Filtrado de kallman para la recuperacion de portadora a partir de estimaciones previas

Two approaches to carrier recovery in a digital communications system under non-stationary conditions are presented for low and high signaling rates with respect to the maximum allowable Doppler frequency. A Kalman-based scheme is proposed for small frequency deviations, while for Doppler uncertainties, equal to the signaling rate or higher, an adaptive scheme based on a zero error detector is shown to perform satisfactorily.Peer ReviewedPostprint (published version

Case Report Eradication of Burkholderia cepacia Using Inhaled Aztreonam Lysine in Two Patients with Bronchiectasis

There are not many articles about the chronic bronchial infection/colonization in patients with underlying lung disease other than cystic fibrosis (CF), especially with non-CF bronchiectasis (NCFBQ). The prevalence of B. cepacia complex is not well known in NCFBQ. The vast majority of published clinical data on Burkholderia infection in individuals with CF is comprised of uncontrolled, anecdotal, and/or single center experiences, and no consensus has emerged regarding treatment. We present two cases diagnosed with bronchiectasis (BQ) of different etiology, with early pulmonary infection by B. cepacia complex, which was eradicated with inhaled aztreonam lysine

A rain and scintillation Ka-band channel simulator

This paper describes the implementation of a Ka-band satellite channel simulator with emphasis on the synthesis of scintillation processes. The problem becomes one of generating a given probability density function, the Moulsley-Vilar distribution, with a specified power spectral density using aWiener model based on orthogonal Hermite polynomials for the nonlinearity. A numerical procedure is devised to calculate the filter and non-linearity coefficients of the Wiener model. The generation of rain processes conforms to the Maseng-Bakken model.Postprint (published version

Effects of weight loss after bariatric surgery on pulmonary function tests and aobtructive sleep apnea in morbidly obese women

Introducción: la obesidad afecta a la función respiratoria e incrementa el riesgo de síndrome de apneas-hipopneas del sueño (SAHS). Objetivo: evaluar el efecto de la cirugía bariátrica, en mujeres con obesidad mórbida, sobre la función respiratoria y sobre el índice de apneas-hipopneas (IAH) tras dos años de seguimiento. Métodos: se incluyeron 15 mujeres (índice de masa corporal [IMC] medio 50,52 ± 12,71 kg.m-2, edad media 40,13 ± 10,06 años). Los enfermos fueron analizados en dos fases: previo a la cirugía bariátrica y tras dos años de la misma. En cada visita se valoraron las medidas antropométricas y se realizaron pruebas de función respiratoria consistentes en espirometría, pletismografía, medida de la presión inspiratoria máxima y del índice de tensión-tiempo de los músculos inspiratorios, así como análisis de gases arteriales. Por último, también se efectuó una poligrafía cardiorrespiratoria durante el sueño. Resultados: tras la cirugía bariátrica el IMC disminuyó en 44,07 kg.m-2 (IC 95% 38,32 – 49,81). De igual forma, se observaron incrementos significativos en el volumen espiratorio forzado al primer segundo (FEV1) (p < 0,01), la capacidad vital forzada (FVC) (p < 0,01), el volumen de reserva espiratorio (ERV) (p = 0,040), la capacidad funcional residual (FRC) (p = 0,009) y la resistencia de las vías aéreas (Raw) (p = 0,018). Por otra parte, el IAH (p = 0,001) y el índice de desaturación de oxígeno (p = 0,001) disminuyeron tras la cirugía. Se observó una correlación significativa entre el grado de pérdida de peso y el incremento del ERV (0,774, p = 0,024). Conclusiones: tras dos años desde la cirugía bariátrica se siguen observando mejorías significativas en la función respiratoria y en la gravedad del SAHS. La mejoría del ERV estaría en relación directa con los niveles de peso perdidoIntroduction: obesity impacts on respiratory function and also it acts as a risk factor for obstructive sleep apnea (OSA). Aims: to study the effects of bariatric surgery on pulmonary function tests and on OSA in morbidly obese women over 4 years. Methods: fifteen morbidly obese women (mean body mass index [BMI] 50.52 ± 12.71 kg.m-2, mean age 40.13 ± 10.06 years) underwent pulmonary function tests (PFT) in two opportunities (before and after weight loss surgery). PFT included spirometry, body plethysmography and measure of maximal inspiratory mouth pressure (PImax) and of tension-time index for inspiratory muscles. Also, in both opportunities, resting arterial blood gas tensions were evaluated and a full night sleep register was performed. Results: BMI significantly decreased after bariatric surgery (-44.07 kg.m-2 [CI 95% -38.32 – -49.81]). Also, there was a significantly increase in forced expiratory volume in 1 second (FEV1) (p < 0.01), forced vital capacity (FVC) (p < 0.01), expiratory reserve volume (ERV) (p = 0.040), functional residual capacity (FRC) (p = 0.009) and a decline in airways resistance (Raw) (p = 0.018). Concerning sleep registers, apnea hypopnea index (p = 0.001) and desaturation index (p = 0.001) were also reduced after weight loss. Improve in ERV had a significant correlation with weight loss (r = 0.774, p = 0.024). Conclussions: pulmonary function tests and apnea hypopnea index improve after bariatric surgery in mor- bidly obese women. Improvement of ERV is well correlated with weight los

