Mediastinitis post revascularización miocárdica: impacto del cambio de profilaxis antibiótica en la fundación Cardioinfantil 2012 - 2013

INTRODUCCIÓN. La mediastinitis posterior a cirugía de revascularización miocárdica es una infección infrecuente, pero potencialmente fatal. En la Fundación Cardioinfantil se ha observado una tendencia al incremento de la misma en los últimos años, obligando a un cambio en las medidas de profilaxis antimicrobiana, pasando de cefalosporinas a vancomicina – gentamicina, sin embargo no se conoce aún el impacto de estas medidas. OBJETIVO: Determinar si el cambio de la profilaxis antibiótica en pacientes sometidos a revascularización miocárdica influye en una disminución de la incidencia de mediastinitis durante los años 2012 – 2013. METODOLOGÍA: Estudio de cohortes retrospectivo, evaluando la incidencia de mediastinitis post revascularización miocárdica, en pacientes expuestos a 2 diferentes tipos de profilaxis antimicrobiana (cefalosporinas vs vancomicina-gentamicina). Se describieron los patrones de susceptibilidad y resistencia de los patógenos encontrados en mediastinitis y la mortalidad de esta patología. RESULTADOS: Los patógenos más frecuentemente aislados en la mediastinitis fueron Staphylococcus aureus y Klebsiella pneumoniae, en la mayoría monomicrobiano. Se encontraron patógenos con perfiles de resistencia como betalactamasas de espectro extendido en Gram negativos y resistencia a la meticilina en cocos Gram positivos. El RR de mediastinitis del grupo expuesto a vancomicina-gentamicina respecto al grupo de cefalosporinas fue de 0,9 con IC 95% 0,28 – 3,28. CONCLUSIÓN: la epidemiologia microbiana de la mediastinitis no difiere de la reportada en otras series. La profilaxis antimicrobiana con vancomicina - gentamicina en pacientes sometidos a revascularización miocárdica, no redujo la incidencia de mediastinitis. Se propone regresar a la terapia de profilaxis con cefalosporinas.

Análisis bibliométrico de depresión infantil

El objetivo de este estudio fue identificar las tendencias en la investigación de la depresión infantil mediante un análisis bibliométrico de artículos publicados entre enero de 2010 y enero de 2015, en las bases de datos EBSCO, Scopus y Scielo. Se incluyeron 146 artículos, escritos en inglés, español y portugués. En el trabajo se identifican los autores más productivos y las tendencias de los autores con respecto al sexo, profesión y producción; así como los países, instituciones y revistas que más publicaron sobre dicho trastorno. La edad y la ansiedad son las variables que con más frecuencia se asocian al tema; de igual forma, se identificó el Children Depression Inventory (CDI) como el instrumento más común para medir la depresión infantil. En este periodo de tiempo destacan los artículos centrados en investigaciones sobre poblaciones con diferentes estados de salud, diseños correlacionales, de corte transversal y escritos por múltiples autores. Al analizar los resultados obtenidos se observa un creciente interés y preocupación de los investigadores por conocer la frecuencia de los trastornos del estado de ánimo y más específicamente de la depresión en niños, y la asociación e influencia que esta puede tener para su desarrollo.

Combined Analysis of the Short-Term Effects of Photochemical Air Pollutants on Mortality within the EMECAM Project

In recent years, some epidemiologic studies have attributed adverse effects of air pollutants on health not only to particles and sulfur dioxide but also to photochemical air pollutants (nitrogen dioxide and ozone). The effects are usually small, leading to some inconsistencies in the results of the studies. Furthermore, the different methodologic approaches of the studies used has made it difficult to derive generic conclusions. We provide here a quantitative summary of the short-term effects of photochemical air pollutants on mortality in seven Spanish cities involved in the EMECAM project, using generalized additive models from analyses of single and multiple pollutants. Nitrogen dioxide and ozone data were provided by seven EMECAM cities (Barcelona, Gijón, Huelva, Madrid, Oviedo, Seville, and Valencia). Mortality indicators included daily total mortality from all causes excluding external causes, daily cardiovascular mortality, and daily respiratory mortality. Individual estimates, obtained from city-specific generalized additive Poisson autoregressive models, were combined by means of fixed effects models and, if significant heterogeneity among local estimates was found, also by random effects models. Significant positive associations were found between daily mortality (all causes and cardiovascular) and NO2, once the rest of air pollutants were taken into account. A 10 μg/m3 increase in the 24-hr average 1-day NO2 level was associated with an increase in the daily number of deaths of 0.43% [95% confidence interval(CI), –0.003–0.86%] for all causes excluding external. In the case of significant relationships, relative risks for cause-specific mortality were nearly twice as much as that for total mortality for all the photochemical pollutants. Ozone was independently related only to cardiovascular daily mortality. No independent statistically significant relationship between photochemical air pollutants and respiratory mortality was found. The results in this study suggest that, given the present levels of photochemical pollutants, people living in Spanish cities are exposed to health risks derived from air pollution

