Alteraciones Neuropsicológicas y Emocionales en Niños Prematuros de muy Bajo Peso al Nacer

 La  prematuridad  es  uno  de  los  problemas  de  salud  más  prevalentes  en  la población infantil de los países desarrollados. Entre un 8 y un 10% de los nacimientos ocurren antes de la 37ª semana de gestación y justifican el 75 % de la mortalidad perinatal y el 50% de la discapacidad en la infancia. El principal objetivo de este trabajo fue realizar una evaluación de las posibles secuelas  neuropsicológicas  y  emocionales  a  los  7  años  de  edad  de  niños prematuros  comparándolo  con  niños  de  la  misma  edad  pero  nacidos  a término.  Instrumentos: Historias  Clínicas  y  Entrevistas.  Batería  de Evaluación Neuropsicológica Infantil (BENI). Sistema de Evaluación de la Conducta  de  niños  y  Adolescentes  (BASC).  Los  resultados  han  mostrado que los niños prematuros presentan alteraciones centradas en la memoria la  función  ejecutiva  en  la  evaluación  neuropsicológica  y  en  problemas  de conducta  y  de  atención  en  la  evaluación  psicopatológica.  Estos  resultados deberían  considerarse  para  iniciar  programas  de  intervención  en  los  dos ámbitos  descritos  que  ayuden  a  estos  niños  a  superar  las  dificultades  que manifiestan por la presencia de dichos problemas. Palabras claves: Prematuridad;  Niños;  Secuelas  neuropsicológicas  y  emocionales;  Batería Neuropsicológica (BENI).   Memory Consolidation and Neural Substrate of Reward: Prematurity is one of the most relevant health problems among children in the developed countries.  Around  8  to  10%  of  children  birth  before  the  37  week  and/or with  a  very  low  birth  weight  (VLBW)  (1500  g).  This  causes  75%  of  the prenatal  mortality  and  the  50%  of  the  children  disability.  The  aim  of  this study  was  to  assess  neuropsychological  and  emotional  impairments  in  7 year old children who were born VLBW. A clinical interview, the Children Neuropsychological  Assessment  Battery,  and  the  Behavioral  Assessment System for Children (BASC) were administrated. VLBW children showed memory  and  executive  function  deficits,  as  well  as,  behavioral  and attention  problems.  These  results  highlight  the  importance  of  long  term follow up of the VLBW children and point out the necessity of developing adequate  neuropsychological  and  emotional  treatment  program  for  these children. Key Words: Prematurity; very low birth weight children; neuropsychological and emotional consequences; Bateria de Evaluación Neuropsicologica Infantil (BENI).

Impact of the first wave of the SARS-CoV-2 pandemic on the outcome of neurosurgical patients: A nationwide study in Spain

Objective To assess the effect of the first wave of the SARS-CoV-2 pandemic on the outcome of neurosurgical patients in Spain. Settings The initial flood of COVID-19 patients overwhelmed an unprepared healthcare system. Different measures were taken to deal with this overburden. The effect of these measures on neurosurgical patients, as well as the effect of COVID-19 itself, has not been thoroughly studied. Participants This was a multicentre, nationwide, observational retrospective study of patients who underwent any neurosurgical operation from March to July 2020. Interventions An exploratory factorial analysis was performed to select the most relevant variables of the sample. Primary and secondary outcome measures Univariate and multivariate analyses were performed to identify independent predictors of mortality and postoperative SARS-CoV-2 infection. Results Sixteen hospitals registered 1677 operated patients. The overall mortality was 6.4%, and 2.9% (44 patients) suffered a perioperative SARS-CoV-2 infection. Of those infections, 24 were diagnosed postoperatively. Age (OR 1.05), perioperative SARS-CoV-2 infection (OR 4.7), community COVID-19 incidence (cases/10 5 people/week) (OR 1.006), postoperative neurological worsening (OR 5.9), postoperative need for airway support (OR 5.38), ASA grade =3 (OR 2.5) and preoperative GCS 3-8 (OR 2.82) were independently associated with mortality. For SARS-CoV-2 postoperative infection, screening swab test <72 hours preoperatively (OR 0.76), community COVID-19 incidence (cases/10 5 people/week) (OR 1.011), preoperative cognitive impairment (OR 2.784), postoperative sepsis (OR 3.807) and an absence of postoperative complications (OR 0.188) were independently associated. Conclusions Perioperative SARS-CoV-2 infection in neurosurgical patients was associated with an increase in mortality by almost fivefold. Community COVID-19 incidence (cases/10 5 people/week) was a statistically independent predictor of mortality. Trial registration number CEIM 20/217

Landscape - wildfire interactions in southern Europe: implications for landscape management

