¿Afectan las redes sociales a nuestra empatía? Un estudio con jóvenes universitarios

El presente trabajo analiza la afección de las redes sociales a la empatía cognitiva y afectiva. Concretamente en la población de jóvenes universitarios estudiantes de educación y psicología. Con este fin se lleva a cabo una investigación de corte cuantitativo mediante un diseño correlacional basado en el uso de cuestionarios psicométricos. Tras el exhaustivo análisis de datos se ha obtenido que existe un uso adictivo a las redes sociales al mismo tiempo que se dan dificultades en la empatía. También se observa que esta situación se ha visto agravada como consecuencia de la actual coyuntura de pandemia mundial. No obstante, se contempla que conforme aumenta la edad y se poseen mejores relaciones sociales, se dan menores dificultades en el componente cognitivo de la empatía. Por último, se obtiene que a pesar de la gran evidencia científica de anteriores estudios en los que se relaciona la adicción a redes sociales con la ansiedad, el presente estudio aboga por su no significancia. Esta circunstancia es aún más habitual en el sexo masculino, siendo el sexo femenino más sensible a padecer dicha situación

Novel Computational Analysis of Left Atrial Anatomy Improves Prediction of Atrial Fibrillation Recurrence after Ablation

The left atrium (LA) can change in size and shape due to atrial fibrillation (AF)-induced remodeling. These alterations can be linked to poorer outcomes of AF ablation. In this study, we propose a novel comprehensive computational analysis of LA anatomy to identify what features of LA shape can optimally predict post-ablation AF recurrence. To this end, we construct smooth 3D geometrical models from the segmentation of the LA blood pool captured in pre-procedural MR images. We first apply this methodology to characterize the LA anatomy of 144 AF patients and build a statistical shape model that includes the most salient variations in shape across this cohort. We then perform a discriminant analysis to optimally distinguish between recurrent and non-recurrent patients. From this analysis, we propose a new shape metric called vertical asymmetry, which measures the imbalance of size along the anterior to posterior direction between the superior and inferior left atrial hemispheres. Vertical asymmetry was found, in combination with LA sphericity, to be the best predictor of post-ablation recurrence at both 12 and 24 months (area under the ROC curve: 0.71 and 0.68, respectively) outperforming other shape markers and any of their combinations. We also found that model-derived shape metrics, such as the anterior-posterior radius, were better predictors than equivalent metrics taken directly from MRI or echocardiography, suggesting that the proposed approach leads to a reduction of the impact of data artifacts and noise. This novel methodology contributes to an improved characterization of LA organ remodeling and the reported findings have the potential to improve patient selection and risk stratification for catheter ablations in AF

