Enfermedad meningocócica e impacto de la vacunación sistemática con la vacuna conjugada antimeningocócica C en el área sanitaria de Andalucía

comenzó en julio de 2000 la vacunación con vacuna conjugada antimeningocócica C de todos los niños nacidos con posterioridad al 1 de enero de 1995, y en septiembre de 2001 se amplíó a los nacidos a partir del 1 de enero de 1991, esto es, hasta los 10 años de edad. El objetivo de este trabajo es valorar la efectividad de esta vacuna tras su introducción masiva en los niños del área geográfica de un distrito sanitario, midiendo su impacto. Métodos: Mediante un estudio longitudinal retrospectivo de incidencia poblacional se calculan las coberturas vacunales de los niños nacidos entre los años 1991 y 2001 y las tasas de incidencia de los casos declarados de enfermedad meningocócica en siete temporadas epidemiológicas (1997/98 a 2003/04). El impacto de la vacunación frente a la meningitis del serogrupo C se calcula comparando las tasas promedios anuales de las temporadas previas y posteriores a las campañas de vacunación en la población menor y mayor de 10 años, utilizando el test exacto de Fisher. Resultados: En el periodo de estudio se declararon 109 casos de enfermedad meningocócica, de los que 50 eran de meningitis C. A partir de la temporada 2000-2001 descendió la incidencia de meningitis C en los niños menores de 10 años. En este grupo de edad se encuentran diferencias significativas entre las tasas promedio anual de las temporadas prevacunales y postvacunales (de 8,2 a 2,0 por 100.000 habitantes). En la población mayor de 10 años no se observa este descenso en la incidencia. En el periodo de estudio no se ha declarado ningún caso de fallo vacunal. Conclusiones: La ausencia de fallos vacunales y la disminución de la incidencia de enfermedad meningocócica C en los niños menores de 10 años sugiere la buena efectividad de esta nueva vacuna conjugada frente al meningococo

Catalunya: difícil quedarse, difícil irse

Un texto colectivo que muestra la complejidad y las paradojas del caso Catalunya, un intento de independencia con muchas aristas y que, por sus alcances, trasciende al reino de España.ITESO, A.C

Effect of Diclofenac with B Vitamins on the Treatment of Acute Pain Originated by Lower-Limb Fracture and Surgery

The aim of this study was to compare the efficacy of diclofenac, for the treatment of acute pain originated by lower-limb fracture and surgery, with that of diclofenac plus B vitamins. This was a single-center, prospective, randomized, and double-blinded clinical trial. Patients with lower-limb closed fractures rated their pain on a 10 cm visual analog scale (VAS). Patients were then randomized to receive diclofenac or diclofenac plus B vitamins (thiamine, pyridoxine, and cyanocobalamin) intramuscularly twice daily. Patient evaluations of pain intensity were recorded throughout two periods: twenty-four hours presurgery and twenty-four hours postsurgical. One hundred twenty-two patients completed the study. The subjects' assessments of limb pain on the VAS showed a significant reduction from baseline values regardless of the treatment group. Diclofenac plus B vitamins combination was more effective to reduce the pain than diclofenac alone. The results showed that the addition of B vitamins to diclofenac increased its analgesic effect. The novelty of this paper consists in that diclofenac and diclofenac plus B vitamins were useful for treatment of acute pain originated by lower-limb fracture and surgery

Understanding the High Ionic Conductivity in Nanostructured Ytterbium Stabilized Zirconia Thin Films

Recently, high ionic conduction has been reported in nanostructured materials. This increase in conductivity can be important in technological applications, including micro-Solid Oxide Fuel Cells, so the understanding of this phenomenon is essential. In this work, XRD, Raman spectroscopy, SEM, EDS maps, and UV-Visible spectroscopy measurements are used to have an insight into the relationship between structural and electrical properties in nanostructured ytterbium stabilized zirconia (YbSZ) thin films prepared by ultrasonic spray pyrolysis. Raman measurements allowed the identification of a mixture of tetragonal and cubic phases at 4% of Yb doping, which cannot be detected by XRD, while the compositional maps suggest that Yb can be located preferentially in the grain boundaries. Changes in the activation energy values in bulk and grain boundaries are related to the small grain sizes (≤10 nm). UV measurements support the ionic nature of the charge transport. These results indicate that the high conductivity is a consequence of different physical parameters in the films such as stress in the materials, different crystalline phases, impurities diffusion to the grain boundaries, and the presence or absence of electronic conduction. A model that explains the increase of conductivity in nanostructured materials must include all these aspects