ReviewEvery year approximately half a million hectares of land are burned by wildfires in southern Europe, causing large ecological and socio-economic impacts. Climate and land use changes in the last decades have increased fire risk and danger. In this paper we review the available scientific knowledge on the relationships between landscape and wildfires in the Mediterranean region, with a focus on its application for defining landscape management guidelines and policies that could be adopted in order to promote landscapes with lower fire hazard. The main findings are that (1) socio-economic drivers have favoured land cover changes contributing to increasing fire hazard in the last decades, (2) large wildfires are becoming more frequent, (3) increased fire frequency is promoting homogeneous landscapes covered by fire-prone shrublands; (4) landscape planning to reduce fuel loads may be successful only if fire weather conditions are not extreme. The challenges to address these problems and the policy and landscape management responses that should be adopted are discussed, along with major knowledge gapsinfo:eu-repo/semantics/publishedVersio

Azimuthal separation in nearly back-to-back jet topologies in inclusive 2-and 3-jet events in pp collisions at root s=13TeV

A measurement for inclusive 2- and 3-jet events of the azimuthal correlation between the two jets with the largest transverse momenta, Delta phi(12), is presented. The measurement considers events where the two leading jets are nearly collinear ("back-to-back") in the transverse plane and is performed for several ranges of the leading jet transverse momentum. Proton-proton collision data collected with the CMS experiment at a center-of-mass energy of 13 TeV and corresponding to an integrated luminosity of 35.9 fb(-1) are used. Predictions based on calculations using matrix elements at leading-order and next-to-leading-order accuracy in perturbative quantum chromodynamics supplemented with leading-log parton showers and hadronization are generally in agreement with themeasurements. Discrepancies between the measurement and theoretical predictions are as large as 15%, mainly in the region 177 degrees <Delta phi(12) <180 degrees. The 2- and 3-jet measurements are not simultaneously described by any of models.Peer reviewe

Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study

Background Results from retrospective studies suggest that use of neuromuscular blocking agents during general anaesthesia might be linked to postoperative pulmonary complications. We therefore aimed to assess whether the use of neuromuscular blocking agents is associated with postoperative pulmonary complications. Methods We did a multicentre, prospective observational cohort study. Patients were recruited from 211 hospitals in 28 European countries. We included patients (aged ≥18 years) who received general anaesthesia for any in-hospital procedure except cardiac surgery. Patient characteristics, surgical and anaesthetic details, and chart review at discharge were prospectively collected over 2 weeks. Additionally, each patient underwent postoperative physical examination within 3 days of surgery to check for adverse pulmonary events. The study outcome was the incidence of postoperative pulmonary complications from the end of surgery up to postoperative day 28. Logistic regression analyses were adjusted for surgical factors and patients’ preoperative physical status, providing adjusted odds ratios (ORadj) and adjusted absolute risk reduction (ARRadj). This study is registered with ClinicalTrials.gov, number NCT01865513. Findings Between June 16, 2014, and April 29, 2015, data from 22803 patients were collected. The use of neuromuscular blocking agents was associated with an increased incidence of postoperative pulmonary complications in patients who had undergone general anaesthesia (1658 [7·6%] of 21694); ORadj 1·86, 95% CI 1·53–2·26; ARRadj –4·4%, 95% CI –5·5 to –3·2). Only 2·3% of high-risk surgical patients and those with adverse respiratory profiles were anaesthetised without neuromuscular blocking agents. The use of neuromuscular monitoring (ORadj 1·31, 95% CI 1·15–1·49; ARRadj –2·6%, 95% CI –3·9 to –1·4) and the administration of reversal agents (1·23, 1·07–1·41; –1·9%, –3·2 to –0·7) were not associated with a decreased risk of postoperative pulmonary complications. Neither the choice of sugammadex instead of neostigmine for reversal (ORadj 1·03, 95% CI 0·85–1·25; ARRadj –0·3%, 95% CI –2·4 to 1·5) nor extubation at a train-of-four ratio of 0·9 or more (1·03, 0·82–1·31; –0·4%, –3·5 to 2·2) was associated with better pulmonary outcomes. Interpretation We showed that the use of neuromuscular blocking drugs in general anaesthesia is associated with an increased risk of postoperative pulmonary complications. Anaesthetists must balance the potential benefits of neuromuscular blockade against the increased risk of postoperative pulmonary complications

Search for WW boson decays to three charged pions

International audienceFor the first time, a search for the rare decay of the W boson to three charged pions has been performed. Proton-proton collision data recorded by the CMS experiment at a center-of-mass energy of 13 TeV, corresponding to an integrated luminosity of 77.3  fb-1, have been analyzed. No significant excess is observed above the background expectation. An upper limit of 1.01×10-6 is set at 95% confidence level on the branching fraction of the W boson to three charged pions. This provides a strong motivation for theoretical calculations of this branching fraction