22 May 2020, 4393 patients were included, of whom 419 (9.5%) were HCW. Median (interquartile range) age of HCW was 52 (15) years and 62.4% were women. Prevalence of comorbidities and severe radiological findings upon admission were less frequent in HCW. There were no difference in need of respiratory support and admission to intensive care unit, but occurrence of sepsis and in-hospital mortality was lower in HCW (1.7% vs. 3.9%; p = 0.024 and 0.7% vs. 4.8%; p<0.001 respectively). Age, male sex and comorbidity, were independently associated with higher in-hospital mortality and healthcare working with lower mortality (OR 0.211, 95%CI 0.067-0.667, p = 0.008). 30-days survival was higher in HCW (0.968 vs. 0.851 p<0.001). Conclusions Hospitalized COVID-19 HCW had fewer comorbidities and a better prognosis than NHCW. Our results suggest that professional exposure to COVID-19 in HCW does not carry more clinical severity nor mortality

Famílies botàniques de plantes medicinals

Facultat de Farmàcia, Universitat de Barcelona. Ensenyament: Grau de Farmàcia, Assignatura: Botànica Farmacèutica, Curs: 2013-2014, Coordinadors: Joan Simon, Cèsar Blanché i Maria Bosch.Els materials que aquí es presenten són els recull de 175 treballs d’una família botànica d’interès medicinal realitzats de manera individual. Els treballs han estat realitzat per la totalitat dels estudiants dels grups M-2 i M-3 de l’assignatura Botànica Farmacèutica durant els mesos d’abril i maig del curs 2013-14. Tots els treballs s’han dut a terme a través de la plataforma de GoogleDocs i han estat tutoritzats pel professor de l’assignatura i revisats i finalment co-avaluats entre els propis estudiants. L’objectiu principal de l’activitat ha estat fomentar l’aprenentatge autònom i col·laboratiu en Botànica farmacèutica

Empresas turísticas en la nueva sociedad del ocio. El caso de Navaleno como ejemplo de turismo rural.

Una zona geográfica que en los últimos años ha conseguido adaptarse de una forma muy positiva y dinámica a las nuevas tendencias de ocio turístico en espacios naturales en el medio rural. Es por ello, que el interés del estudio se centra en analizar la configuración de productos y servicios turísticos alternativos y de calidad, los cuales aportan una nueva forma de ocio diferente para el viajero, fundamentándose en la creación de experiencias y emociones diferentes, a través de una oferta cada vez más diversificada para atender de una manera más especializada y profesional a las necesidades de la demanda turística actual. Dentro de este contexto los objetivos que se plantean en esta investigación son los siguientes: · Describir las características de la nueva sociedad del ocio y el impacto que generan las tecnologías de la información en los hábitos de consumo turístico. · Conocer la evolución del sector turístico en España y su adaptación a una sociedad más digitalizada, estudiando el turismo rural como ejemplo de ocio alternativo al modelo tradicional de sol y playa, donde existe un consumidor mucho más informado que desea un turismo basado principalmente en las experiencias y emociones. · Analizar el turismo rural en la provincia de Soria, centrando el trabajo de campo en la localidad de Navaleno. Estudiar todas sus líneas de adaptación a las nuevas formas de consumo turístico desde la perspectiva de la oferta, así como las características de la demanda. Por otro lado, es importante también observar el papel que juega el cliente a la hora de diseñar las nuevas estrategias empresariales. Las cuales, están orientadas a configurar mejores productos y servicios de ocio turístico, con capacidad de diferenciarse con respecto a otras zonas geográficas, donde el conjunto de empresas que se ubican en la zona, muestran un alto grado de competitividad dentro del sector. · Evaluar las líneas de acción empresarial dentro del sector de turismo rural en la localidad de Navaleno, reflexionando sobre si la zona logra mantener la competitividad dentro del sector y si responde adecuadamente a las necesidades del nuevo entorno turístico actual y futuro. Será preciso analizar si nos encontramos en una zona geográfica con unas características específicas, que propicien un entorno lo suficientemente competitivo en turismo rural, como para configurar en el futuro un clúster empresarial en torno a este sector.Grado en Administración y Dirección de Empresa

Anticuerpo anti-Dectin-1 humano, hibridoma productor de dicho anticuerpo y sus aplicaciones

Anticuerpo anti-Dectin-1 humano, hibridoma productor de dicho anticuerpo y sus aplicaciones. La presente invención consiste en el hibridoma MGD3 y el anticuerpo monocional producido por él (denominado también MGD3), que reconoce de forma especifica al receptor de membrana Decti-1 humano. El anticuerpo MGD3 es capaz de inhibir la unión de Dectin-1 a su ligando natural, los -glucanos que son componentes de la pared de los hongos. Además, bloquea específicamente la unión a Candida albicans así como la secreción de citoquinas inducidas por la misma. El anticuerpo MGD3 obtenido permite la detección in vitro, ex vivo e in vivo de la proteína humana Dectin-1. Del mismo modo, puede emplearse para detectar el nivel de expresión del receptor en leucocitos humanos y para definir el papel de este receptor en la patogenia de enfermedades autoinmunes y de condiciones caracterizadas por inflamación crónica así como para conocer el efecto terapéutico de distintos agentes anti-inflamatorios e inmunosupresores. Además, el anticuerpo MGD3 podría tener potencial terapéutico en enfermedades inflamatorias crónicas.Peer reviewedConsejo Superior de Investigaciones Científicas (España), Fundación para la Investigación Biomédica del Hospital de La PrincesaB1 Patente con informe sobre el estado de la ténic