[Long-term renal function in Wilms tumor survivors]. / Función renal a largo plazo en supervivientes de tumor de Wilms.

OBJETIVE: To evaluate long-term renal function and morbimortality in non-syndromic Wilms tumor (WT) survivors. METHODS: Retrospective study about WT patients treated in 1993-2017, according to SIOP protocols. Mortality, glomerular filtration rate (GFR), prevalence of hypertension and requirement of dialysis and renal transplant were evaluated. Chronic kidney disease (CKD) was defined as GFR <90 ml/min/1.73 m2. RESULTS: Thirty-nine children were treated in the 25 analyzed years. Median time of follow-up was 6 years (0.5-21 years). 48% (19 patients) debuted with stage I or II. Four cases had high-grade histo-logy. Mortality rate was 10%. GFR data were found in 37 patients. Chronic kidney disease (grade I-II) turned up in 6 patients (16%). No patient required renal replacement therapy or renal transplant. 16% of patients developed CKD in both unilateral and bilateral WT, (p>0.05); OR 1.04 (IC 95% 0.09-10.9). Identical results were obtained comparing patients treated with or without radiotherapy (16%). Children with stage I-III had CKD in 11% vs. 40% of patients with stage IV (p=0.12); OR 5.3 (IC 95% 0.61-45). None of them presented hypertension in addition. CONCLUSIONS: In the current study the prevalence of CKD was low but not negligible, although no patients required renal replacement therapy or renal transplant. Bilateral renal involvement and radiotherapy were not associated with CKD development. Metastatic disease determines a higher risk of CKD.

OBJETIVOS: Evaluar la función renal y la morbimortalidad a largo plazo, en supervivientes de tumor de Wilms (TW) no sindrómico. MATERIAL Y METODOS: Estudio retrospectivo de pacientes con TW entre 1993-2017 tratados según protocolos SIOP. Evaluamos mortalidad, filtrado glomerular (FG), prevalencia de hipertensión arterial (HTA), necesidad de diálisis y trasplante renal. Se definió enfermedad renal crónica (ERC) como FG <90 ml/min/1,73 m2. RESULTADOS: En los 25 años analizados se trataron 39 pacientes con edad media diagnóstica de 3,6 años (0,3-11 años). Mediana de seguimiento 6 años (0,5-21 años). El 48% (19 pacientes) debutaron con estadio I o II. Cuatro pacientes presentaron histología de alto riesgo (10%). La mortalidad fue del 10%. El 16% (6 pacientes) desarrolló ERC (grados I-II). Ningún paciente precisó terapia renal sustitutoria (TRS) o trasplante. La presencia de ERC tanto en enfermedad unilateral como bilateral fue del 16%, p>0,05; OR 1,04 (IC 95% 0,09-10,9). Se obtuvieron idénticos resultados (16%) comparando pacientes que recibieron radioterapia frente a aquellos que no. Los pacientes en estadio I, II y III presentaron una prevalencia de ERC del 11% vs. 40% en estadio IV (p=0,12); OR 5,3 (IC 95% 0,61-45). Ningún paciente asoció HTA crónica. CONCLUSIONES: En el presente estudio la prevalencia de ERC en supervivientes de TW no sindrómico es baja pero no desdeñable, aunque ninguno precisó trasplante renal o TRS. La presencia de enfermedad bilateral y la radioterapia no se asociaron al desarrollo de ERC. La enfermedad metastásica condiciona un riesgo mayor de ERC.

Competition between Polar and Nonpolar Lattice Distortions in Oxide Quantum Wells: New Critical Thickness at Polar Interfaces.

