Resultados del tratamiento de la inestabilidad postdisectomia mediante artrodesis posterolateral lumbar

El mecanismo fisiopatológico por el cual, tras una discectomia en columna lumbar, se puede producir inestabilidad en este segmento de la columna, ha sido establecido en múltiples estudios y se encuentra en la bibliografía actual. Sin embargo, hay pocas publicaciones en la literatura que hagan referencia a los resultados de la artrodesis posterolateral lumbar en inestabilidad clínico-radiológica generada tras una discectomia lumbar. El propósito del presente estudio es valorar los resultados obtenidos en mejora de calidad de vida, en pacientes sometidos a artrodesis lumbar con tornillos pediculares en inestabilidad postdisectomía. La población estudiada se trató de 15 pacientes, 10 hombres y 5 mujeres con edades comprendidas entre los 27 y 65 años, la selección de los pacientes además del antecedente de cirugía discal, se basó en la presencia de un cuadro clínico de inestabilidad unido a pruebas radiológicas estáticas, dinámicas y resonancia magnética, y por último la ausencia de problemas de tipo laboral o psicológico, los datos se obtuvieron por entrevista personal y llamada telefónica, utilizando la escala de Oswestry y la escala analógica de Scott. Los resultados obtenidos fueron buenos ya que más del 90% de los pacientes refirieron mejoría en su calidad de vida. Se puede concluir que la artrodesis posterolateral con tornillos pediculares en inestabilidad postdisectomia, es una buena opción quirúrgica, con la cual se puede obtener mejoría del cuadro clínico del paciente.The present study has the aime, the evaluation of results of posterolateral lumbar arthrodesis in patients who had undergone lumbar discal surgery failed because of appearance of instability. Retrospective study in 15 patients with diagnosis instability postdiskectomy made by: clinical, static and dynamic x-ray and MRI, treated with posterolateral lumbar arthrodesis using pedicular screw. Ten males and five female of 27-65 years and average 46, we used the life quality scale Oswestry and Scott scale. The shortest follow up 3 years and longest 6 years. Our results were: time between diskectomy and arthrodesis variated from 1 to 10 years, average 5 years, about: pain intensity, patients need analgesic because pain, help for activities, deambulation, sexual activity all of them improve. We had 3 cases with clinical symptoms, the other one pain free. One case of deep infection of wound where surgical debridement was necessary. Finally Scott¿s scale prior to surgery punctuation was between 1-4. after between 8-10. Excepting 1 case with bad evolution. Conclusion: posterolateral lumbar arthrodesis with pedicular screew can be a good option of treatment in instability postdikectomy

Importancia de la estática del raquis lumbar y pelvis en la estenosis degenerativa del canal raquídeo lumbar

El objetivo de este trabajo es examinar algunos parámetros de la estática del caquis lumbosacro en 50 pacientes diagnosticados de estrechez degenerativa del caneal raquídeo lumbar (EDCL), y en un grupo control de 31 sujetos sin antecedentes de patología raquídea, y evaluar las diferencias entre ambos grupos. Los parámetros estudiados mediante radiología simple han sido: Altura discal, la lordosis lumbar, el ángulo lumbosacro de Ferguson, la pendiente sacra, el índice de Taillard, el ángulo discal L5-S1, el nivel de crestas iliacas, y el ángulo de Cauchoix. El ángulo de inclinación del platillo de S1 respecto de la horizontal fue significativamente mayor en el grupo de pacientes que en el de controles. La lordosis no varió significativamente entre ambos grupos. Pero si se observaron diferencias significativas en función del número de niveles estrechados. En el grupo de control, predominaron de forma significativas las disposiciones pélvicas estables, donde las crestas iliacas coinciden con la cuarta vértebra lumbar.The objective of this paper is to examine some parameters of the static of the lumbosacral spine in 50 patients with degenerative stenose of lumbar spine, and in a control groupe of 31 subjects without antecedents of spine pathology, and to evaluate the differences between both groups. We studied by means of simple radiology: the discal height, the lumbar lordosis, the index of Taillard, the discal angle L5-S1, the level of the iliacs crests, and the angle of Cauchoix. The angel of Ferguson was significantly smaller in the group of patients that in that of the controls. The lordosis didn't vary significantly between groups, but it was significantly different if it was observed in function of the number of narrowed levels. In the control group, the stable pelvic despositions (where the crests iliacas coincides with fourth lumbar vertebra) prevailed in a significant way

Regulation of Kv2.1 channel inactivation by phosphatidylinositol 4,5-bisphosphate.

