MODIFICACIONES EN LA VIVIENDA POR LA COVID-19

Estamos bajo los condicionamientos sanitarios y sociales que nos ha dispensado la pandemia de COVID-19, sin tener un horizonte certero sobre la vuelta a la situación de partida. Hemos soportado confinamientos obligatorios, reduciendo las relaciones exteriores prácticamente al núcleo residencial familiar, y realizando parte de nuestras tareas desde ese ámbito espacial.Con esta perspectiva, ¿qué pensamos de lo adecuado de esas viviendas? ¿qué cambios de usos y costumbres se han introducido en ellas? ¿cuánto influirá esta crisis sanitaria, u otras, a futuro en el diseño de la vivienda?Para intentar responder a estas cuestiones y otras similares, se elaboró una encuesta desde un entorno universitario relacionado con la concepción y construcción del hábitat. Prospección cuyos resultados apuntan el posible panorama evolutivo de la vivienda en cuanto a requisitos funcionales, acomodación de espacios de trabajo, relaciones con el entorno exterior y cuantas preocupaciones nos han atareado el primer semestre de 202

Influence of geographic location in concrete structures

Es muy importante considerar la localización geográfica de un edificio a la hora de realizar su chequeo estructural. Para ello, en este estudio se ha utilizado la conocida técnica de chequeo estructural basada en la correlación de resultados entre la velocidad de ultrasonidos (V) y la resistencia a compresión (R), obtenidas de las probetas testigo extraídas en elementos estructurales de hormigón armado. Para analizar la influencia de la localización geográfica de la estructura, se ha realizado el presente trabajo clasificando los edificios estudiados en función de su distancia a la costa y atendiendo las indicaciones de la instrucción EHE, es decir, utilizando una distancia de referencia de 500 m que permita ordenar los casos estudiados en función de dicha distancia. Como conclusión se puede afirmar que las estructuras más cercanas a las costas marinas están más influenciadas por el medio ambiente, lo que influye en gran manera en la calidad del hormigón de sus estructuras. Esta situación queda demostrada con el resultado de la investigación llevada a cabo, en el que se han analizado 185 casos reales. Para los más cercanos, se justifica estadísticamente la necesidad de su reparación-refuerzo en función de los resultados que arroje este chequeo y los resultados de correlación velocidad ultrasonidos-compresión en probetas testigo.It is very important to consider the geographic location of a building when performing structural check. Therefore, in this study we have used a technique called structural check based on the correlation of results between the ultrasound velocity (V) and compressive strength (R) obtained from the control samples taken in structural reinforced concrete elements. To analyze the influence of the geographic location of the structure, has made this work classifying the buildings studied in terms of their distance from the coast and following the instructions on the EHE instruction, ie, using a reference distance of 500 m order to allow the case studies based on this distance. In conclusion we can say that the closest structures to the shoreline are more influenced by the environment, which greatly influences the quality of concrete structures. This is demonstrated by the result of the research conducted, which used 185 real cases. To the nearest, is statistically justified the need for repair-reinforcement based on the results produced this check and the results of ultrasound-speed compression control specimens correlation

Antiguas estructuras de hormigón. Investigación-Peritación, en función de su edad

Hasta ahora, gran parte de las investigaciones llevadas a cabo para la estimación de las resistencias a compresión de los elementos de hormigón armado de nuestras estructuras, se han realizado en base a chequeos con extracción de un gran número de probetas testigo. Mediante la presente investigación se estudian 185 casos reales de elementos estructurales de hormigón armado, mediante un chequeo basado en la correlación de resultados entre la Velocidad de Ultrasonidos (V) y la Resistencia a Compresión (R). El estudio se desarrolla teniendo en cuenta la edad de las estructuras. Posteriormente se realiza un análisis estadístico con los datos obtenidos y con ellos se ha definido un claro procedimiento científico de análisis de los dos métodos de ensayo y de las herramientas necesarias para realizar un completo chequeo estructural, correlación de resultados, que se propone como aportación para completar la actual normativa y facilitar los procedimientos de peritación estructural, así como para el análisis de antiguas estructuras de hormigón, como objetivo principal de este artículo.Consejo General de la Arquitectura Técnica de Españ

Estudo estruturas de concreto armado. Ultrasonic Velocidade e Resistência à Compressão

