La encefalopatía espongiforme: ¿un trastorno conversivo?

Las prionpatías, constituyen un grupode enfermedades neurodegenerativas con presentaciónfamiliar, esporádica o adquirida, con clínicaheterogenea y resultado fatal. Los síntomas psiquiátricospueden estar presentes al inicio y/o durantela evolución del cuadro, con la presencia o no defocalidad neurológica. Esta condición conlleva aque estos pacientes sean derivados a unidades dePsiquiatría tanto a nivel hospitalario como ambulatorio,para estudio de trastornos psiquiátricos. Elcaso clínico que nos ocupa el paciente fue atendidoen varias ocasiones en las Urgencias Hospitalarias,evaluado por neurólogos y psiquiatras con diversosdiagnósticos psiquiátricos. Sin embargo, la encefalopatíaespongiforme sólo fue diagnosticada en el último mes de enfermedad

Solution-Processed Ni-Based Nanocomposite Electrocatalysts: An Approach to Highly Efficient Electrochemical Water Splitting

In this study, we report an up-scalable and low-cost solution-processed method to in situ synthesize an earth-abundant non-stoichiometric NiOx-based electrocatalytic film for water oxidation. The catalytic activity was found to be inversely proportional to the baking temperature, which varied from 50 to 500 °C. We found the formation of a hybrid nanocomposite thin film of NiOx nanocrystals (<2 nm size) inside an acetate-based organic matrix at low temperatures (<200 °C). The defective and short-range structural order of the NiOx-based nanocomposite electrocatalysts, compatible with lattice stress, low electrical conductivity, and high density of catalytically active surface species, and higher Fe incorporation were responsible for the enhanced electrocatalytic activity. Our champion NiOx catalyst features a 358 mV overpotential at 10 mA cm–2 and more than 60 h of continuous operation without significant losses, which is a remarkable milestone for undoped NiOx electrocatalysts synthesized at nearly room temperature by a solution-processed up-scalable method.Funding for open access charge: CRUE-Universitat Jaume IThe authors acknowledge the financial support from the Ministerio de Ciencia, Innovación y Universidades of Spain through funded projects ENE2017-85087-C3-1-R, RYC-2015-18349, and TEC2017-86102-C2-1-R and Agencia Valenciana de la Innovacion (AVI) INNVAL10/18/032. The authors thank the Central Support Service for Experimental Research (SCSIE) (XRD and SEM facilities) and the Institute of Materials Science (TGA and DTA equipment) of the University of Valencia and the Central Service of Scientific Instrumentation (SCIC) at University Jaume I. The authors also thank Prof. Juan P. Martinez-Pastor for his constructive suggestions and scientific discussions

Type 1 diabetic mellitus patientswith increased atherosclerosisriskdisplay decreased CDKN2A/2B/2BAS gene expression in leukocytes

Background: Type 1 diabetes mellitus (T1DM) patients display increased risk of cardiovascular disease (CVD) and are characterized by a diminished regulatory T (Treg) cell content or function. Previous studies have shown an association between decreased CDKN2A/2B/2BAS gene expression and enhanced CVD. In the present study the potential relationship between CDKN2A/2B/2BAS gene expression, immune cell dysfunction and increased cardiovascular risk in T1DM patients was explored. Methods: A cross-sectional study was performed in 90 subjects divided into controls and T1DM patients. Circulating leukocyte subpopulations analysis by flow cytometry, expression studies on peripheral blood mononuclear cell by qPCR and western blot and correlation studies were performed in both groups of subjects. Results: Analysis indicated that, consistent with the described T cell dysfunction, T1DM subjects showed decreased circulating CD4+CD25+CD127- Treg cells. In addition, T1DM subjects had lower mRNA levels of the transcription factors FOXP3 and RORC and lower levels of IL2 and IL6 which are involved in Treg and Th17 cell differentiation, respectively. T1DM patients also exhibited decreased mRNA levels of CDKN2A (variant 1 p16Ink4a), CDKN2A (p14Arf, variant 4), CDKN2B (p15Ink4b) and CDKN2BAS compared with controls. Notably, T1DM patients had augmented pro-atherogenic CD14++CD16+-monocytes, which predict cardiovascular acute events and enhanced common carotid intima-media thickness (CC-IMT). Conclusions: Decreased expression of CDKN2A/2B/2BAS in leukocytes associates with increased CC-IMT atherosclerosis surrogate marker and proatherogenic CD14++CD16+ monocytes in T1DM patients. These results suggest a potential role of CDKN2A/2B/2BAS genes in CVD risk in T1DM

Comparative study between teachers and education students on knowledge about ADHD

