Aplicaciones de la tecnología geofísica de georradar junto con la termografía infrarroja, el perfilómetro y otras tecnologías complementarias, en la construcción. Limitaciones y posibilidades

Georadar technology has proven to be highly effective in the diagnosis and analysis of soils and the most diverse applications thanks to its effectiveness and non-destructive characteristics. This article describes and analyzes the use of georadar technology supported by other complementary ones, such as the ground electromagnetic survey, infrared thermography, infrared photography and multispectral photography, all of them used together for a common objective in concrete examples related to the field of the construction. Subsequently, the characteristics of the construction systems and the environment that can condition the effectiveness of the results and reduce the advantages of the joint use of the different systems are analyzed, which will allow future actions to adjust the scope of the objectives, optimize the advantages the complementarity of the different systems and, therefore, will open a range of possibilities for future use.La tecnología del georradar se ha probado de gran eficacia en la diagnosis y análisis de suelos y las más diversas aplicaciones gracias a su efectividad y sus características no destructivas. El presente artículo describe y analiza la utilización de la tecnología del georradar apoyada en otras complementarias, como son el perfilómetro, la termografía infrarroja, la fotografía infrarroja y la fotografía multiespectral, empleadas conjuntamente en ejemplos concretos de análisis de construcciones con objetivos relacionados con la detección y diagnóstico de deficiencias en los proyectos. Posteriormente, se analizan las características de los sistemas constructivos y del entorno que pueden condicionar la efectividad de los resultados y merma las ventajas de la utilización conjunta de los distintos sistemas, lo que permitirá en futuras actuaciones ajustar el alcance de los objetivos, optimizar las ventajas de la complementariedad de los distintos sistemas y, por tanto, permitirá abrir un abanico de posibilidades de utilización futura

El sistema de espacios libres en una ciudad y su planeamiento

Durante aproximadamente un siglo de desarrollo industrial con notables crecimientos urbanos, las poblaciones de nuestras ciudades han venido careciendo de una conciencia colectiva sobre el papel a desempeñar en las mismas por los espacios libres y zonas verdes. Realmente hasta que el crecimiento desmesurado de las urbes no ha comenzado a ahogar física y psicológicamente al hombre urbano, no se ha despertado en este la necesidad de tener a su disposición espacios en los que poder descansar, pasear, practicar deportes y entretener en general sus horas de ocio. A partir del segundo cuarto de nuestro siglo, y con carácter generalizado desde los años cincuenta el tema de los espacios libres y zonas verdes se encuentra ya en el terreno de las exigencias que plantean las colectividades urbanas. Hoy en día, el ciudadano como individuo y como miembro de un conjunto social, se haya definitivamente sensibilizado con este tema, como lo demuestra la actualidad del mismo en todos los medios de información. El propósito del presente trabajo es responder a esa actualidad, estudiando el papel que desempeñan y habrán de desempeñar en nuestras ciudades sus sistemas de espacios libres. Para ello se siguen dos líneas de actuación, una de carácter eminentemente informativo sobre la base de un análisis de la problemática que plantea el tema en el momento actual, y otra que intenta ser pragmática pues persigue la posible aplicación al planeamiento de las proposiciones y conclusiones que se obtienen. La primera se centra sobre tres aspectos concretos: dinámica hintórica, funciones exigibles a los espacios libres, en la ciudad actual y futura y necesidades de la población. La segunda se desarrolla en forma de propuesta en los capítulos dedicados al análisis de cuál debe ser el Sistema de Espacios libres en una ciudad funcionalmente organizada y de como conviene diseñar su composición. Finalmente el último capitulo se dedica, con una intención que también quiere ser pragmática, a la exposición de unas consideraciones sobre el papel de los espacios libres en la ciudad del futuro. Esta segunda parte, de carácter eminentemente práctico, esperamos que llene el vacio existente en esta parcela de la literatura española dedicada al urbanismo, contribuyendo de esta forma a la mejora de los sistemas de espacios libres de nuestras ciudades mediante una propuesta concreta de criterios de planeamiento y modulación de los mismos, aplicables a las di£ tintas tipologías de planeamiento urbanístico

Resistance to fosfomycin is increasing and is significantly associated with extended-spectrum β-lactamase-production in urinary isolates of Escherichia coli

