Picaduras y mordeduras de animales

Under the heading of this subject we deal with stings by arthropods, making reference to the differences that exist between the stings of wasps and bees, commenting on the composition of the poisons and the different local and general reactions that are caused by such stings. Also discussed are the stings/bites caused by scorpions, spiders, ticks, and marine animals, with the clinical picture they provoke and the treatment that must be administered. Finally, snakebites are considered, with reference to the most frequent types of ophidia to be found in Navarra, how to differentiate between the bites of snakes and vipers, the different clinical pictures they provoke and the treatment to be applie

Unbalanced and Reactive Currents Compensation in Three-Phase Four-Wire Sinusoidal Power Systems

[EN] In an unbalanced linear three-phase electrical system, there are inefficient powers that increase the apparent power supplied by the network, line losses, machine malfunctions, etc. These inefficiencies are mainly due to the use of unbalanced loads. Unlike a three-wire unbalanced system, a four-wire system has zero sequence currents that circulate through the neutral wire and can be compensated by means of compensation equipment, which prevents it from being delivered by the network. To design a compensator that works with unbalanced voltages, it is necessary to consider the interactions between it and the other compensators used to compensate for negative-sequence currents and positive-sequence reactive currents. In this paper, through passive compensation, a new method is proposed to develop the zero sequence current compensation equipment. The method does not require iteration algorithms and is valid for unbalanced voltages. In addition, the interactions between all compensators are analyzed, and the necessary modifications in the calculations are proposed to obtain a total compensation. To facilitate the application of the method and demonstrate its validity, a case study is developed from a three-phase linear four-wire system with unbalanced voltages and loads. The results obtained are compared with other compensation methods that also use passive elements.This work is supported by the Spanish Ministry of Science, Innovation and Universities (MICINN) and the European Regional Development Fund (ERDF) under grant RTI2018-100732-B-C21.Montoya-Mira, R.; Blasco Espinosa, PA.; Diez-Aznar, J.; Montoya Villena, R.; Reig-Pérez, MJ. (2020). Unbalanced and Reactive Currents Compensation in Three-Phase Four-Wire Sinusoidal Power Systems. Applied Sciences. 10(5):1-23. https://doi.org/10.3390/app10051764S123105Sainz, L., Caro, M., & Caro, E. (2009). Analytical Study of the Series Resonance in Power Systems With the Steinmetz Circuit. IEEE Transactions on Power Delivery, 24(4), 2090-2098. doi:10.1109/tpwrd.2009.2028790Emanuel, A. E. (1993). On the definition of power factor and apparent power in unbalanced polyphase circuits with sinusoidal voltage and currents. IEEE Transactions on Power Delivery, 8(3), 841-852. doi:10.1109/61.252612Willems, J. L. (2004). Reflections on Apparent Power and Power Factor in Nonsinusoidal and Polyphase Situations. IEEE Transactions on Power Delivery, 19(2), 835-840. doi:10.1109/tpwrd.2003.823182Pillay, P., & Manyage, M. (2006). Loss of Life in Induction Machines Operating With Unbalanced Supplies. IEEE Transactions on Energy Conversion, 21(4), 813-822. doi:10.1109/tec.2005.853724Poblador, M. L. A., & Lopez, G. A. R. (2013). Power calculations in nonlinear and unbalanced conditions according to IEEE Std 1459-2010. 2013 Workshop on Power Electronics and Power Quality Applications (PEPQA). doi:10.1109/pepqa.2013.6614957IEEE Recommended Practice for Monitoring Electric Power Quality. (s. f.). doi:10.1109/ieeestd.2019.8796486Blasco, P. A., Montoya-Mira, R., Diez, J. M., Montoya, R., & Reig, M. J. (2019). Compensation of Reactive Power and Unbalanced Power in Three-Phase Three-Wire Systems Connected to an Infinite Power Network. Applied Sciences, 10(1), 113. doi:10.3390/app10010113San-Yi Lee, & Chi-Jui Wu. (1993). On-line reactive power compensation schemes for unbalanced three phase four wire distribution feeders. IEEE Transactions on Power Delivery, 8(4), 1958-1965. doi:10.1109/61.248308Otto, R. A., Putman, T. H., & Gyugyi, L. (1978). Principles and Applications of Static, Thyristor-Controlled Shunt Compensators. IEEE Transactions on Power Apparatus and Systems, PAS-97(5), 1935-1945. doi:10.1109/tpas.1978.354690Origa de Oliveira, L. C., Barros Neto, M. C., & de Souza, J. B. (s. f.). Load compensation in four-wire electrical power systems. PowerCon 2000. 2000 International Conference on Power System Technology. Proceedings (Cat. No.00EX409). doi:10.1109/icpst.2000.898206Li, E., Sheng, W., Wang, X., & Wang, B. (2011). Combined compensation strategies based on instantaneous reactive power theory for reactive power compensation and load balancing. 2011 International Conference on Electrical and Control Engineering. doi:10.1109/iceceng.2011.6057765Leon-Martinez, V., & Montanana-Romeu, J. (2014). Representation of load imbalances through reactances. Application to working standards. 2014 16th International Conference on Harmonics and Quality of Power (ICHQP). doi:10.1109/ichqp.2014.6842894Czarnecki, L. S., & Haley, P. M. (2015). Unbalanced Power in Four-Wire Systems and Its Reactive Compensation. IEEE Transactions on Power Delivery, 30(1), 53-63. doi:10.1109/tpwrd.2014.2314599Czarnecki, L. S. (1989). Reactive and unbalanced currents compensation in three-phase asymmetrical circuits under nonsinusoidal conditions. IEEE Transactions on Instrumentation and Measurement, 38(3), 754-759. doi:10.1109/19.32187Czarnecki, L. S. (1988). Orthogonal decomposition of the currents in a 3-phase nonlinear asymmetrical circuit with a nonsinusoidal voltage source. IEEE Transactions on Instrumentation and Measurement, 37(1), 30-34. doi:10.1109/19.2658Pană, A., Băloi, A., & Molnar-Matei, F. (2018). From the Balancing Reactive Compensator to the Balancing Capacitive Compensator. Energies, 11(8), 1979. doi:10.3390/en1108197

