Subtypes of Patients Experiencing Exacerbations of COPD and Associations with Outcomes

Chronic obstructive pulmonary disease (COPD) is a complex and heterogeneous condition characterized by occasional exacerbations. Identifying clinical subtypes among patients experiencing COPD exacerbations (ECOPD) could help better understand the pathophysiologic mechanisms involved in exacerbations, establish different strategies of treatment, and improve the process of care and patient prognosis. The objective of this study was to identify subtypes of ECOPD patients attending emergency departments using clinical variables and to validate the results using several outcomes. We evaluated data collected as part of the IRYSS-COPD prospective cohort study conducted in 16 hospitals in Spain. Variables collected from ECOPD patients attending one of the emergency departments included arterial blood gases, presence of comorbidities, previous COPD treatment, baseline severity of COPD, and previous hospitalizations for ECOPD. Patient subtypes were identified by combining results from multiple correspondence analysis and cluster analysis. Results were validated using key outcomes of ECOPD evolution. Four ECOPD subtypes were identified based on the severity of the current exacerbation and general health status (largely a function of comorbidities): subtype A (n = 934), neither high comorbidity nor severe exacerbation; subtype B (n = 682), moderate comorbidities; subtype C (n = 562), severe comorbidities related to mortality; and subtype D (n = 309), very severe process of exacerbation, significantly related to mortality and admission to an intensive care unit. Subtype D experienced the highest rate of mortality, admission to an intensive care unit and need for noninvasive mechanical ventilation, followed by subtype C. Subtypes A and B were primarily related to other serious complications. Hospitalization rate was more than 50% for all the subtypes, although significantly higher for subtypes C and D than for subtypes A and B. These results could help identify characteristics to categorize ECOPD patients for more appropriate care, and help test interventions and treatments in subgroups with poor evolution and outcomes.

Procesos inconclusos: la industria y el conocimiento en la C.A. del País Vasco

573 p.: graf.

Programazioaren oinarriak: C-ko eta Java-ko praktikak

Helburuak: Ikasmaterial honen helburu nagusia ikasleek C-ko eta Java-ko klase teorikoetan lantzen dituzten ezagutzak sendotzea da. Norentzat: Programazioari buruzko lehen ezagutzak sendotu nahi dituen edozein ikasleei zuzenduta, baina bereziki telekomunikazio ikasketak egiten ari diren ikasleei.

Una reflexión acerca del problema del desempleo en la C.A.P.V.

La Comunidad Autónoma Vasca presenta una realidad socio-económica compleja sobre la que inciden multitud de variables políticas,económicas y culturales que han mediatizado nuestro desarrollo en los últimos años. Partiendo de que el principal problema que tiene la economía vasca y también la española es el paro,nos planteamos qué líneas de actuación deberían darse, si no para solucionarlo totalmente, sí al menos para reducirlo de una forma significativa.

Salud y desigualdades sociales en salud en la C. A. del País Vasco en el cambio de siglo : una visión desde las esperanzas de salud

328 p. : graf.

Evidence for classification of c.1852_1853AA > GC in MLH1 as a neutral variant for Lynch syndrome

Background: Lynch syndrome (LS) is an autosomal dominant inherited cancer syndrome characterized by early onset cancers of the colorectum, endometrium and other tumours. A significant proportion of DNA variants in LS patients are unclassified. Reports on the pathogenicity of the c.1852_1853AA>GC (p.Lys618Ala) variant of the MLH1 gene are conflicting. In this study, we provide new evidence indicating that this variant has no significant implications for LS. Methods: The following approach was used to assess the clinical significance of the p.Lys618Ala variant: frequency in a control population, case-control comparison, co-occurrence of the p.Lys618Ala variant with a pathogenic mutation, co-segregation with the disease and microsatellite instability in tumours from carriers of the variant. We genotyped p.Lys618Ala in 1034 individuals (373 sporadic colorectal cancer [CRC] patients, 250 index subjects from families suspected of having LS [revised Bethesda guidelines] and 411 controls). Three well-characterized LS families that fulfilled the Amsterdam II Criteria and consisted of members with the p.Lys618Ala variant were included to assess co-occurrence and co-segregation. A subset of colorectal tumour DNA samples from 17 patients carrying the p.Lys618Ala variant was screened for microsatellite instability using five mononucleotide markers. Results: Twenty-seven individuals were heterozygous for the p.Lys618Ala variant; nine had sporadic CRC (2.41%), seven were suspected of having hereditary CRC (2.8%) and 11 were controls (2.68%). There were no significant associations in the case-control and case-case studies. The p.Lys618Ala variant was co-existent with pathogenic mutations in two unrelated LS families. In one family, the allele distribution of the pathogenic and unclassified variant was in trans, in the other family the pathogenic variant was detected in the MSH6 gene and only the deleterious variant co-segregated with the disease in both families. Only two positive cases of microsatellite instability (2/17, 11.8%) were detected in tumours from p.Lys618Ala carriers, indicating that this variant does not play a role in functional inactivation of MLH1 in CRC patients. Conclusions: The p.Lys618Ala variant should be considered a neutral variant for LS. These findings have implications for the clinical management of CRC probands and their relatives.