Fosfomycin has become a therapeutic option in urinary tract infections. Our objective was to evaluate the in vitro activity of fosfomycin against Escherichia coli isolated from urine samples in 2013, 2018 and 2021. We also determined a putative association between fosfomycin resistance and extended-spectrum β-lactamases (ESBL) production. Fosfomycin activity was evaluated against 7367, 8128 and 5072 Escherichia coli urinary isolates in 2013, 2018 and 2021, respectively. We compare the prevalence of fosfomycin-resistant strains among the ESBL- and non-ESBL-producing isolates. MICs of fosfomycin, cefotaxime, and cefotaxime-clavulanate were determined by a microdilution method. 302 ESBL-producers were selected to determine MICs of fosfomycin by agar dilution and genes encoding ESBLs were detected by PCR. Among the total of ESBL-producing strains, 14.3%, 20.8% and 20% were resistant to fosfomycin in 2013, 2018 and 2021, respectively, whereas fosfomycin resistance in non-ESBL producers was 3.5%, 4.05% and 5.53% for each year (P ≤ 0.001). In the 302 selected ESBL-producing isolates, CTX-M was the main ESBL (228 isolates), being 50.7% CTX-M-15. Resistance to fosfomycin among these ESBL-producing strains was associated (P = 0.049) with isolates that produced the CTX-M type. Our data show that fosfomycin resistance is increasing in Escherichia coli urinary isolates and it is related to ESBL-production. A follow-up of fosfomycin resistance is required

I Jornadas de Jóvenes Investigadores en Arqueología: libro de Actas

Libro I de Actas de las Jornadas de Jóvenes Investigadores en Arqueología, celebradas en la Universidad Complutense de Madrid en febrero de 2016

Acute Coronary Syndrome in the Older Patient

Coronary artery disease is one of the leading causes of morbidity and mortality, and its prevalence increases with age. The growing number of older patients and their differential characteristics make its management a challenge in clinical practice. The aim of this review is to summarize the state-of-the-art in diagnosis and treatment of acute coronary syndromes in this subgroup of patients. This comprises peculiarities of ST-segment elevation myocardial infarction (STEMI) management, updated evidence of non-STEMI therapeutic strategies, individualization of antiplatelet treatment (weighting ischemic and hemorrhagic risks), as well as assessment of geriatric conditions and ethical issues in decision making

Identification of CRF66_BF, a New HIV-1 Circulating Recombinant Form of South American Origin

Circulating recombinant forms (CRFs) are important components of the HIV-1 pandemic. Among 110 reported in the literature, 17 are BF1 intersubtype recombinant, most of which are of South American origin. Among these, all 5 identified in the Southern Cone and neighboring countries, except Brazil, derive from a common recombinant ancestor related to CRF12_BF, which circulates widely in Argentina, as deduced from coincident breakpoints and clustering in phylogenetic trees. In a HIV-1 molecular epidemiological study in Spain, we identified a phylogenetic cluster of 20 samples from 3 separate regions which were of F1 subsubtype, related to the Brazilian strain, in protease-reverse transcriptase (Pr-RT) and of subtype B in integrase. Remarkably, 14 individuals from this cluster (designated BF9) were Paraguayans and only 4 were native Spaniards. HIV-1 transmission was predominantly heterosexual, except for a subcluster of 6 individuals, 5 of which were men who have sex with men. Ten additional database sequences, from Argentina (n = 4), Spain (n = 3), Paraguay (n = 1), Brazil (n = 1), and Italy (n = 1), branched within the BF9 cluster. To determine whether it represents a new CRF, near full-length genome (NFLG) sequences were obtained for 6 viruses from 3 Spanish regions. Bootscan analyses showed a coincident BF1 recombinant structure, with 5 breakpoints, located in p17 gag , integrase, gp120, gp41-rev overlap, and nef, which was identical to that of two BF1 recombinant viruses from Paraguay previously sequenced in NFLGs. Interestingly, none of the breakpoints coincided with those of CRF12_BF. In a maximum likelihood phylogenetic tree, all 8 NFLG sequences grouped in a strongly supported clade segregating from previously identified CRFs and from the CRF12_BF "family" clade. These results allow us to identify a new HIV-1 CRF, designated CRF66_BF. Through a Bayesian coalescent analysis, the most recent common ancestor of CRF66_BF was estimated around 1984 in South America, either in Paraguay or Argentina. Among Pr-RT sequences obtained by us from HIV-1-infected Paraguayans living in Spain, 14 (20.9%) of 67 were of CRF66_BF, suggesting that CRF66_BF may be one of the major HIV-1 genetic forms circulating in Paraguay. CRF66_BF is the first reported non-Brazilian South American HIV-1 CRF_BF unrelated to CRF12_BF.This work was funded through Acción Estratégica en Salud Intramural (AESI), Instituto de Salud Carlos III, projects PI16CIII/00033 and PI19CIII/00042; Red de Investigación en SIDA (RIS), Instituto de Salud Carlos III, Subdirección General de Evaluación y Fondo Europeo de Desarrollo Regional (FEDER), Plan Nacional I+D+I, project RD16ISCIII/0002/0004; and scientific agreements with Consellería de Sanidade, Government of Galicia (MVI 1004/16) and Osakidetza-Servicio Vasco de Salud, Government of Basque Country (MVI 1001/16).S

Clinical experience with integrase inhibitors in HIV-2-infected individuals in Spain.

