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Sample records for agudo severo sras

  1. Microstructure Imaging Using Frequency Spectrum Spatially Resolved Acoustic Spectroscopy F-Sras

    NASA Astrophysics Data System (ADS)

    Sharples, S. D.; Li, W.; Clark, M.; Somekh, M. G.

    2010-02-01

    Material microstructure can have a profound effect on the mechanical properties of a component, such as strength and resistance to creep and fatigue. SRAS—spatially resolved acoustic spectroscopy—is a laser ultrasonic technique which can image microstructure using highly localized surface acoustic wave (SAW) velocity as a contrast mechanism, as this is sensitive to crystallographic orientation. The technique is noncontact, nondestructive, rapid, can be used on large components, and is highly tolerant of acoustic aberrations. Previously, the SRAS technique has been demonstrated using a fixed frequency excitation laser and a variable grating period (к-vector) to determine the most efficiently generated SAWs, and hence the velocity. Here, we demonstrate an implementation which uses a fixed grating period with a broadband laser excitation source. The velocity is determined by analyzing the measured frequency spectrum. Experimental results using this "frequency spectrum SRAS" (f-SRAS) method are presented. Images of microstructure on an industrially relevant material are compared to those obtained using the previous SRAS method ("k-SRAS"), excellent agreement is observed. Moreover, f-SRAS is much simpler and potentially much more rapid than k-SRAS as the velocity can be determined at each sample point in one single laser shot, rather than scanning the grating period.

  2. Centro de Biologia Molecular "Severo Ochoa": a center for basic research into Alzheimer's disease.

    PubMed

    Avila, Jesus; Hernandez, Felix; Wandosell, Francisco; Lucas, Jose J; Esteban, Jose A; Ledesma, M Dolores; Bullido, Maria J

    2010-01-01

    One important aspect of studies carried out at the Center for Molecular Biology "Severo Ochoa" is focused on basic aspects of Alzheimer's disease, mainly the search for suitable therapeutic targets for this disorder. Several groups at the Center are involved in these studies, and, in this spotlight, the work they are carrying out will be described.

  3. Optical characterization of the 62-cm telescope at the Severo Diaz Galindo Observatory in Guadalajara

    NASA Astrophysics Data System (ADS)

    Nuñez, J. Manuel; de la Fuente, Eduardo; Luna, Esteban; Herrera, Joel; Velazquez, Enrique; García, Fernando; López, Eduardo; Váldez, Jorge; García, Benjamín; Martínez, Benjamín; Guisa, Gerardo; Quiroz, Fernando; Colorado, Enrique; Ochoa, José Luis; Almaguer, Jaime; Chávez, Arturo

    2009-09-01

    We present the results of the optical characterization of the mirrors of the telescope of 62cm observatory "SEVERO DIAZ GALINDO" property of the University of Guadalajara. We use the Ronchi test and a spherometer to measure by first time, the radius of curvature for the primary and secondary mirror, the parameters of the telescope system were obtained by using the commercial software ZEMAX. We confirm that both mirrors are adequate to work in the telescope configuration and to do optical astronomy.

  4. [Retrospective analysis of the use of the Spanish words severo and severidad in CIRUGIA ESPANOLA during 2007].

    PubMed

    Martínez-Ramos, David

    2008-12-01

    The Spanish words severo (severe) and severidad (severity) are usually used as a synonyms of grave (serious) and gravedad (seriousness), although the Spanish Royal Academy of Language (Real Academia Española [RAE]) specifically recommends not to use them in this sense. A retrospective analysis to evaluate the use of the words severo and severidad in Cirugía Española during 2007 was performed. All the articles published in Cirugía Española during 2007 were reviewed. The articles in which severo and/or severidad were present were selected. For each article, the month of publication, the type of article, the geographic origin and the exact sentence containing these words were analyzed. Correctness and incorrectness of their use was studied according to the RAE normative. A total of 33 articles were selected. Every month (except for January) had, at least, 2 articles. Thirty-one of the articles were from Spain whereas 2 were from Hispano-America. Eleven cases were original articles, 7 reviews, 6 case reports, 3 editorials, 3 special articles and 3 letters to the editor. The Spanish words severo and severidad are inadequately used too often in scientific texts. It must be avoided using them as a synonym of grave, importante or serio, incorrect translations of the English word severe.

  5. Optics and the mechanical system of the 62-cm telescope at the Severo Díaz Galindo Observatory in Guadalajara, Jalisco, México

    NASA Astrophysics Data System (ADS)

    de la Fuente, Eduardo; Nuñez, J. Manuel; Zazueta, Salvador; Ibarra, Salomon Eduardo; García, Benjamin; Martínez, Benjamin; Ochoa, José Luis; Sierra, Gerardo; Lazo, Fransisco; Hirart, David; Corral, Luis; Flores, Jorge L.; Almaguer, Jaime; Kemp, Simon; Navarro, Silvana G.; Nigoche-Netro, Alberto; Ramos-Larios, Gerardo; Phillips, John Peter; Chávez, Arturo; García-Torales, Guillermo; Blanco Alonso, Oscar; Oceguera-Becerra, Tomas; de Alba, Durruty; Bautista, Ruben

    2012-09-01

    We present the results of a modification performed in the optical system of the 62 cm telescope (f/14.32) at observatory “Severo Díaz Galindo” Universidad de Guadalajara, Mexico. This modification consists of a change of distance between the primary and secondary mirrors from 1020 to 1135 mm. With this, a change in the image plane from 5200 mm to 600 mm, measured from the vertex of the primary mirror, is obtained. The latter allow to get the first astronomical images of The Telescope. This modification was necessary because alignment errors, such as distance between primary and secondary mirrors in the original system were presented. Besides, the telescope has a new accurate and adequate mechanical system installed on November 2011. Details and the first images obtained, are here presented.

  6. EJERCICIO Y LA DETECCION DEL MAL AGUDO DE MONTAÑA GRAVE

    PubMed Central

    Garófoli, Adrián; Montoya, Paola; Elías, Carlos; Benzo, Roberto

    2012-01-01

    El Mal Agudo de Montaña (MAM) es un conjunto de síntomas inespecíficos padecidos por sujetos que ascienden rápidamente desde baja a alta altura sin adecuada aclimatación. Usualmente es autolimitado, pero las formas graves (edema pulmonar y cerebral) pueden causar la muerte. La hipoxemia exagerada en reposo está relacionada con el desarrollo de MAM pero su valor predictivo es limitado. Dado que el ejercicio en altura se acompaña de mayor hipoxemia y síntomas, postulamos el valor predictivo de un simple test de ejercicio para pronosticar MAM grave. Se estudió el valor predictivo de la saturación de oxígeno en reposo y ejercicio submáximo a 2 700m y 4 300m en 63 sujetos que ascendían al cerro Aconcagua (6 962m). Se consideró desaturación de oxígeno con ejercicio a una disminución >=5% respecto al reposo. Se utilizó la escala de Lake-Louise para establecer la presencia de MAM grave. 6 sujetos presentaron MAM grave (9.5%) y requirieron evacuación. La saturación de oxígeno en reposo a 2 700m no fue significativa para clasificar sujetos que luego desarrollaron MAM grave. Por el contrario, la asociación de desaturación durante el ejercicio a 2 700m más la saturación inapropiada en reposo a 4 300m fue significativa para clasificar a los sujetos que desarrollaron MAM grave con un valor predictivo positivo de 80% y un valor predictivo negativo del 97%. Nuestros resultados son relevantes para el montañismo y sugieren la adición de un simple test de ejercicio en la predicción del MAM grave. PMID:20228017

  7. Materials Data on Sr(As3Pt2)2 (SG:15) by Materials Project

    SciTech Connect

    Kristin Persson

    2015-02-18

    Computed materials data using density functional theory calculations. These calculations determine the electronic structure of bulk materials by solving approximations to the Schrodinger equation. For more information, see https://materialsproject.org/docs/calculations

  8. Assessing the impact of soil management on soil erosion in vineyards in La Rioja (Spain): La Sierra de Los Agudos

    NASA Astrophysics Data System (ADS)

    Galilea Salvador, Ianire; Lana-Renault, Noemí; Ruiz Flaño, Purificación; Ángel Llorente Adán, Jose; Bellido, Nuria Pascual

    2015-04-01

    La Rioja is a predominantly agricultural region located in the northwestern corner of the Ebro Basin in Spain. In this region, vineyards are a crop of historical and economical importance and large extension that traditionally has been relegated to marginal lands, mainly glacis, high fluvial terraces and slopes linking different levels of terraces and glacis. It is well known that vineyards are among the land uses affected by largest soil erosion losses. Surprisingly, many farmers still apply non-conservative practices that contribute to an increase of soil erosion. In spite of the environmental and economic consequences, very little research on this topic has been undertaken in the region. In this study, we assessed the impact of vineyards and soil management practices on soil erosion in La Sierra de Los Agudos, a heavily eroded area located on quaternary silt loam and clay glacis, where vineyards represent 30% of the agricultural land. For this purpose we used an adapted version of the RUSLE model: R was estimated using data from two nearby weather stations following the methodology of Arnoldus and Fournier for a lapse time of five years; K was assessed from 28 soil samples analyzed by the National Institute of Soil Erosion, and the edaphic map of La Rioja which includes 32 taxa; C was calculated from catastral data, the Information System of Land Occupation, and by a detailed study of each subfactor; LS was obtained from a 10 meters/pixel scale DTM from which the slope length and the percentage of inclination of the slopes was calculated; and P was established by observing different tillage practices in each of the plots. Low erosion values (<0,001-2 Mg ha-¹year-¹) were estimated for the 43 % of the area, while the 37% was affected by moderate (2-12 Mg ha-¹year-¹) and high erosion values (>12 Mg ha-¹year-¹) which exceed the soil loss tolerance (T value) established by Renard (1996). In this study we showed that the current support practices accelerate soil

  9. [Characteristics and mortality following primary percutaneous coronary intervention for acute myocardial infarction in Spain. Results from the TRIANA 1 (TRatamiento del Infarto Agudo de miocardio eN Ancianos) Registry].

    PubMed

    Cequier, Angel; Bueno, Héctor; Augé, Josep M; Bardají, Alfredo; Fernández-Ortiz, Antonio; Heras, Magda

    2005-04-01

    Although more elderly patients will experience acute myocardial infarction (AMI) in coming years, the best reperfusion strategy in these patients remains unknown. The Spanish TRIANA (TRatamiento del Infarto Agudo de miocardio eN Ancianos) registry was set up to determine the feasibility of performing a randomized study of percutaneous coronary intervention (PCI) versus thrombolysis in AMI patients aged > or =75 years. The TRIANA 1 subregistry included consecutive patients of all ages with ST-segment-elevation AMI (< or =12 h from onset) who underwent PCI in selected hospitals. In total, 459 TRIANA-1 patients were included at 25 hospitals over 3 months. Some 11% had cardiogenic shock. PCI was performed as rescue therapy in 24% and, in 15% because thrombolysis was contraindicated. After PCI, 83% had TIMI grade-3 flow without significant residual stenosis. Mortality at 1 month was 10.8%. Independent predictors of mortality identified by multivariate analysis were: cardiogenic shock at admission (OR, 7.2, 95% CI, 2.2-23.3), age (OR, 1.05 per year, 95% CI, 1.005-1.100), maximum creatine kinase MB fraction (OR, 1.01, 95% CI, 1.004-1.270) and post-PCI TIMI grade <3 (OR, 2.8, 95% CI, 1.0-8.3). Of 104 participants aged > or =75 years (mortality, 24%), 58 (55.7%) fulfilled criteria for inclusion in a randomized study. 1) The TRIANA 1 subregistry probably reflects the reality of PCI for AMI in Spain. 2) Mortality at 1 month was associated with classic predictive factors. 3) Some 50% of patients > or =75 years old who underwent PCI could be included in a randomized study. These findings indicate that randomized study to determine the best reperfusion strategy in elderly AMI patients is feasible.

  10. Functional Assessment of School Attendance Problems: An Adapted Version of the School Refusal Assessment Scale-Revised

    ERIC Educational Resources Information Center

    Heyne, David A.; Vreeke, Leonie J.; Maric, Marija; Boelens, Harrie; Van Widenfelt, Brigit M.

    2017-01-01

    The "School Refusal Assessment Scale" (SRAS) was developed to identify four factors that might maintain a youth's school attendance problem (SAP), and thus be targeted for treatment. There is still limited support for the four-factor model inherent to the SRAS and its revision (SRAS-R). Recent studies indicate problems with the wording…

  11. Diagnostics of hydromorphism in soils of autonomous positions on the Severo-Sos'vinsk Upland (Western Siberia)

    NASA Astrophysics Data System (ADS)

    Avetov, N. A.; Sopova, E. O.; Golovleva, Yu. A.; Kiryushin, A. V.; Krasilnikov, P. V.

    2014-11-01

    The complex studies of hydromorphism features in taiga weakly differentiated soils using morphological (color), chemical (iron content in different extracts, indicators of reducing conditions (IRIS)), and geobotanic (using the Ramenskii scale) methods have led to ambiguous conclusions. In all the soils, surface gleying was manifested. According to the results obtained by different methods, the maximum reduction processes were related to either the sublitter or the next deeper horizon. The Schwertmann coefficient, the criterion of Bodegom, and the Ramenskii scale indicated an increase of hydromorphism in the soils studied in the following sequence: the lower part of the ridge slopes drained by the small gullies < the middle part of the slopes < the flat tops of the ridges < the depression between the ridges. The morphological diagnostics of gleying proved to be a less sensitive method, which can recognize only the most contrasting hydromorphic soils. The lower horizons in some taiga soils have a bluish gray color probably not related to the recent soil hydromorphism.

  12. Retiring the Short-Run Aggregate Supply Curve

    ERIC Educational Resources Information Center

    Elwood, S. Kirk

    2010-01-01

    The author argues that the aggregate demand/aggregate supply (AD/AS) model is significantly improved--although certainly not perfected--by trimming it of the short-run aggregate supply (SRAS) curve. Problems with the SRAS curve are shown first for the AD/AS model that casts the AD curve as identifying the equilibrium level of output associated…

  13. Retiring the Short-Run Aggregate Supply Curve

    ERIC Educational Resources Information Center

    Elwood, S. Kirk

    2010-01-01

    The author argues that the aggregate demand/aggregate supply (AD/AS) model is significantly improved--although certainly not perfected--by trimming it of the short-run aggregate supply (SRAS) curve. Problems with the SRAS curve are shown first for the AD/AS model that casts the AD curve as identifying the equilibrium level of output associated…

  14. Developing a short form of the simple Rathus assertiveness schedule using a sample of adults with sickle cell disease.

    PubMed

    Jenerette, Coretta; Dixon, Jane

    2010-10-01

    Ethnic and cultural norms influence an individual's assertiveness. In health care, assertiveness may play an important role in health outcomes, especially for predominantly minority populations, such as adults with sickle cell disease. Therefore, it is important to develop measures to accurately assess assertiveness. It is also important to reduce response burden of lengthy instruments while retaining instrument reliability and validity. The purpose of this article is to describe development of a shorter version of the Simple Rathus Assertiveness Schedule (SRAS). Data from a cross-sectional descriptive study of adults with sickle cell disease were used to construct a short form of the SRAS, guided by stepwise regression analysis. The 19-item Simple Rathus Assertiveness Scale-Short Form (SRAS-SF) had acceptable reliability (α = .81) and construct validity and was highly correlated with the SRAS (r = .98, p = .01). The SRAS-SF reduces response burden, while maintaining reliability and validity.

  15. MASCARA (Manejo del Síndrome Coronario Agudo. Registro Actualizado) study. General findings.

    PubMed

    Ferreira-González, Ignacio; Permanyer-Miralda, Gaietà; Marrugat, Jaume; Heras, Magda; Cuñat, José; Civeira, Emilia; Arós, Fernando; Rodríguez, Juan J; Sánchez, Pedro L; Bueno, Héctor

    2008-08-01

    To investigate the clinical characteristics and treatment of acute coronary syndromes (ACS), and to determine the effects of an early invasive strategy (EIS) in non-ST-elevation ACS (NSTEACS) and of primary percutaneous coronary intervention (PCI) in ST-elevation ACS (STEACS). Data were collected prospectively for 9 months during 2004-2005 from 50 hospitals, which were randomly selected according to the level of care provided. In addition, follow-up data on mortality and readmission for ACS were collected for 6 months. The adjusted effects of different reperfusion strategies were analyzed. After checking data quality, the analysis included data from 32 hospitals, which covered 7923 coronary events (4431 [56%] STEACS, 3034 [38%] NSTEACS and 458 [6%] unclassified ACS) in 7251 patients. Compared with previous studies, the use of primary PCI in STEACS had increased markedly (from 10.7% to 36.8% of patients undergoing reperfusion), as had the use of EIS in NSTEACS (from 11.1% to 19.6%). Overall in-hospital mortality was 5.7% (95% confidence interval [CI], 5.1%-6.2%); for STEACS it was 7.6% (95% CI, 6.7%-8.7%), for NSTEACS 3.9% (95% CI, 3.3%-4.6%), and for unclassified ACS 8.8% (95% CI, 6.2%-12.2%). In the population as a whole, there was no association between prognosis (i.e., 6-month mortality) and EIS in NSTEACS (hazard ratio [HR]=0.94; 95% CI, 0.66-1.3) or between prognosis and primary PCI in STEACS (HR=1; 95% CI, 0.7-1.5). Findings for mortality and rehospitalization for ACS at 6 months were similar. Data for 2004-2005 demonstrated a marked increase in the use of invasive procedures. However, the procedures employed were poorly matched to the patients' baseline risk.

  16. VizieR Online Data Catalog: 86 and 43GHz observations of NRAO 150 (Agudo+, 2007)

    NASA Astrophysics Data System (ADS)

    Agudo, I.; Bach, U.; Krichbaum, T. P.; Marscher, A. P.; Gonidakis, I.; Diamond, P. J.; Perucho, M.; Alef, W.; Graham, D. A.; Witzel, A.; Zensus, J. A.; Bremer, M.; Acosta-Pulido, J. A.; Barrena, R.

    2008-01-01

    The data set presented here consists of 5 VLBI images at 86GHz taken with the Global mm VLBI Array (GMVA, and its predecessor, the CMVA) covering the time range from October 2001 to April 2004, and 34 Very Long Baseline Array (VLBA) images taken at 43GHz from June 1997 to February 2007. Among these 34 images, 20 obtained from June 1997 to May 2002 were taken as calibration measurements of the SiO maser monitoring program of TX Cam. A new 8.4GHz VLBA image obtained in June 2002 is also presented here. (3 data files).

  17. VizieR Online Data Catalog: 3.5 and 1.3mm polarimetric survey of AGN (Agudo+, 2014)

    NASA Astrophysics Data System (ADS)

    Agudo, I.; Thum, C.; Gomez, J. L.; Wiesemeyer, H.

    2014-09-01

    The observations were performed with the XPOL polarimeter connected to the E090 and E230 EMIR receiver system on the IRAM 30m telescope. The advanced design of EMIR allowed us to perform the observations simultaneously at 3.5mm (86GHz with the E090 pair of orthogonal receivers) and 1.3mm (229GHz with the E230 pair of orthogonal receivers) without loss of a significant amount of signal at either waveband. The flexibility of the VESPA autocorrelator in polarimetric mode (i.e., XPOL) also allows us to simultaneously process the 86 and 229GHz signals, although with a limited bandwidth of 640MHz for each of the two orthogonally polarized receivers of the E090 band and 320MHz for those of the E230 band. (3 data files).

  18. VizieR Online Data Catalog: A 3.5mm polarimetric survey of radio-loud AGNs (Agudo+, 2010)

    NASA Astrophysics Data System (ADS)

    Agudo, I.; Thum, C.; Wiesemeyer, H.; Krichbaum, T. P.

    2010-09-01

    In Table 1, we present our sample of 145 observed sources (see also Fig. 1) which has been built essentially from the 138 radio-loud AGNs in the IRAM pointing sources that were contained in the 1Jy catalog (Kuhr et al. 1981, Cat. VIII/5) and/or in the catalog of 404 compact radio sources by Perley (1982, Cat. J/AJ/87/859). (2 data files).

  19. Mortality differences between men and women following first myocardial infarction. RESCATE Investigators. Recursos Empleados en el Síndrome Coronario Agudo y Tiempo de Espera.

    PubMed

    Marrugat, J; Sala, J; Masiá, R; Pavesi, M; Sanz, G; Valle, V; Molina, L; Serés, L; Elosua, R

    1998-10-28

    Mortality after acute myocardial infarction is worse in women than in men, even after adjustment for comorbidity and age dissimilarities between sexes. To assess the influence of sex on survival after acute myocardial infarction. Inception cohort obtained in a prospective registry of patients with acute myocardial infarction from 1992 through 1994. Four teaching hospitals in northeastern Spain. All consecutive patients aged 80 years or younger with first acute myocardial infarction. A total of 331 women and 1129 men were included. Survival at 28 days and mortality or readmission at 6 months. Women were older (mean, 68.6 vs 60.1 years), presented more often with diabetes (52.9% vs 23.3%), hypertension (63.9% vs 42.3%), or previous angina (44.6% vs 37.4%), and developed more severe myocardial infarctions than men (acute pulmonary edema or cardiogenic shock occurred in 24.8% of women and 10.5% of men) (all P<.02). Men were more likely than women to receive thrombolytic therapy (41.3% vs 23.9%; P<.001), but rates of percutaneous transluminal angioplasty and coronary artery bypass graft surgery at 28 days were similar among men and women. The 28-day mortality rate was significantly higher among women (18.5% for women, 8.3% for men; P<.001). Revascularization procedures at 6 months were performed in a similar proportion of women and men. However, women had higher 6-month mortality rates (25.8% in women, 10.8% in men; P<.001) and readmission rates (23.3% for women, 12.2% for men; P<.001). After adjustment, women had greater risk of death than men at 28 days (odds ratio [OR], 1.72; 95% confidence interval [CI], 1.12-2.65) and at 6 months (OR, 1.73; 95% CI, 1.18-2.52). In this study population, women experienced more lethal and severe first acute myocardial infarction than men, regardless of comorbidity, age, or previous angina.

  20. Reducing time delay in the thrombolysis of myocardial infarction: an internal quality improvement project. ARIAM Project Group. Analisis del Retraso en Infarto Agudo de Miocardio.

    PubMed

    Saturno, P J; Felices, F; Segura, J; Vera, A; Rodriguez, J J

    2000-01-01

    The objectives of this study were to improve thrombolytic therapy in acute myocardial infarction by reducing the "door-to-needle" time in a 285-bed university hospital in Spain. A quality management approach was used involving all the relevant staff. Target standard was set at 35 minutes. Baseline data, intervention effect, and continuous monitoring were analyzed using x control charts. Analysis of baseline data showed a wide out-of-control variation and 72 minutes' average delay. Cause analysis revealed organizational and clinical problems that were subjected to intervention. Postintervention data showed a stable process, with an average of 30 minutes. Continuous monitoring showed further improvement in average time and predictable variation. The template of the current control chart has an average of 26 minutes. Quality management methods, particularly staff involvement in problem analysis and intervention design, and the use of control charts were useful to understand, solve, and continuously monitor an important clinical problem whose existence was evident only after it was measured.

  1. An Evaluation of Reference Desk Service in the Brigham Young University Library.

    ERIC Educational Resources Information Center

    Hall, Blaine H.; And Others

    This report describes a five-part study conducted at the Brigham Young University library during the winter semester of 1987 to assess the quality of the reference service provided to library patrons by student reference assistants (SRAs) after a full semester of SRA participation in the reference patron service system. The study focused on…

  2. Managing Performance in the System of Support: Rubric with 52 Indicators, Explanations, and Exemplars

    ERIC Educational Resources Information Center

    Hanes, Susan; Kerins, Thomas; Perlman, Carole; Redding, Sam; Ross, Steven

    2013-01-01

    The Building State Capacity and Productivity (BSCP) Center released a report outlining a process for state education agencies (SEAs) to evaluate and improve their System of Recognition, Accountability, and Support (SRAS). The federal government now sets high expectations for state and local use of federal dollars while allowing greater state…

  3. Seasonal southern hemisphere multi-variable reflection of the southern annular mode in atmosphere and ocean reanalyses

    NASA Astrophysics Data System (ADS)

    Zhang, Zhaoru; Uotila, Petteri; Stössel, Achim; Vihma, Timo; Liu, Hailong; Zhong, Yisen

    2017-04-01

    Variations of southern hemisphere (SH) climate variables are often linked to the southern annular mode (SAM) variability. We examined such linkage by seasons using state-of-the-art atmosphere and ocean/sea-ice reanalyses. The associated SAM related anomaly (SRA) fields of the climate variables, denoting anomalies corresponding to the same variation in SAM, are overall consistent across the reanalyses. Among the atmospheric products, 20CRV2 differs from ERA-interim and CFSR in the sea-level pressure SRAs over the Amundsen Sea, resulting in less warming over the Antarctic Peninsula. Among the ocean reanalyses, ORAP5 and C-GLORS exhibit the largest consistency. The major difference between them and the lower-resolution CFSR and SODA reanalyses is deeper penetration of anomalous meridional currents. Compared to the other ocean reanalyses, CFSR exhibits stronger and spatially more coherent surface-current SRAs, resulting in greater SRAs of sea-ice motion and ice thickness along the ice edges. The SRAs of sensible and total surface heat fluxes are reduced in CFSR due to ocean-atmosphere coupling. Significant sea-ice concentration SRAs are present on the west side of peninsulas along the east Antarctica coast in spring and winter, most notably in ORAP5 and C-GLORS, implying changes in new-ice production and shelf-water formation. Most atmosphere and ocean variables manifest an annular SRA pattern in summer and a non-annular pattern in the other seasons, with a wavenumber-3 structure strongest in autumn and weakest in summer. The wavenumber-3 structure should be related to the zonal wave three pattern of the SH circulation, the relation of which to SAM needs further exploration.

  4. Use of thalidomide for severe recurrent aphthous stomatitis: a multicenter cohort analysis.

    PubMed

    Hello, Muriel; Barbarot, Sébastien; Bastuji-Garin, Sylvie; Revuz, Jean; Chosidow, Olivier

    2010-05-01

    Severe recurrent aphthous stomatitis (SRAS) is a rare, disabling disorder of unknown etiology. Thalidomide is an effective second-line therapy for SRAS, but is suppressive rather than curative, and adverse events limit its use. Few reports describe the efficacy, tolerance, and safety of thalidomide, and how it is actually used as long-term (maintenance) therapy for SRAS. Therefore, we conducted this study to describe thalidomide use in the real-life management of a cohort of patients with SRAS. This multicenter retrospective cohort study covered a period of 5 years and 5 months (January 2003-May 2008). Patients who had started thalidomide monotherapy for SRAS during the 2003-2006 period were eligible. Data were collected from patients' medical charts and supplemented by patients' responses during a targeted telephone interview. Ninety-two patients followed at 14 centers were included: 76 had oral or bipolar aphthosis, and 16 had Behçet disease. Thalidomide was rapidly effective: 85% (78/92) entered complete remission (CR) within a median of 14 days. Response time was independent of the initial thalidomide dose (r = 0.04). Thalidomide was continued for > or =3 months (maintenance therapy) by 77/92 (84%) of the patients on 1 of 2 maintenance regimens: continuous therapy with regular intake (60/77) or intermittent therapy in response to attacks (17/77). Although intermittent therapy was less restrictive than continuous therapy, medical supervision under the former was less rigorous. The median maintenance dose was 100 mg/week, and did not reflect the initial dose (r = 0.18). The intermittent-treatment group's median dose was significantly lower and its median duration of thalidomide intake significantly longer than for patients on continuous therapy (19 vs. 150 mg/wk; p < 0.0001, and 32 vs. 19 mo; p = 0.002, respectively). Adverse events were reported by 84% (77/92) of patients. They were mostly mild (78% of patients), but sometimes severe (21%). Nevertheless, after

  5. Exposure: A New Decision Metric for Selecting Effective Sets of Security Upgrades

    DTIC Science & Technology

    2015-01-01

    consequential dam projects. The Common Risk Model for Dams ( CRM -D) provides a mathematically rigorous and easy-to-implement way to conduct SRAs. The CRM -D...attacker type and an attack vector) carried out on a particular target comprises a scenario. The CRM -D considers three attacker types and thirty-two attack...of the Common Risk Model ( CRM ) for evaluating and comparing risks associated with the Nation’s critical infrastructure. This model incorporates

  6. Scavenger Receptors and Resistance to Inhaled Allergens

    DTIC Science & Technology

    2007-02-01

    resistance to asthma and pneumonia. The scope of the research includes studies using in vivo mouse models (Aim 1), studies of the specific role of...in modulating allergic responses using the mouse model. We have made good progress, matching the projected completion of task 1 in year 1. This...defense of the lung against inhaled allergens using receptor-deficient mice and a model of allergic asthma. We found that sensitized mice lacking SRAs

  7. Atomic-scale structural and electronic properties of SrTiO3/GaAs interfaces: A combined STEM-EELS and first-principles study

    NASA Astrophysics Data System (ADS)

    Hong, Liang; Bhatnagar, Kunal; Droopad, Ravi; Klie, Robert F.; Öǧüt, Serdar

    2017-07-01

    The electronic properties of epitaxial oxide thin films grown on compound semiconductors are largely determined by the interfacial atomic structure, as well as the thermodynamic conditions during synthesis. Ferroelectric polarization and Fermi-level pinning in SrTiO3 films have been attributed to the presence of oxygen vacancies at the oxide/semiconductor interface. Here, we present scanning transmission electron microscopy (STEM) and electron energy-loss spectroscopy analyses of GaAs films grown on SrTiO3 combined with first-principles calculations to determine the atomic and electronic structures of the SrTiO3/GaAs interfaces. An atomically abrupt SrO/As interface is observed and the interfacial SrO layer is found to be O-deficient. First-principles density functional theory (DFT) calculations show SrO/Ga and Sr/As interfaces are favorable under O-rich and O-poor conditions, respectively. The SrO/Ga interface is reconstructed via the formation of Ga-Ga dimers while the Sr/As interface is abrupt and consistent with the experiment. DFT calculations further reveal that intrinsic two-dimensional electron gas (2DEG) forms in both SrO/Ga and Sr/As interfaces, and the Fermi level is pinned to the localized 2DEG states. Interfacial O vacancies can enhance the 2DEG density while it is possible for Ga/As vacancies to unpin the Fermi level from the 2DEG states.

  8. School Refusal Assessment Scale-Revised: Factorial Invariance and Latent Means Differences across Gender and Age in Spanish Children.

    PubMed

    Gonzálvez, Carolina; Inglés, Cándido J; Kearney, Christopher A; Vicent, María; Sanmartín, Ricardo; García-Fernández, José M

    2016-01-01

    The aim of this study was to analyze the factorial invariance and latent means differences of the Spanish version of the School Refusal Assessment Scale-Revised for Children (SRAS-R-C) in a sample of 1,078 students (50.8% boys) aged 8-11 years (M = 9.63, SD = 1.12). The results revealed that the proposed model in this study, with a structure of 18 items divided into four factors (Negative Affective, Social Aversion and/or Evaluation, To Pursue Attention and Tangible Reinforcements), was the best-fit model with a tetra-factorial structure, remaining invariant across gender and age. Analysis of latent means differences indicated that boys and 11-year-old students scored highest on the Tangible Reinforcements subscale compared with their 8- and 9-year-old peers. On the contrary, for the subscales of Social Aversion and/or Evaluation and to Pursue Attention, the differences were significant and higher in younger age groups compared to 11-year-olds. Appropriate indexes of reliability were obtained for SRAS-R-C subscales (0.70, 0.79, 0.87, and 0.72). Finally, the founded correlation coefficients of scores of the SRAS-R-C revealed a predictable pattern between school refusal and positive/negative affect and optimism/pessimism.

  9. School Refusal Assessment Scale-Revised: Factorial Invariance and Latent Means Differences across Gender and Age in Spanish Children

    PubMed Central

    Gonzálvez, Carolina; Inglés, Cándido J.; Kearney, Christopher A.; Vicent, María; Sanmartín, Ricardo; García-Fernández, José M.

    2016-01-01

    The aim of this study was to analyze the factorial invariance and latent means differences of the Spanish version of the School Refusal Assessment Scale-Revised for Children (SRAS-R-C) in a sample of 1,078 students (50.8% boys) aged 8–11 years (M = 9.63, SD = 1.12). The results revealed that the proposed model in this study, with a structure of 18 items divided into four factors (Negative Affective, Social Aversion and/or Evaluation, To Pursue Attention and Tangible Reinforcements), was the best-fit model with a tetra-factorial structure, remaining invariant across gender and age. Analysis of latent means differences indicated that boys and 11-year-old students scored highest on the Tangible Reinforcements subscale compared with their 8- and 9-year-old peers. On the contrary, for the subscales of Social Aversion and/or Evaluation and to Pursue Attention, the differences were significant and higher in younger age groups compared to 11-year-olds. Appropriate indexes of reliability were obtained for SRAS-R-C subscales (0.70, 0.79, 0.87, and 0.72). Finally, the founded correlation coefficients of scores of the SRAS-R-C revealed a predictable pattern between school refusal and positive/negative affect and optimism/pessimism. PMID:28082938

  10. Class A scavenger receptor-mediated dsRNA internalization is independent of innate antiviral signaling and does not require PI3K activity1

    PubMed Central

    Nellimarla, Srinivas; Baid, Kaushal; Loo, Yueh-Ming; Gale, Michael; Bowdish, Dawn M.; Mossman, Karen L.

    2016-01-01

    Double-stranded RNA is a potent trigger of innate immune signaling, eliciting effects within virally infected cells and following release from dying cells. Given its inherent stability, extracellular dsRNA induces both local and systemic effects. Although the class A scavenger receptors (SR-As)3 mediate dsRNA entry, it is unknown if they contribute to signaling beyond ligand internalization. Here, we investigated if SR-As contribute to innate immune signaling independent of the classic TLR and RLR pathways. We generated a stable A549 human epithelial cell line with inducible expression of the Hepatitis C virus protease NS3/4A, which efficiently cleaves TRIF and IPS-1, adaptors for TLR3 and the RLRs respectively. Cells expressing NS3/4A as well as TLR3/MDA5/IPS-1−/− mouse embryonic fibroblasts completely lacked antiviral activity to extracellular dsRNA relative to control cells, suggesting that SR-As do not possess signaling capacity independent of TLR3 or the RLRs. Previous studies implicated PI3K signaling in SR-A-mediated activities and in downstream production of type I interferon. We found that SR-A-mediated dsRNA internalization occurs independent of PI3K activation, while downstream signaling leading to interferon production was partially dependent on PI3K activity. Overall, these findings suggest that SR-A-mediated dsRNA internalization is independent of innate antiviral signaling. PMID:26363049

  11. Community BMI Surveillance Using an Existing Immunization Registry in San Diego, California.

    PubMed

    Ratigan, Amanda R; Lindsay, Suzanne; Lemus, Hector; Chambers, Christina D; Anderson, Cheryl A M; Cronan, Terry A; Browner, Deirdre K; Wooten, Wilma J

    2017-06-01

    This study examines the demographic representativeness of the County of San Diego Body Mass Index (BMI) Surveillance System to determine if the BMI estimates being obtained from this convenience sample of individuals who visited their healthcare provider for outpatient services can be generalized to the general population of San Diego. Height and weight were transmitted from electronic health records systems to the San Diego Immunization Registry (SDIR). Age, gender, and race/ethnicity of this sample are compared to general population estimates by sub-regional area (SRA) (n = 41) to account for regional demographic differences. A < 10% difference (calculated as the ratio of the differences between the frequencies of a sub-group in this sample and general population estimates obtained from the U.S. Census Bureau) was used to determine representativeness. In 2011, the sample consisted of 352,924 residents aged 2-100 years. The younger age groups (2-11, 12-17 years) and the oldest age group (≥65 years) were representative in 90, 75, and 85% of SRAs, respectively. Furthermore, at least one of the five racial/ethnic groups was represented in 71% of SRAs. This BMI Surveillance System was found to demographically represent some SRAs well, suggesting that this registry-based surveillance system may be useful in estimating and monitoring neighborhood-level BMI data.

  12. Six-month outcome in unstable angina patients without previous myocardial infarction according to the use of tertiary cardiologic resources. RESCATE Investigators. Recursos Empleados en el Síndrome Coronario Agudo y Tiempos de Espera.

    PubMed

    Lupón, J; Valle, V; Marrugat, J; Elosua, R; Serés, L; Pavesi, M; Freixa, R; Sanz, G; Masiá, R; Molina, L; Sala, J; Serra, J

    1999-12-01

    The study assessed whether varying accessibility of patients with unstable angina (UA) to coronary angiography and revascularization determined differing usages and outcomes. The appropriate use rate of coronary angiography and revascularization procedures in UA remains to be established. A total of 791 consecutive patients with UA without previous acute myocardial infarction (AMI) admitted to four reference teaching hospitals (one with tertiary facilities) were followed for six months. End points were six-month mortality and readmission for AMI, UA, heart failure, or severe ventricular arrhythmias. Patients admitted to the tertiary hospital were 3.27 (95% confidence interval [CI] 2.32 to 4.62) times more likely to undergo coronary angiography after adjustment for comorbidity and severity than were those admitted to nontertiary facilities (overall six-month use rates 70.1% and 48.3%, respectively). Revascularization procedures were performed in 36.2% of patients in the tertiary hospital and 24.6% in the others (p = 0.0007); adjusted relative risk (RR) 2.37 (95% CI 1.55 to 3.63). Median delay for urgent coronary angiography was shorter in the tertiary hospital (24 h vs. 4 days, p < 0.0002). Six-month mortality and readmission rates were similar in tertiary and nontertiary hospitals: 3.9% versus 5.3% and 16.9% versus 21.2%, respectively. Adjusted RR of death or readmission for the nontertiary hospitals was 1.23 (95% CI 0.57 to 2.67). The use of coronary angiography and revascularization procedures in UA patients with no previous AMI is higher in tertiary than in nontertiary hospitals, but the more selective use of these procedures in nontertiary centers does not imply worse outcome.

  13. Six-month outcome in patients with myocardial infarction initially admitted to tertiary and nontertiary hospitals. RESCATE Investigators. Recursos Empleados en el Síndrome Coronario Agudo y Tiempos de Espera.

    PubMed

    Marrugat, J; Sanz, G; Masiá, R; Valle, V; Molina, L; Cardona, M; Sala, J; Serés, L; Szescielinski, L; Albert, X; Lupón, J; Alonso, J

    1997-11-01

    The aim of the present study was to ascertain whether the degree of accessibility to coronary angiography and revascularization results in differing usages or outcomes, or both, in the setting of a high coverage national health system. The selective use of coronary angiography and revascularization procedures in the management of acute myocardial infarction (MI) remains controversial. A cohort of 1,460 consecutive patients with a first MI admitted to four referral teaching hospitals (one with tertiary facilities) were followed up for 6 months after admission. Only patients initially admitted to each of the study hospitals were retained for analysis in the original hospital's cohort. End points were 6-month mortality and readmission for reinfarction, unstable angina, heart failure or severe ventricular arrhythmia. Patients admitted to the tertiary hospital were more likely to undergo coronary angiography (adjusted relative risk 4.22, 95% confidence interval [CI] 3.37 to 5.45) than those admitted to the nontertiary sites (use rate: 22.1% for nontertiary care, 55.5% for tertiary care). Revascularization procedures were performed in 21.2% of patients in the tertiary hospital and in 8.3% in the nontertiary hospitals (p < 0.0001). Median delay for emergency coronary angiography was shorter in the tertiary hospital (within 1 vs. 2 days, p < 0.0001). Six-month mortality or readmission rates were similar (23.7% and 24.7% for tertiary and nontertiary care, respectively). After adjustment for comorbidity and disease severity, the relative risk of death or readmission for the tertiary hospital was 1.03 (95% CI 0.69 to 1.53) times that of the nontertiary hospitals. Selective use of coronary angiography and revascularization procedures may be as effective as less restricted use in the management of acute MI.

  14. Effects of intensive glucose control on platelet reactivity in patients with acute coronary syndromes. Results of the CHIPS Study ("Control de Hiperglucemia y Actividad Plaquetaria en Pacientes con Sindrome Coronario Agudo").

    PubMed

    Vivas, David; García-Rubira, Juan C; Bernardo, Esther; Angiolillo, Dominick J; Martín, Patricia; Calle-Pascual, Alfonso; Núñez-Gil, Iván; Macaya, Carlos; Fernández-Ortiz, Antonio

    2011-05-01

    Hyperglycaemia has been associated with increased platelet reactivity and impaired prognosis in patients with acute coronary syndrome (ACS). Whether platelet reactivity can be reduced by lowering glucose in this setting is unknown. The aim of this study was to assess the functional impact of intensive glucose control with insulin on platelet reactivity in patients admitted with ACS and hyperglycaemia. This is a prospective, randomised trial evaluating the effects of either intensive glucose control (target glucose 80-120 mg/dl) or conventional control (target glucose 180 mg/dl or less) with insulin on platelet reactivity in patients with ACS and hyperglycaemia. The primary endpoint was platelet aggregation following stimuli with 20 μM ADP at 24 h and at hospital discharge. Aggregation following collagen, epinephrine and thrombin receptor-activated peptide, as well as P2Y₁₂ reactivity index and surface expression of glycoprotein IIb/IIIa and P-selectin were also measured. Of the 115 patients who underwent random assignment, 59 were assigned to intensive and 56 to conventional glucose control. Baseline platelet functions and inhospital management were similar in both groups. Maximal aggregation after ADP stimulation at hospital discharge was lower in the intensive group (47.9 ± 13.2% vs 59.1 ± 17.3%; p=0.002), whereas no differences were found at 24 h. Similarly all other parameters of platelet reactivity measured at hospital discharge were significantly reduced in the intensive glucose control group. In this randomised trial, early intensive glucose control with insulin in patients with ACS presenting with hyperglycaemia was found to decrease platelet reactivity. Clinical Trial Registration Number http://www.controlledtrials.com/ISRCTN35708451/ISRCTN35708451.

  15. [Management of non-ST-segment-elevation acute coronary syndromes in Spain. The DESCARTES (Descripción del Estado de los Síndromes Coronarios Agudos en un Registro Temporal ESpañol) study].

    PubMed

    Bueno, Héctor; Bardají, Alfredo; Fernández-Ortiz, Antonio; Marrugat, Jaume; Martí, Helena; Heras, Magda

    2005-03-01

    There is little information regarding the management of non-ST segment elevation acute coronary syndromes (NSTE ACS) in Spain from a population-based perspective. Our objective was to study the status of clinical care in patients with NSTE ACS in Spain from a representative perspective of the situation on a national level. A prospective registry was used for consecutive patients with NSTE ACS admitted to 52 Spanish hospitals with different cardiological facilities. Centers that fulfilled the quality control criteria for the study were randomly selected for inclusion. Between April and May, 2002, 1877 patients were recruited. Median age was 69 years, 93% had at least one risk factor and 73% had antecedents of cardiovascular disease. The electrocardiogram on admission was abnormal in 76% of the cases, and troponin levels were elevated in 53%. Twenty-seven percent of the patients were admitted to a cardiac care unit or intensive care unit. The rates of use of diagnostic techniques were: echocardiography 56%; non-invasive test for detection of ischemia 39%; coronary angiography 41%. During hospitalization, 24% underwent coronary revascularization, 88% received aspirin, 81% heparin, 37% clopidogrel, 12% glycoprotein IIb/IIIa inhibitors, 63% ss-blockers, 46% angiotensin-converting enzyme inhibitors, and 52% statins. The final diagnosis was angina in 54%, myocardial infarction in 28%, and other in 18%. Mortality was 3.7% at 28 days and 7.8% at 6 months. DESCARTES is the first representative registry of NSTE ACS management in Spain. It shows that despite their high-risk profile, these patients receive suboptimal medical care according to current clinical recommendations.

  16. Primary angioplasty vs. fibrinolysis in very old patients with acute myocardial infarction: TRIANA (TRatamiento del Infarto Agudo de miocardio eN Ancianos) randomized trial and pooled analysis with previous studies.

    PubMed

    Bueno, Héctor; Betriu, Amadeo; Heras, Magda; Alonso, Joaquín J; Cequier, Angel; García, Eulogio J; López-Sendón, José L; Macaya, Carlos; Hernández-Antolín, Rosana

    2011-01-01

    To compare primary percutaneous coronary intervention (pPCI) and fibrinolysis in very old patients with ST-segment elevation myocardial infarction (STEMI), in whom head-to-head comparisons between both strategies are scarce. Patients ≥75 years old with STEMI <6 h were randomized to pPCI or fibrinolysis. The primary endpoint was a composite of all-cause mortality, re-infarction, or disabling stroke at 30 days. The trial was prematurely stopped due to slow recruitment after enrolling 266 patients (134 allocated to pPCI and 132 to fibrinolysis). Both groups were well balanced in baseline characteristics. Mean age was 81 years. The primary endpoint was reached in 25 patients in the pPCI group (18.9%) and 34 (25.4%) in the fibrinolysis arm [odds ratio (OR), 0.69; 95% confidence interval (CI) 0.38-1.23; P = 0.21]. Similarly, non-significant reductions were found in death (13.6 vs. 17.2%, P = 0.43), re-infarction (5.3 vs. 8.2%, P = 0.35), or disabling stroke (0.8 vs. 3.0%, P = 0.18). Recurrent ischaemia was less common in pPCI-treated patients (0.8 vs. 9.7%, P< 0.001). No differences were found in major bleeds. A pooled analysis with the two previous reperfusion trials performed in older patients showed an advantage of pPCI over fibrinolysis in reducing death, re-infarction, or stroke at 30 days (OR, 0.64; 95% CI 0.45-0.91). Primary PCI seems to be the best reperfusion therapy for STEMI even for the oldest patients. Early contemporary fibrinolytic therapy may be a safe alternative to pPCI in the elderly when this is not available.

  17. [Type of treatment and short-term outcome in elderly patients with acute myocardial infarction admitted to hospitals with a primary coronary angioplasty facility. The TRIANA (TRatamiento del Infarto Agudo de miocardio eN Ancianos) Registry].

    PubMed

    Bardají, Alfredo; Bueno, Héctor; Fernández-Ortiz, Antonio; Cequier, Angel; Augé, Josep M; Heras, Magda

    2005-04-01

    The nature and outcome of treatment for acute myocardial infarction in elderly patients admitted to Spanish hospitals with primary angioplasty facilities are not well documented. Prospective analysis of registry data on patients > or =75 years old with ST-segment-elevation acute myocardial infarction admitted between April and July 2002 to Spanish hospitals with an active primary angioplasty program. We followed up 410 consecutive patients for 1 month. Their mean age was 80 (4.3) years and 46% were female. The median delay between symptom onset and arrival at hospital was 190 minutes. Around 42% of patients received no reperfusion therapy, 35% were treated by thrombolysis, and 22% by primary angioplasty. Patients who underwent reperfusion therapy were younger, were more frequently male, had a shorter delay from symptom onset to hospital arrival, and had a better initial hemodynamic status (Killip Class). However, they were more likely to have extensive anterior infarctions. Overall, 30-day mortality was 24.9%. Independent predictors of death were age, systolic blood pressure, and Killip class >1, but not use of thrombolysis or primary angioplasty. Over 42% of elderly patients with myocardial infarction admitted to Spanish hospitals with angioplasty facilities did not receive reperfusion therapy. Thrombolysis was the most frequently used reperfusion therapy. However, neither thrombolysis nor primary angioplasty improved 30-day mortality.

