Plant-parasitic Nematodes Associated with Grasses Grown for Seed in the Willamette Valley of Oregon.

Plant-parasitic nematodes (PPN) are an understudied pathogen group in the Oregon cool-season grass seed cropping system. In this survey, the PPN associated with annual ryegrass, bentgrass, fine fescue, orchardgrass, perennial ryegrass, and tall fescue were determined. Thirty-seven fields were sampled in the 2022 or 2023 growing season by collecting 10 soil cores in each of six 100-m transects for nematode extraction and visual identification. PerMANOVA testing indicated significant differences in PPN community composition across grass host and sampling time. Pratylenchus and Meloidogyne were the most commonly encountered nematodes, with maximum population densities of 1,984 and 2,496 nematodes/100 g soil, respectively. Sequencing of the COX1 gene region indicated the presence of P. crenatus, P. fallax, P. neglectus, P. penetrans, and P. thornei, with some of these species being detected for the first time on these grass hosts. The only Meloidogyne sp. found in these grasses was M. nassi, based upon sequencing of the ITS gene region. This first-of-its-kind survey indicates the need for further assessment of the impact of these PPNs on yield and stand longevity in cool-season grass seed fields in Oregon.

Stability mapping of bipartite tight-binding graphs with losses and gain: PTPT-symmetry and beyond.

We consider bipartite tight-binding graphs composed by N nodes split into two sets of equal size: one set containing nodes with on-site loss, the other set having nodes with on-site gain. The nodes are connected randomly with probability p. Specifically, we measure the connectivity between the two sets with the parameter α, which is the ratio of current adjacent pairs over the total number of possible adjacent pairs between the sets. For general undirected-graph setups, the non-Hermitian Hamiltonian H(γ,α,N) of this model presents pseudo-Hermiticity, where γ is the loss/gain strength. However, we show that for a given graph setup H(γ,α,N) becomes PT-symmetric. In both scenarios (pseudo-Hermiticity and PT-symmetric), depending on the parameter combination, the spectra of H(γ,α,N) can be real even when it is non-Hermitian. Then we demonstrate, for both setups, that there is a well-defined sector of the γα-plane (which grows with N) where the spectrum of H(γ,α,N) is predominantly real.

Causas de la baja visión en los niños: revisión sistemática / Causes of low vision in children: A systematic review

Objetivo Identificar las enfermedades oculares que se reportan como causas de la baja visión en los niños. Material y métodos La búsqueda sistemática se realizó en Medline (PubMed), Embase y Lilacs. Se seleccionaron estudios observacionales con poblaciones entre 0-18 años de edad, que reportaran datos de agudeza visual entre 20/60-20/400, y que informaran sobre la frecuencia de enfermedades oculares. Se excluyeron los estudios en los que el diagnóstico de la condición no hubiera sido verificado por un profesional, o que abarcaran únicamente casos de ceguera, defectos refractivos no corregidos o ambliopía. La calidad metodológica de los artículos se evaluó mediante el instrumento del Instituto Joanna Briggs para estudios de prevalencia. Resultados Fueron incluidos 27 estudios realizados en Asia (13 publicaciones), África (6 estudios), Oceanía (4 estudios) y Europa y Sudamérica (2 estudios cada uno). Las causas de la baja visión más reportadas fueron: la catarata, con prevalencias comprendidas entre el 0,8 y el 27,2%; el albinismo desde el 1,1 al 47%; el nistagmo, con prevalencias entre el 1,3 y el 22%; las distrofias de retina entre el 3,5 y el 50%; la retinopatía del prematuro (ROP) con prevalencias entre el 1,1 y el 65,8%; la atrofia óptica entre el 0,2 y el 17,6% y el glaucoma entre el 2,4 y el 18,1%. Conclusiones La catarata, el albinismo y el nistagmo son las enfermedades oculares más mencionadas por los estudios como causas de la baja visión en los niños, también enfermedades de la retina tales como la ROP y del nervio óptico como la atrofia. Sin embargo, son numerosas las condiciones oculares que pueden causar la baja visión en la población pediátrica. (AU)

