295 research outputs found
P28 85. Análisis de la supervivencia a corto y medio plazo de la cirugía de aorta ascendente
ObjetivosEvaluar la mortalidad hospitalaria y la supervivencia a medio plazo de los pacientes sometidos a una cirugía de aorta ascendente y determinar cuáles son sus factores de riesgo.Material y métodosSe analizó de forma retrospectiva toda la población de pacientes sometidos a un procedimiento quirúrgico de aorta ascendente (sustitución con o sin cirugía valvular o de raíz asociada) entre enero de 2003 y diciembre de 2008. Se evaluó la mortalidad hospitalaria y la supervivencia absoluta en el seguimiento, y mediante análisis uni y multivariante se determinaron las correspondientes variables predictoras.ResultadosTrescientos sesenta y cinco pacientes fueron sometidos de forma consecutiva a algún procedimiento quirúrgico de la aorta ascendente. Edad media: 63,1 años (desviación estándar [DE] 13); n = 99 (27,1%) fueron mujeres; n = 58 (15,9%) habían sido sometidos a una cirugía previa. En 32 pacientes se sustituyó total o parcialmente el arco aórtico. EuroSCORE mediano de 11,72% (interquartile range [IQR]: 6,78-20,43). La mortalidad hospitalaria fue 7,7% (n = 28). Los predictores de mortalidad en análisis multivariante fueron: cirugía cardíaca previa (odds ratio [OR]: 3,18; p = 0,045), tabaquismo activo (OR: 5,7; p = 0,021), insuficiencia renal (OR: 3,03; p = 0,043), estado crítico preoperatorio (OR: 5,63; p = 0,005), edad (OR: 1,06; p = 0,018) y cirugía coronaria asociada (OR: 3,17; p = 0,35). La supervivencia a 1, 3 y 5 años fue 96, 94 y 92%. Sólo edad (hazard ratio [HR]: 1,08; p = 0,022) e hipertensión pulmonar grave (HR: 3,5; p = 0,026) fueron predictores independientes de mortalidad en el seguimiento.ConclusionesEn nuestra experiencia, la sustitución de la aorta ascendente demuestra una baja mortalidad hospitalaria y una adecuada supervivencia a medio plazo
CB6 87. Sustitución valvular aórtica en octogenarios
IntroducciónEn las últimas décadas, la población mayor de 80 años que requiere una cirugía por estenosis aórtica degenerativa ha aumentado sustancialmente.Material y métodosSe compararon los resultados a corto y medio plazo de la sustitución valvular aórtica convencional (SVAo) en estenosis aórtica degenerativa en pacientes mayores y menores de 80 años intervenidos en nuestro centro entre abril de 2004 y diciembre de 2008. Los predictores de mortalidad y eventos adversos mayores cardio y cerebrovasculares (MACCE) en el postoperatorio y el seguimiento se determinaron por análisis multivariante.ResultadosCuatrocientos cincuenta y un pacientes fueron incluidos; 94 (20,8%) eran mayores de 80 años. La cirugía cardíaca previa (odds ratio [OR]: 4,08; p=0,047), la insuficiencia renal (OR: 6,75; p < 0,001), la cirugía coronaria concomitante (OR: 2,57; p=0,034), el sexo femenino (OR: 2,49; p=0,047) y la hipertensión pulmonar grave (OR: 3,68; p=0,024) fueron predictores independientes de mortalidad hospitalaria. En el seguimiento, la edad (hazard ratio [HR]: 2,24; p=0,02), la vasculopatía periférica (HR: 5,1; p < 0,001) e hipertensión arterial (HTA) (HR: 5,2; p=0,025) fueron predictores independientes de mortalidad tardía. Sólo la vasculopatía periférica (HR: 3,55; p=0,014) e HTA (HR: 8,24; p=0,04) fueron predictores independientes de mortalidad cardíaca tardía. La insuficiencia renal (OR: 2,57; p=0,005), hipertensión pulmonar grave (OR: 3,49; p=0,005) y cirugía coronaria asociada (OR: 2,49; p=0,002) fueron predictores independientes de MACCE postoperatorios. Diabetes mellitus (HR: 2,03; p=0,033) y vasculopatía periférica (HR: 2,3; p=0,041) predijeron una mayor incidencia de MACCE en el seguimiento.ConclusionesLa edad mayor de 80 años no empeora el pronóstico a corto y medio plazo tras la SVAo por estenosis aórtica grave degenerativa
Spectral reflectance data of a high temperature stable solar selective coating based on MoSi2-Si3N4
Carbapenem-resistant Citrobacter spp. isolated in Spain from 2013 to 2015 produced a variety of carbapenemases including VIM-1, OXA-48, KPC-2, NDM-1 and VIM-2
Objectives: There is little information about carbapenemase-producing (CP) Citrobacter spp.We studied the molecular epidemiology and microbiological features of CP Citrobacter spp. isolates collected in Spain (2013-15).
