Thrombectomy with embed aspiration in acute ischaemic stroke.

BACKGROUND: In addition to stent retrievers, direct aspiration has become a reasonable thrombectomy strategy. OBJECTIVES: We carried out the thrombectomy by guiding the aspiration catheter fully over the clot and performing immediate manual aspiration; we call this procedure "embed aspiration". METHODS: In this prospective, non-randomised, single-centre study, we included all patients treated at a high volume-of-care stroke centre between 2017 and 2018 for the TRIANA (Thrombectomy in Andalusia using Aspiration) registry. Thrombectomy was carried out by embed aspiration. Patients were classified according to the success (eTICI 2b67-2c-3) or failure (eTICI 0-1-2a-2b50) of the procedure. Baseline clinical data and outcomes were compared, and multivariate analysis was performed. RESULTS: The embed aspiration technique was used in 370 patients. Treatment was successful in 90.3% of patients. Mean puncture-to-recanalisation time was 25 minutes. The overall rate of good outcomes (mRS 0-2) at 3 months was 64%. CONCLUSIONS: This study supports real-life evidence that standardised embed aspiration may be an alternative to stent retrievers for thrombectomy.

Instrumento de medición del conocimiento declarativo y procedimental en el baloncesto escolar / Instrument for measurement of declarative and procedural knowledge in basketball

El propósito de este estudio fue diseñar y validar un instrumento para la evaluación del conocimiento declarativo y procedimental en un deporte de invasión como el baloncesto en el contexto escolar. En el proceso de validación participaron 15 jueces expertos. El instrumento estuvo formado por 34 ítems distribuidos en dos bloques, declarativo y procedimental. Responde al siguiente tipo de preguntas: ¿Qué es?, ¿Sirve para?, ¿Qué se consigue?, ¿Cuál es? y ¿Cómo se realiza? La validez de contenido se calculó mediante el coeficiente V de Aiken y sus intervalos de confianza. Para la consistencia interna se empleó el coeficiente α de Cronbach. Ninguna de las preguntas que componen el test de conocimiento declarativo y procedimental fue eliminada al superar el valor crítico exacto (V≥.74). La consistencia interna de las preguntas fue excelente (α=.95). Por tanto, el instrumento es válido y fiable para la evaluación del conocimiento en el baloncesto escolar. (AU)

The purpose of this study has been the design and validation of an instrument for the evaluation of declarative and procedural knowledge in an invasion sport such as basketball in the school context. 15 expert judges participated in the validation process. The instrument consisted of 34 items distributed in two blocks, declarative and procedural. Answers the following type of questions: Is it useful for?, What is it ?, What is achieved ?, Which one is it? In addition, how is it done? Content validity was calculated using Aiken's V coefficient and its confidence intervals. Cronbach's α coefficient was used for internal consistency. None of the questions that make up the declarative and procedural knowledge test were eliminated by exceeding the exact critical value (V≥.74). The internal consistency of the questions was excellent (α=.95). Therefore, the instrument is valid and reliable for the evaluation of knowledge in school basketball. (AU)

Benefits in quality of life following an obstructive sleep apnea screening and treatment program in patients with acute ischemic stroke. / Beneficios en la calidad de vida de un programa de cribado y tratamiento de apnea obstructiva del sueño en pacientes con ictus isquémico agudo.

INTRODUCTION: Obstructive sleep apnea (OSA) has been proposed as a factor that worsens stroke prognosis. Our aim was to determine if an OSA intervention could improve quality of life (QOL, first objective) and modified Rankin score (mRS, second objective). PATIENTS AND METHODS: The intervention group of this quasi-experimental study included patients with acute ischemic stroke <72 hours who underwent polygraphy and Continuous Positive Airway Pressure (CPAP) and hygienic-dietary measures if required. The control group followed routine clinical practice. The Short Form 36 Health Survey (SF-36) and mRS were applied at the sixth month after stroke in both groups. RESULTS: Fifty-five vs. sixty-two patients were included in the intervention and control group respectively. In the intervention group, 64.71% of patients accepted the proposed CPAP (16 cases with a good adherence). An improvement in SF-36 items was detected in the intervention group: physical functioning (p = 0.008), role physical (p = 0.002), bodily pain (p = 0.008), general health (p <0.001), vitality (p = 0.001) and role emotional (p = 0.015). In a per-protocol analysis, all these improvements were verified in the group of patients treated with good CPAP adherence (p < 0.05 in all the same SF-36 items). The percentage of patients with physical component summatory = 50 was higher in the intervention group (p = 0.003). There were no differences in the median of mRS (p = 0.262). CONCLUSIONS: Although more evidence is needed, a significant improvement in QOL was suggested after our OSA intervention, particularly in patients with good CPAP adherence.

