A non-interventional, multicenter study to characterize the socio-demographics, clinical characteristics, and management of Generalized Pustular Psoriasis (GPP) patients in Spain: IMPULSE study.

BACKGROUND: Generalized pustular psoriasis (GPP) is a chronic, rare, and potentially life-threatening skin condition characterized by flares comprising widespread sterile pustules and systemic inflammation. Both the rarity and heterogeneity of the disease have made GPP classification and standardization of clinical criteria challenging. Before the approval of spesolimab (IL-36R antibody) in 2022 there were no approved treatments in the USA or Europe for GPP flares. Treatment for GPP has amounted to off-label use of medicines approved to treat plaque psoriasis. Our aim was to describe the socio-demographics, clinical characteristics, and treatment patterns of patients with GPP in Spain. METHODS: Non-interventional, descriptive, multi-center, retrospective chart review of patients diagnosed with GPP in Spain. RESULTS: 56 patients (50% women) were included, with a mean (SD) age at diagnosis of 53.7 (20.5) and a mean (SD) time of follow-up of 3.7 (3.1) years. In 80% of patients, GPP diagnosis was associated with a flare and 67.3% had known risk factors for GPP [such as previous diagnosis or family history of plaque psoriasis, comorbidities, smoking or stress. Hypertension and plaque psoriasis were the most frequent comorbidities (44.6% each). The number of GPP flares per patient-year was 0.55 with (range 0-4) a mean (SD) body surface area involvement of 21.3% (19.1). The most frequent manifestations of GPP flares were pustules (88.5%), erythema (76.9%) and scaling (76.9%). Additionally, 65.4% of patients had plaque psoriasis, 53.8% had unspecified skin lesions, and 30.8% experienced pain. The treatments used for GPP flares were off-label conventional systemic drugs (75%), mostly corticosteroids, cyclosporine and acitretin. In the periods between flares, off-label biologics were used in 56.5% of patients. During the study period, 9 patients (16.1%) had at least one complication, and 5 of them required hospitalization. CONCLUSION: This is the first multi-center study in Spanish GPP patients. Most patients were in their fifties, with personal or family history of plaque psoriasis, stress, smoking and a wide range of comorbidities and complications. Even though the number of flares per patient/year was 0.55, there was variability between patients. Both off-label conventional systemics and off-label biologics were used for flare management without a clear treatment pattern.

Dispensation of outpatient hospital medicines by hospital only versus hospital-community pharmacies collaboration: a cross-sectional study and survey of patient's satisfaction.

Goal: To describe the experience of a dispensing model of outpatient hospital medicines (OHM) via collaboration of hospital and community pharmacies, and to explore patient satisfaction with the strategy as compared with the hospital pharmacy only service. Background: Patient satisfaction is an important component of the quality of health care. Study: A new model of dispensing OHM was conducted in the Outpatients Unit of the Service of Hospital Pharmacy of Hospital del Mar, in Barcelona, Spain. Participants were patients on stable chronic treatment with clinical or social fragility, immunocompromised patients, and those whose residence was located at a distance from the hospital that justified drug delivery through the community pharmacy. A cross sectional study was done using an ad hoc 14-item questionnaire collecting demographic data, duration of treatment, usual mode of collecting medication, and the degree of satisfaction regarding waiting time for the collection of medication, attention received by professionals, information received on treatment, and confidentiality. Results: The study population included a total of 4,057 patients (66.8% men) with a mean age of 53 (15.5) years, of whom 1,286 responded, with a response rate of 31.7%. Variables significantly associated with response to the survey were age over 44 years, particularly the age segment of 55-64 years (odds ratio [OR] 2.51) and receiving OHM via the community pharmacy (OR 12.76). Patients in the community pharmacy group (n = 927) as compared with those in the hospital pharmacy group (n = 359) showed significantly higher percentages of 'satisfied' and 'very satisfied' (p < 0.001) in the waiting time for the collection of OHM (88.1% vs. 66%), attention received by professionals (92.5% vs. 86.1%), and information received on treatment (79.4% vs. 77.4%). In relation to confidentiality, results obtained were similar in both pharmacy settings. Conclusion: Dispensing OHM through the community pharmacy was a strategy associated with greater patient satisfaction as compared with OHM collection at the hospital pharmacy service, with greater accessibility, mainly due to close distance to the patient's home. The participation of community pharmacists could further optimize the care received by patients undergoing OHM treatment.

