Hipertensión arterial en el anciano: contexto clínico y tratamiento habitual ¿Se sigue el estándar recomendado?

Antecedentes: la hipertensión arterial produce riesgos cardiovasculares. El anciano que la padece tiene particularidades fisiológicas que interfieren con el tratamiento. Objetivo: evaluar el tratamiento habitual y el contexto clínico de la hipertensión en pacientes ambulatorios de un centro geriátrico. Material y métodos: estudio retrospectivo y aleatorio en pacientes atendidos de manera ambulatoria de enero a mayo del 2004 en un hospital universitario. Los datos del año anterior se extrajeron de los expedientes clínicos. El tratamiento estándar fue el sugerido por Seventh Report Joint National Committee Hypertension. El análisis estadístico se efectuó por medio de frecuencias con intervalo de confianza del 95% (IC95). Se utilizaron las pruebas χ2 y la t de Student para comparar los pacientes con y sin hipertensión arterial. Resultados: la muestra total incluyó 46 (32.4%) hombres y 96 (67.6%) mujeres; 50% de los hombres (IC95% 35.6 a 64.4%) y 65% de las mujeres (IC95% 55.5 a 74.5%) tuvieron hipertensión arterial (valor global de 85 [59.9%, IC95% 51.8 a 67.9%] casos). El índice de masa corporal fue mayor en pacientes con hipertensión arterial que sin ésta (27.0 ± 5 vs 24.6 ± 4, t=2.5, gl=102, p=0.01). También se encontró diabetes en 48 vs 16%; dislipidemia en 28 vs 14%, respectivamente (ambas con p<0.05). El tratamiento prescrito en 70.6% (60/85) de los pacientes consistió en inhibidores de la enzima convertidora de angiotensina, diuréticos en 30.5% (26/85) y β bloqueadores en 22.4%(19/85). Número de antihipertensivos: (ninguno: uno: dos: tres) 9 (10.6%), 42 (49.4%): 27 (31.8%) 7 (8.2%), siendo diurético 4.7%, 66.6%, 85.7% vs inhibidores de la enzima convertidora de angiotensina en 80.9%, 74.1% y 85.7%, respectivamente (p0.05). El colesterol sérico no tuvo diferencias significativas originadas por antihipertensivos. Conclusión: el contexto denota: adiposidad, alta comorbilidad e hipertensión sistólica más frecuente. La administración de diuréticos para el tratamiento de la hipertensión no complicada, fue menor a la recomendada. El uso de diuréticos no tuvo relación con hiperglucemia. Deben realizarse ensayos con ancianos mexicanos para comparar la efectividad de los diuréticos tipo tiazida contra los inhibidores de la enzima convertidora de angiotensina

Efficient FPSoC Prototyping of FCS-MPC for Three-Phase Voltage Source Inverters

This work describes an efficient implementation in terms of computation time and resource usage in a Field-Programmable System-On-Chip (FPSoC) of a Finite Control Set Model Predictive Control (FCS-MPC) algorithm. As an example, the FCS-MPC implementation is used for the current reference tracking of a two-level three-phase power converter. The proposed solution is an enabler for using both complex control algorithms and digital controllers for high switching frequency semiconductor technologies. An original HW/SW (hardware and software) system architecture for an FPSoC is designed to take advantage of a modern operating system, while removing time uncertainty in real-time software tasks, and exploiting dedicated FPGA fabric for the most complex computations. In addition, two different architectures for the FPGA-implemented functionality are proposed and compared in order to study the area-speed trade-off. Experimental results show the feasibility of the proposed implementation, which achieves a speed hundreds of times faster than the conventional Digital Signal Processor (DSP)-based control platform.Ministerio de Economía y Competitividad TEC2016-78430-RFondo Nacional de Investigación de Qatar NPRP 9-310-2-13

Prevalencia de delirium en adultos mayores con fractura de cadera

Objetivo: Establecer la prevalencia de delirium en pacientes adultos mayores con fractura de cadera en el Servicio de Traumatología del Hospital Universitario Dr. José E. González de octubre del 2008 a mayo del 2009. Métodos: se realizó estudio descriptivo, transversal y prospectivo en la población de pacientes mayores de 60 años con diagnóstico de fractura de cadera en un periodo de ocho meses. Se evaluó delirium mediante el método del estado confusional agudo (CAM) y criterios DSM IV, durante el internamiento y al mes del egreso por vía telefónica. Resultados: Se analizó una población de 74 pacientes con una edad promedio de 79.47 años y primordialmente femenina (74.3%), el promedio de días de estancia fue de 14.68 días, observando prevalencia de delirium del 37.8% y una mortalidad final del 17.6%. No se encontraron diferencias entre ambos grupos, la edad es mayor en los pacientes con delirium y esta correlaciona con la patología (edad promedio: delirium= 84 años / sin delirium= 77 años / p = 0.0016; Rho= 0.347 / p = 0.002). Conclusiones: La prevalencia de delirium encontrada es similar a la reportada en otros estudios. Se observó menor tiempo de estancia hospitalaria, así como una mayor mortalidad en ambos grupos durante su hospitalización, de igual manera, un mes después del ingreso, en el grupo de pacientes que desarrollaron delirium

Measurement of indirect CP asymmetries in D0 → K−K+ and D0 → π−π+ decays using semileptonic B decays

Time-dependent CP asymmetries in the decay rates of the singly Cabibbo-suppressed decays D0 → K−K+ and D0 → π−π+ are measured in pp collision data corresponding to an integrated luminosity of 3.0 fb−1 collected by the LHCb experiment. The D0 mesons are produced in semileptonic b-hadron decays, where the charge of the accompanying muon is used to determine the initial state as D0 or D¯0. The asymmetries in effective lifetimes between D0 and D¯0 decays, which are sensitive to indirect CP violation, are determined to be AΓ(K−K+)=(−0.134±0.077−0.026−0.034)%,AΓ(π−π+)=(−0.092±0.145−0.025−0.033)%, where the first uncertainties are statistical and the second systematic. This result is in agreement with previous measurements and with the hypothesis of no indirect CP violation in D0 decays.S

