Trauma craneoencefálico severo en la UCIP del Hospital de la Misericordia, 2010-2013

El Trauma Craneoencefálico (TCE) infantil constituye un motivo frecuente de consulta en Urgencias y supone la primera causa de muerte en niños, llegando a ser hasta del 50% en trauma severo. En Colombia se conocen cifras de TCE por algunos estudios descriptivos, pero no existen reportes en Bogotá ni específicamente en TCE severo. Objetivo: Caracterizar el trauma craneoencefálico severo pediátrico en la Unidad de Cuidado intensivo del Hospital de la Misericordia entre los años 2010 y 2013. Materiales y métodos: Un estudio descriptivo retrospectivo fue realizado en el Hospital de la Misericordia mediante revisión de las historias clínicas de los pacientes que ingresaron a la Unidad de Cuidado Intensivo pediátrico con diagnóstico de trauma craneoencefálico severo entre el año 2010 al 2013. Resultados: Se incluyeron 63 pacientes (71,4% hombres) con una edad mediana de 4 años (RIQ 2-8). La mayoría de los traumas fueron originados por caída o accidente de tránsito (79,4%). La principal lesión fue fractura de cráneo (79%). Casi la mitad de los pacientes sufrieron algún tipo de secuela neurológica al egreso (47,1%). La mayoría de los pacientes que murieron (19%) sufrieron choque hipovolémico (83,3%) y presentaron trauma asociado (66,7%). Conclusión: Las características y epidemiología del trauma craneoencefálico en nuestra población muestran claras similitudes con lo reportados en otras series de la literatura mundial y de Colombia, excepto por la mortalidad, que se esperaba más alta al estudiar solo pacientes con TCE severo.

Participació de les aigües subterrànies en la gènesi d'ambients palustres continentals: el cas dels prats de Sant Sebastià (Caldes de Malavella, Girona)

The area known as 'prats de Sant Sebastià' is in Caldes de Malavella. It is part of the wetlands located in the south-eastern end of the Selva Basin. Several areas with unusually high conductivity (EC up to 24,500 uS/cm) have been identified in this place. This fact allows highly specialised and comparatively rare botanical species to grow in this area. These saline soils follow a north-south line-up. The geophysical data, obtained with a field conductivemeter (EM 31), show that this superficial line-up continues in the subsoil. In addition to this, the conductivity cartography, made for an electromagnetic exploration depth of 6 meters, shows that the width of the region where these salinity anomalies take place increases in depth. When included in the hidrogeological context of this sector of the Selva Basin, these data bring new elements for the study of the genesis and working of these marshy environments. The model that future research will have to confirm, maintains that the groundwater discharges coming from the underlying hydrogeothermal aquifer are a conditioning factor of the aforementioned phenomenon. This ascending flow of highly mineralised waters (TDS of about 3,500 mg/l) can produce and keep stable the soil salinity

Contribució al coneixement de variables geoambientals en l'àmbit de la Costa Brava (Girona)

