At the beginning of the pandemic, we observed that lithium carbonate had a positive effect on the recovery of severely ill patients with COVID-19. Lithium is able to inhibit the replication of ...several types of viruses, some of which are similar to the SARS-CoV-2 virus, increase the immune response and reduce inflammation by preventing or reducing the cytokine storm. Previously, we published an article with data from six patients with severe COVID-19 infection, where we proposed that lithium carbonate could be used as a potential treatment for COVID-19. Now, we set out to conduct a randomized clinical trial number EudraCT 2020-002008-37 to evaluate the efficacy and safety of lithium treatment in patients infected with severe SARS-CoV-2. We showed that lithium was able to reduce the number of days of hospital and intensive care unit admission as well as the risk of death, reduces inflammatory cytokine levels by preventing cytokine storms, and also reduced the long COVID syndromes. We propose that lithium carbonate can be used to reduce the severity of COVID-19.
El objetivo de este monográfico es analizar la contribución y potencial de la Tecnología Digital en el desarrollo socioeducativo de las comunidades locales. A través de esta propuesta queremos ...contribuir a visibilizar algunos de los principales trabajos de investigación relacionados con el tema en el ámbito municipal, ofreciendo un punto de encuentro e intercambio de conocimiento sobre las posibilidades y limitaciones de la Tecnología Digital en las entidades locales (urbanas y rurales).Entendemos los municipios como un espacio desde el que enraizar y contextualizar propuestas educativas en el marco de las situaciones vivenciales más próximas a las personas y a la comunidad.
En la Sección Temática de este monográfico se presentan estos 8 artículos seleccionados de entre 33 artículos recibidos en la convocatoria, siendo 20 los trabajos seleccionados y revisados mediante evaluación ciega por pares.
Asimismo, se publican en este número 8 trabajos de investigación en Sección Abierta, dentro de las áreas de Economía, Trabajo Social, Estudios de Género y Ciencias de la Comunicación.
Abstract
ChEMBL is a large, open-access bioactivity database (https://www.ebi.ac.uk/chembl), previously described in the 2012, 2014 and 2017 Nucleic Acids Research Database Issues. In the last two ...years, several important improvements have been made to the database and are described here. These include more robust capture and representation of assay details; a new data deposition system, allowing updating of data sets and deposition of supplementary data; and a completely redesigned web interface, with enhanced search and filtering capabilities.
Obtaining artificial proteins that mimic the DNA binding properties of natural transcription factors could open new ways of manipulating gene expression at will. In this context it is particularly ...interesting to develop simple synthetic systems. Inspired by the modularity of natural transcription factors, we have designed synthetic miniproteins that combine the zinc finger module of the transcription factor GAGA and AT-hook peptide domains. These constructs are capable of binding to composite DNA sequences of up to 14 base pairs with high affinity and good selectivity. In particular, we have synthesized three different chimeras and characterized their DNA binding properties by electrophoresis and fluorescence anisotropy. We have also used, for the first time in the study of peptide-based DNA binders, nanopore force spectroscopy to obtain further data on the DNA interaction.
Soil particle size and land management practices are known to have considerable influence on carbon (C) storage in soils, but such information is lacking for silvopastoral systems in Spain. This ...study quantified the amounts of soil C stored at various depths to 100 cm under silvopastoral plots of radiata pine (Pinus radiata D. Don) and birch (Betula pendula Roth) in comparison to treeless pasture in Galicia, Spain. Soils were fractionated into three size classes (<53, 53–250, and 250–2000 μm), and C stored in them and in the whole (nonfractionated) soil was determined. Overall, the C stock to 1 m ranged from 80.9 to 176.9 Mg ha−1 in these soils. Up to 1 m depth, 78.82% of C was found in the 0‐ to 25‐cm soil depth, with 12.9, 4.92, and 3.36% in the 25‐ to 50‐, 50‐ to 75‐, and 75‐ to 100‐cm depths, respectively. Soils under birch at 0 to 25 cm stored more C in the 250‐ to 2000‐μm size class as compared with those under radiata pine; at that depth, pasture had more C than pine silvopasture in the smaller soil fractions (<53 and 53–250 μm). In the 75‐ to 100‐cm depth, there was significantly more storage of C in the 250‐ to 2000‐μm fraction in both silvopastures as compared with the pasture. The higher storage of soil C in larger fraction size in lower soil depths of silvopasture suggests that planting of trees into traditional agricultural landscapes will promote longer‐term storage of C in the soil.
To estimate the associations between gestational weight gain (GWG) during pregnancy and neonatal outcomes in low and middle income countries.
Individual participant data meta-analysis.
