El Pigmalión de Shaw, manifiesto teatral de la lingüística

La comedia Pigmalión, que Bernard Shaw escribió en 1912 y estrenó al año siguiente, es una proclamación artística de la lingüística. A pesar de la popularidad de la obra, es un acontecimiento que se conoce como una anécdota extravagante. El extraordinario mérito de Pigmalión ha pasado desapercibido para la historia de la lingüística. Su mérito estriba en la calidad teatral, la capacidad prospectiva de Shaw y la intención social de su mensaje. Shaw anuncia la utilidad de la lingüística en facetas que, décadas después, se conocerán como sociolingüística, planificación lingüística y logopedia. Por otra parte, se ha relacionado de modo simplista el personaje del profesor Higgins al fonetista H. Sweet. The play Pygmalion, that Bernard Shaw wrote in 1912 and released the following year, is an artistic proclamation of Linguistics. Despite the popularity of the play, this event is known as an extravagant story. The History of Linguistics does not recognize the extraordinary merit of Pygmalion. Its merit lays in the theatrical quality ant the social intention of the message. Shaw announces the usefulness of Linguistics in facets that will be known as Sociolinguistics, Language Planning and Speech Therapy. And furthermore, in a simplistic way, the character of Professor Higgins has been linked to the phonetician H. Sweet.

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Alveolar haemorrhage (AH) is a rare and potentially life-threatening condition characterised by diffuse blood leakage from the pulmonary microcirculation into the alveolar spaces due to microvascular damage. It is not a single disease but a clinical syndrome that may have numerous causes. Autoimmune disorders account for fewer than half of cases, whereas the majority are due to nonimmune causes such as left heart disease, infections, drug toxicities, coagulopathies and malignancies. The clinical picture includes haemoptysis, diffuse alveolar opacities at imaging and anaemia. Bronchoalveolar lavage is the gold standard method for diagnosing AH. The lavage fluid appears macroscopically haemorrhagic and/or contains numerous haemosiderin-laden macrophages. The diagnostic work-up includes search for autoimmune disorders, review of drugs and exposures, assessment of coagulation and left heart function, and search for infectious agents. Renal biopsy is often indicated if AH is associated with renal involvement, whereas lung biopsy is only rarely useful. Therapy aims at correction of reversible factors and immunosuppressive therapy in autoimmune causes, with plasmapheresis in selected situations.

Entorse aiguë de la Cheville: quelle immobilisation [Acute ankle sprain: which immobilization?]

Acute ankle sprain is the most frequent orthopaedic injury. Up to 4% of patients admitted to the emergency room will present with an acute ankle sprain. The lateral ligaments are involved at various degrees (anterior talo-fibular and calcaneo-fibular ligaments). Grade I acute ankle sprains are well treated with a compression bandage or an Aircast brace. Grade II and III acute ankle sprains are best treated with a below-knee cast. The Aircast brace is the next best treatment for such lesions (grades II and III) and will provide satisfactory support, but has been shown to be not as effective as the below-knee cast in terms of short to mid-term patients outcome (pain and function).

Hémorragie intra-alvéolaire [Alveolar hemorrhage].

Diffuse alveolar hemorrhage (DAH) is defined by the presence of red blood cells originating from the lung capillaries or venules within the alveoli. The diagnosis is established on clinical features, radiological pattern, and especially bronchoalveolar lavage. Diffuse alveolar hemorrhage may have many immune or non-immune causes. Immune causes of DAH include vasculitides, connective tissue diseases, especially systemic lupus erythematosus, and antiglomerular basement membrane antibody disease (Goodpasture's syndrome). Treatment is both supportive and causal, often based on high dose corticosteroids and immunosuppressive therapy (especially intravenous cyclophosphamide). Plasma exchanges are performed in antiglomerular basement membrane antibody disease and systemic lupus erythematosus, and are considered in systemic vasculitis. Non-immune causes of DAH mainly include heart diseases, coagulation disorders, infections, drug toxicities and idiopathic DAH. Treatment of non-immune DAH is that of its cause. Whatever the cause, DAH is an emergency requiring prompt assessment and early treatment.

