Utility of vein visualization devices in the peripheral intravenous catheterization of pediatric patient

La canalización de vías venosas periféricas es una de las actividades invasivas realizadas por enfermería más frecuentes durante la hospitalización. En el caso del paciente pediátrico, dicha técnica resulta en la mayoría de las ocasiones un reto. El fallo en la canalización puede suponer un retraso de la asistencia sanitaria y un incremento del riesgo de contraer una infección nosocomial. Asimismo, las repetidas punciones en busca de la canalización de una vía venosa periférica, en la mayoría de las ocasiones, tiene efectos traumáticos para el niño y en sus familiares, así como un aumento del estrés y ansiedad en el personal sanitario. El uso de los dispositivos de visualización venosa puede ser un valioso recurso ante la dificultad que presenta el acceso venoso del paciente pediátrico. Combinando las medidas no farmacológicas para reducir el dolor y la ansiedad en el niño, junto con el uso de los dispositivos que facilitan la visualización del capital venoso del paciente, es posible aumentar la probabilidad de éxito en la canalización de un acceso venoso periféricoPeripheral intravenous catheterization is one of the most common invasive techniques performed by nurses during hospitalization. Considering pediatric patients, that technique turns out to be a challenge in most of the cases. The failure of the peripheral venous catheterization can result on a delay of the healthcare and an increase of the risk of developing a nosocomial infection. Likewise, repeated punctures searching the success of a peripheral catheterization, more often than not, have traumatic effects for the child and his family, as well as an increase of the stress and anxiety on the health workers. The use of vein visualization devices can be a valuable resource for the current difficulty that the pediatric vein access shows. Combining non-pharmacological measurements to reduce the pain and anxiety on the child, with the use of vein visualization devices we could improve the probability of success on the peripheral intravenous insertionGrado en Enfermerí

Estevia, el edulcorante natural.

La estevia, Stevia rebaudiana (Bertoni) Bertoni, es una planta herbácea y perenne descrita por primera vez en 1889 por el naturalista Moisés Bertoni. Se trata de una especie originaria de la Región Oriental de Paraguay, donde los indígenas guaraníes la han usado tradicionalmente por sus aplicaciones edulcorantes y medicinales. La hoja fresca de estevia es de 10 a 15 veces más dulce que el azúcar común, la hoja seca y pulverizada lo es unas 70, mientras que los extractos lo son hasta 200 ó 300 veces más, debido a los glucósidos: esteviósido, rebaudósido A, B, C, D, E, dulcósido A y B y steviolbiósido. Entre las propiedades medicinales destacan las acciones hipotensora, antimicrobiana, dietética, digestiva e hipoglucémica, por lo que su uso está muy recomendado para personas afectadas de diabetes tipo 2. El cultivo de estevia ha adquirido importancia en algunos países como China, Paraguay o Brasil. Entre los principales consumidores se encuentran Japón, China, Malasia, Israel, Corea del Sur y Brasil. Sin embargo, en los países de la Unión Europea, por el momento, está denegado su uso como aditivo alimenticio o suplemento dietétic

Elementos facilitadores para la re-significación de la práctica educativa en estudiantes universitarias de educación infantil

El objetivo de este estudio de caso es analizar qué elementos pueden facilitar la re-significación de la práctica educativa en estudiantes universitarias de Educación infantil. El artículo analiza el contenido de los seminarios en los que ocurre la reflexión conjunta, la entrevista a la tutora y el cuestionario que responden las 13 estudiantes en prácticas. Los resultados sugieren que la re-significación acontece en la fase de actividad interactiva denominada interpretación y las ayudas de la tutora que han sido clave para la re-significación de la práctica son: ayudas dialógicas; las dirigidas a la identificación de factores; las orientadas a la construcción de un marco interpretativo; y las ayudas dirigidas al establecimiento de relaciones con experiencias previas, con la situación analizada y con conocimientos académicos.The objective of this case study is to define the elements that can facilitate attaching new meaning to student teaching among undergraduate students majoring in early childhood education. The article analyzes the content of seminars of joint reflection, interviews with the student teacher supervisor, and a questionnaire completed by thirteen student teachers. The results suggest that attaching new significance occurs in the interactive phase known as interpretation and that the forms of assistance from the student teacher supervisor that have been key in attaching new significance to student teaching are: help through dialog, help directed to identifying factors, help in constructing an interpretative framework, and help in establishing associations with previous experiences, with the analyzed situation, and with academic knowledge

Collective and non-collective molecular dynamics in a ferroelectric nematic liquid crystal studied by broadband dielectric spectroscopy

A great deal of effort has been recently devoted to the study of dielectric relaxation processes in ferroelectric nematic liquid crystals, yet their interpretation remains unclear. In this work, we present the results of broadband dielectric spectroscopy experiments of a prototypical ferroelectric nematogen in the frequency range 10 Hz-110 MHz at different electrode separations and under the application of DC bias fields. The results evidence a complex behavior in all phases due to the magnitude of polar correlations in these systems. The observed modes have been assigned to different relaxation mechanisms based on existing theoretical frameworks.Comment: The following article has been submitted to The Journal of Chemical Physics. After it is published, it will be found at https://pubs.aip.org/aip/jc