Hasta ahora, gran parte de las investigaciones llevadas a cabo para la estimación de las resistencias a compresión de los elementos de hormigón armado de nuestras estructuras se han realizado con base en chequeos con gran número de probetas testigo, extraídas de esos elementos. Mediante la presente investigación se analizaron 185 casos reales de elementos estructurales de hormigón armado, mediante un chequeo estructural basado en la correlación de resultados entre la velocidad de ultrasonidos (V) y la resistencia a compresión (R). El estudio se desarrolla teniendo en cuenta la localización de la construcción respecto a la costa marina y la edad de la propia estructura. Posteriormente se realiza un análisis estadístico con los datos obtenidos. Con este trabajo se ha conseguido un procedimiento científico de análisis de los dos métodos de ensayo y de las herramientas necesarias para realizar un completo chequeo estructural, correlación entre ellos y, lo más novedoso del proceso, la confección de fórmulas matemáticas y las gráficas de correlación, que ponen de manifiesto la efectividad del procedimiento, el cual se propone como aportación para normativa.So far, much of the research conducted to estimate the compressive strength of reinforced concrete elements of our structures have been made based on checkups witness many samples drawn from these elements. By this investigation 185 real cases of reinforced concrete structural elements are studied by a structural check based on the correlation of results between the ultrasonic velocity (V) and compressive strength (R). The study was developed taking into account the location of the building relative to the shoreline and the age of the structure. Subsequently, a statistical analysis to the data obtained is performed. This work has achieved a scientific method of analysis of the two test methods and necessary for a full structural check, correlation between them and most innovative process, making mathematical formulas and graphs mapping tools which demonstrate the effectiveness of the procedure, which is proposed as a contribution to policy.Até agora, a maior parte da pesquisa conduzida para estimar a resistência à compressão dos elementos de betão armado de nossas estruturas foram feitas com base em exames testemunha muitas amostras retiradas a partir destes elementos. Por este inquérito 185 casos reais de elementos estruturais de betão armado são estudados por uma verificação estrutural baseada na correlação dos resultados entre a velocidade ultra-sons (V) e a resistência à compressão (R). O estudo foi desenvolvido tendo em conta a localização do edifício em relação à linha da costa e da idade da estrutura. Subsequentemente, uma análise estatística para os dados obtidos é realizada. Este trabalho tem alcançado um método científico de análise dos dois métodos de ensaio e necessário para uma verificação completa a nível estrutural, a correlação entre eles e processo mais inovador, fazendo fórmulas matemáticas e gráficos ferramentas de mapeamento que demonstram a eficácia do procedimento, o que é proposto como um contributo para a política

Monte carlo clinical dosimetry

The choice of the most appropriate strategy for radiotherapy treatment is mainly based on the use of a planning system. With the introduction of new techniques (conformal and/or small fields, asymmetrical and non coplanar beams, true 3D calculation, IMRT) the trustworthiness of the algorithms used is questioned. An alternative verification procedure has become increasingly more necessary to warranty treatment delivery.The reliability of the Monte Carlo method is generally acknowledged. However, its clinical use has not been practical due to the high CPU time required. During the last few years our objective has decreased CPU time by means of a new process distribution technique. This reduction has made it feasible, not only to apply physical dosimetry under special conditions, but also to use it in numerous clinical cases employing photon and electron conformal fields, in radiosurgery, and IMRT.The procedure carried out is presented. Furthermore, conventional Treatment Planning System calculations are compared with the Monte Carlo simulations

The Impact of Healthcare-Associated Infections in Patients Undergoing Oncological Microvascular Head and Neck Reconstruction: A Prospective Multicentre Study

(1) Background: Healthcare-associated infections (HAIs) after head and neck free-flap reconstruction are a common postoperative complication. Risk factors for HAIs in this context and their consequences have not been adequately described. (2) Methods: Ongoing prospective multicentre study between 02/2019 and 12/2020. Demographic characteristics and outcomes were analysed, focusing on infections. (3) Results: Forty out of 65 patients (61.54%) suffered HAIs (surgical site infection: 52.18%, nosocomial pneumonia: 23.20%, bloodstream infection: 13% and urinary tract infection: 5.80%). Methicillin-resistant Staphylococcus aureus (MRSA) and resistant Pseudomonas aeruginosa, Klebsiella pneumoniae and Enterobacter cloacae were the most frequently implicated. The significant risk factors for infection were: previous radiotherapy (Odds ratio (OR): 5.42; 95% confidence interval (CI), 1.39–21.10), anaemia (OR: 8.00; 95% CI, 0.96–66.95), salvage surgery (eight out of eight patients), tracheostomy (OR: 2.86; 95% CI, 1.01–8.14), surgery duration (OR: 1.01; 95% CI, 1.00–1.02), microvascular reoperation <72 h (eight/eight) and flap loss (eight/eight). The major surgical complications were: a need to reoperate (OR: 6.89; 95% CI, 1.42–33.51), prolonged hospital admission (OR: 1.16; 95% CI, 1.06–1.27) and delay in the initiation of postoperative radiotherapy (OR: 9.07; 95% CI, 1.72–47.67). The sixth month mortality rate in patients with HAIs was 7.69% vs. 0% in patients without HAIs (p = 0.50). (4) Conclusions: HAIs were common after this type of surgery, many of them caused by resistant microorganisms. Some modifiable risk factors were identified. Infections played a role in cancer prognosis by delaying adjuvant therapy

