Staphylococcus lugdunensis infective endocarditis. Description of 10 cases and analysis of native valve, prosthetic valve and pacemaker lead endocarditis clinical profiles

bolism. Surgery was needed in 51% of cases and mortality was 42%. Prosthetic valve endocarditis (nine of 60, 13%) predominated in the aortic position and was associated with abscess formation, required surgery, and high mortality (78%). Pacemaker lead IE (seven of 69, 10%) is associated with a better prognosis when antibiotic treatment is combined with surgery. Conclusions:S lugdunensis IE is an uncommon cause of IE, involving mainly native left sided valves, and it is characterised by an aggressive clinical course. Mortality in left sided native valve IE is high but the prognosis has improved in recent years. Surgery has improved survival in left sided IE and, therefore, early surgery should always be considered. Prosthetic valve S lugdunensis IE carries an ominous prognosis.

Splenectomy for refractory Evan' syndrome associated with antiphospholipid antibodies: report of two cases.

The main haematological manifestations seen in patients with antiphospholipid antibodies (aPL) are thrombocytopenia, usually mild, and haemolytic anaemia with a positive Coombs test. Owing to the shared characteristics with idiopathic thrombocytopenic purpura, similar rules are followed in the treatment of these cytopenias. Two patients with severe aPL associated cytopenias, who required splenectomy after being refractory to steroids, immunosuppressive agents, and other treatments (intravenous gammaglobulin, danazol), are described, and previously reported cases are reviewed.

Hepatitis G virus infection in primary Sjögren's syndrome: analysis in a series of 100 patients.

OBJECTIVE To determine the prevalence and clinical significance of hepatitis G virus (HGV) infection in a large cohort of patients with primary Sjögren¿s syndrome (SS). PATIENTS AND METHODS The study included 100 consecutive patients (92 female and eight male), with a mean age of 62 years (range 31¿80) that were prospectively visited in our unit. All patients fulfilled the European Community criteria for SS and underwent a complete history, physical examination, as well as biochemical and immunological evaluation for liver disease. Two hundred volunteer blood donors were also studied. The presence of HGV-RNA was investigated in the serum of all patients and donors. Aditionally, HBsAg and antibodies to hepatitis C virus were determined. RESULTS Four patients (4%) and six volunteer blood donors (3%) presented HGV-RNA sequences in serum. HGV infection was associated with biochemical signs of liver involvement in two (50%) patients. When compared with primary SS patients without HGV infection, no significant differences were found in terms of clinical or immunological features. HCV coinfection occurs in one (25%) of the four patients with HGV infection. CONCLUSION The prevalence of HGV infection in patients with primary SS is low in the geographical area of the study and HCV coinfection is very uncommon. HGV infection alone does not seen to be an important cause of chronic liver injury in the patients with primary SS in this area.

Amyloid arthropathy in patients undergoing periodical haemodialysis for chronic renal failure: a new complication.

Seven patients (five male and two female) with chronic renal failure (CRF) treated by periodical haemodialysis presented with swelling and effusion of more than three months' duration in knees (four bilateral), shoulders (two, one of them bilateral), elbow (one), and ankle (one). Four had a carpal tunnel syndrome both clinically and electromyographically (three bilateral). All patients had hyperparathyroidism secondary to their CRF, which was not due to amyloidosis in any of them. The dialysis duration period varied from five to 14 years, with an average of 8.6 years. Amyloid deposits (Congo red positive areas with green birefringence under polarising microscopy) were shown in six of the seven synovial biopsy specimens of the knee, in five of the sediments of the synovial fluids, and in specimens removed during carpal tunnel syndrome surgery. No amyloid was found in the biopsy specimen of abdominal fat of six of the patients. The finding of amyloid only in the synovial membrane and fluid, and carpal tunnel, its absence in abdominal fat, and the lack of other manifestations of generalised amyloidosis (cardiomyopathy, malabsorption syndrome, macroglossia, etc.) and of Bence Jones myeloma (protein immunoelectrophoresis normal) raises the possibility that this is a form of amyloidosis which is peculiar to CRF treated by periodical haemodialysis.

