Impact of interstitial lung disease on the survival of systemic sclerosis with pulmonary arterial hypertension

To assess severity markers and outcomes of patients with systemic sclerosis (SSc) with or without pulmonary arterial hypertension (PAH-SSc/non-PAH-SSc), and the impact of interstitial lung disease (ILD) on PAH-SSc. Non-PAH-SSc patients from the Spanish SSc registry and PAH-SSc patients from the Spanish PAH registry were included. A total of 364 PAH-SSc and 1589 non-PAH-SSc patients were included. PAH-SSc patients had worse NYHA-functional class (NYHA-FC), worse forced vital capacity (FVC) (81.2 +/- 20.6% vs 93.6 +/- 20.6%, P < 0.001), worse tricuspid annular plane systolic excursion (TAPSE) (17.4 +/- 5.2 mm vs 19.9 +/- 6.7 mm, P < 0.001), higher incidence of pericardial effusion (30% vs 5.2%, P < 0.001) and similar prevalence of ILD (41.8% vs. 44.9%). In individuals with PAH-SSc, ILD was associated with worse hemodynamics and pulmonary function tests (PFT). Up-front combination therapy was used in 59.8% and 61.7% of patients with and without ILD, respectively. Five-year transplant-free survival rate was 41.1% in PAH-SSc patients and 93.9% in non-PAH-SSc patients (P < 0.001). Global survival of PAH-SSc patients was not affected by ILD regardless its severity. The multivariate survival analysis in PAH-SSc patients confirmed age at diagnosis, worse NYHA-FC, increased PVR, reduced DLCO, and lower management with up-front combination therapy as major risk factors. In conclusion, in PAH-SSc cohort risk of death was greatly increased by clinical, PFT, and hemodynamic factors, whereas it was decreased by up-front combination therapy. Concomitant ILD worsened hemodynamics and PFT in PAH-SSc but not survival regardless of FVC impairment

Impact of interstitial lung disease on the survival of systemic sclerosis with pulmonary arterial hypertension

To assess severity markers and outcomes of patients with systemic sclerosis (SSc) with or without pulmonary arterial hypertension (PAH-SSc/non-PAH-SSc), and the impact of interstitial lung disease (ILD) on PAH-SSc. Non-PAH-SSc patients from the Spanish SSc registry and PAH-SSc patients from the Spanish PAH registry were included. A total of 364 PAH-SSc and 1589 non-PAH-SSc patients were included. PAH-SSc patients had worse NYHA-functional class (NYHA-FC), worse forced vital capacity (FVC) (81.2 ± 20.6% vs 93.6 ± 20.6%, P &lt; 0.001), worse tricuspid annular plane systolic excursion (TAPSE) (17.4 ± 5.2 mm vs 19.9 ± 6.7 mm, P &lt; 0.001), higher incidence of pericardial effusion (30% vs 5.2%, P &lt; 0.001) and similar prevalence of ILD (41.8% vs. 44.9%). In individuals with PAH-SSc, ILD was associated with worse hemodynamics and pulmonary function tests (PFT). Up-front combination therapy was used in 59.8% and 61.7% of patients with and without ILD, respectively. Five-year transplant-free survival rate was 41.1% in PAH-SSc patients and 93.9% in non-PAH-SSc patients (P &lt; 0.001). Global survival of PAH-SSc patients was not affected by ILD regardless its severity. The multivariate survival analysis in PAH-SSc patients confirmed age at diagnosis, worse NYHA-FC, increased PVR, reduced DLCO, and lower management with up-front combination therapy as major risk factors. In conclusion, in PAH-SSc cohort risk of death was greatly increased by clinical, PFT, and hemodynamic factors, whereas it was decreased by up-front combination therapy. Concomitant ILD worsened hemodynamics and PFT in PAH-SSc but not survival regardless of FVC impairment