La tesi doctoral desenvolupada, emmarcada dins del camp de les Ciències Ambientals, aplica la Geologia Ambiental orientada al coneixement dels processos i recursos geològics de cara a la planificació i a l'ordenació del territori. Com a zona d'estudi s'ha seleccionat la Costa Brava meridional, concretament tota l'àrea litoral compresa per les conques hidrogràfiques de l'Aubi, riera de Calonge, Ridaura, riera de Tossa i riera de Lloret (75 km de línia de costa i una extensió de 291 km2). Aquest treball, amb l'aptitud integradora dels conceptes i mètodes propis de les Ciències Geològiques i Ambientals, s'ha proposat com a objectius globals l'anàlisi de la qualitat i del comportament físic i químic dels materials terrestres en front les accions humanes i de la seva utilització com a recursos; l'estudi dels processos naturals i de la influència que puguin tenir sobre l'home o bé els efectes que aquest pot causar sobre aquells, i per últim, com a derivació dels anteriors, el disseny i aplicació d'instruments de tipus preventiu en la gestió del territori; és a dir, la planificació dels usos del territori. Amb la filosofia de recerca basada en que els factor geològics són uns elements d'ajuda per a la visió integral d'un territori, s'han estudiat diferents variables geoambientals procurant traduir el coneixement del medi en informació apta per a la presa de decisions sobre l'ús i preservació d'aquest àmbit litoral. Els Sistemes d'Informació Geogràfica (SIG) han estat clau per a la visió sistèmica del territori, per a la integració de les diferents variables geoambientals, així com per a la producció cartogràfica temàtica i final. Pel que fa als processos geològics, lligats a la dinàmica fluviotorrencial, s'han cartografiat les principals àrees d'actuació així com analitzat els factors que inicien, afavoreixen o magnifiquen la seva ocurrència. S'han estudiat les accions denudatives, els processos de transport-sedimentació i amb l'estudi integrat d'aquests processos i formes resultants s'han identificat unitats territorials caracteritzades per un comportament geomòrfic uniforme. En quant a l'anàlisi dels recursos geològics s'ha aprofundit en el coneixement dels recursos hídrics subterranis, les roques industrials i els georecursos litorals. Pel que fa als primers s'ha centrat en la delimitació de les principals unitats i subunitats aqüíferes, així com en acotar les geometries i principals característiques hidràuliques. Pel que fa als àrids i roques de construcció l'objectiu fonamental ha estat la delimitació cartogràfica d'aquells materials que per les seves propietats fisicoquímiques són potencialment aptes per als usos indicats. Finalment s'ha fet una recerca orientada a l'estudi de factors que limiten o condicionen el potencial geoturístic d'aquesta àrea litoral, concretament en els penya-segats i les platges. Les principals aportacions d'aquesta tesi doctoral es poden emmarcar en l'àmbit regional i fenomenològic, aspectes clau en la gestió i planificació territorial. Pel que fa al primer, destaquem l'aportació de dades geoambientals a nivell cartogràfic en relació a variables litoestructurals, de processos dinàmics com de recursos geològics. Des del punt de vista de l'àmbit fenomenològic destaquem la interacció de les variables estudiades a nivell de conca hidrogràfica, com són, entre d'altres, les relacions existents entre les diferents formacions aqüíferes; la possible participació de les aigües subterrànies en la resposta hidrològica del sistema fluviotorrencial, o la problemàtica derivada de l'antropització de la sorra de la platja com a conseqüència d'abocaments de terres i residus inerts als marges de les rieres.

Fish as ecological indicators in Mediterranean freshwater ecosystems

Podeu escriure el text directament o arrossegar-lo des d'un altre document L'objectiu d'aquesta tesi és contribuir a l'ús dels peixos continentals com a indicadors de l'estat ecològic a la conca Mediterrània. En el primer treball es va detectar que encara que tots els índex biològics estaven correlacionats significativament, els peixos integren i expressen els estressos de manera i a una escala diferents, aportant una informació complementària als altres índexs. Al segon article es van estudiar els cabals de sis conques catalanes. S'ha mostrat que els règims hídrics estan alterats amb una tendència a la disminució del cabal i del nivell dels aqüífers. S'ha detectat quatre mètriques de peixos que es troben significativament afectades en zones més castigades per manca d'aigua degut a l'activitat humana. Es discuteix la necessitat de conèixer en profunditat el règim hídric de cada conca abans d'utilitzar els índex biològics. Al tercer article es va detectar que la composició d'espècies capturades va variar significativament al llarg del buidat amb un augment de l'alburn (A. alburnus) a les aigües pelàgiques durant els dies de pitjor qualitat de l'aigua, confirmant que l'alburn és més tolerant a la mala qualitat de l'aigua que la madrilleta vera (R. rutilus) i suggereix el seu potencial com a bioindicador. La condició d'aquestes dues espècies va canviar significativament al llarg del buidat de manera molt estreta amb la qualitat de l'aigua. Al quart capítol es va estudiar la biologia dels peixos d'un embassament altament contaminat (Flix). El percentatge de DELT anomalies i la presència de paràsits externs era major en la zona impactada que als punts de control i els valors més alts de pes eviscerat i pes del fetge estaven als punts de control. Les respostes van ser diferents per cada espècie i la carpa va ser la que va mostrar més clarament els impactes.