Methods: In total, 119 isolates suspected of being CP by the EUCAST screening cut-off values were analysed. Carbapenemases and ESBLs were characterized using PCR and sequencing. The genetic relationship among Citrobacter freundii isolates was studied by PFGE.
Results: Of the 119 isolates, 63 (52.9%) produced carbapenemases, of which 37 (58.7%) produced VIM-1, 20 (31.7%) produced OXA-48, 12 (19%) produced KPC-2, 2 (3.2%) produced NDM-1 and 1 (1.6%) produced VIM- 2; 9 C. freundii isolates co-produced VIM-1 plus OXA-48. Fourteen isolates (22.2%) also carried ESBLs: 8 CTX-M-9 plus SHV-12, 2 CTX-M-9, 2 SHV-12 and 2 CTX-M-15. Fifty-seven isolates (90.5%) were C. freundii, 4 (6.3%) were Citrobacter koseri, 1 (1.6%) was Citrobacter amalonaticus and 1 (1.6%) was Citrobacter braakii. By EUCAST breakpoints, eight (12.7%) of the CP isolates were susceptible to the four carbapenems tested. In the 53 CP C. freundii analysed by PFGE, a total of 44 different band patterns were observed. Four PFGE clusters were identified: cluster 1 included eight isolates co-producing VIM-1 and OXA-48; blaVIM-1 was carried in a class 1 integron (intI-blaVIM-1 - aacA4-dfrB1-aadA1-catB2-qacE¿1/sul1) and blaOXA-48 was carried in a Tn1999.2 transposon.
Conclusions: We observed the clonal and polyclonal spread of CP Citrobacter spp. across several Spanish geographical areas. Four species of Citrobacter spp. produced up to five carbapenemase types, including coproduction of VIM-1 plus OXA-48. Some CP Citrobacter spp. isolates were susceptible to the four carbapenems tested, a finding with potential clinical implications
Massive Star Formation
This chapter reviews progress in the field of massive star formation. It
focuses on evidence for accretion and current models that invoke high accretion
rates. In particular it is noted that high accretion rates will cause the
massive young stellar object to have a radius much larger than its eventual
main sequence radius throughout much of the accretion phase. This results in
low effective temperatures which may provide the explanation as to why luminous
young stellar objects do not ionized their surroundings to form ultra-compact H
II regions. The transition to the ultra-compact H II region phase would then be
associated with the termination of the high accretion rate phase. Objects
thought to be in a transition phase are discussed and diagnostic diagrams to
distinguish between massive young stellar objects and ultra-compact H II
regions in terms of line widths and radio luminosity are presented.Comment: 21 pages, 6 figures, chapter in Diffuse Matter from Star Forming
Regions to Active Galaxies - A Volume Honouring John Dyson, Edited by T.W.
Hartquist, J. M. Pittard, and S. A. E. G. Falle. Series: Astrophysics and
Space Science Proceedings. Springer Dordrecht, 2007, p.6
Human immunodeficiency virus/hepatits C virus coinfection in Spain: Elimination is feasible, but the burden of residual cirrhosis will be significant
Background
We assessed the prevalence of antibodies against hepatitis C virus (HCV-Abs) and active HCV infection in patients infected with human immunodeficiency virus (HIV) in Spain in 2016 and compared the results with those of similar studies performed in 2002, 2009, and 2015.
