Factores sociodemográficos y adecuación de la atención prenatal asociada a la mortalidad perinatal en gestantes colombianas

el adecuado seguimiento clínico y el cumplimiento de los requerimientos nutricionales, son aspectos esenciales para el adecuado desarrollo fetal y la culminación exitosa del embarazo. El objetivo de este estudio fue determinar la asociación entre los factores sociodemográficos y el seguimiento prenatal asociados a la mortalidad perinatal en gestantes de Colombia.An adequate monitoring and the compliance of the nutritional requirements are essential for fetal development and successful control of pregnancy outcomes. This study aimed to determine the association between sociodemographic factors and the pre-birth monitoring associated with

The levels of bone mineralization are influenced by body composition in children and adolescents

Introducción: Existe controversia acerca del efecto del sobrepeso y la obesidad en la mineralización ósea en la adolescencia. Objetivo: El objetivo de este estudio fue valorar el nivel de densidad mineral ósea (DMO) en una población de adolescentes y estudiar su relación con la composición corporal. Material y método: La población de estudio estuvo constituida por 157 adolescentes (93 mujeres y 64 varones) de la provincia de Granada (España). La edad media fue de 14,22 ± 1,41 años. Se valoró la DMO mediante osteosonografía del calcáneo. Los parámetros densitométricos fueron: coeficiente de atenuación de banda ancha (BUA), T-score yZ-score. La composición corporal se determinó con bioimpedanciómetro. Resultados: Los sujetos con obesidad y sobrepeso presentaron valores mayores en el BUA frente a los sujetos con normopeso (95,4± 17,77 y 90,0±1,08 vs. 81,1±17,79) encontrándose diferencias significativas (p<0.001 y p<0.05, respectivamente). Tras el ajuste por masa magra y masa grasa se mantuvieron las diferencias en los sujetos con sobrepeso y obesidad (p<0.001 y p<0.001).La correlación con la masa magra fue mayor que con la masa grasa (B=,402 p<0.000 y B=,228 p<0.002). Conclusiones: Los adolescentes con sobrepeso y/o obesidad presentan mejores niveles de DMO incluso después del ajuste por masa grasa y masa muscular. Nuestros resultados sugieren que la DMO aumenta en respuesta al incremento de la masa muscular en los adolescentes con sobrepeso y/o obesidad.Introduction: There is controversy over the effect of overweight and obesity in bone mineralization in adolescence. Objective: The aim of this study was to assess the level of bone mineral density (BMD) in a population of adolescents and study its relationship with body composition. Methods: The study population consisted of 157 adolescents (93 women and 64 men) of the province of Granada (Spain). The mean age was 14.22 ± 1.41 year. BMD was assessed by calcaneal osteosonography. The densitometric parameters were: Broadbandultrasound attenuation( BUA), T -score and Z -score. Body composition was determined with bio-electrical Impedance analyser. Results: The overweight and obese adolescents had higher values in the BUA versus normal-weighted adolescents (95.4 ± 17.77 and 90.0 ± 1.08 vs 81.1 ± 17.79), showing significant differences(p < 0.001 and p < 0.05, respectively). Even after adjustment for lean mass and fat mass, differences remained in overweight and obese subjects (p < 0.001 and p < 0.001). Correlation with lean mass was greater than with fat mass (B =, 402 p < 0.000 and B =, 228 p < 0.002). Conclusions: Adolescents with overweight and/or obesity have higher levels of BMD even after adjustment for fat mass and muscle mass. Our results suggest that BMD increases in response to increased muscle mass in adolescents with overweight and/or obesity.Proyecto financiado en el marco del Campus de Excelencia Internacional Proyecto GREIB, subprograma START-UP PROJECTS FOR YOUNG RESEARCHERS (GREIB.PYR_2011_27)

Evaluación del estado nutricional en pacientes trasplantados renales durante 5 años de seguimiento

Introducción: El aumento de peso y la malnutrición después del trasplante renal es frecuente, y el sobrepeso y la obesidad resultante se asocia con complicaciones graves de salud. Por el contrario, la prevalencia de la desnutrición en pacientes con trasplante renal y sus efectos en el resultado del trasplante de riñón se subestima. Objetivos: El objetivo de este trabajo fue evaluar el estado nutricional de pacientes trasplantados renales y determinar si en el periodo de cinco años de seguimiento, estos pacientes sufren alteraciones que sugieran deterioro nutricional. Métodos: La muestras estuvo formada por 119 pacientes trasplantados renales, que asistieron durante cinco años a la consulta postrasplante. A todos los pacientes se realizaron determinaciones de colesterol total, lipoproteínas de baja densidad (LDL), lipoproteínas de alta densidad (HDL), concentraciones de triglicéridos y ferritina (Ft), y se les efectuaron mediciones antropométricas de peso, altura e IMC. Los pacientes fueron divididos en tres grupos según la tasa de filtración glomerular : Grupo 1: < 60 mL/min, Grupo 2: 89–60 mL/min Grupo 3: ≥ 90 mL/min. Resultados: El peso e IMC tiende a disminuir en el grupo 3 mientras aumenta en el resto de grupos. Se produce una disminución de Colesterol total, HDL, LDL, Trigliceridos y Ferritina menos acusado en el grupo 3. Conclusiones: Tras cinco años se puede observar una reducción significativa de los parametros bioquímicos nutricionales en general, así mismo el estado nutricional esta estrechamente relacionado y es directamente proporcional a la función del injerto.Introduction: Weight gain and malnutrition after kidney transplantation is common and the resulting overweight and obesity is associated with serious health complications. By contrast, the prevalence of malnutrition in patients with renal transplantation and its impact on the outcome of kidney transplantation is underestimated. Objectives: The aim of this study was to evaluate the nutritional status of renal transplant patients and determine if the five-year follow-up, these patients undergo alterations that suggest nutritional deterioration. Methods: The sample consisted of 119 renal transplant patients who attended for five years post-transplant consultation. All patients measurements of total cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL), triglycerides and ferritin (Ft) were performed. and anthropometric measurements were made of weight, height and BMI. Patients were divided into three groups according to GFR Group 1: <60 mL / min, Group 2: 89-60 mL / min Group 3: ≥ 90 mL / min. Results: The weight and BMI tended to decrease in group 3 while increasing in the other groups. A decrease in total cholesterol, HDL, LDL, Triglycerides and Ferritin less pronounced in group 3 occurs. Conclusions: After five years you can see a significant reduction in nutritional biochemical parameters in general, likewise the nutritional status is closely related, and is directly proportional to the function of the graft

