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In recent years the use of Distributed Acoustic Sensing (DAS) in seismology is gaining extensive usage in different applications. A High-Fidelity DAS system (HDAS) was deployed during the 2021 Tajogaite eruption on Cumbre Volcano (La Palma, Canary Islands), allowing the recording of most of the syn-eruptive and post-eruptive seismicity. The eruption lasted from Sep. 19th until Dec. 13th of 2021. The HDAS was installed on 19th Oct. 2021 and is still operating.The HDAS was installed around 10 km from the eruptive vent and was connected to a submarine fibre optic cable directed toward Tenerife Island. Since then, the HDAS has been recording seismic with a temporal sampling rate of 100 Hz and a spatial sampling rate of 10m for a total length of 30 (first phase) and 50 km using Raman Amplification (last period).The HDAS recorded thousands of local earthquakes as well as regional and teleseismic events. It was revealed to be an excellent tool for volcanic monitoring, allowing a better location of deeper events which location was made difficult by the small aperture of the seismic network of La Palma.The HDAS was also able to record the low-frequency (, The 28th IUGG General Assembly (IUGG2023) (Berlin 2023)

Introduction Influenza vaccination is recommended to pregnant women in Spain to reduce the risk of influenza-related complications. Influenza related hospitalizations pose a significant disease burden in children every year. Although children below 6 months are too young to be vaccinated, they can receive protection against influenza through vaccination of their mothers during pregnancy. We estimated the effectiveness of maternal influenza vaccination to prevent influenza hospitalizations in infants under 6 months of age. Methods This is a retrospective pilot study, using data from the Severe Hospitalized Confirmed Influenza Cases (SHCIC) surveillance system in seasons 2017/18 and 2018/19 in Spain. Maternal vaccination status during pregnancy was collected for cases in children 6 months and younger hospitalized with confirmed influenza infection. Influenza vaccine effectiveness was estimated using the screening method, by comparing the proportion of children with vaccinated mothers during pregnancy (proportion of cases vaccinated, PCV), with the vaccination coverage among pregnant women in Spain (proportion of population vaccinated, PPV). Results For all the study period, the PCV was 17% and the PPV was 35%. Influenza vaccination in mothers during pregnancy prevented influenza confirmed hospitalizations in infants aged 6 months and younger with a 61% (95%CI: 27–79%) effectiveness. Conclusions In line with evidence from other countries, influenza vaccination during pregnancy protects infants up to 6 months of age from influenza hospitalizations in Spain. These results support current recommendations of influenza vaccination in pregnant women, and more studies are needed in Spain to confirm the double protection of maternal vaccination in mothers and infants.

El presente trabajo de tesis desarrolla la creación e implementación de la plataforma virtual DecideMejor.pe, que brindará a los trabajadores independientes urbanos de Lima las herramientas necesarias para mejorar la administración y toma de decisiones de sus finanzas personales. Así, se fomentará la obtención de una adecuada calidad de vida futura al comparar y conocer mejor los productos financieros actuales a fin de garantizar sus objetivos de crecimiento económico. Este proyecto, nace en un contexto donde la economía de los trabajadores independientes ha mostrado un crecimiento sostenido en los últimos años. Sin embargo, producto de la reciente crisis de incertidumbre de la COVID 19, se experimentó un escenario económico complejo donde ejercer un mejor control y conocimiento financiero personal, se convirtió en una necesidad. La investigación realizada para la creación de la solución, abarca un análisis sobre el perfil de trabajadores independientes, su comportamiento frente al ahorro y productos de inversión, y el impacto positivo y contribución de la solución a los objetivos de desarrollo sostenible. Además, muestra hallazgos relevantes como la necesidad de fuentes de información integradas, confiables, accesibles y de fácil comprensión para la toma de decisiones en la administración de sus recursos económicos. Se determinó un modelo de negocio de generación de leads o potenciales clientes para las entidades financieras o de seguros, a través del cual la plataforma se convierte en un canal para que estos aliados estratégicos, logren captar clientes perfilados, con un interés en particular, sobre los productos y servicios que se ofrecen. Como resultado final se logró diseñar un producto rentable y sostenible enfocado a brindar información sobre productos financieros. This thesis work develops the creation and implementation of the virtual platform DecideMejor.pe, which will provide urban independent workers in Lima with the necessary tools to improve the administration and decision-making of their personal finances. Thus, obtaining an adequate quality of future life will be promoted by comparing and learning more about current financial products in order to guarantee their economic growth objectives. This project was born in a context where the economy of independent workers has shown sustained growth in recent years. However, as a result of the recent COVID 19 uncertainty crisis, a complex economic scenario was experienced where exercising better control and personal financial knowledge became a necessity. The research carried out for the creation of the solution includes an analysis of the profile of independent workers, their behavior towards savings and investment products, and the positive impact and contribution of the solution to the sustainable development objectives. In addition, it shows relevant findings such as the need for integrated, reliable, accessible and easily understood sources of information for decision-making in the administration of its economic resources. A business model to generate leads or potential clients was determined for financial or insurance entities, through which the platform becomes a channel for these strategic allies to attract profiled clients, with a particular interest, on the products and services offered. As a final result, it was possible to design a profitable and sustainable product focused on providing information on financial products.

