Caracterización de la durabilidad del hormigón sometido a ciclos hielo deshielo mediante modelos micromecánicos

En este trabajo se exponen los resultados previos de la caracterización de la durabilidad del hormigón frente a los ciclos hielo-deshielo mediante la micromecánica. Los modelos micromecánicos permiten estudiar las propiedades globales del material en función de las propiedades microestructurales de las fases constituyentes: propiedades elásticas, fracción de volumen, distribución y orientación de las heterogeneidades así como su geometría. El trabajo se divide en dos partes, un estudio teórico y una posterior validación experimental. En el estudio teórico se aborda el comportamiento de la velocidad a partir de la variación de las características microestructurales por este tipo de deterioro. Estas predicciones se han comparado con las medidas de velocidad ultrasónica, mostrando buenos resultados

Risk of malnutrition in cancer patients.

La prevalencia de malnutrición en enfermos de cáncer se estima alrededor del 40-80 %. Esta desnutrición en pacientes oncológicos está relacionada con un aumento no solo de mortalidad sino también de morbilidad. Determinar la desnutrición que presentan pacientes oncológicos con tumor sólido y como objetivo secundario especificar esta desnutrición en función del tipo de tumor, presencia o no de metástasis y administración o no de quimioterapia. Estudio descriptivo y analítico con un total de 154 pacientes oncológicos con tumor sólido, 77 en el grupo de prequimioterapia y 77 en el de posquimioterapia (con al menos 6 ciclos de quimioterapia recibidos). Los parámetros recogidos fueron: tipo de tumor, existencia de metástasis y la administración o no de quimioterapia. El test que se aplicó fue la Valoración Subjetiva Global (VSG-GP). 76 pacientes (47,4 %) presentaron niveles de desnutrición de grado B o C. En función del tipo de tumor los pacientes con cáncer de pulmón son los que más desnutrición presentan (69,9 %), seguido del digestivo, de colon y de mama. Teniendo en cuenta la existencia o no de metástasis, los pacientes sin metástasis que presentaban riesgo de desnutrición fue 48,6 % frente al 62,1 % de los pacientes metastásicos (p=0,03). Y en cuanto a la administración de quimioterapia, el grupo que no la había recibido presentó un 39 %, mientras que el que la recibió presentó un 55,9 %, siendo la diferencia significativa (p=0,036). Los pacientes oncológicos presentan elevada desnutrición, pudiéndose observar que esta depende del tipo de tumor, la existencia de metástasis o la administración de quimioterapia.Malnutrition prevalence in cancer patients is estimated around 40-80 %. This malnutrition in oncologic patients is related to an increase not only in mortality but also in morbidity. To determine malnutrition in oncologic patients with solid tumor and to specify this malnutrition based on tumor type, the presence of absence of metastasis and the use of chemotherapy or not. Analytic and descriptive study with a total of 154 oncologic patients with solid tumor, 77 in pre-chemotherapy group and 77 in post-chemotherapy group (with at least 6 chemotherapy cycles received). Parameters gathered were: tumor type, metastasis existence and administration or not of chemotherapy. The test applied was Subjective Global Valuation (VSG-GP). 76 patients (47,4 %) presented B or C malnutrition grades. Based on tumor type, patients with lung cancer presented the highest malnutrition (69,9 %), followed by digestive, colon and breast cancer. Taking into account the presence or absence of metastasis, 48,6 % of patients without metastasis presented malnutrition risk, facing the 62,1 % of metastatic patients (p=0,03). And as far as chemotherapy is concerned, the group without chemotherapy presented a 39 % of malnutrition risk, whereas the chemotherapy group presented a 55,9 % of malnutrition risk, existing a major difference between the two (p=0,036). Oncologic patients present a high level of malnutrition, and it can be observed that this malnutrition depends on tumor type, metastasis or chemotherapy.Nutrición humana y dietétic

