Prevalencia de insuficiencia renal «oculta» en población diabética tipo 2

ObjetivoDeterminar la prevalencia de insuficiencia renal en diabéticos tipo 2 y comparar dos criterios de definición: el basado en la estimación del filtrado glomerular por la fórmula de Cockcroft-Gault corregida para la superficie corporal y el basado en la creatinina sérica.DiseñoEstudio descriptivo y transversal.EmplazamientoZona básica del Centro de Salud de El Cristo, Oviedo.ParticipantesLa totalidad de pacientes diabéticos tipo 2 diagnosticados de la zona básica.Mediciones principalesSe recogieron datos demográficos, clínicos, factores de riesgo y enfermedad cardiovascular. Se diagnosticó insuficiencia renal (IR) según unas cifras de creatinina plasmática ≥ 1,3 mg/dl en mujeres y ≥ 1,4 mg/dl en varones y según el filtrado glomerular (FG) estimado mediante la fórmula de Cockcroft-Gault: moderada para FG, 60-30 ml/min/1,73 m2; grave para FG, 29-15 ml/min/1,73 m2, y terminal para FG, < 15 ml/min/1,73 m2.ResultadosSe incluyó a 499 pacientes. El 52,3% era mujer con una edad de 69,7 ± 0,4 años. La prevalencia de IR según la creatinina sérica fue del 12%, y según la fórmula de Cockcroft-Gault del 40,5%. Los pacientes con FG reducido y creatinina normal tenían mayor edad (75,5 ± 7,9 frente a 65,4 ± 9,8 años; p < 0,001), predominaban las mujeres (76,3 frente a 41,7%; p < 0,001), tenían un menor índice de masa corporal (27,3 ± 3,7 frente a 30,9 ± 4,4), presentaban un peor control glucémico (HbA1c 7,1 ± 1,8 frente a 6,9 ± 1,9%; p = 0,007) y la prevalencia de insuficiencia cardíaca era superior (6,4 frente a 2,1%; IC del 95%, 1,1-8,8; p = 0,02) en comparación con los pacientes con FG y creatinina normales.ConclusiónLa estimación del FG por la fórmula de Cockcroft-Gault corregida para la superficie corporal muestra una insuficiencia renal no conocida en uno de cada 3 pacientes diabéticos tipo 2.ObjectiveTo determine the prevalence of renal failure (RF) in type-2 diabetics and to compare two criteria of definition: that based on the calculation of glomerular filtration by the Cockcroft-Gault formula corrected for body surface area and that based on serous creatinine.DesignCross-sectional, descriptive study.SettingEl Cristo Health Centre,Oviedo, north of Spain.ParticipantsAll patients in the catchment area diagnosed with type-2 diabetes.MethodDemographic, clinical, risk factor, and cardiovascular pathology details were gathered. Renal failure was diagnosed on figures of plasma creatinine ≥1.3 mg/dL in women and ≥1.4 mg/dL in men, and glomerular filtration (GF) calculated by means of the Cockcroft-Gault formula: moderate GF, 60-30 mL/min/1.73 m2; severe GF, 29-15 mL/min/1.73 m2, and terminal GF: <15 mL/min/1.73 m2.Results499 patients were included. 52.3% were women, aged 69.7±10.4 years old. Prevalence of RF by serous creatinine was 12%; and by the Cockcroft-Gault formula, 40.5%. Patients with lower glomerular filtration and normal creatinine were older (75.5±7.9 vs 65.4±9.8; P<.001), mainly female (76.3% vs 41.7%; P<.001), had lower BMI (27.3±3.7 vs 30.9±4.4) and had worse glucaemia control (HbA1c 7.1±1.8% vs 6.9±1.9%; P=.007) and higher indices of cardiac failure (6.4% vs 2.1%; 95% CI, 1.1- 8.8; P=.02) than patients with normal glomerular filtration and creatinine.ConclusionCalculation of glomerular filtration by the Cockcroft-Gault formula corrected for body surface area revealed unknown renal failure in 1 in 3 type-2 diabetes patients

Morpho-kinematic analysis of the point-symmetric, bipolar planetary nebulae Hb 5 and K 3-17, a pathway to poly-polarity

The kinematics of the bipolar planetary nebulae Hb~5 and K 3-17 are investigated in detail by means of a comprehensive set of spatially resolved high spectral resolution, long-slit spectra. Both objects share particularly interesting characteristics, such as a complex filamentary, rosette-type nucleus, axial point-symmetry and very fast bipolar outflows. The kinematic information of Hb~5 is combined with {\it HST} imagery to construct a detailed 3D model of the nebula using the code SHAPE. The model shows that the large scale lobes are growing in a non-homologous way. The filamentary loops in the core are proven to actually be secondary lobes emerging from what appears to be a randomly punctured, dense, gaseous core and the material that forms the point symmetric structure flows within the lobes with a distinct kinematic pattern and its interaction with the lobes has had a shaping effect on them. Hb~5 and K~3-17 may represent a class of fast evolving planetary nebulae that will develop poly-polar characteristics once the nebular core evolves and expands.Comment: 19 pages, 8 figures. To appear in The Astrophysical Journa