Objective To identify the ocular pathologies that are reported as causes of low vision in children. Material and methods The systematic search was carried out in Medline (PubMed), Embase and Lilacs. Observational studies with populations between 0-18 years of age, reporting visual acuity data between 20/60-20/400 and reporting the frequency of ocular pathologies were selected. Studies in which the diagnosis of the condition had not been verified by a professional, or which covered only cases of blindness, uncorrected refractive errors, or amblyopia, were excluded. The methodological quality of the articles was evaluated using the Joanna Briggs Institute instrument for prevalence studies. Results27 studies conducted in Asia (13 publications), Africa (6 studies), Oceania (4 studies), Europe and South America (2 studies each) were included. The most reported causes of low vision were: cataract, with prevalence between 0.8% and 27.2%; albinism with from 1.1% to 47%; nystagmus, with prevalence between 1.3% and 22%; retinal dystrophies between 3.5% and 50%; retinopathy of prematurity (ROP) with prevalence between 1.1% and 65.8%, optic atrophy between 0.2% and 17.6%, and glaucoma from 2.4% to 18.1%. Conclusions Cataract, albinism and nystagmus are the ocular pathologies most mentioned by studies as a cause of low vision in children, as well as retinal diseases such as ROP and optic nerve diseases such as atrophy. However, there are numerous eye conditions that can result in low vision in the pediatric population. (AU)

The BR-body proteome contains a complex network of protein-protein and protein-RNA interactions.

Bacterial RNP bodies (BR-bodies) are non-membrane-bound structures that facilitate mRNA decay by concentrating mRNA substrates with RNase E and the associated RNA degradosome machinery. However, the full complement of proteins enriched in BR-bodies has not been defined. Here we define the protein components of BR-bodies through enrichment of the bodies followed by mass spectrometry-based proteomic analysis. We found 111 BR-body enriched proteins, including several RNA binding proteins, many of which are also recruited directly to in vitro reconstituted RNase E droplets, showing BR-bodies are more complex than previously assumed. While most BR-body enriched proteins that were tested cannot phase separate, we identified five that undergo RNA-dependent phase separation in vitro, showing other RNP condensates interface with BR-bodies. RNA degradosome protein clients are recruited more strongly to RNase E droplets than droplets of other RNP condensates, implying that client specificity is largely achieved through direct protein-protein interactions. We observe that some RNP condensates assemble with preferred directionally, suggesting that RNA may be trafficked through RNP condensates in an ordered manner to facilitate mRNA processing/decay, and that some BR-body associated proteins have the capacity to dissolve the condensate. Finally, we find that RNA dramatically stimulates the rate of RNase E phase separation in vitro, explaining the dissolution of BR-bodies after cellular mRNA depletion observed previously. Altogether, these results suggest that a complex network of protein-protein and protein-RNA interactions controls BR-body phase separation and RNA processing.

Causes of low vision in children: A systematic review.

OBJECTIVE: To identify the ocular pathologies that are reported as causes of low vision in children. MATERIAL AND METHODS: The systematic search was carried out in Medline (PubMed), Embase and Lilacs. Observational studies with populations between 0-18 years of age, reporting visual acuity data between 20/60-20/400 and reporting the frequency of ocular pathologies were selected. Studies in which the diagnosis of the condition had not been verified by a professional, or which covered only cases of blindness, uncorrected refractive errors, or amblyopia, were excluded. The methodological quality of the articles was evaluated using the Joanna Briggs Institute instrument for prevalence studies. RESULTS: 27 studies conducted in Asia (13 publications), Africa (6 studies), Oceania (4 studies), Europe and South America (2 studies each) were included. The most reported causes of low vision were: cataract, with prevalence between 0.8% and 27.2%; albinism with from 1.1% to 47%; nystagmus, with prevalence between 1.3% and 22%; retinal dystrophies between 3.5% and 50%; retinopathy of prematurity (ROP) with prevalence between 1.1% and 65.8%, optic atrophy between 0.2% and 17.6%, and glaucoma from 2.4% to 18.1%. CONCLUSIONS: Cataract, albinism and nystagmus are the ocular pathologies most mentioned by studies as a cause of low vision in children, as well as retinal diseases such as ROP and optic nerve diseases such as atrophy. However, there are numerous eye conditions that can result in low vision in the pediatric population.

Examining if the relationship between BMI and incident type 2 diabetes among middle-older aged adults varies by race/ethnicity: evidence from the Multi-Ethnic Study of Atherosclerosis (MESA).

