Propensity score and desirability of outcome ranking analysis of ertapenem for treatment of nonsevere bacteremic urinary tract infections due to extended-spectrum-beta-lactamase-producing enterobacterales in kidney transplant recipients

There are scarce data on the efficacy of ertapenem in the treatment of bacteremia due to extended-spectrum-beta-lactamase (ESBL)-producing Enterobacterales (ESBL-E) in kidney transplant (KT) recipients. We evaluated the association between treatment with ertapenem or meropenem and clinical cure in KT recipients with nonsevere bacteremic urinary tract infections (B-UTI) caused by ESBL-E. We performed a registered, retrospective, international (29 centers in 14 countries) cohort study (INCREMENT-SOT, NCT02852902). The association between targeted therapy with ertapenem versus meropenem and clinical cure at day 14 (the principal outcome) was studied by logistic regression. Propensity score matching and desirability of outcome ranking (DOOR) analyses were also performed. A total of 201 patients were included; only 1 patient (treated with meropenem) in the cohort died. Clinical cure at day 14 was reached in 45/100 (45%) and 51/101 (50.5%) of patients treated with ertapenem and meropenem, respectively (adjusted OR 1.29; 95% CI 0.51 to 3.22; P = 0.76); the propensity score-matched cohort included 55 pairs (adjusted OR for clinical cure at day 14, 1.18; 95% CI 0.43 to 3.29; P = 0.74). In this cohort, the proportion of cases treated with ertapenem with better DOOR than with meropenem was 49.7% (95% CI, 40.4 to 59.1%) when hospital stay was considered. It ranged from 59 to 67% in different scenarios of a modified (weights-based) DOOR sensitivity analysis when potential ecological advantage or cost was considered in addition to outcome. In conclusion, targeted therapy with ertapenem appears as effective as meropenem to treat nonsevere B-UTI due to ESBL-E in KT recipients and may have some advantages.Instituto de Salud Carlos III RD16/0016/0001Ministerio de Ciencias e Innovación PI18/0184

Prensa online-only española e ideología: análisis de elementos sociales y educativos

En el presente texto se pretende delinear de manera empírica el perfil ideológico que la prensa online-only española manifiesta en el tratamiento de algunos elementos relativos a la sociedad y a la educación. En línea con investigaciones previas que ya han abordado el estudio ideológico-político de la prensa online-only, y a partir de un marco teórico sobre prensa online e ideología, en este capítulo se utiliza una muestra de los diarios digitales más consultados de España, escogiendo como unidades de muestreo un conjunto de columnas de opinión (género donde el sesgo ideológico suele ser más o menos evidente) publicadas en los meses electorales de mayo de 2011 y junio de 2016. La muestra de columnas de cada mes es sometida a un análisis de contenido centrado (junto a otros elementos) en la variable socio-cultural de la ideología; variable de la que se han escogido cuatro tipos de categorías: los jóvenes, los mayores, las clases sociales y la educación (pública, privada y concertada). Dadas estas categorías, se pretende medir mediante un análisis de frecuencias el grado de conservadurismo o progresismo que posee la prensa online-only española. Para ello, y junto al número de menciones de cada elemento, se tiene en cuenta asimismo la valoración que hace el columnista sobre dichas menciones. Los resultados obtenidos permiten afirmar una evolución progresista de la prensa onlineonly española

Pathogenesis and clinicohistopathological caractheristics of melanoacanthoma: a systematic review

Introduction: The melanoacanthoma is a rare benign pigmented tumor, characterized by a fast radial growth and clinical behavior similar to melanoma. Color changes in oral mucosa and dermis are consequence of increased melanocyte activity as response to an irritant factor. There is a vast phenotypic variety. It is difficult to distinguish between a benign pigmented lesion and a melanoma at its early stage. Due to its clinical relevance is crucial to diagnose possible malignancy of the lesions. Objectives: The aim of this article is to conduct a systematic review of all published articles, as well as update and evaluate etiologic factors and clinicopathological features. Material and Methods: We carried out a search in the Medline database (PubMed) using the key words “oral melanoacanthoma” AND “oral melanoacanthosis” AND “oral melanoepithelioma”. Inclusion criteria were all published articles since its discovery. Demographic data, histological features and immunohistochemical findings were extracted from the full articles. Results: A total of 56 articles were analysed. 114 injuries drawn from these articles were studied, a total of 115 injuries with our contribution case. The 74.78% of authors claim a reactive pathogenesis. The average age of lesión appearance is 34.79 years, with an age range of 5-87 years. There is a predominance of the female sex in solitary phenotype 3: 2 and a ratio of women to men 5: 3 if it is multifocal phenotype. Bilateral phenotype is slight higher in women of 2: 1. Conclusions: Histopathological analysis of the lesión is vital to diagnose malignancy. Therefore, any heterogeneous, pigmented lesion with irregular edges, raised surface, fast growth and abrupt appearance should be biopsied. More emphasis on the potential irritants should also be put to improve the quality of life of our patients and to reduce morbidity of melanoacanthoma, as well as, several similar clinical behavior disease

