Drenaje torácico cerrado. Procedimiento y cuidados de enfermería a propósito de un caso

La acumulación en el espacio pleural de aire y/o sangre, pus o partículas grasas, o la acumulación de líquido por tumores que infiltran la pleura, impide la libre expansión pulmonar, pudiendo llegarse al colapso de este pulmón con un intercambio gaseoso limitado o nulo. Por esto, sea cual sea la causa (traumatismos, enfermedades, cirugías), hemos de extraer estas sustancias de la cavidad pleural. Podemos hacerlo a través de una toracocentesis evacuadora, pero en muchos casos la cantidad y las características de las sustancias o el estado del paciente recomiendan instaurar un drenaje torácico permanente y conectarlo a un dispositivo cerrado de recogida. Esto se consigue introduciendo un tubo o trocar a través de la pared torácica hasta el espacio pleural, vaciando las sustancias alojadas de forma patológica. Este tubo, o trocar, se conecta a un aspirador con la finalidad de mantener la presión negativa fisiológica de la cavidad pleural y facilitar de esta manera la completa expansión de los pulmones. Hay trocares de diversas dimensiones y diferentes modelos de dispositivo de recogida, pero todos se basan, a partir de 1876, en el sistema que utilizó Gotthard Bülau para el tratamiento de los empiemas. Tanto para la preparación del paciente como del material, para la instauración y los cuidados, desde el primer momento hasta la retirada, pasando por las muchas valoraciones, comprobaciones y atenciones para evitar los riesgos y las complicaciones inherentes a este drenaje, es imprescindible que los profesionales de enfermería conozcan el procedimiento y las muchas particularidades que hay que observar con él, dada la especificidad de la cavidad en la que está inserto. Asimismo, es fundamental el conocimiento del dispositivo de recogida cerrado más utilizado (Pleur-evac®) desde la preparación, pasando por el funcionamiento y hasta los controles necesarios para una utilización correcta. Este artículo pretende unificar criterios de actuación en los cuidados que requieren los pacientes portadores de drenaje torácico.

Drenaje torácico cerrado. Sistema de recogida no reutilizable: Pleur-evac®

Funcionamiento del sistema desechable de recogida Pleur-evac®. Se trata de un sistema compacto de recogida de drenaje con sello de agua de manejo fácil construido sobre la base del sistema convencional de montaje de drenaje de aspiración de tres botellas. Este sistema se basa en el utilizado en 1876 por Gotthard Bülau para el tratamiento de empiemas y que ha dado nombre a los sistemas de recogida...

The Role of Canyons in Strata Formation

This paper provides a spatial and temporal multi-scale approach of European submarine canyons. We fi rst present the long-term geologic view of European margins as related to controls on submarine canyon development. Then we discuss the extent to which submarine canyon systems resemble river systems because both essentially form drainage networks. Finally, we deal with the hortest-term, highestresolution scale to get a fl avor of the current functioning and health of modern submarine canyons in the northwestern Mediterranean Sea. Submarine canyons are unique features of the seafl oor whose existence was known by European fi shermen centuries ago, especially for those canyons that have their heads at short distance from shoreline. Popular names given to specifi c canyons in the different languages spoken in European coastal communities refer to the concepts of a"deep" or"trench." In the old times it was also common thinking that submarine canyons where so deep that nobody could measure their depth or even that they had no bottom. Submarine canyons are just one of the seven different types of seafl oor valleys identifi ed by Shepard (1973) in his pioneering morphogenetic classifi cation. Shepard (1973) defined submarine canyons as"steep-walled, sinuous valleys, with V-shaped cross sections, and relief comparable even to the largest of land canyons; tributaries are found in most of the canyons and rock outcrops abound on their walls." Canyons are features typical of continental slopes with their upper reaches and heads cut into the continental shelf.

Evidence for coseismic events of recurrent prehistoric deformation along the Alhama de Murcia fault, southeastern Spain

The Alhama de Murcia fault is a 85 km long oblique-slip fault, and is related to historical and instrumental seismic activity. A paleoseismic analysis of the Lorca-Totana sector of the fault containing MSK I=VIII historical earthquakes was made in order to identify and quantify its seismic potential. We present 1) the results of the neotectonic, structural and geomorphological analyses and, 2) the results of trenching. In the study area, the Alhama de Murcia fault forms a depressed corridor between two strands, the northwestern fault with morphological and structural features of a reverse component of slip, bounding the La Tercia range to the South, and the southeastern fault strand with evidence of sinistral oblique strike-slip movement. The offset along this latter fault trapped the sediments in transit from the La Tercia range towards the Guadalentín depression. The most recent of these sediments are arranged in three generations of alluvial fans and terraces. The first two trenches were dug in the most recent sediments across the southeastern fault strand. The results indicate a coseismic reverse fault deformation that involved the sedimentary sequence up to the intermediate alluvial fan and the Holocene terrace deposits. The sedimentary evolution observed in the trenches suggests an event of temporary damming of the Colmenar creek drainage to the South due to uplifting of the hanging wall during coseismic activation of the fault. Trench, structural and sedimentological features provide evidence of at least three coseismic events, which occurred after 125,000 yr. The minimum vertical slip rate along the fault is 0.06 mm/yr and the average recurrence period should not exceed 40,000 yr in accordance with the results obtained by fan topographic profiling. Further absolute dating is ongoing to constrain these estimates.