Two basic lattice distortions permeate the structural phase diagram of oxide perovskites: antiferrodistortive (AFD) rotations and tilts of the oxygen octahedral network and polar ferroelectric modes. With some notable exceptions, these two order parameters rarely coexist in a bulk crystal, and understanding their competition is a lively area of active research. Here we demonstrate, by using the LaAlO_{3}/SrTiO_{3} system as a test case, that quantum confinement can be a viable tool to shift the balance between AFD and polar modes and selectively stabilize one of the two phases. By combining scanning transmission electron microscopy (STEM) and first-principles-based models, we find a crossover between a bulklike LaAlO_{3} structure where AFD rotations prevail, to a strongly polar state with no AFD tilts at a thickness of approximately three unit cells; therefore, in addition to the celebrated electronic reconstruction, our work unveils a second critical thickness, related not to the electronic properties but to the structural ones. We discuss the implications of these findings, both for the specifics of the LaAlO_{3}/SrTiO_{3} system and for the general quest towards nanoscale control of material properties.

Multiple-stable anisotropic magnetoresistance memory in antiferromagnetic MnTe.

Commercial magnetic memories rely on the bistability of ordered spins in ferromagnetic materials. Recently, experimental bistable memories have been realized using fully compensated antiferromagnetic metals. Here we demonstrate a multiple-stable memory device in epitaxial MnTe, an antiferromagnetic counterpart of common II-VI semiconductors. Favourable micromagnetic characteristics of MnTe allow us to demonstrate a smoothly varying zero-field antiferromagnetic anisotropic magnetoresistance (AMR) with a harmonic angular dependence on the writing magnetic field angle, analogous to ferromagnets. The continuously varying AMR provides means for the electrical read-out of multiple-stable antiferromagnetic memory states, which we set by heat-assisted magneto-recording and by changing the writing field direction. The multiple stability in our memory is ascribed to different distributions of domains with the Néel vector aligned along one of the three magnetic easy axes. The robustness against strong magnetic field perturbations combined with the multiple stability of the magnetic memory states are unique properties of antiferromagnets.

[Value of plasma C-reactive protein and lactate dehydrogenase levels in the diagnosis of intestinal obstruction in an emergency department]. / Proteína C reactiva y lactato deshidrogenasa en el diagnóstico de la obstrucción intestinal en un servicio de urgencias.

BACKGROUND: Intestinal obstruction is one of the most frequent surgical emergencies. Its diagnosis is essentially based on clinical history, physical exploration and image tests. The aim of this study was to analyze the diagnostic value of acute phase reactants in patients with benign versus malign intestinal obstruction. METHOD: Historical cohort study of 53 patients who underwent surgery because of intestinal obstruction and/or non-obstructive colorectal cancer. The patients were placed in three groups: group 1 (colorectal cancer with intestinal obstruction) (n=23), group 2 (benign intestinal obstruction)(n=10) and group 3 (non-obstructive cancer of the colon)(n=20). We determined the initial plasma values of the C-reactive protein (CRP) and the lactate dehydrogenase (LDH)enzyme. RESULTS: CRP was quantitatively higher in patients with benign intestinal obstruction (group 2) (p=0.001), while LDH was quantitatively higher in group 1 (patients with obstructive cancer). The plasma levels of LDH were significantly greater in the groups with intestinal obstruction (groups 1 and 2) than in patients without obstruction (p<0.001). Plasma levels of CRP above 11 mg/l and of LDH above 317 U/L showed an acceptable diagnostic value for differentiating patients with intestinal obstruction, with areas under the ROC curve of 80% (CI 95% = 68-92%) and 86% (CI 95%= 75-96%)respectively. Their diagnostic value for differentiating benign or malign origin is lower, with areas under the ROC curve of 56% for levels of CRP > 24 ng/l (CI 95% = 30-82%) and 52% (CI 95% = 29-74%) for levels of LDH > 359 U/L. CONCLUSION: Determination of plasma concentrations of CRP can help in the diagnosis of intestinal obstruction and indicate its benign or malign origin in emergency services.

