Conectando con el autismo: aplicaciones informáticas en el ámbito de los transtornos del espectro autista II

[Resumen] El objetivo principal es explicar cómo a través de varias teorías actuales, podemos elaborar un modelo de cómo funciona la mente de las personas con Trastornos del Espectro del Autismo (TEA) y dar ideas prácticas que se puedan llevar al contexto del aula o al trabajo con adultos, a través de soporte informático. En la primera parte, se da una visión general del funcionamiento de la mente de las personas con TEA, a través de ejemplos lo más visuales posibles (El continuo o espectro autista, Tríada de alteraciones y Comprendiendo el autismo). En la segunda parte se explica el trabajo realizado desde la Asociación a través del programa Intercentros “Disfrutando y aprendiendo con el ordenador”. Utilizando distintos programas informáticos, se presentan ejemplos de adaptaciones de actividades, cuentos,… Por último se hace un repaso de las páginas webs más interesantes en el campo de los TEA y una bibliografía de referencia

Gastric cancer: predictors of recurrence when lymph-node dissection is inadequate

<p>Abstract</p> <p>Background</p> <p>The TNM classification (sixth edition) requires at least 15 lymph nodes to be examined to allow an accurate staging. However, in our environment, only 20% of patients have the recommended minimum of 15 nodes removed.</p> <p>Purpose</p> <p>To evaluate clinicopathological predictors of recurrence in patients with gastric cancer undergoing radical resection with an inadequate number of lymph nodes examined.</p> <p>Methods</p> <p>101 patients were included in this retrospective cohort. We evaluated age, gender, tumoral location, Borrmann type, Lauren histotype, type of gastrectomy, grade, invasion depth of tumor, lymph node involvement, ratio between metastatic and total number of excised lymph nodes keeping 20% as the cutoff value (LNR) and adjuvant treatment. The association between these variables and recurrence was investigated by using univariate methods and multivariate logistic regression analysis.</p> <p>Results</p> <p>Median (range) age was 63 years (44-85). 63% males, 37% females. Median follow-up time for the whole patients population was 36 months (10-104). Median number of lymph nodes retrieved was 6 (0-14). Recurrence: 50 of 101 cases (49,6%); 41 hematogeneus dissemination, 9 locoregional recurrences. The following factors were found to be correlated with the recurrence risk: tumoral location, invasion depth of tumor, lymph node involvement and LNR. A multivariate analysis revealed that depth of invasion [odds ratio (OR) 2.80, 95% confidence interval (CI) 1.03-7.58, P = 0.04] and LNR (OR 2.34, 95% CI 1.05-5.21, P = 0.03) were independent risk factors for recurrences of gastric cancer. Median time to recurrence: 16 months (2-50). 82% of recurrences occurred within the first two years after surgical treatment. The estimated cumulative risk of recurrence at five years: 61% in the whole patients population, with serosal invasion and LNR > and < 20% was 82% and 44%, without serosal invasion 73% and 39% respectively.</p> <p>Conclusion</p> <p>Invasion depth of tumor and LNR were independent predictors of recurrence in gastric cancer after potentially curative resection with an inadequate number of lymph nodes examined.</p

Guías Argentinas para el diagnóstico, la prevención y el tratamiento de la osteoporosis 2015

La osteoporosis es una enfermedad en constante crecimiento y que afecta a más de 200 millones de personas en todo el mundo. Nuestras recomendaciones son guías para el diagnóstico, la prevención y tratamiento, pero no normas para las decisiones clínicas en casos individuales. El médico debe adaptarlas a situaciones en la práctica clínica cotidiana, incorporando factores personales que trascienden los límites de estas guías y hacen al saber y al arte de la práctica médica. Como todo conocimiento científico, deben ser actualizadas periódicamente a medida que se adquieran nuevas, mejores y más efectivas herramientas diagnósticas y terapéuticas.Osteoporosis is an evolving disease which affects over 200 million people worldwide. Our recommendations are guidelines for its diagnosis, prevention and treatment, but they do not constitute standards for clinical decisions in individual cases. The physician must adapt them to individual special situations, incorporating personal factors that transcend the limits of these guidelines and are dependent on the knowledge and art of the practice of Medicine. These guidelines should be reviewed and updated periodically as new, better and more effective diagnostic and therapeutic tools become available

