Importancia del gradiente de presión venosa hepática en pacientes con cirrosis hepática.

La cirrosis hepática y la hipertensión portal son causas importantes de morbilidad y mortalidad en nuestro país. Debido a esto, cada vez son mayores nuestros esfuerzos para incrementar las herramientas diagnósticas y terapéuticas para beneficio de nuestros pacientes. El gradiente de presión venoso hepático (GPVH) es, en la actualidad, una medición de la presión que existe, de manera indirecta, en la vena porta que se utiliza para establecer medidas terapéuticas adecuadas, así como evaluar la respuesta a las mismas con el fin de mejorar el pronóstico y la sobrevida de nuestros pacientes. El GPVH fue utilizado en un inicio para pacientes con hemorragia aguda varicela, así como en profilaxis primaria y secundaria. Algunos otros casos clínicos donde puede ser de utilidad son: carcinoma hepatocelular, sobrevida, eventos de descompensación, hepatitis alcohólica, hepatitis C, entre otros

Condrodisplasia punctata: a propósito de un caso neonatal

Se presenta el caso de un neonato de ocho días de nacido que sufre de condrodisplasia punctata, una displasia esquelética infrecuente que muestra características radiológicas de calcificaciones puntiformes del cartílago en las epífisis y en las vértebras, acompañadas de defectos oculares, dermatológicos, alteraciones del sistema nervioso central y retardo del crecimiento. Se abordan los hallazgos clínicos y radiológicos para su diagnóstico

Immunomodulatory effect of gut microbiota-derived bioactive peptides on human immune system from healthy controls and patients with inflammatory bowel disease

Bioactive peptides secreted by probiotic Bifidobacterium longum (peptide B7) and opportunistic pathogen Bacteroides fragilis (peptide B12) modulate the intestinal cytokine milieu in health. Here, we characterized their capacity to modulate both the mucosal cytokine production and the phenotype of circulating antigen presenting cells (APCs) in active inflammatory bowel disease (IBD). The IBD mucosa produced higher levels of pro-inflammatory cytokines referred to healthy controls (HCs). Peptides B7 and B12, however, did not ameliorate the mucosal cytokine milieu in IBD. Human circulating APCs (B-cells, monocytes, plasmacytoid dendritic cells (pDCs), and conventional dendritic cells (cDCs)) were characterized by flow cytometry in presence/absence of the peptides. Circulating B-cells, monocytes, and cDCs from IBD patients were more activated than those from HCs. Peptide B7, but not B12, decreased CCR2 expression on all APC subsets from HC, but not IBD patients. Moreover, both peptides tend to further increase their pro-inflammatory profile in IBD. In summary, IBD patients display mucosal and circulating APC pro-inflammatory properties. Peptide B7 immunomodulatory capacity elicited over circulating APCs from HC, but not IBD patients, suggests the presence of disrupted modulatory mechanisms for this peptide in IBD. Future studies should address the effect of bacteria-derived immunomodulatory peptides in non-inflamed (quiescent) IBD patientsThis work was supported by the Spanish Ministry of Economy (SAF2014-56642-JIN), the Spanish Ministry of Health (PIE13/00041), GETECCU (Grupo Español de Trabajo en Enfermedad Crohn y Colitis Ulcerosa), and the Community of Madrid (Consejería de Educación, Juventud y Deporte, Programa de Garantía Juvenil 2015 and 2016)

Evaluation of cytokines as robust diagnostic biomarkers for COVID-19 detection

Producción CientíficaAntigen tests or polymerase chain reaction (PCR) amplification are currently COVID-19 diagnostic tools. However, developing complementary diagnosis tools is mandatory. Thus, we performed a plasma cytokine array in COVID-19 patients to identify novel diagnostic biomarkers. A discovery–validation study in two independent prospective cohorts was performed. The discovery cohort included 136 COVID-19 and non-COVID-19 patients recruited consecutively from 24 March to 11 April 2020. Forty-five cytokines’ quantification by the MAGPIX system (Luminex Corp., Austin, TX, USA) was performed in plasma samples. The validation cohort included 117 patients recruited consecutively from 15 to 25 April 2020 for validating results by ELISA. COVID-19 patients showed different levels of multiple cytokines compared to non-COVID-19 patients. A single chemokine, IP-10, accurately identified COVID-19 patients who required hospital admission (AUC: 0.962; 95%CI (0.933–0.992); p < 0.001)). The results were validated in an independent cohort by multivariable analysis (OR: 25.573; 95%CI (8.127–80.469); p < 0.001) and AUROC (AUC: 0.900; 95%CI (0.846–0.954); p < 0.001). Moreover, showing IP-10 plasma levels over 173.35 pg/mL identified COVID-19 with higher sensitivity (86.20%) than the first SARS-CoV-2 PCR. Our discover–validation study identified IP-10 as a robust biomarker in clinical practice for COVID-19 diagnosis at hospital. Therefore, IP-10 could be used as a complementary tool in clinical practice, especially in emergency departments.Instituto de Salud Carlos III (grant COV20/00491)Consejo Superior de Investigaciones científicas (grant CSIC-COV19-016/202020E155)Junta de Castilla y León (project COVID 07.04.467B04.74011.0)IBGM excellence programme (grant CLU-2029-02

