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OBJECTIVE: In order to agree on the fundamental aspects related to the management of pregnancy in patients with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS), the Spanish Societies of Gynaecology and Obstetrics, Internal Medicine and Rheumatology set up a working group for the preparation of three consensus documents. METHODS: Each of the Scientific Societies involved proposed five representatives based on their experience in the field of pregnancy control in patients with autoimmune diseases. The recommendations were developed following the Delphi methodology. RESULTS: This second document contains the recommendations regarding the management of pregnancy in women with SLE and APS, including complications such as lupus activity, congenital heart block, thrombotic and obstetric manifestations of APS and placental vascular disease. CONCLUSIONS: These multidisciplinary recommendations are considered decision-making tools for clinicians involved in the care of patients with SLE/APS during pregnancy.

Objective: In order to agree on the fundamental aspects related to the management of pregnancy in patients with systemic lupus erythematosus and antiphospholipid syndrome, the Spanish Societies of Gynaecology and Obstetrics, Internal Medicine and Rheumatology have set up a working group for the preparation of three consensus documents. Methods: Each of the Scientific Societies involved proposed five representatives based on their experience in the field of pregnancy control in patients with autoimmune diseases. The recommendations were developed following the Delphi methodology. Results: This third document contains the recommendations regarding the management of delivery, puerperium and lactation, including medication use during these periods and the care of the newborn. In addition, a section on contraception is included. Conclusions: These multidisciplinary recommendations are considered decision-making tools for clinicians involved in the care of patients with systemic lupus erythematosus/antiphospholipid syndrome during pregnancy. (c) 2019 Elsevier Espana, S.L.U. and Sociedad Espanola de Reumatologia y Colegio Mexicano de Reumatologia. All rights reserved.

Based in Sydney since 2015, the architectural collective Grandeza/Bajeza operates at the confluence of teaching, academic research, and critical spatial practice, within and beyond the framework of the School of Architecture at the University of Technology Sydney, Australia. Their work studies late-capitalist spaces and narratives to identify – through critical analysis – and neutralize – through political imagination – the mechanisms that veil and normalize neoliberal violence. Their work interrogates the capacity of architecture and cognitive institutions to respond to contemporary environmental, social, and political challenges, beyond the reductive proclivities of “techno determinism”, “resilience” and depoliticised “ecologism”. This paper aims to dissect the work of Grandeza/Bajeza as an ‘epistemological estuary’ that feeds from (and struggles to survive within) the same institutional and cultural frameworks that their work aims to overturn.

Starting from a cloud of smoke that connected two distant cities at the beginning of 2020, this essay explores the historical similarities between these two Pacific ports-Sydney and Valparaíso. Analyzing the commonalities and divergences between Australian and Chilean neoliberalism, the collapse of this model is evidenced in the smoke from fires or barricades that could give rise to new forms of post-liberal coexistence.

Resumen El ser vivo más grande el planeta - el gran arrecife de Coral de Australia - empezó a decolorarse en 2016 como efecto ecosis-témico del cambio climático. Este episodio sirve como lente para mirar no sólo la forma en que el patrimonio de la humanidad se ve afectado por el calentamiento global, sino también cómo los gobiernos niegan esto con estrategias falsas de protección ambiental en paralelo a la promoción continua de los com-bustibles fósiles. Abstract As an ecosystemic effect of climate change, the largest living being on the planet - the great Coral Reef in Australia - started to lose its color in 2016. This episode serves as a lens to look not only at the way in which the heritage of humanity is affected by global warming but also at how governments deny this using false environmental protection strategies in parallel to the continuous promotion of fossil fuels.

