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Augmented renal clearance (ARC) is a phenomenon that can lead to a therapeutic failure of those drugs of renal clearance. The purpose of the study was to ascertain the prevalence of ARC in the critically ill patient, to study the glomerular filtration rate (GFR) throughout the follow-up and analyze the concordance between the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) estimation formula and measured GFR. Observational, prospective, multicenter study. ARC was defined as a creatinine clearance greater than 130 ml/min/1.73 m(2). Eighteen hospitals were recruited. GFR measurements carried out twice weekly during a 2-month follow-up period. A total of 561 patients were included. ARC was found to have a non-negligible prevalence of 30%. More even, up to 10.7% already had ARC at intensive care unit (ICU) admission. No specific pattern of GFR was found during the follow-up. Patients in the ARC group were younger 56.5 (53.5-58.5) versus 66 (63.5-68.5) years than in the non-ARC group, p < 0.001. ICU mortality was lower in the ARC group, 6.9% versus 14.5%, p = 0.003. There was no concordance between the estimation of GFR by the CKD-EPI formula and GFR calculated from the 4-h urine. ARC is found in up to 30% of ICU patients, so renal removal drugs could be under dosed by up to 30%. And ARC is already detected on admission in 10%. It is a dynamic phenomenon without an established pattern that usually occurs in younger patients that can last for several weeks. And the CKD-EPI formula does not work to estimate the real creatinine clearance of these patients.

Objective. Digestive involvement (DI) has been reported in 10-30% of primary Sjögren's syndrome (pSS) patients, and few studies have systematically analysed the prevalence of DI in pSS patients. The aim of this study was to describe DI prevalence in pSS patients from the Sjögrenser Study, and to analyse its clinical associations. Methods. All patients included in the Sjögrenser study, a Spanish multicentre randomised cohort, containing demographic, clinical and histologic data, have been analysed retrospectively. Patients were classified according to the presence of DI (oesophageal, gastric, intestinal, hepatic and pancreatic), and we have performed DI clinical associations, descriptive statistics, Student t or ?2 test, and uni and multivariate logistic regression. Results. From 437 included patients, 95% were women, with a median age of 58 years, 71 (16.2%) presented DI: 21 (29.5%) chronic atrophic gastritis, 12 (16.9%) oesophageal motility dysfunction, 3 (4.2%) lymphocytic colitis, 18 (25.3%) primary biliary cholangitis, 15 (21.1%) autoimmune hepatitis, 7 (9.8%) pancreatic involvement and 5 (7%) coeliac disease. Half of them developed DI at the same time or after pSS diagnosis. Patients with DI were significantly older at pSS diagnosis (p=0.032), more frequently women (p=0.009), presented more autoimmune hypothyroidism and C3 hypocomplementaemia (p=0.040), and were treated more frequently with glucocorticoids, immunosuppressant and biologic therapies. Patients with pancreatic involvement presented more central nervous system and renal involvement, Raynaud's phenomenon, lymphoma and C3/C4 hypocomplementaemia. Conclusion. DI is frequent in Sjögrenser patients, mainly in the form of autoimmune disorders, and seem to be associated with a more severe phenotype. Our results suggest that DI should be evaluated in pSS patients, especially those with more severe disease. © 2020 Clinical and Experimental Rheumatology.

