Acetazolamide in the resolution of cerebrospinal fluid cutaneous fistula after peridural analgesia: Case report1

AbstractBackgroundCerebrospinal fluid cutaneous fistula following spinal anaesthesia is a serious and rare complication which requires a prompt diagnosis. However, the treatment management is not well defined.Clinical caseFemale aged 50 with a stage IIB cervical carcinoma, who had a peridural catheter inserted at lumbar level. Three days after surgery she refers severe headache, which was corroborated by leakage of cerebrospinal fluid through the puncture. She was prescribed antibiotics and acetazolamide 250mg every 8hours for five days with a favourable outcome.ConclusionIn this case, management with acetazolamide and suture of the fistula inhibits cerebrospinal fluid leakage, without the need for a blood patch

Historia, filosofía y ciencia medievales (siglo XIV) según El nombre de la rosa, de Umberto Eco

In the early fourteenth century, the confrontation between the "spiritual" Franciscans and Pope John XXII had arisen. The German Emperor Ludwig of Bavaria intervened in the confrontation in favor of the Franciscans and against the pope. In the novel The Name of the Rose by Umberto Eco, the conflict between the Franciscan William, who represents William of Ockham and the Dominican inquisitor Bernard Guí it is staged. In its pages the author cited the philosophy of Aristotle, Thomas Aquinas, Bonaventure of Bagnoregio, Marsilio of Padua and William of Ockham himself. Political philosophy and scientific knowledge of the time: Albert the Great and Roger Bacon and others complete the picture of that XIV century. This shows an unquestionable educational interest of Umberto Eco's book.En los primeros años del siglo XIV se planteó la polémica entre los franciscanos “espirituales” y el papa Juan XXII. El emperador alemán Luis de Baviera intervino en la confrontación a favor de los franciscanos y en contra del Papa. En la novela El nombre de la Rosa de Umberto Eco, se escenifica el conflicto entre el Franciscano Guillermo, que representa a Guillermo de Ockham y el inquisidor dominico Bernardo de Guí. En sus páginas se cita la filosofía de Aristóteles, Tomás de Aquino Buenaventura de Bagnoregio, Marsilio de Padua y el propio Guillermo de Ockham. La filosofía política y el conocimiento científico de la época: Alberto Magno y Roger Bacon entre otros completan el panorama del citado siglo XIV. Todo ello demuestra una labor educativa incuestionable del libro de Umberto Eco

Aproximación a la tipología del "turismo paisano" en las comarcas rurales de procedencia : el caso de Extremadura

El "turistas paisanos" es una categoría que ha sido consideradas de poca entidad por estudiosos y responsables de las políticas de desarrollo rural, sin embargo, en el proceso de identificación de los actores en la escena del modelo de ¿ruralidad móvil¿ se hace necesario su identificación y la especificación de las funciones que desempeñan. Últimamente, han tomado gran importancia los estudios sobre la movilidad laboral (el fenómeno del ¿commuting¿), los procesos de instalación en el medio rural de inmigrantes de origen urbano (el fenómeno de la contraurbanización, los neorrurales emprendedores), el fenómeno de la ¿gentrificación¿ de los espacios rurales cercanos o alejados de las grandes metrópolis. En el caso de estos últimos, la explicación de los motivos ha girado entorno al atractivo ambiental y a la calidad de vida como palancas que han determinado la estrategia residencial recurriendo a variables como el nivel de estudios y estatus social (por aquello de que la contraurbanización es esencialmente un fenómeno relacionado con las clases medias urbanas). Ahora bien, tanto la experiencia residencial de los retornados como la visita de los turistas paisanos tienen que ver más con la ¿lógica de los sentimientos¿ y la ¿llamada de la tierra¿. Ambos buscan el hábitat imaginado a partir de la experiencia personal vivida y donde la convivencia familiar es esencial para la repetición de la visita o la continuidad de la residencia en el medio rural. De otra parte, la estancia en las comarcas rurales de las que son originarios está caracterizada por una práctica de consumo que, de un lado, ayuda al mantenimiento de la economía rural; de otro lado, presenta matices diferentes en cuanto a pautas de consumo, de otros tipos de turismo, que que el turismo paisano lleva a cabo la mayor parte de su gasto (alojamiento, compras,restauración y diversión) en los rublos y comarcas donde se asienta."Countryman tourist" is a tourist category that was considered insignificant by researchers and heads of rural development policies in the past. However, identification and specification of their roles in the process of identifying the actors on the stage of the "mobile rurality" model is necessary. Lately, studies on job mobility ("commuting" phenomenon), the process of installation in the rural of immigrants of urban origin (counter-urbanization phenomenon, the entrepreneur neo-rural men), and on the gentrification phenomenon of rural areas near or far from major cities, have become very important. In this case, the explanation of the reasons has revolved around the environmental attractiveness and quality of life as levers that have determined the residential strategy, using variables such as education level and social status (counter-urbanization is, essentially, a phenomenon related to the urban middle classes). However, both the residential experience of returnees as the visit of “countrymen tourists” is more related to "the logic of the feelings" and "the call of the earth." Both, the returnees and the “countryman tourist” seek the imagined habitat from personal experience. So, family life is essential to repeat the visit or to continue living in rural areas. On the other hand, their stay in the rural native areas is characterized by a consumer practice that: a) helps to the support of rural economy; b) has different meanings in terms of consumption patterns than the other types of tourism, because “countryman tourist” make most of their spending (accommodation, shopping, restaurants and entertainment) in rubles and counties where he sits. The subject of this communication is to describe the role of this type of tourist in rural communities, to identify and to define their motivations, expectations and idiosyncrasies

