Metastatic non-muscle invasive bladder cancer with cervical lymph node metastasis.

Bladder cancer is a common cancer that may present as superfi cial, invasive, or metastatic disease. Non‐muscle‐invasive bladder cancer (NMIBC) represents the majority of bladder cancer diagnoses, but represents a spectrum of disease with a variable clinical course, notably for signifi cant risk of recurrence and potential for progression. NMIBC metastasis to distant organs without local invasion or regional metastasis is a very rare occurrence, so there are limited case reports about early metastasis in the literature.post-print4,59 M

Estudio del comportamiento de las capacidades físicas en una población de adultos mayores (Original)

The use of physical activities for the elderly in grandparents' circles is a valid proposal, of great relevance and social impact, which multiplies its value when carried out in a population of hypertensive patients. The foregoing could be verified in the investigation carried out in the “Renacer” Grandfather Circle of the health area III in the municipality of Cienfuegos. A sample of 29 subjects that constitutes the adult population was selected. The objective is to diagnose the behavior of physical abilities. The study starts from a deep bibliographic review enriching the theoretical and methodological knowledge on the subject to be investigated, later a group of variables were applied that served for the elaboration of the diagnosis. Theoretical and empirical methods, as well as mathematical methods, were applied with the intention of carrying out the statistical processing of the data recorded in the research. The results achieved reflected a notable decrease in the physical strength capacity in the upper extremities of the elderly, which calls for rehabilitative work in this regard to avoid the progressive deterioration and increase the physical, mental and social well-being of the elderly.El empleo de actividades físicas para los adultos mayores en los círculos de abuelos es una propuesta válida, de gran actualidad e impacto social, lo que se multiplica su valor al realizarse en una población de hipertensos. Lo anterior se pudo constatar en la investigación realizada en el Círculo de abuelo “Renacer” del área de salud III en el municipio de Cienfuegos. Fue seleccionada una muestra de 29 sujetos que constituye la población de adultos. El objetivo se centra en Diagnosticar el comportamiento de las capacidades físicas. El estudio parte de una revisión bibliográfica profunda enriqueciendo los conocimientos teóricos y metodológicos sobre el tema a investigar, posteriormente fueron aplicadas un grupo de variables que sirvieron para la elaboración del diagnóstico. Fueron aplicados métodos teóricos y empíricos, así como matemáticos con la intención de realizar el procesamiento estadístico de los datos registrados en la investigación. Los resultados alcanzados reflejaron notable disminución de la capacidad física fuerza en las extremidades superiores de los adultos mayores, lo que urge un trabajo rehabilitador en este sentido para evitar el progresivo deterioro e incrementar el bienestar físico, psíquico y social de los adultos mayores

Multiancestry analysis of the HLA locus in Alzheimer’s and Parkinson’s diseases uncovers a shared adaptive immune response mediated by HLA-DRB1*04 subtypes

Across multiancestry groups, we analyzed Human Leukocyte Antigen (HLA) associations in over 176,000 individuals with Parkinson’s disease (PD) and Alzheimer’s disease (AD) versus controls. We demonstrate that the two diseases share the same protective association at the HLA locus. HLA-specific fine-mapping showed that hierarchical protective effects of HLA-DRB1*04 subtypes best accounted for the association, strongest with HLA-DRB1*04:04 and HLA-DRB1*04:07, and intermediary with HLA-DRB1*04:01 and HLA-DRB1*04:03. The same signal was associated with decreased neurofibrillary tangles in postmortem brains and was associated with reduced tau levels in cerebrospinal fluid and to a lower extent with increased Aβ42. Protective HLA-DRB1*04 subtypes strongly bound the aggregation-prone tau PHF6 sequence, however only when acetylated at a lysine (K311), a common posttranslational modification central to tau aggregation. An HLA-DRB1*04-mediated adaptive immune response decreases PD and AD risks, potentially by acting against tau, offering the possibility of therapeutic avenues

Estudio del comportamiento de parámetros en adultos hipertensos luego de la aplicación de ejercicios físicos terapéuticos (Original)

