¿Qué opinan profesionales y jóvenes sobre las intervenciones para la prevención de la transmisión sexual del VIH y del consumo de drogas?

El objetivo de este artículo es analizar las opiniones de adolescentes, jóvenes y profesionales que trabajan en contacto directo con estas poblaciones sobre las intervenciones para la prevención de las infecciones de transmisión sexual y del consumo de drogas.Para ello se ha empleado una metodología descriptiva cualitativa. Se han analizado 21 entrevistas semiestructuradas a profesionales y jóvenes informantes claves, además de 14 grupos focales con adolescentes y jóvenes. Los resultados fueron triangulados aplicando un análisis cruzado entre investigadores.El análisis se organiza en torno a 3 temáticas fundamentales: los modelos y metodologías de intervención; las instituciones responsables y los lugares desde los que se interviene; y las estrategias de comunicación, los mensajes y el público al que se dirigen. En cada una de ellas, se articulan una serie de discursos de profesionales y jóvenes participantes en la investigación, en los que se exponen y razonan necesidades y cambios deseables en el ámbito preventivo, así como se vislumbran significados atribuidos a aspectos relacionados con el VIH y otras Infecciones de Transmisión Sexual y el consumo de drogas, que pueden ayudar a una mejor comprensión de determinadas situaciones del ámbito preventivo actual

Oral anticoagulation in elderly patients as secondary prevention of cardioembolic strokes

<p>Abstract</p> <p>Background</p> <p>Stroke incidence increases with age. Atrial fibrillation (AF) is an important risk factor for ischemic stroke and its incidence also increases with age. However oral anticoagulant therapy (OAT) tends to be underused in the elderly population.</p> <p>Methods</p> <p>Elderly patients (> = 80 years) with an ischemic stroke admitted in our department between 1/7/2003 and 31/6/2005 were prospectively evaluated. Baseline characteristics, risk factors, treatment and etiology according to TOAST criteria were recorded. Patients treated with OAT were followed up in order to assess any side effect and stroke recurrence. Mean follow-up was of 19.5 months (7-45) from discharge.</p> <p>Results</p> <p>Sixty four out of a hundred and fifty nine elderly patients (40.25%) were classified as cardioembolic; mean age was 84.5 years (80-97) and 64.6% were women. AF had been previously identified in 60% of them (16.9% were on OAT and 40.6% on antiplatelet therapy). At discharge, 32 patients (49.2%) were on OAT. In the follow-up 4 patients (12.5%) suffered systemic haemorrhages (3 urinary, 1 gastrointestinal bleeding), with no change in their functional status. Mean INR in this group was 5.9 <abbrgrp><abbr bid="B3">3</abbr><abbr bid="B4">4</abbr><abbr bid="B5">5</abbr><abbr bid="B6">6</abbr><abbr bid="B7">7</abbr><abbr bid="B8">8</abbr><abbr bid="B9">9</abbr><abbr bid="B10">10</abbr><abbr bid="B11">11</abbr></abbrgrp> and, in 3 of them, OAT was cancelled. No brain haemorrhages were recorded. Ischemic stroke recurred in 4 patients (INR < 1.8 in 3 of them; the other, INR 2.35). Three patients had died at the end of the follow-up, one of them as a consequence of ischemic stroke recurrence.</p> <p>Discussion</p> <p>Twenty eight point eight of stroke patients admitted in the period of study were >80 years. The high proportion of cardioembolic strokes in this age segment contrasts with the general underuse of OAT as antithrombotic prophylaxis. Our study suggests that OAT is a safe strategy when carefully prescribed, even for elderly patients.</p

Experience with the use of Rituximab for the treatment of rheumatoid arthritis in a tertiary Hospital in Spain: RITAR study

