La inyección intracitoplasmática de espermatozoides : ¿avance o imprudencia científica?

Hace ya más de veinticinco años del nacimiento del primer bebé probeta. Tras todo este tiempo, y a pesar de los esfuerzos de los científicos que las aplican, la eficacia de las denominadas técnicas de reproducción asistida es bastante limitada. Además, en el intento de cubrir todo tipo de demandas de parejas estériles, las técnicas se han vuelto cada vez más invasivas y, en ocasiones, hasta han sustituido artificialmente parte del mismo proceso de fecundación. Simultáneamente, se ha ido generando en el ambiente científico –alcanzado también la opinión pública- una cierta polémica sobre los efectos colaterales de estas técnicas. Es por ello que resultaba aconsejable la edición de un estudio que evaluara de forma global una técnica como es la inyección intracitoplasmática de espermatozoides, que ha alcanzado en estos últimos diez años un gran desarrollo.Ciencias ReligiosasMedicinaArte y Humanidade

Aproximación a la experimentación en Biología Molecular mediante el desarrollo de una sucesión de prácticas concatenadas e integradas para la investigación de un proceso biológico

Memoria ID12-0098. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2012-2013

Moral development in sports at school age: Towards a fair play behaviours typology expressed in the White Card (Tarjeta Blanca) programme

This paper aims to contribute to a better understanding of the moral development in sports at school age. A fair play behaviours typology has been developed, arranged into five stages of ethical progress and performed by young athletes within the White Card programme at the Fundación Real Madrid (FRM) basketball schools. In order to ascertain its validity, descriptions of the behaviours were submitted to the coaches at the FRM (n = 18), and a group of experts in sports and values from the actual FRM (n = 6) in order to rate them on a scale from 1 to 5 depending on the moral value they attribute. The result obtained confirm, with few exceptions, the five proposed stages of progression.

Le développement moral dans le sport à l’âge scolaire : Vers une typologie des conduites de fairplay exprimées dans le programme Carton Blanc (Tarjeta Blanca).

This paper aims to contribute to a better understanding of the moral development in sports at school age. A fair play behaviours typology has been developed, arranged into five stages of ethical progress and performed by young athletes within the White Card programme at the Fundación Real Madrid (FRM) basketball schools. In order to ascertain its validity, descriptions of the behaviours were submitted to the coaches at the FRM (n = 18), and a group of experts in sports and values from the actual FRM (n = 6) in order to rate them on a scale from 1 to 5 depending on the moral value they attribute. The result obtained confirm, with few exceptions, the five proposed stages of progression.Ce travail a pour objet de contribuer à une meilleure compréhension du développement moral dans le sport à l’âge scolaire. Nous avons elaboré une typologie de conduites de fair play ordonnées en cinq niveaux de progression éthique et réalisées par de jeunes sportifs des écoles de basket de la fondation Real Madrid (FRM) dans son programme Carton Blanc (programa Tarjeta Blanca). Pour vérifier sa validité, les descriptions des conduites on été présentées aux entraîneurs de la FRM (n = 18) et à un groupe d’experts en sport et valeurs de la FRM (n = 6) elle-même pour les faire évaluer dans une échelle de 1 à 5 en fonction du mérite moral accordé. Le résultat obtenu, sauf pour de légères exceptions, confirme les cinq niveaux de progression proposés

Las técnicas de aprendizaje grupal como parte o fundamento de las asignaturas de grado: propuestas del equipo docente de Trabajo Colaborativo de la UPCT

