Defining metabolic flexibility in hair follicle stem cell induced squamous cell carcinoma.

Among the numerous changes associated with the transformation to cancer, cellular metabolism is one of the first discovered and most prominent[1, 2]. However, despite the knowledge that nearly every cancer is associated with the strong upregulation of various metabolic pathways, there has yet to be much clinical progress on the treatment of cancer by targeting a single metabolic enzyme directly[3-6]. We previously showed that inhibition of glycolysis through lactate dehydrogenase (LDHA) deletion in cancer cells of origin had no effect on the initiation or progression of cutaneous squamous cell carcinoma[7], suggesting that these cancers are metabolically flexible enough to produce the necessary metabolites required for sustained growth in the absence of glycolysis. Here we focused on glutaminolysis, another metabolic pathway frequently implicated as important for tumorigenesis in correlative studies. We genetically blocked glutaminolysis through glutaminase (GLS) deletion in cancer cells of origin, and found that this had little effect on tumorigenesis, similar to what we previously showed for blocking glycolysis. Tumors with genetic deletion of glutaminolysis instead upregulated lactate consumption and utilization for the TCA cycle, providing further evidence of metabolic flexibility. We also found that the metabolic flexibility observed upon inhibition of glycolysis or glutaminolysis is due to post-transcriptional changes in the levels of plasma membrane lactate and glutamine transporters. To define the limits of metabolic flexibility in cancer initiating hair follicle stem cells, we genetically blocked both glycolysis and glutaminolysis simultaneously and found that frank carcinoma was not compatible with abrogation of both of these carbon utilization pathways. These data point towards metabolic flexibility mediated by regulation of nutrient consumption, and suggest that treatment of cancer through metabolic manipulation will require multiple interventions on distinct pathways.

A Series of 69 COVID-related Dermatoses With Biopsy, Immunohistochemistry With Anti-spike 3, in situ Hybridization and PCR: A Critical Reappraisal of Viral Involvement in COVID-19 Skin Lesions / Serie de 69 dermatosis relacionadas con la COVID con biopsia, estudio inmunohistoquímico con anti-spike 3, hibridación in situ y PCR: Una revisión crítica de la afectación cutánea relacionada con la COVID-19

Background Despite the large number of articles published on skin lesions related to COVID-19, clinicopathological correlation has not been performed consistently and immunohistochemistry to demonstrate spike 3 protein expression has not been validated through RT-PCR. Material and method We compiled 69 cases of patients with confirmed COVID-19, where skin lesions were clinically and histopathologically studied. Immunohistochemistry (IHC) and RT-PCR was performed in skin biopsies. Results After a careful review of the cases, 15 were found to be dermatosis not related to COVID-19, while the rest of the lesions could be classified according to their clinical characteristics as vesicular (4), maculopapular eruptions (41), urticariform (9), livedo and necrosis (10) and pernio-like (5). Although histopathological features were similar to previously reported results, we found two previously unreported findings, maculopapular eruptions with squamous eccrine syringometaplasia and neutrophilic epitheliotropism. IHC showed in some cases endothelial and epidermal staining but RT-PCR was negative in all the tested cases. Thus, direct viral involvement could not be demonstrated. Conclusions Despite presenting the largest series of confirmed COVID-19 patients with histopathologically studied skin manifestations, direct viral involvement was difficult to establish. Vasculopathic and urticariform lesions seem to be those more clearly related to the viral infection, despite IHC or RT-PCR negative results failed to demonstrate viral presence. These findings, as in other dermatological areas, highlight the need of a clinico-pathological correlation to increase knowledge about viral involvement in COVID-19 skin-related lesions (AU)

