Caracterització de la sinovitis mitjançant mètodes artroscòpics i immunohistoquímics. Valor diagnòstic i pronòstic

[cat] La membrana sinovial, és el lloc on s'inicia i es perpetua el procés inflamatori que caracteritza a les diferents artropaties inflamatòries. A diferència d'altres òrgans no té una estructura definida, motiu pel qual el context on es produeix la investigació és un teixit poc diferenciat que dificulta trobar diferències rellevants.Els treballs presentats en aquesta tesi, intenten aportar algunes claus per aprofundir en la patògenia i el pronòstic dels diferents tipus d'artritis.L'objectiu de la tesi seria demostrar si existeixen diferències macroscòpiques vasculars (patrons vasculars valorats per artroscòpia) així com d'expressió cel·lular i de certes mol.lècules entre els diferents tipus d'artritis i la seva correlació amb els mecanismes fisiopatogènics subjacents i amb el pronòstic.La hipòtesi de treball seria que aquestes diferències ens poden orientar sobre el tipus de sinovitis i ens ajuden a trobar marcadors sinovials d'utilitat diagnòstica i pronòstica.L'artroscòpia ha demostrat ser el millor mètode per l'estudi directe de la membrana sinovial i l'obtenció de mostres dirigides. La introducció d'aquesta tècnica en algunes unitats d'artritis ha permès un estudi sistemàtic dels patrons vasculars i la seva correlació amb la clínica. Per altra banda, la anàlisi immunohistoquímica de l'expressió de diferents tipus cel·lulars i mol.leculars, ha estat àmpliament validada en l'estudi microscòpic del teixit sinovial.Els patrons sinovials són útils per diferenciar entre entitats clíniques i entre subtipus d'una mateixa malaltia. Existeixen diferències d'expressió cel·lular i de la proteïna p53 entre els pacients amb artritis reumatoide (AR) i artritis psoriàsica (APso), i aquestes diferències tant a nivell macroscòpic com microscòpic es corresponen amb una realitat clínica i pronòstica dels pacients.Les aportacions d'aquesta tesi apunten a utilitzar aquestes troballes com a ajuda en el coneixement fisiopatògenic d'aquestes malalties i com a via per establir factors pronòstics i de resposta al tractament.[eng] "CLASSIFICATION OF SYNOVITIS BY ARTHROSCOPIC AND IMMUNOHISTOQUIMIC METHODS. DIAGNÒSTIC AND PROGNOSTIC VALUE"TEXT:Inflammation of synovial tissue (synovitis) is a common final pathway in different inflammatory arthritides. Synovium, has not a well defined structure compared with other organs, so investigation in this field makes difficult to find relevant differences. The studies conforming this Doctoral Thesis, try to clarify some of the aspects of pathogenesis and prognostic of different types of arthritis. Our objective would be to assess if there are macroscopic vascular differences (vascular patterns by arthroscopy) either different molecular and cellular expression among different types of arthritis. We also try to correlate these features, with subjacent pathogenic mechanisms and prognosis.Our hypothesis would be that these differences may give us information about the type of synovitis and aid us to find synovial markers with diagnostic and prognostic utility.Arthroscopy has been proved as the best method to provide a direct study of synovial membrane and to obtain specific samples. Introduction of this technique in arthritis units has provide insight into the systematic study of vascular patterns and their correlation with clinical. Furthermore, immunohistochemical analysis of different cellular and molecular expression has been widely validated in the microscopic study of synovial tissue. Synovial vascular patterns may be of interest to discriminate different types of arthritis and different subgroups of patients with the same disease. There is a differential cellular expression and of the protein p53 between patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA). These differences correlate with a clinical and prognostic reality. The contribution of this thesis aim to use these findings as a pathway in the pathogenic knowledge of inflammatory diseases and alights a way to establish prognostic factors and evaluate the efficacy of treatments

Agresividad en estudiantes de primero de secundaria de la institución educativa pública 3048 del distrito de Independencia - 2017

