Biriketako gaixotasun butxatzaile kronikoa barne medikuntzan edo pneumologian

El año 2005 en el Hospital de San Sebastián, en Medicina Interna, los pacientes con enfermedad pulmonar obstructiva crónica (EPOC) eran mayores, había más mujeres, la comorbilidad era mayor y la tasa de mortalidad también era mayor. Los médicos de Pneumología cumplían mejor las Guías Clínicas al dar el alta. Había posibilidades de mejora en la calidad de ambos servicios.Donostiako Ospitalean 2005ean Barne Medikuntzan Biriketako gaixotasun butxatzaile kronikoa (BGBK)zuten gaixoak, zaharragoak ziren, emakume gehiago zeuden eta, Pneumologian baino koerikortasun gehiago zituzten, hilkortasun tasa ere handiagoa zelarik. Pneumologiako sendagileek Gida Klinikoak hobeto betetzen zituzten Alta ematean. Bi zerbitzuetako kalitatea hobetzeko aukera zegoen.En 2005, en Médecine Interne de l'Hôpital de San Sebastián, les patients atteints de maladie obstructive chronique (EPOC) étaient âgés, les femmes étaient plus nombreuses, la comorbidité était plus grande et le taux de mortalité était également plus élevé. Les médecins de Pneumologie respectaient mieux les Guides Cliniques en signant les bulletins de sortie. Il y avait possibilité d'améliorer la qualité des deux services.In 2005 in the Hospital of San Sebastian, in Internal Medicine, the patients with chronic obstructive pulmonary decease (COPD) were elderly, there were more women among them, comorbidity was higher and the mortality rate was also higher. The Pneumology practitioners fulfilled the Clinical Guides better when discharging patients. There was room for improvement in the quality of both services

Filling pressures and collagen metabolism in hypertensive patients with heart failure and normal ejection fraction

This study was designed to evaluate the association between circulating biomarkers of collagen metabolism and elevated left-sided filling pressures (FPs), as assessed from elevated estimated pulmonary capillary wedge pressure (ePCWP), in hypertensive patients with heart failure with normal ejection fraction. Echocardiography was performed and ePCWP was calculated from the formula ePCWP=1.90+1.24(maximum early transmitral flow velocity in diastole:tissue Doppler early mitral annulus velocity). The biomarkers of collagen synthesis (carboxy-terminal propeptide of procollagen type I) and degradation (matrix metalloproteinase [MMP] 1 and tissue inhibitor of MMP-1 [TIMP-1]) were analyzed by ELISA methods. Seventy-eight patients with normal FPs (ePCWP 15 mm Hg) were included. Compared with controls, the levels of the 3 biomarkers were increased in the 2 groups of patients. The MMP-1:TIMP-1 ratio, an index of MMP-1 activity, was increased in patients with normal FPs and unchanged in patients with elevated FPs. Patients with elevated FPs exhibited higher TIMP-1 levels and a lower MMP-1:TIMP-1 ratio than patients with normal FPs. ePCWP was independently associated with TIMP-1 (r=0.349; P<0.001) and the MMP-1:TIMP-1 ratio (r=-0.240; P<0.01) in all of the patients. Receiver operating characteristic curves showed that a cutoff value of TIMP-1 of 1557 ng/mL provided 64% sensitivity and 67% specificity for predicting elevated FPs with a relative risk of 3.71 (95% CI: 1.91 to 7.22). These findings suggest that, in hypertensive patients with heart failure with normal ejection fraction and elevated FPs, collagen synthesis predominates over degradation because of a relative excess of TIMP-1. This imbalance can facilitate myocardial fibrosis, which, in turn, may contribute to the elevation of FPs in these patients

CYP450 and Its Implications in the Clinical Use of Antipsychotic Drugs

Polypharmacy implies a high potential for drug-drug interactions. The capacity of the cytochrome P450 enzyme system involved in the metabolism of psychoactive drugs differs greatly, which leads to variable drug elimination rates and inter-subject differences in serum drug concentrations. Polymorphisms in genes coding for CYP450 enzymes contribute to this inter-subject variability. Therapeutic response and adverse effects vary among patients treated with the same dose of a certain drug. Polypharmacy, comorbidity and the use of certain substances (grapefruit juice, caffeine and tobacco) increase the chances of clinically relevant interactions in a psychotic patient. Choosing drugs with low interaction potential seems to be the best strategy to prevent clinically relevant interactions particularly in elderly, polymedicated, oncologic and HIV patients

