No abstract

Background Psoriasis is a chronic inflammatory skin disease associated with several important medical comorbidities. There are scant data available on the comorbidities of patients with psoriasis in South America. Aim To examine the comorbidity profile of adult patients with psoriasis in Chile and its association with severity of psoriasis. Methods This was a multicentre, cross‐sectional study involving 16 hospitals and clinics in Chile, which used a 48‐item questionnaire to study clinician‐ and patient‐reported outcomes and comorbidities. Inferential analyses were performed by psoriasis severity, using Fisher exact test, Student t‐test and multivariable logistic regression. Results In total, 598 adult patients with psoriasis were included (51.1% male; mean age 49.2 ± 15.1 years); 48.5% mild and 51.4% moderate to severe; Psoriasis Area and Severity Index 11.6 ± 11.5; body surface area 14.7 ± 18.2%. Plaque psoriasis was the most common phenotype (90.2%), followed by guttate (13.4%). Psoriatic arthritis occurred in 27.3% of patients. Comorbidities were reported in 60.2% of all patients with psoriasis. Frequent concomitant diseases were obesity (25.3%), hypertension (24.3%), Type 2 diabetes mellitus (T2DM) (18.7%), dyslipidaemia (17.4%), metabolic syndrome (16.7%) and depression (14.4%). After adjustment, significant associations were found between moderate to severe psoriasis and obesity, T2DM and nonalcoholic fatty liver disease (NAFLD) compared with mild psoriasis. Conclusions We report a large study of comorbidities, including depression, dyslipidaemia, T2DM and NAFLD, in people with psoriasis in Chile. The prevalence of comorbidities with psoriasis in Chile appears similar to that found in Western countries, and emphasizes the importance of assessing patients with psoriasis for risk factors for and presence of, comorbid disease in a multidisciplinary setting.

Abu Dhabi National Oil Company (ADNOC) offshore and Schlumberger jointly initiated a project to drill the longest 12¼-in section ever drilled in United Arabs Emirates (UAE) as part of the integrated drilling service for an extended-reach project. The plan involved drilling 14,400 ft in an extended-reach drilling (ERD) well in the field. The objective was to reach section TD in one run, drilling from 5,194-ft MD and reaching TD at 19,494 ft MD. In the well in study, Well 29, the trajectory crossed different formations—including limestones, shales, and dolomites—and built inclination from 30° to 78° to achieve an optimal step-out for the following sections to reach the boundaries of the reservoir at 27,000 ft. Different formation challenges throughout the section required a step change in engineering to complete the objective successfully. ADNOC needed a robust steerable system selection with metal-to-metal sealing that would be exposed to severe downhole conditions, a new bit technology design, anti-collision analysis to help reduce additional gyroscopic operations, and optimized drilling parameters with an enhanced drillstring design. The section was planned to drill in 17.7 days. The total section was finished 10 days ahead of planned AFE, setting the record for the longest 12¼-in section ever drilled in ADNOC and UAE of 14,400 ft, which was 58% longer lateral than field average. Through increased cutting efficiency and superior impact resistance, the new bit design with ridged diamond elements drilled the fastest 12¼-in section on the field in 0.91 d/1,000 ft. Good hole conditions facilitated successfully running and cementing the longest 9⅝-in casing, meeting ADNOC well integrity barrier requirements. The 12¼-in section had the fastest IADC-recorded ROP in the field, with an on-bottom ROP of 105 ft/h, which was 110% faster than the field average. The Geomagnetic Reference Service correction was implemented for the first time and was allowed to drill in proximity with a high anti-collision risk well, eliminating a gyro trip in the middle of the run. Downhole drilling parameters analysis from the drilling mechanics module was crucial for understanding downhole energy transmission and implementation of efficient drilling strategy and reducing shocks and vibrations. The drillstring was redesigned, replacing the traditional 5-in × 5⅞-in drillpipe and enabling a stiffer BHA, which helped maximize the bit performance.

Un elevado trabajo respiratorio (work of breathing, WOB) asociado a la hiperventilación pulmonar durante el ejercicio físico puede limitar el rendimiento deportivo en corredores de maratón. Evaluar los cambios del WOB durante el ejercicio físico máximo, como es la prueba de consumo de oxígeno (VO2-máx), permite conocer la intensidad de ejercicio a la cual el WOB limita la entrega de nutrientes y oxígeno en músculos periféricos implicados en la locomoción. La evaluación no invasiva de la saturación de oxígeno a nivel muscular (SmO2) por medio de la interpretación de ondas cercanas al rango infrarrojo (Near Infrared Spectroscopy, NIRS) es una método novedoso y útil para cuantificar el trabajo muscular, aplicable tanto en musculatura intercostal (SmO2-m.intercostales) para el WOB, como en musculatura locomotora (SmO2-m.vastus laterallis) para la carga periférica. Así, a medida que aumenta la intensidad del esfuerzo físico es esperable una mayor disminución en SmO2; sin embargo, se desconoce como la estrategia ventilatoria usada para alcanzar la hiperventilación pulmonar afecta la SmO2 de estos grupos musculares, cuyo trabajo muscular los afecta recíprocamente a través del reflejo metabólico. Como caso clínico, presentamos los cambios en SmO2-m.intercostales (WOB) y locomotora (SmO2-m.vastus laterallis) durante la prueba de VO2-máx. en dos corredores competitivos demaratón de similares características antropométricas, capacidad física, régimen de entrenamiento e historial deportivo. El objetivo es entregar nueva información que muestre cómo la estrategia ventilatoria adoptada durante el ejercicio puede limitar el trabajo muscular periférico realizado.

Un elevado trabajo respiratorio (work of breathing, WOB) asociado a la hiperventilación pulmonar durante el ejercicio físico puede limitar el rendimiento deportivo en corredores de maratón. Evaluar los cambios del WOB durante el ejercicio físico máximo, como es la prueba de consumo de oxígeno (VO2-máx), permite conocer la intensidad de ejercicio a la cual el WOB limita la entrega de nutrientes y oxígeno en músculos periféricos implicados en la locomoción. La evaluación no invasiva de la saturación de oxígeno a nivel muscular (SmO2) por medio de la interpretación de ondas cercanas al rango infrarrojo (Near Infrared Spectroscopy, NIRS) es una método novedoso y útil para cuantificar el trabajo muscular, aplicable tanto en musculatura intercostal (SmO2-m.intercostales) para el WOB, como en musculatura locomotora (SmO2-m.vastus laterallis) para la carga periférica. Así, a medida que aumenta la intensidad del esfuerzo físico es esperable una mayor disminución en SmO2; sin embargo, se desconoce como la estrategia ventilatoria usada para alcanzar la hiperventilación pulmonar afecta la SmO2 de estos grupos musculares, cuyo trabajo muscular los afecta recíprocamente a través del reflejo metabólico. Como caso clínico, presentamos los cambios en SmO2-m.intercostales (WOB) y locomotora (SmO2-m.vastus laterallis) durante la prueba de VO2-máx. en dos corredores competitivos demaratón de similares características antropométricas, capacidad física, régimen de entrenamiento e historial deportivo. El objetivo es entregar nueva información que muestre cómo la estrategia ventilatoria adoptada durante el ejercicio puede limitar el trabajo muscular periférico realizado.

No abstract

No abstract