NUEVAS APORTACIONES AL CATÁLOGO FAUNÍSTICO DE LOS QUIRONOMIDOS (DIPTERA: CHIRONOMIDAE) DEL PARQUE NACIONAL DE DOÑANA (SW DE ESPAÑA)

Twenty one species of chironomids have been recorded from Doñana National Park. Amongst these, 12 records are new for the area and 4 for the Iberian península. Total number of chironomid species known in the area rises to 35. A complete list of species including comments on their ecology and biogeography is includedEn los muestreos realizados para la ejecución del presente trabajo se han capturado ejemplares de 21 especies, de ellas 12 son nuevas citas para el Parque Nacional de Doñana y 4 para la Península Ibérica. Con la mencionada aportación, el número de especies de Quironómidos citados para el Parque asciende a 35. Se presenta una relación de las 21 especies capturadas con consideraciones de tipo ecológico y comentarios sobre las implicaciones biogeográficas de las especies más interesantes

Inclusión de la harina de Pennisetum purpureum enriquecida con ensilado biológico de pescado en dietas para codorniz en la etapa de crecimiento-ceba.

Se evaluó el comportamiento productivo de 240 codornices (Coturnix coturnix japonica) en la etapa crecimiento-ceba, al incluir en el pienso diferentes niveles de harina dePennisetum purpureum enriquecida con ensilaje biológico de pescado (HPPE). Los animales fueron distribuidos en un diseño completamente aleatorio en seis unidades experimentales por tratamiento, cada una de ellas con diez animales. Se formuló una dieta isoproteica e isoenergética, con diferentes niveles de inclusión (0; 10; 20 y 30 %). Los valores bromatológicos de proteína cruda estuvieron acordes con los requerimientos de la categoría crecimiento-ceba, y la fibra aumentó en la medida que se incrementó el nivel de inclusión. Los mejores rendimientos de canal se observaron en los niveles de inclusión 0; 10 y 20 %. Al comparar las dietas se encontraron diferencias significativas (P &lt; 0,01) —respecto al consumo de alimento— para el peso y rendimiento en canal, y para los pesos de la pechuga, muslo + encuentro, hígado y la molleja en el tratamiento con  30 % de inclusión. Se presentan diferencias significativas enla pechuga y peso de muslos con descenso para la men-cionada variable. Esta alternativa de alimentación puede utilizarse en 10 y 20 % de inclusión, por mantener los índi-ces productivos y la calidad de la carne.Inclusion of Pennisetum purpureum flour enriched with fish biological ensilado in diets for quails in growth-fattening stage.ABSTRACTThe reproductive behavior of 240 quails (Coturnix coturnix japonica) was assessed in growth-fattening stage, when included different levels of flour of Pennisetum purpureum in the fodder enriched with fish biological ensilaje (HPPE). The animals were distributed in a complete random design in six experimental units per treatment, each one of them with ten animals. A isoproteic and isoenergetic was formulated with different level of inclusion (0; 10; 20 and 30 %). The bromatologicallevels of raw protein were in accordance with the requirements of the growth-fattening category and the fiber increased as the level of inclusion was also increased. The best canal yields were detected in the level of inclusion 0; 10 y 20 %. Significant differences were found when comparing the diets (P &lt; 0,01)- as regards food comsumption- for weigh and canal yield, and for breast, leg+encuentro, liver and gizzard weighs in the treatment with 30% of inclusion. There are significant differences in the gizzard and leg weigh with a decrease for the mentioned variable. The feeding alternative can be used in 10 and 20 % of inclusión, since it keeps reproduc-tive indices and meat quality

Argentine guidelines for the diagnosis, prevention and treatment of osteoporosis, 2015