NAFLD and AATD Are Two Diseases with Unbalanced Lipid Metabolism: Similarities and Differences

Non-alcoholic fatty liver disease (NAFLD) is a type of steatosis commonly associated with obesity, dyslipidemia, hypertension, and diabetes. Other diseases such as inherited alpha-1 antitrypsin deficiency (AATD) have also been related to the development of liver steatosis. The primary reasons leading to hepatic lipid deposits can be genetic and epigenetic, and the outcomes range from benign steatosis to liver failure, as well as to extrahepatic diseases. Progressive hepatocellular damage and dysregulated systemic immune responses can affect extrahepatic organs, specifically the heart and lungs. In this review, we discuss the similarities and differences between the molecular pathways of NAFLD and AATD, and the putative value of hepatic organoids as novel models to investigate the physio pathological mechanisms of liver steatosis.This work was supported by grants from Instituto de Salud Carlos III (ISCIII): AESI PI20CIII/00015 and PISCIIIBB-PT20CIII/00009, and by Polish National Science Centre Grants 2015/17/B/NZ5/01370 and 2018/29/B/NZ5/02346.S

Loss of myocardial LIF receptor in experimental heart failure reduces cardiotrophin-1 cytoprotection. A role for neurohumoral agonists?

OBJECTIVES: Cardiomyocyte loss is involved in the transition from compensatory left ventricular hypertrophy (LVH) to heart failure (HF). Our aim was to investigate the status of the leukaemia inhibitory factor receptor (LIFR)/gp130 survival pathway and its cytoprotective activity in intact cardiac tissue and in cardiomyocytes obtained from adult spontaneously hypertensive rats (SHR) with LVH (non-failing SHR) and from aged SHR with overt HF (failing SHR). METHODS: Cardiac morphometry was assayed by planimetry in an image analysis system. mRNA and protein expression were quantified by real time RT-PCR and Western blotting. Receptors were localized by immunocytochemistry. Trypan blue staining, TUNEL, and MTT cell viability assays were employed to study the cytoprotective activity of cardiotrophin-1 (CT-1) in isolated caridomyocytes. RESULTS: Compared to non-failing SHR, failing SHR exhibited enhanced myocardial cell death (p<0.01) demonstrated by the increase in Bax/Bcl-2 ratio, caspase-3 activation and poly (ADP-ribose) polymerase (PARP) fragmentation. Failing SHR had a 7-fold diminished expression (p<0.01) of LIFR, no changes in gp130, and 1.6-fold increased myocardial expression (p<0.01) of CT-1. In cardiomyocytes isolated from non-failing SHR, recombinant CT-1 inhibited apoptotic and non-apoptotic cell death induced by angiotensin II or hydrogen peroxide. LIFR protein was entirely absent in cardiomyocytes isolated from failing SHR, which were resistant to the cytoprotective effects of CT-1. Finally, stimulation of non-failing SHR cardiomyocytes with angiotensin II, aldosterone, norepinephrine or endothelin-1 significantly decreased (p<0.01) LIFR expression. CONCLUSIONS: These data suggest that loss of CT-1-dependent survival mechanisms may contribute to the increase of cell death associated with HF in SHR. Neurohumoral activation may contribute to this alteration via suppression of LIFR

Otoliths as indicators for fish behaviour and procurement strategies of hunter-gatherers in north Patagonia

This study evaluates the potential use of archaeological otoliths of Genidens barbus (Cuvier and Valenciennes) as a tool to study fish behavior and hunter-gatherers procurement strategies on the North Patagonian coast. The studied samples come from the San Antonio archaeological locality dated at ca. 1000-800 14C yr BP (Late Holocene). To assess whether exposure to fire significantly affects the otolith Sr:Ca and Ba:Ca ratios, burned and unburned modern lapilli otoliths have been analyzed by Laser Ablation Inductively Coupled Plasma Mass Spectrometry and no statistically significant differences were found between the results of both treatments. Core-toedge chemical time series were carried out on ancient otoliths (ca. 1000 14C yr BP) in order to study the fish life history. Three amphidromous patterns were found for ancient samples. The capture environments and seasons inferred by the otolith edge chemistry and marginal increase, respectively, suggest a location in high salinity water (estuary and sea) in summer. Finally, to estimate the size of archaeological fish, a linear regression between total length and otolith length was constructed using 70 modern catfish otoliths. The size variability (358–610 mm) might indicate the use of non-selective capture techniques, probably nets, by hunter-gatherer groups.Fil: Avigliano, Esteban. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Unidad Ejecutora de Investigaciones en Producción Animal. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias. Unidad Ejecutora de Investigaciones en Producción Animal; ArgentinaFil: Martinez, Gustavo Adolfo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tandil. Investigaciones Arqueológicas y Paleontológicas del Cuaternario Pampeano. Universidad Nacional del Centro de la Provincia de Buenos Aires. Investigaciones Arqueológicas y Paleontológicas del Cuaternario Pampeano; ArgentinaFil: Stoessel, Luciana. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tandil. Investigaciones Arqueológicas y Paleontológicas del Cuaternario Pampeano. Universidad Nacional del Centro de la Provincia de Buenos Aires. Investigaciones Arqueológicas y Paleontológicas del Cuaternario Pampeano; ArgentinaFil: Méndez, Ana. Universidad de Oviedo; EspañaFil: Bordel, Nerea. Universidad de Oviedo; EspañaFil: Pisonero, Jorge. Universidad de Oviedo; EspañaFil: Volpedo, Alejandra. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Unidad Ejecutora de Investigaciones en Producción Animal. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias. Unidad Ejecutora de Investigaciones en Producción Animal; Argentin