There is evidence supporting that there are no relevant clinical differences between dosing rituximab 1000 mg or 2000 mg per cycle in rheumatoid arthritis (RA) patients in clinical trials, and low-dose cycles seem to have a better safety profile. Our objective was to describe the pattern of use of rituximab in real-life practice conditions. Methods: Rituximab for RA in clinical practice (RITAR) study is a retrospective cohort study from 2005 to 2015. Eligibility criteria were RA adults treated with rituximab for active articular disease. Response duration was the main outcome defined as months elapsed from the date of rituximab first infusion to the date of flare. A multivariable analysis was performed to determine the variables associated with response duration. Results: A total of 114 patients and 409 cycles were described, 93.0% seropositive and 80.7% women. Rituximab was mainly used as second-line biological therapy. On demand retreatment was used in 94.6% of cases versus fixed 6 months retreatment in 5.4%. Median response duration to on demand rituximab cycles was 10 months (interquartile range, 7–13). Multivariable analysis showed that age older than 65 years, number of rituximab cycles, seropositivity, and first- or second-line therapy were associated with longer response duration. The dose administered at each cycle was not significantly associated with response duration. Conclusions: Our experience suggests that 1000 mg rituximab single infusion on demand is a reasonable schedule for long-term treatment of those patients with good response after the first cycles, especially in seropositive patients and when it is applied as a first- or second-line biological therap

Quantification and analysis of offensive situations in different formats of sided games in soccer

There has been a lot of research that enabled soccer to improve: its technique, tactics and strategy through analysis and training. Nevertheless, players? need to interact with each other turns any defending or attacking situation into complex solutions with a wide range of variables to be considered, in which the player is never isolated and must make the move that has the most positive impact on play. Fifty-four sided games played in three different formats (5v5, 7v7 and 9v9) and with two age groups (U9 and U14) were filmed at three soccer clubs in Spain in order to identify the most relevant attacking moves, from a technical and tactical perspective. This study used the observational method; it is descriptive and is applied through well-prepared systematic quantitative observation in a natural environment. A key part of the method involved viewing the match recordings and logging moves that had been categorised beforehand. Cohen?s Kappa analysis showed that the results for the most representative variables presented a substantial degree of concordance (0.61-0.80). The results show that there were significant variations depending on the game format, and the following study will present a description and analysis of the aspects that had considerable influence on attacking moves in different formats of sided games (5v5, 7v7 and 9v9). The study also presents various practical applications for the area of training and analysing both youth and professional soccer

Quantification and analysis of offensive situations in sided games in soccer

Playing soccer in reduced spaces has become particularly important, both for organised or spontaneous set-ups (Castellano et al., 2008). This type of play offers a great deal of possibilities and combinations and gives players an increased level of interaction in the game. Nevertheless, players' need to interact with each other turns any defending or attacking situation into complex moves with a wide range of variables to be considered, in which the player is never isolated and must make the move that has the most positive impact on play (Gréhaigne et al., 2011). Therefore, the aim of this study was to identify the most relevant attacking moves from a technical and tactical perspective for each game format (5v5, 7v7, 9v9), playing surface (grass, turf, dirt), and age group (U9, U14)

Comparison of tactical offensive variables in different playing surfaces in sided games in soccer

In recent decades soccer has been analysed in great detail, enabling the technical and tactical aspects of the game to be improved through observation, analysis and training. However, there are not significant studies that particularly looked at the impact of the playing surfaces in depth. Thus the main aim of this study is to analyse and compare the quantitative and qualitative effect of the playing surface (grass, dirt or turf) on teams? and players? performances from a tactical perspective, through observing various sided games in youth soccer players. 54 games in three different formats (5v5, 7v7 and 9v9) were analysed, divided into two age groups (378 players of U-9 and U-14 categories) and filmed at three Spanish soccer clubs. This study used the observational and descriptive method and was carried out by systematic observation. This involved watching pre-recorded matches to observe and log different types of behaviour in previously defined categories. Results revealed that there were no significant differences for the different surfaces or game formats, and the study presents a description and analysis of the aspects that had considerable influence on the attacking moves for each surface and game format

