Search

Introducción y objetivos: Las fracturas humerales por fragilidad representan una importante complicación de la osteoporosis, llegando a ser las terceras más prevalentes en los individuos mayores de 60 años. El objetivo de este trabajo ha sido analizar la prevalencia y manejo de las fracturas humerales por fragilidad en un hospital de tercer nivel. Pacientes y métodos: Estudio retrospectivo de los pacientes con fractura humeral por fragilidad atendidos en un hospital terciario universitario durante el año 2013. Se recogieron las variables clínico-epidemiológicas y se analizó la incidencia de nuevas fracturas y la mortalidad en un periodo de seguimiento de 3 años. Resultados: Se analizaron 248 fracturas humerales por fragilidad. El 81% de los pacientes eran mujeres y la media de la edad fue de 71 años. El 28,2% de los pacientes había presentado una fractura previa y el 20,2% sufrió una posterior. El 12,5% había sido diagnosticado previamente de osteoporosis, y solamente el 9,2% recibió el diagnóstico de este trastorno metabólico óseo tras la fractura humeral. Un 18% de los pacientes fallecieron durante el periodo de seguimiento. Conclusión: La fractura humeral por fragilidad se sigue, en nuestro medio, de un bajo porcentaje de diagnóstico y tratamiento de la osteoporosis subyacente, lo que puede condicionar un aumento del riesgo de nuevas fracturas.

Resumen La obstruccion venosa retiniana (OVR) se ha relacionado fundamentalmente con los factores de riesgo vascular y con el glaucoma; sin embargo, existen pocos estudios de la OVR en pacientes con trasplante de organo solido. Se analizo una serie de 331 pacientes que presentaron OVR (de rama en 226 casos y central en 105 casos) a lo largo de 10 anos y se compararon las caracteristicas entre los 4 pacientes con antecedente de trasplante de organo solido (hepatico, renal o bipulmonar) que presentaron una OVR y el resto. En nuestra serie la OVR en los trasplantados comenzo a edades mas tempranas que en el resto de pacientes con OVR (58 vs. 68 anos, respectivamente), afecto a la vena central de la retina (100% vs. 32%) y se asocio con la diabetes mellitus (75% vs. 25%) y con los tratamientos esteroideo (100% vs. 1%) e inmunosupresor (tacrolimus 75% vs. 0%).

Although retinal venous obstruction (RVO) has been primarily related to vascular risk factors and glaucoma, there are a few studies of RVO in patients with solid organ transplants. An analysis was performed on total of 331 patients who presented with RVO (branch RVO in 226 cases and central RVO in 105 cases) over a 10 year period, and the characteristics were compared with the 4 patients with a history of solid organ transplant (liver, renal, or bipulmonary) who presented with RVO. In this series, the onset of RVO in transplant patients occurred at earlier ages than in other patients with RVO (58 vs. 68 years, respectively), affected the central vein of the retina (100% vs. 32%), and was associated with diabetes mellitus (75% vs. 25%), as well as with steroidal (100% vs. 1%) and immunosuppressive (tacrolimus 75% vs. 0%) treatments.

Retinal vein occlusion (RVO) has been related to vascular risk factors and thrombophilia.This is a prospective cohort study of all patients diagnosed with RVO and referred to an Internal Medicine clinic of a tertiary teaching hospital during a 10-year period. Clinical, laboratory and supra-aortic trunks ultrasound variables were analysed and compared according to age.Some 309 patients diagnosed with RVO were included, 25 of them younger than 50 years. The prevalence of high blood pressure, dyslipidaemia, diabetes mellitus, hyperhomocysteinemia, and carotid plaque was significantly higher in patients50 years than in those below. However, the prevalence of inherited thrombophilia was higher in the younger group (32.0% vs 11.4%; p = 0.005). Uncommon diseases related to RVO such as hepatitis C, thalassemia minor, Lyme disease, vasculitis, and periphlebitis were observed in young patients without vascular risk factors.We suggest performing a genetic thrombophilia study in RVO patients younger than 50 years, while an exhaustive control of vascular risk factors is always recommended in all RVO patients. Moreover, we suggest bearing in mind uncommon diseases related to RVO, especially in young patients without vascular risk factors.

Background and objectives A new coronavirus disease in humans, COVID-19, caused by SARS-CoV-2, emerged in December 2019. It has been associated with the development of thrombotic phenomena. Retinal vein occlusion (RVO) is mainly a consequence of vascular risk factors (VRF). This study aimed to analyze cases of COVID-19 in a cohort of patients with RVO (Valdecilla cohort). Patients and methods Between December 2008 and December 2020, 429 patients with RVO were attended to in our clinic. Ten patients had COVID-19, one of which did not have VRF or thrombophilia. The remaining nine patients had RVO prior to the infection and VRF, six had carotid atherosclerosis, and four had antiphospholipid syndrome. The infection did not cause thrombotic phenomena in any of them. Conclusions RVO is a rare manifestation of COVID-19. In our cohort of patients with RVO, COVID-19 disease did not lead to thrombotic events.

