Obesidad en niños: un diagnóstico cada vez más frecuente.

   Obesity is the definition of an excess in the accumulation and storage of body fat, that accounts for a high prevalence worldwide problem for adult and pediatric patients, and that has been growing in the last years. It has a multifactorial etiology, being the environmental factor a big contributor, and so are the genetics, endocrine and epigenetic factors. For the diagnostics, it is important the clinical history, physical exam and laboratory studies. The initial and main management is prevention which includes on diet, exercise, and education for the patient so they can reach adequate changes in lifestyle, and also there is medical and surgical treatment if needed. Treatment is highly important because of the complications that accompany this disease, such as diabetes mellitus type 2 and high cardiovascular risk.    La obesidad se define como un exceso en la acumulación y almacenamiento de la grasa corporal. Es un problema de alta prevalencia a nivel mundial que ha ido en aumento tanto en el adulto como el paciente pediátrico. La etiología es multifactorial, siendo el factor ambiental un gran influyente, así como factores endocrinos, genéticos y epigenéticos. Para su diagnóstico es de suma importancia la historia clínica, el examen físico y los estudios de laboratorio rutinarios. En el manejo, uno de los pilares es la prevención, que incluye la dieta y el ejercicio así como educación del paciente para que se realicen los cambios de estilo de vida adecuados, además de tratamiento médico y quirúrgico en caso de ser necesario. El tratamiento es de suma importancia debido a las complicaciones de esta enfermedad como la diabetes mellitus 2 y el aumento en el riesgo cardiovascular.&nbsp

Enfermedades De La Vesícula y Vías Biliares: Actualidad.

Gallbladder and bile ducts’ diseases comprise several of the most common medical and surgical treated pathologies worldwide. Generally, their etiopathogenesis has been mainly related to metabolic disorders associated with defects in bile lipid secretion (as well as biliary cholesterol supersaturation and the precipitation of crystals made up of this last substance or others such as bilirubin or calcium in many occasions). It is because of all these reasons (as well as its relatively high frequency among the population) that this research is developed, since all over the years the understanding linked to the entire spectrum of biliary clinical conditions has greatly improved, as well as the research concerning the treatments that are usually considered the most appropriate for them owing to the fact that they are considered to be useful for the overall improvement of patients suffering from all of these conditions.Las enfermedades de la vesícula y vía biliar constituyen, en la actualidad, varias de las patologías de manejo médico-quirúrgico más comunes a nivel mundial. Su etiopatogenia, en general, ha sido relacionada principalmente con desórdenes de tipo metabólico asociados a defectos en la secreción de lípidos biliares (así como con la sobresaturación biliar de colesterol y la precipitación de cristales conformados por esta última sustancia u otras como bilirrubina o calcio en muchas ocasiones). Es debido a todos estos motivos (así como a su frecuencia relativamente elevada entre la población) que se plantea la siguiente investigación, esto puesto que con el paso de los años son mayores y más profundos los conocimientos que se han ido adquiriendo no solo acerca de la clínica y del diagnóstico de todo este espectro de condiciones clínicas, sino que también de los tratamientos que se consideran como los más adecuados para estas y con respecto a la utilidad en pro de la mejora de los paciente

Maturity matrix assessment : evaluation of energy efficiency strategies in Brussels historic residential stock

Energy retrofitting of historic or existing buildings is a challenge that it has not yet been properly solved. Multiple projects and methodologies are published every day but neither of them with the holistic approach that will assure success since the design phase. Nevertheless, these buildings play a key role in the achievement of the ambitious energy saving and greenhouse gas reduction targets that Europe has fixed for 2020 and 2050. Research has demonstrated that the impact in terms of decrease of energy use and CO2 will be strong, considering that, in Europe, 80% of the 2030 building stock already exists and 30% are historical buildings. To achieve these goals, reliable data about energy consumption, building components and systems performance of the existing building stock is needed. With the residential stock occupying a 75% of Europe’s floor space, this becomes a difficult task as this stock is never considered as a whole. Its components are installed, serviced and maintained by different companies and in different stages without a holistic approach to the overall building operation. The result is a lack of energy efficiency and feedback of the solutions implemented once the buildings are refurbished. This paper presents a pre-assessment methodology to tackle the energy retrofitting of historic and existing residential buildings based in the Maturity Matrix Assessment. The maturity of the implementation of energy efficiency measures in Brussels historic residential stock is evaluated to measure the gap between the “as is” and “to be” and define future appropriate strategies. The matrix synthetizes appropriate strategies for this specific stock that provides a global map of the problematic, requirements and solutions

