Limnological characterization of Riogrande II Reservoir (Antioquia), Colombia

ABSTRACT: In this investigation Riogrande II reservoir is characterized from the climatic, chemical, and physical perspectives. With this aim were measured two climatic variables (rainfall and wind), six physical (temperature, vertical attenuation for upwelling irradiance, suspended solids, dissolved solids, turbidity, electrical conductivity) and four chemical (dissolved oxygen, free CO2, pH, alkalinity). These quanti cations were carried out along one year in ve sampling stations between which río Chico arriba was signi cantly different due to high degree of material in suspension and high values for all of the descriptors measured, was different to the others. In the gravity-light axis the reservoir was strati ed with upwelling of metalimnetic water inside the surface layer, and anoxic hipolimnio during the entire sampling year in all the sampling points. It is considered that the reservoir has an atelomictic mixture pattern.RESUMEN: En esta investigación se caracteriza el embalse Riogrande II desde las perspectivas climática, física y química. Con este fin se midieron dos variables climatológicas (viento y pluviosidad), seis físicas (temperatura del agua, atenuación vertical de irradiancia descendente, sólidos suspendidos y disueltos, conductividad eléctrica, turbidez) y cuatro químicas (oxígeno disuelto, CO2 libre, pH, alcalinidad). Dichas cuantificaciones se realizaron durante un año en cinco estaciones entre las que río Chico arriba fue diferente de las demás por presentar valores altos tanto de materiales en suspensión como de todos los descriptores medidos. En el eje gravedad-luz el embalse estuvo estratificado todo el tiempo de muestreo, con aforamiento del agua metalimnética dentro la capa superficial, y con hipolimnio anóxico durante todo el año de muestreo en todas las estaciones. Se considera que el embalse Riogrande II presenta un patrón atelomíctico de mezcla

Primary care randomized clinical trial: manual therapy effectiveness in comparison with TENS in patients with neck pain

This study investigated effectiveness of manual therapy (MT) with transcutaneous electrical nerve stimulation (TENS) to reduce pain intensity in patients with mechanical neck disorder (MND). A randomized multi-centered controlled clinical trial was performed in 12 Primary Care Physiotherapy Units in Madrid Region. Ninety patients were included with diagnoses of subacute or chronic MND without neurological damage, 47 patients received MT and 43 TENS. The primary outcome was pain intensity measured in millimeters using the Visual Analogue Scale (VAS). Also disability, quality of life, adverse effects and sociodemographic and prognosis variables were measured. Three evaluations were performed (before, when the procedure ?nished and six months after). Seventy-one patients (79%) completed the follow-up measurement at six months. In more than half of the treated patients the procedure had a clinically relevant ?short term? result after having ended the intervention, when either MT or TENS was used. The success rate decreased to one-third of the patients 6 months after the intervention. No differences can be found in the reduction of pain, in the decrease of disability nor in the quality of life between both therapies. Both analyzed physiotherapy techniques produce a short-term pain reduction that is clinically relevant.Ministerio de SanidadInstituto de Salud Carlos II

Development of a prediction model for postoperative pneumonia A multicentre prospective observational study

BACKGROUND Postoperative pneumonia is associated with increased morbidity, mortality and costs. Prediction models of pneumonia that are currently available are based on retrospectively collected data and administrative coding systems. OBJECTIVE To identify independent variables associated with the occurrence of postoperative pneumonia. DESIGN A prospective observational study of a multicentre cohort (Prospective Evaluation of a RIsk Score for postoperative pulmonary COmPlications in Europe database). SETTING Sixty-three hospitals in Europe. PATIENTS Patients undergoing surgery under general and/or regional anaesthesia during a 7-day recruitment period. MAIN OUTCOME MEASURE The primary outcome was postoperative pneumonia. Definition: the need for treatment with antibiotics for a respiratory infection and at least one of the following criteria: new or changed sputum; new or changed lung opacities on a clinically indicated chest radiograph; temperature more than 38.3 degrees C; leucocyte count more than 12 000 mu l(-1). RESULTS Postoperative pneumonia occurred in 120 out of 5094 patients (2.4%). Eighty-two of the 120 (68.3%) patients with pneumonia required ICU admission, compared with 399 of the 4974 (8.0%) without pneumonia (P < 0.001). We identified five variables independently associated with postoperative pneumonia: functional status [odds ratio (OR) 2.28, 95% confidence interval (CI) 1.58 to 3.12], pre-operative SpO(2) values while breathing room air (OR 0.83, 95% CI 0.78 to 0.84), intra-operative colloid administration (OR 2.97, 95% CI 1.94 to 3.99), intra-operative blood transfusion (OR 2.19, 95% CI 1.41 to 4.71) and surgical site (open upper abdominal surgery OR 3.98, 95% CI 2.19 to 7.59). The model had good discrimination (c-statistic 0.89) and calibration (Hosmer-Lemeshow P = 0.572). CONCLUSION We identified five variables independently associated with postoperative pneumonia. The model performed well and after external validation may be used for risk stratification and management of patients at risk of postoperative pneumonia