Abstract: The European building stock is responsible for 36% of greenhouse gas emissions and 40% of energy consumption, and its rehabilitation would reduce consumption by 26%. In addition to the economic benefits of this reduction, such as its incidence in reducing energy poverty, energy efficient homes imply co-benefits in terms of comfort and health of their inhabitants; however, households are not aware of this, which, together with other barriers, discourages obtaining efficient housing. This work seeks to know the importance that households give to the benefits and co-benefits associated with energy efficiency; understand if it is homogeneous among these, and identify its correlation with its sociodemographic characteristics. To do this, a survey is carried out on a sample of households in Barcelona. Through a multivariate analysis, the patterns of relevance given to the different advantages and their statistical association with the sociodemographic characteristics of the households are identified. The results suggest that the importance of these benefits is heterogeneous. Older and higher-income people value more co-benefits such as health, comfort and environmental conservation, but younger and lower-income people value savings more.

Resumen: El parque edificado europeo es responsable del 36% de las emisiones de gases de efecto invernadero y del 40% del consumo de energía y su rehabilitación reduciría un 26% del consumo. Además de los beneficios económicos de esta reducción, como su incidencia en reducir la pobreza energética, las viviendas energéticamente eficientes implican co-beneficios en el confort y la salud de sus habitantes; sin embargo, los hogares no son conscientes de ello, lo que, aunado a otras barreras, desincentiva la obtención de viviendas eficientes. Este trabajo persigue conocer la importancia que otorgan los hogares a los beneficios y co-beneficios asociados a la eficiencia energética; entender si es homogénea entre éstos e identificar su correlación con sus características sociodemográficas. Para ello, se realiza una encuesta a una muestra de hogares de Barcelona. Mediante un análisis multivariante, se identifican los patrones de la relevancia otorgada a las distintas ventajas y su asociación estadística con las características sociodemográficas de los hogares. Los resultados sugieren que la importancia de estos beneficios es heterogénea. Las personas mayores y de mayor renta aprecian más co-beneficios como la salud, el confort y la conservación medioambiental, pero las personas más jóvenes y de menor renta valoran más los ahorros.

Abstract So far, the data collected in the cases of clinical processes caused by the SARS-CoV-2 (COVID-19) coronavirus in children suggest that they are mild compared to infections in adult patients; However, serious cases such as multisystemic inflammatory syndrome (SIM) have been reported, which requires assessment and emergency action. In the context of the of the Primary Care pediatrician consultation and coinciding with the beginning of the school year, at a time when the incidence of influenza, RSV infection and other respiratory conditions usually increases, consultations for symptoms that can lead to suspect these infections. Therefore, it is important to reach a diagnosis that allows the most appropriate management of the patient and decreasing the community transmission by taking pertinent measures. Given that there are no valid scales that offer a score to assess which is the most appropriate action in the event of a suspected COVID-19 infection, we propose the benefits of a clinical decision algorithm that takes into account epidemiological connotations, based on clinical severity to offer the most appropriate clinical care to patients.

Resumen Hasta ahora, los datos recogidos en los casos de procesos clínicos provocados por el coronavirus SARS-CoV-2 (COVID-19) en niños sugieren que son cuadros leves en comparación con las infecciones en pacientes adultos; no obstante, se ha informado de casos graves, como el síndrome inflamatorio multisistémico (SIM), que precisa de valoración y actuación de emergencia. En el contexto de la consulta del pediatra de Atención Primaria y coincidiendo con el inicio del curso escolar, en una época en la que habitualmente aumenta la incidencia de procesos como la gripe, infección por el virus respiratorio sincitial (VRS) y otros cuadros respiratorios, es habitual la demanda por síntomas que pueden hacer sospechar cualquiera de estas infecciones. En este sentido, es importante llegar a un diagnóstico que permita el manejo más adecuado del paciente. Epidemiológicamente, de manera que se pueda disminuir la transmisión comunitaria tomando las medidas adecuadas y clínicamente para así poder ponderar el nivel de gravedad y poner en marcha las actuaciones más adecuadas. Dado que no existen escalas válidas que ofrezcan un puntaje para valorar cuál es la actuación más adecuada ante la sospecha de una infección COVID-19, planteamos los beneficios de un algoritmo de decisión clínica que tiene en cuenta las connotaciones epidemiológicas, basado en la gravedad clínica, para ofrecer la atención clínica más adecuada a los pacientes.

