Bronchoscopic balloon dilatation in the management of bronchial stenosis following lung transplantation

SummaryBackgroundBronchial stenosis (BS) is currently found in 7–15% of lung transplantation (LT) recipients. Current treatment strategies have included Nd:Yag laser, cryotherapy, bougie dilatation and stent placement. Bronchoscopic balloon dilatation has been used as alternative treatment in a few cases with controversial results. This is a study to prospectively assess the efficacy of bronchoscopic balloon dilatation as a first step in the management of post-LT BS.MethodsFrom January 1995 to December 2002, bronchoscopic balloon dilatation was evaluated as first therapeutic option in all consecutive LT patients with BS. Symptoms, pulmonary function tests, airway diameter and use of other therapeutic techniques were evaluated.ResultsA total of 10 out of 284 anastomed airways (3.5%) in 9 out of 152 LT patients were included in the study and follow-up lasted from 6 to 81 months. Dilatation of all but one BS met with initial success: increase of both luminal dimensions and forced vital capacity (P=0.01), and relief of symptoms. Bronchoscopic balloon dilatation long-term follow-up showed effective results in 5 out of 10 (50%) bronchial stenoses, after an average of 4 bronchoscopic balloon dilatation procedures (range 1–8). No severe complications were observed. Stent placement was required in the other 5 bronchial stenoses.ConclusionsBronchoscopic balloon dilatation is a safe method that should be considered as first therapeutic treatment of post-LT BS. Its use avoids the need for stent placement in up to 50% of cases

Contrôle et lutte contre la fraude du patient européen

Il est des chiffres qui donnent le vertige. Incontestablement, ceux concernant les pertes dues à la fraude et la corruption en matière de soins en font partie. Certaines estimations font en effet état de 56 milliards d'euros perdus annuellement en Europe, ce qui représente près de 80 millions de perte chaque jour et plus de 5% de l'ensemble des budgets nationaux consacrés à la santé (Gee et alii, 2010)

New polymorphic microsatellite markers for California sea lions (Zalophus californianus)

Nine microsatellite loci were isolated and characterized from California sea lions (Zalophus californianus). In addition, two of five loci tested from harbour seal (Phoca vitulina) produced a single, clear band in Z. californianus, as did one out of five loci from grey seal (Halichoerus grypus) and one out of two loci from elephant seal (Mirounga sp.). No locus tested from South American fur seal (Arctocephalus australis) amplified in Z. californianus. Locus variability was assessed in California sea lions from Los Islotes rookery, Baja California Sur, Mexico. All loci were variable, with allele numbers ranging from three to 12. © 2005 Blackwell Publishing Ltd.Peer Reviewe

The short-duration GRB 050724 host galaxy in the context of the long-duration GRB hosts

We report optical and near-infrared broad band observations of the short-duration GRB 050724 host galaxy, used to construct its spectral energy distribution (SED). Unlike the hosts of long-duration gamma-ray bursts (GRBs), which show younger stellar populations, the SED of the GRB 050724 host galaxy is optimally fitted with a synthetic elliptical galaxy template based on an evolved stellar population (age ~2.6 Gyr). The SED of the host is difficult to reproduce with non-evolving metallicity templates. In contrast, if the short GRB host galaxy metallicity enrichment is considered, the synthetic templates fit the observed SED satisfactorily. The internal host extinction is low (A_v \~< 0.4 mag) so it cannot explain the faintness of the afterglow. This short GRB host galaxy is more massive (~5x10^10 Mo) and luminous (~1.1 L*) than most of the long-duration GRB hosts. A statistical comparison based on the ages of short- and long-duration GRB host galaxies strongly suggests that short-duration GRB hosts contain, on average, older progenitors. These findings support a different origin for short- and long-duration GRBs.Comment: A&A in pres

Impact in hospitalization costs of a cardiovascular risk management program in Colombia: a propensity score matching model

