Estudio de la fragilidad en una población de personas mayores de la ciudad de Salamanca: efectos y beneficios de un programa de revitalización geriátrica

[ES]OBJETIVO GENERAL. Evaluar el impacto que el ejercicio físico desarrollado en el Programa de Revitalización Geriátrica tiene sobre los individuos clasificados como frágiles o pre-frágiles según el “Documento Consenso de fragilidad y caídas del Sistema Nacional de Salud”. 3.2. OBJETIVOS ESPECÍFICOS. 1. Establecer una definición consensuada del concepto de fragilidad. 2. Describir qué instrumento de medición de fragilidad identifica mejor a la persona frágil. 3. Valorar el grado de concordancia que existen entre los diferentes instrumentos de fragilidad. 4. Conocer sobre qué instrumento de fragilidad influye más el Programa de Revitalización Geriátrica. 5. Observar si existen analogías clínicas entre los sujetos que presentan fragilidad. 6. Analizar las características de las personas que presentan mejoría en la fragilidad tras la realización de la intervención. 7. Estudiar si existen modificaciones en los eventos negativos producidos por la fragilidad: discapacidad, hospitalizaciones, caídas, institucionalizaciones y muerte

Therapeutic Value of Single Nucleotide Polymorphisms on the Efficacy of New Therapies in Patients with Multiple Sclerosis

The introduction of new therapies for the treatment of multiple sclerosis (MS) is a very recent phenomenon and little is known of their mechanism of action. Moreover, the response is subject to interindividual variability and may be affected by genetic factors, such as polymorphisms in the genes implicated in the pathologic environment, pharmacodynamics, and metabolism of the disease or in the mechanism of action of the medications, influencing the effectiveness of these therapies. This review evaluates the impact of pharmacogenetics on the response to treatment with new therapies in patients diagnosed with MS. The results suggest that polymorphisms detected in the GSTP1, ITGA4, NQO1, AKT1, and GP6 genes, for treatment with natalizumab, ZMIZ1, for fingolimod and dimethyl fumarate, ADA, for cladribine, and NOX3, for dimethyl fumarate, may be used in the future as predictive markers of treatment response to new therapies in MS patients. However, there are few existing studies and their samples are small, making it difficult to generalize the role of these genes in treatment with new therapies. Studies with larger sample sizes and longer follow-up are therefore needed to confirm the results of these studies

Foot Anatomical Structural Variations Increase the Risk of Falls in Older Adults

Falls are common among older adults. The purpose of this study was to demonstrate the relationship between foot anatomical structural variations and balance in older adults and quantify foot posture and stabilometry as predictors of fall risk. This case-control study of older adults classified cases or controls according to falls in the last five years. All subjects were healthy women and men > 65 years old (n = 164), who were divided into two groups: 83 individuals who had suffered from a fall in the previous five years (case group) and 81 individuals who had not suffered from a fall (control group). Hallux abductus valgus (HAV) and tailor’s bunion are stability-determining factors. Women have a higher probability of falling. HAV (p = 0.042) and tailor’s bunion (p = 0.069) also increased the fall probability. Morphological foot variations (HAV and tailor’s bunion) linked to gender and age increase fall risk among older adults. In women fallers with HAV, there was a higher possibility of falling (63.9%). According to age, in older adults with HAV, the percentage of falls is high (62%). Fallers with tailor’s bunion (60.7%) are more numerous than fallers without this pathology. Older adults with HAV and tailor´s bunion had twice the probability of suffering a fall than older people without foot anatomical structural. Foot morphology is decisive in falling risk

Effect of Single Nucleotide Polymorphisms in the Vitamin D Metabolic Pathway on Susceptibility to Non-Small-Cell Lung Cancer

The pathogenesis of non-small-cell lung cancer (NSCLC) is complex, since many risk factors have been identified. Recent research indicates that polymorphisms in the metabolic pathway of vitamin D may be involved in both risk and survival of the disease. The objective of this study is to assess the effect of 13 genetic polymorphisms involved in the vitamin D metabolic pathway on the risk of suffering from NSCLC. We conducted an observational case-control study, which included 204 patients with NSCLC and 408 controls, of Caucasian origin, from southern Spain. The CYP27B1 (rs4646536, rs3782130, rs703842, rs10877012), CYP2R1 (rs10741657), GC (rs7041), CYP24A1, and VDR (BsmI, Cdx-2, FokI, ApaI, TaqI) gene polymorphisms were analyzed by real-time polymerase chain reaction. The logistic regression model, adjusted for smoking and family history of cancer, revealed that in the genotypic model, carriers of the VDR BsmI rs1544410-AA genotype were associated with a lower risk of developing NSCLC compared to the GG genotype (p = 0.0377; OR = 0.51; CI95% = 0.27-0.95; AA vs. GG). This association was maintained in the recessive model (p = 0.0140). Haplotype analysis revealed that the AACATGG and GACATGG haplotypes for the rs1544410, rs7975232, rs731236, rs4646536, rs703842, rs3782130, and rs10877012 polymorphisms were associated with a lower risk of NSCLC (p = 0.015 and p = 0.044 respectively). The remaining polymorphisms showed no effect on susceptibility to NSCLC. The BsmI rs1544410 polymorphism was significantly associated with lower risk of NSCLC and could be of considerable value as a predictive biomarker of the disease.ERDF funds (EU) from the Instituto de Salud Carlos III PT13/0010/003