PENGARUH MEDIA PEMBELAJARAN MIND MAPPING TERHADAP MINAT BELAJAR PESERTA DIDIK PADA PELAJARAN EKONOMI KELAS XI IPS 1 di SMA NEGERI 27 BANDUNG

Judul penelitian ini adalah pengaruh media pembelajaran mind mapping terhadap minat belajar peserta didik pada pelajaran ekonomi kelas XI IPS 1 di SMA Negeri 27 Bandung tahun ajaran 2016-2017. Berdasarkan tinjauan langsung di SMA Negeri 27 Bandung kelas XI IPS 1, Pembelajaran konvensional (ceramah) hanya membuat peserta didik kurang aktif dan malas dalam menerima materi yang ada, karena pembelajaran hanya terpusat pada apa yang disampaikan sehingga tidak dapat dimengerti secara maksimal. Tujuan dari penelitian ini adalah: (1) Mengetahui penggunaan media mind mapping pada mata pelajaran ekonomi kelas XI IPS 1 di SMA Negeri 27 Bandung. (2) Mengetahui minat belajar peserta didik pada mata pelajaran ekonomi kelas XI IPS 1 di SMA Negeri 27 Bandung. (3) Mengetahui seberapa besar pengaruh media mind mapping terhadap minat belajar peserta didik pada mata pelajaran ekonomi kelas XI IPS 1 di SMA Negeri 27 Bandung. Metode yang digunakan dalam penelitian ini adalah survei. Teknik pengumpulan data yang digunakan yaitu observasi dan angket dengan teknik pengolahan data uji validitas, uji reliabilitas, uji normalitas data, analisis regresi linier sederhana dan koefisien determinasi, Hipotesis penelitian berbunyi “Terdapat pengaruh antara media pembelajaran mind mapping (X) terhadap minat belajar peserta didik (Y) pada mata pelajaran ekonomi. Hasil penelitian ini adalah terdapat pengaruh antara variabel X dan Variabel Y sebesar 0,336 atau 33,60%. Untuk mengetahui hubungan fungsional antara variabel X dan variabel Y maka digunakan analisis regresi linier sederhana dengan hasil perhitungan sebagai berikut : Y = 9.915 + 0.537 X artinya bahwa setiap media pembelajaran mind mapping bertambah 9,915 maka minat belajar meningkat sebesar 0,537. Untuk mengetahui seberapa besar pengaruh variabel X (media pembelajaran mind mapping) terhadap variabel Y (minat belajar), maka digunakan koefisien determinasi dengan hasil perhitungan sebesar 33,60% maka sebagian lainnya ditentukan oleh faktor lain yang tidak diteliti. Kesimpulan hipotesis penelitian dapat diterima, sebagai akhir penelitian penulis menyampaikan saran kepada guru agar sebaiknya guru menggunakan variasi media pembelajaran yang menarik berkaitan dengan materi pelajaran yang akan disampaikan, karena cara ini dapat membuat peserta didik aktif dan kreatif untuk belajar. Kepada para praktisi atau peneliti lain di bidang pendidikan dapat melakukan penelitian serupa dengan media pembelajaran dan metode yang berbeda agar diperoleh berbagai alternatif untuk peningkatan pemahaman pembelajaran pada pokok bahasan selanjutnya dan kepada pihak sekolah sebagai bahan kajian bagi sekolah dan menyarankan guru untuk menggunakan media pembelajaran yang mampu meningkatkan prestasi belajar peserta didik untuk mendukung pendekatan saintifik dan media pembelajaran yang baik. Kata Kunci : media pembelajaran mind mapping, minat Belajar

Candidate planetary nebulae in the IPHAS photometric catalogue

Original article can be found at: http://www.aanda.org/ Copyright European Southern Observatory. DOI: 10.1051/0004-6361/200912002Context. We have carried out a semi-automated search for planetary nebulae (PNe) in the INT photometric H-alpha survey (IPHAS) catalogue. We present the PN search and the list of selected candidates. We cross correlate the selected candidates with a number of existing infrared galactic surveys in order to gain further insight into the nature of the candidates. Spectroscopy of a subset of objects is used to estimate the number of PNe present in the entire candidate list. Aims. The overall aim of the IPHAS PN project is to carry out a deep census of PNe in the northern Galactic plane, an area where PN detections are clearly lacking. Methods. The PN search is carried out on the IPHAS photometric catalogue. The candidate selection is based on the IPHAS and 2MASS/UKIDSS colours of the objects and the final candidate selection is made visually. Results. From the original list of ~600 million IPHAS detections we have selected a total of 1005 objects. Of these, 224 are known objects, leaving us with 781 PN candidates. Based on the initial follow-up spectroscopy, we expect the list to include very young and proto-PNe in addition to genuine, normal PNe (~16%) and emission line objects other than PNe. We present additional criteria to select the most probable PN candidates from our candidate list.Peer reviewe

