Tratamiento de la gonartrosis con osteotomía tibial de penetración y fijación con grapas

La osteotomía metafisaria proximal de tibia ha sido utilizada en el tratamiento de 96 gonartrosis con desviación axil en varo (87 casos) o en valgo (nueve casos), con componente de flexo en la mitad de los casos y con cierto grado de laxitud ligamentosa en 1/3 de los casos. Se utilizó un cálculo angular preoperatorio en bipedestación con contraste opaco del eje mecánico de la extremidad y Rx-TV. La osteotomía fue cuneiforme de penetración, se estabilizó con grapas y se aplicó calza de yeso para facilitar el apoyo precoz. Proporcionó un efecto antiálgico en el 94 % de los casos, pero la valoración funcional deja el resultado en 25 % de casos excelentes y 51% de casos buenos. Destacan la necesidad de operar ambas rodillas, la bondad del resultado con independencia del grado de angulación, la compensación de las laxitudes moderadas ya referidas y la repercusión favorable del realineamiento axil sobre la artrosis femoropatelar presente en el 75 % de los casos

Bayesian inference and data cloning in population projection matrices

Discrete time models are used in Ecology for describing the evolution of an agestructured population. Usually, they are considered from a deterministic viewpoint but, in practice, this is not very realistic. The statistical model we propose in this article is a reasonable model for the case in which the evolution of the population is described by means of a projection matrix. In this statistical model, fertility rates and survival rates are unknown parameters and they are estimated by using a Bayesian approach. Usual Bayesian and data cloning methods (based on Bayesian methodology) are applied to real data from the population of the Steller sea lions located in the Alaska coast since 1978 to 2004. The estimates obtained from these methods show a good behavior when they are compared to the actual value

The transmodulation of HER2 and EGFR by Substance P in breast cancer cells requires c-Src and metalloproteinase activation.

BACKGROUND: Substance P (SP) is a pleiotropic cytokine/neuropeptide that enhances breast cancer (BC) aggressiveness by transactivating tyrosine kinase receptors like EGFR and HER2. We previously showed that SP and its cognate receptor NK-1 (SP/NK1-R) signaling modulates the basal phosphorylation of HER2 and EGFR in BC, increasing aggressiveness and drug resistance. In order to elucidate the mechanisms responsible for NK-1R-mediated HER2 and EGFR transactivation, we investigated the involvement of c-Src (a ligand-independent mediator) and of metalloproteinases (ligand-dependent mediators) in HER2/EGFR activation. RESULTS AND DISCUSSION: Overexpression of NK-1R in MDA-MB-231 and its chemical inhibition in SK-BR-3, BT-474 and MDA-MB-468 BC cells significantly modulated c-Src activation, suggesting that this protein is a mediator of NK-1R signaling. In addition, the c-Src inhibitor 4-(4'-phenoxyanilino)-6,7-dimethoxyquinazoline prevented SP-induced activation of HER2. On the other hand, SP-dependent phosphorylation of HER2 and EGFR decreased substantially in the presence of the MMP inhibitor 1-10, phenanthroline monohydrate, and the dual inhibition of both c-Src and MMP almost abolished the activation of HER2 and EGFR. Moreover, the use of these inhibitors demonstrated that this Src and MMP-dependent signaling is important to the cell viability and migration capacity of HER2+ and EGFR+ cell lines. CONCLUSION: Our results indicate that the transactivation of HER2 and EGFR by the pro-inflammatory cytokine/neuropeptide SP in BC cells is a c-Src and MMP-dependent process

Efficacy of Neurofeedback on the Increase of Mindfulness-Related Capacities in Healthy Individuals: a Controlled Trial