Resumen Objetivos Analizar la prevalencia de la hipertension arterial (HTA), el valor de la presion arterial sistolica (PAS), el de la presion arterial diastolica (PAD) y el score de riesgo vascular de Framingham (FRS) en los sujetos con obstruccion venosa retiniana (OVR) y un grupo control. Pacientes y metodo Estudio prospectivo de casos y controles (transversal) de todos los pacientes con el diagnostico de OVR remitidos a la consulta de medicina interna, comparandolos con un grupo control. Se analizaron las variables clinicas y de laboratorio. Resultados Se estudiaron 253 pacientes con OVR (132 varones y 121 mujeres) y 244 controles (112 varones y 132 mujeres) de edad similar (67,9 ± 12,3 vs. 68,1 ± 9,2 anos). La prevalencia de HTA, el valor de la PAS y el de la PAD en la consulta tras la OVR fueron significativamente mayores en los pacientes con OVR que en los controles (71,5% vs. 51,2%), PAS mm Hg (148 ± 22 vs. 138 ± 18 mm Hg), PAD mm Hg (83 ± 10 vs. 77 ± 10 mm Hg). El diagnostico de la HTA se realizo de novo a partir de la OVR en el 23,8% de los casos. Se encontraron diferencias significativas en el FRS entre los pacientes con OVR y los controles 11 ± 8,3 vs. 8,25 ± 6,3. No hubo diferencias en ninguno de los parametros estudiados entre los pacientes con OVR periferica y central. Conclusiones La hipertension es muy prevalente y significativamente mas frecuente en los pacientes con OVR que en los controles. El diagnostico y tratamiento de la misma se establece frecuentemente a partir de la OVR. El FRS es mayor en los pacientes con OVR. No hay diferencias en los parametros estudiados entre los sujetos con OVR central y periferica. Sugerimos considerar la OVR un evento vascular a la hora de definir los objetivos terapeuticos.

This research was carried out in order to study the variations of microstructure and mechanical properties of 9 wt% Mn steel, which was produced by ingot casting, hot rolling and intercritical annealing (IA). Thermodynamic simulation of the corresponding phase diagram for the experimental composition allowed to select a suitable intercritical annealing temperature of 680 °C. After this step, we found a microstructure composed by lamellar ferrite within an austenite matrix. Austenite content was 47% for the hot rolled sample, while it was 36% and 52% for two and 6 h of intercritical annealing, respectively. Unfortunately, austenite phase started to coarsen at 6 h and ferrite lamellas were also fragmented, causing an important hardness and elongation reduction. Mechanical properties were measured comparing hot rolling samples vs. annealed samples at 680 °C for 2 h. We found that an excellent combination of UTS (ultimate tensile strength) of 1200 MPa, an elongation of almost 60% and an impact energy of 55 J could be obtained after IA for 2 h. These results, with the exception of UTS, significantly exceeded the values displayed by hot rolling condition and were associated with the stability of austenite which increased during annealing. Finally, we demonstrated that only TRIP (transformation induced plasticity) effect was present in the hot rolled sample during tension testing, in contrast with the annealed sample in which austenite content only diminished 12%, which indicates that TWIP (twinning induced plasticity) effect was also effective.

REIPI/GEIH Study Group., Sigma factor B (SigB) controls the expression of Staphylococcus aureus genes including virulence factors and plays a role in the bacterial secretion system through membrane vesicle production. Inhibition of SigB could attenuate SigB dependent virulence and secretion system. The objective of this study was to determine the effects of rhodomyrtone on SigB and virulence factors related to SigB. Minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) values of rhodomyrtone against 67 clinical methicillin-resistant S. aureus isolates were 0.25–8 μg/ml, which were similar to those of vancomycin. Using luciferase gene fused to SigB dependent promoters of asp23, five time reduction in SigB activity was observed when the bacteria were treated with rhodomyrtone for 3 h. Rhodomyrtone significantly reduced SigB activity in a concentration dependent manner in exponentially growing cells (P, This work was financially supported by The Royal Golden Jubilee Ph.D. Program (Grant No. PHD/0033/2553) and TRF Senior Research Scholar (Grant No. RTA 6180006), the Thailand Research Fund. M.J.R.O. was funded by the 'XXII Programa Propio de Fomento de la Investigación', University of Córdoba.

Resumen Antecedentes y objetivos En diciembre de 2019 surgio una nueva enfermedad por coronavirus en humanos causada por el virus SARS-CoV-2, la COVID-19, que se ha asociado con fenomenos tromboticos. La obstruccion venosa retiniana (OVR) es principalmente una consecuencia de los factores de riesgo vascular (FRV). El objetivo de este estudio ha sido analizar los casos de infeccion por SARS-CoV-2 en una cohorte de pacientes con OVR (cohorte Valdecilla). Pacientes y metodos Entre diciembre de 2008 y 2020 hemos atendido 429 pacientes con OVR. Diez han padecido COVID-19, de los que uno no presentaba FRV ni trombofilia. Los otros 9 fueron diagnosticados de OVR antes de la infeccion: todos tenian FRV; 6 ateromatosis carotidea y 4 presentaban un sindrome antifosfolipido. La infeccion no causo en ellos fenomenos tromboticos. Conclusiones La OVR es una manifestacion infrecuente de la COVID-19. En nuestra cohorte de pacientes con OVR la COVID-19 no indujo eventos tromboticos.

