Impact of non-invasive mechanical ventilation (niv) in critical patients with influenza (H1N1) PDM09

The use of non-invasive mechanical ventilation (NIV) in patients with influenza A (H1N1)pdm09 admitted to intensive care units (ICU) has been controversial

Evaluación de signos tomográficos no exudativos en casos de degeneración macular asociada a la edad de tipo exudativo

Producción CientíficaABSTRACT. OBJECTIVE: To analyze the prevalence of non-exudative tomographic signs (onion sign, pseudoswelling, external retinal tubulation, pseudocysts, subretinal clefts and macular atrophy) in patients with neovascular age-related macular degeneration. MATERIAL AND METHODS: A total of 174 eyes of patients with neovascular age-related macular degeneration who had not received previous treatment were included in the study. Visual acuity, neovascularization activity, and the appearance or not of the different signs under study were assessed at times 0 (initial visit), 4 months, one year, year and a half, and at 2 and 3 years of follow-up. The following were also evaluated: age, sex, affected eye and type of neovascularization (1, 2, 3, polypoid or mixed). The analysis were performed using the statistical software R (version 3.3.2) and the glmmADMB package (version 0.8.3.3). RESULTS: The presence of pseudocysts and external retinal tubulation increases throughout the follow-up. The onion sign begins with an ascending frequency up to 12 months, then decreases at 18 months and increases again at 24 months. Regarding pseudowelling, it maintains an increase until 18 months to finally decrease. Subretinal clefts is the rarest sign, presenting in 1.1% on the first visit. Finally, macular atrophy, present in 12.6% of the eyes initially, is found in 25% after 2 years. CONCLUSION: Pseudocysts, external retinal tubulation and macular atrophy were the most prevalent signs, while subretinal clefts were the most infrequent

L-Arginine Ameliorates Defective Autophagy in GM2 Gangliosidoses by mTOR Modulation.

AIMS: Tay-Sachs and Sandhoff diseases (GM2 gangliosidosis) are autosomal recessive disorders of lysosomal function that cause progressive neurodegeneration in infants and young children. Impaired hydrolysis catalysed by β-hexosaminidase A (HexA) leads to the accumulation of GM2 ganglioside in neuronal lysosomes. Despite the storage phenotype, the role of autophagy and its regulation by mTOR has yet to be explored in the neuropathogenesis. Accordingly, we investigated the effects on autophagy and lysosomal integrity using skin fibroblasts obtained from patients with Tay-Sachs and Sandhoff diseases. RESULTS: Pathological autophagosomes with impaired autophagic flux, an abnormality confirmed by electron microscopy and biochemical studies revealing the accelerated release of mature cathepsins and HexA into the cytosol, indicating increased lysosomal permeability. GM2 fibroblasts showed diminished mTOR signalling with reduced basal mTOR activity. Accordingly, provision of a positive nutrient signal by L-arginine supplementation partially restored mTOR activity and ameliorated the cytopathological abnormalities. INNOVATION: Our data provide a novel molecular mechanism underlying GM2 gangliosidosis. Impaired autophagy caused by insufficient lysosomal function might represent a new therapeutic target for these diseases. CONCLUSIONS: We contend that the expression of autophagy/lysosome/mTOR-associated molecules may prove useful peripheral biomarkers for facile monitoring of treatment of GM2 gangliosidosis and neurodegenerative disorders that affect the lysosomal function and disrupt autophagy

Satisfaction rating in a group of women from Granada on birthing care, support and breastfeeding lenght

Introducción: El análisis de la satisfacción se está utilizando como instrumento para crear diferentes reformas sanitarias para la mejora de la calidad y numerosos estudios apuntan al incremento de la satisfacción de la madre en relación directa con el cuidado en la maternidad. Objetivos: Identificar el grado de satisfacción de la mujer sobre la atención al parto, el acompañamiento durante el nacimiento y la duración de la lactancia materna. Objetivos: Identificar el grado de satisfacción de la mujer sobre la atención al parto, el acompañamiento durante el nacimiento y la duración de la lactancia materna. Material y método: Estudio descriptivo transversal en el Hospital Universitario San Cecilio de Granada (España), durante el periodo de tiempo agosto del 2011 al 2012, se realizo con una segunda fase de seguimeinto prospectivo a una N= 60 madres. Se utilizó un protocolo (anexo 1) a las 24 horas en el hospital y a los 14 días por teléfono. A los 3 meses, se realizó un seguimeinto relacionado con la alimentación del bebe. Resultados: El nivel de satisfacción global sobre el parto es alto en la población estudiada. Se ha demostrado que la lactancia materna (P=0,514) y el parto vía vaginal sin epidural (P=0,320) crea una mayor satisfacción en la madre. Por otro lado, la satisfacción sobre el parto guarda relación con la duración de la lactancia materna. Conclusión: La opinión satisfactoria de las madres relacionadas con la atención al parto y el acompañamiento durante el nacimiento se incrementa en aquellas mujeres cuyo parto ocurrió de forma eutócica sin epidural e iniciaron la lactancia materna precoz

