Significació dels marcadors d'activació de monòcits i inflamacions en pacients amb Trastorn per Ús d'Alcohol

El Trastorn per Ús d'Alcohol (TUA), que és la forma més greu del consum perjudicial d'alcohol, pot produir problemes hepàtics entre altres alteracions i desequilibris. Un estudi de la Unitat d'Addiccions del Servei de Medicina Interna de l'Hospital Universitari Germans Trias i Pujol, dut a terme amb pacients ingressats a aquest i a Bellvitge, proposa arribar a una correlació d'indicis per actuar abans que la malaltia empitjori. S'ha considerat important analitzar les proteïnes CD163 i sCD14 com a marcadors per al comportament i activació dels monòcits i la IL-6, pel que fa a la inflamació del cos, a causa de la ingerència d'alcohol, ja que es vinculen amb les pertorbacions observades.El Trastorno por Uso de Alcohol (TUA), que es la forma más grave del consumo perjudicial de alcohol, puede producir problemas hepáticos, entre otras alteraciones y desequilibrios. Un estudio de la Unidad de Adicciones del Servicio de Medicina Interna del Hospital Universitario Germans Trias i Pujol, llevado a cabo con pacientes ingresados en este y en Bellvitge, propone llegar a una correlación de indicios para actuar antes de que la enfermedad empeore. Se ha considerado importante analizar las proteínas CD163 y sCD14 como marcadores para el comportamiento y activación de los monocitos y el IL-6, con respecto a la inflamación del cuerpo, debido a la injerencia de alcohol, ya que se vinculan con las perturbaciones observadas.Alcohol Use Disorder (AUD) is the most extreme form of unhealthy alcohol use. It is associated with liver-related problems, among other alterations. A study carried out by the Addiction Unit of the Internal Medicine service of the Germans Trias i Pujol University Hospital with patients from this and Bellvitge, proposes to reach a correlation of indications in order to act before the disease worsens. It has been considered important to analize the CD163 and sCD14 proteins, markers for activation and monocyte behavior and the IL-6, responsible of the inflammation of the body, due to alcohol intake, because both of them are linked to the observed perturbations

Liver Ultrasound Abnormalities in Alcohol Use Disorder

Alcohol-related liver disease is the most common alcohol-related medical illness, and it is the major driver of liver-related deaths worldwide. However, no screening guidelines currently exist for the early detection of liver disease in patients with risky drinking or those with alcohol use disorder. Moreover, most patients with alcohol-related liver fibrosis, which is the main prognostic factor of progression to end-stage liver disease, have normal blood tests. Abdominal ultrasound is a cheap and readily available diagnostic procedure that is rarely used in patients with alcohol use disorder without overt liver disease. In addition, abdominal ultrasound can detect other forms of liver disease, which are not uncommon in patients with unhealthy alcohol use, and can have a negative impact on the natural history of alcohol-related liver disease. In this chapter we will review the current knowledge about the use of liver ultrasound in patients with alcohol use disorder for the early detection of alcohol-related liver disease, as well as the potential use to detect other forms of liver disease. We will also briefly discuss other methods for the noninvasive detection of liver steatosis and/or liver fibrosis in patients with alcohol use disorder

Markers of Monocyte Activation, Inflammation, and Microbial Translocation Are Associated with Liver Fibrosis in Alcohol Use Disorder

