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To assess the effect of hydroxychloroquine (HCQ) and Tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) as pre-exposure prophylaxis on COVID-19 risk. EPICOS is a double-blind, placebo-controlled randomized trial conducted in Spain, Bolivia, and Venezuela. Healthcare workers with negative SARS-CoV-2 IgM/IgG test were randomly assigned to the following: daily TDF/FTC plus HCQ for 12 weeks, TDF/FTC plus HCQ placebo, HCQ plus TDF/FTC placebo, and TDF/FTC placebo plus HCQ placebo. Randomization was performed in groups of four. Primary outcome was laboratory-confirmed, symptomatic COVID-19. We also studied any (symptomatic or asymptomatic) COVID-19. We compared group-specific 14-week risks via differences and ratios with 95% CIs. Of 1002 individuals screened, 926 (92.4%) were eligible and there were 14 cases of symptomatic COVID-19: 220 were assigned to the TDF/FTC plus HCQ group (3 cases), 231 to the TDF/FTC placebo plus HCQ group (3 cases), 233 to the TDF/FTC plus HCQ placebo group (3 cases), and 223 to the double placebo group (5 cases). Compared with the double placebo group, 14-week risk ratios (95% CI) of symptomatic COVID-19 were 0.39 (0.00-1.98) for TDF + HCQ, 0.34 (0.00-2.06) for TDF, and 0.49 (0.00-2.29) for HCQ. Corresponding risk ratios of any COVID-19 were 0.51 (0.21-1.00) for TDF + HCQ, 0.81 (0.44-1.49) for TDF, and 0.73 (0.41-1.38) for HCQ. Adverse events were generally mild. The target sample size was not met. Our findings are compatible with both benefit and harm of pre-exposure prophylaxis with TDF/FTC and HCQ, alone or in combination, compared with placebo.

Durante la última pandemia se vislumbró una falta de herramientas digitales educativas de uso masivo que permita llevar unas clases de manera ordenada visto desde el punto de vista del docente, que requería presentar su material, llevar un control de entrega así como la revisión y devolución del mismo, estos softwares educativos tenían objetivos comunes pero distintos entre sí, el que más cumplió con estos requerimientos durante la etapa pre y postpandemia fue la aplicación educativa google classroom que presentaba muchas ventajas que se aprovechan hasta la fecha como refuerzo de actividades académicas a las clases desarrolladas de manera presencial.

El propósito del presente estudio fue establecer la relación entre la aplicación de la plataforma CANVAS y el aprendizaje de Matemáticas en estudiantes. La investigación es de enfoque cuantitativo, con un diseño correlacional. Tuvo como muestra 32 estudiantes. El instrumento fue el cuestionario. Como resultado se afirma que existe una relación significativa entre la aplicación de la plataforma CANVAS, y el aprendizaje de Matemáticas. La plataforma Canvas es de gran ayuda para el aprendizaje de los estudiantes. Por tal motivo es primordial capacitar a docentes y estudiantes acerca del uso de esta herramienta para las distintas actividades de aprendizaje

Obstructive sleep apnea (OSA) is an important risk factor for poor asthma control. The objective of this study is to analyze the symptomatic control in asthmatic patients with OSA after using continuous positive airway pressure (CPAP).Patients were collected in a monographic asthma consult and a polygraphy was performed due to clinical suspicion or poor disease control. Asthma associated pathologies, as well as clinical and patient-perceived asthma control parameters were evaluated before and after the initiation of CPAP.A hundred patients were included, 59% were women and 41% men. From them, 54% had severe OSA, 33% moderate OSA and 13% mild OSA, and 10% could not tolerate CPAP. Eighty four percent had a moderate or severe degree of asthma with fractional exhaled nitric oxide (FENO) 32 ± 24.6 ppm and an asthma control test (ACT) before CPAP of 19 ± 4. Asthma control before CPAP was good in 41% of patients, partial in 29%, and bad in 30%. After three or more months of CPAP, clinical asthma control was good in 70% (p 0.001), perceived control by ACT after CPAP was 21 ± 4 (p 0.001). When asked for their opinion, 51.5% referred clinical improvement after CPAP, no change in 46.5%.The use of CPAP in asthmatic patients with OSA improves both clinical and perceived asthma control in a statistically significant way. Most patients had good adaptation to CPAP (90%) and 51.5% had clinical improvement.