Prospective ...pregnancy studies from 24 low and middle income countries.
Nine neonatal outcomes related to timing (preterm birth) and anthropometry (weight, length, and head circumference) at birth, stillbirths, and neonatal death.
A systematic search was conducted in PubMed, Embase, and Web of Science which identified 53 prospective pregnancy studies published after the year 2000 with data on GWG, timing and anthropometry at birth, and neonatal mortality. GWG adequacy was defined as the ratio of the observed maternal weight gain over the recommended weight gain based on the Institute of Medicine body mass index specific guidelines, which are derived from data in high income settings, and the INTERGROWTH-21st GWG standards. Study specific estimates, adjusted for confounders, were generated and then pooled using random effects meta-analysis models. Maternal age and body mass index before pregnancy were examined as potential modifiers of the associations between GWG adequacy and neonatal outcomes.
Overall, 55% of participants had severely inadequate (<70%) or moderately inadequate (70% to <90%) GWG, 22% had adequate GWG (90-125%), and 23% had excessive GWG (≥125%). Severely inadequate GWG was associated with a higher risk of low birthweight (adjusted relative risk 1.62, 95% confidence interval 1.51 to 1.72; 48 studies, 93 337 participants; τ
=0.006), small for gestational age (1.44, 1.36 to 1.54; 51 studies, 93 191 participants; τ
=0.016), short for gestational age (1.47, 1.29 to 1.69; 40 studies, 83 827 participants; τ
=0.074), and microcephaly (1.57, 1.31 to 1.88; 31 studies, 80 046 participants; τ
=0.145) compared with adequate GWG. Excessive GWG was associated with a higher risk of preterm birth (1.22, 1.13 to 1.31; 48 studies, 103 762 participants; τ
=0.008), large for gestational age (1.44, 1.33 to 1.57; 47 studies, 90 044 participants; τ
=0.009), and macrosomia (1.52, 1.33 to 1.73; 29 studies, 68 138 participants; τ
=0) compared with adequate GWG. The direction and magnitude of the associations between GWG adequacy and several neonatal outcomes were modified by maternal age and body mass index before pregnancy.
Inadequate and excessive GWG are associated with a higher risk of adverse neonatal outcomes across settings. Interventions to promote optimal GWG during pregnancy are likely to reduce the burden of adverse neonatal outcomes, however further research is needed to assess optimal ranges of GWG based on data from low and middle income countries.
The diagnostic and therapeutic strategy in severe lower gastrointestinal bleeding (LGIB) varies depending on the patient's clinical situation. Actual clinical practice guidelines propose different ...management strategies. We aim to know the attitude of the gastroenterologists from different hospitalary centers in the management of this entity.
Descriptive and observational study using an on-line questionnaire, addressed to gastroenterologists in Spain and Latin America, in December 2021.
We included 281 anonymous questionnaires of gastroenterologists from Spain and Latin America. Diagnostic and therapeutic management of severe LGIB was heterogeneous among the participants. Regarding to the first diagnostic modalities they showed variability between performing computed tomography angiography (CTA) (44.5%), gastroscopy (33.1%), colonoscopy (20.6%) and arteriography (1.1%). The therapeutic attitude after a positive CTA mostly varied between performing arteriography (38.1%) and colonoscopy (44.1%). If negative CTA, in the majority of cases a gastroscopy was performed. If the patient needed intensive critical unit (ICU) care and to undergo colonoscopy, most participants performed an urgent colonoscopy (<24h) (31% always, 43.4% in most cases); while if the patient did not require ICU admission this percentage was lower (10% always, 33.8% in most cases). The 40.9% of the participants admitted having doubts about the management of this patients and the 98.2% considered the need for a creation of an action protocol.
There is a high interhospitalary variability on the management of severe lower gastrointestinal bleeding among gastroenterologists. It is necessary to unify the diagnostic and therapeutic management of this pathology.
The Spanish Registry of Acute Aortic Syndrome (RESA) was launched in 2005 to identify the characteristics of acute aortic syndrome (AAS) in Spain. The aim of this study was to analyze the differences ...in management and mortality in the 3 RESA iterations.
We analyzed data from patients with AAS prospectively included by 24 to 30 tertiary centers during the 3 iterations of the registry: RESA I (2005-2006), RESA-II (2012-2013), and RESA III (2018-2019).
