Kandel y sus aportes teóricos a la psicología y a la psiquiatría

El 2000 fue un año significativo para las neurociencias dado que tres científicos de este campo ganaron el Premio Nobel de Medicina: Arvid Carlsson de la Universidad de Goteborg, Suecia,  Paul Greengard de la Universidad Rockefeller, Nueva York y Eric R. Kandel de la Universidad de Columbia, Nueva York, compartieron este prestigioso reconocimiento por sus contribuciones a la ciencia del cerebro. En este editorial nos centraremos en la vida académica de Eric Kandel, en sus principales aportes a la investigación de las bases neuronales de la memoria y el aprendizaje, pero especialmente expondremos sus ideas sobre la psiquiatría y la psicología actual.Fil: Freidin, Esteban. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Médicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; ArgentinaFil: Mustaca, Alba Elisabeth. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Médicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentin

Extinction of consummatory behavior in rats

Two experiments with rats studied the relationship between reinforcer magnitude and frequency, and extinction rate in a consummatory situation with rats. In Experiment 1, groups received access to either a 2% or a 32% sucrose solution during twenty 5-min sessions and were subsequently shifted to extinction (access to an empty sipper tube). Goal tracking time (time spent near the sipper tube) was the dependent measure. Extinction was faster after training with 2% solution than with 32% solution. In Experiment 2, extinction was faster after training with 50% partial reinforcement than with continuous reinforcement. In both experiments, extinction was gradual and rats exhibited spontaneous recovery of goal-tracking behavior. Results are discussed in the context of evidence pointing to a dissociation of consummatory and instrumental behavior.Fil: Mustaca, Alba Elisabeth. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Médicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; ArgentinaFil: Freidin, Esteban. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Médicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; ArgentinaFil: Papini, Mauricio Roberto. Texas Christian University; Estados Unido

Impacte d’una campanya de prevenció d’Infecció Nosocomial a una Unitat de Cures Intensives Pediàtriques. Utilitat d’un registre multicèntric d’infecció nosocomial