El objetivo de esta investigación fue evaluar la inclusión de harina de hoja de moringa en la dieta de pollos durante los primeros 21 días del periodo de engorda en sistemas de producción familiar o de traspatio como una alternativa para reducir los costos por compra de ingredientes proteicos y generar productos de origen animal de manera eficiente. El trabajo se realizó en la Huasteca Hidalguense utilizando 84 pollos de sexo mixto, en un diseño completamente al azar, con tres tratamientos, cuatro repeticiones considerando siete pollos por unidad experimental. Los tratamientos consistían en la sustitución de la pasta de soya por la harina de hoja de moringa en las dietas de engorda como sigue, tratamiento 1 Control; tratamiento 2 (10% moringa) (TM10) y tratamiento 3 (20% moringa) (TM 20). Los datos obtenidos se analizaron con el paquete estadístico STATISTICA versión 10, utilizando como modelo general lineal un ANDEVA. Los resultados mostraron que el TM 20 generó mayor consumo de alimento, el tratamiento sin moringa con mayor ganancia de peso y el tratamiento con 10% de moringa con la mejor conversión alimenticia, con base a esto se concluye que la inclusión de moringa en dietas para pollos de engorda en etapa de crecimiento en cantidades mayores al 10%, incrementa el consumo de alimento, sin embargo, la ganancia de peso y la eficiencia alimenticia disminuyen.

Glass ionomer cements (GICs) are currently the first-choice materials in minimally invasive dentistry and are widely used in paediatric dentistry. The objective of this study was to evaluate the influence of viscosity and mixing on porosity and the relationship between the porosity and microhardness of GICs. Nine GICs were used: EQUIA® Forte Fil, Ionostar®Plus, 3MTMKetacTM Universal AplicapTM, Riva Light Cure HV®, Riva Silver®, Riva Protect®, VitremerTM, VitrebondTM Plus and Activa BioActive RestorativeTM. Samples were prepared from each material and images were obtained by scanning electron microscopy (SEM). Using software, the number and diameter of pores, area, and percentage of area they occupied were measured. After SEM analysis, the samples were used to make surface microhardness (SMH) measurements. Ionostar® Plus, EQUIA® Forte Fil and Riva Light Cure HV® had the highest number of pores. Riva Protect® had the largest pores and the highest percentage of pore-occupied area, while Activa BioActive RestorativeTM and VitrebondTM Plus had a smaller pore size and a smaller percentage by area. Riva Silver® and EQUIA® Forte Fil showed the highest microhardness values and VitrebondTM Plus and VitremerTM the lowest. In conclusion, when the cement viscosity is low, the type of mixture determines the degree of porosity, but has less influence when viscosity is high. There was no correlation between microhardness and the porosity of GICs.

Coronavirus disease 2019 (COVID-19) was first discovered after unusual cases of severe pneumonia emerged by the end of 2019 in Wuhan (China) and was declared a global public health emergency by the World Health Organization in January 2020. The new pathogen responsible for the infection, genetically similar to the beta-coronavirus family, is known as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), and the current gold standard diagnostic tool for its detection in respiratory samples is the reverse transcription-polymerase chain reaction test. Imaging findings on COVID-19 have been widely described in studies published throughout last year, 2020. In general, ground-glass opacities and consolidations, with a bilateral and peripheral distribution, are the most typical patterns found in COVID-19 pneumonia. Even though much of the literature focuses on chest computed tomography (CT) and X-ray imaging and their findings, other imaging modalities have also been useful in the assessment of COVID-19 patients. Lung ultrasonography is an emerging technique with a high sensitivity, and thus useful in the initial evaluation of SARS-CoV-2 infection. In addition, combined positron emission tomography-CT enables the identification of affected areas and follow-up treatment responses. This review intends to clarify the role of the imaging modalities available and identify the most common radiological manifestations of COVID-19. Sin financiación No data 2020 UEM

Background: Polymeric nanomaterials are important for developing drug delivery systems. The control of nanoparticle size, polydispersity, and morphology in these systems are important goals. Therefore, different strategies have been explored depending on the type of materials used. Objective: To prepare biodegradable segmented poly(urea)urethane nanoparticles and to optimize the nanoparticle size and polydispersity using an experimental design methodology. Methods: In this work, a biodegradable segmented poly(urea)urethane (SPUU) was synthesized. This polymer was used for nanoparticle preparation by the nanoprecipitation technique in the context of the experimental design methodology Taguchi L9. SPUU and nanoparticles were characterized using Fourier transformed infrared, proton nuclear magnetic resonance, transmission electron microscopy, scanning electron microscopy, and dynamic light scattering. Results: This methodology produced polymeric nanoparticles with mean sizes in the range of 60 to 220 nm with polydispersity in the range of 0.077 to 0.233. The statistical analysis showed that the SPUU concentration and the stirring speed were the most influential parameters, while temperature, at the studied range, did not show a relevant effect. Conclusion: The analysis of Taguchi’s experimental design resulted in the optimization of parameters determining SPUU-NPs’ size. Nanoparticles from 60 nm of effective diameter were obtained at low polymer concentration and higher stirring speed.