  18. Primary angioplasty vs. fibrinolysis in very old patients with acute myocardial infarction: TRIANA (TRatamiento del Infarto Agudo de miocardio eN Ancianos) randomized trial and pooled analysis with previous studies

    PubMed Central

    Bueno, Héctor; Betriu, Amadeo; Heras, Magda; Alonso, Joaquín J.; Cequier, Angel; García, Eulogio J.; López-Sendón, José L.; Macaya, Carlos; Hernández-Antolín, Rosana; Bueno, Héctor; Hernández-Antolín, Rosana; Alonso, Joaquín J.; Betriu, Amadeo; Cequier, Angel; García, Eulogio J.; Heras, Magda; López-Sendón, José L.; Macaya, Carlos; Azpitarte, José; Sanz, Ginés; Chamorro, Angel; López-Palop, Ramón; Sionis, Alex; Arós, Fernando; García-Fernández, Eulogio; Rubio, Rafael; Hernández, Felipe; Tascón, Juan Carlos; Moreu, José; Betriu, Amadeu; Heras, Magda; Hernández-Antolín, Rosana; Fernández-Ortiz, Antonio; Morís, César; de Posada, Ignacio Sánchez; Cequier, Ángel; Esplugas, Enrique; Melgares, Rafael; Bosa, Francisco; García-González, Martín Jesús; Lezáun, Román; Carmona, José Ramón; Vázquez, José Manuel; Castro-Beiras, Alfonso; Picart, Joan García; de Rozas, José Domínguez; Fernández, José Díaz; Vázquez, Felipe Fernández; Alonso, Norberto; Zueco, José Javier; San José, José María; San Román, Alberto; Hernández, Carolina; García, José María Hernández; Alcántara, Ángel García; Bethencourt, Armando; Fiol, Miquel; Mancisidor, Xabier; Mancisidor, Xabier; Ruiz, Rafael; Hidalgo, Rafael; Sobrino, Nicolás; Maqueda, Isidoro González; Torres, Alfonso; Arós, Fernando; Amaro, Antonio; Jaquet, Michel

    2011-01-01

    Aims To compare primary percutaneous coronary intervention (pPCI) and fibrinolysis in very old patients with ST-segment elevation myocardial infarction (STEMI), in whom head-to-head comparisons between both strategies are scarce. Methods and results Patients ≥75 years old with STEMI <6 h were randomized to pPCI or fibrinolysis. The primary endpoint was a composite of all-cause mortality, re-infarction, or disabling stroke at 30 days. The trial was prematurely stopped due to slow recruitment after enroling 266 patients (134 allocated to pPCI and 132 to fibrinolysis). Both groups were well balanced in baseline characteristics. Mean age was 81 years. The primary endpoint was reached in 25 patients in the pPCI group (18.9%) and 34 (25.4%) in the fibrinolysis arm [odds ratio (OR), 0.69; 95% confidence interval (CI) 0.38–1.23; P = 0.21]. Similarly, non-significant reductions were found in death (13.6 vs. 17.2%, P = 0.43), re-infarction (5.3 vs. 8.2%, P = 0.35), or disabling stroke (0.8 vs. 3.0%, P = 0.18). Recurrent ischaemia was less common in pPCI-treated patients (0.8 vs. 9.7%, P< 0.001). No differences were found in major bleeds. A pooled analysis with the two previous reperfusion trials performed in older patients showed an advantage of pPCI over fibrinolysis in reducing death, re-infarction, or stroke at 30 days (OR, 0.64; 95% CI 0.45–0.91). Conclusion Primary PCI seems to be the best reperfusion therapy for STEMI even for the oldest patients. Early contemporary fibrinolytic therapy may be a safe alternative to pPCI in the elderly when this is not available. Clinicaltrials.gov # NCT00257309. PMID:20971744

  19. Self-assembly of biaxial discorectangular lead carbonate nanosheets into stacked ribbons studied by SAXS and HAADF-STEM tomographic tilt series.

    PubMed

    Zhang, J; Vad, T; Heidelmann, M; Weirich, T E; Sager, W F C

    2014-12-21

    The self-assembling behaviour of 2.6 nm thin PbCO3 nanoplatelets with discorectangular shape and uniform width and thickness occurring after their formation in nonionic water-in-oil microemulsions has been investigated using synchrotron small angle X-ray scattering (SAXS) and (scanning) transmission electron microscopy ((S)TEM). The presence of attractive depletion forces originating from the ubiquitous microemulsion droplets triggers a new type of superstructure at low particle concentration. Instead of the universally observed formation of face-to-face assembled lamellar mesostructures, the nanosheets self-organise into extended ribbon structures, whereby each on top lying sheet is displaced by a constant shift in the length and width directions leading to a so far unprecedented staggered zigzag-type stack assembly with restricted height. This type of stacking gives rise to a complex interference pattern in the isotropic small angle scattering of the stacked ribbon assemblies (SRAs) in reverse micellar solution. Different to the, for lamellar-structured nanosheets typical, diffraction peaks at multiples of the wave vector corresponding to one particular repeat distance, the scattering peaks measured in this study are asymmetric, displaying a shoulder on their low wave vector side. The asymmetric shape of the observed face-to-face correlation peaks indicates that the SRAs do not extend in one direction only. Their scattering behaviour is analysed by expanding the Kratky-Porod structure factor for stacking plates into three dimensions. High-angle annular dark-field (HAADF)-STEM tilt series have complementary been acquired to retrieve three-dimensional structural information on the SRAs in the dry state and to confirm the model used for the refinement of the SAXS data.

  20. Comparison of grain to grain orientation and stiffness mapping by spatially resolved acoustic spectroscopy and EBSD.

    PubMed

    Mark, A F; Li, W; Sharples, S; Withers, P J

    2017-07-01

    Our aim was to establish the capability of spatially resolved acoustic spectroscopy (SRAS) to map grain orientations and the anisotropy in stiffness at the sub-mm to micron scale by comparing the method with electron backscatter diffraction (EBSD) undertaken within a scanning electron microscope. In the former the grain orientations are deduced by measuring the spatial variation in elastic modulus; conversely, in EBSD the elastic anisotropy is deduced from direct measurements of the crystal orientations. The two test-cases comprise mapping the fusion zones for large TIG and MMA welds in thick power plant austenitic and ferritic steels, respectively; these are technologically important because, among other things, elastic anisotropy can cause ultrasonic weld inspection methods to become inaccurate because it causes bending in the paths of sound waves. The spatial resolution of SRAS is not as good as that for EBSD (∼100 μm vs. ∼a few nm), nor is the angular resolution (∼1.5° vs. ∼0.5°). However the method can be applied to much larger areas (currently on the order of 300 mm square), is much faster (∼5 times), is cheaper and easier to perform, and it could be undertaken on the manufacturing floor. Given these advantages, particularly to industrial users, and the on-going improvements to the method, SRAS has the potential to become a standard method for orientation mapping, particularly in cases where the elastic anisotropy is important over macroscopic/component length scales. © 2017 The Authors Journal of Microscopy © 2017 Royal Microscopical Society.

  1. Chemical Contamination of Green Turtle (Chelonia mydas) Eggs in Peninsular Malaysia: Implications for Conservation and Public Health

    PubMed Central

    van de Merwe, Jason P.; Hodge, Mary; Olszowy, Henry A.; Whittier, Joan M.; Ibrahim, Kamarruddin; Lee, Shing Y.

    2009-01-01

    Background Persistent organic pollutants (POPs)—such as organochlorine pesticides (OCPs), polychlorinated biphenyls (PCBs), and polybrominated diphenyl ethers (PBDEs)—and heavy metals have been reported in sea turtles at various stages of their life cycle. These chemicals can disrupt development and function of wildlife. Furthermore, in areas such as Peninsular Malaysia, where the human consumption of sea turtle eggs is prevalent, egg contamination may also have public health implications. Objective In the present study we investigated conservation and human health risks associated with the chemical contamination of green turtle (Chelonia mydas) eggs in Peninsular Malaysia. Methods Fifty-five C. mydas eggs were collected from markets in Peninsular Malaysia and analyzed for POPs and heavy metals. We conducted screening risk assessments (SRAs) and calculated the percent of acceptable daily intake (ADI) for POPs and metals to assess conservation and human health risks associated with egg contamination. Results C. mydas eggs were available in 9 of the 33 markets visited. These eggs came from seven nesting areas from as far away as Borneo Malaysia. SRAs indicated a significant risk to embryonic development associated with the observed arsenic concentrations. Furthermore, the concentrations of coplanar PCBs represented 3 300 times the ADI values set by the World Health Organization. Conclusions The concentrations of POPs and heavy metals reported in C. mydas eggs from markets in Peninsular Malaysia pose considerable risks to sea turtle conservation and human health. PMID:19750104

  2. Chemical contamination of green turtle (Chelonia mydas) eggs in peninsular Malaysia: implications for conservation and public health.

    PubMed

    van de Merwe, Jason P; Hodge, Mary; Olszowy, Henry A; Whittier, Joan M; Ibrahim, Kamarruddin; Lee, Shing Y

    2009-09-01

    Persistent organic pollutants (POPs)-such as organochlorine pesticides (OCPs), polychlorinated biphenyls (PCBs), and polybrominated diphenyl ethers (PBDEs)-and heavy metals have been reported in sea turtles at various stages of their life cycle. These chemicals can disrupt development and function of wildlife. Furthermore, in areas such as Peninsular Malaysia, where the human consumption of sea turtle eggs is prevalent, egg contamination may also have public health implications. In the present study we investigated conservation and human health risks associated with the chemical contamination of green turtle (Chelonia mydas) eggs in Peninsular Malaysia. Fifty-five C. mydas eggs were collected from markets in Peninsular Malaysia and analyzed for POPs and heavy metals. We conducted screening risk assessments (SRAs) and calculated the percent of acceptable daily intake (ADI) for POPs and metals to assess conservation and human health risks associated with egg contamination. C. mydas eggs were available in 9 of the 33 markets visited. These eggs came from seven nesting areas from as far away as Borneo Malaysia. SRAs indicated a significant risk to embryonic development associated with the observed arsenic concentrations. Furthermore, the concentrations of coplanar PCBs represented 3 300 times the ADI values set by the World Health Organization. The concentrations of POPs and heavy metals reported in C. mydas eggs from markets in Peninsular Malaysia pose considerable risks to sea turtle conservation and human health.

  3. Meso-scale defect evaluation of selective laser melting using spatially resolved acoustic spectroscopy.

    PubMed

    Hirsch, M; Catchpole-Smith, S; Patel, R; Marrow, P; Li, Wenqi; Tuck, C; Sharples, S D; Clare, A T

    2017-09-01

    Developments in additive manufacturing technology are serving to expand the potential applications. Critical developments are required in the supporting areas of measurement and in process inspection to achieve this. CM247LC is a nickel superalloy that is of interest for use in aerospace and civil power plants. However, it is difficult to process via selective laser melting (SLM) as it suffers from cracking during rapid cooling and solidification. This limits the viability of CM247LC parts created using SLM. To quantify part integrity, spatially resolved acoustic spectroscopy (SRAS) has been identified as a viable non-destructive evaluation technique. In this study, a combination of optical microscopy and SRAS was used to identify and classify the surface defects present in SLM-produced parts. By analysing the datasets and scan trajectories, it is possible to correlate morphological information with process parameters. Image processing was used to quantify porosity and cracking for bulk density measurement. Analysis of surface acoustic wave data showed that an error in manufacture in the form of an overscan occurred. Comparing areas affected by overscan with a bulk material, a change in defect density from 1.17% in the bulk material to 5.32% in the overscan regions was observed, highlighting the need to reduce overscan areas in manufacture.

  4. Meso-scale defect evaluation of selective laser melting using spatially resolved acoustic spectroscopy

    PubMed Central

    Hirsch, M.; Catchpole-Smith, S.; Patel, R.; Marrow, P.; Li, Wenqi; Tuck, C.; Sharples, S. D.

    2017-01-01

    Developments in additive manufacturing technology are serving to expand the potential applications. Critical developments are required in the supporting areas of measurement and in process inspection to achieve this. CM247LC is a nickel superalloy that is of interest for use in aerospace and civil power plants. However, it is difficult to process via selective laser melting (SLM) as it suffers from cracking during rapid cooling and solidification. This limits the viability of CM247LC parts created using SLM. To quantify part integrity, spatially resolved acoustic spectroscopy (SRAS) has been identified as a viable non-destructive evaluation technique. In this study, a combination of optical microscopy and SRAS was used to identify and classify the surface defects present in SLM-produced parts. By analysing the datasets and scan trajectories, it is possible to correlate morphological information with process parameters. Image processing was used to quantify porosity and cracking for bulk density measurement. Analysis of surface acoustic wave data showed that an error in manufacture in the form of an overscan occurred. Comparing areas affected by overscan with a bulk material, a change in defect density from 1.17% in the bulk material to 5.32% in the overscan regions was observed, highlighting the need to reduce overscan areas in manufacture. PMID:28989306

  5. Influence of HbA1c levels on platelet function profiles associated with tight glycemic control in patients presenting with hyperglycemia and an acute coronary syndrome. A subanalysis of the CHIPS Study ("Control de HIperglucemia y Actividad Plaquetaria en Pacientes con Síndrome Coronario Agudo").

    PubMed

    Vivas, David; García-Rubira, Juan C; Bernardo, Esther; Angiolillo, Dominick J; Martín, Patricia; Calle-Pascual, Alfonso; Núñez-Gil, Iván; Macaya, Carlos; Fernández-Ortiz, Antonio

    2013-02-01

    Patients with hyperglycemia, an acute coronary syndrome and poor glycemic control have increased platelet reactivity and poor prognosis. However, it is unclear the influence of a tight glycemic control on platelet reactivity in these patients. This is a subanalysis of the CHIPS study. This trial randomized patients with hyperglycemia to undergo an intensive glucose control (target blood glucose 80-120 mg/dL), or conventional glucose control (target blood glucose <180 mg/dL). We analyzed platelet function at discharge on the subgroup of patients with poor glycemic control, defined with admission levels of HbA1c higher than 6.5%. The primary endpoint was maximal platelet aggregation following stimuli with 20 μM ADP. We also measured aggregation following collagen, epinephrine, and thrombin receptor-activated peptide, as well as P2Y12 reactivity index and surface expression of glycoprotein IIb/IIIa and P-selectin. A total of 67 patients presented HbA1c ≥ 6.5% (37 intensive, 30 conventional), while 42 had HbA1c < 6.5% (20 intensive, 22 conventional). There were no differences in baseline characteristics between groups. At discharge, patients with HbA1c ≥6.5% had significantly reduced MPA with intensive glucose control compared with conventional control (46.1 ± 22.3 vs. 60.4 ± 20.0%; p = 0.004). Similar findings were shown with other measures of platelet function. However, glucose control strategy did not affect platelet function parameters in patients with HbA1c < 6.5%. Intensive glucose control in patients presenting with an acute coronary syndrome and hyperglycemia results in a reduction of platelet reactivity only in the presence of elevated HbA1c levels.

  6. [Acute non cholestatic hepatitis as the first manifestation of secondary syphilis].

    PubMed

    Rinascente, Chiara; Candela, Giancarlo; Cervero, Miguel; Lobato, Alejandro; Carbonell, Alejandro

    2015-01-01

    We present a 34 year old male who enter the Digestive Department of the University Hospital Severo Ochoa in Madrid, Spain with jaundice with a great elevation of transaminases in relationship with an infectious syndrome that was correctly diagnosed and treated with a very good outcome.

  7. The origin of early age expansions induced in cementitious materials containing shrinkage reducing admixtures

    SciTech Connect

    Sant, Gaurav; Lothenbach, Barbara; Juilland, Patrick; Le Saout, Gwenn; Weiss, Jason; Scrivener, Karen

    2011-03-15

    Studies on the early-age shrinkage behavior of cement pastes, mortars, and concretes containing shrinkage reducing admixtures (SRAs) have indicated these mixtures frequently exhibit an expansion shortly after setting. While the magnitude of the expansion has been noted to be a function of the chemistry of the cement and the admixture dosage; the cause of the expansion is not clearly understood. This investigation uses measurements of autogenous deformation, X-ray diffraction, pore solution analysis, thermogravimetry, and scanning electron microscopy to study the early-age properties and describe the mechanism of the expansion in OPC pastes made with and without SRA. The composition of the pore solution indicates that the presence of the SRA increases the portlandite oversaturation level in solution which can result in higher crystallization stresses which could lead to an expansion. This observation is supported by deformation calculations for the systems examined.

  8. Topological nodal line semimetals in the CaP3 family of materials

    NASA Astrophysics Data System (ADS)

    Xu, Qiunan; Yu, Rui; Fang, Zhong; Dai, Xi; Weng, Hongming

    2017-01-01

    By using first-principles calculations and a k .p model analysis, we propose that the three-dimensional topological nodal line semimetal state can be realized in the CaP3 family of materials, which includes CaP3,CaAs3,SrP3,SrAs3, and BaAs3, when spin-orbit coupling (SOC) is ignored. The closed topological nodal line near the Fermi energy is protected by time reversal symmetry and spatial inversion symmetry. Moreover, drumheadlike two-dimensional surface states are also obtained on the c -direction surface of these materials. When SOC is included, the gaps open along the nodal line and these materials become strong topological insulators with Z2 indices as (1 ;010 ) .

  9. Scavengers for bacteria: Rainbow trout have two functional variants of MARCO that bind to gram-negative and -positive bacteria.

    PubMed

    Poynter, Sarah J; Monjo, Andrea L; Micheli, Gabriella; DeWitte-Orr, Stephanie J

    2017-07-22

    Class A scavenger receptors (SR-As) are a family of surface-expressed receptors who bind a wide range of polyanionic ligands including bacterial components and nucleic acids and play a role in innate immunity. Macrophage receptor with collagenous structure (MARCO) is a SR-A family member that has been studied in mammals largely for its role in binding bacteria. To date there is little information about SR-As in general and MARCO specifically in fish, particularly what ligands individual SR-A family members bind remains largely unknown. In the present study two novel rainbow trout MARCO transcript variants have been identified and their sequence and putative protein domains have been analyzed. When overexpressed in CHSE-214, a cell line that appears to lack functional scavenger receptors, GFP-tagged rtMARCO-1 and rtMARCO-2 were able to bind gram-positive, and gram-negative bacteria of both mammalian and aquatic sources. rtMARCO appears to bind bacteria via its scavenger receptor cysteine-rich (SRCR) domain, because SRCR deleted rtMARCO-1 and -2 were unable to bind bacteria. rtMARCO did not show any binding to the yeast cell wall component zymosan or to double-stranded (ds)RNA. This is the first time rainbow trout MARCO sequences have been identified and the first in-depth study exploring their ligand binding profile. This study provides novel insight into the role of rainbow trout MARCO in bacterial innate immunity. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Thyroid iodide compartments and their implication in the rat thyroid iodine organification

    SciTech Connect

    Bastiani, P.; Simon, C.

    1982-05-01

    To estimate the relative participation of transported and intrathyroidally generated iodide (internal iodide) in the iodination of newly synthesized and preexisting thyroglobulin (Tg) in the rat thyroid, the specific radioactivities (SRAs) of thyroid iodide, Tg, lysosomal iodine, and plasma hormones were followed for 92 h after radioactive iodide injection in intact or hypophysectomized rats. In control rats, the SRA of Tg and lysosomal iodine reached a maximum at 12 h. However, the SRA of lysosomal iodide was always smaller than that of Tg. In contrast, the SRA of hormonal iodide attained a maximum at 48 h. Thus, newly labeled iodine is endocytosed and mixed inside the lysosomes with older previously iodinated molecules; hormone secretion is mainly due to old labeled iodine (i.e. iodine with a high SRA from 48-96 h). These results are consistent with the presence of least two Tg compartments, with different turnover rates and hormone contents. On the other hand, in hypophysectomized rats, the SRA of Tg, lysosomes, and hormones showed only one maximum, at 24 h. Furthermore, the SRAs of Tg and lysosomes were similar at each time interval. It is inferred that in such rats, the old labeled iodine compartment is strongly reduced, and that inside the lysosomes, newly labeled iodine is predominant. Since in hypophysectomized rats, the recycling of iodide is abolished, it is concluded that in normal rats: 1) transported iodide is organified mainly by direct iodination of newly synthesized Tg, independently of TSH, and 2) internal iodide is organified mainly by delayed iodination of preexisting Tg, this process being TSH dependent.

  11. Fundamental investigations related to the mitigation of volume changes in cement-based materials at early ages

    NASA Astrophysics Data System (ADS)

    Sant, Gaurav Niteen

    The increased use of high-performance, low water-to-cement (w/c) ratio concretes has led to increased occurrences of early-age shrinkage cracking in civil engineering structures. To reduce the magnitude of early-age shrinkage and the potential for cracking, mitigation strategies using shrinkage reducing admixtures (SRAs), saturated lightweight aggregates, expansive cements and extended moist curing durations in construction have been recommended. However, to appropriately utilize these strategies, it is important to have a complete understanding of the driving forces of early-age volume change and how these methods work from a materials perspective to reduce shrinkage. This dissertation uses a first-principles approach to understand the mechanism of shrinkage reducing admixtures (SRAs) to generate an expansion and mitigate shrinkage at early-ages, quantify the influence of a CaO-based expansive additive in reducing unrestrained shrinkage, residual stress development and the cracking potential at early-ages and quantify the influence of shrinkage reducing admixtures (SRAs) and cement hydration (pore structure refinement) on the reduction induced in the fluid transport properties of the material. The effects of shrinkage reducing admixtures (SRAs) are described in terms of inducing autogenous expansions in cement pastes at early ages. An evaluation comprising measurements of autogenous deformation, x-ray diffraction (Rietveld analysis), pore solution and thermogravimetric analysis and electron microscopy is performed to understand the chemical nature and physical effects of the expansion. Thermodynamic calculations performed on the measured liquid-phase compositions indicate the SRA produces elevated Portlandite super-saturations in the pore solution which results in crystallization stress driven expansions. The thermodynamic calculations are supported by deformation measurements performed on cement pastes mixed in solutions saturated with Portlandite or containing

  12. Meta-analysis of theory of mind in anorexia nervosa and bulimia nervosa: A specific İmpairment of cognitive perspective taking in anorexia nervosa?

    PubMed

    Bora, Emre; Köse, Sezen

    2016-08-01

    evidencia disponible sobre el déficit en ToM en AN y BN y examinar los efectos de un número de variables a nivel estudio en los resultados observados. En este meta análisis fueron incluidos 15 estudios (22 muestras con trastornos alimenticios) investigando la función de ToM de 677 individuos con AN o BN y 514 controles sanos. La AN fue relacionada con déficit significativo en ToM (d=0.59) los cuales fueron pronunciados en los pacientes agudos (d=0.67). Se observaron déficits de tamaño pequeño en BN (d=0.34) y AN recuperada (d=0.35). La toma de perspectiva cognitiva (ToM-PT) (d=0.99) y la descodificación de los procesos mentales (descodificación de ToM) (d=0.61) fueron deteriorados en la AN aguda. El deterioro en la descodificación de ToM en BN fue moderado. No se encontró evidencia significativa de déficit en ToM-PT en BN. Algunas variables a nivel estudio incluyendo la larga duración de la enfermedad, índice de masa corporal (IMC) bajo y síntomas depresivos fueron asociados con mayores déficit severos en ToM en AN. DISCUSIÓN: El déficit en ToM, particularmente en ToM-PT puede ser una característica específica en la AN pero no en la BN. El deterioro en la descodificación de ToM puede contribuir a mala percepción, resistencia al tratamiento y deterioro social en AN. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2016; 49:739-749). © 2016 Wiley Periodicals, Inc.

  13. Paleotemperature regime studies of the Barents Sea sediments through spontaneous fission-track analysis

    SciTech Connect

    Il`chenko, V.L.

    1995-09-01

    The results obtained are compared to earlier data on vitrinite reflectance and the catagenetic alteration grade of disseminated organic matter studied in samples from the same boreholes and stratigraphic intervals. Accessory apatite from terricrenous sediments is usable as a geothermometer of higher sensitivity than that based on epigenetic alterations of organic matter. The fission-track analysis data on the paleothermal history of terrigenous sediments from the South Barents Depression are presented. Apatite from six offshore boreholes in the South Barents shelf (Severo-Guliaev, Kurentsov, Murman, Severo-Kil`din, Shtokman, and Ludlov fields) is studied. Paleotemperature values lying within or beyond the upper limit of the oil-productive thermal interval are considered important factors stimulating the generation of hydrocarbons.

  14. Climatology of Marine Atmospheric Refractive Effects. A Compendium of the Integrated Refractive Effects Prediction System (IREPS) Historical Summaries

    DTIC Science & Technology

    1982-12-20

    BRAZIL 111-370 303 82408 FERNANDO NORONHA ...LUIZ BRAZIL 111-37! 303 82397 FORTALEZA BRAZIL 111-367 303 82400 FERNANDO NORONHA BRAZIL 111-366 "" 303 82599 NATAL (AUGUSTO SEVERO) BRAZIL 111-368...NUMBER -’ 301 61902 RSCEHSION ISLAND OCEAN ISLANDS 111-365 303 82400 FERNANDO HOROHHR BRAZIL 111-366 303 82397 FORTALEZA BRAZIL 111-367 383

  15. Medical Aspects of Harsh Environments. Volume 2

    DTIC Science & Technology

    2002-01-01

    Edema agudo del pulmon [Acute mountain sickness: Acute edema of the lungs]. An Fac Med (Lima). 1955;38:244. 9. Hurtado A. Pathological aspects of life...recommendations for career dose lim- its, based on lifetime excess risk of cancer mortality, take into account age at first exposure and gender. The ca- reer

  16. Status report--enhancing the Canadian Best Practices Portal.

    PubMed

    Sims-Jones, N; Dyke, E

    2013-06-01

    La mission de l’Agence de la santé publique du Canada (ASPC) est de : « promouvoir et protéger la santé des Canadiens au moyen du leadership, de partenariats, de l’innovation et de la prise de mesures dans le domaine de la santé publique ». Afin de contribuer à cette mission, l’ASPC a mis en œuvre de nombreuses initiatives de mobilisation des connaissances en vue d’appuyer la prise de décisions fondées sur des données probantes en santé publique. L’une de ces initiatives, lancées en 2006, est le Portail canadien des pratiques exemplaires, une base de données interrogeable en ligne qui contient le détail d’interventions communautaires efficaces visant à promouvoir la santé et à prévenir les maladies chroniques : http://cbpp-pcpe.phac-aspc.gc.ca/fr/. La conception du Portail s’est inscrite dans une initiative fédérale plus globale, qui comprenait la création de l’ASPC elle-même, visant à renforcer les capacités en santé publique au Canada en réaction au SRAS et aux recommandations du Comité consultatif national sur le SRAS et la santé publique. La nécessité d’établir une base de données de qualité élevée contenant des résumés de données probantes récentes sur l’efficacité des interventions auprès de la population et en santé publique avait été plus particulièrement cernée dans un rapport précédent, « Le chemin à parcourir : une consultation pancanadienne sur les priorités en matière de santé publique et des populations ».

  17. Effects of problem-solving interventions on aggressive behaviours among primary school pupils in Ibadan, Nigeria.

    PubMed

    Abdulmalik, Jibril; Ani, Cornelius; Ajuwon, Ademola J; Omigbodun, Olayinka

    2016-01-01

    Aggressive patterns of behavior often start early in childhood, and tend to remain stable into adulthood. The negative consequences include poor academic performance, disciplinary problems and encounters with the juvenile justice system. Early school intervention programs can alter this trajectory for aggressive children. However, there are no studies evaluating the feasibility of such interventions in Africa. This study therefore, assessed the effect of group-based problem-solving interventions on aggressive behaviors among primary school pupils in Ibadan, Nigeria. This was an intervention study with treatment and wait-list control groups. Two public primary schools in Ibadan Nigeria were randomly allocated to an intervention group and a waiting list control group. Teachers rated male Primary five pupils in the two schools on aggressive behaviors and the top 20 highest scorers in each school were selected. Pupils in the intervention school received 6 twice-weekly sessions of group-based intervention, which included problem-solving skills, calming techniques and attribution retraining. Outcome measures were; teacher rated aggressive behaviour (TRAB), self-rated aggression scale (SRAS), strengths and difficulties questionnaire (SDQ), attitude towards aggression questionnaire (ATAQ), and social cognition and attribution scale (SCAS). The participants were aged 12 years (SD = 1.2, range 9-14 years). Both groups had similar socio-demographic backgrounds and baseline measures of aggressive behaviors. Controlling for baseline scores, the intervention group had significantly lower scores on TRAB and SRAS 1-week post intervention with large Cohen's effect sizes of 1.2 and 0.9 respectively. The other outcome measures were not significantly different between the groups post-intervention. Group-based problem solving intervention for aggressive behaviors among primary school students showed significant reductions in both teachers' and students' rated aggressive behaviours

  18. Ultra-fast preparation of high-performance thermoelectric bulk TiNiSb0.05Sn0.95 by microwave synthesis.

    PubMed

    Li, Y; Cheng, C; Lei, Y; Wang, M; Wan, R D

    2016-12-20

    The antimony-doped half-Heusler thermoelectric bulk TiNiSb0.05Sn0.95 was prepared via ultra-fast 4.5 min microwave synthesis, cold-press forming and 20 min microwave pressureless sintering. The electrical properties i.e. the Seebeck coefficient (S), electrical resistivity (ρ), and carrier concentration (n) and mobility (μ) were measured on a Seebeck coefficient/resistance analysis system (S/RAs) and Hall effect measurement system (HEMS), respectively. The thermal conductivity (κ) was measured on a laser flash thermal analyzer (LFA). The results show that a high purity single phase was obtained after microwave sintering. The electrical resistivity is 2.70-5.33 μΩ m at temperatures ranging from ∼300 to 773 K. The highest power factor of 4042 μW m(-1) K(-2) was achieved at 473 K. The microstructure analyses show that numerous circular intercrystalline pores caused by microwave sintering are present within the TiNiSn grains. The lattice and total thermal conductivity are 1.76-3.77 and 4.66-5.98 W m(-1) K(-1). The highest thermoelectric figure of merit of 0.44 was achieved at 623 K.

  19. Sensors of Infection: Viral Nucleic Acid PRRs in Fish

    PubMed Central

    Poynter, Sarah; Lisser, Graeme; Monjo, Andrea; DeWitte-Orr, Stephanie

    2015-01-01

    Viruses produce nucleic acids during their replication, either during genomic replication or transcription. These nucleic acids are present in the cytoplasm or endosome of an infected cell, or in the extracellular space to be sensed by neighboring cells during lytic infections. Cells have mechanisms of sensing virus-generated nucleic acids; these nucleic acids act as flags to the cell, indicating an infection requiring defense mechanisms. The viral nucleic acids are called pathogen-associated molecular patterns (PAMPs) and the sensors that bind them are called pattern recognition receptors (PRRs). This review article focuses on the most recent findings regarding nucleic acids PRRs in fish, including: Toll-like receptors (TLRs), RIG-I-like receptors (RLRs), cytoplasmic DNA sensors (CDSs) and class A scavenger receptors (SR-As). It also discusses what is currently known of the downstream signaling molecules for each PRR family and the resulting antiviral response, either type I interferons (IFNs) or pro-inflammatory cytokine production. The review highlights what is known but also defines what still requires elucidation in this economically important animal. Understanding innate immune systems to virus infections will aid in the development of better antiviral therapies and vaccines for the future. PMID:26184332

  20. [Viruses and bats: rabies and Lyssavirus].

    PubMed

    Tordo, N; Marianneau, M Ph

    2009-01-01

    Recent emerging zoonoses (hemorrhagic fevers due to Ebola or Marburg virus, encephalitis due to Nipah virus, severe acute respiratory syndrome due to SRAS virus...) outline the potential of bats as vectors for transmission of infectious disease to humans. Such a potential is already known for rabies encephalitis since seven out of the eight genotypes of Lyssavirus are transmitted by bats. In addition, phylogenetic reconstructions indicate that Lyssavirus have evolved in chiropters before their emergence in carnivores. Nevertheless, carnivores remain the most critical vectors for public health, in particular dogs that are originating 55.000 rabies deaths per year, essentially in developing countries. Rabies control in carnivores by parenteral (dog) or oral (wild carnivores) vaccination is efficacious and campaigns start to be more widely applied. On the other hand, rabies control in bat still remains non realistic, particularly as the pathogenicity of bat Lyssavirus for bats is still under debate, suggesting that a "diplomatic relationship" between partners would have arisen from a long term cohabitation. While comparing the interactions that humans and bats establish with Lyssavirus, scientists try to understand the molecular basis ofpathogenicity in man, a indispensable prerequisite to identify antiviral targets in a perspective of therapy.

  1. Molecular mechanisms of TSD in reptiles: a search for the magic bullet.

    PubMed

    Spotila, J R; Spotila, L D; Kaufer, N F

    1994-09-15

    Significant progress has been made in understanding mechanisms of genetic sex determination. The ZFY gene encodes a zinc finger protein but is not the primary signal in sex determination. The SRY gene is the testis determining gene in man, mouse, rabbit, and probably marsupial mouse and wallaby. Temperature dependent sex determination probably involves a modification of development of the indifferent gonad due to differential expression of one or more specific DNA sequences whose behavior is controlled by some temperature sensitive process or to differential action of a gene product such as a protein. There are ZFY and SRY-like genes in reptiles. We cloned and sequenced a portion of the ZFY gene (Zft) from snapping turtle (Chelydra serpentina) that is found in both sexes. We cloned and sequenced portions of SRY-like genes (Sra for SRY-related-autosomal) from snapping turtle. Similar genes are found in alligator (Alligator mississippiensis) and lizards. Cladistic analysis suggests that there are two or three major families of SRY-like genes in vertebrates in addition to sex specific SRY genes located on the Y chromosome of eutherian and marsupial mammals. When placed on a phylogenetic tree these data indicate that Sras were present in early tetrapods. Sequestering of the SRY gene on the Y chromosome probably happened only once and this may have been the defining moment that set the mammalian line of Therapsid reptiles apart from other reptilian groups.

  2. Current therapies and mortality in acromegaly.

    PubMed

    Găloiu, S; Poiană, C

    2015-01-01

    Acromegaly is a rare disease most frequently due to a GH secreting pituitary adenoma. Without an appropriate therapy, life of patients with acromegaly can be shortened with ten years. Pituitary surgery is usually the first line therapy for GH secreting pituitary adenomas. A meta-analysis proved that mortality is much lower in operated patients, even uncured, than the entire group of patients and is similar with the general population in patients with GH<1 μg/ L. For the patients with hypersecreting postoperative remnant tumor, those with low chance of surgical cure or with life-threatening comorbidities, medical therapies are available: somatostatin receptor analogues (SRA), dopamine agonists (DA) and GH receptor antagonists. Studies with >30% utilization of SRAs reported a lower mortality ratio than studies with lower percentages of SRA administration. Although therapy with DA has long been used in patients with acromegaly, there are no studies reporting its effect on mortality, but its efficacy is limited by the low remission rate obtained. The use of conventional external radiotherapy, although with good remission rate in time, was linked with increased mortality, mostly due to cerebrovascular diseases. Mortality in acromegaly can be reduced to expected levels from general population by using modern therapies either in monotherapy or by using multimodal approaches in experienced centers.

  3. [Prognosis in pediatric traumatic brain injury. A dynamic cohort study].

    PubMed

    Vázquez-Solís, María G; Villa-Manzano, Alberto I; Sánchez-Mosco, Dalia I; Vargas-Lares, José de Jesús; Plascencia-Fernández, Irma

    2013-01-01

    Introducción: en los niños con traumatismo, las lesiones craneoencefálicas son las principales causas de hospitalización y muerte. El objetivo de esta investigación fue identificar los factores pronóstico del traumatismo craneoencefálico en los niños. Métodos: cohorte dinámica con seis meses de seguimiento. El trauma craneoencefálico se estratificó como leve o moderado-severo, se identificó morbilidad y se realizó evaluación con la escala de coma de Glasgow. Se estimó riesgo relativo (RR) y regresión logística para factores pronóstico. Resultados: se identificaron 440 pacientes con trauma craneoencefálico leve y 98 con moderado-severo; se observó morbilidad en 1 y 5 %, respectivamente. No hubo defunciones. Los factores pronóstico para el trauma moderado-severo fueron los siguientes: lesiones relacionadas (RR = 133), fracturas (RR = 60), accidentes en la calle (RR = 17), horario nocturno (RR = 2.3) y fin de semana (RR = 2). Se presentó deterioro en la puntuación de Glasgow en 9 %, con los siguientes factores pronóstico: lesiones visibles (RR = 3), supervisión por adulto (RR = 2.5) y tiempo de evolución (RR = 1.6). Conclusiones: en los niños con trauma craneoencefálico debe establecerse el pronóstico según la energía cinética de la lesión y con la escala Glasgow.

  4. Early radium experiments in Guadalajara, M'exico

    NASA Astrophysics Data System (ADS)

    de Alba Martínez, Durruty Jesús

    2005-04-01

    In April 01, 1904, two catholic lay priests, Severo D'iaz Galindo and Jos'e Mar'ia Arreola Mendoza, performed firsts Radium experiments in Guadalajara, M'exico, just after Radium experiments realized in Mexico City by Prof. Luis G. Le'on. Results of such experiences where published in the Bolet'in Eclesi'astico y Cient'ifico del Arzobispado de Guadalajara/ (Eclesiastic and Scientific Bulletin of the Guadalajara Archbishopric), here is show this paper and some of the first Radium plates obtained. Scientific and educational situation in Guadalajara is described and how both persons became founders of the modern scientific activity in the city.

  5. [Intra-abdominal pressure as a surgery predictor in patients with acute abdominal pain].

    PubMed

    Campos-Muñoz, Manuel Alejandro; Villarreal-Ríos, Enrique; Chimal-Torres, Mariano; Pozas-Medina, Josué Atila

    2016-01-01

    Introducción: la presión intraabdominal es el estado de equilibrio de la presión de la cavidad abdominal en reposo y puede presentar cambios durante la ventilación mecánica o espontánea. El objetivo fue determinar la presión intraabdominal como predictor de cirugía en el paciente con dolor abdominal agudo. Métodos: se llevó a cabo un estudio de casos y controles anidado en una cohorte de pacientes con dolor abdominal agudo en el servicio de urgencias de un hospital de segundo nivel, en el periodo comprendido entre abril y diciembre de 2013. Se incluyeron 37 pacientes, todos fueron intervenidos quirúrgicamente con previa toma de la presión intraabdominal. Se formaron los grupos con el resultado del estudio anatomopatológico: con evidencia de proceso inflamatorio abdominal agudo (n = 28) y sin evidencia de proceso inflamatorio abdominal agudo (n = 9). Resultados: en los casos el 100 % presentó presión intraabdominal alta con una p = 0.01, RM: 5 (IC 95 %: 2.578-9.699). En los casos la media de la presión intraabdominal fue de 11.46 y en los controles de 9.2 (p = 0.183). Conclusiones: el dolor abdominal que requiere cirugía para su resolución tiene relación directa con una presión intraabdominal > 5 mmHg.

  6. [Biofeedback treatment for acute whiplash patients].

    PubMed

    Gálvez-Hernández, Carmen Lizette; Rodríguez-Ortiz, María Dolores; Del Río-Portilla, Yolanda

    2016-01-01

    Introducción: el objetivo de este trabajo consistió en evaluar el efecto fisiológico y psicológico de la retroalimentación biológica de electromiografía de superficie (RB de EMGs) en combinación con relajación muscular progresiva (RMP) en pacientes con esguince cervical (EC) agudo. Métodos: Un total de 12 pacientes con EC agudo participaron voluntariamente en el estudio, con diseño cuasiexperimental, y grupo control. Criterios de inclusión: máximo dos meses del accidente automovilístico; gravedad I y II. Se excluyeron: pacientes con historia previa de dolor persistente, o que hayan tenido lesión seria. Se dividió en dos grupos aleatoriamente (de intervención y en lista de espera). Se realizó un registro psicofisiológico de los músculos trapecios con EMGs, en conjunto con instrumentos psicométricos: inventario de ansiedad y depresión de Beck; índice de incapacidad de Oswestry; escala visual análoga y de miedo al movimiento. La intervención consistió aplicar RB de EMGs, posterior a un entrenamiento en RMP. Resultados: el grupo de intervención disminuyó significativamente su valor de simetría muscular (permaneciendo dentro de lo normal) así como su percepción subjetiva del dolor, intragrupo antes/después de la intervención. Conclusiones: se produjo un cambio significativo (tanto clínico como estadístico) en la percepción del dolor y la actividad conjunta de músculos pares. Igualmente, muestra la relevancia de atender un problema agudo multidisciplinariamente; así como la utilidad de las estrategias psicofisiológicas clínicas en pacientes agudos de EC.

  7. A comparison of the velocity parameters of SiO V = 1, J = 1 − 0, and J = 2 − 1 maser emission in semiregular variables

    SciTech Connect

    McIntosh, Gordon; Indermuehle, Balthasar E-mail: balt.indermuehle@csiro.au

    2015-03-01

    We have determined and compared the SiO maser velocity parameters of semiregular variables in the v = 1, J = 1 − 0 (J10{sup 1}) and the v = 1, J = 2 − 1 (J21) transitions. Fourteen sources in the Mopra SiO Maser Catalogue are classified as semiregular variables of types SR, SRa, SRb, or SRc. (L2 Puppis, an SRa star with an unusual SiO maser spectrum, has been analyzed individually.) We have previously presented the overall and phase dependent velocity parameters of SiO masers associated with long period variables (LPVs) of well-established periods and maxima. A comparison of the velocity centroid (VC) difference, VC21–VC10, shows mixed results for the variable types. Some differences are negative and some positive. The SRc difference is negative, large, and relatively stable. The SRb difference has the widest distribution. The velocity ranges (VRs) of the maser emission have been compared using arithmetic averages, Gaussian fits to the distributions, and Weibull fits to the distributions. For LPVs, SRs, SRas, and SRcs the VR10 is one to a few km s{sup −1} greater than the VR21. SRcs have the largest VRs by a factor of two or three indicating the greater range over which the conditions necessary for masers to originate exist in these supergiant stars. SRbs are the only classification of semiregular variable in which the VR21 exceeds the VR10. The larger VR21 compared to VR10 for SRbs appears in all comparisons. The difference in the SRb SiO maser velocity parameters may be due to a difference in the oscillation mechanism of the star. The suggested overtone oscillations of SRbs may affect the circumstellar cloud dynamics. Little theoretical work has specifically addressed the masers in semiregular variables. Qualitative comparisons of the data with the existing models of the SiO masers in LPVs are made.

  8. [Identification of the factors conditioning times and indicators of quality in the intrahospital care of acute stroke].

    PubMed

    Palazón-Cabanes, Begoña; López-Picazo Ferrer, Julio J; Morales-Ortiz, Ana; Tomás-García, Nuria

    2016-02-16

    Introduccion. El ictus es una entidad grave, pero potencialmente reversible. La reduccion del tiempo de atencion en el momento agudo es fundamental para limitar la morbimortalidad. La evaluacion de las actuaciones en la atencion al ictus es esencial, porque permite identificar oportunidades de mejora. Objetivo. Conocer y analizar los factores condicionantes de la demora en los tiempos de atencion intrahospitalaria para la posterior implementacion de un ciclo de mejora. Pacientes y metodos. Estudio retrospectivo de pacientes con ictus isquemico agudo tratados con trombolisis intravenosa (TLIV) y/o trombectomia intraarterial mecanica (TIAM) en un hospital terciario entre 2009-2014. Se analizaron los tiempos intrahospitalarios, los indicadores de calidad y sus factores condicionantes. Resultados. Un total de 337 pacientes fueron tratados con TLIV (66,2%) y/o TIAM (54,1%). Tiempos medios de actuacion (intervalo de confianza al 95%): puerta-TLIV, 75,88 min (71,67-80,16 min); puerta-TC, 43,27 min (40,17-46,37 min); TC-TLIV, 38,01 min (34,08-41,93 min); TLIV-TIAM, 127,44 min (108,7-146,18 min); puerta-TIAM, 155,22 min (140,03-170,4 min). El 36,6% fue tratado en menos de 60 min, la neuroimagen se realizo en menos de 25 min en un 19,9% y el tiempo TLIV-TIAM fue menor de 90 min en un 28,8%. La edad, el tiempo inicio-puerta, la procedencia de otro hospital y el periodo de aprendizaje se identificaron como factores condicionantes. Conclusiones. El conocimiento de la situacion actual de los tiempos e indicadores intrahospitalarios y sus factores condicionantes son el punto de partida y proporcionan la motivacion necesaria para impulsar una iniciativa para la mejora de la calidad asistencial en el paciente con ictus agudo.

  9. [Peripheral vertigo versus central vertigo. Application of the HINTS protocol].

    PubMed

    Batuecas-Caletrío, Ángel; Yáñez-González, Raquel; Sánchez-Blanco, Carmen; González-Sánchez, Enrique; Benito, José; Gómez, José Carlos; Santa Cruz-Ruiz, Santiago

    2014-10-16

    Introduccion. Uno de los dilemas mas importantes concernientes al vertigo en urgencias es su diagnostico diferencial. Existen signos de alarma de gran sensibilidad en la exploracion que pueden ponernos en la pista de encontrarnos ante un vertigo central. Objetivo. Determinar la eficacia de la aplicacion del protocolo HINTS en el diagnostico del accidente cerebrovascular que simula un vertigo periferico. Pacientes y metodos. Estudio observacional descriptivo sobre pacientes ingresados con diagnostico de sindrome vestibular agudo en urgencias. Todos los pacientes fueron objeto de un seguimiento diario hasta la mejoria de sus sintomas con informacion del nistagmo, la maniobra de impulso oculocefalico y el test de skew. Se comparan los resultados del estudio de resonancia magnetica con la alteracion en alguno de esos tres signos a lo largo del ingreso del enfermo. Resultados. Se reunio a 91 pacientes, con una edad media de 55,8 años. Se objetivo un accidente cerebrovascular en ocho de ellos. De estos (edad media: 71 años), en siete existia una alteracion en alguno de los signos HINTS y en uno el estudio fue normal (sensibilidad: 0,88; especificidad: 0,96). Todos ellos tenian algun factor de riesgo vascular. Conclusiones. Una exploracion adecuada y dirigida ante un paciente que acude a urgencias con un sindrome vestibular agudo resulta de vital importancia para establecer el diagnostico diferencial entre la patologia periferica y la central, ya que algunos accidentes cerebrovasculares se pueden presentar bajo la apariencia de un vertigo agudo. Aplicar un protocolo como HINTS permite sospechar la patologia central con una gran sensibilidad y especificidad.

  10. RENASICA II: A Mexican acute myocardial infarction registry that highlights the importance of regional registries

    PubMed Central

    Al Suwaidi, Jassim

    2014-01-01

    Cardiovascular diseases are the leading cause of death, worldwide, with disproportionate representation in low- and middle-income countries (LMICs). The Registro Nacional de los Síndromes Coronarios Agudos II (RENASICA II) investigators reported smoking, hypertension and diabetes were the main risk factors among Mexican patients presenting with ST-elevation myocardial infarction (STEMI). Fibrinolytic therapy was administered to 37%. Primary percutaneous coronary intervention (PPCI) was performed in only 15% of patients. 30-day mortality was 10%. This study highlights the importance of conducting regional registries for quality improvement. PMID:25780784

  11. RENASICA II: A Mexican acute myocardial infarction registry that highlights the importance of regional registries.

    PubMed

    Al Suwaidi, Jassim

    2014-01-01

    Cardiovascular diseases are the leading cause of death, worldwide, with disproportionate representation in low- and middle-income countries (LMICs). The Registro Nacional de los Síndromes Coronarios Agudos II (RENASICA II) investigators reported smoking, hypertension and diabetes were the main risk factors among Mexican patients presenting with ST-elevation myocardial infarction (STEMI). Fibrinolytic therapy was administered to 37%. Primary percutaneous coronary intervention (PPCI) was performed in only 15% of patients. 30-day mortality was 10%. This study highlights the importance of conducting regional registries for quality improvement.

