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The accuracy of contemporary risk scores in predicting perioperative mortality in infective endocarditis (IE) remains controversial. The aim is to evaluate the performance of existent mortality risk scores for cardiovascular surgery in IE and the impact on operability at high-risk thresholds. A single-center retrospective review of adult patients diagnosed with acute left-sided IE undergoing surgery from May 2014 to August 2019 (n = 142) was done. Individualized risk calculation was obtained according to the available mortality risk scores: EuroScore I and II, PALSUSE, Risk-E, Costa, De Feo-Cotrufo, AEPEI, STS-risk, STS-IE, APORTEI, and ICE-PCS scores. A cross-validation analysis was performed on the score with the best area under the curve (AUC). The 30-day survival was 96.5% (95%CI 91–98%). The score with worse area under the curve (AUC = 0.6) was the STS-IE score, while the higher was for the RISK-E score (AUC = 0.89). The AUC of the majority of risk scores suggested acceptable performance; however, statistically significant differences in expected versus observed mortalities were common. The cross-validation analysis showed that a large number of survivors (> 75%) would not have been operated if arbitrary high-risk threshold estimates had been used to deny surgery. The observed mortality in our cohort is significantly lower than is predicted by contemporary risk scores. Despite the reasonable numeric performance of the analyzed scores, their utility in judging the operability of a given patient remains questionable, as demonstrated in the cross-validation analysis. Future guidelines may advise that denial of surgery should only follow a highly experienced Endocarditis Team evaluation.

Plantas de 28 poblaciones de Echinochloa spp. de arrozales de Aragón y Navarra fueron tratadas con 6 herbicidas, a dosis estándar, en un ensayo de invernadero diseñado para 7 tratamientos: A) testigo, B) clomazona, preemergencia C) cihalofop, estadio BBCH 11-12, D) imazamox, BBCH 11-12 y 13 y E) penoxulam, F) penoxulam (doble dosis), G) profoxidim en BBCH 13. Por otro lado, utilizando técnicas moleculares, esas mismas poblaciones fueron identificadas a nivel de especie en dos grupos: crus-gallihispidula u oryzicola-oryzoides. Asimismo, se analizaron las secuencias de ADN de la ALS y de la ACCasa para ver si presentaban alguna mutación ligada a mecanismos de resistencia. Los resultados mostraron que las 9 poblaciones de Huesca pertenecen al grupo crus-galli-hispidula y las 8 de Zaragoza y 11 de Navarra al oryzicola-oryzoides y que solo 5 de éste último grupo presentaron mutación, siendo la más frecuente pro/leu 197 con 3 casos en Navarra. Estas tres poblaciones fueron significativamente menos sensibles al imazamox, respecto a las que no mostraron mutación. Clomazona, cihalofop y profoxidim consiguieron significativamente más afecto en poblaciones del grupo crusgalli-hispidula e imazamox en el grupo oryzicola-oryzoides salvo en las poblaciones con mutación. Penoxsulam, incluso a dosis doble, apenas logró control alguno Published

La 16ª Feria de la Ciencia se celebrará en el Palacio de Exposiciones y Congresos de Sevilla los días 3, 4 y 5 de mayo de 2018.

Our laboratory has implemented an in vitro assay to estimate the response to chemotherapy in ovarian cancer cells pertaining to individual patients. In two selected patients, we determined the correlation between an in vitro assay of cells from suspected ovarian cancer ascites, with the clinical chemotherapy response. Cancer cells isolated from peritoneal fluid with suspected ovarian cancer were tested for cytotoxicity with corresponding chemotherapy regimens. Circulating Cal25 levels and attending physician consultation determined clinical course and response to chemotherapy. The in vitro assay result correlated with Cal25 levels, progression free survival and attending physician evaluation. The assay predicted correctly the failure of two successive chemotherapy regimes in the first patient, while predicting a favorable clinical response in the second subject.

