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Introduction: Neuropsychological symptoms and cortical atrophy patterns show similarities between typical Alzheimer’s Disease (AD) and its variants. Thus, correct diagnosis is difficult, leading to errors in the therapeutic process. Indeed, the challenge in cognitive neuroscience focuses on identifying key features of cognitive-linguistic profiles and improving the knowledge of neural correlates for accurate differential diagnosis between the heterogeneous profiles of typical and atypical AD. Aim: This systematic review aims to describe different AD profiles, considering their neuropsychological symptoms and neural correlates. Methods: The present study followed the PRISMA guidelines and included studies from the PubMed, ScienceDirect, Scopus, and Web of Science databases, published between 2011 and 2021. Results: Thirty-one articles were included in this systematic review for critical analysis. Results suggest significant declines in episodic and working memory and executive function. Likewise, in all groups, verbal fluency and visuospatial/visuoconstructive skills declined. However, these symptoms overlap between typical AD, logopenic variant primary progressive aphasia, posterior cortical atrophy, behavioural/dysexecutive or frontal variant AD, and corticobasal syndrome. On the other hand, the neural correlate showed a pattern of atrophy in frontal, temporal, parietal, and occipital areas, even compromising the cuneus and precuneus. Conclusion: Spontaneous language and semantic and phonological verbal fluency could be an important biomarker for differential diagnosis between typical AD and its atypical variants. Likewise, clinical assessment should consider using advanced neuroimaging techniques to establish early associations between brain dysfunction and neuropsychological performance, with particular attention to brain areas such as the cuneus and precuneus. Resumen: Introducción: En la Enfermedad de Alzheimer (EA) la sintomatología neuropsicológica y el patrón de atrofia muestran similitudes entre sus variantes atípicas, conduciendo a errores diagnósticos e intervenciones no atingentes a los déficits en sus perfiles típico y atípicos. Así, el desafío en neurociencia cognitiva se centra en poder identificar los elementos neuropsicológicos y las bases neurales para un diagnóstico diferencial certero entre esta heterogeneidad de perfiles. Objetivo: Caracterizar los distintos perfiles de la EA considerando sus manifestaciones neuropsicológicas y correlato neural. Metodología: La revisión sistemática cualitativa se realizó bajo los criterios de la declaración PRISMA, considerando estudios de las bases de datos PubMed, ScienceDirect, Scopus y Web of Science, entre los años 2011 y 2021. Resultados: La búsqueda dio como resultado 31 artículos finales. Los hallazgos sugieren declives significativos en memoria episódica y de trabajo, función ejecutiva, lenguaje y habilidades visuoespaciales/visuoconstructivas, síntomas que se superponen en EA típica, Afasia Progresía Primaria variante logopénica, Atrofia Cortical Posterior, EA variante frontal y Síndrome Corticobasal. Por otra parte, el correlato neural en estos perfiles sugiere un patrón de atrofia frontal, témporoparietal y occipital, comprometiendo adicionalmente el cuneus y precuneus. Conclusión: El lenguaje espontáneo y la fluidez verbal semántica y fonológica se proponen como claves en el diagnóstico diferencial. Asimismo, la valoración clínica debe considerar el uso de técnicas de neuroimagen avanzadas para establecer asociaciones en etapas tempranas entre la función cerebral afectada y el desempeño neuropsicológico, dando especial atención a áreas como el cuneus y precuneus.

This paper presents the state-of-the-art technologies and development trends of wind turbine drivetrains – the system that converts kinetic energy of the wind to electrical energy – in different stages of their life cycle: design, manufacturing, installation, operation, lifetime extension, decommissioning and recycling. Offshore development and digitalization are also a focal point in this study. Drivetrain in this context includes the whole power conversion system: main bearing, shafts, gearbox, generator and power converter. The main aim of this article is to review the drivetrain technology development as well as to identify future challenges and research gaps. The main challenges in drivetrain research identified in this paper include drivetrain dynamic responses in large or floating turbines, aerodynamic and farm control effects, use of rare-earth material in generators, improving reliability through prognostics, and use of advances in digitalization. These challenges illustrate the multidisciplinary aspect of wind turbine drivetrains, which emphasizes the need for more interdisciplinary research and collaboration.