AAS was diagnosed in 1902 patients (74% men; age, 60.7±12.5 years): 1329 (69.9%) type A and 573 (30.1%) type B. Comparison of the 3 periods revealed that the use of computed tomography increased as the first diagnostic technique (77.1%, 77.9%, and 84.2%, respectively; P=.001). In type A, surgical management increased (79.6%, 78.7%, and 84.5%; P=.045) and overall mortality decreased (41.2%, 34.5%, and 31.2%; P=.002), due to a reduction in surgical mortality (33.4%, 25.1%, and 23.9%; P=.003). In type B, endovascular treatment increased (22.8%, 32.8%, and 38.7%; P=.006), while medical and surgical treatment decreased. Overall type B mortality also decreased (21.6%, 16.1%, and 12.0%; P=.005) in line with a reduction in mortality with medical (16.8%, 13.8%, and 8.8%, P=.030) and endovascular (27.0%, 18.0%, and 9.2%; P=.009) treatments.
The iterations of RESA show a decrease in mortality from type A AAS, coinciding with an increase in surgical treatment and a reduction in surgical mortality. In type B, the use of endovascular treatment was associated with improved survival, allowing better management in patients with complications.
El Registro Español del Síndrome Aórtico Agudo (RESA) se inició en 2005 para valorar las características del síndrome aórtico agudo (SAA) en nuestro país. El objetivo es analizar las diferencias en las características, el abordaje y el tratamiento y la mortalidad observadas entre las 3 ediciones del RESA.
Se analizaron los datos de los pacientes con SAA incluidos prospectivamente por 24-30 hospitales terciarios en las 3 ediciones: RESA I (2005-2006), RESA II (2012-2013) y RESA III (2018-2019).
Se incluyó a 1.902 pacientes (el 74% varones; media de edad, 60,7± 12,5 años), 1.329 (69,9%) tipo A y 573 (30,1%) tipo B. Comparando los RESAS, la tomografía computarizada aumentó como técnica diagnóstica (el 77,1, el 77,9 y el 84,2% respectivamente; p=0,001). El tratamiento quirúrgico del SAA tipo A aumentó (el 79,6, el 78,7 y el 84,5%; p=0,045) y la mortalidad total disminuyó (el 41,2, el 34,5 y el 31,2%; p=0,002), coincidiendo con una reducción de la mortalidad quirúrgica (el 33,4, el 25,1 y el 23,9%; p=0,003). En el tipo B, el tratamiento endovascular aumentó (el 22,8, el 32,8 y el 38,7%; p=0,006). La mortalidad total del SAA tipo B disminuyó (el 21,6, el 16,1 y el 12,0%; p=0,005) como consecuencia de la reducción de la mortalidad de los tratamientos médico (el 16,8, el 13,8 y el 8,8%; p=0,030) y endovascular (el 27,0, el 18,0 y el 9,2%; p=0,009).
El RESA evidencia una disminución de la mortalidad del SAA tipo A coincidiendo con un incremento del tratamiento quirúrgico y una reducción de su mortalidad. En el SAA tipo B, el tratamiento endovascular se asocia con un aumento de la supervivencia, ya que permite una mejor estrategia terapéutica para los pacientes con complicaciones.
Background
Irritable bowel syndrome (IBS) is a functional disorder that leads to abdominal pain; its diagnosis is based on Rome IV criteria (recurrent abdominal pain at least 1 day per week in the ...last 3 months with more than two of the following: related to defecation, associated with a change in stool frequency and/or with a change in stool appearance).
Objective
To characterize an outpatient population diagnosed with IBS in Colombia during 2017–2018.
Methods
A cross-sectional study based on a review of clinical records of patients with a primary diagnosis of IBS. A representative sample of 380 individuals was recruited from a population of 38,182 people with a new diagnosis of IBS from a drug-claim database. Sociodemographic, clinical (symptoms, type of IBS, alarm features, etc.), treatment (pharmacological or not), and follow-up variables (for those with additional medical care at 3–12 months) were analyzed. The diagnosis and treatment used in the consultation were compared with clinical guidelines.
Results
Most of the 380 patients were women (
n
= 238; 62.6%), and the mean age was 40.1 ± 15.0 years. None of the physicians recorded the Rome IV criteria in the medical records. Unclassified IBS was the most prevalent subtype (
n
= 311; 81.8%), and the main symptom was abdominal pain (
n
= 327; 86.1%). Only 73 patients (19.2%) had follow-up data. The most frequently used drugs were aluminum hydroxide (
n
= 203; 53.4%) and hyoscine
N
-butyl bromide (
n
= 200; 52.6%). Regarding drugs included in the clinical practice guidelines, 19 people received loperamide (5.0%), 3 received trimebutine (0.8%), and 1 received sertraline (0.3%).
Conclusions
The patients were diagnosed without clearly established criteria, and they were treated symptomatically with little follow-up.
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