Influencia del árido y materiales cementantes suplementarios en las propiedades de los morteros de cal hidratada

Hydrated lime is a historic material currently used in conservation. It hardens slowly by carbonation slowing construction however, supplementary cementitious materials accelerate hardening enhancing strength. Hydrated-lime mortars with rice husk ash–RHA-; ground granulated blastfurnace slag–GGBS- and increasing amounts of two aggregates were studied. Increasing aggregate lowered strength as interfacial zones proliferate; it lowered hygric properties and raised water demand. Aggregate content/composition didn’t affect the high water retention. For the higher aggregate contents (90 days), limestone mortars are c.20% stronger than silica mortars while the (1:1) silica sand mortars are 56% stronger in flexion. Additions increased strength with little impact on hygric properties. GGBS increased strength c.six times. RHA increased strength with little impact on hygric properties due to its great specific surface and high water-demand increasing porosity. GGBS and RHA properties ruling hydrate production and the kinetics of the pozzolanic reaction are considered partially responsible for the mortar property variation.La cal hydratada es un material histórico que se usa en conservación. Endurece despacio por carbonatacion pero materiales cementantes suplementarios aceleran su endurecimiento. Se estudian morteros de cal con escoria granulada molida de alto horno (GGBS) y ceniza de cascara de arroz (RHA) con cantidades variables de dos tipos de árido. GGBS multiplicó por 6 la resistencia mecánica del mortero de cal. RHA afectó ligeramente las propiedades hídricas por su elevada superficie específica que incrementa el agua de mezclado aumentando la porosidad. El aumento de árido redujo la resistencia mecánica, trabajabilidad y propiedades hídricas del mortero. La cantidad/composición del árido no afectó la alta retención de agua. Los morteros de árido de caliza (2:1 y 3:1) incrementaron un 20% su resistencia a la compresión con respecto a los de arena de sílice mientras que la resistencia a la flexión de los arena de sílice (1:1) es 56% superior que sus equivalentes de caliza

Genetic Architecture of Acute Myocarditis and the Overlap With Inherited Cardiomyopathy.

Background: Acute myocarditis is an inflammatory condition that may herald the onset of dilated cardiomyopathy (DCM) or arrhythmogenic cardiomyopathy (ACM). We investigated the frequency and clinical consequences of DCM and ACM genetic variants in a population-based cohort of patients with acute myocarditis. Methods: This was a population-based cohort of 336 consecutive patients with acute myocarditis enrolled in London and Maastricht. All participants underwent targeted DNA sequencing for well-characterized cardiomyopathy-associated genes with comparison to healthy controls (n=1053) sequenced on the same platform. Case ascertainment in England was assessed against national hospital admission data. The primary outcome was all-cause mortality. Results: Variants that would be considered pathogenic if found in a patient with DCM or ACM were identified in 8% of myocarditis cases compared with <1% of healthy controls (P=0.0097). In the London cohort (n=230; median age, 33 years; 84% men), patients were representative of national myocarditis admissions (median age, 32 years; 71% men; 66% case ascertainment), and there was enrichment of rare truncating variants (tv) in ACM-associated genes (3.1% of cases versus 0.4% of controls; odds ratio, 8.2; P=0.001). This was driven predominantly by DSP-tv in patients with normal LV ejection fraction and ventricular arrhythmia. In Maastricht (n=106; median age, 54 years; 61% men), there was enrichment of rare truncating variants in DCM-associated genes, particularly TTN-tv, found in 7% (all with left ventricular ejection fraction <50%) compared with 1% in controls (odds ratio, 3.6; P=0.0116). Across both cohorts over a median of 5.0 years (interquartile range, 3.9–7.8 years), all-cause mortality was 5.4%. Two-thirds of deaths were cardiovascular, attributable to worsening heart failure (92%) or sudden cardiac death (8%). The 5-year mortality risk was 3.3% in genotype-negative patients versus 11.1% for genotype-positive patients (Padjusted=0.08). Conclusions: We identified DCM- or ACM-associated genetic variants in 8% of patients with acute myocarditis. This was dominated by the identification of DSP-tv in those with normal left ventricular ejection fraction and TTN-tv in those with reduced left ventricular ejection fraction. Despite differences between cohorts, these variants have clinical implications for treatment, risk stratification, and family screening. Genetic counseling and testing should be considered in patients with acute myocarditis to help reassure the majority while improving the management of those with an underlying genetic variant.post-print738 K