Electroencephalogram (EEG) studies of mindfulness have shown it can lead to increases in alpha power, which are similar to those obtained by alpha-based neurofeedback (NF) interventions. It has been hypothesized there may be relationships between mindfulness and NF in terms of the neural pathways through which they induce salutary outcomes. The aim of the study was to evaluate possible changes in mindfulness and cognitive functioning following an alpha-based NF intervention, and the role of alpha power as a mediator of improvements. A controlled, non-randomized, trial with 50 healthy participants was conducted with two experimental conditions: a six-session NF intervention and a waiting-list control group. Both groups were administered mindfulness questionnaires (Mindful Attention Awareness Scale (MAAS), Five Facet Mindfulness Questionnaire (FFMQ)) and cognitive measures (Paced Auditory Serial Addition Task (PASAT)), at pre- and post-test. The NF intervention focused on the up-regulation of upper alpha power. Differences among groups were estimated using ANCOVAs, and mediation assessment through path analyses. Compared to controls, the NF group showed enhanced task-related upper alpha power (effect size (ES) = 1.16, p < 0.001), mindfulness outcomes (MAAS: ES = 0.94, p = 0.004; FFMQ: ES = 1.38, p < 0.001), and a trend of cognitive functioning (PASAT time: ES = 0.59, p = 0.062). Upper alpha power had a mediating effect for cognitive functioning (PASAT errors: indirect effect = 0.81, 95% CI = 0.21–1.85), but not for mindfulness. These results demonstrate the effectiveness of NF for increasing mindfulness in healthy individuals with no previous experience in mindfulness or neurofeedback training, suggesting that NF may be an acceptable method of augmenting mindfulness-related capacities in the general population

A simple scaling analysis of rainfall in Andalusia (Spain) under different precipitation regimes

A simple scaling analysis was performed in Andalusia (Spain) using daily records from 377 selected stations covering the temporal period between 1870 and 2018. Since Andalusia is a region of considerable climatic variety, with notably wet areas as well as extremely dry zones, this study is useful to investigate the relationship between the simple scaling parameter value and the characteristic rainfall regime of a place. Despite the great correspondence with the average annual precipitation (PRCPTOT), a clear dependence on rainfall irregularity was observed, revealed by the ratio of the maximum daily precipitation and PRCPTOT, as well the wet spells frequency index CWD. The spatial distribution of the simple scaling parameter captured the increasing influence of the Mediterranean Sea towards the East. The easternmost dry areas are clearly influenced by Mediterranean disturbances, with a high proportion of convective rainfall and an irregular rainfall pattern. Using a simple scaling parameter, the generalized equations of the intensity-duration-frequency (IDF) curves, of great hydrological interest were calculated for the eight Andalusian provincial capitals. Moreover, the temporal trends of this parameter in the four past decades were studied in the different areas with the aim of determining if changes in their rainfall patterns due to global warming could be detected.Peer ReviewedPostprint (published version

Sistematización diagnóstica de las laxitudes crónicas de la rodilla

Se expone la sistemática llevada a cabo en nuestro Servicio de Patología del Aparato Locomotor para la clasificación y estudio de las laxitudes crónicas de la rodilla, dividiéndolas en dos grandes grupos: moderadas y graves, y dentro de ellos las distintas modalidades de predominio medial lateral y combinadas, para poder efectuar un correcto planteamiento de la táctica quirúrgica de reparación a seguir, tema que es objeto de otro trabajo

Rotura del ligamento cruzado posterior de la rodilla asociada a fractura de fémur o tibia homolateral

Los autores llaman la atención sobre la frecuente asociación de roturas del ligamento cruzado posterior (LCP) a ciertos tipos de fractura del miembro inferior Se revisan 10 casos: 6 asociados a fractura de fémur, y 4 casos asociados a fractura de tibia. Destacan en todos la igualdad en el mecanismo de producción y la frecuencia con que pasa desapercibida la lesión del ligamento hasta la completa resolución de la fractura acompañante, con un peor pronóstico del tratamiento mediante plastias sustitutivas y no mediante simple icinserción en la fase aguda. Por lo tanto, ante todo traumatizado con fracturas de fémur y/o de tibia producidas con la extremidad en flexión (accidente de moto, choque frontal) se debe sospechar la lesión del LCP, explorarlo clínica y radiográficamente y tratarlo cuando hayamos estabilizado la fractura acompañante

Leveraging data compression for performance-efficient and long-lasting NVM-based last-level cache

Non-volatile memory (NVM) technologies are interesting alternatives for building on-chip Last-Level Caches (LLCs). Their advantages, compared to SRAM memory, are higher density and lower static power, but each write operation slightly wears out the bitcell, to the point of losing its storage capacity. In this context, this paper summarizes three contributions to the state-of-the-art NVM-based LLCs. Data compression reduces the size of the blocks and, together with wear-leveling mechanisms, can defer the wear out NVMs. Moreover, as capacity is reduced by write wear, data compression enables degraded cache frames to allocate blocks whose compressed size is adequate. Our first contribution is a microarchitecture design that leverages data compression and an intra-frame wear-leveling to gracefully deal with NVM-LLCs capacity degradation. The second contribution leverages this microarchitecture design to propose new insertion policies for hybrid LLCs using Set Dueling and taking into account the compression capabilities of the blocks. From a methodological point of view, although different approaches are used in the literature to analyze the degradation of a NV-LLC, none of them allows to study in detail its temporal evolution. In this sense, the third contribution is a forecasting procedure that combines detailed simulation and prediction, enabling an accurate analysis of different cache content mechanisms (replacement, wear leveling, compression, etc.) on the temporal evolution of the performance of multiprocessor systems employing such NVM-LLCs. Using this forecasting procedure we show that the proposed NVM-LLCs organizations and the insertion policies for hybrid LLCs significantly outperform the state-of-the-art in both performance and lifetime metrics.Peer ReviewedPostprint (published version

Modification of corneal biomechanics and intraocular pressure following non-penetrating deep sclerectomy

Changes in the cornea can influence outcomes in patients with primary open-angle glaucoma (POAG). We aimed to evaluate the relevance of changes in corneal biomechanics and intraocular pressure (IOP) in patients undergoing non-penetrating deep sclerectomy (NPDS) with the Esnoper V2000 implant® (AJL Ophthalmic S.A., Gasteiz, Spain). We included 42 eyes of 42 patients with POAG scheduled for NPDS with the Esnoper V2000 implant. Biomechanical properties were measured by Ocular Response Analyzer® G3 (ORA; Reichert Inc., Depew, NY, USA). Corneal hysteresis (CH), corneal resistance factor (CRF), corneal compensated IOP (IOPcc), and Goldmann-correlated IOP (IOPg) were measured the day before surgery and on day 1, 7, and 30 and 2 and 3 months after surgery. CH initially increased, fell below the presurgical value at 30 days after the surgery, and increased again at 2 and 3 months. CRF, IOPcc, and IOPg decreased on the first day after surgery, then followed a trend of increasing but stayed below pre-surgery levels. All values reached statistical significance. While observed changes in corneal biomechanics after NPDS and Esnoper V2000 implant were significant, more studies are needed if we are to understand their influence on corneal biomechanics and their clinical relevance in POAG

Agreement between a simple dyspnea-guided treatment algorithm for stable COPD and the GOLD guidelines: A pilot study

Introduction: Guidelines recommendations for the treatment of COPD are poorly followed. This could be related to the complexity of classification and treatment algorithms. The purpose of this study was to validate a simpler dyspnea-based treatment algorithm for inhaled pharmacotherapy in stable COPD, comparing its concordance with the current Global Initiative for Obstructive Lung Disease (GOLD) guideline. Methods: We enrolled patients who had been diagnosed with COPD in three primary care facilities and two tertiary hospitals in Spain. We determined anthropometric data, forced expiratory volume in the 1st second (percent), exacerbations, and dyspnea based on the modified Medical Research Council scale. We evaluated the new algorithm based on dyspnea and exacerbations and calculated the concordance with the current GOLD recommendations. Results: We enrolled 100 patients in primary care and 150 attending specialized care in a respiratory clinic. There were differences in the sample distribution between cohorts with 41% vs 26% in grade A, 16% vs 12% in grade B, 16% vs 22% in grade C, and 27% vs 40% in grade D for primary and respiratory care, respectively (P=0.005). The coincidence of the algorithm with the GOLD recommendations in primary care was 93% and 91.8% in the respiratory care cohort. Conclusion: A simple dyspnea-based treatment algorithm for inhaled pharmacotherapy of COPD could be useful in the management of COPD patients and concurs very well with the recommended schema suggested by the GOLD initiative