Comparing meta-analysis and ecological-longitudinal analysis in time-series studies: a case study of the effects of air pollution on mortality in three Spanish cities

The objective of this paper is to introduce a diVerent approach, called the ecological-longitudinal, to carrying out pooled analysis in time series ecological studies. Because it gives a larger number of data points and, hence, increases the statistical power of the analysis, this approach, unlike conventional ones, allows the complementation of aspects such as accommodation of random effect models, of lags, of interaction between pollutants and between pollutants and meteorological variables, that are hardly implemented in conventional approaches. Design—The approach is illustrated by providing quantitative estimates of the short-termeVects of air pollution on mortality in three Spanish cities, Barcelona,Valencia and Vigo, for the period 1992–1994. Because the dependent variable was a count, a Poisson generalised linear model was first specified. Several modelling issues are worth mentioning. Firstly, because the relations between mortality and explanatory variables were nonlinear, cubic splines were used for covariate control, leading to a generalised additive model, GAM. Secondly, the effects of the predictors on the response were allowed to occur with some lag. Thirdly, the residual autocorrelation, because of imperfect control, was controlled for by means of an autoregressive Poisson GAM. Finally, the longitudinal design demanded the consideration of the existence of individual heterogeneity, requiring the consideration of mixed models. Main results—The estimates of the relative risks obtained from the individual analyses varied across cities, particularly those associated with sulphur dioxide. The highest relative risks corresponded to black smoke in Valencia. These estimates were higher than those obtained from the ecological-longitudinal analysis. Relative risks estimated from this latter analysis were practically identical across cities, 1.00638 (95% confidence intervals 1.0002, 1.0011) for a black smoke increase of 10 μg/m3 and 1.00415 (95% CI 1.0001, 1.0007) for a increase of 10 μg/m3 of sulphur dioxide. Because the statistical power is higher than in the individual analysis more interactions were statistically significant,especially those among air pollutants and meteorological variables. Conclusions—Air pollutant levels were related to mortality in the three cities of the study, Barcelona, Valencia and Vigo. These results were consistent with similar studies in other cities, with other multicentric studies and coherent with both, previous individual, for each city, and multicentric studies for all three cities

Measurement Quality in Indicators of Compositions: a Compositional Multitrait-Multimethod Approach

Compositional data, also called multiplicative ipsative data, are common in survey research instruments in areas such as time use, budget expenditure and social networks. Compositional data are usually expressed as proportions of a total, whose sum can only be 1. Owing to their constrained nature, statistical analysis in general, and estimation of measurement quality with a confirmatory factor analysis model for multitrait-multimethod (MTMM) designs in particular are challenging tasks. Compositional data are highly non-normal, as they range within the 0-1 interval. One component can only increase if some other(s) decrease, which results in spurious negative correlations among components which cannot be accounted for by the MTMM model parameters. In this article we show how researchers can use the correlated uniqueness model for MTMM designs in order to evaluate measurement quality of compositional indicators. We suggest using the additive log ratio transformation of the data, discuss several approaches to deal with zero components and explain how the interpretation of MTMM designs di ers from the application to standard unconstrained data. We show an illustration of the method on data of social network composition expressed in percentages of partner, family, friends and other members in which we conclude that the faceto-face collection mode is generally superior to the telephone mode, although primacy e ects are higher in the face-to-face mode. Compositions of strong ties (such as partner) are measured with higher quality than those of weaker ties (such as other network members)

Avaluació de la toxicitat de metalls pesants i arsènic en diferents models biològics