Phosphatidylinositol 4,5-bisphosphate (PIP2) is a membrane phospholipid that regulates the function of multiple ion channels, including some members of the voltage-gated potassium (Kv) channel superfamily. The PIP2 sensitivity of Kv channels is well established for all five members of the Kv7 family and for Kv1.2 channels; however, regulation of other Kv channels by PIP2 remains unclear. Here, we investigate the effects of PIP2 on Kv2.1 channels by applying exogenous PIP2 to the cytoplasmic face of excised membrane patches, activating muscarinic receptors (M1R), or depleting endogenous PIP2 using a rapamycin-translocated 5-phosphatase (FKBP-Inp54p). Exogenous PIP2 rescued Kv2.1 channels from rundown and partially prevented the shift in the voltage-dependence of inactivation observed in inside-out patch recordings. Native PIP2 depletion by the recruitment of FKBP-Insp54P or M1R activation in whole-cell experiments, induced a shift in the voltage-dependence of inactivation, an acceleration of the closed-state inactivation, and a delayed recovery of channels from inactivation. No significant effects were observed on the activation mechanism by any of these treatments. Our data can be modeled by a 13-state allosteric model that takes into account that PIP2 depletion facilitates inactivation of Kv2.1. We propose that PIP2 regulates Kv2.1 channels by interfering with the inactivation mechanism

Surface indicators are correlated with soil multifunctionality in global drylands

Multiple ecosystem functions need to be considered simultaneously to manage and protect the several ecosystem services that are essential to people and their environments. Despite this, cost effective, tangible, relatively simple and globally relevant methodologies to monitor in situ soil multifunctionality, that is, the provision of multiple ecosystem functions by soils, have not been tested at the global scale. We combined correlation analysis and structural equation modelling to explore whether we could find easily measured, field-based indicators of soil multifunctionality (measured using functions linked to the cycling and storage of soil carbon, nitrogen and phosphorus). To do this, we gathered soil data from 120 dryland ecosystems from five continents. Two soil surface attributes measured in situ (litter incorporation and surface aggregate stability) were the most strongly associated with soil multifunctionality, even after accounting for geographic location and other drivers such as climate, woody cover, soil pH and soil electric conductivity. The positive relationships between surface stability and litter incorporation on soil multifunctionality were greater beneath the canopy of perennial vegetation than in adjacent, open areas devoid of vascular plants. The positive associations between surface aggregate stability and soil functions increased with increasing mean annual temperature. Synthesis and applications. Our findings demonstrate that a reduced suite of easily measured in situ soil surface attributes can be used as potential indicators of soil multifunctionality in drylands world-wide. These attributes, which relate to plant litter (origin, incorporation, cover), and surface stability, are relatively cheap and easy to assess with minimal training, allowing operators to sample many sites across widely varying climatic areas and soil types. The correlations of these variables are comparable to the influence of climate or soil, and would allow cost-effective monitoring of soil multifunctionality under changing land-use and environmental conditions. This would provide important information for evaluating the ecological impacts of land degradation, desertification and climate change in drylands world-wide.Fil: Eldridge, David J.. University of New South Wales; AustraliaFil: Delgado Baquerizo, Manuel. Universidad Rey Juan Carlos; EspañaFil: Quero, José L.. Universidad de Córdoba; EspañaFil: Ochoa, Victoria. Universidad Rey Juan Carlos; España. Universidad de Alicante; EspañaFil: Gozalo, Beatriz. Universidad Rey Juan Carlos; España. Universidad de Alicante; EspañaFil: García Palacios, Pablo. Universidad Rey Juan Carlos; EspañaFil: Escolar, Cristina. Universidad Rey Juan Carlos; EspañaFil: García Gómez, Miguel. Universidad Politécnica de Madrid; EspañaFil: Prina, Aníbal. Universidad Nacional de La Pampa; ArgentinaFil: Bowker, Mathew A.. Northern Arizona University; Estados UnidosFil: Bran, Donaldo Eduardo. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Patagonia Norte. Estación Experimental Agropecuaria San Carlos de Bariloche; ArgentinaFil: Castro, Ignacio. Universidad Experimental Simón Rodríguez; VenezuelaFil: Cea, Alex. Universidad de La Serena; ChileFil: Derak, Mchich. No especifíca;Fil: Espinosa, Carlos I.. Universidad Técnica Particular de Loja; EcuadorFil: Florentino, Adriana. Universidad Central de Venezuela; VenezuelaFil: Gaitán, Juan José. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigación de Recursos Naturales. Instituto de Suelos; Argentina. Universidad Nacional de Luján. Departamento de Tecnología; ArgentinaFil: Gatica, Mario Gabriel. Universidad Nacional de San Juan. Facultad de Ciencias Exactas Físicas y Naturales. Departamento de Biología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Juan. Centro de Investigaciones de la Geosfera y Biosfera. Universidad Nacional de San Juan. Facultad de Ciencias Exactas Físicas y Naturales. Centro de Investigaciones de la Geosfera y Biosfera; ArgentinaFil: Gómez González, Susana. Universidad de Cádiz; EspañaFil: Ghiloufi, Wahida. Université de Sfax; TúnezFil: Gutierrez, Julio R.. Universidad de La Serena; ChileFil: Guzman, Elizabeth. Universidad Técnica Particular de Loja; EcuadorFil: Hernández, Rosa M.. Universidad Experimental Simón Rodríguez; VenezuelaFil: Hughes, Frederic M.. Universidade Estadual de Feira de Santana; BrasilFil: Muiño, Walter. Universidad Nacional de La Pampa; ArgentinaFil: Monerris, Jorge. No especifíca;Fil: Ospina, Abelardo. Universidad Central de Venezuela; VenezuelaFil: Ramírez, David A.. International Potato Centre; PerúFil: Ribas Fernandez, Yanina Antonia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Juan. Centro de Investigaciones de la Geosfera y Biosfera. Universidad Nacional de San Juan. Facultad de Ciencias Exactas Físicas y Naturales. Centro de Investigaciones de la Geosfera y Biosfera; ArgentinaFil: Romão, Roberto L.. Universidade Estadual de Feira de Santana; BrasilFil: Torres Díaz, Cristian. Universidad del Bio Bio; ChileFil: Koen, Terrance B.. No especifíca;Fil: Maestre, Fernando T.. Universidad Rey Juan Carlos; España. Universidad de Alicante; Españ

