Morbilidad de la enfermedad renal oculta en senescentes de un área de salud

Introduction: chronic renal disease is one of the main causes of death, within the group of chronic non-communicable diseases, its prevalence in developed countries is approximately 500 to 1400 patients per million inhabitants, while in Latin America, is 447 patients per million population.Objective: to determine the prevalence of chronic renal disease and predisposing risk factors in older adults from a medical office at “Jimmy Hirzel” University Polyclinic in Bayamo municipality, Granma province, between June 2016 and June 2017.Methods: a descriptive, cross-sectional observational study was carried out with 120 older adults with a health history of type 2 diabetes mellitus and hypertension.Results: the diagnosis of occult renal disease was established in 113 out of the 120 patients studied, the group of 60-69 years old was the most affected by chronic nephropathy, while male sex and mixed race individuals were the most prevalent. The main predisposing risk factors for occult renal disease were chronic ischemic heart disease, dyslipidemia and smoking.Conclusions: there was a high prevalence of occult renal disease in the older adults examined, where the age group corresponding to 60-69 years, male sex and mixed race individuals were the most affected.Introducción: la enfermedad renal crónica forma parte de las principales causas de muerte, dentro del grupo de enfermedades crónicas no comunicables, su prevalencia en países desarrollados es alrededor de 500 a 1 400 pacientes por millón de habitantes, mientras que en Latinoamérica, es de 447 pacientes por millón de población.Objetivo: determinar la prevalencia de la enfermedad renal crónica y factores de riesgos predisponentes en gerontes de un consultorio médico del Policlínico Universitario “Jimmy Hirzel”, municipio Bayamo, Granma entre junio 2016 y junio 2017.Métodos: se realizó un estudio observacional descriptivo, de corte transversal en el que se incluyeron 120 gerontes con antecedentes patológicos personales de diabetes mellitus tipo 2 e hipertensión arterial.Resultados: se estableció el diagnóstico de enfermedad renal oculta en 113 individuos de 120 sujetos estudiados, el grupo de 60-69 años de edad fue el más afectado por la nefropatía crónica, mientras que el sexo masculino y los sujetos mestizos fueron los de mayor prevalencia. Los principales factores de riesgo predisponentes de enfermedad renal oculta fueron la cardiopatía isquémica crónica, la dislipidemias y el tabaquismo.Conclusiones: existió una elevada prevalencia de la enfermedad renal oculta en los adultos mayores examinados, donde el grupo etario correspondiente a 60-69 años de edad, el sexo masculino y los individuos mestizos fueron los más afectados

La docencia en emprendimiento y emprendimiento social en los ecosistemas universitarios de referencia: Aplicación de las metodologías docentes de aprender a emprender en la Universidad Complutense de Madrid.

Fac. de Ciencias Económicas y EmpresarialesFALSEsubmitte

Evaluación del perfil competencial del estudiantado UCM por nivel de iniciativa emprendedora y género. Validación del Modelo Entrecomp de competencias emprendedoras

Examinar la relación entre las competencias emprendedoras propuestas por el Marco Europeo de Competencias Emprendedoras (Entrecomp) y el nivel de intención emprendedora. Se consideran las siguientes variables: sexo, estudios que realiza, si compagina trabajo y estudio, y Universidad en la que estudia

Effectiveness of Fosfomycin for the Treatment of Multidrug-Resistant Escherichia coli Bacteremic Urinary Tract Infections

IMPORTANCE The consumption of broad-spectrum drugs has increased as a consequence of the spread of multidrug-resistant (MDR) Escherichia coli. Finding alternatives for these infections is critical, for which some neglected drugs may be an option. OBJECTIVE To determine whether fosfomycin is noninferior to ceftriaxone or meropenem in the targeted treatment of bacteremic urinary tract infections (bUTIs) due to MDR E coli. DESIGN, SETTING, AND PARTICIPANTS This multicenter, randomized, pragmatic, open clinical trial was conducted at 22 Spanish hospitals from June 2014 to December 2018. Eligible participants were adult patients with bacteremic urinary tract infections due to MDR E coli; 161 of 1578 screened patients were randomized and followed up for 60 days. Data were analyzed in May 2021. INTERVENTIONS Patients were randomized 1 to 1 to receive intravenous fosfomycin disodium at 4 g every 6 hours (70 participants) or a comparator (ceftriaxone or meropenem if resistant; 73 participants) with the option to switch to oral fosfomycin trometamol for the fosfomycin group or an active oral drug or pa renteral ertapenem for the comparator group after 4 days. MAIN OUTCOMES AND MEASURES The primary outcome was clinical and microbiological cure (CMC) 5 to 7 days after finalization of treatment; a noninferiority margin of 7% was considered. RESULTS Among 143 patients in the modified intention-to-treat population (median [IQR] age, 72 [62-81] years; 73 [51.0%] women), 48 of 70 patients (68.6%) treated with fosfomycin and 57 of 73 patients (78.1%) treated with comparators reached CMC (risk difference, -9.4 percentage points; 1-sided 95% CI, -21.5 to infinity percentage points; P = .10). While clinical or microbiological failure occurred among 10 patients (14.3%) treated with fosfomycin and 14 patients (19.7%) treated with comparators (risk difference, -5.4 percentage points; 1-sided 95% CI. -infinity to 4.9; percentage points; P = .19), an increased rate of adverse event-related discontinuations occurred with fosfomycin vs comparators (6 discontinuations [8.5%] vs 0 discontinuations; P = .006). In an exploratory analysis among a subset of 38 patients who underwent rectal colonization studies, patients treated with fosfomycin acquired a new ceftriaxone-resistant or meropenem-resistant gram-negative bacteria at a decreased rate compared with patients treated with comparators (0 of 21 patients vs 4 of 17 patients [23.5%]; 1-sided P = .01). CONCLUSIONS AND RELEVANCE This study found that fosfomycin did not demonstrate noninferiority to comparators as targeted treatment of bUTI from MDR E coli; this was due to an increased rate of adverse event-related discontinuations. This finding suggests that fosfomycin may be considered for selected patients with these infections