Background: HIV-2 is a neglected virus despite estimates of 1–2 million people being infected worldwide. The virus is naturally resistant to some antiretrovirals used to treat HIV-1 and therapeutic options are limited for patients with HIV-2. Methods: In this retrospective observational study, we analysed all HIV-2-infected individuals treated with inte- grase strand transfer inhibitors (INSTIs) recorded in the Spanish HIV-2 cohort. Demographics, treatment modal- ities, laboratory values, quantitative HIV-2 RNA and CD4 counts as well as drug resistance were analysed. Results: From a total of 354 HIV-2-infected patients recruited by the Spanish HIV-2 cohort as of December 2017, INSTIs had been given to 44, in 18 as first-line therapy and in 26 after failing other antiretroviral regimens. After a median follow-up of 13 months of INSTI-based therapy, undetectable viraemia for HIV-2 was achieved in 89% of treatment-naive and in 65.4% of treatment-experienced patients. In parallel, CD4 gains were 82 and 126cells/mm3, respectively. Treatment failure occurred in 15 patients, 2 being treatment-naive and 13 treatment-experienced. INSTI resistance changes were recognized in 12 patients: N155H (5), Q148H/R (3), Y143C/G (3) and R263K (1). Conclusions: Combinations based on INSTIs are effective and safe treatment options for HIV-2-infected individ- uals. However, resistance mutations to INSTIs are selected frequently in failing patients, reducing the already limited treatment options

HTLV-1 infection in solid organ transplant donors and recipients in Spain

Background: HTLV-1 infection is a neglected disease, despite infecting 10–15 million people worldwide and severe illnesses develop in 10% of carriers lifelong. Acknowledging a greater risk for developing HTLV-1 associated illnesses due to immunosuppression, screening is being widely considered in the transplantation setting. Herein, we report the experience with universal HTLV testing of donors and recipients of solid organ transplants in a survey conducted in Spain. Methods: All hospitals belonging to the Spanish HTLV network were invited to participate in the study. Briefly, HTLV antibody screening was performed retrospectively in all specimens collected from solid organ donors and recipients attended since the year 2008. Results: A total of 5751 individuals were tested for HTLV antibodies at 8 sites. Donors represented 2312 (42.2%), of whom 17 (0.3%) were living kidney donors. The remaining 3439 (59.8%) were recipients. Spaniards represented nearly 80%. Overall, 9 individuals (0.16%) were initially reactive for HTLV antibodies. Six were donors and 3 were recipients. Using confirmatory tests, HTLV-1 could be confirmed in only two donors, one Spaniard and another from Colombia. Both kidneys of the Spaniard were inadvertently transplanted. Subacute myelopathy developed within 1 year in one recipient. The second recipient seroconverted for HTLV-1 but the kidney had to be removed soon due to rejection. Immunosuppression was stopped and 3 years later the patient remains in dialysis but otherwise asymptomatic. Conclusion: The rate of HTLV-1 is low but not negligible in donors/recipients of solid organ transplants in Spain. Universal HTLV screening should be recommended in all donor and recipients of solid organ transplantation in Spain. Evidence is overwhelming for very high virus transmission and increased risk along with the rapid development of subacute myelopath

Rapid subacute myelopathy following kidney transplantation from HTLV-1 donors: role of immunosuppresors and failure of antiretrovirals

Two kidney transplant recipients from a single donor became infected with HTLV-1 (human T-lymphotropic virus type 1) in Spain. One developed myelopathy 8 months following surgery despite early prescription of antiretroviral therapy. The allograft was removed from the second recipient at month 8 due to rejection and immunosuppressors discontinued. To date, 3 years later, this patient remains infected but asymptomatic. HTLV-1 infection was recognized retrospectively in the donor, a native Spaniard who had sex partners from endemic regions. Our findings call for a reappraisal of screening policies on donor-recipient organ transplantation. Based on the high risk of disease development and the large flux of persons from HTLV-1 endemic regions, pre-transplant HTLV-1 testing should be mandatory in Spain