Uso da Simulação no Treino de Internos em Técnicas de Pediatria – Técnica da Punção Lombar

Introdução: A punção lombar (PL) é a técnica invasiva mais frequente em Pediatria. O treino é habitualmente realizado sob supervisão, directamente no paciente. O uso de simuladores, possibilita aquisição de capacidades num ambiente seguro, minimizando custos e riscos para o doente. Objectivos: Avaliar a capacidade dos internos de pediatria (IP) na realização da PL e o uso de simulação aplicada à educação médica como ferramenta de melhoria na aquisição de competências. Material e Métodos: Foi elaborado e apresentado a todos os IP, um protocolo e checklist da PL. Realizaram-se 2 sessões clínicas, usando simuladores de PL, a primeira uma semana depois da apresentação do protocolo e a segunda, dois meses depois. Foi avaliado em cada sessão, o cumprimento do protocolo e performance na execução da técnica, mediante a aplicação da checklist. No final de cada sessão foi aplicado um questionário (escala 0-10) sobre experiência, grau de confiança prévio, alterações notadas e reprodutividade da técnica no simulador. Resultados: Participaram em cada sessão, 13 IP Oito haviam realizado menos de 10 PL durante a sua prática clínica, sendo que nenhum tinha realizado, PL em simuladores. Na 1ª sessão, as principais falhas foram a ausência de esclarecimentos sobre a técnica (n=7), cuidados pós PL (n=6) e complicações (n=5); a não aplicação de anestésico local (n=3); ausência de monitorização (n=5) e falhas na assepsia A maioria (n=8) desconhecia, ainda, o sistema de medição da pressão intracraniana (PIC). Na 2ª sessão, verificou-se melhoria em todos os itens avaliados, persistindo, ainda, falhas na monitorização (n=2), informação cuidados pós PL (n=2) e complicações (n=2). Em todos os casos a medição da PIC foi correcta. O score médio do conhecimento e grau de confiança na execução da técnica prévia à 1ª sessão foi 5, constatando-se uma clara melhoria após as 2 sessões (score médio 9). Todos consideraram que os simuladores contribuíram para o aperfeiçoamento da técnica e que os mesmos reproduziam com fiabilidade a prática real (score médio 8). Conclusões: O uso de simuladores no treino da PL melhora a competência dos internos na sua realização, permitindo aquisição de experiência e confiança sem riscos para doente. A introdução destes simuladores no ensino médico pós-graduado deve ser considerado

Cell surface immobilization of GABAARs in cerebellar granule cells depends on the M3/M4 cytoplasmatic loop of the alpha 1 subunit

Gamma-Aminobutyric acid (GABA) is the major inhibitory neurotransmitter in the vertebrate brain. The localization of GABA receptors type A (GABAARs) at strategically located domains of the neuronal membrane is of vital importance for fast inhibitory synapse transmission efficacy. We have shown before that the lateral mobility of GABAARs depends on subunit composition of the complex. To study the lateral mobility of GABAARs in living, cultured neurons, we transfected cerebellar granule cells with either the complete 1 GABAAR subunit or with a truncation of the 1 subunit that lacks the major intracellular loop (M3/M4). We examined the location and lateral mobility of receptors containing both versions of the 1 subunit in living neurons. From fluorescence recovery after photobleaching experiments we present novel evidences that the intracellular M3/M4 loop of the 1 subunit restricts the lateral mobility of GABAARs when expressed in neurons. In addition, our immunocytochemical studies suggested that receptors containing the truncated subunit seem to be unable to reach synaptic localizations. Here we show for the first time that the 1 intracellular loop (M3/M4) domain has a relevant role in controlling the lateral mobility of GABAARs in neurons, and we believe that this is a novel and important contribution in neurobiology of GABAA receptors

Sinostosis húmero-radio-cubital: a propósito de un caso

Se presenta aparentemente el primer caso en la literatura mundial de Sinostosis Húmero-Radio-Cubital unilateral, no asociado a ninguna entidad patológica congénita, observando un crecimiento y desarrollo del resto del organismo dentro de parámetros normales. Siendo este un miembro superior funcional se decide no aplicar ningún tratamiento.We report the first case in the world's literature of unilateral Húmero-Radio-Ulnar Synostosis, not associated to other congenital pathology entity; we observed a normal growth and development of the rest of the body; due to be a funtional upper lim b we decided not give treatment

Fuzzy systems and neural networks XML schemas for soft computing

This article presents an XML[2] based language for the specification of objects in the Soft Computing area. The design promotes reuse and takes a compositional approach in which more complex constructs are built from simpler ones; it is also independent of implementation details as the definition of the language only states the expected behaviour of every possible implementation. Here the basic structures for the specification of concepts in the Fuzzy Logic area are described and a simple construct for a generic neural network model is introduced

Caracterización geoquímica de los sedimentos de la red de drenaje del Rio Garona en la Val d'Aran (Catalunya, España).

