Calidad de vida relacionada con la salud de los pacientes con insuficiencia cardiaca crónica sistólica en España: resultados del estudio VIDA-IC

[Resumen] Introducción y objetivos. La calidad de vida relacionada con la salud de los pacientes con insuficiencia cardiaca está afectada. Hay poca información sobre los factores clínicos asociados a esta mala calidad de vida de la población española con insuficiencia cardiaca. Métodos. Estudio multicéntrico transversal de calidad de vida relacionada con la salud aplicando un cuestionario específico (Kansas City Cardiomyopathy Questionnaire) y otro genérico (EuroQol-5D) a 1.037 pacientes ambulatorios consecutivos con insuficiencia cardiaca sistólica. Resultados. Los pacientes con peor calidad de vida presentaron en su mayoría datos asociados a peor pronóstico y mayor gravedad de la enfermedad. Los pacientes del estudio presentaron mayor incidencia de limitaciones en movilidad, dolor/malestar y ansiedad/depresión cuando se realizó una comparación externa con población general y con pacientes con otras afecciones crónicas. La correlación entre las puntuaciones totales de ambos cuestionarios fue muy alta (r de Pearson = 0,815; p < 0,001). Con regresión lineal multivariable, se observó que mayor edad (β estandarizada = –0,2; p = 0,03), sexo femenino (β estandarizada = –10,3; p < 0,001), peor clase funcional (β estandarizada = –20,4; p < 0,001), mayor comorbilidad según índice de Charlson (β estandarizada = –1,2; p = 0,005) y el ingreso reciente por insuficiencia cardiaca (β estandarizada = 6,28; p = 0,006) son factores independientes predictores de peor calidad de vida relacionada con la salud. Conclusiones. Los pacientes con insuficiencia cardiaca tienen muy afectada su calidad de vida respecto a la población general española y a otras enfermedades crónicas. Sexo femenino, edad avanzada, comorbilidad, síntomas avanzados y hospitalización reciente son factores determinantes en la calidad de vida relacionada con la salud de estos pacientes

Predictors of optimal pharmacological treatment in patients with heart failure and depressed ejection fraction. Results of the VIDA-IC study

Abstrac

Gender Differences in Health-Related Quality of Life in Patients with Systolic Heart Failure: Results of the VIDA Multicenter Study

Previous studies have shown that heart failure is associated with worse health-related quality of life (HRQoL). The existence of differences according to gender remains controversial. We studied 1028 consecutive outpatients with heart failure and reduced ejection fraction (HFrEF) from a multicentre cross-sectional descriptive study across Spain that assessed HRQoL using two questionnaires (KCCQ, Kansas City Cardiomyopathy Questionnaire; and EQ-5D, EuroQoL 5 dimensions). The primary objective of the study was to describe differences in HRQoL between men and women in global scores and domains of health status of patients and explore gender differences and its interactions with heart failure related factors. In adjusted analysis women had lower scores in KCCQ overall summary scores when compared to men denoting worse HRQoL (54.7 +/- 1.3 vs. 62.7 +/- 0.8,p< 0.0001), and specifically got lower score in domains of symptom frequency, symptoms burden, physical limitation, quality of life and social limitation. No differences were found in domains of symptom stability and self-efficacy. Women also had lower scores on all items of EQ-5D (EQ-5D index 0.58 +/- 0.01 vs. 0.67 +/- 0.01,p< 0.0001). Finally, we analyzed interaction between gender and different clinical determinants regarding the presence of limitations in the 5Q-5D and overall summary score of KCCQ. Interestingly, there was no statistical significance for interaction for any variable. In conclusion, women with HFrEF have worse HRQoL compared to men. These differences do not appear to be mediated by clinical or biological factors classically associated with HRQoL nor with heart failure severity

Everolimus plus minimized tacrolimus on kidney function in liver transplantation: REDUCE, a prospective, randomized controlled study