TITLE: Beneficios en la calidad de vida de un programa de cribado y tratamiento de apnea obstructiva del sueño en pacientes con ictus isquémico agudo.Introducción. La apnea obstructiva del sueño (AOS) se ha propuesto como un factor de mal pronóstico en el ictus. Pretendemos determinar si una intervención sobre la AOS puede mejorar las escalas de calidad de vida (primer objetivo) y de discapacidad (segundo objetivo). Pacientes y métodos. El grupo de intervención de este estudio cuasi experimental incluye a pacientes con ictus isquémico agudo menor de 72 horas de evolución a quienes se les realizó poligrafía, así como presión positiva continua en las vías aéreas (CPAP) y medidas higienicodietéticas si se requerían. En el grupo de control se siguió la práctica clínica habitual. Se aplicaron las escalas Short Form 36 Health Survey (SF-36) y modified Rankin Score (mRS) en el sexto mes del ictus en ambos grupos. Resultados. Se incluyó a 55 y a 62 pacientes en el grupo de intervención y en el de control, respectivamente. En el grupo de intervención, el 64,71% de los pacientes aceptó la CPAP indicada (16 casos con buena adhesión). Se detectó una mejoría en los ítems de la escala SF-36 en el grupo de intervención: funcionamiento físico (p = 0,008), rol físico (p = 0,002), dolor corporal (p = 0,008), salud general (p menor de 0,001), vitalidad (p = 0,001) y rol emocional (p = 0,015). En un análisis por protocolo, todas estas mejorías se comprobaron en el grupo de pacientes tratados con CPAP con buena adhesión (p menor de 0,05 en todos los ítems de la SF-36). El porcentaje de pacientes con el sumatorio del componente físico = 50 fue más alto en el grupo de intervención (p = 0,003). No había diferencias en la mediana de la mRS (p = 0,262). Conclusiones. Aunque se necesitan más evidencias, nuestro estudio sugiere una mejoría significativa de la calidad de vida tras nuestra intervención en la AOS, especialmente en pacientes con buena adhesión a la CPAP.

Congenital malformations of the urinary tract: progression to chronic renal disease. / Malformaciones congénitas del tracto urinario (CAKUT): evolución a enfermedad renal crónica.

INTRODUCTION: Congenital nephrourological abnormalities (CAKUT) are a particularly relevant group of diseases due to their high prevalence and the fact they are the main cause of chronic renal disease (CRD) in the pediatric population. Our objective was to determine the characteristics and prevalence of CAKUT in our setting, while identifying the factors associated with the occurrence of renal damage. MATERIALS AND METHODS: A retrospective, descriptive, analytical, cross-sectional study of patients seen in the Pediatric Nephrology Department of a third-level hospital from January 1 to December 31, 2018 was carried out. Epidemiological, clinical, and analytical variables were assessed, and potential risk factors associated with CRD were searched for. RESULTS: The study involved 685 patients with 827 kidney units affected by CAKUT with a mean age of 9.98 ± 5.12 years. 62.2% were male, and the mean follow-up period after diagnosis was 9.95 ± 5.09 years. 58.8% were non-obstructive dilations, followed by renal dysplasia, obstructive dilations, and number and position abnormalities. The most frequent malformation was vesicoureteral reflux (VUR). The most commonly affected side was the left (47.5%). 55% of the diagnoses were prenatal. 172 patients underwent surgery. The initially chosen treatment for VUR was endourological. Overall re-intervention rate was 20%. Of the total number of patients, glomerular filtration rate was analyzed in 383, 95 (24.8%) of whom had CRD (86% in stage 2). Male sex, bilaterality, and proteinuria were risk factors associated with CRD. CONCLUSIONS: Knowledge of the epidemiological and clinical characteristics of children with CAKUT and the factors associated with CRD helps to individualize the clinical follow-up of these patients, thus customizing diagnostic tests and healthcare resources.

