Ultrafast Echocardiography

Grâce à son accessibilité, sa polyvalence et sa sécurité, l'échocardiographie est devenue la technique d'imagerie la plus utilisée pour évaluer la fonction cardiaque. Au vu du succès de l'échographie ultrarapide par ondes planes des techniques similaires pour augmenter la résolution temporelle en échocardiographie ont été mise en oeuvre. L’augmentation de la résolution temporelle de l’échographie cardiaque au-delà des valeurs actuellement atteignables (~ 60 à 80 images par secondes), pourrait être utilisé pour améliorer d’autres caractéristiques de l'échocardiographie, comme par exemple élargir la plage de vitesses détectables en imagerie Doppler couleur limitées par la valeur de Nyquist. Nous avons étudié l'échocardiographie ultrarapide en utilisant des fronts d’ondes ultrasonores divergentes. La résolution temporelle atteinte par la méthode d'ondes divergentes a permis d’améliorer les capacités des modes d’échocardiographie en mode B et en Doppler couleur. La résolution temporelle de la méthode mode B a été augmentée jusqu'à 633 images par secondes, tout en gardant une qualité d'image comparable à celle de la méthode d’échocardiographie conventionnelle. La vitesse de Nyquist de la méthode Doppler couleur a été multipliée jusqu'à 6 fois au delà de la limite conventionnelle en utilisant une technique inspirée de l’imagerie radar; l’implémentation de cette méthode n’aurait pas été possible sans l’utilisation de fronts d’ondes divergentes. Les performances avantageuses de la méthode d'échocardiographie ultrarapide sont supportées par plusieurs résultats in vitro et in vivo inclus dans ce manuscrit.

Safe Contiki OS: Type and Memory Safety for Contiki OS

Embedded systems, especially Wireless Sensor Nodes are highly prone to Type Safety and Memory Safety issues. Contiki, a prominent Operating System in the domain is even more affected by the problem since it makes extensive use of Type casts and Pointers. The work is an attempt to nullify the possibility of Safety violations in Contiki. We use a powerful, still efficient tool called Deputy to achieve this. We also try to automate the process

Safe Contiki OS: Type and Memory Safety for Contiki OS

Embedded systems, especially Wireless Sensor Nodes are highly prone to Type Safety and Memory Safety issues. Contiki, a prominent Operating System in the domain is even more affected by the problem since it makes extensive use of Type casts and Pointers. The work is an attempt to nullify the possibility of Safety violations in Contiki. We use a powerful, still efficient tool called Deputy to achieve this. We also try to automate the process

New studies on the versatile roles of Polyaniline and its composites in polymer based optoelectronic and energy storage devices

