Surgical treatment for genital linfedema. Case presentacions.

El linfedema es la acumulación de líquido en los espacios intersticiales, que lleva a un aumento de volumen de la extremidad o región corporal, con disminución de su capacidad funcional, aumento del peso y modificación del factor estético como consecuencia de alteraciones de la circulación linfática. Se presentan dos pacientes portadores de linfedema genital de larga evolución, secundario a infección local, que fueron sometidos a tratamiento quirúrgico. Se describen el cuadro clínico, estudios complementarios, tratamiento quirúrgico y los resultados.A los pacientes se les realizó la exéresis del tejido edematoso del pene y los escrotos, colgajo cutáneo lateral en alas de mariposa de base de escroto y conservación de testes y recubrimiento del pene con   autoinjerto de piel parcial.El tratamiento quirúrgico del linfedema genital tiene resultados satisfactorios desde el punto de vista funcional, estético y psicológico que aumenta la calidad de vida del paciente y lo reincorpora a una vida social útil.The lymphedema is the accumulation of liquid in the interestitial spaces, which provokes an enlargement of the extremities, decreasing its functional capacity, winning weight and modifying the aesthetic factors as a consequence of the alterations of lymphatic circulation. There are presented two patients carrying genital lymphedema of long evolution, favoring a local infection, and they underwent surgical treatment. There are described some clinical manifestations like complementaries,  surgical treatment and results. It was applied the abscission of the edema tissues of the penis and scrotum, lateral cutaneous flap in butterfly wings of the scrotum  base and testes preservation and recovering  of the penis with cuts of partial skin.To conclude, the surgical treatment of genital lymphedem has satisfactory results ince the functional, aesthetic and psychological point of view what increase the life -quality of the patients and help them start a social interchange

COMPOSICIÓN FLORÍSTICA Y USO FORRAJERO DE ARVENSES QUE CRECEN EN ÁREAS CITRÍCOLAS DE CIEGO DE ÁVILA, CUBA

Con la finalidad de: (1) identificar las plantas herbáceas que se desarrollaron en plantaciones citrícolas de la Empresa Cítricos de Ciego de Ávila, clasificándolas taxonómicamente; y (2) definir, a partir de la literatura, algunas de sus características biológicas y su espectro de utilización agronómica, especialmente dirigido a la alimentación de los animales que se integren al sistema, se hizo un muestreo que incluyó el 10 % de los campos dedicados a naranja (Citrus sinensis (L.) Osbeck) y toronja (Citrus paradisi Macf), tomando en cuenta la distribución geográfica en sus cuatro puntos cardinales. La determinación de las especies existentes en cada campo se hizo por simple inspección visual, siguiendo un recorrido en zigzag, las no determinadas en el campo se herborizaron para su ulterior identificación. Los resultados de la investigación permiten concluir que en las plantaciones de cítricos estudiadas se desarrollan 61 especies de plantas agrupadas en 19 familias y 48 géneros, de las cuales el 74 % pertenecen a la clase Magnoliatae y el resto a la Liliatae. Fabaceae y Poaceae son las familias más representadas en ambas clases, con 11 y 14 especies respectivamente, muchas de las cuales son perennes que se propagan por semillas, consideradas en su gran mayoría pastos constituidos de los sistemas ganaderos de Cuba y otras regiones tropicales

Strategic raw materials for the energy and digital transition in Spain

[EN] One of the main concerns of the European Commission is critical raw materials (CRM), necessary for daily life in a wide range of goods and applications. The EU's industry and economy depend on international markets for many important raw materials, which are produced and supplied by third countries. These CRMs are closely linked to clean technologies, technological progress and quality of life. Concern about access to CRMs led the European Commission to draw up a first list of critical raw materials (CRM) in 2011, and to schedule its review and update every three years, the last being in 2020.Peer reviewe

The Importance of Spanish Data (BDMIN & PANORAMA MINERO) in the European Raw Materials Knowledge Base (EURMKB)

[EN] The IGME has an extensive experience in the field of mineral resources and the main source of information is the Mineral Resources Database (BDMIN) that integrates the geological‐mining information on occurrences, mines and exploitations (active and inactive) of metallic, nonmetallic and industrial minerals, and rocks in Spain. In addition, since 1981, the Panorama Minero has been carried out with the aim of providing reliable data on Spanish mining production, based on the Spanish Mining Statistics (MITERD). This information includes data on the national production of minerals, in tonnage and value, metallurgical production, foreign trade, etc. Other sources include the National Mining Cadastre and Foreign Trade statistics from the Tax Agency.Peer reviewe

Adjuvant interferon gamma in patients with drug – resistant pulmonary tuberculosis: a pilot study

