Incidencia de fibrilación auricular en las primeras 72 horas del post operatorio de revascularización miocárdica

Determinar la incidencia de fibrilación auricular en las primeras 72 horas del post operatorio en pacientes llevados a revascularización miocárdica utilizando dos técnicas de anestésia una convencional (AC) con anestésicos inhalados y opioides y otra con dexmedetomidina (AD.). cohorte retrospectivo, en donde se seleccionarán dos grupos de estudio, un grupo de expuestos, pacientes llevados a revascularización miocárdica con utilización técnica anestésica convencional y un grupo de no expuestos pacientes llevados a revascularización miocárdica con uso de dexmedetomidina como técnica de anestesia; A estos grupos se les hizo seguimiento por 72 horas para determinar la presencia de fibrilación auricular y la terapéutica instaurada.

Identificación y descripción de las características de un líder global

El liderazgo ha sido definido de diferentes maneras por cientos de autores debido al contexto en el que estudian este concepto. Ninguna de estas definiciones es errónea pero algunas han tomado mayor importancia debido a los diferentes factores que enfrenta la sociedad. Desde hace unos años los países se han abierto a diferentes mercados lo cual les ha permitido eliminar las barreras políticas, económicas y culturales existentes. Esto ha llevado a que los líderes deban evaluar la nueva forma de dirigir y direccionar las organizaciones. Este es tan solo uno de los ejemplos que han llevado a modificar el concepto de liderazgo, añadiendo los nuevos retos a los que se ven enfrentados los líderes. En este trabajo de grado se estudia el que se considera uno de los mayores retos de los siglos XX y XXI: la globalización. Este fenómeno ha acercado al mundo a través del intercambio de información, de bienes, de servicios, de conocimientos y sobre todo de cultura. Esto se ha logrado a través de nuevas tecnologías, nuevos servicios de comunicación y transporte, de la ciencia y los avances de la industria. El nuevo líder debe romper la barrera nacional y abrirse a mercados extranjeros, para esto debe contar con ciertas características que le permitirán entender los diferentes mercados y a las personas que se encuentran en este. En este trabajo se identifican las que se consideran las principales características de un líder global; estas son el resultado de la investigación de diferentes autores y estudios.

Música y sociedad: Traslaciones, legitimaciones e identificaciones

Este libro apunta a impulsar estudios sociomusicales y la participación en la comunidad académica internacional que trabaja estos campos. Temáticas y enfoques de los artículos muestran la multiplicidad de esta investigación sobre música y sociedad. Están investigadores de trayectoria como Carlos Miñana sobre músicas indígenas andinas e historiografía del folclor, o Adolfo González y Jorge Nieves sobre música y cultura popular en la región del Caribe. Profesores que han estado configurando sus publicaciones y líneas de investigación como Hugues Sánchez sobre historia musical en el Magdalena Grande o Beatriz Goubert sobre hibridaciones y pedagogías musicales. Michael Birenbaum en su tesis doctoral se ocupa de las intersecciones entre política y música en el Pacífico. Investigadoras que abren nuevos campos como Alejandra Isaza sobre música colonial en Medellín, Alexandra Quintana sobre discriminación de género y mujeres músicas en los festivales de gaitas y Lorena Aja sobre tensiones de la intercuturalidad de las músicas en San Andrés.

Pensamiento complejo y competencias en la formación universitaria : experiencias de innovación en docencia en la Universidad del Rosario

La realidad contemporánea impone nuevos retos al rol de la universidad en la sociedad, y en particular a su función en la formación profesional. Por esta razón, en los escenarios actuales, se hace necesaria la incorporación de estrategias innovadoras que fomenten el desarrollo de pensamiento complejo y competencias profesionales y ciudadanas en los estudiantes universitarios. El libro Pensamiento complejo y competencias en la formación universitaria presenta seis prácticas innovadoras en la Universidad del Rosario en las áreas de las ciencias económicas y administrativas, las relaciones internacionales, la jurisprudencia, las ciencias del lenguaje y las ciencias de la salud. Cada una de estas experiencias nace de las necesidades reales a las que se enfrentan los profesores universitarios hoy en día. También se constituye en un esfuerzo conjunto de un grupo multidisciplinar de profesores por reflexionar sobre las implicaciones de sus prácticas pedagógicas y documentar sus experiencias durante dos años de trabajo compartido, tiempo en el que participaron en el Proyecto INNOVA CESAL, cofinanciado por ALFA III de la Unión Europea.