Anàlisi de les teràpies assistides amb cans en infants amb el trastorn de l'espectre autista

El que es trobarà a continuació és tot el procés de recerca del Treball Final de Grau, on el tema clau s’engloba amb tot el que és el món de la Teràpia Assistida amb Gossos aplicades dintre l’àmbit de les persones amb diferents tipus de discapacitat. No obstant, aquest és un ampli col·lectiu i per tant, s’ha centrat en el context del Trastorn de l’Espectre Autista. És a dir, la finalitat que es busca amb aquesta investigació és saber si les Teràpies Assistides amb Gossos aporten beneficis a infants amb aquest trastorn. La recerca ha estat realitzada amb unes metodologies concretes. Per un costat, s’ha dut a terme un estudi de cas amb observació descriptiva d’un infant amb Trastorn de l’Espectre Autista. Aquí s’ha fet un seguiment d’unes sessions de teràpia concretes amb l’infant autista, el gos i el terapeuta. Així doncs, a partir d’aquest s’ha analitzat, mitjançant unes categories específiques, els beneficis que aporta aquest animal, com a eina terapèutica, a l’Autisme. Encara que, per contrastar aquest, s’ha tingut en compte la opinió des de la vessant familiar i la professional, arribant a una informació més detallada a partir de l’entrevista.

El proyecto ‘Ecosportech’ como ejemplo de universidad emprendedora. Una experiencia a base del ‘Problem Based Learning’

El objetivo de este artículo es presentar el proyecto EcoSPORTech, cuya finalidad es la creación de una empresa social con jóvenes para la realización de actividades deportivas/ocio en el medio natural, integrando las nuevas tecnologías. Este proyecto supone una colaboración interdisciplinaria dentro de la Universidad de Vic, entre las facultades de Empresa y Comunicación (FEC), la de Ciencias de la Salud y el Bienestar (FCSB) y la de Educación (FE) e integra un equipo de profesionales procedentes de los ámbitos de la empresa, el marketing, el periodismo, el deporte y la terapia ocupacional. Estos profesores formarán al grupo de jóvenes con los que se creará la empresa y dirigirán la misma. Esta empresa (cooperativa) se integra en el vivero de empresas sociales que se está creando en la Universidad de Vic.

Helicopter rescue involving the winching of a physician.

INTRODUCTION: We sought to study the operational and medical aspects of helicopter rescue missions involving the use of a winch.¦SETTING: A single helicopter-based medical service of a pre-alpine region of Switzerland.¦METHODS: We prospectively studied consecutive primary rescue interventions involving winching of a physician, from October 1, 1998 to October 1, 2002. Demographic, medical and operational aspects as well as outcome at 48 hours were analyzed.¦RESULTS: We included 133 patients. Most (74%) were male, with traumatic injuries (77%). The median scene time of the nine severely injured patients (Injury Severity Scale [ISS] > 15) was significantly longer compared with the other patients (54 vs 37 minutes; P < .05). The main medical procedures performed were orotracheal intubation (n = 5), fracture reductions (n = 5), major analgesia with sedation (n = 4), and intravenous fluid administration of more than 1,500 mL (n = 4). Fourteen (10%) patients suffering from minor injuries were triaged by the physician and not airlifted to the hospital. All 133 patients were alive at 48 hours. Sixty-nine (52%) were still hospitalized. No secondary interhospital transfer was required.¦CONCLUSION: Our study provides a better knowledge of injury profile, medical aspects, and outcomes of patients rescued necessitating a winching procedure.

Breast cancer suppressor candidate-1 (BCSC-1) is a melanoma tumor suppressor that down regulates MITF.

Understanding the molecular aberrations involved in the development and progression of metastatic melanoma (MM) is essential for a better diagnosis and targeted therapy. We identified breast cancer suppressor candidate-1 (BCSC-1) as a novel tumor suppressor in melanoma. BCSC-1 expression is decreased in human MM, and its ectopic expression in MM-derived cell lines blocks tumor formation in vivo and melanoma cell proliferation in vitro while increasing cell migration. We demonstrate that BCSC-1 binds to Sox10, which down regulates MITF, and results in a switch of melanoma cells from a proliferative to a migratory phenotype. In conclusion, we have identified BCSC-1 as a tumor suppressor in melanoma and as a novel regulator of the MITF pathway.

Seal properties of TachoSil: in vitro hemodynamic measurements.