Interpreting the response of a dryland river system to Late Quaternary climate change

A U-series calcrete chronology has been constructed for three Late Quaternary terrace units, termed the D1, D2 and D3 terraces in age descending order, from the Rio Aguas river system of the Sorbas basin, southeast Spain. The D1 terrace formed between 30,300 +/- 4400 year BP and 12,140 +/- 360 year BP, correlating well with the Last Glacial Maximum when rates of sediment supply would have increased greatly, because of higher rates of weathering, reduced vegetation cover and weak soil development. The D2 terrace formed between 12,800 +/- 1100 year BP and 9,600 +/- 530 year BP, correlating well with the Younger Dryas event. The D3 terrace could only be poorly constrained to the early Holocene and no unequivocal cause could be assigned to this period of aggradation. The sedimentology and geomorphology of the D2 terrace suggests, however, that the aggradation of this unit was a response to diapirism/karstic processes occurring within the underlying Messinian gypsum strata and the subsequent damming of the Aguas system. Therefore, despite its coincident occurrence with the Younger Dryas, aggradation of the D2 terrace is unrelated to climate change. The style of this response, controlled predominantly by the characteristics of the underlying bedrock, makes correlating the terrace record of the Aguas with other systems in the Mediterranean unreliable. This study, therefore, highlights the problems of correlating fluvial sequences in regions of variable tectonics, climatic history and bedrock geology and emphasises the need to properly understand the main controls on individual fluvial systems before any attempt is made to correlate their depositional histories. (C) 2004 Elsevier Ltd. All rights reserved.

A groove-ploughing theory for the production of mega-scale glacial lineations, and implications for ice-stream mechanics

Mega-scale glacial lineations (MSGLs) are longitudinally aligned corrugations (ridge-groove structures 6-100 km long) in sediment produced subglacially. They are indicators of fast flow and a common signature of ice-stream beds. We develop a qualitative theory that accounts for their formation, and use numerical modelling, and observations of ice-stream beds to provide supporting evidence. Ice in contact with a rough (scale of 10-10(3) m) bedrock surface will mimic the form of the bed. Because of flow acceleration and convergence in ice-stream onset zones, the ice-base roughness elements experience transverse strain, transforming them from irregular bumps into longitudinally aligned keels of ice protruding downwards. Where such keels slide across a soft sedimentary bed, they plough through the sediments, carving elongate grooves, and deforming material up into intervening ridges. This explains MSGLs and has important implications for ice-stream mechanics. Groove ploughing provides the means to acquire new lubricating sediment and to transport large volumes of it downstream. Keels may provide basal drag in the force budget of ice streams, thereby playing a role in flow regulation and stability We speculate that groove ploughing permits significant ice-stream widening, thus facilitating high-magnitude ice discharge.

Sources of sulphur in gypsiferous sediments and crusts and pathways of gypsum redistribution in southern Tunisia

Southern Tunisia contains one of the most extensive gypsum accumulations in Africa comprising Triassic, Cretaceous, Eocene and Mio-Pliocene marine evaporites, spring deposits, playa sediments, aeolian sands and gypsum crusts. Sulphur isotope analysis (delta(34)S) of bedrock samples, groundwater, playa brines, playa sediments, and gypsiferous crusts provides insight into the sources of gypsum in the region and sheds light on the processes that lead to gypsum crust formation. Results Suggest that recycling of marine gypsum is the most likely source of the sulphate in the groundwater, playa sediments and crusts. The low PS values found in Eocene and Mio-Pliocene samples suggest that this recycling has been going on for millions of years. Though bedrock appears to be the ultimate source of the gypsum in the crusts, transport of this sulphate to playas, concentration therein, and subsequent dispersal across the landscape by aeolian processes provides the most likely pathway for surticial gypsum crust formation. Comparison of these results with those from Australia, Chile and Namibia suggests that, although the source of the sulphur varies from region to region, the processes of surficial crust formation appear to be similar. Copyright (C) 2004 John Wiley Sons, Ltd.

