Relación de la periodontitis con la expresión clínica y respuesta al tratamiento en los pacientes con artritis reumatoide

La artritis reumatoide (AR) y la periodontitis crónica son dos enfermedades inflamatorias crónicas que se caracterizan por un proceso destructivo tisular local, mecanismos patogénicos similares, un mismo perfil de citocinas proinflamatorias, sobre todo todo TNF-α e IL-6, junto a una susceptibilidad genética compartida. Los resultados de estudios clínicos sugieren que la periodontitis tiene una mayor prevalencia en los pacientes con AR. Sin embargo, el grado de su asociación, así como la relación temporal entre ambas enfermedades, no ha sido aun bien establecido. Existe una evidencia creciente de que la periodontitis podría ser uno de los mecanismos que inicie y mantenga la respuesta autoinmune inflamatoria que ocurre en la AR. Tampoco está bien establecida la relación entre la severidad de la periodontitis y las manifestaciones clínicas de la enfermedad reumatoide, ni con la respuesta al tratamiento, por lo que se han descrito resultados contradictorios. En el presente estudio analizamos si la presencia de periodontitis afecta la expresión clínica y actividad de la AR, tanto precoz (2 años de evolución) y su posible influencia en la respuesta al tratamiento de los pacientes con alto grado de actividad clínica. Para ello estudiamos un grupo de pacientes con AR, y otro grupo control con patología articular no inflamatoria. Se realizó una valoración de la actividad de la enfermedad reumatoide y una exploración oral y periodontal para identificar la presencia y el nivel de severidad de la periodontitis. Nuestros resultados han demostrado una fuerte asociación independiente entre la AR y la periodontitis, estableciendo una asociación adicional entre el nivel de actividad de AR y la severidad de la periodontitis. Por otra parte, hay una mayor prevalencia de pacientes con periodontitis más severas en pacientes con AR y ACPA positivo, que parece no estar influenciada por el hábito tabáquico. Al valorar el posible efecto del tratamiento de la AR sobre el estado periodontal, parece ser independiente de la terapia utilizada, siempre que se logre un adecuado control de la AR. Aunque por el tipo de diseño del estudio no podemos establecer una relación de causalidad, los resultados sugieren una relación bidireccional entre periodontitis y AR, de modo que una actividad clínica mantenida se asocia a un peor estado de salud periodontal y viceversa

Percepciones del alumnado universitario sobre el aprendizaje-servicio como herramienta para su desarrollo personal y profesional

This article presents a teaching innovation experience developed in the first year of a Social Education Degree at a public university in Spain, using a service-learning methodology. The experience involves two disciplines from this degree program working collaboratively and the results show students’ perceptions on the personal and professional skills they acquired. The proposal is based not only on the notion of SL as a tool for the construction of committed and active citizenship, but from the consideration of SL as a methodology able to produce authentic learning, which involves transformations that go much further than cognitive changes and affect students’ own personal construction. We have used two sets of students’ narratives: a questionnaire about their learning perceptions and another on their reflections throughout the experience. The data shows that students more emphatically refer to personal learning, followed by curricular-professional learning and finally learning about the reality. We also found that evaluation of the experience was mainly positive, pointing especially to the idea of learning by doing. We conclude that the methodology used generates in the students personal and social conceptions that go beyond what is achieved with traditional methodologies, showing that SL can be considered as an optimal teaching methodology to generate motivation for learning and commitment in future professionals.El artículo presenta una experiencia de innovación docente desarrollada con metodología de aprendizaje-servicio en el primer curso del Grado de Educación Social de una universidad pública española. La experiencia implica a dos asignaturas llevando a cabo un servicio comunitario en un C.E.I.P. constituido como Comunidad de Aprendizaje en una zona con necesidades de transformación social, con población mayoritaria de etnia gitana. Mostramos los resultados sobre las percepciones de los estudiantes sobre los aprendizajes adquiridos durante la experiencia. Los resultados se han organizado clasificando los aprendizajes percibidos en curriculares-profesionales; sobre la realidad social; y sobre sí mismos. Se analizaron también las valoraciones sobre la metodología empleada. Los datos muestran que el estudiantado destaca especialmente los aprendizajes personales. Concluimos que la metodología empleada es una buena herramienta docente generadora de motivación por el aprendizaje y de futuros profesionales comprometidos

