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El asma es un importante problema de salud pública que afecta a más de 300 millones de personas en el mundo. La importancia de una enfermedad se puede medir por su prevalencia, la carga asistencial, la morbimortalidad.

La hiperplasia benigna de próstata (HBP) es una patología con una alta incidencia. Su diagnóstico y tratamiento son compartidos entre urólogos y médicos de atención primaria. Su manejo consume una enorme cantidad de recursos. La Sociedad Española de Médicos de Atención Primaria (SEMERGEN), la Sociedad Española de Médicos Generales y de Familia (SEMG), la Sociedad Española de Medicina de Familia y Comunitaria (semFYC) y la Asociación Española de Urología (AEU) han elaborado un documento sobre pautas de actuación y seguimiento de la HBP, presentado aquí de manera resumida, en el que se pretende actualizar las guías anteriormente publicadas, en base a las últimas evidencias.

The craniofacial reconstruction after a craniotomy can sometimes be challenging due to the complexity of the fronto-orbital region, an adequate reconstruction can be achieved with combination of autologous bone and alloplastic materials, with low morbidity and mortality rates, even though it is still needed to perform more studies about this technique to assess its functional and aesthetic outcomes.

Realizar un estudio de coste-utilidad en pacientes asmáticos en tratamiento con beclometasona/formoterol en combinación fija en Atención Primaria de Salud.

El embarazo representa un estado procoagulante que aumenta el riesgo de fenómenos trombóticos en la mujer. Al igual que en la población no gestante, deberemos diagnosticar y tratar lo más precozmente posible dichos eventos para evitar la migración del trombo a otras localizaciones. La anticoagulación constituye la medida terapéutica de primera línea. Sin embargo, ciertas situaciones de aumento de sangrado como el trabajo de parto pueden suponer una contraindicación para iniciar dicha anticoagulación. En el siguiente artículo se desarrolla un caso clínico en el que el diagnóstico de trombosis venosa profunda tuvo lugar al inicio del trabajo de parto.

La combinación a dosis fija de fluticasona propionato/formoterol es una nueva combinación de un glucocorticoide inhalado y un agonista β2-adrenérgico de acción larga ampliamente conocidos y utilizados, disponibles por primera vez en un mismo dispositivo. Esta combinación a dosis fija de fluticasona propionato/formoterol ha demostrado su perfil de eficacia y seguridad en distintos ensayos clínicos frente a sus componentes individuales y otras combinaciones a dosis fijas de glucocorticoide inhalado/agonista β2-adrenérgico de acción larga, y está indicada para el tratamiento del asma persistente en adultos y adolescentes. Fluticasona propionato/formoterol está disponible en un amplio rango de dosis, que permite cubrir adecuadamente los escalones terapéuticos recomendados por las guías terapéuticas, y constituye una combinación a dosis fija de glucocorticoide inhalado/agonista β2-adrenérgico de acción larga eficaz, rápida, bien tolerada y con un coste de adquisición razonable. Esta combinación ha sido posicionada por los distintos organismos evaluadores de las comunidades autónomas como alternativa terapéutica adecuada para el asma en el ámbito de la atención primaria.

La enfermedad arterial periférica de las extremidades inferiores (EAP) conlleva una mayor morbimortalidad en pacientes con diabetes mellitus tipo 2 (DM2); este trabajo evalúa la prevalencia en dichos pacientes y su asociación con variables socio-demográficas y clínicas.

National brand (NB) delistings are not uncommon in food retailing; however, retailer boycotts of individual brands may have negative consequences, particularly in terms of store switching intentions. This paper analyses which kind of assortment (‘store brand-only’ or mixed) is more profitable in terms of store loyalty. It also analyses the influence of assortment composition and consumer attitude variables on store loyalty using a controlled, online experiment on an established large consumer panel consisting of 1400 individuals in the Spanish market. Four product categories were evaluated: yoghurt, fresh bread and rolls, toilet tissue and laundry detergent. Our results suggest that mixed assortments – particularly those including a large number of NBs – are associated with greater store loyalty.

La hidatidosis afecta a la columna y a la pelvis en un 60% de los casos, las lesiones en el hueso pueden estar silentes de 10 a 20 años. Las vesículas progresan agresivamente por el canal endomedular y sustituyen a las trabéculas óseas sin formar quistes como en las vísceras, por lo que la posibilidad de anafilaxia es rara. La combinación de quimioterapia y cirugía facilita el manejo anestésico, reduciendo la incidencia de reacciones anafilácticas y las recidivas de la enfermedad.

This paper presents an overview of experimental results and progress made in investigating the role of magnetic configuration on stability and transport in the TJ-II stellarator. Global confinement studies have revealed a positive dependence of energy confinement on the rotational transform and plasma density, together with different parametric dependences for metallic and boronized wall conditions. Spontaneous and biasing-induced improved confinement transitions, with some characteristics that resemble those of previously reported H-mode regimes in other stellarator devices, have been observed. Also, magnetic configuration scan experiments have shown an interplay between magnetic structure (rationals, magnetic shear), transport and electric fields. Although the dc radial electric fields are comparable with those expected from neoclassical calculations, additional mechanisms based on neoclassical/turbulent bifurcations and kinetic effects are needed to explain the impact of magnetic topology on flows and radial electric fields. Hydrocarbon fuelling experiments in configurations with a low-order rational value in the rotational transform located in the proximity of the last closed flux surface (n = 4/m = 2) have shown the impurity screening properties related to the expected divertor effect. The first TJ-II experiments in neutral beam injection plasmas are reported.

