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Programa de Doctorado en Derecho por la Universidad Carlos III de Madrid Presidente: Luciano José Parejo Alfonso.- Secretario: Juan Rosa Moreno.- Vocal: Javier Guillén Carames

OBJECTIVE: This study aimed to assess the impact of obesity on nonrespiratory complications in patients dying with coronavirus disease (COVID-19). METHODS: Medical charts of 3,694 of patients dying with COVID-19 in Italy were reviewed to extract information on demographics, preexisting comorbidities, and in-hospital complications leading to death. Multivariate logistic regressions were performed to assess the association of obesity with nonrespiratory complications. These analyses were adjusted for age, gender, and number of preexisting comorbidities. RESULTS: Obesity was present in 411/3,694 (11.1%) patients dying with COVID-19. Obesity was significantly associated with increased probability of experiencing acute renal failure (adjusted odds ratio [OR], 1.33; 95% CI: 1.04-1.71) and shock (adjusted OR, 1.54; 95% CI: 1.19-1.99). The associations of obesity with acute renal failure and shock were stronger in patients aged < 60 years (adjusted OR, 2.00; 95% CI: 1.09-3.67 and OR, 2.37; 95% CI 1.29-4.36) than in those aged 60 years or older (adjusted OR, 1.20; 95% CI: 0.90-1.60 and OR, 1.22; 95% CI: 0.91-1.65). CONCLUSIONS: In patients dying with COVID-19 in Italy, obesity is associated with an increased probability of nonrespiratory complications, particularly shock and acute renal failure. These associations seem stronger in younger than in older adults. Strategies should be put in place in patients with COVID-19 with obesity to prevent these complications.

Background Aim of the present study is to describe characteristics of COVID-19-related deaths and to compare the clinical phenotype and course of COVID-19-related deaths occurring in adults ( Method Medical charts of 3,032 patients dying with COVID-19 in Italy (368 aged < 65 years and 2,664 aged ≥65 years) were revised to extract information on demographics, preexisting comorbidities, and in-hospital complications leading to death. Results Older adults (≥65 years) presented with a higher number of comorbidities compared to those aged Conclusions Individuals dying with COVID-19 present with high levels of comorbidities, irrespective of age group, but a small proportion of deaths occur in healthy adults with no preexisting conditions. Non-respiratory complications are common, suggesting that the treatment of respiratory conditions needs to be combined with strategies to prevent and mitigate the effects of non-respiratory complications.

Protection of early development contributes to health of next generations. Congenital anomalies (and other adverse reproductive outcomes) are an important public health issue and early indicator of public health risks, as early development is influenced by many risk factors (e.g., nutrition, lifestyles, pollution, infections, medications, etc). Effective primary prevention requires an integrated "One Health" approach, linking knowledge and action. This requires surveillance of health events and potential health-damaging factors, science-based risk analysis, citizens' empowerment and education of health professionals. From the policy standpoint, joint budgeting mechanisms are needed to sustain with equity intersectoral actions (involving policy domains of health, social affairs, education, agriculture and environment). States should devote resources to strengthen registries and systematic data collection for surveillance of congenital anomalies, to better inform national prevention strategies. Investing in primary prevention based on scientific evidence is essential to support sustainable and resilient health systems and sustainable development of the society. This research was supported by the Health Programme of European Union, in the framework of the Joint Action for Rare Diseases, Project n. 677024 “Promoting Implementation of Recommendations on Policy, Information and Data for Rare Diseases – RD-ACTION” Sí

The Mexican energy reform in December 2013 has representeda radical change in the structure of the sector, which has grown from a public monopoly to a competitive market. This article aims to analyze the attributions and the legal and administrative nature which has be granted to the Energy Regulatory Commission (CRE) after the normative change that will play a key role in the correct implementation thereof. The nodal problem is to confirm if the CRE has being given the correct legal instrumentsto develop its function autonomously and transparently. La reforma energética mexicana de diciembre de 2013 harepresentado un cambio radical en la estructuración del sector, el cual ha pasado de ser un monopolio público a un mercado de libre competencia. El presente artículo tiene como objetivo analizar las atribuciones y la naturaleza jurídico administrativa que se ha concedido a la Comisión Reguladora de Energía (CRE) tras el cambio normativo, dado que este, en calidad de organismo regulador del sector, tendrá un rol fundamental en la correcta implementación de la misma. El problema nodal de la cuestión reside en corroborar si se ha dotado a la CRE de los correctos instrumentos jurídicos para desenvolver su función de forma autónoma y transparente.