[SPA]El aprendizaje por competencias en el que se basan las titulaciones de Grado presupone el análisis previo de los objetivos a alcanzar con cada una de las asignaturas que las conforman. Delimitados los objetivos y las competencias genéricas y específicas de una asignatura, el docente debe planificar la tarea de aprendizaje que ha de llevar a su logro, pudiéndose valer para ello de técnicas de aprendizaje colaborativo. La dificultad encontrada a la hora de planificar o poner en práctica tales tareas de aprendizaje lleva a la necesidad de adquirir una cierta formación en su empleo. Es en este contexto, donde se desarrolla la labor del equipo docente de Trabajo Colaborativo de la Universidad Politécnica de Cartagena. La presente comunicación recoge la labor desarrollada por este equipo de trabajo desde su constitución, con las propuestas individuales de cada uno de sus integrantes, en las que se justifica el interés por las nuevas metodologías docentes; así como por la selección de concretas técnicas de aprendizaje en grupo, en función de los objetivos y competencias que se quieren conseguir. [ENG]The learning throughout competences, applied in the new universities degress, involves the previous analysis of the targets in each considered subjetc. Once the aims and the generic and specific competences are delimited for each subjetc, the teacher have to planify the learning procedure to reach this objective. The colabotarive learning techniques are an important tool in this context. The application of these techniquee are not as easy as is expected. The Colaborative Learning team of the Universidad de Cartagena develops an important role in this context. This paper shows the work which has been developed by this group from its beginning. We expose the proposals of each member in which they justify their interest in applying the new teaching tecniques and their learning goals to reach the specific competences of each subjetc.Campus Mare Nostrum, Universidad Politécnica de Cartagena, Universidad de Murcia, Región de Murci

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

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Plitidepsin has a positive therapeutic index in adult patients with COVID-19 requiring hospitalization

Plitidepsin is a marine-derived cyclic-peptide that inhibits SARS-CoV-2 replication at low nanomolar concentrations by the targeting of host protein eEF1A (eukaryotic translation-elongation-factor-1A). We evaluated a model of intervention with plitidepsin in hospitalized COVID-19 adult patients where three doses were assessed (1.5, 2 and 2.5 mg/day for 3 days, as a 90-minute intravenous infusion) in 45 patients (15 per dose-cohort). Treatment was well tolerated, with only two Grade 3 treatment-related adverse events observed (hypersensitivity and diarrhea). The discharge rates by Days 8 and 15 were 56.8% and 81.8%, respectively, with data sustaining dose-effect. A mean 4.2 log10 viral load reduction was attained by Day 15. Improvement in inflammation markers was also noted in a seemingly dose-dependent manner. These results suggest that plitidepsin impacts the outcome of patients with COVID-19.This study has been funded by Pharmamar, S.A. (Madrid, Spain). This work was supported by grants from the Government of Spain (PIE_INTRAMURAL_ LINEA 1 - 202020E079; PIE_INTRAMURAL_CSIC-202020E043). The research of CBIG consortium (constituted by IRTA-CReSA, BSC, & IrsiCaixa) is supported by Grifols pharmaceutical. We also acknowledge the crowdfunding initiative #Yomecorono (https://www.yomecorono.com). N.I.U. has non-restrictive funding from PharmaMar to study the antiviral effect of Plitidepsin. N.J.K. was funded by grants from the National Institutes of Health (P50AI150476, U19AI135990, U19AI135972, R01AI143292, R01AI120694, and P01AI063302); by the Excellence in Research Award (ERA) from the Laboratory for Genomics Research (LGR), a collaboration between UCSF, UCB, and GSK (#133122P); by the Roddenberry Foundation, and gifts from QCRG philanthropic donors. This work was supported by the Defense Advanced Research Projects Agency (DARPA) under Cooperative Agreement #HR0011-19-2-0020. The views, opinions, and/or findings contained in this material are those of the authors and should not be interpreted as representing the official views or policies of the Department of Defense or the U.S. Government. This research was partly funded by CRIP (Center for Research for Influenza Pathogenesis), a NIAID supported Center of Excellence for Influenza Research and Surveillance (CEIRS, contract # HHSN272201400008C), by DARPA grant HR0011-19-2-0020, by supplements to NIAID grants U19AI142733, U19AI135972 and DoD grant W81XWH-20-1-0270, and by the generous support of the JPB Foundation, the Open Philanthropy Project (research grant 2020-215611 (5384)), and anonymous donors to AG-S. S.Y. received funding from a Swiss National Foundation (SNF) Early Postdoc Mobility fellowship (P2GEP3_184202).N

