La societat malalta

Tenint en compte que termes com salut, molèstia o malaltia són construccions de tipus cultural i de significat variable segons el context, i que la societat és un immens grup resultat de la suma dels seus components individuals; la hiperactivitat, la sobreestimulació o la desmotivació s’analitzen com a agents patògens d’una epidemiologia cada vegada més actual, plantejant qui (societat o individu) és el “germen” i qui és la “curació”

Protocolo del estudio de cohortes GESTASTRESS sobre los efectos del estrés durante el embarazo mediante la medida de cortisol en el cabello de la mujer y del recién nacido

Se presenta el protocolo del estudio longitudinal del estrés perinatal desde la concepción hasta un año de vida. El estrés se relaciona con trastornos psicopatológicos, enfermedades cardiovasculares e inmunológicas. Durante el embarazo, la activación del eje hipotalámico-hipofisario-adrenal ante un estímulo estresante aumenta los niveles de cortisol. El estrés durante el embarazo tiene efectos sobre la madre, el feto y el bebé que pueden llegar a la adultez. Sin embargo, existen resultados contradictorios. En este estudio longitudinal se pretendía estudiar los niveles de estrés materno de 807 mujeres embarazadas durante los 3 trimestres de embarazo, mediante evaluación psicológica y mediante la innovadora técnica de niveles de cortisol en pelo. Se estudia la relación con los niveles de cortisol en pelo de recién nacidos, temperamento y neurodesarrollo de los bebés a los 6 y 12 meses de edad. Además, se miden variables sociodemográficas, historia obstétrica, parto y nacimiento, desarrollo fetal e infantil. Los resultados obtenidos permitirán promover la adopción de medidas preventivas y de intervención en Salud Pública.The aim was to present the longitudinal study protocol on the effects of perinatal stress from conception to one year of age. Stress is associated to psychopathological, cardiovascular and inmunological diseases. During pregnancy, the activation of the Hipotalamic-Pituitary-Adrenal results in an increased release of cortisol. Stress during pregnancy is related to maternal, fetal and infant negative outcomes that can last a lifetime. Nevertheless, contradictory findings have been reported. In this longitudinal study maternal stress is assessed from a sample of 807 pregnant women through hair cortisol levels and psychological questionnaires during the three trimesters of pregnancy. Besides, associations with the new-borns´ hair cortisol levels, temperament and neurodevelopment at age 6 and 12 months are assessed. Sociode- mographic, obstetrics, delivery, fetal and newborn development variables are included in analysis. Findings will be able to provide a better understanding of perinatal stress and will improve maternal, fetal and infant outcomes.Este trabajo ha sido financiado por el Ministerio de Economía y Competitividad, Secretaría de Estado de Investigación, Desarrollo e Innovación; Convocatoria 2015 de Proyectos I+D de Excelencia, con número de referencia PSI2015-63494-P y cofinanciado por FEDER funds/European Regional Development Fund (ERDF) - un camino para construir Europa

Assessment of Chainsaw Operators Training in Andalusia (Spain)

The chainsaw, as a work equipment, is considered one of the most dangerous in the field of occupational health and safety. The chainsaw is especially used in the forestry sector, although it is also used in other different sectors such as agriculture, construction or gardening. This study was carried out using an ad-hoc questionnaire as a research tool in order to assess the weaknesses in the training received by workers who use chainsaws in Andalusia, Spain, since it has never been addressed before. To achieve the objective set, the questionnaire was completed by 378 operators working with chainsaw and their responses were analysed. The results of this study show that there are obvious shortcomings related to work with chainsaws in very significant aspects for the occupational health and safety. Of special importance is the lack of training detected on rescue techniques and work at height, since these are aspects of special risk for workers’ health that could cause accidents with severe injuries. Also, a common denominator in all aspects studied was the lack of safety inspections and the state of the equipment to be used. These results evidence that there is a need to regulate chainsaw operator training

Cáncer renal con trombosis de vena renal y vena cava inferior

Venous thromboembolic disease is a frequent and serious clinic complication in cancer patients. Risk is higher in those with metastatic disease, and thrombosis related with cancer is associated with lower survival rates. Anticoagulation is the main treatment, usually continued for a long time, carrying risk for bleeding events. Despite anticoagulation, a high rate of recurrences is described. Venous thrombosis and cancer is a major therapeutic challenge and requires a comprehensive management. We present the case of a 55-year-old male with clear cell renal carcinoma and associated venous thromboembolic disease.La enfermedad tromboembólica venosa es una de las complicaciones más frecuentes y graves de los pacientes oncológicos. La incidencia es mayor en tumores con enfermedad metastásica y su desarrollo se relaciona con una menor supervivencia. La anticoagulación, que es el tratamiento indicado, en la gran mayoría de los casos debe mantenerse a largo plazo, con el riesgo hemorrágico que esto conlleva. Además, la trombosis venosa asociada al cáncer presenta una elevada tasa de recurrencias pese a la anticoagulación. El manejo de la trombosis venosa en el cáncer es complejo y precisa una aproximación multidisciplinar. Presentamos el caso de un varón de 55 años con un carcinoma renal de células claras y enfermedad tromboembólica venosa asociada