Antecedentes A pesar del gran número de artículos publicados sobre las lesiones cutáneas relacionadas con la COVID-19, no se ha realizado una correlación clinicopatológica de manera consistente, y no ha sido validado el estudio de inmunohistoquímica para demostrar la expresión de la proteína spike 3 mediante RT-PCR. Material y métodos Recopilamos 69 casos de pacientes con COVID-19 confirmada, en los que se estudiaron las lesiones cutáneas a nivel clínico e histopatológico, habiéndose realizado la prueba inmunohistoquímica (IHQ) y RT-PCR en las biopsias cutáneas. Resultados Tras una revisión detallada de los casos, en 15 de ellos se encontró que la dermatosis no guardaba relación con la COVID-19, mientras que el resto de las lesiones podrían clasificarse de acuerdo con sus características clínicas como vesiculares (4), erupciones maculopapulares (41), urticariformes (9), livedo y necrosis (10) y de tipo perniosis (5). Aunque las características histopatológicas fueron similares a los resultados previamente reportados, encontramos dos hallazgos no reportados previamente: erupciones maculopapulares con siringometaplasia ecrina escamosa y epiteliotropismo neutrofílico. La IHQ reflejó en ciertos casos tinción endotelial y epidérmica, pero la prueba RT-PCR fue negativa en todos los casos probados. Por ello no pudo demostrarse el compromiso viral directo. Conclusiones A pesar de presentar la mayor serie de pacientes con COVID-19 confirmada y manifestaciones cutáneas histopatológicamente estudiadas, el compromiso viral directo fue difícil de establecer. Las lesiones vasculopáticas e urticariformes parecen ser las más claramente relacionadas con la infección viral, a pesar de que los resultados negativos de la IHQ o RT-PCR no pudieron demostrar la presencia viral (AU)

[Articulo traducido] Serie de 69 dermatosis relacionadas con la COVID-19 con biopsia, estudio inmunohistoquímico con anti-spike 3, hibridación in situ y PCR: Una revisión crítica de la afectación cutánea relacionada con la COVID-19 / A Series of 69 COVID-related Dermatoses With Biopsy, Immunohistochemistry With Anti-spike 3, in situ Hybridization and PCR: A Critical Reappraisal of Viral Involvement in COVID-19 Skin Lesions

Antecedentes A pesar del gran número de artículos publicados sobre las lesiones cutáneas relacionadas con la COVID-19, no se ha realizado una correlación clinicopatológica de manera consistente, y no ha sido validado el estudio de inmunohistoquímica para demostrar la expresión de la proteína spike 3 mediante RT-PCR. Material y métodos Recopilamos 69 casos de pacientes con COVID-19 confirmada, en los que se estudiaron las lesiones cutáneas a nivel clínico e histopatológico, habiéndose realizado la prueba inmunohistoquímica (IHQ) y RT-PCR en las biopsias cutáneas. Resultados Tras una revisión detallada de los casos, en 15 de ellos se encontró que la dermatosis no guardaba relación con la COVID-19, mientras que el resto de las lesiones podrían clasificarse de acuerdo con sus características clínicas como vesiculares (4), erupciones maculopapulares (41), urticariformes (9), livedo y necrosis (10) y de tipo perniosis (5). Aunque las características histopatológicas fueron similares a los resultados previamente reportados, encontramos dos hallazgos no reportados previamente: erupciones maculopapulares con siringometaplasia ecrina escamosa y epiteliotropismo neutrofílico. La IHQ reflejó en ciertos casos tinción endotelial y epidérmica, pero la prueba RT-PCR fue negativa en todos los casos probados. Por ello no pudo demostrarse el compromiso viral directo. Conclusiones A pesar de presentar la mayor serie de pacientes con COVID-19 confirmada y manifestaciones cutáneas histopatológicamente estudiadas, el compromiso viral directo fue difícil de establecer. Las lesiones vasculopáticas e urticariformes parecen ser las más claramente relacionadas con la infección viral, a pesar de que los resultados negativos de la IHQ o RT-PCR no pudieron demostrar la presencia viral (AU)

Background Despite the large number of articles published on skin lesions related to COVID-19, clinicopathological correlation has not been performed consistently and immunohistochemistry to demonstrate spike 3 protein expression has not been validated through RT-PCR. Material and method We compiled 69 cases of patients with confirmed COVID-19, where skin lesions were clinically and histopathologically studied. Immunohistochemistry (IHC) and RT-PCR was performed in skin biopsies. Results After a careful review of the cases, 15 were found to be dermatosis not related to COVID-19, while the rest of the lesions could be classified according to their clinical characteristics as vesicular (4), maculopapular eruptions (41), urticariform (9), livedo and necrosis (10) and pernio-like (5). Although histopathological features were similar to previously reported results, we found two previously unreported findings, maculopapular eruptions with squamous eccrine syringometaplasia and neutrophilic epitheliotropism. IHC showed in some cases endothelial and epidermal staining but RT-PCR was negative in all the tested cases. Thus, direct viral involvement could not be demonstrated. Conclusions Despite presenting the largest series of confirmed COVID-19 patients with histopathologically studied skin manifestations, direct viral involvement was difficult to establish. Vasculopathic and urticariform lesions seem to be those more clearly related to the viral infection, despite IHC or RT-PCR negative results failed to demonstrate viral presence. These findings, as in other dermatological areas, highlight the need of a clinico-pathological correlation to increase knowledge about viral involvement in COVID-19 skin-related lesions (AU)

