Función tiroidea y mortalidad en pacientes ancianos hospitalizados

[ES]Objetivos: Se investigó la relación entre las alteraciones de las pruebas de función tiroidea y la mortalidad por todas las causas y por causa cardiovascular (CV) en ancianos hospitalizados por enfermedad aguda. Pacientes y Métodos: Estudio observacional prospectivo de 7 años de duración. Se estudiaron 404 pacientes >75años ingresados en el servicio de Geriatría del Hospital General (Segovia) durante 2005. Se cuantificaron tirotropina (TSH), tiroxina libre (T4 libre) y triiodotironina libre (T3 libre) al ingreso. Se registraron el tiempo de supervivencia, el número de muertes y la mortalidad global y CV hasta la finalización del estudio (1 de enero de 2012). Resultados: Durante el estudio fallecieron 323 pacientes (80%). El análisis de supervivencia de Kaplan-Meier mostró que la mediana del tiempo de supervivencia para la mortalidad global fue menor en los pacientes del primer tertil tanto de T3 libre, como de TSH y de T4 libre. El análisis multivariante mostró que el cáncer (HR, 1.60; 95% CI 1.12-2.27, p<0.01), la edad (1.03; 1.01-1.05, p<0.01) y las concentraciones de T3 libre (0.73; 0.64-0.84, p<0.001) fueron factores significativamente relacionados con la mortalidad por todas las causas. La causa de muerte pudo averiguarse en 202 pacientes. El 30.2% (61 pacientes) murió por enfermedad CV. Los pacientes pertenecientes al primer tertil de TSH y de T3 libre mostraron una mortalidad significativamente mayor por enfermedad CV. La concentración sérica de T3 libre fue el factor predictor más potente de mortalidad CV (0.74; 0.63-0.88, p<0.001). Conclusiones: Las alteraciones en las pruebas de función tiroidea durante la hospitalización se asocian con la mortalidad a largo plazo en pacientes ancianos. En particular, las concentraciones bajas de T3 libre se relacionan significativamente tanto con la mortalidad global como CV

Ser o no ser y estar o no estar en Internet.

Objective: To reflect the situation of the websites of the hospital libraries in Spain in 2003. Material and methods: The websites of the hospital libraries have been located through C-17 directory, various hospital directories and searching Google, Altavista and Alltheweb. It has been applied the questionnaire of evaluation of websites with pondered punctuation by Lluís Codina. Visibility indicators have been obtained as well as accessibility according TAW. Results: From the C-17 catalogue have been retrieved 176 hospital libraries, of which 13 have a website; we added to these other 19 websites found through other directories and search engines. Of those 32 websites, 2 were not active; the remaining 30 were analyzed. Five of them passed the Codina's test of level I. In the TAW priority level 1, the problems detected automatically oscillated between 0 and 77. Conclusions: The results show the low number of hospital libraries with websites on the internet. The websites quality should be improved following the recommendations of the checkup lists to evaluate digital resources on the internet. The scarce visibility of these webs, hinders greatly its localization. On the other hand, the low accessibility rate of these webs blocks their visualization to handicapped people

Classroom learning and the perception of social responsibility amongst graduate students of management accounting

This study analyzes how learning about social responsibility (SR) can modify the perceptions of university students about the importance of responsible behavior on the part of companies. To this end, a questionnaire was designed and administered to Management Accounting students before (n = 128) and after (n = 71) receiving two training activities on SR. The descriptive results obtained testify to the importance of SR in the views of the sampled students, both before and after receiving the specific learning in SR. In this latter moment, students demonstrated a vision highly committed to the need for SR to be part of the economic agenda. The results also show that there was a significant change in the perception of SR and its implications in terms of benefits and costs before and after receiving the training. All of this suggests that SR training has partially modified students’ perceptions of SR. This paper provides important insights that could be leveraged by university and business school managers for the purpose of designing or modifying curricula related to SR. At the same time, it evaluates the potential of SR learning as a tool for modifying attitudes.Proyecto de Innovación Docente de la Universidad de Jaén “Active learning of Social Responsibility within the Management Accounting subjects”, I2D-UJA 2016–201

Ser o no ser y estar o no estar en Internet.