Reassessing the status of antiphospholipid syndrome in systemic lupus erythematosus.

The antiphospholipid syndrome was initially described in 1986. To reassess the validity of antiphospholipid antibodies in systemic lupus erythematosus (SLE), 95 patients with SLE were studied. Their antiphospholipid antibody profile was analysed and correlated with clinical findings such as thrombosis, abortions, or thrombocytopenia. A low prevalence of these antibodies was found (13 patients; 14%) with a high specificity for thrombosis (92%) and abortions (92%). The importance of anticardiolipin antibodies as a risk factor for thrombosis or abortions, or both, in patients with SLE is reaffirmed by this work.

Role of technetium-99m diphosphonate and gallium-67 citrate bone scanning in the early diagnosis of infectious spondylodiscitis: a comparative study

A comparative study of the parts played by technetium-99m diphosphonate and gallium-67 citrate bone scanning in the early diagnosis of infectious spondylodiscitis is presented. Nineteen patients were included in the study. All patients (11 men aged 19-70 years and eight women aged 18-72 years) had a history of back pain varying in duration from one to 15 weeks. A 99mTc diphosphonate bone scan was positive in 17 patients. The two patients with negative results had less than two weeks of back pain. The 67Ga citrate bone scan showed uptake in all patients.

Inclusió i segregació a l'escola: pràctiques inclusives i excloents amb l'alumnat vulnerable

El present article aborda l'anàlisi dels components inclusius dels centres educatius que es plantegen una educació de qualitat per a tot l'alumnat, posant especial atenció en l'alumnat de grups socialment vulnerables. Es basa en les dades qualitatives d¿una part del projecte integrat INCLUD-ED, que estudià 20 casos de centres educatius d'èxit en diferents països de la Unió Europea. Tots els centres atenien alumnat de baix nivell socioeconòmic i havien demostrat tenir més èxit escolar que el conjunt de centres situats en contextos similars. L'article revisa altres investigacions afins i exposa els resultats agrupats en quatre tòpics: l'agrupament de l'alumnat; les expectatives; el suport; i la participació de les famílies i la comunitat. Les conclusions se sotmeten a discussió.

GIS-based debris flow source and runout susceptibility assessment from DEM data - a case study in NW Nicaragua

In October 1998, Hurricane Mitch triggered numerous landslides (mainly debris flows) in Honduras and Nicaragua, resulting in a high death toll and in considerable damage to property. The potential application of relatively simple and affordable spatial prediction models for landslide hazard mapping in developing countries was studied. Our attention was focused on a region in NW Nicaragua, one of the most severely hit places during the Mitch event. A landslide map was obtained at 1:10 000 scale in a Geographic Information System (GIS) environment from the interpretation of aerial photographs and detailed field work. In this map the terrain failure zones were distinguished from the areas within the reach of the mobilized materials. A Digital Elevation Model (DEM) with 20 m×20 m of pixel size was also employed in the study area. A comparative analysis of the terrain failures caused by Hurricane Mitch and a selection of 4 terrain factors extracted from the DEM which, contributed to the terrain instability, was carried out. Land propensity to failure was determined with the aid of a bivariate analysis and GIS tools in a terrain failure susceptibility map. In order to estimate the areas that could be affected by the path or deposition of the mobilized materials, we considered the fact that under intense rainfall events debris flows tend to travel long distances following the maximum slope and merging with the drainage network. Using the TauDEM extension for ArcGIS software we generated automatically flow lines following the maximum slope in the DEM starting from the areas prone to failure in the terrain failure susceptibility map. The areas crossed by the flow lines from each terrain failure susceptibility class correspond to the runout susceptibility classes represented in a runout susceptibility map. The study of terrain failure and runout susceptibility enabled us to obtain a spatial prediction for landslides, which could contribute to landslide risk mitigation.

