L’atenció primerenca a les Illes Balears

El treball descriu el programa d’atenció primerenca que es desenvolupa a les Illes Balears, la seva evolució, els professionals i les seves funcions en cada un dels àmbits implicats. Per altra part, també s’ofereixen dades sobre la població atesa. Els autors són professionals dels tres àmbits responsables del Pla integral d’atenció primerenca de les Illes Balears (educatiu, sanitari i social), els quals destaquen la importància de la coordinació interdisciplinària i la necessitat de disposar d’una xarxa de serveis que doni resposta a les necessitats dels infants i les seves famílies.El trabajo describe el programa de atención primaria que se desarrolla en las Islas Baleares, su evolución, los profesionales y sus funciones en cada uno de los ámbitos implicados. Por otra parte, también se ofrecen datos sobre la población atendida. Los autores son profesionales de los tres ámbitos responsables del Plan integral de atención primaria de las Islas Baleares (educativo, sanitario y social), los cuales destacan la importancia de la coordinación interdisciplinar y la necesidad de disponer de una red de servicios que den respuesta a las necesidades de los niños y sus familias

T-Cell Subsets in Rheumatoid Arthritis Patients on Long-Term Anti-TNF or IL-6 Receptor Blocker Therapy

Data on the impact of biological therapies on the T-cell phenotype in rheumatoid arthritis are limited. Here, we prospectively measured the percentages of 15 circulating T-cell subtypes using flow cytometry. We obtained transversal and longitudinal data in 30 anti-TNF responders, 19 secondary anti-TNF nonresponders, and 43 IL-6R antagonist responders, before, 8 weeks and at least 6 months after biological therapy. Untreated RA patients and healthy controls were also included. The important findings are the following: ( 1) the proportion of regulatory T-cells (Tregs) which are decreased in untreated RA patients becomes normal in all long-term-treated groups; ( 2) in anti-TNF responders as well as in nonresponders, the frequencies of naive CD4+ and CD8+ cells are lower, whereas those of proinflammatory Th1, Th2, and Th17 cells and HLA-DR+-activated cells are higher than those in untreated RA or healthy controls; ( 3) in IL-6R responders, Th1 proportion is decreased, while that of Th2 and Th17 is increased as compared to that in anti-TNF-treated patients and controls; ( 4) pending confirmation, a CD4CD69 ratio <2.43 at baseline, could be useful to predict a good therapeutic response to anti-TNF therapy. This study provides comprehensive information regarding the long-term impacts of those biological therapies on the ecotaxis of T-cells in RA

Carotenoid composition and content in products of sea buckthorn and peach as determined by high-performance liquid chromatography

A study was conducted to analyse the carotenoids by high-performance liquid chromatography (HPLC) using reversed-phasecross linked end-capping and to study the pigment content and composition in sea buckthorn products as well as in freshly harvested fruitsfrom peach thees grown under organic and integrated farming conditions. It was found that carotenoids in fruits of both crops occur mainlyesterified with fatty acids in form of mono- and di-esters. The major carotenoids were esters of zeaxanthin, lutein, β-cryptoxanthin and β-carotene. The major carotenoids showed different response to processing of sea buckthorn being highly sensitive to thermal treatments suchas blanching, cooking and drying. Significant differences were found between peach varieties in their carotenoid content, whereas the impactof organic farming on carotenoids formation was found to be variety-dependent. Two of the three varieties examined in this work, whencultivated under organic farming conditions contained lower carotenoid level as compared to that found in the fruits of the same varieties butproduced in integrated farms

Carotenoid composition and content in products of sea buckthorn and peach as determined by high-performance liquid chromatography

A study was conducted to analyse the carotenoids by high-performance liquid chromatography (HPLC) using reversed-phase cross linked end-capping and to study the pigment content and composition in sea buckthorn products as well as in freshly harvested fruits from peach thees grown under organic and integrated farming conditions. It was found that carotenoids in fruits of both crops occur mainly esterified with fatty acids in form of mono- and di-esters. The major carotenoids were esters of zeaxanthin, lutein, β-cryptoxanthin and β-carotene. The major carotenoids showed different response to processing of sea buckthorn being highly sensitive to thermal treatments such as blanching, cooking and drying. Significant differences were found between peach varieties in their carotenoid content, whereas the impact of organic farming on carotenoids formation was found to be variety-dependent. Two of the three varieties examined in this work, when cultivated under organic farming conditions contained lower carotenoid level as compared to that found in the fruits of the same varieties but produced in integrated farms