Objective: To reflect the situation of the websites of the hospital libraries in Spain in 2003. Material and methods: The websites of the hospital libraries have been located through C-17 directory, various hospital directories and searching Google, Altavista and Alltheweb. It has been applied the questionnaire of evaluation of websites with pondered punctuation by Lluís Codina. Visibility indicators have been obtained as well as accessibility according TAW. Results: From the C-17 catalogue have been retrieved 176 hospital libraries, of which 13 have a website; we added to these other 19 websites found through other directories and search engines. Of those 32 websites, 2 were not active; the remaining 30 were analyzed. Five of them passed the Codina's test of level I. In the TAW priority level 1, the problems detected automatically oscillated between 0 and 77. Conclusions: The results show the low number of hospital libraries with websites on the internet. The websites quality should be improved following the recommendations of the checkup lists to evaluate digital resources on the internet. The scarce visibility of these webs, hinders greatly its localization. On the other hand, the low accessibility rate of these webs blocks their visualization to handicapped people

CEFLES2: the remote sensing component to quantify photosynthetic efficiency from the leaf to the region by measuring sun-induced fluorescence in the oxygen absorption bands

The CEFLES2 campaign during the Carbo Europe Regional Experiment Strategy was designed to provide simultaneous airborne measurements of solar induced fluorescence and CO2 fluxes. It was combined with extensive ground-based quantification of leaf- and canopy-level processes in support of ESA's Candidate Earth Explorer Mission of the "Fluorescence Explorer" (FLEX). The aim of this campaign was to test if fluorescence signal detected from an airborne platform can be used to improve estimates of plant mediated exchange on the mesoscale. Canopy fluorescence was quantified from four airborne platforms using a combination of novel sensors: (i) the prototype airborne sensor AirFLEX quantified fluorescence in the oxygen A and B bands, (ii) a hyperspectral spectrometer (ASD) measured reflectance along transects during 12 day courses, (iii) spatially high resolution georeferenced hyperspectral data cubes containing the whole optical spectrum and the thermal region were gathered with an AHS sensor, and (iv) the first employment of the high performance imaging spectrometer HYPER delivered spatially explicit and multi-temporal transects across the whole region. During three measurement periods in April, June and September 2007 structural, functional and radiometric characteristics of more than 20 different vegetation types in the Les Landes region, Southwest France, were extensively characterized on the ground. The campaign concept focussed especially on quantifying plant mediated exchange processes (photosynthetic electron transport, CO2 uptake, evapotranspiration) and fluorescence emission. The comparison between passive sun-induced fluorescence and active laser-induced fluorescence was performed on a corn canopy in the daily cycle and under desiccation stress. Both techniques show good agreement in detecting stress induced fluorescence change at the 760 nm band. On the large scale, airborne and ground-level measurements of fluorescence were compared on several vegetation types supporting the scaling of this novel remote sensing signal. The multi-scale design of the four airborne radiometric measurements along with extensive ground activities fosters a nested approach to quantify photosynthetic efficiency and gross primary productivity (GPP) from passive fluorescence

Impact of previous tobacco use with or without cannabis on first psychotic experiences in patients with first-episode psychosis