Use of tocilizumab in kidney transplant recipients with COVID-1

Acute respiratory distress syndrome associated with coronavirus infection is related to a cytokine storm with large interleukin-6 (IL-6) release. The IL-6-receptor blocker tocilizumab may control the aberrant host immune response in patients with coronavirus disease 2019 (COVID-19) . In this pandemic, kidney transplant (KT) recipients are a high-risk population for severe infection and showed poor outcomes. We present a multicenter cohort study of 80 KT patients with severe COVID-19 treated with tocilizumab during hospital admission. High mortality rate was identified (32.5%), related with older age (hazard ratio [HR] 3.12 for those older than 60 years, P = .039). IL-6 and other inflammatory markers, including lactic acid dehydrogenase, ferritin, and D-dimer increased early after tocilizumab administration and their values were higher in nonsurvivors. Instead, C-reactive protein (CRP) levels decreased after tocilizumab, and this decrease positively correlated with survival (mean 12.3 mg/L in survivors vs. 33 mg/L in nonsurvivors). Each mg/L of CRP soon after tocilizumab increased the risk of death by 1% (HR 1.01 [confidence interval 1.004-1.024], P = .003). Although patients who died presented with worse respiratory situation at admission, this was not significantly different at tocilizumab administration and did not have an impact on outcome in the multivariate analysis. Tocilizumab may be effective in controlling cytokine storm in COVID-19 but randomized trials are needed

Development of lessons on chemical and biological reactors in Moodle platform

En este proyecto docente se han desarrollado una serie de actividades académicamente dirigidas dedicadas a los reactores químicos y biológicos, en concreto, se ha empleado una herramienta denominada lección que se encuentra disponible a través de la plataforma virtual Moodle, dichas lecciones se basan en una serie de ventanas secuenciales que permiten profundizar en todos los conceptos fundamentales de los reactores químicos y/o biológicos y, a través de diversas cuestiones complementarias sobre el tema, incluidas durante el desarrollo de dicha lección, permite al alumno realizar un aprendizaje más activo que favorece la consolidación de los conceptos de forma gradual. Previo al estudio de los reactores químicos y/o biológicos es necesario tener en cuenta diversos aspectos químicos, físicos, matemáticos, biológicos e ingenieriles que han de considerarse para desarrollar los aspectos fundamentales básicos para poder alcanzar dicho objetivo y se pretende facilitar esta labor al alumnado con el empleo de las lecciones elaboradas. Previamente a la elaboración de las lecciones se ha realizado una importante labor de preparación y síntesis de toda la información, posteriormente se han desarrollado diferentes lecciones para los conceptos tratados en cada uno de los temas implicados en la elaboración de este proyecto docente y tras una profunda revisión se han puesto a disposición de los alumnos.In this teaching project have developed a series of academic activities devoted to the chemical and biological reactors, in particular, it has been using a tool called lesson which is available through the Moodle virtual platform, these lessons are based on a series of sequential windows allowing to delve into all the fundamental concepts of chemical and/or biological reactors and through various complementary on the theme, including issues during the development of this lesson, students perform a more active learning that promotes the consolidation of concepts gradually. Prior to the study of chemical reactors and/or biological is necessary to take account of various chemical, physical, mathematical, biological and engineering aspects that are to be considered to develop the basic fundamentals to achieve the aim and is intended to facilitate this work to the students with the use of elaborate lessons. Important preparation work has been prior to the preparation of the lessons and synthesis of information, have subsequently developed different lessons for the concepts dealt with in each of the issues involved in the development of this educational project and after a thorough review have been available to the students

Risk factors associated with moderate-to-severe renal dysfunction among heart transplant patients: results from the CAPRI study

