38 research outputs found
EvaluaciĂłn de la densidad mineral Ăłsea con DEXA en futbolistas juveniles
El objetivo de este estudio fue evaluar la densidad mineral Ăłsea (DMO) y el contenido mineral Ăłseo (CMO) de los segmentos corporales durante un periodo de entrenamiento de seis meses. Se realizaron dos tomas de mediciĂłn, una al inicio (TI) y otra al final (TF) a travĂ©s de la absorciometrĂa dual de rayos-x (DEXA) a 41
futbolistas juveniles profesionales. Se encontrĂł un aumento significativo de la DMO de la TI a la TF en la cadera, columna lumbar, triangulo de Ward, tronco y el cuerpo total (p<0.05). En el CMO hubo un aumento significativo en la cadera, columna lumbar, pierna, tronco y costillas (p<0.05). El entrenamiento de fĂștbol fortalece al hueso de las zonas inferiores y de la caja torĂĄcica con el aumento del CMO, considerandolo como una herramienta para la mineralizaciĂłn y fortalecimiento del
hueso, para prevenir lesiones y fracturas
Role of age and comorbidities in mortality of patients with infective endocarditis
[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality.
[Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65âŻyears,65 to 80âŻyears,andâŻâ„âŻ80âŻyears.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk.
[Results]: A total of 3120 patients with IE (1327âŻ<âŻ65âŻyears;1291 65-80âŻyears;502âŻâ„âŻ80âŻyears) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients â„80âŻyears who underwent surgery were significantly lower compared with other age groups (14.3%,65âŻyears; 20.5%,65-79âŻyears; 31.3%,â„80âŻyears). In-hospital mortality was lower in the <65-year group (20.3%,<65âŻyears;30.1%,65-79âŻyears;34.7%,â„80âŻyears;pâŻ<âŻ0.001) as well as 1-year mortality (3.2%, <65âŻyears; 5.5%, 65-80âŻyears;7.6%,â„80âŻyears; pâŻ=âŻ0.003).Independent predictors of mortality were ageâŻâ„âŻ80âŻyears (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32â3.34), CCIâŻâ„âŻ3 (HR:1.62; 95% CI:1.39â1.88),and non-performed surgery (HR:1.64;95% CI:11.16â1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65âŻyears(pâŻ<âŻ0.001) for both in-hospital and 1-year mortality.
[Conclusion]: There were no differences in the clinical presentation of IE between the groups. AgeâŻâ„âŻ80âŻyears, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group
Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)
Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters.
Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs).
Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001).
Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio
The CARMENES search for exoplanets around M dwarfs Guaranteed time observations Data Release 1 (2016-2020)
I. Ribas et al.[Context] The CARMENES instrument, installed at the 3.5 m telescope of the Calar Alto Observatory in AlmerĂa, Spain, was conceived to deliver high-accuracy radial velocity (RV) measurements with long-term stability to search for temperate rocky planets around a sample of nearby cool stars. Moreover, the broad wavelength coverage was designed to provide a range of stellar activity indicators to assess the nature of potential RV signals and to provide valuable spectral information to help characterise the stellar targets.[Aims] We describe the CARMENES guaranteed time observations (GTO), spanning from 2016 to 2020, during which 19 633 spectra for a sample of 362 targets were collected. We present the CARMENES Data Release 1 (DR1), which makes public all observations obtained during the GTO of the CARMENES survey.[Methods] The CARMENES survey target selection was aimed at minimising biases, and about 70% of all known M dwarfs within 10 pc and accessible from Calar Alto were included. The data were pipeline-processed, and high-level data products, including 18 642 precise RVs for 345 targets, were derived. Time series data of spectroscopic activity indicators were also obtained.[Results] We discuss the characteristics of the CARMENES data, the statistical properties of the stellar sample, and the spectroscopic measurements. We show examples of the use of CARMENES data and provide a contextual view of the exoplanet population revealed by the survey, including 33 new planets, 17 re-analysed planets, and 26 confirmed planets from transiting candidate follow-up. A subsample of 238 targets was used to derive updated planet occurrence rates, yielding an overall average of 1.44 ± 0.20 planets with 1 Mâ < Mpl sin i < 1000 Mâ and 1 day < Porb < 1000 days per star, and indicating that nearly every M dwarf hosts at least one planet. All the DR1 raw data, pipeline-processed data, and high-level data products are publicly available online.