Objetivo Las Sociedades Españolas de Ginecología y Obstetricia, de Medicina Interna y de Reumatología han constituido un grupo de trabajo paritario para la elaboración de tres documentos de consenso sobre el control del embarazo en mujeres con lupus eritematoso sistémico y síndrome antifosfolípido. Métodos Cada una de las sociedades científicas implicadas propuso cinco representantes en base a su experiencia en el área del control del embarazo en pacientes con enfermedades autoinmunes. Las recomendaciones se elaboraron siguiendo la metodología Delphi. Resultados En este tercer documento se incluyen las recomendaciones que abordan el manejo del parto, puerperio y lactancia, incluyendo el manejo de los diferentes fármacos en estos periodos. Además se incluye una sección sobre los cuidados iniciales del recién nacido y sobre anticoncepción. Conclusiones Estas recomendaciones multidisciplinares se consideran herramientas en la toma de decisiones para los clínicos involucrados en la asistencia a pacientes con lupus eritematoso sistémico/síndrome antifosfolípido durante el embarazo. Objective In order to agree on the fundamental aspects related to the management of pregnancy in patients with systemic lupus erythematosus and antiphospholipid syndrome, the Spanish Societies of Gynaecology and Obstetrics, Internal Medicine and Rheumatology have set up a working group for the preparation of three consensus documents. Methods Each of the Scientific Societies involved proposed five representatives based on their experience in the field of pregnancy control in patients with autoimmune diseases. The recommendations were developed following the Delphi methodology. Results This third document contains the recommendations regarding the management of delivery, puerperium and lactation, including medication use during these periods and the care of the newborn. In addition, a section on contraception is included. Conclusions These multidisciplinary recommendations are considered decision-making tools for clinicians involved in the care of patients with systemic lupus erythematosus/antiphospholipid syndrome during pregnancy.

© 2019, Pontificia Universidad Catolica de Chile. All rights reserved. As an ecosystemic effect of climate change, the largest living being on the planet – the great Coral Reef in Australia – started to lose its color in 2016. This episode serves as a lens to look not only at the way in which the heritage of humanity is affected by global warming but also at how governments deny this using false environmental protection strategies in parallel to the continuous promotion of fossil fuels.

In order to agree on the fundamental aspects related to the management of pregnancy in patients with systemic lupus erythematosus and antiphospholipid syndrome, the Spanish Societies of Gynaecology and Obstetrics, Internal Medicine and Rheumatology have set up a working group for the preparation of three consensus documents.

© 2017, Pontificia Universidad Catolica de Chile. All rights reserved. Within the framework of the XX Biennial of Architecture and Urbanism of Chile, the question about Valparaíso’s heritage could not be postponed. This installation, designed in Australia, delivers an unprecedented response: a new social contract which, based on a land-trust and a new ‘city-brand,’ takes advantage of the bohemian character of the port to exacerbate otherness and, ultimately, generate a parallel State.

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IDDRG - Conference Proceedings - Tools and Technologies for the Processing of ultra high strength steels

International audience; The fate of cadmium and copper during thermal and ultrasound treatments of activated sludge was studied in terms of mixed liquor physicochemical modifications. Biochemical composition of sludge testfied to the solubilization of its biopolymers. Granulometric measurements demonstrated that ultrasound and temperature induced respectively floe disintegration and macrofloc deflocculation. The uptake of the two metals by sludge floes was improved with an increase in temperature. Both metals were in a different way adsorbed by sludge floes, since mass transfer improvement together with the extended surface area offered by sonicated floes increased the cadmium adsorption. At the same time, an increase in soluble organic ligands limited copper uptake.

