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From chemistry design to clinical application, several approaches have been developed to overcome platinum drawbacks in antitumoral therapies. An in-depth understanding of intracellular signaling may hold the key to the relationship of both conventional drugs and nanoparticles. Within these strategies, first, nanotechnology has become an essential tool in oncotherapy, improving biopharmaceutical properties and providing new immunomodulatory profiles to conventional drugs mediated by activation of endoplasmic reticulum (ER) stress. Secondly, functional proteomics techniques based on microarrays have proven to be a successful method for high throughput screening of proteins and profiling of biomolecule mechanisms of action. Here, we conducted a systematic characterization of the antitumor profile of a platinum compound conjugated with iron oxide nanoparticles (IONPs). As a result of the nano-conjugation, cytotoxic and proteomics profiles revealed a significant improvement in the antitumor properties of the starting material, providing selectivity in certain tumor cell lines tested. Moreover, cell death patterns associated with immunogenic cell death (ICD) response have also been identified when ER signaling pathways have been triggered. The evaluation in several tumor cell lines and the analysis by functional proteomics techniques have shown novel perspectives on the design of new cisplatin-derived conjugates, the high value of IONPs as drug delivery systems and ICD as a rewarding approach for targeted oncotherapy and onco-immunotherapies.

Background: The association between heart rate (HR) and pulmonary embolism (PE) outcomes has not been well studied. Furthermore, optimal cutoffs to identify low-risk and intermediate- to high-risk patients are not well known. Research Question: Does an association exist between baseline HR and PE outcome across the continuum of HR values? Study Design and Methods: The current study included 44,331 consecutive nonhypotensive patients with symptomatic PE from the Registro Informatizado de la Enfermedad TromboEmbólica registry between 2001 and 2021. Outcomes included 30-day all-cause and PE-specific mortality. We used hierarchical logistic regression to assess the association between admission HR and outcomes. Results: A positive relationship was found between admission HR and 30-day all-cause and PE-related mortality. Considering an HR of 80 to 99 beats/min as a reference, patients in the higher HR strata showed higher rates of all-cause death (adjusted OR, 1.5 for HR of 100-109 beats/min; adjusted OR, 1.7 for HR of 110-119 beats/min; adjusted OR, 1.9 for HR of 120-139 beats/min; and adjusted OR, 2.4 for HR of ≥ 140 beats/min). Patients in the lower strata of HR showed significantly lower rates of 30-day all-cause mortality compared with the same reference group (adjusted OR, 0.6 for HR of 60-79 beats/min; and adjusted OR, 0.5 for HR of < 60 beats/min). The findings for 30-day PE-related mortality were similar. For identification of low-risk patients, a cutoff value of 80 beats/min (vs 110 beats/min) increased the sensitivity of the simplified Pulmonary Embolism Severity Index (sPESI) from 93.4% to 98.8%. For identification of intermediate- to high-risk patients, a cutoff value of 140 beats/min (vs 110 beats/min) increased the specificity of the Bova score from 93.2% to 98.0%. Interpretation: In nonhypotensive patients with acute symptomatic PE, a high HR portends an increased risk of all-cause and PE-related mortality. Modifying the HR cutoff in the sPESI and the Bova score improves prognostication of patients with PE.

Venous thromboembolism (VTE) is a frequent complication in patients with cancer and a leading cause of morbidity and death. The objective of the RIETECAT study was to compare the long-term effectiveness and safety of enoxaparin versus dalteparin or tinzaparin for the secondary prevention of VTE in adults with active cancer. We used the data from the multicenter, multinational RIETE registry to compare the rates of VTE recurrences, major bleeding, or death over 6 months in patients with active cancer and acute VTE using full doses of enoxaparin versus dalteparin or tinzaparin, and a multivariable Cox proportional hazard model was used to analyze the primary end point. From January 2009 to June 2018, 4451 patients with active cancer received full doses of the study drugs: enoxaparin, 3526 patients; and dalteparin or tinzaparin, 925 (754 + 171) patients. There was limited difference in VTE recurrences (2.0% vs 2.5%) and mortality rate (19% vs 17%) between the enoxaparin and dalteparin or tinzaparin subgroups. However, there was a slight numerical increase in major bleeding (3.1% vs 1.9%). Propensity score matching confirmed that there were no differences in the risk for VTE recurrences (adjusted hazard ratio [aHR], 0.81; 95% confidence interval [CI], 0.48-1.38), major bleeding (aHR, 1.40; 95% CI, 0.80-2.46), or death (aHR, 1.07; 95% CI, 0.88-1.30) between subgroups. In RIETECAT, in patients with cancer and VTE receiving full-dose enoxaparin or dalteparin or tinzaparin, no statistically significant differences were observed regarding effectiveness and safety outcomes over a 6-month period.

