Multi-response deconvolution of auditory evoked potentials in a reduced representation space.

The estimation of auditory evoked potentials requires deconvolution when the duration of the responses to be recovered exceeds the inter-stimulus interval. Based on least squares deconvolution, in this article we extend the procedure to the case of a multi-response convolutional model, that is, a model in which different categories of stimulus are expected to evoke different responses. The computational cost of the multi-response deconvolution significantly increases with the number of responses to be deconvolved, which restricts its applicability in practical situations. In order to alleviate this restriction, we propose to perform the multi-response deconvolution in a reduced representation space associated with a latency-dependent filtering of auditory responses, which provides a significant dimensionality reduction. We demonstrate the practical viability of the multi-response deconvolution with auditory responses evoked by clicks presented at different levels and categorized according to their stimulation level. The multi-response deconvolution applied in a reduced representation space provides the least squares estimation of the responses with a reasonable computational load. matlab/Octave code implementing the proposed procedure is included as supplementary material.

Alleviating Heat Stress in Fattening Pigs: Low-Intensity Showers in Critical Hours Alter Body External Temperature, Feeding Pattern, Carcass Composition, and Meat Quality Characteristics.

Heat stress is a significant environmental problem that has a detrimental impact on animal welfare and production efficiency in swine farms. The current study was conducted to assess the effect of low-intensity showers, provided during critical high-temperature hours daily, on body external temperature, feeding pattern, and carcass and meat quality characteristics in fattening pigs. A total of 400 animals (200 barrows and 200 gilts) were randomly allotted in 40 pens. A shower nozzle was installed over 20 pens (half barrows and half gilts) where pigs received a low-intensity shower for 2 min in 30 min intervals from 12 to 19 h (SHO group). Another group without showers was also considered (CON). Feeder occupancy measurement, thermographic measures, and carcass and meat quality parameters were studied. In the periods with higher environmental temperatures, SHO animals showed an increase in the feeder occupancy rate compared to the CON group. A decrease in temperature was observed after the shower, regardless of the anatomical location (p < 0.005). The treatment with showers led to higher values than in the CON group of 4.72%, 3.87%, 11.8%, and 15.1% for hot carcass weight, lean meat yield, and fat thickness in Longissimus Dorsi (LD) and Gluteus Medius muscles, respectively (p < 0.01). Pork from CON showed a 14.9% higher value of drip loss, and 18.9% higher malondialdehyde concentration than SHO (p < 0.01); meanwhile, intramuscular fat content was 22.8% higher in SHO than in CON (p < 0.01). On the other hand, the CON group exhibited higher L* (2.13%) and lower a* and b* values (15.8% and 8.97%) compared to the SHO group. However, the pH20h of the CON group was significantly lower than that of the SHO group (p < 0.001), indicating a softer pH decrease. Related to fatty acids in subcutaneous outer and inner layers and intramuscular fat, the CON group showed higher ΣSFA and lower ΣMUFA and Δ9-desaturase indexes than SHO (p < 0.05). In conclusion, the amelioration of heat stress through showers at critical times should be considered an interesting tool that improves both carcass and meat quality, as well as animal welfare.

Robust Amide-Linked Fluorinated Covalent Organic Framework for Long-Term Oxygen Reduction Reaction Electrocatalysis.

The high energy demand of the evolving world opens the door to develop more sustainable and environmentally friendly energy sources. Oxygen reduction reaction (ORR) is a promising candidate, being the 2e- pathway of great interest for the green production of hydrogen peroxide. Metal-free covalent organic frameworks (COFs) electrocatalysts present a suitable alternative to substitute the noble-metals more commonly employed in this application. However, the lability of the linkages building up the framework raises an issue for their long-term use and application in aggressive media. Herein, a stable amide-linked COF is reported through post-synthetic modification of a previously reported imine-linked COF proven to be effective as an electrocatalyst, enhancing its chemical stability and electrochemical response. It is found that after the linkage transformation, the new electrocatalyst displays a higher selectivity toward the H2O2 production (98.5%) and an enhanced turnover frequency of 0.155 s-1, which is among the bests reported to date for metal-free and COF based electrocatalysts. The results represent a promising step forward for metal-free non pyrolyzed electrocatalysts, improving their properties through post-synthetic linkage modification for long-term operation.

