Estudio demográfico de las personas con nuevo diagnóstico de infección por VIH en el área sanitaria de un hospital de tercer nivel / Demographic study of persons living with HIV (PLWH) newly diagnosed in the healthcare area of a tertiary-level hospital

Introducción La lucha contra la infección por VIH sigue siendo un objetivo primordial del Sistema Nacional de Salud español. Los servicios de urgencias son un punto crítico a la hora disminuir las oportunidades de diagnóstico perdidas, donde se estima que se producen una de cada 3 oportunidades perdidas. El objetivo es examinar la distribución geográfica de los nuevos diagnósticos de VIH en el área de un hospital del centro de Madrid. Métodos Estudio descriptivo, observacional y retrospectivo que evalúa la distribución geográfica de los nuevos diagnósticos de VIH en el área asistencial de un hospital universitario de tercer nivel en la Comunidad de Madrid. Resultados Se analizaron 387 personas con un nuevo diagnóstico de infección por VIH entre los años 2018-2020, siendo en su mayoría personas jóvenes con una media de edad de 36±9 años. El 86% fueron hombres gais, bisexuales y otros hombres que tiene sexo con hombres y el 48,6% población inmigrante. El 15,3% se presentó con CD4+<200céls/mm3 y el 9,5% con una enfermedad definitoria de sida. El 32,7% y el 5,1% tenían un ARN-VIH-1>100.000 copias/mL y >500.000 copias/mL respectivamente, presentando, hasta un 13,7% de los sujetos mutaciones de resistencia al diagnóstico. En la distribución geográfica por las Áreas de Salud, el 51,4% de las personas procedían de 4 centros de salud y en 9 centros de salud se incluían más del 70% de los nuevos diagnosticados. Conclusión Conocer mejor la distribución geográfica de los nuevos diagnósticos de VIH por Áreas Sanitarias nos permite identificar las zonas de mayor riesgo de transmisión, para así poder dirigir y efectuar medidas de prevención, diagnóstico y tratamiento precoz (AU)

Introduction Countering HIV infection remains a primary objective of the Spanish National Health System. Emergency services play a crucial role in reducing missed diagnostic opportunities, with estimates suggesting that one in 3 such opportunities occur here. The aim of the study is to examine the geographical dispersion of newly diagnosed HIV cases, within a downtown Madrid hospital. Methods This is an observational, descriptive, retrospective study evaluating the geographical distribution of new HIV diagnoses in the care area of a tertiary University Hospital in the Community of Madrid. Results Three hundred and eighty-seven individuals with a new diagnosis of HIV infection between 2018 and 2020 were analysed, the majority being young people with an average age of 36±9 years. 86% were gay, bisexual and other men who have sex with men and 48.6% were immigrants. 15.3% presented with CD4+<200cells/mm3 and 9.5% with an AIDS-defining illness. 32.7% and 5.1% had an RNA-HIV-1>100,000copies/mL and >500,000copies/mL, respectively, with up to 13.7% of subjects presenting resistance mutations at diagnosis. Geographically, 51.4% of individuals came from 4 Health Centres and more than 70% of the new diagnoses were included in nine Health Centres. Conclusion Better understanding the geographical distribution of new HIV diagnoses by health areas allows us to identify areas of higher transmission risk, thereby directing and implementing prevention, early diagnosis, and treatment measures (AU)

[Demographic study of persons living with HIV (PLWH) newly diagnosed in the healthcare area of a tertiary-level hospital]. / Estudio demográfico de las personas con nuevo diagnóstico de infección por VIH en el área sanitaria de un hospital de tercer nivel.

