Diabetes and atypical presentations of patients hospitalized for an acute myocardial infarction in Puerto Rico

Introduction: Diabetes mellitus is one of the fastest growing health issues concerning the world today with an estimated 382 million individuals affected as of 2013 and a projected increase in number to 592 million by 2035. Diabetes mellitus is a condition affecting 12-15% of the population or around 400,000 people in Puerto Rico. The most common presenting complaint of diabetics who are hospitalized for an acute myocardial infarction (AMI) is chest pain. However, the pervasiveness of atypical symptoms in diabetic patients is yet unclear. The aim of this study is to determine if there is an association between diabetes and the presentation of atypical symptoms in the emergency room in those suffering from an AMI in Puerto Rico. Methods: We conducted a secondary data analysis of data from participants from the 2007, 2009 and 2011 Puerto Rico Cardiovascular Disease Surveillance system (PRCDS), an observational, non-concurrent, cross-sectional study. The main independent variable was presence of diabetes mellitus (Type I and Type II). The outcome was the presence of atypical symptoms at the time of presentation, defined as the absence of chest pain on admission. The prevalence of atypical symptoms in diabetic patients and non-diabetic patients was compared. Binary logistic regression was used to test for independent association. Statistical significance was considered for p-values ≤0.05 for a two-tailed test. Analysis was conducted using SPSS software. Results: We found no association between atypical presentation of an AMI and diabetes, before or after adjustment for age, gender, congestive heart failure, stroke history and BMI. (unadjusted OR= 1.0, 95%CI=0.7-1.4 and adjusted OR=1.0, 95% CI=0.6-1.5). Other independent associations identified were that patients older than 75 were 3.5 times more likely to present atypically than people younger than 55 (OR= 3.5, 95% CI=1.6-7.6), and those with CHF and stroke were more likely to present with atypical symptoms (OR=3.2, 95% CI=1.7-6.1 and OR=4.2 95% CI=2.1-8.4, respectively). Lastly, overweight patients were 3.3 times more likely to present atypically than healthy weight patients (OR=2.0, 95% CI=0.6-7.0). Conclusion: We found no evidence of an association between diabetes and the presentation of atypical symptoms in patients hospitalized for AMI in Puerto Rico

Design of beams and slabs of self-compacting concrete fittings working to flexion

Numerous experimental studies indicate that addition of fibers substantially increases the shear strength of concrete and mortar beams, and that stirrups and reinforcing fibers combination can be really effective. When steel fibers are used as a supplement or substitute for vertical stirrups or folded bars, we obtain the following characteristics: The fibers are distributed randomly by the volume of the concrete with a closer separation than can be achieved with the Armor; The tensile strength at first crack, the ultimate tensile strength and the shear friction resistance are increased

Identification and functional analysis of novel phosphorylation sites in the RNA surveillance protein Upf1.

One third of inherited genetic diseases are caused by mRNAs harboring premature termination codons as a result of nonsense mutations. These aberrant mRNAs are degraded by the Nonsense-Mediated mRNA Decay (NMD) pathway. A central component of the NMD pathway is Upf1, an RNA-dependent ATPase and helicase. Upf1 is a known phosphorylated protein, but only portions of this large protein have been examined for phosphorylation sites and the functional relevance of its phosphorylation has not been elucidated in Saccharomyces cerevisiae. Using tandem mass spectrometry analyses, we report the identification of 11 putative phosphorylated sites in S. cerevisiae Upf1. Five of these phosphorylated residues are located within the ATPase and helicase domains and are conserved in higher eukaryotes, suggesting a biological significance for their phosphorylation. Indeed, functional analysis demonstrated that a small carboxy-terminal motif harboring at least three phosphorylated amino acids is important for three Upf1 functions: ATPase activity, NMD activity and the ability to promote translation termination efficiency. We provide evidence that two tyrosines within this phospho-motif (Y-738 and Y-742) act redundantly to promote ATP hydrolysis, NMD efficiency and translation termination fidelity

Hispanic ethnicity and survival in pediatric acute lymphocytic leukemia (all) patients in Florida

