Psicosis: reflexiones en torno a la asistencia pública y a la continuidad de cuidados.

Como ya se indicaba en un artículo precedente, éste quiere señalar algunos puntos relativos al proceso de continuidad de cuidados entre una Unidad de Agudos y los Centros de Salud Mental de una zona sanitaria. Se comparan dos modelos de atención en la referida continuidad de cuidados y se explican algunas formas de relación entre la citada Unidad y los Centros de Salud Menta

Psicosis: reflexiones en torno a la asistencia pública y a la continuidad de cuidados.

Como ya se indicaba en un artículo precedente, éste quiere señalar algunos puntos relativos al proceso de continuidad de cuidados entre una Unidad de Agudos y los Centros de Salud Mental de una zona sanitaria. Se comparan dos modelos de atención en la referida continuidad de cuidados y se explican algunas formas de relación entre la citada Unidad y los Centros de Salud Menta

Estudio del uso de ligantes modificados en mezclas antifisuras

La fisuración es uno de los deterioros más habituales en firmes de hormigón o mezclas bituminosas muy envejecidas o con bases de ligantes hidráulicos. En los firmes flexibles la aparición de este tipo de deterioros viene asociada, normalmente, a la rotura por fatiga de alguna capa inferior del firme debido a las flexiones repetidas por el paso de vehículos pesados. Esta rotura se traduce en la aparición de grietas en las capas inferiores del firme que se transmiten a la superficie, cuarteándose y aumentando en abertura y extensión con el paso del tiempo. Una de las soluciones a este problema que más éxito han tenido en los últimos años y en la que CEPSA tiene una dilatada experiencia es la utilización de una capa de mezcla antifisuras con alto contenido de ligantes de altas prestaciones (con una alta modificación), lo que permite dar una solución eficaz en una capa de bajo espesor. En el presente artículo se exponen los resultados del estudio sobre comportamiento a fatiga realizado sobre distintos ligantes y en mezclas de este tipo analizando el comportamiento a fatiga de ligantes y mezclas mediante el ensayo EBADE, así como la resistencia a la fisuración de las mezclas con el ensayo Fénix. De los resultados obtenidos se concluye que la utilización de betunes de altas prestaciones con un alto contenido de polímero y una alta viscosidad se traduce en un mejor comportamiento de las mezclas antifisuras.Postprint (published version

Hyperinsulinemic Hypoglycemia after Bariatric Surgery: Diagnosis and Management Experience from a Spanish Multicenter Registry

Background: Severe postprandial hypoglycemia after bariatric surgery is a rare but invalidating complication. Our aim was to describe the different tests performed for its diagnosis and their outcomes as well as the response to the prescribed pharmacological and surgical treatments. Methods: Multicenter, retrospective systematic review of cases with recurrent severe postprandial hypoglycemia. Results: Over 11 years of follow-up, 22 patients were identified. The test most used to provoke hypoglycemia was the oral glucose load test followed by the mixed meal test which was the least standardized test. With pharmacological treatment, 3 patients were symptom-free (with octreotide) and in 12 patients hypoglycemic episodes were attenuated. Seven patients had persistent hypoglycemic episodes and underwent surgery. Partial pancreatectomy was performed in 3 patients who had positive selective arterial calcium stimulation, and nesidioblastosis was confirmed in 2 patients. Reconversion to normal anatomy was performed in 3 patients, and 1 patient underwent a resection of the 'candy cane' roux limb, with resolution of hypoglycemia in all cases. Conclusions: There is high heterogeneity in the evaluation and treatment options for postoperative hypoglycemia. In patients that do not respond to pharmacological treatment, reconstruction of gastrojejunal continuity may be the safest and most successful procedure

El Devónico Inferior del Dominio Obejo-Valsequillo-Puebla de la Reina (Zona de Ossa-Morena): conodontos, braquiópodos, corales, ostrácodos y peces

