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En este reporte se analizan los factores de impacto en el sistema de gestión de la calidad y los del modelo de acreditación de la formación de profesionistas de la educación en la Universidad Autónoma de Tlaxcala, que dan garantía en su formación a través del Modelo Humanista Integrador basado en Competencias, mismo que da dirección al desarrollo curricular de los títulos profesionales. Bajo una metodología cualitativa se analizan los procedimientos de gestión y su congruencia con el desarrollo de los programas educativos ofrecidos en la Facultad de Ciencias de la Educación de las licenciaturas en: Ciencias de la Educación y Comunicación e Innovación Educativa, mediante los procesos de Certificación ISO 9001-2015 y el modelo de acreditación de los títulos profesionales mediante el organismo acreditador ACCECISO. Entre los principales resultados se encuentra que los procesos acreditados vigentes ofrecen un sistema que se ha venido consolidando y de acuerdo con la visión del Plan de Desarrollo rectoral 2030, están en una ruta de Mejora Continua para dar Garantía de Calidad en la formación profesional, mismos que se han visto afectados en algunos indicadores por el proceso pandémico que se atraviesa.

Oxidative stress is produced by the imbalance between the substances or factors pro-oxidant and the antioxidant defense mechanisms, which in turn plays an important role in the development and progression of various pathologies. D-005, lipid extract from the fruits of Acrocomia crispa contains a reproducible mixture of fatty acids, such as: oleic, palmitic, lauric, myristic, palmitoleic, caprylic, capric, and stearic that have antioxidant properties. The objective of this work is to evaluate the effect of D-005 administered as single oral doses on the increase in indicators of oxidative stress induced by carbon tetrachloride (CCl4) in rats. The animals were randomly distributed into seven groups: a negative control without damage and six groups to which CCl4 was administered (intraperitoneal): a positive control treated with vehicle, four with D-005 (5-100 mg/kg), and one with grape seed extract (ESU) (250 mg/kg). The animals in the positive control group (with CCl4) reached significantly higher values of malondialdehyde-marker of lipid peroxidation-, sulfhydryl groups-marker of protein oxidation- and serum transaminases-marker of liver damage- with respect to the animals of the negative control group (without damage). D-005 and ESU markedly and significantly prevented this increase. In conclusion, D-005 administered as single oral doses of 5, 25, 50, and 100 mg/kg inhibits lipid peroxidation and protein oxidation, as well as CCl4-induced liver damage.

Current cancer therapies focus on targeting driver alterations responsible for tumorigenesis - either oncogenic point mutations or oncogenic driver events within large somatic copy number alterations (SCNAs). However, these alterations are often not actionable or are only present in a small subset of patients. Thus, new therapeutic targets are urgently needed. Apart from oncogenic drivers, SCNAs usually also comprise neutral bystander genes without an active role in neoplastic transformation. We hypothesized that passenger events, specifically in amplified regions, could be therapeutically exploited by providing actionable molecules on the cell surface. Using publicly available multi-omics data, we screened cell surface protein-coding genes for their genomic status and expression levels in liver cancer. This screen identified MPZL1 (Myelin protein zero-like 1), a gene amplified in 75% of hepatocellular carcinomas, accompanied by high mRNA expression in tumors compared to normal livers. MPZL1 is located on chromosome 1q, one of the most commonly amplified regions across several solid cancer types, and codes for a glycosylated cell surface receptor. We further validated MPZL1 protein expression in a wide range of human cancer entities (n=2038 samples) and normal tissues (n=163 samples) by immunohistochemistry and assigned expression scores analogous to the clinically implemented HER2-score. A high percentage of tumors showed scores 2 or 3 (e.g. 48% of HCCs or 89% of TNBCs), whereas healthy tissues were mostly negative or just faintly positive (scores 0 or 1). Moreover, in order to target MPZL1-expressing cells, we generated a highly specific monoclonal antibody directed to the extracellular domain of human MPZL1 protein and thoroughly characterized its binding capacity. Next, the scFv sequence of this antibody was used to generate a CAR (chimeric antigen receptor) construct targeting MPZL1. Luciferase-based cytotoxic assays showed that T cells transduced with this construct can kill various MPZL1-high human cancer cell lines in vitro (liver, breast and lung malignant cell lines, among others), whereas they fail to kill respective isogenic cell lines harboring knockout of MPZL1. Upon antigen-specific exposure, MPZL1-28ζ CAR-T cells underwent antigen-dependent proliferation and showed increased cytokine production (IFNγ, TNFα, IL-2, GZMB), further confirming their specificity. In summary, our findings reveal MPZL1 as a new target for treatment of 1q-amplified cancers and implement a novel immunotherapeutic strategy based on MPZL1-28ζ CAR-T cells. Furthermore, our work provides a proof of concept that passenger events within large chromosomal amplifications can serve as potent therapeutic targets and thus opens a new avenue for innovative approaches in anti-cancer drug development. Citation Format: Sonia Jiménez Vázquez, Christos Patsis, Luise Butthof, Joan Crous Masó, Hendrik Wiethoff, Matthias Gaida, Thomas Longerich, Rosella Pellegrino, Ilse Hofmann, Judith Feucht, Darjus Felix Tschaharganeh. Repurposing passenger amplifications for specific therapeutic targeting of solid cancers. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 5003.

