801 resultados para subarachnoid space


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El déficit existente a nuestro país con respecto a la disponibilidad de indicadores cuantitativos con los que llevar a término un análisis coyuntural de la actividad industrial regional ha abierto un debate centrado en el estudio de cuál es la metodología más adecuada para elaborar indicadores de estas características. Dentro de este marco, en este trabajo se presentan las principales conclusiones obtenidas en anteriores estudios (Clar, et. al., 1997a, 1997b y 1998) sobre la idoneidad de extender las metodologías que actualmente se están aplicando a las regiones españolas para elaborar indicadores de la actividad industrial mediante métodos indirectos. Estas conclusiones llevan a plantear una estrategia distinta a las que actualmente se vienen aplicando. En concreto, se propone (siguiendo a Israilevich y Kuttner, 1993) un modelo de variables latentes para estimar el indicador de la producción industrial regional. Este tipo de modelo puede especificarse en términos de un modelo statespace y estimarse mediante el filtro de Kalman. Para validar la metodología propuesta se estiman unos indicadores de acuerdo con ella para tres de las cuatro regiones españolas que disponen d¿un Índice de Producción Industrial (IPI) elaborado mediante el método directo (Andalucía, Asturias y el País Vasco) y se comparan con los IPIs publicados (oficiales). Los resultados obtenidos muestran el buen comportamiento de l¿estrategia propuesta, abriendo así una línea de trabajo con la que subsanar el déficit al que se hacía referencia anteriormente

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The inadequacies and obsolescence of Eurocentric theories based on a binaryand static worldview have become a staple topic of postcolonial studies, and tosome extent also of translation studies. Nonetheless, the literary texts that arecalled upon in order to show the dynamism and hybridity of (post)modern worksbelong for the most part to the languages of the former colonial powers, especiallyEnglish, and remain inserted in a system that construes literatures interms of opposition. As a consequence, there is outside India a doubly misleadingunderstanding of Indian literatures other than those written in English:firstly, that translations of works in Hindi and in the Indian bhāṣā seem to belacking, if not inexistent, and secondly, that these "minor" literatures - as theyare regularly termed - are still often viewed as being highly dependent on theidea of "tradition," in opposition to the "postmodern" hybridity of the literatureswritten in the "dominant" languages, such as English or French. Againstthese views and supported by the analysis of Ajñeya's works in Hindi togetherwith their English translations, this paper aims to show: 1) that translationsfrom Hindi, which are not in fact non-existent, are mainly carried out in India,and 2) that Ajñeya's works, while representing a significant instance of the effectivehybridity present in Indian literatures, help to illustrate the moving spaceof translation. This demonstration effectively invalidates the above-mentionedoppositional standpoint.

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INTRODUCTION: Oxidative stress is involved in the development of secondary tissue damage and organ failure. Micronutrients contributing to the antioxidant (AOX) defense exhibit low plasma levels during critical illness. The aim of this study was to investigate the impact of early AOX micronutrients on clinical outcome in intensive care unit (ICU) patients with conditions characterized by oxidative stress. METHODS: We conducted a prospective, randomized, double-blind, placebo-controlled, single-center trial in patients admitted to a university hospital ICU with organ failure after complicated cardiac surgery, major trauma, or subarachnoid hemorrhage. Stratification by diagnosis was performed before randomization. The intervention was intravenous supplements for 5 days (selenium 270 microg, zinc 30 mg, vitamin C 1.1 g, and vitamin B1 100 mg) with a double-loading dose on days 1 and 2 or placebo. RESULTS: Two hundred patients were included (102 AOX and 98 placebo). While age and gender did not differ, brain injury was more severe in the AOX trauma group (P = 0.019). Organ function endpoints did not differ: incidence of acute kidney failure and sequential organ failure assessment score decrease were similar (-3.2 +/- 3.2 versus -4.2 +/- 2.3 over the course of 5 days). Plasma concentrations of selenium, zinc, and glutathione peroxidase, low on admission, increased significantly to within normal values in the AOX group. C-reactive protein decreased faster in the AOX group (P = 0.039). Infectious complications did not differ. Length of hospital stay did not differ (16.5 versus 20 days), being shorter only in surviving AOX trauma patients (-10 days; P = 0.045). CONCLUSION: The AOX intervention did not reduce early organ dysfunction but significantly reduced the inflammatory response in cardiac surgery and trauma patients, which may prove beneficial in conditions with an intense inflammation. TRIALS REGISTRATION: Clinical Trials.gov RCT Register: NCT00515736.