Biofilms are the most common form of life for bacteria as, in this form, they are protected from environmental attacks. In fact, biofilm bacteria are increasingly resistant to antibiotics than their planktonic counterparts. Part of this resistance is a physical one: certain bacteria produce biofilms with superhydrophobic surfaces. Here, such biofilm property is described as a result of chemical and physical contributions provided by the matrix biomolecules, which in turn, give rise to topographical features that grant these bio-surfaces with different wetting behaviors. Biofilme sind die häufigste Lebensform von Bakterien, da sie in dieser Gestalt gegen externe Angriffe geschützt sind. Tatsächlich sind Biofilme deutlich resistenter gegen Antibiotika als ihre planktonischen Gegenstücke. Ein Teil dieser Resistenz ist physikalisch bedingt: bestimmte Bakterien produzieren Biofilme mit superhydrophoben Oberflächen. Diese Eigenschaft von Biofilmen wurde hier als Resultat chemischer und physikalischer Beiträge beschrieben, die durch die Biomoleküle der Matrix hervorgerufen werden.

Hintergrund/Fragestellung: E-Inclusion ist ein interdisziplinäres Forschungsprojekt zum Einsatz digitaler Technologien für Menschen mit einer Sprachbehinderung. Ziel ist es, forschungsbasiert eine App für Menschen mit Aphasie zu entwickeln. Forschende aus den Bereichen ‘Life[zum vollständigen Text gelangen Sie über die oben angegebene URL], Nützliche patientenrelevante Forschung; 21. Jahrestagung des Deutschen Netzwerks Evidenzbasierte Medizin

Introducción: La incontinencia urinaria es una afección que se caracteriza por pérdida involuntaria de orina y supone un problema grave en nuestra sociedad por su frecuencia, repercusión y magnitud. El objetivo de esta revisión es conocer la eficacia de la gimnasia abdominal hipopresiva en la incontinencia urinaria; además, se pretende evaluar la repercusión entre la prevención y la disminución del gasto económico sanitario. Material y métodos: Revisión bibliográfica de artículos científicos consultando las bases de datos MedLine, PEDro y Scielo publicados en los últimos diez años. Se utilizaron la escala JADAD y STROBE para valorar la calidad metodológica de los artículos seleccionados. Resultados: En la búsqueda inicial se obtuvieron 149 artículos, sin embargo, se hicieron restricciones en cuanto al año de publicación y tipo de estudio. Se revisaron los abstracts y en los casos necesarios los artículos completos, teniéndose en cuenta finalmente 14 artículos que incluían resultados de interés sobre el método hipopresivo. Conclusiones: La gimnasia abdominal hipopresiva favorece la activación muscular y produce cambios morfofuncionales en la musculatura del suelo pélvico y abdominal; sin embargo, para el tratamiento de la incontinencia urinaria es más efectivo si se combina con el entrenamiento muscular del suelo pélvico. No obstante, el método hipopresivo mejora la calidad de vida y la discapacidad percibida, es por ello por lo que se podría recomendar la prescripción de dichos ejercicios como método preventivo dentro de la atención primaria y así reducir el gasto sanitario.