Several studies have documented the synergy between vancomycin/daptomycin and various beta-lactams, and clinical studies have studied this combination therapy in humans. We review the published literature on this topic to know the utility of the combined treatment with beta-lactams in treating bacteraemia methicillin-resistant Staphylococcus aureus (MRSA) infections. Fifteen observational studies, three randomised clinical trials and three systematics reviews are analysed in this article. Observational studies used ceftaroline, cefazolin, piperacillin/tazobactam or cefepime among the beta-lactams. Clinical trials used cloxacillin or flucloxacillin as the most used beta-lactam in two trials and ceftaroline in one. Three systematic reviews are published. One of them only includes studies with vancomycin and included six studies. The other two systematic reviews include patients with daptomycin or vancomycin and included 15 and 9 studies, respectively. Adding a beta-lactam to vancomycin or daptomycin may help shorten bacteraemia and avoid recurrences in patients with MRSA bacteraemia. There is no evidence that combined therapy improves mortality. Nephrotoxicity in clinical trials precludes the use of combination therapy mainly with cloxacillin or flucloxacillin, but systematic reviews have not found a significant difference in this point in observational studies with other beta-lactams. The role of other beta-lactams such as ceftaroline should be thoroughly studied in these patients.

Cultura material e Historia de las mujeres es fruto de la séptima edición del Seminario Internacional 'Historia y Feminismo', organizado por la Asociación Española de Investigación de Historia de las Mujeres y celebrado en septiembre de 2017, en la Facultad de Geografía e Historia de la Universidad Complutense de Madrid. El volumen recoge diez títulos y se estructura en los cuatro bloques, correspondientes a las cuatro sesiones en que se articuló el citado Seminario, así como los talleres didácticos que se llevaron a cabo. La publicación logra el objetivo genérico de mostrar a sus lectores la importancia de la cultura material para el estudio de la Historia de las mujeres, pero, además, tiene el valor de trascender las aportaciones individuales de los autores para presentar una unidad teórica, metodológica y conceptual con perspectivas arqueológicas, antropológicas e históricas.

Background Here, we assess the efficacy and safety of direct antiviral agents (DAAs) in a real-world cohort of co-infected individuals, and evaluate the consistency between clinical practice and guideline recommendations. Methods Multicenter, prospective cohort study of HIV/HCV co-infected patients followed-up in nine sites in Spain. All patients with detectable HCV-RNA naive to second-generation DAAs were enrolled. The primary endpoint was the assessment of sustained virological response at week 12 (SVR12). We performed intention-to-treat (ITT), per-protocol (PP), and multivariable analyses to identify factors associated with therapeutic failure. We compared the DAAs we administered to available guideline recommendations. Schemes not perfectly adjusted to the recommendations were defined as sub-optimal. Results Overall, 316 patients (82.1% male) received a total of 330 treatments. Of these, 43.9% were cirrhotic and 40.6% were treatment-experienced. In the ITT and PP analyses, SVR12 was achieved in 90.9% [95% confidence interval (CI) 87.3-93.6] and 93.7% (95% CI 90.5-95.6), respectively. Only alcohol abuse [odds ratio (OR): 0.33; 95% CI 0.138-0.789, P = 0.013] and a higher basal bilirubin level (OR: 0.595; 95% CI 0.416-0.851, P = 0.004) were independently associated to therapeutic failure. A progressive decrease in the proportion of sub-optimal treatments was observed over time, from 75% in 2014 to 0% in 2018. Being treated with a sub-optimal regimen was not associated with failure. Conclusion Despite numerous difficulties in treatment access and in adaptation to the changing guidelines, we detected no differences among the DAAs used, nor did we detect a lower efficacy when the chosen treatment was not optimal.

Osteoarticular tuberculosis comprises 1–3% of tuberculosis (TB) patients. In 50% of cases of osteoarticular TB affects the spine. Other joints, such as the ankle, hip, and knee, are less affected. The diagnosis may be delayed for months due to an indolent course and absence of specific signs. Here we report the case of a 42-year-old immigrant immunocompetent male with tuberculosis osteoarthritis of the ankle. The patient experienced intermittent arthritis episodes affecting the left ankle following a fracture of the calcaneus 4 years prior. Initial therapy with anti-inflammatory drugs and empirical antibiotics did not produce improvement. A histological study following a surgical biopsy of the bone provided the diagnosis of tuberculosis. The patient had no respiratory symptomatology, and the chest X-ray was normal. The patient improves his symptoms by administering antitubercular chemotherapy with isoniazid, rifampicin, pyrazinamide, and ethambutol. The diagnosis of osteoarticular TB requires a high index of suspicion, mainly in immunocompetent patients and in low-incidence countries.