Background and aim: reduction in calcineurin inhibitor levels is considered crucial to decrease the incidence of kidney dysfunction in liver transplant (LT) recipients. The aim of this study was to evaluate the safety and impact of everolimus plus reduced tacrolimus (EVR + rTAC) vs. mycophenolate mofetil plus tacrolimus (MMF + TAC) on kidney function in LT recipients from Spain. Methods: the REDUCE study was a 52-week, multicenter, randomized, controlled, open-label, phase 3b study in de novo LT recipients. Eligible patients were randomized (1:1) 28 days post-transplantation to receive EVR + rTAC (TAC levels <_ 5 ng/mL) or to continue with MMF + TAC (TAC levels = 6-10 ng/mL). Mean estimated glomerular filtration rate (eGFR), clinical benefit in renal function, and safety were evaluated. Results: in the EVR + rTAC group (n = 105), eGFR increased from randomization to week 52 (82.2 [28.5] mL/min/1.73 m2 to 86.1 [27.9] mL/min/1.73 m2) whereas it decreased in the MMF + TAC (n = 106) group (88.4 [34.3] mL/min/1.73 m2 to 83.2 [25.2] mL/min/1.73 m2), with significant (p < 0.05) differences in eGFR throughout the study. However, both groups had a similar clinical benefit regarding renal function (improvement in 18.6 % vs. 19.1 %, and stabilization in 81.4 % vs. 80.9 % of patients in the EVR + rTAC vs. MMF + TAC groups, respectively). There were no significant differences in the incidence of acute rejection (5.7 % vs. 3.8 %), deaths (5.7 % vs. 2.8 %), and serious adverse events (51.9 % vs. 44.0 %) between the 2 groups. Conclusion: EVR + rTAC allows a safe reduction in tacrolimus exposure in de novo liver transplant recipients, with a significant improvement in eGFR but without significant differences in renal clinical benefit 1 year after liver transplantation

Characterization of New Substrates Targeted By Yersinia Tyrosine Phosphatase YopH

YopH is an exceptionally active tyrosine phosphatase that is essential for virulence of Yersinia pestis, the bacterium causing plague. YopH breaks down signal transduction mechanisms in immune cells and inhibits the immune response. Only a few substrates for YopH have been characterized so far, for instance p130Cas and Fyb, but in view of YopH potency and the great number of proteins involved in signalling pathways it is quite likely that more proteins are substrates of this phosphatase. In this respect, we show here YopH interaction with several proteins not shown before, such as Gab1, Gab2, p85, and Vav and analyse the domains of YopH involved in these interactions. Furthermore, we show that Gab1, Gab2 and Vav are not dephosphorylated by YopH, in contrast to Fyb, Lck, or p85, which are readily dephosphorylated by the phosphatase. These data suggests that YopH might exert its actions by interacting with adaptors involved in signal transduction pathways, what allows the phosphatase to reach and dephosphorylate its susbstrates

CLIL in Action: Educational and Professional Interactions among Teachers

AICLE (Aprendizaje Integrado de Contenidos y Lenguas Extranjeras) es el enfoque oficial europeo para la educación bilingüe, auspiciado por la Comisión Europea y fomentado por una cantidad ingente de investigación e implementación en todos los niveles educativos. Sin embargo, AICLE necesita de más investigación en el aula e interacciones que ofrezcan datos que nos indiquen en qué contextos y bajo qué condiciones específicas las acciones educativas son o no eficaces. Es en esta línea (innovación educativa e interacción en el aula) en la que entendemos que la formación inicial del profesorado en el ámbito de la educación bilingüe ha de estar necesariamente ligada a la formación permanente del profesorado y a la praxis en el aula que proporciona el profesorado en ejercicio. El objetivo esencial de este artículo consiste en establecer el vínculo entre profesorado universitario, profesorado en ejercicio, profesorado en formación (a tres niveles: Grado, Máster y Doctorado) y los CEP de Córdoba y provincia para diseñar una estructura de formación recíproca y cuidadosamente planificada, que contribuya a mejorar la calidad de la educación bilingüe a través del intercambio de prácticas de innovación educativa que fomenten la interacción y el aprendizaje en acción.CLIL (Content and Foreign Language Integrated Learning) is the official European approach to bilingual education, sponsored by the European Commission and fostered by an enormous amount of research and implementation at all levels of education. However, CLIL needs more research in the classroom and interactions which provide data on what contexts and under what specific conditions educational actions are or are not effective. It is in this line (educational innovation and interaction in the classroom) that we understand that the initial training of teachers in the field of bilingual education must necessarily be linked to the ongoing training of teachers and to the praxis in the classroom provided by practising teachers. The essential objective of this article is to establish the link between university teachers, practising teachers, teachers in training (at three levels: Bachelor, Master and Doctorate) and the CEPs of Cordoba and province to design a carefully planned reciprocal training structure that contributes to improving the quality of bilingual education through the exchange of educational innovation practices that foster interaction and learning in action