An ultra-performance liquid chromatography coupled to atmospheric pressure chemical ionization-quadrupole time-of-flight mass spectrometry method has been optimized and validated for the determination of ergosterol and ergocalciferol in mushroom samples, using cholecalciferol as surrogate standard. The separation was carried out with a Synergi Hydro-RP column (100 mm x 3.00 mm i.d, 2.5 μm particle size), (Phenomenex, CA, USA) column, thermostated at 35 °C. The mobile phase was 0.1 % formic acid aqueous solution and methanol in gradient elution mode and it was achieved in 5 min approximately. Detection was achieved by atmospheric pressure chemical ionization in positive mode and quadrupole time-of-flight mass spectrometry. Desolvation and interface temperatures were set at 500 °C and 150 °C, respectively. The recoveries obtained were within 92-105 % for ergosterol, 77-81 % for ergocalciferol and 83-87 % for cholecalciferol. Method limits of detection were 0.4 and 0.5 μg g-1 for ergosterol and ergocalciferol, respectively, and method limits of quantitation were 1.2 and 1.3 μg g-1 for ergosterol and ergocalciferol, respectively. A rapid and simple extraction procedure using small amount of sample (100 mg) with hexane was optimized and the method was applied to the determination of ergosterol and ergocalciferol in white button mushrooms (Agaricus bisporus var. bisporus) exposed to UV irradiation. Results were compared to the corresponding non-irradiated mushrooms.

