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1.
J Chem Phys ; 158(17)2023 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-37139999

RESUMO

The non-exponential character of the structural relaxation is considered one of the hallmarks of the glassy dynamics, and in this context, the relatively narrow shape observed by dielectric techniques for polar glass formers has attracted the attention of the community for long time. This work addresses the phenomenology and role of specific non-covalent interactions in the structural relaxation of glass-forming liquids by the study of polar tributyl phosphate. We show that dipole interactions can couple to shear stress and modify the flow behavior, preventing the occurrence of the simple liquid behavior. We discuss our findings in the general framework of glassy dynamics and the role of intermolecular interactions.

2.
Rev. clín. esp. (Ed. impr.) ; 222(7): 393-400, ago. - sept. 2022. tab
Artigo em Espanhol | IBECS | ID: ibc-207421

RESUMO

Introducción En julio del 2020 se presentó en el Congreso de los Diputados español una propuesta de ley que proponía que la formación médica continuada se financiase exclusivamente por las Administraciones públicas, prohibiendo la participación privada. Objetivos Recoger la opinión de médicos y farmacéuticos sobre la propuesta de ley, conocer qué piensan acerca de la financiación de la formación médica continuada y su posible conflicto de interés. Métodos Estudio descriptivo transversal a través de una encuesta de opinión, voluntaria y anonimizada, dirigida a médicos y farmacéuticos hospitalarios. Resultados Se analizan 435 encuestas, el 59,8% de mujeres. El 87,6% son facultativos especialistas y el 77,2% pertenece a especialidades médicas. El 55,2% no está de acuerdo con la propuesta de ley. El 92,4% se muestra de acuerdo con que el Estado y las instituciones privadas subvencionen la formación de sus trabajadores. El 54,2% está en desacuerdo con que cada profesional financie su formación, mientras que el 14% está de acuerdo. El 19,8% no se ha sentido cómodo cuando le han financiado un curso o congreso y el 74,5% considera que la participación privada de la financiación no influye en la prescripción. Conclusiones La mayoría de los encuestados no está de acuerdo con una propuesta de ley que pretende prohibir que la industria farmacéutica financie la formación médica continuada. Casi todos se muestran de acuerdo con que el Estado y las instituciones privadas subvencionen la formación de sus trabajadores. En general, los encuestados no detectan conflictos de interés en su relación con la industria (AU)


Introduction In July 2020, a draft bill was introduced in Spain's Congress which proposed that continuing medical education be funded exclusively by the Spanish government, barring involvement from private entities. Aims This work aims to gather physicians’ and pharmacists’ opinions on this draft bill, learn what they think about the funding of continuing medical education and possible conflicts of interest. Methods This work is a descriptive cross-sectional study conducted via voluntary anonymous surveys aimed at physicians and hospital pharmacists. Results Four hundred thirty-five surveys were analyzed, 59.8% of which were from women. Of the respondents, 87.6% were specialist physicians and 77.2% were part of a specialist department. A total of 55.2% did not agree with the draft bill while 92.4% agreed that the government and private institutes should subsidize training for their workers. Furthermore, 52.4% disagreed that each professional should pay for his or her own training while 14% agreed they should. A total of 19.8% have felt uncomfortable when a course or conference has been paid for by another entity and 74.5% believe that the involvement of private entities in funding does not influence prescribing. Conclusions The majority of those surveyed did not agree with a draft bill aimed at prohibiting the pharmaceutical industry from funding continuing medical education. Nearly all agreed that the government and private institutions should fund training for their workers. In general, those surveyed did not find conflicts of interest in their relationship with the industry (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Atitude do Pessoal de Saúde , Educação Médica Continuada , Indústria Farmacêutica , Conflito de Interesses , Inquéritos e Questionários , Estudos Transversais
3.
Arch. Soc. Esp. Oftalmol ; 97(7): 376-380, jul. 2022. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-209068