A través de un ensayo de campo implementado de acuerdo a la norma EN 252, se evaluó la efectividad de tratamientos en etapas, tendientes a disminuir la lixiviación de una solución rica en Zn y Mn obtenida a partir de un proceso de reciclado aplicada en la madera por el método Bethell. La segunda etapa antilixiviante agregó bórax por pincelado o por el método Bethell. Se utilizó madera de Pinus taeda. Este trabajo presenta el análisis de la evolución del proceso de deterioro a lo largo de 5 años de ensayo de campo y su evaluación. Se utilizó el índice climático de Scheffer como método de evaluación del riesgo microbiológico en el sitio del ensayo y se realizó un análisis microscópico de la madera, para verificar el tipo de deterioro presente. Los tratamientos al 3% y al 6% en Zn con agregado de bórax por el método Bethell fueron los de mejor desempeño entre los evaluados a pesar de no haber superado el desempeño del preservante de referencia. Se observó la presencia de los tres tipos de pudrición, blanca, marrón y blanda tanto en controles sin tratamiento como en maderas tratadas, en un sitio con condiciones intermedias para el deterioro. The effectiveness of treatments in stages aimed at reducing the leaching of a solution rich in Zn and Mn obtained from a recycling process introduced into the wood by the Bethell method and a second stage in which borax was added by brushing and by the Bethell method, was evaluated through a field test. Pinus taeda wood was used according to EN 252 (1989). This paper presents an analysis of the evaluation and evolution of the process of deterioration over 5 years test. Scheffer climate index was used as a method of microbiological risk assessment at the site of the test and microscopic analysis of wood was carried out to verify the type of damage. Treatments 3% and 6% in Zn with borax added by the Bethell method were the top performers among the evaluated none of them performed better than the reference preserver. The presence of the three types of rot, white, brown and soft both on untreated controls and treated wood, in a site with intermediate conditions for microbial deterioration was observed.

El tenofovir (TDF), es el único inhibidor de la transcriptasa inversa análogo nucleótido para el tratamiento de la infección por virus de la inmunodeficiencia humana (VIH). Ocasionalmente, puede producir insuficiencia renal aguda y síndrome de Fanconi. Presentamos el caso de un varón de 64 años con infección por VIH conocida desde hace 22 años, en tratamiento con tenofovir. En las revisiones ambulatorias refería un cuadro progresivo de astenia y dolores óseos difusos. En varias determinaciones se había observado una elevación de la fosfatasa alcalina y la paratohormona (PTH). Durante el último mes empeoró su estado, por lo que fue ingresado en el hospital. Entre los datos analíticos destacaban: glucosuria marcada, hipofosfatemia, hiperfosfaturia e hipouricemia. Todas las alteraciones se resolvieron tras suspender el TDF, lo que ilustra la importancia de que los clínicos incluyan la posibilidad de tubulopatía proximal por TDF en pacientes con dolores óseos, síndrome general o alteraciones del metabolismo mineral. Tenofovir (TDF), is the only nucleotide analogue reverse transcriptase inhibitor for treating human immunodeficiency virus (HIV). Occasionally, it may cause acute renal failure and Fanconi syndrome. We report the case of a 64-year-old male diagnosed with HIV infection 22 years previous and treated with tenofovir. In outpatient follow-up, the patient complained of progressive fatigue and diffuse aching bones. In several check-ups, increased alkaline phosphatase and parathyroid hormone (PTH) were observed. Over the past month, his condition worsened and he was admitted to hospital. Analytical data included marked glycosuria, hypophosphatemia, hyperphosphaturia and hypouricemia. All changes were resolved when TDF was discontinued.This illustrates the importance of clinical evaluations that include possible TDF-induced proximal tubulopathy in patients with general bone pain syndrome or mineral metabolism disturbances.

Our laboratory has implemented an in vitro assay to estimate the response to chemotherapy in ovarian cancer cells pertaining to individual patients. In two selected patients, we determined the correlation between an in vitro assay of cells from suspected ovarian cancer ascites, with the clinical chemotherapy response. Cancer cells isolated from peritoneal fluid with suspected ovarian cancer were tested for cytotoxicity with corresponding chemotherapy regimens. Circulating Cal25 levels and attending physician consultation determined clinical course and response to chemotherapy. The in vitro assay result correlated with Cal25 levels, progression free survival and attending physician evaluation. The assay predicted correctly the failure of two successive chemotherapy regimes in the first patient, while predicting a favorable clinical response in the second subject.

