Hepatitis C virus point-of-care microelimination approach in a vulnerable population in the South of Spain.

Background: Since the introduction of direct-acting antivirals, thousands of chronic hepatitis C patients have been successfully treated. However, vulnerable populations have a higher prevalence of hepatitis C virus (HCV) infection and face barriers that impede their access to antivirals. We carried out an HCV microelimination program focused on vulnerable population groups in Malaga. Methods: People in drug addiction treatment centers and homeless shelters in Malaga who participated in the program between October 2020 and October 2021 were included. After providing participants with educational information on HCV, a dry drop test (DDT) was used to collect blood for subsequent screening for HCV infection. The participants who were diagnosed with HCV infection were scheduled for comprehensive healthcare assessments, including blood tests, ultrasonography, elastography, and the prescription of antivirals, all conducted in a single hospital visit. Sustained viral response (SVR) was analysed 12 weeks after end of treatment. Results: Of the 417 persons invited to participate, 271 (65%) agreed to participate in the program. These participants were screened for HCV infection and 28 of them were diagnosed with HCV infection (10%). These hepatitis C-infected patients had a mean age of 53 ± 9 years; 86% were males and 93% were or had been drug users. Among 23 patients with HCV infection, HCV genotype 1a predominated (74%). Medical exams showed that 19% (4/21) had advanced fibrosis (F3-4), and 5% (1/21) had portal hypertension. Finally, 23 infected patients received treatment with glecaprevir/pibrentasvir or sofosbuvir/velpatasvir and SVR was confirmed in 22 patients (96%). Conclusions: Drug users and homeless people have a higher prevalence of HCV infection than the general population. The microelimination program with educational activity and screening tools achieved a high participation rate, easy healthcare access, and a high rate of SVR despite the SARS-CoV-2 pandemic.

Strength performance of low-bearing-capacity clayey soils stabilized with ladle furnace slag.

In this paper, the performance of ladle furnace slag (LFS), a by-product of secondary steel refining, is evaluated as a binder to stabilize clayey soils of low bearing capacity. The aim is to define whether additions of this by-product to clayey soil can stabilize the soil in accordance with the technical specifications of Spanish standards. To do so, three different soils stabilized with 5% LFS were compared with the same soils stabilized with 2% lime and with no stabilization, in order to investigate their different behaviors. The chemical and mineralogical characterizations of all the soil mixes were conducted using X-ray fluorescence, X-ray diffraction, and scanning electron microscopy. The Atterberg limit test was used to study the plastic behavior of the soils, and the results of compaction, bearing capacity, unconfined compressive strength, and direct shear strength (cohesion and friction angle) tests defined their strength characteristics. The analysis was completed with the pH monitoring of the mixes along the curing time in order to relate the pH changes with the strength evolution. The addition of LFS to the soils has resulted in an increase in the liquid limit and plastic limit, causing therefore a slight decrease in the plasticity index. All the soils showed increases between 30% and 70% in their California Bearing Ratios immediately after mixing with 5% LFS, and after 90 days of curing, improvements of 30-188% in their unconfined compressive strength were noted in comparison with untreated soil, which were higher than the lime-stabilized soils. The cohesion of soils stabilized with LFS at 28 days of curing obtained improvements ranging from 40 to 300% depending on the type of soil. However, the friction angle showed a slight increase of 10% in two of the soils and zero in another. The high initial pH in LFS-stabilized soils was maintained during the curing time, which favored the development of pozzolanic reactions that improve the soil strength. These results confirmed that the substitution of lime with LFS is a feasible option for soil stabilization.

Teaching lessons learnt by civil-engineering teachers from the COVID-19 pandemic at the University of Burgos, Spain.