El presente trabajo de investigación tiene como finalidad identificar los niveles de agresividad en los estudiantes de primero de secundaria de la institución educativa publica 3048 del Distrito de Independencia, para ello se desarrolló el tema referente a la agresividad y sus dimensiones mediante el marco conceptual, y las diferentes teorías de la agresión según investigación realizada de los diferentes autores, para la aplicación de las encuestas en forma colectiva se utilizó el cuestionario de Agresión de Buss y Perry (1992), que constan de 29 ítems. De los cuales se obtienen resultados que los estudiantes tienen el nivel de agresividad general medio con 29,1%, en cuanto a las dimensiones lo que más predomina es la agresividad verbal y física el primero nivel medio 31,9%, alto 23,4% en tanto en física el nivel medio 30,5%, alto 22,7% de 141 alumnos evaluados, también se obtuvo resultados por genero donde las alumnas mujeres presentan un nivel alto 33,9% y muy alto de agresividad 12,9% mientras que los varones identifican más en el nivel medio de agresividad.32,9%.The present research work aims to identify the levels of aggressiveness in the students of the first year of high school of the public educational institution 3048 of the District of Independence, for that the subject was developed referring to the aggressiveness and its dimensions through the conceptual frame, and the different theories of aggression according to the research carried out by the different authors, for the application of the surveys collectively, the questionnaire of Aggression of Buss and Perry (1992) was used, which consists of 29 items. Of which results are obtained that the students have the level of average general aggression with 29.1%, in terms of the dimensions what predominates most is verbal and physical aggression the first level average 31.9%, high 23.4 % in physics the average level 30.5%, high 22.7% of 141 students evaluated, also results were obtained by gender where female students have a high level of 33.9% and very high aggressiveness 12.9% while males identify more in the average level of aggressiveness.32.9%

Eficiencia De La Terapia Manual Omt KaltenbornEvjenth En La Marcha Del Paciente Geriátrico Diabético

Introducción: La diabetes afecta a la población geriátrica ocasionando alteraciones funcionales, desequilibrio, atrofias y deformidades del pie, generando patrones compensatorios. La terapia manual OMT KaltenbornEvjenth evalúa y trata alteraciones articulares, y es eficaz para la hipomovilidad y la disminución del dolor por medio de tracciones, compresiones y movilizaciones articulares. Objetivo: Determinar la eficacia de la terapia manual OMT Kaltenborn-Evjenth en la marcha del paciente geriátrico diabético. Método: A 28 pacientes diabéticos se les aplicó la prueba de Batería Breve de Rendimiento Físico (por sus siglas en inglés, SPPB) para determinar limitación funcional de la marcha (LFM) y el tipo de la misma, se les aplicó 8 sesiones de terapia manual OMT Kaltenborn-Evjenth para tobillo y pie, realizando deslizamientos plantares, dorsales del escafoides, cuboides, tracciones distales de calcáneo y movilización tibiotarsiana. Tras la última sesión con la prueba SPPB se determinó el cambio del tipo de limitación de la marcha. Resultados: La edad promedio de la población fue de 68 ± 3.3 años, predominando el género femenino hasta en un 82%. Al término de las sesiones de terapia manual por el método OMT Kaltenborn-Evjenth, la LFM predominante fue la leve en un 71% de los pacientes, 18% moderada, y 11% mínima. Mostrando notablemente cambios favorables significativos en el tipo de LFM. Conclusión: la terapia manual OMT Kaltenborn-Evjenth es efectiva para disminuir la LFM pacientes geriátricos diabéticos. Introduction: Diabetes affects the geriatric population causing mechanical and functional alterations, imbalance, atrophy and deformities of the foot. The limitation of the movement increases the stiffness, the pressure of the plantar support and the difficulty to the adaptation of the march, generating compensatory patterns. Manual therapy through the OMT Kaltenborn-Evjenth technique evaluates and treats joint alterations, and is effective for hypomobility and pain reduction through traction, compression and joint mobilization. Objective: To determine the effectiveness of manual therapy OMT Kaltenborn-Evjenth in the geriatric patient's march with diabetes Method: 28 diabetic patients underwent the Short Physical Performance Battery (SPPB) test to determine the gait limitation (FLG) and its type, 8 sessions of manual therapy OMT Kaltenborn-Evjenth were applied for ankle and foot, performing plantar landslides, dorsal scaphoid, cuboid, distal calcaneal traction and tibiotarsian mobilization. After the last session with the SPPB test, the change in the type of gait limitation was determined. Results: The average age of the population was 68 ± 3.3 years, with the female gender prevailing up to 82%. At the end of the manual therapy sessions by the Kaltenborn-Evjenth OMT method, the predominant FLG was mild in 71% of the patients, 18% moderate, and 11% minimal. Significantly showing favorable changes in the type of FLG. Conclusion: Kaltenborn-Evjenth OMT manual therapy is effective in reducing FLG diabetic geriatric patients

