Mis casos clínicos de especialidades odontológicas

Libro que muestra la atención de casos clínicos particulares referente a las diferentes especialidades odontológicasLibro que muestra la atención de casos clínicos particulares referente a las diferentes especialidades odontológicasUniversidad Autónoma de Campeche Universidad Autónoma del Estado de Hidalgo Universidad Autónoma del Estado de Méxic

Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study

Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021)

Intercepción de lluvia por matorral inerme espinoso en Atotonilco el Grande, Hidalgo

Interception of rain is the process by which rainwater modifies its trajectory to be intercepted by the canopy, thereby exerting a marked influence on the pattern of the rain that makes it to the forest floor. Once intercepted, the water is retained by the leaves and branches of trees, including epiphytes, making from now, its trajectory by one or more of these three ways: evaporation, dripping from the top, or flow through the branches to the base of the stem (García, 2006). Interception studies are one of the ways that identify how the current conditions in tree cover, or changes to this structural condition, affect the water balance of a wooded area, either by the application of silvicultural techniques or natural disturbances. In the case of Mexico, this research area has been moderately explored in particular in the field of ecology. The objective of this study is to quantify the interception of rain and its variability, measured under canopy in stands whose dominant vegetation is Acacia farnesiana and Juniperus flaccida. In a forest area of the municipality of Atotonilco el Grande, Hidalgo; it was established a research module of 0.64 ha, where 60 rain gauges were placed under the canopy of a forest area representative, formed by different species and degrees of canopy cover and an irregular topography. The study covered the entire rainy season of 2007. As a result, it was determined an average interception of 18.6%, finding a great variability, both between and within rain events. Is reported a statistical relationship between the logarithmic type between interception percentage and total amount of precipitation by event. We found no statistical relationship between the interceptions with the irregular topography. We conclude on the need to extend the analysis to assess the contribution of site variables and vegetation.La intercepción de lluvia, es el proceso por el cual el agua de lluvia, modifica su trayectoria al ser interceptada por el dosel de los árboles, ejerciendo de esta manera, una marcada influencia en el patrón de la lluvia que alcanza a llegar al piso forestal. Una vez interceptada, el agua es retenida por las hojas y ramas de los árboles, incluso por plantas epifitas, pudiendo a partir de este momento, continuar su trayectoria, por una o más de estas tres vías: evaporarse, gotear desde la copa, o fluir por las ramas hasta la base del fuste (García, 2006). Los estudios de intercepción constituyen una de las formas que permiten identificar cómo es que las condiciones actuales en la cobertura arbórea, o las modificaciones a esta condición estructural, afectan el balance hidrológico de un área arbolada, ya sea por la aplicación de técnicas silvícolas o por perturbaciones naturales. Para el caso de México, esta área de investigación ha sido poco explorada en particular en el ámbito de la ecología. El objetivo del presente trabajo es cuantificar la intercepción de lluvia y su variabilidad, medida bajo dosel en rodales cuya vegetación dominante es Acacia farnesiana y Juniperus flaccida. En una zona forestal del municipio de Atotonilco el Grande, Hidalgo, se estableció un módulo de investigación de 0.64 ha, en donde se colocaron 60 pluviómetros bajo el dosel de un bosque representativo de la zona, conformado por distintas especies y grados de cobertura de copa y con una topografía irregular. El estudio abarcó todo el periodo de lluvia del año 2007. Como resultado, se determinó una intercepción promedio 18.6%, encontrando una gran variabilidad, tanto entre como dentro de los eventos de lluvia. Se reporta una relación estadística de tipo logarítmico entre el porcentaje de intercepción y la cantidad de precipitación total por evento. No se encontró una relación estadística entre la intercepción con los desniveles del terreno. Se concluye sobre la necesidad de ampliar los análisis para evaluar la contribución de variables del sitio y de la vegetación

Revista esencia y espacio

Arquitectur

Synthetic Growth Hormone-Releasing Peptides (GHRPs): A Historical Appraisal of the Evidences Supporting Their Cytoprotective Effects

Background: Growth hormone-releasing peptides (GHRPs) constitute a group of small synthetic peptides that stimulate the growth hormone secretion and the downstream axis activity. Mounting evidences since the early 1980s delineated unexpected pharmacological cardioprotective and cytoprotective properties for the GHRPs. However, despite intense basic pharmacological research, alternatives to prevent cell and tissue demise before lethal insults have remained as an empty niche in the clinical armamentarium. Here, we have rigorously reviewed the investigational development of GHRPs and their clinical niching perspectives. Methodology: PubMed/MEDLINE databases, including original research and review articles, were explored. The search design was date escalated from 1980 and included articles in English only. Results and Conclusions: GHRPs bind to two different receptors (GHS-R1a and CD36), which redundantly or independently exert relevant biological effects. GHRPs’ binding to CD36 activates prosurvival pathways such as PI-3K/AKT1, thus reducing cellular death. Furthermore, GHRPs decrease reactive oxygen species (ROS) spillover, enhance the antioxidant defenses, and reduce inflammation. These cytoprotective abilities have been revealed in cardiac, neuronal, gastrointestinal, and hepatic cells, representing a comprehensive spectrum of protection of parenchymal organs. Antifibrotic effects have been attributed to some of the GHRPs by counteracting fibrogenic cytokines. In addition, GHRP family members have shown a potent myotropic effect by promoting anabolia and inhibiting catabolia. Finally, GHRPs exhibit a broad safety profile in preclinical and clinical settings. Despite these fragmented lines incite to envision multiple pharmacological uses for GHRPs, especially as a myocardial reperfusion damage-attenuating candidate, this family of “drugable” peptides awaits for a definitive clinical niche

Food Allergy Prevalence in Salvadoran Schoolchildren Estimated by Parent-Report

The prevalence of food allergy (FA) has not been estimated at a population level in Central American countries and, consequently, the magnitude and relevance of the problem in the Central American region remains unknown. Thus, our aim was to evaluate the parent-reported prevalence of FA in a population of schoolchildren from the Central American country El Salvador. A Spanish version of a structured questionnaire was utilized. Five hundred and eight (508) parents returned the questionnaire with valid responses (response rate, 32%). The estimated prevalence rates (95% CI) were: adverse food reactions 15.9 (13.0–19.3), “perceived FA, ever” 11.6 (9.1–14.6), “physician-diagnosed FA, ever” 5.7% (4.0–8.0), “immediate-type FA, ever” 8.8% (6.6–11.6), “immediate-type FA, current” 5.3% (3.6–7.6), and anaphylaxis 2.5% (1.5–4.3). The most common food allergens were milk (1.7%), shrimp (1.3), chili (0.7%), chocolate (0.7%), and nuts (0.3%). Most of the “food-dependent anaphylaxis” cases (60.5%) sought medical attention, but only one case reported the prescription of an epinephrine autoinjector. Mild and severe FA cases are not uncommon among Salvadoran schoolchildren and both the prescription of epinephrine autoinjectors by healthcare personnel and the use of the autoinjectors by anaphylactic individuals should be encouraged