Unravelling data for rapid evidence-based response to COVID-19: a summary of the unCoVer protocol

Introduction unCoVer - Unravelling data for rapid evidence-based response to COVID-19 - is a Horizon 2020-funded network of 29 partners from 18 countries capable of collecting and using real-world data (RWD) derived from the response and provision of care to patients with COVID-19 by health systems across Europe and elsewhere. unCoVer aims to exploit the full potential of this information to rapidly address clinical and epidemiological research questions arising from the evolving pandemic. Methods and analysis From the onset of the COVID-19 pandemic, partners are gathering RWD from electronic health records currently including information from over 22 000 hospitalised patients with COVID-19, and national surveillance and screening data, and registries with over 1 900 000 COVID-19 cases across Europe, with continuous updates. These heterogeneous datasets will be described, harmonised and integrated into a multi-user data repository operated through Opal-DataSHIELD, an interoperable open-source server application. Federated data analyses, without sharing or disclosing any individual-level data, will be performed with the objective to reveal patients' baseline characteristics, biomarkers, determinants of COVID-19 prognosis, safety and effectiveness of treatments, and potential strategies against COVID-19, as well as epidemiological patterns. These analyses will complement evidence from efficacy/safety clinical trials, where vulnerable, more complex/heterogeneous populations and those most at risk of severe COVID-19 are often excluded. Ethics and dissemination After strict ethical considerations, databases will be available through a federated data analysis platform that allows processing of available COVID-19 RWD without disclosing identification information to analysts and limiting output to data aggregates. Dissemination of unCoVer's activities will be related to the access and use of dissimilar RWD, as well as the results generated by the pooled analyses. Dissemination will include training and educational activities, scientific publications and conference communications.info:eu-repo/semantics/publishedVersio

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Elaboración del sentido de la realidad en niños de 4 a 7 años de sectores en desventaja socioeconómica de la Costa Atlántica

IP 1215-10-101-94Incluye anexosLIBRO(S): El niño y su comprension del sentido de la realidad/Jose JuanAmar Amar, Raimundo Abello Llanos.;Aparicio y Grey Jimenez. -- En: Revista latinoamericana depsicologia. --Vol. 30, no. 2 (1998); p. 311-336.; Barranquilla : Ediciones Uninorte, 1998. -- 198 p. ; 24cm.-- ISBN 9589105610 -- ARTICULO(S) EN REVISTA:;Habilidades de toma de perspectiva conceptual en niños de0,1256años, pertenecientes a sectores en desventaja;socioeconomica en Colombia / Raimundo Abello, Jose Amar, SalomonMagendzo,Olga Lucia Hoyos, Jose Alfred

Value of Music and Nitrous Oxide for Pain Control during Extracorporeal Shock Wave Lithotripsy (ESWL)

OBJECTIVES: To compare the efficacy of 4 different analgesic regimens that include music and nitrous oxide during the treatment of renal lithiasis with ambulatory extracorporeal shock wave lithotripsy (ESWL). MATERIALS AND METHODS: A single-centre, longitudinal, prospective, randomized, open and parallel group study was conducted. Patients with renal lithiasis were included and were randomized to Group A (basal analgesia: midazolam (1 mg), fentanyl (0.05 mg) and dexketoprofen (50 mg)), Group B (basal analgesia and nitrous oxide), Group C (basal analgesia and music) and Group D (basal analgesia, nitrous oxide and music). For the measurement of pain, a visual analogue scale ranging from 0 (no pain) to 100 (maximum pain imaginable) was used. Patient satisfaction was assessed using a Likert questionnaire. The epidemiological data of the patients in terms of lithiasis, previous clinical and ESWL sessions, and pain measured with the VAS before, during (maximum) at the end of the session and at discharge were recorded. Data on complications were also collected, as was the patients\u27 subjective evaluation of the treatment and their satisfaction. The ESWL procedure was performed with a Storz Modulith SLX-F2® lithotripter. A maximum of 4000 waves were applied at a frequency of 1.5 Hz. RESULTS: Eighty patients were included (20 per group). None of the analgesia guidelines proved to be superior to the others for pain control during the ESWL session. Patients younger than 50 years had significantly higher values for the maximum VAS. Only 13.75% of patients required rescue analgesia. A total of 77.5% described their experience as good, very good or excellent, regardless of the assigned group. CONCLUSIONS: The addition of nitrous oxide and/or music did not result in a statistically significant improvement over the basal analgesia regimen of midazolam, fentanyl and dexketoprofen; however, the degree of patient satisfaction was very high

Radioterapia externa parcial acelerada en pacientes con cáncer de seno en estado temprano