Estudios preliminares para la elaboración de modelos de respuesta a la aplicación de fósforo en el sud este bonaerense, bajo condiciones de invernáculo

p.47-55La predicción de la respuesta a la fertil ización fosforada se mejora con el agregado de diversas variables edáficas y culturales, como complemento de las determinaciones de P extractable. Con el objetivo de analizar estas funciones en forma preliminar se llevó a cabo un ensayo de invernáculo utilizando como planta índice tomate (Lvcopersicum sculentum) en suelos del SE de la Pradera Pampeana. Las técnicas analíticas de P extractable probadas fueron Kurtzy Bray I. Kurtzy Bray 2. Kurtz y Bray 25. Olsen y resinas de intercambio aniónico. Las variables edáficas y culturales complementarias de las medidas analíticas fueron años de agricultura, historia de fertilización, ubicación taxonómica de los suelos, P orgánico. Ct. Nt. pH y diversos parámetros de las ecuaciones de ajuste de las extracciones secuenciales con resinas de intercambio aniónico (a y b). Como variable respuesta vegetal se midió peso seco de los tratamientos testigo, P1 (45 g P- ha). P2 (90 gP-ha)y NP1 (50 g N + 45 g P-ha). Las técnicas analíticas y las variables de sitio incorporadas en los modelos variaron de acuerdo a la respuesta a P1 o NP1 y a las diferentes poblaciones, verificándose diferencias en los valores de los coeficientes de determinación de las ecuaciones de regresión cuando la población se clasificó según taxón o historia de fertilización

Filling pressures and collagen metabolism in hypertensive patients with heart failure and normal ejection fraction

This study was designed to evaluate the association between circulating biomarkers of collagen metabolism and elevated left-sided filling pressures (FPs), as assessed from elevated estimated pulmonary capillary wedge pressure (ePCWP), in hypertensive patients with heart failure with normal ejection fraction. Echocardiography was performed and ePCWP was calculated from the formula ePCWP=1.90+1.24(maximum early transmitral flow velocity in diastole:tissue Doppler early mitral annulus velocity). The biomarkers of collagen synthesis (carboxy-terminal propeptide of procollagen type I) and degradation (matrix metalloproteinase [MMP] 1 and tissue inhibitor of MMP-1 [TIMP-1]) were analyzed by ELISA methods. Seventy-eight patients with normal FPs (ePCWP 15 mm Hg) were included. Compared with controls, the levels of the 3 biomarkers were increased in the 2 groups of patients. The MMP-1:TIMP-1 ratio, an index of MMP-1 activity, was increased in patients with normal FPs and unchanged in patients with elevated FPs. Patients with elevated FPs exhibited higher TIMP-1 levels and a lower MMP-1:TIMP-1 ratio than patients with normal FPs. ePCWP was independently associated with TIMP-1 (r=0.349; P<0.001) and the MMP-1:TIMP-1 ratio (r=-0.240; P<0.01) in all of the patients. Receiver operating characteristic curves showed that a cutoff value of TIMP-1 of 1557 ng/mL provided 64% sensitivity and 67% specificity for predicting elevated FPs with a relative risk of 3.71 (95% CI: 1.91 to 7.22). These findings suggest that, in hypertensive patients with heart failure with normal ejection fraction and elevated FPs, collagen synthesis predominates over degradation because of a relative excess of TIMP-1. This imbalance can facilitate myocardial fibrosis, which, in turn, may contribute to the elevation of FPs in these patients

Composite material incorporating protective coatings for photovoltaic cell encapsulation

Photovoltaic modules consisting of one back-contact cell were manufactured by vacuum resin infusion process using glass reinforced epoxy composite as encapsulant where the cells are embedded. Incorporation of three coatings onto the composite surface was studied with the aim to improve the electrical performance stability of the modules under ultraviolet (UV), thermal cycling and damp-heat environmental weathering. Photovoltaic and aging performance were examined through the short-circuit current density values and colour change of the composite. Decrease in the initial photovoltaic performance of the modules was caused by the coating deposition. The highest drop in the initial values was observed for the varnish type coating, showing a decrease of 2.6% in short-circuit current. Regarding the performance stability, the decrease was more pronounced in the damp-heat test, presenting the varnish type coating the minimum loss of 1.4% in short-circuit current and a variation of 87% in b* chromatic parameter after 1000 h exposure at 85 °C and 85% relative humidity. The study concluded that the protective coating should be selected to provide the composite modules with an optimal trade-off between the initial electrical performance and the desired stability, with further research work targeted to improve moisture barrier properties.This work was supported by Eurostars Programme (Grant Agreement E12409) and Basque Government Elkartek 2021 Programme (Grant Agreement KK-2021/00066)