Pro-BNP como marcador de riesgo en cirugía cardiaca

INTRODUCCIÓN: El riesgo quirúrgico en cirugía cardiaca es valorado mediante formularios que calculan una probabilidad estimada de mortalidad peroperatoria en función de las características del paciente y de la cirugía. De todos ellos, el más utilizado en cirugía cardiaca es el sistema Euroscore. Sin embargo, la gran mayoría de los parámetros incluidos son factores clínicos no modificables. No hay consensuados en la actualidad parámetros bioquímicos que puedan predecir e identificar pacientes con un riesgo más elevado. El péptido natriurético cerebral o BNP es una hormona cardiovascular, cuya determinación actúa como predictor de riesgo y factor pronóstico demostrado en insuficiencia cardiaca y representaría de este modo, una variable más objetiva para valoración del riesgo en el caso de los pacientes sometidos a una cirugía cardiaca. HIPÓTESIS: Los valores de pro-BNP pre y postoperatorios servirán de marcador de riesgo en cirugía cardiaca. MATERIAL Y MÉTODOS: para la realización de nuestro estudio se ha tomado una muestra de 135 pacientes consecutivos, intervenidos de cirugía cardiaca con circulación extracorpórea en el servicio de Cirugía Cardiovascular del Hospital Universitario Miguel Servet de Zaragoza entre 2012 y 2013, con un seguimiento a 18 meses. Se realizó una determinación preoperatoria y otra a las 24 horas tras la IQ de los valores de pro-BNP. Los datos han sido analizados y procesados estadísticamente mediante hoja de cálculo y programa estadístico con el que se han realizado test de contraste de hipótesis y regresión logística. RESULTADOS: las condiciones basales del estudio fueros similares a las encontradas a la literatura en cuanto a edad, sexo y factores de riesgo cardiovasculares. La media de Euroscore II fue de 2,49 (riesgo moderado). la insuficiencia cardiaca se encontró en un 10 % mientras que la insuficiencia renal tuvo una incidencia del 22% de pacientes de la muestra. La mortalidad perioperatoria fue de 5 pacientes (4%). No se encontraron diferencias significativas entre los valores de pro-BNP preoperatorio con Euroscore II, cifras de troponinas, tiempo de clampaje, estancia hospitalaria, complicaciones respiratorias y complicaciones infecciosas. Se encontraron diferencias significativas entre los valores de pro-BNP preoperatorio y postoperatorio en los casos de insuficiencia cardiaca y renal. CONCLUSIONES: en la mayor parte de los pacientes la cirugía cardiaca induce un aumento, muy variable, de los valores postoperatorios de pro-BNP respecto a los preoperatorios. Valores elevados de pro-BNP preoperatorios se correlacionan con una mayor incidencia de disfunción cardiaca e insuficiencia renal postoperatorias, no siendo esta elevación específica. No se ha podido establecer una escala de riesgo de los valores de pro-BNP postoperatorios para predecir el riesgo de morbimortalidad postcirugía cardiaca. Pro-BNP tiene un comportamiento distinto según el tipo de cirugía

Comparative analysis of selected methods for the assessment of antimicrobial and membrane-permeabilizing activity: a case study for lactoferricin derived peptides

<p>Abstract</p> <p>Background</p> <p>Growing concerns about bacterial resistance to antibiotics have prompted the development of alternative therapies like those based on cationic antimicrobial peptides (APs). These compounds not only are bactericidal by themselves but also enhance the activity of antibiotics. Studies focused on the systematic characterization of APs are hampered by the lack of standard guidelines for testing these compounds. We investigated whether the information provided by methods commonly used for the biological characterization of APs is comparable, as it is often assumed. For this purpose, we determined the bacteriostatic, bactericidal, and permeability-increasing activity of synthetic peptides (n = 57; 9–13 amino acid residues in length) analogous to the lipopolysaccharide-binding region of human lactoferricin by a number of the most frequently used methods and carried out a comparative analysis.</p> <p>Results</p> <p>While the minimum inhibitory concentration determined by an automated turbidimetry-based system (Bioscreen) or by conventional broth microdilution methods did not differ significantly, bactericidal activity measured under static conditions in a low-ionic strength solvent resulted in a vast overestimation of antimicrobial activity. Under these conditions the degree of antagonism between the peptides and the divalent cations differed greatly depending on the bacterial strain tested. In contrast, the bioactivity of peptides was not affected by the type of plasticware (polypropylene vs. polystyrene). Susceptibility testing of APs using cation adjusted Mueller-Hinton was the most stringent screening method, although it may overlook potentially interesting peptides. Permeability assays based on sensitization to hydrophobic antibiotics provided overall information analogous – though not quantitatively comparable- to that of tests based on the uptake of hydrophobic fluorescent probes.</p> <p>Conclusion</p> <p>We demonstrate that subtle changes in methods for testing cationic peptides bring about marked differences in activity. Our results show that careful selection of the test strains for susceptibility testing and for screenings of antibiotic-sensitizing activity is of critical importance. A number of peptides proved to have potent permeability-increasing activity at subinhibitory concentrations and efficiently sensitized <it>Pseudomonas aeruginosa </it>both to hydrophilic and hydrophobic antibiotics.</p

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

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 &gt; 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