Turn-On Solid-State Fluorescent Determination of Zinc Ion by Quinoline-Based Covalent Organic Framework.

A new quinoline-based COF (covalent organic framework), obtained by Povarov reaction, containing 2,6-diisopropylphenyl moieties as substituents over the heterocyclic ring is described for detecting Zn2+ in aqueous solution. The introduction of the mentioned bulky phenyl rings into the network favors an increase of the distance between the reticular sheets and their arrangement, obtaining a new material with an alternating AB type stacking. The new material exhibits good selectivity to detect Zn2+ by fluorescence emission in aqueous solutions up to a concentration of 1.2 × 10-4 m of the metal ion. In order to have a deeper insight into the interaction between the COF and the zinc cation, a thorough spectroscopical, microscopical, and theoretical study is also presented and discussed in this communication.

Classification tree obtained by artificial intelligence for the prediction of heart failure after acute coronary syndromes. / Árboles de clasificación obtenidos mediante inteligencia artificial para la predicción de insuficiencia cardiaca tras el síndrome coronario agudo.

BACKGROUND: Coronary heart disease is the leading cause of heart failure (HF), and tools are needed to identify patients with a higher probability of developing HF after an acute coronary syndrome (ACS). Artificial intelligence (AI) has proven to be useful in identifying variables related to the development of cardiovascular complications. METHODS: We included all consecutive patients discharged after ACS in two Spanish centers between 2006 and 2017. Clinical data were collected and patients were followed up for a median of 53months. Decision tree models were created by the model-based recursive partitioning algorithm. RESULTS: The cohort consisted of 7,097 patients with a median follow-up of 53months (interquartile range: 18-77). The readmission rate for HF was 13.6% (964 patients). Eight relevant variables were identified to predict HF hospitalization time: HF at index hospitalization, diabetes, atrial fibrillation, glomerular filtration rate, age, Charlson index, hemoglobin, and left ventricular ejection fraction. The decision tree model provided 15 clinical risk patterns with significantly different HF readmission rates. CONCLUSIONS: The decision tree model, obtained by AI, identified 8 leading variables capable of predicting HF and generated 15 differentiated clinical patterns with respect to the probability of being hospitalized for HF. An electronic application was created and made available for free.

Exploring Advanced Oxygen Reduction Reaction Electrocatalysts: The Potential of Metal-Free and Non-Pyrolyzed Covalent Organic Frameworks.

Oxygen reduction reaction (ORR) electrocatalysis is an area of increasing interest for the in-situ production of H2O2 or the development of energy-related devices such as hydrogen fuel cells. Although pyrolyzed catalysts still offer the best performances to date with reference to the organic-based catalysts, metal-free and non-pyrolyzed covalent organic frameworks (COFs) stands out as promising alternatives candidates due to their favourable characteristics such as crystallinity, porosity, and organic composition, allowing the study of structural-property relationships. Herein, we present the design principles and recent advances in COFs-based ORR electrocatalysts, demonstrating how composition influences the activity and electronic pathway of the oxygen reduction process.

Developmental outcome of electroencephalographic findings in SYNGAP1 encephalopathy.