Eficacia de la estimulación magnética transcraneal en la disminución de severidad en el trastorno depresivo mayor en monoterapia y coadyuvante comparado con tratamientos farmacológicos. Revisión sistemática y meta-análisis

Resumen Introducción Una posible opción de tratamiento para el manejo del trastorno depresivo mayor (TDM) es la estimulación magnética transcraneal (EMT) que ha mostrado propiedades antidepresivas superiores al placebo con un buen perfil de seguridad. El objetivo del presente trabajo es determinar la reducción en la severidad del TDM y la proporción de eventos adversos (EA) en pacientes con TDM refractario y no refractario, posterior al uso de EMT administrada en monoterapia o tratamiento coadyuvante comparado con terapia farmacológica. Metodología Se planteó una pregunta PICOT de la cual se realizó una búsqueda sistemática de estudios clínicos en las bases de datos Medline, EMBASE y Cochrane. Dos investigadores en forma independiente realizaron la selección de artículos, evaluación de calidad con la herramienta de la colaboración Cochrane y extracción de datos. Se extrajeron datos de eficacia como tasa de respuesta, porcentaje de remisión, calidad de vida, diminución sintomática del trastorno depresivo mayor en la escala de Hamilton y capacidad funcional. Igualmente, proporción de pacientes con EA. Se realizó un meta-análisis de estas variables teniendo en cuenta la heterogeneidad. Resultados La presente revisión sistemática incluyó 26 estudios clínicos aleatorizados de baja calidad metodológica mostrando que la EMT presentó una eficacia superior cuando es usada como coadyuvante a las terapias con que venían siendo tratados los pacientes con TDM refractario y no refractario en los desenlaces de tasa de respuesta y porcentaje de remisión. En el caso de intervenciones farmacológicas específicas, la EMT presento eficacia similar, tanto en terapia coadyuvante como en monoterapia comparado con las intervenciones farmacológicas. En cuanto a seguridad, la EMT presenta un buen perfil de seguridad debido a que en todos los escenarios estudiados los EA fueron no serios y baja frecuencia Conclusiones La evidencia disponible sugiere que la EMT mostró ser efectivo y seguro para el manejo del TDM refractario y no refractario. Sin embargo, la evidencia es débil por lo tanto se necesita mayor investigación clínica que soporte su uso.

Anestesia regional y periférica guiada por ultrasonido en el paciente critico

El presente trabajo es un capítulo de libro titulado “Anestesia Regional y Periférica Guiada por Ultrasonido en el Paciente Crítico” que será incluido en la última edición del libro “Manual de Ultrasonido en Terapia Intensiva y Emergencias” cuyo editor es el Doctor José de Jesús Rincón Salas y que será publicado por la Editorial Prado de México para distribución latinoamericana desde dicho país. Por solicitud del editor y teniendo en cuenta el enfoque del libro, el presente trabajo está dirigido a estudiantes de formación, médicos graduados y especialistas en las áreas de cuidado intensivo, anestesiología, dolor, medicina interna y medicina de urgencias. Tiene como propósito empapar de conocimientos necesarios y prácticos en anestesia regional a personas que usualmente no han tenido contacto con la anestesia regional, pues desafortunadamente sólo en los últimos años ha sido posible que la anestesia regional haya comenzado a salir de las salas de cirugía, ámbito donde ha estado confinada tradicionalmente. El lenguaje utilizado es sencillo y el capítulo ha sido escrito para que sea fácil de leer y consultar, dejando así mensajes muy claros sobre la utilidad, viabilidad e implicaciones que tiene el uso de anestesia regional guiada por ultrasonido en cuidado intensivo. Los autores esperamos que de esta manera, el presente capítulo permita continuar superando los obstáculos que se interponen entre los invaluables beneficios de la anestesia regional y los pacientes de cuidado intensivo que necesitan de ella.

