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Summary: Human genetic studies of critical COVID-19 pneumonia have revealed the essential role of type I interferon-dependent innate immunity to SARS-CoV-2 infection. Conversely, an association between the HLA-B∗15:01 allele and asymptomatic SARS-CoV-2 infection in unvaccinated individuals was recently reported, suggesting a contribution of pre-existing T cell-dependent adaptive immunity. We report a lack of association of classical HLA alleles, including HLA-B∗15:01, with pre-omicron asymptomatic SARS-CoV-2 infection in unvaccinated participants in a prospective population-based study in the United States (191 asymptomatic vs. 945 symptomatic COVID-19 cases). Moreover, we found no such association in the international COVID Human Genetic Effort cohort (206 asymptomatic vs. 574 mild or moderate COVID-19 cases and 1,625 severe or critical COVID-19 cases). Finally, in the Human Challenge Characterisation study, the three HLA-B∗15:01 individuals infected with SARS-CoV-2 developed symptoms. As with other acute primary infections studied, no classical HLA alleles favoring an asymptomatic course of SARS-CoV-2 infection were identified.

Objectives: We aimed to determine if starting antiretroviral therapy (ART) in the first 30 days after acquiring HIV infection has an impact on immunovirological response. Methods: Observational, ambispective study including 147 patients with confirmed acute HIV infection (January/1995-August/2022). ART was defined as very early (≤30 days after the estimated date of infection), early (31-180 days), and late (>180 days). We compared time to viral suppression (viral load [VL]

Abstract Coagulase-negative staphylococci (CoNS) are currently considered typical microorganisms causing infective endocarditis (IE) in patients with prosthetic valves. The objective was to determine variables associated with IE in patients with CoNS bacteremia. We performed an analysis of the clinical characteristics of patients with CoNS bacteremia admitted to a university hospital in Madrid (Spain) from 2021 to December 2022 according to the occurrence of IE. This study is an evaluation of a bacteremia registry. During the study period, 106 patients with CoNS bacteremia were detected. In 85 patients an echocardiogram was performed during hospital admission to rule out IE. Among them, 12 episodes were detected that met IE criteria (14.2%). Of the 6 patients with heart valve prostheses, 5 patients (83.3%) had IE (p

Objective The main objective of the study was to evaluate the influence of arterial hypertension, diabetes, dyslipidaemia, smoking, alcoholism and COPD (chronic obstructive pulmonary disease) on the viability of the extracted tissue as well as the donor.Design Observational case–control study.Setting Regional hospital in Northern Spain.Participants 1517 corneas were registered.Interventions Patients’ medical history was reviewed after corneal donation and evaluation. Previous medical information (age, sex and cardiovascular risk factors (CVRFs)) and data related to the donor (type of donor), the corneal tissue and its evaluation, and the viability of the implant were collected.Results A total of 1517 corneas were registered and 81.5% of the donors presented at least one CVRF. In relation to the viability of the donor, it was observed that having suffered from COPD reduced the viability of the donor (no COPD: 93.8% vs COPD: 88%; OR=0.49; 95% CI: 0.28 to 0.84) while alcohol consumption increased it (drinker or ex-drinker: 95.8% vs non-drinker: 92.5%; OR=1.84; 95% CI: 1.01 to 3.33). Regarding tissue viability, decreased viability was observed in the presence of COPD (no COPD: 72.5% vs COPD: 64; OR=0.67; 95% CI: 0.47 to 0.96) and diabetes mellitus (no diabetes: 72.9% vs diabetes: 67.2%; OR=0.76; 95% CI: 0.58 to 0.99). As regards the viability of the implant, a total of 1039 corneas (68.9%) were suitable, observing decreased viability when suffering from COPD (no COPD: 69.8% vs COPD: 60.7%; OR=0.67; 95% CI: 0.47 to 0.94) and increased when having an active smoking habit (no habit: 65.3% vs habit: 74.1%; OR=1.52; 95% CI: 1.21 to 1.91).Conclusions Through this study, it can be concluded that in the absence of absolute exclusion criteria for donors, the assessment of how CVRF, alcoholism and COPD may affect the donor provides details about the quality of the tissue to be obtained.

Summary: Background: While a low CD4/CD8 ratio during HIV treatment correlates with immunosenescence, its value in identifying patients at an increased risk for clinical events remains unclear. Methods: We analyzed data from the CoRIS cohort to determine whether CD4 count, CD8 count, and CD4/CD8 ratio at year two of antiretroviral therapy (ART) could predict the risk of serious non-AIDS events (SNAEs) during the next five years. These included major adverse cardiovascular events, non-AIDS-defining malignancies, and non-accidental deaths. We used pooled logistic regression with inverse probability weighting to estimate the survival curves and cumulative risk of clinical events. Findings: The study included 4625 participants, 83% male, of whom 200 (4.3%) experienced an SNAE during the follow-up period. A CD4/CD8 ratio

