Hospital Universitario Santa Cristina

Obstructive sleep apnea (OSA), characterized by intermittent hypoxia (IH), is strongly associated with metabolic syndrome and metabolic dysfunction-associated steatotic liver disease (MASLD). IH exacerbates MASLD progression through oxidative stress, inflammation, and lipid accumulation. This study aims to investigate the impact of oxygen normalization on metabolic dysfunction in OSA patients using continuous positive airway pressure (CPAP) therapy, and in mice exposed to IH followed by a reoxygenation period. In the clinical study, 76 participants (44 OSA patients and 32 controls) were analyzed. OSA patients had higher insulin resistance, triglycerides, very low density lipoprotein (VLDL) content, and liver enzyme levels, along with a higher prevalence of liver steatosis. After 18 months of CPAP therapy, OSA patients showed significant improvements in insulin resistance, lipid profiles (total cholesterol and VLDL), liver function markers (AST and albumin), and steatosis risk scores (Fatty Liver Index and OWLiver test). In the experimental study, IH induced hepatic lipid accumulation, oxidative stress, and inflammation, and reoxygenation reversed these deleterious effects in mice. At the molecular level, IH downregulated fatty acid oxidation (FAO)-related genes, thus impairing the FAO process. Reoxygenation maintained elevated levels of lipogenic genes but restored FAO gene expression and activity, suggesting enhanced lipid clearance despite ongoing lipogenesis. Indeed, serum β hydroxybutyrate, a key marker of hepatic FAO in patients, was impaired in OSA patients but normalized after CPAP therapy, supporting improved FAO function. CPAP therapy improves lipid profiles, liver function, and MASLD progression in OSA patients. Experimental findings highlight the therapeutic potential of oxygen normalization in reversing IH-induced liver damage by FAO pathway restoration, indicating a metabolic reprogramming in the liver.

Ovarian cancer is more frequently diagnosed in post-menopausal patients, and it is considered an aggressive tumor that is usually diagnosed at an advanced stage [...].

Fray Juan Zapata y Sandoval, OESA, criollo nacido en la ciudad de México y descendiente de auditores y presidentes de audiencia, ingresó en la Orden de san Agustín en el Colegio de san Pablo de México en 1590. Doce años después en 1602 viene a España al Colegio Universitario de san Gabriel de Valladolid, donde es nombrado rector y catedrático de Teología. Trece años después, consagrado obispo, ejerce su ministerio episcopal primero en Chiapas y después en Guatemala. Su condición de criollo y su prestigio científico y humano ante el rey y sus consejeros lo convierten en obligado y preciado consultor en asuntos indianos. Fue una de las figuras quizá más destacadas del Nuevo Mundo en el estudio de dichos temas por la profundidad de sus reflexiones y la originalidad de sus tratados. Su obra es un concienzudo informe de amplia erudición sobre el gobierno de las Indias, especialmente de Nueva España, fundamentado en los ejes de la Escuela de Salamanca y elaborado desde su experiencia.

The generation of hypothyroid and hyperthyroid mouse models is one of the approaches used to investigate the complex interplay between thyroid hormones and the immune system. We present a detailed protocol describing how to induce endotoxic shock by lipopolysaccharide (LPS) administration, and how to investigate the role of immune populations, specifically macrophages, responding to endotoxemia.This book chapter provides the use of different molecular techniques, such as Western Blotting, Immunohistochemistry, q-PCR, Luciferase assays, or ChIP assays, with which researchers can gain valuable insights into the immune system's interaction with hormonal signaling pathways, for instance, examining the effect of thyroid hormones on signaling of STAT3, NF-κB, and ERK in response to LPS, and inflammatory mediators, such as interleukin-6 (IL-6) or tumor necrosis factor-alpha (TNFα) within these cells. The signaling pathways involved and the exploration of the relationship between thyroid hormones and the immune system can be analyzed using several molecular biology technologies in order to clarify their interplay in various disease states.

