Morbimortalidad asociada a transfusiones de glóbulos rojos en una unidad de cuidados intensivos pediátricos de Bogotá

Determinar si las transfusiones de glóbulos rojos en niños en cuidados intensivos se asocian a aumento de la morbimortalidad. Materiales y Métodos: Estudio observacional analítico de cohorte. Se incluyeron niños con anemia de 1 mes a 18 años de edad en un periodo de 10 meses. Resultados: 134 niños con anemia fueron incluidos. En el 51.5% la anemia se desarrolló posterior a su ingreso. De éstos, 66 niños recibieron una transfusión de glóbulos rojos y la mediana de hemoglobina pretransfusión fue de 7.5 g/dl. El 6% de los pacientes transfundidos presentó una Reacción adversa. Entre el grupo de pacientes expuesto a transfusión y los no expuestos existió diferencia significativa en la hemoglobina de ingreso, cantidad de sangre extraída y edad en el análisis bivariado. Los pacientes transfundidos tuvieron mayor mortalidad (15.2% vs. 2.9%, p =0.013). El desarrollo de falla multiorgánica también fue más frecuente en el grupo transfundido (62.1% vs. 16.2%, p < 0.001). La mediana de los días de estancia en la UCI y el tiempo de ventilación mecánica fue mayor en los niños transfundidos que en los no transfundidos, 8 vs. 4 días p< 0.001, y 6 vs. 3 días p<0.001 respectivamente. Un análisis multivariado mostró asociación de transfusión de glóbulos rojos con mortalidad y falla multiorgánica. Conclusión: Las transfusiones de glóbulos rojos se asocian con un aumento en la Mortalidad y en el desarrollo de falla multiorgánica. La estancia en la UCI y el tiempo de ventilación mecánica fue mayor en los niños transfundidos.

Morbimortalidad asociada a transfusiones de glóbulos rojos. Unidad de Cuidados Intensivos, Clínica Infantil Colsubsidio

Objetivos: Determinar si las transfusiones de glóbulos rojos en niños en cuidados intensivos se asocian a aumento de la morbimortalidad. Materiales y Métodos: Estudio observacional analítico de cohorte. Se incluyeron niños con anemia de 1 mes a 18 años de edad en un periodo de 13 meses. Resultados: 156 niños con anemia fueron incluidos. En el 51.5% la anemia se desarrolló posterior a su ingreso. De éstos, 77 niños recibieron una transfusión de glóbulos rojos y la mediana de hemoglobina pretransfusión fue de 7.5 g/dl. El 6.5% de los pacientes transfundidos presentó una Reacción adversa. Entre el grupo de pacientes expuesto a transfusión y los no expuestos existió diferencia significativa en la hemoglobina de ingreso, cantidad de sangre extraída y edad en el análisis bivariado. Los pacientes transfundidos tuvieron mayor mortalidad (12.9% vs. 2.5%, p =0.014). El desarrollo de falla multiorgánica también fue más frecuente en el grupo transfundido (57.1% vs. 13.9%, p < 0.001). La mediana de los días de estancia en la UCI y el tiempo de ventilación mecánica fue mayor en los niños transfundidos que en los no transfundidos, 8 vs. 4 días p< 0.001, y 6 vs. 3 días p<0.001 respectivamente. Un análisis multivariado mostró asociación de transfusión de glóbulos rojos con mortalidad y falla multiorgánica. Conclusión: Las transfusiones de glóbulos rojos se asocian con un aumento en la Mortalidad y en el desarrollo de falla multiorgánica. La estancia en la UCI y el tiempo de ventilación mecánica fue mayor en los niños transfundidos.

Toys poems.