Resumo: Esta pesquisa tem como objetivo, por um lado, explorar as percepções das atletas sobre como são avaliadas pelo seu ambiente social em relação à feminilidade e sua orientação sexual, para vincular-se a uma prática esportiva de alto desempenho e, por outro, analisar a visibilidade e aceitação da homossexualidade no contexto esportivo, tanto pelos atletas como pelos agentes sociais ao seu redor. A metodologia foi qualitativa. Foram feitos cinco grupos focais nos quais participaram 46 mulheres praticando futsal, handebol, vôlei, atletismo e natação. Os resultados mostram que as atletas apresentam um discurso de resistência contra o estereótipo da "Maria-João" o "sapatão" que, verificamos, ainda está em vigor na imaginação coletiva. Embora os avanços sociais sejam percebidos nesse sentido, a homossexualidade permanece estigmatizada e ainda persistem as formas de rejeição cognitivo-afetiva em parte da sociedade espanhola.

Abstract: On the one hand, this research aims to explore the perceptions of women practicing high-performance sports about how they are viewed by their social environment in terms of their femininity and sexual orientation. On the other hand, it analyzes the visibility and acceptance of homosexuality in the sports context by both athletes and the social agents surrounding them. The research methodology was qualitative, with five focus groups including 46 women who practiced futsal, handball, volleyball, athletics and swimming. Results show that they present a resistance-oriented discourse against butch-lesbian stereotypes that, as we prove, are still present in collective imagination. Despite social advances perceived in this regard, homosexuality remains stigmatized and forms of cognitive-affective rejection persist in part of Spanish society.

Resumen: Esta investigación tiene como objetivos, por un lado, explorar las percepciones de las deportistas acerca de cómo son evaluadas por su entorno social con relación a la feminidad y a su orientación sexual por su vinculación con una práctica deportiva de alto rendimiento. Por otro, analizar la visibilidad y aceptación de la homosexualidad en el contexto deportivo tanto por las deportistas como por los agentes sociales que las rodean. La metodología fue de tipo cualitativo. Se llevaron a cabo cinco grupos focales en los que participaron 46 mujeres practicantes de futbol sala, balonmano, voleibol, atletismo y natación. Los resultados muestran que las deportistas presentan un discurso de resistencia frente al estereotipo de marimacho-lesbiana que, comprobamos, continúa vigente en el imaginario colectivo. A pesar de que se perciben avances sociales en este sentido, la homosexualidad sigue estigmatizada y aún persisten formas de rechazo cognitivo-afectivo en parte de la sociedad española.

ABSTRACT Background and aims: infliximab has changed the natural history of inflammatory bowel disease (IBD). The advent of biosimilar treatments such as CT-P13 will hopefully improve the availability of biological therapies. Data with regard to drug switching are currently limited. The objective of the study was to assess the effectiveness and safety of switching from the reference product (RP), infliximab, to CT-P13 in patients with IBD. Methods: this was a multicenter prospective observational study in patients with Crohn's disease (CD) and ulcerative colitis (UC). All patients had switched from infliximab RP (Remicade(r)) to CT-P13 treatment and were followed up for 12 months. The efficacy endpoint was the change in clinical remission assessed at 0 and 12 months, according to the Harvey-Bradshaw score and partial Mayo score for patients with CD and UC, respectively. Adverse events were monitored and recorded throughout the study. Results: a total of 167 patients (116 CD/51 UC) were included; 88.8% (103/116) of patients with CD were in remission at the time of the drug switch and 69.7% were in remission at 12 months. The Harvey-Bradshaw (HB) score significantly changed at 12 months (p = 0.001); 84.3% (43/51) of patients with UC were in remission at the time of the drug switch and 76.7% were in remission at 12 months. No significant changes in the median partial Mayo score (p = 0.87) were observed at 12 months. Serious adverse events related to medication were reported in 12/167 (7.2%) cases. Conclusion: switching from infliximab RP to CT-P13 is safe and effective at 12 months. The loss of efficacy at 12 months was 15.7%.

Background: The incidence of inflammatory bowel disease is increasing in Europe and in Spain. However, there is no recent data from Southern Spain. Objectives: To determine the evolution of the hospital incidence of inflammatory bowel disease in Southern Spain. Material and methods: A retrospective study was performed in two hospitals in Southern Spain. Data was collected from inflammatory bowel disease patients, divided into two periods (1995-2000 and 2001-2014) and compared. The reference population from both areas was 1,011,555 inhabitants. Results: A total of 430 patients were registered during the first period (1995-2000); 50% (215) had Crohn's disease that resulted in a cumulative incidence rate of 7.08 cases/100,000 inhabitants per year. The overall inflammatory bowel disease incidence was 3.54 cases/100,000 inhabitants per year. During the second period (2001-2014), 2,089 patients were collected; 51.7% had ulcerative colitis (1,081). The rate of cumulative incidence of inflammatory bowel disease was 14.7 cases/100,000 inhabitants per year (7.6 cases of ulcerative colitis/100,000 inhabitants/year and 7.1 cases of Crohn's disease/100,000 inhabitants/year). Conclusions: The incidence of inflammatory bowel disease in Southern Spain has doubled in the last decade and is similar to that of the rest of the country and Europe.

