External validation of multidimensional prognostic indices (ADO, BODEx and DOSE) in a primary care international cohort (PROEPOC/COPD cohort)

Background: Due to the heterogeneous and systemic nature of the chronic obstructive pulmonary disease (COPD), the new guidelines are oriented toward individualized attention. Multidimensional scales could facilitate its proper clinical and prognostic assessment, but not all of them were validated in an international primary care cohort, different from the original ones used for model development. Therefore, our main aim is to assess the prognostic capacity of the ADO, BODEx and DOSE indices in primary care for predicting mortality in COPD patients and to validate the models obtained in subgroups of patients, classified by revised Global Initiative for Chronic Obstructive Lung Disease (2011) and updated Spanish Guideline (2014). Besides, we want to confirm that the prognostic capacity of all indices increases if the number of exacerbations is substituted by the interval between them and to assess the impact on health of the patient''s lifestyle, social network and adherence to treatment. Methods: Design: External validation of scales, open and prospective cohort study in primary care. Setting: 36 health centres in 6 European high, medium and low income countries. Subjects: 477 patients diagnosed with COPD, captured in clinical visit by their General Practitioner/Nurse. Predictors: Detailed patient history, exacerbations, lung function test and questionnaires at baseline. Outcomes: Exacerbations, all-cause mortality and specific mortality, within 5 years of recruitment. Analysis: Multivariate logistic regression and Cox regression will be used. Possible non-linear effect of the indices will be studied by using Structured Additive Regression models with penalised splines. Subsequently, we will assess different aspects of the regression models: discrimination, calibration and diagnostic precision. Clinical variables modulated in primary care and the interval between exacerbations will be considered and incorporated into the analysis. Discussion: The Research Agenda for General Practice/Family Medicine highlights that the evidence on predictive values of prognostic indices in primary care is scarce. A prospective cohort like that of PROEPOC/COPD provides good opportunities for research into COPD and make communication easier between family practitioners, nursing staff, pneumologists and other professionals, supporting a multi-disciplinary approach to the treatment of these patients. Trial registration:ISRCTN52402811. Date: 15/01/2015. Prospectively registered

RICORS2040 : The need for collaborative research in chronic kidney disease

Chronic kidney disease (CKD) is a silent and poorly known killer. The current concept of CKD is relatively young and uptake by the public, physicians and health authorities is not widespread. Physicians still confuse CKD with chronic kidney insufficiency or failure. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. Thus health authorities may consider CKD a non-issue: very few persons eventually need KRT and, for those in whom kidneys fail, the problem is 'solved' by dialysis or kidney transplantation. However, KRT is the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated ageing and premature death. The cut-off points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature death. CKD is the most prevalent risk factor for lethal coronavirus disease 2019 (COVID-19) and the factor that most increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality that is 10- to 100-fold higher than similar-age peers, and life expectancy is shortened by ~40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth greatest global cause of death by 2040 and the second greatest cause of death in Spain before the end of the century, a time when one in four Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded Centres for Biomedical Research (CIBER) network structure in Spain. Realizing the underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020-2030 was launched by the American Association of Kidney Patients and the European Kidney Health Alliance. Leading Spanish kidney researchers grouped in the kidney collaborative research network Red de Investigación Renal have now applied for the Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS) call for collaborative research in Spain with the support of the Spanish Society of Nephrology, Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true

Actas de las V Jornadas ScienCity 2022. Fomento de la Cultura Científica, Tecnológica y de Innovación en Ciudades Inteligentes

ScienCity es una actividad que viene siendo continuada desde 2018 con el objetivo de dar a conocer los conocimientos y tecnologías emergentes siendo investigados en las universidades, informar de experiencias, servicios e iniciativas puestas ya en marcha por instituciones y empresas, llegar hasta decisores políticos que podrían crear sinergias, incentivar la creación de ideas y posibilidades de desarrollo conjuntas, implicar y provocar la participación ciudadana, así como gestar una red internacional multidisciplinar de investigadores que garantice la continuación de futuras ediciones. En 2022 se recibieron un total de 48 trabajos repartidos en 25 ponencias y 24 pósteres pertenecientes a 98 autores de 14 instituciones distintas de España, Portugal, Polonia y Países Bajos.Fundación Española para la Ciencia y la Tecnología-Ministerio de Ciencia, Innovación y Universidades; Consejería de la Presidencia, Administración Pública e Interior de la Junta de Andalucía; Estrategia de Política de Investigación y Transferencia de la Universidad de Huelva; Cátedra de Innovación Social de Aguas de Huelva; Cátedra de la Provincia; Grupo de investigación TEP-192 de Control y Robótica; Centro de Investigación en Tecnología, Energía y Sostenibilidad (CITES