A novel HPV 16 L1-based chimeric virus-like particle containing E6 and E7 seroreactive epitopes permits highly specific detection of antibodies in patients with CIN 1 and HPV-16 infection

<p>Abstract</p> <p>Background</p> <p>The presence of IgG antibodies to HPV-16 L1-virus like particles (VLPs) in serum has been reported as a result of persistent exposure to the virus and as a marker of disease progression. However, detection of VLP-specific antibodies in sera does not always indicate a malignant lesion as positive results may also be due to a nonmalignant viral infection. Furthermore, malignant lesions are associated with an increased antibody titer for E6 and E7 proteins. The aim of this study was to develop an ELISA using a novel chimeric virus-like particle (cVLP) encoding an L1 protein fused with a string of HPV-16 E6 and E7 seroreactive epitopes to its C-terminus to be used for detection of HPV-16 specific antibodies in patients with cervical intraepithelial lesion grade 1 (CIN 1).</p> <p>Results</p> <p>The sera of 30 patients with CIN 1 who also tested positive for HPV-16 DNA and of 30 age-matched normal donors negative for HPV infection were tested for the presence of IgG antibodies specific for either VLP-L1 (HPV-16 L1), gVLP (derived from Gardasil), or cVLP by ELISA. The cVLP-reactive sera yielded two distinct groups of results: (H) reactivity levels that presented very strong cVLP-specific titers, and (L) reactivity levels with significantly lower titers similar to those obtained with VLP-L1 and gVLP antigens. Additionally, the sera that presented the higher cVLP titers closely matched those that had significantly stronger reactivity to E6 and E7 epitopes. Interestingly, the samples with the highest titers corresponded to patients with the higher numbers of sexual partners and pregnancies. On the other hand only 4 out of the 12 sera that harbored antibodies with VLP neutralizing ability corresponded to the group with high cVLP antibody titers.</p> <p>Conclusion</p> <p>We report for the first time that chimeric particles containing HPV-16 L1 protein fused with E6 and E7 seroreactive epitopes enable much better detection of IgG antibodies in the sera of CIN 1 patients positive for HPV-16 infection than those obtained with VLPs containing only the HPV-16 L1 protein. We also found that the sera with higher cVLP antibody titers corresponded to patients with more sexual partners and pregnancies, and not always with to those with a high neutralizing activity. This novel assay could help in the development of a tool to evaluate cervical cancer risk.</p

InN/GaN heterojunction electrical behavior

Indium nitride (InN) has been the subject of intense research in recent years. Some of its most attractive features are its excellent transport properties such as its small band edge electron effective mass, high electron mobilities and peak drift velocities, and high frequency transient drift velocity oscillations [1]. These suggest enormous potential applications for InN in high frequency electronic devices. But to date the high unintentional bulk electron concentration (n~1018 cm-3) of undoped InN samples and the surface electron accumulation layer make it a hard task to create a reliable metalsemiconductor Schottky barrier. Some attempts have been made to overcome this problem by means of material oxidation [2] or deposition of insulators [3]. In this work we present a way to obtain an electrical rectification behaviour by means of heterojunction growth. Due to the big band gap differences among nitride semiconductors, it’s possible to create a structure with high band offsets. In InN/GaN heterojunctions, depending on the GaN doping, the magnitude of conduction and valence band offset are critical parameters which allow distinguishing among different electrical behaviours. The earliest estimate of the valence band offset at an InN–GaN heterojunction in a wurtzite structure was measured to be ~0.85 eV [4], while the Schottky barrier heights were determined to be ~ 1,4 eV [5].We grew In-face InN layer with varying thickness (between 150 nm and 1 mm) by plasma assisted molecular beam epitaxy (PA-MBE) on GaNntemplates (GaN/Al2O3), with temperatures ranging between 300°C and 450°C. The different doping in GaN template (Si doping, Fe doping and Mg doping) results in differences in band alignments of the two semiconductors changing electrical barriers for carriers and consequently electrical conduction behaviour. The processing of the devices includes metallization of the ohmic contacts on InN and GaN, for which we used Ti/Al/Ni/Au. Whereas an ohmic contact on InN is straightforward, the main issue was the fabrication of the contact on GaN due to the very low decomposition temperature of InN. A standard ohmic contact on GaN is generally obtained by high temperature rapid thermal annealing (RTA), typically done between 500ºC and 900ºC[6]. In this case, the limitation due to the presence of In-face InN imposes an upper limit on the temperature for the thermal annealing process and ohmic contact formation of about 450°C. We will present results on the morphology of the InN layers by X-Ray diffraction and SEM, and electrical measurements, in particular current-voltage and capacitance-voltage characteristics