Preclinical and randomized phase I studies of plitidepsin in adults hospitalized with COVID-19

Plitidepsin, a marine-derived cyclic-peptide, inhibits SARS-CoV-2 replication at nanomolar concentrations by targeting the host protein eukaryotic translation elongation factor 1A. Here, we show that plitidepsin distributes preferentially to lung over plasma, with similar potency against across several SARS-CoV-2 variants in preclinical studies. Simultaneously, in this randomized, parallel, open-label, proof-of-concept study (NCT04382066) conducted in 10 Spanish hospitals between May and November 2020, 46 adult hospitalized patients with confirmed SARS-CoV-2 infection received either 1.5 mg (n = 15), 2.0 mg (n = 16), or 2.5 mg (n = 15) plitidepsin once daily for 3 d. The primary objective was safety; viral load kinetics, mortality, need for increased respiratory support, and dose selection were secondary end points. One patient withdrew consent before starting procedures; 45 initiated treatment; one withdrew because of hypersensitivity. Two Grade 3 treatment-related adverse events were observed (hypersensitivity and diarrhea). Treatment-related adverse events affecting more than 5% of patients were nausea (42.2%), vomiting (15.6%), and diarrhea (6.7%). Mean viral load reductions from baseline were 1.35, 2.35, 3.25, and 3.85 log10 at days 4, 7, 15, and 31. Nonmechanical invasive ventilation was required in 8 of 44 evaluable patients (16.0%); six patients required intensive care support (13.6%), and three patients (6.7%) died (COVID-19-related). Plitidepsin has a favorable safety profile in patients with COVID-19.This work was supported by grants from the Government of Spain (PIE_INTRAMURAL_ LINEA 1 - 202020E079; PIE_INTRAMURAL_CSIC-202020E043). The research of CBIG consortium (constituted by IRTA-CReSA, BSC, & IrsiCaixa) is supported by Grifols pharmaceutical. We also acknowledge the crowdfunding initiative #Yomecorono (https://www.yomecorono.com). N Izquierdo-Useros has nonrestrictive funding from PharmaMar to study the antiviral effect of Plitidepsin. NJ Krogan was funded by grants from the National Institutes of Health (P50AI150476, U19AI135990, U19AI135972, R01AI143292, R01AI120694, and P01AI063302); by the Excellence in Research Award (ERA) from the Laboratory for Genomics Research (LGR), a collaboration between the University of California, San Francisco (UCSF), University of California, Berkley (UCB), and GlaxoSmithKline (GSK) (#133122P); by the Roddenberry Foundation, and gifts from QCRG philanthropic donors. This work was supported by the Defense Advanced Research Projects Agency (DARPA) under Cooperative Agreement #HR0011-19-2-0020. The views, opinions, and/or findings contained in this material are those of the authors and should not be interpreted as representing the official views or policies of the Department of Defense or the U.S. Government. This research was partly funded by Center for Research for Influenza Pathogenesis and Transmission (CRIPT), a National Institute of Allergy and Infectious Diseases (NIAID) supported Center of Excellence for Influenza Research and Response (CEIRS, contract # 75N93021C00014), by DARPA grant HR0011-19-2-0020, by supplements to NIAID grants U19AI142733, U19AI135972, and DoD grant W81XWH-20-1-0270, and by the generous support of the JPB Foundation, the Open Philanthropy Project (research grant 2020-215611 (5384)), and anonymous donors to A García-Sastre. S Yildiz received funding from a Swiss National Foundation Early Postdoc Mobility fellowship (P2GEP3_184202).Peer reviewe