Seguimiento de las guías españolas para el manejo del asma por el médico de atención primaria: un estudio observacional ambispectivo

Objetivo Evaluar el grado de seguimiento de las recomendaciones de las versiones de la Guía española para el manejo del asma (GEMA 2009 y 2015) y su repercusión en el control de la enfermedad. Material y métodos Estudio observacional y ambispectivo realizado entre septiembre del 2015 y abril del 2016, en el que participaron 314 médicos de atención primaria y 2.864 pacientes. Resultados Utilizando datos retrospectivos, 81 de los 314 médicos (25, 8% [IC del 95%, 21, 3 a 30, 9]) comunicaron seguir las recomendaciones de la GEMA 2009. Al inicio del estudio, 88 de los 314 médicos (28, 0% [IC del 95%, 23, 4 a 33, 2]) seguían las recomendaciones de la GEMA 2015. El tener un asma mal controlada (OR 0, 19, IC del 95%, 0, 13 a 0, 28) y presentar un asma persistente grave al inicio del estudio (OR 0, 20, IC del 95%, 0, 12 a 0, 34) se asociaron negativamente con tener un asma bien controlada al final del seguimiento. Por el contrario, el seguimiento de las recomendaciones de la GEMA 2015 se asoció de manera positiva con una mayor posibilidad de que el paciente tuviera un asma bien controlada al final del periodo de seguimiento (OR 1, 70, IC del 95%, 1, 40 a 2, 06). Conclusiones El escaso seguimiento de las guías clínicas para el manejo del asma constituye un problema común entre los médicos de atención primaria. Un seguimiento de estas guías se asocia con un control mejor del asma. Existe la necesidad de actuaciones que puedan mejorar el seguimiento por parte de los médicos de atención primaria de las guías para el manejo del asma. Objective: To assess the degree of compliance with the recommendations of the 2009 and 2015 versions of the Spanish guidelines for managing asthma (Guía Española para el Manejo del Asma [GEMA]) and the effect of this compliance on controlling the disease. Material and methods: We conducted an observational ambispective study between September 2015 and April 2016 in which 314 primary care physicians and 2864 patients participated. Results: Using retrospective data, we found that 81 of the 314 physicians (25.8%; 95% CI 21.3–30.9) stated that they complied with the GEMA2009 recommendations. At the start of the study, 88 of the 314 physicians (28.0%; 95% CI 23.4–33.2) complied with the GEMA2015 recommendations. Poorly controlled asthma (OR, 0.19; 95% CI 0.13–0.28) and persistent severe asthma at the start of the study (OR, 0.20; 95% CI 0.12–0.34) were negatively associated with having well-controlled asthma by the end of the follow-up. In contrast, compliance with the GEMA2015 recommendations was positively associated with a greater likelihood that the patient would have well-controlled asthma by the end of the follow-up (OR, 1.70; 95% CI 1.40–2.06). Conclusions: Low compliance with the clinical guidelines for managing asthma is a common problem among primary care physicians. Compliance with these guidelines is associated with better asthma control. Actions need to be taken to improve primary care physician compliance with the asthma management guidelines

Accumulation potential of Atriplex halimus to zinc and lead combined with NaCl: Effects on physiological parameters and antioxidant enzymes activities

An experiment in this study was designed to investigate the effect of different concentrations of Zn2+ or Pb2+ (0, 200, 400 and 600 μM) with NaCl (0, 200 mM), on the morphological and physiological parameters as well as the antioxidative response of the halophytic species Atriplex halimus. Results showed that Pb2+ had no significant impact on biomass production while Zn2+ significantly affected plant development mainly at high concentration, 600 μM. Total chlorophyll content did not change significantly under elevation concentrations of Zn2+ when compared to control. However, there was a modest decrease in total chlorophyll concentration in the leaves of A. halimus grown in a medium supplemented with 600 μMPb2+ and with combined stress Pb2+/NaCl. Zn2+ and Pb2+ contents in tissues were higher in the belowground organs of this halophyte. Overall results pointed out that application of different concentrations of Zn2+ or Pb2+ disturbed status of nutrients in A. halimus. Analysis of antioxidant enzymes [ascorbate peroxidase (APX), guaiacol peroxidase (GPX), and catalase (CAT)] showed that the activity was diminished by increasing Zn2+ concentrations in the medium. Whereas, the addition of Pb2+ in the medium increased CAT activity and decreased APX activity.info:eu-repo/semantics/publishedVersio

