Dolor torácico secundario al consumo de drogas atendido en urgencias hospitalarias en España / Chest pain secondary to drug use treated in hospital emergency departments in Spain

Objetivo Conocer las características de los pacientes con dolor torácico (DT) asociado al consumo reciente de drogas. Método Estudio de los casos del Registro REUrHE atendidos en urgencias de 11 hospitales españoles por DT tras el consumo de drogas de uso recreacional. Resultados El DT supuso el 8,97% de las asistencias (varones 82,9%, p<0,001). La cocaína estaba presente en el 70% de los casos, seguida del cannabis (35,7%) y las anfetaminas y derivados (21,4%). La clínica inicial más frecuente fue: palpitaciones (45,5%, p<0,001), ansiedad (42,5%, p<0,001), hipertensión (13,6%, p<0,001) y arritmias (5,9%, p<0,001). Recibieron más tratamiento los pacientes con DT (81,9% vs. 74,1%; p<0,001), aunque ingresaron menos (7,6%, p=0,0), sin diferencias en cuanto a maniobras de reanimación cardiopulmonar, sedación, intubación, o ingreso en cuidados intensivos (1,9%). Conclusiones En el DT tras una intoxicación aguda por drogas predomina el uso de la cocaína, aunque aumentan los casos por consumo de cannabis (AU)

Objective To determine the characteristics of patients with chest pain (CP) associated with recent drug use. Methods Study of cases from the REUrHE registry attended in the emergency department of 11 Spanish hospitals for CP following recreational drug use. Results CP accounted for 8.97% of attendances (males 82.9%, P<.001). Cocaine was present in 70% of cases, followed by cannabis (35.7%) and amphetamines and derivatives (21.4%). The most frequent initial symptoms were: palpitations (45.5%, P<.001), anxiety (42.5%, P<.001), hypertension (13.6%, P<.001) and arrhythmias (5.9%, P<.001). Patients with TD received more treatment (81.9% vs. 74.1%; P<.001), although they were admitted less (7.6%, P=.0), with no differences in terms of CPR manoeuvres, sedation, intubation, or admission to intensive care (1.9%). Conclusions In CP following acute drug intoxication, cocaine use predominates, although cases of cannabis use are increasing (AU)

Chest pain secondary to drug use treated in hospital emergency departments in Spain.

OBJECTIVE: To determine the characteristics of patients with chest pain (CP) associated with recent drug use. METHODS: Study of cases from the REUrHE registry attended in the emergency department of 11 Spanish hospitals for CP following recreational drug use. RESULTS: CP accounted for 8.97% of attendances (males 82.9%, p<0.001). Cocaine was present in 70% of cases, followed by cannabis (35.7%) and amphetamines and derivatives (21.4%). The most frequent initial symptoms were: palpitations (45.5%, p<0.001), anxiety (42.5%, p<0.001), hypertension (13.6%, p<0.001) and arrhythmias (5.9%, p<0.001). Patients with TD received more treatment (81.9% vs 74.1%; p<0.001), although they were admitted less (7.6%, p=0.0), with no differences in terms of CPR manoeuvres, sedation, intubation, or admission to intensive care (1.9%). CONCLUSIONS: In CP following acute drug intoxication, cocaine use predominates, although cases of cannabis use are increasing.

Experimental evolution of the temporal and spectral profiles of noise-like pulses within the mode-locked regions of a figure-eight fiber laser.

We present an experimental analysis of the pulse profile variability within the mode-locked regions of an erbium-doped figure-eight fiber laser (EDFEFL). The tuning of the mode-locked regions was carried out by varying and recording the values of the angle of the polarization controllers in the ring section and in the nonlinear optical loop mirror (NOLM). Within the mode-locked regions, we obtained a large variability of the temporal profile, specifically amplitude and width of the noise-like pulses (NLPs). Subsequently, we recorded and studied the changes in the spectral domain. We identified the mode-locked regions where the temporal profile of the pulse remains constant (stationary state), and where it expels sub-packets (non-stationary state). Finally, a theoretical analysis of the power transmission through the polarizing in the ring section and in the NOLM switching characteristic as a function of wave plate angles is also performed, which allows an understanding of the existence of the multiple mode-locked regions and pulse profile adjustability. We analyze NLPs with a carrier wavelength of 1560 nm with duration of the order of nanoseconds and a repetition rate of 0.9 MHz.

