Monitorización ambulatoria de la presión arterial en adultos y población pediátrica. Una revisión narrativa / Ambulatory blood pressure monitoring, adult and pediatric population. A narrative review

La hipertensión arterial (HTA) se ha convertido en un factor de riesgo central para el desarrollo de enfermedades cardiovasculares (CV), lo que subraya la importancia de su diagnóstico preciso. Numerosos estudios han establecido una estrecha relación entre los valores elevados de la presión arterial sistólica (PAS) y diastólica (PAD) y un incremento en el riesgo de padecer algún evento cardiovascular (ECV). Tradicionalmente, las mediciones de la presión arterial (PA) realizadas en entornos clínicos han sido el principal método para diagnosticar y evaluar la HTA. No obstante, en los últimos años, se ha reconocido que las mediciones de la PA obtenidas fuera del ambiente clínico, mediante la automedida de la presión arterial (AMPA) y la monitorización ambulatoria de la presión arterial (MAPA), ofrecen una perspectiva más realista de la vida cotidiana de los pacientes y, por lo tanto, brindan resultados más fiables. Dada la evolución de los dispositivos médicos, los criterios diagnósticos y la creciente relevancia de componentes de la MAPA en la predicción de ECV, se requiere una actualización integral que sea práctica para la clínica. Esta revisión tiene como objetivo proporcionar una actualización de la MAPA, enfocándose en su importancia en la evaluación de la HTA. Además, se analizarán los umbrales diagnósticos, los distintos fenotipos según el ciclo circadiano y las recomendaciones en diferentes poblaciones, asimismo, se ofrecerán sugerencias concretas para la implementación efectiva de la MAPA en la práctica clínica, lo que permitirá a los profesionales de la salud tomar decisiones fundamentadas y mejorar la atención de sus pacientes.(AU)

Hypertension has become a central risk factor for the development of cardiovascular disease, underscoring the importance of its accurate diagnosis. Numerous studies have established a close relationship between elevated systolic (SBP) and diastolic (DBP) blood pressure and an increased risk of cardiovascular event (CVE). Traditionally, blood pressure (BP) measurements performed in clinical settings have been the main method for diagnosing and assessing hypertension. However, in recent years, it has been recognized that BP measurements obtained outside the clinical setting, using self-monitoring blood pressure (SMBP) and ambulatory blood pressure monitoring (ABPM), offer a more realistic perspective of patients’ daily lives and therefore provide more reliable results. Given the evolution of medical devices, diagnostic criteria, and the increasing relevance of certain components of ABPM in the prediction of adverse cardiovascular outcomes, a comprehensive update that is practical for daily clinical practice is required. The main objective of this article is to provide an updated review of ABPM, focusing on its importance in the evaluation of hypertension and its impact on public health in Colombia. In addition, it will discuss the implications of changes in diagnostic thresholds and provide concrete recommendations for the effective implementation of ABPM in clinical practice, allowing health professionals to make informed decisions and improve the care of their patients.(AU)

[Ambulatory blood pressure monitoring, adult and pediatric population. A narrative review]. / Monitorización ambulatoria de la presión arterial en adultos y población pediátrica. Una revisión narrativa.

Hypertension has become a central risk factor for the development of cardiovascular disease, underscoring the importance of its accurate diagnosis. Numerous studies have established a close relationship between elevated systolic (SBP) and diastolic (DBP) blood pressure and an increased risk of cardiovascular event (CVE). Traditionally, blood pressure (BP) measurements performed in clinical settings have been the main method for diagnosing and assessing hypertension. However, in recent years, it has been recognized that BP measurements obtained outside the clinical setting, using self-monitoring blood pressure (SMBP) and ambulatory blood pressure monitoring (ABPM), offer a more realistic perspective of patients' daily lives and therefore provide more reliable results. Given the evolution of medical devices, diagnostic criteria, and the increasing relevance of certain components of ABPM in the prediction of adverse cardiovascular outcomes, a comprehensive update that is practical for daily clinical practice is required. The main objective of this article is to provide an updated review of ABPM, focusing on its importance in the evaluation of hypertension and its impact on public health in Colombia. In addition, it will discuss the implications of changes in diagnostic thresholds and provide concrete recommendations for the effective implementation of ABPM in clinical practice, allowing health professionals to make informed decisions and improve the care of their patients.

