Analysis of the shoes in a population over 60

El calzado representa una de las partes indispensables en la indumentaria de las personas en la cultura occidental. Utilizado de manera adecuada sirve como un elemento de protección al pie y de ayuda a la deambulación. Sin embargo cuando se utiliza de manera no adecuada se relaciona directamente con caídas, alteraciones en la marcha y aparición o agravamiento de patologías en el pie. En el presente trabajo realizamos un estudio del tipo de calzado más utilizado en una población mayor de 60 años, si éste era adecuado o no y si la población geriátrica poseía información acerca de cuál es el calzado mas adecuado para ellos e intentamos relacionar la visita al Podólogo con la utilización de calzado adecuado o no.Footwear represents an essential part of garment of people in occidental culture. If utilized in a correct way, it provides protection and aid in human gait. Nevertheless, if utilized incorrectly, it’s related to falls, alterations in gait and appearance or worsening in foot pathology. In the present issue, we studied what style of footwear is the most commonly used in a community older of 60, if it was appropriate or inappropriate and if geriatric community had information enough to know what is the most appropriat

University Issues. Year 3. Number 3. Journal of the Center for Research in Social Sciences and Arts

Las opiniones contenidas en los artíuclos de esta revista no vinvulan la institución sono que son exclusiva responsabilidad de los autores, dentro de los principios demacráticos de cátedar libre y libertad de expresión, consagrados en el artículo 3° Estatuto Genral de la Corporación Autónoma de Bucaramanga.Presentación. - 5 Investigación científica y tecnológica. - 8 Reflexión derivada de la investigación. -50 Anaquel. -120 Anexos. -122The opinions contained in the articles of this journal do not vindicate the institution but are the sole responsibility of the authors, within the democratic principles of free cattery and freedom of expression, enshrined in Article 3 General Statute of the Autonomous Corporation of Bucaramanga

Healthcare workers hospitalized due to COVID-19 have no higher risk of death than general population. Data from the Spanish SEMI-COVID-19 Registry

Aim To determine whether healthcare workers (HCW) hospitalized in Spain due to COVID-19 have a worse prognosis than non-healthcare workers (NHCW). Methods Observational cohort study based on the SEMI-COVID-19 Registry, a nationwide registry that collects sociodemographic, clinical, laboratory, and treatment data on patients hospitalised with COVID-19 in Spain. Patients aged 20-65 years were selected. A multivariate logistic regression model was performed to identify factors associated with mortality. Results As of 22 May 2020, 4393 patients were included, of whom 419 (9.5%) were HCW. Median (interquartile range) age of HCW was 52 (15) years and 62.4% were women. Prevalence of comorbidities and severe radiological findings upon admission were less frequent in HCW. There were no difference in need of respiratory support and admission to intensive care unit, but occurrence of sepsis and in-hospital mortality was lower in HCW (1.7% vs. 3.9%; p = 0.024 and 0.7% vs. 4.8%; p<0.001 respectively). Age, male sex and comorbidity, were independently associated with higher in-hospital mortality and healthcare working with lower mortality (OR 0.211, 95%CI 0.067-0.667, p = 0.008). 30-days survival was higher in HCW (0.968 vs. 0.851 p<0.001). Conclusions Hospitalized COVID-19 HCW had fewer comorbidities and a better prognosis than NHCW. Our results suggest that professional exposure to COVID-19 in HCW does not carry more clinical severity nor mortality

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

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

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Implicación de HIF-1α en los mecanismos moleculares de respuesta a fármacos en el tratamiento neoadyuvante del cáncer de mama

Tesis Univ. Granada. Departamento de Bioquímica y Biología Molecular IIEste trabajo forma parte del proyecto PI-0140/2008 concedido por la Consejería de Salud de la Junta de Andalucía (2008-2012

Hypoxia-Inducible Factor-1 Alpha Expression Is Predictive of Pathological Complete Response in Patients with Breast Cancer Receiving Neoadjuvant Chemotherapy