Anthropometric Status and Nutritional Intake in Children (6-9 Years) in Valencia (Spain): The ANIVA Study

The aim of our study was to assess nutritional intake and anthropometric statuses in schoolchildren to subsequently determine nutritional adequacy with Spanish Dietary ReferenceIntake (DRIs). The ANIVA study, a descriptive cross-sectional study, was conducted in 710 schoolchildren (6-9 years) in 2013-2014 in Valencia (Spain). Children's dietary intake was measured using 3-day food records, completed by parents. Anthropometric measures (weight and height) were measured according to international standards, and BMI-for-age was calculated and converted into z-scores by WHO-Anthro for age and sex. Nutrient adequacy was assessed using DRI based on estimated average requirement (EAR) or adequate intake (AI). Pearson's chi-square and Student's t-test were employed. Of our study group (47.61% boys, 52.39% girls),53.1% were normoweight and the weight of 46.9% was inadequate; of these, 38.6% had excess body weight (19.6% overweight and 19.0% obesity). We found intakes were lower for biotin, fiber, fluoride, vitamin D (p < 0.016), zinc, iodine, vitamin E, folic acid, calcium and iron (p < 0.017),and higher for lipids, proteins and cholesterol. Our results identify better nutritional adequacy to Spanish recommendations in overweight children. Our findings suggest that nutritional intervention and educational strategies are needed to promote healthy eating in these children and nutritional adequacies

Storm Gloria: sea state evolution based on in situ measurements and modeled data and its impact on extreme values

Storm Gloria, generated on January 17th, 2020 in the Eastern North Atlantic, crossed the Iberian Peninsula and impacted the Western Mediterranean during the following days. The event produced relevant damages on the coast and the infrastructures at the Catalan-Balearic Sea, due to extraordinary wind and wave fields, concomitant with anomalously intense rain and ocean currents. Puertos del Estado (the Spanish holding of harbors) has developed and operates a complex monitoring and forecasting system (PORTUS System), in collaboration with the Spanish Met Office (AEMET). The present work shows how Gloria was correctly forecasted by this system, alerts were properly issued (with special focus to the ports), and the buoys were able to monitor the sea state conditions during the event, measuring several new records of significant wave height and exceptional high mean wave periods. The paper describes, in detail, the dynamic evolution of the atmospheric conditions, and the sea state during the storm. It is by means of the study of both in situ and modeled PORTUS data, in combination with the AEMET weather forecast system results. The analysis also serves to place this storm in a historical context, showing the exceptional nature of the event, and to identify the specific reasons why its impact was particularly severe. The work also demonstrates the relevance of the PORTUS System to warn, in advance, the main Spanish Ports. It prevents accidents that could result in fatal casualties. To do so, the wave forecast warning performance is analyzed, making special focus on the skill score for the different horizons. Furthermore, it is demonstrated how a storm of this nature results in the need of changes on the extreme wave analysis for the area. It impacts all sorts of design activities at the coastline. The paper studies both how this storm fits into existing extreme analysis and how these should be modified in the light of this particular single event. This work is the first of a series of papers to be published on this issue. They analyze, in detail, other aspects of the event, including evolution of sea level and description of coastal damages

Curso abierto de ayuda para la elaboración del Trabajo Fin de Grado en los Grados en Química e Ingeniería Química

Este proyecto llevará a cabo el desarrollo de un curso abierto que sirva a los estudiantes como guía de ayuda a la hora de elaborar su Trabajo Fin de Grado (TFG) en los Grados de Química e Ingeniería Química. Se incluirá una descripción de herramientas que los estudiantes puedan emplear en el desarrollo de sus TFG. Éstas serán seleccionadas de acuerdo con la experiencia de los miembros del Grupo y en función de las necesidades de los estudiantes. El curso resultante se editará para libre acceso a través del portal iTunes U, de ámbito internacional, convirtiéndose en el primer curso UCM ofertado en esta plataforma (tras consulta y aprobación del Vicerrectorado de Innovación; de no ser así, se alojará en alguna otra plataforma de amplia difusión). Se aprovechará la accesibilidad ofertada a los estudiantes por iTunes U para poner a su disposición el material elaborado logrando una gran difusión, incrementándose la visibilidad internacional de la UCM. El material de ayuda elaborado para el curso se presentará tanto en español como en inglés, para facilitar su uso por alumnos visitantes de la UCM, favoreciendo la movilidad de los estudiantes en el marco del EEES. Este material también se adaptará para poder ser empleado de forma directa, totalmente o en forma de módulos, en el Campus Virtual UCM

Derecho, género e igualdad : cambios en las estructuras jurídicas androcéntricas. Vol I

Este libro es el resultado de trabajos seleccionados del I Congreso Internacional Derecho, Género e Igualdad, realizado en el año 2009 en la Universidad de Barcelona por el Grupo Antígona y el Grupo Dones i Drets

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

CIBERER : Spanish national network for research on rare diseases: A highly productive collaborative initiative

Altres ajuts: Instituto de Salud Carlos III (ISCIII); Ministerio de Ciencia e Innovación.CIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research