¿Interesa la creación de grupos interdisciplinarios para el tratamiento integral del anciano con fractura de cadera?

Las personas mayors de 65 años con fractura de cadera suelen tener antecedents de fracturas vertebrales o de muñeca, así como presentar patologías crónicas de cierta importancia (enfermedades cardiovasculares, insuficiencia respiratoria, alteraciones metabólicas, etc.) y, una vez presentada la fractura, complicaciones postquirúrgicas (mortalidad entre el 11-20%, descompensación de patologías crónicas previas, etc.). En nuestro trabajo encontramos que para disminuir las complicaciones es necesaria la intervención de grupos interdisciplinarios de profesionales (Cirujano ortopédico, anestesista, médico internista o geriatra, rehabilitador, enfermeras, asistentes y trabajadores sociales, médico de atención primaria o de cabecera, siendo discutible la creación de Equipos de atención domiciliaria) para el tratamiento integral e integrado de los pacientes con fractura de cadera.Subjects with hip fracture aged over 65 years used to have antecedents of wrist or vertebral fractures, in addition to other severe chronic illnesses (cardiovascular disease, respiratory insufficiency, metabolic disturbances, etc.) and, after the occurrence of the hip fracture, post-surgical complications (mortality between 11-20%, alterations of previous chromic illnesses, etc.). In this study we found that in order to diminish those complications it is necessary an interdisciplinary approach to provide an integral treatment to those patients through groups of professionals (orthopaedist surgeon, anaesthetist, internist or geriatrician, rehabilitative, nurses, social workers, family doctors, being under discussion the establishment of domiciliary care units)

The hydrological response of baseflow in fractured mountain areas

The study of baseflow in mountainous areas of basin headwaters, where the characteristics of the often fractured materials are very different to the standard issues concerning porous material applied in conventional hydrogeology, is an essential element in the characterization and quantification of water system resources. Their analysis through recession fragments provides information on the type of response of the sub-surface and subterranean systems and on the average relation between the storage and discharge of aquifers, starting from the joining of these fragments into a single curve, the Master Recession Curve (MRC). This paper presents the generation of the downward MRC over fragments selected after a preliminary analysis of the recession curves, using a hydrological model as the methodology for the identification and the characterization of quick sub-surface flows flowing through fractured materials. The hydrological calculation has identified recession fragments through surface runoff or snowmelt and those periods of intense evapotranspiration. The proposed methodology has been applied to three sub-basins belonging to a high altitude mountain basin in the Mediterranean area, with snow present every year, and their results were compared with those for the upward concatenation of the recession fragments. The results show the existence of two different responses, one quick (at the sub-surface, through the fractured material) and the other slow, with linear behaviour which takes place in periods of 10 and 17 days respectively and which is linked to the dimensions of the sub-basin. In addition, recesses belonging to the dry season have been selected in order to compare and validate the results corresponding to the study of recession fragments. The comparison, using these two methodologies, which differ in the time period selected, has allowed us to validate the results obtained for the slow flow

On the influence of cell size in physically-based distributed hydrological modelling to assess extreme values in water resource planning

This paper studies the influence of changing spatial resolution on the implementation of distributed hydrological modelling for water resource planning in Mediterranean areas. Different cell sizes were used to investigate variations in the basin hydrologic response given by the model WiMMed, developed in Andalusia (Spain), in a selected watershed. The model was calibrated on a monthly basis from the available daily flow data at the reservoir that closes the watershed, for three different cell sizes, 30, 100, and 500 m, and the effects of this change on the hydrological response of the basin were analysed by means of the comparison of the hydrological variables at different time scales for a 3-yr-period, and the effective values for the calibration parameters obtained for each spatial resolution. The variation in the distribution of the input parameters due to using different spatial resolutions resulted in a change in the obtained hydrological networks and significant differences in other hydrological variables, both in mean basin-scale and values distributed in the cell level. Differences in the magnitude of annual and global runoff, together with other hydrological components of the water balance, became apparent. This study demonstrated the importance of choosing the appropriate spatial scale in the implementation of a distributed hydrological model to reach a balance between the quality of results and the computational cost; thus, 30 and 100-m could be chosen for water resource management, without significant decrease in the accuracy of the simulation, but the 500-m cell size resulted in significant overestimation of runoff and consequently, could involve uncertain decisions based on the expected availability of rainfall excess for storage in the reservoirs. Particular values of the effective calibration parameters are also provided for this hydrological model and the study area

Structural and electrical transport properties of superconducting Au{0.7}In{0.3} films: A random array of superconductor-normal metal-superconductor (SNS) Josephson junctions