Managing a Pregnancy in the Presence of the Rare Blood Group Antibody PP1Pk.

Pregnant women with p phenotype, who lack antigens P, P1, and Pk, spontaneously form anti-PP1Pk antibodies whose primary target is the placenta. The risk of miscarriage in these women is 50%-70% and reaches 87% in the second trimester. The therapies aim to reduce the titer of antibodies early in pregnancy. They also have risk of hemolytic transfusion reaction, with very few compatible red blood cell donors in the world. In this study, we present a case of successful pregnancy managed with autologous blood donations and plasmapheresis.

Exploring the use of NIR and Raman spectroscopy for the prediction of quality traits in PDO cheeses.

The aims of this proof of principle study were to compare two different chemometric approaches using a Bayesian method, Partial Least Square (PLS) and PLS-discriminant analysis (DA), for the prediction of the chemical composition and texture properties of the Grana Padano (GP) and Parmigiano Reggiano (PR) PDO cheeses by using NIR and Raman spectra and quantify their ability to distinguish between the two PDO and among their ripening periods. For each dairy chain consortium, 9 cheese samples from 3 dairy industries were collected for a total of 18 cheese samples. Three seasoning times were chosen for each dairy industry: 12, 20, and 36 months for GP and 12, 24, and 36 months for PR. A portable NIR instrument (spectral range: 950-1,650 nm) was used on 3 selected spots on the paste of each cheese sample, for a total of 54 spectra collected. An Alpha300 R confocal Raman microscope was used to collect 10 individual spectra for each cheese sample in each spot for a total of 540 Raman spectra collected. After the detection of eventual outliers, the spectra were also concatenated together (NIR + Raman). All the cheese samples were assessed in terms of chemical composition and texture properties following the official reference methods. A Bayesian approach and PLS-DA were applied to the NIR, Raman, and fused spectra to predict the PDO type and seasoning time. The PLS-DA reached the best performances, with 100% correctly identified PDO type using Raman only. The fusion of the data improved the results in 60% of the cases with the Bayesian and of 40% with the PLS-DA approach. A Bayesian approach and a PLS procedure were applied to the NIR, Raman, and fused spectra to predict the chemical composition of the cheese samples and their texture properties. In this case, the best performance in validation was reached with the Bayesian method on Raman spectra for fat (R2VAL = 0.74). The fusion of the data was not always helpful in improving the prediction accuracy. Given the limitations associated with our sample set, future studies will expand the sample size and incorporate diverse PDO cheeses.

Effects of Albumin on Survival after a Hepatic Encephalopathy Episode: Randomized Double-Blind Trial and Meta-Analysis.

No therapies have been proven to increase survival after a hepatic encephalopathy (HE) episode. We hypothesize that two doses of albumin could improve 90-day survival rates after a HE episode. METHODS: (1) A randomized double-blind, placebo-controlled trial (BETA) was conducted in 12 hospitals. The effect of albumin (1.5 g/kg at baseline and 1 g/kg on day 3) on 90-day survival rates after a HE episode grade II or higher was evaluated. (2) A meta-analysis of individual patient's data for survival including two clinical trials (BETA and ALFAE) was performed. RESULTS: In total, 82 patients were included. Albumin failed to increase the 90-day transplant-free survival (91.9% vs. 80.5%, p = 0.3). A competing risk analysis was performed, observing a 90-day cumulative incidence of death of 9% in the albumin group vs. 20% in the placebo (p = 0.1). The meta-analysis showed a benefit in the albumin group, with a lower rate of clinical events (death or liver transplant) than patients in the placebo (HR, 0.44; 95% CI, 0.21-0.82), when analyzed by a competing risk analysis (90-days mortality rate of 11% in the albumin group vs. 30% in the placebo, p = 0.02). CONCLUSIONS: Repeated doses of albumin might be beneficial for patient's survival as an add-on therapy after an HE episode, but an adequately powered trial is needed.