From the early stages of the twentieth century, polyaniline (PANI), a well-known and extensively studied conducting polymer has captured the attention of scientific community owing to its interesting electrical and optical properties. Starting from its structural properties, to the currently pursued optical, electrical and electrochemical properties, extensive investigations on pure PANI and its composites are still much relevant to explore its potentialities to the maximum extent. The synthesis of highly crystalline PANI films with ordered structure and high electrical conductivity has not been pursued in depth yet. Recently, nanostructured PANI and the nanocomposites of PANI have attracted a great deal of research attention owing to the possibilities of applications in optical switching devices, optoelectronics and energy storage devices. The work presented in the thesis is centered around the realization of highly conducting and structurally ordered PANI and its composites for applications mainly in the areas of nonlinear optics and electrochemical energy storage. Out of the vast variety of application fields of PANI, these two areas are specifically selected for the present studies, because of the following observations. The non-linear optical properties and the energy storing properties of PANI depend quite sensitively on the extent of conjugation of the polymer structure, the type and concentration of the dopants added and the type and size of the nano particles selected for making the nanocomposites. The first phase of the work is devoted to the synthesis of highly ordered and conducting films of PANI doped with various dopants and the structural, morphological and electrical characterization followed by the synthesis of metal nanoparticles incorporated PANI samples and the detailed optical characterization in the linear and nonlinear regimes. The second phase of the work comprises the investigations on the prospects of PANI in realizing polymer based rechargeable lithium ion cells with the inherent structural flexibility of polymer systems and environmental safety and stability. Secondary battery systems have become an inevitable part of daily life. They can be found in most of the portable electronic gadgets and recently they have started powering automobiles, although the power generated is low. The efficient storage of electrical energy generated from solar cells is achieved by using suitable secondary battery systems. The development of rechargeable battery systems having excellent charge storage capacity, cyclability, environmental friendliness and flexibility has yet to be realized in practice. Rechargeable Li-ion cells employing cathode active materials like LiCoO2, LiMn2O4, LiFePO4 have got remarkable charge storage capacity with least charge leakage when not in use. However, material toxicity, chance of cell explosion and lack of effective cell recycling mechanism pose significant risk factors which are to be addressed seriously. These cells also lack flexibility in their design due to the structural characteristics of the electrode materials. Global research is directed towards identifying new class of electrode materials with less risk factors and better structural stability and flexibility. Polymer based electrode materials with inherent flexibility, stability and eco-friendliness can be a suitable choice. One of the prime drawbacks of polymer based cathode materials is the low electronic conductivity. Hence the real task with this class of materials is to get better electronic conductivity with good electrical storage capability. Electronic conductivity can be enhanced by using proper dopants. In the designing of rechargeable Li-ion cells with polymer based cathode active materials, the key issue is to identify the optimum lithiation of the polymer cathode which can ensure the highest electronic conductivity and specific charge capacity possible The development of conducting polymer based rechargeable Li-ion cells with high specific capacity and excellent cycling characteristics is a highly competitive area among research and development groups, worldwide. Polymer based rechargeable batteries are specifically attractive due to the environmentally benign nature and the possible constructional flexibility they offer. Among polymers having electrical transport properties suitable for rechargeable battery applications, polyaniline is the most favoured one due to its tunable electrical conducting properties and the availability of cost effective precursor materials for its synthesis. The performance of a battery depends significantly on the characteristics of its integral parts, the cathode, anode and the electrolyte, which in turn depend on the materials used. Many research groups are involved in developing new electrode and electrolyte materials to enhance the overall performance efficiency of the battery. Currently explored electrolytes for Li ion battery applications are in liquid or gel form, which makes well-defined sealing essential. The use of solid electrolytes eliminates the need for containment of liquid electrolytes, which will certainly simplify the cell design and improve the safety and durability. The other advantages of polymer electrolytes include dimensional stability, safety and the ability to prevent lithium dendrite formation. One of the ultimate aims of the present work is to realize all solid state, flexible and environment friendly Li-ion cells with high specific capacity and excellent cycling stability. Part of the present work is hence focused on identifying good polymer based solid electrolytes essential for realizing all solid state polymer based Li ion cells.The present work is an attempt to study the versatile roles of polyaniline in two different fields of technological applications like nonlinear optics and energy storage. Conducting form of doped PANI films with good extent of crystallinity have been realized using a level surface assisted casting method in addition to the generally employed technique of spin coating. Metal nanoparticles embedded PANI offers a rich source for nonlinear optical studies and hence gold and silver nanoparticles have been used for making the nanocomposites in bulk and thin film forms. These PANI nanocomposites are found to exhibit quite dominant third order optical non-linearity. The highlight of these studies is the observation of the interesting phenomenon of the switching between saturable absorption (SA) and reverse saturable absorption (RSA) in the films of Ag/PANI and Au/PANI nanocomposites, which offers prospects of applications in optical switching. The investigations on the energy storage prospects of PANI were carried out on Li enriched PANI which was used as the cathode active material for assembling rechargeable Li-ion cells. For Li enrichment or Li doping of PANI, n-Butyllithium (n-BuLi) in hexanes was used. The Li doping as well as the Li-ion cell assembling were carried out in an argon filled glove box. Coin cells were assembled with Li doped PANI with different doping concentrations, as the cathode, LiPF6 as the electrolyte and Li metal as the anode. These coin cells are found to show reasonably good specific capacity around 22mAh/g and excellent cycling stability and coulombic efficiency around 99%. To improve the specific capacity, composites of Li doped PANI with inorganic cathode active materials like LiFePO4 and LiMn2O4 were synthesized and coin cells were assembled as mentioned earlier to assess the electrochemical capability. The cells assembled using the composite cathodes are found to show significant enhancement in specific capacity to around 40mAh/g. One of the other interesting observations is the complete blocking of the adverse effects of Jahn-Teller distortion, when the composite cathode, PANI-LiMn2O4 is used for assembling the Li-ion cells. This distortion is generally observed, near room temperature, when LiMn2O4 is used as the cathode, which significantly reduces the cycling stability of the cells.