Prophylaxis and antibiotic therapy in management protocols of patients treated with oral and intravenous bisphosphonates

Osteonecrosis of the jaw (MRONJ) linked to bisphosphonate treatment has specific characteristics that render its therapeutic management challenging for clinicians. Poor response to standard treatment makes it essential to take special precautions when treating this type of disease; therefore, antibiotic prophylaxis and/or antibiotic therapy have been proposed as effective and helpful tools in these situations. This article seeks to assess published evidence in order to evaluate the different protocols used for antibiotic prophylaxis and/or antibiotic therapy in the general context of patients treated with bisphosphonates. A literature review of the last 10 years was carried out in PubMed using the following keywords: “antibiotic prophylaxis and osteonecrosis,” “bisphosphonates AND osteonecrosis AND dental management,” “bisphosphonate AND osteonecrosis AND antibiotic prophylaxis AND oral surgery.” A total of 188 articles were obtained, of which 18 were ultimately selected. In patients treated with oral and intravenous bisphosphonates without chemotherapy-associated osteonecrosis of the jaw, antibiotic prophylaxis prior to oral surgery is an important tool to avoid osteonecrosis and promote healing of the affected area. If the patient previously exhibited chemotherapy-associated osteonecrosis after tooth extraction, antibiotic prophylaxis is indicated to prevent recurrent osteonecrosis and promote healing of the extraction site. If chemotherapy-associated osteonecrosis is already present, antibiotic therapy is a vital part of conservative management to reduce the symptomatology of MRONJ and keep it from worsening. Finally, a lack of clinical data and randomized controlled trials makes it difficult to choose the most appropriate protocol for the various clinical situations studied

Analysis of different therapeutic protocols for osteonecrosis of the jaw associated with oral and intravenous bisphpsphonates

Chemotherapy-associated osteonecrosis of the jaw caused by bisphosphonates is an exposure of necrotic bone with more than eight weeks of evolution that is attributable to bisphosphonates and no prior radiation therapy. Its etiopathogenesis remains unknown, although there are two hypotheses that may explain it: the drug?s mechanism of action, and the risk factors that can lead to osteonecrosis. There is a wide range of treatment options for managing chemotherapy-associated osteonecrosis of the jaw, from conservative treatments to surgical procedures of varying levels of invasiveness, which are sometimes supplemented with adjuvant therapies. The objective of this article is to group the therapeutic options for osteonecrosis of the jaw (ONJ) into seven different protocols and to evaluate their effectiveness in relation to stage of ONJ. A literature review was carried out in PubMed following the PRISMA criteria. A total of 47 were collected after compiling a series of variables that define ONJ, applied treatments, and the clinical results obtained. The 47 articles selected have a low to average estimated risk of bias and are of moderate to good quality. According to the data obtained, Protocol 3 (conservative treatment, clinical and radiological follow-up, minimally invasive surgical treatment, and adjuvant therapies) is the most favorable approach for ONJ lesions caused by oral bisphosphonates. For lesions caused by intravenous bisphosphonates, Protocol 2 (conservative treatment, clinical and radiological follow-up, minimally invasive surgical treatment, and no adjuvant therapies) is the best approach. When comparing the different stages of ONJ, Protocol 1 (conservative treatment, clinical and radiological follow-up) promotes better healing of Stage 1 ONJ lesions caused by orally administered bisphosphonates, and Protocol 3 is recommended for Stage II. For ONJ lesions attributable to intravenous bisphosphonates, Protocol 7 (conservative treatment, clinical and radiological follow-up, and adjuvant therapies) provides the best results in Stage 0; in Stages I, II, and III, Protocol 1 gives better results

