Telecolaboración. Una forma estimulante de practicar la interacción a distancia

«In language learning contexts, telecollaboration is generally understood to be Internet-based intercultural exchange between people of different cultural/national backgrounds, set up in an institutional context with the aim of developing both language skills and intercultural communicative competence through structured tasks», según afirman Guth y Helm (2010). La telecolaboración propone modelos tradicionalmente bilingües y entre aprendices de dos culturas diferentes pero cabe también en este concepto el intercambio monolingüe que puede establecerse entre aprendices que adoptan una lengua franca. En nuestro caso hemos promovido el intercambio entre estudiantes universitarios italianos que estudian español y estudiantes de otras universidades europeas que también estudian español, adoptando como lengua franca la lengua meta de ambos grupos. El objetivo de estos encuentros ha sido fundamentalmente el desarrollo de la destreza oral, la práctica de la interacción y, con la ayuda de grabaciones, la sucesiva reflexión sobre la práctica efectuada

Alteraciones del metabolismo hidrocarbonado en el paciene con síndrome coronario agudo. Beneficios del tratamiento con agonistas del receptor de GLP1

La diabetes mellitus (DM) es una enfermedad crónica de elevada y creciente prevalencia a nivel mundial que se asocia a una alta morbilidad y mortalidad, siendo una de las enfermedades con mayor impacto socio sanitario. La enfermedad cardiovascular (ECV) sigue siendo la principal complicación y causa de muerte del paciente con diabetes. La detección de anormalidades glucémicas previamente no conocidas en el paciente con ECV es frecuente. La frecuencia aumentada de estas anormalidades glucémicas en los pacientes con SCA y el riesgo que conllevan tanto en rango diabético como aquellos con estados prediabéticos hacen que su detección temprana sea prioritaria. Una vez diagnosticado el paciente de DM durante el ingreso, el control metabólico intrahospitalario es fundamental. En cuanto al tratamiento de elección para el control glucémico durante el ingreso, se desaconseja el uso de terapias no insulínicas durante la hospitalización y se recomienda el uso de insulina. Las recomendaciones en el paciente con SCA van encaminadas a intentar mantener unos niveles de glucemia lo más normales posibles mediante el uso de pautas de insulina basal-bolus. Sigue estando muy debatido, sin embargo, cuánto de intensivo debe ser el control glucémico en estos pacientes para evitar los efectos de hipoglucemias graves. Por otra parte, no sólo la hiperglucemia o la hipoglucemia puede afectar a estos pacientes, sino que también estudios recientes apuntan hacia la importancia de la variabilidad glucémica. Así pues, las estrategias del manejo glucémico en pacientes con diabetes y SCA deberían ir dirigidas al control de los tres componentes principales de la disglicemia: hiperglucemia mantenida, hipoglucemia y VG tanto a corto como a largo plazo. En 2005-2006 se introdujeron las terapias con inhibidores de la dipeptidil peptidasa 4 (IDPP4) y los agonistas del receptor de GLP 1 que han sido incorporados rápidamente en las guías de práctica habituales de la diabetes mellitus tipo 2, situándose en las más recientes entre los fármacos de segundo escalón terapéutico en el tratamiento de la diabetes tipo 2. El bajo riesgo de hipoglucemia y la buena tolerabilidad de este grupo farmacológico hace que su uso en el medio hospitalario resulte atractivo. Esta tesis resulta de un compendio de artículos publicados. El objetivo general de estos trabajos es estudiar la prevalencia de anormalidades del metabolismo hidrocarbonado en el paciente con síndrome coronario agudo en nuestro medio y el posible impacto positivo en aquellos pacientes diabéticos del tratamiento con agonistas del receptor de GLP-1 en su evolución a corto y medio plazo. Para ello, se realizaron cuatro estudios: 1. Un estudio observacional, consecutivo y prospectivo de pacientes ingresados con el diagnóstico de SCA en los que se estudió la detección de alteraciones del metabolismo hidrocarbonado y variables útiles en la práctica clínica habitual que pudieran predecir pacientes con mayor propensión a padecer estas alteraciones. 2. Un estudio de revisión de los ensayos clínicos publicados más relevantes hasta la fecha de publicación del mismo en el ámbito de los agonistas de receptor de GLP-1 y la enfermedad cardiovascular en la diabetes tipo 2. 3. Un estudio generador de hipótesis en el que se condujo una revisión sistemática para identificar la información más relevante sobre agonistas del receptor de GLP-1, variabilidad glucémica, síndrome coronario agudo y estrés oxidativo. 4. Estudio piloto. Ensayo clínico de 12 semanas, abierto, prospectivo y randomizado con grupos paralelos que evalúa el uso de liraglutida y su impacto en el control glucémico en pacientes con diabetes tipo 2 y síndrome coronario agudo durante el ingreso y los 3 meses posteriores tras el alta. Tras el análisis de los datos de los estudios realizados objetivamos que la prevalencia de anormalidades glucémicas en el paciente con SCA son elevadas, siendo hasta en un 30% desconocidas. La sobrecarga oral de glucosa (SOG) realizada a los 3 meses del alta hospitalaria representa una herramienta de alta rentabilidad para la categorización glucometabólica de los pacientes con SCA. En comparación con la glucemia basal, la SOG presenta una sensibilidad mucho mayor para la clasificación de las alteraciones del metabolismo hidrocarbonado en estos pacientes. La valoración de ciertos parámetros clínicos, demográficos y analíticos al ingreso permiten seleccionar a pacientes en riesgo de presentar anormalidades glucémicas. Por otra parte, los agonistas del receptor de GLP-1 han demostrado un efecto beneficioso sobre factores de riesgo de enfermedad cardiovascular tales como el control glucémico, el peso, la dislipemia y la HTA; así como en estudios preclínicos un posible beneficio sobre la función endotelial, la isquemia miocárdica y la insuficiencia