Osteoporosis: Riesgo aumentado de fracturas

Osteoporosis is a very prevalent disease in the present, it is defined as the decrease in bone mineral density, with a T score <-2.5 standard deviations measured in bone densitometry, in these patients there is a greater predisposition to fractures due to stress. There are many risk factors for the development of this pathology, with advanced age being one of the most important. It manifests mainly with fractures, that is why screening is so important, to identify all people who are at high risk of fractures and who will be beneficiaries of a treatment, among which we will have from changes in lifestyle such as regular exercise, mayor dietary intake of calcium, vitamin D, and pharmacological treatment, bisphosphonates being the first approved therapyLa osteoporosis es una enfermedad muy prevalente en la actualidad, se define como la disminución de la densidad mineral ósea, con un T-score <-2,5 desviaciones estándar medido en la densitometría ósea, en estos pacientes existe una mayor predisposición a fracturas por estrés. Existen muchos factores de riesgo para el desarrollo de esta patología siendo la edad avanzada uno de los más importantes. Se manifiesta principalmente con fracturas, por lo cual es de gran importancia el tamizaje, para identificar a todas las personas que poseen un alto riesgo de fracturas y se verían beneficiados por un tratamiento, entre los que se tienen desde los cambios en el estilo de vida como el ejercicio regular, mayor ingesta alimentaria de calcio, la vitamina D, y hasta tratamiento farmacológico siendo los bifosfonatos la primera terapia aprobada.&nbsp

Sangrado digestivo alto: Una emergencia médica

Upper digestive bleeding occurs at the level of the esophagus, stomach and / or duodenum, which is mainly due to non-variceal causes (80-90%), being the most common cause peptic ulcers, although it can also be caused by the rupture of esophageal varices secondary to portal hypertension. Among the risk factors for the development of this pathology are Helicobacter pylori (H.pylori) infection, the use of non-steroidal anti-inflammatory drugs, as well as the use of antiplatelet and anticoagulant medications. It manifests as hematemesis and melena; and represents a medical emergency, so its initial approach will require evaluationand stabilization of the hemodynamic status and generally endoscopy to identify the cause. Once the cause is found, definitive treatment will be given based on it.El sangrado digestivo alto es aquel que se presenta a nivel de esófago, estómago y/o duodeno, se debe principalmente (80-90%) a causas no variceales siendo la más frecuente las úlcera péptica, sin embargo también puede ocurrir por la ruptura de várices esofágicas secundarias a hipertensión portal. Entre los factores de riesgo para el desarrollo de esta patología se encuentra la infección por Helicobacter pylori(H.pylori), el uso de antiinflamatorios no esteroideos (AINES), así como el uso de medicamentos antiplaquetarios y anticoagulantes. Se manifiesta como hematemesis y melena principalmente. Representa una emergencia médica, razón por la cual el abordaje inicial consiste en valorar y estabilizar el estado hemodinámico y realizar endoscopia para identificar el origen del sangrado digestivo. El tratamiento definitivo va dirigido a corregir la causa subyacente.&nbsp

Angiosarcoma of the nasal cavity: a case report

Angiosarcomas are malignant neoplasias of rapid growth that develop from endothelial cells. They represent 2% of all sarcomas and only 1–4% are located in the aerodigestive tract. Since 1977, only 16 cases have been reported

Galaxy clusters and groups in the ALHAMBRA Survey

We present a catalogue of 348 galaxy clusters and groups with $0.2<z<1.2$ selected in the 2.78 $deg^2$ ALHAMBRA Survey. The high precision of our photometric redshifts, close to $1\%$, and the wide spread of the seven ALHAMBRA pointings ensure that this catalogue has better mass sensitivity and is less affected by cosmic variance than comparable samples. The detection has been carried out with the Bayesian Cluster Finder (BCF), whose performance has been checked in ALHAMBRA-like light-cone mock catalogues. Great care has been taken to ensure that the observable properties of the mocks photometry accurately correspond to those of real catalogues. From our simulations, we expect to detect galaxy clusters and groups with both $70\%$ completeness and purity down to dark matter halo masses of $M_h\sim3\times10^{13}\rm M_{\odot}$ for $z<0.85$. Cluster redshifts are expected to be recovered with $\sim0.6\%$ precision for $z<1$. We also expect to measure cluster masses with $\sigma_{M_h|M^*_{CL}}\sim0.25-0.35\, dex$ precision down to $\sim3\times10^{13}\rm M_{\odot}$, masses which are $50\%$ smaller than those reached by similar work. We have compared these detections with previous optical, spectroscopic and X-rays work, finding an excellent agreement with the rates reported from the simulations. We have also explored the overall properties of these detections such as the presence of a colour-magnitude relation, the evolution of the photometric blue fraction and the clustering of these sources in the different ALHAMBRA fields. Despite the small numbers, we observe tentative evidence that, for a fixed stellar mass, the environment is playing a crucial role at lower redshifts (z$<$0.5).Comment: Accepted for publication in MNRAS. Catalogues and figures available online and under the following link: http://bascaso.net46.net/ALHAMBRA_clusters.htm

