Efectividad del bicarbonato de sodio versus solución salina isotónica en la prevención de la nefropatía inducida por contraste: revisión sistemática y metaanálisis

Introducción: Para la prevención del desarrollo de nefropatía inducida por el uso de contraste (NIC) se han aplicado estrategias como: la administración de bicarbonato de sodio (BS) o solución salina al 0,9% (SS); sin embargo, no se ha establecido cuál de las dos estrategias es más efectiva y los resultados son heterogéneos. Objetivo: Sintetizar la evidencia existente sobre la efectividad del BS versus SS en la prevención de NIC. Métodos: Se realizó una revisión sistemática y metaanálisis de ensayos clínicos controlados aleatorizados (ECA) registrados en cinco bases de datos, siguiendo el diagrama de selección PRISMA con criterios de inclusión y exclusión. Se analizó la efectividad del BS versus SS en la prevención de NIC. El metaanálisis se realizó por efectos aleatorios comparando los riesgos relativos con el software Revman 5.4. El riesgo de sesgo se evaluó con la herramienta de la colaboración Cochrane. Resultados: Se incluyeron 7 estudios (n= 1306) en la revisión sistemática y metaanálisis. La frecuencia de presentación de NIC fue de 10,84% en el grupo que uso BS y de 9,24% en el grupo de SS. El riesgo de presentar NIC fue menor en el grupo al que se le administro SS que en grupo que uso BS sin diferencias significativas, RR= 1.2 (IC 95% 0.56 – 2.24, I2= 73%). Conclusiones: la efectividad del bicarbonato de sodio y la solución salina en la prevención de la nefropatía inducida por contraste es similar.Introduction: There been some Strategies applied to prevent the development of contrast-induced nephropathy (NIC) such as: the administration of sodium bicarbonate (BS) or 0.9% saline solution (SS); however, which of the two strategies is more effective has not been established and the results are heterogeneous. The aim: To Synthesize the existing evidence on the effectiveness of sodium BS versus SS in the prevention of NIC. Methods: A systematic review and meta-analysis of randomized controlled clinical trials (RCT), registered in five databases, was carried out, following the PRISMA selection diagram with inclusion and exclusion criteria. The effectiveness of BS versus SS in the prevention of NIC was analyzed. The meta-analysis was performed by Random effects model comparing the relative risks using Revman 5.4 software. Risk of bias was assessed using the Cochrane Collaboration tool. Results: Seven studies were included in this systematic review and metaanalysis. The frequency of NIC presentation was 10.84% in the group that used BS and 9.24% in the SS group. The risk of presenting NIC was lower in the group that was administered SS than in the group that used BS, without significant differences, RR= 1.2 (95% CI 0.56 - 2.24, I2= 73%). Conclusions: The effectiveness of sodium bicarbonate and saline solution in preventing contrast-induced nephropathy is similar.Tesi

Sistema para la gestión de información de embarazadas en el Policlínico “Ramón Heredia” de Veguita (Original)