Objective: There is high prevalence of cigarette smoking in individuals with first-episode psychosis (FEP) prior to psychosis onset. The purpose of the study was to determine the impact of previous tobacco use with or without cannabis on first psychotic experiences in FEP and the impact of this use on age of onset of symptoms, including prodromes. Methods: Retrospective analyses from the naturalistic, longitudinal, multicentre, “Phenotype-Genotype and Environmental Interaction. Application of a Predictive Model in First Psychotic Episodes (PEPs)” Study. The authors analysed sociodemographic/clinical data of 284 FEP patients and 231 matched healthy controls, and evaluated first psychotic experiences of patients using the Symptom Onset in Schizophrenia Inventory. Results: FEP patients had significantly higher prevalence of tobacco, cannabis, and cocaine use than controls. The FEP group with tobacco use only prior to onset (N = 56) had more sleep disturbances (42.9% vs 18.8%, P = 0.003) and lower prevalence of negative symptoms, specifically social withdrawal (33.9% vs 58%, P = 0.007) than FEP with no substance use (N = 70), as well as lower prevalence of ideas of reference (80.4% vs 92.4%, P = 0.015), perceptual abnormalities (46.4% vs 67.4%, P = 0.006), hallucinations (55.4% vs 71.5%, P = 0.029), and disorganised thinking (41.1% vs 61.1%, P = 0.010) than FEP group with previous tobacco and cannabis use (N = 144). FEP patients with cannabis and tobacco use had lower age at first prodromal or psychotic symptom (mean = 23.73 years [SD = 5.09]) versus those with tobacco use only (mean = 26.21 [SD = 4.80]) (P = 0.011). Conclusions: The use of tobacco alone was not related to earlier age of onset of a first psychotic experience, but the clinical profile of FEP patients is different depending on previous tobacco use with or without cannabis. © 2021 The Author

Physical activity and risk of Metabolic Syndrome in an urban Mexican cohort

Abstract Background In the Mexican population metabolic syndrome (MS) is highly prevalent. It is well documented that regular physical activity (PA) prevents coronary diseases, type 2 diabetes and MS. Most studies of PA have focused on moderate-vigorous leisure-time activity, because it involves higher energy expenditures, increase physical fitness, and decrease the risk of MS. However, for most people it is difficult to get a significant amount of PA from only moderately-vigorous leisure activity, so workplace activity may be an option for working populations, because, although may not be as vigorous in terms of cardio-respiratory efforts, it comprises a considerable proportion of the total daily activity with important energy expenditure. Since studies have also documented that different types and intensity of daily PA, including low-intensity, seem to confer important health benefits such as prevent MS, we sought to assess the impact of different amounts of leisure-time and workplace activities, including low-intensity level on MS prevention, in a sample of urban Mexican adults. Methods The study population consisted of 5118 employees and their relatives, aged 20 to 70 years, who were enrolled in the baseline evaluation of a cohort study. MS was assessed according to the criteria of the National Cholesterol Education Program, ATP III and physical activity with a validated self-administered questionnaire. Associations between physical activity and MS risk were assessed with multivariate logistic regression models. Results The prevalence of the components of MS in the study population were: high glucose levels 14.2%, high triglycerides 40.9%, high blood pressure 20.4%, greater than healthful waist circumference 43.2% and low-high density lipoprotein 76.9%. The prevalence of MS was 24.4%; 25.3% in men and 21.8% in women. MS risk was reduced among men (OR 0.72; 95%CI 0.57–0.95) and women (OR 0.78; 95%CI 0.64–0.94) who reported an amount of ≥30 minutes/day of leisure-time activity, and among women who reported an amount of ≥3 hours/day of workplace activity (OR 0.75; 95%CI 0.59–0.96). Conclusion Our results indicate that both leisure-time and workplace activity at different intensity levels, including low-intensity significantly reduce the risk of MS. This finding highlights the need for more recommendations regarding the specific amount and intensity of leisure-time and workplace activity needed to prevent MS

A qualitative analysis of environmental policy and children's health in Mexico

<p>Abstract</p> <p>Background</p> <p>Since Mexico's joining the North American Free Trade Agreement (NAFTA) and the Organization for Economic Cooperation and Development (OECD) in 1994, it has witnessed rapid industrialization. A byproduct of this industrialization is increasing population exposure to environmental pollutants, of which some have been associated with childhood disease. We therefore identified and assessed the adequacy of existing international and Mexican governance instruments and policy tools to protect children from environmental hazards.</p> <p>Methods</p> <p>We first systematically reviewed PubMed, the Mexican legal code and the websites of the United Nations, World Health Organization, NAFTA and OECD as of July 2007 to identify the relevant governance instruments, and analyzed the approach these instruments took to preventing childhood diseases of environmental origin. Secondly, we interviewed a purposive sample of high-level government officials, researchers and non-governmental organization representatives, to identify their opinions and attitudes towards children's environmental health and potential barriers to child-specific protective legislation and implementation.</p> <p>Results</p> <p>We identified only one policy tool describing specific measures to reduce developmental neurotoxicity and other children's health effects from lead. Other governance instruments mention children's unique vulnerability to ozone, particulate matter and carbon monoxide, but do not provide further details. Most interviewees were aware of Mexican environmental policy tools addressing children's health needs, but agreed that, with few exceptions, environmental policies do not address the specific health needs of children and pregnant women. Interviewees also cited state centralization of power, communication barriers and political resistance as reasons for the absence of a strong regulatory platform.</p> <p>Conclusions</p> <p>The Mexican government has not sufficiently accounted for children's unique vulnerability to environmental contaminants. If regulation and legislation are not updated and implemented to protect children, increases in preventable exposures to toxic chemicals in the environment may ensue.</p

