Characteristics of Induced-Sputum Inflammatory Phenotypes in Adults with Asthma : Predictors of Bronchial Eosinophilia

The objectives of this study were, for patients attending a specialist asthma clinic at a tertiary care hospital, to determine, from sputum induction (SI), proportions of bronchial inflammatory phenotypes, demographic, clinical and functional characteristics of each phenotype, and the most accessible non-invasive inflammatory marker that best discriminates between phenotypes. Included were 96 patients with asthma, attending a specialist asthma clinic at a tertiary care hospital, who underwent testing as follows: SI, spirometry, fractional exhaled nitric oxide (FeNO), blood eosinophilia, total immunoglobulin E (IgE), and a skin prick test. SI phenotypes were 46.9% eosinophilic, 33.3% paucigranulocytic, 15.6% neutrophilic, and 4.2% mixed. No significantly different clinical or functional characteristics were observed between the phenotypes. A positive correlation was observed between SI eosinophilia and both emergency visits in the last 12 months (p = 0.041; r = 0.214) and FeNO values (p = 0.000; r = 0.368). Blood eosinophilia correlated with SI eosinophilia (p = 0.001; r = 0.362) and was the best predictor of bronchial eosinophilia, followed by FeNO, and total blood IgE (area under the receiver operating characteristic curve (AUC-ROC) 72%, 65%, and 53%, respectively), although precision was only fair. In consultations for severe asthma, the most frequent phenotype was eosinophilic. Peripheral blood eosinophilia is a reliable marker for discriminating between different bronchial inflammatory phenotypes, is useful in enabling doctors to select a suitable biologic treatment and so prevent asthma exacerbation, and is a better predictor of bronchial eosinophilia than FeNO and IgE values

Internal dynamics within primary care teams in two Spanish regions during the COVID-19 pandemic: a qualitative study

Background: Pandemics and epidemics have represented public health emergencies with severe consequences at a global level. Primary care teams have played a crucial role in disease surveillance and monitoring during the COVID-19 pandemic through early detection, contact tracing, and isolation of positive cases. The objective of this study was to explore the impact of the COVID-19 pandemic on primary care teams regarding their internal dynamics and their professional performance. Methods: Qualitative study carried out between July and December 2020 in two large central and southern Spanish regions (Castilla la Mancha and Madrid). Semi-structured interviews and focus groups were conducted with primary care workers. Data was analysed using thematic content analysis. Participants were accessed using purposive sampling. Results: A total of 53 primary care workers participated in the study, of which 38 were individually interviewed, and 15 participated in three focus groups.The analysis of their experiences revealed two main themes regarding the impact of the COVID-19 pandemic on primary care teams: 1) The need to reorganise traditional roles: Primary care settings closed their doors to the public and their workers restructured their roles to ensure the delivery of essential services; 2) The need to implement a new primary care delivery model: Each primary care team had to self-organise, making sure their reference population was cared for and developing resource optimisation strategies. Conclusions: Primary care teams have quickly adapted their roles and internal dynamics to respond to the demands generated by COVID-19. In the new delivery model, some positive aspects could be highlighted – such as increased communication between professionals and the use of telemedicine for some cases. However, it is important to address the negative impact that the COVID-19 crisis has had on of the main functions of primary care. These measures are necessary to promote well-being in primary care teams, and to provide quality care that addresses the complex and individual needs of each person and reduces inequalities in healthcare deliveryThis work was supported by the FONDO SUPERA COVID-19, organised by Santander Bank, the Spanish National Research Council (CSIC), and the Conference of Rectors of Spanish Universities (CRUE). It aims to fund programs, collaborative projects, and support activities to minimise the impact of the COVID-19 crisis in the health, education, and social sector

Analysis of Spontaneous EEG Activity in Alzheimer’s Disease Using Cross-Sample Entropy and Graph Theory