Eficácia da Terapia Combinada com Cefquinoma no Tratamento de Mastite Bovina

A Mastite é a afeção mais comum do úbere e consiste na reação inflamatória dos tecidos secretores da glândula mamária, como resposta a lesões traumáticas, infeções bacterianas e fúngicas. É uma das doenças mais observadas em explorações leiteiras, com grande impacto e perdas a nível económico. O objetivo do presente estudo foi a análise da eficácia da utilização de uma terapia combinada com Cefquinoma para o tratamento de mastites, comparando a terapêutica de Cefquinoma e outra terapêutica alternativa, o tempo de tratamento aplicado e a evolução do caso clínico. O estudo foi realizado num total de 80 vacas com mastite clínica em 3 explorações na área de grande Lisboa, tendo sido registados e analisados, para cada caso, qual o tratamento usado (a terapia combinada com Cefquinoma ou a terapêutica protocolar estabelecida pela exploração), o tempo de tratamento e a sua evolução clínica (se obteve cura, morte, refugo ou perda de ¼ mamário). O estudo da eficácia da terapia combinada com Cefquinoma pretende contribuir para um melhor conhecimento da eficácia das terapias existentes como coadjuvantes da melhoria da rentabilidade das explorações leiteiras. Os resultados obtidos permitem estabelecer uma relação positiva entre a taxa de cura e a terapêutica usada.

Priming and re-drying improve the survival of mature seeds of Digitalis purpurea during storage

Most priming studies have been conducted on commercial seed lots of unspecified uniformity and maturity, and subsequent seed longevity has been reported to both increase and decrease. Here a seed lot of Digitalis purpurea L. with relatively uniform maturity and known history was used to analyse the effects of priming on seed longevity in air-dry storage. Seeds collected close to natural dispersal and dried at 15 % relative humidity (RH), 15 degrees C, were placed into experimental storage (60 % RH, 45 degrees C) for 14 or 28 d, primed for 48 h at 0, -1, -2, -5, -10 or -15 MPa, re-equilibrated (47 % RH, 20 degrees C) and then returned to storage. Further seed samples were primed for 2 or 48 h at -1 MPa and either dried at 15 % RH, 15 degrees C or immediately re-equilibrated for experimental storage. Finally, some seeds were given up to three cycles of experimental storage and priming (48 h at -1 MPa). Priming at -1 MPa had a variable effect on subsequent survival during experimental storage. The shortest lived seeds in the control population showed slightly increased life spans; the longer lived seeds showed reduced life spans. In contrast, seeds first stored for 14 or 28 d before priming had substantially increased life spans. The increase tended to be greatest in the shortest lived fraction of the seed population. Both the period of rehydration and the subsequent drying conditions had significant effects on longevity. Interrupting air-dry storage with additional cycles of priming also increased longevity. The extent of prior deterioration and the post-priming desiccation environment affect the benefits of priming to the subsequent survival of mature seeds. Rehydration-dehydration treatments may have potential as an adjunct or alternative to the regeneration of seed accessions maintained in gene banks for plant biodiversity conservation or plant breeding.

