Registro Español de Trasplante Cardiaco. XXXI Informe Oficial de la Asociación de Insuficiencia Cardiaca de la Sociedad Española de Cardiología

Introducción y objetivos Se presentan las características clínicas y los resultados de los trasplantes cardiacos realizados en España con la actualización correspondiente a 2019. Métodos Se describen las características clínicas y los resultados de los trasplantes cardiacos realizados en 2019, así como las tendencias de estos en el periodo 2010-2018. Resultados En 2019 se realizaron 300 trasplantes (8.794 desde 1984; 2.745 entre 2010 y 2019). Respecto a años previos, los cambios más llamativos son el descenso hasta el 38% de los trasplantes realizados en código urgente, y la consolidación en el cambio de asistencia circulatoria pretrasplante, con la práctica desaparición del balón de contrapulsación (0, 7%), la estabilización del uso del oxigenador extracorpóreo de membrana (9, 6%) y el aumento de los dispositivos de asistencia ventricular (29%). La supervivencia en el trienio 2016-2018 es similar a la del trienio 2013-2015 (p = 0, 34), y ambas mejores que la del trienio 2010-2012 (p = 0, 002 y p = 0, 01 respectivamente). Conclusiones Se mantienen estables tanto la actividad del trasplante cardiaco en España como los resultados en supervivencia en los últimos 2 trienios. Hay una tendencia a realizar menos trasplantes urgentes, la mayoría con dispositivos de asistencia ventricular. Introduction and objectives: The present report describes the clinical characteristics and outcomes of heart transplants in Spain and updates the data to 2019. Methods: We describe the clinical characteristics and outcomes of heart transplants performed in Spain in 2019, as well as trends in this procedure from 2010 to 2018. Results: In 2019, 300 transplants were performed (8794 since 1984; 2745 between 2010 and 2019). Compared with previous years, the most notable findings were the decreasing rate of urgent transplants (38%), and the consolidation of the type of circulatory support prior to transplant, with an almost complete disappearance of counterpulsation balloon (0.7%), stabilization in the use of extracorporeal membrane oxygenation (9.6%), and an increase in the use of ventricular assist devices (29.0%). Survival from 2016 to 2018 was similar to that from 2013 to 2015 (P = .34). Survival in both these periods was better than that from 2010 to 2012 (P = .002 and P = .01, respectively). Conclusions: Heart transplant activity has remained stable during the last few years, as have outcomes (in terms of survival). There has been a trend to a lower rate of urgent transplants and to a higher use of ventricular assist devices prior to transplant

Comparación entre la aptitud de las tierras y distribución real de los cultivos en un distrito de riego del valle del Ebro (España)

The present research aims to obtain a better insight into the agreement between land evaluation results and actual crop spatial distribution by comparing biophysical land suitability with different crop frequency parameters and with crop rotations derived from multi-year crop maps. The research was carried out in the Flumen district (33,000 ha), which is located in the Ebro Valley (Northeast Spain). Land evaluation was based on a 1:100,000 soil survey according to the FAO framework for the main crops in the study area (alfalfa, winter cereals, maize, rice and sunflower). Three crop frequency maps and a crop rotation map, derived from a time-series of Landsat TM and ETM+ images of the period 1993-2000 were used for comparison with land suitability maps. The relationships between the two types of variables were analyzed by means of statistical tests (Pearson chi-square (chi2), Cramer's V, Gamma and Somers' D). The results show the existence of a significant (P=0.001) relationship between crops' location and land suitability, except for opportunist crops as sunflower, which is very much influenced by subsidies in the study period. The alfalfa-based rotations show the highest distribution percentages (52%) on the land most suitable for agriculture in the area. The present multitemporal analysis approach offers a more realistic insight than the comparison between a land evaluation map and static year crop map in assessing the degree of agreement of land evaluation recommendations with crops actually cultivated by farmers.El objetivo de la presente investigación fue analizar la correspondencia entre los resultados de una evaluación de tierras con la distribución real de los cultivos. Para ello la aptitud biofísica de las tierras se comparó con diferentes tipologías de frecuencia de ocurrencia de los cultivos y rotaciones derivadas de mapas de cultivos multitemporales. La investigación fue llevada a cabo en el distrito de riego de Flumen (33.000 ha), localizado en el valle del Ebro (NE España). La evaluación de tierras se basó en una cartografía de suelos 1:100.000, según el esquema FAO, para los principales cultivos presentes en el área de estudio (alfalfa, cereales de invierno, maíz, arroz y girasol). Se utilizaron tres mapas de frecuencia de cultivos y un mapa de rotaciones, derivado de una serie temporal de imágenes Landsat TM y ETM+ del periodo 1993-2000, y se compararon con los mapas de aptitud de tierras para los diferentes cultivos. Se analizó estadísticamente (Pearson chi al cuadrado, Cramer V, Gamma y Somers D) la relación entre los dos tipos de variables. Los resultados muestran la existencia de una relación significativa (P=0,001) entre la localización de los cultivos y la idoneidad de las tierras, excepto de cultivos oportunistas como el girasol, muy influenciado por las subvenciones en el periodo estudiado. Las rotaciones basadas en la alfalfa muestran los mayores porcentajes (52%) de ocupación en las tierras más aptas para la agricultura en el área de estudio. El presente enfoque multitemporal de análisis de la información ofrece una visión más real que la comparación entre un mapa de evaluación de tierras y un mapa de cultivos de una fecha determinada, cuando se valora el grado de acuerdo entre las recomendaciones sobre la aptitud de las tierras y los cultivos realmente cultivados por los agricultores

