Surgical Pulmonary Embolectomy Outcomes for Acute Pulmonary Embolism

Introduction: Acute pulmonary embolism (PE) is associated with significant mortality. Surgical embolectomy is a viable treatment option; however, it remains controversial due to variable outcomes. This review investigates patient outcomes following surgical embolectomy for acute PE. Methods: Electronic search was performed to identify articles reporting surgical embolectomy for treatment of PE. 32 studies were included comprising 936 patients. Demographic, perioperative, and outcome data were extracted and pooled for systematic review. Results: Mean patient age was 56.3 [95% CI 52.5; 60.1] years and 50% [46; 55] were male. 82% had right ventricular dysfunction [62; 93], 80% [67; 89] had unstable hemodynamics, and 9% [5; 16] experienced cardiac arrest. Massive PE and submassive PE were present in 83% of patients [43; 97] and 13% [2; 56], respectively. Before embolectomy, 33% of patients [14; 60] underwent systemic thrombolysis and 14% [8; 24] catheter embolectomy. Preoperatively, 47% of patients were ventilated [26; 70] and 36% had percutaneous cardiopulmonary support [11; 71]. Mean operative time and mean cardiopulmonary bypass time were 170 [101; 239] and 56 [42; 70] minutes, respectively. Intraoperative mortality was 4% [2; 8]. Mean hospital and ICU stay were 10 [6; 14] and 2 [1; 3] days, respectively. Mean postoperative systolic pulmonary artery pressure (sPAP) was significantly decreased from preoperative (sPAP 57.8 mmHg [53; 62.7]) to postoperative period (sPAP 31.3 mmHg [24.9; 37.8]), p \u3c0.01). In-hospital mortality was 16% [12; 21]. Overall survival at five years was 73% [64; 81]. Discussion: Surgical embolectomy is an acceptable treatment option with favorable outcomes

On the compact operators case of the Bishop-Phelps-Bollobás property for numerical radius

The authors would like to thank Bill Johnson for kindly answering several inquiries.We study the Bishop–Phelps–Bollobás property for numerical radius restricted to the case of compact operators (BPBp-nu for compact operators in short). We show that C0(L) spaces have the BPBp-nu for compact operators for every Hausdorff topological locally compact space L. To this end, on the one hand, we provide some techniques allowing to pass the BPBp-nu for compact operators from subspaces to the whole space and, on the other hand, we prove some strong approximation property of C0(L) spaces and their duals. Besides, we also show that real Hilbert spaces and isometric preduals of ℓ1 have the BPBp-nu for compact operators

PERCEPCIÓN DE LOS ALUMNOS DE ENFERMERÍA SOBRE LA FUNCIÓN TUTORIAL EN LAS PRÁCTICAS

Nursing students perceived dichotomies/contradictions between the perspectives of male and female nurses while on internship. This is why we have decided to analyze nursing students’ perceptions of the tutorial function of internship. In this investigation we have opted for the descriptive method, which has as a primary objective to systematically describe facts and characteristics of a given population or area of interest in an objective and verifiable way. The study population consists of nursing students of the University School of Health Sciences, University of Seville. Based on the results obtained in this investigation, we believe it useful to provide the information necessary for the tutorial function, with the idea that tutors are aware of the same objectives. Also, they need to be sure that students are aware of the objectives of the internship and help them to understand the importance of caring for patients, and the use of a conceptual model for guidance during the internship and the use of the process of nursing care, as a method of problem solving.Los alumnos de enfermería perciben dicotomías, contradicciones, entre la perspectiva enfermera con que ellos realizan las prácticas y la perspectiva con la que la realizan las enfermeras. Es por lo que nos hemos planteado analizar la percepción de los alumnos de la diplomatura de enfermería sobre la función tutorial en las prácticas. En esta investigación nos hemos decantado por el método descriptivo, que tiene como principal objetivo describir sistemáticamente hechos y características de una población dada o área de interés de forma objetiva y comprobable. La población de estudio la componen los alumnos de enfermería de la Escuela Universitaria Ciencias de la Salud, de la Universidad de Sevilla. En base a los resultados obtenidos en esta investigación, creemos conveniente facilitar la información necesaria para la función tutorial, con la idea de que los tutores conozcan los objetivos de las mismas; que tengan constancia de que los alumnos conocen los objetivos de las prácticas y ayudarles para que comprendan la importancia que tiene para el cuidado de los pacientes la utilización de un modelo conceptual que guíe la práctica y del uso del proceso de cuidados enfermeros, como método de resolución de problemas