Early diagnosis of a Human Immunodeficiency Virus (HIV)-infected person represents a cornerstone of HIV prevention, treatment, and care. Numerous publications have developed recommendations where HIV serology is indicated to reduce missed diagnostic opportunities (MDOs). This retrospective study analyses new HIV infection diagnoses and the relationship between late diagnosis (LD)/advanced HIV disease (AHD), baseline characteristics, and MDOs. Sociodemographic data and data related to contact with the health system in the 5 years before diagnosis were collected. Most of the 273 diagnoses were made in primary care (48.5%). Approximately 50.5% and 34.4% had LD and AHD criteria, respectively. Female sex was associated with a higher incidence of LD. Persons infected through the heterosexual route and those at an older age had a higher risk for LD and AHD. People with previous HIV serology presented a lower percentage of LD and AHD. In total, 10% of the health contact instances were classified as MDOs, mostly occurring in primary care. A significant increase in the median of MDOs was observed in patients with LD/AHD. Female sex and hepatitis C virus co-infection were associated with an increase in the number of MDOs. The high percentage of LD and AHD and the significant number of MDOs show that the current screening system should be improved.

People with HIV (PWH) may be more susceptible to SARS-CoV-2 infection and worse clinical outcomes. We investigated the disparity in SARS-CoV-2 vaccination coverage between PWH and those without HIV (PWoH) in Catalonia, Spain, assessing primary and monovalent booster vaccination coverage from December 2021 to July 2022. The vaccines administered were BNT162, ChAdOx1-S, mRNA-127, and Ad26.COV2.S. Using a 1:10 ratio of PWH to PWoH based on sex, age, and socioeconomic deprivation, the analysis included 201,630 individuals (183,300 PWoH and 18,330 PWH). Despite a higher prevalence of comorbidities, PWH exhibited lower rates of complete primary vaccination (78.2% vs. 81.8%, p < 0.001) but surpassed PWoH in booster coverage (68.5% vs. 63.1%, p < 0.001). Notably, complete vaccination rates were lower among PWH with CD4 p < 0.001, all). However, PWH with CD4 < 200 cells/μL received more boosters (p < 0.001). In multivariable logistic regression analysis of the overall population, a prior SARS-CoV-2 diagnosis, HIV status, migrants, and mild-to-severe socioeconomic deprivation were associated with lower primary vaccination coverage, reflecting barriers to healthcare and vaccine access. However, booster vaccination was higher among PWH. Targeted interventions are needed to improve vaccine coverage and address hesitancy in vulnerable populations.

Aim. To evaluate the influence of time on arterial blood gas values after artery puncture is performed. Method. Prospective longitudinal observational study carried out with gasometric samples from 86 patients, taken at different time intervals (0 (T0), 15 (T15), 30 (T30) and 60 (T60) min), from 21 October 2019 to 21 October 2020. The study variables were: partial pressure of carbon dioxide, bicarbonate, hematocrit, hemoglobin, potassium, lactic acid, pH, partial pressure of oxygen, saturation of oxygen, sodium and glucose. Results. The initial sample consisted of a total of 90 patients. Out of all the participants, four were discarded as they did not understand the purpose of the study; therefore, the total number of participants was 86, 51% of whom were men aged 72.59 on average (SD: 16.23). In the intra-group analysis, differences in PCO2, HCO3, hematocrit, Hb, K+ and and lactic acid were observed between the initial time of the test and the 15, 30 and 60 min intervals. In addition, changes in pH, pO2, SO2, Na and glucose were noted 30 min after the initial sample had been taken. Conclusions. The variation in the values, despite being significant, has no clinical relevance. Consequently, the recommendation continues to be the analysis of the GSA at the earliest point to ensure the highest reliability of the data and to provide the patient with the most appropriate treatment based on those results.

Lung resident memory T (TRM) cells are important for protection from viral infection in the lungs. Here the authors use paired lung biopsy material and blood to characterize T cell responses in patients with COVID-19 over time and find persistence of antiviral lung TRM cells that might be important to limit reinfection.

El cáncer es una enfermedad que afecta a un niño por cada 200 adultos. Es la segunda causa de muerte en el niño de 0-14 años después de los accidentes. Gracias al desarrollo de la oncología pediátrica, el 80% de los niños diagnosticados con cáncer se curan de su enfermedad en nuestro país, sin embargo el 20% aproximadamente fallecen eventualmente de la enfermedad o de las secuelas del tratamiento. Conociendo la gravedad del diagnóstico de una enfermedad oncológica en un niño, con sus posibles consecuencias, es fundamental tratar de integrar la enfermedad en la vida normal del niño, la familia y el entorno que le rodea. El fin es convertir al niño en un adulto sano física, psíquica, social y espiritualmente. Para ello, el niño debe ser el centro de nuestro trabajo y estar rodeado de un equipo multidisciplinar. El inicio de los Cuidados Paliativos debe integrarse desde el momento del diagnóstico en aquellos niños con pocas o nulas posibilidades de curación e iniciarse en el resto en la primera recaída. En los últimos días de vida de cualquier niño, siempre se le ofrece la posibilidad de recibir estos cuidados en casa, en el hospital o en una modalidad combinada (Cuidados Paliativos mixtos), donde reciben parte de los cuidados en su domicilio y al final de su vida se trasladan al hospital para vivir allí sus últimos días. Por ello, deben realizarse desde la óptica de la medicina centrada no sólo en la persona, sino también en la familia.