Fibrin glue products and collagen patches are frequently used as a sealing product, preventing surgical side bleedings. This is especially true in the field of cardiovascular surgery, where increasing numbers of patients are being operated with antiplatelet and anticoagulation therapy. The aim of this report was, in an in vitro hemodynamic setting, to examine the sealant properties of the TachoSil (Nycomed Pharma, Linz, Austria) patch. Burst pressure and normal force of 15 TachoSil sealed defects were measured. This was determined in a closed hydraulic system. Mean burst pressure load for a 5-mm defect was 69+/-11.4 mmHg; for a 7-mm defect was 63+/-16 mmHg; and, 62+/-16 mmHg for the defect with a diameter of 10 mm (P>0.05). The mean calculated normal force was as follows: 0.91+/-0.15 N for the 5 mm defect, 6.5+/-1.6 N for the 7 mm, and 8.1+/-0.75 N for the 10 mm defect. The TachoSil patch has the capability to seal small defects. However, at the larger defects the seal character was significantly reduced. These results suggest that the device may be a good alternative for hemostasis for small defects. The capacity to curtail or stop hemorrhage at the larger defects is unlikely.

Failure of voriconazole to cure disseminated zygomycosis in an immunocompromised child.

Voriconazole is increasingly used as a first-line agent for empirical antifungal therapy of prolonged febrile neutropenia in paediatric cancer patients. We describe the case of a 9-year-old patient with stage IV Burkitt lymphoma, who developed pulmonary and splenic zygomycosis while receiving voriconazole for persistent febrile neutropenia. The causative agent, Absidia corymbifera, was identified by broad-range fungal PCR in a lung biopsy sample. The patient was successfully treated with a combination of partial resection of the left upper lobe and antifungal therapy with high-dose liposomal amphotericin B followed by oral itraconazole as demonstrated by resolving pulmonary infiltrates on serial high resolution CT scans. CONCLUSION: This case emphasises that the lack of in vitro activity of voriconazole against zygomycetes is clinically relevant. Failure of voriconazole in suspected fungal infection should be investigated for the possibility of zygomycosis. Broad-range polymerase chain reaction may be able to identify the causative organism when cultures remain sterile.

Regenerative Medicine at the Single Cell Level

Adult stem cells are instrumental for renewal, regeneration, and repair. Self-renewal and the capacity to generate a tissue for an extended period of time (theoretically a life time) are fundamental properties of adult stem cells that allow longterm tissue reconstruction from a single stem cell as experimentally demonstrated with the bone marrow and the skin. Moreover, human epidermal stem cells (holoclones) can be extensively expanded and manipulated in culture before they are transplanted. We have taken advantage of these unique capacities to demonstrate the feasibility of a single epidermal stem cell approach for ex vivo gene therapy using recessive dystrophic epidermolysis bullosa (RDEB) as a model system. We have demonstrated that is possible to reconstruct a functional epidermis and anchoring fibers from the progeny of a single RDEB epidermal stem cell transduced with a Col7a1 cDNA by means of a SIN retrovirus. Demonstrations of safe proviral insertion, absence of tumorogenicity and of dissemination of the transduced engrafted cells meet regulatory affairs safety requirements.

Prognostic factors affecting long-term outcomes in patients with resected stage IIIA pN2 non-small-cell lung cancer: 5-year follow-up of a phase II study.

The aim was to investigate the efficacy of neoadjuvant docetaxel-cisplatin and identify prognostic factors for outcome in locally advanced stage IIIA (pN2 by mediastinoscopy) non-small-cell lung cancer (NSCLC) patients. In all, 75 patients (from 90 enrolled) underwent tumour resection after three 3-week cycles of docetaxel 85 mg m-2 (day 1) plus cisplatin 40 or 50 mg m-2 (days 1 and 2). Therapy was well tolerated (overall grade 3 toxicity occurred in 48% patients; no grade 4 nonhaematological toxicity was reported), with no observed late toxicities. Median overall survival (OS) and event-free survival (EFS) times were 35 and 15 months, respectively, in the 75 patients who underwent surgery; corresponding figures for all 90 patients enrolled were 28 and 12 months. At 3 years after initiating trial therapy, 27 out of 75 patients (36%) were alive and tumour free. At 5-year follow-up, 60 and 65% of patients had local relapse and distant metastases, respectively. The most common sites of distant metastases were the lung (24%) and brain (17%). Factors associated with OS, EFS and risk of local relapse and distant metastases were complete tumour resection and chemotherapy activity (clinical response, pathologic response, mediastinal downstaging). Neoadjuvant docetaxel-cisplatin was effective and tolerable in stage IIIA pN2 NSCLC, with chemotherapy contributing significantly to outcomes.

Fastidious intracellular bacteria as causal agents of community-acquired pneumonia.