The COVID-19 lockdown in Spain caused abrupt changes for students following the Bachelor's Degree in Civil Engineering at the University of Burgos when face-to-face classes switched to online teaching. The recovery of face-to-face teaching after lockdown meant that classes were taught with obligatory social distancing and the use of masks. Teachers were therefore unable to interact with students closely, to perceive their facial expressions during class, or to conduct group work. The changes to civil-engineering teaching linked to the COVID-19 pandemic and the lessons that civil-engineering teachers learnt from the new teaching scenarios are studied in this paper. The reflections of teachers throughout all three stages of the pandemic (pre-pandemic and lockdown, during lockdown, and post-lockdown), and the qualitative and mixed analysis of their responses to a survey of open-ended questions contributed to the identification of six major lessons: (1) asking questions and using real-time quiz tools enliven classes and help to determine which concepts to emphasize for proper student understanding; (2) autonomous student learning can be promoted through the provision of supplementary documentation and the digitalization of solutions to classroom exercises; (3) virtual site visits and real visual examples interspersed with explanations bring concepts closer to their real applications; (4) the delivery of projects in the form of audio-recorded presentations enable their distribution, so that other students can also learn from them as well as the students who created them; (5) online videoconferences, adapted to the concepts that are addressed, facilitate fast and flexible communication with students; and (6) online continuous-assessment exams can promote better student learning patterns and final-exam preparation. Nevertheless, these six lessons were drawn from the experience of teachers at a small Spanish university where the period of solely online teaching during the COVID-19 pandemic lasted only four months. Thus, it would be interesting to analyze the experience of civil-engineering teachers at larger universities and universities that had longer periods of solely online teaching. A study of the level of implementation of the six aspects when the pandemic is declared over might also be worthwhile.

Relación entre empleo y bienestar emocional en personas con trastorno mental grave / Relationship between employment and emotional state in people with severe mental disorder

Las personas con un diagnóstico de trastorno mental grave (TMG) tienen tasas de desempleo notablemente superiores a las de la población general. Esto se asocia con mayor riesgo de exclusión social y de marginalidad, y favorece la cronicidad de las dificultades personales y sociales. Este estudio observacional pretende evaluar la relación entre el empleo y el estado emocional subjetivo en personas con TMG. El estudio incluyó 744 participantes (304 con TMG usuarias de recursos de rehabilitación psicosocial, 168 personas con TMG con empleo protegido y 272 personas sin TMG con empleo ordinario), con una edad media de 41.9 años y 50.1% mujeres. De los 744 participantes, 577 (77.6%) tuvieron empleo remunerado (409 (60.9%) empleo ordinario y 168 (29.1%) empleo protegido); 244 (32.8%) comunicaron que tenían un diagnóstico de psicosis y 400 (53.8%) que tenían reconocida la discapacidad. Las personas con empleo tuvieron mejores valores de bienestar psicológico subjetivo (p=0.013) que las personas sin empleo, independientemente del diagnóstico o de la discapacidad. Sin embargo, no hubo diferencias significativas en bienestar psicológico subjetivo entre las personas con empleo ordinario y con empleo protegido (p=0.687). Como conclusión, las personas con empleo remunerado tuvieron mayor bienestar psicológico subjetivo que las personas sin empleo, independientemente del diagnóstico, de la discapacidad o de que el empleo fuera ordinario o protegido. (AU)

People with a diagnosis of severe mental disorder (SMD) have significantly higher unemployment rates than the general population. This is associated with a greater risk of social exclusion and marginalization, and favors the chronicity of personal and social difficulties. This observational study aims to assess the relationship between employment and subjective emotional state in people with a SMD diagnosis. The study included 744 participants (304 with a SMD diagnosis who were users of psychosocial rehabilitation resources, 168 with a SMD diagnosis with supported employment, and 272 people without diagnosis of SMD with ordinary (non-supported) employment), with a mean age of 41.9 years and 50.1% women. Out of the 744 participants, 577 (77.6%) had an employment (409 (60.9%) ordinary employment and 168 (29.1%) supported employment), 244 (32.8%) reported that they have a diagnosis of psychosis and 400 (53.8%) that they have a recognized disability. People with an employment had better subjective psychological well-being values than people without an employment (p=0.013), regardless of diagnosis or disability. There were no significant differences in subjective psychological well-being between people with ordinary employment and people with supported employment (p=0.687). In conclusion, people with a paid employment had higher subjective psychological well-being than people without an employment, regardless of diagnosis, disability or whether the employment was ordinary or supported. (AU)

Primer reporte de Enterobacterales dobles productores de carbapenemasas en hospitales de Paraguay. Año 2021

