Análisis coste beneficio en la acción preventiva (I): bases conceptuales

En este documento se plantean una serie de reflexiones y criterios de actuación a fin de acometer la integración del análisis coste beneficio en la gestión de la acción preventiva y poder estimar su rentabilidad económica y social, complementando anteriores NTP que han ido tra- tando diferentes aspectos sobre este tema. Algo que es del todo necesario para responder a exigencias legales y a los principios requeridos de eficiencia en la gestión empresarial. En las dos siguientes NTP se describen estrategias de medición y un caso práctico de aplicación para facilitar su aprendizajePreprin

Análisis coste beneficio en la acción preventiva (II): estrategias de medición

Este documento complementa al anterior en el que se plantearon una serie de reflexiones y criterios de actua - ción a fin de acometer la integración del análisis coste beneficio en la gestión de la acción preventiva para poder estimar su rentabilidad económica y su contribución al bien común. En la presente NTP se describen estrategias de medición, así como unas conclusiones sobre todo lo expuesto, presentándose en la siguiente, un sencillo caso práctico de aplicación para facilitar su aprendizajePreprin

Guillem IV de Cervera, cavalier i monjo de Poblet

Guillem IV of Cervera could be the prototype of the noble closely linked to all spheres of power. This article studies his connections as a councillor to the royal court of Pere I and during the early decades of that of Jaume I, at a time of crisis for this royal institution. Guillem of Cervera was also a key player in the difficult relations between the crown and the earldom of Urgell in the context of the absortion of the earldom into the House of Barcelona. On a spiritual level, the close ties between a lineage like the House of Cervera and the monastery of Poblet will be shown, these perhaps being in the image and reflections of the kings.[fr] Guillem IV de Cervera pourrait être le prototype de chevalier lié étroitement à toutes les spheres du pouvoir. Dans cet article, nous étudions ses relations en tant que conseiller de la cour royale de Pere I et ses relations dans la première époque du règne de Jaume I, à une époque de crise de l'institution royale. Guillem de Cervera fut aussi un personnage clé dans les rapports difficiles entre la Couronne et le Comté d'Urgell, dans un contexte d'absorption du Comté à la Maison de Barcelone. Au niveau spirituel, nous montrons les liens étroits d'une lignée comme celle des Cervera avec le monastère de Poblet, à l'image de ses rois

Differences in peripheral and tissue immune cell populations following haematopoietic stem cell transplantation in Crohn's disease patients

Background and aims: recent studies have shown the efficacy of autologous haematopoietic stem cell transplantation [HSCT] in severely refractory Crohn's disease [CD] patients. HSCT is thought to eliminate auto-reactive cells; however, no specific studies of immune reconstitution in CD patients are available. Methods: we followed a group of CD patients [n = 18] receiving autologous HSCT, with 50% of them achieving endoscopic drug-free remission. To elucidate the mechanisms driving efficacy, we monitored changes after HSCT in blood and intestine immune-cell composition. CD patients [n = 22] receiving anti-tumour necrosis factor [TNF]-α were included for comparison. Results: severe immune ablation followed by HSCT induced dramatic changes in both peripheral blood T and B cells in all patients regardless of the efficacy of the treatment. Endoscopic remission at week 52 following HSCT was associated with significant intestinal transcriptional changes. A comparison of the remission signature with that of anti-TNFα identified both common and unique genes in the HSCT-induced response. Based on deconvolution analysis of intestinal biopsy transcriptome data, we show that response to HSCT, but not to anti-TNFα, is associated with an expansion of naïve B-cells, as seen in blood, and a decrease in the memory resting T-cell content. As expected, endoscopic remission, in response to both HSCT and anti-TNFα, led to a significant reduction in intestinal neutrophil and M1 macrophage content. Conclusions: peripheral blood immune remodelling after HSCT does not predict efficacy. In contrast, a profound intestinal T-cell depletion that is maintained long after transplant is associated with mucosal healing following HSCT, but not anti-TNFα

A mutation in the POT1 gene is responsible for cardiac angiosarcoma in TP53-negative Li-Fraumeni-like families

Cardiac angiosarcoma (CAS) is a rare malignant tumour whose genetic basis is unknown. Here we show, by whole-exome sequencing of a TP53-negative Li-Fraumeni-like (LFL) family including CAS cases, that a missense variant (p.R117C) in POT1 (protection of telomeres 1) gene is responsible for CAS. The same gene alteration is found in two other LFL families with CAS, supporting the causal effect of the identified mutation. We extend the analysis to TP53-negative LFL families with no CAS and find the same mutation in a breast AS family. The mutation is recently found once in 121,324 studied alleles in ExAC server but it is not described in any other database or found in 1,520 Spanish controls. In silico structural analysis suggests how the mutation disrupts POT1 structure. Functional and in vitro studies demonstrate that carriers of the mutation show reduced telomere-bound POT1 levels, abnormally long telomeres and increased telomere fragility

Pla funcional programa d’intercanvi de xeringues a l'atenció primària

Programa d'intercanvi de xeringues; Centres d'atenció primària; Normes d'aplicacióPrograma de intercambio de jeringas; Centros de atención primaria; Normas de aplicaciónSyringe exchange program; Primary care centers; Rules of applicationL’objectiu d’aquest pla funcional és establir les bases per ajudar a la implementació del PIX en els CAP de Catalunya, a més d’homogeneïtzar-ne la metodologia. També pretén facilitar als professionals dels CAP eines i directrius que facilitin la relació amb les persones que s’injecten drogues (PQID) i potenciïn la qualitat d’aquesta interacció

Adopting a High-Polyphenolic Diet Is Associated with an Improved Glucose Profile: Prospective Analysis within the PREDIMED-Plus Trial

Previous studies suggested that dietary polyphenols could reduce the incidence and complications of type-2 diabetes (T2D); although the evidence is still limited and inconsistent. This work analyzes whether changing to a diet with a higher polyphenolic content is associated with an improved glucose profile. At baseline, and at 1 year of follow-up visits, 5921 participants (mean age 65.0 ± 4.9, 48.2% women) who had overweight/obesity and metabolic syndrome filled out a validated 143-item semi-quantitative food frequency questionnaire (FFQ), from which polyphenol intakes were calculated. Energy-adjusted total polyphenols and subclasses were categorized in tertiles of changes. Linear mixed-effect models with random intercepts (the recruitment centers) were used to assess associations between changes in polyphenol subclasses intake and 1-year plasma glucose or glycosylated hemoglobin (HbA1c) levels. Increments in total polyphenol intake and some classes were inversely associated with better glucose levels and HbA1c after one year of follow-up. These associations were modified when the analyses were run considering diabetes status separately. To our knowledge, this is the first study to assess the relationship between changes in the intake of all polyphenolic groups and T2D-related parameters in a senior population with T2D or at high-risk of developing T2