A Series of 69 COVID-related Dermatoses With Biopsy, Immunohistochemistry With Anti-spike 3, in situ Hybridization and PCR: A Critical Reappraisal of Viral Involvement in COVID-19 Skin Lesions. / [Articulo traducido] Serie de 69 dermatosis relacionadas con la COVID-19 con biopsia, estudio inmunohistoquímico con anti-spike 3, hibridación in situ y PCR: Una revisión crítica de la afectación cutánea relacionada con la COVID-19.

BACKGROUND: Despite the large number of articles published on skin lesions related to COVID-19, clinicopathological correlation has not been performed consistently and immunohistochemistry to demonstrate spike 3 protein expression has not been validated through RT-PCR. MATERIAL AND METHODS: We compiled 69 cases of patients with confirmed COVID-19, where skin lesions were clinically and histopathologically studied. Immunohistochemistry (IHC) and RT-PCR was performed in skin biopsies. RESULTS: After a careful review of the cases, 15 were found to be dermatosis not related to COVID-19, while the rest of the lesions could be classified according to their clinical characteristics as vesicular (4), maculopapular eruptions (41), urticariform (9), livedo and necrosis (10) and pernio-like (5). Although histopathological features were similar to previously reported results, we found two previously unreported findings, maculopapular eruptions with squamous eccrine syringometaplasia and neutrophilic epitheliotropism. IHC showed in some cases endothelial and epidermal staining but RT-PCR was negative in all the tested cases. Thus, direct viral involvement could not be demonstrated. CONCLUSIONS: Despite presenting the largest series of confirmed COVID-19 patients with histopathologically studied skin manifestations, direct viral involvement was difficult to establish. Vasculopathic and urticariform lesions seem to be those more clearly related to the viral infection, despite IHC or RT-PCR negative results failed to demonstrate viral presence. These findings, as in other dermatological areas, highlight the need of a clinico-pathological correlation to increase knowledge about viral involvement in COVID-19 skin-related lesions.

A Series of 69 COVID-related Dermatoses With Biopsy, Immunohistochemistry With Anti-spike 3, in situ Hybridization and PCR: A Critical Reappraisal of Viral Involvement in COVID-19 Skin Lesions.

BACKGROUND: Despite the large number of articles published on skin lesions related to COVID-19, clinicopathological correlation has not been performed consistently and immunohistochemistry to demonstrate spike 3 protein expression has not been validated through RT-PCR. MATERIAL AND METHODS: We compiled 69 cases of patients with confirmed COVID-19, where skin lesions were clinically and histopathologically studied. Immunohistochemistry (IHC) and RT-PCR was performed in skin biopsies. RESULTS: After a careful review of the cases, 15 were found to be dermatosis not related to COVID-19, while the rest of the lesions could be classified according to their clinical characteristics as vesicular (4), maculopapular eruptions (41), urticariform (9), livedo and necrosis (10) and pernio-like (5). Although histopathological features were similar to previously reported results, we found two previously unreported findings, maculopapular eruptions with squamous eccrine syringometaplasia and neutrophilic epitheliotropism. IHC showed in some cases endothelial and epidermal staining but RT-PCR was negative in all the tested cases. Thus, direct viral involvement could not be demonstrated. CONCLUSIONS: Despite presenting the largest series of confirmed COVID-19 patients with histopathologically studied skin manifestations, direct viral involvement was difficult to establish. Vasculopathic and urticariform lesions seem to be those more clearly related to the viral infection, despite IHC or RT-PCR negative results failed to demonstrate viral presence. These findings, as in other dermatological areas, highlight the need of a clinico-pathological correlation to increase knowledge about viral involvement in COVID-19 skin-related lesions.