Background: The association between markers of inflammation (interleukin (IL)-6 and IL-10), monocyte activation (sCD163 and sCD14), and microbial translocation (lipopolysaccharide (LPS) and LPS binding protein) and liver fibrosis in patients with alcohol use disorder (AUD) and no overt liver disease is not well established. Methods: We studied patients admitted for treatment of AUD at two hospitals in Barcelona. Advanced liver fibrosis (ALF) was defined as FIB-4 > 3.25. Results: A total of 353 participants (76.3% male) were included and 94 (26.5%) had ALF. In adjusted correlation analyses, sCD163, sCD14, IL-6, IL-10, and LPS binding protein levels directly correlated with FIB-4 values (adjusted correlation coefficients 0.214, 0.452, 0.317, 0.204, and 0.171, respectively). However, LPS levels were inversely associated with FIB-4 (-0.283). All plasma marker levels in the highest quartile, except LPS, were associated with ALF (sCD163, sCD14, IL-6, IL-10, and LPS binding protein: adjusted odds ratio (aOR) 11.49 (95% confidence interval 6.42-20.56), 1.87 (1.11-3.16), 2.99 (1.79-5.01), 1.84 (1.11-3.16), and 2.13 (1.30-3.50), respectively). Conversely, LPS levels in the lowest quartile were associated with ALF (aOR 2.58 (1.48-4.58), p < 0.01). Conclusion: In AUD patients, plasma levels of the markers of inflammation, monocyte activation, and microbial translocation are associated with ALF

Clinical Interest of LMO2 Testing for the Diagnosis of Aggressive Large B-Cell Lymphomas

MYC rearrangements usually confer aggressive biological behavior to large B-cell lymphomas. In this study, we aimed to evaluate the relevance of LMO2 detection to the clinical approach to these tumors. First, the ability of LMO2 loss of expression to recognize the presence of MYC rearrangements was evaluated. A series of 365 samples obtained from 351 patients, including 28 Burkitt lymphoma, 230 diffuse large B-cell lymphoma, 30 high-grade B-cell lymphoma with MYC and BCL2/BCL6 rearrangements, eight high-grade B-cell lymphoma-NOS, 43 transformed diffuse large B-cell lymphoma, and 26 high-grade follicular lymphomas was analyzed. Among the CD10-positive tumors prospectively analyzed in whole tissue sections, LMO2 negative expression obtained values of 88% sensitivity, 94% specificity, and 93% accuracy, proving the utility of LMO2 to screen MYC rearrangements. In addition, survival analyses were performed in a series of 155 patients. As per univariate analyses, the prognosis relevance of LMO2 was as useful as that of the diagnostic categories, MYC rearrangements, and MYC immunohistochemistry. Multivariate models revealed that both LMO2 (hazard ratio 0.51 p = 0.02) and IPI (hazard ratio 1.67 p < 0.005) were independent variables predicting overall survival. Finally, MYC and LMO2 mRNA expression were analyzed in a small group of cases. Taken together, these findings show the interest of LMO2 testing in large B-cell lymphomas

Hydrogeomorphological analysis and modelling for a comprehensive understanding of flash-flood damage processes: the 9 October 2018 event in northeastern Mallorca

[EN] A flash-flood event hit the northeastern part of Mallorca on 9 October 2018, causing 13 casualties. Mal- lorca is prone to catastrophic flash floods acting on a sce- nario of deep landscape transformation caused by Mediter- ranean tourist resorts. As global change may exacerbate dev- astating flash floods, analyses of catastrophic events are cru- cial to support effective prevention and mitigation measures. Field-based remote-sensing and modelling techniques were used in this study to evaluate rainfall¿runoff processes at the catchment scale linked to hydrological modelling. Continu- ous streamflow monitoring data revealed a peak discharge of 442 m³ s¿¹ with an unprecedented runoff response. This ex- ceptional behaviour triggered the natural disaster as a com- bination of heavy rainfall (249 mm in 10 h), karstic features and land cover disturbances in the Begura de Salma River catchment (23 km²). Topography-based connectivity indices and geomorphic change detection were used as rapid post- catastrophe decision-making tools, playing a key role dur- ing the rescue search. These hydrogeomorphological preci- sion techniques were combined with the Copernicus Emer- gency Management Service and ¿ground-based¿ damage as- sessment, which showed very accurately the damage-driving factors in the village of Sant Llorenç des Cardassar. The main challenges in the future are to readapt hydrological modelling to global change scenarios, implement an early flash-flood warning system and take adaptive and resilient measures on the catchment scale.This research was supported by the Spanish Ministry of Science, Innovation and Universities, the Spanish Agency of Research (AEI) and the European Regional Development Fund (ERDF) through the project CGL2017-88200-R "Functional hydrological and sediment connectivity at Mediterranean catchments: global change scenarios -MEDhyCON2".Estrany, J.; Ruiz-Perez, M.; Mutzner, R.; Fortesa, J.; Nacher Rodriguez, B.; Tomas-Burguera, M.; Garcia-Comendador, J.... (2020). Hydrogeomorphological analysis and modelling for a comprehensive understanding of flash-flood damage processes: the 9 October 2018 event in northeastern Mallorca. 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Heterogeneity in pharmacological treatment and outcomes in Crohn's disease patients in Catalonia : a population-based observational study