INTRODUCTION: Countering HIV infection remains a primary objective of the Spanish National Health System. Emergency services play a crucial role in reducing missed diagnostic opportunities, with estimates suggesting that one in 3 such opportunities occur here. The aim of the study is to examine the geographical dispersion of newly diagnosed HIV cases, within a downtown Madrid hospital. METHODS: This is an observational, descriptive, retrospective study evaluating the geographical distribution of new HIV diagnoses in the care area of a tertiary University Hospital in the Community of Madrid. RESULTS: Three hundred and eighty-seven individuals with a new diagnosis of HIV infection between 2018 and 2020 were analysed, the majority being young people with an average age of 36±9 years. 86% were gay, bisexual and other men who have sex with men and 48.6% were immigrants. 15.3% presented with CD4+<200cells/mm3 and 9.5% with an AIDS-defining illness. 32.7% and 5.1% had an RNA-HIV-1>100,000copies/mL and >500,000copies/mL, respectively, with up to 13.7% of subjects presenting resistance mutations at diagnosis. Geographically, 51.4% of individuals came from 4 Health Centres and more than 70% of the new diagnoses were included in nine Health Centres. CONCLUSION: Better understanding the geographical distribution of new HIV diagnoses by health areas allows us to identify areas of higher transmission risk, thereby directing and implementing prevention, early diagnosis, and treatment measures.

Offline Lower-Limb Kinematic Decodification by Segments of EEG Signals.

In this work, hip and knee angles were decoded from low frequency EEG components recorded during the execution of two tasks. In order to compare their performance, three decoders based on multiple linear regression (MLR) models were applied under different conditions; which consisted in considering the processed data as a whole or divided into segments. Results suggest that, when the segments are related to specific tasks, the segmentation provides a better performance than applying the decoding method to unsegmented data.

Central nervous system modulates the neuromechanical delay in a broad range for the control of muscle force.

Force is generated by muscle units according to the neural activation sent by motor neurons. The motor unit is therefore the interface between the neural coding of movement and the musculotendinous system. Here we propose a method to accurately measure the latency between an estimate of the neural drive to muscle and force. Furthermore, we systematically investigate this latency, which we refer to as the neuromechanical delay (NMD), as a function of the rate of force generation. In two experimental sessions, eight men performed isometric finger abduction and ankle dorsiflexion sinusoidal contractions at three frequencies and peak-to-peak amplitudes {0.5, 1, and 1.5 Hz; 1, 5, and 10 of maximal force [%maximal voluntary contraction (MVC)]}, with a mean force of 10% MVC. The discharge timings of motor units of the first dorsal interosseous (FDI) and tibialis anterior (TA) muscle were identified by high-density surface EMG decomposition. The neural drive was estimated as the cumulative discharge timings of the identified motor units. The neural drive predicted 80 ± 0.4% of the force fluctuations and consistently anticipated force by 194.6 ± 55 ms (average across conditions and muscles). The NMD decreased nonlinearly with the rate of force generation ( R2 = 0.82 ± 0.07; exponential fitting) with a broad range of values (from 70 to 385 ms) and was 66 ± 0.01 ms shorter for the FDI than TA ( P < 0.001). In conclusion, we provided a method to estimate the delay between the neural control and force generation, and we showed that this delay is muscle-dependent and is modulated within a wide range by the central nervous system. NEW & NOTEWORTHY The motor unit is a neuromechanical interface that converts neural signals into mechanical force with a delay determined by neural and peripheral properties. Classically, this delay has been assessed from the muscle resting level or during electrically elicited contractions. In the present study, we introduce the neuromechanical delay as the latency between the neural drive to muscle and force during variable-force contractions, and we show that it is broadly modulated by the central nervous system.

Exceso de bases, un marcador útil en el pronóstico del traumatismo torácico en la población geriátrica / Base excess, a useful marker in the prognosis of chest trauma in the geriatric population

No disponible

Electromechanical delay in the tibialis anterior muscle during time-varying ankle dorsiflexion.

We evaluated the electromechanical delay (EMD) for the tibialis anterior (TA) muscle during the performance of time-varying ankle dorsiflexions. Subjects were asked to track a sinusoidal trajectory, for a range of amplitudes and frequencies. Motor unit (MU) action potential trains were identified from surface electromyography (EMG) decomposition and summed to generate the cumulative spike train (CST). CST and the exerted force were cross-correlated to identify the delay between the CST and force, which was considered as an estimate of the EMD. The results showed that the EMD decreased logarithmically with the increase in the slope of the force produced.

