Osteotomías distales de los metatarsianos menores realizadas por cirugía abierta vs cirugía percutánea en el tratamiento de las metatarsalgias.

Objetivo. Comparar los resultados clínicos y radiológicos de las osteotomías distales de los metatarsianos menores realizadas por cirugía abierta y por cirugía percutánea en el tratamiento de las metatarsalgias Material y método. Revisión retrospectiva de 44 metatarsalgias: 22 en cada grupo. Recogida de datos epidemiológicos, clínicos y medición de parámetros radiográficos. Resultados. Se consiguieron modificaciones en los parámetros radiográficos con ambas técnicas, con mayor corrección con la cirugía abierta. Las fórmulas metatarsales postoperatorias continuaron siendo no armónicas en ambos grupos. Todos los pacientes mejoraron clínicamente. La cirugía abierta tuvo más complicaciones. Conclusiones. Los resultados clínicos y radiológicos de las osteotomías percutáneas son similares a los obtenidos por cirugía abierta, pero con menos complicaciones. La obtención de una fórmula metatarsal armónica no debería ser el objetivo principal de la cirugía de las metatarsalgias, ya que, según nuestro estudio, no es una condición indispensable para lograr un buen resultado clínicoObjectives. To compare the radiographic and functional outcomes in lesser metatarsal distal osteotomies performed by percutaneous and open surgery for the treatment of metatarsalgia. Methods. A retrospective medical record review of 44 cases of discharge diagnosis of metatarsalgia: 22 patients in each group. Epidemiological data, clinical data and radiological measurements were collected. Results . Improvement of radiological parameters were obtained with both techniques, with better correction with open than with percutaneous surgery. Postoperatively metatarsal parabola continues being nonharmonious in both groups. All patients improved in clinical assessment. Open surgery had more complications than percutaneous surgery. Conclusions . Clinical and radiological outcomes of lesser metatarsal distal osteotomies performed percutaneously are similar to those obtained by open surgery, but with fewer complications. To obtain a harmonic metatarsal parabola should not be the main purpose of surgery of metatarsalgia because it is not an essential condition to achieve a good clinical outcome

Towards Full Automated Drive in Urban Environments: A Demonstration in GoMentum Station, California

Each year, millions of motor vehicle traffic accidents all over the world cause a large number of fatalities, injuries and significant material loss. Automated Driving (AD) has potential to drastically reduce such accidents. In this work, we focus on the technical challenges that arise from AD in urban environments. We present the overall architecture of an AD system and describe in detail the perception and planning modules. The AD system, built on a modified Acura RLX, was demonstrated in a course in GoMentum Station in California. We demonstrated autonomous handling of 4 scenarios: traffic lights, cross-traffic at intersections, construction zones and pedestrians. The AD vehicle displayed safe behavior and performed consistently in repeated demonstrations with slight variations in conditions. Overall, we completed 44 runs, encompassing 110km of automated driving with only 3 cases where the driver intervened the control of the vehicle, mostly due to error in GPS positioning. Our demonstration showed that robust and consistent behavior in urban scenarios is possible, yet more investigation is necessary for full scale roll-out on public roads.Comment: Accepted to Intelligent Vehicles Conference (IV 2017

Coleccion de cronicas arabes de la Reconquista

T. I : Al-Hulal Al-Mawsiyya : cronica arabe de las dinastias almoravide, almohade y benimerin. - Vol. II : Al-Bayan Al-Mugrib fi ijtisar muluk Al-Andalus wa Al-Magrib = La exposicion sorprendente en el resumen de las noticias de los reyes del Andalus y del Magrib : Los Almohades / Ibn Idari Al-Marrakusi. - Encuadernado con : Vol. III, T. II : Al-Bayan Al-Mugrib fi ijtisar ajbar muluk Al=Andalus wa Al-Magrib = La exposicion sorprendente en el resumen de las noticias de los reyes del Al-Andalus y del Magrib : los Almohades / Ibn Idari Al-Marrakusi. - Vol. IV : Kitab Al-Mugrib fi taljis ajbar Al-Magrib = Lo admirable en el resumen de las noticias del Magrib / Abu Muhammad Abd Al-Wahid Al-Marrakusi4 tomos en 3 v.Indices.Copia digital : Diputación de Málaga. Biblioteca Canovas del Castillo, 201

A Penalty-projection based Efficient and Accurate Stochastic Collocation Method for Magnetohydrodynamic Flows