4to. Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad. Memoria académica

Este volumen acoge la memoria académica de la Cuarta edición del Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad, CITIS 2017, desarrollado entre el 29 de noviembre y el 1 de diciembre de 2017 y organizado por la Universidad Politécnica Salesiana (UPS) en su sede de Guayaquil. El Congreso ofreció un espacio para la presentación, difusión e intercambio de importantes investigaciones nacionales e internacionales ante la comunidad universitaria que se dio cita en el encuentro. El uso de herramientas tecnológicas para la gestión de los trabajos de investigación como la plataforma Open Conference Systems y la web de presentación del Congreso http://citis.blog.ups.edu.ec/, hicieron de CITIS 2017 un verdadero referente entre los congresos que se desarrollaron en el país. La preocupación de nuestra Universidad, de presentar espacios que ayuden a generar nuevos y mejores cambios en la dimensión humana y social de nuestro entorno, hace que se persiga en cada edición del evento la presentación de trabajos con calidad creciente en cuanto a su producción científica. Quienes estuvimos al frente de la organización, dejamos plasmado en estas memorias académicas el intenso y prolífico trabajo de los días de realización del Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad al alcance de todos y todas

Non-Structural Carbohydrates, Foliar Nutrients, Yield Components and Oxidative Metabolism in Pecan Trees in Response to Foliar Applications of Growth Regulators

Foliar sprays of growth regulators have commercial potential for improving the performance of some of the parameters associated with alternate bearing in pecan trees. The objective was to evaluate the behaviour of alternate bearing through analysis of seasonal variations in buds and leaflets of non-structural carbohydrates (glucose, fructose, sucrose, and starch), mineral nutrients (N-total, P, K+, Ca2+, Mg2+, Fe2+, Cu2+, Mn2+ and Zn2+), yield components (nut weight per kilogram and kernel percentage) and oxidative metabolism (superoxide dismutase, hydrogen peroxide, catalase, guaiacol peroxidase and antioxidant capacity) in cv. Wichita pecan trees in response to foliar applications of gibberellic acid (50 mg L−1), calcium prohexadione (500 mg L−1) or thidiazuron (10 mg L−1). The experiment was of a completely randomized experimental design with five replicates. Foliar growth regulator (GRs) sprays help maintain the concentration of non-structural carbohydrates in the leaflets and buds between the evaluation years. With the exception of K+ (12.9 and 10.9 g kg−1) and Zn2+ (45.1 and 30.5 mg kg−1), the GRs did not show any effects on the concentrations of the foliar mineral nutrients. The results suggest foliar sprays of gibberellic acid improve the performance of parameters associated with alternate bearing, including oxidative metabolism

Non-Structural Carbohydrates, Foliar Nutrients, Yield Components and Oxidative Metabolism in Pecan Trees in Response to Foliar Applications of Growth Regulators

Foliar sprays of growth regulators have commercial potential for improving the performance of some of the parameters associated with alternate bearing in pecan trees. The objective was to evaluate the behaviour of alternate bearing through analysis of seasonal variations in buds and leaflets of non-structural carbohydrates (glucose, fructose, sucrose, and starch), mineral nutrients (N-total, P, K+, Ca2+, Mg2+, Fe2+, Cu2+, Mn2+ and Zn2+), yield components (nut weight per kilogram and kernel percentage) and oxidative metabolism (superoxide dismutase, hydrogen peroxide, catalase, guaiacol peroxidase and antioxidant capacity) in cv. Wichita pecan trees in response to foliar applications of gibberellic acid (50 mg L&minus;1), calcium prohexadione (500 mg L&minus;1) or thidiazuron (10 mg L&minus;1). The experiment was of a completely randomized experimental design with five replicates. Foliar growth regulator (GRs) sprays help maintain the concentration of non-structural carbohydrates in the leaflets and buds between the evaluation years. With the exception of K+ (12.9 and 10.9 g kg&minus;1) and Zn2+ (45.1 and 30.5 mg kg&minus;1), the GRs did not show any effects on the concentrations of the foliar mineral nutrients. The results suggest foliar sprays of gibberellic acid improve the performance of parameters associated with alternate bearing, including oxidative metabolism