Associations of dietary energy density with body composition and cardiometabolic risk in children with overweight and obesity: role of energy density calculations, under-reporting energy intake and physical activity

This study examined (1) the association of dietary energy density from solid (EDS) and solid plus liquids (EDSL) with adiposity and cardiometabolic risk factors (CRF) in children with overweight and obesity, (2) the effect of under-reporting on the mentioned associations and (3) whether the association between ED and body composition and CRF is influenced by levels of physical activity. In a cross-sectional design, 208 overweight and obese children (8-12-year-old; 111 boys) completed two non-consecutive 24 h recalls. ED was calculated using two different approaches: EDS and EDSL. Under-reporters were determined with the Goldberg method. Body composition, anthropometry and fasting blood sample measurements were performed. Moderate to vigorous physical activity (MVPA) was registered with accelerometers (7-d-register). Linear regressions were performed to evaluate the association of ED with the previously mentioned variables. Neither EDS nor EDSL were associated with body composition or CRF. However, when under-reporters were excluded, EDS was positively associated with BMI (P=0 019), body fat percentage (P=0 005), abdominal fat (P=0 008) and fat mass index (P=0 018), while EDSL was positively associated with body fat percentage (P=0 008) and fat mass index (P=0 026). When stratifying the group according to physical activity recommendations, the aforementioned associations were only maintained for non-compliers. Cluster analysis showed that the low-ED and high-MVPA group presented the healthiest profile for all adiposity and CRF. These findings could partly explain inconsistencies in literature, as we found that different ED calculations entail distinct results. Physical activity levels and excluding under-reporters greatly influence the associations between ED and adiposity in children with overweight and obesity.The research leading to these results has received funding from la Caixa Foundation and Triptolemos Foundation, the Ministry of Health (FIS PI081297), the Research Network on Preventative Activities and Health Promotion (RD06/0018/ 0038), the Henning and Johan Throne-Holst Foundation (F. B. O.), the Spanish Ministry of Education, Culture and Sport (FPU14/03329 to M. M.), the Spanish Ministry of Economy and Competitiveness (DEP2013-47540 and DEP2016-78377-R; BES-2014-068829 to C. C.-S.), Fondo de Investigacion Sanitaria del Instituto de Salud Carlos III (PI13/01335), Fondos Estructurales de la Union Europea (FEDER), Una manera de hacer Europa, the Spanish Ministry of Science and Innovation (RYC-2011-09011 to F. B. O.), the University of Granada, Plan Propio de Investigacion 2016, Excellence Actions: Units of Excellence, Unit of Excellence on Exercise and Health (UCEES), Programa de Captacion de Talento - UGR Fellows (L. G.-M.), the SAMID III network, RETICS (PN I +D+ I 2017-2021). This study has been partially funded by the University of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of Excellence; Unit of Excellence on Exercise and Health (UCEES), and by the Junta de Andalucia, Consejeria de Conocimiento, Investigacion y Universidades and European Regional Development Fund (ERDF), reference SOMM17/6107/UGR. ISCIII-Sub-Directorate General for Research Assessment and Promotion, the European Regional Development Fund (RD16/ 0022), the EXERNET Research Network on Exercise and Health in Special Populations (DEP2005-00046/ACTI), and the University of the Basque Country (GIU14/21). J. M.-G. is supported by the Spanish Ministry of Education, Culture and Sport (FPU14/06837). J. H. M. is supported by the Spanish Ministry of Education, Culture and Sport (FPU15/02645)

Oral fosfomycin for the treatment of lower urinary tract infections among kidney transplant recipients—Results of a Spanish multicenter cohort