Introduction Cognitive impairment has been commonly found in patients with bipolar disorder (BD).(1) Recent evidence supports the view that global and cognitive functioning decrease as a function of number of prior mood episodes, but the relationship is still not clear. (2) Objectives We conducted a cross-sectional study to explore the associations between the lifetime number of affective episodes and functioning, in particular, cognitive functioning in a cohort of patients with BD. Methods Adult patients with BD were recruited if euthymic for at least 3 months. Socio-demographic and clinical variables were recollected at the baseline evaluation. Functioning was evaluated at baseline with the functioning assessment short test (FAST). The strength of the association between the lifetime number of affective episodes and FAST subscores was explored with Spearman’s correlation test. Linear regression was computed using cognitive functioning as the dependent variable and a set of clinically relevant variables including the lifetime number of affective episodes as independent variables after controlling for illness duration. Results 261 BD patients were recruited. Patients with a higher number of lifetime affective episodes showed a significant positive correlation with higher FAST global score (r=0.334, p

Abstract Background The incidence of non-AIDS defining cancer (NADC) is higher in people living with HIV (PLWH) than in the general population, and it is already one of the leading causes of death in the HIV-infected population. It is estimated that the situation will be aggravated by the progressive aging of PLWH. Early diagnosis through intensive cancer screening may improve the ability for therapeutic interventions and could be critical in reducing mortality, but it might also increase expenditure and harms associated with adverse events. The aim of this study is to evaluate an enhanced screening program for early diagnosis of cancer in PLWH compared to standard practice. The specific objectives are (1) to compare the frequency of cancer diagnosed at an early stage, (2) to analyze safety of the enhanced program: adverse events and unnecessary interventions, (3) to analyze the cost-utility of the program, and (4) to estimate the overall and site-specific incidence of NADC in PLWH. Methods We will conduct a multicenter, non-blinded, randomized, controlled trial, comparing two parallel arms: conventional vs enhanced screening. Data will be recorded in an electronic data collection notebook. Conventional intervention group will follow the standard of care screening in the participating centers, according to the European AIDS Clinical Society recommendations, and the enhanced intervention group will follow an expanded screening aimed to early detection of lung, liver, anal, cervical, breast, prostate, colorectal, and skin cancer. The trial will be conducted within the framework of the Spanish AIDS Research Network Cohort (CoRIS). Discussion The trial will evaluate the efficacy, safety, and efficiency of an enhanced screening program for the early diagnosis of cancer in HIV patients compared to standard of care practice. The information provided will be relevant since there are currently no studies on expanded cancer screening strategies in patients with HIV, and available data estimating cost effectiveness or cost-utility of such as programs are scarce. An enhanced program for NADC screening in patients with HIV could lead to early diagnosis and improve the prognosis of these patients, with an acceptable rate of unnecessary interventions, but it is critical to demonstrate that the benefits clearly outweigh the harms, before the strategy could be implemented. Trial registration ClinicalTrials.gov NCT04735445. Registered on 25 June 2019

Roller bearing failures in wind turbines' gearboxes lead to long downtimes and high repair costs, which could be reduced by the implementation of a predictive maintenance strategy. In this paper and within this context, an acoustic-emission-based condition monitoring system is applied to roller bearing test rigs with the aim of identifying critical operating conditions before bearing failures occurs. Furthermore, a comparison regarding detection times is carried out with traditional vibration-based condition monitoring systems, with a focus on premature bearing failures such as white etching cracks. The investigations show a sensitivity of the acoustic-emission system towards lubricating conditions. In addition, the system has shown that a damaged surface can be detected at least ∼ 4 % (8 h, regarding the time to failure) earlier than by using the vibration-based system. Furthermore, significant deviations from the average acoustic-emission signal were detected up to ∼ 50 % (130 h) before the test stop and are possibly related to sub-surface damage initiation and might result in an earlier damage detection in the future.

Introduction The COVID-19 pandemic entailed several changes in health and medical assistance, economy, and lifestyle. In the Acute Psychiatric Ward of the Hospital Clínic of Barcelona, the implementation of restrictive measures was necessary in order to ensure patients’ safety. Objectives To compare clinical profiles and course of hospitalization of patients admitted before and during the COVID-19 lockdown in our Acute Psychiatric Ward. Methods All patients admitted from January 7th to February 25th and from March 19th to May 7th of 2020 in the Acute Psychiatric Hospitalization Unit of Hospital Clínic of Barcelona, Spain, were retrospectively included for analysis and divided into two groups according to the period when they were admitted. Statistical analyses were performed using SPSS, 23.0 version. Results A total of 117 inpatients were included (73 admitted before lockdown and 44 during lockdown), being 50.4% male, with a mean age of 42.4 (SD 15.73). Patients from the first group presented a significantly higher proportion of antidepressants prescription at discharge (p

We present a strategy to make productive use of semantically-related social data, from a user-centered semantic network, in order to help users (tourists and citizens in general) to discover cultural heritage, points of interest and available services in a smart city. This data can be used to personalize recommendations in a smart tourism application. Our approach is based on flow centrality metrics typically used in social network analysis: flow betweenness, flow closeness and eccentricity. These metrics are useful to discover relevant nodes within the network yielding nodes that can be interpreted as suggestions (venues or services) to users. We describe the semantic network built on graph model, as well as social metrics algorithms used to produce recommendations. We also present challenges and results from a prototypical implementation applied to the case study of the City of Puebla, Mexico.

