Caracterización epidemiológica de la artritis idiopática juvenil y refractariedad a dmard en una institución en Bogotá

La artritis idiopática juvenil (AIJ) es la enfermedad reumatológica crónica más común de la infancia con repercusiones importantes en la calidad de vida del paciente y su familia; las alteraciones físicas presentadas pueden ocasionar ausentismo escolar. Los tratamientos de uso crónico utilizados hacen que la adherencia al mismo en la población infantil y adolescente sea todo un reto. A esto se adiciona la refractariedad a DMARDs (Disease – Modifying – Antirheumatic – Drugs) que conlleva al inicio de terapia biológica y a cambios en el pronóstico de la enfermedad. Materiales y métodos: Estudio observacional retrospectivo mediante la revisión de las historias clínicas de pacientes con diagnóstico de artritis idiopática juvenil que consultaron a la Fundación Cardioinfantil desde enero del 2008 a septiembre de 2015. Se obtuvieron datos como edad, sexo, edad de diagnóstico, manejo actual, remisión, seguimiento, tratamiento, cambios realizados en el mismo y refractariedad a DMARD. Resultados: De 108 registros clínicos evaluados, 90 cumplieron los criterios de elegibilidad. Se diagnosticó con mayor frecuencia en el sexo femenino con un 57.8%, media de edad de 7.88 años. El subtipo poliarticular con Factor Reumatoideo negativo se presentó con una frecuencia con 31,1 %. El tiempo transcurrido entre el inicio de la sintomatología en meses, previo a realizar el diagnóstico, osciló entre 1 y 60 meses con una media de 10,6 meses. Se usaron con mayor frecuencia: AINES (61,1%), metotrexate (47,8%) y corticoides (42,2%). De los 90 pacientes, solo un 11.1% de la población presentó complicaciones, siendo la más frecuente la obesidad en un 3,3 % y la menos frecuente la uveítis con un 1,1%. Discusión: Es importante el entendimiento de la Artritis idiopática juvenil como una entidad de carácter sistémica, lo cual hace necesario el conocimiento de la epidemiología para establecer estrategias de manejo y seguimiento adecuadas. El género femenino continúa siendo afectado en mayor porcentaje. Se observaron leves cambios respecto al subtipo de mayor frecuencia comparado con estudios previos. Se necesitan más estudios de caracterización epidemiológica en la población Colombiana para realización de políticas de salud pública

Aproximacions sintètiques per a la preparació estereoselectiva de noves quinolil i pirazolilglicines i per a la preparació en fase sòlida de llibreries de benzotiazoles, 1,2,4-triazines i benzimidazoles

El treball experimental que ha permès redactar la present Tesi Doctoral ha estat dividit en dues parts. A la primera part es presenten els resultats referents a la síntesi estereocontrolada de noves heteroarilglicines (quinolil i pirazolilglicines) a partir de cetones acetilèniques, substrats quirals que permeten accedir a l'esquelet de diferents heterocicles (quinolines i pirazoles), la posterior obtenció dels corresponents quinolil i pirazolil--aminoalcohols i les diferents metodologies d'oxidació per tal d'accedir a les corresponents quinolil i priazolilglicines objectiu. A la segona part d'aquesta memòria s'ha estudiat, en dissolució, l'habilitat del grup alquilsulfona com a grup sortint eficaç en reaccions d'ipso-substitució nucleofilica. El desenvolupament d'aquesta reacció ha servit de punt de partida per a la creació de llibreries d'heterocicles amb alta diversitat molecular i potencial interès biològic sobre fase sòlida.

Unidades de Cuidados Continuados Integrados: uma resposta ao envelhecimento e à dependência em Portugal

A população portuguesa encontra-se num processo de envelhecimento, e tem de enfrentar esta nova realidade demográfica. Vários determinantes nomeadamente biológicos, psicológicos e sociais, foram já identificados. O aumento da prevalência de doenças crónicas e incapacitantes, como consequência directa do envelhecimento humano, tem aumentado a procura de respostas na área da saúde e ao nível social. A Rede Nacional de Cuidados Continuados Integrados (REDE) surge como resposta a esta nova problemática. Através da implementação de Unidades de Cuidados Continuados Integrados (UCCI), a REDE é uma alternativa aos internamentos nos hospitais de pessoas em situação de dependência e com necessidade de cuidados diferenciados mas sem necessidade de cuidados típicos de uma unidade de agudos. As UCCI apresentam um modelo de intervenção multidisciplinar que contempla as vertentes da saúde, social e económica dos utentes, composta por equipas multidisciplinares. Devido às especificidades da população idosa e/ou dependente, a intervenção especializada dos profissionais das UCCI, deve ser cuidadosamente preparada com base no treino e especialização, aspectos centrais do sucesso da REDE.