Mecanismos patogénicos de infección por SARS-CoV-2 y enfermedad renal: una perspectiva clínico-molecular / Pathogenic mechanisms of SARS-CoV-2 infection and kidney disease: a clinical and molecular perspective

La infección por SARS-CoV-2 se ha convertido en unproblema mundial de salud pública. Su presentaciónclínica es variada, desde benigna hasta un síndrome dedistrés respiratorio agudo, afectación sistémica y fallomultiorgánico. La severidad del cuadro clínico depen-de de factores biológicos del virus y del huésped y decomorbilidades como la enfermedad renal. Además, lainteracción entre el virus, la enzima convertidora deangiotensina 2 y la respuesta inmunológica exacerbadapodría conducir al desarrollo de lesión renal aguda. Sinembargo, las implicaciones de la infección por SARS-CoV-2 sobre las células renales, las repercusiones pro-nósticas en los pacientes con enfermedad renal crónicay su efecto a largo plazo sobre la función renal no estándel todo claras. El objetivo es revisar el papel del SARS-CoV-2 en la enfermedad renal aguda y crónica, y sus po-sibles mecanismos patogénicos en la afectación renal.

The SARS-CoV-2 infection has become as a worldwidepublic health emergency. It exhibits a variety of clinicalpresentations, ranging from benign to acute respira-tory distress syndrome, systemic involvement, andmultiorganic failure. The severity of the clinical picturedepends on host and virus biological features and thepresence of comorbidities such as chronic kidney dis-ease. In addition, the interaction between the virus,angiotensin-converting enzyme 2, and the exacerbatedimmune response could lead to the development ofacute kidney injury. However, the implications of SARS-CoV-2 infection on renal cells, the prognosis of patientswith chronic kidney disease, and the long-term behav-ior of renal function are not entirely understood. Thisreview aims to explore the role of SARS-CoV-2 in acuteand chronic kidney disease and the possible pathogen-ic mechanisms of renal involvement.(AU)

[Pathogenic mechanisms of SARS-CoV-2 infection and kidney disease: a clinical and molecular perspective].

The SARS-CoV-2 infection has become as a worldwide public health emergency. It exhibits a variety of clinical presentations, ranging from benign to acute respiratory distress syndrome, systemic involvement, and multiorganic failure. The severity of the clinical picture depends on host and virus biological features and the presence of comorbidities such as chronic kidney disease. In addition, the interaction between the virus, angiotensin-converting enzyme 2, and the exacerbated immune response could lead to the development of acute kidney injury. However, the implications of SARS-CoV-2 infection on renal cells, the prognosis of patients with chronic kidney disease, and the long-term behavior of renal function are not entirely understood. This review aims to explore the role of SARS-CoV-2 in acute and chronic kidney disease and the possible pathogenic mechanisms of renal involvement.

Structural and magnetic properties of ultra-low density BiFeO3 nanoparticles produced by pulsed laser deposition.

Ultra-low-density BiFeO3 nanoparticles have been prepared by pulsed laser deposition and their structure and magnetic properties have been studied. Annealing increases crystallinity and the size of the particles leading to an alteration of magnetic properties, observed from magnetic studies and evaluated using high-resolution transmission electron microscopy , selected area electron diffraction and x-ray diffraction patterns analysis. Transmission electron microscopy results show that the BiFeO3 as-deposited nanoparticles annealed up to 400 °C exhibit a orthorhombic distorted perovskite structure without secondary phase and with diameters varying from 9 nm (as-deposited) to 17 nm (annealed at 400 °C). Magnetic data exhibit exchange bias and magnetic blocking effects at low temperatures and typical superparamagnetic behavior at high temperatures. Meanwhile, the BiFeO3 nanoparticles annealed at 500 °C exhibit a rhombohedrally distorted perovskite structure with typical antiferromagnetic properties and diameter of about 56 nm. The analysis of magnetic relaxation time using the Arrhenius equation suggests a superparamagnetic blocking process of ferromagnetic clusters on the surface of the nanoparticles at low temperature. The magnetic properties are discussed considering the interactions between nanoparticles and the co-existence of different magnetic phases within the nanoparticles: an ordered antiferromagnetic core and ferromagnetic clusters on the surface.