RESUMO

Objetivo Evaluar la presencia de epiteliopatía en limpiaparabrisas en pacientes con blefaroespasmo o espasmo hemifacial antes del tratamiento habitual con toxina botulínica y 4 semanas después. Métodos Estudio prospectivo compuesto por 31 ojos de 20 pacientes con diagnóstico neurológico de espasmo hemifacial (9 ojos de 9 pacientes) y blefaroespasmo esencial (22 ojos de 11 pacientes). Se evaluaron antes y 4 semanas después de la infiltración con toxina botulínica diversos parámetros de superficie ocular con el cuestionario OSDI, test de Schirmer, tiempo de rotura lagrimal y tinciones de fluoresceína y verde de lisamina valoradas con el test de Oxford y el grado de afectación del limpiaparabrisas palpebral. Resultados El 100% de los pacientes presentaron afectación del limpiaparabrisas palpebral antes (30% grado leve y 70% moderado) y después del tratamiento con toxina (100% grado leve). El 75% de los pacientes presentaron un OSDI normal-leve antes del tratamiento; después del tratamiento fue del 80%. El tiempo de rotura lagrimal fue de 7,2±0,2 s antes y de 7,5±0,7 s después del tratamiento. El test de Schirmer fue de 11,4±5,5 y 12,5±5,5mm antes y después del tratamiento. El test de Oxford resultó patológico inicialmente en el 69,3% de los pacientes; tras 4 semanas solo fue patológico en el 54%. Conclusión La epiteliopatía en limpiaparabrisas está presente en el 100% de los pacientes con blefaroespasmo o espasmo hemifacial. El principal mecanismo fisiopatológico que la desencadena en estos pacientes es el aumento en el coeficiente de fricción, ya que el volumen y la estabilidad lagrimal son normales (AU)


Objective To evaluate the presence of wiper epitheliopathy in patients with blepharospasm and/or hemifacial spasm before and 4 weeks after routine treatment with botulinum toxin. Methods Prospective study comprising 31 eyes of 20 patients with neurological diagnosis of hemifacial spasm (9 eyes of 9 patients) and essential blepharospasm (22 eyes of 11 patients). Various ocular surface parameters were assessed before and 4 weeks after infiltration with botulinum toxin using the OSDI questionnaire, Schirmer's test, tear break-up time, fluorescein and lissamine green staining assessed with the Oxford test and the degree of involvement of the palpebral wiper. Results 100% of the patients had palpebral wiper involvement before (30% mild and 70% moderate) and after toxin treatment (100% mild). 75% of patients had mild-normal OSDI before treatment, after treatment it was 80%. The tear break-up time was 7.2±0.2 sg before and 7.5±0.7 sg after treatment. Schirmer's test was 11.4±5.5 and 12.5±5.5mm before and after treatment. The Oxford test was initially pathological in 69.3% of patients, after 4 weeks it was pathological in only 54%. Conclusion Wiper epitheliopathy is present in 100% of patients with blepharospasm and/or hemifacial spasm. The main pathophysiological mechanism that triggers it in these patients is the increase in the coefficient of friction, as tear volume and stability are norma (AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Blefarospasmo/complicações , Blefarospasmo/tratamento farmacológico , Toxinas Botulínicas Tipo A/uso terapêutico , Espasmo Hemifacial/complicações , Espasmo Hemifacial/tratamento farmacológico , Índice de Gravidade de Doença , Estudos Longitudinais , Estudos Prospectivos
4.
Rev Clin Esp (Barc) ; 222(7): 393-400, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35637092

RESUMO

INTRODUCTION: In July 2020, a draft bill was introduced in Spain's Congress which proposed that continuing medical education be funded exclusively by the Spanish government, barring involvement from private entities. AIMS: This work aims to gather physicians' and pharmacists' opinions on this draft bill, learn what they think about the funding of continuing medical education and possible conflicts of interest. METHODS: This work is a descriptive cross-sectional study conducted via voluntary anonymous surveys aimed at physicians and hospital pharmacists. RESULTS: Four hundred thirty-five surveys were analyzed, 59.8% of which were from women. Of the respondents, 87.6% were specialist physicians and 77.2% were part of a specialist department. A total of 55.2% did not agree with the draft bill while 92.4% agreed that the government and private institutes should subsidize training for their workers. Furthermore, 52.4% disagreed that each professional should pay for his or her own training while 14% agreed they should. A total of 19.8% have felt uncomfortable when a course or conference has been paid for by another entity and 74.5% believe that the involvement of private entities in funding does not influence prescribing. CONCLUSIONS: The majority of those surveyed did not agree with a draft bill aimed at prohibiting the pharmaceutical industry from funding continuing medical education. Nearly all agreed that the government and private institutions should fund training for their workers. In general, those surveyed did not find conflicts of interest in their relationship with the industry.