The Guadalquivir Valley is one of three major O3 hotspots in Spain. An airborne and surface measurement campaign was carried out from July 9th to 11th, 2019 to quantify the local/regional O3 contributions using experimental approaches. Air quality and meteorology data from surface measurements, a microlight aircraft, a helium balloon, and remote sensing data (TROPOMI-NO2-ESA) were used to obtain the 3D distribution of O3 and various tracer pollutants. O3 accumulation over 2.5 days started with inputs from oceanic air masses transported inland by sea breezes, which drew O3 and its precursors from a local/regional origin to the northeastern end of the basin. The orographic–meteorological setting of the valley caused vertical recirculation of the air masses inside the valley that caused the accumulation by increasing regional background O3 concentration by 25–30 ppb. Furthermore, possible Mediterranean O3 contributions and additional vertical recirculation through the entrainment zone of the convective boundary layer also contributed. Using particulate matter finer than 2.5 μm (PM2.5), ultrafine particles (UFP), and black carbon (BC) as tracers of local sources, we calculated that local contributions increased regional O3 levels by 20 ppb inside specific pollution plumes transported by the breeze into the valley, and by 10 ppb during midday when flying over an area with abundant agricultural burning during the morning. Air masses that crossed the southern boundaries of the Betic system at mid-altitude (400–1850 m a.s.l.) on July 10th and 11th may have provided additional O3. Meanwhile, a decreasing trend at high altitudes (3000–5000 m a.s.l.) was observed, signifying that the impact of stratospheric O3 intrusion decreased during the campaign., The present work was supported by the Spanish Ministry for Ecological Transition (17CAES010); the “Agencia Estatal de Investigación” from the Spanish Ministry of Science, Innovation and Universities and FEDER funds under the project HOUSE (CGL2016-78594-R); the Agencia Estatal de Investigación (RTI2018-095937-B-I00); and the Generalitat de Catalunya (AGAUR 2017 SGR41). We would like to thank the Junta de Andalucía for providing us with air quality data, and the Spanish Met Office (AEMET) for providing meteorological data and facilitating staff and instrumentation for the soundings, as well as ESA for providing TROPOMI-NO2 data and NOAA for the HYSPLIT modeling tool. Cristina Carnerero thanks “Agencia Estatal de Investigación” for the grant received to carry out her PhD (FPI grant: BES-2017-080027). Carlos Pérez García-Pando acknowledges support by the AXA Research Fund, and the Spanish Ministry of Science, Innovation and Universities (RYC-2015-18690).

Addiction is a chronic and relapsing brain disorder characterized by compulsive seeking despite adverse consequences. There are both heritable and epigenetic mechanisms underlying drug addiction. Emerging evidence suggests that non-coding RNAs (ncRNAs) such as microRNAs (miRNAs), long non-coding RNAs, and circular RNAs regulate synaptic plasticity and related behaviors caused by substances of abuse. These ncRNAs modify gene expression and may contribute to the behavioral phenotypes of addiction. Among the ncRNAs, the most widely researched and impactful are miRNAs. The goal in this systematic review is to provide a detailed account of recent research involving the role of miRNAs in addiction. This article is categorized under: RNA Interactions with Proteins and Other Molecules > Small Molecule-RNA Interactions RNA in Disease and Development > RNA in Disease.

Extracellular vesicles (EVs) are a broad, heterogeneous class of membranous lipid-bilayer vesicles that facilitate intercellular communication throughout the body. As important carriers of various types of cargo, including proteins, lipids, DNA fragments, and a variety of small noncoding RNAs, including miRNAs, mRNAs, and siRNAs, EVs may play an important role in the development of addiction and other neurological pathologies, particularly those related to HIV. In this review, we summarize the findings of EV studies in the context of methamphetamine (METH), cocaine, nicotine, opioid, and alcohol use disorders, highlighting important EV cargoes that may contribute to addiction. Additionally, as HIV and substance abuse are often comorbid, we discuss the potential role of EVs in the intersection of substance abuse and HIV. Taken together, the studies presented in this comprehensive review shed light on the potential role of EVs in the exacerbation of substance use and HIV. As a subject of growing interest, EVs may continue to provide information about mechanisms and pathogenesis in substance use disorders and CNS pathologies, perhaps allowing for exploration into potential therapeutic options.

AAC-8 and AAC-24 are two widely used scales to evaluate abdominal aortic calcification (AAC) on X-ray images. Levels of ≥3 (AAC-8) and ≥5 points (AAC-24) are of high relevance since they are associated with greater risk of cardiovascular events. Given that it is unknown, our aim was to determine the reliability of both scales at those levels of atherosclerotic burden.The sample (93 subjects, 67.3 ± 9.7 years, BMI 28.8 ± 3.8, 57.6% smokers, 64.1% with hypertension) was classified according to quartiles of calcification. Six clinicians evaluated AAC independently with both scales on lateral lumbar spine X-ray images. We analyzed inter-rater agreement with the intraclass correlation coefficient (ICC) and the Bland-Altman scatterplots.We assessed 15 pairs of raters. Scores in both scales were significantly correlated with cardiovascular risk (r = 0.31 and r = 0.32; p 0.005). Agreement was very high in the first quartile and moderate in the rest (p 0.05). At cut-off points, ICC = 0.70 (95%CI, 0.54-0.86) and ICC = 0.68 (95%CI, 0.60-0.85) with AAC-8 and AAC-24. With the Bland-Altman method, mean of the differences ranged between 0 and 0.4 (AAC-8), and between 0.2 and 1 (AAC-24), while 95% limits of agreement showed values between 2.9 and 4.4 (AAC-8), and between 6 and 11.2 (AAC-24). Analyzing entire scales, ICC = 0.97 (95%CI, 0.97-0.98) and ICC = 0.98 (95%CI, 0.97-0.98) for AAC-8 and AAC-24, respectively.Both scales presented only moderate reliability at levels of atherosclerotic burden. Analyzing quartiles with ICC and the Bland-Altman plot showed concordant results. High global ICC values traditionally reported with both scales are likely biased.AAC predicts subsequent vascular morbidity and mortality and should implicate evaluation of cardiovascular risk. Optimal visualisation of AAC and its correct assessment are mandatory in order to maximize patient care.

AA7075 matrix composite was obtained by mechanical alloying using ZrO2 particles as reinforcement. After that, the powders were cold-compacted into an aluminum tube and consolidated by equal channel angular pressing at 220 °C. The temperature influence was analyzed, and it was found by scanning electron microscopy that this route gave the minimum pore percentage. Besides, it was noticeable that the hardness was wide superior in comparison with the AA 7075 aged bulk alloy. In addition, there was no evidence of any chemical reaction between ZrO2 and alloying elements at the temperature employed. On the other hand, it was numerically and experimentally demonstrated that the more strained regions exhibited a higher relative density values.

