COVID-19 : Age, Interleukin-6, C-reactive protein, and lymphocytes as key clues from a multicentre retrospective study

Background: The SARS-CoV-2 infection has widely spread to become the greatest public health challenge to date, the COVID-19 pandemic. Different fatality rates among countries are probably due to non-standardized records being carried out by local health authorities. The Spanish case-fatality rate is 11.22%, far higher than those reported in Asia or by other European countries. A multicentre retrospective study of demographic, clinical, laboratory and immunological features of 584 Spanish COVID-19 hospitalized patients and their outcomes was performed. The use of renin-angiotensin system blockers was also analysed as a risk factor. Results: In this study, 27.4% of cases presented a mild course, 42.1% a moderate one and for 30.5% of cases, the course was severe. Ages ranged from 18 to 98 (average 63). Almost 60 % (59.8%) of patients were male. Interleukin 6 was higher as severity increased. On the other hand, CD8 lymphocyte count was significantly lower as severity grew and subpopulations CD4, CD8, CD19, and NK showed concordant lowering trends. Severity-related natural killer percent descents were evidenced just within aged cases. A significant severity-related decrease of CD4 lymphocytes was found in males. The use of angiotensin-converting enzyme inhibitors was associated with a better prognosis. The angiotensin II receptor blocker use was associated with a more severe course. Conclusions: Age and age-related comorbidities, such as dyslipidaemia, hypertension or diabetes, determined more frequent severe forms of the disease in this study than in previous literature cohorts. Our cases are older than those so far reported and the clinical course of the disease is found to be impaired by age. Immunosenescence might be therefore a suitable explanation for the hampering of immune system effectors. The adaptive immunity would become exhausted and a strong but ineffective and almost deleterious innate response would account for COVID-19 severity. Angiotensin-converting enzyme inhibitors used by hypertensive patients have a protective effect in regards to COVID-19 severity in our series. Conversely, patients on angiotensin II receptor blockers showed a severer disease

Predictive Power of the "Trigger Tool" for the detection of adverse events in general surgery: a multicenter observational validation study

Background In spite of the global implementation of standardized surgical safety checklists and evidence-based practices, general surgery remains associated with a high residual risk of preventable perioperative complications and adverse events. This study was designed to validate the hypothesis that a new “Trigger Tool” represents a sensitive predictor of adverse events in general surgery. Methods An observational multicenter validation study was performed among 31 hospitals in Spain. The previously described “Trigger Tool” based on 40 specific triggers was applied to validate the predictive power of predicting adverse events in the perioperative care of surgical patients. A prediction model was used by means of a binary logistic regression analysis. Results The prevalence of adverse events among a total of 1,132 surgical cases included in this study was 31.53%. The “Trigger Tool” had a sensitivity and specificity of 86.27% and 79.55% respectively for predicting these adverse events. A total of 12 selected triggers of overall 40 triggers were identified for optimizing the predictive power of the “Trigger Tool”. Conclusions The “Trigger Tool” has a high predictive capacity for predicting adverse events in surgical procedures. We recommend a revision of the original 40 triggers to 12 selected triggers to optimize the predictive power of this tool, which will have to be validated in future studies

CIBERER : Spanish national network for research on rare diseases: A highly productive collaborative initiative

Altres ajuts: Instituto de Salud Carlos III (ISCIII); Ministerio de Ciencia e Innovación.CIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research

Jugamos y aprendemos en el patio

Contiene: anexo con juegos y cancionesEl proyecto consiste en mejorar las condiciones de los patios para crear espacios de aprendizaje, diversión, exploración y descubrimiento. Los objetivos son descubrir, conocer y controlar el propio cuerpo; actuar de forma cada vez más autónoma en sus actividades habituales; establecer relaciones sociales y desarrollar actitudes de ayuda y colaboración; y conocer, disfrutar y proteger el entorno. La metodología es activa con un enfoque globalizador, basada en el juego, adecuada a las necesidades del niño y ligada a los elementos de su entorno inmediato. Las actividades son de movimiento, manipulación, plásticas y de experimentación. Estas consisten en juegos con pelota; juegos con arena; juegos con pompas de jabón; guiñol y teatrillo; fiesta del agua; carreras y juego libre; actividades de clasificación de materiales en cubetas; juegos de grupos y participación -corro de la patata, corro chirimbolo, el patio de mi casa, etc.-; y juegos con triciclos y correpasillos. La evaluación valora la respuesta del niño y su desarrollo.Madrid (Comunidad Autónoma). Consejería de EducaciónMadridMadrid (Comunidad Autónoma). Subdirección General de Formación del Profesorado. CRIF Las Acacias; General Ricardos 179 - 28025 Madrid; Tel. + 34915250893ES