Effect of management strategies on the performance of ruminant livestock production systems and the safety of plant and animal products in the city of Sikasso, Mali

The regional population growth in West Africa, and especially its urban centers, will bring about new and critical challenges for urban development policy, especially in terms of ensuring food security and providing employment for the growing population. (Peri-) urban livestock and vegetable production systems, which can contribute significantly to these endeavours, are limited by various constraints, amongst them limited access to expensive production factors and their (in)efficient use. To achieve sustainable production systems with low consumer health risks, that can meet the urban increased demand, this doctoral thesis determined nutrient use efficiencies in representative (peri-) urban livestock production systems in three West African cities, and investigated potential health risks for consumers ensuing from there. The field study, which was conducted during July 2007 to December 2009, undertook a comparative analysis of (peri-) urban livestock production strategies across 210 livestock keeping households (HH) in the three West African cities of Kano/Nigeria (84 HH), Bobo Dioulasso/Burkina Faso (63 HH) and Sikasso/Mali (63 HH). These livestock enterprises were belonging to the following three farm types: commercial gardening plus field crops and livestock (cGCL; 88 HH), commercial livestock plus subsistence field cropping (cLsC; 109 HH) and commercial gardening plus semi-commercial livestock (cGscL; 13 HH) which had been classified in a preceding study; they represented the diversity of (peri-) urban livestock production systems in West Africa. In the study on the efficiency of ruminant livestock production, lactating cowsand sheep herd units were differentiated based on whether feed supplements were offered to the animals at the homestead (Go: grazing only; Gsf: mainly grazing plus some supplement feeding). Inflows and outflows of nutrients were quantified in these herds during 18 months, and the effects of seasonal variations in nutrient availability on animals’ productivity and reproductive performance was determined in Sikasso. To assess the safety of animal products and vegetables, contamination sources of irrigated lettuce and milk with microbiological contaminants, and of tomato and cabbage with pesticide residues in (peri-) urban agriculture systems of Bobo Dioulasso and Sikasso were characterized at three occasions in 2009. Samples of irrigation water, organic fertilizer and ix lettuce were collected in 6 gardens, and samples of cabbage and tomato in 12 gardens; raw and curdled milk were sampled in 6 dairy herds. Information on health risks for consumers of such foodstuffs was obtained from 11 health centers in Sikasso. In (peri-) urban livestock production systems, sheep and goats dominated (P<0.001) in Kano compared to Bobo Dioulasso and Sikasso, while cattle and poultry were more frequent (P<0.001) in Bobo Dioulasso and Sikasso than in Kano. Across cities, ruminant feeding relied on grazing and homestead supplementation with fresh grasses, crop residues, cereal brans and cotton seed cake; cereal grains and brans were the major ingredients of poultry feeds. There was little association of gardens and livestock; likewise field cropping and livestock were rarely integrated. No relation existed between the education of the HH head and the adoption of improved management practices (P>0.05), but the proportion of HH heads with a long-term experience in (peri-) urban agriculture was higher in Kano and in Bobo Dioulasso than in Sikasso (P<0.001). Cattle and sheep fetched highest market prices in Kano; unit prices for goats and chicken were highest in Sikasso. Animal inflow, outflow and dairy herd growth rates were significantly higher (P<0.05) in the Gsf than in the Go cattle herds. Maize bran and cottonseed expeller were the main feeds offered to Gsf cows as dry-season supplement, while Gsf sheep received maize bran, fresh grasses and cowpea pods. The short periodic transhumance of Go dairy cows help them maintaining their live weight, whereas Gsf cows lost weight during the dry season despite supplement feeding at a rate of 1506 g dry matter per cow and day, resulting in low productivity and reproductive performance. The daily live weight gains of calves and lambs, respectively, were low and not significantly different between the Go and the Gsf system. However, the average live weight gains of lambs were significantly higher in the dry season (P<0.05) than in the rainy season because of the high pressure of gastrointestinal parasites and of Trypanosoma sp. In consequence, 47% of the sheep leaving the Go and Gsf herds died due to diseases during the study period. Thermo-tolerant coliforms and Escherichia coli contamination levels of irrigation water significantly exceeded WHO recommendations for the unrestricted irrigation of vegetables consumed raw. Microbial contamination levels of lettuce at the farm gate and the market place in Bobo Dioulasso and at the farm gate in Sikasso were higher than at the market place in Sikasso (P<0.05). Pesticide residues were detected in only one cabbage and one tomato sample and were below the maximum residue limit for consumption. Counts of thermo-tolerant coliforms and Escherichia coli were higher in curdled than in raw milk (P<0.05). From 2006 to x 2009, cases of diarrhea/vomiting and typhoid fever had increased by 11% and 48%, respectively, in Sikasso. For ensuring economically successful and ecologically viable (peri-) urban livestock husbandry and food safety of (peri-) urban foodstuffs of animal and plant origin, the dissemination and adoption of improved feeding practices, livestock healthcare and dung management are key. In addition, measures fostering the safety of animal products and vegetables including the appropriate use of wastewater in (peri-) urban agriculture, restriction to approve vegetable pesticides and the respect of their latency periods, and passing and enforcement of safety laws is required. Finally, the incorporation of environmentally sound (peri-) urban agriculture in urban planning by policy makers, public and private extension agencies and the urban farmers themselves is of utmost importance. To enable an efficient (peri-) urban livestock production in the future, research should concentrate on cost-effective feeding systems that allow meeting the animals’ requirement for production and reproduction. Thereby focus should be laid on the use of crop-residues and leguminous forages. The improvement of the milk production potential through crossbreeding of local cattle breeds with exotic breeds known for their high milk yield might be an accompanying option, but it needs careful supervision to prevent the loss of the local trypanotolerant purebreds.

