Características clínicas de pacientes llevados a monitoría externa de eventos

ResumenPara la evaluación del paciente con síntomas que sugieran arritmia cardiaca existen varios métodos que pueden ser utilizados. En ese sentido, los monitores externos de eventos pueden mejorar la sensibilidad del diagnóstico. Se realizó un estudio descriptivo, retrospectivo y transversal, que incluyó la revisión de resultados de la monitoría externa de eventos de 203 pacientes.El motivo más común por el cual se solicitó el monitor externo de eventos fueron las palpitaciones en 161 pacientes (79,3%), seguidas por síncope en 21 pacientes (10,3%). El diagnóstico más habitual fue el ritmo sinusal normal sin otras alteraciones en 59 pacientes (29%), seguido por taquicardia sinusal en 54 (26,6%), extrasistolia ventricular en 24 (11,8%), extrasistolia auricular en 17 (8,3%), taquicardia auricular no sostenida en 12 (5,9%) y, en forma menos frecuente, taquicardia supraventricular en 8 (3,94%), taquicardia ventricular no sostenida en 5 (2,4%) y trastorno de la conducción interventricular en 6 (2,9%).Este es el primer estudio descriptivo de la monitoría externa de eventos llevado a cabo en Colombia. Desde el punto de vista epidemiológico y de diagnóstico electrocardiográfico, los hallazgos son similares a los resultados de estudios previos, con las limitaciones que ofrece un análisis de este tipo.AbstractThere are a variety of methods that can be used for the evaluation of patients with symptoms suggestive of cardiac arrhythmia; in this regard, external monitoring of events can improve the sensitivity of diagnosis. A descriptive, retrospective and cross-sectional study, which included review of the results of external monitoring of events of 203 patients was performed.The most common reason for requesting external monitoring of events was palpitations in 161 patients (79.3%), followed by syncope in 21 patients (10.3%). The most common diagnosis was normal sinus rhythm with no other abnormalities in 59 patients (29%), followed by sinus tachycardia in 54 (26.6%), ventricular extrasystoles in 24 (11.8%), atrial extrasystoles in 17 (8.3%), non-sustained atrial tachycardia in 12 (5.9%), and less frequently supraventricular tachycardia in 8 (3.94%), non-sustained ventricular tachycardia in 5 patients (2.4%) and interventricular conduction disturbance in 6 (2.9%).This is the first descriptive study of external monitoring of events held in Colombia. From the epidemiological and diagnosis electrocardiographic point of view, the findings are similar to results of previous studies, with the limitations that provides this type of analysis

Regulatory landscape of the vertebrate six2/six3 locus

Resumen del póster presentado al IX Meeting of the Spanish Society for Developmental Biology celebrado en Granada del 12 al 14 de noviembre de 2012.Peer Reviewe

Emotional processing in healthy ageing, mild cognitive impairment, and alzheimer’s disease

Emotional processing, particularly facial expression recognition, is essential for social cognition, and dysfunction may be associated with poor cognitive health. In pathological ageing con-ditions, such as mild cognitive impairment (MCI) and Alzheimer’s disease (AD), in which cognitive impairments are present, disturbed emotional processing and difficulty with social interactions have been documented. However, it is unclear how pathological ageing affects emotional processing and human social behaviour. The aim of this study is to provide insight into how emotional processing is affected in MCI and AD and whether this capacity can constitute a differentiating factor allowing the preclinical diagnosis of both diseases. For this purpose, an ecological emotional battery adapted from five subsets of the Florida Affect Battery was used. Given that emotion may not be separated from cognition, the affect battery was divided into subtests according to cognitive demand, resulting in three blocks. Our results showed that individuals with MCI or AD had poorer performance on the emotional processing tasks, although with different patterns, than that of controls. Cognitive demand may be responsible for the execution patterns of different emotional processing tests. Tasks with moderate cognitive demand are the most sensitive for discriminating between two cognitive impairment entities. In summary, emotional processing tasks may aid in characterising the neurocog-nitive deficits in MCI or AD. Additionally, identifying these deficits may be useful for developing interventions that specifically target these emotional processing problems.This study was supported by FEDER/the Spanish Ministry of Economy and Competitiveness (MINECO, Agencia Estatal de Investigacioón) FEDER, UE/AEI PSI2017-83408-P to C.P. and FEDER, UE/AEI PSI2016-78737-P to M.J.B

