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Torres Y, Pablos-Heredero C, Morantes M, Rangel J, Espinosa JA, Angón E, García A. El papel de la mujer en la explotación de ganado bovino de doble propósito en Ecuador. ARCHIVOS DE ZOOTECNIA 2016. [DOI: 10.21071/az.v65i251.690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Uno de los objetivos estratégicos para FAO es disminuir la brecha de género en aras del desarrollo rural. El presente trabajo se planteó para conocer la percepción que tienen los productores del sistema de doble propósito ecuatoriano sobre las diferencias de género, tanto en el ámbito familiar como en la unidad de producción. Se tomó una muestra aleatoria de 132 unidades familiares–productivas del bosque tropical de Manabí. La información fue obtenida a través de una encuesta cara a cara, donde se preguntaron cuestiones relacionadas con el perfil socioeconómico de la familia, el sistema de producción y la percepción del papel de los distintos géneros. Los resultados muestran que existen importantes diferencias de género en el mundo rural ecuatoriano. Los productores tienen fuertes creencias en las diferencias sociales y biológicas entre sexos. El trabajo y rol de mujer es percibido únicamente relevante en el ámbito doméstico. Mientras que en la unidad productiva apenas asume responsabilidades. La toma de decisiones es exclusiva del hombre cuando se trata del ámbito empresarial; mientras que la mujer participa junto a él en decisiones del hogar, aunque nunca asume un papel predominante.
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Rangel-Quintos J, De Pablos-Heredero C, Vélez A, Espinosa A, Perea J, Angón E, García A. Sustentabilidad social de agroecosistemas bovinos de doble propósito en México. ARCHIVOS DE ZOOTECNIA 2016. [DOI: 10.21071/az.v65i251.691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
El objetivo de este estudio fue identificar las diferencias existentes en la sustentabilidad social, de los pequeños productores de ganado de doble propósito en el trópico mexicano. En dos zonas ecológicas definidas: Trópico Seco (TS) y Húmedo (TH). Para ello se analizaron las variables socioeconómicas y los indicadores de desarrollo humano establecidos por el Programa de las Naciones Unidas para el Desarrollo (PNUD). Se encontraron diferencias significativas; tanto en los objetivos de la producción (carne y leche) y en los indicadores de desarrollo humano y marginación (p<0,05). Las diferencias encontradas han de ser consideradas para establecer distintas estrategias y políticas públicas para cada una de las zonas ecológicas del trópico mexicano.
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Kollmann-Camaiora A, Alsina E, Domínguez A, Del Blanco B, Yepes MJ, Guerrero JL, García A. Clinical protocol for the management of malignant hyperthermia. ACTA ACUST UNITED AC 2016; 64:32-40. [PMID: 27633384 DOI: 10.1016/j.redar.2016.06.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 06/16/2016] [Accepted: 06/17/2016] [Indexed: 11/24/2022]
Abstract
Malignant hyperthermia is a hypermetabolic syndrome that appears in susceptible patients after exposure to certain anaesthetic drugs (succinylcholine, inhalation anaesthetics). Its incidence in Spain is 1 in 40,000 adults, with a 10% mortality rate. It is induced by an abnormal regulation of the ryanodine receptors, producing a massive release of calcium from the sarcoplasmic reticulum in the striate muscle. Clinical manifestations include: CO2 increase, tachycardia, haemodynamic instability, metabolic and respiratory acidosis, profuse sweating, hyperpyrexia, CPK increase, myoglobinuria, kidney failure, disseminated intravascular coagulation (DIC), and ending in cardiac arrest. Dantrolene sodium is a ryanodine receptor antagonist, and inhibits the release of intracellular calcium. Definitive diagnosis is achieved by the exposure of muscle fibres to caffeine and halothane. Protocols can help guarantee a reliable and secure management when this severe event occurs.