Producción CientíficaThe aim of this pilot study was to analyze spontaneous electroencephalography (EEG) activity in Alzheimer’s disease (AD) by means of Cross-Sample Entropy (Cross-SampEn) and two local measures derived from graph theory: clustering coefficient (CC) and characteristic path length (PL). Five minutes of EEG activity were recorded from 37 patients with dementia due to AD and 29 elderly controls. Our results showed that Cross-SampEn values were lower in the AD group than in the control one for all the interactions among EEG channels. This finding indicates that EEG activity in AD is characterized by a lower statistical dissimilarity among channels. Significant differences were found mainly for fronto-central interactions (p < 0.01, permutation test). Additionally, the application of graph theory measures revealed diverse neural network changes, i.e. lower CC and higher PL values in AD group, leading to a less efficient brain organization. This study suggests the usefulness of our approach to provide further insights into the underlying brain dynamics associated with AD.Ministerio de Economía y Competitividad (TEC2014-53196-R)Junta de Castilla y León (proyecto VA037U16 y BIO/VA08/15

Recursos digitales como herramientas eficaces para los trabajos en grupo

Las exposiciones de trabajos en grupo pueden resultar, dependiendo de las características de la asignatura, un problema para la docencia, tanto por la deficiente asimilación de contenidos, como por el tiempo de clase que se necesita para llevarlas a cabo. En este artículo presentamos un proyecto de innovación docente que emplea recursos digitales para hacer más atractivos estos trabajos y emplear de manera más eficaz el tiempo de clase

Recursos digitales para la docencia de la asignatura “Lingüística”

Las actuales plataformas docentes (LMS - Learning Management System) nos ayudan en la gestión de la docencia mediante la simulación de espacios docentes físicos, permitiendo dejar materiales para los estudiantes, hacer tutoría, consultar el expediente, etc. Este proyecto trata de explotar la plataforma educativa de la Universidad de Cádiz, un espacio virtual construido sobre Moodle, un sistema de gestión del aprendizaje de código abierto con una gama flexible de módulos de actividades y recursos como correo, agenda, programaciones del curso, foros, descarga de contenidos, actividades, etc. El profesor puede diseñar la estructuración del material del curso mientras que el alumno puede gestionar por un lado su tiempo, a la vez que queda constancia de toda esta actividad desarrollada. Aplicada a las clases presenciales de la asignatura de Lingüística de primer curso de los Grados en Filología Hispánica, Grado en Filología Clásica, Grado en Estudios Franceses, Grado en Estudios Ingleses, Grado en Estudios Árabes e Islámicos y el Grado en Lingüística y Lenguas Aplicada de la Facultad de Filosofía y Letras de la Universidad de Cádiz que aglutina cerca de 300 alumnos, los resultados muestran una gran aceptación y valoración como instrumento de aprendizaje y motivación

Endoplasmic reticulum stress sensor IRE1α enhances IL-23 expression by human dendritic cells

Producción CientíficaHuman monocyte-derived dendritic cells (DCs) exposed to pathogen-associated molecular patterns (PAMPs) undergo bioenergetic changes that influence the immune response. We found that stimulation with PAMPs enhanced glycolysis in DCs, whereas oxidative phosphorylation remained unaltered. Glucose starvation and the hexokinase inhibitor 2-deoxy-d-glucose (2-DG) modulated cytokine expression in stimulated DCs. Strikingly, IL23A was markedly induced upon 2-DG treatment, but not during glucose deprivation. Since 2-DG can also rapidly inhibit protein N-glycosylation, we postulated that this compound could induce IL-23 in DCs via activation of the endoplasmic reticulum (ER) stress response. Indeed, stimulation of DCs with PAMPs in the presence of 2-DG robustly activated inositol-requiring protein 1α (IRE1α) signaling and to a lesser extent the PERK arm of the unfolded protein response. Additional ER stressors such as tunicamycin and thapsigargin also promoted IL-23 expression by PAMP-stimulated DCs. Pharmacological, biochemical, and genetic analyses using conditional knockout mice revealed that IL-23 induction in ER stressed DCs stimulated with PAMPs was IRE1α/X-box binding protein 1-dependent upon zymosan stimulation. Interestingly, we further evidenced PERK-mediated and CAAT/enhancer-binding protein β-dependent trans-activation of IL23A upon lipopolysaccharide treatment. Our findings uncover that the ER stress response can potently modulate cytokine expression in PAMP-stimulated human DCs.Plan Nacional de Salud y Farmacia (Proyecto SAF2013-44521-R

La formación docente. Innovaciones en la Facultad de Bioquímica, Química y Farmacia de la UNT