La diferenciación de los hemangiomas y las malformaciones vasculares es histológica, clínica y pronóstica. Aunque la mayoría de los hemangiomas evolucionan a la resolución espontanea, pueden complicarse hasta en un 10% de los casos con ulceración, dolor y hemorragia. Además, la propia localización de los hemangiomas en la cabeza y cuello, junto a estructuras vitales pueden comprometer sus funciones. Así pues, la compresión de vía aérea puede ser una urgencia vital. Los hemangiomas periorbitarios pueden producir ambliopía por deprivación sensorial o por un estrabismo restrictivo. Los hemangiomas lumbosacros deben estudiarse con RMN por su frecuente asociación con alteraciones de la línea media a nivel espinal, anal, genital o renal. Entre los hemangiomas viscerales, los hepáticos son los más graves por su asociación con insuficiencia cardiaca congestiva. La asociación de hemangiomas faciales extensos con anomalías del SNC, anomalías vasculares, cardiacas, oculares y esternales se denomina síndrome PHACE y con frecuencia se complica con deficiencia mental, convulsiones o ictus. Las malformaciones vasculares de localización trigeminal se asocian hasta en un 15% con glaucoma o hemangiomas coroideos o leptomeníngeos (síndrome de Sturge-Weber). Las malformaciones vasculares combinadas localizadas en extremidades pueden complicarse con tromboflebitis, osteolisis regional e incluso tromboembolismos a distancia (Síndrome de Klippel-Treneaunay ). Por otro lado, existe una coagulopatía por consumo (Síndrome de Kassabach-Merrit) que puede complicar algunos tumores vasculares como el hemangiomatoendotelioma kaposiforme y el angioma en penacho. Se revisan por último las complicaciones de los tratamientos empleados. The differentiation of haemangiomas and vascular malformations is histological, clinical and prognostic. Although the majority of haemangiomas evolve towards spontaneous resolution, as many as 10% of cases can develop complications with ulceration, pain and haemorrhaging. Besides, the localisation of haemangiomas in the head and neck, next to vital structures, can compromise their functions. Hence, compression of the airway might be a vital emergency. Periorbital haemangiomas can give rise to amblyopia due to sensory deprivation or due to a restrictive strabismus. Lumbosacral haemangiomas must be studied with Nuclear Magnetic Resonance because of their frequent association with alterations in the midline at the level of the spine, anus, genitals or kidneys. Amongst visceral haemangiomas, hepatic haemangiomas are the most serious due to their association with congestive cardiac insufficiency. The association of extensive facial haemangiomas with anomalies of the central nervous system, vascular, cardiac, ocular and sternal anomalies, is denominated PHACE syndrome and is frequently complicated by mental deficiency, convulsions or ictus. Vascular malformations of trigeminal localisation are associated in up to 15% of cases with glaucoma or choroidal or leptomeningeal haemangiomas (Sturge-Weber syndrome). Combined vascular malformations localised in the extremities can become complicated with thrombophlebitis, regional osteolysis and even distant thromboembolisms (Klippel-Treneaunay Syndrome). On the other hand, there is a coagulopathy due to consumption (Kassabach-Merrit Syndrome) that can complicate some vascular tumours such as the Kaposiform haemangioendothelioma and the tufted angioma. Finally, the complications of the treatments employed are reviewed.