In vivo and macrophage response of graphene and its derivatives

The possible application in the biomedical field of reduced Graphene oxide (ErGO) on CoCr alloy has been studied. Biocompatibility tests were carried out on ErGO/CoCr alloy. The discrepancy of in vivo results found in the literature regarding the side effects of graphene led to perform an in vivo study with graphene. Biocompatibility tests of ErGO/CoCr were evaluated in J774A.1 mouse macrophages cultures. Mitochondrial activity (WST-1 assay) and plasma membrane damage (LDH assay) were measured to evaluate biocompatibility and cytotoxicity, respectively. The ratio of LDH/WST-1 activities was used as an index of biocompatibility as relates cell death and cell number, reaching a low value on ErGO/CoCr. Morphological analyses of macrophages cultures revealed different cell distribution and morphology on CoCr and ErGO/CoCr, after 48 h exposure. Optical microscopy and secondary electron microscopy images showed macrophages on the ErGO/CoCr well-distributed and conserved characteristic cell shape. These results show an improvement in the CoCr biocompatibility due to ErGO films. In vivo tests of graphene and graphene oxide nanosheets were carried out by intraperitoneal inoculation in rats to evaluate possible changes in the blood line and organs after 15 and 30 days. Optical microscopy of liver, kidney, spleen or lung, revealed no visible histological alterations. However, traces of particles were found in the peritoneal cavity. The blood analysis showed alterations indicative of the hepatic inflammatory process. Haematological changes after 30 days consisted of alterations of the red series as microcytosis with a higher concentration of mean haemoglobin. In addition, alteration in prothrombin and thromboplastin caused a longer coagulation time.The authors acknowledge the financial support from MAT2015-67750-C3

Biocompatibility of Electrochemically Reduced Graphene Oxide on biomedical grade CoCr alloy. In vivo response of graphene

The Annual Congress of the European Federation of CorrosionIn this work, electrochemically reduced Graphene oxide (ErGO) films are formed on the biomedical grade CoCr alloy to study its possible application in biomedical field. Biocompatibility tests were carried out to assess the biomedical performance of ErGO on the CoCr alloy. The discrepancy of in vivo results found in the literature regarding the side effects of graphene led to perform a previous in vivo study with Graphene. The reduction of an aqueous suspension of graphene oxide was carried out by electrochemical methods to generate ErGO films on CoCr alloys. The direct electrodeposition process was performed by cyclic voltammetry (CV) at room temperature. Characterization of the ErGO on CoCr alloys was carried out by XPS. Electrochemical procedure led to the deposition of graphene-based films on the CoCr surfaces after the partial removal of the oxygenated functional groups present in the graphene network of starting graphene oxide (GO). Biocompatibility tests of ErGO on CoCr were evaluated in J774A.1 mouse macrophages cultures, which are the main cells involved in the primary response to foreign bodies playing a decisive role in the inflammatory reactions. In vivo tests were carried out by intraperitoneal inoculation of graphene nano particles in rats evaluating possible changes in the blood line and in different organs. CV revealed the reduction of the GO around -1,2 V. The XPS high-resolution C and O peaks mainly showed sp2 bonding and the presence of C=O and C-O residual groups covering the CoCr surface. Biocompatibility studies on mouse macrophages J774A.1 cell cultures measured by the ratio between lactate dehydrogenase and mitochondrial activities showed an enhancement in the biocompatibility on the CoCr with the ErGO films, a result that seems to become more evident as exposition time increased. Optical and SE images and vimentin expression (protein responsible for architecture of cytoplasm) after 48 h exposure in macrophage culture revealed a different cell distribution, morphology and vimentin expression on CoCr or ErGO on CoCr. Macrophages on the ErGO on CoCr surfaces were well-distributed, conserved the characteristic cell shape and vimentin expression was unaffected, results that show an improvement on the CoCr biocompatibility due to the of ErGO films on material surface. Conventional optical microscopy of in vivo experiments revealed that at 15 and 30 days after inoculation there were no visible histological alterations in liver, kidney, spleen or lung, but traces of particles were found in the peritoneal cavity. The blood analysis showed alterations indicative of the hepatic inflammatory process at both 15 and 30 days. Haematological changes were found at 30 days that consisted of alterations of the red series in the form of microcytosis with a higher concentration of mean haemoglobin as well as an alteration in coagulation due to a longer prothrombin and thromboplastin time