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Renata García-Franco,1 Dalia Méndez-Marín,1 Marlon García-Roa,1 Paulina Ramirez-Neria,1 Diego Valera-Cornejo,1 Van Charles Lansingh1,2 1Retina department, Instituto Mexicano de Oftalmología I.A.P., Santiago De Querétaro, Querétaro, México; 2HelpMeSee Inc, NY, New York, USACorrespondence: Diego Valera-CornejoInstituto Mexicano de Oftalmología I.A.P., Colinas de Cimatario, Avenida Estadio Sn, Centro Sur, Santiago De Querétaro 76090, Querétaro, MexicoTel +52 1 442 229 0776Email diegoavalera@gmail.comObjective: To determine normal macular thickness values in a healthy Mexican population and its variation by age and gender using Huvitz spectral-domain optical coherence tomography (HOCT-1F).Methods: This cross-sectional study included 211 consecutive eyes from clinically normal subjects (66 men, 145 women) between October 2018 and December 2018, with best-corrected visual acuities better than 20/30. One eye was selected for the macular scan using the Huvitz OCT (Huvitz OCT-1F, HOCT-1F, Huvitz Co., Ltd., Republic of Korea) with an automated segmentation algorithm. Three vertical and horizontal scans, centered on the fovea with an area of 9 mm, and a color 45° fundus photograph were obtained using Huvitz OCT-1F. Macular measurements were presented as means with standard deviations values for each of the nine regions defined by the Early Treatment Diabetic Retinopathy Study (ETDRS).Results: The mean age was 34.3± 11.9 years. Using the ETDRS map, the mean central subfield thickness (CST) was 227.4± 18.9 μm. Male gender was associated with greater CST (P< 0.001) compared to females. There was no association between mean macular CST (r2=0.011; P=0.11) and age. Macular thickness was thicker in the inner ring than in the outer ring, and there were no significant differences in mean CST among age groups (P=0.70).Conclusion: Normal macular thickness values using the Huvitz OCT in a Mexican healthy population aged from 18– 70 years were thinner in the foveal macular region than values reported in other populations. Female patients had a thinner CST, and age was not correlated with macular thickness.Keywords: retina, tomography, optical coherence, diagnostic imaging, Mexico

Sexual functioning in bipolar disorder (BD) is dependent on multiple clinical and demographic determinants that can eventually lead to sexual dysfunction. However, the contribution of affective temperaments remains unstudied in this population. In this cross-sectional multicentric work, we studied the impact of temperament traits on sexual functioning in 100 euthymic BD outpatients treated only with mood stabilizers with or without benzodiazepines. Temperament was evaluated using the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego - Autoquestionnaire (TEMPS-A) and sexual functioning with the Changes on Sexual Functioning Questionnaire (CSFQ-14). The effect of temperament on sexual functioning was analyzed using Bayesian ordinal regression models, which included age, gender, BD type, dominant polarity, metabolic syndrome, marital status, and affective symptomatology. Our results showed that hyperthymic traits predicted a significantly higher CSFQ-14 score for global sexual functioning (OR = 1.222; 95% CI [1.073, 1.431]), desire (OR = 1.164; 95% CI [1.025, 1.357]), arousal (OR = 1.278; 95% CI: [1.083, 1.551]), and orgasm (OR = 1.182; 95% CI [1.037, 1.365]). We did not find a significant contribution for other types of temperaments. Better sexual functioning was also associated with a better quality of life. Our findings highlight the importance of temperament traits in sexual functioning in euthymic BD, which may have implications in sexual dysfunction prevention.

This research was born as an unknown related to the recent application of Virtual Education in educational centers, not only in Costa Rica, but worldwide. All of the above for reasons of public health prevention, given the presence of the SARS-CoV-2 virus. This is how it is then tried to investigate whether there are implications in relation to the theoretical proposal of the Theory of Mind (TM) and its relationship with Distance Education (virtuality), as part of a new training model (teaching and learning).

Miguel Ángel Díaz Palacios,1 David Hervás Marín,2 Ana Giner Valero,1 Noelia Colomer Hernández,1 Carla Torán Barona,1 Dolores Hernández Fernández de Rojas11Department of Allergy, Hospital Universitari La Fe, Valencia, Spain; 2Department of Biostatistics, Instituto de Investigación Sanitaria La Fe, Valencia, SpainPurpose: Impulse oscillometry (IOS) has been proposed as an alternative test to evaluate the obstruction of small airways and to detect changes in airways earlier than spirometry. In this study, we sought to determine the utility and association of IOS parameters with spirometry and asthma control in an adult population.Patients and methods: Adults 14–82 years of age with asthma were classified into uncontrolled asthma (n=48), partially controlled asthma (n=45), and controlled asthma (n=49) groups,and characterized with fractional exhaled nitric oxide (FENO), IOS, and spirometry in a transversal analysis planned as a one-visit study. The basic parameters evaluated in IOS are resistance at 5 Hz (R5), an index affected by the large and small airway; resistance at 20 Hz (R20), an index of the resistance of large airways; difference between R5 and R20 (R5–R20), indicative of the function of the small peripheral airways; reactance at 5 Hz (X5), indicative of the capacitive reactance in the small peripheral airways; resonance frequency (Fres), the intermediate frequency at which the reactance is null, and reactance area (XA), which represents the total reactance (area under the curve) at all frequencies between 5 Hz to Fres.Results: There were statistical differences between groups in standard spirometry and IOS parameters reflecting small peripheral airways (R5, R10, R5–R20, Fres, XA and X5) (P