A continuación conoceremos los inicios, experiencias y expectativas de un par de jóvenes colombianos, profesionales en salud que en la actualidad trabajan en el desarrollo de tecnologías biomédicas para poblaciones vulnerables y que apoyan la gestión de programas institucionales para identificar, apoyar y motivar la implementación de éstas dentro del sistema de salud. Aclaramos que los textos de soporte y preguntas desarrolladas por la Revista Ingeniería Biomédica (RIB) y las respuestas brindadas no representan necesariamente las ideas e intereses de las instituciones involucradas.

Background:Methodological quality is a reference standard for newly developed clinical practice guidelines (CPGs) and a critical determinant of its adaptation. Special attributes might be useful when conducting non-systematic searches of high quality CPGs. Objectives:To explore the association between[for full text, please go to the a.m. URL], G-I-N Conference 2012

10.1007/s10811-011-9736-6 The purpose of this study was to explore efficient methods of harvesting the microalga Phaeodactylum tricornutum. Natural sedimentation experiments, performed at different light and temperature conditions, did not yield significant improvements in efficiency even after 1 week. When alkalinity-induced flocculation was performed, both the flocculation efficiency and the concentration factor dramatically improved at pH = 9.75 (0.5-0.7 units over the original pH of the culture) after 10 min settling time. Sedimentation rates are documented at pH ranging between pH 9.75 and 11.0. The results of the application of two conventional flocculants used in wastewater treatment, polyaluminium chloride and aluminium sulphate, are also presented. Chitosan was also used as a natural flocculating agent to improve possible contamination problems in the downstream process. pH was adjusted in order to determine optimum flocculation efficiency of chitosan in combination with a high concentration factor. Satisfactory results were found with chitosan at an adjusted pH of 9.9 using concentrations as low as 20 mg L -1, after testing a flocculant range of 5-200 mg L -1.

Continuando con el estudio del uso de una solución obtenida en un proceso de reciclado de baterías domésticas como preservante para madera, se estableció un primer cementerio de estacas basado en la norma EN 252, que evalúa la durabilidad adquirida por probetas de Pinus taeda L. Dicha solución es ácida, contiene 32 g l-1 de Zn y 15 g l-1 de Mn como sulfatos, libre de metales pesados; en ensayos de laboratorio ha demostrado propiedades funguicidas e insecticidas específicos, a concentraciones menores a 3% en Zn (máxima concentración obtenida del reciclado). A las probetas tratadas con la mencionada solución por el método de célula llena, se les realizó un tratamiento posterior antilixiviante con bórax al 2%, por pincelado y por célula. Se comparó la durabilidad natural y la adquirida, con dicha solución (con o sin bórax), con arseniato de cobre cromatado (CCA) a dos retenciones. A 32 meses del inicio del ensayo, las concentraciones de Zn de 3% y mayores con el bórax aplicado por el método de célula llena son las más efectivas. Se analizaron además los agentes de deterioro de madera (insectos, hongos y bacterias) presentes en las probetas. As part of the study of the application of a solution obtained from a domestic batteries recycling process as a wood preservative, a field stakes test was established to assess the acquired durability in loblolly pine (Pinus taeda L.) specimens following the internationally accepted standard EN 252. This solution is acidic, containing 32 g l-1 Zn and 15 g l-1 of Mn as sulfates and free of heavy metals; in laboratory tests the solution proved to have specific fungicidal and insecticidal properties against organisms that degrade wood, at concentrations lower than 3% Zn (the highest concentration obtained from the recycling process). The specimens treated by the full cell method with the mentioned solution were afterwards treated with 2% in borax by the full cell method and by brushing in order to prevent leaching. Natural and acquired durability are compared using different concentrations of the studied solution as well as chromated copper arsenate (CCA) at two different retention levels. At 32 months, 3 % and higher concentrations of Zn and borax applied by full cell method showed to be the most effective. Main degrading agents (insects, fungi and bacteria) found in the specimens are also described.

