Desvio paroxístico do olhar para cima: estudo de caso

La desviación paroxística de la mirada hacia arriba es un síndrome infantil descrito por primera vez en 1988 y desde entonces solo se registran alrededor de cincuenta reportes en el mundo. Su etiología no es clara y, aunque su pronóstico es variable, la mayoría de los informes señalan que durante el crecimiento los episodios tienden a disminuir en frecuencia y duración hasta desaparecer. El caso que se reporta corresponde a un niño de 16 meses de edad, quien desde los 11 meses presenta episodios de supraversión sostenida de la mirada conjugada de duración variable conflexión cervical compensatoria y nistagmo vertical a la fijación ocular sin alteración del estado de conciencia. Los episodios son de predominio matinal y se exacerban por situaciones de estrés como el ayuno o el insomnio; sin embargo, ceden con la conciliación del sueño. Los exámenes neurológico y oftalmológico resultan normales y a su vez las neuroimágenes y electroencefalograma no tienen hallazgos relevantes.The paroxysmal upgaze deviation is a syndrome that described in infants for first time in 1988; there are just about 50 case reports worldwide ever since. Its etiology is unclear and though it prognosis is variable; most case reports indicate that during growth the episodes tend to decrease in frequency and duration until they disappear. It describes a 16-months old male child who since 11-months old presented many episodes of variable conjugate upward deviation of the eyes, compensatory neck flexion and down-beat saccades in attempted downgaze. These events are predominantly diurnal, and are exacerbated by stressful situations such as fasting or insomnia, however and improve with sleep. They have normal neurologic and ophthalmologic examination, and neuroimaging and EEG findings are not relevant.O desvio paroxístico do olhar para cima é um síndrome infantil foi descrito por primeira vez no ano 1988 e desde então só se registram cerca de cinquenta reportes no mundo. Sua etiologia não é clara e, mesmo que seu prognóstico é variável, a maioria dos informes assinalam que durante o crescimento, os episódios tendem a diminuir em frequência e duração até desaparecer. O caso que é reportado corresponde a uma criança de 16 meses de idade, que desde os 11 meses, apresenta episódios de supraversão sustentada do olhar conjugado de duração variável com flexão cervical compensatória e nistagmo vertical à fixação ocular sem alteração do estado de consciência. Os episódios são de predomínio matinal e se exacerbam por situações de estresse como o jejum ou a insônia; no entanto, cedem com a conciliação do sono. Os exames neurológico e oftalmológico resultam normais e a sua vez as neuroimagens e electroencefalograma não têm resultados relevantes

Influence of X Cation Covalence in the Formation of Ni-O-X Mixed Oxides by Reactive Ion Beam Mixing of Ni/X Interfaces

The reaction of the Ni/X interfaces (X = Si or Cr) with O2+ ions at low energy (3 keV) was studied using X-ray photoelectron spectroscopy (XPS) and factor analysis (FA). It was found that low ion doses lead to the formation of a NiO thin film on the surface that was progressively transformed into a Ni-O-X mixed oxide with increasing the ion dose. The degree of transformation of NiO into Ni-O-X depended on the covalence of the X cation, indicating that the reaction was influenced by chemical driving forces. For strong covalent cations (Si and Al), NiO was completely transformed into Ni-O-X at ion doses above 1.8 × 1017 ions/cm2, whereas for ionic cations (Cr) the transformation was incomplete. The ionicity of Ni atoms in the Ni-O-X mixed oxide increased with the increase in the covalence of X cation, and the features of the Ni 2p core level, characteristic of bulk NiO which were attributed to non-local screening, disappearedFinancial support from grant PID2020-116712RB-C21 funded by MCIN/AEI/10.13039/501100011033 is acknowledge

Universitat Barcelona & Lean Library. Take your library to your patrons

This webinar is the first in our series of dedicated webinars for Spanish institutions. We'll explore key findings from Lean Library's Librarian Futures report, including the role of the library in the digital age and how Lean Library can help bring librarian support and services directly to patrons, even when they begin their research journey outside of the library.The University of Barcelona who will showcase Lean Library in action and how it provides patrons with seamless access to content. We'll also explore why The University of Barcelona chose Lean Library, the challenges that this tool solves for both librarians and patrons, and effective strategies to encourage students to install the browser extension

