Inventario preliminar y uso de mamíferos silvestres no voladores en la vereda Camarón, Montes de María (Bolívar-Colombia)

During the months of July and August 2015 and March 2016, field visits to the Camarón village were carried out, as part of the project “Towards the Knowledge and Study of the Wild Fauna in the Vereda Camarón and the Municipality of Santo Domingo de Meza, Montes de María (Bolívar). ”Direct traces were carried out in 5 linear transects of 1 km, two repetitions in each one, in order to obtain a preliminary list of mammal species in the area. Likewise, 140 semi-structured interviews were conducted with the community to determine the uses that communities give to these species. Interviews were preferably conducted with hunters and mammalian field guides were used (Emmons & Feer 1999, Aranda 2012) as well as cards with drawings and photographs of mammals present in the Colombian Caribbean (RaceroCasarrubia & González-Maya 2014).Durante los meses de julio y agosto de 2015 y marzo de 2016, se realizaron visitas de campo a la vereda Camarón, como parte del proyecto “Hacia el Conocimiento y Estudio de la Fauna Silvestre en la Vereda Camarón y el Municipio Santo Domingo de Meza, Montes de María (Bolívar).” Se realizaron rastreos directos en 5 transectos lineales de 1 km, dos repeticiones en cada uno, con el fin de obtener una lista preliminar de especies de mamíferos de la zona. Asimismo, se realizaron 140 entrevistas semiestructuradas a la comunidad para determinar los usos que las comunidades dan a estas especies. Las entrevistas se realizaron preferiblemente a cazadores y se utilizaron guías de campo de mamíferos (Emmons & Feer 1999, Aranda 2012) así como fichas con dibujos y fotografías de los mamíferos presentes en el Caribe colombiano (RaceroCasarrubia & González-Maya 2014).&nbsp

Complement component C4 structural variation and quantitative traits contribute to sex-biased vulnerability in systemic sclerosis

Altres ajuts: Fondo Europeo de Desarrollo Regional (FEDER), "A way of making Europe".Copy number (CN) polymorphisms of complement C4 play distinct roles in many conditions, including immune-mediated diseases. We investigated the association of C4 CN with systemic sclerosis (SSc) risk. Imputed total C4, C4A, C4B, and HERV-K CN were analyzed in 26,633 individuals and validated in an independent cohort. Our results showed that higher C4 CN confers protection to SSc, and deviations from CN parity of C4A and C4B augmented risk. The protection contributed per copy of C4A and C4B differed by sex. Stronger protection was afforded by C4A in men and by C4B in women. C4 CN correlated well with its gene expression and serum protein levels, and less C4 was detected for both in SSc patients. Conditioned analysis suggests that C4 genetics strongly contributes to the SSc association within the major histocompatibility complex locus and highlights classical alleles and amino acid variants of HLA-DRB1 and HLA-DPB1 as C4-independent signals

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

New insights into the genetic etiology of Alzheimer's disease and related dementias

Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele

New insights into the genetic etiology of Alzheimer's disease and related dementias

Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele

Multiancestry analysis of the HLA locus in Alzheimer’s and Parkinson’s diseases uncovers a shared adaptive immune response mediated by HLA-DRB1*04 subtypes

Across multiancestry groups, we analyzed Human Leukocyte Antigen (HLA) associations in over 176,000 individuals with Parkinson’s disease (PD) and Alzheimer’s disease (AD) versus controls. We demonstrate that the two diseases share the same protective association at the HLA locus. HLA-specific fine-mapping showed that hierarchical protective effects of HLA-DRB1*04 subtypes best accounted for the association, strongest with HLA-DRB1*04:04 and HLA-DRB1*04:07, and intermediary with HLA-DRB1*04:01 and HLA-DRB1*04:03. The same signal was associated with decreased neurofibrillary tangles in postmortem brains and was associated with reduced tau levels in cerebrospinal fluid and to a lower extent with increased Aβ42. Protective HLA-DRB1*04 subtypes strongly bound the aggregation-prone tau PHF6 sequence, however only when acetylated at a lysine (K311), a common posttranslational modification central to tau aggregation. An HLA-DRB1*04-mediated adaptive immune response decreases PD and AD risks, potentially by acting against tau, offering the possibility of therapeutic avenues