Effect of Cooperative Work on Learning to Write through Family Involvement

Se sabe que determinadas habilidades como la riqueza léxica, el procesamiento fonológico, el conocimiento alfabético y la velocidad de denominación son precursores importantes del aprendizaje de la escritura en las primeras edades, ya que muestran una alta correlación con el aprendizaje inicial del lenguaje escrito. Sin embargo, no se encuentran trabajos orientados a analizar el impacto que el desarrollo de estas habilidades presenta en el proceso de adquisición de la escritura mediante la participación familiar. El objetivo de este estudio fue analizar el efecto que la intervención de un programa centrado en el desarrollo de las habilidades favorecedoras del aprendizaje de la escritura mediante la implicación familiar a través de la organización de grupos cooperativos presenta en el aprendizaje de la escritura en las primeras edades. Se empleó un diseño cuasi-experimental de comparación entre grupos con medidas pretest y postest. En el estudio han participado 386 alumnos con edades comprendidas entre los 5 y los 6 años. Los resultados apoyan la eficacia de la colaboración de las familias en el acceso al sistema de la escritura. Se sugiere la implementación de modelos de enseñanza que integren el desarrollo de las habilidades facilitadoras del aprendizaje de la escritura a través de dinámicas cooperativas en las que se fomente la participación familiar.Certain skills such as lexical wealth, phonological processing, alphabet knowledge and speed of naming are important precursors of writing learning at an early age as they show a high correlation with the initial learning of written language. However, there are no studies aiming at analyzing the impact that the development of these skills has on the process of acquiring writing through family participation. The objective of this study was to analyze the effect that the intervention of a program focused on the development of the skills that favor the learning of writing through family involvement by means of the organization of cooperative groups has on the learning of writing at a young age. A quasi-experimental study was used to compare compliance of groups pre-test and post-test. The study involved 386 students between the ages of five and six years old. The results support the effectiveness of family collaboration in accessing the writing system. It is suggested the implementation of teaching models that integrate the development of skills that facilitate the learning of writing through cooperative dynamics with family participation encouraged

Interaction Effect between Physical Activity and the BDNF Val66Met Polymorphism on Depression in Women from the PISMA-ep Study

This study was partially funded by the Consejeria de Salud, Junta de Andalucia (PI3222009), Consejeria de Innovacion, Proyecto de Excelencia (CTS-2010-6682), the Institute of Health Carlos III (Co-funded by European Regional Development Fund/European Social Fund "A way to make Europe"/"Investing in your future") (projects PI18/00238 and PI18/00467), the Marie Curie Research Grants Scheme (FP7 626235), and by a NARSAD Young Investigator Grant from the Brain & Behavior Research Foundation (22514). Juan Antonio Zarza-Rebollo was supported by the Spanish Ministry of Economy and Competitiveness (BES-2017-082698). Elena Lopez-Isac received financial support from the Spanish Ministry of Science and Innovation Juan de la Cierva Incorporacion Program (grant code IJC2019-040080-I/AEI/10.13039/501100011033). AnaMPerez-Gutierrez was supported by a grant from the Ministry of Economy and Competitiveness and Institute of Health Carlos III (FI19/00228), and Margarita Rivera was supported by the Ministry of Economy and Competitiveness Ramon y Cajal Program (RYC-2014-15774).The relationship between depression and the Val66Met polymorphism at the brain-derived neurotrophic factor gene (BDNF), has been largely studied. It has also been related to physical activity, although the results remain inconclusive. The aim of this study is to investigate the relationship between this polymorphism, depression and physical activity in a thoroughly characterised sample of community-based individuals from the PISMA-ep study. A total of 3123 participants from the PISMAep study were genotyped for the BDNF Val66Met polymorphism, of which 209 had depression. Our results are in line with previous studies reporting a protective effect of physical activity on depression, specifically in light intensity. Interestingly, we report a gene-environment interaction effect in which Met allele carriers of the BDNF Val66Met polymorphism who reported more hours of physical activity showed a decreased prevalence of depression. This effect was observed in the total sample (OR = 0.95, 95%CI = 0.90–0.99, p = 0.027) and was strengthened in women (OR = 0.93, 95%CI = 0.87–0.98, p = 0.019). These results highlight the potential role of physical activity as a promising therapeutic strategy for preventing and adjuvant treatment of depression and suggest molecular and genetic particularities of depression between sexes.Junta de Andalucia PI3222009Consejeria de Innovacion, Proyecto de Excelencia CTS-2010-6682Institute of Health Carlos III (European Regional Development Fund/European Social Fund "A way to make Europe"/"Investing in your future") PI18/00238 PI18/00467Marie Curie Research Grants Scheme FP7 626235NARSAD 22514Spanish Government BES-2017-082698Spanish Ministry of Science and Innovation Juan de la Cierva Incorporacion Program IJC2019-040080-I/AEI/10.13039/501100011033Ministry of Economy and CompetitivenessInstituto de Salud Carlos III FI19/00228Ministry of Economy and Competitiveness Ramon y Cajal Program RYC-2014-1577

