Fiebre de origen desconocido, una revisión de casos

La fiebre de origen desconocido (FOD) ha sido y continúa siendo una de las patologías de más difícil diagnóstico, constituyendo, en muchas ocasiones, un auténtico reto en el campo de estudio de la Medicina Interna. La FOD es una manifestación de entidades nosológicas tan diferentes como enfermedades reumatológicas/inflamatorias, infecciosas, neoplásicas o misceláneas. Se han descrito más de 200 enfermedades que pueden originar una FOD. Por este motivo, es necesario un abordaje sistemático y un estudio minucioso del paciente y de su entorno. La historia clínica y la exploración física desempeñan un papel básico y fundamental para el diagnóstico, mientras que las nuevas pruebas de laboratorio, fundamentalmente microbiológicas y sobretodo, las técnicas de imagen han permitido determinar etiologías que, hace años, hubieran sido etiquetadas de idiopáticas o cuyo diagnóstico se hubiera prolongado en el tiempo hasta tener manifestaciones más floridas o graves. A pesar de estos avances, paradójicamente, según las diferentes series consultadas hasta en un 51% de los casos no se llega a un diagnóstico. El objetivo de este trabajo es describir los casos diagnosticados de fiebre de origen desconocido en la unidad de diagnóstico rápido (UDR) del servicio de medicina interna del hospital general de Segovia y realizar una revisión bibliográfica. Se diseñó un estudio observacional, retrospectivo y descriptivo durante el periodo de enero de 2015 a enero de 2016. La población accesible fue de 508 pacientes que acudieron a la Unidad de Diagnóstico Rápido y la muestra final fue de 8 pacientes que fueron derivados con el diagnóstico de fiebre de origen desconocido o fiebre prolongada. Se han analizado diferentes variables epidemiológicas, clínicas y analíticas. Como conclusión, la prevalencia de la FOD sigue siendo muy baja y continua siendo una patología de difícil diagnóstico con una mediana de 27 días, donde parece haber más retraso diagnóstico en aquellos pacientes con fiebres más prolongadas. La PCR, VSG, leucocitos y fibrinógeno parecen ayudar al diagnóstico etiológico de la FOD, siendo la anamnesis y exploración física de vital importancia. Las infecciones siguen siendo la causa más frecuente de FOD y se utiliza el tratamiento antibiótico empírico en muchos casos sin evidencia de infección. Las unidades de diagnóstico rápido permiten un pronto y completo estudio de los pacientes evitando muchos ingresos hospitalarios.Grado en Medicin

The importance of heritage on the overall perceived image of a place: Barcelona seen by its residents

Place branding literature generally defines heritage as a major attribute that composes place brands. Moreover, the concept of heritage is deeply connected to place identity, to the point that some authors describe it as its DNA. In this sense, the aim of this article is to test the importance of heritage on the overall perceived image of the city of Barcelona (Spain) by analyzing opinions and perceptions from its local residents. To do so, 300 citizens were surveyed from 10th December 2014 to 30th January 2015 by using a specialized questionnaire designed for studying overall place image perception. Results of the study showed that heritage was a highly valued attribute that clearly dominated above other key attributes in the minds of citizens. Finally, potential opportunities and advantages for Barcelona’s brand arising from those perceptions are discussed

Ground states of quantum kagome antiferromagnets in a magnetic field

We study the ground state properties of a quantum antiferromagnet in the kagome lattice in the presence of a magnetic field, paying particular attention to the stability of the plateau at magnetization 1/3 of saturation. While the plateau is reinforced by certain deformations of the lattice, like the introduction of structural defect lines and against an Ising anisotropy, ground state correlations are seen to be quite different and the undistorted SU(2) case appears to be rather special.Comment: 3 pages, 3 figures, contribution to the Japanese-French symposium on "Quantum magnetism in spin, charge and orbital systems", Paris 1-4 October 200

Faculty recital: John Muratore, guitar with Roberto Cassan, accordion, November 3, 2005

This is the concert program of the Faculty Recital: John Muratore, guitar with Roberto Cassan, accordion performance on Thursday, November 3, 2005 at 8:00 p.m., at the Tsai Performance Center, 685 Commonwealth Avenue. Works performed were "Trois Morceaux Espagnols" by Emilio Pujol, "Shadow Box" by Scott Wheeler, "Histoire du Tango" by Astor Piazzolla, "El Decameron Negro" by Leo Brouwer, "Usher Waltz," Op. 29 (after E. A. Poe) by Nikita Koshkin, and "Trilogy" by Frederic Hand. Digitization for Boston University Concert Programs was supported by the Boston University Center for the Humanities Library Endowed Fund

