Determinación de las características biomecánicas en el pie diabético con y sin neuropatía

Introducción: El síndrome del pie diabético es considerado por la Organización Mundial de la Salud (OMS) como la presencia de ulceración, infección y/o gangrena del pie asociada a la neuropatía diabética y diferentes grados de enfermedad vascular periférica, resultados de la interacción compleja de diferentes factores inducidos por una hiperglicemia mantenida.Se ha descrito que el 15% de los diabéticos desarrollarán a lo largo de su vida una úlcera en el pie, circunstancia responsable de aproximadamente el 70% de las amputaciones no traumáticas en los países desarrollados. La lesión más frecuente en el pie diabético es la úlcera neuropática, asociada a la pérdida de sensibilidad del paciente. Cuando la neuropatía sensitiva se suma a la presencia de deformidades y alteraciones biomecánicas del pie, se producen roces y fricciones en puntos de presión que provocan hiperqueratosis y úlceras en las zonas de apoyo. Las alteraciones biomecánicas del pie diabético van a estar relacionadas fundamentalmente con la neuropatía motora y con la glicosilación no enzimática del colágeno tipo 1. La neuropatía motora provocaría deformidades en el pie y alteraciones en el ciclo de normal de la marcha, y la glicosilación no enzimática del colágeno tipo 1 daría lugar a la limitación de la movilidad articular y al aumento de presiones plantares. Sin embargo en los últimos años se han publicado estudios que describen que las deformidades del paciente con pie diabético son anteriores a la neuropatía, y cabe sospechar que en algunos casos a la propia diabetes. La investigación de la etiología y secuencia de aparición de las alteraciones biomecánicas y estructurales en el pie del paciente con Diabetes Mellitus, permitirá establecer nuevas estrategias preventivas y terapéuticas en torno al síndrome del Pie Diabético. La importancia de este estudio se basa en la ampliación de la investigación a sujetos que previamente no han demandado atención podológica o que aparentemente no padecen patologías en sus pies, para comparar el estado biomecánico y estructural de los mismos, con aquellos en los que supuestamente las han desarrollado a consecuencia de la Neuropatía Diabética.Objetivos: 1) Describir las deformidades estructurales del pie del paciente diabético sin neuropatía. 2) Describir las deformidades estructurales del pie del paciente diabético con neuropatía. 3) Determinar el rang

An Evolutionary Computational Approach for the Problem of Unit Commitment and Economic Dispatch in Microgrids under Several Operation Modes

In the last decades, new types of generation technologies have emerged and have been gradually integrated into the existing power systems, moving their classical architectures to distributed systems. Despite the positive features associated to this paradigm, new problems arise such as coordination and uncertainty. In this framework, microgrids constitute an effective solution to deal with the coordination and operation of these distributed energy resources. This paper proposes a Genetic Algorithm (GA) to address the combined problem of Unit Commitment (UC) and Economic Dispatch (ED). With this end, a model of a microgrid is introduced together with all the control variables and physical constraints. To optimally operate the microgrid, three operation modes are introduced. The first two attend to optimize economical and environmental factors, while the last operation mode considers the errors induced by the uncertainties in the demand forecasting. Therefore, it achieves a robust design that guarantees the power supply for different confidence levels. Finally, the algorithm was applied to an example scenario to illustrate its performance. The achieved simulation results demonstrate the validity of the proposed approach.Ministerio de Ciencia, Innovación y Universidades TEC2016-80242-PMinisterio de Economía y Competitividad PCIN-2015-043Universidad de Sevilla Programa propio de I+D+

Experimental study of two-tone intermodulation products in a communications modulator

This article presents the experimental nonlinear characterization of a quadrature modulator following a two‐tone test approach. The observed intermodulation products show different slopes with respect to the desired carrier level that can be predicted by a simple model. Measurements for two‐tone tests versus carrier level and tone spacing are discussedCICYT TEC2008-06259/TECCICE P07-TIC-0264

Mechanical and contact characteristics of foam materials within wound dressings: theoretical and practical considerations in treatment

In the treatment of acute and chronic wounds, the clinical performance of a given foam-based dressing, and, ultimately, the wound healing and cost of care outcomes are strongly influenced by the mechanical performance of the foam material/s within that dressing. Most aspects of the mechanical performance of foam materials, for example, their stiffness, frictional properties, conformability, swelling characteristics and durability, and the overall mechanical protection provided by a foam-based dressing to a wound strongly depend on the microstructure of the foam components, particularly on their microtopography, density and porosity. This article, therefore, provides, for the first time, a comprehensive, self-inclusive compilation of clinically relevant theoretical and practical considerations, based on published analytical and experimental research as well as clinical experience related to the mechanical performance of foams in foam-based wound dressings. The current bioengineering information is useful for establishing understanding of the importance of mechanical properties of foams in foam-based dressings among clinicians and researchers in industry and academia, and other potential stakeholders in the wound care field, for example, regulators and buyers. This information is also particularly important for the development of standardised test methods for the evaluation of foam-based wound dressings and resulting standard mechanical performance metrics for these dressings.info:eu-repo/semantics/publishedVersio