The cervical cancer represents a problem of public health and is considered the second reason of death by cancer in women. There have been described factors associated, related to the conduct, habits and infectious agents, such as Human Immunodeficiency Virus, herpes virus, Chlamydia trachomatis and Human Papilloma Virus (HPV). In order to establish risk factors and detect preinvasive cervical lesions, 101 samples of women from three indigenous ethnic groups of Zulia State were selected; to which a clinical-epidemiological survey was carried out to study the predisposing factors, in addition to the cytological study. Of the total of patients studied 33.66% were negative to the cytological study, while 66.34% had some type of alteration, observing that the Yukpa the most affected, 21 (20.79%) presented Cervical intraepithelial neoplasia and related infectious agents were found in 56.51% of the women. Coelocytic cells suggestive of HPV were found in 26.21% of all patients. When we analyzed the risk factors, we found that, the onset of sexual intercourse before age 15 as well as alcohol consumption were the most relevant. According to the findings, it is important the timely diagnosis in these communities, which are disassociated, and without access to health centers, whether due to living conditions or cultural implications. Resumen: El cáncer de cuello uterino (CaCu) representa un problema de salud pública y es considerado la segunda causa de muerte por cáncer en mujeres. Se han descrito factores de riesgo, los cuales están relacionados con hábitos, conductas y agentes infecciosos tales como el Virus de Inmunodeficiencia humana, herpes virus, Chlamydia trachomatis y Virus del Papiloma Humano (VPH). Con el fin de establecer los factores de riesgo y detectar lesiones preinvasivas de cérvix, se seleccionaron 101 mujeres de tres etnias indígenas, a las cuales se les realizó una encuesta clínico-epidemiológica, además del estudio citológico. Del total de pacientes estudiadas un 66,34% presentaron algún tipo de alteración, siendo las Yukpa las más afectadas, así mismo 21 (20,79%) presentaron neoplasia intraepitelial cervical y se encontraron agentes infecciosos en un 56,51% de las mujeres. En un 26,21% de las pacientes se encontraron células coilocíticas sugestivas de VPH. Al analizar los factores de riesgo se encontró que el inicio de relaciones sexuales antes de los 15 años, y el consumo de alcohol fueron los más relevantes. Es de importancia el diagnóstico oportuno en estas comunidades que se encuentran desasistidas y sin acceso a centros de salud, ya sea por condiciones de vida o por implicaciones culturales.

Aims: This study is aimed to investigate the effectiveness of an oral stimulation protocol in preterm infants compared to usual care, to reduce the time for achieving safe full oral feeding. Methods: 47 preterm infants (25- 30 weeks of gestational age) were randomized into two groups. Babies of the EG (n = 24) received a 10-minute oral stimulation protocol while the CG (n = 23) received the standard care. The primary outcome were the days from the initiation of the intervention until the achievement of full oral feeding. Secondary outcomes were: days from the first day the intervention started until achieving a first oral intake of 30% in the first 5 minutes, days from the first day the intervention started until achieving a first oral intake of 100%, and days of hospitalization. A parametric survival model with Gaussian distribution was used. Results: The EG achieved full oral feeding 8.3 days before the CG (p = 0.013). EG also achieved the first oral intake of 30% in the first five minutes, 6.03 days before (p = 0.019) and of 100%, 5.88 days before (p = 0.040). EG also spent 6.9 days less hospitalized than CG (p = 0.028). Conclusion: Oral stimulation in preterm infants significantly shortens the time to achieve full oral feeding and reduces the length of hospitalization.

Alzheimer's Disease (AD) is the most common neurodegenerative disease worldwide. So, there is a need to identify AD early diagnosis and monitoring biomarkers in blood samples. The aim of this study was to analyse the utility of lipid peroxidation biomarkers in AD progression evaluation. Participants (n = 19) were diagnosed with AD at early stages (Time 0, T0), and they were re-evaluated 2 years later (Time 1, T1). Plasma biomarkers from AD patients were determined at both times. Some analytes, such as dihomo-isoprostanes (17-epi-17-F2t-dihomo-IsoP, 17-F2t-dihomo-IsoP, Ent-7(RS)-7-F2t-dihomo-IsoP), and neuroprostanes (10-epi-10-F4t-NeuroP) showed very high probability of showing an increasing trend over time. Baseline values allowed to develop an affordable preliminary regression model to predict long-term cognitive status. So, some lipid peroxidation biomarkers would deserve consideration as useful progression AD biomarkers. The developed prediction model would constitute an important minimally invasive approach in AD personalized prognosis and perhaps could have some interest also in experimental treatments evaluation.

