Influence of Assisted Reproductive Techniques in the occurrence of weight discordance in twin gestations

Background:There is no actual evidence that the ART are directly related to the occurrence of weight discordance. In some studies, ART-­‐conceived twin pregnancies are at greater risk than non-­‐ART-­‐conceived ones for pregnancy complications and adverse perinatal outcome: the incidences of pregnancy-­‐induced hypertension, uterine bleeding, premature contractions, IUGR, fetal death, discordance, and cesarean section were significantly higher. Discordance rate was elevated (25.3% vs.17.0%) among ART twins, which can increase perinatal risk (increased incidence of SGA and NICU admission). Other studies say that perinatal and neonatal morbidity, gestational age at delivery, and birth weight are not affected by ART. Regarding the first trimester ultrasound, some studies didn’t notice significant differences in CRL disparity or birth weight discordance between spontaneous and ART-­‐ conceived dichorionic twin pregnancies. In ART-­‐conceived dichorionic twin pregnancies, CRL disparity may be associated with birth weight discordance. In some studies, CRL discordance in twin pregnancies in the first trimester was a frequent finding. Objectives: To analyze the association of the ART in the occurrence of weight discordance in the pregnancies between 2010 and 2013 in the Hospital Universitari de Girona Doctor Josep Trueta, and to describe the proportion of diagnosis of growth discordance in the first trimester by the ultrasonography technology. Methods: A retrospective cohort study will be performed in those patients with twin pregnancies between 2010 and 2013, within the Hospital Universitari de Girona Doctor Josep Trueta (HUJT). A retrospective and descriptive study will be done in those cases with discordance weight in the moment of the birth, in which the CRL will be studied in the first trimester ultrasound, describing the percentage of discordance detected in that moment. The general characteristics of the sample are going to be analyzed by Logistic RegressionInfluenceof

La percepción de los estudiantes universitarios de Bellas Artes sobre sus dificultades de aprendizaje: el caso de las competencias de búsqueda y selección de información relevante

[spa]Identificar las dificultades halladas en el proceso de aprendizaje con la especial relación entre el esfuerzo y el logro experimentada por los estudiantes implica afrontar uno de los problemas fundamentales del aprendizaje. El presente artículo pretende abordar los aprendizajes vinculados a las competencias transversales de la búsqueda y selección de información desde el examen de la percepción de los estudiantes universitarios de arte en la realización de una carpeta de aprendizaje adaptada a la titulación y al perfil del estudiante. A partir de un enfoque cuantitativo, y mediante un estudio descriptivo transversal, se analizará la relación existente entre el esfuerzo realizado, los resultados de aprendizaje declarados y la relación entre ambas cuestiones -lo que a la postre define las dificultades- que manifiestan los estudiantes. [eng]This article aims to address the learning skills associated with the competence of searching and selecting information from the examination of the perceptions of art college students in the drawing up of a learning portfolio tailored to the degree and student profile. From a quantitative approach, and through a cross-sectional descriptive study, we will analyze the relationship between effort, stated learning outcomes and the relationship between these two issues what ultimately defines the difficulties which declare the students.

Evaluation of the indication for surgical extraction of third molars according to the oral surgeon and the primary care dentist. Experience in the Master of Oral Surgery and Implantology at Barcelona University Dental School

Introduction: Third molar extraction is the most frequent procedure in oral surgery. The present study evaluates the indication of third molar extraction as established by the primary care dentist (PCD) and the oral surgeon, and compares the justification for extraction with the principal reason for patient consultation. Patients and method: A descriptive study was made of 319 patients subjected to surgical removal of a third molar in the context of the Master of Oral Surgery and Implantology (Barcelona University Dental School, Barcelona, Spain) between July 2004 and March 2005. The following parameters were evaluated: sex, age, molar, type of impaction, position according to the classifications of Pell and Gregory and of Winter, and the reasons justifying extraction. Results: The lower third molars were the most commonly extracted molars (73.7%). A total of 69.6% of the teeth were covered by soft tissues only. Fifty-six percent of the lower molars corresponded to Pell and Gregory Class IIB, while 42.1% were in the vertical position. The most common reason for patient reference to our Service of Oral Surgery on the part of the PCD was prophylactic removal (51.0% versus 46.1% in the case of the oral surgeon). Discussion and conclusions. Our results show prophylaxis to be the principal indication of third molar extraction, followed by orthodontic reasons. Regarding third molars with associated clinical symptoms or signs, infectious disease-including pericoronitis- was the pathology most often observed by the oral surgeon, followed by caries. This order of frequency was seen to invert in the case of third molars referred for extraction by the PCD. A vertical position predominated among the third molars with associated pathology

