Fiscalidad de la discapacidad

Este Trabajo de Fin de Grado recoge un análisis del tratamiento fiscal que reciben las personas con discapacidad en España. Se trata de un estudio a través de las figuras más importantes del sistema tributario español. Durante la primera mitad se realiza el análisis teórico y la recopilación de los aspectos que pueden resultar más relevantes para las personas con discapacidad en impuestos como IRPF, IVA, Patrimonio, Sucesiones y Donaciones, Transmisiones Patrimoniales y AJD, Matriculación y Circulación. En la segunda mitad llevaremos a cabo un ejercicio práctico que nos permita cuantificar el efecto de estas medidas en el IRPF, contemplando posibles diferencias entre comunidades autónomas.<br /

Exploring the potential of phenolic compounds from the coffee pulp in preventing cellular oxidative stress after in vitro digestion

The coffee pulp, a by-product of the coffee industry, contains a high concentration of phenolic compounds and caffeine. Simulated gastrointestinal digestion may influence these active compounds’ bioaccessibility, bioavailability, and bioactivity. Understanding the impact of the digestive metabolism on the coffee pulp's phenolic composition and its effect on cellular oxidative stress biomarkers is essential. In this study, we evaluated the influence of in vitro gastrointestinal digestion of the coffee pulp flour (CPF) and extract (CPE) on their phenolic profile, radical scavenging capacity, cellular antioxidant activity, and cytoprotective properties in intestinal epithelial (IEC-6) and hepatic (HepG2) cells. The CPF and the CPE contained a high amount of caffeine and phenolic compounds, predominantly phenolic acids (3′,4′-dihydroxycinnamoylquinic and 3,4-dihydroxybenzoic acids) and flavonoids (3,3′,4′,5,7-pentahydroxyflavone derivatives). Simulated digestion resulted in increased antioxidant capacity, and both the CPF and the CPE demonstrated free radical scavenging abilities even after in vitro digestion. The CPF and the CPE did not induce cytotoxicity in intestinal and hepatic cells, and both matrices exhibited the ability to scavenge intracellular reactive oxygen species. The coffee pulp treatments prevented the decrease of glutathione, thiol groups, and superoxide dismutase and catalase enzymatic activities evoked by tert-butyl hydroperoxide elicitation in IEC-6 and HepG2 cells. Our findings suggest that the coffee pulp could be used as a potent food ingredient for preventing cellular oxidative stress due to its high content of antioxidant compoundsThis research was funded by the COCARDIOLAC project from the Spanish Ministry of Science and Innovation (RTI 2018-097504-B-I00) and the Excellence Line for University Teaching Staff within the Multiannual Agreement between the Community of Madrid and the UAM (2019-2023). M. Rebollo-Hernanz received funding from the FPU program of the Ministry of Universities for his predoctoral fellowship (FPU15/04238) and his grant for the requalification of the Spanish university system (CA1/RSUE/2021-00656

https://doi.org/10.1016/j.chemosphere.2023.140364

The fate of the antibiotic sulfamethoxazole in amended soils remains unclear, moreover in basic soils. This work aimed to assess the adsorption, leaching, and biodegradation of sulfamethoxazole in unamended and biochar from holm oak pruning (BC)- and green compost from urban pruning (CG)-amended basic soil. Adsorption properties of the organic amendments and soil were determined by adsorption isotherms of sulfamethoxazole. The leachability of this antibiotic from unamended (Soil) and BC- (Soil + BC) and GC- (Soil + GC) amended soil was determined by leaching columns using water as solvent up to 250 mL. Finally, Soil, Soil + BC, and Soil + GC were spiked with sulfamethoxazole and incubated for 42 days. The degradation rate and microbial activity were periodically monitored. Adsorption isotherms showed poor adsorption of sulfamethoxazole in unamended basic soil. BC and CG showed good adsorption capacity. Soil + BC and Soil + GC increased the sulfamethoxazole adsorption capacity of the soil. The low sulfamethoxazole adsorption of Soil produced quick and intense sulfamethoxazole leaching. Soil + BC reduced the sulfamethoxazole leaching, unlike to Soil + GC which enhanced it concerning Soil. The pH of adsorption isotherms and leachates indicate that the anion of sulfamethoxazole was the major specie in unamended and amended soil. CG enhanced the microbial activity of the soil and promoted the degradability of sulfamethoxazole. In contrast, the high adsorption and low biostimulation effect of BC in soil reduced the degradation of sulfamethoxazole. The half-life of sulfamethoxazole was 2.6, 6.9, and 11.9 days for Soil + GC, Soil, and Soil + BC, respectively. This work shows the benefits and risks of two organic amendments, BC and GC, for the environmental fate of sulfamethoxazole. The different nature of the organic carbon of the amendments was responsible for the different effects on the soilPDC 2021-120744-I0