cardíaca. La variabilidad glucémica (VG) juega un papel determinante en el desarrollo de las complicaciones de la diabetes en el que el estrés oxidativo parece estar involucrado directamente. La VG en el paciente con síndrome coronario agudo es predictora de riesgo de desarrollo de eventos cardiovasculares mayores a medio plazo. A su vez, parece que los agonistas del receptor de GLP-1 podrían tener un impacto positivo sobre la VG. Además, el uso de agonistas del receptor de GLP 1 en el medio hospitalario es seguro. Liraglutida reduce la VG en la fase aguda del paciente con SCA y DM con un óptimo control glucometabólico y una baja incidencia de hipoglucemias. Así pues, se deberían realizar ensayos multicéntricos cuyo objetivo sea introducir en el medio hospitalario en pacientes DM y SCA el tratamiento de agonistas del receptor de GLP1 y explorar su efecto sobre la VG y el estrés oxidativo.Diabetes Mellitus (DM) is a chronic disease, the worldwide prevalence which is high and continually growing. It is associated with high morbidity and mortality and is one of the diseases with greatest impact on public health. Cardiovascular disease continues to be the main complication and cause of death in the diabetic patient. Previously undetected glucose abnormalities are common in patients with cardiovascular disease. The high prevalence of glucose abnormalities in patients with acute coronary syndrome as well as their increased risk both in diabetic and prediabetic stages underline the importance of an early detection. Once the diagnosis of DM is established during hospitalization, metabolic control during the hospital stay must be prioritized. During hospital stay non insulinic treatments are not recommended and insulin is the mainstay treatment. Recommendations of glucose control in patients with acute coronary syndrome aim to achieve values as normal as possible with the use of basal-bolus regimen. The recommendations of how tight should glucose control be, in order to avoid the deleterious effects of hypoglycemia in these patients, remains however highly debated. On the other hand, not solely hypoglycemia and hyperglycemia may affect deleteriously diabetic patients with acute coronary syndrome, recent studies describe that this pernicious effect can be extended to glycemic variability. Therefore, physicians should aim to control the three main components of dysglycemia in patients with acute coronary syndrome and diabetes: chronic hyperglycemia, hypoglycemia,and short-term and long-term glycemic variability. During 2005-2006, therapies with dipeptidil-peptidase 4 inhibitors and GLP-1 receptor agonists were introduced and have been quickly incorporated in type 2 DM guidelines. Recent guidelines point out that this pharmacological group should be positioned as the second step treatment after metformin.The low hypoglycemic risk and the good tolerability of this pharmacological group makes its use in hospital setting intriguing. This thesis is the result of a compendium of published articles. The general purpose of these works is to study the prevalence of glucose abnromalities in acute coronary sydrome patient and the possible positive impact, in these diabetic patients, of treatment with GLP 1 receptor agonists in a short and midterm follow-up. For this reason, four studies were carried out: 1. An observational, consecutive and prospective study of patients admitted with the diagnosis of acute coronary syndrome in which glucose abnormalities were studied as well as the use of reliable tools in clinical practice which could predict patients with a higher predisposition to present these abnormalities. 2. A review study of the most relevant published clinical trials up to the date of publication in the field of GLP 1 receptor agonists and cardiovascular disease in type 2 DM. 3. A hypothesis generating study in which a systematic review to identify the most relevant information about GLP-1 receptor agonists, glycemic variability and oxidative stress was conducted. 4. A pilot study clinical trial. It is a 12-week, open, prospective, randomized pilot clinical study with parallel groups which evaluates the use of liraglutide and its impact in glycemic control in type 2 diabetic patients with acute coronary syndrome at hospital setting and short-term in outpatient. This study reveals that glucose abnormalities are frequent in acute coronary syndrome patients, being about 30% of them previously undetected. Oral glucose tolerance test 3 months after hospital discharge is a reliable tool for glucometabolic classification in acute coronary syndrome patients. Oral glucose tolerance test compared to basal glucose has a higher sensibility to identify glucose abnormalities in this population. Certain clinical, demographical and analytical markers at admission are useful to recognize patients with a higher risk to present glucose abnormalities. On the other hand, GLP-1 receptor agonists have demonstrated a beneficial effect over well known cardovascular risk factors such as glycemic control, weight, dyslipidaemia and arterial hypertension; as well as a possible beneficial effect shown in preclinical trials over endothelial function, coronary ischaemia and heart failure. Glycemic variability plays a determinant role in the development of diabetic complications in which oxidative stress seems to be involved directly. Glycemic variability in patients with acute coronary syndrome has demonstrated to be a powerful independent predictive factor of midterm major cardiovascular events. At the same time, it seems that GLP-1 receptor agonists could have a positive effect over glycemic variability and their use in hospital setting seems safe. Liraglutide reduces glycemic variability in acute phase of acute coronary syndrome, patients achieve an optimal control with low incidence of hypoglycemia. Therefore, multicentric trials which explore the use of GLP-1 receptor agonists in diabetic patients hospitalized with acute coronary syndrome as well as their effect in glycemic variability and oxidative stress should be performed

