Movilización temprana en el paciente crítico

Introducción. Las enfermedades críticas a menudo asociadas con el reposo en cama durante un largo periodo y la falta de actividad física, conducen a debilidad muscular generalizada en la Unidad de Cuidados Intensivos La movilización temprana parece una herramienta útil en la prevención de la misma. Objetivo. Conocer la evidencia disponible sobre el beneficio de la movilización temprana en los pacientes en Unidades de Cuidados Intensivos respecto a la fuerza muscular, función física y su aplicación práctica al trabajo del fisioterapeuta. Material y métodos. La revisión bibliográfica se realizó las bases de datos Pubmed, Biblioteca Cochrane, PeDRO y Scielo. Los términos de búsqueda se realizaron en inglés. Se incluyeron estudios clínicos desarrollados en pacientes adultos, mayores de 18 años, ingresados en Unidades de Cuidados Intensivos, con ventilación mecánica igual o superior a 48 horas, que recibieron tratamiento de fisioterapia, consistiendo ésta en movilización temprana y que en sus conclusiones se hiciera referencia a la función física o fuerza. Resultados. Se evaluaron 5 ensayos clínicos controlados aleatorizados y un estudio de cohorte prospectivo. La evidencia de los ensayos nos indica que la movilización temprana proporciona beneficios respecto la función física al alta hospitalaria y a los 6 meses. No existe evidencia de que un aumento de intensidad de la terapia temprana (mayor tiempo y ejercicios de resistencia), se corresponda con un aumento de fuerza. Conclusión. La movilización temprana en UCI produce beneficios al paciente respecto a la función física, un incremento de la intensidad de la terapia no reporta beneficios añadidos

Procedimientos de criba para la escoliosis

754 escolares, de 5 o y 8o de EGB, han sido explorados para detectar escoliosis importantes. Las técnicas de exploración han sido dos: la «Prueba de Inclinarse hacia Adelante» (PIA) y mediante el uso del Inclinómetro (IN). Los resultados obtenidos son los siguientes: la PIA ha mostrado que el 43 % de los escolares tenía una actitud escoliótica, el IN ha revelado que el 5,5 % de los escolares presentaban un ángulo de inclinación comprendido entre 5o y 10° y sólo el 1,85 % lo tenían mayor de 10o . Diversos autores han establecido que sólo uno de cada 300 niños es tributario de algún tipo de tratamiento para la escoliosis. A la vista de nuestros resultados, se considera que la PIA es inaceptable por el elevado porcentaje de falsos positivos que debe de dar.The screening test for scoliosis was performed on 754 schoolchildren aged 11 and 14 years. Two screening tests were performed: the «Forward Bending Test» (FBT) and the Inclinometer (IN). Through FBT scoliosis was detected in 43 % of these children. The inclinometer measurement was between 5 o and 10o in a 5,5 % and morethan 10° in a 1,85 %. Otheraut hors consider that treatment ¡s mandatory in 1/300 children. So, the FBT is not acceptable as a screening test