Maternal and neonatal factors modulating breast milk cytokines in the first month of lactation

Breast milk (BM) cytokines support and modulate infant immunity, being particularly relevant in premature neonates with adverse outcomes (NAO). This study aimed to examine, in a cohort of Spanish breastfeeding women, changes in BM cytokines in the first month of lactation, their modulation by neonatal factors (sex, gestational age, and NAO), maternal factors (obstetric complications, C-section, and diet), and their relationship with oxidative status. Sixty-three mother-neonate dyads were studied at days 7 and 28 of lactation. Dietary habits were assessed by a 72-h dietary recall, and the maternal dietary inflammatory index (mDII) was calculated. BM cytokines (IL-10, IL-13, IL-8, MCP-1, and TNFα) were assessed by ultra-sensitive chemiluminescence. Total antioxidant capacity was assessed by the ABTS method and lipid peroxidation by the MDA+HNE kit. From days 7 to 28 of lactation, the levels of IL-10 and TNFα remained stable, while IL-13 increased (β = 0.85 ± 0.12, p < 0.001) and IL-8 and MCP-1 levels decreased (β = −0.64 ± 0.27, p = 0.019; β = −0.98 ± 0.22, p < 0.001; respectively). Antioxidant capacity and lipid peroxidation also decrease during lactation. Neonatal sex did not influence any of the cytokines, but BM from mothers with male infants had a higher antioxidant capacity. Gestational age was associated with male sex and NAO, being inversely correlated with the BM proinflammatory cytokines IL-8, MCP-1, and TNFα. From days 7 to 28 of lactation, BM from women with NAO infants increased MCP-1 levels and had a larger drop in antioxidant capacity, with the opposite trend in lipid peroxidation. MCP-1 was also significantly higher in women undergoing C-section; this cytokine declined in women who decreased mDII during lactation, while IL-10 increased. Linear mixed regression models evidenced that the most important factors modulating BM cytokines were lactation period and gestational age. In conclusion, during the first month of lactation, BM cytokines shift towards an anti-inflammatory profile, influenced mainly by prematurity. BM MCP-1 is associated with maternal and neonatal inflammatory processe

Valorization of coffee pulp as bioactive food ingredient by sustainable extraction methodologies

Coffee pulp is an underutilized by-product of coffee industrial production rich in bioactive compounds such as phenolic compounds, caffeine, and dietary fiber. The widely known antioxidant, anti-inflammatory, anti-aging, antimicrobial and hepatoprotective health-promoting properties attributed to mentioned compounds enhance the use of coffee pulp as a bioactive food ingredient. Furthermore, the application of green sustainable extraction techniques pursuing highly efficient and selective extraction processes promotes this by-product exploitation in food science. Hence, this review gathers the available information relative to the impact of the extraction processes on the bioactive compound's recovery from coffee pulp, providing an overview of the most recent advances. An in-depth comparison workout between conventional and alternative extraction methods was performed to identify the most suitable techniques for coffee pulp valorization as functional ingredient until date. A critical discussion focused on advantages and drawbacks of the extraction methods applied to coffee pulp was included together a prospective of emerging extraction techniques

Cocoa Shell Extract Reduces Blood Pressure in Aged Hypertensive Rats via the Cardiovascular Upregulation of Endothelial Nitric Oxide Synthase and Nuclear Factor (Erythroid-Derived 2)-like 2 Protein Expression

