Manual del viajero en Méjico o Compendio de la historia de la ciudad de Méjico con la descripción e historia de sus templos, conventos, edificios públicos, las costumbres de sus habitantes, etc. y con el plan de dicha ciudad

Copia digital. Madrid : Ministerio de Cultura. Subdirección General de Coordinación Bibliotecaria, 200

Grado de conocimiento, tratamiento y control de la hipertensión arterial, hipercolesterolemia y diabetes mellitus en la población general adulta

ObjetivosEstimar la prevalencia de los principales factores de riesgo cardiovascular (FRCV) tras la confirmación diagnóstica con el criterio clínico. Analizar el grado de su conocimiento y control, y evaluar la asociación de los FRCV entre sí, estimando qué población es susceptible de intervención.DiseñoEstudio observacional, descriptivo,transversal.EmplazamientoEstudio poblacional realizado en el Área de Salud número 20 de la Comunidad Valenciana (comarca de la Vega Baja del río Segura)PacientesPersonas con ≥ 20 años residentes en dicha área. Muestreo aleatorio polietápico proporcional con definición de cuotas muestrales según el tipo de residencia. Tamaño muestral: 2.550 personas (falta de respuesta en la primera fase en el 26%). Segunda fase del estudio: se realiza la confirmación clínica de los 374 casos detectados de hipertensión arterial (HTA), los 126 de hipercolesterolemia (HCOL) y los 33 de diabetes mellitus (DM).MedicionesSe realiza una entrevista a los pacientes detectados para las tomas de presión arterial a los hipertensos y para practicar la extracción sanguínea a hipercolesterolémicos y diabéticos. Se han utilizado los criterios diagnósticos preconizados por los últimos consensos.ResultadosParticipan 1.886 personas (78,1%). Prevalencias halladas: HTA total, 42 ± 2,2%; diagnosticada, 11,7 ± 1,4%; HCOL total, 26,6 ± 2%; DM total, 9,5 ± 1,3%; tabaquismo: 33,6 ± 2,1% y obesidad: 31,6 ± 2,1%. Grado de control: HTA, 8,6%; HCOL, 21,7%; DM, 56,1%. Asociación de FRCV: el 25,5% no presenta hipertensión, hipercolesterolemia ni fuma.ConclusionesElevada prevalencia FRCV en nuestra área frente a los resultados publicados de ámbito nacional. El tabaquismo resulta menos frecuente que en el resto del país. El grado de control es escaso y la asociación de los FRCV principales para cardiopatía isquémica reflejan que cerca del 75% de la población debe ser intervenida.ObjectivesTo calculate the prevalence of the main cardiovascular risk factors (CVRF) after diagnostic confirmation using clinical criteria. To analyse the degree of understanding and monitoring of these factors and to evaluate the association of CVRF with each other, so estimating who is susceptible to intervention.DesignCross-sectional, descriptive, observational study.SettingPopulation study conducted in Health Area 20 of the Community of Valencia (county of the Low Plain of the River Segura). Patients. People who had lived in this Area for ³20 years. Proportional, multi-stage randomised sampling with definition of sample quotas according to type of residence. Sample size: 2550 people (no reply in first stage: 26%). The second stage involved the clinical confirmation of those identified as suffering from hypertension (HT) (374), hypercholesterolaemia (HCOL) (126), and diabetes (DM) (33).MeasurementsPatients identified were interviewed for taking blood pressure in the case of those with HT, and blood samples in the case of those with HCOL and DM. The diagnostic criteria recommended by the latest consensus were used.Results1886 people (78.1%) took part. Prevalences found: total HT 42±2.2%, diagnosed: 11.7±1.4; total HCOL 26.6±2%; total DM 9.5±1.3%.Tobacco dependency was 33.6±2.1% and Obesity: 31.6±2.1%. Degree of control: HT, 8.6%; HCOL, 21.7%; DM, 56.1%. Association of CVR factors with each other: 25.5% had neither HT nor HCOL and did not smoke.ConclusionsHigh prevalence of CVRF in our area, compared with published national findings.Tobacco dependency is less common than at national level. The degree of control is very low and the association of the main CVRF factors for ischaemic cardiopathy reflect that nearly 75% of the population requires a preventive intervention

Estudio comparativo de la movilidad cervical, cinestesia cervical y la movilidad oculomotora entre sujetos con dolor cervical crónico y sujetos asintomáticos.