Resumen La enfermedad tromboembolica venosa (ETV) es una de las complicaciones mas frecuentes y graves de los enfermos medicos hospitalizados, siendo la embolia pulmonar la primera causa de muerte prevenible. La ETV prolonga la estancia hospitalaria, con un mayor consumo de recursos y un aumento del gasto sanitario. Los factores de riesgo para su desarrollo pueden ser intrinsecos al paciente o estar relacionados con la propia hospitalizacion. Conocer e identificar estos factores, tanto al ingreso como durante la evolucion del proceso medico, debe ser una prioridad. La profilaxis de la ETV ha demostrado ser eficaz y eficiente. Su aplicacion en el paciente medico conlleva una disminucion de la embolia pulmonar mortal, de las trombosis venosas profundas sintomaticas y de la mortalidad en los 3 meses posteriores al alta. La valoracion individual y detallada del riesgo-beneficio de esta profilaxis es, por tanto, fundamental. Las heparinas de bajo peso molecular siguen siendo de primera eleccion en la profilaxis farmacologica de la ETV en los enfermos medicos. En aquellos pacientes en los que el uso de farmacos este contraindicado se podria plantear el uso de medidas fisicas para su prevencion.

[Background] Nowadays, nanoparticles (NPs) have evolved as multifunctional systems combining different custom anchorages which opens a wide range of applications in biomedical research. Thus, their pharmacological involvements require more comprehensive analysis and novel nanodrugs should be characterized by both chemically and biological point of view. Within the wide variety of biocompatible nanosystems, iron oxide nanoparticles (IONPs) present mostly of the required features which make them suitable for multifunctional NPs with many biopharmaceutical applications., [Results] Cisplatin-IONPs and different functionalization stages have been broadly evaluated. The potential application of these nanodrugs in onco-therapies has been assessed by studying in vitro biocompatibility (interactions with environment) by proteomics characterization the determination of protein corona in different proximal fluids (human plasma, rabbit plasma and fetal bovine serum),. Moreover, protein labeling and LC–MS/MS analysis provided more than 4000 proteins de novo synthetized as consequence of the nanodrugs presence defending cell signaling in different tumor cell types (data available via ProteomeXchanges with identified PXD026615). Further in vivo studies have provided a more integrative view of the biopharmaceutical perspectives of IONPs., [Conclusions] Pharmacological proteomic profile different behavior between species and different affinity of protein coating layers (soft and hard corona). Also, intracellular signaling exposed differences between tumor cell lines studied. First approaches in animal model reveal the potential of theses NPs as drug delivery vehicles and confirm cisplatin compounds as strengthened antitumoral agents., We gratefully acknowledge financial support from the Spanish Health Institute Carlos III (ISCIII) and co-funded by the European Union, for the grants: FIS PI14/01538, FIS PI17/01930, PI21/01545 and CB16/12/00400. We also acknowledge Fondos FEDER (EU) and Junta Castilla-León (COVID19 grant COV20EDU/00187). Fundación Solórzano FS/38-2017. The Proteomics Unit belongs to ProteoRed, PRB3-ISCIII, supported by Grant PT17/0019/0023, of the PE I + D + I 2017-2020, funded by ISCIII and FEDER. This research work was funded by the European Commission—NextGenerationEU, through CSIC's Global Health Platform (PTI Salud Global). This research work was performed in the framework of the Nanomedicine CSIC HUB (ref 202180E048). A. Landeira-Viñuela is supported by VIII Centenario-USAL PhD Program, P. Juanes-Velasco is supported by JCYL PhD Program and scholarship JCYL-EDU/601/2020.

