Las estanterías virtuales : un nuevo espacio en el aula

La Biblioteca de la Universitat Oberta de Catalunya ve oferint des de fa diversos semestres les anomenades Prestatgeries virtuals, un servei que se situa dins de l'aula virtual i que serveix per posar a disposició dels estudiants tota una sèrie de recursos documental que li faciliten el seguiment i aprenentatge de les assignatures a les quals està matriculat.

Solució mental i solució motriu en la iniciació als esports col·lectius en l'Educació Primària

The adjustment of the teaching learning contents in Physical Education, requires of a rigorous analysis that permits to adjust them to the maximum with the educational needs of the student body. It has been approached an investigation study in the one which have intervened pupils, boys and girls, of two different populations, Girona and Madrid in order to prove and analyse the motor and mental components of the student body in the real situation of the game. The hypothesis that we have treated are:if it exists differences between the boys and girls of the educational levels studied in the motor and mental solution in the sports initiation, additionally, the differences that they can exist between the courses and what distance is verified between the study ages to approach a physical activity that implies an initial step to the hour of teaching the collective sports in the classes of Physical education. They have been employed three measure instruments: the first permits to analyse the mental solution without need of practice employing situation photographs of the real game with those which the pupils must choose to who to happen; the second is a pass test that permits to prove the technical dominance to use in a collective sport and the third is a real game situation that permits to put in manifesto the relationship between the mental behaviour and the motor of the pupil. This real game situation is ‘the game of ten pass’ (Blázquez,1986; Torres,1993). The results demonstrate that it do not exist differences between the two sexes in the study ages. In the case of the technical execution level, there is a considerable increase with the age and it is slightly greater in the kids that in the girls. In the case of the real game, we find ourselves with a great variability in the results and we cannot conclude that there are relative differences to the sex in none of the three courses. Respect at participation level during the game is confirmed that the pupils that more participate are not the pupils than more balls lose, what permits to guarantee the idea of the fact that it is convenient to use the real game practice as direct learning element. Finally, there is no a high correlation between the execution level measured in the test of technical execution and the decision execution during the game

Dynamic arterial elastance to predict arterial pressure response to volume loading in preload-dependent patients

INTRODUCTION Hemodynamic resuscitation should be aimed at achieving not only adequate cardiac output but also sufficient mean arterial pressure (MAP) to guarantee adequate tissue perfusion pressure. Since the arterial pressure response to volume expansion (VE) depends on arterial tone, knowing whether a patient is preload-dependent provides only a partial solution to the problem. The objective of this study was to assess the ability of a functional evaluation of arterial tone by dynamic arterial elastance (Ea(dyn)), defined as the pulse pressure variation (PPV) to stroke volume variation (SVV) ratio, to predict the hemodynamic response in MAP to fluid administration in hypotensive, preload-dependent patients with acute circulatory failure. METHODS We performed a prospective clinical study in an adult medical/surgical intensive care unit in a tertiary care teaching hospital, including 25 patients with controlled mechanical ventilation who were monitored with the Vigileo(®) monitor, for whom the decision to give fluids was made because of the presence of acute circulatory failure, including arterial hypotension (MAP ≤65 mmHg or systolic arterial pressure <90 mmHg) and preserved preload responsiveness condition, defined as a SVV value ≥10%. RESULTS Before fluid infusion, Ea(dyn) was significantly different between MAP responders (MAP increase ≥15% after VE) and MAP nonresponders. VE-induced increases in MAP were strongly correlated with baseline Ea(dyn) (r(2) = 0.83; P < 0.0001). The only predictor of MAP increase was Ea(dyn) (area under the curve, 0.986 ± 0.02; 95% confidence interval (CI), 0.84-1). A baseline Ea(dyn) value >0.89 predicted a MAP increase after fluid administration with a sensitivity of 93.75% (95% CI, 69.8%-99.8%) and a specificity of 100% (95% CI, 66.4%-100%). CONCLUSIONS Functional assessment of arterial tone by Ea(dyn), measured as the PVV to SVV ratio, predicted arterial pressure response after volume loading in hypotensive, preload-dependent patients under controlled mechanical ventilation.

