La función respiratoria en los tenistas con lesión medular

Introducción: Los atletas con lesión medular presentan deterioro o pérdida de la función motora y/o sensitiva en los segmentos cervical, torácico, lumbar o sacro de la médula espinal, que provoca en menor o mayor grado disminución en la amplitud de los movimientos y limita el desarrollo de los músculos principales y auxiliares de la respiración. Estos factores contribuyen a que existan dificultades en la función respiratoria, situación que va en detrimento del rendimiento deportivo. Objetivo: Evaluar la función respiratoria de los atletas con lesión medular que integran la selección nacional de tenis de mesa. Materiales y métodos: En la investigación se emplean métodos de orden teórico, empírico y matemático-estadístico. Resultados: se realizó un estudio de corte transversal en la etapa de preparación general, se determinaron en ambos sexos, parámetros respiratorios y cardiovasculares: capacidad vital forzada, tiempo de apnea y frecuencia cardiaca en reposo. A partir de la capacidad vital forzada alcanzada al final de la prueba, del tiempo de apnea en inspiración y el pulso en reposo se determinó las posibilidades generales cardio-respiratoria de los atletas. Los resultados obtenidos, demostraron la necesidad de evaluar periódicamente la función respiratoria de los atletas con lesión medular para lograr la optimización individual del entrenamiento y mejorar los resultados deportivos. Conclusiones: Las pruebas funcionales aplicadas demostraron que los tenistas con lesión medular presentan disminución de la capacidad vital pulmonar, dificultades en la apnea principalmente en la inspiración, además se evidenció que los tenistas con paraplejia tienen mejores posibilidades generales cardiorrespiratorias que los tenistas con tetraplejia

Bacteriemia por staphylococcus aureus. Características epidemiológicas y evolución de los pacientes ingresados en un hospital de nivel terciario

Objetivo: Analizar los aspectos epidemiológicos y la evolución de los pacientes afectados por bacteriemia por Staphylococcus aureus (SA) en un hospital de nivel terciario. Material y métodos: Realizamos un estudio descriptivo retrospectivo de los pacientes mayores de 18 años ingresados en el Hospital Clínico Universitario ``Lozano Blesa’’ (HCULB) de Zaragoza durante el año 2014. Resultados: Analizamos una muestra de 21 pacientes de edades comprendidas entre los 47 y los 88 años. El porcentaje de cepas resistentes fue del 19%. El tipo de bacteriemia más prevalente fue la bacteriemia nosocomial (52,4%), seguida de la adquirida en la comunidad (33,3%) y, finalmente, la asociada a cuidados sanitarios (14,3%). Un 81% de los pacientes presentaban comorbilidades. Un 57,4% eran inmunodeprimidos. El 19% fueron bacteriemias asociadas a catéter. La mortalidad fue de un 14,3%, con una estancia media de 33 días. Conclusiones: La bacteriemia por SA es una patología grave que conlleva elevada morbimortalidad. Tiene predilección por grupos de riesgo como inmunodeprimidos o pacientes con patología previa. Es fundamental el control epidemiológico del germen mediante medidas preventivas hospitalarias. Palabras clave: Staphylococcus aureus, bacteriemia, nosocomial, adquirida en la comunidad, asociada a cuidados sanitarios, sensible a la meticilina, resistente a la meticilina, epidemiología, colonización, catéter

Evaluación multidisciplinar 3D de una estructura kárstica asociada a colapso y subsidencia (Cuenca del Ebro)