RESUMEN Las carbapenemasas se encuentran ampliamente distribuidas en nuestro país, tanto en bacilos gramnegativos fermentadores como no fermentadores. Durante 2021, se ha reportado incremento de cepas con estas enzimas. Con el objetivo de evaluar la doble producción de carbapenemasas en Enterobacterales y comunicar su circulación, fue puesta a punto una PCR convencional múltiple. Estudio retrospectivo en 128 aislamientos provenientes de 20 centros colaboradores de la Red Nacional de Vigilancia de la RAM (Capital, Central e interior del país), remitidos al LCSP entre febrero y setiembre de 2021, para confirmación y genotipificación de carbapenemasas. Se realizaron pruebas fenotípicas y colorimétricas con sustratos específicos, y pruebas genotípicas (PCR convencional múltiple) para la detección simultánea de varios genes de resistencia (bla NDM, bla KPC, bla OXA-48-like, bla IMP y bla VIM). De los 128 aislamientos estudiados, 107 correspondieron a Klebsiella pneumoniae, 14 a Enterobacter cloacae complex, entre otros; aislados en mayor frecuencia de muestras de orina (30%), respiratorias (30%), sangre y catéter (24%). Los genes de resistencia a los carbapenemes detectados fueron: bla NDM (77,3%), bla KPC (17,2%); siendo confirmada la doble producción de carbapenemasas en 7 aislamientos (5,5%) provenientes de 4 centros diferentes de la capital de país y uno de Central; 6 de ellas (K. pneumoniae) con bla NDM+bla KPC y 1 (E. cloacae complex) con bla NDM+bla OXA-48-like; confirmando circulación de Enterobacterales dobles productores de carbapenemasas en el país (KPC+NDM y OXA+NDM); hallazgos que obligan a proveer de capacidades de detección, de manera a que se puedan tomar medidas oportunas y eficaces de contención y control.

ABSTRACT Carbapenemases are widely distributed in our country, both in fermenting and non-fermenting gram-negative bacilli. During 2021, an increase in strains with these enzymes has been reported. In order to evaluate the double production of carbapenemases in Enterobacterales and communicate their circulation, a multiple conventional PCR was set up. Retrospective study carried out in 128 isolates from 20 collaborating centers of the National AMR Surveillance Network (Capital, Central and interior of the country), sent to the LCSP between February and September 2021, for confirmation and genotyping of carbapenemases. Phenotypic and colorimetric tests were performed with specific substrates, as well as genotypic tests (multiple conventional PCR) for the simultaneous detection of several resistance genes (blaNDM, blaKPC, blaOXA-48-like, blaIMP and blaVIM). Of the 128 isolates studied, 107 corresponded to Klebsiella pneumoniae, 14 to Enterobacter cloacae complex, among others; isolated in higher frequency from urine (30%), respiratory (30%), blood and catheter (24%) samples. The genes for resistance to carbapenems detected were: blaNDM (77.3%), blaKPC (17.2%); the double production of carbapenemases was confirmed in 7 isolates (5.5%) from 4 different centers in the capital of the country and one in Central; 6 of them (K. pneumoniae) with blaNDM + blaKPC and 1 (E. cloacae complex) with blaNDM + blaOXA-48-like; confirming circulation of double Enterobacterales producers of carbapenemases in the country (KPC + NDM and OXA + NDM); findings that require the provision of detection capabilities, so that timely and effective containment and control measures can be taken.

Reflections throughout the COVID-19 Lockdown: What Do I Need for Successful Learning of Engineering?

The intention of this study was to identify the elements that engineering students consider fundamental for successful learning on engineering courses. The aim was to provide generic guidelines suitable for any engineering course with which the teaching may be adapted in the light of comments from students, while student learning improves. The abrupt transition from face-to-face to asynchronous online teaching due to the COVID-19 pandemic prompted reflection among students on both teaching methods. Students were invited to evaluate each method through a survey of open-ended questions, identifying useful elements for their learning. The survey was repeated over nine weeks, to obtain the views of students after they had accepted the change and had critically analyzed how to improve online teaching. A cross-coded qualitative and mixed (word counting) analysis showed that the explanation of engineering concepts should be organized, hierarchical, repetitive, and exemplified. Furthermore, the teacher should link all the activities and projects to the concepts explained and quickly solve any doubts that they raised. As a consequence of the online teaching resulting from COVID-19, the need of independent student learning and peer support was also very evident. Teaching functions are essential on engineering courses, as teachers have to explain the overall concepts carefully, identify the key concepts, and demonstrate their industrial and professional applications. Furthermore, teaching methodologies that balance these aspects with autonomy and peer support for learning on engineering courses should be promoted.

The Outbreak of the COVID-19 Pandemic and its Social Impact on Education: Were Engineering Teachers Ready to Teach Online?

