Ultrasonographic study and Doppler flow velocimetry of maternal kidneys and liver in low-risk pregnancy

AbstractObjective:Longitudinal study with B-mode ultrasonography and Doppler ultrasonography of maternal kidneys and liver in low-risk pregnancy, to establish and quantify normality parameters, correlating them with physiological changes.Materials and Methods:Twenty-five pregnant women were assessed and selected to participate in the study, each of them undergoing four examinations at the first, second, third trimesters and postpartum.Results:Findings during pregnancy were the following: increased renal volume, pyelocaliceal dilatation with incidence of 45.4% in the right kidney, and 9% in the left kidney; nephrolithiasis, 18.1% in the right kidney, 13.6% in the left kidney. With pyelocaliceal dilatation, mean values for resistivity index were: 0.68 for renal arteries; 0.66 for segmental arteries; 0.64 for interlobar arteries; 0.64 for arcuate arteries. Without pyelocaliceal dilatation, 0.67 for renal arteries; 0.64 for segmental arteries; 0.63 for interlobar arteries; and 0.61 for arcuate arteries. Portal vein flow velocities presented higher values in pregnancy, with mean value for maximum velocity of 28.9 cm/s, and 22.6 cm/s postpartum. The waveform pattern of the right hepatic vein presented changes persisting in the postpartum period in 31.8% of the patients. Cholelithiasis was observed in 18.1% of the patients.Conclusion:Alterations in renal volume, pyelocaliceal dilatation, nephrolithiasis, cholelithiasis, changes in portal vein flow velocity, alterations in waveform pattern of the right hepatic vein, proved to be significant.

Aetiologies of pulseless electrical activity in out-of-hospital cardiac arrests:A retrospective study and analysis of specific causes

Background: Pulseless electrical activity (PEA) cardiac arrest is defined as a cardiac arrest (CA) presenting with a residual organized electrical activity on the electrocardiogram. In the last decades, the incidence of PEA has regularly increased, compared to other types of CA like ventricular fibrillation or pulseless ventricular tachycardia. PEA is frequently induced by reversible conditions. The "4 (or 5) H" & "4 (or 5) T" are proposed as a mnemonic to asses for Hypoxia, Hypovolemia, Hypo- /Hyperkalaemia, Hypothermia, Thrombosis (cardiac or pulmonary), cardiac Tamponade, Toxins, and Tension pneumothorax. Other pathologies (intracranial haemorrhage, severe sepsis, myocardial contraction dysfunction) have been identified as potential causes for PEA, but their respective probability and frequencies are unclear and they are not yet included into the resuscitation guidelines. The aim of this study was to analyse the aetiologies of PEA out-of-hospital CA, in order to evaluate the relative frequencies of each cause and therefore to improve the management of patients suffering a PEA cardiac arrest. Method: This retrospective study was based on data routinely and prospectively collected for each PEMS intervention. All adult patients treated from January 1st 2002 to December 2012 31st by the PEMS for out-of-hospital cardiac arrest, with PEA as the first recorded rhythm, and admitted to the emergency department (ED) of the Lausanne University Hospital were included. The aetiologies of PEA cardiac arrest were classified into subgroups, based on the classical H&T's classification, supplemented by four other subgroups analysis: trauma, intra-cranial haemorrhage (ICH), non-ischemic cardiomyopathy (NIC) and undetermined cause. Results: 1866 OHCA were treated by the PEMS. PEA was the first recorded rhythm in 240 adult patients (13.8 %). After exclusion of 96 patients, 144 patients with a PEA cardiac arrest admitted to the ED were included in the analysis. The mean age was 63.8 ± 20.0 years, 58.3% were men and the survival rate at 48 hours was 29%. 32 different causes of OHCA PEA were established for 119 patients. For 25 patients (17.4 %), we were unable to attribute a specific cause for the PEA cardiac arrest. Hypoxia (23.6 %), acute coronary syndrome (12.5%) and trauma (12.5 %) were the three most frequent causes. Pulmonary embolism, Hypovolemia, Intoxication and Hyperkaliemia occurs in less than 10% of the cases (7.6 %, 5.6 %, 3.5%, respectively 2.1 %). Non ischemic cardiomyopathy and intra-cranial haemorrhage occur in 8.3 % and 6.9 %, respectively. Conclusions: According to our results, intra-cranial haemorrhage and non-ischemic cardiomyopathy represent noticeable causes of PEA in OHCA, with a prevalence equalling or exceeding the frequency of classical 4 H's and 4 T's aetiologies. These two pathologies are potentially accessible to simple diagnostic procedures (native CT-scan or echocardiography) and should be included into the 4 H's and 4 T's mnemonic.

Online Learning and Teaching in Higher Education, a book review

Peer-reviewed

Combining Generic Programming and Service-Oriented Architectures for the Effective and Timely Development of Complex e-Learning Systems

Peer-reviewed

An Experimental Study on Peer Selection in a P2P Network over PlanetLab

Peer-reviewed

La Enseñanza de los sistemas externos de representación matemáticos y lingüísticos en la educación infantil

El objetivo de este estudio es identificar factores que contribuyen a mantener un enfoque básicamente instrumental para enseñar los sistemas externos de representación matemáticos y lingüísticos en las primeras edades de escolarización. En el estudio han participado 123 maestros de Educación Infantil de diversos centros escolares públicos de Andalucía, Asturias, Cataluña y Navarra que han asistido a cursos de formación permanente del profesorado. El análisis cualitativo realizado se basa en grupos de discusión a partir de tópicos. Los resultados evidencian la influencia de diversos factores: el currículo de Educación Infantil; las concepciones del profesorado; las presiones entre etapas educativas; y, finalmente, la presión social. La identificación de los factores asociados a una enseñanza instrumental de los sistemas externos de representación puede entenderse como un tipo de información relevante acerca de las condiciones de la enseñanza de estos sistemas que, además, pueden servir de base para reconstruir las prácticas educativas