[Abstract] The longer survival of patients with heart transplantation (HT) favors calcineurin inhibitor–related chronic kidney disease (CKD). It behoves to identify risk factors. At 14 Spanish centers, data on 1062 adult patients with HT (age 59.2 ± 12.3 yr, 82.5% men) were collected at routine follow-up examinations. Glomerular filtration rate, GFR, was estimated using the four-variable MDRD equation, and moderate-or-severe renal dysfunction (MSRD) was defined as K/DOQI stage 3 CKD or worse. Time since transplant ranged from one month to 22 yr (mean 6.7 yr). At assessment, 26.6% of patients were diabetic and 63.9% hypertensive; 53.9% were taking cyclosporine and 33.1% tacrolimus; and 61.4% had MSRD. Among patients on cyclosporine or tacrolimus at assessment, multivariate logistic regression identified male sex (OR 0.44), pre- and post-HT creatinine (2.73 and 3.13 per mg/dL), age at transplant (1.06 per yr), time since transplant (1.05 per yr), and tacrolimus (0.65) as independent positive or negative predictors of MSRD. It is concluded that female sex, pre- and one-month post-HT serum creatinine, age at transplant, time since transplant, and immunosuppression with cyclosporine rather than tacrolimus may all be risk factors for development of CKD ≥ stage 3 by patients with HT

ERK5 Is a major determinant of chemical sarcomagenesis: implications in human pathology

Sarcomas are a heterogeneous group of tumors in which the role of ERK5 is poorly studied. To clarify the role of this MAPK in sarcomatous pathology, we used a murine 3-methyl-cholanthrene (3MC)-induced sarcoma model. Our data show that 3MC induces pleomorphic sarcomas with muscle differentiation, showing an increased expression of ERK5. Indeed, this upregulation was also observed in human sarcomas of muscular origin, such as leiomyosarcoma or rhabdomyosarcoma. Moreover, in cell lines derived from these 3MC-induced tumors, abrogation of Mapk7 expression by using specific shRNAs decreased in vitro growth and colony-forming capacity and led to a marked loss of tumor growth in vivo. In fact, transcriptomic profiling in ERK5 abrogated cell lines by RNAseq showed a deregulated gene expression pattern for key biological processes such as angiogenesis, migration, motility, etc., correlating with a better prognostic in human pathology. Finally, among the various differentially expressed genes, Klf2 is a key mediator of the biological effects of ERK5 as indicated by its specific interference, demonstrating that the ERK5–KLF2 axis is an important determinant of sarcoma biology that should be further studied in human pathology.This work has been supported with Grant RTI2018-094093-B-I00 funded by MCIN/AEI/10.13039/501100011033, “ERDF A way of making Europe” to RSP. Also supported with funds from Fundación Leticia Castillejo Castillo, Roche España and ACEPAIN to RSP and MJRH. RSP and MJRH’s Research Institute and the work carried out in their laboratory, received partial support from the European Community through the FEDER. JJ and EAL hold a predoctoral research contract cofounded by the European Social Fund and UCLM. OR holds a contract for accessing the Spanish System of Science, Technology, and Innovation (SECTI) funded by the University of Castilla-La Mancha (UCLM) and received partial support from the European Social Fund (FSE) through its Operative Program for Castilla-La Mancha (2007–2013)

ERK5 Is a Major Determinant of Chemical Sarcomagenesis : Implications in Human Pathology

