Skin Tumors in Patients Aged 90 Years and Older

Background: The aging of the population in the developed world is an accepted fact. Consequently, the number of patients aged 90 years or over with cutaneous cancer will increase in coming years. Objective: The objective was to determine the nature of skin lesions amenable to dermatologic surgery in patients aged 90 years or more. Methods: We studied the clinical histories of 52 outpatients in their 90 s, who had had histopathologic studies made of their skin tumors when attended in the Hospital General de Alicante (Spain) between January 1999 and July 2002. We studied sex, age, type of tumor, site, associated disorders, regular medications, type of anesthesia, and type of treatment given. Results: The average age of the patients was 92.4 years. Thirty-six patients were women and 16 were men. Altogether the 52 patients had a total of 72 lesions. The most frequent diagnosis was basal cell carcinoma with 36 lesions, followed by 20 squamous cell carcinomas. The overall ratio of basal cell carcinoma to squamous cell carcinoma was 1.8. Patients had an average of 1.5 comorbid medical conditions and were taking an average of 2.3 regular medications. Conclusion: Dermatologists often attend patients aged 90 years or over with nonmelanoma skin cancer. The most important decision is as to what is the best management of these patients

La certificación de reumatólogo, experiencia en México

A lo largo de la historia, la sociedad ha buscado garantizar que la actividad médica sea benéfica y cuente con un marco regulatorio que guíe su actuación; antiguamente mediante códigos éticos y deontológicos y más recientemente, mediante mecanismos de rendición de cuentas y de evaluación de resultados como son los procesos de certifiación o acreditación

Voluntats anticipades: dificultats per a la posada en pràctica i finestres d’oportunitat: taula de valors

Declaració de voluntats anticipades; Testament vital; Malalties cròniquesLiving Will Declaration; Chronic diseasesDeclaración de voluntades anticipadas; Testamento vital; Enfermedades crónicasEl present article es centra en les polítiques que tendeixen a incrementar el percentatge de ciutadans amb declaració de voluntats anticipades (DVA) en el context de les malalties cròniques complexes

Weed control options in conventional and GM maize

En el proyecto AMIGA, que estudia los posibles efectos de los cultivos modificados genéticamente y su manejo sobre el agro-eco-sistema y la biodiversidad, se han evaluado varios tratamientos herbicidas sobre maíz Bt y maíz convencional. Se estableció un ensayo de seis hectáreas durante dos años en el que se han utilizado cinco manejos con herbicida que incluyen tratamiento convencional, reducido, glifosato y dos combinaciones de los anteriores. Se muestreó a lo largo del desarrollo del cultivo para determinar las especies de malas hierbas y artrópodos en el tiempo así como su abundancia y diversidad mediante examen visual y uso de trampas de gravedad y adhesivas amarillas. En este trabajo se presentan datos de abundancia de malas hierbas a madurez fisiológica del cultivo y del total de artrópodos en muestreo visual.Effect on weeds and arthropods In the context of AMIGA project which studies the posible effects of genetically modified crops and their management on the agro-ecosystem and biodiversity, we have studied various herbicide treatments applied on conventional and Bt A field was conducted for two years in a six ha plot. Five herbicide treatments including conventional, reduced, glyphosate and two herbicides combinations were established. We sampled along the cropping period to determine the species of weeds and arthropods over time and their abundance and diversity. The presence of arthropods was determined by visual examination and the use of pitfall and yellow sticky traps. In this work whole abundance of weeds at physiological maturity of the crop and total abundance of arthropod in visual examination are presented

Flexible Optical-Comb-Based Multi-Wavelength Conversion for Optical Switching and Multicast

Experimental results on multi-wavelength conversion based on optical comb generation for optical switching and multicast applications are presented. All the newly generated channels showed good performance with clear and open eye diagrams.The work of R. Vilar is supported by the Spanish Government through an FPU grant. This work was partially supported by the BONE NoE (FP7-ICT-2007-1-216863) and by the European Project FIVER (FP7-ICT-2009-4-249142).Vilar Mateo, R.; Marques, C.; Nogueira, RI.; Teixeira, A.; Llorente Sáez, R.; Ramos Pascual, F. (2011). Flexible Optical-Comb-Based Multi-Wavelength Conversion for Optical Switching and Multicast. En Proceedings of the 2011 16th European Conference on Networks and Optical Communications (NOC 2011). Institute of Electrical and Electronics Engineers (IEEE). 196-199. http://hdl.handle.net/10251/61358S19619