El presente estudio analiza los conocimientos de los docentes en activo de educación infantil y primaria y los estudiantes universitarios del Grado de Educación Infantil y Primaria sobre el Trastorno por Déficit de Atención e Hiperactividad (TDAH), y los compara entre sí. En una muestra total de 83 docentes en activo y 109 estudiantes universitarios, se ha implementado la Knowledge of Attention Deficit Hyperactivity Disorder (KADDS) un cuestionario que evalúa tres subescalas de conocimiento sobre el TDAH: Información, Síntomas y Tratamiento. Además, se han añadido ítems sobre el Funcionamiento Ejecutivo. Los resultados indican un pobre conocimiento sobre el TDAH tanto por parte de los docentes en activo como de los estudiantes universitarios, curiosamente, no mostrando diferencias significativas en la comparación general de ambos grupos, pero sí encontrando diferencias significativas en las subescalas individuales de Síntomas y Tratamiento a favor de los estudiantes y a favor de los docentes respectivamente.This study aims to analyze the knowledge of active teachers in early childhood and primary education, as well as university students enrolled in the Early Childhood and Primary Education Degree, regarding Attention Deficit Hyperactivity Disorder (ADHD), and to compare them. A total sample of 83 active teachers and 109 university students underwent assessment using the Knowledge of Attention Deficit Hyperactivity Disorder (KADDS), a questionnaire evaluating three knowledge sub-scales on ADHD: Information, Symptoms, and Treatment. Additional items on Executive Functioning were included. The results indicate a poor understanding of ADHD among both active teachers and university students. Interestingly, there were no significant differences found in the overall comparison between the two groups, but significant differences were identified in the individual sub-scales of Symptoms and Treatment, favoring the students and the teachers respectively

Knowledge, Misconceptions, and Gaps of Spanish/Italian Teachers and Students Regarding Attention Deficit Hyperactivity Disorder (ADHD)

El presente estudio se ha ocupado de examinar los conocimientos (aciertos), concepciones erróneas (fallos) y lagunas (no sé) sobre el Trastorno por Déficit de Atención e Hiperactividad (TDAH) en base a tres áreas de contenido específicas: información general, sintomatología y tratamiento. Para ello, se ha empleado el cuestionario del KADDS (Knowledge of Attention Deficit Hyperactivity Disorder), cumplimentado por un total de 58 maestros/as españoles y boloñeses y 53 estudiantes. Los resultados del KADDS respecto a los docentes muestran un porcentaje de aciertos del 47,3%, 39,2% en fallos y 13,2% en lagunas. En estudiantes el porcentaje es del 56,6%, 26,6% y 16,8% respectivamente. Se observan diferencias entre el profesorado español e italiano. Respecto al porcentaje de aciertos, los docentes españoles puntúan menos en las tres áreas respecto a los docentes italianos: información general (54,5% vs. 78,4%), sintomatología (63,2% vs. 77%) y tratamiento (50,1% vs. 72,7%). Además, se observa que los docentes con estudios específicos en educación especial puntúan mejor en las tres áreas. Debido a la alta prevalencia del TDAH y el posible desconocimiento para su diagnóstico, manejo y tratamiento, sería recomendable una mayor formación a los docentes.This study aimed to examine the knowledge (correct answers), misconceptions (errors), and gaps (I don't know) about Attention Deficit Hyperactivity Disorder (ADHD) among Spanish and Italian teachers and students in three specific areas: general information, symptoms, and treatment. The KADDS (Knowledge of Attention Deficit Hyperactivity Disorder) questionnaire was used, completed by a total of 58 Spanish and Italian teachers and 53 students. The KADDS results for teachers showed a percentage of correct answers of 47.3%, 39.2% for errors, and 13.2% for gaps. For students, the percentages were 56.6%, 26.6%, and 16.8% respectively. Differences were observed between Spanish and Italian teachers. In terms of the percentage of correct answers, Spanish teachers scored lower in all three areas compared to Italian teachers: general information (54.5% vs. 78.4%), symptoms (63.2% vs. 77%), and treatment (50.1% vs. 72.7%). Additionally, it was observed that teachers with specific training in special education scored better in all three areas. Due to the high prevalence of ADHD and the potential lack of knowledge regarding its diagnosis, management, and treatment, it would be recommended to provide teachers with more training

Four-year epidemiological characterization of large burn patients at Celia Sánchez Manduley Surgical Hospital, 2015–2018

Introduction: A "large burn" patient is defined as a patient who suffers a burn of such magnitude that it carries a major risk of life, defined by different parameters. Burns are a national and worldwide public health problem due to the morbidity and mortality they cause. The objective of this study is to describe the epidemiological and clinical characteristics of hospitalized patients with large burns. Methods: A descriptive, retrospective and longitudinal study was carried out at the Plastic Surgery and Burn Service of the Celia Sánchez Manduley Surgical Hospital, Manzanillo - Granma, from January 2015 to December 2018, to understand the epidemiological characteristics of hospitalized large burn patients. Results: The largest number of hospitalizations (45 patients [35.16%]) occurred in 2018. There was a predominance of females (74 patients [57.81%]). Accidents were the most frequent cause of burns (71 patients [55.47%]). Severe large burn patients were the most frequently treated (48 [37.50%]). The highest number of cases occurred in the municipalities of Bayamo (40 cases [31.25%]) and Manzanillo (21 cases [16.41%]). Conclusion: The highest number of cases occurred in 2018, with a predominance of females between the age of 30-59 years. Accidents were the primary cause for burns, and the survival rate exceeded expectations. The municipalities with the most cases were Bayamo and Manzanillo

