Respuesta de hipersensibilidad retardada en pacientes candidatos a artroplastia de cadera

Se estudiaron 100 pacientes escogidos de manera aleatoria de entre los candidatos a artroplastia de cadera (47 por fractura subcapital de fémur Garden IV, y 53 por coxartrosis). En el momento del ingresos se determinaron en sangre niveles de albúmina, proteínas totales y hemoglobina; y se midió la respuesta de hipersensibilidad retardada mediante la inoculación de siete antígenos de memoria con un aplicador Multitest® (Mérieux). La lectura de la reacción de induración se realizó a las 48 horas. Los pacientes fueron clasificados en: normoérgicos (+) a dos o más antígenos) y anérgicos (una o ninguna respuesta (+). La población normoérgica representó el 61% de los pacientes, con una edad 12,5 años menor que la población anérgica (p<0,001). Los pacientes normoérgicos presentaron cifras significativamente más altas de hemoglobina (p<0,001), proteínas totales (p<0,05) y albúmina (p<0,001). La situación de anergia fue más frecuente en el grupo de mujeres (29/57) frente al de hombres (10/43; p<0,001), y en el grupo de fracturas subcapitales (31/47) que en el de coxartrosis (8/53) (p<0,001). No se hallaron relaciones estadísticamente significativas entre los distintos parámetros estudiados y la aparición de infección en el postoperatorio. Las diferencias aparecidas reflejan alteraciones en la respuesta inmunológica que, sin embargo, no resultan pronósticas frente a la aparición de infección en nuestra serie.One hundred candidates for hip arthroplasty were chosen at random (47 Garden IV femoral neck fractures, and 53 osteoarthrosis). Before surgery, serum albumin, total proteins and haemoglobin were determined in peripheral blood. All patients were skin tested with seven memory antigens (Multitest®, Mérieux) in order to measure the delayed hypersensitivity response. The diameter of the resulting induration was measured 48 hours after injection. Patients were classified as reactive if they responded to one antigen or showed no response. Reactive patients supposed 61% of total, and anergic patients were 12,5 years older (p<0,001). Levels of haemoglobin (p<0,001), total proteins (p<0,05) and albumin (p<0,001) were higher in reactive patients. Anergy was more frequent in women (29/57) than in men (10/43; p<0,001), and in fractures (31/47) than in osteoarthrosis (8/53) (p<0,001). No association between the variables studied and postoperative infection was found. These differences show immunologic alterations. However, they have no prognostic value for postoperative infection in hip arthroplasty patients

Opiniones, prácticas, barreras y predisposición al cambio, a la hora de dar consejo para dejar de fumar

ObjetivoConocer las opiniones, las prácticas actuales, las barreras percibidas y la predisposición al cambio con respecto al consejo para dejar de fumar (CF) ofertado a los pacientes por los diferentes profesionales sanitarios (PS) de atención primaria.DiseñoEstudio descriptivo, transversal.EmplazamientoCentros de salud del Área Sanitaria 9, de Madrid.ParticipantesParticiparon 480 PS, entre médicos de familia, pediatras, residentes de medicina familiar y comunitaria, y enfermería.MedicionesMediante cuestionario autocumplimentado y anónimo se recogen variables sociodemográficas, sobre actitudes, creencias y utilización de estrategias en CF y sobre barreras percibidas para darlo, así como la predisposición al cambio.ResultadosContestó al cuestionario el 75,2% (el 94,2, 61,1, 51,6 y 88% de los médicos, enfermeros, pediatras y residentes, respectivamente). El 72% pregunta de manera habitual, con un incremento hasta el 92,4% en las enfermedades relacionadas con el tabaquismo, sin diferencias respecto al sexo, el PS, el hábito tabáquico y la formación previa. El 85,8% ofrece realizar un seguimiento y el 63,5% proporciona consejos escritos. El 75% de los no fumadores se considera modelo social, frente al 40% de los fumadores. Las principales barreras son la falta de tiempo y la baja motivación en los pacientes. El 93,5% cree que es necesaria una formación específica para proporcionar CF.ConclusionesSe pregunta y se ofrece CF, independientemente del hábito tabáquico del PS. A pesar de las barreras, hay una adecuada utilización de las estrategias para proporcionar CF. Hay buena predisposición al cambio para optimizar el CF.ObjectiveTo get to know the opinions, current practices, perceived barriers and stage of change in respect to the smoking cessation advice (SCA) offered to patients by the different health professionals (HP) from primary care.DesignDescriptive cross-sectional study.LocationÁrea Sanitaria 9’s Health Centers, inMadrid, Spain.Participants480 HPs, including primary care doctors, pediatricians, primary care residents, and nursery staff.MeasurementsUsing a self-filled and anonymous questionnaire, we will gather sociodemographic variables and from the HP’s office, regarding the attitudes towards tobacco, efficiency beliefs and use of strategies in the advice, and the perceived barriers to give it, as well as the state of change.Results75.2% of the HPs filled the questionnaire (94.2%, 61.1%, 51.6%, and 88% by doctors, nurses, pediatricians, and residents respectively). 72% ask regularly, this rate increasing to 92.4% over tobacco-related diseases. No differences were made between sexes, professional types, tobacco habits, or previous attendance to courses. 85.8% offers tracing and 63.5% give written advices. Nearly 75% of non-smokers are considered social role models, that against only 40% of smokers. The main barriers found were lack of time and low motivation from the patients. 93.5% consider an specific education necessary to give efficient SCA.ConclusionsInquiries are made and SCA is given, independently of the smoking habits of the SCA. Likewise, there is a good state of change by the HPs to optimize the treatment of tobacco dependency

