Implicaciones del desmantelamiento de un foco de compra y consumo de drogas en Valencia

Desde el año 2003 la Fundación Salud y Comunidad (FSC), con el patrocinio principal de la Generalitat Valenciana, ha trabajado en la zona de 'Las Cañas', lugar que ha sido el foco de compraventa de drogas más activo de Valencia, realizando programas de contacto y de reducción de riesgos y daños, con más de 9.000 usuarios diferentes atendidos. En el año 2008 se realizó una intervención policial en el área con el objetivo de reducir la oferta de drogas. La falta de coordinación y comunicación entre la policía y los agentes sanitarios y sociales generó una situación potencialmente muy peligrosa para la salud de los drogodependientes y el impacto comunitario, lo que motivó una investigación de urgencia para medir y valorar el impacto de dicha actuación. Los resultados, interpretados junto con los datos asistenciales de los años 2007, 2008 y 2009, sugieren que la intervención policial no disminuyó ni difi cultó el acceso a las sustancias como se esperaba, aunque se transformó la estructura de la oferta y la demanda, fomentando el uso de heroína y cocaína inyectada, frente a la anteriormente mayoritaria, y estimulando nuevos puntos de compraventa en otras áreas de la ciudad.Since 2003 Fundación Salud y Comunidad (FSC), under the auspices of the Valencian Regional Government, has been working in the area of 'Las Cañas' that has become the most active drug sale and purchase focal point in Valencia. Outreach programs were started to reduce risks and harm, with more than 9,000 different users helped. In 2008 police action took place in the area with the goal of reducing drug supply. The lack of coordination and communication between the police and health and social agents working in the area prompted an urgent investigation to measure and assess the impact of such action on the health of drug addicts and in the community. The results, interpreted together with data from the service records for the years 2007, 2008 and 2009, suggest that the police actions did not reduce nor hinder the access to substances as expected, although the structure of the supply and demand did indeed change, favouring the use of injected (instead of inhaled) heroin and cocaine, and stimulating new sale and purchase points in other areas of the city

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

Tension wood occurrence in three cultivars of Populus × euramericana. Part I: Inter-clonal and intra-tree variability of tension wood

The main wood quality problem affecting poplar trees is tension wood occurrence associated to end-splits after felling, distortions of products, woolly wood, etc. The objective of this study was to estimate the occurrence of tension wood by using the external shape of the stem and the 3D distribution of annual growth rings. This paper is the first of two papers and presents the inter-clonal and intra-tree tension wood variability. A clear clonal-effect was observed on tension wood area percentage (I-MC>I214>Luisa Avanzo). The clone with the best tree morphology (I-MC) showed the highest percentage of tension wood (15.3%). Concerning the intra-tree variability, tension wood extent increased significantly at the tree base (I214>Luisa Avanzo) et montre aussi que le clone avec la meilleure conformation morphologique (I-MC) présente la proportion de bois de tension plus élevée (15.3 %). En ce qui concerne la variabilité intra-arbre, la proportion de bois de tension présente une augmentation significative à la base de l'arbre (< 30-50 cm). Dans la direction radiale, la distribution du bois de tension présente une structure bi-modale en forme de « U ». Le premier mode du côté de la moelle correspondrait à une phase de croissance libre, dite phase « d'établissement » et le second du côté de l'écorce à une phase de recherche de la lumière dite « phase de compétition

How to relate the standing tree shape to internal wood characteristics: Proposal of an experimental method applied to poplar trees

This paper presents an experimental method allowing 3D measurements of the geometry of a standing mature tree to be closely linked to the spatial distribution of internal wood properties. The accuracy of the geometrical information is assessed from repeated measurements performed on 10 mature poplar trees and demonstrates that wind is the most limiting factor. Since the method was developed to study the spatial distribution of tension wood, some pictures of the latter are presented. Furthermore, some preliminary relationships between variables derived from measurements such as the height, the local tree slope, the eccentricity of the tension wood area, or the eccentricity of the disc are discussed to illustrate the potential of the method.Comment connecter la forme d'un arbre sur pied aux propriétés internes du bois : proposition d'une méthode expérimentale appliquée sur des peupliers. Cet article présente une méthode expérimentale de mesure de la géométrie tridimensionnelle d'un arbre sur pied mature permettant un couplage étroit avec la mesure des propriétés internes du bois. La précision de l'information géométrique est estimée à partir de mesures répétées sur 10 peupliers et met en évidence le vent comme principal facteur limitant. La méthode ayant été développée pour étudier la distribution spatiale du bois de tension, quelques illustrations de cette dernière sont présentées. En outre, des relations préliminaires liant des variables telles que la hauteur, l'inclinaison locale de l'arbre, l'excentricité de la zone de bois de tension ou l'excentricité de la rondelle sont discutées afin d'illustrer le potentiel de la méthode

Dificultats d'aprenentatge dels continguts curriculars, setembre 2012

Recurs d'aprenentatge de la Universitat Oberta de Catalunya.Recurso de aprendizaje de la "Universitat Oberta de Catalunya".Learning resource of the "Universitat Oberta de Catalunya"

Construcció industrialitzada i innovació: recull de treballs curs 2012-2013

2013/201

Recomendaciones de actuación en cirugía oncológica hepatobiliopancreática durante la pandemia COVID-19.

The SARS-CoV-2 (COVID-19) pandemic requires an analysis in the field of oncological surgery, both on the risk of infection, with very relevant clinical consequences, and on the need to generate plans to minimize the impact on possible restrictions on health resources. The AEC is making a proposal for the management of patients with hepatopancreatobiliary (HPB) malignancies in the different pandemic scenarios in order to offer the maximum benefit to patients, minimising the risks of COVID-19 infection, and optimising the healthcare resources available at any time. This requires the coordination of the different treatment options between the departments involved in the management of these patients: medical oncology, radiotherapy oncology, surgery, anaesthesia, radiology, endoscopy department and intensive care. The goal is offer effective treatments, adapted to the available resources, without compromising patients and healthcare professionals safety