Mobile Marketing in Japan

Mobiilimarkkinoinnin markkinat ovat vasta rakentumassa ja suurin osa alan toimijoista etenkin Suomessa yrittää vielä löytää rooliaan. Sen sijaan Japanissa sisällöntuotantoliiketoiminta matkapuhelimille kukoistaa ja mobiilimarkkinointi on jo saavuttanut merkittävän aseman mobiili-internetin palvelutarjonnassa. Toisin kuin Suomessa, jossa mobiilimarkkinat ovat vielä lastenkengissä, Japanissa myös mobiilimarkkinoinnin arvoketju on vähitellen muotoutumassa.Tämän tutkimuksen tavoitteena oli antaa käsitys Japanin mobiilimarkkinoinnin dynamiikasta ja luoda viitekehys operaattorin tulevalle roolille mobiilimarkkinoinnin markkinoiden rakentamisessa. Tutkimus on deskriptiivinen ja aineisto on kerätty alan kirjallisuudesta sekä haastattelemalla tärkeitä mobiilimarkkinoiden toimijoita Japanissa. Japanissa operaattoreilla (NTT DoCoMo, J-Phone ja KDDI) on erittäin vahva asema mobiili-internetin ja mobiilimarkkinoinnin markkinoilla. Ne hallitsevat asiakasrajapintaa, päättävät mobiiliverkon ja matkapuhelimien ominaisuuksista sekä siitä, ketkä sisällöntuottajista pääsevät osaksi heidän laskutusjärjestelmäänsä. Markkinoinnissa operaattoreilla ei ole yhtä näkyvää roolia. Omistussuhteiden kautta ne kuitenkin vaikuttavat lähes koko arvoketjuun. Operaattorit ovat yhdessä Japanin suurimpien mainostoimistojen kanssa luoneet tytäryhtiöitä, jotka hoitavat mainonnan operaattorin mobiiliportaalissa. Japanissa operaattori on ottanut hallitsevan roolin mobiilimarkkinoiden rakentamisessa. Tiivis yhteistyö eri toimijoiden, kuten matkapuhelinvalmistajien, sisällöntuottajien ja mainostoimistojen kanssa, on mahdollistanut kokonaisvaltaisen palvelupaketin tarjoamisen. Palvelupaketti sisältää käyttäjäystävällisen liittymän mobiili-internetiin sekä edulliset puhelimet. Juuri tiivis yhteistyö onkin ollut yksi tärkeimmistä menestystekijöistä Japanin markkinoita rakennettaessa. Mobiilimarkkinoita rakennettaessa operaattorilla on merkittävä rooli markkinoiden muodostajana ja sisällön kokoojana. Operaattorien tulee varautua roskapostin vastaiseen taisteluun, jos sähköpostia annetaan lähettää suoraan matkapuhelimeen. On erityisen tärkeää varmistaa, ettei käyttäjien tarvitse kärsiä roskapostista, muuten suoramarkkinoinnin mahdollisuus matkapuhelimeen menetetään. Ainoastaan aktiivisella edistämisellä ja osallistumisella mobiili-internetin sisällöntuotanto- ja markkinointiliiketoimintaan operaattori voi vahvistaa markkina-asemaansa ja varmistaa osuutensa tulevista markkinoista.

