Electrospinning de poliesteramidas biodegradables

L’electrospinning és una técnica que permet obtener fibres de diàmetres de nanometres fins a micres. Consteix en aplicar una diferencia de potencial en una gota de dissolució de polímer que flueix al llarg del injector. En aquest projecte s’ha realitzat un estudi exhaustiu sobre la formació de fibres a partir de les poliesteramides PADAS i PGBGS. S’ha investigat la relació entre les característiques de les fibres obtingudes amb el dissolvent fet servir, el fluxe d’injecció, la distancia injector-col.lector i la concentració polímer/dissolvent

Electrospinning de poliesteramidas biodegradables

L’electrospinning és una técnica que permet obtener fibres de diàmetres de nanometres fins a micres. Consteix en aplicar una diferencia de potencial en una gota de dissolució de polímer que flueix al llarg del injector. En aquest projecte s’ha realitzat un estudi exhaustiu sobre la formació de fibres a partir de les poliesteramides PADAS i PGBGS. S’ha investigat la relació entre les característiques de les fibres obtingudes amb el dissolvent fet servir, el fluxe d’injecció, la distancia injector-col.lector i la concentració polímer/dissolvent

Efecto de la crisis económica sobre el consumo de psicofármacos en Asturias

ResumenObjetivoEvaluar si la crisis económica de 2008ha comportado cambios en la evolución del consumo de ansiolíticos, hipnótico-sedantes y antidepresivos en Asturias.MétodoEstudio descriptivo y de utilización de medicamentos durante 2003-2013. Se calcularon las dosis diarias definidas por 1000 habitantes/día (DHD) de ansiolíticos, hipnótico-sedantes y antidepresivos. Se obtuvieron coeficientes de regresión lineal (b) de las DHD de la etapa precrisis (2003-2008) y de la etapa de crisis (2009-2013).ResultadosEl consumo de ansiolíticos creció un 40,25%, el de hipnóticos un 88,11% y el de antidepresivos un 80,93%. Para los ansiolíticos: b-(2003-2008)=4,38 DHD/año y b-(2009-2013)=1,08 DHD/año. Para los hipnótico-sedantes: b-(2003-2008)=2,30 DHD/año y b-(2009-2013)=0,40 DHD/año. Para los antidepresivos: b-(2003-2008)=5,79 DHD/año y b-(2009-2013)=2,83 DHD/año.ConclusionesEl incremento del consumo para los tres subgrupos en la época de crisis fue menor que en la época precrisis. No se confirma que la crisis económica haya influido aumentando el consumo de estos medicamentos.AbstractObjectiveTo assess whether the economic crisis of 2008 has changed the consumption of anxiolytics, hypnotics-sedatives and antidepressants in Asturias (Spain).MethodWe conducted a descriptive study of drug use from 2003 -2013. The defined daily doses of 1000 inhabitants per day (DHD) were calculated for anxiolytics, hypnotics-sedatives and antidepressants. Linear regression coefficients (b) of the DHD were obtained for the pre-crisis period (2003-2008) and the crisis period (2009-2013).ResultsThe consumption of anxiolytics increased by 40.25%, that of hypnotics by 88.11% and that of antidepressants by 80.93%. For anxiolytics: b-(2003-2008)=4.38 DDI/year and b-(2009-2013)=1.08 DDI/year. For hypnotics-sedatives: b-(2003-2008)=2.30 DDI/year and b-(2009-2013)=0.40 DDI/year. For antidepressants: b-(2003-2008)=5.79 DDI/year and b-(2009-2013)=2.83 DDI/year.ConclusionsThe rise in consumption of the three subgroups during the crisis period was lower than that of the pre-crisis period. This study does not confirm the influence of the economic crisis on the rise in consumption of these drugs

Clinical repercussions and epidemiological considerations of supernumerary canines : a 26 case series

