Measurement of non-linear optical properties in graphene oxide using the Z-scan technique.

We report the value of non-linear optical parameters in graphene oxide (GO) using the Z-scan technique. The value of the non-linear refractive index η2, non-linear absorption coefficient ß and the complex value of third order susceptibility χ(3) in samples with different concentrations of GO diluted in distilled water were determined. The value of these parameters were obtained directly from the measurement of normalized transmittance of each sample as a consequence of its non-linear response when are exposed to electromagnetic radiation from a Nd:YAG laser emitting at 532 nm in CW mode. In addition, we found that the parameters η2, ß and χ(3) growth by increasing excitation laser power, where ß showed an high order of magnitude around ~10-2 cm/W.

Colitis Ulcerativa Crónica Inespecífica: Evaluación y Recomendaciones Nutricionales / Report of a clinical case Nonspecific Chronic Ulcerative Colitis: Evaluation and Nutritional Recommendations

Introducción: La colitis ulcerativa crónica inespecífica (CUCI) es una patología de la mucosa y submucosa colónica caracterizada por evacuaciones diarreicas, sangrado rectal, eliminación de moco, tenesmo, dolor abdominal tipo cólico, fiebre y frecuentemente con datos de desnutrición. Objetivo: Reportar los hallazgos del estado nutricio y proporcionar recomendaciones nutricionales para un paciente con colitis ulcerativa crónica inespecífica, intervenido quirúrgicamente por una estenosis intestinal. Materiales y métodos: Se realizó una evaluación completa del estado nutricio de un caso clínico de CUCI, considerando parámetros antropométricos, bioquímicos, clínicos y dietéticos, siguiendo los procedimientos estandarizados. Resultados: El diagnóstico nutricional del caso clínico con CUCI fue una desnutrición leve con tendencia a evolucionar a desnutrición moderada por la intervención quirúrgica realizada. El paciente refirió que no había alimentos que ocasionaran recaídas, pero en cuanto la enfermedad reaparecía evitaba los productos lácteos. Conclusiones: La CUCI a pesar de ser una patología poco frecuente, se debe tratar con un equipo multidisciplinario para evitar que el paciente sufra desnutrición y recaídas

Introduction: Chronic Non-specific Ulcerative Colitis (UC) is a disease of the colonic mucosa and submucosa characterized by diarrheal stools, rectal bleeding, disposal of mucus, tenesmus, cramping abdominal pain and fever, often with sings of malnutrition. Objective: Report the findings of nutritional status and provide nutritional recommendations for a patient with UC, underwent surgery for intestinal stenosis. Materials and methods: A thorough assessment of the nutritional status was performed considering anthropometric, biochemical, clinical and dietary indicators. All measurements were realized according to standardized techniques. Results: The nutritional diagnosis was mild malnutrition at risk of progressing to moderate malnutrition due to the surgery. The patient reported no foods that cause relapse, avoiding dairy products as the disease reappeared. Conclusions: Although is Chronic Non-specific Ulcerative Colitis a rare condition, it must be treated by a multidisciplinary team to prevent the patient from suffering malnutrition and relapse

Preclinical cadaveric study of transanal robotic proctectomy with total mesorectal excision combined with laparoscopic assistance.

BACKGROUND: Anterior resection with total mesorectal excision (TME) is the standard method of rectal cancer resection. However, this procedure remains technically difficult. A robotic transanal approach could overcome some of these limitations. An initial laboratory experience with robotic transanal TME using a new designed port on human cadavers is reported. METHODS: The feasibility of robotic transanal TME and ideal set-up were evaluated in human cadavers. For the da Vinci Si HD system transanal access and total mesorectal excision, a specifically designed port was used. RESULTS: It was possible to complete a proctectomy with transanal total mesorectal excision. The port proved to be very reliable and facilitated docking of the robotic arms. CONCLUSION: Using the robotic technology and a specifically designed port for robotic transanal access, TME was shown to be feasible and one specific preferred set-up was determined. Further clinical trials will be necessary to assess the safety and efficacy of this technique.