CARB-ES-19 Multicenter Study of Carbapenemase-Producing Klebsiella pneumoniae and Escherichia coli From All Spanish Provinces Reveals Interregional Spread of High-Risk Clones Such as ST307/OXA-48 and ST512/KPC-3

ObjectivesCARB-ES-19 is a comprehensive, multicenter, nationwide study integrating whole-genome sequencing (WGS) in the surveillance of carbapenemase-producing K. pneumoniae (CP-Kpn) and E. coli (CP-Eco) to determine their incidence, geographical distribution, phylogeny, and resistance mechanisms in Spain.MethodsIn total, 71 hospitals, representing all 50 Spanish provinces, collected the first 10 isolates per hospital (February to May 2019); CPE isolates were first identified according to EUCAST (meropenem MIC > 0.12 mg/L with immunochromatography, colorimetric tests, carbapenem inactivation, or carbapenem hydrolysis with MALDI-TOF). Prevalence and incidence were calculated according to population denominators. Antibiotic susceptibility testing was performed using the microdilution method (EUCAST). All 403 isolates collected were sequenced for high-resolution single-nucleotide polymorphism (SNP) typing, core genome multilocus sequence typing (cgMLST), and resistome analysis.ResultsIn total, 377 (93.5%) CP-Kpn and 26 (6.5%) CP-Eco isolates were collected from 62 (87.3%) hospitals in 46 (92%) provinces. CP-Kpn was more prevalent in the blood (5.8%, 50/853) than in the urine (1.4%, 201/14,464). The cumulative incidence for both CP-Kpn and CP-Eco was 0.05 per 100 admitted patients. The main carbapenemase genes identified in CP-Kpn were blaOXA–48 (263/377), blaKPC–3 (62/377), blaVIM–1 (28/377), and blaNDM–1 (12/377). All isolates were susceptible to at least two antibiotics. Interregional dissemination of eight high-risk CP-Kpn clones was detected, mainly ST307/OXA-48 (16.4%), ST11/OXA-48 (16.4%), and ST512-ST258/KPC (13.8%). ST512/KPC and ST15/OXA-48 were the most frequent bacteremia-causative clones. The average number of acquired resistance genes was higher in CP-Kpn (7.9) than in CP-Eco (5.5).ConclusionThis study serves as a first step toward WGS integration in the surveillance of carbapenemase-producing Enterobacterales in Spain. We detected important epidemiological changes, including increased CP-Kpn and CP-Eco prevalence and incidence compared to previous studies, wide interregional dissemination, and increased dissemination of high-risk clones, such as ST307/OXA-48 and ST512/KPC-3

Relaciones humanas, conservación del medio y futuro

Consiste en la elección de una zona abandonada y su transformación en un parque con características de refugio de especies. El objetivo es establecer relaciones entre áreas diferentes de conocimiento, de forma que se integren aspectos éticos, ambientales, artísticos y tecnológicos. De esta forma, se pretende fomentar la relación solidaria entre los alumnos, hacer frente a las actitudes violentas y pasivas, la participación en actividades de grupo, y la superación de prejuicios discriminatorios. Las actividades previstas son: observación e investigación del ecosistema que se desea cambiar, aprender el manejo de instrumentos de medida y otras herramientas, realización de maquetas a partir de esquemas gráficos, debates en grupo y juegos de rol. Los criterios de evaluación se basan en la participación en las actividades propuestas y la cooperación en los grupos de trabajo y en clase.Madrid (Comunidad Autónoma). Consejería de Educación y CulturaMadridMadrid (Comunidad Autónoma). Subdirección General de Formación del Profesorado. CRIF Las Acacias; General Ricardos 179 - 28025 Madrid; Tel. + 34915250893ES

Teaching methodologies applied to the International Network of University Entrepreneurship Project Laboratories

El emprendimiento como disciplina científica se asienta sobre dos pilares fundamentales: la transversalidad y la internacionalización. Son estos los que requieren una planificación para la aplicación de metodologías que fortalezcan el emprendimiento.Entrepreneurship as a scientific discipline is based on two fundamental pillars: transversality and internationalisation. transversality and internationalisation. It is these that require planning for the application of methodologies application of methodologies that strengthen entrepreneurship.Fac. de Ciencias Económicas y EmpresarialesFALSEunpu