The global burden of chronic urticaria for the patient and society.

Chronic urticaria (CU) affects about 1% of the world population of all ages, mostly young and middle-aged women. It usually lasts for several years (> 1 year in 25-75% of patients) and often takes > 1 year before effective management is implemented. It presents as chronic spontaneous urticaria (CSU), chronic inducible urticaria (CIndU) or both in the same person. More than 25% of cases are resistant to H1 -antihistamines, even at higher doses, and third- and fourth-line therapies (omalizumab and ciclosporin) control the disease only in two-thirds of H1 -antihistamine-resistant patients. Here we review the impact of CU on different aspects of patients' quality of life and the burden of this chronic disease for the patient and society. CU may have a strong impact on health-related quality of life (HRQoL), particularly when CSU is associated with angio-oedema and/or CIndU (Dermatology Life Quality Index > 10 in 30% of patients). Comorbidities, such as anxiety and depression, which are present in more than 30% of patients with CSU, compound HRQoL impairment. Severe pruritus and the unpredictable occurrence of weals and angio-oedema are responsible for sleep disorders; sexual dysfunction; limitations on daily life, work and sports activities; interfering with life within the family and in society; and patients' performance at school and work (6% absenteeism and 25% presenteeism). Apart from treatment costs, with annual values between 900 and 2400 purchasing power parity dollars (PPP$) in Europe and the USA, CU is associated with a high consumption of medical resources and other indirect costs, which may reach a total annual cost of PPP$ 15 550.

[Humeral anterograde nailing. Functional results. A 5 years experience]. / Enclavado centromedular anterógrado de húmero. Resultados funcionales. Experiencia de cinco años.

PURPOSE: The purpose of this study was to investigate the clinical impact on the global function of the shoulder of the use of the anterolateral approach for nailing. MATERIAL AND METHODS: A retrospective cohort at the public sector of Centenario Hospital Miguel Hidalgo in Aguascalientes, Mexico between 2011 and 2016 was analysed. Inclusion criteria were: patients with anterolateral humeral nailing approach. Clinical assessment using the Constant-Murley score, shoulder range of motion and quick DASH questionnaire. RESULTS: Seventeen patients, 16 treated for humeral shaft fracture and one for humeral fibrous dyslasia were obtained. Mean score on Constant-Murley scale was 84.05 with 76.4% of patients achieving excellent result ( 75 points). One patient had a poor functional outcome. The mean quickDASH score was 17.5 points. CONCLUSIONS: The anterolateral approach for humeral nailing has good functional outcome in our series.

OBJETIVO: El propósito de este estudio es investigar el impacto clínico en la función global en el hombro intervenido para el abordaje anterolateral de enclavado centromedular de húmero. MATERIAL Y MÉTODOS: Se trata de una cohorte retrospectiva de casos tratados entre 2011 y 2016. Como criterio de inclusión se revisó todo paciente con antecedente de enclavado de húmero con abordaje anterolateral. Se realizó una evaluación con la escala funcional de Constant-Murley, arquimetría comparativa de ambos hombros y la aplicación de cuestionario quick DASH. RESULTADOS: Se obtuvieron 17 pacientes, 16 tratados para fracturas diafisarias de húmero y uno para displasia fibrosa de húmero. El puntaje promedio de la escala de Constant-Murley obtenido fue de 84.05, 76.4% de los pacientes obtuvieron excelentes resultados ( 75 puntos). Un paciente tuvo un resultado funcional deficiente. El puntaje promedio de quick DASH obtenido fue de 17.5 puntos. CONCLUSIONES: El abordaje anterolateral para enclavado centromedular de húmero tiene buen pronóstico funcional en nuestra serie de casos.

Direct ultrafiltration performance and membrane integrity monitoring by microbiological analysis.

