Objetivos: Investigar la posible asociación entre cuatro polimorfismos serotoninérgicos (A-143BG (rs6311) y T102C (rs6313) del gen del receptor 5-HT2A y 5Tin2 VNTR y 5HTILPR del gen 5LC6A4) e ...impulsividad de la tentativa suicida (T5).
Método: 1BO pacientes (Asturias - Norte de España) que habían realizado una tentativa suicida fueron evaluados utilizando la Suicidal Intent Seale (515) y, posteriormente, genotipados utilizando métodos estándar. Las T5 fueron divididas en dos subgrupos: impulsivas (puntuaciones inferiores a 6 puntos) o no impulsivas (6 o más puntos), utilizando la subescala de planificación suicida de la 515.
Resultados: Edad media (5D) de la muestra total = 35,6 (12,5) años; mujeres: 63,3%. La mayoría de los pacientes (95,6%) tenían al menos un diagnóstico psiquiátrico. Los diagnósticos más prevalentes fueron: trastornos afectivos (36,7%), esquizofrenia y otras psicosis (lB,3%), trastornos de ansiedad (12,2%) y trastornos de la personalidad (11,1%). En un 49,4% se constató la existencia de T5 previas. Un 64,4% de las T5 fueron de tipo impulsivo. Los polimorfismos A-143BG y T102C estaban en completo desequilibrio de ligamiento en nuestra población. El genotipo -143BGG y el alelo -143BG fueron más prevalentes entre los pacientes que realizaron T5 impulsivas 34,5% vs 14,1%, X' (2) = 11,5, P corregida = 0,012; 0,59 vs 0,41; X' (1) = 11,2, P corregida = 0,004, OR = 2,11 (1,36-3,27), respectivamente. No se encontraron diferencias en las distribuciones genotípicas o alélicas de los polimorfismos del gen 5LC6A4. Conclusiones: Variaciones polimórficas del gen 5-HT2A podrían predisponer hacia la realización de T5 de tipo impulsivo. Emergencias 200B;20:93-100
BackgroundPenetrating chest trauma that is associated with pulmonary injuries can trigger different sequelae, the most frequent being the presence of contusions or pulmonary lacerations that are ...accompanied by hemopneumothorax. Materials and methodsDescription of a clinical case of interest and review of the literature on the topic. ResultsIn this study, we present an unusual consequence of this type of trauma, a pulmonary infarction secondary to an extensive pulmonary venous thrombosis stemming from a firearm injury. This finding associated with lung tissue necrosis led to the need for right upper pulmonary bilobectomy. ConclusionsThe aim of this study is to understand this unusual form of presentation of pulmonary trauma, understand the pathophysiology that triggers lung injury, review the medical literature on the subject, and expand the general knowledge on this topic. Study typeTherapeutic/care management.
En gerbera para flor cortada existe una gran gama de colores, los cuales sólo están definidos a nivel de observador en la información comercial ; además, se ha observado que existe variación en la ...intensidad del color en las flores a lo largo del año más o menos evidente, dependiendo de la tonalidad de los cultivares. A este respecto, se han tomado catorce cultivares comerciales, y se ha determinado numéricamente su color para dos estaciones diferentes, invierno y verano, realizándose las mediciones en un espacio de color CIELAB, con un colorímetro MINOLTA CR-300. Los datos se registraron en las coordenadas L*, a*, b*, tras la calibración del aparato en las condiciones del iluminante C. Se han apreciado diferencias numéricas entre los distintos colores, coincidiendo en ciertos casos con el dictamen del observador, pudiendo ser adecuado el sistema de medida, aunque haya que mejorar la metodología para concretar colores que no sean simples y que estén poco definidos.
Smartphones together with the respective applications (apps) and services have become an integral part of our daily life. The feature set of smartphones, such as sensors, cameras, processing speed, ...memory, etc. is constantly increasing and apps exploit these features to offer even more intelligent services for the customers. However, there is only less inter-working between the network and mobile devices as well as the apps. They are considering the wireless access as a bit-pipe without taking into account the characteristics of each wireless technology. This leads to an inefficient use of wireless resources. In this paper we present the concept and the implementation of a context-and policy based interface and traffic management approach which aims to tackle this problem. This approach exploits the feature set of the smartphone as well as the context information available on the smartphone to improve the overall resource usage. Intelligent interface and traffic management mechanisms are envisioned on the device in order to improve the network efficiency as well as the battery runtime on smartphones without affecting the delivered application service quality at the same time.
AIM: To investigate the impact of dual antiplatelet therapy (DAT) in patients on antivitamin K (AVK) regimen requiring percutaneous coronary intervention (PCI).METHODS: Between February 2006 and ...February 2008, 138 consecutive patients under chronic AVK treatment were enrolled in this registry. Of them, 122 received bare metal stent implantation and 16 received drug elutingstent implantation. The duration of DAT, on top of AVK treatment, was decided at the discretion of the clinician. Adequate duration of DAT was def ined according to type of stent implanted and to its clinical indication. RESULTS: The baseline clinical characteristics of patients reflect their high risk, with high incidence of comorbid conditions (Charlson score ≥ 3 in 89% of the patients). At a mean follow-up of 17 ± 11 mo, 22.9% of patients developed a major adverse cardiac event (MACE): 12.6% died from cardiovascular disease and almost 6% had an acute myocardial infarction. Major hemorrhagic events were observed in 7.4%. Adequate DAT was obtained in only 44% of patients. In the multivariate analysis, no adequate DAT and Charlson score were the only independent predictors of MACE (both P = 0.02). CONCLUSION: Patients on chronic AVK therapy represent a high risk population and suffer from a high MACE rate after PCI. An adequate DAT regimen and absence of comorbid conditions are strongly associated with better clinical outcomes.
AIM: To study a cohort of consecutive patients under-going transcatheter aortic valve implantation (TAVI) and compare the outcomes of atrial fibrillation (AF) patients vs patients in sinus rhythm ...(SR). METHODS: All consecutive patients undergoing TAVI in our hospital were included. The AF group comprised patients in AF at the time of TAVI or with history of AF, and were compared with the SR group. Procedural, echocardiographic and follow-up variables were compared. Likewise, the CHA 2 DS 2-VASC stroke risk score and HAS-BLED bleeding risk score and antithrombotic treatment at discharge in AF patients were compared with that in SR patients. RESULTS: From a total of 34 patients undergoing TAVI, 17 (50%) were allocated to the AF group, of whom 15 (88%) were under chronic oral anticoagulation. Patients in the AF group were similar to those in the SR group except for a trend (P = 0.07) for a higher logistic EuroSCORE (28% vs 19%), and a higher prevalence of hypertension (82% vs 53%) and chronic renal failure (17% vs 0%). Risk of both stroke and bleeding was high in the AF group (mean CHA 2 DS 2-VASC 4.3, mean HAS-BLED 2.9). In the AF group, treatment at discharge included chronic oral anticoagulation in all except one case, and in association with an antiplatelet drug in 57% of patients. During a mean follow-up of 11 mo (maximum 32), there were only two strokes, none of them during the peri-procedural period: one in the AF group at 30 mo and one in the SR group at 3 mo. There were no statistical differences in procedural success, and clinical outcome (survival at 1 year 81% vs 74% in AF and SR groups, respectively, P = NS). CONCLUSION: Patients in AF undergoing TAVI show a trend to a higher surgical risk. However, in our cohort, patients in AF did not have a higher stroke rate compared to the SR group, and the prognosis was similar in both groups.
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