Valoración de la impedancia miocárdica transesofágica como técnica diagnóstica de rechazo cardíaco post-trasplante

L'objectiu del present estudi va ser desenvolupar una nova tècnica d'impedància miocàrdica transesofàgica (IMT) i valorar la seva utilitat en el diagnòstic de rebuig cardíac post-trasplantament. Es va mesurar la IMT prèviament a la realització de les biòpsies endomiocàrdiques (BEM) a 19 pacients trasplantats de cor, un 10% de les BEM realitzades van presentar rebuig grau 3A. Els pacients van catalogar la mesura de IMT de 8'9 vegades més còmoda i 9,1 vegada menys molesta que la BEM. En la present sèrie, no es van observar diferències significatives entre els valors de IMT en funció de la presència o no de rebuig

Post Mortem Inquiry - Progress Report To The Minister for Health and Children

The Inquiry is of the view that the Terms of Reference are wide ranging and comprehensive. The issue of organ retention is not one which may be examined properly in isolation and involves consideration of many issues,  most notably the legal context within which the matters arise. The issue is one which needs to be seen in its proper context so that it may be properly and fully understood. Progress Report Addendum to Progress Report

L'exploitation des eaux souterraines en Syrie centrale : construction de diagnostics et politiques d'intervention

Syrian dry areas have been for several millennia a place of interaction between human populations and the environment. If environmental constraints and heterogeneity condition the human occupation and exploitation of resources, socio-political, economic and historical elements play a fundamental role. Since the late 1980s, Syrian dry areas are viewed as suffering a serious water crisis, due to groundwater overdraft. The Syrian administration and international development agencies believe that groundwater overexploitation is also leading to a decline of agricultural activities and to poverty increase. Action is thus required to address these problems.However, the overexploitation diagnosis needs to be reviewed. The overexploitation discourse appears in the context of Syria's opening to international organizations and to the market economy. It echoes the international discourse of "global water crisis". The diagnosis is based on national indicators recycling old Soviet data that has not been updated. In the post-Soviet era, the Syrian national water policy seems to abandon large surface water irrigation projects in favor of a strategy of water use rationalization and groundwater conservation in crisis regions, especially in the district of Salamieh.This groundwater conservation policy has a number of inconsistencies. It is justified for the administration and also probably for international donors, since it responds to an indisputable environmental emergency. However, efforts to conserve water are anecdotal or even counterproductive. The water conservation policy appears a posteriori as an extension of the national policy of food self-sufficiency. The dominant interpretation of overexploitation, and more generally of the water crisis, prevents any controversary approach of the status of resources and of the agricultural system in general and thus destroys any attempt to discuss alternatives with respect to groundwater management, allocation, and their inclusion in development programs.A revisited diagnosis of the situation needs to take into account spatial and temporal dimensions of the groundwater exploitation and to analyze the co-evolution of hydrogeological and agricultural systems. It should highlight the adjustments adopted to cope with environmental and economic variability, changes of water availability and regulatory measures enforcements. These elements play an important role for water availability and for the spatial, temporal, sectoral allocation of water resource. The groundwater exploitation in the last century has obviously had an impact on the environment, but the changes are not necessarily catastrophic.The current groundwater use in central Syria increases the uncertainty by reducing the ability of aquifers to buffer climatic changes. However, the climatic factor is not the only source of uncertainty. The high volatility of commodity prices, fuel, land and water, depending on the market but also on the will (and capacity) of the Syrian State to preserve social peace is a strong source of uncertainty. The research should consider the whole range of possibilities and propose alternatives that take into consideration the risks they imply for the water users, the political will to support or not the local access to water - thus involving a redefinition of the economic and social objectives - and finally the ability of international organizations to reconsider pre-established diagnoses.

Report of the Working Group on Post Mortem Practice

The Madden Report into Post Mortem Practice and Procedure (2005)1 stated that consideration should be given to the implementation of the recommendations made in the Report to other post mortems2, namely those carried out on babies who died before or during birth, minors and adults. It was acknowledged that while many of the recommendations in the Report may apply generically to all categories of post-mortem examinations, these post mortems also raise distinct legal and ethical issues that were not within the Terms of Reference of the Madden Report. The Report advised that a Working Group be established to ensure that appropriate adaptation in relation to those issues takes place. The terms of reference were: Read the report (PDF, 117kb)

Post-adopció i resiliència: l'ajust psicosocial i vivència de l'adopció en infants adoptats internacionalment

Antecedents. Cada cop són més els nens i nenes adoptats internacionalment que creixen en la nostra societat, i el seu ajust psicosocial s’ha convertit en un assumpte d’especial interès i rellevància. Objectius. Estudiar l'ajust psicosocial i la vivència de l'adopció en els infants adoptats internacionalment. Els objectius específics són: 1) estudiar els nivells d’adaptació personal i social en nens i nenes adoptats/des internacionalment, en comparació amb els estàndards de la població normativa; 2) estudiar la vivència de l’adopció en nens i nenes adoptats internacionalment i la percepció que mares i pares en tenen al respecte; 3) analitzar el paper de las variables estrés i estratègies d’afrontament en l’ajust psicosocial dels infants adoptats. Material i Mètode. La mostra està formada per 103 infants adoptats a l’estranger, d’entre 8 i 12 anys, i els seus respectius pares i mares. Els participants completaren les següents proves: BASC (Behavior Assessment System for Children (BASC; Reynolds & Kamphaus, 1992), Qüestionari de punts forts i febles (SDQ; Goodman, 1997, 1999), Escala de la vivència adoptiva (Reinoso, 2008), Kidcope (Spirito, Stara y Williams, 1988). En realitzen anàlisis estadístics de tipus descriptiu, comparatiu, correlacional i exploratori. Resultats. La majoria dels menors adoptats internacionalment presenta bons nivells de funcionament, si bé un 25% d’ells presenta dificultats adaptatives bàsiques. En general s’observa un elevat nivell de convergència en la visió de l’experiència adoptiva entre nens/es i mares i pares. Els infants puntuen més alt en identitat cultural i més baix en discriminació percebuda que els seus pares/mares. Principalment esmenten problemes interpersonals de relació i de salut, malalties i accidents i utilitzen predominantment estratègies d’afrontament aproximatives. Els estressors vinculats amb l’experiència adoptiva són escassament mencionats. Conclusions. L’especificitat de la condició adoptiva requereix d’intervencions ajustades a la realitat d’aquests les necessitats d’aquests nens i les seves families.

