Pharmacological considerations for the treatment of COVID-19 in people living with HIV (PLWH)

Altres ajuts: Gilead Sciences (GLD14/293, GLD17/00299, GLD19/00008)Altres ajuts: European Regional Development Fund (FEDER)Introduction: When coronavirus infectious disease-2019 (COVID-19) blew up, ill-fated auguries on the collision between COVID-19 and the human immunodeficiency virus (HIV) epidemics loomed. Areas covered: Data from observational studies suggest similar incidence attacks of SARS-CoV-2 infection in people living with HIV (PLWH) and HIV-uninfected populations. The mortality rate of COVID-19 is similar in both populations too. The authors discuss the role of combination antiretroviral therapy (cART) in preventing infection or reducing COVID-19 severity. They also discuss the pharmacological interventions for COVID-19 in PLWH. Expert opinion: Management of COVID-19 in PLWH is no different from the general population. It should be based on careful supportive care, emphasizing lung-protective ventilation, and wise pharmacological interventions. The antiviral drug remdesivir and dexamethasone are the only pharmacological interventions with clinical benefit for COVID-19, whereas anticoagulation may prevent thrombotic complications. The experience with using these drugs in PLWH is limited, which prevents from rendering well-founded conclusions. Until more data on COVID-19 in PLWH become available, the best weapons within our reach are sound supportive care and sensible use of RDV and dexamethasone, bearing in mind the potential for drug-drug interactions of most corticosteroids and antiretroviral drugs

Los videojuegos y el aprendizaje de la historia y del patrimonio el videojuego como recurso didáctico en las aulas de secundaria

Es algo innegable que durante las últimas décadas las nuevas tecnologías han experimentado un desarrollo asombroso y los videojuegos han evolucionado de una forma sorprendente. El éxito de los videojuegos con un marcado carácter histórico ha sido muy demandado por el público en los últimos años. ¿Hasta qué punto es posible implementar la utilización de determinados videojuegos en la enseñanza de las Ciencias Sociales? ¿Es posible que los videojuegos puedan contribuir al aprendizaje de nuestros jóvenes? Este trabajo pretende dilucidar la posible utilidad del uso de determinados videojuegos para la enseñanza y aprendizaje de la Historia y el Patrimonio en las aulas de Secundaria

Diseño de un proyecto de terapia de animales para personas residentes en Patronato Municipal San Francisco de Asís en Navarra 2022

Las personas mayores muestran un sentimiento de soledad, vulnerabilidad, problemas mentales, reducción de motricidad y problemas en la alimentación, conforme su edad va avanzando. A través de este Trabajo Fin de Grado, y en lo que se basará en primer lugar el marco teórico, es explicar el proceso de envejecimiento y como influye este en el deterioro de la propia salud, así como los diferentes tipos de terapias con animales. Por otro lado, se llevará a cabo la formulación de un proyecto, a través de la Terapia Asistida con Animales, el cual se llevará a cabo a través de siete sesiones, que se realizará con los residentes de Patronato Municipal San Francisco de Asís.<br /

El voluntariado como elemento del envejecimiento activo: los voluntarios en edad de jubilación de la Fundación Rey Ardid.

El aumento de la esperanza de vida contribuye a que el número de personas mayores crezca en el futuro. Los expertos afirman que tener una actividad diaria mejora las condiciones físicas y mentales, por eso, cada vez son más las personas que optan por un envejecimiento activo. Los individuos pueden descubrir que pueden hacer cosas que no habían hecho nunca y pueden dedicarlo a nuevas aficiones y nuevas actividades. Muchos de ellos se interesan en introducirse en el voluntariado como una forma de mantenerse activo. El voluntariado es una manera de ayudar a los demás y de sentirse bien con uno mismo y en esta investigación averiguare como ha influido el voluntariado en ciertas personas y si es un buen camino para afrontar esta nueva etapa de la vida que les toca vivir

Voluntariado de acción social en la Asociación de Padres de Niños Oncológicos de Aragón (Aspanoa)

Es un trabajo basado en experiencia personal y la investigación realizada hacia la asociación Aspanoa, al haber sido voluntaria dentro de ella el principal planteamiento que quiero conocer en este trabajo será ver qué motivaciones tienen los voluntarios, qué les llevan a elegir esta asociación con este tipo de problemática, en qué puede haber un mayor interés dentro de la asociación para ser voluntario y qué se necesitarí