Anàlisi de l’elecció de la cama d’atac predominant en la prova de 400 metres tanques dels XIII Campionats del Món d’Atletisme Daegu 2011

Objectius: Analitzar la utilització d’una o altra cama com a cama d’atac predominant en atletes de 400 metres tanques d’alt nivell. Mètode: L’estudi és descriptiu de tall transversal. Es van estudiar totes les curses de 400 metres tanques dels 72 participants (34 homes i 38 dones) en els XIII Campionats del Món d’Atletisme Daegu 2011 mitjançant la gravació en vídeo des de la tribuna principal del Daegu Stadium de les 18 curses de 400 metres tanques disputades i la posterior anàlisi mitjançant l’aplicació informàtica Kinovea 0.8.4. Resultats: Per atletes, en el total de les curses masculines, la cama d’atac predominant va ser l’esquerra, amb el 63,6 % (42 atletes), i amb la cama dreta va haver-hi el 34,8 % (23 atletes). Només en un cas hi havia un equilibri entre esquerra i dreta. A la final va haver-hi el 75 % (6 atletes) la cama predominant d’atac dels quals va ser l’esquerra. Quant a les dones, la cama d’atac predominant va ser l’esquerra, amb el 48,6 %, seguida de la cama dreta, amb el 41,4 %, i per al 10 % hi havia un equilibri de les dues. A la final, en canvi, la cama predominant d’atac va ser la dreta, amb el 87,5 % (7 atletes), pel 12,5 % de l’esquerra (1 sola atleta). Es van trobar diferències significatives (p = 0,018) en la mitjana de temps finals dels atletes masculins segons quina fos la seva cama d’atac. Conclusions: La majoria dels atletes ataquen les tanques amb dreta i esquerra en algun moment de la cursa, la qual cosa obliga al domini tècnic bilateral. La cama d’atac més utilitzada és l’esquerra, encara que en menor mesura en el cas de les dones. Per primera vegada en una gran competició, 7 de les 8 finalistes tenen la cama dreta com a cama predominant.

Moxibustión en la malposición fetal

Introducción: La incidencia de la presentación fetal podálica en España es del 3,8%. La moxibustión es parte integral de la milenaria medicina tradicional china. La técnica consiste en la colocación de un palillo incandescente de Artemisia vulgaris a unos pocos centímetros del punto de acupuntura Zhiyin (punto 67 del meridiano de vejiga, ubicado en la base externa de la uña del quinto dedo del pie). Los objetivos son: 1. Conocer el porcentaje de fetos que han rotado a cefálica mediante la moxibustión en gestantes que presenten una malposición fetal a partir de las 32 semanas de embarazo; 2. Identificar las complicaciones materno-fetales en la aplicación de la técnica. Sujetos: Se estudiaron 18 gestantes de más de 32 semanas de embarazo. Material y métodos: Mediante un estudio descriptivo de intervención, analizamos el porcentaje de fetos que rotaron a presentación cefálica. Resultados: Quince gestantes (83,9%) realizaron el tratamiento adecuadamente y las 3 restantes (16,7%) lo realizaron de manera ocasional y terminaron con una cesárea electiva por nalgas. Conclusiones: Parece razonable concluir que el cumplimiento del tratamiento influye en el tipo de parto (χ2= 12,600; gl= 1; p= 0,000), aunque no modifica el Apgar del recién nacido. Esta técnica se presenta como una alternativa económica, segura, sencilla y práctica para la versión fetal de la presentación podálica.

Prevalence of Ischemic Heart Disease and Management of Coronary Risk in Daily Clinical Practice: Results from a Mediterranean Cohort of HIV-Infected Patients

There are conflicting data on the prevalence of coronary events and the quality of the management of modifiable cardiovascular risk factors (CVRF) inHIV-infected patients. Methods.We performed a retrospective descriptive study to determine the prevalence of coronary events and to evaluate the management of CVRF in a Mediterranean cohort of 3760 HIV-1-infected patients from April 1983 through June 2011. Results.We identified 81 patients with a history of a coronary event (prevalence 2.15%); 83% of them suffered an acute myocardial infarction. At the time of the coronary event, CVRF were highly prevalent (60.5% hypertension, 48% dyslipidemia, and 16% diabetes mellitus).OtherCVRF, such as smoking, hypertension, lack of exercise, and body mass index, were not routinely assessed. After the coronary event, a significant decrease in total cholesterol ( � = 0.025) and LDLcholesterol ( � = 0.004) was observed. However, the percentage of patients whomaintained LDL-cholesterol > 100mg/dL remained stable (from 46% to 41%, � = 0.103). Patients using protease inhibitors associated with a favorable lipid profile increased over time ( � = 0.028). Conclusions.The prevalence of coronary events in our cohort is low. CVRF prevalence is high and theirmanagement is far from optimal. More aggressive interventions should be implemented to diminish cardiovascular risk in HIV-infected patients.