INTRODUCCION: Las anomalías nefrourológicas congénitas (CAKUT), constituyen un grupo de enfermedades de gran relevancia por su alta prevalencia y por ser la principal causa de enfermedad renal crónica (ERC) en la población pediátrica. Nuestro objetivo es conocer las características y la prevalencia de CAKUT en nuestro medio, identificando los factores asociados a la aparición de daño renal. MATERIAL Y METODOS: Estudio retrospectivo, descriptivo, analítico y transversal, que incluyó los pacientes atendidos en la consulta de Nefrología Pediátrica de un hospital de tercer nivel desde el 1 de enero al 31 de diciembre de 2018. Se analizaron variables epidemiológicas, clínicas y analíticas, y se buscaron posibles factores de riesgo asociados a ERC. RESULTADOS: Se incluyeron 685 pacientes con 827 unidades renales con CAKUT con una edad media de 9,98 ± 5,12 años. El 62,2% fueron varones y el seguimiento medio desde el diagnóstico fue de 9,95 ± 5,09 años. El 58,8% fueron dilataciones no obstructivas, seguido por displasia renal, dilataciones obstructivas y anomalías de número y posición. La malformación más frecuente fue el reflujo vesicoureteral (RVU). El lado más afectado fue el izquierdo (47,5%). El 55% de los diagnósticos fueron prenatales. Fueron intervenidos 172 pacientes. El tratamiento inicial de elección en el RVU fue endourológico. La tasa de reintervención global alcanzó el 20%. Del total de pacientes, se pudo analizar el filtrado glomerular en 383 pacientes, de los cuales 95 (24,8%) tenían ERC (86% en estadio 2). El sexo masculino, la bilateralidad y la proteinuria fueron factores de riesgo asociados a la ERC. CONCLUSIONES: El conocimiento de las características epidemiológicas y clínicas de los niños con CAKUT y de los factores asociados a la ERC ayuda a individualizar el seguimiento clínico de estos pacientes adecuando las pruebas diagnósticas y los recursos sanitarios.

Malformaciones congénitas del tracto urinario(CAKUT): evolución a enfermedad renal crónica / Congenital malformations of the urinary tract: progression to chronic renal disease

Introducción: Las anomalías nefrourológicas congénitas (CAKUT),constituyen un grupo de enfermedades de gran relevancia por su altaprevalencia y por ser la principal causa de enfermedad renal crónica(ERC) en la población pediátrica. Nuestro objetivo es conocer las ca-racterísticas y la prevalencia de CAKUT en nuestro medio, identificandolos factores asociados a la aparición de daño renal. Material y métodos: Estudio retrospectivo, descriptivo, analíticoy transversal, que incluyó los pacientes atendidos en la consulta deNefrología Pediátrica de un hospital de tercer nivel desde el 1 de eneroal 31 de diciembre de 2018. Se analizaron variables epidemiológicas,clínicas y analíticas, y se buscaron posibles factores de riesgo aso-ciados a ERC.Resultados: Se incluyeron 685 pacientes con 827 unidades rena-les con CAKUT con una edad media de 9,98 ± 5,12 años. El 62,2%fueron varones y el seguimiento medio desde el diagnóstico fue de9,95 ± 5,09 años. El 58,8% fueron dilataciones no obstructivas, se-guido por displasia renal, dilataciones obstructivas y anomalías denúmero y posición. La malformación más frecuente fue el reflujovesicoureteral (RVU). El lado más afectado fue el izquierdo (47,5%).El 55% de los diagnósticos fueron prenatales. Fueron intervenidos172 pacientes. El tratamiento inicial de elección en el RVU fue en-dourológico. La tasa de reintervención global alcanzó el 20%. Deltotal de pacientes, se pudo analizar el filtrado glomerular en 383pacientes, de los cuales 95 (24,8%) tenían ERC (86% en estadio 2).El sexo masculino, la bilateralidad y la proteinuria fueron factoresde riesgo asociados a la ERC. Conclusiones: El conocimiento de las características epidemioló-gicas y clínicas de los niños con CAKUT y de los factores asociados ala ERC ayuda a individualizar el seguimiento clínico de estos pacientesadecuando las pruebas diagnósticas y los recursos sanitarios.(AU)