1ª Competencia Nacional de Vivienda Sustentable Resistente a Fenómenos Naturales para estudiantes de arquitectura 2019 (proyecto 8|8)

Este proyecto intenta dar una solución efectiva a un problema bastante serio, tomamos como caso de aplicación el 1er Concurso Nacional de Vivienda Social Sustentable y Resiliente a Fenómenos Naturales para generar una hipótesis localizada en Manzanillo, Colima que plantea cuestionarnos sobre un problema a escala nacional, la demanda creciente de vivienda social y la falta de fundamentos críticos alrededor de la oferta actual. El proyecto se diseñó para que fuera una propuesta competente ante los problemas sociales, ambientales y culturales de una región. La ubicación geográfica en que se encuentra la comunidad de Valle de Las Garzas, es propensa al acecho de huracanes y tormentas tropicales, estas tormentas afectan de forma constante y agresiva a la comunidad creando inundaciones, pérdidas materiales y viviendas enteras Por esto mismo es que surge el interés por dar una solución factible para que la vivienda se convierta en un agente de cambio, no solo a la comunidad sino que de soporte a esta devastación natural, en pocas palabras, crear una vivienda consiente a su entorno. Al analizar la problemática nos damos cuenta que aparte de dar solución a la forma en la que se desarrolla la construcción actualmente, también tenemos que respetar y dar mucha importancia a la vida de la comunidad. No nos referimos a esto como una segunda problemática o algo que también se tiene que resolver, es algo que influye de gran manera en la forma en la que se resuelve el proyecto pues es consciente de su impacto social. Estamos considerando a la entidad de Valle de las Garzas como un barrio en desarrollo en uno de los principales puertos del país, esto genera el suficiente interés para desarrollar proyectos de multivivienda social, pretendemos abordar la crisis ecológica aunado a la demanda de vivienda desde una perspectiva contemporánea, generando modelos de ciudad compacta, con una densidad suficiente para el abasto de su población y que a la vez sea una comunidad habitacional bien conectada con el resto de la ciudad y los servicios. Interesados en el espacio público y colectivo y en el desarrollo de tecnologías para la construcción nace el proyecto 8 I 8

The molecular basis and biologic significance of the β-dystroglycan-emerin interaction

β-dystroglycan (β-DG) assembles with lamins A/C and B1 and emerin at the nuclear envelope (NE) to maintain proper nuclear architecture and function. To provide insight into the nuclear function of β-DG, we characterized the interaction between β-DG and emerin at the molecular level. Emerin is a major NE protein that regulates multiple nuclear processes and whose deficiency results in Emery–Dreifuss muscular dystrophy (EDMD). Using truncated variants of β-DG and emerin, via a series of in vitro and in vivo binding experiments and a tailored computational analysis, we determined that the β-DG–emerin interaction is mediated at least in part by their respective transmembrane domains (TM). Using surface plasmon resonance assays we showed that emerin binds to β-DG with high affinity (KD in the nanomolar range). Remarkably, the analysis of cells in which DG was knocked out demonstrated that loss of β-DG resulted in a decreased emerin stability and impairment of emerin-mediated processes. β-DG and emerin are reciprocally required for their optimal targeting within the NE, as shown by immunofluorescence, western blotting and immunoprecipitation assays using emerin variants with mutations in the TM domain and B-lymphocytes of a patient with EDMD. In summary, we demonstrated that β-DG plays a role as an emerin interacting partner modulating its stability and function

Ocular related emergencies in Spain during the COVID-19 pandemic, a multicenter study

Purpose: To evaluate ophthalmological emergencies (OE) during the COVID-19 pandemic comparing them with the same period of the previous year. Methods: Retrospective observational study of all OE visits in four tertiary hospitals in Spain comparing data from March 16th to April 30th, 2020 (COVID-19 period) and the same period of 2019 (pre-COVID-19 period). Severity of the conditions was assessed following Channa et al. publication. Data on demographics, diagnosis and treatments were collected from Electronic Medical Records. Results: During lockdown, OE significantly declined by 75.18%, from 7, 730 registered in the pre-COVID-19 period to 1, 928 attended during the COVID-19 period (p < 0.001). In 2019, 23.86% of visits were classified as emergent, 59.50% as non-emergent, and 16.65% could not be determined. In 2020, the percentage of emergent visits increased up to 29.77%, non-emergent visits significantly decreased to 52.92% (p < 0.001), and 17.31% of the visits were classified as “could not determine”. During the pandemic, people aged between 45 and 65 years old represented the largest attending group (37.89%), compared to 2019, where patients over 65 years were the majority (39.80%). In 2019, most frequent diagnosis was unspecified acute conjunctivitis (11.59%), followed by vitreous degeneration (6.47%), and punctate keratitis (5.86%). During the COVID-19 period, vitreous degeneration was the first cause for consultation (9.28%), followed by unspecified acute conjunctivitis (5.63%) and punctate keratitis (5.85%). Conclusions: OE visits dropped significantly during the pandemic in Spain (75.18%), although more than half were classified as non-urgent conditions, indicating a lack of understanding of the really emergent ocular pathologies among population. © 2021, The Author(s)