ADIPOSE TISSUE. METABOLIC ALTERATIONS AND EFFECT OF MICROBIOTA

Obesity is among the top health concerns across the globe, and it has been for many years, yet the world remains unable to stop it. Overweight and obesity follow a clear uptrend pattern and that will not change unless a real battle is waged against their main causes.The present review will explore the causes and mechanisms underlying this health crisis, focusing on what for many years has been disregarded: the active role that the adipose tissue plays in the development of the metabolic alterations regarding obesity and the undeniable implication of gut microbiota in supporting the existing mechanisms for weight gain and fat storage. The aim is to integrate most of the factors to provide a global vision of the processes happening obesity.The review has been methodically elaborated, bringing together information from many different experts in the different fields, striving for accurate and state-of-the-art information throughout the whole review, with special emphasis in the final fragment on the other major health crisis concerning the world right now: COVID-19.<br /

Informe de caso: tolerancia e hiperalgesia por opioides posterior a traumatismo abdominal

ResumenLa tolerancia y la hiperalgesia por opioides son 2 fenómenos que pueden generar grandes dificultades en el manejo del dolor tanto agudo como crónico. El enfoque diagnóstico y terapéutico exige gran conocimiento de la farmacología de los opioides y de fenómenos relacionados, como adicción y pseudoadicción.En el presente artículo se expone el caso de una paciente poliintervenida, con tracto gastrointestinal no funcional, con dolor de aumento progresivo, no controlado y expuesta a altas dosis de opioides.Se diagnosticó tolerancia e hiperalgesia por opioides, se inició esquema de rotación de opioides y posteriormente infusiones de ketamina y dexmedetomidina, con lo que finalmente se obtuvo respuesta.La tolerancia y la hiperalgesia por opioides son 2 fenómenos cuyo enfoque terapéutico es sumamente complejo en ausencia de tracto gastrointestinal funcional. La rotación de los opioides, la ketamina y la dexmedetomidina fueron pilares del tratamiento en este caso.AbstractOpioid tolerance and hyperalgesia are two occurrences that can pose great difficulty in managing both acute and chronic pain. The diagnostic and therapeutic approach requires profound knowledge of opioid pharmacology and related issues such as addiction and pseudoaddiction.This paper presents the case of a patient with multiple interventions, non-functional gastrointestinal tract, increasing uncontrolled pain, exposed to high-dose opioids.Opioid tolerance and hyperalgesia were diagnosed. An opioid rotation regimen was initiated followed by ketamine and dexmedetomidine infusions until a response was finally obtained.Opioid tolerance and hyperalgesia are very difficult to manage and treatment is very complex in the absence of a functional gastrointestinal tract. Opioid rotation, ketamine and dexmedetomidine were the mainstays of treatment in this case

Contribución de las importaciones y la inversión extranjera en el Producto Interno Bruto (PIB) 1993 AL 2014. Análisis de cointegración

En este trabajo se explora la naturaleza del comportamiento de interacción entre dos o más variables económicas muy importantes para entender mejor los retos que enfrenta la economía mexicana para elevar las tasas de crecimiento del Producto Interno Bruto (PIB) desde el papel y contribución que juegan variable como el valor de las Importaciones y el valor de la Inversión Extranjera Directa (IED) y la Inversión Extranjera en Cartera (IEC) en la economía mexicana en los últimos 20 años. Se aplica un análisis de cointegración, método recientemente incorporado al herramental de análisis económico y econométrico y de series de tiempo de variables económicas aleatorias

Does virtual consultation between primary and specialised care improve healthcare quality? A scoping review of healthcare quality domains assessment

Virtual consultation has been proposed as a promising tool to improve the coordination and quality of healthcare between primary and specialised care. However, despite its potential facilitators, the evidence on the usefulness of virtual consultation for improving healthcare quality domains is fragmented and unclear. This scoping review aims to assess the impact of virtual consultation on different healthcare quality domains.Material and methodsWe conducted a scoping review with a rigorous search strategy on PubMed, EMBASE and Cochrane Library databases. The inclusion criteria were original articles, reviews, meta-analyses or letters to the editor, published between 1 January 2017 and 24 June 2022, and available in English, Spanish or French. For each of the articles selected, we identified the addressed healthcare quality domains, their facilitators and barriers, areas of improvement and data gaps. We have adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Review reporting standards.Results1284 manuscripts were retrieved. Finally, 235 papers were included in this review, most of which were original, descriptive studies. The most evaluated quality domain was effectiveness (223 articles). Safety and patient-centred care were the least evaluated. Simultaneous assessment of more than one domain was observed in 117 papers, being effectiveness and timeliness the most frequent combination. Our analysis revealed that virtual consultation is in development and underused. This tool has the potential to improve access to specialised care and enhance coordination between professionals.ConclusionsVirtual consultation has the potential to provide effective, efficient, equitable and timely attention. However, its contribution to safety and patient-centered care needs further evaluation. Our review emphasises the need for more rigorous research and standardised quality assessment criteria to obtain robust evidence on the usefulness of virtual consultation for improving healthcare quality domains