Objective: In this study, our purpose was to demonstrate the feasibility and effectiveness of external beam partial breast irradiation (PBI) in patients with early-stage breast cancer treated with breast-conserving surgery.Methods: 100 patients were treated with PBI with doses ranging from 35 to 38.5 Gy, in 10 fractions b.i.d. All patients were treated with four non-coplanar fields. The clinical tumor volume was well encompassed within the isodose line of 100 % as well as the planning target volume which was within the isodose line of 95 %.Results: The median follow-up was of 54.3 months. The treatment was well tolerated, with no more than grade I toxicity. So far, there has been one patient with local and axillar recurrence.Conclusions: In our experience, the treatment was well tolerated with low toxicity and with good results, in a shorter treatment time, with the economical benefits this has, especially for populations in developing countries.Objetivo: Demostrar la eficacia y efectividad de la radioterapia parcial acelerada en cáncer temprano de mama en pacientes tratadas con cirugía conservativa.Método: Se trataron cien mujeres con radioterapia externa parcial acelerada, con dosis en un rango de 35 a 38,5 Gy, en 10 fracciones en 5 días dos veces al día con un intervalo de 6 horas. Todas se trataron con 4 campos no cooplanares. El volumen tumoral clínico estuvo cubierto de forma homogénea con la isodosis del 100 %; así mismo el volumen de planeación del blanco, incluido en la isodosis del 95 %.Resultados: El seguimiento promedio fue de 54,3 meses. La tolerancia al tratamiento fue buena y ninguna mujer presentó toxicidad grado 2 o 3. Hasta el momento una paciente presentó recaída ganglionar, local y a distancia.Conclusión: El tratamiento fue bien tolerado, con toxicidad baja y con buenos resultados, en un tiempo corto, con posibles beneficios económicos especialmente en la población de países en vías de desarrollo

Clinical assessment of W-band spectroscopy for non-invasive detection and monitoring of sustained hyperglycemia

HbA1c is the gold standard test for monitoring medium/long term glycemia conditions in diabetes care, which is a critical factor in reducing the risk of chronic diabetes complications. Current technologies for measuring HbA1c concentration are invasive and adequate assays are still limited to laboratory-based methods that are not widely available worldwide. The development of a non-invasive diagnostic tool for HbA1c concentration can lead to the decrease of the rate of undiagnosed cases and facilitate early detection in diabetes care. We present a preliminary validation diagnostic study of W-band spectroscopy for detection and monitoring of sustained hyperglycemia, using the HbA1c concentration as reference. A group of 20 patients with type 1 diabetes mellitus and 10 healthy subjects were non-invasively assessed at three different visits over a period of 7 months by a millimeter-wave spectrometer (transmission mode) operating across the full W-band. The relationship between the W-band spectral profile and the HbA1c concentration is studied using longitudinal and non-longitudinal functional data analysis methods. A potential blind discrimination between patients with or without diabetes is obtained, and more importantly, an excellent relation (R-squared = 0.97) between the non-invasive assessment and the HbA1c measure is achieved. Such results support that W-band spectroscopy has great potential for developing a non-invasive diagnostic tool for in-vivo HbA1c concentration monitoring in humans

Radioterapia externa parcial acelerada en pacientes con cáncer de seno en estado temprano

Objective: In this study, our purpose was to demonstrate the feasibility and effectiveness of external beam partial breast irradiation (PBI) in patients with early-stage breast cancer treated with breast-conserving surgery.Methods: 100 patients were treated with PBI with doses ranging from 35 to 38.5 Gy, in 10 fractions b.i.d. All patients were treated with four non-coplanar fields. The clinical tumor volume was well encompassed within the isodose line of 100 % as well as the planning target volume which was within the isodose line of 95 %.Results: The median follow-up was of 54.3 months. The treatment was well tolerated, with no more than grade I toxicity. So far, there has been one patient with local and axillar recurrence.Conclusions: In our experience, the treatment was well tolerated with low toxicity and with good results, in a shorter treatment time, with the economical benefits this has, especially for populations in developing countries.Objetivo: Demostrar la eficacia y efectividad de la radioterapia parcial acelerada en cáncer temprano de mama en pacientes tratadas con cirugía conservativa.Método: Se trataron cien mujeres con radioterapia externa parcial acelerada, con dosis en un rango de 35 a 38,5 Gy, en 10 fracciones en 5 días dos veces al día con un intervalo de 6 horas. Todas se trataron con 4 campos no cooplanares. El volumen tumoral clínico estuvo cubierto de forma homogénea con la isodosis del 100 %; así mismo el volumen de planeación del blanco, incluido en la isodosis del 95 %.Resultados: El seguimiento promedio fue de 54,3 meses. La tolerancia al tratamiento fue buena y ninguna mujer presentó toxicidad grado 2 o 3. Hasta el momento una paciente presentó recaída ganglionar, local y a distancia.Conclusión: El tratamiento fue bien tolerado, con toxicidad baja y con buenos resultados, en un tiempo corto, con posibles beneficios económicos especialmente en la población de países en vías de desarrollo