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The clinical and radiological data of 52 patients with subarachnoid haemorrhage (SAH) and a negative panangiography were analysed with an average follow-up period of 3.8 years. Of these 52 patients, only one (1.9%) was subsequently found to have an aneurysm. Second angiography proved to be inconclusive in all 24 cases where it was performed. Of the 51 'true' non-aneurysmal SAH, 80% were in a good clinical grade on admission and 12% developed cerebral ischaemia. The mortality rate following SAH was 4%. There was one rebleeding. At follow-up examination, 87% of the patients had made a good recovery and 6% were left disabled due to SAH. Four patients with an aneurysmal pattern of SAH required a permanent shunt. All of the 22 patients with a perimesencephalic SAH were in a good neurological condition upon admission; one of them developed an angiography-induced transient cerebral ischaemia and another one suffered from a fatal rebleeding. None of the 21 survivors was disabled at follow-up examination. The clinical course of patients with SAH of unknown cause, especially those with a perimesencephalic pattern of haemorrhage, is good. Repeated angiography in this latter group is not useful. In the aneurysmal pattern SAH group, repeat angiography is advised only if there is strong computed tomographic (CT) scan suspicion of an aneurysm.

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OBJECTIVE: Sleep disordered breathing with central apnea or hypopnea frequently occurs at high altitude and is thought to be caused by a decrease in blood CO(2) level. The aim of this study was to assess the effects of added respiratory dead space on sleep disordered breathing.¦METHODS: Full polysomnographies were performed on 12 unacclimatized swiss mountaineers (11 males, 1 female, mean age 39±12 y.o.) in Leh, Ladakh (3500m). In random order, half of the night was spent with a 500ml increase in dead space through a custom designed full face mask and the other half without it.¦RESULTS: Baseline data revealed two clearly distinct groups: one with severe sleep disordered breathing (n=5, AHI>30) and the other with moderate to no disordered breathing (n=7, AHI<30). DS markedly improved breathing in the first group (baseline vs DS): apnea hypopnea index (AHI) 70.3±25.8 vs 29.4±6.9 (p=0.013), oxygen desaturation index (ODI): 72.9±24.1/h vs 42.5±14.4 (p=0.031), whereas it had no significant effect in the second group or in the total population. Respiratory events were almost exclusively central apnea or hypopnea. Microarousal index, sleep efficiency, and sleep architecture remained unchanged with DS. A minor increase in mean PtcCO(2) (n=3) was observed with DS.¦CONCLUSION: A 500ml increase in dead space through a fitted mask may improve nocturnal breathing in mountaineers with severe altitude-induced sleep disordered breathing.

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El déficit existente a nuestro país con respecto a la disponibilidad de indicadores cuantitativos con los que llevar a término un análisis coyuntural de la actividad industrial regional ha abierto un debate centrado en el estudio de cuál es la metodología más adecuada para elaborar indicadores de estas características. Dentro de este marco, en este trabajo se presentan las principales conclusiones obtenidas en anteriores estudios (Clar, et. al., 1997a, 1997b y 1998) sobre la idoneidad de extender las metodologías que actualmente se están aplicando a las regiones españolas para elaborar indicadores de la actividad industrial mediante métodos indirectos. Estas conclusiones llevan a plantear una estrategia distinta a las que actualmente se vienen aplicando. En concreto, se propone (siguiendo a Israilevich y Kuttner, 1993) un modelo de variables latentes para estimar el indicador de la producción industrial regional. Este tipo de modelo puede especificarse en términos de un modelo statespace y estimarse mediante el filtro de Kalman. Para validar la metodología propuesta se estiman unos indicadores de acuerdo con ella para tres de las cuatro regiones españolas que disponen d¿un Índice de Producción Industrial (IPI) elaborado mediante el método directo (Andalucía, Asturias y el País Vasco) y se comparan con los IPIs publicados (oficiales). Los resultados obtenidos muestran el buen comportamiento de l¿estrategia propuesta, abriendo así una línea de trabajo con la que subsanar el déficit al que se hacía referencia anteriormente