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Triguero J, García A, Molina A, San Miguel C, Notario P, Villegas T, Becerra A, Expósito M, Muffak K, Álvarez MJ, Fundora Y. Complications Associated With Liver Transplantation in Recipients With Body Mass Index >35 kg/m(2): Would It Be a Poor Prognosis Predictive Factor? Transplant Proc 2016; 47:2650-2. [PMID: 26680062 DOI: 10.1016/j.transproceed.2015.10.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 10/04/2015] [Accepted: 10/07/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND Obesity is a global epidemic that continues to increase in a great number of countries, and it has become a major public health problem in Spain. Unfortunately, the impact of obesity on survival in liver transplantation (LT) recipients is underestimated and controversial. The aim of this study was to determine if obesity is a risk factor for morbidity and mortality after LT. METHODS In a retrospective cohort study of the records of 180 consecutive patients who had undergone to LT from 2007 to 2013, 11 obese patients with body mass index (BMI) >35 kg/m(2) were identified. Their data have been compared with recipients with BMI 20-25 kg/m(2). RESULTS There were no differences in demographic data, Child-Pugh score, Model for End-Stage Liver Disease score, or cause of liver failure. BMI >35 kg/m(2) recipients had a significantly higher rate of portal vein thrombosis before LT, compared with the BMI 20-25 kg/m(2) group (36.5% vs 13.9%; P = .041). There were also no differences in development of post-reperfusion syndrome. The groups were also comparable concerning morbidity rate after LT, stay in the intensive care unit, and global hospital stay. However, the mortality rate was significantly higher in the obese group compared with the nonobese group (72.7% vs 38.9%; P = .032). CONCLUSIONS The results of the study clearly demonstrate higher mortality rates in obese patients undergoing LT; thus, it is fair to consider obesity as a poor prognosis predictive factor concerning mortality rate.
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Feliu V, García A, Somolinos JA. Gauge-Based Tip Position Control of a New Three-Degree-of-Freedom Flexible Robot. Int J Rob Res 2016. [DOI: 10.1177/02783640122067598] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Flexible robots have given rise to numerous investigations, and their use is easily justified in two main cases: (1) when the weight of the robot has to be minimized and (2) when collisions of the robot with the environment are foreseen, as a flexible lightweight robot delivers less impact energy. Much work has been done by different authors on the position control of flexible robots using feedback of the tip position or tip acceleration. However, the use of these sensing devices is problematic in practical applications of flexible arms: three-dimensional tip position sensing is expensive, and occlusions appear at some arm configurations. Accelerometers cannot be used when contact of the tip with the environment is expected because these sensors cannot stand the high negative accelerations produced at the impact (unless very low speed motions are performed). This paper studies the possibility of carrying out the tip position control of a three-degree-of-freedom flexible arm using sensing devices placed far away from the tip (where contact is expected) in such way that they can easily stand the impact, which will be needed in the development of a position/force control for flexible robots. A control scheme based on motor position sensing plus some strain gauges placed on the arm structure is proposed. Stability of this control scheme is proven and is experimentally verified on a flexible manipulator prototype that was developed in the authors’ laboratory.