Más de cien mentiras : Quijote y Sabina confabulados

Publicación que conmemora el IV aniversario de la primera edición de El Quijote y que ha reunido a un grupo de profesores de áreas distintas (biología, compensatoria, inglés, educación física, historia, integración, latín y lengua) del IES Manuel Tárrega Escribano de la Región de Murcia. Se trata de un proyecto literario y creativo que tras la lectura de El Quijote se propone a los alumnos para que inventasen relatos breves en los que se jugará con la mentira, la ficción o la paradoja. En casi todos los relatos hay predominio del tema amoroso. El acercamiento al lenguaje barroco les ha llevado a recrear el estilo cervantino y a utilizar los recursos literarios de la época. Al juntar el Quijote a Sabina se ha avivado la creación y excitado la imaginación desencadanada por la canción de éste último titulada 'Es mentira'.MurciaConsejería de Educación y Cultura. Biblioteca Regional; Avda. Juan Carlos I, 17; 30008 Murcia; +34968366599; +34968366600; [email protected]

Experience in the Use of Antibiotics in Large Pediatric Burn Patients

La tasa de mortalidad en el paciente pediátrico gran quemado oscila entre 3.5 a 7% según la extensión de la quemadura, la edad y la presencia de sepsis. Objetivo: describir el uso de antibióticos en pacientes pediátricos grandes quemados en la Unidad de Quemados (UQ) de los Servicios de Salud del Estado de Puebla, México. Material y método: estudio descriptivo, observacional, longitudinal, retrospectivo. Se registraron datos de los antibióticos utilizados en la UQ durante el tiempo de estudio, se describieron los microorganismos involucrados en infección de foco cutáneo, así como la resistencia y sensibilidad de estos. Resultados: se incluyeron 23 pacientes masculinos y 14 femeninos; el grado de lesión predominante fue segundo grado, afectando principalmente a preescolares. Se tomaron 21 cultivos, aislándose con mayor frecuencia microorganismos Gram negativos, 29 pacientes requirieron el uso de antibióticos. Los antibióticos más utilizados en la UQ fueron clindamicina y dicloxacilina. Conclusiones: la implementación de programas para un correcto uso de antibióticos debe ser una prioridad; al proporcionar información sobre los antibióticos más utilizados y las resistencias de los gérmenes a los que se enfrenta la UQ, este trabajo es el primer paso para crear una guía de uso de antibióticos en pacientes pediátricos grandes quemados en la unidad citada. The mortality rate in pediatric major burn patients ranges from 3.5 to 7% depending on the extent of the burn, age, and the presence of sepsis. Objective: to describe the use of antibiotics in major pediatric burn patients in the Burn Unit (BU) of the Health Services of the State of Puebla, Mexico. Materials and method: descriptive, observational, longitudinal, retrospective study. Data on the antibiotics used in the BU during the study period were recorded, and the microorganisms involved in cutaneous focus infection were described, as well as their resistance and sensitivity. Results: 23 male and 14 female patients were included; the predominant degree of injury was a second degree, affecting mainly preschoolers. 21 cultures were taken, isolating Gram-negative microorganisms more frequently. 29 patients required the use of antibiotics. The most used antibiotics in the BU were clindamycin and dicloxacillin. Conclusions: the implementation of programs for the correct use of antibiotics should be a priority; By providing information on the most widely used antibiotics and the resistance of the germs that the BU faces, this work is the first step to creating a guide for the use of antibiotics in major pediatric burn patients in the unit

Viaja con la mente

Este trabajo obtuvo la segunda mención especial de la modalidad B de los Premios Joaquín Sama 2006Se describe un concurso que consistía en realizar varias pruebas y que pretendía preparar a los alumnos para que tuvieran un comportamiento adecuado en el centro escolar. El objetivo principal del proyecto era mejorar la convivencia en el centro escolar, además de promover el trabajo en equipo, aumentar la motivación del alumnado, potenciar la búsqueda de soluciones alternativas ante los problemas diarios en el aula y el centro, dotar al alumno de los recursos necesarios para afrontar los conflictos de forma constructiva, etc. Se detalla la organización y el desarrollo del proyecto, su temporalización, la metodología seguida, los recursos necesarios para llevarlo a cabo, etc..ExtremaduraConsejería de Educación. Dirección General de Política Educativa; Calle Delgado Valencia, 6; 06800 Mérida (Badajoz); Tel. +34924006714; Fax +34924006716; [email protected]