Tracking a mass mortality outbreak of pen shell Pinna nobilis populations: A collaborative effort of scientists and citizens.

A mass mortality event is devastating the populations of the endemic bivalve Pinna nobilis in the Mediterranean Sea from early autumn 2016. A newly described Haplosporidian endoparasite (Haplosporidium pinnae) is the most probable cause of this ecological catastrophe placing one of the largest bivalves of the world on the brink of extinction. As a pivotal step towards Pinna nobilis conservation, this contribution combines scientists and citizens' data to address the fast- and vast-dispersion and prevalence outbreaks of the pathogen. Therefore, the potential role of currents on parasite expansion was addressed by means of drift simulations of virtual particles in a high-resolution regional currents model. A generalized additive model was implemented to test if environmental factors could modulate the infection of Pinna nobilis populations. The results strongly suggest that the parasite has probably dispersed regionally by surface currents, and that the disease expression seems to be closely related to temperatures above 13.5 °C and to a salinity range between 36.5-39.7 psu. The most likely spread of the disease along the Mediterranean basin associated with scattered survival spots and very few survivors (potentially resistant individuals), point to a challenging scenario for conservation of the emblematic Pinna nobilis, which will require fast and strategic management measures and should make use of the essential role citizen science projects can play.

Bloqueos de pared anterior de tórax en cirugía de cáncer de mama: estudio comparativo retrospectivo de casos y controles / Chest wall blocks for breast cancer surgery: A retrospective comparative case-control study

Objetivos: Determinar eficacia analgésica perioperatoria de bloqueos de la pared anterior del tórax (BLOC) en cirugía de cáncer de mama (CCM), valorando requerimientos de opioides intraoperatorio, intensidad de dolor y necesidad de analgesia durante las primeras 24 h del postoperatorio. Materiales y métodos: Estudio retrospectivo comparativo de casos y controles. Se revisaron 112 historias de pacientes sometidas a CCM durante marzo-octubre del 2016. El grupo 1 estuvo conformado por 25 pacientes sometidas a CCM bajo anestesia general total intravenosa (TIVA)+BLOC; el grupo 2 por 24 pacientes sometidas a CCM bajo TIVA. Se excluyó a pacientes que recibieron otro tipo de técnica anestésica locorregional, anestesia inhalatoria u otro opioide diferente de fentanilo. Resultados: Los requerimientos de fentanilo intraoperatorio (μg/kg/h) fueron menores en el grupo 1 que en grupo 2 (TIVA+BLOC: 0,486±0,561; TIVA: 2,415+0,922); no se administró fentanilo durante el acto anestésico-quirúrgico en el 48% de las pacientes del grupo 1. Solo se registraron puntuaciones menores en la intensidad del dolor medida con la escala verbal numérica (EVN) en el grupo 1 a las 6 y 12 h poscirugía. Conclusiones: El uso de BLOC redujo significativamente los requerimientos de opioides intraoperatorios. No hubo diferencias en los requerimientos de analgesia suplementaria durante las primeras 24 h

Objectives: To determine the analgesic effect of chest wall blocks (BLOCs) in breast cancer surgery (BCS) by measuring intraoperative opioid requirements, pain intensity and supplementary analgesia requirements during the first 24hours after surgery. Materials and methods: Retrospective comparative case-control study. We reviewed 112 medical records of patients who underwent BCS from March to October 2016. Group 1 was composed of 25 patients who underwent BCS under total intravenous anaesthesia (TIVA) and BLOCs; group 2 was composed of 24 patients with BCS under TIVA. Patients who underwent another type of locoregional anaesthetic technique, received inhaled anaesthesia or an opioid other than fentanyl were excluded. Results: Intraoperative fentanyl requirements (μg/kg/hour) were much lower in group 1 (TIVA+BLOCs: 0.486+0.561, TIVA: 2.415+0.922). Fentanyl was not administered during anaesthesia/surgery in 48% of patients in group 1. Group 1 reported lower scores on the numeric verbal scale (NVS) of pain at 6 and 12hours after surgery. Conclusions: The use of BLOCs reduced intraoperative opioid requirements, but there was no difference in the requirements for supplementary analgesia during the first 24hours

Biology of the introduced species Triatoma lecticularia (Hemiptera: Reduviidae) to northwestern Mexico, under laboratory conditions.