Intervención psicológica en un caso de ansiedad ante exámenes

The study was carried out on a patient suffering from severe anxiety during exam periods. This pattern was accompanied by a series of obsessive-compulsive tendencies that resulted in a mild chronic anxiety pattern, which is one of the characteristics of the general anxiety disorder this patient was diagnosed with after he was assessed. This had significantly affected his capacity to get involved in leisure activities. The use of cognitive therapy was proposed as a benchmark to test and verify the validity of the patient's beliefs, scanning from the accessible to the most rooted ones. The compensatory strategies used by the patient to ease these beliefs were discovered and the mechanisms that made them prevail were analyzed. The objectives for flexibility and therapeutic change are also described and include the following: Amend inadaptable beliefs related to an excessive dedication to study, Minimize the level of motivation to study and Reduce time devoted to study. These objectives were achieved throughout 28 treatment sessions. The patient is currently being monitored.ResumenEl estudio de caso único que se presenta ha consistido en la intervención psicoterapéutica con un cliente que presentaba ansiedad severa ante los exámenes. Este cuadro ha venido acompañado por una serie de rasgos obsesivoscompulsivos de personalidad que le han predispuesto a experimentar la ansiedad moderada crónica característica del trastorno de ansiedad generalizada que se le ha diagnosticado tras la evaluación, interfiriendo significativamente en las vivencias de sus actividades recreativas. Utilizando como marco de referencia la terapia cognitiva, se propone la utilidad de este método para poner a prueba y comprobar la validez de las creencias de dicho cliente realizando un barrido desde los pensamientos más accesibles a las creencias más nucleares, encontrando qué estrategias compensatorias utiliza dicha persona para sobrellevar dichas creencias, analizando los mecanismos que las mantienen. Se describen también los objetivos para la flexibilización y cambio terapéutico entre los que podemos destacar los siguientes: Modificar creencias desadaptativas, relacionadas con la excesiva devoción al estudio, reducir el grado de activación y reducir el tiempo dedicado al estudio. Los objetivos propuestos fueron conseguidos a lo largo de veintiocho sesiones encontrándose actualmente el sujeto en seguimiento.AbstractThe study was carried out on a patient suffering from severe anxiety during exam periods. This pattern was accompanied by a series of obsessive-compulsive tendencies that resulted in a mild chronic anxiety pattern, which is one of the characteristics of the general anxiety disorder this patient was diagnosed with after he was assessed. This had significantly affected his capacity to get involved in leisure activities. The use of cognitive therapy was proposed as a benchmark to test and verify the validity of the patient's beliefs, scanning from the accessible to the most rooted ones. The compensatory strategies used by the patient to ease these beliefs were discovered and the mechanisms that made them prevail were analyzed. The objectives for flexibility and therapeutic change are also described and include the following: Amend inadaptable beliefs related to an excessive dedication to study, Minimize the level of motivation to study and Reduce time devoted to study. These objectives were achieved throughout 28 treatment sessions. The patient is currently being monitored

ORIGIN: metal creation and evolution from the cosmic dawn

Herder, Jan-Willem den et al.ORIGIN is a proposal for the M3 mission call of ESA aimed at the study of metal creation from the epoch of cosmic dawn. Using high-spectral resolution in the soft X-ray band, ORIGIN will be able to identify the physical conditions of all abundant elements between C and Ni to red-shifts of z = 10, and beyond. The mission will answer questions such as: When were the first metals created? How does the cosmic metal content evolve? Where do most of the metals reside in the Universe? What is the role of metals in structure formation and evolution? To reach out to the early Universe ORIGIN will use Gamma-Ray Bursts (GRBs) to study their local environments in their host galaxies. This requires the capability to slew the satellite in less than a minute to the GRB location. By studying the chemical composition and properties of clusters of galaxies we can extend the range of exploration to lower redshifts (z-0.2). For this task we need a high-resolution spectral imaging instrument with a large field of view. Using the same instrument, we can also study the so far only partially detected baryons in the Warm-Hot Intergalactic Medium (WHIM). The less dense part of the WHIM will be studied using absorption lines at low redshift in the spectra for GRBs. The ORIGIN mission includes a Transient Event Detector (coded mask with a sensitivity of 0.4 photon/cm2/s in 10 s in the 5–150 keV band) to identify and localize 2000 GRBs over a five year mission, of which -65 GRBs have a redshift > 7. The Cryogenic Imaging Spectrometer, with a spectral resolution of 2.5 eV, a field of view of 30 arcmin and large effective area below 1 keV has the sensitivity to study clusters up to a significant fraction of the virial radius and to map the denser parts of the WHIM (factor 30 higher than achievable with current instruments). The payload is complemented by a Burst InfraRed Telescope to enable onboard red-shift determination of GRBs (hence securing proper follow up of high-z bursts) and also probes the mildly ionized state of the gas. Fast repointing is achieved by a dedicated ControlledMomentum Gyro and a low background is achieved by the selected low Earth orbit.The team likes to express its appreciation for the support of Astrium UK for the present study.Peer Reviewe

Effects of reduced and conventional tillage on weed communities: results of a long-term experiment in Southwestern Spain.