Resumen: Introducción: Un niño con baja visión (BV) rehabilitado puede tener una educación integral. Objetivo: Estudiar el perfil de los escolares derivados para evaluación a un Proyecto de Rehabilitación en un organismo de apoyo social. Pacientes y Método: Estudio transversal descriptivo de beneficiarios evaluados entre septiembre 2015 y septiembre 2016 en JUNAEB. Se consideró diagnóstico de derivación, agudeza visual monocular (AV) con corrección óptica para lejos (cartillas Feinbloom) y cerca (cartillas Zeiss). Se clasificaron según AV y perimetría. Se consideró éxito de tratamiento lograr AV > 0,4 para le jos y/o cerca con ayuda óptica. Resultados: Se evaluaron 278 escolares. 153 (55%) fueron hombres, 121(43,5%) entre 10 a 14 años. Catarata congénita bilateral, distrofias retinales, alta miopía, atrofia óptica y nistagmus congénito fueron las patologías más frecuentes. 224 (80,6%) se habilitaron con ayudas. 85 (37,9%) presentaron BV moderada y 63 (28,6%) BV severa. 122 (54,5%) presentaban perimetría normal, 68 (30,4%) campo visual (CV) tubular, 19 (8,5%) defecto sectorial del CV y 15 (6,7%) compromiso central del CV. 198 (88,4%) escolares lograron éxito visual de lejos y todos lograron éxito visual de cerca. 48 (17,2%) escolares no pudieron ser rehabilitados, estando asocia dos a una afección neuroftalmológica (41,7%), alto error refractivo (16,6%) o glaucoma congénito (10,4%). 6 (2,2%) casos mejoraron su AV con nueva corrección óptica. Conclusión: El éxito obteni do demuestra la necesidad de habilitar visualmente a escolares con BV. Nuestro desafío es mantener este programa y educar al oftalmólogo prestador para una derivación oportuna. Abstract: Introduction: A low-vision (LV) rehabilitated child can receive comprehensive education. Objec tive: To study the profile of school children referred for evaluation to a rehabilitation project in a social assistance agency. Patients and Method: Descriptive cross-sectional study of beneficiaries evaluated between September 2015 and September 2016 in the National Board of School Assistan ce and Scholarships (JUNAEB). The referral diagnosis, monocular visual acuity (VA) with optical correction at far (Feinbloom chart) and close (Zeiss chart) distances were considered. They were classified according to VA and perimetry. Treatment success was considered if VA reaches > 0.4 at far and/or close distances with optical devices. Results: 278 students were assessed. 153 (55%) were men, 121 (43.5%) between the ages of 10 to 14. Bilateral congenital cataract, retinal dystrophies, high myopia, optic atrophy, and congenital nystagmus were the most frequent pathologies. 224 students (80.6%) received optical devices. 85 (37.9%) presented moderate LV and 63 (28.6%) severe LV; 122 (54.5%) presented normal perimetry, 68 (30.4%) tubular Visual Field (VF), 19 (8.5%) sectoral VF defects, and 15 (6.7%) central scotoma. 198 (88.4%) students achieved visual success at a far distance and all achieved visual success at a near distance. 48 (17.2%) students could not be rehabilitated due to a neuro-ophthalmological condition (41.7%), high refractive error (16.6%) or congenital glauco ma (10.4%).Six (2.2%) cases improved VA with a new optical correction. Conclusion: This success demonstrates the need to provide low vision aids to schoolchildren with LV. Our challenge is to maintain this program and to educate ophthalmologist for timely referral.

Introduction: A low-vision (LV) rehabilitated child can receive comprehensive education. Objective: To study the profile of school children referred for evaluation to a rehabilitation project in a social assistance agency. Patients and Method: Descriptive cross-sectional study of beneficiaries evaluated between September 2015 and September 2016 in the National Board of School Assistance and Scholarships (JUNAEB). The referral diagnosis, monocular visual acuity (VA) with optical correction at far (Feinbloom chart) and close (Zeiss chart) distances were considered. They were classified according to VA and perimetry. Treatment success was considered if VA reaches ≥ 0.4 at far and/or close distances with optical devices. Results: 278 students were assessed. 153 (55%) were men, 121 (43.5%) between the ages of 10 to 14. Bilateral congenital cataract, retinal dystrophies, high myopia, optic atrophy, and congenital nystagmus were the most frequent pathologies. 224 students (80.6%) received optical devices. 85 (37.9%) presented moderate LV and 63 (28.6%) severe LV; 122 (54.5%) presented normal perimetry, 68 (30.4%) tubular Visual Field (VF), 19 (8.5%) sectoral VF defects, and 15 (6.7%) central scotoma. 198 (88.4%) students achieved visual success at a far distance and all achieved visual success at a near distance. 48 (17.2%) students could not be rehabilitated due to a neuro-ophthalmological condition (41.7%), high refractive error (16.6%) or congenital glaucoma (10.4%).Six (2.2%) cases improved VA with a new optical correction. Conclusion: This success demonstrates the need to provide low vision aids to schoolchildren with LV. Our challenge is to maintain this program and to educate ophthalmologist for timely referral.

Cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer. Although most cSCCs have good prognosis, a subgroup of high-risk cSCC has a higher frequency of recurrence and mortality. Therefore, the identification of molecular risk factors associated with this aggressive subtype is of major interest. In this work we carried out a global-scale approach to investigate the DNA-methylation profile in patients at different stages, from premalignant actinic keratosis to low-risk invasive and high-risk non-metastatic and metastatic cSCC. The results showed massive non-sequential changes in DNA-methylome and identified a minimal methylation signature that discriminates between stages. Importantly, a direct comparison of low-risk and high-risk stages revealed epigenetic traits characteristic of high-risk tumours. Finally, a prognostic prediction model in cSCC patients identified a methylation signature able to predict the overall survival of patients. Thus, the analysis of DNA-methylation in cSCC revealed changes during the evolution of the disease through the different stages that can be of great value not only in the diagnosis but also in the prognosis of the disease.

The aim of this study was to assess the efficacy of anti-endomysium antibodies (EMA) as a serological marker for celiac disease (CD) diagnosis in a pediatric population. A retrospective study of pediatric patients who underwent a CD serological markers study: EMA and anti-tissue transglutaminase antibodies (anti-TG2). Clinical symptomatology, degree of histological lesion, human leukocyte antigen (HLA) haplotype compatible with CD (HLA DQ2 and/or DQ8), and final diagnosis were taken into account. We included 445 patients who were classified in two groups according to the final diagnosis. Group 1: 232 children with CD, 91.4% of whom exhibited small intestinal villous atrophy, 228 being EMA-positive and four EMA-negative. Group 2: 213 children with a non-CD diagnosis, 212 EMA negative and one EMA positive. Both antibodies, EMA and anti-TG2, reached similar sensitivities, 98% and 99% respectively, while EMA had a higher specificity (99%) than anti-TG2 (93%). By using both markers combined, compared to using anti-TG2 alone, 5.7% of patients are better diagnosed. However, when we compare the efficacy of EMA and anti-TG2 in asymptomatic and symptomatic patients, the sensitivity of EMA is 98% irrespective of symptoms, thus higher than for anti-TG2 =10 × upper limit of normal (ULN) (respectively 77% and 84%). Our results support the use of EMA to increase CD diagnostic accuracy in a non-biopsy approach, especially in asymptomatic children.