Heterogeneity in the treatment of a disease is a marker of suboptimal quality of care. The aim of this study is to evaluate the heterogeneity in the treatment used and the outcomes for Crohn's disease (CD) in Catalonia. All patients with CD included in the Catalan Health Surveillance System (data on more than seven million individuals from 2011 to 2017) were identified. The different Catalonian health areas were grouped into 19 district groups (DG). Treatments used rates (systemic corticosteroids, non-biological and biological immunosuppressant) and outcomes rates (hospitalization and surgery) were calculated. The use of systemic corticosteroids presented a decreasing trend over the study period, with an average rate of use in the different territories between 11% and 17%. The use of non-biological immunosuppressant treatment has remained stable, with an average rate of use ranging from 22% to 40% per year depending on the DG. The use of biological immunosuppressant treatment increased with an average rate of use in the different territories ranging from 10 to 23%. Hospitalizations for any reason showed an increasing trend between 2011 and 2017 with an average rate of between 23% and 32% per year depending on the area. Hospitalizations for CD presented a decreasing trend, with an average rate of between 5% and 11% per year. Surgical treatment remained stable over time, rates per year were between 0.5% and 2%. A remarkable geographical heterogeneity in the use of different treatments and in outcomes of CD was observed between different geographical areas of Catalonia

Safety, activity, and molecular heterogeneity following neoadjuvant non-pegylated liposomal doxorubicin, paclitaxel, trastuzumab, and pertuzumab in HER2-positive breast cancer (Opti-HER HEART): an open-label, single-group, multicenter, phase 2 trial

Antecedents: L'assaig Opti-HER HEART tenia com a objectiu optimitzar l'activitat i minimitzar el risc cardíac combinant trastuzumab, pertuzumab i paclitaxel amb doxorubicina liposomal no pegilada en el tractament del càncer de mama precoç HER2-positiu. Mètodes: Els pacients amb càncer de mama HER2 positiu en fase II-IIIB van rebre trastuzumab neoadjuvant, pertuzumab, paclitaxel i una doxorubicina liposomal no pegilada cada tres setmanes durant sis cicles. El principal criteri final va ser la seguretat cardíaca durant la teràpia neoadjuvant. Es van avaluar els esdeveniments cardíacs tipus A (insuficiència cardíaca congestiva simptomàtica) i B (reducció asimptomàtica de la fracció d'ejecció del ventricle esquerre). Els criteris finals secundaris van incloure l'avaluació de la taxa de resposta patològica completa (pCR) i la taxa de resposta global, entre d'altres. Com a anàlisi exploratòria ad-hoc , es va mesurar l'expressió de 55 gens relacionats amb el càncer de mama, inclosos els gens PAM50 , en 58 mostres de tumors basals i 60 mostres quirúrgiques. Resultats: Es van reclutar vuitanta-tres pacients. La incidència d'esdeveniments cardíacs durant el tractament neoadjuvant va ser del 2,4%. No es va observar cap esdeveniment cardíac de tipus A. La taxa global de pCR va ser del 56,6% (interval de confiança (IC) del 95%: 45,3-67,5%). El subtipus enriquit amb HER2, que representava el 52,0% de totes les mostres basals, es va associar amb una taxa de pCR més alta en comparació amb els tumors no enriquits amb HER2 (83,3% vs. 46,3%; odds ratio 5,76; 95% CI 1,71-19,42). L'associació de subtipus amb pCR va ser independent de les variables clínicopatològiques conegudes, inclòs l'estat del receptor hormonal. En comparació amb les mostres basals, els exemplars quirúrgics van mostrar una significativa regulació descendent dels nivells relacionats amb la proliferació ( MKI67 i CCNB1 ) i ERBB2 , i una regulació ascendent significativa dels relacionats amb la llum (ESR1 i PGR ) i gens immunes ( CD8A ). Conclusions: La combinació de doble bloqueig HER2 amb trastuzumab i pertuzumab amb paclitaxel i doxorubicina liposomal no pegilada s'associa amb una baixa taxa d'esdeveniments cardíacs. El subtipus enriquit amb HER2 s'associa a una alta taxa de pCR