Tradicionalmente los hongos han estado vinculados tanto a la alimentación como a la medicina, sin embargo, actualmente y en base a los conocimientos científicos actuales se puede afirmar que ambos campos están fuertemente interconectados. No solo ofrecen un aporte nutricional atractivo de buen sabor y textura, sino que además son candidatos ideales para responder a la demanda creciente de determinados componentes beneficiosos para la salud, como por ejemplo la vitamina D. Así ante la creciente hipovitaminosis D en la población mundial, incluso en los países con alta radiación solar anual, la demanda de productos ricos naturales en vitamina D está experimentando una creciente demanda. Por lo que, en el presente trabajo, se ha considerado la opción de aprovechar los hongos comestibles, ricos en el precursor de la vitamina D2, el ergosterol, como alimentos funcionales para suplir esta demanda. No obstante, estudios recientes están revelando que el ergosterol y otros compuestos presentes en los hongos y setas comestibles, y en particular en A. bisporus, poseen propiedades bioactivas beneficiosas para la salud que pueden reforzar su candidatura como alimento funcional o como base para la formulación de productos nutracéuticos. Para ello, en primer lugar se ha estudiado un procedimiento, basado en la suplementación del medio de cultivo o compost, para aumentar el contenido de ergosterol en A. bisporus. Con tal fin se ha estudiado el efectos de varios suplementos provenientes de la industria aceitera y del cultivo de champiñón (harina de alperujo, HALP, y harina de tallos de champiñón, HTCH, respectivamente) en una formulación de medio mínimo que permite el crecimiento de A. bisporus en medios líquidos y gelificados en agar. Tras seleccionar aquellos suplementos con un impacto significativo en la composición del contenido en ergosterol se comprobó la eficacia en la inducción en compost mínimo siguiendo el procedimiento de cultivo establecido en la industria. Los cultivos obtenidos presentaron un incremento significativo en el contenido en ergosterol respecto a los controles mostrando que es posible alterar la composición en compuestos bioactivos mediante suplementación dirigida del compost. Como confirmación de la inducción de la ruta de biosíntesis del ergosterol se realizó un estudio mediante western-blot en el que se detectaron que tres de las enzimas implicadas en la ruta: ERG-2, ERG-6 y ERG-11 incrementaban sus niveles de expresión proteica entre 1,85 2,75 y 3,52 veces, respectivamente. La conversión de ergosterol a vitamina D2 se llevó a cabo por exposición del ergosterol a una fuente de luz ultravioleta (UVB); estudiándose el tipo de longitud de onda empleada, la temperatura y el contenido en humedad de la biomasa así como la orientación de la fuente de luz ultravioleta que afectan significativamente a la cantidad de vitamina D generada ante una misma dosis de tratamiento. Pese a que los valores óptimos de conversión no coinciden con las condiciones de trabajo habituales en la industria es posible obtener valores de vitamina D2 que cubran las necesidades diarias de vitamina D con una ración de 100g sin que se alcancen los valores de saturación en los que empiezan a manifestarse compuestos nocivos para la salud (toxiesteroles). Los champiñones enriquecidos en vitamina D2, con niveles suficientes para satisfacer la dosis diaria recomendada (15 μg) se han sometido a una evaluación toxicológica por seguridad alimentaria antes de poder considerarse un alimento funcional o la base para productos nutraceuticos. Para ello se comprobó la toxicidad aguda hasta una dosis de 5000 mg/kg de peso corporal y la toxicidad ante exposición prolongada de dosis de 500 mg/kg de peso corporal en ratas no detectándose ningún síntoma característico de efectos adversos debidos a la ingesta ni ninguna muerte; por lo que no se ha podido determinar la DL50 de estos champiñones enriquecidos ni establecer una clasificación de riesgo en la GHS y se requerirán más estudios para confirmar la seguridad total. La Toxicidad sub-crónica también ha revelado la ausencia de efectos adversos tanto a nivel de parámetros sanguíneos (hematológicos, bioquímicos, etc.), peso de órganos o análisis histopatológico. Respecto a la biodisponibilidad de la vitamina D2 obtenida en A. bisporus se ha podido determinar que ante una simulación in vitro del proceso de digestión y de absorción de la fracción micelar en células Caco-2, que aproximadamente el 50% de la vitamina D2 presente en la biomasa ingerida es capaz de atravesar el epitelio intestinal quedando biodisponible para el organismo. Así pues, es posible emplear A. bisporus, como un alimento funcional per se, enriquecido en vitamina D2. Este incremento de valor añadido se produce sin realizar alteraciones significativas en el proceso de producción industrial, mediante la adición de suplementos provenientes de las industrias aceiteras y del cultivo de champiñón. La ausencia de toxicidad y la elevada biodisponibilidad son factores esperanzadores en la aceptación de A. bisporus enriquecidos en vitamina D2 como un alimento funcional que pueda contribuir a satisfacer la demanda creciente de vitamina D.

— Supplementation is one of the most relevant procedures for mushroom growth modulation. Little is known about the influence of supplementation on the concentrations of metabolites with potential health benefits. Experiments on compost require long cultivation times. Similar composition has been detected in fruiting bodies and mycelia. Therefore, the mycelial composition can be assumed to be similar to that of the fruiting bodies. This study examines the effect of supplementing a minimal defined growth medium with components derived from olive oil industry subproducts on A. bisporus mycelial composition, primarily ergosterol, when grown on minimal defined liquid and solid media in an attempt to obtain a higher concentration of ergosterol (pro-vitamin D2). A. bisporus supplemented with alperujo meal (ALPM) and olive leaf meal (OLM) led to higher ergosterol content than that of the fungi grown in non-supplemented media (5.64±0.47, 6.60±0.86 and 4.08±0.53 mg/g p.s. in MDLm and 5.36±0.39, 6.79±0.41 and 4.22±0.43 mg/g p.s. in MDSm). Western blotting was used to validate the cultivation results. Three proteins (ERG2, ERG6, and EGR11) involved in the ergosterol biosynthetic pathway were significantly upregulated, indicating the importance of supplementation to ergosterol biosynthesis. This report represents the first comprehensive study on the protein expression profiling of supplementation studies directed to improve metabolites with potential health benefits in A. bisporus. It provides new insights and a better understanding of the development of cultivation processes directed to increase ergosterol biosynthesis. These results could be used to obtain mycelia with higher vitamin D2 content after irradiation with UVB light.

