Negligence and civil liability in the medical profession : part I

Part 2 of the article can be found through this link: https://www.um.edu.mt/library/oar//handle/123456789/14218Liability in the medical profession arises when the patient is not treated according to acceptable standard of care. It is a well-known fact that the medical professional is not duty bound to give specific results. The medical professional is however obliged to carry out the treatment to the best of his capabilities. The principal aim of this article is to analyse what constitutes negligence and when liability arises. Besides considering the defences that can be raised in a law suit for medical malpractice, this article will also make reference to the opinions and decisions of Maltese courts.peer-reviewe

Arteterapia, un enfoque psicoanalítico: estudio realizado en el Programa de Hospital de Día del Centro de Atención Integral en Salud Mental de Instituto Guatemalteco de Seguridad Social.

Comprobó las bondades, beneficios y contribuciones terapéuticas que brinda la arteterapia, desde la teoría psicoanalítica como tratamiento a pacientes que presentan síntomas característicos de la ansiedad. Esta investigación se realizó con los pacientes que asisten al taller de arteterapia, siendo éste uno de los diferentes abordajes terapéuticos que ofrece el programa de hospital de día del Instituto Guatemalteco de Seguridad Social, ubicado en la 14 Ave. y 4ta. Calle zona 12, Colinas de Pamplona. El estudio se realizó durante el mes de junio de 2013, con una población de diez personas, mujeres y hombres, comprendidos de 23 a 45 años de edad. Para recopilar datos se utilizó las técnicas siguientes: observación directa y arteterapia. Los instrumentos utilizados fueron: guía de registro y observación y cuestionario cerrado. Después del análisis de datos concluye que, la arteterapia a través de la pintura permite el reflejo de los contenidos inconscientes, es decir reprimidos, que es posible mediante el proceso creativo que tiene como resultado final la proyección de símbolos que representan las vivencias conflictivas de quien realiza la pintura en particular. Recomienda, tomar en cuenta los beneficios terapéuticos de la arteterapia como una herramienta útil en el tratamiento de la ansiedad y trascender la visión de esta técnica no solo como algo artístico

Toxina botulínica A para o trismo no tétano cefálico

Cephalic tetanus is a localized form of tetanus. As in generalized forms , trismus is a prominent feature of the disease, leading to considerable difficulty in feeding, swallowing of the saliva and mouth hygiene. These difficulties often precede respiratory problems and aspiration bronchopneumonia is a frequent life-threatening complication. Muscle relaxants other than curare drugs may show a limited benefit for relieving trismus. Tetanospasmin, the tetanic neurotoxin, and botulinum toxin share many similarities, having a closely related chemical structure, an origin from related microorganisms (Clostridium tetani and Clostridium botulinum, respectively), and presumably, the same mechanisms of action in the neuron. The difference between the two lies in their peculiar neurospecificity, acting in different neurons. Injection of minute doses of botulinum toxin in the muscles involved in focal dystonias or other localized spastic disorders have proved to be very effective in these conditions. We describe the use of botulinum toxin A in the successful treatment of trismus in a patient suffering from cephalic tetanus. We believe that this form of treatment may be of value in lowering the risk of pulmonary complications in tetanic patients.O tétano cefálico é uma forma localizada de tétano. Da mesma maneira que nas formas generalizadas, o trismo é componente clínico proeminente, que leva a grande dificuldade na alimentação, na deglutição da saliva e para a higiene da boca. Essas dificuldades freqüentemente precedem os problemas respiratórios e as pneumonias aspirativas, que se constituem em complicações que ameaçam a vida dos pacientes. Drogas relaxantes musculares de outro tipo que as drogas curarizantes trazem pouco benefício para o trismo. A neurotoxina tetânica (tetanospasmin) e a toxina botulínica compartilham muitas semelhanças, como estrutura química símile, origem de microorganismos relacionados (Clostridium tetani e Clostridium botulinum, respectivamente) e, presumivelmente, os mesmos mecanismos de ação no neurônio. A diferença entre as duas reside na sua peculiar neuroespecificidade, atuando em diferentes neurônios. Injeção de doses reduzidas da toxina botulínica em músculos envolvidos em distonias focais ou outras desordens com espasticidade muscular localizada tem se mostrado eficaz em abolir as contrações. Descrevemos o uso da toxina botulínica A com sucesso no tratamento do trismo num paciente sofrendo de tétano cefálico. Acreditamos que esta forma de tratamento possa ser de valor no sentido de diminuir o risco de complicações pulmonares nos pacientes com tétano.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Escola Paulista de Medicina Department of Neurology and NeurosurgeryUNIFESP, EPM, Department of Neurology and NeurosurgerySciEL