The species of the Parmelia saxatilis complex occurring in the Iberian Peninsula were revised. Eight species are accepted, including a new species found in southern Spain, described as P. rojoi A. Crespo, V. J. Rico & Divakar. The new species, which forms a sister-group relationship with P. saxatilis s. str., is rare in the Iberian Peninsula and is restricted to higher altitudes of northern and central Spain. Parmelia rojoi differs from P. saxatilis by generally narrower isidia and a more fragile thallus. The segregation of the new species is also supported by ITS (rDNA) and Mcm7 (MS456) phylogeny and multispecies coalescent-based approaches, including StarBEAST and BP&P. Furthermore, the divergence of P. rojoi is dated back to the Pleistocene, c. 2.13 Ma. A key to the identification of species from the P. saxatilis complex with their diagnostic features is provided. All species of the complex known from Europe are also found in the Iberian Peninsula. We hypothesize that P. rojoi is a relict species that survived the Pleistocene glaciations in refugia in Spain and has been unable to extend its distributional range in postglacial periods.

OBJECTIVE To evaluate the progression of liver stiffness after treatment with direct antiviral agents (DAAs), to identify predictive factors of fibrosis regression and to analyze the changes of scores AST-to-platelet ratio index (APRI) and Fibrosis-4 (FIB-4) after treatment. DESIGN Multicenter prospective cohort study of HIV/HCV co-infected patients conducted within the GECMEI cohort, Spain. METHODS Individuals were eligible if they were willing to start DAAs and underwent two transient elastographies: at baseline and after the end of treatment (EOT). All patients with detectable HCV RNA naive to DAAs were consecutively enrolled from nine medical hospitals. Liver stiffness results were categorized in four Metavir stages (F1: 12.4 kPa). The APRI and FIB-4 scores were calculated at baseline, EOT and 12 weeks after EOT. RESULTS One hundred and seventy-eight patients were examined throughout a follow-up of 16.3 months (IQR: 12.5-25). The median of liver stiffness decrease was 2.6 kPa (IQR: 0-6.3). A greater improvement was observed in F3-F4 compared with F1-F2, (6.4 vs. 0.91 kPa, P

Introduction Standard therapy for HIV treatment has consisted of two nucleoside analogue reverse transcriptase inhibitors (NRTI) paired with a third agent. Use of two-drug regimens (2DR) has been considered for selected patients in part to avoid toxicities associated with the use of NRTIs. This study aimed to compare the real-world outcomes of integrase inhibitor (INSTI)-based three-drug regimens (3DR) versus 2DR of dolutegravir (DTG) + rilpivirine (RPV) or DTG + lamivudine (3TC). Methods All patients in the Spanish VACH cohort switching to INSTI-based 3DR or a 2DR consisting of DTG + RPV or DTG + 3TC between May 2, 2016 and May 15, 2019 were included. Kaplan-Meier curves and Cox proportional hazard models were used to assess time to/risk of discontinuation due to treatment failure (TF) (defined as virologic failure [VF], immunologic failure, or disease progression) and adverse events (AEs). Three secondary analyses were performed: (1) in restricting the analysis to patients who were virologically suppressed (HIV RNA < 50 copies/mL) at switch; (2) matched analysis (2:1, matched by age, sex, number of previous VFs, and line of regimen), and (3) using VF as the primary endpoint in all patients. Results Overall, 5047 3DR and 617 2DR patients were analyzed. Baseline characteristics differed between groups; 2DR patients were older, more treatment experienced, and more likely to be virologically suppressed at switch. Time to discontinuation due to TF was significantly shorter for 2DR (P = 0.002). The hazard ratio (HR) for discontinuation due to TF on 2DR vs 3DR was 2.33 (P = 0.003). No difference was observed for time to discontinuation (P = 0.908) or risk of discontinuation due to AEs (HR = 0.80; P = 0.488). Results were qualitatively similar in virologically suppressed patients, matched analysis, and for VF. Conclusion In the real world, the risks of discontinuation due to TF and VF were more than two times higher in patients switching to DTG-based 2DR than INSTI-based 3DR, with no difference in discontinuation due to AEs. Plain Language Summary People living with HIV (PLHIV) need lifelong treatment to prevent progression to AIDS. Standard HIV treatments use three different drugs in combination, but these can potentially cause unwanted side effects. Treatments using just two drugs have been developed. These aim to reduce side effects and treat HIV effectively. This study included 5664 participants in Spain who were split into two groups: 5047 participants switched from their old treatment to a three-drug regimen (3DR), and 617 participants switched to a two-drug regimen (2DR). The researchers measured how long it took for the participants to stop taking their treatment because it was not working, or it caused too many side effects. At the end of the study, more than 70% of participants in either group were still taking the same treatment. Of the 30% of participants who stopped treatment because it stopped working, those taking a 2DR stopped sooner than those taking a 3DR. This difference started to appear at about 18 months and got bigger until the study ended, which was 3 years after starting treatment. Participants taking a 2DR were twice as likely to stop treatment because it was not working than those taking a 3DR. There was no difference between the groups for how long it took for participants to stop their treatment because of side effects. These results show that for some PLHIV, the 2DR stopped working sooner than 3DR, without the benefit of fewer side effects.