In the "Ramón Heredia" Polyclinic of the Veguita locality, in the Yara municipality, the information corresponding to the pregnant women of the neighborhoods is managed. For each of them, the result of the care provided by the different specialists and the risk indexes they present is recorded per quarter. Consultations are also planned taking into account the risks and the number of accumulated weeks. On a monthly basis, qualified personnel must give a generalized report on registered pregnant women, as well as offer information to specialists when they require it. The reports that are provided see their reliability limited. Faced with these needs, the present research aims to develop a web application to favor the information management of pregnant women. With its use, the control and processing of information is facilitated quickly and safely, with greater consistency, which raises the level of efficiency from the organizational, control and analysis point of view. For its implementation, the XP software development methodology is used, such as PHP 5.5.11, HTML 5, CCS3, JavaScript programming languages; as Apache 2.0 web server, MySQL 5.20 as database manager and Yii 1.9 as development framework.En el Policlínico “Ramón Heredia” de la localidad Veguita, en el municipio Yara, se gestiona la información correspondiente a las embarazadas de los repartos de la cercanía. De cada una de ellas se registra por trimestre el resultado de la atención brindada por los diferentes especialistas y los índices de riesgos que presentan. También se planifican las consultas atendiendo los riesgos y la cantidad de semanas acumuladas. Mensualmente el personal calificado debe dar un reporte generalizado sobre las embarazadas registradas, así como ofrecer información a los especialistas cuando lo requieran. Los informes que se brindan ven su confiabilidad limitada. Ante estas necesidades, la presente investigación tiene como objetivo desarrollar una aplicación web para favorecer la gestión de información de las embarazadas. Con su empleo se facilita el control y procesamiento de la información de forma rápida y segura, con mayor consistencia, lo que eleva el nivel de eficiencia desde el punto de vista organizativo, de control y análisis. Para su implementación se emplea la metodología de desarrollo de software XP, como lenguajes de programación PHP 5.5.11, HTML 5, CCS3, JavaScript; como servidor web Apache 2.0, MySQL 5.20 como gestor de base de datos y Yii 1.9 como framework de desarrollo

Innovación y mejora docente en TFG de la Facultad de Ciencias Económicas y Empresariales 2016-2017

El objetivo de este proyecto es poner en contacto los intereses de las empresas con los temas a desarrollar en un trabajo fin de grado (TFG) en la Facultad de Ciencias Económicas y Empresariales de la Universidad de Sevilla. Para ello, se diseña una web que facilite la solicitud de los temas que puedan interesar a las empresas. Una vez solicitado el tema, este se puede asignar a los alumnos que este curso van a realizar su TFG. Los resultados obtenidos, ponen de manifiesto un importante interés inicial de las empresas por este proyecto que se manifiesta en el número de solicitudes que se han formalizado, a pesar del poco tiempo que lleva funcionando la web. Asimismo, los alumnos que están participando en el proyecto elaborando su TFG para cubrir la demanda de un tema propuesto por una empresa, se muestran ilusionados. Entre las propuestas de cara al futuro destacan la inclusión de otros departamentos en el proyecto y la posibilidad de ofertar estos TFG a todos los alumnos de la facultad en función del expediente académico. Gracias a este proyecto se facilita la transferencia de conocimiento entre Universidad-Empresa y se favorece el contacto del alumno con la realidad empresarial

Control of a hippocampal recurrent excitatory circuit by cannabinoid receptor-interacting protein Gap43

The type-1 cannabinoid receptor (CB1R) is widely expressed in excitatory and inhibitory nerve terminals, and by suppressing neurotransmitter release, its activation modulates neural circuits and brain function. While the interaction of CB1R with various intracellular proteins is thought to alter receptor signaling, the identity and role of these proteins are poorly understood.Using a highthroughput proteomic analysis complemented with an array of in vitro and in vivo approaches in the mouse brain, we report that the C-terminal, intracellular domain of CB1R interacts specifically with growth-associated protein of 43 kDa (GAP43). The CB1R-GAP43 interaction occurs selectively at mossy cell axon boutons, which establish excitatory synapses with dentate granule cells in the hippocampus. This interaction impairs CB1R-mediated suppression of mossy cell to granule cell transmission, thereby inhibiting cannabinoidmediated anti-convulsant activity inmice. Thus, GAP43 acts as a synapse typespecific regulatory partner of CB1R that hampers CB1R-mediated effects on hippocampal circuit function