Discurso misógino sobre acciones misóginas

In this article we intend to elaborate a speech analysis, based on the critical speech analysis by Teun van Dijk, of the text “De porqué sí se les puede pegar a las mujeres!!!” (Why it is possible to hit women) by Mauricio Navas Talero, published in a welEn este artículo pretendemos elaborar un análisis del habla, basado en el análisis crítico del habla de Teun van Dijk, del texto "¡Por qué sí se les puede pegar a las mujeres!" Mauricio Navas Talero, publicado en una conocida revista de impresión naciona

Influence of irrigation regime and seasonal temperatures on nut quality and the oil fatty acid profile of walnuts (Juglans regia L.)

Walnut production is expanding worldwide due to the high demand for natural products with proven nutraceutical properties. This expansion includes new growing areas, such as central–western Argentina, where crop water requirements have yet to be determined and little is known about the response in terms of production quality to the water regime. The aim of this study was to assess the effects of four irrigation regimes (at 50, 75, 100, and 125 % of crop evapotranspiration) and the weather conditions over two consecutive seasons in a young Chandler walnut orchard in terms of in–shell and kernel caliber, kernel color, oil concentration, and fatty acid profile. Quality production characteristics were not significantly affected by irrigation regimes within each season. In contrast, the quality parameters achieved were significantly different between seasons. The first season (S1) was wetter (462 mm) and cooler (17.05 °C mean air temperature in the oil accumulation period) and produced more extra–light kernels (92%). The second season (S2) was drier (326 mm) and warmer (19.02 °C) and produced a lower proportion of extra–light kernels (82.2%). In addition, during the second season, walnuts produced larger kernels with a higher oil concentration (62.7%; +3.5% of S1) and a better omega–6/omega–3 ratio (3.25 in S2 vs. 3.70 in S1). These results suggest that kernel quality was more sensitive to the seasonal temperature than the irrigation studied regimes. The nutritional quality of walnuts may increase significantly in warmer seasons/environments despite the deterioration of kernel color.EEA La ConsultaFil: Calvo, Franco E. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Calvo, Franco E. Universidad Nacional de Chilecito. Instituto de Agricultura Sostenible en el Oasis; ArgentinaFil: Trentacoste, Eduardo Rafael. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria La Consulta; ArgentinaFil: Silvente, Sonia. Universidad Nacional de Chilecito. Instituto de Ambiente de Montaña y Regiones Áridas (IAMRA); Argentin

Provenance of Pleistocene sediments in the ANDRILL AND-1B drillcore: Clay and heavy mineral data

The cryosphere in the McMurdo Sound region has undergone significant modifications during the last 1 Ma. Consequently, the sedimentary sequences underlying the modern McMurdo Ice-Shelf provide geological data to reconstruct variations in transport and depositional mechanisms of terrigenous material due to variations in ice sheet extension, grounding line position and main icestream flow directions during glacial and interglacial periods. The present study aims to investigate the clay and heavy mineral assemblages of the late Pleistocene subglacial and glaciomarine sediments recovered during the ANDRILL-McMurdo Ice Shelf Project in Windless Bight (South of Ross Island). The analyses show that the sediments are a mix of detritus from the McMurdo Volcanic Group (MVG) and the Transantarctic Mountains (TAM) from the south and west. MVG-derived minerals prevail with respect to TAM-derived minerals. The down-core mineralogical variations are determined by changes in the source rocks and the sedimentary processes. Sediments at the drill site are nourished by ice coming from the South which delivered rocks from the McMurdo Volcanic region; the enrichment of a TAM component in massive diamictites testifies that the ice sheet collected debris from the Transantarctic Mountains. When open marine conditions prevailed, only sediments from a local source (i.e. McMurdo volcanics) were deposited