Current antifungal chemotherapy against the prevalent basidiomycete Cryptococcus neoformans displays some drawbacks. This pathogenic fungus is refractory to echinocandins, whereas conventional treatment with amphotericin B plus 5-fluorocytosine has a limited efficacy. In this study, we explored the potential cryptococcal activity of some natural agents. After conducting a screening test with a set of propolis from different geographical areas, we selected an extract from China, which displayed a certain cytotoxic activity against C. neoformans, due to this extract being cheap and easily available in large amounts. The combination of this kind of propolis with carnosic acid in a 1:4 ratio induced a stronger fungicidal effect, which occurred following a synergistic pattern, without visible alterations in external cell morphology. Furthermore, several carnosic acid–propolis formulations applied onto preformed biofilms decreased the metabolic activity of the sessile cells forming biofilms. These data support the potential application of mixtures containing these two natural extracts in the design of new antifungal strategies in order to combat opportunistic infections caused by prevalent pathogenic fungi.

Current antifungal chemotherapy against the prevalent basidiomycete Cryptococcus neoformans displays some drawbacks. This pathogenic fungus is refractory to echinocandins, whereas conventional treatment with amphotericin B plus 5-fluorocytosine has a limited efficacy. In this study, we explored the potential cryptococcal activity of some natural agents. After conducting a screening test with a set of propolis from different geographical areas, we selected an extract from China, which displayed a certain cytotoxic activity against C. neoformans, due to this extract being cheap and easily available in large amounts. The combination of this kind of propolis with carnosic acid in a 1:4 ratio induced a stronger fungicidal effect, which occurred following a synergistic pattern, without visible alterations in external cell morphology. Furthermore, several carnosic acid–propolis formulations applied onto preformed biofilms decreased the metabolic activity of the sessile cells forming biofilms. These data support the potential application of mixtures containing these two natural extracts in the design of new antifungal strategies in order to combat opportunistic infections caused by prevalent pathogenic fungi.

Background: Leptospirosis is a worldwide zoonotic infection, and its management needs to be refined. This study aims to discern which antibiotic would be the best option to treat leptospirosis disease and analyze the efficacy of chemoprophylaxis regimens to prevent this illness. Methods: systematic review and meta-analysis on the efficacy of antibiotic treatment and chemoprophylaxis of leptospirosis in humans. Results: Ten clinical trials compared an antibiotic treatment with placebo or other antibiotic treatments in leptospirosis (the most recent one was published in 2007). The meta-analysis shows no effect of penicillin treatment on mortality compared to placebo (OR 1.65; 95% CI 0.76–3.57; p = 0.21). There are no differences between penicillin and cephalosporins or doxycycline. Penicillin does not reduce the time of defervescence (MD-0.16; 95% CI (−1.4) –1.08; p = 0.80) nor hospital stay (MD 0.15; 95% CI (−0.75)–1.06; p = 0.74). Besides, the data did not demonstrate any effectiveness of the use of penicillin in terms of the incidence of oliguria/anuria, the need for dialysis treatment, time to creatinine normalization, incidence of jaundice, or the liver function normalization time. Eight trials have assessed prophylactic treatment against leptospirosis with different strategies. A weekly dose of 200 mg of doxycycline does not show benefit versus placebo regarding the number of new cases of symptomatic leptospirosis (OR 0.20; 95% CI 0.02–1.87; p = 0.16). A single dose of doxycycline at exposure to flood water could have a beneficial effect (OR 0.23; 95% CI 0.07–0.77; p = 0.02). None of the other chemoprophylaxis regimens tested have shown a statistically significant effect on the number of new symptomatic cases. Conclusion: There is no evidence that antibiotics are a better treatment than placebo regarding mortality, shortening of fever, liver and kidney function, or reduction in the hospital stay. On the other hand, neither doxycycline nor penicillin, nor azithromycin have shown statistically significant differences in preventing symptomatic infection. Well-designed clinical trials, including other antibiotics such as quinolones or aminoglycosides, are urgently needed to improve our understanding of the treatment for this infection, which continues to be a neglected disease.

We present the case of an HIV-positive patient admitted because of costal pain secondary to neoplasia. During investigations, a colonoscopy showed non-specific ulcerations. Histological examination resulted in a diagnosis of intestinal spirochetosis. This infection can be asymptomatic or cause non-specific symptoms such as diarrhoea or abdominal pain. Intestinal spirochetosis should be included in the differential diagnosis of colon lesions in patients with HIV infection. LEARNING POINTS: Intestinal spirochetosis is associated with chronic diarrhoea and often with normal colonoscopy. This infection should be included in the differential diagnosis of HIV patients with digestive symptomatology in the absence of other more frequent causes.

