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Aortic valve stenosis provides complementary information to bleeding risk scores in non-valvular atrial fibrillation patients initiating anticoagulation

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Journal of Geriatric Cardiology 2020年第3期17卷 141-148,I0005-I0007页

作者： Gines Elvira-Ruiz Cesar Caro-Martinez Pedro JoseFlores-Blanco Juan JoseCerezo-Manchado Helena Albendin-Iglesias Alejandro Lova-Navarro Francisco Arregui-Montoya Francisca Maria Munoz-Franco Natalia Garcia-Iniesta Arcadio Garcia-Alberola joseluis bailen-lorenzo Domingo Andres Pascual-Figal Sergio Manzano-Fernández Department of Cardiology University Hospital Virgen de la ArrixacaMurciaSpain Instituto Murciano de Investigación en Biomedicina(IMIB) MurciaSpain Department of Cardiology University Hospital Morales MeseguerMurciaSpain Department of Hematology University Hospital Virgen de la ArrixacaMurciaSpain Department of Internal Medicine University Hospital Virgen de la ArrixacaMurciaSpain School of Medicine University of MurciaMurciaSpain Department of Cardiology Hospital Vega BajaAlicanteSpain

Background The identification of modifiable bleeding risk factors may be of *** aim is to evaluate if aortic stenosis(AS)provides additional information to bleeding risk scores for predicting major bleeding(MB)in non-valvular atrial fibrillation(AF).Methods We designed a retrospective multi-center study including 2880 consecutive non-valvular AF patients initiating oral anticoagulation between January 2013 and December *** was defined as moderate or severe according to European echocardiography guidelines ***,ATRIA and ORBIT scores were used to evaluate the bleeding *** was defined according to the International Society on Thrombosis and Haemostasia criteria and registered at 18 months of *** 168(5.8%)patients had *** with AS had higher risk for MB compared to those without AS(HR=2.13,95%CI:1.40-3.23,P<0.001).Patients without AS and low-intermediate bleeding risk(0 points)showed the lowest MB rate,whereas the MB rate observed among patients with AS and high bleeding risk(2 points)was the highest *** and reclassification analyses showed that AS provided additional information to bleeding risk scores for predicting MB at 18 months of *** In this population,AS was associated with an increased risk for MB at midterm *** three scoring systems showed a moderate discriminatory ability for ***,the addition of AS was associated with a significant improvement in their predictive *** suggest that the presence of this valvulopathy should be taken into account for bleeding risk assessment.

关键词： Anticoagulants Aortic stenosis Atrial fibrillation Major bleeding Valvular disease

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Teleophthalmology: a strategy for timely diagnosis of sight-threatening diabetic retinopathy in primary care, Concepción, Chile

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International Journal of Ophthalmology(English edition) 2019年第9期12卷 1474-1478页

作者： Angelica Avendano-Veloso Felipe Parada-Hernandez Raul Gonzalez-Ramos Camila Dougnac-Osses joseluis Carrasco-Saez Peter Henry Scanlon Telemedicine Unit University of ConcepcionConcepcion4070386Chile School of Medicine University of ConcepcionConcepcion4070386Chile University of Oxford University of GloucestershireOxfordOX1 2JDEnglandUK

AIM: To estimate the prevalence of diabetic retinopathy(DR) in a diabetic population of the public health system. METHODS: This non-experimental, descriptive and crosssectional study, with no direct control over the variables analysed, was carried out by the Telemedicine Unit of the University of Concepción(TELMED) and the Family Health Centers(CESFAM) of the Health Service Concepción, Chile, among a population of 7382 diabetic patients of the public health system, from October 2014 to June 2015. Two digital images for each patient’s eyes were obtained and uploaded to the TELMED tele-ophthalmology platform. The images were remotely evaluated by a retina expert ophthalmologist for diagnosis. Treatment and a referral(if required) were recommended, and an individualised report for each patient was sent to the place of ***: The prevalence of DR in this study was 14.9%. Of these, 48.7% had mild non-proliferative DR(NPDR), 30.8% moderate NPDR, 15.9% severe NPDR, and 4.6% proliferative DR. Of the patients with DR, 17.8% were referred for fluorescein angiography, 4.3% for panretinal photocoagulation, 1.2% for vitrectomy, and 0.4% for cataract ***: The use of telemedicine allowed an increased screening coverage for DR in diabetic patients. The different types of DR were detected in a timely manner, decreasing waiting times due to the lack of specialists in ophthalmology in the public health system.