Effect of band-filling and structural distortions on the Curie temperature of Fe-Mo double perovkites

By means of high resolution neutron powder diffraction at low temperature we have characterized the structural details of $\rm La_{x}Sr_{2-x}FeMoO_6$ ($0\leq {\rm x}\leq 0.5$) and $\rm Ca_{x}Sr_{2-x}FeMoO_6$ ($0\leq {\rm x}\leq 0.6$) series of compounds. This study reveals a similar variation of the mean bond-angle \FeOMo in both series. In contrast, the mean bond-distance \FeMoO\ increases with La but not with Ca substitution. Both series also present a different evolution of the Curie temperature ($T_C$), which raises in the La series and slightly decreases in the Ca one. We thus conclude that the enhancement of $T_C$ in the La series is due to the electron filling of the conduction band and a concomitant rising of the density of states at the Fermi level.Comment: Revtex, 4 Journal pages, 2 figures, 1 tabl

Anti-vascular endothelial growth factor for proliferative diabetic retinopathy.

BACKGROUND: Proliferative diabetic retinopathy (PDR) is a complication of diabetic retinopathy that can cause blindness. Although panretinal photocoagulation (PRP) is the treatment of choice for PDR, it has secondary effects that can affect vision. An alternative treatment such as anti-vascular endothelial growth factor (anti-VEGF), which produces an inhibition of vascular proliferation, could improve the vision of people with PDR. OBJECTIVES: To assess the effectiveness and safety of anti-VEGFs for PDR. SEARCH METHODS: We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2014, Issue 3), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to April 2014), EMBASE (January 1980 to April 2014), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 28 April 2014. SELECTION CRITERIA: We included randomised controlled trials (RCTs) comparing anti-VEGFs to another active treatment, sham treatment or no treatment for people with PDR. We also included studies that assessed the combination of anti-VEGFs with other treatments. DATA COLLECTION AND ANALYSIS: Two review authors independently selected studies for inclusion, extracted data and assessed risk of bias for all included trials. We calculated the risk ratio (RR) or the mean difference (MD), and 95% confidence intervals (CI). MAIN RESULTS: We included 18 RCTs with 1005 participants (1131 eyes) of whom 57% were men. The median number of participants per RCT was 40 (range 15 to 261). The studies took place in Asia (three studies), Europe (two studies), the Middle East (seven studies), North America (three studies) and South America (three studies). Eight RCTs recruited people eligible for PRP, nine RCTs enrolled people with diabetes requiring vitrectomy and one RCT recruited people undergoing cataract surgery. The median follow-up was six months (range one to 12 months). Seven studies were at high risk of bias and the remainder were unclear risk of bias in one or more domains.Very low quality evidence from one study of 61 people showed that people treated with bevacizumab and PRP were less likely to lose 3 or more lines of visual acuity at 12 months compared with people treated with PRP alone (RR 0.19, 95% CI 0.05 to 0.81). People treated with anti-VEGF had an increased chance of gaining 3 or more lines of visual acuity but the effect was imprecise and compatible with no effect or being less likely to gain vision (RR 6.78, 95% CI 0.37 to 125.95). No other study reported these two outcomes. On average, people treated with anti-VEGF (bevacizumab, pegaptanib or ranibizumab) had better visual acuity at 12 months compared with people not receiving anti-VEGF (MD -0.07 logMAR, 95% CI -0.12 to -0.02; 5 RCTs, 373 participants, low quality evidence). There was some evidence to suggest a regression of PDR with smaller leakage on fluorescein angiography but it was difficult to estimate a pooled result from the two trials reporting this outcome. People receiving anti-VEGF were less likely to have vitreous or pre-retinal haemorrhage at 12 months (RR 0.32, 95% CI 0.16 to 0.65; 3 RCTs, 342 participants, low quality evidence). No study reported on fluorescein leakage or quality of life.All of the nine trials of anti-VEGF before or during vitrectomy investigated bevacizumab; most studies investigated bevacizumab before vitrectomy, one study investigated bevacizumab during surgery.People treated with bevacizumab and vitrectomy were less likely to lose 3 or more lines of visual acuity at 12 months compared with people given vitrectomy alone but the effect was imprecise and compatible with no effect or being more likely to lose vision (RR 0.49, 95% CI 0.08 to 3.14; 3 RCTs, 94 participants, low quality evidence). People treated with bevacizumab were more likely to gain 3 or more lines of visual acuity (RR 1.62, 95% CI 1.20 to 2.17; 3 RCTs, 94 participants, low quality evidence). On average, people treated with bevacizumab had better visual acuity at 12 months compared with people not receiving bevacizumab but there was uncertainty in the estimate (the CIs included 0; i.e. were compatible with no effect, and there was considerable inconsistency between studies; MD -0.24 logMAR, 95% CI -0.50 to 0.01; 6 RCTs, 335 participants, I(2) = 67%; low quality evidence). People receiving bevacizumab were less likely to have vitreous or pre-retinal haemorrhage at 12 months (RR 0.30, 95% CI 0.18 to 0.52; 7 RCTs, 393 participants, low quality evidence). No study reported on quality of life.Reasons for downgrading the quality of the evidence included risk of bias in included studies, imprecision of the estimates, inconsistency of effect estimates and indirectness (few studies reported at 12 months).Adverse effects were rarely reported and there was no evidence for any increased risk with anti-VEGF but given the relatively few studies that reported these, and the low event rate, the power of the analysis to detect any differences was low. AUTHORS' CONCLUSIONS: There was very low or low quality evidence from RCTs for the efficacy and safety of anti-VEGF agents when used to treat PDR over and above current standard treatments. However, the results suggest that anti-VEGFs can reduce the risk of intraocular bleeding in people with PDR. Further carefully designed clinical trials should be able to improve this evidence