The human retina, as transducer of light energy, is especially exposed to light toxicity. Solar maculopathy has been the only form of photic maculopathy for millennia, often secondary to the observation of an eclipse. During the last century, technological advances have led to the appearance of new forms of photic maculopathy, related to the exposure to new forms of artificial light, such as welding devices and lasers. In recent years, the general use of laser pointers has led to an upturn in interest in this pathology. The aim of this review is to offer an integrated view of the different types of photic maculopathy. Due to the extension of this topic, the review is presented divided into two parts. In this first part solar maculopathy and welding arc maculopathy are presented.

Trichoderma spp. es un hongo polivalente, cuyas propiedades lo postulan como agente de control biológico de fitopatógenos y como estimulador de crecimiento de plantas. Comúnmente aislado de suelos y madera en descomposición, aunque los aislados II2 y II8 (T viridae y T atroviridae) fueron aislados de monumentos históricos en la Cd de México, DF. Este trabajo presenta la caracterización del antagonismo y promoción de crecimiento vegetal de dichos aislados. Se realizaron pruebas de estos hongos en contra de los hongos fitopatógenos Fusarium oxysporum y Macrophomina phaseolina, aislados de frijol. Los resultados muestran que las especies de Trichoderma en estudio no modifican su velocidad de crecimiento cuando crecen en cultivo dual con los antagonistas. Igual resultado se obtuvo para F oxysporum cuando crece frente a los aislados II8 y II2. M phaseolina incrementa su velocidad de crecimiento de colonia cuando crece en la misma caja de Petri frente a las dos especies de Trichoderma. Se observó antagonismo por competencia por espacio y los mecanismos de antibiosis e hiperparasitismo no fueron detectados en estas pruebas. Al evaluarse el potencial uso agronómico, estimulando el crecimiento en plantas de sorgo a través de la altura y biomasa producida en los diferentes tratamientos se determinó que no tienen la capacidad de estimular el desarrollo de las plantas. Contrariamente, en general se observan efectos inhibitorios del crecimiento y desarrollo de las plantas tratadas. Esto tal vez se deba a que estas cepas se aislaron de monumentos históricos de la zona urbana de la Cd de México.

This paper reports the effects of different process control agents (PCA) (methanol, n-heptane, and stearic acid) and aluminum concentration (x = 0.5, 1.0, and 1.5 at%) on the particle size distribution, structure, microstructure, stability, and prediction of phases in AlxCoCrFeMnNi high-entropy powder synthesized by mechanical alloying. The results showed that the vapor pressure, the polar nature of the different process control agents used, and type of milling (dry/wet) generating changes in the particle size distribution, microstructure, and crystalline structure since the use of PCA modifies the balance between the cold-welding and fracture processes. Quantitative analysis showed that the PCA chemical decomposition generated residual oxygen and carbon in all systems. X-ray diffraction showed that all systems present a mixture of crystal structures BCC-FCC with nanometric crystallite size, and the peak intensities changed in function of lattice deformation generated by type milling employed. On the other hand, the results also showed that the boundary between BCC-FCC and FCC regions is even broader and extends to higher Al concentration than those reported by the valence electron concentration criterion.

Hard coatings are continuously improved due to the industrial needs and urgency to reduce the environmental impact of manufacturing processes. For these reasons, scientists seek hard coatings resistant to high mechanical and thermal loads under extreme working conditions (i.e., dry machining), which is why Hf and other rare earth metals have been added to the metastable c-AlxTi(1-x)N nitrides. In the present investigation, Hf-doped c-Al0.64Ti0.36N was deposited in a 2- & 3-axis rotation system using a semi-industrial coater. For this purpose Hf-pins were fixed in Al/Ti targets that produced coatings with ~0.2 at. % Hf-contents homogeneously dispersed. Hf effect on the crystalline state and microstructure, mechanical properties, high-temperature resistance, and the tribological performance of the coating in an Ar-jet at 900 °C were analyzed. It was found that the Hf-doped Al0.64Ti0.36N 5.07 μm thick-layer was mainly cubic fcc + traces of the hcp phases and displayed higher mean hardness (36 GPa) and E-module (416 GPa) than the coating without Hf (h = 32 GPa and E = 402 Pa). The Hf-containing nitride oxidizes dynamically during the high-temperature tribology testing and produces t-Ti2O3 & o-Al2TiO5 after short exposure periods (2.5–5 min), which strongly affected the CoF, before evolving to thermodynamically stable α-Al2O3 & anatase TiO2 between 10 & 30 min in the Ar-flow, thus resulting in the relative stability of the CoF. The mechanical evaluation of the oxidized coatings indicates that a specific oxide thickness must be reached to avoid catastrophic system damage at high normal loads.

