Home-Based Trimodal Prehabilitation in Patients with Peritoneal Carcinomatosis Undergoing Cytoreductive Surgery: Effect on Functional Walking Capacity and Skeletal Muscle Mass.

Background: Patients with peritoneal carcinomatosis often suffer from loss of skeletal muscle mass and require extensive surgery. Multimodal prehabilitation may improve physical status but its benefits for these specific patients remain unknown. This study aimed to evaluate the effect of prehabilitation on functional walking capacity and skeletal muscle mass, as well as its association with postoperative complications.

Treatment of Chronic Heart Failure in Advanced Chronic Kidney Disease: The HAKA Multicenter Retrospective Real-World Study.

Introduction: Chronic heart failure (HF) has high rates of mortality and hospitalization in patients with advanced chronic kidney disease (aCKD). However, randomized clinical trials have systematically excluded aCKD population. We have investigated current HF therapy in patients receiving clinical care in specialized aCKD units.

Survival After Mitral Valve Replacement for Leaflet Escape in a Contemporary On-X Mechanical Valve.

Leaflet escape in contemporary mechanical valves is an extremely rare and potentially lethal condition. We report the case of a 77-year-old man who presented with embolization of a leaflet from an On-X mitral valve (CryoLife, Kennesaw, GA) with Conform-X Sewing Ring prosthesis (CryoLife) after exercise. The patient recovered completely 6 months after surgery, and he is currently asymptomatic.

QoS Management and Flexible Traffic Detection Architecture for 5G Mobile Networks.

The next generation of 5G networks is being developed to provide services with the highest Quality of Service (QoS) attributes, such as ultra-low latency, ultra-reliable communication, high data rates, and high user mobility experience. To this end, several new settings must be implemented in the mobile network architecture such as the incorporation of Network Function Virtualization (NFV) and Software-Defined Networking (SDN), along with the shift of processes to the edge of the network. This work proposes an architecture combining the NFV and SDN concepts to provide the logic for Quality of Service (QoS) traffic detection and the logic for QoS management in next-generation mobile networks.

How to Manage Kidney Transplant Recipients: Deciding Between Glomerular Filtration Rate-Estimating Equations, Creatinine Clearance and Albumin-Creatinine Ratio, or Albumin Excretion.

Objectives: Management of renal transplant recipients involves measuring glomerular filtration rate and albuminuria; however, data are conflicting on the use of estimating equations or creatinine clearance and albumin-creatinine ratio in early morning urine or albumin excretion in 24-hour urine. We aimed to determine the performance of creatinine clearance and 3 estimated creatinine-based formulas and compare the usefulness of albumin-creatinine ratio related to albumin excretion in kidney transplant patients.

Materials And Methods: This cross-sectional study examined 300 consecutive kidney transplant patients.

Management effectiveness evaluation in protected areas of southern Ecuador.

Protected areas are home to biodiversity, habitats and ecosystem as well as a critical component of human well-being and a generator of leisure-related revenues. However, management is sometimes unsatisfactory and requires new ways of evaluation. Management effectiveness of 36 protected areas in southern Ecuador have been assessed.

Disability transitions after 30 months in three community-dwelling diagnostic groups in Spain.

Background: Little is known about changes in disability over time among community-dwelling patients. Accordingly, this study sought to assess medium-term disability transitions.

Patients And Methods: 300 chronic obstructive pulmonary disease (COPD), chronic heart failure and stroke patients living at home in Madrid were selected from general practitioner lists.

Heart failure in primary care: co-morbidity and utilization of health care resources.

Background: In order to ensure proper management of primary care (PC) services, the efficiency of the health professionals tasked with such services must be known. Patients with heart failure (HF) are characterized by advanced age, high co-morbidity and high resource utilization.

Objective: To ascertain PC resource utilization by HF patients and variability in the management of such patients by GPs.

Energy-environmental benefits and economic feasibility of anaerobic codigestion of Iberian pig slaughterhouse and tomato industry wastes in Extremadura (Spain).

Anaerobic digestion of Iberian pig slaughterhouse and tomato industry wastes, as well as codigestion operations from such residues, are reported to achieve 54-80% reduction in Chemical Oxygen Demand and 6-19 N m(3)/m(3) substrate methane production. Furthermore, 0.79-0.

ICF disability measured by WHO-DAS II in three community diagnostic groups in Madrid, Spain.

Objective: The planning, provision and monitoring of medical and support services for patient groups with chronic ailments may require disability assessment and registration. The purpose of this study was to assess disability in three groups of patients with chronic obstructive pulmonary disease (COPD), chronic heart failure (CHF) or stroke.

Methods: Convenience samples of consecutive patients diagnosed with COPD (102), CHF (99), and stroke (99) were taken from 1,053 primary care users in the southern area of the autonomous region of Madrid.

Evaluation of a telemedicine service for the secondary prevention of coronary artery disease.

Purpose: Efficient ways are needed to implement the secondary prevention (SP) of coronary heart disease. Because few studies have investigated Web-based SP programs, our aim was to determine the usefulness of a new Web-based telemonitoring system, connecting patients provided with self-measurement devices and care managers via mobile phone text messages, as a tool for SP.