关键词： ophthalmology teleophthalmology diabetes mellitus diabetic retinopathy telemedicine

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Excess Levels of ILysine and Threonine in Low Protein, Wheat-based Diets on Serum Amino Acid Concentrations and Performance of Growing Pigs

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Journal of Agricultural Science and Technology(A) 2012年第5期2卷 619-627页

作者： Adriana Morales joseluis Landero Alfonso Araiza Hugo Bernal Willem C. Sauer Antonio Rosas Miguel Cervantes Instituto de Ciencias Agrlcolas Universidad Aut6noma de Baja California Mexicali Baja California 21100 Mexico Facultad de Agronomla Universidad Autonoma de Nuevo Leon Monterrey Mexico IlAF Universidad Michoacana de San Nicolas de Hidalgo Morelia Mich Mexico

Two experiments were conducted to evaluate the growth response and serum concentrations （SC） of amino acids （AA） in pigs fed wheat-based diets with either deficient, adequate or excess Lys and Thr. Previously, the standardized ileal digestibilities of AA in a basal diet were determined with five ileal cannulated pigs in a digestion trial. In experiment 1, 21 pigs （12.5±0.91 kg） were used to evaluate the effect of adding 0%, 0.69%, and 1.38% free L-Lys. The best growth response was obtained with 0.69% added L-Lys, equivalent to 1.05% total in the diet. The SC of Arg, Thr, and Val were lower （P 〈 0.05） in pigs fed the Lys adequate diet, compared to the deficient, but no further change occurred with excess Lys （P 〉 0.10）. Lys SC increased with each increment in the dietary Lys content （P 〈 0.05）. In experiment 2, 20 pigs （14.3 ± 1.57 kg） were used, and the addition of 0%, 0.14%, 0.28%, and 0.42% crystalline Thr, to the 0.69% L-Lys-supplemented basal diet, was evaluated. The best response was obtained with added 0.28% L-Thr, （0.66% total Thr）, but excess Thr reduced feed intake and growth rate. Moderate and excess levels of Yhr increased the SC of Thr, but excess reduced those of Va[ and Lys. These data show that excess Thr, but not Lys, affect the performance of growing pigs. Also, these data indicate that Val may become limiting in low protein diets with excess Lys or Thr.

关键词： Pigs lysine threonine low-wotein wheat.

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墨西哥尤卡坦半岛外星的痕迹和死亡禁地

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环球人文地理 2024年第19期 88-95页

作者：李桓 Michele Tom H marketanovakova joseluis Manuel unai Michael Bogner Дмитрий Eфремычев flickr 摄图网

在中美洲北部，有一座遗世而独立的绿色半岛。其地表之下，隐藏着一个失落的世界……在辽阔的南北美洲之间，有一片美丽而神秘的区域——尤卡坦半岛。作为中美洲地区的主要半岛，尤卡坦半岛夹在墨西哥湾和加勒比海之间，虽然它既不如前...

在中美洲北部，有一座遗世而独立的绿色半岛。其地表之下，隐藏着一个失落的世界……在辽阔的南北美洲之间，有一片美丽而神秘的区域——尤卡坦半岛。作为中美洲地区的主要半岛，尤卡坦半岛夹在墨西哥湾和加勒比海之间，虽然它既不如前者因盛产石油而豪气十足，也不像后者因海盗传说而闻名于世，但却具有独特的气质——雨林与荒漠交相辉映，现代生活与古老文明碰撞融合，谜一样的风情吸引着无数游客到访，使其成为墨西哥的旅游命脉。

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