The microstructural evolution of as-cast and homogenized Znâ21Alâ2Cu samples after two and six passes in an equal channel angular pressing (ECAP) at room temperature was reported. A homogenization treatment for 24 h at 350 °C was applied to the as-cast samples followed by deformation. An annealing heat treatment was performed on all samples after the ECAP process. Our results showed that the homogenized and deformed samples displayed a uniform fine-grained microstructure after annealing, while as-cast samples without homogenization treatment presented only some regions of fine-grained microstructure. The level of microsegregation was higher in the as-cast samples as compared to the homogenized ones even after annealing. Vickers microhardness measurement on samples after deformation is smaller than the original material indicating a softening. However, after the annealing treatment, the microhardness increased, indicating that there was a slight hardening of the material. Keywords: Severe plastic deformation, ECAP, Work softening, Annealing, Hardening, Fine grain

Resumen Objetivos Analizar la importancia de los factores de riesgo vascular, los hallazgos ecograficos de los troncos supraaorticos, y la presencia de fibrilacion auricular no valvular (FANV) anticoagulada en pacientes con obstruccion venosa retiniana (OVR) y en un grupo control. Pacientes y metodos Estudio transversal de todos los pacientes con OVR remitidos consecutivamente a la consulta de Medicina Interna, comparandolos con un grupo control. Se analizaron variables clinicas, electrocardiograficas y ecograficas. Resultados Se estudiaron 212 pacientes (114 varones y 98 mujeres) con OVR y 212 controles (95 varones y 117 mujeres) de edad similar. La hipertension arterial, la dislipidemia y la diabetes mellitus fueron significativamente mas prevalentes en los pacientes con OVR que en los controles (73,6 vs. 50%, 64,6 vs. 48,6%, y 27,8 vs. 12,3%, respectivamente). Se observaron lesiones arterioescleroticas en los troncos supraaorticos en el 55% de las OVR. Los pacientes con OVR y FANV tenian una mayor carga de factores de riesgo vascular que los controles con FANV. No hubo diferencias respecto a la razon internacional normalizada o a la utilizacion de anticoagulantes de accion directa entre casos y controles con FANV. Conclusiones Los factores de riesgo vascular (en especial la hipertension arterial) y la afectacion arterioesclerotica de los troncos supraaorticos son muy prevalentes en la OVR. La anticoagulacion no parece eficaz para prevenir la OVR.

Objective Diurnal birds of prey (raptors) are considered the group of animals with highest visual acuity (VA). The purpose of this work is to review all the information recently published about the visual system of this group of animals. Material and methods A bibliographic search was performed in PubMed. The algorithm used was (raptor OR falcon OR kestrel OR hawk OR eagle) AND (vision OR “visual acuity” OR eye OR macula OR retina OR fovea OR “nictitating membrane” OR “chromatic vision” OR ultraviolet). The search was restricted to the “Title” and “Abstract” fields, and to non-human species, without time restriction. Results The proposed algorithm located 97 articles. Conclusions Birds of prey are endowed with the highest VA of the animal kingdom. However most of the works study one individual or a small group of individuals, and the methodology is heterogeneous. The most studied bird is the Peregrine falcon (Falco peregrinus), with an estimated VA of 140 cycles/degree. Some eagles are endowed with similar VA. The tubular shape of the eye, the large pupil, and a high density of photoreceptors make this extraordinary VA possible. In some species, histology and optic coherence tomography demonstrate the presence of 2 foveas. The nasal fovea (deep fovea) has higher VA. Nevertheless, the exact function of each fovea is unknown. The vitreous contained in the deep fovea could behave as a third lens, adding some magnification to the optic system. pre-print 778 KB

Objectives To analyze the importance of cardiovascular risk factors, ultrasound findings in the supra-aortic trunk and the presence of anticoagulated nonvalvular atrial fibrillation (NVAF) in patients with retinal vein occlusion (RVO) and in a control group. Patients and methods A cross-sectional study was conducted of all patients with RVO consecutively referred to the office of internal medicine, comparing them with a control group. We analyzed clinical, electrocardiographic and ultrasound variables. Results We studied 212 patients (114 men and 98 women) with RVO and 212 controls (95 men and 117 women) of similar ages. Arterial hypertension, dyslipidaemia and diabetes mellitus were significantly more prevalent in the patients with RVO than in the controls (73.6 vs. 50%, 64.6 vs. 48.6% and 27.8 vs. 12.3%, respectively). We observed arteriosclerotic lesions in the supra-aortic trunk in 55% of the patients with RVO. The patients with RVO and NVAF had a greater burden of cardiovascular risk factors than the controls with NVAF. There were no differences in terms of the international normalized ratio or in the use of direct anticoagulants between the cases and controls with NVAF. Conclusions Cardiovascular risk factors (especially arterial hypertension) and arteriosclerotic involvement of the supra-aortic trunk are highly prevalent in RVO. Anticoagulation does not appear to be effective in preventing RVO.

Resumen Objetivo Se considera que las aves rapaces diurnas constituyen el grupo de animales con una agudeza visual (AV) mas alta. El objetivo de este trabajo es revisar la literatura publicada recientemente en relacion con el sistema visual de este grupo de animales. Material y metodos Busqueda bibliografica realizada en PubMed. El algoritmo de busqueda utilizado fue ( raptor OR falcon OR kestrel OR hawk OR eagle) AND (vision OR «visual acuity» OR eye OR macula OR retina OR fovea OR «nictitating membrane» OR «chromatic vision» OR ultraviolet ). La busqueda se restringio a los campos titulo y resumen, solo para otros animales (excluyendo humanos) y sin restriccion temporal. Resultados El algoritmo propuesto localiza un total de 97 articulos. Conclusiones Se considera que las rapaces estan dotadas de la AV mas alta del reino animal, aunque la mayor parte de los trabajos estudian un individuo o un pequeno grupo de individuos y la metodologia es heterogenea. La especie mas estudiada es el halcon peregrino ( Falco peregrinus ) con una AV estimada de 140 ciclos/grado, si bien algunas aguilas estan dotadas de AV similares. La forma tubular del ojo, la gran pupila y la alta densidad de fotorreceptores hacen posible esta extraordinaria AV. En algunas especies, tanto los estudios histologicos como la tomografia de coherencia optica demuestran la existencia de 2 foveas. Parece que la fovea de localizacion nasal (profunda) es la que ofrece una AV mas alta, sin embargo, la funcion exacta de cada una de estas se desconoce. El humor vitreo contenido sobre la fovea profunda podria comportarse como una tercera lente y anadir cierta magnificacion al sistema optico.

