Trombosis intracardíaca asociada a cable de marcapasos en paciente con síndrome antifosfolípido

We introduce the case of a patient with a dual-chamber permanent pacemaker who was admitted because of an initial diagnosis of pulmonary thromboembolism. In the CT scan a filling defect in the right atrium (RA) was detected. A transthoracic echocardiogram was performed and a large mobile mass was observed in the RA attached to the atrial pacemaker lead compatible with thrombus due to its characteristics and location. The presence of antiphospholipid syndrome was detected as a predisposing prothrombotic cause. Medical treatment with indefiniteanticoagulation was chosen due to the clinical stability of the patient.Presentamos el caso de una paciente portadora de marcapasos definitivo bicameral que ingresa con el diagnóstico inicial de tromboembolismo pulmonar. En el TC realizado se observa un defecto de repleción localizado en aurícula derecha (AD). Se realiza ecocardiograma transtorácico que muestra una masa móvil de gran tamaño e AD adherida al electrodo de marcapasos auricular compatible con trombo por sus características y localización. En el estudio se detectó la presencia de síndrome antifosfolipido como causa protrombótica predisponente. Dada la estabilidad clínica de la paciente se optó por tratamiento médico con anticoagulación de forma indefinida

Insuficiencia mitral severa secundaria a rotura del músculo papilar posteromedial

The prevalence of mechanical complications of infarction has decreased in recent years, however, mortality remains high. Echocardiography plays a fundamental role for early diagnosis and management of these complications.  We present the case of a patient with ischemic rupture of the posteromedial papillary muscle and severe mitral regurgitation.La prevalencia de las complicaciones mecánicas del infarto se ha reducido en los últimos años, sin embargo, la mortalidad sigue siendo elevada. La ecocardiografía juega un papel fundamental para un diagnóstico y manejo precoz de estas complicaciones.  Presentamos el caso de una paciente con rotura isquémica del músculo papilar posteromedial e insuficiencia mitral severa

Approximation to the Consumption of Healthcare Resources and the Economic Cost of SARS-CoV-2 Patient Management: A Retrospective Study

Spain has become one of the countries most affected by coronavirus disease 2019 (COVID-19), with the highest testing rates, and one of the worst-performing countries in the fight against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. There are no studies related to the consumption of health resources and the economic cost of the SARS-CoV-2 virus. We present a retrospective analysis of 9,811 (Primary Care and Hospital) patients which aimed to estimate public health expenditure by the consumption of health resources due to COVID-19. According to the results, the gender distribution of patients has a similar rate in both groups, with slightly higher rates in women. Similarly, age is the same in both groups, with a median of 62 years in the case of hospitalizations and 61 years in the case of primary care; using a weighted average of these rates and costs, we can estimate that the average cost of care per patient infected with the SARS-CoV-2 virus, regardless of the course is €2373.24. We conclude that a patient with COVID-19 without hospitalization costs €729.79, while the expenses of a hospitalized patient are between €4294.36 and €14440.68, if there is ICU admission

Absolute and relative handgrip strength as indicators of self-reported physical function and quality of life in breast cancer survivors. The EFICAN study

Background: Although breast cancer (BC) is the most prevalent type of cancer in the world, its high survival rate implies that many people live long after the treatments and face their side effects. The physical function (PF) and health-related quality of life (HRQoL) of people surviving BC decreases significantly, which makes important to identify markers that may be associated with a better health status and prognosis. Previous studies suggest that handgrip strength (HGS) and HGS relative to the body mass index (rHGS) are good indicators of PF and HRQoL in different populations. However, it is unknown whether this applies to BC survivors. This study aimed to evaluate the association of HGS and rHGS with PF and HRQoL in this population. Methods: Sixty female BC survivors participated. Handgrip strength was assessed with a dynamometer. Arm volume was estimated and upper limb impairments, as well as cancer-related fatigue, depression, life satisfaction and HRQoL, were assessed using standardized questionnaires. Results: Higher levels of HGS and rHGS were associated with higher levels of HRQoL, lower cancer-related fatigue, and fewer problems with the affected arm. Conclusions: These results suggest that HGS may be a good indicator of self-reported PF and HRQoL in female BC survivors

Biomarkers of immunotherapy response in patients with non-small-cell lung cancer: microbiota composition, short-chain fatty acids, and intestinal permeability

