DRESS syndrome by sulfonamides, about a case

Among the most feared toxico-dermas is drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome, a rare drug dermatitis that occurs after acute exposure to drugs whose clinical impact is based on multiple organs (skin, liver, kidneys, lungs, heart) and cell lines (eosinophils and lymphocytes). It is an entity with high mortality if it is not identified early, its treatment consists of the immediate suspension of the responsible drug and the administration of steroids, these being the therapeutic protagonists. A 64-year-old male patient with clinical, biochemical and histopathological criteria compatible with DRESS syndrome. It is essential to suspect the clinical course of DRESS syndrome before the appearance of dermatosis with multisystem involvement associated with the use of drugs, emphasis is placed on its early identification and the establishment of timely treatment to modify its prognosis.

Acute myelocytic leukemia in pregnancy case report and literature review: a case report

Leukemia is a rare entity in pregnant women, when it occurs it is usually of myeloid origin and acute course, its diagnosis and management remains a challenge because of the limited availability of information resources due to the low frequency of this pathology, the management decision will be carried out by a multidisciplinary team that includes obstetricians, hematologists, psychologists, involving ethical issues always seeking to improve the maternal and fetal prognosis and never forgetting the wishes of the patient and her family. We present the case of a woman in the fourth decade of life, with pregnancy in the third trimester in which acute myeloid leukemia was diagnosed and where it was decided by a consensus of specialists in hematology, gynecology and pediatrics, to prolong the pregnancy until 32 weeks and then start chemotherapy

Enfrentando los riesgos socionaturales

El objetivo del libro es comprender la magnitud de los Riesgos Socionaturales en México y Latinoamérica, para comprender el peligro que existe por algún tipo de desastre, ya sea inundaciones, sismos, remoción en masa, entre otros, además conocer qué medidas preventivas, correctivas y de contingencias existen para estar atentos ante alguna señal que la naturaleza esté enviando y así evitar alguna catástrofe. El libro se enfoca en los aspectos básicos de análisis de los peligros, escenarios de riesgo, vulnerabilidad y resiliencia, importantes para la gestión prospectiva o preventiva

una mirada desde las Ciencias de la Conducta

Este libro es el resultado de los trabajos presentados en el 1er Congreso Internacional "Convivencia y bienestar con sentido humanista para una cultura de paz"

Decoupling of soil nutrient cycles as a function of aridity in global drylands

18 páginas.- 10 figuras.- 72 referencias.- Online Content Any additional Methods, Extended Data display items and Source Data are available in the online version of the paper; references unique to these sections appear only in the online paper..- Puede conseguir el texto completo en el Portal de la producción científica de la Universidad Complutense de Madrid https://produccioncientifica.ucm.es/documentos/5ec78dc52999520a1d557660 .- o en lel respositorio institucional CONICET digital https://ri.conicet.gov.ar/bitstream/handle/11336/29204/CONICET_Digital_Nro.ead4e2ed-0da6-4041-814b-259e8f27bbf6_D.pdf?sequence=5&isAllowed=yThe biogeochemical cycles of carbon (C), nitrogen (N) and phosphorus (P) are interlinked by primary production, respiration and decomposition in terrestrial ecosystems1. It has been suggested that the C, N and P cycles could become uncoupled under rapid climate change because of the different degrees of control exerted on the supply of these elements by biological and geochemical processes1,2,3,4,5. Climatic controls on biogeochemical cycles are particularly relevant in arid, semi-arid and dry sub-humid ecosystems (drylands) because their biological activity is mainly driven by water availability6,7,8. The increase in aridity predicted for the twenty-first century in many drylands worldwide9,10,11 may therefore threaten the balance between these cycles, differentially affecting the availability of essential nutrients12,13,14. Here we evaluate how aridity affects the balance between C, N and P in soils collected from 224 dryland sites from all continents except Antarctica. We find a negative effect of aridity on the concentration of soil organic C and total N, but a positive effect on the concentration of inorganic P. Aridity is negatively related to plant cover, which may favour the dominance of physical processes such as rock weathering, a major source of P to ecosystems, over biological processes that provide more C and N, such as litter decomposition12,13,14. Our findings suggest that any predicted increase in aridity with climate change will probably reduce the concentrations of N and C in global drylands, but increase that of P. These changes would uncouple the C, N and P cycles in drylands and could negatively affect the provision of key services provided by these ecosystems.This research is supported by the European Research Council (ERC) under the European Community's Seventh Framework Programme (FP7/2007-2013)/ERC Grant agreement no. 242658 (BIOCOM), and by the Ministry of Science and Innovation of the Spanish Government, grant no. CGL2010-21381. CYTED funded networking activities (EPES, Acción 407AC0323). M.D.-B. was supported by a PhD fellowship from the Pablo de Olavide University.Peer reviewe

Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study

Background: Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods: For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings: Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8-13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05-6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50-75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation: Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life

Human impacts and aridity differentially alter soil N availability in drylands worldwide

[Aims]: Climate and human impacts are changing the nitrogen (N) inputs and losses in terrestrial ecosystems. However, it is largely unknown how these two major drivers of global change will simultaneously influence the N cycle in drylands, the largest terrestrial biome on the planet. We conducted a global observational study to evaluate how aridity and human impacts, together with biotic and abiotic factors, affect key soil variables of the N cycle.[Location]: Two hundred and twenty-four dryland sites from all continents except Antarctica widely differing in their environmental conditions and human influence.[Methods]: Using a standardized field survey, we measured aridity, human impacts (i.e. proxies of land uses and air pollution), key biophysical variables (i.e. soil pH and texture and total plant cover) and six important variables related to N cycling in soils: total N, organic N, ammonium, nitrate, dissolved organic:inorganic N and N mineralization rates. We used structural equation modelling to assess the direct and indirect effects of aridity, human impacts and key biophysical variables on the N cycle.[Results]: Human impacts increased the concentration of total N, while aridity reduced it. The effects of aridity and human impacts on the N cycle were spatially disconnected, which may favour scarcity of N in the most arid areas and promote its accumulation in the least arid areas.[Main conclusions]: We found that increasing aridity and anthropogenic pressure are spatially disconnected in drylands. This implies that while places with low aridity and high human impact accumulate N, most arid sites with the lowest human impacts lose N. Our analyses also provide evidence that both increasing aridity and human impacts may enhance the relative dominance of inorganic N in dryland soils, having a negative impact on key functions and services provided by these ecosystems.This research is supported by the European Research Council (ERC) under the European Community's Seventh Framework Programme (FP7/2007‐2013)/ERC grant agreement no. 242658 (BIOCOM), and by the Ministry of Science and Innovation of the Spanish Government, grant no. CGL2010‐21381. CYTED funded networking activities (EPES, Acción 407AC0323). S.G. was funded by CONICYT/FONDAP/15110009.Peer Reviewe

Human impacts and aridity differentially alter soil N availability in drylands worldwide

Aims Climate and human impacts are changing the nitrogen (N) inputs and losses in terrestrial ecosystems. However, it is largely unknown how these two major drivers of global change will simultaneously influence the N cycle in drylands, the largest terrestrial biome on the planet. We conducted a global observational study to evaluate how aridity and human impacts, together with biotic and abiotic factors, affect key soil variables of the N cycle. Location Two hundred and twenty-four dryland sites from all continents except Antarctica widely differing in their environmental conditions and human influence. Methods Using a standardized field survey, we measured aridity, human impacts (i.e. proxies of land uses and air pollution), key biophysical variables (i.e. soil pH and texture and total plant cover) and six important variables related to N cycling in soils: total N, organic N, ammonium, nitrate, dissolved organic:inorganic N and N mineralization rates. We used structural equation modelling to assess the direct and indirect effects of aridity, human impacts and key biophysical variables on the N cycle. Results Human impacts increased the concentration of total N, while aridity reduced it. The effects of aridity and human impacts on the N cycle were spatially disconnected, which may favour scarcity of N in the most arid areas and promote its accumulation in the least arid areas. Main conclusions We found that increasing aridity and anthropogenic pressure are spatially disconnected in drylands. This implies that while places with low aridity and high human impact accumulate N, most arid sites with the lowest human impacts lose N. Our analyses also provide evidence that both increasing aridity and human impacts may enhance the relative dominance of inorganic N in dryland soils, having a negative impact on key functions and services provided by these ecosystems

Pouvoir local, régionalismes, décentralisation

En Amérique latine, depuis le début des années quatre-vingt, deux phénomènes majeurs, l'approfondissement de la crise financière-économique et l'évolution démocratique, ont renouvelé les termes et les enjeux d'un débat désormais généralisé sur les rapports entre pouvoirs centraux, pouvoirs régionaux et pouvoirs locaux. En France, dans la même période, mais dans un contexte politique différent, la discussion puis l'application des lois de décentralisation ont répondu à la volonté des sociétés locales de prendre une plus grande part dans la détermination de leur destin et de celui de leur territoire. Démocratisation et modernisation, modernisation et démocratisation sont ainsi devenues, tant en France (en Europe devrait-on dire) qu'en Amérique latine les mots-clés, les références incontournables pour toute réflexion sur les voies et moyens permettant d'affronter les mutations imposées par la compétition internationale