SYNGAP1 haploinsufficiency results in a developmental and epileptic encephalopathy (DEE) causing generalized epilepsies accompanied by a spectrum of neurodevelopmental symptoms. Concerning interictal epileptiform discharges (IEDs) in electroencephalograms (EEG), potential biomarkers have been postulated, including changes in background activity, fixation-off sensitivity (FOS) or eye closure sensitivity (ECS). In this study we clinically evaluate a new cohort of 36 SYNGAP1-DEE individuals. Standardized questionnaires were employed to collect clinical, electroencephalographic and genetic data. We investigated electroencephalographic findings, focusing on the cortical distribution of interictal abnormalities and their changes with age. Among the 36 SYNGAP1-DEE cases 18 presented variants in the SYNGAP1 gene that had never been previously reported. The mean age of diagnosis was 8 years and 8 months, ranging from 2 to 17 years, with 55.9% being male. All subjects had global neurodevelopmental/language delay and behavioral abnormalities; 83.3% had moderate to profound intellectual disability (ID), 91.7% displayed autistic traits, 73% experienced sleep disorders and 86.1% suffered from epileptic seizures, mainly eyelid myoclonia with absences (55.3%). A total of 63 VEEGs were revised, observing a worsening of certain EEG findings with increasing age. A disorganized background was observed in all age ranges, yet this was more common among older cases. The main IEDs were bilateral synchronous and asynchronous posterior discharges, accounting for ≥50% in all age ranges. Generalized alterations with maximum amplitude in the anterior region showed as the second most frequent IED (≥15% in all age ranges) and were also more common with increasing age. Finally, diffuse fast activity was much more prevalent in cases with 6 years or older. To the best of our knowledge, this is the first study to analyze EEG features across different age groups, revealing an increase in interictal abnormalities over infancy and adolescence. Our findings suggest that SYNGAP1 haploinsufficiency has complex effects in human brain development, some of which might unravel at different developmental stages. Furthermore, they highlight the potential of baseline EEG to identify candidate biomarkers and the importance of natural history studies to develop specialized therapies and clinical trials.

Respuesta biológica en las pacientes con cáncer de mama tratadas con radioterapia intraoperatoria / Biological response in breast cancer patients using intraoperative radiotherapy

Introducción: el tratamiento conservador de la mama junto con la radioterapia es de elección en las pacientes con cáncer de mama precoz. Gracias a un mayor conocimiento de la radiobiología tumoral, la tendencia actual consiste en utilizar técnicas de irradiación parcial acelerada, entre las que destaca la radioterapia intraoperatoria (RIO). Métodos: estudio prospectivo multicéntrico dividido en 2 grupos comparativos con casos consecutivos de las pacientes a que han recibido una cirugía conservadora por cáncer de mama asociada o no a RIO. Se valora la relación de esta terapia con los valores de las proteínas involucradas en la respuesta biológica (IL6, IL8, CXCL10, IL1β y TNF- α) en muestras de suero preoperatorio y a las 24 h desde la cirugía, y de drenaje quirúrgico a las 6 y 24 h desde la cirugía. Resultados: se ha objetivado en las pacientes tratadas con RIO una disminución significativa de IL6 e IL8, así como un aumento de CXCL10 favorable para la lucha contra la progresión del tumor (p valor < 0,05). Las alteraciones del sistema inmunológico se manifiestan tanto en suero como en débito del drenaje quirúrgico a las 6 y 24 h desde la cirugía. Conclusiones: la RIO modifica la respuesta biológica en las pacientes con cáncer de mama. A pesar de que se deben desarrollar más líneas de investigación, la comprensión de los mecanismos de desarrollo del tumor, abre una nueva etapa en el desarrollo de tratamientos perioperatorios dirigidos a dianas concretas que compensen las consecuencias dañinas de la cirugía. (AU)

Introduction: Breast conserving surgery with radiotherapy is the treatment of choice in patients with early breast cancer. Due to a better understanding of tumour radiobiology, the current trend is to use accelerated partial irradiation techniques, among which intraoperative radiotherapy (RIO) stands out. Methods: Prospective multicentre study divided into two comparative groups with consecutive cases of patients who have undergone conservative surgery for breast cancer associated or not with RIO. The relation of this therapy with the values of proteins involved in the biological response (IL6, IL8, CXCL10, IL1β y TNF- α) is assessed in serum samples preoperative and 24 hours after surgery, and surgical drainage samples at 6 and 24 hours after surgery. Results: A significant decrease in IL6 and IL8, as well as an increase in CXCL10 favourable for the fight against tumour progression (p-value < 0.05) was observed in patients treated with RIO. Immune system alterations are manifested in both serum and surgical drainage debit at 6 and 24 hours after surgery. Conclusions: RIO modifies the biological response in breast cancer patients. Although more lines of research need to be developed, the understanding of the mechanisms of tumour development opens a new stage in the development of perioperative treatments directed at specific targets that compensate for the harmful consequences of surgery. (AU)