Identification of patients at risk of non-adherence to oral antirheumatic drugs in rheumatoid arthritis using the Compliance Questionnaire in Rheumatology: an ARCO sub-study

[Abstract] The ARCO study (Study on Adherence of Rheumatoid Arthritis patients to SubCutaneous and Oral Drugs), a multicenter, non-interventional retrospective study, was primarily designed to assess the percentage of patients [aged ≥18 years with an established rheumatoid arthritis (RA) diagnosis] with non-adherence to prescribed subcutaneous biologicals. This paper reports data for the secondary objective from a subset of patients, namely to evaluate non-adherence to prescribed oral antirheumatic drugs in RA patients in Spain using the validated Compliance Questionnaire Rheumatology (CQR). Patients also completed the Morisky–Green Medication Adherence Questionnaire, Beliefs about Medicines Questionnaire, and a questionnaire (developed and validated in Spain) on patient satisfaction with RA treatment and preferences. A total of 271 patients (76.7% females; mean age 55.6 years) were being treated with oral drugs for RA, of which 234 completed the CQR questionnaire. Non-adherence was reported in 49/234 (20.9%) patients. The proportion of non-adherence in younger patients (aged ≤48 years; 37.5%) was double that recorded in patients aged >48 years (p = 0.006). Patients with a perception of lower efficacy also had a higher risk of non-adherence (p = 0.012). Multivariable analysis showed that younger age and male gender were independently associated with risk of non-adherence. There was only slight agreement between the CQR and Morisky–Green assessment tools (kappa coefficient = 0.186), possibly reflecting the fact that both questionnaires measure slightly different aspects of medication adherence. In conclusion, one out of five RA patients was identified as at risk for non-adherence with the CQR, and this was more frequent in younger patients and in males

Evaluación de una experiencia de flipped classroom

This paper has won a Runner-up Prize in the Financial Studies 2022 Award in the Education and New Technologies category. The flipped classroom is an active methodology that changes the traditional teaching model and generates an emotional connection with students (men and women). The purpose of this study is to analyse the extent to which the flipped classroom promotes meaningful learning and is related to students satisfaction and/or stress in a Quality Management course at the Universitat Jaume I, using the novel study demands-resources (SD-R) framework. The research concludes that the flipped classroom enables meaningful learning. Although perceptions of workload affect the level of stress of students, neither the workload nor the level of stress affect negatively in terms of learning.Este trabajo ha obtenido un Accésit del Premio Estudios Financieros 2022 en la modalidad de Educación y Nuevas Tecnologías. La flipped classroom es una metodología activa que cambia el modelo de enseñanza tradicional y genera una conexión emocional con el estudiantado (hombres y mujeres). El propósito de este estudio es analizar en qué medida la flipped classroom promueve el aprendizaje significativo del estudiantado y permite un aumento de su satisfacción y/o estrés en la docencia de la materia de Gestión de la Calidad en la Universitat Jaume I, utilizando el novedoso modelo de demandas y recursos en el estudio (DRE). La investigación concluye que la flipped classroom promueve el aprendizaje significativo. Si bien la percepción de carga de trabajo está relacionada con el nivel de estrés de los estudiantes, ni la carga de trabajo ni el nivel de estrés se traducen negativamente en términos de aprendizaje

