The presence of both HLA-DRB1[*]04:01 and HLA-B[*]15:01 increases the susceptibility to cranial and extracranial giant cell arteritis.

Objectives: To determine if patients with the predominant extracranial large-vessel-vasculitis (LVV) pattern of giant cell arteritis (GCA) have a distinctive HLA-B association, different from that reported in biopsy-proven cranial GCA patients. In a further step we assessed if the combination of HLA-B and HLA-DRB1 alleles confers an increased risk for GCA susceptibility, either for the cranial and extracranial LVV phenotypes. Methods: A total of 184 patients with biopsy-proven cranial GCA, 105 with LVV-GCA and 486 healthy controls were included in our study. We compared HLA-B phenotype frequencies between the three groups. Results: HLA-B*15 phenotype was significantly increased in patients with classic cranial GCA compared to controls (14.7% versus 5.8%, respectively; p<0.01; OR [95% CI] =2.81 [1.54-5.11]). It was mainly due to the HLA-B*15:01 allele (12.5% versus 4.0%, respectively; p<0.01; OR [95% CI] =3.51 [1.77-6.99]) and remained statistically significant after Bonferroni correction. Similar HLA-B*15 association was observed in patients with the LVV-GCA (11.4% versus 5.8%, p=0.04, OR [95% CI] =2.11 [1.04-4.30]). This association was also mainly due to the HLA-B*15:01 allele (10.5% versus 4.0%, respectively; p=0.0054; OR [95% CI] =2.88 [1.19-6.59]). Noteworthy, the presence of HLA-B*15:01 together with HLA-DRB1*04:01 led to an increased risk of developing both cranial and extracranial LVV-GCA. Conclusions: Susceptibility to GCA is strongly related to the HLA region, regardless of the clinical phenotype of expression of the disease.This work was partially supported by RETICS Programs, RD08/0075 (RIER), RD12/0009/0013 and RD16/0012 from ‘‘Instituto de Salud Carlos III’’ (ISCIII) (Spain). However, this research did not receive any specific grant from funding agencies in the commercial or not-for-profit sectors

Tocilizumab in refractory Caucasian Takayasu's arteritis: a multicenter study of 54 patients and literature review

Objective: To assess the efficacy and safety of tocilizumab (TCZ) in Caucasian patients with refractory Takayasu's arteritis (TAK) in clinical practice. Methods: A multicenter study of Caucasian patients with refractory TAK who received TCZ. The outcome variables were remission, glucocorticoid-sparing effect, improvement in imaging techniques, and adverse events. A comparative study between patients who received TCZ as monotherapy (TCZMONO) and combined with conventional disease modifying anti-rheumatic drugs (cDMARDs) (TCZCOMBO) was performed. Results: The study comprised 54 patients (46 women/8 men) with a median [interquartile range (IQR)] age of 42.0 (32.5-50.5) years. TCZ was started after a median (IQR) of 12.0 (3.0-31.5) months since TAK diagnosis. Remission was achieved in 12/54 (22.2%), 19/49 (38.8%), 23/44 (52.3%), and 27/36 (75%) patients at 1, 3, 6, and 12 months, respectively. The prednisone dose was reduced from 30.0 mg/day (12.5-50.0) to 5.0 (0.0-5.6) mg/day at 12 months. An improvement in imaging findings was reported in 28 (73.7%) patients after a median (IQR) of 9.0 (6.0-14.0) months. Twenty-three (42.6%) patients were on TCZMONO and 31 (57.4%) on TCZCOMBO: MTX (n = 28), cyclosporine A (n = 2), azathioprine (n = 1). Patients on TCZCOMBO were younger [38.0 (27.0-46.0) versus 45.0 (38.0-57.0)] years; difference (diff) [95% confidence interval (CI) = -7.0 (-17.9, -0.56] with a trend to longer TAK duration [21.0 (6.0-38.0) versus 6.0 (1.0-23.0)] months; diff 95% CI = 15 (-8.9, 35.5), and higher c-reactive protein [2.4 (0.7-5.6) versus 1.3 (0.3-3.3)] mg/dl; diff 95% CI = 1.1 (-0.26, 2.99). Despite these differences, similar outcomes were observed in both groups (log rank p = 0.862). Relevant adverse events were reported in six (11.1%) patients, but only three developed severe events that required TCZ withdrawal. Conclusion: TCZ in monotherapy, or combined with cDMARDs, is effective and safe in patients with refractory TAK of Caucasian origin.Funding: This work was partially supported by RETICS Programs, RD08/0075 (RIER), RD12/0009/0013 and RD16/0012 from “Instituto de Salud Carlos III” (ISCIII) (Spain)