Este artículo analiza el proceso de adquisición de saberes docentes en las trayectorias docentes de profesores médicos. Partimos de la premisa de que los saberes docentes son plurales y se movilizan en la práctica (TARDIF, 2004), son experienciales y se modifican al transcurrir los ciclos de vida del docente (HÜBERMAN, 1992), desde dos dimensiones de su trayectoria docente: espacio y tiempo (JIMÉNEZ-VÁSQUEZ, 2017). La trayectoria de los docentes médicos se construye a partir de dos campos de actuación profesional que desarrollan de manera simultánea: la medicina y la docencia. Para recuperar las voces de 14 docentes médicos, de la Universidad Autónoma de Tlaxcala, México y la Universidad Federal de Santa María, Brasil, se recurrió a la metodología cualitativa. El instrumento fue una guía de entrevista semi estructurada, los datos se interpretaron con el sustento de la Teoría Fundamentada y, al tratarse de testimonios de docentes, desde una escucha sensible (FREIRE, 2002). Entre los principales hallazgos encontramos que los profesores médicos desarrollan su práctica docente confluyendo, por una parte, los elementos dogmáticos de la medicina como carrera profesional y, por otra parte, la formación experiencial y/o formal que adquieren en el desarrollo de su vida docente. Identificamos que trayectorias de mayor temporalidad en la docencia no constituyeron un factor determinante en la construcción de los saberes necesarios a la docencia. Aunque, se observó que hay mayor preocupación y sensibilidad hacia la atención del aprendizaje de sus alumnos.

Background Acute kidney injury (AKI) induced by renal ischemia/reperfusion (IR) is associated with enhanced production of reactive oxygen species in renal tissues. D-005, a lipid extract obtained from Acrocomia crispa fruit, has previously shown antioxidant effects. The aim of this work was to evaluate the effects of D-005 on renal IR-induced AKI in rats. Methods Rats were randomized into seven groups including a negative control group (vehicle) without AKI and six groups with renal IR-induced AKI as follows: a positive control (vehicle); D-005 treatment at 25, 100, 200, or 400 mg/kg; and dexamethasone at 3 mg/kg. All treatments were orally administered as single doses 1 hour before AKI induction. Biomarkers (serum creatinine, urea, and uric acid concentrations), oxidative variables, and histopathological AKI changes were evaluated in blood and kidney tissues. Results All D-005 doses protected against IR-induced AKI in rats by significantly decreasing biomarkers and histopathological AKI changes as assessed by reduced serum concentrations of creatinine, urea, and uric acid. In addition, all D-005 doses decreased tubular damage, as shown by fewer detached cells and casts in the tubular lumen. D-005 reversed oxidation disturbance markers by decreasing malondialdehyde and sulfhydryl group concentrations in plasma and in kidney homogenates and by increasing kidney catalase activity. Dexamethasone, the reference substance, protected against IR-induced AKI in rats by reducing biochemical and histological variables of renal damage in a similar manner. Conclusion Administration of single oral doses of D-005 markedly and significantly protected against renal IR-induced AKI, possibly due to its known antioxidant effects.