Objetivo: Caracterizar los sistemas de información en salud disponibles y reconocidos en Colombia. Métodos: Análisis documental con revisión de literatura en red y diseño de un instrumento para recolectar, clasificar y analizar la información sobre las bases de datos encontradas en Colombia y algunas relevantes en el mundo. Resultados: Existe diversidad de información en la web que no siempre es reconocida y utilizada, con ventajas y desventajas. Respecto a temáticas, 34.4 % de la información en las bases de datos está relacionada con morbilidad, 28 % con mortalidad y 28 % con registros y atención en salud. Conclusión: Las diferentes bases de datos de información en salud existentes en Colombia tienen funciones específicas que aportan a los actores interesados y facilitan su búsqueda, a pesar de las limitaciones en términos de interoperabilidad y totalidad de la información.

Resumen Objetivo Determinar la proporcion de personas con infeccion por VIH o sida que se encontraban en seguimiento en la cohorte VACH en 2012 y que resultaron perdidas del mismo en 2013 y 2014, asi como establecer las caracteristicas sociodemograficas relacionadas con dicha perdida. Metodos Consideramos perdidos del seguimiento a los sujetos con menos de un registro de consulta por ano analizado. Construimos modelos de regresion logistica para la estimacion de las razones de ventajas (odds ratio [OR]) y sus intervalos de confianza del 95% (IC del 95%) de las variables relacionadas con la perdida de seguimiento. Resultados El porcentaje global de perdidas en seguimiento fue del 15,5% (IC del 95%: 14,9-16,1). Las variables asociadas con la perdida de seguimiento fueron no recibir tratamiento antirretroviral (TAR) (OR: 1,948; IC del 95: 1,651-2,298), ser inmigrante (OR: 1,746; IC del 95: 1,494-2,040), el consumo de farmacos por via intravenosa como mecanismo de transmision del VIH (OR: 1,498; IC del 95: 1,312-1,711), encontrarse en situacion de desempleo (OR: 1,331; IC del 95: 1,179-1,503), no tener pareja (OR: 1,948, IC del 95: 1,651-1,298), pertenecer a un estrato socioeconomico bajo (OR: 1,279; IC del 95: 1,143-1,431) y ser atendido en un hospital con menos de 1.000 pacientes en seguimiento (OR: 1,257; IC del 95%: 1,121-1,457), ademas de menor edad y menos tiempo de seguimiento en la cohorte. Conclusiones El 15,5% de los pacientes fueron perdidos del seguimiento en un periodo de 2 anos en la cohorte VACH. Ello se asocio a una serie de variables sociodemograficas y epidemiologicas, cuya identificacion puede ser util para disenar iniciativas focalizadas sobre las poblaciones mas susceptibles de abandonar los circuitos asistenciales y a orientar estrategias disenadas a la consecucion del objetivo 90-90-90.

While polymer cement concrete is a very versatile material with respect to its functions and economy, it has several disadvantages: high porosity, low flexural modulus and poor resistance to corrosive chemical reagents. Potential improvements include addition of recycled fibers. However, information on effects of fibers is insufficient, and less is known on effects of gamma irradiation on such concretes. In this work, concretes with polyester resin and silica sand were elaborated. Silica sand was partially replaced by recycled tire fibers (0.3, 0.6, 0.9 and 1.2 vol%) and gamma irradiation (50 and 100 kGy) was applied. Mechanical properties were determined in compression and flexion. Significant improvements on the mechanical properties were obtained and related to morphological and structural changes of the recycled tire fibers.

En este trabajo se propone un método para calcular la concentración molar en base al número de nanopartículas poliméricas (Mnps) contenidas en una suspensión coloidal para ser utilizada en estudios de MTT, permitiendo comparar el impacto del número, tamaño y morfología de las nanopartículas en la determinación de la citotoxicidad. Para ello, dos derivados de PBLG, PBLG35-bz y PBLG35-PEG5, fueron sintetizados mediante polimerización por apertura aniónica del anillo γ-bencilo-L-glutamato N-carboxianhídrido. Posteriormente, se prepararon nanopartículas por nanoprecipitación. El sistema PBLG35-bz presenta morfología esférica y el sistema PBLG35-PEG5 morfología de elipsoide prolato. Para cada sistema de nanopartículas, se midió el eje largo y eje corto y se calculó la relación de aspecto y el diámetro equivalente. La Mnps se determinó tomando en cuenta el número de nanopartículas presentes en un determinado volumen de suspensión coloidal expresado en litros, y el número de Avogadro. Los resultados de MTT permiten concluir que, debido a las diferencias en las características morfológicas de los sistemas estudiados, el mejor enfoque para la evaluación de la citotoxicidad en nanopartículas de PBLG es la utilización de la molaridad en base al número de nanopartículas, en lugar de concentración en base a masa de polímero (μg/mL).