The health benefits of extracts from Agaricus bisporus greatly extend its use as components of new functional foods for the treatment and prevention of diseases, rather than restricting it to a good food with high nutritional value and good flavor. A. bisporus aqueous enzymatic extracts (AbAEE) have unique flavor, good taste, and health benefits which makes it a good candidate for its incorporation in different matrices for development of new functional foods and nutraceuticals. The potential use of AbAEE as nutraceutical or incorporated as a part of new functional foods requires its characterization and a subsequent food safety study. The focus of this paper was to carry out a preliminary toxicological study on experimental animals (rats in this case) by acute and sub-chronic oral administration. To evaluate potential adverse effects of AbAEE at high doses the acute toxic class method was used. After administration of the preset doses, behavior changes, toxic symptoms, and deaths were observed continuously for 1 h after treatment and then intermittently at 4th, 8th and 24th h. After these initial observations, the rats were further observed for up to 14 consecutive days for any signs of toxicity and/or death. Because of the likelihood that the results obtained in this preliminary acute toxicity test have a direct relevance for protecting human health with respect to the use of AbAEE as a functional food or nutraceutial, an additional upper dose level of 5000 mg/kg b.wt. was used. Since no death was observed, the LD50 could not be estimated but is expected to exceed 5000 mg/kg and this extract could be classified as hazard category 5 (in Globally Harmonized Classification System for Chemical Substances and Mixtures.) or even unclassified for its acute toxicity by the oral route. The sub-chronic oral toxicity study of AbAEE (250 and 500 mg/kg b.wt. day) did not induce significant alterations in almost all hematological and biochemical parameters in rats. Therefore, the overall results of the present study provide supportive data on the use of AbAEE and provide a promising first step for their use as component of new functional foods or as nutraceutical. Though, further studies in both, animals and humans are needed for better evaluation of the food safety of this extract. Ministerio de Economía y Competitividad (MINECO). España IPT- 2011-1418-060000 FEDER IPT- 2011-1418-060000

Este libro pretende contribuir al reencuentro de la educación con esas finalidades que verdaderamente importan a una niña o un niño: ser feliz, jugar, vivir juntos y (no) aprender. Para ello hemos puesto el arte, nuestras experiencias y el saber acumulado al servicio del disfrute, el cuestionamiento, el análisis crítico y la construcción común de un presente deseable. Un texto colaborativo coordinado por Ignacio Calderón Almendros y realizado por alumnado de Educación y Cambio Social en el Grado en Educación Infantil de la Universidad de Málaga.

Este libro pretende contribuir al reencuentro de la educación con esas finalidades que verdaderamente importan a una niña o un niño: ser feliz, jugar, vivir juntos y (no) aprender. Para ello hemos puesto el arte, nuestras experiencias y el saber acumulado al servicio del disfrute, el cuestionamiento, el análisis crítico y la construcción común de un presente deseable. Un texto colaborativo coordinado por Ignacio Calderón Almendros y realizado por alumnado de Educación y Cambio Social en el Grado en Educación Infantil de la Universidad de Málaga.

