Foot Pain and Morphofunctional Foot Disorders in Patients with Rheumatoid Arthritis: A Multicenter Cross-Sectional Study

[Abstract] Foot problems are highly prevalent in people with rheumatoid arthritis. This study aims to explore the foot morphology, pain and function in rheumatoid arthritis patients and the relation with the time of disease debut. A cross-sectional study was designed. Footprint, the Foot Posture Index, the hallux valgus prevalence, foot pain and function in 66 rheumatoid arthritis patients and the association with time since diagnosis, were recorded. The Foot Function Index, the Manchester Foot Pain and Disability Index, the Visual Analogic Scale, and the Manchester Scale for hallux valgus were administered and analyzed in two groups, with less and more than 10 years of diagnosis of the disease. A high prevalence of pronated (right 36.8% and left 38.6%) and highly pronated (right 15.8% and left 15.8%) feet was observed, as well as an elevated percentage of low arched footprints (right 68.4 and left 66.7%) and hallux valgus (right 59.6% and left 54.4%). Hallux valgus prevalence, toe deformities and Foot Function Index (Functional limitation) factors were significantly associated with the time since RA diagnosed adjusted for the other factors. The adjusted odds ratio of Hallux valgus prevalence was 4.9 (1.2–19.7). In addition, the foot function was diminished, and foot pain was present in most participants. In conclusion, rheumatoid arthritis patients’ feet showed altered morphology and function, and with longer rheumatoid arthritis history, metatarsophalangical stability and foot function, but not pain and global foot posture, were likely to deteriorat

Fomento de la inserción laboral desde el aprendizaje servicio y emprendimiento social en los estudiantes del grado de trabajo social

Este proyecto ha seguido las principales líneas definidas en anteriores proyectos de innovación entre los que se encuentran: 1. El Proyecto de Innovación y Mejora de la Calidad Docente de la Convocatoria 2016/2017, con el nº 109, con el tema: “El impulso del emprendimiento como competencia transversal en los estudiantes del Grado de Trabajo Social”, premiado en la VII EDICIÓN de PREMIOS EMPRENDEDOR UNIVERSITARIO UCM, en la 4ª modalidad de Premio Innova docente. 2. El Proyecto de innovación y Mejora de la Calidad Docente de la Convocatoria 2017/2018, con el nº 54, con el tema: “ Red de Empleabilidad y Emprendimiento en los estudiantes del Grado de Trabajo Social” Se ha seguido investigando sobre el emprendimiento social como competencia transversal “iniciativa y espíritu emprendedor” en las asignaturas de: 1. Bases Teóricas del Trabajo Social, 2º Practicum (donde debe realizarse un Proyecto Social); 3. en el Trabajo Fin de Grado (TFG), ayudando a configurar el perfil profesional del alumnado, visualizando nuevas formas de dar respuesta a las necesidades de la población. En otras universidades españolas estos proyectos de innovación, son definidos en sus convocatorias como proyectos de investigación en innovación ya que la innovación conlleva un previo trabajo de investigación. Estas universidades reconocen la investigación que se realiza. En esta línea se encuentran universidades como la Universidad de Alicante, la Universidad Nacional de Educación a Distancia (UNED), la Universidad de Barcelona, etc., que definen la convocatoria como redes de investigación e innovación. Este reconocimiento y acreditación ha sido solicitado a la Universidad Complutense el 30 de Junio de 2016 por email. La existencia de emprendedores sociales como referentes históricos que vincularon su actividad universitaria con la innovación social y el progreso de la humanidad, justifican esta línea de trabajo. En este sentido se ha continuado con el Proyecto de Aprendizaje Servicio “UCM_MEDIMAYOR_ ALUMNI”, de formación en mediación a un grupo de mayores pertenecientes al Centro de Día Peñagrande del Ayuntamiento de Madrid. La responsabilidad social de la universidad, puede encontrase en esta función ya que se ha potenciado la adquisición de competencias profesionales a través de la colaboración en la sociedad Se ha continuado trabajando el fortalecimiento del emprendimiento social relacionado con el desarrollo social y humano, para la realización de una sociedad más equitativa y participativa desde distintas iniciativas que motiven la participación y la cooperación en esta sociedad desde sus instituciones. Entre los resultados obtenidos está la presentación a los estudiantes de buenas prácticas de emprendedores sociales y de estudiantes que han conseguido su inserción laboral, con el fin de incentivar la generación de nuevas experiencias en los estudiantes del Grado de Trabajo Social. Se destaca el hecho de que 12 estudiantes han terminado con un contrato de trabajo en su centro de practicas externas

