Simultaneous Detection of Circularly Polarized Luminescence and Raman Optical Activity in an Organic Molecular Lemniscate.

Circularly polarized luminescence (CPL) and Raman optical activity (ROA) were observed in a single spectroscopic experiment for a purely organic molecule, an event that had so far been limited to lanthanide-based complexes. The present observation was achieved for [16]cycloparaphenylene lemniscate, a double macrocycle constrained by a rigid 9,9'-bicarbazole subunit, which introduces a chirality source and allows the molecule to be resolved into two configurationally stable enantiomers. Distortion of oligophenylene loops in this lemniscular structure produces a large magnetic transition dipole moment while maintaining the π-conjugation-induced enhancement of the Raman signal, causing the appearance of the CPL/ROA couple. A two-photon mechanism is proposed to explain the population of the lowest-energy excited electronic state prior to the simultaneous emission-scattering event.

Iliopsoas Hematoma After Total Hip Arthroplasty Using a Minimally Invasive Modified Direct Anterior Approach: A Case Report.

CASE: The modified direct anterior approach (MDAA) is a recently popular surgical technique for total hip arthroplasty (THA), with well-documented challenges. Characterized as acute hip and back pain, we present the case of a 78-year-old woman who developed an iliopsoas hematoma after an MDAA THA and discuss the management of this incident. CONCLUSIONS: Iliopsoas hematoma after THA poses a unique challenge and should be considered in patients with acute hip and back pain, with loss of strength on the affected limb after an MDAA THA.

Raman and ROA analyses of twisted anthracenes: connecting vibrational and electronic/photonic structures.

In this article the Raman and Raman Optical Activity (ROA) spectra of a series of enantiomeric twisted anthracenes are presented. The evolution of their vibrational spectra is understood in the context of the variation of π-electron delocalization as a result of the twisting imparted by the belt structure and in terms of the modulation of the resonance Raman/ROA effects which are photonic properties also tuned by anthracene twisting. The Raman/ROA vibrational spectra are simulated by several theoretical approaches to account for their vibrational and electronic properties including the theoretical evaluation of resonance effects. We furthermore incorporate a vibrational and ROA activity dissection analysis as provided in the Pyvib2 program valid to establish correlations among vibrational modes of different molecules with different electronic structures and equivalent vibrational dynamics. This paper is one of the very first attempts to use ROA spectroscopy in π-conjugated molecules with twisted and helical morphologies that contrast with the well-known cases of ROA studies of chiral helicenes in which the impact of π-electron delocalization in the electronic/photonic/vibrational (Raman/ROA) spectra is negligible.

Raman Optical Activity (ROA) as a New Tool to Elucidate the Helical Structure of Poly(phenylacetylene)s.

Poly(phenylacetylene)s are a family of helical polymers constituted by conjugated double bonds. Raman spectra of these polymers show a structural fingerprint of the polyene backbone which, in combination with its helical orientation, makes them good candidates to be studied by Raman optical activity (ROA). Four different well-known poly(phenylacetylene)s adopting different scaffolds and ten different helical senses have been prepared. Raman and ROA spectra were recorded and allowed to establish ROA-spectrum/helical-sense relationships: a left/right-handed orientation of the polyene backbone (Mhelix /Phelix ) produces a triplet of positive/negative ROA bands. Raman and ROA spectra of each polymer exhibited the same profile, and the sign of the ROA spectrum was opposite to the lowest-energy electronic circular dichroism (ECD) band, indicating a resonance effect. Resonance ROA appears then as an indicator of the helical sense of poly(phenylacetylene)s, especially for those with an extra Cotton band in the ECD spectrum, where a wrong helical sense is assigned based on ECD, while ROA alerts of this misassignment.

Spatiotemporal Expression of Foxl2 and Dmrt1 before, during, and after Sex Determination in the Sea Turtle Lepidochelys olivacea.