Influence of Genetic Polymorphisms on Response to Biologics in Moderate-to-Severe Psoriasis

This work was partly supported by a contract for Cristina Membrive Jimenez from the University of Granada and the Fundacion de Investigacion Biosanitaria de Andalucia Oriental (FIBAO). The Virgen de las Nieves University Hospital Biobank was supported by grants co-funded by ERDF funds (EU) from the Instituto de Salud Carlos III (PT13/0010/0039).The results of this research are part of the doctoral thesis that will be presented by Cristina Membrive Jiménez at the University of Granada as part of the doctoral studies in “Pharmacy”.Psoriasis is a chronic inflammatory skin pathology of autoimmune origin and unknown etiology. There are various therapies for treating it, including a wide range of biopharmaceuticals indicated in moderate-to-severe psoriasis. Depending on their therapeutic target, they are classified as tumor necrosis factor inhibitors (anti-TNF) or cytokine inhibitors (interleukin-12, 23, and 17 antagonists). Although they have proved effective and safe, in clinical practice, many patients show a short- and long-term suboptimal response and even varying degrees of toxicity. This variability in response may be influenced by genetic factors, such as polymorphisms in the genes involved in the pathological environment, metabolism or mechanism of action of the drug that could affect the effectiveness and toxicity of biological therapies. This review assesses pharmacogenetic studies of the impact of genetic factors on response to biopharmaceuticals and toxicity in patients diagnosed with moderate-to-severe psoriasis. The results suggest that polymorphisms detected in the HLA genes, in genes that encode cytokines (TNF, IL genes, TNFAIP3), transporters (PDE3A-SLCO1C1, SLC12A8), receptors (TNFRSF1B, CD84, FCGR2A and FCGR3A, IL17RA, IL23R, TLR genes, PGLYRP4) and associated proteins (TNFAIP3, LY96, TIRAP, FBXL19), as well as other genes implicated in the pathogenesis of psoriasis (CDKAL1, CARD14, PTTG1, MAP3K1, ZNF816A, GBP6, CTNNA2, HTR2A, CTLA4, TAP1) can be used in the future as predictive markers of treatment response and/or toxicity with biological therapies in patients diagnosed with moderate-to-severe psoriasis, tailoring treatment to the individual patient.University of GranadaFundacion de Investigacion Biosanitaria de Andalucia Oriental (FIBAO)ERDF funds (EU) from the Instituto de Salud Carlos III PT13/0010/003

Influence of previous mental state on psychological outcomes of Spanish out-of-hospital professionals during the COVID-19 pandemic

Producción CientíficaThis study aimed to describe factors relating to the psychological distress of healthcare workers (HCWs) in Spanish out-of-hospital emergency medical services (EMS), according to the previous or non-use of psychotropic drugs or psychotherapy. A multicentre, cross-sectional descriptive study was designed. The study population were all physicians, nurses, and emergency medical technicians (EMTs) working in any Spanish out-of-hospital EMS between February and April 2021. The main outcomes were the levels of stress, anxiety, depression, and self-efficacy, assessed by DASS-21 and G-SES. Differences in levels of stress, anxiety, depression, and self-efficacy, according to sex, age, previous use of psychotropic drug or psychotherapy, work experience, professional category, type of work, and modification of working conditions were measured using the Student’s t-test for independent samples, one-way ANOVA, Pearson’s correlation, or 2-factor analysis of covariance. A total of 1636 HCWs were included, of whom one in three had severe mental disorders because of the pandemic. The interaction of the previous or non-use of psychotropic drugs or psychotherapy with the rest of the factors considered did not modify the levels of stress, anxiety, depression, and self-efficacy. However, HCWs with a history of psychotropic drug or psychotherapy use had a more intense negative emotional response and lower self-efficacy, regardless of their sex, professional category, type of work, or change in the working conditions. These HCWs are considered particularly vulnerable to the development or recurrence of new disorders or other comorbidities; therefore, the implementation of monitoring and follow-up strategies should be a priority

Percepción del nivel de autoeficacia en los profesionales sanitarios de la gerencia de emergencias sanitarias de Castilla y León durante la pandemia Covid-19