Formulation of the Phasors of Apparent Harmonic Power: Application to Non-Sinusoidal Three-Phase Power Systems

[EN] In this work, the expression of the phasor of apparent power of harmonic distortion is formulated in the time domain. Applying this phasor along with the phasor of apparent unbalancep power allows us to obtain a new set of phasors that include all of the inefficient power components appearing in the transfer of energy in non-linear and unbalanced systems.This work is supported by the Spanish Ministry of Economy and Competitiveness (MINECO) and the European Regional Development Fund (ERDF) under Grant ENE2015-64087-C2-2R.Blasco Espinosa, PA.; Montoya-Mira, R.; Diez-Aznar, J.; Montoya Villena, R.; Reig-Pérez, MJ. (2018). Formulation of the Phasors of Apparent Harmonic Power: Application to Non-Sinusoidal Three-Phase Power Systems. Energies. 11(7):1-16. https://doi.org/10.3390/en11071888S11611

A short critical history of the application of genomics to animal breeding

[EN] Two scientific schools have been in coexistence from the beginning of genetics, one of them searching for factors of inheritance and the other one applying biometrical models to study the relationships between relatives. With the development of molecular genetics, the possibilities of detecting genes having a noticeable effect in traits augmented. Some genes with large or medium effects were localized in animals, although the most common result was to detect markers linked to these genes, allowing the possibility of assisting selection programs with markers. When a large amount of simple and inexpensive markers were available, the SNPs, new possibilities were opened since they did not need the presence of genes of large or medium effect controlling a trait, because the whole genome was scanned. Using a large amount of SNPs permits having a prediction of the breeding value at birth accurate enough to be used in some cases, like dairy cattle, to halve its generation interval. In other animal breeding programs, the implementation of genomic selection is less clear and the way in which it can be useful should be carefully studied. The need for large populations for associating phenotypic data and markers, plus the need for repeating the process continuously, complicates its application in some cases. The implementation of the information provided by the SNPs in current genetic programs has led to the development of complex statistical tools, joining the efforts of the two schools, factorial and biometrical, that nowadays work closely related. (C) 2014 Elsevier B.V. All rights reserved.This work was partially funded by the Ministerio de Economia y Competitividad, Spain (Projects AGL2011-29831-C03-01 and CGL2012-39861-C02-02). We are grateful to Dr. Saif Agha for his useful comments.Blasco Mateu, A.; Toro, MA. (2014). A short critical history of the application of genomics to animal breeding. Livestock Science. 166:4-9. doi:10.1016/j.livsci.2014.03.015S4916

Response of the human myocardium to ischemic injury and preconditioning: The role of cardiac and comorbid conditions, medical treatment, and basal redox status