  12. Causes of Death in an Acute Psychiatric Inpatient Unit of a Portuguese General Hospital.

    PubMed

    Barbosa, Sofia; Sequeira, Márcia; Castro, Sara; Manso, Rita; Klut Câmara, Catarina; Trancas, Bruno; Borja-Santos, Nuno; Maia, Teresa

    2016-08-01

    Introdução: Os doentes afectos de patologia psiquiátrica apresentam maior risco de morte, tanto por causas naturais como não naturais. Este estudo avalia as causas de morte de todos os doentes de uma unidade de internamento de agudos de Psiquiatria num hospital geral em Portugal, ao longo de dezasseis anos (de 1998 a 2013). Material e Métodos: Vinte e um doentes morreram na unidade de internamento de doentes agudos entre 1998 e 2013 (média 1,3 por ano). As características demográficas, os diagnósticos médicos e psiquiátricos foram recolhidos através de um estudo retrospectivo que consistiu na análise dos processos clínicos da amostra selecionada. Os doentes transferidos para outras enfermarias durante o internamento não foram incluídos no estudo. Resultados: As doenças do sistema circulatório foram as causas de morte mais prevalentes, ocorrendo em 2/3 dos doentes, incluindo embolismo pulmonar (n = 6), acidente vascular cerebral (n = 3), arritmia cardíaca (n = 2), enfarte agudo do miocárdio (n = 1), rutura de aneurisma da aorta abdominal (n = 1) e insuficiência cardíaca (n = 1). Dois doentes morreram de pneumonia e em quatro casos a causa de morte foi indeterminada. Apenas um caso de suicídio foi registado. Discussão: As doenças do aparelho circulatório foram as causas de morte mais frequentes nesta unidade de agudos. O suicídio em doentes internados, apesar de constituir um evento raro, é uma realidade que comporta consequências complexas para os profissionais de saúde, familiares e restantes doentes, devendo permanecer como foco de prevenção continuada. Conclusão: Os estudos de mortalidade são importantes para determinar a qualidade dos cuidados de saúde e criar recomendações para medidas preventivas.

  13. Porosity developed during mineral replacement reactions: implications for fluid flux in the Earth

    NASA Astrophysics Data System (ADS)

    Putnis, Christine V.; Trindade Pedrosa, Elisabete; Hövelmann, Jörn; Renard, François; Ruiz-Agudo, Encarnacion

    2017-04-01

    Aqueous fluids, that are ubiquitous in the crust of the Earth, will move through possible pathways in rocks. Rocks characteristically have low permeability but fractures can provide fast fluid channels. Mineral grain boundaries also present easy fluid pathways. However, porosity within minerals forms when a mineral is out of equilibrium with an aqueous fluid and reactions take place in an attempt to reach a new equilibrium. Commonly, dissolution at a mineral-fluid interface initiates one or several coupled reactions involving dissolution and precipitation (Putnis C.V. and Ruiz-Agudo E., 2013; Ruiz-Agudo et al., 2014). In pseudomorphic volume-deficit reactions, a new phase forms while porosity is created, and thereby reactive fluid flow through the originally solid mineral is enhanced. These coupled dissolution-replacement reactions therefore will constrain the flux of material carried by the fluid. These reactions are common during such processes as metamorphism, metasomatism, and weathering. When rock-forming minerals such as feldspars, olivine, pyroxenes and carbonates are in contact with aqueous fluids (typically NaCl-rich) porosity is formed during the interfacial replacement reactions. Elements present in the parent mineral are released to the fluid and therefore mobilized for transport elsewhere. Porosity formation has been shown in a number of systems, such as during the albitisation of feldspars (Hövelmann et al., 2009) and the replacement of carbonates by apatite phases (Pedrosa et al., 2016). Some of these examples will be presented as well as examples from atomic force microscopy (AFM) experiments used to image these reactions at a nanoscale, especially at the calcite-fluid interface, when new phases can be directly observed forming. This mechanism has also been shown as a means of carbon and phosphorus sequestration and for the removal of toxic elements from superficial waters, such as Se and As. References Ruiz-Agudo E., Putnis C.V., Putnis A. (2014

  14. [Rescue treatment in acute thrombosis of intracranial stents].

    PubMed

    Pumar, José M; Banguero, Alexandra; Arias-Rivas, Susana; Blanco, Miguel; Rodríguez-Yáñez, Manuel; Sucasas, Paula; Blanco, Miguel; Castiñeira-Mourenza, José A; Vázquez-Herrero, Fernando

    2014-02-01

    Introduccion. La trombosis aguda intrastent es una complicacion potencialmente grave en el stenting intracraneal. Es primordial determinar cual es la terapia mas adecuada en las trombosis intrastent. Caso clinico. Mujer de 58 años, el primer caso de trombosis aguda de un stent intracraneal, que fue tratada con exito mediante fibrinolisis tras la implantacion de un dispositivo diversificador de flujo (Silk) en un aneurisma basilar fusiforme. Conclusion. La administracion de abciximab como tratamiento de rescate parece segura en los casos de formaciones de trombos agudos intrastent.

  15. [Multiple embolisms by atrial myxoma].

    PubMed

    Contreras, Alejandro E; Cragnolini, Ana C; Brenna, Eduardo J; Parisi, Gustavo R; Chamale, Roberto A; Assante, Maria L; Paladini, Guillermo; Martinez Colombres, Alejandro

    2013-01-01

    El mixoma es el tumor cardiaco más frecuente, se presenta comúnmente entre la tercera y sexta decada de la vida y es más prevalente en mujeres. Una forma de presentación es la embolia sistémica. Una mujer de 56 años de edad presentó síntomas de isquemia cerebral, infarto agudo de miocardio silente e isquemia en miembro inferior derecho. Se diagnosticó mixoma de aurícula izquierda y fue intervenida quirúrgicamente de urgencia.

  16. ALMA Polarization Science Verification: 3C 286

    NASA Astrophysics Data System (ADS)

    Nagai, H.; Nakanishi, K.; Paladino, R.; Moellenbrock, G.; Fomalont, E.; Amigano, A.; Vlahakis, C.; Remijan, A.; ALMA Polarization Team

    2015-12-01

    The ALMA polarization science verification results on 3C 286 are presented. The measured polarization percentage and polarization position angle of the continuum emission at 1.3 mm are about 16% and 39 degrees, respectively. They are quite similar to those at longer wavelength, but seem to increase slightly. Similar trends were also found in the previous measurement using the IRAM 30-m telescope (Agudo et al. 2012). The final image rms on the polarization image is better than 0.1% of the total intensity, demonstrating the very high polarization sensitivity of ALMA.

  17. Paleozoic crudes of Tomsk province

    SciTech Connect

    Smol'yaninova, N.M.; Mashukova, Z.I.; Nemirovskaya, G.V.

    1983-01-01

    The Paleozoic crudes typically have low densities at 20/sup 0/C, low contents of resins, high viscosities at 20/sup 0/C, rather high solid points, and high contents of solid paraffins. The Paleozoic crudes are in no way inferior in quality to the Mesozoic crudes of Tomsk province, and are even better in some respects (yields of high-V.I. and medium-V.I. oils). They can be processed with either a fuel/lube or petrochemical refining scheme. Finds that the crudes from the Ostaninsk and SeveroOstaninsk fields, in terms of their paraffin and sulfur contents and other indexes, are similar to the Jurassic crudes of the Zhetybai field on the Mangyshlak peninsula. These 2 crudes and the Chkalovsk crude, even though the high wax contents offer problems in production and transportation, can serve as good raw materials for fuel and oil production, and also for the manufacture of liquid and solid paraffins.

  18. Patient satisfaction with a home televisiting service based on interactive television over a cable network.

    PubMed

    Valero, M A; Arredondo, M T; del Nogal, F; Rodríguez, J M; Frías, E

    2000-01-01

    Experience shows that high-quality audiovisual contact between remote health carers and patients facilitates a telemedicine service. However, the lack of broadband communication to the home usually prevents domestic televisiting. Deployment of cable networks in Spain has allowed the implementation of a home televisiting service designed for patients with chronic diseases. In a trial, 15 patients received televisits by three specialists and three nurses from the Severo Ochoa Hospital in Madrid. Five patients suffered from chronic pain, five were from the nephrology unit and five had been treated at the intensive-care unit after acute myocardial infarction. Each patient participated in three televisiting sessions, two provided by a specialist and the other by a nurse. The average length of a televisit was 12 min (range 5-21 min). The patients expressed their satisfaction with the service.

  19. Relation of Lagragian structures and drifter dynamics in the Gulf of Mexico

    NASA Astrophysics Data System (ADS)

    Mendoza, Carolina; Mancho, Ana Maria; Wiggins, Stephen

    2013-11-01

    We use a Lagrangian descriptor (the so called function M) which measures the length of particle trajectories on the ocean surface over a given interval of time. With this tool we identify the Lagrangian skeleton of the flow and compare it on three datasets over the Gulf of Mexico during the year 2010. The satellite altimetry data used come from AVISO and simulations from HYCOM GOMl0.04 experiments 30.1 and 31.0. We contrast the Lagrangian structure and transport using the evolution of several surface drifters. We show that the agreement in relevant cases between Lagrangian structures and dynamics of drifters depends on the quality of the data on the studied area. We acknowledge to the grants: Becas de Movilidad de Caja Madrid 2011, MTM2011-26696, ILINK-0145, ONR Grant Number N00014-01-1-0769 and ICMAT Severo Ochoa SEV-2011-0087.

  20. Insights on a Marine Oil Spill from a dynamical system perspective

    NASA Astrophysics Data System (ADS)

    Mancho, Ana M.; Garcia-Garrido, Victor J.; Ramos, Antonio G.; Coca, Josep; Wiggins, Stephen

    2016-11-01

    We use tools from dynamical systems theory and remote sensing techniques and show how they are effective instruments which may greatly contribute to the decision-making protocols of the emergency services in the real-time management of oil spills. This work presents the successful interplay of these techniques for a recent situation, the sinking of the Oleg Naydenov fishing ship that took place in Spain, close to the Canary Islands, in April 2015. This research is supported by MINECO ICMAT Severo Ochoa project SEV-2011-0087 and Grants MTM2014-56392-R, UNLP-13-3E-2664 (2013-2015) and ONR Grant No. N00014- 01-1-0769.

  1. Constituent Quarks and Gluons, Polyakov loop and the Hadron Resonance Gas Model ***

    NASA Astrophysics Data System (ADS)

    Megías, E.; Ruiz Arriola, E.; Salcedo, L. L.

    2014-03-01

    Based on first principle QCD arguments, it has been argued in [1] that the vacuum expectation value of the Polyakov loop can be represented in the hadron resonance gas model. We study this within the Polyakov-constituent quark model by implementing the quantum and local nature of the Polyakov loop [2, 3]. The existence of exotic states in the spectrum is discussed. Presented by E. Megías at the International Nuclear Physics Conference INPC 2013, 2-7 June 2013, Firenze, Italy.Supported by Plan Nacional de Altas Energías (FPA2011-25948), DGI (FIS2011-24149), Junta de Andalucía grant FQM-225, Spanish Consolider-Ingenio 2010 Programme CPAN (CSD2007-00042), Spanish MINECO's Centro de Excelencia Severo Ochoa Program grant SEV-2012-0234, and the Juan de la Cierva Program.

  2. Lagrangian Descriptors: A Method for Revealing Phase Space Structures of General Time Dependent Dynamical Systems

    NASA Astrophysics Data System (ADS)

    Mancho, Ana M.; Wiggins, Stephen; Curbelo, Jezabel; Mendoza, Carolina

    2013-11-01

    Lagrangian descriptors are a recent technique which reveals geometrical structures in phase space and which are valid for aperiodically time dependent dynamical systems. We discuss a general methodology for constructing them and we discuss a ``heuristic argument'' that explains why this method is successful. We support this argument by explicit calculations on a benchmark problem. Several other benchmark examples are considered that allow us to assess the performance of Lagrangian descriptors with both finite time Lyapunov exponents (FTLEs) and finite time averages of certain components of the vector field (``time averages''). In all cases Lagrangian descriptors are shown to be both more accurate and computationally efficient than these methods. We thank CESGA for computing facilities. This research was supported by MINECO grants: MTM2011-26696, I-Math C3-0104, ICMAT Severo Ochoa project SEV-2011-0087, and CSIC grant OCEANTECH. SW acknowledges the support of the ONR (Grant No. N00014-01-1-0769).

  3. Spread of different rhinovirus B genotypes in hospitalized children in Spain.

    PubMed

    Cuevas, María Teresa; Molinero, Mar; Pozo, Francisco; Calvo, Cristina; García-García, Maria Luz; Reyes, Noelia; Ledesma, Juan; Casas, Inmaculada

    2013-09-01

    Human Rhinovirus (HRV) classification is an evolving process. New genotypes have been described within HRV-A and HRV-C species, but only one has been accepted related to HRV-B. From 2003 to 2010, a total of 3987 nasopharyngeal aspirate samples were taken from pediatric patients admitted to the Severo Ochoa Hospital in Madrid (Spain). After viral analysis, 949 (23.8%) tested positive to HRV. A random selection of 397 (42%) positive samples showed that 39 (9.8%) were HRV-B. The sequencing of partial VP4/VP2 coding region revealed the spread of 13 of 25 defined HRV-B serotypes and three putative new genotypes. Such results remark the high diversity of HRV-B.

  4. Alberto Sols, teacher and mentor of spanish biochemists (1917-1989).

    PubMed

    Gancedo, Carlos

    2012-06-01

    Biochemistry in Spain owes much to the figure of Alberto Sols. In words of Nobel Prize winner Severo Ochoa: "He has been the first scientist to establish successfully biochemistry in Spain." His intellectual rigour, care in experimental design, emphasis on quality, and attention to the presentation of results permeated far beyond his inner circle to the then fledging Spanish biochemical community. It would be difficult to find some Spanish biochemist of the generation that now starts to retire who has not been influenced in a way or another by the work of Sols. However, it is also likely that the new generations of biochemists and molecular biologists in the country ignore who was Sols and what their field owns to him. The following lines try to highlight some key points of his scientific biography, the circumstances in which they took place and the state of the corresponding research area at that moment. Copyright © 2012 Wiley Periodicals, Inc.

  5. Esquizofrenia y trastorno en el consumo de sustancias: prevalencia y characterísticas sociodemográficas en la población Latina

    PubMed Central

    Jiménez-Castro, Lorena; Raventós-Vorst, Henriette; Escamilla, Michael

    2012-01-01

    El interés por comprender la co-morbilidad de la esquizofrenia y el trastorno en el uso de sustancias, ha aumentado debido al incremento de este diagnóstico, a los efectos negativos observados en el sujeto y a los costos en los servicios de salud. Este trastorno dual puede tener efectos dramáticos en el curso clínico del trastorno psicótico tales como: mayores recaídas, re-hospitalizaciones, síntomas más severos, no adherencia al tratamiento antipsicótico, cambios marcados del humor, aumento en el grado de hostilidad e ideación suicida, así como alteraciones en otras áreas del funcionamiento incluyendo violencia, victimización, indigencia y problemas legales. La literatura proveniente en particular de Estados Unidos y Europa sugiere que el rango de prevalencia para este diagnóstico puede oscilar entre el 10% hasta el 70%. En este estudio, revisamos la prevalencia del diagnóstico dual de esquizofrenia y trastorno en el uso sustancias, así como sus características sociodemográficas, con base en la literatura disponible alrededor del mundo dando énfasis en la poblacion latina. A pesar de que este diagnóstico es ampliamente aceptado, se conoce poco sobre su prevalencia en la población latina, sobre los factores ambientales, demográficos, clínicos y otras características de estos individuos. Un mejor conocimiento sobre este diagnóstico permitiría mejorar los métodos para la detección y adecuada valoración del trastorno en el uso de sustancias en personas con trastornos metales severos como la esquizofrenia. PMID:21404151

  6. [Isotretinoin and depressive symptoms in patiens with severe and recurrent acne].

    PubMed

    Rubio-García, Leticia; Pulido-Díaz, Nancy; Jímenez-López, José Luis

    2015-01-01

    Introducción: a partir del uso de isotretinoína para el manejo del acné, se han publicado resultados controversiales en torno a una probable asociación entre esta y depresión. El objetivo de este estudio fue conocer si el uso de isotretinoína en pacientes con acné severo y recurrente (ASR) se asocia a depresión.Métodos: se incluyeron 22 pacientes con diagnóstico de ASR pertenecientes a la clínica de acné del Centro Médico Nacional La Raza. Se les aplicó el inventario de depresión de Beck (IDB-II) antes, durante (2 meses) y después del tratamiento con isotretinoína (4 meses), calculada a 0.5 mg/kg.Resultados: en las primeras mediciones se reportaron puntuaciones bajas de síntomas depresivos que disminuyeron aún más al final del tratamiento (mediana = 6.5 antes del tratamiento, 3 a los dos meses y 0 al final, con una p < 0.001).Conclusiones: el tratamiento con isotretinoína en esta muestra de pacientes con acné severo y recurrente no produjo aumento de síntomas depresivos, por el contrario los redujo de manera indirecta al mejorar su imagen corporal.

  7. [Biofeedback effectiveness in patients with fecal incontinence].

    PubMed

    Guerra-Mora, José Raúl; Buenrostro-Acebes, José María; Erciga-Vergara, Nancy; Zubieta-O'Farrill, Gregorio; Castillo-Calcáneo, Juan de Dios; Mosqueda, Maria Elena; Monroy-Argumedo, Montserrat; González-Alvarado, Carlos; Villanueva-Saenz, Eduardo

    2015-01-01

    Introducción: el origen anómalo de la arteria coronaria izquierda del seno coronario derecho (ACAOS) se caracteriza porque la arteria coronaria principal izquierda se origina anómalamente del seno de valsalva aórtico coronario derecho y cuyo trayecto puede seguir cuatro diferentes caminos hacia el lado izquierdo del corazón. Caso clínico: masculino de 73 años de edad, que ingresó al hospital por dolor precordial de tipo opresivo, intensidad 10/10 con irradiación a brazo izquierdo y cuello, acompañado de diaforesis y nausea. El diagnóstico fue de un síndrome isquémico coronario agudo sometido a terapia trombolítica Su evolución posterior fue no satisfactoria debido a diferentes complicaciones que lo llevaron a la muerte. Conclusiones: el diagnóstico del origen anómalo de la arteria coronaria izquierda del seno opuesto (ACAOS), se establece únicamente a través de métodos de diagnósticos como la angiotomografía computada cardiaca o un cateterismo cardiaco como parte del abordaje de un síndrome isquémico coronario agudo que permiten establecer las características morfológicas de las arterias coronarias como las diferentes variantes anatómicas y sus características particulares respecto a las estructuras adyacentes.

  8. [Anomalous origin of the left coronary artery from the opposite breast. Pathological case].

    PubMed

    Valencia-Sánchez, Jesús Salvador; Moreno-Vázquez, Alejandra; González-Díaz, Belinda; Valencia-Palacios, Beatriz Elizabeth

    2015-01-01

    Introducción: el origen anómalo de la arteria coronaria izquierda del seno coronario derecho (ACAOS) se caracteriza porque la arteria coronaria principal izquierda se origina anómalamente del seno de valsalva aórtico coronario derecho y cuyo trayecto puede seguir cuatro diferentes caminos hacia el lado izquierdo del corazón. Caso clínico: masculino de 73 años de edad, que ingresó al hospital por dolor precordial de tipo opresivo, intensidad 10/10 con irradiación a brazo izquierdo y cuello, acompañado de diaforesis y nausea. El diagnóstico fue de un síndrome isquémico coronario agudo sometido a terapia trombolítica Su evolución posterior fue no satisfactoria debido a diferentes complicaciones que lo llevaron a la muerte. Conclusiones: el diagnóstico del origen anómalo de la arteria coronaria izquierda del seno opuesto (ACAOS), se establece únicamente a través de métodos de diagnósticos como la angiotomografía computada cardiaca o un cateterismo cardiaco como parte del abordaje de un síndrome isquémico coronario agudo que permiten establecer las características morfológicas de las arterias coronarias como las diferentes variantes anatómicas y sus características particulares respecto a las estructuras adyacentes.

  9. [Kleine-Levin syndrome: differential diagnosis in recurrent encephalitic syndromes in adolescence].

    PubMed

    Duat-Rodriguez, A; Martinez-Albadalejo, I; Perez-Sebastian, I; Cantarin-Extremera, V; Hedrera-Fernandez, A; Garcia-Penas, J J

    2017-04-01

    Introduccion. El sindrome de Kleine-Levin es una enfermedad rara de causa desconocida que se caracteriza por episodios recurrentes autolimitados de hipersomnia acompañados de alteracion cognitiva y conductual. Entre los episodios, los pacientes tienen un patron de sueño y cognitivo normal. Casos clinicos. Se presentan tres pacientes de 14 años, dos chicos y una chica. Comenzaron tras un desencadenante (vacuna, una infeccion respiratoria por influenza B; en el caso de la chica, coincidian con la menstruacion). En el episodio agudo mostraban tendencia al sueño y en vigilia destacaba bradipsiquia, inquietud motora y gran labilidad emocional, con tendencia al llanto y necesidad de la presencia de los familiares. Presentaron una duracion aproximada de 10-15 dias y periodicidad mensual, y se mostraron asintomaticos entre los episodios. Los tres pacientes fueron valorados por pediatras, diagnosticados y tratados de encefalitis autoinmune. Solo uno cumplia la triada tipica de hipersomnia, hiperfagia e hipersexualidad, pero ninguno de los tres datos se habia recogido en la historia clinica inicial y la familia solo lo referia tras una anamnesis dirigida. Conclusiones. En el sindrome de Kleine-Levin, los sintomas neurologicos durante el cuadro agudo son aun mas frecuentes que los psiquiatricos. La tendencia al sueño y el hecho de que durante la vigilia no esten asintomaticos y se muestren lentos, apaticos, labiles e irascibles, situa en primer lugar la sospecha de sindrome encefalitico. Debemos tener presente esta entidad en encefalitis recurrentes de etiologia no filiada.

  10. [Churg-Strauss abdominal manifestation].

    PubMed

    Suarez-Moreno, Roberto; Ponce-Pérez, Luis Virgilio; Margain-Paredes, Miguel Angel; Garza-de la Llave, Heriberto; Madrazo-Navarro, Mario; Espinosa-Álvarez, Arturo

    2014-01-01

    Antecedentes: la enfermedad de Churg-Strauss es poco común, idiopática, caracterizada por hipereosinofilia en sangre y tejidos, aunada a vasculitis sistémica en pacientes con antecedentes de asma o rinitis alérgica. Las manifestaciones gastrointestinales del síndrome de Churg Strauss se caracterizan por dolor abdominal, seguido de diarrea y hemorragia en 31-45% de los casos. Caso clínico: paciente masculino con antecedente de asma que acudió a consulta por abdomen agudo con probable apendicitis aguda; durante el protocolo de estudio se diagnosticó síndrome de Churg Strauss, con manifestaciones intestinales. Conclusión: el síndrome de Churg Strauss es una vasculitis poco frecuente que puede manifestarse con síntomas intestinales, como en este caso; es importante tenerlo en mente a la hora de los diagnósticos diferenciales. Existen pocos reportes con este síndrome asociado con abdomen agudo, todos ellos con mal pronóstico.

  11. The scavenger receptor repertoire in six cnidarian species and its putative role in cnidarian-dinoflagellate symbiosis

    PubMed Central

    Neubauer, Emilie F.; Poole, Angela Z.; Davy, Simon K.

    2016-01-01

    Many cnidarians engage in a mutualism with endosymbiotic photosynthetic dinoflagellates that forms the basis of the coral reef ecosystem. Interpartner interaction and regulation includes involvement of the host innate immune system. Basal metazoans, including cnidarians have diverse and complex innate immune repertoires that are just beginning to be described. Scavenger receptors (SR) are a diverse superfamily of innate immunity genes that recognize a broad array of microbial ligands and participate in phagocytosis of invading microbes. The superfamily includes subclades named SR-A through SR-I that are categorized based on the arrangement of sequence domains including the scavenger receptor cysteine rich (SRCR), the C-type lectin (CTLD) and the CD36 domains. Previous functional and gene expression studies on cnidarian-dinoflagellate symbiosis have implicated SR-like proteins in interpartner communication and regulation. In this study, we characterized the SR repertoire from a combination of genomic and transcriptomic resources from six cnidarian species in the Class Anthozoa. We combined these bioinformatic analyses with functional experiments using the SR inhibitor fucoidan to explore a role for SRs in cnidarian symbiosis and immunity. Bioinformatic searches revealed a large diversity of SR-like genes that resembled SR-As, SR-Bs, SR-Es and SR-Is. SRCRs, CTLDs and CD36 domains were identified in multiple sequences in combinations that were highly homologous to vertebrate SRs as well as in proteins with novel domain combinations. Phylogenetic analyses of CD36 domains of the SR-B-like sequences from a diversity of metazoans grouped cnidarian with bilaterian sequences separate from other basal metazoans. All cnidarian sequences grouped together with moderate support in a subclade separately from bilaterian sequences. Functional experiments were carried out on the sea anemone Aiptasia pallida that engages in a symbiosis with Symbiodinium minutum (clade B1

  12. Dopamine D3 receptor dysfunction prevents anti-nociceptive effects of morphine in the spinal cord.

    PubMed

    Brewer, Kori L; Baran, Christine A; Whitfield, Brian R; Jensen, A Marley; Clemens, Stefan

    2014-01-01

    Dopamine (DA) modulates spinal reflexes, including nociceptive reflexes, in part via the D3 receptor subtype. We have previously shown that mice lacking the functional D3 receptor (D3KO) exhibit decreased paw withdrawal latencies from painful thermal stimuli. Altering the DA system in the CNS, including D1 and D3 receptor systems, reduces the ability of opioids to provide analgesia. Here, we tested if the increased pain sensitivity in D3KO might result from a modified μ-opioid receptor (MOR) function at the spinal cord level. As D1 and D3 receptor subtypes have competing cellular effects and can form heterodimers, we tested if the changes in MOR function may be mediated in D3KO through the functionally intact D1 receptor system. We assessed thermal paw withdrawal latencies in D3KO and wild type (WT) mice before and after systemic treatment with morphine, determined MOR and phosphorylated MOR (p-MOR) protein expression levels in lumbar spinal cords, and tested the functional effects of DA and MOR receptor agonists in the isolated spinal cord. In vivo, a single morphine administration (2 mg/kg) increased withdrawal latencies in WT but not D3KO, and these differential effects were mimicked in vitro, where morphine modulated spinal reflex amplitudes (SRAs) in WT but not D3KO. Total MOR protein expression levels were similar between WT and D3KO, but the ratio of pMOR/total MOR was higher in D3KO. Blocking D3 receptors in the isolated WT cord precluded morphine's inhibitory effects observed under control conditions. Lastly, we observed an increase in D1 receptor protein expression in the lumbar spinal cord of D3KO. Our data suggest that the D3 receptor modulates the MOR system in the spinal cord, and that a dysfunction of the D3 receptor can induce a morphine-resistant state. We propose that the D3KO mouse may serve as a model to study the onset of morphine resistance at the spinal cord level, the primary processing site of the nociceptive pathway.

  13. The scavenger receptor repertoire in six cnidarian species and its putative role in cnidarian-dinoflagellate symbiosis.

    PubMed

    Neubauer, Emilie F; Poole, Angela Z; Weis, Virginia M; Davy, Simon K

    2016-01-01

    Many cnidarians engage in a mutualism with endosymbiotic photosynthetic dinoflagellates that forms the basis of the coral reef ecosystem. Interpartner interaction and regulation includes involvement of the host innate immune system. Basal metazoans, including cnidarians have diverse and complex innate immune repertoires that are just beginning to be described. Scavenger receptors (SR) are a diverse superfamily of innate immunity genes that recognize a broad array of microbial ligands and participate in phagocytosis of invading microbes. The superfamily includes subclades named SR-A through SR-I that are categorized based on the arrangement of sequence domains including the scavenger receptor cysteine rich (SRCR), the C-type lectin (CTLD) and the CD36 domains. Previous functional and gene expression studies on cnidarian-dinoflagellate symbiosis have implicated SR-like proteins in interpartner communication and regulation. In this study, we characterized the SR repertoire from a combination of genomic and transcriptomic resources from six cnidarian species in the Class Anthozoa. We combined these bioinformatic analyses with functional experiments using the SR inhibitor fucoidan to explore a role for SRs in cnidarian symbiosis and immunity. Bioinformatic searches revealed a large diversity of SR-like genes that resembled SR-As, SR-Bs, SR-Es and SR-Is. SRCRs, CTLDs and CD36 domains were identified in multiple sequences in combinations that were highly homologous to vertebrate SRs as well as in proteins with novel domain combinations. Phylogenetic analyses of CD36 domains of the SR-B-like sequences from a diversity of metazoans grouped cnidarian with bilaterian sequences separate from other basal metazoans. All cnidarian sequences grouped together with moderate support in a subclade separately from bilaterian sequences. Functional experiments were carried out on the sea anemone Aiptasia pallida that engages in a symbiosis with Symbiodinium minutum (clade B1

  14. Sensor Network Demonstration for In Situ Decommissioning - 13332

    SciTech Connect

    Lagos, L.; Varona, J.; Awwad, A.; Rivera, J.; McGill, J.

    2013-07-01

    individual sensors would be immobilized during the grout pouring activities, a set of nine sensor racks were designed. The 270 sensors provided by Idaho National Laboratory (INL), Mississippi State University (MSU), University of Houston (UH), and University of South Carolina (USC) were secured to these racks based on predetermined locations. Once sensor racks were installed inside the test cube, connected and debugged, approximately 32 cubic yards of special grout material was used to entomb the sensors. MSU provided and demonstrated four types of fiber loop ring-down (FLR) sensors for detection of water, temperature, cracks, and movement of fluids. INL provided and demonstrated time differenced 3D electrical resistivity tomography (ERT), advanced tensiometers for moisture content, and thermocouples for temperature measurements. University of Houston provided smart aggregate (SA) sensors, which detect crack severity and water presence. An additional UH sensor system demonstrated was a Fiber Bragg Grating (FBG) fiber optic system measuring strain, presence of water, and temperature. USC provided a system which measured acoustic emissions during cracking, as well as temperature and pH sensors. All systems were connected to a Sensor Remote Access System (SRAS) data networking and collection system designed, developed and provided by FIU. The purpose of SRAS was to collect and allow download of the raw sensor data from all the sensor system, as well as allow upload of the processed data and any analysis reports and graphs. All this information was made available to the research teams via the Deactivation and Decommissioning Knowledge Management and Information Tool (D and D KM-IT). As a current research effort, FIU is performing an energy analysis, and transferring several sensor systems to a Photovoltaic (PV) System to continuously monitor energy consumption parameters and overall power demands. Also, One final component of this research is focusing on developing an integrated

  15. [Evaluation of the quality of scientific evidence of pharmaceutical interventions in an emergency department].

    PubMed

    Pérez León, M; Alonso Ramos, H; González Munguía, S; Marrero Penichet, S M; Molero Gómez, R

    2014-03-01

    Objetivo: Evaluar la calidad de las intervenciones farmacéuticas que motivaron un inicio de tratamiento en un Servicio de Urgencias. Analizar el porcentaje de intervenciones sobre tratamientos agudos o crónicos, y el grupo ATC de los fármacos implicados. Método: Se analizaron y clasificaron las intervenciones farmacéuticas realizadas durante un año, asignándoles el grado de recomendación, nivel de evidencia y reducción de la morbimortalidad teórica asociada según las guías de práctica clínica. También fueron clasificadas según el objetivo del tratamiento de la intervención (agudo o crónico), y por el grupo ATC. Resultado: Se realizaron 2.776 intervenciones farmacéuticas durante el período de estudio, siendo el 47% intervenciones de inicio de tratamiento. El 73% pudieron ser clasificadas según la evidencia científica disponible en las guías de práctica clínica. El 84% obtuvo un grado de recomendación y nivel de evidencia IA, el 9% IC y 4% IB. El 67% tenían asociada una disminución teórica de la morbimortalidad. El 73% de las intervenciones estuvieron relacionadas con el tratamiento crónico del paciente, siendo los grupos ATC más frecuentes el N y C. Mientras que en los tratamientos agudos los más frecuentes fueron el grupo B y A. Conclusiones: Las intervenciones de inicio de tratamiento realizadas por un farmacéutico clínico en el Servicio de Urgencias muestran una elevada adherencia a las guías de práctica clínica con un alto grado de recomendación y evidencia, y reducción teórica de la morbimortalidad asociada. La mayoría de las intervenciones estuvieron relacionadas con la conciliación de tratamientos crónicos, fundamentalmente fármacos del grupo N y C.

  16. [Acute gastric volvulus: late complication of Nissen fundoplication. Report of two cases and review of the literature].

    PubMed

    Reyes-Zamorano, Jesús

    2014-01-01

    Antecedentes: el vólvulo gástrico puede clasificarse por su etiología en primario o secundario, por su anatomía en órgano axial o mesentérico axial y por su presentación en crónico o agudo. El tratamiento del vólvulo gástrico secundario agudo siempre debe ser quirúrgico y la elección del procedimiento basarse en la etiología y en los casos asociados con cirugía previa será importante la lisis de adherencias y el retiro de cuerpos extraños (material de sutura, mallas, banda gástrica). La funduplicatura Nissen es un procedimiento seguro y efectivo que rara vez puede tener complicaciones tardías severas entre las que se encuentran el vólvulo gástrico. Objetivo: comunicar 2 casos y revisar la bibliografía médica. Casos clínicos: se describen 2 casos de vólvulo gástrico agudo secundarios a funduplicatura tipo Nissen laparoscópica, con síntomas de dolor epigástrico y vómito no productivo, ambos tratados por laparoscopia. Se revisan los síntomas de presentación, incidencia, diagnóstico, tratamiento y los factores predisponentes de vólvulo gástrico postfunduplicatura. Conclusión: el vólvulo gástrico rara vez puede ser una complicación de una funduplicatura Nissen con incidencia similar a la de otras de sus complicaciones tardías. Los mecanismos descritos que lo originan se relacionan con adherencias postquirúrgicas, material de sutura (poliéster), mallas, tubos de gastrostomía, gastropexia y por herniación gástrica interna a través del túnel "transfunduplicatura." En pacientes con síntomas de obstrucción gástrica dentro del primer año posterior a una funduplicatura Nissen laparoscópica se requiere un alto índice de sospecha. El tratamiento quirúrgico laparoscópico es seguro con o sin gastropexia para corregir los mecanismos que lo originan.

  17. Pain from the life cycle perspective: Evaluation and Measurement through psychophysical methods of category estimation and magnitude estimation.

    PubMed

    Sousa, Fátima Aparecida Emm Faleiros; Silva, Talita de Cássia Raminelli da; Siqueira, Hilze Benigno de Oliveira Moura; Saltareli, Simone; Gomez, Rodrigo Ramon Falconi; Hortense, Priscilla

    2016-08-18

    to describe acute and chronic pain from the perspective of the life cycle. participants: 861 people in pain. The Multidimensional Pain Evaluation Scale (MPES) was used. in the category estimation method the highest descriptors of chronic pain for children/ adolescents were "Annoying" and for adults "Uncomfortable". The highest descriptors of acute pain for children/adolescents was "Complicated"; and for adults was "Unbearable". In magnitude estimation method, the highest descriptors of chronic pain was "Desperate" and for descriptors of acute pain was "Terrible". the MPES is a reliable scale it can be applied during different stages of development. descrever a dor aguda e a crônica na perspectiva do ciclo vital. Métodos: participaram 861 pessoas com dor. Foi utilizada a Escala Multidimensional de Avaliação da Dor (EMADOR). Resultados: no método da estimação de categoria o descritor da dor crônica de maior atribuição para crianças e adolescentes foi "Chata" e para adultos foi "Desconfortável". Os descritores de maior atribuição para dor aguda em crianças e adolescentes foram "Complicada" e em adultos "Insuportável". No método de estimação de magnitude, o descritor de maior atribuição na dor crônica foi "Atormentadora" e na dor aguda foi "Terrível". a EMADOR é uma escala confiável e pode ser utilizada nas diferentes etapas do desenvolvimento humano. la descripción del dolor agudo y crónico desde las perspectiva del ciclo de vida. participaron 861 personas con dolor. Se utilizó la Escala Multidimensional de Evaluación del Dolor (EMEDOR). en el método de estimación de categoría el descriptor de dolor crónico más alto para niños y adolescentes fue de Molesto y para adultos fue Incómodo. Los descriptores mayores de dolor agudo para niños y adolescentes fueron Complejo y para adultos Insoportable. En el método de estimación de magnitud, el mayor descriptor de dolor crónico fueron Atormentador y el mayor de dolor agudo fue Terrible

  18. Mineral replacement reactions and element mobilization

    NASA Astrophysics Data System (ADS)

    Putnis, Christine V.; Ruiz-Agudo, Encarnacion; King, Helen E.; Hövelmann, Jörn; Renard, François

    2016-04-01

    When a mineral is out of equilibrium with an aqueous fluid, reactions will take place in an attempt to reach a new equilibrium. Commonly in the Earth dissolution at a mineral-fluid interface initiates a coupled reaction involving dissolution and precipitation (Ruiz-Agudo et al., 2014). This is a ubiquitous reaction during such processes as metamorphism, metasomatism and weathering. When rock-forming minerals such as feldspars, olivine, pyroxenes are in contact with aqueous fluids (typically NaCl-rich) resultant new phases are formed and elements present in the parent mineral are released to the fluid and therefore mobilized for transport elsewhere. This has been shown in a number of systems such as the albitisation of feldspars (Hövelmann et al., 2010) when a Ca-bearing plagioclase is replaced by albite (NaAlSi3O8). However during this reaction not only is Ca released to the fluid but most other minor elements, such as Mg, Pb, rare earth elements amongst others, are almost totally mobilized and removed in solution. This interface-coupled dissolution-precipitation reaction has many implications for the redistributon of elements in the crust of the Earth. It is also of note that albitisation occurs often in areas of high mineralization, such as in the Curnamona Province in S. Australia (Au-Cu and Ag-Pb-Zn deposits) and the Bamble District of S. Norway. Secondly atomic force microscopy (AFM) has been used to image these reactions at a nanoscale, especially at the calcite-fluid interface, such as the formation of apatite from phosphate-bearing solutions, and the sequestration of toxic elements, eg., Se and As. References Ruiz-Agudo E., Putnis C.V., Putnis A. (2014) Coupled dissolution and precipitation at mineral-fluid interfaces. Chemical Geology, 383, 132-146. Putnis C.V. and Ruiz-Agudo E. (2013) The mineral-water interface: where minerals react with the environment. Elements, 9, 177-182. Hövelmann J., Putnis A., Geisler T., Schmidt B.C., Golla-Schindler U. (2009

  19. Spectral analysis of Chilean tsunami (February 27, 2010) records on the Pacific coast of Russia

    NASA Astrophysics Data System (ADS)

    Ivelskaya, Tatiana; Shevchenko, George; Korolyov, Pavel

    2010-05-01

    Russian Tsunami Warning Service was developed considerably with the installation of group of telemetric bottom pressure gauges on the Pacific coast in the late 2009. The most important information was obtained from the gauges which were installed on the Pacific coast of Russia: Bering Island (Nikolskoe), in the Avachinsaya Guba Bay (Petropavlovsk-Kamchatsky), on south-eastern coast of Kamchatka (Vodopadnaya) and on the coast of Paramushir Island (Severo-Kurilsk). Three stations were installed on the southeastern coast of Sakhalin (Poronaisk, Starodubskoe, Korsakov) and four on the coasts of Sea of Japan (Vladivostok, Preobrazhenia Bay, Rudnaya Pristan and Kholmsk). We received a tidal gauge tape with Chili tsunami records from Malokurilskoe (Shikotsn Island). The tape records were digitized and used for analysis too. We used data of several gauges which located on the coast of Hokkaido and Honshu Islands (Hanasaki, Ofunato and others). These data we found on the NOAA website http://wcatwc.arh.noaa.gov/about/tsunamimain.php. The tsunami heights were more than 1 meter on the Pacific coast of Russia in spite of the large distance from the source. The maximal heights (from the trough to the crest) were recorded by the Severo-Kurilsk (228 cm), Vodopadnaya (120 cm) and Malokurilskoe gauges (110 cm). As opposed to these stations, the tsunami heights in Petropavlovsk-Kamchatsky (16 cm) and Nikolskoe (19 cm) were significantly smaller. The narrow channel which connected the Pacific Ocean and Avachinskaya Guba Bay is probably a cause of tsunami weakening at Petropavlovsk-Kamchatsky. The cause of tsunami weakening in the area adjacent to the Bering Island is difficult to explain. To examine spectral properties of long wave oscillations for each gauge, we calculated wave spectra using two different data segments (both of two day long because of very long tsunami-caused oscillations): The period from 00:00 of February 26 to 24:00 of February 27 (UTC), preceding the tsunami

  20. Prescribing cascade. A proposed new way to evaluate it.

    PubMed

    Ponte, Marcelo L; Wachs, Lionel; Wachs, Adolfo; Serra, Héctor A

    2017-01-01

    Prescribing cascade is defined as the situation in which a first drug administered to a patient causes adverse event signs and symptoms, that are misinterpreted as a new condition, resulting in a new medication being prescribed. The cascade may have multiple steps and differ in complexity and severity. Despite being well identified, prescribing cascade is an increasingly common problem in medical practice. It constitutes a warning about irrational use of medicines that puts health at risk and increases treatment costs if it is not taken into account. In this article, representative cases taken from Hospital General de Agudos Dr. Cosme Argerich pharmacovigilance database were selected to assess a proper score and an algorithm that define the probable prescribing cascade.

  1. A non-classical view of the modulation of mineral precipitation by organic additives

    NASA Astrophysics Data System (ADS)

    Ruiz-Agudo, Encarnacion; Ruiz-Agudo, Cristina; Burgos-Cara, Alejandro; Putnis, Christine; Rodriguez-Navarro, Carlos; Putnis, Andrew

    2016-04-01

    Questions persist on the mechanisms of crystallization of sparingly soluble minerals such as calcium carbonate, calcium oxalate or barium sulphate. Compared to CaCO3, the mechanisms of nucleation and growth in the CaC2O4-H2O or BaSO4-H2O systems have received less attention. These phases are important due to their relevance as biominerals and/or unwanted mineral deposits in technological applications. Growing evidence suggests that sparingly soluble salts form by non-classical nucleation and growth pathways, where pre-nucleation ion associates and amorphous (solid or liquid) precursor phase(s) play a critical role (e.g. Rodríguez-Navarro et al. (2015), Ruiz-Agudo et al. (2015)). Indeed the identification of pre-nucleation species in these systems and their strong interactions with organic compounds (Verch et al. 2011) raises the possibility that the control of organics on biomineralization may begin even earlier than previously thought. A sound knowledge of the physical mechanisms by which acidic macromolecules affect nucleation and early growth may offer general insights concerning the molecular control of biomineralization, as well as being critical for improving strategies to control unwanted mineral deposition or for the synthesis of biomimetic materials. Here we present investigations on the initial stages of the precipitation of these relevant minerals in organic-free solutions to identify the precipitation pathway and to look for any potential precursor phase(s) to the final, crystalline polymorph. As well, we explore the effects that several acidic organic compounds have on the different precipitation stages identified. We find that organic additives such as citric acid, polyacrilic acid or a commercial copolymer of maleic acid/allyl sulfonic acid with phosphonate groups can be active at modifying pre-nucleation stages (destabilizing of pre-nucleation species or hampering the aggregation and growth of pre-nucleation associates) and subsequently strongly

  2. Are perioperative statins beneficial for cardiac surgery?

    PubMed

    Bravo-Soto, Gonzalo A; Llovet-Gutiérrez, Valentina; Rada, Gabriel

    2017-01-16

    La cirugía cardiaca conlleva una alta morbimortalidad debido a múltiples causas tales como fibrilación auricular, infarto al miocardio, insuficiencia renal aguda, accidente vascular encefálico, entre otros. Por otra parte, las estatinas son una familia de medicamentos que ha demostrado disminución de eventos cardiovasculares, principalmente debido a su efecto clínico en el perfil lipídico. Sin embargo, se ha propuesto un efecto pleiotrópico, incluyendo un mecanismo antiinflamatorio agudo, cuyo real impacto clínico es controvertido. En este contexto, se ha planteado que el uso de estatinas perioperatorias podría disminuir la morbimortalidad en cirugía cardiaca.

  3. Concentration gradients at the mineral-solution interface: implications for understanding dissolution mechanisms

    NASA Astrophysics Data System (ADS)

    Ruiz-Agudo, Encarnacion; Patiño-López, Luis David; Putnis, Christine V.; Rodriguez-Navarro, Carlos; Putnis, Andrew

    2014-05-01

    Dissolution is a key process in fluid-rock interactions, such as in chemical weathering, CO2 carbonation reactions, metasomatism, and metamorphism. Many multicomponent rock-forming minerals are reported to dissolve incongruently, because the elemental molar ratios, measured in the fluid during dissolution experiments, that differ from those in the solid. This frequently results in the formation of chemically and structurally altered zones at the fluid-solid interface of varying thickness that are depleted in some elements relative to the bulk mineral composition. Although the mechanisms of the formation of these altered layers is still a matter of debate (see e.g. Ruiz-Agudo et al. 2012 and Schott et al. 2012), recent AFM studies on the dissolution of two multicomponent minerals, dolomite, Ca0.5Mg0.5CO3 (Urosevic et al. 2012), and wollastonite, CaSiO3 (Ruiz-Agudo et al. 2012), provide experimental evidence showing that these layers are formed in a two-step process: (i) stoichiometric dissolution of the pristine mineral surfaces and (ii) precipitation of a secondary phase. This occurs despite the fact that the bulk solution is undersaturated with respect to such a phase. It has been suggested that after stoichiometric dissolution of the mineral, a boundary layer of fluid in contact with the surface becomes supersaturated with respect to a secondary phase that then precipitates. Here we present in situ observations of the evolution of the fluid composition at the interface during dissolution in acidic solutions (pH 1.5) of dolomite and wollastonite using real-time phase-shift interferometry. We show that immediately when the sparingly soluble dolomite or wollastonite crystals are in contact with the solution, the refractive index of the solution at the crystal surface sharply increases. A steep refractive index gradient (i.e., concentration gradient) develops as a consequence of mineral dissolution producing an interfacial fluid with a different composition to the

  4. [Acute physical exercise increases homocysteine concentrations in young trained male subjects].

    PubMed

    Maroto-Sánchez, Beatriz; Valtueña, Jara; Albers, Ulrike; Benito, Pedro J; González-Gross, Marcela

    2013-01-01

    Introducción: Niveles altos de Homocisteína (Hcy) se han identificado como un factor de riesgo cardiovascular. En relación con la práctica de ejercicio físico, los resultados son contradictorios. Objetivos: El objetivo del presente estudio fue determinar la influencia de ejercicios agudos máximo y submáximo sobre las concentraciones de homocisteína total (tHcy) y otros parámetros sanguíneos relacionados. Material y métodos: Diez varones (23,5 ± 1,8 AÑOs) físicamente activos realizaron una prueba incremental máxima y otra submáxima a una intensidad del 65% del consumo máximo de oxígeno (VO2max) en tapiz rodante. Se analizaron antes y después las concentraciones de tHcy, folato, vitamina B12 y creatinina séricas. Resultados: Las concentraciones de tHcy séricas aumentaron significativamente tras las pruebas de intensidad máxima (p < 0,05) y submáxima (p < 0,01). El folato y la vitamina B12 también aumentaron significativamente tras ambas pruebas (p < 0,05). Las concentraciones de creatinina aumentaron significativamente únicamente en la prueba máxima (p < 0,001). Se encontró una relación inversa entre los niveles de folato y de tHcy en todos los puntos (p < 0,05). Conclusión: Se observaron niveles altos de homocisteína después del ejercicio agudo tanto máximo como submáximo.

  5. [Diagnostic, prognostic and therapeutic implications of transcranial color-coded duplex sonography in acute ischemic stroke: TIBI and COGIF scores validation].