Introducción: El dolor cervical es un síntoma que afecta a un alto porcentaje de la población adulta, se estima que entre el 30 y el 50 % lo sufren al menos un día al año. Muchos de los sujetos con dolor cervical tienen restringida la movilidad cervical, pero también presentan otros signos como disminución de la capacidad sensoriomotora o alteraciones oculomotoras. Los estudios que comparan aspectos de movilidad cervical, capacidad sensoriomotora y movilidad ocular entre sujetos asintomáticos y sujetos con dolor cervical son escasos. Objetivo: Comparar la movilidad, la cinestesia y el dolor entre sujetos con dolor cervical crónico y sujetos asintomáticos. Material y método: Es un estudio transversal, observacional y comparativo. Se registraron distintas variables: intensidad del dolor, índice de discapacidad cervical, rango de movimiento cervical, rango de movimiento cervical superior, cinestesia cervical y la movilidad ocular. Resultados: Cincuenta y ocho adultos participaron en el estudio (21 hombres (36,2 %) y 37 mujeres, la edad media fue de 41,98 ± 12,48), 29 sujetos por grupo. El grupo con dolor cervical crónico mostró restricción en el rango de movimiento hacia la extensión, la rotación derecha y la rotación izquierda y en el test de flexión rotación hacia la derecha. En el test de seguimiento ocular lento (0,044) el grupo de dolor cervical crónico presentaba mayor dificultad que el grupo asintomático. Conclusión: Este estudio sugiere que el dolor cervical crónico afecta a la movilidad de la columna cervical, la cinestesia cervical y el control oculomotor comparado con sujetos asintomáticos

Biogeochemical indicators of elevated nitrogen deposition in semiarid Mediterranean ecosystems

Nitrogen (N) deposition has doubled the natural N inputs received by ecosystems through biological N fixation and is currently a global problem that is affecting the Mediterranean regions. We evaluated the existing relationships between increased atmospheric N deposition and biogeochemical indicators related to soil chemical factors and cryptogam species across semiarid central, southern, and eastern Spain. The cryptogam species studied were the biocrust-forming species Pleurochaete squarrosa (moss) and Cladonia foliacea (lichen). Sampling sites were chosen in Quercus coccifera (kermes oak) shrublands and Pinus halepensis (Aleppo pine) forests to cover a range of inorganic N deposition representative of the levels found in the Iberian Peninsula (between 4.4 and 8.1 kg N ha(-1) year(-1)). We extended the ambient N deposition gradient by including experimental plots to which N had been added for 3 years at rates of 10, 20, and 50 kg N ha(-1) year(-1). Overall, N deposition (extant plus simulated) increased soil inorganic N availability and caused soil acidification. Nitrogen deposition increased phosphomonoesterase (PME) enzyme activity and PME/nitrate reductase (NR) ratio in both species, whereas the NR activity was reduced only in the moss. Responses of PME and NR activities were attributed to an induced N to phosphorus imbalance and to N saturation, respectively. When only considering the ambient N deposition, soil organic C and N contents were positively related to N deposition, a response driven by pine forests. The PME/NR ratios of the moss were better predictors of N deposition rates than PME or NR activities alone in shrublands, whereas no correlation between N deposition and the lichen physiology was observed. We conclude that integrative physiological measurements, such as PME/NR ratios, measured on sensitive species such as P. squarrosa, can provide useful data for national-scale biomonitoring programs, whereas soil acidification and soil C and N storage could be useful as additional corroborating ecosystem indicators of chronic N pollution

Right Paraduodenal Hernia in an Adult Patient: Diagnostic Approach and Surgical Management

Paraduodenal hernia, a rare congenital anomaly which arises from an error of rotation of the midgut, is the most common type of intraabdominal hernia. There are two variants, right and left paraduodenal hernia, the right being less common. We report the case of a 41-year-old patient with a right paraduodenal hernia with a 6-month history of intermittent episodes of intestinal obstruction. Diagnosis was established by CT scan and upper gastrointestinal series with small bowel follow-through. In a planned laparotomy, herniation of the small bowel loops through the fossa of Waldeyer was found. Division of the lateral right attachments of the colon opened the hernia sac widely, replacing the pre- and postarterial segments of the intestine in the positions they would normally occupy at the end of the first stage of rotation during embryonic development. Six months after the surgery, after an uneventful recovery, the patient remains free of symptoms

Left hepatic lobe herniation through an incisional anterior abdominal wall hernia and right adrenal myelolipoma: a case report and review of the literature

