Nova realitat. Cicles Formatius de Grau Superior i universitat

Podeu consultar la Setena trobada de professorat de Ciències de la Salut completa a: http://hdl.handle.net/2445/43352

Nova realitat. Cicles Formatius de Grau Superior i universitat

Podeu consultar la Setena trobada de professorat de Ciències de la Salut completa a: http://hdl.handle.net/2445/43352

Superior pedicle breast reduction for hypertrophy with massive ptosis.

Breast hypertrophy, combined with massive ptosis with a suprasternal notch-to-nipple distance of more than 40 cm, remains an endeavour. Different refinements of the initial technique with free nipple grafts have been described to circumvent the problems of nipple underprojection, areolar hypopigmentation and loss of sensibility secondary to nipple grafting, as well as lacking breast projection due to scarce glandular tissue. Techniques relying on nipple areola complex transposition, rather than grafting, have been described with inferior, superomedial and medial pedicles. The aim of this study is to present the results obtained in a series of 10 patients suffering from bilateral breast hypertrophy with massive ptosis, which was defined as a distance >40 cm from the suprasternal notch-to the nipple. All breasts were managed with a superior pedicle and inverted T technique. The mean preoperative suprasternal notch-to-nipple distance was 44 ± 2 cm, and the resection weight ranged from 800 to 2490 g per breast with an average of about 1450 g in this patient population presenting with overweight or obesity. With a mean nipple areola complex (NAC) lift of 20 ± 3 cm, neither nipple nor areola necrosis was observed. One partial epidermolysis of the areola and two cases of delayed wound healing at the trifurcation point of the inverted T were conservatively managed. Only one re-operation was necessary for an important wound dehiscence of the lateral part of the horizontal scar. These results underscore the safety of the superior pedicle technique in cases of massive ptosis with transposition of the NAC of approximately 20 cm, that is, a pedicle length of about 25 cm.

Persistent left superior vena cava in cardiac congenital surgery.

Persistent left superior vena cava (LSVC) is a relatively frequent finding in congenital cardiac malformation. The scope of the study was to analyze the timing of diagnosis of persistent LSVC, the timing of diagnosis of associated anomalies of the coronary sinus, and the global impact on morbidity and mortality of persistent LSVC in children with congenital heart disease after cardiac surgery. Retrospective analysis of a cohort of children after cardiac surgery on bypass for congenital heart disease. Three hundred seventy-one patients were included in the study, and their median age was 2.75 years (IQR 0.65-6.63). Forty-seven children had persistent LSVC (12.7 %), and persistent LSVC was identified on echocardiography before surgery in 39 patients (83 %). In three patients (6.4 %) with persistent LSVC, significant inflow obstruction of the left ventricle developed after surgery leading to low output syndrome or secondary pulmonary hypertension. In eight patients (17 %), persistent LSVC was associated with a partially or completely unroofed coronary sinus and in two cases (4 %) with coronary sinus ostial atresia. Duration of mechanical ventilation was significantly shorter in the control group (1.2 vs. 3.0 days, p = 0.04), whereas length of stay in intensive care did not differ. Mortality was also significantly lower in the control group (2.5 vs. 10.6 %, p = 0.004). The results of study show that persistent LSVC in association with congenital cardiac malformation increases the risk of mortality in children with cardiac surgery on cardiopulmonary bypass. Recognition of a persistent LSVC and its associated anomalies is mandatory to avoid complications during or after cardiac surgery.

Superior flow for bridge to life with self-expanding venous cannulas.

BACKGROUND: Recently, a compact cardiopulmonary support (CPS) system designed for quick set-up for example, during emergency cannulation, has been introduced. Traditional rectilinear percutaneous cannulas are standard for remote vascular access with the original design. The present study was designed to assess the potential of performance increase by the introduction of next-generation, self-expanding venous cannulas, which can take advantage of the luminal width of the venous vasculature despite a relatively small access orifice. METHODS: Veno-arterial bypass was established in three bovine experiments (69+/-10 kg). The Lifebridge (Lifebridge GmbH, Munich, Germany) system was connected to the right atrium in a trans-jugular fashion with various venous cannulas; and the oxygenated blood was returned through the carotid artery with a 17 F percutaneous cannula. Two different venous cannulas were studied, and the correlation between the centrifugal pump speed (1500-3900 RPM), flow and the required negative pressure on the venous side was established: (A) Biomedicus 19 F (Medtronic, Tolochenaz, Switzerland); (B) Smart canula 18 F/36 F (Smartcanula LLC, Lausanne, Switzerland). RESULTS: At 1500 RPM, the blood flow was 0.44+/-0.26 l min(-1) for the 19 F rectilinear cannula versus 0.73+/-0.34 l min(-1) for the 18/36 F self-expanding cannula. At 2500 RPM the blood flow was 1.63+/-0.62 l min(-1) for the 19F rectilinear cannula versus 2.13+/-0.34 l min(-1) for the 18/36 F self-expanding cannula. At 3500 RPM, the blood flow was 2.78+/-0.47 l min(-1) for the 19 F rectilinear cannula versus 3.64+/-0.39 l min(-1) for the 18/36 F self-expanding cannula (p<0.01 for 18/36 F vs 19 F). At 1500 RPM, the venous line pressure was 18+/-8 mmHg for the 19F rectilinear cannula versus 19+/-5 mmHg for the 18/36 F self-expanding cannula. At 2500 RPM the venous line pressure accounted for -22+/-32 mmHg for the 19 F rectilinear cannula versus 2+/-5 mmHg for the 18/36 F self-expanding cannula. At 3500 RPM, the venous line pressure was -112+/-42 mmHg for the rectilinear cannula versus 28+/-7 mmHg for the 18/36 F self-expanding cannula (p<0.01 for 18 F/36 F vs 19 F). Conclusions: The negative pressure required to achieve adequate venous drainage with the self-expanding venous cannula accounts for approximately 31% of the pressure necessary with the 19 F rectilinear cannula. In addition, a pump flow of more than 4 l min(-1) can be achieved with the self-expanding design and a well-accepted negative inlet pressure for minimal blood trauma of less than 50 mmHg.