    PubMed

    Sobrino-Garcia, P; Garcia-Pastor, A; Garcia-Arratibel, A; Dominguez-Rubio, R; Rodriguez-Cruz, P M; Iglesias-Mohedano, A M; Diaz-Otero, F; Vazquez-Alen, P; Fernandez-Bullido, Y; Villanueva-Osorio, J A; Gil-Nunez, A

    2016-10-16

    Objetivo. Describir la informacion aportada por el duplex color transcraneal (DCTC) en pacientes con ictus isquemico agudo, analizando la relacion entre los hallazgos del DCTC, la gravedad y el pronostico, asi como su utilidad en la toma de decisiones terapeuticas. Pacientes y metodos. Analizamos los DCTC realizados a pacientes con ictus agudo de menos de seis horas de evolucion. Recogimos la existencia de oclusion arterial empleando las clasificaciones TIBI (Thrombolysis in Brain Ischemia) y COGIF (Consensus on Grading Intracranial Flow Obstruction). Determinamos la recanalizacion arterial a las 24 horas del ictus empleando criterios TIBI y COGIF. Consideramos buena evolucion funcional puntuaciones en la escala de Rankin de 0 a 2 a los tres meses. Resultados. Realizamos DCTC en 104 pacientes, 85 tratados con trombolisis intravenosa. Objetivamos oclusion arterial en el 79,8%. La deteccion de una oclusion arterial mediante DCTC permitio indicar tratamiento endovascular en el 23,1% de los pacientes. La presencia de oclusion arterial se asocio a mayor gravedad del ictus. Detectamos recanalizacion arterial en el 44,1% segun los criterios TIBI y en el 45,8% segun los criterios COGIF. El 80,8% de los pacientes que recanalizaron y solo el 39,5% de los que no recanalizaron obtuvieron una buena evolucion funcional a los tres meses. La recanalizacion dependio de la localizacion de la oclusion arterial. Conclusiones. El DCTC es util para deteccion y localizacion de oclusion arterial, aporta informacion pronostica valiosa y permite seleccionar pacientes para el empleo de terapias endovasculares. La informacion aportada por las clasificaciones TIBI y COGIF es equiparable.

  6. [Acute coronary syndromes in Latin America: lessons from the ACCESS registry].

    PubMed

    Martínez-Sánchez, Carlos; Jerjes-Sánchez, Carlos; Nicolau, José Carlos; Bazzino, Oscar; Antepara, Norka; Mármol, Ricardo

    2016-01-01

    Introducción: se desconocen las características, la evolución y el tratamiento de pacientes latinoamericanos con síndromes coronarios agudos (SCA). Métodos: registro internacional multicéntrico y prospectivo para evaluar riesgo, terapéutica y evolución en SCA. Punto primario: toda causa de mortalidad durante el primer año y mortalidad a 30 días. Ingresaron pacientes con síntomas de isquemia coronaria aguda en las primeras 24 horas del inicio de los síntomas y evidencia electrocardiográfica de isquemia. El diagnóstico final requirió pruebas invasivas o no invasivas. Resultados: entre el 2007 y 2008 se ingresaron en ocho países latinoamericanos 4436 pacientes, 2562 con angina inestable o infarto sin elevación del ST y 2374 con infarto con elevación del ST. Al ingreso tuvieron síntomas agudos 79 y 90 %, respectivamente. Ambos grupos tuvieron retraso entre el inicio de síntomas y el ingreso hospitalario. En infarto y elevación del ST se observó baja accesibilidad a reperfusión farmacológica (29 %) y mecánica (32 %). Al ingreso en ambos el porcentaje de tratamiento basado en evidencia fue bajo. Las complicaciones hospitalarias fueron la insuficiencia cardiaca (angina inestable e infarto sin elevación del ST 10 % y el infarto con elevación del ST 20 %) e isquemia recurrente (8 y 11 %). La mortalidad a 30 días fue 2 % y a un año 8 %. Conclusiones: el registro ACCESS ofrece información contemporánea sobre el espectro de pacientes, el manejo hospitalario y la evolución clínica subsecuente.

  7. PubMed

    Zurita-Cruz, Jessie Nallely; Rivas-Ruiz, Rodolfo; Gordillo-Álvarez, Virginia; Villasis-Keever, Miguel Ángel

    2017-03-30

    Objetivo: determinar la efi cacia de la lactancia materna (LM) para el manejo del dolor agudo después de la vacunación en lactantes menores de 6 meses al compararse con el sucedáneo de la leche (SL) y no aplicar ninguna maniobra.Métodos: se realizó un ensayo clínico controlado aleatorizado, ciego simple en fase III en lactantes menores de 6 meses de edad. Se incluyeron 3 grupos: LM, SL y sin aplicar analgesia (control). El dolor se midió a través del tiempo de llanto y una escala de dolor pediátrico. En el análisis estadístico se utilizaron las pruebas de Kruskal Wallis y U de Mann Whitney para variables cuantitativas y para variables cualitativas se aplicó la prueba de Chi2. Se utilizó Kaplan Meier para analizar el tiempo de llanto total.Resultados: se analizaron un total de 144 pacientes, 48 por grupos. El grupo de LM tuvo menor tiempo de llanto (p = 0,007) y menor califi cación de dolor a los 90 (p = 0,006) y 120 (p = 0,003) segundos comparado con los otros 2 grupos. Mientras que entre el grupo SL y el grupo control no hubo diferencia signifi cativa en la duración del llanto ni la escala de dolor.Conclusiones: la lactancia materna es efectiva para el manejo del dolor agudo después de la vacunación en lactantes menores de 6 meses de edad en comparación al sucedáneo de leche y no aplicar analgesia.

  8. Evidence for interfacial dissolution-precipitation during low-temperature mineral weathering

    NASA Astrophysics Data System (ADS)

    Ruiz-Agudo, Encarnacion; Putnis, Christine V.; Rodriguez-Navarro, Carlos; Putnis, Andrew

    2013-04-01

    The dissolution of most common multicomponent minerals and glasses is typically "incongruent" as shown by the nonstoichiometric release of the solid phase components. This frequently results in the formation of so-called surface leached layers. The mechanism of this process has been a recurrent subject of research and debate over the past two decades, due to its relevance to a wide range of natural and technological processes, as well as being crucial in defining rate laws for mineral reactions. Here we report experimental, in situ nanoscale observations that confirm the formation of a cation depleted layer at the mineral-solution interface during dissolution of multicomponent minerals at acidic pH. Our in situ Atomic Force Microscopy studies of the dissolution of wollastonite, CaSiO3, and dolomite, Ca0.5Mg0.5CO3, combined with compositional analysis of reaction products, provide, for the first time, clear direct experimental evidence that cation-depleted (i.e. leached) layers are formed in a tight interface-coupled two step process: stoichiometric dissolution of the pristine mineral surfaces and subsequent precipitation of a secondary phase from a supersaturated boundary layer of fluid in contact with the mineral surface. Such a mechanism presents a new paradigm that differs from the concept of preferential leaching of cations, as postulated by most currently accepted incongruent dissolution models. References Ruiz Agudo, E; Putnis, CV; Rodríguez Navarro, C and Putnis, A. (2012) Mechanism of leached layer formation during chemical weathering of silicate minerals. Geology, 40, 947-950 Urosevic, M; Rodríguez Navarro,C; Putnis, CV; Cardell, C; Putnis, A and Ruiz Agudo, E (2012) In situ nanoscale observations of the dissolution of [10-14] dolomite cleavage surfaces. Geochimica et Cosmochimica Acta, 80, 1-13

  9. [Beta-1 adrenoceptor blockade decreases the firing rate to painful stimuli in spinal wide-dynamic range neurons in rats].

    PubMed

    Lamothe-Molina, Paul J; Lamothe-Molina, Pedro A; López-Ávila, Alberto

    2014-01-01

    Introducción: la epinefrina/norepinefrina inhibe la transmisión del dolor agudo; empero, no es claro el papel de los receptores beta-adrenérgicos. Por tanto, analizamos si los fármacos de estos receptores modulan la transmisión del dolor agudo mediante registro electrofisiológico unitario extracelular in vivo durante estimulación periférica dolorosa y no dolorosa en ratas. Métodos: estudio longitudinal en el que se cotejaron siete grupos de ratas: control (n = 11): solución salina (0,9 %); EPI (n = 8): 100 mcg epinefrina; agonista beta-1 (n = 8): 125 mcg dobutamina; antagonista beta-1 (n = 9): 100 mcg metoprolol; agonista beta-2 (n = 7): 100 mcg clembuterol; antagonista beta-2 (n = 8): butoxamina 100 mcg; antagonista beta-1 + EPI (n = 10): 100 mcg metoprolol + 100 mcg epinefrina. Se hizo análisis estadístico por medio de ANOVA. Resultados: La epinefrina redujo significativamente la tasa de disparo basal (RDB) en 34.1 % (p < 0.05) y la respuesta evocada por la estimulación dolorosa en 56 % (p < 0.05). No hubo cambios en la respuesta provocada por la falta de estimulación dolorosa. El antagonista beta-1 fue el único fármaco con acción beta-adrenérgica que redujo significativamente la respuesta evocada por la estimulación dolorosa en 41 % (p < 0.05). Conclusión: por primera vez un antagonista de los receptores beta-1-adrenérgicos (metoprolol) prueba ser eficaz en la reducción de la respuesta a la estimulación dolorosa en las neuronas ARD.

  10. A Dynamical System Approach to the Surface Search of Debris from MH370

    NASA Astrophysics Data System (ADS)

    Mancho, Ana M.; Garcia-Garrido, V. J.; Wiggins, S.; Mendoza, C.

    2015-11-01

    The disappearance of Malaysia Airlines flight MH370 on the morning of the 8th of March 2014 is one of the great mysteries of our time. One relevant aspect of this mystery is that not a single piece of debris from the aircraft was found during the intensive surface search carried out in the months following the crash. Difficulties in the search efforts, due to the uncertainty in the plane's final impact point and the time passed since the accident, brought the question on how the debris was scattered in an always moving ocean, for which there were multiple datasets that do not uniquely determined its state. Our approach to this problem is based on dynamical systems tools that identify dynamic barriers and coherent structures governing transport. By combining different ocean data with these mathematical techniques, we are able to assess the spatio-temporal state of the ocean in the priority search area at the time of impact and the following weeks. Using this information we propose a revised search strategy by showing why one might not have expected to find debris in some large search areas targeted by the search services and determining regions where one might have expected impact debris to be located and that have not been subjected to any exploration. This research has been supported by MINECO under grants MTM2014-56392-R and ICMAT Severo Ochoa project SEV-2011-0087 and ONR grant No. N00014- 01-1-0769. Computational support from CESGA is acknowledged.

  11. Wanderings in biochemistry.

    PubMed

    Lengyel, Peter

    2014-07-11

    My Ph.D. thesis in the laboratory of Severo Ochoa at New York University School of Medicine in 1962 included the determination of the nucleotide compositions of codons specifying amino acids. The experiments were based on the use of random copolyribonucleotides (synthesized by polynucleotide phosphorylase) as messenger RNA in a cell-free protein-synthesizing system. At Yale University, where I joined the faculty, my co-workers and I first studied the mechanisms of protein synthesis. Thereafter, we explored the interferons (IFNs), which were discovered as antiviral defense agents but were revealed to be components of a highly complex multifunctional system. We isolated pure IFNs and characterized IFN-activated genes, the proteins they encode, and their functions. We concentrated on a cluster of IFN-activated genes, the p200 cluster, which arose by repeated gene duplications and which encodes a large family of highly multifunctional proteins. For example, the murine protein p204 can be activated in numerous tissues by distinct transcription factors. It modulates cell proliferation and the differentiation of a variety of tissues by binding to many proteins. p204 also inhibits the activities of wild-type Ras proteins and Ras oncoproteins.

  12. [Risk factors for the development of severe gastroesophageal reflux in neonates with congenital diaphragmatic hernia surgery].

    PubMed

    Soto-Herrera, David; Campos-Lozada, Ileana; Vázquez-Langle, José Raúl; Sepúlveda-Vildósola, Ana Carolina

    2014-01-01

    INTRODUCCIÓN: el reflujo gastroesofágico posterior a la reparación de la hernia diafragmática congénita se presenta hasta en 89 % de los pacientes; de ellos, 20 a 30 % requerirá manejo quirúrgico. Conocer los factores de riesgo para desarrollar esta complicación podría permitir realizar funduplicatura Nissen en el mismo tiempo quirúrgico en quienes sea necesaria. El objetivo de esta investigación fue identificar esos factores en niños operados de hernia diafragmática. MÉTODOS: se realizó un estudio de casos y controles en el que se incluyeron neonatos operados de hernia diafragmática que fueron atendidos entre 2006 y 2011. Se consideró como casos a los pacientes con reflujo gastroesofágico severo y como controles a quienes no lo presentaron en el seguimiento de un año.

  13. Controlled rephasing of single spin-waves in a quantum memory based on cold atoms

    NASA Astrophysics Data System (ADS)

    Farrera, Pau; Albrecht, Boris; Heinze, Georg; Cristiani, Matteo; de Riedmatten, Hugues; Quantum Photonics With Solids; Atoms Team

    2015-05-01

    Quantum memories for light allow a reversible transfer of quantum information between photons and long lived matter quantum bits. In atomic ensembles, this information is commonly stored in the form of single collective spin excitations (spin-waves). In this work we demonstrate that we can actively control the dephasing of the spin-waves created in a quantum memory based on a cold Rb87 atomic ensemble. The control is provided by an external magnetic field gradient, which induces an inhomogeneous broadening of the atomic hyperfine levels. We show that acting on this gradient allows to control the dephasing of individual spin-waves and to induce later a rephasing. The spin-waves are then mapped into single photons, and we demonstrate experimentally that the active rephasing preserves the sub-Poissonian statistics of the retrieved photons. Finally we show that this rephasing control enables the creation and storage of multiple spin-waves in different temporal modes, which can be selectively readout. This is an important step towards the implementation of a functional temporally multiplexed quantum memory for quantum repeaters. We acknowledge support from the ERC starting grant, the Spanish Ministry of Economy and Competitiveness, the Fondo Europeo de Desarrollo Regional, and the International PhD- fellowship program ``la Caixa''-Severo Ochoa @ICFO.

  14. [Aging and influence of inversion of the CD4:CD8 ratio in the incidence of co-morbidities and mortality in a cohort of patients infected with human immunodeficiency virus].

    PubMed

    Cervero, Miguel; Torres, Rafael; Agud, Jose Luis; Pastor, Susana; Jusdado, Juan José

    2016-03-04

    It has been postulated that the inversion of the CD4:CD8 ratio as a hallmark of immunosenescence can be an independent factor that can herald the risk of co-morbidities. We studied the influence of aging and inversion of the CD4:CD8 ratio in the incidence of comorbidities and mortality in the cohort of Hosptital Severo Ochoa. We analyzed the differences in the incidence rates of age-adjusted morbidities and evaluated the inversion of the CD4:CD8 ratio as predictor of mortality and development of comorbidities. Age was associated with an increased incidence rate of diabetes mellitus, fractures, COPD and non-AIDS malignancies. We found an increased incidence rate of non-AIDS clinical events (OR 2.25; 95% CI 1.025-4.94) and AIDS events (OR 3.48; 95% CI 1.58-7.64) in individuals with CD4:CD8 ratio<0.7. Moreover, patients with a CD4:CD8 ratio<0.7 ratio had a higher risk of mortality (OR 5.96; 95% CI 0.73 to 48.40). It is important to detect and prevent non-AIDS comorbidities in the presence of a CD4:CD8 ratio<0.7. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  15. [Los laboratorios de la Junta para Ampliación de Estudios e Investigaciones Científicas (J.A.E.) y la Residencia de Estudiantes (1912-1939)].

    PubMed

    Barona, Josep L

    2007-01-01

    The policy of promoting fellowships abroad by the JAE for young scientist had an important complement in the foundation of a series of small scientific laboratories and research centres joined basically under the National Institute of Science and the Residencia de Estudiantes. The present article offers a general perspective of the activities developed by some of those laboratories, their main protagonists and research groups, particularly those related to biomedical research. The scientific task developed by the Instituto Cajal and the Natural Sciences Museum is not directly considered, since other contributions in this monographic issue regard those institutions. The process of creation of small teaching and research laboratories since 1912 is shown, and their participation in the university experimental teaching during the 1920s, especially regarding the Residencia de Estudiantes laboratories. Among them, the Laboratory of General Physiology lead by Juan Negrín. The significance of his physiological school is shown as well as the starting point of the scientific career of Severo Ochoa.

  16. Wanderings in Biochemistry

    PubMed Central

    Lengyel, Peter

    2014-01-01

    My Ph.D. thesis in the laboratory of Severo Ochoa at New York University School of Medicine in 1962 included the determination of the nucleotide compositions of codons specifying amino acids. The experiments were based on the use of random copolyribonucleotides (synthesized by polynucleotide phosphorylase) as messenger RNA in a cell-free protein-synthesizing system. At Yale University, where I joined the faculty, my co-workers and I first studied the mechanisms of protein synthesis. Thereafter, we explored the interferons (IFNs), which were discovered as antiviral defense agents but were revealed to be components of a highly complex multifunctional system. We isolated pure IFNs and characterized IFN-activated genes, the proteins they encode, and their functions. We concentrated on a cluster of IFN-activated genes, the p200 cluster, which arose by repeated gene duplications and which encodes a large family of highly multifunctional proteins. For example, the murine protein p204 can be activated in numerous tissues by distinct transcription factors. It modulates cell proliferation and the differentiation of a variety of tissues by binding to many proteins. p204 also inhibits the activities of wild-type Ras proteins and Ras oncoproteins. PMID:24867946

  17. Ten years of global evolution of the human respiratory syncytial virus BA genotype with a 60-nucleotide duplication in the G protein gene.

    PubMed

    Trento, Alfonsina; Casas, Inmaculada; Calderón, Ana; Garcia-Garcia, Maria L; Calvo, Cristina; Perez-Breña, Pilar; Melero, José A

    2010-08-01

    The emergence of natural isolates of human respiratory syncytial virus group B (HRSV-B) with a 60-nucleotide (nt) duplication in the G protein gene in Buenos Aires, Argentina, in 1999 (A. Trento et al., J. Gen. Virol. 84:3115-3120, 2003) and their dissemination worldwide allowed us to use the duplicated segment as a natural tag to examine in detail the evolution of HRSV during propagation in its natural host. Viruses with the duplicated segment were all clustered in a new genotype, named BA (A. Trento et al., J. Virol. 80:975-984, 2006). To obtain information about the prevalence of these viruses in Spain, we tested for the presence of the duplicated segment in positive HRSV-B clinical samples collected at the Severo Ochoa Hospital (Madrid) during 12 consecutive epidemics (1996-1997 to 2007-2008). Viruses with the 60-nt duplication were found in 61 samples, with a high prevalence relative to the rest of B genotypes in the most recent seasons. Global phylogenetic and demographic analysis of all G sequences containing the duplication, collected across five continents up until April 2009, revealed that the prevalence of the BA genotype increased gradually until 2004-2005, despite its rapid dissemination worldwide. After that date and coinciding with a bottleneck effect on the population size, a relatively new BA lineage (BA-IV) replaced all other group B viruses, suggesting further adaptation of the BA genotype to its natural host.

  18. [Diphallia: a case report].

    PubMed

    Rossete-Cervantes, Héctor Enrique; Villegas-Muñoz, Alvaro

    2016-01-01

    Introducción: la difalia es una alteración anatómica poco frecuente que se presenta en uno de cada cinco millones de nacimientos. Su etiología se desconoce y su apariencia varía desde un pene accesorio pequeño hasta la duplicación completa y se asocia con otras malformaciones congénitas urogenitales, gastrointestinales, cardiacas y musculoesqueléticas. Se han diseñado varias clasificaciones de acuerdo con las características anatómicas y el estudio de esta alteración se complementa con ecografía e imagen de resonancia magnética. El tratamiento debe ser temprano y se individualiza con el objetivo de lograr un resultado estético y funcional que sea satisfactorio. Caso clínico: reportamos el hallazgo incidental de difalia, sin otras malformaciones anatómicas asociadas, en un adulto de 83 años que fue hospitalizado y falleció por traumatismo craneoencefálico severo. Conclusión: el caso que presentamos es relevante por lo poco frecuente de esta alteración, la ausencia de otras malformaciones anatómicas asociadas y la edad a la que se detectó.

  19. Modelling direct radiative effect of mineral dust with the NMMB/BSC-CTM for dust outbreak events over the Mediterranean in summer 2012

    NASA Astrophysics Data System (ADS)

    Obiso, Vincezo; Jorba, Oriol; Basart, Sara; Baldasano, Jose M.; Nabat, Pierre

    2014-05-01

    Aerosols interact with the atmospheric system scattering and absorbing solar radiation, with a significant impact on atmospheric energy and hydrologic processes. Radiative forcing associated with these perturbations affects climate and meteorology. In this contribution, we analyse model results of the Direct Radiative Effect (DRE) of mineral dust over the western-Mediterranean during summer 2012. For that, the NMMB/BSC Chemical Transport Model (NMMB/BSC-CTM) is applied on a regional domain at 0.1º horizontal resolution. The NMMB/BSC-CTM is a new on-line chemical weather prediction system coupling atmospheric and chemistry processes. In the radiation module of the model mineral dust is treated as a radiatively active substance interacting both short and longwave radiation. The impact of the mineral dust outbreaks on meteorology is discussed by comparing model forecasts with atmospheric analysis and meteorological observations. The analysis focuses in the vertical structure of the atmosphere and the resulting surface meteorological conditions. The authors acknowledge the support from the grant SEV-2011-00067 of Severo Ochoa Program, awarded by the Spanish Government.

  20. Storage enhanced non-linearities in a cold Rydberg ensemble

    NASA Astrophysics Data System (ADS)

    Distante, Emanuele; Padron-Brito, Auxiliadora; Cristiani, Matteo; Paredes-Barato, David; de Riedmatten, Hugues

    2016-05-01

    The possibility to control the interaction between photons provided by highly nonlinear media is a key ingredient to the goal of quantum information processing using photons and a unique tool to study the dynamics of the many-body correlated system. To mediate this interaction, one can exploit electromagnetically induced transparency (EIT) to map the state of the photons into atomic coherence in the form of Rydberg dark-state polaritons. The combination of EIT with the nonlinear interaction between Rydberg atoms provides and effective interaction between photons. By measuring the dynamics of stored Rydberg polaritons, we experimentally demonstrate that storing a probe pulse as Rydberg polaritons strongly enhances the Rydberg mediated interaction compared to the slow-propagation case. We show that the process is characterized by two time scales. We measure a strong enhancement of the interaction at short time scales. By measuring the time-dependent coherence of the stored polariton, we also show that the long time scale dynamics is dominated by Rydberg induced dephasing of the multiparticle components of the state. Our results have a direct consequence in Rydberg quantum optics and enable the test of new theories of strongly interacting Rydberg systems. This work has been funded by: ERC starting Grant QuLIMA, MINECO, Severo Ochoa Grant, AUGAUR and the Europea Union's Horizon 2020.

  1. Ten Years of Global Evolution of the Human Respiratory Syncytial Virus BA Genotype with a 60-Nucleotide Duplication in the G Protein Gene▿ †

    PubMed Central

    Trento, Alfonsina; Casas, Inmaculada; Calderón, Ana; Garcia-Garcia, Maria L.; Calvo, Cristina; Perez-Breña, Pilar; Melero, José A.

    2010-01-01

    The emergence of natural isolates of human respiratory syncytial virus group B (HRSV-B) with a 60-nucleotide (nt) duplication in the G protein gene in Buenos Aires, Argentina, in 1999 (A. Trento et al., J. Gen. Virol. 84:3115-3120, 2003) and their dissemination worldwide allowed us to use the duplicated segment as a natural tag to examine in detail the evolution of HRSV during propagation in its natural host. Viruses with the duplicated segment were all clustered in a new genotype, named BA (A. Trento et al., J. Virol. 80:975-984, 2006). To obtain information about the prevalence of these viruses in Spain, we tested for the presence of the duplicated segment in positive HRSV-B clinical samples collected at the Severo Ochoa Hospital (Madrid) during 12 consecutive epidemics (1996-1997 to 2007-2008). Viruses with the 60-nt duplication were found in 61 samples, with a high prevalence relative to the rest of B genotypes in the most recent seasons. Global phylogenetic and demographic analysis of all G sequences containing the duplication, collected across five continents up until April 2009, revealed that the prevalence of the BA genotype increased gradually until 2004-2005, despite its rapid dissemination worldwide. After that date and coinciding with a bottleneck effect on the population size, a relatively new BA lineage (BA-IV) replaced all other group B viruses, suggesting further adaptation of the BA genotype to its natural host. PMID:20504933

  2. Plate-like convection in fluids with temperature-dependent viscosity

    NASA Astrophysics Data System (ADS)

    Mancho, Ana M.; Curbelo, Jezabel

    2013-11-01

    The study of instabilities in fluids in which viscosity experiences a transition at a certain temperature range is of great interest for the understanding of planetary interiors, since this phenomena models the melting and solidification of a magma ocean and thus is suitable for representing a lithosphere over a convecting mantle. To this end, we study a 2D convection problem in which viscosity depends on temperature by abruptly changing its value by a factor 400 within a narrow temperature gap at which magma melts. We perform a study which combines bifurcation analysis and time dependent simulations. Solutions such as limit cycles are found that are fundamentally related to the presence of the O(2) symmetry. Sporadically during these cycles, through abrupt bursts, spontaneous plate-like behaviors that rapidly evolve towards a stagnant lid regime emerge. The plate-like evolution alternates motions towards either right or left, introducing temporary asymmetries on the convecting styles. Further time dependent regimes are described for different transition laws which are greatly influenced by the presence of the symmetry. We thank CESGA for computing facilities. This research is supported by the Spanish Ministry of Science under grant MTM2011-26696 and MINECO: ICMAT Severo Ochoa project SEV-2011-0087.

  3. Strongly Coupled Models with a Higgs-like Boson

    NASA Astrophysics Data System (ADS)

    Pich, Antonio; Rosell, Ignasi; José Sanz-Cillero, Juan

    2013-11-01

    Considering the one-loop calculation of the oblique S and T parameters, we have presented a study of the viability of strongly-coupled scenarios of electroweak symmetry breaking with a light Higgs-like boson. The calculation has been done by using an effective Lagrangian, being short-distance constraints and dispersive relations the main ingredients of the estimation. Contrary to a widely spread believe, we have demonstrated that strongly coupled electroweak models with massive resonances are not in conflict with experimentalconstraints on these parameters and the recently observed Higgs-like resonance. So there is room for these models, but they are stringently constrained. The vector and axial-vector states should be heavy enough (with masses above the TeV scale), the mass splitting between them is highly preferred to be small and the Higgs-like scalar should have a WW coupling close to the Standard Model one. It is important to stress that these conclusions do not depend critically on the inclusion of the second Weinberg sum rule. We wish to thank the organizers of LHCP 2013 for the pleasant conference. This work has been supported in part by the Spanish Government and the European Commission [FPA2010-17747, FPA2011- 23778, AIC-D-2011-0818, SEV-2012-0249 (Severo Ochoa Program), CSD2007-00042 (Consolider Project CPAN)], the Generalitat Valenciana [PrometeoII/2013/007] and the Comunidad de Madrid [HEPHACOS S2009/ESP-1473].

  4. Fluid/Gravity Correspondence, Second Order Transport and Gravitational Anomaly***

    NASA Astrophysics Data System (ADS)

    Megías, Eugenio; Pena-Benitez, Francisco

    2014-03-01

    We study the transport properties of a relativistic fluid affected by chiral and gauge-gravitational anomalies. The computation is performed in the framework of the fluid/gravity correspondence for a 5 dim holographic model with Chern-Simons terms in the action. We find new anomalous and non anomalous transport coefficients, as well as new contributions to the existing ones coming from the mixed gauge-gravitational anomaly. Consequences for the shear waves dispersion relation are analyzed. Talk given by E. Megías at the International Nuclear Physics Conference INPC 2013, 2-7 June 2013, Firenze, Italy.Supported by Plan Nacional de Altas Energías (FPA2009-07908, FPA2011-25948), Spanish MICINN Consolider-Ingenio 2010 Programme CPAN (CSD2007-00042), Comunidad de Madrid HEP-HACOS S2009/ESP-1473, Spanish MINECO's Centro de Excelencia Severo Ochoa Program (SEV-2012-0234, SEV-2012-0249), and the Juan de la Cierva Program.

  5. RETOS EN LA INTERVENCIÓN CON ADOLESCENTES PUERTORRIQUEÑOS/AS QUE MANIFIESTAN COMPORTAMIENTO SUICIDA*

    PubMed Central

    Vélez, Yovanska Duarté; Dávila, Paloma Torres; Hernández, Samariz Laboy

    2015-01-01

    Presentamos un estudio de caso de una adolescente puertorriqueña con comportamiento suicida. Esta comenzó una Terapia Socio Cognitivo-Conductual para el Comportamiento Suicida (TSCC-CS) de tipo ambulatorio luego de una hospitalización por intento suicida. La TSCC-CS incorpora una perspectiva ecológica y de desarrollo a la terapia cognitivo-conductual. Inicialmente mostró baja autoestima y severos síntomas depresivos y de ansiedad. Al finalizar el tratamiento, manifestó un cambio significativo en su sintomatología clínica y evidenció una mejoría en sus destrezas de manejo. No presentó ideas suicidas durante meses previos, ni durante el seguimiento. El análisis de este caso permitió realizar cambios en el protocolo de tratamiento, particularmente en las sesiones de familia y de comunicación con el fin de aumentar la viabilidad del tratamiento. PMID:26702337

  6. In Situ Decommissioning Sensor Network, Meso-Scale Test Bed - Phase 3 Fluid Injection Test Summary Report

    SciTech Connect

    Serrato, M. G.

    2013-09-27

    located at the Florida International University Applied Research Center, Miami, FL (FIU-ARC). A follow-on fluid injection test was developed to detect fluid and ion migration in a cementitious material/grouted test cube using a limited number of existing embedded sensor systems. This In Situ Decommissioning Sensor Network, Meso-Scale Test Bed (ISDSN-MSTB) - Phase 3 Fluid Injection Test Summary Report summarizes the test implementation, acquired and processed data, and results from the activated embedded sensor systems used during the fluid injection test. The ISDSN-MSTB Phase 3 Fluid Injection Test was conducted from August 27 through September 6, 2013 at the FIU-ARC ISDSN-MSTB test cube. The fluid injection test activated a portion of the existing embedded sensor systems in the ISDSN-MSTB test cube: Electrical Resistivity Tomography-Thermocouple Sensor Arrays, Advance Tensiometer Sensors, and Fiber Loop Ringdown Optical Sensors. These embedded sensor systems were activated 15 months after initial placement. All sensor systems were remotely operated and data acquisition was completed through the established Sensor Remote Access System (SRAS) hosted on the DOE D&D Knowledge Management Information Tool (D&D DKM-IT) server. The ISDN Phase 3 Fluid Injection Test successfully demonstrated the feasibility of embedding sensor systems to assess moisture-fluid flow and resulting transport potential for contaminate mobility through a cementitious material/grout monolith. The ISDSN embedded sensor systems activated for the fluid injection test highlighted the robustness of the sensor systems and the importance of configuring systems in-depth (i.e., complementary sensors and measurements) to alleviate data acquisition gaps.

  7. Quantifying moisture transport in cementitious materials using neutron radiography

    NASA Astrophysics Data System (ADS)

    Lucero, Catherine L.

    . It has been found through this study that small pores, namely voids created by chemical shrinkage, gel pores, and capillary pores, ranging from 0.5 nm to 50 microm, fill quickly through capillary action. However, large entrapped and entrained air voids ranging from 0.05 to 1.25 mm remain empty during the initial filling process. In mortar exposed to calcium chloride solution, a decrease in sorptivity was observed due to an increase in viscosity and surface tension of the solution as proposed by Spragg et al 2011. This work however also noted a decrease in the rate of absorption due to a reaction between the salt and matrix which results in the filling of the pores in the concrete. The results from neutron imaging can help in the interpretation of standard absorption tests. ASTM C1585 test results can be further analyzed in several ways that could give an accurate indication of the durability of the concrete. Results can be reported in depth of penetration versus the square root of time rather than mm3 of fluid per mm2 of exposed surface area. Since a known fraction of pores are initially filling before reaching the edge of the sample, the actual depth of penetration can be calculated. This work is compared with an 'intrinsic sorptivity' that can be used to interpret mass measurements. Furthermore, the influence of shrinkage reducing admixtures (SRAs) on drying was studied. Neutron radiographs showed that systems saturated in water remain "wetter" than systems saturated in 5% SRA solution. The SRA in the system reduces the moisture diffusion coefficient due an increase in viscosity and decrease in surface tension. Neutron radiography provided spatial information of the drying front that cannot be achieved using other methods.

  8. Influence of the ventilatory mode on acute adverse effects and facial thermography after noninvasive ventilation.

    PubMed

    Pontes, Suzy Maria Montenegro; Melo, Luiz Henrique de Paula; Maia, Nathalia Parente de Sousa; Nogueira, Andrea da Nóbrega Cirino; Vasconcelos, Thiago Brasileiro; Pereira, Eanes Delgado Barros; Bastos, Vasco Pinheiro Diógenes; Holanda, Marcelo Alcantara

    2017-01-01

    To compare the incidence and intensity of acute adverse effects and the variation in the temperature of facial skin by thermography after the use of noninvasive ventilation (NIV). We included 20 healthy volunteers receiving NIV via oronasal mask for 1 h. The volunteers were randomly divided into two groups according to the ventilatory mode: bilevel positive airway pressure (BiPAP) or continuous positive airway pressure (CPAP). Facial thermography was performed in order to determine the temperature of the face where it was in contact with the mask and of the nasal dorsum at various time points. After removal of the mask, the volunteers completed a questionnaire about adverse effects of NIV. The incidence and intensity of acute adverse effects were higher in the individuals receiving BiPAP than in those receiving CPAP (16.1% vs. 5.6%). Thermographic analysis showed a significant cooling of the facial skin in the two regions of interest immediately after removal of the mask. The more intense acute adverse effects occurred predominantly among the participants in whom the decrease in the mean temperature of the nasal dorsum was lower (14.4% vs. 7.2%). The thermographic visual analysis of the zones of cooling and heating on the face identified areas of hypoperfusion or reactive hyperemia. The use of BiPAP mode was associated with a higher incidence and intensity of NIV-related acute adverse effects. There was an association between acute adverse effects and less cooling of the nasal dorsum immediately after removal of the mask. Cutaneous thermography can be an additional tool to detect adverse effects that the use of NIV has on facial skin. Comparar a incidência e a intensidade de efeitos adversos agudos e a variação da temperatura da pele da face através da termografia após a aplicação de ventilação não invasiva (VNI). Foram incluídos 20 voluntários sadios, de ambos os gêneros, submetidos à VNI com máscara oronasal por 1 h e divididos aleatoriamente em

  9. [ANTIOXIDANT DYSFUNCTIONALITY OF HIGH-DENSITY LIPOPROTEINS (HDL) IN DECOMPENSATED DIABETIC PATIENTS].

    PubMed

    Awad, Fernanda; Contreras-Duarte, Susana; Molina, Patricia; Quiñones, Verónica; Serrano, Valentina; Abbott, Eduardo; Maiz, Alberto; Busso, Dolores; Rigotti, Attilio

    2015-09-01

    Introducción: las lipoproteínas de alta densidad (HDL) tienen un importante efecto protector cardiovascular mediado por su función durante el transporte reverso del colesterol, así como por otras actividades, incluyendo una significativa acción antiinflamatoria y antioxidante. La funcionalidad antiinflamatoria y antioxidante de las HDL está alterada en los pacientes diabéticos crónicos estables, aunque no existe mayor información en caso de una crisis hiperglicémica. Objetivo: determinar si durante un estado de descompensación diabética aguda las partículas de HDL exhiben un deterioro de su función antioxidante y si esta logra recuperarse una vez resuelto el cuadro agudo. Métodos: la actividad antioxidante de las HDL se midió mediante un ensayo de fluorescencia in vitro en muestras plasmáticas de pacientes diabéticos con descompensación aguda obtenidas tanto al ingreso, alcanzada la resolución intrahospitalaria del evento agudo, así como en un control ambulatorio post-hospitalización. Como comparación, se analizaron partículas de HDL de algunos sujetos sanos como condición control. Resultados: la actividad antioxidante de las HDL en pacientes con descompensación diabética aguda fue significativamente menor a la observada en el grupo control sano, y esta se fue recuperando progresivamente hasta normalizarse en el momento del control ambulatorio. La crisis hiperglicémica también demostró una baja actividad plasmática de la enzima antioxidante paraoxonasa- 1, la cual aumentó significativamente en el control ambulatorio. Conclusión: las partículas de HDL presentes en pacientes con una descompensación diabética aguda presentan una reducción significativa y reversible de su capacidad antioxidante, probablemente como consecuencia de una alteración en la actividad de la paraoxonasa-1.

  10. Vestibular system paresis due to emergency endovascular catheterization.

    PubMed

    Simoceli, Lucinda; Sguillar, Danilo Anunciatto; Santos, Henrique Mendes Paiva; Caputti, Camilla

    2012-04-01

    Objetivo: O objetivo deste relato de caso é descrever uma causa incomum de vestibulopatia periférica associada à perda auditiva unilateral em paciente idoso pós- cateterismo de urgência.Relato de caso: Paciente do gênero masculino, 82 anos, submetido à correção de aneurisma roto de aorta abdominal, no intra-operatório sofreu infarto agudo do miocárdio necessitando de angioplastia primária. Após alta hospitalar refere queixa de hipoacusia acentuada à direita e vertigem incapacitante, sem sinais neurológicos focais. Ao exame clínico otorrinolaringológico apresentava: Teste de Weber lateralizado para a esquerda, nistagmo espontâneo para a esquerda , marcha oscilante, leve disbasia e ataxia, índex-nariz e diadococinesia normais, Teste de Romberg com oscilação sem queda e Fukuda com desvio lateral para a direita. O exame audiométrico evidenciava anacusia à direita e perda neurossensorial à esquerda em agudos, arreflexia vestibular à direita na prova calórica e, na tomografia computadorizada dos ossos temporais e tronco-encefálico, presença de haste metálica atravessando o osso temporal direito, a partir da veia jugular interna e bulbo jugular, atravessando os canais semicirculares posterior, superior e vestíbulo, projetando-se em lobo temporal. O diagnóstico radiológico foi lesão traumática por guia endovascular metálico durante cateterismo de urgência e a conduta, considerando que o paciente não havia compensado o equilíbrio, foi reabilitação vestibular.Conclusão: Queixas de tontura no paciente idoso devem ser criteriosamente avaliadas diante do seu histórico clínico patológico pois os antecedentes de doenças e tratamentos prévios, em geral, direcionam as hipóteses diagnósticas porém podem trazer alterações inesperadas.

  11. [Predictive factors of clinically significant drug-drug interactions among regimens based on protease inhibitors, non-nucleoside reverse transcriptase inhibitors and raltegravir].

    PubMed

    Cervero, Miguel; Torres, Rafael; Jusdado, Juan José; Pastor, Susana; Agud, Jose Luis

    2016-04-15

    To determine the prevalence and types of clinically significant drug-drug interactions (CSDI) in the drug regimens of HIV-infected patients receiving antiretroviral treatment. retrospective review of database. Centre: Hospital Universitario Severo Ochoa, Infectious Unit. one hundred and forty-two participants followed by one of the authors were selected from January 1985 to December 2014. from their outpatient medical records we reviewed information from the last available visit of the participants, in relation to HIV infection, comorbidities, demographics and the drugs that they were receiving; both antiretroviral drugs and drugs not related to HIV infection. We defined CSDI from the information sheet and/or database on antiretroviral drug interactions of the University of Liverpool (http://www.hiv-druginteractions.org) and we developed a diagnostic tool to predict the possibility of CSDI. By multivariate logistic regression analysis and by estimating the diagnostic performance curve obtained, we identified a quick tool to predict the existence of drug interactions. Of 142 patients, 39 (29.11%) had some type of CSDI and in 11.2% 2 or more interactions were detected. In only one patient the combination of drugs was contraindicated (this patient was receiving darunavir/r and quetiapine). In multivariate analyses, predictors of CSDI were regimen type (PI or NNRTI) and the use of 3 or more non-antiretroviral drugs (AUC 0.886, 95% CI 0.828 to 0.944; P=.0001). The risk was 18.55 times in those receiving NNRTI and 27,95 times in those receiving IP compared to those taking raltegravir. Drug interactions, including those defined as clinically significant, are common in HIV-infected patients treated with antiretroviral drugs, and the risk is greater in IP-based regimens. Raltegravir-based prescribing, especially in patients who receive at least 3 non-HIV drugs could avoid interactions. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  12. Tepidibacillus fermentans gen. nov., sp. nov.: a moderately thermophilic anaerobic and microaerophilic bacterium from an underground gas storage.

    PubMed

    Slobodkina, G B; Panteleeva, A N; Kostrikina, N A; Kopitsyn, D S; Bonch-Osmolovskaya, E A; Slobodkin, A I

    2013-09-01

    A novel moderately thermophilic bacterium, strain STGH(T), was isolated from Severo-Stavropolskoye underground gas storage (Russia). Cells of strain STGH(T) were spore-forming motile straight rods 0.3 μm in diameter and 2.0-4.0 μm in length having a Gram-positive cell wall structure. The temperature range for growth was 36-65 °C, with an optimum at 50-52 °C. The pH range for growth was 5.5-8.0, with an optimum at pH 7.0-7.5. Growth of strain STGH(T) was observed at NaCl concentrations ranging from 0 to 4.0 % (w/v) with an optimum at 1.0 % (w/v). Strain STGH(T) grew anaerobically by reduction of nitrate, thiosulfate, S(0) and AQDS using a number of complex proteinaceous compounds, organic acids and carbohydrates as electron donors. Nitrate was reduced to nitrite; thiosulfate and sulfur were reduced to sulfide. It also was able to ferment pyruvate, glucose, fructose, and maltose. The strain STGH(T) did not grow under aerobic conditions during incubation with atmospheric concentration of oxygen but was able to microaerobic growth (up to 10 % of oxygen in gas phase). The G+C content of DNA of strain STGH(T) was 34.8 mol%. 16S rRNA gene sequence analysis revealed that the isolated organism belongs to the class Bacilli. We propose to assign strain STGH(T) to a new species of a novel genus Tepidibacillus fermentans gen. nov., sp.nov. The type strain is STGH(T) (=DSM 23802(T), =VKM B-2671(T)).

  13. Respiratory Syncytial Virus Coinfections With Rhinovirus and Human Bocavirus in Hospitalized Children

    PubMed Central

    Calvo, Cristina; García-García, María Luz; Pozo, Francisco; Paula, Gallardo; Molinero, Mar; Calderón, Ana; González-Esguevillas, Mónica; Casas, Inmaculada

    2015-01-01

    Abstract It is not clearly established if coinfections are more severe than single viral respiratory infections. The aim of the study was to study and to compare simple infections and viral coinfections of respiratory syncytial virus (RSV) in hospitalized children. From September 2005 to August 2013, a prospective study was conducted on children younger than 14 years of age, admitted with respiratory infection to the Pediatric Department of the Severo Ochoa Hospital, in Spain. Specimens of nasopharyngeal aspirate were taken for virological study by using polymerase chain reaction, and clinical data were recorded. Simple RSV infections were selected and compared with double infections of RSV with rhinovirus (RV) or with human bocavirus (HBoV). In this study, 2993 episodes corresponding to 2525 children were analyzed. At least 1 virus was detected in 77% (2312) of the episodes. Single infections (599 RSV, 513 RV, and 81 HBoV) were compared with 120 RSV-RV and 60 RSV-HBoV double infections. The RSV-RV coinfections had fever (63% vs 43%; P < 0.001) and hypoxia (70% vs 43%; P < 0.001) more often than RV infections. Hypoxia was similar between single or dual infections (71%). Bronchiolitis was more frequent in the RSV simple group (P < 0.001). Pediatric intensive care unit admission was more common in RSV simple or RSV-RV groups than in the RV monoinfection (P = 0.042). Hospitalization was longer for both RSV simple group and RSV-HBoV coinfection, lasting about 1 day (4.7 vs 3.8 days; P < 0.001) longer than in simple HBoV infections. There were no differences in PICU admission. RSV single group was of a younger age than the other groups. Coinfections between RSV-RV and RSV-HBoV are frequent. Overall viral coinfections do not present greater severity, but have mixed clinical features. PMID:26496310

  14. My Life with Bacteriophage φ29

    PubMed Central

    Salas, Margarita

    2012-01-01

    This article is a survey of my scientific work over 52 years. During my postdoctoral stay in Severo Ochoa's laboratory, I determined the direction of reading of the genetic message, and I discovered two proteins that I showed to be involved in the initiation of protein synthesis. The work I have done in Spain with bacteriophage φ29 for 45 years has been very rewarding. I can say that I was lucky because I did not expect that φ29 would give so many interesting results, but I worked hard, with a lot of dedication and enthusiasm, and I was there when the luck arrived. I would like to emphasize our work on the control of φ29 DNA transcription and, in particular, the finding for the first time of a protein covalently linked to the 5′-ends of φ29 DNA that we later showed to be the primer for the initiation of phage DNA replication. Very relevant was the discovery of the φ29 DNA polymerase, with its properties of extremely high processivity and strand displacement capacity, together with its high fidelity. The φ29 DNA polymerase has become an ideal enzyme for DNA amplification, both rolling-circle and whole-genome linear amplification. I am also very proud of the many brilliant students and collaborators with whom I have worked over the years and who have become excellent scientists. This Reflections article is not intended to be the end of my scientific career. I expect to work for many years to come. PMID:23124207

  15. Population Pharmacokinetics of Gentamicin and Dosing Optimization for Infants

    PubMed Central

    Rueda-Naharro, Aída; Peña-Cabia, Silvia; García, Benito; Romano-Moreno, Silvia; Barcia, Emilia

    2014-01-01

    The aim of this study was to characterize and validate the population pharmacokinetics of gentamicin in infants and to determine the influences of clinically relevant covariates to explain the inter- and intraindividual variabilities associated with this drug. Infants receiving intravenous gentamicin and with routine therapeutic drug monitoring were consecutively enrolled in the study. Plasma concentration and time data were retrospectively collected from 208 infants (1 to 24 months old) of the Hospital Universitario Severo Ochoa (Spain), of whom 44% were males (mean age [± standard deviation], 5.8 ± 4.8 months; mean body weight, 6.4 ± 2.2 kg). Data analysis was performed with NONMEM 7.2. One- and two-compartment open models were analyzed to estimate the gentamicin population parameters and the influences of several covariates. External validation was carried out in another population of 55 infants. The behavior of gentamicin in infants exhibits two-compartment pharmacokinetics, with total body weight being the covariate that mainly influences central volume (Vc) and clearance (CL); this parameter was also related to creatinine clearance. Both parameters are age related and different from those reported for neonatal populations. On the basis of clinical presentation and diagnosis, a once-daily dosage regimen of 7 mg/kg of body weight every 24 h is proposed for intravenous gentamicin, followed by therapeutic drug monitoring in order to avoid toxicity and ensure efficacy with minimal blood sampling. Gentamicin pharmacokinetics and disposition were accurately characterized in this pediatric population (infants), with the parameters obtained being different from those reported for neonates and children. These differences should be considered in the dosing and therapeutic monitoring of this antibiotic. PMID:25385111

  16. On the Fate of Debris Associated with the Disappearance of Flight MH370: a Dynamical System Perspective

    NASA Astrophysics Data System (ADS)

    Mancho, A. M.; Garcia-Garrido, V. J.; Wiggins, S.; Mendoza, C.

    2015-12-01

    The disappearance of Malaysia Airlines flight MH370 on the morning of the 8th of March 2014 is one of the great mysteries of our time. One relevant aspect of this mystery is that not a single piece of debris from the aircraft was found during the intensive surface search carried out in the months following the crash. Difficulties in the search efforts were due to the uncertainty in the plane's final impact point and the time passed since the accident and rise the question on how the debris was scattered in an always moving ocean, for which there exist multiple datasets that do not uniquely determine its state. Our approach to this problem is based on dynamical systems tools that identify dynamic barriers and coherent structures governing transport. By combining publicly available information supplied by different ocean data sources with these mathematical techniques, we are able to assess the spatio-temporal state of the ocean in the priority search area at the time of impact and the following weeks. Using this information we propose a revised search strategy by showing why one might not have expected to find debris in some large search areas targeted by the search services and determining regions where one might have expected impact debris to be located and that were not subjected to any exploration. This research has been supported by MINECO under grants MTM2014-56392-R and ICMAT Severo Ochoa project SEV-2011-0087 and ONR grant No. N00014- 01-1-0769. Computational support from CESGA is acknowledged. References [1] V. J. García-Garrido, A. M. Mancho, S. Wiggins, and C. Mendoza. A dynamical systems perspective on the absence of debris associated with the disappearance of flight MH370. Nonlin. Processes Geophys. Discuss., 2,1197-1225, doi:10.5194/npgd-2-1197-2015, 2015

  17. [Acute posterior multifocal placoid pigment epitheliopathy. A rare cause of ischaemic stroke].