Revisión. Viticultura de precisión. Líneas de investigación, retos y oportunidades del manejo sitio-específico en viña

Precision Viticulture (PV) is a concept that is beginning to have an impact on the wine-growing sector. Its practical implementation is dependant on various technological developments: crop sensors and yield monitors, local and remote sensors, Global Positioning Systems (GPS), VRA (Variable-Rate Application) equipment and machinery, Geographic Information Systems (GIS) and systems for data analysis and interpretation. This paper reviews a number of research lines related to PV. These areas of research have focused on four very specific fields: 1) quantification and evaluation of within-field variability, 2) delineation of zones of differential treatment at parcel level, based on the analysis and interpretation of this variability, 3) development of Variable-Rate Technologies (VRT) and, finally, 4) evaluation of the opportunities for site-specific vineyard management. Research in these fields should allow winegrowers and enologists to know and understand why yield variability exists within the same parcel, what the causes of this variability are, how the yield and its quality are interrelated and, if spatial variability exists, whether site-specific vineyard management is justifiable on a technical and economic basis.La Viticultura de Precisión (VP) es un concepto que empieza a tener un cierto impacto en el sector vitivinícola. Su implementación práctica está ligada al desarrollo de cierta tecnología: sensores y monitores de cosecha, sensores locales y remotos, Sistemas de Posicionamiento Global (SPG), equipos y maquinaria de aplicación variable, Sistemas de Información Geográfica (SIG) y sistemas para el análisis y la interpretación de la información. En este trabajo se ha llevado a cabo una revisión de las diferentes líneas de investigación relacionadas con la VP. Dichas áreas de investigación se han centrado en cuatro ámbitos muy concretos: 1) cuantificación y evaluación de la variabilidad intraparcelaria, 2) delimitación a nivel de parcela de zonas de tratamiento diferencial, en base al análisis y la interpretación de dicha variabilidad, 3) desarrollo de tecnologías para la actuación variable en campo (variable-rate technologies, VRT) y, finalmente, 4) evaluación de la oportunidad del manejo sitio-específico en viticultura. La investigación en estos ámbitos debe permitir a viticultores y enólogos conocer y comprender por qué la cosecha varía dentro de una misma parcela, cúales son las causas de dicha variación, cómo están interrelacionadas la cosecha y su calidad y, ante la existencia de variabilidad espacial, si está justificado técnica y económicamente el manejo diferencial de los viñedos

Effects of precipitation patterns and temperature trends on soil water available for vineyards in a Mediterranean climate area