INTRODUCCIÓ: La infecció nosocomial (IN) a les Unitats de Cures Intensives Pediàtriques (UCIP) incrementa la morbimortalitat dels nens. En aquesta memòria de tesi doctoral es presenten dos estudis relacionats. El primer valora l’impacte d’ una campanya de prevenció d’IN a la UCIP, i el segon presenta un registre multicèntric d’IN a UCIP a Espanya. HIPÒTESIS: La campanya de prevenció d’IN a la UCIP podria disminuir les taxes d’IN i comportaria un descens de la morbimortalitat dels pacients. La creació d’un registre nacional multicèntric d’IN a les UCIPs permetria tenir informació sobre l’epidemiología de la infecció i el perfil de resistències. METODOLOGIA: El primer treball és un estudi prospectiu amb intervenció múltiple per reduir IN a la UCIP de l’hospital Sant Joan de Déu. Es dividí en tres períodes: Pre-intervenció (2006), intervenció (2007) en el que simplementaren els mesures i el període de seguiment a llarg plaç (2008). La intervenció radicava en tres accions principals: Crear un grup de Control d’ infecció, un programa educatiu d’higiene de mans i aplicar un paquet de mesures per reduir la IN. S’inclogueren nens ingressats a la UCIP t més de 24 hores. Es calcularen taxes de Bacterièmia relacionada con catèter (BRC), pneumònia associada a ventilació mecànica (NAVM) i infecció urinària associada a sondatge uretral (ITU-SU). El segon estudi és un estudi multicèntric prospectiu, observacional i descriptiu. El 2007 es creà el registre VINCIP (Vigilancia de Infección Nosocomial en Cuidados Intensivos Pediátricos). Es recolliren dades durant un mes (1-31 de març) per cada any d’estudi (2008-2012). No es van fer intervencions específiques durant aquest període com grup, però la majoria de les UCIPs implementen mesures per reduir la IN. Es recolliren taxes de BRC, NAVM i ITU-SU, microorganismes causants i patrons de resistències. RESULTATS: Primer estudi: S’inclogueren 851, 822 y 940 pacients, respectivament. Milloraren la taxa de BRC (8.1 a 6/1000-dies de catèter venós central CVC, p = 0.640), la de NAVM (28.3 a 10.6/1000 dies de ventilació mecànica, p = 0.005) i ITU-SU (23.3 a 5.8/1000 dies de sonda urinària, p < 0.001). Es va reduir l’estada hospitalària (18.56 vs 14,57 dies, p = 0,035) i la mortalitat (5,1% a 3,3%, p = 0.056). El model de regressió logística multivariable mostrà que la presència d’IN era factor independent de risc de mortalitat (OR 2.35 [95% IC, 1.02-5.55]; p = 0.046). Durant el seguiment a llarg plaç (en comparació amb el període pre-intervenció), les taxes van seguir millorant, BRC 4,6/1000 dies de CVC; NAVM, 9,1/1000 dies de ventilació mecànica i ITU-SU 5,2/1000 dies de sonda urinària (p = 0,205, p = 0.001 i p < 0.001 respectivament). Segon estudi. Ingressaren 3667 pacients. El nombre de pacients amb infecció nosocomial fou 90 (2.45%). La mitja de taxes dels 5 anys foren: BRC 3.8/1000 dies de CVC, NAVM 7.5/1000 dies de ventilació mecànica i ITU-SU 4.1/1000 dies de sonda urinària. Les taxes es reduiren homogèniament des de 2009 a 2012: BRC de 5.83 (95% CI 2.67- 11.07) a 0.49 (95% CI 0.0125- 2.76), p =0.0029; NAVM de 10.44 (95% CI 5.21-18.67) a 4.04 (95% CI 1.48-8.80), p= 0.0525; ITU-SU 7.10 (95% CI 3.067-13.999) a2.56 (95% CI 0.697-6.553), p= 0.0817; respectivament. Microorganismes: 63 de 99 (83.6%) bacteris gram-negatius (36.5% resistents), 19 (19.2%) bacteris gram-positius i 17 (17.2%) infeccions per Candida spp. CONCLUSIONS: Respecte al primer estudi, la campanya de prevenció d’IN va baixar globalment les taxes d’IN, l’estada hospitalària i la mortalitat. Els resultats es mantingueren en el període de seguimient a llarg plaç. Respecte al segon estudi presentat, els sistemes de vigilància local aporten informació per millorar les taxes d’infecció nosocomial, així com el patró de resistències.INTRODUCTION: Nosomial infections (NI) in the Pediatric Intensive care Unit (PICU) increases morbidity and mortality of patients. In this thesis we include two related articles. OBJECTIVES: - First study: To evaluate whether a quality improvement intervention could reduce NI in a PICU. - Second study: To report 5-years of NI surveillance data, as well as trends in infections by multidrug resistant organisms in Spanish PICU. METODOLOGY: - First article: Prospective interventional cohort study conducted during three periods: preintervention period, intervention period, and long-term follow-up. The quality improvement intervention consisted of the creation of an infection control team, a program targeting hand hygiene, and quality practices focused on preventing NI. - Second article: multicentre, prospective, descriptive and observational study was conducted using the data from surveillance system for NI created in 2007 for Spanish PICU. Data were collected for one month, between 01 and 31 March, for every study year (2008–2012). RESULTS: - First study: We included 851, 822 and 940 patients. Compared with the preintervention period, in the intervention period, the rates of central line–associated bloodstream infection (CLABSI) decreased from 8.1to 6/1,000 central venous catheter-days (p = 0.640), ventilator associated pneumonia (VAP) decreased from 28.3 to 10.6/1,000 days of ventilation (p = 0.005), and catheter-associated urinary tract infection (CAUTI) decreased from 23.3 to 5.8/1,000 urinary catheter-days (p < 0.001). Furthermore, hospital length of stay decreased from 18.56 to 14.57 days (p = 0.035) and mortality decreased from 5.1% to 3.3% (p = 0.056). - Second study: A total of 3667 patients were admitted to the units during the study period. There were 90 (2.45%) patients with NI. The mean rates during the 5 years study were:CLABSI, 3.8/1000 central venous catheter-days, VAP 7.5/1000 endotracheal tube-days, and cathet CAUTI 4.1/1000 urinary catheter-days. All rates homogeneously decreased from 2009 to 2012. The microorganism analysis: 63 of the 99 isolated bacteria (63.6%) were Gramnegative bacteria (36.5% were resistant), 19 (19.2%) Gram-positive bacteria, and 17 (17.2%) were Candida spp. CONCLUSIONS: A multifaceted quality improvement intervention reduced nosocomial infections rates, hospital length of stay, and mortality in our PICU. The local surveillance systems provide information for dealing with nosocomial infection