Perfil de citosinas relacionadas con linfocitos Th17: rol fisiopatológico y potencial uso comobiomarcadores de actividad del lupus eritematoso sistémico / Profile of Th17 cytokine and its role in the pathophysiology and potential use as biomarkers in the activity of systemic lupus erythematosus

El lupus eritematoso sistémico (LES) es una enfermedad autoinmune, inflamatoria, crónica,que se desarrolla en individuos genéticamente predispuestos. La interacción de un factordetonante en conjunto con la falla de los mecanismos de depuración de potenciales autoantígenosreactivos, dará lugar a la formación de complejos inmunes responsables del dano˜tisular de los órganos blanco. En la fisiopatología han sido implicados una variedad de elementospertenecientes a la inmunidad innata y adaptativa. Una población celular descritarecientemente es la de linfocitos Th17, designados así por la producción de la IL-17; citosinaque media procesos fisiológicos y fisiopatológicos; estos últimos responsables del desarrollode condiciones inflamatorias como las del LES. Dada la heterogeneidad de esta enfermedad,en la actualidad no se cuenta con un biomarcador de actividad lo suficientemente sensible,específico y con un grado de predicción, que permita una confiable toma de decisionesclínicas. Con la intención de suplir dicha carencia, se ha postulado que los niveles séricosde IL-17, pueden ser un biomarcador que cumpla con dichos parámetros. Sin embargo, lainformación al respecto no es conclusiva. A continuación se presenta una revisión sobrelos mecanismos ontogénicos de los linfocitos Th17, la argumentación de su rol fisiopatoló-gico en LES y los estudios clínicos que apoyan y debaten el protagonismo de las citosinasrelacionadas con linfocitos Th17 como biomarcadores de actividad de la enfermedad en LES...

National and regional analysis of road accidents in Spain.

OBJECTIVE: In Spain, the absolute fatality figures decreased almost 50 percent between 1998 and 2009. Despite this great effort, road mortality is still of great concern to political authorities. Further progress requires efficient road safety policy based on an optimal set of measures and targets that consider the initial conditions and characteristics in each region. This study attempts to analyze road accidents in Spain and its provinces in time and space during 1998-2009. METHODS: First, we analyzed daily, monthly, and nationwide (NUTS 0) development of road accidents, the correlation between logarithmic transformations of road accidents and territorial and socioeconomic variables, the causality by simple linear regression of road accidents and territorial and socioeconomic variables, and preliminary frequency by fast Fourier transform. Then we analyzed the annual trend in accidents in the Spanish provinces (NUTS 3) and found a correlation between the logarithmic transformations of the mortality rate, fatalities per fatal accident, and accidents resulting in injuries per inhabitant variables and population, population density, gross domestic product (GDP), length of road network, and area. Finally, causality was analyzed by simple linear regression. RESULTS: The most outstanding results were the negative correlation between mortality rate and population density in Spanish provinces, which has increased over time, and that road accidents in Spain have an approximate periodicity of 57 days. CONCLUSIONS: The fast Fourier transform analysis of road accident frequency in Spain was useful in identifying the periodic, harmonic components of accidents and casualties. The periodicity observed both for the period 1998-2009 and by year showed that the highest intensity in road accidents was bimonthly, despite the lower number of accidents and casualties in the spectra of amplitude and power and efforts to reduce the intensity and concentration during off-season travel (summer and December).

Fasting plasma peptide YY concentrations are increased in patients with major depression who associate weight loss.

BACKGROUND: Many patients with major depression refer a decreased appetite and weight loss among their symptoms. Peptide YY (PYY) and ghrelin belong to the family of peptides of the gut-brain axis implicated in the regulation of appetite and energy metabolism. PYY stimulates a powerful central satiety response and ghrelin increases food intake and weight gain. Brain-derived neurotrophic factor (BDNF) also contributes to the central control of food intake as an anorexigenic factor. AIM: To study fasting plasma total and acylated ghrelin, plasma PYY and serum BDNF levels in patients with major depression with weight loss as one of their symptoms and compare them with matched healthy controls. SUBJECTS AND METHODS: Fifteen adult patients, 9 male and 6 female, with recent diagnosis of major depression, and 16 healthy adult subjects, matched by age and anthropometric parameters were studied. All depressed patients referred weight loss and were not under antidepressant therapy. Fasting total PYY, total ghrelin and acylated ghrelin and BDNF were determined. RESULTS: Fasting total PYY was higher in patients than controls (2.01±0.09 vs 1.29±0.16 pmol/l). There were no differences in fasting total ghrelin, acylated ghrelin or BDNF levels. CONCLUSIONS: Major depressed patients, with weight loss at diagnosis, showed higher fasting plasma PYY levels that could contribute to their reduced appetite.