<p>Abstract</p> <p>Introduction</p> <p>Herniation of the liver through an anterior abdominal wall hernia defect is rare. To the best of our knowledge, only three cases have been described in the literature.</p> <p>Case presentation</p> <p>A 70-year-old Mexican woman presented with a one-week history of right upper quadrant abdominal pain, nausea, vomiting, and jaundice to our Department of General Surgery. Her medical history included an open cholecystectomy from 20 years earlier and excessive weight. She presented with jaundice, abdominal distension with a midline surgical scar, right upper quadrant tenderness, and a large midline abdominal wall defect with dullness upon percussion and protrusion of a large, tender, and firm mass. The results of laboratory tests were suggestive of cholestasis. Ultrasound revealed choledocholithiasis. A computed tomography scan showed a protrusion of the left hepatic lobe through the anterior abdominal wall defect and a well-defined, soft tissue density lesion in the right adrenal topography. An endoscopic common bile duct stone extraction was unsuccessful. During surgery, the right adrenal tumor was resected first. The hernia was approached through a median supraumbilical incision; the totality of the left lobe was protruding through the abdominal wall defect, and once the lobe was reduced to its normal position, a common bile duct surgical exploration with multiple stone extraction was performed. Finally, the abdominal wall was reconstructed. Histopathology revealed an adrenal myelolipoma. Six months after the operation, our patient remains in good health.</p> <p>Conclusions</p> <p>The case of liver herniation through an incisional anterior abdominal wall hernia in this report represents, to the best of our knowledge, the fourth such case reported in the literature. The rarity of this medical entity makes it almost impossible to specifically describe predisposing risk factors for liver herniation. Obesity, the right adrenal myelolipoma mass effect, and the previous abdominal surgery are likely to have contributed to incisional hernia formation.</p

Boreal forest floor greenhouse gas emissions across a Pleurozium schreberi-dominated, wildfire-disturbed chronosequence

The boreal forest is a globally critical biome for carbon cycling. Its forests are shaped by wildfire events that affect ecosystem properties and climate feedbacks including greenhouse gas (GHG) emissions. Improved understanding of boreal forest floor processes is needed to predict the impacts of anticipated increases in fire frequency, severity, and extent. In this study, we examined relationships between time since last wildfire (TSF), forest floor soil properties, and GHG emissions (CO2, CH4, N2O) along a Pleurozium schreberi-dominated chronosequence in mid- to late succession located in northern Sweden. Over three growing seasons in 2012–2014, GHG flux measurements were made in situ and samples were collected for laboratory analyses. We predicted that P. schreberi-covered forest floor GHG fluxes would be related to distinct trends in the soil properties and microbial community along the wildfire chronosequence. Although we found no overall effect of TSF on GHG emissions, there was evidence that soil C/N, one of the few properties to show a trend with time, was inversely linked to ecosystem respiration. We also found that local microclimatic conditions and site-dependent properties were better predictors of GHG fluxes than TSF. This shows that site-dependent co-variables (that is, forest floor climate and plant-soil properties) need to be considered as well as TSF to predict GHG emissions as wildfires become more frequent, extensive and severe

Alternativas de tratamiento en los trastornos del espectro autista: una revisión bibliográfica entre 2000 y 2016

Alternative treatments in autism spectrum disorders: A bibliographical review between 2000 and 2016. The diagnosis of autism spectrum disorders comprises a wide variety of patients who, in spite of having individual differences, show two main characteristics: a limited social interaction, and restricted and repetitive behavioral patterns. The aim of this article is to review different treatments used in the autistic field as well as to mention some findings that intend to prove the efficacy of treatment outcomes. Through a bibliographical review between 2000 and 2016 using the databases PsycInfo, MEDLINE, Google Scholar, Psicodoc and PsycARTICLES, the outcomes highlight that behavioral treatments are the most well-supported interventions by the scientific community. Moreover, an early intervention, a high intensity and structuring, parent participation, and linguistic treatment are essential characteristics of an effective intervention.Bajo el diagnóstico de trastornos del espectro autista (TEA) encontramos una variedad de pacientes que, a pesar de sus diferencias individuales, presentan principalmente dos fuentes de desajuste: un déficit en la interacción social y un patrón de conductas restringido y repetitivo. Este artículo tiene como objetivo revisar algunas de las estrategias de intervención empleadas dentro del ámbito de los TEA así como mencionar algunas investigaciones que tratan de poner a prueba su eficacia. Mediante un procedimiento de revisión bibliográfica entre los años 2000 y 2016 y empleando para ello las bases de datos PsycInfo, MEDLINE, Google Scholar, Psicodoc y PsycARTICLES, los resultados obtenidos destacan que las aproximaciones terapéuticas de corte conductual son las que hasta ahora han recibido un mayor respaldo empírico. Además, el inicio temprano, el carácter intensivo, la elevada estructuración, la intervención paterna y la actuación sobre el lenguaje constituyen características esenciales de cualquier intervención que pretenda ser eficaz