GLP-1 Receptor Agonists and Cardiovascular Disease in Patients with Type 2 Diabetes.

Diabetes mellitus is a chronic disease prevalence of which is high and continually growing. Cardiovascular disease continues to be the leading cause of death in patients with T2DM. The prevention of cardiovascular complications and the cardiovascular safety of treatments should be a primary objective when selecting treatment. Among all the drugs available, the compounds known as glucagon-like peptide-1 receptor agonists (GLP-1 RAs) appear to be not just innocuous in terms of CVD but indeed to be beneficial. GLP-1 RA actions not only translate on an improvement of well-known cardiovascular risk factors such as glycaemic control, dyslipidaemia, weight, or arterial hypertension but also might show benefits on endothelial function, coronary ischaemia, and heart failure. On the other hand, recent clinical trials aimed at studying cardiovascular episodes have been conducted with GLP-1 RAs. Only liraglutide and semaglutide have shown superiority in cardiovascular benefit compared with placebo. Although many of the mechanisms by which liraglutide and semaglutide produce a cardiovascular benefit are still unknown it would be desirable for these benefits to be incorporated into the therapeutic algorithms routinely used in clinical practice. The purpose of this review is to explore GLP-1 RA actions not only in cardiovascular risk factors (glucose, weight, and hypertension) but also the possible effects on established cardiovascular disease

Somatostatin and Somatostatin Receptors: From Signaling to Clinical Applications in Neuroendocrine Neoplasms

Neuroendocrine neoplasms (NENs) are heterogeneous neoplasms which arise from neuroendocrine cells that are distributed widely throughout the body. Although heterogenous, many of them share their ability to overexpress somatostatin receptors (SSTR) on their cell surface. Due to this, SSTR and somatostatin have been a large subject of interest in the discovery of potential biomarkers and treatment options for the disease. The aim of this review is to describe the molecular characteristics of somatostatin and somatostatin receptors and its application in diagnosis and therapy on patients with NENs as well as the use in the near future of somatostatin antagonists

Simultaneous Pancreas Kidney Transplantation Improves Cardiovascular Autonomic Neuropathy with Improved Valsalva Ratio as the Most Precocious Test

