Surgical treatment for secundum atrial septal defects in patients >40 years old A randomized clinical trial

AbstractObjectivesWe prospectively examined whether surgical treatment of secundum atrial septal defects (ASDs) in patients ≥40 years old improves their long-term clinical outcome.BackgroundSurgical treatment of secundum ASDs in adults >40 years old is a subject of controversy because of the perception of good long-term clinical outcomes in patients with unrepaired ASDs and the lack of data from randomized trials.MethodsWe recruited 521 patients >40 years old with secundum ASDs referred for treatment; 48 were excluded. Patients were randomly assigned to surgical closure (n = 232) or medical treatment (n = 241). The primary and secondary end points were a composite of major cardiovascular events (death, pulmonary embolism, major arrhythmic event, embolic cerebrovascular event, recurrent pulmonary infection, functional class deterioration or heart failure) and overall mortality, respectively. We assessed possible prognostic markers. The analysis was performed on an intention-to-treat basis.ResultsThe median follow-up period was 7.3 years (range 2 to 13). The risk of having the primary end point was significantly higher in the medical group, which had a univariate hazards ratio of 1.99 (95% confidence interval [CI] 1.23 to 3.22) and a multivariate hazards ratio of 1.85 (95% CI 1.08 to 3.17). Although the survival analysis did not reveal differences in overall mortality between the surgical and medical treatments (hazards ratio 1.71, 95% CI 0.76 to 3.86), the multivariate analysis, adjusted by age at entry, mean pulmonary artery pressure and cardiac index, demonstrated significant differences between the study groups (hazards ratio 4.09, 95% CI 1.41 to 11.89).ConclusionsSurgical closure was superior to medical treatment in improving both the composite of major cardiovascular events and overall mortality in patients >40 years old with secundum ASDs. This superiority was related to the mean pulmonary artery pressure, age at diagnosis and cardiac index. Because of the higher risk of morbidity and mortality, we believe that anatomic closure should always be attempted as the initial treatment for ASDs in adults >40 years old with pulmonary artery systolic pressure <70 mm Hg and a pulmonary/systemic output ratio ≥1.7. The operation must be performed as soon as possible, even if the symptoms or the hemodynamic impact seems to be minimal

Novel Oleanolic and Maslinic Acids derivatives as a promising treatment against bacterial biofilm in nosocomial infections: An in Vitro and in Vivo study.

Oleanolic acid (OA) and maslinic acid (MA) are pentacyclic triterpenic compounds that abound in industrial olive oil waste. These compounds have renowned antimicrobial properties and lack cytotoxicity in eukaryotic cells as well as resistance mechanisms in bacteria. Despite these advantages, their antimicrobial activity has only been tested in vitro, and derivatives improving this activity have not been reported. In this work, a set of 14 OA and MA C-28 amide derivatives have been synthesized. Two of these derivatives, MA-HDA and OA-HDA, increase the in vitro antimicrobial activity of the parent compounds while reducing their toxicity in most of the Gram-positive bacteria tested, including a methicillin-resistant Staphylococcus aureus-MRSA. MA-HDA also shows an enhanced in vivo efficacy in a Galleria mellonella invertebrate animal model of infection. A preliminary attempt to elucidate their mechanism of action revealed that these compounds are able to penetrate and damage the bacterial cell membrane. More significantly, their capacity to reduce antibiofilm formation in catheters has also been demonstrated in two sets of conditions: a static and a more challenged continuous-flow S. aureus biofilm.This study was partially supported by grants from the Ministerio de Economiá , Industria y Competitividad, MINECO, and Agencia Estatal de Investigación, AEI, Spain, cofunded by Fondo Europeo de Desarrollo Regional, FEDER, European Union (BIO2015−63557-R, FIS2017−85954-R and RTI2018−098573-B-100)

Los congresos de estudiantes como experiencia de aprendizaje cooperativo y colaborativo. IV Congreso ASAT, Murcia

La adaptación del sistema educativo universitario a las necesidades y requerimientos del Espacio Europeo de Educación (EEES) es uno de los desafíos más importantes de los últimos años en el ámbito docente. Supone la instauración de un nuevo sistema de enseñanza basado en nuevas técnicas docentes con una diferente relación profesor-alumno y una mayor participación de este último en el proceso de aprendizaje. El concepto de aprendizaje individualizado donde el alumno actúa de espectador pasivo cambia hacia un papel más activo, en el que el concepto de aprendizaje cooperativo (trabajo en grupo) y colaborativo (dimensión social del aprendizaje) cobra una vital importancia en el nuevo modelo de enseñanza. El siguiente artículo recoge los resultados del IV Congreso Nacional de estudiantes de Arquitectura Técnica e Ingeniería de Edificación realizado durante el curso académico 2013-14 en la Universidad Católica San Antonio de Murcia (UCAM). Pretende demostrar cómo actividades docentes en las que se ponga en práctica el aprendizaje cooperativo y colaborativo con los estudiantes, pueden ser fructíferas en el campo del aprendizaje universitario. La iniciativa de este tipo de congresos de estudiantes acerca el mundo profesional y la investigación al alumno