Generation, characterization, and experimental analysis of noise-like pulse envelopes with complex shapes.

We present the generation of 41 noise-like pulse (NLP) envelopes with complex shapes using a passively mode-locked, erbium-doped figure-eight fiber laser (EDFEFL). The tuning of each of the complex forms was carried out by varying the polarization state within the laser cavity, using a quarter-wave retarder (QWR2) inside a nonlinear optical loop mirror (NOLM), which is part of the EDFEFL. The position of the retarder plate was identified and recorded for each of the complex shapes. The temporal and spectral characterization was done using the position of the WQR2 wave plate as an independent variable. We present a single-shot analysis of the dynamics for the temporal amplitude, the full width at half-maximum (FWHM), and the root-mean-square (RMS) width for each of the 360 cycles measured for the 41 complex envelopes. We also perform an analysis for the case in which the pulse is completely divided into subpackets. We analyze the corresponding spectral profile for each of the complex forms generated. Finally, we evaluate the performance of the NOLM theoretical model with our experimental results. The wavelength of the NLPs is 1560 nm; the period of the cavity fiber laser is 1.1 ms; and the temporal FWHM is within the range of nanoseconds.

[Comparison of surgical techniques for rotator cuff injury: cost-result]. / Comparación de técnicas quirúrgicas para la lesión del manguito de los rotadores: costo-resultado.

INTRODUCTION: Currently, to manage rotator cuff injury (RCI), there is a tendency to replace mini-open (MO) surgery with arthroscopy, but results and costs are controversial. OBJECTIVE: To analyze the cost-result of surgical techniques for RCI. MATERIAL AND METHODS: A partial economic evaluation of cost-result type was performed on 113 patients with RCI surgically operated by mini-open technique (n = 6), or arthroscopy (n = 91), or both (n = 16). Direct costs included: hospital stay, days of work disability, surgery, implants (anchors), medical assessments, laboratory and imaging. One-year shoulder functionality was evaluated with Constant-Murley scale (EscC-M). RESULTS: The MO technique was the most economical (X = $42,950.60 MXN) and the most expensive was the arthroscopy + MO with anchors (X = $89,594.80 MXN); with a non-significant difference in shoulder functionality (EscC-M = 56.33 ± 7.0 vs. 64.25 ± 9.0 points, respectively) (p 0.05; Kruskal-Wallis; post hoc Mann-Whitney). Difference of $46,644.1 MXN between techniques corresponded to 7.92 points. There was a mild relationship between the technique and the functionality of shoulder (rs = 0.26; p = 0.005; Spearman). CONCLUSION: The mini-open technique showed best cost-result, with similar functionality in shoulder to that obtained with the more expensive technique.

INTRODUCCIÓN: Actualmente, para manejar la ruptura del manguito de los rotadores (LMR), se prefiere la artroscopía sobre técnicas abiertas (mini-open [MO]), con resultados y costos controversiales. OBJETIVO: Analizar el costo-resultado de las técnicas quirúrgicas para la LMR. MATERIAL Y MÉTODOS: Se realizó una evaluación económica parcial de tipo costo-resultado a 113 pacientes con LMR intervenidos mediante técnica mini-open (n = 6) o artroscopía (n = 91) o ambas (n = 16). Los costos directos incluyeron: estancia, días de incapacidad laboral, cirugía, implantes (anclas), valoraciones médicas, laboratorio e imagen. Se evaluó la funcionalidad del hombro a un año mediante la escala de Constant-Murley (EscC-M). RESULTADOS: La técnica MO fue la más económica (X = $42,950.60 MXN) y la más costosa fue la artroscopía + MO con anclas (X = $89,594.80 MXN); con una diferencia no significativa en la funcionalidad del hombro (EscC-M = 56.33 ± 7 vs 64.25 ± 9 puntos, respectivamente) (p 0.05; Kruskal-Wallis; post hoc Mann-Whitney). Una diferencia de $46,644.10 MXN entre técnicas correspondió a 7.92 puntos. Hubo relación leve entre la técnica y la funcionalidad del hombro (rs = 0.26; p = 0.005; Spearman). CONCLUSIÓN: La técnica mini-open mostró mejor costo-resultado, con una ganancia en la funcionalidad de hombro similar a la que se obtiene con la técnica más costosa.