An analysis of the evolution of hydrometeorological extremes in newspapers: the case of Catalonia, 1982-2006

This contribution analyzes the evolution of perception of certain natural hazards over the past 25 years in a Mediterranean region. Articles from newspapers have been used as indicator. To this end a specific Spanish journal has been considered and an ACCESS database has been created with the summarized information from each news item. The database includes data such as the location of each specific article in the newspaper, its length, the number of pictures and figures, the headlines and a summary of the published information, including all the instrumental data. The study focused on hydrometeorological extremes, mainly floods and droughts, in the northeast of the Iberian Peninsula. The number of headlines per event, trends and other data have been analyzed and compared with "measured" information, in order to identify any bias that could lead to an erroneous perception of the phenomenon. The SPI index (a drought index based on standardized accumulated precipitation) has been calculated for the entire region, and has been used for the drought analysis, while a geodatabase implemented on a GIS built for all the floods recorded in Catalonia since 1900 (INUNGAMA) has been used to analyze flood evolution. Results from a questionnaire about the impact of natural hazards in two specific places have been also used to discuss the various perceptions between rural and urban settings. Results show a better correlation between the news about drought or water scarcity and SPI than between news on floods in Catalonia and the INUNGAMA database. A positive trend has been found for non-catastrophic floods, which is explained by decrease of the perception thresholds, the increase of population density in the most flood-prone areas and changes in land use.

Flash flood evolution in North-Western Mediterranean

The present paper shows an in-depth analysis of the evolution of floods and precipitation in Catalonia for the period 1981-2010. In order to have homogeneous information, and having in mind that not gauge data was available for all the events, neither for all the rivers and stream flows, daily press from a specific newspaper has been systematically analysed for this period. Furthermore a comparison with a longer period starting in 1900 has been done. 219 flood events (mainly flash flood events) have been identified for the period of 30 years (375 starting in 1900), 79 of them were ordinary, 117 of them were extraordinary and 23 of them were catastrophic, being autumn and summer the seasons with the maxima values. 19% of the events caused a total of 110 casualties. 60% of them died when they tried to cross the street or the stream. Factors like the evolution of precipitation, population density and other socio-economical aspects have been considered. The trend analysis shows an increase of 1 flood/decade that probably has been mainly due to inter-annual and intra-annual changes in population density and in land-use and land-cover.

Genetic diversity and species richness patterns in Baetidae (Ephemeroptera) in the Montseny Mountain range (North-East Iberian Peninsula)

This study aimed to describe patterns of diversity of Baetidae (Ephemeroptera) at the ommunity and population levels within the Montseny Mountain range (North-East Iberian Peninsula). We studied both the distribution of 4 species of baetids in 20 sites among three catchments along the altitudinal gradient (350-1700 masl); and the genetic diversity of the mtDNA cytochrome c oxidase subunit I (cox1) gene of the two common species Baetis alpinus and Baetis rhodani. We found a gradual replacement of the dominant species along the altitudinal gradient. Baetis alpinus inhabited sites at high-altitudes, and this species was replaced by B. rhodani when the altitude decreased. Baetis melanonyx and Alainites muticus attained low abundance at all river sections, and no clear altitudinal trend appeared. Our hypothesis at the population level was that genetic structuring is associated with geographic distance and limited by drainage boundaries among the three studied catchments because of the short-time dispersion of adults. Unexpectedly, analyses of molecular variance (AMOVA) and isolation-bydistance (IBD) showed genetic diversity was unstructured by distance for both species, which may be explained by the relatively short spatial scale studied and small topographic barriers among the three catchments. The Generalized Mixed Yule-Coalescent (GMYC) model showed that B. rhodani had two differentiated genetic lineages that co-occurred in all sites. Overall, diversity of baetids was structured at the community level along the altitudinal gradient, whereas it was unstructured at the population level within the Montseny Mountain range.