Cocoa shell is a by-product of cocoa manufacturing. We obtained an aqueous extract (CSE) rich in polyphenols and methylxanthines with antioxidant and vasodilatory properties. We aimed to evaluate the effects of CSE supplementation in aged hypertensive rats on blood pressure and the mechanism implicated. Eighteen-month-old male and female rats exposed to undernutrition during the fetal period who developed hypertension, with a milder form in females, were used (MUN rats). Systolic blood pressure (SBP; tail-cuff plethysmography) and a blood sample were obtained before (basal) and after CSE supplementation (250 mg/kg; 2 weeks, 5 days/week). Plasma SOD, catalase activity, GSH, carbonyls, and lipid peroxidation were assessed (spectrophotometry). In hearts and aortas from supplemented and non-supplemented age-matched rats, we evaluated the protein expression of SOD-2, catalase, HO-1, UCP-2, total and phosphorylated Nrf2 and e-NOS (Western blot), and aorta media thickness (confocal microscopy). MUN males had higher SBP compared with females, which was reduced via CSE supplementation with a significant difference for group, sex, and interaction effect. After supplementation with plasma, GSH, but not catalase or SOD, was elevated in males and females. Compared with non-supplemented rats, CSE-supplemented males and females exhibited increased aorta e-NOS and Nrf2 protein expression and cardiac phosphorylated-Nrf2, without changes in SOD-2, catalase, HO-1, or UCP-2 in cardiovascular tissues or aorta remodeling. In conclusion, CSE supplementation induces antihypertensive actions related to the upregulation of e-NOS and Nrf2 expression and GSH elevation and a possible direct antioxidant effect of CSE bioactive components. Two weeks of supplementation may be insufficient to increase antioxidant enzyme expression

Cocoa shell extract reduces blood pressure in aged hypertensive rats via the cardiovascular upregulation of endothelial nitric oxide synthase and nuclear factor (erythroid-derived 2)-like 2 protein expression

This article belongs to the Special Issue Antioxidant Foods and Cardiometabolic Health - 2nd Edition.Cocoa shell is a by-product of cocoa manufacturing. We obtained an aqueous extract (CSE) rich in polyphenols and methylxanthines with antioxidant and vasodilatory properties. We aimed to evaluate the effects of CSE supplementation in aged hypertensive rats on blood pressure and the mechanism implicated. Eighteen-month-old male and female rats exposed to undernutrition during the fetal period who developed hypertension, with a milder form in females, were used (MUN rats). Systolic blood pressure (SBP; tail-cuff plethysmography) and a blood sample were obtained before (basal) and after CSE supplementation (250 mg/kg; 2 weeks, 5 days/week). Plasma SOD, catalase activity, GSH, carbonyls, and lipid peroxidation were assessed (spectrophotometry). In hearts and aortas from supplemented and non-supplemented age-matched rats, we evaluated the protein expression of SOD-2, catalase, HO-1, UCP-2, total and phosphorylated Nrf2 and e-NOS (Western blot), and aorta media thickness (confocal microscopy). MUN males had higher SBP compared with females, which was reduced via CSE supplementation with a significant difference for group, sex, and interaction effect. After supplementation with plasma, GSH, but not catalase or SOD, was elevated in males and females. Compared with non-supplemented rats, CSE-supplemented males and females exhibited increased aorta e-NOS and Nrf2 protein expression and cardiac phosphorylated-Nrf2, without changes in SOD-2, catalase, HO-1, or UCP-2 in cardiovascular tissues or aorta remodeling. In conclusion, CSE supplementation induces antihypertensive actions related to the upregulation of e-NOS and Nrf2 expression and GSH elevation and a possible direct antioxidant effect of CSE bioactive components. Two weeks of supplementation may be insufficient to increase antioxidant enzyme expression.This research was funded by the Ministerio de Ciencia, Innovación y Universidades (Spain), grant number RTI2018-097504-B-I00, co-financed with FEDER funds and the Excellence Line (2019–2023) for University Teaching Staff within the Multiannual Agreement between the Community of Madrid (Spain)—UAM.Peer reviewe