Ultraestructura dels espermatozoides de Crassostrea gigas, Mytilus galloprovincialis i Donax trunculus (Mollusca, Bivalvia)

La majoria dels mol·luscs bivalves són organismes gonocòrics, amb alguns casos d'hermafroditisme en diferents grups. La gònada masculina, quan és madura, envaeix tota la cavitat del mantell i els gàmetes són alliberats a la cavitat paleal de l'individu. Els espermatozoides dels bivalves són del tipus primitiu, com tots els dels organismes aquàtics que presenten fecundació externa. Són cèl·lules en les quals es distingeixen tres parts ben diferenciades: cap, peça intermèdia i cua. En les tres espècies estudiades, Crassostrea gigas, Mytilus galloprovincialis i Donax trunculus, els espermatozoides responen a aquest patró, però amb variacions morfològiques especifiques que estan relacionades amb les característiques dels oòcits que han de fecundar. En C. gigas el cap de l'espermatozoide és arrodonit i entre l'acrosoma i el nucli destaca la regió subacrosòmica, amb components fibril·lars d'actina. L'espermatozoide de M. galloprovincialis és molt més allargat que l'anterior i el sistema fibril·lar de la regió subacrosòmica forma un canal intranuclear. L'acrosoma destaca per la seva longitud. L'espermatozoide de D. trunculus segueix el patró considerat primitiu, tot i que en la peça intermèdia conté més mitocondris i els centríols tenen una disposició en línia i no ortogonal, com en els altres estudiats.The majority of bivalve mollusks are gonocoric organisms, and some cases of hermaphroditic individuals have been reported in different groups. When it reaches maturity, the male gonad invades the whole of the mantle cavity and gametes are released into the pallial cavity of the individual. The spermatozoa of bivalve mollusks are of a primitive type, as those of all aquatic organisms with external fertilization. They are cells in which three clearly differentiated parts can be identified: a head, a middle piece and a tail. In all three analyzed species: Crassostrea gigas, Mytilus galloprovincialis and Donax trunculus, the spermatozoa fit within this pattern, but with specific morphological variations related to the characteristics of the oocytes they fertilize. In C. gigas, the sperm head is rounded and between the acrosome and the nucleus stands out the subacrosomal region with fibrillar components of actin. The sperm of M. galloprovincialis is much more elongated and the fibrillar system of the subacrosomal region forms an intranuclear channel. The acrosome is conspicuous because of its length. The sperm of D. trunculus fits with the pattern considered to be primitive, although the middle piece has more mitochondria and the centrioles are arranged in a line instead of being orthogonally oriented as in the other analyzed species

The impact of the COVID-19 pandemic in diabetes and dyslipidemia management in a Spanish region: a retrospective study of the Aragon population

IntroductionPrevious research has indicated that the COVID-19 outbreak had a negative impact on the diagnosis and management of cardiometabolic diseases. Our aim was to analyze the impact of the COVID-19 pandemic on the management of dyslipidemia and type 2 diabetes (T2D) in the Aragon region of Spain.MethodsWe conducted an observational retrospective study, which included data from all patients diagnosed with active T2D or dyslipidemia in Aragon during 2019–2021. Data was collected from the BIGAN platform, a big database that includes all healthcare data from the Aragon population. Clinical, biochemical, and pharmacological prescription information was obtained for each patient and for each year.ResultsOut of the total population of 1,330,000 in the Aragon region, 90,000 subjects were diagnosed with T2D each year, resulting in a prevalence of approximately 7%. The COVID-19 pandemic resulted in a decrease in the prevalence of this disease and a lower incidence during the year 2020. In addition, patients with T2D experienced a deterioration of their glucose profile, which led to an increase in the number of patients requiring pharmacological therapy. The prevalence of dyslipidemia was approximately 23.5% in both 2019 and 2020 and increased to 24.5% in 2021. Despite the worsening of the anthropometric profile, the lipid profile improved significantly throughout 2020 and 2021 compared to 2019. Moreover, the number of active pharmacological prescriptions increased significantly in 2021.DiscussionOur findings suggest that the overload of the health system caused by the COVID-19 pandemic has resulted in an underdiagnosis of T2D. Moreover, patients with T2D experienced a worsening of their glycemic profile, an increase in their pharmacological requirements, and lower performance of their analytical determinations. Dyslipidemic subjects improved their lipid profile although the value of lipid profile determination decreased between 2020 and 2021