The major impacts of the COVID-19 pandemic are still affecting all social dimensions. Its specific impact on education is extensive and quite evident in the adaptation from Face-to-Face (F2F) teaching to online methodologies throughout the first wave of the pandemic and the strict rules on lockdown. As lesson formats changed radically, the relevance of evaluating student on-line learning processes in university degrees throughout this period became clear. For this purpose, the perceptions of engineering students towards five specific course units forming part of engineering degree courses at the University of Burgos, Spain, were evaluated to assess the quality of the online teaching they received. Comparisons were also drawn with their perceptions of the F2F teaching of the course units prior to the outbreak of the pandemic. According to the students' perceptions, the teachers possessed the technical knowledge, the social skills, and the personal capabilities (empathy and understanding of the at times troubled situation of each student) for a very abrupt adaptation of their courses to an online methodology. The shortcomings of the online teaching were related to its particularities and each teacher's personality traits. Overall, engineering teachers appeared well prepared for a situation of these characteristics and, if similar online teaching scenarios were ever repeated, the quality of engineering teaching appears to be guaranteed.

Cohort study with patients older than 80 years with stage 5 chronic kidney failure on hemodialysis vs conservative treatment: Survival outcomes and use of healthcare resources.

Renal replacement treatment has not been generalized to the elderly for different reasons. The main objective of the present cohort study is to compare survival in patients older than 80 years with chronic kidney disease stage 5 on renal replacement treatment with those on conservative treatment. The use of healthcare resources is compared too. A Cox proportional hazards regression analysis was run with the outcome variable death during the follow-up period. The independent variables were treatment type, age, gender, smoking habit, serum albumin, hemoglobin, Charlson Index, diabetes mellitus, arterial hypertension, ischemic cardiopathy, and neoplasm. For outcome variable "death," renal replacement treatment obtained a hazard ratio of 0.273 (P .006, CI95% 0.108-0.686) vs conservative treatment. In conclusion, patients older than 80 years with chronic kidney disease stage 5 on renal replacement treatment presented a lower mortality risk than those receiving conservative treatment. Comorbidity and age are both associated with mortality, but do not cancel out the survival advantage. In healthcare resources, the renal replacement treatment group made greater use of tests, medical visits and consumption of hospital dispensing drugs, but there were no differences with respect to the days of hospital admission or assistance in home hospitalization.

Prevalencia de embolia pulmonar en pacientes con infección por COVID-19, abril-diciembre de 2020 / Prevalence of pulmonary embolism in patients with COVID-19, april - december 2020

ResumenIntroducción: Los fenómenos trombóticos asociados a COVID-19 contribuyen a una mayor morbimortalidad. El objetivo fue determinar las características clínicas e imagenológicas de pacientes con sospecha diagnóstica de embolia pulmonar (EP) y COVID-19, de abril a diciembre de 2020. Metodología: Estudio observacional transversal que incluyó pacientes con diagnóstico molecular de infección por SARS-CoV-2 y angiotomografía computarizada de tórax (Angio-TAC) realizada por sospecha de EP. Se dividieron los pacientes en dos grupos (EP vs. no EP). Se compararon entre sí variables cualitativas con la prueba Chi2 de Pearson o la prueba exacta de Fisher, y se realizó la misma exploración con variables cuantitativas empleando la prueba T de Student o U de Mann-Whitney. Resultados: Se incluyeron 127 pacientes con una mediana de edad de 60 años (RIC 45-69) ­68 (53,5 %) eran hombres­ y el 23,6 % (n = 30) presentó EP. Al comparar EP (n = 30) vs. no EP (n = 97), se observó que en el primer grupo la mayoría requirieron ventilación mecánica, más días de hospitalización y tuvieron una mortalidad mayor, así como niveles más altos de dímero D, todos con diferencia estadísticamente significativa (p < 0,05). Conclusión:Una cuarta parte de los pacientes con COVID-19 sufrieron EP como complicación, con altos niveles de dímero D, mayor frecuencia de asistencia ventilatoria, más días de estancia hospitalaria y mayor mortalidad.

Introduction:Thrombotic events associated with COVID-19 infection contribute to higher morbidity and mortality of patients. The objective was to review the clinical and imaging characteristics of patients with suspected diagnosis of pulmonary embolism (PE) and COVID-19 infection, from April to December 2020. Methodology:Cross-Sectional observational study that included patients with a molecular diagnosis of SARS CoV-2 infection and chest computed tomography angiography (CT angiography) performed for suspected PE.Patients were divided into two groups (PE vs No PE). Qualitative variables were compared with each other with Pearson's Chi2 test or Fisher's exact test, and quantitative variables were analized with the Student's T test or the Mann-Whitney U test.Results: 127 patients were included with a median age of 60 (IQR: 45-69) years, 68 (53.5%) were men and 23.6% (n = 30) presented PE. When comparing PE (n = 30) vs No PE (n = 97), the first group required more mechanical ventilation, extended days of hospitalization, higher mortality as well as higher levels of D-Dimer, all with statistically significant difference (p < 0.05). Conclusion:A quarter of patients with COVID-19 presented PE as a complication with high levels of D-dimer, a higher frequency of ventilatory assistance, more days of hospitalization and higher mortality

Adherence to Secondary Prevention and Influential Factors in Individuals with Coronary Angioplasty.