Human immunodeficiency virus (HIV) establishes a persistent infection in heterogeneous cell reservoirs, which can be maintained by different mechanisms including cellular proliferation, and represent the main obstacle to curing the infection. The expression of the Fcγ receptor CD32 has been identified as a marker of the active cell reservoirs in people on antiretroviral therapy (ART), but if its expression has any role in conferring advantage for viral persistence is unknown. Here, we report that HIV-infected cells expressing CD32 have reduced susceptibility to natural killer (NK) antibody-dependent cell cytotoxicity (ADCC) by a mechanism compatible with the suboptimal binding of HIV-specific antibodies. Infected CD32 cells have increased proliferative capacity in the presence of immune complexes, and are more resistant to strategies directed to potentiate NK function. Remarkably, reactivation of the latent reservoir from antiretroviral-treated people living with HIV increases the pool of infected CD32 cells, which are largely resistant to the ADCC immune mechanism. Thus, we report the existence of reservoir cells that evade part of the NK immune response through the expression of CD32.

ObjectiveTo ascertain the role of inflammation in the response to ocrelizumab in primary-progressive multiple sclerosis (PPMS).MethodsMulticenter prospective study including 69 patients with PPMS who initiated ocrelizumab treatment, classified according to baseline presence [Gd+, n=16] or absence [Gd-, n=53] of gadolinium-enhancing lesions in brain MRI. Ten Gd+ (62.5%) and 41 Gd- patients (77.4%) showed non-evidence of disease activity (NEDA) defined as no disability progression or new MRI lesions after 1 year of treatment. Blood immune cell subsets were characterized by flow cytometry, serum immunoglobulins by nephelometry, and serum neurofilament light-chains (sNfL) by SIMOA. Statistical analyses were corrected with the Bonferroni formula.ResultsMore than 60% of patients reached NEDA after a year of treatment, regardless of their baseline characteristics. In Gd+ patients, it associated with a low repopulation rate of inflammatory B cells accompanied by a reduction of sNfL values 6 months after their first ocrelizumab dose. Patients in Gd- group also had low B cell numbers and sNfL values 6 months after initiating treatment, independent of their treatment response. In these patients, NEDA status was associated with a tolerogenic remodeling of the T and innate immune cell compartments, and with a clear increase of serum IgA levels.ConclusionBaseline inflammation influences which immunological pathways predominate in patients with PPMS. Inflammatory B cells played a pivotal role in the Gd+ group and inflammatory T and innate immune cells in Gd- patients. B cell depletion can modulate both mechanisms.

People living with HIV (PLWH) are prioritised for SARS-CoV-2 vaccination due to their vulnerability to severe COVID-19. Therefore, the epidemiological surveillance of vaccination coverage and the timely identification of suboptimally vaccinated PLWH is vital. We assessed SARS-CoV-2 vaccination coverage and factors associated with under-vaccination among PLWH in Catalonia, Spain. As of 11.12.2021, 9945/14942 PLWH (66.6%) had received ≥1 dose of a SARS-CoV-2 vaccine. Non-Spanish origin (adjusted odds ratio (aOR) 0.64, 95% CI 0.59–0.70), CD4 count of 200–349 cells/μL (aOR 0.74, 95% CI 0.64–0.86) or 350–499 cells/μL (aOR 0.79, 95% CI 0.70–0.88), detectable plasma HIV-RNA (aOR 0.61 95% CI 0.53–0.70), and previous SARS-CoV-2 diagnosis (aOR 0.58 95% CI 0.51–0.65) were associated with under-vaccination. SARS-CoV-2 diagnosis (437 [9.5%] vs. 323 [3.5%], p < 0.001), associated hospitalisations (10 [2.3%] vs. 0 [0%], p < 0.001), intensive care unit admissions (6 [1.4%] vs. 0 [0%], p < 0.001), and deaths (10 [2.3%] vs. 0 [0%], p < 0.001) were higher among unvaccinated PLWH. Vaccination coverage was lower among PLWH with a CD4 count >200 cells/μL, detectable plasma HIV-RNA, previous SARS-CoV-2 diagnosis, and migrants. SARS-CoV-2 diagnosis, associated hospitalisations, and deaths among PLWH were lower among the vaccinated compared with the unvaccinated. SARS-CoV-2 vaccination prioritisation has not completely reached vulnerable PLWH with poorer prognosis. This information can be used to inform public health strategies.

