Caracterización antropométrica y de las alteraciones metabólicas de la obesidad infanto-juvenil en relación con la restricción del crecimiento intrauterino del paciente y su alimentación infantil (lactancia materna y asistencia a comedor escolar)

OBJETIVOS: Estudiar la influencia de nacer con antropometría neonatal pequeña para la edad gestacional (PEG) y la influencia de la lactancia materna y asistencia al comedor escolar, sobre las características antropométricas y las comorbilidades metabólicas observadas en los niños y adolescentes obesos. PACIENTES y MÉTODOS: Estudio observacional retrospectivo, con evaluación de variables perinatales, antropométricas, bioquímicas, hormonales y nutricionales, en 1112 pacientes atendidos en el Servicio de Endocrinología del Hospital Infantil Universitario Niño Jesús de Madrid, con un IMC Z-score > +2 SDS para su edad y sexo en el periodo 2009-2013. RESULTADOS: El 6,3% fueron pacientes obesos nacidos PEG. En éstos, se observó una afectación más grave del metabolismo lipídico e hidrocarbonado que en aquellos pacientes que habían nacido con una antropometría adecuada a su edad gestacional (AEG) y sexo. El 78,7% de los pacientes recibieron lactancia materna. Aquellos que no habían recibido lactancia materna presentaban mayor IMC-SDS y niveles de VLDL, Triglicéridos, TSH y AUC de insulina. El 46,8% asistían al comedor escolar, y presentaban menores niveles de ácido úrico, VLDL, triglicéridos, índice triglicéridos/colesterol HDL, insulina basal, índice HOMA y mayores de HDL en comparación con los que no lo hacían. CONCLUSIONES: El antecedente de antropometría pequeña para la edad gestacional determina un mayor número e intensidad de las alteraciones metabólicas asociadas a la obesidad infanto-juvenil, al tiempo que la lactancia materna y la asistencia al comedor escolar durante la infancia parecen influenciarlas positivament

Ethnicity strongly influences body fat distribution determining serum adipokine profile and metabolic derangement in childhood obesity

Background: Body fat content and distribution in childhood is influenced by sex and puberty, but interethnic differences in the percentage and distribution of body fat also exist. The abdominal visceral/subcutaneous fat ratio has been the main feature of body fat distribution found to associate with the serum adipokine profile and metabolic derangement in adulthood obesity. This has also been assumed for childhood obesity despite the known singularities of this disease in the pediatric age in comparison to adults. Objective: We aimed to investigate the effect of ethnicity, together with sex and pubertal status, on body fat content and distribution, serum adipokine profile, metabolic impairment and liver steatosis in children and adolescents with obesity. Patients and Methods: One hundred and fifty children with obesity (50% Caucasians/50% Latinos; 50% males/50% females) were studied. Body fat content and distribution were studied by whole body DXA-scan and abdominal magnetic resonance, and their relationships with liver steatosis (as determined by ultrasonography), glycemia, insulinemia, lipid metabolism, uric acid, total and HMW-adiponectin, leptin, leptin-receptor, and sex steroid levels were explored. Results: Latino patients had more severe truncal obesity (higher trunk/lower limb fat ratio, odds ratio 10.00; p < 0.05) and higher prevalence of liver steatosis than Caucasians regardless of sex or pubertal status, but there were no difference in the visceral/subcutaneous abdominal fat ratio, except for pubertal females. A higher trunk/lower limb fat ratio, but not the visceral/subcutaneous abdominal fat ratio, was associated with adipokine profile impairment (higher free leptin index and lower adiponectin levels), insulin resistance and dyslipidemia, and was further enhanced when liver steatosis was present (p < 0.05). A higher abdominal visceral/subcutaneous fat ratio was observed in prepubertal children (p < 0.01), except for Latino females, whereas predominant subcutaneous fat deposition was observed in adolescents. Conclusion: Ethnicity is one of the main determinants of increased trunk body fat accumulation in Latino children with obesity, which is best estimated by the trunk/lower limb fat ratio and related to the development of metabolic derangement and liver steatosis.This work was supported by CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN) and the Instituto de Salud Carlos III, FIS (FIS grant numbers PI09/91060; FIS 10/00747; FIS 13/01295; and FIS 16/00485

Sex Differences and Predictors of In-Hospital Mortality among Patients with COVID-19: Results from the ANCOHVID Multicentre Study

Spain is one of the countries most affected by the COVID-19 pandemic. Although risk factors for severe disease are published, sex differences have been widely neglected. In this multicentre study, we aimed to identify predictors of in-hospital mortality in men and women hospitalised with COVID-19. An observational longitudinal study was conducted in the cohort of patients admitted to four hospitals in Andalusia, Spain, from 1 March 2020 to 15 April 2020. Sociodemographic and clinical data were collected from hospital records. The Kaplan–Meier method was used to estimate 30-day survival and multiple Cox regression models were applied. All analyses were stratified by sex. A total of 968 patients were included (54.8% men, median age 67.0 years). In-hospital mortality reached 19.1% in men and 16.0% in women. Factors independently associated with an increased hazard of death were advanced age, higher CURB-65 score and not receiving azithromycin treatment, in both sexes; active cancer and autoimmune disease, in men; cardiovascular disease and chronic lung disease, in women. Disease outcomes and predictors of death differed between sexes. In-hospital mortality was higher in men, but the long-term effects of COVID-19 merit further research. The sex-differential impact of the pandemic should be addressed in public health policies

Calidad de vida en urticaria crónica y su relación con el impacto económico y control de la enfermedad en pacientes atendidos en el Hospital Universitario de Monterrey, México

