EVALUACION DE LA ANALGESIA POST-TORACOTOMIA POR BLOQUEO INTERCOSTAL CON BUPIVACAINA.

Con el objeto de evaluar la eficiencia de la analgesia postoperatoria del Bloqueo Intercostal luego de Cirug\ueda Tor\ue1cica, se estudian prospectivamente 40 pacientes sometidos a Toracotom\uedas posterolaterales. A 20 de ellos se les coloc\uf3 un cat\ue9ter intercostal para administrar Bupivaca\uedna al 0.5% cada 4 horas (Grupo Bupivaca\uedna) y adem\ue1s recibir\uedan drogas opi\ue1ceas si fuera necesario. Los otros 20 pacientes (Grupo Meperidina) fueron tratados exclusivamente con medicaci\uf3n opi\ue1cea. Se determin\uf3 que el grado de analgesia en los pacientes bloqueados (Grupo Bupivaca\uedna) fue mucho mejor que el de los pacientes tratados exclusivamente con Meperidina, mostrado diferencias significativas (p < 0.01) en los registros de dolor postoperatorio de las 4, 24, 48 y 72 horas. As\ued mismo los pacientes del Grupo Bupivaca\uedna, solicitaron un n\ufamero significativamente menor (p < 0.01) de dosis de opi\ue1ceos que los otros pacientes (Grupo Meperidina) durante los tres primeros d\uedas del postoperatorio (31 vs. 178 dosis), esto es una reducci\uf3n del 82,5% de las analg\ue9sicos solicitados. M\ue1s a\ufan 8 de los 20 pacientes bloqueados (40%) no necesitaron de ninguna dosis de Meperidina. Aunque se observaron menos complicaciones respiratorias en los pacientes con bloqueo intercostal (3 vs. 5) \ue9sta diferencia no fue significativa estad\uedsticamente (p>0.05). Sin embargo la reducci\uf3n en la estancia hospitalaria en \ue9stos pacientes bloqueados (4,4 + - 1,18 vs. 6,2 + - 1,96 d\uedas), s\ued mostr\uf3 diferencias significativas (p<0.01). En conclusi\uf3n el bloqueo intercostal utilizando Bupivaca\uedna en bolo, posterior a Cirug\ueda Tor\ue1cica, es un m\ue9todo de analgesia postoperatoria efectivo, sencillo y seguro, que permite un mejor control de dolor en el paciente y una reducci\uf3n tanto del n\ufamero de analg\ue9sicos opi\ue1ceos requeridos, como de la estancia hospitalaria. SUMMARY In order to evaluate the efficiency of postoperative analgesia provided by Intercostal Block following Thoracic Surgery, Forty patients, who underwent posterolateral thoracotomies, were prospectively studied. Twenty of them (bupivacaine group) received 0.5% Bupivacaine every four hours through a single intercostal catheter and additional opiate drugs if requiered. The others twenty patients (meperidine group) only received opiate medications. It was determinated that the analgesia degree was much better in the bupivacaine group than in the meperidine group, reaching significance (p< 0.01) in postoperative pain assessments at 4, 24, 48 and 72 hours. In addition Bupivacaine group patients demanded significantly less analgesic drugs (p < 0.01) than Meperidine group patients (31 vs 178 doses) during the first three postoperative days, that is a 82.5% reduction in the number of doses of meperidine required. Moreover, 8 out of 20 blocked patients (40%) did not demand any meperidine additional dose. Eventhough less number of respiratory complications was observed in the Bupivacaine group (3 vs 5), this was not a statistically significant difference (p > 0.05). However the lower hospital stay, also observed in those patients (4.4 + - 1.18 vs 6.2 + -1.96 days) was significant (p < 0.01). In conclusion, Intercostal Block with 0.5% Bupivacaine bolus injections after thoracic surgery, is an effective, simple and safe method of postoperative analgesia, allowing a better pain alleviation and reduction in both , the total dosis of demanded opiate drugs and the hospital stay

Fundamento del derecho natural según los principios de la doctrina de la ciencia

1.-El carácter de la racionalidad consiste en que el agente [das Handelnde] y lo actuado [das Behandelte] son uno y lo mismo; y con esta descripción se ha agotado el ámbito de la razón como tal. El uso del lenguaje ha depositado en la palabra Yo este concepto sublime para aquéllos que son capaces de él, para los que son capaces de la abstracción de su propio Yo

Vitamin D receptor binding, chromatin states and association with multiple sclerosis.