Feasibility Study and Market Review of Small Scale Bioenergy Heating Plants in North-West Russia

The paper is focused on feasibility study and market review of small scale bioenergy heating plants in the Russian North-West region. The main focus is effective and competitive usage of low-grade wood for heating purposes in the region. As example of economical feasibility estimation it was chosen the project of reconstruction of small scale boiler plant in Leningrad region that Brofta Oy is planning to implement the nearest time. It includes calculation the payback time with and without interest, the estimation of probable investments, the evaluation of possible risks and research on the potential of small scale heating plants projects. Calculations show that the profitability of this kind of projects is high, but payback time is not very short, because of high level of initial investments. Though, the development of small scale bioenergy heating plants in the region is considered to be the best way to solve the problems of heat supply in small settlements using own biomass resources.

Kandinsky y Mondrian: Un pretexto para trabajar la pluralidad estética

A lo largo del tiempo el hombre ha tenido la necesidad de crear obras artísticas que han sido el resultado del contexto social imperante, ya que mediante el artista y la forma de expresar sus sentimientos y sus ideas, se transmiten valores morales

Study and modeling of the desintegration kinetics of coated paper

The disintegration of recovered paper is the first operation in the preparation of recycled pulp. It is known that the defibering process follows a first order kinetics from which it is possible to obtain the disintegration kinetic constant (KD) by means of different ways. The disintegration constant can be obtained from the Somerville index results (%lsv and from the dissipated energy per volume unit (Ss). The %slv is related to the quantity of non-defibrated paper, as a measure of the non-disintegrated fiber residual (percentage of flakes), which is expressed in disintegration time units. In this work, disintegration kinetics from recycled coated paper has been evaluated, working at 20 revise rotor speed and for different fiber consistency (6, 8, 10, 12 and 14%). The results showed that the values of experimental disintegration kinetic constant, Ko, through the analysis of Somerville index, as function of time. Increased, the disintegration time was drastically reduced. The calculation of the disintegration kinetic constant (modelled Ko), extracted from the Rayleigh’s dissipation function, showed a good correlation with the experimental values using the evolution of the Somerville index or with the dissipated energy

Simulando catástrofes : recursos para la enseñanza de los riesgos naturales

Los riesgos naturales son abordados por distintas asignaturas de ciencias naturalesa lo largo de la ESO y el bachillerato. Su tratamiento en el aula es una evidencia del interés y el carácter aplicado de muchos aspectos de las ciencias de la tierra. Para facilitar su enfoque didáctico se proponen algunas actividades prácticas

La diversidad cultural y la cooperación en el centro educativo

Artículo que se propone mostrar la experiencia vivida con todo un colectivo femenino de una misma escuela (alumnas, madres y profesoras), que ha permitido mejorar la autoestima y la integración social de un grupo de mujeres inmigrantes. La finalidad de esta intervención es ayudar a despertar el interés de las madres inmigrantes por el saber, como un bien con el que favorecer su dignidad personal y llegar a participar activamente en la sociedad

Coneixement lingüístic i matemàtic d'escolars de nivel sociocultural baix en programes d'immersió = Linguistic and mathematic knowledge in pupils of low sociocultural level in immersiom programmes

This piece of research compares knowledge of Catalan, Castilian and mathematics, as well as the attitudes to these two languages, of a sample of non-Catalan speaking pupils of low sociocultural level in their fourth year of primary school. Some of the pupils had followed an immersion programme in Catalan, whereas others had approached Catalan through their habitual language (Castilian). The findings show that not only did the immersion pupils obtain significantly better results in L2 (Catalan), but their mother tongue (Castilian) competence was undiminished and their performance on the mathematics test was superior to that of the other group. Moreover, the findings indicate that in pupils starting out from less favourable conditions (a low sociocultural level and a low I.Q.) the effect of the educational approach variable is greater than in other cases

'L’escriptura del jo', una proposta d’educació intercultural i tractament de la diversitat per a l’ensenyament secundari obligatori = The writing of I, an intercultural educational proposal and treatment of diversity for Compulsory Secondary Education

The writing of I is a project that starts an itinerary through past, present and future experiences of each of our students based on following research activities. Reading, creation and recreation of text and other items that turn essentially around autobiographical writing and culminate with the elaboration of a free autobiography

Escacs: un recurs educatiu per ajudar a millorar aprenentatges i conductes

En aquest número, com en el passat, publiquem un proposta didàctica al voltant dels escacs. L’article que us presentem justifica i emmarca aquestes propostes. Les directrius del Parlament de Catalunya i del mateix Parlament Europeu fan que s’iniciï una recerca educativa que evidenciï els avantatges del treball dels escacs a l’aula a nivell cognitiu i social i es converteixi en un programa educatiu institucional que s’està desenvolupant a Catalunya

Matemàtiques per a l'escola o per a la vida?: cap a l'alfabetisme matemàtic a l'educació primària

En aquest article, s’hi planteja que, en els darrers temps, s’ha vist la necessitat de preparar l’alumnat no només per dominar els continguts matemàtics, sinó especialment per poder-los usar de manera comprensiva en diferents contextos de rellevància social. S’hi argumenta que els processos matemàtics són les eines que ens proporcionen les matemàtiques per aprendre a usar els continguts i s’hi presenta una proposta que pretén orientar sobre com els podem treballar a l’educació primària