Assuntos
Educação Médica Continuada , Medicina , Atitude do Pessoal de Saúde , Estudos Transversais , Indústria Farmacêutica , Feminino , Humanos , Masculino
5.
Arch Soc Esp Oftalmol (Engl Ed) ; 97(7): 376-380, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35292220

RESUMO

OBJECTIVE: To evaluate the presence of wiper epitheliopathy in patients with blepharospasm and/or hemifacial spasm before and 4 weeks after routine treatment with botulinum toxin. METHODS: Prospective study comprising 31 eyes of 20 patients with neurological diagnosis of hemifacial spasm (9 eyes of 9 patients) and essential blepharospasm (22 eyes of 11 patients). Various ocular surface parameters were assessed before and 4 weeks after infiltration with botulinum toxin using the OSDI questionnaire, Schirmer's test, tear break-up time (BUT), fluorescein and lissamine green staining assessed with the Oxford test and the degree of involvement of the palpebral wiper. RESULTS: 100% of the patients had palpebral wiper involvement before (30% mild and 70% moderate) and after toxin treatment (100% mild). 75% of patients had mild-normal OSDI before treatment, after treatment it was 80%. The BUT was 7.2 ±â€¯0.2 sg before and 7.5 ±â€¯0.7 sg after treatment. Schirmer's test was 11.4 ±â€¯5.5 and 12.5 ±â€¯5.5 mm before and after treatment. The Oxford test was initially pathological in 69.3% of patients, after 4 weeks it was pathological in only 54%. CONCLUSION: Wiper epitheliopathy is present in 100% of patients with blepharospasm and/or hemifacial spasm. The main pathophysiological mechanism that triggers it in these patients is the increase in the coefficient of friction, as tear volume and stability are normal.


Assuntos
Blefarospasmo , Toxinas Botulínicas Tipo A , Espasmo Hemifacial , Blefarospasmo/complicações , Blefarospasmo/tratamento farmacológico , Toxinas Botulínicas Tipo A/uso terapêutico , Pálpebras , Espasmo Hemifacial/complicações , Espasmo Hemifacial/tratamento farmacológico , Humanos , Estudos Prospectivos
6.
Nat Commun ; 12(1): 4762, 2021 08 06.
Artigo em Inglês | MEDLINE | ID: mdl-34362934

RESUMO

Self-propelling microparticles are often proposed as synthetic models for biological microswimmers, yet they lack the internally regulated adaptation of their biological counterparts. Conversely, adaptation can be encoded in larger-scale soft-robotic devices but remains elusive to transfer to the colloidal scale. Here, we create responsive microswimmers, powered by electro-hydrodynamic flows, which can adapt their motility via internal reconfiguration. Using sequential capillary assembly, we fabricate deterministic colloidal clusters comprising soft thermo-responsive microgels and light-absorbing particles. Light absorption induces preferential local heating and triggers the volume phase transition of the microgels, leading to an adaptation of the clusters' motility, which is orthogonal to their propulsion scheme. We rationalize this response via the coupling between self-propulsion and variations of particle shape and dielectric properties upon heating. Harnessing such coupling allows for strategies to achieve local dynamical control with simple illumination patterns, revealing exciting opportunities for developing tactic active materials.