Both genetic and environmental factors contribute to the aetiology of multiple sclerosis (MS). More than 50 genomic regions have been associated with MS susceptibility and vitamin D status also influences the risk of this complex disease. However, how these factors interact in disease causation is unclear. We aimed to investigate the relationship between vitamin D receptor (VDR) binding in lymphoblastoid cell lines (LCLs), chromatin states in LCLs and MS-associated genomic regions. Using the Genomic Hyperbrowser, we found that VDR-binding regions overlapped with active regulatory regions [active promoter (AP) and strong enhancer (SE)] in LCLs more than expected by chance [45.3-fold enrichment for SE (P < 2.0e-05) and 63.41-fold enrichment for AP (P < 2.0e-05)]. Approximately 77% of VDR regions were covered by either AP or SE elements. The overlap between VDR binding and regulatory elements was significantly greater in LCLs than in non-immune cells (P < 2.0e-05). VDR binding also occurred within MS regions more than expected by chance (3.7-fold enrichment, P < 2.0e-05). Furthermore, regions of joint overlap SE-VDR and AP-VDR were even more enriched within MS regions and near to several disease-associated genes. These findings provide relevant insights into how vitamin D influences the immune system and the risk of MS through VDR interactions with the chromatin state inside MS regions. Furthermore, the data provide additional evidence for an important role played by B cells in MS. Further analyses in other immune cell types and functional studies are warranted to fully elucidate the role of vitamin D in the immune system

Vicia faba Crop Residues for Sustainable Electricity Generation Using a Sludge-based Microbial Fuel Cell

Microbial fuel cells (MFC) simultaneously degrade organic substrates and generate electricity in a sustainable and eco-friendly way. Here, we built a 4-unit MFC and studied the efficiency of MFC at different conditions, including pH, substrate concentration of Vicia faba agricultural wastes with exoelectrogenic bacteria P. aeruginosa. The exoelectrogenic bacteria were obtained from industrial effluents and used to inoculate the MFCs. The optimized conditions in terms of yielding maximum potential of 802 mV, yielding maximum power density of 283 mW m–2 were reported at a substrate concentration of 6 g L–1 of V. faba waste and pH of 5.5, corresponding to a current density 1255.93 mA m–2. Using exoelectrogenic bacteria from industrial effluents and agricultural wastes resulted in efficient MFC. Thus, the developed MFCs using V. faba agricultural wastes can be used in rural areas that have limited access to electricity, by reusing agricultural wastes and concomitant electricity generation. This work is licensed under a Creative Commons Attribution 4.0 International License

Twentieth century turnover of Mexican endemic avifaunas: Landscape change versus climate drivers

Numerous climate change effects on biodiversity have been anticipated and documented, including extinctions, range shifts, phenological shifts, and breakdown of interactions in ecological communities, yet the relative balance of different climate drivers and their relationships to other agents of global change (for example, land use and land-use change) remains relatively poorly understood. This study integrated historical and current biodiversity data on distributions of 115 Mexican endemic bird species to document areas of concentrated gains and losses of species in local communities, and then related those changes to climate and land-use drivers. Of all drivers examined, at this relatively coarse spatial resolution, only temperature change had significant impacts on avifaunal turnover; neither precipitation change nor human impact on landscapes had detectable effects. This study, conducted across species’ geographic distributions, and covering all of Mexico, thanks to two large-scale biodiversity data sets, could discern relative importance of specific climatic drivers of biodiversity change

Reuse of terminological resources for efficient ontological engineering in Life Sciences

This paper is intended to explore how to use terminological resources for ontology engineering. Nowadays there are several biomedical ontologies describing overlapping domains, but there is not a clear correspondence between the concepts that are supposed to be equivalent or just similar. These resources are quite precious but their integration and further development are expensive. Terminologies may support the ontological development in several stages of the lifecycle of the ontology; e.g. ontology integration. In this paper we investigate the use of terminological resources during the ontology lifecycle. We claim that the proper creation and use of a shared thesaurus is a cornerstone for the successful application of the Semantic Web technology within life sciences. Moreover, we have applied our approach to a real scenario, the Health-e-Child (HeC) project, and we have evaluated the impact of filtering and re-organizing several resources. As a result, we have created a reference thesaurus for this project, named HeCTh

