Farmacoterapia de adultos con trastornos por consumo de alcohol

Los trastornos relacionados con el uso del alcohol (TRUA) son una importante fuente de morbimortalidad. Multiplican por tres la mortalidad temprana global y son responsables del 6,5% de las muertes totales en la Unión Europea (Rehm et al., 2009). Se estima que en este mismo ámbito geográfico, 15 millones de personas son dependientes del alcohol (Rehm et al., 2009) y un número sin duda mayor abusarán del mismo, pero sólo un 10% reciben tratamiento (Alonso et al., 2004). En un contexto como este, no es de extrañar que los organismos estatales dediquen fondos y esfuerzos a la investigación sobre las mejores formas de tratamiento de TRUA, y en este marco se inscribe la revisión sistemá- tica (RS) encargada por la prestigiosa Agency for Healthcare Research and Quality (AHRQ) norteamericana sobre la farmacoterapia de los TRUA en régimen externo, un resumen de la cual ha sido publicada en JAMA por el grupo de Jonas (Jonas et al., 2014)

EFFICIENT POSTAL SERVICE AND RESPECTFUL WITH THE ENVIRONMENT

[EN] The postal service is suffering an adaptation to the new markets opened by the users. The traditional post, letters and postcards, is being used less and is substituted by mail and packaging. To adequate to this new market it's important for the postal sector companies. In Spain, the operator of the Universal Postal Service has taken example from other companies of the sector, national and international, implanting electrical bicycle mail and packaging service in the centre of big cities. This is due to the fact that there are more the cities that are forbidding vehicle access to it's historical centres and the volume of packaging to deliver is greater. But, is it viable to deliver using hybrid and electrical vehicles in cities? This study intends to improve the distribution in cities with the implantation of these vehicles. It takes into account the characteristics of populations between 50.000 and 100.000 inhabitants, in which it will be analysed the advantages and inconvenience, doing special emphasis in the economic cost, conducting studies of the costs of implantation and amortization time.Vera López, J.; Pabón Dueñas, AB.; Liñán Ruiz, RJ.; Merino Córdoba, S. (2016). EFFICIENT POSTAL SERVICE AND RESPECTFUL WITH THE ENVIRONMENT. En XII Congreso de ingeniería del transporte. 7, 8 y 9 de Junio, Valencia (España). Editorial Universitat Politècnica de València. 1965-1974. https://doi.org/10.4995/CIT2016.2015.4085OCS1965197

System Optimization Courier and Parcel in Cities

AbstractThe purpose of this paper is to study the distribution networks in order to reduce the costs in this phase. Considering the distribution networks of traditional postal service, carried out by the operator of the universal postal service in cities.Acting directly on the stage that generates more costs for the quantity of human and material resources needed, it can achieve efficiency in distribution and in quality. Optimizing the process it is possible to obtain better use with the already existing resources.It starts with real data from a specific population and by analysis of this information, a study is conducted. It has taken into account various influencing factors: product distribution media and distribution points for greater efficiency and resource optimization of the distribution networks.In particular we have studied Section 21 located in the Distribution Unit of Posts and Telegraphs State, Anonymous Society, in Estepona (Málaga)

Inventario de Emisiones a la Atmósfera de Compuestos Orgánicos Persistentes Seleccionados en Mendoza para el Año 2011

El presente trabajo trata la identificación y análisis de fuentes específicas de Contaminantes Orgánicos Persistentes junto con el cálculo de sus emisiones, en el área del Gran Mendoza, durante el año 2011. Se estimaron las emisiones de Bifenilos Policlorados (PCB), Hexaclorobenceno (HCB), y Diclorodifeniltricloroetano (DDT). Debido a la gran variedad de fuentes y compuestos involucrados y a limitaciones en la disponibilidad de información, no se utilizó un método armonizado para todos los compuestos en la preparación del inventario. Los datos presentados en este estudio proporcionan un panorama general de las emisiones en el Gran Mendoza. Finalmente, se destaca la necesidad de un esfuerzo mayor en la caracterización y validación de las emisiones, tanto para la obtención de relaciones entre fuentes y receptores, como también para el desarrollo de estrategias de control. Asimismo, esta información es crucial para lograr una reducción en la carga de estas sustancias, a nivel local y regional.The present work is focused on the identification and analysis of specific sources of Permanent Organic Pollutants together with the calculation of emissions in the Great Mendoza during 2011. Emissions of polychlorinated biphenyls (PCBs), hexachlorobenzene (HCB) and Dichloro-diphenyl-trichloroethane (DDT) were estimated. Due to the wide variety of sources and compounds involved and the limited availability of information, a harmonized method for all compounds in the preparation of the inventory was not used. Data submitted in this study provide an overview of the emissions in the Great Mendoza urban area. Finally, great efforts in the characterization and validation of emissions, both for obtaining relationships between sources and sinks, as well as for the development of strategies to control them are needed. Also, this information is crucial to achieve a reduction in the burden of these substances, at local and regional level.Fil: Allende, David Gabriel. Universidad Tecnológica Nacional. Facultad Regional Buenos Aires; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Ruggeri, María Florencia. Universidad Tecnológica Nacional. Facultad Regional de Mendoza; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Lana, Nerina Belén. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Provincia de Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Universidad Nacional de Cuyo. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales; ArgentinaFil: Garro López, Karina Mónica. Universidad Tecnológica Nacional. Facultad Regional de Mendoza; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Altamirano, Jorgelina Cecilia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Provincia de Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Universidad Nacional de Cuyo. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales; ArgentinaFil: Puliafito, Salvador Enrique. Universidad Tecnológica Nacional. Facultad Regional de Mendoza; Argentina. Universidad Tecnológica Nacional. Facultad Regional Buenos Aires; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Field and laboratory comparative evaluation of a LAMP assay for the diagnosis of urogenital schistosomiasis in Cubal, Central Angola

