Pie de Charcot. Cuando menos es más.

Paciente diabética de 71 años de edad, insulino-dependiente, obesa e hipertensa con mal con - trol metabólico que presentó una fractura de tobillo y una luxación subastragalina. Inicialmente fue tratada en su hospital con tracción transesquelética durante varias semanas que resultó infructuosa, evolucionando a una desestructuración completa del retropié y a una úlcera profunda y tórpida, al iniciar la marcha la paciente.Con este escenario acude la paciente a nuestras consultas, tras dos años de evolución, para valorar alternativas a la amputación.A 71-years-old female, diabetic pacient insulin-dependent, obese with high blood pressure and poor metabolic control suffered an ankle fracture and a subtalar dislocation. At the beginning skeletal traction was applied at her Institution but result was unsuccessful, so a complete breakdown of the hindfoot and a deep and torpid ulcer developed. Facing this scenario the patient came to our clinic, after two years of evolution, to assess alternatives to amputation

Fracturas de extremidad proximal de cubito en el niño

Las fracturas y epifisiolisis proximales de cubito, son lesiones raras y cuando se producen suelen estar mínimamente ó no desplazadas, pudiendo ser tratadas de forma conservadoras. En los casos en que existe desplazamiento significativo, requieren reducción abierta y osteosíntesis. Independientemente del tipo de tratamiento utilizado, el resultado final suele ser satisfactorio. Realizamos un estudio retrospectivo de 13 casos de fractura-epifisiolisis de extremo proximal de cubito, ocurridas durante el periodo 1992-2001. Nuestro objetivo es analizar los resultados obtenidos en el tratamiento de las lesiones y realizar una revisión bibliográfica, teniendo en cuenta los distintos métodos de clasificación, valoración de resultados y las valoraciones descritas para la iniciación de tratamiento quirúrgico de estas lesiones.The epiphysiolisis and proximal lunar fractures in children rare injuries and usually the aren't displaced. In these cases they can be managed nonoperatively. If there's a marked displacement, open reduction and internal fixation is mandatory. The final outcome uses to be successful despite the management; 13 patients with epiphysiolisis or fracture of the proximal ulna between 1992-2001 ere revised. Our aim is to evaluate our outcomes and reviewed the literatur

Nutritional valuation of schoolchildren from three Ibero-American countries: A comparative analysis of the references proposed by International Obesity Task Force (IOTF) and World Health Organization (WHO)