Transformaciones y retos de la educación en las artes y los diseños (tomo 2)

394 páginas.Libro con diversas muestras de la labor, el pulso, las formas y caminos resolutivos que asumieron los docentes frente a contextos de complejidad en el marco de la educación superior en las artes y los diseños, que buscó la profesionalización de los estudiantes frente a la emergencia de la pandemia Covid-19 yendo más allá y proponiendo mecanismos de creatividad, flexibilidad académica, colaboración y motivación educativa. Aparecen en las investigaciones no solo respuestas y experiencias, sino nuevos planteamientos para una perspectiva futura, necesarios en las transformaciones para las próximas décadas que deberán vivirse en los planes y programas de estudio, los sistemas de evaluación, la formación docente, el perfil y las competencias digitales de los estudiantes, entre otros aspectos. Y a propósito de estas reflexiones, también se plantea un escenario sobre ¿a dónde queremos o debemos llegar en la educación en artes y diseño? Cabe señalar que los aportes de estos textos provienen del ámbito de la educación superior pública en México, que se rige bajo los principios generales de libertad de cátedra para los docentes, y este factor resulta fundamental para poder observar justamente la toma de decisiones, adecuaciones, movilidad y flexibilidad para las adecuaciones curriculares y también en los procesos de enseñanza- aprendizaje que se exponen, resultando un componente central para pensar en contextos de emergencia y complejidad y en los escenarios futuros de la educación en las artes, diseños y en todos los ámbitos del conocimiento.Coordinadoras: Alma Elisa Delgado Coellar, Juana Cecilia Angeles Cañedo & Daniela Velázquez Ruí