Sobrepeso en el periodo post confinamiento por la pandemia covid-19

The research was carried out at the José Chiriboga Grijalva Higher Technological Institute, in Ibarra, Ecuador, on a sample of students to monitor anthropometric measurements, weight and height in the context of COVID-19. For the diagnosis of nutritional status, the Body Mass Index was used; users whose Body Mass Index was between the 85th and &lt;95th percentiles were diagnosed as overweight and those with a value equal to or greater than the 95th percentile, with obesity. The results show that 75% of the students participating in the study who suffer from obesity and 73.4% of those who are overweight live in urban areas. The highest percentage of students who are overweight are in a medium-low socioeconomic level, while the highest percentage of those who are obese are in a high socioeconomic level. Confinement as a sanitary measure for the prevention of COVID-19 infections was related to the increase in the Institute's student index.La investigación se realizó en el Instituto Superior Tecnológico José Chiriboga Grijalva, en Ibarra, Ecuador a una muestra de estudiantes para el seguimiento de medidas antropométricas, peso y talla en el contexto del COVID-19.&nbsp; Para el diagnóstico del estado nutricional se utilizó el Índice de Masa Corporal; los usuarios, cuyo Índice de Masa Corporal estuvo entre los percentiles 85 y &lt;95 se diagnosticaron con sobrepeso y aquellos con un valor igual o mayor que el percentil 95, con obesidad. Los resultados demuestran que el 75% de los estudiantes, participantes en el estudio, que padecen obesidad y el 73,4% de los que tienen sobrepeso habitan en zonas urbanas. El mayor porcentaje de los estudiantes que tienen sobrepeso se encuentran en nivel socioeconómico medio-bajo, mientras que el mayor porcentaje de los que padecen obesidad se encuentran en un nivel socioeconómico alto. El confinamiento como medida sanitaria para la prevención de contagios de COVID-19 estuvo relacionado con el incremento del Índice de los estudiantes del instituto

Configuración cultural de la juventud del sur de Quito en la parroquia la Ferroviaria

This research was carried out in Quito with the aim of understanding the culture of young people living in the south of the city, in the La Ferroviaria parish. The concept of cultural configuration was used, which consists of four dimensions that allowed studying the target group, shared experiences or fields of possibility, logic of interrelation between the parties, common symbolic plot, and shared cultural aspects. The investigation concentrated on the study of fields of possibility. To carry out the study, surveys were applied to 365 young students from two day and night schools, located in the south of Quito, to demonstrate the heterogeneities present within the group. The socioeconomic characteristics of the sector correspond to those of marginal urban areas and therefore the various aspects of the social life of young people, such as their family life, their study possibilities or their job choices, are marked by reality. surrounding social.Esta investigación se realizó en Quito con el objetivo de comprender la cultura de los jóvenes residentes en el sur de la ciudad, en la parroquia La Ferroviaria. Se utilizó el concepto de configuración cultural, el cual consta de cuatro dimensiones que permitieron estudiar al grupo objetivo, experiencias compartidas o campos de posibilidad, lógica de interrelación entre las partes, trama simbólica común y aspectos culturales compartidos. La investigación se concentró en el estudio de los campos de posibilidad. Para la realización del estudio se utilizaron encuestas que fueron aplicadas a 365 jóvenes estudiantes de dos colegios de modalidad de estudios diurna y nocturna, ubicados en el sur de Quito, para evidenciar las heterogeneidades presentes dentro del grupo. Las características socioeconómicas del sector corresponden a aquellas de las zonas urbano-marginales y que por lo tanto los varios aspectos de la vida social de los jóvenes, tales como su vida familiar, sus posibilidades de estudios o sus elecciones laborales, están marcadas por la realidad social circundante

A fast synthesis route of boron-carbon-nitrogen ultrathin layers towards highly mixed ternary B-C-N phases

We report a direct and fast synthesis route to grow boron-carbon-nitrogen layers based on microwave-assisted plasma enhanced chemical vapour deposition (PECVD) by using methylamine borane as a single source molecular precursor. This easy and inexpensive method allows controlled and reproducible growth of B-C-N layers onto thin Cu foils. Their morphological, structural, chemical, optical and transport properties have been thoroughly characterized by a number of different microscopies, transport and spectroscopic techniques. Though disorder and segregation into C-rich and h-BN-rich domains have been observed in ultrathin flat few layers, high doping levels have been reached, inducing strong modifications of the electronic, optical and transport properties of C-rich and h-BN-rich phases. This synthesis procedure can open new routes towards the achievement of homogeneous highly mixed ternary B-C-N phase