Endocarditis infecciosa en un hospital terciario; aumento del número de casos asociados al medio hospitalario

Estudi prospectiu observacional realitzat entre gener 2003-juny 2010 amb casos diagnosticats de EI. Vam estudiar l’epidemiologia i els factors de risc de l'endocarditis infecciosa associada al medi hospitalari (EIAMH). Vam incloure 212 casos, el 34,9% eren EIAMH. Observarem un augment en la incidència en els darrers 4 anys (del 45,9% al 54,1%). La EIAMH s'ha associat a pacients grans i amb més comorbiditat. Staphylococcus aureus (21,7%) va ser el més freqüent. Aquests pacients van ser rebutjats per a la cirurgia amb major freqüència (40% vs 22%) i van presentar una major mortalitat (44,6% vs 19,6%) respecte al grup d'endocarditis comuniataria.

Los col·loquis de la insigne ciutat de Tortosa, de Crisfòfor Despuig

Aquest treball té per finalitat facilitar el coneixement d'una obra cabdal de la literatura catalana; entendre'n el context temporal -el Renaixement i les seues convulsions polítiques, religioses i culturals, l'època del concili de Trento- i espacial -Tortosa, la Corona d'Aragó, l'Imperi espanyol-, per tal de situar-la dins d'unes coordenades espaciotemporals que facilitin la comprensió de l'obra per a estudiants i estudiosos.

Nutrición y anemias en pacientes graves

INTRODUCTION: We made a clinical study, about nutrition in seriously ill patients, which includes a typical heterogeneous group of critical ill patients, with/without anaemia's, that have been admitted to Intensive Care Unit, ICU. It is difficult to individualize and to generalize the relative importance of all the factors that can contribute to these anaemia's in the admission to the Unit, including nutritional deficiencies, inflammatory alterations, the immune response to aggressions, inmunitary modifications and the complex relations existing between these clinic processes. OBJECTIVE: Indirect valuation of the nutritional situation and anaemia's, in a typical heterogeneous group of critical ill patients. METHOD/RESULTS: We studied 202 patients admitted to ICU, of varied and heterogeneous origin, classifying them in 3 groups: control, post surgery and septic group's, becoming the indirect valuation of the nutritional situation on the basis of: Global Subjective Valuation, (VGS) and the nutritional analytical determinations of total lymphocytes, albumin, and transferrin. Also we made hemogram and determinations of sideremia and ferritinemia to all of them. In 57% of the patients, we observed levels haemoglobin < 12.5 g/dl, basically in the post surgery groups, 68 patients and septic group's, 10 patients. And with levels haemoglobin < 10 g/dl, in 25 patient's (12.3%). There were 87 patients, 23 of them in the control group's, 58 in the post surgery and 5 septic group's, with levels haemoglobin > 12.5 g/dl. Regarding the nutritional prognoses indicators, (VGS + nutritional profile), in the control group's, they did not present anaemia nor analytical clinical under nourishment, in the post surgery group's, anaemia and slight under nourishment and in the septic group's, anaemia and moderate under nourishment. There were significant differences between the surgery and septic group and control group's, in values of haemoglobin, iron, total lymphocytes, transferrin and albumin. A statistical correlation between sideremia and albumin was significative. (Spearman's Rho 0,277). CONCLUSIONS: The evaluation of the anaemia and nutritional valuation. and the ferroterapic treatment, as immune-nutrient, can be beneficial for the integrity of the immune system and its defense's abilities against the aggressions in critically ills.

Asma : proceso asistencial integrado

Este Proceso (2012) integra los dos publicados anteriormente de Asma en la edad pediátrica (2003) y Asma en la edad adulta (2004). Fichero en formato pdf, publicado en la página web de la Consejería de Salud y Bienestar Social: www.juntadeandalucia.es/salud (Consejería de Salud y Bienestar Social / Profesionales / Nuestro Compromiso por la Calidad / Procesos Asistenciales Integrados)

Aplicación de la ecografía pediátrica en Atención Primaria; interconexión con la atención hospitalaria

Introduction: The use of ultrasound in pediatric Primary Care improves both the quality and efficiency of care. Material and methods: This study indertook 250 ultrasounds over a 12 moth period from May 2009 to April 2010. Results: Te results found for each anatomical region were 45% abdominal, 25% cranial, 15% of the hip, 10% of parotid and thyroids and 5% of tender areas. From these, the most relevant pathology was Gastroesophageal Reflux, acoounting for 7.2% of all ultrasounds undertaken. Renal pyelectasia accounted for 1.6% cephalhematoma 1.6%, dysplasia of the hip 1.2%, acute parotitis 1.2%, adenopathy 1.2%, cervical angioma 0.4%, and abscessed adenopathy 0.4%. Conclusion: From this analysis, we conclude that ultrasound is a useful tool for the detection of abdominal and cranial pathologies and secondarily, for thyroid, hip and cervical pathologies.