Realfood and cancer: analysis of the reliability and quality of YouTube content

This study analyzes the quality and reliability of videos related to nutrition and cancer on YouTube. Study Design: An observational, retrospective, cross-sectional, time-limited study analyzing activity on the social network YouTube was proposed. Methods: The information from the videos was extracted through an API search tool, using the NodeXL software. The criteria to select the videos on YouTube were the keywords “real food”, “realfood”, and “cancer” and the hashtags #realfood and #cancer were present, videos in English and videos available on 1 December 2022. Results: The DISCERN value in the total number of videos viewed was 2.25 (±0.88) points, indicating low reliability. The videos uploaded by HRU represented only 20.8%. Videos suggesting that the use of foods defined as “real food” could cure cancer without the intervention of any other treatment accounted for 12.5%. Videos that provided external links to scientific/technical evidence verifying the information represented only 13.89% of the total number of videos. Of these videos, 70% corresponded to HRU. The DISCERN value for videos from HRU users was 3.05 (0.88), a value that reflects a good reliability of videos from these users. Conclusions: This study provides information on the content and quality of the videos that we can find on YouTube. We found videos of non-health users who do not base their content on any scientific evidence, with the danger that this entails for the population, but it also highlights that the videos published by HRU have greater reliability and quality, being better perceived by the population, so it is important to encourage healthcare professionals and health institutions to share verified information on YouTube.This research was funded by Fundación Banco Santander and Fundación Alfonso X el Sabio, grant number 1014011. Partial funding for open access charge: Universidad de Málag

Epidemiological and clinical features of Kawasaki disease in Spain over 5 years and risk factors for aneurysm development. (2011-2016): KAWA-RACE study group

Background: Kawasaki disease (KD) is an acute self-limited systemic vasculitis of unknown etiology affecting mainly children less than 5 years of age. Risk factors for cardiac involvement and resistance to treatment are insufficiently studied in non-Japanese children. Objective: This study aimed to investigate the epidemiology, clinical features and risk factors for resistance to treatment and coronary artery lesions (CAL) in KD in Spain. Methods: Retrospective study (May 2011-June 2016) of all patients less than 16 years of age diagnosed with KD included in KAWA-RACE network (84 Spanish hospitals). Results: A total of 625 cases were analyzed, 63% were males, 79% under 5 year-olds and 16.8% younger than 12 months. On echocardiographic examination CAL were the most frequent findings (23%) being ectasia the most common (12%). Coronary aneurysms were diagnosed in 9.6%, reaching 20% in infants under 12 months (p 900,000 cells/mm3, maximum temperature 10 days and fever before treatment ≥ 8 days as independent risk factors for developing coronary aneurysms. Conclusions: In our population, children under 12 months develop coronary aneurysms more frequently and children with KD with anemia and leukocytosis have high risk of cardiac involvement. Adding steroids early should be considered in those patients, especially if the treatment is not started before 8 days of fever. A score applicable to non-Japanese children able to predict the risk of aneurysm development and IVIG resistance is necessary

Pharmaceutical and Botanical Management of Pain Associated with Psychopathology: A Narrative Review