HiperCKemia persistente asintomática en edad pediátrica. Diagnóstico de miopatía central core sin biopsia muscular / Asymptomatic hyperCKemia in children. Central core disease with non-diagnostic muscle biopsy

INTRODUCCIÓN: la elevación persistente de creatinfosfoquinasa (CK) puede constituir la primera manifestación de una patología muscular subyacente. Su correcto abordaje permite un adecuado tratamiento precoz, asesoramiento familiar e información sobre su pronóstico y sus complicaciones. CASO CLÍNICO: niño de siete años, asintomático, con elevación de CK como hallazgo casual en una analítica de rutina, persistiendo en controles seriados. Exploración física normal. Tras un estudio metabólico completo normal, se solicita estudio genético dirigido a descartar distrofinopatías u otras miopatías. Se observa una mutación en el gen RYR1, c.9912C>A; p. (Cys3304*), variante probablemente patogénica compatible con miopatía congénita de cores centrales (#MIM11700). Ante un diagnóstico genético en paciente asintomático, se evita la realización de otras técnicas invasivas. CONCLUSIONES: la miopatía congénita de cores centrales es la patología neuromuscular congénita más frecuente. Se relaciona con la presencia de mutaciones en el gen RYR1 (90% de los pacientes). Pertenece a la familia de los canales liberadores de calcio iónico, cuyo papel es fundamental en el fenómeno de acoplamiento excitación-contracción muscular. Su diagnóstico clásico era la biopsia muscular. Está asociado a complicaciones como hipertermia maligna o rabdomiolisis

INTRODUCTION: persistently elevated serum creatine kinase levels may lean the first manifestation of an underlying neuromuscular disease. Its appropriate approach allows an adequate early treatment, a genetic counselling and information concerning complications and prognosis. CASE DESCRIPTION: our patient was an asymptomatic 7-year-old boy with persistent serum CK elevation. He had a normal physical examination. After a normal metabolic study, a specific genetic study for dystrophinopaties or other myopathies was requested. A variant of uncertain significance mutation [RYR1, c.9912C>A; p. (Cys3304*)] associated with central core disease (#MIM11700) was obtained. Before this genetic diagnosis the invasive testing was rejected. DISCUSSION: central core disease is the most frequent congenital neuromuscular disease. About 90% of cases are linked to RYR1 gene mutations. RYR1 protein is a part of macromolecular complex deputed to excitation-contraction coupling through Ca2+ channels. Its diagnosis is confirmed by histological examination. CCD is associated to malignant hyperthermia and rabdomiolisis susceptibility

Presentación atípica de encefalopatía epiléptica infantil precoz asociada al gen KCNT1 / Atypical presentation of early childhood epileptic encephalopathy associated with the gene KCNT1

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Situación nutricional en una población con parálisis cerebral moderada-grave: más allá del peso / Nutritional status of a population with moderate-severe cerebral palsy: Beyond the weight

INTRODUCCIÓN: La parálisis cerebral (PC) es la causa más frecuente de discapacidad motora en la edad pediátrica. El objetivo es estudiar la situación nutricional de los pacientes con PC controlados en una unidad de referencia, así como la relación entre la afectación neurológica y la nutricional. MATERIAL Y MÉTODOS: Estudio transversal, observacional, descriptivo y analítico en el que se han incluido pacientes con PC con grados III-IV-V (GMFCS) procedentes del área de influencia de un hospital pediátrico de referencia, con edades de 4-15años. Se ha realizado: encuesta (con recogida de datos generales, medicaciones y hábitos nutricionales), estudio antropométrico y bioimpedanciometría (BIA). RESULTADOS: El estudio incluyó 69 pacientes (reclutamiento 84,15%). Edad media 10,46 ± 0,43 años, el 50,7% mujeres. Distribución según GMFCS: grado III (36,2%), grado IV (29%), grado V (34,8%). Según el peso para la talla: desnutrición moderada el 21,8% (grado V: 33,3%), desnutrición grave el 5,8% (grado V: 12,6%), sobrepeso/obesidad el 23,2% (grado III: 24%; grado IV: 35%). Nivel adecuado de masa magra para su talla: grado III (36%), grado IV (55%), grado V (16,7%). Exceso de grasa: grado III (36%), grado IV (40%), grado V (29,2%). Comparación de masa grasa: BIA 6,89 ± 0,64kg versus antropometría 5,56 ± 4,43 kg. CONCLUSIONES: En PC grado GMFCS V es frecuente el déficit de peso asociado a disminución de masa magra para su talla. Los pacientes con PC grados GMFCS III-IV presentan una prevalencia llamativa de sobrepeso/obesidad. La antropometría es una herramienta útil para la valoración nutricional en niños con PC, aunque los niveles de grasa tienden a infravalorarse

