2,361 research outputs found

    Guía de actuación en las anomalías de la diferenciación sexual (ADS) / desarrollo sexual diferente (DSD)

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    Las anomalías de la diferenciación sexual (ADS) engloban un amplio espectro de discordancias entre los criterios cromosómico, gonadal y fenotípico (genital) que definen la diferenciación sexual; actualmente, se aboga por la denominación de «desarrollo sexual diferente» (DSD). Su origen es congénito; se clasifican en función de los cromosomas sexuales presentes en el cariotipo; las causas genéticas conocidas son muy diversas y heterogéneas, aunque algunos casos pueden ser secundarios a factores maternos o medioambientales. Su diagnóstico y tratamiento requieren siempre una atención médica y psicosocial multidisciplinar. El diagnóstico etiológico precisa la interacción entre las exploraciones clínicas, bioquímicas (hormonales), genéticas, de imagen y, eventualmente, quirúrgicas. El tratamiento debe abordar la asignación de género, la posible necesidad de tratamiento hormonal substitutivo (suprarrenal si hay insuficiencia suprarrenal y con esteroides sexuales si hay insuficiencia gonadal a partir de la edad puberal), la necesidad de intervenciones quirúrgicas sobre las estructuras genitales (actualmente se tiende a diferirlas) y/o sobre las gónadas (en función de los riesgos de malignización), la necesidad de apoyo psicosocial y, finalmente, una adecuada programación de la transición a la atención médica en las especialidades de adultos. Las asociaciones de personas afectadas tienen un papel fundamental en el apoyo a familias y la interacción con los medios profesionales y sociales. La utilización de Registros y la colaboración entre profesionales en Grupos de Trabajo de sociedades médicas nacionales e internacionales es fundamental para avanzar en mejorar los medios diagnósticos y terapéuticos que precisan los DSD.Disorders of Sex Development (DSD) include a wide range of anomalies among the chromosomal, gonadal, and phenotypic (genital) characteristics that define sexual differentiation. At present, a definition as Different Sexual Development (DSD) is currently preferred. They originate in the pre-natal stage, are classified according to the sex chromosomes present in the karyotype. The known genetic causes are numerous and heterogeneous, although, in some cases, they may be secondary to maternal factors and/or exposure to endocrine-disrupting chemicals (EDCs). The diagnosis and treatment of DSD always requires multidisciplinary medical and psychosocial care. An aetiological diagnosis needs the interaction of clinical, biochemical (hormonal), genetic, imaging and, sometimes, surgical examinations. The treatment should deal with sex assignment, the possible need for hormone replacement therapy (adrenal if adrenal function is impaired, and with sex steroids from pubertal age if gonadal function is impaired), as well as the need for surgery on genital structures (currently deferred when possible) and/or on gonads (depending on the risk of malignancy), the need of psychosocial support and, finally, an adequate organisation of the transition to adult medical specialties. Patient Support Groups have a fundamental role in the support of families, as well as the interaction with professional and social media. The use of Registries and the collaboration between professionals in Working Groups of national and international medical societies are crucial for improving the diagnostic and therapeutic tools required for the care of patients with DSD

    Constraints on the χ_(c1) versus χ_(c2) polarizations in proton-proton collisions at √s = 8 TeV

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    The polarizations of promptly produced χ_(c1) and χ_(c2) mesons are studied using data collected by the CMS experiment at the LHC, in proton-proton collisions at √s=8  TeV. The χ_c states are reconstructed via their radiative decays χ_c → J/ψγ, with the photons being measured through conversions to e⁺e⁻, which allows the two states to be well resolved. The polarizations are measured in the helicity frame, through the analysis of the χ_(c2) to χ_(c1) yield ratio as a function of the polar or azimuthal angle of the positive muon emitted in the J/ψ → μ⁺μ⁻ decay, in three bins of J/ψ transverse momentum. While no differences are seen between the two states in terms of azimuthal decay angle distributions, they are observed to have significantly different polar anisotropies. The measurement favors a scenario where at least one of the two states is strongly polarized along the helicity quantization axis, in agreement with nonrelativistic quantum chromodynamics predictions. This is the first measurement of significantly polarized quarkonia produced at high transverse momentum

    Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

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    BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

    Enfermedades crónicas

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    Adherencia al tratamiento farmacológico y relación con el control metabólico en pacientes con DM2Aluminio en pacientes con terapia de reemplazo renal crónico con hemodiálisis en Bogotá, ColombiaAmputación de extremidades inferiores: ¿están aumentando las tasas?Consumo de edulcorantes artificiales en jóvenes universitariosCómo crecen niños normales de 2 años que son sobrepeso a los 7 añosDiagnóstico con enfoque territorial de salud cardiovascular en la Región MetropolitanaEfecto a corto plazo de una intervención con ejercicio físico, en niños con sobrepesoEfectos de la cirugía bariátrica en pacientes con síndrome metabólico e IMC < 35 KG/M2Encuesta mundial de tabaquismo en estudiantes de profesiones de saludEnfermedades crónicas no transmisibles: Consecuencias sociales-sanitarias de comunidades rurales en ChileEpidemiología de las muertes hospitalarias por patologías relacionadas a muerte encefálica, Chile 2003-2007Estado nutricional y conductas alimentarias en adolescentes de 4º medio de la Región de CoquimboEstudio de calidad de vida en una muestra del plan piloto para hepatitis CEvaluación del proceso asistencial y de resultados de salud del GES de diabetes mellitus 2Factores de riesgo cardiovascular en población universitaria de la Facsal, universidad de TarapacáImplicancias psicosociales en la génesis, evolución y tratamiento de pacientes con hipertensión arterial esencialInfarto agudo al miocardio (IAM): Realidad en el Hospital de Puerto Natales, 2009-2010Introducción de nuevas TIC y mejoría de la asistencia a un programa de saludNiños obesos atendidos en el Cesfam de Puerto Natales y su entorno familiarPerfil de la mortalidad por cáncer de cuello uterino en Río de JaneiroPerfil del paciente primo-consultante del Programa de Salud Cardiovascular, Consultorio Cordillera Andina, Los AndesPrevalencia de automedicación en mujeres beneficiarias del Hospital Comunitario de Til-TiPrevalencia de caries en población preescolar y su relación con malnutrición por excesoPrevalencia de retinopatía diabética en comunas dependientes del Servicio de Salud Metropolitano Occidente (SSMOC)Problemas de adherencia farmacológica antihipertensiva en población mapuche: Un estudio cualitativoRol biológico de los antioxidantes innatos en pacientes portadores de VIH/SidaSobrepeso en empleados de un restaurante de una universidad pública del estado de São Paul

    Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)

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    Search for dijet resonances using events with three jets in proton-proton collisions at root s=13 TeV

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    A search for a narrow resonance with a mass between 350 and 700 GeV, and decaying into a pair of jets, is performed using proton-proton collision events containing at least three jets. The data sample corresponds to an integrated luminosity of 18.3 fb(-1) recorded at root s = 13 TeV with the CMS detector. Data are collected with a technique known as "data scouting", in which the events are reconstructed, selected, and recorded at a high rate in a compact form by the high-level trigger. The three-jet final state provides sensitivity to lower resonance masses than in previous searches using the data scouting technique. The spectrum of the dijet invariant mass, calculated from the two jets with the largest transverse momenta in the event, is used to search for a resonance. No significant excess over a smoothly falling background is found. Limits at 95% confidence level are set on the production cross section of a narrow dijet resonance and compared with the cross section of a vector dark matter mediator coupling to dark matter particles and quarks. Translating to a model where the narrow resonance interacts only with quarks, upper limits on this coupling range between 0.10 and 0.15, depending on the resonance mass. These results represent the most stringent upper limits in the mass range between 350 and 450 GeV obtained with a flavor-inclusive dijet resonance search. (C) 2020 The Author(s). Published by Elsevier B.V.Peer reviewe

    A measurement of the Higgs boson mass in the diphoton decay channel

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    A measurement of the mass of the Higgs boson in the diphoton decay channel is presented. This analysis is based on 35.9 fb(-1) of proton-proton collision data collected during the 2016 LHC running period, with the CMS detector at a centre-of-mass energy of 13 TeV. A refined detector calibration and new analysis techniques have been used to improve the precision of this measurement. The Higgs boson mass is measured to be m(H) = 125.78 +/- 0.26GeV. This is combined with a measurement of m(H) already performed in the H -> ZZ -> 4l decay channel using the same data set, giving m(H) = 125.46 +/- 0.16GeV. This result, when further combined with an earlier measurement of m(H) using data collected in 2011 and 2012 with the CMS detector, gives a value for the Higgs boson mass of m(H) = 125.38 +/- 0.14GeV. This is currently the most precise measurement of the mass of the Higgs boson. (C) 2020 The Author(s). Published by Elsevier B.V.Peer reviewe

    Measurement of the cross section for tt production with additional jets and b jets in pp collisions at √s = 13 TeV

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    Measurements of the cross section for the production of top quark pairs in association with a pair of jets from bottom quarks (σ_(ttbb)) and in association with a pair of jets from quarks of any flavor or gluons (σ_(ttjj)) and their ratio are presented. The data were collected in proton-proton collisions at a center-of-mass energy of 13 TeV by the CMS experiment at the LHC in 2016 and correspond to an integrated luminosity of 35.9 fb⁻¹. The measurements are performed in a fiducial phase space and extrapolated to the full phase space, separately for the dilepton and lepton+jets channels, where lepton corresponds to either an electron or a muon. The results of the measurements in the fiducial phase space for the dilepton and lepton+jets channels, respectively, are σ_(ttjj) = 2.36±0.02 (stat)±0.20 (syst) pb and 31.0±0.2 (stat)±2.9 (syst) pb, and for the cross section ratio 0.017 ± 0.001 (stat) ± 0.001 (syst) and 0.020 ± 0.001 (stat) ± 0.001 (syst). The values of σ_(ttbb) are determined from the product of the σ_(ttjj) and the cross section ratio, obtaining, respectively, 0.040±0.002 (stat)±0.005 (syst) pb and 0.62±0.03 (stat)±0.07 (syst) pb. These measurements are the most precise to date and are consistent, within the uncertainties, with the standard model expectations obtained using a matrix element calculation at next-to-leading order in quantum chromodynamics matched to a parton shower

    Search for a Narrow Resonance Lighter than 200 GeV Decaying to a Pair of Muons in Proton-Proton Collisions at root s=13 TeV

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    A search is presented for a narrow resonance decaying to a pair of oppositely charged muons using root s = 13 TeV proton-proton collision data recorded at the LHC. In the 45-75 and 110-200 GeV resonance mass ranges, the search is based on conventional triggering and event reconstruction techniques. In the 11.5-45 GeV mass range, the search uses data collected with dimuon triggers with low transverse momentum thresholds, recorded at high rate by storing a reduced amount of trigger-level information. The data correspond to integrated luminosities of 137 and 96.6 fb(-1) for conventional and high-rate triggering, respectively. No significant resonant peaks are observed in the probed mass ranges. The search sets the most stringent constraints to date on a dark photon in the similar to 30-75 and 110-200 GeV mass ranges.Peer reviewe
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