The feasibility of substituting a conventional pre-treatment, consisting of dioxi-chlorination, coagulation/flocculation, settling and sand filtration, of a drinking water treatment plant (DWTP) by direct ultrafiltration (UF) has been assessed from a microbiological standpoint. Bacterial indicators, viral indicators and human viruses have been monitored in raw river, ultrafiltered and conventionally pre-treated water samples during two years. Direct UF has proven to remove bacterial indicators quite efficiently and to a greater extent than the conventional process does. Nevertheless, the removal of small viruses such as some small bacteriophages and human viruses (e.g. enteroviruses and noroviruses) is lower than the current conventional pre-treatment. Membrane integrity has been assessed during two years by means of tailored tests based on bacteriophages with different properties (MS-2, GA and PDR-1) and bacterial spores (Bacillus spores). Membrane integrity has not been compromised despite the challenging conditions faced by directly treating raw river water. Bacteriophage PDR-1 appears as a suitable microbe to test membrane integrity, as its size is slightly larger than the considered membrane pore size. However, its implementation at full scale plant is still challenging due to difficulties in obtaining enough phages for its seeding.

[Benefits of Decumanum Phlebodium intake on the muscle damage in the response to intense physical exercise in sedentary subjects]. / Beneficios de la ingesta del phlebodium decumanum sobre el daño muscular al efectuar ejercicio físico intenso en sujetos sedentarios.

INTRODUCTION: Intense physical exercise provoke muscle damage, that in sedentary people can increase cardiovascular risk. Phlebodium decumanum (PD) has shown to have immunomodulator effects in models of moderate intense physical activities in well conditioned groups. To evaluate the PD effects during eccentric exercise, as a model of muscle inflammation protocol, on a sedentary population with cardiovascular risk. METHODS: This is an experimental, double-blind, multigroup randomized study. Experimental Group 1 (n = 17)received PD, 9 doses of 400 mg (total amount 3.6 g) every 8 hours during 3 days, and Control Group 2 (n = 16)received a placebo. All the subjects performed two treadmill ergoespirometry tests: first, a modified Bruce protocol to discard ischemic responses during exercise and to evaluate VO2max before the experimental phase;and second, with an eccentric protocol (14% descending ramp test) during 10 minutes in stable state at 70-80%VO2max, as experimental inflammatory protocol.We compared intra and inter groups to evaluate differences in the pre and post-test differences results on blood muscle damage variables. RESULTS: The study shown statistically significant differences in all pre-post intra-groups results in muscle damage variables (CK, LDH and Myoglobin, but not in Cardiac Troponin), and in functional lower-limb test (SJand CMJ). The comparison of inter-group results shown less muscle damage and less functional lower-limb deterioration in Group 1 compared with Control group, with statistical significance in both cases. Differences in handgrip dynamometry were no statistically significant. CONCLUSIONS: The eccentric exercise protocol in that study has proven to be a good model to induce muscle and functional damage in sedentary people. Short PD treatment has shown to reduce muscle and functional acute damages compared with placebo control group in this specific population.

Introducción: El ejercicio intenso provoca un daño muscular inflamatorio que, en sujetos sedentarios provoca un aumento del riesgo cardiovascular. El Phlebodium decumanum (PD) ha evidenciado efectos inmunomoduladores protectores frente a ese daño en los deportistas. Para conocer los efectos del PD en una población sedentaria frente al ejercicio excéntrico, y como modelo del daño muscular inflamatorio. Metodología: Se llevó a cabo un estudio experimental, doble ciego, multigrupo, randomizado, con un grupo experimental (n = 17) al que se le administró una formulación de PD (3,6 g/sujeto distribuidos en 9 dosis de 400 mg desde el 3.er día pretest), y un grupo control (n = 16) que tomó sustancia placebo. Se realizaron dos ergoespirometrías en tapiz rodante a cada participante: una previa al estudio (protocolo de Bruce modificado) para descartar signos de isquemia durante el esfuerzo y valorar el VO2max; la segunda, aplicando un protocolo excéntrico (14% de desnivel descendente), durante 10 minutos en estado estable a una intensidad entre 70-80% del VO2max individual, como protocolo experimental. Se efectuaron comparaciones intragrupo e intergrupo del porcentaje de cambio pre-postesfuerzo en variables sanguíneas y de funcionalidad muscular. Resultados: El estudio evidencia aumentos significativos de enzimas musculares MG, CPK y LDH en los dos grupos de estudio, sin cambios para la TncI, siendo significativamente menores en el grupo al que se le administró PD. Se observaron reducciones significativas de los test funcionales SJ, CMJ en ambos grupos, lo que mostró un apreciable menor descenso en el grupo PD. Se apreció una reducción del índice elástico y de la dinamomentría manual solo en el grupo control, aunque las diferencias con el grupo PD no alcanzaron una significación estadística. Conclusiones: El protocolo del ejercicio excéntrico en el presente estudio ha inducido daños musculoesqueléticos y en la funcionalidad muscular, que han resultado significativamente menores en el grupo PD, al mostrar los efectos protectores del Phlebodium Decumanum en tratamientos cortos, frente al daño muscular también en el esfuerzo agudo.

