Thyroid hormones according to gestational age in pregnant Spanish women

<p>Abstract</p> <p>Background</p> <p>Thyroid function changes during pregnancy and maternal thyroid dysfunction have been associated with adverse outcomes. Our aim was to evaluate thyroid hormones levels in pregnant women resident in Aragon, Spain.</p> <p>Findings</p> <p>Samples for 1198 pregnant women with no apparent thyroid disorders were analyzed, using paramagnetic microparticle and chemiluminescent detection technologies, in order to determine levels of thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), thyroid peroxidase antibodies (TPO-Ab), and thyroglobulin antibodies (Tg-Ab). Of the women in our sample, 85.22% had normal values for TPO-Ab and Tg-Ab and 14.77% had results revealing the presence of autoimmune diseases of the thyroid. The thyroid hormone reference values obtained according to gestational age (in brackets) were as follows: for free T3, values were 3.38 ± 0.52 pg/mL (<11 weeks), 3.45 ± 0.54 pg/mL (11-20 weeks), 3.32 ± 0.43 pg/mL (21-30 weeks), 3.21 ± 0.53 pg/mL (31-36 weeks), and 3.23 ± 0.41 pg/mL (>36 weeks); for free T4, values were 1.10 ± 0.14 ng/dL (<10 weeks), 1.04 ± 0.14 ng/dL (11-20 weeks), 0.93 ± 0.12 ng/dL (21-30 weeks), 0.90 ± 0.13 ng/dL (31-36 weeks), and 0.80 ± 0.21 ng/dL (>36 weeks); and for TSH, values were (μIU/mL): 1.12 ± 0.69 (<10 weeks), 1.05 ± 0.67 (11-20 weeks), 1.19 ± 0.60 (21-30 weeks), 1.38 ± 0.76 (31-36 weeks), and 1.46 ± 0.72 (>36 weeks).</p> <p>Conclusion</p> <p>Pregnant women with normal antibody values according to gestational age had values for FT4 and TSH, but not for FT3, that differed to a statistically significant degree. The values we describe can be used as reference values for the Aragon region of Spain.</p

Clinical Characteristics and Long-term outcomes of patients undergoing combined heart-kidney transplantation: a single-center experience

[Abstract] Background. The purpose of the study was to describe clinical characteristics and long-term survival of patients undergoing combined heart-kidney transplant in a single center. Methods. We conducted a retrospective analysis of 22 consecutive patients who underwent combined heart-kidney transplant at our institution between 1995 and 2013. Long-term outcomes were analyzed by means of the Kaplan-Meier method. Results. Four patients underwent re-do transplant (2 cardiac re-transplants, 1 kidney re-transplant, and 1 combined heart-kidney re-transplant). Most frequent underlying cardiac conditions were coronary artery disease (54%), dilated cardiomyopathy (23%), and chronic rejection of a previous heart graft (18%). Known causes of chronic renal dysfunction were nephroangioesclerosis (23%), drug-related toxicity (14%), and Wegener granulomatosis (5%). Non-specified chronic renal dysfunction was present in 50% patients. In-hospital postoperative mortality rate was 5 of 22 (23%). Causes of early death were directly related to kidney transplant surgery in 4 of 5 (80%) patients. Among the remaining 17 patients who surmounted the postoperative period, long-term survival rates 1 year, 5 years, and 10 years after HKT were 88%, 82%, and 65%, respectively. Over a mean follow-up of 6.7 ± 6.4 years, cumulative incidences of cytomegalovirus infection, coronary allograft vasculopathy, malignancy, and acute cardiac graft rejection were 41%, 6%, 24%, and 41%, respectively. There was no episode of acute renal graft rejection. At the end of follow-up, all survivors (n = 11) were in functional New York Heart Association class I. Mean creatinine serum level was 1.68 mg/dL. Conclusions. In our experience, combined heart-kidney transplant is a feasible therapeutic option that yielded favorable long-term outcomes, with a low cumulative incidence of cardiac graft dysfunction. These results were obtained at the expense of a significant risk of early postoperative mortality, which was mainly related to complications of kidney transplant surgery

Short–term effects of air pollution and noise on emergency hospital admissions in Madrid and economic assessment

The aim of this study was to study the effect of air pollution and noise has on the population in Madrid Community (MAR) in the period 2013–2018, and its economic impact

Design and construction of the Maternal Self-efficacy Scale for the Prevention of Excess Weight / Diseño y construcción de la Escala de Autoeficacia Materna para la Prevención del Exceso de Peso