Lattice matching and microstructuring of Gd3+, Lu3+ co-doped KY(WO4)2:Tm3+ channel waveguide lasers

Lattice-matched KY(WO4)2:Gd3+,Lu3+,Tm3+ layers with a thickness of 6 μm have been grown onto pure KY(WO4)2 substrates. Channel waveguides of 7.5 μm to 12.5 μm width have been microstructured to a depth of 1.5 μm using Ar+ beam milling. Laser experiments with buttcoupled mirrors demonstrate laser oscillation near 1844 nm while pumping at 792 nm

Characteristics and dynamics of crescentic bar events at Castelldefels beach

Crescentic sand bars have been studied intensively in the last decades, resulting in good knowledge of some of their characteristics, but the processes behind their formation and destruction are not yet clear. This study aims to increase our understanding of the dynamics of crescentic bars at an open, dissipative Mediterranean beach (Castelldefels, 20 km southwest of Barcelona). Their dynamics have been analysed using a 4.25-year dataset of video images. The crescentic bar events have been identified using visual analysis, including the formation and destruction moments. The results show that crescentic bars hardly occurred when the sandbar was located close to the beach, whilst they developed often when the sandbar was further offshore. Wave conditions during crescentic bar formation were low- to intermediate-energy waves with both oblique and shore-normal angles of incidence. Sandbar straightening was preferably observed for oblique waves (of both intermediate and high energy). The alongshore wavelength and cross- shore amplitude of the crescentic bars have been also quantified, giving some 245 m and 10 m on average, respectively.Peer ReviewedPostprint (published version

Growth, characterization, and waveguide lasing of Yb3+, Lu3+, Gd3+ co-doped KY(WO4)2 thin layers

Monoclinic crystals of KY(WO4)2 (KYW) doped with different rare-earth ions are among the highly promising materials for building compact solid-state lasers. \ud We report the liquid phase epitaxy (LPE) growth of 3-5 µm thick KYW:Gd3+, Lu3+, Yb3+ layers for Yb3+ concentrations of 1.2, 1.7, and 2.4 mol% and 30 to 40-µm-thick KYW:Gd3+, Yb3+ (20 mol%) layers. The concentration of the dopants Yb3+, Lu3+, and Gd3+ in the grown film were determined by laser ablation inductively coupled plasma - mass spectrometry (LA-ICP-MS). The growth conditions were optimized, leading to crack-free layers for all investigated Yb3+ concentrations. X-ray investigations have confirmed the high crystallinity of the films.\ud Based on the Gd3+, Lu3+ co-doped thin films, planar waveguide lasers operating on the Yb3+ transition at 1025 nm were demonstrated. Due to the co-doping, resulting in high refractive-index difference between film and substrate, very thin waveguides with strong light confinement were obtained, thus allowing for a pump threshold of laser operation as low as 18 mW. The highest slope efficiency versus absorbed pump power and output power were 82.3% and 195 mW, respectively

Four Discussions from the September 2019 ACI Structural Journal

Disc. 116-S113/From the September 2019 ACI Structural Journal, p. 201 Reinforcement Limits for Reinforced Concrete Elements with High-Strength Steel. Paper by A. W. Puranam and S. Pujol Disc. 116-S117/From the September 2019 ACI Structural Journal, p. 247 Novel Empirical Expression to Predict Shear Strength of Reinforced Concrete Walls Based on Particle Swarm. Paper by Hadi Baghi, Hani Baghi, and Sasan Siavashi Disc. 116-S141/From the November 2019 ACI Structural Journal, p. 251 Torsional Behavior of Reinforced Concrete Beams with High-Strength Steel Bars. Paper by C. Kim, S. Kim, K.-H. Kim, D. Shin, M. Haroon, and J.-Y. Lee Disc. 117-S04/From the January 2020 ACI Structural Journal, p. 43 Bond Behavior of 0.6 in. (15.2 mm) Prestressing Strand in Beltic Calcium Sulfoaluminate (BCSA) Cement Concrete. Paper by T. M. Bowser, C. D. Murray and R. W. Floy