Esta selección de poesía se ha elegido para que coincida con temas de interés para el grupo de edad: juguetes. Aunque los poemas son completamente independientes de otras historias, pueden ser introducidos junto con libros de cuentos. Destinado a escuelas infantiles, puede utilizarse para el trabajo curricular transversal, así como para la enseñanza de la lectura y el disfrute de la poesía, ritmo y rima. Desarrolla en los niños habilidades fonológicas y el conocimiento de la rima y los introduce en la poesía desde las primeras etapas de la lectura. Ofrece orientación para hablar y escuchar, con especial atención a la lectura en voz alta.

Toys.

Muestra una colección de juguetes par niños de seis meses a dos años. Sirve también como aprendizaje anticipado y divertido para enseñar un vocabulario básico indicandoles las imágenes.

Estudo de vinte casos de hiperadrenocorticismo no cão

O hiperadrenocorticismo canino consiste no conjunto de alterações físicas e bioquímicas resultantes da exposição prolongada e inapropriada, do organismo, a elevadas concentrações de cortisol. Esta dissertação teve como principal objectivo o estudo de vinte casos de hiperadrenocorticismo no cão, com base na recolha e interpretação de dados clínicos, laboratoriais e de imagem, efectuados durante o período de dois anos, entre Março de 2010 e Março de 2012, no Hospital Veterinário da FMVZ/UNESP em Botucatu. Constatou-se que a maioria das características individuais (idade, peso, raça e sexo), sinais clínicos e alterações laboratoriais (hemograma, bioquímicas sanguíneas e urianálise) comuns desta doença estavam presentes. Os cães do nosso estudo eram na sua maioria geriátricos, de raça miniatura como o caniche, com peso inferior a 20 Kg e do sexo feminino; estes apresentavam habituais sinais clínicos como poliúria, polidipsia, distensão abdominal, polifagia, fraqueza muscular, alterações respiratórias, cutâneas e neurológicas, e habituais alterações laboratoriais como trombocitose, linfopenia, eosinopenia, neutrofilia, aumento da fosfatase alcalina sérica, alanina aminotransferase, colesterol e triglicéridos. Alguns destes cães apresentaram ainda três das complicações mais comuns do hiperadrenocorticismo como hipertensão arterial, infecção do tracto urinário inferior e diabetes mellitus. Para chegar ao diagnóstico final realizou-se o teste de supressão de dexametasona a baixas doses em associação com a avaliação das glândulas adrenais através de ecografia, o qual nos permitiu obter a nossa amostra final, os vinte cães com hiperadrenocorticismo. Este estudo contribuiu para aprofundar o conhecimento relativamente às alterações clínicas, laboratoriais e de imagem presentes nos cães com hiperadrenocorticismo e demonstrou que a informação daí retirada é fundamental para chegar ao seu diagnóstico.

A new set of orthogonal patterns in weather and climate: Optimally interpolated patterns.

A new spectral-based approach is presented to find orthogonal patterns from gridded weather/climate data. The method is based on optimizing the interpolation error variance. The optimally interpolated patterns (OIP) are then given by the eigenvectors of the interpolation error covariance matrix, obtained using the cross-spectral matrix. The formulation of the approach is presented, and the application to low-dimension stochastic toy models and to various reanalyses datasets is performed. In particular, it is found that the lowest-frequency patterns correspond to largest eigenvalues, that is, variances, of the interpolation error matrix. The approach has been applied to the Northern Hemispheric (NH) and tropical sea level pressure (SLP) and to the Indian Ocean sea surface temperature (SST). Two main OIP patterns are found for the NH SLP representing respectively the North Atlantic Oscillation and the North Pacific pattern. The leading tropical SLP OIP represents the Southern Oscillation. For the Indian Ocean SST, the leading OIP pattern shows a tripole-like structure having one sign over the eastern and north- and southwestern parts and an opposite sign in the remaining parts of the basin. The pattern is also found to have a high lagged correlation with the Niño-3 index with 6-months lag.