El panorama general sobre el consumo de arte en nuestro país ha propiciado una profunda revisión crítica sobre el estatus del museo en la sociedad española. Dentro de la función educativa ampliamente extendida y asociada a estas instituciones, ha cobrado especial relevancia en los últimos tiempos el concepto de mediación. En el presente artículo, concretamos algunas de las ideas consensuadas sobre las estrategias de diálogo en los museos de arte a la par que exponemos la puesta en práctica de estas teorías en un ejemplo pionero en la ciudad de Valencia.

La evaluación del desempeño docente es una estrategia recomendada por organismos internacionales para alinear los sistemas educativos bajo principios de mercado. A partir de su instalación los países son conminados a re-configurar espacios en los cuales profesores, especialistas, organismos privados y públicos interactúan con disímiles grados de poder. Sin embargo, los estudios sobre sus resultados centran las responsabilidades a nivel individual obviando enfoques comparativos regionales. Este artículo argumenta cómo su implementación en Chile y México adquiere y requiere de particular atención. El objetivo ha sido describir su evolución, así como sus convergencias en distintos niveles de concreción. A partir de puntos críticos se discuten sus supuestos e intereses no evidentes. Los resultados refieren a consecuencias en términos de sus limitaciones para comprender las prácticas que se construyen en las escuelas. Las conclusiones abogan por el desarrollo de miradas territoriales comprehensivas para el diseño de estas políticas.

El convento de carmelitas descalzos de Uclés (Cuenca) ha pasado hasta ahora prácticamente inadvertido por la historiografía artística. El estado ruinoso que presenta desde el siglo XIX y la falta de documentación sobre el mismo ha impedido un análisis en profundidad sobre este interesante ejemplo conventual, cuyas obras se llevaron a cabo durante la llamada etapa de homogenización de los modos arquitectónicos carmelitanos. El presente artículo expone el proceso de fundación y patrocinio del convento por parte de la familia de los Velázquez desde Uclés y desde Nueva España. Además, aporta documentación inédita que constata la participación como trazadores del mismo de los monjes carmelitas fray Francisco de Jesús María y de fray Alberto de la Madre de Dios, siendo ésta hasta la fecha, la primera obra documentada de fray Alberto como tracista.

Several societies have published recommendations for evaluating older adults with cancer in standard conditions. It is vital to assure a proper systematic patient condition evaluation, not only in the oldest (geriatric assessment) but in all adult patients. We have investigated the feasibility of a systematic evaluation of the general condition of all patients diagnosed with hematologic malignancies, and the degree of acceptance by the clinical team, in a prospective cohort of 182 consecutive adults, by using the ECOG performance status scale (ECOG, age 18 and over, 18+), Lee Index for Older Adults (LEE, 50+), Geriatric Assessment in Hematology (GAH, 65+), and the Comprehensive Geriatric Assessment (CGA, 75+). Clinical team acceptance was analyzed with a visual analogue scale, and the objective feasibility was calculated as the proportion of patients that could be finally evaluated with each tool. Acceptance was high, but the objective feasibility was progressively lower as the complexity of the different tools increased (ECOG 100%, LEE 99.4%, GAH 93.2%, and CGA 67.9%). LEE and GAH categories showed a weak concordance (Cohen&rsquo, s Kappa 0.24) that was slight between LEE and CGA (Kappa 0.18). Unexpectedly, we found no significant association between the GAH and CGA categories (p = 0.16). We confirm that a systematic evaluation of all adult patients diagnosed with hematologic malignancies is feasible in daily practice by using an age-adapted approach. Direct comparisons among the different predictive tools in regard to patients&rsquo, tolerance to treatments of different intensities must be a priority research subject in the coming years.