Abstract Genetic defects affecting the remethylation pathway cause hyperhomocysteinemia. Isolated remethylation defects are caused by mutations of the 5, 10-methylenetetrahydrofolate reductase (MTHFR), methionine synthase reductase(MTRR), methionine synthase(MTR), and MMADHC genes, and combined remethylation defects are the result of mutations in genes involved in the synthesis of either methylcobalamin or adenosylcobalamin, that is, the active cofactors of MTRR and methylmalonyl-CoA mutase. Diagnosis is based on the biochemical analysis of amino acids, homocysteine, propionylcarnitine, methylmalonic acid, S-adenosylmethionine, and 5-methylentetrahydrofolate in physiological fluids. Gene-by-gene Sanger sequencing has long been the gold standard genetic analysis for confirming the disorder and identifying the gene involved, but massive parallel sequencing is now being used to examine all those potentially involved in one go. Early treatment to rescue metabolic homeostasis is based on the following of an appropriate diet, betaine administration, and, in some cases, oral or intramuscular administration of vitamin B12 or folate. Elevated ROS levels, apoptosis, endoplasmic reticulum (ER) stress, the activation of autophagy, and alterations in Ca2+ homeostasis may all contribute toward the pathogenesis of the disease. Pharmacological agents to restore the function of the ER and mitochondria and/or to reduce oxidative stress-induced apoptosis might provide novel ways of treating patients with remethylation disorders.

In a professional non-assistential healthcare subjected to intense workloads, the nursing team in the pharmacy of a second-level hospital begins a thoughtful process with nursing's own methodological resources. Object: Propose the Nursing Process as a capable tool of increasing professional motivation and reduce the moral suffering of nurses performing work without welfare functions. Method: Descriptive Study of Nursing Process applied to the job performance of a nursing team in risk of burnout, from april 14, 2010 to december 31, 2013, by establishing a Nursing Diagnosis, Care Plan, Interventions and Evaluations. Main results: Application of the Nursing Process to the Nursing team itself proved to be effective in order to face a difficult situation successfully, turning it into a dynamic and positive process. Identify the Nursing Diagnosis at risk of discouragement and burnout allows for the implementation of a Care Plan and scheduled interventions with effective measures to increase resilience and decrease burnout. Main conclusión: Nurse Process can be a powerful tool in care practice as well as in facing adverse situations by the nursing team. So is assessed the patient care, may be valued the nursing environment at professional risk.

En un entorno profesional sin pacientes y sometido a intensas cargas de trabajo, el equipo de enfermeras en la Farmacia en un Hospital de segundo nivel inicia un proceso reflexivo con herramientas metodológicas propias de su profesión. Objetivo: Proponer el Proceso Enfermero como herramienta capaz de incrementar la motivación profesional, y reducir el sufrimiento moral de enfermeras realizando trabajos desprovistos de funciones asistenciales. Método: Estudio descriptivo del Proceso Enfermero aplicado al desempeño laboral de un equipo de enfermeras en riesgo de burnout, desde el 14 de abril de 2010 al 31 de diciembre de 2013, estableciendo Diagnóstico de Enfermería, Plan de Cuidados, Intervenciones y Evaluaciones. Principales resultados: La aplicación del Proceso Enfermero al propio equipo de Enfermería transformó una situación difícil en un proceso dinámico y positivo, al identificar el diagnóstico de riesgo de desmotivación, e implementar un Plan de Cuidados e Intervenciones que resultaron ser efectivas para reforzar la resiliencia y reducir el riesgo de burnout. Conclusión principal: El Proceso Enfermero puede ser una herramienta potente para afrontar situaciones adversas del equipo de Enfermería. Al igual que se evalúan los pacientes, puede ser valorada la función laboral del equipo de enfermeras en situación de riesgo de deterioro profesional.

En el trabajo se presenta un estudio de cómo la nueva configuración del patrimonio neto establecida en las NIIF/NIC y la adaptación de la normativa contable española a las mismas pueden causar modificaciones en la cifra de capital social de las cooperativas y, por tanto, en sus fondos propios, con la incidencia que ello supone en diversas operaciones societarias.

Cet article présente une étude de la façon dont la nouvelle configuration de l'actif net, établie dans les IFRS/IAS, et l'adaptation de la norme comptable espagnole a leur égard, peuvent entraîner des changements dans le capital social des coopératives et, par conséquent, dans leurs propres fonds, avec l'impact résultant sur plusieurs opérations sociétaires.

This paper presents a study on how the new equity configuration established in the IFRS/IAS and the adaptation of the Spanish accounting regulations, can cause changes in the share capital of cooperative unions and, as consequence, in their own funds, with an expected impact of these in various societary operations.