En aquest estudi, la toxicitat de diversos metalls pesants i l'arsènic va ser analitzada utilitzant diferents models biològics. En la primera part d'aquest treball, el bioassaig de toxicitat Microtox, el qual està basat en la variació de l'emissió lumínica del bacteri luminiscent Vibrio fischeri, va ser utilitzat per establir les corbes dosi-resposta de diferents elements tòxics com el Zn(II), Pb(II), Cu(II), Hg(II), Ag(I), Co(II), Cd(II), Cr(VI), As(V) i As(III) en solucions aquoses. Els experiments es varen portar a terme a pH 6.0 i 7.0 per tal de mostrar que el pH pot influir en la toxicitat final mesurada d'alguns metalls degut als canvis relacionats amb la seva especiació química. Es varen trobar diferents tipus de corbes dosi-resposta depenent del metall analitzat i el pH del medi. En el cas de l'arsènic, l'efecte del pH en la toxicitat de l'arsenat i l'arsenit es va investigar utilitzant l'assaig Microtox en un rang de pHs comprès entre pH 5.0 i 9.0. Els valors d'EC50 determinats per l'As(V) disminueixen, reflectint un augment de la toxicitat, a mesura que el pH de la solució augmenta mentre que, en el cas de l'As(III), els valors d'EC50 quasi bé no varien entre pH 6.0 i 8.0 i només disminueixen a pH 9.0. HAsO42- i H2AsO3- es varen definir com les espècies més tòxiques. Així mateix, una anàlisi estadística va revelar un efecte antagònic entre les espècies químiques d'arsenat que es troben conjuntament a pH 6.0 i 7.0. D'altra banda, els resultats de dos mètodes estadístics per predir la toxicitat i les possibles interaccions entre el Co(II), Cd(II), Cu(II), Zn(II) i Pb(II) en mescles binàries equitòxiques es varen comparar amb la toxicitat observada sobre el bacteri Vibrio fischeri. L'efecte combinat d'aquests metalls va resultar ser antagònic per les mescles de Co(II)-Cd(II), Cd(II)-Zn(II), Cd(II)-Pb(II) i Cu(II)-Pb(II), sinèrgic per Co(II)-Cu(II) i Zn(II)-Pb(II) i additiu en els altres casos, revelant un patró complex de possibles interaccions. L'efecte sinèrgic de la combinació Co(II)-Cu(II) i la forta disminució de la toxicitat del Pb(II) quan es troba en presència de Cd(II) hauria de merèixer més atenció quan s'estableixen les normatives de seguretat ambiental. La sensibilitat de l'assaig Microtox també va ser determinada. Els valors d'EC20, els quals representen la toxicitat llindar mesurable, varen ser determinats per cada element individualment i es va veure que augmenten de la següent manera: Pb(II) < Ag(I) < Hg(II)  Cu(II) < Zn(II) < As(V) < Cd(II)  Co(II) < As(III) < Cr(VI). Aquests valors es varen comparar amb les concentracions permeses en aigues residuals industrials establertes per la normativa oficial de Catalunya (Espanya). L'assaig Microtox va resultar ser suficientment sensible per detectar els elements assajats respecte a les normes oficials referents al control de la contaminació, excepte en el cas del cadmi, mercuri, arsenat, arsenit i cromat. En la segona part d'aquest treball, com a resultats complementaris dels resultats previs obtinguts utilitzant l'assaig de toxicitat aguda Microtox, els efectes crònics del Cd(II), Cr(VI) i As(V) es varen analitzar sobre la taxa de creixement i la viabilitat en el mateix model biològic. Sorprenentment, aquests productes químics nocius varen resultar ser poc tòxics per aquest bacteri quan es mesura el seu efecte després de temps d'exposició llargs. Tot i això, en el cas del Cr(VI), l'assaig d'inhibició de la viabilitat va resultar ser més sensible que l'assaig de toxicitat aguda Microtox. Així mateix, també va ser possible observar un clar fenomen d'hormesis, especialment en el cas del Cd(II), quan s'utilitza l'assaig d'inhibició de la viabilitat. A més a més, diversos experiments es varen portar a terme per intentar explicar la manca de toxicitat de Cr(VI) mostrada pel bacteri Vibrio fischeri. La resistència mostrada per aquest bacteri podria ser atribuïda a la capacitat d'aquest bacteri de convertir el Cr(VI) a la forma menys tòxica de Cr(III). Es va trobar que aquesta capacitat de reducció depèn de la composició del medi de cultiu, de la concentració inicial de Cr(VI), del temps d'incubació i de la presència d'una font de carboni. En la tercera part d'aquest treball, la línia cel·lular humana HT29 i cultius primaris de cèl·lules sanguínies de Sparus sarba es varen utilitzar in vitro per detectar la toxicitat llindar de metalls mesurant la sobreexpressió de proteines d'estrès. Extractes de fangs precedents de diverses plantes de tractament d'aigues residuals i diferents metalls, individualment o en combinació, es varen analitzar sobre cultius cel·lulars humans per avaluar el seu efecte sobre la taxa de creixement i la capacitat d'induir la síntesi de les proteïnes Hsp72 relacionades amb l'estrès cel·lular. No es varen trobar efectes adversos significatius quan els components s'analitzen individualment. Nogensmenys, quan es troben conjuntament, es produeix un afecte advers sobre tan la taxa de creixement com en l'expressió de proteins d'estrès. D'altra banda, cèl·lules sanguínies procedents de Sparus sarba es varen exposar in vitro a diferents concentracions de cadmi, plom i crom. La proteïna d'estrès HSP70 es va sobreexpressar significativament després de l'exposició a concentracions tan febles com 0.1 M. Sota les nostres condicions de treball, no es va evidenciar una sobreexpressió de metal·lotioneïnes. Nogensmenys, les cèl·lules sanguínies de peix varen resultar ser un model biològic interessant per a ser utilitzat en anàlisis de toxicitat. Ambdós models biològics varen resultar ser molt adequats per a detectar acuradament la toxicitat produïda per metalls. En general, l'avaluació de la toxicitat basada en l'anàlisi de la sobreexpressió de proteïnes d'estrès és més sensible que l'avaluació de la toxicitat realitzada a nivell d'organisme. A partir dels resultats obtinguts, podem concloure que una bateria de bioassaigs és realment necessària per avaluar acuradament la toxicitat de metalls ja que existeixen grans variacions entre els valors de toxicitat obtinguts emprant diferents organismes i molts factors ambientals poden influir i modificar els resultats obtinguts.