AIMS: Disparities persist on the prevalence of undiagnosed type 2 diabetes in racial/ethnic minorities in the USA. This study evaluated the association between BMI and incident type 2 diabetes risk by racial/ethnic group, to determine whether BMI and presence of type 2 diabetes risk factors may help clinicians better target type 2 diabetes screening. METHODS: This prospective cohort analysis included 5659 adults free of type 2 diabetes at baseline from the Multi-Ethnic Study of Atherosclerosis (MESA), a population-based cohort (2000-2011). BMI was measured at baseline and time-updated at subsequent visits. Incident type 2 diabetes was defined as fasting glucose ≥ 7.0 mmol/l, or use of any diabetes medications. RESULTS: The mean (sd) age was 62 (10) years and 42% of participants were white, 26% African American, 20% Hispanic and 12% Chinese American. During follow-up, 696 (12%) new type 2 diabetes cases were observed. In age- and sex-adjusted models, in the presence of one or more type 2 diabetes risk factors (the most common scenario), a 10% risk of incident type 2 diabetes was observed at a BMI of 21.7 kg/m2 [95% confidence interval (CI) 20.1 to 22.8] in Chinese Americans, 23.8 kg/m2 (22.7 to 24.9) in Hispanics, 24.7 kg/m2 (23.7 to 25.6) in African Americans and 26.2 kg/m2 (25.1 to 26.9) in white participants. CONCLUSIONS: This study supports including BMI and presence of type 2 diabetes risk factors as action points for clinicians to prioritize which adults aged ≥ 45 years should be screened. The application of race/ethnicity-specific BMI thresholds may reduce the disparity of undiagnosed type 2 diabetes observed in minority groups.

Magnetic vortex nucleation and annihilation in bi-stable ultra-small ferromagnetic particles.

Vortex-mediated magnetization reversal in individual ultra-small (∼100 nm) ferromagnetic particles at low temperatures is studied by nanoSQUID magnetometry. At zero applied bias field, the flux-closure magnetic state (vortex) and the quasi uniform configuration are bi-stable. This stems from the extremely small size of the nanoparticles that lies very close to the limit of single-domain formation. The analysis of the temperature-dependent (from 0.3 to 70 K) hysteresis of the magnetization allows us to infer the nature of the ground state magnetization configuration. The latter corresponds to a vortex state as also confirmed by electron holography experiments. Based on the simultaneous analysis of the vortex nucleation and annihilation data, we estimate the magnitude of the energy barriers separating the quasi single-domain and the vortex state and their field dependence. For this purpose, we use a modified power-law scaling of the energy barriers as a function of the applied bias field. These studies are essential to test the thermal and temporal stability of flux-closure states stabilized in ultra-small ferromagnets.

Highly porous multiwalled carbon nanotube buckypaper using electrospun polyacrylonitrile nanofiber as a sacrificial material.

Polyacrylonitrile (PAN) was solubilized in N,N-dimethyl formamide (DMF) and the electrospinning process has been employed to obtain PAN nanofibers (PF). Multiwalled carbon nanotubes (MWCNT) were dispersed with the aid of Triton X-100 surfactant and subsequently centrifugated. Buckypapers (BP/PF) were prepared by vacuum filtration procedure of MWCNT suspension supernatant stacking four PF layers over a nylon membrane. The PF removal was carried out by immersing the BP/PF system in DMF and removal periods of 10 and 30 min were evaluated. Scanning electron microscopy (SEM) has not shown any PAN residue in the MWCNT network resulting in highly porous BP. However, by Fourier transform infrared spectroscopy (FT-IR) a PAN band was found around of 2243 cm-1 corresponding to nitrile group (C≡N). Besides, PAN leftover was evidenced by thermogravimetric analysis (TGA), high-resolution transmission electron microscopy (HR-TEM), electrical characterization through four-point probe, nitrogen adsorption at 77 K, and X-ray diffraction (XRD).

Utilization and safety of proton-pump inhibitors and histamine-2 receptor antagonists in children and adolescents: an observational cohort study.