Cultura y sociedad en movimiento

La presente compilación de textos, que aborda temáticas diversas sobre cultura y sociedad, es corolario de un esfuerzo compartido de profesores investigadores y alumnos de licenciatura y posgrado con el fin de dar a conocer resultados de las investigaciones que se están realizando en el organismo académico, incluyendo, por supuesto, otros trabajos llevados a cabo por colegas de instituciones y disciplinas afines; de esta manera se fortalecen los cuerpos académicos y se promueven las líneas de generación y aplicación del conocimiento de éstos, evidenciando algunos campos de conocimiento de la antropología.Como es manifiesto, la obra en su conjunto aborda distintos temas desde diversas perspectivas epistemológicas y teórico-conceptuales. Constituye un trabajo plural que articula la perspectiva antropológica, con otras lentes disciplinares. Cuerpo, agricultura, desigualdad y bienestar se entrelazan como ejes en principio divergentes, que hallan en lo sociocultural un elemento común de análisis. Así, los textos aquí englobados tienen la expectativa de aportar en la discusión contemporánea de viejos y nuevos derroteros de interés antropológico, y social en general

Revista del Consejo Superior de Investigaciones Científicas

Alimentación del meloncillo Herpestes ichneumon y de la gineta Genetta genetta en la Reserva Biológica de Doñana, S.O. de la Península Ibérica.Determinación de la edad en Rana perezi Seoane, 1885. Aplicación al análisis del crecimiento somático de poblaciones.Influencias ambientales en la variación del tamaño, forma y peso de los huevos de la collalba rubia (Oenanthe hispanica L.)Características de un coro de sapos corredores (Bufo calamita) en el sureste de España.Estrategias alimentarias del ciervo (Cervus elaphus L.) en Montes de ToledoDistribución de los quirópteros de la provincia de Orense (Noroeste de España).Ecología trófica del lince ibérico en Doñana durante un periodo secoDesarrollo larvario de la rana común (Rana perezi) (anura: ranidae) en charcas temporales del noroeste de la Península Ibérica.Régimen alimenticio del mirlo común (Turdus merula) en el sureste de la Península Ibérica durante el periodo otoño-invierno.Reproducción del gorrión molinero (Passer montanus) en las Islas Canarias.Relación entre la cobertura vegetal y la distribución de nidos en las colonias de pagaza piconegraPeer reviewe

A deletion at Adamts9-magi1 Locus is associated with psoriatic arthritis risk

Objective: Copy number variants (CNVs) have been associated with the risk to develop multiple autoimmune diseases. Our objective was to identify CNVs associated with the risk to develop psoriatic arthritis (PsA) using a genome-wide analysis approach. Methods: A total of 835 patients with PsA and 1498 healthy controls were genotyped for CNVs using the Illumina HumanHap610 BeadChip genotyping platform. Genomic CNVs were characterised using CNstream analysis software and analysed for association using the χ2 test. The most significant genomic CNV associations with PsA risk were independently tested in a validation sample of 1133 patients with PsA and 1831 healthy controls. In order to test for the specificity of the variants with PsA aetiology, we also analysed the association to a cohort of 822 patients with purely cutaneous psoriasis (PsC). Results: A total of 165 common CNVs were identified in the genome-wide analysis. We found a highly significant association of an intergenic deletion between ADAMTS9 and MAGI1 genes on chromosome 3p14.1 (p=0.00014). Using the independent patient and control cohort, we validated the association between ADAMTS9-MAGI1 deletion and PsA risk (p=0.032). Using next-generation sequencing, we characterised the 26 kb associated deletion. Finally, analysing the PsC cohort we found a lower frequency of the deletion compared with the PsA cohort (p=0.0088) and a similar frequency to that of healthy controls (p>0.3). Conclusions: The present genome-wide scan for CNVs associated with PsA risk has identified a new deletion associated with disease risk and which is also differential from PsC risk