Feasibility of the Implementation of LESS-CHRON in Clinical Practice: A Pilot Intervention Study in Older Patients With Multimorbidity

© The Author(s) 2023. Published by Oxford University Press on behalf of The Gerontological Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact [email protected][Background and Objectives] Potentially inappropriate medication refers to the prescription of drugs whose risks outweigh the benefits. There are different pharmacotherapeutic optimization strategies to detect and avoid potentially inappropriate medications (PIMs), namely deprescription. The List of Evidence-Based Deprescribing for Chronic Patients (LESS-CHRON) criteria were designed as a tool to systematize the deprescribing process. LESS-CHRON has established itself as one of the most suitable to be applied in older (≥65 years) multimorbid patients. However, it has not been applied to these patients, to measure the impact on their treatment. For this reason, a pilot study was conducted to analyze the feasibility of implementing this tool in a care pathway.[Research Design and Methods] A pre–post quasi-experimental study was conducted. Older outpatients with multimorbidity from the Internal Medicine Unit of a benchmark Hospital were included. The main variable was feasibility in clinical practice, understood as the likelihood that the deprescribing intervention recommended by the pharmacist would be applied to the patient. Success rate, therapeutic, and anticholinergic burden, and other variables related to health care utilization were analyzed.[Results] A total of 95 deprescribing reports were prepared. Forty-three were evaluated by the physician who assessed the recommendations made by pharmacists. This translates into an implementation feasibility of 45.3%. The application of LESS-CHRON identified 92 PIMs. The acceptance rate was 76.7% and after 3 months 82.7% of the stopped drugs remained deprescribed. A reduction in anticholinergic burden and enhanced adherence was achieved. However, no improvement was found in clinical or health care utilization variables.[Discussion and Implications] The implementation of the tool in a care pathway is feasible. The intervention has achieved great acceptance and deprescribing has been successful in a not insignificant percentage. Future studies with a larger sample size are necessary to obtain more robust results in clinical and health care utilization variables.Peer reviewe

La enfermería ante el reto de la promoción de la salud en pacientes y cuidadores con riesgo de deterioro de la integridad cutánea o con heridas (1ª parte)

El deterioro de la integridad de la piel y tejidos que supone el desarrollo de una úlcera, deteriora la calidad de vida de los afectados, disminuye su autonomía e implica un aumento de la morbilidad e incluso de la mortalidad subyacentes, que a su vez implican un alto coste socioeconómico. La educación para la Salud (EpS), constituye una herramienta eficaz para mejorar el nivel de autonomía de los pacientes, disminuir el riesgo de este tipo de problemas y promover la implicación de pacientes y familiares en la prevención y tratamiento del problema, sin apenas consumir recursos, más allá del tiempo e implicación de los profesionales asistenciales.The deterioration of the integrity of the skin and tissues involved in the development of an ulcer, reduces the quality of life of those affected, decreases its autonomy and involves an increase in morbidity and even mortality underlying, which in turn imply a high socio-economic cost. Health education, is an effective tool to improve the level of autonomy of the patients, decrease the risk of this type of problems and promote the involvement of patients and relatives in the prevention and treatment of the problem, without hardly consume resources beyond time and involvement of health care professionals

La enfermería ante el reto de la promoción de la salud en pacientes y cuidadores con riesgo de deterioro de la integridad cutánea o con heridas ( 2ª parte )

Las habilidades y técnicas de comunicación son imprescindibles para ser capaces de lograr transmitir a los pacientes y cuidadores toda la información que precisan para mejorar sus autocuidados y su calidad de vida al tiempo que se implican y comprometen con el control de su enfermedad. Las técnicas grupales y concretamente los talleres nos ofrecen múltiples beneficios en este ámbito. Para finalizar el artículo se desarrolla un ejemplo práctico de “Taller de educación para la salud grupal a cuidadores principales de pacientes con riesgo de deterioro de la integridad cutánea