The first record of Triatoma lecticularia out of its reported distribution area together with the brief description of the said area is provided in this paper. In addition, some biological parameters related to hatching of eggs, life cycle and feeding and defecation behaviors for each instar of one population of T. lecticularia from its previously reported distribution area (PR) and for each instar of that introduced recently found population (IS) of this species were evaluated and compared. Twenty-eight specimens were collected from IS, mostly (64.29%) from peridomestic areas (mainly chicken coops). No significant (p>0.05) differences were recorded between the two studied cohorts in their average time to hatch, which was close to 19days. The median egg-to-adult development time, the number of blood meals at each nymphal, the instar mortality rates and median time-lapse for beginning of feeding were significantly (p<0.05) shorter for the IS cohort. Median feeding time was higher in PR. Defecation delay was shorter than 10min in both studied cohorts. Given these results, the introduced recently found population of T. lecticularia could be considered an important potential vector of Trypanosoma cruzi to human populations and could replace main triatomine species on its new distribution area.

Evaluación y tratamiento del paciente cirrótico crítico / Evaluation and treatment of the critically ill cirrhotic patient

Los pacientes cirróticos presentan frecuentemente complicaciones graves de su enfermedad que requieren ingreso en la UCI. La encefalopatía hepática gradoIII-IV, el shock séptico, el fracaso agudo sobre crónico y la hemorragia variceal son descompensaciones que precisan un tratamiento intensivo específico en el paciente cirrótico. La mayor eficacia de los tratamientos empleados en cuidados intensivos y la generalización de los programas de trasplante hepático han mejorado de manera sustancial el pronóstico del paciente cirrótico crítico, hecho que ha facilitado su ingreso en las unidades de terapia intensiva. Sin embargo, el conocimiento de digestólogos e intensivistas sobre la patogenia, diagnóstico y tratamiento de estas complicaciones y sobre la evaluación pronóstica del paciente cirrótico crítico es limitado. Las alteraciones hemodinámicas y en la coagulación características de estos pacientes y la disfunción inmune que presentan aumentan la complejidad del tratamiento, el riesgo de presentar nuevas complicaciones y su mortalidad en comparación con la población general. Estas características diferenciales tienen implicaciones diagnósticas y terapéuticas clínicamente relevantes que deben ser conocidas por los intensivistas generales. En este contexto, la Sociedad Catalana de Digestología encomendó a un grupo de expertos la redacción de un documento de posicionamiento sobre la evaluación y el tratamiento del paciente cirrótico crítico. El presente artículo describe las recomendaciones acordadas en las reuniones de consenso y sus principales conclusiones

Cirrhotic patients often develop severe complications requiring ICU admission. Grade III-IV hepatic encephalopathy, septic shock, acute-on-chronic liver failure and variceal bleeding are clinical decompensations that need a specific therapeutic approach in cirrhosis. The increased effectiveness of the treatments currently used in this setting and the spread of liver transplantation programs have substantially improved the prognosis of critically ill cirrhotic patients, which has facilitated their admission to critical care units. However, gastroenterologists and intensivists have limited knowledge of the pathogenesis, diagnosis and treatment of these complications and of the prognostic evaluation of critically ill cirrhotic patients. Cirrhotic patients present alterations in systemic and splanchnic hemodynamics, coagulation and immune dysfunction what further increase the complexity of the treatment, the risk of developing new complications and mortality in comparison with the general population. These differential characteristics have important diagnostic and therapeutic implications that must be known by general intensivists. In this context, the Catalan Society of Gastroenterology and Hepatology requested a group of experts to draft a position paper on the assessment and treatment of critically ill cirrhotic patients. This article describes the recommendations agreed upon at the consensus meetings and their main conclusions

[Evaluation and treatment of the critically ill cirrhotic patient]. / Evaluación y tratamiento del paciente cirrótico crítico.

