Guía Mexicana para el Diagnóstico y el Tratamiento de la Urticaria

La urticaria es una enfermedad que padece una quinta parte de la población en algún momento de su vida. Las guías inter- nacionales recientes han propuesto unos cambios de fondo en su diagnóstico y tratamiento, por lo que había la necesidad de crear una guía nacional y multidisciplinaria, con base amplia en los gremios de especialistas y médicos de primer contacto en México. ABSTRACT Urticaria is a disease that a fifth of the population shall suffer once in a lifetime. Recent clinical guidelines have proposed some fundamental changes in the diagnosis and treatment of urticaria, making the development of a national, multidisciplinary guideline, with wide acceptability among different professional groups –both specialists and primary health care workers–, necessary in Mexico

Management of a caseous lymphadenitis outbreak in a new Iberian ibex (Capra pyrenaica) stock reservoir

Background: In 2010, an Iberian ibex (Capra pyrenaica hispanica) stock reservoir was established for conservation purposes in north-eastern Spain. Eighteen ibexes were captured in the wild and housed in a 17 hectare enclosure. Once in captivity, a caseous lymphadenitis (CLA) outbreak occurred and ibex handlings were carried out at six-month intervals between 2010 and 2013 to perform health examinations and sampling. Treatment with a bacterin-based autovaccine and penicillin G benzatine was added during the third and subsequent handlings, when infection by Corynebacterium pseudotuberculosis was confirmed. Changes in lesion score, serum anti-C. pseudotuberculosis antibodies and haematological parameters were analyzed to assess captivity effects, disease emergence and treatment efficacy. Serum acute phase proteins (APP) Haptoglobin (Hp), Amyloid A (SAA) and Acid Soluble Glycoprotein (ASG) concentrations were also determined to evaluate their usefulness as indicators of clinical status.Once in captivity, 12 out of 14 ibexes (85.7%) seroconverted, preceding the emergence of clinical signs; moreover, TP, WBC, eosinophil and platelet cell counts increased while monocyte and basophil cell counts decreased. After treatment, casualties and fistulas disappeared and both packed cell volume (PCV) and haemoglobin concentration significantly increased. Hp, SAA and ASG values were under the limit of detection or showed no significant differences. Conclusions: A role for captivity in contagion rate is suggested by the increase in antibody levels against C. pseudotuberculosis and the emergence of clinical signs. Although boosted by captivity, this is the first report of an outbreak of caseous lymphadenitis displaying high morbidity and mortality in wild ungulates. Treatment consisting of both vaccination and antibiotic therapy seemed to prevent mortality and alleviate disease severity, but was not reflected in the humoural response. Haematology and APP were not useful indicators in our study, perhaps due to the sampling frequency. Presumably endemic and irrelevant in the wild, this common disease of domestic small ruminants is complicating conservation efforts for the Iberian ibex in north-eastern Spain

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

A Mathematical Dimensional Model for Predicting Bulk Density of Inconel 718 Parts Produced by Selective Laser Melting

In this work, dimensional analysis is used to develop a general mathematical model to predict bulk density of SLMed components taking volumetric energy density, scanning speed, powder&rsquo;s thermal conductivity, specific heat capacity, and average grain diameter as independent variables. Strong relation between dependent and independent dimensionless products is observed. Inconel 718 samples were additively manufactured and a particular expression, in the form of a power-law polynomial, for its bulk density, in the working domain of the independent dimensionless product, was obtained. It is found that with longer laser exposure time, and lower scanning speed, better densification is attained. Likewise, volumetric energy density has a positive influence on bulk density. The negative effect of laser power in bulk density is attributed to improper process conditions leading to powder particle sublimation and ejection. A maximum error percentage between experimental and predicted bulk density of 3.7119% is achieved, which corroborates the accuracy of our proposed model. A general expression for determining the scanning speed, with respect to laser power, needed to achieve highly dense components, was derived. The model&rsquo;s applicability was further validated considering SLMed samples produced by AlSi10Mg and Ti6Al4V alloys. This article elucidates how to tune relevant manufacturing parameters to produce highly dense SLM parts using mathematical expressions derived from Buckingham&rsquo;s &pi;- theorem

Lead Recovery from a Lead Concentrate throughout Direct Smelting Reduction Process with Mixtures of Na₂CO₃ and SiC to 1000 °C

Lead was recovered through a direct smelting reduction route from a lead concentrate by using mixtures of Na2CO3 and SiC to 1000 °C. The lead concentrate was obtained from the mining State of Zacatecas, México by traditional mineral processing and froth flotation. The experimental trials showed that 86 wt.% of lead with a purity up to 97% can be recovered from the lead concentrate by a single step reduction process when 40 wt.% Na2CO3 and 0.4 g SiC were used in the initial charge. The process was modeled in the thermodynamic software FactSage 7.3 to evaluate the effect of adding different amounts of Na2CO3 on the lead recovery rates while holding constant the SiC amount and temperature. The stability phase diagram obtained showed that an addition of 34 wt.% Na2CO3 was enough to reach the highest lead recovery. It was observed that the interaction of Na2CO3 and SiC at a high temperature promotes the formation of C and Na2O, and SiO2, respectively, where the Na2O partially bonds with silica and sulfur forming Na2S and sodium silicates which may decrease the SO2 emissions and increase the weather degradation of the slag. The PbS was mainly reduced by the produced C and CO formed by the interaction between Na2CO3 and SiC at 1000 °C. The predicted results reasonably match with those obtained experimentally in the lead recovery rates and compounds formation

Study of process water effect on the activation of sphalerite during differential flotation of Pb-Cu-Zn

This work was aimed to analyze the effect of concentration of Cu.2+ and Pb.2+ ions in flotation process water with sphalerite activation, the analysis was performed at Cozamin Mining flotation circuit. This analysis demonstrated that (i) it was possible to determine the relationship between Sodium Cyanide and Ammonium Bisulfite used as depressants and Cu.2+ and Pb.2+ contents in the process water. (ii) It also proved the relationship between lead and iron content in the head with the Pb.2+ ions in process water. According to the data gathered and analysis performed, (iii) it was also determined that it was possible to reuse process water as long as the use of Ammonium Bisulfite was reduced and recommended replacing the use of Sodium Cyanide with Zinc Sulfate (ZnSO4) as a depressant of Sphalerite. Additionally, the concentration of Cu.2+ and Pb.2+ ions in the water should be controlled in a range of 10 to 20 ppm and 0.10 to 0.20 ppm, respectively

Estados Unidos : la crisis sistémica y las nuevas condiciones de legitimación

El libro aborda la problemática de la hegemonía decadente de Estados Unidos desde tres ángulos. Desde el entorno global, en relación con la dinámica y los escenarios del sistema capitalista mundial, la aparición de regiones económicas emergentes, la crisis capitalista y los desequilibrios económicos externos, así como la adopción del modelo económico neoliberal y las condiciones de desigualdad salarial en Estados Unidos. En cuanto a la situación y perspectivas internas del país, analiza su estructura social, los fundamentos ideológicos de su hegemonía, el sistema político y las estructuras de poder, la estructura de clase, las condiciones y los desafíos políticos de la clase obrera, los nuevos entornos de competitividad científica y tecnológica, y las condiciones de integración y exclusión laboral, social y cultural de los jóvenes nativos e inmigrantes. Finalmente, considera la nueva geopolítica que emana de Washington y los escenarios para América Latina, sus continuidades y rupturas