OBJECTIVES: To explore the relation between adherence to secondary prevention and factors that influence on said adherence in people with acute coronary syndrome, who underwent percutaneous coronary angioplasty in a clinic in Medellín. METHODS: Cross-sectional study on a random sample of 128 volunteer patients. A questionnaire was used for sociodemographic variables, the "Scale to measure therapeutic adherence for patients with chronic diseases, based on explicit behaviors" by Trujano, Vega, and Nava and the "Instrument to evaluate adherence by patients according to influential cardiovascular risk factors" validated by Consuelo Ortiz. RESULTS: Socioeconomic factors influenced in very low manner on the adherence to secondary prevention; factors related with the therapy did so moderately and patient factors influenced in low manner. No relation was found between the health provider factor and said adherence. CONCLUSIONS: Factors exist that influence in a lesser or higher measure on adherence to secondary prevention and which must be recognized in people with coronary angioplasty to design strategies to improve this aspect of self-care.

Adherence to Secondary Prevention and Influential Factors in Individuals with Coronary Angioplasty

Objective. To explore the relation between adherence to secondary prevention and factors that influence on said adherence in people with acute coronary syndrome, who underwent percutaneous coronary angioplasty in a clinic in Medellín. Methods. Cross-sectional study on a random sample of 128 volunteer patients. A questionnaire was used for sociodemographic variables, the "Scale to measure therapeutic adherence for patients with chronic diseases, based on explicit behaviors" by Trujano, Vega, and Nava and the "Instrument to evaluate adherence by patients according to influential cardiovascular risk factors" validated by Consuelo Ortiz. Results. Socioeconomic factors influenced in very low manner on the adherence to secondary prevention; factors related with the therapy did so moderately and patient factors influenced in low manner. No relation was found between the health provider factor and said adherence. Conclusion. Factors exist that influence in a lesser or higher measure on adherence to secondary prevention and which must be recognized in people with coronary angioplasty to design strategies to improve this aspect of self-care.

Objetivo. Explorar la relación entre la adherencia a la prevención secundaria y los factores que influyen en dicha adherencia en personas con Síndrome Coronario Agudo, a quienes se les realizó angioplastia coronaria percutánea en una clínica de Medellín. Métodos. Estudio de corte transversal en una muestra aleatoria de 128 pacientes voluntarios. Se utilizó un cuestionario para variables sociodemográficas, la "Escala para medir la adherencia terapéutica para pacientes con enfermedades crónicas, basada en comportamientos explícitos" de Trujano, Vega y Nava y el "Instrumento para evaluar la adherencia de los pacientes según factores influyentes de riesgo cardiovascular" validado por Consuelo Ortiz. Resultados. Los factores socioeconómicos influyeron de manera muy baja en la adherencia a la prevención secundaria, los factores relacionados con la terapia lo hicieron en forma moderada y los factores del paciente influyeron de manera baja. No se encontró relación entre el factor del proveedor de salud y dicha adherencia. Conclusión. Existen factores que influyen en menor o mayor medida en la adherencia a la prevención secundaria y que deben ser reconocidos en las personas con angioplastia coronaria para que se diseñen estrategias para el mejoramiento de este aspecto del autocuidado

Objetivo. Explorar a relação entre a adesão à prevenção secundária e os fatores que influenciam essa adesão em pessoas com Síndrome Coronariana Aguda, submetidas a angioplastia coronária percutânea em uma clínica de Medellín (Colômbia). Métodos. Estudo transversal em amostra aleatória de 128 pacientes voluntários. Foi utilizado um questionário para variáveis sócio-demográficas, a "Escala para medir a adesão terapêutica para pacientes com doenças crônicas, baseada em comportamentos explícitos" de Trujano, Vega e Nava, e o "Instrumento para avaliar a adesão do paciente de acordo com fatores de risco cardiovascular influenciadores" validado por Consuelo Ortiz. Resultados. Os fatores socioeconômicos tiveram uma influência muito baixa na adesão à prevenção secundária, os fatores relacionados à terapia tiveram uma influência moderada e os fatores do paciente tiveram uma influência baixa. Não foi encontrada relação entre o fator provedor de saúde e a referida adesão. Conclusão. Existem fatores que influenciam em menor ou maior grau a adesão à prevenção secundária e que devem ser reconhecidos em pessoas com angioplastia coronariana para que estratégias possam ser traçadas para melhorar esse aspecto do autocuidado.