La propagación de cavidades de disolución localizadas por debajo de series aluviales genera una serie de evidencias cuya representación superficial, en ocasiones, puede no ser indicativa de su extensión real en profundidad. La propagación de cavidades a través de medios heterogéneos, en los que pueden existir niveles cementados, puede producir cambios en la progresión de dichas cavidades y la identificación en superficie de grietas, colapsos, o zonas de subsidencia que pueden involucrar decenas de miles de metros cúbicos de material inestable. Cualquier tipo de evaluación de soluciones mitigadoras en estos contextos debe considerar la amplitud de estos volúmenes y el origen del proceso con independencia de la actividad registrada en superficie. En este trabajo se aborda un estudio integrado con el objetivo de determinar la estructura de un sector con evidencias de actividad kárstica superficial y evaluar su extensión y desarrollo tridimensional integrando el análisis geomorfológico, de inspección de campo, geofísica (GPR) y sondeos. The propagation of solution cavities located below alluvial deposits produce surficial evidences that, in some cases, cannot be representative of their actual extension at depth. Cavity propagation through heterogeneous media, for example with interbedded cemented levels, can produce changes in the propagation of deformation producing the identification of cracks, collapses or subsidence zones at the surface. These processes can involve thousands of cubic meters of unstable materials. Any evaluation of mitigation tasks, in this context, needs to consider: i) the amplitude of the affected volumes and ii) the in depth origin with independence of the surficial recorded activity In this work an integrated analysis is developed to evaluate the size and 3D structure of a sector with surficial evidences of karstic activity integrating geomorphological analysis, field inspection, geophysics (GPR) and boreholes

Root canal microbiota as an augmented reservoir of antimicrobial resistance genes in type 2 diabetes mellitus patients

Antimicrobial resistance is a global public health problem. Root canal microbiota associated with apical periodontitis represents a well-known reservoir of antimicrobial resistance genes (ARGs). However, the effect of type 2 diabetes mellitus (T2DM) in this reservoir is unknown. This study aimed to establish if root canal microbiota associated with apical periodontitis in T2DM patients is an augmented reservoir by identifying the prevalence of nine common ARGs and comparing it with the prevalence in nondiabetic patients. Methodology: This cross-sectional study included two groups: A T2DM group conformed of 20 patients with at least ten years of living with T2DM and a control group of 30 nondiabetic participants. Premolar or molar teeth with pulp necrosis and apical periodontitis were included. A sample was collected from each root canal before endodontic treatment. DNA was extracted, and ARGs were identified by polymerase chain reaction. Results: tetW and tetM genes were the most frequent (93.3 and 91.6%, respectively), while ermA was the least frequent (8.3%) in the total population. The distribution of the ARGs was similar in both groups, but a significant difference (p<0.005) was present in ermB, ermC, cfxA, and tetQ genes, being more frequent in the T2DM group. A total of eighty percent of the T2DM patients presented a minimum of four ARGs, while 76.6% of the control group presented a maximum of three. Conclusions: Root canal microbiota associated with apical periodontitis in T2DM patients carries more ARGs. Therefore, this pathological niche could be considered an augmented reservoir

Mobile clinical decision support systems and applications: a literature and commercial review

