Evaluación de los usos de la finasterida en la práctica clínica y sus evidencias científicas

Introducción La Finasterida es un inhibidor selectivo de la 5α-reductasa encargada de la conversión de testosterona en dihidrotestosterona (DHT), cuyo aumento produce hiperplasia benigna de próstata (HBP) y alopecia androgenética. Objetivos Reflejar la posible utilización de un mismo principio activo para dos indicaciones terapéuticas diferentes, así como revisar los estudios que pretenden plantear el uso de esta molécula con alguna indicación no registrada en sus fichas técnicas. Material y métodos Revisión de numerosos artículos contenidos en las bases de datos AEMPS, Micromedex® y Pubmed®. Resultados y discusión Se demostró el uso de Finasterida 5mg como tratamiento eficaz para el tratamiento de HBP. Además, se probó también el uso de Finasterida 1 mg en el tratamiento de la alopecia androgenética. Por último, no se obtuvieron conclusiones suficientes para afirmar que esta molécula podría tratar el hirsutismo, pero sí que podría reducir la incidencia de cáncer de próstata. Conclusiones Un mismo principio activo puede tratar dos patologías diferentes con el simple cambio de su posología. No existen evidencias que demuestren el tratamiento del hirsutismo con finasterida, pero sí que lo hacen como prevención en el tratamiento de cáncer de próstata aunque esta molécula pudiese agravar la patología si se produjese

Ficción radiofónica en tiempos de crisis: Ficción Sonora de RNE (2009-2015)

En la presente aportación se ofrecen los datos obtenidos tras una investigación[1] en la se han recopilado y analizando las ficciones radiofónicas incluidas dentro del espacio Ficción Sonora de RNE entre los años 2009 y 2015. Mediante el análisis de contenido establecemos las principales características de la ficción emitida en esos años ya que la consideramos responsable del mantenimiento del género en la radio española en la actualidad. El medio se adaptaba a los nuevos públicos y demandas del mercado.   [1] Investigación realizada en el seno del Doctorado en Español. Lingüística, Literatura y Comunicación. Tesis Doctoral Ficción Sonora. Análisis de contenido de las emisiones en Radio Nacional de España (2009-2015) (inédita), defendida en la Universidad de Valladolid en octubre de 2017

Automatic blood glucose classification for gestational diabetes with feature selection: decision trees vs neural networks

Automatic blood glucose classification may help specialists to provide a better interpretation of blood glucose data, downloaded directly from patients glucose meter and will contribute in the development of decision support systems for gestational diabetes. This paper presents an automatic blood glucose classifier for gestational diabetes that compares 6 different feature selection methods for two machine learning algorithms: neural networks and decision trees. Three searching algorithms, Greedy, Best First and Genetic, were combined with two different evaluators, CSF and Wrapper, for the feature selection. The study has been made with 6080 blood glucose measurements from 25 patients. Decision trees with a feature set selected with the Wrapper evaluator and the Best first search algorithm obtained the best accuracy: 95.92%

Necrosis retiniana externa progresiva por virus varicela-zóster en paciente con infección por VIH

A patient with an AIDS stage HIV infection and a thoracic herpes zoster treated with acyclovir, presents with visual loss as a consequence of a bilateral progressive outer retinal necrosis (PORN) caused by varicella-zoster virus. Despite of treatment, the patient doesn’t recover visual acuity. An early diagnostic suspicion and treatment are essential for a better prognosis.Paciente con infección por VIH estadio SIDA y herpes zóster torácico tratado con aciclovir, que debuta con pérdida de visión secundaria a necrosis retiniana externa progresiva bilateral por virus varicela-zóster (VVZ). A pesar del tratamiento, el paciente evoluciona desfavorablemente con severo déficit visual. La sospecha diagnóstica precoz y el tratamiento temprano son esenciales para un mejor pronóstico