This study investigates how preservice elementary teachers (PSTs) engage and reflect on two science disciplinary practices: engaging with representations and engaging in evidence-based arguments. In the context of elementary science, teachers blend multiple practices across curricular topics and instruction. However, studies of teachers' use of various practices often examine them independently. Contrastingly, here we examine the blending of these two practices with a focus on PSTs' myriad ways of sensemaking about these practices, referred to as "knowledge resources." Data involve audio recordings of PSTs discussing arguments and representations while engaged in small group activities centered on carefully designed teaching cases where the PSTs were tasked to imagine that they are the teacher in an elementary classroom. Analyses reveal that the PSTs used a variety of knowledge resources for analyzing existing representations, generating new representations, and evaluating and generating both existing and new arguments. We also found that PSTs' knowledge resources about arguments and representations were brought together in two ways: generating arguments based on given representations to enhance their understanding and generating representations in response to student arguments to enhance student understanding. These findings are important for teacher education, how PSTs are taught to engage with these practices, and how they conceptualize different instructional strategies for supporting elementary students' understanding and use of these practices.

Subsidence was measured for the first time on railway tracks in the central sector of Ebro Valley (NE Spain) using Differential Synthetic Aperture Radar Interferometry (DInSAR) techniques. This area is affected by evaporite karst and the analysed railway corridors traverse active sinkholes that produce deformations in these infrastructures. One of the railway tracks affected by slight settlements is the Madrid–Barcelona high-speed line, a form of transport infrastructure highly vulnerable to ground deformation processes. Our analysis based on DInSAR measurements and geomorphological surveys indicates that this line shows dissolution-induced subsidence and compaction of anthropogenic deposits (infills and embankments). Significant sinkhole-related subsidence was also measured by DInSAR techniques on the Castejón–Zaragoza conventional railway line. This study demonstrates that DInSAR velocity maps, coupled with detailed geomorphological surveys, may help in the identification of the railway track sections that are affected by active subsidence.

Resumen: Objetivos: Los ensayos clínicos llevados a cabo con el interferón beta (INFB) en esclerosis múltiple remitente recidivante (EMRR) han mostrado que reducen la tasa de brotes. Sin embargo, no todos los pacientes responden a este tratamiento, si bien aún no hay un absoluto consenso a propósito de la definición de respuesta al tratamiento. Las razones para este fracaso terapéutico no son conocidas, y probablemente hay factores genéticos implicados, como se ha mostrado con los polimorfismos de los genes que codifican la interleuquina 10 o el interferón gamma. El papel del gen de la apolipoproteína E (APOE) en la EM ha sido investigado en los últimos años y no parece aumentar el riesgo de aparición de la enfermedad ni influir en su severidad. Variaciones en este gen influyen en la respuesta al tratamiento con inhibidores de la colinesterasa en la enfermedad de Alzheimer o a las estatinas en la hipercolesterolemia. Esto podría tener implicaciones futuras en la EM. Material y métodos: Hemos revisado retrospectivamente 38 pacientes diagnosticados de EMRR (32 mujeres y 6 varones) tratados con INFB durante al menos dos años. Los criterios para llevar a cabo el tratamiento eran uniformes de acuerdo con las indicaciones del Comité asesor para el tratamiento de la EM. Recogimos datos acerca de la edad y tiempo de evolución de la enfermedad. Al cabo de dos años del inicio del tratamiento los pacientes fueron clasificados como respondedores o no-respondedores de acuerdo con los criterios clínicos disponibles, basados en la presencia de brotes, evolución de la discapacidad, o ambos. El genotipo APOE se determinó de muestras sanguíneas utilizando métodos validados de reacción en cadena de la polimerasa. Se estudió la correlación entre la condición de respondedor o no respondedor y la presencia de los alelos E2 o E4. Resultados: Veinte pacientes (52,6%) recibían INFB1b subcutáneo (Betaferón®), 13 (34,2%) INFB1a intramuscular (Avonex®) y 5 (13,2%) INFB1a subcutáneo (Rebif®). Dos pacientes (5,2%) eran heterocigotos para el alelo E2 y 9 (23,7%) para el alelo E4. Ningún paciente era homocigoto para E2 o E4. La presencia o no de estos alelos no se correlacionó con la respuesta al tratamiento de acuerdo con las 10 variables estudiadas. Conclusión: Tras los resultados de un metanálisis que no muestran influencia del gen APOE en la susceptibilidad o severidad de la EM, no hemos encontrado en nuestra serie influencia de este gen en la respuesta de pacientes con EMRR al INFB. En cualquier caso, series más extensas son necesarias para validar estos resultados. Abstract: Objective: Clinical trials with interferon beta in relapsing remitting multiple sclerosis (RRMS) have demonstrated a reduction in the relapse rate. Nevertheless, not all patients respond to this treatment, although there is no consensus regarding the definition of response to therapy. The reasons for this failure are not known but genetic factors probably influence this, as has been previously shown with Interleukin 10 or Interferon gamma polymorphisms.The role of apolipoprotein E (APOE) gene in MS has been investigated and does not appear to increase risk for MS or influence disease severity. Interestingly APOE variation influences response to cholinesterase inhibitor treatment in Alzheimer disease or to statins in hypercholesterolemia. This might have future implications for MS. Material and methods: We retrospectively reviewed 38 RRMS patients (32 females and 6 males) treated with interferon beta (INFbeta) over at least two years. Criteria for treatment were uniform accordingly to an “Advisory Committee for the Treatment of Multiple Sclerosis”. We collected data variables including age, age of onset, clinical type or disease duration. Patients were classified, two years after the start of treatment, as responders and non-responders based upon clinical criteria available in the literature, which rely on the presence of relapses, increase of disability, or both. APOE genotype was determined from blood samples using validated polymerase chain reaction methods. Correlation between patient responding status with allele E2 or E4 was tested. Results: A total of 20 patients (52.6%) received subcutaneous INFbeta1b (Betaferón®), 13 (34.2%) INFbeta1a intramuscular (Avonex®), and 5 (13.2%) subcutaneous INFbeta1a (Rebif®). We found 2 patients (5.2%) heterozygous for the E2 allele and 9 (23.7%) for the E4 allele. No patient was homozygous for E2 or E4. Comparison of patients with and without E2 or E4 allele showed no significant differences in any of the ten therapy response variables assessed. Conclusion: Findings of a recent meta-analysis have not supported a role for APOE in MS susceptibility or severity. We have not found, in our data, any influence of this gene in the RRMS response to INFbeta. However, larger series would be required to validate these results. Palabras clave: Esclerosis múltiple, Respuesta al tratamiento, Farmacogenética, APOE, Keywords: Multiple sclerosis, Treatment response, Pharmacogenetics, APOE