Teràpia antiretroviral; Diagnòstic i gestió del VIH; Teràpia amb inhibidors de la proteasa Terapia antirretroviral; Diagnóstico y gestión del VIH; Terapia con inhibidores de la proteasa Antiretroviral therapy; HIV diagnosis and management; Protease inhibitor therapy Background Since 1996, the standard of care (SOC) therapy for HIV treatment has consisted of a backbone of two nucleoside analogue reverse transcriptase inhibitors (NRTI) paired with a third agent. Use of two-drug combinations (2DC) has been considered for selected patients to avoid toxicities associated with the use of NRTIs. This study aimed to compare the real-world outcomes of integrase strand transfer inhibitor (INSTI)-containing triple therapy (TT) to dolutegravir- (DTG) and/or boosted protease inhibitor (bPI)-based 2DC in a large Spanish cohort of HIV patients. Methods A retrospective analysis was performed using data from the VACH cohort, a prospective multicentre Spanish cohort of adult HIV patients. All treatment experienced patients initiating a TT of an INSTI combined with two NRTIs or a 2DC-containing DTG and/or a bPI between 01/01/2012 and 01/06/2017 were included. The unit of analysis was patient-regimens. The overall sample analysis was complemented with two sub-analyses. The first sub-analysis focused on patients treated with a backbone plus DTG compared to those treated with DTG+ one other antiretroviral. The second sub-analysis focused on patients with HIV RNA

The reconstruction of the proximal humerus is possible from the resection of the tumor and the placement of a prosthesis. In some cases, they do not meet the anthropometric aspects of the patients.To determine the parameters to size the components of a humeral prosthesis and the development of a set, using design software.Forty patients were selected for prostheses, radiographs and CT scans were analyzed and statistical tests were applied to the measurements.The length of the tumors was 8-20 cm. The minimum length of the humerus was 28 cm and 33 cm the maximum. Correlation was observed between the humerus and the tumor and the height of the patient with p = 0.93088 and p = 0.904564, respectively; humerus diameter, p = 0.2345. The set will include three components, diameter 6-10 mm, and length of 24, 26 and 28 cm. Three modular spacers with lengths of 6, 8.5 and 13 cm. Crowns 6.5 and 8.5 cm long, 1.3 cm in diameter and 5 mm nut.With the development of the set, poorly calculated resections and adaptation to any humerus size can be resolved.La reconstrucción del húmero proximal es posible a partir de la resección del tumor y la colocación de una prótesis. En algunos casos, las prótesis no cumplen con los aspectos antropométricos de los pacientes.Determinar los parámetros para dimensionar los componentes de una prótesis de húmero y el desarrollo de un set, mediante software de diseño.Se seleccionaron 40 pacientes para prótesis, se analizaron radiografías y tomografías computarizadas, y se aplicaron pruebas estadísticas a las mediciones.La longitud de los tumores fue de 8-20 cm. La longitud mínima del húmero fue de 28 cm y la máxima fue de 33 cm. Se observó correlación entre el húmero y el tumor y la altura del paciente, con p = 0.93088 y p = 0.904564, respectivamente; para el diámetro del húmero, p = 0.2345. El set incluye tres componentes, con diámetro de 6-10 mm y longitud de 24, 26 y 28 cm; tres espaciadores modulares con longitudes de 6, 8,5 y 13 cm; coronas de 6,5 y 8,5 cm de largo, 1,3 cm de diámetro y tuerca de 5 mm.Con el desarrollo del set se pueden resolver resecciones mal calculadas y la adaptación a cualquier tamaño de húmero.

Background Etiopathogenesis of the clinical variability of the coronavirus disease 2019 (COVID-19) remains mostly unknown. In this study, we investigate the role of killer cell immunoglobulin-like receptor (KIR)/human leukocyte antigen class-I (HLA-I) interactions in the susceptibility and severity of COVID-19. Methods We performed KIR and HLA-I genotyping and natural killer cell (NKc) receptors immunophenotyping in 201 symptomatic patients and 210 noninfected controls. Results The NKcs with a distinctive immunophenotype, suggestive of recent activation (KIR2DS4low CD16low CD226low CD56high TIGIThigh NKG2Ahigh), expanded in patients with severe COVID-19. This was associated with a higher frequency of the functional A-telomeric activating KIR2DS4 in severe versus mild and/or moderate patients and controls (83.7%, 55.7% and 36.2%, P Conclusions Our results support a crucial role of NKcs in the clinical variability of COVID-19 with specific KIR/ligand interactions associated with disease severity.