Methods
The study was performed in 43 centers during October-November 2016. The sample was estimated for an accuracy of 2% and selected by proportional allocation and simple random sampling. During 2016, criteria for therapy based on direct-acting antiviral agents (DAA) were at least significant liver fibrosis, severe extrahepatic manifestations of HCV, and high risk of HCV transmissibility.
Results
The reference population and the sample size were 38904 and 1588 patients, respectively. The prevalence of HCV-Abs in 2002, 2009, 2015, and 2016 was 60.8%, 50.2%, 37.7%, and 34.6%, respectively (P trend <.001, from 2002 to 2015). The prevalence of active HCV in 2002, 2009, 2015, and 2016 was 54.0%, 34.0%, 22.1%, and 11.7%, respectively (P trend <.001). The anti-HCV treatment uptake in 2002, 2009, 2015, and 2016 was 23.0%, 48.0%, 59.3%, and 74.7%, respectively (P trend <.001). In 2016, HCV-related cirrhosis was present in 7.6% of all HIV-infected individuals, 15.0% of patients with active HCV, and 31.5% of patients who cleared HCV after anti-HCV therapy.
Conclusions
Our findings suggest that with universal access to DAA-based therapy and continued efforts in prevention and screening, it will be possible to eliminate active HCV among HIV-infected individuals in Spain in the short term. However, the burden of HCV-related cirrhosis will continue to be significant among HIV-infected individuals
Search for the standard model Higgs boson decaying into two photons in pp collisions at sqrt(s)=7 TeV
A search for a Higgs boson decaying into two photons is described. The
analysis is performed using a dataset recorded by the CMS experiment at the LHC
from pp collisions at a centre-of-mass energy of 7 TeV, which corresponds to an
integrated luminosity of 4.8 inverse femtobarns. Limits are set on the cross
section of the standard model Higgs boson decaying to two photons. The expected
exclusion limit at 95% confidence level is between 1.4 and 2.4 times the
standard model cross section in the mass range between 110 and 150 GeV. The
analysis of the data excludes, at 95% confidence level, the standard model
Higgs boson decaying into two photons in the mass range 128 to 132 GeV. The
largest excess of events above the expected standard model background is
observed for a Higgs boson mass hypothesis of 124 GeV with a local significance
of 3.1 sigma. The global significance of observing an excess with a local
significance greater than 3.1 sigma anywhere in the search range 110-150 GeV is
estimated to be 1.8 sigma. More data are required to ascertain the origin of
this excess.Comment: Submitted to Physics Letters
Search for a W' boson decaying to a bottom quark and a top quark in pp collisions at sqrt(s) = 7 TeV
Results are presented from a search for a W' boson using a dataset
corresponding to 5.0 inverse femtobarns of integrated luminosity collected
during 2011 by the CMS experiment at the LHC in pp collisions at sqrt(s)=7 TeV.
The W' boson is modeled as a heavy W boson, but different scenarios for the
couplings to fermions are considered, involving both left-handed and
right-handed chiral projections of the fermions, as well as an arbitrary
mixture of the two. The search is performed in the decay channel W' to t b,
leading to a final state signature with a single lepton (e, mu), missing
transverse energy, and jets, at least one of which is tagged as a b-jet. A W'
boson that couples to fermions with the same coupling constant as the W, but to
the right-handed rather than left-handed chiral projections, is excluded for
masses below 1.85 TeV at the 95% confidence level. For the first time using LHC
data, constraints on the W' gauge coupling for a set of left- and right-handed
coupling combinations have been placed. These results represent a significant
improvement over previously published limits.Comment: Submitted to Physics Letters B. Replaced with version publishe
Measurement of isolated photon production in pp and PbPb collisions at sqrt(sNN) = 2.76 TeV
Isolated photon production is measured in proton-proton and lead-lead
collisions at nucleon-nucleon centre-of-mass energies of 2.76 TeV in the
pseudorapidity range |eta|<1.44 and transverse energies ET between 20 and 80
GeV with the CMS detector at the LHC. The measured ET spectra are found to be
in good agreement with next-to-leading-order perturbative QCD predictions. The
ratio of PbPb to pp isolated photon ET-differential yields, scaled by the
number of incoherent nucleon-nucleon collisions, is consistent with unity for
all PbPb reaction centralities.Comment: Submitted to Physics Letters
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