Biological therapies, such as TNF inhibitors (TNFi), are increasing remission (REM) rates in rheumatoid arthritis (RA) patients, although these are still limited. The aim of our study was to analyze changes in the profile of peripheral blood mononuclear cells (PBMC) in patients with RA treated with TNFi in relation to the clinical response. This is a prospective and observational study including 78 RA patients starting the first TNFi. PBMC were analyzed by flow cytometry both at baseline and at 6 months. Disease activity at the same time points was assessed by DAS28, establishing DAS28 ≤ 2.6 as the criteria for REM. Logistic regression models were employed to analyze the association between the changes in PBMC and REM. After 6 months of TNFi treatment, 37% patients achieved REM by DAS28. Patients who achieved REM showed a reduction in the percentage of naive B cells, but only when patients had received concomitant methotrexate (MTX) (OR: 0.59; 95% CI: 0.39–0.91). However, no association was found for patients who did not receive concomitant MTX (OR: 0.85; 95% CI: 0.63–1.16). In conclusion, PBMC, mainly the B-cell subsets, are modified in RA patients with TNFi who achieve clinical REM. A significant decrease in naive B-cell percentage is associated with achieving REM after 6 months of TNFi treatment in patients who received concomitant therapy with MTX.

Resumen: Introducción y objetivos: El exceso de peso, fundamentalmente la obesidad, en edad pediátrica aumenta el riesgo de morbimortalidad en la edad adulta. El objetivo de este trabajo es estimar la prevalencia, global y en función de la edad y del sexo, de bajo peso, normopeso, exceso ponderal y de obesidad abdominal en los escolares gallegos de 6 a 15 años en el curso escolar 2013-2014. Material y métodos: Los datos proceden de un estudio transversal realizado en una muestra representativa por sexo y edad de escolares gallegos de 6 a 15 años. A partir de mediciones realizadas en los centros escolares se estimaron las prevalencias de bajo peso, normopeso, sobrepeso y obesidad, aplicando los puntos de corte propuestos por Cole, y la prevalencia de obesidad abdominal a partir de los puntos de corte de Taylor. Resultados: Se pesaron y midieron 7.438 escolares en los 137 centros educativos participantes. La prevalencia de sobrepeso fue de 24,9% y la de obesidad, de 8,2%. El 25,8% presentaban obesidad abdominal. El 4% de los escolares con normopeso tenían obesidad abdominal. Conclusiones: Estos datos ponen de manifiesto que se deben promover medidas de prevención primaria a edades tempranas encaminadas a disminuir la prevalencia de este factor de riesgo y a evitar complicaciones futuras. La prevalencia de exceso de peso, si no se tiene en cuenta la obesidad abdominal, se estaría infraestimando. Abstract: Introduction and objectives: The excess of weight, mainly obesity, during childhood and adolescence increases morbimortality risk in adulthood. The aim of this article is to estimate both the overall prevalence, as well as according to age and gender, of underweight, overweight, obesity and abdominal obesity among schoolchildren aged between 6-15-years-old in the school year 2013-2014. Material and methods: Data were taken from a cross-sectional community-based study carried out on a representative sample, by gender and age, of the Galician population aged between 6 and 15 years-old. The prevalence of underweight, overweight, and obese children (Cole's cut-off criteria) and abdominal obesity (Taylor's cut-off criteria) were estimated after performing objective measurements of height, weight and waist circumference at school. Results: A total of 7,438 students were weighed and measured in 137 schools. The prevalence of overweight and obese individuals was 24.9% and 8.2%, respectively. The prevalence of abdominal obesity was 25.8%, with 4% of children with normal weight having abdominal obesity. Conclusions: These data highlight the need to promote primary prevention measures at early ages in order to decrease the occurrence of the premature onset of disease in the future. The prevalence of excess weight is underestimated if abdominal obesity is not taken into consideration.

