Metodología del entrenamiento de la resistencia específica en el tenis de competición. Revisión y propuesta

El principal objetivo del entrenamiento de la resistencia en el jugador de tenis de competición es mejorar la habilidad para realizar ejercicios de alta intensidad de manera repetida, recuperarse rápidamente de los esfuerzos y mantener dicha intensidad durante el juego, evitando o retardando de esta manera la aparición de la fatiga. Para el desarrollo de los sistemas energéticos específicos, el jugador debe dirigir los entrenamientos al desarrollo de las vías energéticas y patrones de movimiento que predominan en la competición, respetando en la medida de lo posible la naturaleza intermitente del deporte y la participación muscular específica. El entrenamiento intermitente (EI) es un método adecuado y mejora el nivel de especificidad en relación a los métodos continuos o interválicos largos utilizados tradicionalmente y puede realizarse en la pista de tenis mediante ejercicios específicos. Es importante controlar adecuadamente los parámetros de carga del EI para dirigir adecuadamente las adaptaciones fisiológicas y efectos del entrenamiento a las necesidades del deporte. El objetivo de este trabajo es realizar una revisión sobre los principales aspectos fisiológicos y parámetros específicos de carga necesarios para una orientación específica del EI para el tenis y proponer un modelo de variabilidad de dichos parámetros de carga en un entorno específico de entrenamiento.

Improving interMediAte Risk management. MARK study

Background: Cardiovascular risk functions fail to identify more than 50% of patients who develop cardiovascular disease. This is especially evident in the intermediate-risk patients in which clinical management becomes difficult. Our purpose is to analyze if ankle-brachial index (ABI), measures of arterial stiffness, postprandial glucose, glycosylated hemoglobin, self-measured blood pressure and presence of comorbidity are independently associated to incidence of vascular events and whether they can improve the predictive capacity of current risk equations in the intermediate-risk population. Methods/Design: This project involves 3 groups belonging to REDIAPP (RETICS RD06/0018) from 3 Spanish regions. We will recruit a multicenter cohort of 2688 patients at intermediate risk (coronary risk between 5 and 15% or vascular death risk between 3-5% over 10 years) and no history of atherosclerotic disease, selected at random. We will record socio-demographic data, information on diet, physical activity, comorbidity and intermittent claudication. We will measure ABI, pulse wave velocity and cardio ankle vascular index at rest and after a light intensity exercise. Blood pressure and anthropometric data will be also recorded. We will also quantify lipids, glucose and glycosylated hemoglobin in a fasting blood sample and postprandial capillary glucose. Eighteen months after the recruitment, patients will be followed up to determine the incidence of vascular events (later follow-ups are planned at 5 and 10 years). We will analyze whether the new proposed risk factors contribute to improve the risk functions based on classic risk factors. Discussion: Primary prevention of cardiovascular diseases is a priority in public health policy of developed and developing countries. The fundamental strategy consists in identifying people in a high risk situation in which preventive measures are effective and efficient. Improvement of these predictions in our country will have an immediate, clinical and welfare impact and a short term public health effect

On Fault Tolerance Methods for Networks-on-Chip

Technology scaling has proceeded into dimensions in which the reliability of manufactured devices is becoming endangered. The reliability decrease is a consequence of physical limitations, relative increase of variations, and decreasing noise margins, among others. A promising solution for bringing the reliability of circuits back to a desired level is the use of design methods which introduce tolerance against possible faults in an integrated circuit. This thesis studies and presents fault tolerance methods for network-onchip (NoC) which is a design paradigm targeted for very large systems-onchip. In a NoC resources, such as processors and memories, are connected to a communication network; comparable to the Internet. Fault tolerance in such a system can be achieved at many abstraction levels. The thesis studies the origin of faults in modern technologies and explains the classification to transient, intermittent and permanent faults. A survey of fault tolerance methods is presented to demonstrate the diversity of available methods. Networks-on-chip are approached by exploring their main design choices: the selection of a topology, routing protocol, and flow control method. Fault tolerance methods for NoCs are studied at different layers of the OSI reference model. The data link layer provides a reliable communication link over a physical channel. Error control coding is an efficient fault tolerance method especially against transient faults at this abstraction level. Error control coding methods suitable for on-chip communication are studied and their implementations presented. Error control coding loses its effectiveness in the presence of intermittent and permanent faults. Therefore, other solutions against them are presented. The introduction of spare wires and split transmissions are shown to provide good tolerance against intermittent and permanent errors and their combination to error control coding is illustrated. At the network layer positioned above the data link layer, fault tolerance can be achieved with the design of fault tolerant network topologies and routing algorithms. Both of these approaches are presented in the thesis together with realizations in the both categories. The thesis concludes that an optimal fault tolerance solution contains carefully co-designed elements from different abstraction levels