Baseline nitrate concentration in groundwater of the Chalk in south Dorset, UK

Determining the degree of nitrate pollution in Chalk groundwater is difficult without a clear understanding of concentrations naturally present. In the UK, a general shortage of long-term records of nitrate concentrations in Chalk groundwater prevents a full quantification of baseline concentrations. This paper presents late nineteenth and early twentieth century data on nitrate concentrations in Chalk groundwater in south Dorset, UK and compares them with corresponding data for the last 25 years. The nitrate record is instructive in (1) providing an insight into the baseline nitrate concentration of groundwater; (2) defining the level of nitrate pollution in potable supplies from the Chalk aquifer; and (3) identifying the long-term variations in local nitrate concentrations. Over a period exceeding 100 years mean nitrate concentrations increased from 1.04 mg NO3-N l(-1) to 6.37 mg NO3-N l(-1). Anthropogenic modification of the local groundwater composition is not evident in the early nitrate record. Nitrate data throughout this early period reflect natural background concentrations of approximately I mg NO3-N l(-1) Intensified fertilser use and increased livestock numbers are suggested as the fundamental cause of the rise in nitrate concentrations. The implications of the nitrate record for regional hydrogeological processes are discussed. (C) 2003 Elsevier Science B.V. All rights reserved.

The water quality of the LOCAR Pang and Lambourn catchments

The water quality of the Pang and Lambourn, tributaries of the River Thames, in south-eastern England, is described in relation to spatial and temporal dimensions. The river waters are supplied mainly from Chalk-fed aquifer sources and are, therefore, of a calcium-bicarbonate type. The major, minor and trace element chemistry of the rivers is controlled by a combination of atmospheric and pollutant inputs from agriculture and sewage sources superimposed on a background water quality signal linked to geological sources. Water quality does not vary greatly over time or space. However. in detail, there are differences in water quality between the Pang and Lambourn and between sites along the Pang and the Lambourn. These differences reflect hydrological processes, water flow pathways and water quality input fluxes. The Pangs pattern of water quality change is more variable than that of the Lambourn. The flow hydrograph also shows both a cyclical and 'uniform pattern' characteristic of aquifer drainage with, superimposed, a series of 'flashier' spiked responses characteristic of karstic systems. The Lambourn, in contrast, shows simpler features without the 'flashier' responses, The results are discussed in relation to the newly developed UK community programme LOCAR dealing with Lowland Catchment Research. A descriptive and box model structure is provided to describe the key features of water quality variations in relation to soil, unsaturated and groundwater flows and storage both away from and close to the river.

Rainfall and runoff water quality of the Pang and Lambourn, tributaries of the River Thames, south-eastern England

The water quality of rainfall and runoff is described for two catchments of two tributaries of the River Thames, the Pang and Lambourn. Rainfall chemistry is variable and concentrations of most determinands decrease with increasing volume of catch probably due to 'wash out' processes. Two rainfall sites have been monitored, one for each catchment. The rainfall site on the Lambourn shows higher chemical concentrations than the one for the Pang which probably reflects higher amounts of local inputs from agricultural activity, Rainfall quality data at a long-term rainfall site on the Pang (UK National Air Quality Archive) shows chemistries similar to that for the Lambourn site. but with some clear differences. Rainfall chemistries show considerable variation on an event-to-event basis. Average water quality concentrations and flow-weighted concentrations as well as fluxes vary across the sites, typically by about 30%. Stream chemistry is much less variable due to the main Source of water coming from aquifer sources of high storage. The relationship between rainfall and runoff chemistry at the catchment outlet is described in terms of the relative proportions of atmospheric and within-catchment sources. Remarkably, in view of the quantity of agricultural and sewage inputs to the streams, the catchments appear to be retaining both P and N.

The Dubawnt Lake palaeo-ice stream: evidence for dynamic ics sheet behaviour on the Canadian Shield and insights regarding the controls on ice-stream location and vigour

We report evidence for a major ice stream that operated over the northwestern Canadian Shield in the Keewatin Sector of the Laurentide Ice Sheet during the last deglaciation 9000-8200 (uncalibrated) yr BP. It is reconstructed at 450 km in length, 140 km in width, and had an estimated catchment area of 190000 km. Mapping from satellite imagery reveals a suite of bedforms ('flow-set') characterized by a highly convergent onset zone, abrupt lateral margins, and where flow was presumed to have been fastest, a remarkably coherent pattern of mega-scale glacial lineations with lengths approaching 13 km and elongation ratios in excess of 40:1. Spatial variations in bedform elongation within the flow-set match the expected velocity field of a terrestrial ice stream. The flow pattern does not appear to be steered by topography and its location on the hard bedrock of the Canadian Shield is surprising. A soft sedimentary basin may have influenced ice-stream activity by lubricating the bed over the downstream crystalline bedrock, but it is unlikely that it operated over a pervasively deforming till layer. The location of the ice stream challenges the view that they only arise in deep bedrock troughs or over thick deposits of 'soft' fine-grained sediments. We speculate that fast ice flow may have been triggered when a steep ice sheet surface gradient with high driving stresses contacted a proglacial lake. An increase in velocity through calving could have propagated fast ice flow upstream (in the vicinity of the Keewatin Ice Divide) through a series of thermomechanical feedback mechanisms. It exerted a considerable impact on the Laurentide Ice Sheet, forcing the demise of one of the last major ice centres.