Introducción: El índice de masa corporal (IMC) resulta un indicador útil para valorar la condición nutricional en la infancia y adolescencia. Si bien no existe consenso respecto a los valores o puntos de corte de IMC que deben utilizarse para la diagnosis del sobrepeso, la obesidad o la insuficiencia ponderal, las referencias propuestas por la Organización Mundial de la Salud (OMS) y la International Obesity Task Force (IOTF) son las más aceptadas. No obstante, existen discrepancias importantes en los resultados obtenidos en función de una u otra referencia. Objetivo: Analizar y comparar la condición nutricional de una muestra internacional a partir del IMC, mediante la aplicación simultánea de las referencias recomendadas por la IOTF y la OMS. Métodos: Se calculó el IMC de 1289 escolares de 10 a 13 años de México, Venezuela y España. A cada niño le fue atribuida una categoría nutricional (bajo peso, normopeso, sobrepeso y obesidad) utilizando el criterio de la IOTF (puntos de corte equivalentes a 18,5; 25 y 30 en adultos) y OMS (-1 DE: bajo peso + 1 DE: sobrepeso y +2 DE: obesidad). Las prevalencias de estado nutricional obtenidas por cada criterio fueron comparadas mediante la prueba de Chi-Cuadrado. Resultados: El porcentaje de escolares en cada una de las categorías nutricionales varió significativamente en función de la referencia empleada. La prevalencia de malnutrición por exceso o por defecto fue, en ambos sexos y en los tres países, superior al emplear los parámetros OMS. La referencia OMS evidenció un 10,9% menos de niños normonutridos y un 13,1% más de malnutridos que la IOTF. Discusión: Los resultados de esta investigación permiten inferir que la referencia propuesta por la OMS resulta ser más “preventiva” al momento de identificar individuos malnutridos. Se subraya la importancia de especificar los criterios empleados para la determinación del estado nutricional en los estudios de carácter epidemiológico, así como de contrastar las referencias empleadas para el diagnóstico. Conclusiones: Las referencias OMS para IMC sobrestiman la prevalencia de bajo peso, sobrepeso y obesidad en relación a los puntos de corte propuestos por el IOTF para el diagnóstico de la malnutrición.Introduction: Body Mass Index (BMI) is a useful tool for assessing nutritional status in childhood and adolescence. Although there is no consensus on BMI values or cutoffs to be used for the diagnosis of overweight, obesity and underweight references proposed by World Health Organization (WHO) and International Obesity Task Force (IOTF) are the most accepted. However, there are significant discrepancies in the results obtained in terms of either reference. Objective: To analyze and compare the nutritional status of an international sample from IMC, by simultaneous application of IOTF and WHO recommended references. Methods: 1289 schoolchildren’s BMI between 10 and 13 years of Mexico, Venezuela and Spain was estimated. Each child was assigned a nutritional category (underweight, normal weight, overweight and obese) using the IOTF criteria (points cut equivalent to 18,5, 25 and 30 in adults) and WHO (-1 SD: low weight +1 DE: overweight and +2 SD: obesity). The prevalence of nutritional status of each criterion was compared using the Chi-square test. Results: The percentage of students in each of the nutritional categories mottled significantly depending on the reference used. The prevalence of excess or defect malnutrition, in both sexes and in all three countries, was exceeded using the WHO parameters. WHO reference showed 10,9% less than well-nourished children and 13,1 % more malnourished than the IOTF. Discussion: The results of this research allow inferring that the reference proposed by WHO appears to be more “protecting” when identifying malnourished individuals. The importance of specifying the criteria for determination of nutritional status in epidemiologic studies, as well as to contrast the references used for diagnosis, is emphasized. Conclusions: The WHO BMI references overestimate the prevalence of underweight, overweight and obesity in relation to the cutoff points proposed by the IOTF for diagnosing malnutrition.Fil: Bergel Sanchís, María Laura. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico CONICET- La Plata. Instituto de Genética Veterinaria "Ing. Fernando Noel Dulout". Universidad Nacional de La Plata. Facultad de Ciencias Veterinarias. Instituto de Genética Veterinaria; ArgentinaFil: Cesani Rossi, María Florencia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico CONICET- La Plata. Instituto de Genética Veterinaria "Ing. Fernando Noel Dulout". Universidad Nacional de La Plata. Facultad de Ciencias Veterinarias. Instituto de Genética Veterinaria; ArgentinaFil: Cordero, Maria Laura. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucuman. Instituto Superior de Estudios Sociales. Universidad Nacional de Tucuman. Instituto Superior de Estudios Sociales; ArgentinaFil: Navazo, Bárbara. Universidad Nacional de la Plata. Facultad de Cs.naturales y Museo. Departamento Científico de Antropología. Cátedra de Antropología Biológica Iv; ArgentinaFil: Olmedo, S.. Programa de Ecología Reproductiva del Gran Chaco Argentino. Formosa; ArgentinaFil: Quintero, F.. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico CONICET- La Plata. Instituto de Genética Veterinaria "Ing. Fernando Noel Dulout". Universidad Nacional de La Plata. Facultad de Ciencias Veterinarias. Instituto de Genética Veterinaria; Argentina. Universidad Nacional de la Plata. Facultad de Cs.naturales y Museo. Departamento Científico de Antropología. Cátedra de Antropología Biológica Iv; ArgentinaFil: Sardi, Marina Laura. Universidad Nacional de la Plata. Facultad de Cs.naturales y Museo. Departamento de Antropología; ArgentinaFil: Torres, María Fernanda. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico CONICET- La Plata. Instituto de Genética Veterinaria "Ing. Fernando Noel Dulout". Universidad Nacional de La Plata. Facultad de Ciencias Veterinarias. Instituto de Genética Veterinaria; Argentina. Universidad de Buenos Aires. Facultad de Filosofía y Letras; ArgentinaFil: Arechiga, J.. Universidad Nacional Autónoma de México; MéxicoFil: Méndez de Pérez, B. Universidad Nacional de Venezuela; VenezuelaFil: Marrodán, M. D.. Universidad Complutense de Madrid; Españ

A fast feedback controlled magnetic drive for the ASDEX Upgrade fast-ion loss detectors

A magnetically driven fast-ion loss detector system for the ASDEX Upgrade tokamak has been designed and will be presented here. The device is feedback controlled to adapt the detector head position to the heat load and physics requirements. Dynamic simulations have been performed taking into account effects such as friction, coil self-induction, and eddy currents. A real time positioning control algorithm to maximize the detector operational window has been developed. This algorithm considers dynamical behavior and mechanical resistance as well as measured and predicted thermal loads. The mechanical design and real time predictive algorithm presented here may be used for other reciprocating systems.EURATOM 63305

Genome Wide Meta-Analysis identifies common genetic signatures shared by heart function and Alzheimer's disease

Echocardiography has become an indispensable tool for the study of heart performance, improving the monitoring of individuals with cardiac diseases. Diverse genetic factors associated with echocardiographic measures have been previously reported. The impact of several apoptotic genes in heart development identified in experimental models prompted us to assess their potential association with human cardiac function. This study aimed at investigating the possible association of variants of apoptotic genes with echocardiographic traits and to identify new genetic markers associated with cardiac function. Genome wide data from different studies were obtained from public repositories. After quality control and imputation, a meta-analysis of individual association study results was performed. Our results confirmed the role of caspases and other apoptosis related genes with cardiac phenotypes. Moreover, enrichment analysis showed an over-representation of genes, including some apoptotic regulators, associated with Alzheimer's disease. We further explored this unexpected observation which was confirmed by genetic correlation analyses. Our findings show the association of apoptotic gene variants with echocardiographic indicators of heart function and reveal a novel potential genetic link between echocardiographic measures in healthy populations and cognitive decline later on in life. These findings may have important implications for preventative strategies combating Alzheimer's disease