Is export orientation a major motivator for the adoption of food safety systems in the Turkish dried fig firms?

Food safety management systems (FSMSs) and the scrutinisation of the food safety practices that are intended for adoption on the firm level both offer strategic value to the dried fig sector. This study aims to prove the hypothesis that export orientation is a major motivating force for the adoption of food safety systems in the Turkish dried fig firms. Data were obtained from 91 dried fig firms located in Aydin, Turkey. Interviews were carried out with firms’ managers/owners using a face-to-face questionnaire designed from May to August of 2010. While 36.3 percent of the interviewed firms had adopted one or more systems, the rest had no certification. A binomial logistic econometric model was employed. The parameters that influenced this decision included contractual agreements with other firms, implementation of good practices by the dried fig farmers, export orientation and cost-benefit ratio. Interestingly, the rest of the indicators employed had no statistically significant effect on adoption behaviour. This paper focusses on the export orientation parameter directly in order to test the validity of the main research hypothesis. The estimated marginal effect suggests that when dried fig firms are export-oriented, the probability that these firms will adopt food safety systems goes up by 39.5 percent. This rate was the first range observed among all the marginal probability values obtained and thus verified the hypothesis that export orientation is a major motivator for the adoption of food safety systems in the Turkish dried fig firms.

Organic consumers' attitudes and preferences regarding alternatives to piglet castration without anaesthesia and analgesia in organic farming - an explorative analysis