Introduction and objectives: The excess of weight, mainly obesity, during childhood and adolescence increases morbimortality risk in adulthood. The aim of this article is to estimate both the overall prevalence, as well as according to age and gender, of underweight, overweight, obesity and abdominal obesity among schoolchildren aged between 6 and 15-years-old in the school year 2013–2014. Material and methods: Data were taken from a cross-sectional community-based study carried out on a representative sample, by gender and age, of the Galician population aged between 6 and 15-years-old. The prevalence of underweight, overweight, and obese children (Cole's cut-off criteria) and abdominal obesity (Taylor's cut-off criteria) were estimated after performing objective measurements of height, weight and waist circumference at school. Results: A total of 7438 students were weighed and measured in 137 schools. The prevalence of overweight and obese was 24.9% and 8.2%, respectively. The prevalence of abdominal obesity was 25.8%, with 4% of children with normal weight having abdominal obesity. Conclusions: These data highlight the need to promote primary prevention measures at early ages in order to decrease the occurrence of premature onset of disease in the future. The prevalence of excess weight is underestimated if abdominal obesity is not taken into consideration. Resumen: Introducción y objetivos: El exceso de peso, fundamentalmente la obesidad, en edad pediátrica aumenta el riesgo de morbimortalidad en la edad adulta. El objetivo de este trabajo es estimar la prevalencia, global y en función de la edad y del sexo, de bajo peso, normopeso, exceso ponderal y de obesidad abdominal en los escolares gallegos de 6 a 15 años en el curso escolar 2013-2014. Material y métodos: Los datos proceden de un estudio transversal realizado en una muestra representativa por sexo y edad de escolares gallegos de 6 a 15 años. A partir de mediciones realizadas en los centros escolares se estimaron las prevalencias de bajo peso, normopeso, sobrepeso y obesidad, aplicando los puntos de corte propuestos por Cole, y la prevalencia de obesidad abdominal a partir de los puntos de corte de Taylor. Resultados: Se pesaron y midieron 7.438 escolares en los 137 centros educativos participantes. La prevalencia de sobrepeso fue de 24,9% y la de obesidad, de 8,2%. El 25,8% presentaban obesidad abdominal. El 4% de los escolares con normopeso tenían obesidad abdominal. Conclusiones: Estos datos ponen de manifiesto que se deben promover medidas de prevención primaria a edades tempranas encaminadas a disminuir la prevalencia de este factor de riesgo y a evitar complicaciones futuras. La prevalencia de exceso de peso, si no se tiene en cuenta la obesidad abdominal, se estaría infraestimando.

Background: TNF inhibitors (TNFis) are widely used for the treatment of rheumatoid arthritis (RA), although the response rates to this therapy in patients with RA remains heterogeneous and < 50% achieve remission (REM).Objective: To analyze baseline peripheral blood leukocytes profiles in order to search for biomarkers identifying patients who will most likely not achieve REM under TNFi treatment.Methods: A prospective bi-center pilot study including 98 RA patients treated with TNFis and followed-up during 6 months. Patients were classified according to DAS28 as follows: those who achieved REM (DAS28 ≤ 2.6) and those who did not (DAS28 > 2.6) at 6 months after starting TNFis. These rates were also assessed by simplified disease activity index (SDAI ≤ 3.3 and SDAI > 3.3, respectively). Peripheral blood immune cells were studied by flow cytometry before treatment initiation.Results: At 6 months, 61 or 80% of patients did not achieve REM by DAS28 or SDAI, respectively. Basal leukocyte profiles differed between REM vs. non-REM patients. Non-REM patients showed lower percentages of total and naïve B cells at baseline than REM subjects. A B lymphocyte/CD4+ lymphocyte ratio (BL/CD4 ratio)

Este trabajo contiene una sintética visión de conjunto de los orígenes del constitucionalismo español, desde la invasión francesa de 1808 hasta el fi n del Trienio Liberal en 1823. Tras unas previas consideraciones sobre los afrancesados y el Estatuto de Bayona, se analizan las tres tendencias que se perfi laron en el seno de las Cortes de Cádiz y los modelos constitucionales en los que se inspiraban. A continuación se abordan los dos principios nucleares de la Constitución de 1812, la soberanía nacional y la división de poderes, así como la forma de gobierno resultante de ambos, sin olvidar los derechos reconocidos en su articulado. Los dos siguientes apartados se ocupan del restablecimiento del absolutismo en mayo de 1814 y de la frustrada experiencia constitucional que tuvo lugar entre 1820 y 1823, un período en el que la proyección internacional de la restablecida Constitución doceañista alcanzó su cenit.

Resumen: Introducción y objetivos: Bajo el término malnutrición se agrupa la malnutrición por exceso, por defecto y por retraso en el crecimiento. Su prevalencia, a nivel poblacional, se puede estimar mediante variables antropométricas. El objetivo de este trabajo es estimar la prevalencia de malnutrición en los escolares gallegos de 6 a 15 años en el curso escolar 2013-2014. Métodos: Estudio transversal sobre una muestra representativa por sexo y edad de la población gallega de 6 a 15 años. Se estimó la prevalencia de obesidad, bajo peso y baja estatura en función del sexo y la edad utilizando los criterios de referencia propuestos por la Organización Mundial de la Salud. Resultados: Se pesaron y midieron 7.438 escolares. En global, el 16,4% de los escolares presentaban malnutrición. La prevalencia de obesidad fue del 14,8%, la de bajo peso, del 0,7%, y la de baja estatura para la edad, del 1%. La obesidad fue más prevalente entre los niños; respecto al bajo peso o baja estatura cuando aparecieron diferencias, las prevalencias fueron más altas entre las niñas. Conclusiones: En Galicia, 16 de cada 100 escolares de 6 a 15 años presentaban malnutrición, siendo la malnutrición por exceso u obesidad la manifestación más frecuente. La prevalencia de bajo peso y baja estatura no superaron el 1%. Estos datos ponen de manifiesto que se deben promover medidas de prevención primaria a edades tempranas encaminadas a disminuir la malnutrición, especialmente por exceso o adiposidad. Abstract: Introduction and aims: The term malnutrition includes malnutrition due to excess or obesity, underweight as well as stunted growth. Its prevalence in a population can be estimated using anthropometric variables. The aim of this study is to estimate the prevalence of malnutrition in Galician schoolchildren aged 6 to 15 years in the school year 2013-2014. Methods: A cross-sectional study was conducted on a representative sample by gender and age of the Galician population of 6 to 15 years old. The prevalence of obesity, underweight, and short stature was estimated by age and gender using the reference standards proposed by the World Health Organisation. Results: Of the total of 7,438 schoolchildren weighed and measured, 16.4% had malnutrition. The prevalence of obesity was 14.8%, underweight was 0.7%, and short stature for age was estimated at 1%. Obesity was more prevalent among boys. As regards underweight and short stature, when there were differences, prevalence was higher among girls. Conclusions: In Galicia, 16 out of every 100 schoolchildren aged 6 to 15 years had malnutrition, with that due to excess or obesity being the most frequent. Prevalence of underweight and short stature did not exceed 1%. This data shows that primary prevention measures should be promoted at an early age to reduce malnutrition due to excess or adiposity, in particular.