Methods: A single-blind, randomized controlled, clinical trial of 203 acute coronary syndrome (ACS) survivors, was conducted at a hospital in Madrid, Spain.

[Energy audit: a management tool in health centers].

Objective: The aim of this study was to evaluate the viability of energy audit as a management tool in primary care to improve the energy efficiency and environmental performance of a health center by reducing its operating costs.

Method: We conducted 55 energy audits in health centers from 2005-2010. The health centers were sized between 500 and 3,500 m(2), were located in health areas with 3,500 to 25,000 users, and were built between 1985 and 2007.

[Vitamin D and hypertension].

Low levels of vitamin D, defined as levels of 25-hydroxyvitamin D < 20-30 ng/ml, is a prevalent problem in the general population. Besides the classic relation with musculoskeletal disease, vitamin D has been also related to autoimmune diseases, cancer, metabolic diseases or cardiovascular diseases. High blood pressure, as the main cardiovascular risk factor, also has been related to vitamin D deficiency, constituting two prevalent worldwide health problems.

[Cardiac surgery in the elderly: comparison of medium-term clinical outcomes in octogenarians and the elderly from 75 to 79 years].

Introduction And Objectives: The age of patients undergoing cardiac surgery has increased in recent years. Our aims were to investigate the medium-term clinical outcomes of surgery in octogenarians and to compare them with outcomes in other elderly individuals of a less advanced age.

Methods: We investigated early mortality, the incidence of postoperative complications, medium-term survival and factors associated with these parameters in 589 consecutive elderly patients undergoing surgery: 140 were octogenarians aged 80-87 years (group I) while 449 were aged between 75 and 79 years (group II).

Changes in extracellular glutamate levels in rat orbitofrontal cortex during sleep and wakefulness.

Background: Functional neuroimaging studies have shown that limbic and paralimbic areas display increased activity during REM sleep when compared to wakefulness. This increase in limbic activity is specific to the REM period of sleep. PET scanners do not provide a neurochemical explanation for this increased activity during REM sleep.

Extracellular adenosine in the human brain during sleep and sleep deprivation: an in vivo microdialysis study.

Study Objectives: To examine the pattern of extracellular adenosine in the human brain during sleep deprivation, sleep, and normal wake.

Design: Following recovery from implantation of clinical depth electrodes, epilepsy patients remained awake for 40 continuous hours, followed by a recovery sleep episode.

Setting: Neurology ward at UCLA Medical Center.

Susceptibility for postmenopausal osteoporosis: interaction between genetic, hormonal and lifestyle factors.

Although previous studies have established the importance of genetic, hormonal and lifestyle factors separately, the integral role of these factors on bone mass in postmenopausal women is still controversial. We examined the association of the collagen 1-alpha-1 gene (COLIA1) and vitamin D receptor gene (VDR) polymorphisms, s-IGF-I, s-25OHD and lifestyle factors with bone mineral density (BMD) in postmenopausal women. We determined anthropometric parameters, lifestyle factors, serum levels of IGF-I and 25OHD, the COLIA1 Sp1 (Mscl) and VDR (Bsml, Taql) polymorphisms by PCR and BMD by dual X-ray absorptiometry in 141 ambulatory postmenopausal Spanish women.

[Replacement therapy with protein C for meningococcal sepsis and fulminant purpura in pediatric patients].

Disseminated intravascular coagulation as associated to sepsis contributes to the development of clinical multiple organ failure by extensive thrombosis in microcirculation vessels. This condition commonly manifests itself in severe meningococcal sepsis. On the skin, its clinical manifestation is extensive purpura with necrotic lesions that usually progress to serious distal ischemia and may call for amputation.

Total sleep deprivation decreases immobility in the forced-swim test.

Sleep deprivation can exert antidepressant effects in humans in less than 24 h, making it the fastest acting antidepressant treatment. However, it is rarely used clinically because the effect disappears once the subject goes back to sleep. An understanding of the neurobiological mechanisms underlying the antidepressant effect of sleep deprivation should help to develop new rapidly acting antidepressant strategies.

Total sleep deprivation increases extracellular serotonin in the rat hippocampus.

Sleep deprivation exerts antidepressant effects after only one night of deprivation, demonstrating that a rapid antidepressant response is possible. In this report we tested the hypothesis that total sleep deprivation induces an increase in extracellular serotonin (5-HT) levels in the hippocampus, a structure that has been proposed repeatedly to play a role in the pathophysiology of depression. Sleep deprivation was performed using the disk-over-water method.

Performance of quantitative ultrasound in the discrimination of prevalent osteoporotic fractures in a bone metabolic unit.

There is a growing interest in ultrasound evaluation of bone status as an alternative to the measurement with dual X-ray absorptiometry (DXA), due to its low cost, portability, and nonionizing radiation. The aim of our study was to investigate the relation among DXA, QUS, clinical, anthropometric, and lifestyle factors, and to determine QUS cutoff values in order to discriminate fractures in patients referred to the Bone Metabolic Unit at an Endocrinology Service. We studied 300 patients (281 females and 19 males; age 58 +/- 11 years) referred for evaluation of osteoporosis.