Impact of breeding for coat and spotting patterns on the population structure and genetic diversity of an islander endangered dog breed.

First references of the endangered autochthonous Majorcan Ca Mè dog date from the 13th century and enhance its skills and adaptability to the orography. Genealogical historical records were traced back to founders. Founder number in the reference population (397), maximum generations traced, and average number of complete generations were 32, 5, and 2.75, respectively. Structure assessment revealed the existence of subpopulations regarding criteria such as owners (402), breeders (55), coat colours (liver, lemon, black and orange) and spotting patterns (piebald, roan, solid colour, tie or star presence). Average inbreeding (F) within colour groups ranged from 6.3-10.4%, for orange and black populations, respectively. F ranged from 9.43-12.22% for roan patterns and star presence, respectively. Tan point markings showed an F coefficient of 5.85%. The study of genetic diversity revealed a slightly different genetic background between subpopulations. Average coancestry between and within coat colours suggested orange and roan traits could be ascribed to the original nuclei, without omitting the high relationships among other subpopulations. Breeding strategy should select breeding pairs holding a relatedness coefficient below 15%. Hence, coat patterns in dog breeds can help preserving the genetic diversity in endangered dogs, even when these are geographically isolated.

Performance and Durability of Porous Asphalt Mixtures Manufactured Exclusively with Electric Steel Slags.

Electric arc furnace slag (EAFS) and ladle furnace slag (LFS) are by-products of the electric steelmaking sector with suitable properties for use in bituminous mixtures as both coarse and fine aggregates, respectively. In this research, the production of a porous asphalt mixture with an aggregate skeleton consisting exclusively of electric steelmaking slags (using neither natural aggregates nor fillers) is explored. The test program examines the asphalt mixtures in terms of their mechanical performance (abrasion loss and indirect tensile strength), durability (cold abrasion loss, aging, and long-term behavior), water sensitivity, skid and rutting resistance, and permeability. The results of the slag-mixes are compared with a standard mix, manufactured with siliceous aggregates and cement as filler. The porous mixes manufactured with the slags provided similar results to the conventional standard mixtures. Some issues were noted in relation to compaction difficulties and the higher void contents of the slag mixtures, which reduced their resistance to raveling. Other features linked to permeability and skid resistance were largely improved, suggesting that these mixtures are especially suitable for permeable pavements in rainy regions. In conclusion, a porous asphalt mixture was produced with 100% slag aggregates that met current standards for long-lasting and environmentally friendly mixtures.

Análisis bibliométrico de la Revista Colombiana de Radiología / Bibliometric analysis of the Revista Colombiana de Radiología

Objetivos: Describir las estadísticas y los indicadores bibliométricos de la Revista Colombiana de Radiología desde su primer número, en 1989, hasta el último de 2018. Materiales y métodos: Se revisaron todos los números de la Revista tanto impresos como en versión digital. Se creó una base de datos en el software de referencias JabRef con todas las publicaciones encontradas. Cada referencia, aparte de la información de autores, volumen, número, año de publicación y resumen, contiene datos de filiación institucional, localización geográfica, tipo de publicación y tema. Por medio de un análisis estadístico simple se examinaron los indicadores de producción, como cantidad de publicaciones por número, año, autor, filiación institucional, localización geográfica, tópico y tipo de publicación. Para los indicadores bibliométricos de impacto se realizaron búsquedas de las citaciones sobre la producción de la revista en bases de datos y buscadores. Resultados: En total fueron 902 referencias. El año de más publicaciones fue el 2011 y el tipo de publicación más frecuente fue el de presentación de caso. Las áreas con más publicaciones fueron imagen corporal y neurorradiología. Las ciudades en Colombia con más publicaciones fueron Bogotá y Medellín. Las instituciones que más publicaron fueron la Pontificia Universidad Javeriana, Hospital Universitario San Ignacio y la Fundación Santa Fe de Bogotá y Universidad El Bosque. Conclusiones: La Revista Colombiana de Radiología es la principal publicación sobre radiología en el país. La Revista cuenta con una considerable cantidad de publicaciones de diferente tipo y tema. Este análisis bibliométrico podrá servir de insumo para tomar decisiones respecto al futuro de la Revista