Analyzing EEG signals to detect unexpected obstacles during walking.

BACKGROUND: When an unexpected perturbation in the environment occurs, the subsequent alertness state may cause a brain activation responding to that perturbation which can be detected and employed by a Brain-Computer Interface (BCI). In this work, the possibility of detecting a sudden obstacle appearance analyzing electroencephalographic (EEG) signals is assessed. For this purpose, different features of EEG signals are evaluated during the appearance of sudden obstacles while a subject is walking on a treadmill. The future goal is to use this procedure to detect any obstacle appearance during walking when the user is wearing a lower limb exoskeleton in order to generate an emergency stop command for the exoskeleton. This would enhance the user-exoskeleton interaction, improving the safety mechanisms of current exoskeletons. METHODS: In order to detect the change in the brain activity when an obstacle suddenly appears, different features of EEG signals are evaluated using the recordings of five healthy subjects. Since the change in the brain activity occurs in the time domain, the features evaluated are: common spatial patterns, average power, slope, and the coefficients of a polynomial fit. A Linear Discriminant Analysis-based classifier is used to differentiate between two conditions: the appearance or not of an obstacle. The evaluation of the performance to detect the obstacles is made in terms of accuracy, true positive (TP) and false positive (FP) rates. RESULTS: From the offline analysis, the best performance is achieved when the slope or the polynomial coefficients are used as features, with average detection accuracy rates of 74.0 and 79.5 %, respectively. These results are consistent with the pseudo-online results, where a complete EEG recording is segmented into windows of 500 ms and overlapped 400 ms, and a decision about the obstacle appearance is made for each window. The results of the best subject were 11 out of 14 obstacles detected with a rate of 9.09 FPs/min, and 10 out of 14 obstacles detected with a rate of 6.34 FPs/min using slope and polynomial coefficients features, respectively. CONCLUSIONS: An EEG-based BCI can be developed to detect the appearance of unexpected obstacles. The average accuracy achieved is 79.5 % of success rate with a low number of false detections. Thus, the online performance of the BCI would be suitable for commanding in a safely way a lower limb exoskeleton during walking.

Ventilación mecánica no invasiva en pre e intraoperatorio y vía aérea difícil / Non-invasive mechanical ventilation in the pre- and intraoperative period and difficult airway

La ventilación mecánica no invasiva es un método de asistencia ventilatoria cuya finalidad es aumentar la ventilación alveolar, logrando, en sujetos seleccionados, evitar la intubación endotraqueal y la ventilación mecánica invasiva, con la consiguiente mejora en la supervivencia. Se ha realizado una revisión sistemática y exploración de los aspectos técnicos, experiencias clínicas y recomendaciones relativos a la aplicación de la ventilación mecánica no invasiva en el pre e intraoperatorio. El empleo de ventilación mecánica no invasiva profiláctica en el preoperatorio de cirugías que conllevan una alteración importante de la función ventilatoria puede disminuir la incidencia de complicaciones respiratorias posoperatorias. Su uso intraoperatorio dependerá fundamentalmente del tipo de cirugía, el tipo de técnica anestésica y del estado clínico del paciente. Su empleo permite una mayor profundidad anestésica, sin deterioro de la oxigenación y la ventilación de los pacientes (AU9

Non-invasive mechanical ventilation is a method of ventilatory assistance aimed at increasing alveolar ventilation, thus achieving, in selected subjects, the avoidance of endotracheal intubation and invasive mechanical ventilation, with the consequent improvement in survival. There has been a systematic review and study of the technical, clinical experiences, and recommendations concerning the application of non-invasive mechanical ventilation in the pre- and intraoperative period. The use of prophylactic non-invasive mechanical ventilation before surgery that involves significant alterations in the ventilatory function may decrease the incidence of postoperative respiratory complications. Its intraoperative use will mainly depend on the type of surgery, type of anaesthetic technique, and the clinical status of the patient. Its use allows greater anaesthetic depth without deterioration of oxygenation and ventilation of patients (AU9