Effect of hyaluronidase on ocular motility and eyelid function in sub-Tenon's anaesthesia: randomised controlled trial

Purpose: To assess the effect of hyaluronidase on eye and eyelid movements when used as an adjunct in sub-Tenon's anaesthesia. Methods: A total of 60 patients who had sub-Tenon's anaesthesia prior to phacoemulsification surgery were divided into two equal groups in a double-masked randomised controlled fashion. Of these, Group A had 4 ml lignocaine 2%, while Group B had 4ml lignocaine 2% with the addition of sodium hyaluronidase 75 IU/ml. Ocular motility, levator, and orbicularis oculi function were measured in all patients at 5 and 8 min. Levator function was scored from 0 (no function) to 3 (complete function) while orbicularis function was scored from 0 to 2. The score for ocular motility was the sum in four positions of gaze, each position scoring from 0 to 2. Results were compared using a nonparametric test. Results Group B achieved significantly better ocular and lid akinesia than Group A both at 5 and 8 min with P < 0.01. The median scores for levator function at 5 and 8 min were 2 for Group A and 0 for Group B. For orbicularis function, the median scores at both time intervals were 2 for Group A and 1 for Group B. For ocular motility, the median score for Group A at 5 min was 3 and at 8 min was 2.5; for Group B at 5 min was 0.5 and at 8 min was 0. Conclusions: The addition of hyaluronidase in sub-Tenon's anaesthesia has a significant effect in improving ocular and lid (levator and orbicularis) akinesia.

The role of drama in the teaching of speaking and listening as the basis for social capital

This paper explores how the concept of 'social capital' relates to the teaching of speaking and listening. The argument draws on Bourdieu's notion that a common language is an illusion but posits that an understanding of the grammar of speech can be productive in the development of both an understanding of what constitutes effective speech and the development of competence in speaking. It is argued that applying structuralist notions of written grammar is an inadequate approach to understanding speech acts or enhancing the creative use of speech. An analysis is made of how typical features of speech relate to dramatic dialogue and how the meaning of what is said is contingent upon aural and visual signifiers. On this basis a competent speaker is seen as being one who produces expressions appropriate for a range of situations by intentionally employing such signifiers. The paper draws on research into the way drama teachers make explicit reference to and use of semiotics and dramatic effectiveness in order to improve students' performance and by so doing empower them to increase their social capital. Ultimately, it is concluded that helping students identify, analyse and employ the aural, visual and verbal grammar of spoken English is not an adjunct to the subject of drama, but an intrinsic part of understanding the art form. What is called for is a re-appraisal by drama teachers of their own understanding of concepts relating to speech acts in order to enhance this area of their work.

Protease, peptidase and esterase activities by lactobacilli and yeast isolates from Feta cheese brine

Aims: The study of peptidase, esterase and caseinolytic activity of Lactobacillus paracasei subsp. paracasei, Debaryomyces hansenii and Sacchromyces cerevisiae isolates from Feta cheese brine. Methods and Results: Cell-free extracts from four strains of Lact. paracasei subsp. paracasei, four strains of D. hansenii and three strains of S. cerevisiae, isolated from Feta cheese brine were tested for their proteolytic and esterase enzyme activities. Lactobacillus paracasei subsp. paracasei strains had intracellular aminopeptidase, dipeptidyl aminopeptidase, dipeptidase, endopeptidase and carboxypeptidase activities. Esterases were detected in three of four strains of lactobacilli and their activities were smaller with higher molecular weight fatty acids. The strains of yeasts did not exhibit endopeptidase as well as dipeptidase activities except on Pro-Leu. Their intracellular proteolytic activity was higher than that of lactobacilli. Esterases from yeasts preferentially degraded short chain fatty acids. Lactobacilli degraded preferentially beta-casein. Caseinolytic activity of yeasts was higher than that of lactobacilli. Conclusions: The results suggest that Lact. paracasei subsp. paracasei and yeasts may contribute to the development of flavour in Feta cheese. Significance and impact of the Study: Selected strains could be used as adjunct starters to make high quality Feta cheese.

Characterisation of soils containing naturally occurring radioactive material (NORM) using in situ and rapid laboratory techniques. Case study: South Terras, Cornwall

In situ analysis has become increasingly important for contaminated land investigation and remediation. At present, portable techniques are used mainly as scanning tools to assess the spread and magnitude of the contamination, and are an adjunct to conventional laboratory analyses. A site in Cornwall, containing naturally occurring radioactive material (NORM), provided an opportunity for Reading University PhD student Anna Kutner to compare analytical data collected in situ with data generated by laboratory-based methods. The preliminary results in this paper extend the author‟s poster presentation at last September‟s GeoSpec2010 conference held in Lancaster.

