Biografía de una pediatra pionera en España: Nieves González Barrio (1884-1961) / Biography of a pioneering pediatrician in Spain: Nieves González Barrio (1884-1961)

Introducción: podemos encontrar mujeres pioneras en Pediatría y Puericultura en España, a principios del siglo XX, para rescatarlas del olvido y subrayar su papel dentro de la conquista del espacio público para la mujer. Nieves González Barrio (1884-1961) fue una de ellas. Objetivo: describir su vida profesional como pionera médica y pediatra-puericultora (biografía histórica), enmarcada en un contexto humanístico. Material y métodos: estudio histórico, hemerográfico (Biblioteca Nacional de España [BNE], BNF-Gallica [biblioteca de Francia], diario ABC, Memorias de la Junta de Ampliación de Estudios, la propia González Barrio en Blanco y Negro en 1935, y otros). Seleccionados: 22 artículos científicos, más 26 de prensa histórica y libros. Resultados: González Barrio presentó su tesis doctoral en 1915, sobre Kala-Azar. Fue médica pionera en los viajes formativos a EE. UU. Su actividad: la Medicina de Laboratorio y la Pediatría. Fue profesora (1926-1931) en la Escuela Nacional de Puericultura, encargada del laboratorio y de organizar el servicio de enfermeras visitadoras y niñeras. Fue una promotora de la especialización en enfermería. Perteneció a diversas instituciones médicas y educadoras, y de promoción de la mujer (el Lyceum Club femenino y otras). Comentarios: fue de las primeras médicas pediatras en España, doctoradas, y pionera en formación internacional, en investigación y docencia. Su vida profesional se vio truncada por los vaivenes de la política española y de la Sanidad, así como necesidades familiares. Su figura, su determinación personal, su legado, su gran capacidad polifacética y su labor como mujer científica y pediatra merecen ser tenidas en consideración y estudiadas en profundidad (AU)

Introduction. At the beginning of the 20th century, we can find and rescue from oblivion pioneer women in Pediatrics and Puericulture in Spain, to underline their role within the conquest of public space for women. María Nieves González Barrio (1884-1961) was one of them. Objective: to describe her professional life as a pioneering physician and pediatrician-pediatrician-puericulturist (historical biography), framed in a humanistic context.Material and methods. Historical and hemerographic study (BNE-National Library of Spain-, BNF-Gallica (library of France), ABC newspaper, Memoirs of the Junta de Ampliación de Estudios, González Barrio herself in Black and White in 1935, and others). Selected: 22 scientific articles and books, plus 26 historical press articles.Results. González Barrio presented her doctoral thesis in 1915, on Kala-Azar. She was a pioneer physician in formative trips to the USA. Her activity: Laboratory Medicine and Pediatrics. She was a professor at the National School of Puericulture, from 1926 to 1931, in charge of the laboratory and of organizing the service of visiting nurses and nannies. She was a promoter of nursing specialization. She belonged to several medical and educational institutions, and for the promotion of women, such as the Women's Lyceum Club and others.Comments. She was one of the first pediatric doctors in Spain, with a doctorate, and a pioneer in international training, research and teaching. Her professional life was truncated by the ups and downs of Spanish politics and healthcare, as well as family needs. Her figure, personal determination, legacy, her great multifaceted capacity and her work as a woman scientist and pediatrician deserve to be taken into consideration and studied in greater depth. (AU)

Immunoglobulin A Targets a Unique Subset of the Microbiota in Inflammatory Bowel Disease.

The immunopathogenesis of inflammatory bowel disease (IBD) has been attributed to a combination of host genetics and intestinal dysbiosis. Previous work in a small cohort of IBD patients suggested that pro-inflammatory bacterial taxa are highly coated with secretory immunoglobulin IgA. Using bacterial fluorescence-activated cell sorting coupled with 16S rRNA gene sequencing (IgA-SEQ), we profiled IgA coating of intestinal microbiota in a large cohort of IBD patients and identified bacteria associated with disease and treatment. Forty-three bacterial taxa displayed significantly higher IgA coating in IBD compared with controls, including 8 taxa exhibiting differential IgA coating but similar relative abundance. Patients treated with anti-TNF-α therapies exhibited dramatically altered microbiota-specific IgA responses compared with controls. Furthermore, increased IgA coating of Oscillospira was associated with a delay in time to surgery. These results demonstrate that investigating IgA responses to microbiota can uncover potential disease-modifying taxa and reveal improved biomarkers of clinical course in IBD.

The prenatal gut microbiome: are we colonized with bacteria in utero?

The colonization of the gut with microbes in early life is critical to the developing newborn immune system, metabolic function and potentially future health. Maternal microbes are transmitted to offspring during childbirth, representing a key step in the colonization of the infant gut. Studies of infant meconium suggest that bacteria are present in the foetal gut prior to birth, meaning that colonization could occur prenatally. Animal studies have shown that prenatal transmission of microbes to the foetus is possible, and physiological changes observed in pregnant mothers indicate that in utero transfer is likely in humans as well. However, direct evidence of in utero transfer of bacteria in humans is lacking. Understanding the timing and mechanisms involved in the first colonization of the human gut is critical to a comprehensive understanding of the early life gut microbiome. This review will discuss the evidence supporting in utero transmission of microbes from mother to infants. We also review sources of transferred bacteria, physiological mechanisms of transfer and modifiers of maternal microbiomes and their potential role in early life infant health. Well-designed longitudinal birth studies that account for established modifiers of the gut microbiome are challenging, but will be necessary to confirm in utero transfer and further our knowledge of the prenatal microbiome.

Reflections in the clinical practice.

The purpose of this article is to analyze some models of expert decision and their impact on the clinical practice. We have analyzed decision-making considering the cognitive aspects (explanatory models, perceptual skills, analysis of the variability of a phenomenon, creating habits and inertia of reasoning and declarative models based on criteria). We have added the importance of emotions in decision making within highly complex situations, such as those occurring within the clinical practice. The quality of the reflective act depends, among other factors, on the ability of metacognition (thinking about what we think). Finally, we propose an educational strategy based on having a task supervisor and rectification scenarios to improve the quality of medical decision making.