Spatiotemporal association between the mite Brevipalpus yothersi and Citrus leprosis virus C in orange orchards.

Citrus leprosis virus C (CiLV-C) is an economically important pathogen and the main causative agent of leprosis disease in citrus orchards. The main vector of this disease, the mite Brevipalpus yothersi, is widely distributed in Mexican orchards on a wide range of citrus species. Despite the importance of both the virus and the mite, field studies recording their occurrence and co-occurrence are practically non-existent. We systematically sampled orange orchards for both CiLV-C and B. yothersi throughout the year. The distribution of the CiLV-C and B. yothersi was evaluated on each sampling occasion and their spatiotemporal associations were determined. Specifically, 100-112 orange trees, distributed in 18 rows (five or six trees per row), were sampled monthly between March 2017 and February 2018 (11 sampling dates). Twenty leaves per tree were sampled on each occasion. The number of mites per tree and the percentage of leaves per tree with disease symptoms were recorded. On each sampling occasion, spatiotemporal associations between mites and disease were determined using the Spatial Analysis by Distance Indices (SADIE) method. CiLV-C and B. yothersi were identified using molecular methods. Throughout the study, the distribution of CiLV-C was aggregated and the distribution of B. yothersi was random. No association was found between the virus and the mite on any of the sampling dates. In total, 173 mites were collected, but only 43 mites were found to be carrying CiLV-C. The reason for this lack of association between the virus and the mite, as well as the impact of our findings on the epidemiology of the disease in orange orchards, are discussed.

Methods for the recombinant expression of active tyrosine kinase domains: Guidelines and pitfalls.

Protein tyrosine kinases (PTKs) are key signaling molecules and important drug targets. Although the efficient recombinant production of active PTKs is important for both pharmaceutical industry and academic research, most PTKs are still obtained from conventional, expensive and time-consuming insect-cell based expression. Host toxicity, kinase inactivity, insolubility and heterogeneity are among the reasons thought to preclude PTK expression in Escherichia coli. Herein we review these presumed roadblocks and their possible solutions for bacterial expression of PTKs, and give an overview on kinase activity assays. Finally, we report our experiences and observations with the kinases Src, Lyn and FAK as examples to illustrate implementation, effects and pitfalls of E. coli expression and in vitro assaying of PTKs.

Universal route to optimal few- to single-cycle pulse generation in hollow-core fiber compressors.

Gas-filled hollow-core fiber (HCF) pulse post-compressors generating few- to single-cycle pulses are a key enabling tool for attosecond science and ultrafast spectroscopy. Achieving optimum performance in this regime can be extremely challenging due to the ultra-broad bandwidth of the pulses and the need of an adequate temporal diagnostic. These difficulties have hindered the full exploitation of HCF post-compressors, namely the generation of stable and high-quality near-Fourier-transform-limited pulses. Here we show that, independently of conditions such as the type of gas or the laser system used, there is a universal route to obtain the shortest stable output pulse down to the single-cycle regime. Numerical simulations and experimental measurements performed with the dispersion-scan technique reveal that, in quite general conditions, post-compressed pulses exhibit a residual third-order dispersion intrinsic to optimum nonlinear propagation within the fiber, in agreement with measurements independently performed in several laboratories around the world. The understanding of this effect and its adequate correction, e.g. using simple transparent optical media, enables achieving high-quality post-compressed pulses with only minor changes in existing setups. These optimized sources have impact in many fields of science and technology and should enable new and exciting applications in the few- to single-cycle pulse regime.