Laurentide ice streaming on the Canadian Shield: A conflict with the soft-bedded ice stream paradigm?

Elucidating the controls on the location and vigor of ice streams is crucial to understanding the processes that lead to fast disintegration of ice flows and ice sheets. In the former North American Laurentide ice sheet, ice stream occurrence appears to have been governed by topographic troughs or areas of soft-sediment geology. This paper reports robust evidence of a major paleo-ice stream over the northwestern Canadian Shield, an area previously assumed to be incompatible with fast ice flow because of the low relief and relatively hard bedrock. A coherent pattern of subglacial bedforms (drumlins and megascalle glacial lineations) demarcates the ice stream flow set, which exhibits a convergent onset zone, a narrow main trunk with abrupt lateral margins, and a lobate terminus. Variations in bedform elongation ratio within the flow set match theoretical expectations of ice velocity. In the center of the ice stream, extremely parallel megascalle glacial lineations tens of kilometers long with elongation ratios in excess of 40:1 attest to a single episode of rapid ice flow. We conclude that while bed properties are likely to be influential in determining the occurrence and vigor of ice streams, contrary to established views, widespread soft-bed geology is not an essential requirement for those ice streams without topographic control. We speculate that the ice stream acted as a release valve on ice-sheet mass balance and was initiated by the presence of a proglacial lake that destabilized the ice-sheet margin and propagated fast ice flow through a series of thermomechanical feedbacks involving ice flow and temperature.

Modelling the inorganic nitrogen behaviour in a small Mediterranean forested catchment, Fuirosos (Catalonia)

The aim of this work was to couple a nitrogen (N) sub-model to already existent hydrological lumped (LU4-N) and semi-distributed (LU4-R-N and SD4-R-N) conceptual models, to improve our understanding of the factors and processes controlling nitrogen cycling and losses in Mediterranean catchments. The N model adopted provides a simplified conceptualization of the soil nitrogen cycle considering mineralization, nitrification, immobilization, denitrification, plant uptake, and ammonium adsorption/desorption. It also includes nitrification and denitrification in the shallow perched aquifer. We included a soil moisture threshold for all the considered soil biological processes. The results suggested that all the nitrogen processes were highly influenced by the rain episodes and that soil microbial processes occurred in pulses stimulated by soil moisture increasing after rain. Our simulation highlighted the riparian zone as a possible source of nitrate, especially after the summer drought period, but it can also act as an important sink of nitrate due to denitrification, in particular during the wettest period of the year. The riparian zone was a key element to simulate the catchment nitrate behaviour. The lumped LU4-N model (which does not include the riparian zone) could not be validated, while both the semi-distributed LU4-R-N and SD4-R-N model (which include the riparian zone) gave satisfactory results for the calibration process and acceptable results for the temporal validation process.

A healable supramolecular polymer blend based on aromatic π-π stacking and hydrogen bonding interactions

An elastomeric, supramolecular healable polymer blend, comprising a chain-folding polyimide and a telechelic polyurethane with pyrenyl endgroups, is compatibilised by aromatic π−π stacking between the π-electron-deficient diimide groups and the π-electron-rich pyrenyl units. This inter-polymer interaction is key to forming a tough, healable, elastomeric material. Variable temperature FTIR analysis of the bulk material also conclusively demonstrates the presence of hydrogen bonding, which complements the π–π stacking interactions. Variable temperature SAXS analysis shows that the healable polymeric blend has a nanophase-separated morphology, and that the X-ray contrast between the two types of domain increases with increasing temperature, a feature that is repeatable over several heating and cooling cycles. A fractured sample of this material reproducibly regains more than 95% of the tensile modulus, 91% of the elongation to break, and 77% of the modulus of toughness of the pristine material.