Desarrollo de la ciudadanía intercultural en Sant Quintí de Mediona a través de redes comunitarias

Con este artículo, se propone profundizar en la realidad de una localidad de menos de 3.000 habitantes con un porcentaje de población inmigrante extranjera de más del 10%, se trata de un estudio de caso llevado a cabo en Sant Quintí de Mediona, desde un modelo dinámico de ciudadanía intercultural, incidiendo especialmente en los procesos de acogida y de integración de la población inmigrante y potenciando unas condiciones óptimas para la convivencia. El estudio de estas condiciones ha exigido una evaluación diagnóstica para conocer las características de la población y del proceso migratorio, primeras políticas desarrolladas para la acogida de la población inmigrante y el punto de vista de los participantes en todo este proceso así como la disposición de las entidades que componen la red comunitaria para abrirse a la población recién llegada. Se ha recogido toda esta información a través del estudio documental, entrevistas a informantes claves, grupos de discusión y una encuesta a las entidades existentes en la población seleccionada. Desde el análisis de datos, este estudio diagnóstico, incluye las necesidades de cambio estructural, de nuevas relaciones de convivencia y de formación para toda la población y para colectivos determinados. Una vez presentadas las conclusiones, se ofrece una propuesta de desarrollo de un Plan de ciudadanía intercultural orientado a la convivencia para poblaciones multiculturales, que puede hacerse extensivo a poblaciones parecidas a la estudiada, contemplando el papel de las redes comunitarias como un elemento básico para su desarrollo.

Desarrollo de la ciudadanía intercultural en Sant Quintí de Mediona a través de redes comunitarias

Con este artículo, se propone profundizar en la realidad de una localidad de menos de 3.000 habitantes con un porcentaje de población inmigrante extranjera de más del 10%, se trata de un estudio de caso llevado a cabo en Sant Quintí de Mediona, desde un modelo dinámico de ciudadanía intercultural, incidiendo especialmente en los procesos de acogida y de integración de la población inmigrante y potenciando unas condiciones óptimas para la convivencia. El estudio de estas condiciones ha exigido una evaluación diagnóstica para conocer las características de la población y del proceso migratorio, primeras políticas desarrolladas para la acogida de la población inmigrante y el punto de vista de los participantes en todo este proceso así como la disposición de las entidades que componen la red comunitaria para abrirse a la población recién llegada. Se ha recogido toda esta información a través del estudio documental, entrevistas a informantes claves, grupos de discusión y una encuesta a las entidades existentes en la población seleccionada. Desde el análisis de datos, este estudio diagnóstico, incluye las necesidades de cambio estructural, de nuevas relaciones de convivencia y de formación para toda la población y para colectivos determinados. Una vez presentadas las conclusiones, se ofrece una propuesta de desarrollo de un Plan de ciudadanía intercultural orientado a la convivencia para poblaciones multiculturales, que puede hacerse extensivo a poblaciones parecidas a la estudiada, contemplando el papel de las redes comunitarias como un elemento básico para su desarrollo.

Estudio de la motivación humana

En este articulo se estudia La motivaci6n humana, definiendo las caracteristicas basicas de la misma. A continuación, se presentan los principales modelos que interpretan los fenómenos motivacionales humanos dentro de una Linea interpretativa intencionisld. Después dc un analisis de la teoria de ALkinson, como principal representante de dicha corriente, se plantea la hipótesis de una teoria bi-dimensional de la motivación

Estudio del factor de personalidad Extroversión_Introversión mediante la técnica de los tiempos de reacción

A partir de una breve revisión bibliográfica de las caracteristicas y aplicaciones de la técnica de los tiempos de reacción, se ha planteado una experiencia en la que, siguiendo la linea de Eysenck, se aplica dicha técnica al estudio de la personalidad, concretada aquí en el factor introversión-extroversión. La hipótesis, confirmada en parte por los resultados obtenidos, planteaba en forma afirmativa la existencia de diferencias significativas entre el rendimiento y comportamiento de un grupo de introvertidos, ambivertidos y extrovertidos en unas pruebas de reacciometria.