Specialized proresolving mediators protect against experimental autoimmune myocarditis by modulating Ca2+ handling and NRF2 activation

Preclinical research[Abstract] Specialized proresolving mediators and, in particular, 5(S), (6)R, 7-trihydroxyheptanoic acid methyl ester (BML-111) emerge as new therapeutic tools to prevent cardiac dysfunction and deleterious cardiac damage associated with myocarditis progression. The cardioprotective role of BML-111 is mainly caused by the prevention of increased oxidative stress and nuclear factor erythroid-derived 2-like 2 (NRF2) down-regulation induced by myocarditis. At the molecular level, BML-111 activates NRF2 signaling, which prevents sarcoplasmic reticulum–adenosine triphosphatase 2A down-regulation and Ca2+ mishandling, and attenuates the cardiac dysfunction and tissue damage induced by myocarditis.Ministerio de Economía y Competitividad (España); SAF-2017-84777RInstituto de Salud Carlos III; PI17/01093Instituto de Salud Carlos III; PI17/01344Instituto de Salud Carlos III; PI20/01482Ministerio de Ciencia, Innovación y Universidades (España); PGC2018-097019-B-I00Ministerio de Economía, Industria y Competitividad (España); 10.13039/501100011033Ministerio de Industria, Economía y Competitividad; PID2020-113238RB-I00Ministerio de Industria, Economía y Competitividad (España); PID2019-105600RB-I00Fundación La Caixa; HR17-0024

Inhaled Methoxyflurane Provides Greater Analgesia and Faster Onset of Action Versus Standard Analgesia in Patients With Trauma Pain: InMEDIATE: A Randomized Controlled Trial in Emergency Departments

Study objective: The objective of the InMEDIATE study was to evaluate the change in intensity of traumatic pain over the first 20 min in adult patients treated with methoxyflurane versus standard analgesic treatment in Spain. This the first randomized, active-controlled, multicenter trial of methoxyflurane in the emergency setting in Europe. Methods: This was a randomized, controlled study that enrolled adult patients with acute moderate to severe (score >= 4 on the 11-point Numeric Rating Scale) trauma-associated pain in 14 Spanish emergency departments. Patients were randomized 1:1 to methoxyflurane (up to 2x3 mL) or standard analgesic treatment. Coprimary endpoints were the change from baseline in Numeric Rating Scale pain intensity score during the first 20 minutes of treatment and time to first pain relief. Results: Three hundred five patients were randomized (methoxyflurane 156; standard analgesic treatment 149). Most patients in the standard analgesic treatment group (70%) received intravenous first-step analgesics and 9.4% of patients were treated with opioids. Mean decrease from baseline in Numeric Rating Scale pain intensity score was greater for methoxyflurane than standard analgesic treatment at all points, with a significant treatment difference overall up to 20 minutes (repeated-measures model 2.47 versus 1.39; treatment difference 1.00; 95% confidence interval 0.84 to 1.32). Median time to first pain relief was significantly shorter for methoxyflurane than standard analgesic treatment (3 versus 10 minutes). Methoxyflurane achieved better patient and clinician ratings for pain control and comfort of treatment than standard analgesic treatment and exceeded patient and clinician expectations of treatment in, respectively, 77% and 72% of cases compared with 38% and 19% for standard analgesic treatment. Conclusion: These results support consideration of methoxyflurane as a nonnarcotic, easy-to-administer, rapid-acting, first-line alternative to currently available analgesic treatments for trauma pain

Riesgo quirúrgico tras resección pulmonar anatómica en cirugía torácica. Modelo predictivo a partir de una base de datos nacional multicéntrica

Introduction: the aim of this study was to develop a surgical risk prediction model in patients undergoing anatomic lung resections from the registry of the Spanish Video-Assisted Thoracic Surgery Group (GEVATS). Methods: data were collected from 3,533 patients undergoing anatomic lung resection for any diagnosis between December 20, 2016 and March 20, 2018. We defined a combined outcome variable: death or Clavien Dindo grade IV complication at 90 days after surgery. Univariate and multivariate analyses were performed by logistic regression. Internal validation of the model was performed using resampling techniques. Results: the incidence of the outcome variable was 4.29% (95% CI 3.6-4.9). The variables remaining in the final logistic model were: age, sex, previous lung cancer resection, dyspnea (mMRC), right pneumonectomy, and ppo DLCO. The performance parameters of the model adjusted by resampling were: C-statistic 0.712 (95% CI 0.648-0.750), Brier score 0.042 and bootstrap shrinkage 0.854. Conclusions: the risk prediction model obtained from the GEVATS database is a simple, valid, and reliable model that is a useful tool for establishing the risk of a patient undergoing anatomic lung resection