Beyond pest resistance, rootstocks significantly influence the performance of grapevine varieties. However, the effect of the rootstock is strongly affected by its interaction with the environment, and it is therefore necessary to evaluate their influence in a particular terroir. With the aim of evaluating the influence of 12 rootstocks on the agronomic performance of 'Syrah' and 'Tempranillo', a trial was established in 2011 and 2012 in Miranda de Arga (Navarra, Spain), under the typical environmental conditions of the Ebro Valley. Growth and yield, as well as industrial and phenolic maturity parameters were analysed during four consecutive seasons (2015-2018). Most rootstocks showed a similar performance with both varieties, not always following the trends reported in bibliography, which highlights the relevance of studying rootstocks in different conditions. 3309 C was the rootstock conferring the highest vigour, whereas the lowest were provided by 420 A MGt and 'Fercal'. The implications on grape composition were much more diverse, and were partially conditioned by yield. Results were obtained during the four first harvests of the vineyard, and could therefore change to some extent as the vineyard reaches stability., VITIS - Journal of Grapevine Research, Vol. 58 No. 5 (2019): Vitis (Special Issue)

Evaluate the relationship between structural damage assessed by radiography or ultrasonography in the hands of patients with psoriatic arthritis (PsA) with loss of strength together with functional disability.

A low-vision (LV) rehabilitated child can receive comprehensive education. Objec tive: To study the profile of school children referred for evaluation to a rehabilitation project in a social assistance agency.Descriptive cross-sectional study of beneficiaries evaluated between September 2015 and September 2016 in the National Board of School Assistan ce and Scholarships (JUNAEB). The referral diagnosis, monocular visual acuity (VA) with optical correction at far (Feinbloom chart) and close (Zeiss chart) distances were considered. They were classified according to VA and perimetry. Treatment success was considered if VA reaches0.4 at far and/or close distances with optical devices.278 students were assessed. 153 (55%) were men, 121 (43.5%) between the ages of 10 to 14. Bilateral congenital cataract, retinal dystrophies, high myopia, optic atrophy, and congenital nystagmus were the most frequent pathologies. 224 students (80.6%) received optical devices. 85 (37.9%) presented moderate LV and 63 (28.6%) severe LV; 122 (54.5%) presented normal perimetry, 68 (30.4%) tubular Visual Field (VF), 19 (8.5%) sectoral VF defects, and 15 (6.7%) central scotoma. 198 (88.4%) students achieved visual success at a far distance and all achieved visual success at a near distance. 48 (17.2%) students could not be rehabilitated due to a neuro-ophthalmological condition (41.7%), high refractive error (16.6%) or congenital glauco ma (10.4%).Six (2.2%) cases improved VA with a new optical correction.This success demonstrates the need to provide low vision aids to schoolchildren with LV. Our challenge is to maintain this program and to educate ophthalmologist for timely referral.

Purpose The debate about the impact of intensified hyperglycemia treatment is still ranging. The main objective was to assess whether intensive glycemic control in hospitalized diabetic patients undergoing a liver transplant is associated with a lower rate of graft rejection at 3 months and at 5 years post-transplant. Methods Cross-sectional study comparing a cohort of patients undergoing liver transplant in 2010 and 2011, in whom an intensive insulin protocol was applied, with a retrospective group of patients undergoing a liver transplant in 2005 and 2006, in whom a conventional insulin protocol was applied. Both diabetics and non-diabetics were compared. As intensive insulin therapy is applied mainly in diabetic patients, it is expected that, when comparing both periods, the treatment would only benefit those patients. Results The logistic regression model showed a statistically significant interaction between the treatment group and the presence of diabetes for the rejection rate 3 months and 5 years post-transplant. At both time points, the intensive insulin treatment group had lower rejection rates in the case of diabetic patients, which did not occur in non-diabetic patients. Conclusions Our study shows a decrease in the rate of liver graft rejection in diabetic patients undergoing intensive insulin treatment.

Users that detect defects in the termination of building elements frequently go to courts of justice claiming reparations and/or compensations. This situation generates in the intervening agents doubts and uncertainties about the responsibilities, consequences and penalties that they have to pay to compensate for that deficiencies. The object of present investigation is to propose and validate an automated model in the form of “predictive system” based on a software application “Expert System”. Using this software you can identify and classify these defects. Los usuarios que detectan defectos en edificaciones recientemente acabadas con frecuencia acuden a la vía judicial para reclamar su reparación. Ello genera en los agentes intervinientes cierta incertidumbre respecto a si serán o no condenados como responsables de dichos defectos. El objetivo de la presente investigación se centra en proponer y validar un modelo automatizado en forma de herramienta informatizada que, de manera sencilla, ayude a «tipificar de forma predictiva» los defectos más frecuentes y controvertidos a la hora de delimitar responsabilidades, es decir, los denominados «de terminación o acabado».

The near-infrared microscope (NIRM) is an instrument that has demonstrated its great ability to detect contaminants not by analyzing a single spectrum but rather by analyzing hundreds or thousands of spectra from individual particles, while at the same time being a non-destructive and easy-to-use technique. It has been used for the detection of meat-and-bone meal (MBM) in compound feeds within the context of the European bovine spongiform encephalopathy (BSE; commonly known as "mad cow disease") crisis. This study describes, for the first time, an application of NIRM instrument standardization using a measurement cell in an inter-laboratory study conducted within the framework of a qualitative determination of animal proteins in compound feeds, based on spectra obtained with eight instruments. The standardization cell was assessed for its ability to produce good optical matching of the instruments and/or to evaluate instrument performance.