Brachial artery peak velocity variation to predict fluid responsiveness in mechanically ventilated patients

INTRODUCTION Although several parameters have been proposed to predict the hemodynamic response to fluid expansion in critically ill patients, most of them are invasive or require the use of special monitoring devices. The aim of this study is to determine whether noninvasive evaluation of respiratory variation of brachial artery peak velocity flow measured using Doppler ultrasound could predict fluid responsiveness in mechanically ventilated patients. METHODS We conducted a prospective clinical research in a 17-bed multidisciplinary ICU and included 38 mechanically ventilated patients for whom fluid administration was planned due to the presence of acute circulatory failure. Volume expansion (VE) was performed with 500 mL of a synthetic colloid. Patients were classified as responders if stroke volume index (SVi) increased >or= 15% after VE. The respiratory variation in Vpeakbrach (DeltaVpeakbrach) was calculated as the difference between maximum and minimum values of Vpeakbrach over a single respiratory cycle, divided by the mean of the two values and expressed as a percentage. Radial arterial pressure variation (DeltaPPrad) and stroke volume variation measured using the FloTrac/Vigileo system (DeltaSVVigileo), were also calculated. RESULTS VE increased SVi by >or= 15% in 19 patients (responders). At baseline, DeltaVpeakbrach, DeltaPPrad and DeltaSVVigileo were significantly higher in responder than nonresponder patients [14 vs 8%; 18 vs. 5%; 13 vs 8%; P < 0.0001, respectively). A DeltaVpeakbrach value >10% predicted fluid responsiveness with a sensitivity of 74% and a specificity of 95%. A DeltaPPrad value >10% and a DeltaSVVigileo >11% predicted volume responsiveness with a sensitivity of 95% and 79%, and a specificity of 95% and 89%, respectively. CONCLUSIONS Respiratory variations in brachial artery peak velocity could be a feasible tool for the noninvasive assessment of fluid responsiveness in patients with mechanical ventilatory support and acute circulatory failure. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT00890071.

Long-term follow-up of follicular lymphoma (FL) patients receiving single agent rituximab at two different schedules in trial SAKK 35/98

Background: In FL, Rituximab as a single agent delivered in the standard schedule (4 times weekly) may induce a response rate of 50−70% with an event-free survival (EFS) of 1−3 years according to patients' characteristics. Prolonged Rituximab exposure seems to improve EFS at least in responding patients and to increase the rate of longterm responders. Here we report long-term results of a clinical trial comparing single agent Rituximab delivered in the standard schedule versus prolonged exposure, with focus on the proportion of long-term responders and their characteristics. Material and Methods: Between 1998 and 2002, chemotherapy na¨ıve (n = 64) or pre-treated (n = 138) FL patients received Rituximab in the standard schedule. Those responding or with stable disease were randomized to no further treatment (observation, n = 78) or 4 additional doses of Rituximab given at 2-month intervals (prolonged exposure, n = 73). EFS was calculated from the first dose of standard schedule until progression, relapse, second tumor or death. Results: At a median follow up of 9.4 years and with all living patients having been followed for at least 5 years, the median EFS is 13 months for the observation and 24 months for the prolonged exposure arm (p = 0.0007). In the observation arm 13% had no event at 5-years and only 4% at 8 years, while in the prolonged exposure arm it was 27% at 5 years and remained 21% at 8 years. The only significant prognostic factor for EFS in a multivariate Cox regression was the prolonged Rituximab schedule (hazard ratio 0.58, CI 0.39−0.86, p = 0.007), whereas being chemotherapy na¨ıve, presenting with stage

Projecte de rehabilitació del Mas Sitjar de Salt

El motiu principal que ens ha portat a la realització d’aquest treball ha sigut el nostreinterès en el camp de la rehabilitació. També ha influït en aquesta decisió la possibilitat d’accedir a documentació gràfica i històrica, ja que es tracta d’un edifici històric patrimoni del municipi de Salt. Com a coneixedors de l’estat actual de l’edifici s’ha decidit que l’objecte principal del projecte estigui basat en la consolidació estructural, considerant que no hi ha un ús definit, decidim que l’ús serà el que ve definit al CTE com a categoria C (zones d’accés al públic), que és el més desfavorable en quant a sobrecàrregues d’ús. Llavors, la finalitat del projecte és dur a terme la rehabilitació de l’edifici perquè és pugui adaptar a qualsevol ús que se li vulgui donar. Per tant, cal deixar clar que no és objecte redissenyar o redistribuir l’edifici per donar-li un ús concret

Early estimates of the effectiveness of the 2011/12 influenza vaccine in the population targeted for vaccination in Spain, 25 December 2011 to 19 February 2012.