Reproductive history before and after HIV diagnosis: A cross-sectional study in HIV-positive women in Spain

The aim of this study is to examine the reproductive history of human immunodeficiency virus (HIV)-positive women, before and after HIV diagnosis, to describe the characteristics of women with pregnancies after HIV diagnosis, and to assess the prevalence of mother-to-child transmission. A cross-sectional study was performed among women within reproductive ages (18–49) selected from the cohort in the Spanish AIDS Research Network (CoRIS). A descriptive analysis of the pregnancy outcomes was made according to women’s serostatus at the moment of pregnancy and association of women’s characteristics with having pregnancy after HIV diagnosis was evaluated using logistic regression models. Overall, 161 women were interviewed; of them, 86% had been pregnant at least once and 39% after HIV diagnosis. There were 347 pregnancies, 29% of them occurred after HIV diagnosis and in these, 20% were miscarriages and 29% were voluntary termination of pregnancy. There were 3 cases of mother-to-child transmission among the 56 children born from HIV-positive mothers; in these cases, women were diagnosed during delivery. Having a pregnancy after HIV diagnosis was more likely when the younger women were at the time of diagnosis: odds ratio (OR)=1.29 (95% confidence interval 0.40–4.17) for 25 to 29 years old, OR=0.59 (0.15–2.29) for 30 to 34 years old, OR=0.14 (0.03–0.74) for ≥35 years old, compared with thosediagnosis, who were diagnosed for ≥5 years (OR=5.27 [1.71–16.18]), who received antiretroviral treatment at some point (OR=9.38 [1.09–80.45]), and who received information on reproductive health (OR=4.32 [1.52–12.26]). An important number of pregnancies occurred after HIV diagnosis, reflecting a desire for motherhood in these women.Reproductive and sexual health should be tackled in medical follow-ups

Post-mortem neuropathologic examination of a 5-case series of CAR T-cell treated patients

Introduction: Chimeric antigen receptor (CAR) T-cell therapy is a promising immunotherapy for the treatment of refractory hematopoietic malignancies. Adverse events are common, and neurotoxicity is one of the most important. However, the physiopathology is unknown and neuropathologic information is scarce.Materials and methods: Post-mortem examination of 6 brains from patients that underwent CAR T-cell therapy from 2017 to 2022. In all cases, polymerase chain reaction (PCR) in paraffin blocks for the detection of CAR T cells was performed.Results: Two patients died of hematologic progression, while the others died of cytokine release syndrome, lung infection, encephalomyelitis, and acute liver failure. Two out of 6 presented neurological symptoms, one with extracranial malignancy progression and the other with encephalomyelitis. The neuropathology of the latter showed severe perivascular and interstitial lymphocytic infiltration, predominantly CD8+, together with a diffuse interstitial histiocytic infiltration, affecting mainly the spinal cord, midbrain, and hippocampus, and a diffuse gliosis of basal ganglia, hippocampus, and brainstem. Microbiological studies were negative for neurotropic viruses, and PCR failed to detect CAR T -cells. Another case without detectable neurological signs showed cortical and subcortical gliosis due to acute hypoxic-ischemic damage. The remaining 4 cases only showed a mild patchy gliosis and microglial activation, and CAR T cells were detected by PCR only in one of them.Conclusions: In this series of patients that died after CAR T-cell therapy, we predominantly found non-specific or minimal neuropathological changes. CAR T-cell related toxicity may not be the only cause of neurological symptoms, and the autopsy could detect additional pathological findings

