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Discordance between A1C and fasting glucose (FBG) or oral glucose tolerance glucose (OGTT) in the detection of dysglycemia has been observed in multiracial and multiethnic populations. In most instances, A1C under detected diabetes or prediabetes compared to glucose tests. To determine the relationship between FBG, OGTT and A1C for the diagnosis of prediabetes in a Filipino American population we studied 154 self-reported nondiabetic adult subjects from the Filipino Health study living in the U.S. > 3 year. Mean age 42 ± 18 y, BMI 25.8 ± 3.8, 58% female, and 67% with a family history of diabetes. Using ADA criteria, 5 subjects met the diagnosis of diabetes (4 by A1C and 1 by OGTT, the later subject is not included in Table 1) while 61 (40%) had prediabetes. Prevalence of prediabetes was only 6.5% by FBG and 7.1% by OGTT. However, the prediabetes prevalence was 36% by A1C. Kruskal Wallis was used to test the difference in insulin resistance by HOMA-IR and insulin between HbA1C categories. Subjects with an A1C of 5.7-6.4% (41 of whom had normal FBG and OGTT) were significantly more insulin resistant than those with an A1C < 5.7%. This suggests A1C may be a more sensitive test of abnormal glucose regulation in a Filipino population living in the U.S. than FBG or OGTT. Outcome studies assessing progression to diabetes will be needed to confirm this hypothesis. Disclosure M.P. Mercado: None. S. Kim: None. E.C. Cutiongco de la Paz: None. M. Seielstad: None. E. Paz-Pacheco: None. E. Murphy: None. Funding Philippine-California Advanced Research Institutes

Algunos autores defienden que el ingreso hospitalario constituye un marco ideal para dejar de fumar. Se desconoce lo que sucede con los fumadores que ingresan por primera vez en el Servicio de Neumología, sobre las intervenciones que en ellos se lleva a cabo, así como sus tasas de abandono una vez que son dados de alta. El objetivo de este estudio es analizar el impacto que tiene un primer ingreso hospitalario en el Servicio de Neumología en sujetos fumadores. Conocer sus variables epidemiológicas, el hábito de tabáquico, las intervenciones que el personal médico especializado realiza sobre estos sujetos y las tasas de abstinencia posteriores al alta. Es necesario formar a los especialistas para diagnosticar y tratar al paciente en dicho proceso, de tal forma que sobre todo sujeto fumador hospitalizado se realice alguna intervención. Some authors suggest that hospitalization is an ideal moment to stop smoking. It is unknown the outcome of smokers admitted for the first time in the pulmonology department, which interventions are carried out to achieve smoking cessation and which are the dropout rates once they are discharged. The purpose of this study is to analyze the impact of a first hospital admission in a service of Pneumology on smokers. Epidemiological variables, smoking habit, specialized interventions carried out on these subjects and rate of withdrawal after discharge were studied. It is necessary to train specialists to diagnose and treat the patient in the process, so that on every hospitalized smoker a cessation intervention should be carried out.

Se ha realizado un análisis de diferentes definiciones, de los bienes jurídicos protegidos de los pacientes, responsabilidad médica, tipos de responsabilidad, características y clases de acto médico, ética médica, evolución histórica de responsabilidad penal médica, asimismo se estudiara la normativa utilizando la exegesis de la normativa interna correspondiente, así mismo se toma como referente la legislación comparada; respecto a la fundamentación práctica se obtendrá en base a un trabajo de campo mediante un instrumento denominado cuestionario, aplicado a los responsables y la comunidad jurídica del cual obtendremos resultados que nos brindará una verdadera situación del problema que se ha planteado. El objetivo de la presente investigación se centró en conocer los factores por las cuales no se ha regulado la sanción penal adecuada establecida en el artículo 111 del Código Penal de Homicidio Culposo respecto a la responsabilidad de los profesionales médicos. Para lo cual se planteo la hipótesis: La norma penal respecto a la responsabilidad en el delito de Homicidio Culposo en los profesionales médicos, se vio afectado por Empirismos Aplicativos y Empirismos Normativos. La metodología de la investigación utilizada fue descriptiva – explicativa. Habiéndose arribado a la siguiente conclusión. “La norma penal respecto a la responsabilidad en el delito de Homicidio Culposo en los profesionales médicos, se ve afectada por Empirismos Aplicativos y Empirismos Normativos, que están relacionados causalmente y se explican por el hecho de que no existe la correcta interpretación y aplicación de la norma prescrita en el artículo 111 de Código Penal por parte de los Responsables ante la sanción de la responsabilidad de los médicos”.