Measurement of the CKM angle γ using B ± → DK ± with D → K0S π + π −, K0S K + K − decays

A binned Dalitz plot analysis of B± → DK± decays, with D → K0S + − and D → K0S K+K−, is performed to measure the CP-violating observables x± and y±, which are sensitive to the Cabibbo-Kobayashi-Maskawa angle . The analysis exploits a sample of proton-proton collision data corresponding to 3.0 fb−1 collected by the LHCb experiment. Measurements from CLEO-c of the variation of the strong-interaction phase of the D decay over the Dalitz plot are used as inputs. The values of the parameters are found to be x+ = (−7.7 ± 2.4 ± 1.0 ± 0.4) × 10−2, x− = (2.5 ± 2.5 ± 1.0 ± 0.5) × 10−2, y+ = (−2.2 ± 2.5 ± 0.4 ± 1.0) × 10−2, and y− = (7.5 ± 2.9 ± 0.5 ± 1.4) × 10−2. The first, second, and third uncertainties are the statistical, the experimental systematic, and that associated with the precision of the strong-phase parameters. These are the most precise measurements of these observables and correspond to = (62 +15 −14) , with a second solution at γ → γ  + 180 , and rB = 0.080+0.019 −0.021, where rB is the ratio between the suppressed and favoured B decay amplitudesS

Precise measurements of the properties of the B1(5721)0,+ and B *2(5747)0,+ states and observation of B+,0π−,+ mass structures

Invariant mass distributions of B+π− and B0π+ combinations are investigated in order to study excited B mesons. The analysis is based on a data sample corresponding to 3.0 fb−1 of pp collision data, recorded by the LHCb detector at centre-of-mass energies of 7 and 8 TeV. Precise measurements of the masses and widths of the B1(5721)0,+ and B2(5747)0,+ states are reported. Clear enhancements, particularly prominent at high pion transverse momentum, are seen over background in the mass range 5850-6000 MeV in both B+π− and B0π+ combinations. The structures are consistent with the presence of four excited B mesons, labelled B J (5840)0,+ and B J (5960)0,+, whose masses and widths are obtained under different hypotheses for their quantum numbersS

Measurement of CP asymmetries and polarisation fractions in B0s→K∗0K¯∗0 decays

An angular analysis of the decay B0s→K∗0K¯∗0 is performed using pp collisions corresponding to an integrated luminosity of 1.0 fb−1 collected by the LHCb experiment at a centre-of-mass energy s√=7 TeV. A combined angular and mass analysis separates six helicity amplitudes and allows the measurement of the longitudinal polarisation fraction f L = 0.201 ± 0.057 (stat.) ± 0.040 (syst.) for the B0s→K∗(892)0K¯∗(892)0 decay. A large scalar contribution from the K ∗0(1430) and K ∗0(800) resonances is found, allowing the determination of additional CP asymmetries. Triple product and direct CP asymmetries are determined to be compatible with the Standard Model expectations. The branching fraction B(Bs→K∗(892)0K¯∗(892)0) is measured to be (10.8 ± 2.1 (stat.) ± 1.4 (syst.) ± 0.6 (f d /f s )) × 10−6.S

Measurement of the ηc(1S) production cross-section in proton–proton collisions via the decay ηc(1S)→pp

The production of the ηc(1S) state in proton-proton collisions is probed via its decay to the pp final state with the LHCb detector, in the rapidity range 2.06.5GeV/c. The cross-section for prompt production of ηc(1S) mesons relative to the prompt J/ψ cross-section is measured, for the first time, to be σηc(1S)/σJ/ψ=1.74±0.29±0.28±0.18B at a centre-of-mass energy s√=7 TeV using data corresponding to an integrated luminosity of 0.7 fb−1, and σηc(1S)/σJ/ψ=1.60±0.29±0.25±0.17B at s√=8 TeV using 2.0 fb−1. The uncertainties quoted are, in order, statistical, systematic, and that on the ratio of branching fractions of the ηc(1S) and J/ψ decays to the pp final state. In addition, the inclusive branching fraction of b-hadron decays into ηc(1S) mesons is measured, for the first time, to be B(b→ηcX)=(4.88±0.64±0.29±0.67B)×10−3, where the third uncertainty includes also the uncertainty on the J/ψ inclusive branching fraction from b-hadron decays. The difference between the J/ψ and ηc(1S) meson masses is determined to be 114.7±1.5±0.1MeV/c2.S

Observation of the B0→ρ0ρ0 decay from an amplitude analysis of B0→(π+π−)(π+π−)decays

Proton–proton collision data recorded in 2011 and 2012 by the LHCb experiment, corresponding to an integrated luminosity of 3.0fb−1, are analysed to search for the charmless B0→ρ0ρ0decay. More than 600 B0→(π+π−)(π+π−)signal decays are selected and used to perform an amplitude analysis, under the assumption of no CP violation in the decay, from which the B0→ρ0ρ0decay is observed for the first time with 7.1 standard deviations significance. The fraction of B0→ρ0ρ0decays yielding a longitudinally polarised final state is measured to be fL=0.745+0.048−0.058(stat) ±0.034(syst). The B0→ρ0ρ0branching fraction, using the B0→φK∗(892)0decay as reference, is also reported as B(B0→ρ0ρ0)=(0.94±0.17(stat)±0.09(syst)±0.06(BF))×10−6S