To determine the impact of chronic obstructive pulmonary disease (COPD) on prognosis in patients diagnosed with venous thromboembolic disease (VTED) in Spanish emergency departments.Secondary analysis of data from the ESPHERIA (Spanish acronym for Risk Profile of Patients VTED Attended in Spanish Emergency Departments) registry.A total of 801 patients, 71 (9%) with COPD, were included. Pulmonary thromboembolism was recorded in 77.%% of the patients with COPD (vs in 47.1% of patients without COPD; P.001). Patients with COPD had evidence of right ventricular dysfunction on computed tomography angiography more often than other VTED patients (18.2% vs 13.1%; P.001) and more often required ventilatory support (7% vs 0.5%; P.001). VTED patients with COPD also had a higher rate of readmission or mortality at 180 days (hazard ratio, 1.52; 95% CI, 1.00-2.29; P = .048)] than patients without COPD.COPD affects the prognosis of patients diagnosed with VTED in Spanish emergency departments as evidenced by hospital readmission and mortality.Determinar el impacto pronóstico de la enfermedad pulmonar obstructiva crónica (EPOC) en los pacientes diagnosticados de enfermedad tromboembólica venosa (ETV) en servicios de urgencias (SU) españoles.Análisis secundario del registro ESPHERIA que incluyó pacientes consecutivos con ETV sintomática en 53 SU.Se incluyeron 801 pacientes de los que 71 (9%) tenían EPOC, siendo la tromboembolia pulmonar la forma de presentación más frecuente de ETV en este subgrupo de pacientes (77,5% vs 47,1%, p0,001). Los pacientes con EPOC tuvieron con más frecuencia disfunción de ventrículo derecho en la angiotomografía pulmonar (18,2% vs 13,1%; p0,001) y necesidad de soporte ventilatorio (7% vs 0,5%; p0,001). Los pacientes con ETV y EPOC tuvieron mayor incidencia de reingreso o mortalidad en el seguimiento a 180 días [HR 1,52 (IC 95% 1,00-2,29; p = 0,048)], comparados con los pacientes con ETV sin EPOC.La EPOC tiene impacto pronóstico en los pacientes diagnosticados de ETV en SU españoles, en términos de mortalidad y reingreso hospitalario.

SUMMARY OBJECTIVE: Determine good recovery practices for ambulation of octogenarian women after hospital discharge after being operated on for hip fracture. METHODS: Prospective study during the second half of 2019, with 192 women (85.95 ± 5.1 years) with hip fracture. A medical history, fracture types, complications, surgical treatment, and assessment of the level of ambulation were recorded before and after six months of hospital discharge. RESULTS: 100 patients lived in the family home and 92 in an institutional center, 68.2% provided pertrochanteric fracture and a total of 3.7 comorbidities, all of them received spinal anesthesia and were admitted an average of 11.4 days. After six months, the patients showed a significant loss of functional independence with respect to the situation prior to the fracture, both for the ability to wander and for activities of daily living. It is noteworthy that the worst prognosis in the recovery of ambulation has to do with intermediate levels of ambulation and that the functional level of departure influences to a lesser extent than the place where they perform the recovery. CONCLUSIONS: Age is a factor that influences the recovery of hip fracture, but there are other influential factors since patients who remain in the family home have a better functional prognosis than those who recover in institutionalized centers, after six months of hospital discharge. RESUMO OBJETIVO: Determinar boas práticas para a recuperação da ambulação de octogenárias posterior à alta hospitalar após cirurgia por fratura da pelve. METODOLOGIA: Um estudo prospectivo realizado no segundo semestre de 2019 com 192 mulheres (85,95 ± 5,1 anos) com fratura da pelve. O histórico médico, tipo de fratura, complicações, tratamento cirúrgico, e avaliação do nível de ambulação foram registrados antes da alta hospitalar e após seis meses. RESULTADOS: De todas as pacientes, 100 viviam com a família e 92 em alguma instituição, 68.2% tinham fratura peritrocantérica e uma média de 3,7 comorbidades; todas receberam anastesia espinhal e ficaram internadas por 11,4 dias em média. Após seis meses, as pacientes apresentaram uma perda significativa da independência funcional em relação à situação anterior à fratura, tanto em relação à capacidade de ambulação e atividades cotidianas. É importante ressaltar que o prognóstico negativo em relação à recuperação da ambulação está relacionado a níveis intermediários de ambulação e que o nível funcional de saída tem menor influência do que o local onde a recuperação é feita. CONCLUSÃO: A idade é um fator que influencia a recuperação de fraturas da pelve. Porém, há outros fatores com influência, já que as pacientes que ficam com familiares têm um prognostico funcional melhor do que aquelas que se recuperam em instituições, após seis meses da alta hospitalar.