Abstract The objective of the present study was to design, validate and obtain the reliability of the Maternal Self-efficacy Scale for the Prevention of Overweight. From an exploratory research where the role of mothers in childhood obesity was studied, 25 items were written, after an assessment by a panel of judges. The validation was carried out twice with different samples. The first one were 400 mothers (Mage = 33.1, SD = 6.8) of children aged 3-6 years (M = 5.0, SD = 0.6) and 18 items were obtained, divided into four factors: Food, Programming, Solutions, and Prohibition, with a Cronbach's alpha (α) between .62 - .88 and omega (ω) coefficients of .76 - .94. The second validation was with 369 participants, 97% were mothers (Medad = 32.4, DS = 7.9) of children aged 3-6 years (M = 5.0, DS = 0.6) and 3% were grandmothers. The scale was one-dimensional composed by 11 items, with α = .90, ω = .92, and explaining 52% of the variance that evaluates the perceived self-efficacy in the prevention of body weight excess. The proposed scale showed to be suitable and, therefore, its use will promote a greater understanding of childhood obesity. Resumen El objetivo del presente estudio fue diseñar, validar y obtener la confiabilidad de la Escala de Autoeficacia Materna para la Prevención del Exceso de Peso. De un estudio exploratorio que indagó el papel de las madres en la obesidad infantil, fueron redactados 25 ítems, mismos que fueron evaluados por un panel de jueces. La validación de este instrumento se realizó con diferentes muestras. En la primera, participaron 400 madres (Medad  = 33.1, DS = 6.8) de hijos de 3 a 6 años (M= 5, DS= 0.6), y se obtuvieron 18 ítems, distribuidos en cuatro factores: Alimentación, Programación, Soluciones y Prohibición, con alpha de Cronbach (α) entre .62 y .88, y coeficiente omega (ω) de .76 a .94. En la segunda validación participaron 369 madres (Medad = 32.43, DS = 7.9) de hijos de 3 a 6 años (M= 5, DS= .65) y el 3% de abuelas. La escala fue unidimensional, compuesta por 11 reactivos con α = .90, ω = .92, y varianza explicada del 52% de la autoeficacia percibida para la prevención del exceso de peso. La escala propuesta mostró ser apta y, por tanto, su uso promoverá un mayor entendimiento de la obesidad infantil.

Short-term impact of noise, other air pollutants and meteorological factors on emergency hospital mental health admissions in the Madrid region

A number of environmental factors, such as air pollution, noise in urbanised settings and meteorological-type variables, may give rise to important effects on human health. In recent years, many studies have confirmed the relation between various mental disorders and these factors, with a possible impact on the increase in emergency hospital admissions due to these causes. The aim of this study was to analyse the impact of a range of environmental factors on daily emergency hospital admissions due to mental disorders in the Madrid Autonomous Region (MAR), across the period 2013–2018

Terapias alternativas: retando al alzheimer

Introduction; Alzheimer’s disease is the most frequent cause of dementia. It is a neurodegenerative disease that causes difficulty in remembering recent events.It has no apparent cure, only the existence of drugs and therapies such as cognitive stimulation, music therapy, occupational therapy or activities with animals that improve or reduce the disease. Material and methods; A bibliographic review of these therapies has been carried out by comparing various articles found in several databases to demonstrate their effectiveness compared to traditional methods. Results; After the analysis of the studies found, it has been seen that cognitive stimulation along with music therapy are the most studied; finding several studies in which these patients improve orientation and memory. But not only them, but, all other therapies found, cause a slowdown of the disease by increasing cognitive status, memory, functional capacity or even mood, since these patients are depressed. Conclusion; All these therapies linked to drug treatment provide patients with a better quality of life, reducing not only dementia but also the symptoms that Alzheimer’s carries.Introducción; la enfermedad del Alzheimer es la causa de demencia más frecuente. Se trata de una enfermedad neurodegenerativa que provoca dificultad a la hora de recordar sucesos recientes. No tiene cura aparente, solo la existencia de fármacos y terapias como la estimulación cognitiva, la musicoterapia, la terapia ocupacional o las actividades con animales que mejoran o reducen la enfermedad. Material y métodos; se ha realizado una revisión bibliográfica de estas terapias cotejando diversos artículos encontrados en varias bases de datos para demostrar la eficacia de éstas en comparación con los métodos tradicionales. Resultados; tras el análisis de los estudios hallados, se ha visto que la estimulación cognitiva junto con la musicoterapia, son las más estudiadas; encontrando varios estudios en los cuales dichos pacientes mejoran la orientación y la memoria. Pero que no solo ellas, sino que, todas las demás terapias halladas, provocan una ralentización de la enfermedad incrementando el estado cognitivo, la memoria, la capacidad funcional o incluso el estado de ánimo, ya que estos pacientes se encuentran decaídos. Conclusión; todas estas terapias unidas al tratamiento farmacológico proporcionan a los enfermos una mejor calidad de vida reduciendo no sólo la demencia sino los síntomas que el Alzheimer conlleva

Effectiveness and safety of guselkumab for the treatment of psoriasis in real-world settings at 24 weeks : A retrospective, observational, multicentre study by the Spanish Psoriasis Group