Funkcjonalizacja aglikonu Spiramycyny przez zastosowanie regio- i stereoselektywnych reakcji kaskadowych

Wydział Chemii

Bioremediation of acid mine drainage: an introduction to the Wheal Jane wetlands project

Acid mine drainage (AMD) is a widespread environmental problem associated with both working and abandoned mining operations. As part of an overall strategy to determine a long-term treatment option for AMD, a pilot passive treatment plant was constructed in 1994 at Wheat Jane Mine in Cornwall, UK. The plant consists of three separate systems; each containing aerobic reed beds, anaerobic cell and rock filters, and represents the largest European experimental facility of its kind. The systems only differ by the type of pre-treatment utilised to increase the pH of the influent minewater (pH<4): lime-dosed (LD), anoxic limestone drain (ALD) and lime free (LF), which receives no form of pre-treatment. The Wheal Jane pilot plant offered a unique facility and a major research project was established to evaluate the pilot plant and study in detail the biological mechanisms and the geochemical and physical processes that control passive treatment systems. The project has led to data, knowledge, models and design criteria for the future design, planning and sustainable management of passive treatment systems. A multidisciplinary team of scientists and managers from the U.K. universities, the Environment Agency and the Mining Industry has been put together to obtain the maximum advantage from the excellent facilities facility at Wheal Jane. (C) 2004 Elseaier B.V All rights reserved.

The influence of hilly terrain on canopy-atmosphere carbon dioxide exchange

Topography influences many aspects of forest-atmosphere carbon exchange; yet only a small number of studies have considered the role of topography on the structure of turbulence within and above vegetation and its effect on canopy photosynthesis and the measurement of net ecosystem exchange of CO2 (N-ee) using flux towers. Here, we focus on the interplay between radiative transfer, flow dynamics for neutral stratification, and ecophysiological controls on CO2 sources and sinks within a canopy on a gentle cosine hill. We examine how topography alters the forest-atmosphere CO2 exchange rate when compared to uniform flat terrain using a newly developed first-order closure model that explicitly accounts for the flow dynamics, radiative transfer, and nonlinear eco physiological processes within a plant canopy. We show that variation in radiation and airflow due to topography causes only a minor departure in horizontally averaged and vertically integrated photosynthesis from their flat terrain values. However, topography perturbs the airflow and concentration fields in and above plant canopies, leading to significant horizontal and vertical advection of CO2. Advection terms in the conservation equation may be neglected in flow over homogeneous, flat terrain, and then N-ee = F-c, the vertical turbulent flux of CO2. Model results suggest that vertical and horizontal advection terms are generally of opposite sign and of the same order as the biological sources and sinks. We show that, close to the hilltop, F-c departs by a factor of three compared to its flat terrain counterpart and that the horizontally averaged F-c-at canopy top differs by more than 20% compared to the flat-terrain case.

Comparing correlations of continuous observations from two independent populations using a sequential approach

A sequential study design generally makes more efficient use of available information than a fixed sample counterpart of equal power. This feature is gradually being exploited by researchers in genetic and epidemiological investigations that utilize banked biological resources and in studies where time, cost and ethics are prominent considerations. Recent work in this area has focussed on the sequential analysis of matched case-control studies with a dichotomous trait. In this paper, we extend the sequential approach to a comparison of the associations within two independent groups of paired continuous observations. Such a comparison is particularly relevant in familial studies of phenotypic correlation using twins. We develop a sequential twin method based on the intraclass correlation and show that use of sequential methodology can lead to a substantial reduction in the number of observations without compromising the study error rates. Additionally, our approach permits straightforward allowance for other explanatory factors in the analysis. We illustrate our method in a sequential heritability study of dysplasia that allows for the effect of body mass index and compares monozygotes with pairs of singleton sisters. Copyright (c) 2006 John Wiley & Sons, Ltd.

Intrinsic disorder prediction from the analysis of multiple protein fold recognition models

Motivation: Intrinsic protein disorder is functionally implicated in numerous biological roles and is, therefore, ubiquitous in proteins from all three kingdoms of life. Determining the disordered regions in proteins presents a challenge for experimental methods and so recently there has been much focus on the development of improved predictive methods. In this article, a novel technique for disorder prediction, called DISOclust, is described, which is based on the analysis of multiple protein fold recognition models. The DISOclust method is rigorously benchmarked against the top.ve methods from the CASP7 experiment. In addition, the optimal consensus of the tested methods is determined and the added value from each method is quantified. Results: The DISOclust method is shown to add the most value to a simple consensus of methods, even in the absence of target sequence homology to known structures. A simple consensus of methods that includes DISOclust can significantly outperform all of the previous individual methods tested.