Clinical and preclinical evidence of somatosensory involvement in amyotrophic lateral sclerosis

Amyotrophic lateral sclerosis (ALS) is the most common motor neuron neurodegenerative disease. Although it has been classically considered as a disease limited to the motor system, there is increasing evidence for the involvement of other neural and non-neuronal systems. In this review, we will discuss currently existing literature regarding the involvement of the sensory system in ALS. Human studies have reported intradermic small fibre loss, sensory axonal predominant neuropathy, as well as somatosensory cortex hyperexcitability. In line with this, ALS animal studies have demonstrated the involvement of several sensory components. Specifically, they have highlighted the impairment of sensory?motor networks as a potential mechanism for the disease. The elucidation of these ?non-motor? systems involvement, which might also be part of the degeneration process, should prompt the scientific community to re-consider ALS as a pure motor neuron disease, which may in turn result in more holistic research approaches

Emergence and spread of a B.1.1.28-derived P.6 lineage with Q675H and Q677H spike mutations in Uruguay

Uruguay controlled the viral dissemination during the first nine months of the SARS-CoV-2 pandemic. Unfortunately, towards the end of 2020, the number of daily new cases exponentially increased. Herein, we analyzed the country-wide genetic diversity of SARS-CoV-2 between November 2020 and April 2021. We identified that the most prevalent viral variant during the first epidemic wave in Uruguay (December 2020–February 2021) was a B.1.1.28 sublineage carrying Spike mutations Q675H + Q677H, now designated as P.6, followed by lineages P.2 and P.7. P.6 probably arose around November 2020, in Montevideo, Uruguay’s capital department, and rapidly spread to other departments, with evidence of further local transmission clusters; it also spread sporadically to the USA and Spain. The more efficient dissemination of lineage P.6 with respect to P.2 and P.7 and the presence of mutations (Q675H and Q677H) in the proximity of the key cleavage site at the S1/S2 boundary suggest that P.6 may be more transmissible than other lineages co-circulating in Uruguay. Although P.6 was replaced by the variant of concern (VOC) P.1 as the predominant lineage in Uruguay since April 2021, the monitoring of the concurrent emergence of Q675H + Q677H in VOCs should be of worldwide interest

Real-Time genomic surveillance for SARS-CoV-2 variants of concern, Uruguay

We developed a genomic surveillance program for realtime monitoring of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOCs) in Uruguay. We report on a PCR method for SARSCoV- 2 VOCs, the surveillance workflow, and multiple independent introductions and community transmission of the SARS-CoV-2 P.1 VOC in Uruguay

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

Aspectos inmunológicos implicados en la etiopatogenia de la preeclampsia

RESUMEN: La patología preeclámptica es de suma importancia en lo que a la atención a la gestante se refiere, por la elevada morbimortalidad que puede suponer si no se previene o trata correctamente, y es importante tenerla presente ya que aparece en el 5% de todos los embarazos. He tratado de enfocar esta revisión sobre la preeclampsia como una forma de rechazo agudo, analizando las interacciones inmunológicas que se producen entre madre y embrión. Además, se ha revisado el papel de las distintas células inmunológicas implicadas así como los factores solubles producidos por estas y otras moléculas envueltas en la etiopatogenia y fisiopatología de esta enfermedad. Se ha intentado analizar la preeclampsia desde el punto de vista de una perdida de mecanismos responsables del mantenimiento de tolerancia inmunológica desencadenándose así una respuesta inmune. Por otra parte he revisado los eventos adversos endoteliales implicados en la preeclampsia así como las consecuencias de los mismos. Aunque son muchos los estudios que se han hecho sobre esta enfermedad, son aún numerosos los interrogantes acerca de muchos de los mecanismos implicados, por lo que el estudio de esta patología está aún lejos de ser concluido.ABSTRACT: Preeclampsia is a very frequent condition during pregnancy, with high risk of complications, mainly connected to hypertension. It represents one of the most important causes of morbidity and mortality and appears in about 5% of all pregnancies. The main goal of this work is to summarize the different immunological mechanisms involved in the pathogenesis of the preeclampsia. I have tried to carry out this review focusing on preeclampsia like a way of acute graft versus host rejection, due to the existing immunological mismatches between the mother and the embryo. Thus, I have reviewed the role of the different immune cells and their soluble products together with other molecules involved in the pathophysiology of the preeclampsia. Furthermore, I have analyzed the preeclampsia from a point of view of the loss of several mechanisms responsible for the maintenance of the immune tolerance which could lead to the development of an immune response. On the other hand, I have reviewed some of the endothelial events that have been found involved or related with the appearance of preeclampsia. In spite of the great number of reported mechanisms, further studies are needed to elucidate the complete knowledge of the pathogeny and pathophysiology of this disease.Grado en Medicin

UNA ENTIDAD EXTRAHOTELERA CUBANA EN MEJORA CONTINUA

El estudio, enfoque a procesos y el correcto diseño de estos es de gran importancia en toda organización para la mejora continua y la toma de dediciones de la misma. Se tomó como objeto de estudio una entidad extrahotelera cubana necesitada de una correcta identificación, diseño e implantación de sus procesos. Para determinar e identificar los procesos que se ponen de manifiesto en esta, se aplicó el método de la matriz de procesos derivándose de esto que el proceso de gestión de la calidad era el mas significativo para ser analizado y rediseñado. Para mapear el proceso y conocer la situación en que se encontraba al inicio se realizó un diagnostico de la entidad entorno al mismo y posterior a esto se rediseñó junto con los subprocesos implícitos, estableciéndose los indicadores de medición y la frecuencia a ser medidos. Este estudio se presentó al Consejo de Dirección de esta entidad. El mismo sirvió de asesoría a los directivos que tomaron la decisión de implantarlo a partir de la fecha de presentación y continuar con el rediseño del resto de los procesos en trabajos posteriores.Proceso, calidad, mejora.