5 figures, 1 table.There is evidence of the influence of the intestinal microbiota on the response to immunotherapy in cancer. In addition, we lack markers of response to treatment and toxicity, which obliges us to continue our search for them. In this work, we recruited patients with non-small-cell lung cancer receiving immunotherapy who contributed a fecal and blood sample. We analyzed the possible relationship between the response to immune checkpoint inhibitors and the occurrence of immune-related adverse events, the composition (16S rDNA amplification) and functionality (abundance of short-chain fatty acids) of the gut microbiota, and intestinal membrane permeability as a human factor. No correlations were detected between analytical markers and clinical evolution, with a marked individuality of the gut microbiota in terms of composition, but homogeneity in its functionality and permeability. Immune checkpoint inhibitors have been proposed as the standard treatment for different stages of non-small-cell lung cancer in multiple indications. Not all patients benefit from these treatments, however, and certain patients develop immune-related adverse events. Although the search for predictors of response to these drugs is a major field of research, these issues have yet to be resolved. It has been postulated that microbiota could play a relevant role in conditioning the response to cancer treatments; however, the human factor of intestinal permeability also needs to be considered as it is closely related to the regulation of host–microbiota interaction. In this article, we analyzed the possible relationship between the response to immune checkpoint inhibitors and the onset of immune-related adverse events, gut microbiota status, and intestinal membrane permeability. In a pioneering step, we also measured short-chain fatty acid content in feces. Although the correlation analyses failed to identify predictive biomarkers, even when all variables were integrated, our patients’ microbial gut ecosystems were rich and diverse, and the intestinal barrier’s integrity was preserved. These results add new knowledge on the composition of microbiota and its correlation with barrier permeability and short-chain fatty acids and suggest that more studies are required before these potential biomarkers can be incorporated into the clinical management of patients via immune checkpoint inhibitor treatment.This study was supported by CIBER—Consorcio Centro de Investigación Biomédica en Red—(CB 2021); Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación and Unión Europea—NextGenerationEU; FEDER (Fondo Europeo de Desarrollo Regional), Gobierno de Aragón (Group B29_23R); Ministerio de Ciencia, Innovación e Universidades (MCNU); and Agencia Estatal de Investigación (PID2020-113963RB-I00). It was also supported by a Personalized and Precision Medicine grant from the Instituto de Salud Carlos III (MePRAM Project, PMP22/00092), Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación, and funded by NextGenerationEU funds from the European Union that finance the actions of the Resilience and Recovery Facility.Peer reviewe

Randomized controlled trial of early arachidonic acid and docosahexaenoic acid enteral supplementation in very preterm infants

[Objective]: To evaluate changes in blood long-chain polyunsaturated fatty acid (LCPUFA) and oxylipin concentrations in very preterm infants from birth to 36 weeks’ postmenstrual age (WPA) after providing an emulsified arachidonic acid (ARA):docosahexaenoic acid (DHA) supplement at two different concentrations.[Study design]: This prospective, randomized trial assigned infants to receive a supplement (1) 80:40 group (80 mg/kg/day ARA and 40 mg/kg/day DHA, n = 9) or (2) 120:60 group (120 mg/kg/day ARA and 60 mg/kg/day DHA, n = 9). Infants received supplement daily from birth until 36 WPA. At baseline, 21 days of life and 36 WPA, the LCPUFAs were measured in plasma by gas chromatography/mass spectrophotometry. Additionally, LCPUFAs and oxylipins were analyzed in whole blood by ultra-high-performance liquid chromatography-tandem mass spectrometry. Furthermore, a sample of oral mucosa was obtained to analyze single-nucleotide polymorphism located in the FADS1 gene by PCR.[Results]: Gestational age was similar between groups (80:40 = 28+6 [27+3; 30+3] completed weeks+days; 120:60 = 29+6 [27+3; 30+5] completed weeks+days, p = 0.83). At 36 WPA, the change in plasma ARA was significantly different between groups (80:40 group = 0.15 [−0.67; 0.69] %nmol, 120:60 = 1.68 [1.38; 3.16] %nmol, p = 0.031). In whole blood, the levels of ARA-derived oxylipins (5-, 8-, 9-, 11-, 15-HETE and 8,9-EET) and EPA-derived oxylipins (18-HEPE) significantly increase from baseline to 36 WPA in the 120:60 group than the 80:40 group.[Conclusion]: Supplementation at high doses (120:60 mg/kg/day) increased levels of ARA, and EPA- and ARA-derived oxylipins compared to low doses (80:40 mg/kg/day). Differences were detected in EPA metabolites without a significant increase in plasma DHA.This article was supported by the 20th National Grants for Research in Life Sciences 2021/2021 from Ramón Areces Foundation (Spain), the European Society for Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) networking grant 2021, and Spanish Programs for the generation of Knowledge and Scientific and Technological strengthening of the system and oriented to the challenges of Society (PID2020-119084RB-C21 and PID2020-114821RB-I00 funded by MCIN/AEI/10.13039/501100011033) from the Ministry of Science and Innovation (Spain).Peer reviewe