8.
J Healthc Qual Res ; 36(2): 98-102, 2021.
Artigo em Espanhol | MEDLINE | ID: mdl-33397600

RESUMO

BACKGROUND AND OBJECTIVE: The age and comorbidity of patients admitted to Otolaryngology are increasing, leading to increased consultations/referrals to Internal Medicine, but do not reach the required effectiveness. An alternative is comanagement. A study is conducted on the effect of comanagement on Otolaryngology. METHODS: A retrospective observational study was conducted on patients ≥16 years old admitted in Otolaryngology between 03 December 2017 and 03 December 2019, since 03/12/2018 with comanagement with Internal Medicine since 03 December 2018. An analysis was performed on age, gender, type of admission, and whether the patient had surgery, administrative weight associated with (diagnosis-related group) DRG, total number of diagnoses at discharge, Charlson comorbidity index, deaths, urgent readmissions, and length of stay. RESULTS: Comanaged patients were younger (3.1 years, 95% confidence interval [95% CI] 1.4 to 4.8), but with higher Charlson comorbidity index (0.2; 95% CI; 0.1 to 0.3), number of diagnoses (0.9; 95% CI; 0.6 to 1.2), and administrative weight (0.04; 95% CI; 0 to 0.09). On adjustment, comanagement reduced Otolaryngology length of stay by 26.7%, 0.8 days (95% CI; 0.3 to 1.3), 50% of urgent readmissions, and 60% mortality, both non-significant. The decrease in length of stay implies an Otolaryngology savings of at least € 320,476.5. CONCLUSIONS: Patients admitted to Otolaryngology are increasing in age and comorbidity. Comanagement is associated with reduced length of stay and costs similar to those observed in other surgical services.


Assuntos
Medicina Interna , Otolaringologia , Adolescente , Hospitalização , Humanos , Tempo de Internação , Alta do Paciente
9.
Neuroimage Clin ; 27: 102311, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32570204

RESUMO

Attention Deficit/Hyperactivity Disorder (ADHD) is a self-regulation disorder, with impairments in error monitoring associated with underactivation of the related brain network(s). Psychostimulant medication improves ADHD symptoms and can upregulate brain function, but has side effects, with limited evidence for longer-term effects. Real-time functional magnetic resonance neurofeedback (fMRI-NF) has potential longer-term neuroplastic effects. We previously reported the effects of 11 runs of 8.5 min of fMRI-NF of the right inferior frontal cortex (rIFC) in adolescents with ADHD. This resulted in improvement of clinical symptom and enhanced rIFC activation post-pre treatment during response inhibition, when compared to a control group receiving fMRI-NF of the left parahippocampal gyrus (lPHG). In the current study we applied a novel analysis to the existing data by investigating the effects of fMRI-NF of rIFC in 16 adolescents with ADHD compared to fMRI-NF of lPHG in 11 adolescents with ADHD on the neurofunctional correlates of error monitoring during the same fMRI tracking stop task and potential associations with cognitive and clinical measures. We found stronger performance adjustment to errors in the rIFC-NF compared to the control lPHG-NF group. At the brain function level, fMRI-NF of rIFC compared to that of lPHG was associated with increased activation in error monitoring regions of the left IFC, premotor cortex, insula and putamen. The increased activation in left IFC-insular-striatal error monitoring regions in the rIFC-NF relative to the lPHG-NF group was furthermore trend-wise correlated with NF-induced ADHD symptom improvements. The findings of this study show, that during error monitoring, fMRI-NF training of rIFC upregulation elicited improvement in post-error behavioural adjustments and concomitant increased activation in left hemispheric fronto-insular-striatal and premotor regions mediating self-control and self-monitoring functions. This suggests that the administration of fMRI-NF of the rIFC may have had an impact on wider networks of self-regulation and self-monitoring in adolescents with ADHD.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Neurorretroalimentação , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico por imagem , Lobo Frontal/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Testes Neuropsicológicos
10.
Arch. Soc. Esp. Oftalmol ; 94(4): 165-170, abr. 2019. ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-183300