Prognostic Markers and Prolonged Interferon-alpha Therapy in Renal Cell Carcinoma

Molekyylimarkkerit ja pitkäaikainen alfainterferonihoito munuaissyövässä Munuaissyöpäpotilaiden viiden vuoden elossaololuku on noin 50 %. Aikaisempien tutkimuksien mukaan viiden vuoden elossaololuku metastasoituneessa munuaissyövässä on 3-16 %, kun käytettiin alfainterferonia sisältävää hoitoa. Tyypillisesti alfainterferonia on käytetty vähemmäin kuin 6 kuukautta. Avoimia kysymyksiä ovat alfainterferonin optimaalinen hoitoannos ja hoidon kesto yksin tai yhdessä uusien täsmähoitojen kanssa. Tärkeimmät tavoitteet olivat tutkia 1) jaksotetun pitkäaikaisen alfainterferonihoidon tehoa ja siedettävyyttä metastasoituneessa munuaissyövässä ja 2) p53-, Ki-67- ja COX-2-proteiinituotannon ennusteellista merkitystä munuaissyövässä. Tutkimuksessa 117 metastasoituneelle munuaissyöpää sairastaneelle potilaalle etsittiin yksilöllinen hänen sietämänsä maksimaalinen hoitoannos rekombinanttia alfa2a-interferonia (Roferon-ATM). Hoitoa pyrittiin jatkamaan 24 kuukauden ajan. Kolmen hoitoviikon jälkeen pidettiin yhden viikon tauko. Hoito lopetettiin, jos ilmaantui vakavia haittavaikutuksia tai tauti eteni. Toisessa tutkimuksessa proteiinituotanto analysoitiin immunohistokemiallisesti munuaissyöpäpotilaiden kasvainnäytteistä, joita oli säilytetty parafiinissa. Kasvainnäytteet oli otettu talteen munuaisen poistoleikkauksen yhteydessä. Nämä potilaat jaettiin kolmeen eri ryhmään: metastasointi primaarivaiheessa (n=29), metastasointi myöhemmin (n=37) ja ei metastasointia (n=51). Keskimääräinen alfainterferonihoidon kesto oli 11 kuukautta (kk) [0,5 – 32 kk]. Objektiivinen hoitovaste todettiin 17 %:lla, tautitilanne pysyi ennallaan 42 %:lla ja myöhäinen vaste (yli 12 kk:tta hoidon aloittamisesta) todettiin 3 %:lla. Aika vasteen saavuttamisesta taudin etenemiseen oli keskimäärin 8 kk ja elinaika 19,1 kk. Viiden vuoden elossaololuku oli 16 %. Jos metastasoituneella munuaissyöpäpotilaalla oli keuhkometastasointi, hän selvisi todennäköisemmin viisi vuotta kuin muut potilaat. Henkeä uhkaavia sivuvaikutuksia ei todettu. Yli 12 kk:n ajan kestävä alfainterferonihoito on hyödyllistä niille potilaille, jotka ovat saaneet objektiivisen hoitovasteen tai tautitilanne on pysynyt ennallaan. Positiivinen p53- ja Ki-67-ekspressio yhdessä viittaavat suureen metastasoinnin todennäköisyyteen. Positiivinen COX-2-ekspressio viittaa viivästyneeseen metastaasien ilmaantumiseen. Metastasoituneilla potilailla positiiviset p53- ja Ki-67-ekspressiot viittaavat huonoon ennusteeseen, mutta positiivinen COX-2 ekspressio viittaa suotuisaan ennusteeseen. Positiivinen COX-2- ja negatiivinen Ki-67-ekspressio yhdessä viittaavat parantuneeseen ennusteeseen metastasoituneessa munuaissyövässä.