Tietämyksen kasvattamisen keinot Case: Handwise Oy:n tietämyksen kasvattaminen yksilön ja organisaation oppimisen keinoin

Työn tavoitteena oli selvittää yksilön ja organisaation tietämystä sekä niiden kasvattamista. Tarkoituksena oli löytää yksilön ja organisaation tietämyksen yhdistäviä tekijöitä. Tutkimusmetodologia oli empiirinen deskriptiivinen tutkimus ja tutkimusmenetelmä oli kvalitatiivinen perustuen kymmeneen teemahaastatteluun. Tutkimuksen tuloksena oli, että tietotyöntekijät kasvattavat omaa ja organisaation tietämystä samankaltaisin keinoin, eikä niiden välillä mielletty olevan suurtakaan eroa. Työssä kokeminen yrityksen ja erehdyksen kautta kerrottiin tärkeimmäksi menetelmäksi kasvattaa omaa tietämystä. Kirjoja arvostettiin erityisen paljon tietämyksen kasvattamisessa ja se ohitti tiedon lähteenä jopa internetin. Työkollegat olivat kolmas tärkeä tietämyksen lähde. Kaksi tärkeintä edellytystä tietämyksen kasvattamisessa olivat opiskelun aikana saatu tietopohja sekä oma kiinnostus ja motivaatio. Organisaation tietämyksen kasvattamisessa tärkeimmäksi tekijäksi nousivat dokumentointi, virheistä oppiminen, sisäinen kommunikointi, tietojärjestelmät ja avoin organisaatiokulttuuri. Tutkimuksen perusteella syntyi kolmivaiheinen malli tietämyksen kasvattamisen kehästä, jonka elementit ovat edellytykset, lähteet ja menetelmät. Kehän keskellä on työssä oppiminen, joka on tärkein tekijä tietämyksen kasvattamisessa. Case-yrityksen toiminta oppivana organisaationa osoitti, että yrityksessä tulisi panostaa erityisesti oppimisen tukemiseen ja johtamiseen. Myös tiedon dokumentointi ja muuttaminen avoimeen muotoon sekä yrityksen prosessit tarvitsevat selkiyttämistä. Organisaation avoimuus ja ilmapiiri osoittautuivat hyviksi, mikä auttaa osaltaan tietämyksen kasvattamista.

Validation of a computer-assisted system on classifying lower third molars

Objectives: The present study evaluates the reliability of the Radio Memory® software (Radio Memory; Belo Horizonte,Brasil.) on classifying lower third molars, analyzing intra- and interexaminer agreement of the results. Study Design: An observational, descriptive study of 280 lower third molars was made. The corresponding orthopantomographs were analyzed by two examiners using the Radio Memory® software. The exam was repeated 30 days after the first observation by each examiner. Both intra- and interexaminer agreement were determined using the SPSS v 12.0 software package for Windows (SPSS; Chicago, USA). Results: Intra- and interexaminer agreement was shown for both the Pell & Gregory and the Winter classifications, p<0.01, with 99% significant correlation between variables in all the cases. Conclusions: The use of Radio Memory® software for the classification of lower third molars is shown to be a valid alternative to the conventional method (direct evaluation on the orthopantomograph), for both clinical and investigational applications.