Variability in Damage Caused by the Mite Tetranychus urticae (Trombidiformes: Tetranychidae) Koch on Three Varieties of Strawberry.

The strawberry, Fragaria×ananassa Duchesne (Rosales: Rosaceae), is an important crop in Mexico. We evaluated the tolerance of three newly developed Mexican strawberry varieties (CP0615, CPLE-7, and CPJacona) to Tetranychus urticae Koch (Trombidiformes: Tetranychidae), the most important pest of strawberry. We evaluated the effect of three different initial mite densities on population growth, duration of each developmental stage and survival of T. urticae on the three strawberry varieties. We also compared the photosynthetic activity (Pn), sub-stomatal CO2 concentration (Ci), stomatal conductance (gs) and the area of leaf damaged in the three varieties. The largest final density of mites occurred on the variety CP0615, followed by the varieties CPLE-7 and CPJacona. There were no significant differences in the duration of T. urticae developmental stages amongst the varieties, except for larvae where the shortest duration was on variety CPLE-7. The proportion of eggs reaching the adult stage (survival) was significantly lower on the variety CPLE-7. The number and morphology of the trichomes did not play an important role in the outcomes, as they were similar in the three varieties. There were no significant differences in Pn, Ci, and gs values amongst the three varieties in the presence and absence of T. urticae. The area of leaf damaged in variety CPLE-7 was significantly smaller than for the other varieties. Based on these results, and with regard to spider mite tolerance, we believe that the variety CPLE-7 has the greatest potential for further development, and eventually, for use on a commercial scale in Mexico.

Metarhizium pingshaense applied as a seed treatment induces fungal infection in larvae of the white grub Anomala cincta.

Metarhizium pingshaense has potential as a control agent of the white grub Anomala cincta. We compared its ability to cause infection when applied as a seed treatment or directly to the compost around the plant roots. Although the greatest infection (93%) occured in the direct inoculation treatment, 50% of larvae still became infected by M. pingshaense applied as a seed treatment. The fungus persisted in the compost and also colonised the roots of the developing maize plants endophytically. More research is required but seed treatments with M. pingshaense have potential as cost-effective control options for A. cincta.

Diversity and Genetic Variation among Brevipalpus Populations from Brazil and Mexico.

Brevipalpus phoenicis s.l. is an economically important vector of the Citrus leprosis virus-C (CiLV-C), one of the most severe diseases attacking citrus orchards worldwide. Effective control strategies for this mite should be designed based on basic information including its population structure, and particularly the factors that influence its dynamics. We sampled sweet orange orchards extensively in eight locations in Brazil and 12 in Mexico. Population genetic structure and genetic variation between both countries, among locations and among sampling sites within locations were evaluated by analysing nucleotide sequence data from fragments of the mitochondrial cytochrome oxidase subunit I (COI). In both countries, B. yothersi was the most common species and was found in almost all locations. Individuals from B. papayensis were found in two locations in Brazil. Brevipalpus yothersi populations collected in Brazil were more genetically diverse (14 haplotypes) than Mexican populations (four haplotypes). Although geographical origin had a low but significant effect (ca. 25%) on the population structure, the greatest effect was from the within location comparison (37.02 %). Potential factors driving our results were discussed.