Intervencion social y el debate sobre lo público: reflexiones conceptuales y casos locales

La Oficina de publicaciones de la Facultad de Derecho y Ciencias Sociales de la Universidad Icesi publica el 9no número de su colección "El Sur es Cielo Roto". El libro Intervención social y el debate sobre lo público: reflexiones conceptuales y casos locales recoge los resultados de investigación del Observatorio de Cooperación Internacional, Intervención y Responsabilidad Social (OCIR) sobre las múltiples confluencias en torno a lo público, de los diversos actores relacionales con esos temas, el Estado, las ONG, las empresas y sus fundaciones y las comunidades y sus organizaciones de base..CONTENIDO: Introducción -- Una mirada general de la construcción de lo público / Miriam Fajardo G. -- Rupturas y herencias en la intervención social: filantropía, intelectualidad orgánica y atención estatal como prácticas antecesoras / Viviam Unás y Paola Ocampo -- Intervención social: algunas pistas para su comprensión y para trazar otros horizontes posibles / James, José Eduardo Sánchez y Mary Hellen Burbano Cerón -- La intervención social y sus retos frente al quehacer de las ciencias sociales / Ana Lucía Paz Rueda -- Metáforas de empresa: reflexiones conceptuales sobre responsabilidad social empresarial / Edgar Orlando Benítez y Diego Fernando Varón -- ¿Medir la responsabilidad social empresarial? Hacia una perspectiva crítica /Diego Hernán Varón Rojas -- Notas sobre algunos casos de intervención social. Transformaciones del tercer sector en Santiago de Cali en el periodo 2005-2010 y la información que hacen pública / Nathalia Muñoz Ballesteros -- Las mediadoras de la intervención social en la construcción de un escenario público como el Centro de Escucha de Potrero Grande / María Catalina Gómez Dueñas y Nathalia Muñoz Ballesteros -- Voces subalternas en la construcción de un sueño de vivienda / Nathalia Muñoz Ballesteros -- El Estado, las políticas públicas y la construcción de lo público: elementos de un nuevo marco relacional frente a la sociedad / Harold Valencia Oliveros y César Eduardo Ibáñez Fernández

Emergence and Spread of a B.1.1.28-Derived P.6 Lineage with Q675H and Q677H Spike Mutations in Uruguay

Uruguay controlled the viral dissemination during the first nine months of the SARS-CoV-2 pandemic. Unfortunately, towards the end of 2020, the number of daily new cases exponentially increased. Herein, we analyzed the country-wide genetic diversity of SARS-CoV-2 between November 2020 and April 2021. We identified that the most prevalent viral variant during the first epidemic wave in Uruguay (December 2020–February 2021) was a B.1.1.28 sublineage carrying Spike mutations Q675H + Q677H, now designated as P.6, followed by lineages P.2 and P.7. P.6 probably arose around November 2020, in Montevideo, Uruguay’s capital department, and rapidly spread to other departments, with evidence of further local transmission clusters; it also spread sporadically to the USA and Spain. The more efficient dissemination of lineage P.6 with respect to P.2 and P.7 and the presence of mutations (Q675H and Q677H) in the proximity of the key cleavage site at the S1/S2 boundary suggest that P.6 may be more transmissible than other lineages co-circulating in Uruguay. Although P.6 was replaced by the variant of concern (VOC) P.1 as the predominant lineage in Uruguay since April 2021, the monitoring of the concurrent emergence of Q675H + Q677H in VOCs should be of worldwide interest

Anestesiología : apuntes para el médico general

En su tercera edición, este libro mantiene su foco en las temáticas de la práctica de la Anestesia que son de utilidad para el médico general. Esta versión ha actualizado varios de los capítulos, cuyos conceptos serán fundamentales para lograr objetivos, tales como el manejo de la vía aérea, el abordaje para la evaluación y el tratamiento del dolor agudo, el manejo de la volemia en el perioperatorioy la valoración preanestésica, entre otros. Además, se han incluido nuevos capítulos con la participación de todo el equipo de profesores de Anestesiología de la Pontificia Universidad Javeriana y el Hospital Universitario San Ignacio, entre los que se encuentran el manejo inicial de ritmos cardíacos anormales, reanimación cardiopulmonar en pediatría, la bioética de la reanimación cardiopulmonar, el abordaje del dolor crónico y los conceptos básicos de ultrasonido enfocado, por mencionar solamente algunos de ellos.Bogot