INTRODUCTION: Cerebral palsy (CP) is the most frequent cause of motor disability in the paediatric age. The aim of this article is the study of the nutritional status of patients with CP followed-up in a reference hospital, as well as the relationship between neurological and nutritional state. MATERIAL AND METHODS: A cross-sectional, observational, descriptive and analytical study was conducted on a sample consisting of 4-15 years old patients with CP with Gross Motor Function Classification System (GMFCS) grades III-IV-V, from a specialised paediatric hospital reference area. An interview (collection of general data, medications and nutritional habits), anthropometric study and bioimpedance (BIA) measurements were carried out. RESULTS: The study included 69 patients (recruitment 84.15%), with a mean age of 10.46 ± 0.43 years, and 50.7% females. The distribution according to GMFCS scale was: grade III (36.2%), gradeIV (29%), and grade V (34.8%). According to weight for height: moderate malnutrition 21.8% (grade V: 33.3%), severe malnutrition 5.8% (gradeV: 12.6%), overweight/obesity 23.2% (grade III: 24%, gradeIV: 35%). Adequate level of lean mass for height: gradeIII (36%), grade IV (55%), and gradeV (16.7%). Fat excess: gradeIII (36%), grade IV (40%), and gradeV (29.2%). Fat mass comparison: BIA 6.89 ± 0.64kg versus anthropometry 5.56 ± 4.43kg. CONCLUSIONS: In CP grade GMFCSV, the weight deficit associated with a decrease in lean body mass is common. Patients with CP grades GMFCSIII-IV have a significant prevalence of overweight/obesity. Anthropometry is a useful tool for nutritional assessment in children with CP, although fat levels could be underestimated

Síndrome de duplicación MECP2 familiar / Familial MECP2 duplication síndrome

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El uso del flamenco con equipo reflexivo en una escuela de madres / The Use of Flamenco with a Reflecting Team in a Parenting School for Mothers

OBJETIVO: se estudian los efectos de un programa de flamenco complementario a una escuela de madres en el autoconcepto, la ansiedad, la ira y la depresión. MÉTODO: la muestra fue de 14 mujeres entre los 36 y los 50 años que acudían a una escuela de madres; la mitad de ellas recibió seis sesiones de flamenco, mientras que la otra mitad sirvió de grupo de comparación. A través de un diseño mixto se compararon las medidas pre y post-intervención y entre los dos grupos. Un psicoterapeuta, un equipo reflexivo y una bailaora de flamenco, dirigieron las sesiones. RESULTADOS: el autoconcepto físico mejora sólo en el grupo que acudió a las sesiones de flamenco; además, los niveles de ansiedad y el sentimiento de ira tienden a disminuir, aunque no significativamente

OBJECTIVE: The study investigates the effects of a flamenco program complementary to a parenting school for mothers on self-concept, anxiety, anger and depression. METHOD: The sample was of 14 women between 36 and 50 years old attending a parenting school. Half of them received six flamenco sessions; the other half served as a comparison group. Through a mixed design, the pre and post intervention measures were compared between the two groups. A psychotherapist, a Reflecting Team and a flamenco dancer, directed the sessions. RESULTS: The physical self-concept improves only in the group that attended the flamenco sessions. In addition, anxiety levels and feelings of anger tend to decrease, although not significantly

Cirugía conservadora de cáncer de mama y radioterapia intraoperatoria. ¿Podemos predecir la fibrosis? / Breast-conserving surgery in breast cancer and intraoperative radiotherapy. Can we predict the fibrosis?