A geochemical survey of stream sediments from the Garona River was performed in order to define the main regional lithogeochemical units and, based on this geochemical exploration study, to establish the reference levels of some chemical elements in the upper Garona River basin. The analysis of the lower grainsize fraction (˂180 μm) by HR-ICP-MS of 33 stream sediment samples allowed us establish reference levels for 48 elements. We have also studied the leachates of the sediments to model the environmentally available geochemical fraction. The trace elements with the lowest reference level, ranging between 10 and 50 mg/kg, are Th, Pr, Ga, Y, Ni, Pb, As, Cu, Zr, Li, Cr, Nd, La, and V. Instead, Zn, Rb, Sr, Ce and Ba show concentrations higher than 50 mg/kg. Some enrichments were observed in the streams sediments according to the three main litogeochemical units defined; the Maladeta-Marimanya granitoids (higher concentrations of Y, Th, Pb and U), the metasediments of an extensive area of the basin (enrichments in Pb, Sr and Sn), and the black shales (in Cu, U, Sr, Ni, Zn, V, Sb and Mo) which are present in local areas of the basin.SíPeer Reviewe

Los depósitos de ceniza volcánica del Pleistoceno Superior-Holoceno de la región de Tafí del Valle-Cafayate, noroeste de Argentina

[EN]We identified volcanic ash deposits, whose thickness can exceed sometimes the 4 m, in the southeastern margin of La Puna and neighbouring areas (Provinces of Tucuman and Salta, Argentina). These Late Pleistocene and Holocene deposits show the existence of a highly explosive volcanism only some few thousand years ago, without comparison with any historical volcanic episode in northwestern Argentina. We have characterized the size distribution of ash (laser diffraction), morphology of particles (SEM), mineralogy (XRD) and the geochemistry of major and trace elements in bulk sample using mass spectrometry (HR-ICP-MS). The information provided by these deposits is of great interest to size adequately the geochemical impact models of ashfall in future volcanic eruptions in the Central Volcanic Zone of the Andes, quantifying the contribution of volcanic ash to the regional geochemical balances, both with respect to nutrients (e.g., Ca and Fe) and potentially toxic elements (e.g., As and F), among other elements of interest.[ES] Se han localizado diversos depósitos de ceniza volcánica, cuyos espesores llegan a superar en ocasiones los 4 m al suroeste de La Puna y áreas limítrofes (Provincias de Tucumán y Salta, Argentina). Estos depósitos son de edad Pleistoceno Superior y Holoceno y muestran la existencia hace pocos miles de años de volcanismo altamente explosivo, sin comparación con ningún episodio volcánico histórico en el noroeste de Argentina. Se han caracterizado la distribución granulométrica de la ceniza (difracción laser), la morfología de las partículas (microscopía electrónica de barrido), mineralogía (difracción de rayos X) y la geoquímica de elementos mayores y trazas en muestra total mediante espectrometría de masas (HR-ICP-MS). La información suministrada por estos depósitos tiene gran interés a la hora de dimensionar los modelos de impacto geoquímico de la caída de ceniza de futuras erupciones volcánicas en la Zona Volcánica Central de los Andes, cuantificando la contribución de la ceniza volcánica a los balances geoquímicos regionales, tanto por lo que respecta a nutrientes (p. ej., Ca y Fe), como de elementos potencialmente tóxicos (p. ej., As y F), entre otros elementos de interés.Agradecemos el apoyo técnico del labGEOTOP (infraestructura cofinanciada por FEDER, CSIC08-4E-001) del ICTJA-CSIC; de los Grupos PEGEFA (2009-SGR-972) y GEOVOL y fue financiado por el Proyecto QUECA (CGL2011-23307).Peer reviewe