Cosecha y post-cosecha de nueces

La mecanización integral de la cosecha se reduce todavía a un número limitado de explotaciones, aunque cada día son más las plantaciones en las que se utilizan vibradores en la cosecha. La utilización de cosechadoras está reservada a explotaciones superiores a las 20 ha y se suele recurrir a vibradores de ramas mientras los árboles no alcanzan la envergadura de adultos. Una correcta cosecha se suelen realizar en dos pasadas y en pocas explotaciones se utilizan productos para la maduración artificial. Prácticamente la mayoría de las nuevas plantaciones de nogal disponen de sistemas de secado y acondicionado de las nueces, los productores son conscientes de la importancia del tratamiento de post-cosecha que, sin duda, marca la calidad final de la producción y con ella el precio de la nuez. En la misma explotación las nueces son peladas, lavadas, secadas y muy habitualmente calibradas y envasadas. Las nueces se secan entre 10-12% bh. en cáscara, y hasta 5-6% bh. en grano, utilizando secadores de aire insuflado por la base, los tradicionales de ‘falso fondo’ son los más habituales.

Renograma 99mTc Post-Captoprilen la valoración de la hipertensión vásculo-renal en pacientes portadores de injerto renal.

Objectiu: Descripció de la metodologia del renograma isotòpic basal/postcaptopril (RIB/P) en pacients portadors de empelt renal amb sospita de malaltia vasculo-renal (MVR). Material i mètodes: Es va realitzar en 44 pacients trasplantats renals un renograma basal i 48 hores després un renograma postcaptopril administrant 25 mg de captopril v.o i realitzant una adquisició 30 minuts després. Resultats: Dels 44 estudis 6 van ser positius, constatant-se MVR per angio-TC i 38 van ser negatius tractats posteriorment amb IECAs o ARAII i no van mostrar alteracions significatives del funcionalisme renal. Conclusions: El RIB/P es una eina útil para determinar MVR en pacients amb empelt renal i hipertensió arterial.

Report of Dr Deirdre Madden on Post Mortem Practice and Procedures

This Report aims to set out the general facts in relation to paediatric post-mortem practice in Ireland from 1970 to 2000, the way in which information was communicated to parents of deceased children in relation to post-mortemexaminations, and how these practices might be improved upon for the future Read the Report  

Influence of the blood meal source on the biology of Meccus picturatus Usinger 1939 (Hemiptera: Reduviidae: Triatominae) under laboratory conditions

Aspects related to hatching, time-lapse between presenting the blood meal and beginning of feeding, feeding time, postfeed defecation delay,life time, mortality and fecundity for each stage of Meccus picturatus, life-cycle were evaluated and compared in two cohorts of M. picturatus fed on hens or rabbits. The hatching rate observed for each of the two studied groups of eggs was 78.1% (n = 2298) on the group fed on hens and 82.1% (n = 2704) on that fed on rabbits, and the average time of hatching was 20 days. Mean time-lapse for beginning feeding was under 3 min in nymphal stages and postfeed defecation delay was under 10 min in all stages, in both cohorts. Mean feeding time was significantly (P < 0.05) shorter in triatomines fed on hens than on rabbits. A similar number of nymphs of each cohort, 69 fed on hens (34.5%) and 68 fed on rabbits (34%), completed the cycle. No significantly (P > 0.05) differences were recorded among the average times from NI to adult in the cohort fed on hens (196.8 ± 15.8 days) and the average time in the cohort fed on rabbits (189.5 ± 22.9). The average span in days for each stage fed on hens was not significantly different to the average span for each stage fed on rabbits. The number of blood meals at each nymphal stage varied from 1 to 6 in both cohorts. The mortality rates were higher on fifth nymphal stage, in both cohorts. No significant (P > 0.05) differences were recorded on mortality rates on most nymphal stages of both cohorts. The average number of eggs laid per female from the cohort fed on hens in a 9-month period was 791.1, whereas the average number of eggs in the cohort fed on rabbits was 928.3.

Fonctions du plancher pelvien: de la phase expulsive à la consultation du post-partum [Pelvic floor functions: from the beginning of the second phase of labor to the postpartum consultation].

Vaginal delivery can cause lesions of the various pelvic structures responsible for the mechanisms of continence. These lesions may perhaps be prevented in the future by measuring pressure generated during childbirth. Tear of the anal sphincter during childbirth is a marker of a global impairment of the urinary, ano-rectal and sexual pelvic functions in the short and medium term. Persistence of a defect of the anal sphincter is frequent in spite of immediate suture. The correlation between these defects and ano-rectal incontinence are not established in our experience. The quality of the contraction of the sphincter complex and pubo-rectal sling seems to play a more important role in ano-rectal continence after a traumatic childbirth.

Bucumap: Buscador unificat de cursos, màsters i post-graus

Desenvolupar una aplicació web en Java j2ee, i més concretament un cercador de formacions.