Clinical and Emotional Factors Related to Erectile Dysfunction in HIV-Infected Men

Altres ajuts: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was supported by a grant from Lluita contra la Sida Foundation.The prevalence and associated factors of erectile dysfunction (ED) in Human Immunodeficiency Virus (HIV)-infected men remain controversial. The authors evaluated ED, clinical, and emotional variables in a group of 501 HIV-infected men in a cross-sectional 4-month observational study. ED was assessed using the International Index of Erectile Function-5 and emotional status using the Hospital Anxiety and Depression (HAD) questionnaire. Median age (interquartile range) was 42 (35, 48) years. Time since HIV diagnosis was 6.3 (2.6, 17.1) years, 92% were taking antiretroviral treatment and 81.8% had an HIV-RNA viral load <50 copies. The prevalence of ED was 58.5%. ED was mild in 30.1%, mild to moderate in 19.5%, moderate in 6.1%, and severe in 2.5%. ED medications were used by 19% of men. In the univariate analysis, the variables associated with all degrees of ED were older age, longer time since HIV diagnosis, higher scores in HAD, not taking efavirenz, taking etravirine, taking ritonavir, HIV/Hepatitis C Virus coinfection, and taking a protease inhibitor-containing regimen. For mild to moderate, moderate, and severe ED, the same variables were significant, as were lower nadir CD4 cell count, lower social support, taking atazanavir, concomitant conditions, and concomitant treatments. The variables that remained significant in the multivariate analyses, considering all degrees of ED or excluding mild ED were the following: older age and higher scores in HAD total. In summary, ED affected more than half of this cohort of well controlled HIV-infected men. Age and emotional status seemed to play a fundamental role in its presence

How are the ancient cystic fibrosis patients?: Cystic fibrosis diagnosed over 60 years-old

Background and aims To specify the prevalence of patients diagnosed with CF at age of ≥60 year-old and to analyze their characteristics. Patients and methods Observational study of CF patients which were diagnosed at age ≥60 year-old. The analyzed variables were: age, sex, nationality, lung function parameters, conditions present at diagnosis, microbiological characteristics and genetic findings. Results eight patients were included. 7 patients were female (87.5%) with a mean age of 70.6 years (median 71.5 years, range 60–78 years). The most important findings were: sweat test &gt; 60 mEq/l; heterozygotes F508del; bronchiectasis in CT; methicillin-sensitive Staphylococcus aureus (50%) in sputum. The most patients presented a normal or mild obstructive lung function. Conclusions CF must also be considered a disease diagnosed in adulthood, incorporating the sweat test within the usual techniques of differential diagnosis in patients with different diseases associated with CF, because genetic counselling is esencial

A Phase 3 Study to Compare Delafloxacin With Moxifloxacin for the Treatment of Adults With Community-Acquired Bacterial Pneumonia (DEFINE-CABP)