Salud percibida y salud real: prevalencia en las personas mayores de 60 años / Perceived health and real health: prevalence among persons aged 60 and older / Saúde percebida e saúde real: prevalência nas pessoas idosas de 60 anos

Objetivo: Analizar el estado de salud de la población mayor de 60 años y la relación que existe entre la autopercepción de la salud que tienen las personas mayores y su salud real; se valoró la mediación en esta relación de aspectos sociodemográficos como la edad y el género. Método: Diseño descriptivo, transversal, de prevalencia. Localización: 15 centros de día y 10 residencias de la provincia de Almería (España). Participantes: 1,220 personas mayores de 60 años (M = 70.9; DT = 7.9), de los cuales el 48.3% son hombres y el 51.7% mujeres. Mediciones: Se analizó el género, la edad, el estado civil, la presencia o no de diferentes enfermedades y problemas de salud, y el nivel de salud percibido. Resultados: Los problemas de salud relacionados con los huesos y articulaciones son los más frecuentes. Existen diferencias significativas (p = 0.000) en la percepción de la salud entre ambos géneros; los hombres tienen una mejor percepción de su salud. Hay una relación negativa y significativa (p < 0.001) entre la edad y la percepción de la salud. Tanto el número de enfermedades (r2 = 0.251) como la edad (r2 = 0.010) y el género (r2 = 0.002) forman parte del modelo explicativo de la percepción de salud. Conclusiones: El número de enfermedades, la edad y el género son variables que explican una cuarta parte de la variable subjetiva salud percibida, por tanto ofrecen indicios de poder ser utilizadas en la planificación de las políticas sanitarias.

Objective: To analyze the health of the population aged 60 and older, and the relationship between their perception of their health and their real condition. The relationship with social-demographic issues such as gender was also assessed. Method: Descriptive, transversal and prevalence study of 15 Day and 10 Residential Centers in the province of Almería (Spain), with 1,220 persons aged 60 and older (M = 70.9, SD = 7.9), 48.3% male and 51.7% female. Measurements Gender, age, civil status, and the presence of pathologies and health problems, as well as the perceived health level were all assessed. Results: Health problems related to bones and articulations were the most reported. There are significant differences (P=0.000) in the perception of health between both genders; males have a better perception of their health. There is a negative and significant relation (P < .001) between age and the perception of health. The number of illnesses (r2 = 0.251), age (r2 = 0.010), and gender (r2 = 0.002) are all part of the explicative model of the perception of health. Conclusions: The number of illnesses, age, and gender are variables which explain a quarter of the subjective perception of health variable, and thus, they indicate a possible use in the planning of health policies.

Objetivo: Analisar o estado de saúde da população idosa de 60 anos e, a relação que existe entre a auto percepção da saúde que realizam as pessoas idosas e a sua saúde real. Valorizou-se a intermediação de aspetos sócio demográficos como a idade e o género. Método: Desenho descritivo, transversal de prevalência. Localização: 15 centros de dia e 10 moradias da província de Almería (na Espanha). Participantes: 1220 pessoas idosas de 60 anos (M = 70.9; DT = 7.9), das quais o 48.3% são homens e o 51.7% são mulheres. Medições Analisou-se o género, a idade, o estado civil, a presença e a não presença de diferentes patologias e problemas de saúde e, o nível de saúde percebido. Resultados: Os problemas de saúde relacionados com os ossos e as articulações são os mais frequentes. Existem diferenças significativas (p = 0.000) na percepção de saúde entre ambos os géneros, os homens têm uma melhor percepção da sua saúde. Há uma relação negativa e significativa (p < 0.001) entre a idade e a percepção da saúde. Tanto o número de doenças (r2 = 0.251) como a idade (r2 = 0.010) e o género (r2 = 0.002) formam parte do modelo explicativo da percepção da saúde. Conclusõeso: O número de doenças, a idade e o género são variáveis que explicam uma quarta parte da variável subjetiva "saúde percebida", portanto, oferecem índicios de poderem ser utilizadas na planificação de políticas sanitárias.

Two-dimensional electron gases at LaAlO3/SrTiO3 interfaces: orbital symmetry and hierarchy engineered by crystal orientation.

Recent findings show the emergence of two-dimensional electron gases (2DEGs) at LaAlO(3)/SrTiO(3) interfaces along different orientations; yet details on band reconstructions have remained so far unknown. Via x-ray linear dichroism spectroscopy, we demonstrate that crystal symmetry imposes distinctive 2DEG orbital hierarchies on (001)-and (110)-oriented quantum wells, allowing selective occupancy of states of different symmetry. Such orientational tuning expands the possibilities for electronic engineering of 2DEGs and opens up enticing opportunities to understand the link between orbital symmetry and complex correlated states at LaAlO(3)/SrTiO(3) quantum wells.