In Germany and other European countries piglets are routinely castrated in order to avoid the occurrence of boar taint, an off-flavour and off-odour of pork. Sensory perception of boar taint varies; however, it is regarded as very unpleasant by many people. Surgical castration which is an effective means against boar taint has commonly been performed without anaesthesia or analgesia within the piglets’ first seven days of life. Piglet castration without anaesthesia has been heavily criticised, as the assumption that young piglets perceive less pain than older animals cannot be supported by scientific evidence. Consequently, surgical castration is only allowed with anaesthesia and/or analgesia in organic farming throughout the European Union since January 2012. Abandoning piglet castration without pain relief requires the implementation of alternative methods which improve animal welfare while maintaining sensory meat quality. There are three relevant alternatives: castration with anaesthesia and/or analgesia to reduce pain, a vaccination against boar taint (immunocastration) and the fattening of uncastrated male pigs (fattening of boars) combined with measures to reduce and detect boar taint in meat. Consumers’ attitudes and opinions regarding the alternatives are an important factor with regard to the implementation of alternatives, as they are finally supposed to buy the meat. The objective of this dissertation was to explore organic consumers’ attitudes, preferences and willingness-to-pay regarding piglet castration without pain relief and the three alternatives. Important aspects for the evaluation of the alternatives and influencing factors (e.g. information, taste) on preferences and willingness-to-pay should also be identified. In autumn 2009 nine focus group discussions were conducted each followed by a Vickrey auction including a tasting of boar salami. Overall, 89 consumers of organic pork participated in the study. Information on piglet castration and alternatives (in three variants) was provided as a basis for discussion. The focus group data were analysed using qualitative content analysis. In order to compare the focus group results with those from the auctions, an innovative approach applying an adapted scoring model to further analyse the data set was used. The majority of participants were not aware that piglets are castrated without anaesthesia in organic farming. They reacted shocked and disappointed on learning about this practice which did not fit into their image of animal welfare standards in organic farming. Overall, the results show, that for consumers of organic pork castration with anaesthesia and analgesia as well as the fattening of boars may be acceptable alternatives in organic farming. Considering the strong food safety concerns regarding immunocastration, acceptance of this alternative may be questioned. Communication regarding alternatives to piglet castration without anaesthesia and analgesia should take into account that the relevance of the aspects animal welfare, food safety, taste and costs differs between alternatives. Furthermore, it seems advisable not to address an unappetizing topic like piglet castration directly at the point of sale so as not to deter consumers from buying organic pork. The issue of piglet castration demonstrates exemplarily that it is important for the organic sector to implement and maintain high animal welfare standards and communicate them in an appropriate way, thereby trying to prevent strong discrepancies between consumers’ expectations regarding animal husbandry in organic farming and actual conditions. So, disappointment of consumers and a loss of image due to negative reports about animal welfare issues can be avoided.

When zero doesn't mean it and other geomathematical mischief

There is almost not a case in exploration geology, where the studied data doesn’t includes below detection limits and/or zero values, and since most of the geological data responds to lognormal distributions, these “zero data” represent a mathematical challenge for the interpretation. We need to start by recognizing that there are zero values in geology. For example the amount of quartz in a foyaite (nepheline syenite) is zero, since quartz cannot co-exists with nepheline. Another common essential zero is a North azimuth, however we can always change that zero for the value of 360°. These are known as “Essential zeros”, but what can we do with “Rounded zeros” that are the result of below the detection limit of the equipment? Amalgamation, e.g. adding Na2O and K2O, as total alkalis is a solution, but sometimes we need to differentiate between a sodic and a potassic alteration. Pre-classification into groups requires a good knowledge of the distribution of the data and the geochemical characteristics of the groups which is not always available. Considering the zero values equal to the limit of detection of the used equipment will generate spurious distributions, especially in ternary diagrams. Same situation will occur if we replace the zero values by a small amount using non-parametric or parametric techniques (imputation). The method that we are proposing takes into consideration the well known relationships between some elements. For example, in copper porphyry deposits, there is always a good direct correlation between the copper values and the molybdenum ones, but while copper will always be above the limit of detection, many of the molybdenum values will be “rounded zeros”. So, we will take the lower quartile of the real molybdenum values and establish a regression equation with copper, and then we will estimate the “rounded” zero values of molybdenum by their corresponding copper values. The method could be applied to any type of data, provided we establish first their correlation dependency. One of the main advantages of this method is that we do not obtain a fixed value for the “rounded zeros”, but one that depends on the value of the other variable. Key words: compositional data analysis, treatment of zeros, essential zeros, rounded zeros, correlation dependency