HGF, IL-1α, and IL-27 Are Robust Biomarkers in Early Severity Stratification of COVID-19 Patients

Producción CientíficaPneumonia is the leading cause of hospital admission and mortality in coronavirus disease 2019 (COVID-19). We aimed to identify the cytokines responsible for lung damage and mortality. We prospectively recruited 108 COVID-19 patients between March and April 2020 and divided them into four groups according to the severity of respiratory symptoms. Twenty-eight healthy volunteers were used for normalization of the results. Multiple cytokines showed statistically significant differences between mild and critical patients. High HGF levels were associated with the critical group (OR = 3.51; p < 0.001; 95%CI = 1.95–6.33). Moreover, high IL-1α (OR = 1.36; p = 0.01; 95%CI = 1.07–1.73) and low IL-27 (OR = 0.58; p < 0.005; 95%CI = 0.39–0.85) greatly increased the risk of ending up in the severe group. This model was especially sensitive in order to predict critical status (AUC = 0.794; specificity = 69.74%; sensitivity = 81.25%). Furthermore, high levels of HGF and IL-1α showed significant results in the survival analysis (p = 0.033 and p = 0.011, respectively). HGF, IL-1α, and IL 27 at hospital admission were strongly associated with severe/critical COVID-19 patients and therefore are excellent predictors of bad prognosis. HGF and IL-1α were also mortality biomarkers.Instituto de Salud Carlos III (grant COV20/00491

Antipsicóticos inyectables de liberación prolongada para el tratamiento de la esquizofrenia en España.

Los antipsicóticos son un componente esencial del tratamiento de la esquizofrenia. Las formulaciones inyectables de liberación prolongada (ILP) surgen para mejorar la adherencia con el potencial asociado de reducir el riesgo de recaídas. El objetivo de este artículo es analizar el uso de antipsicóticos ILP en España –que es similar al de otros países europeos pero con un predominio de la utilización de ILP de segunda generación–, discutir las posibles causas de las diferencias de prescripción respecto a otros países de nuestro entorno (entre otras, aspectos organizativos, actitudes de psiquiatras, pacientes y familiares, guías de práctica clínica), y discutir su utilización en unidades de agudos, primeros episodios, y en niños y adolescentes. A nuestro juicio, aunque es necesario aumentar las pruebas existentes respecto a las ventajas de los antipsicóticos ILP y la diferenciación entre aquellos disponibles actualmente, su utilización seguirá probablemente creciendo impulsada por la experiencia clínica.post-print1,08 M

Assessment of the economic performance of the seabream and seabass aquaculture industry in the European Union

Production of gilthead seabream (Sparus aurata) and European seabass (Dicentrarchus labrax) is the second most important aquaculture industry in the European Union in value terms. During the last 10 years, the industry has experienced a process of industry concentration with the aim to overcome efficiency and profitability issues. However, the economic performance of the companies is still in general rather poor. The present work analyzes the economic performance of EU seabream and seabass companies in the period 2008?2016. The work is the first study to analyze companies? profitability in the EU as a whole, by country and company size, using economic and financial data extracted from companies? annual accounts. Based on the results, the study discusses the improvement of production and business profitability in recent years and the different factors that may have caused it, as well as the challenges and threats that seabream and seabass companies will have to face in order to achieve economic sustainability.This research was undertaken under the MedAID project, which has received funding from the European Union's Horizon 2020 Research and Innovation Programme under grant agreement no 727315 (http://www.medaid-h2020.eu/)