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Objective To evaluate the impact of coadministering statins with direct oral anticoagulants (DOACs) on the risk of major bleeding events in patients with venous thromboembolism (VTE).Design Observational cohort analysis based on a multicentre international registry.Setting Data were extracted from the Registro Informatizado de Enfermedad TromboEmbolica Registry, which involves 205 centres across 27 countries.Participants A total of 73 659 patients diagnosed with VTE were classified based on their anticoagulant therapy (DOACs) versus low-molecular-weight heparin (LMWH) or vitamin K antagonists (VKAs) and concurrent use of statins.Methods Multivariable Cox proportional hazards models adjusted for confounding variables to assess the risk of major bleeding events stratified by the type of anticoagulant use and statin use.Results From October 2013 to February 2023, 73 659 patients were recruited: 2573 were statin users on DOACs, 14 090 were statin users on LMWH or VKA therapy, 10 088 were non-statin users on DOACs and 46 908 were non-statin users on LMWH or VKA therapy. Statin users were 10 years older and more likely to have hypertension, diabetes, renal failure or prior artery disease. During anticoagulation (median, 187 days), 1917 patients (2.6%) suffered major bleeding. Rates of major bleeding per 100 patient-years were 2.33 (95% CI 1.72 to 3.09), 3.75 (95% CI 3.43 to 4.10), 1.39 (95% CI 1.13 to 1.69) and 3.10 (95% CI 2.93 to 3.27), respectively. On multivariable analysis, patients treated with DOACs had a significantly lower risk of major bleeding compared with those on LMWH or VKA therapy (adjusted HR 0.59; 95% CI 0.48 to 0.74). The adjusted HR in statin users versus non-users was 1.03 (95% CI 0.92 to 1.14), while in statin users on DOACs versus the rest of patients, it was 1.18 (95% CI 0.79 to 1.76).Conclusions In patients with VTE receiving statins, long-term anticoagulation with DOACs was associated with a reduced risk of major bleeding, regardless of the statin use. These findings support the safety profile of DOACs over VKAs or LMWH in the management of VTE in patients requiring statins.

To describe the prevalence of Peripheral Artery Disease (PAD) in a random population sample and to evaluate its relationship with Mediterranean diet and with other potential cardiovascular risk factors such as serum uric acid and pulse pressure in individuals ranged 45 to 74 years.Cross-sectional analysis of 1568 subjects (mean age 6.5 years, 43% males), randomly selected from the population. A fasting blood sample was obtained to determine glucose, lipids, and HbA1C levels. An oral glucose tolerance test was performed in non-diabetic subjects. PAD was evaluated by ankle-brachial index and/or having a prior diagnosis.PAD prevalence was 3.81% (95% CI, 2.97-4.87) for all participants. In men, PAD prevalence was significantly higher than in women [5.17% (95% CI, 3.74-7.11) vs. 2.78% (95% CI, 1.89-4.07); p = 0.014]. Serum uric acid in the upper quartile was associated with the highest odds ratio (OR) of PAD (for uric acid > 6.1 mg/dl, OR = 4.31; 95% CI, 1.49-12.44). The remaining variables more strongly associated with PAD were: Heart rate >90 bpm (OR = 4.16; 95%CI, 1.62-10.65), pulse pressure in the upper quartile (≥ 54 mmHg) (OR = 3.82; 95%CI, 1.50-9.71), adherence to Mediterranean diet (OR = 2.73; 95% CI, 1.48-5.04), and former smoker status (OR = 2.04; 95%CI, 1.00-4.16).Our results show the existence of a low prevalence of peripheral artery disease in a population aged 45-74 years. Serum uric acid, pulse pressure and heart rate >90 bpm were strongly associated with peripheral artery disease. The direct association between Mediterranean diet and peripheral artery disease that we have found should be evaluated through a follow-up study under clinical practice conditions.

To evaluate the performance of the Finnish Diabetes Risk Score (FINDRISC) and a simplified FINDRISC score (MADRISC) in screening for undiagnosed type 2 diabetes mellitus (UT2DM) and dysglycaemia.A population-based, cross-sectional, descriptive study was carried out with participants with UT2DM, ranged between 45-74 years and lived in two districts in the north of metropolitan Madrid (Spain). The FINDRISC and MADRISC scores were evaluated using the area under the receiver operating characteristic curve method (ROC-AUC). Four different gold standards were used for UT2DM and any dysglycaemia, as follows: fasting plasma glucose (FPG), oral glucose tolerance test (OGTT), HbA1c, and OGTT or HbA1c. Dysglycaemia and UT2DM were defined according to American Diabetes Association criteria.The study population comprised 1,426 participants (832 females and 594 males) with a mean age of 62 years (SD = 6.1). When HbA1c or OGTT criteria were used, the prevalence of UT2DM was 7.4% (10.4% in men and 5.2% in women; p