The structural and superconducting properties of Au{0.7}In{0.3} films, grown by interdiffusion of alternating Au and In layers, have been studied. The films were found to consist of a uniform solid solution of Au{0.9}In{0.1}, with excess In precipitated in the form of In-rich grains of various Au-In phases (with distinct atomic compositions), including intermetallic compounds. As the temperature was lowered, these individual grains became superconducting at a particular transition temperature (Tc), determined primarily by the atomic composition of the grain, before a fully superconducting state of zero resistance was established. From the observed onset Tc, it was inferred that up to three different superconducting phases could have formed in these Au{0.7}In{0.3} films, all of which were embedded in a uniform Au{0.9}In{0.1} matrix. Among these phases, the Tc of a particular one, 0.8 K, is higher than any previously reported for the Au-In system. The electrical transport properties were studied down to low temperatures. The transport results were found to be well correlated with those of the structural studies. The present work suggests that Au{0.7}In{0.3} can be modeled as a random array of superconductor-normal metal-superconductor (SNS) Josephson junctions. The effect of disorder and the nature of the superconducting transition in these Au{0.7}In{0.3} films are discussed.Comment: 8 text pages, 10 figures in one separate PDF file, submitted to PR

Применение оксидно-рутениевых титановых анодов, модифицированных сурьмой для очистки воды

Rationale: Unlike conventional dendritic cells, plasmacytoid DCs (PDC) are poor in antigen presentation and critical for type 1 interferon response. Though proposed to be present in human atherosclerotic lesions, their role in atherosclerosis remains elusive. Objective: To investigate the role of PDC in atherosclerosis. Methods and Results: We show that PDC are scarcely present in human atherosclerotic lesions and almost absent in mouse plaques. Surprisingly, PDC depletion by 120G8 mAb administration was seen to promote plaque T-cell accumulation and exacerbate lesion development and progression in LDLr(-/-) mice. PDC depletion was accompanied by increased CD4(+) T-cell proliferation, interferon-gamma expression by splenic T cells, and plasma interferon-gamma levels. Lymphoid tissue PDC from atherosclerotic mice showed increased indoleamine 2,3-dioxygenase (IDO) expression and IDO blockage abrogated the PDC suppressive effect on T-cell proliferation. Conclusions: Our data reveal a protective role for PDC in atherosclerosis, possibly by dampening T-cell proliferation and activity in peripheral lymphoid tissue, rendering PDC an interesting target for future therapeutic interventions. (Circ Res. 2011;109:1387-1395.

Severity-Related Changes of Bronchial Microbiome in Chronic Obstructive Pulmonary Disease

Bronchial colonization by potentially pathogenic microorganisms (PPMs) is often demonstrated in chronic obstructive pulmonary disease (COPD), but culture-based techniques identify only a portion of the bacteria in mucosal surfaces. The aim of the study was to determine changes in the bronchial microbiome of COPD associated with the severity of the disease. The bronchial microbiome of COPD patients was analyzed by 16S rRNA gene amplification and pyrosequencing in sputum samples obtained during stable disease. Seventeen COPD patients were studied (forced expiratory volume in the first second expressed as a percentage of the forced vital capacity [FEV1%] median, 35.0%; interquartile range [IQR], 31.5 to 52.0), providing a mean of 4,493 (standard deviation [SD], 2,598) sequences corresponding to 47 operational taxonomic units (OTUs) (SD, 17) at a 97% identity level. Patients were dichotomized according to their lung function as moderate to severe when their FEV1% values were over the median and as advanced when FEV1% values were lower. The most prevalent phyla in sputum were Proteobacteria (44%) and Firmicutes (16%), followed by Actinobacteria (13%). A greater microbial diversity was found in patients with moderate-to-severe disease, and alpha diversity showed a statistically significant decrease in patients with advanced disease when assessed by Shannon (ρ = 0.528; P = 0.029, Spearman correlation coefficient) and Chao1 (ρ = 0.53; P = 0.028, Spearman correlation coefficient) alpha-diversity indexes. The higher severity that characterizes advanced COPD is paralleled by a decrease in the diversity of the bronchial microbiome, with a loss of part of the resident flora that is replaced by a more restricted microbiota that includes PPMs

HCV eradication with DAAs differently affects HIV males and females: A whole miRNA sequencing characterization