Beneficios de la ingesta del Phlebodium decumanum sobre el daño muscular al efectuar ejercicio físico intenso en sujetos sedentarios / Benefits of decumanum phlebodium intake on the muscle damage in the response to intense physical exercise in sedentary subjects

Introducción: El ejercicio intenso provoca un daño muscular inflamatorio que, en sujetos sedentarios provoca un aumento del riesgo cardiovascular. El Phlebodium decumanum (PD) ha evidenciado efectos inmunomoduladores protectores frente a ese daño en los deportistas. Para conocer los efectos del PD en una población sedentaria frente al ejercicio excéntrico, y como modelo del daño muscular inflamatorio. Metodología: Se llevó a cabo un estudio experimental, doble ciego, multigrupo, randomizado, con un grupo experimental (n = 17) al que se le administró una formulación de PD (3,6 g/sujeto distribuidos en 9 dosis de 400 mg desde el 3.er día pretest), y un grupo control (n = 16) que tomó sustancia placebo. Se realizaron dos ergoespirometrías en tapiz rodante a cada participante: una previa al estudio (protocolo de Bruce modificado) para descartar signos de isquemia durante el esfuerzo y valorar el VO2max; la segunda, aplicando un protocolo excéntrico (14% de desnivel descendente), durante 10 minutos en estado estable a una intensidad entre 70-80% del VO2max individual, como protocolo experimental. Se efectuaron comparaciones intragrupo e intergrupo del porcentaje de cambio pre-postesfuerzo en variables sanguíneas y de funcionalidad muscular. Resultados: El estudio evidencia aumentos significativos de enzimas musculares MG, CPK y LDH en los dos grupos de estudio, sin cambios para la TncI, siendo significativamente menores en el grupo al que se le administró PD. Se observaron reducciones significativas de los test funcionales SJ, CMJ en ambos grupos, lo que mostró un apreciable menor descenso en el grupo PD. Se apreció una reducción del índice elástico y de la dinamomentría manual solo en el grupo control, aunque las diferencias con el grupo PD no alcanzaron una significación estadística. Conclusiones: El protocolo del ejercicio excéntrico en el presente estudio ha inducido daños musculoesqueléticos y en la funcionalidad muscular, que han resultado significativamente menores en el grupo PD, al mostrar los efectos protectores del Phlebodium Decumanum en tratamientos cortos, frente al daño muscular también en el esfuerzo agudo (AU)

Introduction: Intense physical exercise provoke muscle damage, that in sedentary people can increase cardiovascular risk. Phlebodium decumanum (PD) has shown to have immunomodulator effects in models of moderateintense physical activities in well conditioned groups. To evaluate the PD effects during eccentric exercise, as a model of muscle inflammation protocol, on a sedentary population with cardiovascular risk. Methods. This is an experimental, double-blind, multigroup randomized study. Experimental Group 1 (n = 17) received PD, 9 dosis of 400 mg (total amount 3.6 g) every 8 hours during 3 days, and Control Group 2 (n = 16) received a placebo. All the subjects performed two treadmill ergoespirometry tests: first, a modified Bruce protocol to discard ischemic responses during exercise and to evaluate VO2max before the experimental phase; and second, with an eccentric protocol (14% descending ramp test) during 10 minutes in stable state at 70-80% VO2max, as experimental inflammatory protocol. We compared intra and inter groups to evaluate differences in the pre and post-test differences results on blood muscle damage variables. Results: The study shown statistically significant differences in all pre-post intra-groups results in muscle damage variables (CK, LDH and Myoglobin, but not in Cardiac Troponin), and in functional lower-limb test (SJ and CMJ). The comparison of inter-group results shown less muscle damage and less functional lower-limb deterioration in Group 1 compared with Control group, with statistical significance in both cases. Differences in hand grip dynamometry were no statistically significant. Conclusions: The eccentric exercise protocol in that study has proven to be a good model to induce muscle and functional damage in sedentary people. Short PD treatment has shown to reduce muscle and functional acute damages compared with placebo control group in this specific population (AU)