The final publication is available at Springer via http://dx.doi.org/10.1007/s10916-013-0004-y[EN] Background: The latest advances in eHealth and mHealth have propitiated the rapidly creation and expansion of mobile applications for health care. One of these types of applications are the clinical decision support systems, which nowadays are being implemented in mobile apps to facilitate the access to health care professionals in their daily clinical decisions. Objective: The aim of this paper is twofold. Firstly, to make a review of the current systems available in the literature and in commercial stores. Secondly, to analyze a sample of applications in order to obtain some conclusions and recommendations. Methods: Two reviews have been done: a literature review on Scopus, IEEE Xplore, Web of Knowledge and PubMed and a commercial review on Google play and the App Store. Five applications from each review have been selected to develop an in-depth analysis and to obtain more information about the mobile clinical decision support systems. Results: 92 relevant papers and 192 commercial apps were found. 44 papers were focused only on mobile clinical decision support systems. 171 apps were available on Google play and 21 on the App Store. The apps are designed for general medicine and 37 different specialties, with some features common in all of them despite of the different medical fields objective. Conclusions: The number of mobile clinical decision support applications and their inclusion in clinical practices has risen in the last years. However, developers must be careful with their interface or the easiness of use, which can impoverish the experience of the users.This research has been partially supported by Ministerio de Economía y Competitividad, Spain. This research has been partially supported by the ICT-248765 EU-FP7 Project. 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Accessed 11 September 2013.Apple (2013) iTunes. http://www.apple.com/itunes/ . Accessed 11 September 2013.Google (2013) Google play. https://play.google.com/store . Accessed 11 September 2013.Rowinski, D., (2013) The data doesn’t lie: iOS apps are better than android. Readwrite mobile. http://readwrite.com/2013/01/30/the-data-doesnt-lie-ios-apps-are-better-quality-than-android . Accessed 11 September 2013.Rajan, S. P., and Rajamony, S., Viable investigations and real-time recitation of enhanced ECG-based cardiac telemonitoring system for homecare applications: A systematic evaluation. Telemed J E Health 19(4):278–286, 2013.Logan, A. G., Transforming hypertension management using mobile health technology for telemonitoring and self-care support. Can J Cardiol 29(5):579–585, 2013.Tamrat, T., and Kachnowski, S., Special delivery: An analysis of mHealth in maternal and newborn health programs and their outcomes around the world. Matern Child Health J 16(5):1092–1101, 2012.Martínez-Pérez, B., de la Torre-Díez, I., López-Coronado, M., and Herreros-González, J., Mobile Apps in Cardiology: Review. JMIR Mhealth Uhealth 1(2):e15, 2013.de Wit HA, Mestres Gonzalvo C, Hurkens KP, Mulder WJ, Janknegt R, et al., Development of a computer system to support medication reviews in nursing homes. Int J Clin Pharm. 26, 2013.Dahlström, O., Thyberg, I., Hass, U., Skogh, T., and Timpka, T., Designing a decision support system for existing clinical organizational structures: Considerations from a rheumatology clinic. J Med Syst 30(5):325–31, 2006.Lambin P, Roelofs E, Reymen B, Velazquez ER, Buijsen J, et al., ‘Rapid learning health care in oncology’ - An approach towards decision support systems enabling customised radiotherapy’. Radiother Oncol. 