Determinação simultânea de As, Cd e Pb em amostras de água purificada para hemodiálise por espectrometria de absorção atômica com forno de grafite, após otimização multivariada baseada no uso de planejamento experimental

This paper reports the development of a methodology for simultaneously determining As, Cd and Pb, employing GF AAS with polarized Zeeman-effect background correction. In order to make the procedure applicable, the influence of pyrolysis and atomization temperatures and the amount of chemical modifiers were studied. Factorial and central composite designs were used to optimize these variables. Precision and accuracy of the method were investigated using Natural Water Reference material, Nist SRM 1640. Results are in agreement with certified values at the 95% confidence limit when the Student t-test is used. This methodology was used for quality control of purified water for hemodialysis.

Actualización en técnicas continuas de reemplazo renal

El fracaso renal agudo afecta a un 25% de los pacientes hospitalizados en las unidades de cuidados intensivos. A pesar de los avances tecnológicos, la mortalidad de estos pacientes sigue siendo elevada debido a las complicaciones asociadas. Uno de los tratamientos del fracaso renal agudo son las técnicas continuas de reemplazo renal ya que permiten tratar las complicaciones y disminuir la mortalidad. El conocimiento y la habilidad de la enfermera en relación con estas técnicas serán decisivos para el éxito de la terapia. Para ello, la formación y la experiencia de la enfermera son el componente clave. El presente artículo tiene como objetivo actualizar los conocimientos sobre las técnicas continuas de reemplazo renal. Para ello, se realiza una revisión de los principios físico-químicos, como la difusión y la convección, entre otros, una descripción de las modalidades de las técnicas continuas de reemplazo renal, una presentación de los principales accesos vasculares y una descripción de los cuidados enfermeros y de las complicaciones relacionadas con las técnicas utilizadas.

Optimal trading of wind power in the short term market

The energy reform, which is happening all over the world, is caused by the common concern of the future of the humankind in our shared planet. In order to keep the effects of the global warming inside of a certain limit, the use of fossil fuels must be reduced. The marginal costs of the renewable sources, RES are quite high, since they are new technology. In order to induce the implementation of RES to the power grid and lower the marginal costs, subsidies were developed in order to make the use of RES more profitable. From the RES perspective the current market is developed to favor conventional generation, which mainly uses fossil fuels. Intermittent generation, like wind power, is penalized in the electricity market since it is intermittent and thus diffi-cult to control. Therefore, the need of regulation and thus the regulation costs to the producer differ, depending on what kind of generation market participant owns. In this thesis it is studied if there is a way for market participant, who has wind power to use the special characteristics of electricity market Nord Pool and thus reach the gap between conventional generation and the intermittent generation only by placing bids to the market. Thus, an optimal bid is introduced, which purpose is to minimize the regulation costs and thus lower the marginal costs of wind power. In order to make real life simulations in Nord Pool, a wind power forecast model was created. The simulations were done in years 2009 and 2010 by using a real wind power data provided by Hyötytuuli, market data from Nord Pool and wind forecast data provided by Finnish Meteorological Institute. The optimal bid needs probability intervals and therefore the methodology to create probability distributions is introduced in this thesis. In the end of the thesis it is shown that the optimal bidding improves the position of wind power producer in the electricity market.