Objective: Clinical trials with interferon beta in relapsing remitting multiple sclerosis (RRMS) have demonstrated a reduction in the relapse rate. Nevertheless, not all patients respond to this treatment, although there is no consensus regarding the definition of response to therapy. The reasons for this failure are not known but genetic factors probably influence this, as has been previously shown with Interleukin 10 or Interferon gamma polymorphisms.The role of apolipoprotein E (APOE) gene in MS has been investigated and does not appear to increase risk for MS or influence disease severity. Interestingly APOE variation influences response to cholinesterase inhibitor treatment in Alzheimer disease or to statins in hypercholesterolemia. This might have future implications for MS. Material and methods: We retrospectively reviewed 38 RRMS patients (32 females and 6 males) treated with interferon beta (INFbeta) over at least two years. Criteria for treatment were uniform accordingly to an “Advisory Committee for the Treatment of Multiple Sclerosis”. We collected data variables including age, age of onset, clinical type or disease duration. Patients were classified, two years after the start of treatment, as responders and non-responders based upon clinical criteria available in the literature, which rely on the presence of relapses, increase of disability, or both. APOE genotype was determined from blood samples using validated polymerase chain reaction methods. Correlation between patient responding status with allele E2 or E4 was tested. Results: A total of 20 patients (52.6%) received subcutaneous INFbeta1b (Betaferon®), 13 (34.2%) INFbeta1a intramuscular (Avonex®), and 5 (13.2%) subcutaneous INFbeta1a (Rebif®). We found 2 patients (5.2%) heterozygous for the E2 allele and 9 (23.7%) for the E4 allele. No patient was homozygous for E2 or E4. Comparison of patients with and without E2 or E4 allele showed no significant differences in any of the ten therapy response variables assessed. Conclusion: Findings of a recent meta-analysis have not supported a role for APOE in MS susceptibility or severity. We have not found, in our data, any influence of this gene in the RRMS response to INFbeta. However, larger series would be required to validate these results. Resumen: Objetivos: Los ensayos clínicos llevados a cabo con el interferón beta (INFB) en esclerosis múltiple remitente recidivante (EMRR) han mostrado que reducen la tasa de brotes. Sin embargo, no todos los pacientes responden a este tratamiento, si bien aún no hay un absoluto consenso a propósito de la definición de respuesta al tratamiento. Las razones para este fracaso terapéutico no son conocidas, y probablemente hay factores genéticos implicados, como se ha mostrado con los polimorfismos de los genes que codifican la interleuquina 10 o el interferón gamma. El papel del gen de la apolipoproteína E (APOE) en la EM ha sido investigado en los últimos años y no parece aumentar el riesgo de aparición de la enfermedad ni influir en su severidad. Variaciones en este gen influyen en la respuesta al tratamiento con inhibidores de la colinesterasa en la enfermedad de Alzheimer o a las estatinas en la hipercolesterolemia. Esto podría tener implicaciones futuras en la EM. Material y métodos: Hemos revisado retrospectivamente 38 pacientes diagnosticados de EMRR (32 mujeres y 6 varones) tratados con INFB durante al menos dos años. Los criterios para llevar a cabo el tratamiento eran uniformes de acuerdo con las indicaciones del Comité asesor para el tratamiento de la EM. Recogimos datos acerca de la edad y tiempo de evolución de la enfermedad. Al cabo de dos años del inicio del tratamiento los pacientes fueron clasificados como respondedores o no-respondedores de acuerdo con los criterios clínicos disponibles, basados en la presencia de brotes, evolución de la discapacidad, o ambos. El genotipo APOE se determinó de muestras sanguíneas utilizando métodos validados de reacción en cadena de la polimerasa. Se estudió la correlación entre la condición de respondedor o no respondedor y la presencia de los alelos E2 o E4. Resultados: Veinte pacientes (52,6%) recibían INFB1b subcutáneo (Betaferón®), 13 (34,2%) INFB1a intramuscular (Avonex®) y 5 (13,2%) INFB1a subcutáneo (Rebif®). Dos pacientes (5,2%) eran heterocigotos para el alelo E2 y 9 (23,7%) para el alelo E4. Ningún paciente era homocigoto para E2 o E4. La presencia o no de estos alelos no se correlacionó con la respuesta al tratamiento de acuerdo con las 10 variables estudiadas. Conclusión: Tras los resultados de un metanálisis que no muestran influencia del gen APOE en la susceptibilidad o severidad de la EM, no hemos encontrado en nuestra serie influencia de este gen en la respuesta de pacientes con EMRR al INFB. En cualquier caso, series más extensas son necesarias para validar estos resultados. Keywords: Multiple sclerosis, Treatment response, Pharmacogenetics, APOE, Palabras clave: Esclerosis múltiple, Respuesta al tratamiento, Farmacogenética, APOE