Summary.Introduction: Secondary prevention of venous thromboembolism (VTE) with vitamin K antagonists is often problematic in patients with cancer. We prospectively evaluated the effectiveness and safety of long‐term subcutaneous dalteparin in a series of consecutive patients with symptomatic VTE and metastatic cancer.

TJ-II plasmas respond in a very controllable way to the external induction of a loop voltage in electron cyclotron resonance heating conditions. First experiments showed that the confinement improves (degrades) when a negative (positive) electric field is induced. Combining loop voltage induction with electron cyclotron current drive, the cause is now proven to be the plasma current but not the induced electric field. It is also found that high positive currents (≳7 kA) invert trends in plasma density, no longer deteriorating the confinement. If, as suggested, the current acts via magnetic shear modification, then both its magnitude and sign affect the confining properties of the plasma. Several ideas are put forward based upon magneto-hydrodynamic, particle orbits and drift wave turbulence arguments.

Didymodon erosus is described and illustrated as a new species from two localities in Spain (Iberian Peninsula), growing on calcareous rocks. It is characterized mainly by its markedly erose and papillose-crenulate in the upper middle leaf margins and rhizoidal tubers underground or on rhizoids in the lower part of the stem.

The forming behaviour at high temperature of a modified 9%Cr‐1%Mo (P91) ferritic steel containing B and Ti for elevated temperature service was investigated. The microstructure of the as‐received material is mainly martensite at room temperature, but special etching revealed prior austenite grains of about 25 μm in size. Torsion tests were conducted at temperatures in the range 850 to 1250 °C to simulate the hot rolling process under comparable conditions of temperature, strain rate and strain. The deformation data obtained from these tests were correlated with the Garofalo equation with a stress exponent of 4.6 and an activation energy of 315 kJ/mol. This equation was used to predict the formability behaviour for the rolling process and also to determine the maximum forming efficiency and stability of the steel. A temperature of 1200 °C is recommended to conduct the forming process.

The surface oxide layers formed spontaneously through air contact on three new, non-toxic titanium alloys have been investigated by X-ray photoelectron spectroscopy (XPS). The alloys investigated were Ti–7Nb–6Al, Ti–13Nb–13Zr and Ti–15Zr–4Nb. The results show a large surface enrichment in Al oxides and Zr oxides, respectively, which indicates a considerable outwards diffusion of these two elements. However, an analysis of the Nb 3d spectra reveals that the formation of Nb oxides at the surface is less favoured than in the case of the other alloying elements. The XPS data show for all three Ti alloys a passive layer formed by a mixture of Ti, Al or Zr and Nb oxides.

Determinar los factores de riesgo presentes en los pacientes con disfagia en relación con una población de pacientes críticos.

The tensile and compressive properties at room temperature of powder metallurgy Ni3Al synthesised using rapidly solidified powder particles, which were milled for up to 20 h, have been investigated. Furthermore, the mechanical behaviour at high temperatures has been studied by strain rate change tests in compression at strain rates ranging from 5 × 10-6to 2 × 10-3s-1and temperatures from 1073 to 1373 K. For comparative purposes, tensile tests at room temperature were carried out in materials consolidated from particles in both the as rapidly solidified condition (RS) and after 2 h of milling time. Both materials showed a very similar microstructure composed of equiaxed grains. However, an increase in the yield strength of close to 40% was exhibited by the 2 h milled particle material. The intermetallic made of 20 h milled particles presented a bimodal microstructure and showed a dramatic increase in yield strength at room temperature to 740 MPa, more than twice the value reached by the material consolidated with RS particles. The analysis of the stress–strain rate data of tests performed at elevated temperatures revealed a transition from a stress exponent n ˜ 5 to an exponent n ˜ 3·5 at low stresses and/or high temperatures of testing. An activation energy for plastic flow of 370 kJ mol-1was deduced in the low stress regime.

Low-temperature prolonged blanching was applied to sliced zucchini prior to dehydration. Treatment was optimized by a response surface method. The variables studied were: blanching temperature (50, 55, 65, 75 and 79 °C) and blanching time (23, 79, 30, 45, 60, 66 min). Color, texture (cutting force) and rehydration rate of the product were also evaluated. The optimum conditions for the texture, color (parameter b*) and rehydration rate (RR) of the pretreatment were: temper ature, 61-66 °C for 52-56 min. The prediction model was applied with these conditions and the following values were obtained: rehydration rate 5.14, texture 28.82 Newtons and the color para meter b' (blue-yellow) 34.0. The prediction models for maximum cutting force and parameter b* showed a significant fit (p≤ 0.05) of the experimental values and the prediction model for the RR showed a lack of fit (p≤ 0.05) whereas the parameters L* and a* were not affected significantly. These optimum conditions were verified experimentally, and the experimental values agreed very closely with the predicted values.

The deformation behaviour of a duplex stainless steel has been investigated by tensile and torsion tests at temperatures ranging from 1000 to 1275°C. The microstructure of the as received material consists of elongated islands of austenitic grains in a more or less continuous ferrite matrix. This microstructure remains essentially constant during deformation by tensile strain rate change tests. Deformation occurs by a slip creep process in most of the range of strain rates tested (n = 5) with a transition to a grain boundary sliding mechanism in the lower stress regime. On the other hand, dynamic recrystallisation starts after a critical strain during torsion testing. The flow stress decreases to a steady state value associated with a fine and stable microstructure. The deformation behaviour is characterised by a stress exponent of about 2·5–3, which suggests a contribution to deformation of both, slip creep and grain boundary sliding mechanisms. An activation energy for deformation of 370 kJ mol-1was measured for both tensile and torsion tests. This value is similar to that reported for the activation energy for deformation of austenitic stainless steels.