Neovascular membrana in a young adult. A propos of a case

La degeneración macular asociada a la edad es un deterioro de la porción central de la retina; constituye la causa principal de la pérdida severa e irreversible de la visión en países desarrollados. Una de las formas de esta afección, la neovascular (exudativa), incluye depósitos serosos o hemorrágicos y una escara cicatricial ulterior. La degeneración macular afecta usualmente a personas mayores de 60 años, sólo el 0.05% se observa en edades menores de 50 años, siendo por tanto muy rara en jóvenes. Se realiza la presentación de un paciente joven con esta afecciónThe macular degeneration associated to age is a damage of the central part of the retina; constituting the main cause of the severe and irreversible loss of the sight in developed countries. One of this affections, the neovascular exudative include serous and hemorrhagic deposits and on ulterior cicatricial eschar. The macular degeneration usually affects persons over 60 years old, only the 0.05% was observed in ages under 50 years old, being very weird in young persons. It was presented a young patient with this affection

The environment topography alters the way to multicellularity in Myxococcus xanthus.

peer reviewedThe social soil-dwelling bacterium Myxococcus xanthus can form multicellular structures, known as fruiting bodies. Experiments in homogeneous environments have shown that this process is affected by the physicochemical properties of the substrate, but they have largely neglected the role of complex topographies. We experimentally demonstrate that the topography alters single-cell motility and multicellular organization in M. xanthus In topographies realized by randomly placing silica particles over agar plates, we observe that the cells' interaction with particles drastically modifies the dynamics of cellular aggregation, leading to changes in the number, size, and shape of the fruiting bodies and even to arresting their formation in certain conditions. We further explore this type of cell-particle interaction in a computational model. These results provide fundamental insights into how the environment topography influences the emergence of complex multicellular structures from single cells, which is a fundamental problem of biological, ecological, and medical relevance

Search for 22^{22}Na in novae supported by a novel method for measuring femtosecond nuclear lifetimes

Classical novae are thermonuclear explosions in stellar binary systems, and important sources of $^{26}$Al and $^{22}$Na. While gamma rays from the decay of the former radioisotope have been observed throughout the Galaxy, $^{22}$Na remains untraceable. The half-life of $^{22}$Na (2.6 yr) would allow the observation of its 1.275 MeV gamma-ray line from a cosmic source. However, the prediction of such an observation requires good knowledge of the nuclear reactions involved in the production and destruction of this nucleus. The $^{22}$Na($p,\gamma$)$^{23}$Mg reaction remains the only source of large uncertainty about the amount of $^{22}$Na ejected. Its rate is dominated by a single resonance on the short-lived state at 7785.0(7) keV in $^{23}$Mg. In the present work, a combined analysis of particle-particle correlations and velocity-difference profiles is proposed to measure femtosecond nuclear lifetimes. The application of this novel method to the study of the $^{23}$Mg states, combining magnetic and highly-segmented tracking gamma-ray spectrometers, places strong limits on the amount of $^{22}$Na produced in novae, explains its non-observation to date in gamma rays (flux < 2.5x$10^{-4}$ ph/(cm$^2$s)), and constrains its detectability with future space-borne observatories.Comment: 18 pages, 3 figures, 1 tabl

Prognostic implications of comorbidity patterns in critically ill COVID-19 patients: A multicenter, observational study

Background The clinical heterogeneity of COVID-19 suggests the existence of different phenotypes with prognostic implications. We aimed to analyze comorbidity patterns in critically ill COVID-19 patients and assess their impact on in-hospital outcomes, response to treatment and sequelae. Methods Multicenter prospective/retrospective observational study in intensive care units of 55 Spanish hospitals. 5866 PCR-confirmed COVID-19 patients had comorbidities recorded at hospital admission; clinical and biological parameters, in-hospital procedures and complications throughout the stay; and, clinical complications, persistent symptoms and sequelae at 3 and 6 months. Findings Latent class analysis identified 3 phenotypes using training and test subcohorts: low-morbidity (n=3385; 58%), younger and with few comorbidities; high-morbidity (n=2074; 35%), with high comorbid burden; and renal-morbidity (n=407; 7%), with chronic kidney disease (CKD), high comorbidity burden and the worst oxygenation profile. Renal-morbidity and high-morbidity had more in-hospital complications and higher mortality risk than low-morbidity (adjusted HR (95% CI): 1.57 (1.34-1.84) and 1.16 (1.05-1.28), respectively). Corticosteroids, but not tocilizumab, were associated with lower mortality risk (HR (95% CI) 0.76 (0.63-0.93)), especially in renal-morbidity and high-morbidity. Renal-morbidity and high-morbidity showed the worst lung function throughout the follow-up, with renal-morbidity having the highest risk of infectious complications (6%), emergency visits (29%) or hospital readmissions (14%) at 6 months (p<0.01). Interpretation Comorbidity-based phenotypes were identified and associated with different expression of in-hospital complications, mortality, treatment response, and sequelae, with CKD playing a major role. This could help clinicians in day-to-day decision making including the management of post-discharge COVID-19 sequelae. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Rehabilitación cardíaca intrahospitalaria en pacientes con infarto agudo de miocardio

Se realiza un estudio sobre las ventajas de la aplicación de la fase 1 de la rehabilitación cardiaca en el 100% de los pacientes con infarto agudo del miocardio de bajo riesgo, atendidos en el período 2003–2004 en el Hospital General Docente “Comandante Pinares” en la provincia Pinar del Río. La investigación se basa en la toma de datos obtenidos en los expedientes clínicos de estos pacientes, que están archivados, donde las variables que se exploraron en las encuestas aplicadas incluyen anamnesis, examen físico, electrocardiograma, telecardiografía, aparición de complicaciones mayores y finalmente la clasificación funcional dada al alta hospitalaria. Los resultados demuestran las ventajas de la rehabilitación como parte esencial de la atención y terapéutica a la que deben tener acceso los pacientes con afecciones cardiacas de cualquier edad para mejorar su calidad de vida

Synthesis and 3D Network Architecture of 1- and 16-Hydrated Salts of 4-Dimethylaminopyridinium Decavanadate, (DMAPH)6[V10O28]·nH2O

Two hybrid materials based on decavanadates (DMAPH)6[V10O28]·H2O, (1) and (DMAPH)6[V10O28]·16H2O, (2) (where DMAPH = 4-dimethylaminopyridinium) were obtained by reactions under mild conditions at T = 294 and 283 K, respectively. These compounds are pseudopolymorphs, which crystallize in monoclinic P 2 1 / n and triclinic P 1 ¯ space groups. The structural analysis revealed that in both compounds, six cations DMAPH+ interact with decavanadate anion through N-H∙∙∙Odec hydrogen bonds; in 2, the hydrogen-bonding association of sixteen lattice water molecules leads to the formation of an unusual network stabilized by decavanadate clusters; this hydrogen-bond connectivity is described using graph set notation. Compound 2 differs basically in the water content which in turn increases the π∙∙∙π interactions coming from pyridinium rings. Elemental and thermal analysis (TGA/DSC) as well as FT-IR, FT-Raman, for 1 and 2 are consistent with both structures and are also presented