La educación para la salud del siglo XXI : comunicación y salud

El libro introduce al estudio de los grandes problemas que se perfilan para el siglo XXI que afectan a la Salud de los hombres y mujeres de toda edad y condición y que son, en gran medida, educativos. Resalta los rasgos y señas de identidad de esta generación y el papel que van a jugar las nuevas tecnologías y las estructuras mediáticas, tanto en el lenguaje, la comunicación y las relaciones humanas, como en la manera de aprender y enfermar de las generaciones que van surgiendo. Son campos obligados y novedades en un libro de estas características la Metodología de Investigación en Educación para la Salud: la recreación del método de trabajo -ver, juzgar, actuar- el marco teórico de la educación para la salud junto con los instrumentos, clave para su desarrollo en el siglo XXI, los grandes cambios socio sanitarios, el papel de la educación, el reto de la autoestima como caldo de cultivo del crecimiento de las personas sanas, la fuerza del trabajo en grupo y el dinamismo ético de una educación en valores.Castilla y LeónES

La lectura como medio de socialización

Se realiza un proyecto de innovación educativa sobre la lectura como medio de socialización en el C.R.A. Valdelavía de Navalperal de Pinares, en Ávila. Se pretende mejorar la biblioteca del centro y las bibliotecas de aula, creando un marco óptimo para el fomento de la lectura. Para ello se programan actividades para el fomento de la lectura y el desarrollo de la comprensión lectora con el fin de mejorar los procesos de socialización entre el alumnado de diferentes orígenes socio-culturales. Dentro de las actividades propuestas en el proyecto de innovación están: la creación de bibliotecas en los diferentes centros que componen el C.R.A.; la creación de 'maletas viajeras' con libros para las diferentes localidades se localice el centro; la actividad llamada 'mis historias' en la el alumnado elabora un libro en el que cuenta una historia que acompaña de dibujos en la se quiere mejorar la expresión oral, escrita y enriquecer el vocabulario; se realiza un concurso de relatos del día de la paz; cuando llega el carnaval o la navidad se lee un cuento y sobre él gira la temática en torno a la cual se tienen que disfrazar; en la semana cultural se relaciona una actividad con alguna temática de la lectura; se realizan actividades basadas en el juego como un álbum de personajes, un Twister de cuentos o revuelto de historias. La experiencia ha sido muy positiva en el alumnado, puesto que se ha mejorado la imagen de la biblioteca, se ha iniciado la lectura de libros infantiles y se ha comenzado a animar y a desarrollar el gusto por la lectura desde pequeños.Castilla y LeónConsejería de Educación. Dirección General de Universidades e Investigación; Monasterio de Nuestra Señora de Prado, Autovía Puente Colgante s. n.; 47071 Valladolid; +34983411881; +34983411939ES

Evolution over Time of Ventilatory Management and Outcome of Patients with Neurologic Disease∗

OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need for mechanical ventilation. Although volume-cycled ventilation remained the preferred ventilation mode, there was a significant (p &lt; 0.001) increment in the use of pressure support ventilation. The proportion of patients receiving a protective lung ventilation strategy was increased over time: 47% in 2004, 63% in 2010, and 65% in 2016 (p &lt; 0.001), as well as the duration of protective ventilation strategies: 406 days per 1,000 mechanical ventilation days in 2004, 523 days per 1,000 mechanical ventilation days in 2010, and 585 days per 1,000 mechanical ventilation days in 2016 (p &lt; 0.001). There were no differences in the length of stay in the ICU, mortality in the ICU, and mortality in hospital from 2004 to 2016. Independent risk factors for 28-day mortality were age greater than 75 years, Simplified Acute Physiology Score II greater than 50, the occurrence of organ dysfunction within first 48 hours after brain injury, and specific neurologic diseases such as hemorrhagic stroke, ischemic stroke, and brain trauma. CONCLUSIONS: More lung-protective ventilatory strategies have been implemented over years in neurologic patients with no effect on pulmonary complications or on survival. We found several prognostic factors on mortality such as advanced age, the severity of the disease, organ dysfunctions, and the etiology of neurologic disease