Cirrhotic patients often develop severe complications requiring ICU admission. Grade III-IV hepatic encephalopathy, septic shock, acute-on-chronic liver failure and variceal bleeding are clinical decompensations that need a specific therapeutic approach in cirrhosis. The increased effectiveness of the treatments currently used in this setting and the spread of liver transplantation programs have substantially improved the prognosis of critically ill cirrhotic patients, which has facilitated their admission to critical care units. However, gastroenterologists and intensivists have limited knowledge of the pathogenesis, diagnosis and treatment of these complications and of the prognostic evaluation of critically ill cirrhotic patients. Cirrhotic patients present alterations in systemic and splanchnic hemodynamics, coagulation and immune dysfunction what further increase the complexity of the treatment, the risk of developing new complications and mortality in comparison with the general population. These differential characteristics have important diagnostic and therapeutic implications that must be known by general intensivists. In this context, the Catalan Society of Gastroenterology and Hepatology requested a group of experts to draft a position paper on the assessment and treatment of critically ill cirrhotic patients. This article describes the recommendations agreed upon at the consensus meetings and their main conclusions.

Field evidence of social influence in the expression of political preferences: the case of secessionists flags in Barcelona.

Models of social influence have explored the dynamics of social contagion, imitation, and diffusion of different types of traits, opinions, and conducts. However, few behavioral data indicating social influence dynamics have been obtained from direct observation in "natural" social contexts. The present research provides that kind of evidence in the case of the public expression of political preferences in the city of Barcelona, where thousands of citizens supporting the secession of Catalonia from Spain have placed a Catalan flag in their balconies and windows. Here we present two different studies. 1) During July 2013 we registered the number of flags in 26% of the electoral districts in the city of Barcelona. We find that there is a large dispersion in the density of flags in districts with similar density of pro-independence voters. However, by comparing the moving average to the global mean we find that the density of flags tends to be fostered in electoral districts where there is a clear majority of pro-independence vote, while it is inhibited in the opposite cases. We also show that the distribution of flags in the observed districts deviates significantly from that of an equivalent random distribution. 2) During 17 days around Catalonia's 2013 national holiday we observed the position at balcony resolution of the flags displayed in the facades of a sub-sample of 82 blocks. We compare the 'clustering index' of flags on the facades observed each day to thousands of equivalent random distributions. Again we provide evidence that successive hangings of flags are not independent events but that a local influence mechanism is favoring their clustering. We also find that except for the national holiday day the density of flags tends to be fostered in facades located in electoral districts where there is a clear majority of pro-independence vote.

Terlipressin and albumin for type-1 hepatorenal syndrome associated with sepsis.

BACKGROUND & AIMS: Terlipressin and albumin is the standard of care for classical type-1 hepatorenal syndrome (HRS) not associated with active infections. However, there is no information on efficacy and safety of this treatment in patients with type-1 HRS associated with sepsis. Study aim was to investigate the effects of early treatment with terlipressin and albumin on circulatory and kidney function in patients with type-1 HRS and sepsis and assess factors predictive of response to therapy. METHODS: Prospective study in 18 consecutive patients with type-1 HRS associated with sepsis. RESULTS: Treatment was associated with marked improvement in arterial pressure and suppression of the high levels of plasma renin activity and norepinephrine. Response to therapy (serum creatinine <1.5mg/dl) was achieved in 12/18 patients (67%) and was associated with improved 3-month survival compared to patients without response. Non-responders had significantly lower baseline heart rate, poor liver function tests, slightly higher serum creatinine, and higher Child-Pugh and MELD scores compared to responders. Interestingly, non-responders had higher values of CLIF-SOFA score compared to responders (14±3 vs. 8±1, respectively p<0.001), indicating greater severity of acute-on-chronic liver failure (ACLF). A CLIF-SOFA score ⩾11 had 92% sensitivity and 100% specificity in predicting no response to therapy. No significant differences were observed between responders and non-responders in baseline urinary kidney biomarkers. Treatment was safe and no patient required withdrawal of terlipressin. CONCLUSIONS: Early treatment with terlipressin and albumin in patients with type-1 HRS associated with sepsis is effective and safe. Patients with associated severe ACLF are unlikely to respond to treatment.