Stability lobes diagram identification and surface roughness monitoring in milling processes

La millora de la productivitat i la qualitat són indubtablement dues de les principals exigències del sector productiu modern i factors clau per la competitivitat i la supervivència. Dins aquest sector,la fabricació per arrancada de material juga encara avui en dia un paper protagonista tot i l'aparició de noves tècniques de conformat per addició.Indústries com l'aeronàutica, l'automobilística,la del motlle o l'energètica, depenen en bona part de les prestacions de les màquines-eina. Aquesta Tesi aborda dos aspectes rellevants quan es tracta de millorar de la productivitat i la qualitat del sector productiu: el problema del fimbrament, més conegut per la denominació anglosaxona chatter,i la monitorització de la rugositat superficial en el mecanitzat a alta velocitat.

Reading hybrid texts : remarks on text/image transitions

The reading of printed materials implies the visual processing of information originated in two distinct semiotic systems. The rapid identification of redundancy, complementation or contradiction rhetoric strategies between the two information types may be crucial for an adequate interpretation of bimodal materials. Hybrid texts (verbal and visual) are particular instances of bimodal materials, where the redundant information is often neglected while the complementary and the contradictory ones are essential.Studies using the 504 ASL eye-tracking system while reading either additive or exhibiting captions (Baptista, 2009) revealed fixations on the verbal material and transitions between the written and the pictorial in a much higher number and duration than the initially foreseen as necessary to read the verbal text. We therefore hypothesized that confirmation strategies of the written information are taking place, by using information available in the other semiotic system.Such eye-gaze patterns obtained from denotative texts and pictures seem to contradict some of the scarce existing data on visual processing of texts and images, namely cartoons (Carroll, Young and Guertain, 1992), descriptive captions (Hegarty, 1992 a and b), and advertising images with descriptive and explanatory texts (cf. Rayner and Rotello, 2001, who refer to a previous reading of the whole text before looking at the image, or even Rayner, Miller and Rotello, 2008 who refer to an earlier and longer look at the picture) and seem to consolidate findings of Radach et al. (2003) on systematic transitions between text and image.By framing interest areas in the printed pictorial material of non redundant hybrid texts, we have identified the specific areas where transitions take place after fixations in the verbal text. The way those transitions are processed brings a new interest to further research.