Cardiac magnetic resonance imaging in clinical practice

Objective To evaluate and describe indications, mainly diagnoses and cardiac magnetic resonance imaging findings observed in clinical practice. Materials and Methods Retrospective and descriptive study of cardiac magnetic resonance performed at a private hospital and clinic in the city of Niterói, RJ, Brazil, in the period from May 2007 to April 2011. Results The sample included a total of 1000 studies performed in patients with a mean age of 53.7 ± 16.2 years and predominance for male gender (57.2%). The majority of indications were related to assessment of myocardial perfusion at rest and under pharmacological stress (507/1000; 51%), with positive results in 36.2% of them. Suspected myocarditis was the second most frequent indication (140/1000; 14%), with positive results in 63.4% of cases. These two indications were followed by study of arrhythmias (116/1000; 12%), myocardial viability (69/1000; 7%) and evaluation of cardiomyopathies (47/1000; 5%). In a subanalysis, it was possible to identify that most patients were assessed on an outpatient basis (58.42%). Conclusion Cardiac magnetic resonance has been routinely performed in clinical practice, either on an outpatient or emergency/inpatient basis, and myocardial ischemia represented the main indication, followed by investigation of myocarditis, arrhythmogenic right ventricular dysplasia and myocardial viability.

Evolution of mammographic image quality in the state of Rio de Janeiro

Objective:To evaluate the evolution of mammographic image quality in the state of Rio de Janeiro on the basis of parameters measured and analyzed during health surveillance inspections in the period from 2006 to 2011.Materials and Methods:Descriptive study analyzing parameters connected with imaging quality of 52 mammography apparatuses inspected at least twice with a one-year interval.Results:Amongst the 16 analyzed parameters, 7 presented more than 70% of conformity, namely: compression paddle pressure intensity (85.1%), films development (72.7%), film response (72.7%), low contrast fine detail (92.2%), tumor mass visualization (76.5%), absence of image artifacts (94.1%), mammography-specific developers availability (88.2%). On the other hand, relevant parameters were below 50% conformity, namely: monthly image quality control testing (28.8%) and high contrast details with respect to microcalcifications visualization (47.1%).Conclusion:The analysis revealed critical situations in terms of compliance with the health surveillance standards. Priority should be given to those mammography apparatuses that remained non-compliant at the second inspection performed within the one-year interval.

An ABC for decision making

The present study was aimed at proposing a systematic evaluation of cranial computed tomography, identifying the main aspects to be analyzed in order to facilitate the decision making process regarding diagnosis and management in emergency settings. The present descriptive study comprised a literature review at the following databases: Access Medicine and Access Emergency Medicine (McGraw- Hill Education); British Medical Journal Evidence Center; UptoDate; Bireme; PubMed; Lilacs; SciELO; ProQuest; Micromedex (Thomson Reuters); Embase. Once the literature review was completed, the authors identified the main diseases with tomographic repercussions and proposed the present system to evaluate cranial computed tomography images. An easy-to-memorize ABC system will facilitate the decision making in emergency settings, as it covers the main diseases encountered by intensivists and emergency physicians, and provides a sequential guidance about anatomical structures to be investigated as well as their respective alterations.

Anatomical variations of the celiac trunk and hepatic arterial system: an analysis using multidetector computed tomography angiography

Abstract Objective: To analyze the prevalence of anatomical variations of celiac arterial trunk (CAT) branches and hepatic arterial system (HAS), as well as the CAT diameter, length and distance to the superior mesenteric artery. Materials and Methods: Retrospective, cross-sectional and predominantly descriptive study based on the analysis of multidetector computed tomography images of 60 patients. Results: The celiac trunk anatomy was normal in 90% of cases. Hepatosplenic trunk was found in 8.3% of patients, and hepatogastric trunk in 1.7%. Variation of the HAS was observed in 21.7% of cases, including anomalous location of the right hepatic artery in 8.3% of cases, and of the left hepatic artery, in 5%. Also, cases of joint relocation of right and left hepatic arteries, and trifurcation of the proper hepatic artery were observed, respectively, in 3 (5%) and 2 (3.3%) patients. Mean length and caliber of the CAT were 2.3 cm and 0.8 cm, respectively. Mean distance between CAT and superior mesenteric artery was 1.2 cm (standard deviation = 4.08). A significant correlation was observed between CAT diameter and length, and CAT diameter and distance to superior mesenteric artery. Conclusion: The pattern of CAT variations and diameter corroborate the majority of the literature data. However, this does not happen in relation to the HAS.