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Martínez-Cerón E, García A, Casitas R, Galera R, García-Río F. Cost-Effectiveness Analysis of 3 Methacholine Challenge Tests: Importance of Simplified Protocols. J Investig Allergol Clin Immunol 2016; 26:121-4. [PMID: 27164632 DOI: 10.18176/jiaci.0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Retuerto M, Sierra L, Martín M, Moriano C, García A, Garijo M, Iniguez C, Lopez A, Άlvarez C, Díez E, Pérez T. AB0821 Evolution of The Values of Alkaline Phosphatase (ALP) in Patients Treated with Zoledronic Acid and Diagnosed with The Paget's Disease of Bone. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Retuerto M, Sierra L, Moriano C, Martín M, García A, Garijo M, Iniguez C, Lopez A, Άlvarez C, Díez E, Pérez T. AB0790 Descriptive Study of Zoledronic Acid Treatment in A Hospital of Third Level. Our Experience. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Mastrangelo A, Martos-Moreno GÁ, García A, Barrios V, Rupérez FJ, Chowen JA, Barbas C, Argente J. Insulin resistance in prepubertal obese children correlates with sex-dependent early onset metabolomic alterations. Int J Obes (Lond) 2016; 40:1494-1502. [PMID: 27163744 PMCID: PMC5056960 DOI: 10.1038/ijo.2016.92] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Revised: 03/21/2016] [Accepted: 05/02/2016] [Indexed: 12/16/2022]
Abstract
Background: Insulin resistance (IR) is usually the first metabolic alteration diagnosed in obese children and the key risk factor for development of comorbidities. The factors determining whether or not IR develops as a result of excess body mass index (BMI) are still not completely understood. Objectives: This study aimed to elucidate the mechanisms underpinning the predisposition toward hyperinsulinemia-related complications in obese children by using a metabolomic strategy that allows a profound interpretation of metabolic profiles potentially affected by IR. Methods: Serum from 60 prepubertal obese children (30 girls/30 boys, 50% IR and 50% non-IR in each group, but with similar BMIs) were analyzed by using liquid chromatography–mass spectrometry, gas chromatography–mass spectrometry and capillary electrophoresis–mass spectrometry following an untargeted metabolomics approach. Validation was then performed on a group of 100 additional children with the same characteristics. Results: When obese children with and without IR were compared, 47 metabolites out of 818 compounds (P<0.05) obtained after data pre-processing were found to be significantly different. Bile acids exhibit the greatest changes (that is, approximately a 90% increase in IR). The majority of metabolites differing between groups were lysophospholipids (15) and amino acids (17), indicating inflammation and central carbon metabolism as the most altered processes in impaired insulin signaling. Multivariate analysis (OPLS-DA models) showed subtle differences between groups that were magnified when females were analyzed alone. Conclusions: Inflammation and central carbon metabolism, together with the contribution of the gut microbiota, are the most altered processes in obese children with impaired insulin signaling in a sex-specific fashion despite their prepubertal status.
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Rubí S, Oporto M, García A, Legarda I, Picado M, Peña C. Hipometabolismo estriatal detectado por PET-FDG cerebral en un caso de corea-acantocitosis. Rev Esp Med Nucl Imagen Mol 2016; 35:205-6. [DOI: 10.1016/j.remn.2015.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 08/06/2015] [Accepted: 08/12/2015] [Indexed: 10/22/2022]
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Sáez P, García A, Peña E, Gasser T, Martínez M. Microstructural quantification of collagen fiber orientations and its integration in constitutive modeling of the porcine carotid artery. Acta Biomater 2016; 33:183-93. [PMID: 26827780 DOI: 10.1016/j.actbio.2016.01.030] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 01/11/2016] [Accepted: 01/20/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Mechanical characteristics of vascular tissue may play a role in different arterial pathologies, which, amongst others, requires robust constitutive descriptions to capture the vessel wall's anisotropic and non-linear properties.Specifically, the complex 3D network of collagen and its interaction with other structural elements has a dominating effect of arterial properties at higher stress levels.The aim of this study is to collect quantitative collagen organization as well as mechanical properties to facilitate structural constitutive models for the porcine carotid artery.This helps the understanding of the mechanics of swine carotid arteries, being a standard in clinical hypothesis testing, in endovascular preclinical trials for example. METHOD Porcine common carotid arteries (n=10) were harvested and used to (i) characterize the collagen fiber organization with polarized light microscopy, and (ii) the biaxial mechanical properties by inflation testing.The collagen organization was quantified by the Bingham orientation density function (ODF), which in turn was integrated in a