Disminución del dolor y el peso durante el tratamiento de fisioterapia en pacientes intervenidos de prótesis de rodilla / Decrease in pain and weight loss during physiotherapy treatment in patients operated on for knee prosthesis

El dolor de los pacientes recién intervenidos de prótesis total de rodilla es el principal problema durante la primera fase de fisioterapia, la cual es más rápida y eficiente en pacientes sin sobrepeso. Se realizó un ensayo clínico aleatorio con el fin de demostrar la disminución del dolor y el peso corporal en pacientes obesos intervenidos de prótesis de rodilla mediante la aplicación de un biorritmo fisiológico diario y protocolizado de nutrición, ejercicio físico, hidratación y descanso en los dos meses posteriores a la operación. Al grupo control (19 pacientes) se le aplicó un tratamiento de fisioterapia tras la operación de artroplastia de rodilla, y al grupo de intervención (19 pacientes) además se le aplicó el protocolo. En ambos grupos se efectuaron tres mediciones: recién intervenidos, al mes y a los dos meses. Se observó homogeneidad basal entre ambos grupos en todas las variables recogidas: edad, sexo, índice de masa corporal (IMC), peso y dolor medido mediante escala de valoración analógica (EVA). Se demostraron diferencias significativas en el peso, el IMC y el dolor comparando ambos grupos (p<0,0005). En el grupo de intervención, a los dos meses de la operación los pacientes pesaron 4,5kg menos y el dolor desapareció. En cuanto al grupo control, el peso no varió y el dolor fue de 3 en la EVA. En conclusión, este estudio muestra que un protocolo de ritmo de vida fisiológico de ayuda al tratamiento básico de fisioterapia aplicado en pacientes con sobrepeso recién intervenidos de prótesis de rodilla ocasionaron mejoras significativas en el dolor y la disminución de peso (AU)

Pain of recently operated patients for total knee prosthesis is the main problem during the first phase of physiotherapy, which is faster and more efficient in non-overweight patients. We performed a randomized clinical trial to demonstrate pain and body weight reduction in obese patients undergoing knee prosthesis through daily biorhythms and physiological protocolized nutrition, exercise, hydration and rest during the two months post-operation. The methodology was to compare two groups of 19 patients each. One control group only received physical therapy after knee arthroplasty operation and the protocol was also applied in the second group. Three measurements were performed for each group: at recently intervened, at one month and at two months. Baseline homogeneity was observed between both groups in all of the variables collected: age, sex, body mass index (BMI), weight, measured by pain analogue assessment scale (ASA). Significant differences were demonstrated in weight, BMI and pain when both groups were compared (p<0.0005). At two months of the operation, the interventions weights 4.5kg less and the paid had disappeared. In regards to the control group, their weight did not vary and pain was 3 on the ASA. In conclusion, this study has shown that a physiological life rhythm protocol in combination with basic physiotherapy treatment applied in recently operations overweight patients of knee prosthesis leads to significant improvements in pain and weight loss (AU)

Latitudinal and altitudinal growth patterns of brown trout Salmo trutta at different spatial scales.

Spatial variation in growth of stream-dwelling brown trout Salmo trutta was explored in 13 populations using a long-term study (1993-2004) in the Bay of Biscay drainage, northern Spain. The high variability in fork length (L(F)) of S. trutta in the study area was similar to the body-size range found in the entire European distribution of the species. Mean L(F) at age varied: 0+ years, 57.4-100.7 mm; 1+ years, 111.6-176.0 mm; 2+ years, 155.6-248.4 mm and 3+ years, 194.3-290.9 mm. Average L(F) at age was higher in main courses and lower reaches compared with small tributaries and upper reaches. Annual specific growth rates (G(L)) were: 0+ to 1+ years, 0.634-0.825 mm mm(-1) year(-1); 1+ to 2+ years, 0.243-0.342 mm mm(-1) year(-1); 2+ to 3+ years, 0.166-0.222 mm mm(-1) year(-1), showing a great homogeneity. Regression models showed that water temperature and altitude were the major determinants of L(F) at age variability within the study area. A broader spatial analysis using available data from stream-dwelling S. trutta populations throughout Europe indicated a negative relationship between latitude and L(F) of individuals and a negative interaction between latitude and altitude. These findings support previous evidence of the pervasive role of water temperature on the L(F) of this species. Altitude appeared as the overall factor that includes the local variation of other variables, such as water temperature or food availability. At a larger scale, latitude was the factor that encompassed these environmental gradients and explained the differences in L(F) of S. trutta. In summary, L(F) at age in stream-dwelling S. trutta decreases with latitude in Europe, the converse of Bergmann's rule.

Homogeneous nucleation: classical formulas as asymptotic limits of the Cahn-Hilliard approach.