We propose, analyze, and test a penalty projection-based efficient and accurate algorithm for the Uncertainty Quantification (UQ) of the time-dependent Magnetohydrodynamic (MHD) flow problems in convection-dominated regimes. The algorithm uses the Els\"asser variables formulation and discrete Hodge decomposition to decouple the stochastic MHD system into four sub-problems (at each time-step for each realization) which are much easier to solve than solving the coupled saddle point problems. Each of the sub-problems is designed in a sophisticated way so that at each time-step the system matrix remains the same for all the realizations but with different right-hand-side vectors which allows saving a huge amount of computer memory and computational time. Moreover, the scheme is equipped with ensemble eddy-viscosity and grad-div stabilization terms. The stability of the algorithm is proven rigorously. We prove that the proposed scheme converges to an equivalent non-projection-based coupled MHD scheme for large grad-div stabilization parameter values. We examine how Stochastic Collocation Methods (SCMs) can be combined with the proposed penalty projection UQ algorithm. Finally, a series of numerical experiments are given which verify the predicted convergence rates, show the algorithm's performance on benchmark channel flow over a rectangular step, and a regularized lid-driven cavity problem with high random Reynolds number and magnetic Reynolds number.Comment: 28 pages, 13 figure

Prognostic Impact of Admission Blood Glucose for All-Cause Mortality in Patients with Acute Coronary Syndromes: Added Value on Top of GRACE Risk Score

BACKGROUND: Abnormal glucose metabolism is a predictor of worse outcome after acute coronary syndrome (ACS). However, this parameter is not included in risk prediction scores, including GRACE risk score. We sought to evaluate whether the inclusion of blood glucose at admission in a model with GRACE risk score improves risk stratification. METHODS: Study of consecutive patients included in a single centre registry of ACS. Our primary endpoint was the occurrence of all-cause mortality at one-year follow-up. The ability of the two logistic regression models (GRACE risk score alone and in combination with blood glucose) to predict death was analysed. Continuous net reclassification improvement (NRI) and integrated discrimination improvement (IDI), with corresponding 95% confidence intervals (CIs), were also calculated. RESULTS: We included 2099 patients, with a mean age of 64 (SD=13) years, 69% males. In our sample, 55.1% presented with ST-segment elevation ACS and 13.1% in Killip class ≥ 2. Only 25% were known diabetic at admission. In-hospital mortality was 5.8% and 9.7% at one-year follow-up. The best cut-point for blood glucose was 160 mg/dl (sensitivity 62% and specificity 68%), and 35.2% of the patients had increased levels. This group was elderly, had more prevalence of cardiovascular risk factors, worse renal function and GRACE score as well as more frequently Killip class ≥2. Treatment was similar in both groups besides less frequent use of clopidogrel in high glycaemic patients. The hyperglycaemia group had higher one-year mortality (17.2% vs. 5.6%, p<0.001). Moreover, binary blood glucose remained a predictor of death independently of the GRACE risk score and the presence of diabetes (odds ratio (OR) 1.99, 95% CI 1.40-2.84, p<0.001). The inclusion of blood glucose, as a continuous variable, in a logistic regression model with GRACE score, increased the area under the ROC curve from 0.80 to 0.82 (p=0.018) as well as the goodness-of-fit and was associated with an improvement in both the NRI (37%) and the IDI (0.021), suggesting effective reclassification. CONCLUSIONS: A blood glucose level on admission ≥ 160 mg/dl is an independent predictor of mortality in medium-term follow-up. It offers an incremental predictive value when added to the GRACE risk score, although with a modest magnitude of improvement, probably due to the high predictive performance of the GRACE risk score alone.info:eu-repo/semantics/publishedVersio

Cellular, molecular and functional characterisation of YAC transgenic mouse models of Friedreich Ataxia

Copyright © 2014 Anjomani Virmouni et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.This article has been made available through the Brunel Open Access Publishing Fund.Background - Friedreich ataxia (FRDA) is an autosomal recessive neurodegenerative disorder, caused by a GAA repeat expansion mutation within intron 1 of the FXN gene. We have previously established and performed preliminary characterisation of several human FXN yeast artificial chromosome (YAC) transgenic FRDA mouse models containing GAA repeat expansions, Y47R (9 GAA repeats), YG8R (90 and 190 GAA repeats) and YG22R (190 GAA repeats). Methodology/Principal Findings - We now report extended cellular, molecular and functional characterisation of these FXN YAC transgenic mouse models. FXN transgene copy number analysis of the FRDA mice demonstrated that the YG22R and Y47R lines each have a single copy of the FXN transgene while the YG8R line has two copies. Single integration sites of all transgenes were confirmed by fluorescence in situ hybridisation (FISH) analysis of metaphase and interphase chromosomes. We identified significant functional deficits, together with a degree of glucose intolerance and insulin hypersensitivity, in YG8R and YG22R FRDA mice compared to Y47R and wild-type control mice. We also confirmed increased somatic GAA repeat instability in the cerebellum and brain of YG22R and YG8R mice, together with significantly reduced levels of FXN mRNA and protein in the brain and liver of YG8R and YG22R compared to Y47R. Conclusions/Significance - Together these studies provide a detailed characterisation of our GAA repeat expansion-based YAC transgenic FRDA mouse models that will help investigations of FRDA disease mechanisms and therapy.European Union, Ataxia UK and FARA