Background:Biologic therapy has improved prognosis of Behçet Disease (BD) uveitis (1-5). Although infliximab (IFX) is approved in Japan, most data in Caucasian patients comes from small series. No data on optimization has been publishedObjectives:In a large series of Caucasian patients with refractory uveitis of BD, we assess:a) long-term efficacy and safety;b) IFX optimization when ocular remission was achievedMethods:Multicenter study of IFX-treated patients with BD uveitis refractory to conventional immunosuppressants.103 patients were treated with IFX as 1st biologic as follows: 3-5 mg/kg i.v. at 0, 2, 6 and every 4-8 weeks. The main outcomes were anterior chamber cells, vitritis, retinal vasculitis, macular thickness, visual acuity, and glucocorticoids sparing effect; analysed at baseline, 1st week, 1st and 6th months and 1st and 2nd years. After remission, IFX optimization was performedResults:In whole series (n=103), main outcomes showed a rapid and maintained improvement, reaching remission in 78 patients after a mean IFX duration of 31.5 months. Severe side-effects were observed in 9 patients.Comparative study between optimized and non-optimized groups showed:a) no differences in clinical baseline characteristics;b) similar maintained improvement in most ocular outcomes;c) lower severe adverse events andd) lower IFX cost in optimized group (4826.52 vs 9854.13 euros/patient/year)(Table)Conclusion:IFX seems effective and safe in Caucasian patients with refractory BD uveitis. IFX optimization is effective, safe, and cost-effectiveReferences:[1]Martín-Varillas JL. Ophthalmology 2018;125:1444-1451.[2]Atienza-Mateo B: Arthritis Rheumatol. 2019;71:2081-2089[3]Santos-Gómez M. Clin Exp Rheumatol. 2016;34 (6 Suppl 102): S34-S40[4]Urruticoechea-Arana A. Rheumatol Int. 2019;39:47-58.[5]Atienza-Mateo B. Rheumatology (Oxford). 2018 1;57:856-864Table.OptimizedN=18Non OptimizedN=42PPatients/eyes affected, n/n18/3442/77Age, mean (SD), years39.5 (9.8)38.8 (10.5)0.82Men, %55.659.50.78Duration of uveitis before IFX, median [IQR] months38 [18-119]35 [10-48]0.11Ocular features at time of IFX onset-AC cells count, median [IQR]2 [1-4]2 [1-2]0.29-Vitritis, median [IQR]2 [1.5-3]2 [1-2]0.02-BCVA, mean (SD)0.32 (0.21)0.37 (0.26)0.51-OCT, mean (SD)303.5 (23.3)397.7 (155.7)0.12-Retinal vasculitis, n (%)9 (50)26 (66.7)0.23Uveitis pattern, n (%)-Bilateral/unilateral16/2 (88.9/11.1)35/7 (83.3/16.7)0.71-Anterior0 (0)6 (14.3)0.17-Posterior5 (27.8)8 (19.0)0.50-Panuveitis13 (72.2)28 (66.7)0.67Prednisone dose at IFX onset, mean (SD), mg/d40.3 (20.6)41.4 (15.5)0.81IFX therapyMonotherapy/combined treatment, n (%)15 (83.3)30 (71.4)0.33-AZA5 (27.8)4 (9.5)0.11-CsA9 (33.3)8 (19.0)0.32-MTX4 (22.2)15 (35.7)0.30Follow-up on IFX therapy, median [IQR], months48 [33-60]24 [6-60]0.007-Relapses, median (IQR)0 [0-1]0 [0-2]-Remission, %10075.60.46-Severe side effects, n (per 100 patients/year)0 (0)3 (0.78)0.02-Cost (mean), euros per year4826.529854.130.55–Disclosure of Interests:José Luis Martín-Varillas Grant/research support from: AbbVie, Pfizer, Janssen and Celgene, Speakers bureau: Pfizer and Lilly, Belén Atienza-Mateo: None declared, Vanesa Calvo-Río Grant/research support from: MSD and Roche, Speakers bureau: AbbVie, Lilly, Celgene, Grünenthal, UCB Pharma, Emma Beltrán: None declared, Alfredo Adan: None declared, Elena Aurrecoechea: None declared, Santos Castañeda: None declared, Miguel A González-Gay Grant/research support from: Pfizer, Abbvie, MSD, Speakers bureau: Pfizer, Abbvie, MSD, J. Luis Hernández: None declared, Ricardo Blanco Grant/research support from: AbbVie, MSD, and Roche, Speakers bureau: AbbVie, Pfizer, Roche, Bristol-Myers, Janssen, and MSD

A novel medium-Mn steel microstructure with 0.1 wt.% Nb was designed using Thermo-Calc and JMatPro thermodynamic simulation software. The pseudo-binary equilibrium phase diagram and time&ndash, temperature transformation (TTT) and continuous cooling transformation (CCT) diagrams were simulated in order to analyze the evolution of equilibrium phases during solidification and homogenization heat treatment. Subsequently, the steel was cast in a vacuum induction furnace with the composition selected from simulations. The specimens were heat-treated at 1200 &deg, C and water-quenched. The results of the simulations were compared to the experimental results. The microstructure was characterized using optical microscopy (OM) and scanning electron microscopy (SEM). We found that the as-cast microstructure consisted mainly of a mixture of martensite, ferrite, and a low amount of austenite, while the microstructure in the homogenization condition corresponded to martensite and retained austenite, which was verified by X-ray diffraction tests. In order to design further production stages of the steel, the homogenized samples were subjected to hot compression testing to determine their plastic flow behavior, employing deformation rates of 0.083 and 0.83 s&minus, 1, and temperatures of 800 and 950 &deg, C.

