The university – society relationship through community intervention. Case study. Risk factors related to structural congenital anomalies in neonates at the Dr. Verdi Cevallos Balda Hospital

En América Latina, las anomalías congénitas, después de la prematuridad, son la segunda causa de muerte de recién nacidos y niños menores de 5 años. En Ecuador, las malformaciones congénitas mayores ocuparon la cuarta causa de mortalidad infantil en 2014. Las mismas pueden afectar gravemente a los enfermos, sus familias y la sociedad. En ocasiones es complejo identificar las causas que las generan. Por tal motivo, el objetivo de esta investigación fue demostrar el aporte de la intervención comunitaria en la detección de factores de riesgo relacionados con malformaciones congénitas en recién nacidos en el Hospital Dr. Verdi Cevallos Balda (Portoviejo, Ecuador) en el período de enero de 2018 a junio de 2019. Se realizó un estudio descriptivo, retrospectivo y transversal. La muestra estuvo constituida por 56 nacidos vivos que presentaron anomalías congénitas. Se determinó que los factores de riesgo más frecuentemente asociados a malformaciones congénitas fueron los infecciosos durante la gestación, edad materna mayor a 35 años, anemia y desnutrición de la madre, y obesidad; además del consumo de tabaco y presencia de un hijo anterior con anomalías. La mortalidad neonatal se asoció directamente a las anomalías congénitas estructurales.In Latin America, congenital anomalies, after prematurity, are the second leading cause of death in newborns and children under 5 years of age. In Ecuador, major congenital malformations were the fourth leading cause of infant mortality in 2014. They can seriously affect patients, their families and society. Sometimes it is complex to identify the causes that generate them. For this reason, the objective of this research was to demonstrate the contribution of community intervention in the detection of risk factors related to congenital malformations in newborns at the Dr. Verdi Cevallos Balda Hospital (Portoviejo, Ecuador) in the period of January from 2018 to June 2019. A descriptive, retrospective, and cross-sectional study was carried out. The sample consisted of 56 live births with congenital anomalies. It was determined that the risk factors most frequently associated with congenital malformations were infectious during gestation, maternal age over 35 years, anemia and malnutrition of the mother, and obesity; in addition to tobacco consumption and the presence of a previous child with abnormalities. Neonatal mortality was directly associated with structural congenital abnormalities

Obesidad de una población de escolares de Granada: evaluación de la eficacia de una intervención educativa

Objetivos: El objeto del presente trabajo es estudiar la prevalencia de la obesidad y el sobrepeso en una población de escolares y verificar la efectividad de la intervención educativa desarrollada sobre esos alumnos en términos de mejora de los valores percentilados del índice de masa corporal. Material: La población valorada está compuesta por 977 escolares de entre 9 y 17 años de edad, pertenecientes a 13 centros educativos públicos de la ciudad de Granada y de su provincia (España). Metodología: Se trata de un estudio longitudinal, analítico, multicéntrico y observacional de cohortes, desarrollado en tres fases. En primer lugar, valoración del estado nutricional, mediante técnicas antropométricas (peso, talla e índice de masa corporal, seis pliegues cutáneos y cuatro perímetros corporales) así como la presión arterial. Una segunda fase en la que se desarrolló la intervención educativa sobre la alimentación y el ejercicio físico. En la fase final se evaluó la efectividad de la intervención. Resultados: Se encontró una mayor prevalencia de obesidad en las chicas de entre 12 y 13 años (15,1%). En los chicos, la prevalencia de obesidad fue inferior hasta los 13 años, aunque después mostraron un creciente incremento de dicha prevalencia (12,6%). Se produjo una reducción significativa de los valores de IMC en los dos sexos, aunque más significativa entre las chicas. Conclusiones: Existe un incremento alarmante en la prevalencia de sobrepeso y obesidad entre la población valorada. La reducción significativa de las puntuaciones en el IMC confirma la efectividad de la intervención educativa desarrollada.Objectives: The objective of this research was to study the prevalence of obesity and excess weight in a population of school children and adolescents, and to verify the effectiveness of an educational intervention, as reflected in the variation of their body mass index values. Materials: The population sample was composed of 977 school children and adolescents from 9 to 17 years of age, belonging to 13 public elementary schools and high schools in the city and province of Granada (Spain). Methodology: This longitudinal cohort study was analytical, muticentric, and observational. It was carried out in three phases. The first phase involved the evaluation of the nutritional state of the sample population by means of anthropometric measurements (weight, height, body mass index, six skin folds and four body perimeters) as well as arterial blood pressure. The second phase entailed an educational intervention focusing on good nutritional habits and physical exercise. The third and final phase evaluated the effectiveness of the intervention. Results: A higher obesity prevalence (15.1%) was found in school girls between 12 and 13. In the case of boys, obesity prevalence was lower up to age 13 though afterwards, it progressively increased (12.6%). The educational intervention produced an important reduction in body mass index values in both sexes though this reduction was more significant in young females. Conclusions: There is a currently an alarming increase in obesity and overweight prevalence among the population evaluated in this study. The significant reduction in body mass index values resulting from this research confirmed the effectiveness of the educational intervention to reduce excess weight