Introduction: Congenital nephrourological abnormalities (CAKUT)are a particularly relevant group of diseases due to their high prevalenceand the fact they are the main cause of chronic renal disease (CRD) in thepediatric population. Our objective was to determine the characteristicsand prevalence of CAKUT in our setting, while identifying the factorsassociated with the occurrence of renal damage. Materials and methods: A retrospective, descriptive, analytical, cross-sectional study of patients seen in the Pediatric NephrologyDepartment of a third-level hospital from January 1 to December 31,2018 was carried out. Epidemiological, clinical, and analytical variables were assessed, and potential risk factors associated with CRDwere searched for.Results: The study involved 685 patients with 827 kidney unitsaffected by CAKUT with a mean age of 9.98 ± 5.12 years. 62.2% weremale, and the mean follow-up period after diagnosis was 9.95 ± 5.09years. 58.8% were non-obstructive dilations, followed by renal dysplasia,obstructive dilations, and number and position abnormalities. The mostfrequent malformation was vesicoureteral reflux (VUR). The most commonly affected side was the left (47.5%). 55% of the diagnoses wereprenatal. 172 patients underwent surgery. The initially chosen treatmentfor VUR was endourological. Overall re-intervention rate was 20%. Ofthe total number of patients, glomerular filtration rate was analyzed in383, 95 (24.8%) of whom had CRD (86% in stage 2). Male sex, bilateral ity, and proteinuria were risk factors associated with CRD. Conclusions: Knowledge of the epidemiological and clinical characteristics of children with CAKUT and the factors associated withCRD helps to individualize the clinical follow-up of these patients, thuscustomizing diagnostic tests and healthcare resources.(AU)

Retraso en la administración de tratamiento trombolítico en el ictus minor / Delayed administration of thrombolytic therapy in minor stroke

Introducción: Se considera ictus minor a aquel que se presenta con escasos síntomas; sin embargo, hasta un 40% presenta discapacidad a largo plazo. La tasa de trombólisis en estos pacientes también es inferior a la del resto de ictus. En este estudio se pretende explorar si existen diferencias en los tiempos de atención en la trombólisis intravenosa en los pacientes con ictus minor. Material y métodos. Revisión retrospectiva de los ictus tratados con trombólisis intravenosa en nuestro centro y análisis comparativo de los tiempos de asistencia entre ictus minor y el resto. Resultados: Se encontraron tiempos más alargados en los casos de ictus minor en cuanto al tiempo puerta-tomografía computarizada y puerta-aguja. No fue así, sin embargo, para el tiempo desde el inicio de los síntomas hasta la llegada al hospital. Conclusiones: La presencia de escasos síntomas en el ictus minor puede hacer difícil su reconocimiento y podría ser un motivo de retraso en el tratamiento. La formación entre el personal que atiende a estos pacientes es fundamental para mejorar este aspecto.(AU)

Introduction: Minor strokes are considered to be those that present with few symptoms, although up to 40% of them entail long-term disability. The rate of thrombolysis in these patients is also lower than in other strokes. The aim of this study is to explore whether there are any differences in intravenous thrombolysis care times in minor strokes. Patients and methods: We conducted a retrospective review of strokes treated with intravenous thrombolysis at our centre and a comparative analysis of the care times in minor strokes and in the other types. Results: Longer times were found in minor strokes in terms of door-to-CT scan and door-to-needle time. This was not the case, however, for the time from the onset of symptoms to arrival at the hospital. Conclusions: The presence of few symptoms in minor strokes can make them difficult to recognise and could be a reason for delaying treatment. Training among staff caring for these patients is essential to improve this aspect.(AU)

On sparse ensemble methods: An application to short-term predictions of the evolution of COVID-19.

Since the seminal paper by Bates and Granger in 1969, a vast number of ensemble methods that combine different base regressors to generate a unique one have been proposed in the literature. The so-obtained regressor method may have better accuracy than its components, but at the same time it may overfit, it may be distorted by base regressors with low accuracy, and it may be too complex to understand and explain. This paper proposes and studies a novel Mathematical Optimization model to build a sparse ensemble, which trades off the accuracy of the ensemble and the number of base regressors used. The latter is controlled by means of a regularization term that penalizes regressors with a poor individual performance. Our approach is flexible to incorporate desirable properties one may have on the ensemble, such as controlling the performance of the ensemble in critical groups of records, or the costs associated with the base regressors involved in the ensemble. We illustrate our approach with real data sets arising in the COVID-19 context.

[Clinical characteristics and complications in patients with OHVIRA (obstructed hemivagina and ipsilateral renal anomaly) syndrome. Our experience]. / Síndrome de OHVIRA: características clínicas y complicaciones, nuestra experiencia.