A growth method to obtain flat and relaxed In0.2Ga0.8As on GaAs (0 0 1) developed through in situ monitoring of surface topography and stress evolution

13 páginas, 3 figuras.-- PACS: 81.15.Hi, 81.05.Ea, 78.35.+c, 68.35.Bs.-- Comunicación oral presentada en el XI Molecular Beam Epitaxy (MBE-XI), Pekín (11/09/2000).In this paper we develop a growth process for obtaining flat and relaxed In0.2Ga0.8As layers on GaAs (0 0 1). The process designed is based on the results obtained by in situ and real time characterization of surface morphology and layer relaxation. In particular, our results show that for growth temperatures Ts200°C the relaxation of In0.2Ga0.8As layers is inhibited and the morphology does not evolve to a crosshatched pattern. After growth thermal treatments of these low-temperature (LT) In0.2Ga0.8As layers induce the development of a very faint (rms=0.5 nm) crosshatched-like morphology. The relaxation process during the thermal annealing is strongly asymmetric and the layers present a high final strain state. By growing on top of the LT layer another In0.2Ga0.8As layer at higher temperature, relaxation is increased up to R≈70% and becomes symmetric. Depending on the growth process of the top layers morphology evolution differs, resulting in better morphologies for top layers grown by atomic layer molecular beam epitaxy (ALMBE) at Ts=400°C. We have obtained 400 nm In0.2Ga0.8As layers with a final degree of relaxation R=70% and very flat surfaces (rms=0.9 nm).The authors wish to acknowledge the Spanish “CICYT” for financial support under Project No. TIC99-1035-C02. M.U. González and M. Calleja thank the Consejería de Educación y Cultura de la Comunidad de Madrid for financial support.Peer reviewe

A strategic reflection for the management and implementation of CAR-T therapy in Spain: an expert consensus paper

CAR-T cell therapy represents a therapeutic revolution in the prognosis and treatment of patients with certain types of hematological cancer. However, they also pose new challenges in the healthcare, regulatory and financial fields. The aim of the RET-A project was to undertake a strategic reflection on the management of CAR-T therapies within the Spanish National Health System, to agree on recommendations that will help to better deal with the new context introduced by these cell therapies in the present and in the future. This think tank involved 40 key agents and opinion leaders. The experts identified three great challenges for implementing advanced therapies in Spain: therapeutic individualisation, with a multidisciplinary approach; acceleration of access times, by minimizing bureaucracy; and increase in the number of centers qualified to manage the CAR-T therapies in the NHS. The experts agreed on the ideal criteria for designating those qualified centers. They also agreed on a comprehensive CAR-T care pathway with the timings and roles which would ideally be involved in each part of the process.This study was funded by Gilead Sciences, Inc.Peer reviewe

Emission polarization control in semiconductor quantum dots coupled to a photonic crystal microcavity

8 páginas, 5 figuras.-- OCIS codes: (160.4760) Optical properties; (230.5298) Photonic crystals; (230.5590) Quantumwell, -wire and –dot devices.We study the optical emission of single semiconductor quantum dots weakly coupled to a photonic-crystal micro-cavity. The linearly polarized emission of a selected quantum dot changes continuously its polarization angle, from nearly perpendicular to the cavity mode polarization at large detuning, to parallel at zero detuning, and reversing sign for negative detuning. The linear polarization rotation is qualitatively interpreted in terms of the detuning dependent mixing of the quantum dot and cavity states. The present result is relevant to achieve continuous control of the linear polarization in single photon emitters.This work has been supported by research contracts of the Spanish Ministry of Education Grants MAT2008-01555/NAN, Consolider CSD 2006-19 and Naninpho-QD TEC2008-06756-C03- 01, and the Community of Madrid Grant Grant CAM (S2009/ESP-1503).Peer reviewe