Firm and industry effects on small, medium-sized and large firms’ performance

This paper examines whether or not the relative importance of the firm and industry effects in explaining performance variations is the same regardless of the firm size. In relation to size, we think that there has been particular neglect of studying medium-sized firms separately from SMEs in general. That is why we study separately large, medium-sized and small firms. We also contribute to knowledge on the firm-industry debate testing empirically both effects distinguishing the firms by size according to a standard classification in the EU. Our results show that the performances of large and small firms are mainly explained by the firm effect, albeit for different reasons, while the performance of medium-sized firms is explained primarily by the industry effect

The ongoing volcanic eruption of El Hierro, Canary Islands

El Hierro, the youngest of the Canary Islands (Spain), is no stranger to hazards associated with volcanic activity or to efforts to minimize the effects of these hazards on local communities. As early as 1793, administrative records of El Hierro indicate that a swarm of earthquakes was felt by locals; fearing a greater volcanic catastrophe, the first evacuation plan of an entire island in the history of the Canaries was prepared. The 1793 eruption was probably submarine with no appreciable consequences other than that the earthquakes were felt [Carracedo, 2008]; over the next roughly 215 years the island was seismically quiet. Yet seismic and volcanic activity are expected on this youngest Canary Island due to its being directly above the presumed location of the Canary Island hot spot, a mantle plume that feeds upwelling magma just under the surface, similar to the Hawaiian Islands. Because of this known geologic activity, the Spanish Instituto Geogrfco Nacional (IGN) has managed geophysical monitoring of the island since the beginning of the 1990s.Peer Reviewe

Probiotics and in-hive fermentation as a source of beneficial microbes to support the gut microbial health of honey bees

Managed populations of honey bees (Apis mellifera Linnaeus; Hymenoptera: Apidae) are regularly exposed to infectious diseases. Good hive management including the occasional application of antibiotics can help mitigate infectious outbreaks, but new beekeeping tools and techniques that bolster immunity and help control disease transmission are welcome. In this review, we focus on the applications of beneficial microbes for disease management as well as to support hive health and sustainability within the apicultural industry. We draw attention to the latest advances in probiotic approaches as well as the integration of fermented foods (such as water kefir) with disease-fighting properties that might ultimately be delivered to hives as an alternative or partial antidote to antibiotics. There is substantial evidence from in vitro laboratory studies that suggest beneficial microbes could be an effective method for improving disease resistance in honey bees. However, colony level evidence is lacking and there is urgent need for further validation via controlled field trials experimentally designed to test defined microbial compositions against specific diseases of interest.Fil: Rodríguez, María A.. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas; Argentina. Universidad Nacional del Sur. Departamento de Agronomía. Laboratorio de Estudios Apícolas; Argentina. Western University; CanadáFil: Fernandez, Leticia Andrea. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional del Sur. Departamento de Agronomía. Laboratorio de Estudios Apícolas; Argentina. Universidad Nacional del Sur. Departamento de Biología, Bioquímica y Farmacia; ArgentinaFil: Daisley, Brendan A.. Western University; Canadá. University of Guelph; CanadáFil: Reynaldi, Francisco José. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; Argentina. Universidad Nacional de la Plata. Facultad de Ciencias Veterinarias. Centro de Microbiología Básica y Aplicada;Fil: Allen Vercoe, Emma. University of Guelph; CanadáFil: Thompson, Graham J.. Western University; Canad

Streptococcus caprae sp. nov., isolated from Iberian ibex (Capra pyrenaica hispanica)

Biochemical and molecular genetic studies were performed on a novel Gram-stain-positive, catalase-negative, coccus-shaped organism isolated from tonsil samples of two Iberian ibexes. The micro-organism was identified as a streptococcal species based on its cellular, morphological and biochemical characteristics. 16S rRNA gene sequence comparison studies confirmed its identification as a member of the genus Streptococcus, but the organism did not correspond to any species of this genus. The nearest phylogenetic relative of the unknown coccus from ibex was Streptococcus porci 2923-03T (96.6 % 16S rRNA gene sequence similarity). Analysis based on rpoB and sodA gene sequences revealed sequence similarity values lower than 86.0 and 83.8 %, respectively, from the type strains of recognized Streptococcus species. The novel bacterial isolate was distinguished from Streptococcus porci and other Streptococcus species using biochemical tests. Based on both phenotypic and phylogenetic findings, it is proposed that the unknown bacterium be classified as representing a novel species of the genus Streptococcus, for which the name Streptococcus caprae sp. nov. is proposed. The type strain is DICM07-02790-1CT (= CECT 8872T = CCUG 67170T)