espanolIntroduccion. El diagnostico de la infeccion por SARSCoV-2 presenta limitaciones. La RT-PCR en frotis nasofaringeo es la prueba considerada como el patron oro, aunque puede ofrecer falsos negativos. El objetivo de este trabajo ha sido evaluar la utilidad de repetir el frotis nasofaringeo en pacientes con resultado negativo en funcion de las diferentes probabilidades clinicas. Metodos. Estudio observacional retrospectivo de los primeros pacientes ingresados en el Hospital Universitario Marques de Valdecilla en dos plantas COVID de Medicina Interna durante marzo-abril del 2020. La RT-PCR para la deteccion de al menos dos dianas de los principales genes (E, N, RdRP, ORFab1) y el test de deteccion de anticuerpos para la deteccion de al menos IgG. Resultados. Se analizaron 145 pacientes hospitalizados; 98 (67,5%) con el diagnostico de SARS-CoV-2. Las variables predictivas independientes de SARS-CoV-2 fueron: contacto epidemiologico con otro paciente COVID-19, presentacion clinica como neumonia, ausencia de neumonia en el ano previo, inicio de sintomas >7 dias al ingreso, ≥2 sintomas -tos, disnea y fiebre- y lactato deshidrogenasa >350 U/L (p La repeticion de la prueba permitio detectar un 16% de casos adicionales. El rendimiento global de sucesivas RT-PCR en pacientes con baja probabilidad clinica fue inferior al 5%. Conclusion. Hemos definido un score de probabilidad pre-prueba basado en datos epidemiologicos y clinicos con una buena precision para el diagnostico por infeccion SARSCoV-2. La repeticion del frotis nasofaringeo puede evitar errores de muestreo solo en escenarios de intermedia-alta probabilidad clinica pre-prueba. EnglishBackground. The diagnosis of SARS-CoV-2 infection presents some limitations. RT-PCR in nasopharyngeal swabs is considered the gold standard for the diagnosis, although it can have false negative results. We aimed to analyze the accuracy of repeating nasopharyngeal swabs based on different clinical probabilities. Methods. Retrospective observational study of the first patients admitted to a two COVID Internal Medicine wards at the University Hospital Marques de Valdecilla, Santander, from March to April 2020. RT-PCR targering E, N, RdRP and ORFab1 genes and antibody tests detecting IgG. Results. A total of 145 hospitalized patients with suspected SARS-Cov2 infection were admitted and in 98 (67.5%) diagnosis was confirmed. The independent predictive variables for SARS-CoV-2 infection were: epidemiological contact, clinical presentation as pneumonia, absence of pneumonia in the last year, onset of symptoms > 7 days, two or more of the following symptoms -dyspnea, cough or fever- and serum lactate dehydrogenase levels >350 U/L (p Conclusions. We have defined a pre-test probability score based on epidemiological and clinical data with a high accuracy for diagnosis of SARS-CoV-2. Repeating nasopharyngeal swabs avoids sampling errors, but only in medium of high probability pre-test clinical scenarios.

Computational simulation has become more important in the design of thermomechanical processing since it allows the optimization of associated parameters such as temperature, stresses, strains and phase transformations. This work presents the results of the three-dimensional Finite Element Method (FEM) simulation of the hot rolling process of a medium Mn steel using DEFORM-3D software. Temperature and effective strain distribution in the surface and center of the sheet were analyzed for different rolling passes, also the change in damage factor was evaluated. According to the hot rolling simulation results, experimental hot rolling parameters were established in order to obtain the desired microstructure avoiding the presence of ferrite precipitation during the process. The microstructural characterization of the hot rolled steel was carried out using optical microscopy (OM), scanning electron microscopy (SEM) and X-ray diffraction (XRD). It was found that the phases present in the steel after hot rolling are austenite and α′-martensite. Additionally, to understand the mechanical behavior, tensile tests were performed and concluded that this new steel can be catalogued in the third automotive generation.

According to Lifshitz, Slyozov, and Wagner (LSW) and Trans-Interface Diffusion-Controlled (TICD) theoretical models, this paper reports the microstructure and its coarsening behavior of γ′ metastable-coherent precipitates in concentration gradient of Ni-13.75Ti (at%)/Ni generated by diffusion couple. The coarsening of precipitates was evaluated in two different Ti contents (R1-11.4Ti (at%) and R2-13Ti (at%)) generated along the concentration gradient and includes average size, size distributions and growth rate. The solvus and metastable-coherent bimodal lines as determined at 850 °C of 9.16 (at%) and 9.92Ti (at%) respectively by scanning electron microscopy. This paper suggests that elastic strains produced by the matrix/precipitate lattice mismatch caused significant deviations between the experimental results and those predicted by the LSW or TIDC theories. Activation energies for TIDC (Q i ) and LSW (Q r ) are Q r : 219.69 and 172.61 kJ mol-1 for R1 and R2 regions, respectively, and Q i : 218.46 and 164.56 kJmol-1 for R1 and R2 regions, respectively. A concentration gradient allows the study of various alloys with different concentration and volume-fraction in a single sample.

Objective To communicate relevant and striking aspects about the visual system of some close invertebrates. Material and methods Review of the related literature. Results The capacity of snails to regenerate a complete eye, the benefit of the oval shape of the compound eye of many flying insects as a way of stabilizing the image during flight, the potential advantages related to the extreme refractive error that characterizes the ocelli of many insects, as well as the ability to detect polarized light as a navigation system, are some of the surprising capabilities present in the small invertebrate eyes that are described in this work. Conclusions The invertebrate eyes have capabilities and sensorial modalities that are not present in the human eye. The study of the eyes of these animals can help us to improve our understanding of our visual system, and inspire the development of optical devices.