In this paper, different techniques to test notched Small Punch (SPT) samples for the estimation of the fracture properties in aggressive environments are studied, based on the comparison of the micromechanisms at different rates. Pre-embrittled samples subsequently tested in air at conventional rates (0.01 and 0.002 mm/s) are compared to embrittled ones tested in environment at the same rates (0.01 and 0.002 mm/s) and at a very slow rate (5E-5 mm/s); a set of samples tested in environment under static loads that produce very slow rates complete the experimental results. As a conclusion, is recommended to test SPT notched specimens in environment at very slow rates, of around E-6 mm/s, when characterizing in Hydrogen Embrittlement (HE) scenarios, in order to allow the interaction material-environment to govern the process.

El durazno (Prunus persica L. Batsch.) de la variedad Ana fue obtenido de un árbol proveniente de hueso en la huerta comercial "San Carlos" en Aguascalientes, y tiene las características de alta producción y fruto con buena aceptación en el mercado. La selección es un método de fitomejoramiento de especies frutícolas, que consiste en identificar individuos sobresalientes, teniendo como base las plantas que provienen de semilla y la preferencia de alguna característica deseada como criterio de selección. Los objetivos de esta investigación fueron caracterizar y evaluar selecciones de durazno Ana. La investigación se realizó del 2000 a 2004, en la huerta comercial "San Carlos" ubicada en el municipio de Asientos, Ags. Se seleccionaron 21 árboles provenientes de hueso, a los que se les evaluó la fenología, rendimiento y la calidad del fruto. Para el análisis de la producción y número de frutos se utilizó un diseño de bloques al azar; para las características del fruto, un diseño de bloques al azar con arreglo en parcelas divididas con diez repeticiones, y para la comparación de medias, se utilizó la DMS (P

A study has been conducted to determine the influence of integrated olive production on the quality of extra virgin olive oil. On two different dates, samples from three different holdings were taken in integrated production (I) parcels, and in conventional production (C) parcels, both adjacent. The analytical determinations were free acidity, peroxide value, K232 and K270, fatty acid composition, esterols, phenolic compounds, tocopherols, stability to oxidation and sensory analysis. Most interesting among the results obtained were total contents of esterols and tocopherols, higher in olive oils of integrated production.

Se han realizado experiencias de fluencia en compresión a alta temperatura en muestras de óxido de circonio parcialmente estabilizado con 2,7 mol % de óxido de itrio (Y-TZP), con distintos tamaños de grano para ver la influencia que tiene este parámetro en los procesos de deformación. Para esto se han comparado experiencias realizadas en muestras nanométricas (d ≈ 120 nm) y policristales convencionales (d ≈ 0,3 μm) de la misma composición y deformadas bajo idénticas condiciones experimentales de tensión y temperatura.