© 2016 Elsevier España, S.L.U. Objectives To determine the test-retest reliability of a questionnaire, with a validation preliminary, to assess knowledge of cardiovascular risk (CVR) and cardiovascular disease in patients attending community pharmacies in Spain. To complement the external validity, establishing the relationship between an educational activity and the increase in knowledge about CVR and cardiovascular disease. Design Sub-analysis of a controlled clinical study, EMDADER-CV, in which a questionnaire about knowledge concerning CVR was applied at 4 different times. Location Spanish Community Pharmacies. Participants There were 323 patients in the control group, from the 640 who completed the study. Main measurements Intraclass correlation coefficient to assess the reliability in 3 comparisons (post-educational activity with week 16, post-educational activity with week 32, and week 16 with week 32); and the non-parametric Friedman test to establish the relationship between an oral and written educational activity with increasing knowledge. Results For the 323 patients in the 3 comparisons, the intraclass correlation coefficient values were 0.624; 0.608 and 0.801, respectively (fair-good to excellent reliability). So, the Friedman test showed a statistically significant relationship between educational activity and increased knowledge (p < .0001). Conclusions According to the intraclass correlation coefficient, the questionnaire aimed at assessing the knowledge on CVR and cardiovascular disease has a reliability between acceptable and excellent, which added to the previous validation, shows that the instrument meets the criteria of validity and reliability. Furthermore, the questionnaire showed the ability to relate an increase in knowledge with an educational intervention, feature that complements its external validity.

Comunicació presentada a la 16th International Society for Music Information Retrieval Conference (ISMIR 2015), celebrada els dies 26 a 30 d'octubre de 2015 a Màlaga, Espanya. Measuring rhythm similarity is relevant for the analysis and generation of music. Existing similarity metrics tend to consider our perception of rhythms as being in time without discriminating the importance of some regions over others. In a previously reported experiment we observed that measures of similarity may differ given the presence or absence of a pulse inducing sound and the importance of those measures is not constant along the pattern. These results are now reinterpreted by refining the previously proposed metrics. We consider that the perceptual contribution of each beat to the measured similarity is non-homogeneous but might indeed depend on the temporal positions of the beat along the bar. We show that with these improvements, the correlation between the previously evaluated experimental similarity and predictions based on our metrics increases substantially. We conclude by discussing a possible new methodology for evaluating rhythmic similarity between audio loops. This research has been partially supported by the EU funded GiantSteps project (FP7-ICT- 2013-10 Grant agreement nr 610591).

Aim: The main objective of this study is to demonstrate whether carbohydrate metabolism alterations identified in patients with advanced cirrhosis show any improvement after liver transplant. Methods: The study included 86 patients who underwent liver transplant between March 2010 and February 2011. An oral glucose tolerance test was performed before the liver transplant, and 6 and 12 months after. Beta cell function and insulin resistance were also calculated, applying formulae that use basal plasma glycaemia and insulin, and plasma glycaemia and insulin during an oral glucose tolerance test. Risk factors for pre- and post-transplant diabetes were also studied. The diagnosis of diabetes was based on an OGTT. Results: The proportion of patients with diabetes before transplant, and at month 6 and 12 after transplant were 70.9%, 48.8% and 39.2%, respectively. Compared to baseline, at month 6 the odds ratio of having diabetes was 0.39 (IC 95% [0.21, 0.73]) and at month 12 it was 0.26 (IC 95% [0.14, 0.50]). The composite insulin sensitivity index values at 6 and 12 months were 1.72 units higher (IC 95% [0.84, 2.58]) and 1.58 units higher (IC 95% [0.68, 2.44)] than baseline. A statistically significant association was found between high MELD values and high body mass index, and risk of pre-transplant diabetes (p = 0.001 and p = 0.033, respectively). Cirrhosis aetiology did not influence the risk of diabetes. Conclusions: In this study, we were able to ascertain that alterations in carbohydrate metabolism typical of advanced cirrhosis improve after liver transplant. This improvement is mainly due to an improvement in insulin resistance. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

Objective: To determine the existence of Doppler changes in the fetal vertebral, middle cerebral and umbilical arteries prior to term labor. Methods: Five hundred and twenty eight Doppler examinations of the vertebral (VA), middle cerebral (MCA) and umbilical (UA) arteries resistance indices (RI) were performed between 37 and 41 weeks gestation. For each artery, values were converted into multiples of the median (MoM) and were divided into four groups according to the interval to labor and compared using Kruskal-Wallis tests. Subsequently, values were plotted in scattergrams and linear regressions and 95% confidence intervals were calculated. Finally, using multivariate analysis and model averaging, the importance and interrelationship of Doppler measurements in the explanation of the interval to labor was evaluated. Results: Univariate and multivariate analysis confirmed that, independently of gestational age, fetuses examined close to labor presented more intense Doppler changes in the cerebral arteries with a significant reduction of the VA RI and MCA RI. This reduction was larger in the MCA. No significant changes were detected in the UA. Conclusion: Before the onset of term labor, the fetal cerebral flow presents an additional reduction of impedance, which is more intense in the MCA system.

ObjectiveThe objective of this article is to show the clinical utility of the vertebral artery Doppler as an alternative to the middle cerebral artery Doppler in the follow-up of fetuses affected with early-onset growth restriction [fetal growth restriction (FGR)]. MethodsWe present a group of fetuses with early-onset FGR in which the vertebral artery resistance index (VA RI) and pulsatility index (VA PI) were measured and plotted along with their references earlier calculated using 1980 Doppler examinations. In addition, the VA and middle cerebral artery (MCA) performance was compared using values converted into multiples of the median. ResultsSimilar to that of the MCA, VA RI and VA PI percentiles showed curve shapes with higher values at the beginning of the third trimester. The majority of growth-restricted fetuses showed a notorious decrease in the VA impedance, which was not statistically different to that of the MCA. ConclusionVertebral artery Doppler values can be obtained throughout the second half of pregnancy. Preliminary data suggest a clinical application in the management of early-onset FGR. (c) 2013 John Wiley & Sons, Ltd.