PURPOSE The aim of the study was to determine the cognitive impairment level influence in descriptive characteristics, comorbidities, complications, and pharmacological features of older adults with hip fracture. DESIGN Cross-sectional study. METHOD Five hundred fifty-seven older adults with hip fracture were recruited and divided into cognitive impairment levels (severe/moderate, mild, no impairment). Descriptive characteristics, comorbidities, complications, and pharmacological data were collected. FINDINGS Significant differences (p < .05, R = .012-.475) between cognitive impairment levels were shown. Shorter presurgery hospital length of stay and lower depression and Parkinson comorbidities; delirium complication; and antidepressants, antiparkinsonians, and neuroleptics use were shown for the no-impairment group. With regard to the cognitive impairment groups, lower presence of cardiopathy and hypertension; higher presence of dementia; antihypertensives, antiplatelets, and antidementia medication; infection/respiratory insufficiency complications; and lower constipation complications were shown. CONCLUSION Cognitive impairment levels may determine the characteristics, comorbidities, pharmacology, and complications of older adults with hip fracture. CLINICAL RELEVANCE Cognitive impairment level may impact rehabilitation nursing practice, education, and care coordination.

Age is the biggest risk factor for colorectal cancer, with 70% of the cases in patients over 70 years old. For this reason, a review is presented on the surgical treatment and chemotherapy of cancer of colon and rectum in the elderly. A search was performed in PubMed, including words such as elderly, surgery, colorectal cancer, chemotherapy, radiotherapy, and oncogeriatrics, and review articles and originals on treatment of colorectal cancer in the elderly were selected. A narrative form was developed from the latest evidence with the results obtained on the treatment of this pathology. Although the treatment of colorectal cancer is standardised, a prior comprehensive geriatric assessment is required in the case of the elderly, before deciding the type of treatment in order to offer these robust elderly-standardised guidelines for the robust elderly and adapt them for use in fragile patients.

We apply the Differential Galois Theory of linear partial differential systems to the Backlund–Darboux transformations of the AKNS solitonic partial differential equations. We prove that the Galois group of the transformed system is isomorphic to a subgroup of the Galois group of the initial system. As an example, we study the integrability in closed form of the linear systems corresponding to the solitonic solutions of KdV equation.

340 p. La fractura de la extremidad proximal del fémur o fractura de cadera es la complicación más grave de la osteoporosis por la morbilidad, mortalidad y costes que genera. En España cada año se producen entre 50.000-60.000 fracturas de cadera. Es una entidad común en la población anciana. Más del 85% de las fracturas de cadera ocurren en mayores de 65 años. La repercusión de la fractura de cadera para el anciano se da a nivel funcional, no sólo en la capacidad de deambular sino también en la realización del resto de actividades básicas de la vida diaria, también a nivel cognitivo y contribuye a aumentar la morbimortalidad. La hipótesis es si la capacidad funcional y calidad de vida en personas mayores se ve afectada por los factores asociados a fractura de cadera en el área sanitaria de León. Se incluyeron todos los pacientes mayores de 75 años que sufren una fractura de cadera en un año, y que son ingresados en el Complejo Asistencial Universitario de León. Se ha realizado un análisis descriptivo de las diferentes variables estudiadas, así como un análisis bivariante cruzando todas las variables entre sí. Por último, se han identificado diversos perfiles a través de modelos de regresión logística binaria, con el método “hacia atrás” de Wald, utilizando como variables dependientes aquellas que tengan interés para su estudio, sobre ser > 90 años. El conocimiento epidemiológico de un problema nos facilita la búsqueda de soluciones. Es necesario analizar y registrar para poder comparar y encontrar áreas de mejora. Coincidiendo con los datos preliminares de esta tesis, se empieza a trabajar de forma conjunta los servicios de Traumatología, Anestesia, Rehabilitación y Geriatría, en el desarrollo de una Vía Clínica, con el fin de disminuir la estancia prequirúrgica y mejorar la atención la atención al paciente anciano con fractura de cadera.