[EN] Background. Simultaneous pancreas-kidney (SPK) transplantation is a proven option of treatment for patients with type 1 diabetes mellitus (T1DM) and related end-stage renal disease. There is discrepancy between the results of different studies about the impact of prolonged normalization of glucose metabolism achieved by SPK on the course of diabetic complications including severe forms of diabetic neuropathy. The objective of the study was to evaluate the prevalence of cardiovascular autonomic neuropathy (CAN) in patients undergoing SPK transplantation and its evolution 10 years after transplantation. Methods. Prospective study of 81 patients transplanted in a single center from year 2002 to 2015. Autonomic function was assessed using cardiovascular autonomic reflex tests (CARTs). CARTs were made before SPK transplantation and during the follow-up. Evolution of tests after SPK transplantation was evaluated by contrasting hypotheses (paired tests). Multiple testing was adjusted with the Benjamini-Hochberg procedure with a false discovery rate of 10%. Results. 48 males and 33 females, mean age 37.4 +/- 5.7 years, mean BMI 24.0 +/- 3.4 kg/m2, and mean duration of diabetes 25.5 +/- 6.5 years, received SPK transplantation. Ten years after SPK transplantation, 56 patients re tained the pancreatic graft (42 of them with normofunctioning pancreas and 14 with low doses of insulin therapy). These 42 patients were selected for the autonomic study. Before transplant procedure, all CART results were abnormal. After SPK transplantation, paired test analysis showed an improvement of systolic blood pressure (SBP) response to orthostasis at the 5(th) year after SPK (p=0.03), as well as improvement of the Valsalva ratio at the 3(rd) (p<0.001) and 5(th) (p=0.001) year after SPK. After correcting for the false discovery rate, all the variables of autonomic study reached significance at different time points. Conclusions. Prevalence of CAN in patients who are candidates for SPK transplantation is high and is generally advanced. SPK transplantation improves CAN with improved Valsalva ratio as the most precocious test.Argente-Pla, M.; Pérez-Lázaro, A.; Martinez-Millana, A.; Del Olmo-García, MI.; Espí-Reig, J.; Beneyto-Castello, I.; López-Andújar, R.... (2020). Simultaneous Pancreas Kidney Transplantation Improves Cardiovascular Autonomic Neuropathy with Improved Valsalva Ratio as the Most Precocious Test. Journal of Diabetes Research. 2020:1-10. https://doi.org/10.1155/2020/7574628S1102020Freeman, R. (2014). Diabetic autonomic neuropathy. Handbook of Clinical Neurology, 63-79. doi:10.1016/b978-0-444-53480-4.00006-0Maser, R. E., Mitchell, B. D., Vinik, A. I., & Freeman, R. (2003). The Association Between Cardiovascular Autonomic Neuropathy and Mortality in Individuals With Diabetes: A meta-analysis. Diabetes Care, 26(6), 1895-1901. doi:10.2337/diacare.26.6.1895Dimitropoulos, G. (2014). Cardiac autonomic neuropathy in patients with diabetes mellitus. World J Diabetes, 5(1), 17. doi:10.4239/wjd.v5.i1.17Vinik, A. I., & Ziegler, D. (2007). Diabetic Cardiovascular Autonomic Neuropathy. Circulation, 115(3), 387-397. doi:10.1161/circulationaha.106.634949Kennedy, W. R., Navarro, X., & Sutherland, D. E. R. (1995). Neuropathy profile of diabetic patients in a pancreas transplantation program. Neurology, 45(4), 773-780. doi:10.1212/wnl.45.4.773Pop-Busui, R., Boulton, A. J. M., Feldman, E. L., Bril, V., Freeman, R., Malik, R. A., … Ziegler, D. (2016). Diabetic Neuropathy: A Position Statement by the American Diabetes Association. Diabetes Care, 40(1), 136-154. doi:10.2337/dc16-2042Balcıoğlu, A. S. (2015). Diabetes and cardiac autonomic neuropathy: Clinical manifestations, cardiovascular consequences, diagnosis and treatment. World Journal of Diabetes, 6(1), 80. doi:10.4239/wjd.v6.i1.80Pop-Busui, R., Low, P. A., Waberski, B. H., Martin, C. L., Albers, J. W., Feldman, E. L., … Herman, W. H. (2009). Effects of Prior Intensive Insulin Therapy on Cardiac Autonomic Nervous System Function in Type 1 Diabetes Mellitus. Circulation, 119(22), 2886-2893. doi:10.1161/circulationaha.108.837369Maser, R. E., Lenhard, J. M., & DeCherney, S. G. (2000). Cardiovascular Autonomic Neuropathy. The Endocrinologist, 10(1), 27-33. doi:10.1097/00019616-200010010-00006Vinik, A. I., Erbas, T., & Casellini, C. M. (2013). Diabetic cardiac autonomic neuropathy, inflammation and cardiovascular disease. Journal of Diabetes Investigation, 4(1), 4-18. doi:10.1111/jdi.12042Ewing, D. J., Campbell, I. W., Murray, A., Neilson, J. M., & Clarke, B. F. (1978). Immediate heart-rate response to standing: simple test for autonomic neuropathy in diabetes. BMJ, 1(6106), 145-147. doi:10.1136/bmj.1.6106.145In This Issue of Diabetes Care. (2019). Diabetes Care, 43(1), 1-2. doi:10.2337/dc20-ti01Gremizzi, C., Vergani, A., Paloschi, V., & Secchi, A. (2010). Impact of pancreas transplantation on type 1 diabetes-related complications. Current Opinion in Organ Transplantation, 15(1), 119-123. doi:10.1097/mot.0b013e32833552bcKennedy, W. R., Navarro, X., Goetz, F. C., Sutherland, D. E. R., & Najarian, J. S. (1990). Effects of Pancreatic Transplantation on Diabetic Neuropathy. New England Journal of Medicine, 322(15), 1031-1037. doi:10.1056/nejm199004123221503Bouček, P., Bartoš, V., Vaněk, I., Hýža, Z., & Skibová, J. (1991). Diabetic autonomic neuropathy after pancreas and kidney transplantation. Diabetologia, 34(S1), S121-S124. doi:10.1007/bf00587636Navarro, X., Sutherland, D. E. R., & Kennedy, W. R. (1997). Long-term effects of pancreatic transplantation on diabetic neuropathy. Annals of Neurology, 42(5), 727-736. doi:10.1002/ana.410420509Solders, G., Tyden, G., Persson, A., & Groth, C.