Since humans are travelling into the outer atmospheres of our planet and beyond, a new environmental habitat was established. Knowing that life - possibly since its first appearance on Earth is adapted to terrestrial gravity, the impact of microgravity on prokaryotes and humans remains mostly unclear. Investigating the influence of extreme conditions like those in space, Bacillus subtilis was chosen as model organism. Non-domesticated strains, such as NCIB 3610 have the ability to form biofilms as well as highly resistant endospores. Since it is known that planktonic life is the exception, biofilms are considered as predominant way of living (Moons et al., 2009). Building a biofilm protects the individual cell against shear forces, chemicals (e.g. antibiotics or disinfectants), temperature changes and water as well as nutrient depletion (Vlamakis et al., 2013, Cairns et al., 2014). The intrinsic resistance of biofilms is a problem, not only in industry and medicine, but it can be problematic during spaceflight conditions, especially for the crew as well as for the spacecraft. In particular, long term missions with complex cooling systems, water supply and heat pipes may be vulnerable to biofilm colonisation. In our work, we used a rotating 2D-clinostat to determine the effect of simulated microgravity (sim.-μg) and terrestrial gravity (1g) on B. subtilis biofilms and spores by using different microscopic techniques. White light profilometry, scanning and transmission electron microscopy (SEM, TEM) and confocal laser scanning microscopy (CLSM) were used to analyse biofilms regarding their topology and inner structure, respectively. First results show qualitative architectural differences between simulated microgravity and 1g in cross-sections, but no significant qualitative variations in biofilm surface topography. In order to test the resistance of spores grown under simulated gravity, germination assays, as well as survival assays were used. First results revealed that spores grown under the influence of sim.-μg had an increased spontaneous germination rate compared to spores grown at 1g.

Bacillus subtilis is one of the most studied Gram positive model organisms. Since mission Apollo 16, B. subtilis has been used for a multitude of space experiments. Investigating the influence of extreme conditions like those in space, non-domesticated strains, such as NCIB 3610 are of special interest regarding their ability to form biofilms. Since it is known that planktonic life is the exception, biofilms are considered as predominant way of living (Moons et al., 2009). Biofilms are organized in a complex self-produced extracellular polymeric matrix commonly composed of polysaccharides, proteins and nucleic acids. Building a biofilm protects the individual cell against shear forces, chemicals (e.g. antibiotics or disinfectants), temperature changes and water as well as nutrient depletion (Vlamakis et al., 2013, Cairns et al., 2014). The intrinsic resistance of biofilms is a problem, not only in industry and medicine, but it can be problematic under spaceflight conditions. Especially the loss of gravity coupled with changed levels of radiation might influence the resistance and therefore the virulence of bacterial biofilms. This can possibly evoke problems for the crew as well as for the spacecraft. In particular, long term missions with complex cooling systems, water supply and heat pipes may be vulnerable to biofilm colonisation. In our work, we used the biofilm-forming wildtype strain NCIB 3610 and a biofilm-matrix deficient mutant (deletion of 15-gene exopolysaccharide operon, epsA-O) to study the impact of reduced gravity on maturated biofilms. Our major research goal is to compare biofilm formation in simulated microgravity (using a 2D clinostat) to terrestrial gravity (1g) conditions by using different microscopic techniques. White light profilometry, scanning and transmission electron microscopy (SEM, TEM) and confocal laser scanning microscopy (CLSM) were used to analyse biofilms regarding their topology and inner structure, respectively. First results show qualitative architectural differences between simulated microgravity and 1g in cross-sections, but no significant qualitative variations in biofilm surface topography.

The colonization of surfaces by bacterial biofilms constitutes a huge problem in healthcare and industry. When attempting biofilm inactivation or removal, it is crucial to sufficiently wet the biofilm surface with antibacterial agents; however, certain biofilms efficiently resist wetting, and the origin of this behavior remains to date unclear. Here, we demonstrate that, depending on the growth medium used, the model bacterium Bacillus subtilis can form biofilm colonies with distinct surface properties: we find either hydrophilic or two variants of hydrophobic behavior. We show that those differences in biofilm wetting correlate with distinct surface topologies which, in turn, give rise to different physical wetting regimes known from lotus leaves or rose petals. Forming biofilms with different wetting properties may help bacteria to survive in both arid and humid conditions. Furthermore, converting the surface polarity of a biofilm could facilitate their removal from surfaces by increasing their wettability., Biofilm structure: Surface control of wetting A biofilm’s surface structure affects its susceptibility to wetting, influencing persistence and suggesting strategies for biofilm removal. Effective wetting of biofilm surfaces is essential for combatting them with antibacterial agents. Resistance to the procedures currently available for removing biofilms is a huge problem in healthcare. Researchers in Germany led by Oliver Lieleg at the Technical University of Munich found that Bacillus subtilis bacteria can form colonies with different surface structures that either resist or assist wetting. This structural variability in their biofilms may allow the bacteria to adapt to survive in either arid or humid conditions. The insight that environmental conditions can influence biofilm wettability should spur research to control this natural variation. Learning how to convert biofilms into more readily wetted forms may greatly assist their removal in healthcare situations.