Presentamos un caso clínico de diagnóstico prenatal de una masa testicular. Tras el nacimiento, se realizó la exéresis del tumor y el análisis anatomopatológico determinó que se trataba de un tumor de células de la granulosa juvenil. Los tumores testiculares son raros y deben considerarse en el diagnóstico diferencial de las masas escrotales en los neonatos. El tumor de células de la granulosa juvenil es una entidad clínico-patológica poco frecuente, que representa el 5% de los tumores testiculares prepuberales. Se considera una neoplasia benigna y la orquiectomía es una técnica quirúrgica curativa. We report a case of a prenatally diagnosed testis tumor. After delivery, it was decided to perform right radical orchiectomy which was subsequently diagnosed as a juvenile granulosa cell tumor. Neonatal testicular tumors are rare and should be considered in the differential diagnosis of newborn scrotal masses. Juvenile granulosa cell tumor is a rare benign neoplasm of the testicular stroma that accounts for 5% of all prepuberal testis tumors. As a benign neoplasm, orchiectomy is sufficient for treatment.

The empirical Green function (EGF) model assumes that the recorded far-field waveform of an earthquake is the output of a linear system whose impulse response function is approximated by the waveform of a suitable small earthquake (the EGF) with the same focal mechanism and location as the larger one. The input of the system is the so-called source time function (STF) which describes the energy release and the rupture evolution. In a previous paper the projected Landweber method was applied to this deconvolution problem, i.e. to the estimation of the STF being given the EGF and the recorded waveform of the seismic event. The results obtained are more realistic and qualitatively much better than those provided by linear regularization methods, as a consequence of the beneficial effect of the constraints on the STF (positivity, causality, etc) introduced by means of the projected Landweber method. However, the STFs obtained in this way do not reproduce the observed seismograms within the experimental errors. This effect is presumably due to the modelling error introduced when approximating the exact (but unknown) Green function by means of the EGF so that the problem arises of improving such an approximation. To this purpose we propose a nontrivial modification of an iterative blind-deconvolution method used for image identification. The main feature of our method, which is based on the projected Landweber method, is that the use of different constraints for the EGF and STF is allowed. The convergence of the method is very fast and the results obtained in the case of synthetic and real data are quite satisfactory. Even if described and validated in the specific problem of seismology we are considering, it can be applied to any deconvolution problem where a rough approximation of the point spread function is available and different constraints must be used for the impulse response function and the input of the system.

The empirical Green function (EGF) model, which is used in this paper for the analysis of the waveforms of low-energy earthquakes, consists in assuming that the propagating medium and the recording instrument can be treated as a linear system and that the impulse response function of the system can be approximated by the waveform of a very small earthquake. The deconvolution of the Green function event from the waveform of a larger one, located at approximately the same position, provides information about the source time function (STF) of the latter. Linear inversion methods do not yield satisfactory estimations of the STF which must be positive and causal. Moreover, an estimate of the duration (support) of the STF should be desirable. In this paper we apply to this problem the so-called projected Landweber method, which is an iterative nonlinear method allowing for the introduction of constraints on the solution. The implementation of the method is easy and efficient. We first validate the method by means of synthetic data, generated by the use of waveforms of a seismic swarm that occurred in the Ligurian Alps (north-western Italy) during July 1993. Then, taking into account the indications provided by the simulations, the method has been applied to the inversion of real data, yielding satisfactory results also in the case of quite complex events.

Edvard Munch is one the most transcendental artists of all times. His work is innovative in terms of reflecting the grief, sadness, loneliness and the impact of death in human beings as no one did it before. Behind his work it is possible to find many clues given by Munch himself of the reason of his creativity: a childhood surrounded by death and sorrow, and the development of an affective disorder that led him to alcoholism and many hospitalizations due to psychotic episodes. In this review, we analyze Munch's life and his disease that undoubtedly contributed to his great artistic legacy.