Objetivos: Describir las estadísticas y los indicadores bibliométricos de la Revista Colombiana de Radiología desde su primer número, en 1989, hasta el último de 2018. Materiales y métodos: Se revisaron todos los números de la Revista tanto impresos como en versión digital. Se creó una base de datos en el software de referencias JabRef con todas las publicaciones encontradas. Cada referencia, aparte de la información de autores, volumen, número, año de publicación y resumen, contiene datos de filiación institucional, localización geográfica, tipo de publicación y tema. Por medio de un análisis estadístico simple se examinaron los indicadores de producción, como cantidad de publicaciones por número, año, autor, filiación institucional, localización geográfica, tópico y tipo de publicación. Para los indicadores bibliométricos de impacto se realizaron búsquedas de las citaciones sobre la producción de la revista en bases de datos y buscadores. Resultados: En total fueron 902 referencias. El año de más publicaciones fue el 2011 y el tipo de publicación más frecuente fue el de presentación de caso. Las áreas con más publicaciones fueron imagen corporal y neurorradiología. Las ciudades en Colombia con más publicaciones fueron Bogotá y Medellín. Las instituciones que más publicaron fueron la Pontificia Universidad Javeriana, Hospital Universitario San Ignacio y la Fundación Santa Fe de Bogotá y Universidad El Bosque. Conclusiones: La Revista Colombiana de Radiología es la principal publicación sobre radiología en el país. La Revista cuenta con una considerable cantidad de publicaciones de diferente tipo y tema. Este análisis bibliométrico podrá servir de insumo para tomar decisiones respecto al futuro de la Revista.

Using a multidimensional unfolding approach to assess multiple sclerosis patient preferences for disease-modifying therapy: a pilot study.

PURPOSE: Multidimensional unfolding is a multivariate method to assess preferences using a small sample size, a geometric model locating individuals and alternatives as points in a joint space. The objective was to evaluate relapsing-remitting multiple sclerosis (RRMS) patient preferences toward key disease-modifying therapy (DMT) attributes using multidimensional unfolding. PATIENTS AND METHODS: A cross-sectional pilot study in RRMS patients was conducted. Drug attributes included relapse prevention, disease progression prevention, side-effect risk and route and schedule of administration. Assessment of preferences was performed through a five-card game. Patients were asked to value attributes from 1 (most preferred) to 5 (least preferred). RESULTS: A total of 37 patients were included; the mean age was 38.6 years, and 78.4% were female. Disease progression prevention was the most important factor (51.4%), followed by relapse prevention (40.5%). The frequency of administration had the lowest preference rating for 56.8% of patients. Finally, 19.6% valued the side-effect risk attribute as having low/very low importance. CONCLUSION: Patients' perspective for DMT attributes may provide valuable information to facilitate shared decision-making. Efficacy attributes were the most important drug characteristics for RRMS patients. Multidimensional unfolding seems to be a feasible approach to assess preferences in multiple sclerosis patients. Further elicitation studies using multidimensional unfolding with other stated choice methods are necessary to confirm these findings.

The elusive prediction of stent thrombosis.

Stent thrombosis is a rare PCI complication that occurs in approximately 1% of cases after successful PCI. In about 50% of cases ST occur after 30 days, and in 15% after 1 year. Lesion complexity and baseline presence of thrombus are angiographic predictors for ST and can potentially guide antithrombotic therapy. Further studies are needed to demonstrate whether these predictors can be used to individualize intensity and duration of DAPT.

Heavy-metal extraction from sewage sludge using phosphorous-based salts: optimization process with Na2H2P2O7.

Land application is one of the important disposal alternatives for sewage sludge, but availability of potential toxic metals often restricts its uses. Three phosphorous-based salts (Na2H2P2O7, K4P2O7, KH2PO4) were studied as potential metal extractants. The conclusions of the research were that greater extractive efficiency is achieved through a 30-min process of vertical shaking with disodium diacid pyrophosphate - Na2H2P2O7 - at a concentration of 0.2 M at pH 2. Alternatively, the optimized process with oscillating shaking equipment would require 60 min. In both cases the average of set of extracted metals is around 50%. A second extraction process with potassium pyrophosphate - K4P2O7 at pH 6 achieved the reduction of further total amounts of metal, upper 65% with respect to the initial content. In this way the sludge could be used in land applications, with restrictions on each soil, according to the limit values specified in the future regulations.