In this paper, we focus on applying parallel processing techniques to HEVC encoder in order to significantly reduce the computational power requirements without disturbing its coding efficiency. So, we propose several, synchronous and asynchronous, parallelization approaches working at a coarse grain parallelization level, based on the Group Of Pictures (GOP), which we call GOP-based level. GOP-based approaches encode simultaneously several groups of consecutive frames. Depending on how these GOPs are conformed and distributed it is critical to obtain good parallel performance . The results show that near ideal efficiencies are obtained using up to 10 cores. Furthermore, when the computational load is unbalanced, the asynchronous versions outperform the synchronous ones. The parallel algorithms developed in this work support all standard coding modes proposed by the reference software.

Background:Anti-TNFα agents are useful in uveitis(1-5).Certolizumab pegol (CZP) differs from other anti-TNFα agents due to its limited placental transfer.Objectives:To assess efficacy and safety of CZP in women with uveitis during pregnancy.Methods:Multicenter study of women with uveitis under CZP during pregnancy and their neonates.Results:14 women (23 eyes); mean age 34.3±5.5 yrs (TABLE 1). Pattern of uveitis: 10 anterior, 2 posterior, 1 intermediate, 1 panuveitis. Uveitis was bilateral in 9 and chronic in 7. CZP was started before conception in 10 patients and after in 4. All patients obtained or maintained ocular remission throughout pregnancy (FIGURE). Prednisone was reduced from a mean dose of 21.7±19.7 mg/day to 4.1±3.8 mg/day at 6 months (p=0.03), leading to complete discontinuation in 4. 15 healthy infants were born. Only 1 woman presented a mild infection. No infections or malformations were found in neonates after a follow-up of 6 months. 6 infants were breastfed and all received scheduled vaccinations without complications (TABLE 2).TABLE 1.AgeUnderlying diseaseImmunosuppressants before CZPCombined treatment134SpAMTX, AZA, ADAAZA237SpAMTX, AZA, IFX, ADA, GOLI339SpAAZA, ADAAZA446SpACyA, ETN, ADA, IFX, GOLI532SpASSZ, ADASSZ636SpAMTX, HCQ, ADA740SpAMTX, LFN, HCQ, IFX, ADA, GOLIHCQ831IdiopathicMTX, MMF, CyA, ADA933IdiopathicMTX, AZA, ADA, ETN1032RAMTXAZA1123Vogt-Koyanagi-HaradaAZA, ADAAZA1236Juvenil Idiopathic ArthritisADA1332Punctate inner choroidopathyADA1429BehcetCyA, IFX, ADAConclusion:CZP seems to be effective and safe in female patients with uveitis during pregnancy and neonates.References:[1]Llorenç V et al. Certolizumab Pegol, a New Anti-TNF-α in the Armamentarium against Ocular Inflammation. Ocul Immunol Inflamm. 2016;24(2):167-72. doi: 10.3109/09273948.2014.967779[2]Urruticoechea-Arana A et al. Efficacy and safety of biological therapy compared to synthetic immunomodulatory drugs or placebo in the treatment of Behçet’s disease associated uveitis: a systematic review. Rheumatol Int. 2019 Jan;39(1):47-58. doi: 10.1007/s00296-018-4193-z[3]Martín-Varillas JL et al. Successful Optimization of Adalimumab Therapy in Refractory Uveitis Due to Behçet’s Disease Ophthalmology. 2018 Sep;125(9):1444-1451. doi: 10.1016/j.ophtha.2018.02.020[4]Santos-Gómez M et al. The effect of biologic therapy different from infliximab or adalimumab in patients with refractory uveitis due to Behçet’s disease: results of a multicentre open-label study. Clin Exp Rheumatol. 2016. Sep-Oct;34(6 Suppl 102): S34-S40[5]Calvo-Río V et al. Golimumab in refractory uveitis related to spondyloarthritis. Multicenter study of 15 patients.Semin Arthritis Rheum. 2016 Aug;46(1):95-101. doi: 10.1016/j.semarthrit.2016.03.002Disclosure of Interests:D. Prieto-Peña: None declared, Monica Calderón-Goercke: None declared, Alfredo Adan: None declared, Lillian Chamorro-López: None declared, Olga Maiz: None declared, JR De Dios-Jiménez Aberásturi: None declared, Raul Veroz Gonzalez: None declared, Soledad Blanco: None declared, José M Santos: None declared, Francisco Navarro: None declared, Adela Gallego: None declared, Senen González-Suárez: None declared, Arantxa Conesa: None declared, Andrea García-Valle: None declared, Miguel Cordero-Coma: None declared, Nieves Pardiñas-Barón: None declared, Rosalía Demetrio-Pablo: None declared, Vanesa Calvo-Río Grant/research support from: MSD and Roche, Speakers bureau: AbbVie, Lilly, Celgene, Grünenthal, UCB Pharma, Victor Manuel Mora-Cuesta: None declared, Santos Castañeda: None declared, J. Luis Hernández: None declared, Miguel A González-Gay Grant/research support from: Pfizer, Abbvie, MSD, Speakers bureau: Pfizer, Abbvie, MSD, Ricardo Blanco Grant/research support from: AbbVie, MSD, Roche, Consultant of: Abbvie, Eli Lilly, Pfizer, Roche, Bristol-Myers, Janssen, UCB Pharma and MSD, Speakers bureau: Abbvie, Eli Lilly, Pfizer, Roche, Bristol-Myers, Janssen, UCB Pharma. MSD