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

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

Cáncer de mama en mujeres pinareñas menores de 45 años, serie cronológica de 23 años

Introduction: breast cancer is a worldwide health problem; it is the leading cause of death from malignant tumor in female gender. In recent years there has been a decrease in the age of onset of this disease, and it is a need for the province to carry out research works regarding this entity.Objective: to characterize breast cancer in women under the age of 45 treated at Abel Santamaría Cuadrado General Teaching Hospital in Pinar del Río during in the period 1995 - 2018.Methods: an observational, descriptive, longitudinal and retrospective study was conducted including women less than 45 years old operated on breast cancer. The target group comprised 1223 women, the sampling was intentional (n=256). Methods of descriptive statistics were applied; data were obtained from the central database of the clinic of breast cancer. Results: 21,48 % had a family history of cancer, the right breast was the most affected (57,42 %), the most frequent clinical stage was IIA (31,25 %), conservative surgery was the most frequent surgical technique applied (69,14 %); duct carcinoma with its different variables was the predominant histological type (56,64 %).Conclusions: breast cancer is a public health problem, each year it emerges in younger patients with a family history of cancer, diagnosis is early made in most cases and conservative surgical procedures were the ones applied.Introducción: el cáncer de mama es un problema de salud mundial, constituye la primera causa de muerte por tumor maligno en féminas. En los últimos años se ha apreciado un descenso en la edad de presentación de la enfermedad, y la necesidad de disponer de una investigación que la reporte en la provincia.Objetivo: caracterizar el cáncer de mama en mujeres menores de 45 años atendidas en el Hospital General Docente “Abel Santamaría Cuadrado” de Pinar del Río en el período 1995-2018.Métodos: se realizó un estudio, observacional, descriptivo, longitudinal y retrospectivo en mujeres menores de 45 años operadas por cáncer de mama. Universo 1 223 mujeres, el muestreo fue intencional (n=256). Se aplicaron métodos de estadística descriptiva, los datos fueron obtenidos de la base de datos de la consulta central de mama del hospital. Resultados: el 21,48 % tenían antecedente familiar de cáncer, la mama derecha fue la más afecta (57,42 %), el estadio clínico más frecuente fue IIA, (31,25 %), la técnica quirúrgica frecuente fue la cirugía conservadora (69,14 %), el carcinoma ductal con sus diferentes variables fue el tipo histológico predominante (56,64 %).Conclusiones: el cáncer de mama es un problema de salud pública, cada año aparece en pacientes más jóvenes y con antecedentes familiares de cáncer, el diagnostico se realiza precoz en la mayoría de los casos y las técnicas quirúrgicas conservadoras fueron las empleadas

Hard-to-Heal Wound Healing: Superiority of Hydrogel EHO-85 (Containing Olea europaea Leaf Extract) vs. a Standard Hydrogel. A Randomized Controlled Trial

Chronic wounds, especially those that are hard-to-heal, constitute a serious public-health problem. Although progress has been made in the development of wound dressings for healing, there is little high-quality evidence of their efficacy, with no evidence of superiority in the use of one hydrogel over another. To evaluate the superiority of a hydrogel (EHO-85), containing Olea europaea leaf extract (OELE), over a standard hydrogel (SH), the promotion and/or improvement of healing of difficult-to-heal wounds was compared in a prospective, parallel-group multicenter, randomized, observer-blinded, controlled trial (“MACAON”). Non-hospitalized patients with pressure, venous or diabetic foot-ulcers difficult-to-heal were recruited and treated with standard care, and EHO-85 (n = 35) or VariHesive (n = 34) as SH. Wound-area reduction (WAR; percentage) and healing rate (HR; mm2/day) were measured. EHO-85 showed a statistically significant superior effect over VariHesive. At the end of the follow-up period, the relative WAR decreased by 51.6% vs. 18.9% (p < 0.001), with a HR mean of 10.5 ± 5.7 vs. 1.0 ± 7.5 mm2/day (p = 0.036). EHO-85 superiority is probably based on its optimal ability to balance the ulcer bed, by modulating pH and oxidative stress. That complements the wetting and barrier functions, characteristics of conventional hydrogels. These results support the use of EHO-85 dressing, for treatment of hard-to-heal ulcers. Trial Registration AEMPS:PS/CR623/17/CE.This research was developed by QUESPER R&D, and partially funded by INNCORPO-RA-TU-2011-1886 subprogram (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)