Plant remains as evidence for seasonality of site use in the Mesolithic period

Attempts to identify the seasons during which Mesolithic sites may have been occupied have usually concentrated on evidence from faunal assemblages, while the potential of plant remains has been largely neglected. In this paper the use of plant remains as indicators of seasonality is discussed, especially where they represent the accidental charring of species unlikely to have been deliberately collected and stored. This is illustrated with reference to the early Mesolithic site of Star Carr, North Yorkshire, and discussed in the context of other Mesolithic sites from which assemblages of charred plant remains have been recovered.

Brief and precarious lives: Infant mortality in contrasting sites from medieval and post-medieval England (AD 850-1859)

This study compares the infant mortality profiles of 128 infants from two urban and two rural cemetery sites in medieval England. The aim of this paper is to assess the impact of urbanization and industrialization in terms of endogenous or exogenous causes of death. In order to undertake this analysis, two different methods of estimating gestational age from long bone lengths were used: a traditional regression method and a Bayesian method. The regression method tended to produce more marked peaks at 38 weeks, while the Bayesian method produced a broader range of ages and were more comparable with the expected "natural" mortality profiles. At all the sites, neonatal mortality (28-40 weeks) outweighed post-neonatal mortality (41-48 weeks) with rural Raunds Furnells in Northamptonshire, showing the highest number of neonatal deaths and post-medieval Spitalfields, London, showing a greater proportion of deaths due to exogenous or environmental factors. Of the four sites under study, Wharram Percy in Yorkshire showed the most convincing "natural" infant mortality profile, suggesting the inclusion of all births (i.e., stillbirths and unbaptised infants).

Lesbian migrants in the gentrified valley: other 'geographies' of rural gentrification

This paper explores the migration and cultural consumption practices of lesbian households within processes of rural change. Taking forward Phillips' (2004. Progress in Human Geography 28, 5-30) discussion of neglected geographies of rural gentrification, and building upon Halfacree's (2001. International Journal of Population Geography 7, 395-411) critique of dominant conceptualisations of rural in-migrants, the paper presents empirical findings from a qualitative study of lesbian households in Hebden Bridge, West Yorkshire. This follows up an earlier study of rural gentrification (Smith and Phillips, 2001. Journal of Rural Studies 19, 457-469). Lesbian households are shown to be a significant group that socially and culturally (re)produce distinct constructions of rurality, and act as gentrifiers via their migration, residential, and consumption practices. Many parallels to the migration processes of non-lesbian gentrifiers in Hebden Bridge are revealed, with the alternative cultural structures of Hebden Bridge being a key factor. We therefore argue that lesbian households should not be 'othered' within discourses of rural gentrification. The discussion emphasises the value of focussing upon neglected socio-cultural groups in robust ways, in order to shed light on the wider lifestyles and experiences of diverse rural populations, and to deepen understandings of other geographies of rural gentrification. (c) 2005 Elsevier Ltd. All rights reserved.

Early social experience and individual differences in infants' joint attention

Fifty-nine healthy infants were filmed with their mothers and with a researcher at two, four, six and nine months in face-to-face play, and in toy-play at six and nine months. During toy-play at both ages, two indices of joint attention (JA)—infant bids for attention, and percent of time in shared attention—were assessed, along with other behavioural measures. Global ratings were made at all four ages of infants’ and mothers’ interactive style. The mothers varied in psychiatric history (e.g., half had experienced postpartum depression) and socioeconomic status, so their interactive styles were diverse. Variation in nine-month infant JA — with mother and with researcher — was predicted by variation in maternal behaviour and global ratings at six months, but not at two or four months. Concurrent adult behaviour also influenced nine-month JA, independent of infant ratings. Six-month maternal behaviours that positively predicted later JA (some of which remained important at nine months) included teaching, conjoint action on a toy, and global sensitivity. Other behaviours (e.g., entertaining) negatively predicted later JA. Findings are discussed in terms of social-learning and neurobiological accounts of JA emergence.