The main processes controlling the hydrochemistry of an alluvium-covered evaporite karst area with high sinkhole risk (Ebro Valley, NE Spain) are examined by means of multivariate analyses (Principal Component Analysis and Hierarchical Cluster Analysis), ion correlations and geochemical speciation-solubility calculations. The hydrogeochemistry of the studied system seems to be governed by the interaction between the groundwater from the salt-bearing evaporitic karst aquifer and from the overlying Ebro River alluvial aquifer. The observed hydrochemical features in the alluvial-karst aquifer system are mainly determined by the relative contribution of gypsum/anhydrite and halite dissolution, showing a wide spectrum from relatively fresh recharge waters (mainly irrigation waters) to highly evolved groundwater from the evaporitic aquifer. The variability of these contributions is especially evident at sinkhole ponds which, in some cases, seem to be associated with discharge areas of the karst aquifer in the valley bottom alluvium. Calculated saturation indexes suggest that, in contrast to gypsum, the amounts of halite in the sampled portions of evaporitic aquifer are not large enough to attain equilibrium, which is consistent with the predominance of gypsum/anhydrite reported for these materials. Furthermore, the observed Na:Cl and Ca:SO4 correlations and stoichiometries suggest that other possible processes, such as glauberite dissolution or Na/Ca-exchange, generally play a minor role (compared to halite and gypsum dissolution) in this system. Another important process in the system is the dissolution of carbonate minerals (dolomite and, possibly, calcite) fostered by the input of CO2(g), which is probably produced by pedogenic processes. Dolomite dissolution seems to be particularly relevant in the evaporitic materials probably due to dedolomitisation triggered by gypsum/anhydrite dissolution.

The present study consists in the evaluation of twenty five parameters for determining the influence of continuous system of pastes centrifugation, discontinuous press system and partial extraction system on obtaining of virgin olive oil, and their possible utilization as new quality parameters. Also, those indexes more related to quality than to spoilt degree (acid value, peroxide value and K270) were determined. The tested oils have been obtained in three oil-mills, from three different olive varieties, in two ripening states.

One of the methods for food flavor evaluation is the analysis of volatile components. First step in this kind of analysis Is the isolation and concentration of volatiles. A review is carried out about different techniques applied in foods and especially in vegetable oils. Very different methods have been used, an explication of each one with its different cases are presented. Likewise the applications carried out in vegetable oils during last years are discussed.

The present study developed two objetives: 1) to study the possibility of repeatedly using disposable C18 columns 2) to determine an appropriate analytical scheme and the inherent systematic error in the method to evaluate bitter substances in virgin olive oil. The results confirmed that we were able to recover the principles of olive oil without reducing the effectiveness of the C18 a columns with repeated uses at least ten times. The evaluation method errors of the bitter taste have been determined, in order to determine it precision. The confidence limits calculated for defined work schemes have given sufficient precision.

A mathematical procedure including Canonical Correlation, Factor and cluster analysis and Multiple Regression was designed to study whether two different sensory panels, with different levels of training, could be considered as a unity. Among others, correlations between each attribute of both panels, matrices of partial correlations, variance explained by the most important factors and similarity among clusters were computed as the procedure to evaluate if a Panel in training works as well as an expertise. In addition, every one of the factors was correlated with the final evaluation of quality for analyzing the interrelationship between the profile notes and the grading table of virgin olive oil quality from a mathematical point of view. Finally, a stepwise multiple correlation analyzes how the panels modeled the evaluated samples. Promising directions for future research are also suggested.

El uso de marcapasos epicárdicos transitorios tras cirugía de revascularización miocárdica es una práctica habitual en muchos centros por su seguridad y eficacia. Las complicaciones relacionadas tras la retirada de los mismos son inusuales pero graves, incluyendo hemorragia, taponamiento y muerte. Material y métodos: Describimos el caso de un varón de 48 años sometido a cirugía de revascularización miocárdica. El postoperatorio inmediato transcurrió sin incidencias, siendo extubado a las 3 h de la llegada a la unidad de cuidados intensivos (UCI) y no requiriendo uso de inotrópicos ni hemoderivados. Mantenía ritmo sinusal. A las 48 h se retiraron los tubos de drenaje así como los electrodos de estimulación transitorios ventriculares epicárdicos. A los pocos minutos el paciente comenzó a inestabilizarse hemodinámicamente. Mediante ecocardiografía transtorácica se objetivó un hematoma que comprimía la cara anterior de ventrículo derecho junto con movimiento paradójico del tabique. Requirió reapertura esternal emergente en UCI, objetivándose zona de sangrado activo correspondiente al área de implante de electrodos transitorios. La evolución posterior fue satisfactoria, y el paciente fue dado de alta hospitalaria al décimo día. Conclusión: El uso rutinario de marcapasos epicárdicos transitorios en cirugía de revascularización miocárdica no está justificado en todos los pacientes, y deberíamos seleccionar aquellos que realmente lo precisen. Diabetes mellitus, arritmias preoperatorias y la necesidad de marcapasos en la salida de circulación extracorpórea son factores de riesgo para la necesidad de marcapasos en el postoperatorio inmediato. La cirugía coronaria sin bomba estaría asociada a una menor necesidad de estimulación cardíaca.