We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) allele groups and alleles by PCR-SSP based typing in a total of 15,318 mixed ancestry Mexicans from all the states of the country divided into 78 sample sets, providing information regarding allelic and haplotypic frequencies and their linkage disequilibrium, as well as admixture estimates and genetic substructure. We identified the presence of 4268 unique HLA extended haplotypes across Mexico and find that the ten most frequent (HF > 1%) HLA haplotypes with significant linkage disequilibrium (Δ’≥0.1) in Mexico (accounting for 20% of the haplotypic diversity of the country) are of primarily Native American ancestry (A*02~B*39~DRB1*04~DQB1*03:02, A*02~B*35~DRB1*08~DQB1*04, A*68~B*39~DRB1*04~DQB1*03:02, A*02~B*35~DRB1*04~DQB1*03:02, A*24~B*39~DRB1*14~DQB1*03:01, A*24~B*35~DRB1*04~DQB1*03:02, A*24~B*39~DRB1*04~DQB1*03:02, A*02~B*40:02~DRB1*04~DQB1*03:02, A*68~B*35~DRB1*04~DQB1*03:02, A*02~B*15:01~DRB1*04~DQB1*03:02). Admixture estimates obtained by a maximum likelihood method using HLA-A/-B/-DRB1 as genetic estimators revealed that the main genetic components in Mexico as a whole are Native American (ranging from 37.8% in the northern part of the country to 81.5% in the southeastern region) and European (ranging from 11.5% in the southeast to 62.6% in northern Mexico). African admixture ranged from 0.0 to 12.7% not following any specific pattern. We were able to detect three major immunogenetic clusters correlating with genetic diversity and differential admixture within Mexico: North, Central and Southeast, which is in accordance with previous reports using genome-wide data. Our findings provide insights into the population immunogenetic substructure of the whole country and add to the knowledge of mixed ancestry Latin American population genetics, important for disease association studies, detection of demographic signatures on population variation and improved allocation of public health resources. Fil: Barquera, Rodrigo. Max Planck Institute For The Science Of Human History; Alemania. Instituto Nacional de Antropología E Historia. Escuela Nacional de Antropología E Historia; México Fil: Hernández Zaragoza, Diana Iraíz. Técnicas Genéticas Aplicadas A la Clínica (tgac); México. Instituto Nacional de Antropología E Historia. Escuela Nacional de Antropología E Historia; México Fil: Bravo Acevedo, Alicia. Instituto Mexicano del Seguro Social; México Fil: Arrieta Bolaños, Esteban. Universitat Essen; Alemania Fil: Clayton, Stephen. Max Planck Institute For The Science Of Human History; Alemania Fil: Acuña Alonzo, Víctor. Instituto Nacional de Antropología E Historia, Mexico; México Fil: Martínez Álvarez, Julio César. Instituto Mexicano del Seguro Social; México Fil: López Gil, Concepción. Instituto Mexicano del Seguro Social; México Fil: Adalid Sáinz, Carmen. Instituto Mexicano del Seguro Social; México Fil: Vega Martínez, María del Rosario. Hospital Central Sur de Alta Especialidad; México Fil: Escobedo Ruíz, Araceli. Instituto Mexicano del Seguro Social; México Fil: Juárez Cortés, Eva Dolores. Instituto Mexicano del Seguro Social; México Fil: Immel, Alexander. Max Planck Institute For The Science Of Human History; Alemania. Christian Albrechts Universitat Zu Kiel; Alemania Fil: Pacheco Ubaldo, Hanna. Instituto Nacional de Antropología E Historia. Escuela Nacional de Antropología E Historia; México Fil: González Medina, Liliana. Instituto Nacional de Antropología E Historia. Escuela Nacional de Antropología E Historia; México Fil: Lona Sánchez, Abraham. Instituto Nacional de Antropología E Historia. Escuela Nacional de Antropología E Historia; México Fil: Lara Riegos, Julio. Universidad Autónoma de Yucatán; México Fil: Sánchez Fernández, María Guadalupe de Jesús. Instituto Mexicano del Seguro Social; México Fil: Díaz López, Rosario. Hospital Central Militar, Mexico City; México Fil: Guizar López, Gregorio Ulises. Hospital Central Militar, Mexico City; México Fil: Medina Escobedo, Carolina Elizabeth. Instituto Mexicano del Seguro Social; México Fil: Arrazola García, María Araceli. Instituto Mexicano del Seguro Social; México Fil: Montiel Hernández, Gustavo Daniel. Instituto Nacional de Antropología E Historia. Escuela Nacional de Antropología E Historia; México Fil: Hernández Hernández, Ofelia. Técnicas Genéticas Aplicadas a la Clínica ; México Fil: Ramos de la Cruz, Flor del Rocío. Instituto Mexicano del Seguro Social; México Fil: Juárez Nicolás, Francisco. Instituto Nacional de Pediatría; México Fil: Pantoja Torres, Jorge Arturo. Instituto Mexicano del Seguro Social; México Fil: Rodríguez Munguía, Tirzo Jesús. Hospital General Norberto Treviño Zapata; México Fil: Juárez Barreto, Vicencio. Hospital Infantil de Mexico Federico Gomez; México Fil: Gonzalez-Jose, Rolando. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Centro Nacional Patagónico. Instituto Patagónico de Ciencias Sociales y Humanas; Argentina

Extended half-life of factor IX (FIX) demonstrated clinical benefit and lower treatment burden than standard half-life FIX products in clinical trials. We analysed the impact in efficacy, pharmacokinetics (PKs) and costs of the switch from nonacog alfa (rFIX) to albutrepenonacog alfa (rFIX-FP) in the first patient with haemophilia B (HB) treated in Spain outside clinical trials. A 7-year-old boy presented with HB with poor venous access and repetition infections using rFIX, which was switched to rFIX-FP. Prophylaxis was adjusted by PKs using WAPPS-Hemo tailoring from 100 IU/kg/week of rFIX to 80 IU/kg/3 weeks of rFIX-FP. Comparing 6 months before, rFIX-FP reduced 68.5% FIX consumption/kg and 58.3% infusion frequency, but total costs/weight showed a slight increase. Ratio of half-life between rFIX and rFIX-FP was 3.4-3.7. This case report revealed that switch to rFIX-FP decreased frequency and FIX consumption, without adverse events and bleeds.