RESUMO

Introducción: La displasia ectodérmica hipohidrótica (DEH) es una enfermedad rara caracterizada por la anormal formación de los tejidos derivados del ectodermo. La hipoplasia de las glándulas de Meibomio es una de las manifestaciones oftalmológicas más frecuentes en estos pacientes. Se planteó estudiar la morfología de las glándulas de Meibomio mediante meibografía en un grupo de pacientes con DEH y compararlo con un control. Métodos: Se incluyeron 14 ojos de 7 pacientes diagnosticados de DEH. Y un grupo control con 32 ojos de 16 pacientes. Se les realizó un estudio meibográfico mediante el analizador corneal CA-800 de Topcon®. Se usó una escala meibográfica para valorar el grado de atrofia glandular. Grado 0, sin alteraciones, grado 1 afectación < 25% de ácinos glandulares, grado 2 atrofia entre el 25 y 50%, grado 3, entre el 51-75% y grado 4, alteración > 75%. En la comparación estadística se utilizaron los test no paramétricos de Mann-Whitney. Resultados: Todos los pacientes con DEH mostraron algún grado de afectación. El 57% presentó atrofia severa > 75%. El 35,8% presentó un grado 3 y el 7,2% grado 2. El grado medio de atrofia glandular en DEH fue de 3 (rango 1-4). En el grupo control el 62,5% no presentaron afectación alguna, grado 0. El 28,1% grado 1 y el 9,4% un grado 2. El grado medio de atrofia glandular fue de 0 (0,2). Se encontraron diferencias estadísticamente significativas entre los grupos. Conclusiones: La meibografía es una prueba diagnóstica sencilla que permite diferenciar entre pacientes sanos y con DEH


Introduction: Hypohidrotic ectodermal dysplasia (HED) is a rare disease that results from the abnormal development of the ectodermal germ layer in early embryogenesis. In these patients, hypoplasia of Meibomian glands is one of the most frequent ophthalmological manifestations. The main aim of this study is to evaluate the usefulness of meibography for the morphology of Meibomian glands in a group of patients with HED, and to compare it with a control group. Methods: A total of 14 eyes of 7 patients diagnosed with HED were included, and 32 eyes of 16 patients were included as a control group. The meibographic study was carried out using CA-800 Corneal Analyser (Topcon®). Grading of images was assessed by a meibomian gland atrophy score: grade 0, no alterations; grade 1, ≤25% gland atrophy; grade 2, 25% to 50% gland atrophy; grade 3, 51% to 75% gland atrophy; and grade 4 >75% gland atrophy. Both groups were compared using the Mann-Whitney U non-parametric test. Results: All patients with HED showed some degree of gland atrophy, with 57% showing severe atrophy (>75% of gland atrophy), 35.8% with a grade 3, and 7.2% grade 2. The mean grade of glandular atrophy in HED was 3 (1-4). In the control group, 62.5% had no involvement (grade 0), with 28.1% showing grade 1 and 9.4% grade 2 gland atrophy. The mean glandular atrophy grade within the control group was 0 (0-2). There were statistically significant differences between both groups. Conclusions: Meibography is a simple diagnostic tool that allows to differentiate between patients without disease and those with HED


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Adulto , Glândulas Tarsais/diagnóstico por imagem , Displasia Ectodérmica/diagnóstico por imagem , Estudos de Casos e Controles , Estatísticas não Paramétricas , Índice de Gravidade de Doença , Estudos Transversais
11.
Arch Soc Esp Oftalmol (Engl Ed) ; 94(4): 165-170, 2019 Apr.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30795945

RESUMO

INTRODUCTION: Hypohidrotic ectodermal dysplasia (HED) is a rare disease that results from the abnormal development of the ectodermal germ layer in early embryogenesis. In these patients, hypoplasia of Meibomian glands is one of the most frequent ophthalmological manifestations. The main aim of this study is to evaluate the usefulness of meibography for the morphology of Meibomian glands in a group of patients with HED, and to compare it with a control group. METHODS: A total of 14 eyes of 7 patients diagnosed with HED were included, and 32 eyes of 16 patients were included as a control group. The meibographic study was carried out using CA-800 Corneal Analyser (Topcon®). Grading of images was assessed by a meibomian gland atrophy score: grade 0, no alterations; grade 1, ≤25% gland atrophy; grade 2, 25% to 50% gland atrophy; grade 3, 51% to 75% gland atrophy; and grade 4 >75% gland atrophy. Both groups were compared using the Mann-Whitney U non-parametric test. RESULTS: All patients with HED showed some degree of gland atrophy, with 57% showing severe atrophy (>75% of gland atrophy), 35.8% with a grade 3, and 7.2% grade 2. The mean grade of glandular atrophy in HED was 3 (1-4). In the control group, 62.5% had no involvement (grade 0), with 28.1% showing grade 1 and 9.4% grade 2 gland atrophy. The mean glandular atrophy grade within the control group was 0 (0-2). There were statistically significant differences between both groups. CONCLUSIONS: Meibography is a simple diagnostic tool that allows to differentiate between patients without disease and those with HED.