Background: information/communication technologies such as mobile phone applications (apps) would enable chronic urticaria (CU) patients to self-evaluate their disease activity and control. Yet, recently Antó et al (2021) reported a global paucity of such apps for patients with CU. In this analysis, we assessed patient interest in using apps to monitor CU disease activity and control using questions from the chronic urticaria information and communication technologies (CURICT) study. Methods: the methodology for CURICT has been reported. Briefly, a 23-item questionnaire was completed by 1841 CU patients from 17 UCAREs across 17 countries. Here, we analyzed patient responses to the CURICT questions on the use of apps for urticaria-related purposes. Results: as previously published, the majority of respondents had chronic spontaneous urticaria (CSU; 63%; 18% chronic inducible urticaria (CIndU) [CIndu]; 19% with both), were female (70%) and in urban areas (75%). Over half of patients were very/extremely interested in an app to monitor disease activity (51%) and control (53%), while only ?1/10 were not. Patients with both urticaria types versus those with CSU only (odds ratio [OR], 1.36 [1.03-1.79]) and females versus males (OR [95% CI], 1.47 [1.17-1.85]) were more likely to be very to extremely interested in an app to assess disease control. Conclusions: overall, half of the patients with CU were very to extremely interested in using an app to assess their disease activity and control. Development of well-designed apps, specific to disease types (CSU, CIndU, CSU + CIndU, etc), validated by experts across platforms would help improve the management and possibly outcomes of CU treatment while providing important patient information to be used in future research. Keywords: UCARE; apps; chronic inducible urticaria; chronic spontaneous urticaria; chronic urticaria; chronische induzierbare urtikaria; chronische spontane urtikaria; chronische urtikaria., UCARE

Aims Little is known about the prognosis of patients with massive pulmonary embolism (PE) and its risk of recurrent venous thromboembolism (VTE) compared with non-massive PE, which may inform clinical decisions. Our aim was to compare the risk of recurrent VTE, bleeding, and mortality after massive and non-massive PE during anticoagulation and after its discontinuation. Methods and results We included all participants in the RIETE registry who suffered a symptomatic, objectively confirmed segmental or more central PE. Massive PE was defined by a systolic hypotension at clinical presentation (

Mast cells and basophils interact with various cells in the urticaria lesion microenvironment, such as macrophages,.which form an essential component of innate immunity, and are involved in numerous functions including protein secretion. Objective: The aim of the present study was to characterize the macrophage phenotype in urticarial lesions of patients with chronic spontaneous urticaria (CSU) nonresponsive to antihistamines at optimized doses. And compare the phenotype with clinical and laboratory parameters such as age, gender, urticaria time, C-reactive protein (CRP), and total serum IgE, and autologous serum skin test (ASST). Methods: Twenty-eight patients with CSU refractory to antihistamines were included in the study. Epidemiological data, C-reactive protein, D-dimers, basophils in peripheral blood, and total serum IgE and ASST were assessed. The mannose receptor (CD206), CD163, CMAF, and pSTAT 1 were used to characterize the M1/M2 macrophage subpopulations. The immunolabeled cells per square millimeter were manually enumerated at a 400× magnification in 12 optical fields via light microscopy. Results: A predominance of M2 macrophages was seen in CSU patients. Statistical differences were observed between the CD206 marker and the disease course. No correlation was found between biomarkers and macrophage populations. Expression of CMAF was significantly higher in the patient sample compared to that in the control skin (patients without history of urticaria; p-value < 0.001). Conclusion: M2 macrophages were seen with significantly higher CMAF expression, which indicates macrophage activation in patients with CSU. CD206 expression was inversely correlated with disease time.

Thermal disinfection is probably the oldest water treatment method ever used. Similarly to other disinfection processes, it targets the inactivation of pathogenic (micro)organisms present in water, wastewater and other media. In this work, a pilot-scale continuous-flow thermal disinfection system was investigated using highly contaminated hospital wastewater as influent without any pre-treatment step for turbidity removal. The results proved that the tested system can be used with influent turbidity as high as 100 NTU and still provide up to log 8 microbial inactivation. Further results have shown energy consumption comparable to other commercially available thermal disinfection systems and relatively low influence on the investigated physical–chemical parameters.

Venous thromboembolism (VTE) is a prevalent and serious complication in hospitalized medical patients. Pulmonary embolism is the most common preventable cause of hospital death. VTE extends hospitalization, with a higher resource consumption and an increase in healthcare costs. Risk factors for VTE include intrinsic factors and those related to hospitalization. It is important to know and to identify these factors at the moment of hospital admission and during the course of disease. VTE prophylaxis has demonstrated to be an efficient and effective action. Its implementation reduces life-threatening pulmonary embolism, symptomatic deep vein thrombosis and death rate three months after discharge. An individual and detailed assessment of prophylaxis risk-benefit is a priority. In our country, low molecular weight heparins are still the first option for VTE pharmacological prophylaxis. In those patients at high risk of bleeding or in whom anticoagulation is contraindicated mechanical methods could be used.