BACKGROUND: Little is known about the use of acid-suppressing treatments and related safety events in children. OBJECTIVE: This study compared patient characteristics and safety outcomes among children prescribed acid-suppressing drugs for the first time. METHODS: The Health Improvement Network was used to determine the characteristics of children prescribed a proton pump inhibitor (PPI; esomeprazole or another PPI) or a histamine-2 receptor antagonist (H2RA) by UK primary care physicians between October 2009 and September 2012. Pre-defined safety outcomes were compared among the treatment groups in up to 18 months of follow-up. RESULTS: The cohorts comprised 8,172 patients on PPIs (including 24 patients on esomeprazole) and 7,905 on H2RAs. The baseline characteristics were similar between cohorts, although the children in the PPI cohorts tended to be older. No safety outcomes occurred in the esomeprazole cohort. In the other-PPIs cohort, 92 safety outcomes occurred, most commonly gastroenteritis (n = 36; 39.1%). In the H2RAs cohort, 193 safety outcomes occurred, most commonly gastroenteritis (n = 62; 32.1%). The incidence of most safety outcomes was higher in the H2RAs cohort than in the other-PPIs cohort, including failure to thrive (3.11 [95% confidence interval (CI) = 2.25-4.28] vs 0.49 per 1,000 person-years [95% CI = 0.22-1.07]) and gastroenteritis (5.27 [95% CI = 4.11-6.75] vs 3.04 per 1,000 person-years [95% CI = 2.20-4.20]). CONCLUSION: Esomeprazole is rarely prescribed to children when they first require acid-suppressing medication, compared with other PPIs/H2RAs. Overall, more safety outcomes occurred in the H2RAs cohort than in the PPI cohorts.

Competition between Superconductor - Ferromagnetic stray magnetic fields in YBa2Cu3O7-x films pierced with Co nano-rods.

Superconductivity and ferromagnetism are two antagonistic phenomena that combined can lead to a rich phenomenology of interactions, resulting in novel physical properties and unique functionalities. Here we propose an original hybrid system formed by a high-temperature superconducting film, patterned with antidots, and with ferromagnetic nano-rods grown inside them. This particular structure exhibits the synergic influence of superconductor (SC) - ferromagnetic (FM) stray fields, in both the superconducting behaviour of the film and the three-dimensional (3D) magnetic structure of nano-rods. We show that FM stray fields directly influence the critical current density of the superconducting film. Additional functionalities appear due to the interaction of SC stray fields, associated to supercurrent loops, with the non-trivial 3D remanent magnetic structure of FM nano-rods. This work unravels the importance of addressing quantitatively the effect of stray magnetic fields from both, the superconductor and the ferromagnet in hybrid magnetic nano-devices based on high temperature superconductors.

Inhomogeneous spatial distribution of the magnetic transition in an iron-rhodium thin film.

Monitoring a magnetic state using thermal or electrical activation is mandatory for the development of new magnetic devices, for instance in heat or electrically assisted magnetic recording or room-temperature memory resistor. Compounds such as FeRh, which undergoes a magnetic transition from an antiferromagnetic state to a ferromagnetic state around 100 °C, are thus highly desirable. However, the mechanisms involved in the transition are still under debate. Here we use in situ heating and cooling electron holography to quantitatively map at the nanometre scale the magnetization of a cross-sectional FeRh thin film through the antiferromagnetic-ferromagnetic transition. Our results provide a direct observation of an inhomogeneous spatial distribution of the transition temperature along the growth direction. Most interestingly, a regular spacing of the ferromagnetic domains nucleated upon monitoring of the transition is also observed. Beyond these findings on the fundamental transition mechanisms, our work also brings insights for in operando analysis of magnetic devices.

Incidence of intracranial bleeds in new users of low-dose aspirin: a cohort study using The Health Improvement Network.

Essentials Intracranial bleeds (ICB) are serious clinical events that have been associated with aspirin use. Incidence rates of ICB were calculated among new-users of low-dose aspirin in the UK (2000-2012). Over a median follow-up of 5.58 years, the incidence of ICB was 0.08 per 100 person-years. Our estimates are valuable for inclusion in risk-benefit assessments of low-dose aspirin use. SUMMARY: Background Low-dose aspirin protects against both ischemic cardiovascular (CV) events and colorectal cancer (CRC). However, low-dose aspirin may be associated with a slightly increased risk of intracranial bleeds (ICBs). Objectives To obtain the incidence rates of ICBs overall and by patient subgroups among new users of low-dose aspirin. Patients/Methods Using The Health Improvement Network (THIN) UK primary-care database (2000-2012), we identified a cohort of new users of low-dose aspirin aged 40-84 years (N = 199 079; mean age at start of follow-up, 63.9 years) and followed them for up to 14 years (median 5.58 years). Incident ICB cases were identified and validated through linkage to hospitalization data and/or review of THIN records with free-text comments. Incidence rates with 95% confidence intervals (CIs) were calculated. Results Eight hundred and eighty-one incident ICBs cases were identified: 407 cases of intracerebral hemorrhage (ICH), 283 cases of subdural hematoma (SDH), and 191 cases of subarachnoid hemorrhage (SAH). Incidence rates per 100 person-years were 0.08 (95% CI 0.07-0.08) for all ICBs, 0.04 (95% CI 0.03-0.04) for ICH, 0.03 (95% CI 0.02-0.03) for SDH, and 0.02 (95% CI 0.01-0.02) for SAH. The ICB incidence rates per 100 person-years for individuals with an indication of primary CV disease prevention were 0.07 (95% CI 0.06-0.07) and 0.09 (95% CI 0.08-0.10) for secondary CV disease prevention. Incidence rates were higher in men for SDH, and higher in women for ICH and SAH. Conclusions Our results provide valuable estimates of the absolute ICB risk for incorporation into risk-benefit assessments of low-dose aspirin use.