El desarrollo profesional del profesorado universitario: Circunstancias, problemas y propuestas

La aprobación de la LOU ha sido el punto crítico y el fin de un proceso sobre el desarrollo profesional del docente universitario. Eso nos ha obligado a fijarnos en algunos elementos fundamentales entre ellos el I y II Plan de Evaluación de la Calidad de las Universidades y, específicamente, la evaluación de las Titulaciones. Con la revisión de estas y otras circunstancias y problemas y, previa la contextualización, académica y didáctica de la formación permanente, construimos una propuesta en la que, entremezclamos elementos administrativos con políticos e, indicadas algunas condiciones y principios, proponemos dos estrategias fundamentales: el estudio de caso y la solución de problemas. Viendo, claramente, el camino que toma la Universidad, el discurso comunicativo, moral y académico, de la formación docente, lo hemos abandonado, por el momento, por otro “profesionalizador”, entendiendo que es el más eficaz e, incluso en este momento, a nuestro entender, el único posible.The passing of the LOU has been a critical point and the culmination of a process about the professional development of University Professors. This has forced us to look at some fundamental elements. Among those the I and II plan of Quality Evaluation for Universities, more specifically the evaluation of awards. With the revision of these and other circumstances and problems, and based in this context, academic and didactic of he permanent training, we have created a proposal in which we combine administrative and political elements, and outline a number of conditions and principles; two propositions fundamental strategies: the study of the case and problem resolutions. Looking closely at the path taken by the university, the moral and academic discussion of the teacher training, we have forsaken for now for another "professionalization". Understanding that it is more effective and also at this moment, from our understanding, the only wayGrupo de Investigación FORCE Universidad de Granad

Genetic Etiology for Alcohol-Induced Cardiac Toxicity.

BACKGROUND Alcoholic cardiomyopathy (ACM) is defined by a dilated and impaired left ventricle due to chronic excess alcohol consumption. It is largely unknown which factors determine cardiac toxicity on exposure to alcohol. OBJECTIVES This study sought to evaluate the role of variation in cardiomyopathy-associated genes in the pathophysiology of ACM, and to examine the effects of alcohol intake and genotype on dilated cardiomyopathy (DCM) severity. METHODS The authors characterized 141 ACM cases, 716 DCM cases, and 445 healthy volunteers. The authors compared the prevalence of rare, protein-altering variants in 9 genes associated with inherited DCM. They evaluated the effect of genotype and alcohol consumption on phenotype in DCM. RESULTS Variants in well-characterized DCM-causing genes were more prevalent in patients with ACM than control subjects (13.5% vs. 2.9%; p ¼ 1.2 10 5), but similar between patients with ACM and DCM (19.4%; p ¼ 0.12) and with a predominant burden of titin truncating variants (TTNtv) (9.9%). Separately, we identified an interaction between TTN genotype and excess alcohol consumption in a cohort of DCM patients not meeting ACM criteria. On multivariate analysis, DCM patients with a TTNtv who consumed excess alcohol had an 8.7% absolute reduction in ejection fraction (95% confidence interval: 2.3% to 15.1%; p < 0.007) compared with those without TTNtv and excess alcohol consumption. The presence of TTNtv did not predict phenotype, outcome, or functional recovery on treatment in ACM patients. CONCLUSIONS TTNtv represent a prevalent genetic predisposition for ACM, and are also associated with a worse left ventricular ejection fraction in DCM patients who consume alcohol above recommended levels. Familial evaluation and genetic testing should be considered in patients presenting with ACM.post-print567 K

International External Validation Study of the 2014 European Society of Cardiology Guidelines on Sudden Cardiac Death Prevention in Hypertrophic Cardiomyopathy (EVIDENCE-HCM).