Background: The prevailing evidence calls for using chimney/snorkel endovascular repair (ch-EVAR) with one or two chimney grafts. No studies up to now focus on its applicability and results for the treatment of suprarenal aortic pathologies (SRAP). Hence, we evaluated the clinical and radiologic results of ch-EVAR treatment for SRAP placing three or more chimney grafts within the PERICLES Registry. Methods: Data from 517 patients suffering complex aortic pathologies treated by ch-EVAR between 2008 and 2014 at 13 European and U.S. centers were retrospectively reviewed and analyzed. Results: Sixty-seven ch-EVAR-treated patients (12.9% of the entire PERICLES cohort) presented SRAP (83.5% elective, 16.5% urgent). The majority of patients (95.5%) received three chimney grafts; four patients received four chimney grafts. The Endurant device was the most commonly used (35.8%) followed by the Zenith abdominal endograft (19.4%). Overall, 204 chimney grafts were placed (56.7% covered self-expandable, 40.3% covered balloon-expandable stents, and 10.4% bare metal balloon-expandable stents). At a median follow-up of 24 months (range, 0.1-67.0 days), 30-day mortality was 6.1% (4 patients), and the overall mortality was 16.4% (11 patients). Overall survival was 87.4% (range, 79.5%-96.0%) at 1 year, 81.8% (range, 72.2%-92.2%) at 2 years and thereafter. Type IA endoleak was noted in nine patients (13.4%) intraoperatively and successfully treated in seven cases (97.1% technical success). Aneurysm sac diameter significantly decreased from 70.5 ± 19.3 mm to 66.9 ± 20.6 mm (P

Purpose: To evaluate the feasibility of a patient-specific rehearsal (PsR) before emergency endovascular aneurysm repairs (eEVAR) and its influence on the operation. Materials and Methods: From February 2016 to October 2016, 10 consecutive patients (mean age 75 +/- 7.4 years; 9 men) presenting with a ruptured abdominal aortic aneurysm (rAAA) suitable for standard EVAR were enrolled in the study. A 3-dimensional (3D) model of the abdominal aorta was generated on a virtual reality simulator based on the patient's computed tomography (CT) images. Following the patient-specific simulation setup, PsR was conducted during patient admission or in parallel with the preoperative eEVAR workup. Measured outcomes were PsR feasibility only in the first 4 patients and impact on operative performance thereafter (changes in device selection, the planning process, clinical outcomes, perioperative mortality, and complication rates). Technical metrics and timing of system setup, rehearsal, interval from patient arrival to the actual procedure, and eEVAR were recorded. Results: Mean time for 3D model creation was 21.3 +/- 7.8 minutes (range 13-37); there was a significant positive relationship between aortic neck diameter and segmentation time (p=0.003). The overall mean time for simulator setup and PsR was 54 +/- 14 minutes (range 37-80); PsR alone was completed in a mean 31 +/- 40 minutes (95% confidence interval -60 to -2.2). The actual eEVAR procedure duration was 69 +/- 16 minutes (range 45-90). No delay in the actual eEVAR procedure was registered owing to the PsR pathway. In 6 patients, preprocedure rehearsal induced changes in operative strategy, including device selection, main body introduction side, and/or deployment configuration. In 4 cases, rehearsal was performed twice to achieve optimal performance. Conclusion: PsR before eEVAR was feasible in all cases and caused no time delays in the actual eEVAR procedure. PsR optimized eEVAR planning by identifying optimal strategy for stent-graft component selection and deployment.