Development of an activity disease score in patients with uveitis (UVEDAI)

To develop a disease activity index for patients with uveitis (UVEDAI) encompassing the relevant domains of disease activity considered important among experts in this field. The steps for designing UVEDAI were: (a) Defining the construct and establishing the domains through a formal judgment of experts, (b) A two-round Delphi study with a panel of 15 experts to determine the relevant items, (c) Selection of items: A logistic regression model was developed that set ocular inflammatory activity as the dependent variable. The construct "uveitis inflammatory activity" was defined as any intraocular inflammation that included external structures (cornea) in addition to uvea. Seven domains and 15 items were identified: best-corrected visual acuity, inflammation of the anterior chamber (anterior chamber cells, hypopyon, the presence of fibrin, active posterior keratic precipitates and iris nodules), intraocular pressure, inflammation of the vitreous cavity (vitreous haze, snowballs and snowbanks), central macular edema, inflammation of the posterior pole (the presence and number of choroidal/retinal lesions, vascular inflammation and papillitis), and global assessment from both (patient and physician). From all the variables studied in the multivariate model, anterior chamber cell grade, vitreous haze, central macular edema, inflammatory vessel sheathing, papillitis, choroidal/retinal lesions and patient evaluation were included in UVEDAI. UVEDAI is an index designed to assess the global ocular inflammatory activity in patients with uveitis. It might prove worthwhile to motorize the activity of this extraarticular manifestation of some rheumatic diseases

Effect of Immunosuppressive Treatments on Kidney Outcomes After Gross Hematuria-Related Acute Kidney Injury in Older Patients With IgA Nephropathy

Macroscopic hematuria (MH) bouts, frequently accompanied by acute kidney injury (AKI-MH) are one of the most common presentations of IgA nephropathy (IgAN) in the elderly. Immunosuppressive therapies are used in clinical practice; however, no studies have analyzed their efficacy on kidney outcomes. This is a retrospective, multicenter study of a cohort of patients aged ≥50 years with biopsy-proven IgAN presenting with AKI-MH. Outcomes were complete, partial, or no recovery of kidney function at 1 year after AKI-MH, and kidney survival at 1, 2, and 5 years. Propensity score matching (PSM) analysis was applied to balance baseline differences between patients treated with immunosuppression and those not treated with immunosuppression. The study group consisted of 91 patients with a mean age of 65 ± 15 years, with a mean follow-up of 59 ± 36 months. Intratubular red blood cell (RBC) casts and acute tubular necrosis were found in all kidney biopsies. The frequency of endocapillary hypercellularity and crescents were low. Immunosuppressive therapies (corticosteroids alone or combined with mycophenolate mofetil or cyclophosphamide) were prescribed in 52 (57%) patients, whereas 39 (43%) received conservative treatment. There were no significant differences in the proportion of patients with complete, partial, or no recovery of kidney function at 1 year between patients treated with immunosuppression and those not treated with immunosuppression (29% vs. 36%, 30.8% vs. 20.5% and 40.4 % vs. 43.6%, respectively). Kidney survival at 1, 3, and 5 years was similar among treated and untreated patients (85% vs. 81%, 77% vs. 76% and 72% vs. 66%, respectively). Despite the PSM analysis, no significant differences were observed in kidney survival between the two groups. Fourteen patients (27%) treated with immunosuppression had serious adverse events. Conclusions: Immunosuppressive treatments do not modify the unfavorable prognosis of patients with IgAN who are aged ≥50 years presenting with AKI-MH, and are frequently associated with severe complications

Application of non-parametric functions to model the emergence of Ridolfia segetum