Resumen: Introducción: Se considera que la arteriosclerosis de las arterias extracraneales causa casi un tercio de los ictus isquémicos. El diagnóstico certero del grado de estenosis es fundamental para indicar la mejor estrategia terapéutica. Si bien la angiografía cerebral se considera la técnica de referencia, el estudio ultrasonográfico (EUS) es un procedimiento más disponible, no invasivo y bien establecido en la cuantificación de la estenosis carotídea. Sin embargo, al ser una técnica dependiente del explorador, se recomienda que cada laboratorio valide sus resultados frente a la angiografía. Objetivos: Establecer, en nuestro laboratorio, la validez del estudio neurosonológico en el diagnóstico de la enfermedad ateromatosa extracraneal y determinar su capacidad para cuantificar el grado de estenosis de la arteria carótida interna. Material y métodos: Estudio retrospectivo de los pacientes con enfermedad ateromatosa carotídea extracraneal en cuyo proceso diagnóstico se realizó tanto ultrasonografía carotídea como angiografía por sustracción digital de troncos supraaórticos. Resultados: Se evaluaron 254 carótidas clasificando el grado de estenosis en > 50%, 70-99% y 100%. Para el primer grupo el EUS obtuvo una sensibilidad del 97%, una especificidad del 90%, un valor predictivo positivo (VPP) del 94,6% y un VP negativo (VPN) del 94,2%. En el segundo grupo, se obtuvo: sensibilidad, 96,4%; especificidad, 93%; VPP, 94,4%, y VPN, 95,4%. Para la oclusión carotídea los valores respectivos fueron del 85, el 96,8, el 80 y el 97,8%. Conclusiones: Nuestros datos validan la capacidad del EUS realizado en nuestro laboratorio para el diagnóstico del grado de estenosis carotídea. Abstract: Introduction: Arteriosclerosis of the extra-cranial arteries is believed to be responsible for almost one-third of all ischaemic strokes. The sound diagnosis of the degree of stenosis is essential in deciding the best therapeutic strategy. Although cerebral angiography is considered the reference technique, ultrasound study (UST) is a more readily available, non-invasive and well-established procedure for quantifying carotid stenosis. However, on being a dependent exploratory technique, it is recommended that each laboratory validates its results against angiography. Objetives: To establish the validity of the neuro-ultrasound study in our laboratory for use in the diagnosis of extracranial atheromatous disease, and determine its capacity to quantify the degree of stenosis in the internal carotid artery. Material and methods: A retrospective study of patients with extracranial carotid atheromatous disease, in whom the diagnostic process was carried out with carotid ultrasound as well as supra-aortic trunk digital-subtraction angiography. Results: A total of 254 carotids were evaluated and the degree of stenosis being classified into > 50%, 70-99% and 100%. The UST for the first group had a sensitivity (Se) of 97%, a specificity (Sp) of 90%, a positive predictive value (PPV) of 94.6% and a negative predictive value (NPV) of 94.2%. The second group had an Se of 96.4%, Sp 93%; PPV 94.4% and NPV 95.4%. The respective values for carotid occlusion were, 85%, 96.8%, 80% and 97.8%. Conclusions: Our data validates the ability of UST performed in our Laboratory to diagnose the degree of carotid stenosis. Palabras clave: Angiografía cerebral, Aterosclerosis carotidea, Doppler, Estenosis extracraneal, Estudio ultrasonográfico, Keywords: Cerebral angiography, Carotid atherosclerosis carotidea, Doppler, Extracraneal stenosis, Ultrasound study