SUMMARY BACKGROUND Hip fractures may be the greatest complication secondary to osteoporotic disorder. The objective of this study was to determine the influence of age distribution in the functionality, comorbidity, complications and surgical features of older adults with hip fractures. METHODS A prospective cohort study was carried out from 2013 to 2014. A sample of 557 adults over 75 years old with osteoporotic hip fractures was recruited from the Orthogeriatric Unit of the León University Hospital (Spain). Age distributions of 75–84, 85–90 and >90 years old were considered. Firstly, sociodemographic data, fracture type and hospital staying days were collected. Secondly, baseline functionality (Barthel index), ambulation, cognitive impairment and comorbidities were described. Thirdly, surgical intervention, urgency, type, American Association of Anesthesiologists (ASA) scores, non-surgical cause, and baseline pharmacologic treatments were determined. Finally, complications and features at hospital discharge were observed. RESULTS The age ranges did not show any statistically-significant differences (P.05; R2=.000–.010). CONCLUSION Age distributions greater than 75 years old may determine the functionality, comorbidities, surgical features, baseline pharmacologic treatments, complications and features at hospital discharge for older adults who suffer a hip fracture. RESUMO CONTEXTO As fraturas do quadril podem ser a maior complicação secundária à doença osteoporótica. O objetivo deste estudo foi determinar a influência da distribuição etária na funcionalidade, comorbidade, complicações e características cirúrgicas de idosos com fratura de quadril. MÉTODOS Um estudo prospectivo de coorte foi realizado de 2013-2014. Uma amostra de 557 adultos mais velhos, com mais de 75 anos, com fratura de quadril osteoporótica foi recrutada na Unidade Ortogeriátrica do Hospital Universitário de León (Espanha). As distribuições de idade de 75-84, 85-90 e >90 anos foram consideradas. Em primeiro lugar, foram coletados dados sociodemográficos, tipo de fratura e dias de permanência hospitalar. Em segundo lugar, foram descritas funcionalidades de base (índice Barthel), ambulação, comprometimento cognitivo e comorbidades. Em terceiro lugar, determinaram-se a intervenção cirúrgica, a urgência, o tipo, os resultados da Associação Americana de Anestesiologistas (ASA), a causa não cirúrgica e os tratamentos farmacológicos iniciais. Finalmente, foram observadas complicações e características na alta hospitalar. RESULTADOS As faixas etárias não mostraram diferenças estatisticamente significativas (P 0,05; R2 = ,000-,010). CONCLUSÃO As distribuições de idade após 75 anos podem determinar a funcionalidade, comorbidades, características cirúrgicas, tratamentos farmacológicos de base, complicações e características na alta hospitalar de adultos mais velhos que sofrem fratura de quadril.

Determinar el coste-efectividad de rivaroxaban frente al tratamiento convencional (heparinas de bajo peso molecular y acenocumarol) en el tratamiento del tromboembolismo venoso (TEV), que comprende la trombosis venosa profunda (TVP) y la embolia pulmonar (EP). Se adapto para Espana un modelo de Markov que describe el manejo y consecuencias del TEV. Los pacientes, tras sufrir una TVP o EP son tratados con rivaroxaban o tratamiento convencional durante 6 meses. Las probabilidades de transicion se obtuvieron del analisis combinado de los estudios EINSTEIN (DVT y PE) y de literatura relacionada. Se asignaron costes y resultados en salud a cada estado para estimar el coste por ano de vida ajustado por calidad (AVAC). El analisis considero la perspectiva del Sistema Nacional de Salud (SNS), con la inclusion de los costes directos sanitarios (euros de 2013) y una tasa de descuento del 3%. Se llevaron a cabo diversos analisis de sensibilidad para evaluar la robustez de los resultados. El tratamiento con rivaroxaban comporto una disminucion de costes en comparacion con el tratamiento convencional a los 6 meses de tratamiento de 507 € y 436 € para TVP y EP, respectivamente, asi como un incremento de 0,033 y 0,030 AVAC para TVP y EP, respectivamente, por lo que rivaroxaban es una opcion dominante sobre el tratamiento convencional. Los resultados del analisis de sensibilidad probabilistico confirmaron la eficiencia de rivaroxaban para 3, 6 y 12 meses de tratamiento. Desde la perspectiva del SNS, rivaroxaban resulta una opcion dominante con respecto al tratamiento convencional en el tratamiento del TEV.