Trace elements and lead isotopic composition of copper deposits from the eastern part of the Internal Zone of the Betic Cordillera (SE Iberia): application to provenance of archaeological materials

This paper presents trace element compositions and lead isotope analyses by MC-ICP-MS of 34 copper ore samples from the Internal Zone of the Betic Range, Southeast Spain. Samples were collected during a fieldwork campaign in the mines of Cerro Minado, Pinar de Bédar, Sierra Cabrera and Sierra Almagrera/Herrerías. Most samples are copper oxide minerals from the near surface alteration of the sulfide ore deposits. The aim of the study is to supplement the existing reference data bank on lead isotopic compositions of ancient copper mines from the Iberian Peninsula, complementing this data with trace element compositions. The latter can be useful for discriminating when isotopic overlaps occur. This characterisation will be of great usefulness for provenancing further archaeological materials. Lead isotope ratios range from 18.603 to 20.327 (206Pb/204Pb); from 15.685 to 15.779 (207Pb/204Pb) and from 38.728 to 39.702 (208Pb/204Pb). Data from the literature analysed by TIMS have been also considered for comparison although the larger analytical error is highlighted, especially for isotope 204Pb. The lead isotopic signature of the analysed samples shows three separate isotopic fields. These fields are also consistent with differences in compositions evidenced by principal component analyses

Epidemiología del cáncer de colon en un Plan de Salud de un Hospital de Comunidad. Estudio de cohorte retrospectivo.

Epidemiología del cáncer de colon en un Plan de Salud de un Hospital de Comunidad. Estudio de cohorte retrospectivo. Introducción: el CCR ocupa el 4to lugar en ambos sexos y todas las edades (19.5 casos por 100.000 habitantes) y ocupa el 2do lugar en luego del cáncer de pulmón. Objetivo: Describir la incidencia y sobrevida del cáncer de colon en un hospital de comunidad con Plan de salud (PS) Métodos: Estudio de cohorte retrospectivo (Aprobado por el comité de ética). Se incluyeron todos los afiliados al Plan de Salud (PS) de 20 años o más entre 2009-2019. Se identificaron los casos por patología. Se calcularon las tasas de incidencia tasa cruda, sexo, usando como denominador el tiempo en riesgo desde la afiliación al PS hasta el diagnóstico o censura (baja administrativa)(x 100000 afiliados/año). Se presentan las variables numéricas como mediana y rango intercuartílico(RIC) y las categóricas n y porcentaje(%). Se realizó curva de Kaplan Meyer y se comparó según estadío TNM regresión de Cox. Tasas y HR se presentan con intervalos de confianza del 95%(IC95%); p Resultados: Incluimos 11827, 44,97%(n=5319) sexo femenino, 50,78(17,15)años. Hubo 90 nuevos cánceres; incidencia cruda fue 61,7 (43-88); en hombres 77,62 (48,25 - 124,86) y en mujeres 48,66 (28,25-83,8).De los casos 52,2%(n=47) eran hombres, 69.3 (64-76) años al diagnóstico. La mediana de seguimiento fue de 3,02 (0,98-6,60)años. La mortalidad global fue 40% (n=36). La sobrevida global fue de 0,70 (IC 95% 0,58 -0,79), con una mediana de tiempo a la muerte fue de 2,98. El riesgo de muerte fue mayor en los estadios mayores según TNM, aún ajustado por edad y sexo. El HR crudo fue 3,06 (2-4,66) y el HR ajustado por edad y sexo 3,33 (2,19-5,08) Discusión: Los resultados de incidencia son consistentes con datos nacionales e internacionales. La sobrevida es menor en esta cohorte, pero cuando se ajusta por TNM es similar a otros reportes. Limitaciones relacionada a uso bases administrativas y a representatividad por ser único centro; esto mismo nos da la fortaleza de poder tener un seguimiento completo y la certeza diagnóstica