La osteoporosis es una enfermedad en constante crecimiento y que afecta a más de 200 millones de personas en todo el mundo. Nuestras recomendaciones son guías para el diagnóstico, la prevención y tratamiento, pero no normas para las decisiones clínicas en casos individuales. El médico debe adaptarlas a situaciones en la práctica clínica cotidiana, incorporando factores personales que trascienden los límites de estas guías y hacen al saber y al arte de la práctica médica. Como todo conocimiento científico, deben ser actualizadas periódicamente a medida que se adquieran nuevas, mejores y más efectivas herramientas diagnósticas y terapéuticas.Osteoporosis is an evolving disease which affects over 200 million people worldwide. Our recommendations are guidelines for its diagnosis, prevention and treatment, but they do not constitute standards for clinical decisions in individual cases. The physician must adapt them to individual special situations, incorporating personal factors that transcend the limits of these guidelines and are dependent on the knowledge and art of the practice of Medicine. These guidelines should be reviewed and updated periodically as new, better and more effective diagnostic and therapeutic tools become available.Laboratorio de Investigación en Osteopatías y Metabolismo Minera

Relationship between damage and mortality in juvenile-onset systemic lupus erythematosus: Cluster analyses in a large cohort from the Spanish Society of Rheumatology Lupus Registry (RELESSER)

Objectives: To identify patterns (clusters) of damage manifestation within a large cohort of juvenile SLE (jSLE) patients and evaluate their possible association with mortality. Methods: This is a multicentre, descriptive, cross-sectional study of a cohort of 345 jSLE patients from the Spanish Society of Rheumatology Lupus Registry. Organ damage was ascertained using the Systemic Lupus International Collaborating Clinics Damage Index. Using cluster analysis, groups of patients with similar patterns of damage manifestation were identified and compared. Results: Mean age (years) ± S.D. at diagnosis was 14.2 ± 2.89; 88.7% were female and 93.4% were Caucasian. Mean SLICC/ACR DI ± S.D. was 1.27 ± 1.63. A total of 12 (3.5%) patients died. Three damage clusters were identified: Cluster 1 (72.7% of patients) presented a lower number of individuals with damage (22.3% vs. 100% in Clusters 2 and 3, P < 0.001); Cluster 2 (14.5% of patients) was characterized by renal damage in 60% of patients, significantly more than Clusters 1 and 3 (P < 0.001), in addition to increased more ocular, cardiovascular and gonadal damage; Cluster 3 (12.7%) was the only group with musculoskeletal damage (100%), significantly higher than in Clusters 1 and 2 (P < 0.001). The overall mortality rate in Cluster 2 was 2.2 times higher than that in Cluster 3 and 5 times higher than that in Cluster 1 (P < 0.017 for both comparisons). Conclusions: In a large cohort of jSLE patients, renal and musculoskeletal damage manifestations were the two dominant forms of damage by which patients were sorted into clinically meaningful clusters. We found two clusters of jSLE with important clinical damage that were associated with higher rates of mortality, especially for the cluster of patients with predominant renal damage. Physicians should be particularly vigilant to the early prevention of damage in this subset of jSLE patients with kidney involvement

Estimation in a Competing Risks Proportional Hazards Model Under Length-biased Sampling With Censoring

International audienceWhat population does the sample represent? The answer to this question is of crucial importance when estimating a survivor function in duration studies. As is well-known, in a stationary population, survival data obtained from a cross-sectional sample taken from the population at time $t_0$ represents not the target density $f(t)$ but its length-biased version proportional to $tf(t)$, for $t>0$. The problem of estimating survivor function from such length-biased samples becomes more complex, and interesting, in presence of competing risks and censoring. This paper lays out a sampling scheme related to a mixed Poisson process and develops nonparametric estimators of the survivor function of the target population assuming that the two independent competing risks have proportional hazards. Two cases are considered: with and without independent consoring before length biased sampling. In each case, the weak convergence of the process generated by the proposed estimator is proved. A well-known study of the duration in power for political leaders is used to illustrate our results. Finally, a simulation study is carried out in order to assess the finite sample behaviour of our estimators