Genetic diversity and species richness patterns in Baetidae (Ephemeroptera) in the Montseny Mountain range (North-East Iberian Peninsula)

This study aimed to describe patterns of diversity of Baetidae (Ephemeroptera) at the ommunity and population levels within the Montseny Mountain range (North-East Iberian Peninsula). We studied both the distribution of 4 species of baetids in 20 sites among three catchments along the altitudinal gradient (350-1700 masl); and the genetic diversity of the mtDNA cytochrome c oxidase subunit I (cox1) gene of the two common species Baetis alpinus and Baetis rhodani. We found a gradual replacement of the dominant species along the altitudinal gradient. Baetis alpinus inhabited sites at high-altitudes, and this species was replaced by B. rhodani when the altitude decreased. Baetis melanonyx and Alainites muticus attained low abundance at all river sections, and no clear altitudinal trend appeared. Our hypothesis at the population level was that genetic structuring is associated with geographic distance and limited by drainage boundaries among the three studied catchments because of the short-time dispersion of adults. Unexpectedly, analyses of molecular variance (AMOVA) and isolation-bydistance (IBD) showed genetic diversity was unstructured by distance for both species, which may be explained by the relatively short spatial scale studied and small topographic barriers among the three catchments. The Generalized Mixed Yule-Coalescent (GMYC) model showed that B. rhodani had two differentiated genetic lineages that co-occurred in all sites. Overall, diversity of baetids was structured at the community level along the altitudinal gradient, whereas it was unstructured at the population level within the Montseny Mountain range.

Imposicions estructurals en el drenatge de la conca del riu Onyar (Girona)

The Onyar River basin is situated in the depression of la Selva. His origins are related to tectonic activity during Neogen in this region. In his evolution, we note a slowly and continuous downfall which directs the morphodinamical behaviour. In this sense, the drainage network has a directional trend towards the north, as consecuence of fault systems, and specially the N-S oriented one. A fault of this system has an important influence in the basin morphology, directs the drainage towards the north and avoids a closely drainage in the basin

Hydrology, light and the use of organic and inorganic materials as structuring factors of biological communities in Mediterranean streams

Hydrological disturbances, light availability and nutrients are the most relevant factors determining the structure of the biological communities in Mediterranean rivers. While some hydrological disturbances are able to induce catastrophic effects, which may cause a complete reset in physical and biological conditions, continued enrichment or changes in light availability are factors leading to the progressive shift in the communities of autotrophs and heterotrophs in the systems. Primary production in Mediterranean streams shows relevant seasonal changes which mainly follows the variations in light availability. In most forested streams, the algal community is shade-adapted. Nutrient enrichment (especially phosphorus) leads to marked increases in primary production, but this increase is not lineal and there is a saturation of algal biomass even in the most enriched systems. The heterotrophs (bacteria, fungi) are related to the pattern of DOC availability (which most depends on the seasonal discharge and leaf fall dynamics) and to the available substrata in the stream. It has been repeatedly observed that shorttime increases of extracellular enzyme activities are related to the accumulation of autochthonous (algal) and/or allochthonous (leaves) organic matter on the streambed during spring and summer, this being more remarkable in dry than in wetter years. Flow reduction favours detritus concentration in pools, and the subsequent increase in the density and biomass of the macroinvertebrate community. In Mediterranean streams collectors are accounting for the highest density and biomass, this being more remarkable in the least permanent systems, in accordance with the effect of floods on the organic matter availability. Nutrients, through the effect on the primary producers, also affect the trophic food web in the streams by favouring the predominance of grazers

Proyecto de ejecución para las obras de concesión de dominio público para la reforma y adecuación de la central térmica y de la red de saneamiento en un hospital de 350 camas

El Hospital Punta de Europa en Algeciras (Cádiz), centro sanitario del Servicio Andaluz de Salud, desea optimizar la gestión de sus instalaciones de generación de energía térmica (vapor, agua caliente sanitaria y agua caliente de calefacción) y adecuarlas a la normativa vigente así como la sustitución de bajantes del edificio, para lo cual sacará a concurso público la licitación para la concesión de dominio público de dichas instalaciones. Para definir el alcance y condiciones de la citada concesión, el Hospital Punta de Europa (Algeciras) del Servicio Andaluz de Salud ha solicitado a Pedro Alonso Martín el estudio para la reforma y adecuación de las instalaciones productoras de energía térmica del citado Hospital. El objetivo principal de este trabajo es hacer un estudio, propuesta y valoración de las actuaciones necesarias para la reforma y mejora de la explotación de las instalaciones generadoras de energía térmica y de la red saneamiento interior del Hospital Punta de Europa de Algeciras (Cádiz). Las actuales instalaciones de generación térmica consumidoras de energía del hospital dentro del alcance de este Proyecto son: Generación de vapor (lavandería y esterilización). Producción de agua caliente sanitaria (ACS). Producción de agua caliente de calefacción. La mayoría de los equipos productores de energía datan del año 1975, por lo que en la mayoría de los casos se ha cumplido su plazo de amortización y periodo de vida útil. Se hace necesaria la instalación de gas natural, debido a que se tendrá que abastecer a todas las calderas de la central térmica. El diseño del sistema de producción de agua caliente sanitaria garantiza el máximo confort y economía del usuario, compatible con el máximo ahorro energético y la protección del medio ambiente, cubriendo las necesidades de agua caliente sanitaria mediante la combinación de un sistema de calderas a gas con los colectores solares.