Assuntos
Displasia Ectodérmica Anidrótica Tipo 1/complicações , Doenças Palpebrais/diagnóstico por imagem , Doenças Palpebrais/etiologia , Glândulas Tarsais/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Atrofia/etiologia , Criança , Técnicas de Diagnóstico Oftalmológico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
12.
Neuroimage ; 188: 43-58, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30513395

RESUMO

Attention Deficit Hyperactivity Disorder (ADHD) is associated with poor self-control, underpinned by inferior fronto-striatal deficits. We showed previously that 18 ADHD adolescents over 11 runs of 8.5 min of real-time functional magnetic resonance neurofeedback of the right inferior frontal cortex (rIFC) progressively increased activation in 2 regions of the rIFC which was associated with clinical symptom improvement. In this study, we used functional connectivity analyses to investigate whether fMRI-Neurofeedback of rIFC resulted in dynamic functional connectivity changes in underlying neural networks. Whole-brain seed-based functional connectivity analyses were conducted using the two clusters showing progressively increased activation in rIFC as seed regions to test for changes in functional connectivity before and after 11 fMRI-Neurofeedback runs. Furthermore, we tested whether the resulting functional connectivity changes were associated with clinical symptom improvements and whether they were specific to fMRI-Neurofeedback of rIFC when compared to a control group who had to self-regulate another region. rIFC showed increased positive functional connectivity after relative to before fMRI-Neurofeedback with dorsal caudate and anterior cingulate and increased negative functional connectivity with regions of the default mode network (DMN) such as posterior cingulate and precuneus. Furthermore, the functional connectivity changes were correlated with clinical improvements and the functional connectivity and correlation findings were specific to the rIFC-Neurofeedback group. The findings show for the first time that fMRI-Neurofeedback of a typically dysfunctional frontal region in ADHD adolescents leads to strengthening within fronto-cingulo-striatal networks and to weakening of functional connectivity with posterior DMN regions and that this may be underlying clinical improvement.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/terapia , Lobo Frontal/fisiopatologia , Vias Neurais/fisiopatologia , Neurorretroalimentação/métodos , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Criança , Humanos , Imageamento por Ressonância Magnética , Masculino
13.
Rev Esp Quimioter ; 31(6): 528-531, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30364924

RESUMO

OBJECTIVE: When we evaluate a patient with a suspected imported disease we cannot forget to include any autochthonous causes that may mimic imported pathologies to avoid misdiagnosis and therapeutic delay. METHODS: A descriptive longitudinal retrospective study was designed with patients in whom an imported disease was suspected but who were finally diagnosed with autochthonous processes. The patients were selected from two internal medicine practices specializing in tropical diseases between 2008-2017 in Spain. RESULTS: We report 16 patients, 11 (68.7%) were males, and the mean age was 43.4 ± 13.7 years old. Thirteen patients (81.2%) were travellers. Half of the patients were from Latin America, 7 (43.5%) were from Africa, and 1 (6.2%) was from Asia. The time from trip to evaluation ranged between 1 week and 20 years (median, 4 weeks), and the mean time from evaluation to diagnosis was 58.4 ± 100.9 days. There were 5 (31.2%) cases of autochthonous infection, 5 (31.2%) cases of cancer, 2 (12.5%) cases of inflammatory disease, and 2 (12.5%) cases of vascular disease. CONCLUSIONS: Travel or migration by a patient can sometimes be a confusing factor if an imported disease is suspected and may cause delays in the diagnosis and treatment of an autochthonous disease. We highlight that 1/3 of the patients with autochthonous diseases in this study had cancer. The evaluation of imported diseases requires a comprehensive approach by the internist, especially if he specializes in infectious and/or tropical diseases and is, therefore, the best qualified to make an accurate diagnosis.