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Eficiency and tolerance of olanzapina vs risperidona and tipical antipsicotics study of 3 years

Objetivo: evaluar los resultados de salud y los costos relacionados con los antipsicóticos disponibles, con énfasis en la olanzapina, en entornos ambulatorios naturalistas. Métodos: 572 pacientes con esquizofrenia (CIE-10 o DSM-IV) que iniciaron o cambiaron a un antipsicótico oral se inscribieron en bloques de diez: 5 pacientes para olanzapina y 5 para otro antipsicótico, según prescripción en ese momento. La eficacia se midió mediante el cambio medio en la puntuación en la Escala de Impresión Clínica Global de Severidad de la Enfermedad (GCI-S). La "respuesta clínica" se definió como la disminución ≥ "2 puntos en el GCI-S si la puntuación inicial era ≥" 4 y la disminución ≥ "1 si la línea base era ≤" 3. "Mínimamente sintomático" se definió como alcanzar una puntuación de 1 o 2 en el GCI-S después de la línea de base. Se registraron los eventos adversos resultantes del tratamiento, junto con el uso de cualquier medicación concomitante y las causas de interrupción de la medicación. Resultados: La Región Andina del SOHO inscribió a 272, 97 y 65 pacientes en monoterapia con olanzapina, antipsicóticos típicos (TA) y risperidona respectivamente. Tanto la olanzapina como la risperidona fueron más eficaces que la AT para mejorar los síntomas generales, positivos y negativos a los 12, 24 y 36 meses, pero solo la olanzapina mostró una diferencia estadísticamente significativa frente a la AT en los síntomas depresivos y cognitivos. Menos pacientes que recibieron olanzapina desarrollaron síntomas extrapiramidales (SEP) y eventos sexuales adversos. Los pacientes tratados con olanzapina demostraron la tasa más baja de discinesia tardía a los 3 años. Más pacientes que recibieron olanzapina aumentaron de peso con una diferencia estadísticamente significativa frente a risperidona y TA. El aumento de peso medio con olanzapina fue de 5 kg y el mayor aumento se registró en los primeros 12 meses de tratamiento. Conclusiones: la olanzapina, pero no la risperidona, fue más efectiva que los típicos mejorando los síntomas depresivos y cognitivos con diferencia estadística. La olanzapina se toleró mejor en términos de EPS, discinesia tardía y deterioro de la función sexual. Se registró una mayor ganancia de peso con olanzapina; sin embargo, la tasa de interrupción debido a la intolerancia fue la más baja. Estos resultados apoyan los mayores beneficios de Atypicals en términos de efectividad y tolerabilidad. © INNN, 2007. Conclusiones: la olanzapina, pero no la risperidona, fue más efectiva que los típicos mejorando los síntomas depresivos y cognitivos con diferencia estadística. La olanzapina se toleró mejor en términos de EPS, discinesia tardía y deterioro de la función sexual. Se registró una mayor ganancia de peso con olanzapina; sin embargo, la tasa de interrupción debido a la intolerancia fue la más baja. Estos resultados apoyan los mayores beneficios de Atypicals en términos de efectividad y tolerabilidad. © INNN, 2007. Conclusiones: la olanzapina, pero no la risperidona, fue más efectiva que los típicos mejorando los síntomas depresivos y cognitivos con diferencia estadística. La olanzapina se toleró mejor en términos de EPS, discinesia tardía y deterioro de la función sexual. Se registró una mayor ganancia de peso con olanzapina; sin embargo, la tasa de interrupción debido a la intolerancia fue la más baja. Estos resultados apoyan los mayores beneficios de Atypicals en términos de efectividad y tolerabilidad.Objective: to evaluate the health results and the costs related to the available antipsychotics, with emphasis on olanzapine, in naturalistic outpatient settings. Methods: 572 patients with schizophrenia (ICD-10 or DSM-IV) who began or changed to an oral, antipsychotic were enrolled in blocks of ten: 5 patients for olanzapine and 5 for another antipsychotic, according to the prescription at that time. The effectiveness was measured by the mean change in score on the Global Clinical Impression of Severity of illness Scale (GCI-S). "Clinical response" was defined as the decrease ≥" 2 points on the GCI-S if the baseline score was ≥" 4 and the decrease ≥" 1 if the baseline was ≤" 3. "Minimally symptomatic" was defined as reaching a score of 1 or 2 on the GCI-S after the baseline. Adverse events resulting from the treatment were recorded, along with the use of any concomitant medication and the causes of discontinuation of the medication. Results: The SOHO Andean Region enrolled 272, 97 and 65 patients in monotherapy with olanzapine, typical antipsychotics (TA) and risperidone respectively. Both olanzapine and risperidone were more effective than the TA in improving the general, positive and negative symptoms at 12, 24, and 36 months, but only olanzapine showed a statistically significant difference vs TA in depressive and cognitive symptoms. Less patients on olanzapine developed extrapyramidal symptoms (EPS) and adverse sexual events. The patients on olanzapine demonstrated the lowest rate of tardive dyskinesia at 3 years. More patients on olanzapine gained weight with a statistically significant difference vs risperidone and TA. The mean weight gain with olanzapine was 5 kg and the greatest increase was recorded in the first 12 months of treatment. Conclusions: olanzapine, but not risperidone, was more effective than typicals improving depressive and cognitive symptoms with statistical difference. Olanzapine was better tolerated in terms of EPS, tardive dyskinesia and sexual function impairment. A greater weight gain was recorded with olanzapine; however, the discontinuation rate due to intolerability was the lowest. These results support the greater benefits of Atypicals in terms of effectiveness and tolerability