Objetive: To evaluate the performance of Rapid-Heat LAMPellet assay in field conditions for diagnosis of urogenital schistosomiasis in an endemic area in Cubal, Angola, and to assess the reproducibility in a reference laboratory. Methods: A total of 172 urine samples from school-age children were tested for microhaematuria, microscopic detection of Schistosoma haematobium eggs and LAMP for DNA detection. Urine samples were stored in a basic equipped laboratory. Field-LAMP tests were performed with and without prior DNA extraction from urine samples, and the results were read by turbidity and by colour change. When field procedures were finished, samples were sent to a reference laboratory to be reanalysed by LAMP. Results: A total of 83 of 172 (48.3%) were positive for microhaematuria, 87/172 (50.6%) were microscopy-positive for S. haematobium eggs detection, and 127/172 (73.8%) showed LAMP-positive results for detecting S. haematobium using purified DNA and 109/172 (63.4%) without prior DNA extraction. MacNemar's test showed a statistical significant relation between LAMP results and microscopy-detected S. haematobium infections and microhaematuria (P < 0.001 in both cases), respectively. When samples of purified DNA were reanalysed in a reference laboratory in Spain using the same LAMP methodology, the overall reproducibility achieved 72.1%. Conclusions: The ease of use, simplicity and feasibility demonstrated by LAMP assay in field conditions together with the acceptable level of reproducibility achieved in a reference laboratory support the use of LAMP assay as an effective test for molecular diagnosis of urogenital schistosomiasis in endemic remote areas.This study was supported by Mundo Sano Foundation (www.mundosano.org) and by the Institute of Health Carlos III, ISCIII, Spain (www.isciii.es), grants: RICET RD16/0027/0018, DTS16/00207, PI16/01784 European Union cofinancing by FEDER (Fondo Europeo de Desarrollo Regional) ‘Una manera de hacer Europa’.S

DPYD Exome, mRNA Expression and Uracil Levels in Early Severe Toxicity to Fluoropyrimidines: An Extreme Phenotype Approach

Dihydropyrimidine dehydrogenase deficiency is a major cause of severe fluoropyrimidine-induced toxicity and could lead to interruption of chemotherapy or life-threatening adverse reactions. This study aimed to characterize the DPYD exon sequence, mRNA expression and in vivo DPD activity by plasma uracil concentration. It was carried out in two groups of patients with extreme phenotypes (toxicity versus control) newly treated with a fluoropyrimidine, during the first three cycles of treatment. A novel nonsense gene variant (c.2197insA) was most likely responsible for fluoropyrimidine-induced toxicity in one patient, while neither DPYD mRNA expression nor plasma uracil concentration was globally associated with early toxicity. Our present work may help improve pharmacogenetic testing to avoid severe and undesirable adverse reactions to fluoropyrimidine treatment and it also supports the idea of looking beyond DPYD

Lichens and lichenicolous fungi of Serranía de Ronda (Málaga-Cádiz), southern Spain

As a result of a field trip organised by the Spanish Lichen Society in Serranía de Ronda, south Spain, a catalogue of 360 taxa is presented (336 lichens, 24 lichenicolous fungi). The list includes three new records for the Iberian Peninsula: Arthonia paretinaria, Micarea myriocarpa and Niesslia keissleri, 51new ones for the Autonomous Andalusian Community, and three and 81 new ones for the province of Cádiz and of Málaga, respectively. After these results, the total updated number of the province of Málaga rises to 556 lichens and lichenicolous fungi. The best represented lichen genus is Cladonia (18) with the most species, unlike Lecanora (15), Pertusaria (12), Physconia (12) and Collema (9). As regard habitat, most lichen species are mainly corticolous (55%), as opposed to saxicolous (24%), terricolous (14%) as the species growing on other lichens as lichenicolous fungi (7%). The percentages of lichen growth forms are mainly foliose (50%) and crustose (31%), while fruticose (7%), crustose squamulose (6%) and dimorphic (6%) are less represented. The lichen with a green photobiont (Chlorophyta 84%) predominates, while the cyanobacteria photobiont (15%) is less represented