Bearing in mind the predominance of the Arterial Hypertension in Cuba, where more than two million 800 thousand adults at present endure Arterial Hypertension (HTA), specially the province of Cienfuegos, which reaches a valuation of 144,1 affected by every 1000 inhabitants, and the municipality of Palmira exists 4 970 affected persons, being the Popular Advice North Palmira one of those of major incidence with 22,86 affected ones, for every 1000 inhabitants; reoutfitter makes necessary the application of a Treatment to stabilize the arterial tension inside normal parameters in hypertense adults. The present work investigative takes as a purpose to determine the effect of a treatment reoutfitter by means of physical exercises and educational conferences on the arterial tension in hypertense adults of the above mentioned community. To come to the diagnosis, there was necessary the help of the doctor and the nurse, as well as the clinical information that turn out to be registered in the medical office. A study was realized in the period understood between September, 2016 and June, 2017, selecting a sample of 19 hypertense adults to whom measurements were applied to the beginning and end of the variables. Between both periods they were realized in the morning a plan of physical exercises with a frequency of three times for week and a duration of 45 minutes. The previous thing brought with it a control of the arterial tension, reducing the possible complications, diminishing the risks factors, raising this way the quality of life in the studied sample.Teniendo en cuenta la prevalencia de la Hipertensión Arterial en Cuba, donde más de dos millones 800 mil adultos actualmente padecen Hipertensión Arterial (HTA), específicamente la provincia de Cienfuegos, que alcanza una tasa de 144,1 afectados por cada 1000 habitantes, y el municipio de Palmira existe 4 970 personas afectadas, siendo el Consejo Popular Palmira Norte uno de los de mayor incidencia con 22,86 afectados, por cada 1000 habitantes; se hace necesario la aplicación de un tratamiento rehabilitador para estabilizar la tensión arterial dentro de parámetros normales en adultos hipertensos. El presente trabajo investigativo tiene como finalidad determinar el efecto de un tratamiento rehabilitador mediante ejercicios físicos y conferencias educativas sobre la tensión arterial en adultos hipertensos de dicha comunidad. Para llegar al diagnóstico, fue necesario el auxilio del médico y la enfermera, así como los datos clínicos que aparecen registrados en el consultorio médico. Se realizó un estudio en el período comprendido entre septiembre del 2016 y junio del 2017, seleccionando una muestra de 19 adultos hipertensos a los que se les aplicó mediciones al inicio y final de las variables. Entre ambos períodos fueron realizadas en horas de la mañana un plan de ejercicios físicos con una frecuencia de tres veces por semana y una duración de 45 minutos. Lo anterior trajo consigo un control de la tensión arterial, reduciendo las posibles complicaciones, disminuyendo los factores de riesgos, elevando así la calidad de vida en la muestra estudiada

Portal hypertensive polyps, a new entity?

Presentamos el caso clínico de una mujer de 62 años de edad, con antecedentes de cirrosis hepática secundaria a hepatitis autoinmune, hipertensión portal y coagulopatía, quien presenta en gastroscopia, unas lesiones polipoideas, semipediculadas, polilobuladas en la región prepilórica, que se extirpan y cuya anatomía patológica se describe como pólipos hiperplásicos con edema, congestión vascular e hiperplasia del músculo liso, sin displasia ni cambios adenomatosos, correspondientes a "pólipos de la hipertensión portal" (PHP)

Ensayo automatizado para el desarrollo de caudalímetros

En este artículo se expone la estructura de un banco hidráulico que ha sido desarrollado por el grupo de investigación Instrumentación Electrónica y Aplicaciones, sito en el Departamento de Tecnología Electrónica de la Universidad de Sevilla. Este banco hidráulico sirve como soporte básico para el desarrollo de caudalímetros, permitiendo la generación de diversos caudales (hasta 16 l/min) y el control y adquisición automática de información de cada ensayo por ordenador. Se describen en los siguientes apartados los componentes del banco así como la electrónica y software de control. Asimismo se ha incluido algunos resultados experimentales de la respuesta de un prototipo de medidor de caudal que se está desarrollando.Comisión Interministerial de Ciencia y Tecnología (CJCYT): proyecto HID-075

Probabilistic Evaluation of the Exploration–Exploitation Balance during the Search, Using the Swap Operator, for Nonlinear Bijective S-Boxes, Resistant to Power Attacks