Introduction and aims: The term malnutrition includes malnutrition due to excess or obesity, underweight as well as stunted growth. Its prevalence in a population can be estimated using anthropometric variables. The aim of this study is to estimate the prevalence of malnutrition in Galician schoolchildren aged 6–15 years in the school year 2013–2014. Methods: A cross-sectional study was conducted on a representative sample by gender and age of the Galician population of 6–15 years old. The prevalence of obesity, underweight, and short stature was estimated by age and gender using the reference standards proposed by the World Health Organisation. Results: 7438 schoolchildren weighed and measured 16,4% presented malnutrition. The prevalence of obesity was 14.8%, underweight was 0.7%, and short stature for age was estimated at 1%. Obesity was more prevalent among boys. As regards underweight and short stature, when there were differences, prevalence was higher among girls. Conclusions: In Galicia, 16 out of every 100 schoolchildren aged 6–15 years had malnutrition, with that due to excess or obesity being the most frequent. Prevalence of underweight and short stature did not exceed 1%. This data shows that primary prevention measures should be promoted at an early age to reduce malnutrition due to excess or adiposity, in particular. Resumen: Introducción y objetivos: Bajo el término malnutrición se agrupa la malnutrición por exceso, por defecto y por retraso en el crecimiento. Su prevalencia, a nivel poblacional, se puede estimar mediante variables antropométricas. El objetivo de este trabajo es estimar la prevalencia de malnutrición en los escolares gallegos de 6 a 15 años en el curso escolar 2013–2014. Métodos: Estudio transversal sobre una muestra representativa por sexo y edad de la población gallega de 6 a 15 años. Se estimó la prevalencia de obesidad, bajo peso y baja estatura en función del sexo y la edad utilizando los criterios de referencia propuestos por la Organización Mundial de la Salud. Resultados: Se pesaron y midieron 7.438 escolares. En global, el 16,4% de los escolares presentaban malnutrición. La prevalencia de obesidad fue del 14,8%, la de bajo peso, del 0,7%, y la de baja estatura para la edad, del 1%. La obesidad fue más prevalente entre los niños; respecto al bajo peso o baja estatura cuando aparecieron diferencias, las prevalencias fueron más altas entre las niñas. Conclusiones: En Galicia, 16 de cada 100 escolares de 6 a 15 años presentaban malnutrición, siendo la malnutrición por exceso u obesidad la manifestación más frecuente. La prevalencia de bajo peso y baja estatura no superaron el 1%. Estos datos ponen de manifiesto que se deben promover medidas de prevención primaria a edades tempranas encaminadas a disminuir la malnutrición, especialmente por exceso o adiposidad.

Resumen: Objetivo: Evaluar y corregir, usando escalas de siluetas corporales, el impacto de la no respuesta en las prevalencias de bajo peso, sobrepeso y obesidad en niños/as de 6-15 años de edad. Método: Estudio transversal realizado en 2013 con 8145 escolares gallegos/as de 6-15 años. Quienes aceptaron participar fueron pesados/as y medidos/as, y a partir del índice de masa corporal se estimaron las prevalencias de bajo peso, sobrepeso y obesidad. Los/las profesores/as valoraron a todo el alumnado mediante escalas de siluetas corporales, y las valoraciones se usaron para estimar las prevalencias corregidas por la no respuesta. Aplicando el teorema de Bayes se estimaron las tasas de participación en función del estado ponderal. Resultados: La tasa de participación fue del 92,3% para los/las de 6-11 años y del 90% para los/las de 12-15 años. En ambos grupos, las prevalencias de bajo peso y sobrepeso fueron similares entre participantes y no participantes, pero la obesidad fue mayor entre los no participantes, sobre todo a los 12-15 años (6,3% vs. 12,2%; p

1. SOBERANÍA Y MONARQUÍA. 2. MONARQUÍA Y DIVISIÓN DE PODERES. 3. LA CONFIANZA REGIA Y PARLAMENTARIA DE LOS MINISTROS. 4. EL FRACASO DE LA MONARQUÍA PARLAMENTARIA EN LA HISTORIA CONSTITUCIONAL ESPAÑOLA. 5. LA MONARQUÍA PARLAMENTARIA EN LA TEORÍA CONSTITUCIONAL ESPAÑOLA. 6. APÉNDICE: LA IMPORTANCIA DE LA MONARQUÍA EN LA HISTORIA DE ESPAÑA.