AEEH «Consensus about detection and referral of hidden prevalent liver diseases»

Las enfermedades hepáticas constituyen una carga de enfermedad muy importante para nuestro sistema sanitario, tanto por su alta prevalencia como por su morbimortalidad asociada. La hepatitis C se ha considerado la principal causa de enfermedad hepática en los últimos 30 años, pero gracias al efectivo tratamiento antiviral directo y a las estrategias de cribado, actualmente su peso ha disminuido notablemente. La infección por virus de la hepatitis B sigue afectando a casi el 0,7% de la población...Peer reviewe

Impact of interstitial lung disease on the survival of systemic sclerosis with pulmonary arterial hypertension

To assess severity markers and outcomes of patients with systemic sclerosis (SSc) with or without pulmonary arterial hypertension (PAH-SSc/non-PAH-SSc), and the impact of interstitial lung disease (ILD) on PAH-SSc. Non-PAH-SSc patients from the Spanish SSc registry and PAH-SSc patients from the Spanish PAH registry were included. A total of 364 PAH-SSc and 1589 non-PAH-SSc patients were included. PAH-SSc patients had worse NYHA-functional class (NYHA-FC), worse forced vital capacity (FVC) (81.2 +/- 20.6% vs 93.6 +/- 20.6%, P < 0.001), worse tricuspid annular plane systolic excursion (TAPSE) (17.4 +/- 5.2 mm vs 19.9 +/- 6.7 mm, P < 0.001), higher incidence of pericardial effusion (30% vs 5.2%, P < 0.001) and similar prevalence of ILD (41.8% vs. 44.9%). In individuals with PAH-SSc, ILD was associated with worse hemodynamics and pulmonary function tests (PFT). Up-front combination therapy was used in 59.8% and 61.7% of patients with and without ILD, respectively. Five-year transplant-free survival rate was 41.1% in PAH-SSc patients and 93.9% in non-PAH-SSc patients (P < 0.001). Global survival of PAH-SSc patients was not affected by ILD regardless its severity. The multivariate survival analysis in PAH-SSc patients confirmed age at diagnosis, worse NYHA-FC, increased PVR, reduced DLCO, and lower management with up-front combination therapy as major risk factors. In conclusion, in PAH-SSc cohort risk of death was greatly increased by clinical, PFT, and hemodynamic factors, whereas it was decreased by up-front combination therapy. Concomitant ILD worsened hemodynamics and PFT in PAH-SSc but not survival regardless of FVC impairment

Basophil-lineage commitment in acute promyelocytic leukemia predicts for severe bleeding after starting therapy

Severe hemorrhagic events occur in a significant fraction of acute promyelocytic leukemia patients, either at presentation and/or early after starting therapy, leading to treatment failure and early deaths. However, identification of independent predictors for high-risk of severe bleeding at diagnosis, remains a challenge. Here, we investigated the immunophenotype of bone marrow leukemic cells from 109 newly diagnosed acute promyelocytic leukemia patients, particularly focusing on the identification of basophil-related features, and their potential association with severe bleeding episodes and patient overall survival. From all phenotypes investigated on leukemic cells, expression of the CD203c and/or CD22 basophil-associated markers showed the strongest association with the occurrence and severity of bleeding (p ≤ 0.007); moreover, aberrant expression of CD7, coexpression of CD34+/CD7+ and lack of CD71 was also more frequently found among patients with (mild and severe) bleeding at baseline and/or after starting treatment (p ≤ 0.009). Multivariate analysis showed that CD203c expression (hazard ratio: 26.4; p = 0.003) and older age (hazard ratio: 5.4; p = 0.03) were the best independent predictors for cumulative incidence of severe bleeding after starting therapy. In addition, CD203c expression on leukemic cells (hazard ratio: 4.4; p = 0.01), low fibrinogen levels (hazard ratio: 8.8; p = 0.001), older age (hazard ratio: 9.0; p = 0.002), and high leukocyte count (hazard ratio: 5.6; p = 0.02) were the most informative independent predictors for overall survival. In summary, our results show that the presence of basophil-associated phenotypic characteristics on leukemic cells from acute promyelocytic leukemia patients at diagnosis is a powerful independent predictor for severe bleeding and overall survival, which might contribute in the future to (early) risk-adapted therapy decisions.This work was supported by the Fundación Científica de la Asociación Española Contra el Cáncer (AECC, Madrid, Spain) and the Fundación Rafael del Pino (Madrid, Spain) and both CIBERONC (CB16/12/00400, CB16/12/00233, CB16/12/00480) and grant PI16/00787 from Instituto de Salud Carlos III (Ministerio de Economía y Competitividad, Madrid, Spain)