We present early estimates of influenza vaccine effectiveness (VE) in the population targeted for vaccination, during 25 December 2011 to 19 February 2012. The adjusted VE was 55% (95% CI: 3 to 79) against any type of influenza virus and 54% (95% CI: 1 to 79) against influenza A(H3N2) virus. This suggests a moderate protective effect of the vaccine in the targeted population in a late influenza epidemic with limited match between vaccine and circulating strains.

"Ponte gafas, el VIH no se ", lema del concurso del Día Mundial de lucha frente al SIDA 2013

Boletín semanal para profesionales sanitarios de la Secretaría General de Calidad, Innovación y Salud Pública de la Consejería de Igualdad, Salud y Políticas Sociales

Detection of Mycobacterium leprae in saliva and the evaluation of oral sensitivity in patients with leprosy

The aim of this study was to investigate sensitivity disorders in the oral cavity related to the presence of Mycobacterium leprae in the saliva of treatment-naïve patients with leprosy in the state of Amazonas, Brazil. A cross-sectional study was conducted involving 45 subjects with leprosy. The subjects were interviewed to evaluate the sensitivity of the oral cavity. For the detection of M. leprae, saliva and slit-skin smear samples were collected. The samples were analysed using a bacteriological index (BI) protocol and the real-time quantitative polymerase chain reaction (qPCR). The results indicated that 15 of the 45 (33.3%) subjects with leprosy showed decreased oral sensitivity, which confirmed the importance of the oral cavity sensitivity evaluation. There was not a direct relationship between the presence of M. leprae in saliva and changes in oral sensitivity. Positive saliva qPCR results from six (31.6%) of 19 paucibacillary (PB) patients suggested the possibility of a new site for sample collection. Positive results using these diagnostic techniques (BI, slit-skin smear and saliva qPCR) increased to 55.5%, thus opening the possibility of combining these different techniques to increase the rate of positive diagnoses, especially in PB patients.

PARP-1 regulates metastatic melanoma through modulation of vimentin-induced malignant transformation.

PARP inhibition can induce anti-neoplastic effects when used as monotherapy or in combination with chemo- or radiotherapy in various tumor settings; however, the basis for the anti-metastasic activities resulting from PARP inhibition remains unknown. PARP inhibitors may also act as modulators of tumor angiogenesis. Proteomic analysis of endothelial cells revealed that vimentin, an intermediary filament involved in angiogenesis and a specific hallmark of EndoMT (endothelial to mesenchymal transition) transformation, was down-regulated following loss of PARP-1 function in endothelial cells. VE-cadherin, an endothelial marker of vascular normalization, was up-regulated in HUVEC treated with PARP inhibitors or following PARP-1 silencing; vimentin over-expression was sufficient to drive to an EndoMT phenotype. In melanoma cells, PARP inhibition reduced pro-metastatic markers, including vasculogenic mimicry. We also demonstrated that vimentin expression was sufficient to induce increased mesenchymal/pro-metastasic phenotypic changes in melanoma cells, including ILK/GSK3-β-dependent E-cadherin down-regulation, Snail1 activation and increased cell motility and migration. In a murine model of metastatic melanoma, PARP inhibition counteracted the ability of melanoma cells to metastasize to the lung. These results suggest that inhibition of PARP interferes with key metastasis-promoting processes, leading to suppression of invasion and colonization of distal organs by aggressive metastatic cells.

Biodièsel: impacte en origen del biodièsel consumit a Catalunya i a Espanya

Actualment la situació del mercat espanyol i català del biodièsel es caracteritza per les grans importacions d’oli de palma africana. Per a produir aquesta matèria primera s’estan establint plantacions a gran escala d’Elaeis guineensis (palma africana) a Indonèsia. El monocultiu d’Elaeis guineensis i la producció de l’oli tenen associats grans impactes ambientals i socials. Per una banda, els impactes ambientals són principalment la desforestació, el canvi d’ús del sòl, la pèrdua de biodiversitat, l’erosió del sòl i la contaminació de l’aire, del sòl de l’aigua. Per altra banda, els impactes socials més destacats són la violació dels drets humans dels pobles indígenes, els conflictes d’adquisició de terres i que es compromet la seguretat alimentària del país. Per tant, l’ús del biodièsel produït amb oli de palma africana redueix les emissions de GEH a Espanya i a Catalunya provocant un gran impacte ambiental i social a Indonèsia.