El embarazo cervical es una forma infrecuente de gestación ectópica. El examen ecográfico permite el diagnóstico precoz, y una actuación conservadora. Se describe el caso clínico de una gestación ectópica cervical diagnosticada en el Servicio de Urgencias de Obstetricia y Ginecología del Hospital Universitario Miguel Servet (Zaragoza, España). Paciente nulípara de 31 años que consultó por sangrado genital. El diagnóstico se realizó mediante ecografía transvaginal, objetivándose un embarazo ectópico cervical con embrión vivo acorde a 8 semanas de edad gestacional. Se realizó tratamiento conservador con metotrexato mediante inyección local intrasacular asociado a administración sistémica. Seguimiento con determinaciones seriadas de gonodotrópica coriónica humana, objetivándose un descenso progresivo de ésta. Se efectuaron controles ecográfcos periódicos, evidenciando la reabsorción de la gestación confirmándose el éxito del tratamiento. Cervical ectopic pregnancy is an unusual form of ectopic pregnancy. Ultrasound examination makes early diagnosis possible and permits to perform conservative treatment. We describe a case of cervical ectopic pregnancy diagnosed in the Emergency Section of Miguel Servet University Hospital (Zaragoza, Spain). A 31 year-old nullipara pregnant woman came to our Hospital because of genital bleeding. Ultrasound trans-vaginal examination demonstrated a cervical pregnancy with an 8 weeks embryo. Conservative treatment was prescribed using US-guided injection and systemic methotrexate. After treatment, weekly quantitative human chorionic gonadotrophin levels were determined and decreased progressively. Serial ultrasound exams were performed demonstrating how pregnancy products underwent resorption and confirming therapy success.

Travel-time residuals of teleseismic P waves were analysed in order to elucidate the crust–upper mantle structure in Northwestern Italy, and the Western Alpine Arc. Using digital data obtained from both fixed seismograph networks operating in NW Italy (notably Liguria–Piedmont) and temporary arrays with the aid of cross-correlation techniques reliable travel-time residuals were calculated which were then inverted to obtain models of propagation anomalies. The reliability of the inversion procedure was tested using synthetic data. The model thus obtained appears to be stable and shows strong lateral heterogeneities at a litho–asthenospheric level; in particular, it confirms the high velocity contrast caused by the ‘Ivrea Body’ in the shallower layers and the presence of Alpine ‘roots’ reaching down to at least 200 km. A statistical analysis performed on the propagation times of rays crossing the resulting four-layered model reveals rms below 0.1 s.

El autor y autora comentan que el presupuesto participativo es un mecanismo de participación de la población que permite el ejercicio real de sus derechos y obligaciones; democratiza la gestión pública; y por último nos ayuda a planificar la inversión a corto y mediano plazo, pero aún más, ayuda a la realización de la planificación estratégica elaborada por el Municipio

The neurosteroid allopregnanolone, a reduced metabolite of progesterone, induces anxiolytic effects by enhancing GABA(A) receptor function. Neuropeptide Y (NPY) and GABA are thought to interact functionally in the amygdala, and this interaction may be important in the regulation of anxiety. By using Y(1)R/LacZ transgenic mice, which harbour a fusion construct comprising the promoter of the mouse gene for the Y(1) receptor for NPY linked to the lacZ gene, we previously showed that long-term treatment with benzodiazepine receptor ligands modulates Y(1) receptor gene expression in the medial amygdala. We have now investigated the effects of prolonged treatment with progesterone or allopregnanolone on Y(1)R/LacZ transgene expression, as determined by quantitative histochemical analysis of beta-galactosidase activity. Progesterone increased both the cerebrocortical concentration of allopregnanolone and beta-galactosidase expression in the medial amygdala. Finasteride, a 5alpha-reductase inhibitor, prevented both of these effects. Long-term administration of allopregnanolone also increased both the cortical concentration of this neurosteroid and transgene expression in the medial amygdala. Treatment with neither progesterone nor allopregnanolone affected beta-galactosidase activity in the medial habenula. These data suggest that allopregnanolone regulates Y(1) receptor gene expression through modulation of GABA(A) receptor function, and they provide further support for a functional interaction between GABA and neuropeptide Y in the amygdala.