Tetragonal phase of epitaxial room-temperature antiferromagnet CuMnAs.

Recent studies have demonstrated the potential of antiferromagnets as the active component in spintronic devices. This is in contrast to their current passive role as pinning layers in hard disk read heads and magnetic memories. Here we report the epitaxial growth of a new high-temperature antiferromagnetic material, tetragonal CuMnAs, which exhibits excellent crystal quality, chemical order and compatibility with existing semiconductor technologies. We demonstrate its growth on the III-V semiconductors GaAs and GaP, and show that the structure is also lattice matched to Si. Neutron diffraction shows collinear antiferromagnetic order with a high Néel temperature. Combined with our demonstration of room-temperature-exchange coupling in a CuMnAs/Fe bilayer, we conclude that tetragonal CuMnAs films are suitable candidate materials for antiferromagnetic spintronics.

Soft-chemistry-based routes to epitaxial α-quartz thin films with tunable textures.

Piezoelectric nanostructured quartz films of high resonance frequencies are needed for microelectronic devices; however, synthesis methods have been frustrated by the inhomogeneous crystal growth, crystal twinning, and loss of nanofeatures upon crystallization. We report the epitaxial growth of nanostructured polycrystalline quartz films on silicon [Si(100)] substrates via the solution deposition and gelation of amorphous silica thin films, followed by thermal treatment. Key to the process is the combined use of either a strontium (Sr(2+)) or barium (Ba(2+)) catalyst with an amphiphilic molecular template. The silica nanostructure constructed by cooperative self-assembly permits homogeneous distribution of the cations, which are responsible for the crystallization of quartz. The low mismatch between the silicon and α-quartz cell parameters selects this particular polymorph, inducing epitaxial growth.

Nanoscale strain-induced pair suppression as a vortex-pinning mechanism in high-temperature superconductors.

Boosting large-scale superconductor applications require nanostructured conductors with artificial pinning centres immobilizing quantized vortices at high temperature and magnetic fields. Here we demonstrate a highly effective mechanism of artificial pinning centres in solution-derived high-temperature superconductor nanocomposites through generation of nanostrained regions where Cooper pair formation is suppressed. The nanostrained regions identified from transmission electron microscopy devise a very high concentration of partial dislocations associated with intergrowths generated between the randomly oriented nanodots and the epitaxial YBa(2)Cu(3)O(7) matrix. Consequently, an outstanding vortex-pinning enhancement correlated to the nanostrain is demonstrated for four types of randomly oriented nanodot, and a unique evolution towards an isotropic vortex-pinning behaviour, even in the effective anisotropy, is achieved as the nanostrain turns isotropic. We suggest a new vortex-pinning mechanism based on the bond-contraction pairing model, where pair formation is quenched under tensile strain, forming new and effective core-pinning regions.

Nanostructural control in solution-derived epitaxial Ce(1-x)Gd(x)O(2-y) films.

A novel mechanism based on aliovalent doping, allowing fine tuning of the nanostructure and surface topography of solution-derived ceria films, is reported. While under reducing atmospheric conditions, non-doped ceria films are inherently polycrystalline due to an interstitial amorphous Ce(2)C(3) phase that inhibits grain growth, a high quality epitaxial film can be achieved simply by doping with Gd(3+) cations. Gd(3+) [Formula: see text] Ce(4+) substitutions within the lattice are accompanied by charge-compensating oxygen vacancies throughout the volume of the crystallites acting as an efficient vehicle to reduce the barrier for grain boundary motion caused by interstitial Ce(2)C(3). In this way, the original nanostructure is self-purified by pushing the amorphous Ce(2)C(3) phase towards the free surface of the film. Once a full epitaxial cube-on-cube oriented ceria film is obtained, its surface morphology is dictated by the interplay between faceting on low energy {110} and/or {111} pyramidal planes and truncation of those pyramids by (001) ones. The development of the latter requires the suppression of their polar character which is thought to be achieved by charge compensation between the dopand and oxygen along [Formula: see text] directions.