Risk factors for diabetic macular oedema in type 2 diabetes: A case-control study in a United Kingdom primary care setting.

AIM: To identify risk factors associated with the development of DMO among patients diagnosed with type 2 diabetes managed in a primary care setting in the UK. METHODS: A case-control study nested in a cohort of incident Type 2 diabetes identified in The Health Improvement Network database from 2000-2007. Cases were people with DMO (N=211) and controls were a DMO-free sample (N=2194). No age restrictions were applied. Adjusted odds ratios and 95%CIs were estimated (OR; 95%CI). RESULTS: DMO increased with high alcohol use (2.88; 1.49-5.55), cataracts (4.10; 2.73-6.15), HbA1c ≥7% (1.58; 1.08-2.32), systolic blood pressure ≥160mm Hg (2.03; 1.17-3.53), total cholesterol ≥5mmol/L (1.66; 1.15-2.39), LDL ≥3mmol/L (1.73; 1.14-2.61), and microalbuminuria (1.78; 1.16-2.73). Diuretic drugs were associated with a reduced risk of DMO (0.68; 0.47-0.99), as did smoking (0.47; 0.28-0.77), overweight (0.53; 0.30-0.96) or obesity (0.52; 0.30-0.91) at diabetes diagnosis, and high triglyceride levels (0.51; 0.35-0.74). Patients treated with anti-diabetic drugs showed higher risk of DMO than non-treated patients, particularly those with sulphonylureas (3.40; 2.42-4.78), insulin (3.21; 1.92-5.36) or glitazones (1.88; 1.17-3.04). CONCLUSION: In patients with type 2 diabetes managed in primary care, multiple factors associated with DMO were identified, such as cataracts, microalbuminuria and high levels of HbA1c, systolic BP, total cholesterol, and LDL. Diuretic drugs were associated with a reduced risk of DMO. Treated diabetes, particularly with sulphonylureas, insulin or glitazones showed highest risk of DMO. The inverse association between smoking, obesity, and triglycerides and DMO deserves further research.

Friction force regimes and the conditions for endless penetration of an intruder into a granular medium.

An intruder penetrating into a granular column experiences a depth-dependent friction force F(z). Different regimes of F(z) have been measured depending on the experimental design: a nearly linear dependence for shallow penetrations, total saturation at large depths, and an exponential increase when the intruder approaches the bottom of the granular bed. We report here an experiment that allows us to measure the different regimes in a single run during the quasistatic descent of a sphere in a light granular medium. From the analysis of the resistance in the saturation zone, it was found that F(z) follows a cube-power-law dependence on the intruder diameter and an exponential increase with the packing fraction of the bed. Moreover, we determine the critical mass m_{c} required to observe infinite penetration and its dependence on the above parameters. Finally, we use our results to estimate the final penetration depth reached by intruders of masses m

Exposure to acid-suppressing drugs during pregnancy and the risk of asthma in childhood: an observational cohort study.