    PubMed

    del Saz-Saucedo, Pablo; Alfaya-Muñoz, Laura Blanca; Recio-Bermejo, Marta; Lara-Medina, Francisco Javier; García-Chiclano, Amalia; Ortega-León, Teresa; Rueda-Medina, Ignacio; Domínguez-Fernández, María José; Madrid-Muñiz, Carmen; Franco-Huerta, María

    2013-06-01

    Introduccion. La epiteliopatia pigmentaria placoide multifocal posterior aguda (EPPMPA) es una enfermedad inflamatoria rara, generalmente de etiologia indeterminada, de la coriocapilar, el epitelio pigmentario y la retina externa. Afecta predominantemente a pacientes jovenes y en algunos casos puede involucrar al sistema nervioso central en forma de ictus o de meningoencefalitis. Presentamos el caso clinico de una mujer joven con EPPMPA complicada con ictus e hipertension intracraneal. Caso clinico. Mujer de 16 anos que comienza con cefalea intensa sugestiva de hipertension intracraneal, asi como con un deficit agudo hemisferico izquierdo. La resonancia magnetica craneal ponia de manifiesto lesiones embolicas o vasculiticas en diferentes territorios. No se evidenciaron datos de meningoencefalitis en el estudio del liquido cefalorraquideo, pero si de hipertension intracraneal asociada. La presencia de lesiones muy especificas en el polo ocular posterior permitio el diagnostico de EPPMPA complicada con ictus isquemico, probablemente por mecanismo vasculitico. Un amplio estudio etiologico fue negativo para identificar un factor desencadenante claro del proceso. Se inicio tratamiento corticoideo con buena evolucion clinica y radiologica. Conclusiones. La EPPMPA es una entidad rara que generalmente entrana buen pronostico; sin embargo, en algunos casos puede complicarse con afectacion del sistema nervioso central, y el ictus isquemico secundario a vasculitis es la complicacion mas grave. Ante un paciente joven con ictus que presente sintomatologia visual y lesiones coriorretinianas, debe considerarse la EPPMPA en su diagnostico etiologico.

  18. [Thrombolysis in left mechanical prosthetic heart valve obstruction by thrombus. Following and results].

    PubMed

    Valencia-Sánchez, Jesús Salvador; Arriaga-Nava, Roberto

    2014-01-01

    INTRODUCCIÓN: la obstrucción de la válvula mecánica cardiaca izquierda por trombo es una complicación grave. Los factores relacionados con la mortalidad son clase funcional, tipo de prótesis valvular y urgencia de la cirugía. La trombólisis representa una opción terapéutica a la cirugía cardiaca. El objetivo de esta investigación fue analizar el papel de la trombólisis en el manejo de la válvula mecánica cardiaca izquierda obstruida por trombo. MÉTODOS: se estudiaron 22 casos consecutivos sometidos a trombólisis en el Hospital de Cardiología del Centro Médico Nacional Siglo XXI, bajo dos diferentes circunstancias: con edema agudo pulmonar y estado de choque en clase funcional IV y con clases funcionales I y II. Se realizó monitoreo clínico, ecocardiográfico y fluoroscopia.

  19. [Neurological effects of hypoglycemia in diabetic patients].

    PubMed

    Caballero-Corchuelo, J

    2016-09-16

    Introduccion. El tratamiento farmacologico de la diabetes se asocia a un aumento en el riesgo de hipoglucemia. Los episodios de hipoglucemia afectan a la calidad de vida del paciente y a actividades diarias comunes, ademas de la morbimortalidad que pueden producir en casos con sintomatologia neurologica. Objetivo. Revisar las principales complicaciones neurologicas de la hipoglucemia en pacientes diabeticos, con especial interes en las consecuencias a largo plazo. Desarrollo. Tras revisar la fisiopatologia de la hipoglucemia en el paciente diabetico, se describe el papel de la hipoglucemia en tres situaciones: las alteraciones en los mecanismos neuroendocrinos de regulacion de la glucemia, los efectos de la hipoglucemia en los niños y la relacion con el deterioro cognitivo en los adultos. Conclusiones. Aparte de los daños neurologicos agudos que pueden suceder en casos de hipoglucemia grave, los episodios de hipoglucemia repetidos se asocian a otros efectos neurologicos a largo plazo: afectan a los mecanismos de contrarregulacion ante episodios de hipoglucemia subsiguientes, aumentando el riesgo de hipoglucemias graves, y pueden producir alteraciones cognitivas en poblaciones vulnerables, como los niños pequeños o ancianos.

  20. MRSA Pediatric clone expressing ermC plus lnuA genes causing nosocomial transmission and healthcare workers colonization in a neonatal intensive care unit.

    PubMed

    Faccone, Diego; Togneri, Ana M; Podesta, Laura; Perez, Marcela; Gagetti, Paula; Sanchez, Susana; Romero, Graciela; Corso, Alejandra

    2014-07-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of both nosocomial and community-acquired infections. We describe an outbreak caused by the MRSA Pediatric clone expressing an unusual lincosamide resistant phenotype. Between January and May 2006, an MRSA outbreak was detected at the Neonatal Unit of Hospital Interzonal General de Agudos "Evita", Buenos Aires Province, Argentina that affected ten patients. Seven isolates from seven patients plus five MRSA recovered from health care workers (nasal carriage) were studied. Two phenotypes were observed: (i) ELCi (10), resistance to erythromycin and lincomycin and inducible resistance to clindamycin; (ii) ELiCi (2), resistance to erythromycin and inducible resistance to lincomycin and clindamycin. All 12 MRSA were resistant to oxacillin, erythromycin and gentamicin. Isolates expressing the ELCi-phenotype showed lincomycin MIC values between 16 and 32mg/L, while the remaining 2 isolates with ELiCi-phenotype presented a MIC value of 0.5mg/L. No differences were observed between the clindamycin MIC values in both phenotypes, ranging 0.25-0.5mg/L. Isolates showing ELCi-phenotype harbored ermC plus lnuA genes, and the other two only ermC gene. All 12 isolates were genetically related and belonged to the Pediatric clone (ST100) harboring a new variant of SCCmecIV. This is the first MRSA outbreak expressing an unusual ELCi phenotype due to a combination of ermC plus lnuA genes.

  1. [Hemorrhagic colloid cyst of the third ventricle: fulminant deterioration].

    PubMed

    Martínez-Gómez, Debora; Joanes, Vicente; Herrera, Juan Manuel; Rivera-Paz, Marlon; Vanaclocha, Vicente

    2015-03-16

    Introduccion. Los quistes coloides son tumores benignos del tercer ventriculo. La mayoria permanecen asintomaticos. Sin embargo, algunos pacientes pueden desarrollar desde cefaleas intermitentes hasta un deterioro agudo e incluso muerte subita. Existen varias teorias por las que se produciria una muerte subita en estos pacientes, entre las que se incluyen el rapido crecimiento del quiste, su rotura, la alteracion del control cardiovascular reflejo mediado por el hipotalamo y, rara vez, el sangrado del quiste, con solo 15 casos descritos en la bibliografia. Caso clinico. Varon de 45 años, con hipertension arterial como unico antecedente de interes, que sufre un deterioro brusco del nivel de consciencia a causa de una hidrocefalia aguda debida a un quiste coloide hemorragico del tercer ventriculo. Se implanto un drenaje ventricular externo en cada lado e ingreso en la unidad de cuidados intensivos, donde se certifico la muerte encefalica. Tras la extirpacion del quiste mediante abordaje transcortical frontal, se confirmo el diagnostico de quiste coloide con restos de material hemolizado subagudo. Conclusion. La hemorragia en los quistes coloides es excepcional y puede producirse en pacientes tanto sintomaticos como asintomaticos, lo que dificulta, de forma extraordinaria, el reconocimiento de esta complicacion.

  2. [Therapeutic plasma exchange: applications in neurology].

    PubMed

    Láinez-Andrés, José M; Gascón-Giménez, Francisco; Coret-Ferrer, Francisco; Casanova-Estruch, Bonaventura; Santonja, José M

    2015-02-01

    Introduccion. El recambio plasmatico es una tecnica utilizada en el tratamiento de algunas enfermedades neurologicas de base autoinmune desde los años ochenta, especialmente en situaciones agudas. En los ultimos años se han publicado nuevos datos sobre su empleo en numerosas entidades con base autoinmune, ampliando, con ello, el espectro de utilizacion. Objetivo. Actualizar las indicaciones de esta tecnica en el tratamiento de las enfermedades neurologicas. Desarrollo. Se ha realizado una revision exhaustiva de todos los articulos publicados desde los años ochenta sobre la eficacia del recambio plasmatico en el tratamiento de las diferentes enfermedades neurologicas. Tambien se ha efectuado un analisis detallado de las recomendaciones y evidencias de la utilizacion de este procedimiento por parte de las diferentes sociedades cientificas. Conclusiones. El recambio plasmatico ha demostrado ser una alternativa eficaz con evidencia cientifica de primer nivel en enfermedades como el sindrome de Guillain-Barre, la polineuropatia desmielinizante inflamatoria cronica o la miastenia grave. Ha mostrado ser eficaz en el tratamiento de episodios desmielinizantes agudos sin respuesta a otras terapias, en los brotes de neuromielitis optica y en otras enfermedades del sistema nervioso central producidas por anticuerpos. En los estudios comparativos con inmunoglobulinas intravenosas, la eficacia de ambas terapias es similar. Es preciso seguir realizando estudios comparativos para conocer mejor los mecanismos y establecer indicaciones prioritarias y comparar la relacion coste-eficacia de ambos procedimientos.

  3. [Study of Staphylococcus aureus infections in a general acute care hospital (2002-2013)].

    PubMed

    Togneri, Ana M; Podestá, Laura B; Pérez, Marcela P; Santiso, Gabriela M

    2017-01-23

    A twelve-year retrospective review of Staphylococcus aureus infections in adult and pediatric patients (AP and PP respectively) assisted in the Hospital Interzonal General de Agudos Evita in Lanús was performed to determine the incidence, foci of infection, the source of infection and to analyze the profile of antimicrobial resistance. An amount of 2125 cases of infection in AP and 361 in PP were documented. The incidence in AP decreased significantly in the last three years (χi(2); p<0.05); in PP it increased significantly during the last five years (χ(2); p<0.0001). In both populations was detected a notable increase in skin infections and associated structures (PEA) in bacteremia to the starting point of a focus on PEA, and in total S. aureus infections of hospital-onset (χ(2); p < 0.005). Methicillin-resistance (MRSA) increased from 28 to 78% in PP; in AP it remained around 50%, with significant reduction in accompanying antimicrobial resistance to non-β-lactams in both groups of MRSA. In S. aureus documented from community onset infections (CO-MRSA) in the last three years, the percentage of methicillin-resistance was 57% in PP and 37% in AP; in hospital-onset infections it was 43% and 63% respectively. Although data showed that S. aureus remains a pathogen associated with the hospital-onset, there was an increase of CO-MRSA infections with predominance in PEA in both populations.

  4. PubMed

    Goñi Esarte, S; Zozaya Urmeneta, J M; Goñi Esarte, M; Uriz Otano, J I; Idoate Santesteban, I; Beunza Puyol, M T

    2016-12-30

    La hepatitis isquémica es una entidad poco frecuente. Se asocia a una hipoperfusión hepática debida en primer lugar a un bajo gasto cardíaco (insuficiencia cardiaca congestiva, infarto agudo de miocardio o miocardiopatía dilatada). De forma menos frecuente puede ser secundaria a una insuficiencia respiratoria o al aumento de las necesidades de oxígeno en el contexto de una sepsis.Paciente varón de 49 años que acude al servicio de Urgencias por disnea progresiva e hipotensión, objetivándose una importante elevación de transaminasas (aspartato aminotransferasa de 5.550 U/L, alanina aminotransferasa de 3.826 U/L) y de LDH (10.375 U/L). La ecografía Doppler hepática fue normal. El ecocardiograma confirmó la sospecha diagnóstica, visualizándose la presencia de un derrame pericárdico masivo. El taponamiento cardíaco es una causa excepcional de este cuadro clínico. En el caso de nuestro paciente, el rápido diagnóstico y una pericardiocentesis realizada de forma urgente le llevaron a su pronta recuperación.

  5. [The characteristics, management and prognosis of the acute myocardial infarct patient in the Valencian Community in 1995: the results of the PRIMVAC Registry (The Registry Project of Acute Myocardial Infarct in Valencia, Alicante and Castellón). As representatives of the PRIMVAC investigators].

    PubMed

    Cabadés, A; Echanove, I; Cebrián, J; Cardona, J; Valls, F; Parra, V; Bertomeu, V; Francés, M; González, E; Ballenilla, F; Sogorb, F; Rodríguez, R; Mota, A; Guardiola, F; Calabuig, J

    1999-02-01

    Regional registers of patients with acute myocardial infarction are scarce in Spain. The PRIMVAC register (Proyecto de Registro de Infarto agudo de Miocardio de Valencia, Alicante y Castellón) was initiated to obtain updated information on the management of these patients in the Valencia Autonomous Community. Data of the first twelve months of the register are presented. The 17 participating hospitals cover 2,833,938 inhabitants. Demographic, clinical, procedural and outcome data as well as predictive variables of mortality were analysed in the patients with acute myocardial infarction during their stay in the coronary care units from 1 December 1994 to 30 November 1995. During 12 months, 2,377 patients were included. Mean age was 65.3 years (SD 11.9) and 23.2% were female. Left ventricular failure was present in 39.8%. Thrombolytic therapy was applied in 42.1% with a median time delay of 195 min from chest pain onset. This time was longer in the women (250 min) and in the elderly (210 min). The in-coronary-care-unit-mortality rate was 13.9%. Age, female gender, diabetes, previous myocardial infarction, Q wave and right ventricular infarction independently predicted increased early mortality. Present data show the feasibility of an acute myocardial infarction register in the Valencia Autonomous Community. Although an acceptable level of thrombolysis has been reached, the mortality rate is still high. The long delay in initiating thrombolysis, particularly in female and elderly patients is remarkable.

  6. [Cervical ischaemic neuronopathy and cardioembolism: another cause of man-in-the-barrel syndrome].

    PubMed

    Gonzalez-Usigli, H; Gandarilla, A; Garcia, J J; Serrato, J; Estrada, N

    2016-12-16

    Introduccion. Los infartos de la medula espinal ocurren aproximadamente en el 1% de todos los infartos del sistema nervioso. El cardioembolismo es una causa rara. Las areas comunmente afectadas en infartos medulares son zonas de circulacion limitrofe en la region dorsal o lumbar; sin embargo, se han descrito previamente infartos medulares en la zona cervical asociados a la diseccion de arterias vertebrales. Caso clinico. Se presenta un nuevo caso de sindrome del hombre en el barril asociado con fibrilacion auricular durante un infarto agudo de miocardio, que causo una neuronopatia cervical isquemica (infarto de astas anteriores). Conclusiones. Los hallazgos clasicos de isquemia medular cervical son tetraplejia aguda, disfuncion vesical, intestinal y cardiovascular, asi como perdida de la sensibilidad disociada. La colateralizacion incompleta y las caracteristicas anatomicas de la arteria espinal anterior en la medula cervical hacen de la porcion C3-C5 la region mas vulnerable de daño isquemico, ya que la irrigacion de las arterias radiculares se inicia debajo de C5 y la fisiopatologia de la lisis rapida de un coagulo fresco produce unicamente daño bilateral de las celulas de las astas neuronales.

  7. [Effect of alcohol on electrical organisation in the brain during a visuospatial working memory task and its relationship with the menstrual cycle].

    PubMed

    Sanz-Martin, Araceli; Hernández-González, Marisela; Guevara, Miguel Ángel; Santana, Gloria; Gumá-Díaz, Emilio

    2014-02-01

    Introduccion. El metabolismo del alcohol y el desempeño de muchas funciones cognitivas pueden variar a lo largo del ciclo menstrual. Tanto la ingestion de alcohol como las variaciones hormonales durante el ciclo menstrual se asocian con cambios caracteristicos en la actividad electroencefalografica. Objetivo. Determinar si la actividad electroencefalografica durante una tarea de memoria de trabajo es afectada por el consumo agudo de alcohol, y si dicha actividad varia en funcion del ciclo menstrual. Sujetos y metodos. Muestra de 24 mujeres que ingirieron alcohol o placebo durante las fases folicular y lutea temprana. Se registro el electroencefalograma durante la ejecucion de una tarea de memoria de trabajo visuoespacial. Resultados. Aunque el alcohol no deterioro el rendimiento de la tarea de memoria de trabajo, si produjo en el electroencefalograma una disminucion de la potencia relativa de theta y una menor correlacion frontoparietal derecha en las bandas theta y alfa2. Unicamente las mujeres alcoholizadas en la fase folicular presentaron una mayor potencia relativa de alfa1, que podria indicar menor nivel de alertamiento y atencion. Conclusiones. Estos resultados contribuyen a una mejor comprension de los mecanismos cerebrales que subyacen a los cambios cognitivos con el alcohol y su relacion con el ciclo menstrual.

  8. Short-lived brine infiltration during upper amphibolite facies metamorphism in the continental collision zone

    NASA Astrophysics Data System (ADS)

    Higashino, Fumiko; Kawakami, Tetsuo; Tsuchiya, Noriyoshi; Satish-Kumar, Madhusoodhan; Ishikawa, Masahiro; Grantham, Geoffrey; Sakata, Shuhei; Hirata, Takafumi

    2017-04-01

    The importance of brine is increasingly recognized because of its role on mass transportation at the mid- to lower-crustal pressure-temperature (P-T) conditions (e.g., Newton & Manning, 2010). However, the passage and residence times of brine are not well understood. This study deals with garnet-hornblende (Grt-Hbl) veins, discordantly cutting the gneissose structure of garnet-orthopyroxene-hornblende gneiss from the central Sør Rondane Mountains (SRM), East Antarctica. The Cl contents of hornblende and biotite, K content of hornblende, and the thickness of Na-richer rims of plagioclase decreased with distance from the Grt-Hbl vein. The P-T conditions of the vein formation were estimated to be 680 °C, 0.69 GPa (Higashino et al., under review). In the wall rock in the vicinity of the vein, addition of Li, Cu, Rb, Ba, Pb, and U, which tend to be mobile in brines rather than in melts is observed, using Zr as an immobile element (Higashino et al., 2015). This indicates that the Grt-Hbl vein was formed by the infiltration of NaCl-KCl brine. Trace element concentrations in the wall rock minerals decrease with distance from the vein, and in most cases show concave up/down profiles. Distances where these concentrations in each mineral species become constant are dependent on elements, and not on mineral species. These profiles can be best modelled by diffusion equations, suggesting that the diffusion is the major process transferring the trace elements perpendicular to the vein. Although plagioclase does not show significant trace element zoning within each single grain, the discontinuous drop of anorthite content at rims is preserved. Thin brine films in grain boundaries presumably caused dissolution-reprecipitation (e.g., Ruiz-Agudo et al., 2014), and lattice diffusion in plagioclase would have followed this to form homogeneous trace element zonings. Therefore, the main process of brine infiltration into the wall rock is possibly grain boundary diffusion in wet

  9. Acute Ischemic Stroke on Cancer Patients, a Distinct Etiology? A Case-Control Study.

    PubMed

    Carrilho Romeiro, Ana; Valadas, Anabela; Marques, José

    2015-01-01

    Introdução: Actualmente ainda não se encontra claramente definido se a etiologia do acidente vascular cerebral isquémico agudo difere entre doentes com e sem cancro. O acidente vascular cerebral isquémico e o cancro apresentam factores de risco comuns. No entanto, a literatura sugere que os doentes com cancro apresentam condições específicas que aumentam o risco de acidente vascular cerebral. O nosso objectivo foi comparar a etiologia do acidente vascular cerebral isquémico entre doentes com cancro e sem cancro. Material e Métodos: Estudo de caso-controlo realizado em doentes internados numa Unidade de acidente vascular cerebral entre Janeiro de 2007 e Dezembro de 2012. Os casos foram definidos como doentes com o diagnóstico concomitante de acidente vascular cerebral isquémico agudo e cancro; os controlos apenas com o diagnóstico de acidente vascular cerebral. Foram comparados entre os grupos: idade, género, factores de risco vasculares e etiologia do acidente vascular cerebral. Resultados: Foram identificados 56 casos, 64,3% do género masculino, com idade média de 71 anos; 21 doentes apresentavam doença neoplásica activa. O cancro gastrointestinal (25,9%) foi o mais frequente. Foram incluídos 151 controlos, emparelhados para a idade e género. A comparação dos factores de risco vasculares entre casos e controlos não revelou diferenças estatisticamente significativas, excepto para a diabetes mellitus, mais frequente no grupo de controlo (16,1% vs 33,8%, p = 0,02). A presença de história de eventos trombóticos prévios foi mais frequente na coorte de doentes com doença neoplásica (8,9% vs 0,7%, p = 0,007). O subtipo de etiologia do acidente vascular cerebral (classificação TOAST) âoutra etiologiaâ foi mais frequente nos doentes com cancro (13,04% vs 0,83%, p < 0,01), e a presença de um estado pró-trombótico foi mais frequente nos doentes com neoplasia activa.Discussão: Os resultados obtidos no nosso estudo permitiram definir dois

  10. [Treatment of Gastroenteropancreatic Neuroendocrine Tumors with 177Lu-DOTA-TATE: Experience of the Portuguese Institute of Oncology in Porto].

    PubMed

    Sampaio, Inês Lucena; Luiz, Henrique Vara; Violante, Liliana Sobral; Santos, Ana Paula; Antunes, Luís; Torres, Isabel; Sanches, Cristina; Azevedo, Isabel; Duarte, Hugo

    2016-11-01

    Introdução: O objetivo deste artigo é rever a experiência do Instituto Português de Oncologia do Porto na terapêutica de tumores neuroendócrinos gastroenteropancreáticos com 177Lu-DOTA-TATE, tendo como principais pontos de análise a segurança e eficáciaterapêutica. Material e Métodos: Foi realizada uma análise retrospetiva dos processos clínicos de doentes com tumores neuroendócrinos gastroenteropancreáticos, submetidos a terapêutica com 177Lu-DOTA-TATE entre abril de 2011 e novembro de 2013. Resultados: Dos 36 casos revistos, 30 completaram os três ciclos de 177Lu-DOTA-TATE (83,3%). Nesses doentes foram registados: efeitos colaterais agudos em 8,9% dos ciclos; toxicidade hepática grau 3 CTCAE em 13,3% dos doentes (todos com alterações prévias da função hepática); ausência de toxicidade renal ou hematológica significativa; melhoria sintomática em 71,4% dos doentes; tempo mediano global desde o início da terapêutica até progressão de doença de 25,6 meses; tempo mediano global de sobrevivência desde o diagnóstico de 121,7 meses. Verificou-se um maior tempo livre de progressão de doença e de sobrevivência nos doentes com expressão elevada de recetores da somatostatina (p < 0,05). Discussão: A peptide receptor radionuclide therapy com 177Lu-DOTA-TATE apresenta respostas clínicas favoráveis com segurança e boa tolerabilidade terapêutica, conforme evidenciado no nosso estudo pelos seguintes achados: melhoria dos sintomas na maioria dos doentes e aumento significativo do tempo livre de progressão de doença e da sobrevivência (sobretudo nos doentes com expressão elevada de sstr), com efeitos colaterais agudos e subagudos/crónicos significativos numa minoria de doentes. Conclusão: A peptide receptor radionuclide therapy com 177Lu-DOTA-TATE é uma terapêutica promissora, com benefícios reais em termos de eficácia e segurança nos doentes com tumores neuroendócrinos gastroenteropancreáticos.

  11. The effect of electrolytes on dolomite dissolution: nanoscale observations using in situ Atomic Force Microscopy

    NASA Astrophysics Data System (ADS)

    Urosevic, Maja; Ruiz-Agudo, Encarnacion; Putnis, Christine V.; Cardell, Carolina; Rodriguez-Navarro, Carlos; Putnis, Andrew

    2010-05-01

    Dissolution of carbonate minerals is one of the main chemical reactions occurring at shallow levels in the crust of the Earth and has a paramount importance for a wide range of geological and biological processes. Calcite (CaCO3), and to a lesser extent dolomite (CaMg(CO3)2), are the major carbonate minerals in sedimentary rocks and building stone materials. The dissolution of calcite has been thoroughly investigated over a range of conditions and solution compositions. In contrast, dolomite dissolution studies have been traditionally hampered by its low reaction rates compared to calcite and its poorly constrained relationship between cation ordering and reactivity (Morse and Arvidson, 2002). Yet important questions like the so-called 'dolomite problem' (e.g. Higgins and Hu, 2005) remain unresolved and more experimental work is needed in order to understand the role of other dissolved species, such as soluble salts, on the kinetics and mechanism of dolomite dissolution and precipitation. We have explored the effect of different electrolytes on the dissolution rate of dolomite by using in situ Atomic Force Microcopy (AFM). Experiments were carried out by passing alkali halide, nitrate and sulfate salt solutions (NaCl, KCl, LiCl, NaI, NaNO3 and Na2SO4) with different ionic strengths (IS = 10-3, 10-2 and 10-1) over dolomite {1014} cleavage surfaces. We show that all electrolytes tested enhance dolomite dissolution. Moreover, the morphology and density of etch pits are controlled by the presence of different ions in solution. The etch pit spreading rate and dolomite dissolution rate depend on both (1) the nature of the electrolyte and (2) the ionic strength. This is in agreement with recent experimental studies on calcite dissolution (Ruiz-Agudo et al., 2010). This study highlights the role of electrolytes in dolomite dissolution and points to a common behavior for carbonate minerals. Our results suggest that soluble salts may play a critical role in the weathering of

  12. Treatment of Dyslipidemia with Statins and Physical Exercises: Recent Findings of Skeletal Muscle Responses.

    PubMed

    Bonfim, Mariana Rotta; Oliveira, Acary Souza Bulle; Amaral, Sandra Lia do; Monteiro, Henrique Luiz

    2015-02-13

    -se levantamento da literatura nas bases de dados PubMed e SciELO, utilizando a combinação dos unitermos: "estatina/estatinas" AND "exercício" AND "músculo" ("statin" AND "exercise" AND "muscle"), sendo selecionados apenas artigos originais publicados entre janeiro de 1990 e novembro de 2013. Foram analisados 16 artigos que avaliaram o efeito da associação das estatinas com exercício agudo ou crônico na musculatura esquelética. Os resultados dos estudos apontaram que atletas podem experimentar efeitos deletérios na musculatura esquelética quando do uso de estatinas, visto que os quadros de exacerbação da lesão muscular pelo exercício foram mais frequentes com treinamento intenso ou exercícios agudos excêntricos e extenuantes. O treinamento físico moderado, por sua vez, quando associado às estatinas, não aumenta os relatos de dor nem os níveis de creatina quinase, além de acarretar ganhos nas funções musculares e metabólicas advindas do treinamento. Sugere-se, portanto, que pacientes dislipidêmicos em tratamento com estatinas sejam expostos ao treinamento físico aeróbio combinado a exercícios resistidos, de intensidade moderada, em três sessões semanais, sendo que a oferta do treinamento físico previamente à administração do tratamento medicamentoso, quando possível, faz-se desejável.

  13. [In Process Citation].

    PubMed

    Chacón-Cuberos, Ramón; Castro-Sánchez, Manuel; Muros-Molina, José Joaquín; Espejo-Garcés, Tamara; Zurita-Ortega, Félix; Linares-Manrique, Marta

    2016-03-25

    Introducción: la dieta mediterránea (DM) representa uno de los modelos dietéticos más completos y sanos según expresan numerosos estudios. En este sentido, la etapa universitaria supone un cambio sustancial en los hábitos alimentarios de los adultos jóvenes, alejándose de los estándares asociados a la DM. Objetivo: determinar el nivel de adherencia a la DM de un sector de población universitaria, estableciendo patrones de relación con el tipo de población en el que reside y hábitos de ocio digital asociados a videojuegos. Material y métodos: en esta investigación de diseño descriptivo y corte transversal participaron 490 estudiantes universitarios (M = 22,8 años; DT = 3,639), realizándose la recogida de datos mediante los cuestionarios KIDMED, Cuestionario de Experiencias Relacionadas con los Videojuegos (CERV) y Cuestionario sobre los Hábitos de Consumo de Videojuegos (CHCV). Resultados: más del 70% de la muestra necesitaba mejorar su alimentación y solo un 26,1% se alimentaba adecuadamente. Asimismo, los niveles de adicción a los videojuegos mostraron que un 17,8% de los participantes manifestaba problemas potenciales y un 2,7% severos. Se encontraron diferencias estadísticas en las relaciones dadas para la adhesión a la DM, la frecuencia de uso de videojuegos y el número de videojuegos jugados, concretando que los hábitos de consumo de videojuegos influyen en la adhesión a la DM en la etapa universitaria. Conclusión: ante el bajo porcentaje de universitarios que siguen una dieta de calidad óptima y su relación con el uso de videojuegos, resulta de vital importancia la creación de programas de intervención que mejoren la alimentación de este sector y disminuyan el tiempo de ocio sedentario.

  14. A Real-Time Response to a Marine Oil Spill: an Intedisciplinary Approach.

    NASA Astrophysics Data System (ADS)

    Garcia-Garrido, Victor J.; Ramos, Antonio; Mancho, Ana M.; Coca, Josep; Wiggins, Stephen

    2016-04-01

    By combining tools from dynamical systems theory and remote sensing techniques, we achieve a remarkable representation of the events following the sinking of the Oleg Naydenov fishing ship, that took place close to the Canary Islands in April 2015 [1]. The emergency services acquired a precise knowledge of the evolution of the spill, occurred after the sinking, by means of a formidable, extremely time-consuming and expensive effort. In this presentation we show that remote sensing techniques [2] allowed a direct observation of the spill in extensive areas. The time evolution of the observed spills was pursued by dynamical systems tools that, based on COPERNICUS IBI velocity fields data, were able to predict the impact of the spill in the coast of Gran Canaria. A deep description of the dispersion processes produced by ocean currents is achieved by means of Lagrangian Descriptors [3,4,5] that highlight an invisible but real dynamical skeleton, governing the transport processes in the area. This research is supported by MINECO ICMAT Severo Ochoa project SEV-2011-0087 and SEV-2015-0554 and grants MTM2014-56392-R, UNLP-13-3E-2664 (2013-2015) and ONR grant No. N00014- 01-1-0769. [1] V. J. García-Garrido, A. Ramos, A. M. Mancho, J. Coca, S. Wiggins. Assemblage of Tools for a Real-Time Response to a Marine Oil Spill. Preprint (2015). [2] A. Pisano, F. Bignami, R. Santoleri, Oil spill detection in glint-contaminated near-infrared MODIS imagery, Remote Sens. 7 (1) (2015) 1112-1134. [3] C. Mendoza, A. M. Mancho. The hidden geometry of ocean flows. Physical Review Letters 105 (2010), 3, 038501-1-038501-4. [4] A. M. Mancho, S. Wiggins, J. Curbelo, C. Mendoza. Lagrangian Descriptors: A Method for Revealing Phase Space Structures of General Time Dependent Dynamical Systems. Communications in Nonlinear Science and Numerical Simulation. 18 (2013) 3530-3557. [5] C. Lopesino, F. Balibrea, S. Wiggins, A.M. Mancho. Lagrangian Descriptors for Two Dimensional, Area Preserving

  15. Improvement of C peptide zero BMI 24-34 diabetic patients after tailored one anastomosis gastric bypass (BAGUA).

    PubMed

    Garciacaballero, M; Martínez-Moreno, J M; Toval, J A; Miralles, F; Mínguez, A; Osorio, D; Mata, J M; Reyes-Ortiz, A

    2013-03-01

    Introducción: Aunque la cirugía bariátrica ha demostrado ser un método muy eficaz en el tratamiento de pacientes diabéticos cuyo páncreas aún es capaz de producir insulina (diabetes tipo 2), así como del síndrome metabólico y las complicaciones relacionadas con la diabetes, no hay información sobre el efecto de este tipo de cirugía en pacientes IMC 24-34 cuando el páncreas no produce insulina en absoluto (tipo 1, tipo LADA y diabetes tipo 2 de larga evolución, entre otros). Métodos: Presentamos datos preliminares de una serie de 11 pacientes todos con valores de Péptido C < 0,0 ng/ml. El seguimiento postoperatorio varia de 6 y 60 meses (media 19 meses). Estudiamos los cambios en el control de la glucemia, evolución del síndrome metabólico y complicaciones relacionadas con la diabetes tras bypass de una anastomosis (BAGUA). Resultados: Mejoraron todos los valores relativos al control glucémico HbA1c (de 8,9 ± 0,6 a 6,7 ± 0,2%), FPG (Glucosa Plasmática Ayunas) (de 222,36 ± 16,87 a 94 ± 5 (mg/dl)) así como el requerimiento diario de insulina, tanto de insulina rápida (de 40,6 ± 12,8 a 0 U/día) como de insulina retardada (41,27 ± 7,3 U/día a 15,2 ± 3,3 U/día). Se resolvieron el 100% de las comorbilidades estudiadas y se mejoraron algunas complicaciones graves derivadas de la diabetes como retinopatía o nefropatía. Conclusiones: El bypass gástrico de una anastomosis adaptado a pacientes diabéticos IMC24-34 con péptido C cero elimina el uso de insulina de acción rápida, reduce a una sola inyección diaria la insulina retardada y mejora el control glucémico. Tras la cirugía desaparecen el síndrome metabólico y los episodios severos de hipoglucemia, y mejora significativamente la retinopatía, neuropatía, nefropatía, vasculopatía periférica y cardiopatía.

  16. [EFFECTS OF VOLUNTARY INTAKE OF FLUIDS (WATER AND SPORTS DRINK) IN AMATEUR MOUNTAIN RUNNERS].

    PubMed

    Nebot, Vicente; Drehmer, Eraci; Elvira, Laura; Sales, Sonia; Sanchís, Carlos; Esquius, Laura; Pablos, Ana

    2015-11-01

    Introducción: las carreras por montaña de 21 km y 1.000 metros de desnivel pueden suponer un riesgo si no se mantiene una adecuada reposición hídrica. Objetivo: conocer los niveles de deshidratación y evaluar las diferencias entre una carrera con ingesta voluntaria de agua (CcA) y bebida deportiva (CcB). Método: 18 sujetos de 31,9 (±2,8) años y %MG 10,53 (±2,8), completaron una CcA o una CcB. Se evaluó el efecto de CcA y CcB sobre cada variable; Peso (P), Masa Grasa (MG), Glucosa (GL), Lactato (LT), Tensión Arterial Sistólica (TAS) y Diastólica (TAD), Pulsaciones por Minuto (PPM) y Temperatura Timpánica (Tª). Estas fueron tomadas al inicio (T1) y al final (T2) de cada prueba. Los efectos se calcularon con la ANOVA Friedman. Las diferencias en las variables tiempo de carrera (TC), % de pérdida de peso (%PP) y líquido ingerido (LI) se evaluaron con la prueba de Wilcoxon. Todos los cálculos se realizaron con el SPSS versión 20.0 (IBM, Somers, NY, USA). Resultado: el % PP fue de 2,967 (± 0,969) y 2,883 (± 0,730), para CcA y CcB. En TC, %PP y LI no hay diferencias (p > .05) entre carreras. Para CcA en función del tiempo, son significativos (p < .05) los cambios en: P, %MG, GL, L, TAS y PPM. Para CcB en función del tiempo, solo son significativos en P y PPM. Conclusiones: ningún líquido consigue evitar que los deportistas se deshidraten. No obstante, los efectos de la deshidratación son mucho más severos ingiriendo solo agua.

  17. PubMed

    De Abajo Larriba, Ana Beatriz; Díaz Rodríguez, Ángel; González-Gallego, Javier; Peleteiro Cobo, Beatriz; Capón Álvarez, Jessica; Mahmoud Atoui, Omar; Méndez Rodríguez, Enrique; De Abajo Olea, Serafín; Lumbreras González, Víctor; Minniti, Caterina

    2016-09-20

    Objetivos: estimar las actividades preventivas que realizan los pacientes diagnosticados de enfermedad pulmonar obstructiva crónica (EPOC) en la provincia de León.Métodos: estudio epidemiológico, transversal, multicéntrico (30 centros de salud de la provincia de León). Incluyó pacientes mayores de 35 años diagnosticados y tratados de EPOC. Variables a estudio: edad, sexo, hábitat, datos antropométricos, tabaquismo, estado nutricional, ejercicio físico, vacunación antigripal, vacunación, antineumocócica (VNP23 y VNC13), fenotipo, gravedad, reagudizaciones y hospitalizaciones. Los resultados se expresan con sus IC al 95,5%.Resultados: se incluyeron 833 pacientes, el 85,8% varones, edad media: 64,69 años (53,66-75,61) y 20,65 años (4,47-36,8) de evolución de la EPOC. El 86,67% (80,30-93,30) tenían antecedentes de tabaquismo (n = 722), de 35,26 años de evolución (17,87-52,64), consumían 28,36 paquetes al año (9,60-46,86), p < 0,001, siendo el 58% fumadores severos. En fumadores activos (n = 288) la intervención más efectiva fue terapia cognitivo-conductual más vareniclina, con abstinencias del 29,86%. En total dejaron de fumar el 51,05% (49,49-52,70) de los pacientes con EPOC, p < 0,001. El 73,67% (71,78-75,65) realizaba ejercicio prescrito, el 88,76% (84,82-90,7) realizaba dieta equilibrada, el 89,7% (87,8-91,8) estaba vacunado frente a la gripe, siendo esta más frecuente en los mayores de 65 años y hospitalizados, p < 0,001. El 9,61% (7,7-11,6) de los no vacunados tuvo reagudizaciones que requirieron ingreso hospitalario, p < 0,001. La tasa de vacunación con VNP23 fue del 52,8% (49,3-56,4) vs.4,97% (3,0-6,61) de VNC13, p < 0,05.Conclusiones: las actividades preventivas en los pacientes con EPOC se realizan de forma óptima en nuestro entorno, superior a la media nacional, aunque se deben lograr mayores tasas de cobertura de vacunación frente al neumococo.

  18. Imported malaria in an area in southern Madrid, 2005-2008

    PubMed Central

    2010-01-01

    Background In Spain, malaria cases are mostly due to migrants and travellers returning from endemic areas. The objective of this work was to describe the malaria cases diagnosed at the Severo Ochoa University Hospital (HUSO) in Leganés in the south of the Madrid Region from 2005 to 2008. Methods Descriptive retrospective study performed at HUSO. Data sources are registries from the Microbiology Department and malaria cases notified to the Preventive Medicine Department. Analysed parameters were: administrative, demographical, related to the stay at the endemic country, clinical, microbiological diagnosis method, pregnancy, treatment and prophylaxis, co-infections, and days of hospital stay. Results Fifty-seven patients diagnosed with malaria were studied. Case distribution per year was 13 in 2005, 15 in 2006, 15 in 2007 and 14 in 2008. Thirty-three patients were female (57.9%) and 24 male (42.1%). Mean age was 27.8 years. Most of the malaria cases were acquired in Nigeria (49.1%) and Equatorial Guinea (32.7%). 29.1% of the patients were immigrants who had arrived recently, and 61.8% acquired malaria when travelling to their countries of origin to visit friends and relatives (VFR). Majority of cases were diagnosed between June and September. Microscopy was positive in 39 cases (68.4%) immunochromatography in 42 (73.7%) and PCR in the 55 cases where performed. Plasmodium falciparum was responsible for 94.7% of the cases. The more frequent symptoms were fever (77.2%), followed by headache and gastrointestinal symptoms (33.3%). Nine cases needed hospital admittance, a pregnant woman, three children, four VFR and an African tourist, but all evolved favourably. Chemoprophylaxis data was known from 55 patients. It was taken correctly in one case (1.8%), in five (9.1%) the prophylaxis was improper while the others 49 (89.1%) cases had not followed any anti-malarial prophylaxis. Conclusions Children, pregnant women and the VFR have the highest risk to present severe

  19. February 27, 2010 Chilean Tsunami in Pacific and its Arrival to North East Asia

    NASA Astrophysics Data System (ADS)

    Zaytsev, Andrey; Pelinovsky, EfiM.; Yalciner, Ahmet C.; Ozer, Ceren; Chernov, Anton; Kostenko, Irina; Shevchenko, Georgy

    2010-05-01

    Petropavlosk (Kamchatka), Severo-Kurilsk (Paramushir), Kurilsk (Iturup, coast of the Okhotsk sea), Malokurilskoe (Shikotan), Korsakov, Kholmsk and Aniva Bay (Sakhalin). These records and also other offshore DART records are analyzed and used for comparison of the modeling results with offshore and nearshore records. The transmission of tsunami waves through Sakhalin and Kuril straits and their propagation to nearby coasts are investigated. The spectral analysis of records in settlements of Sakhalin and Kurile Islands are investigated. The performance and capabilities of NAMI DANCE is also presented together with comparisons between the model, observations and discussions.

  20. Dust Model Intercomparison and Extensive Comparison to Observations in the Western Mediterranean for the Summer 2012 Pre-ChArMEx/TRAQA Campaign

    NASA Astrophysics Data System (ADS)

    Basart, S.; Dulac, F.; Baldasano, J. M.

    2014-12-01

    campaign were ADEME and INSU under the umbrella of the programmes PRIMEQUAL and MISTRALS. LOAC was developed with funding from ANR. BSC acknowledges the support from the grant SEV-2011-00067 of Severo Ochoa Program, awarded by the Spanish Government.

  1. Lagrangian descriptors and their applications to oceanic and atmospheric flows

    NASA Astrophysics Data System (ADS)

    Mancho, A. M.

    2012-12-01

    Geometry has been a very useful approach for studying dynamical systems. At the basis are Poincare ideas of seeking structures on the phase space that divide it into regions corresponding to trajectories with different dynamical fates. These ideas have demonstrated to be very powerful for the description of transport in purely advective flows and important applications have been found in geophysics. This presentation explores the performance of new Lagrangian tools, so called, Lagrangian descriptors [1,2,3], which are based on the integration along trajectories of bounded positive scalars which express an intrinsic geometrical or physical property of the trajectory. We analyze the convenience of different descriptors from several points of view and compare outputs with other methods proposed in the literature. We discuss applications of these new tools on oceanic datasets taken from altimeter satellites on the Kuroshio region, and on reanalysis data on the Antarctic polar vortex [4,5,6]. This research has been supported by MINECO under grants MTM2011-26696 and ICMAT Severo Ochoa project SEV-2011-0087 and CSIC under grant ILINK-0145. Computational support from CESGA and CCC-UAM is acknowledged. [1] J. A. J. Madrid, A. M. Mancho. Distinguished trajectories in time dependent vector fields. Chaos 19 (2009), 013111-1-013111-18. [2] C. Mendoza, A. M. Mancho. The hidden geometry of ocean flows. Physical Review Letters 105 (2010), 3, 038501-1-038501-4. [3], A. M. Mancho, S. Wiggins, J. Curbelo, C. Mendoza. In preparation. [4] A. de la Cámara, A. M. Mancho, K. Ide, E. Serrano, C.R. Mechoso. Routes of transport across the Antarctic polar vortex in the southern spring. Journal of Atmospheric Sciences 69, 2 (2012). [5] C. Mendoza, A. M. Mancho, M. H. Rio. The turnstile mechanism across the Kuroshio current: analysis of dynamics in altimeter velocity fields. Nonlinear Proc. Geoph 17 (2010), 2, 103-111. [6] Carolina Mendoza, Ana M. Mancho. The Lagrangian description of

  2. Comparison of Eruptive Processes of the years 1903 and 2015 of the Colima Volcano, Mexico.

    NASA Astrophysics Data System (ADS)

    Suarez-Plascencia, C.; Nuñez-Cornu, F. J.; Hernandez-Rodriguez, A.; Suarez, G. B. V.; Arreola-Ochoa, L. C.

    2015-12-01

    The Colima volcano eruption processes during the months of January - July 2015, was characterized by two types of activity: From January to May we registered 923 exhalations and smaller explosions. Having up to 31 events per day, the columns of ash reached an altitude between 4500 and 7000 masl. Each event frequently averaging between 50 and 500 meters from about 442 or 48% of the total events this period. The reports of falling ash came from as far as the city of Salamanca at 278 km to the NE. The intense activity destroyed the original dome forming a new one with an elliptical crater 224 m by 166 m and 35 m deep. On May 15 we observed the growth of a new dome. On July 4, this created the falling of rocks along the slopes and the formation of three Andesitic lava flows at the N, SW and S flanks. By July 11 the volume of lava extruded was about 6 x106 m3, with a rate extrusion of 1.21 m3per sec. 2. Based on three flyby observations, it was noted that the lava flows on the S and SW sectors had a higher extrusion rate in the N sector. The first two were placed on a slope with an average gradient of 36º, while on the northern slope gradient is 23º, as a result of the interaction of extrusion speed, slope and height of the lava front, there were constant landslides, causing at least 4 Merapi type pyroclastic flows, that flowed by the gullies of Montegrande and San Antonio. The first flow reached distances of 7 km and 10.4 km. It is the largest lava flow recorded since January 20, 1913. The devastating results were the burning of 500 meters of the Templado Forest, burning along the Montegrande Creek and finally affecting many crops and livestock. This type of activity already had shown in 1975 and 1991 by the lava flow and S NE flank where the pyroclastic flows had no destructive effects, except for some small fires in forested areas at the base of the volcano (Thorpe, et al, 1977). In March 1903 Colima volcano showed similar activity per Arreola J. and Diaz Severo

  3. PubMed

    García Almeida, Jose M; Lupiáñez Pérez, Yolanda; Blanco Naveira, Mercedes; Ruiz Nava, Josefina; Medina, José Antonio; Cornejo Pareja, Isabel; Gómez Pérez, Ana; Molina Vega, María; López-Medina, José A; Tinahones Madueño, Francisco

    2017-06-05

    Introducción: en pacientes con riesgo nutricional, la Sociedad Europea de Clínica y Metabolismo (ESPEN) y Parenteral recomienda suplementos nutricionales durante el tratamiento oncológico para prevenir la pérdida de peso involuntaria.Objetivos: nuestro objetivo es conocer el cumplimiento, la aceptabilidad y la tolerancia de un suplemento hiperproteico, hipercalórico, rico en omega 3 en pacientes oncológicos.Métodos: estudio unicéntrico, observacional y prospectivo en pacientes oncológicos con un suplemento nutricional hiperproteico, hipercalórico, rico en omega 3 y de bajo volumen. Fueron incluidos 30 pacientes con desnutrición o en riesgo de desnutrición. La suplementación duró seis días. Se evaluaron el cumplimiento (envases utilizado), la aceptabilidad (escala Madrid), las variables antropométricas y los acontecimientos adversos (AA) gastrointestinales.Resultados: el 70% fueron hombres, con una edad media de 60 años (rango: 32 a 79) y con neoplasias de pulmón (43,3%), ORL (26,7%) y mama (13,3%), en estadio III-IV (56,7%), tratados con radioterapia (93,3%), quimioterapia (60%) y cirugía (16,7%). El producto fue aceptado por todos los pacientes. Se observó un cumplimiento del 100%. En dos pacientes (6,7%) se observaron AA gastrointestinales (grado II) relacionados con el suplemento; ambos sujetos presentaban patologías gastrointestinales previas. La mediana del peso, índice de masa corporal (IMC) y proteínas ingeridas aumentó durante la suplementación (0,2 kg, 0,1 kg/m2 y 6,2 g). No se observaron diferencias respecto a la ingesta de calorías, lípidos y carbohidratos. Conclusión: la elevada aceptación y cumplimiento del suplemento nutricional específico se asoció con la mejora nutricional de los pacientes oncológicos, pues revirtió la pérdida de peso, sin presentar problemas gastrointestinales severos ni producir desplazamiento de la ingesta.

  4. [Latex sensitization prevalence through prick test in patients with genitourinary malformations and more than 3 surgeries].