Vàlvula aòrtica; Isquèmia; MiocardiVálvula aórtica; Isquemia; MiocardioAortic valve; Ischemia; MyocardiumBackground The diseased human myocardium is highly susceptible to ischemia/reoxygenation (I/R)-induced injury but its response to protective interventions such as ischemic preconditioning (IPreC) is unclear. Cardiac and other pre-existing clinical conditions as well as previous or ongoing medical treatment may influence the myocardial response to I/R injury and protection. This study investigated the effect of both on myocardial susceptibility to I/R-induced injury and the protective effects of IPreC. Methods and results Atrial myocardium from cardiac surgery patients (n = 300) was assigned to one of three groups: aerobic control, I/R alone, and IPreC. Lactate dehydrogenase leakage, as a marker of cell injury, and cell viability were measured. The basal redox status was determined in samples from 90 patients. The response to I/R varied widely. Myocardium from patients with aortic valve disease was the most susceptible to injury whereas myocardium from dyslipidemia patients was the least susceptible. Tissue from females was better protected than tissue from males. Myocardium from patients with mitral valve disease was the least responsive to IPreC. The basal redox status was altered in the myocardium from patients with mitral and aortic valve disease. Conclusions The response of the myocardium to I/R and IPreC is highly variable and influenced by the underlying cardiac pathology, dyslipidemia, sex, and the basal redox status. These results should be taken into account in the design of future clinical studies on the prevention of I/R injury and protection.This study was supported by the Instituto de Salud Carlos III (FIS) [grant number 12/00119]

Critically short telomeres and toxicity of chemotherapy in early breast cancer

Cumulative toxicity from weekly paclitaxel (myalgia, peripheral neuropathy, fatigue) compromises long-term administration. Preclinical data suggest that the burden of critically short telomeres ( 21.9% CSTs) had 2-fold higher number of neuropathy (P = 0.04) or fatigue (P = 0.019) episodes and >3-fold higher number of myalgia episodes (P = 0.005). The average telomere length was unrelated to the incidence of side effects.The percentage of CSTs, but not the average telomere size, is associated with weekly paclitaxel-derived toxicity.This work was supported by the Fondo de Investigación Sanitaria [FIS PI10/00288 and FIS PI13/00430]; AECC Scientific Foundation [Beca de Retorno-2010, to MQF]; Spanish Ministry of Economy and Competitiveness Projects [SAF2013-45111-R]; Madrid Regional Government Projects [S2010/BMD- 2303]; AXA Research Found; Fundación Botin; AVON Spain; and Boehringer-Ingelheim Spain.S

Factors Contributing to the Utilization of Adult Mental Health Services in Children and Adolescents Diagnosed with Hyperkinetic Disorder

Objectives. To examine whether age of First diagnosis, gender, psychiatric comorbidity, and treatment modalities (pharmacotherapy or psychotherapy) at Child and Adolescent Mental Health Services (CAMHS) moderate the risk of Adult Mental Health Services (AMHS) utilization in patients diagnosed with hyperkinetic disorder at CAMHS. Methods. Data were derived from the Madrid Psychiatric Cumulative Register Study. The target population comprised 32,183 patients who had 3 or more visits at CAMHS. Kaplan-Meier curves were used to assess survival data. A series of logistic regression analyses were performed to study the role of age of diagnosis, gender, psychiatric comorbidity, and treatment modalities. Results. 7.1% of patients presented with hyperkinetic disorder at CAMHS. Compared to preschool children, children and adolescents first diagnosed with hyperkinetic disorder at CAMHS were more likely to use AMHS. Female gender and comorbidity with affective disorders, schizophrenia, schizotypal and delusional disorders increased the risk of use of AMHS. Pharmacological or combined treatment of hyperkinetic disorder diagnosed at CAMHS was associated with increased risk of use at AMHS. Conclusions. Older age of first diagnosis, female gender, psychiatric comorbidity, and pharmacological treatment at CAMHS are markers of risk for the transition from CAMHS to AMHS in patients with hyperkinetic disorder diagnosed at CAMHS

Satisfacción de los pacientes con la comunicación en las consultas de medicina de familia: comparación de tres métodos para investigar necesidades no satisfechas.