A review and preview of developments in the measurement of sociability.

Sociability is a complex, multifactorial trait. Its importance is underscored by a multitude of negative physical and mental health effects related to loneliness and social isolation. However, current measures of sociability primarily rely on subjective recall and self- report, which have inherent weaknesses and limitations. Although objective and automatic measurements could help to avoid some of these issues, they are still in early stages of development. In this article, the authors review past and present methods of measuring sociability and social interactions. This encompasses both subjective and objective subsets of qualitative and quantitative measurement modalities to gain a broader, more accurate perspective on sociability. Through an analysis of advantages and disadvantages of measurement methods within these categories, a foundational knowledge of sociability measurement can be understood. Utilizing current technology and research methods holds promise to more accurately represent individuals' social networks and social patterns.

Immunohistochemical analysis of cancer-associated fibroblasts and podoplanin in head and neck cancer.

BACKGROUND: To immunohistochemically evaluate the association between the presence of cancer-associated fibroblasts (CAFs) and the tumour expression of podoplanin (PDPN) in head and neck squamous cell carcinoma (HNSCC) and their association with clinicopathological variables. MATERIAL AND METHODS: A tissue microarray (TMA) with biopsy sections from patients diagnosed with HNSCC was stained with antibodies against the CAFs marker, α-smooth muscle actin (α-SMA), and PDPN. We subsequently evaluated their expression to determine the association between them and with clinicopathological variables including age, primary tumour site, TNM stage, and tumour differentiation grade. RESULTS: Positive reaction to α-SMA was observed in the tumour stroma, revealing spindle-shaped cells compatible with CAFs, which showed a high expression in 62% of cases and a significant association with laryngeal carcinomas, advanced clinical stages, and lower tumour differentiation (P ≤ 0.05). PDPN staining on tumour cells showed low expression in 72% of cases, and it was not associated with any clinicopathological variable or with the presence of CAFs. CONCLUSIONS: The presence of CAFs in the tumour stroma is related to an aggressive phenotype and could increase as the disease progresses, although based on our findings, it would have no relationship, at least directly, with the expression of PDPN.

Resonant magneto-acoustic switching: influence of Rayleigh wave frequency and wavevector.

We show on in-plane magnetized thin films that magnetization can be switched efficiently by 180 degrees using large amplitude Rayleigh waves travelling along the hard or easy magnetic axis. Large characteristic filament-like domains are formed in the latter case. Micromagnetic simulations clearly confirm that this multi-domain configuration is compatible with a resonant precessional mechanism. The reversed domains are in both geometries several hundreds of [Formula: see text], much larger than has been shown using spin transfer torque- or field-driven precessional switching. We show that surface acoustic waves can travel at least 1 mm before addressing a given area, and can interfere to create magnetic stripes that can be positioned with a sub-micronic precision.

Técnicas de tratamiento utilizadas por Terapia Ocupacional para niños con dispraxia del desarrollo / Treatment techniques used by Occupational Therapy for children with developmental dyspraxia

Objetivo. Documentar las técnicas de tratamiento utilizadas por Terapia Ocupacional para niños con dispraxia. Metodología. Revisión de literatura que incluye tesauros reconocidos en los MeSH y DeCS como «dispraxia», «desorden del desarrollo de la coordinación», «niños» y «Terapia Ocupacional». Se indagó en ProQuest, EBSCO, Scopus, Science Direct, Embase, Pubmed, OT Seeker, PEDro y National Guideline Clearinghouse. Se organizaron los hallazgos por base de datos, año, país de publicación, revista, enfoque y se procesó dicha información a través de un análisis cualitativo y de frecuencias. Resultados. Se encontraron veintisiete artículos (100%), el 20% de las publicaciones se reportó en Scopus, el 33% incluyeron el enfoque de orientación cognitiva de desempeño ocupacional como el más utilizado en los estudios, los años en los que más se publicó sobre el tema fueron 2012 y 2013 con un 33% y la revista con más publicaciones fue Physical and Occupational Therapy in Pediatrics con un 20%. Conclusión. El enfoque con mayor evidencia es orientación cognitiva de desempeño ocupacional, encaminado a mejorar el rendimiento motor en las actividades ocupacionales (AU)