BACKGROUND: Identification of people with hypertrophic cardiomyopathy (HCM) who are at risk of sudden cardiac death (SCD) and require a prophylactic implantable cardioverter defibrillator is challenging. In 2014, the European Society of Cardiology proposed a new risk stratification method based on a risk prediction model (HCM Risk-SCD) that estimates the 5-year risk of SCD. The aim was to externally validate the 2014 European Society of Cardiology recommendations in a geographically diverse cohort of patients recruited from the United States, Europe, the Middle East, and Asia. METHODS: This was an observational, retrospective, longitudinal cohort study. RESULTS: The cohort consisted of 3703 patients. Seventy three (2%) patients reached the SCD end point within 5 years of follow-up (5-year incidence, 2.4% [95% confidence interval {CI}, 1.9–3.0]). The validation study revealed a calibration slope of 1.02 (95% CI, 0.93–1.12), C-index of 0.70 (95% CI, 0.68–0.72), and D-statistic of 1.17 (95% CI, 1.05–1.29). In a complete case analysis (n= 2147; 44 SCD end points at 5 years), patients with a predicted 5-year risk of <4% (n=1524; 71%) had an observed 5-year SCD incidence of 1.4% (95% CI, 0.8–2.2); patients with a predicted risk of ≥6% (n=297; 14%) had an observed SCD incidence of 8.9% (95% CI, 5.96–13.1) at 5 years. For every 13 (297/23) implantable cardioverter defibrillator implantations in patients with an estimated 5-year SCD risk ≥6%, 1 patient can potentially be saved from SCD. CONCLUSIONS: This study confirms that the HCM Risk-SCD model provides accurate prognostic information that can be used to target implantable cardioverter defibrillator therapy in patients at the highest risk of SCD.post-print846 K

Criptococosis meníngea en un paciente inmunocompetente: reporte de un caso y revisión de la literatura

ResumenLa criptococosis meníngea es una infección infrecuente en pacientes inmunocompetentes. Es de vital importancia realizar una adecuada historia clínica y exploración física para hacer un buen diagnóstico e iniciar un tratamiento lo antes posible, para prevenir complicaciones o secuelas de la misma. Nosotros reportamos un caso de un paciente del sexo masculino de 23años de edad que se presenta a consulta de neurología por cefalea intensa de tipo pulsátil holocraneana, acompañada de náuseas, que no cede ante el uso de analgésicos. Conforme progresaba la enfermedad, se añadían síntomas como vómito en proyectil, parestesias, alteraciones auditivas, disminución en la agudeza visual y cuadriparesia. Se hospitalizó para la realización de estudios complementarios, en los que se concluyó el diagnóstico de criptococosis meníngea. Los aspectos referentes a esta enfermedad, como epidemiología, etiología, diagnóstico, tratamiento y complicaciones, se discuten en este reporte de caso.AbstractThe cryptococcal meningitis is an infrequent infection in immunocompetent patients. It is vital to make an adequate history and physical examination to make a proper diagnosis and begin treatment as soon as possible to prevent complications or consequences thereof. We report a case of a male patient of 23years of age presenting to the neurology service because of an intense, throbbing headache accompanied with nausea that does not yield to the use of analgesics. As the disease progressed, other symptoms presented like projectile vomiting, paresthesias, hearing impairment, decreased visual acuity and quadriparesis. He was hospitalized for complementary studies which concluded the diagnosis of meningeal cryptococcosis. The aspects concerning this disease including epidemiology, etiology, diagnosis, treatment and complications are discussed in this case report

Determinants of profitability in Spanish financial institutions. Comparing aided and non-aided entities

The last financial crisis has led to the greatest contribution of public funds ever made to Spanish banks. This paper studies why the need for support has been asymmetric, with not all of the institutions requiring aid. Based on profitability of assets (ROA), we determine using panel data econometric and logit response models the components of profit and loss accounts that generated profitability as well as the factors leading to some entities to ask for aid. The analyses show that before the beginning of the crisis there were significant differences between entities that needed aid and those that did not. The most profitable banks grounded their success in the traditional revenue components of financial institutions (such as margin on interest rates and commissions), as well as in revenues obtained from participated companies and extraordinary results. The model offers a tool to detect entities in difficulties in advance, reducing the financial and social costs of public interventions. The factors more impacting on profitability of Spanish institutions are also identifie