Thirty-day outcomes in frail older patients discharged home from the emergency department with acute heart failure: effects of high-risk criteria identified by the DEED FRAIL-AHF trial

Objectives: To study the effect of high-risk criteria on 30-day outcomes in frail older patients with acute heart failure (AHF) discharged from an emergency department (ED) or an ED's observation and short-stay areas. Material and methods: Secondary analysis of discharge records in the Older AHF Key Data registry. We selected frail patients (aged > 70 years) discharged with AHF from EDs. Risk factors were categorized as modifiable or nonmodifiable. The outcomes were a composite endpoint for a cardiovascular event (revisits for AHF, hospitalization for AHF, or cardiovascular death) and the number of days alive out-of-hospital (DAOH) within 30 days of discharge. Results: We included 380 patients with a mean (SD) age of 86 (5.5) years (61.2% women). Modifiable risk factors were identified in 65.1%, nonmodifiable ones in 47.8%, and both types in 81.6%. The 30-day cardiovascular composite endpoint occurred in 83 patients (21.8%). The mean 30-day DAOH observed was 27.6 (6.1) days. Highrisk factors were present more often in patients who developed the cardiovascular event composite endpoint: the rates for patients with modifiable, nonmodifiable, or both types of risk were, respectively, as follows in comparison with patients not at high risk: 25.0% vs 17.2%, P = .092; 27.6% vs 16.7%, P = .010; and 24.7% vs 15.2%, P = .098). The 30-day DAOH outcome was also lower for at-risk patients, according to type of risk factor present: modifiable, 26.9 (7.0) vs 28.4 (4.4) days, P = .011; nonmodifiable, 27.1 (7.0) vs 28.0 (5.0) days, P = .127; and both, 27.1 (6.7) vs 28.8 (3.4) days, P = .005). After multivariate analysis, modifiable risk remained independently associated with fewer days alive (adjusted absolute difference in 30-day DAOH, -1.3 days (95% CI, -2.7 to -0.1 days). Nonmodifiable factors were associated with increased risk for the 30-day cardiovascular composite endpoint (adjusted absolute difference, 10.4%; 95% CI, -2.1% to 18.7%). Conclusion: Risk factors are common in frail elderly patients with AHF discharged home from hospital ED areas. Their presence is associated with a worse 30-day prognosis

La formación en Moodle en el Campus Virtual de la Universitat de Barcelona

Este trabajo describe la planificación de la formación en Moodle en la UB. Se recoge la información descriptiva acumulada en los siguientes aspectos: tipología de cursos ofertados, facultades implicadas, participación docente, etc. desde su implantación en el curso 2006-07 hasta la actualidad. Se ha producido una implementación generalizada del uso de Moodle en la docencia cotidiana de los profesores de la UB. Como consecuencia, se están replanteando las metodologías docentes con un enfoque más acorde a las directrices que emanan del EEES. Se ha iniciado la exploración de su uso avanzado por parte de diferentes equipos docentes, al incluirlo en el desarrollo de nuevos proyectos de innovación docente de nuestra universidad

Nucleases as a barrier to gene silencing in the cotton boll weevil, Anthonomus grandis.

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