Low-back pain remains a common pathological entity in the Western population. We have found no data in the literature that assess whether, with correct physical examination and evaluation of simple x-rays of the spine, it is possible to diagnose patients who are highly likely to be candidates for lumbar spine surgery and thus reduce the care burden and resource consumption that this disorder entails. The aim of the study was to develop a user-friendly calculator that allows only patients who are strong candidates for surgical treatment to be referred for spinal surgery consultation.An observational and retrospective study that included all adult patients from the healthcare area of Talavera de la Reina (Toledo, Spain) with a clinical and/or radiological diagnosis of degenerative lumbar spine disease referred by other specialists over one calendar year to the spinal surgery unit to assess whether surgery was indicated after unsuccessful conservative treatment. All the patients were assessed under the same protocol with a follow-up of 6years, at the end of which we performed a check of those who had undergone lumber spine surgery.A total of 201 patients were studied and at the end of the 6-year follow-up, a total of 77 patients had been operated. Concordance of 70% was found between the indication for surgical treatment and the treatment received at the end of the follow-up. Therefore a logistic regression was performed in an attempt to predict the patients that could be referred to the spinal surgery units and from that a calculator was generated, which included the plain x-ray variable as an essential item, and which showed as statistically significant (P.05): age, Waddell's non-organic signs, Lasegue's sign and plain x-ray assessment. Once this tool had been obtained, the likelihood of undergoing surgery was calculated for all patients who were proposed surgical treatment, obtaining results above 62% as the cut-off point when using the calculator.The use of the calculator predicts the possibility of being a candidate for surgical treatment with 70% reliability. Therefore, patients with a result in the calculator of above 62% should be referred for spinal surgery consultation for assessment by a specialist.

Background Venous thromboembolism (VTE) is a major cause of morbidity and mortality postoperatively. The use of pharmacologic prophylaxis is effective in reducing the incidence of VTE. However, the prophylaxis is often discontinued at hospital discharge, especially for those with benign disease. The implications of this practice are not known. We assessed the data from a large, ongoing registry regarding the time course of VTE and outcomes after noncancer surgery. Methods We analyzed the RIETE (Computerized Registry on Venous Thromboembolism) registry, which includes data from consecutive patients with symptomatic confirmed VTE. In the present study, we focused on general surgical patients who had developed symptomatic postoperative VTE in the first 8 weeks after noncancer surgery. The main objective was to assess the interval between surgery and the occurrence of VTE. Additional variables included the clinical presentation associated with the event, the use of thrombosis prophylaxis, and unfavorable outcomes. Results The data from 3296 patients were analyzed. The median time from surgery to the detection of VTE was 16 days (interquartile range, 8-30 days). Of the VTE events, 77% were detected after the first postoperative week and 27% after 4 weeks. Overall, 43.9% of the patients with VTE had received pharmacologic prophylaxis after surgery for a median of 8 days (interquartile range, 5-14 days), and three quarters of the VTE events were detected after pharmacologic prophylaxis had been discontinued. Overall, 54% of the patients with VTE had presented with pulmonary embolism. For 15% of the patients, the clinical outcome was unfavorable, including 4% who had died within 90 days. Conclusions The risk of VTE after noncancer general surgery remains high for ≤2 months. More than one half of the patients had presented with symptomatic PE as the VTE event, and 15% had had unfavorable outcomes. Only 44% of these patients had received pharmacologic prophylaxis for around 1 week.

This work presents a method to improve visualisation of metallographic structures in titanium containing alloys. After conventional selective chemical etching with Kroll’s reagent, the surface of the sample specimen is manually dyed with a phtalocyanine based lacquer. The results are highly detailed and sharp coloured images when investigated with Optical Microscopy, providing much more information compared to the grey shaded, etching only approach.

Background To study the performance of the chimney technique in the treatment of aortic arch pathologic conditions. Methods We retrospectively evaluated the clinical and procedural outcome data of patients undergoing endovascular treatment in the aortic arch by use of the chimney technique at four European centers between June 2002 and December 2014. The primary endpoint was technical success. The secondary endpoints were type I endoleak, 30-day mortality, stroke, primary patency of the chimney graft, and freedom from reintervention. Results Ninety-five patients were included in the study. The underlying pathologic conditions were degenerative aneurysm (n = 45, 47.4%), type B aortic dissection (n = 30, 31.6%), dissecting aneurysm (n = 6, 6.5%), penetrating atherosclerotic ulcer (n = 5, 5.3%), type I endoleak after previous thoracic endovascular aortic repair (n = 6, 6.3%), and aortic embolic disease (n = 3, 3.2%). Twenty-one patients (22%) underwent arch-branch debranching before chimney graft implantation. The majority of patients were treated electively (n = 49, 51.6%). Forty-six patients (48.4%) underwent urgent placement of chimney grafts because of their symptoms (n = 25) or rupture (n = 21). Technical success was 89.5%. The 30-day mortality was 9.5% (9 patients). No aorta-related death was observed. A type Ia endoleak occurred in 10 patients (10.5%) intraoperatively, resolving spontaneously within the first 30 days in 50% of these cases. Major stroke was diagnosed in 2 patients (2%). Primary patency of the chimney grafts was 98%, and 5 patients (5.2%) required a reintervention. Conclusions The chimney technique in the aortic arch proved highly and predictably successful, with a low rate of reinterventions.