Evaluación de la inmunogenicidad de una vacuna recombinante antivirus hepatitis B en mujeres adultas sanas, Santafé de Bogotá, D.C., julio 1997 - noviembre 1998

A hepatitis B antivirus pilot study was carried out to evaluate HEPRECOMB BERNA@ recombinant vaccine immunogenicity and the adverse effects which can be attributed to the vaccine and its application by using and comparing two different doses administered to healthy individuals who presented no clinical evidence of hepatic disease, no serological evidence of hepatic disease and no serological evidence of previous contact with HBV (Hepatitis B virus).The humoral in vivo response induced by the application of the vaccine was also monitored; 49 female volunteers from Santafé de Bogotá were included in the study and randomly divided into two groups. Group 1 was vaccinated with three 20 yg doses, whilst group 2 received three 10 ~g doses. In both groups the 0, 1 and 6 month scheme was used and women were observed for a period of 16 months.The inclusion criteria were: voluntary participation, 18 years or older and absence of anti HBsAg. Antibody titre was significantly greater in group 2 at 2"" and dth month of observation even though the titres were even at the end of the 71h and 16lh months. The present study concludes that the hepatitis B antivirus recombinant vaccine HEPRECOMB BERNA@ given in 10pg doses has a greater response in the first 2 months of observation than 2 0 ~ 9do ses, similar results being found at the end of the seventh month.The recommendation is that studies should be done on bigger populations.Este estudio se realizó con el propósito de evaluar la inmunogenicidad de la vacuna recombinante antivirus de la hepatitis B HEPRECOMB BERNABy el desarrollo de efectos secundarios atribuibles a la vacuna y a la vía de aplicación, empleando y comparando dos dosis distintas en individuos sanos sin evidencia clínica de enfermedad hepática y sin evidencia serológica de contacto previo con VHB (virus hepatitis 6). Igualmente se monitorizó la respuesta humoral in vivo inducida por la aplicación de esta vacuna. Se incluyeron 50 voluntarios del sexo femenino en Santafé de Bogotá, los cuales fueron divididos al azar en dos grupos: El grupo 1, vacunado con tres dosis de 20pg, y el grupo 2, vacunado con tres dosis de 10pg; en ambos grupos se utilizó el esquema O, 1, 6 meses y fueron observados durante 7 meses. Los criterios de inclusión en el estudio fueron la participación voluntaria, edad mayor de 18 años y ausencia de antiHBsAg. El título de anticuerpos fue significativamente mayor para el grupo 2 ( P= 0.03) a los dos y seis meses, aunque al séptimo mes los títulos se igualaron. El trabajo concluyó que lavacuna recombinante antivirus de la hepatitis B HEPRECOMB BERNA 8 con la dosis de 10pg tiene una mayor respuesta a los dos y seis meses de observación, que con la dosis de 20pg, llegando a resultados similares al séptimo mes. Se recomienda realizar estudios con una muestra mayor