A mobile insulator system to detect and disrupt cis-regulatory landscapes in vertebrates

et al.In multicellular organisms, cis-regulation controls gene expression in space and time. Despite the essential implication of cisregulation in the development and evolution of organisms and in human diseases, our knowledge about regulatory sequences largely derives from analyzing their activity individually and outside their genomic context. Indeed, the contribution of these sequences to the expression of their target genes in their genomic context is still largely unknown. Here we present a novel genetic screen designed to visualize and interrupt gene regulatory landscapes in vertebrates. In this screen, based on the random insertion of an engineered Tol2 transposon carrying a strong insulator separating two fluorescent reporter genes, we isolated hundreds of zebrafish lines containing insertions that disrupt the cis-regulation of tissue-specific expressed genes. We therefore provide a new easy-to-handle tool that will help to disrupt and chart the regulatory activity spread through the vast noncoding regions of the vertebrate genome.This study was supported by the Spanish and Andalusian Governments (JLGS grant numbers BFU2010-14839, CSD2007-00008, Proyecto de Excelencia CVI-3488, and JJC grant number BFU2011-22928), an EFSD/Lilly grant, and a Universidad Pablo de Olavide grant (JB grant number PPI0906). A.A. is an FPI fellow and J.B. is a Juan de la Cierva postdoctoral fellow (JCI-2009-04014) of the Consejo Superior de Investigaciones Cientificas. J.B. was also an FCT postdoctoral fellow (SFRH/BPD/38829/2007; POPH/FSE). M.L. is a Junta de Andalucia fellow.Peer Reviewe

