Eficacia de la estimulación magnética transcraneal en la disminución de severidad en el trastorno depresivo mayor en monoterapia y coadyuvante comparado con tratamientos farmacológicos. Revisión sistemática y meta-análisis

Resumen Introducción Una posible opción de tratamiento para el manejo del trastorno depresivo mayor (TDM) es la estimulación magnética transcraneal (EMT) que ha mostrado propiedades antidepresivas superiores al placebo con un buen perfil de seguridad. El objetivo del presente trabajo es determinar la reducción en la severidad del TDM y la proporción de eventos adversos (EA) en pacientes con TDM refractario y no refractario, posterior al uso de EMT administrada en monoterapia o tratamiento coadyuvante comparado con terapia farmacológica. Metodología Se planteó una pregunta PICOT de la cual se realizó una búsqueda sistemática de estudios clínicos en las bases de datos Medline, EMBASE y Cochrane. Dos investigadores en forma independiente realizaron la selección de artículos, evaluación de calidad con la herramienta de la colaboración Cochrane y extracción de datos. Se extrajeron datos de eficacia como tasa de respuesta, porcentaje de remisión, calidad de vida, diminución sintomática del trastorno depresivo mayor en la escala de Hamilton y capacidad funcional. Igualmente, proporción de pacientes con EA. Se realizó un meta-análisis de estas variables teniendo en cuenta la heterogeneidad. Resultados La presente revisión sistemática incluyó 26 estudios clínicos aleatorizados de baja calidad metodológica mostrando que la EMT presentó una eficacia superior cuando es usada como coadyuvante a las terapias con que venían siendo tratados los pacientes con TDM refractario y no refractario en los desenlaces de tasa de respuesta y porcentaje de remisión. En el caso de intervenciones farmacológicas específicas, la EMT presento eficacia similar, tanto en terapia coadyuvante como en monoterapia comparado con las intervenciones farmacológicas. En cuanto a seguridad, la EMT presenta un buen perfil de seguridad debido a que en todos los escenarios estudiados los EA fueron no serios y baja frecuencia Conclusiones La evidencia disponible sugiere que la EMT mostró ser efectivo y seguro para el manejo del TDM refractario y no refractario. Sin embargo, la evidencia es débil por lo tanto se necesita mayor investigación clínica que soporte su uso.

Curso de pedagogia da Faculdade de Educação da Universidade de Salamanca/Espanha (2010): uma chave para reflexões

This was part of the post-doctorate study developed at the Faculty of Eucation in the University of Salamanca - Spain in 2010 with the Professor José Maria Hernández Díaz, who teaches the subject “History of Education” at the Pedagogy course provided by the institution. The objective of this reflection is to present some characteristics of that course, in order to highlight some of its peculiarities, and also indicate some similar issues when compared to Brazilian courses, thus producing a research useful for comparison and deepening of teacher’s training. The method was based on quali-quantitative nature (WOODS, 1996; BESSON, 1995): participant observation (EZPELETA; ROCKWELL, 1986; KETELE; ROEGIERS, 1993) and a questionnaire application (HEGENBERG, 1976; BOOTH; COLOMB; WILLIAMS, 1995) to the first and third classes in 2010, which resulted in a total of 99 students: 17 male and 82 female. This comparative information evinces the feminisation in that course, establishing direct relationship with Brazilian research. Another data, which has not yet been duly checked in Brazil, concerns the intellectual/social role of women in the classroom. Although this data is especific from that school environment, it is an important key-point for teachers’ training and teaching. The potentiality of this reflexition is exactly on this point.

In-situ, satellite measurement and model evidence on the dominant regional contribution to fine particulate matter levels in the Paris Megacity

A detailed characterization of air quality in the megacity of Paris (France) during two 1-month intensive campaigns and from additional 1-year observations revealed that about 70% of the urban background fine particulate matter (PM) is transported on average into the megacity from upwind regions. This dominant influence of regional sources was confirmed by in situ measurements during short intensive and longer-term campaigns, aerosol optical depth (AOD) measurements from ENVISAT, and modeling results from PMCAMx and CHIMERE chemistry transport models. While advection of sulfate is well documented for other megacities, there was surprisingly high contribution from long-range transport for both nitrate and organic aerosol. The origin of organic PM was investigated by comprehensive analysis of aerosol mass spectrometer (AMS), radiocarbon and tracer measurements during two intensive campaigns. Primary fossil fuel combustion emissions constituted less than 20%in winter and 40%in summer of carbonaceous fine PM, unexpectedly small for a megacity. Cooking activities and, during winter, residential wood burning are the major primary organic PM sources. This analysis suggests that the major part of secondary organic aerosol is of modern origin, i.e., from biogenic precursors and from wood burning. Black carbon concentrations are on the lower end of values encountered in megacities worldwide, but still represent an issue for air quality. These comparatively low air pollution levels are due to a combination of low emissions per inhabitant, flat terrain, and a meteorology that is in general not conducive to local pollution build-up. This revised picture of a megacity only being partially responsible for its own average and peak PM levels has important implications for air pollution regulation policies.