FACE GROSSEIRA, HIPOTONIA E REGRESSÃO DO NEURODESENVOLVIMENTO

Inborn errors of metabolism are a heterogeneous class of multisystemic diseases which, although individually rare, are collectively quite common. Central nervous system is usually affected. The authors report the case of a five-month-old girl, daughter of non-consanguineous parents, born after an unremarkable full-term pregnancy and delivery. Hypotonia and neurodevelopmental regression were noted from the age of five months, along with progressive onset of facial dysmorphism, hepatomegaly, seizures, and dilated cardiomyopathy. Gangliosidosis type 1 diagnosis was confirmed by biochemical, enzymatic, and genetic findings. This report enhances the relevance of multidisciplinary approach and follow-up.Os erros hereditários do metabolismo são um grupo de doenças heterogéneas e multissistémicas. Apesar de cada doença individualmente ser rara, no seu conjunto são relativamente comuns. O sistema nervoso central é habitualmente afetado. Os autores apresentam o caso de uma lactente de cinco meses de idade, filha de pais não consanguíneos, nascida de uma gravidez de termo e parto sem intercorrências. Aos cinco meses, iniciou um quadro de hipotonia e regressão do desenvolvimento, apresentando ao longo do tempo dismorfismo facial, hepatomegália, convulsões e cardiomiopatia dilatada. O diagnóstico de Gangliosidose tipo 1 foi confirmado por achados bioquímicos, enzimáticos e genéticos. Este caso clínico reforça a relevância de uma abordagem e seguimento multidisciplinares.info:eu-repo/semantics/publishedVersio

Predictive Impact on Medium-Term Mortality of Hematological Parameters in Acute Coronary Syndromes: Added Value on Top of GRACE Risk Score

BACKGROUND: Red Cell Distribution Width (RDW) prognostic value in patients with Acute Coronary Syndrome (ACS) has been well validated whereas that of Platelet Distribution Width (PDW) is less well known. OBJECTIVES: Investigate the incremental prognostic value, on top of GRACE risk score, of a new variable resulting from the combination of RDW and PDW. METHODS: Consecutive patients with ACS. Complete blood count, with RDW and PDW, was obtained. Primary endpoint was one-year all-cause mortality and Cox regression models were used to measure the influence of RDW and PDW on patients' survival time. A new combination categorical variable (RDW/PDW) was created with both discretized RDW and PDW and logistic regression models were used. Predictive value and discriminative ability of the model with GRACE risk score alone and of the model with inclusion of RDW/PDW was assessed. RESULTS: We included 787 patients. Hospital and one-year mortality rates were 5.1% and 7.8%, respectively. Both continuous RDW and PDW were independent predictors of death. The best cut-off for RDW was 13.9%, and 14.5% for PDW. Inclusion of RDW/PDW in a model with GRACE risk score improved the AUC from 0.81 (95% CI 0.75-0.86) to 0.84 (95% CI 0.79-0.90) (p=0.024) with an improvement in total NRI (56%) and IDI (0.048). CONCLUSIONS: Simple markers such as RDW and PDW can be useful in risk stratification of death after ACS. Combining both markers with GRACE risk score improved the predictive value for all-cause mortality and reduced the estimated risk of those who did not die.info:eu-repo/semantics/publishedVersio

Measurements of heterotypic associations between cluster of differentiation CD74 and CD44 in human breast cancer-derived cells

Interactions between pairs of membrane-bound receptors can enhance tumour development with implications for targeted therapies for cancer. Here we demonstrate clear heterotypic interaction between cluster of differentiation (CD) 74 and CD44, which might act in synergy and hence contribute to breast cancer progression. CD74, a type II transmembrane glycoprotein, is a chaperone for MHC class II biosynthesis and a receptor for the macrophage migration inhibitory factor (MIF). CD44 is the receptor for hyaluronic acid and is a type II transmembrane protein. Interactions between CD74, MIF and the intra-cytoplasmic domain of CD44 result in activation of ERK1/2, leading to increased cell proliferation and decreased apoptosis. The level of CD44 in the breast tumor cell lines CAMA-1, MDA-MB-231, MDA-MB-435 and the immortalized normal luminal cell line 226LDM was higher than that of CD74. It was also observed that CD74 and CD44 exhibit significant variation in expression levels across the cells. CD74 and CD44 were observed to accumulate in cytoplasmic compartments, suggesting they associate with each other to facilitate tumour growth and metastasis. Use of a novel and validated colocalisation and image processing approach, coupled with co-immunoprecipitation, confirmed that CD74 and CD44 physically interact, suggesting a possible role in breast tumour growth. This is the first time that CD74 and CD44 colocalization has been quantified in breast cancer cells using a non-invasive validated bioimaging procedure. Measuring the co-expression levels of CD74 and CD44 could potentially be used as a 'biomarker signature' to monitor different stages of breast cancer