Decoupling of soil nutrient cycles as a function of aridity in global drylands

18 páginas.- 10 figuras.- 72 referencias.- Online Content Any additional Methods, Extended Data display items and Source Data are available in the online version of the paper; references unique to these sections appear only in the online paper..- Puede conseguir el texto completo en el Portal de la producción científica de la Universidad Complutense de Madrid https://produccioncientifica.ucm.es/documentos/5ec78dc52999520a1d557660 .- o en lel respositorio institucional CONICET digital https://ri.conicet.gov.ar/bitstream/handle/11336/29204/CONICET_Digital_Nro.ead4e2ed-0da6-4041-814b-259e8f27bbf6_D.pdf?sequence=5&isAllowed=yThe biogeochemical cycles of carbon (C), nitrogen (N) and phosphorus (P) are interlinked by primary production, respiration and decomposition in terrestrial ecosystems1. It has been suggested that the C, N and P cycles could become uncoupled under rapid climate change because of the different degrees of control exerted on the supply of these elements by biological and geochemical processes1,2,3,4,5. Climatic controls on biogeochemical cycles are particularly relevant in arid, semi-arid and dry sub-humid ecosystems (drylands) because their biological activity is mainly driven by water availability6,7,8. The increase in aridity predicted for the twenty-first century in many drylands worldwide9,10,11 may therefore threaten the balance between these cycles, differentially affecting the availability of essential nutrients12,13,14. Here we evaluate how aridity affects the balance between C, N and P in soils collected from 224 dryland sites from all continents except Antarctica. We find a negative effect of aridity on the concentration of soil organic C and total N, but a positive effect on the concentration of inorganic P. Aridity is negatively related to plant cover, which may favour the dominance of physical processes such as rock weathering, a major source of P to ecosystems, over biological processes that provide more C and N, such as litter decomposition12,13,14. Our findings suggest that any predicted increase in aridity with climate change will probably reduce the concentrations of N and C in global drylands, but increase that of P. These changes would uncouple the C, N and P cycles in drylands and could negatively affect the provision of key services provided by these ecosystems.This research is supported by the European Research Council (ERC) under the European Community's Seventh Framework Programme (FP7/2007-2013)/ERC Grant agreement no. 242658 (BIOCOM), and by the Ministry of Science and Innovation of the Spanish Government, grant no. CGL2010-21381. CYTED funded networking activities (EPES, Acción 407AC0323). M.D.-B. was supported by a PhD fellowship from the Pablo de Olavide University.Peer reviewe

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Combined searches for the production of supersymmetric top quark partners in proton-proton collisions at root s=13 TeV

A combination of searches for top squark pair production using proton-proton collision data at a center-of-mass energy of 13 TeV at the CERN LHC, corresponding to an integrated luminosity of 137 fb(-1) collected by the CMS experiment, is presented. Signatures with at least 2 jets and large missing transverse momentum are categorized into events with 0, 1, or 2 leptons. New results for regions of parameter space where the kinematical properties of top squark pair production and top quark pair production are very similar are presented. Depending on themodel, the combined result excludes a top squarkmass up to 1325 GeV for amassless neutralino, and a neutralinomass up to 700 GeV for a top squarkmass of 1150 GeV. Top squarks with masses from 145 to 295 GeV, for neutralino masses from 0 to 100 GeV, with a mass difference between the top squark and the neutralino in a window of 30 GeV around the mass of the top quark, are excluded for the first time with CMS data. The results of theses searches are also interpreted in an alternative signal model of dark matter production via a spin-0 mediator in association with a top quark pair. Upper limits are set on the cross section for mediator particle masses of up to 420 GeV

Development and validation of HERWIG 7 tunes from CMS underlying-event measurements

This paper presents new sets of parameters (“tunes”) for the underlying-event model of the HERWIG7 event generator. These parameters control the description of multiple-parton interactions (MPI) and colour reconnection in HERWIG7, and are obtained from a fit to minimum-bias data collected by the CMS experiment at s=0.9, 7, and 13Te. The tunes are based on the NNPDF 3.1 next-to-next-to-leading-order parton distribution function (PDF) set for the parton shower, and either a leading-order or next-to-next-to-leading-order PDF set for the simulation of MPI and the beam remnants. Predictions utilizing the tunes are produced for event shape observables in electron-positron collisions, and for minimum-bias, inclusive jet, top quark pair, and Z and W boson events in proton-proton collisions, and are compared with data. Each of the new tunes describes the data at a reasonable level, and the tunes using a leading-order PDF for the simulation of MPI provide the best description of the dat