INTRODUCTION: Obstructed Hemivagina and Ipsilateral Renal Agenesis (OHVIRA) syndrome is a rare variant of Müllerian anomalies. Delay in diagnosis and treatment can produce serious complications in patient's life and fertility. The aim of this study is to present our experience in clinical presentation, diagnosis and complications of patients with OHVIRA syndrome in a 20-year period. PATIENTS AND METHODS: Retrospective analysis of 9 women under 25 years old with OHVIRA syndrome between 1997 and 2017. Analysis included clinical characteristics, demographic, diagnostic methods, follow-up, treatment and complications. RESULTS: A total of 9 patients were studied, 5 diagnosed in prepuberal age and 4 postpuberal. 55% had prenatal diagnosis of renal agenesis and in 3 was incidentally diagnosed. Follow up period for single kidney to diagnosis was 3.6 years (range: 0-13,4 years). Right side was affected in 55%. Symptoms were dysmenorrea (44%), recurrent abdominal pain (22%), urinary dysfunction (22%). Complications were present in postpuberal patients and included hydrometrocolpos (22%) and pyocolpos (11%) requiring septostomy or septum resection. Surgical removal of the septum was performed in 44%). Prepuberal patients were asymptomatic. CONCLUSIONS: OHVIRA syndrome is a rare anomaly in the development of Müllerian ducts with variable clinical presentation. High suspect in patients with single kidney is necessary to avoid potential complications by providing surgical treatment.

INTRODUCCION: El síndrome de OHVIRA (SO) es una rara y compleja variante de las anomalías de los conductos de Müller caracterizado por hemivagina obstruida, útero didelfo y anomalía renal ipsilateral. Su diagnostico prepuberal es raro y el retraso en su diagnóstico y tratamiento compromete la vida y fertilidad de la paciente. MATERIAL Y METODOS: Análisis retrospectivo de las historias clínicas de las pacientes diagnosticadas en nuestro centro en un período de tiempo de 20 años. Los datos se recogen en un protocolo que incluye: características clínicas, diagnóstico, tratamiento y complicaciones. RESULTADOS: Nueve pacientes en total, 55% diagnosticadas en edad prepuberal y 45% postmenarquia. En el 55% se realizó diagnóstico prenatal de malformación renal. En el 33% antecedentes familiares de primer grado de enfermedades nefrourológicas. La media de seguimiento por riñón único, previo al diagnóstico, fue de 3,6 años (rango 0-13,4 años). En el 55% de los casos el lado afecto fue el derecho. Los síntomas fueron ginecológicos en el 44%, miccionales en el 22% y dolor abdominal recurrente en el 22%. Presentaron complicaciones en el 33%, correspondiendo a hidrometrocolpos (22%) y piocolpos (11%). Se realizó septostomía y resección del tabique vaginal como tratamiento en el 44%, todas en edad postpuberal. Las pacientes prepuberales continúan en seguimiento con actitud conservadora y están asintomáticas. CONCLUSIONES: El SO es una rara anomalía del desarrollo de los conductos müllerianos de presentación clínica variable. El alto índice de sospecha y el diagnóstico precoz en niñas con anomalías renales, facilita el tratamiento quirúrgico antes de la presentación de complicaciones.

Síndrome de OHVIRA: características clínicas y complicaciones, nuestra experiencia / Clinical characteristics and complications in patients with OHVIRA (obstructed hemivagina and ipsilateral renal anomaly) syndrome. Our experience

Introducción: El síndrome de OHVIRA (SO) es una rara y compleja variante de las anomalías de los conductos de Müller caracterizado por hemivagina obstruida, útero didelfo y anomalía renal ipsilateral. Su diagnostico prepuberal es raro y el retraso en su diagnóstico y tratamiento compromete la vida y fertilidad de la paciente. Material y métodos: Análisis retrospectivo de las historias clínicas de las pacientes diagnosticadas en nuestro centro en un período de tiempo de 20 años. Los datos se recogen en un protocolo que incluye: características clínicas, diagnóstico, tratamiento y complicaciones. Resultados: Nueve pacientes en total, 55% diagnosticadas en edad prepuberal y 45% postmenarquia. En el 55% se realizó diagnóstico prenatal de malformación renal. En el 33% antecedentes familiares de primer grado de enfermedades nefrourológicas. La media de seguimiento por riñón único, previo al diagnóstico, fue de 3,6 años (rango 0-13,4 años). En el 55% de los casos el lado afecto fue el derecho. Los síntomas fueron ginecológicos en el 44%, miccionales en el 22% y dolor abdominal recurrente en el 22%. Presentaron complicaciones en el 33%, correspondiendo a hidrometrocolpos (22%) y piocolpos (11%). Se realizó septostomía y resección del tabique vaginal como tratamiento en el 44%, todas en edad postpuberal. Las pacientes prepuberales continúan en seguimiento con actitud conservadora y están asintomáticas. Conclusiones: El SO es una rara anomalía del desarrollo de los conductos müllerianos de presentación clínica variable. El alto índice de sospecha y el diagnóstico precoz en niñas con anomalías renales, facilita el tratamiento quirúrgico antes de la presentación de complicaciones