structural constitutive model of the vessel wall.A one-layered and thick-walled model was used to estimate mechanical constitutive parameters by least-square fitting the recorded in vitro inflation test results.Finally, uniaxial data published elsewhere were used to validate the mean collagen organization described by the Bingham ODF. RESULTS Thick collagen fibers, i.e.the most mechanically relevant structure, in the common carotid artery are dispersed around the circumferential direction.In addition, almost all samples showed two distinct families of collagen fibers at different elevation, but not azimuthal, angles.Collagen fiber organization could be accurately represented by the Bingham ODF (κ1,2,3=[13.5,0.0,25.2] and κ1,2,3=[14.7,0.0,26.6]; average error of about 5%), and their integration into a structural constitutive model captured the inflation characteristics of individual carotid artery samples.Specifically, only four mechanical parameters were required to reasonably (average error from 14% to 38%) cover the experimental data over a wide range of axial and circumferential stretches.However, it was critical to account for fibrilar links between thick collagen fibers.Finally, the mean Bingham ODF provide also good approximation to uniaxial experimental data. CONCLUSIONS The applied structural constitutive model, based on individually measured collagen orientation densities, was able to capture the biaxial properties of the common carotid artery. Since the model required coupling amongst thick collagen fibers, the collagen fiber orientations measured from polarized light microscopy, alone, seem to be insufficient structural information. Alternatively, a larger dispersion of collagen fiber orientations, that is likely to arise from analyzing larger wall sections, could have had a similar effect, i.e. could have avoided coupling amongst thick collagen fibers. STATEMENT OF SIGNIFICANCE The applied structural constitutive model, based on individually measured collagen orientation densities, was able to capture the biaxial and uniaxial properties of the common carotid artery. Since the model required coupling amongst thick collagen fibers, an effective orientation density that accounts for cross-links between the main collagen fibers has been porposed. The model provides a good approximation to the experimental data.
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Reyes FP, Sánchez M, Moral E, Terradillos M, López N, Roca M, García A, Russo J. Cerebellar atrophy supporting diagnosis of alcohol dependence: A case report. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.1063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Chronic use of alcohol is a known cause of cerebellar atrophy. This finding could be a valuable diagnosis support when there are not other information sources. In this case report, we describe a 65-year-old male patient who was referred from primary care to specialized consultation because a depressive syndrome it was unresponsive to treatment with desvenlafaxine and lorazepam. In psychopathological exploration we found overvalued ideas of suffering some kind of injury and damage by the family, which oriented the diagnostic hypothesis of delusional disorder with secondary mood symptoms, although the clinical suspicion of abuse of alcohol was proposed as a differential diagnosis. The continuing minimization and denial of consumption by the patient as well as their reluctance to incorporate an external informant made that the workup was a key element to elucidate the diagnosis. We found a discrete increase in transaminases, gamma glutamyl transferase and alkaline phosphatase. Magnetic resonance imaging showed cerebellar atrophy (vermian and, in a lesser extent, in both hemispheres). Once the patient was confronted with these results, he agreed to disclose his problem, which fulfilled alcohol dependence criteria. After that, he accepted to initiate treatment and detoxification in a specialized unity.ConclusionsAlthough psychiatric diagnosis is based on the clinical features and the exclusion of associated medical conditions, in this case the workup provided support to our clinical suspicion, favouring recognition of the problem and willingness to treatment by the patient.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Pavez F, Alcántara A, López N, García A, Sánchez M, Roca M, Moral E, Russo J. Posterior vitreous detachment and electroconvulsive therapy: Insights from a case. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.2049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