A longitudinal study of gene expression in first-episode schizophrenia; exploring relapse mechanisms by co-expression analysis in peripheral blood

Little is known about the pathophysiological mechanisms of relapse in first-episode schizophrenia, which limits the study of potential biomarkers. To explore relapse mechanisms and identify potential biomarkers for relapse prediction, we analyzed gene expression in peripheral blood in a cohort of first-episode schizophrenia patients with less than 5 years of evolution who had been evaluated over a 3-year follow-up period. A total of 91 participants of the 2EPs project formed the sample for baseline gene expression analysis. Of these, 67 provided biological samples at follow-up (36 after 3 years and 31 at relapse). Gene expression was assessed using the Clariom S Human Array. Weighted gene co-expression network analysis was applied to identify modules of co-expressed genes and to analyze their preservation after 3 years of follow-up or at relapse. Among the 25 modules identified, one module was semi-conserved at relapse (DarkTurquoise) and was enriched with risk genes for schizophrenia, showing a dysregulation of the TCF4 gene network in the module. Two modules were semi-conserved both at relapse and after 3 years of follow-up (DarkRed and DarkGrey) and were found to be biologically associated with protein modification and protein location processes. Higher expression of DarkRed genes was associated with higher risk of suffering a relapse and early appearance of relapse (p = 0.045). Our findings suggest that a dysregulation of the TCF4 network could be an important step in the biological process that leads to relapse and suggest that genes related to the ubiquitin proteosome system could be potential biomarkers of relapse. © 2021, The Author(s)

Primary and Secondary Immunodeficiency Diseases in Oncohaematology: Warning Signs, Diagnosis, and Management

Background: Immunodeficiencies (ID), in particular primary immunodeficiencies (PID), are often associated with haematological manifestations, such as peripheral cytopenias or lymphoproliferative syndromes. Early diagnosis and management have significant prognostic implications. Secondary immunodeficiencies (SID) may also be induced by oncohaematological diseases and their treatments. Haematologists and oncologists must therefore be aware of the association between blood disorders and cancer and ID, and be prepared to offer their patients appropriate treatment without delay. Our aim was to define the warning signs of primary and secondary IDs in paediatric and adult patients with oncohaematological manifestations.Methods: A multidisciplinary group of six experts (2 haematologists, 2 immunologists, and 2 paediatricians specializing in ID) conducted a literature review and prepared a document based on agreements reached an in-person meeting. An external group of 44 IDs specialists from all over Spain assessed the document and were consulted regarding their level of agreement.Results: This document identifies the haematological and extra-haematological diseases that should prompt a suspicion of PIDs in adults and children, in both primary care and haematology and oncology departments. Cytopenia and certain lymphoproliferative disorders are key diagnostic pointers. The diagnosis must be based on a detailed clinical history, physical exploration, complete blood count and standard laboratory tests. The immunological and haematological tests included in the diagnostic process will depend on the care level. Patients who are candidates for immunoglobulin replacement therapy must be carefully selected, and treatment should be offered as soon as possible to avoid the development of complications. Finally, this document recommends procedures for monitoring these patients.Conclusions: This document combines scientific evidence with the opinion of a broad panel of experts, and emphasizes the importance of an early diagnosis and treatment to avoid complications. The resulting document is a useful tool for primary care physicians and specialists who see both adult and paediatric patients with oncohaematological diseases