Cardiovascular diseases (CVD) are the leading cause of death and burden of disease in Colombia and globally. In 2017, CVD represented the 12% of total DALYs. CVD is a costly disease from patient, family and societal perspectives. Effective prevention and risk management programs reduces the incidence of CVD by as much as 80%. We aimed to estimate the impact of direct medical hospitalization costs related to adherence in a risk management program in Colombia, 2018. We retrospectively collected data from 6,243 patients with data of enrollment in a cardiovascular risk management program (DTC, in Spanish) of a subsidized insurer, who presented arterial hypertension (AH) or AH+ type 2 diabetes mellitus (DM2). 1,065 were identified adherent to the program (treated) and 5.178 non adherent (controls). We designed a propensity score matching model adjusted with confounding variables to estimate the effect of treatment (program adherence) over hospitalization cost. Costs were calculated based on hospitalization invoices and expressed in Colombian pesos (COP) 2018. DTC has an average negative effect on cost of treated population. Being treated avoids hospitalization costs; these results were statistically significant at the 5% and 10% level (with 95%CI that goes through zero). Hence, being in the DTC program reduces hospital costs that ranges from COP-$11,346,372 to -$ 799,259 (95%CI) compared to the average cost. The overall impact on program costs is a significant saving of COP583,670 per event-year. If all members of the DTC program fulfilled its activities by more than 80%, the savings generated by the program would be close to COP$ 6.85 billion. DTC risk management program reduces direct hospitalization costs of events associated to CVD. Our results are important to design policies focused on the cost and risk management of patients with CVD in poor population

Modeling PM10 Originating from Dust Intrusions in the Southern Iberian Peninsula Using HYSPLIT

The Hybrid Single-Particle Lagrangian Integrated Trajectories (HYSPLIT) model has been applied to calculate the spatial and temporal distributions of dust originating from North Africa. The model has been configured to forecast hourly particulate matter#10 mm(PM10) dust concentrations focusing on the impacts over the southern Iberian Peninsula. Two full years (2008 and 2009) have been simulated and compared against surface background measurement sites. A statistical analysis using discrete and categorical evaluations is presented. The model is capable of simulating the occurrence of Saharan dust episodes as observed at the measurement stations and captures the generally higher levels observed in eastern Andalusia, Spain, with respect to the western Andalusia station. But the simulation tends to underpredict the magnitude of the dust concentration peaks. The model has also been qualitatively compared with satellite data, showing generally good agreement in the spatial distribution of the dust column

An alternative approach to the tomographic reconstruction of smooth refractive index distributions

Continuous, mathematically smooth Phase Objects with radial symmetry are reconstructed from cross sections of their refractive index distribution by a novel method, consisting of a linear combination of Gaussian basis functions, whose technical details are discussed. As an application example, this approach is used to get a fast and accurate estimation of the temperature distribution of an actual soldering tip

SN 2015bh: NGC 2770’s 4th supernova or a luminous blue variable on its way to a Wolf-Rayet star?

Very massive stars in the final phases of their lives often show unpredictable outbursts that can mimic supernovae, so-called, “SN impostors”, but the distinction is not always straightforward. Here we present observations of a luminous blue variable (LBV) in NGC 2770 in outburst over more than 20 yr that experienced a possible terminal explosion as type IIn SN in 2015, named SN 2015bh. This possible SN (or “main event”) had a precursor peaking ~40 days before maximum. The total energy release of the main event is ~1.8 × 1049 erg, consistent with a <0.5 M⊙ shell plunging into a dense CSM. The emission lines show a single narrow P Cygni profile during the LBV phase and a double P Cygni profile post maximum suggesting an association of the second component with the possible SN. Since 1994 the star has been redder than an LBV in an S-Dor-like outburst. SN 2015bh lies within a spiral arm of NGC 2770 next to several small star-forming regions with a metallicity of ~0.5 solar and a stellar population age of 7–10 Myr. SN 2015bh shares many similarities with SN 2009ip and may form a new class of objects that exhibit outbursts a few decades prior to a “hyper eruption” or final core-collapse. If the star survives this event it is undoubtedly altered, and we suggest that these “zombie stars” may evolve from an LBV to a Wolf-Rayet star over the timescale of only a few years. The final fate of these stars can only be determined with observations a decade or more after the SN-like event