A case of bilateral posterior vitreous detachment after electroconvulsive therapy (ECT) has been reported previously in the literature. There is not enough evidence about ocular side effects of this treatment. The literature supports a slight increase in intraocular pressure (IOP), although no ocular complications have been reported in normal, glaucomatous or postsurgical eyes. In this case report, we describe a 73-year-old female patient suffering a recurrent depressive disorder, who was admitted to acute psychiatric unit because a treatment-resistant major depressive episode (after an adequate trial of antidepressant drugs and transcranial magnetic stimulation) and clinical suspicion of visual delusions by her reference psychiatrist. The nonpsychiatric history consisted of hypertension, glaucoma and ulcerative colitis in treatment with azathioprine and mesalazine. After a careful examination in the emergency room, we consulted to ophthalmologist because miodesopsias and glaucoma history. The IOP was normal, but a bilateral posterior vitreous detachment (PVD) was identified. Because this entity is not an absolute contraindication for ECT, and there is scarce evidence, we informed the patient and her family. After that, and through informed consent, we decided to undergo ECT. After fourteen sessions, the patient could be discharged because significant clinical benefit and no ocular complications. Outpatient continuation ECT was indicated.ConclusionsECT can be a safe treatment choice in cases of PVD.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Pavez F, López N, Saura E, Roca M, García A, Russo J, Sánchez M, Moral E. Addictive behaviour and bariatric surgery: Case report and literature review. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.1064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Even though the scientific evidence supports the benefits of bariatric surgery, its indications and contraindications must be continually revised in order to avoid psychiatric complications. Substance use is more common in patients subjected to bariatric surgery than in the general population. There are reports of increased incidence of alcohol abuse in patients after bariatric surgery.ObjectiveTo review the available evidence, after treat the case of a 50-year-old man with addiction history whose addictive behaviour worsened after undergoing bariatric surgery, with decreased tolerance to alcohol effect and increase of the intake, as well as changes in the graduation of alcohol used (including antiseptic). As a result, a dangerous revolving door that led him to repeated admissions, including Intensive Care Unit.ResultsThe case is consistent with the literature that suggests that there is an increased risk of later alcohol-related problems after bariatric surgery. This risk is higher several years post surgery, in patients with previous history of problems related to alcohol, young, men, and Roux-en-Y Gastric Bypass procedure.ConclusionsThe indications for bariatric surgery should thoroughly consider the history of addiction, an adequate assessment of the patient's mental status and psychoeducation about the possible psychiatric side effects, in order to develop preventive strategies.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Herrero MB, García A, Buckett W, Tulandi T, Chan P. Quebec public funding facilitates fertility preservation for male cancer patients. ACTA ACUST UNITED AC 2016; 23:20-5. [PMID: 26966400 DOI: 10.3747/co.23.2793] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Sperm cryopreservation remains the only clinically feasible option to preserve male fertility. The quality of counselling provided by the treating physicians and the cost of sperm cryopreservation can both influence a patient's decision about whether to preserve sperm. On 5 August 2010, the Quebec government introduced provincial coverage of assisted reproductive technologies, with sperm cryopreservation included as a covered service. The aim of the present study was to evaluate whether and how such a program affects the behaviour of cancer patients with respect to sperm cryopreservation. METHODS We analyzed the database derived from male patients undergoing sperm cryopreservation from August 2008 to August 2012 at our centre. The retrieved data included patient age, male infertility or oncologic diagnosis, sperm quality parameters, and details about the number of visits for sperm cryopreservation. RESULTS The number of cancer patients who cryopreserved sperm before and after the policy change did not differ significantly, but a marked increase in the number of non-cancer patients was observed. Further analysis revealed that, after implementation of the public funding program, the total number of sperm cryopreservation sessions per patient increased significantly in cancer patients but not in non-cancer patients. CONCLUSIONS It appears that cancer patients who are willing to freeze sperm are keen to return for more sessions of sperm banking when no fees are associated with the service. Those findings suggest that cost reduction is an important factor for improving delivery of fertility preservation services to male cancer patients.
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García A, Quintero Y, Vicencio N, Rodríguez B, Ozturk D, Mosquera E, Corrales TP, Volkmann UG. Influence of TiO2 nanostructures on anti-adhesion and photoinduced bactericidal properties of thin film composite membranes. RSC Adv 2016. [DOI: 10.1039/c6ra17999a] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
This work investigates the influence of TiO2 nanostructures on the anti-adhesion and photoinduced bactericidal properties of thin film composite (TFC) membranes.