UGR Empática: programa de intervención para el desarrollo de la empatía en el alumnado de Ciencias de la Salud y Ciencias de la Educación

La capacidad empática es fundamental para garantizar el éxito profesional en las carreras de Ciencias de la Educación y Ciencias de la Salud. En tanto que se trata de una capacidad que puede entrenarse, este proyecto pretende desarrollar la empatía en el estudiantado de estas ramas del conocimiento. Para ello se diseñó una acción de innovación docente consistente en una serie de materiales didácticos en formato multimedia en los que se abordan diferentes aspectos de la empatía y que han sido empleados por los docentes de diferentes materias durante sus clases. Los materiales se han agrupado en 8 sesiones, cada una de ellas conteniendo dos actividades breves. Las actividades han sido presentaciones en videos en torno a 5 minutos y casos prácticos de elaboración propia de los componentes del equipo del PID. En cada sesión se ha incluido un ejercicio de aprendizaje por autoevaluación. La duración ha sido de 8 semanas, a razón de una sesión compuesta por las 2 actividades cada semana. Para determinar la eficacia de la acción innovadora se ha evaluado la capacidad de empatía en el estudiantado antes de iniciar el proyecto y tras la finalización del mismo, a través del Índice de Reactividad Interpersonal (IRI), una escala que mide la empatía de forma multidimensional. El IRI ofrece una medida compuesta de la empatía, incluyendo su dimensión cognitiva y afectiva. La empatía cognitiva se mide mediante el grado en el que la persona comprende el punto de vista de otra persona. El IRI tiene 2 escalas para medir empatía cognitiva: a) la Escala de Toma de Perspectiva, que evalúa cómo la persona intenta adoptar las perspectivas de otras personas y ver las cosas desde su punto de vista; y b) la Escala de fantasía, que mide la tendencia a identificarse con los personajes de las películas, novelas, obras teatrales y otras situaciones ficticias. La de mayor interés para este proyecto es la primera. En cuanto a la empatía afectiva o emocional, el IRI intenta captar la respuesta emocional de la persona cuando observa el estado afectivo de otras personas, y lo hace con otras 2 escalas: c) Escala de Preocupación Empática consta de ítems sobre los sentimientos de simpatía, compasión y preocupación por los demás; y d) la Escala de Angustia Personal, que valora si la persona experimenta ansiedad y malestar cuando observa que otros están atravesando por experiencias negativas. En nuestro estudio, el interés estaba en que aumentase la puntuación en la escala de preocupación empática, pero no en la de angustia personal. Los objetivos específicos fueron la mejora en las dimensiones de la capacidad empática más relevantes, considerando que la toma de perspectiva y la preocupación empática son las más relacionadas con el desempeño profesional del estudiantado al que iba dirigido el proyecto. En general, los resultados indican que el conjunto del alumnado que ha participado en el PID ha mejorado su capacidad empática. Por tanto, podemos considerar que los materiales creados son válidos para tal fin y pueden ser de aplicación práctica a la docencia.Empathic skills are fundamental to ensure professional success in the fields of Education and Health Sciences. As it is an ability that can be trained, this project aims to develop empathy in students of these branches of knowledge. To this end, a teaching innovation action was designed consisting of a series of teaching materials in multimedia format in which different aspects of empathy are addressed and which have been used by teachers of different subjects during their classes. The materials have been grouped into 8 sessions, each containing two short activities. The activities consisted of 5-minute video presentations and case studies developed by the IDP team. Each session included a self-assessment learning exercise. The duration was 8 weeks, with one session consisting of the 2 activities each week. To determine the effectiveness of the innovative action, the students' capacity for empathy was assessed before the start of the project and after its completion, using the Interpersonal Reactivity Index (IRI), a scale that measures empathy in a multidimensional way. The IRI provides a composite measure of empathy, including both cognitive and affective dimensions. Cognitive empathy is measured by the degree to which a person understands another person's point of view. The IRI has 2 scales to measure cognitive empathy: a) the Perspective Taking Scale, which assesses how the person tries to adopt other people's perspectives and see things from their point of view; and b) the Fantasy Scale, which measures the tendency to identify with characters in films, novels, plays and other fictional situations. Of most interest for this project is the first one. As for affective or emotional empathy, the IRI attempts to capture the person's emotional response when observing the affective state of other people, and does so with 2 other scales: c) the Empathic Concern Scale consists of items on feelings of sympathy, compassion and concern for others; and d) the Personal Distress Scale, which assesses whether the person experiences anxiety and discomfort when observing that others are going through negative experiences. In our study, the focus was on increasing scores on the empathic concern scale, but not on the personal distress scale. The specific objectives were to improve the most relevant dimensions of empathic ability, considering that perspective-taking and empathic concern are the most related to the professional performance of the target students. In general, the results indicate that the students who participated in the IDP as a whole have improved their empathic ability. Therefore, we can consider that the materials created are valid for this purpose and can be of practical application in teaching