Introduction: Arteriosclerosis of the extra-cranial arteries is believed to be responsible for almost one-third of all ischaemic strokes. The sound diagnosis of the degree of stenosis is essential in deciding the best therapeutic strategy. Although cerebral angiography is considered the reference technique, ultrasound study (UST) is a more readily available, non-invasive and well-established procedure for quantifying carotid stenosis. However, on being a dependent exploratory technique, it is recommended that each laboratory validates its results against angiography. Objectives: To establish the validity of the neuro-ultrasound study in our laboratory for use in the diagnosis of extracranial atheromatous disease, and determine its capacity to quantify the degree of stenosis in the internal carotid artery. Material and methods: A retrospective study of patients with extracranial carotid atheromatous disease, in whom the diagnostic process was carried out with carotid ultrasound as well as supra-aortic trunk digital-subtraction angiography. Results: A total of 254 carotids were evaluated and the degree of stenosis being classified into >50%, 70–99% and 100%. The UST for the fi rst group had a sensitivity (Se) of 97%, a specificity (Sp) of 90%, a positive predictive value (PPV) of 94.6% and a negative predictive value (NPV) of 94.2%. The second group had a Se of 96.4%, Sp 93%; PPV 94.4% and NPV 95.4%. The respective values for carotid occlusion were, 85%, 96.8%, 80% and 97.8%. Conclusions: Our data validates the ability of UST performed in our Laboratory to diagnose the degree of carotid stenosis. Resumen: Introducción: Se considera que la arteriosclerosis de las arterias extracraneales causa casi un tercio de los ictus isquémicos. El diagnóstico certero del grado de estenosis es fundamental para indicar la mejor estrategia terapéutica. Si bien la angiografía cerebral se considera la técnica de referencia, el estudio ultrasonográfico (EUS) es un procedimiento más disponible, no invasivo y bien establecido en la cuantifi cación de la estenosis carotídea. Sin embargo, al ser una técnica dependiente del explorador, se recomienda que cada laboratorio valide sus resultados frente a la angiografía. Objetivos: Establecer, en nuestro laboratorio, la validez del estudio neurosonológico en el diagnóstico de la enfermedad ateromatosa extracraneal y determinar su capacidad para cuantificar el grado de estenosis de la arteria carótida interna. Material y métodos: Estudio retrospectivo de los pacientes con enfermedad ateromatosa carotídea extracraneal en cuyo proceso diagnóstico se realizó tanto ultrasonografía carotídea como angiografía por sustracción digital de troncos supraaórticos. Resultados: Se evaluaron 254 carótidas clasifi cando el grado de estenosis en > 50%, 70–99% y 100%. Para el primer grupo el EUS obtuvo una sensibilidad del 97%, una especificidad del 90%, un valor predictivo positivo (VPP) del 94,6% y un VP negativo (VPN) del 94,2%. En el segundo grupo, se obtuvo: sensibilidad, 96,4%; especifi cidad, 93%; VPP, 94,4%, y VPN, 95,4%. Para la oclusión carotídea los valores respectivos fueron del 85, el 96,8, el 80 y el 97,8%. Conclusiones: Nuestros datos validan la capacidad del EUS realizado en nuestro laboratorio para el diagnóstico del grado de estenosis carotídea. Keywords: Cerebral angiography, Carotid atherosclerosis carotidea, Doppler, Extracraneal stenosis, Ultrasound study, Palabras clave: Angiografía cerebral, Aterosclerosis carotidea, Doppler, Estenosis extracraneal, Estudio ultrasonográfico

Tesis - (Maestría en Políticas Públicas)