The characterisation of physical and chemical properties of meteoroids can be performed from the analysis of meteor and fireball events. This provides useful information about the origin and evolution of meteoroid streams and meteoroids of sporadic origin, but also about the mechanisms that deliver these materials to the Earth One of the systems that the SPanish Meteor Network (SPMN) employs to study the activity of meteor streams is based on high-sensitivity CCD video cameras. These devices, which are commonly used to monitor the night sky, provide useful data for the determination, for instance, of radiant, orbital and photometric parameters [1, 2, 3]. They are also very useful for meteor spectroscopy [3]. As a matter of fact, the recording and analysis of meteor spectra is one of the goals of our network, and some of our observing stations perform a continuous spectroscopic campaign since 2006. In this context, we analyze here a mag. -10 sporadic fireball recorded from two of our meteor stations on October 4, 2011.

The long-term prediction of delivery date with obstetric ultrasound.

To compare the brain sparing mechanism of the fetal vertebral artery (VA), with the one of the middle cerebral artery (MCA) in fetuses with increased umbilical artery (UA) Doppler impedance.

Introducción: La consulta pediátrica pretrasplante es fundamental en un programa de trasplante hepático, allí se evalúan diferentes aspectos como, la indicación del trasplante, el estadio de la enfermedad, comorbilidades asociadas y nos permite corregir las mismas ya que estas influirán en la sobrevida postrasplante. El objetivo fue conocer las características de la población pediátrica evaluada como posibles candidatos a trasplante. Pacientes y Métodos: Se realizó estudio retrospectivo. Se incluyeron todos los pacientes pediátricos que fueron referidos para valoración como posibles candidatos a trasplante hepático desde 2005 al 2010. Resultados: Se estudiaron 152 pacientes, 65 (43%) del sexo masculino y 87 (57%) del sexo femenino, con edad promedio de 6,16 + 5,24 años. Al momento del estudio 61 pacientes no tenían indicación de trasplante, 35 se encontraban en evaluación, 28 se trasplantaron, 21 fallecieron y 7 fueron referidos. Las indicaciones de trasplante fueron: disminución de la síntesis hepática 20, síndrome hepatopulmonar 2, hemorragia digestiva 3, síndrome hepatorrenal 2 y un fallo hepático subagudo. De los pacientes trasplantados 16 presentaban algún grado de desnutrición previa, 3 presentaban ascitis, 7 habían presentado hemorragias digestivas, 6 presentaban infecciones (urinarias, respiratorias y absceso dentarios), 24 tenían patologías odontológicas. Los 28 pacientes tenían esquema de inmunización incompleto durante la evaluación. Todos estos problemas fueron tratados previo al trasplante. Conclusión: La consulta pediátrica de hígado pretrasplante es de suma importancia ya que en ella se identifican los pacientes con indicación de trasplante además de valorar de forma integral al paciente, lo que nos permite conocer aquellas morbilidades asociadas a la enfermedad hepática terminal y resolverlas previo al trasplante, mejorando su posterior sobrevida. Introduction: Pediatric liver pre-transplantation consultation is very important in a liver transplant program, there different aspects are assessed, such as the indication the transplant, disease stage, associated comorbidities and it allows us to correct them as they will affect the survival after transplantation. The objective was to determine the characteristics of the pediatric population evaluated as potential transplant candidates. Patients And Methods: A retrospective study was performed. All pediatric patients who were referred for evaluation as potential candidates for liver transplantation from 2005 to 2010 were included. RESULTS: 152 patients were studied, 65 (43%) were males and 87 (57%) females, mean age 6.16 ± 5.24 years. At the time of the study 61 patients had no indication for transplant, 35 were been evaluated, 28 were transplanted, 21 died and 7 were referred. The indications for transplantation were: decreased hepatic synthesis 20, hepatopulmonary syndrome 2, gastrointestinal bleeding 3, hepatorenal syndrome 2 and one subacute liver failure. Of the transplanted patients 16 had some degree of previous malnutrition, 3 had ascites, 7 had presented gastrointestinal bleeding, 6 had infections (urinary, respiratory and dental abscess), and 24 had dental pathologies. The 28 patients had an incomplete immunization schedule during the evaluation. All these problems were treated prior to transplantation. Conclusion: the pediatric liver pretransplantation consultation is of most importance since in it we identify patients with indication for transplantation; in addition, we can completely asses the patient allowing us to recognize morbidities associated with the end stage liver disease and resolve them before transplantation, improving subsequent survival.

In this paper, a new automated methodology to detect the optic disc (OD) automatically in retinal images from patients with risk of being affected by Diabetic Retinopathy (DR) and Macular Edema (ME) is presented. The detection procedure comprises two independent methodologies. On one hand, a location methodology obtains a pixel that belongs to the OD using image contrast analysis and structure filtering techniques and, on the other hand, a boundary segmentation methodology estimates a circular approximation of the OD boundary by applying mathematical morphology, edge detection techniques and the Circular Hough Transform. The methodologies were tested on a set of 1200 images composed of 229 retinographies from patients affected by DR with risk of ME, 431 with DR and no risk of ME and 540 images of healthy retinas. The location methodology obtained 98.83% success rate, whereas the OD boundary segmentation methodology obtained good circular OD boundary approximation in 94.58% of cases. 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La leucemia mieloide crónica (LMC) es una enfermedad mieloproliferativa caracterizada por la expansión clonal de células mieloides que expresan la proteína de fusión BCR-ABL, responsable de los efectos oncogénicos de la LMC. La terapia actual en el tratamiento de LMC es el inhibidor de la BCR-ABL tirosín-kinasa, imatinib. Aunque este fármaco ha demostrado mejorar la supervivencia en pacientes con LMC, su papel en el contexto del trasplante renal no ha sido ampliamente descrito en la literatura. Presentamos un caso de remisión molecular de LMC en un varón de 55 años con un segundo trasplante renal, hepatitis C y con riesgos cardiovasculares e inmunológicos asociados.