South America, 1825 (Image 1 of 2) (Raster Image)

This layer is a georeferenced raster image of the historic paper map entitled: General-Charte von Süd-America = Carte générale de L'Amerique Méridionale : en deux grandes feuilles. d'après les observations et les cartes spéciales, rapportées du Voyage dans l'intérieur du Brèsil, pendant les années 1817-1820..., par les Docteurs de Spix et de Martius, Chevaliers de L'Ordre civil de la Couronne de Bavière, membres de L'Académie Royale de Munich ; gestochen von Joh. Bapt. Seitz, Kupferstecher im topographischen Bureau des Kön. baier. General-Quartiermeister Stab. It was published by [M. Lindauer] in 1825. Scale [ca. 1:7,000,000]. This layer is image 1 of 2 total images of the two sheet source map, representing the southern portion of the map. Map in German and French. The image inside the map neatline is georeferenced to the surface of the earth and fit to the South America Lambert Conformal Conic projected coordinate system. All map collar and inset information is also available as part of the raster image, including any inset maps, profiles, statistical tables, directories, text, illustrations, index maps, legends, or other information associated with the principal map. This map shows features such as drainage, cities and other human settlements, territorial boundaries, roads, shoreline features, and more. Relief shown by hachures.This layer is part of a selection of digitally scanned and georeferenced historic maps from the Harvard Map Collection. These maps typically portray both natural and manmade features. The selection represents a range of originators, ground condition dates, scales, and map purposes.

South America, 1825 (Image 2 of 2) (Raster Image)

This layer is a georeferenced raster image of the historic paper map entitled: General-Charte von Süd-America = Carte générale de L'Amerique Méridionale : en deux grandes feuilles. d'après les observations et les cartes spéciales, rapportées du Voyage dans l'intérieur du Brèsil, pendant les années 1817-1820..., par les Docteurs de Spix et de Martius, Chevaliers de L'Ordre civil de la Couronne de Bavière, membres de L'Académie Royale de Munich ; gestochen von Joh. Bapt. Seitz, Kupferstecher im topographischen Bureau des Kön. baier. General-Quartiermeister Stab. It was published by [M. Lindauer] in 1825. Scale [ca. 1:7,000,000]. This layer is image 2 of 2 total images of the two sheet source map, representing the northern portion of the map. Map in German and French.The image inside the map neatline is georeferenced to the surface of the earth and fit to the South America Lambert Conformal Conic projected coordinate system. All map collar and inset information is also available as part of the raster image, including any inset maps, profiles, statistical tables, directories, text, illustrations, index maps, legends, or other information associated with the principal map. This map shows features such as drainage, cities and other human settlements, territorial boundaries, roads, shoreline features, and more. Relief shown by hachures.This layer is part of a selection of digitally scanned and georeferenced historic maps from the Harvard Map Collection. These maps typically portray both natural and manmade features. The selection represents a range of originators, ground condition dates, scales, and map purposes.

Bibliografía Colombina. Enumeración de libros y documentos concernientes á Cristobal Colón y sus viajes; obra que publica la Real academia de la historia por encargo de la Junta directiva del cuarto centenario del descubrimiento de América.

For criticism and additions see H. Harrisse, Christophe Colomb et les académiciens espagnols. (in Zentralblatt für bibliothekswesen, 1894, 11: 1-70) : also published separately.

Abrégé de l'Histoire générale des voyages : contenant ce qu'il y a de plus remarquable, de plus utile & de mieux avéré dans les pays ou les voyageurs ont pénétré : les oeurs des habitans, la religion, les usages, arts & sciences, commerce, manufactures : enrichie de cartes géographiques & de figures /

MTSD 0339-10.

Le civilisateur : histoire de l'humanité par les grands hommes /

Contiene: 1re" année. Jeanne d'Arc. Homère. Bernard de Palissy. Christophe Colomb. Cicéron. Gutenberg ; "2e" année. Héloïse. Fénelon. Socrate. Nelson. Rustem. Jacquard. Cromwell ; "3e" année. Cromwell. Guillaume Tell. Bossuet. Milton. Antar. Mad. de Sévigné

Vie des grands hommes ...

At head of title: A. de Lamartine.

Chimie appliquée a l'agriculture : travaux et expériences du dr. A. Voelcker /

"Extrait des annales de la science agronomique français et étrangère".

Monnaies inédites des Francs en Orient.

"Extrait des Mélanges de numismatique, publiés par F. de Saulcy, A. de Barthélemy et E. Hucher."

Les béatitudes d'aprb̀es l'Évangile. [music] /

Caption title: Les bëatitudes (Die Seligkeiten).

La musique.

Mode of access: Internet.

The battle of Trafalgar.

"Reprinted from the United service magazine for September, 1899."