La renovación de la palabra en el bicentenario de la Argentina : los colores de la mirada lingüística

El libro reúne trabajos en los que se exponen resultados de investigaciones presentadas por investigadores de Argentina, Chile, Brasil, España, Italia y Alemania en el XII Congreso de la Sociedad Argentina de Lingüística (SAL), Bicentenario: la renovación de la palabra, realizado en Mendoza, Argentina, entre el 6 y el 9 de abril de 2010. Las temáticas abordadas en los 167 capítulos muestran las grandes líneas de investigación que se desarrollan fundamentalmente en nuestro país, pero también en los otros países mencionados arriba, y señalan además las áreas que recién se inician, con poca tradición en nuestro país y que deberían fomentarse. Los trabajos aquí publicados se enmarcan dentro de las siguientes disciplinas y/o campos de investigación: Fonología, Sintaxis, Semántica y Pragmática, Lingüística Cognitiva, Análisis del Discurso, Psicolingüística, Adquisición de la Lengua, Sociolingüística y Dialectología, Didáctica de la lengua, Lingüística Aplicada, Lingüística Computacional, Historia de la Lengua y la Lingüística, Lenguas Aborígenes, Filosofía del Lenguaje, Lexicología y Terminología

Prevalencia de VIH, hepatitis, sífilis y tuberculosis en la población inmigrante del área sanitaria de A Coruña sometida a un examen de salud

Aim: Knowing the prevalence of viral hepatitis, HIV, tuberculosis and syphilis infection in a healthy immigrant community through a health examination. Methods: Prospective observational study from March 2005 to March 2009 in a healthy population of immigrants with less than 5 years living in Galicia through NGO Ecos do Sur (A Coruña). All were given the option to make the Mantoux test and analytical study: serology for hepatitis, syphilis and HIV. Results : 204 individuals were included (48% males). 54.4% of immigrants had an age range between 21-35 years. 76% came from Latin America. 49% lived in Galicia for less than a year. 2% were carriers of HBV, 1% of HCV, while 1.4% were infected with HIV. 31.9% had a positive Mantoux test. The serology was 7.1% compatible with latent or past syphilis. Conclusion: The immigrant population in our geographical area comes mainly from Latin American countries. The prevalence of positive markers for HBV, HBV, HIV and syphilis was low, with lower rates than other communities of the Mediterranean.OBJETIVOS: Conocer la prevalencia de las hepatitis víricas, infección por VIH, infección tuberculosa y sífilis en un colectivo de inmigrantes sanos a través de un examen de salud. MÉTODOS: Estudio observacional y prospectivo realizado en una población de inmigrantes sanos con menos de 5 años de residencia en Galicia y que acudieron voluntariamente a ONGd Ecos do Sur ( A Coruña ). A todos se les ofreció la posibilidad de realización de prueba de Mantoux y estudio analítico: serología de hepatitis y VIH en centro hospitalario de referencia. El periodo de estudio: desde marzo 2005 a marzo 2009. Resultados : Un total de 204 individuos fueron incluidos en el estudio (48% varones). El 54,4% de los inmigrantes tenía un rango de edad entre 21-35 años. El 76% procedían de Iberoamérica. El 49% residía en Galicia desde hacía menos de un año. El 2% eran portadores del VHB, el 1% lo eran del VHC, mientras que el 1,4% estaban infectados por el VIH. El 34,5% presentaron Mantoux positivo. El 7,1% presentaba una serología compatible con sífilis latente o pasada. Conclusiones: La población inmigrante de nuestra área geográfica procede fundamentalmente de los países iberoamericanos. La prevalencia de marcadores positivos para VHB, VHB, VIH y sífilis fue baja, en menor proporción que otras comunidades de la cuenca mediterráne