Assuntos
Doenças Transmissíveis/diagnóstico , Erros de Diagnóstico , Medicina Tropical , Adulto , Emigrantes e Imigrantes , Feminino , Migração Humana , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Espanha , Viagem , Adulto Jovem
14.
Phys Chem Chem Phys ; 20(44): 27758-27765, 2018 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-30209466

RESUMO

The impact of supramolecular aggregate formation on the shear viscosity response of hydrogen bonded liquids was investigated. In particular, we study the shear mechanical response of several monoalcohols showing exponential and non-exponential shape dielectric Debye-like relaxation. In addition to the structural relaxation, distinctive of the glass transition, and the terminal crossover to pure viscous flow, characteristic of simple liquid flow, systematic analysis of complex viscosity curves evidences the presence of an additional intermediate process between those two. While the recovery of pure viscous flow would reflect the complete relaxation of the hydrogen bonded aggregates the intermediate process correlates with the rotational dynamics of hydroxyl groups, potentially caused by the breaking of individual hydrogen bonds.

16.
Rev Clin Esp (Barc) ; 218(5): 244-252, 2018.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29448981

RESUMO

Invasive pneumococcal disease is a severe infection that mainly affects patients with associated comorbidity. The paediatric conjugate vaccination has resulted in a change in the adult vaccination strategy. The antibiotic resistance of pneumococcus is not currently a severe problem. Nevertheless, the World Health Organisation has included pneumococcus among the bacteria whose treatment requires the introduction of new drugs, such as ceftaroline and ceftobiprole. Although the scientific evidence is still limited, the combination of beta-lactams and macrolides is recommended as empiric therapy for bacteraemic pneumococcal pneumonia.

17.
Acta pediatr. esp ; 75(9/10): 102-107, sept.-oct. 2017. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-168565

RESUMO

Introducción: Los gangliósidos (GG) son compuestos bioactivos importantes para el lactante, con beneficios sobre el desarrollo neuronal, el sistema inmunitario... Están presentes en la leche humana (LH) y, en menor cantidad, también en los preparados para lactantes (PL). Con el objetivo de evaluar el resultado de añadir a los PL un ingrediente rico en membrana del glóbulo graso de la leche (MFGM) y asemejar los contenidos de GG a la LH, se determina el contenido total de GG en diferentes PL comercializados en el mercado europeo. Además, se estima la ingesta de GG en los lactantes alimentados con estos PL. Material y métodos: Se determina el contenido de GG en 13 PL comercializados en Europa mediante espectrofotometría, utilizando el reactivo colorimétrico resorcinol. Para las ingestas, se utilizan volúmenes medios de PL ingeridos por 1.113 lactantes, obtenidos de la bibliografía, correspondientes a los primeros 6 meses. Resultados y discusión: El contenido de GG en los PL varía de 0,30 a 2,69 mg de ácido siálico unido a lípidos por litro (ASUL/L); los mayores contenidos de GG los proporcionan los PL que llevan adicionado en su formulación el ingrediente rico en MFGM (1,23-2,69 mg de ASUL/L). De los PL con MFGM, el que presenta contenidos significativamente mayores es el PL-6 (p <0,05). Con independencia del PL, la ingesta diaria de GG es mayor en los PL con MFGM, que se sitúa entre 0,58 y 0,94 mg de ASUL/día. Conclusiones: La adición de MFGM a los PL es una buena estrategia para mejorar los contenidos e ingestas de GG en PL (AU)


Introduction: Gangliosides (GG) are important bioactive compounds for the newborn (normal neuron development, immune system, etc.), present in human milk (HM) and in lesser amounts in infant formulas (IFs). With the aim of evaluating the influence of the addition of an ingredient rich in milk fat globule membrane (MFGM) and in order to obtain amounts of GG similar to those found in HM, the total GG content was determined in several IFs marketed in Europe. In addition, the GG intake by infants fed with these formulas was estimated. Material and methods: Thirteen powdered cows’ milk-based IFs marketed in Europe were analyzed by spectrophotometry, using the resorcinol method. To estimate GG intake, average IF volume of 1,113 newborn corresponding to the first 6 months of life, obtained from the literature, were used. Results and discussion: The total content of GG of the 13 IFs ranges between 0.30 to 2.69 mg ASUL/L, presenting the highest contents of GG, the IFs enriched with MFGM (1.23-2.69 mg ASUL/L). Of the IFs enriched with MFGM, the higher statistically significant value (p <0.05) was found in IF-6. The dairy intake of GG was higher in IF enriched with MFGM and independently of IF ranges from 0.58 to 0.94 mg ASUL/day. Conclusions: The addition of ingredients rich in MFGM in IFs improves the content and daily intake of GG (AU)