Association Between Preexisting Versus Newly Identified Atrial Fibrillation and Outcomes of Patients With Acute Pulmonary Embolism

Background Atrial fibrillation (AF) may exist before or occur early in the course of pulmonary embolism (PE). We determined the PE outcomes based on the presence and timing of AF. Methods and Results Using the data from a multicenter PE registry, we identified 3 groups: (1) those with preexisting AF, (2) patients with new AF within 2 days from acute PE (incident AF), and (3) patients without AF. We assessed the 90-day and 1-year risk of mortality and stroke in patients with AF, compared with those without AF (reference group). Among 16 497 patients with PE, 792 had preexisting AF. These patients had increased odds of 90-day all-cause (odds ratio [OR], 2.81; 95% CI, 2.33-3.38) and PE-related mortality (OR, 2.38; 95% CI, 1.37-4.14) and increased 1-year hazard for ischemic stroke (hazard ratio, 5.48; 95% CI, 3.10-9.69) compared with those without AF. After multivariable adjustment, preexisting AF was associated with significantly increased odds of all-cause mortality (OR, 1.91; 95% CI, 1.57-2.32) but not PE-related mortality (OR, 1.50; 95% CI, 0.85-2.66). Among 16 497 patients with PE, 445 developed new incident AF within 2 days of acute PE. Incident AF was associated with increased odds of 90-day all-cause (OR, 2.28; 95% CI, 1.75-2.97) and PE-related (OR, 3.64; 95% CI, 2.01-6.59) mortality but not stroke. Findings were similar in multivariable analyses. Conclusions In patients with acute symptomatic PE, both preexisting AF and incident AF predict adverse clinical outcomes. The type of adverse outcomes may differ depending on the timing of AF onset.info:eu-repo/semantics/publishedVersio

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

HTLV-1 infection in solid organ transplant donors and recipients in Spain

HTLV-1 infection is a neglected disease, despite infecting 10-15 million people worldwide and severe illnesses develop in 10% of carriers lifelong. Acknowledging a greater risk for developing HTLV-1 associated illnesses due to immunosuppression, screening is being widely considered in the transplantation setting. Herein, we report the experience with universal HTLV testing of donors and recipients of solid organ transplants in a survey conducted in Spain. All hospitals belonging to the Spanish HTLV network were invited to participate in the study. Briefly, HTLV antibody screening was performed retrospectively in all specimens collected from solid organ donors and recipients attended since the year 2008. A total of 5751 individuals were tested for HTLV antibodies at 8 sites. Donors represented 2312 (42.2%), of whom 17 (0.3%) were living kidney donors. The remaining 3439 (59.8%) were recipients. Spaniards represented nearly 80%. Overall, 9 individuals (0.16%) were initially reactive for HTLV antibodies. Six were donors and 3 were recipients. Using confirmatory tests, HTLV-1 could be confirmed in only two donors, one Spaniard and another from Colombia. Both kidneys of the Spaniard were inadvertently transplanted. Subacute myelopathy developed within 1 year in one recipient. The second recipient seroconverted for HTLV-1 but the kidney had to be removed soon due to rejection. Immunosuppression was stopped and 3 years later the patient remains in dialysis but otherwise asymptomatic. The rate of HTLV-1 is low but not negligible in donors/recipients of solid organ transplants in Spain. Universal HTLV screening should be recommended in all donor and recipients of solid organ transplantation in Spain. Evidence is overwhelming for very high virus transmission and increased risk along with the rapid development of subacute myelopathy

CIBERER : Spanish national network for research on rare diseases: A highly productive collaborative initiative

Altres ajuts: Instituto de Salud Carlos III (ISCIII); Ministerio de Ciencia e Innovación.CIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research

All-cause mortality in the cohorts of the Spanish AIDS Research Network (RIS) compared with the general population: 1997Ł2010