Pienahitsin sijainnin vaikutus kuormaa kantamattoman T-liitoksen väsymiskestävyyteen

Hitsatuissa rakenteissa on paljon hitsien aiheuttamia epäjatkuvuuskohtia, jotka ovat alttiita vaurioitumaan väsyttävän kuormituksen alaisina. Standardit ja normit auttavat suunnittelua rakenneyksityiskohtien analysoinnissa, mutta ohjeiden arvot vaihtelevat paljon. Onkin tär-keää päättää, mitä standardia tai normia käytetään ja saada tutkimustuloksia tukemaan ohjeen käyttöä. Tämä työ on tehty Konecranes Finland Oy:lle. Työn tarkoituksena on etsiä käytössä olevi-en ohjeiden joukosta suunnittelun kannalta parhaiten todellista rakennetta kuvaava. Työssä esitellään käytössä olevia standardeja ja normeja sekä vertaillaan niiden välisiä eroja rakenneyksityiskohdan väsymiskestävyyden määrittämisessä. Työssä tarkastellaan myös hitsatun rakenteen väsymiseen vaikuttavia tekijöitä sekä väsymisanalyysissä käytet-täviä menetelmiä. Tutkittavaan liitokseen valittiin kolme erilaista hitsiä, yksi –ja kaksipuolinen pienahitsi sekä katkopienahitsi. Elementtimenetelmän avulla luotiin malleja koekappaleista ja laskettiin niille väsymiskestävyydet. Tämä lisäksi väsymistä tarkasteltiin väsytyskokeilla, jotka suoritti Lappeenrannan Teknillisen Yliopiston Teräsrakenteiden laboratorio. Lopputuloksena työstä saatiin tietoa hitsien väsymiskestävyyksistä. Liitosten väsymiskes-tävyydet olivat hyviä ja varsinkin katkopienahitsin tulokset olivat odotettua paremmat. Kat-kopienahitsin väsymiskestävyys vaatii tämän työn tulosten perusteella lisää tutkimista.

Trombose mesentérica como complicação da colecistectomia videolaparoscópica

Intestinal complications after laparoscopic cholecystectomy are rare and usually caused by direct injury sustained on trocar insertion. However, intestinal ischaemia has been reported as an unusual complication of the pneumoperitoneum. We describe a 55-years-old patient who underwent an uneventful laparoscopic cholecystectomy after an episode of acute cholecystitis. Initial recovery was complicated by development of increasing abdominal pain which led to open laparotomy on day 2. Gangrene of the distal ileum and right-sided colon was detected and small bowel resection with right colectomy and primary anastomosis was performed. Histological examination of the resected ileum showed features of venous hemorragic infarction and trombosis. In view of the proximity of the operation it is assumed that ileal ischaemia was precipitated by carbon dioxide pneumoperitoneum. Some studies have been demonstrated that, within 30 minutes of establishing a pneumoperitoneum at an intraabdominal pressure of 16 mmHg, cardiac output, blood flow in the superior mesenteric artery and portal vein decrease progressively. Carbon dioxide pneumoperitoneum may lead to mechanical compression of the splanchnic veins and mesenteric vasoconstriction as a result of carbon dioxide absortion. The distribution of the ischaemic segment of intestine is also unusual as the most precarious blood supply is traditionally at the splenic flexure of the colon. It has been suggested that intermittent decompression of the abdomen reduces the risk of mesenteric ischaemia during penumoperitoneum especially in patients with predisposing clinical features for arteriosclerosis intestinal. In present patient was observed intestinal venous infarction what remains unclear but we think the carbon dioxide pneumoperitoneum have been related to it.

Adenoma viloso com transformação carcinomatosa da ampola de Vater

Villous adenomas of the duodenum and ampulla of Vater are uncommon, but they have been diagnosed more frequently with the increasing use of upper gastrointestinal endoscopy. Differential diagnosis with villous adenocarcinoma may be difficult. The authors present a case of a 47-year-old man with a giant villous adenoma of the duodenum, with intermittent jaundice, that was treated by pancreatoduodenectomy.

Hemoptise como manifestação de aneurisma de aorta torácica descendente

Aortotracheal fistula is a rare condition that is invariably fatal if not diagnosed and surgically treated. Patients usually present with small intermittent hemoptysis. The findings using computerized tomography (CT) are usually diagnostic. CT should be considered in the initial investigation of patients suspected to have such a disease. A 62-year-old woman with a aneurysm of the descending thoracic aorta presented with new-onset back pain and hemoptysis. The hemoptysis was thought to be the result of invasion of the bronchial tree by the aneurysm.