Visual Binocular Disorders and Their Relationship with Baropodometric Parameters: A Cross-Association Study

The aim of this study was to establish a relationship between nonstrabismic binocular dysfunction and baropodometric parameters. A total of 106 participants underwent binocular vision assessment by evaluating horizontal heterophoria, horizontal and vertical fusional vergence ranges, and vergence facility. Posturography was measured using the FreeMED baropodometric platform. Among the variables that the software calculates are foot surface, foot load, and foot pressure. Our results showed that in the participants with positive fusional vergence (PFV) (near) blur and recovery values outside the norm, there are statistically significant differences between the total foot area (p<0.05), forefoot area (p<0.05), forefoot load (p<0.05), and rearfoot load (p<0.05), in all of the cases of left foot vs. right foot. In the group of subjects who did not meet Sheard's criterion (distance), that is, those with unstable binocular vision, there was a statistically significant difference (p<0.01) between maximum left and right foot pressure. In conclusion, our results establish a relationship between nonstrabismic binocular dysfunctions and some baropodometric parameters

La representación de la ecología en la prensa online-only española : análisis cuantitativo e implicaciones ideológicas

Esta investigación pretende aportar evidencia empírica para delinear el perfil ideológico de la prensa digital online-only española en un aspecto socio- cultural concreto: la representación y valoración de temas medioambientales. En línea con investigaciones previas que han abordado el estudio ideológico-político de este tipo de prensa, y a partir de un marco teórico sobre prensa online e ideología, nuestra hipótesis afirma que la opinión digital española se ha movido en los últimos años en una dirección progresista en cuestiones ecológicas. Para comprobarlo, utilizamos una muestra empírica de los diarios digitales más consultados, escogiendo como unidades de muestreo un conjunto de columnas de opinión (género donde el sesgo ideológico suele ser más o menos evidente) de dos momentos distintos en el tiempo, en un intervalo de 5 años. La muestra es sometida a un análisis de contenido centrado fundamentalmente en 3 categorías de análisis: ecología / medioambiente, lucha contra el cambio climático, y energía nuclear. Junto a las menciones de cada categoría se tiene en cuenta la valoración que hace el columnista sobre dichas menciones. Además de estas categorías de análisis, el estudio incluye la cuantificación del tipo de objeto y el tema principal de cada columna. Los datos señalan una evolución en el tiempo que indica una mayor conciencia medioambiental en el periodismo de opinión online-only español, de forma que, a la altura de 2016, la consideración de las cuestiones ecológicas es más favorable

Body mass index interacts with a genetic-risk score for depression increasing the risk of the disease in high-susceptibility individuals