Abstract Background: Chronic urticaria (CU) manifests itself with hives and sometimes angioedema. Physical and social discomfort worsens patient quality of life. CU has an important impact on patients’ economy. Objective: To evaluate the relationship of quality of life (QoL) with economic burden and chronic urticaria control of in patients treated at our center. Methods: Cross-sectional, descriptive, observational study. We included CU-diagnosed adult patients. The CU-Q2oL and UCT questionnaires in Spanish and the economic burden and comorbidities questionnaire developed by our center were applied. A sample size of 36 patients was calculated. Results: 36 patients were included, out of which 58.3% were females. Mean age was 39.9 ± 15.6 years. Regarding QoL, 66.7% of patients reported being "A little" aff ected, 25% "Somewhat" and 8.3% "A lot", and its relationship with monthly income yielded a p-value of 0.017. 38.9% of patients reported having a monthly income of less than $ 5000 pesos. When disease control was compared with the CU-Q2oL, a signifi cant diff erence was obtained for questions concerning itching. Conclusion: There was association between the quality of life of patients with chronic urticaria and monthly income, the lower the income, the more will the quality of life be aff ected. Furthermore, greater CU control was observed to reduce the negative eff ects on quality of life caused by itching

Preparación y caracterización de láminas delgadas de óxido de vanadio obtenidas por vía sol-gel y recubrimiento por inmersión

Resumen del proyecto de líneas prioritarias titulado "Preparación y caracterización de láminas delgadas de óxido de vanadio obtenidas por vía sol-gel y recubrimiento por inmersión" del IMEYMAT

Temas Socio-Jurídicos. Volumen 22 No. 46 Julio de 2004

Presentamos a la comunidad académica la edición número 46 de la revista Temas Socio-Jurídicos de la Facultad de Derecho de la Universidad Autónoma de Bucaramanga, que se inserta como muestra del análisis académico en el marco de las preocupantes modificaciones estructurales que dentro del desarrollo jurídico de país, adelanta el Estado Colombiano.We present to the academic community the 46th edition of the Temas Socio-Jurídicos magazine of the Faculty of Law of the Autonomous University of Bucaramanga, which is inserted as a sample of academic analysis within the framework of the worrying structural modifications that within the legal development of country, advances the Colombian State

Towards precision medicine: defining and characterizing adipose tissue dysfunction to identify early immunometabolic risk in symptom-free adults from the GEMM family study

Interactions between macrophages and adipocytes are early molecular factors influencing adipose tissue (AT) dysfunction, resulting in high leptin, low adiponectin circulating levels and low-grade metaflammation, leading to insulin resistance (IR) with increased cardiovascular risk. We report the characterization of AT dysfunction through measurements of the adiponectin/leptin ratio (ALR), the adipo-insulin resistance index (Adipo-IRi), fasting/postprandial (F/P) immunometabolic phenotyping and direct F/P differential gene expression in AT biopsies obtained from symptom-free adults from the GEMM family study. AT dysfunction was evaluated through associations of the ALR with F/P insulin-glucose axis, lipid-lipoprotein metabolism, and inflammatory markers. A relevant pattern of negative associations between decreased ALR and markers of systemic low-grade metaflammation, HOMA, and postprandial cardiovascular risk hyperinsulinemic, triglyceride and GLP-1 curves was found. We also analysed their plasma non-coding microRNAs and shotgun lipidomics profiles finding trends that may reflect a pattern of adipose tissue dysfunction in the fed and fasted state. Direct gene differential expression data showed initial patterns of AT molecular signatures of key immunometabolic genes involved in AT expansion, angiogenic remodelling and immune cell migration. These data reinforce the central, early role of AT dysfunction at the molecular and systemic level in the pathogenesis of IR and immunometabolic disorders

Marco activo de recursos de innovación docente: Madrid

Una guía de espacios e instituciones para actividades educativas complementarias en enseñanza secundaria y Formación Profesional

Efficacy of clozapine versus standard treatment in adult individuals with intellectual disability and treatment-resistant psychosis (CLOZAID): study protocol of a multicenter randomized clinical trial

BackgroundIntellectual disability (ID) affects approximately 1% of the worldwide population and individuals with ID have a higher comorbidity with mental illness, and specifically psychotic disorders. Unfortunately, among individuals with ID, limited research has been conducted since ID individuals are usually excluded from mental illness epidemiological studies and clinical trials. Here we perform a clinical trial to investigate the effectiveness of clozapine in the treatment of resistant psychosis in individuals with ID. The article highlights the complexity of diagnosing and treating psychopathological alterations associated with ID and advocates for more rigorous research in this field.MethodsA Phase IIB, open-label, randomized, multicenter clinical trial (NCT04529226) is currently ongoing to assess the efficacy of oral clozapine in individuals diagnosed with ID and suffering from treatment-resistant psychosis. We aim to recruit one-hundred and fourteen individuals (N=114) with ID and resistant psychosis, who will be randomized to TAU (treatment as usual) and treatment-with-clozapine conditions. As secondary outcomes, changes in other clinical scales (PANSS and SANS) and the improvement in functionality, assessed through changes in the Euro-QoL-5D-5L were assessed. The main outcome variables will be analyzed using generalized linear mixed models (GLMM), assessing the effects of status variable (TAU vs. Clozapine), time, and the interaction between them.DiscussionThe treatment of resistant psychosis among ID individuals must be directed by empirically supported research. CLOZAID clinical trial may provide relevant information about clinical guidelines to optimally treat adults with ID and treatment-resistant psychosis and the benefits and risks of an early use of clozapine in this underrepresented population in clinical trials.Trial registrationClinicaltrials.gov: NCT04529226. EudraCT: 2020-000091-37