The new thermal treatment of subcritical annealing and water quenching, applied to boron steels (30MnB5), which we propose in our research, achieve excellent variability in mechanical properties, as a result of obtaining a very versatile dual structure. In addition, there is a significant reduction in energy consumption and process time, which results in the Life Cycle Analysis (LCA) and process costs. The presence of boron favours the success of the thermal treatment. The explanation of the process has been investigated by means of a metallographic study, mechanical characterization and in this work the results obtained by means of the study of the treated and untreated samples by means of X-Ray diffraction are presented. The presence of very small FeB crystals in the structure are the cause of the dual structure and its good characteristics. They have only been detected by X-Ray Diffraction, although we have also tried Transmission Electron Microscopy with unclear results.

Objective Chimney endovascular aortic aneurysm repair is gaining ever greater acceptance. However, persistent gutters leading to type IA endoleaks represent an unsolved issue. The aim of the current study was to analyze the impact of abdominal endograft oversizing to the occurrence of this phenomenon. Methods The PERformance of the snorkel/chImney endovascular teChnique in the treatment of compLex aortic PathologiesES registry includes the largest experience with chimney endovascular aortic aneurysm repair from 13 vascular centers in Europe and the U.S. Prospectively collected data from centers with standard use of the Endurant stent-graft and balloon-expandable covered stents as chimney grafts only were included in the present analysis. The parameter which varied was the degree of oversizing of the aortic stent-graft classifying the cohort in two groups, group A (20% and less oversizing) and group B (>20% of oversizing). The primary endpoint was the incidence of persistent type IA endoleak needed reintervention. Secondary endpoints were all-cause mortality and freedom from reintervention. Results Group A included 21 patients while group B 144. The mean preoperative pathology’s neck length and diameter was 5.8 mm (±4.4) versus 4.9 mm (±3.8) and 27.6 mm (±4.7) versus 24.9 mm (±3.7) for group A and group B, respectively. The mean length of the new sealing zone after chimney graft placement was similar for both groups (group A versus group B; 17.9 mm versus 18.3 mm, respectively, P = .21). The percentage of oversizing of the aortic stent-graft ranged between 13.8 and 20% versus 22.2 and 30%, for group A and group B, respectively. Patients of group A had more type 1A endoleaks, (14.3%) versus patients of group B (2.1%) based on the first follow-up imaging, P = .02. The incidence of persistent type IA endoleaks needing a reintervention was 14.3 and 1.4% for the group A and group B, respectively, P = .01. The mean volume of contrast medium used was greater in group A versus group B with 239 ml versus150 ml, P = .05. Additionally, 14.3% of patients of group A experienced acute renal failure compared to those in group B which was 1.0%, P = .01. Conclusions Oversizing of ideally 30% of the Endurant stent-graft is associated with significant lower incidence of type IA endoleaks requiring reintervention for patients treated by chimney endovascular aortic aneurysm repair.