Selección de Electrodos Basada en k-means para la Clasificación de Actividad Motora en EEG / Eletrode Selection Based on k-means for Motor Activity Classification in EEG

Se presenta un algoritmo para la selección del grupo de electrodos relacionados con la imaginación de movimiento. El algoritmo utiliza la técnica de agrupamiento llamada k-means para formar grupos de sensores y selecciona el grupo que corresponde a la actividad correlacionada más alta. Para evaluar la selección de electrodos, se calcula el indice de clasificación aplicando la descomposición proyectiva llamada patrones espaciales comunes y un discriminante lineal en una prueba de una sola época para identificar la imaginación del movimiento de mano izquierda vs pie derecho. Esta propuesta reduce significativamente el número de electrodos de 118 a 35, además de mejorar el índice de clasificación.

We present an algorithm for electrodes selection associated with motor imagery activity. The algorithm uses a clustering technique called k-means to form groups of sensors and selects the group corresponding to the highest correlation activity. Then, we evaluate the selected electrodes computing the classification index using the projective decomposition called common spatial patterns and a linear discriminant method in a left hand vs right foot motor imagery classification task. This approach significantly reduces the number of electrodes from 118 to 35 while improving the classification accuracy index.

Role of medical students in preventing patient harm and enhancing patient safety.

BACKGROUND: Substantial efforts are focused on the high prevalence of patient harm due to medical errors and the mechanisms to prevent them. The potential role of the medical student as a valuable member of the team in preventing patient harm has, however, often been overlooked. METHODS: Four cases are presented from two US academic health centers in which medical students prevented or were in a position to prevent patient harm from occurring. The authors directly participated in each case. RESULTS: The types of harm prevented included averting non-sterile conditions, missing medications, mitigating exposure to highly contagious patients, and respecting patients' "do not resuscitate" requests. CONCLUSION: Medical students are often overlooked as valuable participants in ensuring patient safety. These cases show that medical students may be an untapped resource for medical error prevention. Medical students should be trained to recognize errors and to speak up when errors occur. Those supervising students should welcome and encourage students to actively communicate observed errors and near misses and should work to eliminate all intimidation by medical hierarchy that can prevent students from being safety advocates.

Papel del azúcar como fuente de energía en el desarrollo de actividad física / No disponible

No disponible

Six years experience in intracoronary brachytherapy procedures: patient doses from fluoroscopy.

Typical patient dose levels during intracoronary brachytherapy (ICB) procedures using beta sources were determined across a sample of 221 treatments. Dose-area product values, fluoroscopy time and number of frames per procedure, with median values of 62 Gy cm2, 17.0 min and 1493 images, respectively, resulted in a 20% to 50% increase in the values measured for percutaneous transluminal coronary angioplasty procedures in the same medical centre (median values 41 Gy cm2, 14.3 min and 1078 images). Likely reasons for this increase include the additional complexity of ICB, the need for recording and reporting every step of the treatment, getting the essential parameters for the volume determination of the lesion and therapeutic radiation dose calculation and, finally, the learning curve for this kind of procedure. A high concentration skin dose distribution during ICB procedures was measured and in 12% of the patients peak skin doses higher than 1.5 Gy were confirmed. 10 patients were submitted to clinical follow-up and skin injuries were not identified.

Características de la intensidad de juego en el tenis individual masculino en edades adolescentes / Characteristics of game intensity in young male tennis players

El propósito de este estudio ha sido realizar unaaproximación a las características de la intensidadde juego en el tenis individual en edades adolescentes.Para ello se seleccionaron 10 tenistas adolescentesmasculinos, con edades comprendidasentre 14 a 17 años; peso medio de 60,16 ±1,94 kgy talla de 172 ±1,67 cm. Todos los sujetos decidieronparticipar voluntariamente en el estudio. A todoslos sujetos se les determinó en el laboratorioel Consumo Máximo de Oxígeno (VO2max), FrecuenciaCardiaca máxima (FCmáx) y FC en elumbral anaeróbico. Posteriormente, durante suparticipación en un partido oficial de tenis, se evaluóla estructura temporal de juego, así como laevolución de la FC a lo largo del partido. Los resultadosconcluyen la necesidad de considerar laimplicación cardiovascular y estructural del juegodel tenis individual en edad adolescente, para unamayor individualización del entrenamiento deportivo