Hair cortisol concentrations in a Spanish sample of healthy adults

Hair cortisol concentration (HCC), as a novel promising method to retrospectively measure hypothalamic-pituitary-adrenal (HPA) axis activation, is being increasingly studied. We tested the relationships between HCC and a range of possible confounding variables in a Spanish sample of healthy adults and pregnant women. In this sample of healthy Spaniards, results suggested an association between HCC and physical exercise and educational level. In pregnant women, the prevalence of HCC was higher than in non-pregnant woman, and was related to educational level. This study emphasises the need to determine the relationship between HCC and confounders such as sociodemographic and lifestyle variables in the general population and specific groups formed by individuals such as pregnant women.This research is part of a doctoral thesis. It has been economically supported by the "PSI2015-63494-P" I+D Project of the Spanish Ministry of Economy and Competitiveness (MINECO) and FEDE

Approach to Petiole Sap Nutritional Diagnosis Method by Empirical Model Based on Climatic and Growth Parameters

The aim of this work is to evaluate the relationship between the nutrient concentration in petiole sap and different agronomic and climatic variables for a tomato crop grown in a greenhouse in Mediterranean conditions. In addition, the persistence of the nutrient concentration in petiole sap was investigated with the aim of determining the sampling period that implies the best trade-off nutritional information. The experiment consisted of the selection of 20 sampling points inside the greenhouse. The samples of petiole, fully expanded leaf, and soil solution samples were collected weekly from 86 to 163 days after transplanting. Chloride, NO3−-N, H2PO4−-P, Na+, K+, Ca2+, and Mg2+ concentrations were determined in petiole sap and soil solution obtained by suction cups. Nitrogen, P, K, Cl, and Na concentrations were also determined in leaf. Finally, the petiole sap nutritional diagnosis method is the highest sensitive nutritional diagnosis method which compares soil solution and nutrient leaf content related to yield, and the statistical analysis performed in this research demonstrates that crop evapotranspiration (ETc), vapor pressure deficit (DPV), and leaf area index (LAI) are considered the most significant variables that allow the development of these empirical prediction models regarding nutrient concentration in petiole sap

Metabolic-associated fatty liver disease: from simple steatosis towards liver cirrhosis and potential complications. Proceedings of the Third Translational Hepatology Meeting, endorsed by the Spanish Association for the Study of the Liver (AEEH)

This is a meeting report of the 3rd Translational Hepatology Meeting held in Alicante, Spain, in October 2021. The meeting, which was organized by the Spanish Association for the Study of the Liver (AEEH), provided an update on the recent advances in the field of basic and translational hepatology, with a particular focus on the molecular and cellular mechanisms and therapeutic targets involved in metabolic-associated fatty liver disease (MAFLD), metabolic-associated steatohepatitis (MASH), cirrhosis and end-stage hepatocellular carcinoma (HCC).S

Use of eltrombopag for patients 65 years old or older with immune thrombocytopenia

Background Eltrombopag is useful for immune thrombocytopenia (ITP). However, results of clinical trials may not accurately mirror clinical practice reality. Here we evaluated eltrombopag for primary and secondary ITP in our ≥65‐year‐old population. Methods A total of 106 primary ITP patients (16 with newly diagnosed ITP, 16 with persistent ITP, and 74 with chronic ITP) and 39 secondary ITP patients (20 with ITP secondary to immune disorders, 7 with ITP secondary to infectious diseases, and 12 with ITP secondary to lymphoproliferative disorders [LPD]) were retrospectively evaluated. Results Median age of our cohort was 76 (interquartile range, IQR, 70‐81) years. 75.9% of patients yielded a platelet response including 66.2% complete responders. Median time to platelet response was 14 (IQR, 8‐21) days. Median time on response was 320 (IQR, 147‐526) days. Sixty‐three adverse events (AEs), mainly grade 1‐2, occurred. The most common were hepatobiliary laboratory abnormalities (HBLAs) and headaches. One transient ischemic attack in a newly diagnosed ITP and two self‐limited pulmonary embolisms in secondary ITP were the only thrombotic events observed. Conclusion Eltrombopag showed efficacy and safety in ITP patients aged ≥65 years with primary and secondary ITP. However, efficacy results in LPD‐ITP were poor. A relatively high number of deaths were observed