-G. (1992). Improvement of Nerve Conduction in Diabetic Neuropathy: A Follow-up Study 4 Yr After Combined Pancreatic and Renal Transplantation. Diabetes, 41(8), 946-951. doi:10.2337/diab.41.8.946Argente-Pla, M., Martínez-Millana, A., Del Olmo-García, M. I., Espí-Reig, J., Pérez-Rojas, J., Traver-Salcedo, V., & Merino-Torres, J. F. (2019). Autoimmune Diabetes Recurrence After Pancreas Transplantation: Diagnosis, Management, and Literature Review. Annals of Transplantation, 24, 608-616. doi:10.12659/aot.920106Sundkvist, G., & Lilja, B. (1985). Autonomic Neuropathy in Diabetes Mellitus: A Follow-up Study. Diabetes Care, 8(2), 129-133. doi:10.2337/diacare.8.2.129Boulton, A. J. M., Vinik, A. I., Arezzo, J. C., Bril, V., Feldman, E. L., Freeman, R., … Ziegler, D. (2005). Diabetic Neuropathies: A statement by the American Diabetes Association. Diabetes Care, 28(4), 956-962. doi:10.2337/diacare.28.4.956Ewing, D. J., Martyn, C. N., Young, R. J., & Clarke, B. F. (1985). The Value of Cardiovascular Autonomic Function Tests: 10 Years Experience in Diabetes. Diabetes Care, 8(5), 491-498. doi:10.2337/diacare.8.5.491Spallone, V., Bellavere, F., Scionti, L., Maule, S., Quadri, R., Bax, G., … Morganti, R. (2011). Recommendations for the use of cardiovascular tests in diagnosing diabetic autonomic neuropathy☆. Nutrition, Metabolism and Cardiovascular Diseases, 21(1), 69-78. doi:10.1016/j.numecd.2010.07.005Agashe, S., & Petak, S. (2018). Cardiac Autonomic Neuropathy in Diabetes Mellitus. Methodist DeBakey Cardiovascular Journal, 14(4), 251. doi:10.14797/mdcj-14-4-251Valensi, P., Pariès, J., & Attali, J. . (2003). Cardiac autonomic neuropathy in diabetic patients: influence of diabetes duration, obesity, and microangiopathic complications—the french multicenter study. Metabolism, 52(7), 815-820. doi:10.1016/s0026-0495(03)00095-7Tesfaye, S., Boulton, A. J. M., Dyck, P. J., Freeman, R., Horowitz, M., … Kempler, P. (2010). Diabetic Neuropathies: Update on Definitions, Diagnostic Criteria, Estimation of Severity, and Treatments. Diabetes Care, 33(10), 2285-2293. doi:10.2337/dc10-1303Benjamini, Y., & Hochberg, Y. (1995). Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing. Journal of the Royal Statistical Society: Series B (Methodological), 57(1), 289-300. doi:10.1111/j.2517-6161.1995.tb02031.xAdler, G. K., Bonyhay, I., Failing, H., Waring, E., Dotson, S., & Freeman, R. (2008). Antecedent Hypoglycemia Impairs Autonomic Cardiovascular Function: Implications for Rigorous Glycemic Control. Diabetes, 58(2), 360-366. doi:10.2337/db08-1153HATHAWAY, D. K., ABELL, T., CARDOSO, S., HARTWIG, M. S., GEBELY, S. E., & Gaber, A. O. (1994). IMPROVEMENT IN AUTONOMIC AND GASTRIC FUNCTION FOLLOWING PANCREAS-KIDNEY VERSUS KIDNEY-ALONE TRANSPLANTATION AND THE CORRELATION WITH QUALITY OF LIFE1,2. Transplantation, 57(6), 816-822. doi:10.1097/00007890-199403270-00008Arnold, R., Pussell, B. A., Pianta, T. J., Lin, C. S.-Y., Kiernan, M. C., & Krishnan, A. V. (2013). Association Between Calcineurin Inhibitor Treatment and Peripheral Nerve Dysfunction in Renal Transplant Recipients. American Journal of Transplantation, 13(9), 2426-2432. doi:10.1111/ajt.12324Vinik, A. I., Maser, R. E., Mitchell, B. D., & Freeman, R. (2003). Diabetic Autonomic Neuropathy. Diabetes Care, 26(5), 1553-1579. doi:10.2337/diacare.26.5.1553Suarez, G. A. (2005). Sudden cardiac death in diabetes mellitus: risk factors in the Rochester diabetic neuropathy study. Journal of Neurology, Neurosurgery & Psychiatry, 76(2), 240-245. doi:10.1136/jnnp.2004.039339Dinh, W., Füth, R., Lankisch, M., Bansemir, L., Nickl, W., Scheffold, T., … Ziegler, D. (2010). Cardiovascular autonomic neuropathy contributes to left ventricular diastolic dysfunction in subjects with Type 2 diabetes and impaired glucose tolerance undergoing coronary angiography. Diabetic Medicine, no-no. doi:10.1111/j.1464-5491.2010.03221.xWackers, F. J. T., Young, L. H., Inzucchi, S. E., Chyun, D. A., Davey, J. A., Barrett, E. J., … Iskandrian, A. E. (2004). Detection of Silent Myocardial Ischemia in Asymptomatic Diabetic Subjects: The DIAD study. Diabetes Care, 27(8), 1954-1961. doi:10.2337/diacare.27.8.1954Astrup, A. S., Tarnow, L., Rossing, P., Hansen, B. V., Hilsted, J., & Parving, H.-H. (2006). Cardiac Autonomic Neuropathy Predicts Cardiovascular Morbidity and Mortality in Type 1 Diabetic Patients With Diabetic Nephropathy. Diabetes Care, 29(2), 334-339. doi:10.2337/diacare.29.02.06.dc05-1242Pop-Busui, R., Evans, G. W., Gerstein, H. C., Fonseca, V., Fleg, J. L., … Hoogwerf, B. J. (2010). Effects of Cardiac Autonomic Dysfunction on Mortality Risk in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Trial. Diabetes Care, 33(7), 1578-1584. doi:10.2337/dc10-0125Kempler, P., Tesfaye, S., Chaturvedi, N., Stevens, L. K., Webb, D. J., … Eaton, S. (2002). Autonomic neuropathy is associated with increased cardiovascular risk factors: the EURODIAB IDDM Complications Study. Diabetic Medicine, 19(11), 900-909. doi:10.1046/j.1464-5491.2002.00821.xPop-Busui, R., Cleary, P. A., Braffett, B. H., Martin, C. L., Herman, W. H., Low, P. A., … Bluemke, D. A. (2013). Association Between Cardiovascular Autonomic Neuropathy and Left Ventricular Dysfunction. Journal of the American College of Cardiology, 61(4), 447-454. doi:10.1016/j.jacc.2012.10.02