Strong isotropic flux pinning in solution-derived YBa2Cu3O7-x nanocomposite superconductor films.

Power applications of superconductors will be tremendously boosted if an effective method for magnetic flux immobilization is discovered. Here, we report the most efficient vortex-pinning mechanism reported so far which, in addition, is based on a low-cost chemical solution deposition technique. A dense array of defects in the superconducting matrix is induced in YBa(2)Cu(3)O(7-x)-BaZrO(3) nanocomposites where BaZrO(3) nanodots are randomly oriented. Non-coherent interfaces are the driving force for generating a new type of nanostructured superconductor. Angle-dependent critical-current measurements demonstrate that a strong and isotropic flux-pinning mechanism is extremely effective at high temperatures and high magnetic fields leading to high-temperature superconductors with record values of pinning force. The maximum vortex-pinning force achieved at 65 K, 78 GN m(-3), is 500% higher than that of the best low-temperature NbTi superconductors at 4.2 K and so a great wealth of high-field applications will be possible at high temperatures.

[Streptococcus agalactiae infection in adults. Presentation of 3 cases]. / Infección por Streptococcus agalactiae en adultos. Presentación de tres casos.

The Streptococcus of the B group was considered during many years, as a women's prelabor pathogen and neonatus. Lastly an increase of the infections is observed, for this germ in adults, without being in connection with the pregnancy. The Streptococcus agalactiae, affect above all to patients, with any type of illness underlying. The most susceptible are the diabetics and focus of more habitual infection, the soft tissues and the bone. We described three cases of infection by Streptococcus agalactiae in adults picked up during two years, in a Service of Internal Medicine with 51 beds. We are revised Medline, from the year 1985, until 1995, confirming the drop incidence of cases.

[Acute rhabdomyolysis and tetraparesis secondary to hypokalemia due to ingested licorice]. / Rabdomiólisis aguda y tetraparesia secundarias a hipocaliemia por ingesta de regaliz.

The glycirrinic acid, a common component of the natural licorice, has a potent mineralacorticoid effect (primary pseudohyperaldosteronism) which may cause severe hypokalemia and acute rhabdomyolysis. We present the case of a 36-years-old patient who, as the result of the intake of five daily licorice sticks (25 gr/day) for one month, developed analytical and clinical signs of acute rhabdomyolysis associated to the typical disorders of mineralcorticoid excess, that is, severe hypokalemia, arterial hypertension and metabolic alkalosis. The relevance of this clinical case lies on the low frequency of this finding and on the need that physicians working at emergency care centers must be aware of the onset of acute tetraparesis related to hypokalemia secondary to licorice ingesta. The early detection of this pathology is essential, since it will result in the beginning of an specific treatment, avoiding thus, as far as possible, the severe complications that might appear.

[Comparison of chlorthalidone and sustained-action nifedipine in the treatment of mild to moderate arterial hypertension]. / Comparación de la clortalidona y nifedipina retardada en el tratamiento de la hipertensión arterial leve-moderada.

The effectiveness and safety of sustained action nifedipine (NF) were compared to those of chlorthalidone (CL) in two groups of 35 and 37 patients with mild to moderate hypertension followed up for 4 months. There was a significant reduction in blood pressure (BP) after 15 days of therapy. The degree of control was acceptable with both drugs. A second drug was required in 20% patients of the NF group and in 30.8% of CL group. The therapeutic goal (BP less than 160/95) was achieved in 86.7% of patients in CL group and in 48.4% of those in NF group. We found 48.8% of dropouts in the NF group and none in CL group. There was a significant increase in blood glucose in CL group and a reduction of uric acid and an increase of HDL-cholesterol in NF group. Both drugs are useful to treat hypertension, although NF has the drawback of a high dropout rate and CL induces abnormalities in biochemical parameters.