Smoking and incidence of glaucoma The SUN Cohort

Abstract Smoking is a serious global public health concern that has been related to many chronic diseases. However, the effect of smoking on eye disorders has been less studied. The aim of this cohort study was to assess the association between current tobacco smokers and the risk of developing glaucoma and furthermore to evaluate the relationship between passive or former smokers and glaucoma. In this prospective and dynamic cohort, 16,797 participants initially who were found not to have glaucoma were followed up for a median of 8.5 years. Validated data on lifestyle, including tobacco consumption, were assessed at baseline. Information about new diagnosis of glaucoma was collected by follow-up questionnaires every 2 years. The outcome was the incidence of self-reported glaucoma during the follow-up. A subsample was used to validate the glaucoma diagnosis. During the 8.5 years of follow-up, 184 new glaucoma cases were identified. Current smokers had a significantly higher risk of glaucoma compared to participants who had never smoked after controlling for potential confounders (Hazard ratio [HR] 1.88 [95% coefficient interval (CI): 1.26-2.81]; P = 0.002). A nonsignificant increased risk was found among former smokers (HR 1.27 [95% CI: 0.88-1.82]; P = 0.198). When we assessed the exposure as per the number of cigarette pack-years, a dose-response relationship between pack-years and the risk of glaucoma was found (HR for the 5th quintile versus the 1st quintile: 1.70 [95% IC: 1.10-2.64], P for trend, 0.009). However, no relationship was found between passive smokers and glaucoma. ]; P = 0.189). Our results suggest a direct association between current smokers and the incidence of glaucoma. In particular, this association was related to the number of pack-years, which was not found in the case of former smokers nor in the case of passive smokers. Abbreviations: IOP = intraocular pressure, POAG = primary open angle glaucoma, SUN = Seguimiento Universidad de Navarra

Recomendaciones nutricionales para los ancianos

En los últimos años, el rápido envejecimiento de la población está originando un gran número de estudios encaminadosa conocer en mayor profundidad este proceso, así como a identificar los factores de riesgo que puedenmodificarlo de forma negativa. Dentro de estos factores de riesgo hay que considerar la importancia que tiene unaalimentación adecuada en esta etapa de la vida. Sin embargo es difícil establecer unas recomendaciones nutricionalespara un grupo de población tan heterogéneo. En esta revisión, se recogen las recomendaciones nutricionales dadaspor distintos organismos para población mayor

Proptosis, una búsqueda cada vez más rápida y certera

This is a case report corresponding to a young woman with neurological symptoms (headache and diplopia), a structural lesion of the orbit and lesions on chest radiography, where a broad differential diagnosis arises and where the challenge is to quickly locate the most accessible primary lesion that allows more thorough characterization clinical case and enables more accurate treatment.Se trata de un caso clínico correspondiente a una mujer joven con clínica neurológica (cefalea y diplopia), una lesión estructural de la órbita, junto con una radiografía de tórax patológica, donde se plantea un amplio diagnóstico diferencial y donde el reto consiste en la rápida localización de la lesión primaria más accesible que permita la tipificación más exhaustiva y posibilite el tratamiento más certero

Wheat-barley hybridization – the last forty years

Abstract Several useful alien gene transfers have been reported from related species into wheat (Triticum aestivum), but very few publications have dealt with the development of wheat/barley (Hordeum vulgare) introgression lines. An overview is given here of wheat 9 barley hybridization over the last forty years, including the development of wheat 9 barley hybrids, and of addition and translocation lines with various barley cultivars. A short summary is also given of the wheat 9 barley hybrids produced with other Hordeum species. The meiotic pairing behaviour of wheat 9 barley hybrids is presented, with special regard to the detection of wheat– barley homoeologous pairing using the molecular cytogenetic technique GISH. The effect of in vitro multiplication on the genome composition of intergeneric hybrids is discussed, and the production and characterization of the latest wheat/barley translocation lines are presented. An overview of the agronomical traits (b-glucan content, earliness, salt tolerance, sprouting resistance, etc.) of the newly developed introgression lines is given. The exploitation and possible use of wheat/barley introgression lines for the most up-to-date molecular genetic studies (transcriptome analysis, sequencing of flow-sorted chromosomes) are also discussed

Estimación de tasa de crecimiento en un proceso de producción de PHB

El objetivo de este trabajo es el desarrollo de observadores de estados para estimar las tasas de crecimiento en procesos de producción de PHB utilizando la instrumentación disponible en un laboratorio standard. Se propone un esquema conmutado de dos observadores específicamente diseñados para procesos de producción de PHB de alta densidad celular. Durante las primeras horas del proceso, cuando la densidad celular es baja, se utiliza un observador exponencial basado la medida de densidad óptica. Una vez que esa medida deja de ser viable por la alta densidad de células se cambia a un observador asintótico que se basa en la medida de concentración de fuente de nitrógeno obtenida a partir del lazo de control de pH. Se debe recordar que estos observadores se utilizan solo en la fase de crecimiento del proceso.Publicado en Terceras Jornadas de Investigación, Transferencia y Extensión. La Plata: Universidad Nacional de La Plata, 2015.Facultad de Ingenierí