    PubMed

    Macías-Robles, Ana Paola; Morán-Mendoza, Ana Rocío

    2016-01-01

    Antecedentes: la alergia al látex tiene alta prevalencia en grupos de riesgo conocidos, especialmente en pacientes con espina bífida, malformaciones urinarias y ortopédicas con múltiples cirugías. En México no se cuenta con suficientes estudios que reporten la prevalencia y factores de riesgo asociados. Objetivo: determinar la prevalencia de sensibilización al látex mediante prueba de prick con extracto de látex en pacientes con malformaciones genitourinarias y más de tres cirugías en la Unidad Médica de Alta Especialidad de Pediatría del Centro Médico Nacional de Occidente, así como los factores asociados. Material y método: Se realizó un estudio transversal analítico y descriptivo, que incluyó hombres y mujeres de 1 a 16 años, con malformaciones genitourinarias y más de tres cirugías. Se aplicó una encuesta para conocer los factores de riesgo asociados y se realizó prueba cutánea por punción con extracto de látex, con control positivo y negativo. Se midieron niveles séricos de IgE total y eosinófilos en sangre periférica. Resultados: la prevalencia encontrada fue de 30.7% y los factores de riesgo asociados: atopia personal (p=0.047), antecedente de reacción previa con productos con látex (p=0.003), específicamente con globos (p=0.000) y guantes (p=0.002). No hubo asociación entre el número de cirugías e intervenciones quirúrgicas a edades tempranas, tampoco con concentraciones elevadas de IgE sérica total. Tuvieron reacción cruzada a frutas-látex 25% de los pacientes, los alimentos asociados fueron: aguacate, papaya, fresa y kiwi. Conclusión: la prevalencia de sensibilización al látex es alta en los grupos de riesgo, sobre todo con antecedente de atopia, por lo que es importante que el personal de salud identifique a estos pacientes a fin de implementar oportunamente las medidas de prevención primaria y secundaria; evitar efectos severos potencialmente mortales, como la anafilaxia, para disminuir la morbilidad y la

  5. [In Process Citation].

    PubMed

    López-López, Laura; Torres-Sánchez, Irene; González-Jiménez, Emilio; Díaz-Pelegrina, Ana; Merlos-Navarro, Silvia; Valenza, Marie Carmen

    2016-03-25

    Introducción: las alteraciones en el estado nutricional en pacientes con enfermedad pulmonar obstructiva crónica (EPOC) son frecuentes. La sintomatología y la funcionalidad de estos enfermos pueden estar relacionadas con la nutrición, incrementando su gravedad en los sujetos con malnutrición. Objetivos: el objetivo de esta investigación fue profundizar sobre el perfil clínico del paciente con EPOC malnutrido y relacionar el estado nutricional con la funcionalidad y con los síntomas de estos pacientes. Métodos: se desarrolló un estudio observacional en pacientes con EPOC severo. Se valoró el estado de dependencia, la calidad de vida, las comorbilidades y la ansiedad y depresión. La función respiratoria se valoró con el volumen espiratorio forzado en el primer segundo y la escala de Borg modificada y el estado nutricional, con el Mini Nutritional Assessment. La sintomatología fue evaluada mediante el Leicester Cough Questionnaire y el London Chest Activity of Daily Living Scale. Resultados: 154 sujetos fueron incluidos en este estudio, 98 de ellos fueron varones. Un grupo de 71 sujetos mostraron malnutrición y un grupo de 83 sujetos un estado nutricional normal. La comparación entre los grupos mostró características clínicas significativamente diferen- tes (p < 0,05). El análisis mostró diferencias significativas en la disnea (p = 0,043), así como en las subescalas de funcionalidad relacionadas con sintomatología respiratoria autocuidado (p = 0,040), actividades de ocio (p = 0,019) y la puntuación total (p = 0,031), siendo peores en los sujetos malnutridos. Conclusión: los pacientes con EPOC malnutridos presentan más síntomas y peores niveles de funcionalidad que los pacientes con EPOC con estado nutricional normal.

  6. Three dimensional Lagrangian structures in the Antarctic Polar Vortex.

    NASA Astrophysics Data System (ADS)

    Mancho, Ana M.; Garcia-Garrido, Victor J.; Curbelo, Jezabel; Niang, Coumba; Mechoso, Carlos R.; Wiggins, Stephen

    2017-04-01

    Dynamical systems theory has supported the description of transport processes in fluid dynamics. For understanding trajectory patterns in chaotic advection the geometrical approach by Poincaré seeks for spatial structures that separate regions corresponding to qualitatively different types of trajectories. These structures have been referred to as Lagrangian Coherent Structures (LCS), which typically in geophysical flows are well described under the approach of incompressible 2D flows. Different tools have been used to visualize LCS. In this presentation we use Lagrangian Descriptors [1,2,3,4] (function M) for visualizing 3D Lagrangian structures in the atmosphere, in particular in the Antarctic Polar Vortex. The function M is computed in a fully 3D incompressible flow obtained from data provided by the European Centre for Medium-Range Weather Forecast and it is represented in 2D surfaces. We discuss the findings during the final warming that took place in the spring of 1979 [5]. This research is supported by MINECO grant MTM2014-56392-R. Support is acknowledged also from CSIC grant COOPB20265, U.S. NSF grant AGS-1245069 and ONR grant No. N00014- 01-1-0769. C. Niang acknowledges Fundacion Mujeres por Africa and ICMAT Severo Ochoa project SEV-2011-0087 for financial support. [1] C. Mendoza, A. M. Mancho. The hidden geometry of ocean flows. Physical Review Letters 105 (2010), 3, 038501-1-038501-4. [2] A. M. Mancho, S. Wiggins, J. Curbelo, C. Mendoza. Lagrangian Descriptors: A Method for Revealing Phase Space Structures of General Time Dependent Dynamical Systems. Communications in Nonlinear Science and Numerical Simulation. 18 (2013) 3530-3557. [3] C. Lopesino, F. Balibrea-Iniesta, S. Wiggins and A. M. Mancho. Lagrangian descriptors for two dimensional, area preserving autonomous and nonautonomous maps. Communications in Nonlinear Science and Numerical Simulations, 27 (2015) (1-3), 40-51. [4] C. Lopesino, F. Balibrea-Iniesta, V. J. García-Garrido, S. Wiggins, and A

  7. [ASSOCIATION OF SERUM ALBUMIN AND SUBJECTIVE GLOBAL ASSESSMENT ON INCIDENT PERITONEAL DIALYSIS PATIENTS].

    PubMed

    Yanowsky-Escatell, Francisco Gerardo; Pazarín-Villaseñor, Leonardo; Andrade-Sierra, Jorge; Zambrano-Velarde, Miguel Angel; Preciado-Figueroa, Francisco Martin; Santana-Arciniega, Christian Jesús; Galeno-Sánchez, Rogelio Ignacio

    2015-12-01

    Introducción: la albúmina sérica es el biomarcador más frecuentemente utilizado como uno de los tres criterios bioquímicos para el diagnóstico del desgaste proteico energético (DPE). Sin embargo, como parámetro nutricional es poco fiable en la enfermedad renal crónica (ERC). La valoración global subjetiva (VGS) ha sido recomendada para la evaluación nutricional y del DPE en ERC. Objetivo: determinar la asociación de los niveles de albúmina sérica y la VGS en pacientes con insuficiencia renal crónica terminal (IRCT) que iniciaron diálisis peritoneal (DP). Métodos: estudio transversal analítico en pacientes con IRCT que fueron evaluados previo a iniciar DP. Se determinaron niveles de albúmina sérica y se realizó una evaluación nutricional mediante la VGS. Resultados: 69 pacientes, 46 (67%) hombres y 23 (33%) mujeres, con una media de edad de 39,97 ± 18,30 años, albúmina sérica 2,75 ± 0,65 g/dl, creatinina 18,91 ± 10,98 mg/dl, urea 314,80 ± 152,74 mg/dl e IMC 23,37 ± 3,79 kg/m2, la mediana de TFG 3 (1-12) mL/min/1,73m2. La VGS mostró que el 34,8% estaba bien nutrido, el 40,6% tenía riesgo de DPE o moderado y el 24,6% presentaba un DPE severo. No existió asociación (p = ns) entre los niveles de albúmina sérica y la VGS. Conclusión: el presente estudio muestra que la hipoalbuminemia y el DPE son muy frecuentes. La identificación de los niveles de albúmina sérica y la VGS al iniciar DP en nuestra población pudieran ser predictores de mortalidad. La albúmina sérica no es una herramienta útil para la evaluación nutricional en pacientes con IRCT que iniciarán DP.

  8. [Complex febrile crises: should we change the way we act?].

    PubMed

    Martinez-Cayuelas, E; Herraiz-Martinez, M; Villacieros-Hernandez, L; Cean-Cabrera, L; Martinez-Salcedo, E; Alarcon-Martinez, H; Domingo-Jimenez, R; Perez-Fernandez, V

    2014-11-16

    Introduccion. Las convulsiones febriles son una de las causas mas frecuentes de consulta. Hasta ahora, los pacientes con convulsiones febriles complejas (CFC) deben ingresar, dado el mayor porcentaje de epilepsia y complicaciones agudas descrito clasicamente. En la actualidad hay estudios que apoyan ser menos invasivos en el abordaje de estos pacientes. Objetivo. Describir las caracteristicas de los pacientes ingresados por CFC y proponer un nuevo protocolo de actuacion. Pacientes y metodos. Analisis retrospectivo de historias clinicas de ingresados por CFC (enero de 2010-diciembre de 2013). Se ofrecen datos epidemiologicos, clinicos, pruebas complementarias y evolucion. Resultados. Las CFC suponian un 4,2% de los ingresos de neuropediatria (n = 67). Edad media al evento: 25 meses. El 47% tenia antecedentes familiares patologicos, y el 31%, antecedentes personales de convulsion febril previa. En el 54% de los pacientes, la CFC duro menos de cinco minutos; hubo recurrencia, la mayoria con un total de dos crisis y durante el primer dia (las CFC por recurrencia son las mas frecuentes). De las pruebas complementarias realizadas, ninguna de ellas sirvio como apoyo diagnostico en el momento agudo. Durante su seguimiento, cinco pacientes presentaron complicaciones. Los pacientes con antecedentes familiares de convulsiones febriles presentan mayor riesgo de epilepsia o recurrencia (p = 0,02), sin diferencias significativas respecto a la edad, numero de crisis, intervalo de fiebre, estado epileptico o tipo de CFC. Conclusiones. Las CFC no asocian mayores complicaciones agudas; las exploraciones complementarias no permiten discriminar precozmente a los pacientes de riesgo. Su ingreso podria evitarse en ausencia de otros signos clinicos y limitarse a casos seleccionados.

  9. [Experience in kidney transplantation without blood transfusion: kidney transplantation transfusion-free in Jehovah's Witnesses. First communication in Mexico].

    PubMed

    Hernández-Navarrete, Liliana Stefany; Hernández-Jiménez, Jesús Diego; Jiménez-López, Luis Alfredo; Budar-Fernández, Luis Filadelfo; Méndez-López, Marco Tulio; Martínez-Mier, Gustavo

    2013-01-01

    Antecedentes: los Testigos de Jehová rechazan la transfusión sanguínea, pero aceptan el trasplante de órganos, albúmina, inmunoglobulina, vacunas y factores de coagulación. Casos clínicos: comunicamos tres casos de pacientes (dos masculinos y uno femenino) a quienes se realizó trasplante renal en Testigos de Jehová sin transfusión sanguínea, con edad promedio de 31.33 años e índice de masa corporal promedio de 20.99 kg/m(2). Los tres pacientes recibieron diálisis peritoneal pre trasplante por un promedio de 52.3 meses. Se realizaron dos trasplantes de donante vivo y uno de fallecido, con isquemia fría de 23 horas. Los donantes fueron dos femeninos y uno masculino, con edad promedio de 34.33 años. Los tres pacientes recibieron eritropoyetina y hierro dextrán pretrasplante y en el transoperatorio se utilizó una máquina de recuperación celular. Las concentraciones de hemoglobina, hematócrito, glóbulos rojos, creatinina sérica y filtración glomerular a 24 meses postrasplante permanecieron estables. La inducción se realizó con basiliximab y la inmunosupresión inicial con inhibidores de calcineurina. Uno de los pacientes tuvo como complicación un hematoma perirrenal que ameritó reintervención a los 20 días postrasplante. A 5, 26 y 36 meses postrasplante los tres pacientes están vivos y con injerto funcional. Conclusión: es posible realizar trasplantes renales sin transfusión sanguínea en Testigos de Jehová, con supervivencia global aceptable y sin episodios de rechazo agudo.

  10. [Is necessary to perform a transthoracic echocardiogram in all the patients with cryptogenic stroke during hospitalization?].

    PubMed

    Arias-Rivas, Susana; Rodríguez-Yáñez, Manuel; López-Ferreiro, Ana; Santamaría-Cadavid, María; Fernández-Pajarín, Gustavo; González-Juanatey, José Ramón; Castillo, José; Blanco, Miguel

    2013-05-16

    Introduccion. El 15-30% de los ictus isquemicos son de origen cardioembolico. El ecocardiograma transtoracico desempena un papel fundamental en la evaluacion, diagnostico y manejo de la fuente embolica. La ausencia de recomendaciones oficiales para el empleo del ecocardiograma en pacientes con ictus isquemico lleva a una solicitud universal de la prueba, presentando una baja rentabilidad diagnostica. Objetivo. Analizar la rentabilidad diagnostica del ecocardiograma transtoracico en pacientes con ictus isquemico indeterminado tras la aplicacion de criterios clinicos predefinidos de riesgo. Pacientes y metodos. Se analizan los ecocardiogramas realizados a pacientes con ictus isquemico agudo solicitados durante 2009-2011 desde el servicio de neurologia. Se estudia la rentabilidad diagnostica y su aportacion al estudio etiologico. Se aplican unos 'criterios de seleccion de paciente de alto riego con necesidad de realizacion de la prueba durante el ingreso' (edad < 60 anos, alteraciones en el ecocardiograma basal, cardiomegalia en la radiografia de torax basal, antecedentes de cardiopatia, sospecha clinica de endocarditis o neoplasia activa) y se analiza su validez. Resultados. De 930 pacientes, se realizo ecocardiograma a 201 (21,6%) y se detecto una fuente cardioembolica en el 9,95%. Tras la aplicacion de criterios de seleccion, el numero de ecocardiogramas paso a 97 (10,4%). Los criterios propuestos presentan: sensibilidad, 95%; especificidad, 56,9%; valor predictivo positivo, 19,6%, y valor predictivo negativo, 99%. Conclusiones. La aplicacion de nuestros criterios a pacientes con ictus indeterminado identifica con alta eficiencia la fuente cardioembolica, lo que permite la realizacion del ecocardiograma transtoracico ambulatorio en el resto de los pacientes.

  11. Impact of Frailty and Other Geriatric Syndromes on Clinical Management and Outcomes in Elderly Patients With Non-ST-Segment Elevation Acute Coronary Syndromes: Rationale and Design of the LONGEVO-SCA Registry.

    PubMed

    Alegre, Oriol; Ariza-Solé, Albert; Vidán, María T; Formiga, Francesc; Martínez-Sellés, Manuel; Bueno, Héctor; Sanchís, Juan; López-Palop, Ramón; Abu-Assi, Emad; Cequier, Àngel

    2016-07-01

    The incidence of acute coronary syndromes (ACS) is high in the elderly. Despite a high prevalence of frailty and other aging-related variables, little information exists about the optimal clinical management in patients with coexisting geriatric syndromes. The aim of the LONGEVO-SCA registry (Impacto de la Fragilidad y Otros Síndromes Geriátricos en el Manejo y Pronóstico Vital del Anciano con Síndrome Coronario Agudo sin Elevación de Segmento ST) is to assess the impact of aging-related variables on clinical management, prognosis, and functional status in elderly patients with ACS. A series of 500 consecutive octogenarian patients with non-ST-segment elevation ACS from 57 centers in Spain will be included. A comprehensive geriatric assessment will be performed during the admission, assessing functional status (Barthel Index, Lawton-Brody Index), frailty (FRAIL scale, Short Physical Performance Battery), comorbidity (Charlson Index), nutritional status (Mini Nutritional Assessment-Short Form), and quality of life (Seattle Angina Questionnaire). Patients will be managed according to current recommendations. The primary outcome will be the description of mortality and its causes at 6 months. Secondary outcomes will be changes in functional status and quality of life. Results from this study might significantly improve the knowledge about the impact of aging-related variables on management and outcomes of elderly patients with ACS. Clinical management of these patients has become a major health care problem due to the growing incidence of ACS in the elderly and its particularities. © 2016 Wiley Periodicals, Inc.

  12. Gender bias in acute coronary syndromes.

    PubMed

    Bugiardini, Raffaele; Estrada, Jose L Navarro; Nikus, Kjell; Hall, Alistair S; Manfrini, Olivia

    2010-03-01

    The major aim of this review was to ascertain whether effective evidence-based treatments for acute coronary syndromes (ACS) are underutilized in women in various geographic areas compared with men. The focus of our review was the relative use of effective treatments in patients with coronary angiographic evidence of obstructive coronary disease, defined as a lumen stenosis >50% of the adjacent non-diseased arterial diameter. We searched MEDLINE, and the Cochrane Database between January 1998 and May 2008. Only a few of the published clinical registries on ACS provide data on treatments dichotomized by confirmed coronary angiographic disease. Consequently, we also accessed individual patient-level data from 3 established ACS registries: the Finnish TACOS (Tampere Acute COronary Syndrome), the British EMMACE 2 (Evaluation of Methods and Management of Acute Coronary Events) and the Argentine PACS-ITALSIA (Prognosis in Acute Coronary Syndromes and the ITALian hospital Sindrome Isquemico Agudo). Despite presenting with higher risk characteristics and having higher in-hospital and 6 months risk of death, women with ACS and obstructive coronary artery disease were apparently treated less aggressively with secondary preventive drugs than were men, being less likely to receive aspirin, beta-blockers and statins at discharge. Overall, coronary revascularization appears to be performed in a similar proportion of women and men - once angiography has been performed and the coronary anatomy is known. However, substantial geographic variation exists in the relative rate of coronary angiography in men and women. In United Kingdom coronary revascularization tends to be done less frequently in women. Our study, therefore, demonstrates a gender bias in the delivery of secondary drug treatments for ACS, even for patients with documented significant coronary disease.

  13. [Genetic diversity of Tibraca limbativentris Stål (Hemiptera: Pentatomidae) of Santa Catarina and Rio Grande do Sul, Brazil, using RAPD].

    PubMed

    Rampelotti, Fátima T; Ferreira, Anderson; Tcacenco, Fernando A; Martins, José F da S; Grützmacher, Anderson D; Prando, Honório F

    2008-01-01

    The work was carried out to test DNA extraction protocols and to characterize populations of Tibraca limbativentris Stål, an important rice insect-pest. Insects were collected in Joinville, Rio do Oeste and Turvo, in Santa Catarina State, and Agudo, Uruguaiana, Pelotas and Palmares do Sul, in Rio Grande do Sul State, and six literature-referenced protocols, besides a new one, were tested. DNA from ten individuals of each population was extracted using the best protocol and RAPD reactions were carried out with ten initiators. The new protocol showed the best results and was used in the PCR reactions, that generated 151 polymorphic bands, allowing to access genetic differences among all the populations; no individuals from one population were clustered with individuals from another. The largest intrapopulacional similarity was found in Uruguaiana (22%), and the smallest in Palmares do Sul (50%), which was also the most divergent population in relation to the others. The Gst was 0.5215, and the Nm was 0.4588; these values reflect the low similarity between the populations. The smallest genic flow was obtained when Palmares do Sul and Pelotas were included in the comparisons, in accordance with the largest divergence of these two populations in relation to the others. There was no significant relation between geographic distance and genetic similarity, which can reflect unknown model of dispersion of T. limbativentris. New studies exploring the species dispersion strategies may help to understand the insect distribution and to unveil the main factors linked to the genetic variability within and between populations.

  14. Contamination in mafic mineral-rich calc-alkaline granites: a geochemical and Sr-Nd isotope study of the Neoproterozoic Piedade Granite, SE Brazil.

    PubMed

    Leite, Renato J; Janasi, Valdecir A; Martins, Lucelene

    2006-06-01

    The Piedade Granite (approximately 600 Ma) was emplaced shortly after the main phase of granite magmatism in the Agudos Grandes batholith, Apiaí-Guaxupé Terrane, SE Brazil. Its main units are: mafic mineral-rich porphyritic granites forming the border (peraluminous muscovite-biotite granodiorite-monzogranite MBmg unit) and core (metaluminous titanite-bearing biotite monzogranite BmgT unit) and felsic pink inequigranular granite (Bmg unit) between them. Bmg has high LaN/YbN (up to 100), Th/U (> 10) and low Rb, Nb and Ta, and can be a crustal melt derived from deep-seated sources with residual garnet and biotite. The core BmgT unit derived from oxidized magmas with high Mg# (approximately 45), Ba and Sr, fractionated REE patterns (LaN/YbN = 45), 87Sr/86Sr(t) approximately 0.710, epsilonNd(t) approximately -12 to -14, interpreted as being high-K calc-alkaline magmas contaminated with metasedimentary rocks that had upper-crust signature (high U, Cs, Ta). The mafic-rich peraluminous granites show a more evolved isotope signature (87Sr/86Sr(t) = 0.713-0.714; epsilonNd(t) = -14 to -16), similar to Bmg, and Mg# and incompatible trace-element concentrations intermediate between Bmg and BmgT. A model is presented in whichMBmgis envisaged as the product of contamination between a mafic mineral-rich magma consanguineous with BmgT and pure crustal melts akin to Bmg.

  15. Neurovascular ultrasound in emergency settings: diagnostic and therapeutic aspects.

    PubMed

    Santos, T; Veloso, M; Barros, P

    2017-04-16

    Introduccion. La ecografia neurovascular es una tecnica de diagnostico por imagenes rapida, portatil e incruenta que en manos de un ecografista experimentado aporta informacion reproducible y fiable acerca del estado hemodinamico y morfologico de los vasos craneales y cervicales. Objetivo. Revisar los datos disponibles sobre el uso de esta herramienta en el abordaje del ictus isquemico agudo. Desarrollo. La ecografia neurovascular se divide en dos modalidades de uso: diagnostica y terapeutica. A la luz de los bajos porcentajes de recanalizacion de las oclusiones de la arteria carotida interna y del segmento proximal de la arteria cerebral media logradas por el activador del plasminogeno tisular recombinante (r-tPA) por via intravenosa, el uso diligente de la ecografia neurovascular en el servicio de urgencias ayuda a dirimir que pacientes son susceptibles de beneficiarse del tratamiento endovascular. Asimismo, la vigilancia ecografica durante el curso del tratamiento con el r-tPA permite analizar la evolucion de la recanalizacion arterial. La ecografia cervical permite valorar el grado de estenosis y la composicion o la superficie de la placa arterial, extremos que, por ejemplo, pueden indicar la idoneidad de una intervencion carotidea. Por ultimo, tambien se esta investigando el potencial terapeutico de la ecografia. La sonotrombolisis y la sonolisis, la primera combinando el r-tPA con las ondas ultrasonicas y la segunda sirviendose unicamente de ellas como medio para lisar el trombo, han evidenciado hasta el momento resultados alentadores. Conclusion. La ecografia neurovascular ha progresado enormemente hasta adquirir un protagonismo destacado en el estudio de los trastornos cerebrovasculares.

  16. [Wernicke's encephalopathy and Caine criteria. Report of six cases].

    PubMed

    Kleinert-Altamirano, Anke Paula Ingrid; Juárez-Jiménez, Humberto

    2014-01-01

    INTRODUCCIÓN: la encefalopatía de Wernicke es un desorden neurológico agudo y reversible debido a deficiencia de tiamina. En el pasado, se reconocía al alcoholismo crónico como una de las principales causas; actualmente se conocen otras condiciones que lo favorecen: nutrición parenteral prolongada, hiperémesis gravídica, anorexia nerviosa, enteritis regional, síndrome de malabsorción, hemodiálisis, diálisis peritoneal y cirugía abdominal extensa, entre otras. CASOS CLÍNICOS: se describen seis pacientes, tres hombres y tres mujeres que tuvieron en común nutrición parenteral total por más de dos meses debido a complicaciones quirúrgicas abdominales que impedían la vía oral. Las manifestaciones clínicas fueron somnolencia, agitación psicomotriz, oftalmoplejía con limitación para la abducción bilateral y nistagmo horizontal; tres pacientes presentaron ataxia y dismetría apendicular. Los hallazgos en la resonancia magnética fueron hiperintensidad en T2 en los colículos superiores, sustancia gris periacueductal, tubérculos mamilares y núcleos dorsomediales del tálamo; así como hiperintensidad en T1 en ambos núcleos lenticulares por depósito de manganeso debido a la nutrición parenteral total.

  17. Adapting and improving resilience to climate change in communities (moravian community as a pilot), by creating new capabilities based on the implementation of a new water culture; protection and management of natural resources

    NASA Astrophysics Data System (ADS)

    Campos Gallo, A.

    2015-04-01

    Water, in all its dimensions and scope, concerns humans as civilization, individuals and communities immersed in an environment that faces serious environmental threats and changes. The efficient way to deal with this crisis is education of present and future generations, breaking paradigms, creating awareness and new development models, seeking community groups and forces to empower their water resource and care, manage and renew it in an efficient and sustainable manner. The multiple uses of water in personal uses, irrigation, agro-industry and clean energy production, transforms this resource in a strategic element to any nation. With support from the Centro Nacional de Alta Tecnologia (CeNAT), it was possible to formulate the "Agenda Ambiental de Moravia", agreeing to be the "Consejo Tecnico de Fuerzas Vivas" (CTFV) from Moravia - articulated network of stakeholders - the one that coordinate all actions refered to water Resources, pollution and cleaner technologies and protected Areas. CeNAT and CTFV have developed distinguished efforts to improve the Moravians quality of life, and this has led the initiative of constitution of a whole education and training project in rescuing the Upper Basin of the Rio Tarcoles, through the implementation of an ecological - recreative garden ("Parque Comunitario Pulmon Verde de Moravia"), fostersing good use of natural resources, and also works as a platform for training and awareness program in Sustainable Development, based on "Hacia una Nueva Cultura del Agua" (powered through the United Nations by Dr. Pedro Arrojo Agudo and his " Feria de Aguas, Rios y Pueblos", presented in many countries). This initiative is projected to the national and international communities, through the "Water International Conference", which propel initiatives, laws and decisions which enable the development of Costa Rica and other countries under a sustainable model, focused on this essential component for life on the planet.

  18. [The impact of neurological and medical complications on the mortality and functional situation of acute stroke patients].

    PubMed

    Bragado-Trigo, I; Portilla-Cuenca, J C; Falcon-Garcia, A; Fermin-Marrero, J A; Romero-Sevilla, R M; Redondo-Penas, M I; Gamez-Leyva, G; Serrano-Cabrera, A; Gomez, M; Calle-Escobar, M L; Jimenez-Caballero, P E; Casado-Naranjo, I

    2014-11-16

    Introduccion. Los pacientes con ictus presentan un elevado riesgo de presentar complicaciones. Su aparicion puede condicionar el pronostico del ictus. Estudiamos la frecuencia y el impacto de la aparicion de diversas complicaciones en el pronostico precoz y a medio plazo en estos pacientes. Pacientes y metodos. Estudio observacional de los pacientes ingresados en una unidad de ictus. Se registraron las complicaciones durante su estancia, distinguiendose entre complicaciones neurologicas y medicas. Se estudio la influencia de estas segun subtipo de ictus en la mortalidad intrahospitalaria y a los 90 dias, y en la situacion funcional a los 90 dias, analizandose los factores clinicos predictores para la aparicion de complicaciones. Resultados. Muestra de 847 pacientes. Un 29,5% de los pacientes presento complicaciones, que fueron mas frecuentes en el ictus hemorragico (50,5% frente a 26,6%; p < 0,0001). Las complicaciones mas habituales fueron las neurologicas (21%). Para ambos subtipos, la presencia de complicaciones se asocio a mayor mortalidad intrahospitalaria (2,1% frente a 12,6%; p < 0,0001) y a 90 dias (5,7% frente a 29,6%; p < 0,0001), y menor probabilidad de independencia a 90 dias (72,9% frente a 30,4%; p < 0,0001). La gravedad del ictus al ingreso se mostro como el predictor mas potente en la aparicion de cualquier tipo de complicacion. Conclusiones. La aparicion de complicaciones durante la fase aguda del ictus influye de forma adversa en la mortalidad y en el pronostico funcional. La identificacion de factores predictores podria disminuir el impacto sobre la evolucion del paciente con un ictus agudo.

  19. Paradoxical effect of smoking in the Spanish population with acute myocardial infarction or unstable angina: results of the ARIAM Register.

    PubMed

    Ruiz-Bailén, Manuel; de Hoyos, Eduardo Aguayo; Reina-Toral, Antonio; Torres-Ruiz, Juan Miguel; Alvarez-Bueno, Miguel; Gómez Jiménez, Francisco Javier

    2004-03-01

    The paradoxical effect of smoking after acute myocardial infarction (AMI) is a phenomenon consisting of a reduction in the mortality of smokers compared to nonsmokers. However, it is not known whether the benefit of this reduction in mortality is due to smoking itself or to other covariables. Despite acceptance of the paradoxical effect of smoking in AMI, it is not known whether a similar phenomenon occurs in unstable angina. The objective of this study was to investigate the paradoxical effect of smoking in AMI and unstable angina, and to study specifically whether smoking is an independent prognostic variable. The study population was selected from the multicentric ARIAM (Análisis del Retraso en el Infarto Agudo de Miocardio [analysis of delay in AMI]) Register, a register of 29,532 patients with a diagnosis of unstable angina or AMI. Tobacco smokers were younger, presented fewer cardiovascular risk factors such as diabetes or hypertension, fewer previous infarcts, a lower Killip and Kimball class, and a lower crude and adjusted mortality in AMI (odds ratio, 0.774; 95% confidence interval, 0.660 to 0.909; p = 0.002). Smokers with unstable angina were younger, with less hypertension or diabetes. In the multivariate analysis, no statistically significant difference in mortality was found. The reduced mortality observed in smokers with AMI during their stay in the ICU cannot be explained solely by clinical covariables such as age, sex, other cardiovascular factors, Killip and Kimball class, or treatment received. Therefore, smoking may have a direct beneficial effect on reduced mortality in the AMI population. The lower mortality rates found in smokers with unstable angina are not supported by the multivariate analysis. In this case, the difference in mortality can be explained by the other covariables.

  20. Prognostic implication of early ventricular fibrillation among patients with ST elevation myocardial infarction.

    PubMed

    Medina-Rodríguez, Kristel E; Almendro-Delia, Manuel; García-Alcántara, Ángel; Arias-Garrido, José J; Rodríguez-Yáñez, Juan C; Alonso-Muñoz, Gemma; de la Chica-Ruiz-Ruano, Rafael; Reina-Toral, Antonio; Varela-López, Antonio; Arboleda-Sánchez, José A; Poullet-Brea, Ana M; Zaya-Ganfo, Benito; Butrón-Calderón, Michel; Cristo-Ropero, Maria J; Hidalgo-Urbano, Rafael; García-Rubira, Juan C

    2017-11-01

    The aim of this study was to analyze the prognosis of patients presenting early ventricular fibrillation (VF) in the setting of ST elevation myocardial infarction (STEMI). Among patients included in the ARIAM (Análisis del Retraso en el Infarto Agudo de Miocardio) registry with the diagnosis of STEMI, those who received primary revascularization and were admitted in the first 12 h were analyzed retrospectively. From January 2007 to January 2012, 8340 patients were included in the STEMI cohort and 680 (8.2%) of them presented with VF before admission to the ICU (VF). This group comprised younger patients with fewer comorbidities. They received more often primary angioplasty (33.7 vs. 24.9%; P<0.001), had more prevalence of Killip class greater than or equal to 2 at admission (37.5 vs. 17.8%; P<0.001), and suffered more often cardiogenic shock (18.5 vs. 5.9%, P<0.001). By logistic regression analysis, VF was associated with a greater in-hospital mortality [odds rate (OR): 2.08, 95% confidence interval (CI): 1.57-2.81, P<0.001]. After a propensity score matching process, VF was associated with in-hospital mortality (OR: 1.53, 95% CI: 1.05-2.25, P=0.028). However, when analyzing patients treated by primary angioplasty, the mortality was not significantly related to VF (OR: 0.86, 95% CI: 0.45-1.61, P=0.628). Our results show that VF before ICU admission was an independent predictor of in-hospital outcome in a cohort of patients in whom fibrinolysis was the most used revascularization therapy. However, this prognostic value was not found in patients treated with primary angioplasty.

  1. [Basis for a hospital registry of acute myocardial infarction in Spain. The PRIAMO study. Project of a Hospital Registry of Acute Myocardial Infarction].

    PubMed

    Cabadés, A; Marrugat, J; Arós, F; López-Bescós, L; Pereferrer, D; de Los Reyes, M; Sanjosé, J M

    1996-06-01

    Information on the management of myocardial infarction in Spain in scarce. PRIAMHO (Proyecto de Registro de Infarto Agudo de Miocardio Hospitalario) study is aimed at developing standardized methods to allow the registration of characteristics and management of patients discharged with a diagnosis of myocardial infarction. Methods and results of the pilot study are presented. In the present collaborative study with one-year follow-up, all patients diagnosed with myocardial infarction discharged from 33 Spanish hospitals are registered for one year including their demographic, clinical and outcome characteristics, as well as details on their management when admitted to a coronary care unit. Standardized definitions of diagnosis and measurements are used. Confidentiality of patients' identity and anonymous participation of each center are also warranted. The 33 participant coronary care units, covering some 10,000,000 people, admitted on average 83.9% of myocardial infarction patients of their hospital. In 16 participating centers there is a laboratory of hemodynamics and in 11 coronary surgery. During the pilot study, 606 patients were discharged from the participating coronary care units where the case-fatality, rate was 10.3%. While 19.8% of patients developed left heart failure, 44.1% received thrombolytic therapy. The delay between onset of symptoms and first monitoring was approximately 6 hours, and thereafter admission to the coronary unit about 3 hours. PRIAMHO study will allow to establish of the fundamentals for developing a nation-wide myocardial infarction register and will provide an accurate perspective of the characteristics and management of this disease in Spain.

  2. Oxidized LDL, lipoprotein (a) and other emergent risk factors in acute myocardial infarction (FORTIAM study).

    PubMed

    Gómez, Miquel; Valle, Vicente; Arós, Fernando; Sanz, Ginés; Sala, Joan; Fiol, Miquel; Bruguera, Jordi; Elosua, Roberto; Molina, Lluís; Martí, Helena; Covas, M Isabel; Rodríguez-Llorián, Andrés; Fitó, Montserrat; Suárez-Pinilla, Miguel A; Amezaga, Rocío; Marrugat, Jaume

    2009-04-01

    To determine the prevalence of acute myocardial infarction (AMI) without classical risk factors, and to ascertain whether affected patients exhibit a higher prevalence of emergent risk factors and whether the presence of specific emergent risk factors influence prognosis at 6 months. The FORTIAM (Factores Ocultos de Riesgo Tras un Infarto Agudo de Miocardio) study is a multicenter cohort study that includes 1371 AMI patients who were admitted within 24 hours of symptom onset. Strict definitions were used for classical risk factors and the concentrations of the following markers were determined: lipoprotein (a) [Lp(a)], oxidized low-density lipoprotein (oxLDL), high-sensitivity C-reactive protein, fibrinogen, homocysteine and antibody to Chlamydia. The end-points observed during the 6-month follow-up were death, angina and re-infarction. The prevalence of AMI without classical risk factors was 8.0%. The absence of classical risk factors did not affect the 6-month prognosis. The only emergent risk factors independently associated with a poorer prognosis were the Lp(a) and oxLDL concentrations. Cut-points were determined using smoothing splines: 60 mg/ dL for Lp(a) and 74 U/L for oxLDL. The associated hazard ratios, adjusted for age, sex and classical risk factors, were 1.40 (95% confidence interval, 1.06-1.84 ) and 1.48 (95% confidence interval, 1.06-2.06), respectively. The proportion of AMI patients without classical risk factors was low and their prognosis was similar to that in other AMI patients. Both oxLDL and Lp(a) concentrations were independently associated with a poorer 6-month prognosis, irrespective of the presence of classical risk factors.

  3. [Prevalence of malnutrition in Spanish institutionalized older people: a multicentric nationwide analysis].

    PubMed

    Vaca Bermejo, Raúl; Ancizu García, Iciar; Moya Galera, David; de las Heras Rodríguez, Mónica; Pascual Torramadé, Josep

    2014-10-06

    Introducción: Un estado nutricional deficitario tiene importantes consecuencias en la salud de los colectivos en situación de especial vulnerabilidad, como las personas con enfermedades crónicas o personas mayores en situación de dependencia. Objetivo: Conocer el estado nutricional al ingreso de usuarios en centros SARquavitae. Material y Método: Se estudió el estado de salud, cognitivo y funcional de las personas que ingresaron durante el año 2012 en algún centro de la compañía. El estado nutricional fue evaluado mediante la versión corta del Mini Nutritional Assessment. Asimismo, se realizó un análisis para conocer las variables con mayor influencia en el estado nutricional de la muestra objeto de estudio. Resultados: Se analizaron las historias clínicas de 4.297 ingresos. La edad media fue de 82,08 años. Un 66,1% eran mujeres con una alta pluripatología. Al ingreso, un 30,4% de la muestra se encuentra en situación de desnutrición y un 49,4% en riesgo de desnutrición. Se observa una mayor prevalencia de desnutrición en mujeres, en aquellas personas que son derivadas por un hospital de agudos o por sus consultas externas, con peor estado funcional y cognitivo y en aquellas con procesos patológicos como demencia, enfermedades cerebrovasculares o disfagia. Conclusiones: Los resultados de este estudio ponen de manifiesto la alta complejidad clínica de las personas que ingresan en los centros residenciales estudiados, evidenciando la necesidad de realizar valoraciones integrales que permitan establecer planes de cuidados específicos para los perfiles atendidos.

  4. [Spinal cord injury in patients over 65 years of age].

    PubMed

    Varela-Lage, Cristina; Alcobendas-Maestro, Mónica; Luque-Ríos, Inmaculada; Esclarín-De Ruz, Ana; Talavera-Díaz, Francisco; Ceruelo-Abajo, Silvia

    2015-06-01

    Introduccion. La poblacion de mayores de 65 años activos fisicamente continua en aumento, lo que condiciona un mayor riesgo de caidas y de lesion medular en un rango de edad con importante presencia de patologia cronica. Objetivo. Revisar la incidencia, el tipo de lesion, las complicaciones asociadas y los resultados funcionales de las lesiones medulares ocurridas en pacientes mayores de 65 años. Pacientes y metodos. Estudio descriptivo retrospectivo en lesionados medulares agudos mayores de 65 años ingresados en el Hospital Nacional de Paraplejicos desde enero de 2010 hasta diciembre de 2011. Las variables del estudio fueron datos demograficos y de lesion, antecedentes personales, complicaciones ocurridas durante el ingreso y capacidad funcional al alta medida con las escalas Spinal Cord Independence Measure (SCIM III) y Walking Index Spinal Cord Injury (WISCI). Resultados. Se incluyeron 111 individuos con una media de edad de 72,5 años. La incidencia anual fue de 17,3 pacientes/100 ingresos. El 33,3% eran lesiones cervicales y fueron incompletas el 66,7%. La etiologia medica fue mas frecuente que la traumatica. El 5% no presentaba otras enfermedades intercurrentes. El 97% sufrio algun tipo de complicacion. La media alcanzada para la SCIM III fue de 42 puntos y el 35% consiguio capacidad de marcha. Conclusiones. En los ultimos años se ha producido un aumento de lesion medular en mayores de 65 años, en los que la etiologia traumatica no es superior a la medica; mas frecuentemente son lesiones incompletas que asocian mayor comorbilidad que la poblacion general, y se consiguen resultados funcionales mas pobres a pesar de las mejoras neurologicas.

  5. [Algorithm for diagnosis and treatment of hereditary angioedema as a tool for management].

    PubMed

    Baeza, María Luisa; Caballero Molina, Teresa; Crespo Diz, Carlos; González-Quevedo; Guilarte Clavero, Mar; Hernández Fernández de Rojas, Dolores; Lobera Labairu, Teófilo; Marcos Bravo, Carmen; Navarro Ruiz, Andrés; Navarro Ruiz, A; Poveda Andrés, José Luis; Poveda Andrés, J L; Cebollero, María Antonia; Cebollero de Torre, A

    2013-01-01

    Introducción: El angioedema hereditario es una enfermedad rara de baja prevalencia y gran heterogeneidad en la gravedad del cuadro clínico, lo que dificulta su diagnóstico, y establece la necesidad de iniciar un tratamiento precoz y específico con el fin de evitar complicaciones. Objetivo: Proponer un algoritmo de decisión en el angioedema hereditario (AEH), basado en la evidencia disponible, sobre el diagnóstico, valoración clínica y tratamiento. Se trata de presentar opciones terapéuticas disponibles, así como un algoritmo de decisión para seleccionar el tratamiento más eficiente en cada momento. Material y Métodos: Revisión bibliográfica mediante una búsqueda a través de PubMed y otras fuentes de interés. Resultados: Se han desarrollado cuatro algoritmos de decisión para el AEH; diagnóstico de angioedema mediado por bradicinina, tratamiento del ataque agudo y profilaxis a corto y largo plazo del AEH por déficit del inhibidor C1. Conclusiones: La aplicación de un algoritmo de decisión, en función de unas variables clínicas, ayuda a la selección de la opción terapéutica más eficiente en cada momento y puede ser un instrumento de utilidad en el abordaje terapéutico.

  6. Astronomía para ciegos y amblíopes. Proyecto de construcción de un planetario especial en la ciudad de Mar del Plata

    NASA Astrophysics Data System (ADS)

    Musso, S.

    ?`Qué es la Astronomía para Ciegos?. El trabajo es una adaptación en base a la escala de magnitudes de Hipparco que cambia el concepto de luz por una adaptación sonora, donde las estrellas de magnitud 6 se escuchan en 10 dB, más o menos lo que consideramos el umbral de la audición humana. Quienes no escuchan muy bien no pueden escuchar las magnitudes 6, de la misma manera que muchos de nosotros, que no poseemos una visión perfecta, no podemos observar esas mismas estrellas en el cielo (más allá de la polución). A los astros de magnitud 5 vamos a relacionarlos a un sonido en 20 dB. Y así sucesivamente. También los colores estarán representados en una convención de graves a agudos y lo mismo algunas características del cielo. Por ejemplo, la Vía Láctea se mostrará como un ``ruido", como bien nos lo hicieron ver nuestros futuros destinatarios. En Mar del Plata nos encontramos ya trabajando en un proyecto que tiene como objetivo final la construcción del Primer Planetario Acústico del Mundo, una herramienta para la enseñanza de la astronomía, un espacio para la lucha contra la discriminación del discapacitado y una posibilidad de ``ver el cielo de un modo diferente".

  7. Brain abnormalities in attention-deficit hyperactivity disorder: a review.

    PubMed

    Rubia, Katya; Alegría, Analucía A; Brinson, Helen

    2014-02-24

    Objetivo. Revisar los hallazgos de los estudios con resonancia magnetica en el trastorno por deficit de atencion/hiperactividad (TDAH) infantil y adulto. Desarrollo. Dichos estudios han demostrado que el TDAH se caracteriza por la presencia de multiples anomalias de caracter estructural y funcional, primordialmente en los circuitos frontoestriatales, pero tambien en los circuitos frontoparietotemporales, frontocerebelares e, incluso, frontolimbicos. Los datos aportados por los estudios longitudinales de resonancia magnetica estructural demuestran que el TDAH se caracteriza por un retraso en la maduracion estructural del cerebro. Esta conclusion se ve reforzada por los indicios indirectos ofrecidos por los estudios de cortes transversales, que indican la existencia de una inmadurez sustancial tanto en la funcion cerebral como en los patrones de conectividad estructural y funcional, indicios que, sin embargo, estan pendientes de confirmar en estudios longitudinales. La alteracion funcional de la corteza prefrontal ventrolateral parece estar mas afectada en el TDAH que en otros trastornos pediatricos, y existen algunos indicios de anomalias distintivas en los ganglios basales. Un metaanalisis sobre los efectos de los estimulantes en la funcion cerebral demuestra que el mecanismo de accion agudo mas congruente de los farmacos psicoestimulantes consiste en el aumento de la activacion de la corteza prefrontal inferior y los ganglios basales. Los primeros intentos por utilizar los datos de los estudios de neuroimagen para elaborar clasificaciones diagnosticas individuales de los niños con TDAH a partir de tecnicas de reconocimiento de patrones han cosechado resultados alentadores, pero todavia deben ser replicados por mas centros y aparatos de resonancia magnetica. Conclusiones. Durante los ultimos 20 años, las tecnicas de neuroimagen han perfilado los biomarcadores del TDAH, pero es necesario que nuevos estudios descubran la utilidad clinica de esa informacion, como el

  8. [NEURODEGENERATIVE DISEASES; NUTRITIONAL ASPECTS].

    PubMed

    de Luis, Daniel A; Izaola, Olatz; de la Fuente, Beatriz; Muñoz-Calero, Paloma; Franco-Lopez, Angeles

    2015-08-01

    Introducción: las enfermedades neurodegenerativas producen alteraciones en el nivel de conciencia o en los mecanismos de la deglución que con frecuencia hacen necesario un soporte nutricional especializado. Objetivo: revisar el riesgo de desnutrición, así como su tratamiento, en pacientes con enfermedad cerebral vascular, enfermedad de Parkinson, demencia y esclerosis lateral amiotrófica. Desarrollo: las enfermedades neurológicas degenerativas son una de las principales indicaciones de soporte nutricional en nuestro país. En los procesos agudos (enfermedad vascular cerebral), el correcto manejo nutricional se relaciona con una mejor evolución y con una disminución de las complicaciones. En los procesos neurodegenerativos crónicos (esclerosis lateral amiatrófica y demencia), la malnutrición es un problema importante que empeora el pronóstico de estos pacientes siendo, necesario un correcto manejo de la disfagia y sus complicaciones, así como la utilización de diferentes etapas de soporte nutricional. Una correcta valoración nutricional de estos pacientes, así como un claro esquema de intervención nutricional, es imprescindible en el seguimiento de su enfermedad. Por último, en la enfermedad de Parkinson avanzada, el soporte nutricional, como en las enfermedades neurodegenerativas anteriores, es de vital importancia, sin olvidarnos de la carga proteica y su distribución en la dieta de estos pacientes. Las sociedades científicas internacionales (American Society for Parenteral and Enteral Nutrition ASPEN) recomiendan, con un grado de evidencia B, realizar un cribaje de malnutrición a los pacientes con enfermedades neurológicas. Conclusiones: una correcta valoración nutricional, así como un adecuado soporte nutricional deben formar parte del proceso diagnóstico y terapéutico de estas enfermedades.

  9. The Subparsec-Scale Structure and Evolution of Centaurus A. II. Continued Very Long Baseline Array Monitoring

    NASA Astrophysics Data System (ADS)

    Tingay, S. J.; Preston, R. A.; Jauncey, D. L.

    2001-10-01

    We present the results of continued 8.4 GHz Very Long Baseline Array monitoring of the subparsec-scale structure and evolution of Centaurus A, following on from the initial results presented in 1998 by Tingay et al. We include, for the first time, multiepoch VLBI images at 22.2 GHz that show that the jet is linear and well collimated on scales as small as 0.02 pc (~1000rs). Two components in the subparsec-scale jet continue to evolve slowly with a speed of 0.12c. We confirm that an additional component, close to the core, has no significant motion. Some evidence is seen for rapid variations within individual components, as noted dramatically in 1991-1992 by Tingay et al., albeit at a lower level of activity. Both the stationary behavior of the component close to the core and the internal variability of components in the subparsec-scale jet of Centaurus A may be explained as being due to the existence of shocks created in the wake of major component ejections from the nucleus, as simulated by Agudo et al. (published in 2001). Tentative evidence is found to suggest that two subparsec-scale counterjet components are in motion away from the nucleus. The estimated apparent speeds of the jet and counterjet components are consistent with the previously suggested likely jet viewing angle range, 50°-80°. We also compare our Centaurus A images with high-resolution VLBI images of M87 to show that the region of the Centaurus A jet in which collimation likely first occurs lies a factor of 10 below our current resolution limit. Future space VLBI missions at high frequency will be required to resolve this region.

