A Genomic Snapshot of the SARS-CoV-2 Pandemic in the Balearic Islands

7 páginas, 3 figurasObjective: To analyze the SARS-CoV-2 genomic epidemiology in the Balearic Islands, a unique setting in which the course of the pandemic has been influenced by a complex interplay between insularity, severe social restrictions and tourism travels. Methods: Since the onset of the pandemic, more than 2,700 SARS-CoV-2 positive respiratory samples have been randomly selected and sequenced in the Balearic Islands. Genetic diversity of circulating variants was assessed by lineage assignment of consensus whole genome sequences with PANGOLIN and investigation of additional spike mutations. Results: Consensus sequences were assigned to 46 different PANGO lineages and 75% of genomes were classified within a VOC, VUI, or VUM variant according to the WHO definitions. Highest genetic diversity was documented in the island of Majorca (42 different lineages detected). Globally, lineages B.1.1.7 and B.1.617.2/AY.X were identified as the 2 major lineages circulating in the Balearic Islands during the pandemic, distantly followed by lineages B.1.177/B.1.177.X. However, in Ibiza/Formentera lineage distribution was slightly different and lineage B.1.221 was the third most prevalent. Temporal distribution analysis showed that B.1 and B.1.5 lineages dominated the first epidemic wave, lineage B.1.177 dominated the second and third, and lineage B.1.617.2 the fourth. Of note, lineage B.1.1.7 became the most prevalent circulating lineage during first half of 2021; however, it was not associated with an increased in COVID-19 cases likely due to severe social restrictions and limited travels. Additional spike mutations were rarely documented with the exception of mutation S:Q613H which has been detected in several genomes (n = 25) since July 2021. Conclusion: Virus evolution, mainly driven by the acquisition and selection of spike substitutions conferring biological advantages, social restrictions, and size population are apparently key factors for explaining the epidemic patterns registered in the Balearic Islands.This work has been supported by the Instituto de Salud Carlos III of Spain through the project COV20/00140: Addressing unknowns of COVID-19 transmission and infection combining pathogen genomics and epidemiology to inform public health interventions and European Union HERA Incubator program through grant ECDC/HERA/2021/024 ECD.12241. CL-C was supported by a Juan Rodés contract (JR19/00003) from Instituto de Salud Carlos III.Peer reviewe

Universidad y sociedad: comunicación e integración en empresas e instituciones públicas y organizaciones no lucrativas. Renovación y vanguardia

Depto. de Teorías y Análisis de la ComunicaciónFac. de Ciencias de la InformaciónFALSEsubmitte

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

Prevención de Obesógenos Ambientales

Esta guía se ha realizado dentro del marco de los siguientes proyectos de investigación: Beca de Investigación de AEPap 2021 para la investigación en Nutrición Infantil en Pediatría de Atención Primaria. GP/EFSA/ENCO/2018/03 (European Food Safety Authority). PE-0250-2019 (Consejería de Salud de la Junta de Andalucía). P18-RT-4247 (Consejería de Economía, Conocimiento, Empresas y Universidad de la Junta de Andalucía). 30.BF.88.08.01 (Fundación MAPFRE).En esta guía nos gustaría introducir de manera sencilla, clara y práctica, teorías y técnicas que ayuden a combatir la obesidad infantil, un problema que está cada vez más presente en nuestra sociedad y que puede afectar indiscriminadamente a todas las etapas de la vida. Es un recopilatorio de los aspectos más relevantes en nuestra cotidianidad, realizado con términos, conceptos y ejemplos claros que permiten la comprensión de toda la unidad familiar. Nos adentramos en el novedoso mundo de los obesógenos ambientales y comprendemos el porqué y el cómo pueden dañar nuestra salud y la de nuestros pequeños. A lo largo de toda la guía, se han introducido sugerencias y propuestas que pueden ayudar al lector a incorporar estos nuevos u olvidados conocimientos y hábitos.Asociación Española de Pediatría de Atención Primaria (AEPap)Asociación Andaluza de Pediatría de Atención Primaria (AndAPap)Pediatría de Atención Primaria AEPap 2021European Food Safety Authority GP/EFSA/ENCO/2018/03Junta de Andalucía PE-0250-2019, P18-RT-4247Fundación MAPFRE 30.BF.88.08.0

Población y Mercados de Trabajo en América Latina. Temas Emergentes

La Asociación Latinoamericana de Población (ALAP) se enorgullece en presentar el libro número 19 de la Serie Investigaciones, titulado Población y mercados de trabajo en América Latina. Temas emergentes. Este libro colectivo constituye la tercera entrega de las propuestas seleccionadas en la Convocatoria para publicaciones realizada por el Consejo Directivo 2015-2016 de la ALAP. En dicha ocasión, las postulaciones fueron realizadas por las redes de investigación de la Asociación, quienes también se encargaron de la selección, evaluación y revisión de los artículos propuestos. En todos los casos, se trata de trabajos elaborados por integrantes de dichas redes, o que colaboran estrechamente con las mismas. Se espera con esta nueva contribución, continuar con la tarea de difundir el importante trabajo realizado en el marco de la ALAP y, simultáneamente, fortalecer la capacidad creativa y ejecutiva de las redes. Este texto en particular fue elaborado en el marco de la Red de Población y Trabajo de la ALAP, actualmente coordinada por Emma Liliana Navarrete y Ana Escoto. Desde su creación, en 2012, dicha Red trabaja intensamente en el logro de los siguientes objetivos: 1) elaborar investigaciones comparativas sobre la dinámica demográfica y las problemáticas del trabajo; 2) producir documentos conjuntos para conocer las políticas que en materia laboral se llevan a cabo en Amé- rica Latina con la finalidad de palear la crisis económica que se vive en la región, y 3) impulsar los estudios que parten de una concepción amplia del trabajo: trabajo remunerado y trabajo no remunerado (el trabajo doméstico y los cuidados)

Compilación de Proyectos de Investigacion de 1984-2002

Instituto Politecnico Nacional. UPIICS

Evolution over Time of Ventilatory Management and Outcome of Patients with Neurologic Disease∗

OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need for mechanical ventilation. Although volume-cycled ventilation remained the preferred ventilation mode, there was a significant (p &lt; 0.001) increment in the use of pressure support ventilation. The proportion of patients receiving a protective lung ventilation strategy was increased over time: 47% in 2004, 63% in 2010, and 65% in 2016 (p &lt; 0.001), as well as the duration of protective ventilation strategies: 406 days per 1,000 mechanical ventilation days in 2004, 523 days per 1,000 mechanical ventilation days in 2010, and 585 days per 1,000 mechanical ventilation days in 2016 (p &lt; 0.001). There were no differences in the length of stay in the ICU, mortality in the ICU, and mortality in hospital from 2004 to 2016. Independent risk factors for 28-day mortality were age greater than 75 years, Simplified Acute Physiology Score II greater than 50, the occurrence of organ dysfunction within first 48 hours after brain injury, and specific neurologic diseases such as hemorrhagic stroke, ischemic stroke, and brain trauma. CONCLUSIONS: More lung-protective ventilatory strategies have been implemented over years in neurologic patients with no effect on pulmonary complications or on survival. We found several prognostic factors on mortality such as advanced age, the severity of the disease, organ dysfunctions, and the etiology of neurologic disease