The aim of the study was to assess the metabolicresponse during singles tennis play in adolescentplayers. A group of 10 male adolescent players,mean age 15.3 ±1.5 years, weight 60.16 ±1.94 kgand height 172 ± 1.67 cm volunteered for thestudy. In the laboratory, maximal oxygen uptake,maximal heart rate and heart rate during anaerobicthreshold were determined in all players. Afterwards,playing an official tennis match, timing distributionsof rally and heart rate evolution throughthe match were evaluated. The results conclude thenecessity of considering the cardiovascular andstructural implication of the individual tennis gamein adolescent age, for a better individualizationof the sport training

Efectos sobre el metabolismo anaeróbico láctico del aporte de Phlebodium decumanun y de un programa de acondicionamiento físico-salud en profesores de esquí / Effects of Ph D and/or a physical/health conditioning programme on lactic anaerobic metabolism in ski teachers

Minimizar alguno de los efectos nocivos derivados del ejercicio se plantea como objetivo principal de este estudio, donde a una muestra poblacional de profesores de esquí alpino, que no hacen más ejercicio programado que su práctica laboral, se les somete a tres tipos de tratamiento, por la manipulación de dos variables independientes: programa de acondicionamiento físico–salud, aporte de una sustancia natural considerada inmunomoduladora (Phlebodium decumanum), o ambos a la vez, durante 4 semanas consecutivas. En la investigación se estudian las respuestas a ejercicio físico intenso que puede conllevar fatiga, en acciones semejantes al gesto técnico básico del esquí alpino, antes y después del tratamiento, con un diseño factorial que permitirá analizar el efecto de cada variable por sí sola o el efecto combinado. Para ello, se definen como variables dependientes: ión amonio, lactato y test de 45 segundos del Test de Bosco. Tras realizar el análisis estadístico se observan diferencias significativas en todas las variables excepto para el amonio, pudiendo observar que los mejores resultados se obtienen en el grupo donde se asociaban ambas variables. Por ello, podemos concluir de manera general que los resultados del estudio son esperanzadores para evitar riesgos potenciales de alta intensidad

Minimizing some of the harmful slide effects of physical activity is the main aim of this research. Alpine skiing monitors who did not practise more planned exercise but their jobs. Underwent three types of treatment, manipulating two independent variables: a programme of physical-health conditioning and a supplementation with a natural substance which is considered as immunomodulator (Phlebodium decumanum), or both at the same time, for consecutive four weeks. During the research the responses to the intense physical exercise which can cause fatigue because of actions that are similar to the basic technical gesture of the alpin skiing, before and after the treatment, with a factorial design, which will let it analyse the effects of each variable alone or together. As dependent variables ammonio, lactate and Bosco’s test of 45 seconds were considered. After carring out statictical analysis significant differences in all variables except for AMONIO were found. The best results were obtained in the group where both variables were combined. We can conclude saying that the results of the research give us hopes for avoiding potencial risks of high intensity exercise

Evaluation of risk of deterministic effects in fluoroscopically guided procedures.

A methodology for the evaluation of skin dose distribution and possible skin injuries on patients undergoing interventional procedures has been developed as part of the European DIMOND programme. Relevant dosimetric data from the procedures are recorded and other specific measurements for skin dose evaluation (slow films for therapy, radiochromic films, thermoluminescence dosemeters and optically stimulated luminescence dosemeters) have been carried out. For non-cardiac and for some cardiac procedures, dose-area product values of 200 and 300 Gy cm2 were proposed, respectively, as a trigger level for further detailed skin dose investigation and possible clinical follow-up. Results from a survey of 191 selected complex procedures are reported. Out of all the patients included in the trial, 16% received skin doses > or =1.5 Gy. No skin injuries were found in any of the patients followed.

Piomiositis en músculo esternocleidomastoideo / Pyomyositis in sternocleidomastoid muscle

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