El tratamiento farmacológico de la hiperplasia prostática (HP) benigna incluye el uso de antagonistas de los adrenorreceptores-α1, los que fundamentalmente reducen los síntomas del tracto urinario inferior y los inhibidores de la 5α-reductasa, que resultan más efectivos en la disminución del volumen prostático. La terapia combinada, utilizada en los casos severos o refractarios, o ambos inclusive, provee los beneficios de ambas clases terapéuticas. El D-004, extracto lipídico obtenido a partir de los frutos de Roystonea regia que contiene una mezcla de ácidos grasos, previene la HP inducida por testosterona y la atípica inducida por fenilefrina en roedores. Un estudio farmacológico demostró que la terapia combinada administrada diariamente con dosis orales de D-004 (400 mg/kg) + tamsulosín (0,05 mg/kg) durante 14 d fue más efectiva en atenuar la HP atípica inducida por fenilefrina que ambas monoterapias. El presente estudio investigó la toxicidad de la terapia combinada con dosis elevadas de D-004 (2000 mg/kg) + tamsulosin (2 mg/kg) administrada durante 28 d a ratas Sprague Dawley machos. Se distribuyeron aleatoriamente seis animales por cada grupo de tratamiento: un control y tres grupos tratados con la monoterapia de D-004 (2000 mg/kg), o con tamsulosin (2 mg/kg), o con la terapia combinada D-004 (2000 mg/kg) + tamsulosín (2 mg/kg). Se investigaron los efectos sobre los indicadores siguientes: mortalidad, signos clínicos, peso corporal, consumo de alimentos, parámetros hematológicos, bioquímica sanguínea, peso relativo de órganos y hallazgos histopatológicos. Ninguna de las variables mostró cambios significativos en los grupos tratados con respecto al control. En conclusión, la administración oral de D-004 (2000 mg/kg) + tamsulosin (2 mg/kg) a ratas machos durante 28 d no produjo manifestaciones indicativas de toxicidad asociada con este tratamiento.

Anticoagulation therapy is the standard treatment of patients with symptomatic venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism. Until recently, treatment of VTE was based on parenteral or low-molecular-weight heparin for initial therapy (5-10 days) and oral vitamin K antagonists for long-term therapy. Those treatments have some limitations, including parenteral administration (heparins), the need for frequent monitoring and dose adjustments, interactions with several medications, and dietary restrictions (vitamin K antagonists). Rivaroxaban is a new oral direct factor Xa inhibitor with a wide therapeutic window, predictable anticoagulant effect, no food interactions, and few drug interactions. Consequently, no periodic monitoring of anticoagulation is needed, and fixed doses can be prescribed. EINSTEIN program demonstrated that rivaroxaban was as effective as and significantly safer than standard therapy for treatment of VTE. Rivaroxaban was recently authorized so doubts exist about how to use it in daily clinical practice. This document aims to clarify common questions formulated by clinicians regarding the use of this new drug.

The use of contrast media during cardiac resynchronization therapy (CRT) devices implantation is associated with the risk of contrast-induced nephropathy (CIN). The aim of this study was to evaluate the possible beneficial role of periprocedural intravenous volume expansion with isotonic saline and sodium bicarbonate solution in patients who undergo CRT implantation. Eligible patients were randomly assigned in a 1:1 ratio to receive hydration plus one-sixth molar sodium bicarbonate (study group) or not (control group). Primary end point was CIN incidence. Secondary end points were (1) a combined end point of death, heart transplantation, or hospitalization for heart failure at 12 months, (2) incidence of death, and (3) the need for renal replacement therapy at 12 months. Final analysis was performed with 93 patients. In the hydration group CIN incidence was significantly reduced related to control group (0% vs 11%, p = 0.02). There was a trend to reduce the combined end point in hydration group (12.5% vs 22%, p = 0.14). Finally, CIN incidence was related to a higher 12 months mortality (25% vs 7%, p = 0.03). In conclusion, CIN incidence was 11% in a nonselected population of patients receiving a CRT device. CIN appearance could be reduced by using a hydration protocol based on sodium bicarbonate and isotonic saline. (C) 2017 Elsevier Inc. All rights reserved.

The benefits of the collaboration between orthopaedics and geriatrics in the management and care of elderly patients admitted with hip fracture have been widely demonstrated. A questionnaire was sent to all hospital geriatricians of Castilla y Leon in order to determine the characteristics this collaboration between orthopaedics and geriatrics in the public hospitals of Castilla y Leon. They were asked about the type of collaboration with orthopaedics in the care of the elderly patient admitted with hip fracture and details of the treatment of the complications. Most of the hospitals maintain a high level of orthogeriatric collaboration with geriatricians, and the geriatrician attends to most of the medical complications of these patients. The average hospital stay is 10 days, with a surgical delay of 3 days. Management of the most frequent clinical problems in hospitals of Castilla y Leon are detailed in this article, comparing them with the latest articles and current recommendations from clinical practice guides.