Conexiones globales en sistemas tridimensionales lineales a trozos

Presentamos en esta comunicación una técnica para probar de forma analítica la existencia de conexiones globales en sistemas dinámicos continuos lineales a trozos. Más concretamente, utilizamos esta técnica para demostrar la existencia de dos conexiones homoclinas directas (aquellas que cortan al plano de separación exactamente dos veces) y un ciclo heteroclino directo tipo punto-T (cuya conexión por las variedades unidimensionales corta exactamente tres veces al plano de separación mientras que su conexión por las variedades bidimensionales sólo lo hará en un punto) en una familia uniparamétrica de sistemas tridimensionales continuos lineales a trozos con dos zonas, reversibles y con trazas nulas

Improving aircraft performance using machine learning: a review

This review covers the new developments in machine learning (ML) that are impacting the multi-disciplinary area of aerospace engineering, including fundamental fluid dynamics (experimental and numerical), aerodynamics, acoustics, combustion and structural health monitoring. We review the state of the art, gathering the advantages and challenges of ML methods across different aerospace disciplines and provide our view on future opportunities. The basic concepts and the most relevant strategies for ML are presented together with the most relevant applications in aerospace engineering, revealing that ML is improving aircraft performance and that these techniques will have a large impact in the near future

Estudio descriptivo del trastorno de ansiedad asociado a las tecnologías digitales

Una de las consecuencias del impacto de la tecnología en la vida humana es el trastorno clínico denominado tecnofobia. Podría considerarse como una fobia específica situacional. Dado que el trastorno presenta variaciones según el contexto cultural, el objetivo ha sido describir el trastorno en la población adulta argentina (18-79 años), utilizando una escala diagnóstica localmente desarrollada. Un 12.1% de la muestra en estudio cumple todos los criterios de tecnofobia. No es posible trazar un perfil de sujeto tecnofóbico, aunque hay asociación entre algunas variables sociodemográficas y distintos factores que componen el constructo teórico tecnofobia, confirmando la multifactorialidad del trastorno. La percepción del impacto social de las tecnologías en nuestro país es negativa, en general, lo que confirma la importancia del factor cultural en este trastorno

Prognostic value of biomarkers after cardiopulmonary bypass in pediatrics: The prospective PANCAP study

Objective:To assess the usefulness of procalcitonin, pro-adrenomedullin and pro-atrial natriuretic peptide as predictors of need for mechanical ventilation and postoperative complications (need for inotropic support and bacterial infection) in critically ill pediatric patients after cardiopulmonary bypass. Design:A prospective, observational study Setting: Pediatric intensive care unit. Patients: Patients under 18 years old admitted after cardiopulmonary bypass. Measuraments and main results: Serum levels of procalcitonin, pro-adrenomedullin and pro-atrial natriuretic peptide were determined immediately after bypass and at 24-36 hours. Their values were correlated with the need for mechanical ventilation, inotropic support and bacterial infection. One hundred eleven patients were recruited. Septal defects (30.6%) and cardiac valve disease (17.1%) were the most frequent pathologies. 40.7% required mechanical ventilation, 94.6% inotropic support and 15.3% presented invasive bacterial infections. Pro-adrenomedullin and pro-atrial natriuretic peptide showed significant high values in patients needing mechanical ventilation. Cut-off values higher than 1.22 nmol/L and 215.3 pmol/L, respectively for each biomarker, may indicate need for mechanical ventilation with an AUC of 0.721 and 0.746 at admission and 0.738 and 0.753 at 24-36 hours, respectively but without statistical differences. Pro-adrenomedullin and procalcitonin showed statistically significant high values in patients with bacterial infections. Conclusions: After bypass, pro-adrenomedullin and pro-atrial natriuretic peptide are suitable biomarkers to predict the need for mechanical ventilation. Physicians should be alert if the values of these markers are high so as not to progress to early extubation. Procalcitonin is useful for predicting bacterial infection. This is a preliminary study and more clinical studies should be done to confirm the value of pro-adrenomedullin and pro-atrial natriuretic peptide as biomarkers after cardiopulmonary bypass