Shortened primary cilium length and dysregulated Sonic hedgehog signaling in Niemann-Pick C1 disease

The Niemann-Pick type C1 (NPC1) disease is a neurodegenerative lysosomal storage disorder due to mutations in the NPC1 gene, encoding a transmembrane protein related to the Sonic hedgehog receptor, Patched, and involved in intracellular trafficking of cholesterol. We have recently found that the proliferation of cerebellar granule neuron precursors is significantly reduced in Npc1-/- mice due to the downregulation of Shh expression. This finding prompted us to analyze the formation of the primary cilium, a non-motile organelle that is specialized for Shh signal transduction and responsible, when defective, for several human genetic disorders. In this study, we show that the expression and subcellular localization of Shh effectors and ciliary proteins are severely disturbed in Npc1-deficient mice. The dysregulation of Shh signaling is associated with a shortening of the primary cilium length and with a reduction of the fraction of ciliated cells in Npc1-deficient mouse brains and the human fibroblasts of NPC1 patients. These defects are prevented by treatment with 2-hydroxypropyl-β-cyclodextrin, a promising therapy currently under clinical investigation. Our findings indicate that defective Shh signaling is responsible for abnormal morphogenesis of the cerebellum of Npc1-deficient mice and show, for the first time, that the formation of the primary cilium is altered in NPC1 disease

El poder en las interacciones comunicativas de las organizaciones

Without power, organizations do not exist, for administration takes place with it and for it through practices that create and recreate power relations. Organizations regulate, control and discipline work and workers. The ways to do it are evident in comuSin poder, las organizaciones no existen, porque la administración se lleva a cabo con él y para ello a través de prácticas que crean y recrean relaciones de poder. Las organizaciones regulan, controlan y disciplinan el trabajo y los trabajadores. Las fo

Phytoplankton distribution and composition in the Peruvian Sea during the Austral Summer of 2022: Hydroacoustic assessment cruise targeting Engraulis ringens and other pelagic resources 2202-04

Se caracterizó la distribución y composición del fitoplancton durante el Crucero de Evaluación Hidroacústica de anchoveta y otros recursos pelágicos realizado entre febrero y abril 2022. El volumen de plancton registró un valor promedio de 0,37 mL.m-3, con predominancia de fitoplancton en 60% de estaciones, especialmente en la zona costera (30 mn). Asimismo, el mayor volumen promedio de plancton se localizó en 12-14°S entre 30 y 60 mn, con predominancia de fitoplancton. Cuantitativamente, el fitoplancton alcanzó en promedio concentración de 190 x 103 cél. L-1. El mayor aporte fue del microfitoplancton, destacando las diatomeas Leptocylindrus danicus y Skeletonema costatum. El índice de diversidad presentó máximo de 2,36 bits. cel-1, reflejando las primeras fases de sucesión ecológica de la comunidad. Protoperidinium obtusum, indicador de aguas costeras frías del afloramiento (acf), estuvo presente en 64% de estaciones, predominando en la zona costera, de Paita a Ilo, hasta 30 mn, extendiéndose incluso aproximadamente 80 mn frente a Malabrigo y Chimbote.ABSTRACT: This study characterizes the distribution and composition of phytoplankton during the Hydroacoustic Assessment Cruise targeting E. ringens and other pelagic resources conducted between February and April 2022. The average plankton volume recorded was 0.37 mL.m-3, with phytoplankton predominantly observed in 60% of stations, particularly prevalent in the coastal zone (30 nm). Additionally, the highest average plankton volume was localized between 12-14°S at distances of 30 to 60 nm, showcasing a prevalence of phytoplankton. Quantitatively, phytoplankton displayed an average concentration of 190 x 103 cells. L-1. Microphytoplankton contributed significantly, especially diatoms such as Leptocylindrus danicus and Skeletonema costatum. The diversity index peaked at 2.36 bits.cel-1, reflecting the early ecological succession stages within the community. Protoperidinium obtusum, indicative of cold coastal upwelling waters (ccw), was present in 64% of stations, predominantly in the coastal zone stretching from Paita to Ilo, up to 30 nm, and extending to approximately 80 nm off Malabrigo and Chimbote