Objective. To document the treatment techniques used in occupational therapy for children with dyspraxia. Methodology. Literature review that included thesauri recognized in MeSH and DeCS as «dyspraxia», «disorder developmental coordination», «children» and «Occupational Therapy». A search was conducted in the following databases: ProQuest, EBSCO, Scopus, Science Direct, Embase, Pubmed, OT Seeker, PEDro, and the National Guideline Clearinghouse. The findings were organized by database, year, country of publication, journal, and approach. This information was organized and processed through a qualitative analysis and frequency analysis. Results. Twenty-seven ítems (100%) were retrieved. Twenty percent of the publications were reported in Scopus. Thirty-three percent included the approach of cognitive orientation of occupational performance as the most widely used in the studies. The years with the greatest number of publications (33%) on the subject were 2012 and 2013. The journal with most publications (20%) was physical and Occupational Therapy in pediatrics. Conclusion. The approach supported by the greatest evidence is cognitive orientation occupational performance, which seeks to improve motor performance in occupational activities (AU)

Geometrical control of pure spin current induced domain wall depinning.

We investigate the pure spin-current assisted depinning of magnetic domain walls in half ring based Py/Al lateral spin valve structures. Our optimized geometry incorporating a patterned notch in the detector electrode, directly below the Al spin conduit, provides a tailored pinning potential for a transverse domain wall and allows for a precise control over the magnetization configuration and as a result the domain wall pinning. Due to the patterned notch, we are able to study the depinning field as a function of the applied external field for certain applied current densities and observe a clear asymmetry for the two opposite field directions. Micromagnetic simulations show that this can be explained by the asymmetry of the pinning potential. By direct comparison of the calculated efficiencies for different external field and spin current directions, we are able to disentangle the different contributions from the spin transfer torque, Joule heating and the Oersted field. The observed high efficiency of the pure spin current induced spin transfer torque allows for a complete depinning of the domain wall at zero external field for a charge current density of [Formula: see text] A m-2, which is attributed to the optimal control of the position of the domain wall.

Universal Pinning Energy Barrier for Driven Domain Walls in Thin Ferromagnetic Films.

We report a comparative study of magnetic field driven domain wall motion in thin films made of different magnetic materials for a wide range of field and temperature. The full thermally activated creep motion, observed below the depinning threshold, is shown to be described by a unique universal energy barrier function. Our findings should be relevant for other systems whose dynamics can be modeled by elastic interfaces moving on disordered energy landscapes.

Comparison of the use of NiFe and CoFe as electrodes for metallic lateral spin valves.

Spin injection and detection in Co60Fe40-based all-metallic lateral spin valves have been studied at both room and low temperatures. The obtained spin signals amplitudes have been compared to those of identical Ni80Fe20-based devices. The replacement of Ni80Fe20 by CoFe allows increasing the spin signal amplitude by up to one order of magnitude, thus reaching 50 mΩ at room temperature. The spin signal dependence with the distance between the ferromagnetic electrodes has been analyzed using both a 1D spin-transport model and finite element method simulations. The enhancement of the spin signal amplitude when using CoFe electrodes can be explained by a higher effective polarization.

Surface Study of Lithium-Air Battery Oxygen Cathodes in Different Solvent-Electrolyte pairs.

The O2/Li2O2 electrode reaction has been studied on low surface area Au electrodes in three solvent-electrolyte pairs (0.1 M LiPF6/DMSO, LiPF6/ACN, and LiBF4/ACN) using an electrochemical cell coupled to UHV XPS spectrometer, EQCM, AFM, and DEMS. The XPS spectra of the surfaces after treatment at selected electrode potentials for the O2 reduction and reoxidation of the surface show the presence of C and S from solvent decomposition and of F and P from electrolyte decomposition. Furthermore, Li 1s and O 1s peaks due to Li2O2 and decomposition products such as carbonate, organics, LiF, high oxidation sulfur, and phosphorus compounds were also observed. Using ACN instead of DMSO results in less solvent decomposition, whereas using LiBF4 results in less electrolyte decomposition. XPS, AFM, and EQCM show that O2 reduction products removal only takes place at very high overpotentials. In agreement with XPS which shows removal of carbonate surface species, DEMS confirms evolution of CO2 and consumption of O2 at 4.5 V, but LiF cannot be removed completely in a round trip of the Li-O2 battery cathode.