To establish the prevalence of supernumerary canines (SNC) in a sector of the population of Madrid (Spain), as well possible complications associated with this unusual developmental variation. This observational study was performed between 2005 and 2017, among 21,615 patients seeking dental treatment at the Faculty of Dentistry, Complutense University of Madrid (Spain), and at the Virgen de la Paloma Hospital, Madrid (Spain); 22 patients with 26 SNCs were diagnosed. These 22 patients underwent clinical and radiological exploration, registering patient data. SNCs presented a prevalence of 0.10% of the study population. The supernumerary teeth (SNT) were located in the upper maxilla more frequently (61.54%) than the mandible (38.46%). 69.23% were found to be impacted, also causing the impaction of the permanent canine in 53.85% of these cases. In 15.38%, follicular expansion > 3mm was observed. SNCs were associated with other SNT in only four patients. Despite of the fact that the SNCs are usually diagnosed casually in the course of radiological exploration, in the present study over half of them (53.85%) caused impaction of the permanent canine. Early diagnosis allows optimal patient management and treatment planning, with intervention at an appropriate time to prevent complications in development and so reduce later treatment need

Dental caries and treatment needs in 12-year-old schoolchildren from public schools of the municipality of Rionegro (Antioquia, Colombia), 2010

ABSTRACT: Analyzing dental caries conditions of 12-year-old population allows verifying how much of the oralhealth related goals have been achieved. The objective of this study was to describe the experience and prevalence of dental caries and treatment needs of 12-year-old school children in the municipality of Rionegro. Methods: this was a cross-sectional descriptive study on 808 schoolchildren aged 12 years from public schools of the municipality of Rionegro. Both traditional (T) and modified (M) decayed, missing and filled teeth indexes (DMFTT and DMFTM) were used, as well as the Significant Caries Index (SiC). The obtained data were analyzed according to gender, education level, place of residence, and health insurance status. Results: the DMFTT value among the studied population was 1.70 (± 1.63) and the DMFTM was 2.19 (± 1.92). The prevalence of cavitated caries lesions was 59.9%, and for all the lesions it was 70.8%. Caries experience for the DMFTT was 69.9%, and 77.8% in the case of DMFTM. The SiC measured according to the DMFTT was 3.60, and 4.42 for DMFTM. Significant differences were observed in terms of experience, prevalence and treatment needs, especially in relation to gender and school grade. Conclusions: these values indicate accomplishment of the goals set by the WHO and by Colombian standards. Nevertheless, they also reveal some inequalities that must be considered when planning promotion, prevention and attention programs aimed at this population.RESUMEN: El análisis de la situación de caries dental en la población de 12 años permite comprobar el cumplimiento de las metas relacionadas con el componente bucal de la salud. El objetivo de este estudio es describir la experiencia y prevalencia de caries dental y las necesidades de tratamiento en una muestra de escolares de doce años del municipio de Rionegro. Métodos: estudio descriptivo transversal en 808 escolares de 12 años de instituciones educativas públicas del municipio de Rionegro. Se aplicaron criterios del índice de dientes cariados, obturados y perdidos tradicionales y modificados (COPDT-COPDM), y el índice de caries significativo (SiC), y se describieron según sexo, escolaridad, zona de residencia y afiliación a la seguridad social. Resultados: el COPDT en la población fue de 1,70 (± 1,63) y el COPDM de 2,19 (± 1,92). La prevalencia de caries en lesiones cavitacionales fue del 59,9% y para todas las lesiones fue de 70,8%. La experiencia de caries para el COPDT fue del 69,9 y del 77,8% para el COPDM. El SiC tomado a partir del COPDT fue de 3,60 y de 4,42 a partir del COPDM. Se presentaron diferencias significativas en la experiencia, prevalencia y necesidades de tratamiento principalmente de acuerdo con el sexo y el grado de escolaridad. Conclusión: aunque los indicadores muestran el cumplimiento de las metas propuestas por la OMS y según estudios nacionales, se encuentran algunas situaciones de desigualdad que deben ser tenidas en cuenta para la planificación de estrategias de promoción, prevención y atención para esta población