Gestión de recursos electrónicos en el Consorcio de Bibliotecas Universitarias Andaluzas. Una experiencia de cooperación bibliotecaria en entornos digitales

En la actualidad es difícil encontrar bibliotecas digitales nacidas bajo este concepto. La denominación representa más bien la evolución de las bibliotecas tradicionales, sobre todo universitarias, hacia un entorno en que la proliferación de recursos electrónicos en lo últimos años ha cambiado no sólo el concepto de biblioteca sino el mismo concepto de investigación, de estudio y por tanto de trabajo. Bajo esta premisa, en que señalamos recursos electrónicos como origen de bibliotecas digitales, son los consorcios bibliotecarios los que han contribuido de forma extraordinaria y definitiva a su desarrollo. La vieja idea de cooperación se ha materializado en ellos no sólo en la disposición de recursos propios sino que ha encontrado su máxima expresión en el entorno consorciado en que la adquisición y gestión compartidas han sido necesarias para dar respuesta a las necesidades que impone la proliferación de recursos electrónicos en las nuevas bibliotecas digitales. Claro ejemplo de esta afirmación, de estas nuevas formas de organización lo constituye el recientemente creado Grupo de Trabajo de Recursos Electrónicos del Consorcio de Bibliotecas Universitarias Andaluzas (CBUA), cuyo proyecto de cooperación y gestión contribuye a facilitar el acceso a la colección digital en el ámbito universitario andaluz. Se presenta el trabajo realizado hasta la fecha por el Grupo, así como las perspectivas de futuro. Se exponen la metodología de trabajo empleada, las líneas de actuación, las acciones realizadas, las herramientas utilizadas para optimizar la calidad en el acceso y difusión de los recursos de los que disponemos. Palabras clave: bibliotecas universitarias, bibliotecas digitales, gestión de recursos electrónicos, consorcios de bibliotecas, cooperación bibliotecaria