Perceived control over menopausal hot flushes in mid-aged women

Background. Hot flushes (HFs) and night sweats are frequent complaints among both peri- and postmenopausal women. Perceived control of this complaint may vary from one population to another. Objective. To assess perceived control over menopausal HFs and determinant factors among mid-aged Ecuadorian women. Methods. In this cross-sectional study healthy women aged 40–59 years, seeking healthcare centres of eight main cities of Ecuador with more than 100,000 inhabitants, were assessed with the Menopause Rating Scale (MRS) and those presenting HFs were requested to fill out the Perceived Control Index (PCI) and a questionnaire containing socio-demographic data (female and partner). Results. A total of 1154 women participated in this study of which 56% presented HFs (n ¼ 646). According to the MRS, 29.1% and 9.1% of these HFs were graded as severe and very severe, respectively. Mean age of women presenting HFs was 49.5 + 5.2 years, with 51.9% having 12 years or less of education, 61.5% being postmenopausal and 47.2% living in high altitude. At the moment of the survey 13.9% were on hormone therapy, 12.8% on phytoestrogens and 7.1% on psychotropic drugs. There was a significant decreasing trend for PCI scores (total and difficulty in control items) from one menopausal stage to the next, with no differences observed for time since menopause onset. Despite this, logistic regression analysis determined that HF severity, as determined with the MRS, was the only single predictive factor related to lower HF perceived control (total PCI score 538) (OR: 1.83 CI 95% [1.15–2.90], p 5 0.01). Conclusion. As determined with the PCI, HF severity was related to a lower perceived control among mid-aged women.0000-0002-2545-4733Cuenc

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

Tetrahydropyrazolo[1,5-a]Pyrimidine-3-Carboxamide and N-Benzyl-6′,7′-Dihydrospiro[Piperidine-4,4′-Thieno[3,2-c]Pyran] analogues with bactericidal efficacy against Mycobacterium tuberculosis targeting MmpL3

Mycobacterium tuberculosis is a major human pathogen and the causative agent for the pulmonary disease, tuberculosis (TB). Current treatment programs to combat TB are under threat due to the emergence of multi-drug and extensively-drug resistant TB. As part of our efforts towards the discovery of new anti-tubercular leads, a number of potent tetrahydropyrazolo[1,5-a]pyrimidine-3-ca​rboxamide(THPP) and N-benzyl-6′,7′-dihydrospiro[piperidine-4,​4′-thieno[3,2-c]pyran](Spiro) analogues were recently identified against Mycobacterium tuberculosis and Mycobacterium bovis BCG through a high-throughput whole-cell screening campaign. Herein, we describe the attractive in vitro and in vivo anti-tubercular profiles of both lead series. The generation of M. tuberculosis spontaneous mutants and subsequent whole genome sequencing of several resistant mutants identified single mutations in the essential mmpL3 gene. This ‘genetic phenotype’ was further confirmed by a ‘chemical phenotype’, whereby M. bovis BCG treated with both the THPP and Spiro series resulted in the accumulation of trehalose monomycolate. In vivo efficacy evaluation of two optimized THPP and Spiro leads showed how the compounds were able to reduce >2 logs bacterial cfu counts in the lungs of infected mice

Timed Up and Go Test Performance as an Indicator of Fall History in Institutionalized Elderly: A Pilot Study