Experiencia institucional con Palbociclib. Estudio Prospectivo / Institutional experience with Palbociclib. Prospective Study

La ANMAT aprobó en diciembre de 2015 el uso de palbociclib en combinación con letrozol para el tratamiento de primera línea del cáncer de mama metastásico con receptores hormonales positivos y HER2 negativo, y en agosto de 2016 la combinación de palbociclib con fulvestrant para pacientes progresadas a terapia endocrina previa. El propósito del presente estudio fue realizar una evaluación prospectiva de la seguridad y eficacia del tratamiento con palbociclib en el Instituto de Oncología Ángel Roffo. Se evaluaron en forma prospectiva 71 pacientes con cáncer de mama metastásico que calificaron para tratamiento con palbociclib desde marzo de 2016 hasta junio de 2017 inclusive. Las participantes fueron tratadas con palbociclib/letrozol (n = 49) o palbociclib/fulvestrant (n = 22). La mediana de tratamiento con palbociclib/ letrozol fue de 5 meses; 3 pacientes presentaron progresión de la enfermedad, y 36 se encuentran en respuesta parcial. La mediana de tratamiento con palbociclib/fulvestrant fue de 2.6 meses; 3 experimentaron progresión de la enfermedad, mientras que el resto de las participantes de este grupo se encuentran con respuesta parcial. En total, 26 tratadas con palbociclib presentaron toxicidades hematológicas, destacándose la neutropenia de grados I a III, anemia de grados I a II, y plaquetopenia grado III. No se registraron toxicidades de grado IV. A pesar del breve período de seguimiento (16 meses), nuestras pacientes evolucionaron con escasa cantidad de progresiones (8.4%), de acuerdo con lo descrito en la literatura, y con menor toxicidad que la comunicada (36.7%) (AU)

In December 2015, ANMAT approved the use of palbociclib in combination with letrozole for the first-line treatment of hormone-receptor-positive and HER2-negative metastatic breast cancer. Subsequently, the combination of palbociclib with fulvestrant was approved in August 2016 for patients progressing from previous endocrine therapy. The purpose of the present study was to conduct a prospective evaluation of safety and efficacy of palbociclib treatment at Instituto de Oncología Ángel H. Roffo. Seventy one patients with metastatic breast cancer who qualified for treatment with palbociclib from March 2016 to June 2017, were evaluated prospectively. Participants were treated with palbociclib/letrozole (n = 49) or palbociclib/ fulvestrant (n = 22). Median of treatment with palbociclib/letrozole was 5 months; 3 patients showed progression of the disease, and 36 are in partial response. Median of treatment with palbociclib/fulvestrant was 2.6 months; 3 patients experienced disease progression, while the rest of the participants in this group were in partial response. In total, 26 treated with palbociclib presented haematological toxicities, including neutropenia grades I to III, anaemia in grades I to II, and thrombocytopenia grade III. No grade IV toxicities were recorded. Despite the brief follow-up period (16 months), our patients experienced a low number of progression (8.4%), as described in the literature, and with less toxicity than reported (36.7%) (AU)

Plantas medicinales utilizadas para afecciones en Estomatología en los consultorios dentales del distrito de Huancayo / Medicinal plants used for stomatology conditions in the dental offices of the district of Huancayo

Las plantas medicinales son un recurso de la naturaleza que sirven para curar o prevenir determinadas enfermedades, afecciones o problemas de salud. Las afecciones en estomatología son enfermedades que se padece en una determinada parte del organismo relacionada al aparato estomatognático (dientes, periodonto, articulación temporomandibular, sistema neuromuscular y todas las estructuras de la cavidad oral). El objetivo de la presente investigación es determinar que plantas medicinales se utilizan como alternativa de tratamiento para afecciones en estomatología en los consultorios dentales del distrito de Huancayo; asimismo, se aplicó el método descriptivo - transversal, cuyo tipo de investigación es básico. Como resultado de nuestra investigación se ha obtenido información relevante de los cirujanos dentistas de los consultorios dentales particulares del distrito de Huancayo, tales como: las plantas medicinales utilizadas mayormente como alternativa de tratamiento para afecciones en estomatología son: llantén, tomillo, geranio, coca, clavo de olor, muña, inca muña y cebolla; asimismo, las formas de preparación de las mismas son: infusión, machacado, hervido, entre otros; del mismo modo, las afecciones en estomatología tratadas con las plantas medicinales son: caries dental, gingivitis, periodontitis, candidiasis oral, absceso dental, estomatitis herpética y úlceras orales; asimismo, el 87% de cirujanos dentistas si conocen el uso adecuado de las plantas medicinales utilizadas como alternativa de tratamiento en afecciones en estomatología y el 99% si consideran el uso adecuado de las plantas medicinales sería una alternativa de tratamiento para reducir costos y problemas relacionados con el medicamento.