Clinical and epidemiological characteristics of infectious keratitis in Paraguay.

To describe the clinical and epidemiological characteristics of patients with severe infectious keratitis in Asunción, Paraguay between April 2009 and September 2011. All patients with the clinical diagnosis of severe keratitis (ulcer ≥2 mm in size and/or central location) were included. Empiric treatment consisted of topical antibiotics and antimycotics; in cases of advanced keratitis, fortified antibiotics were used. After microbiological analysis, treatment was changed if indicated. In total 48 patients (62.5 % males, 25 % farmers) were included in the analysis. A central ulcer was found in 81.3 % (n = 39). The median delay between onset of symptoms and time of first presentation at our institution was 7 days (range 1-30 days). Fungal keratitis was diagnosed in 64.5 % (n = 31) of patients, of which Fusarium sp. (n = 17) was the most common. Twenty-one patients (43.8 %) reported previous trauma to the eye. The globe could be preserved in all cases. While topical therapy only was sufficient in most patients, a conjunctival flap was necessary in six patients suffering from fungal keratitis. The high rate of fungal keratitis in this series is remarkable, and microbiological analysis provided valuable information for the appropriate treatment. In this setting, one has to be highly suspicious of fungal causes of infectious keratitis.

Elementary depinning processes of magnetic domain walls under fields and currents.

The probability laws associated to domain wall depinning under fields and currents have been studied in NiFe and FePt nanowires. Three basic domain wall depinning processes, associated to different potential landscapes, are found to appear identically in those systems with very different anisotropies. We show that these processes constitute the building blocks of any complex depinning mechanism. A Markovian analysis is proposed, that provides a unified picture of the depinning mechanism and an insight into the pinning potential landscape.

Switchable spin-current source controlled by magnetic domain walls.

Using nonlocal spin injection, spin-orbit coupling, or spincaloritronic effects, the manipulation of pure spin currents in nanostructures underlies the development of new spintronic devices. Here, we demonstrate the possibility to create switchable pure spin current sources, controlled by magnetic domain walls. When the domain wall is located at a given point of the magnetic circuit, a pure spin current is injected into a nonmagnetic wire. Using the reciprocal measurement configuration, we demonstrate that the proposed device can also be used as a pure spin current detector. Thanks to its simple geometry, this device can be easily implemented in spintronics applications; in particular, a single current source can be used both to induce the domain wall motion and to generate the spin signal.

Ensayo clínico aleatorio: papel de la dieta y ejercicios físicos en mujeres con síndrome metabólico / Randomised controlled trial: the role of diet and exercise in women with metabolic syndrome

Objetivo Evaluar la eficacia de un programa de recomendaciones nutricionales y ejercicios físicos en mujeres con síndrome metabólico.Diseño Ensayo clínico aleatorio multicéntrico.EmplazamientoAtención primaria de Holguín, Cuba.ParticipantesMuestreo por conglomerados de 150 mujeres obesas con síndrome metabólico, sin alteraciones de la glucemia. Se asignaron aleatoriamente a un grupo control (n=70) y a uno experimental (n=80). Completaron el estudio (junio 2008-julio 2009), 62 mujeres del control y 60 del grupo de intervención.IntervenciónEn el grupo experimental se aplicó una dieta hipocalórica balanceada y un programa de ejercicio físico. El grupo control recibió los cuidados habituales.Mediciones principalesPeso corporal, índice de masa corporal, circunferencia abdominal, presión arterial, glucemia y el perfil lipídico en sangre.ResultadosAl año, en relación al grupo control, en el grupo experimental se redujo más la presión diastólica (78±0,9 vs. 91±1,1mm Hg), el colesterol total (4,7±0,1 vs. 6,0±0,1mmol/L), los triglicéridos (1,9±0,1 vs. 2,9±0,1mmol/L) y el colesterol-LDL (2,5±0,0 vs. 3,5±0,1mmol/L), y aumentó más el colesterol-HDL (1,2±0,0 vs. 1,1±0,0mmol/L). No se produjeron cambios apreciables en el peso, el índice de masa corporal, la circunferencia abdominal, la presión arterial sistólica y la glucemia.ConclusionesSe demuestra la efectividad del programa de intervención sobre la presión arterial y el perfil de lípidos en sangre. (AU)