An important drawback in adopting minimum tillage (MT) and no-tillage (NT) techniques is the frequently observed weed shift promoting adapted species and achieving poorer weed control. These changes can be detected best with long-term experiments, and results might differ depending on soil characteristics and the local flora. The objectives of this work were to evaluate the effect of reduced tillage on weed seed distribution in the soil profile and to identify possible consequences on weed diversity on a long-term experiment maintained during 24 years in Seville (Spain) with three tillage systems: NT, MT and conventional tillage (CT) including moldboard plow on a vertisol. For this purpose, soil seedbanks at 0-8 cm and 8-16 cm depths were enumerated in autumn 2005 and in-field emerged plants in autumn 2005 and winter 2006. Shannon diversity index (H) and evenness (J’) were calculated for seedbank and aboveground weed communities. Total weed seed density was highest for NT and lowest for CT. Some big-seeded species, such as Chrozophora tinctorea L., showed highest seed density in CT. NT increased the relative density of Amaranthus blitoides S. Watson seeds in the seedbank and the abundance of emerged plants of Malva parviflora L., Anagallis arvensis L. and Picris echioides L. Overall, MT led to a less diverse seedbank in the 0-8 cm depth of soil than CT. The frequent drought-induced deep fractures in the expandable clay soil caused natural tillage, which probably resulted in fewer differences in weed seed and seedling densities among tillage treatments compared to what might be expected in other soil types.Uma desvantagem importante na adoção de técnicas de cultivo mínimo (MT) e plantio direto (NT) é o deslocamento de plantas daninhas frequentemente observado, promovendo espécies adaptadas e, com isso, um controle de plantas daninhas mais precário. Essas mudanças só podem ser detectadas com experimentos de longo prazo, e os resultados podem diferir, dependendo das características do solo e da flora local. Os objetivos deste trabalho foram avaliar o efeito da lavoura reduzida sobre a distribuição de sementes de plantas daninhas no perfil do solo e identificar possíveis consequências na diversidade de plantas daninhas em um experimento de longa duração mantido durante 24 anos em Sevilha (Espanha) com três sistemas de plantio: NT, MT e preparo convencional (CT), incluindo arado de aiveca em um Vertissolo. Com esse propósito, amostras de solo com 0-8 e 8-16 cm de profundidade foram coletadas no inverno de 2005 e na primavera de 2006, e as plântulas de plantas daninhas emergentes foram registradas. O índice de diversidade de Shannon (H) e a uniformidade (J’) foram calculados para comunidades de banco de sementes e plantas daninhas acima do solo. A densidade total de sementes de plantas daninhas foi maior para NT e menor para CT. Algumas espécies de sementes grandes, como Chrozophora tinctorea L., apresentaram maior densidade de sementes no CT. NT aumentou a densidade relativa de sementes de Amaranthus blitoides S. Watson no banco de sementes e a presença de plantas emergidas de Malva parviflora L., Anagallis arvensis L. e Picris echioides L. Com relação aos resultados gerais, a TM levou a um banco de sementes menos diversificado na profundidade de 0 a 8 cm do solo do que a CT. As frequentes fraturas profundas na argila expansível do solo provocam um preparo natural, originando provavelmente menos diferenças dos parâmetros analisados do que em outros tipos de solo

The unexplored virome of two Atlantic coast fish: contribution of next-generation sequencing to fish virology