Molecular differentiation between benign (follicular thyroid adenoma (FTA)) and malignant (follicular thyroid carcinoma (FTC)) thyroid neoplasms is challenging. Here, we explored the genome-wide DNA methylation profile of FTA (n.10) and FTC (n.11) compared to normal thyroid (NT) (n.7) tissues. FTC featured 3564 differentially methylated CpGs (DMCpG), most (84%) of them hypermethylated, with respect to normal controls. At the principal component analysis (PCA), the methylation profile of FTA occupied an intermediate position between FTC and normal tissue. A large fraction (n. 2385) of FTC-associated DMCpG was related (intragenic or within 1500 bp from the transcription start site) to annotated genes (n. 1786). FTC-hypermethylated genes were enriched for targets of the Polycomb transcriptional repressor complex and the specific histone H3 marks (H3K4me2/me3-H3K27me3) found in chromatin domains known as ‘bivalent’. Transcriptome profiling by RNAseq showed that 7.9% of the DMCpGs-associated genes were differentially expressed in FTC compared to NT, suggesting that altered DNA methylation may contribute to their altered expression. Overall, this study suggests that perturbed DNA methylation, in particular hypermethylation, is a component of the molecular mechanisms leading to the formation of FTC and that DNA methylation profiling may help differentiating FTCs from their benign counterpart.

PMID:22919068.-- et al., Anaplastic thyroid carcinoma (ATC) is a very aggressive thyroid cancer. forkhead box protein M1 (FOXM1) is a member of the forkhead box family of transcription factors involved in control of cell proliferation, chromosomal stability, angiogenesis, and invasion. Here, we show that FOXM1 is significantly increased in ATCs compared with normal thyroid, well-differentiated thyroid carcinomas (papillary and/or follicular), and poorly differentiated thyroid carcinomas (P=0.000002). Upregulation of FOXM1 levels in ATC cells was mechanistically linked to loss-of-function of p53 and to the hyperactivation of the phosphatidylinositol-3-kinase/AKT/FOXO3a pathway. Knockdown of FOXM1 by RNA interference inhibited cell proliferation by arresting cells in G2/M and reduced cell invasion and motility. This phenotype was associated with decreased expression of FOXM1 target genes, like cyclin B1 (CCNB1), polo-like kinase 1 (PLK1), Aurora B (AURKB), S-phase kinase-associated protein 2 (SKP2), and plasminogen activator, urokinase: uPA (PLAU). Pharmacological inhibition of FOXM1 in an orthotopic mouse model of ATC reduced tumor burden and metastasization. All together, these findings suggest that FOXM1 represents an important player in thyroid cancer progression to the anaplastic phenotype and a potential therapeutic target for this fatal cancer., This study was supported by the Associazione Italiana per la Ricerca sul Cancro (AIRC), the Ministero dell'Università e della Ricerca (MiUR), and by the grant MERIT of MIUR. G Garcia-Rostan is supported by Programa Ramón y Cajal, Ministerio de Ciencia e Innovación, Social EU Funds, Universidad de Valladolid, Spain. C Nucera (Principal Investigator, Program: Human Thyroid Cancers Preclinical and Translational Research) was funded by the NIHR21CA165039-01A1 and the American Thyroid Association for Thyroid Cancer Research.

For an identification of novel candidate genes in thyroid tumourigenesis, we have investigated gene copy number changes in aTrk-T1transgenic mouse model of thyroid neoplasia. For this aim, 30 thyroid tumours fromTrk-T1transgenics were investigated by comparative genomic hybridisation. Recurrent gene copy number alterations were identified and genes located in the altered chromosomal regions were analysed by Gene Ontology term enrichment analysis in order to reveal gene functions potentially associated with thyroid tumourigenesis. In thyroid neoplasms fromTrk-T1mice, a recurrent gain on chromosomal bands 1C4–E2.3 (10.0% of cases), and losses on 3H1–H3 (13.3%), 4D2.3–E2 (43.3%) and 14E4–E5 (6.7%) were identified. The genesTwist2,Ptma,Pde6d,Bmpr1b,Pdlim5,Unc5c,Srm,Trp73,Ythdf2,Taf12andSlitrk5are located in these chromosomal bands. Copy number changes of these genes were studied by fluorescencein situhybridisation on 30 human papillary thyroid carcinoma (PTC) samples and altered gene expression was studied by qRT-PCR analyses in 67 human PTC. Copy number gains were detected in 83% of cases forTWIST2and in 100% of cases forPTMAandPDE6D. DNA losses ofSLITRK1andSLITRK5were observed in 21% of cases and ofSLITRK6in 16% of cases. Gene expression was significantly up-regulated forUNC5CandTP73and significantly down-regulated forSLITRK5in tumours compared with normal tissue. In conclusion, a global genomic copy number analysis of thyroid tumours fromTrk-T1transgenic mice revealed a number of novel gene alterations in thyroid tumourigenesis that are also prevalent in human PTCs.

Here we describe a conditional doxycycline-dependent mouse model of RET/PTC3 (NCOA4-RET) oncogene-induced thyroid tumorigenesis. In these mice, after 10 days of doxycycline (dox) administration, RET/PTC3 expression induced mitogen activated protein kinase (MAPK) stimulation and a proliferative response which resulted in the formation of hyperplastic thyroid lesions. This was followed, after 2 months, by growth arrest accompanied by typical features of oncogene-induced senescence (OIS), including upregulation of p16INK4A and p21CIP, positivity at the Sudan black B, activation of the DNA damage response (DDR) markers γH2AX and pChk2 T68, and induction of p53 and p19ARF. After 5 months, about half of thyroid lesions escaped OIS and formed tumors that remained dependent on RET/ PTC3 expression. This progression was accompanied by activation of AKT-FOXO1/3a pathway and increased serum TSH levels.