Superior diagnostic performance of perfusion-cardiovascular magnetic resonance versus SPECT to detect coronary artery disease: The secondary endpoints of the multicenter multivendor MR-IMPACT II (Magnetic Resonance Imaging for Myocardial Perfusion Assessment in Coronary Artery Disease Trial).

ABSTRACT: BACKGROUND: Perfusion-cardiovascular magnetic resonance (CMR) is generally accepted as an alternative to SPECT to assess myocardial ischemia non-invasively. However its performance vs gated-SPECT and in sub-populations is not fully established. The goal was to compare in a multicenter setting the diagnostic performance of perfusion-CMR and gated-SPECT for the detection of CAD in various populations using conventional x-ray coronary angiography (CXA) as the standard of reference. METHODS: In 33 centers (in US and Europe) 533 patients, eligible for CXA or SPECT, were enrolled in this multivendor trial. SPECT and CXA were performed within 4 weeks before or after CMR in all patients. Prevalence of CAD in the sample was 49% and 515 patients received MR contrast medium. Drop-out rates for CMR and SPECT were 5.6% and 3.7%, respectively (ns). The study was powered for the primary endpoint of non-inferiority of CMR vs SPECT for both, sensitivity and specificity for the detection of CAD (using a single-threshold reading), the results for the primary endpoint were reported elsewhere. In this article secondary endpoints are presented, i.e. the diagnostic performance of CMR versus SPECT in subpopulations such as multi-vessel disease (MVD), in men, in women, and in patients without prior myocardial infarction (MI). For diagnostic performance assessment the area under the receiver-operator-characteristics-curve (AUC) was calculated. Readers were blinded versus clinical data, CXA, and imaging results. RESULTS: The diagnostic performance (= area under ROC = AUC) of CMR was superior to SPECT (p = 0.0004, n = 425) and to gated-SPECT (p = 0.018, n = 253). CMR performed better than SPECT in MVD (p = 0.003 vs all SPECT, p = 0.04 vs gated-SPECT), in men (p = 0.004, n = 313) and in women (p = 0.03, n = 112) as well as in the non-infarct patients (p = 0.005, n = 186 in 1-3 vessel disease and p = 0.015, n = 140 in MVD). CONCLUSION: In this large multicenter, multivendor study the diagnostic performance of perfusion-CMR to detect CAD was superior to perfusion SPECT in the entire population and in sub-groups. Perfusion-CMR can be recommended as an alternative for SPECT imaging. TRIAL REGISTRATION: ClinicalTrials.gov, Identifier: NCT00977093.

Biblioteca de l’Escola Tècnica Superior d’Arquitectura de Barcelona: Informe d’actuacions 2012

Informe d'actuacions dutes a terme durant l'any 2012: Instal·lacions; Innovació Tecnológica; Col•leccions; Bibliotècnica; Serveis; Habilitats informacionals; Coneixement UPC; Accés a la cultura; Professionals; Organització i gestió.

Caracterização fenológica e produtiva da variedade de uva Superior Seedless cultivada no Vale do São Francisco

A variedade Superior Seedless, devido não somente às excelentes características morfológicas, mas também ao agradável sabor de seus frutos, tem se destacado nos últimos anos como a principal uva sem sementes cultivada no Vale do São Francisco.Este trabalho teve por objetivo caracterizar o comportamento fenológico e produtivo da variedade de uva Superior Seedless cultivada no Vale do São Francisco. As avaliações foram realizadas em uma área comercial, durante o segundo semestre de 1999 e primeiro semestre de 2000. A variedade Superior Seedless apresentou ciclo médio de 94 dias, sendo que, quando a poda foi realizada no primeiro semestre, ocorreu uma antecipação da colheita em 14 dias. A produtividade foi muito baixa (5,3 t.ha-1), mas as características qualitativas como diâmetro e comprimento de baga, sólidos solúveis totais e acidez total titulável, atendem aos padrões exigidos pelo comercio internacional.