Diversidad biológica y cultural del sur de la Amazonia colombiana

La gran cuenca amazónica compartida por Brasil, Colombia, Perú, Bolivia, Venezuela, Ecuador y las tres Guyanas, contiene una de las mayores riquezas biológicas y culturales del planeta y es considerada parte de la seguridad ecológica global. Constituye el 45% de los bosques tropicales del mundo, es una de las áreas silvestres más extensas y de mayor reserva de agua dulce del planeta, su sistema hídrico es el mayor tributario de todos los océanos, alberga aún, cerca de 379 grupos étnicos y en cuanto a endemismo, no existe otra región que se le aproxime. En Colombia, la Amazonia a lo largo de la historia ha sufrido distintos procesos de intervención antrópica: la conquista; la colonización; el auge del caucho y la quina; la explotación maderera, petrolera; la implementación de cultivos de uso ilícito y de sistemas productivos no aptos a las condiciones del medio natural; entre otros, son procesos que han socavado tanto los recursos biológicos como los culturales. Conscientes de la problemática actual de la Amazonia así como de la importancia que reviste para el mundo y para el país, la Corporación para el Desarrollo Sostenible del Sur de la Amazonia –Corpoamazonia– y el Instituto de Investigación de Recursos Biológicos Alexander von Humboldt –IAvH-, firmaron en el año 2004 un convenio con el n de aunar esfuerzos para formular el plan de acción en biodiversidad en la región sur de la Amazonia colombiana (departamentos de Caquetá, Putumayo y Amazonas). El plan de acción, busca posicionar la biodiversidad en el desarrollo regional y contribuir a un mayor conocimiento y a unas mejores prácticas de conservación y utilización sostenible de los recursos biológicos y culturales de este importante espacio geográfico. Desarrolla a escala regional, la Política Nacional en Biodiversidad y la Propuesta Técnica de Plan de Acción Nacional en Biodiversidad – Biodiversidad siglo XXI -

Memorias. Encuentro de Experiencias en Inventarios y Monitoreo Biológico

Las discusiones temáticas alrededor de la consolidación del Inventario Nacional de Biodiversidad para Colombia y la Red de Monitoreo de Biodiversidad como una estrategia de largo plazo, sin duda temas complejos que requerirán de grandes esfuerzos, coordinación y generosidad institucional y personal, los podrá apreciar el lector a lo largo del presente documento, esperando que pueda entender también la importancia que tienen los resultados y la agenda propuesta si en el futuro queremos tomar decisiones con bases científicas