Orientarse en Internet: Hytelnet 6.4

The Hytelnet programme vcrsion 6.4, designed by Peter Scott, is described. This programme is a highly useful tool for the Internet user, as it can both orient and give easy access to the network's resources. The programme contains more than a thousand telnet addresses. Hytelnet is a termínate and stay resident programme in the computer's memory. With hypertext features which are user friendly in terms of both learning and installing. lt describes how to use the programme and the information it contains at the same time. Finally, thc article gives details on how to incorporate Hytelnet into difTerent operating systems, as well as the regular updates that are made.Se describe la versión 6.4 del programa Hytelnet, diseñado por Peter Scott. Este programa es una herramienta muy útil para los usuarios de Internet, ya que permite una orientación y un fácil acceso a los recursos que la red ofrece. Hytelnet es un programa residente en memoria con características de hipertexto de fácil aprendizaje, uso e instalación. Contiene más de un millar de direcciones telnet. Se describe su manejo al mismo tiempo que se explica el tipo de información que contiene. Se proporciona el modo de obtener hytelnet para diferentes sistemas operativos, así como las actualizaciones que periódicamente se realizan

The diurnal cycle of shallow cumulus clouds over land: A single-column model intercomparison study

An intercomparison study for single-column models (SCMs) of the diurnal cycle of shallow cumulus convection is reported. The case, based on measurements at the Atmospheric Radiation Measurement program Southern Great Plains site on 21 June 1997, has been used in a large-eddy simulation intercomparison study before. Results of the SCMs reveal the following general deficiencies: too large values of cloud cover and Cloud liquid water, unrealistic thermodynamic profiles, and high amounts of numerical noise. Results are also strongly dependent on vertical resolution.These results are analysed in terms of the behaviour of the different parametrization schemes involved: the convection scheme, the turbulence scheme, and the cloud scheme. In general the behaviour of the SCMs can be grouped in two different classes: one class with too strong mixing by the turbulence scheme, the other class with too strong activity by the convection scheme. The coupling between (subcloud) turbulence and the convection scheme plays a crucial role. Finally, (in part) motivated by these results several models have been successfully updated with new parametrization schemes and/or their present schemes have been successfully modifie

Thermo- and Fluid-Dynamic Processes in Direct Injection Engines. THIESEL2016 special issue

Payri, R.; Margot, X. (2017). Thermo- and Fluid-Dynamic Processes in Direct Injection Engines. THIESEL2016 special issue. International Journal of Engine Research. 18(1-2):3-5. doi:10.1177/1468087416680663S35181-

Adaptive determination of cut-off frequencies for filtering the in-cylinder pressure in diesel engines combustion analysis

[EN] In-cylinder pressure analysis is a key tool for engine research and diagnosis and it has been object of study from the beginning of the internal combustion engines. One of its most useful application is combustion analysis on the basis of the First Law of Thermodynamics. However, heat release law calculations use the in-cylinder pressure derivative signal. Hence, the noise is increased and pressure filtering becomes necessary to remove high frequency noise, thus allowing for accurate combustion analyses. In this work, a methodology to set the cut-off frequency of a low-pass filter is proposed. Statistical criteria are used to separate the signal from the noise through the calculation of the Discrete Fourier Transform of several consecutive in-cylinder pressures cycles. Thus, only physically meaningful information is preserved. The proposed methodology is compared with some adaptive and non-adaptive algorithms used to select the cut-off frequencies, and it shows a good ability to adapt to different engine operating conditions. © 2011 Elsevier Ltd. All rights reserved.The authors thank the Universidad Politécnica de Valencia (PAID-06-09) and Generalitat Valenciana (GV/2010/045) for its valuable support to this work.Payri González, F.; Olmeda González, PC.; Guardiola García, C.; Martín Díaz, J. (2011). Adaptive determination of cut-off frequencies for filtering the in-cylinder pressure in diesel engines combustion analysis. Applied Thermal Engineering. 31:2869-2876. https://doi.org/10.1016/j.applthermaleng.2011.05.012S286928763

A Blind Circadian Clock in Cavefish Reveals that Opsins Mediate Peripheral Clock Photoreception

Evolution during millions of years in perpetual darkness leads to mutations in non-visual opsin genes (Melanopsin and TMT opsin) and an aberrant, blind circadian clock in cavefish

Sarcoptes scabiei infestation does not alter the stability of ectoparasite communities