Much of the knowledge on viruses is focused on those that can be propagated using cell-cultures or that can cause disease in humans or in economically important animals and plants. However, this only reflects a small portion of the virosphere. Therefore, in this study, we explore by targeted next-generation sequencing, how the virome varies between Atlantic horse mackerels and gilthead seabreams from fisheries and aquaculture from the center and south regions of Portugal. Viral genomes potentially pathogenic to fish and crustaceans, as well as to humans, were identified namely Astroviridae, Nodaviridae, Hepadnaviridae, Birnaviridae, Caliciviridae, and Picornaviridae families. Also bacteriophages sequences were identified corresponding to the majority of sequences detected, with Myoviridae, Podoviridae, and Siphoviridae, the most widespread families in both fish species. However, these findings can also be due to the presence of bacteria in fish tissues, or even to contamination. Overall, seabreams harbored viruses from a smaller number of families in comparison with mackerels. Therefore, the obtained data show that fish sold for consumption can harbor a high diversity of viruses, many of which are unknown, reflecting the overall uncharacterized virome of fish. While cross-species transmission of bonafide fish viruses to humans is unlikely, the finding of human pathogenic viruses in fish suggest that fish virome can be a potential threat regarding food safety

Micropropagation, Characterization, and Conservation of Phytophthora cinnamomi-Tolerant Holm Oak Mature Trees

Holm oak populations have deteriorated drastically due to oak decline syndrome. The first objective of the present study was to investigate the use of axillary budding and somatic embryogenesis (SE) to propagate asymptomatic holm oak genotypes identified in disease hotspots in Spain. Axillary budding was achieved in two out of six tolerant genotypes from the south-western region and in two out of four genotypes from the Mediterranean region. Rooting of shoots cultured on medium supplemented with 3 mg L 121 of indole-3-acetic acid plus 0.1 mg L 121 a-naphthalene acetic acid was achieved, with rates ranging from 8 to 36%. Shoot cultures remained viable after cold storage for 9-12 months; this procedure is therefore suitable for medium-term conservation of holm oak germplasm. SE was induced in two out of the three genotypes tested, by using nodes and shoot tips cultured in medium without plant growth regulators. In vitro cloned progenies of the tolerant genotypes PL-T2 and VA5 inhibited growth of Phytophthora cinnamomi mycelia when exposed to the oomycete in vitro. Significant differences in total phenol contents and in the expression profiles of genes regulating phenylpropanoid biosynthesis were observed between in vitro cultured shoots derived from tolerant trees and cultures established from control genotypes

Pressure-induced changes in Cr3+-doped elpasolites and LiCaAlF6: interpretation of macroscopic data

In the research of pressure effects on Cr3+-doped insulating lattices, it is crucial to understand the dependence of the 10Dq parameter on the sample volume, V. This problem is explored in the present work through ab initio calculations on Cr3+-doped K2NaScF6, Cs2NaYCl6, and Cs2NaYBr6 elpasolite lattices as a function of pressure in the 0?5 GPa range. From the calculated values of the lattice parameter and the Cr3+?X? (X=F, Cl, and Br) distance, R, it is found that R varies with the cell volume, vc, as v(1/3?)c where ? lies around 2.6. These results allow one to understand quantitatively the 10Dq dependence on V?m/3 for LiCaAlF 6:Cr3+ where the measured exponent m=2.3 is seemingly anomalous when compared to the values found for ruby (m=4.5) or NiO (m=5).The support by the Spanish Ministerio de Ciencia y Tecnología under Project No. FIS2009-07083 is acknowledged

Handling of lipemic samples in the clinical laboratory

Interferences in the clinical laboratory may lead physicians misinterpret results for some biological analytes. The most common analytical interferences in the clinical laboratory include hemolysis, icterus and lipemia. Lipemia is defined as turbidity in a sample caused by the accumulation of lipoproteins, mainly very-low density lipoproteins (VLDL) and chylomicrons. Several methods are available for the detection of lipemic samples, including the lipemic index, or triglyceride quantification in serum or plasma samples, or mean corpuscular hemoglobin (MCHC) concentration in blood samples. According to the European Directive 98/79/CE, it is the responsibility of clinical laboratories to monitor the presence of interfering substances that may affect the measurement of an analyte. There is an urgent need to standardize interference studies and the way interferences are reported by manufacturers. Several methods are currently available to remove interference from lipemia and enable accurate measurement of biological quantities. The clinical laboratory should establish a protocol for the handling of lipemic samples according to the biological quantity to be tested