Background: Ageing is associated with sensory and physical declines and falling risk. Objective: To determine the association between 3 performance-based mobility tests and fall history. Methods: Fifty participants' mobility was assessed by Timed Up and Go (TUG) and 4- and 6-m walking tests (WT). Results: The TUG performance correlated with 4- and 6-m WT performance, and performance on 4-m WT positively correlated with 6-m WT. Only TUG performance showed a strong relationship to fall history. Conclusions: Performance tests could indicate the presence of fall history in the institutionalized older adults; the TUG being the most suitable compared with other common WT

Clinical characteristics and outcomes of thymoma-associated myasthenia gravis

[Background and purpose] Prognosis of myasthenia gravis (MG) in patients with thymoma is not well established. Moreover, it is not clear whether thymoma recurrence or unresectable lesions entail a worse prognosis of MG.[Methods] This multicenter study was based on data from a Spanish neurologist-driven MG registry. All patients were aged >18 years at onset and had anti-acetylcholine receptor antibodies. We compared the clinical data of thymomatous and nonthymomatous patients. Prognosis of patients with recurrent or nonresectable thymomas was assessed.[Results] We included 964 patients from 15 hospitals; 148 (15.4%) had thymoma-associated MG. Median follow-up time was 4.6 years. At onset, thymoma-associated MG patients were younger (52.0 vs. 60.4 years, p < 0.001), had more generalized symptoms (odds ratio [OR]: 3.02, 95% confidence interval [CI]: 1.95–4.68, p < 0.001) and more severe clinical forms according to the Myasthenia Gravis Foundation of America (MGFA) scale (OR: 1.6, 95% CI: 1.15–2.21, p = 0.005). Disease severity based on MGFA postintervention status (MGFA-PIS) was higher in thymomatous patients at 1 year, 5 years, and the end of follow-up. Treatment refractoriness and mortality were also higher (OR: 2.28, 95% CI: 1.43–3.63, p = 0.001; hazard ratio: 2.46, 95% CI: 1.47–4.14, p = 0.001). Myasthenic symptoms worsened in 13 of 27 patients with recurrences, but differences in long-term severity were not significant. Fifteen thymomatous patients had nonresectable thymomas with worse MGFA-PIS and higher mortality at the end of follow-up.[Conclusions] Thymoma-associated MG patients had more severe myasthenic symptoms and worse prognosis. Thymoma recurrence was frequently associated with transient worsening of MG, but long-term prognosis did not differ from nonrecurrent thymoma. Patients with nonresectable thymoma tended to present severe forms of MG.This work is supported by Fondo de Investigaciones Sanitarias (FIS) grant FIS19/01774, Instituto de Salud Carlos III and cofunded by the European Union (ERDF/ESF, A Way to Make Europe/Investing in Your Future). Rodrigo Álvarez-Velasco was supported by a PhD for Medical Doctors grant from the Pla Estratègic de Recerca i Innovació en Salut (PERIS), Generalitat de Catalunya (SLT008/18/00207). Elena Cortés-Vicente was supported by a Juan Rodés grant (JR19/00037) from the Fondo de Investigación en Salud, Instituto de Salud Carlos III, Ministry of Health (Spain).Peer reviewe

Un examen actualizado de la percepción de las barreras para la implementación de la farmacogenómica y la utilidad de los pares fármaco/gen en América Latina y el Caribe

