New variable stars discovered in the fields of three Galactic open clusters using the VVV Survey

This project is a massive near-infrared (NIR) search for variable stars in highly reddened and obscured open cluster (OC) fields projected on regions of the Galactic bulge and disk. The search is performed using photometric NIR data in the $J$-, $H$- and $K_s$- bands obtained from the Vista Variables in the V\'ia L\'actea (VVV) Survey. We performed in each cluster field a variability search using Stetson's variability statistics to select the variable candidates. Later, those candidates were subjected to a frequency analysis using the Generalized Lomb-Scargle and the Phase Dispersion Minimization algorithms. The number of independent observations range between 63 and 73. The newly discovered variables in this study, 157 in total in three different known OCs, are classified based on their light curve shapes, periods, amplitudes and their location in the corresponding color-magnitude $(J-K_s,K_s)$ and color-color $(H-K_s,J-H)$ diagrams. We found 5 possible Cepheid stars which, based on the period-luminosity relation, are very likely type II Cepheids located behind the bulge. Among the newly discovered variables, there are eclipsing binaries, $\delta$ Scuti, as well as background RR Lyrae stars. Using the new version of the Wilson & Devinney code as well as the "Physics Of Eclipsing Binaries" (PHOEBE) code, we analyzed some of the best eclipsing binaries we discovered. Our results show that these studied systems turn out to be ranging from detached to double-contact binaries, with low eccentricities and high inclinations of approximately $80^{\circ}$. Their surface temperatures range between $3500$K and $8000$K.Comment: 34 pages, 10 figures, 7 tables. Accepted for publication in New Astronom

Síndrome constitucional, pérdida de fuerza y disfagia

A 52 year-old man who refers a constitutional syndrome and weakness in his legs since several months ago. In his background he used to drink alcohol in abusive way. We performed an electroneuromyogram that showed suggestive data of an axonal polyneurophaty. The study was completed with blood sample, thoracic CT scan, abdominal doppler and an endoscopy; all of them showed no explanation for the patient's symptoms. During follow-up, despite the patient stopped drinking alcohol, he continued with weakness, amyotrophy and dysphagia. In his physical exploration is noted a loss of strength 4/5 and twitching of the tongue which made us suspect of a motor neuron disease. This was confirmed by a new electrophysiological study. This case demonstrates that the diagnosis of a motoneuron disease requires an exhaustive clinical exploration and a high clinical suspect. The presence of some signs, almost pathognomic, provides the diagnosis.Varón de 52 años que refiere desde hace meses un síndrome constitucional y debilidad en miembros. En sus antecedentes destacaba una ingesta excesiva de alcohol. El electroneuromiograma inicial mostró datos sugerentes de polineuropatía de predominio axonal. El estudio con analítica, TC tórax, ecografía abdominal, endoscopia digestiva alta no detectó datos de neoplasia. Durante el seguimiento, a pesar de abandonar el consumo de alcohol, persistió con debilidad generalizada, amiotrofias progresivas, voz nasal y disfagia, destacando en la exploración una fuerza disminuida de forma generalizada 4/5 y fasciculaciones linguales, con lo que se estableció la sospecha clínica de enfermedad de la motoneurona anterior, que fue confirmada mediante un nuevo estudio electrofisiológico.  Con este caso se demuestra que el diagnóstico de esclerosis lateral amiotrófica requiere una exhaustiva exploración física y una alta sospecha clínica. La presencia de determinados signos exploratorios, casi patognomónicos, facilita el diagnóstico

Ankle-brachial index in HIV infection

Prognosis for patients with the human immunodeficiency virus (HIV) has improved with the introduction of highly active antiretroviral therapy (HAART). Evidence over recent years suggests that the incidence of cardiovascular disease is increasing in HIV patients. The ankle-brachial index (ABI) is a cheap and easy test that has been validated in the general population. Abnormal ABI values are associated with increased cardiovascular mortality. To date, six series of ABI values in persons with HIV have been published, but none was a prospective study. No agreement exists concerning the risk factors for an abnormal ABI, though its prevalence is clearly higher in these patients than in the general population. Whether this higher prevalence of an abnormal ABI is associated with a higher incidence of vascular events remains to be determined

Role of telemedicine in the management of oral anticoagulation in atrial fibrillation: a practical clinical approach