Preliminary results of this study were presented at the 29th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID), held in Amsterdam, The Netherlands, from 13 to 16 April, 2019 (oral communication O‐0699).Oral fosfomycin may constitute an alternative for the treatment of lower urinary tract infections (UTIs) in kidney transplant recipients (KTRs), particularly in view of recent safety concerns with fluroquinolones. Specific data on the efficacy and safety of fosfomycin in KTR are scarce. We performed a retrospective study in 14 Spanish hospitals including KTRs treated with oral fosfomycin (calcium and trometamol salts) for posttransplant cystitis between January 2005 and December 2017. A total of 133 KTRs developed 143 episodes of cystitis. Most episodes (131 [91.6%]) were produced by gram‐negative bacilli (GNB), and 78 (54.5%) were categorized as multidrug resistant (including extended‐spectrum β‐lactamase‐producing Enterobacteriaceae [14%] or carbapenem‐resistant GNB [3.5%]). A median daily dose of 1.5 g of fosfomycin (interquartile range [IQR]: 1.5‐2) was administered for a median of 7 days (IQR: 3‐10). Clinical cure (remission of UTI‐attributable symptoms at the end of therapy) was achieved in 83.9% (120/143) episodes. Among those episodes with follow‐up urine culture, microbiological cure at month 1 was achieved in 70.2% (59/84) episodes. Percutaneous nephrostomy was associated with a lower probability of clinical cure (adjusted odds ratio: 10.50; 95% confidence interval: 0.98‐112.29; P = 0.052). In conclusion, fosfomycin is an effective orally available alternative for treating cystitis among KTRs.This study was supported by Plan Nacional de I+D+i 2013‐2016 and Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Ciencia, Innovación y Universidades, Spanish Network for Research in Infectious Diseases (REIPI RD16/0016)—cofinanced by the European Development Regional Fund “A way to achieve Europe”; the Group for Study of Infection in Transplantation and the Immunocompromised Host (GESITRA‐IC) of the Spanish Society of Clinical Microbiology and Infectious Diseases (SEIMC); and the Spanish Network for Research in Renal Diseases (REDInREN RD16/0009). MFR holds a research contract “Miguel Servet” (CP 18/00073) from the Spanish Ministry of Science, Innovation and Universities, Instituto de Salud Carlos III

Methicillin-resistant Staphylococcus aureus (MRSA) catheter-related bacteraemia in haemodialysis patients

Background: the aim of the study was to determine clinical and microbiological differences between patients with methicillin-resistant Staphylococcus aureus (MRSA) catheter-related bacteraemia (CRB) undergoing or not undergoing haemodialysis, and to compare outcomes. Methods: prospective multicentre study conducted at 21 Spanish hospitals of patients with MRSA bacteraemia diagnosed between June 2008 and December 2009. Patients with MRSA-CRB were selected. Data of patients on haemodialysis (HD-CRB) and those not on haemodialysis (non-HD-CRB) were compared. Results: among 579 episodes of MRSA bacteraemia, 218 (37.7 %) were CRB. Thirty-four (15.6 %) were HD-CRB and 184 (84.4 %) non-HD-CRB. All HD-CRB patients acquired the infection at dialysis centres, while in 85.3 % of the non-HD-CRB group the infection was nosocomial (p < .001). There were no differences in age, gender or severity of bacteraemia (Pitt score); comorbidities (Charlson score ≥ 4) were higher in the HD-CRB group than in the non-HD-CRB group (73.5 % vs. 46.2 %, p = .003). Although there were no differences in VAN-MIC ≥1.5 mg/L according to microdilution, using the E-test a higher rate of VAN-MIC ≥1.5 mg/L was observed in HD-CRB than in non-HD-CRB patients (63.3 % vs. 44.1 %, p = .051). Vancomycin was more frequently administered in the HD-CRB group than in the non-HD-CRB group (82.3 % vs. 42.4 %, p = <.001) and therefore the appropriate empirical therapy was significantly higher in HD-CRB group (91.2 % vs. 73.9 %, p = .029). There were no differences with regard to catheter removal (79.4 % vs. 84.2 %, p = .555, respectively). No significant differences in mortality rate were observed between both groups (Overall mortality: 11.8 % vs. 27.2 %, p = .081, respectively), but there was a trend towards a higher recurrence rate in HD-CRB group (8.8 % vs. 2.2 %, p = .076). Conclusions: in our multicentre study, ambulatory patients in chronic haemodialysis represented a significant proportion of cases of MRSA catheter-related bacteraemia. Although haemodialysis patients with MRSA catheter-related bacteraemia had significantly more comorbidities and higher proportion of strains with reduced vancomycin susceptibility than non-haemodialysis patients, overall mortality between both groups was similar