Predictors of major infections in systemic lupus erythematosus

Introduction Infections commonly complicate the course of systemic lupus erythematosus (SLE). Our aim is to investigate the clinical predictors of major infections in patients with SLE. Methods A nested case-control study design was used within the prospective Lupus-Cruces cohort. The endpoints of the study were major infections. Cases were defined as patients with a major infection. Two controls (SLE patients without major infections), matched for time of follow-up until the event and age at diagnosis, were selected for each case. Univariate analysis and logistic regression models were used for the analysis of data. Results Two hundred and forty-nine patients (83 cases, 166 controls) were selected. Eighty-three episodes of major infections were analyzed; E. coli, S. aureus, M. tuberculosis and S. pneumoniae being the most frequent isolates. Univariate analysis identified several variables related with infection: lung and renal involvement, at or previous to the study point; leukopenia at the study point; antiphospholipid antibody-positivity and treatment with prednisone within 3 months previous to the study point, and the dose of prednisone received. Treatment with antimalarials, on the other hand, showed a strong inverse association with major infections. Logistic regression models identified treatment with antimalarials (odds ratio (OR) = 0.06, 95% confidence interval (CI) = 0.02 to 0.18), prednisone dose (OR = 1.12, 95% CI = 1.04 to 1.19) and lung involvement (OR = 4.41, 95% CI = 1.06 to 18.36) as significant and independent predictors of major infections. No significant interactions among these three variables were found. Further adjustment for potential confounders related with antimalarial treatment did not change the results. Conclusions The risk of major infections in patients with SLE is mostly influenced by treatment. Prednisone treatment, even at moderate doses, increases the risk, whilst antimalarials have a protective effect

Low birth weight and small for gestational age are associated with complications of childhood and adolescence obesity: systematic review and meta-analysis

In recent decades, the incidence of type 2 diabetes (T2D) has increased dramatically in children and adolescents, posing a real public health problem. Beyond unhealthy diets and sedentary lifestyles, growing evidence suggests that some perinatal factors, such as low birth weight (LBW), are associated with higher risk of T2D in adulthood. In this regard, it remains unclear whether the increased risk is already present in childhood and adolescence. We conducted a systematic review and meta-analysis to clarify the association of LBW or being small for gestational age (SGA) with insulin resistance in childhood and adolescence. The systematic review resulted in 28 individual studies, and those with the same outcome were included within two random-effects meta-analyses. Compared with children or adolescents born with adequate size for gestational age, those SGA had 2.33-fold higher risk of T2D (95% confidence interval [CI]: 1.05–5.17). Furthermore, LBW and being SGA were associated with 0.20 higher mean homeostasis model assessment of insulin resistance (HOMA-IR) values (95% CI: 0.02–0.38). Given the high prevalence of preterm babies, from a population perspective, these results may be of great importance as they point to the existence of a potentially vulnerable subgroup of children and adolescents that could benefit from screening tests and early preventive strategies

Influence of the Water Vapour Permeability of Airtight Sheets on the Behaviour of Facade

The air-tightness of the thermal envelope of buildings is one of the measures to reduce their energy demands in order to achieve global warming reduction targets. To this end, airtight sheets with different water vapour permeability characteristics are used. The different products studied are highly dispersed in terms of equivalent air thickness values, leading to confusion. After the analysis carried out, it is concluded that all airtight sheets are vapour barriers. To clarify whether or not these sheets are necessary as vapour barriers, a condensation analysis was carried out on 13 different facades for 3 climate zones with severe winters as defined in Spanish regulations. The results reveal that interstitial condensation occurs in only 7 of the 39 case studies, with the traditional facades of brickwork with render causing the greatest problems if the appropriate products are not used. In these cases, airtight sheets with water vapour barrier characteristics must be applied on the interior face of the insulating material. In all other cases (32), the airtight sheets must be permeable to water vapour if it is looked for a more breathable wall to water vapour and a better control of the interior humidity conditions