Proporción de pacientes que presentan hipotermia peri operatoria durante un reemplazo articular de cadera, rodilla u hombro

Introducción: La hipotermia perioperatoria se ha documentado como factor de riesgo para el aumento de la morbimortalidad de los pacientes aumentando morbilidad miocárdica, riesgo de infección, pérdidas sanguíneas y tiempo de hospitalización. La aplicación de anestésicos toma relevancia ya que causa la pérdida de control central de la temperatura. Nuestro objetivo con este estudio fue describir la proporción de casos de hipotermia en la población sometida a un reemplazo articular durante un periodo de cuatro meses. Materiales y métodos: Se realizó un estudio de cohorte prospectivo. La población a estudio fueron los pacientes que fueron sometidos a un reemplazo total de cadera, rodilla u hombro. Se registró la temperatura central en el momento previo a la inducción anestésica, 30, 60 y 90 minutos después, al finalizar el procedimiento y al ingresar a recuperación. Se reportó el porcentaje de pacientes con hipotermia en cada tiempo. Resultados: Se analizaron en total 88 pacientes, el 55,7% fue llevado a cirugía de cadera, 39,7% de rodilla y 4,5% de hombro. El tipo de anestesia más utilizado fue general y la duración promedio de anestesia fue 164 minutos. La medición de la temperatura central se realizó en nasofaringe, esófago o tímpano. La proporción de pacientes que presentaron hipotermia en la inducción fue 21,6%, a 30 minutos 83%, a 60 minutos 73,9%, a 90 minutos 68,2%, al finalizar 59,1% y en recuperación 58%. Se realizó una prueba Chi cuadrado comparando las proporciones entre la inducción y los cinco periodos posteriores, se encontró que la proporción de pacientes con hipotermia en los cinco tiempos posteriores tuvo una diferencia estadísticamente significativa (p=0,00) comparada con la proporción de pacientes con hipotermia durante la inducción. Conclusión: En los pacientes sometidos a un reemplazo articular la hipotermia fue una condición prevalente posterior a la aplicación de los anestésicos sistémicos. Los dispositivos de calentamiento intraoperatorio usados actualmente son insuficientes para evitar la hipotermia, lo que indica concordancia con la literatura en cuanto a las recomendaciones de calentamiento perioperatorio, con énfasis en el precalentamiento, para prevenir la caída significativa de la temperatura y la morbimortalidad asociada.

Presupuestos estructurales de una pedagogía reformista : análisis sociológicos de la pedagogía moderna.

Se pone de manifiesto que la sociedad moderna se describe como un sistema social estructurado sobre la base de una diferenciación funcional. Hipótesis que se comprueba tomando como ejemplo de análisis la educación. Se analiza, como característica que ofrece un sistema social estructurado, la tendencia existente en los más importantes sistemas funcionales a separar dos niveles de dirección del comportamiento, el de la codificación y el de la programación. Se plantea, por un lado, un código binario que hace de la comunicación algo contingente y, por otro, reglas para evaluar si un comportamiento es correcto o útil.

Trabajo Social Escolar desde la perspectiva de alumnas y alumnos en Alemania : un ejemplo de Baden-Würtemberg.

Monográfico con el título: 'Desde la diversidad hacia la desigualdad: ¿destino inexorable de la globalización?'. Resumen basado en el de la publicación

Comprehension of wh-questions in a case of mixed dementia

We investigated processing of wh-questions and declarative sentences with differing syntactic complexity in a case of mixed dementia (FA). FA was impaired in her ability to understand syntactically complex declarative sentences and syntactically complex wh-questions beginning with which but not complex who questions. This profile, novel in dementia, is similar to that reported for people with agrammatic aphasia and discerns a ‘‘fault line’’ of the language system along a syntactic/semantic parameter

Treatment of written verb and written sentence production in an individual with aphasia: A clinical study

Background: Although the efficacy of treatments for spoken verb and sentence production deficits in aphasia has been documented widely, less is known about interventions for written verb and written sentence production deficits. Aims: This study documents a treatment aiming to improve production of (a) written subject-verb sentences (involving intransitive verbs) and (b) written subject-verb-object sentences (involving transitive verbs). Methods & Procedures: The participant, a 63-year-old female aphasic speaker, had a marked language comprehension deficit, apraxia of speech, relatively good spelling abilities, and no hemiplegia. The treatment involved intransitive verbs producing subject-verb active sentences and transitive verbs producing subject-verb-object active non-reversible sentences. The treatment was undertaken in the context of current UK clinical practice. Outcomes & Results: Statistical improvements were noted for the trained sets of verbs and sentences. Other improvements were also noted in LW's ability to retrieve some non-treated verbs and construct written sentences. Treatment did not generalise to sentence comprehension and letter spelling to dictation. Conclusions: Our participant's ability to write verbs and sentences improved as a result of the treatment.