Adelante / Endavant

Séptimo desafío por la erradicación de la violencia contra las mujeres del Institut Universitari d’Estudis Feministes i de Gènere "Purificación Escribano" de la Universitat Jaume

Vida escolar

Partiendo de la base de que la Reforma Educativa ha tenido poco en cuenta la problemática del horario y del calendario escolar, una Inspectora de Enseñanza Primaria de la comarca leonesa del Bierzo muestra un número de encuestas que ha destinado a profesores y padres de los alumnos de Colegios Nacionales y de Escuelas Graduadas para saber su opinión al respecto. Analizando los resultados de tales encuestas, la inspectora ratifica gran parte de las sospechas sobre el déficit de la escuela en relación con la problemática del horario y del calendario escolar, que había intuido.Ministerio Educación CIDEBiblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín, 5 - 3 Planta; 28014 Madrid; Tel. +34917748000; [email protected]

Vida escolar

El objetivo fundamental del trabajo consiste en facilitar a los Directores un documento que ofrezca las bases para la redacción de un reglamento de su centro de Educación General Básica, bien personalmente o a través de la colaboración del Claustro de Profesores. Se apoya en un Organigrama que ha sido utilizado como fundamento en la elaboración de las Bases para la redacción del texto articulado del Reglamento. Se establecen los siguientes apartados: .1 Generalidades. 2. Elementos personales. 3. Elementos docentes. 4. Elementos materiales. 5. Régimen administrativo. 6. Régimen económico.Ministerio Educación CIDEBiblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín, 5 - 3 Planta; 28014 Madrid; Tel. +34917748000; [email protected]

The autoimmunity risk variant LYP-W620 cooperates with CSK in the regulation of TCR signaling

This is an open-access article distributed under the terms of the Creative Commons Attribution License.The protein tyrosine phosphatase LYP, a key regulator of TCR signaling, presents a single nucleotide polymorphism, C1858T, associated with several autoimmune diseases such as type I diabetes, rheumatoid arthritis, and lupus. This polymorphism changes an R by a W in the P1 Pro rich motif of LYP, which binds to CSK SH3 domain, another negative regulator of TCR signaling. Based on the analysis of the mouse homologue, Pep, it was proposed that LYP and CSK bind constitutively to inhibit LCK and subsequently TCR signaling. The detailed study of LYP/CSK interaction, here presented, showed that LYP/CSK interaction was inducible upon TCR stimulation, and involved LYP P1 and P2 motifs, and CSK SH3 and SH2 domains. Abrogating LYP/CSK interaction did not preclude the regulation of TCR signaling by these proteins.This work was supported by a grant (SAF2009-09724) from Ministerio de Ciencia e Innovación (MICINN,http://www.idi.mineco.gob.es/portal/site​/MICINN), by Fundación Mutua Madrileña (http://www.fundacionmutua.es), and by Red Cardiovascular (RECAVA) from Instituto de Salud Carlos III (http://www.recava.com). Y. Bayón has been under contract within the Ramón y Cajal Program of the Ministerio de Educación y Ciencia of Spain, co-funded by the European Social Fund through FEDER-FSE (http://www.educacion.gob.es).Peer Reviewe