  10. Advanced Differential Radar Interferometry (A-DInSAR) as integrative tool for a structural geological analysis

    NASA Astrophysics Data System (ADS)

    Crippa, B.; Calcagni, L.; Rossi, G.; Sternai, P.

    2009-04-01

    Advanced Differential SAR interferometry (A-DInSAR) is a technique monitoring large-coverage surface deformations using a stack of interferograms generated from several complex SLC SAR images, acquired over the same target area at different times. In this work are described the results of a procedure to calculate terrain motion velocity on highly correlated pixels (E. Biescas, M. Crosetto, M. Agudo, O. Monserrat e B. Crippa: Two Radar Interferometric Approaches to Monitor Slow and Fast Land Deformation, 2007) in two area Gemona - Friuli, Northern Italy, Pollino - Calabria, Southern Italy, and, furthermore, are presented some consideration, based on successful examples of the present analysis. The choice of these pixels whose displacement velocity is calculated depends on the dispersion index value (DA) or using coherence values along the stack interferograms. A-DInSAR technique allows to obtain highly reliable velocity values of the vertical displacement. These values concern the movement of minimum surfaces of about 80m2 at the maximum resolution and the minimum velocity that can be recognized is of the order of mm/y. Because of the high versatility of the technology, because of the large dimensions of the area that can be analyzed (of about 10000Km2) and because of the high precision and reliability of the results obtained, we think it is possible to exploit radar interferometry to obtain some important information about the structural context of the studied area, otherwise very difficult to recognize. Therefore we propose radar interferometry as a valid investigation tool whose results must be considered as an important integration of the data collected in fieldworks.

  11. Determining the Macroscopic Properties of Relativistic Jets

    NASA Astrophysics Data System (ADS)

    Hardee, P. E.

    2004-08-01

    The resolved relativistic jets contain structures whose observed proper motions are typically assumed to indicate the jet flow speed. In addition to structures moving with the flow, various normal mode structures such as pinching or helical and elliptical twisting can be produced by ejection events or twisting perturbations to the jet flow. The normal mode structures associated with relativistic jets, as revealed by numerical simulation, theoretical calculation, and suggested by observation, move more slowly than the jet speed. The pattern speed is related to the jet speed by the sound speed in the jet and in the surrounding medium. In the event that normal mode structures are observed, and where proper motions of pattern and flow speed are available or can be estimated, it is possible to determine the sound speed in the jet and surrounding medium. Where spatial development of normal mode structures is observed, it is possible to make inferences as to the heating rate/macroscopic viscosity of the jet fluid. Ultimately it may prove possible to separate the microscopic energization of the synchrotron radiating particles from the macroscopic heating of the jet fluid. Here I present the relevant properties of useful normal mode structures and illustrate the use of this technique. Various aspects of the work presented here have involved collaboration with I. Agudo (Max-Planck, Bonn), M.A. Aloy (Max-Planck, Garching), J. Eilek (NM Tech), J.L. Gómez (U. Valencia), P. Hughes (U. Michigan), A. Lobanov (Max-Planck, Bonn), J.M. Martí (U. Valencia), & C. Walker (NRAO).

  12. [Epidemiological study of traumatic hand injuries in Toluca, State of Mexico].

    PubMed

    Osnaya-Moreno, Humberto; Romero-Espinosa, Jesús Fernando; Mondragón-Chimal, Marco Antonio; Ochoa-González, Gabriel; Escoto-Gómez, Jorge Armando

    2014-01-01

    Antecedentes: las lesiones traumáticas de la mano se encuentran entre los tipos más frecuentes de lesiones y se refieren al daño agudo ocasionado a la mano por un agente externo. Objetivo: determinar las características de las lesiones de mano atendidas en el Centro Médico Lic. Adolfo López Mateos, ISEM y compararlas con lo reportado en otros países. Material y métodos: estudio retrospectivo de pacientes atendidos en el servicio de Cirugía Plástica y Reconstructiva del Centro Médico Licenciado Adolfo López Mateos, entre el 6 de septiembre de 2010 y el 5 de septiembre de 2011, con diagnóstico de lesión traumática de mano. Resultados: se atendieron 105 casos. Predominó el sexo masculino (82.9%). El límite de edad más afectado fue el de 20 a 29 años (44.8%). La mano más lesionada fue la derecha (46.7%). El mecanismo de lesión más común fue por esmeril (41%), seguido por objeto cortante (32.4%). La mano dominante fue la más lesionada (50.47%). Las lesiones más comunes fueron de tipo abierto (88.6%), y simple (84.8%). Conclusiones: las lesiones de mano fueron más comunes en hombres, en sitios de actividad laboral, por lo que deben mejorarse los programas de seguridad en el trabajo. Las características de las lesiones traumáticas de mano en nuestra unidad fueron muy semejantes a las observadas en el resto del mundo.

  13. NUTRITIONAL SUPPORT FOR FULMINANT HEPATITIS.

    PubMed

    Ramos Figueira, Estela Regina; Rocha Filho, Joel Avancini; Souto Nacif, Lucas; Carneiro D'Albuquerque, Luiz; Linetzky Waitzberg, Dan

    2015-12-01

    Introducción: la hepatitis fulminante se asocia a un exacerbado hipercatabolismo, la hipoglicemia y la hiperamonemia están acompañadas por la liberación de citocinas proinflamatorias y hormonas catabólicas en la circulación sistémica, empeorando la condición clínica del paciente. El apoyo nutricional es un elemento crucial para la recuperación de estos pacientes. Objetivos: el objetivo de esta revisión es actualizar el apoyo nutricional para la hepatitis fulminante. Métodos: la revisión se llevó a cabo mediante la búsqueda electrónica en Medline-PubMed, utilizando malla de términos. Resultados y discusión: no hay muchos datos disponibles sobre el apoyo nutricional para lahepatitis fulminante o fallo hepático agudo. Las estrategias de intervención nutricional inicial se centran en el control de los trastornos metabólicos de la hepatitis fulminante descritos anteriormente, que deben ser individualizadas de acuerdo a la gravedad de la situación clínica del paciente. Energía y proteína se pueden proporcionar en cantidades de 25‑40 kcal / kg / día y 0,8-1,2 g / kg / día, respectivamente. La terapia nutricional enteral está indicada en pacientes con encefalopatía avanzada o para aquellos que no pueden ser adecuadamente alimentados por vía oral. Se debe obtener una euglicemia y la ingesta de proteínas puede estar basada en fórmulas de BCAA. Los lípidos se pueden administrar como suplemento energético con precaución. Una terapia nutricional adecuada puede potencialmente reducir la morbilidad y la mortalidad de los pacientes con hepatitis fulminante.

  14. Pneumatosis intestinalis after etoposide-based chemotherapy in a patient with metastatic small cell lung cancer: successful conservative management of a rare condition.

    PubMed

    Faria, Luiza Dib Batista Bugiato; Anjos, Carlos Henrique Dos; Fernandes, Gustavo Dos Santos; Carvalho, Igor Fernando da Silva

    2016-01-01

    A 69-year-old male patient, smoker, was diagnosed with small cell lung cancer metastatic to lung, liver and central nervous system. He received chemotherapy with carboplatin AUC 5 on day 1 and etoposide 100mg/m2 on days 1, 2 and 3. During the first cycle, the patient presented with febrile neutropenia and abdominal distension. Chest, abdomen and pelvis computed tomography scan was performed and detected gas dissecting the wall of sigmoid colon extending to the mesosigmoid. Patient had no abdominal pain, nausea, vomiting, and on physical examination he had no peritoneal irritation, tachycardia or hemodynamic instability compatible with perforation or acute abdomen. Therefore, the radiological finding was interpreted as pneumatosis intestinalis caused by chemotherapy with etoposide. Pneumatosis resolved after continuous oxygen therapy. The second cycle was administered after a complete resolution of the clinical condition and etoposide dose was reduced by 30%. The patient experienced a remarkable evolution. RESUMO Paciente do gênero masculino, 69 anos, fumante, diagnosticado com câncer de pulmão de pequenas células, metastático para pulmão, fígado e sistema nervoso central. Foi administrada quimioterapia com carboplatina AUC 5 no dia 1 e etoposídeo 100mg/m2 nos dias 1, 2 e 3. Durante o primeiro ciclo, o paciente apresentou neutropenia febril e distensão abdominal. Tomografias de tórax, abdome e pelve detectaram gás dissecando a parede do cólon sigmoide, com extensão para o mesossigmoide. O paciente não apresentava dor abdominal, náusea, vômito e não tinha sinais de irritação peritoneal, taquicardia ou instabilidade hemodinâmica compatíveis com perfuração ou abdome agudo. O achado radiológico foi interpretado como pneumatose intestinal causada por etoposídeo. A resolução do quadro ocorreu após suplementação de oxigênio. O segundo ciclo foi administrado após resolução completa do quadro, com redução da dose do quimioterápico em 30

  15. [Adverse effects of seasonal flu vaccine and new influenza A (H1N1) vaccine in health care workers].

    PubMed

    Torruella, Joan Inglés; Soto, Rosa Gil; Valls, Rosa Carreras; Lozano, Judit Valverde; Carreras, Dolors Benito; Cunillera, Arnau Besora

    2013-01-01

    OBJETIVOS: Valorar y comparar los efectos indeseados de la vacuna de la gripe estacional (VGE) y vacuna de la gripe A H1N1 (VGA) en trabajadores sanitarios. MÉTODOS: Estudio transversal multicéntrico en trabajadores sanitarios de hospitales de agudos, centros de asistencia primaria, centros sociosanitarios, centros de salud mental y un hospital geriátrico participantes en la campaña de vacunación antigripal del 2009. Se enviaron encuestas autocumplimentadas a todos los vacunados con VGE y/o VGA. RESULTADOS: De los 1123 vacunados con VGE se obtienen 527 encuestas válidas (46,9%) y de 461 vacunados con VGA se obtienen 242 encuestas (52,5%). De los trabajadores participantes 527 estaban vacunados sólo con VGE, 117 vacunados previamente con VGE y después VGA (VGE+VGA) y 125 sólo vacunados sólo con VGA. El 18,4% (IC 95% 15,1-21,7) del grupo VGE presentaron algún efecto adverso a la vacuna VGE; en el grupo VGE+VGA el 45,3% (IC 95% 36,3-54,3) presentó una reacción adversa al recibir la VGA, y en el grupo VGA fue el 46,4% (IC 95% 37,7-55,1). En todos los participantes el problema más frecuente fue una reacción local. Las mujeres presentan mayor reacción a VGA y VGE que los hombres. Para todas las edades la VGE es menos reactógena que VGA y que la combinación de ambas vacunas, con la excepción de los trabajadores menores de 29 años. CONCLUSIONES: La VGA es más reactógena que la VGE, sin diferencias por orden de administración. Se observan variaciones por sexo y edad, pero siempre con mayor reactogenicidad para la VGA.

  16. Magnitude and consequences of undertreatment of high-risk patients with non-ST segment elevation acute coronary syndromes: insights from the DESCARTES Registry.

    PubMed

    Heras, M; Bueno, H; Bardají, A; Fernández-Ortiz, A; Martí, H; Marrugat, J

    2006-11-01

    To analyse intensity of treatment of high-risk patients with non-ST elevation acute coronary syndromes (NSTEACS) included in the DESCARTES (Descripción del Estado de los Sindromes Coronarios Agudos en un Registro Temporal Español) registry. Patients with NSTEACS (n = 1877) admitted to 45 randomly selected Spanish hospitals in April and May 2002 were studied. Patients with ST segment depression and troponin rise were considered high risk (n = 478) and were compared with non-high risk patients (n = 1399). 46.9% of high-risk patients versus 39.5% of non-high-risk patients underwent angiography (p = 0.005), 23.2% versus 18.8% (p = 0.038) underwent percutaneous revascularisation, and 24.9% versus 7.4% (p < 0.001) were given glycoprotein IIb/IIIa inhibitor. In-hospital and six-month mortality were 7.5% versus 1.1% and 17% versus 4.6% (p < 0.001), respectively. A treatment score (> or = 4, 2-3 and < 2) was defined according to the number of class I interventions recommended in clinical guidelines: aspirin, clopidogrel, beta blockers, angiotensin-converting enzyme inhibitors, statins and revascularisation. Independent predictors of six-month mortality were age (odds ratio (OR) 1.07, 95% confidence interval (CI) 1.04 to 1.10, p < 0.001), diabetes (OR 1.92, 95% CI 1.14 to 3.22, p = 0.014), previous cardiovascular disease (OR 4.17, 95% CI 1.63 to 10.68, p = 0.003), high risk (OR 2.20, 95% CI 1.30 to 3.71, p = 0.003) and treatment score < 2 versus > or = 4 (OR 2.87, 95% CI 1.27 to 6.52, p = 0.012). Class I recommended treatments were underused in high-risk patients in the DESCARTES registry. This undertreatment was an independent predictor of death of patients with an acute coronary syndrome.

  17. Risk factors, therapeutic approaches, and in-hospital outcomes in Mexicans with ST-elevation acute myocardial infarction: the RENASICA II multicenter registry.

    PubMed

    Juárez-Herrera, Úrsulo; Jerjes-Sánchez, Carlos

    2013-05-01

    Ischemic heart disease is a growing health problem in Latin America. We aimed to analyze risk factors, acute management, and short-term outcome of Mexicans with ST-elevation myocardial infarction (STEMI). Modifiable risk factors are associated with the occurrence of STEMI in Mexicans, and potentially preventable acute complications are responsible for most short-term deaths. Among 8600 patients enrolled in Registro Nacional de los Síndromes Coronarios Agudos II (RENASICA II) with a suspected acute coronary syndrome, we analyzed 4555 patients (56%; age 21-100 y) with confirmed STEMI who presented within 24 hours from symptoms' onset. Smoking (66%), hypertension (50%), and diabetes (43%) were the main risk factors. Most patients (74%) presented with Killip class I (class IV in 4%). Anterior-located STEMI occurred in 56% of cases, and posterior-inferior in 40% of cases. Significant Q waves were present in 43%, right bundle branch block in 7%, left bundle branch block in 5%, first-degree atrioventricular block in 2%, and high-degree atrioventricular block in 2%. A total of 1685 (37%) patients received fibrinolytic therapy (streptokinase, 82%; alteplase, 17%; tenecteplase, 1%), with 31% of patients receiving therapy in <2 hours, 36% in 2-4 hours, 19% in 4-6 hours, and 15% in >6 hours. Thirty percent of patients received either percutaneous coronary intervention or coronary artery bypass grafting during hospitalization. Major adverse cardiovascular events were recurrent ischemia (12%), reinfarction (4%), cardiogenic shock (4%), and stroke (1%). The main predictors of 30-day mortality (10%) in multivariate analysis were age ≥65 years (odds ratio [OR]: 2.47, 95% confidence interval [CI]: 1.94-3.13), Killip class IV (OR: 10.60, 95% CI: 6.09-18.40), and cardiogenic shock (OR: 18.76, 95% CI: 10.60-33.20). Largely modifiable risk factors and preventable short-term complications are responsible for most STEMI cases and outcomes in this Mexican population. © 2013 Wiley

  18. Magnitude and consequences of undertreatment of high‐risk patients with non‐ST segment elevation acute coronary syndromes: insights from the DESCARTES Registry

    PubMed Central

    Heras, M; Bueno, H; Bardají, A; Fernández‐Ortiz, A; Martí, H; Marrugat, J

    2006-01-01

    Objective To analyse intensity of treatment of high‐risk patients with non‐ST elevation acute coronary syndromes (NSTEACS) included in the DESCARTES (Descripción del Estado de los Sindromes Coronarios Agudos en un Registro Temporal Español) registry. Patients and setting Patients with NSTEACS (n  =  1877) admitted to 45 randomly selected Spanish hospitals in April and May 2002 were studied. Design Patients with ST segment depression and troponin rise were considered high risk (n  =  478) and were compared with non‐high risk patients (n  =  1399). Results 46.9% of high‐risk patients versus 39.5% of non‐high‐risk patients underwent angiography (p  =  0.005), 23.2% versus 18.8% (p  =  0.038) underwent percutaneous revascularisation, and 24.9% versus 7.4% (p < 0.001) were given glycoprotein IIb/IIIa inhibitor. In‐hospital and six‐month mortality were 7.5% versus 1.1% and 17% versus 4.6% (p < 0.001), respectively. A treatment score (⩾ 4, 2–3 and < 2) was defined according to the number of class I interventions recommended in clinical guidelines: aspirin, clopidogrel, β blockers, angiotensin‐converting enzyme inhibitors, statins and revascularisation. Independent predictors of six‐month mortality were age (odds ratio (OR) 1.07, 95% confidence interval (CI) 1.04 to 1.10, p < 0.001), diabetes (OR 1.92, 95% CI 1.14 to 3.22, p  =  0.014), previous cardiovascular disease (OR 4.17, 95% CI 1.63 to 10.68, p  =  0.003), high risk (OR 2.20, 95% CI 1.30 to 3.71, p  =  0.003) and treatment score < 2 versus ⩾ 4 (OR 2.87, 95% CI 1.27 to 6.52, p  =  0.012). Conclusions Class I recommended treatments were underused in high‐risk patients in the DESCARTES registry. This undertreatment was an independent predictor of death of patients with an acute coronary syndrome. PMID:16644860

  19. [Benefits of Decumanum Phlebodium intake on the muscle damage in the response to intense physical exercise in sedentary subjects].

    PubMed

    Vargas Corzo, M C; Aguilar Cordero, M J; de Teresa Galván, C; Segura Millán, D; Miranda Leon, M T; Castillo Rueda, G; Guisado Barrilao, R

    2014-06-01

    resultado significativamente menores en el grupo PD, al mostrar los efectos protectores del Phlebodium Decumanum en tratamientos cortos, frente al daño muscular también en el esfuerzo agudo.

  20. Effects of exercise on inflammation in cardiac rehabilitation.

    PubMed

    Roca-Rodríguez, María del Mar; Garrido-Sánchez, Lourdes; García-Almeida, Jose Manuel; Ruiz-Nava, Josefina; Alcaide-Torres, Juan; Gómez-González, Adela; Montiel-Trujillo, Angel; Tinahones-Madueño, Francisco

    2015-06-01

    Introducción: a los pacientes con riesgo cardiovascular se les recomiendan programas de pérdida de peso y dieta saludable, pero la eficacia de estos programas a la hora de reducir la mortalidad es controvertida. Objetivo: examinar los efectos agudos y a largo plazo de un programa de rehabilitación cardíaca de dos meses de duración sobre las quemocinas relacionadas con la inflamación en pacientes con enfermedad cardiovascular. Diseño: estudio de cohortes prospectivo. Métodos: se estudiaron 26 pacientes con enfermedad cardiovascular inscritos en un programa de rehabilitación cardíaca basado en intervenciones nutricionales y de ejercicio. Se analizaron el estilo de vida y variables clínicas, metabólicas e inflamatorias. Resultados: 88,5% eran hombres y la edad media fue de 54,9 ± 7,8 años. Al final del programa de rehabilitación cardíaca las variables del perfil glucémico y lipídico descendieron, excepto el colesterol de lipoproteínas de alta densidad, que aumentó. Ácido úrico, interleucina-6, interleucina-1 beta, adiponectina y leptina se mantuvieron estables. Interleucina-6 correlacionó positivamente con proteína C reactiva y negativamente con glucosa en sangre. Interleucina-1 beta correlacionó positivamente con proteína C-reactiva y negativamente con las cifras de presión arterial. Encontramos correlaciones significativas entre los cambios en interleucina-6 e interleucina- 1 beta y los cambios en los equivalentes metabólicos y proteína C-reactiva, antes y después del programa de rehabilitación cardíaca. No se observaron correlaciones significativas con peso, circunferencia de cintura o masa grasa. Conclusiones: la rehabilitación cardiaca mejora las variables antropométricas, las cifras de presión arterial, así como el perfil de lípidos y los resultados de la ergometría. Sin embargo, no se observaron cambios con respecto al estado inflamatorio.

  1. Therapeutic monitoring of pediatric transplant patients with conversion to generic tacrolimus.

    PubMed

    Riva, Natalia; Cáceres Guido, Paulo; Licciardone, Nieves; Imventarza, Oscar; Monteverde, Marta; Staciuk, Raquel; Charroqui, Alberto; Schaiquevich, Paula

    2017-03-01

    Objetivo: La monitorización terapéutica durante el intercambio de marcas comerciales de inmunosupresores es esencial para mantener una similar exposición al fármaco en pacientes trasplantados. Sin embargo, la información disponible en trasplante pediátrico es limitada. El objetivo del trabajo fue evaluar la exposición, seguridad y eficacia en pacientes pediátricos trasplantados en etapa de mantenimiento, sujetos a intercambio entre el producto innovador y el genérico de tacrolimus. Método: El Área de Farmacia del hospital detectó aquellos pacientes sujetos a intercambio de formulaciones según la disponibilidad de medicamentos. Se obtuvieron las concentraciones de tacrolimus en el valle (C0), parámetros de laboratorio y características clínicas antes y después del intercambio. El análisis estadístico se realizó mediante el test de muestras pareadas de Wilcoxon. Resultados: Se incluyeron 10 pacientes con trasplante renal, hepático, cardíaco y de células hematopoyéticas. La mediana (rango) del C0 normalizado por la dosis pre y post intercambio fue 74,8[(ng/ml)/(mg/kg)](13,8-518,4) y 65,1[(ng/ml)/(mg/kg)] (13,5-723,5), respectivamente (p>0,05). La dosis de tacrolimus fue 0,070(mg/kg) (0,024-0,461) y 0,069(mg/kg) (0,017-0,571) para el innovador y el genérico, respectivamente (p>0,05). Los parámetros de laboratorio de funcionalidad renal y hepática no cambiaron con la conversión de marcas (p>0,05). No se observaron eventos adversos, rechazo agudo, muerte o pérdida del injerto durante el periodo analizado. Conclusiones: En la población estudiada, no se observaron diferencias significativas en los parámetros de laboratorio, exposición al tacrolimus o dosis en el intercambio de marcas comerciales. Destacamos el rol de la monitorización terapéutica a la hora de garantizar una sustitución segura, especialmente en poblaciones vulnerables.

  2. Intra-abdominal pressure: an integrative review.

    PubMed

    Milanesi, Rafaela; Caregnato, Rita Catalina Aquino

    2016-01-01

    There is a growing request for measuring intra-abdominal pressure in critically ill patients with acute abdominal pain to be clarified. Summarizing the research results on measurement of vesical intra-abdominal pressure and analyzing the level of evidence were the purposes of this integrative literature review, carried out based on the databases LILACS, MEDLINE and PubMed, from 2005 to July 2012. Twenty articles were identified, in that, 12 literature reviews, 4 descriptive and exploratory studies, 2 expert opinions, one prospective cohort study and one was an experience report. The vesical intra-abdominal pressure measurement was considered gold standard. There are variations in the technique however, but some common points were identified: complete supine position, in absence of abdominal contracture, in the end of expiration and expressed in mmHg. Most research results indicate keeping the transducer zeroed at the level of the mid-axillary line at the iliac crest level, and instill 25mL of sterile saline. Strong evidence must be developed. RESUMO Em pacientes críticos com quadros abdominais agudos a esclarecer é crescente a solicitação da aferição da pressão intra-abdominal. Sintetizar resultados de pesquisas sobre a mensuração da pressão intra-abdominal pela via vesical e analisar o nível de evidência foram os objetivos desta revisão integrativa da literatura, realizada nas bases LILACS, MEDLINE e PubMed, no período de 2005 a julho de 2012. Identificaram-se 20 artigos, sendo 12 revisões de literatura, 4 estudos exploratório-descritivos, 2 opiniões de especialistas, 1 estudo de coorte prospectivo e 1 relato de experiência. O método vesical para mensuração da pressão intra-abdominal foi considerado padrão-ouro. Existem variações na técnica, entretanto pontos em comum foram identificados: posição supina completa, na ausência de contratura abdominal, ao final da expiração e expressa em mmHg. A maioria indica posicionar o ponto zero do

  3. [Variability in the management and prognosis at short- and medium-term of myocardial infarct in Spain: the PRIAMHO study. Registration Project of Hospital Acute Myocardial Infarct].

    PubMed

    Cabadés, A; López-Bescós, L; Arós, F; Loma-Osorio, A; Bosch, X; Pabón, P; Marrugat, J

    1999-10-01

    The paucity of data on myocardial infarction management and results in Spain lead to the design of the PRIAMHO study (Proyecto de Registro de Infarto Agudo de Miocardio Hospitalario [Acute Myocardial Infarction Hospital Registration Project]) which developed standard methods to collect information on the management of patients with such a condition and their characteristics. The variability results among hospitals in myocardial infarction management and in one-year mortality are presented. A cohort study with a one-year follow-up was designed to register all patients diagnosed with acute myocardial infarction discharged from 24 Spanish hospitals that completed all the requisites to participate. The demographic and clinical characteristics of the patients, their management during the coronary care unit stage, and the outcome and complications were prospectively registered. Standard definitions for diagnosis were used. Confidentiality regarding patient identity and participating centers was guaranteed. 5,242 (77.6%) of the 6,756 patients with myocardial infarction admitted in the 24 participating hospitals were registered in the coronary care units. Half of the centers had an on-site hemodynamic laboratory and in seven coronary surgery. The delay between symptom-onset and emergency room admission was 2 hours. Acute pulmonary edema or cardiogenic shock was developed by 16.6% of patients and 41.8% received thrombolysis. Mean time delay between symptom-onset and thrombolysis was 3 hours. A large variability in the use of beta-blockers, thrombolysis, echocardiography, coronary catheterization angiography and invasive revascularization was observed among hospitals. Mortality in the coronary care unit was 10.9% and increased to 14.0% at 28 days and to 18.5% at one year with considerable variation among hospitals. Four hospitals showed higher mortality among their patients, independently from the proportion of diabetes, hypertension, women, anterior location of myocardial

  4. EFFECT OF LONG TERM INTAKE OF WHITE TEA ON ACUTE OXIDATIVE STRESS IN RATS.

    PubMed

    Espinosa, Cristóbal; González-Silvera, Daniel; Pérez-Llamas, Francisca; López-Jiménez, José Ángel; Zamora, Salvador

    2015-08-01

    Introducción: las propiedades antioxidantes del té son ampliamente conocidas, entre las que se incluyen la prevención del cáncer, diversas enfermedades neurodegenerativas y otras patologías relacionadas con el estrés oxidativo. Por otro lado, la adriamicina es un agente antitumoral que tiene la capacidad de generar estrés oxidativo in vivo. Objetivo: valorar el efecto de la ingesta de té blanco a largo plazo sobre la capacidad antioxidante plasmática y el perfil de ácidos grasos de microsomas de hígado y corazón en animales sometidos a estrés oxidativo agudo. Métodos: se dispuso de ratas a las que se les administró diferentes dosis de té blanco: 0,15 y 45 mg de extracto sólido de té/kg de peso corporal durante 12 meses. Tras este periodo de tratamiento con té blanco, todos los animales recibieron una inyección intraperitoneal de adriamicina (ADR), 10 mg/kg de peso corporal, excepto la mitad del grupo control, que recibieron una inyección de solución salina. Fueron obtenidas muestras de sangre, corazón e hígado. Se analizó la capacidad antioxidante total y se realizaron análisis de oxidación proteica y lipídica en plasma. Además, se obtuvo la fase microsomal de hígado y corazón. Resultado y discusión: se observó una fuerte oxidación lipídica en plasma y una recuperación en los animales tratados con las diferentes dosis de té. La actividad antioxidante y la oxidación proteica, aunque relevantes, solo muestran una ligera tendencia a recuperarse con el tratamiento con té. En cuanto al perfil de ácidos grasos, solamente se observan ligeras tendencias en el porcentaje de ácidos grasos saturados, monoinsaturados y poliinsaturados.

  5. [Evolution of contrast nephropathy in patients with chronic kidney disease undergoing a percutaneous coronary intervention].

    PubMed

    López-López, Bibiana; Pérez-López, María Juana; García-Rincón, Andrés; Vázquez-Vega, Benjamín

    2015-01-01

    Introducción: la transición epidemiológica de enfermedades infecciosas a enfermedades crónicodegenerativas está demandando mayor número de procedimientos que requieren medio de contraste, lo cual resulta ser un factor de riesgo para daño renal agudo de importancia en pacientes con enfermedad renal crónica, patología frecuente en pacientes con enfermedades crónicodegenerativas. El objetivo de este artículo es describir la frecuencia y evolución de nefropatía por medio de contraste en pacientes ambulatorios con enfermedad renal crónica sometidos a intervención coronaria percutánea. Métodos: se incluyeron 32 pacientes con daño renal al momento de su exposición al medio de contraste. Se les dio un riesgo y se les ajustaron las medidas de prevención con seguimiento a las 48 horas. El análisis estadístico se realizó con estadística descriptiva. Resultados: de 1236 cateterismos cardiacos realizados, 32 pacientes cumplieron los criterios de inclusión. El 78.13 % fueron hombres y el 21.88 % mujeres. El 96.87 % presentó enfermedades crónico-degenerativas como diabetes o hipertensión, el sobrepeso y la obesidad fueron una constante en el 65.62 % de los casos, en el 21.7 % de los pacientes la dosis de contraste fue ligeramente mayor a la recomendada. El 6.3 % desarrollaron nefropatía por medio de contraste a pesar de las medidas de prevención, sin embargo ninguno de ellos requirió sustitución de la función renal. Conclusiones: la frecuencia de nefropatía por medio de contraste en pacientes con factores de alto riesgo fue menor a la reportada en la literatura, en todos los casos se realizó valoración nefrológica y manejo previo al procedimiento.

  6. Direct observations of the role of solution composition in magnesite dissolution

    NASA Astrophysics Data System (ADS)

    King, H. E.; Putnis, C. V.

    2012-04-01

    Magnesite, MgCO3, occurs in association with the alteration of ultramafic rocks and serpentine during metamorphic and metasomatic events. Its formation from the carbonation of olivine is an indication of natural CO2 sequestration. Both magnesite dissolution and precipitation are controlled by the strongly hydrated nature of the Mg2+ ion in solution. Flow-through experiments have shown that increased dissolution results from an increase in ionic strength of the solution (Pokrovsky and Schott, 1999). To test whether this observation is related to changes in Mg hydration, we have compared the dissolution of the {1014} magnesite surface in solutions of different electrolytes (NaCl, NaNO3 and Na2SO4) using atomic force microscopy (AFM). As the dissolution of magnesite is slow at ambient conditions, experimental solutions (water, 10, 100 and 500 mM) were acidified (pH 2). In all electrolyte solutions, dissolution of the magnesite surface began by the nucleation of randomly spaced etch pits followed by the sudden nucleation of many pits across the entire surface. Coalescence of etch pits produced islands of remnant surface which then dissolved until a single layer was removed and a new flat surface generated. The process was then repeated via the further nucleation of random etch pits one unit cell deep ( 0.3 nm). Dissolution rates were obtained from the frequency of this dissolution cycle using measurements of surface roughness and etch pit spreading rates. The reactivity of magnesite in the presence of added ions varied in the order Na2SO4 < NaCl < NaNO3. Increased dissolution rates in the presence of NO3 compared to Cl is consistent with changes in Mg hydration (Ruiz-Agudo et al., 2010). However, although the ionic strength of the equivalent Na2SO4 concentrations was higher than that of NaCl (expected to increase magnesite dissolution), we observed a decrease in dissolution. The effect of sulfate is most likely dependent on the formation of Mg-SO4 contact ion pairs

  7. The effect of water structure and solute hydration on the kinetics of mineral growth and dissolution (Arne Richter Award for Outstanding Young Scientists)

    NASA Astrophysics Data System (ADS)

    Ruiz-Agudo, E.; Putnis, C. V.; Putnis, A.

    2012-04-01

    Classical crystal growth theory relates growth and dissolution rates to the degree of supersaturation. However, the solution composition may also affect the growth rate of carbonate minerals, via the Ca2+ to CO32- concentration ratio (e.g. Perdikouri et al., 2009; Stack and Grantham, 2010), ionic strength (e.g. Ruiz-Agudo et al. 2010) or the presence of organic matter (Hoch et al., 2000). For this reason, the influence of these parameters on the kinetics of mineral growth and dissolution has generated a considerable amount of research in the last decade. In particular, effects of both inorganic and organic impurities on mineral growth and dissolution have been frequently reported in the literature. Commonly, water in contact with rock forming minerals, contains significant and variable amounts of ions in solution. The effect of such ions on dissolution and growth rates has been traditionally ascribed to changes in solubility. However, experimental studies performed on different minerals have shown that the dependence of growth or dissolution rates on ionic strength is complex, and that the effect of ionic strength is not independent of the ionic species producing it. Here, we report investigations aimed at addressing the basic hypothesis that mineral growth and dissolution is governed by complex interactions between solvent structure, surface hydration and the ion solvation environment induced by the presence of electrolytes. It is proposed that any factor affecting ion solvation should alter growth and dissolution rates. These results have opened the possibility of a new understanding of very diverse phenomena in geochemistry and demonstrate the need for the inclusion of this "hydration effect" in the development of predictive models that describe crystal growth and dissolution in complex systems, such as those found in nature. Furthermore, we can hypothesise that ion-assisted dehydration of trace and minor element ions could occur in biological systems, thus

  8. [Assessment of pulmonary complications in renal transplantation through the use of radiography].

    PubMed

    Ramírez-García, Laura Elena; Juárez-Hernández, Fortunato; Tanus-Hajj, Janet; Avelar-Garnica, Francisco José

    2016-01-01

    Introducción: las infecciones del tracto respiratorio inferior son la complicación más frecuente en pacientes trasplantados de riñón en los primeros seis meses y están asociadas a alta mortalidad. Otras complicaciones pulmonares incluyen edema, embolia y hemorragia pulmonar. Se buscó evaluar las complicaciones pulmonares en los pacientes trasplantados de riñón utilizando la radiografía de tórax. Métodos: se analizaron 516 radiografías de tórax de 150 pacientes que recibieron trasplante renal en el 2014. Las radiografías se tomaron en la valoración preoperatoria, postoperatoria dentro de las 48 horas posteriores, 3 a 7, 8 a 15, 16 a 30, 31 a 90, 91 a 180 y más de 180 días. Para el estudio del parénquima pulmonar se dividió el tórax en cuatro cuadrantes asignando un valor de 1 a cada patrón radiográfico que se encontrara: reticulonodular o de ocupación alveolar, lobar o segmentario, atelectasia y vidrio deslustrado; el parénquima pulmonar obtuvo un valor mínimo de 0 y un mayor de 16 puntos. También se evaluó género, edad, comorbilidad asociada y tipo de trasplante renal. Resultados: se obtuvo la información de un total de 150 pacientes; 19 presentaron complicaciones pulmonares en las primeras 24-48 horas y 15 entre los 90 y los 180 días posteriores al trasplante renal. Las complicaciones más frecuentes fueron edema agudo pulmonar en la etapa temprana e infecciones en la etapa tardía. Conclusión: la prevalencia de complicaciones diagnosticadas por radiografía de tórax fue baja y se observó más en la etapa temprana y tardía.

  9. The Cenozoic stress/deformation field of the Donets coal basin and Northern Azov region and its probable sources

    NASA Astrophysics Data System (ADS)

    Kopp, M.; Korchemagin, V.; Kolesnichenko, A.

    2009-04-01

    ) point to its association with the powerful Late Alpine orogenesis of the adjacent Caucasus. This is also confirmed by an essential role of right-lateral shear which was established during our mesotectonic study (this is also characteristic of the western Greater Caucasus and Scythian platform). According to our data, the strike-slip components of the Severo-Donetskij and Persianovskij reverse faults are fixed in localisation of the quadrangles of compression and extension at the ends of the faults. This, applied to the both borders of the Donbass, right-lateral wrench shear caused a Z-shaped sygmoidal bend of axis of the Donets-Northern Azov neotectonic swell. A common limb of the sygmoid - the Volnovakha neotectonic megaanticline of the thansverse NE-SW strike - formed under NW-SE compression which compensated the general right-lateral shear. On the contrary, a stress source of the Laramic compression may be located somewhere in the west and/or north of the Donbass. It was most likely caused by the known Laramic acivization and compression of the European aulacogens resulted from collisional stresses in the Alps and Dinarides, with the simoultaneous southward spreading pressure in the Northern Atlantic and Arctic started in the Paleocene. The study was supported by the Division of Earth Sciences of the Russian Academy of Sciences (program no. 6 of fundamental investigations).

  10. [Not Available].

    PubMed

    De Abajo Larriba, Ana Beatriz; Díaz Rodríguez, Ángel; González-Gallego, Javier; Méndez Rodríguez, Enrique; Álvarez Álvarez, María Jesús; Capón Álvarez, Jessica; Peleteiro Cobo, Beatriz; Mahmoud Atoui, Omar; De Abajo Olea, Serafín; Martínez de Mandojana Hernández, Juan

    2016-07-19

    Introducción: estimar la prevalencia del tabaquismo y analizar cómo se diagnostican y se trata a los fumadores diagnosticados de EPOC.Métodos: estudio epidemiológico, transversal, multicéntrico (30 centros salud de la provincia de León). Incluyó pacientes mayores de 35 años diagnosticados y tratados de EPOC. Variables analizadas: edad, sexo, hábitat, datos antropométricos, tabaquismo, número de paquetes/año, cooximetría, dependencia (escala analógico-visual), motivación (test de Fagerström), autoeficacia, estado anímico, intentos previos, terapia cognitivo-conductual, tratamiento farmacológico (TSN, bupropión, vareniclina) y recaídas. Los resultados se expresan con sus IC al 95,5%.Resultados: se incluyó a 833 pacientes, el 85,8% varones, edad media: 64,69 (53,66-75,61) años y 20,65 (4,47-36,8) años de evolución de la EPOC. El 86,67% (80,30-93,30) tenían antecedentes de tabaquismo (n = 722), de 35,26 (17,87-52,64) años de evolución, con consumo medio 28,36 (9,60-46,86) paquetes año, p < 0,001, siendo el 58% fumadores severos. El 57,4% (53,90-60,60) son exfumadores. El 29,3% (26,40-32,70) fumadores activos declarados vs. 35,11% (33,90-37,12) fumadores diagnosticados por cooximetría p < 0,05. Los 288 fumadores activos, presentaban baja motivación (49,80%), alta dependencia (49,5%), actitud negativa (52,60%), bajo estado de ánimo (32,05%), con 2,72 (1,74-3,67) intentos para dejar de fumar, p < 0,0001. La terapia conductivo-conductual (TCC) combinado con tratamiento farmacológico se realizó en el 55,8% (52,2-54,9), p < 0,05; La intervención más efectiva fue TCC combinada con vareniclina logrando una abstinencia del 29,86%. En total dejaron de fumar un 51,05% (49,49-52,70) de los pacientes con EPOC, p < 0,001.Conclusiones: la prevalencia de tabaquismo en la EPOC en nuestro medio continúa siendo inadmisiblemente elevada. Es necesaria una mayor implicación para disminuir su impacto en la salud de estos pacientes.

  11. [Use of glutamine in total parenteral nutrition of bone marrow transplant patients].

    PubMed

    Herrera-Martínez, Aura Dulcinea; Alhambra Expósito, María R; Manzano García, Gregorio; Molina Puertas, María J; Calañas Continente, Alfonso; Bahamondez Opazo, Rodrigo; Muñoz Jiménez, Concepción; Rojas Contreras, Rafael; Gálvez Moreno, María A

    2015-04-01

    La glutamina es un amioácido esencial para la síntesis de nucleótidos y una fuente de energía para la replicación celular, existe evidencia contradictoria respecto a los beneficios de su administración como parte de la nutrición parenteral en pacientes sometidos a trasplante de médula ósea (TMO). Más del 75% de los pacientes sometidos a trasplante de precursores hematopoyéticos, presentan durante su evolución complicaciones que comprometen el tracto digestivo, principalmente mucositis, limitando la ingesta oral, de allí la necesidad del uso de nutrición parenteral total (NPT) en estos casos. Objetivo: Analizar la relación entre uso de glutamina en la NPT de TMO y la evolución de complicaciones agudas como mucositis, EICH e infecciones, así como la estancia hospitalaria y los días de nutrición parenteral total. Material y métodos: Estudio observacional retrospectivo. Se incluyeron la totalidad de TMO con NPT entre 2007 y 2013 en nuestro hospital. Se analizaron días de hospitalización, días de soporte nutricional, uso de glutamina y complicaciones agudas. Los resultados se analizaron con el programa SPSS 15.0. Resultados: Se incluyeron 73 pacientes trasplantados, se dividieron en dos grupos según el aporte de glutamina siendo ambos grupos comparables entre sí. La edad media fue de 36,96±12,89 años. El 47,9% de los pacientes estudiados recibió suplemento de glutamina en la NPT. Los pacientes que recibieron glutamina tuvieron una estancia media de 31,49±7,41 días con 14,11±5,87 días de NPT en comparación a los que no recibieron glutamina con 32,16±7,99 y 15,50±7,71 días respectivamente (p=0,71 y 0,39). La duración de la mucositis en los pacientes que recibieron glutamina fue de 12,23±5,66 días comparado con 15,50±7,71 días en los que no recibieron glutamina (p=0,042).Se observaron grados severos de EICH (II, III) en un 20,6% de los pacientes sin glutamina en comparación al 13,7% en los que la recibieron (p=0,636). . Del total

  12. Variabilidad de la Estación de Crecimiento en la Región Sur de Tamaulipas en condiciones climaticas actuales y futuras.

    NASA Astrophysics Data System (ADS)

    Medina-Barrios, M.; Conde-Alvarez, C.; Gay-Garcia, C.

    2007-05-01

    El impacto de la variabilidad y cambio climáticos, afectan el potencial agrícola de la Región Sur de Tamaulipas. Además de los cambios estacionales, bajos rendimientos agrícolas, el manejo de los cultivos y las políticas locales de producción, existe la incertidumbre del mercado regional para los pequeños y grandes productores. La diversificación agrícola ha sido una alternativa para enfrentar las condiciones imperantes en esta región. Pero ésta ha provocado la fragmentación territorial, por lo que sólo algunos productores logran competir en un mercado nacional. Existe una preocupación generalizada por buscar soluciones que permitan que la población que es afectada por la inseguridad de la producción agrícola y económica, pueda adaptarse a las variaciones climáticas que afectan el proceso productivo. La seguridad alimentaría queda sujeta a la fluctuación de las importaciones para los sectores básicos y a las estrategias mercantiles de empresas trasnacionales. La percepción local sugiere un número creciente de eventos climatológicos extremos, constantes y severos en los últimos 20 años, con el aumento creciente de pérdidas económicas. El análisis se centra en la disponibilidad de agua, agregándose un aspecto de capital importancia como es la variabilidad interanual de la lluvia, que condiciona muy fuertemente el riesgo agrícola en el trópico seco, siendo ésta la que determina el momento de inicio de la estación favorable para el crecimiento y su duración. En este trabajo se han obtenido modelos de la distribución espacial de la precipitación y temperaturas, para el escenario base 1961-1990, el escenario actual 1971-2000, para algunos años El Niño y La Niña, así como para los escenarios de Cambio Climático HADLEY, ECHAM y GFDL, con escenarios A2 y B2, para las décadas de los 20s y 50s, para establecer el inicio y duración de la Estación de Crecimiento, utilizando Sistemas de Información Geográfica (ArcView). Estos

  13. Quaternary glacial geomorphosites from the Cantabrian Mountains (northern Iberian Peninsula): the Redes Natural Reservation and Picos de Europa Regional Park

    NASA Astrophysics Data System (ADS)

    Rodríguez-Rodríguez, Laura; Jiménez-Sánchez, Montserrat; José Domínguez-Cuesta, María

    2013-04-01

    the Quaternary glaciations, especially after the last local glacial maximum. Jiménez-Sánchez, M., Rodríguez-Rodríguez, L., García-Ruiz, J.M., Domínguez-Cuesta, M.J., Farias, P., Valero-Garcés, B., Moreno, A., Rico, M., Valcárcel, M., in press. A review of glacial geomorphology and chronology in northern Spain: timing and regional variability during the last glacial cycle. Geomorphology, doi: 10.1016/j.geomorph.2012.06.009. Serrano, E., González-Trueba, J.J., Pellitero, R., González-García, M., Gómez-Lende, M., in press. Quaternary glacial evolution in the Central Cantabrian Mountains (Northern Spain). Geomorphology, doi:10.1016/j.geomorph.2012.05.001. Research funded by the project CANDELA (CGL2012-31938) of the Spanish national research program in Earth Sciences and Hydric Resources (MICINN) and the project FC-11-PC-10-14 (FICYT-Asturias). L. Rodríguez-Rodríguez has developed her research under a grant of the Severo Ochoa Program (FICYT- Asturias).

  14. Como Lo Hago Yo: Mielomeningocele En Bolivia

    PubMed Central

    Dabdoub, Carlos F.; Dabdoub, Carlos B.; Villavicencio, Ramiro; Quevedo, Germán

    2014-01-01

    Introducción: Las malformaciones del tubo neural (MTN) representan la segunda causa más frecuente de anomalías congénitas, luego de las cardiopatías. En este grupo se destaca el mielomeningocele (MMC) por su mayor incidencia, y por ser la más incapacitante y la más compleja entre todas las demás malformaciones del sistema nervioso c`entral (SNC). En Bolivia, como en muchos países de Sudamérica, los bajos niveles socio-culturales y la debilidad en el sistema sanitario, hacen que su incidencia y su morbilidad, sean mayores que en las naciones más desarrolladas. Material y Métodos: Se realizó un estudio retrospectivo y descriptivo de 70 casos de MMC, atendidos por un equipo multidisciplinario en el Hospital Universitario Japonés (HUJ) de Santa Cruz de la Sierra, entre 2008-2011. De ellos, 60 fueron intervenidos quirúrgicamente. Resultados: Se realizaron controles prenatales sólo en 27 mujeres (38.6%), diagnosticándose una disrafia espinal en apenas dos casos (7.4%). La edad de ingreso del MMC en su mayoría fue después de las 24 horas (65.6%), predominando su localización en la región lumbosacra (64.3%). De ellos, 67.2% eran abiertos, presentando un 32.9% un daño neurológico motor parcial mientras que 47.1% tenían paraplejia por debajo de la lesión. De los 70 casos, tres (4.3%) no fueron intervenidos, por presentar defectos congénitos severos o estado general grave. Las principales complicaciones posoperatorias inmediatas fueron: dehiscencia de sutura y/o infección de la herida (16.6%), fístula de líquido cefalorraquídeo (LCR) (10%) e infección del SNC (11.7%). La mortalidad general y postoperatoria fue de 7.1% y 3.3%, respectivamente. Al mes de vida presentaban hidrocefalia un 80% de los pacientes operados, colocándose una derivación ventriculoperitoneal (DVP) de presión media. De 9 pacientes que tuvieron un acompanamiento de dos o más años, seis presentaron una médula anclada, que fueron intervenidas quirúrgicamente. Conclusi

  15. Geothermal resources and energy complex use in Russia

    NASA Astrophysics Data System (ADS)

    Svalova, V.

    2009-04-01

    Geothermal energy use is the perspective way to clean sustainable development of the world. Russia has rich high and low temperature geothermal resources and makes good steps in their use. In Russia the geothermal resources are used predominantly for heat supply both heating of several cities and settlements on Northern Caucasus and Kamchatka with a total number of the population 500000. Besides in some regions of country the deep heat is used for greenhouses of common area 465000 m2. Most active the hydrothermal resources are used in Krasnodar territory, Dagestan and on Kamchatka. The approximately half of extracted resources is applied for heat supply of habitation and industrial puttings, third - to a heating of greenhouses, and about 13 % - for industrial processes. Besides the thermal waters are used approximately on 150 health resorts and 40 factories on bottling mineral water. The most perspective direction of usage of low temperature geothermal resources is the use of heat pumps. This way is optimal for many regions of Russia - in its European part, on Ural and others. The electricity is generated by some geothermal power plants (GeoPP) only in the Kamchatka Peninsula and Kuril Islands. At present three stations work in Kamchatka: Pauzhetka GeoPP (11MW e installed capacity) and two Severo-Mutnovka GeoPP ( 12 and 50 MWe). Moreover, another GeoPP of 100 MVe is now under preparation in the same place. Two small GeoPP are in operation in Kuril's Kunashir Isl, and Iturup Isl, with installed capacity of 2,б MWe and 6 MWe respectively. There are two possible uses of geothermal resources depending on structure and properties of thermal waters: heat/power and mineral extraction. The heat/power direction is preferable for low mineralized waters when valuable components in industrial concentration are absent, and the general mineralization does not interfere with normal operation of system. When high potential geothermal waters are characterized by the high

  16. Inter-comparison of hydrological model simulations with dense time series of SAR-derived soil moisture maps

    NASA Astrophysics Data System (ADS)

    Iacobellis, V.; Gioia, A.; Milella, P.; Satalino, G.; Balenzano, A.; Mattia, F.