BACKGROUND: The host represents a heterogeneous ecosystem where multiple parasite species co-occur and interact with each other for space and resources. Although these interactions may rule the features of an infracommunity and may shape the infracommunity response to external perturbations, the resilience of ectoparasite communities to new infestations remains poorly explored. METHODS: We analysed the composition of the ectoparasite communities found on 214 individual Iberian ibexes (Capra pyrenaica) inhabiting the Sierra Nevada Natural Space, southern Spain. Using classification and regression trees, we explored how the presence of Sarcoptes scabiei (a highly contagious mite), the off-host environment and the host sex govern the prevalence and abundance of lice and ticks. Null model analysis was applied to assess the impact of S. scabiei on the structure of the ectoparasite communities. RESULTS: Our results suggest that S. scabiei infestation acts in tandem with off-host environment and host sex to define the prevalence and abundance of lice and ticks. We also provided evidence for differences in species co-occurrence only at the early stages of S. scabiei infestation. Regarding species diversity, we recorded that ectoparasite communities in scabietic ibexes reached a high richness faster than those in healthy individuals. CONCLUSIONS: Even though we show that ectoparasite burden is correlated with S. scabiei infestation, off-host environment and host sex, the species response to S. scabiei infestation and climate seem to be highly variable and influenced by ectoparasite life-history traits. Ectoparasite communities also appear resilient to perturbations which is in agreement with what was previously reported for endoparasites. Future refinement of sample collection and the incorporation of ecological and epidemiological-related variables may allow us to establish causal effects and deepen the knowledge about the mechanisms and consequences of ectoparasite interactions

Are osteoporotic fractures being adequately investigated?: A questionnaire of GP & orthopaedic surgeons

BACKGROUND: To investigate the current practice of Orthopaedic Surgeons & General Practitioners (GP) when presented with patients who have a fracture, with possible underlying Osteoporosis. METHODS: Questionnaires were sent to 140 GPs and 140 Orthopaedic Surgeons. The participants were asked their routine clinical practice with regard to investigation of underlying osteoporosis in 3 clinical scenarios. 55 year old lady with a low trauma Colles fracture 60 year old lady with a vertebral wedge fracture 70 year old lady with a low trauma neck of femur fracture. RESULTS: Most doctors agreed that patients over 50 years old with low trauma fractures required investigation for osteoporosis, however, most surgeons (56%, n = 66) would discharge patients with low trauma Colles fracture without requesting or initiating investigation for osteoporosis. Most GPs (67%, n = 76) would not investigate a similar patient for osteoporosis, unless prompted by the Orthopaedic Surgeon or patient. More surgeons (71%, n= 83) and GPs (64%, n = 72) would initiate investigations for osteoporosis in a vertebral wedge fracture, but few surgeons (35%, n = 23) would investigate a neck of femur fracture patient after orthopaedic treatment. CONCLUSION: Most doctors know that fragility fractures in patients over 50 years old require investigation for Osteoporosis; however, a large population of patients with osteoporotic fractures are not being given the advantages of secondary prevention

Impact of Daily Thermocycles on Hatching Rhythms, Larval Performance and Sex Differentiation of Zebrafish

In the wild, water temperature cycles daily: it warms up after sunrise, and cools rapidly after sunset. Surprisingly, the impact of such daily thermocycles during the early development of fish remains neglected. We investigated the influence of constant vs daily thermocycles in zebrafish, from embryo development to sexual differentiation, by applying four temperature regimens: two constant (24&deg;C and 28&deg;C) and two daily thermocycles: 28:24&deg;C, TC (thermophase coinciding with daytime, and cryophase coinciding with night-time) and 24:28&deg;C, CT (opposite to TC) in a 12:12 h light:dark cycle (LD). Embryo development was temperature-dependent but enhanced at 28&deg;C and TC. Hatching rhythms were diurnal (around 4 h after lights on), but temperature- and cycle-sensitive, since hatching occurred sooner at 28&deg;C (48 hours post fertilization; hpf) while it was delayed at 24&deg;C (96 hpf). Under TC, hatching occurred at 72 hpf, while under CT hatching displayed two peaks (at 70 hpf and 94 hpf). In constant light (LL) or darkness (DD), hatching rhythms persisted with tau close to 24 h, suggesting a clock-controlled "gating" mechanism. Under 28&deg;C or TC, larvae showed the best performance (high growth and survival, and low malformations). The sex ratio was strongly influenced by temperature, as the proportion of females was higher in CT and TC (79 and 83% respectively), contrasting with 28&deg;C and 24&deg;C, which led to more males (83 and 76%). Ovarian aromatase (cyp19a) expression in females was highest in TC and CT (6.5 and 4.6 fold higher than at 28&deg;C, respectively); while anti-m&uuml;llerian hormone (amh) expression in males increased in testis at 24&deg;C (3.6 fold higher compared to TC) and particularly at 28&deg;C (14.3 fold increase). Taken together, these findings highlight the key role of environmental cycles during early development, which shaped the daily rhythms in fish embryo and larvae, and ultimately influenced sex differentiation