Análisis bibliométrico sobre el Aprendizaje Basado en Problemas (ABP) en la educación superior a partir de la base de datos ERIC

[spa]El estudio bibliométrico descriptivo que sigue presenta tendencias de investigación sobre el aprendizaje basado en problemas entre 1974 y 2009. Se sirve de la base de datos ERIC y trabaja con una muestra de 1007 documentos. Se analizan los registros a tenor de cuatro variables: el año de publicación o realización, la titulación, el área de conocimiento y la tipología de investigación. En cuanto a la producción científica, pueden diferenciarse tres fases: la primera, de 1974 a 1989, supone el inicio de las publicaciones y muestra escasa relevancia estadística; la segunda, de crecimiento, durante la década de los 90 del pasado siglo; y la última, de maduración, desde el año 2000 hasta el año 2009. La distribución de los registros por sectores de conocimiento destaca Ciencias de la Salud, Ciencias Sociales y Enseñanzas Técnicas. Las titulaciones en las que más ha proliferado el ABP son Medicina, Económicas, Empresariales, Pedagogía, Formación del Profesorado y el conjunto de las ingenierías.

Características físicas e físico-químicas de um tipo de bacuri (Platonia insignis Mart.) com rendimento industrial superior

Efetuou-se a caracterização física do fruto e físico-química da polpa do bacuri CPATU 207-3, oriundo de uma planta-matriz do Banco de Germoplasma de Bacurizeiro da Embrapa Amazônia Oriental. Para a caracterização física foi utilizada uma amostra de 50 frutos, os quais foram individualmente analisados quanto aos seguintes aspectos: cor do epicarpo, formato, peso, comprimento, diâmetro, espessura da casca, volume da cavidade interna, número de sementes e de segmentos partenocárpicos, rendimentos porcentuais (p/p) de casca, polpa, sementes e do conjunto representado pela coluna placentária e óvulos abortados. A caracterização físico-química foi efetuada em três amostras de polpa congelada a 18ºC negativos, provenientes de frutos em completo estádio de maturação, coletados nos meses de janeiro, fevereiro e março de 2001, tendo sido consideradas as seguintes variáveis: teores de umidade, de sólidos totais e de sólidos solúveis totais (ºBrix), pH, acidez total e a relação sólidos solúveis totais/acidez total titulável. O bacuri CPATU 207-3 apresentou formato ovalado e com ápice ligeiramente pontiagudo, epicarpo de coloração amarelada, fruto de tamanho considerado médio e peso médio de 265,8 g. As principais características diferenciais desse tipo de bacuri são: a espessura da casca (0,75cm), o rendimento porcentual de polpa (27,7%) e o número de segmentos partenocárpicos (2,8 unidades/fruto). A polpa do bacuri CPATU 207-3 apresentou boas características físico-químicas, com 84,35% de umidade, 15,65% de sólidos totais, teor de sólidos solúveis totais de 14,53ºBrix, pH 3,34, acidez total titulável de 1,24% e relação ºBrix/acidez total titulável igual a 11,4. As características físicas e físico-químicas desse tipo de bacuri permitem sua utilização tanto para consumo na forma de fruta fresca como na forma industrializada. Nesse último caso, é particularmente indicado para fabricação de compota, em decorrência do elevado número de segmentos partenocárpicos que apresenta.

Anelamento e reguladores de crescimento: efeitos sobre as medidas biométricas e qualidade de cachos da videira 'Superior Seedless'

Com o objetivo de se obter maior tamanho de baga, peso médio de cacho e produtividade, os cachos da variedade Superior Seedless foram pulverizados com ácido giberélico (1 + 20 mg.L-1), bioestimulante Crop Set® nas doses de 0,1 e 0,2% e com ou sem anelamento no caule. Esses tratamentos foram aplicados de forma isolada ou combinados entre si. O trabalho foi conduzido durante o período 2001-2002 (dois ciclos de produção), no Campo Experimental de Bebedouro da Embrapa Semi-Árido em Petrolina-PE. O delineamento experimental foi em blocos ao acaso, com 12 tratamentos e três repetições, sendo duas plantas por parcela. Não foram observadas diferenças significativas entre os tratamentos nos dois ciclos de produção. Entretanto, quando o ácido giberélico foi associado ao Crop Set® 0,1% e anelamento, observou-se uma tendência de aumento no peso de cachos, bem como no peso e tamanho de bagas na safra de 2001. Os cachos tratados com ácido giberélico apresentaram engaços mais grossos e pesados, embora não se observem diferenças significativas entre os tratamentos. Algumas plantas submetidas ao anelamento apresentaram problemas de cicatrização, o que provocou a morte das mesmas, recomendando-se evitar a realização desta prática nas condições em que se realizou este trabalho.