En los tiempos actuales la tendencia en la cirugía cardíaca es a realizar procedimientos menos agresivos, en ocasiones demandados por los pacientes. Por este motivo decidimos iniciar el programa de cirugía aórtica por miniesternotomía. Material y métodos: Desde enero de 2010 - enero de 2012 hemos operado a 20 pacientes de sustitución valvular aórtica, por estenosis grave, a través de una miniesternotomía en «J» por el cuarto-quinto espacio intercostal, con una incisión cutánea de 10 cm (rango 8-12). Se trataba de 14 varones y 6 mujeres, con una media de edad de 58 años (rango 28–77). Se implantaron 15 prótesis mecánicas y 5 biológicas. Resumen de la técnica Miniesternotomía en «J» (4–5.° espacio intercostal). Apertura de pericardio y puntos de tracción. Canulación aórtica y unicava superior. Drenaje en vena pulmonar superior derecha (VPSD). Aortotomía transversa. Extirpación e implante de válvula aórtica. Cierre de aortotomía. Purgado de cavidades. Hot-shoot. Resultados: No ha fallecido ningún paciente, no hemos tenido ninguna dehiscencia esternal ni hemorragia postopera-toria. El tiempo de clampaje medio fue 55 min (rango 40–60). El sangrado medio ha sido de 450 cc (rango 200–1.000), el tiempo de intubación de 180 min (rango 90–500), alta hospitalaria a los 6 días (rango 4–12), y no hemos presentado ninguna infección. Conclusiones: La cirugía aórtica por miniesternotomía en «J» es un abordaje seguro para la cirugía de sustitución valvular aórtica. Nuestros resultados son satisfactorios hasta el momento. Es una técnica reproducible. Pensamos que el antiguo aforismo de «a grandes cirujanos, grandes incisiones» ya no está vigente.

La circulación extracorpórea y el tiempo de isquemia prolongados pueden aumentar la morbimortalidad en la cirugía de recambio valvular aórtico, especialmente en pacientes añosos y de alto riesgo quirúrgico. El uso de prótesis autoexpandibles acorta significativamente estos tiempos y ofrece ventajas quirúrgicas. Material y métodos: De abril-diciembre de 2011 hemos implantado una válvula aórtica biológica, sin suturas, autoexpandible, Perceval S (Sorin Biomédica, Sallugia, Italy) a 15 pacientes (edad media 77,4 ± 3; EuroSCORE logístico medio de 14 ± 4%) con estenosis aórtica y con/sin cirugía coronaria concomitante. Recogemos la técnica de implantación tan reproducible a cualquier cirujano y los parámetros hemodinámicos y clínicos de estos pacientes. Resultados: Los tiempos de isquemia fueron de 26 ± 10 min y de circulación extracorpórea de 45 ± 14 min. Los gradientes hemodinámicos al alta fueron de 22 ± 10 de gradiente pico aórtico y de 12 ± 7 de gradiente medio. Dos pacientes recibieron cirugía combinada con puente de arteria mamaria interna a descendente anterior. Perdimos un paciente por sepsis, lo que supone una mortalidad del 6,6%. Conclusiones: El desarrollo de nuevas tecnologías, como es la válvula Perceval S en la cirugía de recambio valvular aórtico con/sin cirugía coronaria combinada, ofrece al cirujano nuevas posibilidades para acortar tiempos quirúrgicos buscando una reducción de la morbimortalidad, sin disminuir la seguridad, con unos buenos resultados clínicos y hemodinámicos en pacientes de alto riesgo quirúrgico. Suponen una mejora técnica cuando existe una calcificación valvular aórtica extrema y/o anillos aórticos pequeños.

Las válvulas aórticas biológicas sin soporte Sorin Freedom Solo (FS) han demostrado una mejoría en el aumento del orificio de área efectivo, así como un mejor perfil en los gradientes transvalvulares, fracción de eyección del ventrículo izquierdo (FEVI) y regresión de la hipertrofia ventricular izquierda. También, se ha comprobado una reducción en los tiempos de isquemia miocárdica y de circulación extracorpórea. Sin embargo no hay mucha información sobre su comportamiento en el contexto de endocarditis valvular. Material y métodos: Desde noviembre de 2006 – septiembre 2011, se implantaron 17 prótesis FS en 16 pacientes (50% hombres, 60,2 ± 15 años) por endocarditis bacteriana. Se determinó la cantidad de plaquetas en el día 5 postimplante, así como la fracción de eyección (FE) y los gradientes transvalvulares posquirúrgicos. Seguimiento medio de 22,5 ± 26 meses. Resultados: La prevalencia de trombocitopenia (< 150.000 plaquetas) y trombocitopenia grave (< 50.000 plaquetas) ha sido de 68,8 y 31,3%, respectivamente. Hubo un total de 4 muertes hospitalarias (25%), 2 intraoperatorias. Gradiente transvalvular medio de 22 ± 18 mmHg, FEVI postoperatoria media de 52,4 ± 10,3%. Tres pacientes fueron reintervenidos, 2 por deterioro precoz (16%), 1 por nueva endocarditis (8%). Conclusión: La prótesis aórtica biológica sin soporte FS muestra un buen perfil hemodinámico, mejorando significati-vamente los gradientes transvalvulares. Nuestra prevalencia de trombocitopenia al quinto día y durabilidad de la válvula se encuentran en valores similares a lo publicado en la literatura. El uso de dicha prótesis en endocarditis aórtica debe considerarse una alternativa eficaz al demostrarse baja tasa de reincidencia de endocarditis.