The sex of sea turtles is determined by temperature during egg incubation. Thus, climate change affects the sex ratio, exacerbating their vulnerability to extinction. Understanding spatiotemporal effects of temperature on sex determination at the gonadal level may facilitate the design of strategies to mitigate the effects of global warming. Here, we used qRT-PCR and immunofluorescence to analyze the spatiotemporal expression of Dmrt1 and Foxl2 in developing gonads of Lepidochelys olivacea incubated at male-producing temperature (MPT, 26°C) or female-producing temperature (FPT, 33°C). Although both transcription factors are expressed in bipotential gonads up to stage 25, the timing of their sexually dimorphic regulation differs. Whereas the dimorphic expression of Dmrt1 protein initiates at stage 24, Foxl2 protein was expressed specifically in females at stage 25. Interestingly, whereas Dmrt1 colocalizes with Sox9 in cell nuclei of primary medullary cords to form the testis cords, Foxl2 protein is first detected in Sox9-negative cells of primary medullary cords, prior to its substantial expression in the ovarian cortex. Thus, results suggest that the temperature-dependent regulation of sexual pathways is stochastic among the cells of primary medullary cords in undifferentiated bipotential gonads of the olive ridley.

Modelo sanitario, índice de calidad asistencial y gasto sanitario público / Health model, care quality and health spending public

No disponible

Recortes en los presupuestos sanitarios y listas de espera / Cutbacks in health budgets and waiting lists

No disponible

Avulsión de la tuberosidad tibial: reporte de un caso y revisión de la literatura / Tibial tubercle avulsion: a case report and literature review

Resumen La fractura por avulsión de la tuberosidad tibial es una patología poco común. Es una lesión característica de la infancia, con afección directa a la fisis, que amerita un diagnóstico oportuno y un tratamiento óptimo a fin de evitar complicaciones en el crecimiento, la mayoría de ellas graves. La reducción abierta y fijación interna ha probado ser un tratamiento adecuado en la mayoría de este tipo de lesiones; sin embargo, el procedimiento quirúrgico es un riesgo agregado al daño de la lesión per se. Con un adecuado tratamiento y rehabilitación la lesión tiende a una evolución por lo general satisfactoria. Tomando en cuenta la baja incidencia de esta patología, en el siguiente artículo reportamos el caso de un paciente de 13 años con avulsión de tuberosidad tibial tipo III de Watson-Jones, el abordaje diagnóstico-terapéutico y el éxito obtenido a 2 años de seguimiento; asimismo, realizamos una revisión de la literatura.

Abstract Tibial tubercle avulsion is an uncommon disease, usually found during childhood, with direct physis affection, that needs an accurate diagnosis and an optimum treatment in order to avoid growth complications which could have disastrous consequences for the child. Open reduction and internal fixation has been reported as an adequate treatment in most of these injuries; nevertheless, surgery increases the risk upon the injury itself. With an appropriate treatment and rehabilitation this injury tends to have a satisfactory evolution. Considering the low incidence of this pathology, a case report of a 13-year-old boy with a Watson-Jones type III avulsion, a diagnostic-therapeutic approach and the successful evolution for a two-years follow up is described, as well as a literature review.

El efecto de los copagos sobre la adherencia a los medicamentos prescritos / Effect of co-payments on the adherence to prescribed medications

No disponible

Limitaciones en la utilización de las tablas de riesgo cardiovascular y de las estatinas / Limitations of the utilization of cardiovascular risk tables and statins

No disponible

Cardiovascular risk factors, lifestyle, and social determinants: a cross-sectional population study.