Assuntos
Humanos , Lactente , Gangliosídeos/uso terapêutico , Nutrição do Lactente , Alimentos Infantis/análise , Alimentos Formulados/análise , Substitutos do Leite Humano , Recomendações Nutricionais
18.
Phys Chem Chem Phys ; 19(23): 15215-15226, 2017 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-28561833

RESUMO

Herein, a combined study of the molecular rotation dynamics and free volume in cis-1,4-poly(isoprene) using two external probing techniques via ESR and PALS together with relaxation dynamics of the host medium via BDS is presented. The spectral evolution of the spin probe TEMPO from simulations over a wide range from 100 K up to 300 K exhibits three different regions of its correlation time consisting of a slow regime at low temperatures followed by the molecular dynamic heterogeneity zone from T = T = 155 K = 0.82 × T up to Tc ≅ 236 K = 1.26 × T and ending with a fast regime at high temperatures with the further characteristic ESR temperatures, T = 186 K ≅ T and T = 260 K. These are in close coincidence with four characteristic PALS temperatures: T = 160 K, T = 190 K, T = 227 K, and T = 263 K. Finally, using BDS, we revealed that the high-frequency features of the structural relaxation of 1,4-PIP 0.8k were related to the observed effects in the ESR and PALS response of the liquid state.

19.
J Chem Phys ; 146(11): 114502, 2017 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-28330358

RESUMO

We have investigated the Debye-like relaxation in a series of monoalcohols (MAs) by broadband dielectric spectroscopy and thermally stimulated depolarization current techniques in order to get further insight on the time dispersion of this intriguing relaxation. Results indicate that the Debye-like relaxation of MAs is not always of exponential type and conforms well to a dispersion of Cole-Davidson type. Apart from the already reported non-exponentiality of the Debye-like relaxation in 2-hexyl-1-decanol and 2-butyl-1-octanol, a detailed analysis of the dielectric permittivity of 5-methyl-3-heptanol shows that this MA also presents some extent of dispersion on its Debye-like relaxation which strongly depends on the temperature. Results suggest that the non-exponential character of the Debye-like relaxation might be a general characteristic in the case of not so intense Debye-like relaxations relative to the α relaxation. Finally, we briefly discuss on the T-dependence and possible origin for the observed dispersion.

20.
Soft Matter ; 12(48): 9705-9727, 2016 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-27808335

RESUMO

The determination of the net charge and size of microgel particles as a function of their concentration, as well as the degree of association of ions to the microgel backbone, has been pursued in earlier studies mainly by scattering and rheology. These methods suffer from contributions due to inter-particle interactions that interfere with the characterization of single-particle properties. Here we introduce dielectric spectroscopy as an alternative experimental method to characterize microgel systems. The advantage of dielectric spectroscopy over other experimental methods is that the polarization due to mobile charges within a microgel particle is only weakly affected by inter-particle interactions. Apart from electrode polarization effects, experimental spectra on PNIPAM-co-AA [poly(N-isopropylacrylamide-co-acrylic acid)] ionic microgel particles suspended in de-ionized water exhibit three well-separated relaxation modes, which are due to the polarization of the mobile charges within the microgel particles, the diffuse double layer around the particles, and the polymer backbone. Expressions for the full frequency dependence of the electrode-polarization contribution to the measured dielectric response are derived, and a theory is proposed for the polarization resulting from the mobile charges within the microgel. Relaxation of the diffuse double layer is modeled within the realm of a cell model. The net charge and the size of the microgel particles are found to be strongly varying with concentration. A very small value of the diffusion coefficient of ions within the microgel is found, due to a large degree of chemical association of protons to the polymer backbone.

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