Rapid and Reversible Recruitment of Early Visual Cortex for Touch

The loss of vision has been associated with enhanced performance in non-visual tasks such as tactile discrimination and sound localization. Current evidence suggests that these functional gains are linked to the recruitment of the occipital visual cortex for non-visual processing, but the neurophysiological mechanisms underlying these crossmodal changes remain uncertain. One possible explanation is that visual deprivation is associated with an unmasking of non-visual input into visual cortex.We investigated the effect of sudden, complete and prolonged visual deprivation (five days) in normally sighted adult individuals while they were immersed in an intensive tactile training program. Following the five-day period, blindfolded subjects performed better on a Braille character discrimination task. In the blindfold group, serial fMRI scans revealed an increase in BOLD signal within the occipital cortex in response to tactile stimulation after five days of complete visual deprivation. This increase in signal was no longer present 24 hours after blindfold removal. Finally, reversible disruption of occipital cortex function on the fifth day (by repetitive transcranial magnetic stimulation; rTMS) impaired Braille character recognition ability in the blindfold group but not in non-blindfolded controls. This disruptive effect was no longer evident once the blindfold had been removed for 24 hours.Overall, our findings suggest that sudden and complete visual deprivation in normally sighted individuals can lead to profound, but rapidly reversible, neuroplastic changes by which the occipital cortex becomes engaged in processing of non-visual information. The speed and dynamic nature of the observed changes suggests that normally inhibited or masked functions in the sighted are revealed by visual loss. The unmasking of pre-existing connections and shifts in connectivity represent rapid, early plastic changes, which presumably can lead, if sustained and reinforced, to slower developing, but more permanent structural changes, such as the establishment of new neural connections in the blind

Mixed cryoglobulinemia

Mixed cryoglobulinemia (MC), type II and type III, refers to the presence of circulating cryoprecipitable immune complexes in the serum and manifests clinically by a classical triad of purpura, weakness and arthralgias. It is considered to be a rare disorder, but its true prevalence remains unknown. The disease is more common in Southern Europe than in Northern Europe or Northern America. The prevalence of 'essential' MC is reported as approximately 1:100,000 (with a female-to-male ratio 3:1), but this term is now used to refer to a minority of MC patients only. MC is characterized by variable organ involvement including skin lesions (orthostatic purpura, ulcers), chronic hepatitis, membranoproliferative glomerulonephritis, peripheral neuropathy, diffuse vasculitis, and, less frequently, interstitial lung involvement and endocrine disorders. Some patients may develop lymphatic and hepatic malignancies, usually as a late complication. MC may be associated with numerous infectious or immunological diseases. When isolated, MC may represent a distinct disease, the so-called 'essential' MC. The etiopathogenesis of MC is not completely understood. Hepatitis C virus (HCV) infection is suggested to play a causative role, with the contribution of genetic and/or environmental factors. Moreover, MC may be associated with other infectious agents or immunological disorders, such as human immunodeficiency virus (HIV) infection or primary Sjögren's syndrome. Diagnosis is based on clinical and laboratory findings. Circulating mixed cryoglobulins, low C4 levels and orthostatic skin purpura are the hallmarks of the disease. Leukocytoclastic vasculitis involving medium- and, more often, small-sized blood vessels is the typical pathological finding, easily detectable by means of skin biopsy of recent vasculitic lesions. Differential diagnoses include a wide range of systemic, infectious and neoplastic disorders, mainly autoimmune hepatitis, Sjögren's syndrome, polyarthritis, and B-cell lymphomas. The first-line treatment of MC should focus on eradication of HCV by combined interferon-ribavirin treatment. Pathogenetic treatments (immunosuppressors, corticosteroids, and/or plasmapheresis) should be tailored to each patient according to the progression and severity of the clinical manifestations. Long-term monitoring is recommended in all MC patients to assure timely diagnosis and treatment of the life-threatening complications. The overall prognosis is poorer in patients with renal disease, liver failure, lymphoproliferative disease and malignancies

Measurement of the cross-section and charge asymmetry of WW bosons produced in proton-proton collisions at s=8\sqrt{s}=8 TeV with the ATLAS detector

This paper presents measurements of the $W^+ \rightarrow \mu^+\nu$ and $W^- \rightarrow \mu^-\nu$ cross-sections and the associated charge asymmetry as a function of the absolute pseudorapidity of the decay muon. The data were collected in proton--proton collisions at a centre-of-mass energy of 8 TeV with the ATLAS experiment at the LHC and correspond to a total integrated luminosity of 20.2~\mbox{fb^{-1}}. The precision of the cross-section measurements varies between 0.8% to 1.5% as a function of the pseudorapidity, excluding the 1.9% uncertainty on the integrated luminosity. The charge asymmetry is measured with an uncertainty between 0.002 and 0.003. The results are compared with predictions based on next-to-next-to-leading-order calculations with various parton distribution functions and have the sensitivity to discriminate between them.Comment: 38 pages in total, author list starting page 22, 5 figures, 4 tables, submitted to EPJC. All figures including auxiliary figures are available at https://atlas.web.cern.ch/Atlas/GROUPS/PHYSICS/PAPERS/STDM-2017-13

Search for chargino-neutralino production with mass splittings near the electroweak scale in three-lepton final states in √s=13 TeV pp collisions with the ATLAS detector

A search for supersymmetry through the pair production of electroweakinos with mass splittings near the electroweak scale and decaying via on-shell W and Z bosons is presented for a three-lepton final state. The analyzed proton-proton collision data taken at a center-of-mass energy of √s=13  TeV were collected between 2015 and 2018 by the ATLAS experiment at the Large Hadron Collider, corresponding to an integrated luminosity of 139  fb−1. A search, emulating the recursive jigsaw reconstruction technique with easily reproducible laboratory-frame variables, is performed. The two excesses observed in the 2015–2016 data recursive jigsaw analysis in the low-mass three-lepton phase space are reproduced. Results with the full data set are in agreement with the Standard Model expectations. They are interpreted to set exclusion limits at the 95% confidence level on simplified models of chargino-neutralino pair production for masses up to 345 GeV