BACKGROUND: Some research has suggested a potential link between prenatal exposure to proton pump inhibitors (PPIs) or H2 -receptor antagonists (H2 RAs) and the development of childhood asthma. AIM: To quantify the relative risk of asthma in children who experienced pre-natal exposure to PPIs and/or H2 RAs, adjusting for potential confounders. METHODS: In this observational cohort study (NCT01787435), women aged 18-45 years with completed pregnancies between January 1996 and December 2010 were identified from The Health Improvement Network in the United Kingdom, and were linked to infants. Hazard ratios (HRs) were estimated using Cox proportional hazard models. RESULTS: Our analysis identified 2371 prenatally exposed and 7745 unexposed infants. The incidence of asthma (per 1000 person-years) was 19.52 in the unexposed cohort, 23.88 in the PPI cohort and 32.16 in the H2 RA cohort. After adjusting for maternal healthcare utilisation during the year before pregnancy, the HR for asthma in infants whose mothers received prescriptions at any time during pregnancy was 1.12 (95% confidence interval: 0.88-1.44) for PPIs and 1.43 (1.20-1.70) for H2 RAs, when compared with unexposed infants. With further adjustment for maternal comorbidities and other medications, the HR for asthma was 1.03 (0.76-1.40) for PPIs and 1.32 (1.05-1.64) for H2 RAs. CONCLUSIONS: Our analysis showed no association between prenatal exposure to PPIs and asthma in childhood after adjusting for confounders. The association found for H2 RAs may be explained largely by underlying environmental or genetic factors, as suggested by reductions in hazard ratio estimates following adjustment for maternal comorbidities.

Peptic Ulcer Bleeding Risk. The Role of Helicobacter Pylori Infection in NSAID/Low-Dose Aspirin Users.

OBJECTIVES: Helicobacter pylori (H. pylori) infection and NSAID/low-dose aspirin (ASA) use are associated with peptic ulcer disease. The risk of peptic ulcer bleeding (PUB) associated with the interaction of these factors remains unclear. The objective of this study was to determine the risk of PUB associated with the interaction between H. pylori infection and current nonsteroidal anti-inflammatory drugs (NSAIDs) or low-dose ASA use. METHODS: This was a case-control study of consecutive patients hospitalized because of PUB. Controls were matched by age, sex, and month of admission. H. pylori infection status was determined in all cases and controls by serology. Drug use was determined by structured questionnaire. Adjusted relative risk (RR) associated with different factors, and the interaction between NSAID/ASA and H. pylori infection was estimated by logistic regression analysis. RESULTS: The study included 666 cases of PUB and 666 controls; 74.3% cases and 54.8% controls (RR: 2.6; 95% confidence interval (CI): 2.0-3.3) tested positive for H. pylori infection; 34.5% of cases had current NSAID use compared with 13.4% of controls (RR: 4.0; 95% CI: 3.0-5.4). Respective proportions for low-dose ASA use were 15.8 and 12%, respectively (RR: 1.9; 95% CI: 1.3-2.7). The RR of PUB for concomitant NSAID use and H. pylori infection suggested an additive effect (RR: 8.0; 95% CI: 5.0-12.8), whereas no interaction was observed with ASA use (RR: 3.5; 95% CI: 2.0-6.1). CONCLUSIONS: NSAID, low-dose ASA use, and H. pylori infection are three independent risk factors for the development of PUB, but there were differences in the interaction effect between low-dose ASA (no interaction) or NSAID (addition) use and H. pylori infection, which may have implications for clinical practice in prevention strategies.

Risk of ischemic stroke associated with non-steroidal anti-inflammatory drugs and paracetamol: a population-based case-control study.

OBJECTIVE: To assess the risk of non-fatal ischemic stroke associated with non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol. The effects of dose, duration of treatment, background cardiovascular (CV) risk and use of concomitant aspirin were studied. METHODS: We performed a population-based case-control study. Patients were considered exposed if they were on treatment within a 30-day window before the index date. We estimated adjusted odds ratios (ORs) and their 95% confidence intervals (CIs) using logistic regression. RESULTS: Two thousand eight hundred and eighty-eight cases and 20 000 controls were included. No increased risk was observed with traditional NSAIDs as a group (OR = 1.03; 95% CI, 0.90-1.19), but results varied across individual agents and conditions of use. An increased risk was found with diclofenac (OR = 1.53; 95% CI, 1.19-1.97), in particular when used at high doses (OR = 1.62; 1.06-2.46), over long-term periods (> 365 days; OR = 2.39; 1.52-3.76) and in patients with a high background CV risk (OR = 1.78; 1.23-2.58), as well as with aceclofenac when used at high doses (OR = 1.67; 1.05-2.67), in long-term treatments (OR = 2.00; 1.14-3.53) and in patients with CV risk factors (OR = 2.33; 1.40-3.87). No association was found with ibuprofen (OR = 0.94; 0.76-1.17) or naproxen (OR = 0.68; 0.36-1.29). The concomitant use of aspirin did not show a significant effect modification. Paracetamol did not increase the risk overall (OR = 0.97; 0.85-1.10) or in patients at high CV risk (OR = 0.94; 0.78-1.14). CONCLUSIONS: Diclofenac and aceclofenac increase the risk of ischemic stroke while ibuprofen and naproxen do not. Dose, duration and baseline CV risk, but not aspirin use, appear to modulate the risk. Paracetamol does not increase the risk, even in patients with a high background CV risk.