La datación de cerámicas arqueológicas por la técnica de grano fino, utiliza el cuarzo con ese propósito. Las cerámicas panameñas contienen cuarzo continental de origen geológico reciente, ya que nuestra región estaba inmersa en el mar hasta el final de la era secundaria (final del cretáceo, 65 millones de años) y surgió con la caída del meteorito sobre la península de Yucatán, con un alto volcanismo. Sin embargo, la técnica de datación por grano fino se puso a punto con cerámicas de cuarzo de épocas geológicas anteriores. Con propósitos de caracterización, se programó un estudio sistemático de cuarzos recientes versus cuarzos geológicamente viejos. Dentro de ese programa se seleccionaron, por exoscopía, dos tipos extremos representativos de la gama de cuarzos. Uno de edad geológica avanzada, de baja cristalización y bastante meteorizado, llamado europeo por el lugar de colecta. El otro de edad geológica reciente, bien cristalizado, con poca meteorización, llamado panameño. En este trabajo se reportan los resultados de esta primera caracterización. Por MEB, los granos del cuarzo europeo manifiestan mayor desgaste de los bordes e irregularidades en la superficie típico de la edad avanzada. Por ATD, se encuentra la transición característica de la estructura alfa a la estructura beta y constató la mayor cristalinidad en el panameño que en el europeo. ATD y MET indican un cuarzo europeo muy fragmentado en su interior. Además, MET mostró muchas dislocaciones, hendiduras, una gran cantidad de burbujas de agua y las señas típicas (maclas) del sometimiento a grandes presiones en el cuarzo europeo, las cuales están ligadas a la presencia de H4O4. El cuarzo panameño solo desplegó, y en un número muy reducido, las burbujas de agua al ser calentado a 700 ºC y no mostró las maclas de las presiones de la caída del meteorito sobre Yucatán. El cuarzo europeo muestra bandas asociadas a los sitios AlO4 y GeO4. Es posible que en el panameño la cantidad de estos sitios sea inferior al límite detectable por el aparato.

Because of the difficulties in tracking a water mass over time and conducting synoptic surveys over large spatial scales, measurements of biological variables in the ocean are often restricted to isolated Eulerian observations. Here a proof-of-concept of a pseudo-Lagrangian transformation was applied to a time series of chlorophyll-a profiles acquired at a single fixed station to diagnose the shape of a phytoplankton patch, and its physical-biological rates of transformation. During August 2013, a 27-hr time series of observations of horizontal currents, hydrographic properties, turbulent mixing and chlorophyll-a was acquired at a central station of the Ría de Vigo (NW Iberian Peninsula). A chlorophyll-a patch, tilted upward toward the inner part of the Ría, was observed moving back and forth past the sampling station. Its shape and position during the sampling period were modulated by the semi-diurnal (M2) tidal currents and the vertically sheared upwelling circulation. The pseudo-Lagrangian transformation allowed estimation of chlorophyll-a net rates of change. These rates were positive between 12 and 14 m depth, and negative elsewhere, with a mean value of −0.001 ± 0.449 days−1 within the patch maximum. After accounting for the effects of diffusion and sinking, the mean net biological production rate in the upper 15 m (0.53 ± 0.25 days−1) was comparable with in vitro estimates of the balance between phytoplankton growth and mortality obtained from dilution experiments carried out under similar conditions (0.2 ± 0.7 days−1). This pseudo-Lagrangian transformation is complementary to traditional analyses for the quantification of ecological processes and biogeochemical budgets.

Trees' functional strategies to cope with extreme drought are essential under climate change. In a mixed Mediterranean forest, we analyzed the functional strategy in response to drought of four co‐occurring species (Pinus pinea, Pinus pinaster, Juniperus oxycedrus, and Quercus ilex) during two years. Specifically, we assessed functional traits related to tree water status, leaf water relations, and gas exchange. Different trait‐syndrome metrics and the functional strategies under water stress observed suggested a species drought‐tolerance differentiation, with the more anysohidric Q. ilex and J. oxycedrus showing a much higher drought tolerance than the more isohydric P. pinea and P. pinaster. All species recovered from negative leaf turgor reached during peak water stress in summer. Q. ilex and J. oxycedrus kept lower leaf osmotic potentials and lower sensitivity of leaf gas exchange and leaf photochemistry to water stress. In contrast, the pine species exhibited more drought‐avoidant and water‐conservative strategies, yet this behavior was less effective in mitigating water stress's impact on their physiology. The pine species were the most affected by drought, with prolonged near‐zero net photosynthesis during summer. P. pinaster was more isohydric than P. pinea and exhibited a lower capacity to maintain leaf turgor. Physiological processes regulating leaf turgor under drought constitute a key functional strategy involved in the carbon and water‐related mechanisms, ultimately inducing mortality under hot drought. The currently observed mortality dynamics for P. pinaster, and to a lower extent in P. pinea, may be exacerbated by loss of functional homeostasis. [ABSTRACT FROM AUTHOR]

Objective. To find out whether the use of indocyanine green for lymphatic sparing in the laparoscopic Palomo technique reduces the incidence of postoperative hydrocele. Materials and methods. A comparative cohort study of varicocele patients treated with the laparoscopic Palomo technique from 2008 to 2023 was carried out. Patients were divided into two groups according to whether fluorescence lymphography (intratesticular indocyanine green) had been performed or not. Epidemiological, surgical, and clinical data, as well as complications, were recorded. A hypothesis test was conducted using the SPSS software. Results. 30 patients undergoing varicocele surgery through the laparoscopic Palomo technique were included. They were divided into two groups –lymphatic sparing (n= 13) vs. spermatic vessel ligation without sparing (n= 17). Mean age at surgery was 14 years. 5 cases of postoperative hydrocele were identified in the no lymphatic sparing group. 1 of them required surgery for hydrocele treatment. No hydrocele cases were noted in the lymphography group. The difference was statistically significant (p= 0.032). There were no statistically significant differences in terms of operating times or mean hospital stay. No recurrences, postoperative testicular atrophies, or indocyanine-green-related complications were recorded. Mean follow-up was 11.4 months. Conclusions. The use of indocyanine green for lymphatic sparing in the treatment of varicocele through the laparoscopic Palomo technique significantly reduces the incidence of postoperative hydrocele. [ABSTRACT FROM AUTHOR]