Neste trabalho, apresenta-se um estudo de como a nova configuração do patrimônio líquido estabelecida nas NIIF/NIC e a adaptação da normativa contábil espanhola a estas podem causar modificações na cifra de capital social das cooperativas e, portanto, em seus fundos próprios, com a incidência que isso supõe em diversas operações societárias.

Se estudiaron los parámetros farmacocinéticos de las especies de antimonio (pentavalente y trivalente) presentes en el antimoniato de meglumina (Glucantime®), en cuatro perros sanos, después de la administración subcutánea de una dosis única de 90 mg/kg-1. Las muestras sanguíneas fueron analizadas por espectroscopia de absorción atómica. Después de la administración de Glucantime®, el antimonio pentavalente mostró un decaimiento en dos fases, la vida media de eliminación fue de 13,18 h, el volumen aparente de distribución de 30,65 Lkg-1, el área bajo la curva (0-24h) 48,25 μg. h mL-1 y el área bajo la curva (0-∞) μg.h mL-1. Mientras que el antimonio trivalente mostró una fase bien distinguida, con una vida media de eliminación de 16,10 h, un volumen aparente de distribución de 126,5 Lkg-1, valores de el área bajo la curva (0-24h) 10,35 μg.h mL-1 y el área bajo la curva (0-∞) 17,35 μg.h mL-1. El porcentaje de conversión sistémica de antimonio pentavalente hacia antimonio trivalente a las 24 horas fue de 23,62%. A pesar del reducido tamaño de la muestra, los resultados obtenidos presentan desigualdad en la farmacocinética de las especies de antimonio en perros, estas podrían explicar, al menos parcialmente, las diferencias en la eficacia terapéutica atribuidas a las especies por separado.

The pharmacokinetic parameters species of antimony present in Glucantime® was studied, in four healthy dogs, following subcutaneous administration of single dose 90 mg/kg-1. Blood samples were analyzed by atomic absorption spectroscopy. After administration, the pentavalent antimony showed decay in two phases, half-life was 13.18 h, volume of distribution Vd of 30,65 Lkg-1, area under curve(0-24h) 48.25 μg. h mL-1 y area under curve(0-∞) 63.55 μg.h mL-1. The trivalent antimony showed one phase well distinguished, the half- life was 16.10 h, volume of distribution of 126.5 Lkg-1, area under curve(0-24h) 10.35 μg.h mL-1 and area under curve(0-∞) 17.35 μg.h mL-1. The systemic conversion of pentavalent antimony to trivalent antimony at 24 hours was 23.62%. The present study was limited by its small sample size, whatever the results obtained revealed a difference in the pharmacokinetics of pentavalent and trivalent antimony in dogs, this might explain, in part, the therapeutic efficacy differences found with separated species.

La aciduria metilmalónica es una acidemia orgánica, autosómica recesiva, causada por la deficiencia de la metilmalonil CoA-mutasa, o por defectos en la biosíntesis del cofactor adenosilcobalamina. Del defecto enzimático, existen dos formas: mut(o) sin actividad enzimática y mut(-) con actividad reducida. Su presentación clínica puede variar desde una forma neonatal grave con acidosis y muerte, hasta una forma crónica progresiva. A continuación se describe el caso de un niño de 4 años de edad, con deficiencia de metilmalonil-CoA mutasa tipo mut(-), que se presentó en forma aguda. El estudio molecular del gen MUT mostró 2 mutaciones c.607G>A (G203R) y c.2080C > T(R694W), confirmadas posteriormente en los padres. El objetivo de este reporte es destacar la importancia de indicar el análisis de ácidos orgánicos en orina entre los estudios de primera línea, en todo niño con un cuadro clínico de presentación aguda y severamente enfermo, sin etiología definida. Por otra parte, se desea resaltar que el diagnóstico oportuno y definitivo es importante ya que permite iniciar un tratamiento específico, lograr una evolución favorable y prevenir las secuelas.

The methylmalonic aciduria is an organic acidemia, inherited as autosomic recessive trait, caused by a deficiency of the methylmalonyl-CoA mutase, or by defects in the biosynthesis of the cofactor adenosylcobalamin. Regarding the enzymatic defect, there are two forms: mut(o) with no detectable enzymatic activity and mut(-) with reduced activity. Its clinical presentation may vary from a severe neonatal form with acidosis and death, up to a progressive chronic form. Here we describe the case of a four year-old boy, with diagnosis of methylmalonyl-CoA mutase deficiency type mut(-) with an acute presentation. Molecular analysis of MUT gene identified two mutations c.607G>A (G203R) and c.2080C>T (R694W), later confirmed in the parents. The aim of this report is to highlight the importance of including the organic acid analysis in urine among the first line exams in acutely and severely ill children with undefined etiology. The definitive diagnosis is important because it may allow a specific treatment and a favorable evolution to prevent the secuelae.