Derecho ex cathedra. 1847-1936 Diccionario de catedráticos españoles

Edición revisada 2020.Publicación de las entradas biográficas del Diccionario de catedráticos españoles de Derecho, accesible en http://www.uc3m.es/diccionariodecatedraticos. Al dar forma de libro al material hemos prescindido de algunos elementos informativos, que se mantienen en la página electrónica indicada. Se recogen ahora solamente a los ingresados en el cuerpo con anterioridad a la guerra civil.Publication of the biographical entries of the Diccionario de catedráticos españoles de Derecho, accessible at http://www.uc3m.es/diccionariodecatedraticos. By giving those material book form, we have dispensed with some informative elements, however kept on the web page. Only professors apointed prior to the Civil War are now included.Esta publicación forma parte del proyecto “La memoria del jurista español: génesis y desarrollo de las disciplinas jurídicas” (ref. DER2014-55035-C2-1-P/DER2014-55035-C2-2-P), financiado por el Ministerio de Economía, Industria y Competitividad (España)

El reto de la inclusión de los Objetivos de Desarrollo Sostenible en la formación inicial de profesores de secundaria: creación del MOOC curso cero sobre educación y ODS, inclusión en asignaturas y en trabajos fin de máster

Memoria ID-041. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2021-2022

Stratification of radiosensitive brain metastases based on an actionable S100A9/RAGE resistance mechanism

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.Whole-brain radiotherapy (WBRT) is the treatment backbone for many patients with brain metastasis; however, its efficacy in preventing disease progression and the associated toxicity have questioned the clinical impact of this approach and emphasized the need for alternative treatments. Given the limited therapeutic options available for these patients and the poor understanding of the molecular mechanisms underlying the resistance of metastatic lesions to WBRT, we sought to uncover actionable targets and biomarkers that could help to refine patient selection. Through an unbiased analysis of experimental in vivo models of brain metastasis resistant to WBRT, we identified activation of the S100A9-RAGE-NF-κB-JunB pathway in brain metastases as a potential mediator of resistance in this organ. Targeting this pathway genetically or pharmacologically was sufficient to revert the WBRT resistance and increase therapeutic benefits in vivo at lower doses of radiation. In patients with primary melanoma, lung or breast adenocarcinoma developing brain metastasis, endogenous S100A9 levels in brain lesions correlated with clinical response to WBRT and underscored the potential of S100A9 levels in the blood as a noninvasive biomarker. Collectively, we provide a molecular framework to personalize WBRT and improve its efficacy through combination with a radiosensitizer that balances therapeutic benefit and toxicity.info:eu-repo/semantics/publishedVersio

Epidemiological trends of HIV/HCV coinfection in Spain, 2015-2019

Altres ajuts: Spanish AIDS Research Network; European Funding for Regional Development (FEDER).Objectives: We assessed the prevalence of anti-hepatitis C virus (HCV) antibodies and active HCV infection (HCV-RNA-positive) in people living with HIV (PLWH) in Spain in 2019 and compared the results with those of four similar studies performed during 2015-2018. Methods: The study was performed in 41 centres. Sample size was estimated for an accuracy of 1%. Patients were selected by random sampling with proportional allocation. Results: The reference population comprised 41 973 PLWH, and the sample size was 1325. HCV serostatus was known in 1316 PLWH (99.3%), of whom 376 (28.6%) were HCV antibody (Ab)-positive (78.7% were prior injection drug users); 29 were HCV-RNA-positive (2.2%). Of the 29 HCV-RNA-positive PLWH, infection was chronic in 24, it was acute/recent in one, and it was of unknown duration in four. Cirrhosis was present in 71 (5.4%) PLWH overall, three (10.3%) HCV-RNA-positive patients and 68 (23.4%) of those who cleared HCV after anti-HCV therapy (p = 0.04). The prevalence of anti-HCV antibodies decreased steadily from 37.7% in 2015 to 28.6% in 2019 (p < 0.001); the prevalence of active HCV infection decreased from 22.1% in 2015 to 2.2% in 2019 (p < 0.001). Uptake of anti-HCV treatment increased from 53.9% in 2015 to 95.0% in 2019 (p < 0.001). Conclusions: In Spain, the prevalence of active HCV infection among PLWH at the end of 2019 was 2.2%, i.e. 90.0% lower than in 2015. Increased exposure to DAAs was probably the main reason for this sharp reduction. Despite the high coverage of treatment with direct-acting antiviral agents, HCV-related cirrhosis remains significant in this population