Introducción: Las técnicas de radioterapia asociadas a la cirugía conservadora del cáncer de mama precoz han evolucionado gracias a un mayor conocimiento de la radiobiología tumoral, destacando entre ellas la radioterapia intraoperatoria (RIO). Sin embargo, se han documentado complicaciones con dicha técnica, principalmente la fibrosis. El factor de crecimiento transformante beta (TGF-β) es una citocina relacionada con la fibrosis inducida después de la radiación que podría servir como marcador temprano del riesgo de desarrollo de la misma. Métodos: Estudio prospectivo multicéntrico de 60 pacientes a las que se les ha sometido a cirugía conservadora por cáncer de mama, asociada a RIO en 30 de ellas. Se evalúan los valores de TGF-β en muestras de suero preoperatorio y a las 24 h desde la cirugía, y de muestras de drenaje a las 6 y 24 h desde la cirugía. Resultados: Los valores de TGF-β objetivados en el suero y en el débito de drenaje a las 24 h desde la cirugía de las pacientes que recibieron RIO fueron significativamente mayores que los de aquellas que no la recibieron (p < 0,0001). De entre ellas, 8 pacientes presentaron valores superiores a 1.000 pg/ml. Estas diferencias entre los grupos no se modifican por el tipo de muestra utilizada, bien sea suero, bien débito de drenaje (p = 0,5881). Conclusiones: Aunque deben realizarse más estudios, valores elevados de TGF-β en las pacientes con cáncer de mama a las que se les realiza cirugía conservadora asociada a RIO pueden predecir el riesgo de fibrosis

Introduction: Radiotherapy techniques associated with breast-conserving surgery have evolved in early breast cancer thanks to a better knowledge of tumor radiobiology, highlighting intraoperative radiotherapy (IORT). However, complications have been documented with this procedure, mainly fibrosis. Transforming growth factor beta (TGF-β) is a cytokine with an active role in radiation-induced fibrosis, which could be used as an early biomarker for the development of fibrosis. Methods: Multicentric prospective analysis of 60 patients with breast cancer who underwent breast-conserving surgery, 30 of whom had received additional IORT. TGF-β values were evaluated in serum pre-surgery and in serum collected 24 h after surgery. In addition, we evaluated surgical wound fluids collected 6 h and 24 h following surgery. Results: Serum and surgical wound fluids TGF-β values collected over 24 h following surgery were significantly higher in patients who received additional IORT (P < .0001). Notably, 8 of these patients showed values above 1,000 pg/ml. There were no differences between the samples (serum or surgical wound fluids) (P = .5881). Conclusions: Although further investigation is needed, higher TGF-β values in IORT during breast-conserving surgery can be used as an early biomarker for the development of fibrosis

Neurofibromatosis 1 y cavernomatosis múltiple familiar en un lactante con sialorrea profusa episódica / Neurofibromatosis 1 and multiple familial cavernomatosis in an infant with episodic profuse sialorrhoea

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FOP con platipnea-ortodesoxia y ausencia de cava inferior / PFO with platypnea-orthodeoxia in the absence of inferior cava

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Posiciones y técnicas de proyección de los judokas de la Universidad Médica de Holguín / Judo´s projection techniques and positions at the Medical University of Holguín