Giant hepatic hemangioma versus conventional hepatic hemangioma: clinical findings, risk factors, and management.

BACKGROUND: Giant hepatic hemangiomas (GHHs) are those that are larger than 4 cm in size. AIMS: The aim of this study was to describe GHH clinical findings, their risk factors, diagnostic approach and management, and to compare these data with those of conventional hemangiomas. METHODS: We performed a retrospective analysis of patients diagnosed with hemangiomas, whether by imaging studies or histopathology, at our hospital within the time frame of 1990-2008. The medical records of each patient were reviewed to obtain clinical and surgical data. RESULTS: Of the 57 patients with liver hemangioma, 41 (72%) were women and 32 (56%) had GHH. Liver hemangioma median size was 4.49 cm. In regard to the patients with GHH, 31.2% were asymptomatic and when symptoms presented, pain was the most common. Both symptoms and oral contraceptive exposure were more common in the GHH patients. Nine patients with GHH underwent surgery: 2 open biopsies due to diagnostic uncertainty, one enucleation, and 6 resections. CONCLUSIONS: GHHs are more prevalent in women and when symptomatic, pain is the most frequent complaint. Diagnosis is usually made through imaging studies, but when there is diagnostic doubt, surgical exploration is sometimes needed. Oral contraceptive use is most likely more of a risk factor for GHH than for conventional hemangioma, but this association needs to be studied further.

High-resolution imaging of remanent state and magnetization reversal of superdomain structures in high-density cobalt antidot arrays.

Remanent state and magnetization reversal processes of a series of cobalt antidot arrays with a fixed hole diameter (d ≈ 55 nm) and an array periodicity (p) ranging between 95 and 524 nm were studied by in situ Lorentz microscopy (LM) as a function of the magnetic field. At remanence, defocused LM images showed the periodicity dependence of the magnetic states inside the lattice. A remarkable transition was observed in the type of domain structures as a function of p: for the large periodicities (p > 300 nm), conventional 90° and 180° domain walls were formed, whereas in small-period antidot arrays (p â‰¦ 160 nm) magnetic superdomain walls (SDWs) were nucleated to separate regions with different average magnetization direction, the so-called magnetic superdomains. In the SDW regime, a low-frequency Fourier filtering method was implemented to allow a quantitative analysis of the LM images by the transport of intensity equation method. In situ LM experiments under applied magnetic fields were performed to study the reversal magnetization process in a particular array (p = 160 nm), and clear differences were observed as a function of the magnetic field orientation. The switching process under magnetic fields parallel to the horizontal antidot rows occurs in two stages: the system first nucleates and propagates horizontal SDWs, parallel to the field. Then, at higher magnetic fields, vertical SDWs, perpendicular to the field, appear before saturation. When the magnetic field is applied at 45° with respect to the antidot rows, both horizontal and vertical SDWs are nucleated and propagated simultaneously. All the experiments were successfully correlated with micromagnetic simulations. The current study sheds new light on the magnetization reversal processes of antidot arrays and opens new possibilities of exploiting the potential of high-resolution in situ LM and new data analysis procedures to probe magnetization processes in nanomagnetism, particularly in periodic arrays of nanomagnets.

Manejo del dolor crónico en Atención Primaria, perfil de prescripción de opiáceos mayores: indicación, coste y efectos secundarios / Managing chronic pain in Primary Care, prescription profile for strong opioids: indications, cost and adverse effects