Increased risk of MAFLD and liver fibrosis in inflammatory bowel disease independent of classic metabolic risk factors

ackground & Aims There is conflicting evidence regarding the prevalence of and risk factors for metabolic-associated fatty liver disease (MAFLD) in patients with inflammatory bowel disease (IBD). We aimed to determine MAFLD prevalence and risk factors in IBD patients. Methods Cross-sectional, case-control study included all consecutive IBD patients treated at 2 different university hospitals. Controls were subjects randomly selected from the general population and matched by age, sex, type 2 diabetes status, and body mass index in a 1:2 ratio. MAFLD was confirmed by controlled attenuation parameter. Liver biopsies were collected when MAFLD with significant liver fibrosis was suspected. In addition, age- and fibrosis stage-paired non-IBD patients with biopsy-proven MAFLD served as a secondary control group. Results Eight hundred thirty-one IBD patients and 1718 controls were included. The prevalence of MAFLD and advanced liver fibrosis (transient elastography ≥9.7 kPa) was 42.00% and 9.50%, respectively, in IBD patients and 32.77% and 2.31%, respectively, in the general population (P < .001). A diagnosis of IBD was an independent predictor of MAFLD (adjusted odds ratio, 1.99; P < .001) and an independent risk factor for advanced liver fibrosis (adjusted odds ratio, 5.55; P < .001). Liver biopsies were obtained from 40 IBD patients; MAFLD was confirmed in all cases, and fibrosis of any degree was confirmed in 25 of 40 cases (62.5%). Body mass index and type 2 diabetes prevalence were significantly lower in IBD-MAFLD patients than in severity-paired patients with biopsy-proven MAFLD. Conclusions MAFLD and liver fibrosis are particularly prevalent in IBD patients, regardless of the influence of classic metabolic risk factors.Acknowledgements: The authors report funding support from the Spanish Instituto de Salud Carlos III-FEDER Grant (FIS - PI18/01304) related to this manuscript

CALIFA, the Calar Alto Legacy Integral Field Area survey: III. Second public data release