COVID-19; Direct oral anticoagulant; TelemedicineCOVID-19; Anticoagulante oral directo; TelemedicinaCOVID-19; Anticoagulant oral directe; TelemedicinaCompared with face-to-face consultations, telemedicine has many advantages, including more efficient use of healthcare resources, partial relief of the burden of care, reduced exposure to COVID-19, treatment adjustment, organization of more efficient healthcare circuits and patient empowerment. Ensuring optimal anticoagulation in atrial fibrillation patients is mandatory if we want to reduce the thromboembolic risk. Of note, telemedicine is an excellent option for the long-term management of atrial fibrillation patients. Moreover, direct oral anticoagulants may provide an added value in telemedicine (versus vitamin K antagonists), as it is not necessary to monitor anticoagulant effect or make continuous dosage adjustments. In this multidisciplinary consensus document, the role of telemedicine in anticoagulation of this population is discussed and practical recommendations are provided.V Barrios has received consultancy/lecture fees from Bayer, BMS/Pfizer, Boehringer Ingelheim and Daiichi Sankyo. S Cinza-Sanjurjo has received honoraria for presentations from Bayer, Boehringer-Ingelheim, Daiichi Sankyo and Pfizer-BMS; advisory board fees from Bayer, Boehringer-Ingelheim, Daiichi Sankyo and Pfizer-BMS; and funding for studies from Bayer. J García-Alegría reports consulting fees and/or lectures honoraria from Bayer, Boehringer Ingelheim, Bristol-Myers Squibb and Daiichi Sankyo. R Freixa-Pamias has received honoraria for presentations from Bayer, Boehringer-Ingelheim, Daiichi Sankyo and Pfizer-BMS. F Llordachs-Marques. No potential conflicts of interest were declared by the author. CA Molina reports consulting fees and/or honoraria from Novo Nordisk, Bayer, Pfizer, BMS, Daiichi Sankyo and Boehringer Ingelheim. A Santamaría has received honoraria per conferences from Octapharma, Novo Nordisk, Bayer, Pfizer, BMS, Sobi, Shire, Sanofi, LEO Pharma, Rovi, Daiichi Sankyo, Werfen and Ferrer. D Vivas reports no potential conflicts of interest were declared by the author. C Suárez has received speaker and/or advisory fees from Bayer, Pfizer/BMS, Daiichi Sankyo. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed

Complications Associated With Initial Clinical Presentation of Cystic Echinococcosis: A 20-year Cohort Analysis

Cystic echinococcosis (CE) is a chronic, complex, and overlooked zoonotic disease caused by Echinococcus granulosus. In humans, it may result in a wide spectrum of clinical manifestations depending on the type of complications, ranging from asymptomatic infection to fatal disease. The primary complications and risk factors associated with CE are not well defined. We performed a retrospective, observational study of inpatients diagnosed with CE from January 1998 to December 2017 in the public health-care system of western Spain. Five hundred and six cases were analyzed. More than half of the patients (302 [59.7%]) were asymptomatic, and the diagnoses were made incidentally. A total of 204 (40.3%) patients had complications associated with CE; 97 (47.5%) were mechanical, 62 (30.4%) were infectious, 15 (7.3%) were immunoallergic, and 30 (14.7%) involved a combination of complications. Mortality was higher in patients with mechanical complications (9.4%) than in patients with infectious complications (5.6%) and in patients with allergic complications (0%) (odds ratio = 19.7, 95% CI, 4.3-89.1, P < 0.001). In summary, CE frequently results in complications, especially in the liver in younger patients and, regardless of other variables, such as size or stage of cyst. Mechanical problems and superinfection are the most frequent complications. CE is an obligatory diagnosis in patients with urticarial or anaphylactoid reactions of unknown cause in endemic areas

Portal hypertension as a complication of cystic echinococcosis: a 20-year cohort analysis

Cystic echinococcosis (CE) is a parasitic disease caused by the larval forms of species of the tapeworm Echinococcus. The most common location is the liver. To assess the frequency and clinical characteristics of portal hypertension (PH) and the risk factors for PH development, we performed a retrospective observational study of inpatients diagnosed with hepatic CE and PH from January 1998 to December 2018, at Complejo Asistencial Universitario de Salamanca, Spain. Of 362 patients analyzed with hepatic CE, 15 inpatients (4.1%) had a portal vein diameter ≥ 14 mm, and the mean diameter of the portal vein was 16.9 (standard deviation [SD] ±2.1) mm. Twelve patients were men. The mean age was 59.5 years (SD ± 17.8 years). Four patients had ascites (26.6%), four had collateral circulation (26.6%), 14 had hepatosplenomegaly (93.3%), five had esophageal varices (33.3%), four had hematemesis, and three had jaundice. Other causes of PH included hepatitis B virus (1 patient) and hepatitis C virus (1 patient) infections and alcohol abuse (1 patient). The host variables associated with PH development were male sex (odds ratio, 4.6; 95% confidence interval, 1.1-20.9; P = 0.030) and larger cyst size (10.8 ± 6.3 versus 7.6 ± 4.1; P = 0.004). Hepatic CE is an infrequent cause of PH that usually occurs without indications of liver failure. Larger cyst size and male sex were the main risk factors associated with this complication. Mortality was higher for patients with hepatic CE with PH than for patients with hepatic CE without PH

Abortos de repetición en paciente con anticuerpos antitiroideos positivos

Thyroid dysfunction is common during pregnancy, and both hyperthyroidism and hypothyroidism are associated with increased risk of adverse pregnancy and perinatal outcomes. Accurate assessment of thyroid status and management of thyroid dysfunction in pregnant women are crucial to optimize maternal-fetal outcomes. We present the case of a 31-year-old pregnant women of 16 weeks with recurrent pregnancy loss, subclinical hypothyroidism and positive anti-peroxidase antibodies.La disfunción tiroidea es frecuente durante el embarazo, y tanto el hipertiroidismo como el hipotiroidismo se asocian con un mayor riesgo de efectos adversos para la gestante y peores resultados perinatales. La evaluación precisa de la función tiroidea y el manejo de la disfunción en embarazadas son cruciales para optimizar los resultados maternofetales. Se presenta el caso de una mujer de 31 años, gestante de 16 semanas con abortos de repetición, hipotiroidismo subclínico y anticuerpos antiperoxidasa positivos