Ecología y sostenibilidad en la Edad Media: arte, ODS e innovación docente

En el curso 2021/2022 se ha puesto en marcha un PIMCD sobre Ecología y sostenibilidad en la Edad Media: arte, ODS e innovación docente a través de la Historia del Arte medieval, con un planteamiento interfacultativo, que ha implicado a la Facultad de Geografía e Historia, a la Facultad de Comercio y Turismo, y a la Facultad de Educación de la Universidad Complutense de Madrid. Ha tenido en cuenta dos de los principales objetivos de la convocatoria: “la mejora de la calidad docente y de los servicios vinculada a procesos de innovación” y “la participación de la comunidad universitaria en la conformación de una cultura de la calidad”. El proyecto ESEM ha aspirado, a su vez, a mejorar el servicio que la universidad ofrece a la sociedad, prestando especial atención a la transferencia del conocimiento y al creciente compromiso de la Universidad Complutense de Madrid con los ODS. Nuestro proyecto de innovación se ha centrado en la elaboración de material docente sobre la relación que hombres y mujeres establecieron a lo largo de la Edad Media con su entorno natural y urbano, por cuyo progresivo deterioro mostraron ya una plena consciencia. La búsqueda de bibliografía y de fuentes, tanto documentales como iconográficas, relativas al tema, ha resultado ardua, de ahí el interés que la creación de un repositorio con este tipo de información y trabajos puede llegar a despertar entre la comunidad educativa y científica. Las cuatro líneas temáticas que se han desarrollado en el marco de las clases prácticas impartidas en el curso 2021/2022 por los miembros PDI del proyecto han sido las siguientes: 1. Arquitectura y paisaje. Responsable de contenidos: Herbert González Zymla, Vicedecano de Estudiantes y Extensión Universitaria, Facultad de Comercio y Turismo / Dpto. Historia del Arte, Facultad de Geografía e Historia, Universidad Complutense de Madrid. 2. Despoblados medievales: Responsable de contenidos: José Arturo Salgado Pantoja, Profesor Contratado Doctor de la Universidad de Castilla – La Macha. 3. Técnicas artísticas, reutilización de materiales y economía circular. Responsable de contenidos: Irene González Hernando, Profesora Contratada Doctora de la Universidad Complutense de Madrid. 4. Mujeres y naturaleza. Responsables de contenidos: Diana Lucía Gómez-Chacón y Ana Valtierra Lacalle, Profesoras Ayudantes Doctoras de la Universidad Complutense de Madrid

Effectiveness of a cognitive behavioral intervention in patients with medically unexplained symptoms: cluster randomized trial

BACKGROUND: Medically unexplained symptoms are an important mental health problem in primary care and generate a high cost in health services.Cognitive behavioral therapy and psychodynamic therapy have proven effective in these patients. However, there are few studies on the effectiveness of psychosocial interventions by primary health care. The project aims to determine whether a cognitive-behavioral group intervention in patients with medically unexplained symptoms, is more effective than routine clinical practice to improve the quality of life measured by the SF-12 questionary at 12 month. METHODS/DESIGN: This study involves a community based cluster randomized trial in primary healthcare centres in Madrid (Spain). The number of patients required is 242 (121 in each arm), all between 18 and 65 of age with medically unexplained symptoms that had seeked medical attention in primary care at least 10 times during the previous year. The main outcome variable is the quality of life measured by the SF-12 questionnaire on Mental Healthcare. Secondary outcome variables include number of consultations, number of drug (prescriptions) and number of days of sick leave together with other prognosis and descriptive variables. Main effectiveness will be analyzed by comparing the percentage of patients that improve at least 4 points on the SF-12 questionnaire between intervention and control groups at 12 months. All statistical tests will be performed with intention to treat. Logistic regression with random effects will be used to adjust for prognostic factors. Confounding factors or factors that might alter the effect recorded will be taken into account in this analysis. DISCUSSION: This study aims to provide more insight to address medically unexplained symptoms, highly prevalent in primary care, from a quantitative methodology. It involves intervention group conducted by previously trained nursing staff to diminish the progression to the chronicity of the symptoms, improve quality of life, and reduce frequency of medical consultations. TRIAL REGISTRATION: The trial was registered with ClinicalTrials.gov, number NCT01484223 [http://ClinicalTrials.gov].S