Fundamentos. Conocer si los factores de riesgo cardiovascular se distribuyen de modo distinto en pacientes con glaucoma primario de ángulo abierto (GPAA) o en pacientes controles. Cuantificar la prevalencia de estos factores en el GPAA. Analizar la patología concomitante más prevalente en este grupo de pacientes y analizar sus implicaciones en el tratamiento médico del GPAA. Material y Métodos. Estudio observacional transversal sobre población hospitalaria con diagnóstico de GPAA. Se seleccionaron mediante muestreo consecutivo 50 pacientes ingresados en un hospital terciario por cualquier motivo con antecedentes de GPAA y se compararon con un grupo control de 50 pacientes con ingreso hospitalario durante el mismo período y sin diagnóstico de GPAA. Se incluyeron las variables edad, sexo, motivo de ingreso codificado según su grupo relacionado por diagnóstico (GRD) y categoría diagnóstica mayor (CDM), tratamiento del glaucoma, antecedentes personales incluyendo la presencia o no de: accidente cerebrovascular, diabetes, hipertensión arterial, cardiopatía isquémica, fenómeno de Raynaud, hipotensión, dislipemia y tabaquismo. Resultados. Existe una asociación aunque no llega al nivel de significación estadística entre el GPAA y el accidente cerebrovascular (razón de prevalencias=2,16; IC al 95%=1,01-2,20; p=0,074*), la hipotensión arterial (razón de prevalencias=5; intervalo de confianza=1,14-2,63; p=0,092*) y la hipertensión arterial (razón de prevalencias=1,35; p=0,16). Con el tamaño de la muestra no se encontró asociación con el resto de las variables estudiadas. El motivo de ingreso hospitalario más frecuente en este grupo de pacientes es debido a trastornos del sistema respiratorio y circulatorio (24 y 22% respectivamente) siendo la neumonía el GRD más frecuente (10%). En el grupo control: las enfermedades del sistema circulatorio seguidas de las del sistema respiratorio (24 y 16% respectivamente). La reagudización de la enfermedad pulmonar obstructiva crónica (EPOC) es el GRD más frecuente (6%). El factor de riesgo vascular más frecuente en ambos grupos es la hipertensión arterial (54 frente a un 40%) seguido del accidente cerebrovascular (26 frente al 12% del grupo control). El tratamiento médico más utilizado en estos pacientes son los betabloqueantes solos (24,3%) o en asociación (18,9%) Conclusiones. El GPAA está asociado con la enfermedad cerebrovascular y las variaciones de la presión arterial (hiper/hipotensión). Las enfermedades del sistema respiratorio (neumonía y EPOC), circulatorio (insuficiencia cardiaca congestiva-ICC- y cardiopatía isquémica) son la causa de morbilidad más prevalente en este grupo. El tratamiento médico del glaucoma más utilizado son los betabloqueantes que están contraindicados en pacientes con EPOC e ICC. Purpose. To determine whether cardiovascular risk factors distribution differ between primary open-angle glaucoma (POAG) and control subjects. To assess the strength of this association in POAG. To analyze the most frequent patology in this group of patients for a better selection of medical treatment. Methods. Observational cross-sectional study in patients with a diagnosis of POAG. Fifty glaucoma patients were selected with consecutive sampling between those who had been admitted to an terciary hospital by any reason and compared with fifty admitted to the same hospital patients without POAG diagnosis in the same period of time. The variables age, sex, the reason for admission to hospital clasificated by diagnosis related group (DRG) and diagnostic mayor criteria (DMC), treatment for glaucoma, stroke, diabetes mellitus, high blood pressure, ischaemic cardiopathy, Raynaud phenomenon, low blood pressure, hypercholesterolemia and tobacco were investigated. Results. An association was found between POAG and stroke (prevalence ratio=2.16;CI al 95%=1.01-2.20; p=0.074*), low blood pressure (prevalence ratio=5; CI=1.14-2.63; p=0.092*) and high blood pressure (prevalence ratio=1.35; p=0.16) but it didn`t reach to the statistical level of signification. No association with the remaining variables was found with this size sample. The most frequent reason for hospital admission in the study group were respiratory and circulatory system disease. circulatorio (24 y 22% respectivaly)with the pneumonia the most frequent DRG (10%). In the control group, the most frequent reason were circulatory and respiratory system disease (24 y 16% respectively). The cronic obstructive airway disease (COAD) was the most frequent DRG in this group (6%). The vascular risk factors most frequently found in both of the groups was high blood pressure (54 and 40% ) and the stroke (26-12%). The medical glaucoma treatment in these patients were the beta-blockers only (24.3%) or in association (18.9%). Conclusions. POAG is associated with stroke and blood pressure variations (high and low). The respiratory (pneumonia and COAD) and circulatory system diseases (congestive heart failure-CHF- and ischaemic cardiopathy) are the most frequently morbility cause in this group of patients. The most frequent medical therapy used for glaucoma are the beta-blockers which are contraindicated in COAD and CHF patients.

Summary Background Results from observational studies suggest that caesarean-section delivery may reduce the risk of mother-to-child transmission of HIV-1 infection in comparison with vaginal delivery. We carried out a randomised clinical trial to address this issue and to assess the extent of postdelivery complications. Methods Eligible women were between 34 and 36 weeks of pregnancy, with a confirmed diagnosis of HIV-1 infection, and without an indication for caesarean-section delivery or a contraindication to this mode of delivery. Women were randomly assigned elective caesareansection delivery at 38 weeks of pregnancy or vaginal delivery. An infant was classified as uninfected if he or she became negative for antibody to HIV-1 by age 18 months or was negative for virus by PCR or culture on at least two occasions, with no clinical, immunological, or viral evidence of infection. From 1993, to March, 1998, 436 women were randomised. Findings We present the results of an analysis updated to November, 1998, with data on the infection status of 370 infants. Three (1·8%) of 170 infants born to women assigned caesarean-section delivery were infected, compared with 21 (10·5%) of 200 born to women assigned vaginal delivery (p