Background: Type B aortic dissection is usually managed by intensive care medical therapy and surgery is reserved for treating the complications that can occur during the evolution of a case. Aim: To assess the endovascular management of acute complications of type B aortic dissection and the closure of the intimal defect and aortic false lumen. Material and Methods: Retrospective analysis of 8 consecutive patients aged 40 to 57 years (seven males) treated for acute complications in the initial episode of a type B aortic dissection between August 2006 and July 2008. Results: Six/eight were known hypertensive patients. The indications for surgery were intractable pain in one, hypertension refractory to treatment in two and distal hypoperfusion in fve. Five patients required covering of the left subclavian artery ostium, without need for surgical repair. One patient was subjected to renal angioplasty and stenting. Technical success was achieved in all cases, with complete closure of the proximal aortic tear and thoracic aortic false lumen, although 7 of patients had a persistent distal aortic false lumen. One case had a transient lower limb paraparesis. No patient died. Conclusions: Endovascular treatment is effective in closing the aortic tear as well as the thoracic aortic false lumen in aortic type B dissections with a low complication rate. Due to the high frequency of distal aortic false lumen persistence, it is not a defnitive treatment for this condition but it is useful for the acute complications of the initial phase of type B aortic dissection.

Background: Type B aortic dissection is usually managed by intensive care medical therapy and surgery is reserved for treating the complications that can occur during the evolution of a case. Aim: To assess the endovascular management of acute complications of type B aortic dissection and the closure of the intimal defect and aortic false lumen. Material and Methods: Retrospective analysis of 8 consecutive patients aged 40 to 57 years (seven males) treated for acute complications in the initial episode of a type B aortic dissection between August 2006 and July 2008. Results: Six/eight were known hypertensive patients. The indications for surgery were intractable pain in one, hypertension refractory to treatment in two and distal hypoperfusion in fve. Five patients required covering of the left subclavian artery ostium, without need for surgical repair. One patient was subjected to renal angioplasty and stenting. Technical success was achieved in all cases, with complete closure of the proximal aortic tear and thoracic aortic false lumen, although 7 of patients had a persistent distal aortic false lumen. One case had a transient lower limb paraparesis. No patient died. Conclusions: Endovascular treatment is effective in closing the aortic tear as well as the thoracic aortic false lumen in aortic type B dissections with a low complication rate. Due to the high frequency of distal aortic false lumen persistence, it is not a defnitive treatment for this condition but it is useful for the acute complications of the initial phase of type B aortic dissection.

El Directorio de la Sociedad de Cirujanos confecha 10 de Enero 2007 encargo al Dr. Juan HeppK. que coordinara el trabajo de una Comision inte-grada por los Drs. Attila Csendes J, FernandoIbanez, Osvaldo Llanos y Sergio San Martin, encar-gados de generar un documento que definiera losaspectos generales y contenidos de un “Programade Formacion de Postgrado en la especialidad deCirugia General”. Como resultado de dicho trabajose concluyo en los siguientes aspectos:INTRODUCCIONLa Cirugia General como especialidad se estaenfrentando en los ultimos anos, especialmente enEstados Unidos y Europa, a una crisis que se ma-nifiesta por los siguientes hechos: disminucion delos alumnos que la eligen como su primera priori-dad, aumento de las subespecialidades, lo quehace que la formacion de Cirugia General sea unpaso para alcanzar dicha especializacion; defini-cion demasiado amplia y difusa de los conocimien-tos y campo de accion del Cirujano General.Hay varios hechos que han ocurrido en losultimos 15 anos, que han cambiado el espectro delprograma de formacion de especialistas en cirugiageneral:- Cambios epidemiologicos de enfermedadestanto aumento como disminucion (obesidad y ulce-ra peptica por ejemplo).– Mayor dedicacion a areas mas especificasde la cirugia, lo que ha mejorado notablemente losresultados quirurgicos: cirujanos de “alto volumen”dedicados a temas mas especificos de la cirugia:esofagogastrica, mama, colorectal etc.–˜Desarrollo de nuevas tecnologias que noexistian hace 15 anos: cirugia laparoscopica yendoscopica, cirugia de trasplantes.– Incorporacion necesaria en la practica quirur-gica diaria de nuevos conocimientos como labioetica, la gestion clinica, la metodologia de lainvestigacion, conocimiento en computacion, etc.En Chile no hay una clara definicion de lascompetencias que debe tener el cirujano que nece-sita el pais. Tambien existe una discordancia entrelo que se aprende durante el programa de forma-cion de Cirugia General y lo que se hace en lapractica profesional. Esto se refiere basicamente alas tecnicas de especialidades como cirugia vas-cular, endocrinologica o torax.Dado que en hospitales de complejidad media-na no existe el superespecialista, y que por un ladola presion de la judicializacion de la medicina y porotro la evidencia de que cirugias complejas tienen