Altres ajuts: Acord transformatiu CRUE-CSICData on the effectiveness and safety of a drug in real-world clinical practice complement the evidence from clinical trials, which are carried out in a different setting. Little has been published on the effectiveness and safety of guselkumab in the treatment of psoriasis in clinical practice. The ojective of this study was to assess the effectiveness and safety of guselkumab at 24 weeks in patients with moderate to severe plaque psoriasis in routine clinical practice. A retrospective, multicentre study of adult patients with moderate to severe plaque psoriasis treated with guselkumab for at least 24 weeks was carried out in Spain. We studied 343 patients, 249 of whom were followed for 24 weeks. By week 24, the mean (SD) psoriasis area severity index (PASI) had decreased from 11.1 (7.3) to 1.7 (2.8) (−9.3; [−10.2;-8.4]), 85.9% of the patients had achieved PASI score of 4 or less and 77.9% a PASI score of 2 or less. In terms of relative PASI response, 59.4% of the patients achieved a PASI-90 response and 49.0% a PASI-100 response. On multivariate analysis, two factors reduced the probability of a PASI of 2 or less at 24 weeks: a BMI ≥30 (OR, 0.44; 95% CI, 0.22-0.88) and a greater previous exposure to biologic therapy (OR, 0.69; 95% CI, [0.56-0.84]). Adverse events were rare (9.9%) and led to withdrawal from treatment in only nine patients (2.6%) by the end of the follow-up period. The results of this study confirm the high efficacy and safety of guselkumab indicated by the clinical trial data. In clinical practice, the absolute PASI score appears to be a better marker of response to treatment than the relative value

Remodeling of Bone Marrow Hematopoietic Stem Cell Niches Promotes Myeloid Cell Expansion during Premature or Physiological Aging

Hematopoietic stem cells (HSCs) residing in the bone marrow (BM) accumulate during aging but are functionally impaired. However, the role of HSC-intrinsic and -extrinsic aging mechanisms remains debated. Megakaryocytes promote quiescence of neighboring HSCs. Nonetheless, whether megakaryocyte-HSC interactions change during pathological/natural aging is unclear. Premature aging in Hutchinson-Gilford progeria syndrome recapitulates physiological aging features, but whether these arise from altered stem or niche cells is unknown. Here, we show that the BM microenvironment promotes myelopoiesis in premature/physiological aging. During physiological aging, HSC-supporting niches decrease near bone but expand further from bone. Increased BM noradrenergic innervation promotes β2-adrenergic-receptor(AR)-interleukin-6-dependent megakaryopoiesis. Reduced β3-AR-Nos1 activity correlates with decreased endosteal niches and megakaryocyte apposition to sinusoids. However, chronic treatment of progeroid mice with β3-AR agonist decreases premature myeloid and HSC expansion and restores the proximal association of HSCs to megakaryocytes. Therefore, normal/premature aging of BM niches promotes myeloid expansion and can be improved by targeting the microenvironment.Y.-H.O. received fellowships from Alborada Scholar-ship (University of Cambridge), Trinity-Henry Barlow Scholarship (Universityof Cambridge), and R.O.C. Government Scholarship to Study Abroad (GSSA). A.G.G. received fellowships from the Ramon Areces Foundationand the LaCaixa Foundation. C.K. was supported by Marie Curie Career Inte-gration (H2020-MSCA-IF-2015-70841). S.M.-F. was supported by Red TerCel (ISCIII-Spanish Cell Therapy Network). V.A. is supported by grants from theSpanish Ministerio de Economıa,Industria y Competitividad (MEIC) with co-funding from the Fondo Europeo de Desarrollo Regional (FEDER, ‘‘Una manerade hacer Europa’’) (SAF2016-79490-R), the Instituto de Salud Carlos III (AC16/00091 and AC17/00067), the Fundacio Marato TV3 (122/C/2015), and the Progeria Research Foundation (Established Investigator Award 2014–52). TheCNIC is supported by the Instituto de Salud Carlos III (ISCIII), the Ministerio de Ciencia, Innovacion y Universidades (MCIU), and the Pro CNIC Foundation,and is a Severo Ochoa Center of Excellence (SEV-2015-0505). This work wassupported by core support grants from the Wellcome Trust and the MRC to theCambridge Stem Cell Institute, MEIC (SAF-2011-30308), Ramon y Cajal Program Grant (RYC-2009-04703), ConSEPOC-Comunidad de Madrid (S2010/BMD-2542), National Health Service Blood and Transplant (United Kingdom), European Union’s Horizon 2020 research (ERC-2014-CoG-64765 and MarieCurie Career Integration grant FP7-PEOPLE-2011-RG-294096), and a Programme Foundation Award from Cancer Research UK to S.M.-F., who wasalso supported in part by an International Early Career Scientist grant fromthe Howard Hughes Medical Institute.S