Is cannulated-screw fixation an alternative to plate osteosynthesis in open book fractures? A biomechanical analysis

Objectives: The current biomechanical work compares the symphyseal and sacroiliac stability obtained with two systems of bone osteosynthesis. The two methods of fixation compared were the 6-hole suprapubic non-locked plate and pubic fixation with two cannulated screws, a novel technique that can be applied percutaneously in the clinical practice. The aim of this study was to examine the validity of the use of two-cannulated-screws osteosynthesis in order to minimize the secondary effects of open fixation, especially in patients in whom an open reduction is contraindicated. Materials and methods: A biomechanical study was designed in 9 fresh, human pelvis specimens, simulating an AO B1.1 type injury, using both fixation systems sequentially in each specimen. In both parts of the test, the specimens were subjected to an axial load of 300N. Displacements and rotations between the different pelvic elements were studied by means of a discrete set of points. The absence of differences between the two systems has been set as the null hypothesis. Results: There were significant differences in favor of the cross-cannulated screws in most of the displacements measured at the pubic symphysis and sacroiliac joint. Conclusions: Fixation of the AO B1.1 type fractures with cross cannulated screws restores the biomechanical behavior of the pubic symphysis, obtaining better stability than fixation with the 6-hole non-locked plate. To date, no comparative, biomechanical studies have been conducted with these two systems of osteosynthesis. This study demonstrates that cross-cannulated screws fixation of the pubic symphysis in AO B1.1 pelvic fractures should be considered as an alternative to the conventional plating system

M.O.I.S.T. concept for the local therapy of chronic wounds: an international update

Chronic wounds remain a significant clinical challenge both for those affected and for healthcare systems. The treatment is often comprised and complex. All patients should receive wound care that is integrated into a holistic approach involving local management that addresses the underlying etiology and provides for gold standard therapy to support healing, avoid complications and be more cost effective. There have been significant advances in medicine over the last few decades. The development of new technologies and therapeutics for the local treatment of wounds is also constantly increasing. To help standardize clinical practice with regard to the multitude of wound products, the M.O.I.S.T. concept was developed by a multidisciplinary expert group. The M stands for moisture balance, O for oxygen balance, I for infection control, S for supporting strategies, and T for tissue management. Since the M.O.I.S.T. concept, which originated in the German-speaking countries, is now intended to provide healthcare professionals with an adapted instrument to be used in clinical practice, and a recent update to the concept has been undertaken by a group of interdisciplinary experts to align it with international standards. The M.O.I.S.T. concept can now be used internationally both as an educational tool and for the practical implementation of modern local treatment concepts for patients with chronic wounds and can also be used in routine clinical practice.info:eu-repo/semantics/publishedVersio

Evaluation of Antioxidant and Wound-Healing Properties of EHO-85, a Novel Multifunctional Amorphous Hydrogel Containing Olea europaea Leaf Extract

The excess of free radicals in the wound environment contributes to its stagnation during the inflammatory phase, favoring hard-to-heal wounds. Oxidative stress negatively affects cells and the extracellular matrix, hindering the healing process. In this study, we evaluated the antioxidant and wound-healing properties of a novel multifunctional amorphous hydrogel-containing Olea europaea leaf extract (OELE). Five assessments were performed: (i) phenolic compounds characterization in OELE; (ii) absolute antioxidant activity determination in OELE and hydrogel (EHO-85); (iii) antioxidant activity measurement of OELE and (iv) its protective effect on cell viability on human dermal fibroblasts (HDFs) and keratinocytes (HaCaT); and (v) EHO-85 wound-healing-capacity analysis on diabetic mice (db/db; BKS.Cg-m+/+Leprdb). The antioxidant activity of OELE was prominent: 2220, 1558, and 1969 µmol TE/g by DPPH, ABTS, and FRAP assays, respectively. Oxidative stress induced with H2O2 in HDFs and HaCaT was normalized, and their viability increased with OELE co-treatment, thus evidencing a protective role. EHO-85 produced an early and sustained wound-healing stimulating effect superior to controls in diabetic mice. This novel amorphous hydrogel presents an important ROS scavenger capacity due to the high phenolic content of OELE, which protects skin cells from oxidative stress and contributes to the physiological process of wound healing.This research was funded by QUESPER R&D, and partially by INNCORPORA-TU-2011-1886 subprogramme (Ministry of Economy and Competitiveness, Spain) and the programme for the Reinforcement of Research Activity in the Clinical Management Units of the Andalusian Health Service (Department of Health. Regional Government of Andalusia, Spain)

Whole-Genome Sequence of Serratia liquefaciens HUMV-21, a Cytotoxic, Quorum-Sensing, and Biofilm-Producing Clinical Isolate

A clinical isolate of Serratia liquefaciens (strain HUMV-21) was obtained from a skin ulcer of an adult patient. We report here its complete genome assembly using PacBio single-molecule real-time (SMRT) sequencing, which resulted in a single circular chromosome with 5.3 Mb. About 5,844 protein-coding genes are predicted from this assembly