BACKGROUND: The influence of socioeconomic development is often disregarded in epidemiological studies into the prevalence of cardiovascular risk factors. AIM: To analyse the relationship between major cardiovascular risk factors and socioeconomic indicators. DESIGN AND SETTING: Cross-sectional, population-wide study in primary care practices in the health area of Don Benito-Villanueva de la Serena, Badajoz, Extremadura, Spain. METHOD: A total of 2833 people aged 25-79 years (mean age 51.2 years), representative of the population, participated in the study. The prevalence and odds ratios (ORs) were calculated for diabetes, arterial hypertension, obesity, hypercholesterolaemia, smoking, and sedentary behaviour, according to level of education and employment status. RESULTS: A high prevalence of cardiovascular risk factors related to the level of education and employment status. Females who had not studied at university had a higher risk of obesity (OR = 2.5, 95% confidence interval [CI] = 1.5 to 4.2), smoking (OR 2.5, 95% CI = 1.7 to 3.7), and sedentary behaviour (OR = 2.5, 95% CI = 1.5 to 3.9) than females with a university education. Males who had not studied at university showed an increased risk of smoking (OR = 2.1, 95% CI = 1.4 to 3.1), arterial hypertension (OR = 1.5, 95% CI = 1.0 to 2.4), hypercholesterolaemia (OR = 1.5, 95% CI = 1.0 to 2.2), and obesity (OR = 1.5, 95% CI = 1.0 to 2.3) than males with a university education. The risk of obesity was higher in unemployed females than those in paid employment (OR =1.4, 95% CI = 1.1 to 1.9), but they showed a lower risk of smoking (OR = 0.7, 95% CI = 0.5 to 0.9). CONCLUSION: The study results confirm an inverse association between the level of education and the prevalence of cardiovascular risk factors. Public health studies and interventions are needed to understand this association and develop interventions targeted at the population that is at greatest risk.

La extrapolación del número de pacientes que es necesario tratar atenta contra la bioestadística y conduce a la inmortalidad / No disponible

No disponible

La reforma de la atención primaria, entre el refugio del pasado y la aventura de la innovación. Informe SESPAS 2012 / The reform of primary care, between the last refuge of adventure and innovation. SESPAS report 2012

La reforma de la atención primaria ya tiene 30 años, pero no ha desarrollado plenamente todas sus capacidades. Las mejoras que se propongan deben acompañarse de financiación suficiente, optimizar su impacto sobre la salud y adaptar la organización y las competencias clínicas al incremento y la banalización de la demanda, a la burocracia y a la medicalización. Las reformas organizativas propuestas no han demostrado hasta ahora diferencias concluyentes a favor de unas u otras. Por su parte, tanto las reformas procontenido como las reformas procoordinación no han demostrado impacto sobre la demanda derivada, sobre el coste de la atención ni sobre los resultados en salud. Las ayudas que aportan los sistemas de información han reducido la burocracia y pueden favorecer la continuidad asistencial. En el nivel de la mesogestión se proponen medidas que favorezcan la accesibilidad; sistemas de pago que equilibren capitación, desempeño y capacidad resolutiva; mejorar la integración de los recursos sociales y sanitarios; comprometer activamente a los profesionales con los objetivos de calidad y eficiencia del sistema sanitario; y finalmente incorporar más contenidos clínicos, preventivos y de colaboración con la comunidad (AU)

Primary care reforms started thirty years ago, but not fully developed their potential. Improvements should be suggested to be accompanied by adequate funding, operational capacity and organization and clinical skills adapt to upgrading and trivialized demand, bureaucracy and medicalization. Organizational-suggested reforms have not shown conclusive differences yet. On the other hand, neither pro-content nor pro-coordination reforms have shown any impact on the derived demand, the cost of care attention or the health outcomes. Thanks to the support of the information systems, bureaucracy has been reduced and care continuity may be promoted. In the middle management level, some measures have been suggested to promote accessibility, restore capitation by payment systems, perform and resolve capacity, improve integration of social care and health care resources, actively engage professionals with the health system-objectives of quality and efficiency and, finally, add more clinical, preventive and community collaboration-contents (AU)

[The reform of primary care, between the last refuge of adventure and innovation. SESPAS report 2012]. / La reforma de la atención primaria, entre el refugio del pasado y la aventura de la innovación. Informe SESPAS 2012.

Primary care reforms started thirty years ago, but not fully developed their potential. Improvements should be suggested to be accompanied by adequate funding, operational capacity and organization and clinical skills adapt to upgrading and trivialized demand, bureaucracy and medicalization. Organizational-suggested reforms have not shown conclusive differences yet. On the other hand, neither pro-content nor pro-coordination reforms have shown any impact on the derived demand, the cost of care attention or the health outcomes. Thanks to the support of the information systems, bureaucracy has been reduced and care continuity may be promoted. In the middle management level, some measures have been suggested to promote accessibility, restore capitation by payment systems, perform and resolve capacity, improve integration of social care and health care resources, actively engage professionals with the health system-objectives of quality and efficiency and, finally, add more clinical, preventive and community collaboration-contents.