The synovial and blood monocyte DNA methylomes mirror prognosis, evolution, and treatment in early arthritis

Identifying predictive biomarkers at early stages of inflammatory arthritis is crucial for starting appropriate therapies to avoid poor outcomes. Monocytes (MOs) and macrophages, largely associated with arthritis, are contributors and sensors of inflammation through epigenetic modifications. In this study, we investigated associations between clinical features and DNA methylation in blood and synovial fluid (SF) MOs in a prospective cohort of patients with early inflammatory arthritis. DNA methylation profiles of undifferentiated arthritis (UA) blood MOs exhibited marked alterations in comparison with those from healthy donors. We identified additional differences both in blood and SF MOs after comparing patients with UA grouped by their future outcomes, i.e., good versus poor. Patient profiles in subsequent visits revealed a reversion toward a healthy level in both groups, those requiring disease-modifying antirheumatic drugs and those who remitted spontaneously. Changes in disease activity between visits also affected DNA methylation, which was partially concomitant in the SF of UA and in blood MOs of patients with rheumatoid arthritis. Epigenetic similarities between arthritis types allow a common prediction of disease activity. Our results constitute a resource of DNA methylation-based biomarkers of poor prognosis, disease activity, and treatment efficacy for the personalized clinical management of early inflammatory arthritis.We thank CERCA Programme/Generalitat de Catalunya and the Josep Carreras Foundation for institutional support. The authors thank all the patients who graciously donated their time and samples to further arthritis research. We are also thankful to Núria Sapena, Marta Bassas, and Cristina González, nurses from the outpatient clinic of the Department of Rheumatology, for their help in the management of biologic samples. This research was funded by Fondo de Investigación en Salud (FIS) grant PI17/00993 from the Institute of Health Carlos III (ISCIII) (to JDC); by grants SAF2017-88086-R and PID2020-117212RB-I00 / AEI / 10.13038/501100011033) from the Spanish Ministry of Science and Innovation (MICINN) (to EB); and by the Thematic Networks for Cooperative Research (RETICS) grant provided by ISCII, Research Network for Inflammation and Rheumatic Diseases (RIER) RD16/0012/0013, cofinanced by the European Fund for Regional Development’s (FEDER) Una manera de hacer Europa program (to JDC and EB).Peer reviewe

Immune response generated with the administration of autologous dendritic cells pulsed with an allogenic tumoral cell lines lysate in patients with newly diagnosed DIPG

Background and objective. Diffuse intrinsic pontine glioma (DIPG) is a lethal brainstem tumor in children. Dendritic cells (DCs) have T-cell stimulatory capacity and, therefore, potential antitumor activity for disease control. DCs vaccines have been shown to reactivate tumor-specific T cells in both clinical and pre-clinical settings. We designed a phase Ib immunotherapy (IT) clinical trial with the use of autologous dendritic cells (ADCs) pulsed with an allogeneic tumors cell-lines lysate (ATCL) in patients with newly diagnosed DIPG after irradiation (RT). Methods. Nine patients with newly diagnosed DIPG met enrollment criteria. Autologous dendritic cell vaccines (ADCV) were prepared from monocytes obtained by leukapheresis. Five ADCV doses were administered intradermally during induction phase. In the absence of tumor progression, patients received 3 boosts of tumor lysate every three months during the maintenance phase. Results. Vaccine fabrication was feasible in all patients included in the study. Non-specific KLH (9/9 patients) and specific (8/9 patients) antitumor response was identified by immunologic studies in peripheral blood mononuclear cells (PBMC). Immunological responses were also confirmed in the T lymphocytes isolated from the cerebrospinal fluid (CSF) of 2 patients. Vaccine administration resulted safe in all patients treated with this schema. Conclusions. These preliminary results demonstrate that ADCV preparation is feasible, safe and generate a DIPG-specific immune response detected in PBMC and CSF. This strategy shows a promising backbone for future schemas of combination immunotherapy