In this paper we apply various inversion methods to a set of teleseismic data collected by a network operating along the Ligurian Belt in the transition region between Alps and Apennines. In particular, we consider the regularization method, the truncated singular value decomposition, the Landweber method (with the Related Simultaneous Iterative Reconstruction Technique) and the conjugate gradient method. All the methods provide rather similar velocity models which are well approximated by that provided by back-projection (used with an appropriate normalization constant). A drawback of these models seems to be the large discrepancy (of the order of 40%) between the observed time residuals and those computed from the model itself. However, for each station of the network, the azimuth dependence of the computed time residuals reproduces rather well the observed one so that it is believable that the most significant information contained in the data has been expIoited. The computed velocity models indicate strong heterogeneities in the first 200 km below the Apennines.

Neuropeptide Y (NPY) is an important central and peripheral modulator of neural and endocrine functions. This neuropeptide interacts with at least two pharmacologically distinct receptors, termed Y1 and Y2. At Y1 receptors, the NPY analog [Leu31,Pro34] NPY, but not the carboxyl-terminal fragment NPY-(18-36), displaces radiolabeled NPY and the sequence-related peptide YY, whereas Y2 receptors exhibit the opposite selectivity. We have used cultured mammalian 293 cells for the high level transient expression of a previously cloned putative neuropeptide receptor of rat brain. We report that this receptor displays the ligand binding properties and selectivity of a Y1 receptor, with a single high affinity site for 125I-NPY (Kd, 0.7 +/- 0.2 nM). The functionality of the recombinantly expressed receptor was demonstrated by an inhibition of adenylyl cyclase and a concomitant mobilization of intracellular Ca2+.

An analysis of P n -wave time residuals for the seismic stations aligned along a profile crossing Northern Apennines Ligurian Belt, Western Alps and Provence has been carried out. The waves generated by the Friuli seismic sequence have been used as input data. The data, statistically treated have shown strong variations along the profile with negative residuals (high velocity in the crust) for some Alpine stations and positive residuals in the Northern Apennines. On the basis of these data a velocity model, tested with the ray-tracing technique, is proposed. From some delayed arrivals of P n phase, very clearly observed in the Ligurian region the presence of a layer characterized by a velocity of 7.6 km/s at a depth of 25 km overlying a Moho discontinuity at 40 km has been proposed.

In this paper two methods for analysing in real time (or on line) microseisms recorded near a coast, with the aim to deduce their fundamental periods and evolution, are presented. Firstly, the autocorrelation of microseisms as a random signal is derived, whereas the second method consisting in a frequential filtering is more extensively used. The application of these methods is also made for simultaneously recorded microseisms in Genoa and in Vesima-Arenzano (station placed just on shore-line). The results show that in Genoa the peak amplitude ratio between secondary and primary microseisms is varying in the range of 3–28, whereas in Vesima this ratio is about the unity. This behaviour is explained on account of the different breaking zones for the two stations.

In GH3 pituitary cell homogenates, acetylcholine (ACh) (IC50 200 nM) inhibits adenylate cyclase [ATP pyrophosphate-lyase (cyclizing), EC 4.6.1.1] activity in a concentration- and GTP-dependent manner. Maximal inhibition was obtained with 10 microM ACh and corresponded to approximately a 50% decrease in basal enzyme activity. ACh inhibition is antagonized by atropine and is mimicked by muscarinic receptor agonists, but not by nicotine. ACh reduces the adenylate cyclase stimulation by vasoactive intestinal peptide (VIP), without changing its EC50. In intact GH3 cells, ACh decreases the cyclic AMP content and the rate of prolactin release in a concentration-dependent manner. When the cells are simultaneously exposed to VIP and ACh, the VIP-induced increases in cyclic AMP accumulation and prolactin release are reduced by 80% and 40%, respectively. The potency of VIP is not significantly changed by the presence of ACh, and vice versa.

Choline oxidase and cholinesterase were found to retain their activity for 1–2 weeks at room temperature while adsorbed to a commercially available anion-exchange cartridge. These enzymes convert acetylcholine to H2O2. Acetylcholine can be measured in tissue extracts by separation at pH 7 on a polymeric reverse-phase high-performance liquid chromatography column, conversion of acetylcholine to H2O2 on a postcolumn enzyme-loaded anion-exchange cartridge, and electrochemical detection of the H2O2 formed.