Effect of the local administration of betamethasone on pain, swelling and trismus after impacted lower third molar extraction. A randomized, triple blinded, controlled trial

OBJECTIVES: The aim of this study is to compare the analgesic and anti-inflammatory effects of the local postoperative administration of a single 12-mg dose of betamethasone after the surgical removal of impacted lower third molars. Study design: A split-mouth, triple-blind, randomized, placebo-controlled clinical trial of 25 patients requiring the surgical removal of symmetrical lower third molars was performed. In the experimental side, a 12-mg dose of betamethasone was administered submucosally after the surgical procedure, while in the control side a placebo (sterile saline solution) was injected in the same area. To assess postoperative pain, visual analogue scales and the consumption of rescue analgesic were used. The facial swelling and trismus were evaluated by measuring facial reference distances and maximum mouth opening. RESULTS: There were no significant differences between the two study groups regarding postoperative pain, facial swelling and trismus. CONCLUSIONS: The injection of a single dose of betamethasone does not seem to reduce pain, facial swelling and trismus after impacted lower third molar removal when compared to placebo

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Effect of the local administration of betamethasone on pain, swelling and trismus after impacted lower third molar extraction. A randomized, triple blinded, controlled trial.

OBJECTIVES: The aim of this study is to compare the analgesic and anti-inflammatory effects of the local postoperative administration of a single 12-mg dose of betamethasone after the surgical removal of impacted lower third molars. STUDY DESIGN: A split-mouth, triple-blind, randomized, placebo-controlled clinical trial of 25 patients requiring the surgical removal of symmetrical lower third molars was performed. In the experimental side, a 12-mg dose of betamethasone was administered submucosally after the surgical procedure, while in the control side a placebo (sterile saline solution) was injected in the same area. To assess postoperative pain, visual analogue scales and the consumption of rescue analgesic were used. The facial swelling and trismus were evaluated by measuring facial reference distances and maximum mouth opening. RESULTS: There were no significant differences between the two study groups regarding postoperative pain, facial swelling and trismus. CONCLUSIONS: The injection of a single dose of betamethasone does not seem to reduce pain, facial swelling and trismus after impacted lower third molar removal when compared to placebo.

Variabilidad de la frecuencia cardíaca y perfiles psicofisiológicos en deportes de equipo de alto rendimiento / Heart rate variability and psychophysiological profiles in high-performance team sports

En el presente trabajo se plantean dos objetivos, llevados a cabo en dos estudios diferentes. En primer lugar, se pretende analizar la utilidad del análisis de la Variabilidad de la Frecuencia Cardíaca (VFC) dentro del contexto de los deportes de equipo de alto rendimiento. Por otra parte, se pretende analizar la VFC en base a los perfiles de estado de ánimo evaluados con el POMS. Para el primer estudio se seleccionaron 53 deportistas de 3 deportes de equipo de élite diferentes: baloncesto, hockey hierba y fútbol. Para el segundo estudio la muestra la formaron 18 futbolistas de élite, divididos en dos grupos: perfil iceberg y estado de ánimo alterado. Los resultados muestran que los futbolistas presentan un perfil de VFC diferente a los jugadores de baloncesto o hockey hierba, que muestran un perfil de VFC bastante parecido. En los futbolistas con perfil iceberg, el factor de Vigor correlaciona negativamente con los parámetros LF/HF y %LF, y positivamente con el parámetro HF%. En los futbolistas con estado de ánimo alterado, el factor de Fatiga correlaciona negativamente con los parámetros pNN50 y HF. Los resultados permiten profundizar en el estudio de la VFC en deportes de equipo para adaptar mejor los seguimientos, así como obtener indicadores de estado de ánimo relacionados con la VFC (AU)

This paper poses two objectives, pursued in two different studies. The first is to analyse the usefulness of a heart rate variability (HRV) analysis within the context of high-performance team sports. The second is to analyse HRV based on mood profiles, assessed using the POMS. For the first study, 53 athletes were selected from 3 different elite team sports: basketball, hockey and soccer. For the second study, the sample comprised 18 elite football players, divided into two groups: the iceberg profile and altered mood state. The results show that football players have a different HRV profile from basketball or hockey players, who both display a fairly similar one. In the case of soccer players with the iceberg profile, the vigour factor is negatively correlated with LF / HF and LF% and positively correlated with the HF% parameter. In the case of soccer players with the altered mood state, the fatigue factor is negatively correlated with the pNN50 and HF parameters. The results offer a deeper insight into HRV in team sports with a view to adapting the monitoring process and obtaining indicators of mood states associated with HRV (AU)

Video sensor architecture for surveillance applications.