To demonstrate the value of hypoxia-inducible factor-1&alpha; (HIF-1&alpha;) in predicting response in patients with breast cancer receiving standard neoadjuvant chemotherapy (NAC). Methods: Ninety-five women enrolled in two prospective studies underwent biopsies for the histopathological diagnosis of breast carcinoma before receiving NAC, based on anthracyclines and taxanes. For expression of HIF-1&alpha;, EGFR, pAKT and pMAPK, tumor samples were analyzed by immunohistochemistry in tissues microarrays. Standard statistical methods (Pearson chi-square test, Fisher exact test, Kruskal&ndash;Wallis test, Mann&ndash;Whitney test and Kaplan&ndash;Meier method) were used to study the association of HIF-1&alpha; with tumor response, survival and other clinicopathologic variables/biomarkers. Results: HIF-1&alpha; expression was positive in 35 (39.7%) cases and was significantly associated to complete pathological response (pCR) (p = 0.014). HIF-1&alpha; expression was correlated positively with tumor grade (p = 0.015) and Ki-67 expression (p = 0.001) and negativity with progesterone receptors (PR) (p = 0.04) and luminal A phenotype expression (p = 0.005). No correlation was found between HIF-1&alpha; expression and EGFR, pAKT and pMAPK. In terms of survival, HIF-1&alpha; expression was associated with a significantly shorter disease-free survival (p = 0.013), being identified as an independent prognostic factor in multivariate analysis. Conclusions: Overexpression of HIF-1&alpha; is a predictor of pCR and shorter DFS; it would be valuable to confirm these results in prospective studies

Modelos de desarrollo e inserción internacional: aportes para el análisis de la política exterior argentina desde la redemocratización 1983-2011

Este libro muestra parte de los resultados obtenidos a través del proyecto de investigación titulado “Modelos de desarrollo e inserción internacional. Aportes para el análisis de la política exterior argentina desde la redemocratización (1983-2011)”, financiado por la Agencia de Promoción Científica y Tecnológica bajo el código PICT-2011-0681. Los motivos que impulsaron esta empresa pueden retrotraerse a los años 2009 y 2010 cuando, tanto en el ámbito académico como en el de los análisis de prensa, aparecían evaluaciones significativamente contrapuestas sobre la política exterior argentina de entonces. En ese marco, un conjunto de docentes-investigadores radicados en la Facultad de Ciencia Política y Relaciones Internacionales de la Universidad Nacional de Rosario se plantearon superar los análisis de coyuntura y orientar el debate hacia las causas de la inestabilidad de la política exterior argentina a partir de la redemocratización. Esta tarea, a la que se sumó un colega de la Universidad Nacional de La Plata, se canalizó en la presentación de un proyecto a la Agencia de Promoción Científica y Tecnológica.Fil: Actis, Esteban. Universidad Nacional de Rosario. Facultad de Ciencia Política y Relaciones Internacionales; Argentina.Fil: Lorenzini, María Elena. Universidad Nacional de Rosario. Facultad de Ciencia Política y Relaciones Internacionales; Argentina.Fil: Zelicovich, Julieta. Universidad Nacional de Rosario. Facultad de Ciencia Política y Relaciones Internacionales; Argentina.Fil: Busso, Anabella. Universidad Nacional de Rosario. Facultad de Ciencia Política y Relaciones Internacionales; Argentina.Fil: Fernández Alonso, José. Universidad Nacional de Rosario. Facultad de Ciencia Política y Relaciones Internacionales; Argentina.Fil: Simonoff, Alejandro. Universidad Nacional de La Plata; Argentina.Fil: Ceppi, Natalia. Universidad Nacional de Rosario. Facultad de Ciencia Política y Relaciones Internacionales; Argentina.Fil: Fabani, Ornela. Universidad Nacional de Rosario. Facultad de Ciencia Política y Relaciones Internacionales; Argentina.Fil: Novello, María Rocío. Universidad Nacional de Rosario. Facultad de Ciencia Política y Relaciones Internacionales; Argentina.Fil: Marini, Gustavo. Universidad Nacional de Rosario. Facultad de Ciencia Política y Relaciones Internacionales; Argentina.Fil: Paredes Rodríguez, Rubén. Universidad Nacional de Rosario. Facultad de Ciencia Política y Relaciones Internacionales; Argentina.Fil: Pignatta, María Eva. Universidad Nacional de Rosario. Facultad de Ciencia Política y Relaciones Internacionales; Argentina.Fil: Calderón, Emilse. Universidad Nacional de Rosario. Facultad de Ciencia Política y Relaciones Internacionales; Argentina.Fil: Zelicovich, Julieta. Universidad Nacional de Rosario. Facultad de Ciencia Política y Relaciones Internacionales; Argentina