Sarcoma is a heterogeneous group of tumors poorly studied with few therapeutic opportunities. Interestingly, the role of MAPKs still remains unclear in sarcomatous pathology. Here, we describe for the first time the critical role of ERK5 in the biology of soft tissue sarcoma by using in vitro and in vivo approaches in a murine experimental model of chemical sarcomagenesis. Indeed, our observations were extrapolated to a short series of human leiomyosarcoma and rhabdomyosarcomas. Furthermore, transcriptome analysis allows us to demonstrate the critical role of KLF2 in the biological effects of ERK5. Therefore, the data presented here open new windows in the diagnosis and therapy of soft tissue sarcomas. Sarcomas are a heterogeneous group of tumors in which the role of ERK5 is poorly studied. To clarify the role of this MAPK in sarcomatous pathology, we used a murine 3-methyl-cholanthrene (3MC)-induced sarcoma model. Our data show that 3MC induces pleomorphic sarcomas with muscle differentiation, showing an increased expression of ERK5. Indeed, this upregulation was also observed in human sarcomas of muscular origin, such as leiomyosarcoma or rhabdomyosarcoma. Moreover, in cell lines derived from these 3MC-induced tumors, abrogation of Mapk7 expression by using specific shRNAs decreased in vitro growth and colony-forming capacity and led to a marked loss of tumor growth in vivo. In fact, transcriptomic profiling in ERK5 abrogated cell lines by RNAseq showed a deregulated gene expression pattern for key biological processes such as angiogenesis, migration, motility, etc., correlating with a better prognostic in human pathology. Finally, among the various differentially expressed genes, Klf2 is a key mediator of the biological effects of ERK5 as indicated by its specific interference, demonstrating that the ERK5-KLF2 axis is an important determinant of sarcoma biology that should be further studied in human pathology

A study protocol for development and validation of a clinical prediction model for frailty (ModulEn): a new European commitment to tackling frailty

There is a growing need to implement and evaluate the technological solutions that allow the early detection of age-related frailty and enable assessment of the predictive values of frailty components. The broad use of these solutions may ensure an efficient and sustainable response of health and social care systems to the challenges related to demographic aging. In this paper, we present the protocol of the ModulEn study that aims to develop and validate a predictive model for frailty. For this purpose, the sample composed by older adults aged 65-80 years and recruited from the community will be invited to use an electronic device ACM Kronowise® 2.0. This device allows proactive and continuous monitoring of circadian health, physical activity, and sleep and eating habits. It will be used during a period of seven to ten days. The participants will also be given the questionnaires evaluating the variables of interest, including frailty level, as well as their experience and satisfaction with the device use. Data provided from these two sources will be combined and the relevant associations will be identified. In our view, the implications of this study' findings for clinical practice include the possibility to develop and validate tools for timely prevention of frailty progress. In the long term, the ModulEn may contribute to the critical reduction of frailty burden in Europe

Acceptance of living liver donation among medical students: A multicenter stratified study from Spain

AIM: To analyze the attitude of Spanish medical students toward living liver donation (LLD) and to establish which factors have an influence on this attitude. METHODS: STUDY TYPE: A sociological, interdisciplinary, multicenter and observational study. STUDY POPULATION: Medical students enrolled in Spain (n = 34000) in the university academic year 2010-2011. SAMPLE SIZE: A sample of 9598 students stratified by geographical area and academic year. Instrument used to measure attitude: A validated questionnaire (PCID-DVH RIOS) was self-administered and completed anonymously. Data collection procedure: Randomly selected medical schools. The questionnaire was applied to each academic year at compulsory sessions. STATISTICAL ANALYSIS: Student´s t test, ?(2) test and logistic regression analysis. RESULTS: The completion rate was 95.7% (n = 9275). 89% (n = 8258) were in favor of related LLD, and 32% (n = 2937) supported unrelated LLD. The following variables were associated with having a more favorable attitude: (1) age (P = 0.008); (2) sex (P < 0.001); (3) academic year (P < 0.001); (4) geographical area (P = 0.013); (5) believing in the possibility of needing a transplant oneself in the future (P < 0.001); (6) attitude toward deceased donation (P < 0.001); (7) attitude toward living kidney donation (P < 0.001); (8) acceptance of a donated liver segment from a family member if one were needed (P < 0.001); (9) having discussed the subject with one's family (P < 0.001) and friends (P < 0.001); (10) a partner's opinion about the subject (P < 0.001); (11) carrying out activities of an altruistic nature; and (12) fear of the possible mutilation of the body after donation (P < 0.001). CONCLUSION: Spanish medical students have a favorable attitude toward LLD