La força pot predir el rendiment i la lesionabilitat al bàsquet professional?

Amb l’objectiu de conèixer les relacions existents entre la força, el rendiment esportiu i la lesionabilitat en un equip masculí de bàsquet professional, es realitza un estudi prospectiu, observacional i descriptiu d’anàlisis d’estadístiques (71 partits), test de mig esquat (n = 7) i patologia lesional, monitoritzant la temporada 09/10, on es relacionen les dades obtingudes de cada jugador referents al rendiment esportiu per partit (valoració estadística), les mitjanes de força, velocitat i potència de cada mesocicle i la lesionabilitat. La tècnica estadística utilitzada ha estat la correlació a partir del paràmetre rho de Spearman. Aquestes correlacions entre força i lesionabilitat mostren que a valors de força més elevats hi ha més lesions: amb 80 kg són molt significatives per a lesions totals (LT) i potència (rho = 0,898; p = 0,006), i significatives per força (rho = 0,823; p = 0,023) i velocitat (rho = 0,774; p = 0,041); la velocitat amb 90 kg es relaciona amb lesions time loss (TL) (rho = 0,878; p = 0,009), i la potència amb 100 kg, amb lesions totals (LT) (rho = 0,805; p = 0,029) i V100 (rho = 0,898; p = 0,006) molt significativament. I la relació entre força i rendiment és significativament negativa en 5 dels 7 mesocicles, és a dir, a menys força, més rendiment. En conclusió, durant l’execució del mig esquat, hi ha valors de força adients per rendir millor i lesionar-se menys: de 800 N a 1.050 N i amb càrregues de 80 kg a 90 kg.

Avaluació dels nivells de nitrats i duresa a l'aigua de consum a quatre zones d'Espanya participants a l'estudi epidemiològic Infància i Medi Ambientl (INMA)

L’aigua és un dels components bàsics per a la vida i una font d’exposició a contaminants ubiqua, ja que tota la població en consumeix. L’estudi epidemiològic INMA avaluarà si l’exposició a nitrats durant l’embaràs i a la duresa de l’aigua durant la infància es relaciona amb el baix pes al néixer i l’èczema atòpica, respectivament. Objectiu: Fer una avaluació dels nivells de nitrats i duresa de l’aigua en aigua de consum de la població de l’estudi INMA. Metodologia: l’estudi descriptiu realitzat a quatre de les set cohorts INMA, a Astúries, Guipúscoa, Sabadell i València. S’ha recopilat dades dels nivells de nitrats i duresa a l’aigua de consum dels municipis durant el període d’interès (2003 al 2008 i 2004 al 2012), a través d’ajuntaments i companyies d’aigua. S’ha calculat la mitjana, la desviació estàndard, el màxim i el mínim dels nivells de nitrat i de duresa en total i segons l’àrea geogràfica, l’any i l’estació. A Sabadell s’han fet tres mostrejos d’aigua per analitzar la duresa a diferents punts de la ciutat. Resultats: el nivell promig de nitrats (mg/L NO3-) és de 4,2 a Astúries, 4,0 a Guipúscoa, 9,2 a Sabadell i 15,2 a València. El nivell promig de duresa (mg/L CaCO3) és de 89,1 a Astúries, 132,7 al Guipúscoa, 178,3 a València i 230,9 a Sabadell. En l’anàlisi que es va realitzar a Sabadell, es detecta una duresa lleugerament inferior a la reportada sense variabilitat geogràfica. No s’observa una pauta clara de variabilitat estacional ni de variabilitat temporal tant per nitrats com per duresa. Conclusions: S’ha detectat variabilitat en els nivells de nitrats i duresa de l’aigua a les zones d’estudi. Els nivells de nitrats són moderats i els més alts es troben a zones agrícoles de València. La duresa de l’aigua és força alta degut al domini calcari dels subsòls de les zones d’estudi.