Uso de hidrolizado proteico en los pacientes de una unida de terapia intensiva neonatal

Introducción. La leche humana es el primer alimento escogido para alimentar a los recién nacidos (RN), especialmente a los prematuros (RNPT y a los de peso muy bajo (RNMBP). Cuando esta leche no está disponible, deben ser recetadas fórmulas especializadas, que promuevan un crecimiento y desarrollo adecuados. El uso de los hidrolizados proteicos (HP) en la UTI neonatal ha sido promovido, debido al riesgo potencial que los RNPT/MBP presentan, por la inmadurez gastrointestinal, problemas de absorción e intolerancia alimentaria. Sin embargo, tales formulaciones no fueran elaboradas para atender las necessidades específicas de estos niños, y pueden, cuando son utilizadas, ocasionar un déficit nutricional. Objetivo. Comparar la progresión de la nutrición enteral (NE) (a través de la oferta de volumen, calorías y proteínas), la evolución ponderal, y las complicaciones clínicas entre recién nacidos de peso muy bajo (RNPMB) alimentados con fórmula para prematuros (FP) e hidrolizado proteico (HP) en la UTI neonatal. Casuística y métodos. Fueran estudiados dos grupos de RNPMB: grupo 1:13RNPMB con edad gestacional media de nacimiento de 30 semanas, peso medio de nacimiento de 1 167 gramos, que recibieron FP. Grupo 2:8 RN con edad gestacional media de nacimiento de 29 semanas, peso medio de nacimiento de 1 141 gramos, alimentados con HP. Las ofertas de volumen, la de calorías y la de proteínas fueran diariamente calculadas para todos los niños en ambos grupos. La nutrición parenteral (NP) que complementaría a la terapia nutricional en las primeras semanas, también fue calculada. Los RNMBP fueron pesados diariamente, por la mañana, en balanza digital (escala de 10 g) debidamente calibrada. El peso medio diario fue calculado hasta el dia 15 de vida. Fueron construidas curvas de crescimento, a través del polinomio de segundo grado para ambos grupos. Para el análisis estadístico se utilizó el test de medias. Resultados. ) La oferta media de volumen, calorías y proteínas fue mayos en la primera semana en el grupo 2, pero de una forma no significativa (p=0.38; 0.34 y 0.05, respectivamente). En las semanas subsequentes, no hubo diferencias significativas en la progresión de NE entre los grupos. No fueron observadas complicaciones clínicas, sólo ocurrieron dos casos de distensión abdominal en el grupo 1, pero no fueron caracterizados como enterocolitis necrosante (ECN). No hubo diferencias estadísticas relacionadas con el aumento de peso entre los dos grupos durante el periodo de estudio; sin embargo, el grupo 1 presentó una tendencia de mejor evolución. conclusión. La prograsión de la NE fue semejante con la utilización de los dos tipos de fórmulas, no feron encontradas diferencias en el aumento de peso de los grupos, y no hubo complicaciones clínicas en ninguno de ellos. No hubo ventajas en el uso del HP en la UTI neonatal; por tanto, no está indicado para RNPMB, sin disfunción intestinal, debido a que su composición nutricional no prevé las necesidades de este grupo de niños

A dança «en-cena» o outro: prerrogativas para uma educação estética através do processo criativo

The dance installs in the body another scene of senses that raises the creative performance and not that can be speculated about it. There, ""who dance"" is the Other one, making the body acting of another manner, beyond the systemic contour of Ego. Without the presence of this forged performance, the body would not pass of one ruled machine in function of something and not in favor of himself, as original movement of himself. This article intends to make a reflection about the corporal perception in the dance, trying to point out the creative performance. So, we opened a way to understand the process creative as field of corporal sensitization where the educative intervention is accomplished in the body.

3-(1-Hydroxy-2-phenylprop-2-en-1-yl)phenol

Two independent pseudo-enantiomeric molecules comprise the asymmetric unit in the title compound, C(15)H(14)O(2). While the central O-C-C-C residue approaches planarity [torsion angles = -15.8 (3) (molecule a) and 15.4 (3)degrees (molecule b)], the benzene rings are approximately orthogonal [the dihedral angles formed between the benzene rings are 62.89 (12) (molecule a) and 80.15 (12)degrees (molecule b)]. Two-dimensional arrays in the ab plane sustained by O-H center dot center dot center dot O hydrogen bonding are found in the crystal structure.

Potassium trifluoro[(Z)-3-(oxan-2-yloxy)prop-1-en-1-yl]borate monohydrate

The title compound, K(+)center dot C(8)H(13)BF(3)O(2)(-)center dot H(2)O, which was obtained from the reaction of a modified form of Z-vinylic telluride via a transmetalation reaction with n-BuLi, crystallizes as K(+) and C(8)H(13)BF(3)O(2)-ions along with a water molecule. The K(+) cation is surrounded by four anions, making close contacts with six F atoms at 2.659 (3)-2.906 (3) angstrom and with two O atoms at 2.806 (3) and 2.921 (3) angstrom in a distorted bicapped trigonal-prismatic geometry.

Prospective and Randomized Comparison of Two Techniques of Staple Line Reinforcement During Open Roux-en-Y Gastric Bypass: Oversewing and Bioabsorbable Seamguard (R)

Aims: Surgical staple line dehiscence usually leads to severe complications. Several techniques and materials have been used to reinforce this stapling and thus reduce the related complications. The objective was to compare safety of two types of anastomotic reinforcement in open gastric bypass. Methods: A prospective, randomized study comparing an extraluminal suture, fibrin glue, and a nonpermanent buttressing material, Seamguard (R), for staple line reinforcement. Fibrin glue was excluded from the study and analysis after two leaks, requiring surgical reintervention, antibiotic therapy, and prolonged patient hospitalization. Results: Twenty patients were assigned to the suture and Seamguard reinforcement groups. The groups were similar in terms of preoperative characteristics. No staple line dehiscence occurred in the two groups, whereas two cases of dehiscence occurred in the fibrin glue group. No mortality occurred and surgical time was statistically similar for both techniques. Seamguard made the surgery more expensive. Conclusion: In our service, staple line reinforcement in open bariatric surgery with oversewing or Seamguard was considered to be safe. Seamguard application was considered to be easier than oversewing, but more expensive.