Intoxicaciones por drogas de abuso: sustancias emergentes en el siglo XXI / Drug-abuse poisoning: new substances in the 21st century

El uso de productos exógenos para modificar el estado de la cociencia ha sido una constante a lo largo de la historia de la humanidad. Inicialmente se utilizaron sustancias derivadas de plantas, pero la evolución tecnológica permitió la elaboración de sustancias sintetizadas de novo o modificadas de otras ya existentes, que actualmente son consumidas por millones de personas con intención experimental o lúdica. Clásicamente se ha asociado el consumo de determinadas drogas con sectores sociales o culturales determinados (cultura reggae y marihuana, jóvenes yuppies y cocaína, o aficionados a la música electrónica y anfetaminas, por ejemplo). Sin embargo, desde el punto de vista sanitario estas asociaciones carecen de fundamento. No sólo porque el mercado de cualquier tipo de droga transciende estos condicionantes sociales, sino porque es habitual que un mismo consumidor utilice múltiples sustancias persiguiendo distintos efectos, en ocasiones a lo largo de una misma noche. La utilización de este tipo de drogas genera gran cantidad de problemas médicos que motivan asistencia urgente. El presente trabajo repasalas drogas de abuso emergentes más utilizadas en los inicios del siglo XXI y los efectos que tienen sobre la salud de los usuarios (AU)

Mind-altering substances have been used throughout history. The earliest psychoactive drugs were derived from plants, but technological advances have introduced substances that have been synthesized de novo or that result from modifications of older drugs. Millions now experiment with such substances or use them recreationally. Certain drugs have traditionally been linked to specific social or cultural groups: for example, we associated reggae with marijuana, young urban professionals (yuppies) with cocaine, and electronic music fans with amphetamines. Such ties are unsupported, however, from the health care professional's vantage, not only because the market for any type of drug is more widespread than any of these social settings but also because it is common for users to combine several substances in pursuit of different effects. Several drugs are sometimes used on a single night. Street drugs cause of a large number of medical problems that lead users to seek emergency care. This review discusses the most common new substances on the street at the beginning of the 21st century and their effects on health (AU)

Contrasting effects of geographical separation on the genetic population structure of sympatric species of mites in avocado orchards.

Oligonychus punicae and Oligonychus perseae (Acari: Tetranychidae) are the most important mite species affecting avocado orchards in Mexico. Here we used nucleotide sequence data from segments of the nuclear ribosomal internal transcribed spacers (ITS1 and ITS2) and mitochondrial cytochrome oxidase subunit I (COI) genes to assess the phylogenetic relationships between both sympatric mite species and, using only ITS sequence data, examine genetic variation and population structure in both species, to test the hypothesis that, although both species co-occur, their genetic population structures are different in both Michoacan state (main producer) and Mexico state. Phylogenetic analysis showed a clear separation between both species using ITS and COI sequence information. Haplotype network analysis done on 24 samples of O. punicae revealed low genetic diversity with only three haplotypes found but a significant geographical population structure confirmed by analysis of molecular variance (AMOVA) and Kimura-2-parameter (K2P) analyses. In addition, a Mantel test revealed that geographical isolation was a factor responsible for the genetic differentiation. In contrast, analyses of 22 samples of O. perseae revealed high genetic diversity with 15 haplotypes found but no geographical structure confirmed by the AMOVA, K2P and Mantel test analyses. We have suggested that geographical separation is one of the most important factors driving genetic variation, but that it affected each species differently. The role of the ecology of these species on our results, and the importance of our findings in the development of monitoring and control strategies are discussed.

Study of a measles outbreak in Granada with preventive measures applied by the courts, Spain, 2010 to 2011.

Measles had practically been eliminated in Granada since the systematic vaccination of children with two doses introduced in 1984. However, in 2009 the disease returned in the form of small outbreaks. This study describes the measles outbreak that occurred in Granada from October 2010 to August 2011 and the measures imposed to control it. Information was sourced from the records of the Andalusian epidemiological surveillance system. A total of 308 cases were recorded, representing an incidence rate of 33.6 cases per 100,000 inhabitants. The first wave of the epidemic took place in Granada city, with the majority of cases occurring among families who lived in the Albaycín neighbourhood and were opposed to vaccination for ideological and/or religious reasons. The initial cases were in unvaccinated children aged 1 to 13 years. The outbreak later spread throughout the province. To control the outbreak, the vaccination schedule for the exposed children was brought up to date. The Regional Ministry of Health decided to take legal action in order to ensure vaccination of those in the initial nucleus of the outbreak.