Minimal residual disease evaluation by flow cytometry is a complementary tool to cytogenetics for treatment decisions in acute myeloid leukaemia

For PETHEMA Programa para el Estudio de la Terapéutica en Hemopatías Malignas Cooperative Study Group.The clinical utility of minimal residual disease (MRD) analysis in acute myeloid leukaemia (AML) is not yet defined. We analysed the prognostic impact of MRD level at complete remision after induction therapy using multiparameter flow cytometry in 306 non-APL AML patients. First, we validated the prognostic value of MRD-thresholds we have previously proposed (≥0.1%; ≥0.01-0.1%; and <0.01), with a 5-year RFS of 38%, 50% and 71%, respectively (p = 0.002). Cytogenetics is the most relevant prognosis factor in AML, however intermediate risk cytogenetics represent a grey zone that require other biomarkers for risk stratification, and we show that MRD evaluation discriminate three prognostic subgroups (p = 0.03). Also, MRD assessments yielded relevant information on favourable and adverse cytogenetics, since patients with favourable cytogenetics and high MRD levels have poor prognosis and patients with adverse cytogenetics but undetectable MRD overcomes the adverse prognosis. Interestingly, in patients with intermediate or high MRD levels, intensification with transplant improved the outcome as compared with chemotherapy, while the type of intensification therapy did not influenced the outcome of patients with low MRD levels. Multivariate analysis revealed age, MRD and cytogenetics as independent variables. Moreover, a scoring system, easy in clinical practice, was generated based on MRD level and cytogenetics.This work was supported in part by Spanish grants from Fondo de Investigación Sanitaria-ISCIII (FIS 00/0023-03, PI12/02321), DGCYT (SAF 94- 0308, SAF2001-1687), Conserjería de Educación de Castilla y León (HUS416A12), and Red Temática de Investigación Cooperativa en Cáncer (RTICC-ISCIII) (RD12/0036/0069).Peer Reviewe

A multicenter, open-label, randomized, proof-of-concept phase II clinical trial to assess the efficacy and safety of icatibant in patients infected with SARS-CoV-2 (COVID-19) and admitted to hospital units without invasive mechanical ventilation: study protocol (ICAT-COVID)

Background: COVID-19 has quickly become a global pandemic with a substantial number of deaths and is a considerable burden for healthcare systems worldwide. Although most cases are paucisymptomatic and limited to the viral infection-related symptoms, some patients evolve to a second phase, with an impaired inflammatory response (cytokine storm) that may lead to acute respiratory distress syndrome and death. This is thought to be caused by increased bradykinin synthesis. Methods: ICAT-COVID is a multicenter, randomized, open-label, proof-of-concept phase II clinical trial assessing the clinical efficacy and safety of adding icatibant to the standard of care in patients hospitalized with COVID-19 without invasive mechanical ventilation. Patients hospitalized with a confirmed COVID-19 pneumonia diagnosis (RTPCR or antigen test <= 10 days prior to randomization, and radiographic evidence of pulmonary infiltrates), rated 4 or 5' on the WHO's clinical status scale, are eligible. Patients will be randomized on a 1:1 ratio to either standard of care-plus-icatibant (experimental group) or to standard of care alone (control group). The experimental group will receive 30 mg of icatibant subcutaneously 3 times a day for 3 days (for a total of 9 doses). The expected sample size is 120 patients (60 per group) from 2 sites in Spain. Primary outcomes are the efficacy and safety of Icatibant. The main efficacy outcome is the number of patients reaching grades 2 or 1 on the WHO scale within 10 days of starting treatment. Secondary outcomes include long-term efficacy: number of patients discharged who do not present COVID-19-related relapse or comorbidity up until 28 days after discharge, and mortality. Discussion: Icatibant, a bradykinin type 2 receptor antagonist with proven effectiveness and safety against hereditary angioedema attacks, may be beneficial for COVID-19 patients by inhibiting bradykinin's action on endothelial cells and by inhibiting the SARS-CoV-2 M protease. Our working hypothesis is that treatment with standard of care-plus-icatibant is effective and safe to treat patients infected with SARS-CoV-2 admitted to hospital for pneumonia without invasive mechanical ventilation