CO-170 Introducción y objetivos: Los factores VIII (FVIII) de semivida extendida (EHL) han mostrado en los ensayos clínicos mejoras de al menos 1, 3 veces la semivida plasmática (t1/2) y 1, 25 veces el área bajo la curva (AUC) respecto a los FVIII estándar (SHL). Herramientas basadas en modelos farmacocinéticos (PK) poblacionales permiten estimar los parámetros PK individuales y ajustar la profilaxis. El objetivo de este estudio es analizar el switch PK-guiado de SHL a EHL en pacientes con hemofilia A (HA). Métodos: Estudio multicéntrico comparativo, cruzado, prospectivo que analiza las diferencias PK tras el cambio de factores SHL a EHL (Elocta® y Adynovi®) en pacientes con HA grave/moderada en profilaxis. Se ha empleado el PopPK WAPPS-Hemo® con 2-3 muestras para realizar un perfil PK individualizado de los valores de FVIII. Los parámetros PK analizados son: t1/2, AUC, nivel pico (NP), nivel valle a las 24, 48 y/o 72 h (NV24/NV48/NV72) y tiempo para alcanzar niveles de FVIII del 5%, 2% y 1% (T5%/T2%/T1%). También analizamos los ratios de t1/2 y AUC, el nº dosis semanales y la dosis/kg/semana. Para comparar los parámetros PK entre ambos periodos empleamos los test de Wilcoxon y Kruskal-Wallis (SPSS®). Los resultados se expresaron con la mediana y el rango o rango intercuartílico (RIC). Resultados: Se han analizado 64 pacientes procedentes de 8 hospitales españoles (48 switch a Elocta® y 16 a Adynovi®), 62 con HA grave y 2 con HA moderada, con una mediana de edad de 32 años (rango=5-64) y sin diferencias en el peso entre ambos periodo [71, 0 (rango=12-116) vs 72, 0 (16, 9- 116) kg; p=0, 156]. La dosis/kg/semana se redujo tras el switch a EHL [74, 5 (RIC:59, 2-108, 1) vs 69, 2 (RIC:46, 2-96, 7) UI/kg/semana; p

RESUMEN Los escarabajos de la subfamilia Scarabaeinae son considerados importantes para estudios de diversidad biológica y conservación de ecosistemas. Realizan una variedad de funciones y son sensibles a las perturbaciones ambientales. Chiapas es una de las regiones con mayor número de registros de Scarabaeinae en México, pero aún existen extensas zonas con poco conocimiento sobre este grupo de insectos, incluyendo algunas áreas naturales protegidas, como es el caso de la Reserva de la Biosfera Selva El Ocote. Se analizaron los ensambles de escarabajos copronecrófagos, producto de cinco muestreos sistemáticos realizados durante 2011 y 2012, en tres hábitats representativos de la reserva. Las recolecciones se realizaron mediante trampas de caída utilizando calamar, estiércol de cerdo y estiércol vacuno como atrayentes. Se recolectaron 5421 escarabajos de seis tribus, 12 géneros y 37 especies. La cobertura del muestreo fue cercana al 100 % y las evaluaciones indican que la Selva tuvo la riqueza más cercana a la estimada mientras que el cultivo de café es el hábitat con mayor posibilidad de adicionar especies al inventario. Los valores de diversidad beta sugieren que las faunas de los tres hábitats forman parte de una sola comunidad de escarabajos, pero la composición de los gremios tróficos es diferente en todos ellos. La fauna obtenida constituye el 31,1 % de las especies registradas en Chiapas. Este trabajo representa el primer estudio mediante muestreos sistemáticos en la Reserva de la Biosfera Selva El Ocote. ABSTRACT Beetles of the subfamily Scarabaeinae are considered important for studies of biological diversity and conservation of ecosystems. They perform a variety of functions and are sensitive to environmental disturbances. Chiapas is one of the regions with the largest number of Scarabaeinae records in Mexico, but there are still extensive areas with little knowledge about this group of insects, including some protected natural areas, such as the Selva El Ocote Biosphere Reserve. Copronecrophagous beetle assemblages, product of five systematic sampling during 2011 and 2012 in three representative habitats of the reserve, were analyzed. The collections were made using pitfall traps using squid, pig dung and cow dung as attractants. 5421 beetles were collected from six tribes, 12 genera and 37 species. The sampling coverage was close to 100 % and the evaluations indicate that the Selva had the closest to the estimated richness while the coffee plantation is the habitat with greater possibility of adding species to the inventory. The values of beta diversity suggest that the faunas of the three habitats are part of a single community of beetles, but the composition of the trophic guilds is different in all of them. The fauna obtained constitutes 31.1 % of the species recorded in Chiapas. This work represents the first study by systematic sampling in the Selva El Ocote Biosphere Reserve.