Robots miniaturizados: diseño, implementación y aplicaciones

Proyecto de Investigación (Código: 5402-1360-2401 FI-298-09) Instituto Tecnológico de Costa Rica. Escuela de Ingeniería Electrónica, Escuela de Física, Escuela de Ingeniería en Computación, 2014Este informe presenta los resultados obtenidos en el proyecto “Robots miniaturizados: diseño, implementación y aplicaciones”, con número de proyecto 5402-1360-2401. Se presentan los resultados obtenidos con respecto a locomoción autónoma, comunicación inalámbrica óptica y alimentación inalámbrica, actuadores para manipulación y microcorte e interfaz con una PC para datos y comandos. El minirobot fue diseñado para operar en un área de al menos 30cm de diámetro y tiene un tamaño de 2.3 cm x 2.6 cm x 1.78 cm. Para el estudio de los actuadores del minirobot se utilizó simulación multifísica por el método de elementos finitos con el software COMSOL Multiphysics. La estructura del informe es la siguiente: en la sección de Introducción se tratan los antecedentes, la descripción del problema a resolver, así como los objetivos planteados en el proyecto de investigación. En la sección de metodología se resume el método de investigación y los flujos de diseño. En la sección de resultados se presentan los resultados obtenidos correspondientes a: comunicación inlámbrica óptica, sistema de locomoción, interfaz humano-máquina y software, alimentación inalámbrica de energia y actuadores. Posteriormente, se discuten los resultados obtenidos junto con las principales conclusiones del proyecto y las recomendaciones para su continuación y/o aprovechamiento de los resultados.Instituto Tecnológico de Costa Rica. Escuela de Ingeniería Electrónica. Escuela de Física. Escuela de Ingeniería en Computación

Ultrasonography in rheumatology: time to learn from patient views

Objective: The objective of this observational, descriptive, cross-sectional, multicentre study was to assess the perceived quality and grade of satisfaction expressed by patients with chronic arthropathies regarding the use of musculoskeletal (MSK) ultrasonography by rheumatologists as an integrated clinical care tool. Methods: All Spanish rheumatology departments with MSK ultrasonography incorporated in their healthcare services were invited to participate in the study. A Spanish-language survey was offered to fill out anonymously to all consecutive patients with chronic arthropathies under follow-up in the rheumatology outpatient clinics who attended their centre for a period of 3 months. The survey consisted of three sections. The first section contained patients’ demographics, disease data, frequency of performing rheumatological ultrasound and information about who performed their ultrasound assessments. The second section consisted of 14 questions about patient’s experience and opinion on different aspects of the management, performance and perceived usefulness of performing ultrasound, to be answered on a Likert scale 1–5. The third section of the survey was addressed to the rheumatologist ultrasonographers. Results: Nine hundred and four patients from 16 university hospital rheumatology departments completed the survey. All questions reached an overall favourable response ≥ 80%. Patients who reported usual ultrasound examinations in their rheumatology care and those in which it was their attending rheumatologist who performed the ultrasound assessments responded more favourably. Conclusion: Our encouraging patient-centred results may be useful in facilitating the implementation of rheumatological ultrasound in rheumatology care worldwide. Key Points • This is the largest multicentre survey carried out in patients with chronic joint diseases designed to assess their experience and perceived benefits with the use of ultrasonography performed by rheumatologists in daily practice. • Musculoskeletal ultrasound incorporated into rheumatology care was very well accepted and valued by most patients. • The patients perceived that ultrasonography helps not only their rheumatologist but also themselves to better understand their condition. • The patients believed that ultrasonography helps them accept and comply with the proposed treatmen

El CSIC reúne a expertos en aeronáutica para debatir sobre el empleo del hidrógeno como combustible

Datos técnicos: 337 minutos, color, español. Ficha técnica: Gabinete de Presidencia CSIC y Departamento de Comunicación. Emitido en directo el 16 diciembre de 2022El Consejo Superior de Investigaciones Científicas (CSIC), en colaboración con la Plataforma Aeroespacial Española PAE y el Centro para el Desarrollo Tecnológico e Industrial (CDTI), organiza el próximo viernes, 16 de diciembre, una jornada sobre nuevos materiales e hidrógeno en la industria aeronáutica. Especialistas en el sector procedentes de distintos ámbitos científicos y de la industria debatirán sobre los nuevos desafíos que implica el empleo del hidrógeno como combustible, así como su interacción con nuevos materiales, en el campus central del CSIC en Madrid.Presentaciones disponibles en : https://plataforma-aeroespacial.es/jornada-materiales-e-h2-en-las-aeronaves/presentaciones/Peer reviewe

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe