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1.
Hipertens Riesgo Vasc ; 41 Suppl 1: S1-S85, 2024 Apr.
Artículo en Español | MEDLINE | ID: mdl-38729667

RESUMEN

Consensus statement on smoking and vascular risk About 22% of the Spanish population are daily smokers. Men are more likely to smoke than women. In Spain, women between 15-25 years of age smoke as much or more than men. Every smoker should be assessed for: physical dependence on nicotine (Fagerström test), social and psychological dependence (Glover Nilsson test), level of motivation to quit (Richmond test), probability of therapy success (Henri-Mondor and Michael-Fiore tests), and stage of behavioral change development (Prochaska and DiClementi). Advice on smoking cessation is highly cost-effective and should always be provided. Smoking is an enhancer of cardiovascular risk because it acts as a pathogen agent in the development of arteriosclerosis and is associated with ischemic heart disease, stroke, and peripheral artery disease. Smoking increases the risk of chronic lung diseases (COPD) and is related to cancers of the lung, female genitalia, larynx, oropharynx, bladder, mouth, esophagus, liver and biliary tract, and stomach, among others. Combined oral contraceptives should be avoided in women smokers older than 35 years of age due to the risk of thromboembolism. In smoking cessation, the involvement of physicians, nurses, psychologists, etc. is important, and their multidisciplinary collaboration is needed. Effective pharmacological treatments for smoking cessation are available. Combined treatments are recommended when smoker's dependence is high. For individuals who are unable to quit smoking, a strategy based on tobacco damage management with a total switch to smokeless products could be a less dangerous alternative for their health than continuing to smoke.


Asunto(s)
Cese del Hábito de Fumar , Fumar , Adolescente , Adulto , Femenino , Humanos , Masculino , Adulto Joven , Enfermedades Cardiovasculares/prevención & control , Enfermedades Cardiovasculares/etiología , Factores de Riesgo de Enfermedad Cardiaca , Fumar/efectos adversos , España , Tabaquismo/terapia
2.
Exp Parasitol ; 260: 108725, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38458554

RESUMEN

Duddingtonia flagrans is a nematophagous fungus which has shown promising results as a non-chemical parasitic control tool. The fungus disrupts the parasite's life cycle by trapping larvae in the environment through the networks generated from chlamydospores, thus preventing the reinfection of animals. One barrier to the development of a commercial product using this tool is the need to increase chlamydospore production in the laboratory for its administration to livestock. The purpose of this study was to evaluate the addition of mannitol to an enriched culture medium and the effect of adverse cultivation conditions on chlamydospore production. D. flagrans was cultivated on Petri dishes with corn agar for 4 weeks at 27 °C and 70% relative humidity (RH). Four groups were then formed, all with Sabouraud agar as a base, to which different growth inducers were added: GSA (glucose Sabouraud agar), GSA-MI (glucose Sabouraud agar + meso inositol), GSA-E (enriched glucose Sabouraud agar), and AE-M (enriched agar + mannitol). After 4 weeks, chlamydospores were recovered by washing the surface of each plate with distilled water and then quantified. The medium that yielded the highest amount of chlamydospores was subjected to different cultivation conditions: NC (normal conditions): 70% RH and 27 °C, AC (adverse conditions) 1: 20% RH and 40 °C, CA2: 60% RH and 27 °C, and CA3: 55% RH and 24 °C. It was determined that mannitol increases chlamydospore production (65x106 chlamydospores/plate), and when reducing humidity by 10% under cultivation conditions it resulted in an approximately 10% increase in chlamydospore production compared to the control group. These results suggest that the addition of polyols, as well as its cultivation under certain environmental conditions, can improve chlamydospore production on a laboratory scale.


Asunto(s)
Agar , Medios de Cultivo , Duddingtonia , Manitol , Esporas Fúngicas , Manitol/farmacología , Medios de Cultivo/química , Esporas Fúngicas/crecimiento & desarrollo , Duddingtonia/crecimiento & desarrollo , Duddingtonia/fisiología , Glucosa/metabolismo , Animales , Inositol/farmacología , Humedad , Temperatura , Agentes de Control Biológico/farmacología
3.
Space Sci Rev ; 219(5): 37, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37448777

RESUMEN

We review comprehensive observations of electromagnetic ion cyclotron (EMIC) wave-driven energetic electron precipitation using data collected by the energetic electron detector on the Electron Losses and Fields InvestigatioN (ELFIN) mission, two polar-orbiting low-altitude spinning CubeSats, measuring 50-5000 keV electrons with good pitch-angle and energy resolution. EMIC wave-driven precipitation exhibits a distinct signature in energy-spectrograms of the precipitating-to-trapped flux ratio: peaks at >0.5 MeV which are abrupt (bursty) (lasting ∼17 s, or ΔL∼0.56) with significant substructure (occasionally down to sub-second timescale). We attribute the bursty nature of the precipitation to the spatial extent and structuredness of the wave field at the equator. Multiple ELFIN passes over the same MLT sector allow us to study the spatial and temporal evolution of the EMIC wave - electron interaction region. Case studies employing conjugate ground-based or equatorial observations of the EMIC waves reveal that the energy of moderate and strong precipitation at ELFIN approximately agrees with theoretical expectations for cyclotron resonant interactions in a cold plasma. Using multiple years of ELFIN data uniformly distributed in local time, we assemble a statistical database of ∼50 events of strong EMIC wave-driven precipitation. Most reside at L∼5-7 at dusk, while a smaller subset exists at L∼8-12 at post-midnight. The energies of the peak-precipitation ratio and of the half-peak precipitation ratio (our proxy for the minimum resonance energy) exhibit an L-shell dependence in good agreement with theoretical estimates based on prior statistical observations of EMIC wave power spectra. The precipitation ratio's spectral shape for the most intense events has an exponential falloff away from the peak (i.e., on either side of ∼1.45 MeV). It too agrees well with quasi-linear diffusion theory based on prior statistics of wave spectra. It should be noted though that this diffusive treatment likely includes effects from nonlinear resonant interactions (especially at high energies) and nonresonant effects from sharp wave packet edges (at low energies). Sub-MeV electron precipitation observed concurrently with strong EMIC wave-driven >1 MeV precipitation has a spectral shape that is consistent with efficient pitch-angle scattering down to ∼ 200-300 keV by much less intense higher frequency EMIC waves at dusk (where such waves are most frequent). At ∼100 keV, whistler-mode chorus may be implicated in concurrent precipitation. These results confirm the critical role of EMIC waves in driving relativistic electron losses. Nonlinear effects may abound and require further investigation.

4.
Rev. argent. dermatol ; 103(3): 41-50, set. 2022. graf
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1431479

RESUMEN

Resumen Mujer de 74 años consulta al servicio de urgencia por cuadro de sepsis origen aparentemente no precisado, hasta su evaluación por dermatología que describe eritema violáceo cervical anterior más una infección en cavidad bucal como puerta de entrada. Considerando la clínica y los estudios por imágenes confirmamos el diagnóstico de Angina de Ludwig, cuadro de alta morbimortalidad que puede progresar a otras complicaciones más graves. Finalmente la paciente evoluciona de manera tórpida no respondiendo a medidas realizadas de soporte y fallece. La Angina de Ludwig es una celulitis de evolución rápida y grave, muy poco frecuente, que por lo general tiene una puerta de entrada a través de infecciones de la mucosa oral, donde su sospecha obliga a iniciar terapia precoz con antibióticos, quirúrgico y soporte.


Abstract This is a 74-year-old female patient with comorbidities who consulted the emergency service due to symptoms of sepsis of apparently unspecified origin, until her evaluation by dermatology revealed mild anterior cervical violaceous erythema and probable dental infection as the portal of entry. Based on clinical and imaging findings, a diagnosis of Ludwig's angina is confirmed, a condition with high morbidity and mortality that can progress to other more severe complications. Finally, the patient had a torpid evolution, not responding to support measures, and died. Ludwig's Angina is a cellulitis of etiology, usually rapidly progressive, infrequent oral infections, where a mandatory physical examination should be considered and suspected in order to start early therapy.

5.
Radiologia (Engl Ed) ; 64(3): 228-236, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35676054

RESUMEN

The interpretation of medical imaging tests is one of the main tasks that radiologists do. For years, it has been a challenge to teach computers to do this kind of cognitive task; the main objective of the field of computer vision is to overcome this challenge. Thanks to technological advances, we are now closer than ever to achieving this goal, and radiologists need to become involved in this effort to guarantee that the patient remains at the center of medical practice. This article clearly explains the most important theoretical concepts in this area and the main problems or challenges at the present time; moreover, it provides practical information about the development of an artificial intelligence project in a radiology department.


Asunto(s)
Inteligencia Artificial , Radiología , Humanos , Radiografía , Radiólogos , Radiología/métodos
6.
Hipertens Riesgo Vasc ; 39(2): 56-61, 2022.
Artículo en Español | MEDLINE | ID: mdl-35168914

RESUMEN

INTRODUCTION: High morning BP surge (MBPS) has been associated with an increased risk of cardiovascular events. We evaluated the presence of a high MBPS in patients with recent ischaemic stroke. MATERIAL AND METHODS: A case-control study was carried out. One hundred patients with an ischaemic stroke in the previous 6 months and fifty hypertensive patients without cardiovascular disease were included as controls. RESULTS: 61 lacunar (LAC) and 39 non-lacunar (NLAC) strokes were studied. The mean age was 65±11 years, and 60 (40%) patients were women. High MBPS was present in 9% of strokes (in 5 LAC and 4 NLAC) and in 8% of controls (p not significant [NS]), with a similar mean value of MBPS in both groups: 23.9±14mmHg and 24.9±15mmHg respectively (p=NS), although the control patients had a higher office BP (systolic [p=.008] and diastolic [p=.0001]), 24h systolic BP (p=.028) and daytime systolic BP (p=.022). Among the stroke patients, high MBPS was associated with previous coronary heart disease (p=.005), circadian BP pattern (p=.029), but not with the type of antihypertensive treatment prescribed. In multivariate analysis, elevated MBPS was only associated with previous coronary artery disease (p=.001). CONCLUSIONS: Approximately one in ten patients with recent ischaemic stroke has a high MBPS. Strategies to detect and treat high MBPS after a stroke are needed.


Asunto(s)
Isquemia Encefálica , Accidente Cerebrovascular Isquémico , Accidente Cerebrovascular , Anciano , Presión Sanguínea , Isquemia Encefálica/epidemiología , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Accidente Cerebrovascular/epidemiología , Accidente Cerebrovascular/etiología
7.
Ultrasonics ; 114: 106410, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-33761341

RESUMEN

The present work aims to develop ultra-wide bandwidth air-coupled capacitive micromachined ultrasonic transducers (CMUTs) for binary gas mixture analysis. The detection principle is based on time-of-flight (ToF) measurements, in order to monitor gas ultrasound velocity variations. To perform such measurements, CMUTs were especially designed to work out of resonance mode, like a microphone. The chosen membrane size is 32 × 32 µm2 and gap height is 250 nm. The resonance frequency and collapse voltage were found at 8 MHz and 58 V respectively. As mentioned, the CMUTs were exploited in quasi-static operating mode, in a very low frequency band, from 1 MHz to 1.5 MHz frequencies. The transducer impulse response was characterised, and a -6 dB relative fractional frequency bandwidth (FBW) higher than 100% was measured, enabling to use CMUT for the targeted application. Additionally, a measuring cell has been designed to hold the fabricated CMUT emitter and receiver prototypes facing each other. The volume inside the cell was kept lower than 3 mL and the surface of emitter/receiver was 1.6 × 8 mm2. To validate the general principle of the proposed technique, two binary gas mixtures of CO2/N2 and H2/N2, with varying concentrations, have been tested. The results are very promising with a measured limit of detection (LOD) of 0.3% for CO2 in N2 and 0.15% for H2 in N2.

8.
J Digit Imaging ; 34(2): 242-256, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33686526

RESUMEN

In December 2019, a new coronavirus known as 2019-nCoV emerged in Wuhan, China. The virus has spread globally and the infection was declared pandemic in March 2020. Although most cases of coronavirus disease 2019 (COVID-19) are mild, some of them rapidly develop acute respiratory distress syndrome. In the clinical management, chest X-rays (CXR) are essential, but the evaluation of COVID-19 CXR could be a challenge. In this context, we developed COVID-19 TRAINING, a free Web application for training on the evaluation of COVID-19 CXR. The application included 196 CXR belonging to three categories: non-pathological, pathological compatible with COVID-19, and pathological non-compatible with COVID-19. On the training screen, images were shown to the users and they chose a diagnosis among those three possibilities. At any time, users could finish the training session and be evaluated through the estimation of their diagnostic accuracy values: sensitivity, specificity, predictive values, and global accuracy. Images were hand-labeled by four thoracic radiologists. Average values for sensitivity, specificity, and global accuracy were .72, .64, and .68. Users who achieved better sensitivity registered less specificity (p < .0001) and those with higher specificity decreased their sensitivity (p < .0001). Users who sent more answers achieved better accuracy (p = .0002). The application COVID-19 TRAINING provides a revolutionary tool to learn the necessary skills to evaluate COVID-19 on CXR. Diagnosis training applications could provide a new original manner of evaluation for medical professionals based on their diagnostic accuracy values, and an efficient method to collect valuable data for research purposes.


Asunto(s)
COVID-19 , Radiografía Torácica , Humanos , SARS-CoV-2 , Tomografía Computarizada por Rayos X , Rayos X
10.
Clin Transl Oncol ; 23(5): 913-921, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33635468

RESUMEN

Head and neck cancers (HNC) are defined as malignant tumours located in the upper aerodigestive tract and represents 5% of oncologic cases in adults in Spain. More than 90% of these tumours have squamous histology. In an effort to incorporate evidence obtained since 2017 publication, the Spanish Society of Medical Oncology (SEOM) presents an update of the squamous cell HNC diagnosis and treatment guideline. Most relevant diagnostic and therapeutic changes from the last guideline have been updated: introduction of sentinel node biopsy in early oral/oropharyngeal cancer treated with surgery, concomitant radiotherapy with weekly cisplatin 40 mg/m2 in the adjuvant setting, new approaches for HPV-related oropharyngeal cancer and new treatments with immune-checkpoint inhibitors in recurrent/metastatic disease.


Asunto(s)
Neoplasias de Cabeza y Cuello/diagnóstico , Neoplasias de Cabeza y Cuello/terapia , Carcinoma de Células Escamosas de Cabeza y Cuello/diagnóstico , Carcinoma de Células Escamosas de Cabeza y Cuello/terapia , Alphapapillomavirus , Quimioradioterapia Adyuvante/métodos , Cisplatino/uso terapéutico , Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Neoplasias de Cabeza y Cuello/patología , Humanos , Inhibidores de Puntos de Control Inmunológico/uso terapéutico , Oncología Médica , Neoplasias de la Boca/diagnóstico , Neoplasias de la Boca/diagnóstico por imagen , Neoplasias de la Boca/patología , Neoplasias de la Boca/terapia , Estadificación de Neoplasias/métodos , Tratamientos Conservadores del Órgano/métodos , Neoplasias Orofaríngeas/diagnóstico , Neoplasias Orofaríngeas/diagnóstico por imagen , Neoplasias Orofaríngeas/terapia , Neoplasias Orofaríngeas/virología , Fármacos Sensibilizantes a Radiaciones/uso terapéutico , Radioterapia Adyuvante/métodos , Biopsia del Ganglio Linfático Centinela , Sociedades Médicas , España , Carcinoma de Células Escamosas de Cabeza y Cuello/diagnóstico por imagen , Carcinoma de Células Escamosas de Cabeza y Cuello/patología
11.
Theor Appl Genet ; 134(4): 1083-1094, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33582854

RESUMEN

KEY MESSAGE: A large association panel of 836 maize inbreds revealed a broader genetic diversity of cold tolerance, as predominantly favorable QTL with small effects were identified, indicating that genomic selection is the most promising option for breeding maize for cold tolerance. Maize (Zea mays L.) has limited cold tolerance, and breeding for cold tolerance is a noteworthy bottleneck for reaching the high potential of maize production in temperate areas. In this study, we evaluate a large panel of 836 maize inbred lines to detect genetic loci and candidate genes for cold tolerance at the germination and seedling stages. Genetic variation for cold tolerance was larger than in previous reports with moderately high heritability for most traits. We identified 187 significant single-nucleotide polymorphisms (SNPs) that were integrated into 159 quantitative trait loci (QTL) for emergence and traits related to early growth. Most of the QTL have small effects and are specific for each environment, with the majority found under control conditions. Favorable alleles are more frequent in 120 inbreds including all germplasm groups, but mainly from Minnesota and Spain. Therefore, there is a large, potentially novel, genetic variability in the germplasm groups represented by these inbred lines. Most of the candidate genes are involved in metabolic processes and intracellular membrane-bounded organelles. We expect that further evaluations of germplasm with broader genetic diversity could identify additional favorable alleles for cold tolerance. However, it is not likely that further studies will find favorable alleles with large effects for improving cold tolerance in maize.


Asunto(s)
Mapeo Cromosómico/métodos , Cromosomas de las Plantas/genética , Frío , Polimorfismo de Nucleótido Simple , Sitios de Carácter Cuantitativo , Zea mays/genética , Estudio de Asociación del Genoma Completo , Fenotipo , Fitomejoramiento , Zea mays/fisiología
12.
Parasitol Res ; 120(3): 773-783, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33501585

RESUMEN

Macrocyclic lactones are frequently used dewormers in livestock farms around the world. Due to their wide spectrum of action against nematodes and arthropods and their practicality of application at very low doses, their use has become massive since their discovery. These compounds are eliminated in a large percentage in the feces of animals, causing adverse effects on coprophilic fauna. Several research groups around the world have been devoted to evaluating these effects on this fauna. The aim of this review is to register the adverse effects of the concentrations in which macrocyclic lactones are eliminated in the feces of domestic animals and the importance of the coprophilic and edaphilous fauna on the degradation of the feces of the animals. The documented data shows that the use of macrocyclic lactones has a high toxicological risk for the different species that colonize the dung, thus causing an adverse effect on its disintegration and its subsequent incorporation into the soil. Even so, more studies at the regional level and their standardization are necessary to make the comparison between different areas possible.


Asunto(s)
Lactonas/farmacología , Animales , Antiparasitarios/química , Antiparasitarios/farmacología , Antiparasitarios/toxicidad , Artrópodos/efectos de los fármacos , Artrópodos/fisiología , Heces/parasitología , Lactonas/química , Lactonas/toxicidad , Nematodos/efectos de los fármacos , Nematodos/fisiología , Suelo/parasitología , Contaminantes del Suelo/química , Contaminantes del Suelo/toxicidad
13.
Clin Transl Oncol ; 23(4): 764-772, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32797376

RESUMEN

BACKGROUND: Our previous phase-3 study (TTCC 2503) failed to show overall survival advantage of 2 induction chemotherapy (IC) regimens followed by standard concurrent chemoradiotherapy (CRT) over CRT alone in patients with unresectable locally advanced head and neck squamous-cell carcinoma (LAHNSCC). This study described the long-term survival of those patients. MATERIALS AND METHODS: Long-term follow-up study of patients with untreated LAHNSCC assigned to IC (three cycles), with either docetaxel, cisplatin and 5-fluorouracil (TPF arm) or cisplatin and 5-fluorouracil (PF arm), followed by CRT, or CRT alone, included in the previous TTCC 2503 trial. RESULTS: In the intention-to-treat population (n = 439), the median OS times were 25.4 (95% CI, 16.8-34.4), 26.2 (95% CI, 18.2-36.6) and 25.4 months (95% CI, 17.4-36.0) in the TPF-CRT, PF-CRT and CRT arms, respectively (log-rank p = 0.51). In the per-protocol population (n = 355), patients with larynx-hypopharynx primary tumors treated with IC (TPF or PF) followed by CRT had a longer median PFS than those who received CRT alone. Moreover, patients with ECOG 0 treated with IC (TPF or PF) followed by CRT had a better TTF than those with CRT alone. There were no statistically significant differences in terms of OS, PFS or TTF, according to the tumor load or affected nodes. CONCLUSION: After a long follow-up, the TTCC 2503 trial failed to show the benefit of IC-CRT in unresectable LAHNSCC regarding the primary end point. However, fit patients with ECOG 0 and primary larynx-hypopharyngeal tumors may benefit from the use of IC if administered by an experienced team. ClinicalTrials.gov identifier NCT00261703.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Quimioradioterapia , Neoplasias de Cabeza y Cuello/mortalidad , Quimioterapia de Inducción , Carcinoma de Células Escamosas de Cabeza y Cuello/mortalidad , Cisplatino/uso terapéutico , Ensayos Clínicos Fase III como Asunto , Intervalos de Confianza , Docetaxel/uso terapéutico , Fluorouracilo/uso terapéutico , Estudios de Seguimiento , Neoplasias de Cabeza y Cuello/tratamiento farmacológico , Neoplasias de Cabeza y Cuello/patología , Neoplasias de Cabeza y Cuello/terapia , Humanos , Neoplasias Hipofaríngeas/tratamiento farmacológico , Neoplasias Hipofaríngeas/mortalidad , Neoplasias Hipofaríngeas/patología , Neoplasias Hipofaríngeas/terapia , Análisis de Intención de Tratar , Neoplasias Laríngeas/tratamiento farmacológico , Neoplasias Laríngeas/mortalidad , Neoplasias Laríngeas/patología , Neoplasias Laríngeas/terapia , Neoplasias de la Boca/tratamiento farmacológico , Neoplasias de la Boca/mortalidad , Neoplasias de la Boca/patología , Neoplasias de la Boca/terapia , Supervivencia sin Progresión , Ensayos Clínicos Controlados Aleatorios como Asunto , Estudios Retrospectivos , Carcinoma de Células Escamosas de Cabeza y Cuello/tratamiento farmacológico , Carcinoma de Células Escamosas de Cabeza y Cuello/patología , Carcinoma de Células Escamosas de Cabeza y Cuello/terapia , Taxoides/uso terapéutico , Resultado del Tratamiento , Carga Tumoral
14.
Clin Transl Oncol ; 22(9): 1565-1579, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32062835

RESUMEN

BACKGROUND: This article describes and compares approved targeted therapies and the newer immunotherapy agents. MATERIALS AND METHODS: This article especially performs an in-depth review of currently available data for tivozanib, explaining its mechanism of action, its safety profile and its role as an efficacy drug in the management of renal cancer. RESULTS: Despite the fact that the treatment of advanced RCC has been dramatically modified in recent years, durable remissions are scarce and it remains a lethal disease. For first- and second-line therapy, there is now growing evidence to guide the selection of the appropriate treatment. CONCLUSIONS: Several TKIs are standard of care at different settings. Among those approved TKIs, tivozanib has similar efficacy than others with a better safety profile. The use of prognostic factors is critical to the selection of optimal therapy.


Asunto(s)
Carcinoma de Células Renales/tratamiento farmacológico , Neoplasias Renales/tratamiento farmacológico , Compuestos de Fenilurea/uso terapéutico , Inhibidores de Proteínas Quinasas/uso terapéutico , Quinolinas/uso terapéutico , Receptores de Factores de Crecimiento Endotelial Vascular/antagonistas & inhibidores , Carcinoma de Células Renales/genética , Carcinoma de Células Renales/metabolismo , Carcinoma de Células Renales/patología , Ensayos Clínicos como Asunto , Consenso , Humanos , Neoplasias Renales/genética , Neoplasias Renales/metabolismo , Neoplasias Renales/patología , Metástasis de la Neoplasia
15.
Clin Transl Oncol ; 22(2): 223-235, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32006340

RESUMEN

Thyroid carcinoma is the most frequent endocrine malignancy and accounts for around 3% of global cancer incidence. Different histologies and clinical scenarios make necessary a multidisciplinary approach that includes new diagnostic methods and surgical, radiopharmaceutical and systemic therapies. This guideline updates several aspects of management of thyroid cancer.


Asunto(s)
Ensayos Clínicos como Asunto/normas , Guías de Práctica Clínica como Asunto/normas , Neoplasias de la Tiroides/terapia , Humanos , Oncología Médica , Sociedades Médicas
16.
Med Intensiva (Engl Ed) ; 44(4): 210-215, 2020 May.
Artículo en Inglés, Español | MEDLINE | ID: mdl-30799042

RESUMEN

OBJECTIVE: To analyze outcomes and factors related to mortality among very elderly trauma patients admitted to intensive care units (ICUs) participating in the Spanish trauma ICU registry. DESIGN: A multicenter nationwide registry. Retrospective analysis. November 2012-May 2017. SETTING: Participating ICUs. PATIENTS: Trauma patients aged ≥80 years. INTERVENTIONS: None. MAIN VARIABLES OF INTEREST: The outcomes and influence of limitation of life sustaining therapy (LLST) were analyzed. Comparisons were established using the Wilcoxon test, Chi-squared test or Fisher's exact test as appropriate. Multiple logistic regression analysis was performed to analyze variables related to mortality. A p-value <0.05 was considered statistically significant. RESULTS: The mean patient age was 83.4±3.3 years; 281 males (60.4%). Low-energy falls were the mechanisms of injury in 256 patients (55.1%). The mean ISS was 20.5±11.1, with a mean ICU stay of 7.45±9.9 days. The probability of survival based on the TRISS methodology was 69.8±29.7%. The ICU mortality rate was 15.5%, with an in-hospital mortality rate of 19.2%. The main cause of mortality was intracranial hypertension (42.7%). The ISS, the need for first- and second-tier measures to control intracranial pressure, and being admitted to the ICU for organ donation were independent mortality predictors. LLST was applied in 128 patients (27.9%). Patients who received LLST were older, with more severe trauma, and with more severe brain injury. CONCLUSIONS: Very elderly trauma ICU patients presented mortality rates lower than predicted on the basis of the severity of injury.


Asunto(s)
Unidades de Cuidados Intensivos , Presión Intracraneal , Anciano , Anciano de 80 o más Años , Mortalidad Hospitalaria , Humanos , Masculino , Sistema de Registros , Estudios Retrospectivos
17.
Theor Appl Genet ; 133(2): 503-516, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31740990

RESUMEN

KEY MESSAGE: We identify the largest amount of QTLs for cold tolerance in maize; mainly associated with photosynthetic efficiency, which opens new possibilities for genomic selection for cold tolerance in maize. Breeding for cold tolerance in maize is an important objective in temperate areas. The objective was to carry out a highly efficient study of quantitative trait loci (QTLs) for cold tolerance in maize. We evaluated 406 recombinant inbred lines from a multi-parent advanced generation intercross (MAGIC) population in a growth chamber under cold and control conditions, and in the field at early and normal sowing. We recorded cold tolerance-related traits, including the number of days from sowing to emergence, chlorophyll content and maximum quantum efficiency of photosystem II (Fv/Fm). Association mapping was based on genotyping with near one million single nucleotide polymorphism (SNP) markers. We found 858 SNPs significantly associated with all traits, most of them under cold conditions and early sowing. Most QTLs were associated with chlorophyll and Fv/Fm. Many candidate genes coincided between the current research and previous reports. These results suggest that (1) the MAGIC population is an efficient tool for identifying QTLs for cold tolerance; (2) most QTLs for cold tolerance were associated with Fv/Fm; (3) most of these QTLs were located in specific genomic regions, particularly bin 10.04; (4) the current study allows genetically improving cold tolerance with genome-wide selection.


Asunto(s)
Aclimatación/genética , Respuesta al Choque por Frío/genética , Zea mays/genética , Aclimatación/fisiología , Clorofila/genética , Clorofila/metabolismo , Mapeo Cromosómico , Respuesta al Choque por Frío/fisiología , Estudio de Asociación del Genoma Completo , Genotipo , Fenotipo , Fotosíntesis/genética , Fotosíntesis/fisiología , Complejo de Proteína del Fotosistema II/genética , Complejo de Proteína del Fotosistema II/metabolismo , Fitomejoramiento , Polimorfismo de Nucleótido Simple , Sitios de Carácter Cuantitativo , Zea mays/metabolismo , Zea mays/fisiología
18.
Arq. bras. med. vet. zootec. (Online) ; 71(4): 1149-1157, jul.-ago. 2019. tab, ilus
Artículo en Inglés | LILACS, VETINDEX | ID: biblio-1038607

RESUMEN

This work aimed to describe the origin, distribution, and ramifications of the ischiadicus nerve in the giant anteater and to provide anatomical data which could explain not only the evolutionary aspects but also provide important information for other related works. For the present study, four specimens were used, prepared by perfusion of 10% formaldehyde solution via the femoral artery, for conservation and dissection. The origin of the right and left ischiadicus nerves in the giant anteater from the ventral ramification of the third lumbar (L3) and the first (S1), second (S2), and third (S3) sacral spinal nerves. These nerves were symmetrical in all animals studied. The distribution and ramification occurred to the superficial, middle, and deep gluteal, gemelli, piriform, quadratus femoris, tensor fasciae latae, caudal crural abductor, cranial and caudal parts of the biceps femoris, adductor, semitendinous, and cranial and caudal parts of the semimembranous muscles. Based on the origins of the ischiadicus nerves, there is a caudal migration in the nerve location in animals in a more recent position on the evolutionary scale due to reconfiguration of the lumbosacral plexus, resulting from the increase in a number of lumbar vertebrae. There is no complete homology of the muscle innervation.(AU)


Objetivou-se descrever as origens, distribuições e ramificações dos nervos isquiáticos no tamanduá-bandeira, disponibilizando, assim, dados anatômicos que possam não só elucidar os aspectos evolutivos como também fornecer informações importantes para áreas afins. Foram utilizados quatro espécimes preparados por meio da perfusão de formaldeído 10% via artéria femoral, para conservação e dissecação. As origens dos nervos isquiáticos direito e esquerdo no tamanduá-bandeira foram provenientes dos ramos ventrais dos nervos espinhais lombares três e sacrais um, dois e três, sendo simétricos em todos os animais estudados. As distribuições e ramificações ocorreram nos músculos glúteos superficial, médio e profundo; gêmeo; piriforme; quadrado femoral; tensor da fáscia lata; abdutor crural caudal; bíceps femoral parte cranial; bíceps femoral parte caudal; adutor; semitendíneo; semimembranáceo parte cranial e semimembranáceo parte caudal. Notou-se que houve uma migração caudal na localização deste nervo nos animais mais recentes na escala evolutiva, devido a uma reconfiguração do plexo lombossacral decorrente do aumento no número de vértebras lombares, não havendo uma homologia total quanto à inervação dos músculos.(AU)


Asunto(s)
Animales , Nervio Ciático/anatomía & histología , Nervio Ciático/irrigación sanguínea , Xenarthra/anatomía & histología
19.
Rev Esp Quimioter ; 32(3): 246-253, 2019 Jun.
Artículo en Español | MEDLINE | ID: mdl-30980520

RESUMEN

OBJECTIVE: To evaluate the clinical impact of Meningitis/Encephalitis FilmArray® panel for the diagnosis of cerebral nervous system infection and to compare the results (including time for diagnosis) with those obtained by conventional microbiological techniques. METHODS: A prospective observational study in an Intensive Care Unit of adults from a tertiary hospital was carried out. Cerebrospinal fluid from all patients was taken by lumbar puncture and assessed by the meningitis/encephalitis FilmArray® panel ME, cytochemical study, Gram, and conventional microbiological cultures. RESULTS: A total of 21 patients admitted with suspicion of Meningitis/Encephalitis. Median age of patients was 58.4 years (RIQ 38.1-67.3), median APACHE II 18 (RIQ 12-24). Median stay in ICU and median hospital stay was 4 (RIQ 2-6) and 17 days (RIQ 14-28), respectively. The overall mortality was 14.3%. A final clinical diagnosis of meningitis or encephalitis was established in 16 patients, obtaining the etiological diagnosis in 12 of them (75%). The most frequent etiology was Streptococcus pneumoniae (8 cases). FilmArray® allowed etiological diagnosis in 3 cases in which the culture had been negative, and the results led to changes in the empirical antimicrobial therapy in 7 of 16 cases (43.8%). FilmArray® yielded a global sensitivity and specificity of 100% and 90%, respectively. The median time to obtain results from the latter and conventional culture (including antibiogram) was 2.9 hours (RIQ 2.1-3.8) and 45.1 hours (RIQ 38.9-58.7), respectively. CONCLUSIONS: The Meningitis/Encephalitis FilmArray® panel was able to establish the etiologic diagnosis faster than conventional methods. Also, it achieved a better sensitivity and led to prompt targeted antimicrobial therapy.


Asunto(s)
Encefalitis/diagnóstico , Unidades de Cuidados Intensivos , Meningitis/diagnóstico , Reacción en Cadena de la Polimerasa Multiplex/métodos , APACHE , Adulto , Anciano , Antibacterianos/uso terapéutico , Encefalitis/líquido cefalorraquídeo , Encefalitis/mortalidad , Femenino , Mortalidad Hospitalaria , Humanos , Tiempo de Internación , Masculino , Meningitis/líquido cefalorraquídeo , Meningitis/mortalidad , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Estudios Prospectivos , Sensibilidad y Especificidad
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