Diseño hidráulico de vertedores escalonados con pendientes moderadas: Metodología basada en un estudio experimental

Durante las últimas tres décadas el interés y diversidad en el uso de canales escalonados han aumentado debido al desarrollo de nuevas técnicas y materiales que permiten su construcción de manera rápida y económica (Concreto compactado con rodillo CCR, Gaviones, etc.). Actualmente, los canales escalonados se usan como vertedores y/o canales para peces en presas y diques, como disipadores de energía en canales y ríos, o como aireadores en plantas de tratamiento y torrentes contaminados. Diversos investigadores han estudiado el flujo en vertedores escalonados, enfocándose en estructuras de gran pendiente (  45o) por lo que a la fecha, el comportamiento del flujo sobre vertedores con pendientes moderadas (  15 a 30o) no ha sido totalmente comprendido. El presente artículo comprende un estudio experimental de las propiedades físicas del flujo aire-agua sobre canales escalonados con pendientes moderadas, típicas en presas de materiales sueltos. Un extenso rango de gastos en condiciones de flujo rasante se investigó en dos modelos experimentales a gran escala (Le = 3 a 6): Un canal con pendiente 3.5H:1V (  16o) y dos alturas de escalón distintas (h = 0.1 y 0.05 m) y un canal con pendiente 2.5H:1V (  22o) y una altura de escalón de h = 0.1 m. Los resultados incluyen un análisis detallado de las propiedades del flujo en vertedores escalonados con pendientes moderadas y un nuevo criterio de diseño hidráulico, el cual está basado en los resultados experimentales obtenidos. English abstract: Stepped chutes have been used as hydraulic structures since antiquity, they can be found acting as spillways and fish ladders in dams and weirs, as energy dissipators in artificial channels, gutters and rivers, and as aeration enhancers in water treatment plants and polluted streams. In recent years, new construction techniques and materials (Roller Compacted Concrete RCC, rip-rap gabions, etc.) together with the development of the abovementioned new applications have allowed cheaper construction methods, increasing the interest in stepped chute design. During the last three decades, research in stepped spillways has been very active. However, studies prior to 1993 neglected the effect of free-surface aeration. A number of studies have focused since on steep stepped chutes (  45o) but the hydraulic performance of moderate-slope stepped channels is not yet totally understood. This study details an experimental investigation of physical air-water flow properties down moderate slope stepped spillways conducted in two laboratory models: the first model was a 3.15 m long stepped chute with a 15.9o slope comprising two interchangeable step heights (h = 0.1 m and h = 0.05 m); the second model was a 3.3 m long, stepped channel with a 21.8o slope (h = 0.1 m). A broad range of discharges within transition and skimming flow regimes was investigated. Measurements were conducted using a double tip conductivity probe. The study provides new, original insights into air-water stepped chute flows not foreseen in prior studies and presents a new design criterion for chutes with moderate slopes based on the experimental results.

Synthesis of (Z)-1-Organylthiobut-1-en-3-ynes: Hydrothiolation of Symmetrical and Unsymmetrical Buta-1,3-diynes

Hydrothiolation of 1-organylbuta-1,3-diynes and 1,4-diorganylbuta-1,3-diynes with the sodium organylthiolate anions, which were generated in situ by reacting diphenyl and dibutyl disulfide with NaBH(4) in ethanol, results in the regio-, stereo-, and chemoselective formation of (Z)-1-organylthio-4-organylbut-1-en-3-ynes and (Z)-1-organylthio-1,4-diorganylbut-1-en-3-ynes, respectively.

Early Changes in Postprandial Gallbladder Emptying in Morbidly Obese Patients Undergoing Roux-en-Y Gastric Bypass: Correlation with the Occurrence of Biliary Sludge and Gallstones

Gallstones have been frequently diagnosed after Roux-en-Y gastric bypass (RYGBP). Gallbladder stasis associated with duodenal exclusion may play a role in their pathogenesis. Gallbladder emptying was studied before and on the 30th and 31st postoperative days (POD) after RYGBP in 20 morbidly obese patients. Gallbladder volume after fasting and every 15 min during a 2-h period following administration of a standard liquid meal was determined by sonography. On the 31st POD, the meal was administered through the gastrostomy in order to promote its transit through the duodenum. Fasting volume (FV), maximum ejection fraction (Max EF), and residual volume (RV) were determined. Biliary sludge and calculi were investigated after 1 and 6 months, respectively. FV was 39.4 +/- 20.2 ml, 50.1 +/- 22.7 ml, and 47.9 +/- 23.4 ml, respectively, for the preoperative and two postoperative assessments (P = 0.09). RV was 7.6 +/- 8.7 ml, 25.1 +/- 20.0 ml, and 24.6 +/- 20.9 ml; and Max EF was 80.5 +/- 20.9%, 54.3 +/- 21.4%, and 50.5 +/- 29.0%, respectively, for the pre-, postoral, and postgastrostomy infusion measurements. There was only a significant difference between the preoperative value and the two postoperative values (P < 0.001). Biliary sludge was detected in 65% of the patients and 46% of them subsequently developed gallstones. Gallbladder emptying became significantly compromised after RYGBP. This impairment was unrelated to duodenal exclusion but it was associated with biliary sludge and stone formation.