Introduction: Obstructed Hemivagina and Ipsilateral Renal Agenesis (OHVIRA) syndrome is a rare variant of Müllerian anomalies. Delay in diagnosis and treatment can produce serious complications in patient's life and fertility. The aim of this study is to present our experience in clinical presentation, diagnosis and complications of patients with OHVIRA syndrome in a 20-year period. Patients and methods: Retrospective analysis of 9 women under 25 years old with OHVIRA syndrome between 1997 and 2017. Analysis included clinical characteristics, demographic, diagnostic methods, follow-up, treatment and complications. Results: A total of 9 patients were studied, 5 diagnosed in prepuberal age and 4 postpuberal. 55% had prenatal diagnosis of renal agenesis and in 3 was incidentally diagnosed. Follow up period for single kidney to diagnosis was 3.6 years (range: 0-13,4 years). Right side was affected in 55%. Symptoms were dysmenorrea (44%), recurrent abdominal pain (22%), urinary dysfunction (22%). Complications were present in postpuberal patients and included hydrometrocolpos (22%) and pyocolpos (11%) requiring septostomy or septum resection. Surgical removal of the septum was performed in 44%). Prepuberal patients were asymptomatic. Conclusions: OHVIRA syndrome is a rare anomaly in the development of Müllerian ducts with variable clinical presentation. High suspect in patients with single kidney is necessary to avoid potential complications by providing surgical treatment

Minimum Penalized ϕ-Divergence Estimation under Model Misspecification.

This paper focuses on the consequences of assuming a wrong model for multinomial data when using minimum penalized ϕ -divergence, also known as minimum penalized disparity estimators, to estimate the model parameters. These estimators are shown to converge to a well-defined limit. An application of the results obtained shows that a parametric bootstrap consistently estimates the null distribution of a certain class of test statistics for model misspecification detection. An illustrative application to the accuracy assessment of the thematic quality in a global land cover map is included.

Síndrome del cascanueces. Una causa poco frecuente de hematuria / Nutcracker syndrome. An uncommon cause of hematuria

El síndrome del cascanueces o síndrome de nutcracker se define como la compresión de la vena renal izquierda entre la aorta y la arteria mesentérica superior. Es una causa poco frecuente de hematuria. Se presenta el caso clínico de un niño con hematuria macroscópica recurrente, en el que por pruebas de imagen se llegó al diagnóstico (AU)

The nutcracker syndrome is defined as the compression of the left renal vein between the aorta and the superior mesenteric artery. It is a rare cause of hematuria. We presented the clinical case of a child with recurrent macroscopic hematuria, in which the diagnosis was reached by imaging test (AU)

Pronóstico de la enfermedad glomerular de comienzo pediátrico. Nefropatía Ig A / Prognosis of pediatric onset glomerular disease. IgA nephropathy

No disponible

Life cycle assessment of swine and dairy manure: pyrolysis and combustion processes.

The valorization of three different manure samples via pyrolysis and combustion processes was evaluated. Dairy manure (sample Pre) was biologically pretreated by anaerobic digestion (sample Dig R) whereas swine manure (sample SW) was pretreated by a biodrying process. Thermal behavior of manure samples were studied by means of thermogravimetric analysis coupled with mass spectrometry (TGA-MS). These processes could be divided into four general stages: dehydration, devolatilization, char transformation (oxidation for combustion) and inorganic matter decomposition. The main differences observed among the samples were attributed to their different composition and pretreatment. The economic feasibility, energetic and environmental impacts of pyrolysis and combustion technologies for dairy samples were carried out by means of life cycle assessment (LCA) methodology. Four different scenarios were analyzed. The economic feasibility of the pyrolysis process was demonstrated, being sample Dig R the best environmental option. However, the combustion of sample Pre was the best energetic option.