Planetary Nebulae: Observational Properties, Mimics, and Diagnostics

The total number of true, likely and possible planetary nebulae (PN) now known in the Milky Way is nearly 3000, double the number known a decade ago. The new discoveries are a legacy of the recent availability of wide field, narrowband imaging surveys, primarily in the light of H-alpha. In this paper, we summarise the various PN discovery techniques, and give an overview of the many types of objects which mimic PN and which appear as contaminants in both Galactic and extragalactic samples. Much improved discrimination of classical PN from their mimics is now possible based on the wide variety of high-quality multiwavelength data sets that are now available. We offer improved taxonomic and observational definitions for the PN phenomenon based on evaluation of these better diagnostic capabilities. However, we note that evidence is increasing that the PN phenomenon is heterogeneous, and PN are likely to be formed from multiple evolutionary scenarios. In particular, the relationships between some collimated symbiotic outflows and bipolar PN remain uncertain.Comment: 25 pages, 6 figures; presentation at the workshop on the Legacies of the Macquarie/AAO/Strasbourg H-alpha Planetary Nebula project, accepted by the Publications of the Astronomical Society of Australia (PASA

New young planetary nebulae in IPHAS

Original article can be found at: http://www.aanda.org/ Copyright The European Southern Observatory. DOI: 10.1051/0004-6361/200811575Aims. We search for very small-diameter galactic planetary nebulae (PNe) representing the earliest phases of PN evolution. The IPHAS catalogue of H-emitting stars provides a useful basis for this study since all sources present in this catalogue must be of small angular diameter. Methods. The PN candidates are selected based on their location in two colour-colour diagrams: IPHAS (r' - H) vs. (r' - i'), and 2MASS (J - H) vs. (H - ). Spectroscopic follow-up was carried out on a sample of candidates to confirm their nature. Results. We present a total of 83 PN candidates. We were able to obtain spectra or find the classification from the literature for 35 candidates. Five of these objects are likely to be new PNe, including one large bipolar PN discovered serendipitously close to an emission-line star. PN distances deduced from extinction-distance relations based on IPHAS field-star photometry are presented for the first time. These yield distance estimates for our objects in the range 2 kpc and 6 kpc. From the data in hand, we conclude that four of the discovered objects are probably young PNe.Peer reviewe

Study of star-forming galaxies in SDSS up to redshift 0.4 II. Evolution from the fundamental parameters: mass, metallicity & SFR

To understand the formation and evolution of galaxies, it is important to have a full comprehension of the role played by the metallicity, star formation rate (SFR), morphology, and color. The interplay of these parameters at different redshifts will substantially affect the evolution of galaxies and, as a consequence, the evolution of them will provide important clues and constraints on the galaxy evolution models. In this work we focus on the evolution of the SFR, metallicity of the gas, and morphology of galaxies at low redshift in search of signs of evolution. We use the S2N2 diagnostic diagram as a tool to classify star--forming, composite, and AGN galaxies. We analyzed the evolution of the three principal BPT diagrams, estimating the SFR and specific SFR (SSFR) for our samples of galaxies, studying the luminosity and mass-metallicity relations, and analyzing the morphology of our sample of galaxies through the g-r color, concentration index, and SSFR. We found that the S2N2 is a reliable diagram to classify star--forming, composite, and AGNs galaxies. We demonstrate that the three principal BPT diagrams show an evolution toward higher values of [OIII]5007/Hb due to a metallicity decrement. We found an evolution in the mass-metallicity relation of ~ 0.2 dex for the redshift range 0.3 < z < 0.4 compared to our local one. From the analysis of the evolution of the SFR and SSFR as a function of the stellar mass and metallicity, we discovered a group of galaxies with higher SFR and SSFR at all redshift samples, whose morphology is consistent with those of late-type galaxies. Finally, the comparison of our local (0.04<z<0.1) with our higher redshift sample (0.3<z<0.4), show that the metallicity, the SFR and morphology, evolve toward lower values of metallicity, higher SFRs, and late--type morphologies for the redshift range 0.3<z<0.4Comment: 16 pages, 15 figures. Accepted for publication in A&

Primary care randomized clinical trial: manual therapy effectiveness in comparison with TENS in patients with neck pain

This study investigated effectiveness of manual therapy (MT) with transcutaneous electrical nerve stimulation (TENS) to reduce pain intensity in patients with mechanical neck disorder (MND). A randomized multi-centered controlled clinical trial was performed in 12 Primary Care Physiotherapy Units in Madrid Region. Ninety patients were included with diagnoses of subacute or chronic MND without neurological damage, 47 patients received MT and 43 TENS. The primary outcome was pain intensity measured in millimeters using the Visual Analogue Scale (VAS). Also disability, quality of life, adverse effects and sociodemographic and prognosis variables were measured. Three evaluations were performed (before, when the procedure ?nished and six months after). Seventy-one patients (79%) completed the follow-up measurement at six months. In more than half of the treated patients the procedure had a clinically relevant ?short term? result after having ended the intervention, when either MT or TENS was used. The success rate decreased to one-third of the patients 6 months after the intervention. No differences can be found in the reduction of pain, in the decrease of disability nor in the quality of life between both therapies. Both analyzed physiotherapy techniques produce a short-term pain reduction that is clinically relevant.Ministerio de SanidadInstituto de Salud Carlos II