Results from the CERN pilot CLOUD experiment

During a 4-week run in October–November 2006, a pilot experiment was performed at the CERN Proton Synchrotron in preparation for the Cosmics Leaving OUtdoor Droplets (CLOUD) experiment, whose aim is to study the possible influence of cosmic rays on clouds. The purpose of the pilot experiment was firstly to carry out exploratory measurements of the effect of ionising particle radiation on aerosol formation from trace H2SO4 vapour and secondly to provide technical input for the CLOUD design. A total of 44 nucleation bursts were produced and recorded, with formation rates of particles above the 3 nm detection threshold of between 0.1 and 100 cm−3 s−1, and growth rates between 2 and 37 nm h−1. The corresponding H2SO4 concentrations were typically around 106 cm−3 or less. The experimentally-measured formation rates and H2SO4 concentrations are comparable to those found in the atmosphere, supporting the idea that sulphuric acid is involved in the nucleation of atmospheric aerosols. However, sulphuric acid alone is not able to explain the observed rapid growth rates, which suggests the presence of additional trace vapours in the aerosol chamber, whose identity is unknown. By analysing the charged fraction, a few of the aerosol bursts appear to have a contribution from ion-induced nucleation and ion-ion recombination to form neutral clusters. Some indications were also found for the accelerator beam timing and intensity to influence the aerosol particle formation rate at the highest experimental SO2 concentrations of 6 ppb, although none was found at lower concentrations. Overall, the exploratory measurements provide suggestive evidence for ion-induced nucleation or ion-ion recombination as sources of aerosol particles. However in order to quantify the conditions under which ion processes become significant, improvements are needed in controlling the experimental variables and in the reproducibility of the experiments. Finally, concerning technical aspects, the most important lessons for the CLOUD design include the stringent requirement of internal cleanliness of the aerosol chamber, as well as maintenance of extremely stable temperatures (variations below 0.1 _C).

Evaluating the efficiency of sampling methods in assessing soil macrofauna communities in arable systems

The soil fauna is often a neglected group in many large-scale studies of farmland biodiversity due to difficulties in extracting organisms efficiently from the soil. This study assesses the relative efficiency of the simple and cheap sampling method of handsorting against Berlese-Tullgren funnel and Winkler apparatus extraction. Soil cores were taken from grassy arable field margins and wheat fields in Cambridgeshire, UK, and the efficiencies of the three methods in assessing the abundances and species densities of soil macroinver-tebrates were compared. Handsorting in most cases was as efficient at extracting the majority of the soil macrofauna as the Berlese-Tullgren funnel and Winkler bag methods, although it underestimated the species densities of the woodlice and adult beetles. There were no obvious biases among the three methods for the particular vegetation types sampled and no significant differences in the size distributions of the earthworms and beetles. Proportionally fewer damaged earthworms were recorded in larger (25 x 25 cm) soil cores when compared with smaller ones (15 x 15 cm). Handsorting has many benefits, including targeted extraction, minimum disturbance to the habitat and shorter sampling periods and may be the most appropriate method for studies of farmland biodiversity when a high number of soil cores need to be sampled. (C) 2008 Elsevier Masson SAS. All rights reserved.

Tests of syntactic comprehension in aphasia: an investigation of task effects

Background: Consistency of performance across tasks that assess syntactic comprehension in aphasia has clinical and theoretical relevance. In this paper we add to the relatively sparse previous work on how sentence comprehension abilities are influenced by the nature of the assessment task. Aims: Our aims are: (1) to compare linguistic performance across sentence-picture matching, enactment, and truth-value judgement tasks; (2) to investigate the impact of pictorial stimuli on syntactic comprehension. Methods Procedures: We tested a group of 10 aphasic speakers (3 with fluent and 7 with non-fluent aphasia) in three tasks (Experiment 1): (i) sentence-picture matching with four pictures, (ii) sentence-picture matching with two pictures, and (iii) enactment. A further task of truth-value judgement was given to a subgroup of those speakers (n=5, Experiment 2). Similar sentence types across all tasks were used and included canonical (actives, subject clefts) and non-canonical (passives, object clefts) sentences. We undertook two types of analyses: (a) we compared canonical and non-canonical sentences in each task; (b) we compared performance between (i) actives and passives, (ii) subject and object clefts in each task. We examined the results of all participants as a group and as case-series. Outcomes Results: Several task effects emerged. Overall, the two-picture sentence-picture matching and enactment tasks were more discriminating than the four-picture condition. Group performance in the truth-value judgement task was similar to two-picture sentence-picture matching and enactment. At the individual level performance across tasks contrasted to some group results. Conclusions: Our findings revealed task effects across participants. We discuss reasons that could explain the diverse profiles of performance and the implications for clinical practice.

Comprehension of wh-questions and declarative sentences in agrammatic aphasia: the set partition hypothesis

Problematic trace-antecedent relations between deep and surface structure have been a dominant theme in sentence comprehension in agrammatism. We challenge this view and propose that the comprehension in agrammatism in declarative sentences and wh-questions stems from impaired processing in logical form. We present new data from wh-questions and declarative sentences and advance a new hypothesis which we call the set partition hypothesis. We argue that elements that signal set partition operations influence sentence comprehension while trace-antecedent relations remain intact. (C) 2007 Elsevier Ltd. All rights reserved.

Processing of wh-questions in a case of posterior cortical atrophy

Posterior cortical atrophy (PCA) is a type of dementia that is characterized by visuo-spatial and memory deficits, dyslexia and dysgraphia, relatively early onset and preserved insight. Language deficits have been reported in some cases of PCA. Using an off-line grammaticality judgement task, processing of wh-questions is investigated in a case of PCA. Other aspects of auditory language are also reported. It is shown that processing of wh-questions is influenced by syntactic structure, a novel finding in this condition. The results are discussed with reference to accounts of wh-questions in aphasia. An uneven profile of other language abilities is reported with deficits in digit span (forward, backward), story retelling ability, comparative questions but intact abilities in following commands, repetition, concept definition, generative naming and discourse comprehension.