±0.25-V Class-AB CMOS Capacitance Multiplier and Precision Rectifiers

Reduction of minimum supply requirements is a crucial aspect to decrease the power consumption in VLSI systems. A high-performance capacitance multiplier able to operate with supplies as low as ±0.25 V is presented. It is based on adaptively biased class-AB current mirrors which provide high current efficiency. Measurement results of a factor 11 capacitance multiplier fabricated in 180-nm CMOS technology verify theoretical claims. Moreover, low-voltage precision rectifiers based on the same class-AB current mirrors are designed and fabricated in the same CMOS process. They generate output currents over 100 times larger than the quiescent current. Both proposed circuits have 300-nW static power dissipation when operating with ±0.25-V supplies

An Op-Amp Approach for Bandpass VGAs With Constant Bandwidth

Two approaches to implement variable gain amplifiers based on Miller op-amps are discussed. One has true constant bandwidth while the other has essentially reduced bandwidth variations with varying gain. Servo-loops and ac coupling techniques with quasi floating gate transistors are used to provide a bandpass response with very low cutoff frequency in the range of hertz. In practice, one of the schemes is shown to have bandwidth variations close to a factor two while the second one has true constant bandwidth over the gain tuning range. Experimental results of test chip prototypes in 180-nm CMOS technology verify the theoretical claims

A polymorphic enhancer near GREM1 influences bowel cancer risk through differential CDX2 and TCF7L2 binding

Under a Creative Commons license.-- et al.A rare germline duplication upstream of the bone morphogenetic protein antagonist GREM1 causes aMendelian-dominant predisposition to colorectal cancer (CRC). The underlying disease mechanism is strong, ectopic GREM1 overexpression in the intestinal epithelium. Here, we confirm that a common GREM1 polymorphism, rs16969681, is also associated with CRC susceptibility, conferring ~20% differential risk in the general population. We hypothesized the underlying cause to be moderate differences inGREM1 expression. We showed that rs16969681 lies in a region of active chromatin with allele- and tissue-specific enhancer activity. The CRC high-risk allele was associated with stronger gene expression, and higher Grem1 mRNA levels increased the intestinal tumor burden in ApcMin mice. The intestine-specific transcription factor CDX2 and Wnt effector TCF7L2 bound near rs16969681, with significantly higher affinity for the risk allele, and CDX2 overexpression in CDX2/GREM1-negative cells caused re-expression of GREM1. rs16969681 influences CRC risk through effects on Wnt-driven GREM1 expression in colorectal tumors. © 2014 The Authors.Funding was provided from Cancer Research UK grant A/16459, an EU FP7 SYSCOL Consortium grant, and the EU COST colorectal cancer initiative. Core funding to the Wellcome Trust Centre for Human Genetics was provided from the Wellcome Trust (090532/Z/09/Z). J.L.G.-S. and J.J.C. were supported by the Spanish/FEDER government grants BFU2010-14839 and BFU2011-2292.Open Access funded by Wellcome Trust.Peer Reviewe

Low-Voltage 0.81mW, 1-32 CMOS VGA with 5% Bandwidth variations and 38dB DC rejection

A CMOS low-voltage amplifier with approximately constant bandwidth and DC rejection is introduced. The design is based on the cascade of a wide linear input range OTA, an op-amp and a servo-loop with extremely large time constants. It operates with ±0.45V supplies and a power consumption of 0.81mW in 180nm technology. The bandwidth changes only from 9.08MHz to 9.54MHz over a gain range from 1 to 32, it has a 9.8Hz low cutoff frequency and a DC attenuation of 38dBs. DC floating voltage sources are used to keep the gates of all differential pairs at a constant value close to a supply rail in order to operate the amplifier circuit with minimum supply voltage. The proposed circuit has small and large signal figures of merit FOM SS = 5380 (MHz*pF/mW) and FOM LS = 0.0085((V/ns)*pF/mA) for a nominal gain A = 32