Management of acute diverticulitis with pericolic free gas (ADIFAS). an international multicenter observational study

Background: There are no specific recommendations regarding the optimal management of this group of patients. The World Society of Emergency Surgery suggested a nonoperative strategy with antibiotic therapy, but this was a weak recommendation. This study aims to identify the optimal management of patients with acute diverticulitis (AD) presenting with pericolic free air with or without pericolic fluid. Methods: A multicenter, prospective, international study of patients diagnosed with AD and pericolic-free air with or without pericolic free fluid at a computed tomography (CT) scan between May 2020 and June 2021 was included. Patients were excluded if they had intra-abdominal distant free air, an abscess, generalized peritonitis, or less than a 1-year follow-up. The primary outcome was the rate of failure of nonoperative management within the index admission. Secondary outcomes included the rate of failure of nonoperative management within the first year and risk factors for failure. Results: A total of 810 patients were recruited across 69 European and South American centers; 744 patients (92%) were treated nonoperatively, and 66 (8%) underwent immediate surgery. Baseline characteristics were similar between groups. Hinchey II-IV on diagnostic imaging was the only independent risk factor for surgical intervention during index admission (odds ratios: 12.5, 95% CI: 2.4-64, P =0.003). Among patients treated nonoperatively, at index admission, 697 (94%) patients were discharged without any complications, 35 (4.7%) required emergency surgery, and 12 (1.6%) percutaneous drainage. Free pericolic fluid on CT scan was associated with a higher risk of failure of nonoperative management (odds ratios: 4.9, 95% CI: 1.2-19.9, P =0.023), with 88% of success compared to 96% without free fluid ( P &lt;0.001). The rate of treatment failure with nonoperative management during the first year of follow-up was 16.5%. Conclusion: Patients with AD presenting with pericolic free gas can be successfully managed nonoperatively in the vast majority of cases. Patients with both free pericolic gas and free pericolic fluid on a CT scan are at a higher risk of failing nonoperative management and require closer observation

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Sistema de evaluación institucional en enseñanza obligatoria en Iberoamérica

La presente aportación se focaliza, en este contexto, en la evaluación institucional externa (vinculada o no a la autoevaluación interna) y, por tanto, considera prioritariamente la manera como se evalúan los centros educativos como totalidad y no tanto alguno de sus aspectos (evaluación de la dirección, de los profesores, de los programas, etc.), que también pueden estar considerados. El énfasis también está en conocer la organización y desarrollo del sistema de evaluación. Recoge la visión de 43 especialistas de trece países iberoamericanos sobre las formas de entender y promover la evaluación institucional en sus centros educativos. Sus aportaciones, que deben contextualizarse en las particularidades educativas de sus países (ya presentadas en anteriores informes de la RedAGE), presentan los aspectos generales y normativos de la evaluación, las formas cómo se organiza, los efectos institucionales que tienen y algunas reflexiones, retos y propuestas para la mejora. Su orientación es claramente práctica y se vincula al encuentro anual que la RedAGE realizado los días 16 y 17 de mayo de 2016 en la ciudad de Leiria (Portugal). Allí, los representantes de las organizaciones miembro seleccionaron la temática por su interés actual (con clara vinculación a la mejora de los sistemas educativos y la acreditación institucional), consensuaron la estructura de las aportaciones y realizaron un intercambio de posibles ideas sobre la temática. Se cubre así y como en ocasiones anteriores el propósito fundamental de la RedAGE, como es el de fomentar el intercambio de experiencias, la promoción del conocimiento sobre administración y gestión educativa y la reflexión sobre la práctica de la gestión. La finalidad última sigue siendo la de mejorar el funcionamiento de los centros educativos (y, a través de ellos, de los sistemas educativos), procurando sean de calidad y un instrumento para el cambio profesional y social