The Millennium Development Goals (MDGs) provide a shares vision of a much improved world by 2015, where extreme poverty is cut in half, child mortality is greatly reduced, gender disparities in primary and secondary education are eliminated, women are more empowered and health and environment indicators improve within a global partnership for development. These goals are ambitious and their attainment will require a global effort. Using the normative framework for human rights codifi ed in the 1948 Universal Declaration of Human Rights, is a solid strategy for national and international policy in poverty reduction. This report establishes that Human Rights and the MDGs have much in common. They share guiding principles such as participation, empowerment and national ownership. They serve as tools for reporting processes that can hold governments accountable and most fundamentally, they share the ultimate objective of promoting human well-being and honouring the inherent dignity of all people. Therefore, Linking Millennium Development Goals with Human Rights is a good possibility in order to obtain a solid normative framework. From a gender perspective, the report link the Goal 3 gender equality and empowerment of women, with two treaty bodies, the International Covenant on Economic, Social and Cultural Rights as well as the Convention on the Elimination of all forms of Discrimination against Women in order to give a solid framework to achieve this Goal. Gender equality is important not only as a goal in itself, but also as a path towards achieving the other goals.Published online: 11 December 2017

Resumen: Objetivo: Valorar los cambios en el consumo de tabaco y estudiar de forma detallada el consumo de tabaco de liar y de cigarrillos electrónicos en la población gallega desde 2007 hasta 2015. Métodos: Información aportada por cinco estudios transversales, independientes, realizados entre 2007 y 2015 en mayores de 15 años (n = 8000/año). Se estimaron prevalencias de consumo, acompañadas de sus intervalos de confianza del 95%, global, en función del sexo y en grupo de edad, ámbito de residencia y nivel de estudios. Resultados: La prevalencia de consumo de tabaco fue del 25,4% en 2007 y del 21,8% en 2015. En 2007, el 1,8% de los fumadores consumían tabaco de liar, y en 2015 eran el 18,6%. El consumo del tabaco de liar entre fumadores aumentó en todos los grupos estudiados. La prevalencia de consumo de cigarrillos electrónicos fue, en 2014 y 2015, del 0,7%. En el ámbito urbano es donde se observan prevalencias más altas de consumo de cigarrillos electrónicos. Conclusión: Entre 2007 y 2015, la prevalencia de consumo de tabaco ha disminuido en Galicia y ha aumentado la prevalencia de fumadores que consumen tabaco de liar. El uso de cigarrillos electrónicos es bajo y más frecuente entre los fumadores, aunque no exclusivo. El auge del tabaco de liar y la introducción de los cigarrillos electrónicos reflejan la importancia de mantener sistemas de vigilancia que puedan identificar de forma inmediata cambios de comportamiento asociados al consumo de tabaco. Abstract: Objective: To assess changes in smoking prevalence and study roll-your-own (RYO) tobacco and e-cigarette use in the Galician population between 2007 and 2015. Methods: Data were obtained from five independent, cross-sectional studies carried out in Galicia (Spain) between 2007-2015 in the population aged 16 and over (n = 8,000/year). Prevalence of use was estimated, with 95% confidence intervals, overall, according to sex and by age group, area of residence and level of education. Results: Smoking prevalence decreased from 25.4% in 2007 to 21.8% in 2015. In 2007, 1.8% of current smokers declared that they had smoked RYO tobacco, compared to 18.6% in 2015. Among smokers, RYO tobacco consumption increased across all demographic groups. In both 2014 and 2015, ever use of e-cigarettes was 0.7%. E-cigarette use was more frequent in urban settings. Conclusion: Smoking prevalence decreased in Galicia between 2007 and 2015, and there has been rapid growth in the prevalence of RYO tobacco use. Although smokers are more likely to use e-cigarettes, both former and never smokers declared their use. The boom of RYO cigarettes and the emergence of e-cigarettes highlight the importance of having continuous surveillance systems to identify smoking behavioural changes. Palabras clave: Prevalencia, Estudio transversal, Epidemiología, Cigarrillos electrónicos, Productos del tabaco, Keywords: Prevalence, Cross-sectional study, Epidemiology, Electronic cigarettes, Tobacco products

The present paper reviews the position of the Spanish Liberals exiled in England and France during the Ominous Decade (1812-1833) regarding the Spanish Constitution of 1812 (abrogated a second time by Fernando VII in 1823). With this aim, three of the most renowned Spanish politician publications of this period are examined: El Español Constitucional, Ocios de Españoles Emigrados y El Precursor. The first two newspapers were printed in London and the third one in Paris.