Desde 2006 se dispone de la vía de implante percutánea para las prótesis valvulares aórticas. Por el momento esta vía percutánea se ha reservado para pacientes de alto riesgo con la cirugía con circulación extracorpórea (CEC). Presentamos la experiencia inicial en nuestro hospital con prótesis aórtica percutánea vía transfemoral. Pacientes y métodos: Se intervinieron 33 pacientes (60% mujeres; 81,6 ± 4,4 años de edad media) entre junio de 2008 y febrero de 2010. EuroSCORE logístico medio de 21% ± 12,5; EuroSCORE aditivo 9 ± 2,3; seguimiento medio de 7 meses (1-20). Se implantaron 20 prótesis n.° 23 (60%) y 12 n.° 26 (40%). Resultados: Durante la hospitalización fallecieron tres pacientes (9%). En un paciente no se logró colocar la prótesis (3%). Las complicaciones más frecuentes fueron las vasculares en 10 pacientes (30%), seguidas de la insuficiencia cardíaca en cuatro pacientes (12%) y de la necesidad de implantar un marcapasos en otros dos (6%). Fueron transfundidos 16 pacientes (47%). Estancia en cuidados intensivos 1,8 ± 2,3 días, y en hospital 10,8 ± 9,7 días. En el seguimiento fallecieron tres pacientes (10%), y seis pacientes (21%) reingresaron en el hospital por causa cardíaca. El ecocardiograma postoperatorio mostró insuficiencia aórtica grado II en cuatro pacientes (14%). Conclusiones: La vía transfemoral permite tratar a pacientes de alto riesgo quirúrgico para el uso de CEC, sin embargo no está exenta de riesgos importantes. Mayor experiencia y seguimiento permitirán conocer los pacientes que más se beneficien de este abordaje.

La transfusión de concentrados de hematíes (CH) en cirugía de revascularización miocárdica (CRM) primaria se asocia a complicaciones y varía mucho entre centros. Ciertas características de los pacientes podrían predecir la transfusión de CH en CRM. Diseñamos un estudio para conocer las variables clínicas asociadas a transfusión de CH en CRM primaria, analizando su impacto sobre la mortalidad a corto y a largo plazo. Pacientes y métodos: Estudio prospectivo observacional de 102 pacientes (72% varones, 64,8 ± 9,4 años) intervenidos entre 2002-2003. Se utilizó un análisis regresión logística para identificar predictores de transfusión de CH. Resultados: Se transfundieron 81 pacientes (79%), con una mediana de 3 (2-6) CH. El 30% (25 pacientes) recibieron más de 4 u CH. Seis pacientes fallecieron en el periodo hospitalario (5,8%). En el análisis de regresión logística resultaron predictores independientes de transfusión de CH: el uso de aminas inotrópicas (p = 0,041; odds ratio [OR]: 9,6; IC 95%: 1,10-83,3), la hemoglobina preoperatoria (p = 0,009; OR: 1,9; IC 95%: 1,17-3,16) y el número de vasos coronarios enfermos (p = 0,035; OR: 3,35; IC 95%: 1,09-10,302). La transfusión de CH no se asoció con mayor mortalidad ni a corto (p = 0,807; 83 vs 79%) ni a largo plazo (p = 0,265; 91 vs 79%). El mejor punto de corte para la hemoglobina preoperatoria fue 13,3 g/dl. Conclusiones: Nuestra tasa de transfusión de CH en CRM primaria es alta. Pacientes con hemoglobina preoperatoria menor de 13,3 g/dl, con enfermedad coronaria más extensa y con apoyo inotrópico, tienen mayor riesgo de transfusión perioperatoria en nuestro ambiente.

Introduction: The critical condition of the patient who presents to an emergency department creates a need to provide timely, safe and warm care. Failing to meet these expectations causes patient dissatisfaction, reflected by complaints, which are mostly justified and lead to opportunities for improvement and corrective measures. Objective: To analyze complaints presented by patients and their relatives at the Adult Emergency Department of the Edgardo Rebagliati Martins National Hospital. Methods: Nonexperimental, descriptive, cross-sectional study. Our sample was comprised of 109 complaints between May and November 2019. We used a data collection sheet based on the information in the complaints book for health care services. Results: We identified 187 reasons for complaints. Our results show that direct relatives filed 47.7%; 43% involved Internal Medicine consultations. In the dimension “inadequate treatment by healthcare workers,” 13.9% of patients complained about impolite and rude treatment. In the dimension “delay in care”, 12.8% were discontent due to the lack of timely care. In the dimension “user disagreement with care or treatment received,” 10.2% were dissatisfied with the care they were provided. 60.6% of complaints were satisfactorily resolved within the period specified by current regulations. Conclusion: Most complaints were related to the direct care of the patient.