Primeros pasos en inglés

El proyecto trata de iniciar a los niños en el conocimiento de la lengua inglesa, a través del juego y de las nuevas tecnologías para apoyar el aprendizaje. Los objetivos son facilitar el acercamiento de los niños a una segunda lengua, concretamente el inglés, a través del juego; acercar al niño al conocimiento del nuevo lenguaje simbólico, mediante el uso del ordenador en el aula; propiciar la tolerancia hacia otros pueblos; mostrar una actitud positiva y respetuosa hacia el inglés; comprender palabras sencillas; utilizar recursos sonoros para comunicarse; relacionar palabras en inglés con imágenes mediante flashcards; y producir oralmente canciones y poemas. La metodología es global, utilizando el juego como principal método de trabajo, y también la acción y la experimentación. Se realizan sesiones fotográficas de las actividades. En cuanto a la evaluación, se recogen en un diario observaciones, se graban en vídeo algunas sesiones y se valora el estado de conservación de los materiales utilizados. Además, se elaboran materiales, como papeles plastificados con imágenes, figuras plastificadas para pegar con velcro en los paneles, juegos de asociación de imágenes mediante el programa Clic, cuentos en vídeo, y canciones sencillas para grabarlas en casete.Madrid (Comunidad Autónoma). Consejería de EducaciónMadridMadrid (Comunidad Autónoma). Subdirección General de Formación del Profesorado. CRIF Las Acacias; General Ricardos 179 - 28025 Madrid; Tel. + 34915250893ES

Spent Nuclear Fuel Management: Levelized Cost of Electricity Generation and Analysis of Various Production Scenarios

This article aims to analyze the results of an economic study carried out to compare the influence of nuclear production capacity in different countries. The analysis is based on LCOEs (levelized cost of electricity) for three back-end strategies: open cycle, closed cycle and advanced closed cycle. The results show that costs are not a relevant criteria in order to select an energy policy for the spent nuclear fuel management

Interdisciplinary mathematics, building professional transitions

Desarrollar estrategias y recursos para la transición a la profesión de los estudiantes de matemáticas favoreciendo la interdisciplinar en matemáticas y la apertura profesional. Orientaciones de evaluación para tutela y evaluación de TFGs interdisciplinares.UCM-Vicerrectorado de CalidadDepto. de Álgebra, Geometría y TopologíaFac. de Ciencias MatemáticasFALSEsubmittedAPC financiada por la UC

Efficacy and safety of dasatinib with trastuzumab and paclitaxel in first line HER2-positive metastatic breast cancer: results from the phase II GEICAM/2010-04 study

[Background]: An important proportion of HER2-positive metastatic breast cancer patients do not respond to trastuzumab. The combination of dasatinib and trastuzumab has shown to be synergistic in preclinical models.[Methods]: We conducted a phase II trial combining dasatinib 100 mg once daily with trastuzumab 2 mg/kg and paclitaxel 80 mg/m2 weekly. Primary objective was objective response rate (ORR) and secondary included safety, other efficacy parameters and pharmacodynamics in tumour tissue, blood samples and skin biopsies.[Results]: From June 2013 to December 2015, 29 patients were included. Median number of cycles was 12 (1–49). Only 6 patients discontinued due to adverse events. ORR was 79.3% (95% CI 60.3–92), clinical benefit rate 82.8% (95% CI 64.2–94.2). Median time to progression 23.9 months (95% CI 14.9–not reached [NR]), median progression-free survival 23.9 months (95% CI 10.3–NR). No grade 4 toxicity was seen. Grade 3 toxicities included: ejection fraction decrease, neutropenia, hyponatremia, fatigue and sensory neuropathy and one left ventricular systolic dysfunction. Phosphorylated (p)-SRC was reduced in peripheral blood mononuclear cells. Phosphorylated SRC, ERK and AKT were also reduced in epidermal keratinocytes.[Conclusions]: Dasatinib can be safely combined with trastuzumab and paclitaxel. The combination is active with an ORR of almost 80%. Trial registration: NCT01306942, EudraCT 2010-023304-27.The study was financially supported by Bristol-Myers Squibb which also supplied the dasatinib