This paper introduces a flexible hardware and software architecture for a smart video sensor. This sensor has been applied in a video surveillance application where some of these video sensors are deployed, constituting the sensory nodes of a distributed surveillance system. In this system, a video sensor node processes images locally in order to extract objects of interest, and classify them. The sensor node reports the processing results to other nodes in the cloud (a user or higher level software) in the form of an XML description. The hardware architecture of each sensor node has been developed using two DSP processors and an FPGA that controls, in a flexible way, the interconnection among processors and the image data flow. The developed node software is based on pluggable components and runs on a provided execution run-time. Some basic and application-specific software components have been developed, in particular: acquisition, segmentation, labeling, tracking, classification and feature extraction. Preliminary results demonstrate that the system can achieve up to 7.5 frames per second in the worst case, and the true positive rates in the classification of objects are better than 80%.

Comparative study of upper lip frenectomy with the CO2 laser versus the Er, Cr: YSGG laser

Objectives: To compare upper lip frenulum reinsertion, bleeding, surgical time and surgical wound healing infrenectomies performed with the CO2 laser versus the Er, Cr:YSGG laser. Study design: A prospective study was carried out on 50 randomized pediatric patients who underwent rhomboidal resection of the upper lip frenulum with either the CO2 laser or the Er, Cr:YSGG laser. Twenty-five patients were assigned to each laser system. All patients were examined at 7, 14, 21 days and 4 months after the operation in order to assess the surgical wound healing. Results: Insertion of the frenulum, which was preoperatively located between the upper central incisors, migrated to the mucogingival junction as a result of using both laser systems in all patients. Only two patients required a single dose of 650 mg of paracetamol, one of either study group. CO2 laser registered improved intraoperative bleeding control results and shorter surgical times. On the other hand, the Er,Cr:YSGG laser achieved faster healing. Conclusions: Upper lip laser frenectomy is a simple technique that results in minimum or no postoperative swellingor pain, and which involves upper lip frenulum reinsertion at the mucogingival junction. The CO2 laser offers a bloodless field and shorter surgical times compared with the Er,Cr:YSGG laser. On the other hand, the Er,Cr:YSGG laser achieved faster wound healing (AU)

[Spontaneous visits to the emergency service and hepatology day hospital by patients with liver cirrhosis]. / Análisis de las consultas espontáneas de enfermos cirróticos a urgencias y hospital de día de hepatología.

INTRODUCTION: Because of the current overload of emergency services, new units, such as day units, have had to be created. Liver cirrhosis (LC) is a chronic disease with frequent decompensations requiring medical attention. The aim of this study was to compare differences between emergency consultations in a hepatology day hospital (HDH) and in an emergency service (ES) among patients with LC. METHODS AND MATERIAL: We performed an observational prospective study. All patients with LC attending the HDH or ES from September 2007 to August 2008 were asked to complete a questionnaire. Demographic, clinical, and radiological variables were collected. RESULTS: There were 743 consultations, of which 62% involved the HDH. The mean age was 65±12 years, and the male/female ratio was 2:3. The most frequent diagnosis in the ES was hepatic encephalopathy (26.2% ES versus 6% HDH, p<0.001) followed by upper gastrointestinal hemorrhage (17.7% ES versus 0.6% HDH, p<0.001), while the most frequent diagnosis in the HDH was ascites (66.2% HDH versus 22.7% ES, p<0.001). The tests performed were as follows: blood analysis: 95% ES versus 60% HDH (p<0.01); radiology: 71% ES versus 11% HDH (p<0.01) and paracentesis: 51% ES versus 74% HDH (p<0.01). The mean length of stay in the ES was 21.3±121.5 hours compared with 3.3±2.4 hours in the HDH (p<0.001). A total of 53% of patients attended in the ES were hospitalized compared with 12% of those attended in the HDH (p<0.05). CONCLUSION: Patients with LC preferentially attend the HDH, where fewer tests are performed and the length of stay is shorter. The care provided in the HDH is appropriate and efficient.