A krónikus kritikus végtagischaemia invazív kezelésének hosszú távú eredményei

INTRODUCTION AND AIM: Surgical tibial bypass for critical limb ischemia is associated with significant morbidity, mortality, and graft failure, whereas percutaneous angioplasty and stenting has promising results. The objective of this study was the investigation of the long term results of below-knee percutaneous angioplasty for restoring straight inline arterial flow in patients with critical limb ischemia. METHOD: The clinical and angiographic data of 281 consecutive patients with critical limb ischemia treated by PTA between 2008 and 2011 was evaluated in a prospective register. The aim of the revascularization was to achieve a straight inline flow to the wound with balloon angioplasty. Stent implantation was done in the case of recoil and flow limiting dissection. Primary end points were clinical success (relief of resting pain, healing of ulceration, limb survival) and major adverse events (death, myocardial infarction, major unplanned amputation, need for surgical revascularization, or major bleeding). Secondary end points were the angiographic result of the intervention, procedural data and consumption of angioplasty equipment. The impact of diabetic leg syndrome and the result of the angioplasty on the limb salvage was also investigated. We have analysed the impact of major amputation on long term mortality. RESULTS: Mean age of patients was 72.5 +/- 10.6 years and the follow-up period was 40.8 +/- 9.7 months. Technical success was reached in 255 (90.7%) of the patient's: 255 limbs straight inline flow with good angiographic result was restored to at least one tibial vessel. Balloon angioplasty, stent implantation and rotational atherectomy was performed in 278 (98.9%), 74 (26.3%) and 2 patients (0.7%). From clinical end points the rest pain was ceased in 56.6%, the ulcer and the gangrena was healed in 73.5% and 46.5%. The long term limb survival was 73.5%; 65.8% in diabetic and 89.6% in non-diabetic leg syndrome (p = 0.001). The major adverse events at long-term follow-up occured in 122 (43.8%) patients. Death occured in 57 (20.3%) of the patients during the long-term follow-up: 38 (13.5%) vs. 19 (6.8%) in diabetic vs. non-diabetic leg subgroup, respectively (p = 0.932). Long-term limb saving occured in 72.3% vs. 84.6% of the patients dependening the procedure was successful or unsuccessful (p = 0.225). CONCLUSION: Below-knee stent angioplasty for critical limb ischemia results in good clinical outcome, but the major adverse event rate is high. Diabetes mellitus is associated with a high rate of mortality and amputation. Orv. Hetil., 2017, 158(11), 418-425

Spin-orbit misalignment in the HD80606 planetary system

We recently reported the photometric and spectroscopic detection of the primary transit of the 111-day-period, eccentric extra-solar planet HD80606 b, at Observatoire de Haute-Provence, France (Moutou et al. 2009). The whole egress of the primary transit and a section of its central part were observed, allowing the measurement of the planetary radius, and evidence for a spin-orbit misalignment through the observation of the Rossiter-McLaughlin anomaly. The ingress having not been observed for this long-duration transit, uncertainties remained in the parameters of the system. We present here a refined, combined analysis of our photometric and spectroscopic data, together with further published radial velocities, ground-based photometry, and Spitzer photometry around the secondary eclipse, as well as new photometric measurements of HD 80606 acquired at Mount Hopkins, Arizona, just before the beginning of the primary transit. Although the transit is not detected in those new data, they provide an upper limit for the transit duration, which narrows down the possible behaviour of the Rossiter-McLaughlin anomaly in the unobserved part of the transit. We analyse the whole data with a Bayesian approach using a Markov-chain Monte Carlo integration on all available information. We find R_p = 0.98 +- 0.03 R_Jup for the planetary radius, and a total primary transit duration of 11.9 +- 1.3 hours from first to fourth contact. Our analysis reinforces the hypothesis of spin-orbit misalignment in this system (alignment excluded at >95 % level), with a positive projected angle between the planetary orbital axis and the stellar rotation (median solution lambda ~ 50 degrees). As HD80606 is a component of a binary system, the peculiar orbit of its planet could result from a Kozai mechanism.Comment: accepted for Publication in Astronomy & Astrophysics, submitted 11 May 200