Chiral gold(I) vs chiral silver complexes as catalysts for the enantioselective synthesis of the second generation GSK-hepatitis C virus inhibitor

The synthesis of a GSK 2(nd) generation inhibitor of the hepatitis C virus, by enantioselective 1,3-dipolar cycloaddition between a leucine derived iminoester and tert-butyl acrylate, was studied. The comparison between silver(I) and gold(I) catalysts in this reaction was established by working with chiral phosphoramidites or with chiral BINAP. The best reaction conditions were used for the total synthesis of the hepatitis C virus inhibitor by a four step procedure affording this product in 99% ee and in 63% overall yield. The origin of the enantioselectivity of the chiral gold(I) catalyst was justified according to DFT calculations, the stabilizing coulombic interaction between the nitrogen atom of the thiazole moiety and one of the gold atoms being crucial.

A High Degree of LINE-1 Hypomethylation Is a Unique Feature of Early-Onset Colorectal Cancer

12 p.

[Reseña] F. Petrarca, De viris illustribus, I, II, IV (eds. S. Ferrone, C. Malta, P. de Capua), Firenze, Le Lettere, 2006-2007

[ES] Un real decreto de 1904, emitido con motivo de la celebración del VI Centenario del nacimiento de Petrarca (1304-1374), creó la Commissione per l’Edizione Nazionale delle Opere di Francesco Petrarca. Después de un siglo en el que los estudios petrarquescos han experimentado un florecimiento espectacular, con varias revistas y colecciones dedicadas exclusivamente a Petrarca y con una deslumbrante nómina de especialistas, han visto la luz siete de los veinte volúmenes previstos inicialmente.

Ejercicio f??sico para supervivientes del c??ncer tras mastectom??a

El c??ncer es una enfermedad que produce alta mortalidad, y el c??ncer de mama es un c??ncer espec??fico que se da especialmente en las mujeres y que les produce una disminuci??n de la calidad de vida y en caso de que sufran una mastectom??a, una disminuci??n de la movilidad del hombro. Por ello es importante que las mujeres realicen un programa ejercicio aer??bico y fuerza as?? como un programa de ejercicios para recuperar esa movilidad del hombro afectado.Espa??ol.

Development of a new modelling framework to estimate the C footprint from Basque dairy farms

19 p.

Estrategia para bloquear la entrada del virus de la Hepatitis C (HCV) en hepatocitos primarios

En esta memoria se presenta una propuesta para desarrollar un proyecto de investigación que permita establecer la eficacia de una estrategia original para evitar la entrada del virus de la hepatitis C (HCV) en las células hepáticas. Se propone la utilización combinada de dos anticuerpos contra dos factores esenciales para la entrada HCV en las células hepáticas, como son las moléculas CD81 y SR-BI. La eficacia para reducir la capacidad infectiva del HCV de bloquear individualmente cada una de estas moléculas ha sido previamente demostrada, así que en este proyecto proponemos que un uso combinado de moléculas que bloqueen ambos receptores permitiría avanzar en la búsqueda de vacunas que eviten eficazmente la infección del HCV.

Fundamentos de informática. Ejercicios resueltos de programación en C

I. Ejercicios cortos de programación: - Enunciados. - Soluciones propuestas. II. Ejercicios largos: - Componentes electrónicos. - Hábitos de consumo: bebidas. - Emisora de radio. - Gasolinera. - Tienda. - Central eléctrica. - Ladrón Elca Comayor. - Cumbres de montaña. - Autopista. - Sala de juegos. - Farolas. - Pueblos de Guipúzcoa. - Olimpiadas. - Ventas S.A. - Accidentes de circulación. - Euskadi Irratia. - San Sebastián.

Informatikaren oinarriak. C lengoaian ebatzitako problemak

I. Programazioko ariketa laburrak: - Enuntziatuak. - Soluzioen proposamenak. II. Ariketa luzeak: - Gailu elektronikoak. - Kontsumo ohiturak: edariak. - Irratsaioa. - Gasolindegia. - Denda. - Zentral elektrikoa. - Elca Comayor lapurra. - Medi igoerak. - Autopista. - Joko aretoa. - Farolak. - Herrien arteko distantziak. - Olinpiadak. - Ventas S.A. - Heriozko istripuak. - Euskadi Irratia. - San Sebastianak

La frontera, borders an transborders. Reflections of the borderlands in Chicana Literature (early 20th-21st c.)

421 p.