Mixing compositions and other scales

Theory of compositional data analysis is often focused on the composition only. However in practical applications we often treat a composition together with covariables with some other scale. This contribution systematically gathers and develop statistical tools for this situation. For instance, for the graphical display of the dependence of a composition with a categorical variable, a colored set of ternary diagrams might be a good idea for a first look at the data, but it will fast hide important aspects if the composition has many parts, or it takes extreme values. On the other hand colored scatterplots of ilr components could not be very instructive for the analyst, if the conventional, black-box ilr is used. Thinking on terms of the Euclidean structure of the simplex, we suggest to set up appropriate projections, which on one side show the compositional geometry and on the other side are still comprehensible by a non-expert analyst, readable for all locations and scales of the data. This is e.g. done by defining special balance displays with carefully- selected axes. Following this idea, we need to systematically ask how to display, explore, describe, and test the relation to complementary or explanatory data of categorical, real, ratio or again compositional scales. This contribution shows that it is sufficient to use some basic concepts and very few advanced tools from multivariate statistics (principal covariances, multivariate linear models, trellis or parallel plots, etc.) to build appropriate procedures for all these combinations of scales. This has some fundamental implications in their software implementation, and how might they be taught to analysts not already experts in multivariate analysis

Laser Safety in higher education - Classic video!

Vintage video (1986) on laser safety, presented by Dr. Gillian Rice. This is a 37 minute video, explaining the hazards which are likely to be encountered and ways to reduce those hazards in teaching and research laboratories in higher education. Presented in 5 parts: Part 1 (1:49) Laser radiation and the body Part 2 (8:49) Classes of laser Part 3 (13:32) Safety measures Part 4 (21:32) Other risks: precautions Part 5 (31:49) Summary

Compromiso neurológico periférico y exposición a plaguicidas en cultivadores de arroz en una zona rural, Colombia.

Objetivos Mediante un estudio descriptivo transversal, establecer la presencia de una relación entre los niveles de exposición a plaguicidas con la presencia de hallazgos clínicos neurológicos periféricos en personas expuestas ocupacionalmente a estos. Resultados La muestra poblacional fue de 59 trabajadores, en el área rural del municipio del Espinal, Tolima. El 52% de la población refirió usar organofosforados, 32 % carbamatos, 16% organoclorados, y 66% otros grupos de plaguicidas. Los niveles sanguíneos de carbamatos estuvieron presentes en el 7% de la población, organofosforados en el 66% y organoclorados en el 100%. En el 42% de la población se estableció sospecha de neuropatía a partir de los síntomas y en el 92% a partir de los signos. Se estableció asociación estadísticamente significativa entre los niveles sanguíneos de determinados organoclorados con la sospecha de neuropatía periférica a partir de síntomas; la presencia de sensación de pérdida de la fuerza en extremidades y la presencia de alteraciones en los reflejos osteotendinosos. Conclusiones El presente estudio permitió identificar los plaguicidas a los cuales está expuesta la población agrícola del municipio del Espinal así como corrobora el efecto de bioacumulación y biomagnificación de los organoclorados. Adicionalmente, se detectó la presencia de hallazgos sugestivos de compromiso neurológico periférico, con asociaciones significativas entre ciertas anormalidades y determinados organoclorados. Este estudio es una aproximación a la relación entre la exposición a plaguicidas de la población agrícola de la zona rural del municipio del Espinal con la secuelas neurológicos periféricas asociadas a esta.

Complicaciones del uso del angioseal vs compresión manual en cateterismo cardíaco mediante punción femoral

Objetivo: Comparar las complicaciones del uso de Angioseal® versus compresión manual en los pacientes llevados a cateterismo cardíaco en el Servicio de Hemodinamia de la Fundación Santa Fe de Bogotá, del 1º de enero de 2005 al 31 de diciembre de 2010, mediante punción arterial femoral percutánea. Metodología: Se realizó un Estudio Observacional, Analítico, de tipo Cohorte Retrospectiva. Partiendo de dos grupos de personas con indicación de cateterismo cardíaco por cualquier causa, uno expuesto al procedimiento con Angioseal® y el otro con compresión manual. Resultados: Con el uso de Angioseal® versus compresión manual la aparición de complicaciones fue 7,3% vs 4,1%, estas diferencias no fueron significativas (OR 1,81 IC95 0,96-3,40; RR 1,75 IC95 0,96-3,18) . La enfermedad coronaria (OR 2,27 IC95 1,07-4,79; RR 2,18 IC95 1,06-4,46) y a la colocación de stent (OR 3,49 IC95 1,82-6,69; RR 3,25 IC95 1,75-6,02 si se relacionaron significativamente con la aparición de complicaciones menores. Conclusión: No encontramos soporte para aprobar o desaprobar el uso de Angioseal® o compresión manual como manejo de la hemostasia, con respecto a las complicaciones. Sin embargo, se encontró que la colocación de stents está fuertemente relacionada con el desarrollo de complicaciones menores, lo cual hace que estos pacientes deban ser objeto de monitorización estrecha.