Ventilación mecánica no invasiva en el postoperatorio. Revisión clínica / Non-invasive mechanical ventilation in postoperative patients. A clinical review

La ventilación mecánica no invasiva (VMNI) es un método de asistencia ventilatoria con importancia creciente en el manejo de la insuficiencia respiratoria postoperatoria. Su papel en la prevención y el tratamiento de las atelectasias cobra especial importancia en el postoperatorio de cirugías torácicas y abdominales. Igualmente, en el paciente trasplantado, la VMNI puede acortar el tiempo de ventilación mecánica invasiva y disminuir el riesgo de complicaciones infecciosas en estos pacientes de alto riesgo. El presente artículo recoge una revisión de la literatura detallando los aspectos técnicos, las experiencias clínicas y las recomendaciones relativas a la aplicación de la VMNI durante el período postoperatorio (AU)

Non-invasive ventilation (NIV) is a method of ventilatory support that is increasing in importance day by day in the management of postoperative respiratory failure. Its role in the prevention and treatment of atelectasis is particularly important in the in the period after thoracic and abdominal surgeries. Similarly, in the transplanted patient, NIV can shorten the time of invasive mechanical ventilation, reducing the risk of infectious complications in these high-risk patients. It has been performed A systematic review of the literature has been performed, including examining the technical, clinical experiences and recommendations concerning the application of NIV in the postoperative period (AU)

[Non-invasive mechanical ventilation in postoperative patients. A clinical review]. / Ventilación mecánica no invasiva en el postoperatorio. Revisión clínica.

Non-invasive ventilation (NIV) is a method of ventilatory support that is increasing in importance day by day in the management of postoperative respiratory failure. Its role in the prevention and treatment of atelectasis is particularly important in the in the period after thoracic and abdominal surgeries. Similarly, in the transplanted patient, NIV can shorten the time of invasive mechanical ventilation, reducing the risk of infectious complications in these high-risk patients. It has been performed A systematic review of the literature has been performed, including examining the technical, clinical experiences and recommendations concerning the application of NIV in the postoperative period.

[Non-invasive mechanical ventilation in the pre- and intraoperative period and difficult airway]. / Ventilación mecánica no invasiva en pre eintraoperatorio y vía aérea difícil.

Non-invasive mechanical ventilation is a method of ventilatory assistance aimed at increasing alveolar ventilation, thus achieving, in selected subjects, the avoidance of endotracheal intubation and invasive mechanical ventilation, with the consequent improvement in survival. There has been a systematic review and study of the technical, clinical experiences, and recommendations concerning the application of non-invasive mechanical ventilation in the pre- and intraoperative period. The use of prophylactic non-invasive mechanical ventilation before surgery that involves significant alterations in the ventilatory function may decrease the incidence of postoperative respiratory complications. Its intraoperative use will mainly depend on the type of surgery, type of anaesthetic technique, and the clinical status of the patient. Its use allows greater anaesthetic depth without deterioration of oxygenation and ventilation of patients.

Three-dimensional power Doppler color ultrasonographic features of a minimal deviation adenocarcinoma of the uterine cervix.

A case of minimal deviation adenocarcinoma of the cervix in a 34-year-old female is presented. The ultrasonographic and three-dimensional power Doppler color studies revealed a nodular cervical lesion with vascularization more prominent in the center of the nodule but also present at the periphery. The imaging diagnosis was suggestive of a myoma but with more vascularization than a conventional one.