Familial hypercholesterolaemia: A study of 36 cases with a phenotype of homozygous familiar hypercholesterolaemia

La hipercolesterolemia familiar homocigótica (HFHo) se caracteriza por niveles muy elevados de cLDL y por enfermedad aterosclerótica temprana. Aunque la frecuencia es baja (1/300.000), las complicaciones son muy severas y pueden ser evitadas. Encontrar y tratar esta población de manera temprana podría reducir la mortalidad. Se describen 36 casos en Colombia, en donde se calcula que haya entre 160 y 200 casos. Resultados Un total de 36 pacientes con fenotipo sugestivo de HFHo fueron identificados y tratados en un período de observación de cuatro años. La media de edad fue 27 años (24 mujeres). 34 pacientes tuvieron un puntaje según la Red de Clínicas de Lípidos de Holanda (RCLH) mayor de 8 (diagnóstico definitivo) y los restantes 2 tenían puntaje equivalente a diagnóstico probable. Un cuarto de los casos procedían de la costa norte colombiana. En las pruebas genéticas, 14 fueron homocigóticos verdaderos para mutación del gen que codifica para el receptor de LDL (LDLR), 12 heterocigóticos compuestos, 2 heterocigóticos dobles y uno autosómico recesivo (LDLRAP1); 5 pacientes fueron heterocigóticos simples (LDLR) y 2 pacientes no autorizaron la prueba. En los homocigóticos verdaderos, la variante más frecuente encontrada fue la c.11G>A. 14 pacientes cursaron con enfermedad coronaria, 9 con estenosis carotídea, 8 con estenosis aórtica y 2 tuvieron ataques cerebrovasculares (ACV). 34 pacientes recibían estatinas (24 rosuvastatina), 30 recibían ezetimibe, 2 recibían evolocumab y 20 recibían lomitapide (dosis promedio 12,7mg). Ninguno recibió aféresis de cLDL. Los medicamentos, en general, fueron bien tolerados y la reducción promedio de cLDL con la terapia fue de 533,7mg/dl a 245,1mg/dl (54%). Conclusiones Todos los pacientes recibieron tratamiento hipolipemiante y se encontraron alteraciones genéticas diagnósticas en todos aquellos que autorizaron el examen. Los niveles elevados de cLDL conllevan tanto riesgo que el tratamiento debe establecerse aún sin conocer el diagnóstico genético.Homozygous familial hypercholesterolemia (HoFH) is characterized for very high levels of cLDL and early cardiovascular disease. Although incidence is low (1/300 000), complications are very severe and can be avoided. Finding and treating this population promptly could reduce mortality. We describe 36 cases in Colombia, where 160 to 200 cases are expected. Results 36 patients with phenotype of HoHF were identified and treated in a follow-up of 4 years. The mean age was 27 years (24 women). 34 of them had at least 8 points in the FH Dutch Lipid Clinic Criteria (definitive diagnosis) and two had probable diagnosis. A quarter of the cases came from the Colombian North Coast. In molecular tests, 14 were true homozygous for LDLR, 12 were compound heterozygous for LDLR, 2 double heterozygous and one was autosomal recessive; 5 were heterozygous and 2 patients did not authorized genetic test. In true homozygous subjects, the most frequent variant was c.11G>A. 14 patients had coronary disease, 9 carotid stenosis, 8 aortic stenosis and 2 had stroke. 34 patients were on statins (25 rosuvastatin), 30 were receiving ezetimibe, 2 were receiving a PSCK9 inhibitor (evolocumab) and 20 were on lomitapide with mean doses of 12.7mg. None received lipoprotein apheresis. Medications were very well tolerated. Changes in cLDL after therapy was from 533.7 mg/dL to 245 mg/dL, (54%). Conclusions Treatment was started in all patients. We found genetic mutations in all patients with genetic tests. The high levels of cLDL mean such a high risk that treatment must be started promptly, even without a genetic test