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García A, Hardisson A, Jaraiz F, León P, Pastor M, Tur J, Zaragoza M, Motero M, Espada I. Hydration campaigns: five years of experience. NUTR HOSP 2015; 32 Suppl 2:10299. [PMID: 26615269 DOI: 10.3305/nh.2015.32.sup2.10299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
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Pérez-Segura P, Manneh R, Ceballos I, García A, Benavides M, Fuster J, Vaz MA, Cano JM, Berros JP, Covela M, Moreno V, Quintanar T, García Bueno JM, Fernández I, Sepúlveda J. GEINOFOTE: efficacy and safety of fotemustine in patients with high-grade recurrent gliomas and poor performance status. Clin Transl Oncol 2015; 18:805-12. [DOI: 10.1007/s12094-015-1444-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 10/26/2015] [Indexed: 11/30/2022]
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Fernández I, Loinaz C, Hernández O, Abradelo M, Manrique A, Calvo J, Manzano M, García A, Cambra F, Castellano G, Jiménez C. Tenofovir/entecavir monotherapy after hepatitis B immunoglobulin withdrawal is safe and effective in the prevention of hepatitis B in liver transplant recipients. Transpl Infect Dis 2015; 17:695-701. [PMID: 26257166 DOI: 10.1111/tid.12434] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Revised: 05/15/2015] [Accepted: 07/20/2015] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND AIMS Combination of hepatitis B immunoglobulin (HBIG) and a nucleos(t)ide analog (NA) is considered the standard of care for prophylaxis of hepatitis B virus (HBV) recurrence after liver transplantation (LT). However, use of lifelong HBIG has significant limitations. We evaluated the efficacy and safety of entecavir (ETV) or tenofovir disoproxil fumarate (TDF) after withdrawal of HBIG in patients who had been under HBIG-regimen prophylaxis post LT. METHODS Patients at low risk of recurrence were eligible for HBIG discontinuation (fulminant HBV hepatitis, co-infection with hepatitis D virus, and hepatitis B e antigen-negative cirrhotic patients with HBV DNA levels <300 copies/mL). All patients had received HBIG, with or without NA, for at least 12 months after LT. After HBIG discontinuation, they continued with ETV or TDF monotherapy. Patients were followed up with HBV serum markers and evaluation of renal function. RESULTS Between September 2011 and June 2014, 58 liver transplant recipients were converted to TDF (31, 53%) or ETV (27, 47%). Mean follow-up after conversion was 28 ± 5 months (range 13-36 months). Five patients (8.6%) developed detectable hepatitis B surface antigen at 7, 9, 13, 15, and 22 months after HBIG discontinuation. However, in every case seroconversion was transitory, serum HBV DNA was undetectable, with no clinical manifestations of HBV recurrence. No adverse effects were observed or dose reductions required associated with ETV or TDF. CONCLUSIONS Maintenance therapy with newer NAs, after discontinuation of HBIG prophylaxis, was safe and effective, with a low rate of serological recurrence and no evident clinical, biochemical, or virological consequences.
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de la Morena-Barrio M, García A, Martínez-Martínez I, Miñano A, Padilla J, Navarro-Fernández J, Roldán V, Águila S, Iniesta J, Corral J, Vicente V. A new method to quantify β-antithrombin glycoform in plasma reveals increased levels during the acute stroke event. Thromb Res 2015; 136:634-41. [DOI: 10.1016/j.thromres.2015.06.039] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 06/02/2015] [Accepted: 06/30/2015] [Indexed: 10/23/2022]
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Wanden-Berghe C, Cheikh Moussa K, Cases Alarcón C, Santacruz N, Muñoz P, Gonzalez-Valls T, Miralle M, Granell L, García A, Sanz-Valero J. SUN-PP157: A Study of Associated Complications to the Route of Administration of Enteral Nutrition (CAFANE). Clin Nutr 2015. [DOI: 10.1016/s0261-5614(15)30308-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Wanden-Berghe C, Granell L, Cases Alarcón C, Muñoz P, Gonzalez-Valls T, Cheikh Moussa K, Miralle M, García A, Santacruz N, Prieto Rey M, Giménez J, Sanz-Valero J. SUN-PP158: Nutritional Evolution for a Sample of Patients with Home Enteral Nutrition. Clin Nutr 2015. [DOI: 10.1016/s0261-5614(15)30309-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Wanden-Berghe C, Cheikh Moussa K, Cases Alarcón C, Santacruz N, Muñoz P, Gonzalez-Valls T, Miralle M, Granell L, García A, Sanz-Valero J. SUN-PP156: Associated Complications to the Administration Form of the Enteral Nutrition: Cafane. Clin Nutr 2015. [DOI: 10.1016/s0261-5614(15)30307-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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