Generally, pain can be described as an unpleasant sensory or emotional experience associated with tissue damage. Chronic pain has become a public health problem because among 35 and 75% of the world population has shown the symptom. In particular, neuropathic pain has shown high comorbidity disorders such as anxiety and depression. Conventional therapies for treating pain include nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, tricyclic antidepressants, anticonvulsants, and opioids, which usually cause some side effects such as gastritis, headache, liver and kidney toxicity, and drug dependence. Conventional pharmaceuticals also tend to be expensive, and they cannot be easily afforded in developing countries, which have led to the use of natural products as an alternative treatment. In this chapter, we reviewed the current research of natural products for pain treatment. We also describe preclinical studies that assess the effect of some natural products on pain therapy, phytochemistry research, toxicity, adverse effects, and biosecurity. We also describe how conventional pain is managed and the possible use of compounds obtained from vegetable species for pain treatment

CAR density influences antitumoral efficacy of BCMA CAR T cells and correlates with clinical outcome

Identification of new markers associated with long-term efficacy in patients treated with CAR T cells is a current medical need, particularly in diseases such as multiple myeloma. In this study, we address the impact of CAR density on the functionality of BCMA CAR T cells. Functional and transcriptional studies demonstrate that CAR T cells with high expression of the CAR construct show an increased tonic signaling with up-regulation of exhaustion markers and increased in vitro cytotoxicity but a decrease in in vivo BM infiltration. Characterization of gene regulatory networks using scRNA-seq identified regulons associated to activation and exhaustion up-regulated in CARHigh T cells, providing mechanistic insights behind differential functionality of these cells. Last, we demonstrate that patients treated with CAR T cell products enriched in CARHigh T cells show a significantly worse clinical response in several hematological malignancies. In summary, our work demonstrates that CAR density plays an important role in CAR T activity with notable impact on clinical response

Comorbidities in patients with Primary Sjögren's Syndrome and Systemic Lupus Erythematosus: A comparative registries-based study

OBJECTIVE: To compare the prevalence of the main comorbidities in 2 large cohorts of patients with primary Sjögren's syndrome (SS) and systemic lupus erythematosus (SLE), with a focus on cardiovascular (CV) diseases. METHODS: This was a cross-sectional multicenter study where the prevalence of more relevant comorbidities in 2 cohorts was compared. Patients under followup from SJOGRENSER (Spanish Rheumatology Society Registry of Primary SS) and RELESSER (Spanish Rheumatology Society Registry of SLE), and who fulfilled the 2002 American-European Consensus Group and 1997 American College of Rheumatology classification criteria, respectively, were included. A binomial logistic regression analysis was carried out to explore potential differences, making general adjustments for age, sex, and disease duration and specific adjustments for each variable, including CV risk factors and treatments, when appropriate. RESULTS: A total of 437 primary SS patients (95% female) and 2,926 SLE patients (89% female) were included. The mean age was 58.6 years (interquartile range [IQR] 50.0-69.9 years) for primary SS patients and 45.1 years (IQR 36.4-56.3 years) for SLE patients (P?<?0.001), and disease duration was 10.4 years (IQR 6.0-16.7 years) and 13.0 years (IQR 7.45-19.76 years), respectively (P?<?0.001). Smoking, dyslipidemia, and arterial hypertension were associated less frequently with primary SS (odds ratio [OR] 0.36 [95% confidence interval (95% CI) 0.28-0.48], 0.74 [95% CI 0.58-0.94], and 0.50 [95% CI 0.38-0.66], respectively) as were life-threatening CV events (i.e., stroke or myocardial infarction; OR 0.57 [95% CI 0.35-0.92]). Conversely, lymphoma was associated more frequently with primary SS (OR 4.41 [95% CI 1.35-14.43]). The prevalence of severe infection was lower in primary SS than in SLE (10.1% versus 16.9%; OR 0.54 [95% CI 0.39-0.76]; P?<?0.001). CONCLUSION: Primary SS patients have a consistently less serious CV comorbidity burden and a lower prevalence of severe infection than those with SLE. In contrast, their risk of lymphoma is greater

Proyecto para la mejora de la empleabilidad mediante el alineamiento de las competencias de los títulos de la Facultad de Economía y Empresa

Memoria ID-0143. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2016-2017