During the search for S-boxes resistant to Power Attacks, the S-box space has recently been divided into Hamming Weight classes, according to its theoretical resistance to these attacks using the metric variance of the confusion coefficient. This partition allows for reducing the size of the search space. The swap operator is frequently used when searching with a random selection of items to be exchanged. In this work, the theoretical probability of changing Hamming Weight class of the S-box is calculated when the swap operator is applied randomly in a permutation. The precision of these probabilities is confirmed experimentally. Its limit and a recursive formula are theoretically proved. It is shown that this operator changes classes with high probability, which favors the exploration of the Hamming Weight class of S-boxes space but dramatically reduces the exploitation within classes. These results are generalized, showing that the probability of moving within the same class is substantially reduced by applying two swaps. Based on these results, it is proposed to modify/improve the use of the swap operator, replacing its random application with the appropriate selection of the elements to be exchanged, which allows taking control of the balance between exploration and exploitation. The calculated probabilities show that the random application of the swap operator is inappropriate during the search for nonlinear S-boxes resistant to Power Attacks since the exploration may be inappropriate when the class is resistant to Differential Power Attack. It would be more convenient to search for nonlinear S-boxes within the class. This result provides new knowledge about the influence of this operator in the balance exploration–exploitation. It constitutes a valuable tool to improve the design of future algorithms for searching S-boxes with good cryptography properties. In a probabilistic way, our main theoretical result characterizes the influence of the swap operator in the exploration–exploitation balance during the search for S-boxes resistant to Power Attacks in the Hamming Weight class space. The main practical contribution consists of proposing modifications to the swap operator to control this balance better

Patients awaiting surgery for neurosurgical diseases during the first wave of the COVID-19 pandemic in Spain: a multicentre cohort study.

The large number of infected patients requiring mechanical ventilation has led to the postponement of scheduled neurosurgical procedures during the first wave of the COVID-19 pandemic. The aims of this study were to investigate the factors that influence the decision to postpone scheduled neurosurgical procedures and to evaluate the effect of the restriction in scheduled surgery adopted to deal with the first outbreak of the COVID-19 pandemic in Spain on the outcome of patients awaiting surgery. This was an observational retrospective study. A tertiary-level multicentre study of neurosurgery activity between 1 March and 30 June 2020. A total of 680 patients awaiting any scheduled neurosurgical procedure were enrolled. 470 patients (69.1%) were awaiting surgery because of spine degenerative disease, 86 patients (12.6%) due to functional disorders, 58 patients (8.5%) due to brain or spine tumours, 25 patients (3.7%) due to cerebrospinal fluid (CSF) disorders and 17 patients (2.5%) due to cerebrovascular disease. The primary outcome was mortality due to any reason and any deterioration of the specific neurosurgical condition. Second, we analysed the rate of confirmed SARS-CoV-2 infection. More than one-quarter of patients experienced clinical or radiological deterioration. The rate of worsening was higher among patients with functional (39.5%) or CSF disorders (40%). Two patients died (0.4%) during the waiting period, both because of a concurrent disease. We performed a multivariate logistic regression analysis to determine independent covariates associated with maintaining the surgical indication. We found that community SARS-CoV-2 incidence (OR=1.011, p Patients awaiting neurosurgery experienced significant collateral damage even when they were considered for scheduled procedures

Bacterial etiology of community-acquired pneumonia in immunocompetent hospitalized patients and appropriateness of empirical treatment recommendations: an international point-prevalence study

An accurate knowledge of the epidemiology of community-acquired pneumonia (CAP) is key for selecting appropriate antimicrobial treatments. Very few etiological studies assessed the appropriateness of empiric guideline recommendations at a multinational level. This study aims at the following: (i) describing the bacterial etiologic distribution of CAP and (ii) assessing the appropriateness of the empirical treatment recommendations by clinical practice guidelines (CPGs) for CAP in light of the bacterial pathogens diagnosed as causative agents of CAP. Secondary analysis of the GLIMP, a point-prevalence international study which enrolled adults hospitalized with CAP in 2015. The analysis was limited to immunocompetent patients tested for bacterial CAP agents within 24 h of admission. The CAP CPGs evaluated included the following: the 2007 and 2019 American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA), the European Respiratory Society (ERS), and selected country-specific CPGs. Among 2564 patients enrolled, 35.3% had an identifiable pathogen. Streptococcus pneumoniae (8.2%) was the most frequently identified pathogen, followed by Pseudomonas aeruginosa (4.1%) and Klebsiella pneumoniae (3.4%). CPGs appropriately recommend covering more than 90% of all the potential pathogens causing CAP, with the exception of patients enrolled from Germany, Pakistan, and Croatia. The 2019 ATS/IDSA CPGs appropriately recommend covering 93.6% of the cases compared with 90.3% of the ERS CPGs (p < 0.01). S. pneumoniae remains the most common pathogen in patients hospitalized with CAP. Multinational CPG recommendations for patients with CAP seem to appropriately cover the most common pathogens and should be strongly encouraged for the management of CAP patients.info:eu-repo/semantics/publishedVersio