Transthoracic oesophagectomy with lymphadenectomy in 100 oesophageal cancer patients: multidisciplinary approach.

OBJECTIVES Analysis of the results on the treatment of esophageal cancer by transthoracic esophagectomy by a multidisciplinary team of surgeons and oncologists. METHODS Between January 1990 and December 2009, 100 consecutive patients underwent transthoracic esophagectomy. Data were collected prospectively and clinical, pathological and histological features of the tumors were analyzed as well as the results of postoperative morbidity and mortality. RESULTS The average patient age was 55 years (range 31- 83 years). In 59 cases the tumor was located in the lower third and in 41 cases in the middle third. Forty-six patients had adenocarcinoma and 54 squamous cell carcinoma. In 54 cases radio-chemotherapy was planned preoperatively. Classifi cation according to pathological tumor stage was: stage 0 in 21 patients, stage I in 10 patients, stage IIa in 28, stage IIb in 9, stage III in 21 and stage IV in 11. The mean number of lymph nodes examined was 14 (range 0-28). Hospital mortality occurred in 4 cases and postoperative complications in 29 patients (33%). The most frequent postoperative complication was pulmonary complications in 17 cases. The average hospital stay was 15.2 days (range 10-40 days) CONCLUSIONS The results of esophageal cancer have been improved in recent years due to the formation of multidisciplinary teams in this pathology. In our study we have shown that the results obtained with the transthoracic technique for cancer of the esophagus are within the ranges reported in the literature for teams with high prevalence of the disease.

Transthoracic oesophagectomy with lymphadenectomy in 100 oesophageal cancer patients: multidisciplinary approach

OBJECTIVES Analysis of the results on the treatment of esophageal cancer by transthoracic esophagectomy by a multidisciplinary team of surgeons and oncologists. METHODS Between January 1990 and December 2009, 100 consecutive patients underwent transthoracic esophagectomy. Data were collected prospectively and clinical, pathological and histological features of the tumors were analyzed as well as the results of postoperative morbidity and mortality. RESULTS The average patient age was 55 years (range 31- 83 years). In 59 cases the tumor was located in the lower third and in 41 cases in the middle third. Forty-six patients had adenocarcinoma and 54 squamous cell carcinoma. In 54 cases radio-chemotherapy was planned preoperatively. Classifi cation according to pathological tumor stage was: stage 0 in 21 patients, stage I in 10 patients, stage IIa in 28, stage IIb in 9, stage III in 21 and stage IV in 11. The mean number of lymph nodes examined was 14 (range 0-28). Hospital mortality occurred in 4 cases and postoperative complications in 29 patients (33%). The most frequent postoperative complication was pulmonary complications in 17 cases. The average hospital stay was 15.2 days (range 10-40 days) CONCLUSIONS The results of esophageal cancer have been improved in recent years due to the formation of multidisciplinary teams in this pathology. In our study we have shown that the results obtained with the transthoracic technique for cancer of the esophagus are within the ranges reported in the literature for teams with high prevalence of the disease (AU)

Combining speech recognition software with Digital Imaging and Communications in Medicine (DICOM) workstation software on a Microsoft Windows platform.

This presentation describes our experience in combining speech recognition software, clinical review software, and other software products on a single computer. Different processor speeds, random access memory (RAM), and computer costs were evaluated. We found that combining continuous speech recognition software with Digital Imaging and Communications in Medicine (DICOM) workstation software on the same platform is feasible and can lead to substantial savings of hardware cost. This combination optimizes use of limited workspace and can improve radiology workflow.