This study was funded by the Spanish Ministry of Health, the Institute of Health Carlos III (ISCIII), and the European Regional Development Fund (grants PS09/02272, PS09/02147, PS09/01095, PS09/00849, PS09/00461, and PI12-02755); the Andalusian Council of Health (grant PI-0569-2010); the Spanish Network of Primary Care Research, redIAPP (grant RD06/ 0018); the Aragon group (grant RD06/0018/0020); the Bizkaya group (grant RD06/0018/0018); the Castilla-Leon group (grant RD06/0018/0027); the Mental Health Barcelona Group (grant RD06/0018/0017); the Mental Health, Services and Primary Care Malaga group (grant RD06/0018/0039); and the projects "PI18/00238" and "PI18/00467" funded by the Institute of Health Carlos III (Co-funded by European Regional Development Fund/European Social Fund "A way tomake Europe"/"Investing in your future"). This study was performed as part of a PhD thesis conducted within the Official Doctoral Programme in Biomedicine of the University of Granada, Spain. Augusto Anguita-Ruiz was supported by a Ministry of Economy and Competitiveness and Institute of Health Carlos III fellowship (IFI17/00048). Juan Antonio Zarza-Rebollo received financial support from the Spanish Ministry of Economy and Competitiveness (BES-2017-082698). Ana M. Perez-Gutierrez was supported by a grant from the Ministry of Economy and Competitiveness and Institute of Health Carlos III (FI19/00228). Elena Lopez-Isac received financial support from the Spanish Ministry of Science and Innovation Juan de la Cierva Incorporacion Program (IJC2019040080-I), and Margarita Rivera was supported by the Ministry of Economy and Competitiveness Ramon y Cajal Program (RYC-2014-15774). The authors thank the Institute of Health Carlos III (ISCIII), the European Regional Development Fund (FEDER), the Andalusian Council of Health and Andalusian Health Service (SAS), the Primary Care Prevention and Health Promotion Research Network (redIAPP), the Biomedical Research Institute of Malaga (IBIMA), and the Biomedical Research Centre (CIBM) from the University of Granada for their economic and logistic support. The authors thank all the patients and General Practitioners who participated in the trial.Depression is strongly associated with obesity among other chronic physical diseases. The latest mega- and meta-analysis of genome-wide association studies have identified multiple risk loci robustly associated with depression. In this study, we aimed to investigate whether a genetic-risk score (GRS) combining multiple depression risk single nucleotide polymorphisms (SNPs) might have utility in the prediction of this disorder in individuals with obesity. A total of 30 depression-associated SNPs were included in a GRS to predict the risk of depression in a large case-control sample from the Spanish PredictD-CCRT study, a national multicentre, randomized controlled trial, which included 104 cases of depression and 1546 controls. An unweighted GRS was calculated as a summation of the number of risk alleles for depression and incorporated into several logistic regression models with depression status as the main outcome. Constructed models were trained and evaluated in the whole recruited sample. Non-genetic-risk factors were combined with the GRS in several ways across the five predictive models in order to improve predictive ability. An enrichment functional analysis was finally conducted with the aim of providing a general understanding of the biological pathways mapped by analyzed SNPs. We found that an unweighted GRS based on 30 risk loci was significantly associated with a higher risk of depression. Although the GRS itself explained a small amount of variance of depression, we found a significant improvement in the prediction of depression after including some non-genetic-risk factors into the models. The highest predictive ability for depression was achieved when the model included an interaction term between the GRS and the body mass index (BMI), apart from the inclusion of classical demographic information as marginal terms (AUC = 0.71, 95% CI = [0.65, 0.76]). Functional analyses on the 30 SNPs composing the GRS revealed an over-representation of the mapped genes in signaling pathways involved in processes such as extracellular remodeling, proinflammatory regulatory mechanisms, and circadian rhythm alterations. Although the GRS on its own explained a small amount of variance of depression, a significant novel feature of this study is that including non-genetic-risk factors such as BMI together with a GRS came close to the conventional threshold for clinical utility used in ROC analysis and improves the prediction of depression. In this study, the highest predictive ability was achieved by the model combining the GRS and the BMI under an interaction term. Particularly, BMI was identified as a trigger-like risk factor for depression acting in a concerted way with the GRS component. This is an interesting finding since it suggests the existence of a risk overlap between both diseases, and the need for individual depression genetics-risk evaluation in subjects with obesity. This research has therefore potential clinical implications and set the basis for future research directions in exploring the link between depression and obesityassociated disorders. While it is likely that future genome-wide studies with large samples will detect novel genetic variants associated with depression, it seems clear that a combination of genetics and non-genetic information (such is the case of obesity status and other depression comorbidities) will still be needed for the optimization prediction of depression in high-susceptibility individuals.Instituto de Salud Carlos III Spanish Government Institute of Health Carlos III (ISCIII) European Commission PS09/02272 PS09/02147 PS09/01095 PS09/00849 PS09/00461 PI12-02755Andalusian Council of Health PI-0569-2010Spanish Network of Primary Care Research, redIAPP RD06/ 0018Gobierno de Aragon RD06/0018/0020Bizkaya group RD06/0018/0018Castilla-Leon group RD06/0018/0027Mental Health Barcelona Group RD06/0018/0017Mental Health, Services and Primary Care Malaga group RD06/0018/0039Instituto de Salud Carlos III PI18/00238 PI18/00467 FI19/00228European Regional Development Fund/European Social Fund "A way tomake Europe"/"Investing in your future"Ministry of Economy and CompetitivenessInstitute of Health Carlos III fellowship IFI17/00048Spanish Government BES-2017-082698Spanish Ministry of Science and Innovation Juan de la Cierva Incorporacion Program IJC2019040080-IMinistry of Economy and Competitiveness Ramon y Cajal Program RYC-2014-15774Andalusian Council of HealthAndalusian Health Service (SAS)Primary Care Prevention and Health Promotion Research Network (redIAPP)Biomedical Research Institute of Malaga (IBIMA)Biomedical Research Centre (CIBM) from the University of GranadaEuropean Commissio