Nuclear Cystatin D has antitumor gene regulatory effects in colon cancer cells

Resumen del póster presentado al 15th International Congress of the ASociación Española de Investigación sobre el CAncer (ASEICA), celebrado en Sevilla del 21 al 23 de octubre de 2015.Cystatin D is a member of the cystatin superfamily of inhibitors of cathepsins, cysteine proteases that degrade multiple targets including adhesion proteins, matrix components and other proteases. Cystatins play multiple roles in physiology and pathology, including tumorigenesis and neurodegenerative disorders, and a number of cathepsins are thought to be involved in cancer and other diseases as regulators of a variety of biochemical processes. Preferential attention has been paid to the deregulation and imbalance between cathepsins and cystatins in invasion and metastasis of several neoplasias. We have previously reportad that cystatin D prometes cell adhesion and decreases proliferation. migration and invasion of colon carcinoma cells. lt is downregulated during human colon carcinogenesis, and considerad as a candidate tumor suppressor gene that is transcriptionally induced by 1,25(OH)2D3, the most active metabolite of vitamin D, mediating its protective effects against this neoplasia (Álvarez-Díaz et al., J. Clin. lnvest., 2009). The finding that mutant forms of cystatin D with no protease inhibitory activity lack the antimigratory but not the antiproliferative effect on colon cancer cells indicates that cystatin D has cathepsin-independent mechanism(s) of action. Cathepsins have traditionally been considerad endosomal/lysosomal or secreted proteases; however, new evidences support their localization in other cellular compartments. Recent studies have reported the activity of cathepsin L. a cystatin D target, within the cell nucleus. Analogously, a few cystatins and other protease inhibitors have been found to act in the nuclear compartment. Taken together, these findings prompted us to investigate in depth the mechanism of action of cystatin D in colon carcinoma cells.Peer Reviewe

Vascular endothelial growth factor haplotypes are associated with severe ischaemic complications in giant cell arteritis regardless of the disease phenotype.

To determine whether functional vascular endothelial growth factor (VEGF) polymorphisms influence the expression of the clinical phenotype of giant cell arteritis (GCA). We also evaluated whether VEGF polymorphism is associated with the development of severe ischaemic manifestations in patients with GCA regardless of the clinical phenotype, classic cranial GCA or predominantly extracranial GCA large vessel vasculitis (LVV). VEGF rs833061 T/C, rs2010963 G/C and rs3025039 C/T polymorphisms were genotyped in 185 patients with biopsy-proven cranial GCA, 105 with extracranial LVV-GCA and 490 healthy controls. Allelic combinations (haplotypes) of VEGF were carried out. Comparisons were performed between patients with GCA and healthy controls as well as between patients with GCA stratified according to the clinical phenotype and the presence of severe ischaemic manifestations. No significant differences in genotype, allele, and haplotype frequencies of VEGF were found between patients with GCA and healthy controls as well as between GCA patients with the classic cranial pattern and the extracranial LVV-GCA pattern of the disease. However, the VEGF CGC haplotype (OR= 1.63 [1.05-2.53]) and the CGT haplotype (OR= 2.55 [1.10-5.91]) were significantly more frequent in GCA patients with severe ischaemic complications compared to those patients without these complications. VEGF haplotypes seem to play a role in the development of severe ischaemic manifestations in GCA patients, regardless of the clinical phenotype of expression of the disease

Guadalmedina Strategy for Malaga_EGM 2035

Esta publicación presenta la propuesta para el “concurso de ideas sobre la integración urbana del río Guadalmedina” elaborado desde el Laboratorio de Urbanismo de la Universidad de Granada en Febrero de 2012, con el que se ganó el premio tercer accesit. Son un conjunto de acciones a corto, medio y largo plazo que se orientan a un objetivo común: la mejora urbanística y ambientaldel cauce del Guadalmedina y su entorno, desde los montes al mar. El diseño del cauce fluvial es solamente una parte muy reducida de lo que se propone: un cambio fundamental en la gestión, en la participación pública, en la integración de políticas de rehabilitación y de reurbanización de las barriadas y en la mejora de una movilidad más eficiente, igualitaria y respetuosa de los valores ambientales, más transporte público y menos coche. Se usará el cauce sin temor, como lugar de cohesión de todos los barrios de su entorno.This is a publication that presents the proposal to the "contest of ideas about urban integration Guadalmedina River" drawn from the Urban Laboratory, University of Granada, February 2012, . They are a set of short, medium and long term that focus on a common goal: improving urban and environmental riverbed of Guadalmedina and its surroundings, from the mountains to the sea. The design of the river channel is only a very small part of what is proposed: a fundamental change in management, public participation, policy integration in rehabilitation and redevelopment of slums and improving mobility more efficient, equitable and respectful of environmental values, more public transit and less car. Will use the riverbed without fear, as a place of unity of all neighborhoods of their environment