Introduction: Pediatric cancer mortality rates have drastically declined according to analyzed population-based surveillance data; however, incidences of most childhood cancers continue to rise. Recent studies have indicated an association between ethnicity/race and cancer survival. Florida's ethnically/racially diverse population and surging pediatric cancer incidence characterize the state as an ideal setting to study the association between ethnicity/race and pediatric cancer survival. Objective: To determine whether or not an association exists between Hispanic ethnicity and cancer survival in a Floridian population of pediatric patients with Acute Lymphocytic Leukemia (ALL). Methods: We will use data from participants 18 years or younger of Florida Cancer Data System (FCDS). Cox-proportional hazard regression was used to assess independent association between Hispanic ethnicity and time to death (time interval from diagnose of ALL to the last patient contact, as recorded in the database). Survival status (death or alive) was assessed at the date of last contact. Those who are alive at last contact were then censored. Results: In the unadjusted model, ethnicity was not associated with risk of death (HR= 0.87, 95% CI=0.73 - 1.04). After adjustment for sex, race, age at diagnosis, insurance status, geographic area, and immunophenotype) the results showed again no association between Hispanic ethnicity and survival (HR = 1.19, 95% CI=0.82 - 1.72). Conclusions: We found no evidence for differences in survival based on ethnic status. Potential difference in racial-survival disparities in pediatric ALL within various geographic regions might depend on Hispanic ancestries or cancer type. Further research on the topic is still deemed necessary as to clarify the nature of the association between ethnicity and cancer survival

Non BPS noncommutative vortices

We construct exact vortex solutions to the equations of motion of the Abelian Higgs model defined in non commutative space, analyzing in detail the properties of these solutions beyond the BPS point. We show that our solutions behave as smooth deformations of vortices in ordinary space time except for parity symmetry breaking effects induced by the non commutative parameter $\theta$.Comment: 17 pages, 5 figure

La terapia interpersonal de la depresión y las psicoterapias en el fin del milenio.

En este trabajo presentamos los fundamentos teóricos y clínicos de la Terapia Interpersonal de la depresión y analizamos los motivos que la han consolidado como una alternativa eficaz y frecuentemente practicada de psicoterapia en los Estados Unidos de América. Exponemos la situación en España y en Europa. Discutimos algunas implicaciones de esto para la práctica de la psicoterapia en los próximos años

La terapia interpersonal de la depresión y las psicoterapias en el fin del milenio.

En este trabajo presentamos los fundamentos teóricos y clínicos de la Terapia Interpersonal de la depresión y analizamos los motivos que la han consolidado como una alternativa eficaz y frecuentemente practicada de psicoterapia en los Estados Unidos de América. Exponemos la situación en España y en Europa. Discutimos algunas implicaciones de esto para la práctica de la psicoterapia en los próximos años

Psicoterapia contemporánea: dilemas y perspectivas

Hablar de una psicoterapia contemporánea nos conduce necesariamente a abordajes en clave de complejidad que favorezcan miradas más abiertas, con más posibilidades, en su constitución, su ámbito de conocimiento, el ejercicio profesional y la formación de psicoterapeutas. Y pensarla desde una perspectiva interdisciplinar es fundamental para la comprensión, el análisis y las posibilidades de tratamiento de los problemas psicológicos que aquejan a las sociedades contemporáneas. Este es el planteamiento central que se desarrolla en esta obra conformada por ocho ensayos, en los cuales se abordan temas como la formación de los psicoterapeutas, la historia de este campo profesional, la influencia del entorno y de la familia en el consultante, así como la importancia del diálogo con otras disciplinas para el perfeccionamiento de este campo de generación e innovación en psicoterapia. Por ello, se recomienda la lectura de este volumen, el primero de la colección Psicoterapia y Diálogo Interdisciplinario, a estudiantes, docentes y profesionales en el campo de la psicoterapia y la salud mental, ya que este ejercicio profesional cobra cada día mayor relevancia para el entendimiento y abordaje de la complejidad de la vida humana hacia la promoción del bienestar.ITESO. A.C