[Conclusions] CARMENES data have proven very useful for identifying and measuring planetary companions. They are also suitable for a variety of additional applications, such as the determination of stellar fundamental and atmospheric properties, the characterisation of stellar activity, and the study of exoplanet atmospheres.CARMENES is an instrument at the Centro AstronĂłmico Hispano en AndalucĂa (CAHA) at Calar Alto (AlmerĂa, Spain), operated jointly by the Junta de AndalucĂa and the Instituto de AstrofĂsica de AndalucĂa (CSIC). CARMENES was funded by the Max-Planck-Gesellschaft (MPG), the Consejo Superior de Investigaciones CientĂficas (CSIC), the Ministerio de EconomĂa y Competitividad (MINECO) and the European Regional Development Fund (ERDF) through projects FICTS-2011-02, ICTS-2017-07-CAHA-4, and CAHA16-CE-3978, and the members of the CARMENES Consortium (Max-Planck-Institut fĂŒr Astronomie, Instituto de AstrofĂsica de AndalucĂa, Landessternwarte Königstuhl, Institut de CiĂšncies de lâEspai, Institut fĂŒr Astrophysik Göttingen, Universidad Complutense de Madrid, ThĂŒringer Landessternwarte Tautenburg, Instituto de AstrofĂsica de Canarias, Hamburger Sternwarte, Centro de AstrobiologĂa and Centro AstronĂłmico Hispano-AlemĂĄn), with additional contributions by the MINECO, the Deutsche Forschungsgemeinschaft (DFG) through the Major Research Instrumentation Programme and Research Unit FOR2544 âBlue Planets around Red Starsâ, the Klaus Tschira Stiftung, the states of Baden-WĂŒrttemberg and Niedersachsen, and by the Junta de AndalucĂa. We acknowledge financial support from the Spanish Agencia Estatal de InvestigaciĂłn of the Ministerio de Ciencia e InnovaciĂłn (AEI-MCIN) and the ERDF âA way of making Europeâ through projects PID2020-117493GB-I00, PID2019-109522GB-C5[1:4], PID2019-110689RB-I00, PID2019-107061GB-C61, PID2019-107061GB-C64, PGC2018-098153-B-C33, PID2021-125627OB-C31/AEI/10.13039/501100011033, and the Centre of Excellence âSevero Ochoaâ and âMarĂa de Maeztuâ awards to the Institut de CiĂšncies de lâEspai (CEX2020-001058-M), Instituto de AstrofĂsica de Canarias (CEX2019-000920-S), Instituto de AstrofĂsica de AndalucĂa (SEV-2017-0709), and Centro de AstrobiologĂa (MDM-2017-0737). We also benefited from additional funding from: the Secretaria dâUniversitats i Recerca del Departament dâEmpresa i Coneixement de la Generalitat de Catalunya and the AgĂšncia de GestiĂł dâAjuts Universitaris i de Recerca of the Generalitat de Catalunya, with additional funding from the European FEDER/ERDF funds, and from the Generalitat de Catalunya/CERCA programme; the DFG through the Major Research Instrumentation Programme and Research Unit FOR2544 âBlue Planets around Red Starsâ (RE 2694/8-1); the University of La Laguna through the Margarita Salas Fellowship from the Spanish Ministerio de Universidades ref. UNI/551/2021-May-26, and under the EU Next Generation funds; the Gobierno de Canarias through projects ProID2021010128 and ProID2020010129; the Spanish MICINN under RamĂłn y Cajal programme RYC-2013-14875; the âFondi di Ricerca Scientifica dâAteneo 2021â of the University of Rome âTor Vergataâ; and the programme âAlien Earthsâ supported by the National Aeronautics and Space Administration (NASA) under agreement No. 80NSSC21K0593. TPeer reviewe
Voluntariado en AcciĂłn CatĂĄlogo de iniciativas de voluntariado Centros de EducaciĂłn para el Desarrollo.
Este catĂĄlogo compila todas las iniciativas de voluntariado que enmarcan y orientan
las acciones de mĂĄs de dos mil voluntarios anuales que aportan con su tiempo y
conocimiento al fortalecimiento de las comunidades, sus organizaciones sociales
y comunitarias que trabajan decididamente para construir una mejor sociedad.
Durante los Ășltimos tres años hemos apostado por el fortalecimiento de esta
estrategia generando nuevas modalidades, diversos escenarios para el desarrollo
del voluntariado, capacitando a los 19 lĂderes y los voluntarios en las sedes,
siempre bajo la profunda convicciĂłn de que el mundo se puede cambiar cuando
mucha gente pequeña, en lugares pequeños, haciendo cosas pequeñas, logran
tocar la vida de las personas que mĂĄs lo necesitan
Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study
Summary
Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally.
Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies
have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of
the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income
countries globally, and identified factors associated with mortality.
Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to
hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis,
exomphalos, anorectal malformation, and Hirschsprungâs disease. Recruitment was of consecutive patients for a
minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical
status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary
intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause,
in-hospital mortality for all conditions combined and each condition individually, stratified by country income status.
We did a complete case analysis.
Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital
diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal
malformation, and 517 with Hirschsprungâs disease) from 264 hospitals (89 in high-income countries, 166 in middleincome
countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male.