El Museo de San Isidro. Un siglo de arqueología en Madrid

El Museo de San Isidro es el heredero de una serie de instituciones municipales encargadas de proteger, estudiar y difundir el rico patrimonio arqueológico madrileño desde la década de los años veinte del siglo pasado hasta la actualidad. Las colecciones, tanto arqueológicas como documentales, reunidas durante estos casi cien años de actividad, hacen del mismo un referente imprescindible para el conocimiento histórico de la ciudad de Madrid y sus alrededore

Guía Mexicana de Práctica Clínica de Inmunoterapia 2011

Existen varias guías internacionales para la práctica clínica de in- munoterapia, que aplican solo parcialmente en México. La primera guía mexicana de inmunoterapia data de 1998

Compromising between European and US allergen immunotherapy schools: Discussions from GUIMIT, the Mexican immunotherapy guidelines

Background: Allergen immunotherapy (AIT) has a longstanding history and still remains the only disease-changing treatment for allergic rhinitis and asthma. Over the years 2 different schools have developed their strategies: the United States (US) and the European. Allergen extracts available in these regions are adapted to local practice. In other parts of the world, extracts from both regions and local ones are commercialized, as in Mexico. Here, local experts developed a national AIT guideline (GUIMIT 2019) searching for compromises between both schools. Methods: Using ADAPTE methodology for transculturizing guidelines and AGREE-II for evaluating guideline quality, GUIMIT selected 3 high-quality Main Reference Guidelines (MRGs): the European Academy of Allergy, Asthma and Immunology (EAACI) guideines, the S2k guideline of various German-speaking medical societies (2014), and the US Practice Parameters on Allergen Immunotherapy 2011. We formulated clinical questions and based responses on the fused evidence available in the MRGs, combined with local possibilities, patient's preference, and costs. We came across several issues on which the MRGs disagreed. These are presented here along with arguments of GUIMIT members to resolve them. GUIMIT (for a complete English version, see Supplementary data) concluded the following: Results: Related to the diagnosis of IgE-mediated respiratory allergy, apart from skin prick testing complementary tests (challenges, in vitro testing and molecular such as species-specific allergens) might be useful in selected cases to inform AIT composition. AIT is indicated in allergic rhinitis and suggested in allergic asthma (once controlled) and IgE-mediated atopic dermatitis. Concerning the correct subcutaneous AIT dose for compounding vials according to the US school: dosing tables and formula are given; up to 4 non-related allergens can be mixed, refraining from mixing high with low protease extracts. When using European extracts: the manufacturer's indications should be followed; in multi-allergic patients 2 simultaneous injections can be given (100% consensus); mixing is discouraged. In Mexico only allergoid tablets are available; based on doses used in all sublingual immunotherapy (SLIT) publications referenced in MRGs, GUIMIT suggests a probable effective dose related to subcutaneous immunotherapy (SCIT) might be: 50–200% of the monthly SCIT dose given daily, maximum mixing 4 allergens. Also, a table with practical suggestions on non-evidence-existing issues, developed with a simplified Delphi method, is added. Finally, dissemination and implementation of guidelines is briefly discussed, explaining how we used online tools for this in Mexico. Conclusions: Countries where European and American AIT extracts are available should adjust AIT according to which school is followed

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

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

Famílies botàniques de plantes medicinals

Facultat de Farmàcia, Universitat de Barcelona. Ensenyament: Grau de Farmàcia, Assignatura: Botànica Farmacèutica, Curs: 2013-2014, Coordinadors: Joan Simon, Cèsar Blanché i Maria Bosch.Els materials que aquí es presenten són els recull de 175 treballs d’una família botànica d’interès medicinal realitzats de manera individual. Els treballs han estat realitzat per la totalitat dels estudiants dels grups M-2 i M-3 de l’assignatura Botànica Farmacèutica durant els mesos d’abril i maig del curs 2013-14. Tots els treballs s’han dut a terme a través de la plataforma de GoogleDocs i han estat tutoritzats pel professor de l’assignatura i revisats i finalment co-avaluats entre els propis estudiants. L’objectiu principal de l’activitat ha estat fomentar l’aprenentatge autònom i col·laboratiu en Botànica farmacèutica