Classical expressions for the critical cluster work of formation approximate the nonclassical expressions based in the density functional theory of capillarity for the limit of low supersaturation degrees. However, the ratio between classical and nonclassical expressions for nucleation rates grows as the supersaturation degree decreases. Here, with the aim to obtain simple and more accurate expressions that approximate the modern nucleation rate formulas, an asymptotic expansion of the Cahn-Hilliard expression of the critical work of formation is developed within the limit of low supersaturation. In such asymptotic expansion, terms up to third order are retained. The ratios between the corrected classical expressions and the nonclassical ones are now decreasing for supersaturation degrees tending to zero. However, the corrected approximate formulas are as difficult to handle as the exact Cahn-Hilliard expressions. When only the two first low-order terms of the asymptotic expansion are retained, a simpler corrected classical expression is obtained but it can only approximate nonclassical expressions up to order unity. Finally, using a Becker-Doring model of nucleation, the kinetic prefactor of the critical nuclei rate of formation is modeled consistently with the Cahn-Hilliard approach to the critical work of formation.

Enfermedad pélvica inflamatoria causada por actinomyces israelii / Pelvic inflamatory disease caused by actinomyces israelii

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Retrospective study of 77 patients harbouring lumbar synovial cysts: functional and neurological outcome.

BACKGROUND: Synovial cysts represent an uncommon and probably underestimated pathological entity of the degenerative lumbar spine. The authors report a retrospective analysis of the clinical presentation, radiological studies and operative findings in 77 patients surgically treated for symptomatic lumbar synovial cysts at their institution. MATERIALS AND METHOD: Between January 1992 and June 1998, a total of 77 patients presenting with symptomatic lumbar synovial cysts were operated on in the author's department. Operative procedure, complications, results and pathological findings were correlated with preoperative assessment. There were 41 men and 36 women with an average age of 63 years (range 44-90 years). RESULTS: On the basis of their symptom complex on presentation, two populations were identified: patients who presented with a single radicular pain (group I = 51 patients), and patients who presented with bilateral neurogenic claudication (group II = 26 patients). Neurological examination on presentation demonstrated motor deficit (12%), sensory loss (26%) and reflex changes (35%). Degenerative disc disease and facet joint osteoarthritis was a frequent finding in patients with pre-operative MRI. Facet joint orientation was >45 degrees in 76.6% of patients. Preoperative spondylolisthesis was found in 48% on radiological studies. All the patients were treated surgically with resection of the cyst. No fusion was performed as a first line procedure. However subsequent fusion was necessary in one patient who developed symptomatic spondylolisthesis. Mean follow-up period was of 45 months ranging from 18 to 105 months. Only one recurrence occurred during the follow-up period. An excellent or good functional outcome was seen in 97.4% of cases, and 89% of the patients with motor deficit recovered. CONCLUSIONS: Surgical resection of lumbar synovial cysts is an effective treatment associated with very low morbidity. Synovial cysts are associated with increased grade and frequency of facet joint asteoarthritis but not with increased grade or frequency of degenerative disc disease compared with patients without cysts. In the author's opinion, at the present time, there is no reliable criterion which allows the development of a symptomatic spinal instability to be predicted in patients with a preoperative spondylolisthesis and therefore fusion as a first line procedure is still debatable.

Contactos infantiles de pacientes tuberculosos en el período 1988-2002 en León / No disponible

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Diagnóstico rápido de neumonía por Legionella pneumophila / Rapid diagnosis of Legionella pneumophilia pneumonia

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Tuberculosis diseminada por Mycobacterium africanum / Disseminated tuberculosis due to Mycobacterium tuberculosis

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[A retrospective study of 32 lumbar synovial cysts. Clinical aspect and surgical management]. / Kystes synoviaux lombaires: aspects cliniques et prise en charge chirurgicale. Etude rétrospective de 32 cas.

We report a retrospective analysis of a series of 32 cases of lumbar synovial cysts. Clinically, two populations were identified: patients who presented radicular pain mimicking the clinical diagnosis of disk herniation (group I) and patients who presented neurogenic claudication consistent with a diagnosis of lumbar spinal stenosis (group II). The radiological work-up consisted in standard X-rays and CT-scan for all patients. MRI (magnetic resonance imaging) was performed in 14 patients. All the patients were operated on. The surgical technique consisted in foraminotomy for patients in group I and more or less extensive laminectomy for patients in group II. Functional outcome was marked by a significant improvement in 96.9% of the patients and those who presented a motor deficit recovered in 83% of the cases. Based on the findings in this series, we discuss the clinical aspects and the therapeutic management of this pathological entity.