La farmacogenómica (PGx) se considera un campo emergente en los países en desarrollo. La investigación sobre PGx en la región de América Latina y el Caribe (ALC) sigue siendo escasa, con información limitada en algunas poblaciones. Por lo tanto, las extrapolaciones son complicadas, especialmente en poblaciones mixtas. En este trabajo, revisamos y analizamos el conocimiento farmacogenómico entre la comunidad científica y clínica de ALC y examinamos las barreras para la aplicación clínica. Realizamos una búsqueda de publicaciones y ensayos clínicos en este campo en todo el mundo y evaluamos la contribución de ALC. A continuación, realizamos una encuesta regional estructurada que evaluó una lista de 14 barreras potenciales para la aplicación clínica de biomarcadores en función de su importancia. Además, se analizó una lista emparejada de 54 genes/fármacos para determinar una asociación entre los biomarcadores y la respuesta a la medicina genómica. Esta encuesta se comparó con una encuesta anterior realizada en 2014 para evaluar el progreso en la región. Los resultados de la búsqueda indicaron que los países de América Latina y el Caribe han contribuido con el 3,44% del total de publicaciones y el 2,45% de los ensayos clínicos relacionados con PGx en todo el mundo hasta el momento. Un total de 106 profesionales de 17 países respondieron a la encuesta. Se identificaron seis grandes grupos de obstáculos. A pesar de los continuos esfuerzos de la región en la última década, la principal barrera para la implementación de PGx en ALC sigue siendo la misma, la "necesidad de directrices, procesos y protocolos para la aplicación clínica de la farmacogenética/farmacogenómica". Las cuestiones de coste-eficacia se consideran factores críticos en la región. Los puntos relacionados con la reticencia de los clínicos son actualmente menos relevantes. Según los resultados de la encuesta, los pares gen/fármaco mejor clasificados (96%-99%) y percibidos como importantes fueron CYP2D6/tamoxifeno, CYP3A5/tacrolimus, CYP2D6/opioides, DPYD/fluoropirimidinas, TMPT/tiopurinas, CYP2D6/antidepresivos tricíclicos, CYP2C19/antidepresivos tricíclicos, NUDT15/tiopurinas, CYP2B6/efavirenz y CYP2C19/clopidogrel. En conclusión, aunque la contribución global de los países de ALC sigue siendo baja en el campo del PGx, se ha observado una mejora relevante en la región. La percepción de la utilidad de las pruebas PGx en la comunidad biomédica ha cambiado drásticamente, aumentando la concienciación entre los médicos, lo que sugiere un futuro prometedor en las aplicaciones clínicas de PGx en ALC.Pharmacogenomics (PGx) is considered an emergent field in developing countries. Research on PGx in the Latin American and the Caribbean (LAC) region remains scarce, with limited information in some populations. Thus, extrapolations are complicated, especially in mixed populations. In this paper, we reviewed and analyzed pharmacogenomic knowledge among the LAC scientific and clinical community and examined barriers to clinical application. We performed a search for publications and clinical trials in the field worldwide and evaluated the contribution of LAC. Next, we conducted a regional structured survey that evaluated a list of 14 potential barriers to the clinical implementation of biomarkers based on their importance. In addition, a paired list of 54 genes/drugs was analyzed to determine an association between biomarkers and response to genomic medicine. This survey was compared to a previous survey performed in 2014 to assess progress in the region. The search results indicated that Latin American and Caribbean countries have contributed 3.44% of the total publications and 2.45% of the PGx-related clinical trials worldwide thus far. A total of 106 professionals from 17 countries answered the survey. Six major groups of barriers were identified. Despite the region’s continuous efforts in the last decade, the primary barrier to PGx implementation in LAC remains the same, the “need for guidelines, processes, and protocols for the clinical application of pharmacogenetics/pharmacogenomics”. Cost-effectiveness issues are considered critical factors in the region. Items related to the reluctance of clinicians are currently less relevant. Based on the survey results, the highest ranked (96%–99%) gene/drug pairs perceived as important were CYP2D6/tamoxifen, CYP3A5/tacrolimus, CYP2D6/opioids, DPYD/fluoropyrimidines, TMPT/thiopurines, CYP2D6/tricyclic antidepressants, CYP2C19/tricyclic antidepressants, NUDT15/thiopurines, CYP2B6/efavirenz, and CYP2C19/clopidogrel. In conclusion, although the global contribution of LAC countries remains low in the PGx field, a relevant improvement has been observed in the region. The perception of the usefulness of PGx tests in biomedical community has drastically changed, raising awareness among physicians, which suggests a promising future in the clinical applications of PGx in LAC