Dormancy is an adaptive mechanism that enables woody plants to survive the freezing temperatures of winter. This complex process is characterized by the cessation of meristem activity, which is accompanied by winter bud set, extensive metabolic remodelling, an acquired high tolerance to cold and, in deciduous trees, by leaf senescence and abscission. The induction of dormancy occurs in response to seasonal environmental signals. In most woody plants, shortening of the photoperiod induces growth cessation, bud set, and some degree of cold acclimation. The subsequent drop in temperature then leads to a greater tolerance to cold and leaf fall. Experimental evidence indicates that the phytochrome system plays an important role as a day length sensor, and it has been recently reported that in poplar (Populus tremula x tremuloides), the photoperiodic control of dormancy induction is driven by a molecular mechanism that shares components with the mechanism of the photoperiodic control of flowering time in Arabidopsis. In contrast, the effects of low temperatures are less well understood. Nonetheless, it has been established that the chestnut (Castanea sativa Mill.) circadian molecular clock is disrupted both during winter and in response to cold, with presumable consequences on the general physiology of the plant. However, there is no direct evidence so far for its role in dormancy regulation., La dormancia es un mecanismo adaptativo que capacita a las plantas leñosas para sobrevivir a las bajas temperaturas invernales. Este complejo proceso se caracteriza por el cese de la actividad de los meristemos, y va acompañado del desarrollo de las yemas de otoño, de notables modificaciones metabólicas, de la adquisición de una elevada tolerancia al frío y, en las especies caducifolias, de la senescencia y abscisión de las hojas. La inducción de la dormancia responde a señales medioambientales. En la mayoría de las plantas leñosas el acortamiento del fotoperiodo induce el cese del crecimiento, la formación de las yemas de otoño y una moderada aclimatación al frío. Después, la bajada de las temperaturas induce una mayor tolerancia al frío y la caída de las hojas. La evidencia experimental indica que el sistema de los fitocromos juega un papel importante como sensor de la duración del día y recientemente se ha comprobado que el control fotoperiódico de la inducción de la dormancia en chopo ocurre mediante un mecanismo molecular que tiene elementos comunes con el que controla la transición floral en respuesta al fotoperiodo en Arabidopsis. La influencia de las bajas temperaturas es menos conocida. El reloj circadiano del castaño (Castanea sativa Mill.) se altera durante el invierno y en respuesta al frío, lo que debe tener importantes consecuencias sobre la fisiología general de la planta. Sin embargo, no hay todavía evidencia directa sobre su incidencia en la regulación de la dormancia.

Popliteal artery entrampment is a rare condition, occurring in young subjects, that causes ischemia of the extremity. The anatomical background is the compression or occlussion of the popliteal artery caused by forced plantar or dorsal flexion. We report a 32 year-old sportsman who presented with gangrene of the right first toe and a history of three months of progressive claudication. The Ankle-Brachial index and pulse volume curve registries showed a severe ischemia below the knee. Angiography showed a medial deviation of the popliteal artery associated to stenosis and aneurysm formation. A CT scan of the contralateral artery was normal. The patient was operated using a posterior approach, performing a reverse saphenous vein bypass graft and excising the popliteal artery. The postoperative period was uneventful

Popliteal artery entrampment is a rare condition, occurring in young subjects, that causes ischemia of the extremity. The anatomical background is the compression or occlussion of the popliteal artery caused by forced plantar or dorsal flexion. We report a 32 year-old sportsman who presented with gangrene of the right first toe and a history of three months of progressive claudication. The Ankle-Brachial index and pulse volume curve registries showed a severe ischemia below the knee. Angiography showed a medial deviation of the popliteal artery associated to stenosis and aneurysm formation. A CT scan of the contralateral artery was normal. The patient was operated using a posterior approach, performing a reverse saphenous vein bypass graft and excising the popliteal artery. The postoperative period was uneventful (Rev Med Chile 2006; 134: 207-10). (Key words: Angiography; Popliteal artery; Vascular occlusion)