COVID-19 has a wide range of symptoms reported, which may vary from very mild cases (even asymptomatic) to deadly infections. Identifying high mortality risk individuals infected with the SARS-CoV-2 virus through a prediction instrument that uses simple clinical and analytical parameters at admission can help clinicians to focus on treatment efforts in this group of patients. Data was obtained retrospectively from the electronic medical record of all COVID-19 patients hospitalized in the Albacete University Hospital Complex until July 2020. Patients were split into two: a generating and a validating cohort. Clinical, demographical and laboratory variables were included. A multivariate logistic regression model was used to select variables associated with in-hospital mortality in the generating cohort. A numerical and subsequently a categorical score according to mortality were constructed (A: mortality from 0% to 5%; B: from 5% to 15%; C: from 15% to 30%; D: from 30% to 50%; E: greater than 50%). These scores were validated with the validation cohort. Variables independently related to mortality during hospitalization were age, diabetes mellitus, confusion, SaFiO2, heart rate and lactate dehydrogenase (LDH) at admission. The numerical score defined ranges from 0 to 13 points. Scores included are: age ≥71 years (3 points), diabetes mellitus (1 point), confusion (2 points), onco-hematologic disease (1 point), SaFiO2 ≤ 419 (3 points), heart rate ≥ 100 bpm (1 point) and LDH ≥ 390 IU/L (2 points). The area under the curve (AUC) for the numerical and categorical scores from the generating cohort were 0.8625 and 0.848, respectively. In the validating cohort, AUCs were 0.8505 for the numerical score and 0.8313 for the categorical score. Data analysis found a correlation between clinical admission parameters and in-hospital mortality for COVID-19 patients. This correlation is used to develop a model to assist physicians in the emergency department in the COVID-19 treatment decision-making process.

Desde los inicios del cine, el contenido musical ha desempeñado un papel fundamental. La música y las canciones son una parte esencial de los productos cinematográficos, especialmente en determinados géneros. El presente artículo realiza un análisis contrastivo de un corpus de doce películas del género de animación infantil y no infantil, musical, comedia romántica y suspense en torno a la modalidad y las estrategias de traducción empleadas según los elementos que priman en cada canción, tales como la rima, la fidelidad o el significado. Los resultados muestran una tendencia al doblaje de canciones en películas destinadas a público infantil, subtitulado de canciones en películas destinadas a público no infantil y no traducción de canciones de la banda sonora no originales. Musical content has played a key role since the beginning of cinema. Music and songs are an essential part of cinematographic products, particularly in certain genres. The present article carries out a comparative analysis based on a corpus composed of twelve films of the children and adult animation, musical, romantic comedy, and thriller cinematographic genres. Such analysis attends to translation modalities and strategies used to prioritize elements such as rime, fidelity or meaning in each song. Results show a trend to dub songs in children movies, to subtitle songs in all audience films, and not to translate not original songs from soundtrack.

Microbial polyesters, such as poly(hydroxyalkanoates) and poly(hydroxy acids), represent a potential sustainable replacement for fossil fuel-based plastics/polymers. They are gaining increasing attention in the biodegradable polymers market either for applications in the biomedical field or as bioplastics for packaging or agricultural applications, for example. In this chapter, we will first describe the structures of microbial (co)polyesters and their classification. Then, the different synthesis routes of microbial polyesters and their copolymers, their main characteristics (processability, biodegradability and biocompatibility) and their main applications will be presented. Finally, the future prospects of such microbial polyesters will be exposed.

Musical content has played a key role since the beginning of cinema. Music and songs are an essential part of cinematographic products, particularly in certain genres. The present article carries out a comparative analysis based on a corpus composed of twelve films of the children and adult animation, musical, romantic comedy, and thriller cinematographic genres. Such analysis attends to translation modalities and strategies used to prioritize elements such as rime, fidelity or meaning in each song. Results show a trend to dub songs in children movies, to subtitle songs in all audience films, and not to translate not original songs from soundtrack. Desde los inicios del cine, el contenido musical ha desempeñado un papel fundamental. La música y las canciones son una parte esencial de los productos cinematográficos, especialmente en determinados géneros. El presente artículo realiza un análisis contrastivo de un corpus de doce películas del género de animación infantil y no infantil, musical, comedia romántica y suspense en torno a la modalidad y las estrategias de traducción empleadas según los elementos que priman en cada canción, tales como la rima, la fidelidad o el significado. Los resultados muestran una tendencia al doblaje de canciones en películas destinadas a público infantil, subtitulado de canciones en películas destinadas a público no infantil y no traducción de canciones de la banda sonora no originales.