The ALHAMBRA survey: Bayesian photometric redshifts with 23 bands for 3 deg2

A. Molino et al.The Advance Large Homogeneous Area Medium-Band Redshift Astronomical (ALHAMBRA) survey has observed eight different regions of the sky, including sections of the Cosmic Evolution Survey (COSMOS), DEEP2, European Large-Area Infrared Space Observatory Survey (ELAIS), Great Observatories Origins Deep Survey North (GOODS-N), Sloan Digital Sky Survey (SDSS) and Groth fields using a new photometric system with 20 optical, contiguous ~300-Å filters plus the JHKs bands. The filter system is designed to optimize the effective photometric redshift depth of the survey, while having enough wavelength resolution for the identification of faint emission lines. The observations, carried out with the Calar Alto 3.5-m telescope using the wide-field optical camera Large Area Imager for Calar Alto (LAICA) and the near-infrared (NIR) instrument Omega-2000, represent a total of ~700 h of on-target science images. Here we present multicolour point-spread function (PSF) corrected photometry and photometric redshifts for ~438 000 galaxies, detected in synthetic F814W images. The catalogues are complete down to a magnitude I~24.5AB and cover an effective area of 2.79 deg2. Photometric zero-points were calibrated using stellar transformation equations and refined internally, using a new technique based on the highly robust photometric redshifts measured for emission-line galaxies. We calculate Bayesian photometric redshifts with the Bayesian Photometric Redshift (BPZ)2.0 code, obtaining a precision of δz/(1+zs)=1 per cent for I<22.5 and δz/(1+zs)=1.4 per cent for 22.5<I<24.5. The global n(z) distribution shows a mean redshift 〈z〉=0.56 for I<22.5 AB and 〈z〉=0.86 for I<24.5 AB. Given its depth and small cosmic variance, ALHAMBRA is a unique data set for galaxy evolution studies. © 2014 The Authors Published by Oxford University Press on behalf of the Royal Astronomical Society.We acknowledge financial support from the Spanish MICINN under the Consolider-Ingenio 2010 Program grant CSD2006-00070: First Science with the GTC. Part of this work was supported by Junta de Andalucía, through grant TIC-114 and the Excellence Project P08-TIC-3531, and by the Spanish Ministry for Science and Innovation through grants AYA2006-1456, AYA2010-15169, AYA2010-22111-C03-02, AYA2010-22111-C03-01 and Generalitat Valenciana project Prometeo 2009/064.Peer Reviewe

A genome-wide association scan implicates DCHS2, RUNX2, GLI3, PAX1 and EDAR in human facial variation

We report a genome-wide association scan for facial features in B6,000 Latin Americans. We evaluated 14 traits on an ordinal scale and found significant association (P valueso5 10 8) at single-nucleotide polymorphisms (SNPs) in four genomic regions for three nose-related traits: columella inclination (4q31), nose bridge breadth (6p21) and nose wing breadth (7p13 and 20p11). In a subsample of B3,000 individuals we obtained quantitative traits related to 9 of the ordinal phenotypes and, also, a measure of nasion position. Quantitative analyses confirmed the ordinal-based associations, identified SNPs in 2q12 associated to chin protrusion, and replicated the reported association of nasion position with SNPs in PAX3. Strongest association in 2q12, 4q31, 6p21 and 7p13 was observed for SNPs in the EDAR, DCHS2, RUNX2 and GLI3 genes, respectively. Associated SNPs in 20p11 extend to PAX1. Consistent with the effect of EDAR on chin protrusion, we documented alterations of mandible length in mice with modified Edar funtion