Eficacia de los inhibidores selectivos de recaptación de serotonina en síntomas no cognitivos del alzhéimer: revisión sistemática

Introducción: El Alzhéimer tiene una prevalencia de 1,6% en las personas mayores de 65 años. Se caracteriza por la pérdida de memoria y otras funciones cognoscitivas, pero más del 70% de los afectados presentan síntomas no cognitivos entre los que se encuentran alteraciones del afecto, comportamiento y psicosis. Estos síntomas están asociados a mayores tasas de institucionalización, morbilidad y mortalidad. Métodos: Revisión sistemática de la literatura de artículos que proporcionaron información sobre la eficacia de los inhibidores selectivos de recaptación de serotonina en síntomas no cognitivos del Alzhéimer. Resultados: La búsqueda inicial arrojó un total de 495 resultados, 64 artículos fueron preseleccionados y 7 se incluyeron en la revisión; éstos se clasificaron como nivel de evidencia Ib; citalopram mostró ser más eficaz que el placebo y similar a antipsicóticos para síntomas comportamentales y psicóticos asociados al Alzhéimer con un perfil de efectos adversos más tolerable; sertralina no mostró eficacia en depresión y sí una mayor incidencia de efectos adversos con respecto al placebo. Discusión: Se obtuvieron resultados favorables en síntomas comportamentales y psicóticos pero no en afectivos. Las diferencias metodológicas de los estudios le dan complejidad a la interpretación de los resultados. Conclusión: La evidencia sugiere que el tratamiento con citalopram es eficaz en síntomas comportamentales y psicóticos asociados al Alzhéimer; para el tratamiento de la depresión asociado a esta demencia aún no existe un antidepresivo que pueda considerarse de elección.

Efecto del flujo del dializado sobre la ganancia interdialítica en hemodiálisis crónica (Estudio FLUGAIN)

Objetivos: Determinar si existe diferencia en la ganancia interdialítica entre los pacientes al ser tratados con flujo de dializado (Qd) de 400 mL/min y 500 mL/min. Diseño: Se realizó un estudio de intervención, cruzado, aleatorizado, doble ciego en pacientes con enfermedad renal crónica en hemodiálisis para determinar diferencias en la ganancia de peso interdialítica entre los pacientes tratados con flujo de dializado (Qd) de 400 ml/min y 500 ml/min. Pacientes: Se analizaron datos de 46 pacientes en hemodiálisis crónica con Qd de 400 ml/min y 45 con Qd de 500 ml/min. Análisis: La prueba de hipótesis para evaluar diferencias en la ganancia interdialítica y las otras variables entre los grupos se realizó mediante la prueba T para muestras pareadas. Para el análisis de correlación se calculó el coeficiente de Pearson. Resultados: No hubo diferencia significativa en ganancia interdialítica usando Qd de 400 ml/min vs 500 ml/min (2.37 ± 0.7 vs 2.41 ± 0.6, p=0.41) ni en Kt/V (1.57 ± 0.25 vs 1.59 ± 0.23, p = 0.45), potasio (4.9 ± 1.1 vs 5.1 ± 1.0, p=0.45), fosforo (4.5 ± 1.2 vs 4.4 ± 1.2, p=0.56) o hemoglobina (11.3 ± 1.8 vs 11.3 ± 1.6, p=0.96). Conclusiones: En pacientes con peso ≤ 65 Kg el uso de Qd de 400 ml/min no se asocia con menor ganancia interdialítica de peso. No hay diferencia en la eficiencia de diálisis lo que sugiere que es una intervención segura a corto plazo.