    2012-04-01

    Over the last years, a vast number of experimental and theoretical studies has widely demonstrated the sensitivity of SAR data to soil moisture content, however, operational services integrating SAR measurements into land process models are not yet available. Important progresses in this field are expected, on the one hand, from SAR missions characterized by a short revisiting time, such as the COSMO-SkyMed or the forthcoming Sentinel-1 and ALOS-2 missions, on the other hand, from a strong effort in implementing hydrological models able to reproduce the dynamic of soil moisture content of the top layer (5 cm depth) of soil. With this latter purpose, we used the DREAM model [Manfreda et al., 2005], realized in a GIS-based approach, that explicitly takes into account the spatial heterogeneity of hydrological processes. The DREAM model carries out continuous hydrological simulations using the daily and the hourly scales. The distinctive feature of the model, which consists of evaluating the lateral flow through a water content redistribution weighted by the topographic index, was preserved. The latter provided the basis for the nested implementation of the Richard equation which has been used for evaluating vertical flows in the top soil layer (5cm).The Richard routine exploits the numerical solution proposed by Simunek et al. [2009] and runs, for each cell of the river basin, in a sub-module of 60 minutes with a vertical (i.e. depth) and temporal resolution of 1 cm and 1 s, respectively. The model was applied to the portion of the Celone at Foggia San Severo river basin downstream the San Giusto Dam, which is a tributary of the Candelaro river, in Puglia region (Southern Italy). Over this area quasi-dense time series of ALOS/PALSAR ScanSAR WB1 and COSMO-SkyMedStripMap images were acquired in 2007 and 2010, respectively. The SAR data have been used to derive time-series of soil moisture maps by means of the SMOSAR software developed for Sentinel-1 data [Balenzano et

  17. Myosin-binding Protein C Compound Heterozygous Variant Effect on the Phenotypic Expression of Hypertrophic Cardiomyopathy.

    PubMed

    Rafael, Julianny Freitas; Cruz, Fernando Eugênio Dos Santos; Carvalho, Antônio Carlos Campos de; Gottlieb, Ilan; Cazelli, José Guilherme; Siciliano, Ana Paula; Dias, Glauber Monteiro

    2017-04-01

    submetida à investigação clínica e genética. As regiões codificadoras dos genes MYH7, MYBPC3 e TNNT2 foram sequenciadas e analisadas. O probando apresenta uma manifestação maligna da doença e é o único em sua família a desenvolver CMH. A análise genética pelo sequenciamento direto dos três principais genes relacionados à essa doença identificou uma variante em heterozigose composta (p.E542Q e p.D610H) em MYBPC3. A análise da família mostrou que os alelos p.E542Q e p.D610H tem origem paterna e materna, respectivamente. Nenhum familiar portador de um dos alelos variantes manifestou sinais clínicos de CMH. Sugerimos que a expressão heterozigótica bialélica de p.E542Q e p.D610H pode ser responsável pelo fenótipo severo da doença encontrada no probando.

  18. New exposure ages for the Last Glacial Cycle in the Sanabria Lake region (northwestern Spain)

    NASA Astrophysics Data System (ADS)

    Rodríguez-Rodríguez, Laura; Jiménez-Sánchez, Montserrat; Domínguez-Cuesta, María Jose; Rinterknecht, Vincent; Pallàs, Raimon; Braucher, Régis; Bourlès, Didier; Valero-Garcés, Blas

    2013-04-01

    ., 2011. Last deglaciation in northwestern Spain: New chronological and geomorphologic evidence from the Sanabria region. Geomorphology 135, 48-65. Palacios, D., Andrés, N., Úbeda, J., Alcalá, J., Marcos, J., Vázquez-Selem, L., 2012. The importance of poligenic moraines in the paleoclimatic interpretation from cosmogenic dating. Geophysical Research Abstracts 14, EGU2012-3759-1. Pérez-Alberti, A., Valcárcel-Díaz, M., Martini, I.P., Pascucci, V., Andrucci, S., 2011. Upper Pleistocene glacial valley-junction sediments at Pias, Trevinca Mountains, NW Spain. In: Martini, I.P., French, H.M., Pérez-Alberti, A. (Eds.), Ice-Marginal and Periglacial Processes and Sediments. Geological Society (London) Special Publication 354, pp. 93-110. Research funded by the projects LIMNOCLIBER (REN2003-09130-C02-02), IBERLIMNO (CGL2005-20236-E/CLI), LIMNOCAL (CGL2006-13327-C04-01) and GRACCIE (CSD2007-00067) of the Spanish Inter-Ministry Commission of Science and Technology (CICYT). Additional funding was provided by the Fundación Patrimonio Natural de Castilla y León through the project "La investigacion en el Lago de Sanabria dentro del proyecto CALIBRE: perspectivas y posibilidades", and by the projects Consolider Ingenio 2006 (CSD2006-0041, Topo-Iberia), 2003 PIRA 00256, HF02.4, and RISKNAT (2009SGR520). L. Rodríguez-Rodríguez has developed her research under a Severo Ochoa Programme fellowship (FICYT- Asturias).

  19. USGS research on geohazards of the North Pacific: past, present, and future

    NASA Astrophysics Data System (ADS)

    McNutt, M. K.; Eichelberger, J. C.

    2012-12-01

    The disastrous earthquakes and tsunamis of Sumatra in 2004 and Tohoku in 2011 have driven re-examination of where and how such events occur. Particular focus is on the North Pacific. Of the top 30 earthquakes recorded instrumentally worldwide, 50% occurred along the line of subduction from the Kuril Islands to the southern Alaska mainland. This region has seen monstrous volcanic eruptions (Katmai-Novarupta, 1912), destructive tsunamis (Severo-Kurilsk, 1952), and one of Earth's largest instrumentally-recorded earthquakes (M9.2 Alaska, 1964). Only the modest populations in these frontier towns half a century ago kept losses to a minimum. Impact of any natural disaster to population, vital infrastructure, and sea and air transportation would be magnified today. While USGS had a presence in Alaska for more than a century, the great Alaska earthquake of 1964 ushered in the first understanding of the area's risks. This was the first mega-thrust earthquake properly interpreted as such, and led to re-examination of the 1960 Chilean event. All modern conceptions of mega-thrust earthquakes and tsunamis derive some heritage from USGS research following the 1964 event. The discovery of oil in the Alaska Arctic prompted building a pipeline from the north slope of Alaska to the ice-free port of Valdez. The USGS identified risks from crossing permafrost and active faults. Accurate characterization of these hazards informed innovative designs that kept the pipeline from rupturing due to ground instability or during the M7.9 Denali earthquake of 2002. As a large state with few roads, air travel is common in Alaska. The frequent ash eruptions of volcanoes in the populous Cook Inlet basin became a serious issue, highlighted by the near-crash of a large passenger jet in 1989. In response, the USGS and its partners developed and deployed efficient seismic networks on remote volcanoes and initiated regular satellite surveillance for early warning of ash eruptions. Close collaboration

  20. Factors associated with mortality in patients undergoing coronary artery bypass grafting.

    PubMed

    Koerich, Cintia; Lanzoni, Gabriela Marcellino de Melo; Erdmann, Alacoque Lorenzini

    2016-08-08

    idade de 65 anos. O infarto agudo do miocárdio foi o diagnóstico de internação que apresentou maior representatividade. A maioria das intercorrências registradas durante a internação caracterizou-se por alterações do sistema cardiovascular e o maior tempo de internação teve relação direta com óbito por choque séptico. os dados fornecem subsídios para a enfermagem atuar com medidas preventivas e identificação precoce de intercorrências associadas à cirurgia de revascularização do miocárdio. Reforça-se a importância da utilização dos dados como indicadores de qualidade objetivando garantir um cuidado pautado em informações confiáveis que orientem gestores no planejamento da assistência ao paciente e dos serviços de saúde de alta complexidade. conocer los factores asociados a la mortalidad de pacientes sometidos a cirugía de revascularización del miocardio en un hospital de referencia cardiovascular en el estado de Santa Catarina. estudio cuantitativo, exploratorio, descriptivo y retrospectivo. Fueron analizados las fichas médicas de 1.447 pacientes, entre 2005 y 2013; las variables relacionadas estadísticamente fueron: perfil, diagnóstico de la internación, factores de riesgo para enfermedad arterial coronariana, complicaciones registradas en la internación, tiempo de internación y causa de la muerte. la tasa de mortalidad fue de 5,3%, en el período del estudio. Las muertes fueron más frecuentes en negros, sexo femenino y promedio de edad de 65 años. El infarto agudo del miocardio fue el diagnóstico de internación que presentó mayor representatividad. La mayoría de las complicaciones registradas durante la internación se caracterizó por alteraciones del sistema cardiovascular; el mayor tiempo de internación tuvo relación directa con muerte por choque séptico. los datos suministran informaciones para que la enfermería pueda actuar con medidas preventivas e identificar precozmente complicaciones asociadas a la cirug

  1. Physical Stress Echocardiography: Prediction of Mortality and Cardiac Events in Patients with Exercise Test showing Ischemia.

    PubMed

    Araujo, Ana Carla Pereira de; Santos, Bruno F de Oliveira; Calasans, Flavia Ricci; Pinto, Ibraim M Francisco; Oliveira, Daniel Pio de; Melo, Luiza Dantas; Andrade, Stephanie Macedo; Tavares, Irlaneide da Silva; Sousa, Antonio Carlos Sobral; Oliveira, Joselina Luzia Menezes

    2014-11-01

    ísico na doença arterial coronária, mas a predição de mortalidade e de eventos cardíacos maiores, em pacientes com teste ergométrico positivo para isquemia miocárdica, é limitada. Objetivo: Avaliar a predição de mortalidade e de eventos cardíacos maiores pela ecocardiografia com estresse físico em pacientes com teste ergométrico positivo para isquemia miocárdica. Métodos: Trata-se de uma coorte retrospectiva em que foram estudados 866 pacientes consecutivos, com teste ergométrico positivo para isquemia miocárdica, submetidos à ecocardiografia com estresse físico. Os pacientes foram divididos em dois grupos: ecocardiografia com estresse físico negativa (G1) ou positiva (G2) para isquemia miocárdica. Os desfechos avaliados foram mortalidade por qualquer causa e eventos cardíacos maiores, definidos como óbito cardíaco e infarto agudo do miocárdio não fatal. Resultados: O G2 constituiu-se de 205 (23,7%) pacientes. Durante o seguimento médio de 85,6 ± 15,0 meses, ocorreram 26 óbitos, sendo seis por causa cardíaca, e 25 casos de infarto agudo do miocárdio não fatais. Os preditores independentes de mortalidade foram idade, diabetes melito e a ecocardiografia com estresse físico + (hazard ratio: 2,69; intervalo de confiança de 95%: 1,20 - 6,01; p = 0,016), com os seguintes eventos cardíacos maiores: idade, doença arterial coronária prévia, ecocardiografia com estresse físico + (hazard ratio: 2,75; intervalo de confiança de 95%: 1,15 - 6,53; p = 0,022) e ausência do incremento de 10% na fração de ejeção. A mortalidade por qualquer causa e os eventos cardíacos maiores foram significativamente superiores no G2 (p < 0, 001 e p = 0,001, respectivamente). Conclusão: A ecocardiografia com estresse físico oferece informações prognósticas adicionais em pacientes com teste ergométrico positivo para isquemia miocárdica.

  2. Acute effects of intradialytic aerobic exercise on solute removal, blood gases and oxidative stress in patients with chronic kidney disease.

    PubMed

    Böhm, Joseane; Monteiro, Mariane Borba; Andrade, Francini Porcher; Veronese, Francisco; Thomé, Fernando Saldanha

    2017-04-27

    Hemodialysis contributes to increased oxidative stress and induces transitory hypoxemia. Compartmentalization decreases the supply of solutes to the dialyzer during treatment. The aim of this study was to investigate the acute effects of intradialytic aerobic exercise on solute removal, blood gases and oxidative stress in patients with chronic kidney disease during a single hemodialysis session. Thirty patients were randomized to perform aerobic exercise with cycle ergometer for lower limbs during 30 minutes with intensity between 60-70% of maximal heart rate, or control group (CG). Blood samples were collected prior to and immediately after exercise or the equivalent time in CG. Analysis of blood and dialysate biochemistry as well as blood gases were performed. Mass removal and solute clearance were calculated. Oxidative stress was determined by lipid peroxidation and by the total antioxidant capacity. Serum concentrations of solutes increased with exercise, but only phosphorus showed a significant elevation (p = 0.035). There were no significant changes in solute removal and in the acid-base balance. Both oxygen partial pressure and saturation increased with exercise (p = 0.035 and p = 0.024, respectivelly), which did not occur in the CG. The total antioxidant capacity decreased significantly (p = 0.027). The acute intradialytic aerobic exercise increased phosphorus serum concentration and decreased total antioxidant capacity, reversing hypoxemia resulting from hemodialysis. The intradialytic exercise did not change the blood acid-base balance and the removal of solutes. A hemodiálise contribui para aumentar o estresse oxidativo e induz a hipoxemia transitória. A compartimentalização dos solutos diminui sua oferta para o dialisador durante o tratamento. O objetivo deste estudo foi investigar os efeitos agudos do exercício aeróbio intradialítico sobre a remoção de solutos, gasometria e estresse oxidativo em pacientes com doença renal crônica durante uma

  3. Effect of maternal exercises on biophysical fetal and maternal parameters: a transversal study.

    PubMed

    Santos, Caroline Mombaque Dos; Santos, Wendel Mombaque Dos; Gallarreta, Francisco Maximiliano Pancich; Pigatto, Camila; Portela, Luiz Osório Cruz; Morais, Edson Nunes de

    2016-01-01

    To evaluate the acute effects of maternal and fetal hemodynamic responses in pregnant women submitted to fetal Doppler and an aerobic physical exercise test according to the degree of effort during the activity and the impact on the well-being. Transversal study with low risk pregnant women, obtained by convenience sample with gestational age between 26 to 34 weeks. The participants carry out a progressive exercise test. After the exercise session, reduced resistance (p=0.02) and pulsatility indices (p=0.01) were identified in the umbilical artery; however, other Doppler parameters analyzed, in addition to cardiotocography and fetal biophysical profile did not achieve significant change. Maternal parameters obtained linear growth with activity, but it was not possible to establish a standard with the Borg scale, and oxygen saturation remained stable. A short submaximal exercise had little effect on placental blood flow after exercise in pregnancies without complications, corroborating that healthy fetus maintains homeostasis even in situations that alter maternal hemodynamics. Avaliar os efeitos agudos de respostas hemodinâmicas maternas e fetais em gestantes submetidas a Doppler fetal e a um teste de exercício físico aeróbio, de acordo com o grau de esforço durante a atividade e o impacto sobre o bem-estar. Estudo transversal desenvolvido com gestantes de baixo risco, por amostra de conveniência com idade gestacional entre 26 e 34 semanas. As participantes realizam um teste de esforço progressivo. Na artéria umbilical, após sessão de exercício físico, identificou-se a redução do índice de resistência (p=0,02) e do índice de pulsatilidade (p=0,01), mas os demais parâmetros Doppler analisados, além da cardiotocografia e do perfil biofísico fetal, não obtiveram alteração significativa. Os parâmetros maternos obtiveram crescimento linear com a atividade, mas não foi possível estabelecer padrão com a escala de Borg, e a saturação de oxig

  4. [Relation between metformin treatment and the development of hyperlactacidemia at the emergency room].

    PubMed

    Guelho, Daniela; Paiva, Isabel; Carrilho, Francisco

    2014-01-01

    Introdução: Em diabéticos tipo 2 sob metformina o desenvolvimento de hiperlactacidemia ou mesmo acidose láctica parece decorrer de um evento precipitante agudo. Este estudo objetiva avaliar a prevalência e risco relativo de hiperlactacidemia em diabéticos observados no Serviço de Urgência, os fatores preditores da concentração de lactatos e a influência da lactacidémia no prognóstico.Material e Métodos: Estudo observacional transversal incluindo 138 diabéticos tipo 2, dos quais 66 sob metformina, e 83 doentes não diabéticos atendidos entre junho e outubro de 2012. Variáveis estudadas: idade, sexo, motivo de urgência, pressão arterial, hábitos farmacológicos, antecedentes, estudo analítico (bioquímica e gasometria arterial com doseamento de lactatos) e destino após observação. Análise estatística realizada com SPSS 21.0®.Resultados: A concentração de lactatos e proporção de hiperlactacidemia foram significativamente superiores nos diabéticos (2,1 ± 0,1 mmol/L vs. 1,1 ± 0,1mmol/L, p < 0,001 e 39,1% vs. 3,6%, p < 0,001, respetivamente); particularmente naqueles sob metformina comparativamente aos restantes diabéticos (2,7 ± 0,2 mmol/L vs. 1,6 ± 0,1 mmol/L, p < 0,001 e 56,9 % vs. 23,3 %, p < 0,001, respetivamente). Os diabéticos sob metformina contabilizaram uma probabilidade de hiperlactacidemia 25x superior (OR = 25,10, p < 0,05). A creatinina representou o único fator preditor independente da lactacidemia (B = 1,33; p < 0,05). Os doentes com hiperlactacidemia apresentaram probabilidade 4,4x superior de serem internados ou falecerem (OR = 4,37, p < 0,05). E, quando internados, contabilizaram tempo de internamento (21,66 ± 5,86 dias vs 13,68 ± 5,33dias, p < 0,001) e número de óbitos superiores (12,5% (n = 4) vs 4,3% (n = 2), p < 0,05).Conclusões: Demonstrou-se um risco acrescido de hiperlactacidemia em diabéticos tipo 2, particularmente naqueles sob metformina. A creatinina sérica representou o único fator preditor

  5. Retained Textile Foreign Bodies: Experience of 27 Years.

    PubMed

    Arikan, Soykan; Kocakusak, Ahmet

    2015-01-01

    Introdução e Objetivos: A retenção de materiais têxteis após a cirurgia é uma situação indesejada, tanto para o doente como para o cirurgião. Frequentemente são subnotificados por questões de natureza médico-legal. Apresentamos 14 casos de textilomas (compressoma) que foram tratados ou seguidos pessoalmente por dois cirurgiões gerais num período de 27 anos para descrever e definir as características clínicas e patológicas. Material e Métodos: Foram avaliados retrospectivamente os dados relativos a uma serie de casos, nomeadamente: características dos doentes (sexo e idade), localização anatómica do corpo estranho, intervalo de tempo até ao diagnóstico, apresentação clínica, queixas, abordagem diagnóstica, motivo de cirurgia, tipo de tratamento cirúrgico e complicações. Resultados: Foram identificados nove doentes do sexo feminino e cinco do sexo masculino, com uma média de idades de 43,07 ± 15,23 (mediano: 45) anos para o momento do diagnóstico. Em três doentes a cirurgia prévia foi cesariana, em quatro casos herniorrafia inguinal, um doente submetido a laparotomia exploradora por abdome agudo, um doente no qual foi realizado uma sigmoidectomia, uma doente submetida a apendicectomia e salpingooforectomia direita, uma doente na qual a cirurgia anterior tinha sido para corrigir uma hérnia incisional após laparotomia por neoplasia do ovário, um caso de tiroidectomia total, uma herniorrafia por hérnia epigástricae uma doente submetida cirurgia conservadora bilateral da mama com pesquisa de gânglio sentinela. A localização mais frequente dos compressomas foi intra-abdominal em sete casos, em quatro doentes a localização foi inguinal, um caso localizado na incisão da correcção da hérnia epigástrica, um doente com textiloma na loca de tiroidectomia, e no caso da doente submetida a cirurgia conservadora da mama em ambas regiões axilares se encontraram corpos estranhos/compressomas. O intervalo de tempo foi em média14

  6. Experimental model of cerussite PbCO3 transformation into phosphate phases at pH 3-11

    NASA Astrophysics Data System (ADS)

    Kwaśniak-Kominek, Monika; Manecki, Maciej

    2014-05-01

    formation of precursors at the reaction front, which later undergo transformation into final products. This is probably combine effect of carbonate dissolution associated with relatively slow diffusion of ions though porous coating, affecting both pH and saturation indices. High concentrations of carbonate ions result in CO32- substitution in the structure of precipitating HPY. This is less pronounced or non-existing in the case of CPY precipitating in the presence of Cl-. Monika Kwasniak-Kominek was partially financed from AGH-UST grant No. 15.11.140.329. Maciej Manecki was financed from research grant No. NCN 2011/01/M/ST10/06999. [1] Wang L., Putnis CV, Ruiz-Agudo E., King HE, Putnis A. Coupled Dissolution and Precipitation at the Cerussite-Phosphate Solutions Interface: Implications for Immobilization of Lead in Soils, Environmental Science & Technology, 2013.

  7. Dobutamine Stress Echocardiography Safety in Chagas Disease Patients.

    PubMed

    Rassi, Daniela do Carmo; Vieira, Marcelo Luiz Campos; Furtado, Rogerio Gomes; Turco, Fabio de Paula; Melato, Luciano Henrique; Hotta, Viviane Tiemi; Nunes, Colandy Godoy de Oliveira; Rassi, Luiz; Rassi, Salvador

    2017-02-01

    seguro, em pacientes coronarianos não chagásicos. Entretanto, há insegurança na prática clínica de indicá-lo no paciente chagásico, devido ao potencial arritmogênico já intrínseco nesta cardiopatia. Analisar a segurança do EED em uma população de chagásicos com suspeita clínica de coronariopatia. Análise retrospectiva de um banco de dados de pacientes encaminhados para a realização do EED entre maio/2012 e fevereiro/2015. Avaliou-se pacientes consecutivos portadores de doença de Chagas e com suspeita de coronariopatia. Confirmou-se a sorologia para doença de Chagas em todos os pacientes. A média etária dos 205 pacientes analisados foi de 64 ± 10 anos, sendo a maioria do sexo feminino (65,4%). Nenhum paciente apresentou eventos adversos significativos, como infarto agudo do miocárdio, fibrilação ventricular, assistolia, acidente vascular encefálico, ruptura cardíaca ou morte. Quanto às arritmias, extrassístoles ventriculares frequentes ocorreram em 48% dos pacientes, taquicardia ventricular não sustentada em 7,3%, bigeminismo em 4,4%, taquicardia supraventricular e taquicardia ventricular sustentada em 1% e fibrilação atrial em 0,5%. O EED mostrou ser um exame seguro nessa população de pacientes chagásicos, onde nenhum desfecho grave foi encontrado.

  8. Effects of emissions from sugar cane burning on the trachea and lungs of Wistar rats.

    PubMed

    Matos, Verena Sampaio Barbosa; Gomes, Felipe da Silva; Oliveira, Tarcio Macena; Schulz, Renata da Silva; Ribeiro, Lídia Cristina Villela; Gonzales, Astria Dias Ferrão; Lima, Januário Mourão; Guerreiro, Marcos Lázaro da Silva

    2017-01-01

    . Após a eutanásia com 200 mg/kg de ketamina/xilazina, foram coletados fragmentos de traqueia e pulmão e fixadas em formol 10%. Análises histológicas foram realizadas com coloração com H&E e picrosírius. Não houve infiltrado inflamatório nos tecidos no GC. O processo inflamatório na análise histológica de tecidos de traqueia e de parênquima pulmonar foi significativamente mais intenso no GE7 quando comparado ao GC (p < 0,05 e p < 0,01, respectivamente). Em comparação com os grupos GC e GE1, apenas no GE21 foi observada angiogênese significativa no parênquima pulmonar e aumento significativo de depósitos de colágeno em tecido de traqueia (p < 0,001 e p < 0,01, respectivamente). Nesta amostra, a fumaça da queima de cana-de-açúcar induziu processo inflamatório focal, difuso e agudo em tecidos de traqueia na lâmina própria, sem perda do tecido epitelial ciliado. Houve presença de edemas intersticiais e alveolares e infiltrados de células polimorfonucleares no parênquima pulmonar nos animais dos grupos experimentais.

  9. National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM): household survey component methods.

    PubMed

    Mengue, Sotero Serrate; Bertoldi, Andréa Dâmaso; Boing, Alexandra Crispim; Tavares, Noemia Urruth Leão; Pizzol, Tatiane da Silva Dal; Oliveira, Maria Auxiliadora; Arrais, Paulo Sérgio Dourado; Ramos, Luiz Roberto; Farias, Mareni Rocha; Luiza, Vera Lucia; Bernal, Regina Tomie Ivata; Barros, Aluísio Jardim Dornellas de

    2016-12-01

    desenvolvido entre setembro de 2013 e fevereiro de 2014. O instrumento de coleta de dados incluiu questões relativas a: informações do domicílio, dos moradores e dos entrevistados; doenças crônicas e medicamentos utilizados; uso de serviços de saúde; doenças e eventos agudos tratados com medicamentos; uso de contraceptivos; uso de serviços de farmácia; comportamentos que podem afetar o uso de medicamentos; bulas e embalagens; estilo de vida e planos de saúde. Foram realizadas 41.433 entrevistas em 20.404 domicílios e 576 conglomerados que correspondem a 586 setores censitários distribuídos nas cinco regiões do Brasil, segundo oito domínios definidos por grupos de idade e sexo. Os resultados obtidos no inquérito podem ser utilizados como uma linha de base para futuros estudos que pretendam avaliar o impacto de ações governamentais nas áreas de acesso e de utilização de medicamentos. Para estudos locais que venham a usar um método compatível, a PNAUM pode servir como ponto de referência para avaliação de variações do espaço e da população. Com ampla avaliação dos aspectos relacionados aos medicamentos, a PNAUM é uma grande fonte de dados para as mais variadas análises, que podem ser conduzidas tanto no meio acadêmico como no âmbito governamental.

  10. Relantionships between gold mineralization and granite - Discussion with the support of a pluridisciplinary study of the Passa Tres gold deposit (South Brazil)

    NASA Astrophysics Data System (ADS)

    Dressel, Bárbara; Chauvet, Alain; Trzaskos, Barbara; Biondi, Joao Carlos; Bruguier, Olivier; Monie, Patrick; Villanova, Sandro; Bazille, Jose

    2016-04-01

    The Passa Três Granite, located at East of the Paraná State is elongated following a NNE-SSW direction. This sienogranite is emplaced within metapelites of the meso to neoproterozoic Açungui Group, between the Morro Agudo and Lancinha transcurrent faults, comprising the N040°E trending Lancinha Transcurrent Fault System. Gold mineralization within the Passa Três Granite is constituted by huge quartz veins with sulfides, variable quantities of fluorite and carbonates, forming orebodies with different internal textures, including massive, banded, sheared and brecciated. Structural data indicate the existence of two major fault systems, one N-S and the other E-W, with dips of 15-45°W and 20-75°S, respectively. Both NS and EW systems are interpreted to be contemporaneous and conjugate. Normal motions are everywhere suspected and main mineralized veins are located at opening sites at these fault systems, such as pull-aparts. The structural model suggests that the normal motion can be initiated by shearing along a "guide" level, in which sulfides and clay minerals are concentrated. This configuration can be observed at several scales, such as field, hand samples and thin section. Mineralized veins mainly contain, in addition to the quartz of the gangue, sulphides (pyrite, chalcopyrite, galena, molybdenite), fluorite, chlorite, muscovite, sericite, and carbonate. The presence of sericite, kaolinite and chlorite indicate the occurrence of, at least, propylitic and phyllic-type alterations, both in core of the granite and best-expressed at the rim of quartz-rich orebodies. Gold occurs as native grains in core of the quartz veins, within fractures that affect pyrite and frequently exhibiting normal motions consistent with the one observed at larger scale and systematically associated with chalcopyrite and galena. Quartz veins are sometimes bordered by aplitic dike. Additionally, some of the veins can exhibit a very thin margin of adularia minerals that seems to

  11. [Active interventions in hypercholesteroloemia patients with high cardivascular risk in primary care].

    PubMed

    Tárraga López, Pedro J; Garcia-Norro Herreros, F J; Tárraga Marcos, Loreto; Solera Albero, Juan; González López, Esteban; Ruiz García, Antonio; Pallarés Carratalá, Vicente; Castro Navarro, José Luis; Alins Presas, Josep; Panisello Royo, Josefa María

    2015-05-01

    Introducción: La hipercolesterolemia es uno de los principales factores de riesgo modificables de la enfermedad cardiovascular (ECV). Su reducción disminuye la morbimortalidad por cardiopatía isquémica y ECV en general, en prevención primaria y en prevención secundaria especialmente. Objetivo: Comprobar si una práctica clínica protocolizada e intensiva permite vencer la inercia y alcanzar el objetivo terapéutico (OT) de c-LDL < 100 mg/dL en pacientes de alto riesgo asistidos en Atención Primaria (AP) de nuestro país. Metodología: Estudio epidemiológico, prospectivo, multicentrico, realizado en Centros de AP de diferentes CC.AA. Mediante muestreo consecutivo se incluyeron 310 pacientes de alto riesgo cardiovascular (diabéticos o con ECV establecida), tratados previamente con estatinas, que no alcanzaban el OT de c-LDL. Resultados: Los sujetos del estudio tenían una edad media de 65,2 años, de los que el 60,32% eran varones. El 41,64% presentaba un EVC previo, infarto agudo de miocardio (20,33%), angina (16,07%), ictus/AIT (9,19%), artropatía (5,25%), diabetes (70,87%), hipertensión (71,01%), y obesidad abdominal (69,62%). El 43,57% (IC95%: 37,21; 50,08) de los pacientes que realizaron la 2a visita (241) consiguieron el OT. El 62,50% (IC95%: 55,68; 68,98) de los que realizaron la 3a (216) consiguieron el OT. Finalmente, el 77,56% (IC95%: 72,13; 83,08) de los pacientes que realizaron la última visita (205) consiguieron el OT. A lo largo del estudio hubo una reducción de los niveles de c-LDL desde los 135,6 mg/ dL en la visita basal, 107,4 mg/dL en la 2a visita, 97,3 mg/ dL en la 3a visita, hasta los 90,7 mg/dL en la visita final (p < 0,0001) El incremento de c-HDL entre la visita basal (50,9 mg/dL) y la final (53,6 mg/dL) también fue significativo (p = 0,013). Conclusiones: La reevaluación e intensificación del tratamiento en pacientes de alto riesgo cardiovascular atendidos en Atención Primaria, aplicando las indicaciones de las gu

  12. Chronic polyarthritis as the first manifestation of childhood systemic polyarteritis nodosa.

    PubMed

    Novak, Glaucia Vanessa; Hayashi, Koken; Sampa, Kohei; Okumura, Yosuke; Ferreira, Gabriela Ribeiro Viola; Silva, Clovis Artur

    2017-01-01

    Arthritis has been reported as an acute pattern, generally evanescent with oligoarthritis, mostly affecting knees and ankles in childhood systemic polyarteritis nodosa. However, chronic polyarthritis with morning stiffness mimicking juvenile idiopathic arthritis has not been reported. We describe the case of a 4-year old girl who had additive and chronic polyarthritis with edema, tenderness, pain on motion and morning stiffness for 2 months. After 45 days, she also presented painful subcutaneous nodules and erythematous-violaceous lesions in the extensor region of upper and lower limbs. She was admitted to university hospital due to high fever, malaise, myalgia, anorexia, loss of weight (1kg), painful skin lesions and severe functional disability. She was bedridden by chronic polyarthritis with limitation on motion. Systolic and diastolic blood pressures were greater than 95th percentile for height. Urine protein/creatinine ratio was 0.39g/day, and immunological tests were negative. Anti-streptolysin O was 1,687UI/mL. Skin biopsy revealed necrotizing vasculitis in medium- and small-sized vessels compatible with polyarteritis nodosa. Therefore, we had the diagnosis of systemic polyarteritis nodosa. Prednisone 2mg/kg/day was administered with complete resolution of skin lesions and arthritis, and improvement of proteinuria (0.26g/day) after 15 days. The diagnosis of childhood systemic polyarteritis nodosa should be considered for patients with chronic polyarthritis associated to cutaneous vasculitis triggered by streptococcal infection. RESUMO Na poliarterite nodosa sistêmica pediátrica, a artrite caracteriza-se pelo padrão agudo, geralmente evanescente, com oligoartrite, e afeta principalmente joelhos e tornozelos. No entanto, a poliartrite crônica com rigidez matinal e simulando artrite idiopática juvenil ainda não foi relatada. Descrevemos o caso de uma menina de 4 anos que apresentou poliartrite crônica aditiva com edema, dor à palpação e movimento, e

  13. Intra-aortic balloon pump in cardiogenic shock: state of the art.

    PubMed

    Thomaz, Petronio Generoso; Moura, Leonel Adelino; Muramoto, Giovana; Assad, Renato Samy

    2017-01-01

    The clinical definition of cardiogenic shock is that of a low cardiac output and evidence of tissue hypoxia in the presence of adequate blood volume. Cardiogenic shock is the main cause of death related to acute myocardial infarction (AMI), with a mortality rate of 45-70% in the absence of aggressive and highly specialized technical care. The intra-aortic balloon pump (IABP) is one of the most widely used mechanical assisting devices. During the last two decades, about 42% of patients with AMI who evolved with cardiogenic shock received mechanical circulatory assistance with IABP. Its clinical indication has been based on non-randomized studies and registry data. Recent studies have shown that the use of IABP did not reduce 30-day mortality in patients with AMI and cardiogenic shock treated with the strategy of early myocardial revascularization as the planned primary objective. The guidelines of the American Heart Association and of the European Society of Cardiology have reassessed their recommendations based on the results of meta-analyzes, including the IABP-SCHOCK II Trial study, which did not evidence an increase in survival of patients who received mechanical support with IABP. This review article addresses the clinical impact of IABP use in the cardiogenic shock caused by AMI. RESUMO A definição clínica de choque cardiogênico é a de um quadro de baixo débito cardíaco e evidência de hipóxia tecidual, na presença de volemia adequada. O choque cardiogênico representa a principal causa de óbito relacionada ao infarto agudo do miocárdio (IAM), com índice de mortalidade em torno de 45% a 70%, na ausência de cuidados técnicos agressivos e altamente especializados. O balão intra-aórtico (BIA) é um dos dispositivos de assistência mecânica mais utilizados no mundo. Nas duas últimas décadas, cerca de 42% dos pacientes com IAM, que evoluíram com choque cardiogênico, receberam assistência circulatória mecânica com BIA. Sua indicação cl

  14. Elastoplasticidad anisotropa de metales en grandes deformaciones

    NASA Astrophysics Data System (ADS)

    Caminero Torija, Miguel Angel

    Eterovic y Bathe para incluir la posibilidad de plasticidad anisotropa con endurecimiento mixto. Este primer algoritmo esta restringido a casos de isotropia elastica. La isotropia elastica es una hipotesis bastante habitual en plasticidad anisotropa y tiene la ventaja de que permite el uso de formulaciones mixtas u/p. El segundo algoritmo, mas complejo y general, incluye la posibilidad de elasticidad anisotropa, plasticidad anisotropa y endurecimiento mixto. Este algoritmo supone una contribucion importante ya que esta basado en hipotesis comunmente aceptadas y utilizadas en elastoplasticidad isotropa: descomposicion multiplicativa del gradiente de deformaciones en parte elastica y parte plastica, descripcion hiperelastica sencilla en funcion de deformaciones logaritmicas e integracion exponencial que conserva el volumen. Ademas, la estructura final del algoritmo es modular y relativamente sencilla, consistiendo en un pre- y un postprocesador geometrico y una correccion plastica realizada en pequenas deformaciones. El algoritmo esta consistentemente linealizado para conservar la convergencia cuadratica asintotica de los metodos de Newton y la forma final que toma dicha linealizacion es similar al caso de isotropia elastoplastica implementado; consiste en el modulo tangente algoritmico de pequenas deformaciones sobre el que se aplica una transformacion para convertirlo en el de grandes deformaciones. Todos estos modelos han sido implementados en un codigo propio de elementos finitos denominado DULCINEA, el cual tiene formulaciones lagrangianas totales y actualizadas para grandes deformaciones. Una de las tareas necesarias para poder realizar las simulaciones, ha sido el estudio e implementacion de diferentes elementos que no sufran el bloqueo volumetrico severo que se observa en formulaciones estandar basadas en desplazamientos. Este bloqueo se debe a la condicion de quasi-incompresibilidad que imponen los modelos de plasticidad desviadores y consiste en una respuesta

  15. Labeling and defining severe and enduring anorexia nervosa: A systematic review and critical analysis.

    PubMed

    Broomfield, Catherine; Stedal, Kristin; Touyz, Stephen; Rhodes, Paul

    2017-06-01

    reclutamiento de participantes cuando se investiga esta muestra, y segundo, el diagnóstico equivocado de pacientes que pueden o no tener un curso duradero de la enfermedad. La presente investigación tiene el propósito de proporcionar una visión general de las etiquetas actuales y los criterios utilizados para definir los casos de AN severa y duradera, y analizar críticamente las implicaciones de estos hallazgos. Método: De acuerdo con las guías PRISMA, se realizó una búsqueda en la literatura utilizando cuatro bases de datos electrónicas (PsycINFO, MEDLINE, Web of Science y Scopus) para identificar 32 artículos que cumplían con los estándares estipulados por los criterios. La extracción de datos incluyó el etiquetado explícito, la definición o criterio utilizado para describir este subgrupo, junto con la edad del participante y el diseño del estudio. Resultados: Se encontró que los términos crónico, severo y duradero eran los adjetivos más comúnmente utilizados cuando se referían a este subgrupo. En términos de criterios, la duración de la enfermedad y el número de intentos de tratamiento previamente fallidos fueron las características definitorias más comunes dentro de la literatura. Discusión: Uno de los objetivos de los autores es inspirar a que se realice más investigación en torno a cuál sería el etiquetado y la definición más apropiados para este subgrupo y así facilitar un mejor abordaje y resultados para los individuos afectados. © 2017 Wiley Periodicals, Inc.

  16. Single Derivation Fragmented QRS Can Predict Poor Prognosis in Successfully Revascularized Acute STEMI Patients.

    PubMed

    Tanriverdi, Zulkif; Dursun, Huseyin; Colluoglu, Tugce; Kaya, Dayimi

    2017-07-20

    -fQRS é tão valioso quanto o fQRS clássico em pacientes com STEMI aguda que tiveram sucesso na revascularização com intervenção coronariana percutânea primária (ICPp). Incluímos 330 pacientes com um primeiro STEMI que tinham sido revascularizados com sucesso com ICPp. O eletrocardiograma do paciente foi obtido nas primeiras 48 horas, e os pacientes foram divididos em três grupos de acordo com a ausência de fQRS (não-fQRS); presença de fQRS numa única derivação (sl-fQRS); e ≥ 2 derivações com fQRS (fQRS clássico). A mortalidade intrahospitalar foi significativamente maior tanto em pacientes com sl-fQRS como em pacientes com ≥ 2 derivações com fQRS em comparação com pacientes com não-fQRS. Na análise da curva ROC, ≥ 1 derivação com fQRS produziu uma sensibilidade de 75% e especificidade de 57,4% para a predição de mortalidade intrahospitalar. A análise multivariada mostrou que sl-fQRS é um preditor independente de mortalidade intrahospitalar (OR: 3,989, IC 95%: 1,237-12,869, p = 0,021). Embora o conceito de pelo menos duas derivações seja mencionado para a definição clássica de fQRS, nosso estudo mostrou que fQRS em apenas uma derivação também está associado com maus resultados. Portanto, ≥ 1 derivação com fQRS pode ser útil ao descrever os pacientes sob risco cardíaco alto em STEMI agudo.

  17. In-Lab Upfront Use of Tirofiban May Reduce the Occurrence of No-Reflow During Primary Percutaneous Coronary Intervention. A Pilot Randomized Study.

    PubMed

    Lago, Igor Matos; Novaes, Gustavo Caires; Badran, André Vannucchi; Pavão, Rafael Brolio; Barbosa, Ricardo; Figueiredo, Geraldo Luiz de; Lima, Moysés de Oliveira; Haddad, Jorge Luiz; Schmidt, André; Marin, José Antônio

    2016-11-01

    da administração, em laboratório, de tirofibana sobre a incidência de NR em infarto agudo do miocárdio com supra do segmento ST (IAMCSST) tratado com ICPP. Pacientes com IAMCSST tratados com ICPP foram randomizados (24 tirofibana e 34 placebo) neste estudo duplo-cego para avaliar o impacto de tirofibana intravenosa sobre a incidência de NR após ICPP de acordo com métodos angiográficos e eletrocardiográfico. Os desfechos do estudo foram: fluxo epicárdico TIMI (grau), grau de fluxo miocárdico (MBG), resolução da elevação do segmento ST < 70% (RST < 70%) aos 90 minutos e 24 horas após ICPP. Características antropométricas, clínicas e angiográficas basais eram equilibradas entre os grupos. A ocorrência de fluxo TIMI < 3 não foi significativamente diferente entre os grupos tirofibana (25%) e placebo (35,3%). MBG ≤ 2 não ocorreu no grupo tirofibana, e foi detectado em 11,7% dos pacientes do grupo placebo (p=0,13). RST < 70% ocorreu em 41,6% x 55,8% (p=0.42) aos 90 minutos, e em 29% x 55,9% (p=0,06) em 24 horas nos grupos tirofibana e placebo, respectivamente. NR grave (RST ≤ 30%) ocorreu em 0% x 26,5% (p=0,01) aos 90 minutos, e em 4,2% x 23,5% (p=0,06) em 24 horas nos grupos tirofibana e placebo, respectivamente. Este estudo piloto mostrou uma tendência de redução de NR associada ao uso, em laboratório, de tirofibana em pacientes com IAMCSST tratados com ICPP, e abre caminho para um estudo em escala real que teste essa hipótese.

  18. Use of generic medicines by the Brazilian population: an evaluation of PNAUM 2014.

    PubMed

    Bertoldi, Andréa Dâmaso; Arrais, Paulo Sergio Dourado; Tavares, Noemia Urruth Leão; Ramos, Luiz Roberto; Luiza, Vera Lucia; Mengue, Sotero Serrate; Dal-Pizzol, Tatiane da Silva; Farias, Mareni Rocha; Oliveira, Maria Auxiliadora

    2016-12-01

    uso de medicamentos genéricos no Brasil segundo variáveis demográficas, socioeconômicas e fontes de obtenção dos medicamentos. Estudo transversal de base populacional, conduzido com dados da Pesquisa Nacional de Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM), com coleta de dados entre setembro de 2013 e fevereiro de 2014 em residências de municípios brasileiros urbanos. O uso dos medicamentos foi investigado em relação ao tratamento de doenças crônicas e, no caso de eventos agudos, quanto ao uso nos últimos 15 dias. Os genéricos foram identificados por visualização das embalagens apresentadas pelos usuários dos medicamentos. As variáveis independentes utilizadas foram sexo, idade, escolaridade, classe econômica e região do País. A avaliação da significância estatística das diferenças entre os grupos foi analisada pelo teste Qui-quadrado de Pearson, considerando nível de significância de 5%. A prevalência de uso de genéricos foi de 45,5% (IC95% 43,7-47,3). Não houve diferença por escolaridade, as prevalências foram maiores no sexo feminino (47,0%; IC95% 44,9-49,0) em relação ao masculino (43,1%; IC95% 40,5-45,8) e foram crescentes com o aumento da idade. Maiores usos de genéricos foram encontrados na classe econômica C (47,0%; IC95% 44,9-49,1) e nas regiões Sul (50,6%; IC95% 46,6-54,6) e Sudeste (49,9%; IC95% 46,8-53,0). Observou-se ainda que os genéricos representaram 37,3% dos medicamentos disponibilizados pelo Sistema Único de Saúde . Pode-se concluir que hoje existe uma alternativa de compra ou fornecimento gratuito pelo Sistema Único de Saúde, caracterizada por garantia de qualidade e preço reduzido em relação aos medicamentos de marca comercial considerados como referência. No mercado privado, boa parte da população está optando pelo uso de medicamentos genéricos, graças à disponibilidade dessa opção para praticamente todos os medicamentos mais utilizados pela população.

  19. Acute Ethanol Intake Induces NAD(P)H Oxidase Activation and Rhoa Translocation in Resistance Arteries.

    PubMed

    Simplicio, Janaina A; Hipólito, Ulisses Vilela; Vale, Gabriel Tavares do; Callera, Glaucia Elena; Pereira, Camila André; Touyz, Rhian M; Tostes, Rita de Cássia; Tirapelli, Carlos R

    2016-11-01

    em artérias de resistência e o papel das espécies reativas de oxigênio (ERO) derivadas da NAD(P)H oxidase nessa resposta. Nós também avaliamos se ocorreu translocação da p47phox e ativação da NAD(P)H oxidase após o consumo agudo de etanol. Ratos Wistar machos foram tratados com etanol via oral (1g/kg, p.o. gavagem) ou água (controle). Alguns ratos foram tratados com vitamina C (250 mg/kg, p.o. gavagem, 5 dias) antes de água ou etanol. O leito arterial mesentérico (LAM) foi coleado 30 min após a administração de etanol. A vitamina C preveniu o aumento da geração de ânion superóxido (O2 -) e lipoperoxidação no LAM induzidos pelo etanol. A atividade da catalase (CAT), da superóxido dismutase (SOD) e os níveis de glutationa reduzida(GSH), nitrato e peróxido de hidrogênio (H2O2) não foram afetados após a ingestão aguda de etanol. A vitamina C e o 4-metilpirazol preveniram o aumento na geração de O2 - induzido pelo etanol em cultura de células do músculo liso vascular (CMLV). O etanol não afetou a fosforilação da proteína quinase B (Akt) e nem da óxido nítrico sintase endotelial (eNOS) (nos resíduos de Ser1177 ou Thr495) ou a reatividade vascular do LAM. A vitamina C preveniu o aumento da razão membrana:citosol da p47phox e a expressão da RhoA no LAM de rato induzido pelo etanol. A ingestão aguda de etanol induz a ativação da via RhoA/Rho quinase por um mecanismo que envolve a geração de ERO. Nas artérias de resistência, o etanol ativa NAD(P)H oxidase induzindo a translocação da p47phox por um mecanismo redox-sensível.

  20. Multi-wavelength polarimetric studies of relativistic jets in active galactic nuclei

    NASA Astrophysics Data System (ADS)

    Casadio, Carolina

    evidences. For this purpose we have performed polarimetric studies of the jets in the radio galaxies 3C 120 and M 87 aimed to understand the nature of the peculiar emitting regions known as C80 and HST-1, located hundreds of parsecs from the core of the jet. In Agudo, Gómez, Casadio, et al. (2012) we analyzed polarimetric VLBA observations at 5, 8, 12, and 15 GHz of the jet in 3C 120 revealing that the stationary component C80 corresponds to the peak emission of a larger and more extended emission structure in arc, downstream of which other moving components are observed. The agreement between our observations and numerical simulations led us to conclude that the emitting region C80 corresponds in fact to a recollimation shock located ∼190 pc from the core of the jet. Interestingly, our observations of the peculiar structure HST-1 in the radio- galaxy M 87 revealed a similar structure to that observed in C80 of 3C 120; in Giroletti et al. (2012) we found that HST-1 corresponds to an extended emission structure in which new components appear to be released from the stationary upstream end of HST-1. It has been suggested that very high-energy emission has been originated in the HST-1 region. However, our new VLBA and JVLA observations of M 87 confirmed that HST-1 was in a low energy state between 2011 and 2013, ruling out its implication in the high energy flare in M 87 in March 2012, as we pointed out also in Hada et al. (2014).