27, 2013.Graham, T. A., Bullard, M. J., Kushniruk, A. W., Holroyd, B. R., and Rowe, B. H., Assessing the sensibility of two clinical decision support systems. J Med Syst 32(5):361–8, 2008.Martínez-Pérez, B., de la Torre-Díez, I., and López-Coronado, M., Mobile health applications for the most prevalent conditions by the World Health Organization: Review and analysis. J Med Internet Res 15(6):e120, 2013.Savel, T. G., Lee, B. A., Ledbetter, G., Brown, S., LaValley, D., et al., PTT advisor: A CDC-supported initiative to develop a mobile clinical laboratory decision support application for the iOS platform. Online J Public Health Inform 5(2):215, 2013.Doctor Doctor Inc. (2009) iDoc. iTunes. https://itunes.apple.com/es/app/idoc/id328354734?mt=8 . Accessed 13 September 2013.Hardyman, W., Bullock, A., Brown, A., Carter-Ingram, S., and Stacey, M., Mobile technology supporting trainee doctors’ workplace learning and patient care: An evaluation. BMC Med Educ 13:6, 2013.Lee, N. J., Chen, E. S., Currie, L. M., Donovan, M., Hall, E. K., et al., The effect of a mobile clinical decision support system on the diagnosis of obesity and overweight in acute and primary care encounters. ANS Adv Nurs Sci 32(3):211–21, 2009.Divall, P., Camosso-Stefinovic, J., and Baker, R., The use of personal digital assistants in clinical decision making by health care professionals: A systematic review. Health Informatics J 19(1):16–28, 2013.Chignell, M, and Yesha, Y, Lo, J., New methods for clinical decision support in hospitals. In Proceedings of the 2010 Conference of the Center for Advanced Studies on Collaborative Research (CASCON’10). Toronto, ON; Canada, 2010Charani, E., Kyratsis, Y., Lawson, W., Wickens, H., Brannigan, E. T., et al., An analysis of the development and implementation of a smartphone application for the delivery of antimicrobial prescribing policy: Lessons learnt. J Antimicrob Chemother 68(4):960–7, 2013.Klucken, J., Barth, J., Kugler, P., Schlachetzki, J., Henze, T., et al., Unbiased and mobile gait analysis detects motor impairment in Parkinson’s disease. PLoS One 8(2):e56956, 2013.Hervás, R., Fontecha, J., Ausín, D., Castanedo, F., Bravo, J., et al., Mobile monitoring and reasoning methods to prevent cardiovascular diseases. Sensors (Basel) 13(5):6524–41, 2013.Di Noia, T., Ostuni, V. C., Pesce, F., Binetti, G., Naso, N., et al., An end stage kidney disease predictor based on an artificial neural networks ensemble. Expert Syst Appl 40(11):4438–4445, 2013.Velikova, M., van Scheltinga, J. T., Lucas, P. J. F., and Spaanderman, M., Exploiting causal functional relationships in Bayesian network modelling for personalised healthcare. Int J Approx Reason, 2013. doi: 10.1016/j.ijar.2013.03.016 .Medical Data Solutions (2012) Pediatric clinical pathways. Google play. https://play.google.com/store/apps/details?id=com.ipathways . Accessed 17 September 2013.QxMD Medical Software Inc. (2013) Calculate by QxMD. Google play. https://play.google.com/store/apps/details?id=com.qxmd.calculate . Accessed 17 September 2013.Skyscape (2012) ACC pocket guides. Google play. https://play.google.com/store/apps/details?id=com.skyscape.packagefiveepkthreeundata.android.voucher.ui . Accessed 17 September 2013.Skyscape (2013) Skyscape medical resources. Google play. https://play.google.com/store/apps/details?id=com.skyscape.android.ui&hl=en . Accessed 17 September 2013.Pieter Kubben, M.D., (2012) NeuroMind. Google play. https://play.google.com/store/apps/details?id=eu.dign.NeuroMind . Accessed 17 September 2013.Mobile Systems, Inc. (2013) 2013 Medical diagnosis TR. Google play. https://play.google.com/store/apps/details?id=com.mobisystems.msdict.embedded.wireless.mcgrawhill.cmdt2013 . 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Proyecto escénico de reconstrucción historicista de la loa y el auto sacramental La vida es sueño de Calderón por los alumnos del Máster de Teatro y Artes Escénicas del Instituto del Teatro de Madrid