An Expanded 2D Fused Aromatic Network with 90-Ring Hexagons

Two-dimensional fused aromatic networks (2D FANs) have emerged as a highly versatile alternative to holey graphene. The synthesis of 2D FANs with increasingly larger lattice dimensions will enable new application perspectives. However, the synthesis of larger analogues is mostly limited by lack of appropriate monomers and methods. Herein, we describe the synthesis, characterisation and properties of an expanded 2D FAN with 90-ring hexagons, which exceed the largest 2D FAN lattices reported to date

Relationship between microstructure and fracture types in a UNS S32205 duplex stainless steel

Duplex stainless steels are susceptible to the formation of sigma phase at high temperature which could potentially be responsible for catastrophic service failure of components. Thermal treatments were applied to duplex stainless steels in order to promote the precipitation of different fractions of sigma phase into a ferrite-austenite microstructure. Quantitative image analysis was employed to characterize the microstructure and Charpy impact tests were used in order to evaluate the mechanical degradation caused by sigma phase presence. The fracture morphology of the Charpy test specimens were thoroughly observed in SEM, looking for a correlation between the microstructure and the fracture types in UNS S32205 duplex stainless steel. The main conclusion is the strong embrittlement effect of sigma phase since it is possible to observe a transition from transgranular fracture to intergranular fracture as increases the percentage of sigma phase. Thus, the mixed modes of fracture are predominant in the present study with high dependence on sigma phase percentages obtained by different thermal treatments

Estudo comparativo entre as técnicas de aglutinação em látex e de imunoturbidimetria para a detecção de fator reumatoide

INTRODUCTION: The rheumatoid factor (RF) is the most common antibody found in patients with rheumatoid arthritis. It is an inflammatory chronic disease characterized by articular involvement, inflammation of synovial fluid, tissue infiltration by leucocytes and joint destruction, which ultimately determine articular deformities. The rheumatoid factor is found in 70%-80% of the adult population and in 10% of the young population. OBJECTIVE: The aim of this research was to compare immunoturbidimetric and latex agglutination methods for the detection of RF in serum. RESULTS: The immunoturbidimetric method displayed sensitivity (95.2%), specificity (89.4%) and high positive correlation (R² = 0,8077) with the latex agglutination method in positive serum samples. CONCLUSION: The study allowed to demonstrate that both immunoturbidimetric and latex agglutination methods equally discriminate between negative and positive serum samples for RF.INTRODUÇÃO: O fator reumatoide (FR) é o autoanticorpo mais comum encontrado em pacientes com artrite reumatoide, uma doença crônica inflamatória caracterizada pelo envolvimento articular com inflamação do líquido sinovial, infiltração de tecido por leucócitos e destruição das articulações, que acaba por determinar deformidades articulares. O FR é encontrado em 70%-80% da população adulta e em 10% da população juvenil. OBJETIVO: Comparar os métodos de imunoturbidimetria e aglutinação (prova do látex) para a determinação de FR em soro. RESULTADO: Foi possível observar que o método imunoturbidimétrico apresenta sensibilidade (95,2%), especificidade (89,4%) e correlação positiva elevada (R² = 0,8077) com o método de aglutinação pelo látex em amostras de soro positivas. CONCLUSÃO: O estudo permitiu demonstrar que o método imunoturbidimétrico e o método de aglutinação pelo látex são igualmente capazes de discriminar amostras negativas e positivas para FR.Faculdade de Medicina do ABCInstituto Paulista de Ensino e Saúde de São PauloFaculdade de Medicina do ABC clinical laboratory analystUniversidade de São Paulo Faculdade de Medicina clinical laboratory biologisHospital Emílio RibasUniversidade PaulistaUSP Instituto de QuímicaUniversidade Federal de São Paulo (UNIFESP) Department of Biological SciencesUniversidade Federal de São Paulo (UNIFESP) Department of Biological SciencesUNIFESP, Department of Biological SciencesUNIFESP, Department of Biological SciencesSciEL