Posture and fluids for preventing post-dural puncture headache

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the effects of posture (bed rest and different positions after a lumbar puncture) and administration of supplementary fluids on preventing post‐dural puncture headache (PDPH) in patients who underwent dural puncture for diagnostic or therapeutic causes

Thermal characterization of Montmorillonite clays saturated with various cations

Emanation thermal analysis (ETA), thermogravimetry and high temperature XRD were used to characterize the thermal behavior during dehydration of natural Na montmorillonite (Upton Wyoming, USA) and homoionic montmorillonite (MMT) samples saturated with different cations, i.e. Li+, Cs+, NH 4 +, Mg2+ and Al3+. ETA results characterized radon mobility and microstructure changes that accompanied the mass loss of the samples due to dehydration on heating in air. A collapse of interlayer space between the silicate sheets after water release from the MMT samples was characterized by a decrease of the radon release rate, ΔE. Decreases in c-axis basal spacing (d 001) values determined from XRD patterns for the different montmorillonite samples follow the sequence: Mg−MMT>Al−MMT>Li−MMT>Na−MMT>NH4−MMT>Cs−MMT The decrease of the radon release rate (ΔE) determined by ETA that characterized microstructure changes due to collapse of interlayer space corresponded well to differences in the c-axis basal spacing (Δd 001) values determined from the XRD patterns before and after samples dehydration.Peer Reviewe

Marcadores ecográficos de cromosomopatías en el I trimestre de la gestación: translucencia nucal

El examen ecográfico detallado de la anatomía fetal permite detectar por un lado las malformaciones y por otro los marcadores ecográficos de cromosomopatías. Analizando especialmente a la translucencia nucal, que representa el grosor del espacio econegativo localizado entre la piel y el tejido blando subcutáneo del embrión a nivel cervical, visualizado entre las semanas 11 a 13+6 de gestación. Se debe utilizar un equipo de ultrasonografía capaz de aumentar lo suficiente la imagen como para que la cabeza y la parte superior del tórax del feto ocupen el monitor y permita diferenciar medidas de hasta 0,1 mm, por vía abdominal o vaginal, situando los calipers en una posición dentro-dentro y evitando confundir la presencia del amnios como un valor alterado de la medida.La translucencia nucal se comporta como el marcador primario por excelencia en el I trimestre del embarazo, en gestaciones únicas o múltiples, de bajo o alto riesgo genético, no solo para discriminar las cromosomopatías, sino también por su importante asociación en fetoseuploides con mayor probabilidad de padecer malformaciones severas, sobre todo cardíacas. Sin embargo, la valoración óptima del riesgo incluye la consideración de otros factores, entre ellos la edad materna, antecedentes familiares y marcadores bioquímicos

Marcadores ecográficos de cromosomopatías en el I trimestre de la gestación: ductus venoso

La evaluación Doppler del flujo en el ductus venoso en el primer trimestre ha venido a contribuir con información clínica relevante en las orientaciones a los padres. No sólo se mostró eficaz en el rastreo de anomalías cromosómicas, como la trisomía 21, disminuyendo la tasa de procedimientos invasivos, sino también en el rastreo de cardiopatías congénitas, redefiniendo el grupo de alto riesgo a ser sometido aecocardiografía precoz. Por su parte, un flujo anormal en el ductus venoso asociado a la translucencia nucal aumentada en uno o en ambos fetos de un embarazo monocoriónico parece una combinación sensible para rastrear precozmente el síndrome de transfusión feto fetal. En todas estas situaciones, el ductus venoso se muestra un marcador eficaz deinsuficiencia/disfunción cardíaca

Bladder cancer index: cross-cultural adaptation into Spanish and psychometric evaluation

BACKGROUND: The Bladder Cancer Index (BCI) is so far the only instrument applicable across all bladder cancer patients, independent of tumor infiltration or treatment applied. We developed a Spanish version of the BCI, and assessed its acceptability and metric properties. METHODS: For the adaptation into Spanish we used the forward and back-translation method, expert panels, and cognitive debriefing patient interviews. For the assessment of metric properties we used data from 197 bladder cancer patients from a multi-center prospective study. The Spanish BCI and the SF-36 Health Survey were self-administered before and 12 months after treatment. Reliability was estimated by Cronbach's alpha. Construct validity was assessed through the multi-trait multi-method matrix. The magnitude of change was quantified by effect sizes to assess responsiveness. RESULTS: Reliability coefficients ranged 0.75-0.97. The validity analysis confirmed moderate associations between the BCI function and bother subscales for urinary (r = 0.61) and bowel (r = 0.53) domains; conceptual independence among all BCI domains (r ≤ 0.3); and low correlation coefficients with the SF-36 scores, ranging 0.14-0.48. Among patients reporting global improvement at follow-up, pre-post treatment changes were statistically significant for the urinary domain and urinary bother subscale, with effect sizes of 0.38 and 0.53. CONCLUSIONS: The Spanish BCI is well accepted, reliable, valid, responsive, and similar in performance compared to the original instrument. These findings support its use, both in Spanish and international studies, as a valuable and comprehensive tool for assessing quality of life across a wide range of bladder cancer patients

Emerging viral threats in Gabon: health capacities and response to the risk of emerging zoonotic diseases in Central Africa

Emerging infectious diseases (EID) are currently the major threat to public health worldwide and most EID events have involved zoonotic infectious agents. Central Africa in general and Gabon in particular are privileged areas for the emergence of zoonotic EIDs. Indeed, human incursions in Gabonese forests for exploitation purposes lead to intensified contacts between humans and wildlife thus generating an increased risk of emergence of zoonotic diseases. In Gabon, 51 endemic or potential endemic viral infectious diseases have been reported. Among them, 22 are of zoonotic origin and involve 12 families of viruses. The most notorious are dengue, yellow fever, ebola, marburg, Rift Valley fever and chikungunya viruses. Potential EID due to wildlife in Gabon are thereby plentiful and need to be inventoried. The Gabonese Public Health system covers geographically most of the country allowing a good access to sanitary information and efficient monitoring of emerging diseases. However, access to treatment and prevention is better in urban areas where medical structures are more developed and financial means are concentrated even though the population is equally distributed between urban and rural areas. In spite of this, Gabon could be a good field for investigating the emergence or re-emergence of zoonotic EID. Indeed Gabonese health research structures such as CIRMF, advantageously located, offer high quality researchers and facilities that study pathogens and wildlife ecology, aiming toward a better understanding of the contact and transmission mechanisms of new pathogens from wildlife to human, the emergence of zoonotic EID and the breaking of species barriers by pathogens

Estudios de género y ciencias sociales en Paraguay

El artículo intenta explicar el proceso de construcción de conocimiento con perspectiva de género en las Ciencias Sociales en Paraguay, cuáles fueron las principales características de esa construcción, enmarcada dentro de un determinado proceso histórico: avances, limitaciones, tensiones y desafíos. Para ello, se analiza la producción bibliográfica sobre mujer y género en Paraguay, desde 1975 al 2000, de manera a poder visualizar el desarrollo de los temas relacionados a los estudios de la mujer. Se toman en cuenta los trabajos clásicos de la caracterización de la perspectiva de género en la literatura internacional y en América latina en particular, para comprender su inserción latinoamericana y la contribución específica en la realidad de las relaciones de género en la región