Escenificación del auto sacramental La vida es sueño, de Calderón, según parámetros de la época de modo que se reproduzca la sensación de contemplar una obra de teatro como la concibió el autor en 1673. Para ello, el Instituto del teatro de Madrid, ha colaborado con el medio teatral y cultural (Festival Internacional de Teatro Clásico de Almagro), investigador (Instituto del Teatro de Madrid) y docente (Máster en Teatro y Artes Escénicas de la UCM y Doctorado en Estudios Teatrales de la UCM)

Libro de Resúmenes del Congreso Euro-Latinoamericano de Intervención en Justicia Juvenil

Libro de Resúmenes del Congreso Euro-Latinoamericano de Intervención en Justicia Juvenil celebrado en la Universidad de Almería del 21/10/15 al 23/10/15

Influencia de factores objetivos y subjetivos en la disciplina Morfofisiología de la Carrera de Estomatología / Influence of the objective and subjective factors in Morphology-physiology discipline in Dentistry Studies

Introducción: la disciplina curricular de Morfofisiología se encuentra bajo la incidencia de los factores objetivos y subjetivos que limitan la estructuración y perfeccionamiento de los nuevos procesos educativos. Objetivo: valorar los factores objetivos y subjetivos que influyen en la dirección del proceso enseñanza aprendizaje de la disciplina Morfofisiología, limitando su estructuración y perfeccionamiento en la Carrera de Estomatología. Método: se realizó un estudio, en la disciplina Morfofisiología, de la Carrera de Estomatología de la provincia de Pinar del Río, en el período comprendido de septiembre de 2007 a enero de 2009. La muestra estuvo constituida por 142 estudiantes, de ellos, 131 de primer año y 101 de segundo. El método empleado fue la revisión y análisis de los documentos. Los datos obtenidos se procesaron utilizando los métodos y procedimientos que brinda la estadística descriptiva. Resultados: se encontraron más bajos niveles de rendimiento académico en la sede central con respecto a las sedes municipales, siendo las asignaturas Morfofisiología II y V las de más bajos resultados. Escasa participación de estudiantes en los exámenes de premio y menor calidad de los mismos en las sedes municipales. Conclusiones: que los resultados académicos en la disciplina Morfofisiología en la provincia de Pinar del Río, indican que el cambio educativo teniendo en cuenta los actuales contextos universitarios, implica necesariamente vincular a los estudiantes a los métodos productivos de enseñanza y a los servicios en la búsqueda de la excelencia educativa.Palabras clave: Rendimiento académico, resultados de promoción, municipalización.ABSTRACTIntroduction: the curricular discipline of Morphology-physiology is under the influence of objective and subjective factors which limit the structuring and improvement of the new educational process. Objective: to assess the objective and subjective factors that influence on the direction of the teaching-learning process of Morphology-physiology which limits its structuring and improvement in Dentistry Studies in Pinar del Rio province. Method: a study was conducted in Morphology-physiology discipline in Dentistry Studies, Pinar del Rio from September 2007 to January 2009. The sample was comprised of 142 students, out of them, 131 from 1st academic year and 101 from 2nd academic year. The methods used were the literature revision and documentary analysis. The data collected were processed using methods and procedures of the descriptive statistics. Results: the lowest levels of academic achievements were found in the central venue in Morphology-physiology (ii and iv) discipline, as well as the poor participation of the students in award-examinations and a low quality of the examinations applied in the municipal venues.Conclusions: the academic results of Morphology-physiology discipline in Pinar del Rio province show that the educational change implies a necessary link of the students with more productive teaching methods and health services considering the current university contexts in order to achieve the excellence in the teaching-learning process.Key words: Academic achievements, educational results, municipal venue

Análisis del riesgo kárstico en medios urbanos asentados sobre depósitos aluviales cementados (mallacán) en la Cuenca del Ebro (España)

Los procesos kársticos en medios urbanos pueden representar un riesgo significativo para la seguridad vial y constructiva. En este trabajo se presenta un estudio integrado de prospección geofísica, análisis superficial y ensayos mecánicos. Se identifica y delimita un dispositivo geométrico de tipo colapso y se aprecia que el mayor riesgo repentino se asocia a sectores marginales del colapso que presenta una orla de cavidades en el subsuelo. Los ensayos geomecánicos muestran una alta compacidad de los materiales naturales parcialmente cementados, lo que podría tomarse como indicador de estabilidad. En realidad, esta compacidad permite el sostenimiento inestable de cavidades propagadas desde el substrato hasta cerca de la superficie, siendo éste el mayor riesgo que aquí se trata de valorar. Active karst processes in urban settings can represent a significative hazard for the population and to buildings and other facilities. In this work, an integrated analysis by means of geophysical survey, surficial analysis and geomechanical tests is presented. The obtained results permit to identify a collapsed geometry where the more sudden hazards are related to the noncollapsed marginal areas of the sinkhole. The geomechanical tests show a high alluvial resistance due to the partial carbonatic cementation with apparent higher stability. However, cementation allows the individualization and the propagation of underground cavities up to near-surface levels being the highest hazard to be analyzed in these contexts

A pyrF auxotrophic mutant of Sinorhizobium fredii HH103 impaired in its symbiotic interactions with soybean and other legumes

Transposon Tn5-Mob mutagenesis allowed the selection of a Sinorhizobium fredii HH103 mutant derivative (SVQ 292) that requires the presence of uracil to grow in minimal media. The mutated gene, pyrF, codes for an orotidine-5´- monophosphate decarboxylase (EC 4.1.1.23). Mutant SVQ 292 and its parental prototrophic mutant HH103 showed similar Nod-factor and lipopolysaccharide profiles. The symbiotic properties of mutant SVQ 292 were severely impaired with all legumes tested. Mutant SVQ 292 formed small ineffective nodules on Cajanus cajan and abnormal nodules (pseudonodules) unable to fix nitrogen on Glycine max (soybean), Macroptitlium atropurpureum, Indigofera tinctoria, and Desmodium canadense. It also did not induce any macroscopic response in Macrotyloma axillare roots. The symbiotic capacity of SVQ 292 with soybean was not enhanced by the addition of uracil to the plant nutritive solution. [Int Microbiol 2007; 10(3):169-176