Diferentes aspectos de la relación medico-paciente se han asociado con la satisfacción y otros resultados de la consulta, pero el “efecto techo” suele limitar estas mediciones. El objetivo del trabajo es evaluar la relación y las diferencias entre tres modos de obtención de información referentes a la satisfacción del paciente y la percepción de necesidades no cubiertas en aspectos comunicativos con el médico.post-print240 K

Intermittent Hypoxia Is Associated With High Hypoxia Inducible Factor-1α but Not High Vascular Endothelial Growth Factor Cell Expression in Tumors of Cutaneous Melanoma Patients

Epidemiological associations linking between obstructive sleep apnea and poorer solid malignant tumor outcomes have recently emerged. Putative pathways proposed to explain that these associations have included enhanced hypoxia inducible factor (HIF)-1α and vascular endothelial growth factor (VEGF) cell expression in the tumor and altered immune functions via intermittent hypoxia (IH). Here, we examined relationships between HIF-1α and VEGF expression and nocturnal IH in cutaneous melanoma (CM) tumor samples. Prospectively recruited patients with CM tumor samples were included and underwent overnight polygraphy. General clinical features, apnea-hypopnea index (AHI), desaturation index (DI4%), and CM characteristics were recorded. Histochemical assessments of VEGF and HIF-1α were performed, and the percentage of positive cells (0, 75%) was blindly tabulated for VEGF expression, and as 0, 0-5.9, 6.0-10.0, >10.0% for HIF-1α expression, respectively. Cases with HIF-1α expression >6% (high expression) were compared with those 75% of cells was compared with those with <75%. 376 patients were included. High expression of VEGF and HIF-1α were seen in 88.8 and 4.2% of samples, respectively. High expression of VEGF was only associated with increasing age. However, high expression of HIF-1α was significantly associated with age, Breslow index, AHI, and DI4%. Logistic regression showed that DI4% [OR 1.03 (95% CI: 1.01-1.06)] and Breslow index [OR 1.28 (95% CI: 1.18-1.46)], but not AHI, remained independently associated with the presence of high HIF-1α expression. Thus, IH emerges as an independent risk factor for higher HIF-1α expression in CM tumors and is inferentially linked to worse clinical CM prognostic indicators.IA is supported by SEPAR (086/2014 and 595/2017). MM-G is supported by the Instituto de Salud Carlos III (PI16/01772) and cofinanced by the European Development Regional Find “A way to achieve Europe” (ERDF) and SEPAR (211/2012). ER-F is the recipient of a postdoctoral fellowship from “Fundación Científica de la Asociación Española Contra el Cáncer” and supported by FMM-2013/0075 of “Fundación Mutua Madrileña.” JR-P is supported by FIS 2014/1737 from the Spanish Ministry of Health. RF is supported in part by the Spanish Ministry of Economy and Competitiveness—Instituto de Salud Carlos III (FIS-PI14/00004); DG is supported by National Institutes of Health grant 1R01HL130984 and by the Herbert T. Abelson Chair in Pediatrics

Impact of the first wave of the SARS-CoV-2 pandemic on the outcome of neurosurgical patients: A nationwide study in Spain

Objective To assess the effect of the first wave of the SARS-CoV-2 pandemic on the outcome of neurosurgical patients in Spain. Settings The initial flood of COVID-19 patients overwhelmed an unprepared healthcare system. Different measures were taken to deal with this overburden. The effect of these measures on neurosurgical patients, as well as the effect of COVID-19 itself, has not been thoroughly studied. Participants This was a multicentre, nationwide, observational retrospective study of patients who underwent any neurosurgical operation from March to July 2020. Interventions An exploratory factorial analysis was performed to select the most relevant variables of the sample. Primary and secondary outcome measures Univariate and multivariate analyses were performed to identify independent predictors of mortality and postoperative SARS-CoV-2 infection. Results Sixteen hospitals registered 1677 operated patients. The overall mortality was 6.4%, and 2.9% (44 patients) suffered a perioperative SARS-CoV-2 infection. Of those infections, 24 were diagnosed postoperatively. Age (OR 1.05), perioperative SARS-CoV-2 infection (OR 4.7), community COVID-19 incidence (cases/10 5 people/week) (OR 1.006), postoperative neurological worsening (OR 5.9), postoperative need for airway support (OR 5.38), ASA grade =3 (OR 2.5) and preoperative GCS 3-8 (OR 2.82) were independently associated with mortality. For SARS-CoV-2 postoperative infection, screening swab test <72 hours preoperatively (OR 0.76), community COVID-19 incidence (cases/10 5 people/week) (OR 1.011), preoperative cognitive impairment (OR 2.784), postoperative sepsis (OR 3.807) and an absence of postoperative complications (OR 0.188) were independently associated. Conclusions Perioperative SARS-CoV-2 infection in neurosurgical patients was associated with an increase in mortality by almost fivefold. Community COVID-19 incidence (cases/10 5 people/week) was a statistically independent predictor of mortality. Trial registration number CEIM 20/217