Sin resumen

The Chua circuit parameter estimation problem is addressed in this paper. This circuit is algebraically observable and identifiable with respect to its two measurable voltages. This fact allows us to straightforwardly propose two linear estimators for recovering the unknown parameters, where the estimator gains are continuously adjusted by means of a gradient algorithm, until the estimated parameters converge to the actual values. The convergence of this method is demonstrated by using the Lyapunov method.

Norm enforcement may be important for resolving conflicts and promoting cooperation. However, little is known about how preferred responses to norm violations vary across cultures and across domains. In a preregistered study of 57 countries (using convenience samples of 22,863 students and non-students), we measured perceptions of the appropriateness of various responses to a violation of a cooperative norm and to atypical social behaviors. Our findings highlight both cultural universals and cultural variation. We find a universal negative relation between appropriateness ratings of norm violations and appropriateness ratings of responses in the form of confrontation, social ostracism and gossip. Moreover, we find the country variation in the appropriateness of sanctions to be consistent across different norm violations but not across different sanctions. Specifically, in those countries where use of physical confrontation and social ostracism is rated as less appropriate, gossip is rated as more appropriate. Little is known about people's preferred responses to norm violations across countries. Here, in a study of 57 countries, the authors highlight cultural similarities and differences in people's perception of the appropriateness of norm violations., Swedish Foundation for Humanities and Social Sciences; Riksbankens Jubileumsfond; Czech Science Foundation; Czech Academy of Sciences; Institute of Psychology; Stockholm University

Índex de Qualitat de la Prescripció Farmacèutica; IQS Índice de Calidad de la Prescripción Farmacéutica; IQS Prescription Quality Index; PQI L'índex de Qualitat de la Prescripció Farmacèutica (IQF) 2015 està constituït per una bateria de 12 indicadors amb objectius específics de millora, distribuïts en tres dimensions (nous medicaments, hiperprescripció i selecció de medicaments) i ponderats d’acord amb la seva contribució a la millora global de la qualitat de la prescripció. El seu disseny s’ha realitzat mitjançant el consens d’un grup d’experts d’acord amb l’evidència científica disponible i serà sotmès a revisió anual, per tal de reflectir l’estat del coneixement científic en cada moment. El Índice de Calidad de la Prescripción Farmacéutica (IQF) 2016 esta constituido por una batería de 12 indicadores con el objetivo específico de mejora, distribuidos en tres dimensiones (nuevos medicamentos, hiper prescripción y selección de medicamentos) y ponderados de acuerdo con su contribución a la mejora global de la calidad de la prescripción. Su diseño se ha realizado mediante el consenso de un grupo de expertos de acuerdo con la evidencia científica disponible y será sometido a revisión anual, con la finalidad de reflejar el estado de conocimiento científico en cada momento.

Depressió major en adults; Pautes del tractament farmacològic; Guia de pràctica clínica Major depression in adults; Patterns of drug treatment; Practice guideline Depresión mayor en adultos; Pautas del tratamiento farmacológico; Guía de práctica clínica L’objectiu d’aquest document és establir les pautes del tractament farmacològic de la depressió major en adults. En l’abast del document no es considera el tractament de la depressió melancòlica, la depressió atípica, ni l’associada a símptomes psicòtics. Tampoc es considera la distímia, la depressió gestacional ni els casos resistents de depressió. El objetivo de este documento es establecer las pautas del tratamiento farmacológico de la depresión mayor en adultos. En el alcance del documento no se considera el tratamiento de la depresión melancólica, la depresión atípica, ni la asociada a síntomas psicóticos. Tampoco se considera la distimia, la depresión gestacional ni los casos resistentes de depresión. The purpose of this document is to establish guidelines for the pharmacological treatment of major depression in adults. In the scope of the document, the treatment of melancholic depression, atypical depression, or associated with psychotic symptoms is not considered. Neither is it considered dysthymia, gestational depression, or resistant cases of depression.