Species composition and abundance of Brevipalpus spp. on different citrus species in Mexican orchards.

We studied the abundance of Brevipalpus spp. in citrus orchards in the Mexican states of Yucatan, Quintana Roo and Campeche. Mites were collected from 100 trees containing a mixture of citrus species where sweet orange was always the main species. Eight collections were made at each location from February 2010 to February 2011. Mites from the genus Brevipalpus were separated from other mites surveyed and their abundance and relationships with the different citrus species were quantified throughout the collection period. A subsample of 25% of the total Brevipalpus mites collected were identified to species level and the interaction of mite species and citrus species were described. Brevipalpus spp. were present on all collection dates and their relative abundance was similar on all citrus species studies. The smallest number of mites collected was during the rainy season. Brevipalpus phoenicis (Geijskes) and Brevipalpus californicus (Banks) were the only two species present and they were found in all locations except Campeche, where only B. phoenicis was present. Yucatan and Campeche are at greater risk of leprosis virus transmission than Quintana Roo because the main vector, B. phoenicis, was more abundant than B. californicus. The implications of our results for the design of more accurate sampling and control methods for Brevipalpus spp. are discussed.

Decamethylcyclopentasiloxane (D5) spiked sediment: bioaccumulation and toxicity to the benthic invertebrate Hyalella azteca.

Chronic toxicity and bioaccumulation of decamethylcyclopentasiloxane (D5) to Hyalella azteca was examined in a series of spiked sediment exposures. Juvenile H. azteca were exposed for 28d (chronic) to a concentration series of D5 in two natural sediments of differing organic carbon content (O.C.) and particle size composition. The chronic, LC50s were 191 and 857µgD5g(-1) dry weight for Lakes Erie (0.5% O.C.) and Restoule (11% O.C.) respectively. Inhibition of growth only occurred with the L. Restoule spiked sediment with a resultant EC25 of 821µgg(-1)dw. Lethality was a more sensitive endpoint than growth inhibition. Biota sediment accumulation factors (BSAFs, 28d) were <1 indicating that D5 did not bioconcentrate based on lipid normalized tissue concentrations and organic carbon normalized sediment concentrations. Organic carbon (OC) in the sediment appeared to be protective, however normalization to OC did not normalize the toxicity. Normalization of D5 concentrations in the sediments to sand content did normalize the toxicity and LC50 values of 3180 and 3570µg D5g(-1) sand dw were determined to be statistically the same.

Effects of primary spherical aberration, coma, astigmatism and field curvature on the focusing of ultrashort pulses: homogenous illumination.

We analyze the spatiotemporal intensity of pulses with durations of 20 fs and shorter and a carrier wavelength of 810 nm at the paraxial focal plane of an achromatic doublet lens. The incident pulse is well-collimated, and we use the Seidel aberration theory for thin lenses to evaluate the phase change due to the aberrations of the lens. In a set of cemented thin lenses with the stop at the lens, there is only spherical aberration, coma, astigmatism and field curvature, whereas the distortion aberration in the phase front is zero. We analyze the effect of these aberrations in the focusing of ultrashort pulses for homogenous illumination. We will show that the temporal spreading introduced by these aberrations in pulses shorter than 20 fs at 810 nm is very small but the spatial spreading is not, which reduces the intensity of the pulse considerably.

Effects of primary spherical aberration, coma, astigmatism, and field curvature on the focusing of ultrashort pulses: Gaussian illumination and experiment.

We analyze the spatiotemporal intensity of Gaussian temporal envelope pulses with initial durations of 200 fs and a carrier wavelength of 810 nm at the paraxial focal plane of an achromatic doublet lens for a well-collimated incoming pulse beam by using the Seidel aberration theory for thin lenses with the stop at the lens. We analyze the effect of these aberrations in the focusing of ultrashort pulses for Gaussian illumination and present experimental results for 200 fs pulses focused by a near-IR achromatic doublet.