Soluções sólidas vs. dispersões sólidas: impacto dos parâmetros de formulação

Filmes matriciais foram preparados com fármacos com diferentes solubilidades aquosas (tartarato de metoprolol, ibuprofeno e diclofenac Na) e diferentes polímeros (etilcelulose, Eudragit RS e Eudragit RL). Foram obtidas soluções sólidas (fármaco dissolvido) e dispersões sólidas (fármaco disperso). A libertação dos fármacos foi estudada em função do tipo de fármaco, doseamento, tipo e quantidade de aditivo e do tipo de polímero. A libertação dos fármacos não foi de acordo com a sua solubilidade aquosa, mas sim com o estado físico do fármaco na matriz. O incremento do conteúdo do fármaco na matriz aumentou a velocidade de libertação monotonicamente para a solução sólida. Em contraste, com a dispersão sólida, o aumento da dosagem de fármaco não originou quase nenhum efeito até 30 %, registando-se apenas, posteriormente, um acréscimo na sua velocidade. A inclusão de aditivos hidrofílicos aumentou principalmente a fase inicial do perfil de libertação do fármaco e não produziu efeito no plateau. Por outro lado, polietilenoglicol 1500 diminuiu a libertação de diclofenac Na devido ao aprisionamento do fármaco nos seus domínios. O efeito do tipo de polímero na libertação de ibuprofeno esteve relacionado com a partição do fármaco com o polímero. No caso do tartarato de metoprolol, a libertação foi muito mais rápida do da matriz de Eudragit RS do que de EC, devido à formação de uma mistura amorfa.

Density dependence and phenological mismatch: consequences for growth and survival of sub-arctic nesting Canada Geese

The extent to which species are plastic in the timing of their reproductive events relative to phenology suggests how climate change might affect their demography. An ecological mismatch between the timing of hatch for avian species and the peak availability in quality and quantity of forage for rapidly growing offspring might ultimately affect recruitment to the breeding population unless individuals can adjust the timing of breeding to adapt to changing phenology. We evaluated effects of goose density, hatch timing relative to forage plant phenology, and weather indices on annual growth of pre-fledging Canada geese (Branta canadensis) from 1993-2010 at Akimiski Island, Nunavut. We found effects of both density and hatch timing relative to forage plant phenology; the earlier that eggs hatched relative to forage plant phenology, the larger the mean gosling size near fledging. Goslings were smallest in years when hatch was latest relative to forage plant phenology, and when local abundance of breeding adults was highest. We found no evidence for a trend in relative hatch timing, but it was apparent that in early springs, Canada geese tended to hatch later relative to vegetation phenology, suggesting that geese were not always able to adjust the timing of nesting as rapidly as vegetation phenology was advanced. Analyses using forage biomass information revealed a positive relationship between gosling size and per capita biomass availability, suggesting a causal mechanism for the density effect. The effects of weather parameters explained additional variation in mean annual gosling size, although total June and July rainfall had a small additive effect on gosling size. Modelling of annual first-year survival probability using mean annual gosling size as an annual covariate revealed a positive relationship, suggesting that reduced gosling growth negatively impacts recruitment.

Sudden stratospheric warmings as noise-induced transitions

Sudden stratospheric warmings (SSWs) are usually considered to be initiated by planetary wave activity. Here it is asked whether small-scale variability (e.g., related to gravity waves) can lead to SSWs given a certain amount of planetary wave activity that is by itself not sufficient to cause a SSW. A highly vertically truncated version of the Holton–Mass model of stratospheric wave–mean flow interaction, recently proposed by Ruzmaikin et al., is extended to include stochastic forcing. In the deterministic setting, this low-order model exhibits multiple stable equilibria corresponding to the undisturbed vortex and SSW state, respectively. Momentum forcing due to quasi-random gravity wave activity is introduced as an additive noise term in the zonal momentum equation. Two distinct approaches are pursued to study the stochastic system. First, the system, initialized at the undisturbed state, is numerically integrated many times to derive statistics of first passage times of the system undergoing a transition to the SSW state. Second, the Fokker–Planck equation corresponding to the stochastic system is solved numerically to derive the stationary probability density function of the system. Both approaches show that even small to moderate strengths of the stochastic gravity wave forcing can be sufficient to cause a SSW for cases for which the deterministic system would not have predicted a SSW.

Enhanced Templating in the Crystallisation of Poly(E-caprolactone) Using 1,3:2,4-di(4-Chlorobenzylidene) Sorbitol

We show that small quantities of 1,3:2,4-di(4-chlorobenzylidene) sorbitol dispersed in poly(epsilon-caprolactone) provide a very effective self-assembling nanoscale framework which, with a flow field, yields extremely high levels of polymer crystal orientation. During modest shear flow of the polymer melt, the additive forms highly extended nano-particles which adopt a preferred alignment with respect to the flow field. On cooling, polymer crystallisation is directed by these particles. This chloro substituted dibenzylidene sorbitol is considerably more effective at directing the crystal growth of poly(epsilon-caprolactone) than the unsubstituted compound.