Plants growing on contaminated and brownfield sites appropriate for use in Organisation for Economic Co-operation and Development terrestrial plant growth test

The Organisation for Economic Co-operation and Development (OECD) Terrestrial plant test is often used for the ecological risk assessment of contaminated land. However, its origins in plant protection product testing mean that the species recommended in the OECD guidelines are unlikely to occur on contaminated land. Six alternative species were tested on contaminated soils from a former Zn smelter and a metal fragmentizer with elevated concentrations of Cd, Cu, Pb, and Zn. The response of the alternative species was compared to two species recommended by the OECD; Lolium perenne (perennial ryegrass) and Trifolium pratense (red clover). Urtica dioica (stinging nettle) and Poa annua (annual meadow-grass) had low emergence rates in the control soil so may be considered unsuitable. Festuca rubra (chewings fescue), Holcus lanatus (Yorkshire fog), Senecio vulgaris (common groundsel), and Verbascum thapsus (great mullein) offer good alternatives to the OECD species. In particular, H. lanatus and S. vulgaris were more sensitive to the soils with moderate concentrations of Cd, Cu, Pb, and Zn than the OECD species.

The impact of Rhinanthus minor in newly established meadows on a productive site

Question: What is the impact of the presence of Rhinanthus minor on forb abundance in newly established swards? Location: Wetherby, West Yorkshire, UK (53 degrees 55' N, 1 degrees 22(1) W). Method: A standard meadow mix containing six forbs and six grasses was sown on an ex-arable field and immediately over-sown using a randomised plot design with three densities of Rhinanthus minor (0, 600, and 1000 seeds per m(2)). Above-ground biomass was analysed over a period of three years, while detailed assessments of sward composition were performed during the first two years. Results: Values of grass biomass were reduced in the presence of Rhinanthus, especially at the higher sowing density. The ratio of grass: forb biomass was also lower in association with Rhinanthus, but only at the higher sowing density. The presence of Rhinanthus, had no effect on species number or diversity, which decreased between years regardless of treatment. Conclusions: Although not tested in a multi-site experiment, the benefit of introducing Rhinanthus into newly established swards to promote for abundance was determined. The efficacy of Rhinanthus presence is likely to depend on whether species not susceptible to the effects of parasitism are present.

Big and little Meccano

The emergence of the mechanical bond during the past 25 years is giving chemistry a fillip in more ways than one. While its arrival on the scene is already impacting materials science and molecular nanotechnology, it is providing a new lease of life to chemical synthesis where mechanical bond formation Occurs as a consequence of the all-important templation Orchestrated by molecular recognition and self-assembly. The way in which covalent bond formation activates noncovalent bonding interactions, switching on molecular recognition that leads to self-assembly, and the template-directed synthesis of mechanically interlocked molecules-of which the so-called catenanes and rotaxanes may be regarded as the prototypes-has introduced a level of integration into chemical synthesis that has not previously been attained jointly at the supramolecular and molecular levels. The challenge now is to carry this I vel of integration during molecular synthesis beyond relatively small molecules into the realms of precisely functionalized extended molecular Structures and superstructures that perform functions in a collective manner as the key sources of instruction, activation, and performance in multi-component integrated Circuits and devices. These forays into organic chemistry by a scientific nomad are traced through thick and thin from the Athens of the North to the Windy City by Lake Michigan with interludes on the edge of the Canadian Shield beside Lake Ontario, in the Socialist Republic of South Yorkshire, on the Plains of Cheshire beside the Wirral, in the Midlands in the Heartland of Albion, and in the City of Angels beside the Peaceful Sea. (C) 2008 Elsevier Ltd. All rights reserved.