Introducción: el presente trabajo aborda un tema de gran vigencia, en el entrenamiento deportivo actual. El desarrollo de la preparación técnica y táctica de estudiantes- atletas de ambos sexos, de la Universidad de Ciencias Médicas de Holguín (UCMHo), en el deporte de Judo. La investigación aporta una metodología sobre las técnicas de proyección en posiciones de transición, durante el entrenamiento y las competencias. Objetivo: elaborar una metodología que logre la ejecución de las técnicas de proyección en posiciones de transición, en los estudiantes- atletas de judo de la UCMHo. Métodos: se desarrolló un estudio pre-experimental de tipo exploratorio con una muestra de 16 estudiantes-atletas de la UCMHo, donde se realizó un ensayo inicial, luego se aplicó la metodología en un periodo de un año y, posteriormente, se realizó una evaluación de los resultados obtenidos. Resultados: al realizar una comparación entre los resultados logrados entre el ensayo inicial y la evaluación de la técnica que nos ocupa (la metodología), se pudo constatar una mejoría, pues en la parte preparatoria 5 sujetos fueron evaluados de excelente (E), 4 de muy bien (MB) y 5 de bien (B). En la parte principal predominaron los evaluados de bien (B) y muy bien (MB); y en la final se dispersan, pues 6 obtienen evaluación de muy bien (MB), 5 de bien (B), y 5 de regular. Conclusiones: el trabajo clarifica la utilidad de las técnicas como objeto de estudio en los entrenamientos, y su posible concertación en competencias.Todo esto fue analizado y utilizado por los entrenadores y especialistas de la provincia de Holguín, como argumento o documento de trabajo, según su aplicación, en el futuro competitivo de los atletas de Judo.

Introduction: this work shows a main topic in the sports training: the development of the technique and tactic in both sex students- athletes of Judo, at the Medical University of Holguín. The investigation brings about projection methodology techniques, during transition positions training. Objective: to improve techniques learning and execution methodology of the students-athletes, at the Medical University of Holguín. Methods: application of scientific methods like theoretical analysis and synthesis, sistemic-structure, induction and deduction and historical-logical; empirical such as: observation, interviews, surveys, experts criteria and statistics operations, using Microsoft Excel. Methodology includes the elaboration and application of 5 projection techniques during transition positions. To demonstrate this theory, 16 athletes showed their methodological steps, variants, combinations, defense and most common mistakes. Results: the 5 techniques used by practitioners and trainers of Judo increased their responses during competitions. Conclusions: roles clarify techniques´ utility for training, and their possible aplication at competitions. In Holguin province, trainers and specialists analized documents and their applications in Judo future competitions.

Uno frente a 2 stents para el tratamiento de lesiones en bifurcación en el contexto de una oclusión coronaria crónica total. Registro multicéntrico / One versus 2-stent strategy for the treatment of bifurcation lesions in the context of a coronary chronic total occlusion. A multicenter registry

Introducción y objetivos: Hay escasa evidencia sobre el tratamiento de lesiones en bifurcación en relación con una oclusión coronaria crónica total (OCT). Este estudio analiza los resultados inmediatos y a medio plazo de pacientes con lesiones en bifurcación en OCT tratados con 1 stent provisional frente a 2 stents en un registro multicéntrico. Métodos: Entre enero de 2012 y junio de 2016, se recanalizaron 922 OCT en los 4 centros participantes. De ellas, 238 (25,8%) con lesión en bifurcación se trataron mediante estrategia simple (n = 201) o compleja (n = 37). Se calculó la puntuación de propensión emparejada para detectar sesgos entre ambos grupos. Los eventos adversos cardiovasculares mayores (MACE) se definieron como muerte cardiaca, infarto y revascularización de la lesión diana. Resultados: Los éxitos angiográfico y del procedimiento fueron similares con la técnica simple (el 94,5 frente al 97,3%; p = 0,48) y con la compleja (el 85,6 frente al 81,1%; p = 0,49), aunque la cantidad de contraste, la dosis de radiación y el tiempo de fluoroscopia fueron menores con la técnica simple. Al seguimiento (25 meses), la tasa de MACE fue del 8% de los pacientes con la técnica simple y el 10,8% de los tratados con 2 stents (p = 0,58). En este grupo hubo tendencia a una menor supervivencia libre de MACE (el 80,1 frente al 69,8%; p = 0,08). Después del análisis de propensión, no se observaron diferencias entre los grupos en los resultados inmediatos ni al seguimiento. Conclusiones: Las LB en OCT pueden tratarse de modo similar que las demás bifurcaciones, para las que el stent provisional es la técnica de elección. Después de la puntuación de propensión emparejada, no hubo diferencias en los resultados inmediatos y a medio plazo entre ambos grupos