5 Pág.[EN] Ridolfia segetum (L.) Moris is a weed native to the Mediterranean basin that causes yield losses in both winter and summer crops in southern Spain. Modeling its emergence is crucial for developing appropriate management strategies. Currently, the predominant technique for predicting weed emergence is non-linear parametric regression, but this approach has some statistical limitations. The Weed Biology and Agroecology Group (BAMh) conducted a study to describe and predict the emergence pattern of R. segetum using a non-parametric regression with a Gaussian distribution. For its development, emergence was studied in five experimental plots in Barcelona, Lleida, Madrid, Seville, and Zaragoza during the 2016/17 season, and the trial was repeated in the following season in Barcelona, Madrid, and Zaragoza. In each plot, 100 seeds from an experimental farm in Seville were sown in 25 x 25 cm grids (4 replicates). For the model, a cumulative kernel density curve was used to relate emergence to a hydrothermal integral based on a two segment equation. A base, optimal, and maximum temperature of -1.0 ºC, 8.1 ºC, and 26.0 ºC, respectively, and a base water potential of -0.6 MPa were established. This model reaches 10 %, 50 %, and 90 % of cumulative emergence at 43.2, 74.7, and 97.4 hydrothermal degrees, respectively. On average, the model exhibited a root mean square error of 16.81%, ranging between 9.1 % and 32.5 %.[ES] Ridolfia segetum (L.) Moris es una mala hierba originaria de la cuenca mediterránea que causa pérdidas de rendimiento en cultivos de invierno y de verano en el sur de España. Modelizar su emergencia es crucial para desarrollar estrategias de manejo adecuadas. Actualmente, la técnica predominante para predecir la emergencia de malas hierbas son las regresiones paramétricas no lineales pero este enfoque tiene algunas limitaciones estadísticas. El grupo de Biología y Agroecología de las Malas Hierbas (BAMh) llevó a cabo un estudio para describir y predecir el patrón de emergencia de R. segetum mediante una regresión no paramétrica con una distribución gaussiana. Para su desarrollo, se estudió la emergencia en cinco parcelas experimentales en Barcelona, Lleida, Madrid, Sevilla y Zaragoza durante la campaña 2016/17 y se repitió el ensayo en la campaña siguiente en Barcelona, Madrid y Zaragoza. En cada parcela se sembraron 100 semillas procedentes de una finca experimental de Sevilla en cuadriculas de 25 x 25 cm (4 repeticiones). Para el modelo se utilizó una curva acumulada de la densidad de Kernel que relacionó la emergencia con una integral hidrotérmica basada en una ecuación de dos segmentos. Se estableció una temperatura base, óptima y máxima de -1,0 ºC, 8,1 ºC y 26,0 ºC, respectivamente y un potencial hídrico base de -0,6 MPa. Este modelo alcanza el 10 %, 50 % y 90 % de la emergencia acumulada a 43,2, 74,7 y 97,4 grados hidrotérmicos, respectivamente. En promedio, el modelo presentó un RMSE (root mean square error) de 16,81 %, oscilando entre 9,1 % y 32,5 %.Peer reviewe

TOMO-ETNA experiment at Etna volcano: Activities on land

In the present paper we describe the on-land field operations integrated in the TOMO-ETNA experiment carried out in June-November 2014 at Mt. Etna volcano and surrounding areas. This terrestrial campaign consists in the deployment of 90 short-period portable three-component seismic stations, 17 broadband seismometers and the coordination with 133 permanent seismic station belonging to Italy’s Istituto Nazionale di Geofisica e Vulcanologia (INGV). This temporary seismic network recorded active and passive seismic sources. Active seismic sources were generated by an array of air-guns mounted in the Spanish oceanographic vessel “Sarmiento de Gamboa” with a power capacity of up to 5200 cubic inches. In total more than 26,000 shots were fired and more than 450 local and regional earthquakes were recorded. We describe the whole technical procedure followed to guarantee the success of this complex seismic experiment. We started with the description of the location of the potential safety places to deploy the portable network and the products derived from this search (a large document including full characterization of the sites, owners and indication of how to arrive to them). A full technical description of the seismometers and seismic sources is presented. We show how the portable seismic network was deployed, maintained and recovered in different stages. The large international collaboration of this experiment is reflected in the participation of more than 75 researchers, technicians and students from different institutions and countries in the on-land activities. The main objectives of the experiment were achieved with great success.PublishedS04272SR. VULCANI - Servizi e ricerca per la SocietàJCR Journalope