Referencias metodológicas sobre investigaciones factuales de políticas económicas instrumentales

Documento preliminar

Effects of different tidal volumes in pulmonary and extrapulmonary lung injury with or without intraabdominal hypertension

We hypothesized that: (1) intraabdominal hypertension increases pulmonary inflammatory and fibrogenic responses in acute lung injury (ALI); (2) in the presence of intraabdominal hypertension, higher tidal volume reduces lung damage in extrapulmonary ALI, but not in pulmonary ALI. Wistar rats were randomly allocated to receive Escherichia coli lipopolysaccharide intratracheally (pulmonary ALI) or intraperitoneally (extrapulmonary ALI). After 24 h, animals were randomized into subgroups without or with intraabdominal hypertension (15 mmHg) and ventilated with positive end expiratory pressure = 5 cmH(2)O and tidal volume of 6 or 10 ml/kg during 1 h. Lung and chest wall mechanics, arterial blood gases, lung and distal organ histology, and interleukin (IL)-1 beta, IL-6, caspase-3 and type III procollagen (PCIII) mRNA expressions in lung tissue were analyzed. With intraabdominal hypertension, (1) chest-wall static elastance increased, and PCIII, IL-1 beta, IL-6, and caspase-3 expressions were more pronounced than in animals with normal intraabdominal pressure in both ALI groups; (2) in extrapulmonary ALI, higher tidal volume was associated with decreased atelectasis, and lower IL-6 and caspase-3 expressions; (3) in pulmonary ALI, higher tidal volume led to higher IL-6 expression; and (4) in pulmonary ALI, liver, kidney, and villi cell apoptosis was increased, but not affected by tidal volume. Intraabdominal hypertension increased inflammation and fibrogenesis in the lung independent of ALI etiology. In extrapulmonary ALI associated with intraabdominal hypertension, higher tidal volume improved lung morphometry with lower inflammation in lung tissue. Conversely, in pulmonary ALI associated with intraabdominal hypertension, higher tidal volume increased IL-6 expression.

Entrevista al Dr. Javier Santaolalla, ingeniero de telecomunicación y fisico español, participante en las investigaciones del boson Higgs en el CERN.

Entrevista a Javier Santaolalla investigador en el experimento del CERN que describió recientemente una nueva partícula: el bosón de Higgs, que trata de explicar el origen de la masa de las partículas elementales. La existencia del bosón de Higgs y su campo asociado intentan explicar la razón de la existencia de masa en las partículas elementales. El 4 de julio de 2012, el CERN anunció la observación de una nueva partícula «consistente con el bosón de Higgs», pero se necesitaría más tiempo y datos para confirmarlo. El 14 de marzo de 2013 el CERN, con dos veces más datos de los que disponía en el anuncio del descubrimiento en julio de 2012, encontraron que la nueva partícula se ve cada vez más como el bosón de Higgs. Javier Santaolalla es ingeniero de telecomunicación por la Universidad de las Palmas de Gran Canaria y licenciado en ciencias físicas por la Universidad Complutense de Madrid. Investigador del CIEMAT (Madrid) y Dr. por esta última universidad en ciencias físicas. El Dr. Javier Santaolalla se encuentra unos días de escala en Las Palmas de Gran Canaria procedente de Brasil y con destino a Ginebra. Le agradecemos cuantas facilidades nos ha proporcionado en la realización de la presente entrevista así como sus aportaciones.

Nuevas investigaciones en torno a los grabados rupestres del Barranco de Balos (Agüimes, Gran Canaria)

[ES] Thirty six years have happened since A. Beltrán carried the first study out in depth of the archaeological area of the Massif of Balos. A study that adheres strictly to this emplacement, without never one alludes to the cultural context of these representations or to the existence of other sets in the same space. The recent studies have made clear not only that the Lomo de los Letreros is not the only rock existing station in this territory but in the same one there is located a nourished representation of places that award to this place an unusual interest to realize an approach to the meaning of this pre-hispanic engravings.

β-Glucan Antigenemia Anticipates Diagnosis of Blood Culture–Negative Intraabdominal Candidiasis

Rationale: Life-threatening intraabdominal candidiasis (IAC) occurs in 30 to 40% of high-risk surgical intensive care unit (ICU) patients. Although early IAC diagnosis is crucial, blood cultures are negative, and the role of Candida score/colonization indexes is not established. Objectives: The aim of this prospective Fungal Infection Network of Switzerland (FUNGINOS) cohort study was to assess accuracy of 1,3-β-d-glucan (BG) antigenemia for diagnosis of IAC. Methods: Four hundred thirty-four consecutive adults with abdominal surgery or acute pancreatitis and ICU stay 72 hours or longer were screened: 89 (20.5%) at high risk for IAC were studied (68 recurrent gastrointestinal tract perforation, 21 acute necrotizing pancreatitis). Diagnostic accuracy of serum BG (Fungitell), Candida score, and colonization indexes was compared. Measurements and Main Results: Fifty-eight of 89 (65%) patients were colonized by Candida; 29 of 89 (33%) presented IAC (27 of 29 with negative blood cultures). Nine hundred twenty-one sera were analyzed (9/patient): median BG was 253 pg/ml (46–9,557) in IAC versus 99 pg/ml (8–440) in colonization (P < 0.01). Sensitivity and specificity of two consecutive BG measurements greater than or equal to 80 pg/ml were 65 and 78%, respectively. In recurrent gastrointestinal tract perforation it was 75 and 77% versus 90 and 38% (Candida score ≥ 3), 79 and 34% (colonization index ≥ 0.5), and 54 and 63% (corrected colonization index ≥ 0.4), respectively. BG positivity anticipated IAC diagnosis (5 d) and antifungal therapy (6 d). Severe sepsis/septic shock and death occurred in 10 of 11 (91%) and 4 of 11 (36%) patients with BG 400 pg/ml or more versus 5 of 18 (28%, P = 0.002) and 1 of 18 (6%, P = 0.05) with BG measurement less than 400 pg/ml. β-Glucan decreased in IAC responding to therapy and increased in nonresponse. Conclusions: BG antigenemia is superior to Candida score and colonization indexes and anticipates diagnosis of blood culture–negative IAC. This proof-of-concept observation in strictly selected high-risk surgical ICU patients deserves investigation of BG-driven preemptive therapy.