La leucemia mieloide crónica (LMC) es una enfermedad mieloproliferativa caracterizada por la expansión clonal de células mieloides que expresan la proteína de fusión BCR-ABL, responsable de los efectos oncogénicos de la LMC. La terapia actual en el tratamiento de LMC es el inhibidor de la BCR-ABL tirosín-kinasa, imatinib. Aunque este fármaco ha demostrado mejorar la supervivencia en pacientes con LMC, su papel en el contexto del trasplante renal no ha sido ampliamente descrito en la literatura. Presentamos un caso de remisión molecular de LMC en un varón de 55 años con un segundo trasplante renal, hepatitis C y con riesgos cardiovasculares e inmunológicos asociados. Abstract Chronic myeloid leukemia (CML) is a myeloproliferative disorder characterized by clonal expansion of cells in the myeloid line, expressing the BCRABL fusion protein responsible for the oncogenic effect of CML. The current frontline therapy in CML is the BCR-ABL tyrosine kinase inhibitor, Imatinib. Although this drug has been shown to improve survival in CML patients, its role in the context of a transplant setting has not been widely described in the literature. We report on the long term molecular remission of CML in a 55 year old man with a second renal transplant who is hepatitis C virus positive, and has associated cardiovascular and immunological risk factors.

La rehabilitacion pulmonar es un recurso terapeutico no farmacologico dirigido a pacientes con EPOC, sus principales objetivos son: reducir los sintomas, mejorar la calidad de vida y aumentar la participacion fisica y emocional de los pacientes en las actividades cotidianas. Los pacientes con EPOC en todos los estadios de la enfermedad se benefician con los programas de entrenamiento, que mejoran tanto la tolerancia al ejercicio como la sensacion de disnea y fatiga. La educacion al paciente se incluye con el objetivo de optimizar sus habilidades, su capacidad de sobrellevar la enfermedad y para mejorar su estado de salud, ademas de la cesacion del habito tabaquico. A continuacion se presenta una revision bibliografica acerca del entrenamiento fisico y la educacion como parte de un programa de rehabilitacion pulmonar.

Primary hyperparathyroidism is the main cause of hypercalcemia in ambulatory patients. Classic surgical resolution of this disease includes bilateral cervical exploration with exhibition of the four parathyroid glands and evaluation of the suspicious gland with a rapid biopsy. We report a 79 years old female with a primary hyperparathyroidism in whom the adenoma causing the disease was located with the help of an intraoperatory gamma-probe that detected the zone of higher radiation counting of Tc99m Sestamibi, that was injected preoperatively. The patient was discharged with normal serum calcium and phosphate levels (Rev Méd Chile 2001; 129: 921-4).

Primary hyperparathyroidism is the main cause of hypercalcemia in ambulatory patients. Classic surgical resolution of this disease includes bilateral cervical exploration with exhibition of the four parathyroid glands and evaluation of the suspicious gland with a rapid biopsy. We report a 79 years old female with a primary hyperparathyroidism in whom the adenoma causing the disease was located with the help of an intraoperatory gamma-probe that detected the zone of higher radiation counting of Tc99m Sestamibi, that was injected preoperatively. The patient was discharged with normal serum calcium and phosphate levels (Rev Méd Chile 2001; 129: 921-4).

Objective To determine the use and performance of a line probe assay (LPA) compared with conventional culture and drug sensitivity testing (CDST) in patients registered with tuberculosis (TB) under routine program conditions in Peru in 2011–2013. Methods This was a descriptive, operational research, cross-sectional study of sputum specimens from patients with smear-positive pulmonary TB and mycobacterial cultures from patients with smear-negative or positive TB. Drug resistance to rifampicin and/or isoniazid detected by LPA was compared to CDST. Sensitivity, specificity, and predictive values were calculated and reliability for detecting drug resistance was assessed through kappa coefficient, with values 0.61–0.80 showing substantial correlation, and 0.81 or above showing almost-perfect correlation. Results In 2011–2013, there were 16 169 LPA tests performed, with the proportion of TB patients receiving the test increasing from 3.2% to 30.2%. In all, 2 905 LPA test results were compared to CDST. For LPA in sputum specimens, sensitivity for rifampicin was 92%; isoniazid, 94%; and MDR-TB, 88%; while specificity for rifampicin was 92%; isoniazid, 92%; and MDR-TB, 95%. For LPA in mycobacterial cultures, sensitivity for rifampicin was 95%; isoniazid, 96%; and MDR-TB, 90%; while specificity for rifampicin was 85%; isoniazid, 91%; and MDR-TB, 94%. Kappa coefficients were at 0.81 or above for all comparisons of LPA with CDST using sputum specimens and cultures, except for isoniazid in cultures, which was at 0.79. Conclusions This study suggests that LPA is a reliable and rapid screening test for drug-resistant TB and should be considered suitable for routine use and scale up in Peru.

Objective To measure time between onset of tuberculosis (TB) symptoms and start of treatment, and to identify factors associated with delay in eight Colombian cities. Methods Operational research with a retrospective analytical cohort design was conducted in 2014 using routinely collected data about new smear-positive pulmonary TB patients from eight cities in Colombia (Barranquilla, Bogotá, Bucaramanga, Cali, Cúcuta, Medellín, Pereira, and Villavicencio). Date of symptom onset was sourced from TB surveillance databases. Data on all other variables came from National TB Program (NTP) registers. Results There were 2 545 new cases of smear-positive pulmonary TB, but a plausible date of symptom onset was available for only 1 456 (57%). Median number of days between symptom onset and treatment start was 51 days (interquartile range: 27–101). A total of 72% of patients had a delay (> 30 days between symptom onset and treatment start), and 28% had a 3+ bacillary load at diagnosis. Based on multiple logistic regression, three factors were significantly associated with delay: being uninsured (odds ratio (OR): 1.30; 95% confidence interval (CI): 1.01–1.68) and having an unknown HIV status (OR: 1.81; CI: 1.04–3.17), which increased risk, and coming from a neighborhood with NTP-employed community health workers, which decreased risk (OR: 0.56; CI: 0.34–0.90). Conclusions Delays still prevent timely TB diagnosis and treatment in Colombia. As the country aims for TB elimination, delays must be reduced, especially in cities and vulnerable neighborhoods, to stop community transmission. The NTP should focus not only on the number of cases detected but also on how long it takes to detect them. To monitor interventions designed to reduce delays, additional dates in the process should be recorded routinely. In addition, reliability and completeness of data are crucial for monitoring.