Intracellular bacteria are common causes of community-acquired pneumonia that grow poorly or not at all on standard culture media and do not respond to beta-lactam antibiotic therapy. Apart from well-established agents of pneumonia such as Legionella pneumophila, Mycoplasma pneumoniae, Chlamydia pneumoniae, Chlamydia psittaci and Coxiella burnetii, some new emerging pathogens have recently been recognized, mainly Parachlamydia acanthamoebae and Simkania negevensis, two Chlamydia-related bacteria. Most of them are causes of benign and self-limited infections. However, they may cause severe pneumonia in some cases (i.e., Legionnaires' disease) and they may cause outbreaks representing a public health problem deserving prompt recognition and appropriate therapy. Although extrapulmonary manifestations are often present, no clinical features allow them to be distinguished from classical bacterial agents of pneumonia such as Streptococcus pneumoniae. Thus, specific molecular diagnostic tools are very helpful for early recognition of the offending bacteria, whereas serology often only allows retrospective or late diagnosis. Macrolides remain the best empirical treatment of intracellular respiratory pathogens, although some observational studies suggest that quinolones may be superior for the treatment of legionellosis.

TBS (Trabecular Bone Score) is More Sensitive Than BMD to Diabetes-Related Fracture Risk

Background:Type 2 diabetes (T2D) is associated with increased fracture risk but paradoxically greater BMD. TBS (trabecular bone score), a novel grey-level texture measurement extracted from DXA images, correlates with 3D parameters of bone micro-architecture. We evaluated the ability of lumbar spine (LS) TBS to account for the increased fracture risk in diabetes. Methods:29,407 women ≥50 years at the time of baseline hip and spine DXA were identified from a database containing all clinical BMD results for the Province of Manitoba, Canada. 2,356 of the women satisfied a well-validated definition for diabetes, the vast majority of whom (>90%) would have T2D. LS L14 TBS was derived for each spine DXA examination blinded to clinical parameters and outcomes. Health service records were assessed for incident non-traumatic major osteoporotic fracture codes (mean follow-up 4.7 years). Results:In linear regression adjusted for FRAX risk factors (age,BMI, glucocorticoids, prior major fracture, rheumatoid arthritis, COPD as a smoking proxy, alcohol abuse) and osteoporosis therapy, diabetes was associated with higher BMD for LS, femoral neck and total hip but lower LS TBS (all p<0.001). Similar results were seen after excluding obese subjects withBMI>30. In logistic regression (Figure), the adjusted odds ratio (OR) for a skeletal measurement in the lowest vs highest tertile was less than 1 for all BMD measurements but increased for LS TBS (adjusted OR 2.61, 95%CI 2.30-2.97). Major osteoporotic fractures were identified in 175 (7.4%) with and 1,493 (5.5%) without diabetes (p < 0.001). LS TBS predicted fractures in those with diabetes (adjusted HR 1.27, 95%CI 1.10-1.46) and without diabetes (HR 1.31, 95%CI 1.24-1.38). LS TBS was an independent predictor of fracture (p<0.05) when further adjusted for BMD (LS, femoral neck or total hip). The explanatory effect of diabetes in the fracture prediction model was greatly reduced when LS TBS was added to the model (indicating that TBS captured a large portion of the diabetes-associated risk), but was paradoxically increased from adding any of the BMD measurements. Conclusions:Lumbar spine TBS is sensitive to skeletal deterioration in postmenopausal women with diabetes, whereas BMD is paradoxically greater. LS TBS predicts osteoporotic fractures in those with diabetes, and captures a large portion of the diabetes-associated fracture risk. Combining LS TBS with BMD incrementally improves fracture prediction.

Choroidal schwannoma: a case series of five patients.

AIM: To report a case series of five patients diagnosed with choroidal schwannoma at the Liverpool Ocular Oncology Centre. METHODS: Patients with choroidal schwannoma were identified by searching the computerised database of the Liverpool Ocular Oncology Centre. RESULTS: The patients (3 males, 2 females) ranged in age from 15 years to 45 years. Three tumours were treated by enucleation, trans-scleral local resection, and combined bevacizumab and photodynamic therapy, respectively. Two were observed after confirmation of the diagnosis by biopsy. CONCLUSIONS: Choroidal schwannoma has a variety of clinical manifestations. Associated features include hard exudates, retinal feeder vessels and serous retinal detachment. Biopsy with immunohistochemistry is required for diagnosis. Tumours not amenable to resection may respond to photodynamic therapy.