Recensiones [Revista de Historia Económica Año II Invierno 1984 n. 1 pp. 191-222]

Miguel Ángel Ladero Quesada. El siglo XV en Castilla. Fuentes de renta y política fiscal (Agustín González Enciso).-- Andalucía Moderna. Actas del II Coloquio de Historia de Andalucía (Antonio Miguel Bernal Rodríguez).-- Miguel Artola. La Hacienda en el Antiguo Régimen (Juan Zafra Oteyza).-- Ovidio García Regueiro. "Ilustración" e intereses estamentales (Carlos D. Malaud).-- Aux Origines du retard économique de l'Espagne, XVI-XIX siécles (Gregorio Núñez Romero-Balmas).-- Leandro Prados De La Escosura. Comercio exterior y crecimiento económico en España, 1826-1913: Tendencias a largo plazo (Javier Cuenca Esteban).-- Manuel Moreno Fraginals. El Ingenio. Complejo económico-social cubano del azúcar (Juan Carlos Jiménez Jiménez).-- Mercedes Cabrera. La patronal en la Segunda República. Organizaciones y estrategia (Santos Julia).-- Giorgio Fua. Problemas del desarrollo tardío en Europa (Enric Sanchís).-- Alain Huete De Lemps y Anne Collin-Delavaud. La canne á sucre en Espagne au Perou et en Equateur (Manuel Martin Rodríguez).-- Ivan T. Berend y Gyorcy Ranki. The European periphery and industrialization, 1780-1914 (Gabriel Tortella)Publicad

Development and installation of a scintillator based detector for fast-ion losses in the MAST-U tokamak

Trabajo presentado en el 45th EPS Conference on Plasma Physics, celebrada en Praga (República Checa), del 2 al 6 de julio de 2018Peer reviewe

Updated Iberian archeomagnetic catalogue: new full vector paleosecular variation curve for the last three millennia

In this work, we present 16 directional and 27 intensity high‐quality values from Iberia. Moreover, we have updated the Iberian archeomagnetic catalogue published more than 10 years ago with a considerable increase in the database. This has led to a notable improvement of both temporal and spatial data distribution. A full vector paleosecular variation curve from 1000 BC to 1900 AD has been developed using high‐quality data within a radius of 900 km from Madrid. A hierarchical bootstrap method has been followed for the computation of the curves. The most remarkable feature of the new curves is a notable intensity maximum of about 80 μT around 600 BC, which has not been previously reported for the Iberian Peninsula. We have also analyzed the evolution of the paleofield in Europe for the last three thousand years and conclude that the high maximum intensity values observed around 600 BC in the Iberian Peninsula could respond to the same feature as the Levantine Iron Age Anomaly, after travelling westward through Europe

Characterisation of Human Embryonic Stem Cells Conditioning Media by 1H-Nuclear Magnetic Resonance Spectroscopy

BACKGROUND: Cell culture media conditioned by human foreskin fibroblasts (HFFs) provide a complex supplement of protein and metabolic factors that support in vitro proliferation of human embryonic stem cells (hESCs). However, the conditioning process is variable with different media batches often exhibiting differing capacities to maintain hESCs in culture. While recent studies have examined the protein complement of conditioned culture media, detailed information regarding the metabolic component of this media is lacking. METHODOLOGY/PRINCIPAL FINDINGS: Using a (1)H-Nuclear Magnetic Resonance ((1)H-NMR) metabonomics approach, 32 metabolites and small compounds were identified and quantified in media conditioned by passage 11 HFFs (CMp11). A number of metabolites were secreted by HFFs with significantly higher concentration of lactate, alanine, and formate detected in CMp11 compared to non-conditioned media. In contrast, levels of tryptophan, folate and niacinamide were depleted in CMp11 indicating the utilisation of these metabolites by HFFs. Multivariate statistical analysis of the (1)H-NMR data revealed marked age-related differences in the metabolic profile of CMp11 collected from HFFs every 24 h over 72 h. Additionally, the metabolic profile of CMp11 was altered following freezing at -20°C for 2 weeks. CM derived from passage 18 HFFs (CMp18) was found to be ineffective at supporting hESCs in an undifferentiated state beyond 5 days culture. Multivariate statistical comparison of CMp11 and CMp18 metabolic profiles enabled rapid and clear discrimination between the two media with CMp18 containing lower concentrations of lactate and alanine as well as higher concentrations of glucose and glutamine. CONCLUSIONS/SIGNIFICANCE: (1)H-NMR-based metabonomics offers a rapid and accurate method of characterising hESC conditioning media and is a valuable tool for monitoring, controlling and optimising hESC culture media preparation