Objetivo: Analizar las prácticas enfermeras en hemodiálisis, a nivel nacional, en relación a la fijación de las agujas de punción de las fístulas arteriovenosas. Material y Método: Estudio descriptivo transversal, realizado en abril-mayo 2024, mediante cuestionario online, dirigido a enfermeras de hemodiálisis de toda España.Variables recogidas: sociodemográficas, tipo de centro, factores relacionados con la salida de agujas, material/técnicas de fijación y conocimiento sobre recomendaciones. Resultados: Participaron 363 enfermeras, 83,5% mujeres, edad media: 44,09±10,7años, experiencia media: 15,18±10,94 años; un 72,7% trabajaban en centros públicos.Según los encuestados, los factores que más influyen en la salida de agujas son “Estado de la piel del paciente”(96,7%) y “Técnica de fijación”(93,9%); siendo los menos influyentes “Tener un Sistema de evaluación del riesgo”(53,4%) y “Tipo de dispositivo de punción”(51%).El 35,4% empleaban técnicas de fijación Chevron y Mariposa; siendo un 55,1% si consideramos t

The postoperative period is the recovery time after surgery and is defined as an individual process whose purpose is to return the person to the state of normality and integrity that they had prior to surgery. Demonstrate the modification of the level of health of people in the early postoperative period through the development and validation of the Health Index Instrument, which is built from the Nursing Outcomes Classification (NOC) standardized language. The design used a mixed method, which involved a first phase of instrument development and a second phase of instrument validation. The methods was based on focus group techniques with text analysis techniques, internal validation with a group of care language experts, external validation with a group of clinical nursing experts and a clinical validation with quantitative and qualitative analysis. A panel of experts in Language of Care evaluated the (NOC) labels and their correlation with the 11 Health Variables to construct the instrument. The instrument developed was subjected to external validation with a panel of clinical nurse experts in post-anesthesia care. The clinical validation included a cross-sectional descriptive study in a postoperative unit. The final sample of the cross-sectional descriptive study was 139 cases. Of the 89 NOCs proposed in the preliminary construction phase of the instrument, 36 passed through the first round. Of those 36 NOCs, 25 passed through to the second round with a review performance and 11 directly as approved. The total number of approved NOCs were 4. The results of the research show that there are changes in the global score of the health level and in each health variable. It is observed that there was a significant increase in the scores of the health variables at admission and discharge (p < 0.001). The results of the data analysis show that six groups present a similar pattern of evolution of the health variables. A correlation was found between the time of stay in the unit with the scores obtained in the health variables, the physical functioning, comfort status and the presence of symptoms being particularly significant.

La Educación Ambiental aparece como asignatura transversal dentro del actual modelo educativo y nuestra labor como profesionales de la educación será proporcionar al alumnado las herramientas necesarias para convertirse en una ciudadanía responsable en el camino hacia la sostenibilidad. Este proyecto se llevará a cabo en la reserva natural de la Laguna de Zóñar entorno ideal para que el alumnado sea consciente de los problemas ambientales y adquiriera actitudes que favorezcan una sostenibilidad ecológica. Por ello, las actividades que conforman nuestra iniciativa estarán enfocadas en el trabajo de los Objetivos de Desarrollo Sostenible (Agenda 2030).

It is now an accepted principle that epigenetic alterations cause cellular dyshomeostasis and functional changes, both of which are essential for the initiation and completion of the tumor cycle. Oral carcinogenesis is no exception in this regard, as most of the tumors in the different subsites of the oral cavity arise from the cross-reaction between (epi)genetic inheritance and the huge challenge of environmental stressors. Currently, the biochemical machinery is put at the service of the tumor program, halting the cell cycle, triggering uncontrolled proliferation, driving angiogenesis and resistance to apoptosis, until the archetypes of the tumor phenotype are reached. Melatonin has the ability to dynamically affect the epigenetic code. It has become accepted that melatonin can reverse (epi)genetic aberrations present in oral and other cancers, suggesting the possibility of enhancing the oncostatic capacity of standard multimodal treatments by incorporating this indolamine as an adjuvant. First steps in this direction confirm the potential of melatonin as a countermeasure to mitigate the detrimental side effects of conventional first-line radiochemotherapy. This single effect could produce synergies of extraordinary clinical importance, allowing doses to be increased and treatments not to be interrupted, ultimately improving patients' quality of life and prognosis. Motivated by the urgency of improving the medical management of oral cancer, many authors advocate moving from in vitro and preclinical research, where the bulk of melatonin cancer research is concentrated, to systematic randomized clinical trials on large cohorts. Recognizing the challenge to improve the clinical management of cancer, our motivation is to encourage comprehensive and robust research to reveal the clinical potential of melatonin in oral cancer control. To improve the outcome and quality of life of patients with oral cancer, here we provide the latest evidence of the oncolytic activity that melatonin can achieve by manipulating epigenetic patterns in oronasopharyngeal tissue.