Retaining principal components for discrete variables

The present study discusses retention criteria for principal components analysis (PCA) applied to Likert scale items typical in psychological questionnaires. The main aim is to recommend applied researchers to restrain from relying only on the eigenvalue-than-one criterion; alternative procedures are suggested for adjusting for sampling error. An additional objective is to add evidence on the consequences of applying this rule when PCA is used with discrete variables. The experimental conditions were studied by means of Monte Carlo sampling including several sample sizes, different number of variables and answer alternatives, and four non-normal distributions. The results suggest that even when all the items and thus the underlying dimensions are independent, eigenvalues greater than one are frequent and they can explain up to 80% of the variance in data, meeting the empirical criterion. The consequences of using Kaiser"s rule are illustrated with a clinical psychology example. The size of the eigenvalues resulted to be a function of the sample size and the number of variables, which is also the case for parallel analysis as previous research shows. To enhance the application of alternative criteria, an R package was developed for deciding the number of principal components to retain by means of confidence intervals constructed about the eigenvalues corresponding to lack of relationship between discrete variables.

Training referential communicative skills to individuals with autism spectrum disorder: a pilot study

Summary. The present study reports the effects of referential communication training in individuals formally diagnosed with autism spectrum disorder (ASD). Participants were 20 children with ASD (M age = 14.3 yr., SD = 4.2; 6 girls, 14 boys) in the role of speakers and 20 control children, who acted as listeners. They were all enrolled in mainstream compulsory education. Inclusion/exclusion criteria were defined according to the clinical diagnosis of ASD, the presence or absence of additional or associated disability, previous training in referential communication, and any drug treatment. Speakers were randomly assigned to one of two groups (trained vs untrained). Linguistic age, cognitive level, and autistic symptoms were analyzed, respectively, with the Peabody Picture Vocabulary Test (PPVT), the Wechsler Intelligence Scale (WISCR or WAISIII), and the Autistic Behavior Checklist (ABC). Communicative abilities were analyzed through two indexes related to message complexity and self-regulation. The trained group was trained in referential communication tasks (task analysis, role taking, and task evaluation), while the untrained group took part in a communicative game but without any specific communicative training. The results showed that the complexity of emitted messages had improved statistically significantly in the trained group as an effect of training. Ecological referential communication is shown to be an appropriate paradigm for studying the communicative process and its products and could be used to develop and implement a training program focused on those skills in which individuals with ASD are most deficient.

Les matemàtiques com a eina d'inclusió i d'equitat per a l'alumnat llatinoamericà nouvingut als centres educatius de Catalunya. El cas equatorià

Les matemàtiques constitueixen un element imprescindible per a l'alumnat, per tal que puguin esdevenir ciutadans responsables, ja que es tracta d'una disciplina que pot ajudar a interpretar la realitat. Per tant, considerem que l'ensenyament i aprenentatge de les matemàtiques és una qüestió d'equitat per a l'alumnat nouvingut. En aquest estudi, es mostren les semblances i les diferències de l'alumnat llatinoamericà (concretament d'alumnes equatorians) respecte als alumnes autòctons d¿ESO en la resolució de problemes matemàtics. Aquest estudi aporta el coneixement de la realitat educativa equatoriana i la comparació amb els alumnes del nostre país. Juntament amb aquesta recerca, s'ha fet també un estudi de cas sobre la realització de problemes matemàtics amb alumnes nouvinguts a l'aula d'acollida i s'han comparat els resultats amb els dels alumnes autòctons. Finalment, a partir de les dades obtingudes de l'estudi de camp s'ha dissenyat un portal web que dóna pautes d'ajuda per a l'acolliment dels alumnes.