The objective of this paper is to analyse the impact of temperature increases and irregular rainfall distribution, associated with climate change, on water availability for rainfed vineyards cultivated in a Mediterranean climate area. The study includes the analysis of the interrelations between precipitation distribution, temperature, evapotranspiration and runoff rates, and the resulting water storage in vineyards soils of the Penedès region (NE Spain). A hierarchical cluster analysis was applied to classify the years according to water availability. The influence of water stored into the soil on yield for some one of the main vine varieties cultivated in the area is analysed. A vineyard, representative of the land management practices in this area, was selected for soil moisture monitoring and runoff evaluations, as well as for grape yield, which was compared with yields recorded in other plots. According to rainfall distribution and water availability, the 12 analysed years represent five different situations: wet years with positive and negative water balance; dry years; years with average annual rainfall but irregularly distributed throughout the year leading to a negative water balance; and extreme situations. Significant water deficits were observed in years in which total rainfall amount was above the annual average in the area, being similar to those observed in dry years: in 8 of the 12 analysed years deficits higher than 100 mm (up to 309 mm) during the growing period (budbreak-harvest) were recorded. At annual scale, 42% of the analysed years recorded deficits ranging between 27.7 and 191.4 mm. In the driest years, and those with more irregular rainfall distribution, soil moisture contents below the wilting point were reached. The high intensity rainfalls, producing important runoff losses (in many cases out of the periods in which crop water needs are higher), together with the increasing temperature trends, which give rise to significant evapotranspiration increases (values up to 32% higher than the average were recorded during the study period), are the main responsible factors for the water deficits recorded during grape development. Winegrape yield was influenced by the water stored into the soil, bloom-veraison or during budbreak-bloom depending on the variety.Climate change Evapotranspiration Rainfall intensity Runoff Soil moisture Soil water balance Vitis vinifera

Assessing ranked set sampling and ancillary data to improve fruit load estimates in peach orchards

International audienceFruit load estimation at plot level before harvest is a key issue in fruit growing. To face this challenge, two sampling methods to estimate fruit load in a peach tree orchard were compared: simple random sampling (SRS) and ranked set sampling (RSS). The study was carried out in a peach orchard (Prunus persica cv. 'Platycarpa') covering a total area of 2.24 ha. Having previously sampled the plot systematically to cover the entire area (104 individual trees or sampling points), both sampling methods (SRS and RSS) were tested by taking samples from this population with varying sample sizes from N = 4 to N = 12. Since RSS requires ancillary information to obtain the samples (ranking mechanism), several proximal and remote sensors already used or recently introduced in agriculture were assessed as data sources. A total of 14 variables provided by 5 different sensors and platforms were considered as potential ancillary variables. Among them, RGB images captured by an unmanned aerial vehicle (UAV), and used to estimate the canopy projected area of individual trees, proved to be the best of the options. This was shown by the high correlation (R = 0.85) between this area and the fruit load, providing RSS with the UAV-based canopy projected area the lowest Coefficient of Error (CE) for a given tree sample size. Then, comparing relative efficiency between random sampling (SRS) and RSS, the latter enables more precise fruit load estimates for any of the considered sample sizes. Interest and opportunity of RSS can be raised from two points of view. In terms of confidence, RSS managed to reduce the variance of fruit load estimates by about half compared to SRS. Sampling errors above the 10% threshold were always produced significantly fewer times using RSS, regardless of the sample size. In terms of operation within the plot, sample size could be reduced by 50%, from N = 10 for SRS to N = 5 for RSS, and this being expected sampling errors less than 10% in practically 70% of the samplings performed in both cases. In summary, fruit growers can take advantage of the combined use of appropriate data (RGB images from UAV) and RSS to optimize sample sizes and operational sampling costs in fruit growing

What is the infection risk of oesophageal dilatations?

Oesophageal dilatation is the most widely used treatment option for the management of oesophageal strictures. Complications include bleeding, a slight increase in body temperature, thoracic or abdominal pain, oesophageal perforation, brain abscess and bacteraemia. We performed a prospective study to evaluate the frequency of postdilatation bacteraemia in nine patients subjected to a total of 50 dilatations. Bacteraemia was detected in 36 cases (72%). In all but three cases, however, it was transient and not associated with fever or other clinical complications. The organisms most commonly responsible (64%) were alpha-haemolytic streptococci (Streptococcus viridans), probably originating as contaminants from the oropharynx and oesophagus and introduced into the bloodstream during dilatation. Despite the relatively low incidence of bacteraemia-related postdilatation complications, the potential severity of such complications argues for the use of antibiotic prophylaxis as a routine measure prior to oesophageal dilatation. Conclusion. Oesophageal dilatation is associated with a high incidence of bacteraemia. The organisms most commonly responsible were alpha-haemolytic streptococci. We recommend the use of antibiotic prophylaxis as a routine measure prior to oesophageal dilatation.SCOPUS: ar.jinfo:eu-repo/semantics/publishe