Gender-specific consequences after HCV eradication are unexplored. MicroRNAs (miRNAs) play a crucial role in the immune response against viral infections. However, few have highlighted miRNA role in sex-biased disease or therapy response. We aim to assess gender differences reflected in the miRNA expression of HIV/HCV-coinfected patients who achieve sustained virological response (SVR) with direct acting antivirals (DAAs). We conducted a prospective study of miRNA expression in PBMCs from 28 chronic HIV/HCV-coinfected patients (HIV/HCV) at baseline and after achieving SVR with DAAs. Sixteen HIV-monoinfected patients (HIV) and 36 healthy controls (HC) were used as controls. Identification of significant differentially expressed (SDE) miRNAs was performed with generalized linear model and mixed GLMs. We also explored putative dysregulated biological pathways. At baseline, the HIV/HCV patients showed differences in the miRNA profile concerning the HIV group (165 and 102 SDE miRNAs for males and females, respectively). Gender-stratified analysis of HIV/HCV group at baseline versus at SVR achievement showed higher differences in males (80 SDE miRNAs) than in females (55 SDE miRNAs). After SVR, HIV/HCV group showed similar values to HIV individuals, especially in females (1 SDE miRNA). However, ten miRNAs in males remained dysregulated, which were mainly involved in cancer, fatty acid, and inflammatory pathways. Taken together, our results show gender-biased dysregulation in the miRNA expression profile of PBMCs after HCV eradication with DAAs. These differences were normalized in females, while miRNA profile and their target-related pathways in males lack of normalization, which may be related to a high-risk of developing liver-related complications.This work has been supported by grants from Institute of Health Carlos III, Spain [PI15CIII/00031 and PI18CIII/00020/ to AFR and VB] and the Foundation Universidad Alfonso X el Sabio-Santander, Spain [Grant no. 1.010.932 to AFR]. AFR is supported by the Miguel Servet programme from Fondo de Investigación Sanitaria (ISCIII), Spain [CP14/CIII/00010 and CPII20CIII/0001]. This study has been conducted within the Spanish AIDS Research Network (RIS), The SPANISH AIDS Research Network – funded by the Institute of Health Carlos III (ISCIII) [RD16CIII/0002/0002].S

Different HCV Exposure Drives Specific miRNA Profile in PBMCs of HIV Patients

Micro RNAs (miRNAs) are essential players in HIV and HCV infections, as both viruses modulate cellular miRNAs and interact with the miRNA-mediated host response. We aim to analyze the miRNA profile of HIV patients with different exposure to HCV to explore specific signatures in the miRNA profile of PBMCs for each type of infection. We massively sequenced small RNAs of PBMCs from 117 HIV+ infected patients: 45 HIV+ patients chronically infected with HCV (HIV/HCV+), 36 HIV+ that spontaneously clarified HCV after acute infection (HIV/HCV-) and 36 HIV+ patients without previous HCV infection (HIV). Thirty-two healthy patients were used as healthy controls (HC). Differential expression analysis showed significantly differentially expressed (SDE) miRNAs in HIV/HCV+ (n = 153), HIV/HCV- (n = 169) and HIV (n = 153) patients. We found putative dysregulated pathways, such as infectious-related and PI3K signaling pathways, common in all contrasts. Specifically, putatively targeted genes involved in antifolate resistance (HIV/HV+), cancer-related pathways (HIV/HCV-) and HIF-signaling (HIV) were identified, among others. Our findings revealed that HCV strongly influences the expression profile of PBMCs from HIV patients through the disruption of its miRNome. Thus, different HCV exposure can be identified by specific miRNA signatures in PBMCs.This work has been supported by grants from Institute of Health Carlos III, [PI15CIII/00031 and PI18CIII/00020/ to AFR and VB] and the Foundation Universidad Alfonso X el Sabio-Santander [grant number 1.010.932 to AFR] and the Spanish AIDS Research Network (RD16CIII/0002/0002), and Centro de Investigación Biomédica en Red (CIBER) en Enfermedades Infecciosas (CB21/13/00044). AFR is supported by the Miguel Servet programme from Fondo de Investigación Sanitaria (ISCIII) [CP14/CIII/00010 and CPII20CIII/0001].info:eu-repo/semantics/publishedVersio

HCV eradication with DAAs differently affects HIV males and females: A whole miRNA sequencing characterization

Gender-specific consequences after HCV eradication are unexplored. MicroRNAs (miRNAs) play a crucial role in the immune response against viral infections. However, few have highlighted miRNA role in sex-biased disease or therapy response. We aim to assess gender differences reflected in the miRNA expression of HIV/HCV-coinfected patients who achieve sustained virological response (SVR) with direct acting antivirals (DAAs). We conducted a prospective study of miRNA expression in PBMCs from 28 chronic HIV/HCV-coinfected patients (HIV/HCV) at baseline and after achieving SVR with DAAs. Sixteen HIV-monoinfected patients (HIV) and 36 healthy controls (HC) were used as controls. Identification of significant differentially expressed (SDE) miRNAs was performed with generalized linear model and mixed GLMs. We also explored putative dysregulated biological pathways. At baseline, the HIV/HCV patients showed differences in the miRNA profile concerning the HIV group (165 and 102 SDE miRNAs for males and females, respectively). Gender-stratified analysis of HIV/HCV group at baseline versus at SVR achievement showed higher differences in males (80 SDE miRNAs) than in females (55 SDE miRNAs). After SVR, HIV/HCV group showed similar values to HIV individuals, especially in females (1 SDE miRNA). However, ten miRNAs in males remained dysregulated, which were mainly involved in cancer, fatty acid, and inflammatory pathways. Taken together, our results show gender-biased dysregulation in the miRNA expression profile of PBMCs after HCV eradication with DAAs. These differences were normalized in females, while miRNA profile and their target-related pathways in males lack of normalization, which may be related to a high-risk of developing liver-related complications