Median gestational age at birth was 38 weeks (IQR 36â39) and median bodyweight at presentation was 2·8 kg (2·3â3·3).
Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income
countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups).
Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome
countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries;
pâ€0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients
combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88â4·11],
p<0·0001; middle-income vs high-income countries, 2·11 [1·59â2·79], p<0·0001), sepsis at presentation (1·20
[1·04â1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention
(ASA 4â5 vs ASA 1â2, 1·82 [1·40â2·35], p<0·0001; ASA 3 vs ASA 1â2, 1·58, [1·30â1·92], p<0·0001]), surgical safety
checklist not used (1·39 [1·02â1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed
(ventilation 1·96, [1·41â2·71], p=0·0001; parenteral nutrition 1·35, [1·05â1·74], p=0·018). Administration of
parenteral nutrition (0·61, [0·47â0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65
[0·50â0·86], p=0·0024) or percutaneous central line (0·69 [0·48â1·00], p=0·049) were associated with lower mortality.
Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome,
middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will
be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger
than 5 years by 2030
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
Abstract
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and lowâmiddle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of âsingle-useâ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for lowâmiddle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both highâ and lowâmiddleâincome countries
Estudio de un producto de infoentretenimiento. Estudio de la octava temporada del programa Salvados
Treball Final de Grau en Periodisme. Codi: PE0932 Curs acadĂšmic 2013-2014El presente artĂculo analiza un producto televisivo de infoentretenimiento
emitido en una cadena privada. Debido a que el infoentretenimiento es entendido por
algunos autores como una forma poco rigurosa de ofrecer informaciĂłn (Blumler, 1992),
estudiaremos qué temas se abarcan desde este tipo de programas y de qué manera
enfocan sus informaciones. El objetivo de este estudio es analizar cuĂĄles son las
caracterĂsticas bĂĄsicas de los programas de infoentrenimiento, y estudiar quĂ© temas
se tratan en Ă©stos basĂĄndonos en concreto en el programa Salvados.This article analyzes a television infotainment product delivered in a private
channel. Because the infotainment is understood by some authors as a less rigorous
way of providing information (Blumler, 1992), we will study what topics are approached
from such programs and how their information focus. The objective of this study is to
analyze which are the basic characteristics of infotainment programs, and to study what
topics are covered in these, based on the specific study program of Salvados
Influence of Genetic Polymorphisms on Clinical Outcomes of Glatiramer Acetate in Multiple Sclerosis Patients
Multiple sclerosis (MS) is a chronic, inflammatory, demyelinating disease of autoimmune
origin, in which inflammation and demyelination lead to neurodegeneration and progressive disability.
Treatment is aimed at slowing down the course of the disease and mitigating its symptoms. One
of the first-line treatments used in patients with MS is glatiramer acetate (GA). However, in clinical
practice, a response rate of between 30% and 55% is observed. This variability in the effectiveness of
the medication may be influenced by genetic factors such as polymorphisms in the genes involved in
the pathogenesis of MS. Therefore, this review assesses the impact of genetic variants on the response
to GA therapy in patients diagnosed with MS. The results suggest that a relationship exists between
the effectiveness of the treatment with GA and the presence of polymorphisms in the following
genes: CD86, CLEC16A, CTSS, EOMES, MBP, FAS, TRBC1, IL1R1, IL12RB2, IL22RA2, PTPRT, PVT1,
ALOX5AP, MAGI2, ZAK, RFPL3, UVRAG, SLC1A4, and HLA-DRB1*1501. Consequently, the identification
of polymorphisms in these genes can be used in the future as a predictive marker of the
response to GA treatment in patients diagnosed with MS. Nevertheless, there is a lack of evidence for
this and more validation studies need to be conducted to apply this information to clinical practice
Therapeutic Value of Single Nucleotide Polymorphisms on the Efficacy of New Therapies in Patients with Multiple Sclerosis
The introduction of new therapies for the treatment of multiple sclerosis (MS) is a very recent phenomenon and little is known of their mechanism of action. Moreover, the response is subject to interindividual variability and may be affected by genetic factors, such as polymorphisms in the genes implicated in the pathologic environment, pharmacodynamics, and metabolism of the disease or in the mechanism of action of the medications, influencing the effectiveness of these therapies. This review evaluates the impact of pharmacogenetics on the response to treatment with new therapies in patients diagnosed with MS. The results suggest that polymorphisms detected in the GSTP1, ITGA4, NQO1, AKT1, and GP6 genes, for treatment with natalizumab, ZMIZ1, for fingolimod and dimethyl fumarate, ADA, for cladribine, and NOX3, for dimethyl fumarate, may be used in the future as predictive markers of treatment response to new therapies in MS patients. However, there are few existing studies and their samples are small, making it difficult to generalize the role of these genes in treatment with new therapies. Studies with larger sample sizes and longer follow-up are therefore needed to confirm the results of these studies