Para atender problemas multifactoriales propios de la educación superior y lograr acreditar sus carreras, la Facultad de Bioquímica, Química y Farmacia de la Universidad Nacional de Tucumán (UNT) respondió adecuando sus Diseños Curriculares, creando un sistema de tutorías y comités académicos para cada carrera y fijando lineamientos específicos. Una de las funciones de los comités es promover la capacitación pedagógica de los docentes tendientes a mejorar los procesos de enseñanza y aprendizaje. Para tal fin se diseñó un programa con ofertas de formación permanente que busca las mejores propuestas de cambio. En la dimensión académica, se asumió que los problemas detectados pueden ser superados si se reconoce la importancia de articular el dominio de los conocimientos disciplinares con los de la didáctica y la pedagogía. En este trabajo se explicitan acciones, propósitos, destinatarios y se reflexiona sobre los resultados parciales obtenidos

Building a network of TP53 and IGHV testing reference centers across Spain: the Red53 initiative

© The Author(s) 2021.Among the different biomarkers predicting response in chronic lymphocytic leukemia (CLL), the most influential parameters are the mutational status of the IGHV genes and the presence of TP53 gene disruptions. Nevertheless, these important assessments are not readily available in most centers dealing with CLL patients. To provide this molecular testing across the country, the Spanish Cooperative Group on CLL (GELLC) established a network of four analytical reference centers. A total of 2153 samples from 256 centers were analyzed over a period of 30 months. In 9% of the patients, we found pathological mutations in the TP53 gene, whereas 48.96% were classified as IGHV unmutated. Results of the satisfaction survey of the program showed a Net Promoter Score of 85.15. Building a national network for molecular testing in CLL allowed the CLL population a broad access to complex biomarkers analysis that should translate into a more accurate and informed therapeutic decision-making.This work was supported in part by Janssen Pharmaceutical Companies of Johnson & Johnson. MC holds a contract from Ministerio de Ciencia, Innovación y Universidades (RYC-2012-12018)

Glomerulonefritis colapsante con marcadores de desdiferenciación podocitaria en síndrome hemofagocítico secundario a linfoma hepatoesplénico de células T

El síndrome hemofagocítico es una condición clínica e histológica grave, secundaria a diferentes procesos. La glomerulonefritis colapsante es una podocitopatía proliferativa, generalmente de pronóstico desfavorable para la función renal. Se presenta un caso en el que las dos condiciones aparecieron asociadas, lo cual es una forma infrecuente de presentación del linfoma hepatoesplénico de células T. Se discute, asimismo, el papel de los marcadores de desdiferenciación podocitaria en esta glomerulopatía, y se revisan la fisiopatología y el tratamiento

Endoplasmic Reticulum Stress Sensor IRE1α Enhances IL-23 Expression by Human Dendritic Cells

Human monocyte-derived dendritic cells (DCs) exposed to pathogen-associated molecular patterns (PAMPs) undergo bioenergetic changes that influence the immune response. We found that stimulation with PAMPs enhanced glycolysis in DCs, whereas oxidative phosphorylation remained unaltered. Glucose starvation and the hexokinase inhibitor 2-deoxy-d-glucose (2-DG) modulated cytokine expression in stimulated DCs. Strikingly, IL23A was markedly induced upon 2-DG treatment, but not during glucose deprivation. Since 2-DG can also rapidly inhibit protein N-glycosylation, we postulated that this compound could induce IL-23 in DCs via activation of the endoplasmic reticulum (ER) stress response. Indeed, stimulation of DCs with PAMPs in the presence of 2-DG robustly activated inositol-requiring protein 1α (IRE1α) signaling and to a lesser extent the PERK arm of the unfolded protein response. Additional ER stressors such as tunicamycin and thapsigargin also promoted IL-23 expression by PAMP-stimulated DCs. Pharmacological, biochemical, and genetic analyses using conditional knockout mice revealed that IL-23 induction in ER stressed DCs stimulated with PAMPs was IRE1α/X-box binding protein 1-dependent upon zymosan stimulation. Interestingly, we further evidenced PERK-mediated and CAAT/enhancer-binding protein β-dependent trans-activation of IL23A upon lipopolysaccharide treatment. Our findings uncover that the ER stress response can potently modulate cytokine expression in PAMP-stimulated human DCs