Staphylococcus aureus and methicillin-resistant Staphylococcus aureus (MRSA) have become serious infections in humans and ruminants. S. aureus strains are showing rapid changes to develop resistance in traditional antibiotic-containing systems. In the continuous fierce fight against the emergent multi-drug resistant bacterial strains, straightforward and scalable synthetic procedures to produce new active molecules are in demand. Analysis of molecular properties points to degraded limonoids as promising candidates. In this article, we report a simple synthetic approach to obtain degraded limonoid analogs as scaffolds for new antibacterial molecules. The minimum inhibitory concentrations against S. aureus were evaluated for the stereoisomer mixtures by the broth microdilution method. Analysis of results showed that the acetylated derivatives were the most active of them all.

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Objetivo: El objetivo de este trabajo fue estimar la prevalencia de la inactividad física en Galicia en el tiempo libre en 2007-2011, así como el impacto que supone en ella el considerar otras actividades cotidianas. Métodos: Estudios transversales en mayores de 15 años (n = 19235). La actividad física se caracterizó mediante el cuestionario Minnesota. En el año 2011 se estimó la inactividad física considerando otras actividades cotidianas. Resultados: Entre 2007 y 2011, la prevalencia de inactividad física en el tiempo libre en Galicia fue estable (p = 0,249), próxima al 50%, y más alta en las mujeres y en la población que trabaja o estudia. La inactividad física disminuyó (47% a 16%) cuando se tuvieron en cuenta las actividades cotidianas. Conclusiones: La prevalencia de inactividad física fue alta y estable en los años estudiados. Tener en cuenta otras actividades de la vida cotidiana hizo disminuir de forma importante esta prevalencia.

Objetivo: La estimación de la prevalencia de exposición al humo ambiental de tabaco (HAT) permite aproximar el impacto de las leyes orientadas al control del tabaquismo. El objetivo de este trabajo fue conocer cómo varió la prevalencia de exposición autodeclarada al HAT en Galicia entre los años 2005 (previo a la Ley 28/2005) y 2011 (posterior a la Ley 42/2010). Métodos: Información aportada por cinco estudios transversales telefónicos independientes de base poblacional entre los años 2005 y 2011 en población de 16 a 74 años de edad (n = 34.419). Se estimaron prevalencias de exposición acompañadas de intervalos de confianza del 95% en función del ámbito de exposición autodeclarada y del consumo de tabaco. Resultados: En 2005, antes de la implementación de la Ley 28/2005, un 95% de la población declaró estar expuesta al HAT; en 2011, después de la implementación de la Ley 42/2010, esta prevalencia fue del 28%. En función del ámbito donde se produce la exposición al HAT, el descenso más importante en 2006, tras la implantación de la Ley 28/2005, fue en el trabajo, y en 2011 en los lugares de ocio. La prevalencia de exposición en el hogar disminuyó al inicio del periodo a estudio y después se mantuvo sin cambios. Conclusiones: En Galicia, en el periodo 2005-2011 disminuyó de forma importante la prevalencia autodeclarada de exposición al HAT, en especial después de la implantación de las Leyes 28/2005 y 42/2010. No obstante, uno de cada cuatro gallegos de 16 a 74 años de edad declararon estar expuestos en 2011.

O artigo examina o desenvolvimento do processo constitucional na Península Ibérica desde os primeiros momentos em que o movimento liberal ganha força. Na Espanha, as Cortes reunidas em Cádiz conseguem promulgar, em 1812, uma constituição que passará a ser um importante modelo para os revolucionários de então. Já em Portugal, a revolução constitucional chega logo depois da restauração liberal espanhola, em 1820, inaugurando uma nova era. Segue-se o estudo dos avanços e das vicissitudes do constitucionalismo peninsular durante toda a primeira metade do século XIX

Examino en este artículo el concepto de pueblo —o quizá más bien los distintos usos de este vocablo— por parte del pensamiento constitucional español durante la primera mitad del siglo XIX. Primero me centro en los liberales de las Cortes de Cádiz, luego en los «progresistas» y «moderados» de los años treinta y cuarenta, para terminar con los «progresistas de izquierda» en las Cortes de 1837, cuyas tesis anuncian las del posterior liberalismo democrático. Para llevar a cabo este examen estudio los debates que se suscitaron durante estos años, dentro y fuera del Parlamento, sobre la soberanía, la representación y, sobre todo, el sufragio. Unos debates en los que las referencias al pueblo (y a otros conceptos afines, como nación, ciudadanía y democracia) son constantes, aunque en modo alguno unívocos.