La escasez de estudios paleontológicos adecuados, la complejidad tectónica y la discontinuidad de los afloramientos dificulta el conocimiento de la secuencia lito y bioestratigráfica del Dominio Obejo-Valsequillo-Puebla de la Reina. Este hecho, nos ha animado a comenzar un estudio multidisciplinar (fundamentalmente conodontos, braquiópodos, corales, estromatoporoideos, ostrácodos, restos de peces y biofacies) del Devónico Inferior de la parte oriental de este Dominio. En este trabajo se presentan datos paleontológicos de cuatro secciones que permiten el establecimiento de un marco temporal preliminar que servirá para futuros estudios de detalle. Estas secciones son, de oeste a este, Guadámez 2 (GUA 2), Zújar (ZUJ), Peñón Cortado (PCR) y Pozo del Rincón (PZR)

Evaluating the Influence of Mood and Stress on GlycemicVariability in People with T1DM Using Glucose MonitoringSensors and Pools

Objective: Assess in a sample of people with type 1 diabetes mellitus whether mood andstress influence blood glucose levels and variability.Material and Methods: Continuous glucosemonitoring was performed on 10 patients with type 1 diabetes mellitus, where interstitial glucosevalues were recorded every 15 min. A daily survey was conducted through Google Forms, collectinginformation on mood and stress. The day was divided into six slots of 4-h each, asking the patientto assess each slot in relation to mood (sad, normal or happy) and stress (calm, normal or nervous).Different measures of glycemic control (arithmetic mean and percentage of time below/above thetarget range) and variability (standard deviation, percentage coefficient of variation, mean amplitudeof glycemic excursions and mean of daily differences) were calculated to relate the mood and stressperceived by patients with blood glucose levels and glycemic variability. A hypothesis test wascarried out to quantitatively compare the data groups of the different measures using the Student’st-test.Results: Statistically significant differences (p-value < 0.05) were found between differentlevels of stress. In general, average glucose and variability decrease when the patient is calm. Thereare statistically significant differences (p-value < 0.05) between different levels of mood. Variabilityincreases when the mood changes from sad to happy. However, the patient’s average glucosedecreases as the mood improves.Conclusions: Variations in mood and stress significantly influenceblood glucose levels, and glycemic variability in the patients analyzed with type 1 diabetes mellitus.Therefore, they are factors to consider for improving glycemic control. The mean of daily differencesdoes not seem to be a good indicator for variability.2021-2

Fecal Metabolome and Bacterial Composition in Severe Obesity:Impact of Diet and Bariatric Surgery

The aim of this study was to monitor the impact of a preoperative low-calorie diet and bariatric surgery on the bacterial gut microbiota composition and functionality in severe obesity and to compare sleeve gastrectomy (SG) versus Roux-en-Y gastric bypass (RYGB). The study also aimed to incorporate big data analysis for the omics results and machine learning by a Lasso-based analysis to detect the potential markers for excess weight loss. Forty patients who underwent bariatric surgery were recruited (14 underwent SG, and 26 underwent RYGB). Each participant contributed 4 fecal samples (baseline, post-diet, 1 month after surgery and 3 months after surgery). The bacterial composition was determined by 16S rDNA massive sequencing using MiSeq (Illumina). Metabolic signatures associated to fecal concentrations of short-chain fatty acids, amino acids, biogenic amines, gamma-aminobutyric acid and ammonium were determined by gas and liquid chromatography. Orange 3 software was employed to correlate the variables, and a Lasso analysis was employed to predict the weight loss at the baseline samples. A correlation between Bacillota (formerly Firmicutes) abundance and excess weight was observed only for the highest body mass indexes. The low-calorie diet had little impact on composition and targeted metabolic activity. RYGB had a deeper impact on bacterial composition and putrefactive metabolism than SG, although the excess weight loss was comparable in the two groups. Significantly higher ammonium concentrations were detected in the feces of the RYGB group. We detected individual signatures of composition and functionality, rather than a gut microbiota characteristic of severe obesity, with opposing tendencies for almost all measured variables in the two surgical approaches. The gut microbiota of the baseline samples was not useful for predicting excess weight loss after the bariatric process

Colecciones ex situ de planta viva para la conservación de la planta amenazada Silene hifacensis, Rouy ex Willk (Caryophyllaceae)

The establishment of seed orchards has allowed obtaining a great deal of germoplasm of Silene hifacensis, an endangered endemic Ibero-Balearic species. In four years, 3.958.531 seeds have been collected in our four seed orchards from a total of 570 plants/year per average, including all genetic variability from natural populations of this species in Alicante province (Illot of Mona, the Pessebret, Cova de les Cendres, Morro de Toix)