Selenium supplementation of lactating dairy cows: effects on milk production and total selenium content and speciation in blood, milk and cheese

Forty-multiparous Holstein cows were used in a 16-wk continuous design study to determine the effects of either selenium (Se) source, selenized yeast (SY) (derived from a specific strain of Saccharomyces cerevisiae CNCM I-3060 Sel-Plex®) or sodium selenite (SS), or inclusion rate of SY on Se concentration and speciation in blood, milk and cheese. Cows received ad libitum a TMR with 1:1 forage:concentrate ratio on a dry matter (DM) basis. There were four diets (T1-T4) which differed only in either source or dose of Se additive. Estimated total dietary Se for T1 (no supplement), T2 (SS), T3 (SY) and T4 (SY) was 0.16, 0.30, 0.30 and 0.45 mg/kg DM, respectively. Blood and milk samples were taken at 28 day intervals and at each time point there were positive linear effects of SY on Se concentration in blood and milk. At day 112 blood and milk Se values for T1-T4 were 177, 208, 248, 279 ± 6.6 and 24, 38, 57, 72 ± 3.7 ng/g fresh material, respectively and indicate improved uptake and incorporation of Se from SY. While selenocysteine (SeCys) was the main selenised amino acid in blood its concentration was not markedly affected by treatment, but the proportion of total Se as selenomethionine (SeMet) increased with increasing inclusion rate of SY. In milk, there were no marked treatment effects on SeCys content, but Se source had a marked effect on the proportion of total Se as SeMet. At day 112 replacing SS (T2) with SY (T3) increased the SeMet concentration of milk from 36 to 111 ng Se/g and its concentration increased further to 157 ng Se/g as the inclusion rate of SY increased further (T4) to provide 0.45 mg Se/kg TMR. Neither Se source nor inclusion rate effected the keeping quality of milk. At day 112, milk from T1, T2, and T3 was made into a hard cheese and Se source had a marked effect on total Se and the proportion of total Se comprised as either SeMet or SeCys. Replacing SS (T2) with SY (T3) increased total Se, SeMet and SeCys content from 180 to 340 ng Se/g, 57 to 153 ng Se/g and 52 to 92 ng Se/g, respectively. Key words: dairy cow, milk and cheese, selenomethionine, selenocysteine, milk keeping quality

Anxiety-induced response perseverance and stereotyping change

This study examined anxiety as a potential moderator of stereotype change. Previous work has independently demonstrated an increase in stereotyping under conditions of high anxiety as well as following attempts to suppress stereotypic thought. The combination of these two antecedent conditions might thus be expected to produce an additive increase in stereotyping. In contrast to an additive pattern, however, we observed an interaction between anxiety and suppression task instruction. Whilst both the instruction to suppress (in the absence of anxiety) or anxiety (in the absence of the instruction to suppress) did independently increase stereotyping, when the two co-occurred, there was no change. We explain this interaction by considering work from neuropsychological domain on response perseverance: cognitive overload (one consequence of anxiety) may inhibit the ability to switch between modes of perception. These findings suggest a potentially important moderator for attempts to suppress social stereotypes, and point to the efficacy of integrating work from diverse domains for understanding the operation of executive processes in person perception.

Estimating oceanic heat content change using isotherms

This paper presents a new analysis of ocean heat content changes over the last 50 yr using isotherms by calculating the mean temperature above the 148C isotherm and the depth of the 148C isotherm as separate variables. A new quantity called the ‘‘relative heat content’’ (‘‘RHC’’) is introduced, which represents the minimum local heat content change over time, relative to a fixed isotherm. It is shown how mean temperature and isotherm depth changes make separable and additive contributions to changes in RHC. Maps of RHC change between 1970 and 2000 show similar spatial patterns to a traditional fixed-depth ocean heat content change to 220 m. However, the separate contributions to RHC suggest a more spatially uniform contribution from warming above the isotherm, while isotherm depth changes show wind-driven signals, of which some are identifiable as being related to the North Atlantic Oscillation. The time series show that the warming contribution to RHC dominates the global trend, while the depth contribution only dominates on the basin scale in the North Atlantic. The RHC shows minima associated with the major volcanic eruptions (particularly in the Indian Ocean), and these are entirely contributed by mean temperature changes rather than isotherm depth changes. The depth change contributions to RHC are strongly affected by the recently reported XBT fall-rate bias, whereas the mean temperature contributions are not. Therefore, only the isotherm depth change contributions toRHCwill need to be reassessed as fall-rate-corrected data become available.