In 2017, the dominant greenhouse gases released into Earth's atmosphere-carbon dioxide, methane, and nitrous oxide-reached new record highs. The annual global average carbon dioxide concentration at Earth's surface for 2017 was 405.0 ± 0.1 ppm, 2.2 ppm greater than for 2016 and the highest in the modern atmospheric measurement record and in ice core records dating back as far as 800 000 years. The global growth rate of CO2 has nearly quadrupled since the early 1960s. With ENSO-neutral conditions present in the central and eastern equatorial Pacific Ocean during most of the year and weak La Niña conditions notable at the start and end, the global temperature across land and ocean surfaces ranked as the second or third highest, depending on the dataset, since records began in the mid-to-late 1800s. Notably, it was the warmest non-El Niño year in the instrumental record. Above Earth's surface, the annual lower tropospheric temperature was also either second or third highest according to all datasets analyzed. The lower stratospheric temperature was about 0.2°C higher than the record cold temperature of 2016 according to most of the in situ and satellite datasets. Several countries, including Argentina, Uruguay, Spain, and Bulgaria, reported record high annual temperatures. Mexico broke its annual record for the fourth consecutive year. On 27 January, the temperature reached 43.4°C at Puerto Madryn, Argentina-the highest temperature recorded so far south (43°S) anywhere in the world. On 28 May in Turbat, western Pakistan, the high of 53.5°C tied Pakistan's all-time highest temperature and became the world-record highest temperature for May. In the Arctic, the 2017 land surface temperature was 1.6°C above the 1981-2010 average, the second highest since the record began in 1900, behind only 2016. The five highest annual Arctic temperatures have all occurred since 2007. Exceptionally high temperatures were observed in the permafrost across the Arctic, with record values reported in much of Alaska and northwestern Canada. In August, high sea surface temperature (SST) records were broken for the Chukchi Sea, with some regions as warm as +11°C, or 3° to 4°C warmer than the longterm mean (1982-present). According to paleoclimate studies, today's abnormally warm Arctic air and SSTs have not been observed in the last 2000 years. The increasing temperatures have led to decreasing Arctic sea ice extent and thickness. On 7 March, sea ice extent at the end of the growth season saw its lowest maximum in the 37-year satellite record, covering 8% less area than the 1981-2010 average. The Arctic sea ice minimum on 13 September was the eighth lowest on record and covered 25% less area than the long-term mean. Preliminary data indicate that glaciers across the world lost mass for the 38th consecutive year on record; the declines are remarkably consistent from region to region. Cumulatively since 1980, this loss is equivalent to slicing 22 meters off the top of the average glacier. Antarctic sea ice extent remained below average for all of 2017, with record lows during the first four months. Over the continent, the austral summer seasonal melt extent and melt index were the second highest since 2005, mostly due to strong positive anomalies of air temperature over most of the West Antarctic coast. In contrast, the East Antarctic Plateau saw record low mean temperatures in March. The year was also distinguished by the second smallest Antarctic ozone hole observed since 1988. Across the global oceans, the overall long-term SST warming trend remained strong. Although SST cooled slightly from 2016 to 2017, the last three years produced the three highest annual values observed; these high anomalies have been associated with widespread coral bleaching. The most recent global coral bleaching lasted three full years, June 2014 to May 2017, and was the longest, most widespread, and almost certainly most destructive such event on record. Global integrals of 0-700-m and 0-2000-m ocean heat content reached record highs in 2017, and global mean sea level during the year became the highest annual average in the 25-year satellite altimetry record, rising to 77 mm above the 1993 average. In the tropics, 2017 saw 85 named tropical storms, slightly above the 1981-2010 average of 82. The North Atlantic basin was the only basin that featured an above-normal season, its seventh most active in the 164-year record. Three hurricanes in the basin were especially notable. Harvey produced record rainfall totals in areas of Texas and Louisiana, including a storm total of 1538.7 mm near Beaumont, Texas, which far exceeds the previous known U.S. tropical cyclone record of 1320.8 mm. Irma was the strongest tropical cyclone globally in 2017 and the strongest Atlantic hurricane outside of the Gulf of Mexico and Caribbean on record with maximum winds of 295 km h-1. Maria caused catastrophic destruction across the Caribbean Islands, including devastating wind damage and flooding across Puerto Rico. Elsewhere, the western North Pacific, South Indian, and Australian basins were all particularly quiet. Precipitation over global land areas in 2017 was clearly above the long-term average. Among noteworthy regional precipitation records in 2017, Russia reported its second wettest year on record (after 2013) and Norway experienced its sixth wettest year since records began in 1900. Across India, heavy rain and flood-related incidents during the monsoon season claimed around 800 lives. In August and September, above-normal precipitation triggered the most devastating floods in more than a decade in the Venezuelan states of Bolívar and Delta Amacuro. In Nigeria, heavy rain during August and September caused the Niger and Benue Rivers to overflow, bringing floods that displaced more than 100 000 people. Global fire activity was the lowest since at least 2003; however, high activity occurred in parts of North America, South America, and Europe, with an unusually long season in Spain and Portugal, which had their second and third driest years on record, respectively. Devastating fires impacted British Columbia, destroying 1.2 million hectares of timber, bush, and grassland, due in part to the region's driest summer on record. In the United States, an extreme western wildfire season burned over 4 million hectares; the total costs of $18 billion tripled the previous U.S. annual wildfire cost record set in 1991.