Effects of deep dry needling on tremor severity and functionality in stroke: A case report

This study aimed to determine the effect of one session of dry needling on the severity of tremor, motor function and skills, and quality of life of a 39-year-old woman with post-stroke tremor. Myofascial trigger points (MTrP) of the following muscles were treated: extensor digitorum, flexor digitorum superficialis and profundus, brachioradialis, short head of biceps brachii, long head of triceps brachii, mid deltoid, infraspinatus, teres minor, upper trapezius, and supraspinatus. Outcomes were assessed via (i) clinical scales (activity of daily living (ADL-T24), a visual analog scale (VAS), and the Archimedes spiral), (ii) a functional test (9-Hole Peg test), and (iii) biomechanical and neurophysiological measurements (inertial sensors, electromyography (EMG), and dynamometry). The subject showed a decrease in the severity of tremor during postural (72.7%) and functional (54%) tasks after treatment. EMG activity decreased after the session and returned to basal levels 4 days after. There was an improvement post-intervention (27.84 s) and 4 days after (32.43 s) in functionality and manual dexterity of the affected limb, measured with the 9-Hole Peg test, as well as in the patient’s hand and lateral pinch strength after the treatment (26.9% and 5%, respectively), that was maintained 4 days later (15.4% and 16.7%, respectively)

Pressure-Induced Referred Pain as a Biomarker of Pain Sensitivity in Fibromyalgia

Background: Fibromyalgia (FM) syndrome is characterized by widespread pain, fatigue, and generalized increased pain sensitivity. Appropriate and simple pain models are methods employed to assess pain mechanisms that can potentially lead to improved treatments. Pressure pain thresholds (PPTs) or mapping the referred pain area produced by pressure stimulation at suprathreshold intensities are used to assess pain mechanisms. The optimal suprathreshold stimulation intensity to elicit referred pain with minimal discomfort for patients with FM has yet to be determined. Objectives: The aim of this study was to compare the area and intensity of pressure-induced referred pain in patients with FM as elicited by systematic increases in PPTs, compared with controls. Study Design: Observational, crossed-section study. Setting: Research laboratory. Methods: Twenty-six patients with FM and 26 healthy controls, age- and gender-matched, were included. Suprathreshold stimulation was applied to the infraspinatus muscle of the dominant side at 4 different intensities (PPT +20%, +30%, +40%, and +50%), after which referred pain was evaluated by measuring the area of pain in pixels using a digital body chart and its intensity on a Visual Analog Scale. Factors related to anxiety condition, pain catastrophizing, depression, and quality of life were recorded. Results: The referred pain areas were larger in the FM group compared with healthy individuals at 120% (P = 0.024), 130% (P = 0.001), 140% (P = 0.001), and 150% (P = 0.001) PPT, however, within the FM group no differences were found between the intensity of suprathreshold stimulation and the size of the referred pain areas (P = 0.135) or pain intensity (P > 0.05). There was a positive correlation between the size of referred pain areas and pain catastrophizing in the FM group (r = 0.457, P = 0.032). Limitations: This study presents some limitations, among which is the variability found in the referred pain areas. Conclusions: These findings show that referred pain induced by applying a suprathreshold pressure of 120% PPT can be a useful biomarker to assess sensitized pain mechanisms in patients suffering from FM