OBJECTIVE: The objective of this study was to describe the polar orientation of renal chimney grafts within the proximal seal zone and to determine whether graft orientation is associated with early type Ia endoleak or renal graft compression after chimney endovascular aneurysm repair (ch-EVAR). METHODS: Patients who underwent ch-EVAR with at least one renal chimney graft from 2009 to 2015 were included in this analysis. Centerline three-dimensional reconstructions were used to analyze postoperative computed tomography scans. The 12-o’clock polar position was set at the takeoff of the superior mesenteric artery. Relative polar positions of chimney grafts were recorded at the level of the renal artery ostium, at the mid-seal zone, and at the proximal edge of the graft fabric. Early type Ia endoleaks were defined as evidence of a perigraft flow channel within the proximal seal zone. RESULTS: There were 62 consecutive patients who underwent ch-EVAR (35 double renal, 27 single renal) for juxtarenal abdominal aortic aneurysms with a mean follow-up of 31.2 months; 18 (29%) early type Ia “gutter” endoleaks were identified. During follow-up, the majority of these (n = 13; 72%) resolved without intervention, whereas two patients required reintervention (3.3%). Estimated renal graft patency was 88.9% at 60 months. Left renal chimney grafts were most commonly at the 3-o’clock position (51.1%) at the ostium, traversing posteriorly to the 5- to 7-o’clock positions (55.5%) at the fabric edge. Right renal chimney grafts started most commonly at the 9-o’clock position (n = 17; 33.3%) and tended to traverse both anteriorly (11 to 1 o’clock; 39.2%) and posteriorly (5 to 7 o’clock; 29.4%) at the fabric edge. In the polar plane, the majority of renal chimney grafts (n = 83; 85.6%) traversed 90 degrees were independently associated with early type Ia endoleaks (odds ratio, 11.5; 95% confidence interval, 2.1–64.8) even after controlling for other device and anatomic variables. Polar orientation of the chimney grafts was not associated with graft kinking or compression (P = .38) or occlusion (P = .10). Takeoff angle of the renal arteries was the most significant predictor of chimney graft orientation. Caudally directed arteries (takeoff angle >30 degrees) were less likely to have implanted chimney grafts that traversed >90 degrees in polar angle (odds ratio, 0.09; 95% confidence interval, 0.01–0.55). CONCLUSIONS: Renal chimney grafts vary considerably in both starting position and their polar trajectory within the proximal seal zone. Grafts that traverse >90 degrees in polar angle within the seal zone may be at increased risk of early type Ia endoleaks and require more frequent imaging surveillance. Caudally directed renal arteries result in a more favorable polar geometry (eg, cranial-caudal orientation) with respect to endoleak risk and thus are more ideal candidates for parallel graft strategies.

We present a metallographic study of archaeological artefacts of steel, had been found in different archaeological sites, which characteristic microstructures reveal that have been affected by levels of fire. Study was performed using FEG (Field Emission Gun). In the laboratory, they are reproduced structures of steels archaeological.Se presenta un estudio metalográfico de piezas arqueológicas de acero, encontradas en distintos yacimientos arqueológicos, cuyas microestructuras características revelan que se han visto afectadas por niveles de incendio. El estudio se ha realizado mediante FEG (Field Emission Gun). Se han reproducido en el laboratorio las estructuras de los aceros arqueológicos.

In the present work have studied two samples with the same pigment, Egyptian Blue, but from different sources. The difference between them is caused by the functionality. In the case of Nefertari´s tomb is decorating interior rooms carved into rock in which they would not suffer any damage since it does not accessed to that place anymore. In the case of Balneum´s baths is decorating very warm and humid rooms, and should resist deterioration resulting from human activity during the use of these baths.En el trabajo presentado se han estudiado dos muestras de pinturas con el mismo pigmento, azul egipcio, de distinta procedencia. Las diferencias entre ellas vienen causadas por la funcionalidad. En el caso de la tumba de Nefertari se trata de decorar estancias interiores excavadas en roca en las que no sufrirían deterioro alguno, dado que no se accedería a ese lugar nunca más. En el caso del Balneum se trata de pinturas que decoran ambientes muy húmedos y cálidos y que, además, deben resistir el deterioro derivado de la actividad humana en dichas termas.

Purpose: To analyze the results of isolated left subclavian artery (LSA) revascularization during thoracic endovascular aortic repair (TEVAR) using carotid-subclavian bypass (CSbp) or chimney grafts (CGs). Methods: A retrospective multicenter, observational study identified 73 patients (mean age 68±13 years, range 22–87; 56 men) with acute or chronic thoracic aortic lesions who underwent TEVAR with isolated LSA revascularization using either CSbp (n=42) or CGs (n=31) from January 2010 and February 2017. Primary endpoints were TEVAR-related mortality, postoperative stroke, freedom from type Ia endoleak, and LSA patency. Results: Primary technical success was achieved in all cases. Early TEVAR-related mortality was 4.2% (CSbp 2% vs CG 6%, p=0.571). Two (3%) patients had major ischemic strokes (one in each group). Mean follow-up was 24±21 months (range 1–72; median 15). Estimated freedom from TEVAR-related mortality was 93%±3% (95% CI 84.3% to 97.0%) at 12 and 36 months, with no significant difference between CSbp and CG (p=0.258). Aortic reintervention did not differ between the groups (CSbp 5% vs CG 6%, p=0.356); nor did freedom from type Ia endoleak (CSbp 98% vs CG 87%, p=0.134). Gutter-related endoleaks occurred in 4 (13%) CG patients, but none of the patients experienced sac enlargement or the need for reintervention and none died. Primary patency of the LSA was 100% for the entire group during the observation period. Conclusion: In our experience, LSA revascularization proved most satisfactory and equally effective with both the CSbp and CG techniques, without discernible differences at midterm follow-up.