An integrated assessment of carbon dioxide capture and storage in the UK

Geological carbon dioxide storage (CCS) has the potential to make a significant contribution to the decarbonisation of the UK. Amid concerns over maintaining security, and hence diversity, of supply, CCS could allow the continued use of coal, oil and gas whilst avoiding the CO2 emissions currently associated with fossil fuel use. This project has explored some of the geological, environmental, technical, economic and social implications of this technology. The UK is well placed to exploit CCS with a large offshore storage capacity, both in disused oil and gas fields and saline aquifers. This capacity should be sufficient to store CO2 from the power sector (at current levels) for a least one century, using well understood and therefore likely to be lower-risk, depleted hydrocarbon fields and contained parts of aquifers. It is very difficult to produce reliable estimates of the (potentially much larger) storage capacity of the less well understood geological reservoirs such as non-confined parts of aquifers. With the majority of its large coal fired power stations due to be retired during the next 15 to 20 years, the UK is at a natural decision point with respect to the future of power generation from coal; the existence of both national reserves and the infrastructure for receiving imported coal makes clean coal technology a realistic option. The notion of CCS as a ‘bridging’ or ‘stop-gap’ technology (i.e. whilst we develop ‘genuinely’ sustainable renewable energy technologies) needs to be examined somewhat critically, especially given the scale of global coal reserves. If CCS plant is built, then it is likely that technological innovation will bring down the costs of CO2 capture, such that it could become increasingly attractive. As with any capitalintensive option, there is a danger of becoming ‘locked-in’ to a CCS system. The costs of CCS in our model for UK power stations in the East Midlands and Yorkshire to reservoirs in the North Sea are between £25 and £60 per tonne of CO2 captured, transported and stored. This is between about 2 and 4 times the current traded price of a tonne of CO2 in the EU Emissions Trading Scheme. In addition to the technical and economic requirements of the CCS technology, it should also be socially and environmentally acceptable. Our research has shown that, given an acceptance of the severity and urgency of addressing climate change, CCS is viewed favourably by members of the public, provided it is adopted within a portfolio of other measures. The most commonly voiced concern from the public is that of leakage and this remains perhaps the greatest uncertainty with CCS. It is not possible to make general statements concerning storage security; assessments must be site specific. The impacts of any potential leakage are also somewhat uncertain but should be balanced against the deleterious effects of increased acidification in the oceans due to uptake of elevated atmospheric CO2 that have already been observed. Provided adequate long term monitoring can be ensured, any leakage of CO2 from a storage site is likely to have minimal localised impacts as long as leaks are rapidly repaired. A regulatory framework for CCS will need to include risk assessment of potential environmental and health and safety impacts, accounting and monitoring and liability for the long term. In summary, although there remain uncertainties to be resolved through research and demonstration projects, our assessment demonstrates that CCS holds great potential for significant cuts in CO2 emissions as we develop long term alternatives to fossil fuel use. CCS can contribute to reducing emissions of CO2 into the atmosphere in the near term (i.e. peak-shaving the future atmospheric concentration of CO2), with the potential to continue to deliver significant CO2 reductions over the long term.

Temperature and the development rates of thrips: evidence for a constraint on local adaptation?

Typically, the relationship between insect development and temperature is described by two characteristics: the minimum temperature needed for development to occur (T-min) and the number of day degrees required (DDR) for the completion of development. We investigated these characteristics in three English populations of Thrips major and T tabaci [Cawood, Yorkshire (N53degrees49', W1degrees7'); Boxworth, Cambridgeshire (N52degrees15', W0degrees1'); Silwood Park, Berkshire (N51degrees24', W0degrees38')], and two populations of Frankliniella occidentalis (Cawood; Silwood Park). While there were no significant differences among populations in either T-min (mean for T major = 7.0degreesC; T tabaci = 5.9degreesC; F. occidentalis = 6.7degreesC) or DDR (mean for T major = 229.9; T tabaci = 260.8; F occidentalis = 233.4), there were significant differences in the relationship between temperature and body size, suggesting the presence of geographic variation in this trait. Using published data, in addition to those newly collected, we found a negative relationship between T-min. and DDR for F occidentalis and T tabaci, supporting the hypothesis that a trade-off between T-min and DDR may constrain adaptation to local climatic conditions.