Volvo de ceco complicado por icterícia séptica

Cecal volvulus is an uncommon cause of acute bowel obstruction in adults. The mechanism is torsion of the enlarged, poorly-fixed or hypermobile cecum. Patients with this condition may display highly variable clinical presentations, ranging from intermittent, self-limiting abdominal discomfort to acute abdominal pain associated with intestinal strangulation and sepsis. The treatment needs to be individualized for each case, but surgical management is required in almost every case. In the presence of gangrene or perforation of the cecum, resection and primary ileocolic anastomosis is recommended. However, in non-complicated cases detorsion and cecopexy are adequate. The authors report one case of cecal volvulus in a 55-year-old women treated with cecopexy that complicated with septic jaundice.

Study of carotid disease in patients with peripheral artery disease

Objective: To study the stenosis of the carotid arteries in patients with symptomatic peripheral arterial disease.Methods: we assessed 100 consecutive patients with symptomatic peripheral arterial disease in stages of intermittent claudication, rest pain or ulceration. Carotid stenosis was studied by echo-color-doppler, and considered significant when greater than or equal to 50%. We used univariate analysis to select potential predictors of carotid stenosis, later taken to multivariate analysis.Results: The prevalence of carotid stenosis was 84%, being significant in 40% and severe in 17%. The age range was 43-89 years (mean 69.78). Regarding gender, 61% were male and 39% female. Half of the patients had claudication and half had critical ischemia. Regarding risk factors, 86% of patients had hypertension, 66% exposure to smoke, 47% diabetes, 65% dyslipidemia, 24% coronary artery disease, 16% renal failure and 60% had family history of cardiovascular disease. In seven patients, there was a history of ischemic cerebrovascular symptoms in the carotid territory. The presence of cerebrovascular symptoms was statistically significant in influencing the degree of stenosis in the carotid arteries (p = 0.02 at overall assessment and p = 0.05 in the subgroups of significant and non-significant stenoses).Conclusion: the study of the carotid arteries by duplex scan examination is of paramount importance in the evaluation of patients with symptomatic peripheral arterial disease, and should be systematically conducted in the study of such patients.

Horizontal Slug Flow in a Large-Size Pipeline: Experimentation and Modeling

The knowledge of the slug flow characteristics is very important when designing pipelines and process equipment. When the intermittences typical in slug flow occurs, the fluctuations of the flow variables bring additional concern to the designer. Focusing on this subject the present work discloses the experimental data on slug flow characteristics occurring in a large-size, large-scale facility. The results were compared with data provided by mechanistic slug flow models in order to verify their reliability when modelling actual flow conditions. Experiments were done with natural gas and oil or water as the liquid phase. To compute the frequency and velocity of the slug cell and to calculate the length of the elongated bubble and liquid slug one used two pressure transducers measuring the pressure drop across the pipe diameter at different axial locations. A third pressure transducer measured the pressure drop between two axial location 200 m apart. The experimental data were compared with results of Camargo's1 algorithm (1991, 1993), which uses the basics of Dukler & Hubbard's (1975) slug flow model, and those calculated by the transient two-phase flow simulator OLGA.

Detection of Horizontal Two-Phase Flow Patterns Through a Neural Network Model

One of the main problems related to the transport and manipulation of multiphase fluids concerns the existence of characteristic flow patterns and its strong influence on important operation parameters. A good example of this occurs in gas-liquid chemical reactors in which maximum efficiencies can be achieved by maintaining a finely dispersed bubbly flow to maximize the total interfacial area. Thus, the ability to automatically detect flow patterns is of crucial importance, especially for the adequate operation of multiphase systems. This work describes the application of a neural model to process the signals delivered by a direct imaging probe to produce a diagnostic of the corresponding flow pattern. The neural model is constituted of six independent neural modules, each of which trained to detect one of the main horizontal flow patterns, and a last winner-take-all layer responsible for resolving when two or more patterns are simultaneously detected. Experimental signals representing different bubbly, intermittent, annular and stratified flow patterns were used to validate the neural model.