Aportacion de la imagen molecular en la exploracion del cerebro.

The study of archaeological analogues is a helpful tool to asses long-term corrosion behaviour for a wide range of materials. In this work, a celtiberic belt-buckle is studied as analogue for a composite material of carbon steel, bronze and a final coating of magnetite, also providing a hypothesis about the ancient fabrication of these coatings. The paper goes through a metallographic examination of the sample and compares the corrosion phenomena suffered with those of two other metallic objects, recovered from the same archaeological site. It includes geochemical analysis of the soil from which the reference objects were recovered. The belt-buckle, after being cremated and buried over two millennia into a rather aggressive environment, showed remarkably high resistance against corrosion.

Mixing and sintering aluminium and 20% mechanically alloyed Fe/B nanoparticles provokes the formation of intermetallics in the aluminium matrix when following a powder metallurgy route. Materials were sintered in a wide range of temperatures (from 600 to 1100 oC). Previous studies have shown that these materials present neither important dimensional changes during sintering nor significant differences in mechanical properties. However, sintering temperature strongly affects corrosion resistance and hot rolling capability. Low sintering temperature provides nanocomposites with lower corrosion properties and hot rolling capability. In this work the nanocomposites obtained at different temperatures were characterized by X-ray diffraction. This technique allows following the formation of different intermetallics at each temperature, since being non-equilibrium processes, the use of ternary phase diagram of these elements is not possible.

Aluminium castings with silicon content above the eutectic are becoming an increasingly important product, meeting a wide range of high end engineering specifications, particularly in automotive and aerospace industries. Its outstanding properties highly depend on their cast microstructures; conventional casting will produce large primary silicon particles in a variety of morphologies. This causes drastically shortened tool life when machining this material, reason for which melt refinement is an ongoing field of investigation. An ultrasound assisted chemical deep etching procedure could be proven to reveal primary and eutectic silicon crystals in all detail while preserving the spatial distribution they had when precipitating from the eutectic during solidification. Different polyhedral growth morphologies, mostly coarser platelets, star-like and blocky structures, were observed in an as cast alloy using Scanning Electron Microscopy. As this metallurgic sample treatment provides to a certain extend spatially resolved information about morphology and distribution of silicon crystals, it is suitable to assess the grade of success of refinement processes aiming to achieve fine and well dispersed silicon particles in the eutectic phase.

For better observation of the microstructure of cast aluminium alloys under an optical microscope, the contrast obtained for the different micro constituents was enhanced by making use of a copper phthalocyanine based colorant. The proposed method allows distinguishing structural details which would remain hidden or poorly resolved when studying the conventionally etched sample. The method produces high relief for silicon precipitates with the tint further accentuating the outlines, allowing detection of morphology change of the aluminium-silicon eutectic due to chemical modification with strontium. Magnesium micro segregations in the α-aluminium phase, caused by incorrect thermal treatment during ageing, can also be clearly distinguished. The coloured images obtained by optical microscopy are very sharp and provide similar or better information than the corresponding Scanning Electron Microscopy images. The method proved to be suitable for Quality Control in the fabrication of cast aluminium alloy compounds, sourcing down possible errors to different stages of the process.

Kurzfassung Mit Hilfe der Rasterelektronenmikroskopie sowie EDX-Analyse wurden Bronzeeinlagerungen in einem Krug aus Graupastenkeramik untersucht. Dieser stammt von einer Fundstelle in der Nähe von Toledo, Spanien und wird auf das VII. Jahrhundert vor Christus datiert. Sowohl die ermittelte Zusammensetzung der binären Kupfer-Zinn-Bronze als auch die Interpreation der Kristallfeinstruktur erhärten die Hypothese, dass es sich bei dem Krug um ein Artefakt der tartesischen Kultur handelt. Dies deutet seinerseits darauf hin, dass der Einflussbereich dieser frühiberischen Kultur wesentlich ausgedehnter war als bisher angenommen.