WASP-4b Arrived Early for the TESS Mission

The Transiting Exoplanet Survey Satellite (TESS) recently observed 18 transits of the hot Jupiter WASP-4b. The sequence of transits occurred 81.6 $\pm$ 11.7 seconds earlier than had been predicted, based on data stretching back to 2007. This is unlikely to be the result of a clock error, because TESS observations of other hot Jupiters (WASP-6b, 18b, and 46b) are compatible with a constant period, ruling out an 81.6-second offset at the 6.4$\sigma$ level. The 1.3-day orbital period of WASP-4b appears to be decreasing at a rate of $\dot{P} = -12.6 \pm 1.2$ milliseconds per year. The apparent period change might be caused by tidal orbital decay or apsidal precession, although both interpretations have shortcomings. The gravitational influence of a third body is another possibility, though at present there is minimal evidence for such a body. Further observations are needed to confirm and understand the timing variation.Comment: AJ accepte

Search for Radiative Decays of Cosmic Background Neutrino using Cosmic Infrared Background Energy Spectrum

We propose to search for the neutrino radiative decay by fitting a photon energy spectrum of the cosmic infrared background to a sum of the photon energy spectrum from the neutrino radiative decay and a continuum. By comparing the present cosmic infrared background energy spectrum observed by AKARI and Spitzer to the photon energy spectrum expected from neutrino radiative decay with a maximum likelihood method, we obatined a lifetime lower limit of $3.1 \times 10^{12}$ to $3.8 \times 10^{12}$ years at 95% confidence level for the third generation neutrino $\nu_3$ in the $\nu_3$ mass range between 50 \mmev and 150 \mmev under the present constraints by the neutrino oscillation measurements. In the left-right symmetric model, the minimum lifetime of $\nu_3$ is predicted to be $1.5 \times 10^{17}$ years for $m_3$ of 50 \mmev. We studied the feasibility of the observation of the neutrino radiative decay with a lifetime of $1.5 \times 10^{17}$ years, by measuring a continuous energy spectrum of the cosmic infrared background

Large A-fiber activity is required for microglial proliferation and p38 MAPK activation in the spinal cord: different effects of resiniferatoxin and bupivacaine on spinal microglial changes after spared nerve injury

BACKGROUND: After peripheral nerve injury, spontaneous ectopic activity arising from the peripheral axons plays an important role in inducing central sensitization and neuropathic pain. Recent evidence indicates that activation of spinal cord microglia also contributes to the development of neuropathic pain. In particular, activation of p38 mitogen-activated protein kinase (MAPK) in spinal microglia is required for the development of mechanical allodynia. However, activity-dependent activation of microglia after nerve injury has not been fully addressed. To determine whether spontaneous activity from C- or A-fibers is required for microglial activation, we used resiniferatoxin (RTX) to block the conduction of transient receptor potential vanilloid subtype 1 (TRPV1) positive fibers (mostly C- and Adelta-fibers) and bupivacaine microspheres to block all fibers of the sciatic nerve in rats before spared nerve injury (SNI), and observed spinal microglial changes 2 days later. RESULTS: SNI induced robust mechanical allodynia and p38 activation in spinal microglia. SNI also induced marked cell proliferation in the spinal cord, and all the proliferating cells (BrdU+) were microglia (Iba1+). Bupivacaine induced a complete sensory and motor blockade and also significantly inhibited p38 activation and microglial proliferation in the spinal cord. In contrast, and although it produced an efficient nociceptive block, RTX failed to inhibit p38 activation and microglial proliferation in the spinal cord. CONCLUSION: (1) Blocking peripheral input in TRPV1-positive fibers (presumably C-fibers) is not enough to prevent nerve injury-induced spinal microglial activation. (2) Peripheral input from large myelinated fibers is important for microglial activation. (3) Microglial activation is associated with mechanical allodynia

Indicators for relational values of nature’s contributions to good quality of life:The IPBES approach for Europe and Central Asia

Relational values are values of desirable relationships between people and nature and among people (through nature). We report on the approach to capture relational values of nature s contributions to people in the regional assessment for Europe and Central Asia of the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES). We present a framework considering indicators along four relational value dimensions about people s relationships with nature: security and sovereignty; health; equity and justice; and heritage, social identity and stewardship. The framework has been operationalized for three nature s contributions to people (NCP): regulation of freshwater quality and quantity, food and feed, and physical and psychological experiences derived from nature. We identify ways to empirically assess relational values of nature s contributions to people at regional and continental scales with social-ecological indicators and proxies, ranging from biophysical indicators to indicators that intersect socio-economic with biophysical data. We conclude that many of the identified indicators can be considered as useful proxies of relational values in a quantitative way. The analysis shows that relational values are essential to consider at the science-policy interface as they are an important set of values that people hold about nature and that go beyond instrumental relations. © 2020, © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor and Francis Group