Introduction and objectives: There is little evidence on the optimal strategy for bifurcation lesions in the context of a coronary chronic total occlusion (CTO). This study compared the procedural and mid-term outcomes of patients with bifurcation lesions in CTO treated with provisional stenting vs 2-stent techniques in a multicenter registry. Methods: Between January 2012 and June 2016, 922 CTO were recanalized at the 4 participating centers. Of these, 238 (25.8%) with a bifurcation lesion (side branch ≥ 2 mm located proximally, distally, or within the occluded segment) were treated by a simple approach (n = 201) or complex strategy (n = 37). Propensity score matching was performed to account for selection bias between the 2 groups. Major adverse cardiac events (MACE) consisted of a composite of cardiac death, myocardial infarction, and clinically-driven target lesion revascularization. Results: Angiographic and procedural success were similar in the simple and complex groups (94.5% vs 97.3%; P = .48 and 85.6% vs 81.1%; P = .49). However, contrast volume, radiation dose, and fluoroscopy time were lower with the simple approach. At follow-up (25 months), the MACE rate was 8% in the simple and 10.8% in the complex group (P = .58). There was a trend toward a lower MACE-free survival in the complex group (80.1% vs 69.8%; P = .08). After propensity analysis, there were no differences between the groups regarding immediate and follow-up results. Conclusions: Bifurcation lesions in CTO can be approached similarly to regular bifurcation lesions, for which provisional stenting is considered the technique of choice. After propensity score matching, there were no differences in procedural or mid-term clinical outcomes between the simple and complex strategies

Consenso SEO-SEFH sobre recomendaciones de utilización y elaboración de preparaciones oftálmicas / Consensus SEO-SEFH of recommendations for use and compounding of ophthalmic preparations

Son muchos los medicamentos que, aun habiendo demostrado eficacia y seguridad en diferentes indicaciones oftalmológicas, no están autorizados ni disponibles comercialmente en una forma adecuada para esta vía de administración. Esto implica, por un lado, que se deban utilizar según la legislación que regula la disponibilidad de medicamentos en situaciones especiales y, por otro, que se deban preparar en los Servicios de Farmacia para su administración por vía oftálmica, conforme a unos criterios de calidad que aseguren su efectividad, estabilidad y esterilidad. Este documento recoge un consenso entre la Sociedad Española de Oftalmología y la Sociedad Española de Farmacia Hospitalaria sobre aquellas preparaciones con suficiente evidencia respecto a su eficacia y seguridad para su uso no autorizado en indicaciones y vía de administración oftálmicas. Se incluyen recomendaciones para su utilización de acuerdo con la legislación vigente. Además, con el ánimo de armonizar la preparación de inyecciones intraoculares en los Servicios de Farmacia Hospitalaria, se establecen unas recomendaciones generales para su elaboración siguiendo los estándares establecidos en la Guía de Buenas Prácticas de Preparación de Medicamentos en los Servicios de Farmacia Hospitalaria. En estas recomendaciones se incluyen apartados como el lugar de preparación, el material, la técnica, el envasado, el periodo de validez, el control de calidad, la prescripción y la trazabilidad de las preparaciones intraoculares (AU)

There are many medicinal products that, although having shown efficacy and safety in different ophthalmological indications, they are not authorized or commercially available for ophthalmic administration. This implies, on one hand, that they must be used according to legislation that regulates the availability of medicines in special situations and, on the other hand, that they must be prepared in the pharmacy services for ophthalmic administration, according to quality criteria to ensure its effectiveness, stability and sterility. This document gathers the consensus between the Spanish Society of Ophthalmology and the Spanish Society of Hospital Pharmacy about these selected preparations which have shown enough evidence in their efficacy and safety for their ophthalmic use (off label) and ophthalmic administration. This document includes recommendations about its use according to the current legislation. In addition, with the aim of harmonizing the preparation of intraocular injections in the hospital pharmacy services, general recommendations are set in this document to ensure the compliance with standards established in the Spanish Guideline for Good Preparation Practices of Medicinal Products in Hospital Pharmacies. These recommendations include sections such as the area of preparation, material, technique, packaging, stability, quality control, prescription and traceability of intraocular preparations (AU)