The role of youth in solving problems of the country

Before the Kyrgyz Republic faces the diffi cult task of modernization and development. One of the main resources of these tasks would be to involve young people in the solution of these problems. At the heart of democracy in the West, largely support the modernization and development — the priority of individualism and personal freedom. Even then — appearing parties, NGOs as a way of strengthening the capacity of individual wills. How do things stand with the priority of individualism and individual freedom among young people in Kyrgyzstan? In Kyrgyzstan, the average life expectancy is low — only 58 years old. The birth rate is quite high by world standards. This leads to the fact that in Kyrgyzstan the population is quite young. Potentially — it is a signifi cant resource for development: young mobile workforce. However, the role of young people in public life is quite low. With what it is connected? In our opinion, the positive and negative factors aff ecting the role of youth in the development of the Kyrgyz Republic are mainly in historical and geopolitical features of the country. So fi rst look at these characteristics, then how they aff ect the role of youth in the development of the country, and fi nally — what conclusions and recommendations from this follow

Quality of life, burden and emotion regulation difficulties in relatives of borderline personality disorder patients.

Treball Final de Grau en Psicologia. Codi: PS1048. Curs: 2018/2019Borderline Personality Disorder (BPD) is a mental disorder characterized by dominant patterns of emotional instability, in addition to presenting alterations of self-image, instability in interpersonal relationships, marked impulsiveness and suicidal behaviors (suicidal ideation and attempts) causing a great interference in the life of the individual. There are several factors involved in BPD, including the family. Thus, relatives play an important role in the onset and development of the disorder, while at the same time the diagnosis of BPD and the associated symptoms influence the status of relatives. Some studies show high levels of burden, difficulties in emotion regulation and a deterioration in the well-being of the relatives of patients with BPD. The objective of this work was to study the level of burden and difficulties in emotional regulation in a sample of 49 relatives of patients with BPD, as well as to determine their levels of quality of life. In addition, the possible relation among these variables was also studied. The Quality of Life Index (QLI), the Difficulties in Emotion Regulation Scale (DERS) and the Burden Assessment Scale (BAS) were used to carry out the study. Regarding the results, relatives showed burden scores above the average, moderate difficulties in emotion regulation and also a moderate level of quality of life. Moreover, a significant and negative correlation was obtained between burden and quality of life, and a significant and positive correlation was shown between the difficulties in emotion regulation and burden. These data provide evidence about the importance of taking into account families in the BPD intervention processes to improve the well-being of both patients and relatives.El Trastorno Límite de la Personalidad (TLP) es un trastorno mental caracterizado por patrones dominantes de inestabilidad emocional, además de presentar alteraciones de la auto-imagen, inestabilidad en las relaciones interpersonales, una marcada impulsividad y conductas suicidas (ideación e intentos suicidas) causando una gran interferencia en la vida del individuo. En el TLP intervienen varios factores, entre los cuales se encuentra la familia. Así, la familia juega un papel importante en la aparición y el desarrollo del trastorno, mientras que al mismo tiempo el diagnóstico de TLP y los síntomas asociados influyen en el estado de los familiares. Algunos estudios muestran niveles altos de carga, dificultades en la regulación emocional y un deterioro en el bienestar de los familiares de pacientes con TLP. El objetivo de este trabajo consistió en estudiar cuál era el nivel de carga y de dificultades en la regulación emocional en una muestra de 49 familiares de pacientes con TLP, así como determinar sus niveles de calidad de vida. Además, se estudió la posible relación entre estas variables. Para llevar a cabo el estudio se utilizaron las escalas de Quality of Life Index (QLI), Difficulties in Emotion Regulation Scale (DERS) y Burden Assessment Scale (BAS). Respecto a los resultados, se obtuvieron puntuaciones de carga por encima de la media, dificultades en regulación emocional moderadas y un nivel de calidad de vida también moderado. Por otra parte, se obtuvo una relación significativa y negativa entre la carga y la calidad de vida, y una relación significativa y positiva entre las dificultades en la regulación emocional y la carga. Estos datos aportan evidencias acerca de la importancia de tener en cuenta a las familias en los procesos de intervención del TLP para mejorar tanto el bienestar de los pacientes como el de sus familiares