Fracturas inestables de radio distal. Nuestra experiencia en osteosíntesis con placa volar de ángulo variable

OBJECTIVE: assess the functional, subjective and radiological results obtained in patients treated with variable-angle locking plate for unstable distal radius fracture and compare these results with current studies. PATIENTS AND METHOD: From October of 2008 to July of 2011, 20 patients were included who had undergone intervention using the volar approach to the Flexor Carpi Radialis. The average follow up was 18 months. Both clinical and radiological results were analyzed. The Mayo Wrist Score and DASH questioner were used. RESULTS: The average age was 50 years; 50% men and 50% women. The consolidation of the fracture was verified in all cases. An average volar angle was obtained of 5º, radial inclination of 19º, radial height of 10.5 mm, and ulnar variance of -1 mm. The clinical assessment revealed an average dorsal flexion of 75º, palm flexion of 70º, supination of 75º and pronation of 73 º. The results for the DASH questionnaire showed an average of 17.8 and 82.7 for the Mayo Wrist Score. CONCLUSIONS: Our experience has provided some good results, both in functional and subjective as well as radio logical terms, similar to those found in studies with implants from the same generation.

Foto de familia, un estudio descriptivo de los recursos de información científica en las bibliotecas del Sistema Sanitario Público Español

G17+1 está integrado por: Elena Primo (Biblioteca Nacional de Ciencias de la Salud), Verónica Juan (BV Andalucía), Montserrat Salas (BV Aragón), Mercedes Corrales y Raquel Lavandera (BV Asturias), Virgili Paéz (BV Baleares), Beatriz Duque (BV Canarias), Fanny Ribes (BV Cantabria), Marisa Alonso (BV Castilla-La Mancha), Pilar Díaz Ruiz (BV Castilla y León), Pilar Roqué (BV Cataluña), Francisco Javier Moreno (BV Extremadura), Teresa Mejuto (BV Galicia), Mayra García Berges y José Manuel Estrada (BV Madrid), Enrique Aguinaga y Juan Antonio Sánchez Sánchez (BV Murcia), Idoia Gaminde (BV Navarra) y Ricardo Aróstegui y Mª Asunción García Martín (BV País Vasco).

Una Estrategia de desarrollo sostenible para la Eurorregión Pirineos-Mediterráneo: orientaciones básicas

El estudio tiene por objeto formular los requisitos necesarios para poner en marcha una estrategia para el desarrollo sostenible de la Eurorregión Pirineo-Mediterráneo. Este es un proyecto de cooperación transfronteriza regional promovido por el ex presidente de la Generalitat, Honorable Sr. Pasqual Maragall, que, además de Cataluña, incluye Aragón, Islas Baleares, Languedoc-Roussillon y Midi-Pyrénées. En la Unión Europea hay más de 70 eurorregiones, que ha sido creadas por regiones o entidades locales, o ambos

Infraestructuras com servicio en arquitecturas de nubes privadas

El objetivo de este trabajo es proporcionar una arquitectura de nube privada basada en sistemas virtualizados, desarrollando el concepto de IaaS, donde la arquitectura propuesta ofrece un nuevo modelo de servicio orientado especialmente a unainfraestructura que a su vez permita ofrecer el servicio de escritorios y servidores virtualizados al personal de la Fundación i2CAT.

FGF signaling controls caudal hindbrain specification through Ras-ERK1/2 pathway

Background: During early steps of embryonic development the hindbrain undergoes a regionalization process along the anterior-posterior (AP) axis that leads to a metameric organization in a series of rhombomeres (r). Refinement of the AP identities within the hindbrain requires the establishment of local signaling centers, which emit signals that pattern territories in their vicinity. Previous results demonstrated that the transcription factor vHnf1 confers caudal identity to the hindbrain inducing Krox20 in r5 and MafB/Kreisler in r5 and r6, through FGF signaling [1].Results: We show that in the chick hindbrain, Fgf3 is transcriptionally activated as early as 30 min after mvHnf1 electroporation, suggesting that it is a direct target of this transcription factor. We also analyzed the expression profiles of FGF activity readouts, such as MKP3 and Pea3, and showed that both are expressed within the hindbrain at early stages of embryonic development. In addition, MKP3 is induced upon overexpression of mFgf3 or mvHnf1 in the hindbrain, confirming vHnf1 is upstream FGF signaling. Finally, we addressed the question of which of the FGF-responding intracellular pathways were active and involved in the regulation of Krox20 and MafB in the hindbrain. While Ras-ERK1/2 activity is necessary for MKP3, Krox20 and MafB induction, PI3K-Akt is not involved in that process.Conclusion: Based on these observations we propose that vHnf1 acts directly through FGF3, and promotes caudal hindbrain identity by activating MafB and Krox20 via the Ras-ERK1/2 intracellular pathway.