Revascularización carotídea con stent: implicaciones clínicas y para el procedimiento de la presencia de una lesión suboclusiva / Carotid artery stenting: clinical and procedural implications for near-occlusion stenosis

Introducción y objetivos: La conveniencia del implante de stent en lesiones carotídeas suboclusivas es un tema controvertido. Nuestro trabajo valoró las implicaciones clínicas y de procedimiento de la revascularización de lesiones carotídeas suboclusivas. Métodos: Se incluyó a 205 pacientes con enfermedad carotídea revascularizados con stent: los pacientes con lesiones suboclusivas (n = 54) fueron comparados con el resto de la población (n = 151). Resultados: No hubo diferencias entre grupos para la edad, el sexo y la tasa de pacientes sintomáticos (que constituían 3 cuartas partes de la población). El implante de stent en lesiones suboclusivas cursó con una alta tasa de éxito (96%), similar al resto de las lesiones (98%). La revascularización de las lesiones suboclusivas condicionó un mayor uso de protección proximal (54% vs. 20,5%, p < 0,001) y necesidad de predilatación (33% vs. 17%, p = 0,01). El abordaje de lesiones suboclusivas ocasionó un mayor desprendimiento de placa, manifestado por una mayor tasa de material embólico extraído (18,5% vs. 7%, p = 0,01) y de lesiones isquémicas cerebrales periprocedimiento (47% vs. 31%, p = 0,07). A los 30 días de la revascularización, la tasa de eventos neurológicos (muerte, ictus mayor, ictus menor) mostró tendencia a ser mayor para el grupo con lesiones suboclusivas (9,2% vs. 3,2%, p = 0,08). Conclusiones: La revascularización con stent de lesiones carotídeas suboclusivas presenta una alta tasa de éxito de procedimiento; sin embargo, su mayor carga de placa ocasiona un superior porcentaje de lesiones isquémicas cerebrales, y de eventos neurovasculares en el primer mes (AU)

Introduction and objectives: The advisability of implanting a stent in carotid near-occlusion stenosis is a controversial topic. We have assessed procedural and clinical implications of stent implantation for carotid artery disease with near occlusion. Methods: We included 205 patients who underwent carotid artery revascularisation with a stent. The group of patients with near-occlusion stenosis (n=54)was compared to the rest of the population (n=151). Results: No differences were found between groups for age, sex, and the percentage of symptomatic patients (three-quarters of the population). Carotid stent revascularisation for near-occlusion stenosis presented a high procedural success rate (96%) similar to that of revascularisation processes for other lesions (98%). Stenting in cases of near-occlusion stenosis required increased use of proximal protection (54% vs. 20.5%, P<.001) and predilation (33% vs. 17%, P=.01). The process to repair near-occlusion stenosis cause increased detachment of plaque, as shown by higher percentages of macroscopic plaque captured by protection devices (18.5% vs. 7%, P=.01) and of perioperative ischaemic brain lesions (47% vs 31%, P = .07). At 30 days of follow-up, the tendency toward adverse neurological events (death, major and minor stroke) was higher in the near-occlusion group (9.2% vs. 3.2%, P=.08). Conclusions: Stent revascularisation for near-occlusion carotid stenosis has a high procedural success rate; however, its higher plaque load was responsible for the increased rate of ischaemic brain lesions and adverse neurovascular events at 30 days post-procedure (AU)

Nanostructured rough gold electrodes as platforms to enhance the sensitivity of electrochemical genosensors.

An electrochemical DNA genosensor constructed by using rough gold as electrode support is reported in this work. The electrode surface nanopatterning was accomplished by repetitive square-wave perturbing potential (RSWPP). A synthetic 25-mer DNA capture probe, modified at the 5' end with a hexaalkylthiol, able to hybridize with a specific sequence of lacZ gene from the Enterobacteriaceae bacterial family was assembled to the rough gold surface. A 25 bases synthetic sequence fully complementary to the thiolated DNA capture probe and a 326 bases fragment of lacZ containing a fully matched sequence with the capture probe, which was amplified by a specific asymmetric polymerase chain reaction (aPCR), were employed as target sequences. The hybridization event was electrochemically monitored by using two different indicators, hexaammineruthenium (III) chloride showing an electrostatic DNA binding mode, and pentaamineruthenium-[3-(2-phenanthren-9-yl-vinyl)-pyridine] (in brief RuL) which binds to double stranded DNA (dsDNA) following an intercalative mechanism. After optimization of the different variables involved in the hybridization and detection reactions, detection limits of 5.30 pg µL(-1) and 10 pg µL(-1) were obtained for the 25-mer synthetic target DNA and the aPCR amplicon, respectively. A RSD value of 6% was obtained for measurements carried out with 3 different genosensors prepared in the same manner.

Carotid artery stenting: clinical and procedural implications for near-occlusion stenosis.