García-Benito, R. et. al.© ESO, 2015. This paper describes the Second Public Data Release (DR2) of the Calar Alto Legacy Integral Field Area (CALIFA) survey. The data for 200 objects are made public, including the 100 galaxies of the First Public Data Release (DR1). Data were obtained with the integral-field spectrograph PMAS/PPak mounted on the 3.5 m telescope at the Calar Alto observatory. Two different spectral setups are available for each galaxy, (i) a low-resolution V500 setup covering the wavelength range 3745-7500 Å with a spectral resolution of 6.0 Å (FWHM); and (ii) a medium-resolution V1200 setup covering the wavelength range 3650-4840 Å with a spectral resolution of 2.3 Å (FWHM). The sample covers a redshift range between 0.005 and 0.03, with a wide range of properties in the color-magnitude diagram, stellar mass, ionization conditions, and morphological types. All the cubes in the data release were reduced with the latest pipeline, which includes improvedspectrophotometric calibration, spatial registration, and spatial resolution. The spectrophotometric calibration is better than 6% and the median spatial resolution is 2.4. In total, the second data release contains over 1.5 million spectra.R.G.B., R.G.D., and E.P. are supported by the Spanish Ministerio de Ciencia e Innovacion under grant AYA2010-15081. S.Z. is supported by the EU Marie Curie Integration Grant >SteMaGE> Nr. PCIG12-GA-2012-326466 (Call Identifier: FP7-PEOPLE-2012 CIG). J.F.B. acknowledges support from grants AYA2010-21322-C03-02 and AIB-2010-DE-00227 from the Spanish Ministry of Economy and Competitiveness (MINECO), as well as from the FP7 Marie Curie Actions of the European Commission, via the Initial Training Network DAGAL under REA grant agreement number 289313. Support for L.G. is provided by the Ministry of Economy, Development, and Tourism's Millennium Science Initiative through grant IC12009, awarded to The Millennium Institute of Astrophysics, M.A.S.L.G. also acknowledges support by CONICYT through FONDECYT grant 3140566. A.G. acknowledges support from the FP7/2007-2013 under grant agreement n. 267251 (AstroFIt). J.M.G. acknowledges support from the Fundacao para a Ciencia e a Tecnologia (FCT) through the Fellowship SFRH/BPD/66958/2009 from FCT (Portugal) and research grant PTDC/FIS-AST/3214/2012. RAM was funded by the Spanish programme of International Campus of Excellence Moncloa (CEI). J.M.A. acknowledges support from the European Research Council Starting Grant (SEDmorph; P.I. V. Wild). I.M., J.M. and A.d.O. acknowledge the support by the projects AYA2010-15196 from the Spanish Ministerio de Ciencia e Innovacion and TIC 114 and PO08-TIC-3531 from Junta de Andalucia. AMI acknowledges support from Agence Nationale de la Recherche through the STILISM project (ANR-12-BS05-0016-02). M.M. acknowledges financial support from AYA2010-21887-C04-02 from the Ministerio de Economia y Competitividad. P.P. is supported by an FCT Investigador 2013 Contract, funded by FCT/MCTES (Portugal) and POPH/FSE (EC). P.P. acknowledges support by FCT under project FCOMP-01-0124-FEDER-029170 (Reference FCT PTDC/FIS-AST/3214/2012), funded by FCT-MEC (PIDDAC) and FEDER (COMPETE). T.R.L. thanks the support of the Spanish Ministerio de Educacion, Cultura y Deporte by means of the FPU fellowship. PSB acknowledges support from the Ramon y Cajal program, grant ATA2010-21322-C03-02 from the Spanish Ministry of Economy and Competitiveness (MINECO). C.J.W. acknowledges support through the Marie Curie Career Integration Grant 303912. V.W. acknowledges support from the European Research Council Starting Grant (SEDMorph P.I. V. Wild) and European Career Re-integration Grant (Phiz-Ev P.I.V. Wild). Y.A. acknowledges financial support from the Ramon y Cajal programme (RyC-2011-09461) and project AYA2013-47742-C4-3-P, both managed by the Ministerio de Economia y Competitividad, as well as the >Study of Emission-Line Galaxies with Integral-Field Spectroscopy> (SELGIFS) programme, funded by the EU (FP7-PEOPLE-2013-IRSES-612701) within the Marie-Sklodowska-Curie Actions schemePeer Reviewe

On-line breath analysis of volatile organic compounds as a method for colorectal cancer detection

Background: Analysis of exhaled volatile organic compounds (VOCs) in breath is an emerging approach for cancer diagnosis, but little is known about its potential use as a biomarker for colorectal cancer (CRC). We investigated whether a combination of VOCs could distinct CRC patients from healthy volunteers. Methods: In a pilot study, we prospectively analyzed breath exhalations of 38 CRC patient and 43 healthy controls all scheduled for colonoscopy, older than 50 in the average-risk category. The samples were ionized and analyzed using a Secondary ElectroSpray Ionization (SESI) coupled with a Time-of-Flight Mass Spectrometer (SESI-MS). After a minimum of 2 hours fasting, volunteers deeply exhaled into the system. Each test requires three soft exhalations and takes less than ten minutes. No breath condensate or collection are required and VOCs masses are detected in real time, also allowing for a spirometric profile to be analyzed along with the VOCs. A new sampling system precludes ambient air from entering the system, so background contamination is reduced by an overall factor of ten. Potential confounding variables from the patient or the environment that could interfere with results were analyzed. Results: 255 VOCs, with masses ranging from 30 to 431 Dalton have been identified in the exhaled breath. Using a classification technique based on the ROC curve for each VOC, a set of 9 biomarkers discriminating the presence of CRC from healthy volunteers was obtained, showing an average recognition rate of 81.94%, a sensitivity of 87.04% and specificity of 76.85%. Conclusions: A combination of cualitative and cuantitative analysis of VOCs in the exhaled breath could be a powerful diagnostic tool for average-risk CRC population. These results should be taken with precaution, as many endogenous or exogenous contaminants could interfere as confounding variables. On-line analysis with SESI-MS is less time-consuming and doesn’t need sample preparation. We are recruiting in a new pilot study including breath cleaning procedures and spirometric analysis incorporated into the postprocessing algorithms, to better control for confounding variables