The clinical and economic burden of community-acquired bacterial pneumonia (CABP) is significant and is anticipated to increase as the population ages and pathogens become more resistant. Delafloxacin is a fluoroquinolone antibiotic approved in the United States for the treatment of adults with acute bacterial skin and skin structure infections. Delafloxacin's shape and charge profile uniquely impact its spectrum of activity and side effect profile. This phase 3 study compared the efficacy and safety of delafloxacin with moxifloxacin for the treatment of CABP. A randomized, double-blind, comparator-controlled, multicenter, global phase 3 study compared the efficacy and safety of delafloxacin 300 mg twice daily or moxifloxacin 400 mg once daily in adults with CABP. The primary end point was early clinical response (ECR), defined as improvement at 96 (±24) hours after the first dose of study drug. Clinical response at test of cure (TOC) and microbiologic response were also assessed. In the intent-to-treat analysis population (ITT), ECR rates were 88.9% in the delafloxacin group and 89.0% in the moxifloxacin group. Noninferiority of delafloxacin compared with moxifloxacin was demonstrated. At TOC in the ITT population, the success rates were similar between groups. Treatment-emergent adverse events that were considered at least possibly related to the study drug occurred in 65 subjects (15.2%) in the delafloxacin group and 54 (12.6%) in the moxifloxacin group. Intravenous/oral delafloxacin monotherapy is effective and well tolerated in the treatment of adults with CABP, providing coverage for Gram-positive, Gram-negative, and atypical pathogens. NCT03534622. This Phase-3 study showed IV/oral delafloxacin monotherapy is well tolerated without QT restrictions or major drug interactions and effective in treatment of adults with CABP due to gram positive and negative as well as atypical pathogens

Laboratory diagnosis of severe hypertriglyceridaemia. Cases from the dyslipidaemia regristy of the spanish atherosclerosis society

Background and Aims Severe hypertriglyceridaemia (sHTG) increases the risk of cardiovascular disease and acute pancreatitis episodes. Patients with sHTG fit mainly into two clinical entities: Familial or Multifactorial Chylomicronemia Syndromes (FCS and MCS, respectively). FCS and MCS exhibit clinical differences but also separate genetic and biochemical characteristics that can be assessed in the laboratory. The aim of this work has been to implement a laboratory workflow to help diagnose sHTG patients with either FCS or MCS. Methods Patients with two fasting triglycerides >1000mg/dL determinations were sequenced with a capture probe panel of 24 triglycerides-related genes using massive parallel sequencing (n=200). Two-step sequential ultracentrifugation was performed (n= 159) to diagnose Type I hyperlipoproteinemia (HLP I) and post heparin lipoprotein lipase activity was measured to discard or confirm its deficiency (n=60). Results Most patients had MCS as they: (i) did not exhibit HLPI and/or (ii) their genetic profile was not compatible with FCS and (iii) were not deficient in LPL activity. FCS cases were identified as they had: (i) HLPI, and/or (ii) biallelic pathogenic variants in LPL (n=5), GPIHBP1 (n=3), or LMF1 (n=2) genes and/or (iii) LPL activity deficiency. We identified 4 FCS patients with HLPI, biallelic pathogenic variants in APOA5 but a rescued LPL activity. An additional study of Apo-AV functionality was designed to confirm the FCS diagnosis in these cases. Conclusions Laboratory studies, in patients with severe hypertriglyceridaemia, provide with information of clinical utility to distinguish between Familial and Multifactorial Chylomicronemia Syndromes.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Effects of integrase inhibitor-based antiretroviral therapy on brain outcomes according to time since acquisition of HIV-1 infection

Integrase strand transfer inhibitors (INSTI) are a main component of the current antiretroviral regimens recommended for treatment of HIV infection. However, little is known about the impact of INSTI on neurocognition and neuroimaging. We developed a prospective observational trial to evaluate the effects of INSTI-based antiretroviral therapy on comprehensive brain outcomes (cognitive, functional, and imaging) according to the time since HIV-1 acquisition. We recruited men living with HIV who initiated antiretroviral therapy with INSTI 6 months since estimated date of HIV-1 acquisition (n = 15). We also recruited a group of matched seronegative individuals (n = 15). Assessments were performed at baseline (before initiation of therapy in HIV arms) and at weeks 4 and 48. Baseline cognitive functioning was comparable between the arms. At week 48, we did not find cognitive differences between starting therapy with INSTI earlier than 3 months or later than 6 months after acquisition of HIV-1 infection. Functional status was poorer in individuals diagnosed earlier. This effect recovered 48 weeks after initiation of therapy. Regarding brain imaging, we found that men living with HIV initiating antiretroviral therapy later experienced a greater decrease in medial orbitofrontal cortex over time, with expected negative repercussions for decision-making tasks