Health emergency personnel in Castilla y León have been part of the first line of care in the COVID-19 pandemic, being one of the groups most exposed to contagion. Determining the degree of self-efficacy that these workers perceive of themselves gives us an idea of their ability to adapt and cope with this adverse event. The aim of the study was to establish the level of self-efficacy perception in healthcare professionals of the Gerencia de Emergencias Sanitarias de Castilla y León during the COVID-19 pandemic, as well as the relationship of self-efficacy with other variables. The methodology used was quantitative and descriptive through surveys. The sample of volunteers is 253 participants. Out-of-hospital professionals obtain a mean score in their level of self-efficacy of 72.36 ± 15.80. A higher score is observed in older professionals, with greater professional experience in the extra-hospital setting, who work in direct care with patients, who have not previously received psychological treatment or who have received some dose of the SARS-CoV-2 vaccine Theself-efficacy of out-of-hospital professionalsis good, finding factorsrelated to a higher or lower level. These results show the ability of these professionals to adapt to adverse situations such as the COVID-19 pandemic.El personal de emergencias sanitarias de Castilla y León ha formado parte de la primera línea asistencial durante la pandemia por COVID-19, siendo uno de los grupos más expuestos al contagio. Determinar el grado de autoeficacia que estos trabajadores perciben de sí mismos nos da una idea de la capacidad de adaptación y afrontamiento que han tenido ante este evento adverso. El objetivo deestudio hasido establecerel nivel de percepción en autoeficaciaen los profesionales sanitarios de la Gerencia de Emergencias Sanitarias de Castilla y León durante la pandemia por COVID-19, así como su relación con otras variables. La metodología empleada es cuantitativa de tipo descriptiva a través de encuestas. La muestra de voluntarios es de 253 participantes. Los profesionales de extrahospitalaria obtienen una puntuación media en su nivel de autoeficacia, de 72.36 ± 15.80. Se observa una mayor puntuación en los profesionales de mayor edad (p=0.030), con una mayor experiencia profesional en el ámbito extrahospitalario (p<0.001), que trabajan en asistencia directa con pacientes (p=0.028), que no han recibido previamente tratamiento psíquico (p=0.014) o que han recibido alguna dosis de la vacuna contra el SARS-CoV-2 (p=0.002). La autoeficacia de los profesionales de extrahospitalaria es buena, existiendo factores que se relacionan con un mayor o menor nivel. Los resultados ponen de manifiesto la capacidad de adaptación de estos profesionales ante situaciones adversas como la vivida durante la pandemia por la COVID-19.

Integración de recursos electrónicos en las bibliotecas del Consorcio de Bibliotecas Universitarias de Andaluzas (CBUA)

En los últimos años, el presupuesto en recursos electrónicos ha ido creciendo paulatinamente en las Bibliotecas Universitarias y como consecuencia las inversiones en este tipo de materiales han ido aumentando, convirtiéndose hoy día la Biblioteca Universitaria en una gran factoría virtual. El Consorcio de Bibliotecas Universitarias Andaluzas (CBUA) que asume entre sus políticas el desarrollo de proyectos para la mejora de la calidad de los servicios a través de la cooperación, consciente de esta situación, acomete el plan de dotar a las Bibliotecas del Consorcio de tecnologías centradas en el usuario, para hacer más accesibles las colecciones de recursos electrónicos y poder competir en la Europa del conocimiento con parámetros de calidad. Se presenta el proyecto que está llevando a cabo el Grupo de Trabajo de MAP y ERM del CBUA, de implementación y puesta en marcha de herramientas, para el acceso, integración y gestión de los recursos electrónicos en las Bibliotecas Universitarias Andaluzas, para un mejor uso de las colecciones digitales contratadas, que redundará en la calidad y mejora de los servicios prestados. Se enumeran las fases del proyecto, los objetivos operativos, las líneas de acción, las acciones realizadas, la documentación generada, la difusión y formación en las nuevas herramientas y la repercusión que está teniendo en las Bibliotecas del CBU

Influence of the Cumulative Incidence of COVID-19 Cases on the Mental Health of the Spanish Out-of-Hospital Professionals

This study aimed to analyze the psychological affectation of health professionals (HPs) of Spanish Emergency Medical Services (EMSs) according to the cumulative incidence (CI) of COVID19 cases in the regions in which they worked. A cross-sectional descriptive study was designed, including all HPs working in any EMS of the Spanish geography between 1 February 2021 and 30 April 2021. Their level of stress, anxiety and depression (DASS-21) and the perception of self-efficacy (GSES) were the study’s main results. A 2-factor analysis of covariance was used to determine if the CI regions of COVID-19 cases determined the psychological impact on each of the studied variables. A total of 1710 HPs were included. A third presented psychological impairment classified as severe. The interaction of CI regions with the studied variables did not influence their levels of stress, anxiety, depression or self-efficacy. Women, younger HPs or those with less EMS work experience, emergency medical technicians (EMT), workers who had to modify their working conditions or those who lived with minors or dependents suffered a greater impact from the COVID-19 pandemic in certain regions. These HPs have shown high levels of stress, anxiety, depression and medium levels of self-efficacy, with similar data in the different geographical areas. Psychological support is essential to mitigate their suffering and teach them to react to adverse events.This research was funded by Fundación ASISA and Sociedad Española de Urgencias y Emergencias (SEMES)

Actividades de aprendizaje colaborativo en la docencia online: tutorías colaborativas y otras iniciativas de aprendizaje de apoyo mutuo entre estudiantes

Memoria del proyecto de innovación docente para la aplicación de estrategias de aprendizaje colaborativo y apoyo mutuo entre estudiantes, con especial atención a las tutorías colaborativas, en los Grados de ADE y Comercio