7 research outputs found
Impacto del eje angiotensina-(1-7)/receptor 'Mas' en la inflamaciĂłn y senescencia vasculares
Tesis doctoral inĂ©dta leĂda en la Universidad AutĂłnoma de Madrid, Facultad de Medicina, Departamento de FarmacologĂa y TerapĂ©utica . Fecha de lectura: 4 de Octubre de 201
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
Trayectorias de un viaje por la investigaciĂłn educativa desde el sentipensar de los maestros y maestras : experiencias en desarrollo del programa de pensamiento crĂtico
428 pĂĄginasEste libro reĂșne 19 experiencias que continĂșan el acompañamiento en la fundamentaciĂłn, desarrollo y estructuraciĂłn de estrategias de tipo pedagĂłgico y didĂĄctico dentro de la ruta sentipensante en el Nivel II: Experiencias en desarrollo. Igualmente, en estas experiencias se hace una ampliaciĂłn de referentes, tĂ©cnicas e instrumentos para recoger informaciĂłn de los 19 textos presentados. De tal manera, estas experiencias son fruto de este acompañamiento que ha realizado el Instituto para la InvestigaciĂłn Educativa y el Desarrollo PedagĂłgico IDEP, que servirĂĄn de base y referente para seguir aportando en la configuraciĂłn y consolidaciĂłn de comunidades de saber y prĂĄctica pedagĂłgica, asĂ como en la conformaciĂłn de colectivos y redes de maestros y maestras
BiosorciĂłn de Metales Pesados en SoluciĂłn Acuosa Mediante Biomasa de Saccharomyces Cerevisiae
En el siguiente trabajo se comprobĂł que la biomasa fĂșngica
de Saccharomyces cerevisiae es capaz de remover plomo y cadmio de aguas
contaminadas. Se estudiaron dos cepas de S. cerevisiae una de ellas procedente
del cepario de la Universidad de las Américas-Puebla denominada UDLAP-07
y la otra de venta comercial denominada CM-05.
La investigaciĂłn realizada se divide en tres partes: RealizaciĂłn
de las curvas de crecimiento de la cepa UDLAP-07 y CM-05 en presencia y ausencia
de soluciĂłn de Pb y Cd, determinaciĂłn de la inmovilizaciĂłn
de Pb y Cd por ambas cepas y estudio de la capacidad de biosorciĂłn
de la cepa CM-05 empleando columna empacada con biomasa fĂșngica.
La primera parte de la investigaciĂłn hace referencia a las curvas
de crecimiento de la cepa UDLAP-07 y la cepa CM-05, se demostrĂł que
la cepa CM-05 tiene un tiempo de generaciĂłn mayor al de la cepa UDLAP-07,
mientras que bajo las mismas concentraciones de plomo el resultado fue inverso,
es decir, la cepa UDLAP-07 presentĂł un tiempo de generaciĂłn
mayor al de la CM-05. Esto podrĂa indicar una diferencia en la
sensibilidad de las cepas de levadura a los dos metales usados.
En cuanto al estudio de la capacidad de inmovilizaciĂłn de Pb y Cd
por la cepa UDLAP-07 y la cepa CM-05, se hizo evidente que la cepa CM-05
permite inmovilizar una mayor cantidad de metales. Las dos cepas de levadura
presentaron una concentraciĂłn mĂnima inhibitoria de ambos metales
a 15 ppm
AsĂ mismo, se observo un fenĂłmeno de desorciĂłn de metales
posterior a los 5 minutos de contacto entre la soluciĂłn de metal y
el biosorbente. La biomasa muerta de la cepa UDLAP-07 fue descartada para
los siguientes estudios, debido a la escasa inmovilizaciĂłn de metales
que presenta; de esta manera la cepa CM-05 se empleo en los experimentos
posteriores.
En el tercer segmento de este trabajo se efectuaron ensayos empleando columnas
empacadas con biomasa fĂșngica bajo las siguientes condiciones: sin
tratamiento, tratamiento ĂĄcido y tratamiento alcalino. Estos experimentos
permitieron comparar el porcentaje promedio de biosorciĂłn, la cantidad
promedio en ppm de metal biosorbida y la influencia de la aplicaciĂłn
o no de tratamientos ĂĄcidos y alcalinos en la adsorciĂłn de
metales a diferentes concentraciones.
Finalmente, las condiciones de tratamiento ĂĄcido y alcalino no influyeron
significativamente en la capacidad de adsorciĂłn de plomo y cadmio.
Se observĂł que al aumentar la concentraciĂłn de metales en la
soluciĂłn se aumentaba de manera proporcional la capacidad de
biosorciĂłn
Clinical Presentation and Short- and Long-term Outcomes in Patients With Isolated Distal Deep Vein Thrombosis vs Proximal Deep Vein Thrombosis in the RIETE Registry
International audienceImportance: Insufficient data exist about the clinical presentation, short-term, and long-term outcomes of patients with isolated distal deep vein thrombosis (IDDVT), that is, thrombosis in infrapopliteal veins without proximal extension or pulmonary embolism (PE).Objective: To determine the clinical characteristics, short-term, and 1-year outcomes in patients with IDDVT and to compare the outcomes in unadjusted and multivariable adjusted analyses with patients who had proximal DVT.Design, setting, and participants: This was a multicenter, international cohort study in participating sites of the Registro Informatizado Enfermedad TromboembĂłlica (RIETE) registry conducted from March 1, 2001, through February 28, 2021. Patients included in this study had IDDVT. Patients with proximal DVT were identified for comparison. Patients were excluded if they had a history of asymptomatic DVT, upper-extremity DVT, coexisting PE, or COVID-19 infection.Main outcomes and measures: Primary outcomes were 90-day and 1-year mortality, 1-year major bleeding, and 1-year venous thromboembolism (VTE) deterioration, which was defined as subsequent development of proximal DVT or PE.Results: A total of 33 897 patients were identified with isolated DVT (without concomitant PE); 5938 (17.5%) had IDDVT (mean [SD] age, 61 [17] years; 2975 male patients [50.1%]), and 27 959 (82.5%) had proximal DVT (mean [SD] age, 65 [18] years; 14 315 male patients [51.2%]). Compared with individuals with proximal DVT, those with IDDVT had a lower comorbidity burden but were more likely to have had recent surgery or to have received hormonal therapy. Patients with IDDVT had lower risk of 90-day mortality compared with those with proximal DVT (odds ratio [OR], 0.47; 95% CI, 0.40-0.55). Findings were similar in 1-year unadjusted analyses (hazard ratio [HR], 0.52; 95% CI, 0.46-0.59) and adjusted analyses (HR, 0.72; 95% CI, 0.64-0.82). Patients with IDDVT had a lower 1-year hazard of VTE deterioration (HR, 0.83; 95% CI, 0.69-0.99). In 1-year adjusted analyses of patients without an adverse event within the first 3 months, IDDVT was associated with lower risk of VTE deterioration (adjusted HR, 0.48; 95% CI, 0.24-0.97). By 1-year follow-up, symptoms or signs of postthrombotic syndrome were less common in patients with IDDVT (47.6% vs 60.5%).Conclusions and relevance: Results of this cohort study suggest that patients with IDDVT had a less ominous prognosis compared with patients with proximal DVT. Such differences were likely multifactorial, including the differences in demographics, risk factors, comorbidities, particularly for all-cause mortality, and a potential association of thrombus location with VTE deterioration and postthrombotic syndrome. Randomized clinical trials are needed to assess the optimal long-term management of IDDVT
Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries
Background
Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks.
Methods
The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned.
Results
A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31).
Conclusion
Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)