Designing and implementing livestock value chain studies: a practical aid for Highly Pathogenic and Emerging Disease (HPED) control

Value chain studies, including production system and market chain studies, are essential to value chain analysis, which when coupled with disease risk analysis is a powerful tool to identify key constraints and opportunities for disease control based on risk management in a livestock production and marketing system. Several production system and market chain studies have been conducted to support disease control interventions in South East Asia. This practical aid summarizes experiences and lessons learned from the implementation of such value chain studies in South East Asia. Based on these experiences it prioritizes the required data for the respective purpose of a value chain study and recommends data collection as well as data analysis tools. This practical aid is intended as an adjunct to the FAO value chain approach and animal diseases risk management guidelines document. Further practical advice is provided for more effective use of value chain studies in South and South East Asia as part of animal health decision support.

Taking the shopping centre online: new models in e-commerce

Purpose – This paper aims to provide a brief re´sume´ of previous research which has analysed the impact of e-commerce on retail real estate in the UK, and to examine the important marketing role of the internet for shopping centre managers, and retail landlords. Design/methodology/approach – Based on the results from a wider study carried out in 2003, the paper uses case studies from two different shopping centres in the UK, and documents the innovative uses of both web-based marketing and online retailing by organisations that historically have not directly been involved in the retailing process. Findings – The paper highlights the importance of considering online sales within a multi-channel approach to retailing. The two types of emerging shopping centre model which are identified are characterised by their ultimate relationship with the physical shopping centre on whose web site they reside. These can be summarised as: the “centre-led” approach, and the “brand-led” or “marketing-led” approach. Research limitations/implications – The research is based on a limited number of in-depth case studies and secondary data. Further research is needed to monitor the continuing impact of e-commerce on retail property and the marketing strategies of shopping centre managers and owners. Practical implications – Internet-based sales provide an important adjunct to conventional retail sales and an important source of potential risk for landlords and tenants in the real estate investment market. Regardless of whether retailers use the internet as a sales channel, as a product-sourcing tool, or merely to provide information to the consumer, the internet has become a keystone within the greater retail marketing mix. The findings have ramifications for understanding the way in which landlords are structuring their retail property to defray potential risks. Originality/value – The paper examines shopping centre online marketing models for the first time in detail, and will be of value to retail occupiers, owners and other stakeholders of shopping centres.

Ecophysiological and bioclimatic foundations for a global plant functional classification

Question: What plant properties might define plant functional types (PFTs) for the analysis of global vegetation responses to climate change, and what aspects of the physical environment might be expected to predict the distributions of PFTs? Methods: We review principles to explain the distribution of key plant traits as a function of bioclimatic variables. We focus on those whole-plant and leaf traits that are commonly used to define biomes and PFTs in global maps and models. Results: Raunkiær's plant life forms (underlying most later classifications) describe different adaptive strategies for surviving low temperature or drought, while satisfying requirements for reproduction and growth. Simple conceptual models and published observations are used to quantify the adaptive significance of leaf size for temperature regulation, leaf consistency for maintaining transpiration under drought, and phenology for the optimization of annual carbon balance. A new compilation of experimental data supports the functional definition of tropical, warm-temperate, temperate and boreal phanerophytes based on mechanisms for withstanding low temperature extremes. Chilling requirements are less well quantified, but are a necessary adjunct to cold tolerance. Functional traits generally confer both advantages and restrictions; the existence of trade-offs contributes to the diversity of plants along bioclimatic gradients. Conclusions: Quantitative analysis of plant trait distributions against bioclimatic variables is becoming possible; this opens up new opportunities for PFT classification. A PFT classification based on bioclimatic responses will need to be enhanced by information on traits related to competition, successional dynamics and disturbance.