INTRODUCTION AND OBJECTIVES: The advisability of implanting a stent in carotid near-occlusion stenosis is a controversial topic. We have assessed procedural and clinical implications of stent implantation for carotid artery disease with near occlusion. METHODS: We included 205 patients who underwent carotid artery revascularisation with a stent. The group of patients with near-occlusion stenosis (n=54)was compared to the rest of the population (n=151). RESULTS: No differences were found between groups for age, sex, and the percentage of symptomatic patients (three-quarters of the population). Carotid stent revascularisation for near-occlusion stenosis presented a high procedural success rate (96%) similar to that of revascularisation processes for other lesions (98%). Stenting in cases of near-occlusion stenosis required increased use of proximal protection (54% vs. 20.5%, P<.001) and predilation (33% vs. 17%, P=.01). The process to repair near-occlusion stenosis cause increased detachment of plaque, as shown by higher percentages of macroscopic plaque captured by protection devices (18.5% vs. 7%, P=.01) and of perioperative ischaemic brain lesions (47% vs 31%, P = .07). At 30 days of follow-up, the tendency toward adverse neurological events (death, major and minor stroke) was higher in the near-occlusion group (9.2% vs. 3.2%, P=.08). CONCLUSIONS: Stent revascularisation for near-occlusion carotid stenosis has a high procedural success rate; however, its higher plaque load was responsible for the increased rate of ischaemic brain lesions and adverse neurovascular events at 30 days post-procedure.

Influence of macroporous gold support and its functionalization on lactate oxidase-based biosensors response.

A general bioanalytical platform for biosensor applications was developed based on three-dimensional ordered macroporous (3DOM) gold film modified electrodes using lactate oxidase (LOx) as a case study, within the framework of developing approaches of broad applicability. The electrode was electrochemically fabricated with an inverted opal template, making the surface area of the 3DOM gold electrode up to 18 times higher than that of bare flat gold electrodes. These new electrochemical transducers were characterized by using Field Emission Scanning Electron Microscopy (FE-SEM), Atomic Force Microscopy (AFM) and the X-ray diffraction (XRD). The biosensor was developed by immobilization of lactate oxidase (LOx), on a 3DOM gold electrode modified with a self-assembled monolayer of dithiobis-N-succinimidyl propionate (DTSP). The resulting lactate oxidase biosensor was characterized by electrochemical impedance spectroscopy (EIS). The 3DOM gold electrode not only provides a good biocompatible microenvironment but also promotes the increase of conductivity and stability. Thus, the developed lactate oxidase bioanalytical platforms showed higher mediated bioelectrocatalytic activity compared to others previously described based on polycrystalline gold transducers. The response to varying lactate concentrations has been obtained in the presence of hydroxymethylferrocene as redox mediator in solution. Under these conditions, the bioanalytical platform response for DTSP covalently bound enzyme was improved with respect to that obtained in absence of DTSP.

[Prevalence and factors associated to malnutrition in patients admitted to a medium-long stay hospital]. / Prevalencia y factores asociados a desnutrición entre pacientes ingresados en un hospital de media-larga estancia.

OBJECTIVES: To determine the prevalence of hyponutrition at admission at a mid- to long-term stay hospital. To analyze the possible factors associated to hyponutrition; the possible relationship with mortality at one month, and the treatments for hyponutrition performed. MATERIALS AND METHOD: Descriptive study from the laboratory data obtained in 140 patients. For diagnosing hyponutrition, a tool based on albumin, total cholesterol, and lymphocytes levels was used. Demographical (age and gender) and clinical data (presence of pressure soars, nasogastric tube, dementia, neoplasm, previous admission to the ICU, and main diagnosis) were gathered at admission as well as the mortality at the first month. The treatments used for hyponutrition were reviewed. RESULTS: patients' age was 77.1 years and 63% were females. 17.1% of the patients presented normal nutritional status, 50.7% met the criteria for mild hyponutrition, 26.4% of moderate hyponutrition, and 5.7% of severe hyponutrition. We found no association between hyponutrition and gender, nasogastric tube, soars, dementia or neoplasm, but we did so with age (P = 0.033). We found a relationship between moderate-severe hyponutrition and pressure soars (P = 0.036). We found an association between hyponutrition and mortality at one month (OR = 1.357, 95% CI 1.121 to 1.643; P = 0.02). 35.6% of the patients with moderate-severe hyponutrition received therapy for this condition (28.9% with protein supplements and 6.7% with enteral diet). CONCLUSIONS: hyponutrition affects most of the patients admitted to a mid to long-term stay hospitals and is associated with higher mortality. One third of hyponutrition patients receive nutritional therapy.