Prevalence of Ischemic Heart Disease and Management of Coronary Risk in Daily Clinical Practice: Results from a Mediterranean Cohort of HIV-Infected Patients

There are conflicting data on the prevalence of coronary events and the quality of the management of modifiable cardiovascular risk factors (CVRF) inHIV-infected patients. Methods.We performed a retrospective descriptive study to determine the prevalence of coronary events and to evaluate the management of CVRF in a Mediterranean cohort of 3760 HIV-1-infected patients from April 1983 through June 2011. Results.We identified 81 patients with a history of a coronary event (prevalence 2.15%); 83% of them suffered an acute myocardial infarction. At the time of the coronary event, CVRF were highly prevalent (60.5% hypertension, 48% dyslipidemia, and 16% diabetes mellitus).OtherCVRF, such as smoking, hypertension, lack of exercise, and body mass index, were not routinely assessed. After the coronary event, a significant decrease in total cholesterol (� = 0.025) and LDLcholesterol (� = 0.004) was observed. However, the percentage of patients whomaintained LDL-cholesterol > 100mg/dL remained stable (from 46% to 41%, � = 0.103). Patients using protease inhibitors associated with a favorable lipid profile increased over time (� = 0.028). Conclusions.The prevalence of coronary events in our cohort is low. CVRF prevalence is high and theirmanagement is far from optimal. More aggressive interventions should be implemented to diminish cardiovascular risk in HIV-infected patients

Dual effect of RYGB on the entero-insular axis: How GLP-1 is enhanced by surgical duodenal exclusion

Background: The role of the ileum and Glucagon Like Peptide-1 (GLP-1) secretion in the pathophysiological processes underlying the effects of Roux-en-Y gastric bypass (RYGB) on type 2 Diabetes mellitus (T2DM) improvement has been previously determined. However, the roles of duodenal exclusion and Glucose Insulinotropic Peptide (GIP) secretion change is not clear. To clarify this aspect, we compared the pathophysiological mechanisms triggered by RYGB, which implies the early arrival of food to the ileum with duodenal exclusion, and through pre-duodenal ileal transposition (PdIT), with early arrival of food to the ileum but without duodenal exclusion, in a nondiabetic rodent model. Methods: We compared plasma and insulin, glucose (OGTT), GIP and GLP-1 plasma levels, ileal and duodenal GIP and GLP-1 tissue expression and beta-cell mass for n = 12 Sham-operated, n = 6 RYGB-operated, and n = 6 PdIT-operated Wistar rats. Results: No surgery induced changes in blood glucose levels after the OGTT. However, RYGB induced a significant and strong insulin response that increased less in PdIT animals. Increased beta-cell mass was found in RYGB and PdIT animals as well as similar GLP-1 secretion and GLP-1 intestinal expression. However, differential GIP secretion and GIP duodenal expression were found between RYGB and PdIT. Conclusion: The RYGB effect on glucose metabolism is mostly due to early ileal stimulation; however, duodenal exclusion potentiates the ileal response within RYGB effects through enhanced GIP secretio

Adipose tissue aging partially accounts for fat alterations in HIV lipodystrophy

Altres ajuts: European Regional Development Fund (FEDER).Lipodystrophy is a major disturbance in people living with HIV-1 (PLWH). Several systemic alterations in PLWH are reminiscent of those that occur in ageing. It is unknown whether the lipodystrophy in PLWH is the consequence of accelerated ageing in adipose tissue. We compared systemic and adipose tissue disturbances in PLWH with those in healthy elderly individuals (~80 y old). We observed similarly enhanced expression of inflammation-related genes and decreased autophagy in adipose tissues from elderly individuals and PLWH. Indications of repressed adipogenesis and mitochondrial dysfunction were found specifically in PLWH, whereas reduced telomere length and signs of senesce were specific to elderly individuals. We conclude that ageing of adipose tissue accounts only partially for the alterations in adipose tissues of PLWH