Elaboración de videos didácticos como alternativa a los ensayos in vivo en las prácticas de farmacología / Didactic video as an alternative to in vivo assays in practical lessons of pharmacology

La Farmacología es una ciencia eminentemente práctica, en la que tiene gran relevancia la investigación "in vivo" con animales de experimentación. Los conocimientos impartidos en las clases teóricas, seminarios y tutorías, se completan con la enseñanza en las sesiones prácticas. Sin embargo, algunos aspectos importantes de esta enseñanza práctica, que incluyen la realización de ensayos “in vivo”, resulta problemático impartirlos correctamente con la normativa actual sobre la utilización de animales de laboratorio. Por ello, nos planteamos la realización de unos vídeos demostrativos de las técnicas experimentales utilizadas en algunas de las sesiones prácticas de las asignaturasde Farmacologia I y II del Grado en Farmacia. En cada sesión el profesor realiza una breve introducción del modelo experimental, indicando los objetivos que se plantea el investigador asi como las posibilidades de dicha técnica. A continuación en los vídeos, los estudiantes ven el desarrollo completo del experimento, los materiales necesarios y las condiciones experimentales adecuadas para su realización, asi como los diferentes parámetros y variables que se pueden medir. Al finalizar la proyección del vídeo se plantean dos tipos de tareas a los estudiantes:- diseño de un protocolo de evaluación de un fármaco con la metodología descrita- análisis, presentación y discusión de resultados, tras proporcionarles ejemplos de datos obtenidos en el ensayo.El procedimiento seguido para la elaboración de los vídeos es: 1) Diseño del ensayo de laboratorio. 2) Preparación del material necesario y las condiciones para una correcta grabación. 3) Grabación. Montaje de las imágenes (incluye fotografías, esquemas) y del sonido. 4) Edición del material filmado (una versión para Video- DVD y otra para incluirla en el Servidor Multimedia de la plataforma de la Universitat de València)(AU)

Pharmacology is a primarily practical science, in which “in vivo” research using experimental animal models plays a relevant role. The topics covered in the theoretical classes, seminars and tutorials are complemented with learning in practical sessions. However, certain important aspects of the practical learning, which include performing “in vivo” assays, represents a challenge given the actual regulations regarding laboratory animal utilization. Therefore, we proposed to produce didactic videos for various practical sessions. The teacher gives a brief introduction of the selected experimental animal model, indicating the intended objectives to be achieved. The students can see in the video the complete experiment progression, necessary materials and the proper experimental conditions toperform the assay, as well as the different parameters and variables to be measured.- a protocol design to evaluate a drug with the described methodology- analysis, result presentation and discussion of given example data obtained with the assay.The procedure used for the video elaboration was: 1) Design of the laboratory assay. 2) Preparation of the necessary materials and conditions for a correct recording. 3) Recording. Image (including photographs, schemes, figures) and sound download. 4) Editing of the filmed material (one version for Video- DVD and another one to be included in the virtual platform Multimedia Server of the University of Valencia)(AU)

Indicaciones autorizadas en España de los fármacos antiosteoporóticos / Indications authorised in Spain of osteoporosis drugs

No disponible

Adenocarcinoma endometrioide en pólipo endometrial / Endometrioid adenocarcinoma in an endometrial polyp

Introducción: En raras ocasiones se diagnostica un adenocarcinoma originado en un pólipo endometrial. Material y métodos: De un total de 1.989 pólipos endometriales diagnosticados en 8 años y medio, 6 presentaban un adenocarcinoma endometrioi de. Se analizan sus características clínico-patológicas y evolución. Resultados: La histeroscopia diagnosticó un pólipo en todas las pacientes, y en 3 de ellas con signos sospechosos de malignidad. En todas las ocasiones la lesión estaba confinada al pólipo y no se observó infiltración miometrial en ningún caso. Los carcinomas fueron de la variedad endometrioide, y el endometrio adyacente era normal. Todas las pacientes están vivas y libres de enfermedad tras un seguimiento medio de 45 meses (entre 6 y 96 meses). Conclusión: Los pólipos endometriales pueden albergar un adenocarcinoma que en muchas ocasiones está confinado al pólipo, y que es de bajo grado de malignidad, por lo que se puede plantear un tratamiento conservador