Objetivos: el objetivo principal del estudio es conocer las características de la prescripción de opiáceos mayores en Atención Primaria. Material y métodos: se diseña un estudio retrospectivo mediante una cohorte histórica, valorando a los pacientes que hayan consumido opiáceos mayores en todos los centros de salud de Jaén capital durante 2011, mediante un muestreo sistemático, 215 pacientes, calculando el tamaño de muestra para un nivel de confianza 95 %, precisión 5 %, y pérdidas 5 % (ampliando la muestra este 5 % por sesgo de información); Se auditan las historias clínicas recogiendo: edad, sexo, antecedentes personales, nivel social, frecuentación sanitaria, características de la prescripción de opiáceos (dosis, duración, coste, efectos secundarios) y uso de otros analgésicos/coadyuvantes. Se procesan los datos para ofrecer un estudio descriptivo y una posterior comparación en función del opiáceo prescrito. Resultados: se valoran 215 pacientes (44 % del total de la población), de los que se obtienen 323 prescripciones de opiáceos en el año de estudio (23 % de la muestra con dos prescripciones de opiáceos y 13 % con tres). Los opiáceos más prescritos son fentanilo (60 %) y buprenorfina (22%), por un 3 % de morfina. La buprenorfina es el más usado en monoterapia (70 %), preferentemente en mujeres de edad avanzada y pensionistas, sobre todo para el dolor mixto por parte del médico de familia. El fentanilo se usa principalmente en parches (95 % de las prescripciones de fentanilo) y la hidromorfona se emplea en pacientes de menor edad (< 60 años), prescrito por la Unidad del Dolor y Reumatología (43 % y 20 % del total de prescripciones, respectivamente). La oxicodona se emplea más en pacientes de zonas necesitadas de transformación social (46 % del total de opioides prescritos en ZNTS) y exclusivamente para el dolor neuropático y mixto (52 % y 48 % respectivamente de las prescripciones totales de oxicodona), sobre todo por parte de Reumatología y Unidad del Dolor (25 % y 43 % del total de prescripciones respectivamente). La morfina se emplea en pacientes oncológicos por vía oral (46 % de las prescripciones de morfina), la mitad en formulación retard (45 % de las prescripciones de morfina), siendo estos pacientes quienes presentan una demanda sanitaria superior (91 % del total de pacientes con prescripción de morfina, acuden al servicio de urgencias, y un 46 % precisan ingreso hospitalario). Conclusiones: como medida de mejora, contrastando los resultados obtenidos, se debería fomentar la prescripción de morfina como analgésico de elección tanto en dolor agudo como en dolor crónico severo. Es preciso mejorar los instrumentos de medida específicos para cada tipo de dolor teniendo en cuenta la etiopatogenia de este, así como fomentar una mayor utilización de escalas de valoración, tanto al inicio del tratamiento, como durante el seguimiento de cada paciente para evaluar la evolución del dolor y la efectividad del tratamiento (AU)

Objectives: The main objective of the study was to determine the characteristics of major opioids prescribing in Primary Care. Material and methods: A retrospective study was designed through the use of a historical cohort, assessing patients who have consumed major opiates in all Jaén city health centers during 2011, by systematic sampling, 215 patients, computing the sample size for a confidence level of 95 %, accuracy 5 %, 5 % losses (expanding the 5 % sample by reporting bias). Medical records were audited to collect the following data: Age, sex, medical history, social status, number of appointments and use of hospital resources, characteristics of opioids prescription (dose, duration, cost, adverse reaction) and use of other analgesics/ adjuvants. Data were processed for a descriptive study and a subsequent comparison according to the prescribed opioid. Results: 215 patients were included (44 % of total population) those obtained 323 prescriptions for opiates in the study year (23 % of the sample with two prescriptions of opiates and 13 % with three). Most prescribed opioids were fentanyl (60 %) and buprenorphine (22 %) and the least prescribed is by 3 % morphine. Buprenorphine is the most used in monotherapy (70 %), preferably in older women and pensioners, especially for joint pain by the general practitioner. The fentanyl is mainly used in patches (95 % of prescriptions of fentanyl) and hydromorphone is used in younger patients (< 60 years), prescribed by the Pain and Rheumatology Departments (43 % and 20 % of total prescriptions, respectively). Oxycodone is used in patients from areas with social transformation needs (46 % of prescribed opioids in ZNTS) and exclusively for neuropathic and mixed pain (52 % and 48 % respectively of total prescriptions of oxycodone), especially by the Rheumatology and Pain Unit. Morphine is used orally in cancer patients (46 % of prescriptions for morphine), half in retard formulation (45 % of prescriptions for morphine), and these patients were who have a higher healthcare demands (91 % of totals patients prescribed morphine, go to the emergency department, and 46 % required hospital admission). Conclusions: As improvement measure, after contrasting the results, we should encourage the prescription of morphine as an analgesic of choice in both acute and chronic severe pain. An improvement in the measuring instruments specific to each type of pain considering its pathogenesis is required, as well as fostering a greater use of rating scales, both at the start of treatment and during the follow-up of each patient to assess the evolution of pain and treatment effectiveness (AU)