Lung recruitment and endotracheal suction in ventilated preterm infants measured with electrical impedance tomography

Aims Although suctioning is a standard airway maintenance procedure, there are significant associated risks, such as loss of lung volume due to high negative suction pressures. This study aims to assess the extent and duration of change in end-expiratory level (EEL) resulting from endotracheal tube (ETT) suction and to examine the relationship between EEL and regional lung ventilation in ventilated preterm infants with respiratory distress syndrome. Methods A prospective observational clinical study of the effect of ETT suction on 20 non-muscle-relaxed preterm infants with respiratory distress syndrome (RDS) on conventional mechanical ventilation was conducted in a neonatal intensive care unit. Ventilation distribution was measured with regional impedance amplitudes and EEL using electrical impedance tomography. Results ETT suction resulted in a significant increase in EEL post-suction (P < 0.01). Regionally, anterior EEL decreased and posterior EEL increased post-suction, suggesting heterogeneity. Tidal volume was significantly lower in volume-guarantee ventilation compared with pressure-controlled ventilation (P = 0.04). Conclusions ETT suction in non-muscle-relaxed and ventilated preterm infants with RDS results in significant lung volume increase that is maintained for at least 90 min. Regional differences in distribution of ventilation with ETT suction suggest that the behaviour of the lung is heterogeneous in nature.

Prolegomenos del derecho

UANL

Algunas reflexiones acerca de la enseñanza del francés en España.

El francés es materia obligatoria en la actualidad en los planes de enseñanza españoles. Empieza a estudiarse en 6õ de EGB y se continúa hasta COU, incluido. Lo que supone siete años completos de francés al cabo de los cuales los resultados no son los deseados. Tras comprobar la idoneidad del profesorado que ha tenido que seguir cursos de formación, etcétera, al pasar a realizar su práctica docente lo primero que debe hacer es la elección del libro de texto, que no lo es todo. Pero es importante, debe ser la base sobre la que se apoye e incluso es un verdadero método. El profesor pues tiene que saber aplicar el método. En todo método de enseñanza del francés hay ejercicios. También debe controlar el grado de conocimiento de sus alumnos y calificaciones y evaluarlos. Para conseguir según el nivel un grado satisfactorio por parte del alumno o no y prueba de recuperación. En definitiva, lo que se busca cuando se enseña francés tanto en EGB como en BUP y COU es cubrir lo mejor posible los cuatro canales de la comunicación lingüística, la emisión y recepción oral y escrita hoy día ni el libro, ni el profesor, ni la clase tienen poder de atracción alguno sobre los alumnos. Pero ninguno debe ser desterrado. Hay que contar con ellos y utilizar diferentes recursos para intentar atraer su atención. Son técnicas de aprovechamiento que el profesor debe intentar alcanzar y requiere tener también imaginación.

Patellofemoral pain syndrome: Electromyography in a frequency domain analysis

The Patellofemoral Pain Syndrome (PFPS), has a multifactorial etiology and affects approximately 7 to 15% of the population, mostly women, youth, adults and active persons. PFPS causes anterior or retropatelar pain that is exacerbated during functional motor gestures, such as up and down stairs or spending long periods of time sitting, squatting or kneeling. As the diagnostic evaluation of this syndrome is still indirect, different mechanisms and methodologies try to make a classification that distinguishes patients with PFPS in relation to asymptomatic. Thereby, the purpose of this investigation was to determine the characteristics of the electromyographic (EMG) signal in the frequency domain of the vastus medialis oblique (VMO) and vastus lateralis (VL) in patients with PFPS, during the ascent of stairs. 33 young women (22 control group and 11 PFPS group), were evaluated by EMG during ascent of stairs. The VMO mean power frequency (MPF) and the VL frequency 95% (F95) were lower in symptomatic individuals. This may be related to the difference in muscle recruitment strategy exerted by each muscle in the PFPS group compared to the control group.

The Social Pillar already exists… but more effort is needed to strengthen it. CEPS Commentary, 9 March 2016 Wednesday, 9 March 2016

There is an unmet demand for a more social Europe in the EU. Asked what would strengthen the feeling of being a European citizen, 32% of the respondents replied: “a European social welfare system harmonised between the Member States”. This answer ranked higher than any other possible response, such as being able to use your mobile phone in all EU countries at the same price (23%), a European emergency response service to fight international natural disasters (22%) and having a European ID card in addition to national ID cards (20%) (Eurobarometer, 2014).

Annotated record of the detailed examination of Mn deposits recovered by the Geological Survey of Japan (GSJ) during the 1971-1974 period in the Pacific Ocean

In 1974, the Geological Survey of Japan began its systematic investigation of manganese nodules in the Central Pacific Basin on the new geological research vessel Hakurei Maru. The first cruise (GH 74-5) was carried out over an eastern part area of the Basin (6°-10°30'N, 164°30'-171°30'W), and the authors report here the preliminary results on the occurrence of manganese nodule deposits, paying particular consideration to their relationship to submarine topography and surficial and sub-bottom sedimentary facies. The surveyed area comprises a deep-sea basin at 5,000-5,400 m, defined to the north and east by the chain of seamounts and guyots of the Christmas Ridge. The deep-sea basin is divided roughly into 2 contrasting topographic features. The eastern part is characterised by flattened topography resulting from continuous deposition of turbidities; the meridian and western parts are characterised by gently rolling topography and the existence of a large number of deep-sea hills. Manganese nodules are almost lacking in the former flattened eastern area, whereas they are widely distributed in the latter rolling meridian and western parts. The population density of nodules varies from less than 1 Kg/m² to 26 kg/m² and the higher density is found in the siliceous-calcareous ooze zone of rather small, flat basins surrounded by deep-sea hills. The density is closely related to the thickness of the transparent layer obtained by 3.5 kHz PDR profiling over the whole area. Considering the various data of grab sampling, 3.5 kHz PDR profiling and to a lesser extent of deep-sea television and camera observations, the most promising manganese field in the present area seems to be confined to the north of the western sector of the area.