Introduction: Endometrial polyps bearing an adenocarcinoma are rarely diagnosed. Material and methods: Of 1989 endometrial polyps diagnosed in eight and a half years, only six showed an endometrioid adenocarcinoma. Their clinicopathologic characteristics and outcome are discussed. Results: All polyps were diagnosed by hysteroscopy. Of these, three showed signs suspicious for malignancy. In all cases, the neoplasm was confined to the polyp without myometrial infiltration. Histological type was endometrioid and the adjacent endometrium was normal. All patients are alive and disease free after a mean follow-up of 45 months (range: 6-96 months). Conclusion: Endometrial polyps can bear an adenocarcinoma, which is often confined to the polyp and of a low grade of malignancy. Conservative treatment can be considered

[Nonthermal levels of electric currents applied in capacitive electric transfer therapy provokes partial cytotoxic effects in human neuroblastoma cultures]. / Niveles atérmicos de corrientes eléctricas usadas en terapia por transferencia eléctrica capacitiva inducen efectos citotóxicos parciales en cultivos de neuroblastoma humano.

The present study investigates the cellular response to weak, sine wave, 0.5-MHz electric currents. The experimental exposure to identical signals at an intensity high enough as to significantly increase the temperature in target tissues, has provided positive responses in clinical treatments of tumors with capacitive electric transfer (CET) thermal therapy. The present results show that the in vitro exposure to CET signals at athermal doses causes cytotoxic effects in human neuroblastoma cells. Such a response seems to be due to signal-induced alterations in the cell cycle. As a whole, the results suggest that the potential therapeutic effects of the CET strategy could be due to the thermal response of the tissues to the currents, added to an athermal response of the cells to the electric current itself.

Niveles atérmicos de corrientes eléctricas usadas en terapia por transferencia eléctrica capacitiva inducen efectos citotóxicos parciales en cultivos de neuroblastoma humano / Nonthermal levels of electric currents applied in capacitive electric transfer therapy provokes partial cytotoxic effects in human neuroblastoma cultures

El presente estudio investiga la respuesta celular a corrientes eléctricas débiles, de señal sinusoidal y 0,5 MHz. La aplicación experimental de corrientes con idéntica señal, pero de intensidad suficientemente elevada como para incrementar significativamente la temperatura de los tejidos blanco, ha proporcionado respuestas satisfactorias en el tratamiento clínico de tumores cerebrales mediante terapia térmica por transferencia eléctrica capacitiva (TEC). Los resultados del presente trabajo muestran que la exposición in vitro a niveles atérmicos de señal TEC provoca efectos citotóxicos en células de neuroblastoma humano. Tal respuesta parece estar mediada por alteraciones en el ciclo celular. En su conjunto, los resultados sugieren que la potencial eficacia terapéutica de la técnica TEC podría obedecer a una acción sinérgica entre una respuesta tisular a los efectos térmicos del paso de la corriente más, una respuesta celular atérmica a la propia señal eléctrica. (AU)

Effect of some hexahydroimidazo[1,2-c]pyrimidines in inflammatory responses involving leucocytes and macrophages.

We have studied the effects of some hexahydroimidazo[1,2-c]pyrimidine derivatives (HIPs) on leucocyte functions in-vitro and we have assayed the anti-inflammatory activity of these compounds in two models of inflammation. All HIPs inhibited the human neutrophil degranulation process and superoxide generation at concentrations in the microM range. In mouse peritoneal macrophages stimulated with lipopolysaccharide, HIP-4 and HIP-5 inhibited nitrite production without affecting prostaglandin E2 (PGE2) accumulation. HIP-4 was also active in the zymosan-injected mouse air pouch model (at 100 nmol/pouch), with significant reductions in leucocyte migration and PGE2 and leukotriene B4 levels in the air pouch exudate. To confirm the anti-inflammatory effects of this compound, we tested HIP-4 orally (10-40 mg kg(-1)) on carrageenan mouse-paw oedema where it exerted a dose-dependent inhibition of paw swelling with significant reductions of myeloperoxidase and elastase activity and PGE2 levels in paw homogenates. This study demonstrates that some HIPs inhibit leucocyte functions and one of these derivatives (HIP-4) shows anti-inflammatory activity when administered by the oral route, which can be related to inhibition of leucocyte migration.