Predicted effect of climate change on the invasibility and distribution of the Western corn root-worm

1 Insect pests, biological invasions and climate change are considered to representmajor threats to biodiversity, ecosystem functioning, agriculture and forestry.Deriving hypothesis of contemporary and/or future potential distributions of insectpests and invasive species is becoming an important tool for predicting the spatialstructure of potential threats.2 The western corn rootworm (WCR) Diabrotica virgifera virgifera LeConte is apest of maize in North America that has invaded Europe in recent years, resultingin economic costs in terms of maize yields in both continents. The present studyaimed to estimate the dynamics of potential areas of invasion by the WCR under aclimate change scenario in the Northern Hemisphere. The areas at risk under thisscenario were assessed by comparing, using complementary approaches, the spatialprojections of current and future areas of climatic favourability of the WCR. Spatialhypothesis were generated with respect to the presence records in the native rangeof the WCR and physiological thresholds from previous empirical studies.3 We used a previously developed protocol specifically designed to estimatethe climatic favourability of the WCR. We selected the most biologicallyrelevant climatic predictors and then used multidimensional envelope (MDE) andMahalanobis distances (MD) approaches to derive potential distributions for currentand future climatic conditions.4 The results obtained showed a northward advancement of the upper physiologicallimit as a result of climate change, which might increase the strength of outbreaksat higher latitudes. In addition, both MDE and MD outputs predict the stability ofclimatic favourability for the WCR in the core of the already invaded area in Europe,which suggests that this zone would continue to experience damage from this pestin Europe.

Geographical and temporal body size variation in a reptile: roles of sex, ecology, phylogeny and ecology structured in phylogeny.

Geographical body size variation has long interested evolutionary biologists, and a range of mechanisms have been proposed to explain the observed patterns. It is considered to be more puzzling in ectotherms than in endotherms, and integrative approaches are necessary for testing non-exclusive alternative mechanisms. Using lacertid lizards as a model, we adopted an integrative approach, testing different hypotheses for both sexes while incorporating temporal, spatial, and phylogenetic autocorrelation at the individual level. We used data on the Spanish Sand Racer species group from a field survey to disentangle different sources of body size variation through environmental and individual genetic data, while accounting for temporal and spatial autocorrelation. A variation partitioning method was applied to separate independent and shared components of ecology and phylogeny, and estimated their significance. Then, we fed-back our models by controlling for relevant independent components. The pattern was consistent with the geographical Bergmann's cline and the experimental temperature-size rule: adults were larger at lower temperatures (and/or higher elevations). This result was confirmed with additional multi-year independent data-set derived from the literature. Variation partitioning showed no sex differences in phylogenetic inertia but showed sex differences in the independent component of ecology; primarily due to growth differences. Interestingly, only after controlling for independent components did primary productivity also emerge as an important predictor explaining size variation in both sexes. This study highlights the importance of integrating individual-based genetic information, relevant ecological parameters, and temporal and spatial autocorrelation in sex-specific models to detect potentially important hidden effects. Our individual-based approach devoted to extract and control for independent components was useful to reveal hidden effects linked with alternative non-exclusive hypothesis, such as those of primary productivity. Also, including measurement date allowed disentangling and controlling for short-term temporal autocorrelation reflecting sex-specific growth plasticity.

Description of the third instar larvae of five species of Cyclocephala (Coleoptera, Melolonthidae, Dynastinae) from Mexico

Description of the third instar larvae of five species of Cyclocephala (Coleoptera, Melolonthidae, Dynastinae) from Mexico. Larvae of four species of Cyclocephala are described for the first time based on specimens collected in Mexican localities: C. barrerai Martínez, 1969 from Puebla, C. sinaloae Howden & Endrödi, 1966 from Sinaloa, C. fasciolata Bates, 1888 from Veracruz, and C. jalapensis Casey, 1915 from Hidalgo. Larva of C. lunulata Burmeister, 1847, is redescribed based on specimens from the Mexican states of Morelos, Puebla, and Veracruz. Diagnostic structures are illustrated and the differences and similarities of each species with other previously described larvae of the genus are commented.

SharingTools : Aplicació Android per a l'intercanvi d'eines

El projecte final de carrera SharingTools tracta sobre la construcció d'una aplicació per a la plataforma Android, la qual permet als usuaris compartir eines amb altres persones. L'aplicació utilitza el posicionament per xarxa i la càmara dels dispositius.