BACKGROUND: Tuberculosis (TB) is increasing in the world and drug-resistant (DR) disease beckons new treatments. METHODS: To evaluate the action of interferon (IFN) gamma as immunoadjuvant to chemotherapy on pulmonary DR-TB patients, a pilot, open label clinical trial was carried out in the Cuban reference ward for the management of this disease. The eight subjects existing in the country at the moment received, as in-patients, 1 × 10(6 )IU of recombinant human IFN gamma intramuscularly, daily for one month and then three times per week up to 6 months as adjuvant to the indicated chemotherapy, according to their antibiograms and WHO guidelines. Sputum samples collection for direct smear observation and culture as well as routine clinical and thorax radiography assessments were done monthly. RESULTS: Sputum smears and cultures became negative for acid-fast-bacilli before three months of treatment in all patients. Lesion size was reduced at the end of 6 months treatment; the lesions disappeared in one case. Clinical improvement was also evident; body mass index increased in general. Interferon gamma was well tolerated. Few adverse events were registered, mostly mild; fever and arthralgias prevailed. CONCLUSIONS: These data suggest that IFN gamma is useful and well tolerated as adjunctive therapy in patients with DR-TB. Further controlled clinical trials are encouraged

5to. Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad. Memoria académica

El V Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad, CITIS 2019, realizado del 6 al 8 de febrero de 2019 y organizado por la Universidad Politécnica Salesiana, ofreció a la comunidad académica nacional e internacional una plataforma de comunicación unificada, dirigida a cubrir los problemas teóricos y prácticos de mayor impacto en la sociedad moderna desde la ingeniería. En esta edición, dedicada a los 25 años de vida de la UPS, los ejes temáticos estuvieron relacionados con la aplicación de la ciencia, el desarrollo tecnológico y la innovación en cinco pilares fundamentales de nuestra sociedad: la industria, la movilidad, la sostenibilidad ambiental, la información y las telecomunicaciones. El comité científico estuvo conformado formado por 48 investigadores procedentes de diez países: España, Reino Unido, Italia, Bélgica, México, Venezuela, Colombia, Brasil, Estados Unidos y Ecuador. Fueron recibidas un centenar de contribuciones, de las cuales 39 fueron aprobadas en forma de ponencias y 15 en formato poster. Estas contribuciones fueron presentadas de forma oral ante toda la comunidad académica que se dio cita en el Congreso, quienes desde el aula magna, el auditorio y la sala de usos múltiples de la Universidad Politécnica Salesiana, cumplieron respetuosamente la responsabilidad de representar a toda la sociedad en la revisión, aceptación y validación del conocimiento nuevo que fue presentado en cada exposición por los investigadores. Paralelo a las sesiones técnicas, el Congreso contó con espacios de presentación de posters científicos y cinco workshops en temáticas de vanguardia que cautivaron la atención de nuestros docentes y estudiantes. También en el marco del evento se impartieron un total de ocho conferencias magistrales en temas tan actuales como la gestión del conocimiento en la universidad-ecosistema, los retos y oportunidades de la industria 4.0, los avances de la investigación básica y aplicada en mecatrónica para el estudio de robots de nueva generación, la optimización en ingeniería con técnicas multi-objetivo, el desarrollo de las redes avanzadas en Latinoamérica y los mundos, la contaminación del aire debido al tránsito vehicular, el radón y los riesgos que representa este gas radiactivo para la salud humana, entre otros

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Peri-operative red blood cell transfusion in neonates and infants: NEonate and Children audiT of Anaesthesia pRactice IN Europe: A prospective European multicentre observational study

BACKGROUND: Little is known about current clinical practice concerning peri-operative red blood cell transfusion in neonates and small infants. Guidelines suggest transfusions based on haemoglobin thresholds ranging from 8.5 to 12 g dl-1, distinguishing between children from birth to day 7 (week 1), from day 8 to day 14 (week 2) or from day 15 (≥week 3) onwards. OBJECTIVE: To observe peri-operative red blood cell transfusion practice according to guidelines in relation to patient outcome. DESIGN: A multicentre observational study. SETTING: The NEonate-Children sTudy of Anaesthesia pRactice IN Europe (NECTARINE) trial recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. PATIENTS: The data included 5609 patients undergoing 6542 procedures. Inclusion criteria was a peri-operative red blood cell transfusion. MAIN OUTCOME MEASURES: The primary endpoint was the haemoglobin level triggering a transfusion for neonates in week 1, week 2 and week 3. Secondary endpoints were transfusion volumes, 'delta haemoglobin' (preprocedure - transfusion-triggering) and 30-day and 90-day morbidity and mortality. RESULTS: Peri-operative red blood cell transfusions were recorded during 447 procedures (6.9%). The median haemoglobin levels triggering a transfusion were 9.6 [IQR 8.7 to 10.9] g dl-1 for neonates in week 1, 9.6 [7.7 to 10.4] g dl-1 in week 2 and 8.0 [7.3 to 9.0] g dl-1 in week 3. The median transfusion volume was 17.1 [11.1 to 26.4] ml kg-1 with a median delta haemoglobin of 1.8 [0.0 to 3.6] g dl-1. Thirty-day morbidity was 47.8% with an overall mortality of 11.3%. CONCLUSIONS: Results indicate lower transfusion-triggering haemoglobin thresholds in clinical practice than suggested by current guidelines. The high morbidity and mortality of this NECTARINE sub-cohort calls for investigative action and evidence-based guidelines addressing peri-operative red blood cell transfusions strategies. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT02350348