Abstract Background: Combination antiretroviral therapy (cART) has produced significant changes in mortality of HIVinfected persons. Our objective was to estimate mortality rates, standardized mortality ratios and excess mortality rates of cohorts of the AIDS Research Network (RIS) (CoRIS-MD and CoRIS) compared to the general population. Methods: We analysed data of CoRIS-MD and CoRIS cohorts from 1997 to 2010. We calculated: (i) all-cause mortality rates, (ii) standardized mortality ratio (SMR) and (iii) excess mortality rates for both cohort for 100 personyears (py) of follow-up, comparing all-cause mortality with that of the general population of similar age and gender. Results: Between 1997 and 2010, 8,214 HIV positive subjects were included, 2,453 (29.9%) in CoRIS-MD and 5,761 (70.1%) in CoRIS and 294 deaths were registered. All-cause mortality rate was 1.02 (95% CI 0.91-1.15) per 100 py, SMR was 6.8 (95% CI 5.9-7.9) and excess mortality rate was 0.8 (95% CI 0.7-0.9) per 100 py. Mortality was higher in patients with AIDS, hepatitis C virus (HCV) co-infection, and those from CoRIS-MD cohort (1997. Conclusion: Mortality among HIV-positive persons remains higher than that of the general population of similar age and sex, with significant differences depending on the history of AIDS or HCV coinfection

Actitud en niños y adultos sobre los estereotipos de género en juguetes infantiles

By playing, children learn and reproduce conduct patterns that are displayed in the children’s social setting, academic and family environment, and mainly in the mass media. The aim of this article, based on a survey of 400 children aged from three to seven and 200 university students, is to analyze play preferences and prejudices that are filtered through different educational circles. The results show an increasingly positive attitude, as can be deduced from our survey on stereotypes of gender in games and toys. The older the children are, the greater the neutral value increases and masculine choices are less recurrent. Nevertheless, both adults and children maintain a deep stereotypical attitude to those toys traditionally associated with the feminine gender.El trabajo muestra cómo a través del juego las nuevas generaciones aprenden y reproducen los patrones de conducta que observan en su entorno familiar, social, escolar y, especialmente, en los medios de comunicación. En este estudio participan 400 niños de entre tres y siete años de edad y 200 universitarios, y se realiza un análisis de las preferencias y prejuicios lúdicos que se filtran a través de los diferentes ámbitos educativos. Los resultados de las encuestas realizadas muestran que hay una actitud positiva creciente sobre los estereotipos de género en los juguetes. A medida que los niños y las niñas tienen más edad las respuestas de valor neutro aumentan, disminuyendo en la misma proporción las respuestas masculinas. No obstante, todos los sujetos de la muestra mantuvieron una alta actitud estereotipada hacia los juguetes tradicionalmente asociados con el género femenino

Actitud en niños y adultos sobre los estereotipos de género en juguetes infantiles

El trabajo muestra cómo a través del juego las nuevas generaciones aprenden y reproducen los patrones de conducta que observan en su entorno familiar, social, escolar y, especialmente, en los medios de comunicación. En este estudio participan 400 niños de entre tres y siete años de edad y 200 universitarios, y se realiza un análisis de las preferencias y prejuicios lúdicos que se filtran a través de los diferentes ámbitos educativos. Los resultados de las encuestas realizadas muestran que hay una actitud positiva creciente sobre los estereotipos de género en los juguetes. A medida que los niños y las niñas tienen más edad las respuestas de valor neutro aumentan, disminuyendo en la misma proporción las respuestas masculinas. No obstante, todos los sujetos de la muestra mantuvieron una alta actitud estereotipada hacia los juguetes tradicionalmente asociados con el género femenino.By playing, children learn andreproduce conduct patterns that are displayedin the children’s social setting, academic andfamily environment, and mainly in the massmedia. The aim of this article, based on asurvey of 400 children aged from three toseven and 200 university students, is to analyzeplay preferences and prejudices that arefiltered through different educational circles.The results show an increasingly positiveattitude, as can be deduced from our survey onstereotypes of gender in games and toys. Theolder the children are, the greater the neutralvalue increases and masculine choices areless recurrent. Nevertheless, both adults andchildren maintain a deep stereotypical attitudeto those toys traditionally associated with thefeminine gender